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Sample records for incisionless fundoplication tif

  1. Transoral incisionless fundoplication: current status

    PubMed Central

    Sami Trad, Karim

    2016-01-01

    Purpose of review Transoral incisionless fundoplication (TIF) performed with the EsophyX device (Redmond, Washington, USA) is a totally endoscopic procedure with the objectives to mechanically repair a defective gastroesophageal valve and to reduce small hiatal hernias. The recent publication of randomized controlled trials and long-term follow-up data offers the opportunity to reevaluate this treatment modality and its role in the management of patients with chronic gastroesophageal reflux disease (GERD). Recent findings Randomized controlled trials have confirmed the ability of TIF to eliminate troublesome GERD symptoms, heal esophagitis, and improve distal esophageal acid exposure in appropriately selected patient populations. These studies establish TIF's superiority to conventional medical therapy, especially in clinical scenarios where proton-pump inhibitors fail to provide complete symptom relief across the spectrum of classic and atypical GERD manifestations, including regurgitation and laryngopharyngeal reflux. Long-term data indicate sustained positive outcomes and durability up to 6 years after procedure. These results were achieved with a low rate of serious adverse events and usually without introducing troublesome dysphagia, gas bloat, or flatulence. Summary Based on the most recent data, TIF appears to be a valuable treatment alternative for the management of appropriately selected patients with moderate to severe chronic GERD symptoms. PMID:27023164

  2. Revision of failed transoral incisionless fundoplication by subsequent laparoscopic Nissen fundoplication

    PubMed Central

    Ashfaq, Awais; Rhee, Hyun K; Harold, Kristi L

    2014-01-01

    AIM: To evaluate the feasibility and outcomes of laparoscopic Nissen fundoplication after failed transoral incisionless fundoplication (TIF). METHODS: TIF is a new endoscopic approach for treating gastroesophageal reflux disease (GERD). In cases of TIF failure, subsequent laparoscopic fundoplication may be required. All patients from 2010 to 2013 who had persistence and objective evidence of recurrent GERD after TIF underwent laparoscopic Nissen fundoplication. Primary outcome measures included operative time, blood loss, length of hospital stay and complications encountered. RESULTS: A total of 5 patients underwent revisional laparoscopic Nissen fundoplication (LNF) or gastrojejunostomy for recurrent GERD at a median interval of 24 mo (range: 16-34 mo) after TIF. Patients had recurrent reflux symptoms at an average of 1 mo following TIF (range: 1-9 mo). Average operative time for revisional surgical intervention was 127 min (range: 65-240 min) and all surgeries were performed with a minimal blood loss (< 50 mL). There were no cases of gastric or esophageal perforation. Three patients had additional finding of a significant hiatal hernia that was fixed simultaneously. Median length of hospitalization was 2 d (range: 1-3 d). All patients had resolution of symptoms at the last follow up. CONCLUSION: LNF is a feasible and safe option in a patient who has persistent GERD after a TIF. Previous TIF did not result in additional operative morbidity. PMID:25493024

  3. Transoral Incisionless Fundoplication for Refractory Gastroesophageal Reflux Disease: Where Do We Stand?

    PubMed Central

    Jain, Deepanshu; Singhal, Shashideep

    2016-01-01

    Gastroesophageal reflux disease (GERD) is a chronic, progressive, and costly medical condition affecting a substantial proportion of the world population, predominantly the Western population. The available treatment options for patients with refractory GERD symptoms are limited to either laparoscopic surgery with significant sequelae or potentially lifelong, high-dose proton pump inhibitor therapy. The restoration of the antireflux competence of the gastroesophageal junction at the anatomic and physiologic levels is critical for the effective long-term treatment of GERD. Transoral incisionless fundoplication (TIF) surgery is a safe, well-tolerated, and effective treatment that has yielded significant symptomatic improvement in patients with medically refractory GERD symptoms. In this review article, we have summarized case series and reports describing the role of TIF for patients with gastroesophageal reflux symptoms. The reported indications, techniques, complications, and success rates are also discussed. PMID:26878326

  4. Esophgeal Perforation and Bilateral Empyema Following Endoscopic EsophyX Transoral Incisionless Fundoplication.

    PubMed

    Edriss, Hawa; El-Bakush, Amal; Nugent, Kenneth

    2014-11-01

    Transoral incisionless fundoplication (TIF) has been used for endoscopic treatment of gastroesophageal reflux disease (GERD). TIF using the EsophyX device system (EndoGastric Solutions) was designed to create a full-thickness valve at the gastroesophageal junction through the insertion of multiple fasteners; it improves GERD, reduces proton pump inhibitor use, and improves quality of life. Although TIF is effective in select patients, a significant subset of patients undergoing TIF develop persistent or recurrent GERD symptoms and may need antireflux surgery to control the GERD symptoms. We now report a 48-year-old man with chronic GERD unresponsive to medical management. He underwent TIF complicated by esophageal perforation and developed mediastinitis, left pneumothorax, bilateral pleural effusions, and acute respiratory failure. He required chest tube placement and bilateral decortication for treatment of nonresolving empyemas. Additional postmarketing studies are required to assess the safety, efficacy, and clinical outcomes of this novel procedure, and patients undergoing this procedure need close postprocedural follow-up. PMID:25505723

  5. Transoral incisionless fundoplication for gastro-esophageal reflux disease: Techniques and outcomes

    PubMed Central

    Testoni, Pier Alberto; Mazzoleni, Giorgia; Testoni, Sabrina Gloria Giulia

    2016-01-01

    Gastro-esophageal reflux disease (GERD) is a very common disorder that results primarily from the loss of an effective antireflux barrier, which forms a mechanical obstacle to the retrograde movement of gastric content. GERD can be currently treated by medical therapy, surgical or endoscopic transoral intervention. Medical therapy is the most common approach, though concerns have been increasingly raised in recent years about the potential side effects of continuous long-term medication, drug intolerance or unresponsiveness, and the need for high dosages for long periods to treat symptoms or prevent recurrences. Surgery too may in some cases have consequences such as long-lasting dysphagia, flatulence, inability to belch or vomit, diarrhea, or functional dyspepsia related to delayed gastric emptying. In the last few years, transoral incisionless fundoplication (TIF) has proved an effective and promising therapeutic option as an alternative to medical and surgical therapy. This review describes the steps of the TIF technique, using the EsophyX® device and the MUSETM system. Complications and their management are described in detail, and the recent literature regarding the outcomes is reviewed. TIF reconfigures the tissue to obtain a full-thickness gastro-esophageal valve from inside the stomach, by serosa-to-serosa plications which include the muscle layers. To date the procedure has achieved lasting improvement of GERD symptoms (up to six years), cessation or reduction of proton pump inhibitor medication in about 75% of patients, and improvement of functional findings, measured by either pH or impedance monitoring. PMID:27158533

  6. Transoral Incisionless Fundoplication Effective in Eliminating GERD Symptoms in Partial Responders to Proton Pump Inhibitor Therapy at 6 Months

    PubMed Central

    Barnes, William E.; Simoni, Gilbert; Shughoury, Ahmad B.; Mavrelis, Peter G.; Raza, Mamoon; Heise, Jeffrey A.; Turgeon, Daniel G.; Fox, Mark A.

    2015-01-01

    Background. Incomplete control of troublesome regurgitation and extraesophageal manifestations of chronic gastroesophageal reflux disease (GERD) is a known limitation of proton pump inhibitor (PPI) therapy. This multicenter randomized study compared the efficacy of transoral incisionless fundoplication (TIF) against PPIs in controlling these symptoms in patients with small hiatal hernias. Methods. Between June and August 2012, 63 patients were randomized at 7 US community hospitals. Patients in the PPI group were placed on maximum standard dose (MSD). Patients in the TIF group underwent esophagogastric fundoplication using the EsophyX2 device. Primary outcome was elimination of daily troublesome regurgitation or extraesophageal symptoms. Secondary outcomes were normalization of esophageal acid exposure (EAE), PPI usage and healing of esophagitis. Results. Of 63 randomized patients (40 TIF and 23 PPI), 3 were lost to follow-up leaving 39 TIF and 21 PPI patients for analysis. At 6-month follow-up, troublesome regurgitation was eliminated in 97% of TIF patients versus 50% of PPI patients, relative risk (RR) = 1.9, 95% confidence interval (CI) = 1.2-3.11 (P = .006). Globally, 62% of TIF patients experienced elimination of regurgitation and extraesophageal symptoms versus 5% of PPI patients, RR = 12.9, 95% CI = 1.9-88.9 (P = .009). EAE was normalized in 54% of TIF patients (off PPIs) versus 52% of PPI patients (on MSD), RR = 1.0, 95% CI = 0.6-1.7 (P = .914). Ninety percent of TIF patients were off PPIs. Conclusion. At 6-month follow-up, TIF was more effective than MSD PPI therapy in eliminating troublesome regurgitation and extraesophageal symptoms of GERD. PMID:24756976

  7. Transoral incisionless fundoplication for gastro-esophageal reflux disease: Techniques and outcomes.

    PubMed

    Testoni, Pier Alberto; Mazzoleni, Giorgia; Testoni, Sabrina Gloria Giulia

    2016-05-01

    Gastro-esophageal reflux disease (GERD) is a very common disorder that results primarily from the loss of an effective antireflux barrier, which forms a mechanical obstacle to the retrograde movement of gastric content. GERD can be currently treated by medical therapy, surgical or endoscopic transoral intervention. Medical therapy is the most common approach, though concerns have been increasingly raised in recent years about the potential side effects of continuous long-term medication, drug intolerance or unresponsiveness, and the need for high dosages for long periods to treat symptoms or prevent recurrences. Surgery too may in some cases have consequences such as long-lasting dysphagia, flatulence, inability to belch or vomit, diarrhea, or functional dyspepsia related to delayed gastric emptying. In the last few years, transoral incisionless fundoplication (TIF) has proved an effective and promising therapeutic option as an alternative to medical and surgical therapy. This review describes the steps of the TIF technique, using the EsophyX(®) device and the MUSE(TM) system. Complications and their management are described in detail, and the recent literature regarding the outcomes is reviewed. TIF reconfigures the tissue to obtain a full-thickness gastro-esophageal valve from inside the stomach, by serosa-to-serosa plications which include the muscle layers. To date the procedure has achieved lasting improvement of GERD symptoms (up to six years), cessation or reduction of proton pump inhibitor medication in about 75% of patients, and improvement of functional findings, measured by either pH or impedance monitoring. PMID:27158533

  8. Fundoplication

    MedlinePlus

    ... to cause symptoms of gastroe- sophageal reflux disease (GERD). Why does my child need a fundoplication? Fundoplication ... who have complications or persistent symptoms related to GERD that are not improved with appropriate medical treatment. ...

  9. Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy-responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?

    PubMed Central

    Smeets, Fabiënne G M; Keszthelyi, Daniel; Bouvy, Nicole D; Masclee, Ad A M; Conchillo, José M

    2015-01-01

    Background/Aims In patients with gastroesophageal reflux disease (GERD), an increased esophagogastric junction (EGJ) distensibility has been described. Assessment of EGJ distensibility with the endoscopic functional luminal imaging probe (EndoFLIP) technique might identify patients responsive to transoral incisionless fundoplication (TIF), whereas postoperative measurement of EGJ distensibility might provide insight into the antireflux mechanism of TIF. Therefore, we investigated the value of the EndoFLIP technique in GERD patients treated by TIF. Methods Forty-two GERD patients underwent EGJ distensibility measurement before TIF using the EndoFLIP technique. In a subgroup of 25 patients, EndoFLIP measurement was repeated both postoperative and at 6 months follow-up. Treatment outcome was assessed according to esophageal acid exposure time (AET; objective outcome) and symptom scores (clinical outcome) 6 months after TIF. Results Multiple logistic regression analysis showed that preoperative EGJ distensibility (OR, 0.16; 95% CI, 0.03–0.78; P = 0.023) and preoperative AET (OR, 0.62; 95% CI, 0.42–0.90; P = 0.013) were independent predictors for objective treatment outcome but not for clinical outcome after TIF. The best cut-off value for objective outcome was 2.3 mm2/mmHg for preoperative EGJ distensibility and 11% for preoperative AET. EGJ distensibility decreased direct postoperative from 2.0 (1.2–3.3) to 1.4 (1.0–2.2) mm2/mmHg (P = 0.014), but increased to 2.2 (1.5–3.0) at 6 months follow-up (P = 0.925, compared to preoperative). Conclusions Preoperative EGJ distensibility and preoperative AET were independent predictors for objective treatment outcome but not for clinical outcome after TIF. According to our data, the EndoFLIP technique has no added value either in the preoperative diagnostic work-up or in the post-procedure evaluation of endoluminal antireflux therapy. PMID:25742904

  10. Single-Site Nissen Fundoplication Versus Laparoscopic Nissen Fundoplication

    PubMed Central

    Sharp, Nicole E.; Vassaur, John

    2014-01-01

    Background: Advances in minimally invasive surgery have led to the emergence of single-incision laparoscopic surgery (SILS). The purpose of this study is to assess the feasibility of SILS Nissen fundoplication and compare its outcomes with traditional laparoscopic Nissen fundoplication. Methods: This is a retrospective study of 33 patients who underwent Nissen fundoplication between January 2009 and September 2010. Results: There were 15 SILS and 18 traditional laparoscopic Nissen fundoplication procedures performed. The mean operative time was 129 and 182 minutes in the traditional laparoscopic and single-incision groups, respectively (P = .019). There were no conversions in the traditional laparoscopic group, whereas 6 of the 15 patients in the SILS group required conversion by insertion of 2 to 4 additional ports (P = .0004). At short-term follow-up, recurrence rates were similar between both groups. To date, there have been no reoperations. Conclusions: SILS Nissen fundoplication is both safe and feasible. Short-term outcomes are comparable with standard laparoscopic Nissen fundoplication. Challenges related to the single-incision Nissen fundoplication include overcoming the lengthy learning curve and decreasing the need for additional trocars. PMID:25392613

  11. Fundoplication in chronic intractable cough

    PubMed Central

    2012-01-01

    Background Airway reflux is a common cause of chronic cough and this is often refractory to medical therapy. Surgery in the form of Nissen fundoplication has been highly successful in the treatment of the classic reflux symptoms of heartburn and dyspepsia. There is a paucity of data regarding response to fundoplication in patients presenting with chronic cough. Methods We retrospectively reviewed the case notes of patients from the Hull Cough Clinic who had undergone Nissen fundoplication over the past 6 years. Demographic details, duration of symptoms, presence of other symptoms, results of oesophageal studies, outcome and complications were recorded. Patients were contacted by post and asked to complete a questionnaire detailing current symptoms. In a subgroup with continued troublesome cough 24 hour pharyngeal pH measurements were undertaken. Results Forty seven patients underwent fundoplication. The average duration of pre-operative cough was 8 years. Gastro intestinal symptoms were present in the majority. In 30 (64%) patients a positive response to treatment was recorded. Mild dysphagia or bloating was seen in 18 patients following surgery. Four patients needed repeat surgical intervention for modification of fundoplication. One patient developed aspiration pneumonia eight weeks following surgery and died of a myocardial infarction. Two thirds of patients with persisting cough had evidence of airway reflux on pharyngeal pH monitoring. Conclusion In these patients with intractable cough a long term response rate of 63% represents a useful therapeutic option. Treatment failure is more frequent than for classic peptic symptoms and may be related to persistent gaseous reflux. PMID:22812601

  12. Development of acute pancreatitis after Nissen fundoplication.

    PubMed

    Inoue, Mikihiro; Uchida, Keiichi; Otake, Kohei; Okigami, Masato; Maji, Tomoaki; Kusunoki, Masato

    2015-04-01

    Acute pancreatitis subsequent to Nissen fundoplication for gastroesophageal reflux disease (GERD) is an extremely rare adverse event. We describe a pediatric case of acute pancreatitis resulting from superior mesenteric artery syndrome (SMAS) and gas bloat after fundoplication. Gas bloat is one of the known postoperative complications after Nissen fundoplication. Poor nutrition status, which is often associated with severe pediatric GERD, is a risk factor for SMAS. In this case, development of gas bloat and SMAS led to the formation of a closed loop and increased intraluminal pressure of the duodenum and pancreatic duct. Many pediatric patients who need anti-reflux surgery face the risk of developing this entity. Preventive measures, such as treatment with prokinetics and frequent small-volume meals, should be considered until improvement of nutritional status after fundoplication. PMID:25868962

  13. Gallbladder function before and after fundoplication.

    PubMed

    Morton, John M; Bowers, Steven P; Lucktong, Tananchai A; Mattar, Samer; Bradshaw, W Alan; Behrns, Kevin E; Koruda, Mark J; Herbst, Charles A; McCartney, William; Halkar, Raghuveer K; Smith, C Daniel; Farrell, Timothy M

    2002-01-01

    No study has reported an association between gastroesophageal reflux disease (GERD) or its therapies and gallbladder function. We compared pre- and postoperative gallbladder function in patients undergoing fundoplication to determine the following: (1) whether patients with chronic GERD have preexisting gallbladder motor dysfunction; (2) whether medical or surgical therapy alters gallbladder function; and (3) whether division of the hepatic branch of the anterior vagus nerve is detrimental to gallbladder motility. Nineteen patients with documented GERD consented to a preoperative cholecystokinin-stimulated technetium hepatobiliary (CCK-HIDA) scan to quantify the gallbladder ejection fraction (GBEF). All patients underwent laparoscopic Nissen fundoplication. One month after fundoplication, 12 patients completed a repeat CCK-HIDA scan for determination of GBEF, with comparison to the preoperative GBEF. Among patients with preoperative GERD, 11 (58%) of 19 met the scintigraphic criteria for gallbladder dysfunction (GBEF <35%), which is a ratio comparable to that in patients undergoing a CCK-HIDA scan for presumed biliary dyskinesia during the same time period (31 [60%] of 53; P = NS, chi-square test) and exceeds the rate of abnormal GBEF reported in healthy volunteers (3%). Six of seven patients with a low preoperative GBEF who underwent repeat evaluation postoperatively had normalization of the GBEF (P < 0.05, paired t-test). In the 12 patients who underwent postoperative CCK-HIDA scanning, there was no association between preservation or division of the hepatic branch of the anterior vagus nerve and postoperative gallbladder dysfunction (P = NS, chi-square test). Unexpectedly, 58% of patients with GERD demonstrated gallbladder motor dysfunction prior to fundoplication, with improvement to normal occurring in most of those studied postoperatively. These data support controlled trials to determine the effect of chronic GERD and antisecretory therapy on gallbladder and

  14. Thal fundoplication in neurologically impaired children.

    PubMed

    Ramachandran, V; Ashcraft, K W; Sharp, R J; Murphy, P J; Snyder, C L; Gittes, G K; Bickler, S W

    1996-06-01

    Children with neurological impairment (NI) frequently require feeding gastrostomy, and this often aggravates or produces gastroesophageal reflux (GER). From 1976 to 1994, 141 children with severe NI underwent Thal fundoplication and gastrostomy (GT). GER was evident in 80%; in the rest, fundoplication was an adjunct to GT. Ph results were positive in 38 cases, and 57 children had reflux according to the barium studies. There were no major intraoperative complications. Disruption of the repair and/or recurrent GER was noted in 14 cases (10%); 8 were redone as Thals, and 6 were converted to Nissen procedures. Pyloroplasty was done later in 9 children (6%). Bowel obstruction was seen in 4 patients (3%). Clinical follow-up (mean, 54 months) showed improvement in 96%; only 5 of the 141 (3.2%) have residual symptoms. Of the patients with an intact Thal, 67% could burp or vomit. The ability to vomit may protect the Thal fundoplication and avoid disruption of the repair. PMID:8783112

  15. Gastroesophageal reflux disease treatment: side effects and complications of fundoplication.

    PubMed

    Richter, Joel E

    2013-05-01

    Even skilled surgeons will have complications after antireflux surgery. Fortunately, the mortality is low (<1%) with laparoscopic surgery, immediate postoperative morbidity is uncommon (5%-20%), and conversion to an open operation is <2.5%. Common late postoperative complications include gas-bloat syndrome (up to 85%), dysphagia (10%-50%), diarrhea (18%-33%), and recurrent heartburn (10%-62%). Most of these complications improve during the 3-6 months after surgery. Dietary modifications, pharmacologic therapies, and esophageal dilation may be helpful. Failures after antireflux surgery usually occur within the first 2 years after the initial operation. They fall into 5 patterns: herniation of the fundoplication into the chest, slipped fundoplication, tight fundoplication, paraesophageal hernia, and malposition of the fundoplication. Reoperation rates range from 0%-15% and should be performed by experienced foregut surgeons. PMID:23267868

  16. Postoperative Chylous Ascites: A Rare Complication of Laparoscopic Nissen Fundoplication

    PubMed Central

    Bacelar, Tércio Souto; de Arruda, Pedro Carlos Loureiro; Ferraz, Álvaro Antonio Bandeira; Ferraz, Edmundo Machado

    2003-01-01

    The accumulation of chylous fluid in the abdominal cavity is an infrequent, yet alarming, complication in abdominal surgery. Laparoscopic fundoplication has assumed a central role in the surgical treatment of gastroesophageal reflux disease and is significantly altering the balance of therapy toward more common and earlier surgical intervention. We report the case of a 67-year-old woman with gastroesophageal reflux disease and intense esophagitis who underwent a laparoscopic Nissen fundoplication in February 2000. The procedure was performed without apparent complications. Twenty days later, the patient complained of abdominal pain and distension. Ultrasonography showed ascites, whereas endoscopic and radiological exploration of the fundoplication demonstrated no abnormalities. A paracentesis was performed, which showed a milky fluid with high concentrations of triglycerides (1024 ng/dL) and cholesterol (241 ng/dL). The patient was treated successfully with total parenteral nutrition for 3 weeks, followed by a low-fat diet. To our knowledge, this is the third reported case of chylous ascites after a Nissen fundoplication and the second case after laparoscopic fundoplication. The development of chylous ascites seems to be related to the injury of lymphatic vessels, including the thoracic duct, during the retroesophageal window dissection. The careful dissection and judicious use of diathermy is proposed to prevent this rare complication. PMID:14558719

  17. A modification of incisionless otoplasty for correcting the prominent ear deformity.

    PubMed

    Haytoglu, Suheyl; Haytoglu, Tahir Gokhan; Yildirim, Ilhami; Arikan, Osman Kursat

    2015-11-01

    This article describes a modification of the incisionless otoplasty. We investigated the complication rates, recurrence risks, and patient satisfaction with this modified procedure. In total, 26 patients (49 ears) complaining of prominent ear were operated on. Auriculocephalic distances were measured at three different levels, pre-operatively, at the end of the surgery, and at 4 weeks and 6 months after surgery to evaluate the efficacy of the technique. Patient satisfaction was evaluated using a visual analog scale and the global aesthetic improvement scale was applied by an independent non-participating plastic surgeon at 6 months after the surgery. The mean loss of medialization was ~1 mm at 4 weeks after surgery and 2 mm at 6 months after surgery for all levels. According to visual analog scale, patient or parent satisfaction increased significantly. The global aesthetic improvement scale rated the patients as 93.9% "improved" and 6.1% as "no change." No rating was "worse." There are many advantages of this technique. The operation is not time-consuming, does not require a dressing, and it can be performed in adults with local anesthesia under office conditions, with no need for hospitalization. After the operation, patients can return to their daily activities immediately. It is associated with a low complication rate and high patient satisfaction. This technique is a good option for otoplasty in patients with isolated, inadequate development of anti-helical ridge, and with soft auricular cartilage. PMID:25311308

  18. A physiologic approach to laparoscopic fundoplication for gastroesophageal reflux disease.

    PubMed Central

    Hunter, J G; Trus, T L; Branum, G D; Waring, J P; Wood, W C

    1996-01-01

    OBJECTIVE: The authors examined indications, evaluations, and outcomes after laparoscopic fundoplication in patients with gastroesophageal reflux through this single-institution study. SUMMARY OF BACKGROUND DATA: Laparoscopic fundoplication has been performed for less than 5 years, yet the early and intermediate results suggest that this operation is safe and equivalent in efficacy to open techniques of antireflux surgery. METHODS: Over a 4-year period, 300 patients underwent laparoscopic Nissen fundoplication (252) or laparoscopic Toupet fundoplication (48) for gastroesophageal reflux refractory to medical therapy or requiring daily therapy with omeprazole or high-dose H2 antagonists. Preoperative evaluation included symptom assessment, esophagogastroduodenoscopy, 24-hour pH evaluation, and esophageal motility study. Physiologic follow-up included 24-hour pH study and esophageal motility study performed 6 weeks and 1 to 3 years after operation. RESULTS: The most frequent indication for surgery was the presence of residual typical and atypical gastroesophageal reflux symptoms (64%) despite standard doses of proton pump inhibitors. At preoperative evaluation, 51% of patients had erosive esophagitis, stricture, or Barrett's metaplasia. Ninety-eight percent of patients had an abnormal 24-hour pH study. Seventeen percent had impaired esophageal motility and 2% had aperistalsis. There were four conversions to open fundoplication (adhesions, three; large liver, one). Intraoperative technical difficulties occurred in 19(6%) patients and were dealt with intraoperatively in all but 1 patient (bleeding from enlarged left liver lobe). Minor complications occurred in 6% and major complications in 2%. There was no mortality. Median follow-up was 17 months. One year after operation, heartburn was absent in 93%. Four percent took occasional H2 antagonists, and 3% were back on daily therapy. Atypical reflux symptoms (e.g., asthma, hoarseness, chest pain, or cough) were eliminated

  19. Gastropericardial fistula as a delayed complication of a Nissen fundoplication

    PubMed Central

    Kakarala, Kokila; Edriss, Hawa

    2015-01-01

    A 41-year-old man presented to the emergency department with substernal chest pain and was found to have ST elevations in the inferior leads on his electrocardiogram. An emergent cardiac catheterization did not identify significant coronary narrowing. Computed tomography of the thorax demonstrated a pneumopericardium and a hiatal hernia. The patient had a complicated past surgical history, including a Nissen fundoplication and three additional surgeries for postoperative complications. An esophagram later revealed an ulcer and possible fistula, and the patient underwent gastropericardial fistula resection after the fistula failed to close with fibrin sealant application. Enteropericardial fistulas occur infrequently but have high morbidity and mortality rates. This possibility is much more likely in patients with prior gastroesophageal surgery, including laparoscopic Nissen fundoplication. PMID:26424947

  20. Dysphagia after antireflux fundoplication: endoscopic, radiological and manometric evaluation

    PubMed Central

    MORAIS, Drausio Jeferson; LOPES, Luiz Roberto; ANDREOLLO, Nelson Adami

    2014-01-01

    Background The transient dysphagia after fundoplication is common and most often disappears until six weeks postoperatively. Aim Analyze a group of patients who presented late and persistent dysphagia postoperatively. Methods Forty-one patients after Nissen fundoplication, 14 male and 27 female, mean age 48 year, were evaluated based on medical history, esophagogastroduodenoscopy, contrast radiographic examination and esophageal manometry. The results were compared with another 19 asymptomatic individuals. Results Contrast radiographic examination of the esophagus revealed in six cases delayed emptying, characterizing that four patients had achalasia and two diffuse spasm of the esophagus. Esophageal manometry showed that maximal expiratory pressure of the lower sphincter ranged from 10 to 38 mmHg and mean respiratory pressure from 14 to 47 mmHg, values similar to controls. Residual pressure ranged from 5 to 31 mmHg, and 17 patients had the same values as the control group. Conclusion The residual pressure of the lower sphincter was higher and statistically significant in patients with dysphagia compared with those operated without dysphagia. Future studies individualizing and categorizing each motility disorder, employing other techniques of manometry, and the analysis of the residual pressure may contribute to understand of persistent dysphagia in the postoperative fundoplication. PMID:25626933

  1. Unconventional Management of Chyloascites After Laparoscopic Nissen Fundoplication

    PubMed Central

    Ospina, Karen A.; Lee, Earl H.; Rehring, Scott R.

    2012-01-01

    Background & Objectives: Chyloascites is a rare complication that can result from abdominal trauma, neoplasm, inflammatory conditions, or various abdominal surgeries. Few cases have been described secondary to iatrogenic injury from laparoscopic Nissen fundoplication. We describe a case in which this surgery resulted in chyloascites that was successfully treated by lymphatic glue embolization. Methods: A 37-year-old male presented with signs and symptoms consistent with chronic reflux disease. He underwent an uneventful laparoscopic Nissen fundoplication. Two weeks postoperatively, he was admitted for dehydration. During his admission, he began to develop a persistent cough, shortness of breath, and abdominal distention. Imaging and fluid analysis from thoracocentesis and paracentesis were consistent with chyle leakage. Despite nonoperative measures, the patient's presentation persisted. Results: Thoracic duct ligation was performed without success. Bipedal lymphangiography identified an extensive leak revealing a severely lacerated thoracic duct spilling contrast freely into the abdomen and no contrast entering the thoracic duct in the chest. The site of injury was successfully sealed off with percutaneous glue embolization through lymph channels. Conclusion: Chyloascites is a rare complication of laparoscopic Nissen fundoplication. When not successful with conservative measures, lymphatic glue embolization can provide effective treatment. PMID:23477184

  2. Feasibility of esophagogastric junction distensibility measurement during Nissen fundoplication.

    PubMed

    Ilczyszyn, A; Botha, A J

    2014-01-01

    Increased esophagogastric junction distensibility has been implicated in the development of gastroesophageal reflux disease (GERD). Previous authors have demonstrated a reduction in distensibility following anti-reflux surgery, but the changes during the operation are not clear. Our study aimed to ascertain the feasibility of measuring intraoperative distensibility changes and to assess if this would have potential to modify the operation. Seventeen patients with GERD were managed in a standardized manner consisting of preoperative assessment with symptom scoring, endoscopy, 24 hours pH studies, and manometry. Patients then underwent laparoscopic Nissen fundoplication with intraoperative distensibility measurement using an EndoFLIP EF-325 functional luminal imaging probe (Crospon Ltd, Galway, Ireland). This device utilizes impedance planimetry technology to measure cross-sectional area and distensibility within a balloon-tipped catheter. This is inflated at the esophagogastric junction to fixed distension volumes. Thirty-second median cross-sectional area and intraballoon pressure measurements were recorded at 30 and 40 mL balloon distensions. Measurement time points were initially after induction of anesthesia, after pneumoperitoneum, after hiatal mobilization, after hiatal repair, after fundoplication, and finally pre-extubation. Postoperatively, patients continued on protocol and were discharged after a two-night stay tolerating a sloppy diet. Patients with a hiatus hernia on high-resolution manometry had a significantly higher initial esophagogastric junction distensibility index (DI) than those without. Hiatus repair and fundoplication resulted in a significant overall reduction in the median DI from the initial to final recordings (30 mL balloon distension reduction of 3.26 mm(2) /mmHg (P = 0.0087), 40 mL balloon distension reduction of 2.39 mm(2) /mmHg [P = 0.0039]). There was also a significant reduction in the DI after pneumoperitoneum, hiatus

  3. Cough in adult cystic fibrosis: diagnosis and response to fundoplication

    PubMed Central

    Fathi, Hosnieh; Moon, Tanya; Donaldson, Jo; Jackson, Warren; Sedman, Peter; Morice, Alyn H

    2009-01-01

    Background Gastroesophageal reflux is one of the most common causes of chronic cough in the general population. Reflux occurs frequently in patients with cystic fibrosis (CF). We undertook laparoscopic Nissen fundoplication in adult CF patients with a clinical diagnosis of reflux cough who had failed conventional medical therapies. Objective We determined the response to the surgical route in the treatment of intractable reflux cough in CF. Method Patients with refractory cough were assessed by 24 h pH monitoring and oesophageal manometry. Pre-and post-operation cough, lung function and exacerbation frequency were compared. Cough was assessed by the Leicester Cough Questionnaire (LCQ), lung function by spirometry and exacerbation frequency was defined by comparing the postoperative epoch with a similar preoperatively. Results Significant abnormalities of oesophageal function were seen in all patients studied. 6 patients (2 females), with the mean age of 34.5 years consented to surgery. Their mean number of reflux episodes was 144.4, mean DeMeester score was 39.2, and mean lower oesophageal sphincter pressure 12.4 mmHg. There was a small change in the FEV1 from 1.03 L to 1.17 (P = 0.04), and FVC improved from 2.62 to 2.87 (P = 0.05). Fundoplication lead to a marked fall in cough with the total LCQ score increasing from 11.9 to 18.3 (P = 0.01). Exacerbation events were reduced by 50% post operatively. Conclusion Whilst there is an obvious attention to respiratory causes of cough in CF, reflux is also a common cause. Fundoplication is highly effective in the control of reflux cough in CF. Significant reduction in exacerbation frequency may indicate that reflux with possible aspiration is a major unrecognised contributor to airway disease. PMID:19149907

  4. Unilateral Versus Bilateral Wrap Crural Fixation in Laparoscopic Nissen Fundoplication for Children

    PubMed Central

    2014-01-01

    Introduction: Gastroesophageal reflux (GERD) is common in neurologically impaired (NI) children. Fundoplication and gastrostomy have previously been indicated in NI children with GERD who have not responded to medical treatment. The most common reason for fundoplication failure is intrathoracic migration of the wrap. Objective: The aim of the study is to measure the effect of wrap fixation on the final outcome of laparoscopic Nissen fundoplication in NI children. Patients and Methods: A retrospective file review was conducted for all NI children who underwent laparoscopic Nissen fundoplication in 2 tertiary pediatric surgery centers in the United Arab Emirates from February 15, 2006 to February 15, 2013. Redo fundoplication patients were excluded from the study. Patients were divided into 2 groups: group 1 in which the fundoplication wrap was fixed to the right crus only, and group 2 in which the wrap was fixed to the right and left crus simultaneously. Results: The study population included 68 patients; there were 47 male and 21 female children. Mean age at time of surgery was 8.2 years. Recurrent GERD at 1 year postoperatively was 26% versus 7% in group 1 and group 2, respectively, by upper contrast study. Redo surgery was required in 21% versus 3% in group 1 and group 2, respectively. Conclusions: Bilateral fixation of the wrap to diaphragmatic crura significantly reduced recurrent GERD, in laparoscopic Nissen fundoplication for neurologically impaired children, with no increased risk of morbidities. Future prospective studies should be conducted with larger patient populations and longer follow-up periods. PMID:25516705

  5. Gastrostomy and Nissen fundoplication in neurologically impaired children.

    PubMed

    Stringel, G; Delgado, M; Guertin, L; Cook, J D; Maravilla, A; Worthen, H

    1989-10-01

    We report our experience with 90 neurologically impaired children treated with gastrostomy and Nissen fundoplication. Malnutrition was the main problem, followed by aspiration, recurrent pneumonia, and vomiting. The symptomatology was caused by swallowing incoordination and gastroesophageal reflux. The diagnosis of gastroesophageal reflux was confirmed by upper gastrointestinal series and pH probe. Nissen fundoplication was performed following a standard technique with preservation of the vagus nerves and its branches, repair of the diaphragmatic crura, reconstruction of the angle of His, and a 360 degree wrap. A gastrostomy and pyloroplasty or pyloric dilatation were part of the operative procedure. There were no deaths and few complications related to the surgical procedure. Marked nutritional improvement was seen in most cases with an average weight gain of 3.2 kg/patient 3 months following surgery. There was also improvement in milestones and seizure control. The majority of parents were very satisfied and would recommend the procedure to other parents with similar problems. PMID:2809949

  6. Gastric necrosis: A late complication of nissen fundoplication.

    PubMed

    Salinas, Javier; Georgiev, Tihomir; González-Sánchez, Juan Antonio; López-Ruiz, Elena; Rodríguez-Montes, José Antonio

    2014-09-27

    Gastric necrosis is a rare condition because of the rich blood supply and the extensive submucosal vascular network of the stomach. "Gas-bloat" syndrome is a well known Nissen fundoplication postoperative complication. It may cause severe gastric dilatation, but very rarely an ischemic compromise of the organ. Other factors, such as gastric outlet obstruction, may concur to cause an intraluminal pressure enough to blockade venous return and ultimately arterial blood supply and oxygen deliver, leading to ischaemia. We report a case of a 63-year-old women, who presented a total gastric necrosis following laparoscopic Nissen fundoplication and a pyloric phytobezoar which was the trigger event. No preexisting gastric motility disorders were present by the time of surgery, as demonstrated in the preoperative barium swallow, thus a poor mastication (patient needed no dentures) of a high fiber meal (cabbage) may have been predisposing factors for the development of a bezoar in an otherwise healthy women at the onset of old age. A total gastrectomy with esophagojejunostomy was performed and patient was discharged home after a 7-d hospital stay with no immediate complications. We also discuss some technical aspects of the procedure that might be important to reduce the incidence of this complication. PMID:25276288

  7. The effect of laparoscopic fundoplication in therapy of Barrett's esophagus

    PubMed Central

    Aujeský, René; Neoral, Čestmír; Vrba, Radek; Vomáčková, Katherine

    2014-01-01

    Introduction Barrett's esophagus is the most significant precancer of the esophagus. Its malignization gives rise to most adenocarcinomas of the esophagus. Therefore selection of adequate therapy for this precancerous condition is of the utmost importance. Aim The authors of the work addressed the question of whether effective therapy of reflux disease alone may halt the process of malignization of Barrett's mucosa or even cause its regression. Material and methods The analyzed set comprised 50 patients with Barrett's esophagus, who in 48 cases underwent laparoscopic fundoplication and in two cases underwent an indirect antireflux procedure in the form of gastric resection with a Roux-en-Y gastrojejunal anastomosis. The effect of the procedure was evaluated by comparing preoperative and postoperative endoscopic examinations, as well as histological analysis by biopsy taken from Barrett's mucosa. Results In 19 patients (38%), Barrett's mucosa was not detected postoperatively. An improved finding in terms of disappearance of mucosal dysplasia was found in 8 (16%) patients. Findings remained unchanged in 18 (36%) patients. In 5 (10%) patients progression of the disease was discovered. Conclusions A surgical antireflux procedure, primarily in the form of laparoscopic fundoplication, is considered an effective method for treating Barrett's esophagus up to the stage of mild dysplasia. If this therapy is unsuccessful, the method of choice is local therapy, either an endoscopic mucosectomy or radiofrequency ablation. PMID:25097689

  8. Is single port incisionless-intracorporeal conventional equipment-endoscopic surgery feasible in patients with retrocecal acute appendicitis?

    PubMed Central

    Karakus, Suleyman Cuneyt; Koku, Naim; Ertaskin, Idris

    2013-01-01

    Purpose Since laparoscopic appendectomy was first described, various modifications, such as single port incisionless-intracorporeal conventional equipment-endoscopic surgery (SPICES), have been described for reducing pain and improving cosmetic results. In the retrocecal and retrocolic positions, attachments to the lateral peritoneum and cecum may lead to difficulties during SPICES, which is performed with only one port. Here, we present the effects of variations in the position of the vermiform appendix in treating acute appendicitis with SPICES. Methods We retrospectively reviewed 52 children who underwent SPICES for acute appendicitis between March 2010 and November 2011 in our institution. One group (group A) consisted of 30 patients (mean age, 10.5 ± 2.5 years) with retrocecal appendix, while the other group (group B) included 22 patients (mean age, 10.9 ± 2.3 years) with the appendix lying free in the peritoneal cavity. Results There were no significant differences between groups in terms of patient age, gender, success rate of SPICES, mean operating time, mean follow-up period, overall complication rates or mean postoperative hospitalization period. Conclusion These results suggest that SPICES is a safe and feasible approach even in patients with retrocecal acute appendicitis. PMID:23908965

  9. Teacher Leader Programs: Structure and Staffing in Four TIF Districts

    ERIC Educational Resources Information Center

    Pyatigorsky, Mikhail; Heneman, Herb; Steele, Clarissa; Finster, Matthew; Milanowski, Tony

    2015-01-01

    Some Teacher Incentive Fund (TIF) grantees are experimenting with the design and operation of teacher leader (TL) programs as part of their performance-based compensation systems (PBCS). Much of the impetus for this is the U.S Department of Education TIF 4 requirement that grantees' PBCS should provide for "additional responsibilities and…

  10. Derepression of colicin E1 synthesis in the constitutive tif mutant strain (spr tif sfi) and in a tif sfi mutant strain of Escherichia coli K-12.

    PubMed Central

    Tessman, E S; Gritzmacher, C A; Peterson, P K

    1978-01-01

    We show here that expression of the colicin gene of the ColE1 plasmid is greatly derepressed in Escherichia coli K-12 strain DM1187 spr tif sfi, which is a constitutive tif mutant, altered in the lexA gene, and which shows constitutive expression of various pathways of the recA-dependent, lexA-blocked (SOS) repair system. In this strain colicin E1 synthesis is at least 100-fold greater than that observed in uninduced control strains (spr+ tif sfi and spr+ tif+ sfi). This result confirms the regulatory role of the lexA product in colicin E1 synthesis. Colicin yields by the uninduced strain DM1187 are as high as the maximum yields from mitomycin-induced control strains and often are several-fold higher. When the nonconstitutive tif sfi strain GC467 is raised to 43 degrees C to induce the SOS system, a low level of colicin synthesis is observed which is less than one-tenth of the yield obtained by induction with mitomycin C. Addition of adenine at the time of shift-up can increase the colicin yield of tif sfi to about one-third of the yield obtained with mitomycin C. We have also found that colicin overproduction can be detected by altered colony appearance in an overlay assay with colicin-sensitive bacteria. In addition, the lethality of the process of colicin synthesis is observed here without the use of bacteriostatic inducing agents. Images PMID:353034

  11. Laparoscopic hiatal herniorrhaphy with posterior fundoplication for gastroesophageal reflux.

    PubMed

    Barr, L L

    1998-12-01

    Complications and side effects following laparoscopic antireflux procedures are common. This article describes an alternative laparoscopic technique to prevent gastroesophageal reflux. This method consists of posterior approximation of the diaphragmatic crura followed by a posterior fundoplication of approximately 270 degrees wrap. In avoiding the 360 degree wrap and obtaining length from the longitudinal axis of the stomach, it is not necessary to take down the gastrosplenic vessels. The principle of the procedure is to accentuate the cardioesophageal angle of His. No sutures are placed in the esophagus. While this article primarily concerns technique, it also constitutes a brief report on the first 50 patients who have been followed up for 1 year or more. All patients but one are free of reflux symptoms and have discontinued taking all medication. There has been no dysphagia to liquids, and solid food dysphagia has not lasted >1 month. Bloating from gas is minimal, as most patients are able to burp early in their recovery. An outcome paper describing preoperative and postoperative objective testing and evaluation is in process. PMID:9864104

  12. Adenovirus E4-ORF3-dependent relocalization of TIF1{alpha} and TIF1{gamma} relies on access to the Coiled-Coil motif

    SciTech Connect

    Vink, Elizabeth I.; Yondola, Mark A.; Wu, Kai; Hearing, Patrick

    2012-01-20

    The adenovirus E4-ORF3 protein promotes viral replication by relocalizing cellular proteins into nuclear track structures, interfering with potential anti-viral activities. E4-ORF3 targets transcriptional intermediary factor 1 alpha (TIF1{alpha}), but not homologous TIF1{beta}. Here, we introduce TIF1{gamma} as a novel E4-ORF3-interacting partner. E4-ORF3 relocalizes endogenous TIF1{gamma} in virus-infected cells in vivo and binds to TIF1{gamma} in vitro. We used the homologous nature, yet differing binding capabilities, of these proteins to study how E4-ORF3 targets proteins for track localization. We mapped the ability of E4-ORF3 to interact with specific TIF1 subdomains, demonstrating that E4-ORF3 interacts with the Coiled-Coil domains of TIF1{alpha}, TIF1{beta}, and TIF1{gamma}, and that the C-terminal half of TIF1{beta} interferes with this interaction. The results of E4-ORF3-directed TIF1 protein relocalization assays performed in vivo were verified using coimmunoprecipitation assays in vitro. These results suggest that E4-ORF3 targets proteins for relocalization through a loosely homologous sequence dependent on accessibility.

  13. Partial versus Complete Fundoplication for the Correction of Pediatric GERD: A Systematic Review and Meta-Analysis

    PubMed Central

    Glen, Peter; Chassé, Michaël; Doyle, Mary-Anne; Nasr, Ahmed; Fergusson, Dean A.

    2014-01-01

    Background There is no consensus as to what extent of “wrap” is required in a fundoplication for correction of gastroesophageal reflux disease (GERD). Objective To evaluate if a complete (360 degree) or partial fundoplication gives better control of GERD. Methods A systematic search of MEDLINE and Scopus identified interventional and observational studies of fundoplication in children. Screening identified those comparing techniques. The primary outcome was recurrence of GERD following surgery. Dysphagia and complications were secondary outcomes of interest. Meta-analysis was performed when appropriate. Study quality was assessed using the Cochrane Risk of Bias Tool. Results 2289 abstracts were screened, yielding 2 randomized controlled trials (RCTs) and 12 retrospective cohort studies. The RCTs were pooled. There was no difference in surgical success between partial and complete fundoplication, OR 1.33 [0.67,2.66]. In the 12 cohort studies, 3 (25%) used an objective assessment of the surgery, one of which showed improved outcomes with complete fundoplication. Twenty-five different complications were reported; common were dysphagia and gas-bloat syndrome. Overall study quality was poor. Conclusions The comparison of partial fundoplication with complete fundoplication warrants further study. The evidence does not demonstrate superiority of one technique. The lack of high quality RCTs and the methodological heterogeneity of observational studies limits a powerful meta-analysis. PMID:25386679

  14. Telomere Dysfunction Induced Foci (TIF) Analysis

    PubMed Central

    Mender, Ilgen; Shay, Jerry W.

    2016-01-01

    Telomerase maintains telomeric DNA in eukaryotes during early developments, ~90% of cancer cells and some proliferative stem like cells. Telomeric repeats at the end of chromosomes are associated with the shelterin complex. This complex consists of TRF1, TRF2, Rap1, TIN2, TPP1, POT1 which protect DNA from being recognized as DNA double-stranded breaks. Critically short telomeres or impaired shelterin proteins can cause telomere dysfunction, which eventually induces DNA damage responses at the telomeres. DNA damage responses can be identified by antibodies to 53BP1, gammaH2AX, Rad17, ATM, and Mre11. DNA damage foci at uncapped telomeres are referred to as Telomere dysfunction-Induced Foci (TIFs) (de Lange, 2005; Takai et al., 2003). The TIF assay is based on the co-localization detection of DNA damage by an antibody against DNA damage markers, such as gamma-H2AX, and telomeres using an antibody against one of the shelterin proteins such as TRF2 (Takai et al., 2003; de Lange, 2002; Karlseder et al., 1999). The method we describe here can be used in normal human and cancer cells. Other commonly used methods-Telomere Restriction Fragment (TRF) Analysis (Mender and Shay, 2015b) and Telomere Repeat Amplification Protocol (TRAP) (Mender and Shay, 2015a)- in telomere biology can be found by clicking on the indicated links.

  15. Nissen fundoplication in children with profound neurologic disability. High risks and unmet goals.

    PubMed

    Smith, C D; Othersen, H B; Gogan, N J; Walker, J D

    1992-06-01

    Anti-reflux procedures have been advocated in children with profound neurologic disability referred for feeding gastrostomy when gastroesophageal reflux is present. Facilitation of care, reduction in pneumonia and vomiting, and improvement in the general health and survival of these children have been major goals of fundoplication and gastrostomy. In large pediatric series, these procedures have been reported to have low risk and negligible mortality rates. Recent reports, however, document an increased incidence of sequelae of fundoplication in children with profound neurologic disability. This paper retrospectively reviews a series of 35 nonverbal, nonambulatory pediatric patients undergoing a total of 39 fundoplications (37 Nissen, 1 Thal, and 1 Belsey) over an 11-year period. Neurologic impairment of 17 (49%) patients was acquired, 13 (37%) congenital, and 5 (14%) due to a syndrome. Perioperative complications occurred in six (17%). Three additional complications led to early postoperative death. A fourth early death was unexplained. Fourteen (40%) had recurrent pneumonia, 11 (31%) recurrent vomiting, 8 (23%) choking-gagging-retching complex, and 3 (9%) bowel obstruction requiring laparotomy. Recurrent gastroesophageal reflux was documented in seven (20%) patients. A second ARP was performed in six (17%). There were 14 (40%) late deaths. Although the major goals of anti-reflux procedure are clearly achieved in many severely impaired children with gastroesophageal reflux, the use of Nissen fundoplication to resolve the complications of swallowing disorders and improve outcome with an acceptably low risk in this complex set of patients does not appear to be established. PMID:1632687

  16. Nissen fundoplication in children with profound neurologic disability. High risks and unmet goals.

    PubMed Central

    Smith, C D; Othersen, H B; Gogan, N J; Walker, J D

    1992-01-01

    Anti-reflux procedures have been advocated in children with profound neurologic disability referred for feeding gastrostomy when gastroesophageal reflux is present. Facilitation of care, reduction in pneumonia and vomiting, and improvement in the general health and survival of these children have been major goals of fundoplication and gastrostomy. In large pediatric series, these procedures have been reported to have low risk and negligible mortality rates. Recent reports, however, document an increased incidence of sequelae of fundoplication in children with profound neurologic disability. This paper retrospectively reviews a series of 35 nonverbal, nonambulatory pediatric patients undergoing a total of 39 fundoplications (37 Nissen, 1 Thal, and 1 Belsey) over an 11-year period. Neurologic impairment of 17 (49%) patients was acquired, 13 (37%) congenital, and 5 (14%) due to a syndrome. Perioperative complications occurred in six (17%). Three additional complications led to early postoperative death. A fourth early death was unexplained. Fourteen (40%) had recurrent pneumonia, 11 (31%) recurrent vomiting, 8 (23%) choking-gagging-retching complex, and 3 (9%) bowel obstruction requiring laparotomy. Recurrent gastroesophageal reflux was documented in seven (20%) patients. A second ARP was performed in six (17%). There were 14 (40%) late deaths. Although the major goals of anti-reflux procedure are clearly achieved in many severely impaired children with gastroesophageal reflux, the use of Nissen fundoplication to resolve the complications of swallowing disorders and improve outcome with an acceptably low risk in this complex set of patients does not appear to be established. PMID:1632687

  17. Outcome of laparoscopic Nissen fundoplication in patients with disordered preoperative peristalsis.

    PubMed Central

    Baigrie, R J; Watson, D I; Myers, J C; Jamieson, G G

    1997-01-01

    BACKGROUND: A 360 degrees or Nissen fundoplication remains controversial in patients with disordered peristalsis, some surgeons preferring a partial wrap to minimise postoperative dysphagia. AIM: To evaluate symptoms and manometric outcome in patients with disordered peristalsis after Nissen fundoplication. PATIENTS: In an initial series of 345 patients studied prospectively, 31 patients who had undergone a Nissen fundoplication had disordered peristalsis. Using preoperative manometry, patients were classified as: equivocal primary peristalsis (eight patients); abnormal primary peristalsis (four patients); abnormal maximal contraction pressure (13 patients); abnormal primary peristalsis and maximal contraction pressure (six patients). METHODS: Postoperatively, patients underwent a barium meal, oesophageal manometry and standardised clinical review by a blinded scientific officer. RESULTS: Twenty eight (90%) patients had satisfaction scores of at least 8 out of a maximum of 10 and all would undergo surgery again. Whereas 15 (48%) patients had dysphagia scores greater than 4/10 preoperatively, only two (6%) had these scores at one year. Improved peristalsis was seen in 78% of postoperative manometric studies, and mean preoperative lower oesophageal sphincter pressure increased from 6.6 (range 0-21) mm Hg to 19 (4-50) mm Hg. CONCLUSIONS: These results are similar to the overall group of 345 patients and suggest that disordered peristalsis, and possibly even absent peristalsis, is not a contraindication to Nissen fundoplication as performed in these patients. PMID:9135529

  18. A Meta-Analysis of Randomized Controlled Trials to Compare Long-Term Outcomes of Nissen and Toupet Fundoplication for Gastroesophageal Reflux Disease

    PubMed Central

    Zhang, Wei; Jiang, Dao-zhen; Qiu, Ming

    2015-01-01

    Aim In recent years, several studies with large sample sizes and recent follow-up data have been published comparing outcomes between laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication. It is now timely to be re-evaluated and synthesized long-term efficacy and adverse events of both total and partial posterior fundoplication. Materials and Methods Electronic searches for RCTs comparing the outcome after laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication were performed in the databases of MEDLINE, EMBASE, and the Cochrane Center Register of Controlled Trials. The data of evaluation in positive and adverse results of laparoscopic Nissen fundoplication and laparoscopic Nissen fundoplication were extracted and compared using meta-analysis. Results 13 RCTs were ultimately identified involving 814 (52.05%) and 750 (47.95%) patients who underwent laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication, respectively. The operative time, perioperative complications, postoperative satisfaction, recurrence, and the rates of medication adoption or re-operation due to recurrence were not significantly different between two groups. The two types of fundoplication both reinforced the anti-reflux barrier and elevated the lower esophageal sphincter pressure. However, rates of adverse results involving dysphasia, gas-bloat syndrome, inability to belch and re-operation due to severe dysphasia were significantly higher after LNF. In the subgroup analysis of wrap length≤2cm, laparoscopic Nissen fundoplication was associated with a significantly higher incidence of postoperative dysphagia. However, in the subgroup wrap length>2cm, the difference was not statistically significant. Conclusion Laparoscopic Toupet fundoplication might be the better surgery approach for gastroesophageal reflux disease with a lower rate of postoperative adverse results and equal effectiveness as Laparoscopic Nissen fundoplication. PMID:26121646

  19. Minimally invasive Roux-en-Y gastric bypass for fundoplication failure offers excellent gastroesophageal reflux control.

    PubMed

    Kim, Mimi; Navarro, Fernando; Eruchalu, Chukwuma N; Augenstein, Vedra A; Heniford, B Todd; Stefanidis, Dimitrios

    2014-07-01

    Roux-en-Y gastric bypass (RYGB) may represent a superior alternative to reoperative fundoplication in patients with symptomatic failure. Our goal was to assess early outcomes of patients after RYGB for failed fundoplication. Records of patients who underwent fundoplication takedown and RYGB from March 2007 to June 2013 were reviewed for demographics, comorbidities, operative findings, and perioperative outcomes. Data are reported as medians (range). Forty-five patients who had undergone 64 prior antireflux procedures (range, one to three fundoplications) were identified. Median patient age was 56 years (range, 25 to 72 years) with a body mass index of 33 kg/m(2) (range, 22 to 51 kg/m(2)). Most patients had comorbidities: hypertension (60%), anxiety/depression (44.4%), dyslipidemia (33.3%), asthma (31%), obstructive sleep apnea (26.7%), arthritis (22.2%), and diabetes (11.1%). Median symptom-free interval was 3 years (range, 0 to 25 years). All patients had an anatomic reason for failure: 83 per cent had a hiatal hernia and 35 per cent had a slipped Nissen fundoplication. The procedures were accomplished laparoscopically in 28, robotically in 13, and open in four cases. Median operative time was 367 minutes (range, 190 to 600 minutes) and estimated blood loss averaged 100 mL (range, 25 to 500 mL). Five patients (11%) required reoperation: one for an anastomotic leak, one for anastomotic obstruction, and three for early obstruction resulting from adhesions. Two patients developed respiratory failure requiring prolonged mechanical ventilation. Length of stay averaged four days (range, 1 to 33 days) with two readmissions: one for melena and one for vomiting and dehydration; neither required intervention. There was no mortality. At 11 months of follow-up (range, 2.3 to 54 months), 93.3 per cent of patients were symptom-free. When primary fundoplication for gastroesophageal reflux disease fails, fundoplication takedown and RYGB can be accomplished safely with minimally

  20. A Single Institution's First 100 Patients Undergoing Laparoscopic Anti-Reflux Fundoplications: Where Are They 20 Years Later?

    PubMed

    Sadowitz, Benjamin D; Luberice, Kenneth; Bowman, Ty A; Viso, Alexandra M; Ayala, Daniel E; Ross, Sharona B; Rosemurgy, Alexander S

    2015-08-01

    Although anti-reflux surgery has been used liberally over the past decades for the treatment of gastroesophageal reflux disease (GERD), few studies report follow-up after 10 years. This study was undertaken to report follow-up on 100 consecutive GERD patients up to 22 years after utilizing a laparoscopic fundoplication. Hundred consecutive patients undergoing laparoscopic fundoplication for GERD were prospectively followed beginning in 1992. The frequency and severity of symptoms before and after laparoscopic fundoplication were scored on a Likert scale (1 = never/none to 10 = always/very bothersome). Median data are reported. Of the 100 patients who underwent laparoscopic fundoplication for their GERD, nine were reoperations. Twenty-six patients are deceased on average 11 years after their fundoplications. Seventy-four patients are alive, with 27 patients, actively followed for 19 years after their fundoplications. At most recent follow-up, patients experienced long-term amelioration of symptom frequency and severity after fundoplication (e.g., heartburn frequency = 8-2, severity = 8-1; P < 0.01 for each). Eighty-four per cent of patients rated their symptom frequency as less than once per month. Eighty-eight per cent of patients were satisfied with their postoperative results, and 95 per cent of patients confirmed they would have the operation again knowing what they know now. Long-term follow-up documents high patient satisfaction and durable symptomatic relief up to two decades after laparoscopic fundoplication for GERD. Patients should seek this operation not only for symptomatic relief, but to mitigate the deleterious effects of long-term acid exposure and anti-acid therapy. PMID:26215241

  1. The importance of the mesh shape in preventing recurrence after Nissen fundoplication

    PubMed Central

    Tanrikulu, Yusuf; Kar, Fatih; Yalcin, Boran; Yilmaz, Gokhan; Temi, Volkan; Cagsar, Mithat

    2015-01-01

    Gastro esophageal reflux disease (GERD) is the most common gastrointestinal disorder and often is associated with hiatal hernia (HH). Nissen fundoplication is the most common surgical treatment method. Despite surgical treatment, recurrence rate is still high. In this study, we aimed to identify the importance of the mesh shape in preventing recurrence after Nissen fundoplication. A hundred twenty two patients who operated Nissen fundoplication owing to GERD and/or HH were evaluated. Nissen fundoplication was made all patients. Patients were divided into three groups according to hiatoplasty procedure; group 1 (V-shaped mesh), group 2 (V-shaped mesh + Fibrin glue), and group 3 (special designed mesh, Kar’s mesh). Groups were compared regarding intraoperative, postoperative early- and long-term complications. Mean age was 42.75 years, and male to female ratio was 1:2.98. The mean follow-up period was 27 mounts. There was no mortality during follow-up. The most common presenting symptom was heartburn (93.4%). There wasn’t difference between groups in terms of the intraoperative complications and postoperative early-term complications. The overall recurrences rate was 4.9% and dysphagia > 3 months rate was 1.6%. No recurrence was not observed in group 3, while recurrence was observed in 4 patients in group 1 (P = 0.030). Patients should be carefully selected for surgery because complication rate is high despite successful anti-reflux surgical treatment. In this study, we have used a special designed mesh. We believe that this special designed mesh can be used safely and effectively in anti-reflux surgery because recurrence and complications were not observed. PMID:26309643

  2. Outcomes of pediatric laparoscopic fundoplication: A critical review of the literature

    PubMed Central

    Martin, Kathryn; Deshaies, Catherine; Emil, Sherif

    2014-01-01

    BACKGROUND/OBJECTIVE: Laparoscopic fundoplication for gastroesophageal reflux disease (GERD) is one of the most common procedures performed in children. A critical literature review was performed to evaluate the level and quality of evidence supporting the efficacy of this procedure. METHODS: Systematic reviews of the EMBASE, PubMed and CENTRAL databases were conducted to retrieve all articles published over a 15-year period (1996 to 2010) reporting medium- to long-term outcomes (minimum six months follow-up) of laparoscopic fundoplication for the treatment of pediatric GERD. Articles were critically appraised using the Newcastle-Ottawa quality assessment scale and the Cochrane risk of bias assessment tool. Extracted outcomes included GERD recurrence, need for reoperation, postoperative morbidity and mortality. RESULTS: A total of 5302 articles were retrieved. Thirty-six studies met inclusion and exclusion criteria, including five prospective (level 2b), four retrospective comparative (level 3b) and 27 case series (level 4). No studies compared laparoscopic fundoplication with medical treatment. Thirty-six per cent of studies did not describe the symptoms used to suspect GERD; 11% did not disclose the diagnostic modalities used; and 41% did not report the findings of diagnostic modalities. Only 17% of studies provided a definition of recurrence, and only 14% attempted to control for confounding variables. The follow-up intervals were inconsistently reported, ranging between two months and nine years. Significant heterogeneity among studies limited the ability to pool outcomes. Mean (± SD) recurrence rates varied between 0% and 48±19.6% of patients. Reoperation was required in 0.69±0.95% to 17.7±8.4% of patients. Mortality ranged between 0% and 24±16.7%. CONCLUSION: The level and quality of the evidence supporting laparoscopic fundoplication are extremely poor. Higher-quality data are required before the procedure can be considered to be an effective

  3. The importance of the mesh shape in preventing recurrence after Nissen fundoplication.

    PubMed

    Tanrikulu, Yusuf; Kar, Fatih; Yalcin, Boran; Yilmaz, Gokhan; Temi, Volkan; Cagsar, Mithat

    2015-01-01

    Gastro esophageal reflux disease (GERD) is the most common gastrointestinal disorder and often is associated with hiatal hernia (HH). Nissen fundoplication is the most common surgical treatment method. Despite surgical treatment, recurrence rate is still high. In this study, we aimed to identify the importance of the mesh shape in preventing recurrence after Nissen fundoplication. A hundred twenty two patients who operated Nissen fundoplication owing to GERD and/or HH were evaluated. Nissen fundoplication was made all patients. Patients were divided into three groups according to hiatoplasty procedure; group 1 (V-shaped mesh), group 2 (V-shaped mesh + Fibrin glue), and group 3 (special designed mesh, Kar's mesh). Groups were compared regarding intraoperative, postoperative early- and long-term complications. Mean age was 42.75 years, and male to female ratio was 1:2.98. The mean follow-up period was 27 mounts. There was no mortality during follow-up. The most common presenting symptom was heartburn (93.4%). There wasn't difference between groups in terms of the intraoperative complications and postoperative early-term complications. The overall recurrences rate was 4.9% and dysphagia > 3 months rate was 1.6%. No recurrence was not observed in group 3, while recurrence was observed in 4 patients in group 1 (P = 0.030). Patients should be carefully selected for surgery because complication rate is high despite successful anti-reflux surgical treatment. In this study, we have used a special designed mesh. We believe that this special designed mesh can be used safely and effectively in anti-reflux surgery because recurrence and complications were not observed. PMID:26309643

  4. Laparoscopic Watson Fundoplication Is Effective and Durable in Children with Gastrooesophageal Reflux

    PubMed Central

    Dunckley, Matthew G.; Rajwani, Kapil M.; Mahomed, Anies A.

    2014-01-01

    Gastroesophageal reflux (GOR) affects 2–8% of children over 3 years of age and is associated with significant morbidity. The disorder is particularly critical in neurologically impaired children, who have a high risk of aspiration. Traditionally, the surgical antireflux procedure of choice has been Nissen's operation. However, this technique has a significant incidence of mechanical complications and has a reoperation rate of approximately 7%, leading to the development of alternative approaches. Watson's technique of partial anterior fundoplication has been shown to achieve long-lasting reflux control in adults with few mechanical complications, but there is limited data in the paediatric population. We present here short- and long-term outcomes of laparoscopic Watson fundoplication in a series of 76 children and infants, 34% of whom had a degree of neurological impairment including severe cerebral palsy and hypoxic brain injury. The overall complication rate was 27.6%, of which only 1 was classified as major. To date, we have not recorded any incidences of perforation and no revisions. In our experience, Watson's laparoscopic partial fundoplication can be performed with minimal complications and with durable results, not least in neurologically compromised children, making it a viable alternative to the Nissen procedure in paediatric surgery. PMID:25614833

  5. Laparoscopic Nissen Rossetti fundoplication: Possibility towards day care anti-reflux surgeries

    PubMed Central

    Bharatam, Kaundinya Kiran; Raj, Rajiv; Subramanian, Jayantan Bhaskar; Vasudevan, Anjana; Bodduluri, Sudeep; Sriraman, K.B.; Abineshwar, N.J.

    2015-01-01

    Introduction As we proceed towards more and more day care surgeries we always need to choose patients and procedures within a great deal of safety margin. Anti reflux surgeries are gaining more popularity and awareness and Laparoscopic Nissen Rosetti fundoplication is a safe and effective method of performing them. Methods and observations Our case series of 25 patients who underwent day care Laparoscopic Nissen Rossetti fundoplication done over a period of 3 years suggests the feasibility and safety of performing day care anti reflux surgeries with no complications. Discussion Surgical outcomes of procedure are unaffected and the main challenge faced remains pain relief and which can be effectively tackled by local blocks or plain NSAIDs. Results Laparoscopic Nissen Rossetti fundoplication is a safe procedure to be offered as day care anti-reflux surgery. We encourage more studies in this regards with appropriate blinding to enforce its possibility as day care surgery and help patients with early recovery and decreasing cost of surgeries. PMID:26594356

  6. Dynamics of quality of life improvement after floppy Nissen fundoplication for gastroesophageal reflux disease

    PubMed Central

    Kaska, Łukasz; Pindel, Magdalena; Szarmach, Arkadiusz; Janiak, Maria; Proczko-Markuszewska, Monika; Stefaniak, Tomasz; Łaski, Dariusz; Łachiński, Andrzej; Śledziński, Zbigniew

    2015-01-01

    Introduction Gastroesophageal reflux disease (GERD) has a negative impact on global quality of life (QOL) of patients. In patients affected by GERD, laparoscopic Nissen fundoplication is one of the most commonly performed laparoscopic procedures worldwide. Aim To prospectively analyze the dynamics of QOL as well as severity of pain in patients with GERD, before and after laparoscopic floppy Nissen fundoplication. Material and methods The study involved 104 consecutive patients operated on for GERD in whom laparoscopic floppy Nissen fundoplication was performed. QOL was assessed before surgery and 1, 3, 6, 12 and 24 months after. The following instruments were used: FACIT-G, FACIT-TS-G, GIQLI, GERD symptom scale. Results It was found that symptom relief and quality of life improvement presented different dynamics in the postoperative course. Observations revealed relief of symptoms 1 month after surgery and improvement in QOL related to the gastrointestinal tract and pain 3 months after surgery. Global QOL increased significantly as late as 12 months after surgery. Conclusions Gastroesophageal reflux disease is a chronic disease of long duration, leading to impairment of quality of life. Patients, apart from typical symptoms of GERD, suffer from pain of significant severity. QOL improves significantly after surgery. Surgical treatment results in relief of GERD symptoms, which leads to gradual improvement of QOL. PMID:26649085

  7. The extended learning curve for laparoscopic fundoplication: a cohort analysis of 400 consecutive cases.

    PubMed

    Gill, J; Booth, M I; Stratford, J; Dehn, T C B

    2007-04-01

    Many studies have looked at the learning curve associated with laparoscopic Nissen fundoplication (LNF) in a given institution. This study looks at the learning curve of a single surgeon with a large cohort of patients over a 10-year period. Prospective data were collected on 400 patients undergoing laparoscopic fundoplication for over 10 years. The patients were grouped consecutively into cohorts of 50 patients. The operating time, the length of postoperative hospital stay, the conversion rate to open operation, the postoperative dilatation rate, and the reoperation rate were analyzed. Results showed that the mean length of operative time decreased from 143 min in the first 50 patients to 86 min in the last 50 patients. The mean postoperative length of hospital stay decreased from 3.7 days initially to 1.2 days latterly. There was a 14% conversion to open operation rate in the first cohort compared with a 2% rate in the last cohort. Fourteen percent of patients required reoperation in the first cohort and 6% in the last cohort. Sixteen percent required postoperative dilatation in the first cohort. None of the last 150 patients required dilatation. In conclusion, laparoscopic fundoplication is a safe and effective operation for patients with gastroesophageal reflux disease. New techniques and better instrumentation were introduced in the early era of LNF. The learning curve, however, continues well beyond the first 20 patients. PMID:17436134

  8. Asymptomatic Partial Splenic Infarction In Laparoscopic Floppy Nissen Fundoplication And Brief Literature Review

    PubMed Central

    Odabasi, Mehmet; Abuoglu, Haci Hasan; Arslan, Cem; Gunay, Emre; Yildiz, Mehmet Kamil; Eris, Cengiz; Ozkan, Erkan; Aktekin, Ali; Muftuoglu, Tolga

    2014-01-01

    Short gastric vessels are divided during the laparoscopic Nissen fundoplication resulting in splenic infarct in some cases. We report a case of laparoscopic floppy Nissen fundoplication with splenic infarct that was recognized during the procedure and provide a brief literature review. The patient underwent a laparoscopic floppy Nissen fundoplication. We observed a partial infarction of the spleen. She reported no pain. A follow-up computed tomography scan showed an infarct, and a 3-month abdominal ultrasound showed complete resolution. Peripheral splenic arterial branches have very little collateral circulation. When these vessels are occluded or injured, an area of infarction will occur immediately. Management strategies included a trial of conservative management and splenectomy for persistent symptoms or complications resulting from splenic infarct. In conclusion, we believe that the real incidence is probably much higher because many cases of SI may have gone undiagnosed during or following an operation, because some patients are asymptomatic. We propose to check spleen carefully for the possibility of splenic infarct. PMID:24833155

  9. Expression of the Dermatomyositis Autoantigen TIF1γ in Regenerating Muscle

    PubMed Central

    Mohassel, Payam; Rosen, Paul; Casciola-Rosen, Livia; Pak, Katherine; Mammen, Andrew L.

    2014-01-01

    Objective Autoantibodies against TIF1γ are found in many patients with dermatomyositis (DM). Although TIF1γ is known to play a role in the differentiation of other tissues, its functional role in muscle regeneration has not been elucidated. This study was undertaken to explore the regulation and functional role of this protein during muscle differentiation and regeneration. Methods TIF1γ expression was analyzed in human muscle biopsy specimens using immunofluorescence microscopy. Immunofluorescence microscopy and immunoblotting analyses were used to study TIF1γ expression in a mouse model of muscle injury and repair. The effect of premature TIF1γ silencing on muscle differentiation was studied in cultured mouse myoblasts. Results In muscle biopsy specimens from DM patients, TIF1γ was expressed at low levels in the nuclei of histologically normal muscle cells but at high levels in the centralized nuclei of atrophic, perifascicular myofibers expressing markers of regeneration. TIF1γ levels were also increased in regenerating myonuclei following muscle injury in mice. Premature silencing of TIF1γ in vitro using siRNA did not accelerate the expression of myogenin, a transcription factor that plays a central role in regulating relatively early stages of muscle differentiation. However, premature silencing of TIF1γ did accelerate myotube fusion and the expression of myosin heavy chain (MyHC), a later marker of muscle differentiation. Conclusion The DM autoantigen TIF1γ is markedly upregulated during muscle regeneration in human and mouse muscle cells. Premature silencing of this protein in cultured myoblasts accelerates MyHC expression and myoblast fusion. However, TIF1γ may function independently of, or downstream from myogenin. PMID:25186009

  10. The Accuracy of Gastric Insufflation in Testing for Gastroesophageal Perforations during Laparoscopic Nissen Fundoplication

    PubMed Central

    Bass, Robert C.

    1999-01-01

    Background: Laparoscopic Nissen fundoplication is an effective technique for the symptomatic relief of the manifestations of gastroesophageal reflux disorder but is associated with a 0.8-1% rate of gastroesophageal perforation. Early detection and repair of these injuries is critical to patient outcome, but occult injuries occur and may be missed. Gastric insufflation technique evaluates the integrity of the gastroesophageal wall after laparoscopic Nissen fundoplication. Gastric insufflation technique involves occlusion of the proximal stomach with a non-crushing bowel clamp while insufflating the submerged gastroesophageal junction. We conducted an animal study to assess the utility of gastric insufflation technique. Methods: Five pigs (mean weight, 40.4 kg) underwent testing of laparoscopic gastric insufflation technique. In four animals, laparoscopic Nissen fundoplication was performed and then gastroesophageal junction injuries were created (3-5 mm distraction-type wall injuries). Non-crushing bowel clamps provided occlusion of the pylorus and then the proximal stomach during gastroesophageal insufflation. The gastroesophageal junction was then submerged. In the fifth animal, gastric insufflation technique was repeated while calibrated injuries were created to determine the smallest detectable injury. An injury was considered detectable if rising air bubbles were noted from the submerged gastroesophageal structures. Maximal luminal pressures needed to detect injuries were recorded with an in-line manometer. Results: In all animals, 5-7 mm injuries of the gastroesophageal junction were easily detected using gastric insufflation technique when the proximal stomach was occluded. When the pylorus alone was occluded, detection of gastroesophageal injuries was inconsistent. Small injuries (lt;3 mm) of the esophagus were difficult to visualize with pyloric occlusion alone but were consistently detectable with proximal stomach occlusion at pressures less than 20 mm Hg

  11. On-line Technology Information System (OTIS): Solid Waste Management Technology Information Form (SWM TIF)

    NASA Technical Reports Server (NTRS)

    Levri, Julie A.; Boulanger, Richard; Hogan, John A.; Rodriguez, Luis

    2003-01-01

    Contents include the following: What is OTIS? OTIS use. Proposed implementation method. Development history of the Solid Waste Management (SWM) Technology Information Form (TIF) and OTIS. Current development state of the SWM TIF and OTIS. Data collection approach. Information categories. Critiques/questions/feedback.

  12. Arterial calcifications and increased expression of vitamin D receptor targets in mice lacking TIF

    PubMed Central

    Ignat, Mihaela; Teletin, Marius; Tisserand, Johan; Khetchoumian, Konstantin; Dennefeld, Christine; Chambon, Pierre; Losson, Régine; Mark, Manuel

    2008-01-01

    Calcification of arteries is a major risk factor for cardiovascular mortality in humans. Using genetic approaches, we demonstrate here that the transcriptional intermediary factor 1α (TIF1α), recently shown to function as a tumor suppressor in murine hepatocytes, also participates in a molecular cascade that prevents calcifications in arterioles and medium-sized arteries. We further provide genetic evidence that this function of TIF1α is not exerted in hepatocytes. The sites of ectopic calcifications in mutant mice lacking TIF1α resemble those seen in mice carrying an activating mutation of the calcium sensor receptor (Casr) gene and, in TIF1α-deficient kidneys, Casr expression is increased together with that of many other vitamin D receptor (VDR) direct target genes, namely Car2, Cyp24a1, Trpv5, Trpv6, Calb1, S100g, Pthlh, and Spp1. Thus, our data indicate that TIF1α represses the VDR pathway in kidney and suggest that an up-regulation of Casr expression in this organ could account for ectopic calcifications generated upon TIF1α deficiency. Interestingly, the calcifying arteriopathy of TIF1α-null mutant mice shares features with the human age-related Mönckeberg's disease and, overall, the TIF1α-null mutant pathological phenotype supports the hypothesis that aging is promoted by increased activity of the vitamin D signaling pathway. PMID:18287084

  13. 77 FR 35757 - Final Priorities, Requirements, Definitions, and Selection Criteria-Teacher Incentive Fund (TIF...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-14

    ...The Assistant Secretary for Elementary and Secondary Education announces priorities, requirements, definitions, and selection criteria under the TIF program. The Assistant Secretary may use one or more of these priorities, requirements, definitions, and selection criteria for competitions in fiscal year (FY) 2012 and later years. We are taking this action so that TIF-funded performance-based......

  14. Nissen fundoplication and gastrointestinal-related complications: a guide for the primary care physician.

    PubMed

    Hazan, Tal B; Gamarra, Fernando N; Stawick, Lawrence; Maas, Luis C

    2009-10-01

    Gastroesophageal reflux disease is a common condition affecting many individuals in the Western world. Most patients are managed successfully with acid suppression, while others may require more invasive interventions. The majority of patients undergoing antireflux surgery will have favorable outcomes. A small percentage, however, will be considered surgical failures and will either present with new or recurrent symptoms, or develop postoperative complications. These include, but are not limited to, symptoms such as dysphagia, gas-bloat syndrome, and bowel dysfunctions that may significantly impair the patient's health and quality of life. As the number of antireflux procedures for this condition continue to increase, the number of complications is also likely to become more prevalent. The primary care physician will be challenged to recognize them and initiate appropriate management. In this review, we address the more common gastrointestinal complications of laparoscopic Nissen fundoplication and offer general guidelines in their diagnosis and management. PMID:19738518

  15. Laparoscopic Nissen fundoplication in a patient with situs inversus totalis: an ergonomic consideration.

    PubMed

    Koo, Kenny P

    2006-06-01

    We report a laparoscopic Nissen fundoplication for gastroesophageal reflux disease in a patient with situs inversus totalis. The 65-year-old man was previously diagnosed with situs inversus totalis and presented with chronic gastroesophageal reflux disease inadequately controlled by medications. The laparoscopic procedure was performed with 5 ports placed in a mirror-image configuration and with the patient in the lithotomy position. Few technical difficulties were encountered during the operation. The position of the primary surgeon, working between the lower limbs of the patient, was considered critical to the success of this case. In situs inversus totalis, this position provides the least visual disorientation from the reversed abdominal organs. We recommend this position for all upper abdominal laparoscopic procedures in patients with situs inversus totalis, including laparoscopic cholecystectomy. PMID:16796439

  16. Reconstructive phase transition in (NH4)3TiF7 accompanied by the ordering of TiF6 octahedra.

    PubMed

    Molokeev, Maxim; Misjul, S V; Flerov, I N; Laptash, N M

    2014-12-01

    An unusual phase transition P4/mnc → Pa\\bar 3 has been detected after cooling the (NH4)3TiF7 compound. Some TiF6 octahedra, which are disordered in the room-temperature tetragonal structure, become ordered in the low-temperature cubic phase due to the disappearance of the fourfold axis. Other TiF6 octahedra undergo large rotations resulting in huge displacements of the F atoms by 1.5-1.8 Å that implies a reconstructive phase transition. It was supposed that phases P4/mbm and Pm\\bar 3m could be a high-temperature phase and a parent phase, respectively, in (NH4)3TiF7. Therefore, the sequence of phase transitions can be written as Pm\\bar 3m → P4/mbm → P4/mnc → Pa\\bar 3. The interrelation between (NH4)3TiF7, (NH4)3GeF7 and (NH4)3PbF7 is found, which allows us to suppose phase transitions in relative compounds. PMID:25449615

  17. Akt activation enhances ribosomal RNA synthesis through casein kinase II and TIF-IA

    PubMed Central

    Nguyen, Le Xuan Truong; Mitchell, Beverly S.

    2013-01-01

    Transcription initiation factor I (TIF-IA) plays an essential role in regulating ribosomal RNA (rRNA) synthesis by tethering RNA polymerase I (Pol I) to the rDNA promoter. We have found that activated Akt enhances rRNA synthesis through the phosphorylation of casein kinase IIα (CK2α) on a threonine residue near its N terminus. CK2 in turn phosphorylates TIF-IA, thereby increasing rDNA transcription. Activated Akt also stabilizes TIF-IA, induces its translocation to the nucleolus, and enhances its interaction with Pol I. Treatment with AZD8055, an inhibitor of both Akt and mammalian target of rapamycin phosphorylation, but not with rapamycin, disrupts Akt-mediated TIF-IA stability, translocation, and activity. These data support a model in which activated Akt enhances rRNA synthesis both by preventing TIF-IA degradation and phosphorylating CK2α, which in turn phosphorylates TIF-IA. This model provides an explanation for the ability of activated Akt to promote cell proliferation and, potentially, transformation. PMID:24297901

  18. Repression of TIF1γ by SOX2 promotes TGF-β-induced epithelial-mesenchymal transition in non-small-cell lung cancer.

    PubMed

    Wang, L; Yang, H; Lei, Z; Zhao, J; Chen, Y; Chen, P; Li, C; Zeng, Y; Liu, Z; Liu, X; Zhang, H-T

    2016-02-18

    TIF1γ is a novel regulator of transforming growth factor (TGF)-β/Smad signaling. Our previous studies show that dysregulated expression of transcriptional intermediary factor 1 γ (TIF1γ) and abnormal TGF-β/Smad signaling are implicated in non-small-cell lung cancer (NSCLC) separately. However, how TIF1γ contributes to NSCLC by controlling TGF-β/Smad signaling is poorly understood. Here, we investigated the mechanistic role of TIF1γ in TGF-β-induced epithelial-mesenchymal transition (EMT), as well as a link between TIF1γ and SOX2 in NSCLC. We show that TIF1γ is a downstream target of SOX2 in NSCLC cells. SOX2 overexpression negatively regulated TIF1γ promoter activity and thereby attenuated TIF1γ mRNA and protein expression levels; SOX2 knockdown significantly enhanced TIF1γ promoter activity and augmented TIF1γ expression. Moreover, TIF1γ mRNA expression was downregulated in human NSCLC tissues and negatively correlated with SOX2 protein, which was upregulated in NSCLC tissues. Importantly, knockdown of TIF1γ or SOX2 overexpression augmented SMAD4 (human Mad (mothers against decapentaplegic)-related homologous protein 4)-dependent transcriptional responses, and enhanced TGF-β-induced EMT and human NSCLC cell invasion; knockdown of SOX2 impaired TGF-β-induced EMT and NSCLC cell invasion. In an in vivo model of metastasis, knockdown of TIF1γ promotes NSCLC cell metastasis. In addition, our data suggested that TIF1γ inhibited TGF-β-induced EMT through competing with SMAD4 in NSCLC cells. Taken together, our findings reveal a new mechanism by which SOX2-mediated transcription repression of TIF1γ promotes TGF-β-induced EMT in NSCLC. PMID:25961934

  19. Early myotomy and fundoplication in achalasia in childhood: a single-centre experience for 22 years.

    PubMed

    Erginel, Basak; Gun Soysal, Feryal; Keskin, Erbug; Celik, Alaaddin; Salman, Tansu

    2016-02-01

    Introduction The aim of this study was to review a single institution's experience with surgical interventions in children with achalasia and to determine treatment strategies for this rare disorder. Patients and methods This study is a retrospective analysis of 22 cases of childhood achalasia from 1991 to 2013. The patients were evaluated in terms of age, symptoms, interventions, intraoperative complications, and recurrent dysphagia. Results There were 13 boys and nine girls (7 months to 17 years old). The clinical symptoms were vomiting (68%), dysphagia (36%), wheezing (18%), coughing (13%), and weight-loss (13%). The mean duration of symptoms was 2.4 years (1 month to 6 years). A barium contrast X-ray study was performed in all of the patients. Oesophageal manometry was performed in eight patients. Six patients underwent multiple oesophageal dilatations (ED) as a first intervention. A Heller myotomy (HM) and fundoplication were performed in all the patients except two patients who recovered with dilatation. In the long term, one patient had a stricture due to the operation and had to undergo a reoperation. Of the Heller myotomy patients, one had a recurrent stricture that responded to dilatation. No other complications were present. All the patients are now asymptomatic. Conclusion Early diagnosis and prompt surgical treatment is important to prevent growth impairment in childhood achalasia cases. A Heller myotomy followed by a partial anti-reflux procedure is an effective treatment for achalasia in children. Based on our experience, it is superior to oesophageal dilatation therapy. PMID:27385135

  20. Trypanosoma brucei TIF2 suppresses VSG switching by maintaining subtelomere integrity

    PubMed Central

    Jehi, Sanaa E; Wu, Fan; Li, Bibo

    2014-01-01

    Subtelomeres consist of sequences adjacent to telomeres and contain genes involved in important cellular functions, as subtelomere instability is associated with several human diseases. Balancing between subtelomere stability and plasticity is particularly important for Trypanosoma brucei, a protozoan parasite that causes human African trypanosomiasis. T. brucei regularly switches its major variant surface antigen, variant surface glycoprotein (VSG), to evade the host immune response, and VSGs are expressed exclusively from subtelomeres in a strictly monoallelic fashion. Telomere proteins are important for protecting chromosome ends from illegitimate DNA processes. However, whether they contribute to subtelomere integrity and stability has not been well studied. We have identified a novel T. brucei telomere protein, T. brucei TRF-Interacting Factor 2 (TbTIF2), as a functional homolog of mammalian TIN2. A transient depletion of TbTIF2 led to an elevated VSG switching frequency and an increased amount of DNA double-strand breaks (DSBs) in both active and silent subtelomeric bloodstream form expression sites (BESs). Therefore, TbTIF2 plays an important role in VSG switching regulation and is important for subtelomere integrity and stability. TbTIF2 depletion increased the association of TbRAD51 with the telomeric and subtelomeric chromatin, and TbRAD51 deletion further increased subtelomeric DSBs in TbTIF2-depleted cells, suggesting that TbRAD51-mediated DSB repair is the underlying mechanism of subsequent VSG switching. Surprisingly, significantly more TbRAD51 associated with the active BES than with the silent BESs upon TbTIF2 depletion, and TbRAD51 deletion induced much more DSBs in the active BES than in the silent BESs in TbTIF2-depleted cells, suggesting that TbRAD51 preferentially repairs DSBs in the active BES. PMID:24810301

  1. Trypanosoma brucei TIF2 and TRF Suppress VSG Switching Using Overlapping and Independent Mechanisms.

    PubMed

    Jehi, Sanaa E; Nanavaty, Vishal; Li, Bibo

    2016-01-01

    Trypanosoma brucei causes debilitating human African trypanosomiasis and evades the host's immune response by regularly switching its major surface antigen, VSG, which is expressed exclusively from subtelomeric loci. We previously showed that two interacting telomere proteins, TbTRF and TbTIF2, are essential for cell proliferation and suppress VSG switching by inhibiting DNA recombination events involving the whole active VSG expression site. We now find that TbTIF2 stabilizes TbTRF protein levels by inhibiting their degradation by the 26S proteasome, indicating that decreased TbTRF protein levels in TbTIF2-depleted cells contribute to more frequent VSG switching and eventual cell growth arrest. Surprisingly, although TbTIF2 depletion leads to more subtelomeric DNA double strand breaks (DSBs) that are both potent VSG switching inducers and detrimental to cell viability, TbTRF depletion does not increase the amount of DSBs inside subtelomeric VSG expression sites. Furthermore, expressing an ectopic allele of F2H-TbTRF in TbTIF2 RNAi cells allowed cells to maintain normal TbTRF protein levels for a longer frame of time. This resulted in a mildly better cell growth and partially suppressed the phenotype of increased VSG switching frequency but did not suppress the phenotype of more subtelomeric DSBs in TbTIF2-depleted cells. Therefore, TbTIF2 depletion has two parallel effects: decreased TbTRF protein levels and increased subtelomeric DSBs, both resulting in an acute increased VSG switching frequency and eventual cell growth arrest. PMID:27258069

  2. Trypanosoma brucei TIF2 and TRF Suppress VSG Switching Using Overlapping and Independent Mechanisms

    PubMed Central

    Jehi, Sanaa E.; Nanavaty, Vishal; Li, Bibo

    2016-01-01

    Trypanosoma brucei causes debilitating human African trypanosomiasis and evades the host’s immune response by regularly switching its major surface antigen, VSG, which is expressed exclusively from subtelomeric loci. We previously showed that two interacting telomere proteins, TbTRF and TbTIF2, are essential for cell proliferation and suppress VSG switching by inhibiting DNA recombination events involving the whole active VSG expression site. We now find that TbTIF2 stabilizes TbTRF protein levels by inhibiting their degradation by the 26S proteasome, indicating that decreased TbTRF protein levels in TbTIF2-depleted cells contribute to more frequent VSG switching and eventual cell growth arrest. Surprisingly, although TbTIF2 depletion leads to more subtelomeric DNA double strand breaks (DSBs) that are both potent VSG switching inducers and detrimental to cell viability, TbTRF depletion does not increase the amount of DSBs inside subtelomeric VSG expression sites. Furthermore, expressing an ectopic allele of F2H-TbTRF in TbTIF2 RNAi cells allowed cells to maintain normal TbTRF protein levels for a longer frame of time. This resulted in a mildly better cell growth and partially suppressed the phenotype of increased VSG switching frequency but did not suppress the phenotype of more subtelomeric DSBs in TbTIF2-depleted cells. Therefore, TbTIF2 depletion has two parallel effects: decreased TbTRF protein levels and increased subtelomeric DSBs, both resulting in an acute increased VSG switching frequency and eventual cell growth arrest. PMID:27258069

  3. Bromodomain-PHD finger protein 1 is critical for leukemogenesis associated with MOZ-TIF2 fusion.

    PubMed

    Shima, Haruko; Yamagata, Kazutsune; Aikawa, Yukiko; Shino, Mika; Koseki, Haruhiko; Shimada, Hiroyuki; Kitabayashi, Issay

    2014-01-01

    Chromosomal translocations that involve the monocytic leukemia zinc finger (MOZ) gene are typically associated with human acute myeloid leukemia (AML) and often predict a poor prognosis. Overexpression of HOXA9, HOXA10, and MEIS1 was observed in AML patients with MOZ fusions. To assess the functional role of HOX upregulation in leukemogenesis by MOZ-TIF2, we focused on bromodomain-PHD finger protein 1 (BRPF1), a component of the MOZ complex that carries out histone acetylation for generating and maintaining proper epigenetic programs in hematopoietic cells. Immunoprecipitation analysis showed that MOZ-TIF2 forms a stable complex with BRPF1, and chromatin immunoprecipitation analysis showed that MOZ-TIF2 and BRPF1 interact with HOX genes in MOZ-TIF2-induced AML cells. Depletion of BRPF1 decreased the MOZ localization on HOX genes, resulting in loss of transformation ability induced by MOZ-TIF2. Furthermore, mutant MOZ-TIF2 engineered to lack histone acetyltransferase activity was incapable of deregulating HOX genes as well as initiating leukemia. These data indicate that MOZ-TIF2/BRPF1 complex upregulates HOX genes mediated by MOZ-dependent histone acetylation, leading to the development of leukemia. We suggest that activation of BRPF1/HOX pathway through MOZ HAT activity is critical for MOZ-TIF2 to induce AML. PMID:24258712

  4. Surgical treatment of GERD. Comperative study of WTP vs. Toupet fundoplication – results of 151 consecutive cases

    PubMed Central

    Wróblewski, Tadeusz; Nowosad, Małgorzata; Krawczyk, Marek

    2016-01-01

    Introduction Gastroesophageal reflux disease (GERD) is recognized as one of the most common disorders of the upper gastrointestinal tract (GIT). The best choice of management for advanced GERD is laparoscopic surgery. Aim To compare and evaluate the results of surgical treatment of GERD patients operated on using two different techniques. Material and methods Between 2001 and 2012, 353 patients (211 female and 142 male), aged 17–76 years (mean 44), underwent laparoscopic antireflux surgery. The study included patients who underwent a Toupet fundoplication or Wroblewski Tadeusz procedure (WTP). Results The mean age of the group was 47.77 years (17–80 years). Forty-nine (32.45%) patients had severe symptoms, 93 (61.58%) had mild symptoms and 9 (5.96%) had a single mild but intolerable sign of GERD. Eighty-six (56.95%) patients had a Toupet fundoplication and 65 (43.04%) had a WTP. The follow-up period was 18–144 months. The average operating time for Toupet fundoplication and the WTP procedure was 164 min (90–300 min) and 147 min (90–210 min), respectively. The perioperative mortality rate was 0.66%. The average post-operative hospitalization period was 5.4 days (2–16 post-operative days (POD) = Toupet) vs. 4.7 days (2–9 POD = WTP). No reoperations were performed. No major surgical complications were identified. Conclusions Wroblewski Tadeusz procedure due to a low percentage of post-operative complications, good quality of life of patients and a zero recurrence rate of hiatal hernia should be a method of choice. PMID:27458484

  5. Development of TIF based figuring algorithm for deterministic pitch tool polishing

    NASA Astrophysics Data System (ADS)

    Yi, Hyun-Su; Kim, Sug-Whan; Yang, Ho-Soon; Lee, Yun-Woo

    2007-12-01

    Pitch is perhaps the oldest material used for optical polishing, leaving superior surface texture, and has been used widely in the optics shop floor. However, for its unpredictable controllability of removal characteristics, the pitch tool polishing has been rarely analysed quantitatively and many optics shops rely heavily on optician's "feel" even today. In order to bring a degree of process controllability to the pitch tool polishing, we added motorized tool motions to the conventional Draper type polishing machine and modelled the tool path in the absolute machine coordinate. We then produced a number of Tool Influence Function (TIF) both from an analytical model and a series of experimental polishing runs using the pitch tool. The theoretical TIFs agreed well with the experimental TIFs to the profile accuracy of 79 % in terms of its shape. The surface figuring algorithm was then developed in-house utilizing both theoretical and experimental TIFs. We are currently undertaking a series of trial figuring experiments to prove the performance of the polishing algorithm, and the early results indicate that the highly deterministic material removal control with the pitch tool can be achieved to a certain level of form error. The machine renovation, TIF theory and experimental confirmation, figuring simulation results are reported together with implications to deterministic polishing.

  6. [The effect of Nissen-Rossetti fundoplication on the motor function of swallowing in patients with reflux diseases].

    PubMed

    Wallner, G; Misiuna, P; Dabrowski, A; Abramowicz, K; Polkowski, W; Mijal, M

    1997-01-01

    This prospective study was undertaken to assess the motility of the middle and lower esophagus and LES resting pressure changes following the N-R fundoplication for GER. The study was carried out in 53 consecutive patients (37 women, 16 men, median age 49.1 +/- 6.2 years), operated due to antireflux mechanism insufficiency. Threefold solid state for manometry and double channel for pH metry catheters in the body of the esophagus were used before and after the operation (median follow up time was 18 months). The LES length and resting pressure were evaluated with Synectics On-line interface. The objective results obtained during 24-h pH metry and manometry were shown as median and standard deviation, with statistical significances determined using the SPSS/PC+ packet (p < 0.05 considered as significant). The individual patients' data were analyzed by Synectics software. 24-h pH metry confirmed that Nissen-Rossetti fundoplication efficaciously reduced pathological GER (significant decrease of DeMeester score from 105.6 +/- 12.2 to 5.2 +/- 3.4, p < 0.0002). Manometry proved the increase of the LES resting pressure from 7.6 +/- 3.2 to 18.2 +/- 4.2, p < 0.0005, and its total length from 3.1 +/- 0.8 to 4.2 +/- 1.0, p < 0.01. The improvement of the esophageal body peristalsis was found first of all in total period. Motility changes following N-R fundoplication during the reflux period were unsatisfactory. The frequency of peristalic contractions with higher amplitude and longer duration significantly increased after the operation in total period in all levels. The increase of the complete peristaltic contractions following N-R fundoplication was high significant from 22.15% to 60.21%, p < 0.0001. Although significant improvement of the efficacy of esophageal peristalis was observed, however it was still under 50% of normal level all the time (15.4% v. 41.7%, p < 0.002). The most impressive improvement of esophageal peristalis was noticed in the lower part of the esophagus

  7. The treatment of gastroesophageal reflux disease with laparoscopic Nissen fundoplication: prospective evaluation of 100 patients with "typical" symptoms.

    PubMed Central

    Peters, J H; DeMeester, T R; Crookes, P; Oberg, S; de Vos Shoop, M; Hagen, J A; Bremner, C G

    1998-01-01

    OBJECTIVE: To evaluate prospectively the outcome of laparoscopic fundoplication in a large cohort of patients with typical symptoms of gastroesophageal reflux. SUMMARY BACKGROUND DATA: The development of laparoscopic fundoplication over the past several years has resulted in renewed interest in the surgical treatment of gastroesophageal reflux disease (GERD). METHODS: One hundred patients with typical symptoms of GERD were studied. The study was limited to patients with positive 24-hour pH studies and "typical" symptoms of GERD. Laparoscopic fundoplication was performed when clinical assessment suggested adequate esophageal motility and length. Outcome measures included assessment of the relief of the primary symptom responsible for surgery; the patient's and the physician's evaluation of outcome; quality of life evaluation; repeated upper endoscopy in 30 patients with presurgical esophagitis; and postsurgical physiologic studies in 28 unselected patients, consisting of 24-hour esophageal pH and lower esophageal sphincter manometry. RESULTS: Relief of the primary symptom responsible for surgery was achieved in 96% of patients at a mean follow-up of 21 months. Seventy-one patients were asymptomatic, 24 had minor gastrointestinal symptoms not requiring medical therapy, 3 had gastrointestinal symptoms requiring medical therapy, and 2 were worsened by the procedure. Eighty-three patients considered themselves cured, 11 were improved, and 1 was worse. Occasional difficulty swallowing not present before surgery occurred in 7 patients at 3 months, and decreased to 2 patients by 12 months after surgery. There were no deaths. Clinically significant complications occurred in four patients. Median hospital stay was 3 days, decreasing from 6.3 in the first 10 patients to 2.3 in the last 10 patients. Endoscopic esophagitis healed in 28 of 30 patients who had presurgical esophagitis and returned for follow-up endoscopy. Twenty-four-hour esophageal acid exposure had returned to

  8. Autoantibodies to transcription intermediary factor (TIF)1β associated with dermatomyositis

    PubMed Central

    2012-01-01

    Introduction Myositis specific autoantibodies are associated with unique clinical subsets and are useful biomarkers in polymyositis/dermatomyositis (PM/DM). A 120 kD protein recognized by certain patients with DM was identified and clinical features of patients with this specificity were characterized. Methods The 120 kD protein recognized by a prototype serum was purified and identified by mass spectrometry and immunological methods. Autoantibody to this 120 kD protein was screened in sera from 2,356 patients with various diagnoses from four countries, including 254 PM/DM, by immunoprecipitation of 35S-methionine labeled K562 cell extracts. Clinical information of patients with this specificity was collected. Results The 120 kD protein, which exactly comigrated with PL-12, was identified as transcription intermediary factor TIF1β (TRIM28) by mass spectrometry and validated by immunoassays. By immunofluorescence, anti-TIF1β positivity showed a fine-speckled nuclear staining pattern. Four cases of anti-TIF1β were identified; all are women, one each in a Japanese, African American, Caucasian, and Mexican individual. Three had a diagnosis of DM and one case was classified as having an undifferentiated connective tissue disease with an elevated CPK but without significant muscle symptoms. This individual also had a history of colon cancer, cervical squamous metaplasia and fibroid tumors of the uterus. Myopathy was mild in all cases and resolved without treatment in one case. The anti-TIF1β specificity was not found in other conditions. Conclusions Anti-TIF1β is a new DM autoantibody associated with a mild form of myopathy. Whether it has an association with malignancy, as in the case of anti-TIF1γ, or other unique features will need to be evaluated in future studies. PMID:22513056

  9. In vitro reduction of dental erosion by low-concentration TiF4 solutions.

    PubMed

    Vieira, A M; Ruben, J L; Bronkhorst, E M; Huysmans, M C D N J M

    2011-01-01

    The aims of this study were to compare daily versus single applications of low-concentration TiF(4) solutions for reduction of enamel erosion and to evaluate the enamel surface loss due to application of these solutions. Sixty bovine enamel samples were randomly divided into 2 groups: single versus daily treatment with TiF(4) solution (ST vs. DT), which were subdivided into 5 subgroups (n = 6): 0% (control); 0.1, 0.5, 0.75 and 1% TiF(4) concentration. Fluoride treatment was performed by immersing specimens in 10 ml of the TiF(4) solutions for 5 min and rinsing them with tap water for 30 s. ST specimens were treated once only, DT specimens were treated before each erosion cycle. All specimens were subjected to 4 erosion cycles: 6 immersions of 2 min in Sprite, tap water rinse for 1 min and storage in artificial saliva for 1.5 h. Erosive enamel loss was measured using light profilometry, after each fluoride treatment and each erosive cycle. The values of surface loss/gain at application of the TiF(4) solutions did not significantly differ from zero. At the end of the 4 erosion cycles, 0.5% showed the least (ST: 3.45 ± 0.27 μm, DT: 1.08 ± 1.69 μm) and 1% showed the most surface loss (ST: 4.87 ± 1.13 μm, DT: 6.56 ± 1.49 μm). A significant reduction of surface loss was found only for 0.5% DT (p = 0.009). Within the limitations of an in vitro study, it was concluded that multiple applications of a 0.5% TiF(4) solution significantly reduced enamel erosion in vitro and caused no enamel loss at application. PMID:21454977

  10. Prospective, Randomized Ex Vivo Trial to Assess the Ideal Stapling Site for Endoscopic Fundoplication with Medigus Ultrasonic Surgical Endostapler.

    PubMed

    Gweon, Tae-Geun; Matthes, Kai

    2016-01-01

    Background and Aims. Endoscopic fundoplication is an emerging technique for the treatment of gastroesophageal reflux disease (GERD). The aim of this study is to determine the ideal position of the staples in relation to gastroesophageal junction (GEJ). Methods. Ten endoscopic fundoplication procedures were performed in each group using fresh ex vivo porcine stomachs: Group A: 2 staples each at 3 cm above the GEJ and 180° apart; Group B: 2 staples at 3 cm and 90° apart; Group C: 2 staples at 4 cm and 180° apart; Group D: 3 staples at 3 cm with 90° between each staple (180° total). After the procedure, the stomach was gradually filled with water. Gastric yield pressure (GYP) was determined by detection of reflux of the water in esophagus or by rupture of staples. Results. Mean increase of GYPs (±SD) after the procedure was as follows: Group A: 16.9 ± 8.7; Group B: 8.1 ± 7.9; Group C: 12.2 ± 9.4; Group D: 22.7 ± 13.3. GYP in Group A and Group D was higher than Group B (p = 0.03 and p = 0.01, resp.). Conclusions. We recommend the placement of 3 staples at 3 cm distance from the GEJ, which resulted in the highest increase of GYP. PMID:27547219

  11. Gastric fundus tension before and after division of the short gastric vessels in a cadaveric model of fundoplication.

    PubMed

    Szor, D J; Herbella, F A M; Bonini, A L; Moreno, D G; Del Grande, J C

    2009-01-01

    Short gastric vessels (SGV) division is a controversial topic in antireflux surgery. Some surgeons do not divide the SGV routinely to perform a fundoplication; however, excessive tension of the gastric fundus (GF) forces this procedure necessary in some cases. This study aims to evaluate in a cadaveric model of Nissen fundoplication: (i) the correlation of GF tension with anatomic parameters; and (ii) the effect of SGV division on GF tension. In total, 23 fresh cadavers (18 men, mean age 62 years) were studied. The abdominal esophagus was dissected, and the GF transposed to a limit of 3 cm to the right border of the esophagus. A dynamometer was attached to the GF and the tension recorded. Cadavers were grouped according to the presence or absence of tension. SGV were divided and GF tension measured again. The presence or absence of initial GF tension was correlated to: (i) number of SGV; (ii) length of the GF; (iii) distance between His angle and the first SGV; and (iv) size of the spleen. The mean GF pressure was 0.5 N +/- 1.0 (0-2.5) before SGV division and 0.1 N +/- 0.3 (0-1.5) after SGV division (P= 0.002). Initial tension was absent in 12 (52.2%) cases. GF tension did not correlate with any of the anatomic parameters. Our results show that: (i) GF tension does not correlate with anatomic parameters; and (ii) SGV division affects GF tension significantly. PMID:19222530

  12. Prospective, Randomized Ex Vivo Trial to Assess the Ideal Stapling Site for Endoscopic Fundoplication with Medigus Ultrasonic Surgical Endostapler

    PubMed Central

    2016-01-01

    Background and Aims. Endoscopic fundoplication is an emerging technique for the treatment of gastroesophageal reflux disease (GERD). The aim of this study is to determine the ideal position of the staples in relation to gastroesophageal junction (GEJ). Methods. Ten endoscopic fundoplication procedures were performed in each group using fresh ex vivo porcine stomachs: Group A: 2 staples each at 3 cm above the GEJ and 180° apart; Group B: 2 staples at 3 cm and 90° apart; Group C: 2 staples at 4 cm and 180° apart; Group D: 3 staples at 3 cm with 90° between each staple (180° total). After the procedure, the stomach was gradually filled with water. Gastric yield pressure (GYP) was determined by detection of reflux of the water in esophagus or by rupture of staples. Results. Mean increase of GYPs (±SD) after the procedure was as follows: Group A: 16.9 ± 8.7; Group B: 8.1 ± 7.9; Group C: 12.2 ± 9.4; Group D: 22.7 ± 13.3. GYP in Group A and Group D was higher than Group B (p = 0.03 and p = 0.01, resp.). Conclusions. We recommend the placement of 3 staples at 3 cm distance from the GEJ, which resulted in the highest increase of GYP. PMID:27547219

  13. Prospective Study of Laparoscopic Nissen Fundoplication in a Community Hospital and Its Effect on Typical, Atypical, and Nonspecific Gastrointestinal Symptoms

    PubMed Central

    Danielson, Amanda; Maxwell, J. Gary; Harris, James A.

    2007-01-01

    Background: Laparoscopic Nissen fundoplication (LNF) provides long-term improvement in the typical symptoms of gastroesophageal reflux disease. Few studies have prospectively addressed LNF in the community hospital or the effect of LNF on specific atypical symptoms, other related gastrointestinal symptoms, and weight change. Methods: Data were collected prospectively on consecutive patients having LNF. Three typical, 6 atypical, and 3 other gastrointestinal symptoms were studied. Results: Short-term data on 91 patients and long-term data on 84 patients were studied. Overall long-term improvement was 98%. Regarding typical symptoms, the greatest improvement occurred in heartburn and regurgitation. Regarding atypical symptoms, the greatest improvement occurred in cough and sore throat, but chest pain, hoarseness, and throat clearing also showed significant durable improvement. Bloating, nausea, and diarrhea showed no significant change from preoperative to postoperative surveys. Mild weight loss was common. Conclusion: LNF can be safely performed in a community hospital with results equal to those of university hospitals. Improvement in typical symptoms was greater than improvement in atypical symptoms, but results for both were significant and durable. Nonspecific gastrointestinal symptoms, such as nausea, bloating, and diarrhea, may be unrelated to Nissen fundoplication. PMID:17651559

  14. Transcriptional repression by RING finger protein TIF1 beta that interacts with the KRAB repressor domain of KOX1.

    PubMed Central

    Moosmann, P; Georgiev, O; Le Douarin, B; Bourquin, J P; Schaffner, W

    1996-01-01

    Many of the vertebrate zinc finger factors of the Kruppel type (C2H2 zinc fingers) contain in their N-terminus a conserved sequence referred to as the KRAB (Kruppel-associated box) domain that, when tethered to DNA, efficiently represses transcription. Using the yeast two-hybrid system, we have isolated an 835 amino acid RING finger (C3HC4 zinc finger) protein, TIF1 beta (also named KAP-1), that specifically interacts with the KRAB domain of the human zinc finger factor KOX1/ZNF10. TIF1 beta, TIF1 alpha, PML and efp belong to a characteristic subgroup of RING finger proteins that contain one or two other Cys/His-rich clusters (B boxes) and a putative coiled-coil in addition to the classical C3HC4 RING finger motif (RBCC configuration). Like TIF1 alpha, TIF1 beta also contains an additional Cys/His cluster (PHD finger) and a bromo-related domain. When tethered to DNA, TIF1 beta can repress transcription in transiently transfected mammalian cells both from promoter-proximal and remote (enhancer) positions, similarly to the KRAB domain itself. We propose that TIF1 beta is a mediator of the transcriptional repression exerted by the KRAB domain. PMID:9016654

  15. STAT5 is crucial to maintain leukemic stem cells in acute myelogenous leukemias induced by MOZ-TIF2.

    PubMed

    Tam, Winnie F; Hähnel, Patricia S; Schüler, Andrea; Lee, Benjamin H; Okabe, Rachel; Zhu, Nan; Pante, Saskia V; Raffel, Glen; Mercher, Thomas; Wernig, Gerlinde; Bockamp, Ernesto; Sasca, Daniel; Kreft, Andreas; Robinson, Gertraud W; Hennighausen, Lothar; Gilliland, D Gary; Kindler, Thomas

    2013-01-01

    MOZ-TIF2 is a leukemogenic fusion oncoprotein that confers self-renewal capability to hematopoietic progenitor cells and induces acute myelogenous leukemia (AML) with long latency in bone marrow transplantation assays. Here, we report that FLT3-ITD transforms hematopoietic cells in cooperation with MOZ-TIF2 in vitro and in vivo. Coexpression of FLT3-ITD confers growth factor independent survival/proliferation, shortens disease latency, and results in an increase in the number of leukemic stem cells (LSC). We show that STAT5, a major effector of aberrant FLT3-ITD signal transduction, is both necessary and sufficient for this cooperative effect. In addition, STAT5 signaling is essential for MOZ-TIF2-induced leukemic transformation itself. Lack of STAT5 in fetal liver cells caused rapid differentiation and loss of replating capacity of MOZ-TIF2-transduced cells enriched for LSCs. Furthermore, mice serially transplanted with Stat5(-/-) MOZ-TIF2 leukemic cells develop AML with longer disease latency and finally incomplete penetrance when compared with mice transplanted with Stat5(+/+) MOZ-TIF2 leukemic cells. These data suggest that STAT5AB is required for the self-renewal of LSCs and represents a combined signaling node of FLT3-ITD and MOZ-TIF2 driven leukemogenesis. Therefore, targeting aberrantly activated STAT5 or rewired downstream signaling pathways may be a promising therapeutic option. PMID:23149921

  16. The transcriptional co-regulators TIF2 and SRC-1 regulate energy homeostasis by modulating mitochondrial respiration in skeletal muscles

    PubMed Central

    Duteil, Delphine; Chambon, Céline; Ali, Faisal; Malivindi, Rocco; Zoll, Joffrey; Kato, Shigeaki; Geny, Bernard; Chambon, Pierre; Metzger, Daniel

    2010-01-01

    Summary The two p160 transcriptional co-regulator family members SRC-1 and TIF2 have important metabolic functions in white and brown adipose tissues, as well as in the liver. To analyze TIF2 cell-autonomous functions in skeletal muscles, we generated TIF2(i)skm-/- mice, in which TIF2 was selectively ablated in skeletal muscle myofibers at adulthood. We found that increased mitochondrial uncoupling in skeletal muscle myocytes protected these mice from decreased muscle oxidative capacities induced by sedentariness, delayed the development of type 2 diabetes and attenuated high caloric diet-induced obesity. Moreover, our results demonstrate that SRC-1 and TIF2 can modulate the expression of the uncoupling protein UCP3 in an antagonistic manner, and that enhanced SRC-1 levels in TIF2-deficient myofibers are critically involved in the metabolic changes of TIF2(i)skm-/- mice. Thus, modulation of the expression and/or activity of these co-regulators represents an attractive way to prevent or treat metabolic disorders. PMID:21035760

  17. Characterization of a new TiF(4) and β-cyclodextrin inclusion complex and its in vitro evaluation on inhibiting enamel demineralization.

    PubMed

    Nassur, Camila; Alexandria, Adílis Kalina; Pomarico, Luciana; de Sousa, Valeria Pereira; Cabral, Lúcio Mendes; Maia, Lucianne Cople

    2013-03-01

    Titanium tetrafluoride (TiF(4)) is an effective but instable caries preventive agent. As the stability problems could be minimized through the use of drug carriers this study aimed to prepare and characterize a new TiF(4) nanoinclusion complex and to evaluate its potential in inhibiting enamel demineralization under pH cycling conditions. The TiF(4) nanosystems were prepared using β-cyclodextrin (βCD) and sodium montmorillonite (MMTNa). Bovine enamel blocks (n=48) with known surface microhardness (SMH), were randomly assigned to 4 groups (n=12) and submitted to one of the following treatments: distilled deionized water (as negative control) and solutions containing 1% βCD, 1% TiF(4) and TiF(4):βCD. The solutions were blinded applied once on the blocks with a microbrush(®) on the surface for 1min before pH-cycling. After that, samples were reavaluated by SMH, %SMH loss, cross-sectional microhardness (CSMH), scanning electron microscope (SEM) and energy dispersive spectrometry (EDX). The inclusion complex of TiF(4):βCD offered better protection against demineralization in the subsurface. The SEM analysis showed that TiF(4) and TiF(4):βCD samples presented the most intact enamel than the control. The EDX analysis identified titanium in TiF(4) and TiF(4):βCD groups. TiF(4):βCD has higher potential on inhibiting demineralization in the inner enamel. TiF(4):βCD is a new alternative to TiF(4) stabilization in order to reduce enamel subsurface demineralization. PMID:23246339

  18. Development and Implementation Costs of Student Learning Objectives: Considerations for TIF Grantees

    ERIC Educational Resources Information Center

    Fermanich, Mark; Carl, Brad; Finster, Matthew

    2015-01-01

    This brief explores the costs of developing and implementing Student Learning Objectives (SLOs) in order to help Teacher Incentive Fund (TIF) grantees interested in adopting SLOs anticipate and understand the costs of implementing them in a district or school. The brief focuses on the costs involved with the initial design and implementation of an…

  19. Expression of the MOZ-TIF2 oncoprotein in mice represses senescence.

    PubMed

    Largeot, Anne; Perez-Campo, Flor Maria; Marinopoulou, Elli; Lie-a-Ling, Michael; Kouskoff, Valerie; Lacaud, Georges

    2016-04-01

    The MOZ-TIF2 translocation, which fuses monocytic leukemia zinc finger protein (MOZ) histone acetyltransferase (HAT) with the nuclear co-activator TIF2, is associated with the development of acute myeloid leukemia. We recently found that in the absence of MOZ HAT activity, p16(INK4a) transcriptional levels are significantly increased, triggering an early entrance into replicative senescence. Because oncogenic fusion proteins must bypass cellular safeguard mechanisms, such as senescence and apoptosis, to induce leukemia, we hypothesized that this repressive activity of MOZ over p16(INK4a) transcription could be preserved, or even reinforced, in MOZ leukemogenic fusion proteins, such as MOZ-TIF2. We describe here that, indeed, MOZ-TIF2 silences expression of the CDKN2A locus (p16(INK4a) and p19(ARF)), inhibits the triggering of senescence and enhances proliferation, providing conditions favorable to the development of leukemia. Furthermore, we describe that abolishing the MOZ HAT activity of the fusion protein leads to a significant increase in expression of the CDKN2A locus and the number of hematopoietic progenitors undergoing senescence. Finally, we report that inhibition of senescence by MOZ-TIF2 is associated with increased apoptosis, suggesting a role for the fusion protein in p53 apoptosis-versus-senescence balance. Our results underscore the importance of the HAT activity of MOZ, preserved in the fusion protein, for repression of the CDKN2A locus transcription and the subsequent block of senescence, a necessary step for the survival of leukemic cells. PMID:26854485

  20. Expression of the MOZ-TIF2 oncoprotein in mice represses senescence

    PubMed Central

    Largeot, Anne; Perez-Campo, Flor Maria; Marinopoulou, Elli; Lie-a-Ling, Michael; Kouskoff, Valerie; Lacaud, Georges

    2016-01-01

    The MOZ-TIF2 translocation, which fuses monocytic leukemia zinc finger protein (MOZ) histone acetyltransferase (HAT) with the nuclear co-activator TIF2, is associated with the development of acute myeloid leukemia. We recently found that in the absence of MOZ HAT activity, p16INK4a transcriptional levels are significantly increased, triggering an early entrance into replicative senescence. Because oncogenic fusion proteins must bypass cellular safeguard mechanisms, such as senescence and apoptosis, to induce leukemia, we hypothesized that this repressive activity of MOZ over p16INK4a transcription could be preserved, or even reinforced, in MOZ leukemogenic fusion proteins, such as MOZ-TIF2. We describe here that, indeed, MOZ-TIF2 silences expression of the CDKN2A locus (p16INK4a and p19ARF), inhibits the triggering of senescence and enhances proliferation, providing conditions favorable to the development of leukemia. Furthermore, we describe that abolishing the MOZ HAT activity of the fusion protein leads to a significant increase in expression of the CDKN2A locus and the number of hematopoietic progenitors undergoing senescence. Finally, we report that inhibition of senescence by MOZ-TIF2 is associated with increased apoptosis, suggesting a role for the fusion protein in p53 apoptosis-versus-senescence balance. Our results underscore the importance of the HAT activity of MOZ, preserved in the fusion protein, for repression of the CDKN2A locus transcription and the subsequent block of senescence, a necessary step for the survival of leukemic cells. PMID:26854485

  1. Laparoscopic Fundoplication with or Without Pyloroplasty in Patients with Gastroesophageal Reflux Disease After Lung Transplantation: How I Do It

    PubMed Central

    Davis, Christopher S.; Jellish, W. Scott

    2011-01-01

    Introduction Several studies have confirmed that gastroesophageal reflux disease (GERD) in lung transplant patients is a risk factor for the development and progression of bronchiolitis obliterans syndrome (BOS), a form of rejection after lung transplantation. Moreover, numerous reports indicate that surgical correction of GERD may control the decline in lung function characteristic of BOS. Although laparoscopic fundoplication is an accepted treatment option for these patients with GERD, the surgical technique, which often includes a laparoscopic pyloroplasty, has not been standardized. Methods The purpose of this article is to describe a step-by-step approach to the laparoscopic treatment of GERD in lung transplant patients. We also address specific technical concerns encountered in the surgical management of this high-risk patient population; we provide data on the safety of this operation; and we illustrate the evidence-based rationale for each technical step of the procedure. PMID:20499201

  2. Protective effect of experimental mouthrinses containing NaF and TiF4 on dentin erosive loss in vitro

    PubMed Central

    de CASTILHO, Aline Rogéria Freire; SALOMÃO, Priscila Maria Aranda; BUZALAF, Marília Afonso Rabelo; MAGALHÃES, Ana Carolina

    2015-01-01

    Objective This in vitro study assessed the anti-erosive effect of experimental mouthrinses containing TiF4 and NaF on dentin erosive loss. Material and Methods Bovine dentin specimens were randomly allocated into the groups (n=15): 1) SnCl2/NaF/AmF (Erosion Protection®/GABA, pH 4.5, positive control); 2) experimental solution with 0.0815% TiF4 (pH 2.5); 3) 0.105% NaF (pH 4.5); 4) 0.042% NaF+0.049% TiF4 (pH 4.4); 5) 0.063% NaF+0.036% TiF4 (pH 4.5); 6) no treatment (negative control). Each specimen was cyclically demineralized (Sprite Zero, pH 2.6, 4x90 s/day) and exposed to artificial saliva between the erosive challenges for 7 days. The treatment with the fluoride solutions was done 2x60 s/day, immediately after the first and the last erosive challenges of the day. Dentin erosive loss was measured by profilometry (μm). The data were analyzed using Kruskal Wallis/Dunn tests (p<0.05). Results Mouthrinses containing TiF4 or Sn/F were able to show some protective effect against dentin erosive loss compared to negative control. The best anti-erosive effect was found for experimental solution containing 0.0815% TiF4 (100% reduction in dentin loss), followed by 0.042% NaF+0.049% TiF4 (58.3%), SnCl2/NaF/AmF (52%) and 0.063% NaF+0.036% TiF4 (40%). NaF solution (13.3%) did not significantly differ from control. Conclusion The daily application of experimental mouthrinse containing TiF4 and NaF has the ability to reduce dentin erosion, as well as Erosion Protection® and TiF4 alone. PMID:26537719

  3. TIF1β functions as a coactivator for C/EBPβ and is required for induced differentiation in the myelomonocytic cell line U937

    PubMed Central

    Rooney, John W.; Calame, Kathryn L.

    2001-01-01

    Representational difference analysis (RDA) cloning has identified transcriptional intermediary factor 1 beta (TIF1β) as a gene inducibly expressed early during myeloid differentiation of the promyelocytic cell lines HL-60 and U937. To assess the role of TIF1β, U937 cell lines were made that expressed antisense-hammerhead ribozymes targeted specifically against TIF1β mRNA. These cells failed to differentiate into macrophages, as determined by several criteria: a nonadherent morphology, a failure to arrest cell cycle, lowered levels of macrophage-specific cell surface markers, resistance to Legionella pneumophila infection, a loss of the ability to phagocytose and chemotax, and decreased expression of chemokine mRNAs. One way TIF1β acts in macrophage differentiation is to augment C/EBPβ transcriptional activity. Furthermore, we show by EMSA supershifts and coimmunoprecipitation that C/EBPβ and TIF1β physically interact. Although TIF1β is necessary for macrophage differentiation of U937 cells, it is not sufficient, based on the inability of ectopically expressed TIF1β to induce or augment phorbol ester-induced macrophage differentiation. We conclude that TIF1β plays an important role in the terminal differentiation program of macrophages, which involves the coactivation of C/EBPβ and induction of C/EBPβ-responsive myeloid genes. PMID:11711437

  4. Identification of EhTIF-IA: The putative E. histolytica orthologue of the human ribosomal RNA transcription initiation factor-IA.

    PubMed

    Srivastava, Ankita; Bhattacharya, Alok; Bhattacharya, Sudha; Jhingan, Gagan Deep

    2016-03-01

    Initiation of rDNA transcription requires the assembly of a specific multi-protein complex at the rDNA promoter containing the RNA Pol I with auxiliary factors. One of these factors is known as Rrn3P in yeast and Transcription Initiation Factor IA (TIF-IA) in mammals. Rrn3p/TIF-IA serves as a bridge between RNA Pol I and the pre-initiation complex at the promoter. It is phosphorylated at multiple sites and is involved in regulation of rDNA transcription in a growth-dependent manner. In the early branching parasitic protist Entamoeba histolytica, the rRNA genes are present exclusively on circular extra chromosomal plasmids. The protein factors involved in regulation of rDNA transcription in E. histolytica are not known. We have identified the E. histolytica equivalent of TIF-1A (EhTIF-IA) by homology search within the database and was further cloned and expressed. Immuno-localization studies showed that EhTIF-IA co-localized partially with fibrillarin in the peripherally localized nucleolus. EhTIF-IA was shown to interact with the RNA Pol I-specific subunit RPA12 both in vivo and in vitro. Mass spectroscopy data identified RNA Pol I-specific subunits and other nucleolar proteins to be the interacting partners of EhTIF-IA. Our study demonstrates for the first time a conserved putative RNA Pol I transcription factor TIF-IA in E. histolytica. PMID:26949087

  5. Taking TiF4 complexes to extremes--the first examples with phosphine co-ligands.

    PubMed

    Jura, Marek; Levason, William; Petts, Edmund; Reid, Gillian; Webster, Michael; Zhang, Wenjian

    2010-11-14

    The first soft donor adducts of TiF(4), [TiF(4)(diphosphine)] (diphosphine = o-C(6)H(4)(PMe(2))(2), R(2)P(CH(2))(2)PR(2), R = Me or Et) have been prepared from [TiF(4)(MeCN)(2)] and the diphosphines in rigorously anhydrous CH(2)Cl(2), as extremely moisture sensitive yellow solids, and characterised by multinuclear NMR ((1)H, (31)P, (19)F), IR and UV/vis spectroscopy. The crystal structure of [TiF(4){Et(2)P(CH(2))(2)PEt(2)}] has been determined and shows a distorted six-coordinate geometry with disparate Ti-F(transF) and Ti-F(transP) distances and long Ti-P bonds. Weaker soft donor ligands including Ph(3)P, Ph(2)P(CH(2))(2)PPh(2), o-C(6)H(4)(PPh(2))(2), Ph(2)As(CH(2))(2)AsPh(2), o-C(6)H(4)(AsMe(2))(2) and (i)PrS(CH(2))(2)S(i)Pr do not form stable complexes with TiF(4), although surprisingly, fluorotitanate(IV) salts of the previously unknown doubly protonated ligand cations [LH(2)][Ti(4)F(18)] (L = o-C(6)H(4)(PPh(2))(2), o-C(6)H(4)(AsMe(2))(2) and (i)PrS(CH(2))(2)S(i)Pr) are formed in some cases as minor by-products. The structure of [o-C(6)H(4)(PPh(2)H)(2)][Ti(4)F(18)] shows the first authenticated example of a diprotonated o-phenylene-diphosphine. The synthesis and full spectroscopic characterisation are reported for a range of TiF(4) adducts with hard N- or O-donor ligands for comparison purposes, along with crystal structures of [TiF(4)(thf)(2)], [TiF(4)(Ph(3)EO)(2)]·2CH(2)Cl(2) (E = P or As), and [TiF(4)(bipy)]. PMID:20882256

  6. Thickness and nanomechanical properties of protective layer formed by TiF4 varnish on enamel after erosion.

    PubMed

    Medeiros, Maria Isabel Dantas de; Carlo, Hugo Lemes; Lacerda-Santos, Rogério; Lima, Bruno Alessandro Guedes de; Souza, Frederico Barbosa de; Rodrigues, Jonas Almeida; Carvalho, Fabiola Galbiatti de

    2016-05-31

    The layer formed by fluoride compounds on tooth surface is important to protect the underlying enamel from erosion. However, there is no investigation into the properties of protective layer formed by NaF and TiF4 varnishes on eroded enamel. This study aimed to evaluate the thickness, topography, nanohardness, and elastic modulus of the protective layer formed by NaF and TiF4 varnishes on enamel after erosion using nanoindentation and atomic force microscopy (AFM). Human enamel specimens were sorted into control, NaF, and TiF4 varnish groups (n = 10). The initial nanohardness and elastic modulus values were obtained and varnishes were applied to the enamel and submitted to erosive challenge (10 cycles: 5 s cola drink/5 s artificial saliva). Thereafter, nanohardness and elastic modulus were measured. Both topography and thickness were evaluated by AFM. The data were subjected to ANOVA, Tukey's test and Student's t test (α = 0.05). After erosion, TiF4 showed a thicker protective layer compared to the NaF group and nanohardness and elastic modulus values were significantly lower than those of the control group. It was not possible to measure nanohardness and elastic modulus in the NaF group due to the thin protective layer formed. AFM showed globular deposits, which completely covered the eroded surface in the TiF4 group. After erosive challenge, the protective layer formed by TiF4 varnish showed significant properties and it was thicker than the layer formed by NaF varnish. PMID:27253145

  7. Evaluation of fluoride release from experimental TiF4 and NaF varnishes in vitro

    PubMed Central

    COMAR, Livia Picchi; de SOUZA, Beatriz Martines; GRIZZO, Larissa Tercilia; BUZALAF, Marília Afonso Rabelo; MAGALHÃES, Ana Carolina

    2014-01-01

    Fluoride varnishes play an important role in the prevention of dental caries, promoting the inhibition of demineralization and the increase of remineralization. Objective This study aimed to analyze the amount of fluoride released into water and artificial saliva from experimental TiF4 and NaF varnishes, with different concentrations, for 12 h. Material and Methods Fluoride varnishes were applied on acrylic blocks and then immersed in 10 ml of deionized water and artificial saliva in polystyrene bottles. The acrylic blocks were divided in seven groups (n=10): 1.55% TiF4 varnish (0.95% F, pH 1.0); 3.10% TiF4 varnish (1.90% F, pH 1.0); 3.10% and 4% TiF4 varnish (2.45% F, pH 1.0); 2.10% NaF varnish (0.95% F, pH 5.0); 4.20% NaF varnish (1.90% F, pH 5.0); 5.42% NaF varnish (2.45% F, pH 5.0) and control (no treatment, n=5). The fluoride release was analyzed after 1/2, 1, 3, 6, 9 and 12 h of exposure. The analysis was performed using an ion-specific electrode coupled to a potentiometer. Two-way ANOVA and Bonferroni's test were applied for the statistical analysis (p<0.05). Results TiF4 varnishes released larger amounts of fluoride than NaF varnishes during the first 1/2 h, regardless of their concentration; 4% TiF4 varnish released more fluoride than NaF varnishes for the first 6 h. The peak of fluoride release occurred at 3 h. There was a better dose-response relationship among the varnishes exposed to water than to artificial saliva. Conclusions The 3.10% and 4% TiF4 -based varnishes have greater ability to release fluoride into water and artificial saliva compared to NaF varnish; however, more studies must be conducted to elucidate the mechanism of action of TiF4 varnish on tooth surface. PMID:24676585

  8. Evaluating Student-Teacher Linkage Data in Teacher Incentive Fund (TIF) Sites: Acquisition, Verification, and System Development. The Harvesting Project

    ERIC Educational Resources Information Center

    Watson, Jeffery; Witham, Peter; St. Louis, Timothy

    2010-01-01

    The U.S. Department of Education Teacher Incentive Fund (TIF) seeks to transform education compensation systems so that principal and teacher performance (measured through classroom productivity measures) connects to compensation. Classroom-level productivity measures require robust student-teacher linkage data. Organizations such as the…

  9. Co-precipitation synthesis and luminescence properties of K2 TiF6 :Mn(4+) red phosphors for warm white light-emitting diodes.

    PubMed

    Liao, Jinsheng; Nie, Liling; Zhong, Laifu; Gu, Qingjie; Wang, Qi

    2016-05-01

    K2 TiF6 :Mn(4+) red phosphors with different Mn(4+) doping concentrations were obtained using the co-precipitation method. X-Ray diffraction, scanning electron microscopy, Raman spectra, Fourier transform infrared spectroscopy, photoluminescence excitation and emission spectra and decay curves were used to characterize the properties of K2 TiF6 :Mn(4+) phosphors. Under excitation at 470 nm, an intense red emission peak around 631 nm corresponding to the (2) Eg -(4) A2 transition of Mn(4+) was observed for 2.48 mol% K2 TiF6 :Mn(4+) phosphors and was used as the optimum doping concentration. The excellent luminescent properties of K2 TiF6 :Mn(4+) suggest that this material might be a promising red phosphor for generating warm white light in phosphor-converted white light-emitting diodes. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26387574

  10. LKB1 promotes cell survival by modulating TIF-IA-mediated pre-ribosomal RNA synthesis under uridine downregulated conditions

    PubMed Central

    Liu, Xiuju; Huang, Henry; Wilkinson, Scott C.; Zhong, Diansheng; Khuri, Fadlo R.; Fu, Haian; Marcus, Adam; He, Yulong; Zhou, Wei

    2016-01-01

    We analyzed the mechanism underlying 5-aminoimidazole-4-carboxamide riboside (AICAR) mediated apoptosis in LKB1-null non-small cell lung cancer (NSCLC) cells. Metabolic profile analysis revealed depletion of the intracellular pyrimidine pool after AICAR treatment, but uridine was the only nucleotide precursor capable of rescuing this apoptosis, suggesting the involvement of RNA metabolism. Because half of RNA transcription in cancer is for pre-ribosomal RNA (rRNA) synthesis, which is suppressed by over 90% after AICAR treatment, we evaluated the role of TIF-IA-mediated rRNA synthesis. While the depletion of TIF-IA by RNAi alone promoted apoptosis in LKB1-null cells, the overexpression of a wild-type or a S636A TIF-IA mutant, but not a S636D mutant, attenuated AICAR-induced apoptosis. In LKB1-null H157 cells, pre-rRNA synthesis was not suppressed by AICAR when wild-type LKB1 was present, and cellular fractionation analysis indicated that TIF-IA quickly accumulated in the nucleus in the presence of a wild-type LKB1 but not a kinase-dead mutant. Furthermore, ectopic expression of LKB1 was capable of attenuating AICAR-induced death in AMPK-null cells. Because LKB1 promotes cell survival by modulating TIF-IA-mediated pre-rRNA synthesis, this discovery suggested that targeted depletion of uridine related metabolites may be exploited in the clinic to eliminate LKB1-null cancer cells. PMID:26506235

  11. Differential ligand-dependent interactions between the AF-2 activating domain of nuclear receptors and the putative transcriptional intermediary factors mSUG1 and TIF1.

    PubMed Central

    vom Baur, E; Zechel, C; Heery, D; Heine, M J; Garnier, J M; Vivat, V; Le Douarin, B; Gronemeyer, H; Chambon, P; Losson, R

    1996-01-01

    Using a yeast two-hybrid system we report the isolation of a novel mouse protein, mSUG1, that interacts with retinoic acid receptor alpha (RAR alpha) both in yeast cells and in vitro in a ligand- and AF-2 activating domain (AF-2 AD)-dependent manner and show that it is a structural and functional homologue of the essential yeast protein SUG1. mSUG1 also efficiently interacts with other nuclear receptors, including oestrogen (ER), thyroid hormone (TR), Vitamin D3 (VDR) and retinoid X (RXR) receptors. By comparing the interaction properties of these receptors with mSUG1 and TIF1, we demonstrate that: (i) RXR alpha efficiently interacts with TIF1, but not with mSUG1, whereas TR alpha interacts much more efficiently with mSUG1 than with TIF1, and RAR alpha, VDR and ER efficiently interact with mSUG1 and TIF1; (ii) the amphipathic alpha-helix core of the AF-2 AD is differentially involved in interactions of RAR alpha with mSUG1 and TIF1; (iii) the AF-2 AD cores of RAR alpha and ER are similarly involved in their interaction with TIF1, but not with mSUG1. Thus, the interaction interfaces between the different receptors and either mSUG1 or TIF1 may vary depending on the nature of the receptor and the putative mediator of its AF-2 function. We discuss the possibility that mSUG1 and TIF1 may mediate the transcriptional activity of the AF-2 of nuclear receptors through different mechanisms. Images PMID:8598193

  12. Observation of TiF+ by Velocity Modulation Laser Spectroscopy and Analysis of the

    PubMed

    Focsa; Pinchemel; Collet; Huet

    1998-06-01

    The molecular ion TiF+ has been observed for the first time using high-resolution spectroscopy. The ions were produced in the positive column of an AC glow discharge with a gas mixture of He/TiF4. A single-mode cw dye laser along with the velocity modulation detection technique was used to record an absorption spectrum in the spectral region 16 800-18 600 cm-1. The observed system was assigned to the 0-0 and 1-1 bands of the [17.6]3Delta-X3Phi transition of TiF+. The rotational analysis of the main subbands has been performed up to J values equal to 77 and 56 for the 0-0 and 1-1 bands, respectively. Despite a careful search, no intercombination band was observed. A set of effective molecular parameters has been determined, characterizing the v = 0, 1 levels of the [17.6]3Delta and X3Phi states. The spin-orbit constants Ae and the vibrational constants omegae, omegaexe have been estimated for both electronic states, as well as their equilibrium distances Re (1.7509 and 1.7800) Å for the [17.6]3Delta and X3Phi states, respectively). Copyright 1998 Academic Press. PMID:9647721

  13. Simultaneous laparoscopic Nissen fundoplication and percutaneous endoscopic gastrostomy to treat an elderly patient with a large paraesophageal hernia: a case report.

    PubMed

    Mimatsu, Kenji; Oida, Takatsugu; Kida, Kazutoshi; Fukino, Nobutada; Kawasaki, Atsushi; Kano, Hisao; Kuboi, Youichi; Amano, Sadao

    2014-05-01

    Laparoscopic Nissen fundoplication (LNF) and gastrostomy are often performed in children with gastroesophageal reflux disease. With a population that is increasingly aging, the number of elderly patients with paraesophageal hernia who have a nutritional disorder due to dysphagia has increased. In these patients with feeding difficulties, LNF and percutaneous endoscopic gastrostomy (PEG) are effective procedures for providing nutritional support. Here, we describe the case of an 82-year-old woman with paraesophageal hernia and certain comorbidities. She was receiving enteral feeding through a nasogastric tube, which was discontinued because aspiration pneumonia occurred. Therefore, LNF and crural repair without mesh placement were performed. The PEG tube was placed using the Ponsky pull technique under direct visualization with a laparoscope and gastroscope. The patient's nutritional status improved after she received enteral nutrition through the PEG tube. Thus, LNF and PEG may be useful techniques for nutritional support in elderly patients with a large paraesophageal hernia. PMID:24754880

  14. Aircraft motion and passenger comfort response data from TIFS ride-quality flight experiments

    NASA Technical Reports Server (NTRS)

    Schoonover, W. E., Jr.

    1976-01-01

    The aircraft motion data and passenger comfort response data obtained during ride-quality flight experiments using the USAD Total In-Flight Simulator (TIFS) are given. During each of 40 test flights, 10 passenger subjects individually assessed the ride comfort of various types of aircraft motions. The 115 individuals who served as passenger subjects were selected to be representative of air travelers in general. Aircraft motions tested consisted of both random and sinusoidal oscillations in various combinations of five degrees of freedom (transverse, normal, roll, pitch, and yaw), as well as of terminal-area flight maneuvers. The data are sufficiently detailed to allow analysis of passenger reactions to flight environments, evaluation of the use of a portable environment measuring/recording system and comparison of the in-flight simulator responses with input commands.

  15. TIF-IA-Dependent Regulation of Ribosome Synthesis in Drosophila Muscle Is Required to Maintain Systemic Insulin Signaling and Larval Growth

    PubMed Central

    Ghosh, Abhishek; Rideout, Elizabeth J.; Grewal, Savraj S.

    2014-01-01

    The conserved TOR kinase signaling network links nutrient availability to cell, tissue and body growth in animals. One important growth-regulatory target of TOR signaling is ribosome biogenesis. Studies in yeast and mammalian cell culture have described how TOR controls rRNA synthesis—a limiting step in ribosome biogenesis—via the RNA Polymerase I transcription factor TIF-IA. However, the contribution of TOR-dependent ribosome synthesis to tissue and body growth in animals is less clear. Here we show in Drosophila larvae that ribosome synthesis in muscle is required non-autonomously to maintain normal body growth and development. We find that amino acid starvation and TOR inhibition lead to reduced levels of TIF-IA, and decreased rRNA synthesis in larval muscle. When we mimic this decrease in muscle ribosome synthesis using RNAi-mediated knockdown of TIF-IA, we observe delayed larval development and reduced body growth. This reduction in growth is caused by lowered systemic insulin signaling via two endocrine responses: reduced expression of Drosophila insulin-like peptides (dILPs) from the brain and increased expression of Imp-L2—a secreted factor that binds and inhibits dILP activity—from muscle. We also observed that maintaining TIF-IA levels in muscle could partially reverse the starvation-mediated suppression of systemic insulin signaling. Finally, we show that activation of TOR specifically in muscle can increase overall body size and this effect requires TIF-IA function. These data suggest that muscle ribosome synthesis functions as a nutrient-dependent checkpoint for overall body growth: in nutrient rich conditions, TOR is required to maintain levels of TIF-IA and ribosome synthesis to promote high levels of systemic insulin, but under conditions of starvation stress, reduced muscle ribosome synthesis triggers an endocrine response that limits systemic insulin signaling to restrict growth and maintain homeostasis. PMID:25356674

  16. Longitudinal comparison of quality of life in patients undergoing laparoscopic Toupet fundoplication versus magnetic sphincter augmentation: Observational cohort study with propensity score analysis.

    PubMed

    Asti, Emanuele; Bonitta, Gianluca; Lovece, Andrea; Lazzari, Veronica; Bonavina, Luigi

    2016-07-01

    Only a minority of patients with gastro-esophageal reflux disease (GERD) are offered a surgical option. This is mostly due to the fear of potential side effects, the variable success rate, and the extreme alteration of gastric anatomy with the current gold standard, the laparoscopic Nissen fundoplication. It has been reported that laparoscopic Toupet fundoplication (LTF) and laparoscopic sphincter augmentation using a magnetic device (LINX) can treat reflux more physiologically and with a lower incidence of side-effects and reoperation rate. We present the first comparing quality of life in patients undergoing LTF versus LINX.Observational cohort study. Consecutive patients undergoing LTF or LINX over the same time period were compared by using the propensity score full matching method and generalized estimating equation. Criteria of exclusion were >3 cm hiatal hernia, grade C-D esophagitis, ineffective esophageal motility, body mass index >35, and previous upper abdominal surgery. The primary study outcome was quality of life measured with the Gastro-Esophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) questionnaire. Secondary outcomes were proton pump inhibitors (PPI) use, presence of gas-related symptoms or dysphagia, and reoperation-free probability.Between March 2007 and July 2014, 238 patients with GERD met the criteria of inclusion in the study. Of these, 103 underwent an LTF and 135 a LINX procedure. All patients had a minimum 1-year follow-up. Over time, patients in both groups had similar GERD-HRQL scores (odds ratio [OR] 1.04, confidence interval [CI] 0.89-1.27; P = 0.578), PPI use (OR 1.18, CI 0.81-1.70; P = 0.388), gas-related symptoms (OR 0.69, CI 0.21-2.28; P = 0.542), dysphagia (OR 0.62, CI 0.26-1.30; P = 0.241), and reoperation-free probability (stratified log-rank test = 0.556).In 2 concurrent cohorts of patients with early stage GERD undergoing LTF or LINX and matched by propensity score analysis, health

  17. Trim33/Tif1γ is involved in late stages of granulomonopoiesis in mice.

    PubMed

    Chrétien, Marie-Lorraine; Legouge, Caroline; Martin, Romain Z; Hammann, Arlette; Trad, Malika; Aucagne, Romain; Largeot, Anne; Bastie, Jean-Noël; Delva, Laurent; Quéré, Ronan

    2016-08-01

    Trim33/Tif1γ (Trim33) is a member of the tripartite motif family. Using a conditional hematopoietic-specific Trim33 knock-out (Trim33(Δ/Δ)) mouse, we showed previously that Trim33 deficiency in hematopoietic stem cells leads to severe defects in hematopoiesis, resembling the main features of human chronic myelomonocytic leukemia. We also demonstrated that Trim33 is involved in hematopoietic aging through TGFβ signaling. Nevertheless, how Trim33 contributes to the terminal stages of myeloid differentiation remains to be clarified. We reveal here the crucial role of Trim33 expression in the control of mature granulomonocytic differentiation. An important component of Trim33-deficient mice is the alteration of myeloid differentiation, as characterized by dysplastic features, abnormal granulocyte and monocyte maturation, and the expansion of CD11b(+)Ly6G(high)Ly6C(low) myeloid cells, which share some features with polymorphonuclear-myeloid-derived suppressor cells. Moreover, in Trim33(Δ/Δ) mice, we observed the alteration of CSF-1-mediated macrophage differentiation in association with the lack of Csf-1 receptor. Altogether, these results indicate that Trim33 deficiency leads to the expansion of a subset of myeloid cells characterizing the myelodysplastic/myeloproliferative neoplasm. PMID:27130375

  18. Emission and transport of 1,3-dichloropropene and chloropicrin in a large field tarped with VaporSafe TIF.

    PubMed

    Gao, Suduan; Ajwa, Husein; Qin, Ruijun; Stanghellini, Michael; Sullivan, David

    2013-01-01

    Tarping fumigated fields with low permeability films such as commercial Totally Impermeable Film (TIF) can significantly reduce emissions, but it can also increase fumigant residence time in the soil such that extended tarp-covering durations may be required to address potential exposure risks during tarp-cutting and removal. In an effort to develop safe practices for using TIF, a large field study was conducted in the San Joaquin Valley of California. Comprehensive data on emissions (measured with dynamic flux chambers), fate, and transport of 1,3-dichloropropene and chloropicrin were collected in a 3.3 ha field fumigated with Pic-Clor 60 via broadcast shank application. Low emission flux (below 15 μg m(-2) s(-1)) was observed from the tarped field throughout the tarp-covering period of 16 days with total emission loss of <8% of total applied for both chemicals. Although substantially higher flux was measured at tarp edges (up to 440 μg m(-2) s(-1)), the flux was reduced to below 0.5 μg m(-2) s(-1) beyond 2 m of tarp edge where total mass loss was estimated to be ≤ 1% of total applied to the field. Emission flux increased following tarp-cutting, but was much lower compared to 5 or 6 d tarp-covering periods determined in other fields. This study demonstrated the ability of TIF to significantly reduce fumigant emissions with supporting data on fumigant movement in soil. Proper management on use of the tarp, such as extending tarp-covering period, can reduce negative impact on the environment and help maintain the beneficial use of soil fumigants for agricultural productions. PMID:23171232

  19. Implementation and Impacts of Pay-for-Performance: The 2010 Teacher Incentive Fund (TIF) Grantees after Two Years. NCEE Study Snapshot. NCEE 2015-4022

    ERIC Educational Resources Information Center

    National Center for Education Evaluation and Regional Assistance, 2015

    2015-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  20. Registration of Peanut Germplasm Line TifGP-1 with Resistance to the Root-knot Nematode and Tomato Spotted Wilt Virus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    TifGP-1 (Reg. No. , PI ) is a runner-type peanut (Arachis hypogaea L. subsp. hypogaea var. hypogaea) germplasm line that was released by the USDA-ARS and the Georgia Agricultural Experiment Stations in 2006. This material was released based on resistance to both tomato spotted wilt (caused b...

  1. The N-terminal part of TIF1, a putative mediator of the ligand-dependent activation function (AF-2) of nuclear receptors, is fused to B-raf in the oncogenic protein T18.

    PubMed Central

    Le Douarin, B; Zechel, C; Garnier, J M; Lutz, Y; Tora, L; Pierrat, P; Heery, D; Gronemeyer, H; Chambon, P; Losson, R

    1995-01-01

    Nuclear receptors (NRs) bound to response elements mediate the effects of cognate ligands on gene expression. Their ligand-dependent activation function, AF-2, presumably acts on the basal transcription machinery through intermediary proteins/mediators. We have isolated a mouse nuclear protein, TIF1, which enhances RXR and RAR AF-2 in yeast and interacts in a ligand-dependent manner with several NRs in yeast and mammalian cells, as well as in vitro. Remarkably, these interactions require the amino acids constituting the AF-2 activating domain conserved in all active NRs. Moreover, the oestrogen receptor (ER) AF-2 antagonist hydroxytamoxifen cannot promote ER-TIF1 interaction. We propose that TIF1, which contains several conserved domains found in transcriptional regulatory proteins, is a mediator of ligand-dependent AF-2. Interestingly, the TIF1 N-terminal moiety is fused to B-raf in the mouse oncoprotein T18. Images PMID:7744009

  2. New Gene Evolution in the Bonus-TIF1-γ/TRIM33 Family Impacted the Architecture of the Vertebrate Dorsal–Ventral Patterning Network

    PubMed Central

    Wisotzkey, Robert G.; Quijano, Janine C.; Stinchfield, Michael J.; Newfeld, Stuart J.

    2014-01-01

    Uncovering how a new gene acquires its function and understanding how the function of a new gene influences existing genetic networks are important topics in evolutionary biology. Here, we demonstrate nonconservation for the embryonic functions of Drosophila Bonus and its newest vertebrate relative TIF1-γ/TRIM33. We showed previously that TIF1-γ/TRIM33 functions as an ubiquitin ligase for the Smad4 signal transducer and antagonizes the Bone Morphogenetic Protein (BMP) signaling network underlying vertebrate dorsal–ventral axis formation. Here, we show that Bonus functions as an agonist of the Decapentaplegic (Dpp) signaling network underlying dorsal–ventral axis formation in flies. The absence of conservation for the roles of Bonus and TIF1-γ/TRIM33 reveals a shift in the dorsal–ventral patterning networks of flies and mice, systems that were previously considered wholly conserved. The shift occurred when the new gene TIF1-γ/TRIM33 replaced the function of the ubiquitin ligase Nedd4L in the lineage leading to vertebrates. Evidence of this replacement is our demonstration that Nedd4 performs the function of TIF1-γ/TRIM33 in flies during dorsal–ventral axis formation. The replacement allowed vertebrate Nedd4L to acquire novel functions as a ubiquitin ligase of vertebrate-specific Smad proteins. Overall our data reveal that the architecture of the Dpp/BMP dorsal–ventral patterning network continued to evolve in the vertebrate lineage, after separation from flies, via the incorporation of new genes. PMID:24881051

  3. Electrochemical Behaviour and Electrorefining of Cobalt in NaCl-KCl-K2TiF6 Melt

    NASA Astrophysics Data System (ADS)

    Kuznetsov, Sergey A.; Kazakova, Olga S.; Makarova, Olga V.

    2009-08-01

    The electrorefining of cobalt in NaCl-KCl-K2TiF6 (20 wt%) melt has been investigated. It was shown that complexes of Ti(III) and Co(II) appeared in the melt due to the reaction 2Ti(IV) + Co → 2Ti(III) + Co(II) and this reaction was entirely shifted to the right hand side. On the base of linear sweep voltammetry diagnostic criteria it was found that the discharge of Co(II) to Co metal is controlled by diffusion. The limiting current density of discharge Co(II) to metal in NaCl-KCl-K2TiF6 (20 wt%) melt was determined by steady-state voltammetry. The electrorefining of cobalt was carried out in hermetic electrolyser under argon atmosphere. Initial cathodic current density was changed from 0.2 Acm-2 up to 0.7 Acm-2, the electrolysis temperature varied within 973 - 1123 K. Behaviour of impurities during cobalt electrorefining was discussed. It was shown that electrorefining led to the elimination of most of the interstitial impurities (H2, N2, O2, C), with the result that the remaining impurity levels below 10 ppm impart high ductility to cobalt.

  4. The Total In-Flight Simulator (TIFS) aerodynamics and systems: Description and analysis. [maneuver control and gust alleviators

    NASA Technical Reports Server (NTRS)

    Andrisani, D., II; Daughaday, H.; Dittenhauser, J.; Rynaski, E.

    1978-01-01

    The aerodynamics, control system, instrumentation complement and recording system of the USAF Total In/Flight Simulator (TIFS) airplane are described. A control system that would allow the ailerons to be operated collectively, as well as, differentially to entrance the ability of the vehicle to perform the dual function of maneuver load control and gust alleviation is emphasized. Mathematical prediction of the rigid body and the flexible equations of longitudinal motion using the level 2.01 FLEXSTAB program are included along with a definition of the vehicle geometry, the mass and stiffness distribution, the calculated mode frequencies and mode shapes, and the resulting aerodynamic equations of motion of the flexible vehicle. A complete description of the control and instrumentation system of the aircraft is presented, including analysis, ground test and flight data comparisons of the performance and bandwidth of the aerodynamic surface servos. Proposed modification for improved performance of the servos are also presented.

  5. TiF4 and NaF varnishes as anti-erosive agents on enamel and dentin erosion progression in vitro

    PubMed Central

    COMAR, Livia Picchi; CARDOSO, Cristiane de Almeida Baldini; CHARONE, Senda; GRIZZO, Larissa Tercilia; BUZALAF, Marília Afonso Rabelo; MAGALHÃES, Ana Carolina

    2015-01-01

    Objective This study assessed the effect of fluoride varnishes on the progression of tooth erosion in vitro. Material and Methods: Forty-eight enamel and 60 root dentin samples were previously demineralized (0.1% citric acid, pH 2.5, 30 min), leading to a baseline and erosive wear of 12.9 and 11.4 µm, respectively. The samples were randomly treated (6 h) with a 4% TiF4 varnish (2.45%F-, pH 1.0), a 5.42% NaF varnish (2.45%F-, pH 5.0), a placebo varnish and no varnish (control). The samples were then subjected to erosive pH cycles (4x90 s/day in 0.1% citric acid, intercalated with artificial saliva) for 5 days. The increment of the erosive tooth wear was calculated. In the case of dentin, this final measurement was done with and without the demineralized organic matrix (DOM). Enamel and dentin data were analyzed using ANOVA/Tukey’s and Kruskal-Wallis/Dunn tests, respectively (p<0.05). Results The TiF4 (mean±s.d: 1.5±1.1 µm) and NaF (2.1±1.7 µm) varnishes significantly reduced enamel wear progression compared to the placebo varnish (3.9±1.1 µm) and control (4.5±0.9 µm). The same differences were found for dentin in the presence and absence of the DOM, respectively: TiF4 (average: 0.97/1.87 µm), NaF (1.03/2.13 µm), placebo varnish (3.53/4.47 µm) and control (3.53/4.36 µm). Conclusion The TiF4 and NaF varnishes were equally effective in reducing the progression of tooth erosion in vitro. PMID:25760263

  6. Hydrogenation thermodynamics of melt-spun magnesium rich Mg-Ni nanocrystalline alloys with the addition of multiwalled carbon nanotubes and TiF3

    NASA Astrophysics Data System (ADS)

    Hou, Xiaojiang; Hu, Rui; Zhang, Tiebang; Kou, Hongchao; Li, Jinshan

    2016-02-01

    Based on the complexity of hydrogen absorption/desorption process and from the perspective of overall control, the as-cast Mg-10wt%Ni (Mg10Ni) alloy has been successively optimized by melt-spinning and surface catalyzed to realize the internal refinement as well as surface modification. The isothermal hydrogenation behavior of modified Mg-rich alloys has been investigated in this work. The results indicate that melt-spun Mg10Ni catalyzed by multiwalled carbon nanotubes (MWCNTs) coupling with TiF3 possesses superior activation properties and can absorb 6.23 wt% at 250 °C under 2.5 MPa. It is worth mentioning that the hydrogenation capacities of Mg10Ni-MWCNTs-TiF3 are 5.93 wt% and 5.99 wt% within the initial 1 min and 5 min, respectively. Meanwhile, the catalytic effect of MWCNTs and TiF3 has been discussed. The improved activation performance as well as the thermodynamics properties of Mg10Ni catalyzed by MWCNTs and TiF3 is attributed to the synergistic effect on dissociation of H2 molecules, diffusion of H-atoms and heterogeneous nucleation of hydrides.

  7. Effects of Inboard Horizontal Field of View Display Limitations on Pilot Path Control During Total In-Flight Simulator (TIFS) Flight Test

    NASA Technical Reports Server (NTRS)

    Kramer, Lynda J.; Parrish, Russell V.; Williams, Steven P.; Lavell, Jeffrey S.

    1999-01-01

    A flight test was conducted aboard Calspan's Total In-Flight Simulator (TIFS) aircraft by researchers within the External Visibility System (XVS) element of the High-Speed Research program. The purpose was to investigate the effects of inboard horizontal field of view (FOV) display limitations on pilot path control and to learn about the TIFS capabilities and limitations for possible use in future XVS flight tests. The TIFS cockpit windows were masked to represent the front XVS display area and the High-Speed Civil Transport side windows, as viewed by the pilot. Masking limited the forward FOV to 40 deg. horizontal and 50 deg. vertical for the basic flight condition, With an increase of 10 deg. horizontal in the inboard direction for the increased FOV flight condition. Two right-hand approach tasks (base-downwind-final) with a left crosswind on final were performed by three pilots using visual flight rules at Niagara Falls Airport. Each of the two tasks had three replicates for both horizontal FOV conditions, resulting in twelve approaches per test subject. Limited objective data showed that an increase of inboard FOV had no effect (deficiences in objective data measurement capabilities were noted). However, subjective results showed that a 50 deg. FOV was preferred over the 40 deg. FOV.

  8. The adenovirus E4-ORF3 protein functions as a SUMO E3 ligase for TIF-1γ sumoylation and poly-SUMO chain elongation.

    PubMed

    Sohn, Sook-Young; Hearing, Patrick

    2016-06-14

    The adenovirus (Ad) early region 4 (E4)-ORF3 protein regulates diverse cellular processes to optimize the host environment for the establishment of Ad replication. E4-ORF3 self-assembles into multimers to form a nuclear scaffold in infected cells and creates distinct binding interfaces for different cellular target proteins. Previous studies have shown that the Ad5 E4-ORF3 protein induces sumoylation of multiple cellular proteins and subsequent proteasomal degradation of some of them, but the detailed mechanism of E4-ORF3 function remained unknown. Here, we investigate the role of E4-ORF3 in the sumoylation process by using transcription intermediary factor (TIF)-1γ as a substrate. Remarkably, we discovered that purified E4-ORF3 protein stimulates TIF-1γ sumoylation in vitro, demonstrating that E4-ORF3 acts as a small ubiquitin-like modifier (SUMO) E3 ligase. Furthermore, E4-ORF3 significantly increases poly-SUMO3 chain formation in vitro in the absence of substrate, showing that E4-ORF3 has SUMO E4 elongase activity. An E4-ORF3 mutant, which is defective in protein multimerization, exhibited severely decreased activity, demonstrating that E4-ORF3 self-assembly is required for these activities. Using a SUMO3 mutant, K11R, we found that E4-ORF3 facilitates the initial acceptor SUMO3 conjugation to TIF-1γ as well as poly-SUMO chain elongation. The E4-ORF3 protein displays no SUMO-targeted ubiquitin ligase activity in our assay system. These studies reveal the mechanism by which E4-ORF3 targets specific cellular proteins for sumoylation and proteasomal degradation and provide significant insight into how a small viral protein can play a role as a SUMO E3 ligase and E4-like SUMO elongase to impact a variety of cellular responses. PMID:27247387

  9. Anti-reflux surgery - children - discharge

    MedlinePlus

    Fundoplication - children - discharge; Nissen fundoplication - children - discharge; Belsey (Mark IV) fundoplication - children - discharge; Toupet fundoplication - children - discharge; Thal fundoplication - ...

  10. β-Catenin Binds to the Activation Function 2 Region of the Androgen Receptor and Modulates the Effects of the N-Terminal Domain and TIF2 on Ligand-Dependent Transcription

    PubMed Central

    Song, Liang-Nian; Herrell, Roger; Byers, Stephen; Shah, Salimuddin; Wilson, Elizabeth M.; Gelmann, Edward P.

    2003-01-01

    β-Catenin is a multifunctional molecule that is activated by signaling through WNT receptors. β-Catenin can also enhance the transcriptional activity of some steroid hormone receptors such as the androgen receptor and retinoic acid receptor α. Androgens can affect nuclear translocation of β-catenin and influence its subcellular distribution. Using mammalian two-hybrid binding assays, analysis of reporter gene transcription, and coimmunoprecipitation, we now show that β-catenin binds to the androgen receptor ligand-binding domain (LBD) and modulates the transcriptional effects of TIF2 and the androgen receptor N-terminal domain (NTD). In functional assays, β-catenin bound to androgen receptor only in the presence of ligand agonists, not antagonists. β-Catenin binding to the androgen receptor LBD was independent of and cooperative with the androgen receptor NTD and the p160 coactivator TIF2, both of which bind to the activation function 2 (AF-2) region of the androgen receptor. Different mutations of androgen receptor helix 3 amino acids disrupted binding of androgen receptor NTD and β-catenin. β-Catenin, androgen receptor NTD, and TIF2 binding to the androgen receptor LBD were affected similarly by a subset of helix 12 mutations, but disruption of two sites on helix 12 affected only binding of β-catenin and not of TIF2 or the androgen receptor NTD. Mutational disruption of each of five LXXLL peptide motifs in the β-catenin armadillo repeats did not disrupt either binding to androgen receptor or transcriptional coactivation. ICAT, an inhibitor of T-cell factor 4 (TCF-4), and E-cadherin binding to β-catenin also blocked binding of the androgen receptor LBD. We also demonstrated cross talk between the WNT and androgen receptor signaling pathways because excess androgen receptor could interfere with WNT signaling and excess TCF-4 inhibited the interaction of β-catenin and androgen receptor. Taken together, the data show that β-catenin can bind to the

  11. Factor recruitment and TIF2/GRIP1 corepressor activity at a collagenase-3 response element that mediates regulation by phorbol esters and hormones

    PubMed Central

    Rogatsky, Inez; Zarember, Kol A.; Yamamoto, Keith R.

    2001-01-01

    To investigate determinants of specific transcriptional regulation, we measured factor occupancy and function at a response element, col3A, associated with the collagenase-3 gene in human U2OS osteosarcoma cells; col3A confers activation by phorbol esters, and repression by glucocorticoid and thyroid hormones. The subunit composition and activity of AP-1, which binds col3A, paralleled the intracellular level of cFos, which is modulated by phorbol esters and glucocorticoids. In contrast, a similar AP-1 site at the collagenase-1 gene, not inducible in U2OS cells, was not bound by AP-1. The glucocorticoid receptor (GR) associated with col3A through protein–protein interactions with AP-1, regardless of AP-1 subunit composition, and repressed transcription. TIF2/GRIP1, reportedly a coactivator for GR and the thyroid hormone receptor (TR), was recruited to col3A and potentiated GR-mediated repression in the presence of a GR agonist but not antagonist. GRIP1 mutants deficient in GR binding and coactivator functions were also defective for corepression, and a GRIP1 fragment containing the GR-interacting region functioned as a dominant-negative for repression. In contrast, repression by TR was unaffected by GRIP1. Thus, the composition of regulatory complexes, and the biological activities of the bound factors, are dynamic and dependent on cell and response element contexts. Cofactors such as GRIP1 probably contain distinct surfaces for activation and repression that function in a context-dependent manner. PMID:11689447

  12. Factor recruitment and TIF2/GRIP1 corepressor activity at a collagenase-3 response element that mediates regulation by phorbol esters and hormones.

    PubMed

    Rogatsky, I; Zarember, K A; Yamamoto, K R

    2001-11-01

    To investigate determinants of specific transcriptional regulation, we measured factor occupancy and function at a response element, col3A, associated with the collagenase-3 gene in human U2OS osteosarcoma cells; col3A confers activation by phorbol esters, and repression by glucocorticoid and thyroid hormones. The subunit composition and activity of AP-1, which binds col3A, paralleled the intracellular level of cFos, which is modulated by phorbol esters and glucocorticoids. In contrast, a similar AP-1 site at the collagenase-1 gene, not inducible in U2OS cells, was not bound by AP-1. The glucocorticoid receptor (GR) associated with col3A through protein-protein interactions with AP-1, regardless of AP-1 subunit composition, and repressed transcription. TIF2/GRIP1, reportedly a coactivator for GR and the thyroid hormone receptor (TR), was recruited to col3A and potentiated GR-mediated repression in the presence of a GR agonist but not antagonist. GRIP1 mutants deficient in GR binding and coactivator functions were also defective for corepression, and a GRIP1 fragment containing the GR-interacting region functioned as a dominant-negative for repression. In contrast, repression by TR was unaffected by GRIP1. Thus, the composition of regulatory complexes, and the biological activities of the bound factors, are dynamic and dependent on cell and response element contexts. Cofactors such as GRIP1 probably contain distinct surfaces for activation and repression that function in a context-dependent manner. PMID:11689447

  13. T-cell-intrinsic Tif1α/Trim24 regulates IL-1R expression on TH2 cells and TH2 cell-mediated airway allergy.

    PubMed

    Perez-Lloret, Jimena; Okoye, Isobel S; Guidi, Riccardo; Kannan, Yashaswini; Coomes, Stephanie M; Czieso, Stephanie; Mengus, Gabrielle; Davidson, Irwin; Wilson, Mark S

    2016-02-01

    There is a paucity of new therapeutic targets to control allergic reactions and forestall the rising trend of allergic diseases. Although a variety of immune cells contribute to allergy, cytokine-secreting αβ(+)CD4(+) T-helper 2 (TH2) cells orchestrate the type-2-driven immune response in a large proportion of atopic asthmatics. To identify previously unidentified putative targets in pathogenic TH2 cells, we performed in silico analyses of recently published transcriptional data from a wide variety of pathogenic TH cells [Okoye IS, et al. (2014) Proc Natl Acad Sci USA 111(30):E3081-E3090] and identified that transcription intermediary factor 1 regulator-alpha (Tif1α)/tripartite motif-containing 24 (Trim24) was predicted to be active in house dust mite (HDM)- and helminth-elicited Il4(gfp+)αβ(+)CD4(+) TH2 cells but not in TH1, TH17, or Treg cells. Testing this prediction, we restricted Trim24 deficiency to T cells by using a mixed bone marrow chimera system and found that T-cell-intrinsic Trim24 is essential for HDM-mediated airway allergy and antihelminth immunity. Mechanistically, HDM-elicited Trim24(-/-) T cells have reduced expression of many TH2 cytokines and chemokines and were predicted to have compromised IL-1-regulated signaling. Following this prediction, we found that Trim24(-/-) T cells have reduced IL-1 receptor (IL-1R) expression, are refractory to IL-1β-mediated activation in vitro and in vivo, and fail to respond to IL-1β-exacerbated airway allergy. Collectively, these data identify a previously unappreciated Trim24-dependent requirement for IL-1R expression on TH2 cells and an important nonredundant role for T-cell-intrinsic Trim24 in TH2-mediated allergy and antihelminth immunity. PMID:26787865

  14. Postoperative problems 2011: fundoplication and obesity surgery.

    PubMed

    Rohof, W O; Bisschops, R; Tack, J; Boeckxstaens, G E

    2011-12-01

    Although the surgical treatment of both GERD and obesity is very successful, these procedures have a significant impact on the physiology and function of the proximal GI tract. With the increasing prevalence of both GERD and obesity, more and more patients present at the motility outpatient clinic with symptoms related to surgical interventions for these medical problems. In this review, we describe the main complications following antireflux surgery: dysphagia, gas bloat syndrome, recurrent (persistent) GERD symptoms, and dyspeptic symptoms. The most common motility-related complications of obesity surgery are dumping syndrome and esophageal dysmotility. PMID:22100119

  15. Endoscopic Treatment of Refractory Gastroesohageal Reflux Disease

    PubMed Central

    Kim, Won Hee; Park, Pil Won; Hahm, Ki Baik

    2013-01-01

    Though efficient acid suppression with proton pump inhibitors (PPIs) remains the mainstay of treatment of gastroesophageal reflux disease (GERD), some of the patients showed refractory response to PPIs, necessitating further intervention. After increasing dose of PPIs and other kinds of pharmacological intervention adopting prokinetics or others, variable endoscopic treatments are introduced for the treatment of these refractory cases. The detailed introduction regarding endoscopic treatment for GERD is forwarded in this review article. Implantation of reabsorbable or synthetic materials in the distal esophagus was tried in vain and is expelled from the market due to limited efficacy and serious complication. Radiofrequency energy delivery (Stretta) and transoral incisionless fundoplication (EsophyX) are actively tried currently. PMID:23767031

  16. Antireflux Endoluminal Therapies: Past and Present

    PubMed Central

    Yew, Kuo Chao; Chuah, Seng-Kee

    2013-01-01

    The basic principle of antireflux procedures employing endoscopic intervention aims to create a mechanical barrier to prevent primary pathophysiology in gastroesophageal reflux disease (GERD). We review, highlight, and discuss the past and present status of endoluminal therapy. Currently, there are 3 commonly employed anti-reflux endoluminal procedures: fundoplication or suturing techniques (EndoCinch, NDO, and EsophyX), intramural injection or implant techniques (enhancing lower esophageal sphincter (LES) volume and/or strengthening compliance of the LES-Enteryx and Gatekeeper), and radiofrequency ablation of LES and cardia. EndoCinch plication requires further study and modification of technique before it can be recommended because of durability issues. Esophynx, the transoral incisionless fundoplication, may reduce hiatal hernias and increase LES length. Preliminary studies have shown promising reduction in symptoms and medication use but evidence concerning safety and long-term durability is still pending. The safety issue with injection technique is the main concern as evident from the incidences of implant withdrawals after reported major adverse events. Future research with cautious monitoring is required before any new implant material can be recommended for commercial application. Radiofrequency ablation therapy is regaining popularity in treating refractory symptoms despite PPI use due to improved efficacy, durability, and safety after years of refinement of protocol. PMID:23935608

  17. Preemergence herbicides influence sprig establishment of 'TifEagle' bermudagrass

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The presence of weeds during bermudagrass (Cynodon dactylon x C. transvaalensis Burtt-Davy) putting green establishment can reduce growth and turf quality. Three field experiments were conducted in Georgia to investigate efficacy of dimethenamid, S-metolachlor, and oxadiazon on the establishment of...

  18. Totally impermeable film (TIF) reduces emissions in perennial crop fumigation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Orchard/vineyard replanting for fruit trees, nut trees, and grapevines in many situations still depends on soil fumigation for control of soil-borne pests and replanting diseases in California. Perennial tree and grapevine nurseries also rely heavily on soil fumigation to meet the state’s requiremen...

  19. TIF film, substrates and nonfumigant soil disinfestation maintain fruit yields

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A 5-year project to facilitate the adoption of strawberry production systems that do not use methyl bromide initially focused on fumigant alternatives and resulted in increased use of barrier films that reduce fumigant emissions. The focus shifted in year 3 to evaluating and demonstrating nonfumigan...

  20. Using TIF tarp and reduced fumigation rates for almond replanting

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Almond replanting still relies on pre-plant soil fumigation to control soil-borne pests and diseases in order to establish productive and healthy trees. With the environmental constraints on fumigant use, fumigation methods for high pest control efficiency and low emissions are needed greatly. In l...

  1. Pattern of esophageal eosinophilic infiltration in patients with achalasia and response to Heller myotomy and Dor fundoplication.

    PubMed

    Cools-Lartigue, J; Chang, S-Y; Mckendy, K; Mayrand, S; Marcus, V; Fried, G M; Ferri, L E

    2013-01-01

    Eosinophilic esophagitis (EoE) is now recognized as a common cause of dysphagia. Eosinophilic infiltration of the esophagus has also been associated with other conditions, such as gastroesophageal reflux disease (GERD); however, the incidence, pattern, and clinical significance of eosinophilic infiltration in achalasia are poorly documented. We sought to characterize this histological finding in patients undergoing Heller myotomy (HM) for achalasia. Ninety-six patients undergoing laparoscopic HM for primary achalasia between 1999 and 2008 were identified from a prospective database. Serial mid and distal per-endoscopic esophageal biopsies taken from patients before and after surgery were assessed for the presence of elevated intraepithelial eosinophils (EIEs). Slides from patients with reports suggestive of EIE were reviewed independently by two pathologists, and the highest eosinophil count/high-power field (eos/hpf) was recorded. Dysphagia scores (0 = none to 5 = severe dysphagia), GERD health-related quality of life scores (0 = best to 45 = worst), and 24-hour pH results were compared before and 3 months after surgery. We related the highest eos to the symptoms and response to HM. Data are presented as median (range). Paired t-test and Wilcoxon signed-rank test determined significance, *P < 0.05. Of 96 patients with achalasia, 50 had undergone pre-HM biopsies revealing EIE in 17/50 (34%), with a median of 3 eos/hpf (1-21). Two patients were found to have superimposed esophageal candidiasis. One patient met the pathologic criteria for EoE. Twenty-five of 50 (50%) postoperative biopsies demonstrated a median of 5 eos/hpf (1-62) for a total of 28/50 patients (56%) with EIE in either the preoperative or postoperative period. Four patients (8%) met the pathologic criteria for EoE, and two demonstrated persistent esophageal candidiasis. A decrease in eosinophils was found in 6/28 patients (21%) from 3/hpf (1-21) to 0.5/hpf (0-4). Increase in eosinophils was found in 22/28 patients (79%) from 0.5/hpf (0-8) to 5/hpf (1-62). Preoperative and postoperative dysphagia scores were available in 23 patients. Dysphagia scores improved in 22/23 patients. (3 [0-5] to 0 [0-2])*. Preoperative and postoperative GERD scores were available in 21 patients. GERD scores improved in 20/21 patients (10 [3-38] to 2 [2-14])*. Four of 13 patients (30.7%) demonstrated significant reflux in the postoperative period. No difference in clinical response to HM was detected between patients with preoperative EIE compared with patients with no EIE. No correlation between postoperative esophageal pH and eos was observed. A significant number of patients with achalasia demonstrate esophageal eosinophilic infiltration even at numbers demonstrable in patients with EoE (8% 4/50). While the interaction between achalasia and esophageal eosinophilic infiltration needs further investigation, this does not represent a distinct clinical entity. Thus, the presence of esophageal eosinophils in patients presenting with dysphagia should not preclude further work-up for other etiologies, including achalasia. PMID:22891632

  2. Role of titanium tetrafluoride (TiF4) in conservative dentistry: A systematic review

    PubMed Central

    Wahengbam, Pragya; Tikku, A P; Lee, Wahengbam Bruce

    2011-01-01

    The role of fluoride to reduce demineralization and enhance remineralization of dental hard tissue has been well documented. Different forms of fluoride solutions have been topically used in dentistry as prophylactic agents against tooth decay. In the recent past, metal fluorides, especially titanium tetrafluoride, have become popular in the fraternity of dental research due to their unique interaction with dental hard tissue. Many studies on titanium tetrafluoride, with positive and negative conclusions, have been published in many research journals. This gives the reader a plethora of inconclusive results with one study neutralizing the outcome of other, which confuses us regarding the present status of titanium tetrafluoride in the field of dentistry. This is an endeavor to organize and present the various studies of this unique compound, to provide us with a lucid overall review of its versatile potential application in dentistry, along with its fallacy/drawbacks. We have discussed its role as a cariostatic agent, pit and fissure sealant, tooth desensitizer, against dental erosion, as a root canal irrigant and others. PMID:21814345

  3. Materials Data on TiF3 (SG:221) by Materials Project

    SciTech Connect

    Kristin Persson

    2014-11-02

    Computed materials data using density functional theory calculations. These calculations determine the electronic structure of bulk materials by solving approximations to the Schrodinger equation. For more information, see https://materialsproject.org/docs/calculations

  4. Evaluation of TIF to reduce fumigant emissions and the potential to use reduced rates

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Strawberry growers in California rely heavily on soil fumigation to assure profitable berries and high yields. However, the adverse impact on air quality from fumigant emissions threatens the availability of fumigants for agricultural use. The objective of this research was to determine the performa...

  5. Materials Data on TiF4 (SG:62) by Materials Project

    SciTech Connect

    Kristin Persson

    2014-11-02

    Computed materials data using density functional theory calculations. These calculations determine the electronic structure of bulk materials by solving approximations to the Schrodinger equation. For more information, see https://materialsproject.org/docs/calculations

  6. Materials Data on Li3TiF6 (SG:15) by Materials Project

    SciTech Connect

    Kristin Persson

    2015-03-19

    Computed materials data using density functional theory calculations. These calculations determine the electronic structure of bulk materials by solving approximations to the Schrodinger equation. For more information, see https://materialsproject.org/docs/calculations

  7. Time to Pay Up: Analyzing the Motivational Potential of Financial Awards in a TIF Program

    ERIC Educational Resources Information Center

    Rice, Jennifer King; Malen, Betty; Jackson, Cara; Hoyer, Kathleen Mulvaney

    2015-01-01

    The effectiveness of educator incentive programs rests on the assumption that the potential rewards for participants will motivate them to behave in certain ways (e.g., choose certain jobs, expend greater effort, engage in capacity-building professional development). Some researchers have examined the impact of financial incentives on teacher…

  8. Acid Reflux (Gastroesophageal Reflux Disease) in Adults (Beyond the Basics)

    MedlinePlus

    ... sphincter. The most common surgical treatment is the laparoscopic Nissen fundoplication. This procedure involves wrapping the upper ... Ovaska JT. Comparison of long-term outcome of laparoscopic and conventional nissen fundoplication: a prospective randomized study ...

  9. 75 FR 57907 - Teacher Incentive Fund

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-23

    ... in the Federal Register (75 FR 28713). The purpose of the TIF program is to support projects that... inviting applications (NIA) for both TIF competitions for FY 2010 (75 FR 28740). The TIF Evaluation... TIF Evaluation. See 75 FR 28735. As an incentive for applicants to identify high-need schools...

  10. The Persistent Problems and Confounding Challenges of Educator Incentives: The Case of TIF in Prince George's County, Maryland

    ERIC Educational Resources Information Center

    Rice, Jennifer King; Malen, Betty; Baumann, Paul; Chen, Elke; Dougherty, Amy; Hyde, Laura; Jackson, Cara; Jacobson, Reuben; McKithen, Clarissa

    2012-01-01

    While education accountability systems emphasize teacher quality as a prerequisite for student learning, education administrators have struggled to staff low-performing schools with effective teachers. Fueled in part by the federal Teacher Incentive Fund, compensation reforms have gained center stage status among strategies aimed at improving…

  11. Presence of a tumour-inhibiting factor (TIF) in sera from normal but not tumour-bearing mice.

    PubMed Central

    Kim, B S; Chin, D K

    1980-01-01

    Some plasmacytomas produce myeloma proteins with known antibody specificities and the secretion of these proteins by individual tumour cells can be determined using haemolytic plaque assay. After a 3 day culture of mouse plasmacytoma cells in medium containing 10% normal mouse serum, the number of plaques was reduced to less than 10% when compared to that of tumour cells incubated with either foetal calf serum or normal rabbit serum. However, tumour cells incubated with sera from mice bearing TEPC-15, McPC-603, or MOPC-315 plasmacytomas displayed control levels of plaques. The production of plaques paralleled the viability of tumour cells suggesting that the reduction of plaque formation is due to the decreased viable cell number. The tumour-inhibiting activity was recovered from the fraction of apparent molecular weight of 300,000-400,000 after a partial purification using an agarose (A 0.5 M) column. This fraction, however, did not suppress in vitro induction of antibody production. Kinetic experiments using sera obtained sequentially from individual mice receiving either TEPC-15 or MOPC-315 plasmacytomas further indicated that the tumour-inhibiting activity is severely reduced during a 2 week period after tumour inoculation. The inhibition of tumour cells did not appear to be specific since tumour cells of three plasmacytomas (TEPC-15, MOPC-167 and MOPC-315), a mastocytoma (P815) and a lymphoma (EL-4) displayed a similar susceptibility to normal serum. PMID:7002770

  12. Radiologic evaluation of postoperative gastropericardial fistula

    PubMed Central

    Chen, Jeffrey S.; Hal, Hassan M.; Tappouni, Rafel F.R.

    2015-01-01

    Laparoscopic Nissen fundoplication is the current standard surgical option for complicated GERD and symptomatic hiatal hernia. Though comparable in safety, short-term efficacy, and patient satisfaction when compared with open operation, laparoscopic Nissen fundoplication has demonstrated shorter hospital stays and recuperative times. Commonly reported complications include gastric or esophageal injury, splenic injury, pneumothorax, bleeding, pneumonia, fever, wound infections, and dysphagia. We present an unusual case of gastropericardial fistula that developed as a late complication of laparoscopic Nissen fundoplication performed 4 years earlier.

  13. Anti-reflux surgery in lung transplant recipients: outcomes and effects on quality of life.

    PubMed

    Robertson, A G N; Krishnan, A; Ward, C; Pearson, J P; Small, T; Corris, P A; Dark, J H; Karat, D; Shenfine, J; Griffin, S M

    2012-03-01

    Fundoplication may improve survival after lung transplantation. Little is known about the effects of fundoplication on quality of life in these patients. The aim of this study was to assess the safety of fundoplication in lung transplant recipients and its effects on quality of life. Between June 1, 2008 and December 31, 2010, a prospective study of lung transplant recipients undergoing fundoplication was undertaken. Quality of life was assessed before and after surgery. Body mass index (BMI) and pulmonary function were followed up. 16 patients, mean ± sd age 38 ± 11.9 yrs, underwent laparoscopic Nissen fundoplication. There was no peri-operative mortality or major complications. Mean ± SD hospital stay was 2.6 ± 0.9 days. 15 out of 16 patients were satisfied with the results of surgery post fundoplication. There was a significant improvement in reflux symptom index and DeMeester questionnaires and gastrointestinal quality of life index scores at 6 months. Mean BMI decreased significantly after fundoplication (p = 0.01). Patients operated on for deteriorating lung function had a statistically significant decrease in the rate of lung function decline after fundoplication (p = 0.008). Laparoscopic fundoplication is safe in selected lung transplant recipients. Patient benefit is suggested by improved symptoms and satisfaction. This procedure is acceptable, improves quality of life and may reduce deterioration of lung function. PMID:21778169

  14. Equity and Entrepreneurialism: The Impact of Tax Increment Financing on School Finance.

    ERIC Educational Resources Information Center

    Weber, Rachel

    2003-01-01

    Describes tax increment financing (TIF), an entrepreneurial strategy with significant fiscal implications for overlapping taxing jurisdictions that provide these functions. Statistical analysis of TIF's impact on the finances of one Illinois county's school districts indicates that municipal use of TIF depletes the property tax revenues of schools…

  15. Peer Evaluation of Teachers in Maricopa County's Teacher Incentive Fund Program

    ERIC Educational Resources Information Center

    Milanowski, Anthony; Heneman, Herbert G., III; Finster, Matthew

    2015-01-01

    This case study describes the peer evaluation system the Maricopa County Educational Services Agency (MCESA) is using in the districts participating in its Teacher Incentive Fund (TIF) 3 and 4 grants. Maricopa County's TIF districts cover much of the Phoenix, Arizona, metropolitan area. Including both TIF 3 and 4 cohorts, 12 districts with a total…

  16. Meeting the Challenges of Stakeholder Engagement and Communication: Lessons from Teacher Incentive Fund Grantees. The Harvesting Project

    ERIC Educational Resources Information Center

    Koppich, Julia E.

    2010-01-01

    As of August 2010, a total of 33 states, school districts, charter school coalitions, and other education organizations had received Teacher Incentive Funds (TIF) to redesign compensation programs for teachers and principals. The U.S. Department of Education named a new cohort of TIF grantees on September 23, 2010. TIF grantees have faced a number…

  17. 75 FR 8854 - Teacher Incentive Fund Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-26

    ... competitions: The Main TIF competition, which will provide TIF funding to eligible entities to support their... competition, which will provide, in accordance with the priorities, the Main TIF requirements, the definitions... funds to develop and implement in high-need schools PBCSs that-- (a) Consider gains in student...

  18. 75 FR 28713 - Teacher Incentive Fund

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-21

    ... the Federal Register on February 26, 2010 (75 FR 8854). That notice contained background information... compensation for non-instructional personnel.'' 75 FR 8856. Under the Department's FY 2010 Appropriations Act... separate and distinct TIF grant competitions: The Main TIF competition, which will provide TIF funding...

  19. Teacher Incentive Fund; Notice Inviting Applications for New Awards for Fiscal Year (FY) 2010; Rule and Notice. Federal Register, Part III. Department of Education, 34 CFR Subtitle B, Chapter II

    ERIC Educational Resources Information Center

    Melendez de Santa Ana, Thelma

    2010-01-01

    The Secretary of Education (Secretary) establishes priorities, requirements, definitions, and selection criteria under the Teacher Incentive Fund (TIF) program. These priorities, requirements, definitions, and selection criteria will be used in two separate and distinct TIF grant competitions: The Main TIF competition, which will provide TIF…

  20. Tracheoinnominate fistula: surgical management of an iatrogenic disaster.

    PubMed

    Ridley, R W; Zwischenberger, J B

    2006-08-01

    Tracheoinnominate fistula (TIF) is a rare condition with significant potential for mortality if surgical intervention is not immediate. We present two cases of successfully managed TIF. Both cases involve ligation and resection of the innominate artery at the TIF followed by a pectoralis major muscle flap. In both cases, success was largely due to a high index of suspicion and immediate control of the bleeding with transport to the operating room for surgical repair. The history, aetiology, and pathogenesis of TIF are reviewed, yielding an algorithm for recommended management of TIF. PMID:16709270

  1. Synthesis of Nanocrystalline TiOF2 Embedded in a Carbonaceous Matrix from TiF4 and D-Fructose.

    PubMed

    Evangelisti, Claudio; Hayatifar, Mohammad; Marchetti, Fabio; Marelli, Marcello; Pampaloni, Guido; Piccinelli, Fabio

    2016-02-15

    Nanostructured titanium oxide difluoride embedded in a matrix of amorphous carbon was synthesized by pyrolysis of D-fructose in the presence of titanium tetrafluoride (optimal Ti/fructose molar ratio = 5.5), both in the solid state at ca. 150 °C and in suspension of 1,2-dichloroethane at reflux temperature. The resulting solid materials were characterized by powder X-ray diffraction (PXRD), transmission electron microscopy (TEM), and elemental analysis. In every case, PXRD and TEM data indicated the presence of an unique crystalline phase (TiOF2) embedded in a light matrix (amorphous carbon). The average crystal size of the powder can be regulated by varying the reaction time. PMID:26824591

  2. Quantitative assessment of epidermal melanogenesis in C3H/Tif hr/hr mice treated with topical furocoumarins and UVA radiation.

    PubMed

    Kinley, J S; Moan, J; Dall'Aqua, F; Young, A R

    1994-07-01

    We report quantitative data on epidermal melanogenesis by established and new furocoumarins. The ears and dorsal skin of pigmented hairless mice were treated for 12 d with compounds in ethanol, at equi-optical concentrations, and exposed to subphototoxic doses of ultraviolet A. Increased pigmentation was observed with 6,4,4'-trimethylangelicin > psoralen > 8-methoxypsoralen > 5-methoxypsoralen > 4,4',5'-trimethylazapsoralen = bergamot oil. Assessment of melanocyte numbers and morphology in epidermal sheet dihydroxyphenylalanine preparations showed that 6,4,4'-trimethylangelicin was the best compound with 536 ear melanocytes/mm2 +/- 15 SEM compared with 46 +/- 4 in controls. Psoralen induced 297/mm2 +/- 33, compared with its methoxy derivatives with ranges between 200 and 240/mm2.6,4,4'-trimethylangelicin had a striking effect on dorsal skin with 462 +/- 18 melanocytes/mm2 compared to less than 80/mm2 in all other ultraviolet A treatment groups. Khellin, 5-GOP and ultraviolet A only and all non-ultraviolet A controls had no effect. Melanogenesis was associated with increased dendricity, melanocyte size, especially with 5-methoxypsoralen, and giant melanocytes were noted with some treatments. The potency of 6,4,4'-trimethylangelicin, which does not form DNA interstrand crosslinks, may be related to its high DNA binding constant. Our data may be useful in the selection of compounds to treat vitiligo. PMID:8027588

  3. Management Information Reporting 2000-01 Data Analysis for Special Education, English as a Second Language (ESL), Early Literacy Initiative (ELI), and Technology Integration Funding (TIF).

    ERIC Educational Resources Information Center

    Alberta Learning, Edmonton.

    This report is intended to stimulate inquiry into the achievement of special groups of students in Alberta schools and model reporting to the public on these students, a traditionally weak area of school board Annual Education Results reports. The data in the report provide provincial level comparisons to data that may be compiled by school…

  4. Tamarind (Tamarindus indica) fruit shell carbon: A calcium-rich promising adsorbent for fluoride removal from groundwater.

    PubMed

    Sivasankar, V; Rajkumar, S; Murugesh, S; Darchen, A

    2012-07-30

    Tamarindus indica fruit shells (TIFSs) are naturally calcium rich compounds. They were impregnated with ammonium carbonate and then carbonized, leading to ammonium carbonate activated ACA-TIFS carbon. The resulting materials and carbon arising from virgin fruit shells V-TIFS were characterized and assayed as adsorbent for the removal of fluoride anions from groundwater. The fluoride scavenging ability of TIFS carbons was due to naturally dispersed calcium compounds. X-ray diffraction (XRD) showed that TIFS carbon contained a mixture of calcium oxalate and calcium carbonate. Batch studies on the fluoride removal efficiency of TIFS carbons with respect to contact time, pH, initial fluoride concentration, and co-ion interference were conducted. Applicability of various kinetic models (viz., pseudo-first-order, pseudo-second-order, intra-particle diffusion and Elovich) and sorption isotherms were tested for batch techniques. The fluoride removal capacity of TIFS carbons was found to be 91% and 83% at a pH of 7.05 for V-TIFS and ACA-TIFS carbons, respectively. The practical applicability of TIFS carbons using groundwater samples was approved. The fluoride removal was greater in groundwater without hydrogen carbonate ions than those containing these ions. The characterizations of fluoride unloaded and loaded TIFS carbons were done by SEM and XRD studies. PMID:22626627

  5. Thermally induced fracturing of Ula water injectors

    SciTech Connect

    Svendsen, A.P.; Wright, M.S. ); Clifford, P.J.; Berry, P.J. )

    1991-11-01

    This paper describes the impact that thermally induced fracturing (TIF) has had on the North Sea Ula field injection wells, allowing higher than anticipated water injection rates to be achieved. This work also discusses how thermal stress reduced fracture propagation pressures by 2,000 psi and how a 3D simulation code developed to model TIF was used. Injection-water-quality specifications and techniques to optimize TIF are presented.

  6. Compensating for velocity truncation during subaperture polishing by controllable and time-variant tool influence functions.

    PubMed

    Dong, Zhichao; Cheng, Haobo; Tam, Hon-Yuen

    2015-02-10

    The velocity-varying regime used in deterministic subaperture polishing employs a time-invariant tool influence function (TIF) to figure localized surface errors by varying the transverse velocities of polishing tools. Desired transverse velocities have to be truncated if they exceed the maximal velocity of computer numerical control (CNC) machines, which induces excessive material removal and reduces figuring efficiency (FE). A time-variant (TV) TIF regime is presented, in which a TIF serves as a variable to compensate for excessive material removal when the transverse velocities are truncated. Compared with other methods, the TV-TIF regime exhibits better performance in terms of convergence rate, FE, and versatility; its operability can also be strengthened by a TIF library. Comparative experiments were conducted on a magnetorheological finishing machine to validate the effectiveness of the TV-TIF regime. Without a TV-TIF, the tool made an unwished dent (depth of 76 nm) at the center because of the velocity truncation problem. Through compensation with a TV-TIF, the dent was completely removed by the second figuring process, and a TV-TIF improved the FE from 0.029 to 0.066  mm(3)/h. PMID:25968037

  7. Protein and DNA elements involved in transactivation of the promoter of the bovine herpesvirus (BHV) 1 IE-1 transcription unit by the BHV alpha gene trans-inducing factor.

    PubMed Central

    Misra, V; Bratanich, A C; Carpenter, D; O'Hare, P

    1994-01-01

    In herpes simplex virus (HSV)-infected cells, the transcription of immediate-early (alpha) genes is regulated by a virion component, the alpha gene trans-inducing factor (alpha TIF). This protein forms a complex with cellular factors and TAATGARAT motifs present in one or more copies in the promoters of all alpha genes. We have characterized the bovine herpesvirus 1 (BHV-1) homolog of this protein. Like its HSV counterpart, the BHV alpha TIF was synthesized in the later stages of infection and could be demonstrated to be a component of purified virions. In transient expression assays, BHV alpha TIF was a strong transactivator and stimulated the activity of IE-1, the major BHV-1 alpha gene promoter, with an efficiency comparable to that of HSV alpha TIF. This stimulation was largely dependent on a TAATGAGCT sequence present in a single copy in IE-1, and BHV alpha TIF, in conjunction with cellular factors, formed a complex with oligonucleotides containing this sequence. Despite these similarities between the two alpha TIFs, our preliminary observations suggest that the proteins may activate transcription by different mechanisms. Although BHV alpha TIF strongly transactivated IE-1, it differed from its HSV counterpart in that the carboxyl terminus of BHV alpha TIF, when fused to the DNA-binding domain of GAL4, was a relatively poor stimulator of a promoter containing GAL4-binding sites. Also unlike HSV alpha TIF, removal of the carboxyl terminus of BHV alpha TIF reduced but did not eliminate the ability of the protein to transactivate IE-1. These results are discussed in view of the structural similarities and differences among the alpha TIFs of alphaherpes-viruses. Images PMID:8035488

  8. Evaluation of Safety and Efficacy of the EndoLift Liver Retractor

    ClinicalTrials.gov

    2015-08-03

    Minimally Invasive Surgical Procedure; Laparoscopic Gastric Banding; Laparoscopic Roux-en-Y Gastric Bypass; Laparoscopic Sleeve Gastrectomy; Laparoscopic Fundoplication Procedure; Laparoscopic Heller Myotomy; Laparoscopic Paraesophageal Hernia Repair; Laparoscopic Gastric Resection

  9. EFFECT OF 4% TITANIUM TETRAFLUORIDE SOLUTION ON THE EROSION OF PERMANENT AND DECIDUOUS HUMAN ENAMEL: AN IN SITU/EX VIVO STUDY

    PubMed Central

    Magalhães, Ana Carolina; Rios, Daniela; Honório, Heitor Marques; Delbem, Alberto Carlos Botazzo; Buzalaf, Marília Afonso Rabelo

    2009-01-01

    This in situ/ex vivo study assessed the effect of titanium tetrafluoride (TiF4) solution on erosion of permanent (P) and deciduous (d) human enamel. Ten volunteers wore acrylic palatal appliances containing 4 enamel samples, divided into two rows: TiF4 and no - TiF4 (control). Each row contained one deciduous and one permanent enamel sample. During the 1st day, formation of a salivary pellicle was allowed. At the 2nd day, the 4% TiF4 solution was applied on one row (TiF4), while the other row remained untreated (control). From the 3rd until the 7th day, the samples were subjected to erosion by immersion in a cola drink for 5 min, 4 times/day. Enamel alterations were determined by microhardness testing (%SMHC). Data were analyzed using 2 two-way ANOVA and Tukey's post hoc test (a=0.05). The mean %SMHC (±SD) amounted to: P (TiF4 - 73.32 ± 5.16 and control - 83.49 ± 4.59) and d (TiF4 - 83.01 ± 7.41 and control - 75.75 ± 2.57). In conclusion, the application of 4% TiF4 solution reduced the softening of permanent enamel but not of deciduous enamel significantly. However, no significant differences were detected between the permanent and deciduous enamel when the factor substrate was considered. PMID:19148407

  10. Suprasternal approach for impending tracheo-innominate artery fistula.

    PubMed

    Fujimoto, Yoshifumi; Hirose, Keiichi; Ota, Noritaka; Murata, Masaya; Ide, Yujiro; Tosaka, Yuko; Tachi, Maiko; Sakamoto, Kisaburo

    2010-09-01

    We report preventive innominate artery division or ligation through a suprasternal approach for impending tracheo-innominate artery fistula (TIF) with recurrent airway oozing in patients with severe neuromuscular disease. Our approach is less invasive and a favorable procedure as preventive surgery for impending TIF. PMID:20859729

  11. Novel In Situ Collection of Tumor Interstitial Fluid from a Head and Neck Squamous Carcinoma Reveals a Unique Proteome with Diagnostic Potential

    PubMed Central

    Stone, Matthew D.; Odland, Rick M.; McGowan, Thomas; Onsongo, Getiria; Tang, Chaunning; Rhodus, Nelson L.; Jagtap, Pratik; Bandhakavi, Sricharan

    2010-01-01

    Introduction Tumors lack normal drainage of secreted fluids and consequently build up tumor interstitial fluid (TIF). Unlike other bodily fluids, TIF likely contains a high proportion of tumor-specific proteins with potential as biomarkers. Methods Here, we evaluated a novel technique using a unique ultrafiltration catheter for in situ collection of TIF and used it to generate the first catalog of TIF proteins from a head and neck squamous cell carcinoma (HNSCC). To maximize proteomic coverage, TIF was immunodepleted for high abundance proteins and digested with trypsin, and peptides were fractionated in three dimensions prior to mass spectrometry. Results We identified 525 proteins with high confidence. The HNSCC TIF proteome was distinct compared to proteomes of other bodily fluids. It contained a relatively high proportion of proteins annotated by Gene Ontology as “extracellular” compared to other secreted fluid and cellular proteomes, indicating minimal cell lysis from our in situ collection technique. Several proteins identified are putative biomarkers of HNSCC, supporting our catalog’s value as a source of potential biomarkers. Conclusions In all, we demonstrate a reliable new technique for in situ TIF collection and provide the first HNSCC TIF protein catalog with value as a guide for others seeking to develop tumor biomarkers. Electronic supplementary material The online version of this article (doi:10.1007/s12014-010-9050-3) contains supplementary material, which is available to authorized users. PMID:20930922

  12. Tularosa Basin Play Fairway Analysis: Partial Basin and Range Heat and Zones of Critical Stress Maps

    SciTech Connect

    Adam Brandt

    2015-11-15

    Interpolated maps of heat flow, temperature gradient, and quartz geothermometers are included as TIF files. Zones of critical stress map is also included as a TIF file. The zones are given a 5km diameter buffer. The study area is only a part of the Basin and Range, but it does includes the Tularosa Basin.

  13. 77 FR 12257 - Proposed Priorities, Requirements, Definitions, And Selection Criteria; Teacher Incentive Fund...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-29

    ...The Assistant Secretary for Elementary and Secondary Education proposes priorities, requirements, definitions, and selection criteria under the TIF program. We may use one or more of these priorities, requirements, definitions, and selection criteria for competitions in fiscal year (FY) 2012 and later years. We are taking this action so that TIF-funded performance-based compensation systems......

  14. Software for goniometer control in the Triple Ion Implantation Facility

    SciTech Connect

    Allen, W.R.

    1994-02-01

    A computer program is described tat controls the goniometer employed in the ion scattering chamber of the Triple Ion Implantation Facility (TIF) in the Metals and Ceramics Division at Oak Ridge National Laboratory. Details of goniometer operation and its incorporation into the ion scattering setup specific to the TIF are also discussed.

  15. Sequence and function of canine herpesvirus alpha-transinducing factor and its interaction with an immediate early promoter.

    PubMed

    Tyack, Scott G; Studdert, Michael J; Johnson, Michael A

    2006-12-01

    The sequence of the alpha-transinducing factor (alpha-TIF) of canine herpesvirus (CHV-l) was determined. Alignment of the predicted CHV-1 alpha-TIF amino acid sequence with other alpha-TIF homologues reveals a core region of similarity with divergent amino and carboxyl termini. Analysis of the CHV-1 infected cell protein 4 promoter region identified a region containing nine copies of a 52 bp repeat that showed significant up-regulation of transcription by alpha-TIF. This region contained an imperfect 'TAATGARAT' motif, the binding site for herpes simplex virus 1 alpha-TIF, with an imperfect Oct-1 binding site immediately following. The infectious laryngotracheitis virus alpha-TIF was also shown to up-regulate transcription through this region of the promoter. Transfection of CHV-1 genomic DNA failed to yield infectious virus in canine kidney cell lines. Co-transfection of genomic DNA and an alpha-TIF expression plasmid resulted in virus plaques, indicating a potential essential role for alpha-TIF in CHV-1 infection. PMID:16991001

  16. Increasing Educator Effectiveness: Lessons Learned from Teacher Incentive Fund Sites

    ERIC Educational Resources Information Center

    Eckert, Jonathan

    2013-01-01

    Created by the U.S. Congress in 2006, the Teacher Incentive Fund (TIF) represents the first federal initiative targeted directly at state and district efforts to introduce performance measures into educator compensation. TIF responds to a growing body of evidence that existing pay structures do not respond to labor force realities or adequately…

  17. The Effect of Local Limitations on General State Aid in Illinois.

    ERIC Educational Resources Information Center

    Bush, Erik

    2002-01-01

    Study to determine if a substantive relationship exits between the progression of a federal Tax Increment Financing (TIF) district, the long-term effects of the state Property Tax Extension Limitation Law (PTELL), and the General State Aid funding of school districts in Illinois. Finds that both TIF and PTELL lead to an increase in General State…

  18. Tax Increment Financing and Education Expenditures: The Case of Iowa

    ERIC Educational Resources Information Center

    Nguyen-Hoang, Phuong

    2014-01-01

    This is the first study to directly examine the relationship between tax increment financing (TIF) and education expenditures, using the state of Iowa as a case study. I find that greater use of TIF is associated with reduced education expenditures. I also find little evidence to support the commonly held proposition that school spending increases…

  19. Panel Design Variations in the Multistage Test Using the Mixed-Format Tests

    ERIC Educational Resources Information Center

    Kim, Jiseon; Chung, Hyewon; Dodd, Barbara G.; Park, Ryoungsun

    2012-01-01

    This study compared various panel designs of the multistage test (MST) using mixed-format tests in the context of classification testing. Simulations varied the design of the first-stage module. The first stage was constructed according to three levels of test information functions (TIFs) with three different TIF centers. Additional computerized…

  20. Teacher Incentive Fund: First Implementation Report, 2006 and 2007 Grantees

    ERIC Educational Resources Information Center

    Humphrey, Daniel C.; Gallagher, H. Alix; Yee, Kaily M.; Goss, G. Kyle; Campbell, Ashley Z.; Cassidy, Lauren J.; Mitchell, Nyema M.

    2012-01-01

    The Teacher Incentive Fund (TIF) supports projects that are designed to reform teacher and principal compensation. Initially, the Department of Education (the Department) made two rounds of awards, in 2006 and 2007, to a total of 34 grantees. The specific goals of TIF were to reward teachers and principals for improving student achievement,…

  1. Designing and Implementing Human Capital Management Systems in Educator Evaluation

    ERIC Educational Resources Information Center

    Kraemer, Sara; Milanowski, Anthony; Scott, Jenna; Adrien, Richard; Fairbairn, Shane; Bourn, Ronda; Hill, Marsha

    2015-01-01

    The Department of Education's Teacher Incentive Fund (TIF) 4 program represents a programmatic shift away from educator compensation reform as the primary lever of change for teacher performance and student learning. The TIF 4 program is designed to encourage the use of educator effectiveness measures to support the strategic instructional vision…

  2. In Vitro Effects of 2.5% Titanium Tetrafluoride on Streptococcus Mutans and Lactobacillus Casei in Dentin Followed by Self-Etching Adhesive Systems.

    PubMed

    Bridi, Enrico Coser; Amaral Flávia Lucisano Botelho; França Fabiana Mantovani Gomes; Turssi Cecilia Pedroso; Florio, Flávia Martão; Basting, Roberta Tarkany

    2015-12-01

    The aim was to evaluate the effect of a 2.5% titanium tetrafluoride (TiF4) solution followed by self-etching adhesives against Streptococcus mutans/Sm and Lactobacillus casei/Lc. Four cylindrical-shaped cavities were performed on each dentin surface of 40 third molars and contaminated with Sm or Lc. Each one of the four cavities received one of the following treatments (n = 10): 1) control; 2) TiF4; 3) Clearfil SE Bond/CSE or Adper EasyOne/AEO; 4) TiF4 followed by CSE or AED. ANOVA was applied to data. The TiF4 solution showed an antimicrobial effect, although the TiF4 used for dentin pretreatment before CSE or AEO showed no influence on antimicrobial effect. PMID:26767239

  3. Modeling and validation of polishing tool influence functions for manufacturing segments for an extremely large telescope.

    PubMed

    Li, Hongyu; Walker, David; Yu, Guoyu; Zhang, Wei

    2013-08-10

    We present a simulation technique to predict tool influence functions (TIFs) based on the Precessions polishing process, which is driven by addressing mass fabrication of the European Extremely Large Telescope mirror segments. Precessions polishing requires accurate and predictable TIFs to optimize the multiple process parameters, particularly when sequential polishing runs are performed by different polishing tools. In this paper, the static and dynamic TIFs are simulated based on the Preston equation. The velocity distribution is calculated according to the geometry of the precession motion. The pressure distribution at the polishing spot is calculated by means of finite element analysis (FEA). The FEA result is validated by direct force measurement with a simulation error of 4.3%. The simulation results of TIFs are verified by an experiment that shows the residual errors are less than 5% for both static and dynamic TIFs. PMID:23938432

  4. Tumor interstitial fluid promotes malignant phenotypes of lung cancer independently of angiogenesis.

    PubMed

    Li, Hong; Li, Ganggang; Liu, Linxin; Guo, Zhenzhen; Ma, Xiaofang; Cao, Ning; Lin, Haihong; Han, Guang; Duan, Yongjian; Du, Gangjun

    2015-11-01

    Angiogenesis is necessary for cancer progression, but antiangiogenic therapy actually promotes tumor recurrence, progression, and metastasis. This study focused on the contribution of the tumor interstitial fluid (TIF) to lung cancer progression. TIF was isolated and quantified for 10 μg protein/mL. Malignant driver characteristics of TIF were examined by tumor-initiating cells (TIC), self-renewal, epithelial-mesenchymal transition (EMT), autophagy, and apoptosis in vitro. In vivo tumor model was used to investigate the mechanistic roles of TIF in lung cancer progression. In vitro, TIF exhibited distinct malignant driver characteristics, which led to increased numbers of TICs, increased self-renewal and EMT, as well as to decreased autophagy and apoptosis under cell starvation conditions. In vivo, the contribution of TIF was similar, as judged by increased TICs indicated by the cancer stem cell marker Nanog, the proliferation marker proliferating cell nuclear antigen, and the EMT marker N-cadherin; TIF also increased the formation of pulmonary tumors. Interestingly, the blockers of inflammation, Na-K-ATPase, and aldosterone receptor decreased TIF-induced tumor progression but increased angiogenesis. Further, we found that the water content of the tissue was positively correlated with the levels of plasma 5-hydroxyindoleacetic acid or tissue aquaporin-1 but not with CD31. However, vadimezan reduced angiogenesis but promoted TIF-induced tumor progression. Our results suggested that TIF could provide better nutrition to the tumor than angiogenesis and that it could promote the development of malignant phenotypes of lung cancer independently of angiogenesis. PMID:26342025

  5. [Two Cases of Emergency Extracorporeal Membrane Oxygenation Support in Children Suffering from Tracheo-innominate Artery Fistula].

    PubMed

    Ideno, Satoshi; Shinto, Atsushi; Matsuoka, Taku; Miyazawa, Noriko; Yamamoto, Shinichi

    2016-02-01

    Tracheoinnominate artery fistula (TIF) is a relatively rare life-threating complication of long-term tracheostomy. Two patients with TIF were successfully resuscitated by extracorporeal membrane oxygenation (ECMO) support along with advanced cardiovascular life support. The first patient was a 16-year-old boy undergoing long-term tracheostomy because of cerebral palsy, and the other patient was a previously healthy 11-year-old girl who had undergone primary tracheal tumor resection. In both cases, the onset of TIF was sudden, and the patients were immediately transferred to the operating room for emergency thoracotomy under ongoing cardiopulmonary resuscitation. Innominate artery division was performed under ECMO support. Adequate fluid replacement and hemorrhage control are primary treatment options for resuscitating a patient with TIF. However, hemorrhagic shock in patients with TIF is different from that in other patients, because bleeding into the trachea causes severe respiratory failure and poor oxygenation, which may worsen the resuscitation rate. Thus, ECMO can be used as an option for maintaining oxygenation during cardiopulmonary resuscitation in TIF. Anesthesiologists should pay attention to the increased risk of bleeding due to anticoagulation during ECMO initiation. In conclusion, the results of these cases demonstrate the effectiveness of extracorporeal cardiopulmonary resuscitation in TIF patients. PMID:27017768

  6. Nanomechanical properties, SEM, and EDS microanalysis of dentin treated with 2.5% titanium tetrafluoride, before and after an erosive challenge.

    PubMed

    Basting, Roberta Tarkany; Leme, Ariene Arcas; Bridi, Enrico Coser; Amaral, Flávia Lucisano Botelho do; França, Fabiana Mantovani Gomes; Turssi, Cecília Pedroso; Bedran-Russo, Ana Karina

    2015-05-01

    The aim was to assess the nanohardness (H) and the reduced modulus of elasticity (Er ) of 2.5% titanium tetrafluoride (TiF4 ) modified dentin, before and after an erosive challenge with 0.3% citric acid (CA). Exposed dentin surfaces were divided into two groups (n = 5): (1) Control-no dentin pretreatment with TiF4 prior to etching with CA, and (2) Experimental-dentin pretreatment with TiF4  + CA. The H and the Er of intertubular dentin were measured using a triboindenter at different time points: baseline for both groups, after using 2.5% TiF4 for the experimental group, and after using CA for both the experimental and the control groups. Scanning electron microscope and energy dispersive X-ray spectroscopy (EDS) analysis of the dentin surfaces were undertaken at the same time points for both groups. Two-way ANOVA for randomized block design was applied. There was significant interaction between the application of the TiF4 solution and different time points (p = 0.001 for H and p < 0.001 for Er ), identified by Tukey's test. Erosive challenge provided a significant decrease in H and Er mean values. The TiF4 solution caused a significant increase in H and Er values, but no significant differences were found between post-TiF4 and post-CA application. TiF4 application produced a precipitate surface layer on intertubular and intratubular dentin. EDS analysis indicated the presence of titanium. The H and Er of the dentin surface were greatly increased after application of 2.5% TiF4 . TiF4 may modify the micromorphology of the dentin surface and produces an erosive resistance surface. PMID:25111838

  7. Sinus Meridiani: uncontrolled Mars Global Surveyor (MGS) Mars Orbital Camera (MOC): digital context photomosaic (250 megapixel resolution)

    USGS Publications Warehouse

    Noreen, Eric

    2000-01-01

    These images were processed from a raw format using Integrated Software for Images and Spectrometers (ISIS) to perform radiometric corrections and projection. All the images were projected in sinusoidal using a center longitude of 0 degrees. There are two versions of the mosaic, one unfiltered (sinusmos.tif), and one produced with all images processed through a box filter with an averaged pixel tone of 7.5 (sinusmosflt.tif). Both mosaics are ArcView-ArcInfo(2) ready in TIF format with associated world files (*.tfw).

  8. Central Valles Marineris: uncontrolled Mars Global Surveyor (MGS) Mars Orbital Camera (MOC) digital context photomosaic (250 megapixel resolution)

    USGS Publications Warehouse

    Noreen, Eric

    2000-01-01

    These images were processed from a raw format using Integrated Software for Images and Spectrometers (ISIS) to perform radiometric corrections and projection. All the images were projected in sinusoidal using a center longitude of 70 degrees. There are two versions of the mosaic, one unfiltered (vallesmos.tif), and one produced with all images processed through a box filter with an averaged pixel tone of 7.699 (vallesmosflt.tif). Both mosaics are ArcView-ArcInfo ready in TIF format with associated world files (*.tfw).

  9. Surgery for gastroesophageal reflux disease with Gaucher disease type 2.

    PubMed

    Kubo, Hiroyuki; Shimono, Ryuichi; Tanaka, Aya; Fujii, Takayuki; Yasuda, Saneyuki; Koyano, Kosuke; Jinnai, Wataru; Kondo, Sonoko; Kondo, Takeo; Kusaka, Takashi

    2016-07-01

    Gaucher disease, the most common lysosomal storage disease, is sometimes complicated with gastroesophageal reflux disease (GERD). The present patient was a 136-day-old Japanese boy with Gaucher disease type 2. Enzyme replacement therapy and chemical chaperone therapy were successful for the skin disorders, joint contractures, hepatosplenomegaly and thrombocytopenia, but he also had GERD. Accordingly, a Nissen fundoplication with gastrostomy was performed. There was no vulnerability of organs, easy bleeding or difficulty of maintaining the visual field because of hepatosplenomegaly during operation. In the perioperative period, there was no prolonged wound healing or infection. GERD was improved. In the near future, the number of long-term survivors of Gaucher disease will increase due to improvements in medical therapy. Therefore, it is expected that the number of patients requiring fundoplication will also increase. In patients with successful medical therapy, surgical fundoplication can be safely and effectively performed. PMID:26842663

  10. Delayed sternal closure after vacuum-assisted closure therapy for tracheo-innominate artery fistula repair.

    PubMed

    Suzuki, Ryo; Mikamo, Akihito; Kurazumi, Hiroshi; Hamano, Kimikazu

    2011-08-01

    We report a case of successful innominate artery resection with delayed sternal closure after vacuum-assisted closure (VAC) therapy for a tracheo-innominate artery fistula (TIF). A 42-year-old woman with cerebral palsy underwent tracheostomy for respiratory assistance. On postoperative day 14, she was transferred to our hospital after an episode of massive hemoptysis. TIF was diagnosed based on the findings of multidetector computed tomography. Thus, we resected the innominate artery and started VAC therapy to control the postoperative local infection. The patient recovered uneventfully, without any infectious sequelae. Our strategy, which includes VAC therapy, for TIF repair may eliminate postoperative infective problems that could induce sequential bleeding and sternal compromise. To our knowledge, this is the first report of using VAC therapy for TIF. PMID:21628318

  11. Key theoretical frameworks for intervention: understanding and promoting behavior change in parent-infant feeding choices in a low-income population.

    PubMed

    Brophy-Herb, Holly E; Silk, Kami; Horodynski, Mildred A; Mercer, Laura; Olson, Beth

    2009-03-01

    The early introduction of solids to infants is a risk factor associated with later health problems including allergies, overweight, and diabetes. The Infant Feeding Series (TIFS), a newly designed curriculum that promotes the appropriate transition to solids through parenting education and behavior change among low-income mothers, used the Theory of Planned Behavior and the Transtheoretical Model of Change to develop TIFS curricular foci and activities. Using a pre-post design, pilot study results indicate that after exposure to the TIFS curriculum, mothers had significantly increased knowledge about appropriate infant feeding, could more accurately identify developmental indicators of infants' readiness for solids, and reported greater feelings of self efficacy about initiating and maintaining healthy feeding practices. Editors' Strategic Implications: replication is necessary, but TIFS appears to be a promising prevention program based on short-term knowledge and long-term behavioral outcomes (i.e., healthy feeding practices). PMID:19283484

  12. Effect of the inflated-pressure to the tool influence function for polishing using SR bonnet

    NASA Astrophysics Data System (ADS)

    Wang, Chunjin; Yang, Xu; Zhong, Bo; Wang, Zhenzhong; Guo, Yinbiao; Xu, Qiao

    2014-08-01

    The purpose of this paper is to study the effect of the inner pressure to the tool influence function (TIF) for polishing using a semi-rigid (SR) bonnet tool. The simulation model of a Semi-rigid (SR) bonnet polishing tool polishing BK7 is demonstrated and the pressure distribution data under different inflated-pressures in the contact area has been extracted. It's observed that the inflated-pressure has few effects to the polishing pressure, and their shapes are also Gaussian-like. Hence, we made a hypothesis that the effect of inflated-pressure to the TIF is rather small. To verify this hypothesis, a group of experiments to generate TIFs under different inflated-pressure are conducted, and the hypothesis has been proved to be correct through comparing these TIFs.

  13. Effects of single-base substitutions within the acanthamoeba castellanii rRNA promoter on transcription and on binding of transcription initiation factor and RNA polymerase I

    SciTech Connect

    Kownin, P.; Bateman, E.; Paule, M.R.

    1988-02-01

    Single-point mutations were introduced into the promoter region of the Acanthamoeba castellanii rRNA gene by chemical mutagen treatment of a single-stranded clone in vitro, followed by reverse transcription and cloning of the altered fragment. The promoter mutants were tested for transcription initiation factor (TIF) binding by a template commitment assay plus DNase I footprinting and for transcription by an in vitro runoff assay. Point mutations within the previously identified TIF interaction region (between -20 and -47, motifs A and B) indicated that TIF interacts most strongly with a sequence centered at -29 and less tightly with sequences upstream and downstream. Some alterations of the base sequence closer to the transcription start site (and outside the TIF-protected site) also significantly decrease specific RNA synthesis in vitro. These were within the region which is protected from DNAse I digestion by polymerase I, but these mutations did not detectably affect the binding of polymerase to the promoter.

  14. Events during eucaryotic rRNA transcription initiation and elongation: Conversion from the closed to the open promoter complex requires nucleotide substrates

    SciTech Connect

    Bateman, E.; Paule, M.R.

    1988-05-01

    Chemical footprinting and topological analysis were carried out on the Acanthamoeba castellanii rRNA transcription initiation factor (TIF) and RNA polymerase I complexes with DNA during transcription initiation and elongation. The results show that the binding of TIF and polymerase to the promoter does not alter the supercoiling of the DNA template and the template does not become sensitive to modification by diethylpyro-carbonate, which can identify melted DNA regions. Thus, in contrast to bacterial RNA polymerase, the eucaryotic RNA polymerase I-promoter complex is in a closed configuration preceding addition of nucleotides in vitro. Initiation and 3'-O-methyl CTP-limited translocation by RNA polymerase I results in separation of the polymerase-TIF footprints, leaving the TIF footprint unaltered. In contrast, initiation and translocation result in a significant change in the conformation of the polymerase-DNA complex, culminating in an unwound DNA region of at least 10 base pairs.

  15. Prevalence of gallstones in 1,229 patients submitted to surgical laparoscopic treatment of GERD and esophageal achalasia: associated cholecystectomy was a safe procedure

    PubMed Central

    SALLUM, Rubens Antonio Aissar; PADRÃO, Eduardo Messias Hirano; SZACHNOWICZ, Sergio; SEGURO, Francisco C. B. C.; BIANCHI, Edno Tales; CECCONELLO, Ivan

    2015-01-01

    Background Association between esophageal achalasia/ gastroesophageal reflux disease (GERD) and cholelithiasis is not clear. Epidemiological data are controversial due to different methodologies applied, the regional differences and the number of patients involved. Results of concomitant cholecistectomy associated to surgical treatment of both diseases regarding safety is poorly understood. Aim To analyze the prevalence of cholelithiasis in patients with esophageal achalasia and gastroesophageal reflux submitted to cardiomyotomy or fundoplication. Also, to evaluate the safety of concomitant cholecistectomy. Methods Retrospective analysis of 1410 patients operated from 2000 to 2013. They were divided into two groups: patients with GERD submitted to laparocopic hiatoplasty plus Nissen fundoplication and patients with esophageal achalasia to laparoscopic cardiomyotomy plus partial fundoplication. It was collected epidemiological data, specific diagnosis and subgroups, the presence or absence of gallstones, surgical procedure, operative and clinical complications and mortality. All groups/subgroups were compared. Results From 1,229 patients with GERD or esophageal achalasia, submitted to laparoscopic cardiomyotomy or fundoplication, 138 (11.43%) had cholelitiasis, occurring more in females (2.38:1) with mean age of 50,27 years old. In 604 patients with GERD, 79 (13,08%) had cholelitiasis. Lower prevalence occurred in Barrett's esophagus patients 7/105 (6.67%) (p=0.037). In 625 with esophageal achalasia, 59 (9.44%) had cholelitiasis, with no difference between chagasic and idiopathic forms (p=0.677). Complications of patients with or without cholecystectomy were similar in fundoplication and cardiomyotomy (p=0.78 and p=1.00).There was no mortality or complications related to cholecystectomy in this series. Conclusions Prevalence of cholelithiasis was higher in patients submitted to fundoplication (GERD). Patients with chagasic or idiopatic forms of achalasia had the

  16. Production of Tuber-Inducing Factor

    NASA Technical Reports Server (NTRS)

    Stutte, Gary W.; Yorio, Neil C.

    2006-01-01

    A process for making a substance that regulates the growth of potatoes and some other economically important plants has been developed. The process also yields an economically important by-product: potatoes. The particular growth-regulating substance, denoted tuber-inducing factor (TIF), is made naturally by, and acts naturally on, potato plants. The primary effects of TIF on potato plants are reducing the lengths of the main shoots, reducing the numbers of nodes on the main stems, reducing the total biomass, accelerating the initiation of potatoes, and increasing the edible fraction (potatoes) of the overall biomass. To some extent, these effects of TIF can override environmental effects that typically inhibit the formation of tubers. TIF can be used in the potato industry to reduce growth time and increase harvest efficiency. Other plants that have been observed to be affected by TIF include tomatoes, peppers, radishes, eggplants, marigolds, and morning glories. In the present process, potatoes are grown with their roots and stolons immersed in a nutrient solution in a recirculating hydroponic system. From time to time, a nutrient replenishment solution is added to the recirculating nutrient solution to maintain the required nutrient concentration, water is added to replace water lost from the recirculating solution through transpiration, and an acid or base is added, as needed, to maintain the recirculating solution at a desired pH level. The growing potato plants secrete TIF into the recirculating solution. The concentration of TIF in the solution gradually increases to a range in which the TIF regulates the growth of the plants.

  17. Tracheo-innominate artery fistula in children with high-lying innominate artery.

    PubMed

    Chittithavorn, Voravit; Rergkliang, Chareonkiat; Chetpaophan, Apirak; Vasinanukorn, Prasert

    2006-12-01

    Tracheo-innominate artery fistula (TIF) is an uncommon but frequently fatal complication of tracheostomy. Significant airway hemorrhage usually occurs after premonitory bleeding. When massive bleeding occurs, immediate control of arterial bleeding, control of the airway and subsequent definite treatment are the principles for saving lives. Without prompt surgical intervention, the outcome of this complication is grave. Physicians should maintain a high index of suspicion of TIF in any patient with a recent tracheostomy and subsequent tracheal hemorrhage. PMID:17130330

  18. André Toupet: Surgeon Technician Par Excellence

    PubMed Central

    Katkhouda, Namir; Khalil, Michael R.; Manhas, Sharan; Grant, Steven; Velmahos, George C.; Umbach, Thomas W.; Kaiser, Andreas M.

    2002-01-01

    André Toupet is best known for the posterior fundoplication that bears his name, currently used for the treatment of gastroesophageal reflux disease (GERD) or completing Heller’s myotomy and subject today to intense discussions. This was not different in 1963, when Toupet proposed his technique at a time when the Nissen fundoplication was emerging as the treatment of choice for GERD. Behind the procedure, we discover a man with great surgical talent and meticulous attention to technical details who opposed criticism with hard work and strong family values. PMID:11923617

  19. Tracheo-innominate artery fistula after percutaneous tracheostomy: three case reports and a clinical review.

    PubMed

    Grant, C A; Dempsey, G; Harrison, J; Jones, T

    2006-01-01

    Tracheo-innominate artery fistula (TIF) is an uncommon yet life threatening complication after a tracheostomy. Rates of 0.1-1% after surgical tracheostomy have been reported, with a peak incidence at 7-14 days post procedure. It is usually fatal unless treatment is instituted immediately. Initial case reports of TIF resulted from surgically performed tracheostomies. We present three fatalities attributable to TIF, confirmed by histopathology, after percutaneous dilatational tracheostomy (PDT). The use of PDT has resulted in tracheostomies being performed by specialists from different backgrounds and the incidence of this complication may be increasing. Pressure necrosis from high cuff pressure, mucosal trauma from malpositioned cannula tip, low tracheal incision, radiotherapy and prolonged intubation are all implicated in TIF formation. Massive haemorrhage occurring 3 days to 6 weeks after tracheostomy is a result of TIF until proven otherwise. We present a simple algorithm for management of this situation. The manoeuvres outlined will control bleeding in more than 80% of patients by a direct tamponade effect. Surgical stasis is obtained by debriding the innominate artery proximally, then transecting and closing the lumen. Neurological sequelae are few. Post-mortem diagnosis of TIF may be difficult, but specific pathology request should be made to assess innominate artery abnormalities. PMID:16299043

  20. The Hippo-Salvador signaling pathway regulates renal tubulointerstitial fibrosis

    PubMed Central

    Seo, Eunjeong; Kim, Wan-Young; Hur, Jeongmi; Kim, Hanbyul; Nam, Sun Ah; Choi, Arum; Kim, Yu-Mi; Park, Sang Hee; Chung, Chaeuk; Kim, Jin; Min, Soohong; Myung, Seung-Jae; Lim, Dae-Sik; Kim, Yong Kyun

    2016-01-01

    Renal tubulointerstitial fibrosis (TIF) is the final pathway of various renal injuries that result in chronic kidney disease. The mammalian Hippo-Salvador signaling pathway has been implicated in the regulation of cell proliferation, cell death, tissue regeneration, and tumorigenesis. Here, we report that the Hippo-Salvador pathway plays a role in disease development in patients with TIF and in a mouse model of TIF. Mice with tubular epithelial cell (TEC)-specific deletions of Sav1 (Salvador homolog 1) exhibited aggravated renal TIF, enhanced epithelial-mesenchymal transition-like phenotypic changes, apoptosis, and proliferation after unilateral ureteral obstruction (UUO). Moreover, Sav1 depletion in TECs increased transforming growth factor (TGF)-β and activated β-catenin expression after UUO, which likely accounts for the abovementioned enhanced TEC fibrotic phenotype. In addition, TAZ (transcriptional coactivator with PDZ-binding motif), a major downstream effector of the Hippo pathway, was significantly activated in Sav1-knockout mice in vivo. An in vitro study showed that TAZ directly regulates TGF-β and TGF-β receptor II expression. Collectively, our data indicate that the Hippo-Salvador pathway plays a role in the pathogenesis of TIF and that regulating this pathway may be a therapeutic strategy for reducing TIF. PMID:27550469

  1. The Hippo-Salvador signaling pathway regulates renal tubulointerstitial fibrosis.

    PubMed

    Seo, Eunjeong; Kim, Wan-Young; Hur, Jeongmi; Kim, Hanbyul; Nam, Sun Ah; Choi, Arum; Kim, Yu-Mi; Park, Sang Hee; Chung, Chaeuk; Kim, Jin; Min, Soohong; Myung, Seung-Jae; Lim, Dae-Sik; Kim, Yong Kyun

    2016-01-01

    Renal tubulointerstitial fibrosis (TIF) is the final pathway of various renal injuries that result in chronic kidney disease. The mammalian Hippo-Salvador signaling pathway has been implicated in the regulation of cell proliferation, cell death, tissue regeneration, and tumorigenesis. Here, we report that the Hippo-Salvador pathway plays a role in disease development in patients with TIF and in a mouse model of TIF. Mice with tubular epithelial cell (TEC)-specific deletions of Sav1 (Salvador homolog 1) exhibited aggravated renal TIF, enhanced epithelial-mesenchymal transition-like phenotypic changes, apoptosis, and proliferation after unilateral ureteral obstruction (UUO). Moreover, Sav1 depletion in TECs increased transforming growth factor (TGF)-β and activated β-catenin expression after UUO, which likely accounts for the abovementioned enhanced TEC fibrotic phenotype. In addition, TAZ (transcriptional coactivator with PDZ-binding motif), a major downstream effector of the Hippo pathway, was significantly activated in Sav1-knockout mice in vivo. An in vitro study showed that TAZ directly regulates TGF-β and TGF-β receptor II expression. Collectively, our data indicate that the Hippo-Salvador pathway plays a role in the pathogenesis of TIF and that regulating this pathway may be a therapeutic strategy for reducing TIF. PMID:27550469

  2. High-Content Positional Biosensor Screening Assay for Compounds to Prevent or Disrupt Androgen Receptor and Transcriptional Intermediary Factor 2 Protein–Protein Interactions

    PubMed Central

    Hua, Yun; Shun, Tong Ying; Strock, Christopher J.

    2014-01-01

    Abstract The androgen receptor–transcriptional intermediary factor 2 (AR-TIF2) positional protein–protein interaction (PPI) biosensor assay described herein combines physiologically relevant cell-based assays with the specificity of binding assays by incorporating structural information of AR and TIF2 functional domains along with intracellular targeting sequences and fluorescent reporters. Expression of the AR-red fluorescent protein (RFP) “prey” and TIF2-green fluorescent protein (GFP) “bait” components of the biosensor was directed by recombinant adenovirus constructs that expressed the ligand binding and activation function 2 surface domains of AR fused to RFP with nuclear localization and nuclear export sequences, and three α-helical LXXLL motifs from TIF2 fused to GFP and an HIV Rev nucleolar targeting sequence. In unstimulated cells, AR-RFP was localized predominantly to the cytoplasm and TIF2-GFP was localized to nucleoli. Dihydrotestosterone (DHT) treatment induced AR-RFP translocation into the nucleus where the PPIs between AR and TIF2 resulted in the colocalization of both biosensors within the nucleolus. We adapted the translocation enhanced image analysis module to quantify the colocalization of the AR-RFP and TIF2-GFP biosensors in images acquired on the ImageXpress platform. DHT induced a concentration-dependent AR-TIF2 colocalization and produced a characteristic condensed punctate AR-RFP PPI nucleolar distribution pattern. The heat-shock protein 90 inhibitor 17-N-allylamino-17-demethoxygeldanamycin (17-AAG) and antiandrogens flutamide and bicalutamide inhibited DHT-induced AR-TIF2 PPI formation with 50% inhibition concentrations (IC50s) of 88.5±12.5 nM, 7.6±2.4 μM, and 1.6±0.4 μM, respectively. Images of the AR-RFP distribution phenotype allowed us to distinguish between 17-AAG and flutamide, which prevented AR translocation, and bicalutamide, which blocked AR-TIF2 PPIs. We screened the Library of Pharmacologically Active

  3. Natural orifice transluminal endoscopy surgery: A review

    PubMed Central

    Moreira-Pinto, João; Lima, Estevão; Correia-Pinto, Jorge; Rolanda, Carla

    2011-01-01

    Minimally invasive surgery started spreading worldwide in 1987, when the first laparoscopic cholecystectomy was performed. Meanwhile, improvement of endoscopic equipment and instruments allowed gastroenterologists to attempt more aggressive endoluminal interventions, even beyond the wall barrier. The first transgastric peritoneoscopy, in 2004, brought to light the concept of natural orifice transluminal endoscopic surgery (NOTES). The idea of incisionless surgery is attractive and has become a new goal for both surgeons and other people interested in this field of investigation. The authors present a review of all developments concerning NOTES, including animal studies and human experience. PMID:21987621

  4. Treatment of Prominent Ears and Otoplasty: A Contemporary Review.

    PubMed

    Pawar, Sachin S; Koch, Cody A; Murakami, Craig

    2015-01-01

    Prominent ears affect approximately 5% of the population and can have a significant psychological impact on patients. A wide variety of otoplasty techniques have been described, all sharing the goal of re-creating the normal appearance of the ear and achieving symmetry between the 2 sides. Recent trends in otoplasty techniques have consistently moved toward less invasive options, ranging from nonsurgical newborn ear molding to cartilage-sparing surgical techniques and even incisionless, office-based procedures. Herein, we review anatomy of the external ear, patient evaluation, the evolution of nonsurgical and surgical otoplasty techniques, otoplasty outcomes, and future trends for treatment of prominent ears. PMID:26158729

  5. Treatment Options for GERD or Acid Reflux Disease: A Review of the Research for Adults

    MedlinePlus

    ... surgery might help you. How does surgery for GERD work? In a fundoplication, the top part of your ... how well endoscopic treatments (EndoCinch™, Stretta®, and EsophyX™) work to control the symptoms of GERD. What are the side effects of endoscopic treatments? ...

  6. Apparent G syndrome presenting as neck and upper limb dystonia and severe gastroesophageal reflux.

    PubMed

    Williams, C A; Frias, J L

    1987-10-01

    We have studied a 3-month-old boy with severe gastroesophageal reflux, feeding difficulties, neck and upper limb dystonia, abnormal ears, normal genitalia, and anatomically apparently normal larynx and trachea. Initially diagnosed as suffering from Sandifer "syndrome," he was treated with a gastrostomy and Nissen fundoplication. However, his characteristic facial appearance subsequently led to the diagnosis of G syndrome. PMID:3425612

  7. Endoscopic dilatation, heller myotomy, and peroral endoscopic myotomy: treatment modalities for achalasia.

    PubMed

    Allaix, Marco E; Patti, Marco G

    2015-06-01

    At present, LHM with partial fundoplication is considered the gold standard for the treatment of patients with esophageal achalasia. Endoscopic procedures such as EBTI and PD should be considered as primary treatment modalities only in frail patients. POEM is a new approach with promising short-term results. PMID:25965130

  8. A new method for determining the throughfall fraction and throughfall depth in vegetation canopies

    NASA Astrophysics Data System (ADS)

    Dunkerley, David

    2010-05-01

    SummaryA new method for quantifying throughfall fractions and depths under vegetation canopies is introduced and evaluated. The method employs the progressive loss of weight of tablets of calcium sulphate hemihydrate ('Plaster of Paris') set out beneath conventional throughfall collecting funnels to form 'throughfall integrating funnels' (TIFs). The tablets are temporarily removed for weighing after any desired sampling period, and can continue to integrate throughfall depths for extended periods (>1 year). The throughfall fraction TF f can be found directly in 'uncalibrated TIF mode' by comparing the weight loss of matched open-field and sub-canopy TIFs, because sub-canopy TIFs lose less weight than open-field TIFs. The diminution in weight loss is in direct proportion to the reduction in throughfall in comparison with open-field rainfall. No other field apparatus is required, and no rainfall measurements are necessary. Alternatively, weight loss can be calibrated in g/mm using a pluviograph record, and throughfall depth TF d found using 'calibrated TIF mode'. Estimates of throughfall made using TIFs are compared with measurements made with 16 conventional throughfall troughs, from an 8-month trial in sub-alpine snowgum woodland and closed shrub heath communities in Victoria, Australia. For the plaster tablets used, the mean open-field weight loss was 0.0096 g/mm for tablets that weighed ˜30 g initially. Average TF d estimates across eight measurement periods from the two independent method differed by <1% (91.6 mm from trough data and 91.9 mm from TIFs). Average TF f was 0.84 using trough data and 0.82 using TIFs, a difference of 2%. These very close agreements, after 871.1 mm of rain, falling in events of varying depth, duration, and rain rate, confirm that TIFs yield results consistent with those from conventional instrumental measurement of throughfall. Under a low and dense shrub heath canopy, where conventional throughfall collectors could not be installed

  9. Quantitative Proteomics Analysis of Tissue Interstitial Fluid for Identification of Novel Serum Candidate Diagnostic Marker for Hepatocellular Carcinoma.

    PubMed

    Sun, Wei; Xing, Baocai; Guo, Lihai; Liu, Zhilei; Mu, Jinsong; Sun, Longqin; Wei, Handong; Zhao, Xiaohang; Qian, Xiaohong; Jiang, Ying; He, Fuchu

    2016-01-01

    Hepatocellular carcinoma (HCC) is the fifth most common malignant cancer in the world. The sensitivity of alpha-fetoprotein (AFP) is still inadequate for HCC diagnosis. Tissue interstitial fluid (TIF), as the liquid microenvironment of cancer cells, was used for biomarker discovery in this study. Paired tumor and nontumor TIF samples from 6 HBV-HCC patients were analyzed by a proteomic technique named iTRAQ (isobaric tag for relative and absolute quantitation). Totally, 241 up-regulated proteins (ratio ≥ 1.3, p < 0.05) and 288 down-regulated proteins (ratio ≤ -1.3, p < 0.05) in tumor TIF were identified. Interestingly, proteins in S100 family were found remarkably up-regulated in tumor TIF. One dramatically up-regulated protein S100A9 (ratio = 19) was further validated by ELISA in sera from liver cirrhosis (LC, HCC high risk population) and HCC patients (n = 47 for each group). The level of this protein was significantly elevated in HCC sera compared with LC (p < 0.0001). The area under the curve of this protein to distinguish HCC from LC was 0.83, with sensitivity of 91% (higher than AFP) and specificity of 66%. This result demonstrated the potential of S100A9 as a candidate HCC diagnostic biomarker. And TIF was a kind of promising material to identify candidate tumor biomarkers that could be detected in serum. PMID:27216119

  10. Tumor Interstitial Fluid Formation, Characterization, and Clinical Implications.

    PubMed

    Wagner, Marek; Wiig, Helge

    2015-01-01

    The interstitium, situated between the blood and lymph vessels and the cells, consists of a solid or matrix phase and a fluid phase representing the tissue microenvironment. In the present review, we focus on the interstitial fluid phase of solid tumors, the tumor interstitial fluid (TIF), i.e., the fluid bathing the tumor and stroma cells, also including immune cells. This is a component of the internal milieu of a solid tumor that has attracted regained attention. Access to this space may provide important insight into tumor development and therapy response. TIF is formed by transcapillary filtration, and since this fluid is not readily available we discuss available techniques for TIF isolation, results from subsequent characterization and implications of recent findings with respect to fluid filtration and uptake of macromolecular therapeutic agents. There appear to be local gradients in signaling substances from neoplastic tissue to plasma that may provide new understanding of tumor biology. The development of sensitive proteomic technologies has made TIF a valuable source for tumor specific proteins and biomarker candidates. Potential biomarkers will appear locally in high concentrations in tumors and may eventually be found diluted in the plasma. Access to TIF that reliably reflects the local tumor microenvironment enables identification of substances that can be used in early detection and monitoring of disease. PMID:26075182

  11. [Experience of 3 successfully treated cases of tracheo-innominate artery fistula and significance of preventive surgery].

    PubMed

    Kawahito, Tomohisa; Takano, Shinji; Egawa, Yoshiyasu; Yoshida, Homare

    2012-12-01

    Tracheo-innominate artery fistula (TIF) is a rare but fatal complication after tracheostomy. Necessary lifesaving measures include proper ventilation, temporary hemostasis, and surgery. Recently, we successfully managed 3 cases of TIF. Ventilation and temporary hemostasis were secured by a long endotracheal tube and overinflated cuff. Division of the innominate artery, restoration of the tracheal fistula with an autologous pericardial patch or direct closure, and aorto-innominate bypass grafting or extra-anatomical bypass grafting with a polytetrafluoroethylene (PTFE) graft were performed through an emergency median sternotomy. All 3 patients recovered with no problems. After TIF occurs, the patient's condition rapidly worsens, and the risk of bacterial contamination in the operative field may increase. Surgical intervention should be performed for patients with tracheal stenosis who are judged to be at high risk for TIF. This preventive surgery includes bypass grafting to divide the innominate artery and partial resection of the anterior bony thorax(upper sternum, medial part of clavicles, and anterior part of upper ribs if necessary). We believe that this procedure will improve tracheal stenosis and minimize the risk of TIF. Thus far, 10 patients have undergone this operation, and their mid-term results are satisfactory. PMID:23202704

  12. The influence of fluoride ions on the equilibrium between titanium ions and titanium metal in fused alkali chloride melts.

    PubMed

    Song, Jianxun; Wang, Qiuyu; Wu, Jinyu; Jiao, Shuqiang; Zhu, Hongmin

    2016-08-15

    KF is employed as a source of fluoride ions added to the melt to disclose the influence of fluoride on the disproportionation reactions of titanium ions, 3Ti(2+) = 2Ti(3+) + Ti, and 4Ti(3+) = 3Ti(4+) + Ti. The results reveal that the equilibrium transferred to the right direction for the first reaction and the apparent equilibrium constant increased sharply, mainly because of the formation of coordination compounds: TiFi(3-i). The accurate values of the equilibrium constants referring to the formation reactions of Ti(3+) + iF(-) = TiFi(3-i) (i = 1-6) in NaCl-KCl melt at 1023 K were evaluated with a best fit least squares method. It is also revealed that the stable states of the coordination compounds are TiF(2+), TiF2(+), TiF4(-) and TiF6(3-). Moreover, the Gibbs free energies for complex formation were estimated. Ti(2+) was undetectable when the concentration of fluoride ion was high enough. The equilibrium constant for the formation reaction, Ti(4-) + 6F(-) = TiF6(2-), was evaluated. The equilibrium constant, Kc2, for the disproportionation reaction 4Ti(3+) = 3Ti(4+) + Ti, in chloride melt was determined as 0.015. PMID:27212433

  13. Tracheo-innominate artery fistula successfully treated by endovascular stent-graft repair.

    PubMed

    Nakai, Motoki; Sato, Hirotatsu; Sato, Morio; Ikoma, Akira; Sanda, Hiroki; Nakata, Kohei; Minamiguchi, Hiroki; Kawai, Nobuyuki; Sonomura, Tetsuo; Nishimura, Yoshiharu; Okamura, Yoshitaka

    2013-01-01

    We report two patients who developed a tracheo-innominate artery fistula (TIF) after tracheostomy. Contrast-enhanced computed tomography revealed a pseudoaneurysm of the innominate artery protruding into the trachea. Stent grafts were deployed for the innominate artery via two different access routes: the transfemoral approach and the right carotid artery approach. Endovascular stent-graft repair resulted in complete exclusion of the TIF and control of the bleeding from the tracheal stoma. At 12- and 16-month follow-ups, neither patient had clinical signs of graft infection, recurrent fistulization, or ischemic complications. It is feasible and useful to employ the carotid artery approach for stent-graft implantation in patients who have vascular anatomical limitations for the transfemoral approach. Endovascular repair of TIF by stent grafting is a minimally invasive treatment that can be tolerated by patients in poor clinical condition, and is a feasible alternative to surgical treatment. PMID:23065488

  14. Conformational changes of the glucocorticoid receptor ligand binding domain induced by ligand and cofactor binding, and the location of cofactor binding sites determined by hydrogen/deuterium exchange mass spectrometry

    PubMed Central

    Frego, Lee; Davidson, Walter

    2006-01-01

    HXMS (hydrogen/deuterium exchange mass spectrometry) of the glucocorticoid receptor ligand-binding domain (GR LBD) complexed with the agonist dexamethasone and the antagonist RU-486 is described. Variations in the rates of exchange were observed in regions consistent with the published crystal structures of GR LBD complexed with RU-486 when compared with the GR dexamethasone complex. We also report the HXMS results for agonist-bound GR LBD with the coactivator transcriptional intermediary factor 2 (TIF2) and anatagonist-bound GR LBD with nuclear receptor corepressor (NCoR). Alterations in exchange rates observed for agonist-bound GR LBD with TIF2 present were consistent with the published crystal structural contacts for the complex. Alterations in exchange rates observed for antagonist-bound GR LBD with NCoR were a subset of those observed with TIF2 binding, suggesting a common or overlapping binding site for coactivator and corepressor. PMID:16600964

  15. Characterization of a novel origin recognition complex-like complex: implications for DNA recognition, cell cycle control, and locus-specific gene amplification.

    PubMed

    Mohammad, Mohammad; York, Randall D; Hommel, Jonathan; Kapler, Geoffrey M

    2003-07-01

    The origin recognition complex (ORC) plays a central role in eukaryotic DNA replication. Here we describe a unique ORC-like complex in Tetrahymena thermophila, TIF4, which bound in an ATP-dependent manner to sequences required for cell cycle-controlled replication and gene amplification (ribosomal DNA [rDNA] type I elements). TIF4's mode of DNA recognition was distinct from that of other characterized ORCs, as it bound exclusively to single-stranded DNA. In contrast to yeast ORCs, TIF4 DNA binding activity was cell cycle regulated and peaked during S phase, coincident with the redistribution of the Orc2-related subunit, p69, from the cytoplasm to the macronucleus. Origin-binding activity and nuclear p69 immunoreactivity were further regulated during development, where they distinguished replicating from nonreplicating nuclei. Both activities were lost from germ line micronuclei following the programmed arrest of micronuclear replication. Replicating macronuclei stained with Orc2 antibodies throughout development in wild-type cells but failed to do so in the amplification-defective rmm11 mutant. Collectively, these findings indicate that the regulation of TIF4 is intimately tied to the cell cycle and developmentally programmed replication cycles. They further implicate TIF4 in rDNA gene amplification. As type I elements interact with other sequence-specific single-strand breaks (in vitro and in vivo), the dynamic interplay of Orc-like (TIF4) and non-ORC-like proteins with this replication determinant may provide a novel mechanism for regulation. PMID:12832485

  16. Structural analysis of an eIF3 subcomplex reveals conserved interactions required for a stable and proper translation pre-initiation complex assembly

    PubMed Central

    Herrmannová, Anna; Daujotytė, Dalia; Yang, Ji-Chun; Cuchalová, Lucie; Gorrec, Fabrice; Wagner, Susan; Dányi, István; Lukavsky, Peter J.; Shivaya Valášek, Leoš

    2012-01-01

    Translation initiation factor eIF3 acts as the key orchestrator of the canonical initiation pathway in eukaryotes, yet its structure is greatly unexplored. We report the 2.2 Å resolution crystal structure of the complex between the yeast seven-bladed β-propeller eIF3i/TIF34 and a C-terminal α-helix of eIF3b/PRT1, which reveals universally conserved interactions. Mutating these interactions displays severe growth defects and eliminates association of eIF3i/TIF34 and strikingly also eIF3g/TIF35 with eIF3 and 40S subunits in vivo. Unexpectedly, 40S-association of the remaining eIF3 subcomplex and eIF5 is likewise destabilized resulting in formation of aberrant pre-initiation complexes (PICs) containing eIF2 and eIF1, which critically compromises scanning arrest on mRNA at its AUG start codon suggesting that the contacts between mRNA and ribosomal decoding site are impaired. Remarkably, overexpression of eIF3g/TIF35 suppresses the leaky scanning and growth defects most probably by preventing these aberrant PICs to form. Leaky scanning is also partially suppressed by eIF1, one of the key regulators of AUG recognition, and its mutant sui1G107R but the mechanism differs. We conclude that the C-terminus of eIF3b/PRT1 orchestrates co-operative recruitment of eIF3i/TIF34 and eIF3g/TIF35 to the 40S subunit for a stable and proper assembly of 48S pre-initiation complexes necessary for stringent AUG recognition on mRNAs. PMID:22090426

  17. MAD2B-mediated SnoN downregulation is implicated in fibroblast activation and tubulointerstitial fibrosis.

    PubMed

    Tang, Hui; Su, Hua; Fan, Di; Ye, Chen; Lei, Chun-Tao; Jiang, Hua-Jun; Gao, Pan; He, Fang-Fang; Zhang, Chun

    2016-07-01

    MAD2B, an anaphase-promoting complex/cyclosome (APC/C) inhibitor and a small subunit of DNA polymerase ζ, is indispensible for mitotic checkpoint control and DNA repair. Previously, we established that MAD2B is expressed in glomerular and tubulointerstitial compartments and participates in high glucose-induced podocyte injury. However, its role in other renal diseases remains elusive. In the present study, we aim to illustrate the potential role of MAD2B in the pathogenesis of renal fibrosis. By immunofluorescence and Western blotting, we found MAD2B expression is obviously increased in tubulointerstitial fibrosis (TIF) patients and unilateral ureteral obstruction (UUO) mice. It is widely accepted that resident fibroblasts are the major source of collagen-producing myofibroblasts during TIF. Therefore, we evaluated the level of MAD2B in fibroblasts (NRK-49F) exposed to transforming growth factor (TGF)-β1 by immunoblotting and revealed that MAD2B is upregulated in a time-dependent manner. Intriguingly, SnoN, a transcriptional repressor of the TGF-β1/Smad signaling pathway, is decreased in TGF-β1-treated fibroblasts as well as the kidney cortex from TIF patients and UUO mice. Either in vitro or in vivo, local genetic depletion of MAD2B by lentiviral transfection could preserve SnoN abundance and suppress Smad3 phosphorylation, which finally dampens fibroblast activation, ECM accumulation, and alleviates the severity of TIF. However, the ubiquitin ligase APC/C is not involved in the MAD2B-mediated SnoN decline, although this process is ubiquitination dependent. In conclusion, our observation proposes that besides cell cycle management, MAD2B has a profibrotic role during fibroblast activation and TIF by suppressing SnoN expression. Targeting the MAD2B-SnoN pathway is a promising intervention for TIF. PMID:27122545

  18. Emerging therapeutic options in GERD.

    PubMed

    Woodland, Philip; Amarasinghe, Gehanjali; Sifrim, Daniel

    2013-06-01

    Gastroesophageal reflux disease (GERD) is a prevalent problem resulting in a high level of healthcare consultation and expenditure in the Western World. Although standard medical therapy (in the form of proton pump inhibitor drugs) is effective in the majority of cases, there remains a significant proportion who are refractory to treatment. In addition, surgical therapy (in the form of laparoscopic fundoplication) is not always effective, and in some can be associated with significant side-effects, particularly gas-bloat, flatulence and dysphagia. As such there remains an unmet need in GERD to develop new therapies for refractory cases, and to develop alternatives to fundoplication with fewer side-effects. This article discusses the current state of pharmacological and non-pharmacological emerging therapies for GERD. PMID:23998982

  19. Dumping syndrome in a young Jamaican child.

    PubMed

    McKenzie, C; Boyne, M; Venugopal, S; Cooper, E

    1998-12-01

    The dumping syndrome in childhood is an uncommon complication of gastro-oesophageal surgery, principally Nissen fundoplication. A Jamaican child developed the syndrome after fundoplication and pyloroplasty to relieve gastro-oesophageal reflux complicating the repair of a congenital tracheo-oesophageal fistula. He developed marasmus and failed to gain weight on the standard remedial milk-based high-energy diet. An oral glucose tolerance test confirmed the diagnosis of dumping syndrome. A low sugar low milk diet based on adult type meals with continuous nibbling of fried dumplings relieved his diarrhoea and hypoglycaemia and he gained weight. This is a cheaper and more practical dietary therapy than the regimens described previously. PMID:10097670

  20. Use of SPECT/CT to confirm inconclusive gastric emptying scintigraphy results.

    PubMed

    Henrichon, Stephen; Seltzer, Marc; Siegel, Alan

    2015-06-01

    A 70-year-old man with cramping, abdominal pain, and diarrhea for 5 months after revision of a Nissen fundoplication underwent further evaluation with solid gastric emptying scintigraphy. On sequential planar images, we were uncertain if activity was present within the stomach or within loops of small bowel. SPECT/CT performed at 4 hours was used to localize the tracer, confirming its presence within the stomach. PMID:25783518

  1. Pain after laparoscopic antireflux surgery

    PubMed Central

    Szczebiot, L; Peyser, PM

    2014-01-01

    Introduction The benefits of antireflux surgery are well established. Laparoscopic techniques have been shown to be generally safe and effective. The aim of this paper was to review the subject of pain following laparoscopic antireflux surgery. Methods A systematic review of the literature was conducted using the PubMed database to identify all studies reporting pain after laparoscopic antireflux surgery. Publications were included for the main analysis if they contained at least 30 patients. Operations in children, Collis gastroplasty procedures, endoluminal fundoplication and surgery for paraoesophageal hernias were excluded. The frequency of postoperative pain was calculated and the causes/management were reviewed. An algorithm for the investigation of patients with pain following laparoscopic fundoplication was constructed. Results A total of 17 studies were included in the main analysis. Abdominal pain and chest pain following laparoscopic fundoplication were reported in 24.0% and 19.5% of patients respectively. Pain was mild or moderate in the majority and severe in 4%. Frequency of pain was not associated with operation type. The authors include their experience in managing patients with persistent, severe epigastric pain following laparoscopic anterior fundoplication. Conclusions Pain following laparoscopic antireflux surgery occurs in over 20% of patients. Some have an obvious complication or a diagnosis made through routine investigation. Most have mild to moderate pain with minimal effect on quality of life. In a smaller proportion of patients, pain is severe, persistent and can be disabling. In this group, diagnosis is more difficult but systematic investigation can be rewarding, and can enable appropriate and successful treatment. PMID:24780664

  2. Reversibility of cardiopulmonary impairment after laparoscopic repair of large hiatal hernia

    PubMed Central

    Asti, Emanuele; Bonavina, Luigi; Lombardi, Massimo; Bandera, Francesco; Secchi, Francesco; Guazzi, Marco

    2015-01-01

    Giant hiatus hernia with or without intrathoracic gastric volvulus often presents with symptoms suggestive of both cardiac and pulmonary compression. Cardiopulmonary impairment may be reversible in these patients by laparoscopic crural repair and fundoplication as shown in this case report. Cardiac magnetic resonance and the cardiopulmonary exercise test may help selecting patients for surgery. These preliminary findings led us to start a prospective study using this multimodality diagnostic approach. PMID:26210719

  3. Gastroesophageal reflux disease in children.

    PubMed

    Barnhart, Douglas C

    2016-08-01

    Despite the frequency with which antireflux procedures are performed, decisions about gastroesophageal reflux disease treatment remain challenging. Several factors contribute to the difficulties in managing gastroesophageal reflux. First, the distinction between physiologic and pathologic gastroesophageal reflux (gastroesophageal reflux disease-GERD) is not always clear. Second, measures of the extent of gastroesophageal reflux often poorly correlate to symptoms or other complications attributed to reflux in infants and children. A third challenge is that the outcome of antireflux procedures, predominately fundoplications, are relatively poorly characterized. All of these factors contribute to difficulty in knowing when to recommend antireflux surgery. One of the manifestations of the uncertainties surrounding GERD is the high degree of variability in the utilization of pediatric antireflux procedures throughout the United States. Pediatric surgeons are frequently consulted for GERD and fundoplication, uncertainties notwithstanding. Although retrospective series and anecdotal observations support fundoplication in some patients, there are many important questions for which sufficient high-quality data to provide a clear answer is lacking. In spite of this, surgeons need to provide guidance to patients and families while awaiting the development of improved evidence to aid in these recommendations. The purpose of this article is to define what is known and what is uncertain, with an emphasis on the most recent evidence. PMID:27521711

  4. Antireflux Surgery in Korea: A Nationwide Study from 2011 to 2014

    PubMed Central

    Lee, Jun-Hyun; Park, Joong-Min; Han, Sang-Uk; Kim, Jin-Jo; Song, Kyo Young; Ryu, Seung Wan; Seo, Kyung Won; Kim, Hyoung-Il; Kim, Wook

    2016-01-01

    Background/Aims Although laparoscopic fundoplication is a well-established therapy for gastroesophageal reflux disease (GERD) in Western countries, the mainstay of GERD treatment in Korea is long-term proton pump inhibitor (PPI) use. The aim of the present study was to evaluate nationwide data regarding antireflux surgery in Korea. Methods Data from 2011 to 2014 were collected from the Korean Antireflux Surgery Study Group and then analyzed. Results A total of 87 patients underwent laparoscopic fundoplication for the treatment of GERD. Preoperatively, typical symptoms were present in 81 patients (93%) and atypical symptoms were present in 51 patients (59%). Twenty-seven patients (31%) had poor PPI responses. The average surgical time and postoperative hospital stay were 116.3±42.3 minutes and 4.3±3.1 days, respectively. At 3 months after surgery, typical symptoms were completely controlled in 86.3% of patients and partially controlled in 11.7%, whereas atypical symptoms were completely controlled in 63.3% of patients and partially controlled in 23.3%. Conclusions This study showed that although atypical symptoms and PPI nonresponders are common, the complete control rates of typical and atypical symptoms were 86.3% and 63.3%, respectively. Laparoscopic fundoplication is an efficacious method of controlling the symptoms of GERD and has an acceptable rate of postoperative morbidity and adverse symptoms. PMID:27114420

  5. Improving School Leadership through Support, Evaluation, and Incentives: The Pittsburgh Principal Incentive Program. Monograph

    ERIC Educational Resources Information Center

    Hamilton, Laura S.; Engberg, John; Steiner, Elizabeth D.; Nelson, Catherine Awsumb; Yuan, Kun

    2012-01-01

    In 2007, the Pittsburgh Public Schools (PPS) received funding from the U.S. Department of Education's Teacher Incentive Fund (TIF) program to implement the Pittsburgh Urban Leadership System for Excellence (PULSE), a set of reforms designed to improve the quality of school leadership throughout the district. A major component of PULSE is the…

  6. Oregon Cascades Play Fairway Analysis: Raster Datasets and Models

    DOE Data Explorer

    Adam Brandt

    2015-11-15

    This submission includes maps of the spatial distribution of basaltic, and felsic rocks in the Oregon Cascades. It also includes a final Play Fairway Analysis (PFA) model, with the heat and permeability composite risk segments (CRS) supplied separately. Metadata for each raster dataset can be found within the zip files, in the TIF images

  7. Translation initiation factor 4A from Saccharomyces cerevisiae: analysis of residues conserved in the D-E-A-D family of RNA helicases.

    PubMed Central

    Schmid, S R; Linder, P

    1991-01-01

    The eukaryotic translation initiation factor 4A (eIF-4A) possesses an in vitro helicase activity that allows the unwinding of double-stranded RNA. This activity is dependent on ATP hydrolysis and the presence of another translation initiation factor, eIF-4B. These two initiation factors are thought to unwind mRNA secondary structures in preparation for ribosome binding and initiation of translation. To further characterize the function of eIF-4A in cellular translation and its interaction with other elements of the translation machinery, we have isolated mutations in the TIF1 and TIF2 genes encoding eIF-4A in Saccharomyces cerevisiae. We show that three highly conserved domains of the D-E-A-D protein family, encoding eIF-4A and other RNA helicases, are essential for protein function. Only in rare cases could we make a conservative substitution without affecting cell growth. The mutants show a clear correlation between their growth and in vivo translation rates. One mutation that results in a temperature-sensitive phenotype reveals an immediate decrease in translation activity following a shift to the nonpermissive temperature. These in vivo results confirm previous in vitro data demonstrating an absolute dependence of translation on the TIF1 and TIF2 gene products. Images PMID:2046664

  8. Development and Impact of Vegetative Propagation in Warm-Season Forage and Turf Grasses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Today, after years of research, development and promotion we enjoy the beauty of the high quality 'Tif' male and female sterile triploid hybrid turf bermudagrasses (Cynodon dactylon x C. transvaalensis) on golf courses, athletic fields, and lawns and the high yielding and high quality vegetatively p...

  9. Evaluation of the Teacher Incentive Fund: Implementation and Early Impacts of Pay-for-Performance after One Year

    ERIC Educational Resources Information Center

    Max, Jeffrey; Constantine, Jill; Wellington, Alison; Hallgren, Kristin; Glazerman, Steven; Chiang, Hanley; Speroni, Cecilia

    2015-01-01

    Recent efforts to attract and retain effective educators and to improve teaching practices have focused on reforming evaluation and compensation systems for teachers and principals. In 2006, Congress established the Teacher Incentive Fund (TIF), which provides grants to support performance-based compensation systems for teachers and principals in…

  10. Districts Abandon Grants Targeting Teacher Quality

    ERIC Educational Resources Information Center

    Zubrzycki, Jaclyn

    2012-01-01

    Three big-city districts--Chicago, Milwaukee, and New York--have terminated federal grants aimed at promoting performance-based compensation plans and professional development for teachers and principals. Overall, the 2010 Teacher Incentive Fund (TIF) grants to the three districts would have provided an $88 million payout over five years--nearly 7…

  11. Alternative Compensation Terminology: Considerations for Education Stakeholders, Policymakers, and the Media. Emerging Issues. Report No. 2

    ERIC Educational Resources Information Center

    Rowland, Cortney; Potemski, Amy

    2009-01-01

    Schools, districts, and states across the nation are changing the way educators are paid. Through the Teacher Incentive Fund (TIF) and other publicly and independently funded programs, educators at every level are designing and implementing modified pay and reward structures for teachers and principals. Sometimes these initiatives are called…

  12. Evaluation of the Teacher Incentive Fund: Implementation and Early Impacts of Pay-for-Performance after One Year. Executive Summary. NCEE 2014-4020

    ERIC Educational Resources Information Center

    Max, Jeffrey; Constantine, Jill; Wellington, Alison; Hallgren, Kristin; Glazerman, Steven; Chiang, Hanley; Speroni, Cecilia

    2014-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  13. Evaluation of the Teacher Incentive Fund: Implementation and Impacts of Pay-for-Performance after Two Years. Executive Summary. NCEE 2015-4021

    ERIC Educational Resources Information Center

    Chiang, Hanley; Wellington, Alison; Hallgren, Kristin; Speroni, Cecilia; Herrmann, Mariesa; Glazerman, Steven; Constantine, Jill

    2015-01-01

    Recent efforts to attract and retain effective educators and to improve teaching practices have focused on reforming evaluation and compensation systems for teachers and principals. In 2006, Congress established the Teacher Incentive Fund (TIF), which provides grants to support performance-based compensation systems for teachers and principals in…

  14. Evaluation of the Teacher Incentive Fund: Implementation and Impacts of Pay-for-Performance after Two Years. NCEE 2015-4020

    ERIC Educational Resources Information Center

    Chiang, Hanley; Wellington, Alison; Hallgren, Kristin; Speroni, Cecilia; Herrmann, Mariesa; Glazerman, Steven; Constantine, Jill

    2015-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  15. Evaluation of the Teacher Incentive Fund: Implementation and Early Impacts of Pay-for-Performance after One Year. NCEE 2014-4019

    ERIC Educational Resources Information Center

    Max, Jeffrey; Constantine, Jill; Wellington, Alison; Hallgren, Kristin; Glazerman, Steven; Chiang, Hanley; Speroni, Cecilia

    2014-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  16. Early Implementation Experiences of the 2010 Teacher Incentive Fund Grantees. NCEE Study Snapshot. NCEE 2014-4021

    ERIC Educational Resources Information Center

    National Center for Education Evaluation and Regional Assistance, 2014

    2014-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The study measures the impact of pay-for-performance bonuses as part of a comprehensive compensation system within a large, multisite random assignment study design. The treatment schools were to…

  17. An Evaluation of the Teacher Advancement Program (TAP) in Chicago: Year Two Impact Report

    ERIC Educational Resources Information Center

    Glazerman, Steven; Seifullah, Allison

    2010-01-01

    In 2007, the Chicago Public Schools (CPS) began implementing a schoolwide reform called the Teacher Advancement Program (TAP) using funds from the federal Teacher Incentive Fund (TIF) and private foundations. Under the TAP model, teachers can earn extra pay and responsibilities through promotion to mentor or master teacher as well as annual…

  18. Fumigant degradation as affected by different application rate in five soils

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil fumigation is critical in controlling soil-borne pests and diseases and ensuring high yields for many crops. The excellent performance of the totally impermeable film (TIF) on fumigant emission control and pest control efficacy made it possible to use reduced fumigation rates under the tarp to ...

  19. Meeting the Challenges of Fiscal and Programmatic Sustainability: Lessons from Teacher Incentive Fund Grantees. The Harvesting Project

    ERIC Educational Resources Information Center

    Schuermann, Patrick; Archibald, Sarah; Kluender, Ray; Ptak, Kirsten

    2011-01-01

    A total of 33 sites, including states, school districts, charter school coalitions, and other education organizations make up Cohorts 1 and 2 of the Teacher Incentive Fund (TIF). These sites received funds beginning in the fall of 2006 and spring of 2007 to redesign compensation programs for teachers and principals. The U.S. Department of…

  20. Selection of reference genes for analysis of stress-responsive genes after challenge with viruses and temperature changes in the silkworm Bombyx mori.

    PubMed

    Guo, Huizhen; Jiang, Liang; Xia, Qingyou

    2016-04-01

    Viruses and high temperature (HT) are the primary threats to silkworms. Changes in the expression of stress-response genes can be measured using quantitative polymerase chain reaction (qPCR) after exposure to viruses or HT. However, appropriate reference genes (RGs) for qPCR data normalization have not been established in this organism. In this study, we summarized the RGs used in the previous silkworm studies after infection with Bombyx mori nucleopolyhedrovirus (BmNPV), B. mori cytoplasmic polyhedrosis virus (BmCPV), or B. mori densovirus (BmDNV) or after HT treatment. The expression levels of these RGs were extracted from silkworm transcriptome data to screen for candidate RGs that were unaffected by the experimental conditions. Actin-1 (A1), actin-3 (A3), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and translation initiation factor 4a (TIF-4A) were selected for further qPCR verification. The results of RNA-seq and qPCR showed that GAPDH and TIF-4A were suitable RGs after BmNPV challenge or HT stress, whereas TIF-4A was an appropriate RG for BmCPV or BmDNV-Z challenge in silkworms. These results suggested that TIF-4A may be the most appropriate RG for gene expression analysis after challenge with viruses or HT in silkworms. PMID:26437927

  1. Value-Added and Other Methods for Measuring School Performance. Working Paper 2008-17

    ERIC Educational Resources Information Center

    Meyer, Robert H.; Christian, Michael S.

    2008-01-01

    One of the central challenges of designing and implementing a performance pay program is developing an approach for determining which schools, teachers, and administrators have performed well enough to have earned a bonus. The U.S. Department of Education's Teacher Incentive Fund (TIF) program provides grantees substantial latitude to create…

  2. Coastcross II, Russell, and Tifton 85 bermudagrass hay intake and digestion by steers

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Coastcross II is a new bermudagrass entry being compared with other cultivars for quality and yields for grazing and hay production. Exp.1. In a 2-yr (2005, 2006) replicated small plot study (4 plots/entry, each 10m2, total annual N 196.7 kg/ha), Coastal (C), Coastcross II (C2), Russell (R), and Tif...

  3. Baseline Statistics for Evaluation of the Effective Practice Incentive Community. Final Report

    ERIC Educational Resources Information Center

    Cody, Scott; Wellington, Alison; Sullivan, Margaret; Knechtel, Virginia; Chaplin, Duncan

    2009-01-01

    In 2006 and 2007, the U.S. Department of Education awarded Teacher Incentive Fund (TIF) grants for the development of innovative strategies for teacher compensation. New Leaders for New Schools (NLNS), with five partner organizations--Memphis City Schools (MCS), the District of Columbia Public Schools (DCPS), Denver Public Schools, Prince…

  4. Design of the Evaluation of the Effective Practice Incentive Community Initiative. Final Report

    ERIC Educational Resources Information Center

    Cody, Scott; Wellington, Alison; Chaplin, Duncan

    2009-01-01

    In 2006 and 2007, the U.S. Department of Education (ED) awarded $478 million in grants from the Teacher Incentive Fund (TIF) to support the development of innovative teacher compensation strategies. New Leaders for New Schools (NLNS), together with five partners--Memphis City Schools (MCS), the District of Columbia Public Schools (DCPS), Denver…

  5. 2008 Principal/Vice Principal Survey Results for Evaluation of the Effective Practice Incentive Community (EPIC). Final Report

    ERIC Educational Resources Information Center

    Chaplin, Duncan; Verghese, Shinu; Chiang, Hanley; Sonnenfeld, Kathy; Sullivan, Margaret; Kennen, Barbara; Knechtel, Virginia; Hall, John; Harris, Dominic

    2009-01-01

    In 2006 and 2007, the U.S. Department of Education (USDOE) awarded Teacher Incentive Fund (TIF) grants for the development of systems to compensate teachers and principals in part based on increases in student achievement. New Leaders for New Schools (NLNS) received five of these grants and is using them to implement its Effective Practice…

  6. Compensation Reform and Design Preferences of Teacher Incentive Fund Grantees. Policy Paper

    ERIC Educational Resources Information Center

    Heyburn, Sara; Lewis, Jessica; Ritter, Gary

    2010-01-01

    In U.S. K-12 public education, incentive pay for educators remains firmly fixed as a high-interest policy topic and has recently become a popular reform initiative in many school systems. The Teacher Incentive Fund (TIF), created in 2006 by the U.S. Department of Education, is at the forefront of this policy movement and has provided hundreds of…

  7. SE Great Basin Play Fairway Analysis

    DOE Data Explorer

    Adam Brandt

    2015-11-15

    Within this submission are multiple .tif images with accompanying metadata of magnetotelluric conductor occurrence, fault critical stress composite risk segment (CRS), permeability CRS, Quaternary mafic extrusions, Quaternary fault density, and Quaternary rhyolite maps. Each of these contributed to a final play fairway analysis (PFA) for the SE Great Basin study area.

  8. Key Theoretical Frameworks for Intervention: Understanding and Promoting Behavior Change in Parent-Infant Feeding Choices in a Low-Income Population

    ERIC Educational Resources Information Center

    Brophy-Herb, Holly E.; Silk, Kami; Horodynski, Mildred A.; Mercer, Laura; Olson, Beth

    2009-01-01

    The early introduction of solids to infants is a risk factor associated with later health problems including allergies, overweight, and diabetes. The Infant Feeding Series (TIFS), a newly designed curriculum that promotes the appropriate transition to solids through parenting education and behavior change among low-income mothers, used the Theory…

  9. Creating IRT-Based Parallel Test Forms Using the Genetic Algorithm Method

    ERIC Educational Resources Information Center

    Sun, Koun-Tem; Chen, Yu-Jen; Tsai, Shu-Yen; Cheng, Chien-Fen

    2008-01-01

    In educational measurement, the construction of parallel test forms is often a combinatorial optimization problem that involves the time-consuming selection of items to construct tests having approximately the same test information functions (TIFs) and constraints. This article proposes a novel method, genetic algorithm (GA), to construct parallel…

  10. Simulation of fumigant transport and volatilization from tarped broadcast applications

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We evaluated the ability of the HYDRUS 2D/3D model to simulate chloropicrin and 1,3-dichloropropene fate, transport and volatilization. Three fields with similar soil conditions were broadcast fumigated under a totally impermeable film (TIF). One field was used to calibrate HYDRUS by adjusting fumig...

  11. Distribution, efficacy, and off-tarp emissions of carbonated fumigants in low permeability film tarped field

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Previous research in Florida indicated that carbonated fumigants can distribute more quickly and uniformly through soil which suggests that soil-borne disease control could be improved compared to conventional nitrogen pressurized fumigants. Tarping fields with totally impermeable film (TIF) may fur...

  12. Deep drip fumigation in totally impermeable film tarped raised-beds production systems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Tarping raised-beds with totally impermeable film (TIF) and applying fumigant to deeper depths may help strawberry growers to achieve pest control and emission reduction targets, but no field data are available to optimize these methods in the raised-bed production system. Under the support of Natio...

  13. An Evaluation of the Chicago Teacher Advancement Program (Chicago TAP) after Four Years. Final Report

    ERIC Educational Resources Information Center

    Glazerman, Steven; Seifullah, Allison

    2012-01-01

    In 2007, using funds from the federal Teacher Incentive Fund (TIF) and private foundations, the Chicago Public Schools (CPS) began piloting its version of a schoolwide reform model called the Teacher Advancement Program (TAP). Under the TAP model, teachers can earn extra pay and take on increased responsibilities through promotion (to mentor…

  14. Activation of human papillomavirus type 18 gene expression by herpes simplex virus type 1 viral transactivators and a phorbol ester

    SciTech Connect

    Gius, D.; Laimins, L.A.

    1989-02-01

    Several viral trans-activators and a tumor promoter were examined for the ability to activate human papillomavirus type 18 (HPV-18) gene expression. A plasmid containing the HPV-18 noncoding region placed upstream of the chloramphenicol acetyltransferase reporter gene was cotransfected with different herpes simplex virus type 1 (HSV-1) genes into several cell lines. Both HSV-1 TIF and ICPO activated HPV-18 expression; however, activation by TIF was observed only in epithelial cells, while ICPO stimulated expression in a wide variety of cells. The element activated by both TIF and ICOP was mapped to a 229-base-pair fragment which also contains an HPV-18 epithelial cell-preferred enhancer. The inclusion of a papillomavirus E2 trans-activator with TIF and ICOP further increased HPV-18 expression. In contrast, the HSV-1 ICP4 and ICP27 genes, as well as the human T-cell lymphotropic virus type I and human immunodeficiency virus type 1 tat genes, were found to have no effect on HPV-18 expression. In transient assays, the addition of the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) also activated HPV-18 expression. The region of HPV-18 activated by TPA was localized to a sequence which is homologous to other TPA-responsive elements.

  15. Heterosis and Combining Ability Estimates in Isoflavone Content Using Different Parental Soybean Accessions: Wild Soybean, a Valuable Germplasm for Soybean Breeding

    PubMed Central

    Bi, Yingdong; Li, Wei; Xiao, Jialei; Lin, Hong; Liu, Ming; Liu, Miao; Luan, Xiaoyan; Zhang, Bixian; Xie, Xuejun; Guo, Donglin; Lai, Yongcai

    2015-01-01

    Isoflavone, a group of secondary metabolites in soybean, is beneficial to human health. Improving isoflavone content in soybean seeds has become one of the most important breeding objectives. However, the narrow genetic base of soybean cultivars hampered crop improvement. Wild soybean is an extraordinarily important gene pool for soybean breeding. In order to select an optimal germplasm for breeding programs to increase isoflavone concentration, 36 F1 soybean progenies from different parental accessions (cultivars, wild, Semi-wild and Interspecific) with various total isoflavone (TIF) concentration (High, Middle, Low) were analyzed for their isoflavone content. Results showed that male parents, except for Cultivars, showed positive GCA effects. In particular, wild soybean had higher positive GCA effects for TIF concentration. Both MP and BP heterosis value declined in the hybrid in which male parents were wild soybean, semi-wild soybean, interspecific offspring and cultivar in turn. In general, combining ability and heterosis in hybrids which had relative higher TIF concentration level parents showed better performance than those which had lower TIF concentration level parents. These results indicated characteristics of isoflavone content were mainly governed by additive type of gene action, and wild relatives could be utilized for breeding of soybean cultivars with this trait. A promising combination was found as the best potential hybrid for isoflavone content improvement. PMID:25607952

  16. Hand-held transendoscopic robotic manipulators: A transurethral laser prostate surgery case study

    PubMed Central

    Hendrick, Richard J.; Mitchell, Christopher R.; Herrell, S. Duke; Webster, Robert J.

    2016-01-01

    Natural orifice endoscopic surgery can enable incisionless approaches, but a major challenge is the lack of small and dexterous instrumentation. Surgical robots have the potential to meet this need yet often disrupt the clinical workflow. Hand-held robots that combine thin manipulators and endoscopes have the potential to address this by integrating seamlessly into the clinical workflow and enhancing dexterity. As a case study illustrating the potential of this approach, we describe a hand-held robotic system that passes two concentric tube manipulators through a 5 mm port in a rigid endoscope for transurethral laser prostate surgery. This system is intended to catalyze the use of a clinically superior, yet rarely attempted, procedure for benign prostatic hyperplasia. This paper describes system design and experiments to evaluate the surgeon’s functional workspace and accuracy using the robot. Phantom and cadaver experiments demonstrate successful completion of the target procedure via prostate lobe resection. PMID:27570361

  17. Translacrimal transnasal laser-assisted dacryocystorhinostomy.

    PubMed

    Pearlman, S J; Michalos, P; Leib, M L; Moazed, K T

    1997-10-01

    Chronic dacryocystitis is due to an obstruction in the nasolacrimal duct, with subsequent infection of the lacrimal sac. The goal of surgery is to reestablish intranasal drainage of the lacrimal sac. Classic dacryocystorhinostomy (DCR) requires an external incision and drilling through the lacrimal bone into the middle meatus. In our study a 600-micron neodymium:YAG (Nd:YAG) fiber with a blunt hemispherical tip is inserted via the lacrimal puncta. An intranasal ostium is created with the laser under intranasal endoscopic control. Silicon tubes are then left in place for 6 months. We have performed 49 procedures over the past 2 1/2 years, with a success rate of 85% after one surgical procedure, which is commensurate with standard DCR. This procedure provides a simple, bloodless, incisionless alternative to standard DCR. PMID:9331314

  18. Field evaluation of a new plastic film (vapor safe) to reduce fumigant emissions and improve distribution in soil.

    PubMed

    Qin, Ruijun; Gao, Suduan; Ajwa, Husein; Sullivan, David; Wang, Dong; Hanson, Bradley D

    2011-01-01

    Preplant soil fumigation is an important pest management practice in coastal California strawberry production regions. Potential atmospheric emissions of fumigants from field treatment, however, have drawn intensive environmental and human health concerns; increasingly stringent regulations on fumigant use have spurred research on low-emission application techniques. The objectives of this research were to determine the effects of a new low-permeability film, commonly known as totally impermeable film (TIF), on fumigant emissions and on fumigant distribution in soil. A 50/50 mixture of 1,3-dichloropropene (1,3-D) and chloropicrin (CP) was shank-applied at 314 kg ha in two location-separate field plots (0.4 ha each) in Ventura County, California, in fall 2009. One plot was surface-covered with standard polyethylene (PE) film, and the other was covered with TIF immediately after fumigant application. Data collection included emissions, soil-gas phase concentration profile, air concentration under the film, and soil residuals of the applied fumigants. Peak emission flux of 1,3-D and CP from the TIF field was substantially lower than from the PE field. Total through-film emission loss was 2% for 1,3-D and <1% for CP from the TIF field during a 6-d film covering period, compared with 43% for 1,3-D and 12% for CP from the PE field. However, on film-cutting, greater retention of 1,3-D in the TIF field resulted in a much higher emission surge compared with the PE field, while CP emissions were fairly low in both fields. Higher concentrations and a more uniform distribution in the soil profile for 1,3-D and CP were observed under the TIF compared with the PE film, suggesting that the TIF may allow growers to achieve satisfactory pest control with lower fumigant rates. The surging 1,3-D emissions after film-cutting could result in high exposure risks to workers and bystanders and must be addressed with additional mitigation measures. PMID:21712589

  19. Tumor necrosis factor alpha transcription in macrophages is attenuated by an autocrine factor that preferentially induces NF-kappaB p50.

    PubMed

    Baer, M; Dillner, A; Schwartz, R C; Sedon, C; Nedospasov, S; Johnson, P F

    1998-10-01

    Macrophages are a major source of proinflammatory cytokines such as tumor necrosis factor alpha (TNF-alpha), which are expressed during conditions of inflammation, infection, or injury. We identified an activity secreted by a macrophage tumor cell line that negatively regulates bacterial lipopolysaccharide (LPS)-induced expression of TNF-alpha. This activity, termed TNF-alpha-inhibiting factor (TIF), suppressed the induction of TNF-alpha expression in macrophages, whereas induction of three other proinflammatory cytokines (interleukin-1beta [IL-1beta], IL-6, and monocyte chemoattractant protein 1) was accelerated or enhanced. A similar or identical inhibitory activity was secreted by IC-21 macrophages following LPS stimulation. Inhibition of TNF-alpha expression by macrophage conditioned medium was associated with selective induction of the NF-kappaB p50 subunit. Hyperinduction of p50 occurred with delayed kinetics in LPS-stimulated macrophages but not in fibroblasts. Overexpression of p50 blocked LPS-induced transcription from a TNF-alpha promoter reporter construct, showing that this transcription factor is an inhibitor of the TNF-alpha gene. Repression of the TNF-alpha promoter by TIF required a distal region that includes three NF-kappaB binding sites with preferential affinity for p50 homodimers. Thus, the selective repression of the TNF-alpha promoter by TIF may be explained by the specific binding of inhibitory p50 homodimers. We propose that TIF serves as a negative autocrine signal to attenuate TNF-alpha expression in activated macrophages. TIF is distinct from the known TNF-alpha-inhibiting factors IL-4, IL-10, and transforming growth factor beta and may represent a novel cytokine. PMID:9742085

  20. Tumor Necrosis Factor Alpha Transcription in Macrophages Is Attenuated by an Autocrine Factor That Preferentially Induces NF-κB p50

    PubMed Central

    Baer, Mark; Dillner, Allan; Schwartz, Richard C.; Sedon, Constance; Nedospasov, Sergei; Johnson, Peter F.

    1998-01-01

    Macrophages are a major source of proinflammatory cytokines such as tumor necrosis factor alpha (TNF-α), which are expressed during conditions of inflammation, infection, or injury. We identified an activity secreted by a macrophage tumor cell line that negatively regulates bacterial lipopolysaccharide (LPS)-induced expression of TNF-α. This activity, termed TNF-α-inhibiting factor (TIF), suppressed the induction of TNF-α expression in macrophages, whereas induction of three other proinflammatory cytokines (interleukin-1β [IL-1β], IL-6, and monocyte chemoattractant protein 1) was accelerated or enhanced. A similar or identical inhibitory activity was secreted by IC-21 macrophages following LPS stimulation. Inhibition of TNF-α expression by macrophage conditioned medium was associated with selective induction of the NF-κB p50 subunit. Hyperinduction of p50 occurred with delayed kinetics in LPS-stimulated macrophages but not in fibroblasts. Overexpression of p50 blocked LPS-induced transcription from a TNF-α promoter reporter construct, showing that this transcription factor is an inhibitor of the TNF-α gene. Repression of the TNF-α promoter by TIF required a distal region that includes three NF-κB binding sites with preferential affinity for p50 homodimers. Thus, the selective repression of the TNF-α promoter by TIF may be explained by the specific binding of inhibitory p50 homodimers. We propose that TIF serves as a negative autocrine signal to attenuate TNF-α expression in activated macrophages. TIF is distinct from the known TNF-α-inhibiting factors IL-4, IL-10, and transforming growth factor β and may represent a novel cytokine. PMID:9742085

  1. Quantitative Proteomics Analysis of Tissue Interstitial Fluid for Identification of Novel Serum Candidate Diagnostic Marker for Hepatocellular Carcinoma

    PubMed Central

    Sun, Wei; Xing, Baocai; Guo, Lihai; Liu, Zhilei; Mu, Jinsong; Sun, Longqin; Wei, Handong; Zhao, Xiaohang; Qian, Xiaohong; Jiang, Ying; He, Fuchu

    2016-01-01

    Hepatocellular carcinoma (HCC) is the fifth most common malignant cancer in the world. The sensitivity of alpha-fetoprotein (AFP) is still inadequate for HCC diagnosis. Tissue interstitial fluid (TIF), as the liquid microenvironment of cancer cells, was used for biomarker discovery in this study. Paired tumor and nontumor TIF samples from 6 HBV-HCC patients were analyzed by a proteomic technique named iTRAQ (isobaric tag for relative and absolute quantitation). Totally, 241 up-regulated proteins (ratio ≥ 1.3, p < 0.05) and 288 down-regulated proteins (ratio ≤ −1.3, p < 0.05) in tumor TIF were identified. Interestingly, proteins in S100 family were found remarkably up-regulated in tumor TIF. One dramatically up-regulated protein S100A9 (ratio = 19) was further validated by ELISA in sera from liver cirrhosis (LC, HCC high risk population) and HCC patients (n = 47 for each group). The level of this protein was significantly elevated in HCC sera compared with LC (p < 0.0001). The area under the curve of this protein to distinguish HCC from LC was 0.83, with sensitivity of 91% (higher than AFP) and specificity of 66%. This result demonstrated the potential of S100A9 as a candidate HCC diagnostic biomarker. And TIF was a kind of promising material to identify candidate tumor biomarkers that could be detected in serum. PMID:27216119

  2. Oropharyngeal Dysphagia in Dermatomyositis: Associations with Clinical and Laboratory Features Including Autoantibodies

    PubMed Central

    Mugii, Naoki; Hasegawa, Minoru; Matsushita, Takashi; Hamaguchi, Yasuhito; Oohata, Sacihe; Okita, Hirokazu; Yahata, Tetsutarou; Someya, Fujiko; Inoue, Katsumi; Murono, Shigeyuki; Fujimoto, Manabu; Takehara, Kazuhiko

    2016-01-01

    Objective Dysphagia develops with low frequency in patients with dermatomyositis. Our objective was to determine the clinical and laboratory features that can estimate the development of dysphagia in dermatomyositis. Methods This study included 92 Japanese patients with adult-onset dermatomyositis. The associations between dysphagia and clinical and laboratory features including disease-specific autoantibodies determined by immunoprecipitation assays were analyzed. Results Videofluoroscopy swallow study (VFSS) was performed for all patients with clinical dysphagia (n = 13, 14.1%) but not for patients without clinical dysphagia. Typical findings of dysphagia (pharyngeal pooling, n = 11 and/or nasal regurgitation, n = 4) was detected by VFSS in all patients with clinical dysphagia. Eleven patients with dysphagia (84.6%) had anti-transcription intermediary factor 1γ (TIF-1γ) antibody. By univariate analysis, the average age and the male to female ratio, internal malignancy, and anti-TIF-1γ antibody were significantly higher and the frequency of interstitial lung diseases and manual muscle testing (MMT) scores of sternomastoid and dertoid muscles were significantly lower in patients with dysphagia than in patients without dysphagia. Among patients with anti-TIF-1γ antibody, the mean age, the ratios of male to female and internal malignancy were significantly higher and mean MMT scores of sternomastoid muscle were significantly lower in patients with dysphagia compared with patients without dysphagia. By multivariable analysis, the risk of dysphagia was strongly associated with the existence of internal malignancy and ant-TIF-1γ antibody and was also associated with reduced scores of manual muscle test of sternomastoid muscle. Dysphagia was markedly improved after the treatment against myositis in all 13 patients. Conclusion These findings indicate that dysphagia can develop frequently in patients with internal malignancy, anti-TIF-1γ antibody, or severe muscle

  3. Reproduction of Belonolaimus longicaudatus, Meloidogyne javanica, Paratrichodorus minor, and Pratylenchus brachyurus on Pearl Millet (Pennisetum glaucum)

    PubMed Central

    Timper, P.; Hanna, W. W.

    2005-01-01

    Pearl millet (Pennisetum glaucum) has potential as a grain crop for dryland crop production in the southeastern United States. Whether or not pearl millet will be compatible in rotation with cotton (Gossypium hirsutum), corn (Zea mays), and peanut (Arachis hypogaea) will depend, in part, on its host status for important plant-parasitic nematodes of these crops. The pearl millet hybrid 'TifGrain 102' is resistant to both Meloidogyne incognita race 3 and M. arenaria race 1; however, its host status for other plant-parasitic nematodes was unknown. In this study, the reproduction of Belonolaimus longicaudatus, Paratrichodorus minor, Pratylenchus brachyurus, and Meloidogyne javanica race 3 on pearl millet ('HGM-100' and TifGrain 102) was compared relative to cotton, corn, and peanut. Separate greenhouse experiments were conducted for each nematode species. Reproduction of B. longicaudatus was lower on peanut and the two millet hybrids than on cotton and corn. Reproduction of P. minor was lower on peanut and TifGrain 102 than on cotton, corn, and HGM-100. Reproduction of P. brachyurus was lower on both millet hybrids than on cotton, corn, and peanut. Reproduction of M. javanica race 3 was greater on peanut than on the two millet hybrids and corn. Cotton was a nonhost. TifGrain 102 was more resistant than HGM-100 to reproduction of B. longicaudatus, P. minor, and M. javanica. Our results demonstrated that TifGrain 102 was a poor host for B. longicaudatus and P. brachyurus (Rf < 1) and, relative to other crops tested, was less likely to increase densities of P. minor and M. javanica. PMID:19262863

  4. Combined tracheoinnominate artery fistula and tracheoesophageal fistula: A very rare complication of indwelling tracheostomy tube

    PubMed Central

    Dalouee, Marziyeh Nouri; Masuom, Seyed Hossein Fattahi; Rahnama, Ali; Rajai, Zahra

    2016-01-01

    Tracheoinnominate artery fistula (TIF) is a serious complication of tracheostomy. If untreated, it could be life-threatening. The emergency approach to the condition that includes prompt diagnosis, rapid control of bleeding with a clear airway, and operation with or without interruption of the innominate artery are the most important factors influencing patient outcome. Tracheoesophageal fistula (TEF) is another complication of tracheostomy. In association with compromised quality of life, this condition is really hard to be treated. We report a case of combined TIF and TEF in a 27-year-old man with quadriplegia who suffered a car accident but was successfully managed with interruption and ligature of the innominate artery repair of trachea. PMID:27051118

  5. Composite behaviors of dual meminductor circuits

    NASA Astrophysics Data System (ADS)

    Zheng, Ci-Yan; Yu, Dong-Sheng; Liang, Yan; Chen, Meng-Ke

    2015-11-01

    This paper focuses on analyzing the composite dynamic behaviors of two meminductors in serial and parallel connections with different polarities. Based on the constitutive relations, two time-integral-of-flux (TIF) controlled meminductors are adopted to theoretically demonstrate the variation of memductance in terms of TIF, charge, flux, and current. By utilizing a floating memristor-less meminductor emulator, the theoretical analysis reported in this paper is confirmed via a PSPICE simulation study and hardware experiment. Good agreement among theoretical analysis, simulation, and hardware validation confirms that dual meminductor circuits in composite connections behave as a new meminductor with higher complexity. Project supported by the Fundamental Research Funds for the Central Universities, China (Grant No. 2013QNB28.)

  6. How a Thermally Unstable Metal Hydrido Complex Can Yield High Catalytic Activity Even at Elevated Temperatures.

    PubMed

    Ehm, Christian; Krüger, Juliane; Lentz, Dieter

    2016-06-27

    Despite their instability in ethereal solvents, organotitanium hydride catalysts are successfully employed in catalysis at moderate to high temperatures (110 °C), even in the presence of alcohols. It is shown computationally (bond dissociation energy (BDE) analysis and energetic profile for regeneration) and experimentally (EPR studies and kinetic studies), with the specific example of hydrodefluorination (HDF), that despite the long standing belief, regeneration of Ti-H bonds from Ti-F bonds using silanes is endergonic. The resulting low concentration of Ti-H species is crucial for the catalytic stability of those systems. The resting state in the catalysis is a Ti-F species. The most promising silanes for regeneration are not the ones that have the strongest Si-F bond, but the ones that show the largest difference in Si-F and Si-H BDEs. PMID:27257786

  7. Combined tracheoinnominate artery fistula and tracheoesophageal fistula: A very rare complication of indwelling tracheostomy tube.

    PubMed

    Dalouee, Marziyeh Nouri; Masuom, Seyed Hossein Fattahi; Rahnama, Ali; Rajai, Zahra

    2016-01-01

    Tracheoinnominate artery fistula (TIF) is a serious complication of tracheostomy. If untreated, it could be life-threatening. The emergency approach to the condition that includes prompt diagnosis, rapid control of bleeding with a clear airway, and operation with or without interruption of the innominate artery are the most important factors influencing patient outcome. Tracheoesophageal fistula (TEF) is another complication of tracheostomy. In association with compromised quality of life, this condition is really hard to be treated. We report a case of combined TIF and TEF in a 27-year-old man with quadriplegia who suffered a car accident but was successfully managed with interruption and ligature of the innominate artery repair of trachea. PMID:27051118

  8. Pulsed laser-assisted focused electron-beam-induced etching of titanium with XeF2: enhanced reaction rate and precursor transport.

    PubMed

    Noh, J H; Fowlkes, J D; Timilsina, R; Stanford, M G; Lewis, B B; Rack, P D

    2015-02-25

    In order to enhance the etch rate of electron-beam-induced etching, we introduce a laser-assisted focused electron-beam-induced etching (LA-FEBIE) process which is a versatile, direct write nanofabrication method that allows nanoscale patterning and editing. The results demonstrate that the titanium electron stimulated etch rate via the XeF2 precursor can be enhanced up to a factor of 6 times with an intermittent pulsed laser assist. The evolution of the etching process is correlated to in situ stage current measurements and scanning electron micrographs as a function of time. The increased etch rate is attributed to photothermally enhanced Ti-F reaction and TiF4 desorption and in some regimes enhanced XeF2 surface diffusion to the reaction zone. PMID:25629708

  9. Dual lithium insertion and conversion mechanisms in a titanium-based mixed-anion nanocomposite.

    PubMed

    Dambournet, Damien; Chapman, Karena W; Chupas, Peter J; Gerald, Rex E; Penin, Nicolas; Labrugere, Christine; Demourgues, Alain; Tressaud, Alain; Amine, Khalil

    2011-08-31

    The electrochemical reaction of lithium with a vacancy-containing titanium hydroxyfluoride was studied. On the basis of pair distribution function analysis, NMR, and X-ray photoelectron spectroscopy, we propose that the material undergoes partitioning upon initial discharge to form a nanostructured composite containing crystalline Li(x)TiO(2), surrounded by a Ti(0) and LiF layer. The Ti(0) is reoxidized upon reversible charging to an amorphous TiF(3) phase via a conversion reaction. The crystalline Li(x)TiO(2) is involved in an insertion reaction. The resulting composite electrode, Ti(0)-LiF/Li(x)TiO(2) ⇔ TiF(3)/ Li(y)TiO(2), allows reaction of more than one Li per Ti, providing a route to higher capacities while improving the energy efficiency compared to pure conversion chemistries. PMID:21809881

  10. A Review of New Surgical and Endoscopic Therapies for Gastroesophageal Reflux Disease.

    PubMed

    Ganz, Robert A

    2016-07-01

    Treatment of gastroesophageal reflux disease in the United States today is binary, with the majority of patients with gastroesophageal reflux disease being treated with antisecre-tory medications and a minority of patients, typically those with volume regurgitation, undergoing Nissen fundoplication. However, there has been increasing dissatisfaction with proton pump inhibitor therapy among a significant number of patients with gastroesophageal reflux disease owing to cost, side effects, and refractory symptoms, and there has been a general reluctance to undergo surgical fundoplication due to its attendant side-effect profile. As a result, a therapy gap exists for many patients with gastroesophageal reflux disease. Alternative techniques are available for these gap patients, including 2 endoscopic fundoplication techniques, an endoscopic radiofrequency energy delivery technique, and 2 minimally invasive surgical procedures. These alternative techniques have been extensively evaluated; however, there are limitations to published studies, including arbitrary definitions of success, variable efficacy measurements, deficient reporting tools, inconsistent study designs, inconsistent lengths of follow-up postintervention, and lack of comparison data across techniques. Although all of the techniques appear to be safe, the endoscopic techniques lack demonstrable reflux control and show variable symptom improvement and variable decreases in proton pump inhibitor use. The surgical techniques are more robust, with evidence for adequate reflux control, symptom improvement, and decreased proton pump inhibitor use; however, these techniques are more difficult to perform and are more intrusive. Additionally, these alternative techniques have only been studied in patients with relatively normal anatomy. The field of gastroesophageal reflux disease treatment is in need of consistent definitions of efficacy, standardized study design and outcome measurements, and improved reporting

  11. A Review of New Surgical and Endoscopic Therapies for Gastroesophageal Reflux Disease

    PubMed Central

    2016-01-01

    Treatment of gastroesophageal reflux disease in the United States today is binary, with the majority of patients with gastroesophageal reflux disease being treated with antisecre-tory medications and a minority of patients, typically those with volume regurgitation, undergoing Nissen fundoplication. However, there has been increasing dissatisfaction with proton pump inhibitor therapy among a significant number of patients with gastroesophageal reflux disease owing to cost, side effects, and refractory symptoms, and there has been a general reluctance to undergo surgical fundoplication due to its attendant side-effect profile. As a result, a therapy gap exists for many patients with gastroesophageal reflux disease. Alternative techniques are available for these gap patients, including 2 endoscopic fundoplication techniques, an endoscopic radiofrequency energy delivery technique, and 2 minimally invasive surgical procedures. These alternative techniques have been extensively evaluated; however, there are limitations to published studies, including arbitrary definitions of success, variable efficacy measurements, deficient reporting tools, inconsistent study designs, inconsistent lengths of follow-up postintervention, and lack of comparison data across techniques. Although all of the techniques appear to be safe, the endoscopic techniques lack demonstrable reflux control and show variable symptom improvement and variable decreases in proton pump inhibitor use. The surgical techniques are more robust, with evidence for adequate reflux control, symptom improvement, and decreased proton pump inhibitor use; however, these techniques are more difficult to perform and are more intrusive. Additionally, these alternative techniques have only been studied in patients with relatively normal anatomy. The field of gastroesophageal reflux disease treatment is in need of consistent definitions of efficacy, standardized study design and outcome measurements, and improved reporting

  12. Tracheoinnominate fistula: diagnosis and management.

    PubMed

    Allan, James S; Wright, Cameron D

    2003-05-01

    TIF is a rare and often fatal complication of tracheostomy. Bleeding from the trachea after tracheostomy demands urgent investigation. Bronchoscopy is the diagnostic procedure of choice. Bedside control of hemorrhage by cuff overinflation or by digital arterial compression can be lifesaving. Prompt operation with division of the innominate artery and subsequent separation of the trachea from the divided artery by viable tissue is indicated. Neurologic complications are rare. PMID:12755317

  13. Management of tracheoinnominate artery fistula.

    PubMed

    Wright, C D

    1996-11-01

    TIF is a rare and often fatal complication of tracheostomy. Bleeding from the trachea after tracheostomy demands urgent investigation. Bronchoscopy is the diagnostic procedure of choice. Bedside control of hemorrhage by cuff overinflation or digital arterial compression can be lifesaving. Prompt operation with division of the innominate artery and separation of the trachea from the divided artery by viable tissue is indicated. Neurologic complications are rare. PMID:8934014

  14. Effects of Infection by Belonolaimus longicaudatus on Rooting Dynamics among St. Augustinegrass and Bermudagrass Genotypes

    PubMed Central

    Aryal, Sudarshan K.; Crow, William T.; McSorley, Robert; Giblin-Davis, Robin M.; Rowland, Diane L.; Poudel, Bishow; Kenworthy, Kevin E.

    2015-01-01

    Understanding rooting dynamics using the minirhizotron technique is useful for cultivar selection and to quantify nematode damage to roots. A 2-yr microplot study including five bermudagrass (‘Tifway’, Belonolaimus longicaudatus susceptible; two commercial cultivars [TifSport and Celebration] and two genotypes [‘BA132’ and ‘PI 291590’], which have been reported to be tolerant to B. longicaudatus) and two St. Augustinegrass (‘FX 313’, susceptible, and ‘Floratam’ that was reported as tolerant to B. longicaudatus) genotypes in a 5 x 2 and 2 x 2 factorial design with four replications, respectively, was initiated in 2012. Two treatments included were uninoculated and B. longicaudatus inoculated. In situ root images were captured each month using a minirhizotron camera system from April to September of 2013 and 2014. Mixed models analysis and comparison of least squares means indicated significant differences in root parameters studied across the genotypes and soil depths of both grass species. ‘Celebration’, ‘TifSport’ and ‘PI 291590’ bermudagrass, and ‘Floratam’ St. Augustinegrass had significantly different root parameters compared to the corresponding susceptible genotypes (P ≤ 0.05). Only ‘TifSport’ had no significant root loss when infested with B. longicaudatus compared to non-infested. ‘Celebration’ and ‘PI 291590’ had significant root loss but retained significantly greater root densities than ‘Tifway’ in B. longicaudatus-infested conditions (P ≤ 0.05). Root lengths were greater at the 0 to 5 cm depth followed by 5 to 10 and 10 to 15 cm of vertical soil depth for both grass species (P ≤ 0.05). ‘Celebration’, ‘TifSport’, and ‘PI 291590’ had better root vigor against B. longicaudatus compared to Tifway. PMID:26941461

  15. Hydrogeochemical niches associated with hyporheic exchange beneath an acid mine drainage-contaminated stream

    NASA Astrophysics Data System (ADS)

    Larson, Lance N.; Fitzgerald, Michael; Singha, Kamini; Gooseff, Michael N.; Macalady, Jennifer L.; Burgos, William

    2013-09-01

    Biological low-pH Fe(II)-oxidation creates terraced iron formations (TIFs) that remove Fe(III) from solution. TIFs can be used for remediation of acid mine drainage (AMD), however, as sediment depth increases, Fe(III)-reduction in anoxic subsurface areas may compromise treatment effectiveness. In this study we used near-surface electrical resistivity imaging (ERI) and in situ pore-water samplers to spatially resolve bulk conductivity changes within a TIF formed in a stream emanating from a large abandoned deep clay mine in Cambria County, Pennsylvania, USA. Because of the high fluid electrical conductivity of the emergent AMD (1860 μS), fresh water (42 μS) was added as a dilution tracer to visualize the spatial and temporal extent of hyporheic exchange and to characterize subsurface flow paths. Distinct hydrogeochemical niches were identified in the shallow subsurface beneath the stream by overlaying relative groundwater velocities (derived from ERI) with pore-water chemistry profiles. Niches were classified based on relatively “fast” versus “slow” rates of hyporheic exchange and oxic versus anoxic conditions. Pore-water concentrations and speciation of iron, pH, and redox potential differed between subsurface flow regimes. The greatest extent of hyporheic exchange was beneath the center of the stream, where a shallower (<10 cm) Fe(II)-oxidizing zone was observed. Meanwhile, less hyporheic exchange was observed near the channel banks, concurrent with a more pronounced, deeper (>70 cm) Fe(II)-oxidizing zone. At these locations, relatively slower groundwater exchange may promote biotic Fe(II)-oxidation and improve the long-term stability of Fe sequestered in TIFs.

  16. Ab initio calculation of Ti NMR shieldings for titanium oxides and halides

    NASA Astrophysics Data System (ADS)

    Tossell, J. A.

    Titanium NMR shielding constants have been calculated using ab initio coupled Hartree-Fock perturbation theory and polarized double-zeta basis sets for TiF 4, TiF 62-, TiCI 4, Ti(OH) 4, Ti(OH 2) 64+, Ti(OH) 4O, and Ti(OH) 3O -. In all cases the calculations were performed at Hartree-Fuck energy-optimized geometries. For Ti(OH) 4 a S4-symmetry geometry with nonlinear ∠ TiOH was employed. Relative shieldings are in reasonable agreement with experiment for TiF 62-, TiCI 4, and Ti(OR) 4, where R = H or alkyl. Ti(OH 2) 64+ is predicted to be more highly shielded than Ti(OH) 4 by about 340 ppm. The five-coordinate complex Ti(OH) 4O, whose calculated structure matches well that measured by extended X-ray absorption fine structure in K 2O · TiO 2 · SiO 2 glass, is actually deshielded compared to Ti(OH) 4 by about 40 ppm. X-ray absorption-near-edge spectral energies have also been calculated for TiF 4, TiCI 4, Ti(OH) 4, and Ti(OH) 4O using an equivalent ionic core virtual-orbital method and the observed reduction in term energy for the five-coordinate species compared to Ti(OH) 4 has been reproduced. Replacement of the H atoms in Ti(OH) 4 by point charges has only a slight effect upon σTi, suggesting a possible means of incorporating second-neighbor effects in NMR calculations for condensed phases.

  17. Obtaining and processing Daymet data using Python and ArcGIS

    USGS Publications Warehouse

    Bohms, Stefanie

    2013-01-01

    This set of scripts was developed to automate the process of downloading and mosaicking daily Daymet data to a user defined extent using ArcGIS and Python programming language. The three steps are downloading the needed Daymet tiles for the study area extent, converting the netcdf file to a tif raster format, and mosaicking those rasters to one file. The set of scripts is intended for all levels of experience with Python programming language and requires no scripting by the user.

  18. Facet-controlled anatase TiO2 nanoparticles through various fluorine sources for superior photocatalytic activity.

    PubMed

    Lee, Seung Muk; Park, Geun Chul; Seo, Tae Yang; Jung, Seung-Boo; Lee, Ju Ha; Kim, Young Dok; Choi, Dae Hyuk; Lim, Jun Hyung; Joo, Jinho

    2016-09-30

    Reactive surface-exposed anatase TiO2 (a-TiO2) is highly desirable for applications requiring superior photocatalytic activity. In order to obtain a favorable surface, morphology control of the a-TiO2 using capping agents has been widely investigated. Herein, we systematically study the effects of different F sources (HF, TiF4, and NH4F) as the capping agent on the morphology control and photocatalytic activities of a-TiO2 in a hydrothermal process. When either HF or TiF4 was added, large truncated bipyramids formed with the photocatalytically active {001} facet, whereas the NH4F was not effective for facet control, yielding nanospheres similar to the pure a-TiO2. The morphology changes were related to the decomposition behaviors of the F sources in the solvent material: HF and TiF4 decomposed and supplied F(-) ions before a-TiO2 nucleation, which changed the nucleation rate and growth direction, leading to the resultant a-TiO2 morphology. On the other hand, NH4F supplied F(-) ions after a-TiO2 nucleation and could not change the growth behavior. In terms of the photocatalytic effect, the HF- and TiF4-treated a-TiO2 effectively decomposed ∼90% and ∼80% of methylene blue, respectively, in 1 h, while ∼60% was decomposed for the NH4F-treated a-TiO2. Note that pure a-TiO2 photocatalytically decomposed only ∼10% of methylene blue over the same time. These results pave the way to precise control of the facet of TiO2 through using different capping agents. PMID:27560359

  19. Clinical Conundrum: Killian-Jamieson Diverticulum with Paraesophageal Hernia.

    PubMed

    Bock, Jonathan M; Knabel, Michael J; Lew, Daniel A; Knechtges, Paul M; Gould, Jon C; Massey, Benson T

    2016-08-01

    Killian-Jamieson diverticulum is a outpouching of the lateral cervical esophageal wall adjacent to the insertion of the recurrent laryngeal to the larynx and is much less common in clinical practice than Zenkers Diverticulum. Surgical management of Killian-Jamieson diverticulum requires open transcervical diverticulectomy due to the proximity of the recurrent laryngeal nerve to the base of the pouch. We present a case of a Killian-Jamieson diverticulum associated with a concurrent large type III paraesophageal hernia causing significant solid-food dysphagia, post-prandial regurgitation of solid foods, and chronic cough managed with open transcervical diverticulectomy and laparoscopic paraesophageal hernia repair with Nissen fundoplication. PMID:26753928

  20. Operation for gastro-oesophageal reflux associated with severe mental retardation.

    PubMed Central

    Spitz, L; Roth, K; Kiely, E M; Brereton, R J; Drake, D P; Milla, P J

    1993-01-01

    One hundred and seventy six children with severe mental retardation underwent a fundoplication for considerable gastro-oesophageal reflux. There were six 'early' (3%) deaths and five 'late' deaths. Major complications developed in 17 (10%) children whereas 86 (49%) had 'minor' complications. A revision operation was required in 27 patients. Overall 142 (81%) children achieved a good result. In spite of the high complication rate and the need for a secondary operation in 15% of the patients, the quality of life for these children and their parents and carers is greatly improved by antireflux surgery. PMID:8466236

  1. [New method of treating achalasia is now being tested. Minimally Invasive POEM has produced promising results so far].

    PubMed

    Håkanson, Bengt; Tsai, Jon; Kumagai, Koshi; Efendic, Enes; Lundell, Lars; Thorell, Anders

    Achalasia of the cardia is a motor disorder of the esophagus and lower esophageal sphincter with dysphagia as the dominating symptom. The diagnosis is based on esophageal manometry and barium swallow. During work-up dysphagia of other origin should be excluded by endoscopy. Standard treatment of achalasia today is laparoscopic esophagogastromyotomy with partial fundoplication or pneumatic dilatation of the lower esophageal sphincter. POEM (PerOral Endoscopic Myotomy), a new minimally invasive technique, has recently been introduced in Sweden. So far, 45 patients have been treated. POEM is currently being compared with laparoscopic esophagogastromyotomy within a European randomized multicenter study. PMID:25386642

  2. PERIOPERATIVE CARE OF A CHILD WITH CRISPONI SYNDROME.

    PubMed

    Rafiq, Mahmood; Almasry, Shadi; Abdulrahman, Anas; Al-Sohabani, Mazen; Tobias, Joseph D

    2016-06-01

    Crisponi syndrome is an autosomal recessive disorder characterized by intermittent episodes of muscular contraction of the facial muscles with trismus and excessive salivation simulating a tetanic spasm. These episodes occur in response to tactile stimulation or during crying. Associated physical and constitutional findings include characteristic facial anomalies, camptodactyly, intermittent hyperthermia, and feeding difficulties. We present a 15-month-old girl who required anesthetic care during laparoscopic fundoplication and gastric tube insertion. The perioperative implications of the disorder are reviewed and suggestions for anesthetic management provided. PMID:27487643

  3. Bronchobiliary fistula: a case report

    PubMed Central

    Fischer, James D.

    1998-01-01

    Fewer than 20 cases of bronchobiliary fistula have been reported in the literature. In this report a newborn female infant was referred for investigation of gastroesophageal reflux. Upper gastrointestinal endoscopy and 24-hour pH monitoring revealed severe reflux. A fundoplication was carried out. In the immediate postoperative period bile was noticed coming from the endotracheal tube. Bronchoscopy revealed an abnormal opening just to the left of the carina. Fistulography and HIDA scanning confirmed the presence of a bronchobiliary fistula. A right thoracotomy was used to divide the fistula. The child made an uncomplicated recovery. Pathological examination of the excised specimen demonstrated tissue most consistent with an esophageal origin. PMID:9854540

  4. Laparoscopic paraesophageal hernia repair: current controversies.

    PubMed

    Soper, Nathaniel J; Teitelbaum, Ezra N

    2013-10-01

    The advent of laparoscopy has significantly improved postoperative outcomes in patients undergoing surgical repair of a paraesophageal hernia. Although this minimally invasive approach considerably reduces postoperative pain and recovery times, and may improve physiologic outcomes, laparoscopic paraesophageal hernia repair remains a complex operation requiring advanced laparoscopic skills and experience with the anatomy of the gastroesophageal junction and diaphragmatic hiatus. In this article, we describe our approach to patient selection, preoperative evaluation, operative technique, and postoperative management. Specific attention is paid to performing an adequate hiatal dissection and esophageal mobilization, the decision of whether to use a mesh to reinforce the crural repair, and construction of an adequate antireflux barrier (ie, fundoplication). PMID:24105282

  5. Barrett esophagus.

    PubMed

    Splittgerber, Mark; Velanovich, Vic

    2015-06-01

    Although there are many unanswered questions with Barrett esophagus, we can safely say that the incidence is increasing, chemoprevention strategies for the prevention of Barrett metaplasia and its progression to adenocarcinoma may be in the offing, surveillance should be considered for all patients who are discovered to have Barrett esophagus, RFA is the treatment of choice for those with HGD and strongly considered in those with LGD, EMR should be the treatment of choice for patients with nodular high-grade Barrett esophagus, and, finally, vagal-sparing esophagectomy reserved for patients with persistent HGD or a strong suspicion of carcinoma, with consideration of a concomitant fundoplication. PMID:25965132

  6. Nuclear medicine and esophageal surgery

    SciTech Connect

    Taillefer, R.; Beauchamp, G.; Duranceau, A.C.; Lafontaine, E.

    1986-06-01

    The principal radionuclide procedures involved in the evaluation of esophageal disorders that are amenable to surgery are illustrated and briefly described. The role of the radionuclide esophagogram (RE) in the diagnosis and management of achalasia, oculopharyngeal muscular dystrophy and its complications, tracheoesophageal fistulae, pharyngeal and esophageal diverticulae, gastric transposition, and fundoplication is discussed. Detection of columnar-lined esophagus by Tc-99m pertechnetate imaging and of esophageal carcinoma by Ga-67 citrate and Tc-99m glucoheptonate studies also is presented. 37 references.

  7. Critical Assessment of Endoscopic Techniques for Gastroesophageal Reflux Disease.

    PubMed

    Lo, Wai-Kit; Mashimo, Hiroshi

    2015-10-01

    Over the past 2 decades, a number of new endoscopic techniques have been developed for management of gastroesophageal (GE) reflux disease symptoms as alternatives to medical management and surgical fundoplication. These devices include application of radiofrequency treatment (Stretta), endoscopic plication (EndoCinch, Plicator, Esophyx, MUSE), and injection of bulking agents (Enteryx, Gatekeeper, Plexiglas, Duragel). Their goal was symptom relief through reduction of tissue compliance and enhancement of anatomic resistance at the GE junction. In this review, we critically assess the research behind the efficacy, safety, and durability of these treatments to better understand their roles in contemporary GE reflux disease management. PMID:26241152

  8. Investigation on W/Fe diffusion bonding using Ti foil and Ti powder interlayer by SPS

    NASA Astrophysics Data System (ADS)

    Chen, Hong-Yu; Luo, Lai-Ma; Zhang, Jun; Zan, Xiang; Zhu, Xiao-Yong; Luo, Guang-Nan; Wu, Yu-Cheng

    2015-12-01

    W/steel composites are being developed for potential application in He gas-cooled divertors and plasma-facing components in fusion reactors. In this study, the dissimilar metal joints between W and Fe were fabricated at 950 °C via spark plasma sintering method with Ti foil (Ti-F) and Ti powder (Ti-P) as the interlayer under Ar atmosphere for 5 min at 57 MPa. Microscopic structures of the W/Fe diffusion joints with Ti-F and Ti-P were investigated and compared via field-emission scanning electron microscopy and energy-dispersive X-ray spectroscopy. Thermal cycling tests were employed to measure the thermal stability of different types of W/Ti/Fe samples. The hardness distribution across joining interfaces was also determined. After thermal cycling tests, a crack occurred along the W/Ti-P interface in the W/Ti-P/Fe samples, whereas the W/Ti-F/Fe samples were intact at the interfaces. Results revealed that Ti-F is more suitable as an interlayer than Ti-P, and the interfaces of the W/Ti-F/Fe samples have better thermal stability than those of the W/Ti-P/Fe ones.

  9. Functional anion concept: effect of fluorine anion on hydrogen storage of sodium alanate.

    PubMed

    Yin, Li-Chang; Wang, Ping; Kang, Xiang-Dong; Sun, Cheng-Hua; Cheng, Hui-Ming

    2007-03-28

    Doping NaAlH(4) with Ti-catalyst has produced a promising hydrogen storage system that can be reversibly operated at moderate temperature conditions. Of the various dopant precursors, TiCl(3) was well recognized due to its pronounced catalytic effect on the reversible dehydrogenation processes of sodium aluminium hydrides. Quite recently we experimentally found that TiF(3) was even better than TiCl(3) in terms of the critical hydrogen storage properties of the doped hydrides, in particular the dehydriding performance at Na(3)AlH(6)/NaH + Al step at moderate temperature. We present here the DFT calculation results of the TiF(3) or TiCl(3) doped Na(3)AlH(6). Our computational studies have demonstrated that F(-) and Cl(-) anions differ substantially from each other with regard to the state and function in the doped sodium aluminium hydride. In great contrast to the case of chloride doping where Cl(-) anion constitutes the "dead weight" NaCl, the fluoride doping results in a substitution of H(-) by F(-) anion in the hydride lattice and accordingly, a favorable thermodynamics adjustment. These results well explain the observed dehydriding performance associated with TiF(3)/TiCl(3)-doping. More significantly, the coupled computational and experimental efforts allow us to put forward a "functional anion" concept. This renews the current mechanism understanding in the catalytically enhanced sodium alanate. PMID:17356758

  10. Rigid conformal polishing tool using non-linear visco-elastic effect.

    PubMed

    Kim, Dae Wook; Burge, James H

    2010-02-01

    Computer controlled optical surfacing (CCOS) relies on a stable and predictable tool influence function (TIF), which is the shape of the wear function created by the machine. For a polishing lap, which is stroked on the surface, both the TIF stability and surface finish rely on the polishing interface maintaining intimate contact with the workpiece. Pitch tools serve this function for surfaces that are near spherical, where the curvature has small variation across the part. The rigidity of such tools provides natural smoothing of the surface, but limits the application for aspheric surfaces. Highly flexible tools, such as those created with an air bonnet or magnetorheological fluid, conform to the surface, but lack intrinsic stiffness, so they provide little natural smoothing. We present a rigid conformal polishing tool that uses a non-linear visco-elastic medium (i.e. non-Newtonian fluid) that conforms to the aspheric shape, yet maintains stability to provide natural smoothing. The analysis, design, and performance of such a polishing tool is presented, showing TIF stability of <10% and providing surface finish with <10A roughness. PMID:20174053

  11. Highly efficient non-rare-earth red emitting phosphor for warm white light-emitting diodes

    NASA Astrophysics Data System (ADS)

    Zhu, Haomiao; Lin, Chun Che; Luo, Wenqin; Shu, Situan; Liu, Zhuguang; Liu, Yongsheng; Kong, Jintao; Ma, En; Cao, Yongge; Liu, Ru-Shi; Chen, Xueyuan

    2014-07-01

    Mn4+-activated fluoride compounds, as an alternative to commercial (oxy)nitride phosphors, are emerging as a new class of non-rare-earth red phosphors for high-efficacy warm white LEDs. Currently, it remains a challenge to synthesize these phosphors with high photoluminescence quantum yields through a convenient chemical route. Herein we propose a general but convenient strategy based on efficient cation exchange reaction, which had been originally regarded only effective in synthesizing nano-sized materials before, for the synthesis of Mn4+-activated fluoride microcrystals such as K2TiF6, K2SiF6, NaGdF4 and NaYF4. Particularly we achieve a photoluminescence quantum yield as high as 98% for K2TiF6:Mn4+. By employing it as red phosphor, we fabricate a high-performance white LED with low correlated colour temperature (3,556 K), high-colour-rendering index (Ra=81) and luminous efficacy of 116 lm W-1. These findings show great promise of K2TiF6:Mn4+ as a commercial red phosphor in warm white LEDs, and open up new avenues for the exploration of novel non-rare-earth red emitting phosphors.

  12. Edge control in CNC polishing, paper 2: simulation and validation of tool influence functions on edges.

    PubMed

    Li, Hongyu; Walker, David; Yu, Guoyu; Sayle, Andrew; Messelink, Wilhelmus; Evans, Rob; Beaucamp, Anthony

    2013-01-14

    Edge mis-figure is regarded as one of the most difficult technical issues for manufacturing the segments of extremely large telescopes, which can dominate key aspects of performance. A novel edge-control technique has been developed, based on 'Precessions' polishing technique and for which accurate and stable edge tool influence functions (TIFs) are crucial. In the first paper in this series [D. Walker Opt. Express 20, 19787-19798 (2012)], multiple parameters were experimentally optimized using an extended set of experiments. The first purpose of this new work is to 'short circuit' this procedure through modeling. This also gives the prospect of optimizing local (as distinct from global) polishing for edge mis-figure, now under separate development. This paper presents a model that can predict edge TIFs based on surface-speed profiles and pressure distributions over the polishing spot at the edge of the part, the latter calculated by finite element analysis and verified by direct force measurement. This paper also presents a hybrid-measurement method for edge TIFs to verify the simulation results. Experimental and simulation results show good agreement. PMID:23388930

  13. A genetic mouse model for progressive ablation and regeneration of insulin producing beta-cells

    PubMed Central

    Shamsi, Farnaz; Parlato, Rosanna; Collombat, Patrick; Mansouri, Ahmed

    2014-01-01

    The putative induction of adult β-cell regeneration represents a promising approach for the treatment of type 1 diabetes. Toward this ultimate goal, it is essential to develop an inducible model mimicking the long-lasting disease progression. In the current study, we have established a novel β-cell ablation mouse model, in which the β-cell mass progressively declines, as seen in type 1 diabetes. The model is based on the β-cell specific genetic ablation of the transcription initiation factor 1A, TIF-IA, essential for RNA Polymerase I activity (TIF-IAΔ/Δ). Using this approach, we induced a slow apoptotic response that eventually leads to a protracted β-cell death. In this model, we observed β-cell regeneration that resulted in a complete recovery of the β-cell mass and normoglycemia. In addition, we showed that adaptive proliferation of remaining β-cells is the prominent mechanism acting to compensate for the massive β-cell loss in young but also aged mice. Interestingly, at any age, we also detected β-like cells expressing the glucagon hormone, suggesting a transition between α- and β-cell identities or vice versa. Taken together, the TIF-IAΔ/Δ mouse model can be used to investigate the potential therapeutic approaches for type 1 diabetes targeting β-cell regeneration. PMID:25558832

  14. Edge effect modeling and experiments on active lap processing.

    PubMed

    Liu, Haitao; Wu, Fan; Zeng, Zhige; Fan, Bin; Wan, Yongjian

    2014-05-01

    Edge effect is regarded as one of the most difficult technical issues for fabricating large primary mirrors, especially for large polishing tools. Computer controlled active lap (CCAL) uses a large size pad (e.g., 1/3 to 1/5 workpiece diameters) to grind and polish the primary mirror. Edge effect also exists in the CCAL process in our previous fabrication. In this paper the material removal rules when edge effects happen (i.e. edge tool influence functions (TIFs)) are obtained through experiments, which are carried out on a Φ1090-mm circular flat mirror with a 375-mm-diameter lap. Two methods are proposed to model the edge TIFs for CCAL. One is adopting the pressure distribution which is calculated based on the finite element analysis method. The other is building up a parametric equivalent pressure model to fit the removed material curve directly. Experimental results show that these two methods both effectively model the edge TIF of CCAL. PMID:24921777

  15. Data analyses and perspectives on laparoscopic surgery for esophageal achalasia.

    PubMed

    Tsuboi, Kazuto; Omura, Nobuo; Yano, Fumiaki; Hoshino, Masato; Yamamoto, Se-Ryung; Akimoto, Shunsuke; Masuda, Takahiro; Kashiwagi, Hideyuki; Yanaga, Katsuhiko

    2015-10-14

    In general, the treatment methods for esophageal achalasia are largely classified into four groups, including drug therapy using nitrite or a calcium channel blocker, botulinum toxin injection, endoscopic therapy such as endoscopic balloon dilation, and surgery. Various studies have suggested that the most effective treatment of esophageal achalasia is surgical therapy. The basic concept of this surgical therapy has not changed since Heller proposed esophageal myotomy for the purpose of resolution of lower esophageal obstruction for the first time in 1913, but the most common approach has changed from open-chest surgery to laparoscopic surgery. Currently, the laparoscopic surgery has been the procedure of choice for the treatment of esophageal achalasia. During the process of the transition from open-chest surgery to laparotomy, to thoracoscopic surgery, and to laparoscopic surgery, the necessity of combining antireflux surgery has been recognized. There is some debate as to which type of antireflux surgery should be selected. The Toupet fundoplication may be the most effective in prevention of postoperative antireflux, but many medical institutions have selected the Dor fundoplication which covers the mucosal surface exposed by myotomy. Recently, a new endoscopic approach, peroral endoscopic myotomy (POEM), has received attention. Future studies should examine the long-term outcomes and whether POEM becomes the gold standard for the treatment of esophageal achalasia. PMID:26478674

  16. Laparoscopic gastrostomy in children.

    PubMed

    Humphrey, G M; Najmaldin, A

    1997-09-01

    During a 30-month period, 28 children aged 6 months-15 years underwent fashioning of a laparoscopic gastrostomy. Indications for operation included: feeding difficulties and failure to thrive in neurologically impaired children (13); chronic renal failure (9); and others (6). There were 17 conventional tube and 11 button gastrostomies. Twelve children had insertion of a gastrostomy alone; the others underwent a concomitant laparoscopic Nissen fundoplication (NFP). The average operation time for gastrostomy alone was 65 min (range 35-104) and for gastrostomy plus NFP 155 min (range 130-246). There were no specific laparoscopic complications. Two patients who required large volumes of eternal drugs and peritoneal dialysis from the 1st post-operative day developed minor external leaks from their stomas. It appears that laparoscopy provides for safe and precise positioning of any standard balloon or button gastrostomy. It is a particularly attractive technique for use in patients already undergoing a laparoscopic fundoplication and those in whom other minimally invasive techniques are contraindicated or fail. PMID:9238116

  17. Electrical stimulation for gastroesophageal reflux disease: current state of the art

    PubMed Central

    Kim, Sharon E; Soffer, Edy

    2016-01-01

    Patients with gastroesophageal reflux disease (GERD) who are not satisfied with acid suppression therapy can benefit primarily from fundoplication, a surgical intervention. Fundoplication has been the standard surgical procedure for GERD. It is effective but is associated with adverse effects, resulting in a declining number of interventions, creating a need for alternative interventions that are effective, yet have a better adverse effect profile. One such alternative involves the application of electrical stimulation to the lower esophageal sphincter. A number of animal studies showed that such stimulation can increase resting lower esophageal sphincter pressure. An acute human study confirmed this effect, and was followed by two open-label studies, with a follow-up of up to 3 years. Results thus far show that the therapy is associated with a significant improvement in symptoms, a significant reduction in esophageal acid exposure, and a very good safety profile. This review will describe the evolution of electrical stimulation therapy for GERD, as well as the safety and efficacy of this intervention. PMID:26834494

  18. Data analyses and perspectives on laparoscopic surgery for esophageal achalasia

    PubMed Central

    Tsuboi, Kazuto; Omura, Nobuo; Yano, Fumiaki; Hoshino, Masato; Yamamoto, Se-Ryung; Akimoto, Shunsuke; Masuda, Takahiro; Kashiwagi, Hideyuki; Yanaga, Katsuhiko

    2015-01-01

    In general, the treatment methods for esophageal achalasia are largely classified into four groups, including drug therapy using nitrite or a calcium channel blocker, botulinum toxin injection, endoscopic therapy such as endoscopic balloon dilation, and surgery. Various studies have suggested that the most effective treatment of esophageal achalasia is surgical therapy. The basic concept of this surgical therapy has not changed since Heller proposed esophageal myotomy for the purpose of resolution of lower esophageal obstruction for the first time in 1913, but the most common approach has changed from open-chest surgery to laparoscopic surgery. Currently, the laparoscopic surgery has been the procedure of choice for the treatment of esophageal achalasia. During the process of the transition from open-chest surgery to laparotomy, to thoracoscopic surgery, and to laparoscopic surgery, the necessity of combining antireflux surgery has been recognized. There is some debate as to which type of antireflux surgery should be selected. The Toupet fundoplication may be the most effective in prevention of postoperative antireflux, but many medical institutions have selected the Dor fundoplication which covers the mucosal surface exposed by myotomy. Recently, a new endoscopic approach, peroral endoscopic myotomy (POEM), has received attention. Future studies should examine the long-term outcomes and whether POEM becomes the gold standard for the treatment of esophageal achalasia. PMID:26478674

  19. Radiologic and Endoscopic Characteristics of Laparoscopic Antireflux Wrap: Correlation With Outcome

    PubMed Central

    Braghetto, Italo; Korn, Owen; Csendes, Attila; Valladares, Héctor; Davanzo, Cristóbal; Debandi, Aníbal

    2012-01-01

    After antireflux surgery for gastroesophageal reflux disease, 10% to 15% of patients may have unsuccessful results as a result of abnormal restoration of the esophagogastric junction. The purpose of this study was to evaluate the postoperative endoscopic and radiologic characteristics of the antireflux barrier and their correlation with the postoperative results. After surgery, endoscopic and radiologic features of the antireflux wrap were evaluated in 120 consecutive patients. Jobe's classification of the postoperative valve was used for the definition of a “normal” or “defective” wrap. Patients were evaluated 3 to 5 years later in order to determine the clinical and objective failed fundoplication. A “normal” antireflux wrap was associated with successful results in 81.7% of the patients. On the contrary, defective radiologic or endoscopic antireflux wrap was observed in 19% of cases. Among these patients, hypotensive lower esophageal sphincter was observed in 50% to 65% of patients, abnormal 24-hour pH monitoring in 91%, and recurrent postoperative erosive esophagitis in 50% of patients, respectively (P < 0.001). “Defective” antireflux fundoplication is associated with recurrent reflux symptoms, presence of endoscopic esophagitis, hypotensive lower esophageal sphincter, and abnormal acid reflux. PMID:23113845

  20. Initial outcomes of laparoscopic paraesophageal hiatal hernia repair with mesh.

    PubMed

    Gebhart, Alana; Vu, Steven; Armstrong, Chris; Smith, Brian R; Nguyen, Ninh T

    2013-10-01

    The use of mesh in laparoscopic paraesophageal hiatal hernia repair (LHR) may reduce the risk of late hernia recurrence. The aim of this study was to evaluate initial outcomes and recurrence rate of 92 patients who underwent LHR reinforced with a synthetic bioabsorbable mesh. Surgical approaches included LHR and Nissen fundoplication (n = 64), LHR without fundoplication (n = 10), reoperative LHR (n = 9), LHR with a bariatric operation (n = 6), and emergent LHR (n = 3). The mean length of hospital stay was 2 ± 3 days (range, 1 to 30 days). There were no conversions to open laparotomy and no intraoperative complications. One of 92 patients (1.1%) required intensive care unit stay. The 90-day mortality was zero. Minor complications occurred in 3.3 per cent, major complications in 2.2 per cent, and late complications in 5.5 per cent of patients. There were no perforations or early hernia recurrence. The 30-day reoperation rate was 1.1 per cent. For patients with available 1-year follow-up, the overall recurrence rate was 18.5 per cent with a mean follow-up of 30 months (range, 12 to 51 months). LHR repair with mesh is associated with low perioperative morbidity and no mortality. The use of bioabsorbable mesh appears to be safe with no early hiatal hernia recurrence or late mesh erosion. Longer follow-up is needed to determine the long-term rate of hernia recurrence associated with LHR with mesh. PMID:24160791

  1. Hiatal Hernia Repair with Gore Bio-A Tissue Reinforcement: Our Experience

    PubMed Central

    Antonino, Agrusa; Giorgio, Romano; Giuseppe, Frazzetta; Giovanni, De Vita; Silvia, Di Giovanni; Daniela, Chianetta; Giuseppe, Di Buono; Vincenzo, Sorce; Gaspare, Gulotta

    2014-01-01

    Type I hiatal hernia is associated with gastroesophageal reflux disease (GERD) in 50–90% of cases. Several trials strongly support surgery as an effective alternative to medical therapy. Today, laparoscopic fundoplication is considered as the procedure of choice. However, primary laparoscopic hiatal hernia repair is associated with upto 42% recurrence rate. Mesh reinforcement of the crural closure decreases the recurrence but can lead to complications, above all nonabsorbable ones. We experiment a new totally absorbable mesh by Gore. Case. We present a case of a 65-year-old female patient with a 6-year classic history of GERD. Endoscopy revealed a large hiatal hernia and esophagitis. pH study was positive for acid reflux; esophageal manometry revealed LES intrathoracic dislocation. With laparoscopic approach, the hiatal hernia defect was identified and primarily repaired, by crural closure. Gore Bio-A Tissue Reinforcement was trimmed to fit the defect accommodating the esophagus. Nissen fundoplication was performed. Result. Bio-A mesh was easily placed laparoscopically. It has good handling and could be cut and tailored intraoperatively for optimal adaptation. There were no short-term complications. Conclusion. Crural closure reinforcement can be done readily with this new totally absorbable mesh replaced by soft tissue over six months. However, further data and studies are needed to evaluate long-term outcomes. PMID:24864221

  2. Is the advanced age a contraindication to GERD laparoscopic surgery? Results of a long term follow-up

    PubMed Central

    2013-01-01

    Background In this prospective non randomized observational cohort study we have evaluated the influence of age on outcome of laparoscopic total fundoplication for GERD. Methods Six hundred and twenty consecutive patients underwent total laparoscopic fundoplication for GERD. Five hundred and twenty-four patients were younger than 65 years (YG), and 96 patients were 65 years or older (EG). The following parameters were considered in the preoperative and postoperative evaluation: presence, duration, and severity of GERD symptoms, presence of a hiatal hernia, manometric and 24 hour pH-monitoring data, duration of operation, incidence of complications and length of hospital stay. Results Elderly patients more often had atypical symptoms of GERD and at manometric evaluation had a higher rate of impaired esophageal peristalsis in comparison with younger patients. The duration of the operation was similar between the two groups. The incidence of intraoperative and postoperative complications was low and the difference was not statistically significant between the two groups. An excellent outcome was observed in 93.0% of young patients and in 88.9% of elderly patients (p = NS). Conclusions Laparoscopic antireflux surgery is a safe and effective treatment for GERD even in elderly patients, warranting low morbidity and mortality rates and a significant improvement of symptoms comparable to younger patients. PMID:24267613

  3. Hiatal hernia repair with gore bio-a tissue reinforcement: our experience.

    PubMed

    Antonino, Agrusa; Giorgio, Romano; Giuseppe, Frazzetta; Giovanni, De Vita; Silvia, Di Giovanni; Daniela, Chianetta; Giuseppe, Di Buono; Vincenzo, Sorce; Gaspare, Gulotta

    2014-01-01

    Type I hiatal hernia is associated with gastroesophageal reflux disease (GERD) in 50-90% of cases. Several trials strongly support surgery as an effective alternative to medical therapy. Today, laparoscopic fundoplication is considered as the procedure of choice. However, primary laparoscopic hiatal hernia repair is associated with upto 42% recurrence rate. Mesh reinforcement of the crural closure decreases the recurrence but can lead to complications, above all nonabsorbable ones. We experiment a new totally absorbable mesh by Gore. Case. We present a case of a 65-year-old female patient with a 6-year classic history of GERD. Endoscopy revealed a large hiatal hernia and esophagitis. pH study was positive for acid reflux; esophageal manometry revealed LES intrathoracic dislocation. With laparoscopic approach, the hiatal hernia defect was identified and primarily repaired, by crural closure. Gore Bio-A Tissue Reinforcement was trimmed to fit the defect accommodating the esophagus. Nissen fundoplication was performed. Result. Bio-A mesh was easily placed laparoscopically. It has good handling and could be cut and tailored intraoperatively for optimal adaptation. There were no short-term complications. Conclusion. Crural closure reinforcement can be done readily with this new totally absorbable mesh replaced by soft tissue over six months. However, further data and studies are needed to evaluate long-term outcomes. PMID:24864221

  4. [Anti-reflux surgery: indications, principles and contribution of laparoscopy].

    PubMed

    Cadière, G B

    1994-01-01

    Surgery is indicated when gastro-oesophageal reflux disease (GORD) is resistant to medical treatment. Manometry, upper GI series, pH-metry, gastric emptying studies and gastric acid sampling are performed in order to demonstrate that GORD is caused by a deficient gastro-oesophageal valve mechanism, and hence that surgical treatment will be beneficial. The surgical principle is restoring an anti-reflux barrier by recreating a sufficient pressure gradient in the distal oesophagus, and by correcting the gastro-oesophageal Hiss. Nissen' fundoplication is probably the most efficient anti-reflux procedure. However, it can cause dysphagia, gas bloating and inability to burp. One hundred and fifty-six laparoscopic Nissen fundoplications have been performed by the author. Operating time average 120 min. No perioperative death was observed. There were 3 conversions to laparotomy and 4 peroperative complications: 1 gastric perforation, 2 lesions of the pleura and 1 liver laceration. Four postoperative complications occurred: 1 pneumonia, 1 necrosis of the wrap, 1 small bowel perforation and 1 obstruction due to migration of the entire stomach into the chest. Hospitalisation time ranged between 2 and 14 days (median 2), with a follow up of a median of 10 months. Long-term postoperative complications were: 1 recurrent heartburn 6 months postoperatively and 2 severe dysphagia. PMID:8191168

  5. LAPAROSCOPIC ANTIREFLUX SURGERY IN PATIENTS WITH EXTRA ESOPHAGEAL SYMPTOMS RELATED TO ASTHMA

    PubMed Central

    da SILVA, Amanda Pinter Carvalheiro; TERCIOTI-JUNIOR, Valdir; LOPES, Luiz Roberto; COELHO-NETO, João de Souza; BERTANHA, Laura; RODRIGUES, Paulo Rodrigo de Faria; ANDREOLLO, Nelson Adami

    2014-01-01

    Background Asthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease. Aim To analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma. Methods Were reviewed the medical records of 400 patients with gastroesophageal reflux disease submitted to laparoscopic Nissen fundoplication from 1994 to 2006, and identified 30 patients with extra-esophageal symptoms related to asthma. The variables considered were: gender, age, gastroesophageal symptoms (heartburn, acid reflux and dysphagia), time of reflux disease, treatment with proton pump inhibitor, use of specific medications, treatment and evolution, number of attacks and degree of esophagitis. Data were subjected to statistical analysis, comparing the pre- and post-surgical findings. Results The comparative analysis before surgery (T1) and six months after surgery (T2) showed a significant reduction on heartburn and reflux symptoms. Apart from that, there was a significant difference between the patients with daily crises of asthma (T1 versus T2, 45.83% to 16.67%, p=0.0002) and continuous crises (T1, 41.67% versus T2, 8.33%, p=0.0002). Conclusion Laparoscopic Nissen fundoplication was effective in improving symptoms that are typical of reflux disease and clinical manifestations of asthma. PMID:25004284

  6. Laparoscopic Heller Myotomy for Non-Dilated Esophageal Achalasia in Children with Intraoperative Stepped Dilation Under Image Guidance: Attempting Complete Myotomy.

    PubMed

    Miyano, Go; Miyake, Hiromu; Koyama, Mariko; Morita, Keiichi; Kaneshiro, Masakatsu; Nouso, Hiroshi; Yamoto, Masaya; Fukumoto, Koji; Urushihara, Naoto

    2016-05-01

    This study presents a modified surgical approach to laparoscopic myotomy for achalasia using stepped dilation with a Rigiflex balloon and contrast medium under image guidance. A 10-year-old boy with persistent dysphagia and vomiting had ingested only liquids for 3 months, losing >10 kg in body weight. Barium swallow and esophageal manometry diagnosed esophageal achalasia with mild esophageal dilatation. After failed pneumatic dilatation, laparoscopic Heller myotomy with Dor fundoplication was performed. Prior to surgery, a Rigiflex balloon dilator was placed within the esophagus near the diaphragmatic hiatus. A four-port technique was used, and mobilization of the esophagus was limited to the anterior aspect. A 5-cm Heller myotomy was performed, extending another 2 cm onto the anterior gastric wall. During myotomy, the Rigiflex balloon was serially dilated from 30 to 50 mL, and filled with contrast medium under fluoroscopic image guidance in order to maintain appropriate tension on the esophagus to facilitate myotomy, and to confirm adequate myotomy with sufficient release of lower esophageal sphincter by resecting residual circular muscle fibers. Residual circular muscle fibers can be simultaneously visualized under both fluoroscopic image guidance and direct observation through the laparoscope, and they were cut precisely until the residual notch fully disappeared. Dor fundoplication was completed. The operative time was 180 minutes, and oral intake was started after esophagography on postoperative day 1. As of the 12-month follow-up, the patient has not shown any symptoms, and his postoperative course appeared satisfactory. PMID:26845662

  7. Trends in electrocardiographic R-wave amplitude during intraoperative pneumothorax.

    PubMed

    Tomiyama, Yoshinobu; Higashijima, Sachiyo; Kadota, Takako; Kume, Katsuyoshi; Kawahara, Tomiya; Ohshita, Naohiro

    2014-01-01

    Tension pneumothorax is a rare but potentially life-threating complication of laparoscopic fundoplication. Electrocardiogram (ECG) changes may be used in the diagnosis of intraoperative tension pneumothorax. This case study examines a pediatric patient who underwent laparoscopic fundoplication. Sudden decreases in oxygen saturation were observed during dissection, although the patient's decrease in blood pressure was less marked. Manual ventilation with high inspiratory pressure and inspiratory pause improved oxygenation. The amplitude of the R-wave decreased from 0.8 mV to 0.3 mV in 5 seconds. Twenty minutes later, oxygen saturation decreased again, the R-wave amplitude decreased from 0.3 mV to 0.1 mV in 1 second, and the decrease in blood pressure was marked. Manual ventilation with high inspiratory pressure improved oxygenation, blood pressure, and R-wave amplitude within two minutes. After conversion to open surgery, the cardiorespiratory condition gradually improved, but the R-wave amplitude did not fully recover, even at the end of surgery. Right-side pneumothorax was subsequently confirmed by postoperative chest X-ray. Chest drains were inserted after surgery. This case suggests that trends in R-wave amplitude are potential indicators of intraoperative tension pneumothorax. PMID:25264070

  8. Minimally Invasive Surgery for Inflammatory Bowel Disease

    PubMed Central

    Holder-Murray, Jennifer; Marsicovetere, Priscilla

    2015-01-01

    Abstract: Surgical management of inflammatory bowel disease is a challenging endeavor given infectious and inflammatory complications, such as fistula, and abscess, complex often postoperative anatomy, including adhesive disease from previous open operations. Patients with Crohn's disease and ulcerative colitis also bring to the table the burden of their chronic illness with anemia, malnutrition, and immunosuppression, all common and contributing independently as risk factors for increased surgical morbidity in this high-risk population. However, to reduce the physical trauma of surgery, technologic advances and worldwide experience with minimally invasive surgery have allowed laparoscopic management of patients to become standard of care, with significant short- and long-term patient benefits compared with the open approach. In this review, we will describe the current state-of the-art for minimally invasive surgery for inflammatory bowel disease and the caveats inherent with this practice in this complex patient population. Also, we will review the applicability of current and future trends in minimally invasive surgical technique, such as laparoscopic “incisionless,” single-incision laparoscopic surgery (SILS), robotic-assisted, and other techniques for the patient with inflammatory bowel disease. There can be no doubt that minimally invasive surgery has been proven to decrease the short- and long-term burden of surgery of these chronic illnesses and represents high-value care for both patient and society. PMID:25989341

  9. Endoscopic therapy for weight loss: Gastroplasty, duodenal sleeves, intragastric balloons, and aspiration

    PubMed Central

    Kumar, Nitin

    2015-01-01

    A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and weight loss surgery. Endoscopic procedures have the potential to bridge the gap between medical therapy and surgery. Current primary endoscopic bariatric therapies can be classified as restrictive, bypass, space-occupying, or aspiration therapy. Restrictive procedures include the USGI Primary Obesity Surgery Endolumenal procedure, endoscopic sleeve gastroplasty using Apollo OverStitch, TransOral GAstroplasty, gastric volume reduction using the ACE stapler, and insertion of the TERIS restrictive device. Intestinal bypass has been reported using the EndoBarrier duodenal-jejunal bypass liner. A number of space-occupying devices have been studied or are in use, including intragastric balloons (Orbera, Reshape Duo, Heliosphere BAG, Obalon), Transpyloric Shuttle, and SatiSphere. The AspireAssist aspiration system has demonstrated efficacy. Finally, endoscopic revision of gastric bypass to address weight regain has been studied using Apollo OverStitch, the USGI Incisionless Operating Platform Revision Obesity Surgery Endolumenal procedure, Stomaphyx, and endoscopic sclerotherapy. Endoscopic therapies for weight loss are potentially reversible, repeatable, less invasive, and lower cost than various medical and surgical alternatives. Given the variety of devices under development, in clinical trials, and currently in use, patients will have multiple endoscopic options with greater efficacy than medical therapy, and with lower invasiveness and greater accessibility than surgery. PMID:26240686

  10. Endoscopic therapy for weight loss: Gastroplasty, duodenal sleeves, intragastric balloons, and aspiration.

    PubMed

    Kumar, Nitin

    2015-07-25

    A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and weight loss surgery. Endoscopic procedures have the potential to bridge the gap between medical therapy and surgery. Current primary endoscopic bariatric therapies can be classified as restrictive, bypass, space-occupying, or aspiration therapy. Restrictive procedures include the USGI Primary Obesity Surgery Endolumenal procedure, endoscopic sleeve gastroplasty using Apollo OverStitch, TransOral GAstroplasty, gastric volume reduction using the ACE stapler, and insertion of the TERIS restrictive device. Intestinal bypass has been reported using the EndoBarrier duodenal-jejunal bypass liner. A number of space-occupying devices have been studied or are in use, including intragastric balloons (Orbera, Reshape Duo, Heliosphere BAG, Obalon), Transpyloric Shuttle, and SatiSphere. The AspireAssist aspiration system has demonstrated efficacy. Finally, endoscopic revision of gastric bypass to address weight regain has been studied using Apollo OverStitch, the USGI Incisionless Operating Platform Revision Obesity Surgery Endolumenal procedure, Stomaphyx, and endoscopic sclerotherapy. Endoscopic therapies for weight loss are potentially reversible, repeatable, less invasive, and lower cost than various medical and surgical alternatives. Given the variety of devices under development, in clinical trials, and currently in use, patients will have multiple endoscopic options with greater efficacy than medical therapy, and with lower invasiveness and greater accessibility than surgery. PMID:26240686

  11. Usage of Magnetic Resonance Guided Focused Ultrasound Surgery (mrgfus) in Oncology

    NASA Astrophysics Data System (ADS)

    Bauer, Yair

    2011-09-01

    Magnetic resonance guided focused ultrasound surgery (MRgFUS) is a non-invasive incision-less surgical approach which limits the tissue destruction to the targeted tumor. Acoustic energy penetrates through intact skin and through the tissues surrounding the tumor without causing any significant bio-effects. Energy deposition takes place mainly at the focal spot where heat induced thermal coagulation of the targeted tissue is accomplished. Real time targeting and image guidance is provided by MRI tumor margin definition and real time thermometry provides closed loop feedback control of energy deposition. The patient lies in the MRI scanner throughout the treatment planning and treatment, and the physician conducts the treatment from the MRgFUS workstation in the adjacent MR control room. The ExAblate system for MRgFUS is commercially available in many countries for treatment of uterine fibroids. The system has also received CE and KFDA approval for pain palliation of bone metastases, and research of other oncologic applications is underway.

  12. PA1 protein, a new competitive decelerator acting at more than one step to impede glucocorticoid receptor-mediated transactivation.

    PubMed

    Zhang, Zhenhuan; Sun, Yunguang; Cho, Young-Wook; Chow, Carson C; Simons, S Stoney

    2013-01-01

    Numerous cofactors modulate the gene regulatory activity of glucocorticoid receptors (GRs) by affecting one or more of the following three major transcriptional properties: the maximal activity of agonists (A(max)), the potency of agonists (EC(50)), and the partial agonist activity of antisteroids (PAA). Here, we report that the recently described nuclear protein, Pax2 transactivation domain interaction protein (PTIP)-associated protein 1 (PA1), is a new inhibitor of GR transactivation. PA1 suppresses A(max), increases the EC(50), and reduces the PAA of an exogenous reporter gene in a manner that is independent of associated PTIP. PA1 is fully active with, and strongly binds to, the C-terminal half of GR. PA1 reverses the effects of the coactivator TIF2 on GR-mediated gene induction but is unable to augment the actions of the corepressor SMRT. Analysis of competition assays between PA1 and TIF2 with an exogenous reporter indicates that the kinetic definition of PA1 action is a competitive decelerator at two sites upstream from where TIF2 acts. With the endogenous genes IGFBP1 and IP6K3, PA1 also represses GR induction, increases the EC(50), and decreases the PAA. ChIP and re-ChIP experiments indicate that PA1 accomplishes this inhibition of the two genes via different mechanisms as follows: PA1 appears to increase GR dissociation from and reduce GR transactivation at the IGFBP1 promoter regions but blocks GR binding to the IP6K3 promoter. We conclude that PA1 is a new competitive decelerator of GR transactivation and can act at more than one molecularly defined step in a manner that depends upon the specific gene. PMID:23161582

  13. Destabilization effect of transition metal fluorides on sodium borohydride.

    PubMed

    Kalantzopoulos, Georgios N; Guzik, Matylda N; Deledda, Stefano; Heyn, Richard H; Muller, Jiri; Hauback, Bjørn C

    2014-10-14

    The effect of transition metal fluorides on the decomposition of NaBH4 has been investigated for NaBH4 ball milled with TiF3, MnF3 or FeF3. The compounds were examined by thermal programmed desorption with residual gas analysis, thermo gravimetric analysis and volumetric measurements using a Sieverts-type apparatus. The phase formation process during thermal decomposition was studied by in situ synchrotron radiation powder X-ray diffraction on the as-milled powders. NaBF4 was among the products in all mechano-chemical reactions. (11)B-NMR spectra analysis gave NaBF4 : NaBH4 ratios of 1 : 150 for Na-Ti, 1 : 40 for Na-Mn, and 1 : 10 for Na-Fe. Pure NaBH4 possessed a hydrogen release onset temperature of 430 °C. The hydrogen release in the NaBH4-MnF3 system began as low as 130 °C. FeF3 decreased the onset temperature to 161 °C and TiF3 to 200 °C. TiF3 reacted completely with NaBH4 below 320 °C. All the examined systems have negligible emissions of diborane species. H-sorption studies performed at selected temperatures above 300 °C exhibited relatively fast desorption kinetics. Partial hydrogen re-absorption was observed for the Na-Mn and Na-Fe samples. PMID:25140831

  14. Implementation of quality systems by Mexican exporters of processed meat.

    PubMed

    Maldonado-Siman, E; Bernal-Alcántara, R; Cadena-Meneses, J A; Altamirano-Cárdenas, J R; Martinez-Hernández, P A

    2014-12-01

    Requirements of hazard analysis and critical control points (HACCP) are becoming essential for international trade in food commodities as a safety assurance component. This research reports the level of the adoption of ISO 9000 and the HACCP system by Federal Inspection Type (TIF) pork-exporting enterprises. Implementation and operating costs are reported as well as the benefits involved in this food industry process. In Mexico, there are 97 companies classified as TIF enterprises, and 22 are registered as exporters of processed pork with the National Services for Safety and Quality and Animal Health of the Secretariat of Agriculture, Livestock, Rural Development, Fisheries and Food. Surveys were administered to 22 companies, with a 95.2% response rate. Enterprise characteristics were evaluated, as well as their operating activities. Fieldwork consisted of administering structured questionnaires to TIF exporters. All the surveyed enterprises had implemented HACCP, whereas the ISO 9000 regulation was applied in only 30%. Of total production, 75% is exported to 13 countries, and 25% goes to the Mexican market niche. Results indicate that the main factors for adopting HACCP are related to accessibility to international markets, improving quality, and reducing product quality audits by customers. The results also indicated that staff training was the most important issue. Microbiological testing was the highest cost of the operation. The main benefits reported were related to better access to international markets and a considerable reduction in microbial counts. This study shows the willingness of Mexican pork processors to implement food safety protocols for producing safe and quality products to compete in the international food trade. PMID:25474065

  15. Alpha calcium/calmodulin dependent protein kinase II in learning-dependent plasticity of mouse somatosensory cortex.

    PubMed

    Skibinska-Kijek, A; Radwanska, A; Kossut, M

    2008-02-01

    Calcium/calmodulin dependent protein kinase II (CaMKII), and more specifically its alpha subunit, is widely believed to be fundamental for hippocampal synaptic plasticity. In the cerebral cortex, deprivation-evoked plasticity was shown to depend on alphaCaMKII autophosphorylation abilities. Here we analyzed how learning-induced functional reorganization of cortical representations affected alphaCaMKII in adult Swiss mice. Mice were subjected to short-lasting sensory training in which stimulation of whiskers was paired with tail shock. The pairing results in enlargement of functional representation of vibrissae activated during the training. alphaCaMKII protein and its autophosphorylation level were determined by Western-blotting in somatosensory cortex crude synaptosomal fraction (P2) and postsynaptic protein-enriched, Triton X-100 insoluble fraction (TIF). The first training session resulted in an increase in alphaCaMKII autophosphorylation at autonomy site observed in TIF. A similar increase was also observed after the first session of just whiskers stimulation, which alone does not induce rearrangement of cortical representations. These data indicate that increased autophosphorylation of postsynaptic alphaCaMKII is not a correlate of induction phase of plasticity related reorganization of cortical representation of vibrissae. The increase observed in both experimental groups was transient and did not persist in the maintenance phase of the plastic change. Furthermore, we found that the training caused a delayed upregulation of alphaCaMKII protein level in crude synaptosomal fraction, but not in TIF, and the upregulation was not accompanied by an increase in autophosphorylation level of the kinase. The result indicates alphaCaMKII involvement in the late phase of plastic change and suggests the participation of a presynaptic pool of kinase rather than postsynaptic at this point. PMID:18164137

  16. Myositis-specific autoantibodies are specific for myositis compared to genetic muscle disease

    PubMed Central

    Casciola-Rosen, Livia; Christopher-Stine, Lisa; Lloyd, Thomas E.; Wagner, Kathryn R.

    2015-01-01

    Objective: To determine the specificity of myositis-specific autoantibodies (MSAs) for autoimmune myopathy compared with inherited muscle diseases. Methods: Serum samples from 47 patients with genetically confirmed inherited muscle diseases were screened for the most common MSAs, including those recognizing TIF1γ, NXP2, Mi2, MDA5, Jo1, SRP, and HMGCR. We compared these results with the findings in a cohort of patients with dermatomyositis (DM) previously screened for anti-TIF1γ, -NXP2, -Mi2, -MDA5, and -Jo1. Results: Overall, the presence of anti-TIF1γ, -NXP2, -Mi2, -MDA5, or -Jo1 was 96% specific and 67% sensitive for DM compared to patients with genetic muscle diseases. No patients with inherited muscle disease had anti-SRP or anti-HMGCR autoantibodies. Only 2 patients with genetic muscle disease had a MSA. One patient with anti-Mi2 autoantibodies had both genetically confirmed facioscapulohumeral dystrophy and dermatomyositis based on a typical skin rash and partial response to immunosuppressive medications. A second patient with anti-Jo-1 autoantibodies had both genetically defined limb-girdle muscular dystrophy type 2A (i.e., calpainopathy) and a systemic autoimmune process based on biopsy-confirmed lupus nephritis, sicca symptoms, and anti-Ro52 autoantibodies. Conclusions: The MSAs tested for in this study are highly specific for autoimmune muscle disease and are rarely, if ever, found in patients who only have genetic muscle disease. In patients with genetic muscle disease, the presence of a MSA should suggest the possibility of a coexisting autoimmune process. PMID:26668818

  17. 1990: Annus Mirabilis of Potassium Channels

    NASA Astrophysics Data System (ADS)

    Miller, Christopher

    1991-05-01

    Voltage-gated potassium channels make up a large mo- lecular family of integral membrane proteins that are fundamentally involved in the generation of bioelectric signals such as nerve impulses. These proteins span the cell membrane, forming potassium-selective pores that are rapidly switched open or closed by changes in mem- brane voltage. After the cloning of the first potassium channel over 3 years ago, recombinant DNA manipula- tion of potassium channel genes is now leading to a molecular understanding of potassium channel behavior. During the past year, functional domains responsible for channel gating and potassium selectivity have been iden- tiffed, and detailed structural pictures underlying these functions are beginning to emerge.

  18. Ride quality of terminal-area flight maneuvers

    NASA Technical Reports Server (NTRS)

    Schoonover, W. E., Jr.

    1975-01-01

    Complex terminal-area flight maneuvers being considered for airline operations may not be acceptable to passengers. To provide technology in this area, a series of flight experiments was conducted by NASA using the U. S. Air Force Total In-Flight Simulator (TIFS) aircraft to obtain subjective responses of a significant number of passenger test subjects to closely controlled and repeatable flight maneuvers. Regression analysis of the data produced a mathematical model which closely predicts mean passenger ride-comfort rating as a function of the rms six-degree-of-freedom aircraft motions during the maneuver. This ride-comfort model was exercised to examine various synthesized flight maneuvers.

  19. A case with tracheo-innominate artery fistula. Successful management of endovascular embolization of innominate artery.

    PubMed

    Takasaki, Kenji; Enatsu, Kaori; Nakayama, Masahiko; Uchida, Takatoshi; Takahashi, Haruo

    2005-06-01

    Tracheo-innominate artery fistula (TIF) is known as a fatal complication after tracheostomy. We report a 9-year-old girl with early hypoxic encephalopathy who had a tracheo-innominate artery fistula with exsanguinating hemorrhage from her tracheostoma 10 months after tracheostomy. After temporary control of bleeding, embolization of the innominate artery was performed. The patient has remained well 1 year after the procedure. We reviewed the aetiology, diagnosis and management of the tracheo-innominate fistula, and findings suggest that endovascular embolization of the innominate artery may be an appropriate treatment for patients with tracheo-innominate artery fistula. PMID:15917179

  20. The interpretation of flying qualities requirements for flight control system design

    NASA Technical Reports Server (NTRS)

    Rynaski, E. G.

    1985-01-01

    An experimental flight test program was designed for the Total In Flight Simulator (TIFS) directed toward the interface between flying qualities requirements and flight control system design criteria. The eventual goal is to provide an interpretation or translation of flying qualities requirements for use by the flight control system designer. Specifically, an angle of attack and pitch rate command system matrix involving both short term and long term dynamics are specified for evaluation. Flying qualities criteria and flight control system configuration or architecture can be independent was demonstrated. Finally, additional configurations are proposed to evaluate the efficacy of dynamic decoupling.

  1. A porcine model of relief of unilateral ureteral obstruction: study on self-repairing capability over multiple time points.

    PubMed

    Liu, Yingying; Sun, Jing; Miao, Lining; Ji, Lei; Luo, Manyu; Li, Bing; Cui, Wenpeng; Wang, Yangwei; Xie, Yuansheng; Chen, Xiangmei

    2016-08-01

    It is still controversial whether renal tubular interstitial fibrosis (TIF) is a reversible process. Although previous studies examining TIF have been carried out in rodents, their kidney size and physiological character differ with humans, and the difference among diverse individuals before and after damage was obvious. Thus an experimental animal model to simulate human kidney disease was urged to be established. In order to clarify whether TIF is reversible, and the exact time points that the kidney has the capacity to be repaired, a porcine relief of unilateral ureteral obstruction (R-UUO) model was developed. Kidney damage and reparation were observed dynamically in vivo over various time points. Pigs were randomized divided into three groups (n = 6): UUO 5 days group, UUO 7 days, and UUO 10 days group. Each porcine in that groups underwent UUO and subsequent R-UUO for three time points. Renal function, histological structure, and protein expressions of α-smooth muscle actin (α-SMA), vimentin and E-cadherin were evaluated at different time points. Following R-UUO after 5 and 7 days of UUO, compared to UUO, serum creatinine levels were significantly decreased. Renal pathological tissue damage was repaired. The expressions of α-SMA and vimentin were decreased and E-cadherin expression was increased (P < 0.05). However, during R-UUO 14, 28, and 56 days after 10 days of UUO, serum creatinine was not decreased significantly. The expressions of α-SMA and vimentin consistently remained at high levels. Renal damage was unable to be restored and resulted in chronic lesions. Kidney damage induced by UUO can be reversed in early stages. However, longer time of UUO with significant levels of TIF showed limited reversibility. The porcine R-UUO model provides an ideal animal model for the investigation of kidney injury and repair as well as for the evaluation of the effect of drug treatment. PMID:27381184

  2. The effect of daily fluoride mouth rinsing on enamel erosive/abrasive wear in situ.

    PubMed

    Stenhagen, K R; Hove, L H; Holme, B; Tveit, A B

    2013-01-01

    It is not known whether application of fluoride agents on enamel results in lasting resistance to erosive/abrasive wear. We investigated if one daily mouth rinse with sodium fluoride (NaF), stannous fluoride (SnF(2)) or titanium tetrafluoride (TiF(4)) solutions protected enamel against erosive/abrasive wear in situ (a paired, randomised and blind study). Sixteen molars were cut into 4 specimens, each with one amalgam filling (measurement reference surface). Two teeth (2 × 4 specimens) were mounted bilaterally (buccal aspects) on acrylic mandibular appliances and worn for 9 days by 8 volunteers. Every morning, the specimens were brushed manually with water (30 s) extra-orally. Then fluoride solutions (0.4% SnF(2) pH 2.5; 0.15% TiF(4) pH 2.1; 0.2% NaF pH 6.5, all 0.05 M F) were applied (2 min). Three of the specimens from each tooth got different treatment, and the fourth served as control. At midday, the specimens were etched for 2 min in 300 ml fresh 0.01 M hydrochloric acid and rinsed in tap water. This etch procedure was repeated in the afternoon. Topographic measurements were performed by a white-light interferometer. Mean surface loss (±SD) for 16 teeth after 9 days was: SnF(2) 1.8 ± 1.9 µm, TiF(4) 3.1 ± 4.8 µm, NaF 26.3 ± 4.7 µm, control 32.3 ± 4.4 µm. Daily rinse with SnF(2), TiF(4) and NaF resulted in 94, 90 and 18% reduction in enamel erosive/abrasive wear, respectively, compared with control (p < 0.05). The superior protective effect of daily rinse with either stannous or titanium tetrafluoride solutions on erosive/abrasive enamel wear is promising. PMID:23006823

  3. A Descriptive in vitro Electron Microscopic Study of Acidic Fluoride-Treated Enamel: Potential Anti-Erosion Effects.

    PubMed

    Hjortsjö, Carl; Young, Alix; Kiesow, Andreas; Cismak, Andreas; Berthold, Lutz; Petzold, Matthias

    2015-01-01

    This study aimed to investigate the surface zones of acidic fluoride-treated enamel. Human teeth were each divided into three or four enamel specimens that were treated for 10 min with solutions of 0.2 and 0.4% HF (pH 3.09 and 2.94), 1.74% SnF2 (pH 2.9), 0.68% TiF4 (pH 1.6) and 0.84% NaF (pH 4.5). Untreated specimens functioned as negative controls. The microstructure and elemental composition of the surface zones were studied by scanning electron microscopy/energy-dispersive X-ray (EDX) analysis, transmission electron microscopy (TEM) and nanospot-EDX following cross-sectional preparation using focused ion beam technology. TEM/EDX analyses of NaF-treated specimens showed a 500-nm-thick closed surface film containing 20-40 at% (atomic percent) F. HF-treated specimens had a distinct surface film 200-600 nm thick (dense, not globular) containing 45-47 at% F. TiF4-treated specimens had a surface film of 200-300 nm in thickness containing 8-11 at% Ti but no detectable fluoride. SnF2-treated specimens had a modified surface enamel layer varying in thickness from 200 to 800 nm with an inhomogeneous distribution of Sn. Local spots were detected with as high as 8 at% Sn (30 wt%, weight percent). The results suggest that the reaction mechanisms of SnF2 and TiF4 solutions with dental enamel differ from those occurring after enamel exposure to acidulated NaF and HF solutions. While the HF and NaF treatments resulted in the formation of CaF2-like material as shown by EDX, no significant surface fluoridation was found for SnF2 and TiF4 solutions within the TEM/EDX detection limits. These results suggest that the erosion-protective mechanisms of these latter compounds probably relate more to the formation of hardly soluble and acid-resistant reaction surface films and less to surface fluoride incorporation. PMID:26536617

  4. Validation of the Passenger Ride Quality Apparatus (PRQA) for simulation of aircraft motions for ride-quality research

    NASA Technical Reports Server (NTRS)

    Bigler, W. B., II

    1977-01-01

    The NASA passenger ride quality apparatus (PRQA), a ground based motion simulator, was compared to the total in flight simulator (TIFS). Tests were made on PRQA with varying stimuli: motions only; motions and noise; motions, noise, and visual; and motions and visual. Regression equations for the tests were obtained and subsequent t-testing of the slopes indicated that ground based simulator tests produced comfort change rates similar to actual flight data. It was recommended that PRQA be used in the ride quality program for aircraft and that it be validated for other transportation modes.

  5. Novel surgical options for gastroesophageal reflux disease.

    PubMed

    Chiu, Jenny; Soffer, Edy

    2015-07-01

    There are limited options to patients with gastroesophageal reflux disease (GERD) who are not satisfied with acid suppression therapy. Fundoplication, the standard surgical procedure for GERD, is effective but is associated with adverse side effects and has thus been performed less frequently, creating a need for alternative surgical interventions that are effective, yet less invasive and reversible. Lately, two such interventions were developed: the magnetic sphincter augmentation and electrical stimulation of the lower esophageal sphincter. Human studies describing safety and efficacy over a follow-up period of a number of years have been published, documenting efficacy and safety of these interventions. Future studies should clarify the role of these procedures in the spectrum of GERD therapy. PMID:25947638

  6. [Differencial diagnosis of gastroesophageal reflux disease -- eosinophilic esophagitis: case report].

    PubMed

    Franzius, M; Stolte, M; Porschen, R

    2005-04-01

    We report on a 22-year-old man with dysphagia and repeated bolus impaction in the esophagus for 10 years. Bolus impactions were frequently mobilised using an endoscope. At endoscopy, esophagitis IV degrees was described. After treatment with omeprazol there was no improvement. The patient was submitted to our hospital for fundoplication. pH-metry demonstrated an increased reflux. At endoscopy of the esophagus, we found red stripes which did not show the typical appearance of erosions. Manometry and X-ray films of the esophagus did not reveal any pathological findings. In combination with anamnesis, symptoms, and endoscopy, the diagnosis of eosinophilic esophagitis was documented by histology. After administration of oral corticosteroids a rapid improvement of the clinical symptoms was observed. The diagnosis of eosinophilic esophagitis should be kept in mind in patients with chronic symptoms of gastroesophageal reflux persisting despite medical therapy, pathological pH-metry and repeated bolus impactions. PMID:15830305

  7. Evaluation and management of patients with symptoms after anti-reflux surgery.

    PubMed

    Lin, D C; Chun, C L; Triadafilopoulos, G

    2015-01-01

    Over the past two decades, there has been an increase in the number of anti-reflux operations being performed. This is mostly due to the use of laparoscopic techniques, the increasing prevalence of gastroesophageal reflux disease (GERD) in the population, and the increasing unwillingness of patients to take acid suppressive medications for life. Laparoscopic fundoplication is now widely available in both academic and community hospitals, has a limited length of stay and postoperative recovery time, and is associated with excellent outcomes in carefully selected patients. Although the operation has low mortality and postoperative morbidity, it is associated with late postoperative complications, such as gas bloat syndrome, dysphagia, diarrhea, and recurrent GERD symptoms. This review summarizes the diagnostic evaluation and appropriate management of such postoperative complications. If a reoperation is needed, it should be performed by experienced foregut surgeons. PMID:23826861

  8. Surgical treatments for esophageal cancers

    PubMed Central

    Allum, William H.; Bonavina, Luigi; Cassivi, Stephen D.; Cuesta, Miguel A.; Dong, Zhao Ming; Felix, Valter Nilton; Figueredo, Edgar; Gatenby, Piers A.C.; Haverkamp, Leonie; Ibraev, Maksat A.; Krasna, Mark J.; Lambert, René; Langer, Rupert; Lewis, Michael P.N.; Nason, Katie S.; Parry, Kevin; Preston, Shaun R.; Ruurda, Jelle P.; Schaheen, Lara W.; Tatum, Roger P.; Turkin, Igor N.; van der Horst, Sylvia; van der Peet, Donald L.; van der Sluis, Peter C.; van Hillegersberg, Richard; Wormald, Justin C.R.; Wu, Peter C.; Zonderhuis, Barbara M.

    2015-01-01

    The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of the nurse in preparation of esophageal resection (ER); the management of patients who develop high-grade dysplasia after having undergone Nissen fundoplication; the trajectory of care for the patient with esophageal cancer; the influence of the site of tumor in the choice of treatment; the best location for esophagogastrostomy; management of chylous leak after esophagectomy; the optimal approach to manage thoracic esophageal leak after esophagectomy; the choice for operational approach in surgery of cardioesophageal crossing; the advantages of robot esophagectomy; the place of open esophagectomy; the advantages of esophagectomy compared to definitive chemoradiotherapy; the pathologist report in the resected specimen; the best way to manage patients with unsuspected positive microscopic margin after ER; enhanced recovery after surgery for ER: expedited care protocols; and long-term quality of life in patients following esophagectomy. PMID:25266029

  9. Laparoscopic approach in the treatment of large epiphrenic esophageal diverticulum

    PubMed Central

    Kvietkauskas, Mindaugas; Beiša, Augustas; Strupas, Kęstutis

    2015-01-01

    Epiphrenic diverticulum of the lower third of the esophagus is a relatively rare disorder. We present the case of a large, 7.5 cm diameter esophageal epiphrenic diverticulum treated by the laparoscopic approach. Surgery was indicated by the severity of the patient‘s symptoms and size of the diverticulum. A laparoscopic transhiatal diverticulectomy with a myotomy and Dor fundoplication was carried out. The overall operative time was 180 min. The patient tolerated the surgery well and was discharged from hospital 4 days after the surgery. From the 10th postoperative day the patient resumed a regular diet. Four weeks after the operation the patient had no complaints, symptoms of dysphagia or vomiting. The laparoscopic approach in the treatment of a large, 7.5 cm epiphrenic diverticulum of the esophagus is feasible, safe and well tolerated by the patient. PMID:26865897

  10. Cardiac complications after laparoscopic large hiatal hernia repair. Is it related with staple fixation of the mesh? -Report of three cases

    PubMed Central

    Fernandez, Maria del Carmen; Diaz, María; López, Fernando; Martí-Obiol, Roberto; Ortega, J.

    2015-01-01

    Introduction Laparoscopic Nissen operation with mesh reinforcement remains being the most popular operation for large hiatal hernia repair. Complications related to mesh placement have been widely described. Cardiac complications are rare, but have a fatal outcome if they are misdiagnosed. Presentation of cases We sought to outline our institutional experience of three patients who developed cardiac complications following a laparoscopic Nissen operation for large hiatal hernia repair. Discussion Laparoscopic hiatoplasty and Nissen fundoplication are safe and effective procedures for the hiatal hernia repair, but they are not exempt from complications. Fixation technique and material used must be taken into account. We have conducted a review of the literature on complications related to these procedures. Conclusion In the differential diagnosis of hemodynamic instability after laparoscopic hiatal hernia repair, cardiac tamponade and other cardiac complications should be considered. PMID:26635954

  11. Paraesophageal hernia.

    PubMed

    Oleynikov, Dmitry; Jolley, Jennifer M

    2015-06-01

    The treatment of PEHs is challenging. They tend to occur in patients in their 60s and 70s with multiple medical problems and a variety of associated symptoms. Detailed preoperative evaluation is crucial to determining a safe and effective strategy for repair in the operating room. Laparoscopic PEH repair has shown to be advantageous compared with conventional open repair with regard to hospital stay, recovery time, and decreased complications. Although some results indicate there are higher recurrence rates in laparoscopic PEH repair, the clinical significance of these recurrences has not yet been determined. In order to maximize the efficacy of this procedure, modifications have emerged, such as performing a fundoplication and using an absorbable mesh onlay to reinforce the cruroplasty. Althoughmoreprospective, randomized studies are needed to support the superior results of these surgical adjuncts, laparoscopic PEH repair with an antireflux procedure and absorbable mesh should be the current standard of care. PMID:25965129

  12. Transmural gastric migration of dual-sided PTFE/ePTFEE mesh after laparoscopic surgery for a recurrent hiatal hernia with dysphagia: case report.

    PubMed

    Acin-Gandara, D; Miliani-Molina, C; Carneros-Martin, Ja; Martinez-Pineiro, J; Vega, M De; Pereira-Perez, F

    2014-01-01

    Several series have shown that laparoscopic fundoplication is feasible and safe for the treatment of hiatal hernia, although a high recurrence rate of 42% has been published. The use of mesh repair in these hernias has shown fewer recurrences than primary suture with small number of complications reported.Some of these are severe fibrosis within the hiatus, mesh erosion of the intestinal wall, esophageal strictures, mesh migration into the upper gastrointestinal tract and esophageal perforations. We present a case with late erosion and complete transmural gastric migration of the mesh after surgery. In these cases, the patients may require complex surgical intervention.That was not the case in our patient, who did not require further surgery because the mesh migrated completely. It is therefore advisable to use a mesh very selectively for the laparoscopic repair of hiatal hernias, taking into account the surgeon's experience, the anatomy of the hiatus and the symptoms of the patient. PMID:25149620

  13. Gastrointestinal tract obstruction secondary to post-operative oedema: does dexamethasone administration help?

    PubMed Central

    Atie, M.; Khoma, O.; Dunn, G.; Falk, G.L.

    2016-01-01

    Oedema can occur in handled tissues following upper gastrointestinal surgery with anastomosis formation. Obstruction of the lumen may result in delayed return of enteric function. Intravenous steroid use may be beneficial. Three cases of delayed emptying following fundoplication, gastro-enteric and entero-enteric anastomoses are reviewed. Conservative management with supportive measures failed. Dexamethasone was administered to treat the oedematous obstruction. A literature review in PubMed, Cochrane database and Medline for English language publications on the use of dexamethasone in the treatment of acute post surgical oedema of the upper gastrointestinal was conducted. Administration of dexamethasone led to resolution of symptoms and successful outcome. No reports on the use of steroids in this context were identified in the literature. The use of dexamethasone may effectively treat intestinal obstruction due to inflammatory or oedematous cause in the early post-operative period. PMID:27554826

  14. An appraisal of current dysphagia diagnosis and treatment strategies.

    PubMed

    Kaindlstorfer, Adolf; Pointner, Rudolph

    2016-08-01

    Dysphagia is a common, serious health problem with a wide variety of etiologies and manifestations. This review gives a general overview of diagnostic and therapeutic options for oropharyngeal as well as esophageal swallowing disorders respecting the considerable progress made over recent years. Diagnosis can be challenging and requires expertise in interpretation of symptoms and patient history. Endoscopy, barium radiography and manometry are still the diagnostic mainstays. Classification of esophageal motor-disorders has been revolutionized with the introduction of high-resolution esophageal pressure topography and a new standardized classification algorithm. Automated integrated impedance manometry is a promising upcoming tool for objective evaluation of oropharyngeal dysphagia, in non-obstructive esophageal dysphagia and prediction of post fundoplication dysphagia risk. Impedance planimetry provides new diagnostic information on esophageal and LES-distensibility and allows controlled therapeutic dilatation without the need for radiation. Peroral endoscopic myotomy is a promising therapeutic approach for achalasia and spastic motility disorders. PMID:26906944

  15. Laparoscopic and robot-assisted laparoscopic digestive surgery: Present and future directions

    PubMed Central

    Rodríguez-Sanjuán, Juan C; Gómez-Ruiz, Marcos; Trugeda-Carrera, Soledad; Manuel-Palazuelos, Carlos; López-Useros, Antonio; Gómez-Fleitas, Manuel

    2016-01-01

    Laparoscopic surgery is applied today worldwide to most digestive procedures. In some of them, such as cholecystectomy, Nissen’s fundoplication or obesity surgery, laparoscopy has become the standard in practice. In others, such as colon or gastric resection, the laparoscopic approach is frequently used and its usefulness is unquestionable. More complex procedures, such as esophageal, liver or pancreatic resections are, however, more infrequently performed, due to the high grade of skill necessary. As a result, there is less clinical evidence to support its implementation. In the recent years, robot-assisted laparoscopic surgery has been increasingly applied, again with little evidence for comparison with the conventional laparoscopic approach. This review will focus on the complex digestive procedures as well as those whose use in standard practice could be more controversial. Also novel robot-assisted procedures will be updated. PMID:26877605

  16. [Diagnostics and therapy of achalasia].

    PubMed

    von Rahden, B H A; Filser, J; Seyfried, F; Veldhoen, S; Reimer, S; Germer, C-T

    2014-12-01

    The low incidence (1:100,000) makes primary idiopathic achalasia a problem of special importance. Patients often have a long medical history of suffering before the diagnosis is established and adequate therapy provided. Surgeons who perform antireflux surgery must be certain of detecting achalasia patients within their collective of gastroesophageal reflux disease (GERD) patients to avoid contraindicated fundoplication. The current gold standard for establishing the diagnosis of achalasia is manometry. Especially in early stages, symptom evaluation, endoscopy and barium swallow lack adequate sensitivity. High-resolution manometry (HRM) is increasingly used and allows characterization of different achalasia types (i.e. type I classical achalasia, type II panesophageal pressurization and type III spasmodic achalasia) and differentiation from other motility disorders (e.g. distal esophageal spasm, jackhammer esophagus and nutcracker esophagus). For patients over 45 years of age additional endoscopic ultrasound and computed tomography are recommended to exclude pseudoachalasia. A curative treatment restoring normal esophageal function does not exist; however, there are good options for symptom control. Therapy aims are abolishment of dysphagia, improvement of esophageal clearance, prevention of reflux and abolishment of chest pain. The current standard treatment is cardiomyotomy, which was first described 100 years ago by the German surgeon Ernst Heller and has been shown to be clearly superior when compared to endoscopic treatment (e.g. botox injection and balloon dilatation). Heller's myotomy procedure is preferentially performed via the laparoscopic route and combined with partial fundoplication. Currently, an alternative to performing Heller's myotomy via the endoscopic route is under intensive investigation in several centers worldwide. The peroral endoscopic myotomy (POEM) procedure has shown very promising initial results and warrants further clinical

  17. Hiatal Hernia Repair with Novel Biological Graft Reinforcement

    PubMed Central

    Sasse, Kent C.; Ackerman, Ellen; Brandt, Jared

    2016-01-01

    Background and Objectives: Hiatal hernias are repaired laparoscopically with increasing use of reinforcement material. Both synthetic and biologically derived materials reduce the recurrence rate compared to primary crural repair. Synthetic mesh introduces complications, such as mesh erosion, fibrosis, and infection. Urinary bladder matrix (UBM) represents a biologically derived material for use in hiatal hernia repair reinforcement with the potential to improve durability of repair without incurring the risks of other reinforcement materials. Methods: The 15 cases presented involved hiatal hernia repair with primary crural repair with UBM reinforcement and fundoplication. Patients were followed for an average of 3 years, and were assessed with upper gastrointestinal (GI) series, endoscopy, and assessments of subjective symptoms of gastroesophageal reflux disease (GERD). Results: Hernia diameters averaged 6 cm. Each repair was successful and completed laparoscopically. UBM exhibited favorable handling characteristics when placed as a horseshoe-type graft sutured to the crura. One patient underwent endoscopic balloon dilatation of a mild postoperative stenosis that resolved. No other complications occurred. In more than 3 years of follow-up, there have been no recurrences or long-term complications. GERD-health-related quality of life (HRQL) scores averaged 6 (range, 0–12, of a possible 50), indicating little reflux symptomatology. Follow-up upper GI series were obtained in 9 cases and showed intact repairs. An upper endoscopy was performed in 8 patients and showed no recurrences. Conclusion: Surgeons may safely use laparoscopic fundoplication with UBM reinforcement for successful repair of hiatal hernias. In this series, repairs with UBM grafts have been durable at 3 years of follow-up and may serve as an alternative to synthetic mesh reinforcement of hiatal hernia repairs. PMID:27186066

  18. Durability of laparoscopic repair of paraesophageal hernia.

    PubMed Central

    Edye, M B; Canin-Endres, J; Gattorno, F; Salky, B A

    1998-01-01

    OBJECTIVES: To define a method of primary repair that would minimize hernia recurrence and to report medium-term follow-up of patients who underwent laparoscopic repair of paraesophageal hernia to verify durability of the repair and to assess the effect of inclusion of an antireflux procedure. SUMMARY BACKGROUND DATA: Primary paraesophageal hernia repair was completed laparoscopically in 55 patients. There were five recurrences within 6 months when the sac was not excised (20%). After institution of a technique of total sac excision in 30 subsequent repairs, no early recurrences were observed. METHODS: Inclusion of an antireflux procedure, incidence of subsequent hernia recurrence, dysphagia, and gastroesophageal reflux symptoms were recorded in clinical follow-up of patients who underwent a laparoscopic procedure. RESULTS: Mean length of follow-up was 29 months. Forty-nine patients were available for follow-up, and one patient had died of lung cancer. Mean age at surgery was 68 years. The surgical morbidity rate in elderly patients was no greater than in younger patients. Eleven patients (22%) had symptoms of mild to moderate reflux, and 15 were taking acid-reduction medication for a variety of dyspeptic complaints. All but 2 of these 15 had undergone 360 degrees fundoplication at initial repair. Two patients (4%) had late recurrent hernia, each small, demonstrated by esophagram or endoscopy. CONCLUSIONS: Laparoscopic repair in the medium term appeared durable. The incidence of postsurgical reflux symptoms was unrelated to inclusion of an antireflux procedure. In the absence of motility data, partial fundoplication was preferred, although dysphagia after floppy 360 degrees wrap was rare. With the low morbidity rate of this procedure, correction of symptomatic paraesophageal hernia appears indicated in patients regardless of age. Images Figure 1. PMID:9790342

  19. Augmenter of liver regeneration inhibits TGF-β1-induced renal tubular epithelial-to-mesenchymal transition via suppressing TβR II expression in vitro

    SciTech Connect

    Liao, Xiao-hui; Zhang, Ling; Chen, Guo-tao; Yan, Ru-yu; Sun, Hang; Guo, Hui; Liu, Qi

    2014-10-01

    Tubular epithelial-to-mesenchymal transition (EMT) plays a crucial role in the progression of renal tubular interstitial fibrosis (TIF), which subsequently leads to chronic kidney disease (CKD) and eventually, end-stage renal disease (ESRD). We propose that augmenter of liver regeneration (ALR), a member of the newly discovered ALR/Erv1 protein family shown to ameliorate hepatic fibrosis, plays a similar protective role in renal tubular cells and has potential as a new treatment option for CKD. Here, we showed that recombinant human ALR (rhALR) inhibits EMT in renal tubular cells by antagonizing activation of the transforming growth factor-β1 (TGF-β1) signaling pathway. Further investigation revealed that rhALR suppresses the expression of TGF-β receptor type II (TβR II) and significantly alleviates TGF-β1-induced phosphorylation of Smad2 and nuclear factor-κB (NF-κB). No apparent adverse effects were observed upon the addition of rhALR alone to cells. These findings collectively suggest that ALR plays a role in inhibiting progression of renal tubular EMT, supporting its potential utility as an effective antifibrotic strategy to reverse TIF in CKD. - Highlights: • ALR is involved in the pathological progression of renal EMT in NRK-52E cells. • ALR suppresses the expression of TβRII and the phosphorylation of Smad2 and NF-κB. • ALR plays a role in inhibiting progression of renal tubular EMT.

  20. [Detection of SOS response inhibitor with E. coli GW1104 and GW1107 and its mechanism].

    PubMed

    Qian, J; Jin, Z C

    1994-03-01

    E. coli GW1104 and GW1107 are temperature-sensitive strains carrying a fusion gene umu:: Mud(Ap,lac) with genotypes recA441 (tif-1) and recA441 (tif-1),lexA (Def) (spr), respectively. SOS response can be produced spontaneously at 32 degrees C in E. coli GW1107, and induced at 42 degrees C in both E. coli GW1107 and GW1104. To detect SOS response inhibitor and to study its mechanism, a quick-test-system was established based on their genetic characteristics of the two strains. It was found some kinds of Chinese herbal medicine, vegetables, and chemicals could inhibit SOS response in the strains to different extent with varied mechanisms. Shell of water chestnut could inhibit temperature-induced SOS response at 42 degrees C in E. coli GW1104, and spontaneously-produced one at 32 degrees C in E.coli GW1107. Chinese chives can only inhibit temperature-induced SOS response in E. coli GW1104. It suggested the former's inhibition effect on SOS response occurred at lexA gene or on the pathway of SOS response before lexA gene, and so did the latter's on the pathway after lexA gene. PMID:7924653

  1. Increase in the Late Diastolic Filling Force is Associated With Impaired Transmitral Flow Efficiency in Acute Moderate Elevation of Left Ventricular Afterload

    PubMed Central

    Jiamsripong, Panupong; Calleja, Anna M.; Alharthi, Mohsen S.; Cho, Eun Joo; McMahon, Eileen M.; Heys, Jeffrey J.; Milano, Michele; Sengupta, Partho P.; Khandheria, Bijoy K.; Belohlavek, Marek

    2009-01-01

    Aims Analysis of intraventricular flow force and efficiency is a novel concept of quantitatively assessing left ventricular (LV) hemodynamic performance. We have parametrically characterized diastolic filling flow by early inflow force (EIF), late inflow force (LIF), and total inflow force (TIF) and by vortex formation time (VFT), a fundamental parameter of fluid transport efficiency. The purpose was to determine what changes in inflow forces characterize a decrease in diastolic blood transport efficiency in acute moderate elevation of LV afterload. Methods and Results In 8 open-chest pigs, the flow force and VFT parameters were calculated from conventional and flow Doppler echocardiography measurements at baseline and during brief (3-minute) moderate elevation in afterload induced by increasing systolic blood pressure to 130% of baseline value. Systolic LV function decreased significantly during elevated afterload. EIF did not significantly change, whereas LIF increased from 5,822.09 ± 1,656.50 to 13,948.25 ± 9,773.96 dyn (P = 0.0490) and TIF increased from 13,783.35 ± 4,816.58 to 21,836.67 ± 8,635.33 dyn (P = 0.0310). VFT decreased from 4.09 ± 0.29 to 2.79 ± 1.10 (P = 0.0068), confirming suboptimal flow transport efficiency. Conclusions Even a brief moderate increase of LV afterload causes a significant increase in the late diastolic filling force and impairs transmitral flow efficiency. PMID:19168767

  2. Simulation studies of alternate longitudinal control systems for the space shuttle orbiter in the landing regime

    NASA Technical Reports Server (NTRS)

    Powers, B. G.; Sarrafian, S. K.

    1986-01-01

    Simulations of the space shuttle orbiter in the landing task were conducted by the NASA Ames-Dryden Flight Research Facility using the Ames Research Center vertical motion simulator (VMS) and the total in-flight simulator (TIFS) variable-stability aircraft. Several new control systems designed to improve the orbiter longitudinal response characteristics were investigated. These systems improved the flightpath response by increasing the amount of pitch-rate overshoot. Reduction in the overall time delay was also investigated. During these evaluations, different preferences were noted for the baseline or the new systems depending on the pilot background. The trained astronauts were quite proficient with the baseline system and found the new systems to be less desirable than the baseline. On the other hand, the pilots without extensive flight training with the orbiter had a strong preference for the new systems. This paper presents the results of the VMS and TIFS simulations. A hypothesis is presented regarding the control strategies of the two pilot groups and how this influenced their control systems preferences. Interpretations of these control strategies are made in terms of open-loop aircraft response characteristics as well as pilot-vehicle closed-loop characteristics.

  3. Porphyrin Based neuton capture agents for cancer therapy

    DOEpatents

    Vicente, Maria Da; Shetty, Shankar Jayaram; Jaquinod, Laurent; Smith, Kevin M.

    2006-06-27

    The invention describes the synthesis of a panel of novel carbon-carbon linked carboranyl-containing 5,10,15,20-tetraphenylporphyrins bearing 25–44% boron by weight. In certain embodiments, a phenyl porphyrin compound has a carboranyl group attached to the phenyl group by a carbon-carbon linkage, wherein the phenyl group corresponds to the following formula TIF" alt="embedded image" img-content="chem" img-format="tif"/>
    where R7 through R11 are hydrogen, a carboranyl group, or are selected from the group consisting of hydroxyl, NMe3+, PMePh2+, PO(OH)2, SO3H, COOH, and NH2. In this embodiment, the carboranyl group is attached to the phenyl group by a carbon-carbon linkage, either one or two of R7 through R11 are other than hydrogen; and the phenyl porphyrin compound contains at least one phenyl group having at least one of said carboranyl groups.

  4. Prevention and Treatment of Life-Threatening Bleeding After Thyroid Surgery

    PubMed Central

    Zhang, Xiwei; An, Changming; Liu, Jie; Li, Zhengjiang; Tang, Pingzhang; Xu, Zhengang

    2015-01-01

    Background Few reports have discussed life-threatening bleeding that occurs postoperatively in patients who have undergone thyroid surgery. In this article, we discuss the causes, treatment measures, and possible ways of preventing this severe complication. Material/Methods From Jan 2002 to Dec 2014 we retrospectively analyzed 7 patients who developed life-threatening bleeding after undergoing thyroid surgery at our center. Results Among the group of 7 patients, there was 1 case of superior thyroid artery hemorrhage (STAH), 5 cases of carotid blowout syndrome (CBS), and 1 case of tracheo-innominate fistula (TIF). The STAH was caused by unreliable ligation. All the cases of CBS and TIF were caused by surgical wound infection. Six patients were transferred to the operating room immediately; open surgical treatment was performed on these 6 patients. Out of these 6 patients, 1 patient did not survive the operation, and hemorrhage was successfully controlled in 3 patients. The remaining 2 patients again experienced bleeding even after undergoing open surgery. Only 1 patient developed long-term neurological complications. Conclusions Infection is the most common cause of life-threatening bleeding that occurs postoperatively in some patients who have undergone thyroid surgery. Early surgical intervention can save the lives of these patients without causing any severe neurological complications. PMID:26613576

  5. Characterization of PCDD/Fs and heavy metals from MSW incineration plant in Harbin.

    PubMed

    Bie, Rushan; Li, Shiyuan; Wang, Hai

    2007-01-01

    The characterization of PCDD/Fs and heavy metals in the flue gas and fly ash of Harbin municipal solid waste (MSW) incineration plant, located in the northeast of China, was investigated in this study. The MSW was treated in a twin internal fluidized (TIF) bed incinerator. The results indicate that the emission of PCDD/Fs into the environment is 0.02 ng I-TEQ/m3 and the level of PCDD/Fs in the fabric filter fly ash is 0.7982 ng I-TEQ/g. The leachability levels of Pb, Cd and Hg in the fly ash are below the limits of environmental protection standard in China. However, the contents of Cu, Zn, and Hg are high in the fly ash. This suggests that the fly ash is a hazardous waste that requires special treatment and disposal. The practice of more than four years of operation shows that the TIF bed incinerator is very suitable and practical for China. PMID:17188487

  6. Detection of particle flow patterns in tumor by directional spatial frequency analysis

    NASA Astrophysics Data System (ADS)

    Russell, Stewart; Camara, Hawa; Shi, Lingyan; Hoopes, P. Jack; Kaufman, Peter; Pogue, Brian; Alfano, Robert

    2016-04-01

    Drug delivery to tumors is well known to be chaotic and limited, partly from dysfunctional vasculature, but also because of microscopic regional variations in composition. Modeling the of transport of nanoparticle therapeutics, therefore must include not only a description of vascular permeability, but also of the movement of the drug as suspended in tumor interstitial fluid (TIF) once it leaves the blood vessel. Understanding of this area is limited because we currently lack the tools and analytical methods to characterize it. We have previously shown that directional anisotropy of drug delivery can be detected using Directional Fourier Spatial Frequency (DFSF) Analysis. Here we extend this approach to generate flow line maps of nanoparticle transport in TIF relative to tumor ultrastructure, and show that features of tumor spatial heterogeneity can be identified that are directly related to local flow isometries. The identification of these regions of limited flow may be used as a metric for determining response to therapy, or for the optimization of adjuvant therapies such as radiation pre-treatment, or enzymatic degradation.

  7. In vivo model for microbial invasion of tooth root dentinal tubules

    PubMed Central

    BRITTAN, Jane L; SPRAGUE, Susan V; MACDONALD, Emma L; LOVE, Robert M; JENKINSON, Howard F; WEST, Nicola X

    2016-01-01

    ABSTRACT Objective Bacterial penetration of dentinal tubules via exposed dentine can lead to root caries and promote infections of the pulp and root canal system. The aim of this work was to develop a new experimental model for studying bacterial invasion of dentinal tubules within the human oral cavity. Material and Methods Sections of human root dentine were mounted into lower oral appliances that were worn by four human subjects for 15 d. Roots were then fixed, sectioned, stained and examined microscopically for evidence of bacterial invasion. Levels of invasion were expressed as Tubule Invasion Factor (TIF). DNA was extracted from root samples, subjected to polymerase chain reaction amplification of 16S rRNA genes, and invading bacteria were identified by comparison of sequences with GenBank database. Results All root dentine samples with patent tubules showed evidence of bacterial cell invasion (TIF value range from 5.7 to 9.0) to depths of 200 mm or more. A spectrum of Gram-positive and Gram-negative cell morphotypes were visualized, and molecular typing identified species of Granulicatella, Streptococcus, Klebsiella, Enterobacter, Acinetobacter, and Pseudomonas as dentinal tubule residents. Conclusion A novel in vivo model is described, which provides for human root dentine to be efficiently infected by oral microorganisms. A range of bacteria were able to initially invade dentinal tubules within exposed dentine. The model will be useful for testing the effectiveness of antiseptics, irrigants, and potential tubule occluding agents in preventing bacterial invasion of dentine. PMID:27119760

  8. In vivo model for microbial invasion of tooth root dentinal tubules.

    PubMed

    Brittan, Jane L; Sprague, Susan V; Macdonald, Emma L; Love, Robert M; Jenkinson, Howard F; West, Nicola X

    2016-04-01

    Objective Bacterial penetration of dentinal tubules via exposed dentine can lead to root caries and promote infections of the pulp and root canal system. The aim of this work was to develop a new experimental model for studying bacterial invasion of dentinal tubules within the human oral cavity. Material and Methods Sections of human root dentine were mounted into lower oral appliances that were worn by four human subjects for 15 d. Roots were then fixed, sectioned, stained and examined microscopically for evidence of bacterial invasion. Levels of invasion were expressed as Tubule Invasion Factor (TIF). DNA was extracted from root samples, subjected to polymerase chain reaction amplification of 16S rRNA genes, and invading bacteria were identified by comparison of sequences with GenBank database. Results All root dentine samples with patent tubules showed evidence of bacterial cell invasion (TIF value range from 5.7 to 9.0) to depths of 200 mm or more. A spectrum of Gram-positive and Gram-negative cell morphotypes were visualized, and molecular typing identified species of Granulicatella, Streptococcus, Klebsiella, Enterobacter, Acinetobacter, and Pseudomonas as dentinal tubule residents. Conclusion A novel in vivo model is described, which provides for human root dentine to be efficiently infected by oral microorganisms. A range of bacteria were able to initially invade dentinal tubules within exposed dentine. The model will be useful for testing the effectiveness of antiseptics, irrigants, and potential tubule occluding agents in preventing bacterial invasion of dentine. PMID:27119760

  9. The Impact of Migrations on the Health Services for Rare Diseases in Europe: The Example of Haemoglobin Disorders

    PubMed Central

    Angastiniotis, Michalis; Vives Corrons, Joan-Lluis; Soteriades, Elpidoforos S.; Eleftheriou, Androulla

    2013-01-01

    Migration from different parts of the world to several European countries leads to the introduction of haemoglobinopathy genes into the population, which creates several demanding needs for prevention and treatment services for Hb disorders. In this paper we examined the degree to which European health services have responded to such challenges and in particular to health services necessary to address the needs of patients with thalassaemia and sickle cell disease (SCD). Information on available services was obtained from international organizations, collaborated European project, and the Thalassaemia International Federation (TIF) Databases, which include information from published surveys, registries, field trips, and delegation visits to countries and regions by expert advisors, local associations, and other collaborators' reports. Results show that countries with traditional strong prevention and treatment programs are well prepared to face the above challenges, while others are urgently needed to address these problems in a systematic way. The Thalassaemia International Federation (TIF) is committed to monitor the progress, raise awareness, and support the promotion of more immigrant-oriented health policies to ensure their integration in society and their access to appropriate, adequate, and timely health services. PMID:23576907

  10. Proper use of common image file formats in handling radiological images.

    PubMed

    Faccioli, N; Perandini, S; Comai, A; D'Onofrio, M; Pozzi Mucelli, R

    2009-04-01

    This paper highlights the differences among the most common file formats used for storing digital radiological images. It promotes the proper use of these formats to guarantee easy manipulation in handling the most typical practical applications in daily radiological practice. The authors provide a simple yet exhaustive introduction to the concept of "file format" and describe the algorithms and main features of the most common formats (BMP, JPEG, GIF, DICOM, TIF, PNG) and Portable Network Graphics (PNG).The different formats are compared in terms of dimension, quality, portability and with reference to the following specific needs: electronic communications, publication on the World Wide Web, presentation of electronic posters, video presentations for teaching and manuscript publishing. We also illustrate how to handle the various formats with the programmes supplied with standard software installations.The large number of digital applications of image file formats calls for a simplification in daily radiological practice. We recommend the use of JPEG and PNG for electronic communications; PNG and GIF for publication on the worldwide web; JPEG and PNG for electronic poster presentations; DICOM, PNG and JPEG for teaching presentations; TIF and PNG for printing on paper. PMID:19330427

  11. An approach to distribution short-term load forecasting

    SciTech Connect

    Stratton, R.C.; Gaustad, K.L.

    1995-03-01

    This paper reports on the developments and findings of the Distribution Short-Term Load Forecaster (DSTLF) research activity. The objective of this research is to develop a distribution short-term load forecasting technology consisting of a forecasting method, development methodology, theories necessary to support required technical components, and the hardware and software tools required to perform the forecast The DSTLF consists of four major components: monitored endpoint load forecaster (MELF), nonmonitored endpoint load forecaster (NELF), topological integration forecaster (TIF), and a dynamic tuner. These components interact to provide short-term forecasts at various points in the, distribution system, eg., feeder, line section, and endpoint. This paper discusses the DSTLF methodology and MELF component MELF, based on artificial neural network technology, predicts distribution endpoint loads for an hour, a day, and a week in advance. Predictions are developed using time, calendar, historical load, and weather data. The overall DSTLF architecture and a prototype MELF module for retail endpoints have been developed. Future work will be focused on refining and extending MELF and developing NELF and TIF capabilities.

  12. Thermal properties and phase transition in the fluoride, (NH4)3SnF7

    NASA Astrophysics Data System (ADS)

    Kartashev, A. V.; Gorev, M. V.; Bogdanov, E. V.; Flerov, I. N.; Laptash, N. M.

    2016-05-01

    Calorimetric, dilatometric and differential thermal analysis studies were performed on (NH4)3SnF7 for a wide range of temperatures and pressures. Large entropy (δS0=22 J/mol K) and elastic deformation (δ(ΔV/V)0=0.89%) jumps have proven that the Pa-3↔Pm-3m phase transition is a strong first order structural transformation. A total entropy change of ΔS0=32.5 J/mol K is characteristic for the order-disorder phase transition, and is equal to the sum of entropy changes in the related material, (NH4)3TiF7, undergoing transformation between the two cubic phases through the intermediate phases. Hydrostatic pressure decreases the stability of the high temperature Pm-3m phase in (NH4)3SnF7, contrary to (NH4)3TiF7, characterised by a negative baric coefficient. The effect of experimental conditions on the chemical stability of (NH4)3SnF7 was observed.

  13. Focused ultrasound as a non-invasive intervention for neurological disease: a review.

    PubMed

    Piper, Rory J; Hughes, Mark A; Moran, Carmel M; Kandasamy, Jothy

    2016-06-01

    Focused ultrasound (FUS) is an incision-less intervention that is a Food and Drug Association (FDA) approved surgical treatment for various pathologies including uterine fibroids and bone metastases. Recent advances in magnetic resonance imaging thermometry and ability to use FUS across the intact calvarium have re-opened interest in the use of FUS in the treatment of neurological diseases. FUS currently has a European CE mark for use in movement disorders. However, it shows potential in the treatment of other neuropathologies including tumours and as a lesional tool in epilepsy. FUS may exert its therapeutic effect through thermal or mechanical fragmentation of intracranial lesions, or by enhancing delivery of pharmaceutical agents across the blood-brain barrier. In this review, we summarise the mechanisms, clinical applications and potential future of FUS for the treatment of neurological disease. We have searched for and described the recently completed and on-going clinical trials investigating FUS for the treatment of neurological disorders. We identified phase one trials investigating utility of FUS in: movement disorders (including essential tremor and Parkinson's disease), chronic pain, obsessive-compulsive disorder and cerebral tumours. Current literature also reports pre-clinical work exploring utility in epilepsy, neurodegenerative conditions (such as Alzheimer's disease) and thrombolysis. Safety and early efficacy data are now emerging, suggesting that transcalvarial FUS is a feasible and safe intervention. Further evidence is required to determine whether FUS is an effective alternative in comparison to current neurosurgical interventions. The cost of requisite hardware is currently a barrier to widespread uptake in UK neurosurgical centres. PMID:27101792

  14. Mapping Isoflavone QTL with Main, Epistatic and QTL × Environment Effects in Recombinant Inbred Lines of Soybean

    PubMed Central

    Wang, Yan; Han, Yingpeng; Zhao, Xue; Li, Yongguang; Teng, Weili; Li, Dongmei; Zhan, Yong; Li, Wenbin

    2015-01-01

    Soybean (Glycine max (L.) Merr.) isoflavone is important for human health and plant defense system. To identify novel quantitative trait loci (QTL) and epistatic QTL underlying isoflavone content in soybean, F5:6, F5:7 and F5:8 populations of 130 recombinant inbred (RI) lines, derived from the cross of soybean cultivar ‘Zhong Dou 27′ (high isoflavone) and ‘Jiu Nong 20′ (low isoflavone), were analyzed with 95 new SSR markers. A new linkage map including 194 SSR markers and covering 2,312 cM with mean distance of about 12 cM between markers was constructed. Thirty four QTL for both individual and total seed isoflavone contents of soybean were identified. Six, seven, ten and eleven QTL were associated with daidzein (DZ), glycitein (GC), genistein (GT) and total isoflavone (TI), respectively. Of them 23 QTL were newly identified. The qTIF_1 between Satt423 and Satt569 shared the same marker Satt569 with qDZF_2, qGTF_1 and qTIF_2. The qGTD2_1 between Satt186 and Satt226 was detected in four environments and explained 3.41%-10.98% of the phenotypic variation. The qGTA2_1, overlapped with qGCA2_1 and detected in four environments, was close to the previously identified major QTL for GT, which were responsible for large a effects. QTL (qDZF_2, qGTF_1 and qTIF_2) between Satt144-Satt569 were either clustered or pleiotropic. The qGCM_1, qGTM_1 and qTIM_1 between Satt540-Sat_244 explained 2.02%–9.12% of the phenotypic variation over six environments. Moreover, the qGCE_1 overlapped with qGTE_1 and qTIE_1, the qTIH_2 overlapped with qGTH_1, qGCI_1 overlapped with qDZI_1, qTIL_1 overlapped with qGTL_1, and qTIO_1 overlapped with qGTO_1. In this study, some of unstable QTL were detected in different environments, which were due to weak expression of QTL, QTL by environment interaction in the opposite direction to a effects, and/or epistasis. The markers identified in multi-environments in this study could be applied in the selection of soybean cultivars for higher

  15. Metabolic Actions of Estrogen Receptor Beta (ERβ) are Mediated by a Negative Cross-Talk with PPARγ

    PubMed Central

    Foryst-Ludwig, Anna; Clemenz, Markus; Hohmann, Stephan; Hartge, Martin; Sprang, Christiane; Frost, Nikolaj; Krikov, Maxim; Bhanot, Sanjay; Barros, Rodrigo; Morani, Andrea; Gustafsson, Jan-Åke; Unger, Thomas; Kintscher, Ulrich

    2008-01-01

    Estrogen receptors (ER) are important regulators of metabolic diseases such as obesity and insulin resistance (IR). While ERα seems to have a protective role in such diseases, the function of ERβ is not clear. To characterize the metabolic function of ERβ, we investigated its molecular interaction with a master regulator of insulin signaling/glucose metabolism, the PPARγ, in vitro and in high-fat diet (HFD)-fed ERβ -/- mice (βERKO) mice. Our in vitro experiments showed that ERβ inhibits ligand-mediated PPARγ-transcriptional activity. That resulted in a blockade of PPARγ-induced adipocytic gene expression and in decreased adipogenesis. Overexpression of nuclear coactivators such as SRC1 and TIF2 prevented the ERβ-mediated inhibition of PPARγ activity. Consistent with the in vitro data, we observed increased PPARγ activity in gonadal fat from HFD-fed βERKO mice. In consonance with enhanced PPARγ activation, HFD-fed βERKO mice showed increased body weight gain and fat mass in the presence of improved insulin sensitivity. To directly demonstrate the role of PPARγ in HFD-fed βERKO mice, PPARγ signaling was disrupted by PPARγ antisense oligonucleotide (ASO). Blockade of adipose PPARγ by ASO reversed the phenotype of βERKO mice with an impairment of insulin sensitization and glucose tolerance. Finally, binding of SRC1 and TIF2 to the PPARγ-regulated adiponectin promoter was enhanced in gonadal fat from βERKO mice indicating that the absence of ERβ in adipose tissue results in exaggerated coactivator binding to a PPARγ target promoter. Collectively, our data provide the first evidence that ERβ-deficiency protects against diet-induced IR and glucose intolerance which involves an augmented PPARγ signaling in adipose tissue. Moreover, our data suggest that the coactivators SRC1 and TIF2 are involved in this interaction. Impairment of insulin and glucose metabolism by ERβ may have significant implications for our understanding of hormone receptor

  16. Hydrocarbon Rocket Technology Impact Forecasting

    NASA Technical Reports Server (NTRS)

    Stuber, Eric; Prasadh, Nishant; Edwards, Stephen; Mavris, Dimitri N.

    2012-01-01

    Ever since the Apollo program ended, the development of launch propulsion systems in the US has fallen drastically, with only two new booster engine developments, the SSME and the RS-68, occurring in the past few decades.1 In recent years, however, there has been an increased interest in pursuing more effective launch propulsion technologies in the U.S., exemplified by the NASA Office of the Chief Technologist s inclusion of Launch Propulsion Systems as the first technological area in the Space Technology Roadmaps2. One area of particular interest to both government agencies and commercial entities has been the development of hydrocarbon engines; NASA and the Air Force Research Lab3 have expressed interest in the use of hydrocarbon fuels for their respective SLS Booster and Reusable Booster System concepts, and two major commercially-developed launch vehicles SpaceX s Falcon 9 and Orbital Sciences Antares feature engines that use RP-1 kerosene fuel. Compared to engines powered by liquid hydrogen, hydrocarbon-fueled engines have a greater propellant density (usually resulting in a lighter overall engine), produce greater propulsive force, possess easier fuel handling and loading, and for reusable vehicle concepts can provide a shorter turnaround time between launches. These benefits suggest that a hydrocarbon-fueled launch vehicle would allow for a cheap and frequent means of access to space.1 However, the time and money required for the development of a new engine still presents a major challenge. Long and costly design, development, testing and evaluation (DDT&E) programs underscore the importance of identifying critical technologies and prioritizing investment efforts. Trade studies must be performed on engine concepts examining the affordability, operability, and reliability of each concept, and quantifying the impacts of proposed technologies. These studies can be performed through use of the Technology Impact Forecasting (TIF) method. The Technology Impact

  17. Lewis acid-promoted hydrofluorination of alkynyl sulfides to generate α-fluorovinyl thioethers

    PubMed Central

    Bello, Davide

    2015-01-01

    Summary A new method for the preparation of α-fluorovinyl thioethers is reported which involves the hydrofluorination of alkynyl sulfides with 3HF·Et3N, a process that requires Lewis acid activation using BF3·Et2O and TiF4. The method gives access to a range of α-fluorovinyl thioethers, some in high stereoselectivity with the Z-isomer predominating over the E-isomer. The α-fluorovinyl thioether motif has prospects as a steric and electronic mimetic of thioester enols and enolates, important intermediates in enzymatic C–C bond forming reactions. The method opens access to appropriate analogues for investigations in this direction. PMID:26664609

  18. Engineering of highly ordered TiO2 nanopore arrays by anodization

    NASA Astrophysics Data System (ADS)

    Wang, Huijie; Huang, Zhennan; Zhang, Li; Ding, Jie; Ma, Zhaoxia; Liu, Yong; Kou, Shengzhong; Yang, Hangsheng

    2016-07-01

    Finite element analysis was used to simulate the current density distributions in the TiO2 barrier layer formed at the initial stage of Ti anodization. The morphology modification of the barrier layer was found to induce current density distribution change. By starting the anodization with proper TiO2 barrier layer morphology, the current density distribution can be adjusted to favor the formation of either nanotube arrays or nanopore arrays of anodic TiO2. We also found that the addition of sodium acetate into the electrolyte suppressed both the field-assisted chemical dissolution of TiO2 and the TiF62- hydrolysis induced TiO2 deposition during anodization, and thus further favored the nanopore formation. Accordingly, highly ordered anodic TiO2 nanopore arrays, similar to anodic aluminum oxide nanopore arrays, were successfully prepared.

  19. A novel telomerase substrate precursor rapidly induces telomere dysfunction in telomerase positive cancer cells but not telomerase silent normal cells

    PubMed Central

    Mender, Ilgen; Gryaznov, Sergei; Shay, Jerry W.

    2015-01-01

    Although telomerase is an almost universal target for cancer therapy, there has been no effective telomerase targeted inhibitor that has progressed to late stage human clinical trials. Recently, we reported that a telomerase-mediated telomere-disrupting compound, 6-thio-2′-deoxyguanosine (6-thio-dG), was very effective at targeting telomerase positive cancer cells while sparing telomerase silent normal cells. 6-thio-dG, a nucleoside analogue of the already-approved drug 6-thioguanine, is incorporated into telomeres by telomerase, resulting in disruption of the telomere-protecting shelterin complex. This disruption leads to Telomere dysfunction-Induced Foci (TIFs) formation and rapid cell death for the vast majority of cancer cells. Since most chemotherapies eventually fail due to drug acquired resistance, novel drugs such as 6-thio-dG, as a single first line agent or in the maintenance setting, may represent an effective new treatment for cancer patients. PMID:26425659

  20. Production of unstable proteins through the formation of stable core complexes

    PubMed Central

    Levy, Nicolas; Eiler, Sylvia; Pradeau-Aubreton, Karine; Maillot, Benoit; Stricher, François; Ruff, Marc

    2016-01-01

    Purification of proteins that participate in large transient complexes is impeded by low amounts, heterogeneity, instability and poor solubility. To circumvent these difficulties we set up a methodology that enables the production of stable complexes for structural and functional studies. This procedure is benchmarked and applied to two challenging protein families: the human steroid nuclear receptors (SNR) and the HIV-1 pre-integration complex. In the context of transcriptional regulation studies, we produce and characterize the ligand-binding domains of the glucocorticoid nuclear receptor and the oestrogen receptor beta in complex with a TIF2 (transcriptional intermediary factor 2) domain containing the three SNR-binding motifs. In the context of retroviral integration, we demonstrate the stabilization of the HIV-1 integrase by formation of complexes with partner proteins and DNA. This procedure provides a powerful research tool for structural and functional studies of proteins participating in non-covalent macromolecular complexes. PMID:26983699

  1. RegiStax: Alignment, stacking and processing of images

    NASA Astrophysics Data System (ADS)

    Berrevoets, Cor; DeClerq, Bart; George, Tony; Makolkin, Dmitry; Maxson, Paul; Pilz, Bob; Presnyakov, Pavel; Roel, Eric; Weiller, Sylvain

    2012-06-01

    RegiStax is software for alignment/stacking/processing of images; it was released over 10 years ago and continues to be developed and improved. The current version is RegiStax 6, which supports the following formats: AVI, SER, RFL (RegiStax Framelist), BMP, JPG, TIF, and FIT. This version has a shorter and simpler processing sequence than its predecessor, and optimizing isn't necessary anymore as a new image alignment method optimizes directly. The interface of RegiStax 6 has been simplified to look more uniform in appearance and functionality, and RegiStax 6 now uses Multi-core processing, allowing the user to have up to have multiple cores(recommended to use maximally 4) working simultaneous during alignment/stacking.

  2. Effects of Ti-Based Additives on the Hydrogen Storage Properties of a L i B H 4 / C a H 2 Destabilized System

    DOE PAGESBeta

    Yang, Hongwei; Ibikunle, Adeola; Goudy, Andrew J.

    2010-01-01

    Tmore » he hydrogen storage properties of a destabilized LiBH 4 / CaH 2 system ball-milled with TiCl 3 , TiF 3 , and TiO 2 additives have been investigated. It is found that the system with TiCl 3 additive has a lower dehydrogenation temperature than the ones with other additives. Further study shows that a higher amount of TiCl 3 is more effective in reducing the desorption temperature of the LiBH 4 / CaH 2 system, since it leads to a lower activation energy of dehydrogenation.he activations energies for mixtures containing 4, 10, and 25 mol% of TiCl 3 are 141, 126, and 110 kJ/mol, respectively. However, the benefits of higher amounts of TiCl 3 are offset by a larger reduction in hydrogen capacity of the mixtures.« less

  3. Analysis of the murine Dtk gene identifies conservation of genomic structure within a new receptor tyrosine kinase subfamily

    SciTech Connect

    Lewis, P.M.; Crosier, K.E.; Crosier, P.S.

    1996-01-01

    The receptor tyrosine kinase Dtk/Tyro 3/Sky/rse/brt/tif is a member of a new subfamily of receptors that also includes Axl/Ufo/Ark and Eyk/Mer. These receptors are characterized by the presence of two immunoglobulin-like loops and two fibronectin type III repeats in their extracellular domains. The structure of the murine Dtk gene has been determined. The gene consists of 21 exons that are distributed over 21 kb of genomic DNA. An isoform of Dtk is generated by differential splicing of exons from the 5{prime} region of the gene. The overall genomic structure of Dtk is virtually identical to that determined for the human UFO gene. This particular genomic organization is likely to have been duplicated and closely maintained throughout evolution. 38 refs., 3 figs., 1 tab.

  4. Ligand-dependent contribution of RXRβ to cholesterol homeostasis in Sertoli cells

    PubMed Central

    Mascrez, Bénédicte; Ghyselinck, Norbert B; Watanabe, Mitsuhiro; Annicotte, Jean-Sébastien; Chambon, Pierre; Auwerx, Johan; Mark, Manuel

    2004-01-01

    We show that mice expressing retinoid X receptor β (RXRβ) impaired in its transcriptional activation function AF-2 (Rxrbaf20 mutation) do not display the spermatid release defects observed in RXRβ-null mutants, indicating that the role of RXRβ in spermatid release is ligand-independent. In contrast, like RXRβ-null mutants, Rxrbaf20 mice accumulate cholesteryl esters in Sertoli cells (SCs) due to reduced ABCA1 transporter-mediated cholesterol efflux. We provide genetic and molecular evidence that cholesterol homeostasis in SCs does not require PPARα and β, but depends upon the TIF2 coactivator and RXRβ/LXRβ heterodimers, in which RXRβ AF-2 is transcriptionally active. Our results also indicate that RXRβ may be activated by a ligand distinct from 9-cis retinoic acid. PMID:14993927

  5. Studying the R-branch and the Q-branch emission spectral lines of diatomic molecules using improved analytical formula

    NASA Astrophysics Data System (ADS)

    Jiang, Yonghong; Sun, Weiguo; Zhang, Yi; Fu, Jia; Fan, Qunchao; Li, Huidong; Feng, Hao

    2016-06-01

    The difference converging method (DCM) used to predict the R-branch and the Q-branch high-lying rotational lines for diatomic systems is improved in this study. The key analytical formulae of the DCM method are modified by adding a higher order spectral term Hυ, and adding a physical converging criterion to improve the accuracy of predictions. Applications of the improved DCM method to the R-branch of the TiF molecule and the Q-branch of the 193IrN molecule show that the accuracy of the R-branch and the Q-branch rotational lines is about one order of magnitude better than the results obtained using the previous formulae, which demonstrate the necessity of the added small term Hυ and the physical converging criterion. The DCM results are also shown to be better than the extrapolated rotational lines using the least-squares method.

  6. Reversible force-resistivity behavior of thin films of the TTF-TCNQ family

    SciTech Connect

    Vollmann, W.; Sonntag, H.U.

    1997-05-01

    The electrical properties of vacuum sublimed thin films of TIF-TCNQ and its derivatives mainly are determined by electron barriers at grain boundaries. The electrical conductivity is thermal activated and exhibits a significant dependence on a force acting perpendicularly to the film plane. The sample resistance R decreases continuously with increasing force F. TCNQ thin films on steel show a similar R-F relation. The effect has been observed already at forces of 1 N, but also up to about 60 kN. An explanation of these phenomena is given by a grain boundary limited hopping mechanism with pressure dependent potential barrier width and height. Morphology investigations by SEM support the model.

  7. A disposable, reagentless, third-generation glucose biosensor based on overoxidized poly(pyrrole)/tetrathiafulvalene-tetracyanoquinodimethane composite.

    PubMed

    Palmisano, Francesco; Zambonin, Pier Giorgio; Centonze, Diego; Quinto, Maurizio

    2002-12-01

    A disposable glucose biosensor based on glucose oxidase immobilized on tetrathiafulvalene-tetracyanoquinodimethane (ITF-TCNQ) conducting organic salt synthesized in situ onto an overoxidized poly(pyrrole) (PPy(ox).) film is described. The TIF-TCNQ crystals grow through the nonconducting polypyrrole film (ensuring electrical connection to the underlying Pt electrode) and emerge from the film forming a treelike structure. The PPy(ox) film prevents the interfering substances from reaching the electrode surface. The sensor behavior can be modeled by assuming a direct reoxidation of the enzyme at the surface of the TTF-TCNQ crystals. A heterogeneous rate constant around 10(-6) - 10(-7) cm s(-1) has been estimated. The biosensor is nearly oxygen- and interference-free and when integrated in a flow injection system displays a remarkable sensitivity (70 nA/mM) and stability. PMID:12498183

  8. Rapid determination of major bioactive isoflavonoid compounds during the extraction process of kudzu (Pueraria lobata) by near-infrared transmission spectroscopy

    NASA Astrophysics Data System (ADS)

    Wang, Pei; Zhang, Hui; Yang, Hailong; Nie, Lei; Zang, Hengchang

    2015-02-01

    Near-infrared (NIR) spectroscopy has been developed into an indispensable tool for both academic research and industrial quality control in a wide field of applications. The feasibility of NIR spectroscopy to monitor the concentration of puerarin, daidzin, daidzein and total isoflavonoid (TIF) during the extraction process of kudzu (Pueraria lobata) was verified in this work. NIR spectra were collected in transmission mode and pretreated with smoothing and derivative. Partial least square regression (PLSR) was used to establish calibration models. Three different variable selection methods, including correlation coefficient method, interval partial least squares (iPLS), and successive projections algorithm (SPA) were performed and compared with models based on all of the variables. The results showed that the approach was very efficient and environmentally friendly for rapid determination of the four quality indices (QIs) in the kudzu extraction process. This method established may have the potential to be used as a process analytical technological (PAT) tool in the future.

  9. Pulsed Laser-Assisted Focused Electron-Beam-Induced Etching of Titanium with XeF 2 : Enhanced Reaction Rate and Precursor Transport

    SciTech Connect

    Noh, J. H.; Fowlkes, J. D.; Timilsina, R.; Stanford, M. G.; Lewis, B. B.; Rack, P. D.

    2015-01-28

    We introduce a laser-assisted focused electron-beam-induced etching (LA-FEBIE) process which is a versatile, direct write nanofabrication method that allows nanoscale patterning and editing; we do this in order to enhance the etch rate of electron-beam-induced etching. The results demonstrate that the titanium electron stimulated etch rate via the XeF2 precursor can be enhanced up to a factor of 6 times with an intermittent pulsed laser assist. Moreover, the evolution of the etching process is correlated to in situ stage current measurements and scanning electron micrographs as a function of time. Finally, the increased etch rate is attributed to photothermally enhanced Ti–F reaction and TiF4 desorption and in some regimes enhanced XeF2 surface diffusion to the reaction zone.

  10. Pulsed Laser-Assisted Focused Electron-Beam-Induced Etching of Titanium with XeF 2 : Enhanced Reaction Rate and Precursor Transport

    DOE PAGESBeta

    Noh, J. H.; Fowlkes, J. D.; Timilsina, R.; Stanford, M. G.; Lewis, B. B.; Rack, P. D.

    2015-01-28

    We introduce a laser-assisted focused electron-beam-induced etching (LA-FEBIE) process which is a versatile, direct write nanofabrication method that allows nanoscale patterning and editing; we do this in order to enhance the etch rate of electron-beam-induced etching. The results demonstrate that the titanium electron stimulated etch rate via the XeF2 precursor can be enhanced up to a factor of 6 times with an intermittent pulsed laser assist. Moreover, the evolution of the etching process is correlated to in situ stage current measurements and scanning electron micrographs as a function of time. Finally, the increased etch rate is attributed to photothermally enhancedmore » Ti–F reaction and TiF4 desorption and in some regimes enhanced XeF2 surface diffusion to the reaction zone.« less

  11. Production of unstable proteins through the formation of stable core complexes.

    PubMed

    Levy, Nicolas; Eiler, Sylvia; Pradeau-Aubreton, Karine; Maillot, Benoit; Stricher, François; Ruff, Marc

    2016-01-01

    Purification of proteins that participate in large transient complexes is impeded by low amounts, heterogeneity, instability and poor solubility. To circumvent these difficulties we set up a methodology that enables the production of stable complexes for structural and functional studies. This procedure is benchmarked and applied to two challenging protein families: the human steroid nuclear receptors (SNR) and the HIV-1 pre-integration complex. In the context of transcriptional regulation studies, we produce and characterize the ligand-binding domains of the glucocorticoid nuclear receptor and the oestrogen receptor beta in complex with a TIF2 (transcriptional intermediary factor 2) domain containing the three SNR-binding motifs. In the context of retroviral integration, we demonstrate the stabilization of the HIV-1 integrase by formation of complexes with partner proteins and DNA. This procedure provides a powerful research tool for structural and functional studies of proteins participating in non-covalent macromolecular complexes. PMID:26983699

  12. HSV-1 Remodels Host Telomeres To Facilitate Viral Replication

    PubMed Central

    Deng, Zhong; Kim, Eui Tae; Vladimirova, Olga; Dheekollu, Jayaraju; Wang, Zhuo; Newhart, Alyshia; Liu, Dongmei; Myers, Jaclyn L.; Hensley, Scott E.; Moffat, Jennifer; Janicki, Susan M.; Fraser, Nigel W.; Knipe, David M.; Weitzman, Matthew D.; Lieberman, Paul M.

    2015-01-01

    Summary Telomeres protect the ends of cellular chromosomes. We show here that infection with herpes simplex virus 1 (HSV-1) results in chromosomal structural aberrations at telomeres and the accumulation of telomere dysfunction-induced DNA damage foci (TIFs). At the molecular level, HSV-1 induces transcription of telomere repeat-containing RNA (TERRA), followed by the proteolytic degradation of the telomere protein TPP1, and loss of the telomere repeat DNA signal. The HSV-1 encoded E3 ubiquitin ligase ICP0 is required for TERRA transcription and facilitates TPP1 degradation. shRNA depletion of TPP1 increases viral replication, arguing that TPP1inhibits viral replication. Viral replication protein ICP8 forms foci that coincide with telomeric proteins and ICP8 null virus failed to degrade telomere DNA signal. These findings suggest that HSV-1 reorganizes telomeres to form ICP8-associated pre-replication foci and promotes viral genomic replication. PMID:25497088

  13. Motion simulator study of longitudinal stability requirements for large delta wing transport airplanes during approach and landing with stability augmentation systems failed

    NASA Technical Reports Server (NTRS)

    Snyder, C. T.; Fry, E. B.; Drinkwater, F. J., III; Forrest, R. D.; Scott, B. C.; Benefield, T. D.

    1972-01-01

    A ground-based simulator investigation was conducted in preparation for and correlation with an-flight simulator program. The objective of these studies was to define minimum acceptable levels of static longitudinal stability for landing approach following stability augmentation systems failures. The airworthiness authorities are presently attempting to establish the requirements for civil transports with only the backup flight control system operating. Using a baseline configuration representative of a large delta wing transport, 20 different configurations, many representing negative static margins, were assessed by three research test pilots in 33 hours of piloted operation. Verification of the baseline model to be used in the TIFS experiment was provided by computed and piloted comparisons with a well-validated reference airplane simulation. Pilot comments and ratings are included, as well as preliminary tracking performance and workload data.

  14. TFIIH plays an essential role in RNA polymerase I transcription.

    PubMed

    Iben, Sebastian; Tschochner, Herbert; Bier, Mirko; Hoogstraten, Deborah; Hozák, Pavel; Egly, Jean Marc; Grummt, Ingrid

    2002-05-01

    TFIIH is a multisubunit protein complex that plays an essential role in nucleotide excision repair and transcription of protein-coding genes. Here, we report that TFIIH is also required for ribosomal RNA synthesis in vivo and in vitro. In yeast, pre-rRNA synthesis is impaired in TFIIH ts strains. In a mouse, part of cellular TFIIH is localized within the nucleolus and is associated with subpopulations of both RNA polymerase I and the basal factor TIF-IB. Transcription systems lacking TFIIH are inactive and exogenous TFIIH restores transcriptional activity. TFIIH is required for productive but not abortive rDNA transcription, implying a postinitiation role in transcription. The results provide a molecular link between RNA polymerase I transcription and transcription-coupled repair of active ribosomal RNA genes. PMID:12015980

  15. Targeting Aberrant Epigenetic Networks Mediated by PRMT1 and KDM4C in Acute Myeloid Leukemia

    PubMed Central

    Cheung, Ngai; Fung, Tsz Kan; Zeisig, Bernd B.; Holmes, Katie; Rane, Jayant K.; Mowen, Kerri A.; Finn, Michael G.; Lenhard, Boris; Chan, Li Chong; So, Chi Wai Eric

    2016-01-01

    Summary Transcriptional deregulation plays a major role in acute myeloid leukemia, and therefore identification of epigenetic modifying enzymes essential for the maintenance of oncogenic transcription programs holds the key to better understanding of the biology and designing effective therapeutic strategies for the disease. Here we provide experimental evidence for the functional involvement and therapeutic potential of targeting PRMT1, an H4R3 methyltransferase, in various MLL and non-MLL leukemias. PRMT1 is necessary but not sufficient for leukemic transformation, which requires co-recruitment of KDM4C, an H3K9 demethylase, by chimeric transcription factors to mediate epigenetic reprogramming. Pharmacological inhibition of KDM4C/PRMT1 suppresses transcription and transformation ability of MLL fusions and MOZ-TIF2, revealing a tractable aberrant epigenetic circuitry mediated by KDM4C and PRMT1 in acute leukemia. PMID:26766589

  16. LANL12-RS-107J PYTHON Radiography Analysis Tool (PyRAT). Mid-Year Deliverable Report for FY15

    SciTech Connect

    Temple, Brian Allen; Armstrong, Jerawan Chudoung

    2015-04-14

    This document is a mid-year report on a deliverable for the PYTHON Radiography Analysis Tool (PyRAT) for project LANL12-RS-107J in FY15. The deliverable is deliverable number 2 in the work package and is titled “Add the ability to read in more types of image file formats in PyRAT”. Right now PyRAT can only read in uncompressed TIF files (tiff files). It is planned to expand the file formats that can be read by PyRAT, making it easier to use in more situations. A summary of the file formats added include jpeg, jpg, png and formatted ASCII files.

  17. Targeting Aberrant Epigenetic Networks Mediated by PRMT1 and KDM4C in Acute Myeloid Leukemia.

    PubMed

    Cheung, Ngai; Fung, Tsz Kan; Zeisig, Bernd B; Holmes, Katie; Rane, Jayant K; Mowen, Kerri A; Finn, Michael G; Lenhard, Boris; Chan, Li Chong; So, Chi Wai Eric

    2016-01-11

    Transcriptional deregulation plays a major role in acute myeloid leukemia, and therefore identification of epigenetic modifying enzymes essential for the maintenance of oncogenic transcription programs holds the key to better understanding of the biology and designing effective therapeutic strategies for the disease. Here we provide experimental evidence for the functional involvement and therapeutic potential of targeting PRMT1, an H4R3 methyltransferase, in various MLL and non-MLL leukemias. PRMT1 is necessary but not sufficient for leukemic transformation, which requires co-recruitment of KDM4C, an H3K9 demethylase, by chimeric transcription factors to mediate epigenetic reprogramming. Pharmacological inhibition of KDM4C/PRMT1 suppresses transcription and transformation ability of MLL fusions and MOZ-TIF2, revealing a tractable aberrant epigenetic circuitry mediated by KDM4C and PRMT1 in acute leukemia. PMID:26766589

  18. Prevention and control of haemoglobinopathies.

    PubMed Central

    Angastiniotis, M.; Modell, B.; Englezos, P.; Boulyjenkov, V.

    1995-01-01

    In many developing countries the haemoglobinopathies (thalassaemias and sickle-cell disorder) are so common that they provide a convenient model for working out a genetic approach to control of chronic childhood diseases. At present, about 250 million people (4.5% of the world population) carry a potentially pathological haemoglobinopathy gene. Each year about 300,000 infants are born with major haemoglobinopathies. Haemoglobinopathy control programmes, based on WHO approaches and recommendations, have been established in different countries in all WHO Regions and have been successful in management of the problem. Following WHO recommendations the health burden of hereditary anaemias could be significantly reduced. This article summarizes the presentations and discussion made at a joint WHO/TIF (Thalassaemia International Federation) meeting, held in Cyprus in April 1993, and reviews the experience of programmes in several countries for the control of haemoglobinopathies in the world. PMID:7614670

  19. Studying the R-branch and the Q-branch emission spectral lines of diatomic molecules using improved analytical formula.

    PubMed

    Jiang, Yonghong; Sun, Weiguo; Zhang, Yi; Fu, Jia; Fan, Qunchao; Li, Huidong; Feng, Hao

    2016-06-01

    The difference converging method (DCM) used to predict the R-branch and the Q-branch high-lying rotational lines for diatomic systems is improved in this study. The key analytical formulae of the DCM method are modified by adding a higher order spectral term Hυ, and adding a physical converging criterion to improve the accuracy of predictions. Applications of the improved DCM method to the R-branch of the TiF molecule and the Q-branch of the (193)IrN molecule show that the accuracy of the R-branch and the Q-branch rotational lines is about one order of magnitude better than the results obtained using the previous formulae, which demonstrate the necessity of the added small term Hυ and the physical converging criterion. The DCM results are also shown to be better than the extrapolated rotational lines using the least-squares method. PMID:26974473

  20. Enhanced visible-light-driven photocatalytic H2-production activity of CdS-loaded TiO2 microspheres with exposed (001) facets

    NASA Astrophysics Data System (ADS)

    Gao, Bifen; Yuan, Xia; Lu, Penghui; Lin, Bizhou; Chen, Yilin

    2015-12-01

    CdS-loaded TiO2 microspheres with highly exposed (001) facets were prepared by hydrothermal treatment of a TiF4-HCl-H2O mixed solution followed by a chemical bath deposition of CdS onto TiO2 microspheres. The crystal structure, surficial micro-structure and photo-absorption property of the samples were characterized by XRD, FE-SEM, TEM and UV-vis diffuse reflectance spectroscopy, etc. The as-prepared samples exhibited superior visible-light-driven photocatalytic H2-production activity from lactic acid aqueous solution in comparison with CdS-sensitized TiO2 nanoparticles, whose surface was dominated by (101) facets. Photoelectrochemical measurement confirmed that (001) facet is beneficial for the transfer of photo-generated electron from CdS to TiO2 microsphere, which led to the unexpected high photocatalytic activity of CdS-loaded TiO2 microspheres.

  1. Synthesis of anhydrous K2TiOF4 via a mild hydrothermal method

    NASA Astrophysics Data System (ADS)

    Felder, Justin B.; Yeon, Jeongho; zur Loye, Hans-Conrad

    2015-10-01

    The synthesis of anhydrous K2TiOF4 has been previously attempted by transforming precursor compounds, such as the peroxide (K2Ti(O2)F4), hydrate (K2TiOF4·H2O) and fluoride (K2TiF6). Due to the large structural differences between these precursors and the anhydrous oxyfluorides, however, these preparations have been unsuccessful. Therefore, a direct method of synthesis has been employed to grow single crystals of K2TiOF4 that were characterized by single crystal x-ray diffraction. K2TiOF4 was found to be isostructural with the previously known K2VOF4.

  2. Polymyositis and dermatomyositis as a risk of developing cancer

    PubMed Central

    Kwiatkowska, Brygida; Maślińska, Maria

    2015-01-01

    Polymyositis (PM) is an idiopathic inflammatory myopathy that affects striated muscles. Dermatomyositis (DM) is an idiopathic inflammatory myopathy with presence of skin symptoms. Both are characterized by acute or subacute onset, symmetrical proximal muscle weakness, the presence of mononuclear cell infiltrates of the muscles and increased activity of muscle enzymes. The treatment still remains glucocorticoids and disease-modifying drugs. Symptoms of PM/DM can be a signal of developing cancer. Known risk factors for cancer in patients with PM/DM are older age, male gender, dysphagia, skin necrosis, cutaneous vasculitis, rapid onset of the disease, elevated creatinine kinase (CK) and C reactive protein (CRP), and an increase in the erythrocyte sedimentation rate (ESR). Recently three new myositis-specific autoantibodies (MSA) predicting the risk of cancer have been discovered: melanoma differentiation-associated protein 5 (anti-MDA-5), transcription intermediary factor 1γ (TIF-1γ), and nuclear matrix protein NXP-2.

  3. Triple ion-beam studies of radiation damage effects in a 316LN austenitic alloy for a high power spallation neutron source

    SciTech Connect

    Lee, E.H.; Rao, G.R.; Hunn, J.D.; Rice, P.M.; Lewis, M.B.; Cook, S.W.; Farrell, K.; Mansur, L.K.

    1997-09-01

    Austenitic 316LN alloy was ion-irradiated using the unique Triple Ion Beam Facility (TIF) at ORNL to investigate radiation damage effects relevant to spallation neutron sources. The TIF was used to simulate significant features of GeV proton irradiation effects in spallation neutron source target materials by producing displacement damage while simultaneously injecting helium and hydrogen at appropriately high gas/dpa ratios. Irradiations were carried out at 80, 200, and 350 C using 3.5 MeV Fe{sup ++}, 360 keV He{sup +}, and 180 keV H{sup +} to accumulate 50 dpa by Fe, 10,000 appm of He, and 50,000 appm of H. Irradiations were also carried out at 200 C in single and dual ion beam modes. The specific ion energies were chosen to maximize the damage and the gas accumulation at a depth of {approximately} 1 {micro}m. Variations in microstructure and hardness of irradiated specimens were studied using transmission electron microscopy (TEM) and a nanoindentation technique, respectively. TEM investigation yielded varying damage defect microstructures, comprising black dots, faulted and unfaulted loops, and a high number density of fine bubbles (typically less than 1 nm in diameter). With increasing temperature, faulted loops had a tendency to unfault, and bubble microstructure changed from a bimodal size distribution to a unimodal distribution. Triple ion irradiations at the three temperatures resulted in similar increases in hardness of approximately a factor of two. Individually, Fe and He ions resulted in a similar magnitude of hardness increase, whereas H ions showed only a very small effect. The present study has yielded microstructural information relevant to spallation neutron source conditions and indicates that the most important concern may be radiation induced hardening and associated ductility loss.

  4. Gas Phase Properties of MX2 and MX4 (X = F, Cl) for M = Group 4, Group 14, Cerium, and Thorium.

    PubMed

    Thanthiriwatte, K Sahan; Vasiliu, Monica; Battey, Samuel R; Lu, Qing; Peterson, Kirk A; Andrews, Lester; Dixon, David A

    2015-06-01

    Structures, vibrational frequencies, and heats of formation were predicted for MX4 and both singlet and triplet states of MX2 (M = group 4, group 14, Ce, and Th; X = F and Cl) using the Feller-Peterson-Dixon composite electronic structure approach based on coupled cluster CCSD(T) calculations extrapolated to the complete basis set limit with additional corrections including spin orbit effects. The spin-orbit corrections are not large but need to be included for chemical accuracy of ±1 kcal/mol. The singlet-triplet splittings were calculated for the dihalides and all compounds have singlet ground states except for the dihalides of Ti, Zr, and Ce which have triplet ground states. The calculated heats of formation are in good agreement with the available experimental data. Our predictions suggest that the experimental heats of formation need to be revised for a number of tetrahalides: TiF4, HfF4, PbF4, PbCl4, and ThCl4 as well as a number of dihalides: GeF2, SnF2, PbF2, TiF2, and TiCl2. The calculated heats of formation were used to predict various thermodynamic properties including average M-F and M-Cl bond dissociation energies and the reaction energies for MX2 + X2 → MX4. Edge inversion barriers were predicted. The calculated edge inversion barriers for the tetrafluorides show that the barriers for the group 14 tetrafluorides decrease with increasing atomic number, the group 4 barriers are ∼50 kcal/mol and CeF4 and ThF4 have inversion barriers of ∼25 kcal/mol. PMID:25942320

  5. Real-time dataflow and workflow with the CMS tracker data

    NASA Astrophysics Data System (ADS)

    Filippis, N. D.; Bagliesi, G.; Bainbridge, R.; Boccali, T.; Ciulli, V.; Giordano, D.; Hufnagel, D.; Mason, D.; Mirabito, L.; Noeding, C.; Palla, F.; Piedra, J.; Sarkar, S.

    2008-07-01

    The Tracker detector took data with cosmics rays at the Tracker Integration Facility (TIF) at CERN. First on-line monitoring tasks were executed at the Tracker Analysis Centre (TAC) which is a dedicated Control Room at TIF with limited computing resources. A set of software agents were developed to perform the real-time data conversion in a standard format, to archive data on tape at CERN and to publish them in the official CMS data bookkeeping systems. According to the CMS computing and analysis model, most of the subsequent data processing has to be done in remote Tier-1 and Tier-2 sites, so data were automatically transferred from CERN to the sites interested to analyze them, currently Fermilab, Bari and Pisa. Official reconstruction in the distributed environment was triggered in real-time by using the tool currently used for the processing of simulated events. Automatic end-user analysis of data was performed in a distributed environment, in order to derive the distributions of important physics variables. The tracker data processing is currently migrating to the Tier-0 CERN as a prototype for the global data taking chain. Tracker data were also registered into the most recent version of the data bookkeeping system, DBS-2, by profiting from the new features to handle real data. A description of the dataflow/workflow and of the tools developed is given, together with the results about the performance of the real-time chain. Almost 7.2 million events were officially registered, moved, reconstructed and analyzed in remote sites by using the distributed environment.

  6. Electronic structure and anisotropic chemical bonding in TiNF from ab initio study

    SciTech Connect

    Matar, Samir F.

    2012-01-15

    Accounting for disorder in anatase titanium nitride fluoride TiNF is done through atoms re-distributions based on geometry optimizations using ultra soft pseudo potentials within density functional theory DFT. The fully geometry relaxed structures are found to keep the body centering of anatase (I4{sub 1}/amd No. 141). The new structural setups are identified with space groups I-4m2 No. 119 and Imm2 No. 44 which obey the 'group to subgroup' relationships with respect to anatase. In the ground state Imm2 structure identified from energy differences, TiNF is found semi-conducting with similar density of states features to anatase TiO{sub 2} and a chemical bonding differentiated between covalent like Ti-N versus ionic like Ti-F. Inter-anion N-F bonding is also identified. - Graphical Abstract: The geometry optimized ground state anatase derived TiNF structure with arrangement of open faceted TiN3F3 distorted octahedra. The insert shows the arrangement of octahedra in anatase TiO{sub 2}. Highlights: Black-Right-Pointing-Pointer Original approach of TiNF structure for addressing the electronic band structure. Black-Right-Pointing-Pointer Based on anatase, two different ordering scheme models with geometry optimization. Black-Right-Pointing-Pointer New structures obeying the group{yields}subgroup relationships with Imm2 ground state from energy. Black-Right-Pointing-Pointer In the ground state TiNF is found semi-conducting with similar density of states to anatase TiO{sub 2}. Black-Right-Pointing-Pointer Chemical bonding differentiated between covalent like Ti-N and ionic Ti-F.

  7. GPFA-AB_Phase1UtilizationTask4DataUpload

    SciTech Connect

    Teresa E. Jordan

    2015-09-30

    This submission of Utilization Analysis data to the Geothermal Data Repository (GDR) node of the National Geothermal Data System (NGDS) is in support of Phase 1 Low Temperature Geothermal Play Fairway Analysis for the Appalachian Basin (project DE-EE0006726). The submission includes data pertinent to the methods and results of an analysis of the Surface Levelized Cost of Heat (SLCOH) for US Census Bureau ‘Places’ within the study area. This was calculated using a modification of a program called GEOPHIRES, available at http://koenraadbeckers.net/geophires/index.php. The MATLAB modules used in conjunction with GEOPHIRES, the MATLAB data input file, the GEOPHIRES output data file, and an explanation of the software components have been provided. Results of the SLCOH analysis appear on 4 .png image files as mapped ‘risk’ of heat utilization. For each of the 4 image (.png) files, there is an accompanying georeferenced TIF (.tif) file by the same name. In addition to calculating SLCOH, this Task 4 also identified many sites that may be prospects for use of a geothermal district heating system, based on their size and industry, rather than on the SLCOH. An industry sorted listing of the sites (.xlsx) and a map of these sites plotted as a layer onto different iterations of maps combining the three geological risk factors (Thermal Quality, Natural Reservoir Quality, and Risk of Seismicity) has been provided. In addition to the 6 image (.png) files of the maps in this series, a shape (.shp) file and 7 associated files are included as well. Finally, supporting files (.pdf) describing the utilization analysis methodology and summarizing the anticipated permitting for a deep district heating system are supplied.

  8. [Juvenile dermatomyositis and new autoantibodies: Cases and review].

    PubMed

    Guarella, M; Jurquet, A-L; Retornaz, K; Bardin, N; Chastang, M-C; Desjonquere, M; Fabien, N; Belot, A

    2015-12-01

    Juvenile dermatomyositis (JDM) is the most common inflammatory myopathy in children. Its diagnosis is usually made on a clinical basis following the criteria of Bohan and Peter (1975). Recently, the presence of myositis-specific autoantibodies (MSAs) have started to be associated with specific outcome in adult patients; the diagnosis and prognosis value of these autoantibodies remains to be identified in children. We report four cases of JDM with MSAs focusing on clinical, biological, and radiological manifestations, and then we describe associated treatment. The cohort comprises four girls with an average age of 8.5 years. The time to diagnosis was 1 week to 4 months. For these patients, the immunologic study found one patient positive for the MDA5 antibody (or CADM 140), one positive for the TIF1γ antibody (or p155/140), and two patients positive for the NXP2 antibody (or p140/MJ). Each patient showed specific and characteristic cutaneous manifestations. For example, the girl positive for the TIF1γ antibody presented the most severe skin disease with urticaria, face edema, and vascularity of the neck and shoulders. However, regarding muscular features, proximal weakness was present in most of the cohort, except for the child positive for the MDA5 antibody, who presented no sign of muscular disease at the beginning with low CK levels. Importantly, acute pancreatitis also affected this patient. Concerning radiological indications, muscular MRI evidenced hyperinflammation, a sign of diffuse myositis, in all these patients. Treatments consisted in corticosteroids together with methotrexate or mycofenolate mofetil associated or not with intravenous immunoglobulin therapy. This report highlights the importance of systematic detection and analysis of MSA in diagnosis and characterization of JDM, and describes a new approach that would allow more focused treatments and be a useful predictor of clinical complications and prognosis in JDM-affected subjects. PMID:26598044

  9. IR reflection spectra of the silicate surface layer of yellowed rice plant leaf

    NASA Astrophysics Data System (ADS)

    Sato, Kenzo

    1986-09-01

    We have investigated the IR reflectional properties of the three-hold cytrogical surface layer (kutchikura layer on silicate layer n(SiO2) on silicate cellulose layer C6H10SixOy) and that of chlorophyll, a(C55H72MgN4O5) etc., present in bladder's cells by using our experimental method. From analysis of three set of anisotropical reflection spectra assigned as due to CO, SiO and NC surface oscillators contained in the cytrogical cells and measured at 2500 2200 cm-1, 1200 700 cm-1 and at 700 200 cm-1 regions, we have confirmed some important results. One is their quantized directional distributions that of the numbers of fine step spectrum and that of the reflection integrals of these spectra. Here, that of the NC oscillators were found to distribute in pentagonal directions relating to the molecular structure of chlorophyll. Second, we confirmed the pecularity of eight fine step-series measured in these sensitive spectra comparing with that of bamboo's seven series. Third, from analysis of the stepnized variation of the “reflection integrals”, we estimated the origin of this effect as which is presumably due to statistical, transfer of the 2p4 valence electrons etc. in the oxygen atoms from C=O, Si=O double bonding side upto the shallower quantized states, E(N,J) which were formed softly around the MediaObjects/10762_2005_BF01012055_f1.tif and MediaObjects/10762_2005_BF01012055_f2.tif surface oscillators. And these surface oscillators were confirmed as to make photo-chemical reaction process by receiving energy higher than ˜24 m eV especially under the illumination of sunshine etc.

  10. An On-Line Technology Information System (OTIS) for Advanced Life Support

    NASA Technical Reports Server (NTRS)

    Levri, Julie A.; Boulanger, Richard; Hoganm John A.; Rodriquez, Luis

    2003-01-01

    An On-line Technology Information System (OTIS) is currently being developed for the Advanced Life Support (ALS) Program. This paper describes the preliminary development of OTIS, which is a system designed to provide centralized collection and organization of technology information. The lack of thorough, reliable and easily understood technology information is a major obstacle in effective assessment of technology development progress, trade studies, metric calculations, and technology selection for integrated testing. OTIS will provide a formalized, well-organized protocol to communicate thorough, accurate, current and relevant technology information between the hands-on technology developer and the ALS Community. The need for this type of information transfer system within the Solid Waste Management (SWM) element was recently identified and addressed. A SWM Technology Information Form (TIF) was developed specifically for collecting detailed technology information in the area of SWM. In the TIF, information is requested from SWM technology developers, based upon the Technology Readiness Level (TRL). Basic information is requested for low-TRL technologies, and more detailed information is requested as the TRL of the technology increases. A comparable form is also being developed for the wastewater processing element. In the future, similar forms will also be developed for the ALS elements of air revitalization, food processing, biomass production and thermal control. These ALS element-specific forms will be implemented in OTIS via a web-accessible interface,with the data stored in an object-oriented relational database (created in MySQLTM) located on a secure server at NASA Ames Research Center. With OTIS, ALS element leads and managers will be able to carry out informed research and development investment, thereby promoting technology through the TRL scale. OTIS will also allow analysts to make accurate evaluations of technology options. Additionally, the range

  11. Mechanism of the tissue-specific action of the selective androgen receptor modulator S-101479.

    PubMed

    Furuya, Kazuyuki; Yamamoto, Noriko; Ohyabu, Yuki; Morikyu, Teruyuki; Ishige, Hirohide; Albers, Michael; Endo, Yasuhisa

    2013-01-01

    Selective androgen receptor modulators (SARMs) comprise a new class of molecules that induce anabolic effects with fewer side effects than those of other anabolic agents. We previously reported that the novel SARM S-101479 had a tissue-selective bone anabolic effect with diminished side effects in female animals. However, the mechanism of its tissue selectivity is not well known. In this report, we show that S-101479 increased alkaline phosphatase activity and androgen receptor (AR) transcriptional activity in osteoblastic cell lines in the same manner as the natural androgen ligand dihydrotestosterone (DHT); conversely, stimulation of AR dimerization was very low compared with that of DHT (34.4%). S-101479 increased bone mineral content in ovariectomized rats without promoting endometrial proliferation. Yeast two-hybrid interaction assays revealed that DHT promoted recruitment of numerous cofactors to AR such as TIF2, SRC1, β-catenin, NCoA3, gelsolin and PROX1 in a dose-dependent manner. SARMs induced recruitment of fewer cofactors than DHT; in particular, S-101479 failed to induce recruitment of canonical p160 coactivators such as SRC1, TIF2 and notably NCoA3 but only stimulated binding of AR to gelsolin and PROX1. The results suggest that a full capability of the AR to dimerize and to effectively and unselectively recruit all canonical cofactors is not a prerequisite for transcriptional activity in osteoblastic cells and resulting anabolic effects in bone tissues. Instead, few relevant cofactors might be sufficient to promote AR activity in these tissues. PMID:23449329

  12. Material removal characteristics of orthogonal velocity polishing tool for efficient fabrication of CVD SiC mirror surfaces

    NASA Astrophysics Data System (ADS)

    Seo, Hyunju; Han, Jeong-Yeol; Kim, Sug-Whan; Seong, Sehyun; Yoon, Siyoung; Lee, Kyungmook; Lee, Haengbok

    2015-09-01

    Today, CVD SiC mirrors are readily available in the market. However, it is well known to the community that the key surface fabrication processes and, in particular, the material removal characteristics of the CVD SiC mirror surface varies sensitively depending on the shop floor polishing and figuring variables. We investigated the material removal characteristics of CVD SiC mirror surfaces using a new and patented polishing tool called orthogonal velocity tool (OVT) that employs two orthogonal velocity fields generated simultaneously during polishing and figuring machine runs. We built an in-house OVT machine and its operating principle allows for generation of pseudo Gaussian shapes of material removal from the target surface. The shapes are very similar to the tool influence functions (TIFs) of other polishing machine such as IRP series polishing machines from Zeeko. Using two CVD SiC mirrors of 150 mm in diameter and flat surface, we ran trial material removal experiments over the machine run parameter ranges from 12.901 to 25.867 psi in pressure, 0.086 m/sec to 0.147 m/sec in tool linear velocity, and 5 to 15 sec in dwell time. An in-house developed data analysis program was used to obtain a number of Gaussian shaped TIFs and the resulting material removal coefficient varies from 3.35 to 9.46 um/psi hour m/sec with the mean value to 5.90 ± 1.26(standard deviation). We report the technical details of the new OVT machine, of the data analysis program, of the experiments and the results together with the implications to the future development of the OVT machine and process for large CVD SiC mirror surfaces.

  13. Prevalence of Taenia saginata Larvae (Cysticercus bovis) in Feedlot Cattle Slaughtered in a Federal Inspection Type Abattoir in Northwest México.

    PubMed

    Cueto González, Sergio Arturo; Rodríguez Castillo, José Luis; López Valencia, Gilberto; Bermúdez Hurtado, Rosa María; Hernández Robles, Erika Selene; Monge Navarro, Francisco Javier

    2015-05-01

    The prevalence of bovine cysticercosis was established using routine postmortem inspection of 52,322 feedlot cattle slaughtered at 1 Federal Inspection Type abattoir (TIF 301) located in the Mexicali Valley in Baja California, México. The study included 31,393 animals (60.0%) purchased and transported to Baja California from stocker operations located in 17 states of México and 20,929 animals (40.0%) native to Baja California. A total of 208 carcasses showed lesions suggestive of cysticercosis, and 109 were confirmed as positive for the parasite with a prevalence of 0.21%, equivalent to 2.1 cases/1000 carcasses inspected, 2.8 cases/1000 carcasses for cattle purchased in other states, and 1.0 cases/1000 carcasses for cattle native from Baja California. The sensitivity of the postmortem inspection, when compared to a gold standard of stereoscopic microscopy, was 52.4%. The prevalence of cysticercosis was 2.8 times higher in cattle from other states compared with those native to Baja California. Cysticerci were most frequently found in the heart, followed by liver and masseter muscles. In cattle from other states, 96.6% of cysticerci were classified as calcified and <4% as viable; in cattle native to Baja California, 29% of cysticerci were classified as calcified and 71% as viable. The prevalence of bovine cysticercosis established at TIF 301 was found to be 28% lower than a previous report for Baja California. However, given the sensitivity of the postmortem inspection calculated between 10% and 50%, it is possible that an undetermined number of carcasses pass as being free of cysticerci and that the meat reached both domestic and international wholesale markets, increasing the possibility of human infection and causing substantial economic loss through condemnation of infected meat and trade restrictions for endemic regions. PMID:25803448

  14. Utilization Analysis in Low-Temperature Geothermal Play Fairway Analysis for the Appalachian Basin (GPFA-AB)

    DOE Data Explorer

    Teresa E. Jordan

    2015-09-30

    This submission of Utilization Analysis data to the Geothermal Data Repository (GDR) node of the National Geothermal Data System (NGDS) is in support of Phase 1 Low Temperature Geothermal Play Fairway Analysis for the Appalachian Basin (project DE-EE0006726). The submission includes data pertinent to the methods and results of an analysis of the Surface Levelized Cost of Heat (SLCOH) for US Census Bureau ‘Places’ within the study area. This was calculated using a modification of a program called GEOPHIRES, available at http://koenraadbeckers.net/geophires/index.php. The MATLAB modules used in conjunction with GEOPHIRES, the MATLAB data input file, the GEOPHIRES output data file, and an explanation of the software components have been provided. Results of the SLCOH analysis appear on 4 .png image files as mapped ‘risk’ of heat utilization. For each of the 4 image (.png) files, there is an accompanying georeferenced TIF (.tif) file by the same name. In addition to calculating SLCOH, this Task 4 also identified many sites that may be prospects for use of a geothermal district heating system, based on their size and industry, rather than on the SLCOH. An industry sorted listing of the sites (.xlsx) and a map of these sites plotted as a layer onto different iterations of maps combining the three geological risk factors (Thermal Quality, Natural Reservoir Quality, and Risk of Seismicity) has been provided. In addition to the 6 image (.png) files of the maps in this series, a shape (.shp) file and 7 associated files are included as well. Finally, supporting files (.pdf) describing the utilization analysis methodology and summarizing the anticipated permitting for a deep district heating system are supplied.

  15. Leishmania infantum LeIF protein is an ATP-dependent RNA helicase and an eIF4A-like factor that inhibits translation in yeast.

    PubMed

    Barhoumi, Mourad; Tanner, N K; Banroques, Josette; Linder, Patrick; Guizani, Ikram

    2006-11-01

    LeIF, a Leishmania protein similar to the eukaryotic initiation factor eIF4A, which is a prototype of the DEAD box protein family, was originally described as a Th1-type natural adjuvant and as an antigen that induces an IL12-mediated Th1 response in the peripheral blood mononuclear cells of leishmaniasis patients. This study aims to characterize this protein by comparative biochemical and genetic analysis with eIF4A in order to assess its potential as a target for drug development. We show that a His-tagged, recombinant, LeIF protein of Leishmania infantum, which was purified from Escherichia coli, is both an RNA-dependent ATPase and an ATP-dependent RNA helicase in vitro, as described previously for other members of the DEAD box helicase protein family. In vivo experiments show that the LeIF gene cannot complement the deletion of the essential TIF1 and TIF2 genes in the yeast Saccharomyces cerevisiae that encode eIF4A. In contrast, expression of LeIF inhibits yeast growth when endogenous eIF4A is expressed off only one of its two encoding genes. Furthermore, in vitro binding assays show that LeIF interacts with yeast eIF4G. These results show an unproductive interaction of LeIF with translation initiation factors in yeast. Furthermore, the 25 amino terminal residues were shown to enhance the ability of LeIF to interfere with the translation machinery in yeast. PMID:17087726

  16. An intact small animal model of myocardial ischemia-reperfusion: Characterization of metabolic changes by hyperpolarized 13C MR spectroscopy.

    PubMed

    Yoshihara, Hikari A I; Bastiaansen, Jessica A M; Berthonneche, Corinne; Comment, Arnaud; Schwitter, Juerg

    2015-12-15

    Hyperpolarized carbon-13 magnetic resonance spectroscopy ((13)C MRS) enables the sensitive and noninvasive assessment of the metabolic changes occurring during myocardial ischemia-reperfusion. Ischemia-reperfusion models using hyperpolarized (13)C MRS are established in heart preparations ex vivo and in large animals in vivo, but an in vivo model in small animals would be advantageous to allow the study of reperfusion metabolism with neuroendocrine and inflammatory responses intact with the option to perform a greater number of experiments. A novel intact rat model of ischemia-reperfusion is presented that incorporates hyperpolarized (13)C MRS to characterize reperfusion metabolism. Typically, in an in vivo model, a tissue input function (TIF) is required to account for apparent changes in the metabolism of injected hyperpolarized [1-(13)C]pyruvate resulting from changes in perfusion. Whereas the measurement of a TIF by metabolic imaging is particularly challenging in small animals, the ratios of downstream metabolites can be used as an alternative. The ratio of [(13)C]bicarbonate:[1-(13)C]lactate (RatioBic/Lac) measured within 1-2 min after coronary release decreased vs. baseline in ischemic rats (n = 10, 15-min occlusion, controls: n = 10; P = 0.017 for interaction, 2-way ANOVA). The decrease in oxidative pyruvate metabolism [RatioBic/Lac(Ischemia)/RatioBic/Lac(Baseline)] modestly correlated with area at risk (r = 0.66; P = 0.002). Hyperpolarized (13)C MRS was also used to examine alanine production during ischemia, which is observed in ex vivo models, but no significant change was noted; metrics incorporating [1-(13)C]alanine did not substantially improve the discrimination of ischemic-reperfused myocardium from nonischemic myocardium. This intact rat model, which mimics the human situation of reperfused myocardial infarction, could be highly valuable for the testing of new drugs to treat reperfusion injury, thereby facilitating translational research. PMID

  17. Bermudagrass (Cynodon spp) dose-response relationships with clethodim, glufosinate and glyphosate.

    PubMed

    Webster, Theodore M; Hanna, Wayne W; Mullinix, Benjamin G

    2004-12-01

    Greenhouse studies were conducted to evaluate the sensitivity of three commercial cultivars, eight experimental cultivars and common bermudagrass to clethodim, glufosinate and glyphosate. Each herbicide was applied at eight doses. Data were regressed on herbicide dose using a log-logistic curve (R2 = 0.56-0.95 for clethodim, R2 = 0.60-0.94 for glufosinate, and R2 = 0.70-0.96 for glyphosate). The herbicide rate that elicited a 50% plant response (I50) in the bermudagrass cultivars ranged from 0.04 to 0.19 kg ha(-1) clethodim, 0.19 to 1.33 kg ha(-1) glufosinate and 0.34 to 1.14 kg ha(-1) glyphosate. Relative to other cultivars, common bermudagrass was intermediate in its response to clethodim and among the most tolerant cultivars to glufosinate and glyphosate. TifSport was relatively tolerant to clethodim and glufosinate compared with other cultivars, but relatively sensitive to glyphosate. One cultivar, 94-437, was consistently among the most sensitive cultivars to each of the herbicides. While there were differential herbicide tolerances among the tested bermudagrass cultivars, there did not appear to be any naturally occurring herbicide resistance that could be commercially utilized. However, research indicated that breeding efforts should target herbicide resistance that is at least four times the registered use rate. Also, TifSport and Tifway have been identified as suitable representatives of triploid hybrid bermudagrass cultivars to be used to evaluate the success of turfgrass renovation programs. PMID:15578605

  18. Recent advances in laparoscopic surgery.

    PubMed

    Lee, Wei-Jei; Chan, Chien-Pin; Wang, Bing-Yen

    2013-02-01

    Laparoscopic surgery has been widely adopted and new technical innovation, procedures and evidence based knowledge are persistently emerging. This review documents recent major advancements in laparoscopic surgery. A PubMed search was made in order to identify recent advances in this field. We reviewed the recent data on randomized trials in this field as well as papers of systematic review. Laparoscopic cholecystectomy is the most frequently performed procedure, followed by laparoscopic bariatric surgery. Although bile duct injuries are relatively uncommon (0.15%-0.6%), intraoperative cholangiography still plays a role in reducing the cost of litigation. Laparoscopic bariatric surgery is the most commonly performed laparoscopic gastrointestinal surgery in the USA, and laparoscopic Nissen fundoplication is the treatment of choice for intractable gastroesophageal reflux disease. Recent randomized trials have demonstrated that laparoscopic gastric and colorectal cancer resection are safe and oncologically correct procedures. Laparoscopic surgery has also been widely developed in hepatic, pancreatic, gynecological and urological surgery. Recently, SILS and robotic surgery have penetrated all specialties of abdominal surgery. However, evidence-based medicine has failed to show major advantages in SILS, and the disadvantage of robotic surgery is the high costs related to purchase and maintenance of technology. Laparoscopic surgery has become well developed in recent decades and is the choice of treatment in abdominal surgery. Recently developed SILS techniques and robotic surgery are promising but their benefits remain to be determined. PMID:23126424

  19. Novel association of rectal evacuation disorder and rumination syndrome: Diagnosis, comorbidities, and treatment

    PubMed Central

    Vijayvargiya, Priya; Iturrino, Johanna; Shin, Andrea; Vazquez-Roque, Maria; Katzka, David A; Snuggerud, Jill R; Seime, Richard J

    2014-01-01

    Background Patients with disorders of gastrointestinal function may undergo unnecessary treatment if misdiagnosed as motility disorders. Objective To report on clinical features, medical, surgical, and psychiatric comorbidities, and prior treatments of a patient cohort diagnosed concurrently with nonpsychogenic rumination syndrome and pelvic floor dysfunction (also termed rectal evacuation disorder). Methods From a consecutive series (1994–2013) of 438 outpatients with rectal evacuation disorders in the practice of a single gastroenterologist at a tertiary care centre, 57 adolescents or adults were diagnosed with concomitant rumination syndrome. All underwent formal psychological assessment or completed validated questionnaires. Results All 57 patients (95% female) fulfilled Rome III criteria for rumination syndrome; rectal evacuation disorder was confirmed by testing of anal sphincter pressures and rectal balloon evacuation. Prior to diagnosis, most patients underwent multiple medical and surgical treatments (gastrostomy, gastric fundoplication, other gastric surgery, ileostomy, colectomy) for their symptoms. Psychological comorbidity was identified in 93% of patients. Patients were managed predominantly with psychological and behavioural approaches: diaphragmatic breathing for rumination and biofeedback retraining for pelvic floor dysfunction. Conclusions Awareness of concomitant rectal evacuation disorder and rumination syndrome and prompt identification of psychological comorbidity are keys to instituting behavioural and psychological methods to avoid unnecessary treatment. PMID:24724013

  20. Management of achalasia: surgery or pneumatic dilation.

    PubMed

    Richter, Joel E; Boeckxstaens, Guy E

    2011-06-01

    Achalasia is an esophageal motility disorder of unknown cause, characterised by aperistalsis of the esophageal body and impaired lower esophageal sphincter relaxation. Patients present at all ages, primarily with dysphagia for solids/liquids and bland regurgitation. The diagnosis is suggested by barium esophagram or endoscopy and confirmed by esophageal manometry. Achalasia cannot be cured. Instead, our goal is to relieve symptoms, improve esophageal emptying and prevent the development of megaesophagus. The most successful therapies are pneumatic dilation and surgical myotomy. The advantages of pneumatic dilation include an outpatient procedure, minimal pain, return to work the next day, mild if any GERD, and can be performed in any age group and even during pregnancy. Pneumatic dilation does not hinder future myotomy, and all cost analyses find it less expensive than Heller myotomy. Laparoscopic myotomy with a partial fundoplication has the advantage of being a single procedure, dysphagia relief is longer at the cost of more troubling heartburn, and a myotomy may be more effective treatment in adolescents and younger adults, especially men. Over a two year horizon, the clinical success of pneumatic dilation and laparoscopic myotomy are comparable in a recent large European randomised trial. The prognosis for achalasia patients to return to near-normal swallowing and good quality of life are excellent, but few are "cured" with a single treatment and intermittent "touch up" procedures may be required. PMID:21303915

  1. Recurrent respiratory distress and cardiopulmonary arrest caused by megaoesophagus secondary to achalasia☆

    PubMed Central

    Mabvuure, Nigel Tapiwa; Hey, Shi Ying; Forshaw, Matthew

    2014-01-01

    INTRODUCTION Respiratory distress and arrest from tracheal compression secondary to megaoesophagus are rare complications of achalasia. We present the case of a man with end-stage achalasia who required oesophagectomy to prevent recurrent life-threatening tracheal compression and respiratory arrest. A literature review is also presented. PRESENTATION OF CASE A 40-year old man presented with post-prandial stridor which resolved spontaneously, later being diagnosed with achalasia. He underwent pneumatic dilatation year later, intended as definitive treatment. Despite intervention, the patient had developed megaoesophagus. One month later he presented with tracheal compression and cardiorespiratory arrest but was successfully resuscitated. He subsequently underwent elective oesophagectomy. DISCUSSION Over 40 case reports of achalasia presenting with stridor have been published. However, only three cases (all female, age range, 35–79 years old) of cardiac, respiratory or cardiorespiratory arrest have been published. The definitive treatments received by these patients were botulinum toxin injections, open Heller cardiomyotomy with Dor fundoplication and pneumatic dilatation. None of these patients suffered recurrent respiratory distress following definitive treatment. The patient currently reported was unique as he suffered cardiorespiratory arrest following an intended definitive treatment, pneumatic dilatation. As such oesophagectomy was considered the greatest risk-reduction intervention. CONCLUSION Oesophagectomy should be considered for patients with end-stage achalasia and mega-oesophagus causing respiratory compromise to avoid potential fatal complications such as tracheal compression and subsequent respiratory arrest. PMID:25128729

  2. Full-thickness gastroplication for the treatment of gastroesophageal reflux disease: short-term results of a feasibility clinical trial.

    PubMed

    Kaindlstorfer, Adolf; Koch, Oliver O; Berger, Johannes; Uwe Asche, Kai; Pointner, Rudolph

    2012-12-01

    This was a prospective study that evaluates subjective and objective patient parameters 3 months after full-thickness gastroplication. Forty-one patients with documented gastroesophageal reflux disease and persistent symptoms despite medical treatment, without radiologic visible hiatal hernia, were enrolled in the study and underwent endoscopic full-thickness gastroplication with one or more plicator implants. Evaluation of Gastrointestinal Quality of Life Index, symptoms typically related to reflux, gas bloat, and bowel dysfunction and esophageal manometry, and impedance-pH monitoring were performed at baseline and 3 months after the procedure. The mean Gastrointestinal Quality of Life Index score, and general and reflux-specific scores improved significantly (P<0.01), and gas bloat-specific symptom scores and bowel dysfunction-specific symptom scores were reduced (P<0.05) on follow-up. The numbers of total, acid, proximal, upright, and recumbent reflux episodes were all reduced (P<0.01). Manometric data remained almost unchanged. DeMeester score reduced nonsignificantly (P<0.098). 21.6% of the patients were on proton-pump inhibitor medication on a daily basis after the procedure. There was only 1 postprocedure incident (bleeding) that required intervention. In conclusion, endoscopic full-thickness plication is a safe and well-tolerated procedure that significantly improves quality of life and eliminates gastroesophageal reflux disease symptoms in the majority of patients, without side effects seen after laparoscopic fundoplication. PMID:23238376

  3. Gastroesophageal Reflux Affects Sleep Quality in Snoring Obese Children

    PubMed Central

    Woodley, Frederick W; Skaggs, Beth; Di Lorenzo, Carlo; Eneli, Ihuoma; Splaingard, Mark; Mousa, Hayat

    2016-01-01

    Purpose This study was performed to evaluate the quality of sleep in snoring obese children without obstructive sleep apnea (OSA); and to study the possible relationship between sleep interruption and gastroesophageal reflux (GER) in snoring obese children. Methods Study subjects included 13 snoring obese children who were referred to our sleep lab for possible sleep-disordered breathing. Patients underwent multichannel intraluminal impedance and esophageal pH monitoring with simultaneous polysomnography. Exclusion criteria included history of fundoplication, cystic fibrosis, and infants under the age of 2 years. Significant association between arousals and awakenings with previous reflux were defined by symptom-association probability using 2-minute intervals. Results Sleep efficiency ranged from 67-97% (median 81%). A total of 111 reflux episodes (90% acidic) were detected during sleep, but there were more episodes per hour during awake periods after sleep onset than during sleep (median 2.3 vs. 0.6, p=0.04). There were 279 total awakenings during the sleep study; 56 (20.1%) of them in 9 patients (69.2%) were preceded by reflux episodes (55 acid, 1 non-acid). In 5 patients (38.5%), awakenings were significantly associated with reflux. Conclusion The data suggest that acid GER causes sleep interruptions in obese children who have symptoms of snoring or restless sleep and without evidence of OSA. PMID:27066445

  4. The laparoscopic hiatoplasty with antireflux surgery is a safe and effective procedure to repair giant hiatal hernia

    PubMed Central

    2014-01-01

    Background Although minimally invasive repair of giant hiatal hernias is a very surgical challenge which requires advanced laparoscopic learning curve, several reports showed that is a safe and effective procedure, with lower morbidity than open approach. In the present study we show the outcomes of 13 patients who underwent a laparoscopic repair of giant hiatal hernia. Methods A total of 13 patients underwent laparoscopic posterior hiatoplasty and Nissen fundoplication. Follow-up evaluation was done clinically at intervals of 3, 6 and 12 months after surgery using the Gastro-oesophageal Reflux Health-Related Quality of Life scale, a barium swallow study, an upper gastrointestinal endoscopy, an oesophageal manometry, a combined ambulatory 24-h multichannel impedance pH and bilirubin monitoring. Anatomic recurrence was defined as any evidence of gastric herniation above the diaphragmatic edge. Results There were no intraoperative complications and no conversions to open technique. Symptomatic GORD-HQL outcomes demonstrated a statistical significant decrease of mean value equal to 3.2 compare to 37.4 of preoperative assessment (p < 0.0001). Combined 24-h multichannel impedance pH and bilirubin monitoring after 12 months did not show any evidence of pathological acid or non acid reflux. Conclusion All patients were satisfied of procedure and no hernia recurrence was recorded in the study group, treated respecting several crucial surgical principles, e.g., complete sac excision, appropriate crural closure, also with direct hiatal defect where possible, and routine use of antireflux procedure. PMID:24401085

  5. Incidence of Port-Site Incisional Hernia After Single-Incision Laparoscopic Surgery

    PubMed Central

    Rainville, Harvey; Ikedilo, Ojinika; Vemulapali, Pratibha

    2014-01-01

    Background and Objectives: Single-incision laparoscopic surgery is gaining popularity among minimally invasive surgeons and is now being applied to a broad number of surgical procedures. Although this technique uses only 1 port, the diameter of the incision is larger than in standard laparoscopic surgery. The long-term incidence of port-site hernias after single-incision laparoscopic surgery has yet to be determined. Methods: All patients who underwent a single-incision laparoscopic surgical procedure from May 2008 through May 2009 were included in the study. Single-incision laparoscopic surgical operations were performed either by a multiport technique or with a 3-trocar single-incision laparoscopic surgery port. The patients were seen at 30 to 36 months' follow-up, at which time they were examined for any evidence of port-site incisional hernia. Patients found to have hernias on clinical examination underwent repairs with mesh. Results: A total of 211 patients met the criteria for inclusion in the study. The types of operations included were cholecystectomy, appendectomy, sleeve gastrectomy, gastric banding, Nissen fundoplication, colectomy, and gastrojejunostomy. We found a port-site hernia rate of 2.9% at 30 to 36 months' follow-up. Conclusion: Port-site incisional hernia after single-incision laparoscopic surgical procedures remains a major setback for patients. The true incidence remains largely unknown because most patients are asymptomatic and therefore do not seek surgical aid. PMID:24960483

  6. Management of primary achalasia: The role of endoscopy

    PubMed Central

    Luján-Sanchis, Marisol; Suárez-Callol, Patricia; Monzó-Gallego, Ana; Bort-Pérez, Inmaculada; Plana-Campos, Lydia; Ferrer-Barceló, Luis; Sanchis-Artero, Laura; Llinares-Lloret, María; Tuset-Ruiz, Juan Antonio; Sempere-Garcia-Argüelles, Javier; Canelles-Gamir, Pilar; Medina-Chuliá, Enrique

    2015-01-01

    Achalasia is an oesophageal motor disorder which leads to the functional obstruction of the lower oesophageal sphincter (LES) and is currently incurable. The main objective of all existing therapies is to achieve a reduction in the obstruction of the distal oesophagus in order to improve oesophageal transit, relieve the symptomatology, and prevent long-term complications. The most common treatments used are pneumatic dilation (PD) and laparoscopic Heller myotomy, which involves partial fundoplication with comparable short-term success rates. The most economic non-surgical therapy is PD, with botulinum toxin injections reserved for patients with a higher surgical risk for whom the former treatment option is unsuitable. A new technology is peroral endoscopic myotomy, postulated as a possible non-invasive alternative to surgical myotomy. Other endoluminal treatments subject to research more recently include injecting ethanolamine into the LES and using a temporary self-expanding metallic stent. At present, there is not enough evidence permitting a routine recommendation of any of these three novel methods. Patients must undergo follow-up after treatment to guarantee that their symptoms are under control and to prevent complications. Most experts are in favour of some form of endoscopic follow-up, however no established guidelines exist in this respect. The prognosis for patients with achalasia is good, although a recurrence after treatment using any method requires new treatment. PMID:26078828

  7. Achalasia with megaesophagus and tracheal compression in a young patient: A case report

    PubMed Central

    Kaths, J. Moritz; Foltys, Daniel B.; Scheuermann, Uwe; Strempel, Mari; Niebisch, Stefan; Ebert, Maren; Jansen-Winkeln, Boris; Gockel, Ines; Lang, Hauke

    2015-01-01

    Introduction Achalasia is one of the most common causes of dysphagia. Typical symptoms include difficulties in controlling the swallowing process, regurgitation, weight loss, and chest pain. A megaesophagus rarely causes tracheal compression with consecutive acute dyspnea or similar respiratory symptoms. Presentation of case A 23-year-old male patient presented with difficulties in swallowing, a consecutive massive weight loss over the past three years, and minor respiratory ailments. Further diagnostics revealed a megaesophagus caused by achalasia leading to a severe compression of the trachea. A laparoscopic Heller myotomy with anterior semi-fundoplication 180° according to Dor was performed. Discussion Acute dyspnea and similar respiratory symptoms are rarely observed in patients with achalasia, especially in young patients. Early diagnosis and timely, proper treatment are the hallmarks of restoring esophageal and tracheobronchial function and of successful prevention of severe long-lasting complications of the disease. When not treated properly, the disease may have progressed rapidly, leading to distinct respiratory symptoms such as stridor and acute dyspnea Conclusion This report emphasizes that physicians should be alert and consider airway obstruction and signs of dyspnea as severe and threatening symptoms in extensive cases of achalasia with megaesophagus. Early surgical treatment provides a therapeutic option to obviate the occurrence of acute respiratory distress and consecutive complications. In particular, difficulties in intubation prior to surgery must be considered. PMID:26209755

  8. Collis-Nissen gastroplasty for short oesophagus.

    PubMed

    Mattioli, Sandro; Lugaresi, Marialuisa; Ruffato, Alberto; Daddi, Niccolò; Di Simone, Massimo Pierluigi; Perrone, Ottorino; Brusori, Stefano

    2015-01-01

    The Collis-Nissen procedure is performed for the surgical treatment of 'true short oesophagus'. When this condition is strongly suspected radiologically, the patient is placed in the 45° left lateral position on the operating table with the left chest and arm lifted to perform a thoracostomy in the V-VI space, posterior to the axillary line. The hiatus is opened and the distal oesophagus is widely mobilized. With intraoperative endoscopy, the position of the oesophago-gastric junction in relationship to the hiatus is determined and the measurement of the length of the intra-abdominal oesophagus is performed to decide either to carry out a standard anti-reflux procedure or to lengthen the oesophagus. If the oesophagus is irreversibly short ('true short oesophagus'), the short gastric vessels are divided and the gastric fundus is mobilized. An endostapler is introduced into the left chest. The left thoracoscopic approach is suitable to control effectively the otherwise blind passage of the endostapler into the mediastinum and upper abdomen (if a second optic is not used). The tip of the stapler is clearly visible while 'walking' on the left diaphragm. The Collis gastroplasty is performed over a 46 Maloney bougie. A floppy Nissen fundoplication and the hiatoplasty complete the procedure. PMID:26585969

  9. The barrier-free trocar technique in three laparoscopic standard procedures

    PubMed Central

    Rückbeil, Oskar; Lewin, Andreas; Federlein, Matthias; Gellert, Klaus

    2012-01-01

    BACKGROUND: Numerous technical and surgical innovations took place in laparoscopic surgery in the recent past. It is debatable whether single-access surgery or natural orifice surgery (NOS) will establish for several standard procedures. Most of the NOS-procedures are controversial and single-access surgery still has to prove its equality in controlled trials. In the intention to reduce the ingress incisons and to facilitate instrumentation, we decided to test the barrier-free AirSeal®-trocar in clinical practice. MATERIALS AND METHODS: Laparoscopically we performed a cholecystectomy, gastric wedge-resection and a fundoplication using the barrier-free AirSeal® 12-mm-trocar. This trocar works without any mechanical barrier so that via this trocar the use of two instruments is possible. RESULTS: All three operations were successful. CONCLUSION: Laparoscopic standard procedures are feasible using this barrier-free trocar without a higher degree of difficulty. Because of the facilitated instrumentation, it is possible to work more efficiently and to maintain the focus on the surgical field. PMID:22303082

  10. Highly selective laparoscopic vagotomy in the management of duodenal ulcer and gastroesophageal reflux: the technique and results in 150 patients.

    PubMed

    Awad, W; Loehnert, C; Yarmuch, G J

    1997-11-01

    Highly selective vagotomy is the surgical treatment of choice for duodenal ulcer. It is the procedure that best maintains digestive anatomy and physiology with very few side effects, and widely performed all over the world. It has also been employed to treat gastroesophageal reflux for its many advantages: it reduces gastric acid output; it permits easy access to the gastroesophageal junction, assuring a precise, secure fundoplication. We have been using this technique in open surgery since 1978. This prospective study reproduces with laparoscopic guidance, the same technique we used to employ in open surgery. The purpose is to analyze the laparoscopic procedure and discuss the results in 150 patients who were treated between March 1992 and August 1996. This series deals with 36 patients with duodenal ulcer, 80 with gastroesophageal reflux and 34 who presented both. All the duodenal ulcer patients were treated successfully, with no recurrences to date. Recurrences have been recorded in two complex cases of gastroesophageal reflux. The remaining patients show no clinical evidence of reflux and present normal endoscopic findings, esophageal manometric studies and 24-hour esophageal pH measurements. Laparoscopic surgery with this technique appears to be an interesting alternative to prolonged medical treatment of these diseases in certain refractory patients. PMID:9534356

  11. LINX® Reflux Management System in chronic gastroesophageal reflux: a novel effective technology for restoring the natural barrier to reflux

    PubMed Central

    Saino, Greta; Lipham, John C.; DeMeester, Tom R.

    2013-01-01

    Gastroesophageal reflux disease (GERD) results from incompetency of the lower esophageal sphincter that allows the contents of the stomach to reflux into the esophagus, the airways, and the mouth. The disease affects about 10% of the western population and has a profound negative impact on quality of life. The majority of patients are successfully treated with proton-pump inhibitors, but up to 40% have incomplete relief of symptoms even after dose adjustment. The laparoscopic Nissen fundoplication represents the surgical gold standard, but is largely underused because of the level of technical difficulty and the prevalence of side effects. These factors have contributed to the propensity of patients to continue with medical therapy despite inadequate symptom control and complications of the disease. As a consequence, a significant ‘therapy gap’ in the treatment of GERD remains evident in current clinical practice. The LINX® Reflux Management System (Torax Medical, St. Paul, MN, USA) is designed to provide a permanent solution to GERD by augmenting the sphincter barrier with a standardized, reproducible laparoscopic procedure that does not alter gastric anatomy and is easily reversible. Two single-group trials confirmed that a magnetic device designed to augment the lower esophageal sphincter can be safely and effectively implanted using a standard laparoscopic approach. The device decreased esophageal acid exposure, improved reflux symptoms and quality of life, and allowed cessation of proton-pump inhibitors in the majority of patients. PMID:23814607

  12. [The upside-down stomach. Laparoscopic treatment is possible].

    PubMed

    Hohmann, U; Jähnichen, A; Schramm, H

    2000-01-01

    An upside-down-stomach, usually occurring in eldery patients describes an extreme case of paraesophageal hernia. Due to the possibility of life threatening complications there is an urgent need for surgical intervention. In 1998 three patients suffering from complete upside-down-stomach were treated by laparoscopic surgery at our hospital. Two of them received a hiatoplastic with fundo- and corpophrenicopexy. In one case we did a 360 degrees-floppy Nissen's-fundoplication. Perioperatively, one patient developed a left sided pneumothorax Long-term follow-up 6 months postoperatively in our out-patient department revealed unconspicuous clinical and gastroscopical findings and high patient satisfaction with postoperative outcome. Our case reports show the possibility of adequate operating on upside-down-stomach by means of laparoscopic surgery. Minimal invasive methods provide a good overlock on the operating field and are poor in complications when done by an experienced surgeon, so that patients may profit from comfort of laparoscopic surgery. PMID:10829322

  13. Laparoscopic repair of paraesophageal hernia.

    PubMed Central

    Willekes, C L; Edoga, J K; Frezza, E E

    1997-01-01

    OBJECTIVE: The purpose of this report is to describe the authors' technique for the laparoscopic repair of paraesophageal hernias and the outcome in their series of patients. METHODS: Thirty patients underwent elective laparoscopic repair of paraesophageal hernias. All were pure type II paraesophageal hernias as defined by upper gastrointestinal contrast studies. All operations were performed by a single surgeon (JKE) assisted by five different chief surgical residents. The authors have used various prototypes of a laparoscopic utility belt to reduce the physician requirement to the surgeon and a first assistant. The operative setup and specific techniques of the repair are described and illustrated. A concomitant anti-reflux procedure was performed in the last 23 patients. RESULTS: Satisfactory repair using video-laparoscopic techniques was achieved in all cases. There were no deaths. Complications occurred in 8 of 30 patients. Postoperative gastroesophageal reflux developed in three of the first seven patients in whom fundoplication was not performed. Three consecutive patients had left lower lobe atelectasis believed to be related to endotracheal tube displacement during the passage of the bougie. One patient had postoperative dysphagia. There was one case of major deep venous thrombosis with pulmonary embolism. Twenty-eight of 30 patients were discharged home by postoperative day 3. Twenty-four of 30 patients had returned to normal activity by the time of their first postoperative office visit 1 week after surgery. Images Figure 9. Figure 10. PMID:8998118

  14. Reconstruction after proximal gastrectomy for gastric cancer in the upper third of the stomach: a review of the literature published from 2000 to 2014.

    PubMed

    Nakamura, Masaki; Yamaue, Hiroki

    2016-05-01

    Proximal gastrectomy (PG) is occasionally performed to preserve the physiological function of the remnant stomach with the aim of maintaining a gastric reservoir for patients with early gastric cancer in the upper third of the stomach. Many reconstructive procedures after PG have been reported, including esophagogastrostomy (EG), jejunal interposition, jejunal pouch interposition, and double tract. However, no general agreement exists regarding the optimal reconstructive procedure. This article reviews the current reconstructive procedures available for PG. We examined the surgical outcomes, postoperative complications, endoscopic findings, and quality of life (QOL) according to the reconstructive procedures. We found no significant difference in anastomotic leakage and anastomotic stricture among the procedures. The frequency of reflux esophagitis was higher with simple EG compared with the other reconstructive procedures. Some additional procedures, such as fundoplication, the use of a narrow gastric conduit, and placement of a gastric tube in the lower mediastinum on EG, could decrease the frequency of reflux esophagitis and reflux symptoms. These additional procedures may improve the QOL; however, the previous studies were small and could not adequately compare the reconstructive procedures. Prospective randomized controlled trials that involve a longer trial period and more institutions are needed to clarify the optimal reconstructive procedures after PG. PMID:25987497

  15. Treatment of giant hiatal hernia by laparoscopic Roux-en-Y gastric bypass

    PubMed Central

    Duinhouwer, Lucia E.; Biter, L. Ulas; Wijnhoven, Bas P.; Mannaerts, Guido H.

    2015-01-01

    Introduction Obesity is a risk factor for hiatal hernia. In addition, much higher recurrence rates are reported after standard surgical treatment of hiatal hernia in morbidly obese patients. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective surgical treatment for morbid obesity and is known to effectively control symptoms of gastroesophageal reflux (GERD). Case presentation Two patients suffering from giant hiatal hernias where a combined LRYGB and hiatal hernia repair (HHR) with mesh was performed are presented in this paper. There were no postoperative complications and at 1 year follow-up, there was no sign of recurrence of the hernia. Discussion The gold standard for all symptomatic reflux patients is still surgical correction of the paraesophageal hernia, including complete reduction of the hernia sac, resection of the sac, hiatal closure and fundoplication. However, HHR outcome is adversely affected by higher BMI levels, leading to increased HH recurrence rates in the obese. Conclusion Concomitant giant hiatal hernia repair with LRYGB appears to be safe and feasible. Moreover, LRYGB plus HHR appears to be a good alternative for HH patients suffering from morbid obesity as well than antireflux surgery alone because of the additional benefit of significant weight loss and improvement of obesity related co-morbidity. PMID:25723747

  16. Management of acute upside-down stomach

    PubMed Central

    2013-01-01

    Background Upside-down stomach (UDS) is characterized by herniation of the entire stomach or most gastric portions into the posterior mediastinum. Symptoms may vary heavily as they are related to reflux and mechanically impaired gastric emptying. UDS is associated with a risk of incarceration and volvulus development which both might be complicated by acute gastric outlet obstruction, advanced ischemia, gastric bleeding and perforation. Case presentation A 32-year-old male presented with acute intolerant epigastralgia and anterior chest pain associated with acute onset of nausea and vomiting. He reported on a previous surgical intervention due to a hiatal hernia. Chest radiography and computer tomography showed an incarcerated UDS. After immediate esophago-gastroscopy, urgent laparoscopic reduction, repair with a 360° floppy Nissen fundoplication and insertion of a gradually absorbable GORE® BIO-A®-mesh was performed. Conclusion Given the high risk of life-threatening complications of an incarcerated UDS as ischemia, gastric perforation or severe bleeding, emergent surgery is indicated. In stable patients with acute presentation of large paraesophageal hernia or UDS exhibiting acute mechanical gastric outlet obstruction, after esophago-gastroscopy laparoscopic reduction and hernia repair followed by an anti-reflux procedure is suggested. However, in cases of unstable patients open repair is the surgical method of choice. Here, we present an exceptionally challenging case of a young patient with a giant recurrent hiatal hernia becoming clinically manifest in an incarcerated UDS. PMID:24228771

  17. High-resolution manometry findings in patients with an intrathoracic stomach.

    PubMed

    Martinelo, Vanderlei; Mardiros Herbella, Fernando Augusto; Patti, Marco G

    2015-04-01

    Intrathoracic stomach is a rare finding. The real value of the high-resolution manometry (HRM) in the preoperative evaluation of these patients has not yet being fully tested. This study aims to evaluate: 1) the HRM pattern of patients with an intrathoracic stomach; and 2) HRM findings as predictors for prosthetic reinforcement of the hiatus. We reviewed 33 patients (27 women, mean age 66 years) with an intrathoracic stomach who underwent HRM. Fifteen patients did the HRM as part of preoperative workup and were operated on in our institution. All patients were submitted to a laparoscopic Nissen fundoplication. HRM results show that the lower esophageal sphincter (LES) was transposed in all patients. Hiatal hernia was diagnosed in 21 (63%) patients. The length of the hernia was 4 ± 2 cm (range, 1 to 9 cm). LES oscillation was observed in 23 (69%) patients with a mean of 1 ± 0.4 cm (range, 0.4 to 2 cm). Hiatal mesh reinforcement was necessary in five (33%) of the operated patients. HRM findings did not predict hiatal mesh reinforcement. Our results show that: 1) HRM has a poor sensibility for hiatal hernia diagnosis; 2) half of the patients with an intrathoracic stomach have a normal HRM; and 3) HRM does not predict mesh hiatal hernia repair. PMID:25831180

  18. A case of advanced systemic sclerosis with severe GERD successfully treated with acotiamide.

    PubMed

    Kato, Ryo; Nakajima, Kiyokazu; Takahashi, Tsuyoshi; Miyazaki, Yasuhiro; Makino, Tomoki; Kurokawa, Yukinori; Yamasaki, Makoto; Takiguchi, Shuji; Mori, Masaki; Doki, Yuichiro

    2016-12-01

    The majority of systemic sclerosis (SSc) patients have gastrointestinal tract involvement, but therapies of prokinetic agents are usually unsatisfactory. Patients are often compromised by the use of steroid; therefore, a surgical indication including fundoplication has been controversial. There is no report that advanced SSc with severe gastroesophageal reflux disease (GERD) is successfully treated with acotiamide, which is the acetylcholinesterase (AChE) inhibitor designed for functional dyspepsia (FD). We report a 44-year-old woman of SSc with severe GERD successfully treated with acotiamide. She had received medical treatment in our hospital since 2003. She had been aware of the significant gastroesophageal reflux symptoms (e.g., heartburn, chest pain, and dysphagia) due to the development of esophageal hardening associated with SSc since 2014. As a result of upper gastrointestinal series, upper gastrointestinal endoscopy, and 24-h pH monitoring and frequency scale for the symptoms of the GERD (FSSG) scoring, she has been diagnosed with GERD associated with SSc. First of all, she started to take prokinetic agents Rikkunshito and mosapride and proton pump inhibitor; there was no change in reflux symptoms. So, we started to prescribe her the acotiamide.After oral administration started, reflux symptoms have been improved. Five months after oral administration, FSSG score, a questionnaire for evaluation of the symptoms of GERD, was improved. Since its introduction of acotiamide, the patient has kept free from symptoms for 6 months. PMID:27072944

  19. Barrett's oesophagus: effect of antireflux surgery on symptom control and development of complications.

    PubMed

    Attwood, S E; Barlow, A P; Norris, T L; Watson, A

    1992-10-01

    Forty-five patients with histologically proven Barrett's columnar-lined oesophagus (CLO) were treated in one unit over a 9-year period. Patients were studied prospectively as part of a surveillance programme; all initially received standard conservative treatment including high-dose H2-receptor antagonists. A satisfactory initial response was seen in 21 patients, but in 24 the symptoms were unchanged or progressed; 19 patients in the latter group were considered suitable for antireflux surgery and underwent fundoplication. Symptoms of heartburn or dysphagia persisted or recurred in 88 per cent of patients receiving medical treatment alone and complications developed in 38 per cent, including nine strictures and one adenocarcinoma. In patients undergoing antireflux surgery, symptoms persisted or recurred in 21 per cent and complications developed in 16 per cent (P < 0.01). Complete regression of Barrett's CLO occurred in two patients (11 per cent) after antireflux surgery. The results of this study suggest the superiority of antireflux surgery over pharmacological acid suppression in the control of symptoms and prevention of complications in patients with Barrett's CLO. PMID:1422717

  20. Achalasia - An Update

    PubMed Central

    2010-01-01

    Achalasia is an esophageal motility disorder of unknown cause, characterized by aperistalsis of the esophageal body and impaired lower esophageal sphincter relaxation. Patients present at all ages, primarily with dysphagia for solids/liquids and bland regurgitation. The diagnosis is suggested by barium esophagram and confirmed by esophageal manometry. Achalasia cannot be cured. Instead, our goal is to relieve symptoms, improve esophageal emptying and prevent the development of megaesophagus. The most successful therapies are pneumatic dilation and surgical myotomy. The overall success rate of graded pneumatic dilation is 78%, with women and older patients responding best. Laparoscopic myotomy, usually combined with a partial fundoplication, has an overall success rate of 87%. Young patients, especially men, are the best candidates for surgical myotomy. Botulinum toxin injection into the lower esophageal sphincter and smooth muscle relaxants are usually reserved for older patients or those with co-morbid illness. The prognosis for achalasia patients to return to near normal swallowing is good, but the disease is rarely "cured" with a single procedure and intermittent touch-up procedures may be required. PMID:20680161

  1. [Transition to adult care for children with chronic neurological disorders; which is the best way to make it?].

    PubMed

    Moreno Villares, José Manuel

    2014-01-01

    Chronic neurological disorders in children have significant effects on adult medical and social function. Transition from pediatric to adult services is a complex process. No objective data are available to inform physicians about the most effective approach. Nevertheless the most recommended approach is a joint pediatric/adult transition clinic. Malnutrition, either under or overnutrition, is a common condition among neurologically impaired children. Undernutrition is most prevalent, and its causes are diverse: insufficient caloric intake, excessive nutrient losses and abnormal energy metabolism. Malnutrition is associated with significant morbidity, while nutritional rehabilitation improves overall health as well as quality of life. It is not easy to determine which the nutritional needs in these patients are. Besides, they often present difficulties for oral feeding, mainly due to oromotor dysfunction. Gastrointestinal symptoms, gastro esophageal reflux and constipation, as well as spasticity, scoliosis and joint deformities contribute to these difficulties. Because of that, an assessment of nutritional status should be performed periodically, and to assess efficacy and security of oral intake. If modifying oral diet we cannot confirm an adequate support, a nasogastric tube or a gastrostomy need to be considered. Often, a fundoplication is associated to the placement of a gastrostomy. Although the outcomes in a better nutritional status and quality of life are often obtained, it is not an easy decision for families. PMID:25077342

  2. Gastroesophageal reflux in infants and children. Recognition and treatment.

    PubMed

    Johnson, D G; Jolley, S G

    1981-10-01

    Gastroesophageal reflux is common in infants and children and is associated with a broad spectrum of symptoms and disease. The majority of young patients with reflux can be managed nonoperatively because growth and time usually bring maturation of the antireflux mechanisms. We feel that operation is justified and indicated for the child with complications of reflux that are not reversed by a six-week medical trial, and children with stricture or infants with reflux-related apnea should have operation without delay. In our experience, analysis of the 24-hour esophageal pH tracing has proved most useful to correlate respiratory symptoms with reflux. The Nissen fundoplication is the most effective and the most reliable antireflux procedure, but it must be constructed loosely to minimize the side effects of dysphagia and gas bloating. Because the population at risk for reflux disease has approximately a 50 per cent incidence of significant associated medical problems, morbidity and mortality from some of these problems is inevitable. There should be little or no mortality associated with the antireflux operation itself. PMID:7313926

  3. Gastroesophageal Reflux and Altered Motility in Lung Transplant Rejection

    PubMed Central

    Castor, John M; Wood, Richard K.; Muir, Andrew J.; Palmer, Scott M.; Shimpi, Rahul A.

    2010-01-01

    Background Lung transplantation has become an effective therapeutic option for selected patients with end stage lung disease. Long-term survival is limited by chronic rejection manifest as bronchiolitis obliterans syndrome (BOS). The aspiration of gastric contents has been implicated as a causative or additive factor leading to BOS. Gastroesophageal reflux (GER) and altered foregut motility are common both before and after lung transplantation. Further, the normal defense mechanisms against reflux are impaired in the allograft. Recent studies using biomarkers of aspiration have added to previous association studies to provide a growing body of evidence supporting the link between rejection and GER. Further, the addition of high-resolution manometry (HRM) and impedance technology to characterize bolus transit and the presence and extent of reflux regardless of pH might better identify at-risk patients. Although additional prospective studies are needed, fundoplication appears useful in the prevention or treatment of post-transplant BOS. Purpose This review will highlight the existing literature on the relationship of gastroesophageal reflux and altered motility to lung transplant rejection, particularly BOS. The article will conclude with a discussion of the evaluation and management of patients undergoing lung transplantation at our center. PMID:20507544

  4. Pathologic aerophagia: a rare cause of chronic abdominal distension

    PubMed Central

    de Jesus, Lisieux Eyer; Cestari, Ana Beatriz C.S.S.; da Silva, Orli Carvalho; Fernandes, Marcia Antunes; Firme, Livia Honorato

    2015-01-01

    Objective: To describe an adolescent with pathologic aerophagia, a rare condition caused by excessive and inappropriate swallowing of air and to review its treatment and differential diagnoses. Case description: An 11-year-old mentally impaired blind girl presenting serious behavior problems and severe developmental delay with abdominal distension from the last 8 months. Her past history included a Nissen fundoplication. Abdominal CT and abdominal radiographs showed diffuse gas distension of the small bowel and colon. Hirschsprung's disease was excluded. The distention was minimal at the moment the child awoke and maximal at evening, and persisted after control of constipation. Audible repetitive and frequent movements of air swallowing were observed. The diagnosis of pathologic aerophagia associated to obsessive-compulsive disorder and developmental delay was made, but pharmacological treatment was unsuccessful. The patient was submitted to an endoscopic gastrostomy, permanently opened and elevated relative to the stomach. The distention was resolved, while maintaining oral nutrition. Comments: Pathologic aerophagia is a rare self-limiting condition in normal children exposed to high levels of stress and may be a persisting problem in children with psychiatric or neurologic disease. In this last group, the disease may cause serious complications. Pharmacological and behavioral treatments are ill-defined. Severe cases may demand surgical strategies, mainly decompressive gastrostomy. PMID:26100594

  5. [In Process Citation].

    PubMed

    Kotsis, Lajos; Kostic, Szilárd; Agócs, László; Vadász, Pál

    2015-12-01

    Right-sided spontaneous oesophageal rupture developed two days after left pneumonectomy and vomiting. In this extremely rare emergency, we used a transhiatal approach for primary repair of the rupture, combined with right-sided pleural and mediastinal drainage, gastrostomy and feeding jejunostomy. The seven-day barium meal showed healing of the rupture. It was mandatory that contamination of the pneumonectomized left thoracic cavity during rupture closure as well as a contralateral thoracotomy with its respiratory consequences had to be avoided by all means. Reconstruction and reinforcement (with omentum) of the oesophageal wall was achieved without difficulties, but we did not mobilize the oesophagus to avoid rupture of the left-sided mediastinal pleura. After massive haematamesis, a 68-year-old man was admitted for a huge (8×5 cm) mass in the lower-posterior mediastinum at the right side of the vertebra, seen on CT scan. On the barium meal incarcerated hiatal hernia, secondary short oesophagus and intramediastinally penetrating high lesser curvature ulcer was discovered. To reduce the magnitude of intervention one-stage transhiatal approach was decided. Through enlarged hiatus, dissection of incarcerated and firmly adherent hiatal hernia and of the short oesophagus was done. The following step was the removal of an encapsulated, huge lipomatosus mass from the posterior mediastinum, extending high from behind the vertebra, arising from the lesser curvature of the stomach. The lesser curvature ulcer was excised - sutured and a Toupet type (270 posterior) fundoplication was finally carried out. The follow-up was free from recurrence. This experience suggests that for some particular lower posterior mediastinal or esophageal problems, transhiatal access seems to be a useful alternative of traditional mediastinal approaches. PMID:26654357

  6. Laparoscopic surgery: A qualified systematic review

    PubMed Central

    Buia, Alexander; Stockhausen, Florian; Hanisch, Ernst

    2015-01-01

    AIM: To review current applications of the laparoscopic surgery while highlighting the standard procedures across different fields. METHODS: A comprehensive search was undertaken using the PubMed Advanced Search Builder. A total of 321 articles were found in this search. The following criteria had to be met for the publication to be selected: Review article, randomized controlled trials, or meta-analyses discussing the subject of laparoscopic surgery. In addition, publications were hand-searched in the Cochrane database and the high-impact journals. A total of 82 of the findings were included according to matching the inclusion criteria. Overall, 403 full-text articles were reviewed. Of these, 218 were excluded due to not matching the inclusion criteria. RESULTS: A total of 185 relevant articles were identified matching the search criteria for an overview of the current literature on the laparoscopic surgery. Articles covered the period from the first laparoscopic application through its tremendous advancement over the last several years. Overall, the biggest advantage of the procedure has been minimizing trauma to the abdominal wall compared with open surgery. In the case of cholecystectomy, fundoplication, and adrenalectomy, the procedure has become the gold standard without being proven as a superior technique over the open surgery in randomized controlled trials. Faster recovery, reduced hospital stay, and a quicker return to normal activities are the most evident advantages of the laparoscopic surgery. Positive outcomes, efficiency, a lower rate of wound infections, and reduction in the perioperative morbidity of minimally invasive procedures have been shown in most indications. CONCLUSION: Improvements in surgical training and developments in instruments, imaging, and surgical techniques have greatly increased safety and feasibility of the laparoscopic surgical procedures. PMID:26713285

  7. Insult of gastroesophageal reflux on airway: clinical significance of pharyngeal nozzle.

    PubMed

    Wang, Zhonggao; Hu, Zhiwei; Wu, Jimin; Ji, Feng; Wang, Hongtao; Lai, Yungang; Gao, Xiang; Ning, Yachan; Zhang, Chengchao; Li, Zhitong; Liang, Weitao; Liu, Jianjun

    2015-03-01

    At the very time of global paying the highest attention to the worst insults of smoking as well as haze on the airway, everybody knows both are exogenous and noticeable. However, people mostly, including many medical personnel, do not know how badly the gastroesophageal reflux (GER) insults on our own airway. Symptoms of GER are commonly seen as heartburn and regurgitation, which can be mostly tolerated. However, when the up going gastric content reversely passes the esophagus and then the distal pharynx, where it appears a beak like stricture, serving as a nozzle, so as to produce numerous micro-particles and reach the oro-nasal cavity and also the airway causing allergic rhinitis and asthmatic attacks, even pulmonary parenchyma lesions. It will reduce life quality or even jeopardize life. The point that the endogenous insult appears in the respiratory system, but originates from the digestive tract is not well known and often undiagnosed and not correctly treated. The GER induced airway challenge is a treatable and preventive entity, as soon as a diagnosis is made, a good relief could be expected by means of life style adjustment, medicine, or fixation of the patulous cardia through radiofrequency or fundoplication. The author Dr. Zhonggao Wang had suffered it for long and symptoms disappeared for 8 years after anti-reflux surgery. Here is a presentation of Dr. Zhonggao Wang and his team's work and would call attention to the public so as to recognize this relatively unknown entity - a treatable condition occurring from human itself, but not from outside surroundings as smoking or haze does. PMID:25034240

  8. Robotic Surgical Training in an Academic Institution

    PubMed Central

    Chitwood, W. Randolph; Nifong, L. Wiley; Chapman, William H. H.; Felger, Jason E.; Bailey, B. Marcus; Ballint, Tara; Mendleson, Kim G.; Kim, Victor B.; Young, James A.; Albrecht, Robert A.

    2001-01-01

    Objective To detail robotic procedure development and clinical applications for mitral valve, biliary, and gastric reflux operations, and to implement a multispecialty robotic surgery training curriculum for both surgeons and surgical teams. Summary Background Data Remote, accurate telemanipulation of intracavitary instruments by general and cardiac surgeons is now possible. Complex technologic advancements in surgical robotics require well-designed training programs. Moreover, efficient robotic surgical procedures must be developed methodically and safely implemented clinically. Methods Advanced training on robotic systems provides surgeon confidence when operating in tiny intracavitary spaces. Three-dimensional vision and articulated instrument control are essential. The authors’ two da Vinci robotic systems have been dedicated to procedure development, clinical surgery, and training of surgical specialists. Their center has been the first United States site to train surgeons formally in clinical robotics. Results Established surgeons and residents have been trained using a defined robotic surgical educational curriculum. Also, 30 multispecialty teams have been trained in robotic mechanics and electronics. Initially, robotic procedures were developed experimentally and are described. In the past year the authors have performed 52 robotic-assisted clinical operations: 18 mitral valve repairs, 20 cholecystectomies, and 14 Nissen fundoplications. These respective operations required 108, 28, and 73 minutes of robotic telemanipulation to complete. Procedure times for the last half of the abdominal operations decreased significantly, as did the knot-tying time in mitral operations. There have been no deaths and few complications. One mitral patient had postoperative bleeding. Conclusion Robotic surgery can be performed safely with excellent results. The authors have developed an effective curriculum for training teams in robotic surgery. After training, surgeons

  9. Neurogenic dysphagia resulting from Chiari malformations.

    PubMed

    Pollack, I F; Pang, D; Kocoshis, S; Putnam, P

    1992-05-01

    Between 1980 and 1989, 15 of 46 patients (11 children, 4 adults) who underwent suboccipital craniectomy and cervical laminectomy for symptomatic Chiari malformations presented with manifestations of neurogenic dysphagia. Each of these patients had normal swallowing function before the development of dysphagic symptoms. Dysphagia was progressive in all 15 and, in most cases, preceded the onset of other severe brain stem signs. The rate of symptom progression varied depending on the age of the patient. Whereas the six infants (all Chiari II) deteriorated rapidly after the onset of initial symptoms, the five older children (two Chiari I, three Chiari II) and four adults (all Chiari I) showed a more gradual deterioration. In 11 patients with severe dysphagia, barium video esophagograms, pharyngoesophageal motility studies, continuous esophageal pH monitoring, and appropriate scintigraphic studies were useful in defining the scope of the swallowing impairment and determining whether perioperative nasogastric or gastrostomy feedings, gastric fundoplication, and/or tracheostomy were needed to maintain adequate nutrition and avoid aspiration. These patients all had widespread dysfunction of the swallowing mechanism, with a combination of diffuse pharyngoesophageal dysmotility, cricopharyngeal achalasia, nasal regurgitation, tracheal aspiration, and gastroesophageal reflux. The pathophysiology of these swallowing impairments and their relation to the hindbrain malformation is discussed. Postoperative outcome with regard to swallowing function correlated with the severity of preoperative symptoms. The four patients with mild dysphagia showed rapid improvement in swallowing function after surgery. Seven patients with more severe impairment but without other signs of severe brain stem compromise, such as central apnea or complete bilateral vocal cord paralysis, also improved, albeit more slowly. In contrast, the outcome in the four patients who developed other signs of severe

  10. Upside-down stomach – results of mini-invasive surgical therapy

    PubMed Central

    Vrba, Radek; Aujesky, Rene; Vomackova, Katherine; Zbrozkova, Lenka

    2011-01-01

    Aim The authors evaluate the results of mini-invasive therapy in patients diagnosed with upside-down stomach. Material and methods From 1998 to 2008, a total of 27 patients diagnosed with upside-down stomach were surgically treated at the 1st Department of Surgery, University Hospital Olomouc. Before the operation, patients were examined endoscopically and a barium swallow was performed. In all 27 patients (100%), the operation was performed electively laparoscopically. The principle of the operation in all cases was reposition of the stomach into the abdominal cavity, resection of the hernial sac and hiatoplasty. In addition, in 15 patients (56%) with reflux symptoms or endoscopic findings of reflux oesophagitis, fundoplication in Nissen's modification was also performed. Fundopexy was indicated in 12 patients (44%). Results In all patients (100%), the operation was performed mini-invasively; conversion to an open procedure was never necessary. In 3 cases (11%), the left pleural cavity was opened during the operation; this was treated by introducing a chest drain. The operation mortality in the patient set was zero; morbidity was 11%. A year after the operation, patients were re-examined, and follow-up endoscopy and barium swallow were performed. Conclusions In all patients diagnosed with upside-down stomach, surgical treatment is indicated due to the risk of developing severe complications. Mini-invasive surgical therapy in the hands of an experienced surgeon is a safe procedure which offers patients all the benefits of mini-invasive therapy with promising short- and long-term results. PMID:23255985

  11. Scintigraphy in laryngopharyngeal and gastroesophageal reflux disease: A definitive diagnostic test?

    PubMed Central

    Falk, Gregory L; Beattie, John; Ing, Alvin; Falk, SE; Magee, Michael; Burton, Leticia; Van der Wall, Hans

    2015-01-01

    AIM: To investigate the utility of scintigraphic studies in predicting response to laparoscopic fundoplication (LF) for chronic laryngopharyngeal reflux symptoms. METHODS: Patients with upper aero-digestive symptoms that remained undiagnosed after a period of 2 mo were studied with conventional pH and manometric studies. Patients mainly complained of cough, sore throat, dysphonia and globus. These patients were imaged after ingestion of 99m-technetium diethylene triamine pentaacetic acid. Studies were quantified with time activity curves over the pharynx, upper and lower oesophagus and background. Late studies of the lungs were obtained for aspiration. Patients underwent LF with post-operative review at 3 mo after surgery. RESULTS: Thirty four patients (20 F, 14 M) with an average age of 57 years and average duration of symptoms of 4.8 years were studied. Twenty four hour pH and manometry studies were abnormal in all patients. On scintigraphy, 27/34 patients demonstrated pharyngeal contamination and a rising or flat pharyngeal curve. Lung aspiration was evident in 50% of patients. There was evidence of pulmonary aspiration in 17 of 34 patients in the delayed study (50%). Pharyngeal contamination was found in 27 patients. All patients with aspiration showed pharyngeal contamination. In the 17 patients with aspiration, graphical time activity curve showed rising activity in the pharynx in 9 patients and a flat curve in 8 patients. In those 17 patients without pulmonary aspiration, 29% (5 patients) had either a rising or flat pharyngeal graph. A rising or flat curve predicted aspiration with a positive predictive value of 77% and a negative predictive value of 100%. Over 90% of patients reported a satisfactory symptomatic response to LF with an acceptable side-effect profile. CONCLUSION: Scintigraphic reflux studies offer a good screening tool for pharyngeal contamination and aspiration in patients with gastroesophageal reflux disease. PMID:25834329

  12. The use of a sternothyroid muscle flap to prevent the re-recurrence of a recurrent tracheoesophageal fistula found 10 years after the primary repair.

    PubMed

    Takayasu, Hajime; Masumoto, Kouji; Ishikawa, Miki; Sasaki, Takato; Ono, Kentaro

    2016-12-01

    Recurrent tracheoesophageal fistula (TEF) is still difficult to diagnose and repair. In almost all cases, recurrence appears relatively soon after the primary surgery. We herein describe a case of recurrent TEF that appeared 10 years after the primary repair. At 2 years of age, the patient suffered from mental retardation due to encephalitis and developed a hiatus hernia with gastro-esophageal reflux. He underwent the repair of a hiatus hernia and fundoplication at 3 years of age. However, the hiatus hernia recurred 6 months after the operation. The patient suffered from recurrent pneumonia for 6 years after the appearance of the recurrent hiatus hernia. At 9 years of age, he was hospitalized frequently due to recurrent severe pneumonia. After admission at 9 years of age, an endoscopic study under general anesthesia was performed and revealed subglottic stenosis and a dilated esophagus with a recurrent hiatus hernia. Tracheotomy or laryngotracheal separation was first planned in order to improve his upper airway and facilitate the safer repair of the recurrent hiatus hernia. After laryngotracheal separation, the patient still suffered from severe pneumonia. In addition, a small volume of nutritional supplement was aspirated from the tracheostomy. Thus, recurrent TEF was suspected. Tests using dye under both esophagoscopy and bronchoscopy confirmed recurrent TEF. The fistula recurred in the cervical area because of the elevation of the esophagus due to the recurrent hiatus hernia. The fistula was surgically closed, with a sternothyroid muscle flap to prevent re-recurrence. At 4 months after this operation, the recurrent hiatus hernia was repaired. Thereafter, the patient's respiratory symptoms showed a dramatic improvement. The patient is now doing well and free from further recurrences of TEF and hiatus hernia at 2 years after the final operation. PMID:27589983

  13. [Medium-term outcome, follow-up, and quality of life in children treated for type III esophageal atresia].

    PubMed

    Lepeytre, C; De Lagausie, P; Merrot, T; Baumstarck, K; Oudyi, M; Dubus, J-C

    2013-10-01

    The aim of this study was to evaluate the medium-term outcome (health status, medical and surgical French National Health Authority-recommended follow-up, and quality of life) of children born with type III esophageal atresia (EA). Previous events (during the perinatal period, associated abnormalities, respiratory and digestive complications) of children treated for type III EA at the Marseille university hospitals between 1999 and 2009 were noted. Parents completed a standardized questionnaire concerning the health of their children during the previous year, and a quality-of-life questionnaire (PedsQL 4.0) was also completed by children aged more than 8 years. Among the 68 children treated, 44 responded to our solicitation (mean age, 7.6 years; range, 3-12.8 years). Previous important events were : pneumonia(s) (65%), asthma before the age of 3 years (66%), hospitalization for a respiratory event (45%), fundoplication (20%), and esophageal dilatation (45%). We noted current chronic cough (16%), asthma (30%), dysphagia (39%), and symptomatic gastroesophageal reflux (9%). National guidelines were not respected, except for the surgical indications in children aged less than 6 years. The quality-of-life scores (n=43 children) were similar to healthy controls but were negatively influenced by a gastrostomy procedure (P=0.020), pneumonia (P=0.013), and hospitalization due to a respiratory event (P=0.006) or a digestive event (P=0.010), and also by current asthma (P=0.004). In conclusion, despite recurrent respiratory or digestive symptoms and inadequate recommended follow-up, the quality of life of children treated for type III of EA is good. PMID:23932659

  14. Idiopathic Pulmonary Fibrosis: Novel Concepts of Proton Pump Inhibitors as Antifibrotic Drugs.

    PubMed

    Ghebre, Yohannes T; Raghu, Ganesh

    2016-06-15

    The prevalence of abnormal acid gastroesophageal reflux (GER) is higher in patients with idiopathic pulmonary fibrosis (IPF) than in matched control subjects. Several studies demonstrated that more than one-third of patients with IPF have abnormal esophageal acid exposures. In addition, many of these studies indicate that the majority of patients with IPF have silent reflux with no symptoms of GER. Findings of abnormal reflux persist in a large proportion of patients with IPF placed on antacid therapy such as proton pump inhibitors (PPIs). This seemingly paradoxical observation suggests that either patients with IPF are somehow resistant to PPI-based intervention or PPIs are inherently unable to suppress acid GER. By contrast, patients with IPF who undergo Nissen fundoplication surgery are effectively relieved from the complications of GER, and retrospective studies suggest improved lung function. Retrospective, anecdotal data suggest a beneficial role of PPIs in IPF including stabilization of lung function, reduction in episodes of acute exacerbation, and enhanced longevity. The recent evidence-based guidelines for treatment of IPF approved conditional recommendation of PPIs for all patients with IPF regardless of their GER status. Recently, we have reported that PPIs possess antiinflammatory and antifibrotic activities by directly suppressing proinflammatory cytokines, profibrotic proteins, and proliferation of lung fibroblasts. Our study provides an alternative explanation for the beneficial effect of PPIs in IPF. In this Perspective, we reviewed emerging progress on antifibrotic effect of PPIs using IPF as a disease model. In addition, we summarized surgical and pharmacological interventions for GER and their downstream effect on lung physiology. PMID:27110898

  15. Laparoscopic Repair of Paraesophageal Hernias

    PubMed Central

    Borao, Frank; Squillaro, Anthony; Mansson, Jonas; Barker, William; Baker, Thomas

    2014-01-01

    Background and Objectives: Laparoscopy has quickly become the standard surgical approach to repair paraesophageal hernias. Although many centers routinely perform this procedure, relatively high recurrence rates have led many surgeons to question this approach. We sought to evaluate outcomes in our cohort of patients with an emphasis on recurrence rates and symptom improvement and their correlation with true radiologic recurrence seen on contrast imaging. Methods: We retrospectively identified 126 consecutive patients who underwent laparoscopic repair of a large paraesophageal hernia between 2000 and 2010. Clinical outcomes were reviewed, and data were collected regarding operative details, perioperative and postoperative complications, symptoms, and follow-up imaging. Radiologic evidence of any size hiatal hernia was considered to indicate a recurrence. Results: There were 95 female and 31 male patients with a mean age (± standard deviation) of 71 ± 14 years. Laparoscopic repair was completed successfully in 120 of 126 patients, with 6 operations converted to open procedures. Crural reinforcement with mesh was performed in 79% of patients, and 11% underwent a Collis gastroplasty. Fundoplications were performed in 90% of patients: Nissen (112), Dor (1), and Toupet (1). Radiographic surveillance, obtained at a mean time interval of 23 months postoperatively, was available in 89 of 126 patients (71%). Radiographic evidence of a recurrence was present in 19 patients (21%). Reoperation was necessary in 6 patients (5%): 5 for symptomatic recurrence (4%) and 1 for dysphagia (1%). The median length of stay was 4 days. Conclusion: Laparoscopic paraesophageal hernia repair results in an excellent outcome with a short length of stay when performed at an experienced center. Radiologic recurrence is observed relatively frequently with routine surveillance; however, many of these recurrences are small, and few patients require correction of the recurrence. Furthermore, these

  16. A technique for the laparoscopic repair of paraoesophageal hernia without mesh.

    PubMed

    D'Netto, Trevor J; Falk, Gregory L

    2014-04-01

    Laparoscopic paraoesophageal hernia repair is a challenging procedure, both in surgical technical difficulty and in prevention of recurrence, in the setting of operating on an older patient cohort with associated co-morbidities. However, modifications based on sound surgical principles can lead to better outcomes. This article describes and illustrates in detail the technique for the laparoscopic repair of paraoesophageal hernia without mesh with cardio-oesophageal junction fixation. The data and results of the study supporting this technique have been published previously by Gibson et al. (Surgical Endoscopy 27: 618-623, 2013). The previously published article has reported on the numbers of patients, mean age, American Society of Anesthesiologists Physical Status Classification System, body mass index, duration of follow-up, complications, Visick scores and quality of life pre- and post-operatively. The principles of complete reduction of the hernia sac, preservation of both crura, mobilisation of the phreno-oesophageal ligament and phreno-gastric attachments, adequate mediastinal mobilisation of the oesophagus and the cardio-oesophageal junction into the abdomen without tension, preservation of both vagi, a tension-free crural repair including the fascial aspects adjacent to the diaphragm, an anterior hiatal repair in combination with the recognised posterior approximation, a loose fundoplication and a secure cardiopexy to the median arcuate ligament and multiple points of attachment; we have found leads to good operative results(Gibson et. al.) without the need for mesh. This article outlines in detail the operative technique guided by these principles with annotated intra-operative photographs illustrating the anatomy and procedure. The technique used by our team since March 2009 for the last 154 cases, based on the experience of an aggregate of 544 cases since 1999, we believe results in an acceptable level of symptomatic and anatomic recurrence without using

  17. Resorbable biosynthetic mesh for crural reinforcement during hiatal hernia repair.

    PubMed

    Alicuben, Evan T; Worrell, Stephanie G; DeMeester, Steven R

    2014-10-01

    The use of mesh to reinforce crural closure during hiatal hernia repair is controversial. Although some studies suggest that using synthetic mesh can reduce recurrence, synthetic mesh can erode into the esophagus and in our opinion should be avoided. Studies with absorbable or biologic mesh have not proven to be of benefit for recurrence. The aim of this study was to evaluate the outcome of hiatal hernia repair with modern resorbable biosynthetic mesh in combination with adjunct tension reduction techniques. We retrospectively analyzed all patients who had crural reinforcement during repair of a sliding or paraesophageal hiatal hernia with Gore BioA resorbable mesh. Objective follow-up was by videoesophagram and/or esophagogastroduodenoscopy. There were 114 patients. The majority of operations (72%) were laparoscopic primary repairs with all patients receiving a fundoplication. The crura were closed primarily in all patients and reinforced with a BioA mesh patch. Excessive tension prompted a crural relaxing incision in four per cent and a Collis gastroplasty in 39 per cent of patients. Perioperative morbidity was minor and unrelated to the mesh. Median objective follow-up was one year, but 18 patients have objective follow-up at two or more years. A recurrent hernia was found in one patient (0.9%) three years after repair. The use of crural relaxing incisions and Collis gastroplasty in combination with crural reinforcement with resorbable biosynthetic mesh is associated with a low early hernia recurrence rate and no mesh-related complications. Long-term follow-up will define the role of these techniques for hiatal hernia repair. PMID:25264654

  18. Gastroesophageal reflux disease: A review of surgical decision making

    PubMed Central

    Moore, Maureen; Afaneh, Cheguevara; Benhuri, Daniel; Antonacci, Caroline; Abelson, Jonathan; Zarnegar, Rasa

    2016-01-01

    Gastroesophageal reflux disease (GERD) is a very common disorder with increasing prevalence. It is estimated that up to 20%-25% of Americans experience symptoms of GERD weekly. Excessive reflux of acidic often with alkaline bile salt gastric and duodenal contents results in a multitude of symptoms for the patient including heartburn, regurgitation, cough, and dysphagia. There are also associated complications of GERD including erosive esophagitis, Barrett’s esophagus, stricture and adenocarcinoma of the esophagus. While first line treatments for GERD involve mainly lifestyle and non-surgical therapies, surgical interventions have proven to be effective in appropriate circumstances. Anti-reflux operations are aimed at creating an effective barrier to reflux at the gastroesophageal junction and thus attempt to improve physiologic and mechanical issues that may be involved in the pathogenesis of GERD. The decision for surgical intervention in the treatment of GERD, moreover, requires an objective confirmation of the diagnosis. Confirmation is achieved using various preoperative evaluations including: ambulatory pH monitoring, esophageal manometry, upper endoscopy (esophagogastroduodenoscopy) and barium swallow. Upon confirmation of the diagnosis and with appropriate patient criteria met, an anti-reflux operation is a good alternative to prolonged medical therapy. Currently, minimally invasive gastro-esophageal fundoplication is the gold standard for surgical intervention of GERD. Our review outlines the many factors that are involved in surgical decision-making. We will review the prominent features that reflect appropriate anti-reflux surgery and present suggestions that are pertinent to surgical practices, based on evidence-based studies. PMID:26843915

  19. Paraesophageal Hernia Repair With Partial Longitudinal Gastrectomy in Obese Patients

    PubMed Central

    Rodriguez, John; El-Hayek, Kevin; Brethauer, Stacy; Schauer, Philip; Zelisko, Andrea; Chand, Bipan; O'Rourke, Colin; Kroh, Matthew

    2015-01-01

    Background and Objectives: Treatment of gastroesophageal reflux disease (GERD) with hiatal hernia in obese patients has proven difficult, as studies demonstrate poor symptom control and high failure rates in this patient population. Recent data have shown that incorporating weight loss procedures into the treatment of reflux may improve overall outcomes. Methods: We retrospectively reviewed 28 obese and morbidly obese patients who presented from December 2007 through July 2013 with large or recurrent type 3 or 4 paraesophageal hernia. All of the patients underwent combined paraesophageal hernia repair and partial longitudinal gastrectomy. Charts were retrospectively reviewed, and the patients were contacted to determine symptomatic relief. Results: Mean preoperative body mass index was 38.1 ± 4.9 kg/m2. Anatomic failure of prior fundoplication occurred in 7 patients (25%). The remaining 21 had primary paraesophageal hernia, 3 of which were type 4. Postoperative complications included pulmonary embolism (n = 1), pulmonary decompensation (n = 2), and wound infection (n = 1). Mean hospital stay was 5 ± 3 days. Upper gastrointestinal esophagogram was performed in 21 patients with no immediate recurrence or staple line dehiscence. Mean excess weight loss was 44 ± 25%. All of the patients surveyed experienced near to total resolution of their preoperative symptoms within the first month. At 1 year, symptom scores decreased significantly. At 27 months, however, there was a mild increase in the scores. Return of severe symptoms occurred in 2 patients, both of whom underwent conversion to gastric bypass. Conclusions: Combined laparoscopic paraesophageal hernia repair with longitudinal partial gastrectomy offers a safe, feasible approach to the management of large or recurrent paraesophageal hernia in well-selected obese and morbidly obese patients. Short-term results were promising; however, intermediate results showed increasing rates of reflux symptoms that required

  20. Gastroesophageal Reflux Disease Is Associated With an Increased Rate of Acute Rejection in Lung Transplant Allografts

    PubMed Central

    Shah, N.S.; Force, S.D.; Mitchell, P.O.; Lin, E.; Lawrence, E.C.; Easley, K.; Qian, J.; Ramirez, A.; Neujahr, D.C.; Gal, A.; Leeper, K.; Pelaez, A.

    2012-01-01

    Purpose Gastric fundoplication (GF) for gastroesophageal reflux disease (GERD) may protect against the progression of chronic rejection in lung transplant (LT) recipients. However, the association of GERD with acute rejection episodes (ARE) is uncertain. This study sought to identify if ARE were linked to GERD in LT patients. Methods This single-center retrospective observational study, of patients transplanted from January 1, 2000, to January 31, 2009, correlated results of pH probe testing for GERD with ARE (≥International Society for Heart and Lung Transplantation A1 or B1). We compared the rates of ARE among patients with GERD (DeMeester Score > 14.7) versus without GERD as number of ARE per 1,000 patient-days after LT. Patients undergoing GF prior to LT were excluded. Results The analysis included 60 LT subjects and 9,249 patient-days: 33 with GERD versus 27 without GERD. We observed 51 ARE among 60 LT recipients. The rate of ARE was highest among patients with GERD: 8.49 versus 2.58, an incidence density ratio (IDR) of 3.29 (P = .00016). Upon multivariate negative binomial regression modeling, only GERD was associated with ARE (IDR 2.15; P = .009). Furthermore, GERD was associated with multiple ARE (36.4% vs 0%; P < .0001) and earlier onset compared with patients without GERD: ARE proportion at 2 months was 0.55 versus 0.26 P = .004). Conclusion In LT recipients, GERD was associated with a higher rate, multiple events, and earlier onset of ARE. The efficacy of GF to reduce ARE among patients with GERD needs further evaluation. PMID:20832573

  1. Lower esophageal sphincter injections for the treatment of gastroesophageal reflux disease.

    PubMed

    Watson, Thomas J; Peters, Jeffrey H

    2005-08-01

    . Outcomes to date have been assessed over the short to medium term; long-term outcome studies are lacking. The durability of response, therefore, remains largely unknown, as does the incidence of any long-term complications or side effects. A postmarket study to assess the long-term safety and durability of Enteryx therapy up to 36 months is under way, as required by the FDA, with a target enrollment of 300 patients. Detailed cost analyses have yet to be reported. Such data are important not only for comparing the various endoluminal therapies but also for comparison to standard medical therapy and antireflux surgery. At present, no randomized trials are completed that compare injection therapies to other accepted treatments of GERD. The ability to perform fundoplication safely and effectively after failed LES injection therapy is not well known, in that the number of subsequent surgical cases is small and the results largely anecdotal to date. Likewise, the ability to use LES injection as salvage therapy after failed fundoplication has not been tested. The data regarding endoluminal injection therapies are similar to those after endoscopic plication and radiofrequency application to the LES, in that a definite symptomatic response is observed, but the objective documentation of diminished esophageal acid exposure lags behind. Esophageal acid exposure is normalized in a minority of treated subjects and improved in an additional subgroup, whereas the rate of symptomatic response exceeds these objective improvements. The reasons for this disconnect are the subject of much speculation and controversy. A placebo effect has been discussed, but clearly more factors are at play. Perhaps a study effect also is important, in that patients enrolled in clinical trials for GERD control may be more likely to modify their dietary and lifestyle habits in an effort to bring about symptom relief. Maybe the understanding of the perception of reflux events is lacking, and these endoluminal

  2. Complications after tracheal resection and reconstruction: prevention and treatment

    PubMed Central

    Auchincloss, Hugh G.

    2016-01-01

    Tracheal resection and reconstruction (TRR) and laryngotracheal resection and reconstruction (LTRR) is commonly performed for post-intubation tracheal stenosis, tracheal tumor, idiopathic laryngotracheal stenosis (ILTS), and tracheoesophageal fistula (TEF). Ninety-five percent of patients have a good result from surgery. Complications occur in ~20% of patients, of which half are anastomotic complications. Complications include granulation tissue formation, restenosis of the trachea, anastomotic separation, TEF and tracheoinnominate fistula (TIF), wound infection, laryngeal edema, and glottic dysfunction. Risk factors for anastomotic complication include diabetes, reoperation, previous tracheal appliance, and long-segment tracheal resection. Bronchoscopy should be part of the diagnostic workup when a complication is suspected. Anastomotic separation—the most feared complication of tracheal surgery—may present subtly with stridor and wound infection, or with respiratory distress and extremis. Prompt management is required to prevent devastating consequences. The airway should be secured, bronchoscopy should be performed to address the degree of separation, and the anastomosis should be revised if needed, usually with the addition of t-tube or tracheostomy. Anastomotic complications that are managed aggressively typically yield good results. More than half of such patients will eventually have a satisfactory airway. However, an anastomotic complication is associated with a thirteen-fold increase in the risk of death following tracheal resection. PMID:26981267

  3. Treatment with topical khellin in combination with ultraviolet A or solar-simulated radiation is carcinogenic to lightly pigmented hairless mice.

    PubMed

    Bech-Thomsen, N; Wulf, H C

    1996-01-01

    Khellin is used together with either UVA irradiation or sun exposure in the treatment of vitiligo. The purpose of this study was to investigate the carcinogenic effect of topically applied khellin together with UVA or solar simulated radiation (SSR) in lightly pigmented C3H/Tif mice. For comparison purposes a 0.1% 8-methoxypsoralen (8-MOP) cream was also tested in combination with SSR. Fifty microliters of a 5% khellin cream, a 0.1% 8-MOP cream, or a cream without active substances were spread uniformly on the back of the mice 30 minutes before UVA or SSR irradiation. All mice were irradiated 3 times a week until age or skin tumor development necessitated killing. Treatment with topical khellin and UVA irradiation was carcinogenic to lightly pigmented hairless mice, time to 50% of the mice had developed one tumor (t50) was 507 days. This indicates that the combination of topical khellin and UVA radiation, formerly expected to be rather innocuous, is carcinogenic to mice. Also the combination of khellin and SSR (t50 = 268 days) enhanced skin tumor development significantly compared with control cream and SSR (t50 = 330 days), P < 0.05. In addition, the combination of khellin and SSR was found to have the same carcinogenic effect as treatment with 0.1% 8-MOP and SSR (t50 = 262 days). This study shows that topically applied khellin increases the carcinogenic effect of both UVA and sunlight. PMID:8738715

  4. Design and optimization of a beam shaping assembly for BNCT based on D-T neutron generator and dose evaluation using a simulated head phantom.

    PubMed

    Rasouli, Fatemeh S; Masoudi, S Farhad

    2012-12-01

    A feasibility study was conducted to design a beam shaping assembly for BNCT based on D-T neutron generator. The optimization of this configuration has been realized in different steps. This proposed system consists of metallic uranium as neutron multiplier, TiF(3) and Al(2)O(3) as moderators, Pb as reflector, Ni as shield and Li-Poly as collimator to guide neutrons toward the patient position. The in-air parameters recommended by IAEA were assessed for this proposed configuration without using any filters which enables us to have a high epithermal neutron flux at the beam port. Also a simulated Snyder head phantom was used to evaluate dose profiles due to the irradiation of designed beam. The dose evaluation results and depth-dose curves show that the neutron beam designed in this work is effective for deep-seated brain tumor treatments even with D-T neutron generator with a neutron yield of 2.4×10(12) n/s. The Monte Carlo Code MCNP-4C is used in order to perform these calculations. PMID:23041781

  5. Complications after tracheal resection and reconstruction: prevention and treatment.

    PubMed

    Auchincloss, Hugh G; Wright, Cameron D

    2016-03-01

    Tracheal resection and reconstruction (TRR) and laryngotracheal resection and reconstruction (LTRR) is commonly performed for post-intubation tracheal stenosis, tracheal tumor, idiopathic laryngotracheal stenosis (ILTS), and tracheoesophageal fistula (TEF). Ninety-five percent of patients have a good result from surgery. Complications occur in ~20% of patients, of which half are anastomotic complications. Complications include granulation tissue formation, restenosis of the trachea, anastomotic separation, TEF and tracheoinnominate fistula (TIF), wound infection, laryngeal edema, and glottic dysfunction. Risk factors for anastomotic complication include diabetes, reoperation, previous tracheal appliance, and long-segment tracheal resection. Bronchoscopy should be part of the diagnostic workup when a complication is suspected. Anastomotic separation-the most feared complication of tracheal surgery-may present subtly with stridor and wound infection, or with respiratory distress and extremis. Prompt management is required to prevent devastating consequences. The airway should be secured, bronchoscopy should be performed to address the degree of separation, and the anastomosis should be revised if needed, usually with the addition of t-tube or tracheostomy. Anastomotic complications that are managed aggressively typically yield good results. More than half of such patients will eventually have a satisfactory airway. However, an anastomotic complication is associated with a thirteen-fold increase in the risk of death following tracheal resection. PMID:26981267

  6. GPFA-AB_Phase1RiskAnalysisTask5DataUpload

    DOE Data Explorer

    Teresa E. Jordan

    2015-09-30

    This submission contains information used to compute the risk factors for the GPFA-AB project (DE-EE0006726). The risk factors are natural reservoir quality, thermal resource quality, potential for induced seismicity, and utilization. The methods used to combine the risk factors included taking the product, sum, and minimum of the four risk factors. The files are divided into images, rasters, shapefiles, and supporting information. The image files show what the raster and shapefiles should look like. The raster files contain the input risk factors, calculation of the scaled risk factors, and calculation of the combined risk factors. The shapefiles include definition of the fairways, definition of the US Census Places, the center of the raster cells, and locations of industries. Supporting information contains details of the calculations or processing used in generating the files. An image of the raster will have the same name except *.png as the file ending instead of *.tif. Images with “fairways” or “industries” added to the name are composed of a raster with the relevant shapefile added. The file About_GPFA-AB_Phase1RiskAnalysisTask5DataUpload.pdf contains information the citation, special use considerations, authorship, etc. More details on each file are given in the spreadsheet “list_of_contents.csv” in the folder “SupportingInfo”. Code used to calculate values is available at https://github.com/calvinwhealton/geothermal_pfa under the folder “combining_metrics”.

  7. Preparation of fibrous titania oxynitride - carbon catalyst and oxygen reduction reaction analysis in both acidic and alkaline media

    NASA Astrophysics Data System (ADS)

    Kinumoto, Taro; Sou, Yoshinori; Ono, Kohei; Matsuoka, Miki; Arai, Yasuhiko; Tsumura, Tomoki; Toyoda, Masahiro

    2015-01-01

    A fibrous catalyst of titania oxynitride and carbon is prepared and its catalytic behavior in the oxygen reduction reaction (ORR) are investigated in both HClO4 and KOH aqueous solutions. TiO2 particles are successfully deposited on activated carbon fibers by a liquid phase deposition technique using (NH4)2TiF6 and H3BO3. The catalyst obtained after subsequent ammonia nitridation at 1273 K had a fibrous structure with TiOxNy and TiN components. Interestingly, the product demonstrates catalytic activity for the ORR in not only HClO4 but also KOH aqueous solution. The onset potential in HClO4 solution is assumed to be moderate, at 0.85 V; on the other hand, that in KOH solution is relatively high at 0.95 V. Furthermore, it is considered from the Tafel plot analysis of the KOH solution result that the ORR mechanism follows a peroxide intermediate pathway and the rate-determining step would be a one-electron-transfer reaction to oxygen molecules adsorbed on the active site.

  8. Cytoskeletal protein filamin A is a nucleolar protein that suppresses ribosomal RNA gene transcription.

    PubMed

    Deng, Wensheng; Lopez-Camacho, Cesar; Tang, Jen-Yang; Mendoza-Villanueva, Daniel; Maya-Mendoza, Apolinar; Jackson, Dean A; Shore, Paul

    2012-01-31

    Filamin A (FLNA) is an actin-binding protein with a well-established role in the cytoskeleton, where it determines cell shape and locomotion by cross-linking actin filaments. Mutations in FLNA are associated with a wide range of genetic disorders. Here we demonstrate a unique role for FLNA as a nucleolar protein that associates with the RNA polymerase I (Pol I) transcription machinery to suppress rRNA gene transcription. We show that depletion of FLNA by siRNAs increased rRNA expression, rDNA promoter activity and cell proliferation. Immunodepletion of FLNA from nuclear extracts resulted in a decrease in rDNA promoter-driven transcription in vitro. FLNA coimmunoprecipitated with the Pol I components actin, TIF-IA, and RPA40, and their occupancy of the rDNA promoter was increased in the absence of FLNA in vivo. The FLNA actin-binding domain is essential for the suppression of rRNA expression and for inhibiting recruitment of the Pol I machinery to the rDNA promoter. These findings reveal an additional role for FLNA as a regulator of rRNA gene expression and have important implications for our understanding of the role of FLNA in human disease. PMID:22307607

  9. Quantitative RT-PCR Gene Evaluation and RNA Interference in the Brown Marmorated Stink Bug

    PubMed Central

    Bansal, Raman; Mittapelly, Priyanka; Chen, Yuting; Mamidala, Praveen; Zhao, Chaoyang; Michel, Andy

    2016-01-01

    The brown marmorated stink bug (Halyomorpha halys) has emerged as one of the most important invasive insect pests in the United States. Functional genomics in H. halys remains unexplored as molecular resources in this insect have recently been developed. To facilitate functional genomics research, we evaluated ten common insect housekeeping genes (RPS26, EF1A, FAU, UBE4A, ARL2, ARP8, GUS, TBP, TIF6 and RPL9) for their stability across various treatments in H. halys. Our treatments included two biotic factors (tissues and developmental stages) and two stress treatments (RNAi injection and starvation). Reference gene stability was determined using three software algorithms (geNorm, NormFinder, BestKeeper) and a web-based tool (RefFinder). The qRT-PCR results indicated ARP8 and UBE4A exhibit the most stable expression across tissues and developmental stages, ARL2 and FAU for dsRNA treatment and TBP and UBE4A for starvation treatment. Following the dsRNA treatment, all genes except GUS showed relatively stable expression. To demonstrate the utility of validated reference genes in accurate gene expression analysis and to explore gene silencing in H. halys, we performed RNAi by administering dsRNA of target gene (catalase) through microinjection. A successful RNAi response with over 90% reduction in expression of target gene was observed. PMID:27144586

  10. CytometryML: a markup language for analytical cytology

    NASA Astrophysics Data System (ADS)

    Leif, Robert C.; Leif, Stephanie H.; Leif, Suzanne B.

    2003-06-01

    Cytometry Markup Language, CytometryML, is a proposed new analytical cytology data standard. CytometryML is a set of XML schemas for encoding both flow cytometry and digital microscopy text based data types. CytometryML schemas reference both DICOM (Digital Imaging and Communications in Medicine) codes and FCS keywords. These schemas provide representations for the keywords in FCS 3.0 and will soon include DICOM microscopic image data. Flow Cytometry Standard (FCS) list-mode has been mapped to the DICOM Waveform Information Object. A preliminary version of a list mode binary data type, which does not presently exist in DICOM, has been designed. This binary type is required to enhance the storage and transmission of flow cytometry and digital microscopy data. Index files based on Waveform indices will be used to rapidly locate the cells present in individual subsets. DICOM has the advantage of employing standard file types, TIF and JPEG, for Digital Microscopy. Using an XML schema based representation means that standard commercial software packages such as Excel and MathCad can be used to analyze, display, and store analytical cytometry data. Furthermore, by providing one standard for both DICOM data and analytical cytology data, it eliminates the need to create and maintain special purpose interfaces for analytical cytology data thereby integrating the data into the larger DICOM and other clinical communities. A draft version of CytometryML is available at www.newportinstruments.com.

  11. Structural evidence of [Rh(Thio) 6] 3+ and [Rh(Thio) 5Cl] 2+ cations in three novel ionic systems based on Co(III) dioximates

    NASA Astrophysics Data System (ADS)

    Bourosh, Paulina N.; Coropceanu, Eduard B.; Rija, Andrei P.; Bologa, Olga A.; Gdaniec, Maria; Bulhac, Ion I.

    2011-07-01

    Multicomponent mixed metal ionic-type dioximates, [Со(DH) 2(Thio) 2][Rh(Thio) 6][BF 4] 4 ( 1), [Со(DH) 2(Thio) 2][Rh(Thio) 6][TiF 6] 2·H 2O ( 2) and [Со(NioxH) 2(Thio) 2] 2[Rh(Thio) 5Cl][TiF 6] 2·CH 3OH·3H 2O ( 3), where DH 2 is dimethylglyoxime, NioxH 2 is 1.2-cyclohexanedionedioxime, and Thio is thiourea, were synthesized and their structures were determined by an X-ray method. Compounds 1-3 consist of two different mononuclear coordination cations with cobalt(III) and rhodium(III) as octahedrally coordinated metal centers and fluorine-containing anions as counterions. In the studied systems, Rh(III) mostly binds Thio ligands instead of dioximes, while a typical bis-dioximate in trans geometry is formed by Co(III) with two Thio ligands placed in axial positions. A structural characterization of coordination cations [Rh(Thio) 6] 3+ and [Rh(Thio) 5Cl] 2+ is given for the first time. The interactions and arrangement of the components in crystals 1-3 are discussed.

  12. Characteristics and anticorrosion performance of Fe-doped TiO2 films by liquid phase deposition method

    NASA Astrophysics Data System (ADS)

    Liu, Yu; Xu, Chao; Feng, ZuDe

    2014-09-01

    Fe-doped TiO2 thin films were fabricated by liquid phase deposition (LPD) method, using Fe(III) nitrate as both Fe element source and fluoride scavenger instead of commonly-used boric acid (H3BO3). Scanning electron microscopy (SEM), X-ray diffraction (XRD), and UV-vis spectrum were employed to examine the effects of Fe element on morphology, structure and optical characteristics of TiO2 films. The as-prepared films were served as photoanode applied to photogenerated cathodic protection of SUS304 stainless steel (304SS). It was observed that the photoelectrochemical properties of the as-prepared films were enhanced with the addition of Fe element compared to the undoped TiO2 film. The highest photoactivity was achieved for Ti13Fe (Fe/Ti = 3 molar ratio) film prepared in precursor bath containing 0.02 M TiF4 + 0.06 M Fe(NO3)3 under white-light illumination. The effective anticorrosion behaviors can be attributed to the Fe element incorporation which decreases the probability of photogenerated charge-carrier recombination and extends the light response range of Fe-doped TiO2 films appeared to visible-light region.

  13. TiO2 hierarchical nanostructures: Hydrothermal fabrication and application in dye-sensitized solar cells

    NASA Astrophysics Data System (ADS)

    Liang, Jia; Zhang, Gengmin; Yang, Jin; Sun, Wentao; Shi, Mingji

    2015-01-01

    Arrays of TiO2 hierarchical nanostructures that consisted of rutile nanorods and anatase branches were hydrothermally fabricated and employed as photoanodes in dye-sensitized solar cells (DSSCs). Each hierarchical nanostructure array was attained in two steps. First, a primary nanorod array was synthesized in aqueous solutions of hydrochloric acid (HCl) and tetrabutyl titanate (C16H36O4Ti); subsequently, secondary branches were grown on the nanorods in aqueous solutions of ammonium hexafluorotitanate ((NH4)2TiF6) and boric acid (H3BO3). The secondary anatase branches filled part of the space among the primary rutile nanorods and gave rise to a larger surface area. Light-harvesting capability of the DSSCs with TiO2 hierarchical nanostructures as photoanodes was appreciably improved because more dye molecules could be loaded on the photoanodes and more light could be scattered inside the DSSCs. Therefore, the conversion efficiencies of the DSSCs were doubled by replacing the photoanode of primary TiO2 nanorod array with the photoanodes of TiO2 hierarchical nanostructure arrays. Furthermore, in order to reach a compromise between the photoanode surface area and the inter-nanorod space volume, the growth time of the secondary TiO2 anatase branches was optimized.

  14. The effect of active galactic nuclei feedback on the halo mass function

    NASA Astrophysics Data System (ADS)

    Cui, Weiguang; Borgani, Stefano; Murante, Giuseppe

    2014-06-01

    We investigate baryon effects on the halo mass function (HMF), with emphasis on the role played by active galactic nuclei (AGN) feedback. Haloes are identified with both friends-of-friends (FoF) and spherical overdensity (SO) algorithms. We embed the standard SO algorithm into a memory-controlled frame program and present the Python spherIcAl Overdensity code - PIAO (Chinese character: tif"/>). For both FoF and SO haloes, the effect of AGN feedback is that of suppressing the HMFs to a level even below that of dark matter (DM) simulations. The ratio between the HMFs in the AGN and in the DM simulations is ˜0.8 at overdensity Δc = 500, a difference that increases at higher overdensity Δc = 2500, with no significant redshift and mass dependence. A decrease of the halo masses ratio with respect to the DM case induces the decrease of the HMF in the AGN simulation. The shallower inner density profiles of haloes in the AGN simulation witnesses that mass reduction is induced by the sudden displacement of gas induced by thermal AGN feedback. We provide fitting functions to describe halo mass variations at different overdensities, which can recover the HMFs with a residual random scatter ≲5 per cent for halo masses larger than 1013 h-1 M⊙.

  15. Effect of co-products of enzyme-assisted aqueous extraction of soybeans on ethanol production in dry-grind corn fermentation.

    PubMed

    Sekhon, Jasreen K; Jung, Stephanie; Wang, Tong; Rosentrater, Kurt A; Johnson, Lawrence A

    2015-09-01

    Enzyme-assisted aqueous extraction processing (EAEP) is an environmentally-friendly alternative to solvent and mechanical oil extraction methods, and can achieve ∼ 97% oil recovery from soybeans. The present study utilized soy skim (protein rich) and insoluble fiber (IF; carbohydrate rich), both co-products of EAEP, in dry-grind corn fermentation. The effects of adding soy skim and untreated IF (UIF), either separately or together, and adding pretreated IF (TIF), on ethanol production were investigated. Maximum ethanol production was achieved when UIF and skim were slurried together (corn-to-UIF ratio 1:0.16; skim-to-UIF ratio 6.5:1) and when fiber-hydrolyzing enzymes were added to corn fermentation. This modification to corn fermentation increased ethanol yield by 20%, ethanol production rate by 3%, and decreased fermentation time by 38 h compared to corn-only fermentation. An attempt was also made to utilize pentoses (from soy skim and IF) in integrated corn-soy fermentation slurry by an additional Escherichia coli KO11 fermentation step. PMID:26080102

  16. Cloud Optimized Image Format and Compression

    NASA Astrophysics Data System (ADS)

    Becker, P.; Plesea, L.; Maurer, T.

    2015-04-01

    Cloud based image storage and processing requires revaluation of formats and processing methods. For the true value of the massive volumes of earth observation data to be realized, the image data needs to be accessible from the cloud. Traditional file formats such as TIF and NITF were developed in the hay day of the desktop and assumed fast low latency file access. Other formats such as JPEG2000 provide for streaming protocols for pixel data, but still require a server to have file access. These concepts no longer truly hold in cloud based elastic storage and computation environments. This paper will provide details of a newly evolving image storage format (MRF) and compression that is optimized for cloud environments. Although the cost of storage continues to fall for large data volumes, there is still significant value in compression. For imagery data to be used in analysis and exploit the extended dynamic range of the new sensors, lossless or controlled lossy compression is of high value. Compression decreases the data volumes stored and reduces the data transferred, but the reduced data size must be balanced with the CPU required to decompress. The paper also outlines a new compression algorithm (LERC) for imagery and elevation data that optimizes this balance. Advantages of the compression include its simple to implement algorithm that enables it to be efficiently accessed using JavaScript. Combing this new cloud based image storage format and compression will help resolve some of the challenges of big image data on the internet.

  17. Co-sputtered metal and polymer nanocomposite films and their electrical responses for gas sensing application

    NASA Astrophysics Data System (ADS)

    Rujisamphan, Nopporn; Murray, Roy E.; Deng, Fei; Supasai, Thidarat

    2016-04-01

    Titanium and polytetrafluoroethylene (Ti-PTFE) nanocomposite thin films were successfully fabricated on glass substrates using a combination of dc and rf magnetron sputtering. When the Ti-PTFE composites were prepared at below the percolation threshold i.e. 27% metal volume filling (F), Ti clusters with the average sizes of 7 ± 2 nm were found. As the Ti content was increased above the percolation threshold (F = 62%), the connecting regions of Ti were formed within the polymer matrix and the electrical property changed rapidly from insulator-like to metal-like properties. The Ti-PTFE composites prepared near the percolation threshold showed the electrical response to different volatile organic compounds (VOCs). The sensitivity significantly depended upon the VOCs concentrations. These composites devices showed the presence of distinct chemical bonds of Csbnd C, Csbnd CF, Csbnd F and CF2 and TiF in TiO2 on the surface as investigated by X-ray photoelectron spectroscopy (XPS) while the surface morphology, characterized by atomic force microscopy (AFM) presented the root mean square (RMS) surface roughness of 13.3 nm. Cross-section transmission electron microscopy (TEM) images of the device revealed Ti clusters dispersed in PTFE matrix with particle sizes varied between 10 nm and 30 nm.

  18. Basolateral sorting of chloride channel 2 is mediated by interactions between a dileucine motif and the clathrin adaptor AP-1

    PubMed Central

    de la Fuente-Ortega, Erwin; Gravotta, Diego; Bay, Andres Perez; Benedicto, Ignacio; Carvajal-Gonzalez, Jose Maria; Lehmann, Guillermo L.; Lagos, Carlos F.; Rodríguez-Boulan, Enrique

    2015-01-01

    In spite of the many key cellular functions of chloride channels, the mechanisms that mediate their subcellular localization are largely unknown. ClC-2 is a ubiquitous chloride channel usually localized to the basolateral domain of epithelia that regulates cell volume, ion transport, and acid–base balance; mice knocked out for ClC-2 are blind and sterile. Previous work suggested that CLC-2 is sorted basolaterally by TIFS812LL, a dileucine motif in CLC-2's C-terminal domain. However, our in silico modeling of ClC-2 suggested that this motif was buried within the channel's dimerization interface and identified two cytoplasmically exposed dileucine motifs, ESMI623LL and QVVA635LL, as candidate sorting signals. Alanine mutagenesis and trafficking assays support a scenario in which ESMI623LL acts as the authentic basolateral signal of ClC-2. Silencing experiments and yeast three-hybrid assays demonstrated that both ubiquitous (AP-1A) and epithelium-specific (AP-1B) forms of the tetrameric clathrin adaptor AP-1 are capable of carrying out basolateral sorting of ClC-2 through interactions of ESMI623LL with a highly conserved pocket in their γ1-σ1A hemicomplex. PMID:25739457

  19. Effects of heavy-atom salts on the luminescence properties of Tetrol I-1 on [alpha]-cyclodextrin/salt matrices

    SciTech Connect

    Corley, J.; Hurtubise, R.J. )

    1994-06-01

    Benzo([alpha])pyrene [B(a)P] is one of the most widely studied polyaromatic hydrocarbons. In the human body and in lower animals, B(a)P can become chemically bonded to DNA. Tetrols are the products obtained from the hydrolysis of B(a)P-DNA adducts. It has been proposed that the amount of tetrols detected in human body fluids can be used as a measure of the amount of B(a)P-DNA adducts present in the body. The effects of several heavy-atom salts on the solid-matrix fluorescence and phosphorescence properties of the tetrols were investigated. TINO[sub 3] and TIF were very useful in enhancing the room-temperature phosphorescence (RTP) of the tetrols. For tetrol I-1 on 1:1:8 [alpha]-cyclodextrin:TINO[sub 3]:NaNO[sub 3], the limit of detection was 0.38 femtomole/mg. The RTP approach with the 1:1:8 [alpha]-cyclodextrin:TINO[sub 3]:NaNO[sub 3] matrix would be useful for detecting subfemtomole quantities of the tetrols of B(a)P-DNA adducts from biological samples.

  20. Surficial geologic map of the Heath-Northfield-Southwick-Hampden 24-quadrangle area in the Connecticut Valley region, west-central Massachusetts

    USGS Publications Warehouse

    Stone, Janet R.; DiGiacomo-Cohen, Mary L.

    2010-01-01

    The surficial geologic map layer shows the distribution of nonlithified earth materials at land surface in an area of 24 7.5-minute quadrangles (1,238 mi2 total) in west-central Massachusetts. Across Massachusetts, these materials range from a few feet to more than 500 ft in thickness. They overlie bedrock, which crops out in upland hills and as resistant ledges in valley areas. The geologic map differentiates surficial materials of Quaternary age on the basis of their lithologic characteristics (such as grain size and sedimentary structures), constructional geomorphic features, stratigraphic relationships, and age. Surficial materials also are known in engineering classifications as unconsolidated soils, which include coarse-grained soils, fine-grained soils, and organic fine-grained soils. Surficial materials underlie and are the parent materials of modern pedogenic soils, which have developed in them at the land surface. Surficial earth materials significantly affect human use of the land, and an accurate description of their distribution is particularly important for assessing water resources, construction aggregate resources, and earth-surface hazards, and for making land-use decisions. This work is part of a comprehensive study to produce a statewide digital map of the surficial geology at a 1:24,000-scale level of accuracy. This report includes explanatory text, quadrangle maps at 1:24,000 scale (PDF files), GIS data layers (ArcGIS shapefiles), metadata for the GIS layers, scanned topographic base maps (TIF), and a readme.txt file.

  1. Electrospinning processed nanofibrous TiO(2) membranes for photovoltaic applications.

    PubMed

    Onozuka, Katsuhiro; Ding, Bin; Tsuge, Yosuke; Naka, Takayuki; Yamazaki, Michiyo; Sugi, Shinichiro; Ohno, Shingo; Yoshikawa, Masato; Shiratori, Seimei

    2006-02-28

    We have recently fabricated dye-sensitized solar cells (DSSCs) comprising nanofibrous TiO(2) membranes as electrode materials. A thin TiO(2) film was pre-deposited on fluorine doped tin oxide (FTO) coated conducting glass substrate by immersion in TiF(4) aqueous solution to reduce the electron back-transfer from FTO to the electrolyte. The composite polyvinyl acetate (PVac)/titania nanofibrous membranes can be deposited on the pre-deposited thin TiO(2) film coated FTO by electrospinning of a mixture of PVac and titanium isopropoxide in N,N-dimethylformamide (DMF). The nanofibrous TiO(2) membranes were obtained by calcining the electrospun composite nanofibres of PVac/titania as the precursor. Spectral sensitization of the nanofibrous TiO(2) membranes was carried out with a ruthenium (II) complex, cis-dithiocyanate-N,N(')-bis(2,2(')-bipyridyl-4,4(')-dicarboxylic acid) ruthenium (II) dihydrate. The results indicated that the photocurrent and conversion efficiency of electrodes can be increased with the addition of the pre-deposited TiO(2) film and the adhesion treatment using DMF. Additionally, the dye loading, photocurrent, and efficiency of the electrodes were gradually increased by increasing the average thickness of the nanofibrous TiO(2) membranes. The efficiency of the fibrous TiO(2) photoelectrode with the average membrane thickness of 3.9 µm has a maximum value of 4.14%. PMID:21727376

  2. Electrospinning processed nanofibrous TiO2 membranes for photovoltaic applications

    NASA Astrophysics Data System (ADS)

    Onozuka, Katsuhiro; Ding, Bin; Tsuge, Yosuke; Naka, Takayuki; Yamazaki, Michiyo; Sugi, Shinichiro; Ohno, Shingo; Yoshikawa, Masato; Shiratori, Seimei

    2006-02-01

    We have recently fabricated dye-sensitized solar cells (DSSCs) comprising nanofibrous TiO2 membranes as electrode materials. A thin TiO2 film was pre-deposited on fluorine doped tin oxide (FTO) coated conducting glass substrate by immersion in TiF4 aqueous solution to reduce the electron back-transfer from FTO to the electrolyte. The composite polyvinyl acetate (PVac)/titania nanofibrous membranes can be deposited on the pre-deposited thin TiO2 film coated FTO by electrospinning of a mixture of PVac and titanium isopropoxide in N,N-dimethylformamide (DMF). The nanofibrous TiO2 membranes were obtained by calcining the electrospun composite nanofibres of PVac/titania as the precursor. Spectral sensitization of the nanofibrous TiO2 membranes was carried out with a ruthenium (II) complex, cis-dithiocyanate-N,N'-bis(2,2'-bipyridyl-4,4'-dicarboxylic acid) ruthenium (II) dihydrate. The results indicated that the photocurrent and conversion efficiency of electrodes can be increased with the addition of the pre-deposited TiO2 film and the adhesion treatment using DMF. Additionally, the dye loading, photocurrent, and efficiency of the electrodes were gradually increased by increasing the average thickness of the nanofibrous TiO2 membranes. The efficiency of the fibrous TiO2 photoelectrode with the average membrane thickness of 3.9 µm has a maximum value of 4.14%.

  3. Flared landing approach flying qualities. Volume 2: Appendices

    NASA Technical Reports Server (NTRS)

    Weingarten, Norman C.; Berthe, Charles J., Jr.; Rynaski, Edmund G.; Sarrafian, Shahan K.

    1986-01-01

    An in-flight research study was conducted utilizing the USAF/Total In-Flight Simulator (TIFS) to investigate longitudinal flying qualities for the flared landing approach phase of flight. A consistent set of data were generated for: determining what kind of command response the pilot prefers/requires in order to flare and land an aircraft with precision, and refining a time history criterion that took into account all the necessary variables and the characteristics that would accurately predict flying qualities. Seven evaluation pilots participated representing NASA Langley, NASA Dryden, Calspan, Boeing, Lockheed, and DFVLR (Braunschweig, Germany). The results of the first part of the study provide guidelines to the flight control system designer, using MIL-F-8785-(C) as a guide, that yield the dynamic behavior pilots prefer in flared landings. The results of the second part provide the flying qualities engineer with a derived flying qualities predictive tool which appears to be highly accurate. This time-domain predictive flying qualities criterion was applied to the flight data as well as six previous flying qualities studies, and the results indicate that the criterion predicted the flying qualities level 81% of the time and the Cooper-Harper pilot rating, within + or - 1%, 60% of the time.

  4. Map Showing Inventory and Regional Susceptibility for Holocene Debris Flows, and Related Fast-Moving Landslides in the Conterminous United States

    USGS Publications Warehouse

    Brabb, Earl E.; Colgan, Joseph P.; Best, Timothy C.

    2000-01-01

    Introduction Debris flows, debris avalanches, mud flows and lahars are fast-moving landslides that occur in a wide variety of environments throughout the world. They are particularly dangerous to life and property because they move quickly, destroy objects in their paths, and often strike without warning. This map represents a significant effort to compile the locations of known debris flows in United Stated and predict where future flows might occur. The files 'dfipoint.e00' and 'dfipoly.e00' contain the locations of over 6600 debris flows from published and unpublished sources. The locations are referenced by numbers that correspond to entries in a bibliography, which is part of the pamphlet 'mf2329pamphlet.pdf'. The areas of possible future debris flows are shown in the file 'susceptibility.tif', which is a georeferenced TIFF file that can be opened in an image editing program or imported into a GIS system like ARC/INFO. All other databases are in ARC/INFO export (.e00) format.

  5. Single electron capture in fast ion-atom collisions

    NASA Astrophysics Data System (ADS)

    Milojević, Nenad

    2014-12-01

    Single-electron capture cross sections in collisions between fast bare projectiles and heliumlike atomic systems are investigated by means of the four-body boundary-corrected first Born (CB1-4B) approximation. The prior and post transition amplitudes for single charge exchange encompassing symmetric and asymmetric collisions are derived in terms of twodimensional real integrals in the case of the prior form and five-dimensional quadratures for the post form. The dielectronic interaction V12 = 1/r12 = 1/|r1 - r2| explicitly appears in the complete perturbation potential Vf of the post transition probability amplitude T+if. An illustrative computation is performed involving state-selective and total single capture cross sections for the p - He (prior and post form) and He2+, Li3+Be4+B5+C6+ - He (prior form) collisions at intermediate and high impact energies. We have also studied differential cross sections in prior and post form for single electron transfer from helium by protons. The role of dynamic correlations is examined as a function of increased projectile energy. Detailed comparisons with the measurements are carried out and the obtained theoretical cross sections are in reasonable agreement with the available experimental data.

  6. Concerted global effort to combat sickle cell disease: the first global congress on sickle cell disease in Accra, Ghana.

    PubMed

    Odame, Isaac; Kulkarni, Roshni; Ohene-Frempong, Kwaku

    2011-12-01

    The First Global Congress on Sickle Cell Disease was held in Accra, Ghana, on July 20-23, 2010, to commemorate 100 years since the first published report of sickle cell disease (SCD). The idea of the Global Congress was conceived following the 2007 meeting in Nicosia, Cyprus, jointly organized by the WHO and the Thalassaemia International Federation (TIF), which recommended that groups working in SCD around the world needed to consolidate efforts into a stronger and more unified umbrella organization. The need for a united global effort received further endorsements at the 2009 International Symposium and Workshop held in Cotonou, Benin, and the 2009 inaugural commemoration of World Sickle Cell Disease Awareness Day, UN Headquarters, New York, New York. The overall goals of the Global Congress were to promote international cooperation and foster collaboration in advancing clinical care and furthering basic and applied research in SCD. Issues covered at the conference included health education, psychosocial needs, public health, medical care, research, program development, and development of international community-based organizations. The Congress participants included medical and research scientists, public health officials, community-based SCD organizations, other nongovernmental organizations, and people with SCD and their families. The Congress concluded with a call on patients and families affected by SCD, as well as advocacy groups, healthcare professionals, scientists, and national governments working to combat SCD to endorse the formation of the World Sickle Cell Disease Federation. PMID:22099367

  7. A Combination of CRISPR/Cas9 and Standardized RNAi as a Versatile Platform for the Characterization of Gene Function

    PubMed Central

    Wissel, Sebastian; Kieser, Anja; Yasugi, Tetsuo; Duchek, Peter; Roitinger, Elisabeth; Gokcezade, Joseph; Steinmann, Victoria; Gaul, Ulrike; Mechtler, Karl; Förstemann, Klaus; Knoblich, Jürgen A.; Neumüller, Ralph A.

    2016-01-01

    Traditional loss-of-function studies in Drosophila suffer from a number of shortcomings, including off-target effects in the case of RNA interference (RNAi) or the stochastic nature of mosaic clonal analysis. Here, we describe minimal in vivo GFP interference (miGFPi) as a versatile strategy to characterize gene function and to conduct highly stringent, cell type-specific loss-of-function experiments in Drosophila. miGFPi combines CRISPR/Cas9-mediated tagging of genes at their endogenous locus with an immunotag and an exogenous 21 nucleotide RNAi effector sequence with the use of a single reagent, highly validated RNAi line targeting this sequence. We demonstrate the utility and time effectiveness of this method by characterizing the function of the Polymerase I (Pol I)-associated transcription factor Tif-1a, and the previously uncharacterized gene MESR4, in the Drosophila female germline stem cell lineage. In addition, we show that miGFPi serves as a powerful technique to functionally characterize individual isoforms of a gene. We exemplify this aspect of miGFPi by studying isoform-specific loss-of-function phenotypes of the longitudinals lacking (lola) gene in neural stem cells. Altogether, the miGFPi strategy constitutes a generalized loss-of-function approach that is amenable to the study of the function of all genes in the genome in a stringent and highly time effective manner. PMID:27280787

  8. Time-Series Photographs of the Sea Floor in Western Massachusetts Bay: June 1998 to May 1999

    USGS Publications Warehouse

    Butman, Bradford; Alexander, P. Soupy; Bothner, Michael H.

    2004-01-01

    This report presents time-series photographs of the sea floor obtained from an instrumented tripod deployed at Site A in western Massachusetts Bay (42? 22.6' N., 70? 47.0' W., 30 m water depth, figure 1) from June 1998 through May 1999. Site A is approximately 1 km south of an ocean outfall that began discharging treated sewage effluent from the Boston metropolitan area into Massachusetts Bay in September 2000. Time-series photographs and oceanographic observations were initiated at Site A in December 1989 and are anticipated to continue to September 2005. This one of a series of reports that present these images in digital form. The objective of these reports is to enable easy and rapid viewing of the photographs and to provide a medium-resolution digital archive. The images, obtained every 4 hours, are presented as a movie (in .avi format, which may be viewed using an image viewer such as QuickTime or Windows Media Player) and as individual images (.tif format). The images provide time-series observations of changes of the sea floor and near-bottom water properties.

  9. Time-Series Photographs of the Sea Floor in Western Massachusetts Bay: May to September 1999; May to September 2000; and October 2001 to February 2002

    USGS Publications Warehouse

    Butman, Bradford; Alexander, P. Soupy; Bothner, Michael H.

    2004-01-01

    This report presents time-series photographs of the sea floor obtained from an instrumented tripod deployed at Site A in western Massachusetts Bay (42? 22.6' N., 70? 47.0' W., 30 m water depth, figure 1) from May 1999 to September 1999; May 2000 to September 2000; and October 2001 to February 2002. Site A is approximately 1 km south of an ocean outfall that began discharging treated sewage effluent from the Boston metropolitan area into Massachusetts Bay in September 2000. Time-series photographs and oceanographic observations were initiated at Site A in December 1989 and are anticipated to continue to September 2005. This one of a series of reports that present these images in digital form. The objective of these reports is to enable easy and rapid viewing of the photographs and to provide a medium-resolution digital archive. The images, obtained every 4 hours, are presented as a movie (in .avi format, which may be viewed using an image viewer such as QuickTime or Windows Media Player) and as individual images (.tif format). The images provide time-series observations of changes of the sea floor and near-bottom water properties.

  10. Time-Series Photographs of the Sea Floor in Western Massachusetts Bay: June 1997 to June 1998

    USGS Publications Warehouse

    Butman, Bradford; Alexander, P. Soupy; Bothner, Michael H.

    2004-01-01

    This report presents time-series photographs of the sea floor obtained from an instrumented tripod deployed at Site A in western Massachusetts Bay (42? 22.6' N., 70? 47.0' W., 30 m water depth, figure 1) from June 1997 through June 1998. Site A is approximately 1 km south of an ocean outfall that began discharging treated sewage effluent from the Boston metropolitan area into Massachusetts Bay in September 2000. Time-series photographs and oceanographic observations were initiated at Site A in December 1989 and are anticipated to continue to September 2005. This is the first in a series of reports planned to summarize and distribute these images in digital form. The objective of these reports is to enable easy and rapid viewing of the photographs and to provide a medium-resolution digital archive. The images, obtained every 4 hours, are presented as a movie (in .avi format, which may be viewed using an image viewer such as QuickTime or Windows Media Player) and as individual images (.tif format). The images provide time-series observations of changes of the sea floor and near-bottom water properties.

  11. In vivo estimation of pigmentation in ultraviolet-exposed hairless mice.

    PubMed

    Hansen, A B; Bech-Thomsen, N; Wulf, H C

    1995-02-01

    A new in vivo method of visual scoring of pigmentation in hairless hr/hr mice with a C3H/Tif background is described. The mice were placed under a bank of 6 Philips TL08 fluorescent ultraviolet A (UVA) tubes in a dark room, and the pigmentation of the skin was compared with a Kodak Gray Scale with 20 different shades from white to black. The radiation from the tubes changed both the color of the back of the mouse and the gray scale into purple hues. The purple color of the back of each mouse could then be classified as one of 20 shades on the gray scale. An experiment was conducted exposing 3 groups of 20 mice to different doses of UV radiation from Philips TL01 tubes. One group of 20 mice was not irradiated and served as control. The pigmentation of each mouse was scored by one investigator every 2-3 weeks. After a few weeks of exposure a clear distinction between the groups was seen. To evaluate the inter- and intrapersonal variation of the method, 30 mice with various degrees of pigmentation were scored independently and blindly by two investigators. This was done twice during the study with a few days' interval. No interpersonal difference was found, but one investigator scored differently the first and second time by only 0.5 points. The described method provides a reproducible in vivo method, with very good discrimination, for estimation of pigmentation in hairless mice. PMID:7654561

  12. Functional analysis of the uL11 protein impact on translational machinery.

    PubMed

    Wawiórka, Leszek; Molestak, Eliza; Szajwaj, Monika; Michalec-Wawiórka, Barbara; Boguszewska, Aleksandra; Borkiewicz, Lidia; Liudkovska, Vladyslava; Kufel, Joanna; Tchórzewski, Marek

    2016-04-17

    The ribosomal GTPase associated center constitutes the ribosomal area, which is the landing platform for translational GTPases and stimulates their hydrolytic activity. The ribosomal stalk represents a landmark structure in this center, and in eukaryotes is composed of uL11, uL10 and P1/P2 proteins. The modus operandi of the uL11 protein has not been exhaustively studied in vivo neither in prokaryotic nor in eukaryotic cells. Using a yeast model, we have brought functional insight into the translational apparatus deprived of uL11, filling the gap between structural and biochemical studies. We show that the uL11 is an important element in various aspects of 'ribosomal life'. uL11 is involved in 'birth' (biogenesis and initiation), by taking part in Tif6 release and contributing to ribosomal subunit-joining at the initiation step of translation. uL11 is particularly engaged in the 'active life' of the ribosome, in elongation, being responsible for the interplay with eEF1A and fidelity of translation and contributing to a lesser extent to eEF2-dependent translocation. Our results define the uL11 protein as a critical GAC element universally involved in trGTPase 'productive state' stabilization, being primarily a part of the ribosomal element allosterically contributing to the fidelity of the decoding event. PMID:26939941

  13. An evaluation on the design of beam shaping assembly based on the D-T reaction for BNCT

    NASA Astrophysics Data System (ADS)

    Asnal, M.; Liamsuwan, T.; Onjun, T.

    2015-05-01

    Boron Neutron Capture Therapy (BNCT) can be achieved by using a compact neutron generator such as a compact D-T neutron source, in which neutron energy must be in the epithermal energy range with sufficient flux. For these requirements, a Beam Shaping Assembly (BSA) is needed. In this paper, three BSA designs based on the D-T reaction for BNCT are discussed. It is found that the BSA configuration designed by Rasouli et al. satisfies all of the International Atomic Energy Agency (IAEA) criteria. It consists of 14 cm uranium as multiplier, 23 cm TiF3 and 36 cm Fluental as moderator, 4 cm Fe as fast neutron filter, 1 mm Li as thermal neutron filter, 2.6 cm Bi as gamma ray filter, and Pb as collimator and reflector. It is also found that use of specific filters is important for removing the fast and thermal neutrons and gamma contamination. Moreover, an appropriate neutron source plays a key role in providing a proper epithermal flux.

  14. Safety evaluation of cosmetics in the EU. Reality and challenges for the toxicologist.

    PubMed

    Pauwels, Marleen; Rogiers, Vera

    2004-06-15

    Council Directive 76/768/EEC, its seven amendments and 30 adaptations to technical progress form the basis of the cosmetic EU legislation today. There are actually four key principles for safety in the cosmetic legislation. (i) The full responsibility for the safety of cosmetics for human health is placed on the manufacturer, first importer in the EU or marketer. (ii) The safety evaluation of finished products is based on safety of individual ingredients, more specifically on their chemical structure, toxicological profile and their level of exposure. (iii) A compilation of information on each cosmetic product (dossier) must be kept readily available for inspection by the competent authorities of the Member State concerned. This information source, usually called a technical information file (TIF) or product information file/requirements (PIF(R)), contains, as the most important part, the safety assessment of the product undersigned by a competent safety assessor. (iv) The use of validated replacement alternative methods instead of animal testing forms the 4th key principle for safety of cosmetic products on the EU market. The 7th amendment imposes strict deadlines for the abolition of animal in vivo studies on cosmetic ingredients. These legal requirements induce a number of important challenges for the cosmetic industry and more specifically for the toxicologist involved as safety assessor. PMID:15177635

  15. Fast Camera Movies of NSTX Plasmas

    DOE Data Explorer

    Maqueda, Ricky; Wurden, Glenn

    The National Spherical Torus Experiment (NSTX) is an innovative magnetic fusion device that is being used to study the physics principles of spherically shaped plasmas -- hot ionized gases in which nuclear fusion will occur under the appropriate conditions of temperature, density, and confinement in a magnetic field. Fusion is the energy source of the Sun and all the stars. Scientists believe it can provide an inexhaustible, safe, and environmentally attractive source. NSTX was constructed by the Princeton Plasma Physics Laboratory (PPPL) in conjunction with Oak Ridge National Laboratory, Columbia University, and the University of Washington Seattle. The original TIF images recorded by the KODAK digital camera (i.e., "raw data") are available, using the contact information given on the same web page that provides access to these fast camera movies. MPEG clips are organized under the following headings: • Gas Puff Imaging (GPI) diagnostic • GPI experiments • H-modes (longer) • H-modes (short) • Coaxial Helicity Injection experiments More than 100 MPEGS dating back to 1999 are available for public access.

  16. Preparation of antibacterial composite material of natural rubber particles coated with silica and titania

    NASA Astrophysics Data System (ADS)

    Wisutiratanamanee, Apisit; Poompradub, Sirilux; Poochinda, Kunakorn

    2014-06-01

    Silica coating, followed by titania coating, was performed over spray-dried natural rubber (NR) compound for physical and anti-bacterial characterizations. Titania has a strong photo-oxidative catalytic property, which can disinfect bacteria, but may degrade NR. Therefore, silica coating was intended to form a barrier between NR and titania. First, NR particles were prepared by spray-drying of NR compound latex, formulated for household glove products, mixed with sodium dodecyl sulfate (SDS) to reduce particle agglomeration. The factorial experimental design was employed to investigate the effects of nozzle flow rate (500-700 Lh-1), inlet air temperature (110-150 °C), SDS content (35-55 phr) and mass flow rate (1.2-1.7 g rubber/min) on NR yield and moisture content. Then, the NR compound particles prepared at the optimum condition were coated with silica, using tetraethoxysilane (TEOS) as the precursor, by chemical vapor deposition (CVD) at 60 °C for 2-48 hours. Next, the particles were coated with titania using titanium tetrafluoride (TiF4) by liquid phase deposition (LPD) at 60 ºC for 4-8 hours. The NR composites were characterized for surface morphology by SEM, silica and titania content by TGA and EDX. The NR composites were found to cause more than 99% reduction of Escherichia coli and Staphylococcus aureus under 1-hour exposure to natural light.

  17. Myositis-specific autoantibodies: an important tool to support diagnosis of myositis.

    PubMed

    Betteridge, Z; McHugh, N

    2016-07-01

    The idiopathic inflammatory myopathies are characterized by muscle weakness, skin disease and internal organ involvement. Autoimmunity is known to have a role in myositis pathogenesis, and myositis-specific autoantibodies, targeting important intracellular proteins, are regarded as key biomarkers aiding in the diagnosis of patients. In recent years, a number of novel myositis autoantibodies including anti-TIF1, anti-NXP2, anti-MDA5, anti-SAE, anti-HMGCR and anti-cN1A have been identified in both adult and juvenile patients. These autoantibodies correlate with distinct clinical manifestations and importantly are found in inclusion body, statin-induced, clinically amyopathic and juvenile groups of myositis patients, previously believed to be mainly autoantibody negative. In this review, we will describe the main myositis-specific and myositis-associated autoantibodies and their frequencies and clinical associations across different ages and ethnic groups. We will also discuss preliminary studies investigating correlations between specific myositis autoantibody titres and clinical markers of disease course, collectively demonstrating the utility of myositis autoantibodies as both diagnostic and prognostic markers of disease. PMID:26602539

  18. SUMOylation of the Transcriptional Corepressor KAP1 is Regulated by the Serine and Threonine Phosphatase PP1

    PubMed Central

    Li, Xu; Lin, H. Helen; Chen, Hanqing; Xu, Xingzhi; Shih, Hsiu-Ming; Ann, David K.

    2012-01-01

    KRAB domain–associated protein 1 (KAP1, also known as TIF1β) is a universal transcriptional corepressor that is susceptible to phosphorylation at Ser824 by ataxia-telangiectasia mutated (ATM) and to modification by small ubiquitin-like modifying (SUMO) proteins. Here, we found that whereas protein phosphatase 1α (PP1α) directly interacted with KAP1 under unstressed conditions, PP1β interacted with KAP1 under conditions of genotoxic stress. Changes in the abundance of PP1α or PP1β led to a differential inverse-coregulation of the phosphorylation and SUMOylation states of KAP1 under basal conditions and in response to DNA double-strand breaks (DSBs). Chromatin immunoprecipitation and re-immunoprecipitation experiments revealed that PP1α and PP1β were recruited to KAP1 with different kinetics before and after the induction of DNA DSBs, which provided a mechanistic basis for the switch in the dephosphorylation and SUMOylation states of KAP1. PP1β-stimulated SUMOylation of KAP1 occurred by mechanisms that were dependent and independent of the phosphorylation status of Ser824. We posit a mechanism whereby the combined actions of PP1α and PP1β dynamically cause dephosphorylation of KAP1 Ser824 and assure the SUMOylation of KAP1 to counter the effect of ATM, thereby regulating the transcription of KAP1 target genes in unstressed and stressed cells. PMID:20424263

  19. Flared landing approach flying qualities. Volume 1: Experiment design and analysis

    NASA Technical Reports Server (NTRS)

    Weingarten, Norman C.; Berthe, Charles J., Jr.; Rynaski, Edmund G.; Sarrafian, Shahan K.

    1986-01-01

    An inflight research study was conducted utilizing the USAF Total Inflight Simulator (TIFS) to investigate longitudinal flying qualities for the flared landing approach phase of flight. The purpose of the experiment was to generate a consistent set of data for: (1) determining what kind of commanded response the pilot prefers in order to flare and land an airplane with precision, and (2) refining a time history criterion that took into account all the necessary variables and their characteristics that would accurately predict flying qualities. The result of the first part provides guidelines to the flight control system designer, using MIL-F-8785-(C) as a guide, that yield the dynamic behavior pilots perfer in flared landings. The results of the second part provides the flying qualities engineer with a newly derived flying qualities predictive tool which appears to be highly accurate. This time domain predictive flying qualities criterion was applied to the flight data as well as six previous flying qualities studies, and the results indicate that the criterion predicted the flying qualities level 81% of the time and the Cooper-Harper pilot rating, within + or - 1, 60% of the time.

  20. Why Japanese workers show low work engagement: An item response theory analysis of the Utrecht Work Engagement scale

    PubMed Central

    2010-01-01

    With the globalization of occupational health psychology, more and more researchers are interested in applying employee well-being like work engagement (i.e., a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption) to diverse populations. Accurate measurement contributes to our further understanding and to the generalizability of the concept of work engagement across different cultures. The present study investigated the measurement accuracy of the Japanese and the original Dutch versions of the Utrecht Work Engagement Scale (9-item version, UWES-9) and the comparability of this scale between both countries. Item Response Theory (IRT) was applied to the data from Japan (N = 2,339) and the Netherlands (N = 13,406). Reliability of the scale was evaluated at various levels of the latent trait (i.e., work engagement) based the test information function (TIF) and the standard error of measurement (SEM). The Japanese version had difficulty in differentiating respondents with extremely low work engagement, whereas the original Dutch version had difficulty in differentiating respondents with high work engagement. The measurement accuracy of both versions was not similar. Suppression of positive affect among Japanese people and self-enhancement (the general sensitivity to positive self-relevant information) among Dutch people may have caused decreased measurement accuracy. Hence, we should be cautious when interpreting low engagement scores among Japanese as well as high engagement scores among western employees. PMID:21054839

  1. [Progress of Autoantibody Examinations for Connective Tissue Diseases].

    PubMed

    Akashi, Kengo; Saegusa, Jun; Morinobu, Akio

    2015-05-01

    Connective tissue diseases are chronic inflammatory diseases that can affect multiple organs and, thus, have a broad spectrum of clinical presentations. Various autoantibodies are detected in patients with connective tissue diseases, represented by anti-nuclear antibody for systemic lupus erythematosus (SLE), systemic sclerosis (SSc), polymyositis/dermatomyositis (PM/DM), Sjögren's syndrome, and mixed connective tissue disease. Assessment of the autoantibody profile is fundamental for the clinical management of patients with connective tissue diseases, providing important data for the diagnosis, clinical characterization, and disease activity evaluation. Anti-ribosomal P antibody and anti-NMDA receptor antibody are associated with neuropsychiatric SLE. Anti-synthetase syndrome comprises the association of myositis (PM/DM), interstitial lung disease, fever, Raynaud's phenomenon, mechanic's hands, and anti-aminoacyl tRNA synthetase antibodies. Anti-MDA5 antibody is detected in patients with clinically amyopathic DM, often complicated by rapidly progressive interstitial lung disease. Between 50 and 75% of malignancy-associated DM patients are positive for anti-TIF1-γ antibody. Anti-RNA polymerase III antibody is associated with diffuse cutaneous SSc and renal crisis. This review focuses on the importance and usefulness of these autoantibodies for the diagnosis and management of patients with connective tissue diseases in clinical practice. PMID:26524895

  2. Risk Factor Analysis in Low-Temperature Geothermal Play Fairway Analysis for the Appalachian Basin (GPFA-AB)

    DOE Data Explorer

    Teresa E. Jordan

    2015-09-30

    This submission contains information used to compute the risk factors for the GPFA-AB project (DE-EE0006726). The risk factors are natural reservoir quality, thermal resource quality, potential for induced seismicity, and utilization. The methods used to combine the risk factors included taking the product, sum, and minimum of the four risk factors. The files are divided into images, rasters, shapefiles, and supporting information. The image files show what the raster and shapefiles should look like. The raster files contain the input risk factors, calculation of the scaled risk factors, and calculation of the combined risk factors. The shapefiles include definition of the fairways, definition of the US Census Places, the center of the raster cells, and locations of industries. Supporting information contains details of the calculations or processing used in generating the files. An image of the raster will have the same name except *.png as the file ending instead of *.tif. Images with “fairways” or “industries” added to the name are composed of a raster with the relevant shapefile added. The file About_GPFA-AB_Phase1RiskAnalysisTask5DataUpload.pdf contains information the citation, special use considerations, authorship, etc. More details on each file are given in the spreadsheet “list_of_contents.csv” in the folder “SupportingInfo”. Code used to calculate values is available at https://github.com/calvinwhealton/geothermal_pfa under the folder “combining_metrics”.

  3. High-pressure synthesis of LiTi MF 6 ( M = Mn, Fe, Co, Ni) with trirutile, Na 2SiF 6, and PbSb 2O 6 structures

    NASA Astrophysics Data System (ADS)

    Sekino, Tohru; Endo, Tadashi; Sato, Tsugio; Shimada, Masahiko

    1990-10-01

    High- and low-pressure forms of LiTi M2+F 6 ( M2 = Mn, Fe, Co, and Ni) were prepared by the reaction of LiF, TiF 3, and MF 2 under conditions of 1.5-7.0 GPa and 700-1200°C. All the low-pressure phases belonged to a trirutile structure. On the other hand, the high-pressure phases crystallized in a Na 2SiF 6-type structure for M2+ = Mn and a PbSb 2O 6-type structure for M2+ = Fe, Co, and Ni. According to the Rietveld analysis, it was observed that such structures were basically described as hexagonal close packing of F - ions with cations placed in half of the octahedral sites, but involved a significant difference in cationic proportions at the z = 0 and {1}/{2} levels. Detailed structure data of high- and low-pressure phases are included in the present paper, and the structural stability of each phase is discussed relative to the synthetic P T conditions.

  4. Crystal structure and optical properties of new 0D-hybrid hydroxyfluorotitanates

    NASA Astrophysics Data System (ADS)

    Lhoste, Jérôme; Galven, Cyrille; Leblanc, Marc; Maisonneuve, Vincent; Rocquefelte, Xavier; Jobic, Stéphane; Bujoli-Doeuff, Martine

    2013-10-01

    New 0D hybrid organic-inorganic hydroxyfluorotitanates result from the microwave assisted reactions in autoclaves of TiF4 with organic amines (3-5 diamino-1,2,4,triazol (guaz), ethylenediamine (en) and diethylenetriamine (dien)) and concentrated aqueous HF in ethanol at 190 °C for 1 h. Four compounds, [Hguaz]2·(TiF4.9(OH)1.1) (I), [H2guaz]·(TiF4.8(OH)1.2) (II), [H2en]·(TiF4.3(OH)1.7) (III) and [H2dien]·(Ti(F,OH)6)·2H2O (IV) are prepared and characterized. All structures are built up from isolated (Ti(F,OH)6)2- anions interacting with mono- or di-protonated amines which local symmetry dictates the long range stacking of the Ti(F,OH)6 octahedra. Insertion of crystallized water molecules is only observed for IV. The experimental optical gaps of I, II and III have been measured at about 3.4 eV and compare well with the theoretical values estimated from the examination of density of state diagrams. The optical thresholds are mainly due to O(2p) → Ti(3d) electronic transitions, the F(2p) → Ti(3d) charge transfers occurring at higher energy.

  5. Optimizing Cloud Based Image Storage, Dissemination and Processing Through Use of Mrf and Lerc

    NASA Astrophysics Data System (ADS)

    Becker, Peter; Plesea, Lucian; Maurer, Thomas

    2016-06-01

    The volume and numbers of geospatial images being collected continue to increase exponentially with the ever increasing number of airborne and satellite imaging platforms, and the increasing rate of data collection. As a result, the cost of fast storage required to provide access to the imagery is a major cost factor in enterprise image management solutions to handle, process and disseminate the imagery and information extracted from the imagery. Cloud based object storage offers to provide significantly lower cost and elastic storage for this imagery, but also adds some disadvantages in terms of greater latency for data access and lack of traditional file access. Although traditional file formats geoTIF, JPEG2000 and NITF can be downloaded from such object storage, their structure and available compression are not optimum and access performance is curtailed. This paper provides details on a solution by utilizing a new open image formats for storage and access to geospatial imagery optimized for cloud storage and processing. MRF (Meta Raster Format) is optimized for large collections of scenes such as those acquired from optical sensors. The format enables optimized data access from cloud storage, along with the use of new compression options which cannot easily be added to existing formats. The paper also provides an overview of LERC a new image compression that can be used with MRF that provides very good lossless and controlled lossy compression.

  6. Targeted Gene Therapy of Cancer: Second Amendment toward Holistic Therapy.

    PubMed

    Barar, Jaleh; Omidi, Yadollah

    2013-01-01

    It seems solid tumors are developing smart organs with specialized cells creating specified bio-territory, the so called "tumor microenvironment (TME)", in which there is reciprocal crosstalk among cancer cells, immune system cells and stromal cells. TME as an intricate milieu also consists of cancer stem cells (CSCs) that can resist against chemotherapies. In solid tumors, metabolism and vascularization appears to be aberrant and tumor interstitial fluid (TIF) functions as physiologic barrier. Thus, chemotherapy, immunotherapy and gene therapy often fail to provide cogent clinical outcomes. It looms that it is the time to accept the fact that initiation of cancer could be generation of another form of life that involves a cluster of thousands of genes, while we have failed to observe all aspects of it. Hence, the current treatment modalities need to be re-visited to cover all key aspects of disease using combination therapy based on the condition of patients. Perhaps personalized cluster of genes need to be simultaneously targeted. PMID:23878787

  7. Tumor interstitial fluid - a treasure trove of cancer biomarkers.

    PubMed

    Gromov, Pavel; Gromova, Irina; Olsen, Charlotta J; Timmermans-Wielenga, Vera; Talman, Mai-Lis; Serizawa, Reza R; Moreira, José M A

    2013-11-01

    Tumor interstitial fluid (TIF) is a proximal fluid that, in addition to the set of blood soluble phase-borne proteins, holds a subset of aberrantly externalized components, mainly proteins, released by tumor cells and tumor microenvironment through various mechanisms, which include classical secretion, non-classical secretion, secretion via exosomes and membrane protein shedding. Consequently, the interstitial aqueous phase of solid tumors is a highly promising resource for the discovery of molecules associated with pathological changes in tissues. Firstly, it allows one to delve deeper into the regulatory mechanisms and functions of secretion-related processes in tumor development. Secondly, the anomalous secretion of molecules that is innate to tumors and the tumor microenvironment, being associated with cancer progression, offers a valuable source for biomarker discovery and possible targets for therapeutic intervention. Here we provide an overview of the features of tumor-associated interstitial fluids, based on recent and updated information obtained mainly from our studies of breast cancer. Data from the study of interstitial fluids recovered from several other types of cancer are also discussed. This article is a part of a Special Issue entitled: The Updated Secretome. PMID:23416532

  8. Microstructural analysis of Al alloys dispersed with TiB2 particulate for MMC applications

    PubMed

    Wang; Brydson; Jha; Ellis

    1999-11-01

    A dispersion of TiB2 particulates in an Al alloy matrix was formed via the in-situ reaction between mixtures of K2TiF6 (K2ZrF6), KBF4 and molten aluminium. The dispersion of the ceramic phase in the aluminium matrix was also achieved in some experiments by adding exogenous TiB2 particles to the fluoride melt in contact with molten aluminium. In this work, we have examined the microstructure of the as-cast metal matrix composites using analytical electron microscopy and X-ray diffraction techniques. The phases formed as a result of the reaction between the molten fluoride flux and liquid aluminium have been identified. These were (Ti, Zr, Al)B2, Al3Ti and possibly AlB12 in the Al-matrix, and KAlF4 and KMgF3 in the solidified flux. The mechanism of formation of TiB2 and Al3Ti is explained. The role of alloying elements is also explained in the context of interfacial chemistry and dispersion. PMID:10540266

  9. Evaluation of Chloropicrin as a Soil Fumigant against Ralstonia solanacarum in Ginger (Zingiber officinale Rosc.) Production in China

    PubMed Central

    Ma, Taotao; Liu, Pengfei; Shen, Jin; Li, Yuan; Ouyang, Canbin; Guo, Meixia; Cao, Aocheng

    2014-01-01

    Background Chloropicrin (Pic) offers a potential alternative to methyl bromide (MB) against Ralstonia solanacarum in ginger (Zingiber officinale Rosc.) production. MB is scheduled to be withdrawn from routine use by 2015 in developing countries. Methods Pic treatments were evaluated in a laboratory study and in three commercial ginger fields. Results Laboratory studies showed that the EC50 value and EC80 value of Pic were 2.7 and 3.7 mg a.i. kg−1 soil, respectively. Field trials in highly infested soil revealed that treatments of Pic at the dose of 50 g m−2 covered with totally impermeable film (TIF) or polyethylene film (PE) sharply reduced Ralstonia solanacarum and maintained high ginger yields. Both of the Pic treatments provided results similar to, or in some cases slightly lower than, MB with respect to Ralstonia solanacarum control, plant survival, plant growth and yield. All of the fumigant treatments were significantly better than the non-treated control. Conclusions The present study confirms that the Pic is a promising alternative with good efficacy against Ralstonia solanacarum for ginger production and could be used in integrated pest management programs in China. PMID:24618853

  10. Direct Synthesis of Anatase Films with ~100% (001) Facets and [001] Preferred Orientation

    PubMed Central

    Ichimura, Andrew S.; Mack, Brianne; Usmani, Shirin M.; Mars, Diana

    2012-01-01

    Anatase films exhibiting ~100% (001) reactive facets at the surface were grown hydrothermally on gold substrate from a homogeneous solution of TiF4 and NaF. In addition to NaF, it was found that TiO2 films with very similar properties could be prepared with the fluoride salts LiF, CsF, HF, NH4F, and N(CH2CH3)4F. The polycrystalline anatase films are continuous, approximately 1 μm thick, and evenly coat the substrate. The surface grain size is ~400 nm. Grazing angle XRD measurements show that the films exhibit a high degree of preferred orientation with the c-axis normal to the substrate surface. SEM images reveal that the grains span the thickness of the films. Annealing the films at 500 °C removes fluorine and causes crystallites within the grains to restructure as shown by SEM, XRD, and Raman spectroscopy. Supported anatase films grown from this one-pot method may serve as oxidative photocatalysts and electrodes for photoelectrochemical applications such as solar cells and hydrogen evolution. PMID:22844184

  11. MOZ regulates B-cell progenitors and, consequently, Moz haploinsufficiency dramatically retards MYC-induced lymphoma development.

    PubMed

    Sheikh, Bilal N; Lee, Stanley C W; El-Saafin, Farrah; Vanyai, Hannah K; Hu, Yifang; Pang, Swee Heng Milon; Grabow, Stephanie; Strasser, Andreas; Nutt, Stephen L; Alexander, Warren S; Smyth, Gordon K; Voss, Anne K; Thomas, Tim

    2015-03-19

    The histone acetyltransferase MOZ (MYST3, KAT6A) is the target of recurrent chromosomal translocations fusing the MOZ gene to CBP, p300, NCOA3, or TIF2 in particularly aggressive cases of acute myeloid leukemia. In this study, we report the role of wild-type MOZ in regulating B-cell progenitor proliferation and hematopoietic malignancy. In the Eμ-Myc model of aggressive pre-B/B-cell lymphoma, the loss of just one allele of Moz increased the median survival of mice by 3.9-fold. MOZ was required to maintain the proliferative capacity of B-cell progenitors, even in the presence of c-MYC overexpression, by directly maintaining the transcriptional activity of genes required for normal B-cell development. Hence, B-cell progenitor numbers were significantly reduced in Moz haploinsufficient animals. Interestingly, we find a significant overlap in genes regulated by MOZ, mixed lineage leukemia 1, and mixed lineage leukemia 1 cofactor menin. This includes Meis1, a TALE class homeobox transcription factor required for B-cell development, characteristically upregulated as a result of MLL1 translocations in leukemia. We demonstrate that MOZ localizes to the Meis1 locus in pre-B-cells and maintains Meis1 expression. Our results suggest that even partial inhibition of MOZ may reduce the proliferative capacity of MEIS1, and HOX-driven lymphoma and leukemia cells. PMID:25605372

  12. Hematopoietic Differentiation Is Required for Initiation of Acute Myeloid Leukemia.

    PubMed

    Ye, Min; Zhang, Hong; Yang, Henry; Koche, Richard; Staber, Philipp B; Cusan, Monica; Levantini, Elena; Welner, Robert S; Bach, Christian S; Zhang, Junyan; Krivtsov, Andrei V; Armstrong, Scott A; Tenen, Daniel G

    2015-11-01

    Mutations in acute myeloid leukemia (AML)-associated oncogenes often arise in hematopoietic stem cells (HSCs) and promote acquisition of leukemia stem cell (LSC) phenotypes. However, as LSCs often share features of lineage-restricted progenitors, the relative contribution of differentiation status to LSC transformation is unclear. Using murine MLL-AF9 and MOZ-TIF2 AML models, we show that myeloid differentiation to granulocyte macrophage progenitors (GMPs) is critical for LSC generation. Disrupting GMP formation by deleting the lineage-restricted transcription factor C/EBPa blocked normal granulocyte formation and prevented initiation of AML. However, restoring myeloid differentiation in C/EBPa mutants with inflammatory cytokines reestablished AML transformation capacity. Genomic analyses of GMPs, including gene expression and H3K79me2 profiling in conjunction with ATAC-seq, revealed a permissive genomic environment for activation of a minimal transcription program shared by GMPs and LSCs. Together, these findings show that myeloid differentiation is a prerequisite for LSC formation and AML development, providing insights for therapeutic development. PMID:26412561

  13. Sward characteristics, nutritive value and choice by cattle of conterminous monocultures of centipedegrass (Eremochloa ophiuroides) and bahiagrass (Paspalum notatum).

    PubMed

    Hirata, Masahiko; Okuma, Toshiro; Tanaka, Yuichiro; Tobisa, Manabu

    2016-05-01

    In south-western Japan, centipedegrass (Eremochloa ophiuroides; CG) offers a novel option for a warm-season perennial for grazing use in areas where bahiagrass (Paspalum notatum; BG) can be grown. However, the potential of CG as a forage has not been fully explored because of the short history as a forage crop. We conducted four experiments to evaluate CG (cv. TifBlair) in comparison with BG (cv. Pensacola) in terms of sward characteristics, nutritive value and choice by animals. In each experiment, four Japanese Black cows (Bos taurus) were individually allowed to graze conterminous monocultures of CG and BG (5 × 10 m each) for 30 min. Irrespective of regrowth durations and fertilizer rates, CG was consistently shorter, leafier and denser, contained lower acid detergent fiber and cellulose, and was preferred or equally selected by cows, as compared with BG. Furthermore, CG maintained sufficient levels of crude protein (80-89 g/kg DM) to ensure voluntary intake of ruminant animals under extended regrowth(‡) and without fertilizer, whereas BG failed to do so (65 g/kg DM). CG provided higher digestible dry matter than BG when crude protein concentration exceeded 86 g/kg DM. The results indicate advantages of CG as a forage. PMID:26355386

  14. Sum1, a highly conserved WD-repeat protein, suppresses S-M checkpoint mutants and inhibits the osmotic stress cell cycle response in fission yeast.

    PubMed Central

    Humphrey, T; Enoch, T

    1998-01-01

    The S-M checkpoint ensures that entry into mitosis is dependent on completion of DNA replication. In the fission yeast Schizosaccharomyces pombe, the SM checkpoint mutant cdc2-3w is thought to be defective in receiving the checkpoint signal. To isolate genes that function in the checkpoint pathway, we screened an S. pombe cDNA library for genes that, when overexpressed, could suppress the checkpoint defect of cdc2-3w. Using this approach, we have identified a novel gene, sum1+ (suppressor of uncontrolled mitosis). sum1+ encodes a highly conserved WD-transducin repeat protein with striking sequence similarity to the human transforming growth factor (TGF)-beta-receptor interacting protein TRIP-1 and to the translation initiation factor 3 subunit eIF3-p39, encoded by the TIF34 gene in Saccharomyces cerevisiae. S. pombe sum1+ is an essential gene, required for normal cell growth and division. In addition to restoring checkpoint control, overexpression of sum1+ inhibits the normal cell cycle response to osmotic stress. Furthermore, we demonstrate that inactivation of the stress-activated MAP kinase pathway, required for cell cycle stress response, restores the S-M checkpoint in cdc2-3w cells. These results suggest that Suml interacts with the stress-activated MAP kinase pathway and raise the possibility that environmental conditions may influence the checkpoint response in fission yeast. PMID:9560390

  15. A Combination of CRISPR/Cas9 and Standardized RNAi as a Versatile Platform for the Characterization of Gene Function.

    PubMed

    Wissel, Sebastian; Kieser, Anja; Yasugi, Tetsuo; Duchek, Peter; Roitinger, Elisabeth; Gokcezade, Joseph; Steinmann, Victoria; Gaul, Ulrike; Mechtler, Karl; Förstemann, Klaus; Knoblich, Jürgen A; Neumüller, Ralph A

    2016-01-01

    Traditional loss-of-function studies in Drosophila suffer from a number of shortcomings, including off-target effects in the case of RNA interference (RNAi) or the stochastic nature of mosaic clonal analysis. Here, we describe minimal in vivo GFP interference (miGFPi) as a versatile strategy to characterize gene function and to conduct highly stringent, cell type-specific loss-of-function experiments in Drosophila miGFPi combines CRISPR/Cas9-mediated tagging of genes at their endogenous locus with an immunotag and an exogenous 21 nucleotide RNAi effector sequence with the use of a single reagent, highly validated RNAi line targeting this sequence. We demonstrate the utility and time effectiveness of this method by characterizing the function of the Polymerase I (Pol I)-associated transcription factor Tif-1a, and the previously uncharacterized gene MESR4, in the Drosophila female germline stem cell lineage. In addition, we show that miGFPi serves as a powerful technique to functionally characterize individual isoforms of a gene. We exemplify this aspect of miGFPi by studying isoform-specific loss-of-function phenotypes of the longitudinals lacking (lola) gene in neural stem cells. Altogether, the miGFPi strategy constitutes a generalized loss-of-function approach that is amenable to the study of the function of all genes in the genome in a stringent and highly time effective manner. PMID:27280787

  16. Design, development, and evaluation of focused ultrasound arrays for transesophageal cardiac ablations

    NASA Astrophysics Data System (ADS)

    Lee, Hotaik

    The ultimate purpose of this dissertation is the evaluation of the feasibility of transesophageal cardiac surgery in arrhythmia treatment, using therapeutic ultrasound energy without the requirement for surgical incisions or blood contact. Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting over 2.2 million Americans. One effective treatment is cardiac ablation, which shows a high rate of success in treating paroxysmal AF. As a prevailing modality for this treatment, catheter ablation using radiofrequency has been effective, but there is measurable morbidity and significant costs and time associated with this invasive procedure for permanent or persistent AF. To address these issues, a transesophageal ultrasound applicator for noninvasive cardiac ablations has been designed, developed and evaluated in this dissertation. Focused ultrasound for thermal ablation has gained interest for decades due to its noninvasive characteristics. Since the esophagus is close to the posterior of the left atrium, its position makes it attractive for the incision-less surgery of the selected area of the heart using ultrasound. The overall goal of this study is to bring an applicator as closely as possible to the heart in order to effectively deliver ultrasound energy, and create electrically isolating lesions in myocardial tissue, replicating the currently used Maze procedure. The Maze procedure is a surgical operation that treats AF by creating a grid of incisions resulting in non-conductive scar tissue in the atria. The initial design of an ultrasound applicator capable of creating atrial lesions from the esophagus, involved evaluating sound pressure fields within layers of the esophagus and myocardium. Based on the multiple factors of the simulation results of transducer arrays, current transesophageal medical devices, and the throat anatomy, a focused ultrasound transducer that can be inserted into the esophagus has been designed and tested. In this study, a

  17. Chandra Clocks Million Mile Per Hour Wind Expanding From Vicinity of Giant Black Hole

    NASA Astrophysics Data System (ADS)

    2000-05-01

    NASA's Chandra X-ray Observatory has examined the stormy environs of a giant black hole in the active galaxy NGC 3783 and measured the dramatic effects of intense radiation produced by matter before it plunges into the black hole. This radiation heats surrounding gas and drives a million mile per hour wind away from the crushing grip of the black hole's gravity. NGC 3783 Image The central bright spot in this image is the Chandra X-ray image of NGC 3783. The long intersecting lines represent dispersed X-ray spectra, or rainbows, produced by the Chandra grating spectrometer. The faint vertical lines are instrumental artifacts. Jpeg |Tif | PS | Powerpoint and PDF Credit: NASA/PSU A team of researchers used the High Energy Transmission Grating in combination with the CCD X-ray camera aboard Chandra to study the properties of the wind. "X-ray observations allow astronomers to probe these extremely powerful gas flows that have been suspected to exist, but have been impossible to study precisely before," said Professor Niel Brandt, of Penn State University, University Park, one of the leaders of the team. The grating spreads the incident X-ray beam into a rainbow-like display of hundreds of different X-ray "colors" or energies. Computers translated this display into a jagged-line plot that resembles an electrocardiogram. Specific elements reveal their presence by sharp absorption dips in the plot. By examining the widths and locations of these dips, the researchers can use the same principle used by a radar gun to measure velocities in the extreme environment of the galaxy's core. "This is the most detailed X-ray spectrum ever taken of a galaxy with an active black hole," said Dr. Shai Kaspi, also of Penn State. "It reveals that the wind contains oxygen, neon, magnesium, silicon, sulfur, argon, and iron." An analysis of the wind by team member Professor Hagai Netzer of Tel-Aviv University in Israel, showed that the wind almost completely surrounds the black hole. NGC 3783

  18. Topical pimecrolimus and tacrolimus do not accelerate photocarcinogenesis in hairless mice after UVA or simulated solar radiation.

    PubMed

    Lerche, Catharina M; Philipsen, Peter A; Poulsen, Thomas; Wulf, Hans Christian

    2009-03-01

    Pimecrolimus and tacrolimus are topical calcineurin inhibitors developed specifically for the treatment of atopic eczema. Experience with long-term use of topical calcineurin inhibitors is limited and the risk of rare but serious adverse events remains a concern. We have previously demonstrated the absence of carcinogenic effect of tacrolimus alone and in combination with simulated solar radiation (SSR) on hairless mice. The aim of this study is to determine whether pimecrolimus accelerates photocarcinogenesis in combination with SSR or pimecrolimus and tacrolimus accelerate photocarcinogenesis in combination with UVA. We used 11 groups of 25 hairless female C3.Cg/TifBomTac immunocompetent mice (n = 275). Pimecrolimus cream or tacrolimus ointment was applied on their dorsal skin three times weekly followed by SSR (2, 4, or 6 standard erythema doses, SED) or UVA (25 J/cm(2)) 3-4 h later. This was done up to 365 days in the SSR-treated groups and up to 500 days in the UVA-treated groups. Pimecrolimus did not accelerate the time for development of the first, second or third tumor in any of the groups. Median time to the first tumor was 240 days for the control-2SED group compared with pimecrolimus-2SED group (233 days), control-4SED group (156 days) compared with pimecrolimus-4SED group (163 days) and control-6SED group (162 days) compared with pimecrolimus-6SED group (170 days). Only one mouse in each of the three UVA groups developed a tumor. We conclude that pimecrolimus in combination with SSR and both pimecrolimus and tacrolimus in combination with UVA do not accelerate photocarcinogenesis in hairless mice. PMID:19183401

  19. Coactivator recruitment of AhR/ARNT1.

    PubMed

    Endler, Alexander; Chen, Li; Shibasaki, Futoshi

    2014-01-01

    A common feature of nuclear receptors (NRs) is the transformation of external cell signals into specific transcriptions of the signal molecule. Signal molecules function as ligands for NRs and, after their uptake, activated NRs form homo- or heterodimers at promoter recognition sequences of the specific genes in the nucleus. Another common feature of NRs is their dependence on coactivators, which bridge the basic transcriptional machinery and other cofactors to the target genes, in order to initiate transcription and to unwind histone-bound DNA for exposing additional promoter recognition sites via their histone acetyltransferase (HAT) function. In this review, we focus on our recent findings related to the recruitment of steroid receptor coactivator 1 (SRC1/NCoA1) by the estrogen receptor-α (ERα) and by the arylhydrocarbon receptor/arylhydrocarbon receptor nuclear translocator 1 (AhR/ARNT1) complex. We also describe the extension of our previously published findings regarding the binding between ARNT1.1 exon16 and SRC1e exon 21, via in silico analyses of androgen receptor (AR) NH2-carboxyl-terminal interactions, the results of which were verified by in vitro experiments. Based on these data, we suggest a newly derived tentative binding site of nuclear coactivator 2/glucocorticoid receptor interacting protein-1/transcriptional intermediary factor 2 (NCOA-2/ GRIP-1/TIF-2) for ARNT1.1 exon 16. Furthermore, results obtained by immunoprecipitation have revealed a second leucine-rich binding site for hARNT1.1 exon 16 in SRC1e exon 21 (LSSTDLL). Finally, we discuss the role of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) as an endocrine disruptor for estrogen related transcription. PMID:24950180

  20. Enhancement on photocatalytic activity of an amorphous titanium oxide film with nano-textured surface by selective-fluorination etching process

    SciTech Connect

    Shih, Pin-Chun; Huang, Cheng-Hao; Chen, Tai-Hong; Lai, Li-Wen; Lu, Yi-Shan; Liu, Day-Shan

    2014-04-01

    Highlights: • The amorphous TiO{sub x} film surface was modified via selective fluorination etching process. • The resulting nano-textured surface markedly enriched the specific surface area and surface acidity. • The photocatalytic activity was comparable to an annealed TiO{sub x} film with anatase structure. - Abstract: A selective-fluorination etching process achieved by an UV light pre-irradiation and the subsequently fluorination etching was developed to enhance the photocatalytic activity of a low-temperature deposited amorphous titanium oxide (a-TiO{sub x}) film. Textured surface on the a-TiO{sub x} films formed by this process were investigated using atomic force microscope and field emission scanning electron microscope. Evidence of the fluorine ions introduced into the a-TiO{sub x} films was examined using Fourier transform infrared spectrometry and X-ray photoelectron spectroscopy. The etching thickness of the a-TiO{sub x} film was found to be deeply relevant to the film pre-irradiated by the UV light. An a-TiO{sub x} film with nano-textured surface, which was favorable to enlarge the specific surface area, thus was obtainable from the notable etching selectivity of the film pre-irradiated by UV light through a nano-sized mask. In addition, the surface acidity of the a-TiO{sub x} film was enhanced by the formation of the Ti-F chemical bonds originating from the fluorination etching process, which also was functional to facilitate the production of surface OH free radicals. Accordingly, the resulting fluorinated a-TiO{sub x} film with nano-textured surface performed a quality photocatalytic activity comparable to that of the high-temperature achieved TiO{sub x} film with anatase structures.

  1. Androgen receptors in prostate cancer.

    PubMed

    Culig, Z; Klocker, H; Bartsch, G; Hobisch, A

    2002-09-01

    The androgen receptor (AR), a transcription factor that mediates the action of androgens in target tissues, is expressed in nearly all prostate cancers. Carcinoma of the prostate is the most frequently diagnosed neoplasm in men in industrialized countries. Palliative treatment for non-organ-confined prostate cancer aims to down-regulate the concentration of circulating androgen or to block the transcription activation function of the AR. AR function during endocrine therapy was studied in tumor cells LNCaP subjected to long-term steroid depletion; newly generated sublines could be stimulated by lower concentrations of androgen than parental cells and showed up-regulation of AR expression and activity as well as resistance to apoptosis. Androgenic hormones regulate the expression of key cell cycle regulators, cyclin-dependent kinase 2 and 4, and that of the cell cycle inhibitor p27. Inhibition of AR expression could be achieved by potential chemopreventive agents flufenamic acid, resveratrol, quercetin, polyunsaturated fatty acids and interleukin-1beta, and by the application of AR antisense oligonucleotides. In the clinical situation, AR gene amplification and point mutations were reported in patients with metastatic disease. These mutations generate receptors which could be activated by other steroid hormones and non-steroidal antiandrogens. In the absence of androgen, the AR could be activated by various growth-promoting (growth factors, epidermal growth factor receptor-related oncogene HER-2/neu) and pleiotropic (protein kinase A activators, interleukin-6) compounds as well as by inducers of differentiation (phenylbutyrate). AR function is modulated by a number of coactivators and corepressors. The three coactivators, TIF-2, SRC-1 and RAC3, are up-regulated in relapsed prostate cancer. New experimental therapies for prostate cancer are aimed to down-regulate AR expression and to overcome difficulties which occur because of the acquisition of agonistic properties

  2. Development of Advanced Life Cycle Costing Methods for Technology Benefit/Cost/Risk Assessment

    NASA Technical Reports Server (NTRS)

    Yackovetsky, Robert (Technical Monitor)

    2002-01-01

    The overall objective of this three-year grant is to provide NASA Langley's System Analysis Branch with improved affordability tools and methods based on probabilistic cost assessment techniques. In order to accomplish this objective, the Aerospace Systems Design Laboratory (ASDL) needs to pursue more detailed affordability, technology impact, and risk prediction methods and to demonstrate them on variety of advanced commercial transports. The affordability assessment, which is a cornerstone of ASDL methods, relies on the Aircraft Life Cycle Cost Analysis (ALCCA) program originally developed by NASA Ames Research Center and enhanced by ASDL. This grant proposed to improve ALCCA in support of the project objective by updating the research, design, test, and evaluation cost module, as well as the engine development cost module. Investigations into enhancements to ALCCA include improved engine development cost, process based costing, supportability cost, and system reliability with airline loss of revenue for system downtime. A probabilistic, stand-alone version of ALCCA/FLOPS will also be developed under this grant in order to capture the uncertainty involved in technology assessments. FLOPS (FLight Optimization System program) is an aircraft synthesis and sizing code developed by NASA Langley Research Center. This probabilistic version of the coupled program will be used within a Technology Impact Forecasting (TIF) method to determine what types of technologies would have to be infused in a system in order to meet customer requirements. A probabilistic analysis of the CER's (cost estimating relationships) within ALCCA will also be carried out under this contract in order to gain some insight as to the most influential costs and the impact that code fidelity could have on future RDS (Robust Design Simulation) studies.

  3. Hematopoietic progenitor cells grow on 3T3 fibroblast monolayers that overexpress growth arrest-specific gene-6 (GAS6).

    PubMed

    Dormady, S P; Zhang, X M; Basch, R S

    2000-10-24

    Pluripotential hematopoietic stem cells grow in close association with bone marrow stromal cells, which play a critical role in sustaining hematopoiesis in long-term bone marrow cultures. The mechanisms through which stromal cells act to support pluripotential hematopoietic stem cells are largely unknown. This study demonstrates that growth arrest-specific gene-6 (GAS6) plays an important role in this process. GAS6 is a ligand for the Axl (Ufo/Ark), Sky (Dtk/Tyro3/Rse/Brt/Tif), and Mer (Eyk) family of tyrosine kinase receptors and binds to these receptors via tandem G domains at its C terminus. After translation, GAS6 moves to the lumen of the endoplasmic reticulum, where it is extensively gamma-carboxylated. The carboxylation process is vitamin K dependent, and current evidence suggests that GAS6 must be gamma-carboxylated to bind and activate any of the cognate tyrosine kinase receptors. Here, we show that expression of GAS6 is highly correlated with the capacity of bone marrow stromal cells to support hematopoiesis in culture. Nonsupportive stromal cell lines express little to no GAS6, whereas supportive cell lines express high levels of GAS6. Transfection of the cDNA encoding GAS6 into 3T3 fibroblasts is sufficient to render this previously nonsupportive cell line capable of supporting long-term hematopoietic cultures. 3T3 cells, genetically engineered to stably express GAS6 (GAS6-3T3), produce a stromal layer that supports the generation of colony-forming units in culture (CFU-c) for up to 6 wk. Hematopoietic support by genetically engineered 3T3 is not vitamin K dependent, and soluble recombinant GAS6 does not substitute for coculturing the hematopoietic progenitors with genetically modified 3T3 cells. PMID:11050245

  4. Fail-safe mechanism of GCN4 translational control—uORF2 promotes reinitiation by analogous mechanism to uORF1 and thus secures its key role in GCN4 expression

    PubMed Central

    Gunišová, Stanislava; Valášek, Leoš Shivaya

    2014-01-01

    One of the extensively studied mechanisms of gene-specific translational regulation is reinitiation. It takes place on messenger RNAs (mRNAs) where main ORF is preceded by upstream ORF (uORF). Even though uORFs generally down-regulate main ORF expression, specific uORFs exist that allow high level of downstream ORF expression. The key is their ability to retain 40S subunits on mRNA upon termination of their translation to resume scanning for the next AUG. Here, we took advantage of the exemplary model system of reinitiation, the mRNA of yeast transcriptional activator GCN4 containing four short uORFs, and show that contrary to previous reports, not only the first but the first two of its uORFs allow efficient reinitiation. Strikingly, we demonstrate that they utilize a similar molecular mechanism relying on several cis-acting 5′ reinitiation-promoting elements, one of which they share, and the interaction with the a/TIF32 subunit of translation initiation factor eIF3. Since a similar mechanism operates also on YAP1 uORF, our findings strongly suggest that basic principles of reinitiation are conserved. Furthermore, presence of two consecutive reinitiation-permissive uORFs followed by two reinitiation-non-permissive uORFs suggests that tightness of GCN4 translational control is ensured by a fail-safe mechanism that effectively prevents or triggers GCN4 expression under nutrient replete or deplete conditions, respectively. PMID:24623812

  5. The G-quadruplex-stabilising agent RHPS4 induces telomeric dysfunction and enhances radiosensitivity in glioblastoma cells.

    PubMed

    Berardinelli, F; Siteni, S; Tanzarella, C; Stevens, M F; Sgura, A; Antoccia, A

    2015-01-01

    G-quadruplex (G4) interacting agents are a class of ligands that can bind to and stabilise secondary structures located in genomic G-rich regions such as telomeres. Stabilisation of G4 leads to telomere architecture disruption with a consequent detrimental effect on cell proliferation, which makes these agents good candidates for chemotherapeutic purposes. RHPS4 is one of the most effective and well-studied G4 ligands with a very high specificity for telomeric G4. In this work, we tested the in vitro efficacy of RHPS4 in astrocytoma cell lines, and we evaluated whether RHPS4 can act as a radiosensitising agent by destabilising telomeres. In the first part of the study, the response to RHPS4 was investigated in four human astrocytoma cell lines (U251MG, U87MG, T67 and T70) and in two normal primary fibroblast strains (AG01522 and MRC5). Cell growth reduction, histone H2AX phosphorylation and telomere-induced dysfunctional foci (TIF) formation were markedly higher in astrocytoma cells than in normal fibroblasts, despite the absence of telomere shortening. In the second part of the study, the combined effect of submicromolar concentrations of RHPS4 and X-rays was assessed in the U251MG glioblastoma radioresistant cell line. Long-term growth curves, cell cycle analysis and cell survival experiments, clearly showed the synergistic effect of the combined treatment. Interestingly the effect was greater in cells bearing a higher number of dysfunctional telomeres. DNA double-strand breaks rejoining after irradiation revealed delayed repair kinetics in cells pre-treated with the drug and a synergistic increase in chromosome-type exchanges and telomeric fusions. These findings provide the first evidence that exposure to RHPS4 radiosensitizes astrocytoma cells, suggesting the potential for future therapeutic applications. PMID:25467559

  6. Mild Glucose Starvation Induces KDM2A-Mediated H3K36me2 Demethylation through AMPK To Reduce rRNA Transcription and Cell Proliferation

    PubMed Central

    Tanaka, Yuji; Yano, Hirohisa; Ogasawara, Sachiko; Yoshioka, Sho-ichi; Imamura, Hiromi; Okamoto, Kengo

    2015-01-01

    Environmental conditions control rRNA transcription. Previously, we found that serum and glucose deprivation induces KDM2A-mediated H3K36me2 demethylation in the rRNA gene (rDNA) promoter and reduces rRNA transcription in the human breast cancer cell line MCF-7. However, the molecular mechanism and biological significance are still unclear. In the present study, we found that glucose starvation alone induced the KDM2A-dependent reduction of rRNA transcription. The treatment of cells with 2-deoxy-d-glucose, an inhibitor of glycolysis, reduced rRNA transcription and H3K36me2 in the rDNA promoter, both of which were completely dependent on KDM2A in low concentrations of 2-deoxy-d-glucose, that is, mild starvation conditions. The mild starvation induced these KDM2A activities through AMP-activated kinase (AMPK) but did not affect another AMPK effector of rRNA transcription, TIF-IA. In the triple-negative breast cancer cell line MDA-MB-231, the mild starvation also reduced rRNA transcription in a KDM2A-dependent manner. We detected KDM2A in breast cancer tissues irrespective of their estrogen receptor, progesterone receptor, and HER2 status, including triple-negative cancer tissues. In both MCF-7 and MDA-MB-231 cells, mild starvation reduced cell proliferation, and KDM2A knockdown suppressed the reduction of cell proliferation. These results suggest that under mild glucose starvation AMPK induces KDM2A-dependent reduction of rRNA transcription to control cell proliferation. PMID:26416883

  7. [Prosthetic evaluation of the sagittal curve of the edentulous mandibular ridge].

    PubMed

    Fejérdy, Pál; Esztári, Imre; Kaán, Miklós

    2003-10-01

    The literature lacks reports on measurement-based investigations of the sagittal curve of the mandibular ridge. The prosthetic significance of that curve is a debated issue even today. Our investigations have been carried out on functional samples of randomly selected edentulous patients (55 females and 17 males) treated at the Department of Prosthodontics of the Semmelweis University, Budapest. We made photographs using a Polaroid MACRO 5 SLR camera on a squared factory-made film, under standard circumstances, from both right and left directions. The photographs were then scanned with 600 dpi resolution and saved as non-compressed tif files (Tag Image File Format). The evaluation of the digitalized photographs has been carried out using a specifically developed computer program. On the four-times enlarged pictures, we made three measurements at each point; the arithmetical means of those sets of three figures served as a basis for statistical analysis. The data were analysed by gender and by side, using the SPSS program package (t-test). Our measurements showed that the sagittal curve is characteristic of the edentulous mandibular ridge as well. However, it does not exhibit significant differences by gender, individual, or side. The average value of the lowest point of the sagittal curve was 5.78 mm, s +/- 1.96 mm, minimum = 1.83 mm, maximum = 11.12 mm. It was concluded from our measurements and comparative anatomical data--clinical observations, as well as measurement-based investigations--that the Spee-curve of the healthy dentition and the sagittal curve of the edentulous mandibular ridge are formed by the same forces. If, in everyday practice, sagittal curves of the occlusion surfaces of complete lower dentures are set parallel with the mandibular edge, this is the most preferable solution with respect to both the stability of complete lower dentures and the optimal functioning of constrictor muscles. PMID:14635490

  8. Telomere Restriction Fragment (TRF) Analysis

    PubMed Central

    Mender, Ilgen; Shay, Jerry W.

    2016-01-01

    While telomerase is expressed in ~90% of primary human tumors, most somatic tissue cells except transiently proliferating stem-like cells do not have detectable telomerase activity (Shay and Wright, 1996; Shay and Wright, 2001). Telomeres progressively shorten with each cell division in normal cells, including proliferating stem-like cells, due to the end replication (lagging strand synthesis) problem and other causes such as oxidative damage, therefore all somatic cells have limited cell proliferation capacity (Hayflick limit) (Hayflick and Moorhead, 1961; Olovnikov, 1973). The progressive telomere shortening eventually leads to growth arrest in normal cells, which is known as replicative senescence (Shay et al., 1991). Once telomerase is activated in cancer cells, telomere length is stabilized by the addition of TTAGGG repeats to the end of chromosomes, thus enabling the limitless continuation of cell division (Shay and Wright, 1996; Shay and Wright, 2001). Therefore, the link between aging and cancer can be partially explained by telomere biology. There are many rapid and convenient methods to study telomere biology such as Telomere Restriction Fragment (TRF), Telomere Repeat Amplification Protocol (TRAP) (Mender and Shay, 2015b) and Telomere dysfunction Induced Foci (TIF) analysis (Mender and Shay, 2015a). In this protocol paper we describe Telomere Restriction Fragment (TRF) analysis to determine average telomeric length of cells. Telomeric length can be indirectly measured by a technique called Telomere Restriction Fragment analysis (TRF). This technique is a modified Southern blot, which measures the heterogeneous range of telomere lengths in a cell population using the length distribution of the terminal restriction fragments (Harley et al., 1990; Ouellette et al., 2000). This method can be used in eukaryotic cells. The description below focuses on the measurement of human cancer cells telomere length. The principle of this method relies on the lack of

  9. Charge recombination between P700+ and A1- occurs directly to the ground state of P700 in a photosystem I core devoid of FX, FB, and FA.

    PubMed

    Warren, P V; Golbeck, J H; Warden, J T

    1993-01-26

    The charge recombination between P700+ and electron acceptor A1- was studied by flash kinetic spectroscopy in a photosystem I core devoid of iron-sulfur centers FX, FB, and FA. We showed previously that the majority of the flash-induced absorption change at 820 nm decayed with a 10-microseconds half-time, which we assigned to the disappearance of the P700 triplet formed from the backreaction of P700+ with A1- [Warren, P.V., Parrett, K.G., Warden, J.T., & Golbeck, J.H. (1990) Biochemistry 29, 6545-6550]. We have reinvestigated this assignment in the near-UV, blue, and near-IR wavelength regions. The difference spectrum from 380 to 480 nm and from 720 to 910 nm shows that the P700+ A1- charge recombination is dominated by the P700 cation rather than the P700 triplet. Accordingly, the 10-microseconds kinetic transient represents the direct backreaction of P700+ with A1-, which repopulates the ground state of P700. This is unlike a P700-FA/FB complex where, in the presence of reduced FX-, FB-, and FA-, the P700+ A1- charge recombination populates the P700 triplet state [Sétif, P., & Bottin, H. (1989) Biochemistry 28, 2689-2697]. The A1 acceptor is highly susceptible to disruption by detergents in the absence of iron-sulfur center FX. The addition of 0.1% Triton X-100 to the P700-A1 core leads to a approximately 2.5-fold increase in the magnitude of the flash-induced absorption change at 780 nm; thereafter, 85% of the absorption change decays with a 25-ns half-time and 15% decays with a 3-microseconds half-time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8422389

  10. Inhibition of mRNA turnover in yeast by an xrn1 mutation enhances the requirement for eIF4E binding to eIF4G and for proper capping of transcripts by Ceg1p.

    PubMed Central

    Brown, J T; Yang, X; Johnson, A W

    2000-01-01

    Null mutants of XRN1, encoding the major cytoplasmic exoribonuclease in yeast, are viable but accumulate decapped, deadenylated transcripts. A screen for mutations synthetic lethal with xrn1Delta identified a mutation in CDC33, encoding eIF4E. This mutation (glutamate to glycine at position 72) affected a highly conserved residue involved in interaction with eIF4G. Synthetic lethality between xrn1 and cdc33 was not relieved by high-copy expression of eIF4G or by disruption of the yeast eIF4E binding protein Caf20p. High-copy expression of a mutant eIF4G defective for eIF4E binding resulted in a dominant negative phenotype in an xrn1 mutant, indicating the importance of this interaction in an xrn1 mutant. Another allele of CDC33, cdc33-1, along with mutations in CEG1, encoding the nuclear guanylyltransferase, were also synthetic lethal with xrn1Delta, whereas mutations in PRT1, encoding a subunit of eIF3, were not. Mutations in CDC33, CEG1, PRT1, PAB1, and TIF4631, encoding eIF4G1, have been shown to lead to destabilization of mRNAs. Although such destabilization in cdc33, ceg1, and pab1 mutants can be partially suppressed by an xrn1 mutation, we observed synthetic lethality between xrn1 and either cdc33 or ceg1 and no suppression of the inviability of a pab1 null mutation by xrn1Delta. Thus, the inhibition of mRNA turnover by blocking Xrn1p function does not suppress the lethality of defects upstream in the turnover pathway but it does enhance the requirement for (7)mG caps and for proper formation of the eIF4E/eIF4G cap recognition complex. PMID:10790382

  11. The partitioning of calcium and sulfur between bottom ash and flyash in a commercial CFB boiler

    SciTech Connect

    Rozelle, P.L.; Pisupati, S.V.; Morrison, J.L.; Scaroni, A.W.

    1999-07-01

    As part of a program to examine the effect of sorbent properties on sulfation performance in the circulating fluidized bed (CFB) combustion process, a series of sorbents varying in chemical composition was tested under similar operating conditions in a 30 MW(e) CFB boiler. These sorbents ranged from 27.8 to 55.2 wt% CaO, and from 0.54 to 18.8 wt% MgO. The fuel used was a high ash content (68 wt%) coal refuse. Parameters of boiler operation were established from distributed control system data, used to screen test results, and data were eliminated from consideration where changes in boiler load or bed inventory levels were seen prior to sampling of bottom ash and flyash streams. This, and the development of a set of simultaneous equations for measuring individual ash stream flow rates, allowed the computation of calcium and sulfur material balances around the boiler for each sorbent test. The partitioning of calcium and sulfur to the bottom ash and flyash streams was examined. It was found that the majority of both calcium and sulfur fed to the boiler was removed with the flyash, regardless of the sorbent. It was further found that across the range of sorbent properties, the flow of sulfur as a solid with the flyash was relatively uniform (71 to 86 wt% of that fed to the boiler). Calcium to sulfur ratios in the bottom ash were uniformly higher than those found for the corresponding flyash streams, indicating that attrition may play a key role in overall sorbent performance. The calcium balance data also indicated that thermally induced fractures (TIFs) may affect attrition.

  12. Molecular mechanisms of mutagenesis and carcinogenesis. Final report, November 1, 1978-October 31, 1979

    SciTech Connect

    Ptashne, M.

    1980-04-01

    The recA gene product mediates induction of a battery of cellular functions in E. coli collectively known as the SOS inducible functions. These include prophage induction, induction of filamentous cell growth, induction of DNA repair systems and induction of the recA gene itself. Prophage induction has been demonstrated to result from cleavage of the phage repressor protein by a specific protease function of the recA protein. Such cleavage destroys repressor function in lysogenic cells and allows the prophage to enter the vegetative growth cycle. Normally, the protease function of recA protein only becomes active in the cell in response to signals produced by agents (carcinogens) or treatments that specifically damage DNA or interfere with DNA replication. In the tif-1 mutant of recA, however, the protease can be made to be active simply by raising the temperature of the culture from 30/sup 0/ to 40/sup 0/ C; lambda prophage is induced and the cell produces a normal burst of phage. Indeed, all known SOS functions are also induced under these conditions. Thus, it has been proposed that all SOS functions are similarly regulated by repressors that are sensitive to the recA portease function. We have sought to further characterize the recA-/mediated cleavage reaction and its requirements for lambda repressor in vitro and to extend our biochemical studies to a cellular SOS repressor, the lexA gene product which is proposed to negatively regulate several SOS inducible functions, including the recA gene, a gene controlling cell separation and lexA gene itself.

  13. Transparent, 3-dimensional light-collected, and flexible fiber-type dye-sensitized solar cells based on highly ordered hierarchical anatase TiO2 nanorod arrays

    NASA Astrophysics Data System (ADS)

    Liang, Jia; Zhang, Gengmin; Yin, Jianbo; Yang, Yingchao

    2014-12-01

    Two kinds of hierarchical anatase TiO2 structures are synthesized by a facile hydrothermal method in this report. A new transparent, 3D light-collected, and flexible fiber-type dye-sensitized solar cell (FF-DSSC) with such hierarchical TiO2 structures is developed. The conversion efficiency of the FF-DSSC based on a TiCl4-treated TiO2 nanorod array (hierarchical structure I) exhibits about 4 times higher than that based on a HCl-treated TiO2 nanorod array, and further rises to 4.4% when the TiCl4-treated TiO2 nanorod array is treated in a mixed solution of (NH4)2TiF6 and H3BO3 three times (hierarchical structure II). The obvious enhancement in conversion efficiency can be ascribed to the dye adsorption promotion benefiting from their hierarchical structures. Beyond the attractive conversion efficiency, the new designed FF-DSSC possesses several advantages including good flexibility, excellent stability, and 3D light-collection. The conversion efficiencies of the FF-DSSCs can still keep 85%-90% even the FF-DSSCs are bent for 1000 times. The maximum power outputs of the FF-DSSCs characterized by Diffuse Illumination Mode using home-made Al reflector exhibit about 3 times higher than that done by Standard Illumination Mode due to 3D light-collections. The FF-DSSCs based on highly ordered hierarchical anatase TiO2 nanorod arrays hold great promise in future energy harvest.

  14. Copper vapor laser fragmentation of gallstones: in vitro measurements of wall heat transmission.

    PubMed

    Dayton, M T; Decker, D L; McClane, R; Dixon, J A

    1988-07-01

    Laser fragmentation is a promising new modality in management of retained CBD stones. Recent reports demonstrate the feasibility of lasers for this, but few studies have evaluated their safety (e.g., thermal injury may occur at greater than 43 degrees C). This study was conducted to measure heat transmission from lased bilirubinate and mixed stones to a simulated CBD wall. Four welded thermocouples were passed to the inside wall of 6-mm polyvinyl tubing 90 degrees apart to surround the lumen stone. The thermocouples were interfaced to a computer and temperatures were recorded every 270 msec. The tubing was submerged in a 37 degrees C water bath for all lasing work. A copper vapor laser (wavelength, 510 nm; 5.6 W; 5 kHz; pulse length, 30 ns) was attached to a 650-micron quartz fiber. A stone was "impacted" in the tubing and the laser fiber was pushed against the stone while making multiple passes to fragment it. Thirty mixed gallstones (mean size, 6.9 X 5.1 mm) and 20 bilirubinate gallstones (mean size, 7.1 X 5.2 mm) were fragmented during the study. Maximum temperature (Tmax), duration of Tmax (TmaxD), interval to stone piercing (TiP), and interval to fragmentation (TiF) were measured and comparisons were carried out with the SPSS statistical package using the t test procedure. The Tmax generated during fragmentation of bilirubinate stones (43.4 +/- 1.7 degrees C) was significantly less (P less than 0.002) than the Tmax for mixed stones (54.0 +/- 2.7 degrees C) but both Tmax values represented potentially injurious temperature levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3392997

  15. iRODS-Based Climate Data Services and Virtualization-as-a-Service in the NASA Center for Climate Simulation

    NASA Astrophysics Data System (ADS)

    Schnase, J. L.; Duffy, D. Q.; Tamkin, G. S.; Strong, S.; Ripley, D.; Gill, R.; Sinno, S. S.; Shen, Y.; Carriere, L. E.; Brieger, L.; Moore, R.; Rajasekar, A.; Schroeder, W.; Wan, M.

    2011-12-01

    Scientific data services are becoming an important part of the NASA Center for Climate Simulation's mission. Our technological response to this expanding role is built around the concept of specialized virtual climate data servers, repetitive cloud provisioning, image-based deployment and distribution, and virtualization-as-a-service. A virtual climate data server is an OAIS-compliant, iRODS-based data server designed to support a particular type of scientific data collection. iRODS is data grid middleware that provides policy-based control over collection-building, managing, querying, accessing, and preserving large scientific data sets. We have developed prototype vCDSs to manage NetCDF, HDF, and GeoTIF data products. We use RPM scripts to build vCDS images in our local computing environment, our local Virtual Machine Environment, NASA's Nebula Cloud Services, and Amazon's Elastic Compute Cloud. Once provisioned into these virtualized resources, multiple vCDSs can use iRODS's federation and realized object capabilities to create an integrated ecosystem of data servers that can scale and adapt to changing requirements. This approach enables platform- or software-as-a-service deployment of the vCDSs and allows the NCCS to offer virtualization-as-a-service, a capacity to respond in an agile way to new customer requests for data services, and a path for migrating existing services into the cloud. We have registered MODIS Atmosphere data products in a vCDS that contains 54 million registered files, 630TB of data, and over 300 million metadata values. We are now assembling IPCC AR5 data into a production vCDS that will provide the platform upon which NCCS's Earth System Grid (ESG) node publishes to the extended science community. In this talk, we describe our approach, experiences, lessons learned, and plans for the future.

  16. Genomic organization of the human VP16 accessory protein, a housekeeping gene (HCFC1) mapping to Xq28

    SciTech Connect

    Frattini, A.; Faranda, S.; Redolfi, E.

    1994-09-01

    The region between DXS52 and Factor VIII gene in the human Xq28 chromosomal band contains a G+C-rich isochore to which many genes have been mapped. We report here the isolation and characterization of a transcript mapping about 50 kb telomeric from the vasopressin type 2 receptor gene in a 180-kb YAC/cosmid contig containing the L1CAM gene at its centromeric end. The determined transcribed sequence from a human fetal brain library is identical to that of the recently identified accessory protein HCFC1 (host cell factor, also called C1) that activates herpes simplex virus VP16 ({alpha}TIF) transactivator protein for association with the octamer motif-binding protein Oct-1. The gene is expressed in a ubiquitous pattern and a larger transcript of approximately 10 kb is present in all the tissues tested, while an alternatively spliced RNA of approximately 8.0 kb is present in muscle and heart tissues. Genomic sequencing allowed us to determine that the sequenced transcript is assembled from 26 exons spread over a relatively small genomic region of approximately 24 kb. This allowed us to determine that a previously reported cDNA clone arises from the splicing out of an internal portion of exon 8 which does not change the reading frame. All together these results raise the possibility that alternative mRNA processing could partly contribute to the diversity of the polypeptide HCFC1 family in a subset of tissues. 31 refs., 3 figs., 1 tab.

  17. Tubular cell phenotype in HIV-associated nephropathy: role of phospholipid lysophosphatidic acid.

    PubMed

    Ayasolla, Kamesh R; Rai, Partab; Rahimipour, Shai; Hussain, Mohammad; Malhotra, Ashwani; Singhal, Pravin C

    2015-08-01

    Collapsing glomerulopathy and microcysts are characteristic histological features of HIV-associated nephropathy (HIVAN). We have previously reported the role of epithelial mesenchymal transition (EMT) in the development of glomerular and tubular cell phenotypes in HIVAN. Since persistent tubular cell activation of NFκB has been reported in HIVAN, we now hypothesize that HIV may be contributing to tubular cell phenotype via lysophosphatidic acid (LPA) mediated downstream signaling. Interestingly, LPA and its receptors have also been implicated in the tubular interstitial cell fibrosis (TIF) and cyst formation in autosomal dominant polycystic kidney disease (PKD). Primary human proximal tubular cells (HRPTCs) were transduced with either empty vector (EV/HRPTCs), HIV (HIV/HRPTCs) or treated with LPA (LPA/HRPTC). Immunoelectrophoresis of HIV/HRPTCs and LPA/HRPTCs displayed enhanced expression of pro-fibrotic markers: a) fibronectin (2.25 fold), b) connective tissue growth factor (CTGF; 4.8 fold), c) α-smooth muscle actin (α-SMA; 12 fold), and d) collagen I (5.7 fold). HIV enhanced tubular cell phosphorylation of ILK-1, FAK, PI3K, Akt, ERKs and P38 MAPK. HIV increased tubular cell transcriptional binding activity of NF-κB; whereas, a LPA biosynthesis inhibitor (AACOCF3), a DAG kinase inhibitor, a LPA receptor blocker (Ki16425), a NF-κB inhibitor (PDTC) and NFκB-siRNA not only displayed downregulation of a NFκB activity but also showed attenuated expression of profibrotic/EMT genes in HIV milieu. These findings suggest that LPA could be contributing to HIV-induced tubular cell phenotype via NFκB activation in HIVAN. PMID:26079546

  18. High Mobility Group A2 protects cancer cells against telomere dysfunction

    PubMed Central

    Natarajan, Suchitra; Begum, Farhana; Gim, Jeonga; Wark, Landon; Henderson, Dana; Davie, James R.

    2016-01-01

    The non-histone chromatin binding protein High Mobility Group AT-hook protein 2 (HMGA2) plays important roles in the repair and protection of genomic DNA in embryonic stem cells and cancer cells. Here we show that HMGA2 localizes to mammalian telomeres and enhances telomere stability in cancer cells. We present a novel interaction of HMGA2 with the key shelterin protein TRF2. We found that the linker (L1) region of HMGA2 contributes to this interaction but the ATI-L1-ATII molecular region of HMGA2 is required for strong interaction with TRF2. This interaction was independent of HMGA2 DNA-binding and did not require the TRF2 interacting partner RAP1 but involved the homodimerization and hinge regions of TRF2. HMGA2 retained TRF2 at telomeres and reduced telomere-dysfunction despite induced telomere stress. Silencing of HMGA2 resulted in (i) reduced binding of TRF2 to telomere DNA as observed by ChIP, (ii) increased telomere instability and (iii) the formation of telomere dysfunction-induced foci (TIF). This resulted in increased telomere aggregation, anaphase bridges and micronuclei. HMGA2 prevented ATM-dependent pTRF2T188 phosphorylation and attenuated signaling via the telomere specific ATM-CHK2-CDC25C DNA damage signaling axis. In summary, our data demonstrate a unique and novel role of HMGA2 in telomere protection and promoting telomere stability in cancer cells. This identifies HMGA2 as a new therapeutic target for the destabilization of telomeres in HMGA2+ cancer cells. PMID:26799419

  19. Identification and analysis of the TIFY gene family in Gossypium raimondii.

    PubMed

    He, D H; Lei, Z P; Tang, B S; Xing, H Y; Zhao, J X; Jing, Y L

    2015-01-01

    The highly conserved TIFY domain is included in the TIFY protein family of transcription factors, which is important in plant development. Here, 28 TIFY family genes were identified in the Gossypium raimondii genome and classified into JAZ (15 genes), ZML (8), PPD (3), and TIFY (2). The normal (TIF[F/Y]XG) motif was dominant in the TIFY family, excluding the ZML subfamily, in which TLSFXG was prevalent. TIFY family genes were unevenly distributed in the G. raimondii genome, with TIFY clusters present on chromosome 9. Phylogenetic analysis indicated abundant variations in the G. raimondii TIFY family, which were most closely related to those in Theobroma cacao among 5 species. Exon-intron organization and intron phases were homologous within each subfamily, correlating with their phylogeny. Intra-species synteny analyses indicated that genomic duplication contributed to the expansion of the TIFY family. Inter-species synteny analyses indicated that synteny regions involved in G. raimondii TIFY family genes were also present in the comparison of G. raimondii vs Arabidopsis thaliana or T. cacao, signifying that these genes had common ancestors and play the same or similar roles in biological processes. Greater synteny was present in the comparison of G. raimondii vs T. cacao than of G. raimondii vs A. thaliana. The expression patterns of TIFY family genes were characterized and most TIFY family genes were indicated to be involved in fiber development. Our study provides new data related to the evolution of TIFYs and their role as important regulators of transcription; these data can be useful for fiber development. PMID:26345949

  20. RIPK3-Mediated Necroptosis and Apoptosis Contributes to Renal Tubular Cell Progressive Loss and Chronic Kidney Disease Progression in Rats

    PubMed Central

    Zhu, Yongjun; Cui, Hongwang; Xia, Yunfeng; Gan, Hua

    2016-01-01

    Tubulointerstitial fibrosis (TIF) is caused by the progressive loss of renal tubular cells and the consequent replacement of the extracellular matrix. The progressive depletion of renal tubular cells results from apoptosis and necroptosis; however, the relative significance of each of these cell death mechanisms at different stages during the progression of chronic kidney disease (CKD) remains unclear. We sought to explore the mechanisms of renal tubular cell death during the early and intermediate stages of chronic renal damage of subtotal nephrectomied (SNx) rats. The results of tissue histological assays indicated that the numbers of necrotic dying cells and apoptotic cells were significantly higher in kidney tissues derived from a rat model of CKD. In addition, there was a significant increase in necroptosis observed by transmission electron microscopy (TEM) and an increase in the proportion of TUNEL-positive cells in kidney tissues from SNx rats compared with control rats, and necrostatin-1 (Nec-1) could inhibit necroptosis and reduce the proportion of TUNEL-positive cells. More importantly, we observed a significant increase in the incidence of necroptosis compared with apoptosis by TEM in vivo and in vitro and a significant increase in the proportion of TUNEL-positive tubular epithelial cells that did not express caspase-3 compared with those expressing cleaved caspase-3 in vitro. Furthermore, treatment with Nec-1 and zVAD strongly reduced necroptosis- and apoptosis-mediated renal tubular cell death and decreased the levels of blood urea nitrogen and serum creatinine and tubular damage scores of SNx rats. These results suggest that necroptotic cell death plays a more significant role than apoptosis in mediating the loss of renal tubular cells in SNx rats and that effectively blocking both necroptosis and apoptosis improves renal function and tubular damage at early and intermediate stages of CKD. PMID:27281190