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Sample records for med transluminal angioplastik 13

  1. Redefining the MED13L syndrome.

    PubMed

    Adegbola, Abidemi; Musante, Luciana; Callewaert, Bert; Maciel, Patricia; Hu, Hao; Isidor, Bertrand; Picker-Minh, Sylvie; Le Caignec, Cedric; Delle Chiaie, Barbara; Vanakker, Olivier; Menten, Björn; Dheedene, Annelies; Bockaert, Nele; Roelens, Filip; Decaestecker, Karin; Silva, João; Soares, Gabriela; Lopes, Fátima; Najmabadi, Hossein; Kahrizi, Kimia; Cox, Gerald F; Angus, Steven P; Staropoli, John F; Fischer, Ute; Suckow, Vanessa; Bartsch, Oliver; Chess, Andrew; Ropers, Hans-Hilger; Wienker, Thomas F; Hübner, Christoph; Kaindl, Angela M; Kalscheuer, Vera M

    2015-10-01

    Congenital cardiac and neurodevelopmental deficits have been recently linked to the mediator complex subunit 13-like protein MED13L, a subunit of the CDK8-associated mediator complex that functions in transcriptional regulation through DNA-binding transcription factors and RNA polymerase II. Heterozygous MED13L variants cause transposition of the great arteries and intellectual disability (ID). Here, we report eight patients with predominantly novel MED13L variants who lack such complex congenital heart malformations. Rather, they depict a syndromic form of ID characterized by facial dysmorphism, ID, speech impairment, motor developmental delay with muscular hypotonia and behavioral difficulties. We thereby define a novel syndrome and significantly broaden the clinical spectrum associated with MED13L variants. A prominent feature of the MED13L neurocognitive presentation is profound language impairment, often in combination with articulatory deficits. PMID:25758992

  2. MED13-dependent signaling from the heart confers leanness by enhancing metabolism in adipose tissue and liver

    PubMed Central

    Baskin, Kedryn K; Grueter, Chad E; Kusminski, Christine M; Holland, William L; Bookout, Angie L; Satapati, Santosh; Kong, Y Megan; Burgess, Shawn C; Malloy, Craig R; Scherer, Philipp E; Newgard, Christopher B; Bassel-Duby, Rhonda; Olson, Eric N

    2014-01-01

    The heart requires a continuous supply of energy but has little capacity for energy storage and thus relies on exogenous metabolic sources. We previously showed that cardiac MED13 modulates systemic energy homeostasis in mice. Here, we sought to define the extra-cardiac tissue(s) that respond to cardiac MED13 signaling. We show that cardiac overexpression of MED13 in transgenic (MED13cTg) mice confers a lean phenotype that is associated with increased lipid uptake, beta-oxidation and mitochondrial content in white adipose tissue (WAT) and liver. Cardiac expression of MED13 decreases metabolic gene expression in the heart but enhances them in WAT. Although exhibiting increased energy expenditure in the fed state, MED13cTg mice metabolically adapt to fasting. Furthermore, MED13cTg hearts oxidize fuel that is readily available, rendering them more efficient in the fed state. Parabiosis experiments in which circulations of wild-type and MED13cTg mice are joined, reveal that circulating factor(s) in MED13cTg mice promote enhanced metabolism and leanness. These findings demonstrate that MED13 acts within the heart to promote systemic energy expenditure in extra-cardiac energy depots and point to an unexplored metabolic communication system between the heart and other tissues. See also: M Nakamura & J Sadoshima (December 2014) PMID:25422356

  3. Percutaneous transluminal coronary angioplasty (PTCA)

    MedlinePlus Videos and Cool Tools

    Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle. The procedure ...

  4. HSI2 Repressor Recruits MED13 and HDA6 to Down-Regulate Seed Maturation Gene Expression Directly During Arabidopsis Early Seedling Growth.

    PubMed

    Chhun, Tory; Chong, Suet Yen; Park, Bong Soo; Wong, Eriko Chi Cheng; Yin, Jun-Lin; Kim, Mijung; Chua, Nam-Hai

    2016-08-01

    Arabidopsis HSI2 (HIGH-LEVEL EXPRESSION OF SUGAR-INDUCIBLE GENE 2) which carries a EAR (ERF-associated amphiphilic repression) motif acts as a repressor of seed maturation genes and lipid biosynthesis, whereas MEDIATOR (MED) is a conserved multiprotein complex linking DNA-bound transcription factors to RNA polymerase II transcription machinery. How HSI2 executes its repressive function through MED is hitherto unknown. Here, we show that HSI2 and its homolog, HSI2-lik (HSL1), are able to form homo- and heterocomplexes. Both factors bind to the TRAP240 domain of MED13, a subunit of the MED CDK8 module. Mutant alleles of the med13 mutant show elevated seed maturation gene expression and increased lipid accumulation in cotyledons; in contrast, HSI2- or MED13-overexpressing plants display the opposite phenotypes. The overexpression phenotypes of HSI2 and MED13 are abolished in med13 and hsi2 hsl1, respectively, indicating that HSI2 and MED13 together are required for these functions. The HSI2 C-terminal region interacts with HDA6, whose overexpression also reduces seed maturation gene expression and lipid accumulation. Moreover, HSI2, MED13 and HDA6 bind to the proximal promoter and 5'-coding regions of seed maturation genes. Taken together, our results suggest that HSI2 recruits MED13 and HDA6 to suppress directly a subset of seed maturation genes post-germination. PMID:27335347

  5. A role for Mediator complex subunit MED13L in Rb/E2F-induced growth arrest

    PubMed Central

    Angus, Steven P.; Nevins, Joseph R.

    2013-01-01

    The Rb/E2F pathway is deregulated in virtually all human tumors. It is clear that, in addition to Rb itself, essential co-factors required for transcriptional repression and silencing of E2F target genes are mutated or lost in cancer. To identify novel co-factors required for Rb/E2F-mediated inhibition of cell proliferation, we performed a genome-wide shRNA screen. In addition to several known Rb co-factors, the screen identified components of the Mediator complex, a large multiprotein coactivator required for RNA polymerase II transcription. We show that the Mediator complex subunit MED13L is required for Rb/E2F control of cell growth, the complete repression of cell cycle target genes, and cell cycle inhibition. PMID:22249253

  6. Deletion of the MED13 and CDK8 subunits of the Mediator improves the phenotype of a long-lived respiratory deficient mutant of Podospora anserina.

    PubMed

    Humbert, Adeline; Bovier, Elodie; Sellem, Carole H; Sainsard-Chanet, Annie

    2015-09-01

    In Podospora anserina, the loss of function of the cytochrome segment of the mitochondrial respiratory chain is viable. This is due to the presence in this organism, as in most filamentous fungi, of an alternative respiratory oxidase (AOX) that provides a bypass to the cytochrome pathway. However mutants lacking a functional cytochrome pathway present multiple phenotypes including poorly colored thin mycelium and slow growth. In a large genetic screen based on the improvement of these phenotypes, we isolated a large number of independent suppressor mutations. Most of them led to the constitutive overexpression of the aox gene. In this study, we characterize a new suppressor mutation that does not affect the production of AOX. It is a loss-of-function mutation in the gene encoding the MED13 subunit of the kinase module of the Mediator complex. Inactivation of the cdk8 gene encoding another subunit of the same module also results in partial suppression of a cytochrome-deficient mutant. Analysis of strains lacking the MED13 or CDK8 subunits points to the importance of these subunits as regulators involved in diverse physiological processes such as growth, longevity and sexual development. Interestingly, transcriptional analyses indicate that in P. anserina, loss of the respiratory cytochrome pathway results in the up-regulation of glycolysis-related genes revealing a new type of retrograde regulation. The loss of MED13 augments the up-regulation of some of these genes. PMID:26231682

  7. MEDLI Animation

    NASA Video Gallery

    Animation of MEDLI, the Mars Science Laboratory Entry, Descent, and Landing Instrument, which contains multiple sophisticated temperature sensors to measure atmospheric conditions and performance o...

  8. Percutaneous transluminal angioplasty of radiation-induced arterial stenoses

    SciTech Connect

    Guthaner, D.F.; Schmitz, L.

    1982-07-01

    A case of atherosclerosis resulting from previous irradiation was successfully treated using percutaneous transluminal angioplasty for recanalization of the vessel. Irradiation may result in extensive perivascular fibrosis around an area of arterial narrowing; percutaneous transluminal angioplasty appears to be the method of choice for treatment of such lesions.

  9. 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

  10. Effect of percutaneous transluminal coronary angioplasty on coronary reserve

    SciTech Connect

    Lassar, T.; Hendrix, L.; Ray, G.; Schmidt, D.

    1984-01-01

    This study was done to assess the effect of percutaneous transluminal coronary angioplasty (PTCA) on regional myocardial perfusion (RMP) in the region distal to a stenosis in 48 patients. Quantitative RMP in ml/100g/min was measured from the washout of Xe-133 following selective injection into the involved coronary artery. After successful dilation, determined by a reduction in %stenosis to a less than or equal to 50% lesion and in pressure gradient across the lesion, the RMP measurement was repeated. In these patients, means %stenosis was 85% pre PTCA and 29% post PTCA with mean pressure gradient of 60 Hg pre PTCA and 21 mm Hg post PTCA. 21 of these 48 patients also had RMP measured after isoproterenol (ISO) both pre and post PTCA to increase myocardial oxygen demand to assess coronary reserve. Heart rate (HR) and systolic blood pressure (SBP) were constant pre and post PTCA which allowed a valid comparison. The results are presented. A group of 13 patients with normal coronary arteries and ventricular function showed a mean control RMP of 78 +- 15 and a mean ISO RMP of 140 +- 26. The data demonstrate that following successful PTCA quantitative RMP improves both at rest and with an ISO challenge and is similar to RMP in normal coronary arteries.

  11. [Exercise tolerance in patients after successful percutaneous transluminal coronary angioplasty].

    PubMed

    Tsumoto, S; Nakagawa, Y; Asakuma, S; Naruse, H; Komasa, N; Ohyanagi, M; Tateishi, J; Yasutomi, N; Fujitani, K; Iwasaki, T

    1991-01-01

    In 32 patients with successful percutaneous transluminal coronary angioplasty (PTCA), we performed treadmill exercise tests (TMET) before and about one month after PTCA to assess the correlation between the improvement in coronary artery lesions and exercise tolerance. Either the Bruce protocol (B: n = 12) or the modified Bruce protocol (MB: n = 20) was used; with the latter being applied to patients whose cardiac function seemed depressed. In 15 patients, oxygen consumption (VO2) was measured by analyzing the expired gases, 13 patients underwent exercise thallium-201 myocardial perfusion scintigraphy before and after PTCA, whose results were compared with those of TMET. In both B and MB protocols, the treadmill walking time was significantly prolonged after PTCA, compared to that before PTCA (B: 7.4 +/- 1.3 vs 9.5 +/- 1.9, MB: 11.4 +/- 3.5 vs 12.7 +/- 3.5 min). Heart rates (HR) and rate pressure products (RPP) were significantly increased after PTCA in both protocols (HR B: 139 +/- 18 vs 154 +/- 17, MB: 121 +/- 20 vs 137 +/- 19 bpm, RPP B: 26,500 +/- 5,600 vs 30,300 +/- 6,700, MB: 19,400 +/- 6,200 vs 22,700 +/- 6,600 mmHg.bpm), however, systolic blood pressure did not change significantly after PTCA in either protocol. While there was a significant improvement in VO2 after PTCA (21.6 +/- 6.3 vs 25.7 +/- 4.2 ml/kg/min), the O2-pulse remained unchanged. Thallium-201 myocardial scintigraphy revealed improvement of myocardial perfusion in 8 of the 13 cases examined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1841916

  12. [Natural orifice transluminal endoscopic surgery: current situation].

    PubMed

    Delgado, Salvadora; Ibarzábal, Ainitze; Fernández-Esparrach, Glòria

    2008-10-01

    Natural orifice transluminal endoscopic surgery (NOTES) is the paradigm of the evolution of minimally invasive surgery. The laparoscopic has introduced new ideas in general surgery, one of them being that modern surgery is the work of multidisciplinary teams. A clear example of this is provided by NOTES. The aim of this type of surgery is to perform conventional laparoscopic procedures without incision, using flexible endoscopic technology usually employed in the diagnosis and treatment of intraluminal lesions and reaching the inside of the abdominal cavity through natural orifices (mouth, anus, vagina and even urethra). This type of access opens a highly interesting field for certain types of patients, such as those with high surgical risk, the morbidly obese, and those with multiple prior abdominal interventions or surgical wound infections. Animal models have shown that a wide variety of interventions (cholecystectomy, appendicectomy, splenectomy, hysterectomy, tubal ligations, gastroenteroanastomosis, peritoneoscopy, liver biopsy and herniorrhaphy, among others) can be performed. However, before use in humans, this new technique must be shown to be safe and to provide real advantages for patients. To do this, a series of issues, including safe methods for closure of the gastric incision and the avoidance of infections, among others, must be solved. Another critical element for the development of this new type of surgery is the creation of appropriate instrumentation, requiring input not only from medical professionals but also from engineers and industry. The present article describes the major advances made in NOTES since this technique was first described and analyzes the risks and potential benefits associated with this novel procedure. PMID:18928752

  13. Angioscopy by a new percutaneous transluminal coronary angioscope

    NASA Astrophysics Data System (ADS)

    Sakurada, Masami; Mizuno, Kyoichi; Miyamoto, Akira; Arakawa, Koh; Satomura, Kimio; Shibuya, Toshio; Yanagida, Shigeki; Okamoto, Yasuyuki; Kurita, Akira; Nakamura, Haruo; Arai, Tsunenori; Suda, Akira; Kikuchi, Makoto; Utsumi, Atsushi; Takeuchi, Kiyoshi; Akai, Yoshiro

    1990-07-01

    We developed a new percutaneous transluminal coronary angioscopic catheter for visualization of coronary artery.This angioscopic catheter has an inflatable balloon at the distal tip and one - directional angulation mechanism.We performed percutaneous transluminal coronary angioscopy during cardiac catheterization cosecutively in 155 patients. With this angioscope , we could get good'-'fair visualization in 81%(131 of 162 lesions)without major complications.We could investigate the endothelial macropathology of ischemic heart disease such as unstable angina and acute myocardial infarction.

  14. Salvage of Immature Arteriovenous Fistulas with Percutaneous Transluminal Angioplasty

    SciTech Connect

    Shin, Sung Wook; Do, Young Soo Choo, Sung Wook; Lieu, Wei Chiang; Choo, In-Wook

    2005-05-15

    The purpose of this study was to assess the value of percutaneous transluminal angioplasty (PTA) for the salvage of arteriovenous fistulas (AVFs) that fail to mature. From November 1998 to February 2003, 19 patients who were treated with PTA due to immature forearm AVFs were selected. Fistulography and PTA were performed via a retrograde transvenous approach after direct puncture of the fistular vein. Technical success was defined as less than a 30% residual stenosis, whereas clinical success was defined as the ability to perform at least one session of normal hemodialysis after PTA. Findings of fistulograms, success rates of PTA, and patency rates were evaluated. On initial fistulograms, stenoses were observed in all cases and 68% (13/19) of the stenoses were located in the perianastomotic area of these immature AVFs. The initial technical success rate was 84% (16/19). Technical failures comprised two patients with diffuse narrowing and segmental thrombosis of the cephalic veins and one case of elastic recoil of the anastomotic site stenosis after PTA. Two patients were immediately lost on follow-up. The remaining 14 cases underwent successful hemodialysis 0 to 33 (mean = 15) days after PTA, showing 74% (14/19) clinical success. Although accessory branch veins were noted in most cases (74%, 14/19), leaving them alone did not affect the maturation of AVFs following PTA. There was no significant procedural or late complication. Primary and secondary patency rates at 1 year were 61 and 82%, respectively. For those AVFs that failed to mature, there were stenoses along their vascular courses as underlying causes. For the percutaneous procedure, the retrograde transvenous approach was a reasonable one. As PTA is effective and quick for the salvation of immature AVFs, it can be considered a primary method for salvaging these immature AVFs.

  15. Natural orifice transluminal endoscopic surgery (NOTES): implications for anesthesia.

    PubMed

    Schaefer, Michael

    2009-01-01

    Natural orifice transluminal endoscopic surgery (NOTES) has recently evolved as a novel approach for abdominal surgery with great potential to further improve the advantages of laparoscopy over laparotomy. The first patients undergoing NOTES cholecystectomy or appendectomy reported no or only minimal pain, required no narcotic analgesics, and were discharged early from the hospital and immediately resumed daily activities. If this is confirmed by randomized controlled clinical trials, what are the potential implications for anesthesia? PMID:20948698

  16. Transluminal aortic valve placement. A feasibility study with a newly designed collapsible aortic valve.

    PubMed

    Moazami, N; Bessler, M; Argenziano, M; Choudhri, A F; Cabreriza, S E; Allendorf, J D; Rose, E A; Oz, M C

    1996-01-01

    Percutaneous stents are used in vascular applications in conjunction with angioplasty and in combination with graft material for repair of abdominal aneurysms. The authors have designed a collapsible bioprosthetic aortic valve for placement by a transluminal catheter technique. This trileaflet stent valve is composed of stainless steel and bovine pericardium. Stent valves, 23 and 29 mm, were tested in a pulse duplicator system with rigid rings from 21 to 31 mm in 2 mm increments. At a mean flow of 3.1 L/min (+/-0.7), normal systemic aortic pressure was generated with a transvalvular gradient of 14.9 +/- 7 mmHg (mean +/- SD). Regurgitation fraction ranged from 10 to 18% (mean 13.8 +/- 3%) in the best ring size. Valves with the best hemodynamic profile were used for implantation in three 70 kg pigs in an open chest model. The valve was collapsed in a 24 Fr catheter designed to allow slow, controlled release. After resection of the native leaflets, the new valve was placed in the subcoronary position. No additional sutures were used for securing the valve. Two animals were successfully weaned from cardiopulmonary bypass and maintained systemic pressures of 100/45 (+/-10) and 116/70 (+/-15) mmHg, respectively. Intraoperative color echocardiography revealed minimal regurgitation, central flow, full apposition of all leaflets, and no interference with coronary blood flow. Both animals were sacrificed after being off bypass for 2 hr. Postmortem examination revealed the valves to be securely anchored. The third animal was weaned from cardiopulmonary bypass but developed refractory ventricular fibrillation because of valve dislodgment due to structural failure. Although long term survival data are needed, development of a hemodynamically acceptable prosthetic aortic valve for transluminal placement is feasible. PMID:8944912

  17. Successful Percutaneous Transluminal Angioplasty and Stenting in Acute Mesenteric Ischemia

    SciTech Connect

    Gartenschlaeger, Soeren Bender, Siegfried; Maeurer, Juergen; Schroeder, Ralf J.

    2008-03-15

    Acute mesenteric ischemia (AMI) is a life-threatening emergency. The complications are high by the time of diagnosis in most cases and therefore only few data on primary percutaneous intervention with percutaneous transluminal angioplasty (PTA) and stenting in AMI are available. We present the case of an 84-year-old woman who presented to our emergency department complaining of an acute worsening of pre-existing abdominal periumbilical pain, nausea, vomiting, and diarrhea. She had previously undergone percutaneous transluminal embolectomy for an acute occlusion of the left common femoral artery. Due to suspicion of intestinal infarction, conventional angiography of the aorta and the superior mesenteric artery (SMA) was performed and confirmed a proximal occlusion of the SMA. Percutaneous SMA recanalization with balloon dilation and subsequent stent implantation was carried out successfully. The abdominal symptoms subsided after this procedure. In AMI that is diagnosed early, endovascular stenting should be considered as an alternative treatment to the surgical approach that avoids the need for surgical bowel resection.

  18. Hemodynamic evaluation of transluminal iliac artery balloon dilatation.

    PubMed

    Breslau, P J; van Soest, M; Janevski, B; Jörning, P J

    1985-10-01

    In order to document the hemodynamic results of transluminal iliac artery balloon dilatation, 23 aortoiliac segments were evaluated before and after treatment. Hemodynamic parameters were: intra-arterial common femoral pressure measurements, indirect ankle pressure measurements and femoral velocity waveform analysis. The segments were divided into group (a) aortoiliac segments with an open superficial femoral artery (n = 8), and group (b) aortoiliac segments with an occluded superficial femoral artery (n = 15). In group (a) all patients were free of symptoms and ankle pressure improved significantly six months after dilatation. Velocity waveform analysis of the common femoral artery did not correlate with this improvement. In group (b) intra-arterial pressure measurements showed improvement in 60% (9/15) after six months. Ankle pressure measurements and velocity waveform analysis did not correlate with the intra-arterial pressure changes. Transluminal iliac artery balloon dilatation of iliac stenosis in patients with an open superficial femoral artery can be evaluated by indirect ankle pressure measurements. In patients with iliac stenosis in combination with occluded superficial femoral arteries intra-arterial pressure measurements are needed to demonstrate hemodynamic improvement. PMID:2932658

  19. Emergency transvaginal hybrid natural orifice transluminal endoscopic surgery.

    PubMed

    Noguera, J F; Cuadrado, A; Sánchez-Margallo, F M; Dolz, C; Asencio, J M; Olea, J M; Morales, R; Lozano, L; Vicens, J C

    2011-05-01

    In a clinical series, 10 consecutive female patients with intra-abdominal infections were successfully treated with natural orifice transluminal endoscopic surgery (NOTES) performed transvaginally. The surgery, which consisted of a hybrid NOTES procedure using a transvaginal approach, was performed on an emergency basis by the surgical team on call. The indications for surgery were acute cholecystitis (n = 6), acute appendicitis (n = 2), and pelvic peritonitis (n = 2) with intra-abdominal infection. The procedure was successfully performed in all patients using a dual-channel endoscope and mini-laparoscopy assistance. This is the first clinical series in which NOTES has been performed on an emergency basis to treat intra-abdominal infections. Transvaginal surgery for intra-abdominal infection is a feasible procedure for groups experienced in the elective NOTES approach. PMID:21165824

  20. More accurate assessment of stenotic lesions in percutaneous transluminal angioplasty.

    PubMed

    Janevski, B K; Breslau, P J; Jorning, P J

    1986-01-01

    Eighty patients underwent percutaneous transluminal dilatation and recanalisation of atheromatous lesions of the arteries of the lower extremities in the University Hospital of Maastricht in the period of 1980 to 1984. Out of 80 attempted procedures of the iliac and femoro-popliteal tract 71 (89%) were technically possible and were considered initially successful. In all cases of iliac artery lesions a retrograde arteriogram was performed prior to PTA. Intra-arterial pressure measurements at rest and after hyperemia were used for exact assessment of the hemodynamic significance of the stenosis before and after PTA. A follow-up of all patients successfully treated by angioplasty was performed. The early hemodynamic success rate of PTA for iliac lesions was 90 per cent and for femoral-popliteal segment 83 per cent. There was no morbidity or mortality. The cumulative 3-year patency rate for both segments was 74 per cent. PMID:2943842

  1. Recent advances in natural orifice transluminal endoscopic surgery†.

    PubMed

    Yip, Hon-chi; Chiu, Philip Wai-yan

    2016-01-01

    Natural orifice transluminal endoscopic surgery (NOTES) has emerged as one of the most exciting areas in the field of minimally invasive surgery during the last decade. NOTES comprises a wide spectrum of procedures from various natural accesses such as transgastric or transvaginal routes, and different direct-target or distant-target organs. Since polypectomy was first performed in 1955, major advances in technology and refinement of endoscopic technique have allowed endoscopic surgeons to perform complex endoscopic interventions such as endoscopic submucosal dissection. Recognizing the safety and feasibility of submucosal tunnelling and mucosal closure, endoscopic resection beyond the level of mucosa has been increasingly reported. One of these procedures, peroral endoscopic myotomy for achalasia, has gained much popularity and excellent results have been published comparable with that of traditional Heller's cardiomyotomy. Submucosal tunnelling endoscopic resection has also been reported for tumours situated in the muscular layer of the gastrointestinal tract. To overcome the difficulty of intestinal closure after NOTES, researchers have collaborated with the industry in developing different endoscopic suturing devices such as the Eagle Claw (Olympus Medical Systems, Tokyo, Japan) and Overstitch™ (Apollo Endosurgery, Austin TX, USA). These devices allow precise and secure suture application with the ordinary flexible endoscope, achieving tissue approximation similar to open surgical suturing. To further expand the potential of NOTES, investigators had also developed multitasking platforms enabling the performance of surgical procedures of even higher complexity. Recently, a novel endoscopic robotic system 'Master and Slave Transluminal Endoscopic Robot' (MASTER) has been developed. Early results of endoscopic resection utilizing this system have been encouraging, allowing both experts and novices in endoscopy to perform difficult endoscopic resection with a

  2. Percutaneous transluminal radiofrequency closure of the coronary artery in animal studies

    PubMed Central

    ZHANG, CHENYUN; YI, WEI; CAI, YUNCHANG; FANG, SHOUNIAN; JIANG, XINAN; WEN, ANZHI; WU, QIANG

    2013-01-01

    The aim of this study was to investigate the safety and effectiveness of a novel method for the selective transcoronary closure of small coronary arteries by the intraluminal application of radiofrequency (RF) energy. Twenty-six small (diameter of 1–2 mm) coronary artery branches were selected in 13 dogs. An RF electrode wire (CRW-Zcy) was placed into the target vessel and a coronary balloon was used to transiently block the blood flow and limit damage to the proximal vessel. A therapeutic dosage of 20–30 W of RT energy every 10–30 sec (selected according the diameter of the target artery) was discharged via the CRW-Zcy inside a microcatheter two or three times in order to achieve arterial closure. A high dosage of 60 W every 120 sec of RF energy was used to conduct the safety study. All 26 branches were successfully closed resulting in the complete blockage of the antegrade and retrograde flows. The area of injury was limited to the target artery and the supplied myocardium. High-dose RF did not cause injury to the adjacent vessels and myocardium. The animals tolerated the procedure well without any untoward systemic effects. A follow-up angiography at two weeks revealed no evidence of recanalization or retrograde filling of the target artery. Percutaneous transluminal radiofrequency closure is a safe and effective interventional approach for closing the small coronary arteries, and is potentially valuable for further investigation. PMID:24137313

  3. Diabetic foot wounds in haemodialysis patients: 2-year outcome after percutaneous transluminal angioplasty and minor amputation.

    PubMed

    Matsuzaki, Kyoichi; Miyamoto, Akira; Hakamata, Naohiro; Fukuda, Masahiro; Yamauchi, Yasutaka; Akita, Takako; Kuhara, Ryoji; Tezuka, Shingo

    2012-12-01

    Critical limb ischaemia (CLI) is known to be associated with high mortality. In some patients, surgery cannot be performed due to high risk of perioperative death and complications. In other cases, there is only pain at rest but no wound. Therefore, it is difficult to accurately predict the prognosis of individual patients. We examined the prognosis of CLI cases in which therapeutic footwear was made for ambulation after wounds healed. The subjects were 31 haemodialysis patients with diabetic foot wounds, which were treated with percutaneous transluminal angioplasty and minor amputation. The subjects were 22 men and 9 women. Female patients were significantly older than male patients (P = 0.046). Two-year postoperative outcomes were survival in 19 patients and death in 12 patients. Eight of twelve deceased patients had a history of coronary intervention. There were 8 deaths among 13 patients with such history, indicating a marginally significant increase in the mortality rate (P = 0.060). Re-amputation was performed in 6 of 19 patients who survived. Two years postoperatively, 41.9% of patients overall survived without re-amputation. It is important to increase the number of cases for further study to improve the well-being of CLI patients and to examine medical economics. PMID:23095148

  4. [Percutaneous transluminal angioplasty in aortic coarctation. The short- and median-term results].

    PubMed

    Ledesma Velasco, M; Acosta Valdes, J L; Munayer Calderón, J; Salgado Escobar, J L; Arias Monroy, L; Soberanis Torruco, C N

    1991-01-01

    Percutaneous transluminal angioplasty (PTA) was performed in 34 patients with aortic coarctation (Ao Co). One of them with coarctation after surgical correction, the rest were native Ao Co. We used one balloon in 28 patients and two balloons simultaneously in 6. They were separated in three groups according to the degree of aortic arc hypoplasia. Group I (mild to moderate hypoplasia N = 9) the gradient dropped 39% with angiographic improvement of 48% during the follow-up (m = 13.1 months). Three cases with restenosis, 2 were satisfactory dilated and one was sent to surgery. In Group II (severe hypoplasia N = 4) the gradient dropped 31% with angiographic improvement of 30% (follow-up 16.3 months). Two cases with recoarctation were sent to surgery. In Group III (without hypoplasia N = 21) we obtained dropped of gradient of 71% with angiographic improvement of 60% (follow-up 18.5 months). Two cases were redilated successfully. The complications were: cerebral hemorrhage with death due to hypertensive crisis, (1) cerebral embolism, (1) thrombosis in the puncture site 1 and small aneurysm in dilated zone. (1) We think PTA is a good choice to conventional surgery with low rate of morbidity-mortality. The results depend basically on the anatomic type of coarctation and degree of aortic arch hypoplasia. PMID:1828657

  5. Intracoronary transluminal attenuation gradient in coronary CT angiography for determining coronary artery stenosis.

    PubMed

    Choi, Jin-Ho; Min, James K; Labounty, Troy M; Lin, Fay Y; Mendoza, Dorinna D; Shin, Dae Hee; Ariaratnam, Nikki S; Koduru, Sunaina; Granada, Juan F; Gerber, Thomas C; Oh, Jae K; Gwon, Hyeon-Cheol; Choe, Yeon Hyeon

    2011-11-01

    Coronary computed tomography angiography (CTA) assessment of calcified or complex coronary lesions is frequently challenging. Transluminal attenuation gradient (TAG), defined as the linear regression coefficient between luminal attenuation and axial distance, has a potential to evaluate the degree of coronary stenosis. We examined the value of TAG in determining the stenosis severity on 64-slice coronary CTA. The value of TAG of 370 major coronary arteries was measured from 7,263 intervals of 5-mm length. Compared with coronary CTA and invasive coronary angiography, TAG decreased consistently and significantly with maximum stenosis severity on a per-vessel basis, from -1.91 ± 4.25 Hounsfield units/10 mm for diameter stenosis of 0% to 49% to -13.37 ± 9.81 Hounsfield units/10 mm for diameter stenosis of 100% (p < 0.0001). Adding TAG to the interpretation of coronary CTA improved diagnostic accuracy (p = 0.001), especially in vessels with calcified lesions (N = 127; net reclassification improvement 0.095; p = 0.046). TAG appears to be able to contribute to improved classification of coronary artery stenosis severity in coronary CTA, especially in severely calcified lesions. PMID:22093264

  6. Percutaneous transluminal radiofrequency closure of the coronary artery in animal studies.

    PubMed

    Zhang, Chenyun; Yi, Wei; Cai, Yunchang; Fang, Shounian; Jiang, Xinan; Wen, Anzhi; Wu, Qiang

    2013-10-01

    The aim of this study was to investigate the safety and effectiveness of a novel method for the selective transcoronary closure of small coronary arteries by the intraluminal application of radiofrequency (RF) energy. Twenty-six small (diameter of 1-2 mm) coronary artery branches were selected in 13 dogs. An RF electrode wire (CRW-Zcy) was placed into the target vessel and a coronary balloon was used to transiently block the blood flow and limit damage to the proximal vessel. A therapeutic dosage of 20-30 W of RT energy every 10-30 sec (selected according the diameter of the target artery) was discharged via the CRW-Zcy inside a microcatheter two or three times in order to achieve arterial closure. A high dosage of 60 W every 120 sec of RF energy was used to conduct the safety study. All 26 branches were successfully closed resulting in the complete blockage of the antegrade and retrograde flows. The area of injury was limited to the target artery and the supplied myocardium. High-dose RF did not cause injury to the adjacent vessels and myocardium. The animals tolerated the procedure well without any untoward systemic effects. A follow-up angiography at two weeks revealed no evidence of recanalization or retrograde filling of the target artery. Percutaneous transluminal radiofrequency closure is a safe and effective interventional approach for closing the small coronary arteries, and is potentially valuable for further investigation. PMID:24137313

  7. Predictive value of early maximal exercise test and thallium scintigraphy after successful percutaneous transluminal coronary angioplasty.

    PubMed Central

    Wijns, W; Serruys, P W; Simoons, M L; van den Brand, M; de Feijter, P J; Reiber, J H; Hugenholtz, P G

    1985-01-01

    Restenosis of the dilated vessel after percutaneous transluminal coronary angioplasty can be detected by non-invasive procedures but their ability to predict later restenosis soon after a successful angioplasty as well as recurrence of angina has not been assessed. A maximal exercise test and myocardial thallium perfusion scintigraphy were, therefore, performed in 91 asymptomatic patients a median of 5 weeks after they had undergone a technically successful angioplasty. Primary success of the procedure was confirmed by the decrease in percentage diameter stenosis from 64(12)% to 30(13)% as measured from the coronary angiograms and in the trans-stenotic pressure gradient (normalised for mean aortic pressure) from 0.61(0.16) to 0.17(0.09). A clinical follow up examination (8.6(4.9) months later) was carried out in all patients and a late coronary angiogram obtained in 77. The thallium perfusion scintigram showing the presence or absence of a reversible defect was highly predictive for restenosis whereas the exercise test was not. The positive predictive value of an abnormal scintigram was 82% compared with 60% for the exercise test (ST segment depression/or angina or both at peak workload). Angina or a new myocardial infarction occurred in 60% of patients with abnormal and in 21% of patients with normal scintigrams. PMID:3155619

  8. Flexible platforms for natural orifice transluminal and endoluminal surgery

    PubMed Central

    Patel, Nisha; Seneci, Carlo; Yang, Guang-Zhong; Darzi, Ara; Teare, Julian

    2014-01-01

    The flexible endoscope is playing an increasingly pivotal role in minimally invasive transluminal and endoluminal surgery. Whilst the flexible nature of the platform is desirable in order to navigate through the abdominal cavity or through a lumen, there are a number of issues with using the platform for this purpose. The challenges associated with using flexible endoscopes such as a lack of triangulation of instruments and force transmission, which is often inadequate for endoscopic surgery are discussed in this review. As a result of these difficulties, a number of mechanically and robotically driven devices based upon the flexible endoscope are emerging. The design of these devices and potential problems are also reviewed. Finally, future robotic systems which are still in the development and validation stage are briefly discussed. The field of gastroenterology is diverging. The narrowing divide between minimally invasive and endoluminal surgery has led to a surge of innovative and novel devices which may in the future enable precise, seamless and scar less surgery. PMID:26135256

  9. Tool/tissues interaction modeling for transluminal angioplasty simulation.

    PubMed

    Le Fol, T; Haigron, P; Lucas, A

    2007-01-01

    In this paper, a simulation environment is described for balloon dilation during percutaneous transluminal angioplasty. It means simulating tool/tissues interactions involved in the inflation of a balloon by considering patient specific data. In this context, three main behaviors have been identified: soft tissues, crush completely under the effect of the balloon, calcified plaques, do not admit any deformation but could move in deformable structures and blood vessel wall and organs, try to find their original forms. A deformable soft tissue model is proposed, based on the Enhanced ChainMail method to take into account tissues deformation during dilatation. We improved the original ChainMail method with a "forbidden zone" step to facilitate tool/tissues interactions. The simulation was implemented using five key steps: 1) initialization of balloon parameters; 2) definition of the data structure; 3) dilatation of the balloon and displacement approximation; 4) final position estimation by an elastic relaxation; and 5) interpolation step for visualization. Preliminary results obtained from patient CT data are reported. PMID:18002311

  10. Flexible platforms for natural orifice transluminal and endoluminal surgery.

    PubMed

    Patel, Nisha; Seneci, Carlo; Yang, Guang-Zhong; Darzi, Ara; Teare, Julian

    2014-06-01

    The flexible endoscope is playing an increasingly pivotal role in minimally invasive transluminal and endoluminal surgery. Whilst the flexible nature of the platform is desirable in order to navigate through the abdominal cavity or through a lumen, there are a number of issues with using the platform for this purpose. The challenges associated with using flexible endoscopes such as a lack of triangulation of instruments and force transmission, which is often inadequate for endoscopic surgery are discussed in this review. As a result of these difficulties, a number of mechanically and robotically driven devices based upon the flexible endoscope are emerging. The design of these devices and potential problems are also reviewed. Finally, future robotic systems which are still in the development and validation stage are briefly discussed. The field of gastroenterology is diverging. The narrowing divide between minimally invasive and endoluminal surgery has led to a surge of innovative and novel devices which may in the future enable precise, seamless and scar less surgery. PMID:26135256

  11. [Coronary arterial rupture during percutaneous transluminal coronary angioplasty: a case report].

    PubMed

    Hsu, Y S; Tamai, H; Odawara, K; Yamagata, T; Ueda, K; Tomita, T; Koya, M; Motohara, S; Uehata, H

    1990-01-01

    A case who developed rupture in a diagonal branch of the left anterior descending coronary artery (LAD) during percutaneous transluminal coronary angioplasty (PTCA) is reported here. The present case was 80-year-old man with severe focal stenosis of the LAD at its junction with a diagonal branch. PTCA for the LAD lesion was successfully performed, but occlusion of the diagonal branch developed later. A subsequent ECG showed elevation of an ST segment in a VL, and PTCA for the diagonal branch was attempted. A 018 Hi-torque floppy guide wire was introduced into the occluded diagonal branch, and its dilatation was attempted using a 2 mm Simpson-Robert catheter. During a maximal pressure of 120 psi, a deformity was found at the distal end of the balloon. Post-PTCA angiograms showed rupture of the diagonal arterial branch, and mild to moderate pericardial effusion was observed by echocardiography. The patient experienced transient hypotension (60 mmHg at systolic), but his condition gradually stabilized after the administration of only a pressor medication. Neither pericardiocentesis nor emergency surgery was performed. The next day, follow-up angiograms showed diagonal branch occlusion at the proximal portion of the rupture site. His clinical course was satisfactory with spontaneous resolution of pericardial effusion and mild elevation of his cardiac enzymes (CPK = 243IU). In this case, it was concluded that the cause of coronary arterial rupture was the difference in diameters of the coronary artery (1 mm) and the balloon catheter (2 mm). This was the first rupture case experienced among 750 PTCA sites (0.13%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2104423

  12. The MedDRA paradox.

    PubMed

    Merrill, Gary H

    2008-01-01

    MedDRA (the Medical Dictionary for Regulatory Activities Terminology) is a controlled vocabulary widely used as a medical coding scheme. However, MedDRA's characterization of its structural hierarchy exhibits some confusing and paradoxical features. The goal of this paper is to examine these features, determine whether there is a coherent view of the MedDRA hierarchy that emerges, and explore what lessons are to be learned from this for using MedDRA and similar terminologies in a broad medical informatics context that includes relations among multiple disparate terminologies, thesauri, and ontologies. PMID:18998828

  13. [A myocardial infarction during pregnancy treated by percutaneous transluminal coronary angioplasty and stent implantation. Case report].

    PubMed

    Dubois, N; de Muylder, X; Foading, B

    2007-01-01

    Acute myocardial infarction is an un-frequent event during pregnancy. It clearly causes an increase in both maternal and fetal mortality. We describe a case of pregnancy complicated during the second trimester by an acute myocardial infarction witch was treated by percutaneous transluminal coronary angioplasty combined with stenting. The challenge involved in managing this condition during pregnancy is briefly discussed. PMID:17567523

  14. Unusual Case of Exercise-Induced ST Segment Elevation Alternans: Successful Treatment with Transluminal Angioplasty

    PubMed Central

    Mammen, George; Krajcer, Zvonimir; Leachman, Robert D.

    1983-01-01

    Alternans of the ST segment is sometimes observed in experimental studies but is rarely seen in the clinical setting. Described is a case of exercise-induced ST segment elevation alternans that was successfully treated with transluminal coronary artery angioplasty. Theories regarding the cause and mechanism of this phenomenon are discussed. Images PMID:15227140

  15. Acute inflammatory response to transgastric natural orifice transluminal endoscopic surgery peritoneoscopy: An experimental study in swine

    PubMed Central

    Rezende, Marcelo; Montero, Edna Frasson de Souza; Salomão, Reinaldo; Brunialti, Milena; Rodrigues, Rodrigo; Gomes, Gustavo; Libera, Alice Della; Ferrari, Angelo; Libera, Ermelindo Della

    2013-01-01

    OBJECTIVE: To investigate the impact of transgastric peritoneal access on plasma biomarkers of acute inflammatory response in comparison to laparoscopy. METHODS: This was a prospective and comparative study in a porcine model. Transgastric peritoneal access performed by natural orifice transluminal endoscopic surgery was compared with laparoscopy. Laparotomy and sham groups were used as positive and negative controls, respectively. Thirty-four pigs were assigned to receive transgastric natural orifice transluminal endoscopic surgery (n = 12), laparoscopy (n = 8), laparotomy (n = 8) or a sham procedure involving only anesthesia (n = 6). In the natural orifice transluminal endoscopic surgery group, peritoneoscopy was performed with a gastroscope via transgastric access. Blood samples were collected at baseline and 1, 3, 6, 9 and 24 h after the surgical procedure for measurement of interleukins 1β, 6 and 10 and tumor necrosis factor-α. A complete blood count was performed, and C-reactive protein levels were measured at baseline and at 24 h. RESULTS: All surgical and endoscopic procedures were performed without major complications. Peritoneal cavity inventory showed no signs of peritonitis in any animal. Interleukin 1β, interleukin 10 and tumor necrosis factor-α levels were below the threshold of detection. The mean level of interleukin 6 was statistically significantly higher in the laparotomy group than in the other groups (p<0.05), with no significant differences among the sham, laparoscopy and natural orifice transluminal endoscopic surgery groups (p>0.05). C-reactive protein analysis indicated significant increases in all groups, with no differences among the groups. Complete blood count analysis showed no differences among the groups. CONCLUSIONS: Based on the observed interleukin 6 patterns, the systemic inflammatory response resulting from transgastric peritoneal access by natural orifice transluminal endoscopic surgery is similar in

  16. Post-marketing surveillance in the published medical and grey literature for percutaneous transluminal coronary angioplasty catheters: a systematic review

    PubMed Central

    2013-01-01

    Background Post-marketing surveillance (PMS) may identify rare serious incidents or adverse events due to the long-term use of a medical device, which was not captured in the pre-market process. Percutaneous transluminal coronary angioplasty (PTCA) is a non-surgical procedure that uses a balloon-tipped catheter to enlarge a narrowed artery. In 2011, 1,942 adverse event reports related to the use of PTCA catheters were submitted to the FDA by the manufacturers, an increase from the 883 reported in 2008. The primary research objective is to conduct a systematic review of the published and grey literature published between 2007 and 2012 for the frequency of incidents, adverse events and malfunctions associated with the use of PTCA catheters in patients with coronary artery disease (CAD). Grey literature has not been commercially published. Methods We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and PubMed for medical literature on PMS for PTCA catheters in patients with CAD published between January 2007 and July 2012. We also searched the grey literature. Results This review included 11 studies. The in-hospital adverse events reported were individual cases of myocardial infarction and hematoma. In studies of patients with coronary perforation, more patients with balloon angioplasty were identified compared with patients who required stenting. Conclusions Our systematic review illustrates that the volume and quality of PMS studies associated with the use of PTCA catheters in patients with CAD are low in the published and grey literature, and may not be useful sources of information for decisions on safety. In most studies, the objectives were not to monitor the long-term safety of the use of PTCA catheters in clinical practice. Future studies can explore the strengths and limitations of PMS databases administered by regulatory authorities. PMID:24112460

  17. MSL Launches With MEDLI Sensors

    NASA Video Gallery

    NASA engineers Michelle Munk and David Way explain the MEDLI -- Mars Science Laboratory (MSL) Entry, Descent and Landing Instrumentation -- package on the MSL aeroshell that will measure the heatin...

  18. Current developments in natural orifices transluminal endoscopic surgery: An evidence-based review

    PubMed Central

    Teoh, Anthony Yuen Bun; Chiu, Philip Wai Yan; Ng, Enders Kwok Wai

    2010-01-01

    Tremendous advances have been made in recent years addressing the key obstacles to safe performance and introduction of human natural orifice transluminal endoscopic surgery (NOTES). Animal studies have focused on identifying optimal solutions to these obstacles, in particular methods of creating transluminal access, safe closure of the point of access, and development of a multitasking platform with dedicated instruments. Whether the performance data generated from these animal studies can be reproduced in humans has yet to be determined. Reports of human NOTES procedures are emerging, and the possibility of accomplishing human NOTES based on existing technology has been demonstrated. However, dedicated platforms and devices are still lacking to allow for pure NOTES procedures, and whether NOTES can deliver the postulated benefits of earlier recovery and improved cosmesis remains uncertain. PMID:20939107

  19. Anesthetic management of transoral natural orifice transluminal endoscopic surgery: two cases report

    PubMed Central

    Chung, Chan Jong; Lee, Seung Cheo; Shin, Ho Jin

    2014-01-01

    Natural orifice transluminal endoscopic surgery (NOTES) is an evolving field of minimally invasive surgery. NOTES reaches the target organ by inserting the endoscope through a natural orifice (e.g. mouth, anus, urethra, vagina) and offers advantages of less postoperative pain and lower complication rate. Since its first description in 2004, NOTES has progressed from use on animal models to humans. We experienced anesthetic care of two patients who underwent transoral NOTES under general anesthesia. PMID:25237454

  20. The MedCLIVAR Network

    NASA Astrophysics Data System (ADS)

    Lionello, Piero; Medclivar Sc, The

    2014-05-01

    MedCLIVAR serves as a scientific network to promote interaction among different scientific disciplines and to develop a multidisciplinary vision of the evolution of the Mediterranean climate through studies that integrate atmospheric, marine, and terrestrial climate components at time scales ranging from paleoreconstructions to future climate scenarios. The network deals with scientific issues including past climate variability; connections between the Mediterranean and global climate; the Mediterranean Sea circulation and sea level; feedbacks on the global climate system; and regional responses to greenhouse gas, air pollution, and aerosols. The MedCLIVAR initiative was proposed at the 2003 European Geosciences Union assembly in Nice, France. In 2005, it was endorsed by the International Climate Variability and Predictability (CLIVAR) office. Subsequently, the MedCLIVAR Research Network Project was formally approved by the European Science Foundation and launched in May 2006 for a five year duration. Now MedCLIVAR is continuing with self supporting initiatives, such as the third MedCLIVAR conference, which will be held in June 2014 in Ankara (Turkey) , the publication of a special issue of Regional Environmental Change devoted to the climate of the Mediterranean region, and a newsletter, which is published every six months. More information available in Lionello, P., Gacic, M., Gomis, D., Garcia-Herrera, R., Giorgi, F., Planton, S., Trigo, R., (...), Xoplaki, E. (2012) Program focuses on climate of the Mediterranean region, Eos Trans. AGU 93:105-106

  1. Overview of the MEDLI Project

    NASA Technical Reports Server (NTRS)

    Gazarik, Michael J.; Little, Alan; Cheatwood, F. Neil; Wright, Michael J.; Herath, Jeff A.; Martinez, Edward R.; Munk, Michelle; Novak, Frank J.; Wright, Henry S.

    2008-01-01

    The Mars Science Laboratory Entry, Descent, and Landing Instrumentation (MEDLI) Project s objectives are to measure aerothermal environments, sub-surface heatshield material response, vehicle orientation, and atmospheric density for the atmospheric entry and descent phases of the Mars Science Laboratory (MSL) entry vehicle. The flight science objectives of MEDLI directly address the largest uncertainties in the ability to design and validate a robust Mars entry system, including aerothermal, aerodynamic and atmosphere models, and thermal protection system (TPS) design. The instrumentation suite will be installed in the heatshield of the MSL entry vehicle. The acquired data will support future Mars entry and aerocapture missions by providing measured atmospheric data to validate Mars atmosphere models and clarify the design margins for future Mars missions. MEDLI thermocouple and recession sensor data will significantly improve the understanding of aeroheating and TPS performance uncertainties for future missions. MEDLI pressure data will permit more accurate trajectory reconstruction, as well as separation of aerodynamic and atmospheric uncertainties in the hypersonic and supersonic regimes. This paper provides an overview of the project including the instrumentation design, system architecture, and expected measurement response.

  2. Overview of the MEDLI Project

    NASA Technical Reports Server (NTRS)

    Gazarik, Michael J.; Hwang, Helen; Little, Alan; Cheatwood, Neil; Wright, Michael; Herath, Jeff

    2007-01-01

    The Mars Science Laboratory Entry, Descent, and Landing Instrumentation (MEDLI) Project's objectives are to measure aerothermal environments, sub-surface heatshield material response, vehicle orientation, and atmospheric density for the atmospheric entry and descent phases of the Mars Science Laboratory (MSL) entry vehicle. The flight science objectives of MEDLI directly address the largest uncertainties in the ability to design and validate a robust Mars entry system, including aerothermal, aerodynamic and atmosphere models, and thermal protection system (TPS) design. The instrumentation suite will be installed in the heatshield of the MSL entry vehicle. The acquired data will support future Mars entry and aerocapture missions by providing measured atmospheric data to validate Mars atmosphere models and clarify the design margins for future Mars missions. MEDLI thermocouple and recession sensor data will significantly improve the understanding of aeroheating and TPS performance uncertainties for future missions. MEDLI pressure data will permit more accurate trajectory reconstruction, as well as separation of aerodynamic and atmospheric uncertainties in the hypersonic and supersonic regimes. This paper provides an overview of the project including the instrumentation design, system architecture, and expected measurement response.

  3. Percutaneous transluminal rotational atherectomy in the treatment of peripheral vascular disease using a transluminal endatherectomy catheter (TEC): Initial results and angiographic follow-up

    SciTech Connect

    Rilinger, Norbert; Goerich, Johannes; Scharrer-Pamler, Reinhard; Vogel, Jochen; Tomczak, Reinhard; Merkle, Elmar; Sokiranski, Roman; Brambs, Hans-Juergen

    1997-07-15

    Purpose. To evaluate the clinical results of percutaneous transluminal rotational atherectomy in the treatment of peripheral vascular disease. Methods. Rotational atherectomy was performed in 39 patients aged 39-87 years (mean 66.6 years). A total of 71 lesions (43 stenoses and 28 occlusions) were treated in 40 limbs. Additional balloon angioplasty was required in 54% of lesions. Fifteen patients (37.5%) presented in Fontaine stage II, 10 patients (25%) in Fontaine stage III and 15 patients (37.5%) in Fontaine stage IV. Rotational atherectomy at 750 rpm was carried out over a 0.014-inch guidewire with continuous aspiration into a vacuum, bottle. Follow-up angiography and color flow Doppler examinations were performed in 22 patients (23 limbs) after a mean period of 6 months (range 2-14 months). Results. There was one primary technical failure. In 36 of 40 lesions there was a good angiographic result with residual stenoses in less than 30%. In 70 lesions treated by rotational atherectomy, however, 54% showed residual stenoses of 30%-50% and these cases required additional balloon angioplasty. The mean ankle-brachial index improved significantly (p<0.001), from 0.49 before the procedure to 1.01 after the procedure. A single distal embolus, related to primary recanalization, occurred and there were two large inguinal hematomas. Cumulative clinical patency after 6 months was 83.8% and cumulative angiographic patency after 6 months was 79.1%. Conclusion. Percutaneous rotational atherectomy is a promising approach for the treatment of chronic peripheral vascular disease. Further prospective, randomized studies are necessary to compare percutaneous transluminal angioplasty with this new technical approach.

  4. Hybrid Natural Orifice Transluminal Endoscopic Surgery with Sentinel Lymph Node Navigation for Deep Early Gastric Cancer in the Fundic Region

    PubMed Central

    Park, Yoon Suk; Kim, Seong Hwan; Ryu, Hee Yun; Cho, Young Kwan; Jo, Yun Ju; Son, Tae il; Hong, Young Ok

    2016-01-01

    For patients refusing surgical treatment for deep early gastric cancer, hybrid natural orifice transluminal endoscopic surgery with sentinel lymph node navigation is a potential treatment option, particularly when the anatomic location of the cancer has low probability of lymph node metastasis. We report a case of deep early gastric cancer of the fundus beyond the endoscopic submucosal dissection indication that was treated by hybrid natural orifice transluminal endoscopic surgery with sentinel lymph node navigation. In a conventional approach, a total gastrectomy would have been needed; however, the patient refused surgical intervention. In this case, since the patient showed no positivity of the sentinel lymph node on intraoperative navigation, laparoscopic basin lymph node dissection was not performed. Hybrid natural orifice transluminal endoscopic surgery might be considered for specific regions such as the safety zone where lymph node metastases are less likely to occur. PMID:27020308

  5. Reliability of pressure recordings via catheters used for transluminal coronary angioplasty.

    PubMed

    Busch, U W; Sebening, H; Beeretz, R; Heinze, R

    1984-06-01

    Because of common difficulties in obtaining adequate pressure tracing during transluminal coronary angioplasty, the pressure transmission characteristics of catheter systems used for angioplasty were determined. Transmission of cine wave pressures (0.2 to 14 Hz) and of arterial pressure pulses reproduced in vitro was evaluated. Following adequate elimination of air bubbles from the system, the Grüntzig dilatation catheters yielded satisfactory frequency response curves and thus good reproduction of arterial pressure waveforms. The Simpson-Robert catheter showed clearly inferior frequency response characteristics, explaining the more significant damping of the pressure tracings. However, mean pressures were reliably recorded with each type. PMID:15227077

  6. Clinical outcome of angiosome-oriented infrapopliteal percutaneous transluminal angioplasty for isolated infrapopliteal lesions in patients with critical limb ischemia

    PubMed Central

    Jeon, Eui-Yong; Cho, Young Kwon; Yoon, Dae Young; Kim, Dae Jung; Woo, Jeong Joo

    2016-01-01

    PURPOSE We aimed to evaluate the clinical usefulness and outcome of angiosome-oriented percutaneous transluminal angioplasty (IP-PTA) and its clinical outcome for isolated infrapopliteal lesions in diabetic critical limb ischemia. METHODS We retrospectively reviewed 70 patients (82 limbs) with diabetic critical limb ischemia who had localized disease at the level of the infrapopliteal artery. Patients underwent IP-PTA between January 2011 and December 2013 and were followed up for a mean of 13 months. The primary target arterial lesions were chosen according to the angiosome concept. We evaluated clinical findings, technical success, and patients’ clinical outcome. The angiographic outcome of IP-PTA was assessed using the angiosome score. We analyzed the relationship between the angiosome score and the amputation rate. RESULTS There were 69 anterior tibial artery (ATA) lesions, 70 posterior tibial artery (PTA) lesions, and 58 peroneal artery (PA) lesions. The primary target arteries were the ATA (n=43), PTA (n=26), PA (n=2), and ATA + PTA (n=11). We divided the treated limbs into target (n=63) and nontarget (n=19) groups. The overall initial technical success rate was 91.4%. Successful wound healing rates were 87.3% (55/63) and 47.3% (9/19) in the target and nontarget groups, respectively (P < 0.05). CONCLUSION Angiosome-oriented primary targeted IP-PTA shows a highly effective treatment outcome in diabetic critical limb ischemia. In cases with inadequate angioplastic results of the target artery, IP-PTA of the nontarget artery should be recommended to improve the limb salvage rates. PMID:26573976

  7. Transcutaneous oxygen tension measurements following peripheral transluminal angioplasty procedure has more specificity and sensitivity than ankle brachial index

    PubMed Central

    Pardo, M; Bernal, F L; Felices, J M; Achel, G D; Canteras, M

    2015-01-01

    Objective: To evaluate the superiority of transcutaneous oxygen pressure (TcPO2) before, during and after peripheral transluminal angioplasty (PTA) in comparison with ankle brachial index (ABI) in patients with diabetes. Methods: 40 consecutive patients with diabetes treated by PTA where included. This study shows results before, during and after PTA and their progression for 8 weeks. Results: The TcPO2 increased from 28.11 ± 8.1 to 48.03 ± 8.4 mmHg, 8 weeks after PTA (p < 0.001). The ABI increased from 0.48 ± 0.38 to 0.77 ± 0.39 after PTA (p < 0.001). After PTA, the stenosis of the vessel decreased from 58.33 ± 20.07% to 21.87 ± 13.57% (p < 0.001). TcPO2 was determined in all the patients, but ABI could not be determined in all patients. Furthermore, we determined patients with “false negatives” with an improvement in ABI and “false positives” in 12.5% of patients. Additionally, in this study, we monitored TcPO2 while performing PTA, revealing variations in each phase of the radiological procedure. Conclusion: The increase in TcPO2 measurements following PTA procedure has more specificity and sensitivity than does ABI. The use of TcPO2 may represent a more accurate alternative than traditional methods (ABI) used in assessing PTA results. The TcPO2 also allows the radiologist to assess changes in tissue oxygenation during PTA, allowing changes to the procedure and subsequent treatment. Advances in knowledge: This is the first time that a graph is shown with TcPO2 results during PTA performance in many patients. PMID:25431933

  8. Fiberoptic study on the effects of transluminal angioplasty in experimental occlusive arterial thrombosis.

    PubMed

    Tomaru, T; Uchida, Y; Sugimoto, T

    1988-02-01

    Percutaneous transluminal coronary angioplasty has been proposed as definitive therapy for coronary recanalization of occluded coronary arteries in patients with acute myocardial infarction (AMI). The effects of transluminal angioplasty (TA) on experimental occlusive canine arterial thrombi that closely simulated the clinical condition was examined by a fiberoptic method. Experimental arterial thrombosis was produced by endothelial denudation and induction of luminal stenosis. Eighteen dogs that showed total occlusion of the iliac artery with thrombi were evaluated. Seven dogs (group A) with 6-hour-old thrombi received 20,000 IU/kg intravenous urokinase (UK) but did not show recanalization. TA was performed with a Gruentzig or Simpson-Robert balloon catheter and its effect was evaluated by a vascular fibroscope. Eight dogs (group B) with 6-hour-old thrombi underwent primary TA. After TA, less than 50% luminal obstruction with residual thrombi was visualized in five dogs (71%) of group A and four dogs (50%) of group B. Residual thrombi showed a doughnut-like or globular type shape and consisted of dense fibrin networks and compact platelet aggregates. All dogs in group B received 20,000 IU/kg intravenous UK after TA, but most of them showed progression of thrombus size despite UK infusion. In conclusion, the results suggest (1) that TA is effective in recanalization of an occluded artery with aged thrombus that is resistant to thrombolytic therapy and (2) that vascular fiberscope is a useful method for evaluation of the effects of TA on occlusive arterial thrombus. PMID:2963513

  9. Follow up study of 70 patients with renal artery stenosis treated by percutaneous transluminal dilatation.

    PubMed Central

    Geyskes, G G; Puylaert, C B; Oei, H Y; Mees, E J

    1983-01-01

    Between April 1978 and April 1981, 70 patients with hypertension and renal artery stenosis were treated by percutaneous transluminal arterial dilatation. Selection of the patients was based solely on arteriographic criteria. Arteriography after dilatation showed considerable widening of the stenosed area in all patients. In 65 patients the effect of treatment on the blood pressure was assessed during follow up periods of one to four years. In 14 of these patients the hypertension was cured, in 29 it was improved, and in 22 there was no change. Patients with fibromuscular lesions benefited distinctly more than did those with atheromatous stenosis, only one of the 21 patients with fibromuscular lesions showing no change as compared with 21 of the 44 patients with atheromatous lesions. The only serious complication encountered was microcholesterol emboli, which developed in two patients with severe atheromatous lesions of the aorta. In the atheromatous group age and overall renal function had no influence on the blood pressure response. In the subgroup of patients with a unilateral lesion the renal vein renin ratios and asymmetrical curves obtained by renography had only a very limited predictive value. In experienced hands percutaneous transluminal arterial dilatation is relatively safe, and this study suggests that it should be attempted in all patients with renal artery stenosis. Only in patients with severe atheromatosis of the aorta should the risk associated with the catheterisation be weighed against the 50% or so chance of benefit from the procedure. PMID:6223685

  10. Mini-Med School Planning Guide

    ERIC Educational Resources Information Center

    National Institutes of Health, Office of Science Education, 2008

    2008-01-01

    Mini-Med Schools are public education programs now offered by more than 70 medical schools, universities, research institutions, and hospitals across the nation. There are even Mini-Med Schools in Ireland, Malta, and Canada! The program is typically a lecture series that meets once a week and provides "mini-med students" information on some of the…

  11. Percutaneous Transluminal Angioplasty and Enclosed Thrombolysis Versus Percutaneous Transluminal Angioplasty in the Treatment of Femoropopliteal Occlusions: Results of a Prospective Randomized Trial

    SciTech Connect

    Nicholson, Tony

    1998-11-15

    Purpose: To determine whether percutaneous transluminal angioplasty (PTA) and enclosed thrombolysis (ET) is superior to PTA alone in the treatment of femoropopliteal occlusions. Methods: Twenty-five patients with 5-15-cm-long occlusions in the femoropopliteal segments, with otherwise normal run-in arteries and at least one normal tibioperoneal artery to the foot, were randomized to ET/PTA or PTA alone. Ankle brachial systolic index (ABI) was measured before the procedure and at 24 hr and 12 months after the procedure, when a duplex scan was also carried out. End points in the study were patency at, or repeat intervention before, 12 months. Results: Procedures were successful in 23 of 25 patients. There was one immediate occlusion of tibioperoneal arteries, and one early reocclusion of a reopened segment in the ET/PTA group. There was one early reocclusion in the PTA group. At 12 months patency was 70% and 69.2% in the ET/PTA and PTA groups respectively. Covariant analysis showed no significant difference in ABI between the two groups at any of the three measurement times. Conclusion: This trial demonstrated no difference between ET/PTA and PTA alone in femoropopliteal occlusions associated with normal proximal arteries and at least one normal tibioperoneal artery.

  12. MED-SUV Data policy

    NASA Astrophysics Data System (ADS)

    Sangianantoni, Agata; Puglisi, Giuseppe

    2014-05-01

    MED-SUV proposes the development and implementation of a digital infrastructure for data access and for volcanic risk management aimed at applying the rationale of Supersites GEO initiative to Campi Flegrei/Vesuvius and Mt. Etna. It's fully recognized the clear need of an open data policy in order to ensure that data will be properly and in an ethical manner managed and can be used and accessed from its community. In MED-SUV there is a multitude of different partners with varying scientific, technical, legal and economical interests and therefore data and data products produced will be wide-ranging so it's necessary to set principles and legal arrangements. Within Europe several Directives and Regulations have brought into force which provide the leading guidelines in terms of the principle of openness to knowledge and access to scientific information. So in creating a suite policy the EC Supersites (MarSite and FutureVolc, under the EPOS umbrella) projects need to strength their efforts in defining a common data management strategy. In this presentation we will show the leading principles of the data policy, as for instance Open Access, flexibility of approach in order to harmonize the different methods of data distribution among its partners, Creative Commons licensing, data preservation and unique identification through Persistent Identifiers.

  13. Clinical results and quality of life after percutaneous transluminal coronary angioplasty: a preliminary report.

    PubMed

    McKenna, K T; McEniery, P T; Maas, F; Aroney, C N; Bett, J H; Cameron, J; Garrahy, P; Holt, G; Hossack, K F; Murphy, A L

    1992-10-01

    To evaluate the effect of percutaneous transluminal coronary angioplasty (PTCA) on quality of life, data on symptomatic status, functional capacity, life satisfaction, and psychological wellness were collected on 102 patients at 1 day pre-PTCA and 2 months post-PTCA, and on the first 50 of these patients at 10 months post-PTCA. There were highly significant changes (p < 0.001) in all quality of life measures between pre-PTCA and the 1st follow-up measurements. No further significant changes occurred in these measures between the 1st and 2nd follow-up measurements, indicating that the initial improvement in quality of life was sustained over this period. Data on primary success rate, complications, and pre- and post-PTCA risk factor scores are also reported. PMID:1446341

  14. Natural orifice transluminal endoscopic surgery: new minimally invasive surgery come of age.

    PubMed

    Huang, Chen; Huang, Ren-Xiang; Qiu, Zheng-Jun

    2011-10-21

    Although in the past two decades, laparoscopic surgery, considered as a great revolution in the minimally invasive surgery field, has undergone major development worldwide, another dramatic surgical revolution has quietly appeared in recent years. Ever since Kalloo's first report on transgastric peritoneoscopy in a porcine model in 2004, interest in a new surgical procedure named natural orifice transluminal endoscopic surgery (NOTES) has blossomed worldwide. Considering that a NOTES procedure could theoretically avoid any abdominal incision, operation-related pain and scarring, many surgeons and endoscopists have been enthusiastic in their study of this new technique. In recent years, several NOTES studies have been carried out on porcine models and even on humans, including transvaginal cholecystectomy, transgastric appendectomy, transvaginal appendectomy, and transvesical peritoneoscopy. So what is the current situation of NOTES and how many challenges do we still face? This review discusses the current research progress in NOTES. PMID:22110263

  15. Natural orifice transluminal endoscopic surgery (NOTES) for clinical management of intra-abdominal diseases.

    PubMed

    Liu, Liu; Chiu, Philip W Y; Reddy, Nagewasher; Ho, Khek-Yu; Kitano, Seigo; Seo, Dong Wan; Tajiri, Hisao

    2013-11-01

    Clinical research on natural orifice transluminal endoscopic surgery (NOTES) has been increasingly reported over the past 5 years and more than 1200 patients have received various NOTES procedures. The present article reviews the clinical practice of NOTES for the treatment of intra-abdominal diseases, and was carried out through systematic search with specific keywords in major databases for NOTES-related clinical literature. The last date of the search was 15 August, 2012. Transvaginal cholecystectomy is the commonest NOTES procedure reported, and its clinical feasibility and safety was established through prospective case series and randomized trials. There is a regional difference in NOTES development with the majority of NOTES fromCaucasian countries being transvaginal cholecystectomy and most reports from Asian countries being NOTES-related procedures. Safe closure of gastrointestinal access remains challenging, and novel endoscopic instruments are essential to enhance future development of NOTES. PMID:23967798

  16. Iatrogenic Subtotal Stenosis of the Right Subclavian Artery Treated With Percutaneous Transluminal Angioplasty

    SciTech Connect

    Smeenk, Robert M.; Kock, Mark C. J. M.; Elgersma, Otto E. H.; Schnater, Marco J.

    2011-02-15

    This report describes a rare vascular complication of surgical placement of a marking clip and a possible approach to problem solving. A 55-year-old patient presented with loss of sensation in the fingers and loss of peripheral pulsations in the right arm 4 days after right upper lobectomy for a pT2N1 moderately differentiated adenocarcinoma of the lung. Duplex examination and computed tomography were performed the same day and showed a subtotal stenosis of the right subclavian artery, which was caused by the surgical placement of a metal clip to mark the surgical boundary. Selective angiography was subsequently performed. Percutaneous transluminal angioplasty (PTA) successfully dilated the stenosis and pushed the clip off. Flow in the right subclavian artery (RSA) was completely restored as were neurology and peripheral pulses. In conclusion, arterial stenosis by a surgical (marking) clip may be feasibly treated with PTA.

  17. Preliminary results utilizing a new percutaneous transluminal coronary angioplasty balloon catheter.

    PubMed

    Talley, J D; Joseph, A; Kupersmith, J

    1990-06-01

    We report our initial experience with a new percutaneous transluminal coronary angioplasty (PTCA) balloon catheter and compare it to a similar over-the-wire system in a retrospective, nonrandomized fashion. There was no statistical difference in pre-PTCA angiographic indices and post-PTCA angiographic and clinical success rates between the two groups. There was a trend toward a decrease in length of fluoroscopy (P = .08) and a significant decrease in the amount of contrast utilized (P = .007) with the new balloon catheter. Several new construction features of the new catheter account for this improvement and are discussed. The long-term success of this balloon catheter remains to be investigated. PMID:2354509

  18. [A Case of Vertebral Artery Stenosis Presenting with Progressing Stroke and Treated by Percutaneous Transluminal Angioplasty].

    PubMed

    Hayashi, Kentaro; Matsuo, Yoshitaka; Toyoda, Keisuke; Hayashi, Yukishige; Shirakawa, Kiyoshi; Kaminogo, Makio

    2016-05-01

    A 75-year-old man with a history of diabetes mellitus and hypertension was suffered from dizziness and vomiting and brought to the near-by hospital. MRI showed cerebellar infarction due to right vertebral artery stenosis. Despite best medical treatment, the infarction progressed day by day and he was transferred to our hospital five days later. Neurological examination showed mild disturbance of consciousness and right hemiparesis. Right vertebral angiography revealed high-grade stenosis accompanied with atherosclerosis at the V3-V4 portion. Percutaneous transluminal angioplasty(PTA)was performed with 2.5mm×14mm balloon with 6 atm dilation. Postoperative course was uneventful and no further stroke occurred after the treatment. PTA was effective for vertebral artery stenosis manifested with progressing stroke. The indication of stent placement for the cerebral artery should be prudent. PMID:27166843

  19. Treatment of the Budd-Chiari syndrome in polycythemia vera by repeated percutaneous transluminal angioplasty of a hepatic vein stenosis

    PubMed Central

    Nishikawa, M.; Miyoshi, S.; Imai, Y.; Tarui, S.; Seki, K.; Minami, Y.; Kawata, S.; Nakamura, H.

    1982-01-01

    This report is of a 63-year-old man with polycythemia vera who developed the Budd-Chiari syndrome due to right hepatic vein stenosis. Diagnosis was made by laparoscopy and liver biopsy, and confirmed by hepatic venography. The patient was treated by percutaneous transluminal angioplasty, and recovered completely from ascites, leg oedema and venous stasis. No pulmonary embolism was observed. One month after angioplasty, a second laparoscopy and liver biopsy showed a marked improvement in hepatic congestion and haemorrhagic necrosis, thereby confirming the effectiveness of this technique in treating the Budd-Chiari syndrome. Further treatments with percutaneous transluminal angioplasty were required with a good clinical outcome. ImagesFig. 1Fig. 2Fig. 4 PMID:6215641

  20. Percutaneous transluminal angioplasty and stenting for symptomatic intracranial arterial stenosis: a systematic review and meta-analysis

    PubMed Central

    Tsivgoulis, Georgios; Katsanos, Aristeidis H.; Magoufis, Georgios; Kargiotis, Odysseas; Papadimitropoulos, Georgios; Vadikolias, Konstantinos; Karapanayiotides, Theodoros; Ellul, John; Alexandrov, Anne W.; Mitsias, Panayiotis D.; Alexandrov, Andrei V.

    2016-01-01

    Objectives: The cumulative safety and efficacy measures of percutaneous transluminal angioplasty and stenting (PTAS) for secondary stroke prevention in patients with symptomatic intracranial arterial stenosis (sICAS) have not previously been evaluated using a meta-analytical approach. Methods: We conducted a systematic review and random effects meta-analysis of all available randomized controlled trials (RCTs) evaluating the safety and efficacy of PTAS (in comparison with medical therapy) for sICAS. Results: Three RCTs (678 total patients) were included in the quantitative analysis. PTAS was associated with a higher risk of recurrent ischemic stroke in the territory of qualifying artery both within 30 days [risk ratio (RR) = 2.21, 95% confidence interval (CI) 1.10–4.43] and 1 year (RR = 1.92, 95% CI 1.10–3.36). PTAS was also related to a higher risk of any ischemic stroke within 30 days from the index event (RR = 2.08, 95% CI 1.17–3.71). The risk for intracranial hemorrhage was found to be higher in PTAS patients both within 30 days (RR = 10.60, 95% CI 1.98–56.62) and 1 year (RR = 8.15, 95% CI 1.50–44.34). The composite outcome of any stroke or death within 1 year (RR = 2.29, 95% CI 1.13–4.66) and 2 years (RR = 1.52, 95% CI 1.04–2.21) was higher in PTAS than in medical therapy. PTAS was associated with a higher risk of any stroke or death within 2 years in the sICAS subgroup located in posterior circulation (RR = 2.37, 95% CI 1.27–4.42). Conclusions: PTAS is associated with adverse early and long-term outcomes and should not be recommended in patients with sICAS. Further research to identify subgroups of patients who could also serve as candidates for future interventional trials along with efforts to reduce procedure-related complications are needed.

  1. Radiotherapy-Related Axillary Artery Occlusive Disease: Percutaneous Transluminal Angioplasty and Stenting. Two Case Reports and Review of the Literature

    SciTech Connect

    Farrugia, M. Gowda, K.M.S.; Cheatle, T.R.; Ashok, T.P.

    2006-12-15

    Radiotherapy-related axillary artery occlusive disease is a relatively rare condition. This complication is usually encountered in patients with breast carcinoma treated by radiotherapy and might be frequently concealed by the presence of lymphoedema. We discuss this rare complication of radiotherapy treatment for breast cancer and present two cases and their successful treatment by a modified percutaneous transluminal angioplasty and stenting technique. A review of literature on the subject is also presented.

  2. New trend in endoscopic surgery: transvaginal appendectomy NOTES (Natural Orifice Transluminal Endoscopic Surgery).

    PubMed

    Tabutsadze, T; Kipshidze, N

    2009-03-01

    Natural Orifice Transluminal Endoscopic Surgery is a new method of mini invasive surgery, which involves passing surgical instruments, and a tiny camera, through a natural orifice, such as the mouth, vagina, urethra or rectum, what provides the access to the desired organ. The procedure is approved due to its benefits - less pain, quicker recoveries, fewer complications and no scar - as it lets us avoid major incisions through the skin, muscle and nerves of the abdomen. Besides that the transluminal access is considered to be the most safe and feasible for clinical application. Here are discussed the two operations of Transvaginal Appendectomy performed in Caucasus - Academician N. Kipshidze University Hospital in Tbilisi. The first patient - a 28-year woman, weight - 72 kg, height - 180 cm, married, has one child - was submitted to the hospital with anamnesis of 48 hours acute appendicitis, typical clinical semiotics and laboratory records. In the second case the patient was a 22-year old woman, height - 170 cm, weight - 68 kg, married, with 2 children. She was hospitalized with 24 hours acute appendicitis anamnesis and typical clinical semiotics and laboratory records. Both operations were performed under general anesthesia, using Karl Storz GmbH & Co. equipment. The duration of the first procedure was 76 minutes and the second operation lasted for 88 minutes. The operations were made without any technical difficulties or complications. None of the patients had the need of non-narcotic analgesia during the post-operational period. No gynecological or surgical problems or any complications were detected during the observation period. The patients had superior postoperative evolution, so the stationary stay made up 36 hours after the first operation and 30 hours after the second. Essentially NOTES is a new trend in endoscopic surgery - the non-scar surgery with major advantages compared to the conventional - the NOTES takes endoscopic surgery one step further in

  3. Role of intracoronary thrombus in acute complications during percutaneous transluminal coronary angioplasty.

    PubMed

    Arora, R R; Platko, W P; Bhadwar, K; Simpfendorfer, C

    1989-04-01

    Coronary angiograms from 2,372 consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA) were retrospectively reviewed for the presence of intracoronary thrombus (ICT) before dilatation. Patients with evolving acute myocardial infarction and those receiving thrombolytic therapy were excluded from analysis. Coronary artery thrombus was present in 126 patients (6%) (group 1). When compared to 2,246 patients (group 2) without ICT, group 1 had a higher incidence of unstable angina, 74% vs. 66% (less than 0.06), previous myocardial infarction, 59% vs. 37% (P less than .0001), and history of a recent myocardial infarction, 28% vs. 9% (P less than .0001). Patients with predilatation intracoronary thrombus had a higher risk for acute occlusion, 6% vs. 2% (P less than .002); however, the incidence of emergency coronary bypass surgery and myocardial infarction was similar in both groups. Therefore, the presence of predilatation intracoronary thrombus heralds an increased risk of acute occlusion, but not myocardial infarction or emergency coronary artery bypass surgery. PMID:2523243

  4. Percutaneous Aspiration Thrombectomy for the Treatment of Arterial Thromboembolic Occlusions Following Percutaneous Transluminal Angioplasty

    SciTech Connect

    Schleder, Stephan; Diekmann, Matthias; Manke, Christoph; Heiss, Peter

    2015-02-15

    PurposeThis study was designed to evaluate the technical success and the early clinical outcome of patients undergoing percutaneous aspiration thrombectomy (PAT) for the treatment of arterial thromboembolism following percutaneous infrainguinal transluminal angioplasty (PTA).MethodsIn this single-center study, during a period of 7 years retrospectively, 47 patients (22 male, 47 %) with a mean age of 73 (range 53–96) years were identified in whom PAT was performed for the treatment of thromboembolic complications of infrainguinal PTA. Primary technical success was defined as residual stenosis of <50 % in diameter after sole PAT, whereas secondary technical success was defined as residual stenosis of <50 % in diameter after PAT and additional PTA and/or stenting. Clinical outcome parameters (e.g., need for further intervention, minor/major amputation) were evaluated for the 30-day postinterventional period.ResultsPrimary technical success was achieved in 64 % of patients (30/47); secondary technical success was obtained in 96 % of patients (45/47). Clinical outcome data were available in 38 patients. In 87 % of patients (33/38), there was no need for further intervention within the 30-day postinterventional period. In three patients, minor amputations were conducted due to preexisting ulcerations (Rutherford Category 5 respectively).ConclusionsPAT enables endovascular treatment of iatrogenic thromboembolic complications after PTA with good technical and early clinical results and minimal morbidity.

  5. Haemodynamic observations during percutaneous transluminal coronary angioplasty in the presence of synchronised diastolic coronary sinus retroperfusion.

    PubMed Central

    Beatt, K J; Serruys, P W; de Feyter, P; van den Brand, M; Verdouw, P D; Hugenholtz, P G

    1988-01-01

    Animal studies have demonstrated that synchronised coronary sinus retroperfusion with arterial blood can provide effective perfusion of ischaemic myocardium. Preliminary clinical studies have shown that the technique can also be used with safety in human beings, and in the present study its effectiveness was assessed in three patients undergoing repeated coronary artery occlusions during percutaneous transluminal coronary angioplasty. Arterial blood was removed via an 8F catheter positioned in the femoral artery and delivered by a retroperfusion pumping system to a 7F retroperfusion balloon catheter positioned in the anterior cardiac vein. Ischaemia-related indices were monitored both before and during coronary sinus retroperfusion. These indices included high fidelity left ventricular pressure recordings and pressure derived indices (including velocities of isovolumic contraction and relaxation), as well as electrocardiographic changes and symptoms. Analysis of these variables showed that the ischaemic changes induced during coronary artery occlusion were not prevented by this type of coronary sinus retroperfusion. There was no major complication in any of the patients. It may be that adaptation of the technique or the use of alternative end points will establish a benefit, but further modifications of the delivery system are necessary for effective clinical use. Images Fig 1 PMID:2963657

  6. Assessment Of Coronary Artery Aneurysms Using Transluminal Attenuation Gradient And Computational Modeling In Kawasaki Disease Patients

    NASA Astrophysics Data System (ADS)

    Grande Gutierrez, Noelia; Kahn, Andrew; Shirinsky, Olga; Gagarina, Nina; Lyskina, Galina; Fukazawa, Ryuji; Owaga, Shunichi; Burns, Jane; Marsden, Alison

    2015-11-01

    Kawasaki Disease (KD) can result in coronary artery aneurysms (CAA) in up to 25% of patients, putting them at risk of thrombus formation, myocardial infarction and sudden death. Clinical guidelines recommend CAA diameter >8 mm as the arbitrary criterion for initiating systemic anticoagulation. KD patient specific modeling and flow simulations suggest that hemodynamic data can predict regions at increased risk of thrombosis. Transluminal Attenuation Gradient (TAG) is determined from the change in radiological attenuation per vessel length and has been proposed as a non-invasive method for characterizing coronary stenosis from CT Angiography. We hypothesized that CAA abnormal flow could be quantified using TAG. We computed hemodynamics for patient specific coronary models using a stabilized finite element method, coupled numerically to a lumped parameter network to model the heart and vascular boundary conditions. TAG was quantified in the major coronary arteries. We compared TAG for aneurysmal and normal arteries and we analyzed TAG correlation with hemodynamic and geometrical parameters. Our results suggest that TAG may provide hemodynamic data not available from anatomy alone. TAG represents a possible extension to standard CTA that could help to better evaluate the risk of thrombus formation in KD.

  7. Transluminal Attenuation Gradient for Thrombotic Risk Assessment in Kawasaki Disease Patients with Coronary Artery Aneurysms

    NASA Astrophysics Data System (ADS)

    Grande Gutierrez, Noelia; Kahn, Andrew; Burns, Jane; Marsden, Alison

    2014-11-01

    Kawasaki Disease (KD) can result in coronary aneurysms in up to 25% of patients if not treated early putting patients at risk of thrombus formation, myocardial infarction and sudden death. Clinical guidelines for administering anti-coagulation therapy currently rely on anatomy alone. Previous studies including patient specific modeling and computer simulations in KD patients have suggested that hemodynamic data can predict regions susceptible to thrombus formation. In particular, high Particle Residence Time gradient (PRTg) regions have shown to correlate with regions of thrombus formation. Transluminal Attenuation Gradient (TAG) is determined from the change in radiological attenuation per vessel length. TAG has been used for characterizing coronary artery stenoses, however this approach has not yet been used in aneurysmal vessels. The aim of this study is to analyze the correlation between TAG and PRTg in KD patients with aneurysms and evaluate the use of TAG as an index to quantify thrombotic risk. Patient specific anatomic models for fluids simulations were constructed from CT angiographic image data from 3 KD aneurysm patients and one normal control. TAG values for the aneurysm patients were markedly lower than for the non-aneurysmal patient (mean -18.38 vs. -2). In addition, TAG values were compared to PRTg obtained for each patient. Thrombotic risk stratification for KD aneurysms may be improved by incorporating TAG and should be evaluated in future prospective studies.

  8. Influence of a variant angina on the results of percutaneous transluminal coronary angioplasty.

    PubMed Central

    Leisch, F; Schützenberger, W; Kerschner, K; Herbinger, W

    1986-01-01

    Nineteen (86%) of 22 patients with variant angina and important coronary stenoses (greater than 60%) had successful percutaneous transluminal coronary angioplasty. The acute complications in two patients were not caused by coronary spasms but by dissection with disturbance of perfusion. One of these two patients required a coronary bypass graft; the other was treated conservatively. Myocardial infarction developed in both patients. Despite long term administration of nifedipine (30-80 mg daily), restenoses occurred within six months (on average after 10 weeks) in nine patients with symptoms and one without. In four patients the restenoses exceeded the degree of stenosis before angioplasty. Five patients were revascularised by surgical means. Vessels in three out of four patients were later successfully dilated. After a mean period of observation of 24 months (6-51 months) 18 of the 19 patients are symptom free and do not require medication. The results confirm that angioplasty is an effective method of treating patients with variant angina and important coronary stenoses. The problem of the high frequency of restenosis, however, remains unresolved. PMID:2945575

  9. Relation of Depression, Anxiety, and Quality of Life with Outcome after Percutaneous Transluminal Coronary Angioplasty

    PubMed Central

    Chaudhury, Suprakash; Srivastava, Kalpana

    2013-01-01

    Background. Despite, increasing number of percutaneous transluminal coronary angioplasty (PTCA) being performed, there is a paucity of Indian studies on the psychological effects of PTCA. Aim. To study the relation of anxiety, depression, and health related quality of life with outcome after PTCA. Methods. A total of 35 patients undergoing PTCA were included in the present project with their informed consent. All patients filled a specially designed proforma, the Hospital Anxiety and Depression Scale, Coronary Scale, Seattle Angina Questionnaire, and a health related quality of life measure (EQ 5D) one day before undergoing PTCA. Three days after PTCA patients were reassessed with the Hospital anxiety & depression scale, Seattle angina questionnaire and the EQ 5D. Results. Analysis showed that 46% had significant anxiety and 32.1% had significant depression before PTCA. Following successful PTCA, none of the patients had significant anxiety, and only 2 (3.6%) had significant depression. On the Seattle Angina Questionnaire, physical limitation reduced from 67.9 to 48. Disease perception improved from 21.2 to 37.1. On the EQ5D, the health status improved from 42.7 before PTCA to 78.7 after PTCA. Conclusion. Successful PTCA resulted in significant reduction in anxiety, depression, and physical limitation and improvement in disease perception and health status. PMID:24319368

  10. Early detection of restenosis after successful percutaneous transluminal coronary angioplasty by exercise-redistribution thallium scintigraphy

    SciTech Connect

    Wijns, W.; Serruys, P.W.; Reiber, J.H.; de Feyter, P.J.; van den Brand, M.; Simoons, M.L.; Hugenholtz, P.G.

    1985-02-01

    The value of exercise testing and thallium scintigraphy in predicting recurrence of angina pectoris and restenosis after a primary successful transluminal coronary angioplasty (PTCA) was prospectively evaluated. In 89 patients, a symptom-limited exercise electrocardiogram (ECG) and thallium scintigraphy were performed 4 weeks after they had undergone successful PTCA. Thereafter, the patients were followed for 6.4 +/- 2.5 months (mean +/- standard deviation) or until recurrence of angina. They all underwent a repeat coronary angiography at 6 months or earlier if symptoms recurred. PTCA was considered successful if the patients had no symptoms and if the stenosis was reduced to less than 50% of the luminal diameter. Restenosis was defined as an increase of the stenosis to more than 50% luminal diameter. The ability of the thallium scintigram (presence of a reversible defect) to predict recurrence of angina was 66%, vs 38% for the exercise ECG (ST-segment depression or angina at peak workload). Restenosis was predicted in 74% of patients by thallium scintigraphy, but only in 50% of patients by the exercise ECG. Thus, thallium scintigraphy was highly predictive but the exercise ECG was not (p less than 0.005). These results suggest that restenosis had occurred to some extent already at 4 weeks after the PTCA in most patients in whom it was going to occur.

  11. Transluminally Placed Endovascular Grafts for Venous Lesions in Patients on Hemodialysis

    SciTech Connect

    Quinn, S.F. Kim, J.; Sheley, R.C.

    2003-08-15

    This report summarizes a feasibility study of transluminally placed endovascular grafts (TPEG) using pre-expanded polytetrafluoroethylene (PTFE) to treat venous abnormalities inpatients on hemodialysis. Seventeen patients with peripheral(n = 11) or central (n = 6) venous lesions were treated with TPEG devices. Covered Gianturco stents were used for the peripheral lesions and covered Palmaz stents were used for central lesions. Venous abnormalities included vascular rupture after balloon angioplasty or surgical thrombectomy (n = 4),stenosis associated with an aneurysm (n = 2) and occlusive disease and central stenoses not responsive to balloon angioplasty (n = 11). The mean primary patency period was 37 days. The mean secondary patency period was 215 days. At 60,180, and 360 days the primary and secondary patency rates were 40%,32%, and 32%, and 70%, 55%, and 39%, respectively. Follow-up studies have shown various outcomes of the implanted TPEG devices,which have included stenoses within the TPEG (n = 2),stenoses central to the TPEG (n = 1), stenoses peripheral to the TPEG (n = 3), acute thrombosis extending to the TPEG without a stenosis (n = 1), graft abandoned with patent TPEG (n = 6), and TPEG patent within primary patency period at last follow-up (n =4). The TPEG devices, made with pre-expanded PTFE, appear safe in the short term, do not prevent progressive dialysis access site failure, and need to be compared to PTA and endovascular stenting in a randomized prospective trial.

  12. [CanMEDS 2015: better doctors?].

    PubMed

    Borleffs, J C C; Mourits, M J E; Scheele, F

    2016-01-01

    Recently, the CanMEDS model, which forms the basis for competency-based learning in both undergraduate and postgraduate training, has been renewed by the introduction of CanMEDS 2015. The most prominent change is the emphasis on leadership skills, which is also reflected by the name change for the role of 'manager' to 'leader'. The addition of milestones provides clearly defined targets for learning and assessment, which facilitates the monitoring of the progression in competence. Furthermore, CanMEDS 2015 strongly focusses on the overall coherence of the separate competencies. CanMEDS, designed as a model that helps to train young doctors to become good doctors, also helps us - the trainers - to become better doctors ourselves. PMID:27438391

  13. MEDLI Will Aid in Understanding of Mars

    NASA Video Gallery

    The MEDLI instrument package, contained in the heat shield of the Mars Science Laboratory, will help scientists and engineers improve their computer models and simulations, and provide data to help...

  14. Renal Branch Artery Occlusion in a 13-Year-Old Hypertensive Girl: Initial Treatment and Treatment of Recurrent Stenosis by Balloon Angioplasty

    SciTech Connect

    Konez, Orhan; Burrows, Patricia E.; Harmon, William E.

    2001-09-15

    A 13-year-old girl who recently developed hypertension was diagnosed to have an occluded right renal branch artery and was treated successfully with percutaneous transluminal angioplasty (PTA). To our knowledge, PTA has not been reported as a treatment for totally occluded renal branch arteries, and there is no data available regarding the success rate and possible complications.

  15. The MED-SUV Multidisciplinary Interoperability Infrastructure

    NASA Astrophysics Data System (ADS)

    Mazzetti, Paolo; D'Auria, Luca; Reitano, Danilo; Papeschi, Fabrizio; Roncella, Roberto; Puglisi, Giuseppe; Nativi, Stefano

    2016-04-01

    In accordance with the international Supersite initiative concept, the MED-SUV (MEDiterranean SUpersite Volcanoes) European project (http://med-suv.eu/) aims to enable long-term monitoring experiment in two relevant geologically active regions of Europe prone to natural hazards: Mt. Vesuvio/Campi Flegrei and Mt. Etna. This objective requires the integration of existing components, such as monitoring systems and data bases and novel sensors for the measurements of volcanic parameters. Moreover, MED-SUV is also a direct contribution to the Global Earth Observation System of Systems (GEOSS) as one the volcano Supersites recognized by the Group on Earth Observation (GEO). To achieve its goal, MED-SUV set up an advanced e-infrastructure allowing the discovery of and access to heterogeneous data for multidisciplinary applications, and the integration with external systems like GEOSS. The MED-SUV overall infrastructure is conceived as a three layer architecture with the lower layer (Data level) including the identified relevant data sources, the mid-tier (Supersite level) including components for mediation and harmonization , and the upper tier (Global level) composed of the systems that MED-SUV must serve, such as GEOSS and possibly other global/community systems. The Data level is mostly composed of existing data sources, such as space agencies satellite data archives, the UNAVCO system, the INGV-Rome data service. They share data according to different specifications for metadata, data and service interfaces, and cannot be changed. Thus, the only relevant MED-SUV activity at this level was the creation of a MED-SUV local repository based on Web Accessible Folder (WAF) technology, deployed in the INGV site in Catania, and hosting in-situ data and products collected and generated during the project. The Supersite level is at the core of the MED-SUV architecture, since it must mediate between the disparate data sources in the layer below, and provide a harmonized view to

  16. Revascularization therapy for coronary artery disease. Coronary artery bypass grafting versus percutaneous transluminal coronary angioplasty.

    PubMed Central

    Wilson, J M; Ferguson, J J

    1995-01-01

    Coronary artery bypass surgery relieves the symptoms of myocardial ischemia and prolongs survival of patients with more severe coronary artery disease. Randomized trials of surgical therapy have consistently shown that the benefits of surgical revascularization are proportional to the amount of myocardium affected by, or at risk for, ischemic injury. This risk is inferred from angiographically delineated coronary anatomy, estimates of left ventricular function, and physiologic testing. The population that may see a survival benefit from surgical revascularization has probably been expanded beyond that reported in the VA, CASS, and ECSS trials, due to improved perioperative care, longer graft survival, and the use of internal mammary artery grafts. Percutaneous transluminal coronary angioplasty revascularizes myocardium by dilating a stenotic segment of coronary artery. While successful in relieving the symptoms of myocardial ischemia, PTCA is hindered by the occurrence of abrupt vessel closure and the frequent development of restenosis. Furthermore, firm proof of a survival benefit, outside of emergency therapy for acute myocardial infarction, is not yet available. However, because the risk of procedure-related death or serious complication is lower than that seen with bypass surgery, PTCA provides a useful alternative revascularization method for patients with less extensive disease, in whom the risk of surgery may equal or exceed any beneficial effect. New technology and growing experience are widening the scope of percutaneous revascularization by extending the hope of symptomatic relief and survival benefit even to patients with extensive, severe coronary artery disease. Comparisons between surgical therapy and PTCA in select populations with single- and multivessel coronary artery disease have shown that PTCA is not as effective as surgery for long-term symptomatic control, and that it often requires repeat PTCA or cross-over to bypass surgery; however, long

  17. Endoscopic transluminal pancreatic necrosectomy using a self-expanding metal stent and high-flow water-jet system

    PubMed Central

    Hritz, István; Fejes, Roland; Székely, András; Székely, Iván; Horváth, László; Sárkány, Ágnes; Altorjay, Áron; Madácsy, László

    2013-01-01

    Walled-off pancreatic necrosis and a pancreatic abscess are the most severe complications of acute pancreatitis. Surgery in such critically ill patients is often associated with significant morbidity and mortality within the first few weeks after the onset of symptoms. Minimal invasive approaches with high success and low mortality rates are therefore of considerable interest. Endoscopic therapy has the potential to offer safe and effective alternative treatment. We report here on 3 consecutive patients with infected walled-off pancreatic necrosis and 1 patient with a pancreatic abscess who underwent direct endoscopic necrosectomy 19-21 d after the onset of acute pancreatitis. The infected pancreatic necrosis or abscess was punctured transluminally with a cystostome and, after balloon dilatation, a non-covered self-expanding biliary metal stent was placed into the necrotic cavity. Following stent deployment, a nasobiliary pigtail catheter was placed into the cavity to ensure continuous irrigation. After 5-7 d, the metal stent was removed endoscopically and the necrotic cavity was entered with a therapeutic gastroscope. Endoscopic debridement was performed via the simultaneous application of a high-flow water-jet system; using a flush knife, a Dormia basket, and hot biopsy forceps. The transluminal endotherapy was repeated 2-5 times daily during the next 10 d. Supportive care included parenteral antibiotics and jejunal feeding. All patients improved dramatically and with resolution of their septic conditions; 3 patients were completely cured without any further complications or the need for surgery. One patient died from a complication of prolonged ventilation severe bilateral pneumonia, not related to the endoscopic procedure. No procedure related complications were observed. Transluminal endoscopic necrosectomy with temporary application of a self-expanding metal stent and a high-flow water-jet system shows promise for enhancing the potential of this endoscopic

  18. Endoscopic transluminal pancreatic necrosectomy using a self-expanding metal stent and high-flow water-jet system.

    PubMed

    Hritz, István; Fejes, Roland; Székely, András; Székely, Iván; Horváth, László; Sárkány, Agnes; Altorjay, Aron; Madácsy, László

    2013-06-21

    Walled-off pancreatic necrosis and a pancreatic abscess are the most severe complications of acute pancreatitis. Surgery in such critically ill patients is often associated with significant morbidity and mortality within the first few weeks after the onset of symptoms. Minimal invasive approaches with high success and low mortality rates are therefore of considerable interest. Endoscopic therapy has the potential to offer safe and effective alternative treatment. We report here on 3 consecutive patients with infected walled-off pancreatic necrosis and 1 patient with a pancreatic abscess who underwent direct endoscopic necrosectomy 19-21 d after the onset of acute pancreatitis. The infected pancreatic necrosis or abscess was punctured transluminally with a cystostome and, after balloon dilatation, a non-covered self-expanding biliary metal stent was placed into the necrotic cavity. Following stent deployment, a nasobiliary pigtail catheter was placed into the cavity to ensure continuous irrigation. After 5-7 d, the metal stent was removed endoscopically and the necrotic cavity was entered with a therapeutic gastroscope. Endoscopic debridement was performed via the simultaneous application of a high-flow water-jet system; using a flush knife, a Dormia basket, and hot biopsy forceps. The transluminal endotherapy was repeated 2-5 times daily during the next 10 d. Supportive care included parenteral antibiotics and jejunal feeding. All patients improved dramatically and with resolution of their septic conditions; 3 patients were completely cured without any further complications or the need for surgery. One patient died from a complication of prolonged ventilation severe bilateral pneumonia, not related to the endoscopic procedure. No procedure related complications were observed. Transluminal endoscopic necrosectomy with temporary application of a self-expanding metal stent and a high-flow water-jet system shows promise for enhancing the potential of this endoscopic

  19. Association Between Disruption of Fibrin Sheaths Using Percutaneous Transluminal Angioplasty Balloons and Late Onset of Central Venous Stenosis

    SciTech Connect

    Ni, Nina Mojibian, Hamid; Pollak, Jeffrey; Tal, Michael

    2011-02-15

    To compare the rates of central venous stenosis in patients undergoing hemodialysis who underwent disruption of fibrin sheath with percutaneous transluminal angioplasty balloons and those who underwent over-the-wire catheter exchange. This study is a retrospective review of 209 percutaneous transluminal angioplasty balloon disruption and 1304 over-the-wire catheter exchange procedures performed in 753 patients. Approval from the Human Investigations Committee was obtained for this study. Up to 10-year follow-up was performed. A {chi}{sup 2} test was used to compare the rates of central venous stenosis after balloon disruption versus catheter exchange. A t-test was used to compare time to central venous stenosis development. Of the 753 patients in the study, 127 patients underwent balloon disruption of fibrin sheath and 626 had catheter exchange. Within the balloon disruption group, 18 (14.2%) of 127 patients subsequently developed central venous stenosis, compared with 44 (7.0%) of 626 in the catheter exchange group (P < 0.01, {chi}{sup 2} test). Time to central venous stenosis development was approximately 3 years in both groups and not significantly different (1371 and 1010 days, P = 0.20). A total of 25.2% of patients in the balloon disruption group had four or more subsequent catheter exchanges, versus 12.6% in the catheter exchange group (P < 0.01, {chi}{sup 2} test). In conclusions, there is a possible association between percutaneous transluminal angioplasty balloon disruption of fibrin sheath and late-onset central venous stenosis. Because venography was not routinely performed in catheter exchange patients, future randomized studies are necessary to confirm these findings.

  20. Vascular brachytherapy after percutaneous transluminal angioplasty of superficial femoral arteries--Polish pilot group

    SciTech Connect

    Walichiewicz, Piotr; Piecuch, Jerzy; Bialas, Brygida; Orkisz, Witold; Fijalkowski, Marek; Miszczyk, Leszek

    2002-03-01

    Purpose: The article presents the results of treatment with vascular brachytherapy (VBT) in superficial femoral arteries. This method aims to minimize frequency of restenosis after percutaneous transluminal angioplasty (PTA). Method: Treatment was carried out in 20 cases. The patients with severe stenoses or total occlusions verified in angiography were selected. In the group of 19 patients, two were women (the average age of the patients was 58.7 years). VBT was performed immediately after PTA. A 15-Gy dose, with high dose rate, was applied. The dose was calculated based on individually chosen distance from the internal surface of the artery wall, which varied from 2 to 3 mm. The mean observation time after treatment was 8 months. The shortest time was 1 month and the longest 14 months. At the end of the observation time, the control DSA angiography was performed on every patient. Results: During the first 2 months, in three cases, an acute thrombosis in treated artery was observed. In the third month, one treated artery occluded. In the sixth month of observation, one case of acute thrombosis was observed. The rest of the patients were free of restenoses. Conclusions: (1) In superficial femoral arteries, a low value of ankle brachial pressure index (ABPI; below 0.4) is very probably responsible for acute thrombosis after PTA with or without stent implantation followed by VBT. (2) Diabetes, rest ischaemia before treatment, poor vessel status confirmed in angiography may also be responsible for acute thrombosis after VBT. (3) Anticoagulants or antiplatelet (ticlipidine) treatment must be ordered for 6 months after VBT in patients with implanted stents.

  1. Frequency, risk factors, and outcome for bacteremia after percutaneous transluminal coronary angioplasty.

    PubMed

    Samore, M H; Wessolossky, M A; Lewis, S M; Shubrooks, S J; Karchmer, A W

    1997-04-01

    The objectives of this study were to examine bacteremias after percutaneous transluminal coronary angioplasty (PTCA) with respect to incidence, outcome, and risk factors. Patients undergoing PTCA from January 1990 through April 1994 were studied; during this period a total of 4,217 PTCAs were performed in 3,473 patients. With use of predefined clinical and microbiologic criteria, bacteremias were divided into 3 categories according to the relation to the PTCA procedure: PTCA-related, unrelated, and indeterminate. Ninety-one patients with at least 1 positive blood culture during a 7-week period after PTCA were identified. The bacteremia was classified as unrelated to the PTCA procedure in 32 patients, PTCA-related in 27, and indeterminant in the remaining 32 patients. The attack rate of PTCA-related bacteremia during the 52-month period was 0.64%. The most common organisms causing PTCA-related bacteremia were Staphylococcus aureus (14 patients), coagulase-negative staphylococci (9 patients) and group B streptococci (6 patients). Septic complications, which included femoral artery mycotic aneurysm, septic arthritis, and septic thrombosis, occurred in 10 patients (0.24%). Independent risk factors for PTCA-related bacteremia included duration of procedure (odds ratio [OR] 2.9; p = 0.04), number of catheterizations at the same site (OR 4.0; p = 0.015), difficult vascular access (OR 14.9; p = 0.007), arterial sheath in place > 1 day (OR 6.8; p = 0.025), congestive heart failure (OR 43.3; p = 0.002). Thus, PTCA-related bacteremia is an infrequent complication of PTCA but can be associated with significant morbidity, particularly when the infecting organism is S. aureus. Four of the 5 risk factors for PTCA-related bacteremia appear to correlate directly with increased vascular injury or maintenance of the arterial entry for the procedure. PMID:9104897

  2. Exploration of the retroperitoneum using the transvaginal natural orifice transluminal endoscopic surgery technique.

    PubMed

    Zacharopoulou, Chrysoula; Nassif, Joseph; Allemann, Pierre; Dallemagne, Bernard; Perretta, Silvana; Marescaux, Jacques; Wattiez, Arnaud

    2009-01-01

    We sought to evaluate the feasibility of the retroperitoneum's exploration via natural orifice transluminal endoscopic surgery (NOTES) using transvaginal access in a porcine model, and its possible application in human beings. Six female pigs (25-30 kg) were used to establish anatomic landmarks and technical steps. Six additional pigs were used for the survival study. Under general anesthesia and with the pig supine, a 1-cm posterolateral colpotomy was performed with the double-channel gastroscope's needle knife. The incision was enlarged laterally using blunt dissection while keeping in contact with the psoas muscle. A retroperitoneal tunnel was created using carbon-dioxide dissection and the movements of the gastroscope up to the level of the kidney. The colpotomy site was closed using interrupted sutures (polyglactin 2/0). A follow-up laparoscopy and necropsy were performed 3 weeks postoperatively. Successful access to the retroperitoneum was achieved in all pigs with a mean operative time of 30 minutes. However, in the first 3 pigs used for the acute study, the peritoneum was perforated during the six-pig dissection and the procedure was abandoned because of the space's collapse. No perforation occurred during the survival study. An excellent view of the retroperitoneal space and structures, such as the vascular and lymphatic tissues, the kidney, the adrenal gland, and the ureter, was obtained. No intraoperative complications or bleeding or injury to any of the retroperitoneal structures occurred. The 3-week follow-up laparoscopy showed no adhesions or abscesses. These findings were confirmed at necropsy. The retroperitoneal space can be successfully accessed via NOTES. Transvaginal NOTES access to the retroperitoneum avoids any transparietal trocars, so it could decrease surgical trauma, be better tolerated, and offer better visualization, with the obvious gender limitation. Future clinical application in human beings may include procedures such as

  3. Real-time computed tomography-based augmented reality for natural orifice transluminal endoscopic surgery navigation

    PubMed Central

    Azagury, D. E.; Ryou, M.; Shaikh, S. N.; Estéepar, R. San José; Lengyel, B. I.; Jagadeesan, J.; Vosburgh, K. G.; Thompson, C. C.

    2013-01-01

    Background Natural orifice transluminal endoscopic surgery (NOTES) is technically challenging owing to endoscopic short-sighted visualization, excessive scope flexibility and lack of adequate instrumentation. Augmented reality may overcome these difficulties. This study tested whether an image registration system for NOTES procedures (IR-NOTES) can facilitate navigation. Methods In three human cadavers 15 intra-abdominal organs were targeted endoscopically with and without IR-NOTES via both transgastric and transcolonic routes, by three endoscopists with different levels of expertise. Ease of navigation was evaluated objectively by kinematic analysis, and navigation complexity was determined by creating an organ access complexity score based on the same data. Results Without IR-NOTES, 21 (11·7 per cent) of 180 targets were not reached (expert endoscopist 3, advanced 7, intermediate 11), compared with one (1 per cent) of 90 with IR-NOTES (intermediate endoscopist) (P = 0·002). Endoscope movements were significantly less complex in eight of the 15 listed organs when using IR-NOTES. The most complex areas to access were the pelvis and left upper quadrant, independently of the access route. The most difficult organs to access were the spleen (5 failed attempts; 3 of 7 kinematic variables significantly improved) and rectum (4 failed attempts; 5 of 7 kinematic variables significantly improved). The time needed to access the rectum through a transgastric approach was 206·3 s without and 54·9 s with IR-NOTES (P = 0·027). Conclusion The IR-NOTES system enhanced both navigation efficacy and ease of intra-abdominal NOTES exploration for operators of all levels. The system rendered some organs accessible to non-expert operators, thereby reducing one impediment to NOTES procedures. PMID:22864885

  4. Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty

    PubMed Central

    Dawkes, Susan; Smith, Graeme D; Elliott, Lawrie; Raeside, Robert; Donaldson, Jayne H

    2016-01-01

    Objective To explore how older patients self-manage their coronary heart disease (CHD) after undergoing elective percutaneous transluminal coronary angioplasty (PTCA). Methods This mixed methods study used a sequential, explanatory design and recruited a convenience sample of patients (n = 93) approximately three months after elective PTCA. The study was conducted in two phases. Quantitative data collected in Phase 1 by means of a self-administered survey were subject to univariate and bivariate analysis. Phase 1 findings informed the purposive sampling for Phase 2 where ten participants were selected from the original sample for an in-depth interview. Qualitative data were analysed using thematic analysis. This paper will primarily report the findings from a sub-group of older participants (n = 47) classified as 65 years of age or older. Results 78.7% (n = 37) of participants indicated that they would manage recurring angina symptoms by taking glyceryl trinitrate and 34% (n = 16) thought that resting would help. Regardless of the duration or severity of the symptoms 40.5% (n = 19) would call their general practitioner or an emergency ambulance for assistance during any recurrence of angina symptoms. Older participants weighed less (P = 0.02) and smoked less (P = 0.01) than their younger counterparts in the study. Age did not seem to affect PTCA patients' likelihood of altering dietary factors such as fruit, vegetable and saturated fat consumption (P = 0.237). Conclusions The findings suggest that older people in the study were less likely to know how to correctly manage any recurring angina symptoms than their younger counterparts but they had fewer risk factors for CHD. Age was not a factor that influenced participants' likelihood to alter lifestyle factors. PMID:27594866

  5. The Primary Patency of Percutaneous Transluminal Angioplasty in Hemodialysis Patients With Vascular Access Failure

    PubMed Central

    Kim, Woo Shin; Pyun, Wook Bum

    2011-01-01

    Background and Objectives Dysfunction of arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) contributes significantly to morbidity and hospitalization in the dialysis population. We evaluated the primary patency of AVFs following percutaneous transluminal angioplasty (PTA) in haemodialysis patients. Subjects and Methods We performed 231 interventions in 118 patients with a mean age of 62.1±12.9 years. We performed 122 interventions in 53 AVG patients (44.9%), and 109 interventions in 65 AVF patients (55.1%). If there was thrombosis of the vascular access, urokinase was administered and/or thrombus aspiration was performed. The stent was inserted when balloon dilatation did not expand sufficiently or elastic recoil occurred. Results For the 118 patients, the median patency time was 10.45±10.29 months at 92 months of follow-up. The primary patencies for stenotic AVFs at 6, 12, 24, 36, 48, and 60 months were 63.4%, 41.4%, 17.0%, 9.7%, 7.3%, and 2.4%, respectively. The primary patencies for AVGs at 6, 12, 24, and 36 months were 36.9%, 19.5%, 10.8%, 2.1%, respectively, and were obtained by means of the Kaplan-Meier analysis (log rank=6.42, p<0.05). The median patency time was 11.0 months and 4.45 months in the non-thrombus and thrombus groups, respectively. The complication rate was 1.73% (4/231); two cases of pseudoaneurysms and two cases of extravasation were detected. All therapy failures (5/231) occurred in thrombotic lesions of AVGs and were treated surgically. Conclusion PTA is an efficacious method for the correction of stenosis of AVFs for hemodialysis, thus prolonging the patency of the fistulas. PMID:22022326

  6. Monitoring plasma cardiac troponin I for the detection of myocardial injury after percutaneous transluminal coronary angioplasty.

    PubMed

    Ricchiuti, V; Shear, W S; Henry, T D; Paulsen, P R; Miller, E A; Apple, F S

    2000-12-01

    The objective of this study was to detect myocardial injury defined by an increase of plasma cardiac troponin I (cTnI) following percutaneous transluminal coronary angioplasty (PTCA) and compare plasma cTnI with the risk of cardiac complications at 30 days. Plasma cTnI, creatine kinase (CK) MB, and total CK were determined in 83 patients before (baseline) and 6, 12 and 24 h after PTCA. Thirty-eight patients underwent conventional PTCA, 39 PTCA-stent and six rotational atherectomy. Patients with acute myocardial infarction (AMI) and increased pre-procedural cTnI >0.8 microg/l were categorized into group 1 (n=23). The remaining 60 patients (pre-procedural cTnI=0.8 microg/l) were categorized as follows: group 2 (n=15) AMI; group 3 (n=20) unstable angina (UA); group 4 (n=25) coronary artery disease (CAD). Twelve hours post-procedure, all three cardiac markers were more frequently increased over baseline in group 2 patients (40-60%) compared to patients in group 3 (5-29%, P<0.03) or group 4 (0.5-5%, P<0.01). This was also true for patients undergoing PTCA-stent compared to conventional PTCA or rotational atherectomy (27-40 vs. 4-14%, P<0.02). cTnI was more sensitive (60%) to detect release of myocardial protein after PTCA compared to total CK (47%) or CKMB (43%). A moderate increase of cTnI (0.8-1.5 microg/l) in groups 2, 3 and 4 was associated with higher risk of complications 30 days post-procedure. PMID:11074073

  7. Percutaneous transluminal angioplasty in a patient with internal carotid artery stenosis following gamma knife radiosurgery for recurrent pituitary adenoma

    PubMed Central

    Ito, Hidemichi; Onodera, Hidetaka; Sase, Taigen; Uchida, Masashi; Morishima, Hiroyuki; Oshio, Kotaro; Shuto, Takashi; Tanaka, Yuichiro

    2015-01-01

    Background: Intracranial vascular complications following radiosurgery are extremely rare. Case Description: We report a case of stenosis in the internal carotid artery 5 years after gamma knife radiosurgery for a recurrent pituitary adenoma. Percutaneous transluminal angioplasty was performed successfully with anatomical and functional improvement. Conclusion: These results suggested the importance of monitoring for arterial stenosis in the long-term follow-up. Moreover, this is the first case of endovascular treatment as an effective therapy for intracranial arterial stenosis due to radiotherapy. PMID:26069850

  8. Exercise electrocardiography and myocardial scintigraphy in the serial evaluation of the results of percutaneous transluminal coronary angioplasty

    SciTech Connect

    Schall, J.M.; Chaitman, B.R.; David, P.R.; Dupras, G.; Brevers, G; Val, P.G.; Crepeau, J.; Lesperance, J.; Bourassa, M.G.

    1982-08-01

    The diagnostic value of exercise electrocardiography using 14 leads and thallium-201 scintigraphy were evaluated in 54 of 70 patients who underwent percutaneous transluminal coronary angioplasty (PTCA), both in the initial assessment and serial follow-up of patients after PTCA. Of the 45 patients who had successful PTCA, 36 had complete noninvasive studies performed before and 1 month after PTCA. The use of clinical symptoms in conjunction with the physiologic data, ECG and myocardial scintigram acquired during exercise provide important short-term data on the angiographic evolution of PTCA results. The noninvasive tests may be useful in determining guidelines for repeat angiography in patients who have had PTCA. (JMT)

  9. Human melioidosis reported by ProMED

    PubMed Central

    Nasner-Posso, Katherinn Melissa; Cruz-Calderón, Stefania; Montúfar-Andrade, Franco E.; Dance, David A.B.; Rodriguez-Morales, Alfonso J.

    2015-01-01

    Summary Objective There are limited sources describing the global burden of emerging diseases. A review of human melioidosis reported by ProMED was performed and the reliability of the data retrieved assessed in comparison to published reports. The effectiveness of ProMED was evaluated as a source of epidemiological data by focusing on melioidosis. Methods Using the keyword ‘melioidosis’ in the ProMED search engine, all of the information from the reports and collected data was reviewed using a structured form, including the year, country, gender, occupation, number of infected individuals, and number of fatal cases. Results One hundred and twenty-four entries reported between January 1995 and October 2014 were identified. A total of 4630 cases were reported, with death reported in 505 cases, suggesting a misleadingly low overall case fatality rate (CFR) of 11%. Of 20 cases for which the gender was reported, 12 (60%) were male. Most of the cases were reported from Australia, Thailand, Singapore, Vietnam, and Malaysia, with sporadic reports from other countries. Conclusions Internet-based reporting systems such as ProMED are useful to gather information and synthesize knowledge on emerging infections. Although certain areas need to be improved, ProMED provided good information about melioidosis. PMID:25975651

  10. Iliofemoral Deep Vein Thrombosis: Conventional Therapy Versus Lysis and Percutaneous Transluminal Angioplasty and Stenting

    PubMed Central

    AbuRahma, Ali F.; Perkins, Samuel E.; Wulu, John T.; Ng, Hong K.

    2001-01-01

    Objective To compare conventional treatment (heparin and warfarin) of iliofemoral venous thrombosis with multimodality treatment (lysis and stenting). Summary Background Data Several studies have reported on conventional therapy for iliofemoral venous thrombosis with disappointing results. However, more recent studies have reported better results with multimodality treatment. Methods Fifty-one consecutive patients with extensive iliofemoral venous thrombosis were treated during a 10-year period. If there were no contraindications, patients were given the option to choose between conventional therapy (group 1) and multimodality therapy (group 2). The multimodality treatment strategy included catheter-directed lysis followed by percutaneous transluminal balloon angioplasty (PTA) and stenting for residual iliac stenoses. All patients underwent routine venous duplex imaging at 30 days, 3 months, 6 months, and every 6 months thereafter. Results There were 33 patients in group 1 and 18 patients in group 2. Demographic and clinical characteristics were comparable for both groups. Initial lysis was achieved in 16 of 18 patients (89%) in group 2. Ten of 18 patients in group 2 had residual stenosis after lysis (8 primary and 2 secondary to malignancy), and they were treated with PTA/stenting with an initial success rate of 90%. Two patients in group 1 (6%) had a symptomatic pulmonary embolism (none in group 2). At 30 days, venous patency and symptom resolution were achieved in 1 of 33 patients (3%) in group 1 versus 15 of 18 (83%) in group 2. Kaplan-Meier analysis showed primary iliofemoral venous patency rates at 1, 3, and 5 years of 24%, 18%, and 18% and 83%, 69%, and 69% for groups 1 and 2, respectively. Long-term symptom resolution was achieved in 10 of 33 patients (30%) in group 1 versus 14 of 18 (78%) in group 2. Kaplan-Meier life table analysis showed similar survival rates at 1, 3, and 5 years of 100%, 93%, and 85% for group 1 and 100%, 93%, and 81% for group 2

  11. Hemorheological and oxygen free radical associated alterations during and after percutaneous transluminal coronary angioplasty.

    PubMed

    Késmárky, G; Tóth, K; Vajda, G; Habon, L; Halmosi, R; Róth, E

    2001-01-01

    Percutaneous transluminal coronary angioplasty (PTCA) is a frequently used method in the treatment of coronary artery disease. Coronary stenosis, endothelial injury, and ischemia-reperfusion caused by the balloon inflation and deflation during this procedure can cause several changes in blood flow. In our study 19 patients (mean age: 58 +/- 9 years) undergoing PTCA were examined. For the laboratory measurements several blood samples were taken from the femoral vein and the coronary sinus before and 30 minutes after PTCA, and from the cubital vein 1, 2, 5 days and 1, 6 months after PTCA. Among hemorheologic parameters hematocrit, plasma fibrinogen level, plasma and whole blood viscosities were measured and corrected blood viscosity value was calculated. To characterize the oxidative stress, samples were analyzed for thiobarbituric acid reactive substances (TBARS) of blood as a marker of lipidperoxidation and changes in the antioxidant system were investigated by measuring the activity of superoxide dismutase, catalase and the concentration of glutathione; superoxide generating capacity of isolated leukocytes and platelet aggregation were examined as markers of cellular activation. Plasma fibrinogen concentration increased markedly during the first and second day after PTCA (p < 0.001), which was accompanied by the elevation of plasma viscosity (p < 0.05). Plasma fibrinogen returned to the baseline at the one-month check-up visit, but there was a significant increase in its concentration by the end of the sixth month follow-up. Apparent whole blood viscosity at 90 s (-1) showed gradually increasing values up to the one- and six-month check-up visits (p < 0.01), which can partially be explained by the elevation of hematocrit. Corrected blood viscosity was significantly elevated on the fifth day already (p < 0.01), and one month later also. Superoxide production of leukocytes showed an increasing tendency (p = 0.05), and blood TBARS was elevated after one day (p < 0

  12. MED GATA factors promote robust development of the C. elegans endoderm

    PubMed Central

    Maduro, Morris F.; Broitman-Maduro, Gina; Choi, Hailey; Carranza, Francisco; Wu, Allison Chia-Yi; Rifkin, Scott A.

    2015-01-01

    The MED-1,2 GATA factors contribute to specification of E, the progenitor of the C. elegans endoderm, through the genes end-1 and end-3, and in parallel with the maternal factors SKN-1, POP-1 and PAL-1. END-1,3 activate elt-2 and elt-7 to initiate a program of intestinal development, which is maintained by positive autoregulation. Here, we advance the understanding of MED-1,2 in E specification. We find that expression of end-1 and end-3 is greatly reduced in med-1,2(−) embryos. We generated strains in which MED sites have been mutated in end-1 and end-3. Without MED input, gut specification relies primarily on POP-1 and PAL-1. 25% of embryos fail to make intestine, while those that do display abnormal numbers of gut cells due to a delayed and stochastic acquisition of intestine fate. Surviving adults exhibit phenotypes consistent with a primary defect in the intestine. Our results establish that MED-1,2 provide robustness to endoderm specification through end-1 and end-3, and reveal that gut differentiation may be more directly linked to specification than previously appreciated. The results argue against an “all-or-none” description of cell specification, and suggest that activation of tissue-specific master regulators, even when expression of these is maintained by positive autoregulation, does not guarantee proper function of differentiated cells. PMID:25959238

  13. Two male sibs with severe micrognathia and a missense variant in MED12.

    PubMed

    Prescott, Trine E; Kulseth, Mari Ann; Heimdal, Ketil R; Stadheim, Barbro; Hopp, Einar; Gambin, Tomasz; Coban Akdemir, Zeynep H; Jhangiani, Shalini N; Muzny, Donna M; Gibbs, Richard A; Lupski, James R; Stray-Pedersen, Asbjørg

    2016-08-01

    Missense variants in MED12 cause three partially overlapping dysmorphic X-linked intellectual disability (XLID) syndromes: Lujan-Fryns syndrome (also known as Lujan syndrome), FG syndrome (also known as Opitz-Kaveggia syndrome) and X-linked Ohdo syndrome. We report a family with two severely micrognathic male sibs, a 10½ year old boy and a fetus, in which hemizygosity for a previously unreported missense variant in exon 13 of MED12 (NM_005120.2), c.1862G > A, p.(Arg621Gln) was detected by whole exome sequencing. The affected sibs shared no other rare variant with relevance to the phenotype. X-chromosome inactivation in blood was completely skewed (100:0) in the unaffected heterozygous mother, most likely as a result of preferential inactivation of the X-chromosome harbouring the missense variant in MED12. Neither the unaffected brother nor the unaffected maternal grandfather carried the missense variant in MED12. In the 10½ year old boy, upper airway obstruction secondary to Pierre Robin sequence necessitated a tracheostomy for the first 10 months of life. He has mild to moderate intellectual disability and some dysmorphic features seen in MED12-related syndromes. In addition, he has a horizontal gaze paresis, anomalies of the inner ear, and a cervical block vertebra. This report contributes to the expanding phenotypic range associated with MED12-mutations. PMID:27286923

  14. BALANCE AND PIPETTE CALIBRATION AT MED

    EPA Science Inventory

    Yearly, every MED analytical balance and automatic pipette inventoried is certified as working or it is repaired to working condition. - - - The QA office maintains three sets of standard weights that can be used by the staff to verify balance operation routinely after the yearly...

  15. MED-SUV Data Life Cycle

    NASA Astrophysics Data System (ADS)

    Sangianantoni, Agata; Puglisi, Giuseppe; Spampinato, Letizia; Tulino, Sabrina

    2015-04-01

    The MED-SUV project aims to implement a digital e-infrastructure for data access in order to promote the monitoring and study of key volcanic regions prone to volcanic hazards, and thus improve hazard assessment, according to the rationale of Supersite GEO initiative to Vesuvius- Campi Flegrei and Mt Etna, currently identified as Permanent Supersites. The present study focuses on the life cycle of MED-SUV data generated in the first period of the project and highlights the managing approach, as well as the crucial steps to be implemented for ensuring that data will be properly and ethically managed and can be used and accessed from both MED-SUV and the external community. The process is conceived outlining how research data being handled as the project progresses, describing what data are collected, processed or generated and how these data are going to be shared and made available through Open Access. Data cycle begins with their generation and ends with the deposit in the digital infrastructure, its key series of stages through which MED-SUV data passes are Collection, Data citation, Categorization of data, Approval procedure, Registration of datasets, Application of licensing models, and PID assignment. This involves a combination of procedures and practices taking into account the scientific core mission and the priorities of the project as well as the potential legal issues related to the management and protection of the Intellectual Property. We believe that the implementation of this process constitutes a significant encouragement in MED-SUV data sharing and as a consequence a better understanding on the volcanic processes, hazard assessment and a better integration with other Supersites projects.

  16. MED-SUV final strategic issues

    NASA Astrophysics Data System (ADS)

    Spampinato, Letizia; Puglisi, Giuseppe; Sangianantoni, Agata

    2016-04-01

    Aside the scientific, technical and financial aspects managed by the "Project Management" Work Package (WP1), the great challenge and more time consuming task of this WP has surely been the definition and application of some strategic guidelines crucial to trace the project right path to its final success and for the project outcome sustainability after month 36. In particular, given that one of the main objectives of MED-SUV is that to be compliant with the GEO initiative, particularly concerning the data sharing, great efforts have been made by WP1 at first to define the MED-SUV Data Policy Guidelines, and currently to make it suitable for the EU Supersites. At present, WP1 is also dealing with the exploitation of the achieved foreground among the project's participant and to define a Memorandum of Understanding to sustain the monitoring systems and e-infrastructure developed in the project framework. Whilst the Data Policy guidelines document was implemented in the first year of MED-SUV, WP1 is now focused on the last deliverable 'Strategic and Legal deliverables', which includes the remaining issues. To the aim, WP1 has strategically separated the Exploitation of Foreground document preparation from the Memorandum of Understanding definition. The Exploitation of Foreground process has regarded the identification of Foreground, the exploitable results, the purpose of such Foreground, the collection of information from either the scientific community of MED-SUV or industrial participants; to this aim WP1 circulated an ad hoc questionnaire to put together information on (the) every kind of MED-SUV outcome, on their owners, on the kind of ownership (single/joint), on the outcome exploitation, and on proposals for its sustainability. While the first information will allow us to prepare the final Exploitation Agreement among the project's participant, the information on the exploitation of the outcome and likely sustainability proposals will contribute to the

  17. Modified single transluminal gateway transcystic multiple drainage technique for a huge infected walled-off pancreatic necrosis: A case report.

    PubMed

    Minaga, Kosuke; Kitano, Masayuki; Imai, Hajime; Yamao, Kentaro; Kamata, Ken; Miyata, Takeshi; Matsuda, Tomohiko; Omoto, Shunsuke; Kadosaka, Kumpei; Yoshikawa, Tomoe; Kudo, Masatoshi

    2016-06-01

    We report a successful endoscopic ultrasonography-guided drainage of a huge infected multilocular walled-off necrosis (WON) that was treated by a modified single transluminal gateway transcystic multiple drainage (SGTMD) technique. After placing a wide-caliber fully covered metal stent, follow-up computed tomography revealed an undrained subcavity of WON. A large fistula that was created by the wide-caliber metal stent enabled the insertion of a forward-viewing upper endoscope directly into the main cavity, and the narrow connection route within the main cavity to the subcavity was identified with a direct view, leading to the successful drainage of the subcavity. This modified SGTMD technique appears to be useful for seeking connection routes between subcavities of WON in some cases. PMID:27275106

  18. Modified single transluminal gateway transcystic multiple drainage technique for a huge infected walled-off pancreatic necrosis: A case report

    PubMed Central

    Minaga, Kosuke; Kitano, Masayuki; Imai, Hajime; Yamao, Kentaro; Kamata, Ken; Miyata, Takeshi; Matsuda, Tomohiko; Omoto, Shunsuke; Kadosaka, Kumpei; Yoshikawa, Tomoe; Kudo, Masatoshi

    2016-01-01

    We report a successful endoscopic ultrasonography-guided drainage of a huge infected multilocular walled-off necrosis (WON) that was treated by a modified single transluminal gateway transcystic multiple drainage (SGTMD) technique. After placing a wide-caliber fully covered metal stent, follow-up computed tomography revealed an undrained subcavity of WON. A large fistula that was created by the wide-caliber metal stent enabled the insertion of a forward-viewing upper endoscope directly into the main cavity, and the narrow connection route within the main cavity to the subcavity was identified with a direct view, leading to the successful drainage of the subcavity. This modified SGTMD technique appears to be useful for seeking connection routes between subcavities of WON in some cases. PMID:27275106

  19. LactMed: New NLM Database on Drugs and Lactation

    MedlinePlus

    ... Issues Research News From NIH LactMed: New NLM Database on Drugs and Lactation Past Issues / Summer 2006 ... Javascript on. Photo: Comstock LactMed, a free online database with information on drugs and lactation, is one ...

  20. Technical development of PubMed Interact: an improved interface for MEDLINE/PubMed searches

    PubMed Central

    Muin, Michael; Fontelo, Paul

    2006-01-01

    Background The project aims to create an alternative search interface for MEDLINE/PubMed that may provide assistance to the novice user and added convenience to the advanced user. An earlier version of the project was the 'Slider Interface for MEDLINE/PubMed searches' (SLIM) which provided JavaScript slider bars to control search parameters. In this new version, recent developments in Web-based technologies were implemented. These changes may prove to be even more valuable in enhancing user interactivity through client-side manipulation and management of results. Results PubMed Interact is a Web-based MEDLINE/PubMed search application built with HTML, JavaScript and PHP. It is implemented on a Windows Server 2003 with Apache 2.0.52, PHP 4.4.1 and MySQL 4.1.18. PHP scripts provide the backend engine that connects with E-Utilities and parses XML files. JavaScript manages client-side functionalities and converts Web pages into interactive platforms using dynamic HTML (DHTML), Document Object Model (DOM) tree manipulation and Ajax methods. With PubMed Interact, users can limit searches with JavaScript slider bars, preview result counts, delete citations from the list, display and add related articles and create relevance lists. Many interactive features occur at client-side, which allow instant feedback without reloading or refreshing the page resulting in a more efficient user experience. Conclusion PubMed Interact is a highly interactive Web-based search application for MEDLINE/PubMed that explores recent trends in Web technologies like DOM tree manipulation and Ajax. It may become a valuable technical development for online medical search applications. PMID:17083729

  1. PubMedMiner: Mining and Visualizing MeSH-based Associations in PubMed.

    PubMed

    Zhang, Yucan; Sarkar, Indra Neil; Chen, Elizabeth S

    2014-01-01

    The exponential growth of biomedical literature provides the opportunity to develop approaches for facilitating the identification of possible relationships between biomedical concepts. Indexing by Medical Subject Headings (MeSH) represent high-quality summaries of much of this literature that can be used to support hypothesis generation and knowledge discovery tasks using techniques such as association rule mining. Based on a survey of literature mining tools, a tool implemented using Ruby and R - PubMedMiner - was developed in this study for mining and visualizing MeSH-based associations for a set of MEDLINE articles. To demonstrate PubMedMiner's functionality, a case study was conducted that focused on identifying and comparing comorbidities for asthma in children and adults. Relative to the tools surveyed, the initial results suggest that PubMedMiner provides complementary functionality for summarizing and comparing topics as well as identifying potentially new knowledge. PMID:25954472

  2. PubMedMiner: Mining and Visualizing MeSH-based Associations in PubMed

    PubMed Central

    Zhang, Yucan; Sarkar, Indra Neil; Chen, Elizabeth S.

    2014-01-01

    The exponential growth of biomedical literature provides the opportunity to develop approaches for facilitating the identification of possible relationships between biomedical concepts. Indexing by Medical Subject Headings (MeSH) represent high-quality summaries of much of this literature that can be used to support hypothesis generation and knowledge discovery tasks using techniques such as association rule mining. Based on a survey of literature mining tools, a tool implemented using Ruby and R – PubMedMiner – was developed in this study for mining and visualizing MeSH-based associations for a set of MEDLINE articles. To demonstrate PubMedMiner’s functionality, a case study was conducted that focused on identifying and comparing comorbidities for asthma in children and adults. Relative to the tools surveyed, the initial results suggest that PubMedMiner provides complementary functionality for summarizing and comparing topics as well as identifying potentially new knowledge. PMID:25954472

  3. Pub-Med-dot-com, here we come!

    PubMed

    Pulst, Stefan M

    2016-08-01

    As of April 8, 2016, articles in Neurology® Genetics can be searched using PubMed. Launched in 1996, PubMed is a search engine that accesses citations and abstracts of more than 26 million articles. Its primary sources include the MEDLINE database, which was started in the 1960s, and biomedical and life sciences journal articles that date back to 1946. In addition, PubMed accesses other sources, for example, citations to those life sciences journals that submit full-text articles to PubMed Central (PMC). PubMed Central was launched in 2000 as a free archive of biomedical and life science journals. PMID:27583303

  4. COSMO-SkyMed and GIS applications

    NASA Astrophysics Data System (ADS)

    Milillo, Pietro; Sole, Aurelia; Serio, Carmine

    2013-04-01

    Geographic Information Systems (GIS) and Remote Sensing have become key technology tools for the collection, storage and analysis of spatially referenced data. Industries that utilise these spatial technologies include agriculture, forestry, mining, market research as well as the environmental analysis . Synthetic Aperture Radar (SAR) is a coherent active sensor operating in the microwave band which exploits relative motion between antenna and target in order to obtain a finer spatial resolution in the flight direction exploiting the Doppler effect. SAR have wide applications in Remote Sensing such as cartography, surface deformation detection, forest cover mapping, urban planning, disasters monitoring , surveillance etc… The utilization of satellite remote sensing and GIS technology for this applications has proven to be a powerful and effective tool for environmental monitoring. Remote sensing techniques are often less costly and time-consuming for large geographic areas compared to conventional methods, moreover GIS technology provides a flexible environment for, analyzing and displaying digital data from various sources necessary for classification, change detection and database development. The aim of this work si to illustrate the potential of COSMO-SkyMed data and SAR applications in a GIS environment, in particular a demostration of the operational use of COSMO-SkyMed SAR data and GIS in real cases will be provided for what concern DEM validation, river basin estimation, flood mapping and landslide monitoring.

  5. COSMO-SkyMed Second Generation planner

    NASA Astrophysics Data System (ADS)

    Covello, Fabio; Scopa, Tiziana; Serva, Stefano; Caltagirone, Francesco; De Luca, Giuseppe Francesco; Pacaccio, Alessandro; Profili, Mario

    2014-10-01

    COSMO-SkyMed Second Generation (CSG) system has been conceived, according to Italian Space Agency (ASI) and Italian Ministry of Defence (It-MoD) requirements, at the twofold objective of ensuring operational continuity to the current constellation (COSMO-SkyMed - CSK), while improving functionality and performances. It is an "end-to-end" Italian Earth Observation Dual-Use (Civilian and Defence) Space System with Synthetic Aperture Radar (SAR) operating in X-Band. CSG mission planning purpose is to fully employ the system resources, shared between partners with very different needs, producing a mission plan that satisfies the higher priority requests and optimizes the overall plan with the remaining requests according to the users programming rights consumption. CSG Mission Planning tool provides new performances in terms of adaptability and flexibility of the planning and scheduling algorithms conceived to select and synchronize data acquisition and downloading activities. CSG planning and scheduling problem is characterized by a large size of research space and a particular structure of technical and managerial constraints that has led to the implementation of innovative design of the planning algorithms based on both priority criteria and saturation of system resources. This approach envisages two scheduling strategies: the rank-based and the optimization-based. The former strategy is firstly applied to the most important request categories, with an associated rank value or priority level; the latter is subsequently applied to the unranked or lower priority requests. This is an iterative dynamic process of finding optimal solutions able to better answer the demanding requirements coming from the needs of heterogeneous users.

  6. Is the presence of hyperlipidemia associated with impairment of endothelium-dependent neointimal relaxation after percutaneous transluminal coronary angioplasty?

    PubMed

    Sakai, A; Hirayama, A; Adachi, T; Nanto, S; Hori, M; Inoue, M; Kamada, T; Kodama, K

    1996-01-01

    To determine whether hyperlipidemia affects the endothelium-dependent vasomotor response along the dilated vessel after percutaneous transluminal coronary angioplasty (PTCA), we evaluated 32 patients with one-vessel disease, 3-6 months after successful PTCA without restenosis. Fourteen patients had mild stenotic lesions not subjected to PTCA (non-PTCA sites) in addition to the PTCA sites. Vessel diameter changes at 32 PTCA and 36 non-PTCA sites were assessed by quantitative angiography, before and after intracoronary injection of acetylcholine (20 micrograms to the right and 50 micrograms to the left coronary artery) and of nitroglycerin (0.1-0.3 mg). The acetylcholine response ranged from 46% (dilation) to -100% (constriction). All coronary arteries were dilated in response to nitroglycerin, which suggested preservation of the function of vascular smooth muscle, and the presence of an abnormality in endothelial function in those patients with a constrictor response to acetylcholine. There was a negative correlation between the acetylcholine response and the serum total cholesterol level at PTCA sites (r = -0.37; P = 0.038) and at non-PTCA sites (r = -0.46; P = 0.005). These findings indicate that hyperlipidemia is associated with a loss of endothelium-dependent vasodilation, not only at non-PTCA but also at PTCA sites, at which restoration of endothelial function might have occurred. They also suggest that hyperlipidemia may be related to the functional state of the regenerated endothelium at sites where PTCA had been previously performed. PMID:9129246

  7. Percutaneous Transluminal Angioplasty of Hepatic Artery Stenosis in Patients After Orthotopic Liver Transplantation: Mid-term Results

    SciTech Connect

    Jarmila, Lastovickova Jan, Peregrin

    2011-12-15

    Purpose: This study was designed to present our experience with percutaneous treatment of hepatic artery stenosis in orthotopic liver transplant patients and to evaluate the efficacy, technical outcomes, and mid-term clinical results of the procedure. Methods: Twenty-two percutaneous transluminal angioplasties (PTAs) were performed in 19 liver transplant recipients at our institution between 1998 and 2010. Stents were placed into the hepatic/celiac artery in 16 PTAs, but balloon dilatation alone was performed in 6 because of the anatomical condition of the vessel. PTA/stenting was indicated in 17 patients because of elevated liver enzymes; 2 patients were asymptomatic. The objective of treating stenosis was prevention of long-term complications, including thrombosis. Results: Technical success was achieved in all patients. There was only one complication: dissection of the treated artery without any subsequent adverse effects. In all patients, elevated liver enzyme levels improved after treatment. No restenosis was observed in any patient during a mean follow-up of 2.6 years (1 month to 5.5 years). Conclusions: Percutaneous angioplasty/stent placement is a safe method for the treatment of hepatic artery stenosis after orthotopic liver transplantation, with a high technical success rate and promising mid-term results.

  8. The Use of Below-Knee Percutaneous Transluminal Angioplasty in Arterial Occlusive Disease Causing Chronic Critical Limb Ischemia

    SciTech Connect

    Loefberg, Ann-Marie; Loerelius, Lars-Erik; Karacagil, Sadettin; Westman, Bo; Almgren, Bo; Berqgvist, David

    1996-09-15

    Purpose: To determine the efficacy, safety and long-term results of crural artery percutaneous transluminal angioplasty (PTA) in limbs with chronic critical limb ischemia (CLI). Methods: Patients undergoing crural artery PTA due to CLI were followed at regular clinic visits with ankle brachial pressure index (ABPI) measurements. PTA of the crural arteries was attempted either alone (n= 39) or in combination with PTA of the superficial and/or popliteal artery (n= 55) in 86 limbs (82 patients and 94 procedures) presenting with CLI. The ages of patients ranged from 37 to 94 years (mean 72 years). The indications for PTA were rest pain in 10 and ulcer/gangrene in 84 limbs.Results: A technically successful PTA with at least one crural level was achieved in 88% of cases (n= 83). Cumulative primary clinical success rates at 6, 12, 24, and 36 months were 55%, 51%, 36%, and 36%, respectively. Cumulative secondary clinical success and limb salvage rates at 36 months were 44% and 72%, respectively. Conclusion: PTA of the crural arteries might be considered the primary choice of treatment in patients with CLI and distal lesions with localized stenosis or segmental short occlusions.

  9. Longitudinal Stent-Shortening during Percutaneous Transluminal Angioplasty with Stenting of Right Superficial Femoral Artery: A Case Report.

    PubMed

    Rahman, A; Pasha, K; Hossain, G M; Islam, M M

    2015-10-01

    Longitudinal stent deformation (LSD) involving coronary arteries during PCI have been reported in several literatures. But, LSD occurring during PTA (Percutaneous Transluminal Angioplasty) involving peripheral arteries is rare. We had such a case who presented with coronary and peripheral artery disease. Longitudinal stent deformation occurred during PTA with stenting of right superficial femoral artery (SFA). For CAD, PCI to RCA and LAD was done beforehand and the peripheral procedure was done 4 days later to avoid increased contrast load. Due to LSD occurring during PTA to Rt. SFA, we had to deploy another stent to cover the lesion over that artery. There was no technical fault or difficulty during negotiating the stent and positioning it covering the lesion. So, we did not find any obvious reason for this complication. Since longitudinal stent deformation is uncommon during PCI of coronary arteries and probably rare during PTA of peripheral arteries and we did not find any literature regarding this, we decided to report this case. PMID:26620030

  10. Neointimal Hyperplasia after Silverhawk Atherectomy versus Percutaneous Transluminal Angioplasty (PTA) in Femoropopliteal Stent Reobstructions: A Controlled, Randomized Pilot Trial

    SciTech Connect

    Brodmann, Marianne Rief, Peter; Froehlich, Harald; Dorr, Andreas; Gary, Thomas; Eller, Philipp; Hafner, Franz; Deutschmann, Hannes; Seinost, Gerald; Pilger, Ernst

    2013-02-15

    Due to intimal hyperplasia instent reobstruction in the femoropopliteal arterial segment is still an unsolved problem. Different techniques have been discussed in case of reintervention to guarantee longlasting patency rate. We conducted a randomized, controlled, pilot trial comparing Silverhawk atherectomy with percutaneous transluminal angioplasty (PTA) in patients with a first instent reobstruction in the femoropopliteal arterial segment, to evaluate intima media thickness (IMT) within the treated segment, as a parameter of recurrence of intimal hyperplasia. In a total 19 patients were included: 9 patients in the atherectomy device and 10 patients in the PTA arm. IMT within the treated segment was statistically significantly elevated in all patients treated with the Silverhawk device versus the patients treated with PTA. The obvious differentiation in elevation of IMT in nonfavor for patients treated with the Silverhawk device started at month 2 (max IMT SH 0.178 mm vs. IMT PTA 0.1 mm, p = 0.001) with a spike at month 5 (max IMT SH 0.206 mm vs. IMT PTA 0.145 mm, p = 0.003) and a decline once again at month 6 (max IMT SH 0.177 mm vs. IMT PTA 0.121 mm, p = 0.02). The values for mean IMT performed the same way. Although Silverhawk atherectomy provides good results at first sight, in the midterm follow-up of treatment of first instent restenosis it did not perform better than PTA as it showed elevated reoccurrence of intimal media hyperplasia.

  11. Clinical efficacy and scintigraphic evaluation of post-coronary bypass patients undergoing percutaneous transluminal coronary angioplasty for recurrent angina pectoris

    SciTech Connect

    Reed, D.C.; Beller, G.A.; Nygaard, T.W.; Tedesco, C.; Watson, D.D.; Burwell, L.R.

    1989-01-01

    The efficacy of percutaneous transluminal angioplasty in improving recurrent anginal symptoms and myocardial perfusion after coronary artery bypass graft surgery was assessed prospectively in 55 patients, of whom 50 had an initial angiographic and clinical success. Although 80% of those successfully dilated were initially free of angina at 23 +/- 11 months of follow-up, one half of these patients had recurrent angina. Although only 48% of the patient cohort had complete relief of angina, 94% had less angina than before dilatation and 86% were able to decrease antianginal medications. Fifteen patients with persistent or recurrent angina had from one to five repeat dilatations. After angioplasty, lung thallium uptake, the extent of abnormal scan segments, and the magnitude of redistribution in dilated lesions were significantly reduced (n = 24 patients). Redistribution defects were seen in 38% of patients on postangioplasty scans. All were associated with subsequent angina. Of various clinical, angiographic, exercise, and thallium-201 scan variables, only the presence of delayed redistribution was an independent predictor of recurrent angina. Restenosis was the most common underlying cause for this exercise-induced perfusion defect. Thus percutaneous coronary angioplasty performed as primary therapy for recurrent angina after bypass surgery is moderately successful in long-term follow-up for the amelioration of symptoms and enhancement of regional myocardial perfusion.

  12. Safety and Efficacy of Transluminal Balloon Angioplasty Using a Compliant Balloon for Severe Cerebral Vasospasm after an Aneurysmal Subarachnoid Hemorrhage

    PubMed Central

    Choi, Beom Jin; Lee, Jae Il; Ko, Jun Kyeung; Park, Hwa Seung; Choi, Chang Hwa

    2011-01-01

    Objective Vasospasm of cerebral vessels remains a major source of morbidity and mortality after an aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to evaluate the safety and efficacy of transluminal balloon angioplasty (TBA) for SAH-induced vasospasm. Methods Eleven patients with an angiographically confirmed significant vasospasm (>50% vessel narrowing and clinical deterioration) were studied. A total of 54 vessel segments with significant vasospasm were treated by TBA. Digital subtraction angiography was used to confirm the presence of vasospasm, and TBA was performed to dilate vasospastic arteries. Medical and angiographic reports were reviewed to determine technical efficacy and for procedural complications. Results TBA using Hyper-Glide or Hyper-Form balloons (MicroTherapeutics, Irvine, CA) was successfully accomplished in 88.9% vasospastic segments (48 of 54), namely, in the distal internal carotid artery (100%, n=7), the middle cerebral artery (100%), including the M1 (n=10), M2 (n=10), and M3 segments (n=4), in the vertebral artery (100%, n=2), basilar artery (100%, n=1), and in the anterior cerebral artery (ACA), including the A1 (66%), A2 (66%), and A3 segments (100%). Vessel diameters significantly increased after TBA. There were no cases of vessel rupture or thromboembolic complications. GCS at one day after TBA showed an improvement in all patients except one. Conclusion This study suggests that TBA using Hyper-Glide or Hyper-Form balloons is a safe and effective treatment for subarachnoid hemorrhage-induced cerebral vasospasm. PMID:21556235

  13. Enabling technologies for natural orifice transluminal endoscopic surgery (N.O.T.E.S) using robotically guided elasticity imaging

    NASA Astrophysics Data System (ADS)

    Sen, H. T.; Deshmukh, Nishikant; Goldman, Roger; Kazanzides, Peter; Taylor, Russell H.; Boctor, Emad; Simaan, Nabil

    2012-02-01

    Natural orifice transluminal endoscopic surgery (N.O.T.E.S) is a minimally invasive surgical technique that could benefit greatly from additional methods for intraoperative detection of tissue malignancies (using elastography) along with more precise control of surgical tools. Ultrasound elastography has proven itself as an invaluable imaging modality. However, elasticity images typically suffer from low contrast when imaging organs from the surface of the body. In addition, the palpation motions needed to generate elastography images useful for identifying clinically significant changes in tissue properties are difficult to produce because they require precise axial displacements along the imaging plane. Improvements in elasticity imaging necessitate an approach that simultaneously removes the need for imaging from the body surface while providing more precise palpation motions. As a first step toward performing N.O.T.E.S in-vivo, we integrated a phased ultrasonic micro-array with a flexible snake-like robot. The integrated system is used to create elastography images of a spherical isoechoic lesion (approximately 5mm in cross-section) in a tissue-mimicking phantom. Images are obtained by performing robotic palpation of the phantom at the location of the lesion.

  14. PubMed Informer: Monitoring MEDLINE/PubMed through E-mail Alerts, SMS, PDA downloads and RSS feeds

    PubMed Central

    Muin, Michael; Fontelo, Paul; Ackerman, Michael

    2005-01-01

    Summary PubMed Informer is a Web-based monitoring tool for topics of interest from MEDLINE/PubMed primarily designed for healthcare professionals. Five tracking methods are available: Web access, e-mail, Short Message Service (SMS), PDA downloads and RSS feeds. PubMed Informer delivers focused search updates and specific information to users with varying information-seeking practices. PMID:16779344

  15. Mars 2020 Entry, Descent and Landing Instrumentation (MEDLI2)

    NASA Technical Reports Server (NTRS)

    Bose, Deepak; Wright, Henry; White, Todd; Schoenenberger, Mark; Santos, Jose; Karlgaard, Chris; Kuhl, Chris; Oishi, TOmo; Trombetta, Dominic

    2016-01-01

    This paper will introduce Mars Entry Descent and Landing Instrumentation (MEDLI2) on NASA's Mars2020 mission. Mars2020 is a flagship NASA mission with science and technology objectives to help answer questions about possibility of life on Mars as well as to demonstrate technologies for future human expedition. Mars2020 is scheduled for launch in 2020. MEDLI2 is a suite of instruments embedded in the heatshield and backshell thermal protection systems of Mars2020 entry vehicle. The objectives of MEDLI2 are to gather critical aerodynamics, aerothermodynamics and TPS performance data during EDL phase of the mission. MEDLI2 builds up the success of MEDLI flight instrumentation on Mars Science Laboratory mission in 2012. MEDLI instrumentation suite measured surface pressure and TPS temperature on the heatshield during MSL entry into Mars. MEDLI data has since been used for unprecedented reconstruction of aerodynamic drag, vehicle attitude, in-situ atmospheric density, aerothermal heating, transition to turbulence, in-depth TPS performance and TPS ablation. [1,2] In addition to validating predictive models, MEDLI data has highlighted extra margin available in the MSL forebody TPS, which can potentially be used to reduce vehicle parasitic mass. MEDLI2 expands the scope of instrumentation by focusing on quantities of interest not addressed in MEDLI suite. The type the sensors are expanded and their layout on the TPS modified to meet these new objectives. The paper will provide key motivation and governing requirements that drive the choice and the implementation of the new sensor suite. The implementation considerations of sensor selection, qualification, and demonstration of minimal risk to the host mission will be described. The additional challenges associated with mechanical accommodation, electrical impact, data storage and retrieval for MEDLI2 system, which extends sensors to backshell will also be described.

  16. Using MedDRA: implications for risk management.

    PubMed

    Brown, Elliot G

    2004-01-01

    The introduction of MedDRA, the Medical Dictionary for Regulatory Activities, as a standardised terminology may have a major impact on the performance of risk management. Thus, MedDRA is likely to have an important effect on the analysis of clinical trial safety data. Review of the most commonly used terms in clinical trial tables from the labelling of ten products indicated that each adverse event could be represented by many MedDRA preferred terms; this might theoretically lead to failure to identify differences in adverse event incidence between treatment arms. Possible solutions are proposed. The use of MedDRA in spontaneous reporting systems is a regulatory requirement in some countries. Variability in modes of implementation and use of the terminology are discussed; these may impose additional limitations on any use of spontaneous data for comparative purposes. There are important differences in the ways that safety databases interface with MedDRA and uncertainty about the most appropriate way to manage version changes. The characteristics of MedDRA must be taken into account when establishing methods for signal detection and its use will affect the retrieval of similar cases as required for signal evaluation. The use of MedDRA in the periodic safety update report is discussed. The possible use of MedDRA in pharmacoepidemiology is highly relevant to risk management, and some issues are briefly outlined. With regard to communication of risk, if MedDRA is introduced into existing product labelling, care must be taken that the change itself does not cause misunderstanding; the most appropriate use of MedDRA in this regard remains to be determined. There is a need for careful evaluation of MedDRA in fulfilling its various functions in pharmacovigilance, followed by definitive regulatory guidance on its use. PMID:15154830

  17. Bosnian and Herzegovinian medical scientists in PubMed database.

    PubMed

    Masic, Izet

    2013-01-01

    In this paper it is shortly presented PubMed as one of the most important on-line databases of the scientific biomedical literature. Also, the author has analyzed the most cited authors, professors of the medical faculties in Bosnia and Herzegovina, from the published papers in the biomedical journals abstracted and indexed in PubMed. PMID:24341067

  18. MedEdPORTAL: Educational Scholarship for Teaching

    ERIC Educational Resources Information Center

    Reynolds, Robby J.; Candler, Christopher S.

    2008-01-01

    MedEdPORTAL is an online publication service provided at no charge by the Association of American Medical Colleges (AAMC). The intent is to promote collaboration and educational scholarship by helping educators publish and share educational resources. With MedEdPORTAL, users can quickly locate high-quality, peer-reviewed teaching materials in both…

  19. 47 CFR 95.628 - MedRadio transmitters.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 5 2011-10-01 2011-10-01 false MedRadio transmitters. 95.628 Section 95.628 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES Technical Regulations Technical Standards § 95.628 MedRadio transmitters. (a) Frequency...

  20. 75 FR 52304 - MedBow-Routt Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-25

    ... Forest Service MedBow-Routt Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The MedBow-Routt Resource Advisory Committee will meet in Saratoga, Wyoming. The... is for an update on projects proposed for funding, and selection of some projects. DATES: The...

  1. 75 FR 39201 - MedBow-Routt Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... Forest Service MedBow-Routt Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The MedBow-Routt Resource Advisory Committee will meet in Steamboat Springs, Colorado... Act (Pub. L. 110-343) and in compliance with the Federal Advisory Committee Act. The purpose of...

  2. Public accessibility of biomedical articles from PubMed Central reduces journal readership—retrospective cohort analysis

    PubMed Central

    Davis, Philip M.

    2013-01-01

    Does PubMed Central—a government-run digital archive of biomedical articles—compete with scientific society journals? A longitudinal, retrospective cohort analysis of 13,223 articles (5999 treatment, 7224 control) published in 14 society-run biomedical research journals in nutrition, experimental biology, physiology, and radiology between February 2008 and January 2011 reveals a 21.4% reduction in full-text hypertext markup language (HTML) article downloads and a 13.8% reduction in portable document format (PDF) article downloads from the journals' websites when U.S. National Institutes of Health-sponsored articles (treatment) become freely available from the PubMed Central repository. In addition, the effect of PubMed Central on reducing PDF article downloads is increasing over time, growing at a rate of 1.6% per year. There was no longitudinal effect for full-text HTML downloads. While PubMed Central may be providing complementary access to readers traditionally underserved by scientific journals, the loss of article readership from the journal website may weaken the ability of the journal to build communities of interest around research papers, impede the communication of news and events to scientific society members and journal readers, and reduce the perceived value of the journal to institutional subscribers.—Davis, P. M. Public accessibility of biomedical articles from PubMed Central reduces journal readership—retrospective cohort analysis. PMID:23554455

  3. Percutaneous Transluminal Angioplasty and Drug-Eluting Stents for Infrapopliteal Lesions in Critical Limb Ischemia (PADI) Trial

    PubMed Central

    Spreen, Marlon I.; Martens, Jasper M.; Hansen, Bettina E.; Knippenberg, Bob; Verhey, Elke; van Dijk, Lukas C.; de Vries, Jean-Paul P.M.; Vos, Jan-Albert; de Borst, Gert Jan; Vonken, Evert-Jan P.A.; Wever, Jan J.; Statius van Eps, Randolph G.; Mali, Willem P.Th.M.

    2016-01-01

    Background— Endovascular infrapopliteal treatment of patients with critical limb ischemia using percutaneous transluminal angioplasty (PTA) and bail-out bare metal stenting (BMS) is hampered by restenosis. In interventional cardiology, drug-eluting stents (DES) have shown better patency rates and are standard practice nowadays. An investigator-initiated, multicenter, randomized trial was conducted to assess whether DES also improve patency and clinical outcome of infrapopliteal lesions. Methods and Results— Adults with critical limb ischemia (Rutherford category ≥4) and infrapopliteal lesions were randomized to receive PTA±BMS or DES with paclitaxel. Primary end point was 6-month primary binary patency of treated lesions, defined as ≤50% stenosis on computed tomographic angiography. Stenosis >50%, retreatment, major amputation, and critical limb ischemia–related death were regarded as treatment failure. Severity of failure was assessed with an ordinal score, ranging from vessel stenosis through occlusion to the clinical failures. Seventy-four limbs (73 patients) were treated with DES and 66 limbs (64 patients) received PTA±BMS. Six-month patency rates were 48.0% for DES and 35.1% for PTA±BMS (P=0.096) in the modified-intention-to-treat and 51.9% and 35.1% (P=0.037) in the per-protocol analysis. The ordinal score showed significantly worse treatment failure for PTA±BMS versus DES (P=0.041). The observed major amputation rate remained lower in the DES group until 2 years post-treatment, with a trend toward significance (P=0.066). Less minor amputations occurred after DES until 6 months post-treatment (P=0.03). Conclusions— In patients with critical limb ischemia caused by infrapopliteal lesions, DES provide better 6-month patency rates and less amputations after 6 and 12 months compared with PTA±BMS. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00471289. PMID:26861113

  4. Cost-efficacy modeling of functional testing with perfusion imaging to detect asymptomatic restenosis following percutaneous transluminal coronary angioplasty.

    PubMed

    Mak, K H; Eisenberg, M J; Shaw, J

    1999-12-01

    The objective of this study was to perform a theoretical cost-efficacy analysis on the use of routine functional testing with perfusion imaging to identify patients with asymptomatic restenosis following percutaneous transluminal coronary angioplasty (PTCA) procedures. Approximately 50% of patients with restenosis following PTCA are asymptomatic. Routine functional testing is commonly performed at 3 to 6 months to identify these patients. The cost-efficacy associated with this strategy is unknown. Theoretical models were constructed based on assumed costs for functional testing (U.S. $1,300) and coronary angiography (U.S. $3,000). Restenosis rates were assumed to be 40%, and half of patients with restenosis were assumed to be asymptomatic. To provide a range of costs to identify a patient with asymptomatic restenosis, three scenarios were constructed based on the diagnostic test characteristics of functional testing. Sensitivity analyses were performed using a range of costs for functional testing, restenosis rates, and proportion of patients with restenosis who are asymptomatic. Depending on the diagnostic accuracy of functional testing, it costs $8,200 to $22,400 to identify an asymptomatic patient with restenosis following PTCA. The cost to identify a patient with asymptomatic restenosis varies inversely with the rates of restenosis. When restenosis rates are < 20%, the cost to identify a patient with asymptomatic restenosis exceeds $10,000. Similarly, the cost to identify a patient with asymptomatic restenosis increases when the proportion of patients with asymptomatic restenosis decreases. The cost, associated with the use of routine functional testing for the identification of asymptomatic patients with restenosis appears exorbitant. However, a formal study is warranted to determine the cost-efficacy of such a strategy. Cathet. Cardiovasc. Intervent. 48:352-356, 1999. PMID:10559811

  5. Drug-Coated Balloon Versus Standard Percutaneous Transluminal Angioplasty for the Treatment of Superficial Femoral and Popliteal Peripheral Artery Disease

    PubMed Central

    Tepe, Gunnar; Schneider, Peter; Brodmann, Marianne; Krishnan, Prakash; Micari, Antonio; Metzger, Christopher; Scheinert, Dierk; Zeller, Thomas; Cohen, David J.; Snead, David B.; Alexander, Beaux; Landini, Mario; Jaff, Michael R.

    2015-01-01

    Background— Drug-coated balloons (DCBs) have shown promise in improving the outcomes for patients with peripheral artery disease. We compared a paclitaxel-coated balloon with percutaneous transluminal angioplasty (PTA) for the treatment of symptomatic superficial femoral and popliteal artery disease. Methods and Results— The IN.PACT SFA Trial is a prospective, multicenter, single-blinded, randomized trial in which 331 patients with intermittent claudication or ischemic rest pain attributable to superficial femoral and popliteal peripheral artery disease were randomly assigned in a 2:1 ratio to treatment with DCB or PTA. The primary efficacy end point was primary patency, defined as freedom from restenosis or clinically driven target lesion revascularization at 12 months. Baseline characteristics were similar between the 2 groups. Mean lesion length and the percentage of total occlusions for the DCB and PTA arms were 8.94±4.89 and 8.81±5.12 cm (P=0.82) and 25.8% and 19.5% (P=0.22), respectively. DCB resulted in higher primary patency versus PTA (82.2% versus 52.4%; P<0.001). The rate of clinically driven target lesion revascularization was 2.4% in the DCB arm in comparison with 20.6% in the PTA arm (P<0.001). There was a low rate of vessel thrombosis in both arms (1.4% after DCB and 3.7% after PTA [P=0.10]). There were no device- or procedure-related deaths and no major amputations. Conclusions— In this prospective, multicenter, randomized trial, DCB was superior to PTA and had a favorable safety profile for the treatment of patients with symptomatic femoropopliteal peripheral artery disease. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique Identifiers: NCT01175850 and NCT01566461. PMID:25472980

  6. HALON—hysterectomy by transabdominal laparoscopy or natural orifice transluminal endoscopic surgery: a randomised controlled trial (study protocol)

    PubMed Central

    Baekelandt, Jan; De Mulder, Peter A; Le Roy, Ilse; Mathieu, Chantal; Laenen, Annouschka; Enzlin, Paul; Weyers, Steven; Mol, Ben WJ; Bosteels, Jan JA

    2016-01-01

    Introduction Natural orifice transluminal endoscopic surgery (NOTES) uses natural body orifices to access the cavities of the human body to perform surgery. NOTES limits the magnitude of surgical trauma and has the potential to reduce postoperative pain. This is the first randomised study in women bound to undergo hysterectomy for benign gynaecological disease comparing NOTES with classical laparoscopy. Methods and analysis All women aged 18–70 years, regardless of parity, consulting at our practice with an indication for hysterectomy due to benign gynaecological disease will be eligible. After stratification according to uterine size on clinical examination, participants will be randomised to be treated by laparoscopy or by transvaginal NOTES. Participants will be evaluated on day 0, days 1–7 and at 3 and 6 months. The following data will be collected: the proportion of women successfully treated by removing the uterus by the intended approach as randomised; the proportion of women admitted to the inpatient hospital; postoperative pain scores measured twice daily by the women from day 1 to 7; the total amount of analgesics used from day 1 to 7; readmission during the first 6 weeks; presence and intensity of dyspareunia and sexual well-being at baseline, 3 and 6 months (Short Sexual Functioning Scale (SSFS) scale); duration of surgery; postoperative infection or other surgical complications; direct and indirect costs incurred up to 6 weeks following surgery. The primary outcome will be the proportion of women successfully treated by the intended technique; all other outcomes are secondary. Ethics and dissemination The study was approved on 1 December 2015 by the Ethics Committee of the Imelda Hospital, Bonheiden, Belgium. The first patient was randomised on 17 December 2015. The last participant randomised should be treated before 30 November 2017. The results will be presented in peer-reviewed journals and at scientific meetings within 4

  7. Outcome of patients with hypertrophic obstructive cardiomyopathy after percutaneous transluminal septal myocardial ablation and septal myectomy surgery

    NASA Technical Reports Server (NTRS)

    Qin, J. X.; Shiota, T.; Lever, H. M.; Kapadia, S. R.; Sitges, M.; Rubin, D. N.; Bauer, F.; Greenberg, N. L.; Agler, D. A.; Drinko, J. K.; Martin, M.; Tuzcu, E. M.; Smedira, N. G.; Lytle, B.; Thomas, J. D.

    2001-01-01

    OBJECTIVES: This study was conducted to evaluate follow-up results in patients with hypertrophic obstructive cardiomyopathy (HOCM) who underwent either percutaneous transluminal septal myocardial ablation (PTSMA) or septal myectomy. BACKGROUND: Controversy exists with regard to these two forms of treatment for patients with HOCM. METHODS: Of 51 patients with HOCM treated, 25 were treated by PTSMA and 26 patients via myectomy. Two-dimensional echocardiograms were performed before both procedures, immediately afterwards and at a three-month follow-up. The New York Heart Association (NYHA) functional class was obtained before the procedures and at follow-up. RESULTS: Interventricular septal thickness was significantly reduced at follow-up in both groups (2.3 +/- 0.4 cm vs. 1.9 +/- 0.4 cm for septal ablation and 2.4 +/- 0.6 cm vs. 1.7 +/- 0.2 cm for myectomy, both p < 0.001). Estimated by continuous-wave Doppler, the resting pressure gradient (PG) across the left ventricular outflow tract (LVOT) significantly decreased immediately after the procedures in both groups (64 +/- 39 mm Hg vs. 28 +/- 29 mm Hg for PTSMA, 62 +/- 43 mm Hg vs. 7 +/- 7 mm Hg for myectomy, both p < 0.0001). At three-month follow-up, the resting PG remained lower in the PTSMA and myectomy groups (24 +/- 19 mm Hg and 11 +/- 6 mm Hg, respectively, vs. those before procedures, both p < 0.0001). The NYHA functional class was also significantly improved in both groups (3.5 +/- 0.5 vs. 1.9 +/- 0.7 for PTSMA, 3.3 +/- 0.5 vs. 1.5 +/- 0.7 for myectomy, both p < 0.0001). CONCLUSIONS: Both myectomy and PTSMA reduce LVOT obstruction and significantly improve NYHA functional class in patients with HOCM. However, there are benefits and drawbacks for each therapeutic method that must be counterbalanced when deciding on treatment for LVOT obstruction.

  8. Common Iliac Artery Thrombosis following Pelvic Surgery Resulting in Kidney Allograft Failure Successfully Treated by Percutaneous Transluminal Angioplasty with Balloon-Expandable Covered Stent

    PubMed Central

    Golla, Maheswara S.; Acharjee, Subasit; Jaber, Bertrand L.; Garcia, Lawrence A.

    2015-01-01

    We report the case of a 66-year-old woman who developed acute kidney allograft failure due to thrombotic occlusion of the common iliac artery after hysterectomy requiring emergent allograft rescue. She underwent percutaneous transluminal angioplasty with endovascular balloon expandable covered stent graft placement in the right common iliac artery. Although there are a handful of case reports of acute limb ischemia secondary to acute common iliac artery thrombosis, this is the first case reported in the literature resulting in successful kidney allograft rescue following pelvic surgery. PMID:26355669

  9. International multicenter comparative trial of transluminal EUS-guided biliary drainage via hepatogastrostomy vs. choledochoduodenostomy approaches

    PubMed Central

    Khashab, Mouen A.; Messallam, Ahmed A.; Penas, Irene; Nakai, Yousuke; Modayil, Rani J.; De la Serna, Carlos; Hara, Kazuo; El Zein, Mohamad; Stavropoulos, Stavros N.; Perez-Miranda, Manuel; Kumbhari, Vivek; Ngamruengphong, Saowanee; Dhir, Vinay K.; Park, Do Hyun

    2016-01-01

    Background and study aims: Endoscopic ultrasound-guided biliary drainage (EUS-BD) can be performed entirely transgastrically (hepatogastrostomy/EUS-HG) or transduodenally (choledochoduodenostomy/EUS-CDS). It is unknown how both techniques compare. The aims of this study were to compare efficacy and safety of both techniques and identify predictors of adverse events. Patients and methods: Consecutive jaundiced patients with distal malignant biliary obstruction who underwent EUS-BD at multiple international centers were included. Technical/clinical success, adverse events, stent complications, and survival were assessed. Results: A total of 121 patients underwent EUS-BD (CDS 60, HG 61). Technical success was achieved in 112 (92.56 %) patients (EUS-CDS 93.3 %, EUS-HG 91.8 %, P = 0.75). Clinical success was attained in 85.5 % of patients who underwent EUS-CDS group as compared to 82.1 % of patients who underwent EUS-HG (P = 0.64). Adverse events occurred more commonly in the EUS-HG group (19.67 % vs. 13.3 %, P = 0.37). Both plastic stenting (OR 4.95, 95 %CI 1.41 – 17.38, P = 0.01) and use of non-coaxial electrocautery (OR 3.95, 95 %CI 1.16 – 13.40, P = 0.03) were independently associated with adverse events. Length of hospital stay was significantly shorter in the CDS group (5.6 days vs. 12.7 days, P < 0.001). Mean follow-up duration was 151 ± 159 days. The 1-year stent patency probability was greater in the EUS-CDS group [0.98 (95 %CI 0.76 – 0.96) vs 0.60 (95 %CI 0.35 – 0.78)] but overall patency was not significantly different. There was no difference in median survival times between the groups (P = 0.36) Conclusions: Both EUS-CDS and EUS-HG are effective and safe techniques for the treatment of distal biliary obstruction after failed ERCP. However, CDS is associated with shorter hospital stay, improved stent patency, and fewer procedure- and stent-related complications. Metallic stents

  10. The Arabidopsis mediator complex subunits MED16, MED14, and MED2 regulate mediator and RNA polymerase II recruitment to CBF-responsive cold-regulated genes.

    PubMed

    Hemsley, Piers A; Hurst, Charlotte H; Kaliyadasa, Ewon; Lamb, Rebecca; Knight, Marc R; De Cothi, Elizabeth A; Steele, John F; Knight, Heather

    2014-01-01

    The Mediator16 (MED16; formerly termed SENSITIVE TO FREEZING6 [SFR6]) subunit of the plant Mediator transcriptional coactivator complex regulates cold-responsive gene expression in Arabidopsis thaliana, acting downstream of the C-repeat binding factor (CBF) transcription factors to recruit the core Mediator complex to cold-regulated genes. Here, we use loss-of-function mutants to show that RNA polymerase II recruitment to CBF-responsive cold-regulated genes requires MED16, MED2, and MED14 subunits. Transcription of genes known to be regulated via CBFs binding to the C-repeat motif/drought-responsive element promoter motif requires all three Mediator subunits, as does cold acclimation-induced freezing tolerance. In addition, these three subunits are required for low temperature-induced expression of some other, but not all, cold-responsive genes, including genes that are not known targets of CBFs. Genes inducible by darkness also required MED16 but required a different combination of Mediator subunits for their expression than the genes induced by cold. Together, our data illustrate that plants control transcription of specific genes through the action of subsets of Mediator subunits; the specific combination defined by the nature of the stimulus but also by the identity of the gene induced. PMID:24415770

  11. Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions.

    PubMed Central

    Marin, M L; Veith, F J; Cynamon, J; Sanchez, L A; Lyon, R T; Levine, B A; Bakal, C W; Suggs, W D; Wengerter, K R; Rivers, S P

    1995-01-01

    OBJECTIVES: Complex arterial occlusive, traumatic, and aneurysmal lesions may be difficult or impossible to treat successfully by standard surgical techniques when severe medical or surgical comorbidities exist. The authors describe a single center's experience over a 2 1/2-year period with 96 endovascular graft procedures performed to treat 100 arterial lesions in 92 patients. PATIENTS AND METHODS: Thirty-three patients had 36 large aortic and/or peripheral artery aneurysms, 48 had 53 multilevel limb-threatening aortoiliac and/or femoropopliteal occlusive lesions, and 11 had traumatic arterial injuries (false aneurysms and arteriovenous fistulas). Endovascular grafts were placed through remote arteriotomies under local (16[17%]), epidural (42[43%]), or general (38[40%]) anesthesia. RESULTS: Technical and clinical successes were achieved in 91% of the patients with aneurysms, 91% with occlusive lesions, and 100% with traumatic arterial lesions. These patients and grafts have been followed from 1 to 30 months (mean, 13 months). The primary and secondary patency rates at 18 months for aortoiliac occlusions were 77% and 95%, respectively. The 18-month limb salvage rate was 98%. Immediately after aortic aneurysm exclusion, a total of 6 (33%) perigraft channels were detected; 3 of these closed within 8 weeks. Endovascular stented graft procedures were associated with a 10% major and a 14% minor complication rate. The overall 30-day mortality rate for this entire series was 6%. CONCLUSIONS: This initial experience with endovascular graft repair of complex arterial lesions justifies further use and careful evaluation of this technique for major arterial reconstruction. Images Figure 1. Figure 4. Figure 5. Figure 5. Figure 6. Figure 7. Figure 8. Figure 9. Figure 11. PMID:7574926

  12. Many Addicts Going without Meds That Curb Opioid Abuse

    MedlinePlus

    ... html Many Addicts Going Without Meds That Curb Opioid Abuse In 2013, just 17 percent were given ... is in the grip of an epidemic of opioid abuse. However, new research suggests that drugs that ...

  13. Many Parents Ill-Informed about Kids' Asthma Meds

    MedlinePlus

    ... 159117.html Many Parents Ill-Informed About Kids' Asthma Meds Only half surveyed knew what drugs were ... News) -- Only half of parents of children with asthma fully understand the use of their youngsters' asthma ...

  14. ADHD Meds Tied to Lower Bone Density in Kids

    MedlinePlus

    ... nlm.nih.gov/medlineplus/news/fullstory_157591.html ADHD Meds Tied to Lower Bone Density in Kids ... 3, 2016 (HealthDay News) -- Children on medications for attention deficit hyperactivity disorder (ADHD) may have lower bone density than their ...

  15. Most Teens Who Abuse ADHD Meds Get Them from Others

    MedlinePlus

    ... news/fullstory_157662.html Most Teens Who Abuse ADHD Meds Get Them From Others Study finds 54 ... TUESDAY, March 8, 2016 (HealthDay News) -- Abuse of ADHD stimulant drugs such Ritalin or Adderall is on ...

  16. 1 in 4 Medicare Patients Uses Blood Pressure Meds Incorrectly

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_160930.html 1 in 4 Medicare Patients Uses Blood Pressure Meds ... year in the United States, accounting for about one out of every three deaths, Frieden said. Uncontrolled ...

  17. LactMed: New NLM Database on Drugs and Lactation

    MedlinePlus

    ... Current Issue Past Issues Research News From NIH LactMed: New NLM Database on Drugs and Lactation Past ... milk, infant levels in blood, potential effects in breast-feeding infants and on lactation itself. The American Academy ...

  18. Skipping Meds Greatly Ups Heart Patients' Risk of Stroke

    MedlinePlus

    ... Skipping Meds Greatly Ups Heart Patients' Risk of Stroke: Study Fatal strokes seven times more likely if drugs to control ... are much more likely to die from a stroke if they don't take cholesterol-lowering statin ...

  19. Dual role of Med12 in PRC1-dependent gene repression and ncRNA-mediated transcriptional activation.

    PubMed

    Papadopoulou, Thaleia; Kaymak, Aysegül; Sayols, Sergi; Richly, Holger

    2016-06-01

    Mediator is considered an enhancer of RNA-Polymerase II dependent transcription but its function and regulation in pluripotent mouse embryonic stem cells (mESCs) remains unresolved. One means of controlling the function of Mediator is provided by the binding of the Cdk8 module (Med12, Cdk8, Ccnc and Med13) to the core Mediator. Here we report that Med12 operates together with PRC1 to silence key developmental genes in pluripotency. At the molecular level, while PRC1 represses genes it is also required to assemble ncRNA containing Med12-Mediator complexes. In the course of cellular differentiation the H2A ubiquitin binding protein Zrf1 abrogates PRC1-Med12 binding and facilitates the association of Cdk8 with Mediator. This remodeling of Mediator-associated protein complexes converts Mediator from a transcriptional repressor to a transcriptional enhancer, which then mediates ncRNA-dependent activation of Polycomb target genes. Altogether, our data reveal how the interplay of PRC1, ncRNA and Mediator complexes controls pluripotency and cellular differentiation. PMID:27096886

  20. Laparoscopic right-sided colonic resection with transluminal colonoscopic specimen extraction

    PubMed Central

    Kayaalp, Cuneyt; Kutluturk, Koray; Yagci, Mehmet Ali; Ates, Mustafa

    2015-01-01

    AIM: To study the transcolonic extraction of the proximally resected colonic specimens by colonoscopic assistance at laparoscopic colonic surgery. METHODS: The diagnoses of our patients were Crohn’s disease, carcinoid of appendix and adenocarcinoma of cecum. We preferred laparoscopic total mesocolic resections. Colon and terminal ileum were divided with endoscopic staplers. A colonoscope was placed per anal and moved proximally in the colon till to reach the colonic closed end under the laparoscopic guidance. The stump of the colon was opened with laparoscopic scissors. A snare of colonoscope was released and the intraperitoneal complete free colonic specimen was grasped. Specimen was moved in to the colon with the help of the laparoscopic graspers and pulled gently through the large bowel and extracted through the anus. The open end of the colon was closed again and the ileal limb and the colon were anastomosed intracorporeally with a 60-mm laparoscopic stapler. The common enterotomy orifice was closed in two layers with a running intracorporeal suture. RESULTS: There were three patients with laparoscopic right-sided colonic resections and their specimens were intended to remove through the remnant colon by colonoscopy but the procedure failed in one patient (adenocarcinoma) due to a bulky mass and the specimen extraction was converted to transvaginal route. All the patients had prior abdominal surgeries and had related adhesions. The operating times were 210, 300 and 500 min. The lengths of the specimens were 13, 17 and 27 cm. In our cases, there were no superficial or deep surgical site infections or any other complications. The patients were discharged uneventfully within 4-5 d and they were asymptomatic after a mean 7.6 mo follow-up (ranged 4-12). As far as we know, there were only 12 cases reported yet on transcolonic extraction of the proximal colonic specimens by colonoscopic assistance after laparoscopic resections. With our cases, success rate of the

  1. PubMed searches: overview and strategies for clinicians.

    PubMed

    Lindsey, Wesley T; Olin, Bernie R

    2013-04-01

    PubMed is a biomedical and life sciences database maintained by a division of the National Library of Medicine known as the National Center for Biotechnology Information (NCBI). It is a large resource with more than 5600 journals indexed and greater than 22 million total citations. Searches conducted in PubMed provide references that are more specific for the intended topic compared with other popular search engines. Effective PubMed searches allow the clinician to remain current on the latest clinical trials, systematic reviews, and practice guidelines. PubMed continues to evolve by allowing users to create a customized experience through the My NCBI portal, new arrangements and options in search filters, and supporting scholarly projects through exportation of citations to reference managing software. Prepackaged search options available in the Clinical Queries feature also allow users to efficiently search for clinical literature. PubMed also provides information regarding the source journals themselves through the Journals in NCBI Databases link. This article provides an overview of the PubMed database's structure and features as well as strategies for conducting an effective search. PMID:23442731

  2. Public accessibility of biomedical articles from PubMed Central reduces journal readership--retrospective cohort analysis.

    PubMed

    Davis, Philip M

    2013-07-01

    Does PubMed Central--a government-run digital archive of biomedical articles--compete with scientific society journals? A longitudinal, retrospective cohort analysis of 13,223 articles (5999 treatment, 7224 control) published in 14 society-run biomedical research journals in nutrition, experimental biology, physiology, and radiology between February 2008 and January 2011 reveals a 21.4% reduction in full-text hypertext markup language (HTML) article downloads and a 13.8% reduction in portable document format (PDF) article downloads from the journals' websites when U.S. National Institutes of Health-sponsored articles (treatment) become freely available from the PubMed Central repository. In addition, the effect of PubMed Central on reducing PDF article downloads is increasing over time, growing at a rate of 1.6% per year. There was no longitudinal effect for full-text HTML downloads. While PubMed Central may be providing complementary access to readers traditionally underserved by scientific journals, the loss of article readership from the journal website may weaken the ability of the journal to build communities of interest around research papers, impede the communication of news and events to scientific society members and journal readers, and reduce the perceived value of the journal to institutional subscribers. PMID:23554455

  3. Med1 regulates meiotic progression during spermatogenesis in mice

    PubMed Central

    Huszar, Jessica M.; Jia, Yuzhi; Reddy, Janardan K.; Payne, Christopher J.

    2015-01-01

    Spermatogenesis is a highly coordinated process. Signaling from nuclear hormone receptors, like those for retinoic acid, is important for normal spermatogenesis. However, the mechanisms regulating these signals are poorly understood. Mediator complex subunit 1 (MED1) is a transcriptional enhancer that directly modulates transcription from nuclear hormone receptors. MED1 is present in male germ cells throughout mammalian development, but its function during spermatogenesis is unknown. To determine its role, we generated mice lacking Med1 specifically in their germ cells beginning just before birth. Conditional Med1 knockout males are fertile, exhibiting normal testis weights and siring ordinary numbers of offspring. Retinoic acid-responsive gene products Stimulated by retinoic acid gene 8 (STRA8) and Synaptonemal complex protein 3 (SYCP3) are first detected in knockout spermatogonia at the expected time points during the first wave of spermatogenesis and persist with normal patterns of cellular distribution in adult knockout testes. Meiotic progression, however, is altered in the absence of Med1. At postnatal day 7 (P7), zygotene-stage knockout spermatocytes are already detected, unlike in control testes, with fewer pre-leptotene-stage cells and more leptotene spermatocytes observed in the knockouts. At P9, Med1 knockout spermatocytes prematurely enter pachynema. Once formed, greater numbers of knockout spermatocytes remain in pachynema relative to the other stages of meiosis throughout testis development and its maintenance in the adult. Meiotic exit is not inhibited. We conclude that MED1 regulates the temporal progression of primary spermatocytes through meiosis, with its absence resulting in abbreviated pre-leptotene, leptotene and zygotene stages, and a prolonged pachytene stage. PMID:25778538

  4. CoMed: a real-time collaborative medicine system.

    PubMed

    Sung, M Y; Kim, M S; Kim, E J; Yoo, J H; Sung, M W

    2000-07-01

    CoMed is a prototype of a real-time collaborative medicine system that allows medical specialists to share patient records and to communicate with each other on the Internet. CoMed consists of a multimedia medical database containing relevant information about laryngeal diseases and a real-time collaboration system including a teleconferencing system, a whiteboard and a chatting system. CoMed is web-based. We adopted the object database O2 and CORBA technologies for the multimedia medical database. Therefore, our system can provide the flexibility, extensibility and location transparency of patient databases. We developed a SeeYou Active X control for the teleconferencing system and a Java applet for the whiteboard and chatting system. CoMed improves the efficiency of the overall system by separating the servers on a UNIX machine and a Windows NT machine. CoMed can be utilized for stand-alone research, for collaborative consultations among medical specialists and for a telemedicine in participation with the patients and medical specialists. Our system can be extended easily into other types of the collaborative systems, such as collaborative distance learning, collaborative science system, etc. PMID:10961568

  5. A novel MED12 mutation: Evidence for a fourth phenotype.

    PubMed

    Prontera, Paolo; Ottaviani, Valentina; Rogaia, Daniela; Isidori, Ilenia; Mencarelli, Amedea; Malerba, Natascia; Cocciadiferro, Dario; Rolph, Pfundt; Stangoni, Gabriela; Vulto-van Silfhout, Anneke; Merla, Giuseppe

    2016-09-01

    Mutations of the MED12 gene have been reported mainly in males with FG (Opitz-Kaveggia), Lujan-Fryns, or X-linked Ohdo syndromes. Recently, a different phenotype characterized by minor anomalies, severe intellectual disability (ID), and absent language was reported in female and male patients belonging to the same family and carrying a frameshift MED12 mutation (c.5898dupC). Here, we report on two brothers and their niece affected by severe and mild ID, respectively, where whole exome sequencing combined with variant analysis within a panel of ID-related genes, disclosed a novel c.2312T>C (p.Ile771Thr) MED12 mutation. This variant, which has not been reported as a polymorphism, was not present in a third unaffected brother, and was predicted to be deleterious by five bioinformatic databases. This finding together with the phenotypic analogies shared with the carriers of c.5898dupC mutation suggests the existence of a fourth MED12-related disorder, characterized by severe ID, absent or deficient language and, milder, clinical manifestation in heterozygotes. We have reviewed the literature on MED12 heterozygotes, their clinical manifestations, and discuss the possible biological causes of this condition. © 2016 Wiley Periodicals, Inc. PMID:27312080

  6. A Model Expert System For Machine Failure Diagnosis (MED)

    NASA Astrophysics Data System (ADS)

    Liqun, Yin

    1987-05-01

    MED is a model expert system for machine failure diagnosis. MED can help the repairer quickly determine milling machine electrical failure. The key points in MED are a simple method to deal with the "subsequent visit" problem in machine failure diagnosis, a weighted list to interfere in the control of AGENDA to imitate an expert's continuous thinking process and to keep away erratic questioning and problem running away caused by probabilistic reasoning, the structuralized AGENDA, the characteristics of machine failure diagnosis and people's thinking pattern in faulure diagnosis. The structuralized AGENDA gives an idea to supply a more powerful as well as flexible control strategy in best-first search by using AGENDA. The "subsequent visit" problem is a very complicated task to solve, it will be convenient to deal with it by using a simple method to keep from consuming too much time in urgent situations. Weighted list also gives a method to improve control in inference of expert system. The characteristics of machine failure diagnosis and people's thinking pattern are both important for building a machine failure diagnosis expert system. When being told failure phenomena, MED can determine failure causes through dialogue. MED is written in LISP and run in UNIVAC 1100/10 and IBM PC/XT computers. The average diagnosis time per failure is 11 seconds to CPU, 2 minites to terminal operation, and 11 minites to a skilful repairer.

  7. MedAustron: The Austrian ion therapy facility

    NASA Astrophysics Data System (ADS)

    Benedikt, Michael

    MedAustron is a synchrotron-based light-ion beam therapy center for cancer treatment as well as for clinical and non-clinical research in Wiener Neustadt, Austria. The center is designed for the treatment of up to 1200 patients per year and for non-clinical research in the areas of radiobiology and medical radiation physics, as well as in experimental physics. MedAustron is an interdisciplinary project, benefiting from close cooperation and knowledge transfer with medical, scientific and research institutes on the national and international level. Three medical irradiation rooms will allow quasi-permanent patient treatment during two shifts on working days. The remaining beam time will be used for non-clinical research applications in a dedicated fourth irradiation room. The expected start of operation of MedAustron is mid-2016...

  8. Gaps in affiliation indexing in Scopus and PubMed

    PubMed Central

    Schmidt, Cynthia M.; Cox, Roxanne; Fial, Alissa V.; Hartman, Teresa L.; Magee, Martha L.

    2016-01-01

    Objective The authors sought to determine whether unexpected gaps existed in Scopus's author affiliation indexing of publications written by the University of Nebraska Medical Center or Nebraska Medicine (UNMC/NM) authors during 2014. Methods First, we compared Scopus affiliation identifier search results to PubMed affiliation keyword search results. Then, we searched Scopus using affiliation keywords (UNMC, etc.) and compared the results to PubMed affiliation keyword and Scopus affiliation identifier searches. Results We found that Scopus's records for approximately 7% of UNMC/NM authors' publications lacked appropriate UNMC/NM author affiliation identifiers, and many journals' publishers were supplying incomplete author affiliation information to PubMed. Conclusions Institutions relying on Scopus to track their impact should determine whether Scopus's affiliation identifiers will, in fact, identify all articles published by their authors and investigators. PMID:27076801

  9. The Human CDK8 Subcomplex Is a Histone Kinase That Requires Med12 for Activity and Can Function Independently of Mediator▿

    PubMed Central

    Knuesel, Matthew T.; Meyer, Krista D.; Donner, Aaron J.; Espinosa, Joaquin M.; Taatjes, Dylan J.

    2009-01-01

    The four proteins CDK8, cyclin C, Med12, and Med13 can associate with Mediator and are presumed to form a stable “CDK8 subcomplex” in cells. We describe here the isolation and enzymatic activity of the 600-kDa CDK8 subcomplex purified directly from human cells and also via recombinant expression in insect cells. Biochemical analysis of the recombinant CDK8 subcomplex identifies predicted (TFIIH and RNA polymerase II C-terminal domain [Pol II CTD]) and novel (histone H3, Med13, and CDK8 itself) substrates for the CDK8 kinase. Notably, these novel substrates appear to be metazoan-specific. Such diverse targets imply strict regulation of CDK8 kinase activity. Along these lines, we observe that Mediator itself enables CDK8 kinase activity on chromatin, and we identify Med12—but not Med13—to be essential for activating the CDK8 kinase. Moreover, mass spectrometry analysis of the endogenous CDK8 subcomplex reveals several associated factors, including GCN1L1 and the TRiC chaperonin, that may help control its biological function. In support of this, electron microscopy analysis suggests TRiC sequesters the CDK8 subcomplex and kinase assays reveal the endogenous CDK8 subcomplex—unlike the recombinant submodule—is unable to phosphorylate the Pol II CTD. PMID:19047373

  10. [Repeated percutaneous transluminal septal myocardial ablation leads to reduction of left ventricular outflow-tract pressure gradient in hypertrophic obstructive cardiomyopathy: a case report].

    PubMed

    Takeda, Masafumi; Mori, Takao; Ohashi, Yoshitaka; Ichikawa, Shinobu; Terashima, Mitsuyasu; Ejiri, Junya; Awano, Kojiro

    2006-06-01

    A 61-year-old man with hypertrophic obstructive cardiomyopathy was treated twice with percutaneous transluminal septal myocardial ablation (PTSMA). The first procedure improved the left ventricular outflow tract pressure gradient (LVOTG) from 148 to 48 mmHg and the New York Heart Association (NYHA) class from III to II in a week. However, the LVOTG increased to 197 mmHg and the NYHA class worsened to III within 3 months. In spite of medical treatment with beta-blocker, syncope attack occurred suddenly. Repeated PTSMA was performed. Just after the second procedure, the LVOTG did not decrease. However, the LVOTG decreased to 81 mmHg and the NYHA class improved to II with 3 months. The different response of pressure gradient in the acute and chronic phase with repeated PTSMA was interesting. PMID:16800375

  11. Death, dying and informatics: misrepresenting religion on MedLine

    PubMed Central

    Rodríguez del Pozo, Pablo; Fins, Joseph J

    2005-01-01

    Background The globalization of medical science carries for doctors worldwide a correlative duty to deepen their understanding of patients' cultural contexts and religious backgrounds, in order to satisfy each as a unique individual. To become better informed, practitioners may turn to MedLine, but it is unclear whether the information found there is an accurate representation of culture and religion. To test MedLine's representation of this field, we chose the topic of death and dying in the three major monotheistic religions. Methods We searched MedLine using PubMed in order to retrieve and thematically analyze full-length scholarly journal papers or case reports dealing with religious traditions and end-of-life care. Our search consisted of a string of words that included the most common denominations of the three religions, the standard heading terms used by the National Reference Center for Bioethics Literature (NRCBL), and the Medical Subject Headings (MeSH) used by the National Library of Medicine. Eligible articles were limited to English-language papers with an abstract. Results We found that while a bibliographic search in MedLine on this topic produced instant results and some valuable literature, the aggregate reflected a selection bias. American writers were over-represented given the global prevalence of these religious traditions. Denominationally affiliated authors predominated in representing the Christian traditions. The Islamic tradition was under-represented. Conclusion MedLine's capability to identify the most current, reliable and accurate information about purely scientific topics should not be assumed to be the same case when considering the interface of religion, culture and end-of-life care. PMID:15992401

  12. UCSD's MedPics: implementation and impact on the curriculum.

    PubMed Central

    Hoffman, H. M.; Irwin, A. E.; Baird, S.; Bloor, C. M.; Miyai, K.; Savoia, M. C.

    1993-01-01

    MedPics is a computer-based image delivery system with supporting text fields and on-screen graphics to assist in key feature identification. It has been used by the University of California, San Diego as an integral part of the Human Disease course since 1992. Initially created to support pathology and histology, the program has now expanded to include hematology. MedPics has had a positive impact on the second year curriculum for which it was created. Moreover, use of this program has improved student attitudes toward computer-based resources and increased faculty interest in instructional development. Images Figure 1 PMID:8130582

  13. Student employment opportunities within ORD, with an emphasis on MED

    EPA Science Inventory

    This is a talk to undergraduate Juniors and Seniors in the UW-Madison School of Pharmacy's Pharm/Tox program about student employment opportunities w/in ORD such as SSC, ORISE, etc. wtih an emphasis on MED. I would classify as this as Outreach: how to navigate EPA websites to f...

  14. 76 FR 12016 - MedBow-Routt Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ...The MedBow-Routt Resource Advisory Committee will meet in Walden, Colorado. The committee is meeting as authorized under the Secure Rural Schools and Community Self-Determination Act (Pub. L. 110- 343) and in compliance with the Federal Advisory Committee Act. The purpose of the meeting is to review new project proposals and update RAC members on the progress of previously approved...

  15. ADHD Meds May Pose Heart Risks for Some Kids

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_159140.html ADHD Meds May Pose Heart Risks for Some Kids ... HealthDay News) -- Ritalin, a popular drug for treating attention-deficit hyperactivity disorder (ADHD), might increase the risk of an abnormal ...

  16. PubMed Central Canada: Beyond an Open Access Repository?

    ERIC Educational Resources Information Center

    Nariani, Rajiv

    2013-01-01

    PubMed Central Canada (PMC Canada) represents a partnership between the Canadian Institutes of Health Research (CIHR), the National Research Council's Canada Institute for Scientific and Technical Information (NRC-CISTI), and the National Library of Medicine of the US. The present study was done to gauge faculty awareness about the CIHR Policy on…

  17. How Complementary and Alternative Medicine Practitioners Use PubMed

    PubMed Central

    Quint-Rapoport, Mia

    2007-01-01

    Background PubMed is the largest bibliographic index in the life sciences. It is freely available online and is used by professionals and the public to learn more about medical research. While primarily intended to serve researchers, PubMed provides an array of tools and services that can help a wider readership in the location, comprehension, evaluation, and utilization of medical research. Objective This study sought to establish the potential contributions made by a range of PubMed tools and services to the use of the database by complementary and alternative medicine practitioners. Methods In this study, 10 chiropractors, 7 registered massage therapists, and a homeopath (N = 18), 11 with prior research training and 7 without, were taken through a 2-hour introductory session with PubMed. The 10 PubMed tools and services considered in this study can be divided into three functions: (1) information retrieval (Boolean Search, Limits, Related Articles, Author Links, MeSH), (2) information access (Publisher Link, LinkOut, Bookshelf ), and (3) information management (History, Send To, Email Alert). Participants were introduced to between six and 10 of these tools and services. The participants were asked to provide feedback on the value of each tool or service in terms of their information needs, which was ranked as positive, positive with emphasis, negative, or indifferent. Results The participants in this study expressed an interest in the three types of PubMed tools and services (information retrieval, access, and management), with less well-regarded tools including MeSH Database and Bookshelf. In terms of their comprehension of the research, the tools and services led the participants to reflect on their understanding as well as their critical reading and use of the research. There was universal support among the participants for greater access to complete articles, beyond the approximately 15% that are currently open access. The abstracts provided by PubMed were

  18. Influenza virus vaccine live intranasal--MedImmune vaccines: CAIV-T, influenza vaccine live intranasal.

    PubMed

    2003-01-01

    (now Wyeth Vaccines) had begun a phase II bridging study with a refrigerator-stable liquid formulation of FluMist in the Southern Hemisphere. The randomised single-blind trial is being conducted together with Aviron (now MedImmune Vaccines) and is intended to demonstrate clinical equivalence between frozen and liquid FluMist. At the time of the announcement, more than 500 children aged 1-3 years had been enrolled to receive either frozen or liquid FluMist. The final study population is approximately 1300. If clinical equivalence of the two forms of FluMist is demonstrated in this study, MedImmune Vaccines will be able to use data from trials of frozen FluMist in licence applications for international markets. Aviron submitted a Biologics Licence Application (BLA) to the US FDA in July 1998. The FDA rejected this application on the grounds of a lack of data on manufacturing, validation and stability. In June 1999, Aviron announced that it had completed a bridging study on FluMist designed to provide some of the manufacturing data required by the US FDA on FluMist prepared at one of two manufacturing sites. Preliminary analysis indicated that the results had met the company's objectives. The primary endpoint of the study was to demonstrate that the batch of FluMist blended and filled at Packaging Coordinators, Inc. in Philadelphia had similar immunogenicity for all three 1997-98 influenza strains as the vaccine used in earlier clinical trials, which was manufactured by Medeva Pharma (now Evans Vaccines, a subsidiary of PowderJect Pharmaceuticals) in England. The secondary endpoint was to show that these lots of FluMist had similar safety and tolerability profiles. Aviron then submitted a BLA in October 2000. However, in late July 2001, an FDA advisory committee declined to recommend approval of the vaccine, citing concerns with safety. Aviron subsequently received a Complete Response Letter from the FDA requesting additional clinical and manufacturing data. Aviron stated

  19. TeleMed: A distributed virtual patient record system

    SciTech Connect

    Forslund, D.W.; Phillips, R.L.; Kilman, D.G.; Cook, J.L.

    1996-06-01

    TeleMed is a distributed diagnosis and analysis system, which permits physicians who are not collocated to consult on the status of a patient. The patient`s record is dynamically constructed from data that may reside at several sites but which can be quickly assembled for viewing by pointing to the patient`s name. Then, a graphical patient record appears, through which consulting physicians can retrieve textual and radiographic data with a single mouse click. TeleMed uses modern distributed object technology and emerging telecollaboration tools. The authors describe in this paper some of the motivation for this change, what they mean by a virtual patient record, and some results of some early implementations of a virtual patient record.

  20. The medical dictionary for regulatory activities (MedDRA).

    PubMed

    Brown, E G; Wood, L; Wood, S

    1999-02-01

    The International Conference on Harmonisation has agreed upon the structure and content of the Medical Dictionary for Regulatory Activities (MedDRA) version 2.0 which should become available in the early part of 1999. This medical terminology is intended for use in the pre- and postmarketing phases of the medicines regulatory process, covering diagnoses, symptoms and signs, adverse drug reactions and therapeutic indications, the names and qualitative results of investigations, surgical and medical procedures, and medical/social history. It can be used for recording adverse events and medical history in clinical trials, in the analysis and tabulations of data from these trials and in the expedited submission of safety data to government regulatory authorities, as well as in constructing standard product information and documentation for applications for marketing authorisation. After licensing of a medicine, it may be used in pharmacovigilance and is expected to be the preferred terminology for international electronic regulatory communication. MedDRA is a hierarchical terminology with 5 levels and is multiaxial: terms may exist in more than 1 vertical axis, providing specificity of terms for data entry and flexibility in data retrieval. Terms in MedDRA were derived from several sources including the WHO's adverse reaction terminology (WHO-ART), Coding Symbols for a Thesaurus of Adverse Reaction Terms (COSTART), International Classification of Diseases (ICD) 9 and ICD9-CM. It will be maintained, further developed and distributed by a Maintenance Support Services Organisation (MSSO). It is anticipated that using MedDRA will improve the quality of data captured on databases, support effective analysis by providing clinically relevant groupings of terms and facilitate electronic communication of data, although as a new tool, users will need to invest time in gaining expertise in its use. PMID:10082069

  1. The MEDiterranean SUpersite Volcanoes (MED-SUV) project

    NASA Astrophysics Data System (ADS)

    Puglisi, Giuseppe

    2014-05-01

    The MEDiterranean SUpersite Volcanoes (MED-SUV) project aims at gaining new insights in the knowledge of the processes on the base of the volcanic phenomena observable at the surface by using the broad inventory of multidisciplinary data available for Mt. Etna and Campi Flegrei/Vesuvius. These active volcanic areas, which have been here considered as a cluster of supersites, represent test cases since they embrace the main characteristics typical of both "opened- and closed-conduit" volcanic systems. For the purpose, MED-SUV objectives focus on the (i) development of novel monitoring instrumentations and data collection methods, (ii) implementation of the current observation infrastructures, (iii) better constraint of crucial volcanic parameters by integration of in-situ and satellite data, and (iv) the development of an e-infrastructure for data sharing. In this framework, MED-SUV is a great opportunity for scientific collaboration among diverse research institutions and industrial sectors. MED-SUV aims to use the achieved results to gain robust sets of multi-parametric observations using the most advanced analytic data processing techniques and volcanic process and hazard modelling methods. These will provide new insights in the current and past eruptive activity of the three test case volcanoes that will increase our technical-scientific ability of tracking volcanic-related hazards in the targeted areas, and of communicating with the proper decision-maker bodies. The implementation of an e-infrastructure compliant with EPOS and the other two supersite projects, MARsite and FUTUREVOLC, will contribute to the GEO/GEOSS interoperability principles and to the GEO 2012-15 work plan.

  2. Mars 2020 Entry, Descent and Landing Instrumentation 2 (MEDLI2)

    NASA Technical Reports Server (NTRS)

    Hwang, Helen H.; Bose, Deepak; White, Todd R.; Wright, Henry S.; Schoenenberger, Mark; Kuhl, Christopher A.; Trombetta, Dominic; Santos, Jose A.; Oishi, Tomomi; Karlgaard, Christopher D.; Mahzari, Milad; Pennington, Steven P.

    2016-01-01

    The Mars Entry Descent and Landing Instrumentation 2 (MEDLI2) sensor suite will measure aerodynamic, aerothermodynamic, and TPS performance during the atmospheric entry, descent, and landing phases of the Mars 2020 mission. The key objectives are to reduce design margin and prediction uncertainties for the aerothermal environments and aerodynamic database. For MEDLI2, the sensors are installed on both the heatshield and backshell, and include 7 pressure transducers, 17 thermal plugs, and 3 heat flux sensors (including a radiometer). These sensors will expand the set of measurements collected by the highly successful MEDLI suite, collecting supersonic pressure measurements on the forebody, a pressure measurement on the aftbody, direct heat flux measurements on the aftbody, a radiative heating measurement on the aftbody, and multiple near-surface thermal measurements on the thermal protection system (TPS) materials on both the forebody and aftbody. To meet the science objectives, supersonic pressure transducers and heat flux sensors are currently being developed and their qualification and calibration plans are presented. Finally, the reconstruction targets for data accuracy are presented, along with the planned methodologies for achieving the targets.

  3. Complex event extraction at PubMed scale

    PubMed Central

    Björne, Jari; Ginter, Filip; Pyysalo, Sampo; Tsujii, Jun'ichi; Salakoski, Tapio

    2010-01-01

    Motivation: There has recently been a notable shift in biomedical information extraction (IE) from relation models toward the more expressive event model, facilitated by the maturation of basic tools for biomedical text analysis and the availability of manually annotated resources. The event model allows detailed representation of complex natural language statements and can support a number of advanced text mining applications ranging from semantic search to pathway extraction. A recent collaborative evaluation demonstrated the potential of event extraction systems, yet there have so far been no studies of the generalization ability of the systems nor the feasibility of large-scale extraction. Results: This study considers event-based IE at PubMed scale. We introduce a system combining publicly available, state-of-the-art methods for domain parsing, named entity recognition and event extraction, and test the system on a representative 1% sample of all PubMed citations. We present the first evaluation of the generalization performance of event extraction systems to this scale and show that despite its computational complexity, event extraction from the entire PubMed is feasible. We further illustrate the value of the extraction approach through a number of analyses of the extracted information. Availability: The event detection system and extracted data are open source licensed and available at http://bionlp.utu.fi/. Contact: jari.bjorne@utu.fi PMID:20529932

  4. Overview of the SkyMed/COSMO mission

    NASA Astrophysics Data System (ADS)

    Caltagirone, Francesco; Spera, Paolo; Vigliotti, R.; Manoni, Gemma

    1998-12-01

    The impact of natural and man-made disasters on the social and economic progress is going to become more significant, making necessary to consider natural disasters reduction. Therefore civil protection and resource managers need elements to make quicker and better decisions on a day-to-day basis, so giving the start to an emerging world-wide remote sensing market. A deep analysis on the potential users, mainly devoted to Mediterranean basin, highlights that existing and/or planned systems are not able to completely satisfy their requirements. To fulfill this gap, Italy decided to promote the SkyMed/COSMO system, presently financed by the Italian Space Agency. SkyMed/COSMO is a constellation of small satellites for observation, remote sensing and data exploitation for risks management and coastal zone monitoring, conceived to provide products, services and logistics to both institutional and commercial remote sensing users on global scale. Furthermore the system is able to satisfy a broad spectrum of important applications also in the field of the resource management, land use and law enforcement. The SkyMed/COSMO current system architecture foresees a constellation of small satellites in two different orbit planes composed by 4 satellite equipped with X-band SAR and 3 satellites equipped with optical sensors. The system is characterized by good spatial resolution, day and night/all-weather imaging capability and by a very good revisit time. The program, currently in phase B, is carried out by an industrial consortium lead by Alenia Aerospazio.

  5. Mitigation of Volcanic Risk: The COSMO-SkyMed Contribution

    NASA Astrophysics Data System (ADS)

    Sacco, Patrizia; Daraio, Maria Girolamo; Battagliere, Maria Libera; Coletta, Alessandro

    2015-05-01

    The Italian Space Agency (ASI) promotes Earth Observation (EO) applications related to themes such as the prediction, monitoring, management and mitigation of natural and anthropogenic hazards. The approach generally followed is the development and demonstration of prototype services, using currently available data from space missions, in particular the COSMO-SkyMed (Constellation of Small Satellites for Mediterranean basin observation) mission, which represents the largest Italian investment in Space System for EO and thanks to which Italy plays a key role worldwide. Projects funded by ASI provide the convergence of various national industry expertise, research and institutional reference users. In this context a significant example is represented by the ASI Pilot Projects, recently concluded, dealing with various thematic, such as volcanoes. In this paper a special focus will be addressed to the volcanic risk management and the contribution provided in this field by COSMO-SkyMed satellite constellation during the last years. A comprehensive overview of the various national and international projects using COSMO-SkyMed data for the volcanic risk mitigation will be given, highlighting the Italian contribution provided worldwide in this operational framework.

  6. Mediator MED23 cooperates with RUNX2 to drive osteoblast differentiation and bone development

    PubMed Central

    Liu, Zhen; Yao, Xiao; Yan, Guang; Xu, YiChi; Yan, Jun; Zou, Weiguo; Wang, Gang

    2016-01-01

    How lineage specifiers are regulated during development is an outstanding question, and the molecular regulation of osteogenic factor RUNX2 remains to be fully understood. Here we report that the Mediator subunit MED23 cooperates with RUNX2 to regulate osteoblast differentiation and bone development. Med23 deletion in mesenchymal stem cells or osteoblast precursors results in multiple bone defects similar to those observed in Runx2+/− mice. In vitro, Med23-deficient progenitor cells are refractory to osteoblast differentiation, and Med23 deficiency reduces Runx2-target gene activity without changing Runx2 expression. Mechanistically, MED23 binds to RUNX2 and modulates its transcriptional activity. Moreover, Med23 deficiency in osteoprogenitor cells exacerbates the skeletal abnormalities observed in Runx2+/− mice. Collectively, our results establish a genetic and physical interaction between RUNX2 and MED23, suggesting that MED23 constitutes a molecular node in the regulatory network of anabolic bone formation and related diseases. PMID:27033977

  7. MedlinePlus FAQ: MedlinePlus and MEDLINE/PubMed

    MedlinePlus

    ... links to preformulated searches of the MEDLINE/PubMed database, allowing you to find references to latest health ... articles on your topic. MEDLINE/PubMed: Is a database of professional biomedical literature Is a Web-based, ...

  8. 77 FR 65438 - MedLink International, Inc.; Order of Suspension of Trading

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION MedLink International, Inc.; Order of Suspension of Trading October 24, 2012. It appears to the... securities of MedLink International, Inc. (``MedLink''). Questions have arisen concerning the accuracy...

  9. 47 CFR 95.627 - MedRadio transmitters in the 401-406 MHz band.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false MedRadio transmitters in the 401-406 MHz band... SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES Technical Regulations Technical Standards § 95.627 MedRadio transmitters in the 401-406 MHz band. The following provisions apply only to MedRadio transmitters operating...

  10. 47 CFR 95.627 - MedRadio transmitters in the 401-406 MHz band.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false MedRadio transmitters in the 401-406 MHz band... SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES Technical Regulations Technical Standards § 95.627 MedRadio transmitters in the 401-406 MHz band. The following provisions apply only to MedRadio transmitters operating...

  11. Frequency of MED12 mutations in phyllodes tumors: Inverse correlation with histologic grade.

    PubMed

    Yoon, Nara; Bae, Go Eun; Kang, So Young; Choi, Mi Sun; Hwang, Hye Won; Kim, Seok Won; Lee, Jeong Eon; Nam, Seok Jin; Gong, Gyungyub; Lee, Hee Jin; Bae, Young Kyung; Lee, Ahwon; Cho, Eun Yoon

    2016-06-01

    Phyllodes tumor (PT) is a rare breast biphasic tumor with a potential risk of recurrence and metastasis. In this study, the frequency of MED12 mutations in 176 PTs (49 benign, 49 borderline, and 78 malignant) was determined and the prognostic effect of these mutations in malignant type PT was evaluated. Analysis of MED12 mutations was performed by Sanger sequencing targeting the hotspot mutation region (exon 2) of MED12. Immunohistochemistry was also applied for evaluation of MED12 protein expression on tissue microarray blocks for 133 PTs including 50 benign, 50 borderline, and 33 malignant cases. A notable difference in the frequency of MED12 mutations was found according to histologic grade (71.4% of benign PTs, 51% of borderline PTs, 26.9% of malignant PTs; P < 0.001). MED12 protein expression was not correlated with MED12 mutation status. Patients with malignant PTs that harbored MED12 mutations demonstrated improved disease-free survival (DFS) compared with those without MED12 mutation (P = 0.07). MED12 mutation was a common molecular alteration in PT and the frequency of MED12 mutation decreased with increasing histologic grade. In malignant PT, MED12 exon 2 mutations showed improved DFS but without significance. © 2016 Wiley Periodicals, Inc. PMID:26856273

  12. Fate of side branches after intracoronary implantation of the Gianturco-Roubin flex-stent for acute or threatened closure after percutaneous transluminal coronary angioplasty.

    PubMed

    Mazur, W; Grinstead, W C; Hakim, A H; Dabaghi, S F; Abukhalil, J M; Ali, N M; Joseph, J; French, B A; Raizner, A E

    1994-12-15

    Side branch occlusion may occur in the course of percutaneous transluminal coronary angioplasty (PTCA), particularly if complicated by site dissection. Concern that the additional placement of a stent may further jeopardize side branches is logical. Consequently, this study analyzed pre-PTCA, post-PTCA, poststent, and 6-month follow-up angiograms of 100 consecutive patients in whom 103 Gianturco-Roubin stents were implanted for acute or threatened closure after PTCA. Side branches were defined as major (> 50% of the stented vessel diameter) and minor (< 50%). Minor branches, often < 1 mm in diameter, were assessed only for patency. One hundred eight major branches, of which 33 were diseased (> 50% stenosis), and 129 minor branches were analyzed. Seven major branches (6%), all of which were diseased before PTCA, and 23 minor branches (18%) were lost after PTCA. Immediately after stent insertion, only 1 additional major and 1 minor branch were lost, whereas 2 of 7 major (29%) and 9 of 23 minor (39%) branches reappeared. At follow-up angiography, 7 major branches (6%) were more stenosed and 6 (6%) were improved compared with the angiogram before PTCA. Only 2 major (2%) and 5 minor (4%) branches remained occluded. Additionally, 2 major and 1 minor branch, which were patent after PTCA and stenting, were occluded at follow-up as a result of total occlusion of the stented segment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7977091

  13. The Effects of Discharge Plan on Stress, Anxiety and Depression in Patients Undergoing Percutaneous Transluminal Coronary Angioplasty: A Randomized Controlled Trial

    PubMed Central

    Sharif, Farkhondeh; Moshkelgosha, Fariba; Molazem, Zahra; Najafi Kalyani, Majid; Vossughi, Mehrdad

    2014-01-01

    Background: Angioplasty is one of the most common methods for treating coronary artery diseases. However, a large number of those undergoing this treatment face psychological problems that negatively affect the quality of their life and recovery. We aimed to determine the effects of discharge planning on stress, anxiety, and depression in patients undergone percutaneous transluminal coronary angioplasty (PTCA). Methods: In this randomized controlled trial, 80 candidates for PTCA during January to April 2013 were randomly assigned to equal experimental and control groups. The patients in the experimental group participated in two training sessions before and after the procedure and an informative booklet was used for their training. These patients were followed by phone during the two weeks after discharge. The depression anxiety stress scale (DASS-21) was completed by all subjects upon admission, at discharge, and one month after discharge. Data were analyzed using SPSS software, version 18. t test was used as appropriated. Results: The experimental group showed a statistically significant decrease in their stress, anxiety and depression a month after receiving the planned discharge (P<0.001). Although scores of stress (P=0.696), anxiety (P=0.110), depression (P=0.073) of the experimental group did not differ significantly on the day of discharge, the decrease was considerable compared with that of the control group. Conclusion: Using a planned discharge program in patients undergoing PTCA lowered their stress, anxiety, and depression. Trial Registration Number: IRCT201302182812N12 PMID:25349846

  14. Budd-Chiari Syndrome Caused by Obstruction of the Hepatic Inferior Vena Cava: Immediate and 2-Year Treatment Results of Transluminal Angioplasty and Metallic Stent Placement

    SciTech Connect

    Xu Ke; He Fangxian; Zhang Hanguo; Zhang Xitong; Han Minjun; Wang Changrong; Kaneko, Masao; Takahashi, Motoichiro; Okawada, Taketoshi

    1996-11-15

    Purpose: To assess the usefulness of percutaneous transluminal angioplasty (PTA) and expandable metallic stent (EMS) placement for treatment of Budd-Chiari syndrome (BCS). Methods: Thirty-two patients with BCS were treated by PTA alone or by PTA and EMS placement. Among the 32 patients, a membranous obstruction was found in 24 and a segmental stenosis or occlusion in 8 patients. The follow-up period for PTA was 38<+>-<+>68 months (mean 52.2 months); for EMS it was 20<+>-<+>36 months (mean 24.3 months). Results: Twenty-one patients underwent PTA as the primary treatment. Of these, one patient died of disseminated intravascular coagulation shortly after the procedure; 20 had good to excellent initial angiographic and clinical results. Of the 20, restenosis or reocclusion developed in 10 patients (48%), all before 27 months; 8 patients (38%) became symptomatic, and 2 remained symptom-free for a total recurrent obstruction rate of 50%. The EMS group of 17 patients included 11 patients who underwent primary stenting and 6 patients with secondary stenting after recurrence following primary PTA; restenosis was demonstrated in only 2 patients (12%). Conclusions: We conclude that PTA alone produces excellent short-term results and about 50% sustained patency after 2 years in patients with BCS; therefore it should remain the procedure of first choice. Stents should be reserved for primary or secondary PTA failures.

  15. Rest and stress transluminal attenuation gradient and contrast opacification difference for detection of hemodynamically significant stenoses in patients with suspected coronary artery disease.

    PubMed

    Ko, Brian S; Seneviratne, Sujith; Cameron, James D; Gutman, Sarah; Crossett, Marcus; Munnur, Kiran; Meredith, Ian T; Wong, Dennis T L

    2016-07-01

    This study evaluated the feasibility of stress 320 detector CT coronary angiography (CTA) derived transluminal attenuation gradient (TAG320) and contrast opacification (CO) difference to detect hemodynamically significant stenoses as determined by invasive fractional flow reserve (FFR ≤ 0.80). Twenty-seven patients, including 51 vessels on rest CTA were studied. 16 (31 %) vessels were not interpretable on stress CTA largely secondary to motion artefacts. Receiver operating characteristic curve analysis showed a comparable area under the curve (AUC) for rest and stress TAG320 (0.78 and 0.75) which was higher than CTA alone (0.68), and rest and stress CO difference (0.76 and 0.67). Compared with rest CTA, stress CTA demonstrated inferior image quality (Median Likert score 4 vs. 3, P < 0.0001) and required a higher mean radiation exposure (3.2 vs. 5.1 mSv, P < 0.0001). Stress TAG320 and CO difference is less feasible and was not superior in diagnostic performance when compared with rest TAG320 and CO difference. PMID:26951537

  16. Transanal natural orifice transluminal endoscopic surgery total mesorectal excision in animal models: endoscopic inferior mesenteric artery dissection made easier by a retroperitoneal approach

    PubMed Central

    Park, Sun Jin; Chang, Tae Young; Jung, Yunho; Kim, Hyung Jin; Kim, Young Ill; Chun, Ho-Kyung

    2014-01-01

    Purpose We report the performance of natural orifice transluminal endoscopic surgery (NOTES) low anterior resection in animals using transanal total mesorectal excision (TME) with laparoscopic assistance and endoscopic inferior mesenteric artery (IMA) dissection. Methods Four pigs weighing 45 kg each, and one dog weighing 25 kg, underwent surgery via a transanal approach. The rectum was occluded transanally using a purse-string suture, approximately 3-4 cm from the anal verge. The rectal mucosa was incised circumferentially just distal to the purse-string. A SILS or GelPOINT port was inserted transanally. Transanal TME was assisted by laparoscopy and proceeded up to the peritoneal reflection. More proximal dissection, including IMA dissection, was performed along the retroperitoneal avascular plane by endoscopy alone and facilitated by CO2 insufflation. The IMA was clipped and divided endoscopically. The mobilized rectosigmoid were exteriorized transanally and transected. A colorectal anastomosis was performed using a circular stapler with a single stapling technique. Results Endoscopic dissection of the IMA was successful in all five animals. The mean operation time was 125 minutes (range, 90-170 minutes). There were no intraoperative complications or hemodynamic instability. The mean length of the resected specimen was 14.4 cm (range, 12-16 cm). Conclusion A NOTES retroperitoneal approach to the IMA with CO2 insufflation and intact peritoneal covering overcame the difficulties of retraction and exposure of endoscopic dissection in animals. PMID:25025019

  17. MED23: a new Mediator of H2B monoubiquitylation.

    PubMed

    Streubel, Gundula; Bracken, Adrian P

    2015-12-01

    The Mediator multiprotein complex physically links transcription factors to RNA polymerase II and the basal transcription machinery. While the Mediator complex has been shown to be required for transcriptional initiation and elongation, the understanding of its interplay with histone modifying enzymes and post‐translational modifications remains elusive. In this issue of The EMBO Journal, Yao et al (2015) report that the MED23 subunit of the Mediator complex physically associates with the heterodimeric RNF20/40 E3‐ligase complex to facilitate the monoubiquitylation of histone H2B on gene bodies of actively transcribed genes. PMID:26438725

  18. Cohort profile: Greifswald approach to individualized medicine (GANI_MED)

    PubMed Central

    2014-01-01

    Background Individualized Medicine aims at providing optimal treatment for an individual patient at a given time based on his specific genetic and molecular characteristics. This requires excellent clinical stratification of patients as well as the availability of genomic data and biomarkers as prerequisites for the development of novel diagnostic tools and therapeutic strategies. The University Medicine Greifswald, Germany, has launched the “Greifswald Approach to Individualized Medicine” (GANI_MED) project to address major challenges of Individualized Medicine. Herein, we describe the implementation of the scientific and clinical infrastructure that allows future translation of findings relevant to Individualized Medicine into clinical practice. Methods/design Clinical patient cohorts (N > 5,000) with an emphasis on metabolic and cardiovascular diseases are being established following a standardized protocol for the assessment of medical history, laboratory biomarkers, and the collection of various biosamples for bio-banking purposes. A multi-omics based biomarker assessment including genome-wide genotyping, transcriptome, metabolome, and proteome analyses complements the multi-level approach of GANI_MED. Comparisons with the general background population as characterized by our Study of Health in Pomerania (SHIP) are performed. A central data management structure has been implemented to capture and integrate all relevant clinical data for research purposes. Ethical research projects on informed consent procedures, reporting of incidental findings, and economic evaluations were launched in parallel. PMID:24886498

  19. Ice Charting Services And Developments With COSMO-SkyMed

    NASA Astrophysics Data System (ADS)

    Angelucci, Maria; Karvonen, Juha; Eriksson, Patrick B.

    2013-12-01

    The use of satellites in ice detection and monitoring applications is a very efficient way to monitor wide sea areas and relevant ice conditions, independently from the day time and weather conditions. EO SAR(Synthetic Aperture RADAR) technology is more suitable with respect to optical sensors, as SAR provides information independently on the day time and weather and allows a more accurate ice classification into different classes. SAR data provide information on the ice coverage, the size of ice floes, the shape of ice floes and the edges of ice. The COSMO-SkyMed satellite constellation in particular contributes to support Ice Services' stakeholders, as it provides worldwide SAR data with an incomparable performance in terms of revisit time, image resolution, rapid coverage of huge areas and number of acquired scenes. It provides synoptic information during day and night and at all weather conditions. e-GEOS and FMI are partnering to exploit and develop COSMO-SkyMed capabilities (X-band), for operational Ice Charting services.

  20. MedCast: a discussion support system for cooperative work

    NASA Astrophysics Data System (ADS)

    Moreno, Ramon A.; Lima, Vinícius; Lopes, Isidro; Gutierrez, Marco A.

    2012-02-01

    The availability of low cost Internet connections and specialized hardware, like webcams and headsets, makes possible the development of solutions for remote collaborative work. These solutions can provide advantages compared to presential meetings, such as: availability of experts on remote locations; lower price compared to presential meetings; creation of online didactic material (e.g. video-classes); richer forms of interaction between participants. These technologies are particularly interesting for continent-sized countries where typically there is a short number of skilled people in remote areas. However, the application of these technologies in medical field represents a special challenge due to the more complex requirements of this area, such as: Provide confidentiality (patient de-identification) and integrity of patient data; Guarantee availability of the system; Guarantee authenticity of data and users; Provide simple and effective user interface; Be compliant with medical standards such as DICOM and HL7. In order to satisfy those requirements a prototype called MedCast is under development whose architecture allows the integration of the Hospital Information System (HIS) with a collaborative tool in compliance with the HIPAA rules. Some of the MedCast features are: videoconferencing, chat, recording of the sessions, sharing of documents and reports and still and dynamic images presentation. Its current version allows the remote discussion of clinical cases and the remote ECG evaluation.

  1. A link between the cytoplasmic engulfment protein Elmo1 and the Mediator complex subunit Med31.

    PubMed

    Mauldin, Joshua P; Lu, Mingjian; Das, Soumita; Park, Daeho; Ernst, Peter B; Ravichandran, Kodi S

    2013-01-21

    The cytoplasmic Elmo1:Dock180 complex acts as a guanine nucleotide exchange factor (GEF) for the small GTPase Rac and functions downstream of the phagocytic receptor BAI1 during apoptotic cell clearance, and in the entry of Salmonella and Shigella into cells. We discovered an unexpected binding between Elmo1 and the Mediator complex subunit Med31. The Mediator complex is a regulatory hub for nearly all gene transcription via RNA polymerase II, bridging the general transcription machinery with gene-specific regulatory proteins. Med31 is the smallest and the most evolutionarily conserved Mediator subunit, and knockout of Med31 results in embryonic lethality in mice; however, Med31 function in specific biological contexts is poorly understood. We observed that in primary macrophages, during Salmonella infection, Elmo1 and Med31 specifically affected expression of the cytokine genes Il10 and Il33 among the >25 genes monitored. Although endogenous Med31 is predominantly nuclear localized, Elmo1 increased the cytoplasmic localization of Med31. We identify ubiquitination as a novel posttranslational modification of Med31, with the cytoplasmic monoubiquitinated form of Med31 being enhanced by Elmo1. These data identify Elmo1 as a novel regulator of Med31, revealing a previously unrecognized link between cytoplasmic signaling proteins and the Mediator complex. PMID:23273896

  2. An anti-CD11/CD18 monoclonal antibody in patients with acute myocardial infarction having percutaneous transluminal coronary angioplasty (the FESTIVAL study).

    PubMed

    Rusnak, J M; Kopecky, S L; Clements, I P; Gibbons, R J; Holland, A E; Peterman, H S; Martin, J S; Saoud, J B; Feldman, R L; Breisblatt, W M; Simons, M; Gessler, C J; Yu, A S

    2001-09-01

    Maximal benefits of coronary reperfusion after acute myocardial infarction (AMI) with ST-segment elevation may be attenuated by neutrophil-mediated reperfusion injury. Inflammatory mediators released from potentially viable myocytes cause activation of neutrophils, which traverse the endothelium and enter the myocardium. This process involves interaction between the neutrophil-expressed CD11/CD18 and endothelial-expressed intercellular adhesion molecule-1 (ICAM-1). Preclinical studies have shown that monoclonal antibodies (MAb) to CD18 can limit infarct size and preserve left ventricular function. We sought to determine the initial clinical safety and tolerability of Hu23F2G (LeukArrest), a humanized MAb to CD11/CD18, in patients with AMI who underwent percutaneous transluminal coronary angioplasty (PTCA). Sixty patients with AMI were randomized to low- (0.3 mg/kg) or high-dose (1.0 mg/kg) Hu23F2G or to placebo immediately before PTCA. We found no clinically significant differences in vital signs, physical examination, laboratory evaluation, or need for subsequent cardiac interventions. In Hu23F2G treatment groups, serum concentration of Hu23F2G increased rapidly to 3,234 +/- 1,298 microg/L (low-dose group) and 15,558 +/- 4409 microg/L (high-dose group) between 5 and 60 minutes, then declined over 72 hours to near-baseline values. Myocardial single-photon emission computed tomographic imaging 120 to 260 hours after PTCA showed no statistically significant differences in final left ventricular defect size. Hu23F2G was well tolerated, with no increase in adverse events, including infections. Thus, Hu23F2G appears safe and well tolerated in patients undergoing PTCA for AMI. PMID:11524054

  3. Predicting Factors for Successful Maturation of Autogenous Haemodialysis Fistulas After Salvage Percutaneous Transluminal Angioplasty in Diabetic Nephropathy: A Study on Follow-Up Doppler Ultrasonography

    PubMed Central

    Jeon, Eui-Yong; Cho, Young Kwon; Cho, Sung Bum; Yoon, Dae Young; Suh, Seong O

    2016-01-01

    Background: Maturation failure of autogenous arteriovenous fistula (aAVF) has been increasing after surgical procedures and the salvage percutaneous transluminal angioplasty (sPTA) for immature aAVF has been identified as an effective treatment modality. Objectives: The aim of this study was to identify factors predicting successful aAVF maturation and to determine positive technical aspects of sPTA. Patients and Methods: We retrospectively reviewed medical records and radiological images of 59 patients who had undergone sPTA for non-maturing aAVFs. We analysed images from pre-surgical mapping Doppler ultrasonography, angiography, and angioplasty and follow-up Doppler ultrasonography performed within two weeks after sPTA. We assessed the following factors, for their ability to predict successful aAVF maturation: 1) patient factors (age; sex; co-morbidities; and aAVF age, side and type); 2) vessel factors (cephalic vein diameter and depth, presence of accessory veins, and pre- and postoperative radial artery disease); 3) lesion factors (stenosis number, location and severity); and 4) technical factors (presence of residual stenosis and anatomic success ratio (ASR) on follow-up Doppler ultrasonography). Results: The technical and clinical success rates were both 94.9% (56/59); the mean ASR was 0.84. An ASR of ≥ 0.7 and no significant residual stenosis (< 30%) (both P < 0.001) on two-week follow-up Doppler ultrasonography predicted successful aAVF maturation. Conclusion: For more precise prediction of successful aAVF maturation after sPTA, short-term follow-up Doppler ultrasonography (< 2 weeks) was useful. If the ASR was < 0.7 or if residual stenosis was ≥ 30%, immediate repeat sPTA is recommended. PMID:27127581

  4. Natural orifice transluminal endoscopic wedge hepatic resection with a water-jet hybrid knife in a non-survival porcine model

    PubMed Central

    Shi, Hong; Jiang, Sheng-Jun; Li, Bin; Fu, Deng-Ke; Xin, Pei; Wang, Yong-Guang

    2011-01-01

    AIM: To explore the feasibility of a water-jet hybrid knife to facilitate wedge hepatic resection using a natural orifice transluminal endoscopic surgery (NOTES) approach in a non-survival porcine model. METHODS: The Erbe Jet2 water-jet system allows a needleless, tissue-selective hydro-dissection with a pre-selected pressure. Using this system, wedge hepatic resection was performed through three natural routes (trans-anal, trans-vaginal and trans-umbilical) in three female pigs weighing 35 kg under general anesthesia. Entry into the peritoneal cavity was via a 15-mm incision using a hook knife. The targeted liver segment was marked by an APC probe, followed by wedge hepatic resection performed using a water-jet hybrid knife with the aid of a 4-mm transparent distance soft cap mounted onto the tip of the endoscope for holding up the desired plane. The exposed vascular and ductal structures were clipped with Endoclips. Hemostasis was applied to the bleeding cut edges of the liver parenchyma by electrocautery. After the procedure, the incision site was left open, and the animal was euthanized followed by necropsy. RESULTS: Using the Erbe Jet2 water-jet system, trans-anal and trans-vaginal wedge hepatic resection was successfully performed in two pigs without laparoscopic assistance. Trans-umbilical attempt failed due to an unstable operating platform. The incision for peritoneal entry took 1 min, and about 2 h was spent on excision of the liver tissue. The intra-operative blood loss ranged from 100 to 250 mL. Microscopically, the hydro-dissections were relatively precise and gentle, preserving most vessels. CONCLUSION: The Erbe Jet2 water-jet system can safely accomplish non-anatomic wedge hepatic resection in NOTES, which deserves further studies to shorten the dissection time. PMID:21412502

  5. Diagnostic Performance of Transluminal Attenuation Gradient and Noninvasive Fractional Flow Reserve Derived from 320-Detector Row CT Angiography to Diagnose Hemodynamically Significant Coronary Stenosis: An NXT Substudy.

    PubMed

    Ko, Brian S; Wong, Dennis T L; Nørgaard, Bjarne L; Leong, Darryl P; Cameron, James D; Gaur, Sara; Marwan, Mohamed; Achenbach, Stephan; Kuribayashi, Sachio; Kimura, Takeshi; Meredith, Ian T; Seneviratne, Sujith K

    2016-04-01

    Purpose To compare the diagnostic performance of 320-detector row computed tomography (CT) coronary angiography-derived computed fractional flow reserve (FFR; FFRCT), transluminal attenuation gradient (TAG; TAG320), and CT coronary angiography alone to diagnose hemodynamically significant stenosis as determined by invasive FFR. Materials and Methods This substudy of the prospective NXT study (no. NCT01757678) was approved by each participating institution's review board, and informed consent was obtained from all participants. Fifty-one consecutive patients who underwent 320-detector row CT coronary angiographic examination and invasive coronary angiography with FFR measurement were included. Independent core laboratories determined coronary artery disease severity by using CT coronary angiography, TAG320, FFRCT, and FFR. TAG320 is defined as the linear regression coefficient between luminal attenuation and axial distance from the coronary ostium. FFRCT was computed from CT coronary angiography data by using computational fluid dynamics technology. Diagnostic performance was evaluated and compared on a per-vessel basis by the area under the receiver operating characteristic (ROC) curve (AUC). Results Among 82 vessels, 24 lesions (29%) had ischemia by FFR (FFR ≤ 0.80). FFRCT exhibited a stronger correlation with invasive FFR compared with TAG320 (Spearman ρ, 0.78 vs 0.47, respectively). Overall per-vessel accuracy, sensitivity, specificity, and positive and negative predictive values for TAG320 (<15.37) were 78%, 58%, 86%, 64%, and 83%, respectively; and those of FFRCT were 83%, 92%, 79%, 65%, and 96%, respectively. ROC curve analysis showed a significantly larger AUC for FFRCT (0.93) compared with that for TAG320 (0.72; P = .003) and CT coronary angiography alone (0.68; P = .008). Conclusion FFRCT computed from 320-detector row CT coronary angiography provides better diagnostic performance for the diagnosis of hemodynamically significant coronary stenoses

  6. Trisomy 13

    MedlinePlus

    ... artery at birth. There are often signs of congenital heart disease , such as: Abnormal placement of the heart toward ... almost immediately. Most infants with trisomy 13 have congenital heart disease. Complications may include: Breathing difficulty or lack of ...

  7. Mars Science Laboratory (MSL) Entry, Descent, and Landing Instrumentation (MEDLI): Complete Flight Data Set

    NASA Technical Reports Server (NTRS)

    Cheatwood, F. McNeil; Bose, Deepak; Karlgaard, Christopher D.; Kuhl, Christopher A.; Santos, Jose A.; Wright, Michael J.

    2014-01-01

    The Mars Science Laboratory (MSL) entry vehicle (EV) successfully entered the Mars atmosphere and landed the Curiosity rover safely on the surface of the planet in Gale crater on August 6, 2012. MSL carried the MSL Entry, Descent, and Landing (EDL) Instrumentation (MEDLI). MEDLI delivered the first in-depth understanding of the Mars entry environments and the response of the entry vehicle to those environments. MEDLI was comprised of three major subsystems: the Mars Entry Atmospheric Data System (MEADS), the MEDLI Integrated Sensor Plugs (MISP), and the Sensor Support Electronics (SSE). Ultimately, the entire MEDLI sensor suite consisting of both MEADS and MISP provided measurements that were used for trajectory reconstruction and engineering validation of aerodynamic, atmospheric, and thermal protection system (TPS) models in addition to Earth-based systems testing procedures. This report contains in-depth hardware descriptions, performance evaluation, and data information of the three MEDLI subsystems.

  8. On the COSMO-SkyMed Exploitation for Interferometric DEM Generation

    NASA Astrophysics Data System (ADS)

    Teresa, C. M.; Raffaele, N.; Oscar, N. D.; Fabio, B.

    2011-12-01

    Work supported by ASI (Agenzia Spaziale Italiana) in the framework of the project "AO-COSMO Project ID-1462 - Feasibility of possible use of COSMO/SkyMed in bistatic SAR Earth observation - ASI Contract I/063/09/0". References [1] B. Rabus, M. Eineder, A. Roth, and R. Bamler, "The Shuttle Radar Topography Mission-A new class of digital elevation models acquired by spaceborne radar," ISPRS J. Photogramm. Remote Sens., vol. 57, no. 4, pp. 241-262, Feb. 2003. [2] F. BOVENGA, D. O. NITTI, R. NUTRICATO, M. T. CHIARADIA, "C- and X-band multi-pass InSAR analysis over Alpine and Apennine regions". In Proceedings of the European Space Agency Living Planet Symposium, June 28 - July 2, 2010, Bergen, Norway. [3] D. REALE, D. O. NITTI, D. PEDUTO, R. NUTRICATO, F. BOVENGA, G. FORNARO, "Postseismic Deformation Monitoring With The COSMO/SKYMED Constellation". IEEE Geoscience Remote Sensing Letters, 2011. DOI: 10.1109/LGRS.2010.2100364 [4] Nitti, D.O., Nutricato, R., Bovenga, F., Conte, D., Guerriero, L. & Milillo, G., "Quantitative Analysis of Stripmap And Spotlight SAR Interferometry with CosmoSkyMed constellation.", Proceedings if IEEE IGARSS 2009, July 13-17, 2009. Cape Town, South Africa.

  9. The Mediterranean Supersite Volcanoes (MED-SUV) Project: an overview

    NASA Astrophysics Data System (ADS)

    Puglisi, Giuseppe

    2014-05-01

    The EC FP7 MEDiterranean SUpersite Volcanoes (MED-SUV) EC-FP7 Project, which started on June 2013, aims to improve the capacity of the scientific institutions, end users and SME forming the project consortium to assess the volcanic hazards at Italian Supersites, i.e. Mt. Etna and Campi Flegrei/Vesuvius. The Project activities will focus on the optimisation and integration of ground and space monitoring systems, the breakthrough in understanding of volcanic processes, and on the increase of the effectiveness of the coordination between the scientific and end-user communities in the hazard management. The overall goal of the project is to apply the rationale of the Supersites GEO initiative to Mt. Etna and Campi Flegrei/Vesuvius, considered as cluster of Supersites. For the purpose MED-SUV will integrate long-term observations of ground-based multidisciplinary data available for these volcanoes, i.e. geophysical, geochemical, and volcanological datasets, with Earth Observation (EO) data. Merging of different parameters over a long period will provide better understanding of the volcanic processes. In particular, given the variety of styles and intensities of the volcanic activity observed at these volcanoes, and which make them sort of archetypes for 'closed conduit ' and 'open conduit' volcanic systems, the combination of different data will allow discrimination between peculiar volcano behaviours associated with pre-, syn- and post-eruptive phases. Indeed, recognition of specific volcano patterns will allow broadening of the spectrum of knowledge of geo-hazards, as well as better parameterisation and modelling of the eruptive phenomena and of the processes occurring in the volcano supply system; thus improving the capability of carrying out volcano surveillance activities. Important impacts on the European industrial sector, arising from a partnership integrating the scientific community and SMEs to implement together new observation/monitoring sensors/systems, are

  10. The Mediterranean Supersite Volcanoes (MED-SUV) Project: an overview

    NASA Astrophysics Data System (ADS)

    Puglisi, G.

    2013-12-01

    The EC FP7 MEDiterranean SUpersite Volcanoes (MED-SUV) EC-FP7 Project, which started on June 2013, aims to improve the capacity of the scientific institutions, end users and SME forming the project consortium to assess the volcanic hazards at Italian Supersites, i.e. Mt. Etna and Campi Flegrei/Vesuvius. The Project activities will focus on the optimisation and integration of ground and space monitoring systems, the breakthrough in understanding of volcanic processes, and on the increase of the effectiveness of the coordination between the scientific and end-user communities in the hazard management. The overall goal of the project is to apply the rationale of the Supersites GEO initiative to Mt. Etna and Campi Flegrei/Vesuvius, considered as cluster of Supersites. For the purpose MED-SUV will integrate long-term observations of ground-based multidisciplinary data available for these volcanoes, i.e. geophysical, geochemical, and volcanological datasets, with Earth Observation (EO) data. Merging of different parameters over a long period will provide better understanding of the volcanic processes. In particular, given the variety of styles and intensities of the volcanic activity observed at these volcanoes, and which make them sort of archetypes for 'closed conduit '; and ';open conduit' volcanic systems, the combination of different data will allow discrimination between peculiar volcano behaviours associated with pre-, syn- and post-eruptive phases. Indeed, recognition of specific volcano patterns will allow broadening of the spectrum of knowledge of geo-hazards, as well as better parameterisation and modelling of the eruptive phenomena and of the processes occurring in the volcano supply system; thus improving the capability of carrying out volcano surveillance activities. Important impacts on the European industrial sector, arising from a partnership integrating the scientific community and SMEs to implement together new observation/monitoring sensors

  11. TERENO-MED: Terrestrial Environmental Observatories in the Mediterranean Region

    NASA Astrophysics Data System (ADS)

    Krueger, Elisabeth; Friesen, Jan; Kallioras, Andreas; Bogena, Heye; Devaraju, Anusuriya; Vereecken, Harry; Teutsch, Georg

    2013-04-01

    Centres and jointly operated with local partners across the Mediterranean region. In a number of Mediterranean mesoscale hydrological catchments TERENO-MED will investigate the long-term effects of global change on the quality and the dynamics of water resources in human-influenced environments under water scarcity. The Helmholtz Centres UFZ (overall coordinator) and FZJ have therefore initiated the set-up of a network of global change observatories in 5-10 Mediterranean river catchments. The TERENO-MED observatories will: - investigate societally relevant water problems in the context of 'typical' Mediterranean environments, - provide long-term and quality-controlled data available to the scientific community, - be operated and maintained through local research institutes and universities, - establish common monitoring platforms and foster synergies between research organizations, - provide solutions to pressing local and regional water problems by building partnerships between scientific partners and regional authorities.

  12. The Mediterranean Supersite Volcanoes (MED-SUV) Project: an overview

    NASA Astrophysics Data System (ADS)

    Puglisi, Giuseppe

    2013-04-01

    In response to the EC call ENV.2012.6.4-2 (Long-term monitoring experiments in geologically active regions of Europe prone to natural hazards: the Supersite concept - FP7-ENV-2012-two-stage) a wide community of volcanological institutions proposed the project Mediterranean Supersite Volcanoes (MED-SUV), which is in the negotiation phase at the time of writing. The Consortium is composed by 18 European University and research institutes, four Small or Medium Enterprises (SME) and two non-European University and research institutes. MED-SUV will improve the consortium capacity of assessment of volcanic hazards in Supersites of Southern Italy by optimising and integrating existing and new observation/monitoring systems, by a breakthrough in understanding of volcanic processes and by increasing the effectiveness of the coordination between the scientific and end-user communities. More than 3 million of people are exposed to potential volcanic hazards in a large region in the Mediterranean Sea, where two among the largest European volcanic areas are located: Mt. Etna and Campi Flegrei/Vesuvius. This project will fully exploit the unique detailed long-term in-situ monitoring data sets available for these volcanoes and integrate with Earth Observation (EO) data, setting the basic tools for a significant step ahead in the discrimination of pre-, syn- and post-eruptive phases. The wide range of styles and intensities of volcanic phenomena observed on these volcanoes, which can be assumed as archetypes of 'closed conduit ' and 'open conduit' volcano, together with the long-term multidisciplinary data sets give an exceptional opportunity to improve the understanding of a very wide spectrum of geo-hazards, as well as implementing and testing a large variety of innovative models of ground deformation and motion. Important impacts on the European industrial sector are expected, arising from a partnership integrating the scientific community and SMEs to implement together new

  13. A New Era of Therapeutic Strategies for Chronic Thromboembolic Pulmonary Hypertension by Two Different Interventional Therapies; Pulmonary Endarterectomy and Percutaneous Transluminal Pulmonary Angioplasty

    PubMed Central

    Ando, Motomi; Fukuda, Keiichi; Yoshino, Hideaki; Satoh, Toru

    2014-01-01

    Background Pulmonary endarterectomy (PEA) is established for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH). Recently, percutaneous transluminal pulmonary angioplasty (PTPA) has been added for peripheral-type CTEPH, whose lesions exist in segmental, subsegmental, and more distal pulmonary arteries. A shift in clinical practice of interventional therapies occurred in 2009 (first mainly PEA, later PTPA). We examined the latest clinical outcomes of patients with CTEPH. Methods and Results This study retrospectively included 136 patients with CTEPH. Twenty-nine were treated only with drug (Drug-group), and the other 107 underwent interventional therapies (Interventions-group) (39 underwent PEA [PEA-group] and 68 underwent PTPA [PTPA-group]). Total 213 PTPA sessions (failures, 0%; mortality rate, 1.47%) was performed in the PTPA-group (complications: reperfusion pulmonary edema, 7.0%; hemosputum or hemoptysis, 5.6%; vessel dissection, 2.3%; wiring perforation, 0.9%). Although baseline hemodynamic parameters were significantly more severe in the Interventions-group, the outcome after the diagnosis was much better in the Interventions-group than in the Drug-group (98% vs. 64% 5-year survival, p<0.0001). Hemodynamic improvement in the PEA-group was a 46% decrease in mean pulmonary arterial pressure (PAP) and a 49% decrease in total pulmonary resistance (TPR) (follow-up period; 74.7±32.3 months), while those in the PTPA-group were a 40% decrease in mean PAP and a 49% decrease in TPR (follow-up period; 17.4±9.3 months). The 2-year survival rate in the Drug-group was 82.0%, and the 2-year survival rate, occurrence of right heart failure, and re-vascularization rate in the PEA-group were 97.4%, 2.6%, and 2.8%, and those in the PTPA-group were 98.5%, 2.9%, and 2.9%, respectively. Conclusion The patients who underwent interventional therapies had better results than those treated only with drugs. The availability of both of these operative and catheter

  14. Exploitation of a large COSMO-SkyMed interferometric dataset

    NASA Astrophysics Data System (ADS)

    Nutricato, Raffaele; Nitti, Davide O.; Bovenga, Fabio; Refice, Alberto; Chiaradia, Maria T.

    2014-10-01

    In this work we explored a dataset made by more than 100 images acquired by COSMO-SkyMed (CSK) constellation over the Port-au-Prince (Haiti) metropolitan and surrounding areas that were severely hit by the January 12th, 2010 earthquake. The images were acquired along ascending pass by all the four sensors of the constellation with a mean rate of 1 acquisition/week. This consistent CSK dataset was fully exploited by using the Persistent Scatterer Interferometry algorithm SPINUA with the aim of: i) providing a displacement map of the area; ii) assessing the use of CSK and PSI for ground elevation measurements; iii) exploring the CSK satellite orbital tube in terms of both precision and size. In particular, significant subsidence phenomena were detected affecting river deltas and coastal areas of the Port-au-Prince and Carrefour region, as well as very slow slope movements and local ground instabilities. Ground elevation was also measured on PS targets with resolution of 3m. The density of these measurable targets depends on the ground coverage, and reaches values higher than 4000 PS/km2 over urban areas, while it drops over vegetated areas or along slopes affected by layover and shadow. Heights values were compared with LIDAR data at 1m of resolution collected soon after the 2010 earthquake. Furthermore, by using geocoding procedures and the precise LIDAR data as reference, the orbital errors affecting CSK records were investigated. The results are in line with other recent studies.

  15. Performing Environmental Change: MED Theatre and the Changing Face of Community-Based Performance Research

    ERIC Educational Resources Information Center

    Schaefer, Kerrie

    2012-01-01

    This article examines a programme of work produced by community-based theatre company, Manaton and East Dartmoor (MED) Theatre, addressing issues of climate change as they impact on life in rural Devon, UK. After some discussion of MED Theatre's constitution as a community-based company and the group's long-term engagement with the place, history,…

  16. Insertional mutation of the motor endplate disease (med) locus on mouse chromosome 15

    SciTech Connect

    Kohrman, D.C.; Plummer, N.W.; Schuster, T.

    1995-03-20

    Homozygous transgenic mice from line A4 have an early-onset progressive neuromuscular disorder characterized by paralysis of the rear limbs, muscle atrophy, and lethality by 4 weeks of age. The transgene insertion site was mapped to distal chromosome 15 close to the locus motor endplate disease (med). The sequence of mouse DNA flanking the insertion site junctions was determined. A small (<20 kb) deletion was detected at the insertion site, with no evidence of additional rearrangement of the chromosomal DNA. Noncomplementation of the transgene-induced mutation and med was demonstrated in a cross with med{sup J}/ + mice. The new allele is designated med{sup TgNA4Bs}(med{sup tg}). The homologous human locus MED was assigned to chromosome 12. Synaptotagmin 1 and contactin 1 were eliminated as candidate genes for the med mutation. The transgene-induced allele provides molecular access to the med gene, whose function is required for synaptic transmission at the neuromuscular junction and long-term survival of cerebellar Purkinje cells. 49 refs., 5 figs., 1 tab.

  17. 47 CFR 95.627 - MedRadio transmitters in the 401-406 MHz band.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...Radio programmer/control transmitters operating in the 401-406 MHz band must operate under the control... used by the programmer/control transmitter for a communications session. Before the monitoring system of a MedRadio programmer/control transmitter initiates a MedRadio communications session,...

  18. How to improve your PubMed/MEDLINE searches: 1. background and basic searching.

    PubMed

    Fatehi, Farhad; Gray, Leonard C; Wootton, Richard

    2013-12-01

    PubMed provides free access via the Internet to more than 23 million records, of which over 19 million are from the MEDLINE database of journal articles. PubMed also provides access to other databases, such as the NCBI Bookshelf. To perform a basic search, you can simply enter the search terms or the concept that you are looking for in the search box. However, taking care to clarify your key concepts may save much time later on, because a non-specific search is likely to produce an overwhelming number of result hits. One way to make your search more specific is to specify which field you want to search using field tags. By default, the results of a search are sorted by the date added to PubMed and displayed in summary format with 20 result hits (records) on each page. In summary format, the title of the article, list of authors, source of information (e.g., journal name followed by date of publication, volume, issue, pages) and the unique PubMed record number called the PubMed identifier (PMID) are shown. Although information is stored about the articles, PubMed/MEDLINE does not store the full text of the papers themselves. However, PubMedCentral (PMC) stores more than 2.8 million articles (roughly 10% of the articles in PubMed) and provides access to them for free to the users. PMID:24197398

  19. Formalizing MedDRA to support semantic reasoning on adverse drug reaction terms.

    PubMed

    Bousquet, Cédric; Sadou, Éric; Souvignet, Julien; Jaulent, Marie-Christine; Declerck, Gunnar

    2014-06-01

    Although MedDRA has obvious advantages over previous terminologies for coding adverse drug reactions and discovering potential signals using data mining techniques, its terminological organization constrains users to search terms according to predefined categories. Adding formal definitions to MedDRA would allow retrieval of terms according to a case definition that may correspond to novel categories that are not currently available in the terminology. To achieve semantic reasoning with MedDRA, we have associated formal definitions to MedDRA terms in an OWL file named OntoADR that is the result of our first step for providing an "ontologized" version of MedDRA. MedDRA five-levels original hierarchy was converted into a subsumption tree and formal definitions of MedDRA terms were designed using several methods: mappings to SNOMED-CT, semi-automatic definition algorithms or a fully manual way. This article presents the main steps of OntoADR conception process, its structure and content, and discusses problems and limits raised by this attempt to "ontologize" MedDRA. PMID:24680984

  20. MED12 methylation by CARM1 sensitizes human breast cancer cells to chemotherapy drugs

    PubMed Central

    Wang, Lu; Zeng, Hao; Wang, Qiang; Zhao, Zibo; Boyer, Thomas G.; Bian, Xiuwu; Xu, Wei

    2015-01-01

    The RNA polymerase II mediator complex subunit 12 (MED12) is frequently mutated in human cancers, and loss of MED12 has been shown to induce drug resistance through activation of transforming growth factor–β receptor (TGF-βR) signaling. We identified MED12 as a substrate for coactivator-associated arginine methyltransferase 1 (CARM1). Not only are the expression levels of CARM1 and MED12 positively correlated, but their high expression also predicts better prognosis in human breast cancers after chemotherapy. MED12 was methylated at R1862 and R1912 by CARM1, and mutation of these sites in cell lines resulted in resistance to chemotherapy drugs. Furthermore, we showed that the methylation-dependent drug response mechanism is distinct from activation of TGF-βR signaling, because methylated MED12 potently suppresses p21/WAF1 transcription. Cells defective in MED12 methylation have up-regulated p21 protein, which correlates with poor prognosis in breast cancer patients treated with chemotherapy. Collectively, this study identifies MED12 methylation as a sensor for predicting response to commonly used chemotherapy drugs in human cancers. PMID:26601288

  1. A Study of GRATEFUL MED Use in a Graduate Health Program.

    ERIC Educational Resources Information Center

    Henry, Marcia Klinger

    A study of "Grateful Med," an interface to Medline, was conducted at California State University/Northridge to discover how efficiently students enrolled in graduate-level research methods classes in health sciences and communicative disorders could access Medline using Grateful Med, what the average costs would be, and how frequently students…

  2. A Model for Persistent Improvement of Medical Education as Illustrated by the Surgical Reform Curriculum HeiCuMed

    PubMed Central

    Kadmon, Guni; Schmidt, Jan; De Cono, Nicola; Kadmon, Martina

    2011-01-01

    Background: Heidelberg Medical School underwent a major curricular change with the implementation of the reform curriculum HeiCuMed (Heidelberg Curriculum Medicinale) in October 2001. It is based on rotational modules with daily cycles of interactive, case-based small-group seminars, PBL tutorials and training of sensomotor and communication skills. For surgical undergraduate training an organisational structure was developed that ensures continuity of medical teachers for student groups and enables their unimpaired engagement for defined periods of time while accounting for the daily clinical routine in a large surgery department of a university hospital. It includes obligatory didactic training, standardising teaching material on the basis of learning objectives and releasing teaching doctors from clinical duties for the duration of a module. Objective: To compare the effectiveness of the undergraduate surgical reform curriculum with that of the preceding traditional one as reflected by students' evaluations. Method: The present work analyses student evaluations of the undergraduate surgical training between 1999 and 2008 including three cohorts (~360 students each) in the traditional curriculum and 13 cohorts (~150 students each) in the reform curriculum. Results: The evaluation of the courses, their organisation, the teaching quality, and the subjective learning was significantly better in HeiCuMed than in the preceding traditional curriculum over the whole study period. Conclusion: A medical curriculum based on the implementation of interactive didactical methods is more important to successful teaching and the subjective gain of knowledge than knowledge transfer by traditional classroom teaching. The organisational strategy adopted in the surgical training of HeiCuMed has been successful in enabling the maintenance of a complex modern curriculum on a continuously high level within the framework of a busy surgical environment. PMID:21818239

  3. Ablation of Coactivator Med1 Switches the Cell Fate of Dental Epithelia to That Generating Hair

    PubMed Central

    Nguyen, Thai; Sakai, Kiyoshi; He, Bing; Fong, Chak; Oda, Yuko

    2014-01-01

    Cell fates are determined by specific transcriptional programs. Here we provide evidence that the transcriptional coactivator, Mediator 1 (Med1), is essential for the cell fate determination of ectodermal epithelia. Conditional deletion of Med1 in vivo converted dental epithelia into epidermal epithelia, causing defects in enamel organ development while promoting hair formation in the incisors. We identified multiple processes by which hairs are generated in Med1 deficient incisors: 1) dental epithelial stem cells lacking Med 1 fail to commit to the dental lineage, 2) Sox2-expressing stem cells extend into the differentiation zone and remain multi-potent due to reduced Notch1 signaling, and 3) epidermal fate is induced by calcium as demonstrated in dental epithelial cell cultures. These results demonstrate that Med1 is a master regulator in adult stem cells to govern epithelial cell fate. PMID:24949995

  4. The inclusion of an online journal in PubMed central - a difficult path.

    PubMed

    Grech, Victor

    2016-01-01

    The indexing of a journal in a prominent database (such as PubMed) is an important imprimatur. Journals accepted for inclusion in PubMed Central (PMC) are automatically indexed in PubMed but must provide the entire contents of their publications as XML-tagged (Extensible Markup Language) data files compliant with PubMed's document type definition (DTD). This paper describes the various attempts that the journal Images in Paediatric Cardiology made in its efforts to convert the journal contents (including all of the extant backlog) to PMC-compliant XML for archiving and indexing in PubMed after the journal was accepted for inclusion by the database. PMID:27244254

  5. Retrieving Clinical Evidence: A Comparison of PubMed and Google Scholar for Quick Clinical Searches

    PubMed Central

    Bejaimal, Shayna AD; Sontrop, Jessica M; Iansavichus, Arthur V; Haynes, R Brian; Weir, Matthew A; Garg, Amit X

    2013-01-01

    Background Physicians frequently search PubMed for information to guide patient care. More recently, Google Scholar has gained popularity as another freely accessible bibliographic database. Objective To compare the performance of searches in PubMed and Google Scholar. Methods We surveyed nephrologists (kidney specialists) and provided each with a unique clinical question derived from 100 renal therapy systematic reviews. Each physician provided the search terms they would type into a bibliographic database to locate evidence to answer the clinical question. We executed each of these searches in PubMed and Google Scholar and compared results for the first 40 records retrieved (equivalent to 2 default search pages in PubMed). We evaluated the recall (proportion of relevant articles found) and precision (ratio of relevant to nonrelevant articles) of the searches performed in PubMed and Google Scholar. Primary studies included in the systematic reviews served as the reference standard for relevant articles. We further documented whether relevant articles were available as free full-texts. Results Compared with PubMed, the average search in Google Scholar retrieved twice as many relevant articles (PubMed: 11%; Google Scholar: 22%; P<.001). Precision was similar in both databases (PubMed: 6%; Google Scholar: 8%; P=.07). Google Scholar provided significantly greater access to free full-text publications (PubMed: 5%; Google Scholar: 14%; P<.001). Conclusions For quick clinical searches, Google Scholar returns twice as many relevant articles as PubMed and provides greater access to free full-text articles. PMID:23948488

  6. Towards a multidisciplinary e-infrastructure for the Mediterranean Supersite Volcanoes (MED-SUV) project

    NASA Astrophysics Data System (ADS)

    Nativi, Stefano; Mathieu, Pierre Philippe; Cossu, Roberto; Santoto, Mattia; Martini, Marcello; Puglisi, Giuseppe

    2014-05-01

    The MED-SUV European project (http://med-suv.eu/) aims to design and implement a multidisciplinary infrastructure for the volcanic risk management life-cycle in southern Italy. The MED-SUV infrastructure will rely upon the improvements of the understanding of geophysical processes underlying the volcanic systems of Vesuvius / Campi Flegrei and Mt. Etna. It will also achieve the integration of existing components, such as monitoring systems and data bases, novel sensors for the measurements of volcanic parameters, and tools for data analysis and process modelling. This effort will contribute to GEOSS (Global Earth Observation System of Systems - http://www.earthobservations.org/geoss.shtml) as one the volcano Supersite recognized by GEO (Group on Earth Observation) -see http://supersites.earthobservations.org/. To achieve its goals, MED-SUV needs an advanced e-infrastructure allowing: (a) heterogeneous data and processing systems to provide and share their resources, and (b) supersite Users to run their workflows and generate significant products. This presentation discusses the general interoperability approach and architecture characterizing the MED-SUV e-infrastructure. The MED-SUV e-infrastructure considered the concepts and solutions adopted by the GEOSS Common Infrastructure (GCI). The architecture requirements and system technologies builds on the experience done by relevant European projects in the framework of GEOSS and ESFRI (e.g. EuroGEOSS, GENESI, GEOWOW). MED-SUV e-infrastructure adopts three-tiers approach distinguishing among: (a) local and distributed Data/Information Providers; (b) the MED-SUV Brokering framework for harmonization and interoperability; (c) the MED-SUV e-collaboration environment for the generation and publication of advanced products. MED-SUV e-infrastructure development considers interoperability with the other two FP7 supersite projects: MARSITE and FUTUREVOLC, as well as EPOS.

  7. Genetics Home Reference: trisomy 13

    MedlinePlus

    ... of age. Am J Med Genet A. 2007 Mar 1;143A(5):518-20. Citation on PubMed FitzPatrick ... Pediatric Cardiac Care Consortium). Am J Cardiol. 2004 Mar 15;93(6):801-3. Citation on ... 1;143A(19):2242-8. Citation on PubMed Iliopoulos ...

  8. Coseismic liquefaction phenomenon analysis by COSMO-SkyMed: 2012 Emilia (Italy) earthquake

    NASA Astrophysics Data System (ADS)

    Chini, Marco; Albano, Matteo; Saroli, Michele; Pulvirenti, Luca; Moro, Marco; Bignami, Christian; Falcucci, Emanuela; Gori, Stefano; Modoni, Giuseppe; Pierdicca, Nazzareno; Stramondo, Salvatore

    2015-07-01

    The liquefaction phenomenon that occurred in the coseismic phase of the May 20, 2012 Emilia (Italy) earthquake (ML 5.9) is investigated. It was induced by the water pressure increase in the buried and confined sand layers. The level-ground liquefaction was the result of a chaotic ground oscillation caused by the earthquake shaking and the observed failures were due to the upward water flow caused by the excess of pore pressures. We exploited the capability of the differential synthetic aperture radar interferometry (DInSAR) technique to detect soil liquefactions and estimate their surface displacements, as well as the high sensitivity to surface changes of complex coherence, SAR backscattering and intensity correlation. To this aim, a set of four COSMO-SkyMed X-band SAR images, covering the period April 1-June 6, 2012, was used. Geological-geotechnical analysis was also performed in order to ascertain if the detected SAR-based surface effects could be due to the compaction induced by liquefaction of deep sandy layers. In this regards, the results obtained from 13 electrical cone penetrometer tests show the presence of a fine to medium sandy layer at depths, ranging between 9 and 13 m, which probably liquefied during the earthquake, inducing vertical displacements between 3 and 16 cm. The quantitative results from geological-geotechnical analysis and the surface punctual effects measured by DInSAR are in good agreement, even if some differences are present, probably ascribable to the local thickness and depth variability of the sandy layer, or to lack of deformation detection due to DInSAR decorrelation. The adopted approach permitted us to define the extent of the areas that underwent liquefaction and to quantify the local subsidence related to these phenomena. The latter achievement provides useful information that must be considered in engineering practices, in terms of expected vertical deformations.

  9. Enhancement on spotlight COSMO-SkyMed SAR products

    NASA Astrophysics Data System (ADS)

    Lorusso, R.; Milillo, G.

    2015-10-01

    COSMO-SkyMed (CSK) satellites are providing images with a resolution in the meter regime using the sliding spotlight mode (SL). This is an imaging mode which can obtain better azimuth resolution at the expense of azimuth imaged area than stripmap mode .Spotlight SAR data processing is already an established topic; efficient and accurate solutions in frequency domain have been proposed over the last years. However, the assumptions of these algorithms start to be invalid when applied to high-resolution spotlight SAR data acquired in spaceborne low Earth orbit (LEO) configurations. The assumption of a hyperbolic range history is no longer accurate for sub-metric spatial resolutions due to the satellite curved orbit. Since velocity of a space-borne platform is quite uniform, a simple focusing scheme had been designed in order to handle no straight line trajectory, using both approximated and accurate ω-k focusing kernel. Moreover, when getting close to decimeter resolution (at X-band) other several effects appear; in particular the motion of the satellite during the transmission and reception of the chirp signal deteriorate the impulse response function (IRF), if not properly considered (so called stop-and-go approximation). This paper shows that also CSK SL SAR data, with a resolution close to 1 meter, are not immune to disturbance effects when the stop-and-go approximation is assumed. The ω-k algorithm with satellite curved orbit handling is used to focus CSK spotlight data, and the stop-and-go approximation correction is included in the data processing chain. Experimental results with CSK spotlight data are provided to show quality enhancement on SAR standard focused products.

  10. Connecting the Dots between PubMed Abstracts

    PubMed Central

    Hossain, M. Shahriar; Gresock, Joseph; Edmonds, Yvette; Helm, Richard; Potts, Malcolm; Ramakrishnan, Naren

    2012-01-01

    Background There are now a multitude of articles published in a diversity of journals providing information about genes, proteins, pathways, and diseases. Each article investigates subsets of a biological process, but to gain insight into the functioning of a system as a whole, we must integrate information from multiple publications. Particularly, unraveling relationships between extra-cellular inputs and downstream molecular response mechanisms requires integrating conclusions from diverse publications. Methodology We present an automated approach to biological knowledge discovery from PubMed abstracts, suitable for “connecting the dots” across the literature. We describe a storytelling algorithm that, given a start and end publication, typically with little or no overlap in content, identifies a chain of intermediate publications from one to the other, such that neighboring publications have significant content similarity. The quality of discovered stories is measured using local criteria such as the size of supporting neighborhoods for each link and the strength of individual links connecting publications, as well as global metrics of dispersion. To ensure that the story stays coherent as it meanders from one publication to another, we demonstrate the design of novel coherence and overlap filters for use as post-processing steps. Conclusions We demonstrate the application of our storytelling algorithm to three case studies: i) a many-one study exploring relationships between multiple cellular inputs and a molecule responsible for cell-fate decisions, ii) a many-many study exploring the relationships between multiple cytokines and multiple downstream transcription factors, and iii) a one-to-one study to showcase the ability to recover a cancer related association, viz. the Warburg effect, from past literature. The storytelling pipeline helps narrow down a scientist's focus from several hundreds of thousands of relevant documents to only around a hundred

  11. Aspergillus fumigatus MedA governs adherence, host cell interactions and virulence

    PubMed Central

    Gravelat, Fabrice N.; Ejzykowicz, Daniele E.; Chiang, Lisa Y.; Chabot, Josée C.; Urb, Mirjam; Macdonald, K. Denyese; al-Bader, Nadia; Filler, Scott G.; Sheppard, Donald C.

    2010-01-01

    In medically important fungi, regulatory elements that control development and asexual reproduction often govern the expression of virulence traits. We therefore cloned the Aspergillus fumigatus developmental modifier MedA and characterized its role in conidiation, host cell interactions and virulence. As in the model organism Aspergillus nidulans, disruption of medA in A. fumigatus dramatically reduced conidiation. However, the conidiophore morphology was markedly different between the two species. Further, gene expression analysis suggested that MedA governs conidiation through different pathways in A. fumigatus compared to A. nidulans. The A. fumigatus ΔmedA strain was impaired in biofilm production and adherence to plastic, as well as adherence to pulmonary epithelial cells, endothelial cells and fibronectin in vitro. The ΔmedA strain also had reduced capacity to damage pulmonary epithelial cells, and stimulate pro-inflammatory cytokine mRNA and protein expression. Consistent with these results, the A. fumigatus ΔmedA strain also exhibited reduced virulence in both an invertebrate and a mammalian model of invasive aspergillosis. Collectively these results suggest that the downstream targets of A. fumigatus MedA mediate virulence, and may provide novel therapeutic targets for invasive aspergillosis. PMID:19889083

  12. A Functional Portrait of Med7 and the Mediator Complex in Candida albicans

    PubMed Central

    Tebbji, Faiza; Chen, Yaolin; Richard Albert, Julien; Gunsalus, Kearney T. W.; Kumamoto, Carol A.; Nantel, André; Sellam, Adnane; Whiteway, Malcolm

    2014-01-01

    Mediator is a multi-subunit protein complex that regulates gene expression in eukaryotes by integrating physiological and developmental signals and transmitting them to the general RNA polymerase II machinery. We examined, in the fungal pathogen Candida albicans, a set of conditional alleles of genes encoding Mediator subunits of the head, middle, and tail modules that were found to be essential in the related ascomycete Saccharomyces cerevisiae. Intriguingly, while the Med4, 8, 10, 11, 14, 17, 21 and 22 subunits were essential in both fungi, the structurally highly conserved Med7 subunit was apparently non-essential in C. albicans. While loss of CaMed7 did not lead to loss of viability under normal growth conditions, it dramatically influenced the pathogen's ability to grow in different carbon sources, to form hyphae and biofilms, and to colonize the gastrointestinal tracts of mice. We used epitope tagging and location profiling of the Med7 subunit to examine the distribution of the DNA sites bound by Mediator during growth in either the yeast or the hyphal form, two distinct morphologies characterized by different transcription profiles. We observed a core set of 200 genes bound by Med7 under both conditions; this core set is expanded moderately during yeast growth, but is expanded considerably during hyphal growth, supporting the idea that Mediator binding correlates with changes in transcriptional activity and that this binding is condition specific. Med7 bound not only in the promoter regions of active genes but also within coding regions and at the 3′ ends of genes. By combining genome-wide location profiling, expression analyses and phenotyping, we have identified different Med7p-influenced regulons including genes related to glycolysis and the Filamentous Growth Regulator family. In the absence of Med7, the ribosomal regulon is de-repressed, suggesting Med7 is involved in central aspects of growth control. PMID:25375174

  13. Percutaneous transluminal coronary angioplasty (PTCA)

    MedlinePlus Videos and Cool Tools

    ... minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart ... area and putting a needle into the femoral artery, the blood vessel that runs down the leg. ...

  14. Comparative study of NOTES alone versus NOTES guided by a new image registration system for navigation in the mediastinum: a study in a porcine model

    PubMed Central

    Córdova, Henry; Estépar, Raúl San José; Rodríguez-D’Jesús, Antonio; Martínez-Pallí, Graciela; Arguis, Pedro; de Miguel, Cristina Rodríguez; Navarro-Ripoll, Ricard; Perdomo, Juan M.; Cuatrecasas, Miriam; Llach, Josep; Vosburgh, Kirby G.; Fernández-Esparrach, Gloria

    2013-01-01

    Background Natural orifice transluminal endoscopic surgery (NOTES) mediastinoscopy (MED) through the esophagus has proved to be feasible in the animal model. However, injury of the adjacent pleura and pneumothorax has been reported as a frequent adverse event when using a blind access. Objective To assess the utility and safety of a CT-based image registration system (IRS) for navigation in the mediastinum. Design Prospective, randomized, controlled trial in 30 Yorkshire pigs. Thirty-minute MEDs were performed: 15 MEDs were performed with IRS guidance (MED-IRS), and 15 MEDs were performed with a blind access. Setting Animal research laboratory. Interventions In both groups, the mediastinum was accessed through a 10-cm submucosal tunnel in the esophageal wall. Timed exploration was performed with identification of 8 mediastinal structures. Main Outcome Measurements Technical feasibility, adverse events, and the number of mediastinal structures identified. Results Thirty animals weighing 31.5 ± 3.5 kg were included in this study. MED was not possible in 2 animals in the “MED with blind access” group but was possible in all MEDs performed with IRS. The mean number of identified organs was slightly higher in “with IRS-MED” (6.13 ± 1.3) than with MED with blind access (4.7 ± 2.3; P = .066). Moreover, the right atrium and vena cava were identified in more cases with IRS-MED than in MED with blind access (13 vs 3 and 15 vs 11, P = .000 and P = .03, respectively). There were 3 (23%) adverse events with IRS-MED and 4 (27%) with “MED with blind access” (P = not significant), with pneumothorax being the most frequent (2 and 3, respectively). Limitations Nonsurvival animal study. Conclusions This study demonstrates that the IRS system appears feasible in natural orifice transluminal endoscopic surgery MED and suggests that IRS guidance might be useful for selected procedures. PMID:23261099

  15. 14 CFR 13.13 - Consent orders.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Consent orders. 13.13 Section 13.13 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES Legal Enforcement Actions § 13.13 Consent orders. (a) At any...

  16. 14 CFR 13.13 - Consent orders.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Consent orders. 13.13 Section 13.13 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES Legal Enforcement Actions § 13.13 Consent orders. (a) At any...

  17. 14 CFR 13.13 - Consent orders.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Consent orders. 13.13 Section 13.13... INVESTIGATIVE AND ENFORCEMENT PROCEDURES Legal Enforcement Actions § 13.13 Consent orders. (a) At any time before the issuance of an order under this subpart, the official who issued the notice and the...

  18. HubMed: a web-based biomedical literature search interface

    PubMed Central

    Eaton, Alfred D.

    2006-01-01

    HubMed is an alternative search interface to the PubMed database of biomedical literature, incorporating external web services and providing functions to improve the efficiency of literature search, browsing and retrieval. Users can create and visualize clusters of related articles, export citation data in multiple formats, receive daily updates of publications in their areas of interest, navigate links to full text and other related resources, retrieve data from formatted bibliography lists, navigate citation links and store annotated metadata for articles of interest. HubMed is freely available at . PMID:16845111

  19. Roles of MED1 in quiescence of hair follicle stem cells and maintenance of normal hair cycling.

    PubMed

    Nakajima, Takeshi; Inui, Shigeki; Fushimi, Tomohiro; Noguchi, Fumihito; Kitagawa, Yutaka; Reddy, Janardan K; Itami, Satoshi

    2013-02-01

    MED1 (mediator complex subunit 1) is expressed by human epidermal keratinocytes and functions as a coactivator of several transcription factors. To elucidate the role of MED1 in keratinocytes, we established keratinocyte-specific Med1-null (Med1(epi-/-)) mice using the K5Cre/LoxP system. Development of the epidermis and appendages of Med1(epi-/-) mice were macroscopically and microscopically normal until the second catagen of the hair cycle. However, the hair cycle of Med1(epi-/-) mice was spontaneously repeated after the second telogen, which does not occur in wild-type (WT) mice. Hair follicles of Med1(epi-/-) mice could not enter anagen after 6 months of age, resulting in sparse pelage hair in older Med1(epi-/-) mice. Interfollicular epidermis (IFE) of Med1(epi-/-) mice was acanthotic and more proliferative than that of WT mice, whereas these findings were less evident in older Med1(epi-/-) mice. Flow cytometric analysis revealed that the numbers of hair follicle bulge stem cells were reduced in Med1(epi-/-) mice from a few months after birth. These results suggest that MED1 has roles in maintaining quiescence of keratinocytes and preventing depletion of the follicular stem cells. PMID:22931914

  20. Breast Cancer Meds Won't Raise Chances of Heart Attack, Stroke, Study Suggests

    MedlinePlus

    ... Breast Cancer Meds Won't Raise Chances of Heart Attack, Stroke, Study Suggests But there was a slightly ... aromatase inhibitors doesn't raise the risk of heart attacks and strokes among breast cancer survivors, a new ...

  1. Automatic annotation of ICD-to-MedDRA mappings with SKOS predicates.

    PubMed

    Declerck, Gunnar; Souvignet, Julien; Rodrigues, Jean-Marie; Jaulent, Marie-Christine

    2014-01-01

    Robust alignments between ICD and MedDRA are essential to enable the secondary use of clinical data for pharmacovigilance research. UMLS makes available ICD-to-MedDRA mappings, but they are only poorly specified, which introduces difficulties when exploited in an automatic way. SKOS vocabulary can help achieve quality and machine-processable mappings. We have developed an algorithm based on several simple rules which annotates automatically ICD-to-MedDRA mappings with SKOS predicates. The method was tested and evaluated on a sample of ICD-10-to MedDRA mappings extracted from UMLS. The algorithm demonstrated satisfying performances, especially for skos:exactMatch properties, which suggests that automatic methods can be used to improve the quality of terminology mappings. PMID:25160341

  2. How Safe Is Condomless Sex When Partner with HIV Takes Meds?

    MedlinePlus

    ... news/fullstory_159830.html How Safe Is Condomless Sex When Partner With HIV Takes Meds? Study suggests ... is highly unlikely among straight couples who have sex without condoms when one partner carries the virus ...

  3. EPA MED-DULUTH'S ECOTOX AND ECO-SSL WEB APPLICATIONS

    EPA Science Inventory

    The ECOTOX (ECOTOXicology Database) system developed by the USEPA, National Health and Environmental Effects Research Laboratory (NHEERL), Mid-Continent Ecology Division in Duluth, MN (MED-Duluth), provides a web browser search interface for locating aquatic and terrestrial toxic...

  4. MedlinePlus FAQ: MedlinePlus and MEDLINE/PubMed

    MedlinePlus

    ... topic. MEDLINE/PubMed: Is a database of professional biomedical literature Is a Web-based, searchable database of ... million article references published in more than 5600 biomedical journals. Can be searched for free Includes links ...

  5. Breast Cancer Meds Won't Raise Chances of Heart Attack, Stroke, Study Suggests

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_158441.html Breast Cancer Meds Won't Raise Chances of Heart Attack, ... the risk of heart attacks and strokes among breast cancer survivors, a new study suggests. However, the researchers ...

  6. Use and reported effectiveness of Tel-Med: a telephone health information system.

    PubMed Central

    Diseker, R A; Michielutte, R; Morrison, V

    1980-01-01

    In January 1977, a Telephone Information System (Tel-Med) was begun in Winston-Salem, North Carolina. A survey was conducted to determine how Tel-Med was meeting the community's need for health information and to see if program objectives were being met. Respondents in 3,005 randomly selected households were interviewed by telephone to determine user characteristics, user motivation, action taken, knowledge and information gained, and system improvements. A key finding indicated that larger percentages of adults with lower income and educational levels were not aware of the service than were the adults in upper income and educational levels. However, income and education are not related to use of Tel-Med among individuals who know of this service. This finding suggests that the poorer and lesser educated would use Tel-Med in a way similar to that of their more fortunate peers if efforts were made to inform them of the service. PMID:7356084

  7. [Use of PubMed to improve evidence-based medicine in routine urological practice].

    PubMed

    Rink, M; Kluth, L A; Shariat, S F; Chun, F K; Fisch, M; Dahm, P

    2013-03-01

    Applying evidence-based medicine in daily clinical practice is the basis of patient-centered medicine and knowledge of accurate literature acquisition skills is necessary for informed clinical decision-making. PubMed is an easy accessible, free bibliographic database comprising over 21 million citations from the medical field, life-science journals and online books. The article summarizes the effective use of PubMed in routine urological clinical practice based on a common case scenario. This article explains the simple use of PubMed to obtain the best search results with the highest evidence. Accurate knowledge about the use of PubMed in routine clinical practice can improve evidence-based medicine and also patient treatment. PMID:23503794

  8. High-Resolution Melting Analysis of MED12 Mutations in Uterine Leiomyomas in Chinese Patients

    PubMed Central

    Wang, Hua; Qian, Hua; Zhou, Ruifang; Jiang, Jun; Ye, Lihua

    2015-01-01

    Objectives: Somatic mutations in mediator complex subunit 12 (MED12) have emerged as a critical genetic change in the development of uterine leiomyomas. Studies, however, have focused largely on cohorts consisting of Caucasian patients. In this study, uterine leiomyomas from Chinese patients were examined for MED12 mutations. In addition, polymerase chain reaction (PCR)-based high-resolution melting analysis (HRMA) was compared with direct sequencing as a potentially more sensitive method for the detection of MED12 mutations. Methods: Tissue samples with the pathologies of uterine leiomyoma (n=181) and other endometrial diseases (n=157) were collected from Chinese patients at the Taizhou People's Hospital and Taizhou Polytechnic College (Taizhou City, China). Genomic DNA was prepared from all samples. Both PCR-based HRMA and PCR-based direct sequencing were used to detect MED12 mutations. Results: PCR-based HRMA and direct sequencing revealed MED12 mutations in 95/181 (52.5%) and 93/181 (51.4%) uterine leiomyomas, respectively. Nearly half of these mutations (46/93) were found in a single codon, codon 131. The coincidence rate between the two methods was 98.9% (179/181) so that no statistically significant difference was evident in the application of the methodologies (χ2=0.011, p=0.916). In addition, MED12 mutations were identified in 1/157 (4.17%) case of other endometrial pathologies by both methods. Conclusions: MED12 mutations were closely associated with the development of uterine leiomyomas, as opposed to other uterine pathologies in Chinese patients, and PCR-based HRMA was found to be a reliable method for the detection of MED12 mutations. PMID:25615570

  9. MED23-associated refractory epilepsy successfully treated with the ketogenic diet.

    PubMed

    Lionel, Anath C; Monfared, Nasim; Scherer, Stephen W; Marshall, Christian R; Mercimek-Mahmutoglu, Saadet

    2016-09-01

    We report a new patient with refractory epilepsy associated with a novel pathogenic homozygous MED23 variant. This 7.5-year-old boy from consanguineous parents had infantile onset global developmental delay and refractory epilepsy. He was treated with the ketogenic diet at 2.5 years of age and became seizure free on the first day. He had microcephaly and truncal hypotonia. His brain MRI showed delayed myelination and thin corpus callosum. He was enrolled in a whole exome sequencing research study, which identified a novel, homozygous, likely pathogenic (c.1937A>G; p.Gln646Arg) variant in MED23. MED23 is a regulator of energy homeostasis and glucose production. Liver-specific Med23-knockout mice showed reduced liver gluconeogenesis and lower blood glucose levels compared to control mice. This is the first patient with documented refractory epilepsy caused by a novel homozygous pathogenic variant in MED23 expanding the phenotypic spectrum. Identification of the underlying genetic defect in MED23 sheds light on the possible mechanism of complete response to the ketogenic diet in this child. © 2016 Wiley Periodicals, Inc. PMID:27311965

  10. Software-Enabled Distributed Network Governance: The PopMedNet Experience

    PubMed Central

    Davies, Melanie; Erickson, Kyle; Wyner, Zachary; Malenfant, Jessica; Rosen, Rob; Brown, Jeffrey

    2016-01-01

    Introduction: The expanded availability of electronic health information has led to increased interest in distributed health data research networks. Distributed Research Network Model: The distributed research network model leaves data with and under the control of the data holder. Data holders, network coordinating centers, and researchers have distinct needs and challenges within this model. Software Enabled Governance: PopMedNet: The concerns of network stakeholders are addressed in the design and governance models of the PopMedNet software platform. PopMedNet features include distributed querying, customizable workflows, and auditing and search capabilities. Its flexible role-based access control system enables the enforcement of varying governance policies. Selected Case Studies: Four case studies describe how PopMedNet is used to enforce network governance models. Issues and Challenges: Trust is an essential component of a distributed research network and must be built before data partners may be willing to participate further. The complexity of the PopMedNet system must be managed as networks grow and new data, analytic methods, and querying approaches are developed. Conclusions: The PopMedNet software platform supports a variety of network structures, governance models, and research activities through customizable features designed to meet the needs of network stakeholders. PMID:27141522

  11. Extracting and standardizing medication information in clinical text – the MedEx-UIMA system

    PubMed Central

    Jiang, Min; Wu, Yonghui; Shah, Anushi; Priyanka, Priyanka; Denny, Joshua C.; Xu, Hua

    2014-01-01

    Extraction of medication information embedded in clinical text is important for research using electronic health records (EHRs). However, most of current medication information extraction systems identify drug and signature entities without mapping them to standard representation. In this study, we introduced the open source Java implementation of MedEx, an existing high-performance medication information extraction system, based on the Unstructured Information Management Architecture (UIMA) framework. In addition, we developed new encoding modules in the MedEx-UIMA system, which mapped an extracted drug name/dose/form to both generalized and specific RxNorm concepts and translated drug frequency information to ISO standard. We processed 826 documents by both systems and verified that MedEx-UIMA and MedEx (the Python version) performed similarly by comparing both results. Using two manually annotated test sets that contained 300 drug entries from medication list and 300 drug entries from narrative reports, the MedEx-UIMA system achieved F-measures of 98.5% and 97.5% respectively for encoding drug names to corresponding RxNorm generic drug ingredients, and F-measures of 85.4% and 88.1% respectively for mapping drug names/dose/form to the most specific RxNorm concepts. It also achieved an F-measure of 90.4% for normalizing frequency information to ISO standard. The open source MedEx-UIMA system is freely available online at http://code.google.com/p/medex-uima/. PMID:25954575

  12. The Mars Science Laboratory (MSL) Entry, Descent And Landing Instrumentation (MEDLI): Hardware Performance and Data Reconstruction

    NASA Technical Reports Server (NTRS)

    Little, Alan; Bose, Deepak; Karlgaard, Chris; Munk, Michelle; Kuhl, Chris; Schoenenberger, Mark; Antill, Chuck; Verhappen, Ron; Kutty, Prasad; White, Todd

    2013-01-01

    The Mars Science Laboratory (MSL) Entry, Descent and Landing Instrumentation (MEDLI) hardware was a first-of-its-kind sensor system that gathered temperature and pressure readings on the MSL heatshield during Mars entry on August 6, 2012. MEDLI began as challenging instrumentation problem, and has been a model of collaboration across multiple NASA organizations. After the culmination of almost 6 years of effort, the sensors performed extremely well, collecting data from before atmospheric interface through parachute deploy. This paper will summarize the history of the MEDLI project and hardware development, including key lessons learned that can apply to future instrumentation efforts. MEDLI returned an unprecedented amount of high-quality engineering data from a Mars entry vehicle. We will present the performance of the 3 sensor types: pressure, temperature, and isotherm tracking, as well as the performance of the custom-built sensor support electronics. A key component throughout the MEDLI project has been the ground testing and analysis effort required to understand the returned flight data. Although data analysis is ongoing through 2013, this paper will reveal some of the early findings on the aerothermodynamic environment that MSL encountered at Mars, the response of the heatshield material to that heating environment, and the aerodynamic performance of the entry vehicle. The MEDLI data results promise to challenge our engineering assumptions and revolutionize the way we account for margins in entry vehicle design.

  13. Mining locus tags in PubMed Central to improve microbial gene annotation

    PubMed Central

    2014-01-01

    Background The scientific literature contains millions of microbial gene identifiers within the full text and tables, but these annotations rarely get incorporated into public sequence databases. We propose to utilize the Open Access (OA) subset of PubMed Central (PMC) as a gene annotation database and have developed an R package called pmcXML to automatically mine and extract locus tags from full text, tables and supplements. Results We mined locus tags from 1835 OA publications in ten microbial genomes and extracted tags mentioned in 30,891 sentences in main text and 20,489 rows in tables. We identified locus tag pairs marking the start and end of a region such as an operon or genomic island and expanded these ranges to add another 13,043 tags. We also searched for locus tags in supplementary tables and publications outside the OA subset in Burkholderia pseudomallei K96243 for comparison. There were 168 publications containing 48,470 locus tags and 83% of mentions were from supplementary materials and 9% from publications outside the OA subset. Conclusions B. pseudomallei locus tags within the full text and tables of OA publications represent only a small fraction of the total mentions in the literature. For microbial genomes with very few functionally characterized proteins, the locus tags mentioned in supplementary tables and within ranges like genomic islands contain the majority of locus tags. Significantly, the functions in the R package provide access to additional resources in the OA subset that are not currently indexed or returned by searching PMC. PMID:24499370

  14. Trends and topics in eye disease research in PubMed from 2010 to 2014

    PubMed Central

    Denion, Eric; Mortemousque, Bruno; Mouriaux, Fréderic

    2016-01-01

    Background: The purpose of this study is to provide a report on scientific production during the period 2010–2014 in order to identify the major topics as well as the predominant actors (journals, countries, continents) involved in the field of eye disease. Methods: A PubMed search was carried out to extract articles related to eye diseases during the period 2010–2014. Data were downloaded and processed through developed PHP scripts for further analysis. Results: A total of 62,123 articles were retrieved. A total of 3,368 different journals were found, and 19 journals were identified as “core journals” according to Braford’s law. English was by far the predominant language. A total of 853,182 MeSH terms were found, representing an average of 13.73 (SD = 4.98) MeSH terms per article. Among these 853,182 MeSH terms, 14,689 different MeSH terms were identified. Vision Disorders, Glaucoma, Diabetic Retinopathy, Macular Degeneration, and Cataract were the most frequent five MeSH terms related to eye diseases. The analysis of the total number of publications showed that Europe and Asia were the most productive continents, and the USA and China the most productive countries. Interestingly, using the mean Five-Year Impact Factor, the two most productive continents were North America and Oceania. After adjustment for population, the overall ranking positions changed in favor of smaller countries (i.e. Iceland, Switzerland, Denmark, and New Zealand), while after adjustment for Gross Domestic Product (GDP), the overall ranking positions changed in favor of some developing countries (Malawi, Guatemala, Singapore). Conclusions: Due to the large number of articles included and the numerous parameters analyzed, this study provides a wide view of scientific productivity related to eye diseases during the period 2010–2014 and allows us to better understand this field. PMID:26819840

  15. Rapid Estimation of TPH Reduction in Oil-Contaminated Soils Using the MED Method

    SciTech Connect

    Edenborn, H.M.; Zenone, V.A.

    2007-09-01

    Oil-contaminated soil and sludge generated during federal well plugging activities in northwestern Pennsylvania are currently remediated on small landfarm sites in lieu of more expensive landfill disposal. Bioremediation success at these sites in the past has been gauged by the decrease in total petroleum hydrocarbon (TPH) concentrations to less than 10,000 mg/kg measured using EPA Method 418.1. We tested the “molarity of ethanol droplet” (MED) water repellency test as a rapid indicator of TPH concentration in soil at one landfarm near Bradford, PA. MED was estimated by determining the minimum ethanol concentration (0 – 6 M) required to penetrate air-dried and sieved soil samples within 10 sec. TPH in soil was analyzed by rapid fluorometric analysis of methanol soil extracts, which correlated well with EPA Method 1664. Uncontaminated landfarm site soil amended with increasing concentrations of waste oil sludge showed a high correlation between MED and TPH. MED values exceeded the upper limit of 6 M as TPH estimates exceed ca. 25,000 mg/kg. MED and TPH at the land farm were sampled monthly during summer months over two years in a grid pattern that allowed spatial comparisons of site remediation effectiveness. MED and TPH decreased at a constant rate over time and remained highly correlated. Inexpensive alternatives to reagent-grade ethanol gave comparable results. The simple MED approach served as an inexpensive alternative to the routine laboratory analysis of TPH during the monitoring of oily waste bioremediation at this landfarm site.

  16. PosMed: ranking genes and bioresources based on Semantic Web Association Study

    PubMed Central

    Makita, Yuko; Kobayashi, Norio; Yoshida, Yuko; Doi, Koji; Mochizuki, Yoshiki; Nishikata, Koro; Matsushima, Akihiro; Takahashi, Satoshi; Ishii, Manabu; Takatsuki, Terue; Bhatia, Rinki; Khadbaatar, Zolzaya; Watabe, Hajime; Masuya, Hiroshi; Toyoda, Tetsuro

    2013-01-01

    Positional MEDLINE (PosMed; http://biolod.org/PosMed) is a powerful Semantic Web Association Study engine that ranks biomedical resources such as genes, metabolites, diseases and drugs, based on the statistical significance of associations between user-specified phenotypic keywords and resources connected directly or inferentially through a Semantic Web of biological databases such as MEDLINE, OMIM, pathways, co-expressions, molecular interactions and ontology terms. Since 2005, PosMed has long been used for in silico positional cloning studies to infer candidate disease-responsible genes existing within chromosomal intervals. PosMed is redesigned as a workbench to discover possible functional interpretations for numerous genetic variants found from exome sequencing of human disease samples. We also show that the association search engine enhances the value of mouse bioresources because most knockout mouse resources have no phenotypic annotation, but can be associated inferentially to phenotypes via genes and biomedical documents. For this purpose, we established text-mining rules to the biomedical documents by careful human curation work, and created a huge amount of correct linking between genes and documents. PosMed associates any phenotypic keyword to mouse resources with 20 public databases and four original data sets as of May 2013. PMID:23761449

  17. PosMed: Ranking genes and bioresources based on Semantic Web Association Study.

    PubMed

    Makita, Yuko; Kobayashi, Norio; Yoshida, Yuko; Doi, Koji; Mochizuki, Yoshiki; Nishikata, Koro; Matsushima, Akihiro; Takahashi, Satoshi; Ishii, Manabu; Takatsuki, Terue; Bhatia, Rinki; Khadbaatar, Zolzaya; Watabe, Hajime; Masuya, Hiroshi; Toyoda, Tetsuro

    2013-07-01

    Positional MEDLINE (PosMed; http://biolod.org/PosMed) is a powerful Semantic Web Association Study engine that ranks biomedical resources such as genes, metabolites, diseases and drugs, based on the statistical significance of associations between user-specified phenotypic keywords and resources connected directly or inferentially through a Semantic Web of biological databases such as MEDLINE, OMIM, pathways, co-expressions, molecular interactions and ontology terms. Since 2005, PosMed has long been used for in silico positional cloning studies to infer candidate disease-responsible genes existing within chromosomal intervals. PosMed is redesigned as a workbench to discover possible functional interpretations for numerous genetic variants found from exome sequencing of human disease samples. We also show that the association search engine enhances the value of mouse bioresources because most knockout mouse resources have no phenotypic annotation, but can be associated inferentially to phenotypes via genes and biomedical documents. For this purpose, we established text-mining rules to the biomedical documents by careful human curation work, and created a huge amount of correct linking between genes and documents. PosMed associates any phenotypic keyword to mouse resources with 20 public databases and four original data sets as of May 2013. PMID:23761449

  18. Chemical discrimination between dC and 5MedC via their hydroxylamine adducts

    PubMed Central

    Münzel, Martin; Lercher, Lukas; Müller, Markus; Carell, Thomas

    2010-01-01

    The presence of the methylated nucleobase 5MedC in CpG islands is a key factor that determines gene silencing. False methylation patterns are responsible for deteriorated cellular development and are a hallmark of many cancers. Today genes can be sequenced for the content of 5MedC only with the help of the bisulfite reagent, which is based exclusively on chemical reactivity differences established by the additional methyl group. Despite intensive optimization of the bisulfite protocol, the method still has specificity problems. Most importantly ∼95% of the DNA analyte is degraded during the analysis procedure. We discovered that the reagent O-allylhydroxylamine is able to discriminate between dC and 5MedC. The reagent, in contrast to bisulfite, does not exploit reactivity differences but gives directly different reaction products. The reagent forms a stable mutagenic adduct with dC, which can exist in two states (E versus Z). In case of dC the allylhydroxylamine adduct switches into the E-isomeric form, which generates dC to dT transition mutations that can easily be detected by established methods. Significantly, the 5MedC-adduct adopts exclusively the Z-isomeric form, which causes the polymerase to stop. O-allylhydroxylamine does allow differentiation between dC and 5MedC with high accuracy, leading towards a novel and mild chemistry for methylation analysis. PMID:20813757

  19. MET network in PubMed: a text-mined network visualization and curation system

    PubMed Central

    Dai, Hong-Jie; Su, Chu-Hsien; Lai, Po-Ting; Huang, Ming-Siang; Jonnagaddala, Jitendra; Rose Jue, Toni; Rao, Shruti; Chou, Hui-Jou; Milacic, Marija; Singh, Onkar; Syed-Abdul, Shabbir; Hsu, Wen-Lian

    2016-01-01

    Metastasis is the dissemination of a cancer/tumor from one organ to another, and it is the most dangerous stage during cancer progression, causing more than 90% of cancer deaths. Improving the understanding of the complicated cellular mechanisms underlying metastasis requires investigations of the signaling pathways. To this end, we developed a METastasis (MET) network visualization and curation tool to assist metastasis researchers retrieve network information of interest while browsing through the large volume of studies in PubMed. MET can recognize relations among genes, cancers, tissues and organs of metastasis mentioned in the literature through text-mining techniques, and then produce a visualization of all mined relations in a metastasis network. To facilitate the curation process, MET is developed as a browser extension that allows curators to review and edit concepts and relations related to metastasis directly in PubMed. PubMed users can also view the metastatic networks integrated from the large collection of research papers directly through MET. For the BioCreative 2015 interactive track (IAT), a curation task was proposed to curate metastatic networks among PubMed abstracts. Six curators participated in the proposed task and a post-IAT task, curating 963 unique metastatic relations from 174 PubMed abstracts using MET. Database URL: http://btm.tmu.edu.tw/metastasisway PMID:27242035

  20. MET network in PubMed: a text-mined network visualization and curation system.

    PubMed

    Dai, Hong-Jie; Su, Chu-Hsien; Lai, Po-Ting; Huang, Ming-Siang; Jonnagaddala, Jitendra; Rose Jue, Toni; Rao, Shruti; Chou, Hui-Jou; Milacic, Marija; Singh, Onkar; Syed-Abdul, Shabbir; Hsu, Wen-Lian

    2016-01-01

    Metastasis is the dissemination of a cancer/tumor from one organ to another, and it is the most dangerous stage during cancer progression, causing more than 90% of cancer deaths. Improving the understanding of the complicated cellular mechanisms underlying metastasis requires investigations of the signaling pathways. To this end, we developed a METastasis (MET) network visualization and curation tool to assist metastasis researchers retrieve network information of interest while browsing through the large volume of studies in PubMed. MET can recognize relations among genes, cancers, tissues and organs of metastasis mentioned in the literature through text-mining techniques, and then produce a visualization of all mined relations in a metastasis network. To facilitate the curation process, MET is developed as a browser extension that allows curators to review and edit concepts and relations related to metastasis directly in PubMed. PubMed users can also view the metastatic networks integrated from the large collection of research papers directly through MET. For the BioCreative 2015 interactive track (IAT), a curation task was proposed to curate metastatic networks among PubMed abstracts. Six curators participated in the proposed task and a post-IAT task, curating 963 unique metastatic relations from 174 PubMed abstracts using MET.Database URL: http://btm.tmu.edu.tw/metastasisway. PMID:27242035

  1. MedReach: building an Area Health Education Center medical information outreach system for northwest Ohio.

    PubMed

    Steiner, Victoria; Hartmann, Jonathan; Ronau, Theodore

    2002-07-01

    In collaboration with regional partners in northwest Ohio, the Area Health Education Center (AHEC) program at the Medical College of Ohio (MCO) at Toledo is reaching out to underserved areas, helping to provide educational opportunities to health care professionals in these communities. This paper describes the development of MedReach, a medical information outreach system that connects regional AHEC sites to MCO via the Internet. MedReach provides physicians and other health care professionals access and support to search computerized textbooks and databases for current information on medical diagnoses, treatments, and research. A unique aspect of the MedReach project is that users are able to receive personal help with information retrieval by calling or emailing MCO's outreach librarian. Periodically, the AHEC program and the Mulford Library at MCO also sponsor an educational program, titled "Medical Applications of Computers," for regional practitioners. Current feedback on both the medical information outreach system and the educational program has been positive. PMID:12113517

  2. Specific erythroid-lineage defect in mice conditionally deficient for Mediator subunit Med1.

    PubMed

    Stumpf, Melanie; Yue, Xiaojing; Schmitz, Sandra; Luche, Hervé; Reddy, Janardan K; Borggrefe, Tilman

    2010-12-14

    The Mediator complex forms the bridge between transcriptional activators and the RNA polymerase II. Med1 (also known as PBP or TRAP220) is a key component of Mediator that interacts with nuclear hormone receptors and GATA transcription factors. Here, we show dynamic recruitment of GATA-1, TFIIB, Mediator, and RNA polymerase II to the β-globin locus in induced mouse erythroid leukemia cells and in an erythropoietin-inducible hematopoietic progenitor cell line. Using Med1 conditional knockout mice, we demonstrate a specific block in erythroid development but not in myeloid or lymphoid development, highlighted by the complete absence of β-globin gene expression. Thus, Mediator subunit Med1 plays a pivotal role in erythroid development and in β-globin gene activation. PMID:21098667

  3. [MedDRA and its applications in statistical analysis of adverse events].

    PubMed

    Lu, Meng-jie; Liu, Yu-xiu

    2015-11-01

    Safety assessment in clinical trials is dependent on an in-depth analysis of the adverse events to a great extent. However, there are difficulties in summary classification, data management and statistical analysis of the adverse events because of the different expressions on the same adverse events caused by regional, linguistic, ethnic, cultural and other differences. In order to ensure the normative expressions, it's necessary to standardize the terms in recording the adverse events. MedDRA (medical dictionary for regulatory activities) has been widely recommended and applied in the world as a powerful support for the adverse events reporting in clinical trials. In this paper, the development history, applicable scope, hierarchy structure, encoding term selection and standardized query strategies of the MedDRA is introduced. Furthermore, the practical process of adverse events encoding with MedDRA is proposed. Finally, the framework of statistical analysis about adverse events is discussed. PMID:26911031

  4. TeleMed: Wide-area, secure, collaborative object computing with Java and CORBA for healthcare

    SciTech Connect

    Forslund, D.W.; George, J.E.; Gavrilov, E.M.

    1998-12-31

    Distributed computing is becoming commonplace in a variety of industries with healthcare being a particularly important one for society. The authors describe the development and deployment of TeleMed in a few healthcare domains. TeleMed is a 100% Java distributed application build on CORBA and OMG standards enabling the collaboration on the treatment of chronically ill patients in a secure manner over the Internet. These standards enable other systems to work interoperably with TeleMed and provide transparent access to high performance distributed computing to the healthcare domain. The goal of wide scale integration of electronic medical records is a grand-challenge scale problem of global proportions with far-reaching social benefits.

  5. Genomics of the Proteorhodopsin-Containing Marine Flavobacterium Dokdonia sp. Strain MED134▿†

    PubMed Central

    González, José M.; Pinhassi, Jarone; Fernández-Gómez, Beatriz; Coll-Lladó, Montserrat; González-Velázquez, Mónica; Puigbò, Pere; Jaenicke, Sebastian; Gómez-Consarnau, Laura; Fernàndez-Guerra, Antoni; Goesmann, Alexander; Pedrós-Alió, Carlos

    2011-01-01

    Proteorhodopsin phototrophy is expected to have considerable impact on the ecology and biogeochemical roles of marine bacteria. However, the genetic features contributing to the success of proteorhodopsin-containing bacteria remain largely unknown. We investigated the genome of Dokdonia sp. strain MED134 (Bacteroidetes) for features potentially explaining its ability to grow better in light than darkness. MED134 has a relatively high number of peptidases, suggesting that amino acids are the main carbon and nitrogen sources. In addition, MED134 shares with other environmental genomes a reduction in gene copies at the expense of important ones, like membrane transporters, which might be compensated by the presence of the proteorhodopsin gene. The genome analyses suggest Dokdonia sp. MED134 is able to respond to light at least partly due to the presence of a strong flavobacterial consensus promoter sequence for the proteorhodopsin gene. Moreover, Dokdonia sp. MED134 has a complete set of anaplerotic enzymes likely to play a role in the adaptation of the carbon anabolism to the different sources of energy it can use, including light or various organic matter compounds. In addition to promoting growth, proteorhodopsin phototrophy could provide energy for the degradation of complex or recalcitrant organic matter, survival during periods of low nutrients, or uptake of amino acids and peptides at low concentrations. Our analysis suggests that the ability to harness light potentially makes MED134 less dependent on the amount and quality of organic matter or other nutrients. The genomic features reported here may well be among the keys to a successful photoheterotrophic lifestyle. PMID:22003006

  6. Understanding PubMed® user search behavior through log analysis

    PubMed Central

    Islamaj Dogan, Rezarta; Murray, G. Craig; Névéol, Aurélie; Lu, Zhiyong

    2009-01-01

    This article reports on a detailed investigation of PubMed users’ needs and behavior as a step toward improving biomedical information retrieval. PubMed is providing free service to researchers with access to more than 19 million citations for biomedical articles from MEDLINE and life science journals. It is accessed by millions of users each day. Efficient search tools are crucial for biomedical researchers to keep abreast of the biomedical literature relating to their own research. This study provides insight into PubMed users’ needs and their behavior. This investigation was conducted through the analysis of one month of log data, consisting of more than 23 million user sessions and more than 58 million user queries. Multiple aspects of users’ interactions with PubMed are characterized in detail with evidence from these logs. Despite having many features in common with general Web searches, biomedical information searches have unique characteristics that are made evident in this study. PubMed users are more persistent in seeking information and they reformulate queries often. The three most frequent types of search are search by author name, search by gene/protein, and search by disease. Use of abbreviation in queries is very frequent. Factors such as result set size influence users’ decisions. Analysis of characteristics such as these plays a critical role in identifying users’ information needs and their search habits. In turn, such an analysis also provides useful insight for improving biomedical information retrieval. Database URL: http://www.ncbi.nlm.nih.gov/PubMed PMID:20157491

  7. A Computational Protein Phenotype Prediction Approach to Analyze the Deleterious Mutations of Human MED12 Gene.

    PubMed

    Banaganapalli, Babajan; Mohammed, Kaleemuddin; Khan, Imran Ali; Al-Aama, Jumana Y; Elango, Ramu; Shaik, Noor Ahmad

    2016-09-01

    Genetic mutations in MED12, a subunit of Mediator complex are seen in a broad spectrum of human diseases. However, the underlying basis of how these pathogenic mutations elicit protein phenotype changes in terms of 3D structure, stability and protein binding sites remains unknown. Therefore, we aimed to investigate the structural and functional impacts of MED12 mutations, using computational methods as an alternate to traditional in vivo and in vitro approaches. The MED12 gene mutations details and their corresponding clinical associations were collected from different databases and by text-mining. Initially, diverse computational approaches were applied to categorize the different classes of mutations based on their deleterious impact to MED12. Then, protein structures for wild and mutant types built by integrative modeling were analyzed for structural divergence, solvent accessibility, stability, and functional interaction deformities. Finally, this study was able to identify that genetic mutations mapped to exon-2 region, highly conserved LCEWAV and Catenin domains induce biochemically severe amino acid changes which alters the protein phenotype as well as the stability of MED12-CYCC interactions. To better understand the deleterious nature of FS-IDs and Indels, this study asserts the utility of computational screening based on their propensity towards non-sense mediated decay. Current study findings may help to narrow down the number of MED12 mutations to be screened for mediator complex dysfunction associated genetic diseases. This study supports computational methods as a primary filter to verify the plausible impact of pathogenic mutations based on the perspective of evolution, expression and phenotype of proteins. J. Cell. Biochem. 117: 2023-2035, 2016. © 2016 Wiley Periodicals, Inc. PMID:26813965

  8. CDAPubMed: a browser extension to retrieve EHR-based biomedical literature

    PubMed Central

    2012-01-01

    Background Over the last few decades, the ever-increasing output of scientific publications has led to new challenges to keep up to date with the literature. In the biomedical area, this growth has introduced new requirements for professionals, e.g., physicians, who have to locate the exact papers that they need for their clinical and research work amongst a huge number of publications. Against this backdrop, novel information retrieval methods are even more necessary. While web search engines are widespread in many areas, facilitating access to all kinds of information, additional tools are required to automatically link information retrieved from these engines to specific biomedical applications. In the case of clinical environments, this also means considering aspects such as patient data security and confidentiality or structured contents, e.g., electronic health records (EHRs). In this scenario, we have developed a new tool to facilitate query building to retrieve scientific literature related to EHRs. Results We have developed CDAPubMed, an open-source web browser extension to integrate EHR features in biomedical literature retrieval approaches. Clinical users can use CDAPubMed to: (i) load patient clinical documents, i.e., EHRs based on the Health Level 7-Clinical Document Architecture Standard (HL7-CDA), (ii) identify relevant terms for scientific literature search in these documents, i.e., Medical Subject Headings (MeSH), automatically driven by the CDAPubMed configuration, which advanced users can optimize to adapt to each specific situation, and (iii) generate and launch literature search queries to a major search engine, i.e., PubMed, to retrieve citations related to the EHR under examination. Conclusions CDAPubMed is a platform-independent tool designed to facilitate literature searching using keywords contained in specific EHRs. CDAPubMed is visually integrated, as an extension of a widespread web browser, within the standard PubMed interface. It has

  9. PyMedTermino: an open-source generic API for advanced terminology services.

    PubMed

    Lamy, Jean-Baptiste; Venot, Alain; Duclos, Catherine

    2015-01-01

    The integration of terminologies is still a challenging problem in medical informatics research and software applications, due to the high number of heterogeneous terminologies. In this paper, we present a generic API (Application Programming Interface) for a multi-terminology multilingual terminology service, and PyMedTermino, its open-source implementation in Python with 5 terminological resources (ICD10, SNOMED CT, MedDRA, CDF, VCM iconic language) and the UMLS compendium. This service has been designed for research and educational purpose. It offers various advanced functionalities rarely present in terminology services. PMID:25991291

  10. Determining correspondences between high-frequency MedDRA concepts and SNOMED: a case study

    PubMed Central

    2010-01-01

    Background The Systematic Nomenclature of Medicine Clinical Terms (SNOMED CT) is being advocated as the foundation for encoding clinical documentation. While the electronic medical record is likely to play a critical role in pharmacovigilance - the detection of adverse events due to medications - classification and reporting of Adverse Events is currently based on the Medical Dictionary of Regulatory Activities (MedDRA). Complete and high-quality MedDRA-to-SNOMED CT mappings can therefore facilitate pharmacovigilance. The existing mappings, as determined through the Unified Medical Language System (UMLS), are partial, and record only one-to-one correspondences even though SNOMED CT can be used compositionally. Efforts to map previously unmapped MedDRA concepts would be most productive if focused on concepts that occur frequently in actual adverse event data. We aimed to identify aspects of MedDRA that complicate mapping to SNOMED CT, determine pattern in unmapped high-frequency MedDRA concepts, and to identify types of integration errors in the mapping of MedDRA to UMLS. Methods Using one years' data from the US Federal Drug Administrations Adverse Event Reporting System, we identified MedDRA preferred terms that collectively accounted for 95% of both Adverse Events and Therapeutic Indications records. After eliminating those already mapping to SNOMED CT, we attempted to map the remaining 645 Adverse-Event and 141 Therapeutic-Indications preferred terms with software assistance. Results All but 46 Adverse-Event and 7 Therapeutic-Indications preferred terms could be composed using SNOMED CT concepts: none of these required more than 3 SNOMED CT concepts to compose. We describe the common composition patterns in the paper. About 30% of both Adverse-Event and Therapeutic-Indications Preferred Terms corresponded to single SNOMED CT concepts: the correspondence was detectable by human inspection but had been missed during the integration process, which had created