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Sample records for incisionless fundoplication tif

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

    PubMed Central

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

    2016-01-01

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

  2. Antireflux Transoral Incisionless Fundoplication Using EsophyX: 12-Month Results of a Prospective Multicenter Study

    PubMed Central

    Buset, Michel; Muls, Vinciane; Rajan, Amin; Rösch, Thomas; Eckardt, Alexander J.; Weerts, Joseph; Bastens, Boris; Costamagna, Guido; Marchese, Michele; Louis, Hubert; Mana, Fazia; Sermon, Filip; Gawlicka, Anna K.; Daniel, Michael A.; Devière, Jacques

    2008-01-01

    Background A novel transoral incisionless fundoplication (TIF) procedure using the EsophyX system with SerosaFuse fasteners was designed to reconstruct a full-thickness valve at the gastroesophageal junction through tailored delivery of multiple fasteners during a single-device insertion. The safety and efficacy of TIF for treating gastroesophageal reflux disease (GERD) were evaluated in a prospective multicenter trial. Methods Patients (n = 86) with chronic GERD treated with proton pump inhibitors (PPIs) were enrolled. Exclusion criteria included an irreducible hiatal hernia > 2 cm. Results The TIF procedure (n = 84) reduced all hiatal hernias (n = 49) and constructed valves measuring 4 cm (2–6 cm) and 230° (160°–300°). Serious adverse events consisted of two esophageal perforations upon device insertion and one case of postoperative intraluminal bleeding. Other adverse events were mild and transient. At 12 months, aggregate (n = 79) and stratified Hill grade I tight (n = 21) results showed 73% and 86% of patients with ≥50% improvement in GERD health-related quality of life (HRQL) scores, 85% discontinuation of daily PPI use, and 81% complete cessation of PPIs; 37% and 48% normalization of esophageal acid exposure; 60% and 89% hiatal hernia reduction; and 62% and 80% esophagitis reduction, respectively. More than 50% of patients with Hill grade I tight valves had a normalized cardia circumference. Resting pressure of the lower esophageal sphincter (LES) was improved significantly (p < 0.001), by 53%. EsophyX-TIF cured GERD in 56% of patients based on their symptom reduction and PPI discontinuation. Conclusion The 12-month results showed that EsophyX-TIF was safe and effective in improving quality of life and for reducing symptoms, PPI use, hiatal hernia, and esophagitis, as well as increasing the LES resting pressure and normalizing esophageal pH and cardia circumference in chronic GERD patients. PMID:18443855

  3. Needlescopic fundoplication.

    PubMed

    Pace, D E; Chiasson, P M; Schlachta, C M; Poulin, E C; Boutros, Y; Mamazza, J

    2002-04-01

    Minimally invasive surgery continues to evolve, with an emphasis on developing new techniques and applying new technology to surgical procedures. The purpose of this study was to compare the short-term outcomes of needlescopic fundoplication with those of conventional laparoscopic fundoplication. Between January 1999 and June 2000, 38 needlescopic fundoplications were performed, and the short-term outcomes for these patients were compared with those for a contemporary matched cohort of patients who had undergone a conventional laparoscopic fundoplication. There was a nonsignificant trend toward decreased operative time (143.4 to 127 min; p = 0.13), blood loss (54.3 to 48 ml; p = 0.30), narcotic requirements (29.5 to 19.5 morphine equivalents; p = 0.32), and length of hospital stay (1.78 to 1.49 days; p = 0.10) in the needlescopic group. There were no significant differences in intraoperative complications (2.6% vs 2.6%; p = 1.0). Two needlescopic cases were converted to laparoscopic cases because of obesity. Postoperatively, there were no significant differences in rates of early dysphagia (7.9% vs 7.9%), bloating (13.2% vs 5.3%; p = 0.43), or other complications (5.3% vs 5.3%) between the groups. There was a significant reduction in mean operative time for needlescopic fundoplication after the first four cases (166 +/- 44 vs 120 +/- 32 min; p = 0.03). Needlescopic fundoplication poses no disadvantage, and it offers the added cosmetic benefit of smaller incisions.

  4. When Fundoplication Fails

    PubMed Central

    Smith, C Daniel; McClusky, David A.; Rajad, Murad Abu; Lederman, Andrew B.; Hunter, John G.

    2005-01-01

    Objective: The largest series in the literature dealing with redo fundoplication was presented and published in 1999 and included 100 patients. Herein we update this initial series of 100, with 207 additional patients who have undergone redo fundoplication (n = 307). Summary Background Data: Increasing numbers of patients are failing esophagogastric fundoplication and requiring redo procedures. Data regarding the nature of these failures have been scant. Methods: Data on all patients undergoing foregut surgery are collected prospectively. Between 1991 and 2004, 307 patients underwent redo fundoplication for the management of anatomic complications or recurrent GERD. Statistical analysis was performed with multiple χ2 and Mann-Whitney U analyses, as well as ANOVA. Results: Between 1991 and 2004, 1892 patients underwent primary fundoplication for GERD (1734) or paraesophageal hernia (158). Of these, 54 required redo fundoplication (2.8%). The majority of failures (73%) were managed within 2 years of the initial operation (P = 0.0001). The mechanism of failure was transdiaphragmatic wrap herniation in 33 of 54 (61%). In the 231 patients who underwent fundoplication elsewhere, 109 had transdiaphragmatic herniation (47%, P = NS). In this group of 285 patients, 22 (8%) required another redo (P = NS). The majority of the procedures were initiated laparoscopically (240/307, 78%), with 20 converted (8%). Overall mortality was 0.3%. Conclusions: Failure of fundoplication is unusual in experienced hands. Most are managed within 2 years of the initial operation. Wrap herniation has now become the most common mechanism of failure requiring redo. Redo fundoplication was successful in 93% of patients, and most could be safely handled laparoscopically. PMID:15912035

  5. Laparoscopic Nissen fundoplication.

    PubMed Central

    Jamieson, G G; Watson, D I; Britten-Jones, R; Mitchell, P C; Anvari, M

    1994-01-01

    OBJECTIVE: The authors laparoscopic approach for a Nissen fundoplication is presented. SUMMARY BACKGROUND DATA: The technique has been undertaken in 155 patients over 29 months, with 137 patients having been observed for more than 3 months. METHODS: Three hundred sixty degree fundoplication was undertaken using three or four sutures to secure the wrap. Short gastric vessels were not divided, and the anterior wall of the stomach was used to construct the wrap around the esophagus with a large bougie in position. RESULTS: The operation was not completed laparoscopically in 19 patients because a satisfactory wrap could not be achieved. Ten patients undergoing laparoscopic fundoplication underwent a subsequent operation related to the laparoscopic procedure within 6 months, and there was one postoperative death. Seven other patients were readmitted to the hospital several days subsequent to their discharge, four because of pulmonary emboli. Of 137 patients who have been observed for more than 3 months, 133 patients are well and currently are free from reflux symptoms. CONCLUSIONS: In uncomplicated cases, laparoscopic fundoplication has similar advantages to laparoscopic cholecystectomy. In spite of the fact that it has not yet achieved the overall usefulness of open fundoplication, it seems likely that laparoscopic fundoplication will be used increasingly in the treatment of patients with gastroesophageal reflux disease. Images Figure 7. Figure 8. PMID:8053735

  6. Fundoplication improves disordered esophageal motility.

    PubMed

    Heider, T Ryan; Behrns, Kevin E; Koruda, Mark J; Shaheen, Nicholas J; Lucktong, Tananchai A; Bradshaw, Barbara; Farrell, Timothy M

    2003-02-01

    Patients with gastroesophageal reflux disease (GERD) and disordered esophageal motility are at risk for postoperative dysphagia, and are often treated with partial (270-degree) fundoplication as a strategy to minimize postoperative swallowing difficulties. Complete (360-degree) fundoplication, however, may provide more effective and durable reflux protection over time. Recently we reported that postfundoplication dysphagia is uncommon, regardless of preoperative manometric status and type of fundoplication. To determine whether esophageal function improves after fundoplication, we measured postoperative motility in patients in whom disordered esophageal motility had been documented before fundoplication. Forty-eight of 262 patients who underwent laparoscopic fundoplication between 1995 and 2000 satisfied preoperative manometric criteria for disordered esophageal motility (distal esophageal peristaltic amplitude < or =30 mm Hg and/or peristaltic frequency < or =80%). Of these, 19 had preoperative manometric assessment at our facility and consented to repeat study. Fifteen (79%) of these patients had a complete fundoplication and four (21%) had a partial fundoplication. Each patient underwent repeat four-channel esophageal manometry 29.5 +/- 18.4 months (mean +/- SD) after fundoplication. Distal esophageal peristaltic amplitude and peristaltic frequency were compared to preoperative data by paired t test. After fundoplication, mean peristaltic amplitude in the distal esophagus increased by 47% (56.8 +/- 30.9 mm Hg to 83.5 +/- 36.5 mm Hg; P < 0.001) and peristaltic frequency improved by 33% (66.4 +/- 28.7% to 87.6 +/- 16.3%; P < 0.01). Normal esophageal motor function was present in 14 patients (74%) after fundoplication, whereas in five patients the esophageal motor function remained abnormal (2 improved, 1 worsened, and 2 remained unchanged). Three patients with preoperative peristaltic frequencies of 0%, 10%, and 20% improved to 84%, 88%, and 50%, respectively

  7. Training system for laparoscopic fundoplication.

    PubMed

    Yokoyama; Mailaender; Raestrup; Buess

    2003-07-01

    Laparoscopic fundoplication is widely used today as a surgical standard for gastro-esophageal reflux disease (GERD). However, the procedures are complicated and require advanced laparoscopic skills. In addition, surgical complications correlate with the surgeon's technique and experience. Thus, a training course in laparoscopic fundoplication should be attended before performing surgery. This paper reports on a training course for laparoscopic Nissen fundoplication developed by our group. This course involves practice in suture knotting as part of the laparoscopic operation, practical experience in fundoplication using a porcine organ training model, and observation of a live operation in the operating room. The course improves laparoscopic skills via practical experience and contributes to the learning curve for laparoscopic fundoplication.

  8. Single-Site Nissen Fundoplication Versus Laparoscopic Nissen Fundoplication

    PubMed Central

    Sharp, Nicole E.; Vassaur, John

    2014-01-01

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

  9. Laparoscopic Nissen fundoplication.

    PubMed

    Nowzaradan, Y; Barnes, P

    1993-10-01

    A technique for laparoscopic Nissen fundoplication is described and a series of 11 cases is presented. The technique secures the patient to the operating table with three safety straps and the patient is then placed in a reverse Trendelenburg position with the hips flexed. The surgeon operates from the patient's right side using two midline trocar sites as the main operating ports. Other ports provide retraction and laparoscope access. The liver retractor is held by a mechanical arm. Once the esophageal peritoneum has been opened, the esophagus and diaphragmatic crura are dissected out and elevated by a Penrose drain sling. The short gastrics are divided and the fundus is brought posterior to the esophagus passing from left to right. A large Maloney dilator is placed in the esophagus and the fundal wrap is sutured to the anterior aspect of the stomach by three sutures; the inferior--most of which incorporates the anterior wall of the esophagus. Once the fundoplication is completed, the dilator is replaced by a nasogastric tube. Postoperatively, patients are given clear liquids and when these are tolerated the nasogastric tube is removed. Most patients are discharged on the second or third postoperative day. Operating time averaged 147 min, and all patients returned to unrestricted activity within 2 to 3 weeks. All patients reported complete relief of gastroesophageal reflux. Average follow up was 120 days with a median of 148 days. Long-term follow up is in progress.

  10. Laparoscopic fundoplication for gastroesophageal reflux disease.

    PubMed

    Frazzoni, Marzio; Piccoli, Micaela; Conigliaro, Rita; Frazzoni, Leonardo; Melotti, Gianluigi

    2014-10-21

    Gastroesophageal reflux disease (GERD) is a condition that develops when the reflux of gastric contents into the esophagus leads to troublesome symptoms and/or complications. Heartburn is the cardinal symptom, often associated with regurgitation. In patients with endoscopy-negative heartburn refractory to proton pump inhibitor (PPI) therapy and when the diagnosis of GERD is in question, direct reflux testing by impedance-pH monitoring is warranted. Laparoscopic fundoplication is the standard surgical treatment for GERD. It is highly effective in curing GERD with a 80% success rate at 20-year follow-up. The Nissen fundoplication, consisting of a total (360°) wrap, is the most commonly performed antireflux operation. To reduce postoperative dysphagia and gas bloating, partial fundoplications are also used, including the posterior (Toupet) fundoplication, and the anterior (Dor) fundoplication. Currently, there is consensus to advise laparoscopic fundoplication in PPI-responsive GERD only for those patients who develop untoward side-effects or complications from PPI therapy. PPI resistance is the real challenge in GERD. There is consensus that carefully selected GERD patients refractory to PPI therapy are eligible for laparoscopic fundoplication, provided that objective evidence of reflux as the cause of ongoing symptoms has been obtained. For this purpose, impedance-pH monitoring is regarded as the diagnostic gold standard.

  11. Fundoplication for laryngopharyngeal reflux despite preoperative dysphagia.

    PubMed

    Falk, G L; Van der Wall, H; Burton, L; Falk, M G; O'Donnell, H; Vivian, S J

    2017-03-01

    INTRODUCTION Fundoplication for laryngopharyngeal disease with oesophageal dysmotility has led to mixed outcomes. In the presence of preoperative dysphagia and oesophageal dysmotility, this procedure has engendered concern in certain regards. METHODS This paper describes a consecutive series of laryngopharyngeal reflux (LPR) patients with a high frequency of dysmotility. Patients were selected for surgery with 24-hour dual channel pH monitoring, oesophageal manometry and standardised reflux scintigraphy. RESULTS Following careful patient selection, 33 patients underwent fundoplication by laparoscopy. Surgery had high efficacy in symptom control and there was no adverse dysphagia. CONCLUSIONS Evidence of proximal reflux can select a group of patients for good results of fundoplication for atypical symptoms.

  12. Fundoplication

    MedlinePlus

    ... by wrapping the upper portion of the stomach (fundus) around the lower portion of the esophagus. This ... or it may be performed using a small camera (laparoscope) and instruments placed through three to four ...

  13. Evidence-Based Appraisal of Antireflux Fundoplication

    PubMed Central

    Catarci, Marco; Gentileschi, Paolo; Papi, Claudio; Carrara, Alessandro; Marrese, Renato; Gaspari, Achille Lucio; Grassi, Giovanni Battista

    2004-01-01

    Objective: To highlight the current available evidence in antireflux surgery through a systematic review of randomized controlled trials (RCTs). Summary Background Data: Laparoscopic fundoplication is currently suggested as the gold standard for the surgical treatment of gastroesophageal reflux disease, but many controversies are still open concerning the influence of some technical details on its results. Methods: Papers related to RCTs identified via a systematic literature search were evaluated according to standard criteria. Data regarding the patient sample, study methods, and outcomes were abstracted and summarized across studies. Defined outcomes were examined for 41 papers published from 1974 to 2002 related to 25 RCTs. A meta-analysis was performed pooling the results as odds ratios (OR), rate differences (RD), and number needed to treat (NNT). Data given as mean and/or median values were pooled as a mean ± SD (SD). Results: No perioperative deaths were found in any of the RCTs. Immediate results showed a significantly lower operative morbidity rate (10.3% versus 26.7%, OR 0.33, RD −12%, NNT 8), shorter postoperative stay (3.1 versus 5.2 days, P = 0.03), and shorter sick leave (20.1 versus 35.8 days, P = 0.03) for laparoscopic versus open fundoplication. No significant differences were found regarding the incidence of recurrence, dysphagia, bloating, and reoperation for failure at midterm follow-up. No significant differences in operative morbidity (13.1% versus 9.4%) and in operative time (90.2 versus 84.2 minutes) were found in partial versus total fundoplication. A significantly lower incidence of reoperation for failure (1.6% versus 9.6%, OR 0.21, RD −7%, NNT 14) was found after partial fundoplication, with no significant differences regarding the incidence of recurrence and/or dysphagia. Routine division of short gastric vessels during total fundoplication showed no significant advantages regarding the incidence of postoperative dysphagia and

  14. Laparoscopic fundoplication: a new technique with new complications?

    PubMed

    Overdijk, L E; Rademaker, B M; Ringers, J; Odoom, J A

    1994-01-01

    We report pneumomediastinum, pneumopericardium, and subcutaneous emphysema occurring in patients who underwent laparoscopic fundoplication in our clinic. These complications might adversely affect hemodynamics during this procedure.

  15. Over 250 Laparoendoscopic Single Site (LESS) Fundoplications: Lessons Learned.

    PubMed

    Sukharamwala, Prashant; Teta, Anthony; Ross, Sharona; Co, Franka; Alvarez-Calderon, Giannina; Luberice, Kenneth; Rosemurgy, Alexander

    2015-09-01

    Laparoendoscopic single site (LESS) surgery is a more recent advance in the progression of minimally invasive surgery. This study was undertaken to assess lessons learned after our first 250 LESS fundoplications for gastroesophageal reflux disease (GERD). All patients undergoing LESS fundoplications were prospectively followed from 2008 to 2014. Patients scored the frequency/severity of their symptoms before/after LESS fundoplication using a Likert scale (0 = never/not bothersome to 10 = always/very bothersome). Patients also scored satisfaction with their incision using a Likert scale (1 = revolting to 10 = beautiful). A total of 300 patients undergoing LESS fundoplication for GERD were not different by age or gender. Surgeons undertook 190 Nissen fundoplications and 110 Toupet fundoplications; 28 of which were "redo" fundoplications. Preoperative symptoms were notable, especially heartburn (frequency = 8, severity = 7). Symptoms were ameliorated postoperatively (e.g., heartburn: frequency = 0, severity = 0, P < 0.01). Postoperatively, patients scored satisfaction of their incisions with a median score of 10. Eighty-three per cent of patients were at least satisfied with their overall experience; 92 per cent would undergo the operation again knowing what they know now. Patients report significant symptom relief, high satisfaction, and excellent cosmesis after LESS fundoplication. LESS fundoplication safely ameliorates symptoms of GERD with pronounced satisfaction, in part, because of the cosmetic outcome (i.e., lack of scaring), and its application is encouraged.

  16. Impact of Scoliosis on Laparoscopic Nissen Fundoplication.

    PubMed

    Ishimaru, Tetsuya; Sugiyama, Masahiko; Arai, Mari; Satoh, Kaori; Uotani, Chizue; Takahashi, Masataka; Takami, Shohei; Fujishiro, Jun; Iwanaka, Tadashi

    2016-11-01

    Scoliosis, which is often associated with neurological impairment in children, sometimes makes it difficult to perform laparoscopic procedures. This study assessed the impact of scoliosis on performing laparoscopic Nissen fundoplication. Medical records and radiographic examinations of patients who underwent laparoscopic Nissen fundoplication at a single institution from 2006 to 2015 were reviewed retrospectively. Patients' data on age at surgery, height, weight, duration of pneumoperitoneum, and amount of bleeding were collected. The Cobb angle was measured using X-rays, and the direction (right or left) of the scoliotic curve was recorded. The chest compression ratio was calculated using computed tomography axial images. Eighty-five patients were included and analyzed in this study, of which 89% were neurologically impaired. Median age, height, and weight were 120 months, 110 cm, and 17 kg, respectively. A positive correlation between age and the Cobb angle (ρ = 0.64) and a negative correlation between age and the chest compression ratio (ρ = -0.56) were observed. The right-curved scoliotic group showed significantly more bleeding than the nonscoliotic (<10°) group (P = .01; nonscoliotic, 0 mL; right curved, 7.5 mL; left curved, 0 mL). The severe scoliotic group (≥45°) showed more bleeding than the nonscoliotic group (P = .02). Neither the direction of the scoliotic curve nor scoliotic severity showed a significant difference in the duration of pneumoperitoneum. The older the patient, the more severe their scoliosis and chest compression were. Right-curved or severe scoliosis could be risk factors for intraoperative bleeding in laparoscopic Nissen fundoplication.

  17. Laparoscopic fundoplication: learning curve and patient satisfaction.

    PubMed Central

    Menon, V. S.; Manson, J. McK; Baxter, J. N.

    2003-01-01

    AIMS: Laparoscopic fundoplication is now accepted as the optimal surgical option for the management of selected cases of gastro-oesophageal reflux disease. The principal aim of this study was to evaluate the learning curve experience of two consultant surgeons in the technique of laparoscopic fundoplication (LF). Additional variables assessed were total number of cases, preoperative investigations, conversion rate, duration of operation, ASA grade, morbidity, mortality, necessity of further procedures, and patient satisfaction rate. PATIENTS AND METHODS: Retrospective case-note analysis of all adult patients who underwent fundoplication under the care of two consultant general surgeons over a 3-year period from January 1997 to December 1999. RESULTS: A total of 61 patients were included, 31 males and 30 females, with a median age of 46 years (range, 21-73 years). Of the patients, 90% were either ASA 1 or 2. The mean time for which the 24-h pH < 4 was 20.5% (95% CI, 15.3-25.7). Of the 61 patients, 6 were operated on by open technique, for medical reasons and previous abdominal procedures. Out of the remaining 55 patients, 13 had to be converted (23.6%). Mean operating times were 120 min for LF, 85 min for open operation and 142 min for LF plus conversion. There was a significant decline in conversion rate with time (P < 0.002). Mortality was nil. One patient had a perforation of the cricopharyngeus secondary to insertion of a bougie. The mean length of hospital stay following the laparoscopic technique was 3.4 days compared to 8.7 days following the open technique. Overall, 59 patients (96%) were happy with the result, and the operation failed in 2 patients. Five patients (8%) needed endoscopic dilatation in the first few weeks after the operation. CONCLUSIONS: The results show that LF is a safe procedure, takes longer than open procedure, and has an acceptable morbidity. Experience with the technique reduces the need for conversion. The mean length of hospital stay

  18. Mathematical model of fluid flow in fundoplication

    NASA Astrophysics Data System (ADS)

    Ghosh, S. K.; Zaki, T. A.; Brasseur, J. G.; Kahrilas, P. J.

    2000-11-01

    Fundoplication is a surgical procedure to reduce chronic acid reflux that permanently narrows the diameter and lengthens the "hiatus" at the esophagus-stomach junction. However, muscle tone required to force a food "bolus" from the esophageal "ampulla" through the constricted hiatus to the stomach increases. Our aim was to analyze these supranormal tonic requirements using a mathematical model. The hiatus was modeled as a narrow axisymmetric tube through which viscous liquid is forced from a modeled ampulla to an isobaric outlet. The time changes in ampullary pressure were calculated using lubrication theory with specified time changes in length and radius of the ampulla and hiatal canal, parametrized from radiographic data. Whereas measurements show that ampullary pressure increases during emptying, the model indicates that a nonlinear reduction in ampullary radius with time is required. Two distinct phases in emptying are predicted, an initial period in which pressure depends both on hiatal diameter and length, and a final period of rapid pressure increase that depends only on hiatal length. These results have important implications to surgery.

  19. Fundoplication for Gastroesophageal Reflux Disease: Tips for Success.

    PubMed

    Patti, Marco G; Schlottmann, Francisco; Farrell, Timothy M

    2017-01-01

    Gastroesophageal reflux disease affects almost 20% of the population in the United States. Today, proton pump inhibitors are the most frequently prescribed drugs, with an estimated cost of 10 billion dollars per year. Although these medications control heartburn in the majority of patients, other symptoms such as regurgitation and respiratory symptoms often are not controlled, particularly in patients with large hiatal hernias. In these patients a properly performed laparoscopic fundoplication controls esophageal and extraesophageal symptoms and avoids life-long medical therapy. Key elements for the success of a fundoplication are careful patient selection, a complete preoperative evaluation, and a properly executed operation.

  20. Comparison of the result of consolidative technique otoplasty and incisionless otoplasty in the repairs of prominent ears.

    PubMed

    Temel, Metin; Şamil Kahraman, Ş; Berber, Özge; Çevik, Cengiz; Akoğlu, Ertap

    2016-10-01

    We aimed to compare the long-term results of complications of consolidative technique otoplasty (CTO) and incisionless otoplasty (IO). The study consists of 156 patients who were operated between 2006 and 2015. According to surgical techniques, these patients were divided into two groups as IO group and CTO group. The distance between the head and the ear was assessed by measuring the four points preoperatively and postoperatively (SUP: most superior helical point, SCA: superior conchal attachment, ICA: inferior conchal attachment, and lobule). Early and late postoperative complications, operative time were recorded. 128 ears in IO group, 163 ears in CTO group were prominent. When postoperative SUP, SCA, ICA, lobule values for right and left ears in both groups were statistically evaluated, it was found that CTO technique has led to significantly greater improvement compared to the IO technique (p < 0.001). The success rate in IO technique and CTO technique was 72 and 96 %, respectively. Early complications were similar in both groups. The late period complication determined much more frequently was seen in the IO group. Concerning operative time, it was identified as significantly lower in the IO group (p < 0.001). The early-term outcomes of both techniques were similar; however, the complication rates due to suture material and needed for revision in IO technique were higher whereas CTO technique was more permanent with lower complication risks.

  1. Recurrent heartburn after laparoscopic fundoplication is not always recurrent reflux.

    PubMed

    Thompson, Sarah K; Jamieson, Glyn G; Myers, Jennifer C; Chin, Kin-Fah; Watson, David I; Devitt, Peter G

    2007-05-01

    A small cohort of patients present after antireflux surgery complaining of recurrent heartburn. Many of these patients have been empirically recommenced on proton pump inhibitors. The aim of this study was to determine whether patients with symptoms that suggest recurrent reflux had objective evidence of reflux, and to determine predictors of recurrent reflux. We identified all patients from an existing database who had undergone pH monitoring for "recurrent heartburn" after fundoplication. These patients were then cross-referenced to another database, which recorded the outcomes for patients who had undergone a laparoscopic fundoplication. Patients complaining of dysphagia or other problems without heartburn were excluded from analysis. Seventy-six patients were identified who met the inclusion criteria. Fifty-six (74%) of these had a normal 24-h pH study. Thirty-five patients (63%) with a normal pH study were on medication for heartburn at the time of referral. Three factors were found to be associated with an abnormal 24-h pH study: a partial fundoplication (P = 0.039), onset of symptoms 6 months or more after surgery (P < 0.001), and a good symptom response when antireflux medication was recommenced (P = 0.015). Not all patients complaining of recurrent heartburn after fundoplication have evidence of abnormal reflux. Objective evidence of abnormal esophageal acid exposure should be confirmed before recommencing antireflux medication.

  2. Dumping Syndrome as a Complication of Laparoscopic Nissen Fundoplication in an Adult

    PubMed Central

    Kreckler, Simon; Dowson, Henry

    2006-01-01

    Background: Dumping syndrome is a recognized complication of various gastric surgical procedures, such as vagotomy, pyloroplasty, and gastrojejunostomy. However, it has not to date been reported following laparoscopic Nissen fundoplication in adults. Case Report: We describe the case of a 34-year-old woman who developed late dumping syndrome following an uneventful laparoscopic Nissen fundoplication for gastroesophageal reflux disease. Conclusion: This condition should be considered in patients who develop hypoglycemic symptoms following laparoscopic fundoplication. PMID:16709369

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

    PubMed Central

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

    1996-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  5. Is Dor fundoplication optimum after laparoscopic Heller myotomy for achalasia? A meta-analysis.

    PubMed

    Wei, Ming-Tian; He, Ya-Zhou; Deng, Xiang-Bing; Zhang, Yuan-Chuan; Yang, Ting-Han; Jin, Cheng-Wu; Hu, Bing; Wang, Zi-Qiang

    2013-11-21

    To compare the outcome of acid reflux prevention by Dor fundoplication after laparoscopic Heller myotomy (LHM) for achalasia. Electronic database PubMed, Ovid (Evidence-Based Medicine Reviews, EmBase and Ovid MEDLINE) and Cochrane Library were searched between January 1995 and September 2012. Bibliographic citation management software (EndNote X3) was used for extracted literature management. Quality assessment of random controlled studies (RCTs) and non-RCTs was performed according to the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and a modification of the Newcastle-Ottawa Scale, respectively. The data were analyzed using Review Manager (Version 5.1), and sensitivity analysis was performed by sequentially omitting each study. Finally, 6 studies, including a total of 523 achalasia patients, compared Dor fundoplication with other types of fundoplication after LHM (Dor-other group), and 8 studies, including a total of 528 achalasia patients, compared Dor fundoplication with no fundoplication after LHM (Dor-no group). Dor fundoplication was associated with a significantly higher recurrence rate of clinical regurgitation and pathological acid reflux compared with the other fundoplication group (OR = 7.16, 95%CI: 1.25-40.93, P = 0.03, and OR = 3.79, 95%CI: 1.23-11.72, P = 0.02, respectively). In addition, there were no significant differences between Dor fundoplication and no fundoplication in all subjects. Other outcomes, including complications, dysphagia, postoperative physiologic testing, and operation-related data displayed no significant differences in the two comparison groups. Dor fundoplication is not the optimum procedure after LHM for achalasia. We suggest more attention should be paid on quality of life among different fundoplications.

  6. Is Dor fundoplication optimum after laparoscopic Heller myotomy for achalasia? A meta-analysis

    PubMed Central

    Wei, Ming-Tian; He, Ya-Zhou; Deng, Xiang-Bing; Zhang, Yuan-Chuan; Yang, Ting-Han; Jin, Cheng-Wu; Hu, Bing; Wang, Zi-Qiang

    2013-01-01

    AIM: To compare the outcome of acid reflux prevention by Dor fundoplication after laparoscopic Heller myotomy (LHM) for achalasia. METHODS: Electronic database PubMed, Ovid (Evidence-Based Medicine Reviews, EmBase and Ovid MEDLINE) and Cochrane Library were searched between January 1995 and September 2012. Bibliographic citation management software (EndNote X3) was used for extracted literature management. Quality assessment of random controlled studies (RCTs) and non-RCTs was performed according to the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and a modification of the Newcastle-Ottawa Scale, respectively. The data were analyzed using Review Manager (Version 5.1), and sensitivity analysis was performed by sequentially omitting each study. RESULTS: Finally, 6 studies, including a total of 523 achalasia patients, compared Dor fundoplication with other types of fundoplication after LHM (Dor-other group), and 8 studies, including a total of 528 achalasia patients, compared Dor fundoplication with no fundoplication after LHM (Dor-no group). Dor fundoplication was associated with a significantly higher recurrence rate of clinical regurgitation and pathological acid reflux compared with the other fundoplication group (OR = 7.16, 95%CI: 1.25-40.93, P = 0.03, and OR = 3.79, 95%CI: 1.23-11.72, P = 0.02, respectively). In addition, there were no significant differences between Dor fundoplication and no fundoplication in all subjects. Other outcomes, including complications, dysphagia, postoperative physiologic testing, and operation-related data displayed no significant differences in the two comparison groups. CONCLUSION: Dor fundoplication is not the optimum procedure after LHM for achalasia. We suggest more attention should be paid on quality of life among different fundoplications. PMID:24282369

  7. Multislice computed tomography for the study of complications of gastric fundoplication.

    PubMed

    Rodríguez Carnero, P; Herrasti Gallego, A; García Villafañe, C; Méndez Fernández, R; Rodríguez González, R

    2014-01-01

    The traditional approach to the imaging evaluation of patients after gastric fundoplication is an upper gastrointestinal series obtained by fluoroscopy. In this article, we describe a new technique using multislice computed tomography that we think can be useful to evaluate patients with suspected complications or late failure after gastric fundoplication.

  8. Complete fundoplication is not associated with increased dysphagia in patients with abnormal esophageal motility.

    PubMed

    Heider, T R; Farrell, T M; Kircher, A P; Colliver, C C; Koruda, M J; Behrns, K E

    2001-01-01

    Abnormal esophageal motility is a relative contraindication to complete (360-degree) fundoplication because of a purported risk of postoperative dysphagia. Partial fundoplication, however, may be associated with increased postoperative esophageal acid exposure. Our aim was to determine if complete fundoplication is associated with increased postoperative dysphagia in patients with abnormal esophageal motor function. Medical records of 140 patients (79 females; mean age 48 +/- 1.1 years) who underwent fundoplication for gastroesophageal reflux disease (GERD) were reviewed retrospectively to document demographic data, symptoms, and diagnostic test results. Of the 126 patients who underwent complete fundoplication, 25 met manometric criteria for abnormal esophageal motility (#30 mm Hg mean distal esophageal body pressure or #80% peristalsis), 68 had normal esophageal function, and 33 had incomplete manometric data and were therefore excluded from analysis. Of the 11 patients who underwent partial fundoplication, eight met criteria for abnormal esophageal motility, two had normal esophageal function, and one had incomplete data and was therefore excluded. After a median follow-up of 2 years (range 0.5 to 5 years), patients were asked to report heartburn, difficulty swallowing, and overall satisfaction using a standardized scoring scale. Complete responses were obtained in 72%. Sixty-five patients who underwent complete fundoplication and had manometric data available responded (46 normal manometry; 19 abnormal manometry). Outcomes were compared using the Mann-Whitney U test. After complete fundoplication, similar postoperative heartburn, swallowing, and overall satisfaction were reported by patients with normal and abnormal esophageal motility. Likewise, similar outcomes were reported after partial fundoplication. This retrospective study found equally low dysphagia rates regardless of baseline esophageal motility; therefore a randomized trial comparing complete versus

  9. Division of Short Gastric Vessels at Laparoscopic Nissen Fundoplication

    PubMed Central

    O’Boyle, Colm J.; Watson, David I.; Jamieson, Glyn G.; Myers, Jennifer C.; Game, Philip A.; Devitt, Peter G.

    2002-01-01

    Objective To determine whether division of the short gastric vessels at laparoscopic fundoplication confers long-term clinical benefit to patients. Summary Background Data Dividing the short gastric vessels during surgery for gastroesophageal reflux is controversial. This prospective randomized study was designed to determine whether there is a benefit in terms of patient outcome at a minimum of 5 years after primary surgery. Methods Between May 1994 and October 1995, 102 patients undergoing a laparoscopic Nissen fundoplication were randomized to have their short gastric vessels either divided or left intact. By September 2000, 99 (50 no division, 49 division) patients were available for follow-up, and they all underwent a detailed telephone interview by an independent and masked investigator. Results There were no significant differences between the groups at 5 years of follow-up in terms of the incidence of epigastric pain, regurgitation, odynophagia, early satiety, inability to belch, anorexia, nausea, vomiting, nocturnal coughing, and nocturnal wheezing. There was also no difference between the groups in the incidence of heartburn when determined by either yes/no questioning or a 0-to-10 visual analog scale. There was no difference between the groups in terms of the incidence and severity of dysphagia determined by yes/no questioning, 0-to-10 visual analog scales, or a composite dysphagia score. There was a significantly increased incidence of flatus production and epigastric bloating and a decreased incidence of ability to relieve bloating in patients who underwent division of the short gastric vessels. Conclusions Division of the short gastric vessels during laparoscopic Nissen fundoplication does not improve any measured clinical outcome at 5 years of follow-up and is associated with an increased incidence of “wind-related” problems. PMID:11807353

  10. Gastric necrosis: A late complication of nissen fundoplication

    PubMed Central

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

    2014-01-01

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

  11. Post-fundoplication symptoms and complications: Diagnostic approach and treatment.

    PubMed

    Sobrino-Cossío, S; Soto-Pérez, J C; Coss-Adame, E; Mateos-Pérez, G; Teramoto Matsubara, O; Tawil, J; Vallejo-Soto, M; Sáez-Ríos, A; Vargas-Romero, J A; Zárate-Guzmán, A M; Galvis-García, E S; Morales-Arámbula, M; Quiroz-Castro, O; Carrasco-Rojas, A; Remes-Troche, J M

    Laparoscopic Nissen fundoplication is currently considered the surgical treatment of choice for gastroesophageal reflux disease (GERD) and its long-term effectiveness is above 90%. Adequate patient selection and the experience of the surgeon are among the predictive factors of good clinical response. However, there can be new, persistent, and recurrent symptoms after the antireflux procedure in up to 30% of the cases. There are numerous causes, but in general, they are due to one or more anatomic abnormalities and esophageal and gastric function alterations. When there are persistent symptoms after the surgical procedure, the surgery should be described as "failed". In the case of a patient that initially manifests symptom control, but the symptoms then reappear, the term "dysfunction" could be used. When symptoms worsen, or when symptoms or clinical situations appear that did not exist before the surgery, this should be considered a "complication". Postoperative dysphagia and dyspeptic symptoms are very frequent and require an integrated approach to determine the best possible treatment. This review details the pathophysiologic aspects, diagnostic approach, and treatment of the symptoms and complications after fundoplication for the management of GERD. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  12. Gastric necrosis after fundoplication: a novel approach for esophageal preservation.

    PubMed

    Bass, K D; Meagher, D P; Haase, G M

    1998-11-01

    An 11-year-old boy presented moribund, with massive abdominal distension. A Nissen fundoplication and gastrostomy tube had been established at age 2 years. After attempts to pass a nasogastric tube were unsuccessful, the old gastrostomy site was used to gain percutaneous access to the stomach resulting in release of gastric contents and stabilization of blood pressure and perfusion. During operation, massive gastric distention with gastric necrosis was found. Subtotal gastrectomy was performed with stapled closure of the distal intraabdominal esophagus and prepyloric region. Sump suction was placed in the proximal esophagus and the abdomen was drained widely. A distal esophageal perforation was apparent on postoperative day 19 confirmed by imaging and endoscopy. A nasoesophageal tube was passed into the abdomen, tied to a Jackson-Pratt drain, and the composite tube repositioned in the midesophagus allowing controlled proximal and distal drainage. Six months later, a Hunt-Laurence esophagojejunal pouch was created. At age 13, the child is clinically well, and enjoys 50% of his nutritional needs orally, with the remainder delivered overnight via tube feedings. This case describes gastric necrosis after gas bloat syndrome as a late complication of Nissen fundoplication. A novel approach to the management of distal esophageal perforation allowed preservation of a functional, intact native esophagus.

  13. Does the addition of fundoplication to repair the intra-thoracic stomach improve quality of life?

    PubMed

    Svetanoff, Wendy Jo; Pallati, Pradeep; Nandipati, Kalyana; Lee, Tommy; Mittal, Sumeet K

    2016-10-01

    The role of fundoplication in addition to hiatal hernia repair has been controversial. The aim of this study was to compare quality of life related to gastroesophageal reflux disease (GERD) in patients who underwent intra-thoracic stomach repair with and without fundoplication. We proposed that the group without a fundoplication would have poorer quality of life due to continued symptoms. All patients undergoing foregut surgery at the Creighton University Esophageal Center are entered in a prospectively maintained database. The database was queried to identify patients who underwent surgery for a near complete (>75 % of stomach in chest) intra-thoracic stomach with gastric volvulus between 2004 and 2013. A questionnaire was derived from the Quality of Life in Reflux and Dyspepsia and Frequency Scale for Symptoms of GERD questionnaires to assess for symptoms related to reflux, and this questionnaire was administered by phone. A total of 150 patients underwent repair of ITS during the study period. A total of 109 patients had ITS repair with fundoplication, while 41 had only ITS repair. Follow-up was available in 54 % of patients in the fundoplication group (median follow-up of 5.2 years) and in 49 % of patients in the non-fundoplication group (median follow-up of 4 years). Significantly, more patients woke up at night (p < 0.01) and found themselves coughing around mealtime (p < 0.01) in the fundoplication group. Patients in the non-fundoplication group had significantly more daytime reflux (p = 0.02). Despite these symptoms, only one patient in the fundoplication group and no patients in the non-fundoplication group admitted that these symptoms were severe enough to severely affect their quality of life. All other patients contacted felt satisfied, and >80 % rated their quality of life as either good or excellent. We conclude that there is not a significant difference in quality-of-life parameters on long-term follow-up between patients undergoing ITS

  14. Symptoms and Antireflux Medication Use Following Laparoscopic Nissen Fundoplication: Outcome at 1 and 4 Years

    PubMed Central

    Bloomston, Mark; Nields, William

    2003-01-01

    Background: We have reported 1-year outcomes and antacid medication use in 100 patients undergoing laparoscopic Nissen fundoplication. As a follow-up study, we queried these same patients to determine whether their outcomes endured 4 years after fundoplication. Methods: One hundred patients undergoing laparoscopic Nissen fundoplication between 1992 and 1997 were asked, at 1 to 2 years and 4 to 6 years postoperatively, to grade their symptoms on a scale of 1 (mild) to 10 (severe). Patients were also queried as to the number/cost of antacid medications used before and after fundoplication. Results: Significant improvements were noted in symptoms of heartburn, postprandial emesis, gas/bloating, and dysphagia after fundoplication. Significant decreases in antacid medication use (97%vs 19%) and monthly costs ($168±$91 vs $30±$54) were seen following fundoplication. The number of patients on antacid medications and the monthly costs of these medications (37%and $53±$87, respectively) increased significantly from early to late follow-up, but were still significantly lower than those before surgery. Overall, 87%and 90%of patients were pleased with their outcome at early and late follow-up, respectively, and 93%and 92%of patients stated they would consider undergoing fundoplication again if necessary (P=NS). Conclusion: Laparoscopic Nissen fundoplication results in a significant reduction in the symptoms of reflux and the use of antacid medications with a high degree of patient satisfaction. Although some patients return to antacid medications at late follow-up, they continue to have few symptoms and are pleased with their outcomes. PMID:14558708

  15. Fundoplication and the pediatric surgeon: implications for shared decision-making and the medical home.

    PubMed

    Fox, David; Barnard, Juliana; Campagna, Elizabeth J; Dickinson, L Miriam; Bruny, Jennifer; Kempe, Allison

    2012-01-01

    Almost one-half of all pediatric gastrostomy tube insertions are accompanied by a fundoplication, yet little is understood about the surgical decision-making for these procedures. The objective of this study was to examine the decision-making process of surgeons about whether to perform a fundoplication in children already scheduled to have a gastrostomy tube placed. A written questionnaire of all pediatric surgeons at a major children's hospital was completed for each planned gastrostomy procedure over the course of 1 year; the questionnaire asked about various influences on the fundoplication decision: primary care and subspecialty physicians' opinions, patient characteristics, and parent opinions. Patient demographics and clinical characteristics from the medical record, as well as questionnaire responses, were summarized for each gastrostomy occurrence. We modeled the association of questionnaire responses and patient characteristics with the outcome of having a fundoplication. We received questionnaires on 161 of 169 eligible patients (95%). A total of 52% of patients had fundoplication. Primary care physicians were involved in 44% of decisions, and when involved had "a lot" of influence on the fundoplication decision only 28% of time, compared with neonatologists (61%), hospitalists (44%), pediatric pulmonologists (42%), and pediatric gastroenterologists (40%). A total of 86% of patients had a subspecialist involved, and 28% had >1 subspecialist. A pH probe was performed in 7.5% of cases, and failed pharmacotherapy was noted by the surgeons in only 26.5% of the fundoplications performed. The decision to do a fundoplication was rarely based on definitive testing or failed medical treatment. From the surgeon's perspective, subspecialists were more influential than primary care physicians, which is at odds with current concepts of the medical home. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  16. Superior Mesenteric Vein Thrombosis Following Laparoscopic Nissen Fundoplication

    PubMed Central

    Martin, Matthew J.; Garafalo, Thomas; Ko, Tak-ming; Place, Ronald J.

    2003-01-01

    This report describes the second case of a superior mesenteric and portal vein thrombosis following an uneventful laparoscopic Nissen fundoplication. The patient presented on postoperative day 10 with acute onset of abdominal pain and inability to tolerate oral food. A computed tomography (CT) scan revealed superior mesenteric and portal venous thrombosis with questionable viability of the proximal small bowel. He was heparinized and taken for emergent exploratory laparotomy. At surgery and at a planned re-exploration the following day, the bowel was viable and no resection was needed. Despite continuation on anticoagulation therapy, he developed a pulmonary embolism. A hypercoagulable workup was normal. After continued anticoagulation therapy and supportive care, a duplex ultrasound 2 months after the event showed normal flow in both the superior mesenteric and portal veins. Possible mechanisms are discussed along with a review of the pertinent literature. PMID:12856849

  17. [Laparoscopic Heller myotomy for esophageal achalasia. Is a fundoplication necessary?].

    PubMed

    Patti, M G; Fisichella, P M

    2009-01-01

    The last decade has witnessed radical changes in the treatment of esophageal achalasia due to the development of minimally invasive techniques. Because of the high success rate of the laparoscopic Heller myotomy, a radical shift in the treatment algorithm of these patients has occurred, and today this is the preferred treatment modality for achalasia. This remarkable change is due to the recognition by gastroenterologists and patients that a laparoscopic Heller myotomy outperforms pneumatic dilatation and intra-sphincteric injection of botulinum toxin injection. While there is agreement about the technique of the myotomy per se, some questions still linger about the need for a fundoplication after the myotomy. The following review describes the data present in the literature in order to identify the best procedure that can achieve relief of dysphagia while avoiding development of gastroesophageal reflux.

  18. Hospital admissions for respiratory symptoms and failure to thrive before and after Nissen fundoplication.

    PubMed

    Lee, Steven L; Shabatian, Hooman; Hsu, Jin-Wen; Applebaum, Harry; Haigh, Philip I

    2008-01-01

    The purpose of this study is to determine whether Nissen fundoplication decreases hospital admissions for respiratory symptoms and failure to thrive (FTT). A retrospective study using discharge abstract data from Southern California Kaiser Permanente hospitals during the last decade was done. Three hundred forty-two pediatric patients had at least one Nissen fundoplication. Hospital admissions for aspiration and other pneumonia, respiratory distress/apnea, and FTT were determined before and after Nissen fundoplication. Age and associated neurologic disorders were also studied. Statistical analysis was determined by chi(2) analysis, Poisson regression analysis, and relative risk. The number of patients requiring hospital admission for aspiration and other pneumonia, respiratory distress/apnea, and FTT was similar before and after Nissen fundoplication. The proportion of readmission within 1 year after Nissen fundoplication for aspiration pneumonia was 0.1250 (95% confidence interval [CI], 0.0266-0.3236); other pneumonia, 0.5465 (95% CI, 0.4355-0.6542); respiratory distress/apnea, 0.5039 (95% CI, 0.4145-0.5931); and FTT, 0.5669 (95% CI, 0.4761-0.6545). Associated neurologic disorders independently increased hospital admissions for aspiration and other pneumonia, respiratory distress/apnea, and FTT. Age was inversely related to hospital admissions for respiratory distress and FTT. Nissen fundoplication did not improve hospital admissions for pneumonia, respiratory distress/apnea, and FTT. Associated neurologic disorders increased readmissions for pneumonia, respiratory distress/apnea, and FTT, whereas increasing age decreased readmission for respiratory distress and FTT.

  19. A novel transcription initiation factor (TIF), TIF-IE, is required for homogeneous Acanthamoeba castellanii TIF-IB (SL1) to form a committed complex.

    PubMed

    Radebaugh, C A; Kubaska, W M; Hoffman, L H; Stiffler, K; Paule, M R

    1998-10-16

    The fundamental transcription initiation factor (TIF) for ribosomal RNA expression by eukaryotic RNA polymerase I, TIF-IB, has been purified to near homogeneity from Acanthamoeba castellanii using standard techniques. The purified factor consists of the TATA-binding protein and four TATA-binding protein-associated factors with relative molecular weights of 145,000, 99,000, 96,000, and 91,000. This yields a calculated native molecular weight of 460, 000, which compares well with its mass determined by scanning transmission electron microscopy (493,000) and its sedimentation rate, which is close to RNA polymerase I (515,000). Both impure and nearly homogeneous TIF-IB exhibit an apparent equilibrium dissociation constant of 56 +/- 3 pM. However, although impure TIF-IB can form a promoter-DNA complex resistant to challenge by other promoter-containing DNAs, near homogeneous TIF-IB cannot do so. An additional transcription factor, dubbed TIF-IE, restores the ability of near homogeneous TIF-IB to sequester DNA into a committed complex.

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  1. A Novel RNA Polymerase I Transcription Initiation Factor, TIF-IE, Commits rRNA Genes by Interaction with TIF-IB, Not by DNA Binding

    PubMed Central

    Al-Khouri, Anna Maria; Paule, Marvin R.

    2002-01-01

    In the small, free-living amoeba Acanthamoeba castellanii, rRNA transcription requires, in addition to RNA polymerase I, a single DNA-binding factor, transcription initiation factor IB (TIF-IB). TIF-IB is a multimeric protein that contains TATA-binding protein (TBP) and four TBP-associated factors that are specific for polymerase I transcription. TIF-IB is required for accurate and promoter-specific initiation of rRNA transcription, recruiting and positioning the polymerase on the start site by protein-protein interaction. In A. castellanii, partially purified TIF-IB can form a persistent complex with the ribosomal DNA (rDNA) promoter while homogeneous TIF-IB cannot. An additional factor, TIF-IE, is required along with homogeneous TIF-IB for the formation of a stable complex on the rDNA core promoter. We show that TIF-IE by itself, however, does not bind to the rDNA promoter and thus differs in its mechanism from the upstream binding factor and upstream activating factor, which carry out similar complex-stabilizing functions in vertebrates and yeast, respectively. In addition to its presence in impure TIF-IB, TIF-IE is found in highly purified fractions of polymerase I, with which it associates. Renaturation of polypeptides excised from sodium dodecyl sulfate-polyacrylamide gels showed that a 141-kDa polypeptide possesses all the known activities of TIF-IE. PMID:11784852

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

    SciTech Connect

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

    2012-01-20

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

  3. Robotic-assisted laparoscopic Nissen fundoplication with gastrostomy preservation in neurologically impaired children.

    PubMed

    Margaron, Franklin C; Oiticica, Claudio; Lanning, David A

    2010-06-01

    Robotic fundoplication has equivalent safety profiles, hospital stay, and time to alimentation, compared to laparoscopic fundoplication, but is not indicated for routine repair due to higher cost, decreased availability, and longer procedure time. Robotic surgery does offer key advantages over standard laparoscopy by employing internally articulating arms, a stable camera platform, and three dimensional imaging. Children presenting for initial or redo fundoplication after feeding gastrostomy are a subset of patients that may benefit from the robotic approach. Minimal dissection of the phrenoesophageal ligament, in combination with four anchoring sutures from the esophagus to the crura, has been shown to lead to less wrap herniation in children. This technique is particularly difficult in standard laparoscopy without dislodgement of the gastrostomy, particularly if there are abundant adhesions or a replaced left hepatic artery to preserve. In this article, we present 15 children with neurologic impairment and previous gastrostomy who underwent Nissen fundoplication, using the da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA). All patients underwent a floppy Nissen fundoplication after crural closure and placement of four anchoring stitches to the crura. Six patients (40%) had redo Nissens and 5 (33.3%) had replaced left hepatic or accessory arteries that were preserved. Seven patients underwent repair of a hiatal hernia and 2 had biologic mesh placed. There were no conversions to open or intraoperative complications. One child had a revision of the gastrostomy site, because the prior percutaneous endoscopic gastrostomy had been placed through the transverse mesocolon. There were only a few minor postoperative complications. All children were doing well at latest follow-up (average, 32 months). The da Vinci surgical robot can be used to safely perform fundoplications in patients with gastrostomy tubes. The articulating instruments allow for the

  4. Herniation of an abdominal antireflux fundoplication into the chest: what does it mean?

    PubMed

    Deswysen, Yannick; Volonté, Francesco; Gutschow, Christian; Romagnoli, Renato; Strignano, Paolo; Ouazzani, Aous; Verstraete, Luc; De Gheldere, Charles; Thoma, Maximillien; Uluma, Vincent; Ungureanu, Felicia; Mabrut, Jean-Yves; Collard, Jean-Marie

    2014-07-01

    The specific contribution of the herniation of an abdominal antireflux fundoplication into the chest to symptomatic and therefore surgical failure remains unclear. The study was conducted in 189 consecutive fundoplication patients, categorized as patients reoperated on for chest herniation of either an abdominal 360° (Group 1; n = 95) or a partial (Group 2; n = 10) fundoplication, and patients having undergone an intrathoracic 360° fundoplication for short oesophagus (Group 3; n = 84; reference group). There were four subgroups in Group 1: 1A: wrap still complete and perioesophageal; 1B: wrap still complete but perigastric; 1C: wrap still perioesophageal but partially disrupted and 1D: wrap perigastric and partially disrupted. The prevalence of defective symptoms (heartburn and regurgitation) was significantly lower (P < 0.0001) in Group 3 (0.0%) and Subgroup 1A (3.7%) than in Subgroups 1B (84.4%), 1C (86.7%) and 1D (100%) and Group 2 (100%). The prevalence of obstructive symptoms (dysphagia, chest pain, necrosis and perforation) was significantly higher (P < 0.0001) in Subgroup 1A (100%) than in Subgroups 1B (57.8%), 1C (60.0%) and 1D (25.0%). The prevalence of a short oesophagus, an abdominal wall hernia repair and high abdominal pressure episodes in reoperated patients were 13.7, 36.2 and 67.2%, respectively. Unlike perigastric or partial fundoplication, a 360° perioesophageal abdominal fundoplication, when herniated into the chest, is still effective against reflux. Obstructive symptoms are due to either diaphragmatic strangulation or perigastric migration of the wrap (slipknot effect). Short oesophagus, weakness of the abdominal wall and high abdominal pressure episodes favour the herniation process. © The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  5. Gastric Emptying and Vagus Nerve Function After Laparoscopic Partial Fundoplication

    PubMed Central

    Lindeboom, Maud Y. A.; Ringers, Jan; van Rijn, Pieter J. J.; Neijenhuis, Peter; Stokkel, Marcel P. M.; Masclee, Ad A. M.

    2004-01-01

    Objective: To establish the relation between vagus nerve dysfunction, gastric emptying, and antireflux surgery. Summary Background Data: Delayed gastric emptying occurs in up to 40% of reflux patients. After antireflux surgery, gastric emptying becomes normal or is even accelerated. Occasionally, severe gastric stasis is found and is associated with a negative outcome of the antireflux procedure. It has been suggested that injury to the vagus nerve could be the cause of this delayed emptying. Methods: We evaluated in a prospective study gastric emptying of solids and vagus nerve function (pancreatic polypeptide response to hypoglycemia) before and after surgery in 41 patients (22 women; age 43 ± 1.6 years) who underwent laparoscopic hemifundoplication. Results: All patients had relief of reflux symptoms varying from adequate (n = 8) to complete relief (n = 33). Gastric emptying of solids increased significantly (P < 0.001) after operation: lag phase from 19 ± 2 to 10 ± 1 minute, emptying rate (%/h) from 37 ± 2 to 48 ± 5 and half emptying time from 110 ± 8 to 81 ± 4 minutes. Gastric emptying improved to a similar extent in patients with delayed and normal preoperative gastric emptying. Postoperative signs of vagus nerve damage (PP peak < 47pmol/L) were present in 4 patients (10%). In these 4 patients gastric emptying both before and after operation did not differ from patients with normal vagus nerve function. In fact, none of the 41 patients had severely delayed emptying after laparoscopic hemifundoplication. Conclusions: Laparoscopic hemifundoplication affects vagus nerve integrity in 10% of patients, but this does not lead to a delay in gastric emptying. In fact, gastric emptying improved significantly after fundoplication. PMID:15492559

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

    PubMed Central

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

    1997-01-01

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

  7. Laparoscopic Heller Myotomy and Dor Fundoplication for Esophageal Achalasia: Technique and Perioperative Management.

    PubMed

    Andolfi, Ciro; Fisichella, P Marco

    2016-11-01

    Surgical correction of achalasia using laparoscopic Heller myotomy with Dor fundoplication is argued to be the gold standard treatment for patients with achalasia. The goal of this technical report is to illustrate our preferred approach to patients with achalasia and to provide the reader with a detailed description of our operative technique, its rationale, and our pre and postoperative management.

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

    PubMed Central

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

    2015-01-01

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

  9. The use of esophageal transit and gastric emptying studies in the evaluation of patients undergoing laparoscopic fundoplication.

    PubMed

    Schuchert, Matthew J; Pettiford, Brian L; Abbas, Ghulam; Oostdyk, Alicia; Landreneau, James R; Kilic, Arman; Landreneau, Joshua P; Luketich, James D; Landreneau, Rodney J

    2010-12-01

    Preservation of esophageal and gastric function is a hallmark principle in ensuring optimal surgical outcomes after gastric fundoplication. In this study, we evaluated the impact of fundoplication on esophageal transit and gastric emptying using scintigraphy studies and related these functional findings to symptomatic outcomes. A total of 106 consecutive patients (37 women, 69 men) with both preoperative and 6-month postoperative nuclear scintigraphy studies undergoing partial (Toupet) fundoplication at a single institution were analyzed. Primary variables included alterations in esophageal transit and gastric emptying times after fundoplication (1 = rapid; 2 = normal; 3 = mild delay; 4 = severe delay). Symptomatic variables included heartburn, regurgitation, dysphagia, pulmonary symptoms, and bloating. Mean age was 57.2 years. Symptomatic improvement was achieved in 91.5% of patients. Significant reduction of all symptoms (heartburn, regurgitation, pulmonary symptoms, and dysphagia) was noted after fundoplication, except gas bloating (4.7 vs. 20.8%). There were no significant differences in preoperative and postoperative esophageal transit (2.53 vs. 2.52) and gastric emptying (2.13 vs. 2.06) scores after fundoplication. Interestingly, 17% of esophageal transit times and 18% of gastric emptying times improved after fundoplication. However, worsening scores were seen in 16 and 12%, respectively. There was no significant postoperative dysphagia, even in patients with impaired transit times. Nuclear scintigraphic assessment of esophageal transit and gastric emptying are valuable, user-friendly tools to identify and avoid functional motility problems in the setting of fundoplication. These studies seem to be a reasonable alternative to manometry in assessing esophageal function before surgery in this setting. Postoperative symptoms may be related to objective changes in esophageal transit or gastric emptying. The causes may be iatrogenic in nature or related to vagal

  10. Continuous glucose monitoring for suspected dumping syndrome in infants after Nissen fundoplication.

    PubMed

    Ueda, Kazutoshi; Mizumoto, Hiroshi; Shibata, Hirofumi; Miyauchi, Yuya; Sato, Masahito; Hata, Daisuke

    2013-12-01

    Dumping syndrome is infrequently reported, but known to occur after Nissen fundoplication in children. However, it may be difficult both to diagnose and manage. Here we presented four infants who received Nissen fundoplication for severe gastroesophageal reflux disease, two of whom developed dumping syndrome whilst the other two did not. Continuous glucose monitoring (CGM) was very useful to clearly detect large glycemic fluctuation around each feeding. CGM was also helpful to prove the effect of treatment to avoid abnormal glucose levels. We believe that dumping syndrome in children may be underdiagnosed if clinicians rely solely on the recognition of symptoms or limited frequency of blood samplings. CGM might be the most sensitive diagnostic tool.

  11. Laparoscopic Toupet fundoplication with duodenojejunostomy for the management of superior mesenteric artery syndrome with reflux symptoms

    PubMed Central

    Yan, Chao; Hu, Zhi-Wei; Wu, Ji-Min; Zhang, Chao; Yan, Liang; Wang, Zhong-Gao

    2017-01-01

    Abstract Rationale: The patient had symptoms of GERD and the reflux even caused the symptom of cough. Gaining weight is a risk factor for the treatment of reflux as it could exacerbated symptoms of reflux and the drug treatment is not effective. Surgical intervention becomes necessary when there is failure following conservative medical therapy or the patient. Patient concerns: The patient was not satisfied with the drug treatment. Diagnoses: Superior mesenteric artery syndrome, gastroesophageal reflux disease. Interventions: Laparoscopic Toupet fundoplication with duodenojejunostomy. Outcomes: The patient discharged from hospital 10 days after surgery without any postoperative complication. The patient achieved complete relief of symptoms and discontinuation of drug. Lessons subsections: Superior mesenteric artery (SMA) syndrome may manifest the symptoms of GERD such as heartburn, acid reflux and cough. It is necessary to complete examination to exclude superior mesenteric artery syndrome for these patients. Laparoscopic fundoplication with duodenojejunostomy provided an effective treatment for patients who failed drug treatment. PMID:28099334

  12. Impact of total fundoplication on esophageal transit: analysis by combined multichannel intraluminal impedance and manometry.

    PubMed

    Del Genio, Gianmattia; Tolone, Salvatore; Del Genio, Federica; D'Alessandro, Antonio; Brusciano, Luigi; Aggarwal, Rajesh; Conzo, Giovanni; Orditura, Michele; Docimo, Ludovico; Del Genio, Alberto

    2012-01-01

    Laparoscopic total fundoplication is considered the most effective surgical option for gastroesophageal reflux (GER) disease. Some authors assume that total fundoplication may expose the patient to delayed transit of the swallowed bolus and increased risk of dysphagia, particularly when peristaltic dysfunction is present. We undertook this study to evaluate by means of combined multichannel intraluminal impedance and esophageal manometry (MII-EM) the impact of fundoplication on esophageal physiology. An objective measurement of the influence of the total wrap on bolus transit may be helpful in refining the optimal antireflux wrap (ie, partial vs. total). In this study, 25 consecutive patients who underwent laparoscopic Nissen-Rossetti fundoplication had MII-EM and combined 24-hour pH and multichannel intraluminal impedance (MII-pH) before and after the surgical procedure. All patients completed preoperative and postoperative symptom questionnaires. The following were calculated for liquid and viscous deglutition lower esophageal sphincter pressure and relaxation, distal esophageal amplitude, the number of complete esophageal bolus transits and the mean total bolus transit time. The acid and nonacid GER episodes were calculated by MII-pH with the patient in both upright and recumbent positions. The postoperative MII-EM showed an increased lower esophageal sphincter pressure (P < 0.05), whereas lower esophageal sphincter relaxation and distal esophageal amplitude did not change after surgery (P = NS). Complete esophageal bolus transits and bolus transit time did not change for liquid swallows (P = NS), but was more rapid for viscous after surgery (P < 0.05). Twenty-four hour pH monitoring confirmed the postoperative reduction of both acid and nonacid reflux (P < 0.05). Laparoscopic Nissen-Rossetti is effective in controlling both acid and nonacid GER without impairment of esophageal function. Appropriate preoperative investigation, meticulous patient selection and

  13. Reoperative antireflux surgery for failed fundoplication: an analysis of outcomes in 275 patients.

    PubMed

    Awais, Omar; Luketich, James D; Schuchert, Matthew J; Morse, Christopher R; Wilson, Jonathan; Gooding, William E; Landreneau, Rodney J; Pennathur, Arjun

    2011-09-01

    With an increase in the performance of laparoscopic antireflux procedures, more patients with a failed primary antireflux operation are being referred to thoracic surgeons for complex redo procedures. The objective of this study was to evaluate our results of redo antireflux surgery. We conducted a retrospective review of patients who underwent redo surgery for failed fundoplication. The primary endpoint was failure of the redo operation; other endpoints included gastroesophageal reflux disease-health-related quality of life (HRQOL) after redo fundoplication. A total of 275 patients (median age, 52 years; range, 17 to 88 years; men 82, women 193) underwent redo antireflux surgery. The most common pattern of failure of the initial operation was transmediastinal migration-recurrent hernia in 177 patients (64%). Redo surgery included Nissen fundoplication in 200 (73%), Collis gastroplasty in 119 (43%), and partial fundoplication in 41 (15%). There was no perioperative mortality. At a median follow-up of 39.6 months, 31 patients (11.2%) had a failure of the redo surgery, requiring reoperation. The two-year estimated probability of freedom from failure was 93% (95% confidence interval 89% to 96%). The HRQOL scores, available for 186 patients, were excellent to satisfactory in 85.5%, and poor in 14.5%. Redo antireflux surgery can be performed safely in experienced centers with outcomes that are similar to published open results. Complete takedown and reestablishment of the normal anatomy, recognition of a short esophagus, and proper placement of the wrap are essential components of the procedure. Thoracic surgeons with significant laparoscopic and open esophageal surgical experience can perform minimally invasive, complex redo esophageal antireflux procedures safely with good results. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Asymptomatic partial splenic infarction in laparoscopic floppy Nissen fundoplication and brief literature review.

    PubMed

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

    2014-01-01

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

  15. A study for active control research and validation using the Total In-Flight Simulator (TIFS) aircraft

    NASA Technical Reports Server (NTRS)

    Chen, R. T. N.; Daughaday, H.; Andrisani, D., II; Till, R. D.; Weingarten, N. C.

    1975-01-01

    The results of a feasibility study and preliminary design for active control research and validation using the Total In-Flight Simulator (TIFS) aircraft are documented. Active control functions which can be demonstrated on the TIFS aircraft and the cost of preparing, equipping, and operating the TIFS aircraft for active control technology development are determined. It is shown that the TIFS aircraft is as a suitable test bed for inflight research and validation of many ACT concepts.

  16. [Laparoscopic fundoplication for gastro-esophageal reflux. Multicenter study of 1,470 cases].

    PubMed

    Arnaud, J P; Pessaux, P; Ghavami, B; Flament, J B; Trébuchet, G; Meyer, C; Hutten, N; Champault, G

    1999-11-01

    The aim of this multicenter retrospective study was to evaluate the immediate and 2-year results of the laparoscopic fundoplication for gastroesophageal reflux disease (GERD). From 1992 to 1996, 1,470 laparoscopic fundoplications were performed for symptomatic GERD. Preoperative workup included upper GI tract endoscopy in 1,437 patients (97.7%), 24-hour pHmetry in 799 patients (54.3%) and esophageal manometry in 934 patients (63.5%). Four procedures were performed: Nissen, Nissen-Rossetti, Toupet and Toupet with cardiopexy. The results were estimated at 1 month and 3 months. The patients were examined or called 2 years after surgery in order to evaluate the functional results with Visick classification. Mean length of hospital stay was 4.6 days (range 2-48 days). Morbidity and mortality rates were 3.2% (47 patients) and 0.07% (1 patient) respectively. Conversion rate into laparotomy was 6.5% (96 patients). After 3 months, 87 patients (5.9%) had severe dysphagia and 91.9% of the patients were satisfied. At 2 years, 78 patients (5.6%) had a clinical recurrence. Five patients (0.35%) had a persistent dysphagia, 90 patients (6.5%) had secondary side effects; 38 patients had been reoperated; 92.7% of the patients were satisfied. There was no significant difference between the results of the four procedures, 3 months and 2 years after surgery. Laparoscopic fundoplication for treatment of GERD is a safe and effective procedure; 92.7% of the patients were satisfied 2 years after surgery.

  17. A Chinese randomized prospective trial of floppy Nissen and Toupet fundoplication for gastroesophageal disease.

    PubMed

    Wang, Bin; Zhang, Wei; Liu, Sheng; Du, Zhipeng; Shan, Chengxiang; Qiu, Ming

    2015-11-01

    To evaluate the clinical outcomes of laparoscopic floppy Nissen fundoplication (LNF) and laparoscopic Toupet fundoplication (LTF) for the treatment of gastroesophageal disease (GERD). A total of 84 patients with GERD were randomized to either LNF (n = 43) or LTF (n = 41) between January 2010 and January 2013. The primary endpoint measures were the DeMeester score, distal esophageal amplitude (DEA), peristaltic frequency, lower esophageal sphincter pressure (LESP), short-term and long-term postoperative dysphagia and recurrence rate. The secondary endpoints were improvements in symptom scores and quality of life (QoL), and perioperative complications. LNF group had a lower DeMeester score and a higher LESP compared to LTF group after surgery (DeMeester score: P = 0.007; LESP: P = 0.027). The mean DEA and peristaltic frequency both improved significantly after surgery in 2 groups. There was no difference in the incidence of short-term adverse events (including dysphagia, heartburn, regurgitation et al.) between the two groups (P = 0.157). At the time of the latest follow-up, there was no difference in the incidence of symptomatic reflux symptom (heartburn and regurgitation) between the two groups (heartburn: P = 0.363; regurgitation: P = 1.000). A higher frequency of dysphagia was present in the LNF group compared with the LTF group (P = 0.023). LNF is associated with an excessive elevation of LESP which may lead to further persistent dysphagia. Partial fundoplication may provide adequate reflux control, improve esophageal body motility and minimize complications associated with an 'over-tight' fundal wrap. LTF seems to be as safe and effective on the long-term as LNF, but with a lower incidence of postoperative dysphagia (ChiCTR-TRC-13003945). Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  18. High-resolution Manometry in Patients with Gastroesophageal Reflux Disease Before and After Fundoplication

    PubMed Central

    Rerych, Katarzyna; Kurek, Józef; Klimacka-Nawrot, Ewa; Błońska-Fajfrowska, Barbara; Stadnicki, Antoni

    2017-01-01

    Background/Aims The study aimed to determine pre- and post-fundoplication esophagogastric junction (EGJ) pressure and esophageal peristalsis by high-resolution manometry (HRM) in patients with gastroesophageal reflux disease (GERD). Methods Pre-operative and post-operative HRM data from 25 patients with GERD were analyzed using ManoView version 2.0.1. with updated software for Chicago classification and pressure topography. The study involved swallowing water boluses of 10 mL in the upright position. Results Significant increase of mean basal EGJ pressure and minimal basal EGJ pressure was found in post-operative as compared with preoperative patients (P < 0.05 and P < 0.001, respectively). Integrated relaxation pressure (IRP) reached higher values in post-operative patients than in pre-operative patients (P < 0.001). Intra-bolus pressure (IBP) was significantly higher (P < 0.05) and contractile front velocity (CFV) was slower (P < 0.01) in post-operative patients than in pre-operative patients. Moreover significant increase of distal contractile integral (DCI) was found in post-operative patients (P < 0.05). Hiatal hernia was detected by HRM in 11 pre-operative patients. Fifteen out of 25 post-operative patients complained of dysphagia. Conclusions Fundoplication restores the antireflux barrier by reinforcing EGJ basal pressures, repairing hiatal hernias, and enhances peristaltic function of the esophagus by increasing DCI. However slight IRP elevation found in post-fundoplication patients may result in bolus pressurization and motility disorders. PMID:27535114

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

    NASA Technical Reports Server (NTRS)

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

    2003-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2003-01-01

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

  1. Is Toupet fundoplication the procedure of choice for treating gastroesophageal reflux disease? Results of a prospective randomized experimental trial comparing three major antireflux operations in a porcine model.

    PubMed

    Bachmann, K; Wachowiak, R; Rempf, C; Vashist, Y; Mann, O; Yekebas, E F; Izbicki, J R; Gawad, K A

    2011-10-01

    Gastroesophageal reflux disease (GERD) is among the most common dysfunctions of the upper gastrointestinal tract. It interferes with quality of life and is a risk factor for the development of adenocarcinoma in the lower esophagus. Laparoscopic fundoplication is an effective treatment of GERD, but the physiologic mechanisms of the different available procedures had not been investigated to date. In this study, 28 German Landrace pigs underwent baseline manometry and 24-h pH monitoring followed by myotomy to induce reflux esophagitis. After new-onset reflux was proved, the pigs were randomized to groups based on four treatments: total fundoplication, anterior hemifundoplication, posterior hemifundoplication, and control. On days 10 and 60 after the intervention, the effectiveness of the different fundoplication modifications was compared with that of the control subjects by 24-h pH monitoring manometry. Finally, the pigs were killed, after which the minimum volume and pressure required to breach the gastroesophageal junction were recorded. After myotomy, a significant increase in the reflux could be confirmed. The findings after fundoplication showed a significant decrease in the fraction of time that the pH fell below four and an increase in the vector volume compared with the measurement after myotomy. Total fundoplication and posterior hemifundoplication were highly effective, whereas measurements after anterior fundoplication still showed increased fraction times. Pharmacologic stimulation with pentagastrin showed an increase in the vector volume of the esophageal sphincter. Total fundoplication and posterior hemifundoplication are potent operations for the treatment of GERD. Anterior hemifundoplication reduces the reflux as well, but the effects are significantly less than with total and posterior fundoplication. Pharmacologic stimulation showed excellent results after posterior hemifundoplication, and a tendency to overcorrection was shown after total

  2. Evidence-based appraisal in laparoscopic Nissen and Toupet fundoplications for gastroesophageal reflux disease

    PubMed Central

    Shan, Cheng-Xiang; Zhang, Wei; Zheng, Xiang-Min; Jiang, Dao-Zhen; Liu, Sheng; Qiu, Ming

    2010-01-01

    AIM: To demonstrate the optimal surgical procedure for gastroesophageal reflux disease. METHODS: The electronic databases of Medline, Elsevier, Springerlink and Embase over the last 16 years were searched. All clinical trials involved in the outcomes of laparoscopic Nissen fundoplication (LNF) and laparoscopic Toupet fundoplication (LTF) were identified. The data of assessment in benefits and adverse results of LNF and LTF were extracted and compared using meta-analysis. RESULTS: We ultimately identified a total of 32 references reporting nine randomized controlled trials, eight prospective cohort trials and 15 retrospective trials. These studies reported a total of 6236 patients, of whom 4252 (68.18%) underwent LNF and 1984 (31.82%) underwent LTF. There were no differences between LNF and LTF in patients’ satisfaction, perioperative complications, postoperative heartburn, reflux recurrence and re-operation. Both LNF and LTF enhanced the function of lower esophageal sphincter and improved esophagitis. The postoperative dysphagia, gas-bloating syndrome, inability to belch and the need for dilatation after LNF were more common than after LTF. Subgroup analyses showed that dysphagia after LNF and LTF was similar in patients with normal esophageal peristalsis (EP), but occurred more frequently in patients with weak EP after LNF than after LTF. Furthermore, patients with normal EP after LNF still had a higher risk of developing dysphagia than did patients with abnormal EP after LTF. CONCLUSION: Compared with LNF, LTF offers equivalent symptom relief and reduces adverse results. PMID:20572311

  3. Minimal vs extensive esophageal mobilization during laparoscopic fundoplication: a prospective randomized trial

    PubMed Central

    St. Peter, Shawn D.; Barnhart, Douglas C.; Ostlie, Daniel J.; Tsao, KuoJen; Leys, Charles M.; Sharp, Susan W.; Bartle, Donna; Morgan, Tracey; Harmon, Carroll M.; Georgeson, Keith E.; Holcomb, George W.

    2011-01-01

    Purpose Laparoscopic Nissen fundoplication has been traditionally performed with extensive esophageal dissection to create 2 to 3 cm of intraabdominal esophagus. Retrospective data have suggested that minimal esophageal mobilization may reduce the risk of postoperative herniation of the wrap into the lower mediastinum. To compare complete esophageal dissection to leaving the phrenoesophageal attachment intact, we conducted a 2-center, prospective, randomized trial. Methods After obtaining permission/assent, patients were randomized to circumferential division of the phrenoesophageal attachments (MAX) or minimal mobilization with no violation of the phrenoesophageal membrane (MIN). A contrast study was performed at 1 year. The primary outcome variable was postoperative wrap herniation. Results One hundred seventy-seven patients were enrolled in the study (MIN, n = 90; MAX, n = 87) from February 2006 to May 2008. There were no differences in demographics or operative time. Contrast studies were performed in 64 MIN and 71 MAX patients, respectively. The transmigration rate was 30% in the MAX group compared with 7.8% in the MIN group (P = .002). The reoperation rate was 18.4% in the MAX group and 3.3% in the MIN group (P = .006) Conclusions Minimal esophageal mobilization during laparoscopic fundoplication decreases postoperative wrap transmigration and the need for a redo operation. PMID:21238659

  4. Factors predicting outcomes of laparoscopic Nissen fundoplication for gastroesophageal reflux disease: experience at a single institution in Korea

    PubMed Central

    Kim, Beom Jin; Kim, Jae Gyu; Chi, Kyong-Choun

    2017-01-01

    Purpose Laparoscopic fundoplication is considered the standard surgical treatment for gastroesophageal reflux disease (GERD) in Western countries. However, some patients experience poor surgical outcomes with this procedure. The study aimed to identify the predictive factors of the surgical outcomes of laparoscopic Nissen fundoplication for the treatment of Korean GERD patients. Methods Sixty-one patients with GERD were treated using laparoscopic Nissen fundoplication between November 2012 and February 2015. Symptom control rates were compared according to clinical and surgical factors to identify predictive factors of successful surgical outcomes. Results Thirty-five men and 26 women were enrolled. Preoperatively, typical symptoms were present in 60 patients (98%), while atypical symptoms were present in 40 patients (66%). Postoperatively, typical symptoms were controlled in 51 of 60 patients (85.0%), while atypical symptoms were controlled in 33 of 40 patients (82.5%). Overall, at 6 months postsurgery, 54 (88.5%) reported some resolution of GERD symptoms, with 48 (78.7%) achieving complete control. Patients who exhibited a good response to proton pump inhibitor therapy had a significantly greater rate of complete symptom control (P = 0.035). Conclusion Laparoscopic fundoplication is effective for controlling GERD symptoms. Response to preoperative proton pump inhibitor was a predictor of successful outcome. PMID:28382290

  5. Impact of gastroesophageal reflux control through tailored proton pump inhibition therapy or fundoplication in patients with Barrett’s esophagus

    PubMed Central

    Baldaque-Silva, Francisco; Vieth, Michael; Debel, Mumen; Håkanson, Bengt; Thorell, Anders; Lunet, Nuno; Song, Huan; Mascarenhas-Saraiva, Miguel; Pereira, Gisela; Lundell, Lars; Marschall, Hanns-Ulrich

    2017-01-01

    AIM To determine the impact of upwards titration of proton pump inhibition (PPI) on acid reflux, symptom scores and histology, compared to clinically successful fundoplication. METHODS Two cohorts of long-segment Barrett’s esophagus (BE) patients were studied. In group 1 (n = 24), increasing doses of PPI were administered in 8-wk intervals until acid reflux normalization. At each assessment, ambulatory 24 h pH recording, endoscopy with biopsies and symptom scoring (by a gastroesophageal reflux disease health related quality of life questionnaire, GERD/HRLQ) were performed. Group 2 (n = 30) consisted of patients with a previous fundoplication. RESULTS In group 1, acid reflux normalized in 23 of 24 patients, resulting in improved GERD/HRQL scores (P = 0.001), which were most pronounced after the starting dose of PPI (P < 0.001). PPI treatment reached the same level of GERD/HRQL scores as after a clinically successful fundoplication (P = 0.5). Normalization of acid reflux in both groups was associated with reduction in papillary length, basal cell layer thickness, intercellular space dilatation, and acute and chronic inflammation of squamous epithelium. CONCLUSION This study shows that acid reflux and symptom scores co-vary throughout PPI increments in long-segment BE patients, especially after the first dose of PPI, reaching the same level as after a successful fundoplication. Minor changes were found among GERD markers at the morphological level. PMID:28533674

  6. TIF1 Activates the Intra-S-Phase Checkpoint Response in the Diploid Micronucleus and Amitotic Polyploid Macronucleus of Tetrahymena

    PubMed Central

    Yakisich, J. Sebastian; Sandoval, Pamela Y.; Morrison, Tara L.

    2006-01-01

    The ribosomal DNA origin binding protein Tif1p regulates the timing of rDNA replication and is required globally for proper S-phase progression and division of the Tetrahymena thermophila macronucleus. Here, we show that Tif1p safeguards chromosomes from DNA damage in the mitotic micronucleus and amitotic macronucleus. TIF1p localization is dynamically regulated as it moves into the micro- and macronucleus during the respective S phases. TIF1 disruption mutants are hypersensitive to hydroxyurea and methylmethanesulfonate, inducers of DNA damage and intra-S-phase checkpoint arrest in all examined eukaryotes. TIF1 mutants incur double-strand breaks in the absence of exogenous genotoxic stress, destabilizing all five micronuclear chromosomes. Wild-type Tetrahymena elicits an intra-S-phase checkpoint response that is induced by hydroxyurea and suppressed by caffeine, an inhibitor of the apical checkpoint kinase ATR/MEC1. In contrast, hydroxyurea-challenged TIF1 mutants fail to arrest in S phase or exhibit caffeine-sensitive Rad51 overexpression, indicating the involvement of TIF1 in checkpoint activation. Although aberrant micro- and macronuclear division occurs in TIF1 mutants and caffeine-treated wild-type cells, TIF1p bears no similarity to ATR or its substrates. We propose that TIF1 and ATR function in the same epistatic pathway to regulate checkpoint responses in the diploid mitotic micronucleus and polyploid amitotic macronucleus. PMID:17005912

  7. Gastro-oesophageal reflux related cough and its response to laparoscopic fundoplication

    PubMed Central

    Allen, C.; Anvari, M.

    1998-01-01

    BACKGROUND—This study was designed to determine prospectively the rate of cough before and after laparoscopic Nissen fundoplication performed for the control of gastro-oesophageal reflux disease.
METHODS—One hundred and ninety five consecutive patients (76 men) of mean (SD) age 46.9 (14.1) years with proven gastro-oesophageal reflux disease, who were either on long term omeprazole (n = 187) or who had not responded to a trial of omeprazole (n = 8), took part in the study which was carried out in a university teaching hospital that included a regional respiratory referral centre. Patients underwent oesophageal manometry, 24 hour oesophageal pH testing, and symptom score evaluation by an independent observer before and six months after laparoscopic Nissen fundoplication.
RESULTS—One hundred and thirty three patients presented with reflux symptoms and 62 with respiratory symptoms; 68% of patients complained of cough before surgery (86% with respiratory symptoms, 60% with gastrointestinal symptoms). The percentage reflux time in 24 hours fell significantly (p<0.0001) from a mean (SD) of 9.38 (10.99)% to 1.22 (2.92)%, lower oesophageal sphincter tone rose significantly (p<0.0001) from a mean (SD) of 7.71 (5.90) mm Hg to 21.74 (10.84) mm Hg, and the cough score fell from a median value of 8.0 (IQR 12.0) to 0 (IQR 3) following surgery. Of the patients with cough, 51% were cough free after surgery and 31% improved. The patients with respiratory symptoms had a higher cough score before (median 12.0 (IQR 5.5) versus 4.0 (IQR 8.75), p<0.0001) and after surgery (median 1 (7.5) versus 0.0 (IQR 1.0), p = 0.0045) than those with gastrointestinal symptoms.
CONCLUSIONS—Patients who present to gastroenterologists with severe reflux commonly complain of cough. Laparoscopic Nissen fundoplication is effective in the control of cough in patients with gastro-oesophageal reflux disease, with or without primary respiratory disease.

 PMID:10193396

  8. Reflux symptoms and side effects among patients with gastroesophageal reflux disease at baseline, during treatment with PPIs, and after Nissen fundoplication.

    PubMed

    Rantanen, Tuomo; Kiljander, Toni; Salminen, Paulina; Ranta, Arto; Oksala, Niku; Kellokumpu, Ilmo

    2013-06-01

    There are no prospective studies available on the behavior of extraesophageal and esophageal symptoms and treatment-related side effects in patients without effective antireflux medication, receiving the most effective antireflux medication, and after laparoscopic fundoplication. Extraesophageal and esophageal reflux symptoms and treatment-related side effects were assessed in 60 patients while they were on no effective antireflux medication (three-week washout period), after three month of treatment with double-dose esomeprazole, and 3 months after laparoscopic Nissen fundoplication. Esophageal and extraesophageal reflux symptoms, rectal flatulence, and bloating were analyzed with the visual analog scale. In addition, dysphagia, rectal flatulence, and bloating were recorded as none, mild, moderate, or severe. Both extraesophageal and esophageal reflux symptoms decreased after treatment with esomeprazole and were further reduced after fundoplication. Dysphagia and flatulence did not increase from baseline after surgery. Bloating decreased both after treatment with esomeprazole and after fundoplication. In contrast, dysphagia and increased flatus were found more often after surgery than during treatment with esomeprazole. Dysphagia and rectal flatulence were less common during treatment with esomeprazole than at baseline or after surgery. Both extraesophageal and esophageal reflux symptoms decreased after treatment with esomeprazole and were reduced further after fundoplication. Any treatment-related side effect was not increased after surgery when compared to baseline. However, compared to esomeprazole there was more dysphagia and flatulence after fundoplication.

  9. A modification of Nissen fundoplication improves patients' outcome and may reduce procedure-related failure rate.

    PubMed

    Bardini, Romeo; Rampado, Sabrina; Salvador, Renato; Zanatta, Lisa; Angriman, Imerio; Degasperi, Silvia; Ganss, Angelica; Savarino, Edoardo

    2017-02-01

    Laparoscopic anti-reflux surgery has a failure rate of 10-20%. We aimed to investigate whether a modification of Nissen fundoplication (MNF) may improve patients' outcome and reduce failure rate. We prospectively compared 40 consecutive patients with gastroesophageal reflux disease who underwent anti-reflux surgery: 20 Nissen fundoplication (NF) and 20 the MNF approach. Eight cases in the MNF group needed redo surgery. The MNF consisted in suturing the esophagus to the diaphragmatic crura on each side by means of 4 non-absorbable stitches and in fixing the upper stitch of the valve to diaphragm. In case of clearly weak crura, a reinforcement with Ultrapro mesh was used. All patients were assessed before and after surgery using validated symptoms and quality of life (GERD-HRQL) questionnaires, manometry and 24-h impedance-pH monitoring, endoscopy and barium-swallow. Mortality and postoperative complications were nil. At a median follow-up of 36 months, no significant differences emerged between the MNF and NF group in terms of symptoms, GERD-HRQL scores, manometric findings, and impedance-pH features. Dysphagia was not reported by the MNF group, while it was quite common (20% vs.0%, p = ns) in the NF group. Anti-reflux surgery was successful in all patients in the MNF group, whereas two patients in the NF group presented a slipped wrap and one recurrent reflux; two of these cases required redo-surgery (10% vs. 0%, p = ns). Our preliminary data demonstrated that the MNF is a safe and effective procedure. Further, it seems to reduce the failure rate associated to the surgical procedure. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Morbidity of laparoscopic fundoplication for gastroesophageal reflux: a retrospective study about 1470 patients.

    PubMed

    Pessaux, P; Arnaud, J P; Ghavami, B; Flament, J B; Trebuchet, G; Meyer, C; Huten, N; Tuech, J J; Champault, G

    2002-01-01

    The aim of this retrospective study was to report and quantify the immediate and 3-year complications after laparoscopic anti-reflux surgery in order to understand the mechanism. From 1992 to 1996, 1470 laparoscopic fundoplications were performed for symptomatic gastroesophageal reflux disease. Preoperative checkup included upper gastrointestinal tract endoscopy in 1437 patients (97.7%), esophageal manometry in 934 patients (63.5%), and 24-hour pHmetry in 799 patients (54.3%). Three procedures were performed: Nissen (n = 655), Nissen-Rossetti (n = 423), and Toupet (n = 392). The results were estimated at 1 and 3 months; thereafter they were evaluated at 3 years. Patients unable to return to the hospital center were contacted by telephone. Mean length of hospital stay was 4.6 days (range: 2-48 days). The preoperative complication rate was 2.1% (n = 31). The postoperative morbidity and mortality rates were 2.9% (43 patients) and 0.07% (1 patient), respectively. Conversion rate to laparotomy was 6.5% (96 patients). At 3 months, 87 patients (5.9%) had invalid dysphagia but there was no difference between the 3 procedures. Twelve patients have been reoperated (0.8%). At 3 years, 78 patients (5.6%) presented a clinical recurrence. The rate of dysphagia was 0.35%, and 38 patients were reoperated. Laparoscopic fundoplication is safe and effective with a low morbidity and mortality rate if junior surgeons commenced this procedure under the direct supervision of an experienced surgeon. Despite the advantage of this technique, we believe that indications for surgical management remain unchanged in the laparoscopic era.

  11. Laparoscopic Nissen (total) versus anterior 180° fundoplication for gastro-esophageal reflux disease

    PubMed Central

    Du, Xing; Wu, Ji-Min; Hu, Zhi-Wei; Wang, Feng; Wang, Zhong-Gao; Zhang, Chao; Yan, Chao; Chen, Mei-Ping

    2017-01-01

    Abstract Background: Laparoscopic Nissen fundoplication (LNF) has been the gold standard for the surgical management of Gastro-esophageal reflux disease (GERD). Laparoscopic anterior 180° fundoplication (180° LAF) is reported to reduce the incidence of postoperative complications while obtaining similar control of reflux. The present meta-analysis was conducted to confirm the value of the 2 techniques. Methods: PubMed, Medline, Embase, Cochrane Library, Springerlink, and China National Knowledge Infrastructure Platform databases were searched for randomized controlled trials (RCTs) comparing LNF and 180° LAF. Data regarding the benefits and adverse results of 2 techniques were extracted and compared using a meta-analysis. Results: Six eligible RCTs comparing LNF (n = 266) and 180° LAF (n = 265) were identified. There were no significant differences between LNF and 180° LAF with regard to operating time, perioperative complications, length of hospital stay, patient satisfaction, willingness to undergo surgery again, quality of life, postoperative heartburn, proton pump inhibitor (PPI) use, postoperative DeMeester scores, postoperative lower esophageal sphincter (LES) pressure, postoperative gas-bloating, unable to belch, diarrhea, or overall reoperation. LNF was associated with a higher prevalence of postoperative dysphagia compared with 180° LAF, while 180° LAF was followed by more reoperation for recurrent reflux symptoms. Conclusion: LNF and 180° LAF are equally effective in controlling reflux symptoms and obtain a comparable prevalence of patient satisfaction. 180° LAF can reduce the incidence of postoperative dysphagia while this is offset by a higher risk of reoperation for recurrent symptoms. The risk of recurrent symptoms should need to be balanced against the risk of dysphagia when surgeons choose surgical procedures for each individual with GERD. PMID:28906412

  12. Specific esophagogram to assess functional outcomes after Heller's myotomy and Dor's fundoplication for esophageal achalasia.

    PubMed

    Tsoukali, E; Gouvas, N; Tsiaoussis, J; Pechlivanides, G; Zervakis, N; Mantides, A; Xynos, E

    2011-09-01

    Esophageal emptying assessed at the 'timed barium' esophagogram correlates well with symptomatic outcomes after pneumatic dilation for esophageal achalasia, although 30% of patients with satisfactory outcome exhibit partial improvement in emptying. The aim of the study was to investigate any correlation of esophageal emptying to symptomatic response after laparoscopic Heller's myotomy and Dor's fundoplication. 'Bread and barium' (transit time of a barium opaque bread bolus) and 'timed barium' (height of esophageal barium column 5 minutes after ingestion of 200-250 mL of barium suspension) esophagogram was used to assess esophageal emptying in 73 patients with esophageal achalasia before 1 and 5 years (31 cases) after laparoscopic myotomy and anterior fundoplication. Symptoms assessment was based to a specific score. At 1-year follow-up, excellent and good symptomatic results were obtained in 95% of the cases. Esophageal maximum diameter, esophageal transit time, and esophageal barium column were significantly correlated to each other and to symptom score postoperatively (P < 0.001). Complete and partial (<90% and 50-90% postoperative reduction in barium column, respectively) emptying was seen in 55% and 31% of patients with excellent result. Patients with a pseudodiverticulum postoperatively had a more delayed esophageal emptying than those without. Symptomatic outcome and esophageal emptying did not deteriorate at 5-year follow-up. Esophageal emptying assessed by 'barium and bread' and 'timed barium' esophagogram correlated well with symptomatic outcome after laparoscopic myotomy for esophageal achalasia. Complete symptomatic relief does not necessarily reflect complete esophageal emptying. Outcomes do not deteriorate by time. Because of wide availability, esophagogram can be applied in follow-up of postmyotomy patients in conjunction with symptomatic evaluation.

  13. mTOR-dependent activation of the transcription factor TIF-IA links rRNA synthesis to nutrient availability.

    PubMed

    Mayer, Christine; Zhao, Jian; Yuan, Xuejun; Grummt, Ingrid

    2004-02-15

    In cycling cells, transcription of ribosomal RNA genes by RNA polymerase I (Pol I) is tightly coordinated with cell growth. Here, we show that the mammalian target of rapamycin (mTOR) regulates Pol I transcription by modulating the activity of TIF-IA, a regulatory factor that senses nutrient and growth-factor availability. Inhibition of mTOR signaling by rapamycin inactivates TIF-IA and impairs transcription-initiation complex formation. Moreover, rapamycin treatment leads to translocation of TIF-IA into the cytoplasm. Rapamycin-mediated inactivation of TIF-IA is caused by hypophosphorylation of Se 44 (S44) and hyperphosphorylation of Se 199 (S199). Phosphorylation at these sites affects TIF-IA activity in opposite ways, for example, phosphorylation of S44 activates and S199 inactivates TIF-IA. The results identify a new target formTOR-signaling pathways and elucidate the molecular mechanism underlying mTOR-dependent regulation of RNA synthesis.

  14. Polarimetric Interferometric SAR: Literature Review and an Assessment of its Utility for DND: TIF Project Memorandum

    DTIC Science & Technology

    2003-09-01

    SAR : Literature Review and an Assessment of its utility for DND TIF Project.Memorandum Karim E. Mattar, Maureen L. Yeremy and Chuck Livingstone...September 2003 Canada 20031119 057 Polarimetric Interferometric SAR : Literature Review and an Assessment of its utility for DND TIF Project Memorandum Karim...Radar ( SAR ) is a recent area of research that has had significant attention from the mid-1990s. This area of research has combined the utility of two SAR

  15. First report of anti-TIF1γ dermatomyositis in a patient with myelodysplastic syndrome.

    PubMed

    Palterer, B; Vitiello, G; Cammelli, D

    2017-08-03

    Inflammatory myopathies as para-neoplastic phenomena were first described by Sterz in 1916. Recently, myositis specific autoantibodies were described in cancer-associated myositis. Anti-transcription intermediary factor 1 gamma (anti-TIF1γ) antibodies have been found in both young adults affected by juvenile dermatomyositis and in elderly patients with cancer-associated myositis. In this regard, we report herein the first case of anti-TIF1γ dermatomyositis secondary to a myelodysplastic syndrome.

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

    PubMed

    Nguyen, Le Xuan Truong; Mitchell, Beverly S

    2013-12-17

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

  17. A leak too far - Gastro-pleural fistula mimicking recurrence of repaired congenital diaphragmatic hernia following fundoplication

    PubMed Central

    Lakshminarayanan, Bhanumathi; Morgan, Robert David; Platt, Kaye; Lakhoo, Kokila

    2013-01-01

    Recurrence rate after a congenital diaphragmatic hernia repair is high especially after a patch repair. Recurrence can be asymptomatic, followed by respiratory or gastrointestinal symptoms and the diagnosis is usually confirmed radiologically. We present an unusual case of radiologically diagnosed recurrent left diaphragmatic hernia but at surgery was found to be a gastro-pleural fistula that occurred as a complication following fundoplication surgery. PMID:24421956

  18. Gastric greater curvature plication combined with Nissen fundoplication in the treatment of gastroesophageal reflux disease and obesity.

    PubMed

    Ospanov, Oral; Maleckas, Almantas; Orekeshova, Akzhunus

    2016-01-01

    Established anti-reflux procedures such as fundoplications are less efficient in obese patients. The aim of this study was to investigate clinical effectiveness of the fundoplication combined with gastric greater curvature plication in the treatment of gastroesophageal reflux disease (GERD) in obese patients. During the period from June 2010 to September 2014, patients operated for GERD with BMI from 30 to 39.9kg/m(2) were included into the prospective study. Laparoscopic Nissen fundoplication (LNF, n=58) was performed until February 2013 and later laparoscopic Nissen fundoplication was combined with gastric greater curvature plication (LNFGP, n=56). The groups were compared according to the control of GERD and weight loss. In LNF group there were significantly more males, patients had lower BMI and longer duration of GERD symptoms. Duration of surgery was significantly longer in LNFGP group, 96.5 (17.3)min vs. 59.8 (16.1)min (P<0.0001). Postoperative morbidity was similar, 3.6% and 3.4% in LNFGP and LNF groups, respectively (P=0.9539). The average percentage of excess BMI loss after 12 months was 45.3 (5.8) in LNFGP group as compared to 18.4 (4.6) in LNF group (P<0.0001). Significantly more patients experienced remission or improvement of type 2 diabetes mellitus (P=0.03) and hypercholesterolemia (P=0.0001) in LNFGP group. No significant differences between the groups in postoperative DeMeester score, GERD-HRQL mean score, overall satisfaction and healing of esophagitis were observed. LNFGP took significantly longer time to perform, but resulted in significantly higher weight reduction and remission/improvement of comorbidities. Both procedures produced similar anti-reflux effect. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  19. The analgesic efficacy of intravenous lidocaine infusion after laparoscopic fundoplication: a prospective, randomized, double-blind, placebo-controlled trial.

    PubMed

    Dale, Gregory J; Phillips, Stephanie; Falk, Gregory L

    2016-01-01

    This study aimed to determine if intravenous lidocaine infusion reduces postoperative pain intensity following laparoscopic fundoplication surgery and to also validate the safety of intravenous lidocaine at the dose tested. This was an equally randomized, double-blind, placebo-controlled, parallel-group, single center trial. Adult patients undergoing laparoscopic fundoplication were recruited. The intervention group received 1 mg/kg intravenous lidocaine bolus prior to induction of anesthesia, then an intravenous infusion at 2 mg/kg/h for 24 hours. The primary outcome was pain, measured using a numeric rating scale for 30 hours postoperatively. Secondary outcomes were nausea and vomiting, opioid requirements, adverse events, serum lidocaine concentration, and length of hospital stay. The study was terminated after an interim analysis of 24 patients showed evidence of futility. There was no difference in postoperative pain scores (lidocaine versus control, mean ± standard deviation) at rest (2.0 ± 2.7 vs 2.1 ± 2.4, P=0.286) or with movement (2.0 ± 2.6 vs 2.6 ± 2.7, P=0.487). Three adverse events occurred in the lidocaine group (25% of patients). Intravenous lidocaine did not provide clinically significant analgesia to patients undergoing laparoscopic fundoplication. The serum lidocaine concentration of patients who experienced adverse events were within the therapeutic range. This trial cannot confirm the safety of intravenous lidocaine at the dose tested.

  20. The analgesic efficacy of intravenous lidocaine infusion after laparoscopic fundoplication: a prospective, randomized, double-blind, placebo-controlled trial

    PubMed Central

    Dale, Gregory J; Phillips, Stephanie; Falk, Gregory L

    2016-01-01

    This study aimed to determine if intravenous lidocaine infusion reduces postoperative pain intensity following laparoscopic fundoplication surgery and to also validate the safety of intravenous lidocaine at the dose tested. This was an equally randomized, double-blind, placebo-controlled, parallel-group, single center trial. Adult patients undergoing laparoscopic fundoplication were recruited. The intervention group received 1 mg/kg intravenous lidocaine bolus prior to induction of anesthesia, then an intravenous infusion at 2 mg/kg/h for 24 hours. The primary outcome was pain, measured using a numeric rating scale for 30 hours postoperatively. Secondary outcomes were nausea and vomiting, opioid requirements, adverse events, serum lidocaine concentration, and length of hospital stay. The study was terminated after an interim analysis of 24 patients showed evidence of futility. There was no difference in postoperative pain scores (lidocaine versus control, mean ± standard deviation) at rest (2.0 ± 2.7 vs 2.1 ± 2.4, P=0.286) or with movement (2.0 ± 2.6 vs 2.6 ± 2.7, P=0.487). Three adverse events occurred in the lidocaine group (25% of patients). Intravenous lidocaine did not provide clinically significant analgesia to patients undergoing laparoscopic fundoplication. The serum lidocaine concentration of patients who experienced adverse events were within the therapeutic range. This trial cannot confirm the safety of intravenous lidocaine at the dose tested. PMID:27980437

  1. Longitudinal comparison of quality of life in patients undergoing laparoscopic Toupet fundoplication versus magnetic sphincter augmentation

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2014-07-01

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

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

    PubMed Central

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

    2016-01-01

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

  5. Interaction of TIF-90 and filamin A in the regulation of rRNA synthesis in leukemic cells.

    PubMed

    Nguyen, Le Xuan Truong; Chan, Steven M; Ngo, Tri Duc; Raval, Aparna; Kim, Kyeong Kyu; Majeti, Ravindra; Mitchell, Beverly S

    2014-07-24

    The transcription initiation factor I (TIF-IA) is an important regulator of the synthesis of ribosomal RNA (rRNA) through its facilitation of the recruitment of RNA polymerase I (Pol I) to the ribosomal DNA promoter. Activation of the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) pathway, which occurs commonly in acute myelogenous leukemia, enhances rRNA synthesis through TIF-IA stabilization and phosphorylation. We have discovered that TIF-IA coexists with a splicing isoform, TIF-90, which is expressed preferentially in the nucleolus and at higher levels in proliferating and transformed hematopoietic cells. TIF-90 interacts directly with Pol I to increase rRNA synthesis as a consequence of Akt activation. Furthermore, TIF-90 binds preferentially to a 90-kDa cleavage product of the actin binding protein filamin A (FLNA) that inhibits rRNA synthesis. Increased expression of TIF-90 overcomes the inhibitory effect of this cleavage product and stimulates rRNA synthesis. Because activated Akt also reduces FLNA cleavage, these results indicate that activated Akt and TIF-90 function in parallel to increase rRNA synthesis and, as a consequence, cell proliferation in leukemic cells. These results provide evidence that the direct targeting of Akt would be an effective therapy in acute leukemias in which Akt is activated. © 2014 by The American Society of Hematology.

  6. Can different subsets of ineffective esophageal motility influence the outcome of nissen fundoplication?

    PubMed

    Simić, Aleksandar P; Skrobić, Ognjan M; Gurski, Richard R; Šljukić, Vladimir M; Ivanović, Nenad R; Peško, Predrag M

    2014-10-01

    Ineffective esophageal motility (IEM) in patients with gastroesophageal reflux disease includes three different subsets that may affect symptom profiles. Our aim was to assess symptoms and functional outcome in patients with erosive esophagitis according to different subsets of IEM, before and after Nissen fundoplication (NF). A retrospective study with prospective follow-up of 72 patients with reflux esophagitis and IEM in whom open NF was performed. Based on principal manometric esophageal body motility disorder, patients were divided in three groups: predominantly low-amplitude (LAC, N = 38), non-propulsive (NPC, N = 18), and simultaneous low-amplitude esophageal contractions (SC, N = 16). Patients underwent symptomatic questionnaire and stationary esophageal manometry before and 6 months, 1 year, and 3 years after surgery. Preoperatively, patients in NPC and SC groups had higher mean scores of dysphagia, without statistical significance as opposed to the LAC group (p = 0.239). Postoperative dysphagia occurred in 36 patients, without statistical significance between groups regarding dysphagia grades (p = 0.390). A longer duration of postoperative dysphagia was noted in the SC group (p < 0.05). Improvement of nadir values of contraction amplitudes in distal esophagus occurred postoperatively in all groups, significantly higher in LAC (p < 0.001). Three years after NF, successful symptomatic and functional outcome was achieved in analyzed groups of patients with erosive esophagitis regardless of IEM subtype.

  7. The effect of endoscopic fundoplication and proton pump inhibitors on baseline impedance and heartburn severity in GERD patients.

    PubMed

    Rinsma, N F; Farré, R; Bouvy, N D; Masclee, A A M; Conchillo, J M

    2015-02-01

    Antireflux therapy may lead to recovery of impaired mucosal integrity in gastro-esophageal reflux disease (GERD) patients as reflected by an increase in baseline impedance. The study objective was to evaluate the effect of endoscopic fundoplication and proton pump inhibitor (PPI) PPI therapy on baseline impedance and heartburn severity in GERD patients. Forty-seven GERD patients randomized to endoscopic fundoplication (n = 32) or PPI therapy (n = 15), and 29 healthy controls were included. Before randomization and 6 months after treatment, baseline impedance was obtained during 24-h pH-impedance monitoring. Heartburn severity was evaluated using the GERD-HRQL questionnaire. Before treatment, baseline impedance in GERD patients was lower than in healthy controls (p < 0.001). Antireflux therapy increased baseline impedance (from 1498 [IQR 951-2472] to 2393 [IQR 1353-3027] Ω, p = 0.001), however it only led to a partial recovery when compared to healthy controls (2393 [IQR 1353-3027] vs 2983 [2335-3810] Ω, p < 0.01). The effect of both treatment options was not significantly different (p = 0.13) despite the increased number of non-acid reflux events in the PPI group. No correlation was found between baseline impedance and GERD symptoms before or after treatment. Reduction in acid reflux by endoscopic fundoplication or PPI therapy leads to an increase in baseline impedance in GERD patients, likely to reflect recovery of mucosal integrity. The impact of non-acid reflux events on esophageal mucosal integrity may be limited as no difference in the increase in baseline impedance was observed after both treatment options. The lack of association between impedance baseline and heartburn severity indicates that other factors may contribute to heartburn perception in GERD. © 2014 John Wiley & Sons Ltd.

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

    PubMed Central

    Wróblewski, Tadeusz; Nowosad, Małgorzata; Krawczyk, Marek

    2016-01-01

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

  9. Vertical gastric plication versus Nissen fundoplication in the treatment of gastroesophageal reflux in children with cerebral palsy.

    PubMed

    Durante, Antonio Paulo; Schettini, Sergio Tomaz; Fagundes, Djalma José

    2007-01-04

    Association between neurological lesions and gastroesophageal reflux disease (GERD) in children is very common. When surgical treatment is indicated, the consensus favors the fundoplication technique recommended by Nissen, despite its high morbidity and relapse rates. Vertical gastric plication is a procedure that may have advantages over Nissen fundoplication, since it is less aggressive and more adequately meets anatomical principles. The authors proposed to compare the results from the Nissen and vertical gastric plication techniques. Randomized prospective study within the Postgraduate Surgery and Experimentation Program of UNIFESP-EPM, at Hospital do Servidor Público Estadual (IAMSPE) and Hospital Municipal Infantil Menino Jesus. Fourteen consecutive children with cerebral palsy attended between November 2003 and July 2004 were randomized into two groups for surgical treatment of GERD: NF, Nissen fundoplication (n = 7); and VGP, vertical gastric plication (n = 7). These were clinically assessed by scoring for signs and symptoms, evaluation of esophageal pH measurements, duration of the operation, intra and postoperative complications, mortality and length of hospital stay. The mean follow-up was 5.2 months; symptoms were reduced by 42.8% (NF) (p = 0.001) and 57.1% (VGP) (p = 0.006). The Boix-Ochoa score was favorable for both groups: NF (p < 0.001) and VGP (p < 0.042). The overall mortality was 14.28% in both groups and was due to causes unrelated to the surgical treatment. The two operative procedures were shown to be efficient and efficacious for the treatment of GERD in neuropathic patients, over the study period.

  10. A combinative effect of low-molecular-weight heparin and intermittent pneumatic compression device for thrombosis prevention during laparoscopic fundoplication.

    PubMed

    Kiudelis, Mindaugas; Gerbutavicius, Rolandas; Gerbutaviciene, Rima; Griniūte, Rasa; Mickevicius, Antanas; Endzinas, Zilvinas; Pundzius, Juozas

    2010-01-01

    BACKGROUND. Venous thromboembolism is known to be an important social and health care problem because of its high incidence among patients who undergo surgery. For instance, 20-30% of patients develop this problem after general surgical operations, while 5.5% of patients have this complication when laparoscopic fundoplications are performed without any prophylaxis. The aim of our study was to evaluate the hypocoagulation effect of the following treatments during and after laparoscopic fundoplication: a) intermittent pneumatic compression (IPC) and b) combination of low-molecular-weight heparin (LMWH) and IPC. MATERIAL AND METHODS. The study was performed on 20 consecutive patients who were randomized into two groups. The first group received IPC during operation, the second group received IPC during operation and LMWH before operation. Plasma prothrombin fragment F1+2 (F1+2), thrombin-antithrombin complex (TAT) - markers of thrombogenesis - and plasma free tissue factor pathway inhibitor (fTFPI) - a marker of hypocoagulation effect - were measured 1 h before, during, and after the laparoscopic operation. RESULTS. In the IPC group, plasma F1+2 and TAT levels increased significantly during and after laparoscopic gastrofundoplication. In the IPC+LMWH group, F1+2 and plasma TAT levels did not change during or after the operation. fTFPI levels significantly increased during and after the operation in the IPC+LMWH group; however, fTFPI levels did not change during or after the laparoscopic operation in the IPC group. CONCLUSIONS. A combination of low-molecular-weight heparin and intermittent pneumatic compression during laparoscopic fundoplication caused hypocoagulation effect in the patients, which was not observed in the patients who were treated with intermittent pneumatic compression alone.

  11. A new innovative laparoscopic fundoplication training simulator with a surgical skill validation system.

    PubMed

    Jimbo, Takahiro; Ieiri, Satoshi; Obata, Satoshi; Uemura, Munenori; Souzaki, Ryota; Matsuoka, Noriyuki; Katayama, Tamotsu; Masumoto, Kouji; Hashizume, Makoto; Taguchi, Tomoaki

    2017-04-01

    We developed and validated a specific laparoscopic fundoplication simulator for use with the objective endoscopic surgical skills evaluation system. The aim of this study was to verify the quality of skills of surgeons. We developed a 1-year-old infant body model based on computed tomography data and reproduced pneumoperitoneum model based on the clinical situation. The examinees were divided into three groups: fifteen pediatric surgery experts (PSE), twenty-four pediatric surgery trainees (PSN), and ten general surgeons (GS). They each had to perform three sutures ligatures for construction of Nissen wrap. Evaluate points are time for task, the symmetry of the placement of the sutures, and the uniformity of the interval of suture ligatures in making wrap. And the total path length and velocity of forceps were measured to assess bi-hand coordination. PSE were significantly superior to PSN regarding total time spent (p < 0.01) and total path length (p < 0.01). GS used both forceps faster than the other groups, and PSN used the right forceps faster than the left forceps (p < 0.05). PSE were shorter with regard to the total path length than GS (p < 0.01). PSE showed most excellent results in the symmetry of the wrap among three groups. Our new model was used useful to validate the characteristics between GS and pediatric surgeon. Both PSE and GS have excellent bi-hand coordination and can manipulate both forceps equally and had superior skills compared to PSN. In addition, PSE performed most compact and accurate skills in the conflicted operative space.

  12. Laparoscopic graduated cardiomyotomy with anterior fundoplication as treatment for achalasia: experience of 48 cases.

    PubMed

    Etchegaray-Dondé, A; Rodríguez-Espínola, G; Higuera-Hidalgo, F; Ortiz-Higareda, V; Chapa-Azuela, O; Etchegaray-Solana, A

    2017-08-23

    At the Upper Gastrointestinal Tract Clinic of the Hospital General de Mexico, achalasia treatment has been standarized through strictly graduated cardiomyotomy. This procedure guarantees a complete myotomy for the satisfactory resolution of dysphagia, a characteristic symptom of achalasia. To ensure the inclusion of the entire lower esophageal sphincter, an 8cm Penrose drain is placed at the surgical site 6cm above the gastroesophageal junction and 2cm in a caudal direction, for accurate laparoscopic measuring. The aim of our study was to evaluate the results of this technique. A descriptive, retrospective, longitudinal, and observational study was conducted on a cohort of patients diagnosed with achalasia at the Upper Gastrointestinal Tract Clinic of the Hospital General de México "Dr. Eduardo Liceaga". The study included 48 patients, 40 of whom had no prior surgical treatment and 8 that presented with recurrence. Forty-seven patients (97.9%) underwent a laparoscopic procedure and conversion to open surgery was required in 2 of them (4.25% conversion rate). Postoperative progression was satisfactory in all cases, with mean oral diet commencement at 52h and mean hospital stay of 5.7 days. No recurrence was registered during the mean follow-up period of 35.75 months and there were no deaths. Laparoscopic graduated (strictly measured) cardiomyotomy with anterior fundoplication is a reproducible, efficacious, and safe option for the surgical treatment of achalasia. Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  13. [Nissen fundoplication in children under 1 year of age: is age important?

    PubMed

    Romo, M I; López-Fernández, S; Núñez, V; Amesty, M V; Triana, P; Domínguez, E; De La Torre, C A; Barrena, S; López-Santamaría, M; Martínez, L

    2016-10-10

    Nissen fundoplication (NF) is a procedure with technical difficulties and variable functional prognosis the lower the patient's age is. Our objective is to analyze the peculiarities of this procedure when performed in children under 1 year. Retrospective study of the NF in our center from 1999 to 2014. We review the differences between children under 1 year of age and the leftover of the series: history, indications, surgical approach and postoperative outcomes. A total of 233 patients (57.1% male) were operated at a median age of 2.3years (1 month-17.31years), of which 82 (35.2%) were younger than 1 year. It Open surgery was performed in 118 patients (86.6% of children under 1 year and 31.1% over 1 year, p <0.05) and laparoscopic in 115. The median follow-up was 3.92 ± 3.24 years. Patients under 1 year had a higher number of comorbidities (91.5% vs 81.5%), respiratory symptoms (76.8% vs 49.7%) and postoperative complications (20.7% vs 9.9% OR = 2.4), with statistically significant differences (p <0.05). There were not differences in the Nissen's failure rate (15.9% vs 8.6%) or the need of reoperation (15.9% vs 7.9%). Patients under 1 year operated by NF form a group with particular indications and comorbidities. Although the outcomes among these patients are favourable, surgical complications are more frequent than in older children.

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

    PubMed Central

    2012-01-01

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

  15. LATE EVALUATION OF PATIENTS OPERATED FOR GASTROESOPHAGEAL REFLUX DISEASE BY NISSEN FUNDOPLICATION.

    PubMed

    Ribeiro, Maxwel Capsy Boga; Araújo, Amanda Bueno de; Terra-Júnior, Juverson Alves; Crema, Eduardo; Andreollo, Nelson Adami

    2016-01-01

    Surgical treatment of GERD by Nissen fundoplication is effective and safe, providing good results in the control of the disease. However, some authors have questioned the efficacy of this procedure and few studies on the long-term outcomes are available in the literature, especially in Brazil. To evaluate patients operated for gastro-esophageal reflux disease, for at least 10 years, by Nissen fundoplication. Thirty-two patients were interviewed and underwent upper digestive endoscopy, esophageal manometry, 24 h pH monitoring and barium esophagogram, before and after Nissen fundoplication. Most patients were asymptomatic, satisfied with the result of surgery (87.5%) 10 years after operation, due to better symptom control compared with preoperative and, would do it again (84.38%). However, 62.5% were in use of some type of anti-reflux drugs. The manometry revealed lower esophageal sphincter with a mean pressure of 11.7 cm H2O and an average length of 2.85 cm. The average DeMeester index in pH monitoring was 11.47. The endoscopy revealed that most patients had a normal result (58.06%) or mild esophagitis (35.48%). Barium swallow revealed mild esophageal dilatation in 25,80% and hiatal hernia in 12.9% of cases. After at least a decade, most patients were satisfied with the operation, asymptomatic or had milder symptoms of GERD, being better and with easier control, compared to the preoperative period. Nevertheless, a considerable percentage still employed anti-reflux medications. O tratamento cirúrgico para DRGE empregando a fundoplicatura à Nissen é eficaz e seguro, oferecendo bons resultados no controle da doença. Entretanto, alguns autores têm questionado quanto a sua eficácia, e poucos estudos com avaliação tardia destes doentes são encontrados na literatura, sobretudo no Brasil. Avaliar pacientes operados por doença do refluxo gastroesofágico há pelo menos 10 anos, pela técnica de Nissen. Trinta e dois pacientes foram entrevistados e submetidos

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

    PubMed Central

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

    1996-01-01

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

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

    PubMed

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

    2013-03-01

    Titanium tetrafluoride (TiF(4)) is an effective but instable caries preventive agent. As the stability problems could be minimized through the use of drug carriers this study aimed to prepare and characterize a new TiF(4) nanoinclusion complex and to evaluate its potential in inhibiting enamel demineralization under pH cycling conditions. The TiF(4) nanosystems were prepared using β-cyclodextrin (βCD) and sodium montmorillonite (MMTNa). Bovine enamel blocks (n=48) with known surface microhardness (SMH), were randomly assigned to 4 groups (n=12) and submitted to one of the following treatments: distilled deionized water (as negative control) and solutions containing 1% βCD, 1% TiF(4) and TiF(4):βCD. The solutions were blinded applied once on the blocks with a microbrush(®) on the surface for 1min before pH-cycling. After that, samples were reavaluated by SMH, %SMH loss, cross-sectional microhardness (CSMH), scanning electron microscope (SEM) and energy dispersive spectrometry (EDX). The inclusion complex of TiF(4):βCD offered better protection against demineralization in the subsurface. The SEM analysis showed that TiF(4) and TiF(4):βCD samples presented the most intact enamel than the control. The EDX analysis identified titanium in TiF(4) and TiF(4):βCD groups. TiF(4):βCD has higher potential on inhibiting demineralization in the inner enamel. TiF(4):βCD is a new alternative to TiF(4) stabilization in order to reduce enamel subsurface demineralization. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Successful laparoscopic Nissen fundoplication in a patient with mixed connective tissue disease with a short esophagus: report of a case.

    PubMed

    Nakajima, Kiyokazu; Takahashi, Tsuyoshi; Takiguchi, Shuji; Miyata, Hiroshi; Yamasaki, Makoto; Kurokawa, Yukinori; Mori, Masaki; Doki, Yuichiro

    2013-11-01

    A 51-year-old female with esophageal stricture was referred to our hospital. She was diagnosed to have mixed connective tissue disease and had been placed on steroid and immunosuppressant treatment. She presented with passage disturbance and free reflux of the gastric contents when in the supine position. Pneumatic dilatation and medication resulted in partial relief of her symptoms. Preoperative imaging studies demonstrated a shortened esophagus with severe stricture of the esophagogastric junction and a moderate hiatal hernia. A DeMeester's score of 140.1 was noted on 24-h pH monitoring. Under a diagnosis of stricturing reflux esophagitis, surgical treatment was indicated. Laparoscopic transhiatal mediastinal dissection with crural repair and fundoplication was offered instead of thoracotomy and/or laparotomy, since she had a high risk due to immunosuppression. The esophagus was extensively dissected through the hiatus up to the level of the tracheal bifurcation, and fundoplication was completed without Collis gastroplasty. Her postoperative course was rapid and uneventful. Postoperatively, her clinical symptoms were resolved with anatomical/functional improvement.

  19. The learning curve of robot-assisted laparoscopic fundoplication in children: a prospective evaluation and CUSUM analysis.

    PubMed

    Cundy, Thomas P; Rowland, Simon P; Gattas, Nicholas E; White, Alan D; Najmaldin, Azad S

    2015-06-01

    Fundoplication is a leading application of robotic surgery in children, yet the learning curve for this procedure (RF) remains ill-defined. This study aims to identify various learning curve transition points, using cumulative summation (CUSUM) analysis. A prospective database was examined to identify RF cases undertaken during 2006-2014. Time-based surgical process outcomes were evaluated, as well as clinical outcomes. A total of 57 RF cases were included. Statistically significant transitions beyond the learning phase were observed at cases 42, 34 and 37 for docking, console and total operating room times, respectively. A steep early learning phase for docking time was overcome after 12 cases. There were three Clavien-Dindo grade ≥ 3 complications, with two patients requiring redo fundoplication. We identified numerous well-defined learning curve trends to affirm that experience confers significant temporal improvements. Our findings highlight the value of the CUSUM method for learning curve evaluation. Copyright © 2014 John Wiley & Sons, Ltd.

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

    PubMed Central

    2016-01-01

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

  1. YouTube as a Potential Training Resource for Laparoscopic Fundoplication.

    PubMed

    Frongia, Giovanni; Mehrabi, Arianeb; Fonouni, Hamidreza; Rennert, Helga; Golriz, Mohammad; Günther, Patrick

    To analyze the surgical proficiency and educational quality of YouTube videos demonstrating laparoscopic fundoplication (LF). In this cross-sectional study, a search was performed on YouTube for videos demonstrating the LF procedure. The surgical and educational proficiency was evaluated using the objective component rating scale, the educational quality rating score, and total video quality score. Statistical significance was determined by analysis of variance, receiver operating characteristic curve, and odds ratio analysis. A total of 71 videos were included in the study; 28 (39.4%) videos were evaluated as good, 23 (32.4%) were moderate, and 20 (28.2%) were poor. Good-rated videos were significantly longer (good, 22.0 ± 5.2min; moderate, 7.8 ± 0.9min; poor, 8.5 ± 1.0min; p = 0.007) and video duration was predictive of good quality (AUC, 0.672 ± 0.067; 95% CI: 0.541-0.802; p = 0.015). For good quality, the cut-off video duration was 7:42 minute. This cut-off value had a sensitivity of 67.9%, a specificity of 60.5%, and an odds ratio of 3.23 (95% CI: 1.19-8.79; p = 0.022) in predicting good quality. Videos uploaded from industrial sources and with a higher views/days online ratio had a higher objective component rating scale and total video quality score. In contrast, the likes/dislikes ratio was not predictive of video quality. Many videos showing the LF procedure have been uploaded to YouTube with varying degrees of quality. A process for filtering LF videos with high surgical and educational quality is feasible by evaluating the video duration, uploading source, and the views/days online ratio. However, alternative videos platforms aimed at professionals should also be considered for educational purposes. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  2. Laparoscopic Magnetic Sphincter Augmentation vs Laparoscopic Nissen Fundoplication: A Matched-Pair Analysis of 100 Patients.

    PubMed

    Reynolds, Jessica L; Zehetner, Joerg; Wu, Phil; Shah, Shawn; Bildzukewicz, Nikolai; Lipham, John C

    2015-07-01

    The efficacy and safety of magnetic sphincter augmentation (MSA) with the LINX device (Torax Medical) has been reported in several short-and long-term studies, rivaling historic results of laparoscopic Nissen fundoplication (LNF), but with fewer side effects. However, there have been no studies comparing patients with similar disease to validate these results. We conducted a retrospective analysis of 1-year outcomes of patients undergoing MSA and LNF from June 2010 to June 2013. Patients were matched using propensity scores incorporating multiple preoperative variables. Outcomes were measured by GERD Health Related Quality of Life scores, proton-pump inhibitor use, satisfaction, and complications. One hundred and seventy-nine patients met inclusion criteria, 62 MSA and 117 LNF. Propensity score matching identified 50 patients in both groups using the "best-fit" model with a caliper of 0.5 SD. At 1 year after surgery, both groups had similar GERD Health Related Quality of Life scores (4.2 MSA and 4.3 LNF; p = 0.897) and proton-pump inhibitor use (17% of MSA and 8.5% of LNF; p = 0.355). Although there was no difference in the number of patients reporting mild gas and bloating (27.6% MSA and 27.6% LNF; p = 1.000), there were no patients with severe gas and bloating in the MSA group compared with 10.6% in the LNF group (p = 0.022). More LNF patients were unable to belch (8.5% of MSA and 25.5% of LNF; p = 0.028) or vomit (4.3% of MSA and 21.3% of LNF; p = 0.004). The incidence of postoperative dysphagia was similar between the groups (46.8% MSA and 44.7% LNF; p = 0.766). Analogous GERD patients had similar control of reflux symptoms after both MSA and LNF. The inabilities to belch and vomit were significantly fewer with MSA, along with a significantly lower incidence of severe gas-bloat symptoms. These results support the use of MSA as first-line therapy in patients with mild to moderate GERD. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc

  3. Ways to Evaluate the Success of Your Teacher Incentive Fund Project in Meeting TIF Goals

    ERIC Educational Resources Information Center

    Milanowski, Anthony; Finster, Matthew

    2016-01-01

    This brief outlines some simple methods that Teacher Incentive Fund grants could add to their local evaluations to find out how well they are promoting attainment of the four overall TIF goals. The methods described in this brief can help grantees determine if they are moving toward improving effectiveness, student achievement, and equity.…

  4. 77 FR 35757 - Final Priorities, Requirements, Definitions, and Selection Criteria-Teacher Incentive Fund (TIF...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-14

    ... improve instruction by informing performance- based compensation and other key human capital decisions... Department recognizes that there are many aspects of performance-based compensation and human capital... year (FY) 2012 and later years. We are taking this action so that TIF-funded performance-based...

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

    ERIC Educational Resources Information Center

    Fermanich, Mark; Carl, Brad; Finster, Matthew

    2015-01-01

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

  6. TIF-IA: An oncogenic target of pre-ribosomal RNA synthesis.

    PubMed

    Jin, Rui; Zhou, Wei

    2016-12-01

    Cancer cells devote the majority of their energy consumption to ribosome biogenesis, and pre-ribosomal RNA transcription accounts for 30-50% of all transcriptional activity. This aberrantly elevated biological activity is an attractive target for cancer therapeutic intervention if approaches can be developed to circumvent the development of side effects in normal cells. TIF-IA is a transcription factor that connects RNA polymerase I with the UBF/SL-1 complex to initiate the transcription of pre-ribosomal RNA. Its function is conserved in eukaryotes from yeast to mammals, and its activity is promoted by the phosphorylation of various oncogenic kinases in cancer cells. The depletion of TIF-IA induces cell death in lung cancer cells and mouse embryonic fibroblasts but not in several other normal tissue types evaluated in knock-out studies. Furthermore, the nuclear accumulation of TIF-IA under UTP down-regulated conditions requires the activity of LKB1 kinase, and LKB1-inactivated cancer cells are susceptible to cell death under such stress conditions. Therefore, TIF-IA may be a unique target to suppress ribosome biogenesis without significantly impacting the survival of normal tissues.

  7. Incision-less reversal of Hartmann's procedure.

    PubMed

    Joshi, H M; Gosselink, M P; Adusumilli, S; Cunningham, C; Lindsey, I; Jones, O M

    2014-09-01

    After taking down the colostomy in a patient who has previously undergone a Hartmann's operation, it is possible to restore bowel continuity using the single-port technique via the colostomy site itself. This study presents our experience of this approach using the glove port and standard laparoscopic instrumentation. Between October 2010 and October 2013, 14 patients [median age 62 years (range 42-83 years); median body mass index 25.2 kg/m(2) (range 22.7-34.9) kg/m(2)] underwent attempted single-port (via colostomy site) reversal of Hartmann's. All but one patient had had a laparotomy for their primary surgery. The glove port was used with a camera and two working ports. Additional remote access was needed in 3 (21 %) patients [1 × 5 mm port (two patients); 2 × 5-mm ports ; 2 × 5-mm ports and Pfannenstiel]. Median operative time was 150 min (range 75-270 min). Mortality was nil. One patient required reoperation and a stoma. Median hospital stay was 5 days (range 2-36 days). Glove port reversal of Hartmann's is technically possible, though challenging if extensive adhesions are present. Outcomes are variable. Further studies will be needed to assess whether this is a safe technique.

  8. Repression of the c-fms gene in fibroblast cells by c-Myc-MM-1-TIF1beta complex.

    PubMed

    Satou, Akiko; Hagio, Yuko; Taira, Takahiro; Iguchi-Ariga, Sanae M M; Ariga, Hiroyoshi

    2004-08-13

    MM-1 has been reported to repress the E-box-dependent transcription activity of c-Myc by recruiting histone deacetylase 1 complex via TIF1beta/KAP1. In this study, to identify target genes for c-Myc-MM-1-TIF1beta, we established rat-1 cells harboring the dominant-negative form of TIF1beta to abrogate the pathway from TIF1beta to MM-1-c-Myc. This cell line, in which transcription activity of c-Myc was activated, was found to be tumorigenic. By DNA-microarray analysis of this cell line, expression and promoter activity of the c-fms oncogene were found to be upregulated. Of the two promoters, pE1 and pE2, in the c-fms gene, pE1 promoter activity was found to be activated in an E-box-dependent manner.

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

    PubMed Central

    Davis, Christopher S.; Jellish, W. Scott

    2011-01-01

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

  10. New technology for the division of short gastric vessels during laparoscopic Nissen fundoplication. A prospective randomized trial.

    PubMed

    Laycock, W S; Trus, T L; Hunter, J G

    1996-01-01

    Division of the short gastric vessels (SGV) is a standard component of laparoscopic Nissen fundoplications (LNF) at our institution. This study compares our original method of vessel control, multifire clip applier (MCA) and sharp division, to the Ultracision Harmonic Scalpel LCS (LCS). Twenty consecutive patients were evaluated in a randomized prospective fashion. Times for SGV division and estimated blood loss (EBL) were recorded. Cost data represent patient charges for use of either the MCA or LCS and the charge for operative time. Use of the LCS produced a significant reduction in the time required for SGV division and in the charges to the patient. [table: see text] We feel it is important to divide the SGV in all LNFs, and LCS use can result in significant savings of time and money.

  11. How does dexamethasone influence surgical outcome after laparoscopic Nissen fundoplication? A randomized double-blind placebo-controlled trial.

    PubMed

    Schietroma, M; Giuliani, M; Zoccali, G; Carlei, F; Carnei, F; Bianchi, Z; Amiccucci, G; Amicucci, G; Daniloiu, A G

    2010-08-01

    Laparoscopic floppy Nissen fundoplication (LFNF) is an effective treatment for gastroesophageal reflux disease. The duration of convalescence, after noncomplicated LFNF, may depend on several factors of which pain, fatigue and sociocultural factors are the most important. Nausea and vomiting occur mainly on the day of operation. Glucocorticoids are well known for their analgesic, anti-inflammatory, immune-modulating and antiemetic effects. We therefore undertook the present study to investigate whether preoperative dexamethasone could improve surgical outcome in patients undergoing uncomplicated laparoscopic floppy Nissen fundoplication. From March 2005 to April 2008, 82 patients were randomized to receive dexamethasone (8 mg) intravenously, 90 min before skin incision or saline (placebo). Patients received a similar standardized anesthetic, surgical and multimodal analgesic treatment. The primary end points were pain and fatigue. Preoperatively and at several times during the first 24 postoperative hours, we measured C-reactive protein (CRP), interleukin-6 and 1 (IL-6, IL-1), pain scores and nausea, and the number of vomiting episodes were registered. Dexamethasone significantly reduced postoperative levels of CRP (p = 0.01), IL-6 and IL-1 (p < 0.05), fatigue (p = 0.01) and overall pain during the first 24 postoperative hours (p < 0.05) and the total requirement of analgesic (ketorolac) (p < 0.05). Dexamethasone also reduced nausea and vomiting on the day of operation (p < 0.05). Preoperative dexamethasone (8 mg) reduced pain, fatigue, nausea and vomiting in patients undergoing uncomplicated LNF when compared with placebo.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-03-01

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

  14. Reflux parameters as modified by laparoscopic fundoplication in 40 patients with heartburn/regurgitation persisting despite PPI therapy: a study using impedance-pH monitoring.

    PubMed

    Frazzoni, Marzio; Conigliaro, Rita; Melotti, Gianluigi

    2011-04-01

    Patients with typical reflux symptoms (heartburn/regurgitation) persisting despite proton pump inhibitor (PPI) therapy are not uncommon. Impedance-pH monitoring detects gastroesophageal reflux at all pH levels and may establish if ongoing symptoms on PPI therapy are associated with acid/nonacid reflux. Laparoscopic fundoplication is a therapeutic option in such patients but reflux parameters on PPI therapy and after intervention and their relationship with symptom persistence/remission have been scarcely studied. The aim of this study was to assess reflux parameters and their relationship with symptoms before and after laparoscopic fundoplication, on and off PPI therapy, respectively, in patients with PPI-unresponsive heartburn/regurgitation and with a positive symptom-reflux association and/or abnormal reflux parameters detected on PPI therapy. Impedance-pH monitoring was performed on high-dose PPI therapy and 3 months after laparoscopic fundoplication, off PPI therapy, in 40 patients with PPI-unresponsive heartburn/regurgitation. Symptoms were scored by a validated questionnaire. Esophageal acid exposure time as well as the number of total and proximal reflux events and of acid and weakly acidic refluxes decreased significantly after surgery: normal values were found in 100, 77, 95, 92 and 65% of cases, respectively. Weakly alkaline refluxes increased significantly postoperatively but neither before nor after intervention were associated with symptoms. All patients reported total/subtotal remission of heartburn/regurgitation 3 months after surgery. Laparoscopic fundoplication improves acid and weakly acidic reflux parameters when compared with PPI therapy. This improvement justifies the very high post-surgical symptom remission rate that we observed. Prolonged follow-up is warranted but our findings strongly support the surgical option in PPI failures.

  15. Interleukin-6 increases prostate cancer cells resistance to bicalutamide via TIF2

    PubMed Central

    Feng, Siting; Tang, Qizhu; Sun, Meng; Chun, Jae Yeon; Evans, Christopher P.; Gao, Allen C.

    2011-01-01

    The standard treatment for advanced, androgen-responsive prostate cancer is androgen deprivation therapy with or without a nonsteroidal antiandrogen, such as bicalutamide. Although maximal androgen blockade exhibits favorable responses in the majority of patients, prostate cancer eventually progresses to an androgen-refractory stage. The mechanism underlying bicalutamide resistance in the course of prostate cancer progression is incompletely understood. However, interleukin-6 (IL-6) plays a critical role in the development and progression of CRPC. Herein, we explored an association between IL-6 and bicalutamide resistance. To study this, series of lower and higher passages of LNCaP cell sublines generated by long-term exposure to IL-6 were used. The cells from higher passages of LNCaP treated with IL-6 developed resistance to bicalutamide treatment compared with parental LNCaP cells. The levels of transcriptional intermediary factor 2 (TIF2) in IL-6-treated LNCaP cells were found to be significantly higher than parental LNCaP cells. Down-regulation of TIF2 expression via short hairpin RNA in IL-6-treated LNCaP cells sensitized these cells to bicalutamide treatment, whereas overexpression of TIF2 in the parental LNCaP cells increased resistance to bicalutamide. Furthermore, overexpression of IL-6 attenuated bicalutamide-mediated blockage of androgen-induced androgen receptor nuclear translocation and recruitment. These results show that overexpression of IL-6 increases the resistance of prostate cancer cells to bicalutamide via TIF2. Overexpression of IL-6 not only plays an important role in prostate cancer progression but also contributes to bicalutamide resistance. Our studies suggest that bicalutamide-IL-6-targeted adjunctive therapy may lead to a more effective intervention than bicalutamide alone. PMID:19240160

  16. Interleukin-6 increases prostate cancer cells resistance to bicalutamide via TIF2.

    PubMed

    Feng, Siting; Tang, Qizhu; Sun, Meng; Chun, Jae Yeon; Evans, Christopher P; Gao, Allen C

    2009-03-01

    The standard treatment for advanced, androgen-responsive prostate cancer is androgen deprivation therapy with or without a nonsteroidal antiandrogen, such as bicalutamide. Although maximal androgen blockade exhibits favorable responses in the majority of patients, prostate cancer eventually progresses to an androgen-refractory stage. The mechanism underlying bicalutamide resistance in the course of prostate cancer progression is incompletely understood. However, interleukin-6 (IL-6) plays a critical role in the development and progression of CRPC. Herein, we explored an association between IL-6 and bicalutamide resistance. To study this, series of lower and higher passages of LNCaP cell sublines generated by long-term exposure to IL-6 were used. The cells from higher passages of LNCaP treated with IL-6 developed resistance to bicalutamide treatment compared with parental LNCaP cells. The levels of transcriptional intermediary factor 2 (TIF2) in IL-6-treated LNCaP cells were found to be significantly higher than parental LNCaP cells. Down-regulation of TIF2 expression via short hairpin RNA in IL-6-treated LNCaP cells sensitized these cells to bicalutamide treatment, whereas overexpression of TIF2 in the parental LNCaP cells increased resistance to bicalutamide. Furthermore, overexpression of IL-6 attenuated bicalutamide-mediated blockage of androgen-induced androgen receptor nuclear translocation and recruitment. These results show that overexpression of IL-6 increases the resistance of prostate cancer cells to bicalutamide via TIF2. Overexpression of IL-6 not only plays an important role in prostate cancer progression but also contributes to bicalutamide resistance. Our studies suggest that bicalutamide-IL-6-targeted adjunctive therapy may lead to a more effective intervention than bicalutamide alone.

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

    PubMed

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

    2010-11-14

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

  18. Genome-wide identification of transcript start and end sites by Transcript Isoform Sequencing, TIF-Seq

    PubMed Central

    Pelechano, Vicent; Wei, Wu; Jakob, Petra; Steinmetz, Lars M.

    2014-01-01

    Hundreds of transcript isoforms with varying boundaries and alternative regulatory signals are transcribed from the genome, even in a genetically homogeneous population of cells. To study this transcriptional heterogeneity, we developed Transcript Isoform Sequencing (TIF-Seq), a method that allows the genome-wide profiling of full-length transcript isoforms defined by their exact 5′ and 3′ boundaries. TIF-Seq entails generating full-length cDNA libraries, followed by their circularization and the sequencing of the junction fragments spanning the 5′ and 3′ transcript ends. By determining the respective co-occurrence of start and end sites of individual transcript molecules, TIF-Seq can distinguish variations that conventional approaches for mapping single ends cannot, such as short abortive transcripts, bicistronic messages, and overlapping transcripts that differ in lengths. The TIF-Seq protocol we describe here can be applied to any eukaryotic organism (e.g., yeast, human) and requires 6-10 days to generate TIF-Seq libraries, 10 days for sequencing and 2-3 days for analysis. PMID:24967623

  19. Tif1γ regulates the TGF-β1 receptor and promotes physiological aging of hematopoietic stem cells

    PubMed Central

    Quéré, Ronan; Saint-Paul, Laetitia; Carmignac, Virginie; Martin, Romain Z.; Chrétien, Marie-Lorraine; Largeot, Anne; Hammann, Arlette; Pais de Barros, Jean-Paul; Bastie, Jean-Noël; Delva, Laurent

    2014-01-01

    The hematopoietic system declines with age. Myeloid-biased differentiation and increased incidence of myeloid malignancies feature aging of hematopoietic stem cells (HSCs), but the mechanisms involved remain uncertain. Here, we report that 4-mo-old mice deleted for transcription intermediary factor 1γ (Tif1γ) in HSCs developed an accelerated aging phenotype. To reinforce this result, we also show that Tif1γ is down-regulated in HSCs during aging in 20-mo-old wild-type mice. We established that Tif1γ controls TGF-β1 receptor (Tgfbr1) turnover. Compared with young HSCs, Tif1γ−/− and old HSCs are more sensitive to TGF-β signaling. Importantly, we identified two populations of HSCs specifically discriminated by Tgfbr1 expression level and provided evidence of the capture of myeloid-biased (Tgfbr1hi) and myeloid-lymphoid-balanced (Tgfbr1lo) HSCs. In conclusion, our data provide a new paradigm for Tif1γ in regulating the balance between lymphoid- and myeloid-derived HSCs through TGF-β signaling, leading to HSC aging. PMID:25002492

  20. Tif1γ regulates the TGF-β1 receptor and promotes physiological aging of hematopoietic stem cells.

    PubMed

    Quéré, Ronan; Saint-Paul, Laetitia; Carmignac, Virginie; Martin, Romain Z; Chrétien, Marie-Lorraine; Largeot, Anne; Hammann, Arlette; Pais de Barros, Jean-Paul; Bastie, Jean-Noël; Delva, Laurent

    2014-07-22

    The hematopoietic system declines with age. Myeloid-biased differentiation and increased incidence of myeloid malignancies feature aging of hematopoietic stem cells (HSCs), but the mechanisms involved remain uncertain. Here, we report that 4-mo-old mice deleted for transcription intermediary factor 1γ (Tif1γ) in HSCs developed an accelerated aging phenotype. To reinforce this result, we also show that Tif1γ is down-regulated in HSCs during aging in 20-mo-old wild-type mice. We established that Tif1γ controls TGF-β1 receptor (Tgfbr1) turnover. Compared with young HSCs, Tif1γ(-/-) and old HSCs are more sensitive to TGF-β signaling. Importantly, we identified two populations of HSCs specifically discriminated by Tgfbr1 expression level and provided evidence of the capture of myeloid-biased (Tgfbr1(hi)) and myeloid-lymphoid-balanced (Tgfbr1(lo)) HSCs. In conclusion, our data provide a new paradigm for Tif1γ in regulating the balance between lymphoid- and myeloid-derived HSCs through TGF-β signaling, leading to HSC aging.

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

    PubMed

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

    2016-01-19

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

  2. [Management of gastroesophageal reflux in children. Single centre experience in conventional and laparoscopic Nissen fundoplication in the last 15 years].

    PubMed

    Betancourth-Alvarenga, Josué Eduardo; Garrido Pérez, José Ignacio; Castillo Fernández, Aurora Lucía; Murcia Pascual, Francisco Javier; Cárdenas Elias, Miguel Angel; Escassi Gil, Alvaro; Paredes-Esteban, Rosa María

    2017-04-01

    Nissen fundoplication (NF) is the most used and effective technique for the treatment of gastroesophageal reflux in children. The laparoscopic approach (LNF) is safe, with low morbidity and high success rate, although some cases require a conventional approach (CNF). The aim of the study is to compare the results between LNF and CNF in our centre. A retrospective review was performed on patients <14years after NF between 2000 and 2015. A comparison was made of the complications, hospital stay, and follow-up for both approaches. Of the total 75 NF performed, 49 (65.3%) were LNF, 23 (30.7%) CNF, and 3 (4.0%) reconversions. Concomitant laparoscopic gastrostomy was performed in 10.7%, and open gastrostomy in 5.3% of cases. Prior to NF, 10.7% had a gastrostomy. The mean age was 4 years and 68.7% were male. Of the diagnoses, 36% had encephalopathy, 14.7% hiatal hernia, 5.4% oesophageal atresia, and 5.4% an acute life-threatening event. No differences were found in operation time. More than two-thirds (36%) had complications, which were more frequent in the CNF (OR=3.30, 95%CI: 1.1-9.6). The hospital-stay decreased by 9 days in the LNF (95%CI: 5.5-13.5). Mean follow-up was 26 months (95%CI: 20.9-31.6). Mortality during follow-up was of 5.3% (5 respiratory failure, 1 sudden cardiac death, and 2 due to complications of the encephalopathy), 4.2% required re-fundoplication, 15.8% had symptomatic improvement, and 64.0% had absence of symptoms. The LNF is an effective technique for the treatment of gastroesophageal reflux, with lower morbidity and shorter hospital stay than CNF. It is recommended as the first surgical option. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    PubMed

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

    2016-05-31

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

  4. Nissen Fundoplication for Laryngopharyngeal Reflux After Patient Selection Using Dual pH, Full Column Impedance Testing: A Pilot Study.

    PubMed

    Carroll, Thomas L; Nahikian, Kael; Asban, Ammar; Wiener, Daniel

    2016-09-01

    Prior studies demonstrate inconsistent diagnostic strategies for laryngopharyngeal reflux disease (LPR) patients who are offered laparoscopic Nissen fundoplication (Nissen). Superior symptom resolution outcomes are demonstrated in patients with accompanying typical gastroesophageal reflux (GERD) symptoms. This study aims to evaluate the efficacy of selecting patients with LPR complaints for Nissen using full column, dual pH impedance catheters (multichannel intraluminal impedance catheters [MII]). All patients who underwent Nissen for management of LPR symptoms refractory to at least 3 months of twice daily (BID) proton pump inhibitor (PPI) therapy with reflux symptom index (RSI) of 13 or higher and who had demonstrable reflux on MII were included. Pre- and (minimum) 16 week post-Nissen RSI scores as well as LPR-specific complaints were collected. Eleven patients met criteria. Nine subjects (5 female, 4 male) had complete data. All 9 (100%) achieved improvement in RSI. The average pre-Nissen RSI was 31.7, and average post-Nissen RSI was 10 (P < .001). Six (67%) subjects dropped below an RSI of 13. Seven subjects (78%) had resolution of their primary LPR symptom, and 6 (67%) subjects had resolution of all LPR symptoms. Patients with LPR who are selected using dual pH and full column impedance are likely to demonstrate improvement in RSI following Nissen. © The Author(s) 2016.

  5. Recurrent symptoms after fundoplication with a negative pH study--recurrent reflux or functional heartburn?

    PubMed

    Thompson, Sarah K; Cai, Wang; Jamieson, Glyn G; Zhang, Alison Y; Myers, Jennifer C; Parr, Zoe E; Watson, David I; Persson, Jenny; Holtmann, Gerald; Devitt, Peter G

    2009-01-01

    A small cohort of patients present after antireflux surgery complaining of recurrent heartburn. Over two thirds of these patients will have a negative 24-h pH study. The aim of our study is to determine whether these patients have an associated functional disorder or abnormal cytokine activity and to examine the reproducibility of pH testing. A prospective analysis was carried out on a cohort of patients who had undergone a fundoplication and postoperative pH testing for recurrent heartburn: group A--patients with recurrent heartburn and a negative 24-h pH study and group B (control group)--patients with recurrent heartburn and a positive pH study. Questionnaires, a blood sample, and repeat pH testing were completed. Sixty-nine patients were identified. Group A's depression score (8.6 +/- 4.1) was significantly higher than group B's (5.9 +/- 4.2; P = 0.03). Cytokine levels were similar in both groups. Forty-seven of 49 (96%) patients who underwent repeat pH testing had a negative study. Symptom-reflux correlation was highly significant (P < 0.001). Some patients with recurrent heartburn and a negative pH study have associated functional or psychiatric comorbidities such as depression. Reproducibility of 24-h pH testing in these patients is excellent.

  6. Nissen fundoplication for gastroesophageal reflux: No deterioration of gastric emptying measured by 13C-acetate breath test

    PubMed Central

    Okada, Tadao; Honda, Shohei; Miyagi, Hisayuki; Minato, Masashi

    2011-01-01

    Aim: To study the gastric emptying 30 days after laparoscopic Nissen fundoplication (NF) in gastroesophageal reflux. Materials and Methods: Three patients were evaluated with 13C-acetate breath test (ABT) performed pre and post-NF. The liquid test meal consisted of Racol™ mixed with 13C-acetate. Results: In the patient without neurological impairment (NI), the preoperative t½ex and t lag were 0.900 and 0.510 hours, respectively. The postoperative t½ex and t lag were 0.959 and 0.586 hours, respectively. In one patient with NI, the preoperative t½ex and t lag were 1.828 and 1.092 hours, respectively. The postoperative t½ex and t lag were 2.081 and 1.025 hours, respectively. In the other patient with NI, the preoperative t½ex and t lag were 2.110 and 0.980 hours, respectively. The postoperative t½ex and t lag were 1.118 and 0.415 hours, respectively. Conclusions: Our findings suggest that 13C-ABT parameters did not worsen in any of the children after laparoscopic NF. PMID:22121311

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

    PubMed

    Comar, Livia Picchi; Souza, Beatriz Martines de; Grizzo, Larissa Tercilia; Buzalaf, Marília Afonso Rabelo; Magalhães, Ana Carolina

    2014-04-01

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

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

    PubMed Central

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

    2014-01-01

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

  9. Clinical characteristics of patients with anti-TIF1-γ antibodies.

    PubMed

    Masiak, Anna; Kulczycka, Julia; Czuszyńska, Zenobia; Zdrojewski, Zbigniew

    2016-01-01

    Inflammatory myopathies are a group of idiopathic, heterogeneous systemic diseases affecting predominantly skeletal muscles, though they can also involve the skin and internal organs. The association between cancer and idiopathic inflammatory myopathies, particularly dermatomyositis, which is termed cancer-associated myositis (CAM), has been reported in the medical literature. A newly described autoantibody to a 155-kDa nuclear protein, identified as transcription intermediary factor 1-gamma (TIF1-γ), has proven useful for cancer screening in patients with dermatomyositis. Based on our database of laboratory results, between November 2014 and January 2016, we found 80 patients with a positive autoimmune inflammatory myopathy immunoblot profile. Eleven of 80 patients revealed the presence of anti-TIF1-γ antibodies: 8 women and 3 men with average age 54.2 years. Dermatomyositis (DM) was diagnosed in 6 cases, polymyositis in 1 case, myositis limited to ocular muscles and rhabdomyolysis in 1 case each, and undifferentiated connective tissue disease in 2 cases. Neoplasm was found in 4 cases. All of those patients had DM. The average time between DM and diagnosis of neoplasm was 7.5 months (from 1 to 18 months). The association between cancer and idiopathic inflammatory myopathies, particularly DM, is well known, and cancer screening should be obligatory in such patients. So far there is no consensus as to the method or frequency with which patients with an idiopathic inflammatory myopathy should be tested to rule out neoplasm. Detection of anti-TIF1-γ antibodies in patients with DM gives the clinicians the very important suggestion of CAM. It seems reasonable that these patients should have more detailed and often repeated differential diagnostics.

  10. The fundamental ribosomal RNA transcription initiation factor-IB (TIF-IB, SL1, factor D) binds to the rRNA core promoter primarily by minor groove contacts.

    PubMed

    Geiss, G K; Radebaugh, C A; Paule, M R

    1997-11-14

    Acanthamoeba castellanii transcription initiation factor-IB (TIF-IB) is the TATA-binding protein-containing transcription factor that binds the rRNA promoter to form the committed complex. Minor groove-specific drugs inhibit TIF-IB binding, with higher concentrations needed to disrupt preformed complexes because of drug exclusion by bound TIF-IB. TIF-IB/DNA interactions were mapped by hydroxyl radical and uranyl nitrate footprinting. TIF-IB contacts four minor grooves in its binding site. TIF-IB and DNA wrap around each other in a right-handed superhelix of high pitch, so the upstream and downstream contacts are on opposite faces of the helix. Dimethyl sulfate protection assays revealed limited contact with a few guanines in the major groove. This detailed analysis suggests significant DNA conformation dependence of the interaction.

  11. Paraesophageal hernia repair in the emergency setting: is laparoscopy with the addition of a fundoplication the new gold standard?

    PubMed

    Klinginsmith, Michael; Jolley, Jennifer; Lomelin, Daniel; Krause, Crystal; Heiden, Jace; Oleynikov, Dmitry

    2016-05-01

    Laparoscopic repair of paraesophageal hernia (PEH) with fundoplication is currently the preferred elective strategy, but emergent cases are often done open without an anti-reflux (AR) procedure. This study examined PEH repair in elective and urgent/emergent settings and investigated patient characteristic influence on the use of adjunctive techniques, such as AR procedures or gastrostomy tube (GT) placement. Utilizing the University HealthSystem Consortium Clinical Database Resource Manager, selected discharge data were retrieved using International Classification of Disease 9 diagnosis codes for PEH and procedure specific codes. Chi-squared and paired t tests were applied (α = 0.05). Discharge data from October 2010 through June 2014 indicated 7950 patients (≥18 years) underwent PEH surgery, 84.7 % were performed laparoscopically and 15.3 % open. 24.6 % of cases were classified urgent/emergent upon admission, and almost 70 % of these were completed laparoscopically. Open paraesophageal hernia repairs (OHR) represented a higher proportion of urgent/emergent cases but were only 30 % of this total. Laparoscopic paraesophageal hernia repair (LHR) patients were more likely to receive an AR procedure in all situations (54.9 % LHR vs. 26.3 % OHR). Almost 90 % of elective PEH repairs in this cohort were laparoscopic. Elective cases were more commonly associated with AR procedures than emergent cases which frequently incorporated GT placement. We demonstrate that laparoscopic PEH repair has become accepted in emergent cases. Open PEH repair is often reserved for emergent surgeries and less commonly includes an AR procedure. Laparoscopy with an AR procedure is clearly the standard of care in elective surgery. The decision to perform an open or laparoscopic surgery, with or without adjunctive techniques, may be based more on the physician's comfort with laparoscopic surgery and surgical practices than the patient's condition. Long-term follow-up studies are

  12. Comparison of Stretta procedure and toupet fundoplication for gastroesophageal reflux disease-related extra-esophageal symptoms.

    PubMed

    Yan, Chao; Liang, Wei-Tao; Wang, Zhong-Gao; Hu, Zhi-Wei; Wu, Ji-Min; Zhang, Chao; Chen, Mei-Ping

    2015-12-07

    To compare the outcomes between the Stretta procedure and laparoscopic toupet fundoplication (LTF) in patients with gastroesophageal reflux disease (GERD)-related extra-esophageal symptoms. From January 2011 to February 2012, a total of 98 patients diagnosed with GERD-related extra-esophageal symptoms who met the inclusion criteria were enrolled in this study. All patients who either underwent the Stretta procedure or LTF treatment have now completed the 3-year follow-up. Primary outcome measures, including frequency and severity of extra-esophageal symptoms, proton pump inhibitor (PPI) use, satisfaction, and postoperative complications, were assessed. The results of the Stretta procedure and LTF therapy were analyzed and compared. There were 47 patients in the Stretta group and 51 patients in the LTF group. Ninety patients were available at the 3-year follow-up. The total of the frequency and severity scores for every symptom improved in both groups (P < 0.05). Improvement in symptom scores of cough, sputum, and wheezing did not achieve statistical significance between the two groups (P > 0.05). However, the score for globus hysterics was different between the Stretta group and the LTF group (4.9 ± 2.24 vs 3.2 ± 2.63, P < 0.05). After the Stretta procedure and LTF treatment, 29 and 33 patients in each group achieved PPI therapy independence (61.7% vs 64.7%, P = 0.835). The patients in the LTF group were more satisfied with their quality of life than those in the Stretta procedure group (P < 0.05). Most complications resolved without intervention within two weeks; however, two patients in the LTF group still suffered from severe dysphagia 2 wk after the operation, and it improved after bougie dilation treatment in both patients. The Stretta procedure and LTF were both safe and effective for the control of GERD-related extra-esophageal symptoms and the reduction of PPI use.

  13. Correlation of the exon/intron organization to the conserved domains of the mouse transcriptional corepressor TIF1beta.

    PubMed

    Cammas, F; Garnier, J; Chambon, P; Losson, R

    2000-08-08

    TIF1beta, a member of the transcriptional intermediary factor 1 family, has been reported to function as a corepressor for the large class of KRAB domain-containing zinc finger proteins of the Krüppel type. In this study, we report the genomic organization and nucleotide sequence of the mouse TIF1beta gene. This gene comprises 17 coding exons located within 7 kb of genomic DNA. Exon sizes vary from 37 bp (exon 10) to 901 bp (exon 1), and intron sizes range from 71 bp to 1843 bp. All introns have the conserved GT and AG dinucleotides present at the donor and acceptor sites, respectively. The functional/homology regions of the TIF1beta protein are encoded by distinct exons. The amino-terminal RING finger is encoded by two exons interrupted by a small intron. The B boxes lie within individual exons. Similarly to the RING finger, the PHD finger is encoded by two exons. Three exons constitute the carboxy-terminal bromodomain, and their position correlates well with the secondary structure elements of the domain as predicted by computer modeling. Taken together, these results will facilitate the genetic manipulation of TIF1beta for future in vivo structure-function studies.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    PubMed Central

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

    1996-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  17. Identification of partners of TIF34, a component of the yeast eIF3 complex, required for cell proliferation and translation initiation.

    PubMed Central

    Verlhac, M H; Chen, R H; Hanachi, P; Hershey, J W; Derynck, R

    1997-01-01

    Eukaryotic initiation factor-3 (eIF3) in the yeast Saccharomyces cerevisiae plays a central role in initiation of translation. The eIF3 complex contains at least eight different proteins, but, as yet, little is known about the function of the individual proteins. In this study we have characterized the role of TIF34 (eIF3-p39), a recently identified WD-40 domain-containing protein of 39 kDa, in the eIF3 complex. Using temperature-sensitive mutants of TIF34 we show that this protein is required for cell cycle progression and for mating and plays an essential role in initiation of protein synthesis. By two-hybrid screening we have identified two partners that directly associate with TIF34: PRT1, a previously characterized eIF3 subunit, and a novel protein of 33 kDa (eIF3-p33) which is part of the eIF3 complex and has an RNA binding domain. TIF34 and p33 interact with each other and overexpression of p33 complements the growth defect of a tif34-ts mutant. Our results provide support for both physical and functional interactions between three subunits, TIF34, PRT1 and p33, in the eIF3 complex. PMID:9362495

  18. Structural and antigenic identification of the ORF12 protein (alpha TIF) of equine herpesvirus 1.

    PubMed

    Lewis, J B; Thompson, Y G; Feng, X; Holden, V R; O'Callaghan, D; Caughman, G B

    1997-04-14

    The equine herpesvirus 1 (EHV-1) homolog of the herpes simplex virus type 1 (HSV-1) tegument phosphoprotein, alpha TIF (Vmw65; VP16), was identified previously as the product of open reading frame 12 (ORF12) and shown to transactivate immediate early (IE) gene promoters. However, a specific virion protein corresponding to the ORF12 product has not been identified definitively. In the present study the ORF12 protein, designated ETIF, was identified as a 60-kDa virion component on the basis of protein fingerprint analyses in which the limited proteolysis profiles of the major 60-kDa in vitro transcription/ translation product of an ORF12 expression vector (pT7-12) were compared to those of purified virion proteins of similar size. ETIF was localized to the viral tegument in Western blot assays of EHV-1 virions and subvirion fractions using polyclonal antiserum and monoclonal antibodies generated against a glutathione-S-transferase-ETIF fusion protein. Northern and Western blot analyses of EHV-1-infected cell lysates prepared under various metabolic blocks indicated that ORF12 is expressed as a late gene, and cross reaction of polyclonal anti-GST-ETIF with a 63.5-kDa HSV-1 protein species suggested that ETIF and HSV-1 alpha TIF are antigenically related. Last, DNA band shift assays used to assess ETIF-specific complex formation indicated that ETIF participates in an infected cell protein complex with the EHV-1 IE promoter TAATGARAT motif.

  19. Dumping syndrome following nissen fundoplication in an adult patient diagnosed by continuous online 13C/12C monitoring of 13C-Octanoic acid breath test "a case report"

    PubMed Central

    2011-01-01

    Background Nissen Fundoplication is a common surgical procedure performed in treating gastroesophageal reflux disease (GERD). Complications include dysphagia, gastric hypersensitivity, abnormal gastric motility, gas bloat syndrome and GERD relapse. Dumping syndrome may occur when a large volume of gastric content is delivered to the duodenum or jejunum, resulting in both gastrointestinal and vasomotor symptoms. Occasionally, dumping syndrome may be a complication in patients that have undergone nissen Fundoplication, especially in adults. The BreathID® continuous online 13C-Octanoicoctanoic acid breath test detects variations of less than 1/100,000 in the 13CO2/12CO2 ratio in exhaled air. Case presentation We report a case of a 38 year old male who was admitted and diagnosed with dumping syndrome following nissen Fundoplication, who was diagnosed using the BreathID® continuous online 13C-Octanoic acid breath test. Conclusions Early performance of a gastric emptying rate breath test in symptomatic patients, following upper GI tract surgery may help in the prediction or diagnosis of nissen Fundoplication complications such as dumping syndrome. PMID:21929798

  20. Dumping syndrome following nissen fundoplication in an adult patient diagnosed by continuous online 13C/12C monitoring of ¹³C-Octanoic acid breath test "a case report".

    PubMed

    Mizrahi, Meir; Almogy, Gideon; Adar, Tomer; Lysy, Joseph

    2011-09-19

    Nissen Fundoplication is a common surgical procedure performed in treating gastroesophageal reflux disease (GERD). Complications include dysphagia, gastric hypersensitivity, abnormal gastric motility, gas bloat syndrome and GERD relapse. Dumping syndrome may occur when a large volume of gastric content is delivered to the duodenum or jejunum, resulting in both gastrointestinal and vasomotor symptoms. Occasionally, dumping syndrome may be a complication in patients that have undergone nissen Fundoplication, especially in adults. The BreathID® continuous online 13C-Octanoicoctanoic acid breath test detects variations of less than 1/100,000 in the 13CO2/12CO2 ratio in exhaled air. We report a case of a 38 year old male who was admitted and diagnosed with dumping syndrome following nissen Fundoplication, who was diagnosed using the BreathID® continuous online 13C-Octanoic acid breath test. Early performance of a gastric emptying rate breath test in symptomatic patients, following upper GI tract surgery may help in the prediction or diagnosis of nissen Fundoplication complications such as dumping syndrome.

  1. Nissen fundoplication vs proton pump inhibitors for laryngopharyngeal reflux based on pH-monitoring and symptom-scale.

    PubMed

    Zhang, Chao; Hu, Zhi-Wei; Yan, Chao; Wu, Qiong; Wu, Ji-Min; Du, Xing; Liu, Dian-Gang; Luo, Tao; Li, Fei; Wang, Zhong-Gao

    2017-05-21

    To compare the outcomes between laparoscopic Nissen fundoplication (LNF) and proton pump inhibitors (PPIs) therapy in patients with laryngopharyngeal reflux (LPR) and type I hiatal hernia diagnosed by oropharyngeal pH-monitoring and symptom-scale assessment. From February 2014 to January 2015, 70 patients who were diagnosed with LPR and type I hiatal hernia and referred for symptomatic assessment, oropharyngeal pH-monitoring, manometry, and gastrointestinal endoscopy were enrolled in this study. All of the patients met the inclusion criteria. All of the patients underwent LNF or PPIs administration, and completed a 2-year follow-up. Patients' baseline characteristics and primary outcome measures, including comprehensive and single symptoms of LPR, PPIs independence, and satisfaction, and postoperative complications were assessed. The outcomes of LNF and PPIs therapy were analyzed and compared. There were 31 patients in the LNF group and 39 patients in the PPI group. Fifty-three patients (25 in the LNF group and 28 in the PPI group) completed reviews and follow-up. Oropharyngeal pH-monitoring parameters were all abnormal with high acid exposure, a large amount of reflux, and a high Ryan score, associated reflux symptom index (RSI) score. There was a significant improvement in the RSI and LPR symptom scores after the 2-year follow-up in both groups (P < 0.05), as well as typical symptoms of gastroesophageal reflux disease. Improvement in the RSI (P < 0.005) and symptom scores of cough (P = 0.032), mucus (P = 0.011), and throat clearing (P = 0.022) was significantly superior in the LNF group to that in the PPI group. After LNF and PPIs therapy, 13 and 53 patients achieved independence from PPIs therapy (LNF: 44.0% vs PPI: 7.14%, P < 0.001) during follow-up, respectively. Patients in the LNF group were more satisfied with their quality of life than those in the PPI group (LNF: 62.49 ± 28.68 vs PPI: 44.36 ± 32.77, P = 0.004). Body mass index was significantly lower in

  2. Comparison of Stretta procedure and toupet fundoplication for gastroesophageal reflux disease-related extra-esophageal symptoms

    PubMed Central

    Yan, Chao; Liang, Wei-Tao; Wang, Zhong-Gao; Hu, Zhi-Wei; Wu, Ji-Min; Zhang, Chao; Chen, Mei-Ping

    2015-01-01

    AIM: To compare the outcomes between the Stretta procedure and laparoscopic toupet fundoplication (LTF) in patients with gastroesophageal reflux disease (GERD)-related extra-esophageal symptoms. METHODS: From January 2011 to February 2012, a total of 98 patients diagnosed with GERD-related extra-esophageal symptoms who met the inclusion criteria were enrolled in this study. All patients who either underwent the Stretta procedure or LTF treatment have now completed the 3-year follow-up. Primary outcome measures, including frequency and severity of extra-esophageal symptoms, proton pump inhibitor (PPI) use, satisfaction, and postoperative complications, were assessed. The results of the Stretta procedure and LTF therapy were analyzed and compared. RESULTS: There were 47 patients in the Stretta group and 51 patients in the LTF group. Ninety patients were available at the 3-year follow-up. The total of the frequency and severity scores for every symptom improved in both groups (P < 0.05). Improvement in symptom scores of cough, sputum, and wheezing did not achieve statistical significance between the two groups (P > 0.05). However, the score for globus hysterics was different between the Stretta group and the LTF group (4.9 ± 2.24 vs 3.2 ± 2.63, P < 0.05). After the Stretta procedure and LTF treatment, 29 and 33 patients in each group achieved PPI therapy independence (61.7% vs 64.7%, P = 0.835). The patients in the LTF group were more satisfied with their quality of life than those in the Stretta procedure group (P < 0.05). Most complications resolved without intervention within two weeks; however, two patients in the LTF group still suffered from severe dysphagia 2 wk after the operation, and it improved after bougie dilation treatment in both patients. CONCLUSION: The Stretta procedure and LTF were both safe and effective for the control of GERD-related extra-esophageal symptoms and the reduction of PPI use. PMID:26668513

  3. Nissen fundoplication vs proton pump inhibitors for laryngopharyngeal reflux based on pH-monitoring and symptom-scale

    PubMed Central

    Zhang, Chao; Hu, Zhi-Wei; Yan, Chao; Wu, Qiong; Wu, Ji-Min; Du, Xing; Liu, Dian-Gang; Luo, Tao; Li, Fei; Wang, Zhong-Gao

    2017-01-01

    AIM To compare the outcomes between laparoscopic Nissen fundoplication (LNF) and proton pump inhibitors (PPIs) therapy in patients with laryngopharyngeal reflux (LPR) and type I hiatal hernia diagnosed by oropharyngeal pH-monitoring and symptom-scale assessment. METHODS From February 2014 to January 2015, 70 patients who were diagnosed with LPR and type I hiatal hernia and referred for symptomatic assessment, oropharyngeal pH-monitoring, manometry, and gastrointestinal endoscopy were enrolled in this study. All of the patients met the inclusion criteria. All of the patients underwent LNF or PPIs administration, and completed a 2-year follow-up. Patients’ baseline characteristics and primary outcome measures, including comprehensive and single symptoms of LPR, PPIs independence, and satisfaction, and postoperative complications were assessed. The outcomes of LNF and PPIs therapy were analyzed and compared. RESULTS There were 31 patients in the LNF group and 39 patients in the PPI group. Fifty-three patients (25 in the LNF group and 28 in the PPI group) completed reviews and follow-up. Oropharyngeal pH-monitoring parameters were all abnormal with high acid exposure, a large amount of reflux, and a high Ryan score, associated reflux symptom index (RSI) score. There was a significant improvement in the RSI and LPR symptom scores after the 2-year follow-up in both groups (P < 0.05), as well as typical symptoms of gastroesophageal reflux disease. Improvement in the RSI (P < 0.005) and symptom scores of cough (P = 0.032), mucus (P = 0.011), and throat clearing (P = 0.022) was significantly superior in the LNF group to that in the PPI group. After LNF and PPIs therapy, 13 and 53 patients achieved independence from PPIs therapy (LNF: 44.0% vs PPI: 7.14%, P < 0.001) during follow-up, respectively. Patients in the LNF group were more satisfied with their quality of life than those in the PPI group (LNF: 62.49 ± 28.68 vs PPI: 44.36 ± 32.77, P = 0.004). Body mass index was

  4. University of Virginia acquisition of passenger ride quality data aboard the Total In-Flight Simulator (TIFS)

    NASA Technical Reports Server (NTRS)

    Mcclurken, E. W., Jr.

    1975-01-01

    The subjective response of passengers to vehicle motions was investigated on the Total In-Flight Simulator (TIFS) aircraft. Prerecorded signals were converted into controlled aircraft motion for evaluation by ten subjects on a seven-point rating scale. Eighteen test flights were flown on August and September 1974, the results of which are to be used in validation studies on ground based simulators at NASA/Langley Research Center and to extend passenger response models.

  5. Laparoscopic antireflux surgery: comparative study of Nissen, Nissen-Rossetti, and Toupet fundoplication. Société Française de Chirurgie Laparoscopique.

    PubMed

    Pessaux, P; Arnaud, J P; Ghavami, B; Flament, J B; Trebuchet, G; Meyer, C; Huten, N; Champault, G

    2000-11-01

    The aim of this retrospective study was to compare the results of Nissen, Nissen-Rossetti, and Toupet laparoscopic fundoplication in terms of gastroesophageal reflux disease (GERD). From 1992 to 1996, 1,470 laparoscopic fundoplications were performed using one of three procedures: Nissen (n = 655), Nissen-Rossetti (n = 423), and Toupet (n = 392). Preoperative checkup included esophagogastroduodenoscopy in 1,437 patients (97. 7%), esophageal manometry in 934 patients (63.5%), and 24-h pH-metry in 799 patients (54.3%). The results were estimated at 1 month, 3 months, and 2 years. Patients unable to visit the hospital center were contacted by telephone. The three groups were quite similar regarding demographic data such as age, gender, preoperative clinical symptoms, and duration of GERD. One death (0.07%) occurred. At 3 months, there were no differences among the three groups concerning conversion, morbidity, dysphagia, early reintervention, or postoperative length of stay. The length of surgery was more important in the Toupet procedure. In the Nissen group, there were fewer Visick grade I patients but more Visick grade III patients. At 2 years, the recurrence and reintervention rates were similar. The overall residual severe dysphagia rate was 0.35% (n = 5). In the Nissen group, there were fewer Visick grade I patients but more in Visick grade II patients. There was no difference in Visick grade III and IV among the groups. More than 90% of the patients were satisfied (Visick I + Visick II), with no significant difference among the three groups. The results of this study do not differ significantly from the data reported in the literature, suggesting such surgical techniques are effective and well tolerated, and that both can be properly used in the treatment of GERD.

  6. Laparoscopic Nissen (total) versus anterior 180° fundoplication for gastro-esophageal reflux disease: A meta-analysis and systematic review.

    PubMed

    Du, Xing; Wu, Ji-Min; Hu, Zhi-Wei; Wang, Feng; Wang, Zhong-Gao; Zhang, Chao; Yan, Chao; Chen, Mei-Ping

    2017-09-01

    Laparoscopic Nissen fundoplication (LNF) has been the gold standard for the surgical management of Gastro-esophageal reflux disease (GERD). Laparoscopic anterior 180° fundoplication (180° LAF) is reported to reduce the incidence of postoperative complications while obtaining similar control of reflux. The present meta-analysis was conducted to confirm the value of the 2 techniques. PubMed, Medline, Embase, Cochrane Library, Springerlink, and China National Knowledge Infrastructure Platform databases were searched for randomized controlled trials (RCTs) comparing LNF and 180° LAF. Data regarding the benefits and adverse results of 2 techniques were extracted and compared using a meta-analysis. Six eligible RCTs comparing LNF (n = 266) and 180° LAF (n = 265) were identified. There were no significant differences between LNF and 180° LAF with regard to operating time, perioperative complications, length of hospital stay, patient satisfaction, willingness to undergo surgery again, quality of life, postoperative heartburn, proton pump inhibitor (PPI) use, postoperative DeMeester scores, postoperative lower esophageal sphincter (LES) pressure, postoperative gas-bloating, unable to belch, diarrhea, or overall reoperation. LNF was associated with a higher prevalence of postoperative dysphagia compared with 180° LAF, while 180° LAF was followed by more reoperation for recurrent reflux symptoms. LNF and 180° LAF are equally effective in controlling reflux symptoms and obtain a comparable prevalence of patient satisfaction. 180° LAF can reduce the incidence of postoperative dysphagia while this is offset by a higher risk of reoperation for recurrent symptoms. The risk of recurrent symptoms should need to be balanced against the risk of dysphagia when surgeons choose surgical procedures for each individual with GERD.

  7. Reconfiguring the AR-TIF2 Protein-Protein Interaction HCS Assay in Prostate Cancer Cells and Characterizing the Hits from a LOPAC Screen.

    PubMed

    Fancher, Ashley T; Hua, Yun; Camarco, Daniel P; Close, David A; Strock, Christopher J; Johnston, Paul A

    2016-10-01

    The continued activation of androgen receptor (AR) transcription and elevated expression of AR and transcriptional intermediary factor 2 (TIF2) coactivator observed in prostate cancer (CaP) recurrence and the development of castration-resistant CaP (CRPC) support a screening strategy for small-molecule inhibitors of AR-TIF2 protein-protein interactions (PPIs) to find new drug candidates. Small molecules can elicit tissue selective effects, because the cells of distinct tissues express different levels and cohorts of coregulatory proteins. We reconfigured the AR-TIF2 PPI biosensor (PPIB) assay in the PC-3 CaP cell line to determine whether AR modulators and hits from an AR-TIF2 PPIB screen conducted in U-2 OS cells would behave differently in the CaP cell background. Although we did not observe any significant differences in the compound responses between the assay performed in osteosarcoma and CaP cells, the U-2 OS AR-TIF2 PPIB assay would be more amenable to screening, because both the virus and cell culture demands are lower. We implemented a testing paradigm of counter-screens and secondary hit characterization assays that allowed us to identify and deprioritize hits that inhibited/disrupted AR-TIF2 PPIs and AR transcriptional activation (AR-TA) through antagonism of AR ligand binding or by non-specifically blocking nuclear receptor trafficking. Since AR-TIF2 PPI inhibitor/disruptor molecules act distally to AR ligand binding, they have the potential to modulate AR-TA in a cell-specific manner that is distinct from existing anti-androgen drugs, and to overcome the development of resistance to AR antagonism. We anticipate that the application of this testing paradigm to characterize the hits from an AR-TIF2 PPI high-content screening campaign will enable us to prioritize the AR-TIF2 PPI inhibitor/disruptor leads that have potential to be developed into novel therapeutics for CaP and CRPC.

  8. Catalytic effects of TiF3 on hydrogen spillover on Pt/carbon for hydrogen storage.

    PubMed

    Chen, Hao; Yang, Ralph T

    2010-10-05

    Recent studies have shown that using the hydrogen spillover phenomena is a promising approach for developing new materials for hydrogen storage at ambient temperature. However, the rates need to be improved. Significant catalytic effects on both spillover (i.e., adsorption) and reverse spillover (i.e., desorption) on Pt-doped carbon by TiF(3) were found. By doping 2 wt % TiF(3) on the Pt-doped Maxsorb (a superactivated carbon), both adsorption and desorption rates were significantly increased while the storage capacity decreased only slightly due to decreased surface areas. The effect of the heat treatment temperature (473 K vs 673 K) of the doped TiF(3) on its catalytic effects was also studied. XPS analyses showed that C-F bonds were formed upon heat treatment and that the amount of C-F bonds increased with the heat treatment temperature. The catalytic effects also increased with the heat treatment temperature, indicating that the catalytic mechanism possibly involved the formation of C-F bonds on the carbon edge sites. In addition, the issue of proper sample preparation of Pt/carbon was briefly addressed; missteps in metal doping and consequently poor metal dispersion will result in significantly diminished spillover enhancements (Stadie et al.).

  9. TIF-IA-dependent regulation of ribosome synthesis in drosophila muscle is required to maintain systemic insulin signaling and larval growth.

    PubMed

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

    2014-10-01

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

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

    PubMed Central

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

    2014-01-01

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

  11. Red-emitting phosphor Rb2TiF6:Mn4+ with high thermal-quenching resistance for wide color-gamut white light-emitting diodes

    NASA Astrophysics Data System (ADS)

    Wang, Zhengliang; Yang, Zhiyu; Tan, Huiying; Brik, Mikhail G.; Zhou, Qiang; Chen, Guo; Liang, Hongbin

    2017-10-01

    Red-emitting phosphor plays a critical role in improving performance of the phosphor-converted white light-emitting diodes (pc-WLEDs). Herein, a red-emitting phosphor, Rb2TiF6:Mn4+, was synthesized via the ion exchange method under mild condition. The crystal structure and morphology were characterized by the powder X-ray diffraction (XRD), scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). The Rietveld refinements of Rb2TiF6:Mn4+ indicate that this sample is of single phase with hexagonal crystal structure. The as-prepared Rb2TiF6:Mn4+ has sharp red emissions with broad excitation band at ∼460 nm. The luminescent behavior of Mn4+ was discussed in detail. The temperature-dependent emission spectra of Rb2TiF6:Mn4+ indicate that this phosphor shares high thermal quenching resistance and excellent color stability. A series of WLEDs with tunable color rendering index and color temperature were fabricated by combining commercial Y3Al5O12:Ce3+ and Rb2TiF6:Mn4+ on blue GaN-LED chips. With the addition of Rb2TiF6:Mn4+, WLED with wide gamut was obtained with low color temperature (3123 K), high color rendering index (91.5) and high luminous efficacy (187.9 lm/W). These findings show this phosphor could be a promising commercial red phosphor in wide color-gamut WLEDs.

  12. Mechanism of Action of TiF4 on Dental Enamel Surface: SEM/EDX, KOH-Soluble F, and X-Ray Diffraction Analysis.

    PubMed

    Comar, Lívia P; Souza, Beatriz M; Al-Ahj, Luana P; Martins, Jessica; Grizzo, Larissa T; Piasentim, Isabelle S; Rios, Daniela; Buzalaf, Marília Afonso Rabelo; Magalhães, Ana Carolina

    2017-10-12

    This in vitro study aimed to evaluate the action of TiF4 on sound and carious bovine and human enamel. Sound (S) and pre-demineralised (DE) bovine and human (primary and permanent) enamel samples were treated with TiF4 (pH 1.0) or NaF varnishes (pH 5.0), containing 0.95, 1.95, or 2.45% F for 12 h. The enamel surfaces were analysed using SEM-EDX (scanning electron microscopy/energy-dispersive X-ray spectroscopy) (n = 10, 5 S and 5 DE) and KOH-soluble fluoride was quantified (n = 20, 10 S and 10 DE). Hydroxyapatite powder produced by precipitation method was treated with the corresponding fluoride solutions for 1 min (n = 2). The formed compounds were detected using X-ray diffraction (XRD). All TiF4 varnishes produced a coating layer rich in Ti and F on all types of enamel surface, with micro-cracks in its extension. TiF4 (1.95 and 2.45% F) provided higher fluoride deposition than NaF, especially for bovine enamel (p < 0.0001). It also induced a higher fluoride deposition on DE samples compared to S samples (p < 0.0001), except for primary enamel. The Ti content was higher for bovine and human primary enamel than human permanent enamel, with some differences between S and DE. The XRD analysis showed that TiF4 induced the formation of new compounds such as CaF2, TiO2, and Ti(HPO4)2·H2O. In conclusion, TiF4 (>0.95% F) interacts better, when compared to NaF, with bovine and human primary enamel than with human permanent enamel. TiF4 provoked higher F deposition compared to NaF. Carious enamel showed higher F uptake than sound enamel by TiF4 application, while Ti uptake was dependent on the enamel condition and origin. © 2017 S. Karger AG, Basel.

  13. Achalasia-Specific Quality of Life After Pneumatic Dilation or Laparoscopic Heller Myotomy With Partial Fundoplication: A Multicenter, Randomized Clinical Trial.

    PubMed

    Chrystoja, Caitlin C; Darling, Gail E; Diamant, Nicholas E; Kortan, Paul P; Tomlinson, George A; Deitel, Wayne; Laporte, Audrey; Takata, Julie; Urbach, David R

    2016-11-01

    Achalasia is a chronic, progressive, and incurable esophageal motility disease. There is clinical uncertainty about which treatment should be recommended as first-line therapy. Our objective was to evaluate the effectiveness of pneumatic dilation compared with laparoscopic Heller myotomy with partial fundoplication in improving achalasia-specific quality of life. This was a prospective, multicenter, randomized trial at five academic hospitals in Canada. Fifty previously untreated adults with a clinical diagnosis of primary achalasia, confirmed by manometric testing, were enrolled between November 2005 and March 2010, and followed for 5 years after treatment. Randomization was stratified by site, in random blocks of size four and with balanced allocation. Patients were treated with pneumatic dilation or laparoscopic Heller myotomy with partial fundoplication. The primary outcome was the difference between the treatments in the mean improvement of the achalasia severity questionnaire (ASQ) score at 1 year from baseline. Prespecified secondary outcomes included general and gastrointestinal quality of life, symptoms, esophageal physiology measures (lower esophageal sphincter relaxation and pressure, esophageal emptying, abnormal esophageal acid exposure), complications, and incidence of retreatment. Functional and imaging studies were performed blinded and all outcome assessors were blinded. There were no significant differences between treatments in the improvement of ASQ score at 1 year from baseline (27.5 points in the Heller myotomy arm vs. 20.2 points in the pneumatic dilation arm; difference 7.3 points, 95% confidence interval -4.7 to 19.3; P=0.23). There were no differences between treatments in improvement of symptoms, general and gastrointestinal quality of life, or measures of esophageal physiology. Improvements in ASQ score diminished over time for both interventions. At 5 years, there were no differences between treatments in improvement of ASQ score

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

    PubMed

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

    2016-07-01

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

  15. Polishing tool and the resulting TIF for three variable machine parameters as input for the removal simulation

    NASA Astrophysics Data System (ADS)

    Schneider, Robert; Haberl, Alexander; Rascher, Rolf

    2017-06-01

    The trend in the optic industry shows, that it is increasingly important to be able to manufacture complex lens geometries on a high level of precision. From a certain limit on the required shape accuracy of optical workpieces, the processing is changed from the two-dimensional to point-shaped processing. It is very important that the process is as stable as possible during the in point-shaped processing. To ensure stability, usually only one process parameter is varied during processing. It is common that this parameter is the feed rate, which corresponds to the dwell time. In the research project ArenA-FOi (Application-oriented analysis of resource-saving and energy-efficient design of industrial facilities for the optical industry), a touching procedure is used in the point-attack, and in this case a close look is made as to whether a change of several process parameters is meaningful during a processing. The ADAPT tool in size R20 from Satisloh AG is used, which is also available for purchase. The behavior of the tool is tested under constant conditions in the MCP 250 CNC by OptoTech GmbH. A series of experiments should enable the TIF (tool influence function) to be determined using three variable parameters. Furthermore, the maximum error frequency that can be processed is calculated as an example for one parameter set and serves as an outlook for further investigations. The test results serve as the basic for the later removal simulation, which must be able to deal with a variable TIF. This topic has already been successfully implemented in another research project of the Institute for Precision Manufacturing and High-Frequency Technology (IPH) and thus this algorithm can be used. The next step is the useful implementation of the collected knowledge. The TIF must be selected on the basis of the measured data. It is important to know the error frequencies to select the optimal TIF. Thus, it is possible to compare the simulated results with real measurement

  16. [Evolution of cataract surgery: smaller incision--less complications].

    PubMed

    Draganić, Vladimir; Vukosavljević, Miroslav; Milivojević, Milorad; Resan, Mirko; Petrović, Nenad

    2012-05-01

    Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/forceps IOL implantation, phacoemulsification/injector IOL implantation, microincision cataract surgery (MICS). Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Uncorrected visual aquity 30 days postoperatively was > or = 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS) there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

  17. Implementation and Impacts of Pay-for-Performance: The 2010 Teacher Incentive Fund (TIF) Grantees after Three Years. NCEE Study Snapshot. NCEE 2016-2006

    ERIC Educational Resources Information Center

    Wellington, Alison; Chiang, Hanley; Hallgren, Kristin; Speroni, Cecilia; Herrmann, Mariesa; Burkander, Paul

    2016-01-01

    The Teacher Incentive Fund (TIF) provides grants to support performance-based compensation systems for teachers and principals in high-need schools. The goal of the grants is to increase the number of high-performing teachers in high-need schools by rewarding educators for improving students' achievement. The report on which this snapshot is based…

  18. Resolving Some Issues in Using Value-Added Measures of Productivity for School and Teacher Incentives: Ideas from Technical Assistance and TIF Grantee Experience. The Harvesting Project

    ERIC Educational Resources Information Center

    Milanowski, Anthony

    2011-01-01

    Although many researchers and policy analysts (e.g., Harris, Glazerman et al., 2011; 2010) consider value-added to be the state of the art in school and teacher productivity measurement, only a minority of Teacher Incentive Fund (TIF) Round 1 and 2 grantees used value-added as a measure of school or teacher performance. Fourteen of the 34 grantees…

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

    USDA-ARS?s Scientific Manuscript database

    Tarping fumigated fields with low permeability films such as commercial Totally Impermeable Film (TIF) significantly reduces fumigant emissions, but it can also increase fumigant residence time in the soil such that extended tarp-covering durations may be required to address potential exposure to wo...

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

    ERIC Educational Resources Information Center

    National Center for Education Evaluation and Regional Assistance, 2015

    2015-01-01

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

  1. Effectiveness of short-term endoscopic surgical skill training for young pediatric surgeons: a validation study using the laparoscopic fundoplication simulator.

    PubMed

    Jimbo, Takahiro; Ieiri, Satoshi; Obata, Satoshi; Uemura, Munenori; Souzaki, Ryota; Matsuoka, Noriyuki; Katayama, Tamotsu; Masumoto, Kouji; Hashizume, Makoto; Taguchi, Tomoaki

    2015-10-01

    Pediatric surgeons require highly advanced skills when performing endoscopic surgery; however, their experience is often limited in comparison to general surgeons. The aim of this study was to evaluate the effectiveness of endoscopic surgery training for less-experienced pediatric surgeons and then compare their skills before and after training. Young pediatric surgeons (n = 7) who participated in this study underwent a 2-day endoscopic skill training program, consisting of lectures, box training and live tissue training. The trainees performed the Nissen construction tasks before and after training using our objective evaluation system. A statistical analysis was conducted using the two-tailed paired Student's t tests. The time for task was 984 ± 220 s before training and 645 ± 92.8 s after training (p < 0.05). The total path length of both forceps was 37855 ± 10586 mm before training and 22582 ± 3045 mm after training (p < 0.05). The average velocity of both forceps was 26.1 ± 3.68 mm/s before training and 22.9 ± 2.47 mm/sec after training (p < 0.1). The right and left balance of suturing was improved after training (p < 0.05). Pediatric surgery trainees improved their surgical skills after receiving short-term training. We demonstrated the effectiveness of our training program, which utilized a new laparoscopic fundoplication simulator.

  2. Effect of NaF, SnF(2), and TiF(4) Toothpastes on Bovine Enamel and Dentin Erosion-Abrasion In Vitro.

    PubMed

    Comar, Lívia Picchi; Gomes, Marina Franciscon; Ito, Naiana; Salomão, Priscila Aranda; Grizzo, Larissa Tercília; Magalhães, Ana Carolina

    2012-01-01

    The aim of this study was to compare the effect of toothpastes containing TiF(4), NaF, and SnF(2) on tooth erosion-abrasion. Bovine enamel and dentin specimens were distributed into 10 groups (n = 12): experimental placebo toothpaste (no F); NaF (1450 ppm F); TiF(4) (1450 ppm F); SnF(2) (1450 ppm F); SnF(2) (1100 ppm F) + NaF (350 ppm F); TiF(4) (1100 ppm F) + NaF (350 ppm F); commercial toothpaste Pro-Health (SnF(2)-1100 ppm F + NaF-350 ppm F, Oral B); commercial toothpaste Crest (NaF-1.500 ppm F, Procter & Gamble); abrasion without toothpaste and only erosion. The erosion was performed 4 × 90 s/day (Sprite Zero). The toothpastes' slurries were applied and the specimens abraded using an electric toothbrush 2 × 15 s/day. Between the erosive and abrasive challenges, the specimens remained in artificial saliva. After 7 days, the tooth wear was evaluated using contact profilometry (μm). The experimental toothpastes with NaF, TiF(4), SnF(2), and Pro-Health showed a significant reduction in enamel wear (between 42% and 54%). Pro-Health also significantly reduced the dentin wear. The toothpastes with SnF(2)/NaF and TiF(4)/NaF showed the best results in the reduction of enamel wear (62-70%) as well as TiF(4), SnF(2), SnF(2)/NaF, and TiF(4)/NaF for dentin wear (64-79%) (P < 0.05). Therefore, the experimental toothpastes containing both conventional and metal fluoride seem to be promising in reducing tooth wear.

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

    PubMed Central

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

    1995-01-01

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

  4. Inhibition of demineralization around the enamel-dentin/restoration interface after dentin pretreatment with TiF4 and self-etching adhesive systems.

    PubMed

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

    2016-05-01

    The objective of this study was to evaluate the inhibition of demineralization around enamel-dentin/restoration interface after dentin pretreatment with 2.5% titanium tetrafluoride (TiF4). Forty dental class V cavities at the cementoenamel junction were distributed into four groups (n = 10), according to the presence or absence of TiF4 and to the adhesive system (Clearfil SE Bond/CL and Adper EasyOne/AD), and restored with a resin composite. A dynamic pH cycling model was used to induce the development of artificial caries lesions. After sectioning the dental blocks, Knoop microhardness tests were performed at different depths (20, 40, and 60 μm from the occlusal margin of the restoration) and at different distances (100, 200, and 300 μm from the adhesive interface). Repeated measures three-way analysis of variance (ANOVA) and Tukey's test were used (α = 0.05). For enamel, there were no differences in the microhardness values for CL, AD, and TiF4-AD at depths, regardless of the distances. Considering each depth, there were no significant differences among treatments. For dentin, ANOVA showed no significant interaction among the independent variables treatment*distance*depth (p = 0.994), no significant interaction between treatment*depth (p = 0.722), no significant interaction between treatment*distance (p = 0.265), no significant interaction between depth*distance (p = 0.365), and no significant effect on treatment (p = 0.151), depth (p = 0.067), or distance (p = 0.251). Dentin pretreatment of the cavity walls with TiF4 before self-etching adhesive systems was not effective in inhibiting demineralization around the enamel-dentin/restoration interfaces. The mechanism of incorporating fluoride in enamel and dentin of the cavity walls to inhibit demineralization around restorations seems ineffective when using TiF4 as a dentin pretreatment.

  5. New gene evolution in the bonus-TIF1-γ/TRIM33 family impacted the architecture of the vertebrate dorsal-ventral patterning network.

    PubMed

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

    2014-09-01

    Uncovering how a new gene acquires its function and understanding how the function of a new gene influences existing genetic networks are important topics in evolutionary biology. Here, we demonstrate nonconservation for the embryonic functions of Drosophila Bonus and its newest vertebrate relative TIF1-γ/TRIM33. We showed previously that TIF1-γ/TRIM33 functions as an ubiquitin ligase for the Smad4 signal transducer and antagonizes the Bone Morphogenetic Protein (BMP) signaling network underlying vertebrate dorsal-ventral axis formation. Here, we show that Bonus functions as an agonist of the Decapentaplegic (Dpp) signaling network underlying dorsal-ventral axis formation in flies. The absence of conservation for the roles of Bonus and TIF1-γ/TRIM33 reveals a shift in the dorsal-ventral patterning networks of flies and mice, systems that were previously considered wholly conserved. The shift occurred when the new gene TIF1-γ/TRIM33 replaced the function of the ubiquitin ligase Nedd4L in the lineage leading to vertebrates. Evidence of this replacement is our demonstration that Nedd4 performs the function of TIF1-γ/TRIM33 in flies during dorsal-ventral axis formation. The replacement allowed vertebrate Nedd4L to acquire novel functions as a ubiquitin ligase of vertebrate-specific Smad proteins. Overall our data reveal that the architecture of the Dpp/BMP dorsal-ventral patterning network continued to evolve in the vertebrate lineage, after separation from flies, via the incorporation of new genes. © The Author 2014. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. The Tromso Infant Faces Database (TIF): Development, Validation and Application to Assess Parenting Experience on Clarity and Intensity Ratings

    PubMed Central

    Maack, Jana K.; Bohne, Agnes; Nordahl, Dag; Livsdatter, Lina; Lindahl, Åsne A.W.; Øvervoll, Morten; Wang, Catharina E. A.; Pfuhl, Gerit

    2017-01-01

    Newborns and infants are highly depending on successfully communicating their needs; e.g., through crying and facial expressions. Although there is a growing interest in the mechanisms of and possible influences on the recognition of facial expressions in infants, heretofore there exists no validated database of emotional infant faces. In the present article we introduce a standardized and freely available face database containing Caucasian infant face images from 18 infants 4 to 12 months old. The development and validation of the Tromsø Infant Faces (TIF) database is presented in Study 1. Over 700 adults categorized the photographs by seven emotion categories (happy, sad, disgusted, angry, afraid, surprised, neutral) and rated intensity, clarity and their valance. In order to examine the relevance of TIF, we then present its first application in Study 2, investigating differences in emotion recognition across different stages of parenthood. We found a small gender effect in terms of women giving higher intensity and clarity ratings than men. Moreover, parents of young children rated the images as clearer than all the other groups, and parents rated “neutral” expressions as more clearly and more intense. Our results suggest that caretaking experience provides an implicit advantage in the processing of emotional expressions in infant faces, especially for the more difficult, ambiguous expressions. PMID:28392772

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

    NASA Astrophysics Data System (ADS)

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

    2009-08-01

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

  8. The Tromso Infant Faces Database (TIF): Development, Validation and Application to Assess Parenting Experience on Clarity and Intensity Ratings.

    PubMed

    Maack, Jana K; Bohne, Agnes; Nordahl, Dag; Livsdatter, Lina; Lindahl, Åsne A W; Øvervoll, Morten; Wang, Catharina E A; Pfuhl, Gerit

    2017-01-01

    Newborns and infants are highly depending on successfully communicating their needs; e.g., through crying and facial expressions. Although there is a growing interest in the mechanisms of and possible influences on the recognition of facial expressions in infants, heretofore there exists no validated database of emotional infant faces. In the present article we introduce a standardized and freely available face database containing Caucasian infant face images from 18 infants 4 to 12 months old. The development and validation of the Tromsø Infant Faces (TIF) database is presented in Study 1. Over 700 adults categorized the photographs by seven emotion categories (happy, sad, disgusted, angry, afraid, surprised, neutral) and rated intensity, clarity and their valance. In order to examine the relevance of TIF, we then present its first application in Study 2, investigating differences in emotion recognition across different stages of parenthood. We found a small gender effect in terms of women giving higher intensity and clarity ratings than men. Moreover, parents of young children rated the images as clearer than all the other groups, and parents rated "neutral" expressions as more clearly and more intense. Our results suggest that caretaking experience provides an implicit advantage in the processing of emotional expressions in infant faces, especially for the more difficult, ambiguous expressions.

  9. Modeling the kinematics of multi-axial composite laminates as a stacking of 2D TIF plies

    NASA Astrophysics Data System (ADS)

    Ibañez, Ruben; Abisset-Chavanne, Emmanuelle; Chinesta, Francisco; Huerta, Antonio

    2016-10-01

    Thermoplastic composites are widely considered in structural parts. In this paper attention is paid to sheet forming of continuous fiber laminates. In the case of unidirectional prepregs, the ply constitutive equation is modeled as a transversally isotropic fluid, that must satisfy both the fiber inextensibility as well as the fluid incompressibility. When the stacking sequence involves plies with different orientations the kinematics of each ply during the laminate deformation varies significantly through the composite thickness. In our former works we considered two different approaches when simulating the squeeze flow induced by the laminate compression, the first based on a penalty formulation and the second one based on the use of Lagrange multipliers. In the present work we propose an alternative approach that consists in modeling each ply involved in the laminate as a transversally isotropic fluid - TIF - that becomes 2D as soon as incompressibility constraint and plane stress assumption are taken into account. Thus, composites laminates can be analyzed as a stacking of 2D TIF models that could eventually interact by using adequate friction laws at the inter-ply interfaces.

  10. A comparison of pre-operative comorbidities and post-operative outcomes among patients undergoing laparoscopic nissen fundoplication at high- and low-volume centers.

    PubMed

    Varban, Oliver Adrian; McCoy, Thomas P; Westcott, Carl

    2011-07-01

    Commonly cited data promoting laparoscopic Nissen fundoplication (LNF) as safe and efficacious are typically published by single centers, affiliated with teaching institutions with a high volume of cases, but LNF is not universally performed at these hospitals. The purpose of this study is to assess where these procedures are being done and to compare pre-operative comorbidities and post-operative outcomes between high-and low-volume centers using a state-wide inpatient database. This is a retrospective study using data from the North Carolina Hospital Association Patient Data System. Selected patients include adults (>17 years old) that have undergone laparoscopic Nissen fundoplication for gastroesophageal reflux disease as an inpatient from 2005 to 2008. Patients that underwent operative management for emergent purposes or had associated diagnoses of esophageal cancer or achalasia were excluded from the study. High-volume centers were defined as institutions that performed ten or more LNFs per year averaged over a period of 4 years. Comparative statistics were performed on comorbidities and complications between high- and low-volume centers. A total of 1,019 patients underwent LNF for GERD in North Carolina between 2005 and 2008 in the inpatient setting. High-volume centers performed 530 LNFs (52%) while low-volume centers performed 489 LNFs (48%). Patients at high-volume centers were older (median 52.5 years old vs. 49.0 years old, p = 0.019), had a higher incidence of diabetes (13.4% vs. 8.8%, p = 0.026), chronic obstructive pulmonary disease (5.1% vs. 2.0 %, p = 0.015), hyperlipidemia (9.6% vs. 4.7%, p = 0.004), and cystic fibrosis (2.8% vs. 0.8%, p = 0.03). Patients with a history of transplantation were also more likely to undergo LNF at a high-volume center (15.8% vs. 1.6%, p < 0.0001). There were no deaths among the two groups and also no difference between median length of stay (2.7 days for high-volume center vs. 2.6

  11. The erosion and abrasion-inhibiting effect of TiF(4) and NaF varnishes and solutions on enamel in vitro.

    PubMed

    Levy, Flávia Mauad; Magalhães, Ana Carolina; Gomes, Marina Franciscon; Comar, Livia Picchi; Rios, Daniela; Buzalaf, Marília Afonso Rabelo

    2012-01-01

    OBJECTIVE. Previous in vitro study has shown that TiF(4) varnish might reduce enamel erosion. No data regarding the effect of this experimental varnish on enamel erosion plus abrasion, however, are available so far. Thus, this in vitro study aimed to analyse the effect of TiF(4) compared with NaF varnishes and solutions, to protect against enamel erosion with or without abrasion. METHODS. Enamel specimens were pre-treated with experimental-TiF(4) (2.45% F), experimental-NaF (2.45% F), NaF-Duraphat (2.26% F), and placebo varnishes; NaF (2.26% F) and TiF(4) (2.45% F) solutions. Controls remained untreated. The erosive challenge was performed using a soft drink (pH 2.6) 4 × 90 s/day (ERO) and the toothbrushing abrasion (ERO+ABR) 2 × 10 s/day, for 5 days. Between the challenges, the specimens were exposed to artificial saliva. Enamel loss was measured profilometrically (μm). RESULTS. Kruskal-Wallis/Dunn tests showed that all fluoridated varnishes (TiF(4) -ERO:0.53 ± 0.20, ERO+ABR:0.65 ± 0.19/NaF-ERO:0.94 ± 0.18, ERO+ABR:1.74 ± 0.37/Duraphat-ERO:1.00 ± 0.37, ERO+ABR:1.72 ± 0.58) were able to significantly reduce enamel loss when compared with placebo varnish (ERO:3.45 ± 0.41/ERO+ABR:3.20 ± 0.66) (P < 0.0001). Placebo varnish, control (ERO:2.68 ± 0.53/ERO+ABR:3.01 ± 0.34), and fluoridated (NaF-ERO:2.84 ± 0.09/ERO+ABR:2.40 ± 0.21/TiF(4) -ERO:3.55 ± 0.59/ERO+ABR:4.10 ± 0.38) solutions did not significantly differ from each other. CONCLUSION. Based on the results, it can be concluded that the TiF(4) varnish seems to be a promising treatment to reduce enamel loss under mild erosive and abrasive conditions in vitro. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.

  12. A meta-analysis of long follow-up outcomes of laparoscopic Nissen (total) versus Toupet (270°) fundoplication for gastro-esophageal reflux disease based on randomized controlled trials in adults.

    PubMed

    Du, Xing; Hu, Zhiwei; Yan, Chao; Zhang, Chao; Wang, Zhonggao; Wu, Jimin

    2016-08-02

    Laparoscopic Nissen fundoplication (LNF) is the most common surgical procedure for the surgical management of gastro-esophageal reflux disease (GERD). Laparoscopic Toupet fundoplication (LTF) has been reported to have a lower prevalence of postoperative complications yet still obtain a similar level of reflux control. We conducted a meta-analysis to confirm the value of LNF and LTF. PubMed, Medline, Embase, Cochrane Library and Springerlink were searched for randomized controlled trials (RCTs) comparing LNF and LTF. Data regarding the benefits and adverse results of two techniques were extracted and compared using a meta-analysis. Eight eligible RCTs comparing LNF (n = 625) and LTF (n = 567) were identified. There were no significant differences between LNF and LTF with regard to hospitalization duration, perioperative complications, patient satisfaction, postoperative heartburn, regurgitation, postoperative DeMeester scores, or esophagites. A shorter operative time and higher postoperative lower esophageal sphincter pressure were associated with LNF. Prevalence of postoperative dysphagia, gas-bloating, inability to belch, dilatation for dysphagia and reoperation were higher after LNF, but subgroup analyses showed that differences with respect to dysphagia between LNF and LTF disappeared over time. Subgroup analyses did not support "tailored therapy" according to preoperative esophageal motility. LNF and LTF have equivalently good control of GERD and result in a similar prevalence of patient satisfaction. Based on current evidence, it is not rational or advisable to abandon LNF when choosing a surgical procedure for GERD.

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

    NASA Technical Reports Server (NTRS)

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

    1978-01-01

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

  14. Acanthamoeba castellanii contains a ribosomal RNA enhancer binding protein which stimulates TIF-IB binding and transcription under stringent conditions.

    PubMed Central

    Yang, Q; Radebaugh, C A; Kubaska, W; Geiss, G K; Paule, M R

    1995-01-01

    The intergenic spacer (IGS) of Acanthamoeba castellanii rRNA genes contains repeated elements which are weak enhancers for transcription by RNA polymerase I. A protein, EBF, was identified and partially purified which binds to the enhancers and to several other sequences within the IGS, but not to other DNA fragments, including the rRNA core promoter. No consensus binding sequence could be discerned in these fragments and bound factor is in rapid equilibrium with unbound. EBF has functional characteristics similar to vertebrate upstream binding factors (UBF). Not only does it bind to the enhancer and other IGS elements, but it also stimulates binding of TIF-IB, the fundamental transcription initiation factor, to the core promoter and stimulates transcription from the promoter. Attempts to identify polypeptides with epitopes similar to rat or Xenopus laevis UBF suggest that structurally the protein from A.castellanii is not closely related to vertebrate UBF. Images PMID:7501455

  15. Acanthamoeba castellanii contains a ribosomal RNA enhancer binding protein which stimulates TIF-IB binding and transcription under stringent conditions.

    PubMed

    Yang, Q; Radebaugh, C A; Kubaska, W; Geiss, G K; Paule, M R

    1995-11-11

    The intergenic spacer (IGS) of Acanthamoeba castellanii rRNA genes contains repeated elements which are weak enhancers for transcription by RNA polymerase I. A protein, EBF, was identified and partially purified which binds to the enhancers and to several other sequences within the IGS, but not to other DNA fragments, including the rRNA core promoter. No consensus binding sequence could be discerned in these fragments and bound factor is in rapid equilibrium with unbound. EBF has functional characteristics similar to vertebrate upstream binding factors (UBF). Not only does it bind to the enhancer and other IGS elements, but it also stimulates binding of TIF-IB, the fundamental transcription initiation factor, to the core promoter and stimulates transcription from the promoter. Attempts to identify polypeptides with epitopes similar to rat or Xenopus laevis UBF suggest that structurally the protein from A.castellanii is not closely related to vertebrate UBF.

  16. PU.1-mediated upregulation of CSF1R is crucial for leukemia stem cell potential induced by MOZ-TIF2.

    PubMed

    Aikawa, Yukiko; Katsumoto, Takuo; Zhang, Pu; Shima, Haruko; Shino, Mika; Terui, Kiminori; Ito, Etsuro; Ohno, Hiroaki; Stanley, E Richard; Singh, Harinder; Tenen, Daniel G; Kitabayashi, Issay

    2010-05-01

    Leukemias and other cancers possess self-renewing stem cells that help to maintain the cancer. Cancer stem cell eradication is thought to be crucial for successful anticancer therapy. Using an acute myeloid leukemia (AML) model induced by the leukemia-associated monocytic leukemia zinc finger (MOZ)-TIF2 fusion protein, we show here that AML can be cured by the ablation of leukemia stem cells. The MOZ fusion proteins MOZ-TIF2 and MOZ-CBP interacted with the transcription factor PU.1 to stimulate the expression of macrophage colony-stimulating factor receptor (CSF1R, also known as M-CSFR, c-FMS or CD115). Studies using PU.1-deficient mice showed that PU.1 is essential for the ability of MOZ-TIF2 to establish and maintain AML stem cells. Cells expressing high amounts of CSF1R (CSF1R(high) cells), but not those expressing low amounts of CSF1R (CSF1R(low) cells), showed potent leukemia-initiating activity. Using transgenic mice expressing a drug-inducible suicide gene controlled by the CSF1R promoter, we cured AML by ablation of CSF1R(high) cells. Moreover, induction of AML was suppressed in CSF1R-deficient mice and CSF1R inhibitors slowed the progression of MOZ-TIF2-induced leukemia. Thus, in this subtype of AML, leukemia stem cells are contained within the CSF1R(high) cell population, and we suggest that targeting of PU.1-mediated upregulation of CSF1R expression might be a useful therapeutic approach.

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

    PubMed Central

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

    2015-01-01

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

  18. Pub1p C-terminal RRM domain interacts with Tif4631p through a conserved region neighbouring the Pab1p binding site.

    PubMed

    Santiveri, Clara M; Mirassou, Yasmina; Rico-Lastres, Palma; Martínez-Lumbreras, Santiago; Pérez-Cañadillas, José Manuel

    2011-01-01

    Pub1p, a highly abundant poly(A)+ mRNA binding protein in Saccharomyces cerevisiae, influences the stability and translational control of many cellular transcripts, particularly under some types of environmental stresses. We have studied the structure, RNA and protein recognition modes of different Pub1p constructs by NMR spectroscopy. The structure of the C-terminal RRM domain (RRM3) shows a non-canonical N-terminal helix that packs against the canonical RRM fold in an original fashion. This structural trait is conserved in Pub1p metazoan homologues, the TIA-1 family, defining a new class of RRM-type domains that we propose to name TRRM (TIA-1 C-terminal domain-like RRM). Pub1p TRRM and the N-terminal RRM1-RRM2 tandem bind RNA with high selectivity for U-rich sequences, with TRRM showing additional preference for UA-rich ones. RNA-mediated chemical shift changes map to β-sheet and protein loops in the three RRMs. Additionally, NMR titration and biochemical in vitro cross-linking experiments determined that Pub1p TRRM interacts specifically with the N-terminal region (1-402) of yeast eIF4G1 (Tif4631p), very likely through the conserved Box1, a short sequence motif neighbouring the Pab1p binding site in Tif4631p. The interaction involves conserved residues of Pub1p TRRM, which define a protein interface that mirrors the Pab1p-Tif4631p binding mode. Neither protein nor RNA recognition involves the novel N-terminal helix, whose functional role remains unclear. By integrating these new results with the current knowledge about Pub1p, we proposed different mechanisms of Pub1p recruitment to the mRNPs and Pub1p-mediated mRNA stabilization in which the Pub1p/Tif4631p interaction would play an important role.

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

    NASA Technical Reports Server (NTRS)

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

    1999-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-02-01

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

  1. O-GlcNAcase Is an RNA Polymerase II Elongation Factor Coupled to Pausing Factors SPT5 and TIF1β.

    PubMed

    Resto, Melissa; Kim, Bong-Hyun; Fernandez, Alfonso G; Abraham, Brian J; Zhao, Keji; Lewis, Brian A

    2016-10-21

    We describe here the identification and functional characterization of the enzyme O-GlcNAcase (OGA) as an RNA polymerase II elongation factor. Using in vitro transcription elongation assays, we show that OGA activity is required for elongation in a crude nuclear extract system, whereas in a purified system devoid of OGA the addition of rOGA inhibited elongation. Furthermore, OGA is physically associated with the known RNA polymerase II (pol II) pausing/elongation factors SPT5 and TRIM28-KAP1-TIF1β, and a purified OGA-SPT5-TIF1β complex has elongation properties. Lastly, ChIP-seq experiments show that OGA maps to the transcriptional start site/5' ends of genes, showing considerable overlap with RNA pol II, SPT5, TRIM28-KAP1-TIF1β, and O-GlcNAc itself. These data all point to OGA as a component of the RNA pol II elongation machinery regulating elongation genome-wide. Our results add a novel and unexpected dimension to the regulation of elongation by the insertion of O-GlcNAc cycling into the pol II elongation regulatory dynamics.

  2. Training model for laparoscopic Heller and Dor fundoplication: a tool for laparoscopic skills training and assessment-construct validity using the GOALS score.

    PubMed

    Bellorin, Omar; Kundel, Anna; Sharma, Saurabh; Ramirez-Valderrama, Alexander; Lee, Paul

    2016-08-01

    Laparoscopic training demands practice. The transfer of laparoscopic skills from training models to real surgical procedures has been proven. The global operative assessment of laparoscopic skills (GOALS) score is a 5-item global rating scale developed to evaluate laparoscopic skills by direct observation. This scale has been used to demonstrate construct validity of several laparoscopic training models. Here, we present a low-cost model of laparoscopic Heller-Dor for advanced laparoscopic training. The aim of this study was to determine the capability of a training model for laparoscopic Heller-Dor to discriminate between different levels of laparoscopic expertise. The performance of two groups with different levels of expertise, novices (<30 laparoscopic procedures PGY1-2) and experts (>300 laparoscopic procedures PGY4-5) was assessed. All participants were instructed to perform two tasks (esophageal myotomy and fundoplication). All the performances were recorded in a digital format. A laparoscopic expert who was blinded to subject's identity evaluated the recordings using the GOALS score. Autonomy, one of the five items of GOALS, was removed since the evaluator and the trainee did not have interaction. The time required to finish each task was also recorded. Performance was compared using the Mann-Whitney U test (p < 0.05 was significant). Twenty subjects were evaluated: ten in each group, using the GOALS score. The mean total GOALS score for novices was 7.5 points (SD: 1.64) and 13.9 points (SD: 1.66) for experts (p < 0.05).The expert group was superior in each domain of the GOALS score compared to novices: depth perception (mean: 3.3 vs 2 p < 0.05), bimanual dexterity (mean 3.4 vs 2.1 p < 0.05), efficiency (mean 3.4 vs 1.7 p < 0.05) and tissue handling (mean 3.6 vs 1.7 p < 0.05). With regard to time, experts were superior in task 1 (mean 9.7 vs 14.9 min p < 0.05) and task 2 (mean 24 vs 47.1 min p < 0.05) compared to novices. The laparoscopic

  3. Atomic layer deposition of photocatalytic TiO2 thin films from TiF4 and H2O.

    PubMed

    Pore, Viljami; Kivelä, Tiina; Ritala, Mikko; Leskelä, Markku

    2008-12-07

    Titanium dioxide (TiO2) thin films were grown by atomic layer deposition (ALD) at 300-500 degrees C using TiF4 and H2O as precursors. The films were characterized by FESEM, EDX, UV/Vis and XRD techniques. Two glass types, soda lime and borosilicate, were used as the substrate materials. It was found that the type of the glass substrate had a very strong influence on the growth and properties of the resulting films. At substrate temperatures of 400 and 500 degrees C, the growth rates on borosilicate were 0.8 and 1.0 A per cycle, respectively, and the films were mainly anatase. With the same deposition conditions on soda lime, rutile phase was formed and the growth rates were 1.1 and 1.5 A per cycle, respectively. Growth saturation was confirmed for both glass substrates at 400 degrees C by varying the pulse lengths of the precursors. Both anatase and rutile films prepared at 400-500 degrees C possessed photocatalytic activity in degrading stearic acid under UV and visible light, whereas the films prepared at 300 degrees C had virtually no activity. All the films, including those prepared at 300 degrees C, turned superhydrophilic under UV light.

  4. Separate regions of glucocorticoid receptor, coactivator TIF2, and comodulator STAMP modify different parameters of glucocorticoid-mediated gene induction.

    PubMed Central

    Awasthi, Smita; Simons, S. Stoney

    2012-01-01

    Increased specificity in steroid-regulated gene expression is a long-sought goal of endocrinologists. Considerable progress has resulted from the discovery of coactivators, corepressors, and comodulators that adjust the total activity (Amax) of gene induction. Two less frequently quantitated, but equally potent, means of improving specificity are the concentration of agonist steroid required for half-maximal activity (EC50) and the residual or partial agonist activity displayed by most antisteroids (PAA). It is usually assumed that the modulatory activity of transcriptional cofactors coordinately regulates Amax, EC50, and PAA. Here we examine the hypothesis that these three parameters can be independently modified by separate protein domains. The test system involves three differently sized fragments of each of three factors (glucocorticoid receptor [GR], coactivator TIF2, and comodulator STAMP), which are shown to form a ternary complex and similarly affect the induction properties of transfected and endogenous genes. Twenty five different fragment combinations of the ternary complex are examined for their ability to modulate the Amax, EC50, and PAA of a transiently transfected synthetic reporter gene. Different combinations selectively alter one, two, or all three parameters. These results clearly demonstrate that Amax, EC50, and PAA can be independently regulated under some conditions by different pathways or molecular interactions. This new mechanistic insight suggests that selected activities of individual transcription factors are attractive targets for small molecules, which would have obvious clinical applications for increasing the specificity of steroids during endocrine therapies. PMID:22342989

  5. Structural snapshot of cytoplasmic pre-60S ribosomal particles bound by Nmd3, Lsg1, Tif6 and Reh1.

    PubMed

    Ma, Chengying; Wu, Shan; Li, Ningning; Chen, Yan; Yan, Kaige; Li, Zhifei; Zheng, Lvqin; Lei, Jianlin; Woolford, John L; Gao, Ning

    2017-03-01

    A key step in ribosome biogenesis is the nuclear export of pre-ribosomal particles. Nmd3, a highly conserved protein in eukaryotes, is a specific adaptor required for the export of pre-60S particles. Here we used cryo-electron microscopy (cryo-EM) to characterize Saccharomyces cerevisiae pre-60S particles purified with epitope-tagged Nmd3. Our structural analysis indicates that these particles belong to a specific late stage of cytoplasmic pre-60S maturation in which ribosomal proteins uL16, uL10, uL11, eL40 and eL41 are deficient, but ribosome assembly factors Nmd3, Lsg1, Tif6 and Reh1 are present. Nmd3 and Lsg1 are located near the peptidyl-transferase center (PTC). In particular, Nmd3 recognizes the PTC in its near-mature conformation. In contrast, Reh1 is anchored to the exit of the polypeptide tunnel, with its C terminus inserted into the tunnel. These findings pinpoint a structural checkpoint role for Nmd3 in PTC assembly, and provide information about functional and mechanistic roles of these assembly factors in the maturation of the 60S ribosomal subunit.

  6. Separate regions of glucocorticoid receptor, coactivator TIF2, and comodulator STAMP modify different parameters of glucocorticoid-mediated gene induction.

    PubMed

    Awasthi, Smita; Simons, S Stoney

    2012-05-15

    Increased specificity in steroid-regulated gene expression is a long-sought goal of endocrinologists. Considerable progress has resulted from the discovery of coactivators, corepressors, and comodulators that adjust the total activity (A(max)) of gene induction. Two less frequently quantitated, but equally potent, means of improving specificity are the concentration of agonist steroid required for half-maximal activity (EC(50)) and the residual or partial agonist activity displayed by most antisteroids (PAA). It is usually assumed that the modulatory activity of transcriptional cofactors coordinately regulates A(max), EC(50), and PAA. Here we examine the hypothesis that these three parameters can be independently modified by separate protein domains. The test system involves three differently sized fragments of each of three factors (glucocorticoid receptor [GR], coactivator TIF2, and comodulator STAMP), which are shown to form a ternary complex and similarly affect the induction properties of transfected and endogenous genes. Twenty-five different fragment combinations of the ternary complex are examined for their ability to modulate the A(max), EC(50), and PAA of a transiently transfected synthetic reporter gene. Different combinations selectively alter one, two, or all three parameters. These results clearly demonstrate that A(max), EC(50), and PAA can be independently regulated under some conditions by different pathways or molecular interactions. This new mechanistic insight suggests that selected activities of individual transcription factors are attractive targets for small molecules, which would have obvious clinical applications for increasing the specificity of steroids during endocrine therapies.

  7. Efficacy of TiF4 and NaF varnish and solution: a randomized in situ study on enamel erosive-abrasive wear.

    PubMed

    Levy, Flávia Mauad; Rios, Daniela; Buzalaf, Marília A R; Magalhães, Ana Carolina

    2014-05-01

    This in situ/ex vivo study analysed the anti-erosive/abrasive effect of TiF4 and NaF varnish and solution on enamel wear. Twelve subjects took part in this study which was performed in three periods (phases) with the duration of 5 days each. Each two human enamel specimens per subject were pretreated with experimental NaF varnish or solution (phase A), experimental-TiF4 varnish or solution (phase B) and placebo varnish or untreated control (phase C). The specimens were worn in palatal appliances; one enamel specimen, from each treatment, was subjected to erosion (ERO; cola soft drink, 4 × 90 s/day), and the other specimen was subjected to erosion plus abrasion (ERO + ABR; tooth brushing, 2 × 10 s/day). The tooth wear was quantified by a contact profilometer (micrometre) and analysed using two-way repeated measures ANOVA and Bonferroni's test (n = 12 subjects, p < 0.05). All fluoride varnishes and solutions reduced the enamel wear (around 25 %) significantly compared to the control and placebo varnish. There were no significant differences among the fluoride formulations and between the conditions ERO and ERO + ABR. Therefore, it can be concluded that TiF4 has the same protective potential as NaF formulations to reduce human enamel wear under this experimental in situ model. In vitro studies have indicated a better anti-erosive/abrasive effect of TiF4 compared to NaF varnish. The present in situ study does not support the previous findings. Therefore, any of the tested professional fluoride varnishes in principle could be able to partially reduce enamel wear.

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

    PubMed Central

    Sohn, Sook-Young; Hearing, Patrick

    2016-01-01

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

  9. Bonus, a Drosophila Homolog of TIF1 Proteins, Interacts with Nuclear Receptors and Can Inhibit βFTZ-F1-Dependent Transcription

    PubMed Central

    Beckstead, Robert; Ortiz, José A; Sanchez, Cecilia; Prokopenko, Sergei N; Chambon, Pierre; Losson, Régine; Bellen, Hugo J

    2013-01-01

    The Drosophila bonus (bon) gene encodes a homolog of the vertebrate TIF1 transcriptional cofactors. bon is required for male viability, molting, and numerous events in metamorphosis including leg elongation, bristle development, and pigmentation. Most of these processes are associated with genes that have been implicated in the ecdysone pathway, a nuclear hormone receptor pathway required throughout Drosophila development. Bon is associated with sites on the polytene chromosomes and can interact with numerous Drosophila nuclear receptor proteins. Bon binds via an LxxLL motif to the AF-2 activation domain present in the ligand binding domain of βFTZ-F1 and behaves as a transcriptional inhibitor in vivo. PMID:11336699

  10. Four dermatomyositis-specific autoantibodies-anti-TIF1γ, anti-NXP2, anti-SAE and anti-MDA5-in adult and juvenile patients with idiopathic inflammatory myopathies in a Hungarian cohort.

    PubMed

    Bodoki, Levente; Nagy-Vincze, Melinda; Griger, Zoltán; Betteridge, Zoe; Szöllősi, Lászlóné; Dankó, Katalin

    2014-12-01

    Idiopathic inflammatory myopathies (IIMs) are chronic systemic autoimmune diseases characterised by symmetrical, proximal muscle weakness. Dermatomyositis represents one subset of IIMs, in which skin rashes are present in addition to muscle weakness. Myositis-specific antibodies can only be detected in myositis, and they are directed against specific proteins found in the cytoplasm or in the nucleus of cells. With this case-based article, we introduce the recently detected anti-TIF1γ, anti-NXP2, anti-SAE and anti-MDA5 antibodies that form various clinical groups. These antibodies could be detected in patients with dermatomyositis. The myositis-specific autoantibodies of three hundred and thirty-seven Hungarian patients with IIM were detected. Retrospective analysis of the clinical findings has also been introduced by revision of the medical history. We had twelve patients with anti-TIF1γ positivity, four patients with anti-NXP2 positivity and four patients with anti-SAE positivity. We did not have any positive anti-MDA5 patients. The most relevant clinical findings were similar to those seen in previously published reports. Eleven of the twelve patients with anti-TIF1γ positivity had classical dermatomyositis. Three of the twelve anti-TIF1γ patients had cancer during the disease progression. This was two out of four for the anti-NXP2 subgroup and one in four for the anti-SAE subgroup. In two juvenile dermatomyositis cases, typical ulceration was seen in patients with anti-TIF1γ positivity. The frequency of pulmonary fibrosis during the disease progression was 2/12, 1/4 and 1/4 in anti-TIF1γ, anti-NXP2 and anti-SAE, respectively. Other extra-muscular manifestations, such as arthralgia, dysphagia, dysphonia and dyspnoea, were also detectable. The myositis subgroups determined by these myositis-specific autoantibodies differ from each other in their symptoms, prognosis and therapy responsiveness. Their detection is helpful for the preparation of an adequate

  11. Heat shock represses rRNA synthesis by inactivation of TIF-IA and lncRNA-dependent changes in nucleosome positioning

    PubMed Central

    Zhao, Zhongliang; Dammert, Marcel A.; Hoppe, Sven; Bierhoff, Holger; Grummt, Ingrid

    2016-01-01

    Attenuation of ribosome biogenesis in suboptimal growth environments is crucial for cellular homeostasis and genetic integrity. Here, we show that shutdown of rRNA synthesis in response to elevated temperature is brought about by mechanisms that target both the RNA polymerase I (Pol I) transcription machinery and the epigenetic signature of the rDNA promoter. Upon heat shock, the basal transcription factor TIF-IA is inactivated by inhibition of CK2-dependent phosphorylations at Ser170/172. Attenuation of pre-rRNA synthesis in response to heat stress is accompanied by upregulation of PAPAS, a long non-coding RNA (lncRNA) that is transcribed in antisense orientation to pre-rRNA. PAPAS interacts with CHD4, the adenosine triphosphatase subunit of NuRD, leading to deacetylation of histones and movement of the promoter-bound nucleosome into a position that is refractory to transcription initiation. The results exemplify how stress-induced inactivation of TIF-IA and lncRNA-dependent changes of chromatin structure ensure repression of rRNA synthesis in response to thermo-stress. PMID:27257073

  12. Results of left thoracoscopic Collis gastroplasty with laparoscopic Nissen fundoplication for the surgical treatment of true short oesophagus in gastro-oesophageal reflux disease and Type III-IV hiatal hernia.

    PubMed

    Lugaresi, Marialuisa; Mattioli, Benedetta; Perrone, Ottorino; Daddi, Niccolò; Di Simone, Massimo Pierluigi; Mattioli, Sandro

    2016-01-01

    Controversy exists regarding surgery for true short oesophagus (TSOE). We compared the results of thoracoscopic Collis gastroplasty-laparoscopic Nissen procedure for the treatment of TSOE with the results of standard laparoscopic Nissen fundoplication. Between 1995 and 2013, the Collis-Nissen procedure was performed in 65 patients who underwent minimally invasive surgery when the length of the abdominal oesophagus, measured intraoperatively after maximal oesophageal mediastinal mobilization, was ≤1.5 cm. The results of the Collis-Nissen procedure were frequency-matched according to age, sex and period of surgical treatment with those of 65 standard Nissen fundoplication procedures in patients with a length of the abdominal oesophagus >1.5 cm. Postoperative mortality and morbidity were evaluated according to the Accordion classification. The patients underwent a timed clinical-instrumental follow-up that included symptoms assessment, barium swallow and endoscopy. Symptoms, oesophagitis and global results were graded according to semi-quantitative scales. The results were considered to be excellent in the absence of symptoms and oesophagitis, good if symptoms occurred two to four times a month in the absence of oesophagitis, fair if symptoms occurred two to four times a week in the presence of hyperaemia, oedema and/or microscopic oesophagitis and poor if symptoms occurred on a daily basis in the presence of any grade of endoscopic oesophagitis, hiatal hernia of any size or type, or the need for antireflux medical therapy. The follow-up time was calculated from the time of surgery to the last complete follow-up. The postoperative mortality rate was 1.5% for the Collis-Nissen and 0 for the Nissen procedure. The postoperative complication rate was 24% for the Collis-Nissen and 7% for Nissen (P = 0.001) procedure. The complication rate for the Collis-Nissen procedure was 43% in the first 32 cases and 6% in the last 33 cases (P < 0.0001). The median follow-up period

  13. MoTeX-II: structured MoTif eXtraction from large-scale datasets.

    PubMed

    Pissis, Solon P

    2014-07-08

    Identifying repeated factors that occur in a string of letters or common factors that occur in a set of strings represents an important task in computer science and biology. Such patterns are called motifs, and the process of identifying them is called motif extraction. In biology, motif extraction constitutes a fundamental step in understanding regulation of gene expression. State-of-the-art tools for motif extraction have their own constraints. Most of these tools are only designed for single motif extraction; structured motifs additionally allow for distance intervals between their single motif components. Moreover, motif extraction from large-scale datasets-for instance, large-scale ChIP-Seq datasets-cannot be performed by current tools. Other constraints include high time and/or space complexity for identifying long motifs with higher error thresholds. In this article, we introduce MoTeX-II, a word-based high-performance computing tool for structured MoTif eXtraction from large-scale datasets. Similar to its predecessor for single motif extraction, it uses state-of-the-art algorithms for solving the fixed-length approximate string matching problem. It produces similar and partially identical results to state-of-the-art tools for structured motif extraction with respect to accuracy as quantified by statistical significance measures. Moreover, we show that it matches or outperforms these tools in terms of runtime efficiency by merging single motif occurrences efficiently. MoTeX-II comes in three flavors: a standard CPU version; an OpenMP-based version; and an MPI-based version. For instance, the MPI-based version of MoTeX-II requires only a couple of hours to process all human genes for structured motif extraction on 1056 processors, while current sequential tools require more than a week for this task. Finally, we show that MoTeX-II is successful in extracting known composite transcription factor binding sites from real datasets. Use of MoTeX-II in biological

  14. Anti-reflux surgery - children - discharge

    MedlinePlus

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

  15. Ab initio investigation of the ground and low-lying states of the diatomic fluorides TiF, VF, CrF, and MnF.

    PubMed

    Koukounas, Constantine; Kardahakis, Stavros; Mavridis, Aristides

    2004-06-22

    The electronic structure of the ground and low-lying states of the diatomic fluorides TiF, VF, CrF, and MnF was examined by multireference and coupled cluster methods in conjunction with extended basis sets. For a total of 34 states we report binding energies, spectroscopic constants, dipole moments, separation energies, and charge distributions. In addition, for all states we have constructed full potential curves. The suggested ground state binding energies of TiF(X (4)Phi), VF(X (5)Pi), CrF(X (6)Sigma(+)), and MnF(X (7)Sigma(+)) are 135, 130, 110, and 108 kcal/mol, respectively, with first excited states A (4)Sigma(-), A (5)Delta, A (6)Pi, and a (5)Sigma(+) about 2, 3, 23, and 19 kcal/mol higher. In essence all our numerical findings are in harmony with experimental results. For all molecules and states studied it is clear that the in situ metal atom (M) shows highly ionic character, therefore the binding is described realistically by M(+)F(-).

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

    PubMed Central

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

    2016-01-01

    There is a paucity of new therapeutic targets to control allergic reactions and forestall the rising trend of allergic diseases. Although a variety of immune cells contribute to allergy, cytokine-secreting αβ+CD4+ T-helper 2 (TH2) cells orchestrate the type-2–driven immune response in a large proportion of atopic asthmatics. To identify previously unidentified putative targets in pathogenic TH2 cells, we performed in silico analyses of recently published transcriptional data from a wide variety of pathogenic TH cells [Okoye IS, et al. (2014) Proc Natl Acad Sci USA 111(30):E3081–E3090] and identified that transcription intermediary factor 1 regulator-alpha (Tif1α)/tripartite motif-containing 24 (Trim24) was predicted to be active in house dust mite (HDM)- and helminth-elicited Il4gfp+αβ+CD4+ TH2 cells but not in TH1, TH17, or Treg cells. Testing this prediction, we restricted Trim24 deficiency to T cells by using a mixed bone marrow chimera system and found that T-cell–intrinsic Trim24 is essential for HDM-mediated airway allergy and antihelminth immunity. Mechanistically, HDM-elicited Trim24−/− T cells have reduced expression of many TH2 cytokines and chemokines and were predicted to have compromised IL-1–regulated signaling. Following this prediction, we found that Trim24−/− T cells have reduced IL-1 receptor (IL-1R) expression, are refractory to IL-1β–mediated activation in vitro and in vivo, and fail to respond to IL-1β–exacerbated airway allergy. Collectively, these data identify a previously unappreciated Trim24-dependent requirement for IL-1R expression on TH2 cells and an important nonredundant role for T-cell–intrinsic Trim24 in TH2-mediated allergy and antihelminth immunity. PMID:26787865

  17. TATA box-binding protein (TBP) is a constituent of the polymerase I-specific transcription initiation factor TIF-IB (SL1) bound to the rRNA promoter and shows differential sensitivity to TBP-directed reagents in polymerase I, II, and III transcription factors.

    PubMed Central

    Radebaugh, C A; Matthews, J L; Geiss, G K; Liu, F; Wong, J M; Bateman, E; Camier, S; Sentenac, A; Paule, M R

    1994-01-01

    The role of the Acanthamoeba castellanii TATA-binding protein (TBP) in transcription was examined. Specific antibodies against the nonconserved N-terminal domain of TBP were used to verify the presence of TBP in the fundamental transcription initiation factor for RNA polymerase I, TIF-IB, and to demonstrate that TBP is part of the committed initiation complex on the rRNA promoter. The same antibodies inhibit transcription in all three polymerase systems, but they do so differentially. Oligonucleotide competitors were used to evaluate the accessibility of the TATA-binding site in TIF-IB, TFIID, and TFIIIB. The results suggest that insertion of TBP into the polymerase II and III factors is more similar than insertion into the polymerase I factor. Images PMID:8264628

  18. TATA box-binding protein (TBP) is a constituent of the polymerase I-specific transcription initiation factor TIF-IB (SL1) bound to the rRNA promoter and shows differential sensitivity to TBP-directed reagents in polymerase I, II, and III transcription factors.

    PubMed

    Radebaugh, C A; Matthews, J L; Geiss, G K; Liu, F; Wong, J M; Bateman, E; Camier, S; Sentenac, A; Paule, M R

    1994-01-01

    The role of the Acanthamoeba castellanii TATA-binding protein (TBP) in transcription was examined. Specific antibodies against the nonconserved N-terminal domain of TBP were used to verify the presence of TBP in the fundamental transcription initiation factor for RNA polymerase I, TIF-IB, and to demonstrate that TBP is part of the committed initiation complex on the rRNA promoter. The same antibodies inhibit transcription in all three polymerase systems, but they do so differentially. Oligonucleotide competitors were used to evaluate the accessibility of the TATA-binding site in TIF-IB, TFIID, and TFIIIB. The results suggest that insertion of TBP into the polymerase II and III factors is more similar than insertion into the polymerase I factor.

  19. Tripartite Motif 24 (Trim24/Tif1α) Tumor Suppressor Protein Is a Novel Negative Regulator of Interferon (IFN)/Signal Transducers and Activators of Transcription (STAT) Signaling Pathway Acting through Retinoic Acid Receptor α (Rarα) Inhibition*

    PubMed Central

    Tisserand, Johan; Khetchoumian, Konstantin; Thibault, Christelle; Dembélé, Doulaye; Chambon, Pierre; Losson, Régine

    2011-01-01

    Recent genetic studies in mice have established that the nuclear receptor coregulator Trim24/Tif1α suppresses hepatocarcinogenesis by inhibiting retinoic acid receptor α (Rara)-dependent transcription and cell proliferation. However, Rara targets regulated by Trim24 remain unknown. We report that the loss of Trim24 resulted in interferon (IFN)/STAT pathway overactivation soon after birth (week 5). Despite a transient attenuation of this pathway by the induction of several IFN/STAT pathway repressors later in the disease, this phenomenon became more pronounced in tumors. Remarkably, Rara haplodeficiency, which suppresses tumorigenesis in Trim24−/− mice, prevented IFN/STAT overactivation. Moreover, together with Rara, Trim24 bound to the retinoic acid-responsive element of the Stat1 promoter and repressed its retinoic acid-induced transcription. Altogether, these results identify Trim24 as a novel negative regulator of the IFN/STAT pathway and suggest that this repression through Rara inhibition may prevent liver cancer. PMID:21768647

  20. A novel mutation F826L in the human androgen receptor in partial androgen insensitivity syndrome; increased NH2-/COOH-terminal domain interaction and TIF2 co-activation.

    PubMed

    Wong, Hao Yun; Hoogerbrugge, Jos W; Pang, Kar Lok; van Leeuwen, Marije; van Royen, Martin E; Molier, Michel; Berrevoets, Cor A; Dooijes, Dennis; Dubbink, Hendrikus Jan; van de Wijngaart, Dennis J; Wolffenbuttel, Katja P; Trapman, Jan; Kleijer, Wim J; Drop, Stenvert L S; Grootegoed, J Anton; Brinkmann, Albert O

    2008-09-24

    A novel mutation F826L located within the ligand binding domain (LBD) of the human androgen receptor (AR) was investigated. This mutation was found in a boy with severe penoscrotal hypospadias (classified as 46,XY DSD). The AR mutant F826L appeared to be indistinguishable from the wild-type AR, with respect to ligand binding affinity, transcriptional activation of MMTV-luciferase and ARE2-TATA-luciferase reporter genes, protein level in genital skin fibroblasts (GSFs), and sub-cellular distribution in transfected cells. However, an at least two-fold higher NH2-/COOH-terminal domain interaction was found in luciferase and GST pull-down assays. A two-fold increase was also observed for TIF2 (transcription intermediary factor 2) co-activation of the AR F826L COOH-terminal domain. This increase could not be explained by a higher stability of the mutant protein, which was within wild-type range. Repression of transactivation by the nuclear receptor co-repressor (N-CoR) was not affected by the AR F826L mutation. The observed properties of AR F826L would be in agreement with an increased activity rather than with a partial defective AR transcriptional activation. It is concluded that the penoscrotal hypospadias in the present case is caused by an as yet unknown mechanism, which still may involve the mutant AR.

  1. Endoscopic Treatment of Refractory Gastroesohageal Reflux Disease

    PubMed Central

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

    2013-01-01

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

  2. Disruption of Ttll5/Stamp Gene (Tubulin Tyrosine Ligase-like Protein 5/SRC-1 and TIF2-associated Modulatory Protein Gene) in Male Mice Causes Sperm Malformation and Infertility*

    PubMed Central

    Lee, Geun-Shik; He, Yuanzheng; Dougherty, Edward J.; Jimenez-Movilla, Maria; Avella, Matteo; Grullon, Sean; Sharlin, David S.; Guo, Chunhua; Blackford, John A.; Awasthi, Smita; Zhang, Zhenhuan; Armstrong, Stephen P.; London, Edra C.; Chen, Weiping; Dean, Jurrien; Simons, S. Stoney

    2013-01-01

    TTLL5/STAMP (tubulin tyrosine ligase-like family member 5) has multiple activities in cells. TTLL5 is one of 13 TTLLs, has polyglutamylation activity, augments the activity of p160 coactivators (SRC-1 and TIF2) in glucocorticoid receptor-regulated gene induction and repression, and displays steroid-independent growth activity with several cell types. To examine TTLL5/STAMP functions in whole animals, mice were prepared with an internal deletion that eliminated several activities of the Stamp gene. This mutation causes both reduced levels of STAMP mRNA and C-terminal truncation of STAMP protein. Homozygous targeted mutant (Stamptm/tm) mice appear normal except for marked decreases in male fertility associated with defects in progressive sperm motility. Abnormal axonemal structures with loss of tubulin doublets occur in most Stamptm/tm sperm tails in conjunction with substantial reduction in α-tubulin polyglutamylation, which closely correlates with the reduction in mutant STAMP mRNA. The axonemes in other structures appear unaffected. There is no obvious change in the organs for sperm development of WT versus Stamptm/tm males despite the levels of WT STAMP mRNA in testes being 20-fold higher than in any other organ examined. This defect in male fertility is unrelated to other Ttll genes or 24 genes previously identified as important for sperm function. Thus, STAMP appears to participate in a unique, tissue-selective TTLL-mediated pathway for α-tubulin polyglutamylation that is required for sperm maturation and motility and may be relevant for male fertility. PMID:23558686

  3. Antireflux Endoluminal Therapies: Past and Present

    PubMed Central

    Yew, Kuo Chao; Chuah, Seng-Kee

    2013-01-01

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

  4. Antireflux endoluminal therapies: past and present.

    PubMed

    Yew, Kuo Chao; Chuah, Seng-Kee

    2013-01-01

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

  5. An Experimental Investigation of Effects of Fluxes (Na3AlF6 and K2TiF6), Element Alloys (Mg), and Composite Powders ((Al + TiC)CP and (Al + B4C)CP) on Distribution of Particles and Phases in Al-B4C and Al-TiC Composites

    NASA Astrophysics Data System (ADS)

    Mazaheri, Younes; Emadi, Rahmatollah; Meratian, Mahmood; Zarchi, Mehdi Karimi

    2017-01-01

    The wettability, incorporation, and gravity segregation of TiC and B4C particles into molten aluminum are important problems in the production of Al-TiC and Al-B4C composites by the casting techniques. In order to solve these problems, different methods consisting of adding the Na3AlF6 and K2TiF6 fluxes and Mg (as the alloying element) into the molten aluminum and injection of the (Al + TiC)CP and (Al + B4C)CP composite powders instead of B4C and TiC particles are evaluated. In this work, the conditions of sample preparation, such as particle addition temperature, stirring speed, and stirring time, are determined after many studies and tests. Microstructural characterizations of samples are investigated by scanning electron microscopy equipped with energy dispersive spectroscopy (EDS) and X-ray diffractometry. The results show better distribution and incorporation of TiCp and B4Cp in aluminum matrix when the fluxes are used, as well as EDS analysis of the interface between the matrix and reinforcement-strengthened formation of the different phases such as Al4C3 in the Al-TiC composites and Al3BC, TiB2 in the Al-B4C composites.

  6. An Experimental Investigation of Effects of Fluxes (Na3AlF6 and K2TiF6), Element Alloys (Mg), and Composite Powders ((Al + TiC)CP and (Al + B4C)CP) on Distribution of Particles and Phases in Al-B4C and Al-TiC Composites

    NASA Astrophysics Data System (ADS)

    Mazaheri, Younes; Emadi, Rahmatollah; Meratian, Mahmood; Zarchi, Mehdi Karimi

    2017-04-01

    The wettability, incorporation, and gravity segregation of TiC and B4C particles into molten aluminum are important problems in the production of Al-TiC and Al-B4C composites by the casting techniques. In order to solve these problems, different methods consisting of adding the Na3AlF6 and K2TiF6 fluxes and Mg (as the alloying element) into the molten aluminum and injection of the (Al + TiC)CP and (Al + B4C)CP composite powders instead of B4C and TiC particles are evaluated. In this work, the conditions of sample preparation, such as particle addition temperature, stirring speed, and stirring time, are determined after many studies and tests. Microstructural characterizations of samples are investigated by scanning electron microscopy equipped with energy dispersive spectroscopy (EDS) and X-ray diffractometry. The results show better distribution and incorporation of TiCp and B4Cp in aluminum matrix when the fluxes are used, as well as EDS analysis of the interface between the matrix and reinforcement-strengthened formation of the different phases such as Al4C3 in the Al-TiC composites and Al3BC, TiB2 in the Al-B4C composites.

  7. [Action of plasmid ColIb-P9 on the survival after ultraviolet irradiation and on the mutagenesis of the imiC, uvm, recL, uvrE and tif1 sfiA lexA spr mutants of Escherichia coli K-12 cells].

    PubMed

    Kopylov, V M; Khmel', I A

    1983-08-01

    To clarify the mechanisms whereby the ColIb-P9 plasmid affects DNA repair processes, its effect was studied in mutant Escherichia coli K-12 cells with altered mutagenesis and DNA repair. The plasmid was shown to protect umuC, uvm, recL and uvrE mutants after UV irradiation. The frequency of UV-induced his+ revertants increased in the presence of the plasmid in umuC, uvm and recL mutant cells. The ColIb-P9 plasmid completely restored the UV mutability and survival of umuC mutants. These results suggest that the ColIb-P9 plasmid may encode a product similar to that of the umuC gene. In the tif1 sfiA lexA spr mutant cells where SOS functions are constitutively expressed, the ColIb-P9 plasmid increased the number of his+ revertants several times. This suggests that the action of ColIb-P9 is probably brought about not via the derepression of the recA gene but at the subsequent stages of the recA+lexA+-dependent DNA error-prone repair.

  8. Anesthetic management of a child with Aicardi syndrome undergoing laparoscopic Nissen's fundoplication: a case report.

    PubMed

    Terakawa, Yui; Miwa, Takaaki; Mizuno, Yoshiko; Ichinohe, Tatsuya; Kaneko, Yuzuru; Ka, Koui

    2011-02-01

    Aicardi syndrome (AS) is a rare congenital syndrome and is characterized by the triad of infantile spasm, agenesis of the corpus callosum, and anomaly of chorioretinal lacunae. We here report a case of a patient with AS under general anesthesia. Although there is no report in which muscle relaxants were used in AS patients, vecuronium bromide was used for artificial pneumoperitoneum in this case. Careful management is important for AS patients during an operation that significantly affects respiratory function. In addition, it is possible that muscle relaxants be administered safely in AS patients. Careful monitoring such as epileptiform electroencephalogram and bispectral index monitors may be needed for the early detection of epileptic activities.

  9. Pepsin detection in patients with laryngopharyngeal reflux before and after fundoplication.

    PubMed

    Wassenaar, Eelco; Johnston, Nikki; Merati, Albert; Montenovo, Martin; Petersen, Rebecca; Tatum, Roger; Pellegrini, Carlos; Oelschlager, Brant

    2011-12-01

    Some patients with gastroesophageal reflux disease (GERD) suffer from laryngopharyngeal reflux (LPR). There is no reliable diagnostic test for LPR as there is for GERD. We hypothesized that detection of pepsin (a molecule only made in the stomach) in laryngeal epithelium or sputum should provide evidence for reflux of gastric contents to the larynx, and be diagnostic of LPR. We tested this hypothesis in a prospective study in patients with LPR symptoms undergoing antireflux surgery (ARS). Nine patients undergoing ARS for LPR symptoms were studied pre- and postoperatively using a clinical symptom questionnaire, laryngoscopy, 24-h pH monitoring, biopsy of posterior laryngeal mucosa, and sputum collection for pepsin Western blot assay. The primary presenting LPR symptom was hoarseness in six, cough in two, and globus sensation in one patient. Pepsin was detected in the laryngeal mucosa in eight of nine patients preoperatively. There was correlation between biopsy and sputum (+/+ or -/-) in four of five patients, both analyzed preoperatively. Postoperatively, pH monitoring improved in all but one patient and normalized in five of eight patients. Eight of nine patients reported improvement in their primary LPR symptom (six good, two mild). Only one patient (who had negative preoperative pepsin) reported no response to treatment of the primary LPR symptom. Postoperatively, pepsin was detected in only one patient. Pepsin is often found on laryngeal epithelial biopsy and in sputum of patients with pH-test-proven GERD and symptoms of LPR. ARS improves symptoms and clears pepsin from the upper airway. Detection of pepsin improves diagnostic accuracy in patients with LPR.

  10. E-TIF: An Electronic Terminology Interchange Format.

    ERIC Educational Resources Information Center

    Melby, Alan

    1995-01-01

    Emphasizes the importance of terminology in an age of machine-based translation systems. Discusses differences between lexicography and terminology. Concludes with an argument for a new system based on the Text Encoding Initiative-based notions of elements and attributes. (CFR)

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

    USDA-ARS?s Scientific Manuscript database

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

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

    USDA-ARS?s Scientific Manuscript database

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

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

    USDA-ARS?s Scientific Manuscript database

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

  14. Bistatic Synthetic Aperture Radar, TIF - Report (Phase 1)

    DTIC Science & Technology

    2004-11-01

    d’observation du radar bistatique et l’obtention DRDC Ottawa TR 2004-190 subs~quente d’images en fonction de diff6rentes configurations de radar...assumption has been developed and coded in MATLAB . The simulated SAR configurations comprise the simple stripmap mode as well as more sophisticated modes...developed and implemented in MATLAB ®. The simulator generates the raw data with high accuracy including the full three-dimensional geometry, the antenna

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

    USDA-ARS?s Scientific Manuscript database

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

  16. Administrator Responses to Financial Incentives: Insights from a TIF Program

    ERIC Educational Resources Information Center

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

    2017-01-01

    This article provides evidence and generates insights about the power of financial rewards to motivate school administrators and the design features that influence their motivational potency. The multi-year mixed-methods study is grounded in expectancy and goal setting theories that suggest (a) awards must be salient and sizable enough to appeal…

  17. [Acute gastric volvulus: late complication of Nissen fundoplication. Report of two cases and review of the literature].

    PubMed

    Reyes-Zamorano, Jesús

    2014-01-01

    Antecedentes: el vólvulo gástrico puede clasificarse por su etiología en primario o secundario, por su anatomía en órgano axial o mesentérico axial y por su presentación en crónico o agudo. El tratamiento del vólvulo gástrico secundario agudo siempre debe ser quirúrgico y la elección del procedimiento basarse en la etiología y en los casos asociados con cirugía previa será importante la lisis de adherencias y el retiro de cuerpos extraños (material de sutura, mallas, banda gástrica). La funduplicatura Nissen es un procedimiento seguro y efectivo que rara vez puede tener complicaciones tardías severas entre las que se encuentran el vólvulo gástrico. Objetivo: comunicar 2 casos y revisar la bibliografía médica. Casos clínicos: se describen 2 casos de vólvulo gástrico agudo secundarios a funduplicatura tipo Nissen laparoscópica, con síntomas de dolor epigástrico y vómito no productivo, ambos tratados por laparoscopia. Se revisan los síntomas de presentación, incidencia, diagnóstico, tratamiento y los factores predisponentes de vólvulo gástrico postfunduplicatura. Conclusión: el vólvulo gástrico rara vez puede ser una complicación de una funduplicatura Nissen con incidencia similar a la de otras de sus complicaciones tardías. Los mecanismos descritos que lo originan se relacionan con adherencias postquirúrgicas, material de sutura (poliéster), mallas, tubos de gastrostomía, gastropexia y por herniación gástrica interna a través del túnel "transfunduplicatura." En pacientes con síntomas de obstrucción gástrica dentro del primer año posterior a una funduplicatura Nissen laparoscópica se requiere un alto índice de sospecha. El tratamiento quirúrgico laparoscópico es seguro con o sin gastropexia para corregir los mecanismos que lo originan.

  18. Laparoscopic Heller myotomy plus Dor fundoplication in 137 achalasic patients: results on symptoms relief and successful outcome predictors.

    PubMed

    Parise, Paolo; Santi, Stefano; Solito, Biagio; Pallabazzer, Giovanni; Rossi, Mauro

    2011-03-01

    Aim of this study was to review our experience with laparoscopic Heller-Dor (LHD) intervention and identify possible success predictors. LHD is an effective and safe treatment for achalasia. However, open debates are still held on which antireflux procedure should be added and on how long the myotomy on to the stomach should be. A lot of successful outcome predictors have been investigated with sometimes conflicting results. 137 achalasic patients underwent LHD at our institution. Pre-operatively all underwent a complete morphologic and functional work-up. Follow-up visits were scheduled at 1, 3, 6 months and then every year. Median follow-up was 65 months. Pre-operatively dysphagia was present in 100% cases, regurgitation in 84.6% and mean lower esophageal sphincter (LES) resting pressure was 29.1 mmHg. We observed 3 mucosal perforations. Mortality was null. The median of oral food intake resumption was second post-operative day and mean post-operative hospital stay was 3.4 days. Dysphagia was treated with success in 94.78% cases and regurgitation in 82.84%. Post-operative mean LES resting pressure was 13.64 mmHg. New-onset heartburn was observed in 10.9% of patients. 9.7% of cases required pneumatic dilations and 1.5% a laparoscopic re-do myotomy. An high pre-operative dysphagia score resulted to be the only statistically significant prognostic factor. Sex, age, dysphagia duration and LES resting pressure did not reach statistical significance. LHD is a safe procedure with good results in about 90% of patients even at a long-term follow-up. Predictors of successful outcome are still poorly plain and sometimes conflicting in literature.

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

    PubMed

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

    2013-01-01

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

  20. Enteral feeding in neurologically impaired children with gastroesophageal reflux: Nissen fundoplication and gastrostomy tube placement versus percutaneous gastrojejunostomy.

    PubMed

    Veenker, Erin

    2008-10-01

    Parents or caregivers of neurologically impaired children with gastroesophageal reflux who require enteral nutrition are often faced with the option of having their child undergo an antireflux surgery and placement of a gastrostomy tube or have a percutaneous gastrojejunostomy tube placed under fluoroscopic guidance. It is important that nurses have an understanding of these procedures and their associated risks and benefits as well as knowledge of the impact each might have on the daily life and care of these children to help support families during this decision-making process.

  1. Materials Data on TiF3 (SG:12) by Materials Project

    SciTech Connect

    Kristin Persson

    2016-04-23

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

  2. Novel Functionalized Carbon Nanotube Supercapacitor Materials: Contribution to the Supercapacitor TIF

    DTIC Science & Technology

    2014-08-01

    optical profilometry, formed by immersing a pre-patterned glass slide with 90-μm squares of cross-linked PVMP into an aqueous solution of a-PP-SWNTs. (B...9 Figure 9 SEM images of patterned SWNTs on a glass substrate. A...platforms that require power include micro electro mechanical devices (MEMs), portable battery packs, unmanned aerial vehicles (UAVs), light armoured

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

    USDA-ARS?s Scientific Manuscript database

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  5. Fabrication of Organic Radar Absorbing Materials: A Report on the TIF Project

    DTIC Science & Technology

    2005-05-01

    frequency dependent. The melt-injected material was macroscopically insulating with Maxwell-Wagner type relaxation. The relaxation frequency is...electrochemical deposits with p-Toluene sulfonic acid as the dopant.[205] Radar absorbing materials can be formed by loading an insulating polymer...1999, 4, 2622. (92) Jones, A. K., Wooding , E.R. IEEE Trans. Antennas and Propagation 1964, AP-12, 508. (93) Dallenbach, W.; Kleinsteuber, W. Hochfreq

  6. Effect of TiN coating on microstructure of Tif/Al composite.

    PubMed

    Xiu, Z Y; Chen, G Q; Wang, M; Hussain, Murid

    2013-02-01

    In the present work, Ti fibre reinforced Al matrix composites (Ti(f)/Al) were fabricated by pressure infiltration method. In order to suppress the severe Ti-Al reaction and reduce the formation of brittle TiAl(3) phase, a TiN layer was coated on Ti fibres by an arc ion plating method before composite preparation. A thin TiN layer was coated on the Ti fibre surface, and the maximum and minimum thickness values of layer were about 3.5 and 1μm, respectively. Prefer orientation of TiN on (111) and (200) was found by XRD analysis. A thin and uniform TiAl(3) layer was observed in Ti(f)/Al composite. However, after coated with TiN layer, no significant reaction layer was found in (Ti(f)+TiN)/Al composite. Segregation of Mg element was found in Ti(f)/Al composite, and the presence of TiN layer showed little effect on this behaviour. Due to the large CTE difference between Ti fibre and Al matrix, high density dislocations were observed in the Al matrix. Meanwhile, fine dispersed Mg(2)Al(3) phases were also found in Al matrix. Ti fibre is mainly composed of α- and β-Ti. Small discontinuous needle-like TiAl(3) phases were detected at TiN/Al interface, which implies that the presence of TiN layer between the Ti fibre and Al matrix could effectively hinder the formation of TiAl(3) phases. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Materials Data on KRb2TiF6 (SG:225) by Materials Project

    SciTech Connect

    Kristin Persson

    2016-04-23

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

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

    SciTech Connect

    Kristin Persson

    2016-02-10

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  10. Routine versus selective contrast imaging to identify the need for early re-intervention following laparoscopic fundoplication: A retrospective cohort study.

    PubMed

    Shahzad, Khalid; Menon, Ashok; Turner, Paul; Ward, Jeremy; Pursnani, Kishore; Alkhaffaf, Bilal

    2015-08-01

    The prompt recognition of complications is essential in reducing morbidity following anti-reflux surgery. Consequently, many centres employ a policy of routine post-operative contrast studies. The study aimed to examine whether routine contrast studies more effectively recognised early post-operative complications following anti-reflux surgery compared with selective use. This was a retrospective analysis of 240 adults who had undergone primary anti-reflux surgery. Selective use of water-soluble contrast swallows was employed for 115 patients (Group 1) while 125 patients (Group 2) had routine studies. 10 (0.9%) patients from Group 1 underwent contrast studies, four (40%) of which were abnormal. Routine studies in Group 2 identified thirty-two abnormalities (27%) however the inter-group difference was not significant (p = 0.32). Only one case from group 2 required immediate re-intervention. This was not statistically significant (p = 0.78). Multivariate analysis found no significant association between selective or routine imaging and re-intervention rates. One patient from group 2 presented three days following discharge with wrap migration requiring reoperation despite a normal post-operative study. Routine use of contrast imaging following anti-reflux and hiatus hernia surgery is not necessary. It does not identify a significantly greater number of post-operative complications in comparison to selective use. Additionally, routine use of contrast studies does not ensure the diagnosis of all complications in the post-operative period. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  11. Laparoscopic surgery - series (image)

    MedlinePlus

    ... performed laparoscopically, including gallbladder removal (laparoscopic cholecystectomy), esophageal surgery (laparoscopic fundoplication), colon surgery (laparoscopic colectomy), and surgery on ...

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  13. The alpha-TIF (VP16) homologue (ETIF) of equine herpesvirus 1 is essential for secondary envelopment and virus egress.

    PubMed

    von Einem, Jens; Schumacher, Daniel; O'Callaghan, Dennis J; Osterrieder, Nikolaus

    2006-03-01

    The equine herpesvirus 1 (EHV-1) alpha-trans-inducing factor homologue (ETIF; VP16-E) is a 60-kDa virion component encoded by gene 12 (ORF12) that transactivates the immediate-early gene promoter. Here we report on the function of EHV-1 ETIF in the context of viral infection. An ETIF-null mutant from EHV-1 strain RacL11 (vL11deltaETIF) was constructed and analyzed. After transfection of vL11deltaETIF DNA into RK13 cells, no infectious virus could be reconstituted, and only single infected cells or small foci containing up to eight infected cells were detected. In contrast, after transfection of vL11deltaETIF DNA into a complementing cell line, infectious virus could be recovered, indicating the requirement of ETIF for productive virus infection. The growth defect of vL11deltaETIF could largely be restored by propagation on the complementing cell line, and growth on the complementing cell line resulted in incorporation of ETIF in mature and secreted virions. Low- and high-multiplicity infections of RK13 cells with phenotypically complemented vL11deltaETIF virus resulted in titers of virus progeny similar to those used for infection, suggesting that input ETIF from infection was recycled. Ultrastructural studies of vL11deltaETIF-infected cells demonstrated a marked defect in secondary envelopment at cytoplasmic membranes, resulting in very few enveloped virions in transport vesicles or extracellular space. Taken together, our results demonstrate that ETIF has an essential function in the replication cycle of EHV-1, and its main role appears to be in secondary envelopment.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  15. STUDY OF METAL FLUORINE COMPLEXES.

    DTIC Science & Technology

    spectroscopy. These series consisted of fluorotitanate complexes of formula TiF4.2(donor) and TiF5.(donor)(-), where donor represents an organic molecule... fluorotitanate complexes. The temperature dependence of the TiF4.2D spectra was also studied. The low infrared spectra of some SnF4.2D and TiF4.2D were also obtained. (Author)

  16. Evaluating Programs for Strengthening Teaching and Leadership

    ERIC Educational Resources Information Center

    Teacher Incentive Fund, US Department of Education, 2016

    2016-01-01

    The U.S. Department of Education (ED) expects all Teacher Incentive Fund (TIF) grantees to conduct an evaluation of their programs. Experience with earlier rounds of TIF grants has shown that evaluations can provide valuable information for managing and improving TIF-supported activities, as well as evidence that these activities have had a…

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Melendez de Santa Ana, Thelma

    2010-01-01

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

  19. Distinctive cutaneous and systemic features associated with antitranscriptional intermediary factor-1γ antibodies in adults with dermatomyositis.

    PubMed

    Fiorentino, David F; Kuo, Karen; Chung, Lorinda; Zaba, Lisa; Li, Shufeng; Casciola-Rosen, Livia

    2015-03-01

    Antibodies against transcriptional intermediary factor (TIF)-1γ are associated with malignancy in dermatomyositis (DM). Identification of clinical findings associated with anti-TIF-1γ antibodies in DM is a high priority for both patient diagnosis and risk assessment. We sought to define the clinical phenotype of patients with anti-TIF-1γ DM. Using a novel, sensitive, and specific assay for anti-TIF-1γ antibodies, we retrospectively tested plasma from 134 adult patients with DM and examined associations between anti-TIF-1γ antibodies and particular clinical and laboratory features. In all, 55 (41%) patients had autoantibodies to TIF-1γ. Anti-TIF-1γ positive patients were less likely to have systemic features including interstitial lung disease, Raynaud phenomenon, and arthritis/arthralgia. Patients with TIF-1γ autoantibodies had more extensive skin involvement, and some patients manifested characteristic findings including palmar hyperkeratotic papules, psoriasis-like lesions and a novel finding of hypopigmented and telangiectatic ("red on white") patches. This was a retrospective study from a single tertiary referral center. TIF-1γ is the most commonly targeted DM-specific autoantigen in adults in a large US cohort. Although these patients tend to have less systemic involvement, their skin disease is often extensive and characteristic. Recognition of cutaneous findings in anti-TIF-1γ positive patients may allow more accurate and timely diagnosis and effective treatment of patients with DM. Copyright © 2014 American Academy of Dermatology, Inc. All rights reserved.

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

    PubMed

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

    2012-07-30

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

  1. Laparoscopic Surgical Treatment of Severe Obesity Combined with Gastroesophageal Reflux Disease: A Pilot Randomized Two-Arm Controlled Clinical Study

    ERIC Educational Resources Information Center

    Ospanov, Oral B.; Orekeshova, Akzhunis M.; Fursov, Roman A.; Yelemesov, Aset A.

    2016-01-01

    Obesity and gastroesophageal reflux disease (GERD) are serious medical, social, and economic problems of modern society. A pilot randomized two-arm controlled clinical study was conducted to compare laparoscopic plication of the greater gastric curvature combined with Nissen fundoplication (LFN+LGP) versus only Nissen fundoplication (LFN). The…

  2. Strategies to increase health literacy in the infant feeding series (TIFS): a six-lesson curriculum for low-income mothers.

    PubMed

    Silk, Kami J; Horodynski, Mildred A; Rienzo, Marie; Mercer, Laura; Olson, Beth; Aldrich, Rosalie

    2010-03-01

    Low literacy can be a serious barrier to educating audiences about important health issues. This article explicates strategies used to increase health literacy in The Infant Feeding Series, a six-lesson curriculum on infant feeding practices. The curriculum was developed by a multidisciplinary team of researchers, health educators, and community stakeholders with the primary goal of increasing low-income mothers' knowledge and self-efficacy to delay the introduction of solid foods into infants' diets. Strategies used to develop the low literate accessible materials include (a) incorporation of formative research and theory, (b) media components, (c) reading level assessment of materials, (d) review of materials by multiple stakeholders, (e) one-on-one home delivery, (f) pilot evaluation of lessons, and (g) a workbook incentive designed to integrate knowledge and motivate participants to complete the curriculum through scrapbook activities. These strategies are discussed as they relate to lesson content and curriculum effectiveness.

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

    ERIC Educational Resources Information Center

    Alberta Learning, Edmonton.

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

  4. The Angiogenic Secretome in VEGF overexpressing Breast Cancer Xenografts

    PubMed Central

    Dore-Savard, Louis; Lee, Esak; Kakkad, Samata; Popel, Aleksander S.; Bhujwalla, Zaver M.

    2016-01-01

    The plasticity of cancer cells and the fluidity of the tumor microenvironment continue to present major challenges in the comprehensive understanding of cancer that is essential to design effective treatments. The tumor interstitial fluid (TIF) encompasses the secretome and holds the key to several of the phenotypic characteristics of cancer. Difficulties in sampling this fluid have resulted in limited characterization of its components. Here we have sampled TIF from triple negative and estrogen receptor (ER)-positive human breast tumor xenografts with or without VEGF overexpression. Angiogenesis-related factors were characterized in the TIF and plasma, to understand the relationship between the TIF and plasma secretomes. Clear differences were observed between the TIF and plasma angiogenic secretomes in triple negative MDA-MB-231 breast cancer xenografts compared to ER-positive MCF-7 xenografts with or without VEGF overexpression that provide new insights into TIF components and the role of VEGF in modifying the angiogenic secretome. PMID:27995973

  5. Impedance probe testing prior to pediatric airway reconstruction.

    PubMed

    Hart, Catherine K; de Alarcon, Alessandro; Tabangin, Meredith E; Hamilton, Steven; Rutter, Michael J; Pentiuk, Scott P; Garza, Jose M

    2014-09-01

    This study aimed to determine if preoperative impedance testing changed management and if testing was associated with surgical outcome in patients undergoing airway reconstruction. Retrospective review of patients who had impedance testing prior to airway reconstruction at a tertiary pediatric hospital from January 2010 to September 2011. Charts were reviewed for demographics, medical/surgical history, impedance testing, and surgical outcomes. Fifty-seven patients were included. Forty-seven (82%) were premature. Forty-seven (82%) had a primary diagnosis of subglottic stenosis. Twenty-six (45%) had prior airway surgery. Thirty-six (63%) had gastroesophageal reflux and 21 (36%) had undergone fundoplication. Patients without fundoplication had a median 46 total reflux, 7 proximal, and 14.5 acidic events compared to a median 5 total reflux, 0 proximal, and 0 acidic events in patients with fundoplication. Impedance testing changed management in 22% (8/36) of nonfundoplication patients and 9.5% (2/21) of fundoplication patients. In unadjusted analysis, fewer fundoplication patients had successful surgery compared to those without (33% vs 67%, P = .01). Prematurity, age at surgery, and previous airway surgery were also important predictors of surgical success. Fewer patients than anticipated had a change in management. Impedance testing was unlikely to change management in fundoplication patients. Patients with fundoplication were less likely to have a successful outcome, suggesting that factors other than reflux influence airway reconstruction outcomes. © The Author(s) 2014.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  7. 75 FR 37765 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-30

    ... will also seek to analyze TIF's relationship to increasing student achievement. This evaluation of the... and Policy Development Type of Review: Revision. Title of Collection: Evaluation of the Teacher... 2006, the U.S. Department of Education launched the Teacher Incentive Fund (TIF), which...

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  9. Assessment of buffer systems for harvesting proteins from tissue interstitial fluid for proteomic analysis.

    PubMed

    Teng, Pang-ning; Rungruang, Bunja J; Hood, Brian L; Sun, Mai; Flint, Melanie S; Bateman, Nicholas W; Dhir, Rajiv; Bhargava, Rohit; Richard, Scott D; Edwards, Robert P; Conrads, Thomas P

    2010-08-06

    Tissue interstitial fluid (TIF) bathes cells in tissues, and it is hypothesized that TIF proximal to a developing tumor may contain an enriched population of tumor-specific shed and secreted proteins relative to peripheral blood. Extraction of TIF proteins is typically accomplished through passive incubation of surgically resected tissues in phosphate buffered saline (PBS); however, its influence on cellular activity and viability has not been fully explored. The present investigation sought to characterize whether different buffer systems influence the recovered TIF proteome. Five TIF buffer systems were investigated including PBS, Dulbecco's modified Eagle medium (DMEM), and three organ transplantation preservative solutions: Celsior solution S (CS), histidine-tryptophan-ketoglutarate (HTK), and University of Wisconsin (UW). Kidney tumor, adjacent normal kidney, and ovarian tumor tissues were incubated in each of the buffer systems, and the harvested TIF proteins were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Although the present results indicate that no significant differences exist in the recovered proteins from these two neoplasms between the five solution groups, additional sample preparative steps are required prior to LC-MS/MS for TIF proteins harvested from DMEM, UW, CS, and HTK. These data support that PBS is a suitable and convenient solution for harvesting TIF proteins for MS-based proteomics.

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

    DOE Data Explorer

    Adam Brandt

    2015-11-15

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

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

    ERIC Educational Resources Information Center

    Nguyen-Hoang, Phuong

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Eckert, Jonathan

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  14. Estimation of Reliability Coefficients Using the Test Information Function and Its Modifications.

    ERIC Educational Resources Information Center

    Samejima, Fumiko

    1994-01-01

    The reliability coefficient is predicted from the test information function (TIF) or two modified TIF formulas and a specific trait distribution. Examples illustrate the variability of the reliability coefficient across different trait distributions, and results are compared with empirical reliability coefficients. (SLD)

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

    SciTech Connect

    Allen, W.R.

    1994-02-01

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

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

    PubMed Central

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

    2009-01-01

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

  17. Conserved interaction between distinct Krüppel-associated box domains and the transcriptional intermediary factor 1 β

    PubMed Central

    Abrink, Magnus; Ortiz, José A.; Mark, Charlotta; Sanchez, Cecilia; Looman, Camilla; Hellman, Lars; Chambon, Pierre; Losson, Régine

    2001-01-01

    The Krüppel-associated box (KRAB) domain, originally identified as a 75-aa sequence present in numerous Krüppel-type zinc-finger proteins, is a potent DNA-binding-dependent transcriptional repression domain that is believed to function through interaction with the transcriptional intermediary factor 1 (TIF1) β. On the basis of sequence comparison and phylogenetic analysis, we have recently defined three distinct subfamilies of KRAB domains. In the present study, individual members of each subfamily were tested for transcriptional repression and interaction with TIF1β and two other closely related family members (TIF1α and TIF1γ). All KRAB variants were shown, (i) to repress transcription when targeted to DNA through fusion to a heterologous DNA-binding domain in mammalian cells, and (ii) to interact specifically with TIF1β, but not with TIF1α or TIF1γ. Taken together, these results implicate TIF1β as a common transcriptional corepressor for the three distinct subfamilies of KRAB zinc-finger proteins and suggest a high degree of conservation in the molecular mechanism underlying their transcriptional repression activity. PMID:11171966

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  19. 75 FR 28713 - Teacher Incentive Fund

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-21

    ... students. TIF is one such effort that advances the ARRA's third assurance of recruiting, developing, and... central premises of the TIF program: That since we know good teachers matter, it makes sense for... in its PBCS have difficulty in recruiting highly qualified or effective teachers, particularly in...

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

    PubMed

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

    2015-12-01

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

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

    PubMed

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

    2013-08-10

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

  2. TLR4-dependent immune response promotes radiation-induced liver disease by changing the liver tissue interstitial microenvironment during liver cancer radiotherapy.

    PubMed

    Zhi-Feng, Wu; Le-Yuan, Zhou; Xiao-Hui, Zhou; Ya-Bo, Gao; Jian-Ying, Zhang; Yong, Hu; Zhao-Chong, Zeng

    2014-12-01

    Liver tissue interstitial fluid (TIF) a special microenvironment around liver cells, which may play a vital role in cell communication during liver injury. Moreover, toll-like receptor 4 (TLR4) is an important trigger of the immune response that may also play a role in liver injuries, including radiation-induced liver disease (RILD). Therefore, the purpose of this study was to identify the roles of the TLR4-dependent immune response and TIFs in RILD after radiation therapy (RT) for liver cancer. This study consisted of two phases, and in the primary phase, the livers of TLR4 mutant (TLR4(-)) and normal (TLR4(+)) mice were irradiated with 30 Gy. TIF was then obtained from mouse livers and assessed by cytokine array analysis 20 days after irradiation, and cytokines in the TIFs, TLR4 and RILD were analyzed. In the second or validation phase, hepatocytes were isolated from TLR4(+) or TLR4(-) mice irradiated with 8 Gy and were co-cultured with TIFs from mouse livers, apoptosis of the hepatocytes was then measured using flow cytometry. We found that severe RILD was accompanied by higher expression of granulocyte macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor-related apoptosis inducing ligand (TRAIL) and vascular endothelial growth factor receptor 2(VEGFR-2) in liver TIFs, from in TLR4(+) mice compared with TLR4(-) mice (P < 0.05). In both TLR4(+) and TLR4(-) hepatocytes, apoptosis after irradiaton was increased significantly after co-culture in TIFs from TLR4(+) mice that had their livers irradiated, compared with TIFs from TLR4(-) mice that had their livers irradiated or TIFs from unirradiated mice (P < 0.05). In summary, these findings indicate that the TLR4-dependent immune response may promote RILD by enhancing the expression of GM-CSF, VEGFR-2 and TRAIL in liver TIFs.

  3. [Use of laparoscopic technic for treatment of patients with reflux diseases].

    PubMed

    Bobrzyński, A; Budzyński, A; Biesiada, Z

    2001-01-01

    Pathophysiology, symptomatology and diagnostic work-out in gastroesophageal reflux disease was presented. Treatment strategies and indication for surgery were discussed. Detailed description of the laparoscopic Nissen fundoplication was given. Complications, drawbacks and advantages of this procedure were discussed.

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

    ClinicalTrials.gov

    2015-08-03

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

  5. Some control-related issues in mini-robotics for endoluminal surgery.

    PubMed

    Poignet, Philippe; Chemori, Ahmed; Zemiti, Nabil; Liu, Chao

    2009-01-01

    This paper introduces some issues related to the development of robotics for endoluminal surgery from control point of view. Endoluminal surgery are incisionless procedures performed through natural orifices within the natural pathways. New devices are then required to achieve these new surgical procedures. Besides the development of new devices, control issues arise in both technological and theoretical aspects. The paper presents some of them and we propose a teleoperation architecture that has already been tested for needle insertion that could be used for teleoperated endoluminal surgery especially for instance for biopsies or anastomoses.

  6. Quantification of the concentration gradient of biomarkers between ovarian carcinoma interstitial fluid and blood

    PubMed Central

    Haslene-Hox, Hanne; Madani, Amina; Berg, Kaja C.G.; Woie, Kathrine; Salvesen, Helga B.; Wiig, Helge; Tenstad, Olav

    2014-01-01

    Background Tumor interstitial fluid (TIF) rather than plasma should be used in cancer biomarker discovery because of the anticipated higher concentration of locally produced proteins in the tumor microenvironment. Nevertheless, the actual TIF-to-plasma gradient of tumor specific proteins has not been quantified. We present the proof-of-concept for the quantification of the postulated gradient between TIF and plasma. Methods TIF was collected by centrifugation from serous (n = 19), endometrioid (n = 9) and clear cell (n = 3) ovarian carcinomas with early (n = 15) and late stage (n = 16) disease in grades 1 (n = 2), 2 (n = 8) and 3 (n = 17), and ELISA was used for the determination of CA-125, osteopontin and VEGF-A. Results All three markers were significantly up-regulated in TIF compared with plasma (p < 0.0001). The TIF-to-plasma ratio of the ovarian cancer biomarker CA-125 ranged from 1.4 to 24,300 (median = 194) and was inversely correlated to stage (p = 0.0006). The cancer related osteopontin and VEGF-A had TIF-to-plasma ratios ranging from 1 to 62 (median = 15) and 2 to 1040 (median = 59), respectively. The ratios were not affected by tumor stage, indicative of more widespread protein expression. Conclusion We present absolute quantitative data on the TIF-to-plasma gradient of selected proteins in the tumor microenvironment, and demonstrate a substantial and stage dependent gradient for CA-125 between TIF and plasma, suggesting a relation between total tumor burden and tissue-to-plasma gradient. General significance We present novel quantitative data on biomarker concentration in the tumor microenvironment, and a new strategy for biomarker selection, applicable in future biomarker studies. PMID:26673827

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

    USGS Publications Warehouse

    Noreen, Eric

    2000-01-01

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

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

    USGS Publications Warehouse

    Noreen, Eric

    2000-01-01

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

  9. Cytogenetic and Cytogenomic Microarray Characterization of Chromothripsis in Chromosome 8 Affecting MOZ/NCOA2 (TIF2), FGFR1, RUNX1T1, and RUNX1 in a Pediatric Acute Myeloid Leukemia.

    PubMed

    Koduru, Prasad R; Wilson, Kathleen; Wen, Jiadi; Garcia, Rolando; Patel, Sangeeta; Monaghan, Sara A

    2017-05-01

    Concurrent perturbations in different driver genes have been reported primarily in lymphoma. In acute myeloid leukemia (AML), cases with concurrent alterations in 2 driver genes are infrequently reported. In contrast to pathogenetic pathways in lymphoma with concurrently perturbed genes, the initial gene alteration in AML arrests maturation and the alteration in the second gene promote self-renewal of the blasts. Here, we report a unique case of infantile leukemia in which chromothripsis in chromosome 8 completely altered the G-band structure and resulted in concurrent changes in MOZ/NCOA2, FGFR1, RUNX1T1, and RUNX1. These multiple-hit abnormalities in AML have not been reported previously.

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

    PubMed

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

    2011-08-01

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

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

    SciTech Connect

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

    1988-02-01

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

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

    SciTech Connect

    Bateman, E.; Paule, M.R.

    1988-05-01

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

  13. Co-precipitation synthesis and luminescence properties of K₂TiF₆:Mn⁴⁺ red phosphors for warm white light-emitting diodes.

    PubMed

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

    2016-05-01

    K2TiF6:Mn(4+) red phosphors with different Mn(4+) doping concentrations were obtained using the co-precipitation method. X-Ray diffraction, scanning electron microscopy, Raman spectra, Fourier transform infrared spectroscopy, photoluminescence excitation and emission spectra and decay curves were used to characterize the properties of K2TiF6:Mn(4+) phosphors. Under excitation at 470 nm, an intense red emission peak around 631 nm corresponding to the (2)E(g)-(4)A2 transition of Mn(4+) was observed for 2.48 mol% K2TiF6:Mn(4+) phosphors and was used as the optimum doping concentration. The excellent luminescent properties of K2TiF6:Mn(4+) suggest that this material might be a promising red phosphor for generating warm white light in phosphor-converted white light-emitting diodes. Copyright © 2015 John Wiley & Sons, Ltd.

  14. 76 FR 44579 - Notice of Submission for OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ..., Information and Records Management Services, Office of Management. Institute of Education Sciences Type of... estimate the impact of the differentiated pay component of the TIF program on student achievement and...

  15. Production of Tuber-Inducing Factor

    NASA Technical Reports Server (NTRS)

    Stutte, Gary W.; Yorio, Neil C.

    2006-01-01

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

  16. Endoscopic and laparoscopic treatment of gastroesophageal reflux.

    PubMed

    Watson, David I; Immanuel, Arul

    2010-04-01

    Gastroesophageal reflux is extremely common in Western countries. For selected patients, there is an established role for the surgical treatment of reflux, and possibly an emerging role for endoscopic antireflux procedures. Randomized trials have compared medical versus surgical management, laparoscopic versus open surgery and partial versus total fundoplications. However, the evidence base for endoscopic procedures is limited to some small sham-controlled studies, and cohort studies with short-term follow-up. Laparoscopic fundoplication has been shown to be an effective antireflux operation. It facilitates quicker convalescence and is associated with fewer complications, but has a similar longer term outcome compared with open antireflux surgery. In most randomized trials, antireflux surgery achieves at least as good control of reflux as medical therapy, and these studies support a wider application of surgery for the treatment of moderate-to-severe reflux. Laparoscopic partial fundoplication is an effective surgical procedure with fewer side effects, and it may achieve high rates of patient satisfaction at late follow-up. Many of the early endoscopic antireflux procedures have failed to achieve effective reflux control, and they have been withdrawn from the market. Newer procedures have the potential to fashion a surgical fundoplication. However, at present there is insufficient evidence to establish the safety and efficacy of endoscopic procedures for the treatment of gastroesophageal reflux, and no endoscopic procedure has achieved equivalent reflux control to that achieved by surgical fundoplication.

  17. Defining the learning curve of laparoendoscopic single-site Heller myotomy.

    PubMed

    Ross, Sharona B; Luberice, Kenneth; Kurian, Tony J; Paul, Harold; Rosemurgy, Alexander S

    2013-08-01

    Initial outcomes suggest laparoendoscopic single-site (LESS) Heller myotomy with anterior fundoplication provides safe, efficacious, and cosmetically superior outcomes relative to conventional laparoscopy. This study was undertaken to define the learning curve of LESS Heller myotomy with anterior fundoplication. One hundred patients underwent LESS Heller myotomy with anterior fundoplication. Symptom frequency and severity were scored using a Likert scale (0 = never/not bothersome to 10 = always/very bothersome). Symptom resolution, additional trocars, and complications were compared among patient quartiles. Median data are presented. Preoperative frequency/severity scores were: dysphagia = 10/8 and regurgitation = 8/7. Additional trocars were placed in 12 patients (10%), of whom all were in the first two quartiles. Esophagotomy/gastrotomy occurred in three patients. Postoperative complications occurred in 9 per cent. No conversions to "open" operations occurred. Length of stay was 1 day. Postoperative frequency/severity scores were: dysphagia = 2/0 and regurgitation = 0/0; scores were less than before myotomy (P < 0.001). There were no apparent scars, except where additional trocars were placed. LESS Heller myotomy with anterior fundoplication well palliates symptoms of achalasia with no apparent scar. Placement of additional trocars only occurred early in the experience. For surgeons proficient with the conventional laparoscopic approach, the learning curve of LESS Heller myotomy with anterior fundoplication is short and safe, because proficiency is quickly attained.

  18. Angiotensin-converting-enzyme inhibitors slow renal decline in IgA nephropathy, independent of tubulointerstitial fibrosis at presentation.

    PubMed

    Kanno, Y; Okada, H; Yamaji, Y; Nakazato, Y; Suzuki, H

    2005-03-01

    Tubulointerstitial fibrosis (TIF) is a marker of progression of diabetic and non-diabetic nephropathy, correlating with creatinine clearance (CCr), and functional outcome. Angiotensin-converting-enzyme inhibitors (ACEIs) slow the rate of decline of renal function in proteinuric patients. To examine whether ACEIs affect TIF, directly or indirectly. Prospective 3-year follow-up study. We enrolled 49 patients with IgA nephropathy (IgAN), treating some with ACE inhibitors (n = 26, 1-2 mg/day temocapril or trandolapril) and some with calcium-channel blockers (CCB, n = 23, 2.5-5 mg/day amlodipine). Blood pressure, serum creatinine, and urinalysis were measured monthly, and 24-h endogenous creatinine clearance (CCr) at least once a year. In the CCB group, TIF was positively correlated with the rate of decline in CCr (dCCr), consistent with previous observations. In the ACEI group, dCCr was lower (0.02 +/- 0.02 vs. 0.06 +/- 0.03), and the TIF-dCCr correlation was absent. In the absence of post-treatment histological data, it is not possible to say whether ACEIs have an effect on TIF. However, ACEIs appear to slow the progression of renal failure in IgAN, regardless of the degree of TIF at presentation.

  19. In situ effect of sodium fluoride or titanium tetrafluoride varnish and solution on carious demineralization of enamel.

    PubMed

    Comar, Livia P; Wiegand, Annette; Moron, Bruna M; Rios, Daniela; Buzalaf, Marília A R; Buchalla, Wolfgang; Magalhães, Ana C

    2012-08-01

    This study evaluated the effect of titanium tetrafluoride (TiF(4)) formulations on enamel carious demineralization in situ. Thirteen subjects took part in this cross-over, split-mouth, double-blind study performed in three phases of 14 d each. In each subject, two sound and two predemineralized specimens of bovine enamel were worn intra-orally and plaque accumulation was allowed. One sound and one predemineralized specimen in each subject was treated once with sodium fluoride (NaF) varnish or solution (Treatment A); TiF(4) varnish or solution (Treatment B); or placebo varnish or no treatment (Treatment C). The initially sound enamel specimens were exposed to severe cariogenic challenge (20% sucrose, eight times daily for 5 min each time), whereas the predemineralized specimens were not. Eleven subjects were able to finish all experimental phases. The enamel alterations were quantified by surface hardness and transversal microradiography. Demineralization of previously sound enamel was reduced by all test formulations except for the NaF solution, while both TiF(4) formulations were as effective as NaF varnish. For the predemineralized specimens, enamel surface hardness was increased only by TiF(4) formulations, while subsurface mineral remineralization could not be seen in any group. Within the experimental protocol, TiF(4) was able to decrease enamel demineralization to a similar degree as NaF varnish under severe cariogenic challenges, while only TiF(4) formulations remineralized the enamel surface. © 2012 Eur J Oral Sci.

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

    PubMed Central

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

    2014-01-01

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

  1. Laparoscopic repair of hiatal hernia with mesenterioaxial volvulus of the stomach.

    PubMed

    Inaba, Kazuki; Sakurai, Yoichi; Isogaki, Jun; Komori, Yoshiyuki; Uyama, Ichiro

    2011-04-21

    Although mesenterioaxial gastric volvulus is an uncommon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mesenterioaxial intrathoracic gastric volvulus, which was successfully treated with laparoscopic repair of the diaphragmatic hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication. A 70-year-old Japanese woman was admitted to our hospital because of sudden onset of upper abdominal pain. An upper gastrointestinal series revealed an incarcerated intrathoracic mesenterioaxial volvulus of the distal portion of the stomach and the duodenum. The complete laparoscopic approach was used to repair the volvulus. The laparoscopic procedures involved the repair of the hiatal hernia using polytetrafluoroethylene mesh and Toupet fundoplication. This case highlights the feasibility and effectiveness of the laparoscopic procedure, and laparoscopic repair of the hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication may be useful for preventing postoperative recurrence of hiatal hernia, volvulus, and gastroesophageal reflux.

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

    PubMed Central

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

    2015-01-01

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

  3. Epidermal growth factor increases coactivation of the androgen receptor in recurrent prostate cancer.

    PubMed

    Gregory, Christopher W; Fei, Xiaoyin; Ponguta, Liliana A; He, Bin; Bill, Heather M; French, Frank S; Wilson, Elizabeth M

    2004-02-20

    Growth of normal and neoplastic prostate is mediated by the androgen receptor (AR), a ligand-dependent transcription factor activated by high affinity androgen binding. The AR is highly expressed in recurrent prostate cancer cells that proliferate despite reduced circulating androgen. In this report, we show that epidermal growth factor (EGF) increases androgen-dependent AR transactivation in the recurrent prostate cancer cell line CWR-R1 through a mechanism that involves a post-transcriptional increase in the p160 coactivator transcriptional intermediary factor 2/glucocorticoid receptor interacting protein 1 (TIF2/GRIP1). Site-specific mutagenesis and selective MAPK inhibitors linked the EGF-induced increase in AR transactivation to phosphorylation of TIF2/GRIP1. EGF signaling increased the coimmunoprecipitation of TIF2 and AR. AR transactivation and its stimulation by EGF were reduced by small interfering RNA inhibition of TIF2/GRIP1 expression. The data indicate that EGF signaling through MAPK increases TIF2/GRIP1 coactivation of AR transactivation in recurrent prostate cancer.

  4. Increased urinary lysophosphatidic acid in mouse with subtotal nephrectomy: potential involvement in chronic kidney disease.

    PubMed

    Mirzoyan, Koryun; Baïotto, Anna; Dupuy, Aude; Marsal, Dimitri; Denis, Colette; Vinel, Claire; Sicard, Pierre; Bertrand-Michel, Justine; Bascands, Jean-Loup; Schanstra, Joost P; Klein, Julie; Saulnier-Blache, Jean-Sébastien

    2016-12-01

    Increased incidence of chronic kidney disease (CKD) with consecutive progression to end-stage renal disease represents a significant burden to healthcare systems. Renal tubulointerstitial fibrosis (TIF) is a classical hallmark of CKD and is well correlated with the loss of renal function. The bioactive lysophospholipid lysophosphatidic acid (LPA), acting through specific G-protein-coupled receptors, was previously shown to be involved in TIF development in a mouse model of unilateral ureteral obstruction. Here, we study the role of LPA in a mouse subjected to subtotal nephrectomy (SNx), a more chronic and progressive model of CKD. Five months after surgical nephron reduction, SNx mice showed massive albuminuria, extensive TIF, and glomerular hypertrophy when compared to sham-operated animals. Urinary and plasma levels of LPA were analyzed using liquid chromatography tandem mass spectrometry. LPA was significantly increased in SNx urine, not in plasma, and was significantly correlated with albuminuria and TIF. Moreover, SNx mice showed significant downregulation in the renal expression of lipid phosphate phosphohydrolases (LPP1, 2, and 3) that might be involved in reduced LPA bioavailability through dephosphorylation. We concluded that SNx increases urinary LPA through a mechanism that could involve co-excretion of plasma LPA with albumin associated with a reduction of its catabolism in the kidney. Because of the previously demonstrated profibrotic activity of LPA, the association of urinary LPA with TIF suggests the potential involvement of LPA in the development of advanced CKD in the SNx mouse model. Targeting LPA metabolism might represent an interesting approach in CKD treatment.

  5. DNA structural variation affects complex formation and promoter melting in ribosomal RNA transcription.

    PubMed

    Marilley, M; Radebaugh, C A; Geiss, G K; Laybourn, P J; Paule, M R

    2002-08-01

    Eukaryotic ribosomal RNA promoters exhibit an unusual conservation of non-canonical DNA structure (curvature, twist angle and duplex stability) despite a lack of primary sequence conservation. This raises the possibility that rRNA transcription factors might utilize structural anomalies in their sequence recognition process. We have analyzed in detail the interaction of the polymerase I transcription factor TIF-IB from Acanthmoeba castellanii with the CORE promoter. TIF-IB interacts primarily with the minor groove of the promoter. By correlating the effects on transcription and on DNA structure of promoter point mutations, we show that the TIF-IB interaction is strongly inhibited by increases in minor groove width. This suggests that a particular DNA structure is required for interaction with the transcription factor. In addition, TIF-IB induces a small bend in the promoter upon binding. Modeling of this bend reveals that it requires an additional narrowing of the minor groove, which would favor binding to mutants with narrower grooves. We also discuss how this narrowing would induce a small destabilization of the helix upstream of the transcription start site. Telestability predicts this would result in destabilization of the sequence that melts during initiation, suggesting that TIF-IB may have a role in stimulating melting.

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

    PubMed

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

    2016-08-15

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

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

    PubMed Central

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

    2016-01-01

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

  8. [Natural orifice trans-luminal endoscopic surgery (notes)--a new era in general surgery].

    PubMed

    Elazary, Ram; Horgan, Santiago; Talamini, Mark A; Rivkind, Avraham I; Mintz, Yoav

    2008-10-01

    Four years ago, a new surgical technique was presented, the natural orifice trans-luminal endoscopic surgery (NOTES). This technique provides an incisionless operation. The surgical devices are inserted into the peritoneal cavity through the gastrointestinal or the urogenital tracts. Today, a cholecystectomy can be performed using an advanced endoscope inserted through the stomach or the vagina. The advantages of NOTES are: reduced post operative pain, no hernias, no surgical wounds infections and better cosmetic results. The disadvantages are: difficulties in achieving safe enterotomy closure or a leak proof anastomosis, it necessitates performing more operations compared to open or laparoscopic operations in order to obtain the skills for performing these operations, and difficulties of acquiring satisfactory endoscopic vision due to lack of advanced technology. Several NOTES operations have already been performed in humans. However, many other surgical procedures were tested in laboratory animals. Development and improvement of surgical devices may promote this surgical modality in the future.

  9. Pre-operative clinical and instrumental factors as antireflux surgery outcome predictors.

    PubMed

    Tolone, Salvatore; Gualtieri, Giorgia; Savarino, Edoardo; Frazzoni, Marzio; de Bortoli, Nicola; Furnari, Manuele; Casalino, Giuseppina; Parisi, Simona; Savarino, Vincenzo; Docimo, Ludovico

    2016-11-27

    Gastroesophageal reflux disease (GERD) is nowadays a highly prevalent, chronic condition, with 10% to 30% of Western populations affected by weekly symptoms. Many patients with mild reflux symptoms are treated adequately with lifestyle modifications, dietary changes, and low-dose proton pump inhibitors (PPIs). For those with refractory GERD poorly controlled with daily PPIs, numerous treatment options exist. Fundoplication is currently the most commonly performed antireflux operation for management of GERD. Outcomes described in current literature following laparoscopic fundoplication indicate that it is highly effective for treatment of GERD; early clinical studies demonstrate relief of symptoms in approximately 85%-90% of patients. However it is still unclear which factors, clinical or instrumental, are able to predict a good outcome after surgery. Virtually all demographic, esophagogastric junction anatomic conditions, as well as instrumental (such as presence of esophagitis at endoscopy, or motility patterns determined by esophageal high resolution manometry or reflux patterns determined by means of pH/impedance-pH monitoring) and clinical features (such as typical or atypical symptoms presence) of patients undergoing laparoscopic fundoplication for GERD can be factors associated with symptomatic relief. With this in mind, we sought to review studies that identified the factors that predict outcome after laparoscopic total fundoplication.

  10. Pre-operative clinical and instrumental factors as antireflux surgery outcome predictors

    PubMed Central

    Tolone, Salvatore; Gualtieri, Giorgia; Savarino, Edoardo; Frazzoni, Marzio; de Bortoli, Nicola; Furnari, Manuele; Casalino, Giuseppina; Parisi, Simona; Savarino, Vincenzo; Docimo, Ludovico

    2016-01-01

    Gastroesophageal reflux disease (GERD) is nowadays a highly prevalent, chronic condition, with 10% to 30% of Western populations affected by weekly symptoms. Many patients with mild reflux symptoms are treated adequately with lifestyle modifications, dietary changes, and low-dose proton pump inhibitors (PPIs). For those with refractory GERD poorly controlled with daily PPIs, numerous treatment options exist. Fundoplication is currently the most commonly performed antireflux operation for management of GERD. Outcomes described in current literature following laparoscopic fundoplication indicate that it is highly effective for treatment of GERD; early clinical studies demonstrate relief of symptoms in approximately 85%-90% of patients. However it is still unclear which factors, clinical or instrumental, are able to predict a good outcome after surgery. Virtually all demographic, esophagogastric junction anatomic conditions, as well as instrumental (such as presence of esophagitis at endoscopy, or motility patterns determined by esophageal high resolution manometry or reflux patterns determined by means of pH/impedance-pH monitoring) and clinical features (such as typical or atypical symptoms presence) of patients undergoing laparoscopic fundoplication for GERD can be factors associated with symptomatic relief. With this in mind, we sought to review studies that identified the factors that predict outcome after laparoscopic total fundoplication. PMID:27933133

  11. [Impaired lung function and anemia from large hiatal hernia: a case report].

    PubMed

    Suppa, Marianna; Colzi, Marina; Magnanelli, Elisa; Migliozzi, Elisa; Negri, Silvia; Millarelli, Federica; Coppola, Alessandro

    2013-05-01

    We present the clinical case of a 54 years old man who accessed for dyspnea and severe anemia. After being transfused, he underwent to gastroscopy, which showed an erosive gastritis with large hiatal hernia. The hernia was surgically reduced with laparoscopic hiatoplastic and Nissen-Rossetti fundoplication. In conclusion, dyspnea is not merely a medical competence but also a surgical one.

  12. Nutritional manipulation in the management of dumping syndrome.

    PubMed Central

    Khoshoo, V; Reifen, R M; Gold, B D; Sherman, P M; Pencharz, P B

    1991-01-01

    Two children with Nissen's fundoplication and either gastrocystoplasty or pyloroplasty developed dumping syndrome. Correction of their blood glucose abnormalities, resolution of symptoms, and weight gain were effectively achieved by addition of fats and uncooked corn starch (50 g/l) to their feeds. PMID:1776896

  13. Massive gastric dilatation and anuria resolved with naso-gastric tube decompression.

    PubMed

    Peces, Ramón; Vega, Cristina; Peces, Carlos; Trébol, Julio; González, Juan A

    2010-09-01

    We report for the first time a case of acute kidney injury associated with severe gastric distention after a laparoscopic Nissen-Rossetti fundoplication of the stomach for hiatal hernia. An abdominal compartment syndrome secondary to intra-abdominal hypertension was suspected. Naso-gastric tube decompression resulted in immediate resaturation of the diuresis and progressive recovery of renal function.

  14. Laparoscopic repair of a gastric volvulus occurring as a long-term complication of left pneumonectomy: report of a case.

    PubMed

    Batirel, Hasan Fevzi; Uygur-Bayramicli, Oya; Guler, Sevgi; Yildizeli, Bedrettin; Yuksel, Mustafa

    2007-01-01

    Gastric volvulus is an extremely rare late complication of pneumonectomy. We report the case of a 61-year-old man who presented with a 1-year history of progressive intolerance of solids and weight loss 33 years after a left pneumonectomy. Preoperative examinations showed a mesenteroaxial gastric volvulus. We performed a laparoscopic Toupet fundoplication and anterior gastropexy, following which his symptoms disappeared.

  15. Sav1 Loss Induces Senescence and Stat3 Activation Coinciding with Tubulointerstitial Fibrosis.

    PubMed

    Leung, Janet Y; Wilson, Harper L; Voltzke, Kristin J; Williams, Lindsay A; Lee, Hyo Jin; Wobker, Sara E; Kim, William Y

    2017-06-15

    Tubulointerstitial fibrosis (TIF) is recognized as a final phenotypic manifestation in the transition from chronic kidney disease (CKD) to end-stage renal disease (ESRD). Here we show that conditional inactivation of Sav1 in the mouse renal epithelium resulted in upregulated expression of profibrotic genes and TIF. Loss of Sav1 induced Stat3 activation and a senescence-associated secretory phenotype (SASP) that coincided with the development of tubulointerstitial fibrosis. Treatment of mice with the YAP inhibitor verteporfin (VP) inhibited activation of genes associated with senescence, SASPs, and activation of Stat3 as well as impeded the development of fibrosis. Collectively, our studies offer novel insights into molecular events that are linked to fibrosis development from Sav1 loss and implicate VP as a potential pharmacological inhibitor to treat patients at risk for developing CKD and TIF. Copyright © 2017 American Society for Microbiology.

  16. Spatial frequency analysis of high-density lipoprotein and iron-oxide nanoparticle transmission electron microscope image structure for pattern recognition in heterogeneous fields

    NASA Astrophysics Data System (ADS)

    Russell, Stewart; Nguyen, Thien An; Torres, Clyde Rey; Bhagroo, Stephen; Russell, Milo J.; Alfano, Robert R.

    2014-01-01

    The optical spatial frequencies of tumor interstitial fluid (TIF) are investigated. As a concentrated colloidal suspension of interacting native nanoparticles, the TIF can develop internal ordering under shear stress that may hinder delivery of antitumor agents within tumors. A systematic method is presented to characterize the TIF nanometer-scale microstructure in a model suspension of superparamagnetic iron-oxide nanoparticles and reconstituted high-density lipoprotein by Fourier spatial frequency (FSF) analysis so as to differentiate between jammed and fluid structural features in static transmission electron microscope images. The FSF method addresses one obstacle faced in achieving quantitative dosimetry to neoplastic tissue, that of detecting these nanoscale barriers to transport, such as would occur in the extravascular space immediately surrounding target cells.

  17. Modeling of edge effect in subaperture tool influence functions of computer controlled optical surfacing.

    PubMed

    Wan, Songlin; Zhang, Xiangchao; He, Xiaoying; Xu, Min

    2016-12-20

    Computer controlled optical surfacing requires an accurate tool influence function (TIF) for reliable path planning and deterministic fabrication. Near the edge of the workpieces, the TIF has a nonlinear removal behavior, which will cause a severe edge-roll phenomenon. In the present paper, a new edge pressure model is developed based on the finite element analysis results. The model is represented as the product of a basic pressure function and a correcting function. The basic pressure distribution is calculated according to the surface shape of the polishing pad, and the correcting function is used to compensate the errors caused by the edge effect. Practical experimental results demonstrate that the new model can accurately predict the edge TIFs with different overhang ratios. The relative error of the new edge model can be reduced to 15%.

  18. Study on active lap tool influence function in grinding 1.8 m primary mirror.

    PubMed

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

    2013-11-01

    We present a theoretical modeling method to predict the ring tool influence function (TIF) based on the computer-controlled active lap process. The gap on the lap-grinding layer is considered, and its influence on the ring TIF is analyzed too. The relationship between the shape of the ring TIF and the lap-workpiece rotation speed ratio is discussed in this paper. The recipe for calculating dwell time for axisymmetric fabrication is discussed. The grinding process of a 1.8 m primary mirror is improved based on these results. The grinding process is accomplished after 30 circles of grinding, and the surface shape error is from PV 82 μm RMS 16.4 μm reduced to PV 13.5 μm RMS 2.5 μm.

  19. Analytical data for reconnaissance geochemical samples from mine dumps, stream sediments and waters at the Thompson Creek Tungsten Mine, Custer County, Idaho

    USGS Publications Warehouse

    Van Gosen, B. S.; Eppinger, R.G.; Hammarstrom, J.M.; Briggs, P.H.; Crock, J.G.; Gent, C.; Meier, A.L.; Sutley, S.J.; Theodorakos, P.M.

    2000-01-01

    The Thompson Creek mine is an inactive and abandoned tungsten mine located along Thompson Creek about 10.5 miles (17 km) northwest of Clayton, Idaho (see location map in file LOCATION.PDF). The mine consisted initially of open pit mining of outcrops and later of underground workings accessed by a single adit. The mine was worked through 1955 and waste piles presently reside in the flood plain above the east bank of Thompson Creek. A view of the collapsed adit is provided in the TIFF (Tagged-Image File Format) file ADIT.TIF (all photographs taken on 08/13/99). A south-facing view of the mine waste dumps is provided in the TIFF file SOUTH.TIF and a north-facing view is provided in NORTH.TIF.

  20. Robotic-Assisted Procedures in Pediatric Surgery: A Critical Appraisal of the Current Best Evidence in Comparison to Conventional Minimally Invasive Surgery.

    PubMed

    Friedmacher, Florian; Till, Holger

    2015-11-01

    In recent years, the use of robotic-assisted surgery (RAS) has expanded within pediatric surgery. Although increasing numbers of pediatric RAS case-series have been published, the level of evidence remains unclear, with authors mainly focusing on the comparison with open surgery rather than the corresponding laparoscopic approach. The aim of this study was to critically appraise the published literature comparing pediatric RAS with conventional minimally invasive surgery (MIS) in order to evaluate the current best level of evidence. A systematic literature-based search for studies comparing pediatric RAS with corresponding MIS procedures was performed using multiple electronic databases and sources. The level of evidence was determined using the Oxford Centre for Evidence-based Medicine (OCEBM) criteria. A total of 20 studies met defined inclusion criteria, reporting on five different procedures: fundoplication (n=8), pyeloplasty (n=8), nephrectomy (n=2), gastric banding (n=1), and sleeve gastrectomy (n=1). Included publications comprised 5 systematic reviews and 15 cohort/case-control studies (OCEBM Level 3 and 4, respectively). No studies of OCEBM Level 1 or 2 were identified. Limited evidence indicated reduced operative time (pyeloplasty) and shorter hospital stay (fundoplication) for pediatric RAS, whereas disadvantages were longer operative time (fundoplication, nephrectomy, gastric banding, and sleeve gastrectomy) and higher total costs (fundoplication and sleeve gastrectomy). There were no differences reported for complications, success rates, or short-term outcomes between pediatric RAS and conventional MIS in these procedures. Inconsistency was found in study design and follow-up with large clinical heterogeneity. The best available evidence for pediatric RAS is currently OCEBM Level 3, relating only to fundoplication and pyeloplasty. Therefore, higher-quality studies and comparative data for other RAS procedures in pediatric surgery are required.

  1. Laparoscopic revision surgery for gastroesophageal reflux disease

    PubMed Central

    Celasin, Haydar; Genc, Volkan; Celik, Suleyman Utku; Turkcapar, Ahmet Gökhan

    2017-01-01

    Abstract Laparoscopic antireflux surgery is a frequently performed procedure for the treatment of gastroesophageal reflux in surgical clinics. Reflux can recur in between 3% and 30% of patients on whom antireflux surgery has been performed, and so revision surgery can be required due to recurrent symptoms or dysphagia in approximately 3% to 6% of the patients. The objective of this study is to evaluate the mechanism of recurrences after antireflux surgery and to share our results after revision surgery in recurrent cases. From 2001 to 2014, revision surgery was performed on 43 patients (31 men, 12 women) between the ages of 24 and 70 years. The technical details of the first operation, recurrence symptoms, endoscopy, and manometry findings were evaluated. The findings of revision surgery, surgical techniques, morbidity rates, length of hospitalization, and follow-up period were also recorded and evaluated. The first operation was Nissen fundoplication in 34 patients and Toupet fundoplication in 9 patients. Mesh hiatoplasty was performed for enforcement in 18 (41.9%) of these patients. The period between the first operation and the revision surgery ranged from 4 days to 60 months. The most common finding was slipped fundoplication and presence of hiatal hernia during revision surgery. Revision fundoplication and hernia repair with mesh reinforcement were used in 33 patients. The other techniques were Collis gastroplasty, revision fundoplication, and hernia repair without mesh. The range of follow-up period was from 2 to 134 months. Recurrence occurred in 3 patients after revision surgery (6.9%). Although revision surgery is difficult and it has higher morbidity, it can be performed effectively and safely in experienced centers. PMID:28072725

  2. A gas-tight Cu K alpha x-ray transparent reaction chamber for high-temperature x-ray diffraction analyses of halide gas/solid reactions.

    PubMed

    Shian, Samuel; Sandhage, Kenneth H

    2009-11-01

    An externally heated, x-ray transparent reaction chamber has been developed to enable the dynamic high temperature x-ray diffraction (HTXRD) analysis of a gas/solid [TiF(4)(g)/SiO(2)(s)] reaction involving a halide gas reactant formed at elevated temperatures (up to 350 degrees C) from a condensed source (TiF(4) powder) sealed within the chamber. The reaction chamber possessed x-ray transparent windows comprised of a thin (13 microm) internal layer of Al foil and a thicker (125 microm) external Kapton film. After sealing the SiO(2) specimens (diatom frustules or Stober spheres) above TiF(4) powder within the reaction chamber, the chamber was heated to a temperature in the range of 160-350 degrees C to allow for internal generation of TiF(4)(g). The TiF(4)(g) underwent a metathetic reaction with the SiO(2) specimen to yield a TiOF(2)(s) product. HTXRD analysis, using Cu K alpha x rays passed through the Kapton/Al windows of the chamber, was used to track the extent of SiO(2) consumption and/or TiOF(2) formation with time. The Al foil inner layer of the windows protected the Kapton film from chemical attack by TiF(4)(g), whereas the thicker, more transparent Kapton film provided the mechanical strength needed to contain this gas. By selecting an appropriate combination of x-ray transparent materials to endow such composite windows with the required thermal, chemical, and mechanical performance, this inexpensive reaction chamber design may be applied to the HTXRD analyses of a variety of gas/solid reactions.

  3. Myositis-specific autoantibodies and their association with malignancy in Italian patients with polymyositis and dermatomyositis.

    PubMed

    Ceribelli, Angela; Isailovic, Natasa; De Santis, Maria; Generali, Elena; Fredi, Micaela; Cavazzana, Ilaria; Franceschini, Franco; Cantarini, Luca; Satoh, Minoru; Selmi, Carlo

    2017-02-01

    This study aims to characterize myositis-specific antibodies in a well-defined cohort of patients with idiopathic inflammatory myopathy and to determine their association with cancer. Sera from 40 patients with polymyositis, dermatomyositis, and controls were tested by protein and RNA immunoprecipitation to detect autoantibodies, and immunoprecipitation-Western blot was used for anti-MJ/NXP-2, anti-MDA5, and anti-TIF1γ/α identification. Medical records were re-evaluated with specific focus on cancer. Anti-MJ/NXP-2 and anti-TIF1γ/α were the most common antibodies in dermatomyositis. In six dermatomyositis cases, we found five solid forms of cancer and one Hodgkin's lymphoma in long-term remission. Among patients with cancer-associated dermatomyositis, three were positive for anti-TIF1γ/α, two for anti-Mi-2, and one for anti-MJ/NXP-2. The strongest positivity of anti-TIF1γ was seen in two active forms of cancer, and this antibody was either negative or positive at low titers in the absence of cancer or in the 7-year remission Hodgkin's lymphoma. Four out of twenty (20 %) patients with polymyositis had solid cancer, but no specific association with autoantibodies was identified; further, none of the four cases of antisynthetase syndrome had a history of cancer. No serum myositis-associated autoantibody was observed in control sera, resulting in positive predictive value 75 %, negative predictive value 78.5 %, sensitivity 50 %, specificity 92 %, and area under the ROC curve 0.7083 for the risk of paraneoplastic DM in anti-TIF1γ/α (+) patients. Myositis-specific autoantibodies can be identified thanks to the use of immunoprecipitation, and their association with cancer is particularly clear for anti-TIF1γ/α in dermatomyositis. This association should be evaluated in a prospective study by immunoprecipitation in clinical practice.

  4. Effect of suppressors of SOS-mediated filamentation on sfiA operon expression in Escherichia coli.

    PubMed Central

    Huisman, O; D'Ari, R

    1983-01-01

    In Escherichia coli, the cell division block observed during the SOS response requires the product of the sfiA gene, whose expression is regulated negatively by the LexA repressor and positively by the RecA protease. We have studied the effect on sfiA expression of sfiA, sfiB, infA, and infB mutations, which are known to affect SOS-associated filamentation. To measure sfiA expression in the different strains, we first constructed a lambda transducing phage carrying an sfiA::lac operon fusion. Mutations at the sfiA locus (dominant and recessive) and the sfiB locus (recessive) had no effect on sfiA expression. The mutations tif (at the recA locus) and tsl (at the lexA locus) are known to induce filamentation and a high level of sfiA expression at 42 degrees C. The infB1 mutation, which suppresses filamentation in a tif tsl strain at 42 degrees C, reduced sfiA expression at 42 degrees C in tif tsl infB1 and tsl infB1 strains but not in a tif infB1 strain. The infA3 mutation, which suppresses tif-mediated filamentation, reduced induction of sfiA expression in a tif infA3 strain at 42 degrees C or after UV irradiation. The isolation and characterization of sfiA constitutive strains revealed only lexA-linked mutations in a sfiA-background, suggesting that LexA is the only readily eliminated repressor of the sfiA gene. Nevertheless, the infA and infB mutations could define elements involved in the regulation of sfiA expression. PMID:6336731

  5. Estimating neurotransmitter kinetics with ntPET: a simulation study of temporal precision and effects of biased data.

    PubMed

    Normandin, Marc D; Morris, Evan D

    2008-02-01

    We recently introduced neurotransmitter PET (ntPET), an analysis technique that estimates the kinetics of stimulus-induced neurotransmitter (NT) release. Here, we evaluate two formulations of ntPET. The arterial (ART) approach measures the tracer input function (TIF) directly. The reference (REF) approach derives the TIF from reference region data. Arterial sampling is considered the gold standard in PET modeling but reference region approaches are preferred for reduced cost and complexity. If simulated PET data with unbiased TIFs were analyzed using ART or REF, temporal precision was better than 3 min provided NT concentration peaked less than 30 min into the scanning session. The consequences of biased TIFs or stimulus-induced changes in tracer delivery were also evaluated. ART TIFs were biased by the presence of uncorrected radiometabolites in the plasma whereas REF TIFs were biased by specific binding in the reference region. Simulated changes in tracer delivery emulated ethanol-induced blood flow alterations observed previously with PET. ART performance deteriorated significantly if metabolites amounted to 50% of plasma radioactivity by 60 min. The accuracy and precision of REF were preserved even if the reference region contained 40% of the receptor density of the target region. Both methods were insensitive to blood flow alterations (proportional changes in K(1) and k(2)). Our results suggest that PET data contain information--heretofore not extracted--about the timing of NT release. The REF formulation of ntPET proved to be robust to many plausible model violations and under most circumstances is an appropriate alternative to ART.

  6. Predatory potential of Geocoris spp. and Orius insidiosus on fall armyworm in resistant and susceptible turf.

    PubMed

    Joseph, S V; Braman, S K

    2009-06-01

    Predatory potential and performance of the predaceous heteropterans, Geocoris punctipes (Say), G. uliginosus (Say) (Geocoridae), and Orius insidiosus (Say) (Anthocoridae), were evaluated using fall armyworm, Spodoptera frugiperda (J. E. Smith), as prey on different turfgrass taxa (resistant zoysiagrasses, 'Cavalier' and 'Palisades'; moderately resistant Bermuda grass, 'TifSport'; and susceptible seashore paspalum, 'Sea Isle 1') through laboratory and field studies. When background mortality was taken into account, in small arena trials in the laboratory, the greatest mortality by predators occurred on TifSport. The predator impact on TifSport by O. insidiosus was 92.6% above the mortality in the no-predator treatment on that grass. Predator induced mortality was rarely significant on the highly resistant zoysiagrass cultivar Cavalier because mortality, even in the absence of predators, was so high. Survival of larvae on TifSport Bermuda grass was significantly reduced by the addition of just two O. insidiosus per pot in laboratory pot trials. An increase in predator density to 4, 6, 8, or 10 further suppressed larval survival. O. insidiosus reduced larval survival on Sea Isle 1 at all densities. On Sea Isle 1, a density of two O. insidiosus resulted in > 50% reduction in live fall armyworms compared with the no predator treatment in laboratory trials. However, addition of O. insidiosus did not significantly reduce survival of fall armyworm larvae on this cultivar in the field in the presence of alternative prey and predators. O. insidiosus densities of six or higher per 181.4 cm2 did significantly reduce larval survival on TifSport Bermuda grass by as much as 80% during a 5-d trial period in the field. Predator-induced mortality among all trials was most consistent on a grass of intermediate resistance, TifSport Bermuda grass.

  7. Enzyme-linked immunosorbent assays for detection of anti-transcriptional intermediary factor-1 gamma and anti-Mi-2 autoantibodies in dermatomyositis.

    PubMed

    Fujimoto, Manabu; Murakami, Akihiro; Kurei, Shunsuke; Okiyama, Naoko; Kawakami, Atsushi; Mishima, Michiaki; Sato, Shinji; Seishima, Mariko; Suda, Takafumi; Mimori, Tsuneyo; Takehara, Kazuhiko; Kuwana, Masataka

    2016-12-01

    Autoantibodies against transcriptional intermediary factor 1 (TIF1) and Mi-2 are selectively detected in patients with dermatomyositis (DM). To measure these antibodies readily, the development of reliable ELISA systems has been needed. This study aimed to establish enzyme-linked immunosorbent assays (ELISAs) for anti-TIF1γ and anti-Mi-2β antibodies (Abs) and to assess their utility. Serum samples were obtained from 104 patients with classic DM, 68 with clinically amyopathic DM (CADM) and 70 with polymyositis, who were followed up at 8 medical centers across Japan. Serum samples from 190 patients with other connective tissue diseases (CTDs) and 123 healthy individuals were also assessed. Serum antibody levels were examined by ELISAs coated with full-length TIF1γ or Mi-2β proteins produced by a baculovirus expression system. To assess the cross-reactivity, partial-length Mi-2β proteins with or without mutations were produced and examined for reactivity. When compared with immunoprecipitation assay, anti-TIF1γ Ab ELISA showed 100% sensitivity and 100% specificity, while anti-Mi-2β Ab ELISA showed 100% sensitivity and 99.6% specificity. Anti-TIF1γ Ab was positive in 30 (28.8%) with classic DM and 4 (5.9%) with CADM, whereas 14 (13.5%) with classic DM, but none with CADM, were positive for anti-Mi-2β Ab. Of 30 anti-TIF1γ Ab-positive DM patients, 23 (67.6%) had malignancy. Anti-Mi-2β Ab-positive serum samples exhibited modest cross-reactivity with the TIF1γ protein due to the homologous amino acid sequence containing cysteines in their plant homeodomains. The current study demonstrates the utility of newly established ELISAs for anti-TIF1γ and anti-Mi-2β Abs, which can serve as easier detection systems for routine testing. Copyright © 2016 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

  8. How does robotic anti-reflux surgery compare with traditional open and laparoscopic techniques: a cost and outcomes analysis.

    PubMed

    Owen, Benjamin; Simorov, Anton; Siref, Andy; Shostrom, Valerie; Oleynikov, Dmitry

    2014-05-01

    Conventional laparoscopic fundoplications (CLF) have been the gold standard for Nissen fundoplications (NFs) for two decades. The advent of a robotic approach for fundoplication procedures creates a potential alternative. Thus, we used a national database to examine perioperative outcomes with respect to open, laparoscopic, and robotic approaches. The University Health System Consortium is an alliance of medical centers, numbering over 115 academic institutions and their 271 affiliated hospitals. We used International Classification of Diseases codes to elicit patients over the age of 18 years who received NF procedures. A total of 12,079 patients of similar demographic background received fundoplication procedures from October 2008 to June 2012. Of those, 2,168 were open fundoplications (OF), 9,572 were CLF, and 339 were robot-assisted laparoscopic fundoplications (RLF). CLF and RLF displayed no significance in mortality (0.1 vs. 0 %; p = 0.5489), morbidity (4.0 vs. 5.6 %; p = 0.1744), length of stay (2.8 ± 3.6 vs. 3.0 ± 3.5; p = 0.3242), and intensive care unit (ICU) cases (8.4 vs. 11.5 %; p = 0.051). However, CLF remained superior, with a lower 30-day re-admission rate (1.8 vs. 3.6 %; p < 0.05) and cost (US$7,968 ± 6,969 vs. US$10,644 ± 6,041; p < 0.05). When RLF was compared with OF, RLF had significantly improved morbidity (5.6 vs. 11 %; p < 0.05), length of stay (6.1 ± 7.2 vs. 3.0 ± 3.5 days; p < 0.05), less ICU admission (11.5 vs. 23.1 %; p <0.05) and less cost (US$10,644 ± 6,041 vs. US$12,766 ± 13,982; p < 0.05). Current data suggests that robot-assisted NF procedures have similar patient outcomes to conventional laparoscopic NF, with the exception of added cost and higher re-admission rate. While the higher costs are expected given the new technology, increasing re-admission rates are concerning and may represent the level of experience of the surgeon as well as the robotic learning curve.

  9. Evaluation of the Teacher Incentive Fund: Implementation and Impacts of Pay-for-Performance after Two Years

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Glazerman, Steven; Seifullah, Allison

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Meyer, Robert H.; Christian, Michael S.

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  13. Report of the 2002 Texas Public School Technology Survey Prepared for the Telecommunications Infrastructure Fund Board and Texas Public Schools.

    ERIC Educational Resources Information Center

    Denton, Jon; Davis, Trina; Strader, Arlen; Durbin, Brooke

    Over the past four legislative sessions, the Texas State Legislature enacted laws that have accelerated the integration of technology into public education. The significant effort to build technology infrastructure in Texas is evident through the thousands of public school awards provided by the Telecommunications Infrastructure Fund (TIF) Board,…

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

    DOE Data Explorer

    Adam Brandt

    2015-11-15

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

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

    ERIC Educational Resources Information Center

    Rowland, Cortney; Potemski, Amy

    2009-01-01

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

  16. SE Great Basin Play Fairway Analysis

    DOE Data Explorer

    Adam Brandt

    2015-11-15

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

  17. Field tests on biochar to reduce emissions from soil fumigation

    USDA-ARS?s Scientific Manuscript database

    Soil fumigation continues to be one of the most important strategies for pest management in orchards. Although low permeability tarp such as totally impermeable film (TIF) has shown to be the most effective in reducing fumigant emissions, costs are high and tarp disposal is needed after use. The obj...

  18. A Conceptual Framework for Understanding Armed Non State Actors (ANSAs): Strategic Roles and Operational Dynamics

    DTIC Science & Technology

    This is the Final Report of the Technology Investment Fund (TIF) Project entitled A Conceptual Framework for Understanding Armed Non-state Actors...Cmap. The generic ANSA Cmap is a high-level conceptual framework grounded in both multidisciplinary theory and mixed methods practice that distills our

  19. Word Criticality Analysis. MOS: 91R. Skill Levels 1 & 2.

    DTIC Science & Technology

    1981-09-01

    77i, IN .7Z j: n tn4 tif 7 *1 -- -% V~~~~~~~~~~~ I t"---------- -~ --.---- M- --l- 12 II.A3LV 2 ut sAIU 1)𔃻 Z r.tVIAtII:AITM Uhi1EJ:S1t.1EO 4’ a

  20. Hybrid ultramicroporous materials (HUMs) with enhanced stability and trace carbon capture performance.

    PubMed

    Kumar, Amrit; Hua, Carol; Madden, David G; O'Nolan, Daniel; Chen, Kai-Jie; Keane, Lee-Ann J; Perry, John J; Zaworotko, Michael J

    2017-05-30

    Fine-tuning of HUMs through pillar substitution can significantly enhance trace CO2 sorption performance and stability. The resulting materials, exemplified by the new material TIFSIX-3-Ni, [Ni(pyrazine)2(TiF6)]n, are shown through temperature programmed desorption experiments to remove trace quantities of CO2 from moist gas mixtures.

  1. Fused Salt Electrodeposited TiB2 Coatings on High-Speed Steel Twist Drills

    DTIC Science & Technology

    1987-09-01

    this process was the ternary eutectic of lithium -, sodium-, and potassium-fluoride (FLINAK), melting at 842 0 F (454 0 C) with titanium and boron added...as fluotitanate (TiF6 ) and fluoborate (BF 4 ), respectively. The fused salt cell was operated under an inert gas enclosure ("dry box"). Four heavy

  2. Off-tarp emissions, distribution, and efficacy of carbonated fumigants in a low permeability film tarped field

    USDA-ARS?s Scientific Manuscript database

    Carbonated fumigants have been shown to distribute quickly and uniformly in sandy soils and improve pest control efficacy for annual crops. Low permeability films, such as VaporSafe® (TIF), could further improve fumigant dispersion by effectively retaining the fumigant in soil; however, there is a c...

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  4. US EPA, Pesticide Product Label, AGSCO 600, 03/08/1971

    EPA Pesticide Factsheets

    2011-04-14

    ... 't'I;('f .... ltl.I ... '" Ir.,)t n-,., I" :",' r' fr" t .• ,t, C'wm ,,-,II '!l' ~"I"" n .1': '~,I' ",j' • I" j I H',· ~WfP, , .. 't,lh'cj ,n fbt , 1.1·,t·j .... t~n u "~ ,n .IC( "!If'(e .... ,fh .1 .... ( ...

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

    ERIC Educational Resources Information Center

    Glazerman, Steven; Seifullah, Allison

    2012-01-01

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

  6. Edge control in a computer controlled optical surfacing process using a heterocercal tool influence function.

    PubMed

    Hu, Haixiang; Zhang, Xin; Ford, Virginia; Luo, Xiao; Qi, Erhui; Zeng, Xuefeng; Zhang, Xuejun

    2016-11-14

    Edge effect is regarded as one of the most difficult technical issues in a computer controlled optical surfacing (CCOS) process. Traditional opticians have to even up the consequences of the two following cases. Operating CCOS in a large overhang condition affects the accuracy of material removal, while in a small overhang condition, it achieves a more accurate performance, but leaves a narrow rolled-up edge, which takes time and effort to remove. In order to control the edge residuals in the latter case, we present a new concept of the 'heterocercal' tool influence function (TIF). Generated from compound motion equipment, this type of TIF can 'transfer' the material removal from the inner place to the edge, meanwhile maintaining the high accuracy and efficiency of CCOS. We call it the 'heterocercal' TIF, because of the inspiration from the heterocercal tails of sharks, whose upper lobe provides most of the explosive power. The heterocercal TIF was theoretically analyzed, and physically realized in CCOS facilities. Experimental and simulation results showed good agreement. It enables significant control of the edge effect and convergence of entire surface errors in large tool-to-mirror size-ratio conditions. This improvement will largely help manufacturing efficiency in some extremely large optical system projects, like the tertiary mirror of the Thirty Meter Telescope.

  7. Cell proliferation markers at the invasive tumor front of oral squamous cell carcinoma: comparative analysis in relation to clinicopathological parameters of patients.

    PubMed

    Cortegoso, Aurita Veronica Beovide; Laureano, Natalia Koerich; Silva, Alessandra Dutra da; Danilevicz, Chris Krebs; Magnusson, Alessandra Sellinger; Visioli, Fernanda; Rados, Pantelis Varvaki

    2017-01-01

    To evaluate the number of AgNORs per nucleus and the expression of Ki-67 at the tumor invasion front (TIF) in relation to clinical parameters (TNM), TIF classification and the prognosis of oral squamous cell carcinomas in an Uruguayan population. This study was conducted through a retrospective survey from 2000 to 2010 at the National Institute of Cancer Montevideo, Uruguay and included 40 patients. The samples were obtained from the resection of the tumor and the TIF was defined according with Bryne, et al.5 (1992). Expression of Ki-67 was assessed by the percentage of positive tumor cells and the AgNOR was recorded as the mean AgNOR (mAgNOR) and the percentage of AgNOR per nucleus (pAgNOR). All analyzes were performed by a blinded and calibrated observer. No statistically significant association was observed between immunostaining of Ki-67 and AgNOR with the different types of TIF, regional metastasis and patients prognosis, however it was observed an increase in Ki-67 expression associated with worse patient's clinical staging, although not statistically significant. Our results suggest that proliferation markers as AgNOR and Ki-67 are not prognostic markers at the tumor invasive front of carcinoma of oral squamous cell.

  8. Cell proliferation markers at the invasive tumor front of oral squamous cell carcinoma: comparative analysis in relation to clinicopathological parameters of patients

    PubMed Central

    Veronica, Aurita; CORTEGOSO, Beovide; LAUREANO, Natalia Koerich; da SILVA, Alessandra Dutra; DANILEVICZ, Chris Krebs; MAGNUSSON, Alessandra Sellinger; VISIOLI, Fernanda; RADOS, Pantelis Varvaki

    2017-01-01

    Abstract Objectives To evaluate the number of AgNORs per nucleus and the expression of Ki-67 at the tumor invasion front (TIF) in relation to clinical parameters (TNM), TIF classification and the prognosis of oral squamous cell carcinomas in an Uruguayan population. Material and Methods This study was conducted through a retrospective survey from 2000 to 2010 at the National Institute of Cancer Montevideo, Uruguay and included 40 patients. The samples were obtained from the resection of the tumor and the TIF was defined according with Bryne, et al.5 (1992). Expression of Ki-67 was assessed by the percentage of positive tumor cells and the AgNOR was recorded as the mean AgNOR (mAgNOR) and the percentage of AgNOR per nucleus (pAgNOR). All analyzes were performed by a blinded and calibrated observer. Results No statistically significant association was observed between immunostaining of Ki-67 and AgNOR with the different types of TIF, regional metastasis and patients prognosis, however it was observed an increase in Ki-67 expression associated with worse patient’s clinical staging, although not statistically significant. Conclusions Our results suggest that proliferation markers as AgNOR and Ki-67 are not prognostic markers at the tumor invasive front of carcinoma of oral squamous cell. PMID:28678951

  9. Heterosis and combining ability estimates in isoflavone content using different parental soybean accessions: wild soybean, a valuable germplasm for soybean breeding.

    PubMed

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

    2015-01-01

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

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

    SciTech Connect

    Gius, D.; Laimins, L.A.

    1989-02-01

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

  11. TRAP1 ameliorates renal tubulointerstitial fibrosis in mice with unilateral ureteral obstruction by protecting renal tubular epithelial cell mitochondria.

    PubMed

    Chen, Jun-Feng; Wu, Qi-Shun; Xie, Yu-Xian; Si, Bo-Lin; Yang, Ping-Ping; Wang, Wen-Yan; Hua, Qin; He, Qing

    2017-10-01

    Mitochondrial dysfunction causes renal tubular epithelial cell injury and promotes cell apoptosis and renal tubulointerstitial fibrosis (TIF) progression. TNF receptor-associated protein 1 (TRAP1) is a molecular chaperone protein that is localized in mitochondria. It plays an important role in cell apoptosis; however, its functional mechanism in TIF remains unclear. In this study, we observed the effects of TRAP1 in renal tubular epithelial cell mitochondria in mice with unilateral ureteral obstruction and its function in cell apoptosis and TIF. Results show that TRAP1 could protect the mitochondrial structure in renal tubular epithelial cells; maintain the levels of mitochondrial membrane potential, ATP, and mitochondrial DNA copy number; inhibit reactive oxygen species production; stabilize the expression of the mitochondrial inner membrane protein mitofilin; reduce renal tubular epithelial cell apoptosis; and inhibit TIF. These results provide new theoretical foundations for additional understanding of the antifibrotic mechanism of TRAP1 in the kidney.-Chen, J.-F., Wu, Q.-S., Xie, Y.-X., Si, B.-L., Yang, P.-P., Wang, W.-Y., Hua, Q., He, Q. TRAP1 ameliorates renal tubulointerstitial fibrosis in mice with unilateral ureteral obstruction by protecting renal tubular epithelial cell mitochondria. © FASEB.

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

    PubMed

    Guo, Huizhen; Jiang, Liang; Xia, Qingyou

    2016-04-01

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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  15. Implications of changing the amount of thickener in thickened infant formula for infants with dysphagia.

    PubMed

    September, Cindy; Nicholson, Timothy M; Cichero, Julie A Y

    2014-08-01

    When a dysphagic infant is prescribed thickened infant formula (TIF) as a treatment method, some clinicians determine their own addition rates of thickener to meet the specific needs of the infant rather than relying on the directions on the tin. In this study the rheological behaviour of a TIF at different addition levels of thickener was measured to determine whether there was a difference in full rheological response and in viscosity. In addition, the time taken for the TIF to reach a near-stable viscosity was also measured. One hundred grams of Karicare® infant formula was made up according to the manufacturer’s instructions and Karicare® feed thickener was added at levels of 2, 3, 4, 5, and 6 g, respectively. A strain-controlled rheometer (ARES) with Couette geometry was used to rheologically characterise the TIF at the different levels of thickener addition. There was a significant difference in viscosity between the low levels and the higher levels of addition thickener (p < 0.05). Also, the low levels of thickener addition showed Newtonian-like behaviour, whereas the higher levels of addition were shear-thinning. The time taken for the thickener to reach a near-stable viscosity was found to be 10 min. Guidelines for thickened infant formula need to take into account the different levels of thickener addition rates.

  16. Feature selection and classification of urinary mRNA microarray data by iterative random forest to diagnose renal fibrosis: a two-stage study

    PubMed Central

    Zhou, Le-Ting; Cao, Yu-Han; Lv, Lin-Li; Ma, Kun-Ling; Chen, Ping-Sheng; Ni, Hai-Feng; Lei, Xiang-Dong; Liu, Bi-Cheng

    2017-01-01

    Renal fibrosis is a common pathological pathway of progressive chronic kidney disease (CKD). However, kidney function parameters are suboptimal for detecting early fibrosis, and therefore, novel biomarkers are urgently needed. We designed a 2-stage study and constructed a targeted microarray to detect urinary mRNAs of CKD patients with renal biopsy and healthy participants. We analysed the microarray data by an iterative random forest method to select candidate biomarkers and produce a more accurate classifier of renal fibrosis. Seventy-six and 49 participants were enrolled into stage I and stage II studies, respectively. By the iterative random forest method, we identified a four-mRNA signature in urinary sediment, including TGFβ1, MMP9, TIMP2, and vimentin, as important features of tubulointerstitial fibrosis (TIF). All four mRNAs significantly correlated with TIF scores and discriminated TIF with high sensitivity, which was further validated in the stage-II study. The combined classifiers showed excellent sensitivity and outperformed serum creatinine and estimated glomerular filtration rate measurements in diagnosing TIF. Another four mRNAs significantly correlated with glomerulosclerosis. These findings showed that urinary mRNAs can serve as sensitive biomarkers of renal fibrosis, and the random forest classifier containing urinary mRNAs showed favourable performance in diagnosing early renal fibrosis. PMID:28045061

  17. How to Maximize the Advantages of Interior Lines at the Operational Level.

    DTIC Science & Technology

    1987-05-01

    ars Ct~fF ** **. A. 1II .%4.u4IN4 ’ Vlex ft..e.*1 V ~ ~~~~~~~~ I~tifIR 4?PtaTAY.AC!R l ..Ar~a ..........0 ....... . .. .. .... .. L~~~~~~~~~~~~~ ToRior

  18. Fumigation efficacy and emission reduction using low-permeability film in orchard soil fumigation.

    PubMed

    Gao, Suduan; Sosnoskie, Lynn M; Cabrera, Jose Alfonso; Qin, Ruijun; Hanson, Bradley D; Gerik, James S; Wang, Dong; Browne, Greg T; Thomas, John E

    2016-02-01

    Many orchards use fumigation to control soilborne pests prior to replanting. Controlling emissions is mandatory to reduce air pollution in California. This research evaluated the effects of plastic film type [polyethylene (PE) or totally impermeable film (TIF)], application rate of Telone C35 [full (610 kg ha(-1) ), 2/3 or 1/3 rates] and carbonation at 207 kPa on fumigant transport (emission and in soil) and efficacy. While increasing fumigant concentrations under the tarp, TIF reduced emissions >95% (∼2% and <1% of total applied 1,3-dichloropropene and chloropicrin respectively) relative to bare soil, compared with ∼30% reduction by PE. All fumigation treatments, regardless of film type, provided good nematode control above 100 cm soil depth; however, nematode survival was high at deeper depths. Weed emergence was mostly affected by tarping and fumigant rate, with no effects from the carbonation. TIF can effectively reduce fumigant emissions. Carbonation under the studied conditions did not improve fumigant dispersion and pest control. The 2/3 rate with TIF controlled nematodes as effectively as the full rate in bare soil or under the PE film to 100 cm soil depth. However, control of nematodes in deeper soil remains a challenge for perennial crops. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  20. External skeletal fixator intramedullary pin tie-in for the repair of tibiotarsal fractures in raptors: 37 cases (1995-2011).

    PubMed

    Bueno, Irene; Redig, Patrick T; Rendahl, Aaron K

    2015-11-15

    To evaluate the outcome of the application of an external skeletal fixator intramedullary pin tie-in (TIF) to tibiotarsal fractures in raptors. Retrospective case series. Thirty-four raptors with 37 tibiotarsal fractures. Medical records and radiographs for raptors with tibiotarsal fractures that were treated at The Raptor Center at the University of Minnesota between 1995 and 2011 were reviewed. Descriptive statistics were generated and univariate logistic regression analyses were used to assess whether age, sex, body weight, location and nature of the fracture, and type of surgical reduction were significantly associated with whether the fracture healed following surgical reduction and TIF application. 31 of 37 (84%) tibiotarsal fractures successfully healed following surgical reduction and TIF application. The mean healing time was 38 days (range, 15 to 70 days). None of the variables assessed were significantly associated with whether the tibiotarsal fracture healed. Twenty of the 34 (59%) raptors were eventually rehabilitated and released. Results indicated that most tibiotarsal fractures were successfully managed by surgical reduction and stabilization with a TIF. However, other comorbidities (eg, systemic infections and visual deficits) negatively affected the rehabilitation of raptors and sometimes resulted in euthanasia despite the fact that the tibiotarsal fracture had healed, and those comorbidities, along with the variables evaluated (eg, age, sex, and nature of the fracture), should be used as triage criteria and prognostic indicators.

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

    ERIC Educational Resources Information Center

    Cody, Scott; Wellington, Alison; Chaplin, Duncan

    2009-01-01

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

  2. 2008 Principal/Vice Principal Survey Results for Evaluation of the Effective Practice Incentive Community (EPIC). Final Report

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  4. Evaluating Statistical Targets for Assembling Parallel Mixed-Format Test Forms

    ERIC Educational Resources Information Center

    Debeer, Dries; Ali, Usama S.; van Rijn, Peter W.

    2017-01-01

    Test assembly is the process of selecting items from an item pool to form one or more new test forms. Often new test forms are constructed to be parallel with an existing (or an ideal) test. Within the context of item response theory, the test information function (TIF) or the test characteristic curve (TCC) are commonly used as statistical…

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

    PubMed Central

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

    2015-01-01

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

  6. Vapor phase growth of titania whiskers by hydrolysis of titanium flouride

    NASA Astrophysics Data System (ADS)

    Oota, Toshitaka; Yamai, Iwao; Yokoyama, Mitsunori

    1984-04-01

    The chemical vapor deposition of TiO 2 crystals from the system TiF 4-H 2O was studied at elevated temperatures. When Na 2TiF 6 was used as a TiF 4 source, rutile-type TiO 2 needles grew to 30 mm in length in a comparatively short time over the melt in a platinum crucible in air. The needles were mostly skeletal or twinned intergrowths of acicular crystals. Rutile gradually changed to Na 2Ti 6O 13 by the reaction with NaF and moisture in the air. The formation of Na 2Ti 6O 13 was inhibited by addition of TiO 2 to the raw material. The rutile whiskers were grown under controlled conditions by means of a flow method from the system Na 2TiF 6-TiO 2-H 2O. The needles or whiskers were found to grow preferentially in the [001] direction.

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

    USDA-ARS?s Scientific Manuscript database

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

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

    USDA-ARS?s Scientific Manuscript database

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

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

    ERIC Educational Resources Information Center

    National Center for Education Evaluation and Regional Assistance, 2014

    2014-01-01

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

  10. 49 CFR 599.302 - Dealer application for reimbursement-submission, contents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... supporting documentation in electronic format (pdf, tif, jpeg) in the following order: (i) Proof of title. A...” marking on both sides. (ii) Proof of insurance. A copy of insurance policy cards or documents for the... origin of the new vehicle. (vii) CARS purchaser survey. (viii) Fueleconomy.gov side-by-side comparison...

  11. 49 CFR 599.302 - Dealer application for reimbursement-submission, contents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... supporting documentation in electronic format (pdf, tif, jpeg) in the following order: (i) Proof of title. A...” marking on both sides. (ii) Proof of insurance. A copy of insurance policy cards or documents for the... origin of the new vehicle. (vii) CARS purchaser survey. (viii) Fueleconomy.gov side-by-side comparison...

  12. 49 CFR 599.302 - Dealer application for reimbursement-submission, contents.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... supporting documentation in electronic format (pdf, tif, jpeg) in the following order: (i) Proof of title. A...” marking on both sides. (ii) Proof of insurance. A copy of insurance policy cards or documents for the... origin of the new vehicle. (vii) CARS purchaser survey. (viii) Fueleconomy.gov side-by-side comparison...

  13. 49 CFR 599.302 - Dealer application for reimbursement-submission, contents.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... supporting documentation in electronic format (pdf, tif, jpeg) in the following order: (i) Proof of title. A...” marking on both sides. (ii) Proof of insurance. A copy of insurance policy cards or documents for the... origin of the new vehicle. (vii) CARS purchaser survey. (viii) Fueleconomy.gov side-by-side comparison...

  14. 49 CFR 599.302 - Dealer application for reimbursement-submission, contents.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... supporting documentation in electronic format (pdf, tif, jpeg) in the following order: (i) Proof of title. A...” marking on both sides. (ii) Proof of insurance. A copy of insurance policy cards or documents for the... origin of the new vehicle. (vii) CARS purchaser survey. (viii) Fueleconomy.gov side-by-side comparison...

  15. Comparative evaluation of microhardness of dentin treated with 4% titanium tetrafluoride and 1.23% acidic phosphate fluoride gel before and after exposure to acidic pH: An ex vivo study

    PubMed Central

    Kandanuru, Vivek; Madhusudhana, Koppolu; Ramachandruni, Vamsi Krishna; Vitta, Harish Madhav; Babu, Lenin

    2016-01-01

    Aim: The aim of this study was to comparatively evaluate the effect of 4% titanium tetrafluoride (TiF4) and 1.23% acidic phosphate fluoride (APF) gel on the microhardness of human coronal dentin. Materials and Methods: Thirty noncarious extracted premolars were collected and sectioned buccolingually with the help of diamond disk. Exposing the sectioned surface, teeth were embedded in self-cure acrylic. Exposed coronal dentin was polished with abrasive papers starting with 220–5000 grit. Microhardness was evaluated by Vickers microhardness evaluator, at four different stages as follows - stage 1: Baseline values, Stage 2: Exposure of specimens to acidic environment at a pH 1 for 5 min, Stage 3: Application of 1.23% APF gel and 4% TiF4 (after dividing the specimens into two groups, i.e., Group A and B, respectively), and Stage 4: Followed by exposure of fluoridated specimens to acidic protocol as mentioned above. Results: Paired t-test was used to compare the readings between Groups A and B. Group B has shown greater resistance to decrease in microhardness of coronal dentin (P < 0.05) on exposure to acidic protocol. Conclusion: Due to acidic pH (1.5) of 4% TiF4, amount of increase in microhardness of dentin is <1.23% APF gel. 4% TiF4 was more effective in resisting demineralization than 1.23% APF gel. PMID:27994319

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

    USDA-ARS?s Scientific Manuscript database

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

  17. Teacher Leadership Program Readiness Surveys. Toolkit/Guide

    ERIC Educational Resources Information Center

    Finster, Matthew

    2016-01-01

    Federal initiatives, such as the Teacher Incentive Fund (TIF), encourage school districts to develop teacher leadership (TL) roles and use funds to provide incentives for teachers to fill them. Before starting a teacher leader program, school districts should assess whether their current conditions are favorable to implementing teacher leader…

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  20. Calibration and optimization of computer-controlled optical surfacing for large optics

    NASA Astrophysics Data System (ADS)

    Kim, Dae Wook; Martin, Hubert M.; Burge, James H.

    2011-09-01

    Precision optical surfaces can be efficiently manufactured using a computer-controlled optical surfacing (CCOS) process. Most CCOS processes are based on control of the dwell time of a tool on the workpiece, according to the desired removal and the tool influence function (TIF), which is the material wear function of the tool. Several major topics were investigated to improve current CCOS processes and provide new solutions for the next generation of CCOS processes. A rigid conformal (RC) lap using a visco-elastic non-Newtonian medium was invented. It conforms to the aspheric surface shape, yet maintains stiffness on short time scales to provide natural smoothing. The smoothing removes mid- to high-frequency errors while controlled dwell time removes low-frequency errors. A parametric smoothing model was also introduced to predict the smoothing effects. A parametric edge TIF model to represent measured edge TIFs was developed and demonstrated. This model covers the removal behavior as the tool overhangs the edge of the workpiece. These new tools and models were applied in a new process optimization technique called nonsequential optimization. The non-sequential approach performs a comprehensive optimization of dwell time using multiple TIFs (multiple tools) simultaneously. An overview of these newly implemented CCOS features** is presented along with some actual CCOS results.

  1. Department of Education: Teacher Incentive Fund. GAO-10-791R

    ERIC Educational Resources Information Center

    Cramer, Robert J.

    2010-01-01

    Pursuant to section 801(a)(2)(A) of title 5, United States Code, this is the author's report on a major rule promulgated by the Department of Education (Education), entitled "Teacher Incentive Fund." The final rule establishes priorities, requirements, definitions, and selection criteria under the Teacher Incentive Fund (TIF) program,…

  2. 77 FR 12257 - Proposed Priorities, Requirements, Definitions, And Selection Criteria; Teacher Incentive Fund...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-29

    ... improve instruction by informing performance-based compensation and other key human capital decisions... performance-based compensation on student growth, multiple observations, and other factors; and Provide... competitions in fiscal year (FY) 2012 and later years. We are taking this action so that TIF-funded performance...

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  5. Accumulation of small hyaluronan oligosaccharides in tumour interstitial fluid correlates with lymphatic invasion and lymph node metastasis.

    PubMed

    Schmaus, A; Klusmeier, S; Rothley, M; Dimmler, A; Sipos, B; Faller, G; Thiele, W; Allgayer, H; Hohenberger, P; Post, S; Sleeman, J P

    2014-07-29

    Association studies have implicated the glycosaminoglycan hyaluronan (hyaluronic acid, HA) and its degrading enzymes the hyaluronidases in tumour progression and metastasis. Oligosaccharides of degraded HA have been ascribed a number of biological functions that are not exerted by high-molecular-weight HA (HMW-HA). However, whether these small HA oligosaccharides (sHA) have a role in tumour progression currently remains uncertain due to an inability to analyse their concentration in tumours. We report a novel method to determine the concentration of sHA ranging from 6 to 25 disaccharides in tumour interstitial fluid (TIF). Levels of sHA were measured in TIF from experimental rat tumours and human colorectal tumours. While the majority of HA in TIF is HMW-HA, concentrations of sHA up to 6 μg ml(-1) were detected in a subset of tumours, but not in interstitial fluid from healthy tissues. In a cohort of 72 colorectal cancer patients we found that increased sHA concentrations in TIF are associated with lymphatic vessel invasion by tumour cells and the formation of lymph node metastasis. These data document for the first time the pathophysiological concentration of sHA in tumours, and provide evidence of a role for sHA in tumour progression.

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  7. Performance-Based Compensation: Linking Performance to Teacher Salaries. Ask the Team

    ERIC Educational Resources Information Center

    Behrstock-Sherratt, Ellen; Potemski, Amy

    2013-01-01

    To achieve the goal of attracting and retaining talented professionals in education, performance-based compensation systems (PBCS) must offer salaries that are both fair and sufficiently competitive at each point across an educator's career continuum. Although many states, especially with the support of the Teacher Incentive Fund (TIF) grants,…

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

    PubMed

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

    2011-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    Timper, P.; Hanna, W. W.

    2005-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  12. Proteomic characterization of the interstitial fluid perfusing the breast tumor microenvironment: a novel resource for biomarker and therapeutic target discovery.

    PubMed

    Celis, Julio E; Gromov, Pavel; Cabezón, Teresa; Moreira, José M A; Ambartsumian, Noona; Sandelin, Kerstin; Rank, Fritz; Gromova, Irina

    2004-04-01

    Clinical cancer proteomics aims at the identification of markers for early detection and predictive purposes, as well as to provide novel targets for drug discovery and therapeutic intervention. Proteomics-based analysis of traditional sources of biomarkers, such as serum, plasma, or tissue lyzates, has resulted in a wealth of information and the finding of several potential tumor biomarkers. However, many of these markers have shown limited usefulness in a clinical setting, underscoring the need for new clinically relevant sources. Here we present a novel and highly promising source of biomarkers, the tumor interstitial fluid (TIF) that perfuses the breast tumor microenvironment. We collected TIFs from small pieces of freshly dissected invasive breast carcinomas and analyzed them by two-dimensional polyacrylamide gel electrophoresis in combination with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, Western immunoblotting, as well as by cytokine-specific antibody arrays. This approach provided for the first time a snapshot of the protein components of the TIF, which we show consists of more than one thousand proteins--either secreted, shed by membrane vesicles, or externalized due to cell death--produced by the complex network of cell types that make up the tumor microenvironment. So far, we have identified 267 primary translation products including, but not limited to, proteins involved in cell proliferation, invasion, angiogenesis, metastasis, inflammation, protein synthesis, energy metabolism, oxidative stress, the actin cytoskeleton assembly, protein folding, and transport. As expected, the TIF contained several classical serum proteins. Considering that the protein composition of the TIF reflects the physiological and pathological state of the tissue, it should provide a new and potentially rich resource for diagnostic biomarker discovery and for identifying more selective targets for therapeutic intervention.

  13. Expression of MAGE-A1-A12 subgroups in the invasive tumor front and tumor center in oral squamous cell carcinoma.

    PubMed

    Brisam, M; Rauthe, S; Hartmann, S; Linz, C; Brands, R C; Kübler, A C; Rosenwald, A; Müller-Richter, U D

    2016-04-01

    MAGE-A proteins are highly expressed in oral squamous cell carcinoma (OSCC) and are promising targets for cancer immunotherapy. This study examined the presence of MAGE-A expression within the tumor center (TC) and tumor invasive front (TIF) and evaluated its relationship to poor prognosis. The expression rate of each MAGE-A subtype, A1-A12, was examined in 68 OSCCs at the TIF and TC. Slides (1-µm) of tissue microarrays (diameter =0.6 mm) were immunohistochemically stained, and the findings were correlated to clinical data. Approximately 95% of the tumors had MAGE-A expression. Higher expression in the TC was shown significantly for MAGE-A1, -A5, -A6, -A9 and -A12 (P<0.05). MAGE-A2 and -A3 exhibited the opposite behavior (not significant, P>0.05). Age, tumor size, grade and survival time were not associated with the expression of certain MAGE-A subgroups. When expression in the whole tumor tissue was considered, only MAGE-A1 was expressed at a significantly higher rate in male patients (P=0.034). At the TIF, MAGE-A9 and the UICC disease stage were significantly correlated (P=0.0263), and MAGE-A6 and the UICC disease stage exhibited a strong trend (P=0.0596). The expression of MAGE-A3, -A4, -A5, -A9 and -A11 was significantly associated with lymph node metastasis, while MAGE-A4 was expressed in all regions of the tumors (TIF and TC). This study showed that higher expression of most MAGE-A antigens occurred at the TC rather than at the TIF. MAGE‑A1, -A3, -A4, -A5, -A9 and -A11 were significantly associated with clinically advanced stages of disease and seem to be of particular interest.

  14. Endoluminal methods of treating gastroesophageal reflux disease.

    PubMed

    Roy-Shapira, A; Stein, H J; Scwartz, Doron; Fich, A; Sonnenschein, E

    2002-01-01

    Several endoluminal methods of treating gastroesophageal reflux disease (GERD) have either been approved, or are under investigation and development. This review outlines the two approved methods (Bard's endoluminal sewing machine and Curon's Stretta radiofrequency treatment), and describes the available data on new methods under investigation. The various methods can be divided into three broad categories: methods that create a controlled stricture, methods that bulk the gastroesophageal junction, and methods that attempt to create a fundoplication. The pros and cons of each method are discussed. Unlike medical treatment, these methods attack the reflux itself, not just the symptoms. This is a promising approach. However, the controlled stricture and bulking methods do not approach the success rate of a standard fundoplication.

  15. Hiatal and paraesophageal hernia repair in pediatric patients.

    PubMed

    Garvey, Erin M; Ostlie, Daniel J

    2017-04-01

    Hiatal and paraesophageal hernia (HH/PEH) can be congenital, resulting from embryologic abnormalities/genetic predisposition, or acquired, most commonly after gastroesophageal surgery such as fundoplication. Minimizing circumferential esophageal dissection at the time of Nissen fundoplication has been shown to decrease the risk of acquired HH/PEH from 36.5% to 12.2%. Gastrointestinal, respiratory, and constitutional symptoms, including anemia and failure to thrive, are common with high rates of associated gastroesophageal reflux. Chest x-ray is often abnormal and upper GI confirms the diagnosis. Treatment is surgical with the goal of reducing the hernia contents, excising the hernia sac, closing the crura, and performing an antireflux procedure. The laparoscopic approach is safe and effective. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Gastroesophageal reflux.

    PubMed

    Slater, Bethany J; Rothenberg, Steven S

    2017-04-01

    Gastroesophageal reflux disease (GERD) is a very common condition and affects approximately 7-20% of the pediatric population. Symptoms from pathological GERD include regurgitation, irritability when feeding, respiratory problems, and substernal pain. Treatment typically starts with dietary modifications and postural changes. Antireflux medications may then be added. Indications for operative management in the pediatric population include failure of medical therapy with poor weight gain or failure to thrive, continued respiratory symptoms, and complications such as esophagitis. Laparoscopic Nissen fundoplication has become the standard of care for surgical treatment of children with GERD. The key technical aspects of laparoscopic Nissen fundoplication include creation of an adequate intra-abdominal esophagus, minimal dissection of the hiatus with exposure of the right crus to identify the gastroesophageal junction, crural repair, and creation of floppy, 360° wrap that is oriented at the 11 o׳clock position. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. [Robots in general surgery: present and future].

    PubMed

    Galvani, Carlos; Horgan, Santiago

    2005-09-01

    Robotic surgery is an emerging technology. We began to use this technique in 2000, after it was approved by the Food and Drug Administration. Our preliminary experience was satisfactory. We report 4 years' experience of using this technique in our institution. Between August 2000 and December 2004, 399 patients underwent robotic surgery using the Da Vinci system. We performed 110 gastric bypass procedures, 30 Lap band, 59 Heller myotomies, 12 Nissen fundoplications, 6 epiphrenic diverticula, 18 total esophagectomies, 3 esophageal leiomyoma resections, 1 pyloroplasty, 2 gastrojejunostomies, 2 transduodenal sphincteroplasties, 10 adrenalectomies and 145 living-related donor nephrectomies. Operating times for fundoplications and Lap band were longer. After the learning curve, the operating times and morbidity of the remaining procedures were considerably reduced. Robot-assisted surgery allows advanced laparoscopic procedures to be performed with enhanced results given that it reduces the learning curve as measured by operating time and morbidity.

  18. 24-hour pH-impedance monitoring on therapy to select patients with refractory reflux symptoms for antireflux surgery. A single center retrospective study.

    PubMed

    Desjardin, M; Luc, G; Collet, D; Zerbib, F

    2016-01-01

    Treatment of gastro-esophageal reflux refractory symptoms is challenging. This monocenter retrospective study assessed the value of preoperative pH-impedance monitoring 'on' therapy to predict functional outcome after laparoscopic fundoplication in patients with refractory reflux symptoms. Patients with a preoperative pH-impedance monitoring 'on' proton pump inhibitors (PPIs) twice daily were assessed at least 6 months after a laparoscopic fundoplication for refractory reflux symptoms. Failure of fundoplication was defined by a Visick score > 2. Postoperative symptoms were assessed by the reflux disease questionnaire (RDQ). The pH-impedance parameters analyzed were the number of reflux events (total, acid, non-acid), esophageal acid exposure time, esophageal bolus exposure time, and symptom-reflux association defined by symptom index (SI) >50% and symptom association probability (SAP) >95%. Thirty-three patients (18 female patients, median age 46 years) were assessed after a mean follow-up of 41.3 (range 7-102.2) months. Seven (21.2%) patients were considered as failures. Compared to patients with favorable outcome, these patients were more often 'on' PPI therapy (86% vs 23%, p < 0.05) and had higher RDQ scores in each domain: heartburn (p < 0.05), regurgitation (p < 0.05) and dyspepsia (p < 0.05). A positive SAP was the only pH-impedance parameter statistically associated with successful postoperative outcome (p = 0.004). On therapy, a preoperative positive symptom association probability is the only pH-impedance parameter associated with favorable outcome after laparoscopic fundoplication for refractory reflux symptoms. These results should be confirmed by prospective studies. © 2015 John Wiley & Sons Ltd.

  19. Laparoscopic diverticulectomy with the aid of intraoperative gastrointestinal endoscopy to treat epiphrenic diverticulum

    PubMed Central

    Yu, Lei; Wu, Ji-xiang; Chen, Xiao-hong; Zhang, Yun-Feng; Ke, Ji

    2016-01-01

    OBJECTIVE: Most researchers believe that the presence of large epiphrenic diverticulum (ED) with severe symptoms should lead to the consideration of surgical options. The choice of minimally invasive techniques and whether Heller myotomy with antireflux fundoplication should be employed after diverticulectomy became points of debate. The aim of this study was to describe how to perform laparoscopic transhiatal diverticulectomy (LTD) and oesophagomyotomy with the aid of intraoperative gastrointestinal (GI) endoscopy and how to investigate whether the oesophagomyotomy should be performed routinely after LTD. PATIENTS AND METHODS: From 2008 to 2013, 11 patients with ED underwent LTD with the aid of intraoperative GI endoscopy at our department. Before surgery, 4 patients successfully underwent oesophageal manometry: Oesophageal dysfunction and an increase of the lower oesophageal sphincter pressure (LESP) were found in 2 patients. RESULTS: There were 2 cases of conversion to an open transthoracic procedure. Six patients underwent LTD, Heller myotomy and Dor fundoplication; and 3 patients underwent only LTD. The dysphagia and regurgitation 11 patients experienced before surgery improved significantly. Motor function studies showed that there was no oesophageal peristalsis in 5 patients during follow-up, while 6 patients showed seemingly normal oesophageal motility. The LESP of 6 patients undergoing LTD, myotomy and Dor fundoplication was 16.7 ± 10.2 mmHg, while the LESPs of 3 patients undergoing only LTD were 26 mmHg, 18 mmHg and 21 mmHg, respectively. In 4 cases experiencing LTD, myotomy and Dor fundoplication, the gastro-oesophageal reflux occurred during the sleep stage. CONCLUSIONS: LTD constitutes a safe and valid approach for ED patients with severe symptoms. As not all patients with large ED have oesophageal disorders, according to manometric and endoscopic results, surgeons can categorise and decide whether or not myotomy and antireflux surgery after LTD will

  20. Pain after laparoscopic antireflux surgery

    PubMed Central

    Szczebiot, L; Peyser, PM

    2014-01-01

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

  1. Defective upper gastrointestinal function after repair of combined esophageal and duodenal atresia.

    PubMed

    Fragoso, Ana Catarina; Ortiz, Ruben; Hernandez, Francisco; Olivares, Pedro; Martinez, Leopoldo; Tovar, Juan A

    2015-04-01

    Both esophageal atresia (EA) and duodenal atresia (DA) involve deficient anti-reflux barrier, poor esophageal function and eventually, duodenogastric reflux. This study aims at examining the upper gastrointestinal functional status in a cohort of patients with both EA and DA. A retrospective survey of patients treated for EA and DA between 1965 and 2012 was conducted. Clinical charts, office visits, imaging, upper gastrointestinal endoscopy and esophageal pH metry/impedance were used to assess the long-term condition of the esophagus, the presence of gastroesophageal reflux disease (GERD) and/or the need for fundoplication. Twenty out of 581 patients treated for EA had associated DA. Ten/twenty children survived; 1 had primary esophageal replacement. With a median follow-up of 9 years, 8/9 had complicated outcomes and 5 still suffered digestive ailments: 2 GER; 1 eosinophilic esophagitis; 1 nodular gastritis, and 1 wrap herniation. A total of 10 procedures were performed: 8 fundoplications, 1 esophagogastric dissociation and 1 replacement with colon. The association of EA with DA involves a poor upper digestive function with high risks of GERD and fundoplication failure. The lifelong synergistic play of esophageal, gastric and duodenal dysfunctions in these patients prompts long-term follow-up, and eventually active treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Gastroesophageal reflux disease in children.

    PubMed

    Barnhart, Douglas C

    2016-08-01

    Despite the frequency with which antireflux procedures are performed, decisions about gastroesophageal reflux disease treatment remain challenging. Several factors contribute to the difficulties in managing gastroesophageal reflux. First, the distinction between physiologic and pathologic gastroesophageal reflux (gastroesophageal reflux disease-GERD) is not always clear. Second, measures of the extent of gastroesophageal reflux often poorly correlate to symptoms or other complications attributed to reflux in infants and children. A third challenge is that the outcome of antireflux procedures, predominately fundoplications, are relatively poorly characterized. All of these factors contribute to difficulty in knowing when to recommend antireflux surgery. One of the manifestations of the uncertainties surrounding GERD is the high degree of variability in the utilization of pediatric antireflux procedures throughout the United States. Pediatric surgeons are frequently consulted for GERD and fundoplication, uncertainties notwithstanding. Although retrospective series and anecdotal observations support fundoplication in some patients, there are many important questions for which sufficient high-quality data to provide a clear answer is lacking. In spite of this, surgeons need to provide guidance to patients and families while awaiting the development of improved evidence to aid in these recommendations. The purpose of this article is to define what is known and what is uncertain, with an emphasis on the most recent evidence. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. An Evidence-Based Approach to the Treatment of Gastroesophageal Reflux Disease.

    PubMed

    Patti, Marco G

    2016-01-01

    Gastroesophageal reflux disease (GERD) is prevalent worldwide, particularly in developed countries. It is estimated that the prevalence of GERD in the United States is approximately 20% and that it is increasing because of the epidemic of obesity. To review the pathophysiology, clinical presentation, diagnostic evaluation, and treatment of GERD. A search of PubMed was conducted for the years spanning 1985 to 2015 and included the following terms: heartburn, regurgitation, dysphagia, gastroesophageal reflux disease, cough, aspiration, laryngitis, GERD, GORD, endoscopy, manometry, pH monitoring, proton pump inhibitors, open fundoplication, and laparoscopic fundoplication. Only articles in English were included. Lifestyle modifications, proton pump inhibitors, and laparoscopic fundoplication are proven treatment modalities for GERD. Endoscopic procedures have not been proven as effective. A Roux-en-Y gastric bypass is the procedure of choice when GERD and morbid obesity coexist. Gastroesophageal reflux disease is a highly prevalent disease. Once the diagnosis has been established, the best results are obtained by a multidisciplinary team with the goal of individualizing treatment for patients.

  4. Solution Structures of PPARγ2/RXRα Complexes.

    PubMed

    Osz, Judit; Pethoukhov, Maxim V; Sirigu, Serena; Svergun, Dmitri I; Moras, Dino; Rochel, Natacha

    2012-01-01

    PPARγ is a key regulator of glucose homeostasis and insulin sensitization. PPARγ must heterodimerize with its dimeric partner, the retinoid X receptor (RXR), to bind DNA and associated coactivators such as p160 family members or PGC-1α to regulate gene networks. To understand how coactivators are recognized by the functional heterodimer PPARγ/RXRα and to determine the topological organization of the complexes, we performed a structural study using small angle X-ray scattering of PPARγ/RXRα in complex with DNA from regulated gene and the TIF2 receptor interacting domain (RID). The solution structures reveal an asymmetry of the overall structure due to the crucial role of the DNA in positioning the heterodimer and indicate asymmetrical binding of TIF2 to the heterodimer.

  5. Solution Structures of PPARγ2/RXRα Complexes

    PubMed Central

    Osz, Judit; Pethoukhov, Maxim V.; Sirigu, Serena; Svergun, Dmitri I.; Moras, Dino; Rochel, Natacha

    2012-01-01

    PPARγ is a key regulator of glucose homeostasis and insulin sensitization. PPARγ must heterodimerize with its dimeric partner, the retinoid X receptor (RXR), to bind DNA and associated coactivators such as p160 family members or PGC-1α to regulate gene networks. To understand how coactivators are recognized by the functional heterodimer PPARγ/RXRα and to determine the topological organization of the complexes, we performed a structural study using small angle X-ray scattering of PPARγ/RXRα in complex with DNA from regulated gene and the TIF2 receptor interacting domain (RID). The solution structures reveal an asymmetry of the overall structure due to the crucial role of the DNA in positioning the heterodimer and indicate asymmetrical binding of TIF2 to the heterodimer. PMID:23319938

  6. Effects of pyridostigmine bromide on in-flight aircrew performance.

    PubMed

    Gawron, V J; Schiflett, S G; Miller, J C; Slater, T; Ball, J F

    1990-02-01

    The effects of a chemical defense pretreatment drug, pyridostigmine bromide (PB), on in-flight aircrew performance were assessed using the Total In-Flight Simulator (TIFS) aircraft. TIFS was used to supply appropriate control dynamics, handling characteristics, and cockpit instrumentation for a tactical transport airdrop simulation. Twenty-one C-130 pilots flew two familiarization and four data flights. During two data flights PB was given to both members of the aircrew using the dosage regimen of 30 mg/8 h prescribed by the U.S. Air Force surgeon general. The drug was administered using a double-blind technique. The results indicated that (1) aircrews successfully completed their assigned mission, (2) airdrop inaccuracies and navigation errors in time and distance were not specifically related to PB, (3) performance and crew coordination were not affected by PB, (4) PB and pilot/copilot not discriminate beyond chance between PB and placebo conditions.

  7. The antagonism activity of bacteria isolated from potato cultivated soil.

    PubMed

    Mezaache-Aichour, S; Sayah, N; Zerroug, M M; Guechi, A

    2012-01-01

    Soil-borne fungal and bacterial root pathogens can cause serious losses to agricultural crops. Resistant plant varieties are not available for several soil-borne pathogens and chemical control is often insufficiently effective in soil. The enhancement of disease suppressive properties of soils will limit disease development, thus, being of great importance for sustainable agriculture as well as organic farming systems. The aim of this research is to find and identify suppressive soils in the Sétif's areas (potato field located in different regions of Sétif); this allows the selection of the indigenous soil bacteria that are able to develop several mechanisms of action related to biocontrol of phytopathogenic fungi affecting potato crops. Among 50 bacterial strains only 14 showed a wide range of antifungal action against the tested phytopathogenic fungi. With a range of inhibition percent from 0 to 92.30% especially Fusarium oxysporum f. sp. albedinis with 92% inhibition.

  8. Field Responses of Bermudagrass and Seashore paspalum Cultivars to Sting and Spiral Nematodes

    PubMed Central

    Pang, Wenjing; Luc, John E.; Crow, William T.; Kenworthy, Kevin E.; Giblin-Davis, Robin M.; McSorley, Robert; Kruse, Jason K.

    2011-01-01

    Belonolaimus longicaudatus and Helicotylenchus spp. are damaging nematode species on bermudagrass (Cynodon spp.) and seashore paspalum (Paspalum vaginatum) in sandy soils of the southeastern United States. Eight bermudagrass and three seashore paspalum cultivars were tested for responses to both nematode species in field plots for two years in Florida. Soil samples were taken every three months and nematode population densities in soil were quantified. Turfgrass aboveground health was evaluated throughout the growing season. Results showed that all bermudagrass cultivars, except TifSport, were good hosts for B. longicaudatus, and all seashore paspalum cultivars were good hosts for H. pseudorobustus. Overall, bermudagrass was a better host for B. longicaudatus while seashore paspalum was a better host for H. pseudorobustus. TifSport bermudagrass and SeaDwarf seashore paspalum cultivars supported the lowest population densities of B. longicaudatus. Seashore paspalum had a higher percent green cover than bermudagrass in the nematode-infested field. Nematode intolerant cultivars were identified. PMID:23430148

  9. The Electrochemical Behavior of Doped Silane Pre-Treatments on Galvanized Steel Substrates

    NASA Astrophysics Data System (ADS)

    Zhao, Qiliang; Guo, Wei; Zhong, Qingdong; Zhang, Junliang; Sun, Jinhu; Li, Hui

    In this paper, galvanized steel substrates were pre-treated in γ-(2,3-epoxypropoxy)propyl trimethoxy silane solutions containing salts ((NH4)2TiF6, K2ZrF6 and NaVO3) and SiO2. The surface microstructures of the coated substrates were evaluated by scanning electron microscopy (SEM). The anti-corrosion performance of the modified silane film applied on galvanized steel substrates was evaluated by potentio-dynamic polarization (Tafel) and electrochemical impedance spectroscopy (EIS). The electrochemical results reveal that the addition of salts ((NH4)2TiF6, K2ZrF6 and NaVO3) may produce a more stable and protective fluoride combined with their oxides in the silane layer. The results also reveal that the addition of the SiO2 nanoparticles reinforced the barrier properties of the silane films and imparted its corrosion inhibition ability.

  10. Identification of previously unrecognized common elements in eukaryotic promoters. A ribosomal RNA gene initiator element for RNA polymerase I.

    PubMed

    Radebaugh, C A; Gong, X; Bartholomew, B; Paule, M R

    1997-02-07

    A new ribosomal RNA promoter element with a functional role similar to the RNA polymerase II initiator (Inr) was identified. This sequence, which we dub the ribosomal Inr (rInr) is unusually conserved, even in normally divergent RNA polymerase I promoters. It functions in the recruitment of the fundamental, TATA-binding protein (TBP)-containing transcription factor, TIF-IB. All upstream elements of the exceptionally strong Acanthamoeba castellanii ribosomal RNA core promoter, to within 6 base pairs of the transcription initiation site (tis), can be deleted without loss of specific transcription initiation. Thus, the A. castellanii promoter can function in a manner similar to RNA polymerase II TATA-less promoters. Sequence-specific photo-cross-linking localizes a 96-kDa subunit of TIF-IB and the second largest RNA polymerase I subunit (A133) to the rInr sequence. A185 also photo-cross-links when polymerase is stalled at +7.

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

    PubMed

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

    2015-02-25

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

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

    PubMed Central

    Kumar, Nitin

    2015-01-01

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

  13. Minimally Invasive Surgery for Inflammatory Bowel Disease

    PubMed Central

    Holder-Murray, Jennifer; Marsicovetere, Priscilla

    2015-01-01

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

  14. The Feasibility of Transesophageal Cardiac Ablation by Focused Ultrasound

    NASA Astrophysics Data System (ADS)

    Lee, Hotaik; Francischelli, David; Smith, Nadine Barrie

    2007-05-01

    Atrial fibrillation (AF) is the most common arrhythmia, affecting over 2.2 million Americans. One effective treatment is cardiac ablation, which shows a high rate of success in treating paroxysmal AF. Focused ultrasound has gained interest for thermal ablation for decades due to its noninvasive characteristics. Based on the simulation results of transducer arrays, current transesophageal medical devices, and the throat anatomy, we have designed, fabricated, and tested a focused ultrasound applicator that can be inserted into the esophagus for incisionless cardiac ablation. The overall goal is to bring this applicator as closely as possible to the heart in order to effectively deliver ultrasound energy, and create electrically isolating lesions in myocardial tissue, which replicate the currently used Maze procedure. The transducer design is a two-dimensional sparse phased array with flat tapered elements operating at a frequency of 1.6 MHz. This array uses 64 active elements spatially sampled from 195 rectangular elements. Its probe head housing is 19 mm in diameter and incorporates an acoustic window. A prototype applicator has been successfully tested ex vivo using fresh porcine myocardial tissue. The results demonstrated a potential applicability of an ultrasound applicator to transesophageal cardiac surgery in AF treatment.

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

    NASA Astrophysics Data System (ADS)

    Bauer, Yair

    2011-09-01

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

  16. Drosophila switch gene Sex-lethal can bypass its switch-gene target transformer to regulate aspects of female behavior.

    PubMed

    Evans, Daniel S; Cline, Thomas W

    2013-11-19

    The switch gene Sex-lethal (Sxl) was thought to elicit all aspects of Drosophila female somatic differentiation other than size dimorphism by controlling only the switch gene transformer (tra). Here we show instead that Sxl controls an aspect of female sexual behavior by acting on a target other than or in addition to tra. We inferred the existence of this unknown Sxl target from the observation that a constitutively feminizing tra transgene that restores fertility to tra(-) females failed to restore fertility to Sxl-mutant females that were adult viable but functionally tra(-). The sterility of these mutant females was caused by an ovulation failure. Because tra expression is not sufficient to render these Sxl-mutant females fertile, we refer to this pathway as the tra-insufficient feminization (TIF) branch of the sex-determination regulatory pathway. Using a transgene that conditionally expresses two Sxl feminizing isoforms, we find that the TIF branch is required developmentally for neurons that also sex-specifically express fruitless, a tra gene target controlling sexual behavior. Thus, in a subset of fruitless neurons, targets of the TIF and tra pathways appear to collaborate to control ovulation. In most insects, Sxl has no sex-specific functions, and tra, rather than Sxl, is both the target of the primary sex signal and the gene that maintains the female developmental commitment via positive autoregulation. The TIF pathway may represent an ancestral female-specific function acquired by Sxl in an early evolutionary step toward its becoming the regulator of tra in Drosophila.

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

    PubMed Central

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

    2015-01-01

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

  18. Investigation of possibility to fabricate Si3N4-TiN ceramic nanocomposite powder by azide SHS method

    NASA Astrophysics Data System (ADS)

    Kondratieva, L. A.; Kerson, I. A.; Illarionov, A. Yu; Amosov, A. P.; Bichurov, G. V.

    2016-11-01

    The process of self-propagating high-temperature synthesis with use of a powder of sodium azide NaN3 as a nitriding agent (the SHS-Az method) was applied to fabricate a nanocomposite powder Si3N4-TiN. Combustion of the initial mixtures of NaN3 only with precursors that are halides of silicon and titanium: Na2SiF6, (NH4)2SiF6, Na2TiF6, (NH4)2TiF6 did not allow us to synthesize the composite powder of Si3N4-TiN, as the phases of silicon nitride Si3N4 were not formed. After water washing, the ultrafine powdered product of combustion consisted of one target phase of titanium nitride only and a large amount of impurity of side phases. Replacement of the halide salt of one of the elements (Si or Ti) by the powder of this element in the initial mixture of SHS-Az system resulted in formation of silicon nitride together with the titanium nitride and impurities. The least amount of impurities was obtained by burning the initial mixtures of xSi + y(NH4)2TiF6 + zNaN3 system. Only the initial mixture of 9Si + (NH4)2TiF6 + 6NaN3 allowed us to obtain as a result of the SHS-Az process the nanostructured composite powder of Si3N4-TiN without impurities.

  19. Cytokine profiling of tumor interstitial fluid of the breast and its relationship with lymphocyte infiltration and clinicopathological characteristics.

    PubMed

    Espinoza, Jaime A; Jabeen, Shakila; Batra, Richa; Papaleo, Elena; Haakensen, Vilde; Timmermans Wielenga, Vera; Møller Talman, Maj-Lis; Brunner, Nils; Børresen-Dale, Anne-Lise; Gromov, Pavel; Helland, Åslaug; Kristensen, Vessela N; Gromova, Irina

    2016-01-01

    The tumor microenvironment is composed of many immune cell subpopulations and is an important factor in the malignant progression of neoplasms, particularly breast cancer (BC). However, the cytokine networks that coordinate various regulatory events within the BC interstitium remain largely uncharacterized. Moreover, the data obtained regarding the origin of cytokine secretions, the levels of secretion associated with tumor development, and the possible clinical relevance of cytokines remain controversial. Therefore, we profiled 27 cytokines in 78 breast tumor interstitial fluid (TIF) samples, 43 normal interstitial fluid (NIF) samples, and 25 matched serum samples obtained from BC patients with Luminex xMAP multiplex technology. Eleven cytokines exhibited significantly higher levels in the TIF samples compared with the NIF samples: interleukin (IL)-7, IL-10, fibroblast growth factor-2, IL-13, interferon (IFN)γ-inducible protein (IP-10), IL-1 receptor antagonist (IL-1RA), platelet-derived growth factor (PDGF)-β, IL-1β, chemokine ligand 5 (RANTES), vascular endothelial growth factor, and IL-12. An immunohistochemical analysis further demonstrated that IL-1RA, IP-10, IL-10, PDGF-β, RANTES, and VEGF are widely expressed by both cancer cells and tumor-infiltrating lymphocytes (TILs), whereas IP-10 and RANTES were preferentially abundant in triple-negative breast cancers (TNBCs) compared to Luminal A subtype cancers. The latter observation corresponds with the high level of TILs in the TNBC samples. IL-1β, IL-7, IL-10, and PDGFβ also exhibited a correlation between the TIF samples and matched sera. In a survival analysis, high levels of IL-5, a hallmark TH2 cytokine, in the TIF samples were associated with a worse prognosis. These findings have important implications for BC immunotherapy research.

  20. Profiling of microRNAs in tumor interstitial fluid of breast tumors - a novel resource to identify biomarkers for prognostic classification and detection of cancer.

    PubMed

    Halvorsen, Ann Rita; Helland, Åslaug; Gromov, Pavel; Wielenga, Vera Timmermans; Talman, Maj-Lis Møller; Brunner, Nils; Sandhu, Vandana; Børresen-Dale, Anne-Lise; Gromova, Irina; Haakensen, Vilde D

    2017-02-01

    It has been hypothesized based on accumulated data that a class of small noncoding RNAs, termed microRNAs, are key factors in intercellular communication. Here, microRNAs present in interstitial breast tumor fluids have been analyzed to identify relevant markers for a diagnosis of breast cancer and to elucidate the cross-talk that exists among cells in a tumor microenvironment. Matched tumor interstitial fluid samples (TIF, n = 60), normal interstitial fluid samples (NIF, n = 51), corresponding tumor tissue specimens (n = 54), and serum samples (n = 27) were collected from patients with breast cancer, and detectable microRNAs were analyzed and compared. In addition, serum data from 32 patients with breast cancer and 22 healthy controls were obtained for a validation study. To identify potential serum biomarkers of breast cancer, first the microRNA profiles of TIF and NIF samples were compared. A total of 266 microRNAs were present at higher level in the TIF samples as compared to normal counterparts. Sixty-one of these microRNAs were present in > 75% of the serum samples and were subsequently tested in a validation set. Seven of the 61 microRNAs were associated with poor survival, while 23 were associated with the presence of immune cells and adipocytes. To our knowledge, these data demonstrate for the first time that profiling of microRNAs in TIF can identify novel biomarkers for the prognostic classification and detection of breast cancer. In addition, the present findings demonstrate that microRNAs may represent the cross-talk that occurs between tumor cells and their surrounding stroma. © 2016 The Authors. Published by FEBS Press and John Wiley & Sons Ltd.

  1. The Role of Natural Killer (NK) Cells and NK Cell Receptor Polymorphisms in the Assessment of HIV-1 Neutralization

    DTIC Science & Technology

    2012-04-11

    for positive wells (used for the Spearman - Karber titer calculation) was 3 times the relative light units (RLU) for cells alone. Viral permissivity...guishable within the polyclonal response to HIV infection and to vaccination with candidate vaccines. Materials and Methods Ethics Statement This study...and methods for more details. (TIF) Figure S2 Rank values for viral permissivity (A) and neutralization (B). For viral permissivity (A), PBMC were

  2. Stability against brushing abrasion and the erosion-protective effect of different fluoride compounds.

    PubMed

    Wiegand, A; Schneider, S; Sener, B; Roos, M; Attin, T

    2014-01-01

    This study aimed to analyse the impact of brushing on the protective effect of different fluoride solutions on enamel and dentin erosion. Bovine enamel and dentin specimens were rinsed once with TiF4, AmF, SnF2 (0.5 M F, 2 min) or water (control). Specimens were either left unbrushed or brushed with 10, 20, 50, 100 or 500 brushing strokes in an automatic brushing machine (2 N, non-fluoridated toothpaste slurry). Ten specimens per group were eroded with hydrochloric acid (HCl) (pH 2.3) for 60 s, and calcium release into the acid was determined by atomic absorption spectroscopy. Additionally, enamel and dentin surfaces were analysed by X-ray energy-dispersive spectroscopy (EDS) (n = 6/group) and scanning electron microscopy (SEM) (n = 2/group) before brushing and after 500 brushing strokes. Statistical analysis (p < 0.05) was performed by three- and one-way ANOVA (calcium release) or repeated measures ANOVA (EDS). TiF4, AmF and SnF2 reduced the erosive calcium loss in unbrushed specimens to 58-67% (enamel) and 23-31% (dentin) of control. Calcium release increased with increasing brushing strokes prior to erosion and amounted to 70-88% (enamel) and 45-78% (dentin) of control after 500 brushing strokes. Brushing reduced the surface concentration of fluoride (AmF), tin (SnF2) and titanium (TiF4). SEM revealed that surface precipitates were affected by long-term brushing. Brushing reduced the protective potential of TiF4, AmF and SnF2 solutions. However, considering a small number of brushing strokes, the protective effect of fluoride solutions is only slightly affected by brushing abrasion.

  3. Enhancement of CO2 selectivity in a pillared pcu MOM platform through pillar substitution.

    PubMed

    Nugent, Patrick; Rhodus, Vanessah; Pham, Tony; Tudor, Brant; Forrest, Katherine; Wojtas, Lukasz; Space, Brian; Zaworotko, Michael

    2013-02-25

    Pillar substitution in a long-known metal-organic material with saturated metal centres, [Cu(bipy)(2)(SiF(6))](n), has afforded the first crystallographically characterized porous materials based upon TiF(6)(2-) and SnF(6)(2-) anions as pillars. Gas adsorption studies revealed similar surface areas and adsorption isotherms but enhanced selectivity towards CO(2)vs. CH(4) and N(2).

  4. Acceptance Test Plan.

    DTIC Science & Technology

    2014-09-26

    7 RD-Ai507 154 CCEPTANCE TEST PLN(U) WESTINGHOUSE DEFENSE ND i/i ELECTRO ICS CENTER BALTIMORE MD DEVELOPMENT AND OPERATIONS DIY D C KRRiJS 28 JUN...Ln ACCEPTANCE TEST PLAN FOR SPECIAL RELIABILITY TESTS FOR BROADBAND MICROWAVE AMPLIFIER PANEL David C. Kraus, Reliability Engineer WESTINGHOUSE ...ORGANIZATION b. OFFICE SYMBOL 7g& NAME OF MONITORING ORGANIZATION tIf appdeg ble) WESTINGHOUSE ELECTRIC CORP. - NAVAL RESEARCH LABORATORY e. AOORES$ (Ci7t

  5. Influence of dentin pretreatment with titanium tetrafluoride and self-etching adhesive systems on microtensile bond strength.

    PubMed

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

    2013-06-01

    To evaluate the effect of dentin pretreatment with 2.5% titanium tetrafluoride (TiF4) on microtensile bond strength (microTBS) of one- or two-step self-etching adhesive systems. 24 human sound third molars were used. A flat dentin surface of each tooth was exposed. After planing, teeth were divided into groups so that dentin would be left untreated or treated with a 2.5% TiF4 solution for 1 minute. Specimens were then subdivided into two groups to receive one of the following adhesive systems: one-step self-etching Adper Easy One (ADP) or two-step self-etching adhesive Clearfil SE Bond (CLEAR). A block of composite measuring 5.0 mm high and 5.0 mm wide was made incrementally on the tooth. Specimens were taken to a metallographic cutter to fabricate sticks with a bond area of approximately 1 mm2. After 24 hours, specimens were submitted to microTBS testing and the failure mode was recorded by examining specimens under stereomicroscopy. Scanning electron microscope (SEM) photomicrographs were obtained of the tooth/restoration interface. Two-way ANOVA and Tukey's test demonstrated that pretreatment of dentin with a TiF4 solution did not affect the microTBS values of either of the adhesive systems (P = 0.675). CLEAR provided higher bond strength than ADP, regardless of whether dentin was or was not pretreated with the TiF4 solution. Failure mode showed mostly adhesive failures in all groups, except when only ADP was used, causing mostly cohesive fractures in resin.

  6. Detection of cadherin-17 in human colon cancer LIM1215 cell secretome and tumour xenograft-derived interstitial fluid and plasma.

    PubMed

    Bernhard, Oliver K; Greening, David W; Barnes, Thomas W; Ji, Hong; Simpson, Richard J

    2013-11-01

    Colorectal cancer (CRC), one of the most prevalent cancers in the western world, is treatable if detected early. However, 70% of CRC is detected at an advanced stage. This is largely due to the inadequacy of current faecal occult blood screening testing and costs involved in conducting population-based colonoscopy, the 'gold standard' for CRC detection. Another biomarker for CRC, carcinoembryonic antigen, while useful for monitoring CRC recurrence, is ineffective, lacking the specificity required early detection of CRC. For these reasons there is a need for more effective blood-based markers for early CRC detection. In this study we targeted glycoproteins secreted from the human colon carcinoma cell line LIM1215 as a source of potential CRC biomarkers. Secreted candidate glycoproteins were confirmed by MS and validated by Western blot analysis of tissue/tumour interstitial fluid (Tif) from LIM1215 xenograft tumours grown in immunocompromised mice. Overall, 39 glycoproteins were identified in LIM1215 culture media (CCM) and 5 glycoproteins in LIM1215 tumour xenograft Tif; of these, cadherin-17 (CDH17), galectin-3 binding protein (LGALS3BP), and tyrosine-protein kinase-like 7 (PTK7) were identified in both CM and glycosylation motifs. Swiss-Prot was used to annotate Tif. Many of the glycoproteins identified in this study (e.g., AREG, DSG2, EFNA1, EFNA3, EFNA4, EPHB4, ST14, and TIMP1) have been reported to be implicated in CRC biology. Interestingly, the cadherin-17 ectodomain, but not full length cadherin-17, was identified in CM, Tif and plasma derived from mice bearing the LIM1215 xenograft tumour. To our knowledge, this is the first report of the cadherin-17 ectodomain in plasma. In this study, we report for the first time that the presence of full-length cadherin-17 in exosomes released into the CM. This article is part of a Special Issue entitled: An Updated Secretome.

  7. Concept for a Common Performance Measurement System for Unit Training at the National Training Center (NTC) and with Simulation Networking (SIMNET) platoon-Movement to Contact

    DTIC Science & Technology

    1990-09-01

    Simulation Networking (SIMNET) Platoon-Movement to Contact James W. Kerins and Nancy K. Atwood BDM International, Inc. DTIC’ CTE SEP 2 6 190 Field Unit at...terrain search techniques. tiffed in the unit’s SOP are reviewed Engagement techniquesare reviewed and followed. and rehearsed: * "Two Football Field...34 technique for jet aircraft * "Half Football Field" technique for slow aircraft or helicopters • "Reference Point or Series of Reference Points

  8. In-plane shearing of a UD prepreg modeled as transversely isotropic fluid: Comparison between continuous and discontinuous fiber tension approaches

    NASA Astrophysics Data System (ADS)

    Sorba, Grégoire; Binetruy, Christophe; Chinesta, Francisco

    2016-10-01

    In this paper a model of Transversely Isotropic Fluid (TIF), developed by Pipkin in [1], is presented and used for example to model in 2D the in-plane shearing of UD prepreg. This problem demonstrates the need to have a continuous fiber tension field over the elements, with the final objective of detecting the wrinkling of fibers during the forming process, at the price of a lower accuracy of the velocity field.

  9. Expression of transcription factor Snai1 and tubulointerstitial fibrosis in progressive nephropathy.

    PubMed

    Ohnuki, Keiko; Umezono, Tomoya; Abe, Makiko; Kobayashi, Takako; Kato, Mayuko; Miyauchi, Masaaki; Yamamoto, Naoyuki; Kimura, Moritsugu; Toyoda, Masao; Suzuki, Daisuke

    2012-01-01

    Tubulointerstitial fibrosis (TIF) is seen as the final stage of progressive nephropathy, and the degree of TIF is reported to be a major determinant in renal outcomes. In recent years, epithelial-mesenchymal transition (EMT) and the zinc-finger transcription factor snail homolog 1 (Snai1) have each been implicated in the mechanism of TIF. The relationship between EMT and these transcription factors is unclear, however, so in this study we attempted to elucidate the correlation between the expression of Snai1 and clinical markers. We performed immunohistochemical staining on human renal tissue obtained from patients with diabetic nephropathy (DN), IgA nephropathy (IgAN), minimal change disease (MCD) and minor glomerular abnormality (MGA) using anti-Snai1 and anti-vimentin antibodies. We counted Snai1-positive and Snai1/vimentin double positive tubular epithelial cells. Snai1 protein was mainly observed in the nuclei of flattened, damaged tubular epithelial cells, especially in IgAN and DN, and positive cell numbers were significantly higher in IgAN than in MGA, MCD or DN. Snai1/vimentin double staining showed that some vimentin-positive tubular epithelial cells also contained Snai1-positive nuclei, and double positive cell numbers were increased in IgAN and DN. Statistical analysis revealed positive correlations between Snai1/vimentin double positive cell numbers and proteinuria and creatinine in IgAN. Positive correlations were also seen between Snai1/vimentin double positive cell numbers and the severity of proteinuria in DN. The results of this study indicate that Snai1 plays an important role in TIF in patients with progressive nephropathy.

  10. Pre-computed tsunami inundation database and forecast simulation in Pelabuhan Ratu, Indonesia

    NASA Astrophysics Data System (ADS)

    Setiyono, Urip; Gusman, Aditya Riadi; Satake, Kenji; Fujii, Yushiro

    2017-08-01

    We built a pre-computed tsunami inundation database in Pelabuhan Ratu, one of tsunami-prone areas on the southern coast of Java, Indonesia, which can be employed for a rapid estimation of tsunami inundation during an event. The pre-computed tsunami waveforms and inundations are from a total of 340 scenarios ranging from 7.5 to 9.2 in moment magnitude scale (Mw), including simple fault models of 208 thrust faults and 44 tsunami earthquakes on the plate interface, as well as 44 normal faults and 44 reverse faults in the outer-rise region. Using our tsunami inundation forecasting algorithm (NearTIF), we could rapidly estimate the tsunami inundation in Pelabuhan Ratu for three different hypothetical earthquakes. The first hypothetical earthquake is a megathrust earthquake type (Mw 9.0) offshore Sumatra which is about 600 km from Pelabuhan Ratu to represent a worst-case event in the far-field. The second hypothetical earthquake (Mw 8.5) is based on a slip deficit rate estimation from geodetic measurements and represents a most likely large event. The third hypothetical earthquake is a tsunami earthquake type (Mw 8.1) which often occurs south of Java. We compared the tsunami inundation maps produced by the NearTIF algorithm with results of direct forward inundation modeling for the hypothetical earthquakes. The tsunami inundation maps produced from both methods are similar for the three cases. However, the tsunami inundation map from the inundation database can be obtained in much shorter time (1 min) than the one from a forward inundation modeling (40 min). These indicate that the NearTIF algorithm based on pre-computed inundation database is reliable and useful for tsunami warning purposes. This study also demonstrates that the NearTIF algorithm can work well, though the earthquake source is located outside the area of fault model database because it uses a time shifting procedure for the best-fit scenario searching.

  11. Utilization of Quantum Distribution Functions for Ultra-Submicron Device Transport

    DTIC Science & Technology

    1981-10-01

    mfithode utilisable pour dicrire lea phinomines de transport quantique dans la physique des disposi- tifs submicroniques. La fonction de distribution...de Wigner est rappele ici et sa non unicitf eat discutle, ainsi que sS ghngralisation aux autres fonctions de distribution quantique . L’fquation du...montre qua lea Equations du moment contiennent des corrections quantiques par rapport aux Equations classiques et que ces termes quantiques ne sont pas

  12. Nanosecond Pulser Thyratrons.

    DTIC Science & Technology

    1982-01-01

    Entire assembly is immersed in oil to avoid flashover . The 5 tiF capacitor is charged by a 6 kv pulse applied at the anode stud end.) -9- ., HY-1802...ferrites to delay the current rise until the anode fall is over. Electrode design modifications to decrease the fall and recovery times will also be...IUnannouncoed 0 V Load voltage trjo ajstiticatlo V0 Initial storage capacitor voltage Zo Transmission line impedance D stributioU/_.... s Microseconds

  13. Obtaining and processing Daymet data using Python and ArcGIS

    USGS Publications Warehouse

    Bohms, Stefanie

    2013-01-01

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

  14. Drosophila switch gene Sex-lethal can bypass its switch-gene target transformer to regulate aspects of female behavior

    PubMed Central

    Evans, Daniel S.; Cline, Thomas W.

    2013-01-01

    The switch gene Sex-lethal (Sxl) was thought to elicit all aspects of Drosophila female somatic differentiation other than size dimorphism by controlling only the switch gene transformer (tra). Here we show instead that Sxl controls an aspect of female sexual behavior by acting on a target other than or in addition to tra. We inferred the existence of this unknown Sxl target from the observation that a constitutively feminizing tra transgene that restores fertility to tra− females failed to restore fertility to Sxl-mutant females that were adult viable but functionally tra−. The sterility of these mutant females was caused by an ovulation failure. Because tra expression is not sufficient to render these Sxl-mutant females fertile, we refer to this pathway as the tra-insufficient feminization (TIF) branch of the sex-determination regulatory pathway. Using a transgene that conditionally expresses two Sxl feminizing isoforms, we find that the TIF branch is required developmentally for neurons that also sex-specifically express fruitless, a tra gene target controlling sexual behavior. Thus, in a subset of fruitless neurons, targets of the TIF and tra pathways appear to collaborate to control ovulation. In most insects, Sxl has no sex-specific functions, and tra, rather than Sxl, is both the target of the primary sex signal and the gene that maintains the female developmental commitment via positive autoregulation. The TIF pathway may represent an ancestral female-specific function acquired by Sxl in an early evolutionary step toward its becoming the regulator of tra in Drosophila. PMID:24191002

  15. Non-Destructive Inspection Practices. Volume II

    DTIC Science & Technology

    1975-10-01

    structures anti notabl\\ honeycomb sandwich structures. Adhesive btonding is increasingly- used for thme mnanufacture tif components such is: fuselage and...applications. .Foam It is intended for hoiheycomb/lhoneycomb adhesion and honeycomb /edge. It is available in the form of "sheets. 4.3.2.1.2 Adhesive ... honeycomb sandwich sub-assemblies. 4.3.2.2.5 Curing Process 4.3.2.2.5.1 Different mt thods Curing of thermosett ng adhesive bonded structures can be

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

    NASA Astrophysics Data System (ADS)

    Tossell, J. A.

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

  17. General Reevaluation Report, Upper Skunk River Basin, Iowa (Ames Lake).

    DTIC Science & Technology

    1987-07-01

    the Gulf of Mexico and cold, dry air moving from the Arctic polar regions. Rainfall is adequate for crop growth if properly distributed. Droughts have...BUREAL IC? ( 2 ER ’ E ACFI I I 1’’ i SINGCLE CtJPILS CISTR1BLTrO ENCEF Is AS1ci(ti-c 7 )IS tif RUT (CA -- T’’ g L RALPHE SCHUP, SKLNK FIVER

  18. The Logic of Definition

    DTIC Science & Technology

    2009-05-01

    081) for the Technology Investment Fund (TIF) Project entitled “A Conceptual Framework for Understanding Armed Non-state Actors ( ANSAs ): Strategic...auspices of Defence Research & Development Canada (DRDC), the Science and Technology (S&T) agency of the Department of National Defence (DND), Canada...are likely to be out of date” (Copi & Cohen 2005: 100). A stipulative definition deliberately assigns meaning to a new term (or to an old term used

  19. Fuels and Lubricants Influence on Turbine Engine Design and Performance

    DTIC Science & Technology

    1974-08-01

    class of fluids are the hexafluoropropylene epoxide (HFPO) polymers, marketed by Du Pont tnder the trade name " Krytox "** fluids, and by Montecatini-Edison...System opthimiz-tion with the higher tLeniperature lubricants was accomplished by the removal of he-It shield-.- and insulation al-L by scaling the tif...perfluorinated polyether permits the removal of the heat shield on the aft wall of the forward sump, however, its high vapor pressure necessitates nonvented

  20. Digital image compression in dermatology: format comparison.

    PubMed

    Guarneri, F; Vaccaro, M; Guarneri, C

    2008-09-01

    Digital image compression (reduction of the amount of numeric data needed to represent a picture) is widely used in electronic storage and transmission devices. Few studies have compared the suitability of the different compression algorithms for dermatologic images. We aimed at comparing the performance of four popular compression formats, Tagged Image File (TIF), Portable Network Graphics (PNG), Joint Photographic Expert Group (JPEG), and JPEG2000 on clinical and videomicroscopic dermatologic images. Nineteen (19) clinical and 15 videomicroscopic digital images were compressed using JPEG and JPEG2000 at various compression factors and TIF and PNG. TIF and PNG are "lossless" formats (i.e., without alteration of the image), JPEG is "lossy" (the compressed image has a lower quality than the original), JPEG2000 has a lossless and a lossy mode. The quality of the compressed images was assessed subjectively (by three expert reviewers) and quantitatively (by measuring, point by point, the color differences from the original). Lossless JPEG2000 (49% compression) outperformed the other lossless algorithms, PNG and TIF (42% and 31% compression, respectively). Lossy JPEG2000 compression was slightly less efficient than JPEG, but preserved image quality much better, particularly at higher compression factors. For its good quality and compression ratio, JPEG2000 appears to be a good choice for clinical/videomicroscopic dermatologic image compression. Additionally, its diffusion and other features, such as the possibility of embedding metadata in the image file and to encode various parts of an image at different compression levels, make it perfectly suitable for the current needs of dermatology and teledermatology.

  1. U.S. Army Dugway Proving Ground, UT and the West Desert Test Center

    DTIC Science & Technology

    2007-11-02

    ra to ry I ns tr uc tio n G ra du at e Le ve l C la ss ro om E qu ip m en t C er tif ic at io n T ec h In fo rm at io n Su pp or t DPG Homeland...Chemical/ Biological events – Tailored – Realistic l Large and Small scale Chemical and Biological weapons production/storage l Terrorists dissemination

  2. A Modified Pressure-Impulse Blast Damage Model

    DTIC Science & Technology

    1977-01-01

    rndldontffy by b!ock number) ComputerSimulation Iso -DamageModeling StructuralDamageModeling Overpressure Blast Damage ZO.ABSTRACT(==@nJ*UMr-W- ti+~f~ -fd.tuf...11 2. Pressure-Impulse Iso -Damage Model . . . . . . . . . . . . . 13 3. Representation of Youngdahl’s Model...and REPSIL Computer Codes . , . . 29 II. Single Degree-of-Freedom Iso -Damage Data . . . . . . . . 32 III. Five Degree-of-FreedomIso-Damage Data

  3. Target Gas Effects on Collision-Induced Dissociation of Peptides in a Tandem Four-Sector Mass Spectrometer.

    DTIC Science & Technology

    1991-05-01

    regulator to the metering valve at the collision cell was thoroughly evacuated and then purged three times before each experiment by introducing small amounts...Thesis; Aug 89 - May 91 4. TIfLE AND S.BTiTLE S. FUNDING NUMBERS Target Gas Effects on Collision-Induced Dissociation of Peptides in a Tandem Four...intensities of ihe undecapeptide physalaemin during collision-induced dissociation (CID) has been determined to be target mass dependent. The data

  4. High Performance Liquid Chromatography/Video Fluorometry. Part II. Applications.

    DTIC Science & Technology

    1981-09-30

    HIGH PERFORMANCE LIQUID CHROMATOGRAPHY /VIDEO FLUOROMETRY. PART...REP«T_N&:-ŗ/ High Performance Liquid Chromatography /Video Fluorometry» Part II. Applications« by | Dennis C./Shelly* Michael P./Vogarty and...Data EnlirtdJ REPORT DOCUMENTATION PAGE t. REPORT NUMBER 2 GOVT ACCESSION NO 4. T1TI.F (and Submit) lP-^fffsyva High Performance Liquid Chromatography

  5. SeisCORK Meeting Report

    DTIC Science & Technology

    2006-02-01

    microbiological sampling) on a single CORK (Circulation Obviation Retrofit Kit) system [ Davis et al., 1992; Jannasch el al., 2003; Shipboard Scientific...Shiboard Scie tif gic Party 04) Sir For2B SeisCORK Meeting Report WHOI-01-2006 Appendix A: Meeting Participants Tom Pettigrew, P.E. Fred Spiess Staff...Expedition 301 benefits from operational and scientific achievements from Ocean Drilling Program (ODP) Leg 168 [ Davis et al., 1997], which focused on

  6. Computing Science and Statistics: Proceedings of the Symposium on the Interface: Computationally Intensive Methods in Statistics (20th) Held in Fairfax, Virginia on April 20-23, 1988

    DTIC Science & Technology

    1989-03-15

    exsampr~le . irmmltiplc trantsfsormed data sets tif irwiss to tesi for sti nat -is suich it ms exmin a mtionm or pmitterims in car respoiirg to a Simgll...we can look at the following example: of a hospital - fiscally stable or fiscally we wish to determine the financial measures that distressed. are...a fiscally distressed and 30% are fiscally sound. New York State management group’s opinion as Based upon these probabilities (group membership to the

  7. Species and cultivar influences on survival and parasitism of fall armyworm.

    PubMed

    Braman, S K; Duncan, R R; Hanna, W W; Engelke, M C

    2004-12-01

    Interactions between host plant resistance and biological control may benefit or hinder pest management efforts. Turfgrass cultivars have rarely been tested for extrinsic resistance characteristics such as occurrence and performance of beneficial arthropods on plant genotypes with resistance to known turf pests. Parasitism of fall armyworm, Spodoptera frugiperda (J.E. Smith), among six turfgrass genotypes was evaluated. The six grasses tested [Sea Isle-1 and 561-79 seashore paspalum, Paspalum vaginatum Swartz; TifSport and TifEagle hybrid Bermuda grass, Cynodon dactylon (L.) x C. transvaalensis (Burtt-Davy); and Cavalier and Palisades zoysiagrass, Zoysia japonica von Steudel and Z. matrella (L.) Merrill, respectively] represented a range in resistance to S. frugiperda. Differential recovery of larvae released as first instars reflected this gradient in resistance of Cavalier > or = Palisades > or = TifSport = TifEagle > or = 561- = Sea Isle-1 Larval recovery (percentage of initial number released) was greatest in May, less in July and August, and least in October, probably reflecting the increase in activity of on-site predators and disease pressure. Parasitism of the fall armyworm by the braconid Aleiodes laphygmae Viereck varied among turfgrass genotypes. Parasitism was greatest during July. In total, 20,400 first instars were placed in the field; 2,368 were recovered; 468 parasitoids were subsequently reared; 92.2% were A. laphygmae. In the field, the greatest percentage of reduction in S. frugiperda larvae by A. laphygmae occurred on the armyworm-susceptible seashore paspalums (51.9% on Sea Isle-1 in July). Cotesia marginiventris Cresson and Meteorus sp. also were reared from collected larvae. No parasitoids were reared from larvae collected from resistant Cavalier zoysiagrass. A. laphygmae and C. marginiventris were reared from larvae collected from the other five grass cultivars. No parasitoids of older larvae or pupae were observed.

  8. Customer Driven Uniform Manufacture (CDUM) Program. Customer Driven Uniform Management Apparel Research

    DTIC Science & Technology

    2008-11-13

    Production Allocation Pr od uc tio n A llo ca tio n 2.4a Set Option for RFID data Capture R FI D O pt io ns 2.5a Identify Users Id en tif y...SP010003D4155, delivery order 0007 submitted on Aug 27 2007 8: 20AM has been APPROVED and the data was updated. For further questions contact

  9. Development and Validation of a Shear Punch Test Fixture

    DTIC Science & Technology

    2013-08-01

    Current DRDC Defence Research and Development Canada FSP Friction Stir Processing LVDT Linear Variable Displacement Transducer MMC Metal Matrix...properties of metallic materials. The shear punch tester uses very small, thin specimens to evaluate shear behaviour of materials, the results of which...composites (MMC) manufactured by friction stir processing (FSP) that are being developed as part of a Technology Investment Fund (TIF) project, as the

  10. A study of intrauterine infusion of human chorionic gonadotropin (hCG) before frozen-thawed embryo transfer after two or more implantation failures.

    PubMed

    Huang, Pinxiu; Wei, Lihong; Li, Xinlin

    2017-01-01

    To investigate the effect of intrauterine infusion of human chorionic gonadotropin (hCG) before frozen-thawed embryo transfer (FET) after two or more implantation failures (TIFs). The study was a prospective randomized single-blind study of 161 cycles in patients undergoing FET who had TIFs. The intervention group received an intrauterine injection of 1000 IU of hCG before embryo transfer (ET) (n = 62). A placebo group (n = 49) received an intrauterine injection of physiological saline before ET. A control group (n = 50) did not receive an intrauterine injection. Clinical pregnancy rates, abortion rates, and ongoing pregnancy rates were compared between the three groups. The clinical pregnancy rates were 59.68%, 53.06%, and 32.00% in the hCG group, placebo group, and control group, respectively. The clinical pregnancy rates were significantly higher in the hCG and placebo groups than in the control group. There were no significant differences in the abortion rates among the three groups. An intrauterine administration of hCG before FET significantly improved the pregnancy rates after TIFs. But local injury caused by the operation of intrauterine perfusion may play an important role in improving clinical pregnancy rates.

  11. PU.1-mediated upregulation of M-CSFR is critical for MOZ-leukemia stem cell potential

    PubMed Central

    Aikawa, Yukiko; Katsumoto, Takuo; Zhang, Pu; Shima, Haruko; Shino, Mika; Terui, Kiminori; Ito, Etsuro; Ohno, Hiroaki; Stanley, E. Richard; Singh, Harinder; Tenen, Daniel G; Kitabayashi, Issay

    2011-01-01

    Leukemias and other cancers possess self-renewing stem cells that help to maintain the cancer1,2. Cancer stem cell eradication is thought to be critical for successful anti-cancer therapy. Using an acute myeloid leukemia (AML) model induced by introducing the leukemia-associated monocytic leukemia zinc finger (MOZ)-TIF2 fusion protein, we show here that AML can be cured by the ablation of leukemia stem cells. The MOZ-fusion proteins interacted with PU.1 to stimulate the expression of macrophage-colony stimulating factor receptor (M-CSFR, also called CSF1R/c-FMS/CD115). Analysis using PU.1-deficient mice demonstrated that PU.1 was essential for MOZ-TIF2 to establish and maintain AML stem cells. Cells expressing high levels of CSF1R (CSF1Rhigh cells), but not those expressing low levels of CSF1R (CSF1Rlow/− cells), showed potent leukemia-initiating activity. Using transgenic mice expressing a drug-inducible suicide gene controlled by the CSF1R promoter, AML was cured by ablation of the CSF1Rhigh cells. Induction of AML was suppressed in CSF1R-deficient mice. CSF1R inhibitors slowed the progress of MOZ-TIF2–induced leukemia. Thus, CSF1Rhigh cells contain leukemia stem cells, and the PU.1-mediated upregulation of CSF1R may be a useful therapeutic target for MOZ leukemia. PMID:20418886

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

    PubMed

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

    2007-03-28

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

  13. Defining the pathway of cytoplasmic maturation of the 60S ribosomal subunit

    PubMed Central

    Lo, Kai-Yin; Li, Zhihua; Bussiere, Cyril; Bresson, Stefan; Marcotte, Edward M; Johnson, Arlen W.

    2010-01-01

    In eukaryotic cells the final maturation of ribosomes occurs in the cytoplasm, where trans-acting factors are removed and critical ribosomal proteins are added for functionality. Here, we have carried out a comprehensive analysis of cytoplasmic maturation, ordering the known steps into a coherent pathway. Maturation is initiated by the ATPase Drg1. Downstream, assembly of the ribosome stalk is essential for the release of Tif6. The stalk recruits GTPases during translation. Because the GTPase Efl1, which is required for the release of Tif6, resembles the translation elongation factor eEF2, we suggest that assembly of the stalk recruits Efl1, triggering a step in 60S biogenesis that mimics aspects of translocation. Efl1 could thereby provide a mechanism to functionally check the nascent subunit. Finally, the release of Tif6 is a prerequisite for the release of the nuclear export adapter Nmd3. Establishing this pathway provides an important conceptual framework for understanding ribosome maturation. PMID:20670889

  14. LPA1 receptor activation promotes renal interstitial fibrosis.

    PubMed

    Pradère, Jean-Philippe; Klein, Julie; Grès, Sandra; Guigné, Charlotte; Neau, Eric; Valet, Philippe; Calise, Denis; Chun, Jerold; Bascands, Jean-Loup; Saulnier-Blache, Jean-Sébastien; Schanstra, Joost P

    2007-12-01

    Tubulointerstitial fibrosis in chronic renal disease is strongly associated with progressive loss of renal function. We studied the potential involvement of lysophosphatidic acid (LPA), a growth factor-like phospholipid, and its receptors LPA(1-4) in the development of tubulointerstitial fibrosis (TIF). Renal fibrosis was induced in mice by unilateral ureteral obstruction (UUO) for up to 8 d, and kidney explants were prepared from the distal poles to measure LPA release into conditioned media. After obstruction, the extracellular release of LPA increased approximately 3-fold. Real-time reverse transcription PCR (RT-PCR) analysis demonstrated significant upregulation in the expression of the LPA(1) receptor subtype, downregulation of LPA3, and no change of LPA2 or LPA4. TIF was significantly attenuated in LPA1 (-/-) mice compared to wild-type littermates, as measured by expression of collagen III, alpha-smooth muscle actin (alpha-SMA), and F4/80. Furthermore, treatment of wild-type mice with the LPA1 antagonist Ki16425 similarly reduced fibrosis and significantly attenuated renal expression of the profibrotic cytokines connective tissue growth factor (CTGF) and transforming growth factor beta (TGFbeta). In vitro, LPA induced a rapid, dose-dependent increase in CTGF expression that was inhibited by Ki16425. In conclusion, LPA, likely acting through LPA1, is involved in obstruction-induced TIF. Therefore, the LPA1 receptor might be a pharmaceutical target to treat renal fibrosis.

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

    NASA Astrophysics Data System (ADS)

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

    2014-07-01

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

  16. Recent advances in dermatomyositis-specific autoantibodies.

    PubMed

    Fujimoto, Manabu; Watanabe, Rei; Ishitsuka, Yosuke; Okiyama, Naoko

    2016-11-01

    In dermatomyositis, disease-specific autoantibodies now cover more than 70% of patients. These autoantibodies closely correlate with distinct clinical manifestations. In the past few years, extensive evidence has been accumulated on clinical significance of dermatomyositis-specific autoantibodies including autoantibodies against melanoma differentiation antigen 5 (MDA5), transcriptional intermediary factor 1 (TIF1), nuclear matrix protein 2 (NXP2), and small ubiquitin-like modifier activating enzyme (SAE). Anti-MDA5 antibodies are found with high specificity in clinically amyopathic dermatomyositis presenting rapidly progressive interstitial lung disease (ILD) especially in Asian population. Similar tendency has been reported in the US/Europe, although the frequency of positivity and the type of ILD may differ. Anti-TIF1 antibodies are present in juvenile and adult dermatomyositis patients with close correlation with malignancy in adult population. Anti-NXP2 antibodies share similar phenotype with anti-TIF1 antibodies, except that anti-NXP2 antibodies are associated with calcinosis and severe muscle disease. Although numbers are still small, patients with anti-SAE antibodies tend to present skin disease first and then progress to muscle weakness with systematic symptoms including dysphagia. Moreover, distinct cutaneous manifestations and muscle histopathology findings for each autoantibody have been reported. 'Autoantibody-based classification' of dermatomyositis subsets is now a useful strategy for comprehending the heterogeneous spectrum of dermatomyositis.

  17. Protein X is the product of the recA gene of Escherichia coli.

    PubMed Central

    McEntee, K

    1977-01-01

    The inducible protein X of Escherichia coli has been compared to the recA+ protein made by specialized recA transducing phages. The molecular weights and isoelectric points of these proteins are identical. Two mutations located in the recA gene that alter the electrophoretic mobility or the isoelectric point of protein X have been studied. A recA12 mutant strain, deficient in homologous recombination and repair, produces a smaller-than-normal protein X. A transducing phage carrying the recA12 allele directs the synthesis of a smaller recA protein after infection of irradiated cells. A transducing phage carrying the recA region of a tif-1 mutant strain codes for a recA protein with an isoelectric point more basic than that of the lambdaprecA+ product. The protein X of a tif-1 mutant strain shows an identical shift in its isoelectric properties. Examination of several tsl- recA- strains indicates that protein X can be induced in several missense recA mutants but is not detected in tsl- strains carrying amber or deletion mutations of the recA gene. These results demonstrate that protein X is the product of the recA gene and that the tif-1 mutation alters the properties of the recA protein. A model is suggested for autoregulation of the recA protein in the induction of functions expressed in response to DNA damage (SOS functions). Images PMID:341151

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

    PubMed

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

    2014-05-05

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

  19. Case report of anti-transcription intermediary factor-1-γ/α antibody-positive dermatomyositis associated with gastric cancer and immunoglobulin G4-positive pulmonary inflammatory pseudotumor.

    PubMed

    Ito, Kotaro; Imafuku, Shinichi; Hamaguchi, Yasuhito; Fujimoto, Manabu; Nakayama, Juichiro

    2013-07-01

    Dermatomyositis is a rare connective tissue disease often associated with internal malignancy and interstitial pneumonitis. Serologically, various auto-antibodies (Ab) are associated with dermatomyositis. Anti-transcription intermediary factor-1-γ/α (TIF-1-γ/α) Ab was recently identified as an auto-Ab and was observed mostly in cancer-associated dermatomyositis. IgG4-related disease is a newly described entity characterized by increased serum IgG4 levels and IgG4-positive plasma cell infiltration with fibrosis in organs such as the pancreas and parotid gland. IgG4-related disease also includes inflammatory pseudotumors in various organs. We report herein a 59-year-old Japanese man who had dermatomyositis complicated with a gastric cancer and an IgG4-related pulmonary inflammatory pseudotumor. He manifested typical classical Gottron's papules on the fingers, V-sign erythema on the chest, flagellate erythema on the back, nail fold bleeding and facial erythema. Serum levels of anti-TIF-1-γ/α Ab were positive as assessed by immunoprecipitation assay. He also had bilateral swelling of the parotid gland, and an excised specimen of the lung showed inflammatory pseudotumor with IgG4-positive plasma cells. As far as we know, this case is the first to report the association of IgG4-related disease and TIF-1-γ/α-positive dermatomyositis. Further accumulation of such cases is required to elucidate the mechanism of this association.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  1. Genetic interactions of yeast eukaryotic translation initiation factor 5A (eIF5A) reveal connections to poly(A)-binding protein and protein kinase C signaling.

    PubMed Central

    Valentini, Sandro R; Casolari, Jason M; Oliveira, Carla C; Silver, Pamela A; McBride, Anne E

    2002-01-01

    The highly conserved eukaryotic translation initiation factor eIF5A has been proposed to have various roles in the cell, from translation to mRNA decay to nuclear protein export. To further our understanding of this essential protein, three temperature-sensitive alleles of the yeast TIF51A gene have been characterized. Two mutant eIF5A proteins contain mutations in a proline residue at the junction between the two eIF5A domains and the third, strongest allele encodes a protein with a single mutation in each domain, both of which are required for the growth defect. The stronger tif51A alleles cause defects in degradation of short-lived mRNAs, supporting a role for this protein in mRNA decay. A multicopy suppressor screen revealed six genes, the overexpression of which allows growth of a tif51A-1 strain at high temperature; these genes include PAB1, PKC1, and PKC1 regulators WSC1, WSC2, and WSC3. Further results suggest that eIF5A may also be involved in ribosomal synthesis and the WSC/PKC1 signaling pathway for cell wall integrity or related processes. PMID:11861547

  2. Tetrahymena ORC contains a ribosomal RNA fragment that participates in rDNA origin recognition.

    PubMed

    Mohammad, Mohammad M; Donti, Taraka R; Sebastian Yakisich, J; Smith, Aaron G; Kapler, Geoffrey M

    2007-12-12

    The Tetrahymena thermophila ribosomal DNA (rDNA) replicon contains dispersed cis-acting replication determinants, including reiterated type I elements that associate with sequence-specific, single-stranded binding factors, TIF1 through TIF4. Here, we show that TIF4, previously implicated in cell cycle-controlled DNA replication and rDNA gene amplification, is the T. thermophila origin recognition complex (TtORC). We further demonstrate that TtORC contains an integral RNA subunit that participates in rDNA origin recognition. Remarkably, this RNA, designated 26T, spans the terminal 282 nts of 26S ribosomal RNA. 26T RNA exhibits extensive complementarity to the type I element T-rich strand and binds the rDNA origin in vivo. Mutations that disrupt predicted interactions between 26T RNA and its complementary rDNA target change the in vitro binding specificity of ORC and diminish in vivo rDNA origin utilization. These findings reveal a role for ribosomal RNA in chromosome biology and define a new mechanism for targeting ORC to replication initiation sites.

  3. A novel three-step method for preparation of a TiB2-promoted LiBH4-MgH2 composite for reversible hydrogen storage.

    PubMed

    Kang, Xiangdong; Wang, Kuikui; Zhong, Yujie; Yang, Bing; Wang, Ping

    2013-02-14

    The reversible dehydrogenation properties of the 2LiBH(4)-MgH(2) composite can be effectively improved by incorporating heterogeneous nucleation agents, typically transition metal borides. A careful study of the 2LiBH(4)-MgH(2) composite with a titanium trifluoride (TiF(3)) additive finds that using the conventional one-step milling method renders only a partial conversion from TiF(3) to titanium boride (TiB(2)) through an intermediate of titanium hydride (TiH(2)). Based on a fundamental understanding of the reaction processes of the system, we developed a three-step preparation method, which involves pre-milling the LiBH(4)-TiF(3) mixture, isothermal treatment and milling together with MgH(2). A combination of phase/chemical state/microstructural analyses using X-ray diffraction, X-ray photoelectron spectroscopy and transmission electron microscopy techniques shows that the newly developed method can effectively promote the formation of TiB(2) and meanwhile, ensure a homogeneous dispersion of TiB(2) nanoparticles in the composite matrix. As a consequence, the composite sample prepared by the new method exhibits a favorable combination of high hydrogen capacity, fast reaction kinetics and satisfactory cyclic stability.

  4. Self-templated synthesis of TiO2 hierarchical structure photocatalyst with high efficiency and good sedimentation property

    NASA Astrophysics Data System (ADS)

    Wang, Xiaoning; Sang, Yuanhua; Yu, Xin; Liu, Baishan; Liu, Hong

    2016-10-01

    The balance between highly efficient photocatalysis and a good emulsion/water extraction property is crucial for the practical application of TiO2 photocatalysts. The TiO2 hierarchical structure was synthesized via a hydrothermal treatment of H2Ti3O7 nanobelts with TiF4. The hydrolysis of TiF4 supplies the TiO2 nucleus, and HF, which is derived from the hydrolysis process, acts as a corrosive to etch the H2Ti3O7 nanobelt, resulting in a dynamic dissolution and precipitation process. The etching process resulted in self-generated TiF4 and initiated hydrolysis to generate new TiO2 primary particles. Induced by F etching process, Ti3+ defects were formed in the hierarchical structures, which was beneficial to the photocatalytic property. This hydrolysis-etching-hydrolysis process allows for template dissolution and self-assembly of anatase TiO2 nanobelts to form the TiO2 hierarchical structures. This process balances the nanominiaturization and sedimentation property requirements by the photocatalytic and emulsion/water extraction properties. This simple hydrolysis-etching-hydrolysis process can be applied to the synthesis of many other hierarchical structures.

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

    PubMed

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

    2013-01-14

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

  6. Non-sequential optimization technique for a computer controlled optical surfacing process using multiple tool influence functions.

    PubMed

    Kim, Dae Wook; Kim, Sug-Whan; Burge, James H

    2009-11-23

    Optical surfaces can be accurately figured by computer controlled optical surfacing (CCOS) that uses well characterized sub-diameter polishing tools driven by numerically controlled (NC) machines. The motion of the polishing tool is optimized to vary the dwell time of the polisher on the workpiece according to the desired removal and the calibrated tool influence function (TIF). Operating CCOS with small and very well characterized TIF achieves excellent performance, but it takes a long time. This overall polishing time can be reduced by performing sequential polishing runs that start with large tools and finish with smaller tools. In this paper we present a variation of this technique that uses a set of different size TIFs, but the optimization is performed globally - i.e. simultaneously optimizing the dwell times and tool shapes for the entire set of polishing runs. So the actual polishing runs will be sequential, but the optimization is comprehensive. As the optimization is modified from the classical method to the comprehensive non-sequential algorithm, the performance improvement is significant. For representative polishing runs we show figuring efficiency improvement from approximately 88% to approximately 98% in terms of residual RMS (root-mean-square) surface error and from approximately 47% to approximately 89% in terms of residual RMS slope error.

  7. Effect of 4% titanium tetrafluoride solution on dental erosion by a soft drink: an in situ/ex vivo study.

    PubMed

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

    2008-05-01

    This in situ/ex vivo study assessed the effect of titanium tetrafluoride (TiF(4)) on permanent human enamel subjected to erosion. Ten volunteers took part in this study performed in two phases. In the first phase (ERO), they wore acrylic palatal appliances containing two enamel blocks, divided into two rows: TiF(4) (F) and no-TiF(4) (no-F). During the 1st day, the formation of a salivary pellicle was allowed. In the 2nd day, the TiF(4) solution was applied on one row (ERO+F), whereas on the other row no treatment was performed (ERO+no-F). From 3rd until 7th day, the blocks were subjected to erosion, 4x per day. In the 2nd phase (no-ERO), the volunteers wore acrylic palatal appliances containing one enamel block, during 2 days, to assess the effect of TiF(4) only (no-ERO+F). Enamel alterations were determined using profilometry (wear), microhardness (%SMHC) tests, scanning electron microscope and microprobe analysis. The %SMHC and wear were tested using ANOVA and Tukey's post hoc tests (p<0.05). The mean of %SMHC and wear (microm) values (+/-S.D.) were, respectively: ERO+F -73.32+/-5.16(A)/2.40+/-0.60(a); ERO+no-F -83.49+/-4.59(B)/1.17+/-0.48(b) and no-ERO+F -67.92+/-6.16(A)/0.21+/-0.09(c). In microscope analysis, the no-F group showed enamel with honeycomb appearance. For F groups, it was observed a surface coating with microcracks. The microprobe analysis revealed the presence of the following elements (%) in groups ERO+F, ERO+no-F and no-ERO+F, respectively: Ca (69.9, 72.5, 66.25); P (25.9, 26.5, 26.06); Ti (3.0, 0, 5.93). The TiF(4) was unable to reduce dental erosion.

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

    PubMed

    Ganz, Robert A

    2016-07-01

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

  9. Preliminary results of thoracoscopic Belsey Mark IV antireflux procedure.

    PubMed

    Nguyen, N T; Schauer, P R; Hutson, W; Landreneau, R; Weigel, T; Ferson, P F; Keenan, R J; Luketich, J D

    1998-06-01

    Laparoscopic Nissen fundoplication has replaced open approaches for refractory gastroesophageal reflux disease (GERD) in many major medical centers. Here we report our preliminary results of the Belsey Mark IV antireflux procedure performed by video-assisted thoracoscopy (VATS-Belsey). Fifteen patients underwent VATS-Belsey. The indications for surgery included GERD refractory to medical therapy (n=10), achalasia (n=2), diffuse esophageal spasms (n=1), epiphrenic esophageal diverticulum (n=1), and paraesophageal hernia (n=1). The median operative time was 235 min. There were three conversions to open minithoracotomy (8-10 cm) necessitated by severe adhesions (n=2) and repair of a gastric perforation (n=1). The median hospital stay was 4 days. Postoperative complications included persistent air leaks, requiring discharge with a Heimlich valve in one patient. There were no perioperative deaths. At a median follow-up of 19 months, ten patients (66%) were asymptomatic and were not taking any antacids. One patient who had taken proton pump inhibitors preoperatively required postoperative H2 blockers for mild heartburn. In three patients, recurrent GERD symptoms (mean follow-up 6 months) led to laparoscopic takedown of the Belsey and Nissen fundoplication. One patient with achalasia, who had recurrent dysphagia after 1 year of relief following VATS myotomy and Belsey, underwent esophagectomy. The Belsey Mark IV antireflux procedure is technically feasible by VATS with minimal morbidity. However, our preliminary results suggest that open thoracotomy for Belsey Mark IV should remain the standard operation for GERD with poor esophageal motility when a thoracic approach is desired. We have modified our approach to laparoscopic partial fundoplications (Toupet or Dor) for severe GERD and poor esophageal motility when an abdominal approach is possible.

  10. Safety and efficacy of high-dose acarbose treatment for dumping syndrome.

    PubMed

    De Cunto, Angela; Barbi, Egidio; Minen, Federico; Ventura, Alessandro

    2011-07-01

    Dumping syndrome (DS) is a complication of Nissen fundoplication. Dietary strategies can ameliorate symptoms, but this approach is not always foolproof. Limited evidence reports the efficacy of acarbose for children who are unresponsive to feeding manipulations. We report 8 patients with DS aged between 7 and 24 months. In 4 of 8 nutritional strategies failed, and acarbose treatment was started. The initial dose was 25 mg for meals, and increased until postprandial glucose was stable. In 3 of 4 children the final dose was higher than previously reported, without adverse effects. Acarbose is useful to treat DS in cases of failure of dietary strategies.

  11. [Surgical treatment for gastroesophageal reflux disease (GERD)].

    PubMed

    Iida, Atsushi; Yamaguchi, Akio

    2007-05-01

    Proton pump inhibitor (PPI) is major treatment for acid reflux. It reduces major symptom of GERD and effective. However, the cause of GERD is the insufficiency of anti-reflux mechanism of cardia. Only surgical treatment can care for hiatal hernia as the main cause of the disruption. Redundant reflux against conservative treatment or obvious hiatal hernia is indication for laparoscopic Nissen fundoplication. Late diagnosis might request radical operation, so we need to know the indication for laparoscopic treatment. For the safer laparoscopic procedure, we perform curtain retraction technique and Floppy Nissen -short cuff method. The former contribute to prevent hemorrhage or pneumothorax, and the latter can reduce the post-operative disphagia.

  12. Laparoscopic antireflux surgery. What is real progress?

    PubMed Central

    Collard, J M; de Gheldere, C A; De Kock, M; Otte, J B; Kestens, P J

    1994-01-01

    OBJECTIVE: The authors aim to substantiate, with objective arguments, potential advantages of laparoscopic versus open antireflux surgery in the light of the recent crude experience of the Louvain Medical School Hospital. METHODS: Seventy-two consecutive patients with disabling gastroesophageal reflux disease ([GERD], n = 56), symptomatic hiatal hernia without GERD (n = 5), or unsatisfactory outcome after unsuccessful antireflux procedure (n = 11) were operated on by laparotomy (n = 28), laparoscopy (n = 39), or thoracotomy (n = 5). The antireflux procedure was a subdiaphragmatic Nissen fundoplication (n = 60), an intrathoracic Nissen fundoplication (short esophagus, n = 3), a subdiaphragmatic 240 degrees fundoplication (severe motility disorders, n = 3), a Lortat-Jacob repair (hiatal hernia without GERD, n = 5), and a duodenal diversion (delayed gastric emptying, n = 1). RESULTS: Major postoperative morbidity included two pulmonary embolisms (one laparoscopy patient and one laparotomy patient), and one hemothorax (one thoracotomy patient). Mean hospital stay was 6.4 days for laparoscopy, 7.8 days for laparotomy, and 12.5 days for thoracotomy. Postoperative morphine consumption (patient-controlled analgesia) averaged 47 mg/48 hrs (laparoscopy) versus 46 mg/48 hrs (laparotomy with primary antireflux surgery) (p > 0.05). Although 93% of the laparoscopy patients returned to work within 3 weeks after surgery, 92% of the laparotomy and thoracotomy patients resumed their activity after more than 6 weeks. At follow-up, 87.5% of the patients were asymptomatic or had inconsequential symptoms, 9.8% had disabling side effects, and 2.7% had persistent or recurring esophageal symptoms. There were four parietal herniations, i.e., one incisional hernia and one recurrence of a repaired umbilical hernia in the laparotomy group, and two herniations of the wrap into the chest--probably related to a premature return to manual work--in the laparoscopy group. Three laparoscopy patients

  13. Nuclear medicine and esophageal surgery

    SciTech Connect

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

    1986-06-01

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

  14. Adenocarcinoma of the Distal Esophagus in a Patient With a Magnetic Sphincter Augmentation Device: First of Many to Come?

    PubMed

    Stadlhuber, Rudolf J; Dubecz, Attila; Meining, Alexander; Stein, Hubert J

    2015-06-01

    Recently an alternative treatment option utilizing a laparoscopically placed magnetic sphincter device has been introduced for gastroesophageal reflux disease patients who are hesitant to undergo Nissen-fundoplication. Based on previous experience with similar devices, concerns have been raised about migration, and in case of a subsequently developing esophageal cancer, technical challenges during the endoscopic or surgical treatment caused by the foreign body reaction around the abdominal esophagus. In this article, we report of the first case of esophagectomy for cancer in a patient with a previously implanted magnetic sphincter augmentation device. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Total Esophageal Gastric Dissociation for the Failed Antireflux Procedure in a Child with Microgastria

    PubMed Central

    Hattori, Kengo; Bvulani, Bruce; Numanoglu, Alp; Cox, Sharon Gail; Millar, Alastair J. W.

    2016-01-01

    Microgastria is a very rare anomaly characterized by a very small tubular stomach that presents with severe gastroesophageal reflux disease due to the small reservoir capacity of the stomach. We present a patient with microgastria-related reflux and a failed fundoplication who was treated with total esophageal gastric dissociation (TEGD) resulting in an excellent outcome. In our experience with this good long-term result, we would suggest that TEGD be added to the armamentarium of procedures that can be used in the treatment of microgastria. PMID:28018800

  16. Robot-assisted surgery in children: current status.

    PubMed

    Sinha, C K; Haddad, M

    2008-01-01

    The horizon of robotic paediatric surgery has grown in leaps and bounds with advances in technology. The aim of this study was to analyse the extent of robotic involvement in paediatric surgical practice. A systematic database search was performed. Data about children who had undergone robot-assisted procedures were reviewed retrospectively from all published reports up to October 2007. Success rates were defined in term of completion of the procedures, their complications, and the time taken. These results were further studied in comparison with the procedures performed by open and laparoscopic methods. A total of 31 studies were identified describing 566 patients. Of these, four studies were case control, comparing with either laparoscopic or open procedures, one study was a prospective trial, and the rest of the studies were either case reports or series. The most common robotic system used was the da Vinci (23 studies) followed by the Zeus (four studies). The mean age of the children was 8.3 years. The commonest operation was pyeloplasty (141 cases), followed by fundoplication (122 cases) and patent ductus arteriosus ligation (50 cases). The mean operation time for robot-assisted pyeloplasty was 221 min (open pyeloplasty 214 min). The mean operation times for fundoplication were robotic, 170 min, laparoscopic, 158 min, and open, 121 min. The mean operation times for patent ductus arteriosus ligation were 166 min (robotic) and 83 min (open). Overall conversion rate for all paediatric robotic procedures was 4.7% and complications ranged from 0 to 15%. For robotic fundoplications the conversion and complication rates were 0.8 and 3.3%, respectively. For robotic pyeloplasties the conversion and complication rates were 2.1 and 3.5%, respectively. Many other major operations were performed successfully. All studies recommended robotic procedure as safe and feasible. Currently, the most common robotic operations in practice are pyeloplasties and

  17. Paediatric robotic surgery in clinical practice: a cost analysis.

    PubMed

    Anderberg, M; Kockum, C C; Arnbjornsson, E

    2009-10-01

    Since 2006 we have used robotic assistance when performing minimally invasive laparoscopic fundoplications in children. We compared the costs of robotic surgery with the costs for open and laparoscopic surgery to test our hypothesis that the increased costs of the new technology are acceptable. Costs were calculated using the regional hospital prices for our first 14 fundoplications in children, performed with the aid of the da Vinci Surgical System from Intuitive Surgical. We compared these costs with those of our ten latest fundoplications performed using open and laparoscopic surgery, respectively. There were no differences in the demographic data, work-up or indications for surgery between the three groups of children. The mean cost of robotic surgical fundoplications (EUR 9 584) was 7% higher than the mean cost of laparoscopic surgery (EUR 8 982) and 9% lower than the mean costs for open surgical procedures (EUR 10 521). These differences can be explained by the increased cost of robotic instruments (EUR 2 081 per operation). The duration of the operation and the duration of in-hospital stay are comparable to those of laparoscopic surgical interventions. The time required for the operative intervention was considerably longer than for the open surgical procedure; the duration of the in-hospital stay was only half of that of the open surgical procedure. The patients seemed to benefit from the use of robotic instruments with less morphine (as a marker of less postoperative pain) and a shorter hospital stay. The introduction of robotic assistance into surgical practice involves increased in-hospital costs, mainly because of the cost of the new instruments. This increase in cost can be offset by the shorter hospital stay compared to open surgery. After laparoscopic surgery the hospital stay is about the same as after operations performed with robotic assistance. Cheaper instruments and shorter operating time will make robotic surgery cost efficient in the future

  18. A case report: Liraglutide as a novel treatment option in late dumping syndrome.

    PubMed

    Chiappetta, Sonja; Stier, Christine

    2017-03-01

    Postprandial hyperinsulinemic hypoglycemia, known as late dumping syndrome, is a rare but often misdiagnosed complication after gastric surgery. The pathophysiological mechanisms are poorly understood and the treatment of this syndrome is challenging. New-onset postsurgical late dumping syndrome after Toupet fundoplication. Sigstad Score, OGTT, CGM. Daily subcutaneous injection of liraglutide (0.6 mg and 1.2 mg). Reduction in fasting and postprandial peak insulin level with improvement in symptomatic hypoglycemic events. Liraglutide may be a novel treatment option for postprandial hyperinsulinemic hypoglycemia after gastric surgery.

  19. A case report: Liraglutide as a novel treatment option in late dumping syndrome

    PubMed Central

    Chiappetta, Sonja; Stier, Christine

    2017-01-01

    Abstract Rationale: Postprandial hyperinsulinemic hypoglycemia, known as late dumping syndrome, is a rare but often misdiagnosed complication after gastric surgery. The pathophysiological mechanisms are poorly understood and the treatment of this syndrome is challenging. Patient concerns: New-onset postsurgical late dumping syndrome after Toupet fundoplication. Diagnoses: Sigstad Score, OGTT, CGM. Interventions: Daily subcutaneous injection of liraglutide (0.6 mg and 1.2 mg). Outcomes: Reduction in fasting and postprandial peak insulin level with improvement in symptomatic hypoglycemic events. Lessons: Liraglutide may be a novel treatment option for postprandial hyperinsulinemic hypoglycemia after gastric surgery. PMID:28328816

  20. Gavaging the infant lung.

    PubMed

    Avital, Avraham; Godfrey, Simon; Bortz, Raphael; Uwyyed, Kamal; Springer, Chaim

    2002-11-01

    An 8-month-old female infant was hospitalized for persistent bilateral infiltrates, failure to thrive, and tachypnea. An extensive diagnostic workup was negative, except for strong oil-red O staining of the white-turbid bronchoalveolar lavage fluid and borderline esophageal pH monitoring. Conservative treatment failed, and she was scheduled for gastrostomy and Nissen-fundoplication until the family physician found that the anxious mother was feeding the child forcibly, which caused chronic aspiration pneumonitis. The mother was given psychological support and was supervised, and the child recovered completely.

  1. Surgery for Gastroesophageal Reflux Disease in the Morbidly Obese Patient.

    PubMed

    Duke, Meredith C; Farrell, Timothy M

    2017-01-01

    The prevalence of gastroesophageal reflux disease (GERD) has mirrored the increase in obesity, and GERD is now recognized as an obesity-related comorbidity. There is growing evidence that obesity, specifically central obesity, is associated with the complications of chronic reflux, including erosive esophagitis, Barrett's esophagus, and esophageal adenocarcinoma. While fundoplication is effective in creating a competent gastroesophageal junction and controlling reflux in most patients, it is less effective in morbidly obese patients. In these patients a bariatric operation has the ability to correct both the obesity and the abnormal reflux. The Roux-en-Y gastric bypass is the preferred procedure.

  2. The evolution of the treatment of esophageal achalasia: a look at the last two decades.

    PubMed

    Allaix, Marco E; Herbella, Fernando A; Patti, Marco G

    2012-09-01

    Thanks to the development of minimally invasive surgery, the last 20 years have witnessed a revolution in the treatment of benign esophageal disorders, particularly for esophageal achalasia. This has brought a shift in the treatment algorithm of this disease, as today a laparoscopic Heller myotomy with partial fundoplication is considered the primary form of treatment in most Centers in North America. This article reviews the evolution of the treatment of esophageal achalasia during the last two decades, with particular stress on the key technical elements of this operation.

  3. [Surgical treatment of esophageal achalasia--20 years experience].

    PubMed

    Yaramov, N; Sokolov, M; Angelov, K; Toshev, S; Petrov, B

    2009-01-01

    Achalasia comes from a Greek word that means "failure to relax." Cardiospasm and achalasia refer to the same condition. This report addresses esophageal achalasia--its history, diagnosis, pathophysiology, and treatment options. We report our experience in treating this disorder surgically using modified Heller myotomy combined or not with partial gastric fundoplication. 47 patients with achalasia surgically operated in 20-years period are reported by authors. These features make it reasonable to reasses the relative indications for surgery and nonsurgical therapy in achalasia of the esophagus.

  4. Video. Transanal specimen retrieval using the transanal endoscopic microsurgery (TEM) system in minimally invasive colon resection.

    PubMed

    Makris, Konstantinos I; Rieder, Erwin; Kastenmeier, Andrew S; Swanström, Lee L

    2012-04-01

    During laparoscopic colectomy, the specimen is retrieved through substantial incisions, which increase postoperative pain, wound infections, and incisional hernias. In the era of natural orifice transluminal endoscopic surgery (NOTES), incisionless transrectal approaches for colon resections have been investigated with promising results [4-6]. Transanal retrieval of the colonic specimen in laparoscopic colectomy has been described but not widely adopted, although it seems to be an appealing step towards NOTES colectomy. We have used the TEM rectoscope (Richard Wolf Medical Instruments Corporation, Vernon Hills, IL, USA) as a retrieval conduit, which facilitates transanal extraction of the specimen, and protects the rectal edge and anal sphincter during laparoscopic left colectomy. After standard laparoscopic dissection and vascular control, the colon is divided distally, whereas the proximal colonic end is ligated to prevent fecal spillage. The TEM rectoscope is advanced through the rectal stump. The proximal colon is grasped and withdrawn through the rectoscope. The colon is stapled off proximally, and the specimen is removed transanally. An anvil is introduced into the pelvis through the rectoscope and inserted in the descending colon through a colotomy, which is subsequently sealed with an endo-loop. The rectoscope is withdrawn, and the rectal stump edge is stapled off. A circular stapler is introduced in the rectum, and end-to-end anastomosis is performed. The extraction incisions in laparoscopic colectomy increase invasiveness and compromise the "purity" of the laparoscopic approach. Retrieval of the specimen through natural orifices constitutes a stepping stone in the transition to future incisionless NOTES colectomy. These techniques have not been widely adopted because of technical difficulties and concerns regarding trauma. In our experience, transanal retrieval of the colonic specimen is hampered by friction between the specimen and the rectum, which

  5. [Analysis of anti-reflux surgery failure].

    PubMed

    Cano Novillo, I; Benavent Gordo, M I; Portela Casalod, E; Delgado Muñoz, M D; Aguado Roncero, P; Vilariño Mosquera, A; Berchi García, F J

    2000-01-01

    Recurrent gastroesophageal reflux following fundoplication is a challenging problem, because it is usually refractory to medical treatment and a second, technically difficult, antireflux operation is required. Different factors that may contribute to surgery failure have been identified in children. We present 8 cases who underwent redofundoplication after failed procedures, from a total number of 96 patients operated on due to gastroesophageal reflux. Four patient's had their initial fundoplication performed at our institution. Six patients were neurologically impaired, six had chronic pulmonary disease, and two had esophageal atresia. The main presenting symptoms were recurrent vomiting (n = 8) and aspiration (n = 4). Gastroesophageal reflux was confirmed by barium swallow and endoscopy. Operative findings showed wrap breakdown in two cases, warp breakdown associated with hiatal hernia in five, wrap breakdown associated with paraesophageal hernia in two cases, and paraesophageal hernia with normal wrap in one. A second Nissen procedure were performed in five cases, whereas a Collis-Nissen gastroplasty was realized in three with a short esophagus. Six patients had a successful outcome remaining symptom free, one has severe disphagia, and one has recurrent vomiting. In our experience, patients with recurrent gastroesophageal reflux disease should undergo an antireflux procedure tailored to specific anatomic or functional abnormalities.

  6. [Laparoscopic management of oesophageal epiphrenic diverticulum: a case report].

    PubMed

    Ceretti, Andrea Pisani; Carzaniga, Pierluigi

    2005-01-01

    Epiphrenic diverticuli are rare pulsion "pseudodiverticuli" of the distal oesophagus that are commonly associated with oesophageal motility disorders. Surgical treatment is usually reserved for patients with symptoms. Traditionally, patients are treated with diverticulectomy, myotomy and fundoplication via a left thoracotomy. The aim of this study was to describe the laparoscopic technique and review the international literature on this minimally invasive approach. We report the case of a 66-year-old woman with a 1-year history of retrosternal pain, regurgitation and weight loss caused by an oesophageal epiphrenic diverticulum. The patient underwent barium oesophagography and oesophagogastroduodenoscopy. The oesophageal diverticulum measured 5 cm. We treated the condition with a laparoscopic oesophageal diverticulectomy, Heller myotomy and Dor fundoplication with intraoperative endoscopy. The operative time was 210 minutes. The postoperative course was complicated by a suspected leakage from the staple line, which was not subsequently confirmed. The patient is now totally asymptomatic after 3 months. Laparoscopy offers good access to the distal oesophagus and the inferior mediastinum. Resection of the diverticulum, treatment of the motor disorder and prevention of postoperative reflux can be obtained with this approach. It should be considered as an alternative to the traditional transthoracic approach and may eventually become the standard technique.

  7. [Learning curve and his consequences in laparoscopic antireflux surgery].

    PubMed

    Cristian, D; Sgarbură, Olivia; Jitea, N; Burcoş, T

    2005-01-01

    The laparoscopic fundoplication became the gold standard of the laparoscopic antireflux surgery (LARS). Our aim is to indicate the evolution of the learning curve as well as its consequences on the patient's outcome. We studied the gastro-esophageal reflux (GER) cases treated laparoscopically in Colţea University Hospital throughout 6 years. We gathered a group of 40 patients with an average age of 54, 57 years and a sex ratio F:M = 1.67. The patients had either a simple GER disease, small and medium hiatal hernias (21 cases) or giant hiatal hernias (GHH--19 cases). Two equal groups resulted: group 1 consisted of the first 20 patients operated from 1999 to 2002, group 2 consisted of the rest of the patients. Operating time, hospital time, complication rate and postoperatory endoscopy were compared. The average of the operating time was calculated. For giant hiatal hernias, a separate average was also taken into account. The total operating time for GER, small and medium hiatal hernias was 115 min in group 1 and 80 min in group 2 meanwhile for GHH it was 143 min vs. 130 min. The average operatory time was 129 min vs. 105 min. All these differences were statistically significant but there were no differences concerning complication rate and post-operatory endoscopy. Although the learning of the laparoscopic fundoplication requires practice, the learning curve does not have influence on the patients' outcome.

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

    PubMed Central

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

    2014-01-01

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

  9. Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy in Children and Adolescents

    PubMed Central

    Yu, Sherman C.; Petty, John K.; Bensard, Denis D.; Partrick, David A.; Bruny, Jennifer L.

    2005-01-01

    Objective: Pediatric gastric access for long-term enteral feeding may be performed via a laparotomy, laparoscopy, or a percutaneous approach. In children and adolescents, laparoscopic-assisted gastrostomy may be difficult due to a thick abdominal wall. Therefore, if the abdominal wall is estimated to be >2 cm on physical examination, or in children in whom a percutaneous endoscopic gastrostomy was unsuccessfully attempted by a gastroenterologist, we routinely perform a laparoscopic-assisted percutaneous endoscopic gastrostomy. Methods: From January 1998 through February 2003, we retrospectively reviewed 15 cases of a laparoscopic-assisted percutaneous endoscopic gastrostomy. Instruments used to perform this technique are a percutaneous endoscopic gastrostomy kit, an Olympus flexible endoscope, and one 5-mm STEP port placed through an infraumbilical incision for a 5-mm, 30-degree scope. Results: Age range was 2 years to 20 years (mean, 10). Operative time ranged from 20 minutes to 45 minutes. When a concurrent laparoscopic Nissen fundoplication was performed (n = 6), the percutaneous endoscopic gastrostomy was placed after completion of the Nissen fundoplication. No intraoperative complications occurred, and all tubes were successfully placed. Feeds were instituted the following day and advanced to goal. To date, no postoperative complications have occurred, and revision has not been necessary. Conclusions: Laparoscopic-assisted percutaneous endoscopic gastrostomy in children and adolescents is safe and effective. Utilizing laparoscopy permits evaluation of the peritoneum and lysis of adhesions, if necessary. Moreover, laparoscopy provides excellent exposure for accurate placement of the PEG, while avoiding injury to other organs. PMID:16121876

  10. Laparoscopic treatment of Bochdalek hernia without the use of a mesh.

    PubMed

    Brusciano, L; Izzo, G; Maffettone, V; Rossetti, G; Renzi, A; Napolitano, V; Russo, G; Del Genio, A

    2003-09-01

    Bochdalek hernia is a rare pathology. The preoperative diagnosis is difficult, and few reports are available regarding its treatment. Herein we report the case of a 25-year-old woman referred for symptoms of dyspepsia, dysphagia, and thoracic pain exacerbated by pregnancy. Preoperative radiography, EGD, and CT scan revealed a paraesophageal hiatal hernia. Laparoscopic exploration showed the complete thoracic migration of the stomach through a left posterolateral diaphragmatic foramen. The diagnosis of a Bochdalek hernia was then made. The diaphragmatic defect was repaired without inserting a prosthesis, using five separate non-reabsorbable stitches (Rieder technique). The procedure was completed with a Nissen-Rossetti fundoplication. The duration of the procedure was 150 min. Hospital stay was 12 days. There were no complications. Postoperative Gastrografin radiography of the esophagus and stomach showed a normal-shaped fundoplication and confirmed the subdiaphragmatic location of the stomach. We conclude that the laparoscopic approach represents the gold standard for the diagnosis and treatment of Bochdalek hernia and any associated complications.

  11. Robot-assisted oesophageal and gastric surgery for benign disease: antireflux operations and Heller's myotomy.

    PubMed

    Falkenback, Dan; Lehane, Christopher W; Lord, Reginald V N

    2015-03-01

    Robot-assisted general surgery operations are being performed more frequently. This review investigates whether robotic assistance results in significant advantages or disadvantages for the operative treatment of gastro-oesophageal reflux disease and achalasia. The electronic databases (Medline, Embase, PubMed) were searched for original English language publications for antireflux surgery and Heller's myotomy between January 1990 and December 2013. Thirty-three publications included antireflux operations and 20 included Heller's myotomy. The publications indicate that the safety and effectiveness of robotic surgery is similar to that of conventional minimally invasive surgery for both operations. The six randomized trials of robot-assisted versus laparoscopic antireflux surgery showed no significant advantages but significantly higher costs for the robotic method. Gastric perforation during non-redo robotic fundoplication occurred in four trials. No consistent advantage for robot-assisted antireflux surgery has been demonstrated, and there is an increased cost with current robotic technology. A reported advantage for robotic in reducing the perforation rate during Heller's myotomy for achalasia remains unproven. Gastric perforation during robotic fundoplication may be due to the lack of haptic feedback combined with the superhuman strength of the robot. © 2014 Royal Australasian College of Surgeons.

  12. Antireflux operations at flexible endoscopy using endoluminal stitching techniques: an experimental study.

    PubMed

    Kadirkamanathan, S S; Evans, D F; Gong, F; Yazaki, E; Scott, M; Swain, C P

    1996-08-01

    Three antireflux operations-gastroplasty, fundoplication, and anterior gastropexy-were developed for performance at flexible endoscopy without laparotomy or laparoscopy. An endoscopic sewing machine mounted on a standard gastroscope, endoscopic knotting devices, overtube, and nylon thread were used to perform these operations in adult beagle dogs. Gastroplasty (n = 10) was accomplished by suturing the anterior and posterior wall of the stomach to create a gastric tube (neoesophagus) along the lesser curve. An anatomic arrangement similar to fundoplication (n = 6) was achieved by invaginating the esophagus and fixing it to the stomach 2 cm distal to the cardioesophageal junction. Anterior gastropexy (n = 6) was performed using a technique similar to that used in creating percutaneous gastrostomies. There was no mortality. Ninety percent of sutures were seen at repeat endoscopy at 4 to 8 week intervals. The gastroplasty group was selected for more extensive evaluation. Manometry using a three-channel perfused catheter system before and after the procedures showed an increase in the lower esophageal sphincter pressure (preoperative median 4.6 mm Hg; post-operative median 13.33 mm Hg, p = 0.008) and cardiac yield pressures (preoperative median 10 mm Hg; postoperative median 19 mm Hg, p = 0.007). This study demonstrates the feasibility of performing antireflux operations at flexible endoscopy, without laparoscopy or laparotomy, by use of endoluminal suturing techniques.

  13. Sandifer syndrome--a multidisciplinary diagnostic and therapeutic challenge.

    PubMed

    Lehwald, N; Krausch, M; Franke, C; Assmann, B; Adam, R; Knoefel, W T

    2007-06-01

    Sandifer syndrome, named after the neurologist Paul Sandifer, was first reported by M. Kinsbourne in 1962 who noticed a disorder of the upper gastrointestinal tract with neurological manifestations occurring in children and adolescents. Sandifer syndrome is a combination of gastro-oesophageal reflux disease with spastic torticollis and dystonic body movements with or without hiatal hernia. It is hypothesised that the positioning of the head provides relief from abdominal discomfort caused by acid reflux. The true pathophysiological mechanisms of the condition are still unclear. We report the diagnosis of Sandifer syndrome in a 9-year-old boy with a history of chronic torticollis and dystonic episodes for 5 years associated with abdominal symptoms. The cause of the dystonic body movements had not been found, although multiple neuropsychiatric diseases were suspected. The patient had been seen by many different specialities including Paediatrics, Paediatric Neurology, Psychology, Orthopaedic Surgery and ENT but the reason for the torticollis remained elusive. Unclear abdominal discomfort was the indication for an endoscopy that revealed severe gastro-oesophageal reflux disease with oesophagitis III degrees and a hiatal hernia which led to the correct diagnosis of Sandifer syndrome. After medical treatment and laparoscopic floppy Nissen fundoplication the symptoms nearly resolved 3 months after operation. Few reports of this syndrome exist, but Sandifer syndrome is probably underrecognised. Children with torticollis, dystonic episodes or atypical seizures should be evaluated for GERD and Sandifer syndrome. Early surgery, for example a laparoscopic floppy Nissen fundoplication or a Toupet procedure, can resolve the symptoms.

  14. Reconstruction after proximal gastrectomy for early gastric cancer in the upper third of the stomach: an analysis of our 13-year experience.

    PubMed

    Nakamura, Masaki; Nakamori, Mikihito; Ojima, Toshiyasu; Katsuda, Masahiro; Iida, Takeshi; Hayata, Keiji; Matsumura, Shuuichi; Kato, Tomoya; Kitadani, Junya; Iwahashi, Makoto; Yamaue, Hiroki

    2014-07-01

    Fundoplication during esophagogastrostomy (EG) after proximal gastrectomy (PG) is a useful procedure to prevent reflux esophagitis, but it is unclear how much of the remnant stomach should be wrapped around the esophagus. We analyzed data from 101 patients who underwent PG for upper third early gastric cancer between 1999 and 2011. In all, 64 patients underwent EG, 25 underwent jejunal interposition (JI), and 12 underwent jejunal pouch interposition (JPI). We compared intraoperative details and postoperative outcomes, and investigated the relationships between the degree of the fundoplication during EG and endoscopic findings. The length of the operation was significantly shorter in the EG group than in the other 2 groups (P < .05), and the intraoperative blood loss was significantly less in the EG group (P < .05). The JI and the JPI groups had significantly greater rates of early complications than did the EG group (P = .01). Reflux esophagitis was present in 22% of patients in the EG group, 8% in the JPI group, and none in the JI group. In the EG group, reflux esophagitis was significantly less common in patients with a >180° wrap of the remnant stomach around the esophagus than in patients with a smaller wrap (P = .0008). The rate of body weight loss was significantly less in the EG group compared with the other 2 groups (P < .05). Considering the low invasiveness of the procedure and postoperative outcomes, we consider that EG with a >180° wrap as the optimal reconstructive procedure. Copyright © 2014 Mosby, Inc. All rights reserved.

  15. Esophagogastric junction distensibility assessed using the functional lumen imaging probe

    PubMed Central

    Chen, Joan W; Rubenstein, Joel H

    2017-01-01

    AIM To assess reference values in the literature for esophageal distensibility and cross-sectional area in healthy and diseased subjects measured by the functional lumen imaging probe (FLIP). METHODS Systematic search and review of articles in Medline and Embase pertaining to the use of FLIP in the esophagus was conducted in accordance with the PRISMA guidelines. Cross-sectional area and distensibility at the esophagogastric junction (EGJ) were abstracted for normal subjects, achalasia, and gastroesophageal reflux disease (GERD) patients, stratified by balloon length and volume of inflation. RESULTS Six achalasia studies (n = 154), 3 GERD (n = 52), and 5 studies including healthy controls (n = 98) were included in the systematic review. Normative data varied widely amongst studies of healthy volunteers. In contrast, studies in achalasia patients uniformly demonstrated low point estimates in distensibility ≤ 1.6 mm2/mmHg prior to treatment that increased to ≥ 3.4 mm2/mmHg following treatment at 40mL bag volume. In GERD patients, distensibility fell to the range of untreated achalasia (≤ 2.85 mm2/mmHg) following fundoplication. CONCLUSION FLIP may be a useful tool in assessment of treatment efficacy in achalasia. The drastic drop in EGJ distensibility after fundoplication suggests that FLIP measurements need to be interpreted in the context of esophageal body motility and highlights the importance of pre-operative screening for dysmotility. Future studies using standardized FLIP protocol and balloon size are needed. PMID:28275309

  16. Surgical Management of Hiatal Hernia in Children with Asplenia Syndrome.

    PubMed

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

    2016-09-08

    Purpose Patients with asplenia syndrome (AS) are likely to have upper gastrointestinal tract malformations such as hiatal hernia. This report discusses the treatment of such conditions. Methods Seventy-five patients with AS underwent initial palliation in our institution between 1997 and 2013. Of these, 10 patients had hiatal hernia. Of the patients with hiatal hernia, 6 had brachyesophagus and 7 had microgastria. Results Of the 10 patients with hiatal hernia, 9 underwent surgery in infancy (7 before Glenn operation, 2 after Glenn operation). Two underwent typical Toupet fundoplication, and the other 7 underwent atypical repair including reduction of the stomach. Two patients with atypical repair showed recurrence of hernia and required reoperation. Three patients required reoperation due to duodenal obstruction. Duodenal obstruction occurred due to preduodenal portal vein or abnormal vessels compressing the duodenum. Obstructive symptoms were not seen in any cases preoperatively. Conclusions In patients with hiatal hernia, typical fundoplication is often difficult because most have concomitant brachyesophagus, microgastria, and hypoplasia of the esophageal hiatus. However, we should at least reduce the stomach to the abdominal cavity as early as possible to increase thoracic cavity volume and allow good feeding. Increasing the volume of the thoracic cavity thus makes Glenn and Fontan circulations more stable. Duodenal obstruction secondary to vascular anomalies is also common, so the anatomy in the area near the duodenum should be evaluated pre- and intraoperatively.

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

    PubMed

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

    2013-10-01

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

  18. [Long-term evolution of esophago-gastric junctions surgically treated to correct gastro-esophageal reflux. 111 cases].

    PubMed

    Vaysse, P; Baunin, C; Guitard, J; Moscovici, J; Visentin, M; Chansou, A; Fedacou, F; Juskiewenski, S

    1989-01-01

    One hundred eleven patients underwent a surgical procedure for correction of intractable gastroesophageal reflux. Twenty children were severely mentally retarded. The range of follow up was 6 months to 15 years. Upper gastro-intestinal series was realised at tenth post-operative day for 111 children, then during the first year for 97 children, between the first and fifth year for 62 children and after the fifth year for 25 children. The first upper gastro-intestinal control (at tenth day) was normal for 111 patients. Next controls revealed, usually during the first post-operative year, an esophago-gastric junction anomaly for 49 patients (44%). Most of them are light (41/111 = 37%): occasional reflux (9 children; more frequent without pyloroplasty) of little paraesophageal hernia (32 children; more frequent with closure of esophageal hiatus by two suture lines, with esophageal fixation on median arcuatum ligament or without esophageal fixation on esophageal hiatus); these light anomalies are symptom free and sometimes transitories. Rarely, anomalies are important (8/111 = 7%): big paraesophageal hernia of recurrence (more frequent with partial posterior fundoplication and in children severely mentally retarded); five patients were symptomatic and had to be reoperated. Also now, we don't use partial posterior fundoplication and in mentally retarded children we prefer a Collis procedure.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-10-14

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

  1. Do endoscopic antireflux procedures fit in the current treatment paradigm of gastroesophageal reflux disease?

    PubMed

    Pandolfino, John E; Krishnan, Kumar

    2014-04-01

    Gastroesophageal reflux disease (GERD) is a common condition requiring considerable medical resources. The mainstay of therapy is proton pump inhibitors (PPIs), which are effective at reducing acid reflux. In patients who have refractory acid reflux and esophagitis despite high-dose PPI, or are intolerant of the side effects of PPI therapy, surgical fundoplication is the primary therapy. The risk and cost gap between medical therapy and surgery has resulted in substantial interest in less-invasive endoscopic therapies. In this review, we discuss the underlying physiology of GERD along with the anatomic hurdles that must be overcome to develop an effective antireflux procedure. We also review the current published literature and assess the clinical efficacy of the devices that have been studied or currently are being investigated. Despite promising early studies, many of the devices fall short in high-quality randomized controlled trials. Furthermore, the physiologic aberration resulting in GERD oftentimes is addressed inadequately. Although there is certainly a need for less-invasive, safe, and effective therapy for reflux, therapy will need to withstand the established clinical efficacy of both PPI and surgical fundoplication. At present, we have the luxury of time to wait for such a device to become available.

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

    PubMed Central

    Kim, Sharon E; Soffer, Edy

    2016-01-01

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

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

    PubMed

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

    2016-05-01

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

  4. "The missing LINX" for gastroesophageal reflux disease: Operative techniques video for the Linx magnetic sphincter augmentation procedure.

    PubMed

    Kuckelman, John P; Barron, Morgan R; Martin, Matthew J

    2017-05-01

    In 2012 the FDA approved a magnetic sphincter augmentation (MSA) device (LINX, Torax Medical, Inc) for placement around the lower esophageal sphincter as an alternative approach to fundoplication for gastroesophageal reflux disease (GERD). This is a relatively new procedure and there is not widespread familiarization with the standard indications and techniques of device placement. We present two operative videos to highlight the standard surgical technique and technical points needed for successful LINX placement. First will be placement in a standard indications setting of uncomplicated GERD with no hiatal hernia. Second will be placement with complicated anatomy due to alterations from prior gastric surgery and a hiatal hernia. Our experience has revealed that the LINX device can be placed safely in patients with normal or significantly altered anatomy but requires adherence to several key principles and technical points. This procedure offers a new option that is anatomically and physiologically unique compared to standard fundoplication, and that offers highly effective control of GERD with a less invasive approach. Published by Elsevier Inc.

  5. Minimally invasive entero-enteral dual-path bypass using self-assembling magnets.

    PubMed

    Ryou, Marvin; Aihara, Hiroyuki; Thompson, Christopher C

    2016-10-01

    A minimally invasive method of entero-enteral bypass may be desirable for treatment of obstruction, obesity, or metabolic syndrome. We have developed a technology based on miniature self-assembling magnets which create large-caliber anastomoses (incisionless anastomosis system or IAS). The aim of this study was to assess (a) procedural characteristics of IAS deployment and (b) long-term integrity and patency of the resulting jejuno-ileal dual-path bypass. Endoscopic jejuno-ileal bypass creation using IAS magnets was performed in 8 Yorkshire pigs survived 3 months. The jejunal magnet was endoscopically deployed. However, the ileal magnet required surgical delivery given restraints of porcine anatomy. A 5-mm enterotomy was created through which the ileal magnet was inserted using a modified laparoscopic delivery tool. Magnets were manually coupled. Pigs underwent serial endoscopies for anastomosis assessment. Three-month necropsies were performed, followed by pressure testing of anastomoses and histological analysis. Jejuno-ileal bypass creation using self-assembling IAS magnets was successful in all 8 pigs (100 %). Patent, leak-free bypasses formed in all animals by day 10. All IAS magnets were expelled by day 12. Anastomoses were widely patent at 3 months, with mean maximal diameter of 30 mm. At necropsy, adhesions were minimal. Pressure testing confirmed superior integrity of anastomotic tissue. Histology showed full epithelialization across the anastomosis with no evidence of submucosal fibrosis or inflammation. Entero-enteral bypass using self-assembling IAS magnets is safe and technically feasible in the porcine model. IAS magnets can be rapidly delivered endoscopically or through a modified laparoscopic device. Expulsion of fused magnets avoids retention of prosthetic material. Anastomoses are widely patent and fully re-epithelialized. Three-month pressure testing reveals anastomotic tissue to be as robust as native tissue, while necropsy and histology

  6. Endoscopic intestinal bypass creation by using self-assembling magnets in a porcine model.

    PubMed

    Ryou, Marvin; Agoston, A Tony; Thompson, Christopher C

    2016-04-01

    A purely endoluminal method of GI bypass would be desirable for the treatment of obstruction, obesity, or metabolic syndrome. We have developed a technology based on miniature self-assembling magnets that create large-caliber anastomoses (Incisionless Anastomosis System [IAS]). The aim of this study was to evaluate procedural characteristics of IAS deployment and long-term anastomotic integrity and patency. We performed a 3-month survival study of Yorkshire pigs (5 interventions, 3 controls). Intervention pigs underwent simultaneous enteroscopy/colonoscopy performed with the animals under intravenous sedation. The IAS magnets were deployed and coupled with reciprocal magnets under fluoroscopy. Every 3 to 6 days pigs underwent endoscopy until jejunocolonic anastomosis (dual-path bypass) creation and magnet expulsion. Necropsies and histological evaluation were performed. The primary endpoints were technical success; secondary endpoints of anastomosis integrity, patency, and histological characteristics were weight trends. Under intravenous sedation, endoscopic bypass creation by using IAS magnets was successfully performed in 5 of 5 pigs (100%). Given porcine anatomy, the easiest dual-path bypass to create was between the proximal jejunum and colon. The mean procedure time was 14.7 minutes. Patent, leak-free anastomoses formed by day 4. All IAS magnets were expelled by day 12. All anastomoses were fully patent at 3 months with a mean diameter of 3.5 cm. The mean 3-month weight was 45 kg in bypass pigs and 78 kg in controls (P = .01). At necropsy, adhesions were absent. Histology showed full re-epithelialization across the anastomosis without fibrosis or inflammation. Large-caliber, leak-free, foreign body-free endoscopic intestinal bypass by using IAS magnets can be safely and rapidly performed in the porcine by model using only intravenous sedation. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  7. Brushing abrasion of eroded bovine enamel pretreated with topical fluorides.

    PubMed

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

    2006-01-01

    Topical fluorides have been proposed for the prevention of erosive dental wear. This study evaluated the in vitro effect of a single professional application of 4% titanium tetrafluoride (TiF4), 1% amine fluoride (AmF) and 0.1% difluorosilane varnish (FV) in preventing wear due to combined erosion and brushing abrasion. One hundred and eight bovine enamel samples were used. Control groups were not pretreated with any product (C), pretreated with a fluoride-free varnish (FV-bl) or pretreated with fluoride varnish and subsequently submitted to varnish removal (FV-r). Wear was modeled by submitting the fluoride-treated and control groups to 3 cycles of the following regimens: erosion/remineralization (er/remin), abrasion/remineralization (abr/remin) or erosion/abrasion/remineralization (er/abr/remin). Erosion was simulated by immersion of the samples for 10 min in citric acid 50 mM (pH 3). Abrasion was carried out for 1 min (200 strokes, load 150 g) in a wear device. Remineralization (2 h artificial saliva) took place between the cycles. Two-way ANOVA showed that there was a significant interaction (pTiF4 and AmF groups, but the amounts lost were not statistically significant (p=0.185 and p=1.000, respectively). Under er/abr/remin all products showed a significant protective effect, except for TiF4. It was concluded that FV and AmF protected bovine enamel against erosion followed by brushing abrasion in vitro.

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

    PubMed

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

    2014-12-01

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

  9. Structure of a 13-fold superhelix (almost) determined from first principles

    PubMed Central

    Schoch, Guillaume A.; Sammito, Massimo; Millán, Claudia; Usón, Isabel; Rudolph, Markus G.

    2015-01-01

    Nuclear hormone receptors are cytoplasm-based transcription factors that bind a ligand, translate to the nucleus and initiate gene transcription in complex with a co-activator such as TIF2 (transcriptional intermediary factor 2). For structural studies the co-activator is usually mimicked by a peptide of circa 13 residues, which for the largest part forms an α-helix when bound to the receptor. The aim was to co-crystallize the glucocorticoid receptor in complex with a ligand and the TIF2 co-activator peptide. The 1.82 Å resolution diffraction data obtained from the crystal could not be phased by molecular replacement using the known receptor structures. HPLC analysis of the crystals revealed the absence of the receptor and indicated that only the co-activator peptide was present. The self-rotation function displayed 13-fold rotational symmetry, which initiated an exhaustive but unsuccessful molecular-replacement approach using motifs of 13-fold symmetry such as α- and β-barrels in various geometries. The structure was ultimately determined by using a single α-helix and the software ARCIMBOLDO, which assembles fragments placed by PHASER before using them as seeds for density modification model building in SHELXE. Systematic variation of the helix length revealed upper and lower size limits for successful structure determination. A beautiful but unanticipated structure was obtained that forms superhelices with left-handed twist throughout the crystal, stabilized by ligand interactions. Together with the increasing diversity of structural elements in the Protein Data Bank the results from TIF2 confirm the potential of fragment-based molecular replacement to significantly accelerate the phasing step for native diffraction data at around 2 Å resolution. PMID:25866655

  10. Impaired growth, hematopoietic colony formation, and ribosome maturation in human cells depleted of Shwachman-Diamond syndrome protein SBDS.

    PubMed

    Sezgin, Gulay; Henson, Adrianna L; Nihrane, Abdallah; Singh, Sharon; Wattenberg, Max; Alard, Pascale; Ellis, Steven R; Liu, Johnson M

    2013-02-01

    Shwachman-Diamond syndrome (SDS), associated with SBDS mutations, is characterized by pancreatic exocrine dysfunction and marrow failure. Sdo1, the yeast ortholog of SBDS, is implicated in maturation of the 60S ribosomal subunit, with delayed export of 60S-like particles from the nucleoplasm when depleted. Sdo1 is needed for release of the anti-subunit association factor Tif6 from 60S subunits, and Tif6 may not be recycled to the nucleus when Sdo1 is absent. To clarify the role of SBDS in human ribosome function, TF-1 erythroleukemia and A549 lung carcinoma cells were transfected with vectors expressing RNAi against SBDS. Growth and hematopoietic colony forming potential of TF-1 knockdown cells were markedly hindered when compared to controls. To analyze the effect of SBDS on 60S subunit maturation in A549 cells, subunit localization was assessed by transfection with a vector expressing a fusion between human RPL29 and GFP: we found a higher percentage of SBDS-depleted cells with nuclear localization of 60S subunits. Polysome analysis of TF-1 knockdown cells showed a decrease in free 60S and 80S subunits. We also analyzed the levels of eIF6 (human ortholog of Tif6) following near-complete knockdown of SBDS in TF-1 cells and found an approximately 20% increase in the amount of eIF6 associated with the 60S subunit. We conclude that knockdown of SBDS leads to growth inhibition and defects in ribosome maturation, suggesting a role for wild-type SBDS in nuclear export of pre-60S subunits. Furthermore, knockdown of SBDS may interfere with eIF6 recycling. Copyright © 2012 Wiley Periodicals, Inc.

  11. Site-directed photo-cross-linking of rRNA transcription initiation complexes.

    PubMed Central

    Gong, X; Radebaugh, C A; Geiss, G K; Simon, M N; Paule, M R

    1995-01-01

    Site-specific photo-cross-linking of the rRNA committed transcription complex was carried out by using 5-[N-(p-azidobenzoyl)-3-aminoallyl]-dUMP-derivatized promoter DNA. Putative TAFIs of 145, 99, 96, and 91 kDa, as well as TATA-binding protein (TBP), were found to specifically photo-cross-link to different positions along the promoter. These had been identified as potential subunits of the fundamental transcription initiation factor TIF-IB (also known as SL1, factor D, and TFID) from Acanthamoeba castellanii by purification to apparent homogeneity. No other polypeptides attributable to the rRNA architectural transcription factor UBF were identified, suggesting that this protein is not part of the committed complex. Scanning transmission electron microscopy of the complexes was used to estimate the mass of the complex and the contour length of the DNA in the complex. This showed that a single molecule of TIF-IB is in each committed complex and that the DNA is not looped around the protein, as would be expected if UBF were in the complex. A circular permutation analysis of DNA bending resulting from TIF-IB binding revealed a 45 +/- 3.1 degrees (n = 14) bend centered 23 bp upstream of the transcription initiation site. This degree of bending and the position of the bend relative to the site of TBP photo-cross-linking are consistent with earlier data showing that the TBP TATA box-binding domain is not utilized in the assembly of the rRNA committed complex (C. A. Radebaugh, J. L. Mathews, G. K. Geiss, F. Liu, J. Wong, E. Bateman, S. Camier, A. Sentenac, and M. R. Paule, Mol. Cell. Biol. 14:597-605, 1994). PMID:7651413

  12. Site-directed photo-cross-linking of rRNA transcription initiation complexes.

    PubMed

    Gong, X; Radebaugh, C A; Geiss, G K; Simon, M N; Paule, M R

    1995-09-01

    Site-specific photo-cross-linking of the rRNA committed transcription complex was carried out by using 5-[N-(p-azidobenzoyl)-3-aminoallyl]-dUMP-derivatized promoter DNA. Putative TAFIs of 145, 99, 96, and 91 kDa, as well as TATA-binding protein (TBP), were found to specifically photo-cross-link to different positions along the promoter. These had been identified as potential subunits of the fundamental transcription initiation factor TIF-IB (also known as SL1, factor D, and TFID) from Acanthamoeba castellanii by purification to apparent homogeneity. No other polypeptides attributable to the rRNA architectural transcription factor UBF were identified, suggesting that this protein is not part of the committed complex. Scanning transmission electron microscopy of the complexes was used to estimate the mass of the complex and the contour length of the DNA in the complex. This showed that a single molecule of TIF-IB is in each committed complex and that the DNA is not looped around the protein, as would be expected if UBF were in the complex. A circular permutation analysis of DNA bending resulting from TIF-IB binding revealed a 45 +/- 3.1 degrees (n = 14) bend centered 23 bp upstream of the transcription initiation site. This degree of bending and the position of the bend relative to the site of TBP photo-cross-linking are consistent with earlier data showing that the TBP TATA box-binding domain is not utilized in the assembly of the rRNA committed complex (C. A. Radebaugh, J. L. Mathews, G. K. Geiss, F. Liu, J. Wong, E. Bateman, S. Camier, A. Sentenac, and M. R. Paule, Mol. Cell. Biol. 14:597-605, 1994).

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

    PubMed

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

    2014-10-14

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

  14. Insights on Glucocorticoid Receptor Activity Modulation through the Binding of Rigid Steroids

    PubMed Central

    Presman, Diego M.; Alvarez, Lautaro D.; Levi, Valeria; Eduardo, Silvina; Digman, Michelle A.; Martí, Marcelo A.; Veleiro, Adriana S.; Burton, Gerardo; Pecci, Adali

    2010-01-01

    Background The glucocorticoid receptor (GR) is a transcription factor that regulates gene expression in a ligand-dependent fashion. This modular protein is one of the major pharmacological targets due to its involvement in both cause and treatment of many human diseases. Intense efforts have been made to get information about the molecular basis of GR activity. Methodology/Principal Findings Here, the behavior of four GR-ligand complexes with different glucocorticoid and antiglucocorticoid properties were evaluated. The ability of GR-ligand complexes to oligomerize in vivo was analyzed by performing the novel Number and Brightness assay. Results showed that most of GR molecules form homodimers inside the nucleus upon ligand binding. Additionally, in vitro GR-DNA binding analyses suggest that ligand structure modulates GR-DNA interaction dynamics rather than the receptor's ability to bind DNA. On the other hand, by coimmunoprecipitation studies we evaluated the in vivo interaction between the transcriptional intermediary factor 2 (TIF2) coactivator and different GR-ligand complexes. No correlation was found between GR intranuclear distribution, cofactor recruitment and the homodimerization process. Finally, Molecular determinants that support the observed experimental GR LBD-ligand/TIF2 interaction were found by Molecular Dynamics simulation. Conclusions/Significance The data presented here sustain the idea that in vivo GR homodimerization inside the nucleus can be achieved in a DNA-independent fashion, without ruling out a dependent pathway as well. Moreover, since at least one GR-ligand complex is able to induce homodimer formation while preventing TIF2 coactivator interaction, results suggest that these two events might be independent from each other. Finally, 21-hydroxy-6,19-epoxyprogesterone arises as a selective glucocorticoid with potential pharmacological interest. Taking into account that GR homodimerization and cofactor recruitment are considered essential

  15. Distinct localizations and repression activities of MM-1 isoforms toward c-Myc.

    PubMed

    Hagio, Yuko; Kimura, Yumiko; Taira, Takahiro; Fujioka, Yuko; Iguchi-Ariga, Sanae M M; Ariga, Hiroyoshi

    2006-01-01

    MM-1 was identified as a c-Myc-binding protein and has been reported to repress the E-box-dependent transcription activity of c-Myc by recruiting HDAC1 complex via TIF1 beta/KAP1. In this study, originally isolated MM-1 was found to be a fusion protein comprised of the N-terminal 13 amino acids from the sequence of chromosome 14 and of the rest of the amino acids from that of chromosome 12 and was found to be expressed ubiquitously in all human tissues. Four splicing isoforms of MM-1, MM-1alpha, MM-1beta, MM-1gamma, and MM-1delta, which are derived from the sequence of chromosome 12, were then identified. Of these isoforms, MM-1alpha, MM-1gamma, and MM-1delta were found to be expressed in tissue-specific manners and MM-1beta was found to be expressed ubiquitously. Although all of the isoforms potentially possessed c-Myc- and TIF1beta-binding activities, MM-1beta and MM-1delta were found to be mainly localized in the cytoplasm and MM-1alpha and MM-1gamma were found to be localized in the nucleus together with both c-Myc and TIF1beta. Furthermore, when repression activities of MM-1 isoforms toward c-Myc transcription activity were examined by reporter gene assays in HeLa cells, MM-1alpha, MM-1gamma, and MM-1gamma, but not MM-1beta, were found to repress transcription activity of c-Myc, and the degrees of repression by MM-1gamma and MM-1delta were smaller than those by MM-1 and MM-1alpha. These results suggest that each MM-1 isoform distinctly regulates c-Myc transcription activity in respective tissues.

  16. The use of androgen receptor amino/carboxyl-terminal interaction assays to investigate androgen receptor gene mutations in subjects with varying degrees of androgen insensitivity.

    PubMed

    Ghali, Shereen A; Gottlieb, Bruce; Lumbroso, Rose; Beitel, Lenore K; Elhaji, Youssef; Wu, Jian; Pinsky, Leonard; Trifiro, Mark A

    2003-05-01

    Five mutations in the ligand-binding domain (LBD) of the human androgen receptor (hAR) found in patients with varying degrees of androgen insensitivity syndrome (AIS) were investigated for their effects on receptor dynamics. These were Arg(871)Gly (mild), Ser(814)Asn (partial), Glu(772)Ala (partial), Val(866)Met (complete), and Arg(774)Cys (complete). Previous analysis showed that the mutant receptors exhibited near-normal kinetics, except Arg(774)Cys, which had severely reduced androgen binding, and Val(866)Met, which showed increased equilibrium dissociation constant (K(d)) and elevated dissociation rate (k) values. Ser(814)Asn exhibited ligand-selective k values, i.e. increased for dihydrotestosterone and mibolerone, but normal for methyltrenolene. Using mammalian two-hybrid assays, hAR amino/carboxyl (N/C)-terminal interactions of the mutant receptors were analyzed in the presence and absence of the hAR coactivator transcription intermediary factor 2 (TIF2). The mutations conferred decreased hAR N/C-terminal interaction, i.e. mild (approximately 1.5-fold), partial (2-fold), and complete (10-fold), that mirrored the degree of AIS. All mutant LBDs showed a 2- to 3-fold increase in N/C-terminal interactions when TIF2 was cotransfected, although of a magnitude still less than that of wild-type LBD with TIF2. The ligand-selective properties of the Ser(814)Asn mutant were also clearly reflected by the N/C-terminal interactions. Thus, measurement of N/C-terminal interactions may assist in the molecular analysis of mutant hARs associated with AIS.

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Rynaski, E. G.

    1985-01-01

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

  19. Method for the Synthesis of Dibenzo[g,p]Chrysenes: Domino Friedel-Crafts-Type Cyclization of Difluoroethenes Bearing Two Biaryl Groups.

    PubMed

    Suzuki, Naoto; Fujita, Takeshi; Ichikawa, Junji

    2015-10-16

    Dibenzo[g,p]chrysenes were readily synthesized via the superacid- or TiF4-mediated domino Friedel-Crafts-type cyclization of 1,1-difluoroethenes bearing two biaryl groups, which were easily prepared via the Suzuki-Miyaura coupling of 1,1-difluoro-2,2-diiodoethene or 1-(biphenyl-2-yl)-1-bromo-2,2-difluoroethene. Using this approach, the activation of both vinylic and aromatic C-F bonds was successfully achieved to make new C-C bonds.

  20. Autoantibody levels in myositis patients correlate with clinical response during B cell depletion with rituximab.

    PubMed

    Aggarwal, Rohit; Oddis, Chester V; Goudeau, Danielle; Koontz, Diane; Qi, Zengbiao; Reed, Ann M; Ascherman, Dana P; Levesque, Marc C

    2016-06-01

    To determine the longitudinal trends in serum levels of four myositis-associated autoantibodies: anti-Jo-1, -transcription intermediary factor 1 γ (TIF1-γ), -signal recognition particle (SRP) and -Mi-2, after B cell depletion with rituximab, and to determine the longitudinal association of these autoantibody levels with disease activity as measured by myositis core-set measures (CSMs). Treatment-resistant adult and pediatric myositis subjects (n = 200) received rituximab in the 44-week Rituximab in Myositis Trial. CSMs [muscle enzymes, manual muscle testing (MMT), physician and patient global disease activity, HAQ, and extramuscular disease activity] were evaluated monthly and anti-Jo-1 (n = 28), -TIF1-γ (n = 23), -SRP (n = 25) and -Mi-2 (n = 26) serum levels were measured using validated quantitative ELISAs. Temporal trends and the longitudinal relationship between myositis-associated autoantibodies levels and CSM were estimated using linear mixed models. Following rituximab, anti-Jo-1 levels decreased over time (P < 0.001) and strongly correlated with all CSMs (P < 0.008). Anti-TIF1-γ levels also decreased over time (P < 0.001) and were only associated with HAQ, MMT and physician and patient global disease activity. Anti-SRP levels did not change significantly over time, but were significantly associated with serum muscle enzymes. Anti-Mi-2 levels significantly decreased over time and were associated with muscle enzymes, MMT and the physician global score. Anti-Jo-1, anti-TIF1-γ and anti-Mi-2 levels in myositis subjects decreased after B cell depletion and were correlated with changes in disease activity, whereas anti-SRP levels were only associated with longitudinal muscle enzyme levels. The strong association of anti-Jo-1 levels with clinical outcomes suggests that anti-Jo-1 autoantibodies may be a good biomarker for disease activity. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights