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Sample records for previously unknown stricture

  1. Previously unknown species of Aspergillus.

    PubMed

    Gautier, M; Normand, A-C; Ranque, S

    2016-08-01

    The use of multi-locus DNA sequence analysis has led to the description of previously unknown 'cryptic' Aspergillus species, whereas classical morphology-based identification of Aspergillus remains limited to the section or species-complex level. The current literature highlights two main features concerning these 'cryptic' Aspergillus species. First, the prevalence of such species in clinical samples is relatively high compared with emergent filamentous fungal taxa such as Mucorales, Scedosporium or Fusarium. Second, it is clearly important to identify these species in the clinical laboratory because of the high frequency of antifungal drug-resistant isolates of such Aspergillus species. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) has recently been shown to enable the identification of filamentous fungi with an accuracy similar to that of DNA sequence-based methods. As MALDI-TOF MS is well suited to the routine clinical laboratory workflow, it facilitates the identification of these 'cryptic' Aspergillus species at the routine mycology bench. The rapid establishment of enhanced filamentous fungi identification facilities will lead to a better understanding of the epidemiology and clinical importance of these emerging Aspergillus species. Based on routine MALDI-TOF MS-based identification results, we provide original insights into the key interpretation issues of a positive Aspergillus culture from a clinical sample. Which ubiquitous species that are frequently isolated from air samples are rarely involved in human invasive disease? Can both the species and the type of biological sample indicate Aspergillus carriage, colonization or infection in a patient? Highly accurate routine filamentous fungi identification is central to enhance the understanding of these previously unknown Aspergillus species, with a vital impact on further improved patient care.

  2. 1979J2 - Discovery of a previously unknown Jovian satellite

    NASA Technical Reports Server (NTRS)

    Synnott, S. P.

    1980-01-01

    Detailed examination of imaging data of Jupiter taken by Voyager 1 reveals a previously unknown satellite 1979J2. Analysis of the image on the Jovian disk indicates that it is not an atmospheric feature or the shadow of any known satellite. The orbital period is calculated at 16 hours 11 minutes 21.25 seconds + or - 0.5 second and the semimajor axis is 3.1054 Jupiter radii. The observed profile is roughly circular with a diameter of 80 kilometers. An albedo of approximately 0.05 is reported, which is similar to Amalthea's. The geometry of the observational situation is illustrated.

  3. Twelve previously unknown phage genera are ubiquitous in global oceans

    SciTech Connect

    Holmfeldt, Karin; Solonenko, Natalie; Shah, Manesh B; Corrier, Kristen L; Riemann, Lasse; Verberkmoes, Nathan C; Sullivan, Matthew B

    2013-01-01

    Viruses are fundamental to ecosystems ranging from oceans to humans, yet our ability to study them is bottlenecked by the lack of ecologically relevant isolates, resulting in unknowns dominating culture-independent surveys. Here we present genomes from 31 phages infecting multiple strains of the aquatic bacterium Cellulophaga baltica (Bacteroidetes) to provide data for an underrepresented and environmentally abundant bacterial lineage. Comparative genomics delineated 12 phage groups that (i) each represent a new genus, and (ii) represent one novel and four wellknown viral families. This diversity contrasts the few well-studied marine phage systems, but parallels the diversity of phages infecting human-associated bacteria. Although all 12 Cellulophaga phages represent new genera, the podoviruses and icosahedral, nontailed ssDNA phages were exceptional, with genomes up to twice as large as those previously observed for each phage type. Structural novelty was also substantial, requiring experimental phage proteomics to identify 83% of the structural proteins. The presence of uncommon nucleotide metabolism genes in four genera likely underscores the importance of scavenging nutrient-rich molecules as previously seen for phages in marine environments. Metagenomic recruitment analyses suggest that these particular Cellulophaga phages are rare and may represent a first glimpse into the phage side of the rare biosphere. However, these analyses also revealed that these phage genera are widespread, occurring in 94% of 137 investigated metagenomes. Together, this diverse and novel collection of phages identifies a small but ubiquitous fraction of unknown marine viral diversity and provides numerous environmentally relevant phage host systems for experimental hypothesis testing.

  4. Twelve previously unknown phage genera are ubiquitous in global oceans.

    PubMed

    Holmfeldt, Karin; Solonenko, Natalie; Shah, Manesh; Corrier, Kristen; Riemann, Lasse; Verberkmoes, Nathan C; Sullivan, Matthew B

    2013-07-30

    Viruses are fundamental to ecosystems ranging from oceans to humans, yet our ability to study them is bottlenecked by the lack of ecologically relevant isolates, resulting in "unknowns" dominating culture-independent surveys. Here we present genomes from 31 phages infecting multiple strains of the aquatic bacterium Cellulophaga baltica (Bacteroidetes) to provide data for an underrepresented and environmentally abundant bacterial lineage. Comparative genomics delineated 12 phage groups that (i) each represent a new genus, and (ii) represent one novel and four well-known viral families. This diversity contrasts the few well-studied marine phage systems, but parallels the diversity of phages infecting human-associated bacteria. Although all 12 Cellulophaga phages represent new genera, the podoviruses and icosahedral, nontailed ssDNA phages were exceptional, with genomes up to twice as large as those previously observed for each phage type. Structural novelty was also substantial, requiring experimental phage proteomics to identify 83% of the structural proteins. The presence of uncommon nucleotide metabolism genes in four genera likely underscores the importance of scavenging nutrient-rich molecules as previously seen for phages in marine environments. Metagenomic recruitment analyses suggest that these particular Cellulophaga phages are rare and may represent a first glimpse into the phage side of the rare biosphere. However, these analyses also revealed that these phage genera are widespread, occurring in 94% of 137 investigated metagenomes. Together, this diverse and novel collection of phages identifies a small but ubiquitous fraction of unknown marine viral diversity and provides numerous environmentally relevant phage-host systems for experimental hypothesis testing.

  5. Previously unknown class of metalorganic compounds revealed in meteorites.

    PubMed

    Ruf, Alexander; Kanawati, Basem; Hertkorn, Norbert; Yin, Qing-Zhu; Moritz, Franco; Harir, Mourad; Lucio, Marianna; Michalke, Bernhard; Wimpenny, Joshua; Shilobreeva, Svetlana; Bronsky, Basil; Saraykin, Vladimir; Gabelica, Zelimir; Gougeon, Régis D; Quirico, Eric; Ralew, Stefan; Jakubowski, Tomasz; Haack, Henning; Gonsior, Michael; Jenniskens, Peter; Hinman, Nancy W; Schmitt-Kopplin, Philippe

    2017-03-14

    The rich diversity and complexity of organic matter found in meteorites is rapidly expanding our knowledge and understanding of extreme environments from which the early solar system emerged and evolved. Here, we report the discovery of a hitherto unknown chemical class, dihydroxymagnesium carboxylates [(OH)2MgO2CR](-), in meteoritic soluble organic matter. High collision energies, which are required for fragmentation, suggest substantial thermal stability of these Mg-metalorganics (CHOMg compounds). This was corroborated by their higher abundance in thermally processed meteorites. CHOMg compounds were found to be present in a set of 61 meteorites of diverse petrological classes. The appearance of this CHOMg chemical class extends the previously investigated, diverse set of CHNOS molecules. A connection between the evolution of organic compounds and minerals is made, as Mg released from minerals gets trapped into organic compounds. These CHOMg metalorganic compounds and their relation to thermal processing in meteorites might shed new light on our understanding of carbon speciation at a molecular level in meteorite parent bodies.

  6. Previously unknown class of metalorganic compounds revealed in meteorites

    PubMed Central

    Ruf, Alexander; Kanawati, Basem; Hertkorn, Norbert; Yin, Qing-Zhu; Moritz, Franco; Harir, Mourad; Lucio, Marianna; Michalke, Bernhard; Wimpenny, Joshua; Shilobreeva, Svetlana; Bronsky, Basil; Saraykin, Vladimir; Gabelica, Zelimir; Gougeon, Régis D.; Quirico, Eric; Ralew, Stefan; Jakubowski, Tomasz; Haack, Henning; Gonsior, Michael; Jenniskens, Peter; Hinman, Nancy W.; Schmitt-Kopplin, Philippe

    2017-01-01

    The rich diversity and complexity of organic matter found in meteorites is rapidly expanding our knowledge and understanding of extreme environments from which the early solar system emerged and evolved. Here, we report the discovery of a hitherto unknown chemical class, dihydroxymagnesium carboxylates [(OH)2MgO2CR]−, in meteoritic soluble organic matter. High collision energies, which are required for fragmentation, suggest substantial thermal stability of these Mg-metalorganics (CHOMg compounds). This was corroborated by their higher abundance in thermally processed meteorites. CHOMg compounds were found to be present in a set of 61 meteorites of diverse petrological classes. The appearance of this CHOMg chemical class extends the previously investigated, diverse set of CHNOS molecules. A connection between the evolution of organic compounds and minerals is made, as Mg released from minerals gets trapped into organic compounds. These CHOMg metalorganic compounds and their relation to thermal processing in meteorites might shed new light on our understanding of carbon speciation at a molecular level in meteorite parent bodies. PMID:28242686

  7. Triple outlet right ventricle: a previously unknown cardiac malformation.

    PubMed

    Tingo, Jennifer E; Carroll, Sheila J; Crystal, Matthew A

    2015-03-01

    We present the case of an infant with three distinct outflow tracts from the right ventricle. Three outlets from the heart have been previously named the "Tritruncal Heart". We review the two previously reported cases of tritruncal hearts and describe the anatomy, diagnosis, surgical management, and outcome of our case. Embryologic implications are also discussed.

  8. Urethral stricture

    MedlinePlus

    ... and not near the muscles that control the exit from the bladder, the stricture may be cut ... work, a urinary diversion called an appendicovesicostomy (Mitrofanoff procedure) may be done. This lets you drain your ...

  9. A previously unknown reovirus of bat origin is associated with an acute respiratory disease in humans

    PubMed Central

    Chua, Kaw Bing; Crameri, Gary; Hyatt, Alex; Yu, Meng; Tompang, Mohd Rosli; Rosli, Juliana; McEachern, Jennifer; Crameri, Sandra; Kumarasamy, Verasingam; Eaton, Bryan T.; Wang, Lin-Fa

    2007-01-01

    Respiratory infections constitute the most widespread human infectious disease, and a substantial proportion of them are caused by unknown etiological agents. Reoviruses (respiratory enteric orphan viruses) were first isolated from humans in the early 1950s and so named because they were not associated with any known disease. Here, we report a previously unknown reovirus (named “Melaka virus”) isolated from a 39-year-old male patient in Melaka, Malaysia, who was suffering from high fever and acute respiratory disease at the time of virus isolation. Two of his family members developed similar symptoms ≈1 week later and had serological evidence of infection with the same virus. Epidemiological tracing revealed that the family was exposed to a bat in the house ≈1 week before the onset of the father's clinical symptoms. Genome sequence analysis indicated a close genetic relationship between Melaka virus and Pulau virus, a reovirus isolated in 1999 from fruit bats in Tioman Island, Malaysia. Screening of sera collected from human volunteers on the island revealed that 14 of 109 (13%) were positive for both Pulau and Melaka viruses. This is the first report of an orthoreovirus in association with acute human respiratory diseases. Melaka virus is serologically not related to the different types of mammalian reoviruses that were known to infect humans asymptomatically. These data indicate that bat-borne reoviruses can be transmitted to and cause clinical diseases in humans. PMID:17592121

  10. A previously unknown reovirus of bat origin is associated with an acute respiratory disease in humans.

    PubMed

    Chua, Kaw Bing; Crameri, Gary; Hyatt, Alex; Yu, Meng; Tompang, Mohd Rosli; Rosli, Juliana; McEachern, Jennifer; Crameri, Sandra; Kumarasamy, Verasingam; Eaton, Bryan T; Wang, Lin-Fa

    2007-07-03

    Respiratory infections constitute the most widespread human infectious disease, and a substantial proportion of them are caused by unknown etiological agents. Reoviruses (respiratory enteric orphan viruses) were first isolated from humans in the early 1950s and so named because they were not associated with any known disease. Here, we report a previously unknown reovirus (named "Melaka virus") isolated from a 39-year-old male patient in Melaka, Malaysia, who was suffering from high fever and acute respiratory disease at the time of virus isolation. Two of his family members developed similar symptoms approximately 1 week later and had serological evidence of infection with the same virus. Epidemiological tracing revealed that the family was exposed to a bat in the house approximately 1 week before the onset of the father's clinical symptoms. Genome sequence analysis indicated a close genetic relationship between Melaka virus and Pulau virus, a reovirus isolated in 1999 from fruit bats in Tioman Island, Malaysia. Screening of sera collected from human volunteers on the island revealed that 14 of 109 (13%) were positive for both Pulau and Melaka viruses. This is the first report of an orthoreovirus in association with acute human respiratory diseases. Melaka virus is serologically not related to the different types of mammalian reoviruses that were known to infect humans asymptomatically. These data indicate that bat-borne reoviruses can be transmitted to and cause clinical diseases in humans.

  11. Interspecific hybridization transfers a previously unknown glyphosate resistance mechanism in Amaranthus species.

    PubMed

    Gaines, Todd A; Ward, Sarah M; Bukun, Bekir; Preston, Christopher; Leach, Jan E; Westra, Philip

    2012-01-01

    A previously unknown glyphosate resistance mechanism, amplification of the 5-enolpyruvyl shikimate-3-phosphate synthase gene, was recently reported in Amaranthus palmeri. This evolved mechanism could introgress to other weedy Amaranthus species through interspecific hybridization, representing an avenue for acquisition of a novel adaptive trait. The objective of this study was to evaluate the potential for this glyphosate resistance trait to transfer via pollen from A. palmeri to five other weedy Amaranthus species (Amaranthus hybridus, Amaranthus powellii, Amaranthus retroflexus, Amaranthus spinosus, and Amaranthus tuberculatus). Field and greenhouse crosses were conducted using glyphosate-resistant male A. palmeri as pollen donors and the other Amaranthus species as pollen recipients. Hybridization between A. palmeri and A. spinosus occurred with frequencies in the field studies ranging from <0.01% to 0.4%, and 1.4% in greenhouse crosses. A majority of the A. spinosus × A. palmeri hybrids grown to flowering were monoecious and produced viable seed. Hybridization occurred in the field study between A. palmeri and A. tuberculatus (<0.2%), and between A. palmeri and A. hybridus (<0.01%). This is the first documentation of hybridization between A. palmeri and both A. spinosus and A. hybridus.

  12. Interspecific hybridization transfers a previously unknown glyphosate resistance mechanism in Amaranthus species

    PubMed Central

    Gaines, Todd A; Ward, Sarah M; Bukun, Bekir; Preston, Christopher; Leach, Jan E; Westra, Philip

    2012-01-01

    A previously unknown glyphosate resistance mechanism, amplification of the 5-enolpyruvyl shikimate-3-phosphate synthase gene, was recently reported in Amaranthus palmeri. This evolved mechanism could introgress to other weedy Amaranthus species through interspecific hybridization, representing an avenue for acquisition of a novel adaptive trait. The objective of this study was to evaluate the potential for this glyphosate resistance trait to transfer via pollen from A. palmeri to five other weedy Amaranthus species (Amaranthus hybridus, Amaranthus powellii, Amaranthus retroflexus, Amaranthus spinosus, and Amaranthus tuberculatus). Field and greenhouse crosses were conducted using glyphosate-resistant male A. palmeri as pollen donors and the other Amaranthus species as pollen recipients. Hybridization between A. palmeri and A. spinosus occurred with frequencies in the field studies ranging from <0.01% to 0.4%, and 1.4% in greenhouse crosses. A majority of the A. spinosus × A. palmeri hybrids grown to flowering were monoecious and produced viable seed. Hybridization occurred in the field study between A. palmeri and A. tuberculatus (<0.2%), and between A. palmeri and A. hybridus (<0.01%). This is the first documentation of hybridization between A. palmeri and both A. spinosus and A. hybridus. PMID:25568027

  13. Chemical and toxicological investigations of a previously unknown poisonous European mushroom Tricholoma terreum.

    PubMed

    Yin, Xia; Feng, Tao; Shang, Jian-Hua; Zhao, Yun-Li; Wang, Fang; Li, Zheng-Hui; Dong, Ze-Jun; Luo, Xiao-Dong; Liu, Ji-Kai

    2014-06-02

    The established tradition of consuming and marketing wild mushrooms has focused attention on mycotoxicity, which has become a global issue. In the present study, we describe the toxins found in a previously unknown poisonous European mushroom Tricholoma terreum. Fifteen new triterpenoids terreolides A-F (1-6) and saponaceolides H-P (8-16) were isolated from the fruiting bodies of the toxic mushroom T. terreum. Terreolides A-C (1-3) possessed a unique 5/6/7 trioxaspiroketal system, whereas terreolides D-F (4-6) possessed an unprecedented carbon skeleton. Two abundant compounds in the mushroom, saponaceolide B (7) and saponaceolide M (13), displayed acute toxicity, with LD50 values of 88.3 and 63.7 mg kg(-1) when administered orally in mice. Both compounds were found to increase serum creatine kinase levels in mice, indicating that T. terreum may be the cause of mushroom poisoning ultimately leading to rhabdomyolysis.

  14. Factors influencing incidental representation of previously unknown conservation features in marine protected areas.

    PubMed

    Bridge, Tom C L; Grech, Alana M; Pressey, Robert L

    2016-02-01

    Spatially explicit information on species distributions for conservation planning is invariably incomplete; therefore, the use of surrogates is required to represent broad-scale patterns of biodiversity. Despite significant interest in the effectiveness of surrogates for predicting spatial distributions of biodiversity, few researchers have explored questions involving the ability of surrogates to incidentally represent unknown features of conservation interest. We used the Great Barrier Reef marine reserve network to examine factors affecting incidental representation of conservation features that were unknown at the time the reserve network was established. We used spatially explicit information on the distribution of 39 seabed habitats and biological assemblages and the conservation planning software Marxan to examine how incidental representation was affected by the spatial characteristics of the features; the conservation objectives (the minimum proportion of each feature included in no-take areas); the spatial configuration of no-take areas; and the opportunity cost of conservation. Cost was closely and inversely correlated to incidental representation. However, incidental representation was achieved, even in a region with only coarse-scale environmental data, by adopting a precautionary approach that explicitly considered the potential for unknown features. Our results indicate that incidental representation is enhanced by partitioning selection units along biophysical gradients to account for unknown within-feature variability and ensuring that no-take areas are well distributed throughout the region; by setting high conservation objectives that (in this case >33%) maximize the chances of capturing unknown features incidentally; and by carefully considering the designation of cost to planning units when using decision-support tools for reserve design. The lessons learned from incidental representation in the Great Barrier Reef have implications for

  15. Previously unknown and highly divergent ssDNA viruses populate the oceans.

    PubMed

    Labonté, Jessica M; Suttle, Curtis A

    2013-11-01

    Single-stranded DNA (ssDNA) viruses are economically important pathogens of plants and animals, and are widespread in oceans; yet, the diversity and evolutionary relationships among marine ssDNA viruses remain largely unknown. Here we present the results from a metagenomic study of composite samples from temperate (Saanich Inlet, 11 samples; Strait of Georgia, 85 samples) and subtropical (46 samples, Gulf of Mexico) seawater. Most sequences (84%) had no evident similarity to sequenced viruses. In total, 608 putative complete genomes of ssDNA viruses were assembled, almost doubling the number of ssDNA viral genomes in databases. These comprised 129 genetically distinct groups, each represented by at least one complete genome that had no recognizable similarity to each other or to other virus sequences. Given that the seven recognized families of ssDNA viruses have considerable sequence homology within them, this suggests that many of these genetic groups may represent new viral families. Moreover, nearly 70% of the sequences were similar to one of these genomes, indicating that most of the sequences could be assigned to a genetically distinct group. Most sequences fell within 11 well-defined gene groups, each sharing a common gene. Some of these encoded putative replication and coat proteins that had similarity to sequences from viruses infecting eukaryotes, suggesting that these were likely from viruses infecting eukaryotic phytoplankton and zooplankton.

  16. Prediction and accelerated laboratory discovery of previously unknown 18-electron ABX compounds

    NASA Astrophysics Data System (ADS)

    Gautier, Romain; Zhang, Xiuwen; Hu, Linhua; Yu, Liping; Lin, Yuyuan; Sunde, Tor O. L.; Chon, Danbee; Poeppelmeier, Kenneth R.; Zunger, Alex

    2015-04-01

    Chemists and material scientists have often focused on the properties of previously reported compounds, but neglect numerous unreported but chemically plausible compounds that could have interesting properties. For example, the 18-valence electron ABX family of compounds features examples of topological insulators, thermoelectrics and piezoelectrics, but only 83 out of 483 of these possible compounds have been made. Using first-principles thermodynamics we examined the theoretical stability of the 400 unreported members and predict that 54 should be stable. Of those previously unreported ‘missing’ materials now predicted to be stable, 15 were grown in this study; X-ray studies agreed with the predicted crystal structure in all 15 cases. Among the predicted and characterized properties of the missing compounds are potential transparent conductors, thermoelectric materials and topological semimetals. This integrated process—prediction of functionality in unreported compounds followed by laboratory synthesis and characterization—could be a route to the systematic discovery of hitherto missing, realizable functional materials.

  17. A previously unknown zinc finger protein, DST, regulates drought and salt tolerance in rice via stomatal aperture control

    PubMed Central

    Huang, Xin-Yuan; Chao, Dai-Yin; Gao, Ji-Ping; Zhu, Mei-Zhen; Shi, Min; Lin, Hong-Xuan

    2009-01-01

    Abiotic stresses, such as drought and salinity, lead to crop growth damage and a decrease in crop yields. Stomata control CO2 uptake and optimize water use efficiency, thereby playing crucial roles in abiotic stress tolerance. Hydrogen peroxide (H2O2) is an important signal molecule that induces stomatal closure. However, the molecular pathway that regulates the H2O2 level in guard cells remains largely unknown. Here, we clone and characterize DST (drought and salt tolerance)—a previously unknown zinc finger transcription factor that negatively regulates stomatal closure by direct modulation of genes related to H2O2 homeostasis—and identify a novel pathway for the signal transduction of DST-mediated H2O2-induced stomatal closure. Loss of DST function increases stomatal closure and reduces stomatal density, consequently resulting in enhanced drought and salt tolerance in rice. These findings provide an interesting insight into the mechanism of stomata-regulated abiotic stress tolerance, and an important genetic engineering approach for improving abiotic stress tolerance in crops. PMID:19651988

  18. A previously unknown zinc finger protein, DST, regulates drought and salt tolerance in rice via stomatal aperture control.

    PubMed

    Huang, Xin-Yuan; Chao, Dai-Yin; Gao, Ji-Ping; Zhu, Mei-Zhen; Shi, Min; Lin, Hong-Xuan

    2009-08-01

    Abiotic stresses, such as drought and salinity, lead to crop growth damage and a decrease in crop yields. Stomata control CO(2) uptake and optimize water use efficiency, thereby playing crucial roles in abiotic stress tolerance. Hydrogen peroxide (H(2)O(2)) is an important signal molecule that induces stomatal closure. However, the molecular pathway that regulates the H(2)O(2) level in guard cells remains largely unknown. Here, we clone and characterize DST (drought and salt tolerance)-a previously unknown zinc finger transcription factor that negatively regulates stomatal closure by direct modulation of genes related to H(2)O(2) homeostasis-and identify a novel pathway for the signal transduction of DST-mediated H(2)O(2)-induced stomatal closure. Loss of DST function increases stomatal closure and reduces stomatal density, consequently resulting in enhanced drought and salt tolerance in rice. These findings provide an interesting insight into the mechanism of stomata-regulated abiotic stress tolerance, and an important genetic engineering approach for improving abiotic stress tolerance in crops.

  19. Advances in urethral stricture management.

    PubMed

    Gallegos, Maxx A; Santucci, Richard A

    2016-01-01

    Urethral stricture/stenosis is a narrowing of the urethral lumen. These conditions greatly impact the health and quality of life of patients. Management of urethral strictures/stenosis is complex and requires careful evaluation. The treatment options for urethral stricture vary in their success rates. Urethral dilation and internal urethrotomy are the most commonly performed procedures but carry the lowest chance for long-term success (0-9%). Urethroplasty has a much higher chance of success (85-90%) and is considered the gold-standard treatment. The most common urethroplasty techniques are excision and primary anastomosis and graft onlay urethroplasty. Anastomotic urethroplasty and graft urethroplasty have similar long-term success rates, although long-term data have yet to confirm equal efficacy. Anastomotic urethroplasty may have higher rates of sexual dysfunction. Posterior urethral stenosis is typically caused by previous urologic surgery. It is treated endoscopically with radial incisions. The use of mitomycin C may decrease recurrence. An exciting area of research is tissue engineering and scar modulation to augment stricture treatment. These include the use of acellular matrices or tissue-engineered buccal mucosa to produce grafting material for urethroplasty. Other experimental strategies aim to prevent scar formation altogether.

  20. Advances in urethral stricture management

    PubMed Central

    Gallegos, Maxx A.; Santucci, Richard A.

    2016-01-01

    Urethral stricture/stenosis is a narrowing of the urethral lumen. These conditions greatly impact the health and quality of life of patients. Management of urethral strictures/stenosis is complex and requires careful evaluation. The treatment options for urethral stricture vary in their success rates. Urethral dilation and internal urethrotomy are the most commonly performed procedures but carry the lowest chance for long-term success (0–9%). Urethroplasty has a much higher chance of success (85–90%) and is considered the gold-standard treatment. The most common urethroplasty techniques are excision and primary anastomosis and graft onlay urethroplasty. Anastomotic urethroplasty and graft urethroplasty have similar long-term success rates, although long-term data have yet to confirm equal efficacy. Anastomotic urethroplasty may have higher rates of sexual dysfunction. Posterior urethral stenosis is typically caused by previous urologic surgery. It is treated endoscopically with radial incisions. The use of mitomycin C may decrease recurrence. An exciting area of research is tissue engineering and scar modulation to augment stricture treatment. These include the use of acellular matrices or tissue-engineered buccal mucosa to produce grafting material for urethroplasty. Other experimental strategies aim to prevent scar formation altogether. PMID:28105329

  1. Breeding sites and winter site fidelity of Piping Plovers wintering in The Bahamas, a previously unknown major wintering area

    USGS Publications Warehouse

    Gratto-Trevor, Cheri; Haig, Susan M.; Miller, Mark P.; Mullins, Thomas D.; Maddock, Sidney; Roche, Erin A.; Moore, Predensa

    2016-01-01

    Most of the known wintering areas of Piping Plovers (Charadrius melodus) are along the Atlantic and Gulf coasts of the United States and into Mexico, and in the Caribbean. However, 1066 threatened/endangered Piping Plovers were recently found wintering in The Bahamas, an area not previously known to be important for the species. Although representing about 27% of the birds counted during the 2011 International Piping Plover Winter Census, the location of their breeding site(s) was unknown. Thus, our objectives were to determine the location(s) of their breeding site(s) using molecular markers and by tracking banded individuals, identify spring and fall staging sites, and examine site fidelity and survival. We captured and color-banded 57 birds in January and February 2010 in The Bahamas. Blood samples were also collected for genetic evaluation of the likely subspecies wintering in The Bahamas. Band re-sightings and DNA analysis revealed that at least 95% of the Piping Plovers wintering in The Bahamas originated on the Atlantic coast of the United States and Canada. Re-sightings of birds banded in The Bahamas spanned the breeding distribution of the species along the Atlantic coast from Newfoundland to North Carolina. Site fidelity to breeding and wintering sites was high (88–100%). Spring and fall staging sites were located along the Atlantic coast of the United States, with marked birds concentrating in the Carolinas. Our estimate of true survival for the marked birds was 0.71 (95% CI: 0.61–0.80). Our results indicate that more than one third of the Piping Plover population that breeds along the Atlantic coast winters in The Bahamas. By determining the importance of The Bahamas to the Atlantic subspecies of Piping Plovers, future conservation efforts for these populations can be better focused on where they are most needed.

  2. Esophageal stricture - benign

    MedlinePlus

    ... esophagus. These may include household cleaners, lye, disc batteries, or battery acid. Treatment of esophageal varices Symptoms Symptoms may ... Prognosis) The stricture may come back in the future. This would require a repeat dilation. Possible Complications ...

  3. The Epipolythiodiketopiperazine Gene Cluster in Claviceps purpurea: Dysfunctional Cytochrome P450 Enzyme Prevents Formation of the Previously Unknown Clapurines

    PubMed Central

    Tudzynski, Paul; Humpf, Hans-Ulrich

    2016-01-01

    Claviceps purpurea is an important food contaminant and well known for the production of the toxic ergot alkaloids. Apart from that, little is known about its secondary metabolism and not all toxic substances going along with the food contamination with Claviceps are known yet. We explored the metabolite profile of a gene cluster in C. purpurea with a high homology to gene clusters, which are responsible for the formation of epipolythiodiketopiperazine (ETP) toxins in other fungi. By overexpressing the transcription factor, we were able to activate the cluster in the standard C. purpurea strain 20.1. Although all necessary genes for the formation of the characteristic disulfide bridge were expressed in the overexpression mutants, the fungus did not produce any ETPs. Isolation of pathway intermediates showed that the common biosynthetic pathway stops after the first steps. Our results demonstrate that hydroxylation of the diketopiperazine backbone is the critical step during the ETP biosynthesis. Due to a dysfunctional enzyme, the fungus is not able to produce toxic ETPs. Instead, the pathway end-products are new unusual metabolites with a unique nitrogen-sulfur bond. By heterologous expression of the Leptosphaeria maculans cytochrome P450 encoding gene sirC, we were able to identify the end-products of the ETP cluster in C. purpurea. The thioclapurines are so far unknown ETPs, which might contribute to the toxicity of other C. purpurea strains with a potentially intact ETP cluster. PMID:27390873

  4. Esophageal stricture in a cougar (Puma concolor).

    PubMed

    Desmarchelier, Marion; Lair, Stéphane; Defarges, Alice; Lécuyer, Manon; Langlois, Isabelle

    2009-06-01

    A 7-mo-old female cougar (Puma concolor) was presented with a 2-wk history of anorexia and a 1-wk history of regurgitation. Barium contrast esophagogram and gastroesophagoscopy revealed the presence of a segmental intraluminal esophageal stricture in the middle third of the esophagus. The stricture was potentially secondary to a previous anesthetic episode. Three endoscopic balloon dilations allowed increasing the luminal diameter to a size that enabled the cougar to eat food softened with water without any signs of discomfort or regurgitation. Two months after being discharged, the cougar was doing well, had gained weight and was eating horsemeat softened with water.

  5. Transcription of the Streptococcus pyogenes hyaluronic acid capsule biosynthesis operon is regulated by previously unknown upstream elements.

    PubMed

    Falaleeva, Marina; Zurek, Oliwia W; Watkins, Robert L; Reed, Robert W; Ali, Hadeel; Sumby, Paul; Voyich, Jovanka M; Korotkova, Natalia

    2014-12-01

    The important human pathogen Streptococcus pyogenes (group A Streptococcus [GAS]) produces a hyaluronic acid (HA) capsule that plays critical roles in immune evasion. Previous studies showed that the hasABC operon encoding the capsule biosynthesis enzymes is under the control of a single promoter, P1, which is negatively regulated by the two-component regulatory system CovR/S. In this work, we characterize the sequence upstream of P1 and identify a novel regulatory region controlling transcription of the capsule biosynthesis operon in the M1 serotype strain MGAS2221. This region consists of a promoter, P2, which initiates transcription of a novel small RNA, HasS, an intrinsic transcriptional terminator that inefficiently terminates HasS, permitting read-through transcription of hasABC, and a putative promoter which lies upstream of P2. Electrophoretic mobility shift assays, quantitative reverse transcription-PCR, and transcriptional reporter data identified CovR as a negative regulator of P2. We found that the P1 and P2 promoters are completely repressed by CovR, and capsule expression is regulated by the putative promoter upstream of P2. Deletion of hasS or of the terminator eliminates CovR-binding sequences, relieving repression and increasing read-through, hasA transcription, and capsule production. Sequence analysis of 44 GAS genomes revealed a high level of polymorphism in the HasS sequence region. Most of the HasS variations were located in the terminator sequences, suggesting that this region is under strong selective pressure. We discovered that the terminator deletion mutant is highly resistant to neutrophil-mediated killing and is significantly more virulent in a mouse model of GAS invasive disease than the wild-type strain. Together, these results are consistent with the naturally occurring mutations in this region modulating GAS virulence.

  6. A Previously Unknown Oxalyl-CoA Synthetase Is Important for Oxalate Catabolism in Arabidopsis[W

    PubMed Central

    Foster, Justin; Kim, Hyun Uk; Nakata, Paul A.; Browse, John

    2012-01-01

    Oxalate is produced by several catabolic pathways in plants. The best characterized pathway for subsequent oxalate degradation is via oxalate oxidase, but some species, such as Arabidopsis thaliana, have no oxalate oxidase activity. Previously, an alternative pathway was proposed in which oxalyl-CoA synthetase (EC 6.2.1.8) catalyzes the first step, but no gene encoding this function has been found. Here, we identify ACYL-ACTIVATING ENZYME3 (AAE3; At3g48990) from Arabidopsis as a gene encoding oxalyl-CoA synthetase. Recombinant AAE3 protein has high activity against oxalate, with Km = 149.0 ± 12.7 μM and Vmax = 11.4 ± 1.0 μmol/min/mg protein, but no detectable activity against other organic acids tested. Allelic aae3 mutants lacked oxalyl-CoA synthetase activity and were unable to degrade oxalate into CO2. Seeds of mutants accumulated oxalate to levels threefold higher than the wild type, resulting in the formation of oxalate crystals. Crystal formation was associated with seed coat defects and substantially reduced germination of mutant seeds. Leaves of mutants were damaged by exogenous oxalate and more susceptible than the wild type to infection by the fungus Sclerotinia sclerotiorum, which produces oxalate as a phytotoxin to aid infection. Our results demonstrate that, in Arabidopsis, oxalyl-CoA synthetase encoded by AAE3 is required for oxalate degradation, for normal seed development, and for defense against an oxalate-producing fungal pathogen. PMID:22447686

  7. Posterior Urethral Strictures

    PubMed Central

    Gelman, Joel; Wisenbaugh, Eric S.

    2015-01-01

    Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect) after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty. PMID:26691883

  8. Isolation of Novel Afipia septicemium and Identification of Previously Unknown Bacteria Bradyrhizobium sp. OHSU_III from Blood of Patients with Poorly Defined Illnesses

    PubMed Central

    Lo, Shyh-Ching; Hung, Guo-Chiuan; Li, Bingjie; Lei, Haiyan; Li, Tianwei; Nagamine, Kenjiro; Zhang, Jing; Tsai, Shien; Bryant, Richard

    2013-01-01

    Cultures previously set up for isolation of mycoplasmal agents from blood of patients with poorly-defined illnesses, although not yielding positive results, were cryopreserved because of suspicion of having low numbers of unknown microbes living in an inactive state in the broth. We re-initiated a set of 3 cultures for analysis of the "uncultivable" or poorly-grown microbes using NGS technology. Broth of cultures from 3 blood samples, submitted from OHSU between 2000 and 2004, were inoculated into culture flasks containing fresh modified SP4 medium and kept at room temperature (RT), 30°C and 35°C. The cultures showing evidence of microbial growth were expanded and subjected to DNA analysis by genomic sequencing using Illumina MiSeq. Two of the 3 re-initiated blood cultures kept at RT after 7–8 weeks showed evidence of microbial growth that gradually reached into a cell density with detectable turbidity. The microbes in the broth when streaked on SP4 agar plates produced microscopic colonies in ∼ 2 weeks. Genomic studies revealed that the microbes isolated from the 2 blood cultures were a novel Afipia species, tentatively named Afipia septicemium. Microbes in the 3rd culture (OHSU_III) kept at RT had a limited level of growth and could not reach a plateau with high cell density. Genomic sequencing identified the microbe in the culture as a previously unknown species of Bradyrhizobium bacteria. This study reports on the isolation of novel Afipia and Bradyrhizobium species. Isolation of Bradyrhizobium species bacteria has never been reported in humans. The study also reveals a previously unrecognized nature of hematogenous infections by the 2 unique groups of Bradyrhizobiaceae. Our studies show that improvement of culture system plus effective use of NGS technology can facilitate findings of infections by unusual microbes in patients having poorly-defined, sometimes mysterious illnesses. PMID:24155888

  9. Analysis of TETRAKETIDE α-PYRONE REDUCTASE Function in Arabidopsis thaliana Reveals a Previously Unknown, but Conserved, Biochemical Pathway in Sporopollenin Monomer Biosynthesis[C][W

    PubMed Central

    Grienenberger, Etienne; Kim, Sung Soo; Lallemand, Benjamin; Geoffroy, Pierrette; Heintz, Dimitri; Souza, Clarice de Azevedo; Heitz, Thierry; Douglas, Carl J.; Legrand, Michel

    2010-01-01

    The precise structure of the sporopollenin polymer that is the major constituent of exine, the outer pollen wall, remains poorly understood. Recently, characterization of Arabidopsis thaliana genes and corresponding enzymes involved in exine formation has demonstrated the role of fatty acid derivatives as precursors of sporopollenin building units. Fatty acyl-CoA esters synthesized by ACYL-COA SYNTHETASE5 (ACOS5) are condensed with malonyl-CoA by POLYKETIDE SYNTHASE A (PKSA) and PKSB to yield α-pyrone polyketides required for exine formation. Here, we show that two closely related genes encoding oxidoreductases are specifically and transiently expressed in tapetal cells during microspore development in Arabidopsis anthers. Mutants compromised in expression of the reductases displayed a range of pollen exine layer defects, depending on the mutant allele. Phylogenetic studies indicated that the two reductases belong to a large reductase/dehydrogenase gene family and cluster in two distinct clades with putative orthologs from several angiosperm lineages and the moss Physcomitrella patens. Recombinant proteins produced in bacteria reduced the carbonyl function of tetraketide α-pyrone compounds synthesized by PKSA/B, and the proteins were therefore named TETRAKETIDE α-PYRONE REDUCTASE1 (TKPR1) and TKPR2 (previously called DRL1 and CCRL6, respectively). TKPR activities, together with those of ACOS5 and PKSA/B, identify a conserved biosynthetic pathway leading to hydroxylated α-pyrone compounds that were previously unknown to be sporopollenin precursors. PMID:21193572

  10. A previously unknown mechanism in viral pathogenesis leading to effective new vaccines and post-exposure immune treatments of viral infections.

    PubMed

    Bijlenga, G

    2013-08-01

    Investigations with the rabies virus identified a previously unknown mechanism of viral pathogenesis. After ultracentrifugation of a suspension of rabid dog brain and rabies vaccine strains, the supernatant was found to contain active components, as evaluated in an in vitro plaque test. The unexpected detection of active components in non-sedimented material prompted further research and the finding that these components, and not the complete virus, were responsible for paralysis and death. Vaccination of cattle with existing rabies vaccines showed that even low titres of antibodies against these components provided protection after challenge. In a control group of non-vaccinated cows, cows that had low titres of these antibodies survived rabies challenge. These low titres could not be detected with the usual serum neutralization test in mice but only with a plaque reduction test, which is more sensitive. A hyperimmune serum raised in rabbits against active components isolated from the brain of a rabid dog was injected intracerebrally into mice that had been previously injected intramuscularly with a rabies virus. This delayed post-exposure treatment was still effective against advanced rabies (virus already in the brain, but not yet paralytic symptoms). This promising finding makes the development of a new inactivated rabies vaccine possible and opens the way for post-exposure treatment for humans, particularly in developing countries where rabies is still a major problem. The role of these active components in other viral diseases, such as human immunodeficiency virus, should be investigated.

  11. Treatment of colonic anastomotic strictures with 'through the scope' balloon dilators.

    PubMed Central

    Dinneen, M D; Motson, R W

    1991-01-01

    Stricture occurs in 1.2-4.2% of colonic anastomoses. Symptomatic strictures have previously been treated by resection and re-anastomosis and more recently by radiographically guided dilatation by a modified Seldinger technique. This paper describes the endoscopic balloon dilatation of five symptomatic cases and three asymptomatic cases. Eight patients underwent balloon dilatation of colonic anastomotic strictures. Four patients had no symptoms post dilatation and the strictures remained patient on follow-up endoscopy. All the remaining patients required re-dilatation at approximately 2 months. One of these patients underwent dilatation but remained symptomatic, the dilatation was repeated and a colonic perforation occurred at this time. Of the other three, two continue to be followed up, and are well and one patient died of disseminated malignancy. Balloon dilatation with 'through the scope' dilators is a simpler technique than radiologically guided dilatation. These early results suggest that endoscopic dilatation may avoid further surgery in some patients with anastomotic stricture. PMID:2041001

  12. Single stage: dorsolateral onlay buccal mucosal urethroplasty for long anterior urethral strictures using perineal route

    PubMed Central

    Prabha, Vikram; Devaraju, Shishir; Vernekar, Ritesh; Hiremath, Murigendra

    2016-01-01

    ABSTRACT Objective To assess the outcome of single stage dorsolateral onlay buccal mucosal urethroplasty for long anterior urethral strictures (>4cm long) using a perineal incision. Materials and Methods From August 2010 to August 2013, 20 patients underwent BMG urethroplasty. The cause of stricture was Lichen sclerosis in 12 cases (60%), Instrumentation in 5 cases (25%), and unknown in 3 cases (15%). Strictures were approached through a perineal skin incision and penis was invaginated into it to access the entire urethra. All the grafts were placed dorsolaterally, preserving the bulbospongiosus muscle, central tendon of perineum and one-sided attachement of corpus spongiosum. Procedure was considered to be failure if the patient required instrumentation postoperatively. Results Mean stricture length was 8.5cm (range 4 to 12cm). Mean follow-up was 22.7 months (range 12 to 36 months). Overall success rate was 85%. There were 3 failures (meatal stenosis in 1, proximal stricture in 1 and whole length recurrent stricture in 1). Other complications included wound infection, urethrocutaneous fistula, brownish discharge per urethra and scrotal oedema. Conclusion Dorsolateral buccal mucosal urethroplasty for long anterior urethral strictures using a single perineal incision is simple, safe and easily reproducible by urologists with a good outcome. PMID:27286122

  13. Serum Proteome Profiles in Stricturing Crohn’s Disease: A pilot study.

    SciTech Connect

    Townsend, Peter; Zhang, Qibin; Shapiro, Jason; Webb-Robertson, Bobbie-Jo M.; Bramer, Lisa M.; Schepmoes, Athena A.; Weitz, Karl K.; Mallette, Meaghan; Moniz, Heather; Bright, Renee; Merrick, Marjorie; Shah, Samir A.; Sands, Bruce E.; Leleiko, Neal

    2015-08-01

    Background: Crohn’s disease (CD) is a form of inflammatory bowel disease (IBD) with different described behaviors, including stricture. At present, there are no laboratory studies that can differentiate stricturing CD from other phenotypes of IBD. We performed a pilot study to examine differences in the proteome among patients with stricturing Crohn’s disease, non-stricturing Crohn’s disease, and ulcerative colitis (UC). Methods: Serum samples were selected from the Ocean State Crohn’s and Colitis Area Registry (OSCCAR), an established cohort of patients with IBD. Crohn’s disease patients with surgically-resected stricture were matched with similar patients with Crohn’s disease without known stricture, and with UC. Serum samples from each patient were digested and analyzed using liquid chromatography-mass spectrometry to characterize the proteome. Statistical analyses were performed to identify peptides and proteins that can differentiate CD with stricture. Results: Samples from 9 patients in each group (27 total patients) were analyzed. Baseline demographic characteristics were similar among the three groups. We quantified 7668 peptides and 897 proteins for analysis. ROC analysis identified a subset of peptides with an area under the curve greater than 0.9, indicating greater separation potential. Partial least squares discriminant analysis was able to distinguish among the three groups with up to 70% accuracy by peptides, and up to 80% accuracy by proteins. We identified the significantly different proteins and peptides, and determined their function based on previously published literature. Conclusions: The serum of patients with stricturing CD, non-stricturing CD, and UC are distinguishable via proteomic analysis. Some of the proteins that differentiate the stricturing phenotype have been implicated in complement activation, fibrinolytic pathways, and lymphocyte adhesion.

  14. A Previously Unknown Path to Corpuscularism in the Seventeenth Century: Santorio's Marginalia to the Commentaria in Primam Fen Primi Libri Canonis Avicennae (1625).

    PubMed

    Bigotti, Fabrizio

    2017-03-28

    This paper presents some of Santorio's marginalia to his Commentaria in primam fen primi libri Canonis Avicennae (Venice, 1625), which I identified in the Sloane Collection of the British Library in 2016, as well as the evidence for their authorship. The name of the Venetian physician Santorio Santori (1561-1636) is linked with the introduction of quantification in medicine and with the invention of precision instruments that, displayed for the first time in this work, laid down the foundations for what we today understand as evidence-based medicine. But Santorio's monumentale opus also contains evidence of many quantified experiments and displays his ideas on mixtures, structure of matter and corpuscles, which are in many cases clarified and completed by the new marginalia. These ideas testify to an early interest in chemistry within the Medical School of Padua which predates both Galileo and Sennert and which has hitherto been unknown.

  15. Treatment of Radiation-Induced Urethral Strictures.

    PubMed

    Hofer, Matthias D; Liu, Joceline S; Morey, Allen F

    2017-02-01

    Radiation therapy may result in urethral strictures from vascular damage. Most radiation-induced urethral strictures occur in the bulbomembranous junction, and urinary incontinence may result as a consequence of treatment. Radiation therapy may compromise reconstruction due to poor tissue healing and radionecrosis. Excision and primary anastomosis is the preferred urethroplasty technique for radiation-induced urethral stricture. Principles of posterior urethroplasty for trauma may be applied to the treatment of radiation-induced urethral strictures. Chronic management with suprapubic tube is an option based on patient comorbidities and preference.

  16. Hybrid therapy with locoregional steroid injection and polyglycolic acid sheets to prevent stricture after esophageal endoscopic submucosal dissection

    PubMed Central

    Nagami, Yasuaki; Shiba, Masatsugu; Tominaga, Kazunari; Ominami, Masaki; Fukunaga, Shusei; Sugimori, Satoshi; Tanaka, Fumio; Kamata, Noriko; Tanigawa, Tetsuya; Yamagami, Hirokazu; Watanabe, Toshio; Fujiwara, Yasuhiro; Arakawa, Tetsuo

    2016-01-01

    Background and study aim: The incidence of stricture formation caused by endoscopic submucosal dissection (ESD) for widespread lesions is high, and stricture formation can reduce quality of life. We evaluated the prophylactic efficacy of hybrid therapy using a locoregional steroid injection and polyglycolic acid (PGA) sheets with fibrin glue to prevent stricture formation after esophageal ESD in high risk patients in whom we predicted stricture formation would be difficult to prevent with a single prophylactic steroid injection. Methods: Ten patients who underwent esophageal ESD were enrolled (entire-circumference: n = 6; sub-circumference, more than 5/6 of the circumference: n = 4). A single locoregional steroid injection and PGA sheets with fibrin glue were used after ESD. We evaluated the incidence of stricture formation, the number of endoscopic balloon dilation (EBD) procedures needed to treat the stricture formation, and adverse events of the therapy. Results: Esophageal stricture formation occurred in 50.0 % of patients (5/10) (median EBD sessions 0.5, range 0 – 16). Subanalysis showed that stricture formation occurred in 37.5 % of patients (3/8) excluded the lesions located near a previous scar from ESD or surgical anastomosis site (median EBD sessions 0, range 0 – 4). Conclusion: Hybrid therapy using a locoregional steroid injection and PGA sheets with fibrin glue may have the potential to prevent esophageal stricture formation after esophageal ESD in high risk patients. PMID:27652294

  17. A New Species of Pengornithidae (Aves: Enantiornithes) from the Lower Cretaceous of China Suggests a Specialized Scansorial Habitat Previously Unknown in Early Birds

    PubMed Central

    Hu, Han; O’Connor, Jingmai K.; Zhou, Zhonghe

    2015-01-01

    We describe a new enantiornithine bird, Parapengornis eurycaudatus gen. et sp. nov. from the Lower Cretaceous Jiufotang Formation of Liaoning, China. Although morphologically similar to previously described pengornithids Pengornis houi, Pengornis IVPP V18632, and Eopengornis martini, morphological differences indicate it represents a new taxon of the Pengornithidae. Based on new information from this specimen we reassign IVPP V18632 to Parapengornis sp. The well preserved pygostyle of the new specimen elucidates the morphology of this element for the clade, which is unique in pengornithids among Mesozoic birds. Similarities with modern scansores such as woodpeckers may indicate a specialized vertical climbing and clinging behavior that has not previously been inferred for early birds. The new specimen preserves a pair of fully pennaceous rachis-dominated feathers like those in the holotype of Eopengornis martini; together with the unique morphology of the pygostyle, this discovery lends evidence to early hypotheses that rachis-dominated feathers may have had a functional significance. This discovery adds to the diversity of ecological niches occupied by enantiornithines and if correct reveals are remarkable amount of locomotive differentiation among Enantiornithes. PMID:26039693

  18. A new species of pengornithidae (aves: enantiornithes) from the lower cretaceous of China suggests a specialized scansorial habitat previously unknown in early birds.

    PubMed

    Hu, Han; O'Connor, Jingmai K; Zhou, Zhonghe

    2015-01-01

    We describe a new enantiornithine bird, Parapengornis eurycaudatus gen. et sp. nov. from the Lower Cretaceous Jiufotang Formation of Liaoning, China. Although morphologically similar to previously described pengornithids Pengornis houi, Pengornis IVPP V18632, and Eopengornis martini, morphological differences indicate it represents a new taxon of the Pengornithidae. Based on new information from this specimen we reassign IVPP V18632 to Parapengornis sp. The well preserved pygostyle of the new specimen elucidates the morphology of this element for the clade, which is unique in pengornithids among Mesozoic birds. Similarities with modern scansores such as woodpeckers may indicate a specialized vertical climbing and clinging behavior that has not previously been inferred for early birds. The new specimen preserves a pair of fully pennaceous rachis-dominated feathers like those in the holotype of Eopengornis martini; together with the unique morphology of the pygostyle, this discovery lends evidence to early hypotheses that rachis-dominated feathers may have had a functional significance. This discovery adds to the diversity of ecological niches occupied by enantiornithines and if correct reveals are remarkable amount of locomotive differentiation among Enantiornithes.

  19. Aluminum phosphide-induced esophageal strictures: a new cause of benign esophageal strictures.

    PubMed

    Misra, Sri Prakash; Dwivedi, Manisha

    2009-01-01

    Fifteen consecutive patients presenting with dysphagia due to aluminum phosphide (AP)-induced esophageal strictures were studied retrospectively to elucidate the natural history of AP-induced esophageal strictures and to evaluate the efficacy of bougie dilation. The median time lag between consumption of AP and occurrence of dysphagia was 3 weeks. All patients had a single stricture and could be dilated using a bougie dilator. Thirteen patients were relieved of dysphagia on a mean (SD) follow-up of 18 (7.3) months. Two patients had recalcitrant strictures and needed needle-knife incision of the stricture followed by balloon dilation. The strictures opened up well in both the patients and they were relieved of dysphagia. AP-induced esophageal stricture is a new cause of benign esophageal stricture. Most patients present with dysphagia around 3 weeks after consumption of AP tablets. A single esophageal stricture is found in these patients. Most strictures respond very well to bougie dilation. However, some of the strictures may be recalcitrant and may require needle-knife incision and balloon dilation.

  20. Searching for 'Unknown Unknowns'

    NASA Technical Reports Server (NTRS)

    Parsons, Vickie S.

    2005-01-01

    The NASA Engineering and Safety Center (NESC) was established to improve safety through engineering excellence within NASA programs and projects. As part of this goal, methods are being investigated to enable the NESC to become proactive in identifying areas that may be precursors to future problems. The goal is to find unknown indicators of future problems, not to duplicate the program-specific trending efforts. The data that is critical for detecting these indicators exist in a plethora of dissimilar non-conformance and other databases (without a common format or taxonomy). In fact, much of the data is unstructured text. However, one common database is not required if the right standards and electronic tools are employed. Electronic data mining is a particularly promising tool for this effort into unsupervised learning of common factors. This work in progress began with a systematic evaluation of available data mining software packages, based on documented decision techniques using weighted criteria. The four packages, which were perceived to have the most promise for NASA applications, are being benchmarked and evaluated by independent contractors. Preliminary recommendations for "best practices" in data mining and trending are provided. Final results and recommendations should be available in the Fall 2005. This critical first step in identifying "unknown unknowns" before they become problems is applicable to any set of engineering or programmatic data.

  1. Common controversies in management of biliary strictures

    PubMed Central

    Parsi, Mansour A

    2017-01-01

    Biliary strictures are caused by a heterogeneous group of benign and malignant conditions, each requiring a specific treatment approach. Management of biliary strictures often involves endoscopy either for definite treatment, as a bridge to surgery or for palliative purposes. Endoscopic treatment of various types of biliary strictures is not standardized and there are multiple areas of controversy regarding the best treatment options. These controversies are mainly due to lack of well-designed comparative studies to support a specific therapy. This paper reviews three common areas of controversy in the endoscopic management of biliary strictures. The areas discussed in this editorial include the role of biliary drainage in resectable malignant strictures and whether such drainage should be performed routinely prior to surgery, the best endoscopic palliation for unresectable hilar strictures and whether unilateral or bilateral stenting should be attempted, and the optimal endoscopic management for dominant strictures in patients with primary sclerosing cholangitis. The goal of this editorial is twofold. The first is to review the current literature on management of the aforementioned strictures and offer recommendations based on available evidence. The second goal is to highlight the gaps in our knowledge which in turn can encourage future research on these topics. PMID:28275292

  2. Management of Benign Biliary Strictures

    SciTech Connect

    Laasch, Hans-Ulrich; Martin, Derrick F.

    2002-12-15

    Benign biliary strictures are most commonly a consequence of injury at laparoscopic cholecystectomy or fibrosis after biliary-enteric anastomosis. These strictures are notoriously difficult to treat and traditionally are managed by resection and fashioning of acholedocho- or hepato-jejunostomy. Promising results are being achieved with newer minimally invasive techniques using endoscopic or percutaneous dilatation and/or stenting and these are likely to play an increasing role in the management. Even low-grade biliary obstruction carries the risks of stone formation, ascending cholangitis and hepatic cirrhosis and it is important to identify and treat this group of patients. There is currently no consensus on which patient should have what type of procedure, and the full range of techniques may not be available in all hospitals. Careful assessment of the risks and likely benefits have to be made on an individual basis. This article reviews the current literature and discusses the options available. The techniques of endoscopic and percutaneous dilatation and stenting are described with evaluation of the likely success and complication rates and compared to the gold standard of biliary-enteric anastomosis.

  3. Percutaneous management of postoperative anastomotic biliary strictures.

    PubMed

    Saad, Wael E A

    2008-06-01

    Postoperative anastomotic biliary strictures can occur after surgery in bile ducts belonging to transplanted or native (nontransplanted) livers. The majority of postoperative anastomotic strictures encountered by interventional radiologists are most likely in liver transplant recipients due to the large and growing liver transplant recipient population worldwide compared with patients with native livers and biliary enteric anastomoses. They occur after 2.5 to 13% of liver transplantations and they represent at least one-half of biliary strictures encountered after liver transplantation. Anastomotic biliary strictures are considered technical in nature, accentuated by fibrosis and scarring that may be secondary to, if not exacerbated by, graft ischemia. There are numerous variables in the percutaneous transhepatic balloon dilation protocols applied to treat anastomotic biliary strictures. These include (1) types of balloons, (2) how long balloons are inflated, (3) how frequently patients return for additional dilation sessions, and (4) the interval(s) at which they return. No alteration in these variables has proven to improve long-term patency. In addition, new technology such as cutting balloons and stents has not been fully evaluated to determine their effect on long-term patency. The current article describes the overall theme of balloon dilation protocols for the management of anastomotic biliary strictures and discusses possible future management of such strictures.

  4. Management of Long-Segment and Panurethral Stricture Disease

    PubMed Central

    Martins, Francisco E.; Kulkarni, Sanjay B.; Joshi, Pankaj; Warner, Jonathan; Martins, Natalia

    2015-01-01

    Long-segment urethral stricture or panurethral stricture disease, involving the different anatomic segments of anterior urethra, is a relatively less common lesion of the anterior urethra compared to bulbar stricture. However, it is a particularly difficult surgical challenge for the reconstructive urologist. The etiology varies according to age and geographic location, lichen sclerosus being the most prevalent in some regions of the globe. Other common and significant causes are previous endoscopic urethral manipulations (urethral catheterization, cystourethroscopy, and transurethral resection), previous urethral surgery, trauma, inflammation, and idiopathic. The iatrogenic causes are the most predominant in the Western or industrialized countries, and lichen sclerosus is the most common in India. Several surgical procedures and their modifications, including those performed in one or more stages and with the use of adjunct tissue transfer maneuvers, have been developed and used worldwide, with varying long-term success. A one-stage, minimally invasive technique approached through a single perineal incision has gained widespread popularity for its effectiveness and reproducibility. Nonetheless, for a successful result, the reconstructive urologist should be experienced and familiar with the different treatment modalities currently available and select the best procedure for the individual patient. PMID:26779259

  5. Dilation of benign strictures in the esophagus and colon with the polyflex stent: a case series study.

    PubMed

    García-Cano, Jesús

    2008-02-01

    Polyflex, a new self-expanding plastic stent (SEPS), is increasingly used to treat obstructions in the gastrointestinal tract. The majority of reports on Polyflex come from tertiary referral centers. This retrospective study describes the efficacy and safety of this new SEPS for the treatment of benign strictures in esophagus and colon and its use in a community hospital. Seven patients were treated from August 2003 through December 2006. All of them presented with severe strictures, and were treated with Polyflex insertion. Four patients had esophageal obstructions (three peptic, one postoperative) and the remaining three patients had postoperative strictures in the rectosigmoid. One patient had a coexisting fistula. Two strictures (one esophageal and another colonic, both postoperative) received the Polyflex as the first line of treatment, without previous sessions of dilation. Esophageal strictures were solved after several consecutive SEPS insertions. Migrated stents were easily extracted from the stomach. On the other hand, colonic strictures achieved permanent dilation with a single stent. The patient with coexisting stricture and fistula became asymptomatic and still had the SEPS in place after four months. The one complication was mild pain after insertion. Polyflex seems to be a useful tool in the dilation of severe benign strictures in esophagus and rectosigmoid and, as in large centers, good results are achieved in a community hospital.

  6. Ileocecocolic strictures in two captive cheetahs (Acinonyx jubatus jubatus).

    PubMed

    Travis, Erika K; Duncan, Mary; Weber, Martha; Adkesson, Michael J; Junge, Randall E

    2007-12-01

    Intestinal strictures were diagnosed in two captive cheetahs (Acinonyx jubatus jubatus). The cheetahs presented with lethargy, anorexia, diarrhea, and weight loss. The first cheetah had a stricture of the ileocecocolic junction diagnosed at necropsy. The second had an ileocecocolic stricture causing obstruction that was diagnosed at surgery. After resection and anastomosis, the cheetah recovered well. The etiology of the strictures remains undetermined. Intestinal stricture, particularly of the ileocecocolic junction, should be considered as a differential diagnosis for cheetahs with nonspecific gastrointestinal signs.

  7. Eosinophilic esophagitis: strictures, impactions, dysphagia.

    PubMed

    Khan, Seema; Orenstein, Susan R; Di Lorenzo, Carlo; Kocoshis, Samuel A; Putnam, Philip E; Sigurdsson, Luther; Shalaby, Theresa M

    2003-01-01

    Eosinophilic esophagitis, long known to be a feature of acid reflux, has recently been described in patients with food allergies and macroscopically furrowed esophagus. The pathophysiology and optimal management of patients with eosinophilic esophagitis is unclear. We describe our clinical experience related to eosinophilic esophagitis and obstructive symptoms in children and propose etiopathogenesis and management guidelines. Twelve children with obstructive esophageal symptoms (11 male), median age 5 years, and identified to have eosinophilic esophagitis with > 5 eosinophils per high-power field (eos/hpf) are reported. Of these, four had strictures, six had impactions, and two had only dysphagia. A diagnostic evaluation included esophagogastroduodenoscopy with biopsies in all and upper gastrointestinal series, IgE, radioallergosorbent tests, and skin tests for food allergies in some cases. Esophageal histology specimens were independently analyzed for eosinophil density by two authors. Four of five children with > 20 eos/hpf responded to elimination diets/steroids. The fifth child responded to a fundoplication. Seven children had 5-20 eos/hpf and three of them with no known food allergies responded to antireflux therapy alone. Three others in this group with positive food allergies responded to treatment with elimination diets and/or steroids. The seventh patient in this group was lost to follow-up. In conclusion, on the basis of response to therapy, eosinophilic esophagitis can be subdivided into two groups: those with likely gastroesophageal reflux disease if < 20 eos/hpf and no food allergies, and others with allergic eosinophilic esophagitis associated with food allergies and often with > 20 eos/hpf.

  8. Current management of urethral stricture disease

    PubMed Central

    Smith, Thomas G.

    2016-01-01

    Introduction: Broadly defined, urethral strictures are narrowing of the urethral lumen that is surrounded by corpus spongiosum, i.e., urethral meatus through the bulbar urethra. Urethral stenosis is narrowing of the posterior urethra, i.e., membranous urethra through bladder neck/prostate junction, which is not enveloped by corpus spongiosum. The disease has significant quality of life ramifications because many times younger patients are affected by this compared to many other urological diseases. Methods: A review of the scientific literature concerning urethral stricture, stenosis, treatment, and outcomes was performed using Medline and PubMed (U.S. National Library of Medicine and the National Institutes of Health). Abstracts from scientific meetings were included in this review. Results: There is level 3 evidence regarding the etiology and epidemiology of urethral strictures, stenoses, and pelvic fracture urethral injuries. Outcomes data from literature regarding intervention for urethral stricture are largely limited to level 3 evidence and expert opinion. There is a single level 1 study comparing urethral dilation and direct vision internal urethrotomy. Urethroplasty outcomes data are limited to level 3 case series. Conclusions: Progress is being made toward consistent terminology, and nomenclature which will, in turn, help to standardize treatment within the field of urology. Treatment for urethral stricture and stenosis remains inconsistent between reconstructive and nonreconstructive urologists due to varying treatment algorithms and approaches to disease management. Tissue engineering appears to be future for reconstructive urethral surgery with reports demonstrating feasibility in the use of different tissue substitutes and grafts. PMID:26941491

  9. Biliary strictures: endoscopic assessment and management

    PubMed Central

    Paranandi, Bharat; Oppong, Kofi W

    2017-01-01

    The diagnosis of biliary strictures can be challenging. Endoscopy has an established role in the diagnosis and therapy of biliary strictures. However, the diagnostic yield from conventional endoscopic retrograde cholangiopancreatography tissue sampling is modest. Improvements in existing technologies as well as the implementation of novel technologies and techniques have the potential to improve the diagnostic performance of endoscopy and expand its therapeutic role. Recent studies have enabled greater clarity about the role of preoperative biliary drainage and the choice of stents in this setting as well as the utility of metal stents in benign and malignant disease. PMID:28261440

  10. Early Experience with Hyaluronic Acid Instillation to Assist with Visual Internal Urethrotomy for Urethral Stricture

    PubMed Central

    Kim, Hak Min; Kang, Dong Il; Shim, Bong Suk

    2010-01-01

    Purpose The clinical usefulness of hyaluronic acid (HA) instillation during visual internal urethrotomy (VIU) for decreasing the incidence of recurrent urethral stricture was assessed. Materials and Methods Twenty-eight patients were treated by VIU with HA instillation between May 2007 and June 2009. After insertion of a Foley catheter following urethrotomy, HA was instilled via an 18-gauge tube catheter between the urethral lumen and Foley catheter. Seventeen cases were analyzed retrospectively 12 months postoperatively. We evaluated the success rate of this procedure by comparing retrograde urethrography (RGU) results, maximum flow rates, and postvoid residual urine volumes preoperatively and 3 and 12 months postoperatively. Success was defined as either a maximum flow rate of at least 15 ml/s or no visible urethral stricture on RGU at 12 months postoperatively. Results Total success rates were 76.5% (13/17) and 52.9% (9/17) at 3 and 12 months postoperatively, respectively. By etiology, success rates at 3 and 12 months postoperatively, respectively, were 66.7% and 33.3% for inflammation, 66.7% and 50.0% for trauma, and 83.3% and 66.7% for unknown causes. Success rates were 63.6% for strictures less than 10 mm in length and 33.3% for strictures of 10 mm or more in length at 12 months postoperatively. Success rates were 61.5% for single strictures and 25% for multiple strictures at 12 months postoperatively. Conclusions The success rate of VIU with HA instillation was not better than that observed in the literature for conventional VIU. PMID:21221206

  11. Severe endobronchitis and airway stricture caused by inhalation of cosmetic talc.

    PubMed

    Ong, Thun How; Takano, Angela

    2012-08-01

    Pulmonary disease caused by talc is well described, but previous reports mainly describe lung parenchymal involvement. We describe what is, to our knowledge, the first case in which inhalation of cosmetic talc led to intense endobronchitis and airway stricture. A 70-year-old woman presented with new-onset wheezing and was found to have right upper lobe collapse on chest radiography. CT imaging of the thorax showed right upper lobe collapse with occlusion of the right upper lobe. Bronchoscopy showed severe endobronchitis with thickened mucosa throughout the right and left main stem bronchi and a fibrotic stricture occluding the right upper lobe. Bronchial biopsy specimens showed foreign-body granulomatosis encasing birefringent crystalline material. Spectral analysis confirmed the crystals to be consistent with cosmetic talc used by the patient. We hypothesize that the patient inhaled a large amount of talc, which was trapped in the larger airways and resulted in intense foreign-body granulomatosis, leading to an airway stricture.

  12. The glucose breath test: a diagnostic test for small bowel stricture(s) in Crohn's disease.

    PubMed

    Mishkin, Daniel; Boston, Francis M; Blank, David; Yalovsky, Morty; Mishkin, Seymour

    2002-03-01

    The aim of this study was to determine whether an indirect noninvasive indicator of proximal bacterial overgrowth, the glucose breath test, was of diagnostic value in inflammatory bowel disease. Twenty four of 71 Crohn's disease patients tested had a positive glucose breath test. No statistical conclusions could be drawn between the Crohn's disease activity index and glucose breath test status. Of patients with radiologic evidence of small bowel stricture(s), 96.0% had a positive glucose breath test, while only one of 46 negative glucose breath test patients had a stricture. The positive and negative predictive values for a positive glucose breath test as an indicator of stricture formation were 96.0% and 97.8%, respectively. This correlation was not altered in Crohn's disease patients with fistulae or status postresection of the terminal ileum. The data in ulcerative colitis were nondiagnostic. In conclusion, the glucose breath test appears to be an accurate noninvasive inexpensive diagnostic test for small bowel stricture(s) and secondary bacterial overgrowth in Crohn's disease.

  13. Evaluation and management of anterior urethral stricture disease

    PubMed Central

    Mangera, Altaf; Osman, Nadir; Chapple, Christopher

    2016-01-01

    Urethral stricture disease affects many men worldwide. Traditionally, the investigation of choice has been urethrography and the management of choice has been urethrotomy/dilatation. In this review, we discuss the evidence behind the use of ultrasonography in stricture assessment. We also discuss the factors a surgeon should consider when deciding the management options with each individual patient. Not all strictures are identical and surgeons should appreciate the poor long-term results of urethrotomy/dilatation for strictures longer than 2 cm, strictures in the penile urethra, recurrent strictures, and strictures secondary to lichen sclerosus. These patients may benefit from primary urethroplasty if they have many adverse features or secondary urethroplasty after the first recurrence. PMID:26918169

  14. Histone H1 Variants in Arabidopsis Are Subject to Numerous Post-Translational Modifications, Both Conserved and Previously Unknown in Histones, Suggesting Complex Functions of H1 in Plants

    PubMed Central

    Kotliński, Maciej; Rutowicz, Kinga; Kniżewski, Łukasz; Palusiński, Antoni; Olędzki, Jacek; Fogtman, Anna; Rubel, Tymon; Koblowska, Marta; Dadlez, Michał; Ginalski, Krzysztof; Jerzmanowski, Andrzej

    2016-01-01

    Linker histones (H1s) are conserved and ubiquitous structural components of eukaryotic chromatin. Multiple non-allelic variants of H1, which differ in their DNA/nucleosome binding properties, co-exist in animal and plant cells and have been implicated in the control of genetic programs during development and differentiation. Studies in mammals and Drosophila have revealed diverse post-translational modifications of H1s, most of which are of unknown function. So far, it is not known how this pattern compares with that of H1s from other major lineages of multicellular Eukaryotes. Here, we show that the two main H1variants of a model flowering plant Arabidopsis thaliana are subject to a rich and diverse array of post-translational modifications. The distribution of these modifications in the H1 molecule, especially in its globular domain (GH1), resembles that occurring in mammalian H1s, suggesting that their functional significance is likely to be conserved. While the majority of modifications detected in Arabidopsis H1s, including phosphorylation, acetylation, mono- and dimethylation, formylation, crotonylation and propionylation, have also been reported in H1s of other species, some others have not been previously identified in histones. PMID:26820416

  15. Histone H1 Variants in Arabidopsis Are Subject to Numerous Post-Translational Modifications, Both Conserved and Previously Unknown in Histones, Suggesting Complex Functions of H1 in Plants.

    PubMed

    Kotliński, Maciej; Rutowicz, Kinga; Kniżewski, Łukasz; Palusiński, Antoni; Olędzki, Jacek; Fogtman, Anna; Rubel, Tymon; Koblowska, Marta; Dadlez, Michał; Ginalski, Krzysztof; Jerzmanowski, Andrzej

    2016-01-01

    Linker histones (H1s) are conserved and ubiquitous structural components of eukaryotic chromatin. Multiple non-allelic variants of H1, which differ in their DNA/nucleosome binding properties, co-exist in animal and plant cells and have been implicated in the control of genetic programs during development and differentiation. Studies in mammals and Drosophila have revealed diverse post-translational modifications of H1s, most of which are of unknown function. So far, it is not known how this pattern compares with that of H1s from other major lineages of multicellular Eukaryotes. Here, we show that the two main H1variants of a model flowering plant Arabidopsis thaliana are subject to a rich and diverse array of post-translational modifications. The distribution of these modifications in the H1 molecule, especially in its globular domain (GH1), resembles that occurring in mammalian H1s, suggesting that their functional significance is likely to be conserved. While the majority of modifications detected in Arabidopsis H1s, including phosphorylation, acetylation, mono- and dimethylation, formylation, crotonylation and propionylation, have also been reported in H1s of other species, some others have not been previously identified in histones.

  16. Jejunal Epiphany: Diverticulae, Enteroliths and Strictures

    PubMed Central

    Rehmani, Babar; Kumar, Navin

    2016-01-01

    Multiple jejunal diverticulae represent a rare entity and are usually asymptomatic. This case report is about one such jejunal diverticulae along with multiple enteroliths and jejunal strictures. All these three different findings in a short segment of jejunum is a very rare finding with all three variants seen in a segment of jejunum. We herein present a case of a 45-year-old male, who presented with vague abdominal pain for one and half years associated with nausea and vomiting and altered bowel habits. Laparotomy revealed multiple large jejunal diverticulae compressing the bowel with multiple enteroliths and two strictures in a short segment of jejunum leading to intestinal obstruction. Patient underwent resection of the involved jejunal segment and then repair by anastomosis. Post-operative period was uneventful. PMID:28208925

  17. Intestinal and cloacal strictures in free-ranging and aquarium-maintained green sea turtles (Chelonia mydas).

    PubMed

    Erlacher-Reid, Claire D; Norton, Terry M; Harms, Craig A; Thompson, Rachel; Reese, David J; Walsh, Michael T; Stamper, M Andrew

    2013-06-01

    Intestinal or cloacal strictures that resulted in intestinal obstruction were diagnosed in six green sea turtles (Chelonia mydas) from three rehabilitation facilities and two zoologic parks. The etiologies of the strictures were unknown in these cases. It is likely that anatomic adaptations of the gastrointestinal tract unique to the green sea turtle's herbivorous diet, paired with causes of reduced intestinal motility, may predispose the species to intestinal damage and subsequent obstructive intestinal disease. In aquarium-maintained green sea turtles, obesity, diet, reduced physical activity, chronic intestinal disease, and inappropriate or inadequate antibiotics might also be potential contributing factors. Clinical, radiographic, and hematologic abnormalities common among most of these sea turtles include the following: positive buoyancy; lethargy; inappetence; regurgitation; obstipation; dilated bowel and accumulation of oral contrast material; anemia; hypoglycemia; hypoalbuminemia; hypocalcemia; and elevated creatine kinase, aspartate aminotransferase, and blood urea nitrogen. Although these abnormalities are nonspecific with many possible contributing factors, intestinal disease, including strictures, should be considered a differential in green sea turtles that demonstrate all or a combination of these clinical findings. Although diagnostic imaging, including radiographs, computed tomography, or magnetic resonance imaging, are important in determining a cause for suspected gastrointestinal disease and identifying an anatomic location of obstruction, intestinal strictures were not successfully identified when using these imaging modalities. Lower gastrointestinal contrast radiography, paired with the use of oral contrast, was useful in identifying the suspected site of intestinal obstruction in two cases. Colonoscopy was instrumental in visually diagnosing intestinal stricture in one case. Therefore, lower gastrointestinal contrast radiography and

  18. Cologastric strictures: What is the best treatment?

    PubMed Central

    Lu, Richard; Brown, Kimberly; Okereke, Ikenna

    2017-01-01

    A 31-year-old gentleman who had undergone an emergent esophagectomy and reconstruction with a colon interposition graft, presented with a long-standing cologastric stricture. He had undergone multiple attempts at endoscopic dilation over multiple decades with little symptomatic relief. He underwent a resection and reconstruction of the anastomosis entirely through an abdominal approach. He did well from surgery and experienced complete symptomatic relief immediately. Complications of colon interposition grafts can occasionally be treated using an abdominal incision only. PMID:28069881

  19. Management issues in post living donor liver transplant biliary strictures

    PubMed Central

    Wadhawan, Manav; Kumar, Ajay

    2016-01-01

    Biliary complications are common after living donor liver transplant (LDLT) although with advancements in surgical understanding and techniques, the incidence is decreasing. Biliary strictures are more common than leaks. Endoscopic retrograde cholangiopancreatography (ERCP) is the first line modality of treatment of post LDLT biliary strictures with a technical success rate of 75%-80%. Most of ERCP failures are successfully treated by percutaneous transhepatic biliary drainage (PTBD) and rendezvous technique. A minority of patients may require surgical correction. ERCP for these strictures is technically more challenging than routine as well post deceased donor strictures. Biliary strictures may increase the morbidity of a liver transplant recipient, but the mortality is similar to those with or without strictures. Post transplant strictures are short segment and soft, requiring only a few session of ERCP before complete dilatation. Long-term outcome of patients with biliary stricture is similar to those without stricture. With the introduction of new generation cholangioscopes, ERCP success rate may increase, obviating the need for PTBD and surgery in these patients. PMID:27057304

  20. TaHsfA6f is a transcriptional activator that regulates a suite of heat stress protection genes in wheat (Triticum aestivum L.) including previously unknown Hsf targets.

    PubMed

    Xue, Gang-Ping; Drenth, Janneke; McIntyre, C Lynne

    2015-02-01

    Heat stress is a significant environmental factor adversely affecting crop yield. Crop adaptation to high-temperature environments requires transcriptional reprogramming of a suite of genes involved in heat stress protection. This study investigated the role of TaHsfA6f, a member of the A6 subclass of heat shock transcription factors, in the regulation of heat stress protection genes in Triticum aestivum (bread wheat), a poorly understood phenomenon in this crop species. Expression analysis showed that TaHsfA6f was expressed constitutively in green organs but was markedly up-regulated during heat stress. Overexpression of TaHsfA6f in transgenic wheat using a drought-inducible promoter resulted in up-regulation of heat shock proteins (HSPs) and a number of other heat stress protection genes that included some previously unknown Hsf target genes such as Golgi anti-apoptotic protein (GAAP) and the large isoform of Rubisco activase. Transgenic wheat plants overexpressing TaHsfA6f showed improved thermotolerance. Transactivation assays showed that TaHsfA6f activated the expression of reporter genes driven by the promoters of several HSP genes (TaHSP16.8, TaHSP17, TaHSP17.3, and TaHSP90.1-A1) as well as TaGAAP and TaRof1 (a co-chaperone) under non-stress conditions. DNA binding analysis revealed the presence of high-affinity TaHsfA6f-binding heat shock element-like motifs in the promoters of these six genes. Promoter truncation and mutagenesis analyses identified TaHsfA6f-binding elements that were responsible for transactivation of TaHSP90.1-A1 and TaGAAP by TaHsfA6f. These data suggest that TaHsfA6f is a transcriptional activator that directly regulates TaHSP, TaGAAP, and TaRof1 genes in wheat and its gene regulatory network has a positive impact on thermotolerance.

  1. Refractory strictures despite steroid injection after esophageal endoscopic resection

    PubMed Central

    Hanaoka, Noboru; Ishihara, Ryu; Uedo, Noriya; Takeuchi, Yoji; Higashino, Koji; Akasaka, Tomofumi; Kanesaka, Takashi; Matsuura, Noriko; Yamasaki, Yasushi; Hamada, Kenta; Iishi, Hiroyasu

    2016-01-01

    Background: Although steroid injection prevents stricture after esophageal endoscopic submucosal dissection (ESD), some patients require repeated sessions of endoscopic balloon dilation (EBD). We investigated the risk for refractory stricture despite the administration of steroid injections to prevent stricture in patients undergoing esophageal ESD. Refractory stricture was defined as the requirement for more than three sessions of EBD to resolve the stricture. In addition, the safety of steroid injections was assessed based on the rate of complications. Patients and methods: We analyzed data from 127 consecutive patients who underwent esophageal ESD and had mucosal defects with a circumferential extent greater than three-quarters of the esophagus. To prevent stricture, steroid injection was performed. EBD was performed whenever a patient had symptoms of dysphagia. Results: The percentage of patients with a tumor circumferential extent greater than 75 % was significantly higher in those with refractory stricture than in those without stricture (P = 0.001). Multivariate analysis adjusted for age, sex, history of radiation therapy, tumor location, and tumor diameter showed that a tumor circumferential extent greater than 75 % was an independent risk factor for refractory stricture (adjusted odds ratio [OR] 5.49 [95 %CI 1.91 – 15.84], P = 0.002). Major adverse events occurred in 3 patients (2.4 %): perforation during EBD in 2 patients and delayed perforation after EBD in 1 patient. The patient with delayed perforation underwent esophagectomy because of mediastinitis. Conclusions: A tumor circumferential extent greater than 75 % is an independent risk factor for refractory stricture despite steroid injections. The development of more extensive interventions is warranted to prevent refractory stricture. PMID:27004256

  2. Endoscopic palliation of malignant biliary strictures

    PubMed Central

    Salgado, Sanjay M; Gaidhane, Monica; Kahaleh, Michel

    2016-01-01

    Malignant biliary strictures often present late after the window for curative resection has elapsed. In such patients, the goal of therapy is typically focused on palliation. While historically, palliative measures were performed surgically, the advent of endoscopic intervention offers minimally invasive options to provide relief of symptoms, improve quality of life, and in some cases, increase survival of these patients. Some of these therapies, such as endoscopic biliary decompression, have become mainstays of treatment for decades, whereas newer modalities, including radiofrequency ablation, and photodynamic therapy offer additional options for patients with incurable biliary malignancies. PMID:26989459

  3. Salvage therapy using self-expandable metal stents for recalcitrant anastomotic strictures after living-donor liver transplantation

    PubMed Central

    Jang, Sung Ill; Sung, Se Yong; Park, Hyunsung; Lee, Kwang-Hun; Joo, Seung-Moon; Lee, Dong Ki

    2017-01-01

    Background: Recently, there has been an increase in clinical success rates using nonsurgical methods to resolve anastomotic biliary strictures (ABSs) that develop after liver transplantation (LT). However, some strictures are particularly refractory and cannot be completely resolved by an endoscopic or percutaneous procedure. Consequently, the aim of this study was to examine the feasibility and efficacy of using a newly designed fully covered self-expandable metal stent (FCSEMS) to resolve refractory ABS. Methods: A total of 35 patients with an ABS that developed after LT, but could not be resolved by an endoscopic or percutaneous procedure, were included in this study. FCSEMSs were positioned endoscopically and removed after 2–3 months. After stent removal, the patients were followed to assess complications, including re-stenosis. Results: The mean period from LT to stricture was 13.7 months, and the mean duration of the stricture was 31.8 months. The type and mean number of procedures previously attempted were endoscopic retrograde cholangiopancreatography (ERCP) (9.1 ± 5.1) in 19 patients and percutaneous transhepatic biliary drainage (9.2 ± 4.8) in 16 patients. All patients had successful FCSEMS insertions and removals; the mean stent indwelling time was 3.2 months. The mean follow-up period was 18.7 months (range: 6.4–37.8 months). Stricture recurrence was observed in 6 of 29 patients (recurrence rate: 20.7%). The anastomotic stricture resolved with the FCSEMS insertion in 29 of 35 patients (clinical success rate: 82.9%). Conclusions: The newly designed FCSEMS is a potentially feasible and effective treatment for anastomotic strictures that develop after LT but are not amenable to treatment by conventional procedures. PMID:28246547

  4. Approach to bulbar urethral strictures: Which technique and when?

    PubMed Central

    Joshi, Pankaj; Kaya, Cevdet; Kulkarni, Sanjay

    2016-01-01

    Bulbar urethra is the most common site of anterior urethral stricture and this stricture develops secondary to idiopathic (40%), iatrogenic (35%), inflammatory (10%), and traumatic (15%) causes. Various techniques and approaches with buccal mucosal graft have been described. We wanted to describe different techniques of repair with specific advantages. PMID:27274887

  5. Adult urethral stricture: practice of Turkish urologists

    PubMed Central

    Akyuz, Mehmet; Sertkaya, Zulfu; Koca, Orhan; Calıskan, Selahattin; Kutluhan, Musab Ali; Karaman, Muhammet Ihsan

    2016-01-01

    ABSTRACT Objectives: To evaluate national practice patterns in the treatment of male anterior urethral strictures among Turkish urologists. Materials and Methods: A survey form including 12 questions prepared to determine active Turkish urologists' approach to diagnosis and treatment of the adult urethral stricture (US) were filled out. Based on the survey results, the institutions which 218 urologists work and their years of expertise, methods they used for diagnosis and treatment, whether or not they perform open urethroplasty and timing of open urethroplasty were investigated. Results: Optic internal urethrotomy and dilatation are the most commonly used minimal invasive procedures in treatment of US with the ratios of 93.5% and 63.3% respectively. On the other hand it was seen that urethroplasty was a less commonly used procedure, compared to minimal invasive techniques, with the ratio of 36.7%. Survey results showed us that the number of US cases observed and open urethroplasty procedures performed increases with increasing years of professional experience. Conclusions: As a method demanding special surgical experience and known as a time-consuming and challenging procedure, open urethroplasty will be able to take a greater part in current urological practice with the help of theoretical education and practical courses given by specific centers and experienced authors. PMID:27256189

  6. Prophylactic stenting for esophageal stricture prevention after endoscopic submucosal dissection

    PubMed Central

    Shi, Ke-Da; Ji, Feng

    2017-01-01

    Endoscopic submucosal dissection (ESD) of superficial esophageal cancer has been increasingly used as an alternative to surgery because it is minimally invasive and has a high rate of en bloc resection. However, a high rate of esophageal stricture is observed after ESD for large lesions, which can dramatically decrease the patient’s quality of life. Stricture prevention is necessary to allow for endoscopic therapy to expand. We, herein, review the most recent evidence and discuss the role of the metallic self-expandable stent and the biodegradable stent in esophageal stricture prevention. Limited studies suggested that prophylactic stenting could reduce the stricture rate without increasing the number of complications. In addition, the number of bougie dilation procedures was significantly lower with stent placement. Esophageal stenting is a promising option for post-ESD stricture prevention. However, current evidence is too preliminary to formulate practice standards. Future studies are needed to further validate the efficacy and safety of prophylactic stenting and determine the best strategy for stricture prevention. Stent migration is the most common complication. A new stent that has advantages of a low migration rate and minimal tissue reaction will need to be developed. Therefore, randomized controlled trials with long-term follow-up periods are required before prophylactic stenting could be considered a valid option to prevent post-ESD stricture. PMID:28246466

  7. Advanced endoscopic imaging of indeterminate biliary strictures

    PubMed Central

    Tabibian, James H; Visrodia, Kavel H; Levy, Michael J; Gostout, Christopher J

    2015-01-01

    Endoscopic evaluation of indeterminate biliary strictures (IDBSs) has evolved considerably since the development of flexible fiberoptic endoscopes over 50 years ago. Endoscopic retrograde cholangiography pancreatography (ERCP) was introduced nearly a decade later and has since become the mainstay of therapy for relieving obstruction of the biliary tract. However, longstanding methods of ERCP-guided tissue acquisition (i.e., biliary brushings for cytology and intraductal forceps biopsy for histology) have demonstrated disappointing performance characteristics in distinguishing malignant from benign etiologies of IDBSs. The limitations of these methods have thus helped drive the search for novel techniques to enhance the evaluation of IDBSs and thereby improve diagnosis and clinical care. These modalities include, but are not limited to, endoscopic ultrasound, intraductal ultrasound, cholangioscopy, confocal endomicroscopy, and optical coherence tomography. In this review, we discuss established and emerging options in the evaluation of IDBSs. PMID:26675379

  8. Characterizing intestinal strictures with acoustic resolution photoacoustic microscopy

    NASA Astrophysics Data System (ADS)

    Lei, Hao; Xu, Guan; Liu, Shengchun; Johnson, Laura A.; Moons, David S.; Higgins, Peter D. R.; Rice, Michael D.; Ni, Jun; Wang, Xueding

    2016-03-01

    Crohn's disease (CD) is an autoimmune disease, which may cause obstructing intestinal strictures due to inflammation, fibrosis (deposition of collagen), or a combination of both. Identifying the different stages of the disease progression is still challenging. In this work, we indicated the feasibility of non-invasively characterizing intestinal strictures using photoacoustic imaging (PAI), utilizing the uniquely optical absorption of hemoglobin and collagen. Surgically removed human intestinal stricture specimens were investigated with a prototype PAI system. 2D PA images with acoustic resolution at wavelength 532, 1210 and 1310 nm were formulated, and furthermore, the PA histochemical components images which show the microscopic distributions of histochemical components were solved. Imaging experiments on surgically removed human intestinal specimens has demonstrated the solved PA images were significantly different associated with the presence of fibrosis, which could be applied to characterize the intestinal strictures for given specimens.

  9. Buccal mucosal graft in reconstructive urology: uses beyond urethral stricture.

    PubMed

    Pandey, Abhishek; Dican, Razvan; Beier, Jörn; Keller, Hansjörg

    2014-07-01

    The use of buccal mucosal grafts for the reconstruction of urethral strictures is an established procedure. Because of its robustness, the buccal mucosal graft could also potentially provide an alternative for other indications in reconstructive urology. We report here six consecutive patients who received a buccal mucosal graft for ureteral strictures, glans reconstruction and stoma stenosis. The follow up for all patients ranged from 26 to 50 months. The buccal mucosal graft showed excellent functional results for the ureteral strictures and stenosis from ureterocutaneostomy. For glans reconstructions, the buccal mucosal grafts delivered excellent cosmetic and functional results without causing meatal stenosis. We conclude the buccal mucosal graft can be used in reconstructive surgery beyond the reconstruction of urethral strictures.

  10. Current status of minimally invasive endoscopic management of ureteric strictures

    PubMed Central

    Kachrilas, Stefanos; Karaolides, Theocharis; Nikitopoulou, Stavroula; Papadopoulos, George; Buchholz, Noor; Masood, Junaid

    2013-01-01

    Endourological techniques are used more often nowadays in the treatment of ureteric strictures of various etiologies. Advances in technology have provided new tools to the armamentarium of the endoscopic urological surgeon. Numerous studies exist that investigate the efficiency and safety of each of the therapeutic modalities available. In this review, we attempt to demonstrate the available and contemporary evidence supporting each minimally invasive modality in the management of ureteric strictures. PMID:24294293

  11. Advanced Cytologic Techniques for the Detection of Malignant Pancreatobiliary Strictures

    PubMed Central

    Moreno Luna, Laura E.; Kipp, Benjamin; Halling, Kevin C.; Sebo, Thomas J.; Kremers., Walter K.; Roberts, Lewis R.; Barr Fritcher, Emily G.; Levy, Michael J.; Gores, Gregory J.

    2006-01-01

    Background & Aims Two advanced cytologic techniques for detecting aneuploidy, digital image analysis (DIA) and fluorescence in situ hybridization (FISH) have recently been developed to help identify malignant pancreatobiliary strictures. The aim of this study was to assess the clinical utility of cytology, DIA, and FISH for the identification of malignant pancreatobiliary strictures. Methods Brush cytologic specimens from 233 consecutive patients undergoing ERCP for pancreatobiliary strictures were examined by all three techniques. Strictures were stratified as proximal (n=33) or distal (n=114) based on whether they occurred above or below the cystic duct, respectively. Strictures in patients with PSC (n=86) were analyzed separately. Results Despite the stratification, the performances of the tests were similar. Routine cytology has a low sensitivity (5–20%) but 100% specificity. Because of the high specificity for cytology, we assessed the performance of the other tests when routine cytology was negative. In this clinical context, FISH had an increased sensitivity (35–60%) when assessing for chromosomal gains (polysomy) while preserving the specificity of cytology. The sensitivity and specificity of DIA was intermediate as compared to routine cytology and FISH, but was additive to FISH values demonstrating only trisomy of chromosome 7 or chromosome 3. Conclusions These findings suggest that FISH and DIA increase the sensitivity for the diagnosis of malignant pancreatobiliary tract strictures over that obtained by conventional cytology while maintaining an acceptable specificity. PMID:17030177

  12. Eosinophilic Cholangitis—A Challenging Diagnosis of Benign Biliary Stricture

    PubMed Central

    Fragulidis, Georgios Panagiotis; Vezakis, Antonios I.; Kontis, Elissaios A.; Pantiora, Eirini V.; Stefanidis, Gerasimos G.; Politi, Aikaterini N.; Koutoulidis, Vasilios K.; Mela, Maria K.; Polydorou, Andreas A.

    2016-01-01

    Abstract When confronting a biliary stricture, both benign and malignant etiologies must be carefully considered as a variety of benign biliary strictures can masquerade as hilar cholangiocarcinoma (CCA). Therefore, patients could undergo a major surgery despite the possibility of a benign biliary disease. Approximately 15% to 24% of patients undergoing surgical resection for suspected biliary malignancy will have benign pathology. Eosinophilic cholangitis (EC) is a rare benign disorder of the biliary tract, which can cause obstructive jaundice and can pose a difficult diagnostic task. We present a rare case of a young woman who was referred to our hospital with obstructive painless jaundice due to a biliary stricture at the confluence of the hepatic bile ducts, with a provisional diagnosis of cholangiocarcinoma. Though, during her work up she was found to have EC, an extremely rare benign cause of biliary stricture, which is characterized by a dense eosinophilic infiltration of the biliary tree causing stricturing, fibrosis, and obstruction and which is reversible with short-term high-dose steroids. Despite its rarity, EC should be taken into consideration when imaging modalities demonstrate a biliary stricture, especially if preoperative diagnosis of malignancy cannot be made, in the setting of peripheral eosinophilia and the absence of cardinal symptoms of malignancy. PMID:26735539

  13. Esophageal Stricture Prevention after Endoscopic Submucosal Dissection

    PubMed Central

    Jain, Deepanshu; Singhal, Shashideep

    2016-01-01

    Advances in diagnostic modalities and improvement in surveillance programs for Barrett esophagus has resulted in an increase in the incidence of superficial esophageal cancers (SECs). SEC, due to their limited metastatic potential, are amenable to non-invasive treatment modalities. Endoscopic ultrasound, endoscopic mucosal resection, and endoscopic submucosal dissection (ESD) are some of the new modalities that gastroenterologists have used over the last decade to diagnose and treat SEC. However, esophageal stricture (ES) is a very common complication and a major cause of morbidity post-ESD. In the past few years, there has been a tremendous effort to reduce the incidence of ES among patients undergoing ESD. Steroids have shown the most consistent results over time with minimal complications although the preferred mode of delivery is debatable, with both systemic and local therapy having pros and cons for specific subgroups of patients. Newer modalities such as esophageal stents, autologous cell sheet transplantation, polyglycolic acid, and tranilast have shown promising results but the depth of experience with these methods is still limited. We have summarized case reports, prospective single center studies, and randomized controlled trials describing the various methods intended to reduce the incidence of ES after ESD. Indications, techniques, outcomes, limitations, and reported complications are discussed. PMID:26949124

  14. Percutaneous Balloon Dilatation for the Treatment of Early and Late Ureteral Strictures After Renal Transplantation: Long-Term Follow-Up

    SciTech Connect

    Bachar, Gil N. Mor, E.; Bartal, G.; Atar, Eli; Goldberg, N.; Belenky, A.

    2004-08-15

    We report our experience with percutaneous balloon dilatation (PBD) for the treatment of ureteral strictures in patients with renal allografts. Of the 422 consecutive patients after renal transplantation in our center 10 patients had ureteral strictures. An additional 11 patients were referred from other centers. The 21 patients included 15 men and 6 women aged 16 to 67 years. Strictures were confirmed by sonography and scintigraphy in all cases. Patients underwent 2 to 4 PBDs at 7-10-day intervals. Clinical success was defined as resolution of the stenosis and hydronephrosis on sequential ultrasound and normalization of creatinine levels. Patients were divided into two groups: those who underwent transplantation more than 3 months previously and those who underwent transplantation less than 3 months previously. PBD was successful in 13 of the 21 patients (62%). There was no statistically significant difference in success rate between the patients with early (n 12) and those with late (n = 9) obstruction: 58.4% and 66%, respectively. No major complications were documented. PBD is a safe and simple tool for treating ureteral strictures and procedure-related morbidity is low. It can serve as an initial treatment in patients with early or late ureteral strictures after renal transplantation.

  15. Management of Recurrent Stricture Formation after Transverse Vaginal Septum Excision

    PubMed Central

    Gupta, Ridhima; Bozzay, Joseph D.; Williams, David L.; DePond, Robert T.; Gantt, Pickens A.

    2015-01-01

    Background. A transverse vaginal septum (TVS) is a rare obstructing anomaly, caused due to improper fusion of Müllerian ducts and urogenital sinus during embryogenesis. Case. A 15-year-old girl presented with primary amenorrhea. She had multiple congenital anomalies. Initial examination and imaging investigation revealed the presence of a unicornuate uterus and a TVS. The TVS was excised; however the patient was unable to perform vaginal dilation postoperatively leading to recurrent stricture formation. She underwent multiple surgeries for excision of the stricture. The patient was eventually evaluated every day in the clinic until she was able to demonstrate successful vaginal dilatation in the presence of a clinician. Summary and Conclusion. Properly guided regular and intensive vaginal dilation after TVS excision may decrease the need of reoperations due to recurrent stricture formation. PMID:26078895

  16. Endoscopic balloon dilatation of Crohn’s-associated intestinal strictures: High patient satisfaction and long-term efficacy

    PubMed Central

    Rueda Guzmán, Anna; Wehkamp, Jan; Kirschniak, Andreas; Naumann, Aline; Malek, Nisar P.

    2016-01-01

    Introduction Stricture formation is a common long-term complication of Crohn’s disease. Endoscopic balloon dilatation offers a bowel-sparing treatment option, but long-term outcome and its association with patient-, stricture-, and procedure-related factors is only poorly understood. Patient satisfaction with endoscopic balloon dilatation is largely unknown. Methods We performed a retrospective review of all endoscopic balloon dilatation for Crohn’s disease-related strictures between January 2005 and January 2013. Long-term outcome, complication rates and predictive factors were evaluated. Patient satisfaction was assessed using a questionnaire and telephone interviews. Results A total of 118 balloon dilatations were performed for 69 strictures in 46 patients. One patient was excluded from further analysis due to malignancy. Median time from diagnosis of Crohn’s disease to symptomatic stricture formation was 19 years. Technical success, defined as passage of the endoscope after dilatation, was reportedly obtained in 95 of 106 procedures (89.6%). Two perforations occurred, one of which could be managed conservatively. No episodes of severe bleeding were recorded (procedure-related complication rate: 2/118; 1.7%). During a median follow-up of 4.8 years (range 0.4–8.7), 55.6% (25/45) of patients were able to avoid surgery. Of the patients, 35.6% (16/45) did not need any further intervention, 40.0% (18/45) underwent more than one dilatation, and 24.4% (11/45) were operated after the first dilatation. The percentage of patients who were satisfied with the procedure and would again opt for balloon dilation as first line therapy was 83.3% (35/42). None of the risk factors examined in this study correlated with the necessity for subsequent surgery. Discussion Endoscopic balloon dilatation is a safe and effective first line therapy for Crohn’s disease-related strictures. No technical, stenosis-, or patient-related factor reliably predicted sustained dilatation

  17. Obstructive jaundice due to radiation-induced hepatic duct stricture

    SciTech Connect

    Chandrasekhara, K.L.; Iyer, S.K.

    1984-10-01

    A case of obstructive jaundice due to radiation-induced hepatic duct stricture is reported. The patient received postoperative radiation for left adrenal carcinoma, seven years prior to this admission. The sequelae of hepatobiliary radiation and their management are discussed briefly.

  18. Crohn’s disease complicated by strictures: a systematic review

    PubMed Central

    Rieder, Florian; Zimmermann, Ellen M; Remzi, Feza H; Sandborn, William J

    2016-01-01

    The occurrence of strictures as a complication of Crohn’s disease is a significant clinical problem. No specific antifibrotic therapies are available. This systematic review comprehensively addresses the pathogenesis, epidemiology, prediction, diagnosis and therapy of this disease complication. We also provide specific recommendations for clinical practice and summarise areas that require future investigation. PMID:23626373

  19. Use of Cutting Balloon in the Treatment of Urethral Stricture: A Novel Technique

    SciTech Connect

    Yildirim, Erkan; Cicek, Tufan; Istanbulluoglu, Okan; Ozturk, Bulent

    2009-05-15

    The peripheral cutting balloon has been used to treat various nonvascular strictures as well as vascular stenosis. In this article, we describe for the first time the use of the cutting balloon in the treatment of patients with urethral stricture. Four patients with bulbar urethral stricture were included in the study. All strictures were successfully dilated with the cutting balloon, and patients were free of symptoms at 6-month follow-up. Cutting-balloon dilatation is a safe, easy-to-perform, and effective treatment for patients with tight urethral strictures.

  20. Role of metallic stents in benign esophageal stricture

    NASA Astrophysics Data System (ADS)

    Shim, Chan Sup

    2012-10-01

    Simple esophageal strictures, which are focal, straight, and large in diameter, usually require 1 - 3 dilation sessions to relieve symptoms. However, complex strictures, which are long, tortuous, or associated with a severely compromised luminal diameter, are usually more difficult to treat with conventional bougie or balloon dilation techniques, and often have high recurrence rates. Although the permanent placement of self-expandable metal stents (SEMS) has been used to manage refractory benign esophageal strictures, this procedure is associated with additional problems, such as stricture from tissue hyperplasia, stent migration, and fistula formation. Thus, several new types of stents have been developed, including temporary SEMS, self-expandable plastic stents (SEPS), and biodegradable stents. The use of these new products has produced varied results. Temporary SEMS that have been used to relieve benign esophageal conditions have caused granulation tissue at both ends of the stent because of contact between the mucosa and the exposed metal components of the stent, thus hindering stent removal. We examined the tissue response to two new types of SEMS, a flange-type and a straighttype, each coated with a silicone membrane on the outside of the metal mesh. These two SEMS were evaluated individually and compared with a conventional control stent in animal experiments. Although the newly designed stents resulted in reduced tissue hyperplasia, and were thus more easily separated from the esophageal tissue, some degree of tissue hyperplasia did occur. We suggest that newly designed DES (drug-eluting stents) may provide an alternative tool to manage refractory benign esophageal stricture.

  1. Intraluminal Radioactive Stent Compared with Covered Stent Alone for the Treatment of Malignant Esophageal Stricture

    SciTech Connect

    Wang Zhongmin; Huang Xunbo; Cao Jun; Huang Gang; Chen Kemin LIu Yu; Liu Fenju

    2012-04-15

    Objective: This study was designed to compare the clinical effectiveness of intraluminal radioactive stent loaded with iodine-125 seeds implantation versus covered stent alone insertion in patients with malignant esophageal stricture. Methods: We studied two groups of patients with malignant esophageal stricture. Group A comprised 28 patients (19 men and 9 women) who underwent intraluminal radioactive stent loaded with iodine-125 seeds implantation and were followed prospectively. Group B comprised 30 patients (18 men and 12 women) who had previously received covered stent alone insertion; these patients were evaluated retrospectively. There was no crossover between the two groups during follow-up. Informed consent was obtained from each patient, and our institutional review board approved the study. The dysphagia score, overall survival rates, complication rates, and reintervention rates were compared in the two groups. Results: There were no significant differences between the two groups in terms of baseline characteristics. Stent placement was technically successful and well tolerated in all patients. The dysphagia score was improved in both groups after stent placement. The median survival was significantly longer in group A than in group B: 11 versus 4.9 months, respectively (P < 0.001). The complications of chest pain, esophageal reflux, and stent migration was more frequent in group B, but this difference did not reach statistical significance. There was no statistical difference in reintervention between two groups. Conclusions: Intraluminal radioactive stent loaded with iodine-125 seeds implantation was a feasible and practical management in treating malignant esophageal stricture and was superior to covered stent alone insertion, as measured by survival.

  2. Metallic stents in the management of ureteric strictures

    PubMed Central

    Kulkarni, Ravi

    2014-01-01

    Management of ureteric strictures is a challenging task. Subtle presentation, silent progression and complex aetiology may delay diagnosis. A wide range of available treatment options combined with the lack of adequate randomised trials has led to the introduction of personal bias in the management of this difficult group of patients. Metallic ureteric stents offer an alternative to the conventional treatment modalities. A review of the currently available metallic stents and their role in the long-term management of ureteric strictures is presented. Materials used in the manufacture of indwelling urological devices are evolving all the time. Improved endo-urological techniques combined with new devices made from better compounds will continue to improve patient experience. PMID:24497686

  3. Role of stents and laser therapy in biliary strictures

    NASA Astrophysics Data System (ADS)

    Chennupati, Raja S.; Trowers, Eugene A.

    2001-05-01

    The most frequent primary cancers causing malignant obstructive jaundice were pancreatic cancer (57%), hilar biliary cancer (19% including metastatic disease), nonhilar biliary cancer (14%) and papillary cancer (10%). Endoscopic stenting has widely replaced palliative surgery for malignant biliary obstruction because of its lower risk and cost. Self-expandable metal stents are the preferred mode of palliation for hilar malignancies. Plastic stents have a major role in benign biliary strictures. Major complications and disadvantages associated with metallic stents include high cost, cholangitis. malposition, migration, unextractability, and breakage of the stents, pancreatitis and stent dysfunction. Dysfunction due to tumor ingrowth can be relieved by thermal methods (argon plasma coagulator therapy). We present a concise review of the efficacy of metallic stents for palliation of malignant strictures.

  4. SIU/ICUD Consultation on Urethral Strictures: The management of anterior urethral stricture disease using substitution urethroplasty.

    PubMed

    Chapple, Christopher; Andrich, Daniela; Atala, Anthony; Barbagli, Guido; Cavalcanti, André; Kulkarni, Sanjay; Mangera, Altaf; Nakajima, Yosuke

    2014-03-01

    In this systematic review of the literature, a search of the PubMed database was conducted to identify articles dealing with augmentation/substitution urethral reconstruction of the anterior urethral stricture. The evidence was categorized by stricture site, surgical technique, and the type of tissue used. The committee appointed by the International Consultation on Urological Disease reviewed this data and produced a consensus statement relating to the augmentation and substitution of the anterior urethra. In this review article, the background pathophysiology is discussed. Most cases of urethral stricture disease in the anterior urethra are consequent on an ischemic spongiofibrosis. The choice of technique and the surgical approach are discussed along with the potential pros and cons of the use of a graft vs a flap. There is research potential for tissue engineering. The efficacy of the surgical approach to the urethra is reviewed. Whenever possible, a 1-stage approach is preferable from the patient's perspective. In some cases, with complex penile urethral strictures, a 2-stage procedure might be appropriate, and there is an important potential role for the use of a perineal urethrostomy in cases where there is an extensive anterior urethral stricture or where the patient does not wish to undergo complex surgery, or medical contraindications make this hazardous. It is important to have accurate outcome measures for the follow-up of patients, and in this context, a full account needs to be taken of patients' perspectives by the use of appropriate patient-reported outcome measures. The use of symptoms and a flow rate can be misleading. It is well established that with a normally functioning bladder, the flow rate does not diminish until the caliber of the urethra falls below 10F. The most accurate means of following up patients after stricture surgery are by the use of endoscopy or visualization by urethrography. Careful consideration needs to be made of the

  5. Incidental adenocarcinoma in patients undergoing surgery for stricturing Crohn's disease

    PubMed Central

    Kristo, Ivan; Riss, Stefan; Argeny, Stanislaus; Maschke, Svenja; Chitsabesan, Praminthra; Stift, Anton

    2017-01-01

    AIM To evaluate frequency and clinical course of incidental adenocarcinoma in patients with stricturing Crohn's disease (CD). METHODS In this study, consecutive patients, who were operated on for stricturing CD between 1997-2012, were included at an academic tertiary referral center. Demographic data and clinical course were obtained by an institutional database and individual chart review. Besides baseline characteristics, intraoperative findings and CD related history were also recorded. Colorectal cancer was classified and staged according to the Union for International Cancer Control (UICC). RESULTS During the study period 484 patients underwent resections due to stricturing CD. Incidental adenocarcinoma was histologically confirmed in 6 (1.2%) patients (4 males, 2 females). Patients diagnosed with colorectal cancer had a median age of 43 (27-66) years and a median history of CD of 16 (7-36) years. Malignant lesions were found in the rectum (n = 4, 66.7%), descending colon (n = 1, 16.7%) and ileocolon (n = 1, 16.7%). According to the UICC classification two patients were stages as I (33.3%), whereas the other patients were classified as stage IIA (16.7%), stage IIIB (16.7%), stage IIIC (16.7%) and stage IV (16.7%), respectively. After a median follow-up of 2 (0.03-8) years only 1 patient is still alive. CONCLUSION The frequency of incidental colorectal cancer in patients, who undergo surgery for stenotic CD, is low but associated with poor prognosis. However, surgeons need to be aware about the possibility of malignancy in stricturing CD, especially if localized in the rectum. PMID:28210083

  6. Fasciocutaneous flap in esophageal stricture with ventriculoperitoneal shunt.

    PubMed

    Seong, Yong Won; Kang, Chang Hyun; Chang, Hak; Park, In Kyu; Kim, Young Tae

    2014-01-01

    Abdominal surgery in a patient with ventriculoperitoneal shunt may increase the risk of shunt malfunction and infection. We present a successful case of resection and reconstruction of the cervical esophagus by rolled lateral thoracic artery fasciocutaneous flap in a patient with corrosive esophageal stricture and preexisting ventriculoperitoneal shunt. Follow-up esophagogastroscopy after 3 months revealed wide patent graft. Rolled fasciocutaneous flap may be a safe alternative treatment without risk of shunt-associated complications in a patient with ventriculoperitoneal shunt.

  7. Pharyngoesophageal stricture and fistula. Treatment by free jejunal graft.

    PubMed Central

    Hester, T R; McConnel, F; Nahai, F; Cunningham, S J; Jurkiewicz, M J

    1984-01-01

    Fifty-five patients with disorders of the pharynx or cervical esophagus requiring extensive ablative therapy were reconstructed by heterotopic autotransplantation of a segment of jejunum. Of these 55 patients, the overwhelming majority were treated for squamous cell carcinoma or the complications of combined radiation and operative therapy. There were six graft failures in the entire group of 55 patients for a transfer reliability of 90%. Three patients died in the perioperative period (5%). The purpose of this paper is to report on the treatment of a subset of these patients in whom fixed cicatricial stenosis of the gullet was the problem or in whom a radionecrotic cutaneous fistula existed. Fourteen such patients were treated, ten with stricture and four with fistula. Both patch grafts of on-lay segments and more routine circumferentially intact tubed segments of jejunum were used depending upon the nature of the defect. The youngest patient in this group was a 3-year-old juvenile diabetic with caustic stricture and the oldest was a 75-year-old man with fixed stricture following operation and radiation for cancer. Nine of ten and four of four anatomic reconstructions were successful in the stricture and fistula patients, respectively. All of these 13 patients with a neo- gullet of jejunum were able to handle secretions and liquids satisfactorily. Eleven patients were on a regular diet and had no discernible physiological impairment in alimentation. One patient had mild dysphagia and used a blenderized diet. One patient was able to swallow liquids only. In this patient the resection for tumor was so high and so extensive that the physiologic act of deglutition itself was impaired. There were no perioperative deaths, although one patient has succumbed to recurrent and metastatic carcinoma. When conventional treatment for stricture or fistula in the cervical alimentary tract has failed, reconstruction can be accomplished safely by free revascularized jejunal graft

  8. Predictive factors and clinical practice profile for strictures post-necrotising enterocolitis

    PubMed Central

    Zhang, Han; Chen, Jiaping; Wang, Yan; Deng, Chun; Li, Lei; Guo, Chunbao

    2017-01-01

    Abstract Intestinal stricture is a severe and common complication of necrotizing enterocolitis (NEC), causing severe and prolonged morbidity. Our goal was to investigate the clinical predictors for strictures developing after NEC and evaluate the management outcome of the post-NEC strictures to better orient their medicosurgical care. A total of 188 patients diagnosed with NEC with identical treatment protocols throughout the period under study were retrospectively reviewed from 4 academic neonatal centers between from January 1, 2011, and October 31, 2016. Clinical predictive factors and clinical outcomes, including demographic information, clinical management, laboratory data, histopathology of resected bowel segment, and discharge summaries, were evaluated on the basis of with post-NEC strictures or not. Of the involved variables examined, the late-onset NEC [risk ratio (RR), 0.56; 95% confidence interval (95% CI), 0.41–0.92; P < 0.001], cesarean delivery (RR, 1.42; 95% CI, 0.98–2.29; P = 0.026), and first procalcitonin (PCT) (onset of symptoms) (RR, 1.82; 95% CI, 0.98–3.15; P = 0.009) were the independent predictive factors for the post-NEC strictures. C-reactive protein (CRP), white blood cell (WBC), and plateletcrit levels were markedly higher on infants with stricture and elevated levels were maintained until the stricture was healed. Infants with intestinal stricture had significantly longer times to beginning enteral feeds (23.9 ± 12.1), than infants without intestinal stricture (18.6 ± 8.8) (P = 0.023). The median age at discharge was also significantly higher in the group with stricture (P = 0.014). This retrospective and multicenter study demonstrates that the early-onset NEC and cesarean delivery conferred protection over the post-NEC stricture. Infants with post-NEC stricture need prolonged hospitalization. PMID:28272242

  9. Wire-guided balloon coloplasty--a new treatment for colorectal strictures?

    PubMed Central

    Banerjee, A K; Walters, T K; Wilkins, R; Burke, M

    1991-01-01

    A new technique for dilatation of colorectal anastomotic strictures--wire-guided balloon coloplasty--is described. It is suitable for high strictures, may be performed without general anaesthetic and is repeatable. It does not require endoscopy and may be used to relieve obstructive symptoms in both benign and malignant strictures so avoiding the need for a defunctioning colostomy. Images Figure 1. Figure 2. Figure 3. PMID:2013892

  10. Benign Post-Radiation Rectal Stricture Treated with Endoscopic Balloon Dilation and Intralesional Triamcinolone Injection

    PubMed Central

    Karanikas, Michael; Touzopoulos, Panagiotis; Mitrakas, Alexandros; Zezos, Petros; Zarogoulidis, Paul; Machairiotis, Nikolaos; Efremidou, Eleni; Liratzopoulos, Nikolaos; Polychronidis, Alexandros; Kouklakis, George

    2012-01-01

    Post-radiation stricture is a rare complication after pelvis irradiation, but must be in the mind of the clinician evaluating a lower gastrointestinal obstruction. Endoscopy has gained an important role in chronic radiation proctitis with several therapeutic options for management of intestinal strictures. The treatment of rectal strictures has been limited to surgery with high morbidity and mortality. Therefore, a less invasive therapeutic approach for benign rectal strictures, endoscopic balloon dilation with or without intralesional steroid injection, has become a common treatment modality. We present a case of benign post-radiation rectal stricture treated successfully with balloon dilation and adjuvant intralesional triamcinolone injection. A 70-year-old woman presented to the emergency room complaining for 2 weeks of diarrhea and meteorism, 11 years after radiation of the pelvis due to adenocarcinoma of the uterus. Colonoscopy revealed a stricture at the rectum and multiple endoscopic biopsies were obtained from the stricture. The stricture was treated with endoscopic balloon dilation and intralesional triamcinolone injection. The procedure appears to have a high success rate and a very low complication rate. Histologic examination of the biopsies revealed non-specific inflammatory changes of the rectal mucosa and no specific changes of the mucosa due to radiation. All biopsies were negative for malignancy. The patient is stricture-free 12 months post-treatment. PMID:23271987

  11. Visual Internal Urethrotomy for Adult Male Urethral Stricture Has Poor Long-Term Results

    PubMed Central

    Al Taweel, Waleed; Seyam, Raouf

    2015-01-01

    Objective. To determine the long-term stricture-free rate after visual internal urethrotomy following initial and follow-up urethrotomies. Methods. The records of all male patients who underwent direct visual internal urethrotomy for urethral stricture disease in our hospital between July 2004 and May 2012 were reviewed. The Kaplan-Meier method was used to analyze stricture-free probability after the first, second, third, fourth, and fifth urethrotomies. Results. A total of 301 patients were included. The overall stricture-free rate at the 36-month follow-up was 8.3% with a median time to recurrence of 10 months (95% CI of 9.5 to 10.5, range: 2–36). The stricture-free rate after one urethrotomy was 12.1% with a median time to recurrence of eight months (95% CI of 7.1–8.9). After the second urethrotomy, the stricture-free rate was 7.9% with a median time to recurrence of 10 months (95% CI of 9.3 to 10.6). After the third to fifth procedures, the stricture-free rate was 0%. There was no significant difference in the stricture-free rate between single and multiple procedures. Conclusion. The long-term stricture-free rate of visual internal urethrotomy is modest even after a single procedure. PMID:26494995

  12. Urethral Strictures and Stenoses Caused by Prostate Therapy

    PubMed Central

    Chen, Mang L.; Correa, Andres F.; Santucci, Richard A.

    2016-01-01

    The number of patients with prostate cancer and benign prostatic hyperplasia is on the rise. As a result, the volume of prostate treatment and treatment-related complications is also increasing. Urethral strictures and stenoses are relatively common complications that require individualized management based on the length and location of the obstruction, and the patient’s overall health, and goals of care. In general, less invasive options such as dilation and urethrotomy are preferred as first-line therapy, followed by more invasive substitution, flap, and anastomotic urethroplasty. PMID:27601967

  13. Exploring the Unknown

    ERIC Educational Resources Information Center

    Pallant, Amy; Pryputniewicz, Sarah; Lee, Hee-Sun

    2012-01-01

    Scientists, and science in general, move from the unknown to increasing levels of certainty. Teaching students about science means encouraging them to embrace and investigate the unknown, make reliable scientific claims, justify those claims with evidence, and evaluate the quality of the evidence. In all areas of science--and especially in…

  14. The Accordion Sign in the Transplant Ureter: Ramifications During Balloon Dilation of Strictures

    SciTech Connect

    Kriegshauser, J. Scott Naidu, Sailen G.; Chang, Yu-Hui H.; Huettl, Eric A.

    2015-04-15

    PurposeThis study was designed to demonstrate the accordion sign within the transplant ureter and evaluate its ramifications during balloon dilation of strictures.MethodsA retrospective electronic chart and imaging review included demographic characteristics, procedure reports, and complications of 28 renal transplant patients having ureteral strictures treated with percutaneous balloon dilation reported in our transplant nephrology database during an 8-year period. The accordion sign was deemed present or absent on the basis of an imaging review and was defined as present when a tortuous ureter became kinked and irregular when foreshortened after placement of a wire or a catheter. Procedure-related urine leaks were categorized as occurring at the stricture if within 2 cm; otherwise, they were considered away from the stricture.ResultsThe accordion sign was associated with a significantly greater occurrence of leaks away from the stricture (P = 0.001) but not at the stricture (P = 0.34).ConclusionsThe accordion sign is an important consideration when performing balloon dilation procedures on transplant ureteral strictures, given the increased risk of leak away from the stricture. Its presence should prompt additional care during wire and catheter manipulations.

  15. Biliary strictures and hepatic artery flow abnormalities in split liver transplants.

    PubMed

    O'Loughlin, Edward V; Stormon, Michael O; Shun, Albert; Verran, Deborah; Jermyn, Vicki; Wong, Christopher; Lord, David

    2010-02-01

    The aim of this study was to examine the role of HA flow abnormalities in the development of biliary strictures following split liver transplants. Data was obtained from a prospective data base of all patients undergoing split liver transplants from 2000-2008 with a follow up time of at least six months. Forty-six transplants were performed in 44 patients. Fourteen of 46 developed strictures of whom four were intrahepatic and 10 anastomotic. Nine of 14 with strictures had either hepatic artery thromobosis (HAT, four) or abnormalities of HA flow identified by routine Doppler ultrasound (5) compared with two of 32 without strictures (p < 0.02, (one temporary loss of flow and one HA aneurysm). There were no differences between the stricture and non stricture group with regard to age or weight at transplant, donor age, cold and warm ischemia times or intraoperative portal vein flow though there was a significant decrease in intraoperative HA flow in the stricture group. In conclusion, both HAT and hepatic artery flow abnormalities are associated with biliary strictures in the majority of split liver transplants. However, unrecognised abnormalities in HA flow and or other factors are likely to contribute.

  16. Self-Expandable Metal Stenting of Refractory Upper Gut Corrosive Strictures: A New Role for Endoscopy?

    PubMed Central

    Manta, Raffaele; Conigliaro, Rita; Bertani, Helga; Manno, Mauro; Soliman, Ahmed; Fedeli, Paolo; Bassotti, Gabrio

    2011-01-01

    Caustic strictures of the gastrointestinal tract are often difficult to treat, since relapses are frequent after medical or endoscopic treatment. Thus, novel approaches are needed. We report here our experience with self-expandable metallic stents (SEMS) as a new endoscopic approach in three patients with corrosive strictures of the upper gastrointestinal tract. PMID:22606415

  17. Mitomycin-C: 'a ray of hope' in refractory corrosive esophageal strictures.

    PubMed

    Nagaich, N; Nijhawan, S; Katiyar, P; Sharma, R; Rathore, M

    2014-04-01

    Increasingly frequent dilation may become a self-defeating cycle in refractory stricture as recurrent trauma enhance, scar formation, and ultimately recurrence and potential worsening of the stricture. In 12 patients of caustic induced esophageal stricture, who failed to respond despite rigorous dilatation regimen for more than one year, a trial of topical mitomycin-C application to improve dilatation results was undertaken, considering the recently reported efficacy and safety of this agent. Mitomycin-C was applied for 2-3 minutes at the strictured esophageal segment after dilation with wire-guided Savary-Gilliard dilator. Patient was kept nil by mouth for 2-3 hours. After 4-6 sessions of mitomycin-C treatment, resolution of symptoms and significant improvement in dysphagia score and periodic dilatation index was seen in all 12 patients. Mitomycin-C topical application may be a useful strategy in refractory corrosive esophageal strictures and salvage patients from surgery.

  18. Self-Expanding Metal Stenting in the Management of a Benign Colonic Stricture

    PubMed Central

    Jessamy, Kegan; Ozden, Nuri; Simon, Howard M.; Kobrossi, Semaan; Ubagharaji, Ezinnaya

    2016-01-01

    Colonic postanastomotic strictures occur in 1.5–8% of patients following colorectal surgery. Traditionally, colonic strictures were treated by multiple modalities including endoscopic dilatation. Self-expanding metal stents (SEMS) have been indicated in the management of benign colonic strictures; however, there are limited available data with regard to their efficacy. We present the case of a 68-year-old male who had perforated sigmoid diverticulitis followed by Hartmann's procedure with eventual reanastomosis 6 months later. He subsequently developed benign colonic stricture, which was treated with a metal stent. SEMS are associated with a low mortality rate and are appropriate in treating acute colonic obstruction as a result of benign stricture in the setting of postanastomosis. PMID:27403114

  19. Direct visual internal urethrotomy for isolated, post-urethroplasty strictures: a retrospective analysis

    PubMed Central

    Brown, Elizabeth Timbrook; Mock, Stephen; Dmochowski, Roger; Reynolds, W. Stuart; Milam, Douglas; Kaufman, Melissa R.

    2016-01-01

    Background: Urethroplasty is often successful for the treatment of male urethral stricture disease, but limited data exists on recurrence management. Our goal was to evaluate direct visual internal urethrotomy (DVIU) as a treatment option for isolated, recurrent strictures after urethroplasty. Methods: We retrospectively identified male patients who underwent urethroplasty from 1999 to 2013 and developed an isolated, recurrent stricture at the urethroplasty site treated with DVIU. Success was defined as lack of symptomatology and no subsequent intervention. Comparative analysis identified characteristics and stricture properties associated with success. Results: A total of 436 urethroplasties were performed in 401 patients at our institution between 1999 and 2013. Stricture recurrence was noted in 64 (16%) patients. Of these, 47 (73%) underwent a DVIU. A total of 37 patients met inclusion criteria and underwent 50 DVIU procedures at the urethroplasty site. A single DVIU was successful in 13 of 37 patients (35%). A total of 4 of 6 patients required a second DVIU (67%). Overall, 17 of 43 (40%) of the total DVIUs were successful after urethroplasty. Success did not differ by age, stricture length or location, surgical technique, radiation history, prior urethroplasty or DVIU, time to failure, or etiology. Conclusions: Post-urethroplasty DVIU for isolated, recurrent strictures may be offered as a minimally invasive treatment option. Approximately 40% of patients were spared further intervention. PMID:28203286

  20. A case report on buccal mucosa graft for upper ureteral stricture repair

    PubMed Central

    Sabale, Vilas Pandurang; Thakur, Naveen; Kankalia, Sharad Kumar; Satav, Vikram Pramod

    2016-01-01

    Management of ureteric stricture especially long length upper one-third poses a challenging job for most urologists. With the successful use of buccal mucosa graft (BMG) for stricture urethra leads the foundation for its use in ureteric stricture also. A 35-year-old male diagnosedcase of left upper ureteric stricture, postureteroscopy with left percutaneous nephrostomy (PCN) in situ. Cysto-retrograde pyelography and nephrostogram done simultaneously suggestive of left upper ureteric stricture of 3 cm at L3 level. On exploration, diseased ureteral segment exposed, BMG harvested and sutured as onlay patch graft with supportive omental wrap. The treatment choice for upper ureteric long length stricture is inferior nephropexy, autotransplantation, or bowel interposition. With PCN in situ, inferior nephropexy becomes technically difficult, other two are morbid procedures. Use of BMG in this situation is technically better choice with all the advantages of buccal mucosa. Onlay BMG for ureteral stricture is technically easy, less morbid procedure and can be important choice in future. PMID:28057996

  1. Balloon Dilatation of Salivary Duct Strictures: Report on 36 Treated Glands

    SciTech Connect

    Drage, Nicholas A.; Brown, Jackie E.; Escudier, Michael P.; Wilson, Ron F.; McGurk, Mark

    2002-10-15

    Purpose: This paper describes the technique for balloon dilatation of salivary duct strictures and evaluates the clinical and radiographic findings in a consecutive series of 36 affected glands. Methods: Thirty-four patients (36 glands) had balloon dilatation of their salivary duct strictures performed under fluoroscopic control. They were evaluated immediately afterwards and at review by sialography. Results: In 36 cases attempted, 33 (92%) strictures were dilated. The immediate post-treatment sialogram was available in 28 cases, of which 23 (82%) demonstrated complete and four (14%) partial elimination of stricture. In one case the appearance was unchanged(4%). Review data (mean 6.8 months) were available on 25 glands: 12 were asymptomatic (48%), 12 (48%) had reduced symptoms and one (4%)failed to improve. Sialographic data were available on 21 glands: in 10(48%) the duct remained patent, in one (5%) the stricture was partially eliminated, in seven (33%) the strictures had returned and in the remaining three (14%) cases there was complete obstruction. Conclusions: Balloon dilatation is an effective treatment of salivary duct stenosis. In half the cases the stricture recurred but symptomatic improvement was achieved and maintained in the majority of cases.

  2. Atypical abdominal pain: post-traumatic transverse colon stricture.

    PubMed

    Rotar, Raluca; Uwechue, Raphael; Sasapu, Kishore Kumar

    2013-08-23

    A driver presented to the emergency department 1 day after an accident driving his excavator with abdominal pain and vomiting. He was admitted to the surgical ward 2 days later, after reattending. A CT scan revealed wall thickening and oedema in the transverse colon. This was supported by a subsequent CT virtual colonoscopy which raised the suspicion of neoplasia. A follow-up colonoscopy was not carried further than the transverse colon due to an indurated, tight stricture. Biopsies from that area showed ulceration and inflammatory changes non-specific for ischaemia, drug-induced changes or inflammatory bowel disease. As a consequence of the subocclusive symptoms and the possibility of a neoplastic diagnosis, a laparoscopic-assisted transverse colectomy was performed. The histology of the resected segment revealed post-traumatic inflammation and fibrosis with no evidence of neoplasia.

  3. Eosinophilic cholecystitis with common bile duct stricture: a rare disease.

    PubMed

    Mehanna, Daniel; Naseem, Zainab; Mustaev, Muslim

    2016-05-24

    Although the most common cause of cholecystitis is gallstones, other conditions may present as acute cholecystitis. We describe a case of eosinophilic cholecystitis with common bile duct stricture. A 36-year-old woman initially had generalised abdominal pain and peripheral eosinophilia. Diagnostic laparoscopy showed eosinophilic ascites and necrotic nodules on the posterior abdominal wall. She was treated with anthelminthics on presumption of toxacara infection based on borderline positivity of serological tests. She later presented with acute cholecystitis and had a cholecystectomy and choledocotomy. Day 9 T-tube cholangiogram showed irregular narrowing of the distal common bile duct. The patient's symptoms were improved with steroids and the T-tube was subsequently removed.

  4. High-pressure balloon dilation for male anterior urethral stricture: single-center experience*

    PubMed Central

    Yu, Shi-cheng; Wu, Hai-yang; Wang, Wei; Xu, Li-wei; Ding, Guo-qing; Zhang, Zhi-gen; Li, Gong-hui

    2016-01-01

    Objectives: We retrospectively reviewed the urethral stricture cases treated in our tertiary center, and assessed the safety and feasibility of the high-pressure balloon dilation (HPBD) technique for anterior urethral stricture. Methods: From January 2009 to December 2012, a total of 31 patients with anterior urethral strictures underwent HPBD at our center, while another 25 cases were treated by direct vision internal urethrotomy (DVIU). Patient demographics, stricture characteristics, surgical techniques, and operative outcomes were assessed and compared between the two groups. The Kaplan-Meier survival analysis was applied to evaluate the stricture-free rate for the two surgical techniques. Results: The operation time was much shorter for the HPBD procedure than for the DVIU ((13.19±2.68) min vs. (18.44±3.29) min, P<0.01). For the HPBD group, the major postoperative complications as urethral bleeding and urinary tract infection (UTI) were less frequently encountered than those in DVIU (urethral bleeding: 2/31 vs. 8/25, P=0.017; UTI: 1/31 vs. 6/25 P=0.037). The Kaplan-Meier survival analysis showed that there was no significant difference in stricture-free rate at 36 months between the two groups (P=0.21, hazard ratio (HR)=0.65, 95% confidence interval (CI): 0.34 to 1.26). However, there was a significantly higher stricture-free survival in the HPBD group at 12 months (P=0.02, HR=0.35, 95% CI: 0.14 to 0.87), which indicated that the stricture recurrence could be delayed by using the HPBD technique. Conclusions: HPBD was effective and safe and it could be considered as an alternative treatment modality for anterior urethral stricture disease. PMID:27604864

  5. Clinical profile and outcome of aluminum phosphide-induced esophageal strictures.

    PubMed

    Kochhar, Rakesh; Dutta, Usha; Poornachandra, Kuchhangi Sureshchandra; Vaiphei, Kim; Bhagat, Suraj; Nagi, Birinder; Singh, Kartar

    2010-09-01

    Aluminum phosphide (AlP) is a lethal solid fumigant pesticide which has been recently linked to esophageal stricture formation. This paper aims to study the clinical profile and response to treatment of AlP-induced esophageal strictures. Data on all patients of AlP-induced strictures seen between January 2004 and June 2008 were retrieved and analyzed for clinical parameters and response to endoscopic dilation. Each patient underwent barium swallow to define the site and length of stricture and then was dilated endoscopically. Twelve patients of AlP-induced esophageal stricture (seven males) with a mean age of 26.83+/-8.43 years were evaluated. They had consumed one to three AlP tablets, 4-156 weeks before reporting to us. They had onset of dysphagia within 2 to 8 weeks of ingestion of AlP. Of 14 strictures in 12 patients, seven were in upper third, two in middle third, and five in lower third of esophagus with a mean length of 1.96+/-0.75 cm. Nine patients responded to dilation requiring 5.56+/-2.65 dilations. Four patients were given intralesional steroids to augment the effect of dilation. Three patients failed and were operated upon. All patients remained symptom free over a follow-up of 3-30 (15.67+/-9.41) months. AlP-induced esophageal strictures can be dilated endoscopically in a majority of patients; however, 25% of them require surgical intervention. AlP-induced esophageal strictures, thus, behave like caustic-induced strictures.

  6. Classification of Esophageal Strictures following Esophageal Atresia Repair.

    PubMed

    Macchini, Francesco; Parente, Giovanni; Morandi, Anna; Farris, Giorgio; Gentilino, Valerio; Leva, Ernesto

    2017-03-06

    Introduction The aim of this study was to stratify anastomotic strictures (AS) following esophageal atresia (EA) repair and to establish predictors for the need of dilations. Material and Methods A retrospective study on children operated on for EA between 2004 and 2014 was conducted. The stricture index (SI) was measured both radiologically (SIXR) and endoscopically (SIEND). A correlation analysis between the SI and the number of dilations was performed using Spearman's test and linear regression analysis. Results In this study, 40 patients were included: 35 (87.5%) presented with Gross's type C EA, 3 (7.5%) type A, 1 (2.5%) type B, and 1 (2.5%) type D. The mean follow-up time was 101 ± 71.1 months (range: 7.8-232.5, median: 97.6). The mean SIXR was 0.56 ± 0.16 (range: 0.15-0.86). The mean SIEND was 0.45 ± 0.22 (range: 0.15-0.85). Twenty-four patients (60%) underwent a mean of 2 endoscopic dilations (range: 1-9). The number of dilations was poorly correlated with SIXR, while significantly correlated with SIEND. Patients who did not need dilations had a SIEND < 0.33, patients who needed only one dilation had 0.33 ≤ SIEND < 0.44, and those with SIEND ≥ 0.44 needed two or more dilations. No significant association with other clinical variables was found. All patients were asymptomatic at the time of the first endoscopy. Conclusion SIEND is a useful tool to classify AS and can represent a predictor of the need for endoscopic dilation. The role of the SIEND becomes even more important as clinical characteristics have a low predictive value for the development of an AS and the need for subsequent endoscopic esophageal dilatations.

  7. The Use of Flaps and Grafts in the Treatment of Urethral Stricture Disease

    PubMed Central

    Wisenbaugh, Eric S.; Gelman, Joel

    2015-01-01

    The use of various grafts and flaps plays a critical role in the successful surgical management of urethral stricture disease. A thorough comprehension of relevant anatomy and principles of tissue transfer techniques are essential to understanding the appropriate use of grafts or flaps to optimize outcomes. We briefly review these principles and discuss which technique may be best suited for a given anterior urethral stricture, depending on the location and length of the stricture, the presence or absence of an intact corpus spongiosum, and the availability of adequate and healthy penile skin. PMID:26664357

  8. Should plastic stents be avoided in all unresectable malignant perihilar biliary strictures?

    PubMed

    Kawashima, Hiroki; Itoh, Akihiro; Ohno, Eizaburo; Goto, Hidemi; Hirooka, Yoshiki

    2013-05-01

    Clinical guidelines of the European Society of Gastrointestinal Endoscopy recommend the insertion of self-expandable metallic stents (SEMS) as opposed to plastic stents (PS) in patients with unresectable malignant perihilar stricture (MHS). However, PS are cheaper and easier to insert into the biliary duct compared to SEMS. Furthermore, PS are removable and easy to move into subsequent drainage procedures. We conducted the present retrospective single-center study to elucidate the predictive factors associated with stent patency period duration in patients with unresectable MHS who would benefit from a long patency period after PS placement. This study included 56 consecutive patients with unresectable MHS who were drained using PS. PS failure occurred in 26 (46.4%) patients. The median patency period was 72 days (95% confidence interval: 29.8-114). The only significant predictive factor associated with the length of the stent patency period was history of previous endoscopic sphincterotomy (EST). Median patency periods with and without previous EST were 28 and 109 days, respectively (P = 0.016). In conclusion, we suggest that conventional biliary drainage with PS is still a suitable option for the treatment of unresectable MHS in patients without previous EST.

  9. Allocating monitoring effort in the face of unknown unknowns

    USGS Publications Warehouse

    Wintle, B.A.; Runge, M.C.; Bekessy, S.A.

    2010-01-01

    There is a growing view that to make efficient use of resources, ecological monitoring should be hypothesis-driven and targeted to address specific management questions. 'Targeted' monitoring has been contrasted with other approaches in which a range of quantities are monitored in case they exhibit an alarming trend or provide ad hoc ecological insights. The second form of monitoring, described as surveillance, has been criticized because it does not usually aim to discern between competing hypotheses, and its benefits are harder to identify a priori. The alternative view is that the existence of surveillance data may enable rapid corroboration of emerging hypotheses or help to detect important 'unknown unknowns' that, if undetected, could lead to catastrophic outcomes or missed opportunities. We derive a model to evaluate and compare the efficiency of investments in surveillance and targeted monitoring. We find that a decision to invest in surveillance monitoring may be defensible if: (1) the surveillance design is more likely to discover or corroborate previously unknown phenomena than a targeted design and (2) the expected benefits (or avoided costs) arising from discovery are substantially higher than those arising from a well-planned targeted design. Our examination highlights the importance of being explicit about the objectives, costs and expected benefits of monitoring in a decision analytic framework. ?? 2010 Blackwell Publishing Ltd/CNRS.

  10. Metrology with Unknown Detectors.

    PubMed

    Altorio, Matteo; Genoni, Marco G; Somma, Fabrizia; Barbieri, Marco

    2016-03-11

    The best possible precision is one of the key figures in metrology, but this is established by the exact response of the detection apparatus, which is often unknown. There exist techniques for detector characterization that have been introduced in the context of quantum technologies but apply as well for ordinary classical coherence; these techniques, though, rely on intense data processing. Here, we show that one can make use of the simpler approach of data fitting patterns in order to obtain an estimate of the Cramér-Rao bound allowed by an unknown detector, and we present applications in polarimetry. Further, we show how this formalism provides a useful calculation tool in an estimation problem involving a continuous-variable quantum state, i.e., a quantum harmonic oscillator.

  11. High grade anorectal stricture complicating Crohn's disease: endoscopic treatment using insulated-tip knife

    PubMed Central

    Chon, Hyung Ku; Shin, Ik Sang; Kim, Sang Wook

    2016-01-01

    Endoscopic treatments have emerged as an alternative to surgery, in the treatment of benign colorectal stricture. Unlike endoscopic balloon dilatation, there is limited data on endoscopic electrocautery incision therapy for benign colorectal stricture, especially with regards to safety and long-term patency. We present a case of a 29-year-old female with Crohn's disease who had difficulty in defecation and passing thin stools. A pelvic magnetic resonance imaging scan, gastrograffin enema, and sigmoidoscopy showed a high-grade anorectal stricture. An endoscopic insulated-tip knife incision was successfully performed to resolve the problem. From our experience, we suggest that endoscopic insulated-tip knife treatment may be a feasible and effective modality for patients with short-segment, very rigid, fibrotic anorectal stricture. PMID:27433152

  12. Can esophageal dilation be avoided in the treatment of severe esophageal stricture caused by eosinophilic esophagitis?

    PubMed

    Silva, D; Santos, F; Piedade, S; Morais-Almeida, M

    2015-07-01

    Eosinophilic esophagitis (EoE) is an inflammatory immune-mediated disease with predominant eosinophilic inflammation characterized by the presence of esophageal dysfunction symptoms. Treatment delay can be associated with disease complications, like esophageal strictures, that can justify the use of invasive procedures which are not deprived of side effects. We present a case report of a 14 year old child with severe esophageal stricture secondary to EoE, that was treated with topical and systemic corticosteroid before any invasive procedure was considered. After 26 weeks of medical treatment, significant improvement of esophageal dysfunction occurred with histological remission and stricture resolution. In patients with severe esophageal strictures secondary to EoE, the need for esophageal dilation procedures should be considered only after anti-inflammatory treatment.

  13. Inflammatory stricture of the right ureter following perforated appendicitis: The first Indian report

    PubMed Central

    Rajkumar, Janavikula Sankaran; Ganesh, Deepa; Rajkumar, Anirudh

    2016-01-01

    Perforated appendicitis leading to inflammatory stricture of the right ureter is a rarity. We present this fairly uncommon case of a patient who developed a stricture of the right ureter secondary to an ongoing inflammatory process in the peritoneum and retroperitoneum. A perforated appendicitis was operated upon, and on follow-up the mild hydronephrosis had worsened. Stenting of the right ureter completely solved the problem. PMID:27251819

  14. B Cell Acute Lymphocytic Leukemia Presenting as a Bile Duct Stricture Diagnosed With Cholangioscopy

    PubMed Central

    Bartel, Michael J.; Jiang, Liuyan; Lukens, Frank

    2016-01-01

    Indeterminate biliary strictures represent a diagnostic challenge requiring further work-up, which encompasses a variety of diagnostic modalities. We report a very rare case of B-cell acute lymphocytic leukemia presenting as a biliary stricture following remission of acute myeloid leukemia, which was initially treated with allogenic stem cell transplant. After multiple diagnostic modalities were implemented with no success, the use of cholangioscopy-guided biopsies was the key for the final diagnosis. PMID:27807569

  15. Current diagnosis and treatment of benign biliary strictures after living donor liver transplantation

    PubMed Central

    Chang, Jae Hyuck; Lee, Inseok; Choi, Myung-Gyu; Han, Sok Won

    2016-01-01

    Despite advances in surgical techniques, benign biliary strictures after living donor liver transplantation (LDLT) remain a significant biliary complication and play an important role in graft and patient survival. Benign biliary strictures after transplantation are classified into anastomotic or non-anastomotic strictures. These two types differ in presentation, outcome, and response to therapy. The leading causes of biliary strictures include impaired blood supply, technical errors during surgery, and biliary anomalies. Because patients usually have non-specific symptoms, a high index of suspicion should be maintained. Magnetic resonance cholangiography has gained widespread acceptance as a reliable noninvasive tool for detecting biliary complications. Endoscopy has played an increasingly prominent role in the diagnosis and treatment of biliary strictures after LDLT. Endoscopic management in LDLT recipients may be more challenging than in deceased donor liver transplantation patients because of the complex nature of the duct-to-duct reconstruction. Repeated aggressive endoscopic treatment with dilation and the placement of multiple plastic stents is considered the first-line treatment for biliary strictures. Percutaneous and surgical treatments are now reserved for patients for whom endoscopic management fails and for those with multiple, inaccessible intrahepatic strictures or Roux-en-Y anastomoses. Recent advances in enteroscopy enable treatment, even in these latter cases. Direct cholangioscopy, another advanced form of endoscopy, allows direct visualization of the inner wall of the biliary tree and is expected to facilitate stenting or stone extraction. Rendezvous techniques can be a good option when the endoscopic approach to the biliary stricture is unfeasible. These developments have resulted in almost all patients being managed by the endoscopic approach. PMID:26819525

  16. Usefulness of biodegradable polydioxanone stents in the treatment of postsurgical colorectal strictures and fistulas.

    PubMed

    Pérez Roldán, F; González Carro, P; Villafáñez García, M C; Aoufi Rabih, S; Legaz Huidobro, M L; Sánchez-Manjavacas Múñoz, N; Roncero García-Escribano, O; Ynfante Ferrús, M; Bernardos Martín, E; Ruiz Carrillo, F

    2012-03-01

    Benign colonic strictures and fistulas are a growing problem presenting most commonly after bowel resection. Standard treatment is with endoscopic bougies or, more usually, balloon dilation. When these approaches are not successful, other solutions are available and different endoscopic and surgical approaches have been used to treat fistulas. We present an additional option--biodegradable stents--for the treatment of colonic strictures and fistulas that have proven refractory to other endoscopic interventions. We analyzed the results from 10 patients with either a postsurgical colorectal stricture (n =7) or rectocutaneous fistula (n =3) treated with the biodegradable SX-ELLA esophageal stent (covered or uncovered). Stents were successfully placed in nine patients, although early migration subsequently occurred in one. Placement was impossible in one patient due to deformity of the area and the fact that the stricture was approximately 30cm from the anus. The fistulas were successfully closed in all patients, although symptoms reappeared in one patient. In the six patients who received stents for strictures, symptoms resolved in five; in the remaining patient, the stent migrated shortly after the endoscopy. Treatment of colonic strictures and rectocutaneous fistulas with biodegradable stents is an effective alternative in the short-to-medium term. The stent does not have to be removed and is subject to very few complications. The drawbacks of this approach are the need to repeat the procedure in some patients and the lack of published series on efficacy.

  17. Meta-Analysis of the Long Term Success Rate of Different Interventions in Benign Biliary Strictures

    PubMed Central

    Huszár, Orsolya; Kokas, Bálint; Mátrai, Péter; Hegyi, Péter; Pétervári, Erika; Vincze, Áron; Pár, Gabriella; Sarlós, Patrícia; Bajor, Judit; Czimmer, József; Mosztbacher, Dóra; Márta, Katalin; Zsiborás, Csaba; Varjú, Péter; Szücs, Ákos

    2017-01-01

    Background Benign biliary stricture is a rare condition and the majority of the cases are caused by operative trauma or chronic inflammation based on various etiology. Although the initial results of endoscopic, percutaneous and surgical treatment are impressive, no comparison about long term stricture resolution is available. Aims The goal of this study was to compare the long term disease free survival in benign biliary strictures with various etiology after surgery, percutaneous transhepatic—and endoscopic treatment. Methods PubMed, Embase, and Cochrane Library were searched by computer and manually for published studies. The investigators selected the publications according to the inclusion and exclusion criteria, processed the data and assessed the quality of the selected studies. Meta-analysis of data of 24 publications was performed to compare long term disease free survival of different treatment groups. Results Compared the subgroups surgery resulted in the highest long term stricture resolution rate, followed by the percutaneous transhepatic treatment, the multiple plastic stent insertion and covered self-expanding metal stents (SEMS), however the difference was not significant. All compared methods are significantly superior to the single plastic stent placement. Long term stricture resolution rate irrespectively of any therapy is still not more than 84%. Conclusions In summary, the use of single plastic stent is not recommended. Further randomized studies and innovative technical development are required for improving the treatment of benign biliary strictures. PMID:28076371

  18. Palliative Treatment of Malignant Colorectal Strictures with Metallic Stents

    SciTech Connect

    Paul Diaz, Laura; Pinto Pabon, Isabel; Fernandez Lobato, Rosa; Montes Lopez, Carmen

    1999-01-15

    Purpose: To assess the effectiveness and safety of self-expanding metallic stents as a primary palliative treatment for inoperable malignant colorectal strictures. Methods: Under radiological guidance 20 self-expanding metallic Wallstents were implanted in 16 consecutive patients with colorectal stenoses caused by malignant neoplasms, when surgical treatment of the condition had been ruled out. The patients were followed up clinically for 1-44 months, until death or termination of this study. Results: The stents were successfully implanted in all cases and resolved the clinical obstruction in all the patients except one, who underwent subsequent colostomy. During follow-up of the remaining 15 patients, clinical complications arising from the procedure were pain (two patients), minor rectal bleeding (one patient), and severe rectal bleeding (one patient) (26%). There were three cases of stent migration and three cases of stent occlusion, and reintervention by us was necessary in 20% of cases (3/15). The mean life span following the procedure was 130 days, and none of the patients exhibited clinical symptoms of obstruction at the time of death (12 patients) or termination of the study (3 patients). Conclusion: Deployment of metallic stents under radiologic guidance is an effective alternative as a primary palliative measure in malignant colorectal obstruction, though the possible clinical complications and need for repeat intervention during follow-up should be taken into account.

  19. Percutaneous Management of Biliary Strictures After Pediatric Liver Transplantation

    SciTech Connect

    Miraglia, Roberto Maruzzelli, Luigi; Caruso, Settimo; Riva, Silvia; Spada, Marco; Luca, Angelo; Gridelli, Bruno

    2008-09-15

    We analyze our experience with the management of biliary strictures (BSs) in 27 pediatric patients who underwent liver transplantation with the diagnosis of BS. Mean recipient age was 38 months (range, 2.5-182 months). In all patients percutaneous transhepatic cholangiography, biliary catheter placement, and bilioplasty were performed. In 20 patients the stenoses were judged resolved by percutaneous balloon dilatation and the catheters removed. Mean number of balloon dilatations performed was 4.1 (range, 3-6). No major complications occurred. All 20 patients are symptom-free with respect to BS at a mean follow-up of 13 months (range, 2-46 months). In 15 of 20 patients (75%) one course of percutaneous stenting and bilioplasty was performed, with no evidence of recurrence of BS at a mean follow-up of 15 months (range, 2-46 months). In 4 of 20 patients (20%) two courses of percutaneous stenting and bilioplasty were performed; the mean time to recurrence was 9.8 months (range, 2.4-24 months). There was no evidence of recurrence of BS at a mean follow-up of 12 months (range, 2-16 months). In 1 of 20 patients (5%) three courses of percutaneous stenting and bilioplasty were performed; there was no evidence of recurrence of BS at a mean follow-up of 10 months. In conclusion, BS is a major problem following pediatric liver transplantation. Radiological percutaneous treatment is safe and effective, avoiding, in most cases, surgical revision of the anastomosis.

  20. Recovery of normal esophageal function in a kitten with diffuse megaesophagus and an occult lower esophageal stricture.

    PubMed

    Schneider, Jaycie; Ames, Marisa; DiCicco, Michael; Savage, Mason; Atkins, Clarke; Wood, Michael; Gookin, Jody L

    2015-06-01

    An 8-week-old male domestic shorthair was presented to the Internal Medicine Service at North Carolina State University for regurgitation. Radiographic diagnosis of generalized esophageal dilation and failure of esophageal peristalsis were compatible with diagnosis of congenital megaesophagus. Endoscopic examination of the esophagus revealed a fibrous stricture just orad to the lower esophageal sphincter. Conservative management to increase the body condition and size of the kitten consisted of feeding through a gastrostomy tube, during which time the esophagus regained normal peristaltic function, the stricture orifice widened in size and successful balloon dilatation of the stricture was performed. Esophageal endoscopy should be considered to rule out a stricture near the lower esophageal sphincter in kittens with radiographic findings suggestive of congenital megaesophagus. Management of such kittens by means of gastrostomy tube feeding may be associated with a return of normal esophageal motility and widening of the esophageal stricture, and facilitate subsequent success of interventional dilation of the esophageal stricture.

  1. SIU/ICUD Consultation On Urethral Strictures: Epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, strictures, and pelvic fracture urethral disruption injuries.

    PubMed

    Latini, Jerilyn M; McAninch, Jack W; Brandes, Steven B; Chung, Jae Yong; Rosenstein, Daniel

    2014-03-01

    This committee reviewed and evaluated published data, and recommended standardized terminology relating to the epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, urethral strictures, and pelvic fracture urethral disruption injuries, as well as their surgical management. A literature search using Medline, PubMed (U.S. National Library of Medicine and the National Institutes of Health), Embase, online acronym databases, and abstracts from scientific meetings was performed from 1980-2010. Articles were evaluated using the Levels of Evidence adapted by the International Consultation on Urological Diseases (ICUD) from the Oxford Centre for Evidence-Based Medicine. Recommendations were based on the level of evidence and discussed among the committee to reach a consensus. There is expert opinion to support standards regarding the epidemiology, anatomy, and nomenclature of urethral stenoses, urethral strictures, and pelvic fracture urethral disruption injuries. There is level 3 evidence regarding the epidemiology and etiology of urethral stenoses, urethral strictures, and pelvic fracture urethral injuries. The literature regarding the epidemiology, anatomy, and nomenclature of urethral stenoses, urethral strictures, and pelvic fracture urethral disruption injuries are sparse and generally of a low level of evidence. The proposed ICUD system does not readily apply to these areas. Further research is needed so that stronger levels of evidence can be developed leading to recommendations regarding the accuracy of the data. To improve future research and promote effective scientific progress and communication, a standardized nomenclature and anatomy regarding the urethra and urethral surgery is detailed herein.

  2. Topical mitomycin C can effectively alleviate dysphagia in children with long-segment caustic esophageal strictures.

    PubMed

    El-Asmar, K M; Hassan, M A; Abdelkader, H M; Hamza, A F

    2015-07-01

    Caustic ingestion in children and the resulting long esophageal strictures are usually difficult to be managed, and eventually, esophageal replacement was required for cases refractory to frequent dilatation sessions. Topical mitomycin C (MMC) application has been used recently to improve the results of endoscopic dilatation for short esophageal strictures. The study aims to assess the role of MMC application in management of long-segment caustic esophageal strictures. From January 2009 to June December 2013, patients presented with long caustic esophageal stricture (>3 cm in length) were included in this study and subjected to topical MMC application after endoscopic esophageal dilatation on multiple sessions. Regular follow-up and re-evaluation were done. A dysphagia score was used for close follow-up clinically; verification was done radiologically and endoscopically. During the specified follow-up period, 21 patients with long caustic esophageal stricture were subjected to topical MMC application sessions. Clinical, radiological, and endoscopic resolution of strictures occurred in 18 patients (85.7% cure rate). Number of dilatation sessions to achieve resolution of dysphagia was (n = 14.3 ± 5.7) with application of mitomycin two to six times. There was no recurrence in short- and mid-term follow-up. No complications were encountered related to topical MMC application. MMC is a promising agent in management of long-segment caustic esophageal strictures. Long-term follow-up is needed to prove its efficacy and to evaluate potential long-term side-effects of MMC application.

  3. Treatment of Ureterointestinal Anastomotic Strictures by Diathermal or Cryoplastic Dilatation

    SciTech Connect

    Orsi, Franco; Penco, Silvia Matei, Victor; Bonomo, Guido; Vigna, Paolo Della; Monfardini, Lorenzo; Cobelli, Ottavio De

    2007-09-15

    Background. Ureterointestinal anastomotic strictures (UAS) complicate 10-15% of surgeries for urinary diversion and are the main cause of deterioration in renal function. Treatments are surgical revision, management with autostatic stent, balloon dilatation, endoscopic incision, and percutaneous transrenal diathermy (Acucise). A new option is cryoplastic dilatation (Polar-Cath). Purpose. To assess the feasibility, complications, and preliminary results of UAS treatment using the Acucise and Polar-Cath systems. Methods. Nineteen UAS, diagnosed by ultrasonography or computed tomography and sequential renal scintigraphy, occurred in 15 cancer patients after radical cystectomy and urinary diversion. Fifteen were managed with balloon diathermy and 4 by balloon cryoplasty in a three-stage procedure-percutaneous nephrostomy, diathermal or cryoplastic dilatation, and transnephrostomic control with nephrostomy removal-each separated by 15 days. All patients gave written informed consent. Results. Dilatations were successful in all cases. The procedure is simple and rapid (about 45 min) under fluoroscopic control and sedation. Procedural complications occurred in 1 (5%) patient with UAS after Wallace II uretero-ileocutaneostomy: a common iliac artery lesion was induced by diathermal dilatation, evident subsequently, and required surgical repair. Patency with balloon diathermy was good, with two restenoses developing over 12 months (range 1-22) of follow-up. With balloon cryoplastic dilatation, one restenosis developed in the short term; follow-up is too brief to assess the long-term efficacy. Conclusion. Our short-term results with diathermal and cryoplastic dilatation to resolve UAS are good. If supported by longer follow-up, the techniques may be considered as first-choice approaches to UAS. Surgery should be reserved for cases in which this minimally invasive technique fails.

  4. Comparison of sonoelastography with sonourethrography and retrograde urethrography in the evaluation of male anterior urethral strictures

    PubMed Central

    Talreja, Shyam Manoharlal; Tomar, Vinay; Yadav, Sher Singh; Jaipal, Usha; Priyadarshi, Shivam; Agarwal, Neeraj; Vyas, Nachiket

    2016-01-01

    Objective Retrograde urethrography (RUG) is the most common and preferred imaging modality for imaging of the anterior urethral strictures despite its well-known limitations and disadvantages. Sonourethrography (SUG) was introduced in 1988 to overcome the limitations of RUG and to provide more accurate results. As proper selection of imaging modality is very important for planning the treatment, various advances in this area are required. One of the major factors for recurrence of stricture disease is spongiofibrosis. Sonoelastography (SE) is a newer technique, tried in various other pathologies. In this study, we have used this technique for the first time to assess its efficacy in the evaluation of anterior urethral stricture disease by comparison with RUG and SUG. Material and methods Between August 2014 and May 2015, 77 patients with clinical features of anterior urethral stricture disease were included in the study and evaluated by RUG followed by SUG and SE for stricture location, length, depth of spongiofibrosis and periurethral pathologies. The results were then correlated with operative and histopathological findings. Results Overall diagnostic accuracy of SE, SUG, and RGU for the estimation of stricture location, and length were estimated 92.68% vs. 91.54%, 79% vs. 78.87% and 80.48% vs. 43.66%, respectively, while for depth of spongiofibrosis SE, and SUG had accuracy rates of 87.3%, 48%, respectively. The mean length measured on SE was nearest to the mean intra-operative stricture length (21.34+11.8 mm). SE findings significantly correlated with the colour of bladder mucosa on cystoscopic examination (p=0.003) whereas the association was non-significant (p=0.127) for difficulty in incision. While a nonsignificant correlation existed between SUG findings related both to the colour of the bladder mucosa and difficulty in incision on cystoscopy, SE findings had a significant association (p<0.001) with histopathology findings for severe degree of fibrosis

  5. Penile inversion through a penoscrotal incision for the treatment of penile urethral strictures

    PubMed Central

    Tracey, James M; Zhumkhawala, Ali A; Chan, Kevin G.; Lau, Clayton S.

    2016-01-01

    Purpose This article describes a novel technique for the repair of penile urethral strictures and establishes the safety, feasibility, and efficacy of this innovative surgical approach. Materials and Methods Patients with urethral strictures underwent a one-sided anterior dorsal oral mucosal graft urethroplasty through a penoscrotal inversion technique. The clinical outcome was considered a failure when any instrumentation was needed postoperatively, including dilatation. Results Five patients underwent the novel procedure. The patients' mean age was 58 years. The cause of stricture was instrumentation in 2 cases (40%), lichen sclerosis in 1 case (20%), and failed hypospadias repair in 2 cases (40%). The mean stricture length was 3 cm. The overall mean (range) follow-up was 6 months (range, 3–9 months). Of the 5 patients, 4 (80%) had a successful outcome and 1 (20%) had a failed outcome. The failure was successfully treated by use of a meatotomy. Conclusions The penile inversion technique through a penoscrotal incision is a viable option for the management of penile urethral strictures with several advantages to other techniques: namely, no penile skin incision, a single-stage operation, and supine positioning. PMID:26981596

  6. An animal model of photodynamic-therapy-induced esophageal stricture: preliminary report

    NASA Astrophysics Data System (ADS)

    Perry, Yaron; Epperly, Michael W.; Finkelstein, Sydney; Klein, Edwin; Greenberger, Joel; Luketich, James

    2003-06-01

    Photodynamic Therapy (PDT) using Photofrin has been recently approved by the FDA for the treatment of esophageal cancer and Barrett's esophagus. A major limitation of PDT for Barrett's esophagus is the development of esophageal stricture in up to 53% of patients. Mechanisms of PDT stricture formation have not been elucidated. The major difficulty is the lack of an animal model for PDT-induced stricture. We have used a pig model in which the esophagus is very similar to that of the human esophagus. Two (Scrofa) domestic pigs were injected with Photofrin at dosage of 2 mg/kg 48 hours prior to photoactivation with 630 nm light. Following anesthesia, a laser probe (2.5 cm in length) was passed through the oral cavity to approximately the mid-point of the esophagus via an endoscope. Light energy (400 Joules (J)/cm) was delivered as a single dose in one pig or repeated at 72 hours in the second pig. In this pig model, upper endoscopy, Barium swallow and pathological studies confirmed stricture formation following esophageal PDT exposure of 400 J as one or two fractions. We believe that this is the first animal model created to study esophageal strictures resulting from PDT.

  7. Intensity-Modulated Radiotherapy for Head and Neck Cancer of Unknown Primary: Toxicity and Preliminary Efficacy

    SciTech Connect

    Klem, Michelle L. Mechalakos, James G.; Wolden, Suzanne L.; Zelefsky, Michael J.; Singh, Bhuvanesh; Kraus, Dennis; Shaha, Ashok; Shah, Jatin; Pfister, David G.; Lee, Nancy Y.

    2008-03-15

    Purpose: Unknown primary head and neck cancers often require comprehensive mucosal and bilateral neck irradiation. With conventional techniques, significant toxicity can develop. Intensity-modulated radiotherapy (IMRT) has the potential to minimize the toxicity. Methods and Materials: Between 2000 and 2005, 21 patients underwent IMRT for unknown primary head and neck cancer at our center. Of the 21 patients, 5 received IMRT with definitive intent and 16 as postoperative therapy; 14 received concurrent chemotherapy and 7 IMRT alone. The target volumes included the bilateral neck and mucosal surface. The median dose was 66 Gy. Acute and chronic toxicities, esophageal strictures, and percutaneous endoscopic gastrostomy tube dependence were evaluated. Progression-free survival, regional progression-free survival, distant metastasis-free survival, and overall survival were estimated with Kaplan-Meier curves. Results: With a median follow-up of 24 months, the 2-year regional progression-free survival, distant metastasis-free survival, and overall survival rate was 90%, 90%, and 85%, respectively. Acute grade 1 and 2 xerostomia was seen in 57% and 43% of patients, respectively. Salivary function improved with time. Percutaneous endoscopic gastrostomy tube placement was required in 72% with combined modality treatment and 43% with IMRT alone. Only 1 patient required percutaneous endoscopic gastrostomy support at the last follow-up visit. Two patients treated with combined modality and one treated with IMRT alone developed esophageal strictures, but all had improvement or resolution with dilation. Conclusion: The preliminary analysis of IMRT for unknown primary head and neck cancer has shown acceptable toxicity and encouraging efficacy. The analysis of the dosimetric variables showed excellent tumor coverage and acceptable doses to critical normal structures. Esophageal strictures developed but were effectively treated with dilation. Techniques to limit the esophageal dose

  8. 66. Buckwheat Launder, date unknown Historic Photograph, Photographer Unknown; Collection ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    66. Buckwheat Launder, date unknown Historic Photograph, Photographer Unknown; Collection of William Everett, Jr. (Wilkes-Barre, PA), photocopy by Joseph E.B. Elliot - Huber Coal Breaker, 101 South Main Street, Ashley, Luzerne County, PA

  9. 6. Photocopy of photograph Photographer unknown, date unknown DETAIL OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. Photocopy of photograph Photographer unknown, date unknown DETAIL OF BOTTOM OF DRUM, SHOWING DECORATIVE MOLDING OF DRUM AND ARCHES: NOTE EFFECT OF BOX BEAMS CREATED BY MOLDING - University of Kentucky, Carnegie Library, Lexington, Fayette County, KY

  10. 22. Photocopy of photograph (photographer unknown, date unknown, original print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. Photocopy of photograph (photographer unknown, date unknown, original print in possession of National Park Service, Petrified Forest National Park), EROSION CONTROL IN RIVER NEAR BRIDGE. - Rio Puerco Bridge, Mainline Road, spanning Rio Puerco, Holbrook, Navajo County, AZ

  11. 7. Photocopy of painting (Source unknown, Date unknown) EXTERIOR SOUTH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. Photocopy of painting (Source unknown, Date unknown) EXTERIOR SOUTH FRONT VIEW OF MISSION AND CONVENTO AFTER 1913 - Mission San Francisco Solano de Sonoma, First & Spain Streets, Sonoma, Sonoma County, CA

  12. 6. Photocopy of photograph (location of original negative unknown) Unknown, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. Photocopy of photograph (location of original negative unknown) Unknown, Photographer, Date Unknown PERSPECTIVE VIEW OF SOUTH (FRONT) AND EAST SIDE DURING MOVE SHOWING HOUSE RAISED - Hamilton Grange, (Moved From) 237 West 141 Street to 141st Street & Amsterdam, New York County, NY

  13. 4. Photocopy of photograph (location of original negative unknown) Unknown, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. Photocopy of photograph (location of original negative unknown) Unknown, Photographer, Date Unknown PERSPECTIVE VIEW OF SOUTH (FRONT) AND EAST SIDE BEFORE HOUSE MOVED SHOWING THIRTEEN LIQUIDAMBAR TREES IN FOREGROUND - Hamilton Grange, (Moved From) 237 West 141 Street to 141st Street & Amsterdam, New York County, NY

  14. International prostate symptom score as a clinical outcome measure for Ethiopian patients with urethral stricture.

    PubMed

    Lemma, Be-ede; Taye, Mulat; Hawando, Tegene; Bakke, August

    2004-10-01

    Eighty-four urethral stricture patients and 73 controls were studied prospectively over a 6 months period in Tikur Anbessa Hospital from April to August 2000. The purpose of the study was to evaluate the use of International Prostate Symptom Score (IPSS) as an outcome measurement instrument for urethral stricture patients in Ethiopia. The Amharic translation of IPSS (IPSS Amh) was used in this study. Internal consistency was 0.91. Construct validity was 0.73. Test-retest reliability was 0.95. Sensitivity and specificity were 76% and 71% respectively. In conclusion the IPSS Amh was found to be valid for use in urethral stricture patients in Ethiopia. We recommend the wide use of this cheap and easily available clinical measurement instrument.

  15. [Dilatation of anastomotic stricture by Nd:YAG laser beam under endoscopy].

    PubMed

    Lu, Z C; Chen, L G; Zhang, Y Y

    1994-11-01

    Anastomotic stricture has become a common complication following surgical treatment of upper gastrointestinal cancers. A technique was devised to alleviate the stricture with Nd. YAG laser beam under endoscopy. The laser beam was applied at 3-4 different points near the anastomotic stoma. The thermal effect of the beam would cut the scar tissues in and underneath the mucosa, leading to dilatation of the stoma. A total of 48 patients with cancer of the esophagus (n = 21), gastric cardia (n = 20), body of stomach (n = 6) and gastric stump (n = 1) with postoperative anastomotic stricture was so treated. According to the degree of dilatation, the result of treatment upon longterm follow-up was good (the anastomotic stoma was enlarged more than 6 mm) in 41 (85.4%), fair (the stoma enlarged 4-5 mm) in 5 (10.4%) and poor in the remaining 2. Due precautions should be made to avoid bleeding and perforation.

  16. Side to Side Esophagogastrojejunoplasty in Post-corrosive Stricture of Distal Esophagus and Proximal Stomach.

    PubMed

    Sharma, Praveen; Pancholi, Mukesh; Patel, Gulab; Sharma, Anju

    2015-12-01

    A four years old female child presented after 2 months of ingestion of battery fluid (sulfuric acid) accidently with stricture of the distal esophagus, esophagogastric junction, and fundus as well as proximal portion of the body of the stomach. Corrosive stricture involving the distal esophagus with the proximal stomach is not a frequently encountered condition. Side to side esophagogastrojejunostomy without removal of the strictured esophagus or stomach (side to side esophagogastrojejunoplasty) can be done in such patient hence preserving the stomach which is important physiologically as a reservoir and for the secretion of gastric juices. In review of literature in search engines like MD Consult, PubMed, Cochrane Library, and Embase and standard textbooks of surgery, we could not find such procedure had been performed till date, so that it is the innovative approach with support of literature and surgical principles.

  17. Challenges in the Diagnosis and Management of Acquired Nontraumatic Urethral Strictures in Boys in Yaoundé, Cameroon

    PubMed Central

    Mouafo Tambo, F. F.; Fossi kamga, G.; Kamadjou, C.; Mbouche, L.; Nwaha Makon, A. S.; Birraux, J.; Andze, O. G.; Angwafo, F. F.; Mure, P. Y.

    2016-01-01

    Introduction. Urethral strictures in boys denote narrowing of the urethra which can be congenital or acquired. In case of acquired strictures, the etiology is iatrogenic or traumatic and rarely infectious or inflammatory. The aim of this study was to highlight the diagnostic and therapeutic difficulties of acquired nontraumatic urethral strictures in boys in Yaoundé, Cameroon. Methodology. The authors report five cases of nontraumatic urethral strictures managed at the Pediatric Surgery Department of the YGOPH over a two-year period (November 2012–November 2014). In order to confirm the diagnosis of urethral stricture, all patients were assessed with both cystourethrography and urethrocystoscopy. Results. In all the cases the urethra was inflammatory with either a single or multiple strictures. The surgical management included internal urethrotomy (n = 1), urethral dilatation (n = 1), vesicostomy (n = 2), and urethral catheterization (n = 3). With a median follow-up of 8.2 months (4–16 months) all patients remained symptoms-free. Conclusion. The authors report the difficulties encountered in the diagnosis and management of nontraumatic urethral strictures in boys at a tertiary hospital in Yaoundé, Cameroon. The existence of an inflammatory etiology of urethral strictures in boys deserves to be considered. PMID:27239364

  18. Laparoscopic transgastric endoscopic retrograde cholangiopancreatography for benign common bile duct stricture after Roux-en-Y gastric bypass.

    PubMed

    Peters, M; Papasavas, P K; Caushaj, P F; Kania, R J; Gagné, D J

    2002-07-01

    Access to the gastric remnant and duodenum is lost after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Traditionally, a percutaneous transhepatic access to the common bile duct has been used to manage choledocholithiasis and duct strictures. We present a novel method of laparoscopic transgastric endoscopic retrograde cholangiopancreatography for managing a benign biliary stricture after a Roux-en-Y gastric bypass.

  19. [First experience of Ho:YAG laser urethrotomy in the treatment of strictures in patients with prostate cancer].

    PubMed

    Lebedinets, A A; Shkol'nik, M I; Timofeev, D A

    2014-01-01

    Strictures of vesicourethral anastomosis (VUA), urethral strictures, and bladder neck obliteration are frequent complications occurring after treatment for prostate cancer and dramatically reducing the quality of life of the patients. To date, there is no single standard treatment of urethral strictures. One of the promising methods is laser optical urethrotomy using a solid-state Ho:YAG- laser. Since 2012, we treated 12 patients with strictures of VUA, urethral strictures, and bladder neck obliteration. According urethrography, the maximum length of stricture was 4.5 cm. Treatment efficacy was assessed at 6 months after surgery objectively according urethrography, uroflowmetry, and ultrasound of the bladder with the definition of residual urine; and subjectively--by IPSS questionnaire and QoL questionnaire. After removal of the urethral catheter, all patients had recovered independent urination, decreased IPSS scores by 59.5%, IPSS-QoL score by 45.87%, decreased residual urine volume by 89.92%, and increased maximum urinary flow rate by 78.19%. Intraoperative complications and early postoperative complications were not observed. Ho:YAG laser is a minimally invasive and safe tool for urethrotomy of strictures of VUA, urethral strictures, and bladder neck obliteration arising after treatment for prostate cancer. Definitive conclusions about the effectiveness of this method should be based on long-term results of comparative trials.

  20. Controlled unknown quantum operations on hybrid systems

    NASA Astrophysics Data System (ADS)

    He, Yong; Luo, Ming-Xing

    2016-12-01

    Any unknown unitary operations conditioned on a control system can be deterministically performed if ancillary subspaces are available for the target systems [Zhou X Q, et al. 2011 Nat. Commun. 2 413]. In this paper, we show that previous optical schemes may be extended to general hybrid systems if unknown operations are provided by optical instruments. Moreover, a probabilistic scheme is proposed when the unknown operation may be performed on the subspaces of ancillary high-dimensional systems. Furthermore, the unknown operations conditioned on the multi-control system may be reduced to the case with a control system using additional linear circuit complexity. The new schemes may be more flexible for different systems or hybrid systems. Project supported by the National Natural Science Foundation of China (Grant Nos. 61303039 and 61201253), Chunying Fellowship, and Fundamental Research Funds for the Central Universities, China (Grant No. 2682014CX095).

  1. Learning for an Unknown Future

    ERIC Educational Resources Information Center

    Barnett, Ronald

    2012-01-01

    What is it to learn for an unknown future? It might be said that the future has always been unknown but this question surely takes on a new pedagogical challenge in the contemporary age. Generic skills may seem to offer the basis of just such a learning for an unknown future. Generic skills, by definition, are those that surely hold across…

  2. Evaluation of risk factors and treatment options in patients with ureteral stricture disease at a single institution

    PubMed Central

    Tran, Henry; Arsovska, Olga; Paterson, Ryan F.; Chew, Ben H.

    2015-01-01

    Introduction: Ureteral strictures are a significant cause of morbidity and mortality, resulting in potential kidney damage requiring several surgical procedures. Non-malignant causes include radiation, trauma from calculi impaction, pelvic surgery, or ureteroscopy (URS). We identified risk factors in our patients with ureteral strictures and the success of their treatment outcomes. Methods: A retrospective chart review of 25 patients with 29 ureteral strictures was performed to determine the success of their treatment. Results: Twenty-five (25) patients with 29 benign ureteral strictures were identified. Most cases (60%) were caused by impacted stones where the median stone size was 1.15 cm (0.37–1.8 cm). Intervention for stones prior to stricture development included shockwave lithotripsy, URS, and percutaneous nephrolithotomy. Five patients with strictures from impacted stones had ureteric complications during stone treatment including perforation +/− urinoma (n=3), fractured guidewire left in situ (n=1), and ureteric orifice resection (n=1). Other stricture etiologies included radiation (28%) and endometriosis (4%). Treatment modalities used included ureteroureterostomy (n=2), ureteral re-implant (n=3), urinary diversion (n=3), autotrasplant (n=1), laser endoureterotomy +/− balloon dilation (n=8), nephrectomy (n=2), balloon dilation +/− stent (n=3), ureterovesical junction (UVJ) resection + stent (n=1), chronic stent changes (n=4), or surveillance (n=3). Conclusions: Our evaluation highlights important principles. Patients with complicated ureteroscopies or severely impacted calculi warrant close followup with imaging after stone treatment due to possibility of rapid renal deterioration from stricture formation. Radiation-induced strictures are difficult to manage, possibly requiring subsequent urinary diversion. Finally, endoscopic management of benign ureteral strictures via balloon dilation and laser endoureterotomy is an excellent choice in properly

  3. 7. Photocopy of photograph (location of original negative unknown) Unknown, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. Photocopy of photograph (location of original negative unknown) Unknown, Photographer, Date Unknown PERSPECTIVE VIEW (SOUTHEAST) FROM ORIGINAL SITE SHOWING THIRTEEN LIQUIDAMBAR TREES (FOREGROUND) AND NORTH AND WEST SIDES OF HOUSE AS LOCATED AND ALTERED AT PRESENT SITE (ENTRANCE STAIRS FROM ORIGINAL SOUTH FRONT MOVED TO PRESENT WEST FRONT) - Hamilton Grange, (Moved From) 237 West 141 Street to 141st Street & Amsterdam, New York County, NY

  4. Cost-effective Strategies for the Management and Treatment of Urethral Stricture Disease.

    PubMed

    Osterberg, E Charles; Murphy, Gregory; Harris, Catherine R; Breyer, Benjamin N

    2017-02-01

    Following failed endoscopic intervention, the most cost-effective strategy for recurrent urethral stricture disease (USD) is urethroplasty. Inpatient hospital costs associated with urethroplasty are driven by patient comorbidities and postoperative complications. Symptom-based surveillance for USD recurrence will reduce unnecessary diagnostic procedures and cost.

  5. Role of endoscopic retrograde cholangiopancreatography in the management of benign biliary strictures: What’s new?

    PubMed Central

    Ferreira, Rosa; Loureiro, Rui; Nunes, Nuno; Santos, António Alberto; Maio, Rui; Cravo, Marília; Duarte, Maria Antónia

    2016-01-01

    Benign biliary strictures comprise a heterogeneous group of diseases. The most common strictures amenable to endoscopic treatment are post-cholecystectomy, post-liver transplantation, related to primary sclerosing cholangitis and to chronic pancreatitis. Endoscopic treatment of benign biliary strictures is widely used as first line therapy, since it is effective, safe, noninvasive and repeatable. Endoscopic techniques currently used are dilation, multiple plastic stents insertion and fully covered self-expandable metal stents. The main indication for dilation alone is primary sclerosing cholangitis related strictures. In the vast majority of the remaining cases, temporary placement of multiple plastic stents with/without dilation is considered the treatment of choice. Although this approach is effective, it requires multiple endoscopic sessions due to the short duration of stent patency. Fully covered self-expandable metal stents appear as a good alternative to plastic stents, since they have an increased radial diameter, longer stent patency, easier insertion technique and similar efficacy. Recent advances in endoscopic technique and various devices have allowed successful treatment in most cases. The development of novel endoscopic techniques and devices is still ongoing. PMID:26962404

  6. ‘Real-time sonoelastography’ in anterior urethral strictures: A novel technique for assessment of spongiofibrosis

    PubMed Central

    Yadav, Sher Singh; Tomar, Vinay; Agarwal, Neeraj; Jaipal, Usha; Priyadarshi, Shivam

    2016-01-01

    Introduction Spongiofibrosis assessment is critically important in the evaluation of anterior urethral strictures as its severity is directly proportional to stricture recurrence and thus affects management. Retrograde urethrography (RGU) is ineffective in the evaluation of spongiofibrosis. Sonourethrography (SUG) delineates it but does not accurately estimate its depth. Real-time elastography (RTE), a newer technique that not only attempts a qualitative but also quantitative estimation of spongiofibrosis (tissue stiffness) which results due to underlying pathological processes. Material and methods In the present study, various elastographic patterns and strain ratios in anterior urethral stricture patients were studied and compared to operative and histopathological findings. Sixty-three RGU diagnosed anterior urethral stricture cases were taken and re-evaluated by SUG and SE by another radiologist who was blinded to the findings of the RGU. Strain patterns and ratios of spongiofibrotic segments were documented and compared with operative findings as gold standard. Results Blue pattern on RTE showed 100% concordance with severe fibrosis as evaluated against histopathological findings whereas green pattern showed 87.5% concordance with moderate degree of fibrosis. Severe degree of fibrosis cases, confirmed on histopathology had a significantly higher mean strain ratio (10.51 ±2.297) as compared to moderate degree (6.33 ±2.353) (p <0.001 S). Conclusions Real time sonoelastography in the evaluation of spongiofibrosis not only assesses it qualitatively but also quantifies it. Strain ratios are statistically better indicators for estimating spongiofibrosis. PMID:28127461

  7. Photodynamic therapy for Barrett's esophagus: effect of steroid therapy on stricture formation

    NASA Astrophysics Data System (ADS)

    Panjehpour, Masoud; Overholt, Bergein F.; Haydek, John M.; Lee, Sharon G.

    1999-07-01

    The primary goal of this study was to investigate whether the use of oral steroids would reduce the incidence of stricture formation after balloon photodynamic therapy in patients with dysplasia and early caner in Barrett's esophagus. The effect of other treatment parameters such as light dose and multiple treatments were also investigated.

  8. Probe-Based Confocal Laser Endomicroscopy for Indeterminate Biliary Strictures: Refinement of the Image Interpretation Classification

    PubMed Central

    Giovannini, Marc; Jamidar, Priya; Gan, S. Ian; Cesaro, Paola; Caillol, Fabrice; Filoche, Bernard; Karia, Kunal; Smith, Ioana; Slivka, Adam

    2015-01-01

    Background. Accurate diagnosis and clinical management of indeterminate biliary strictures are often a challenge. Tissue confirmation modalities during Endoscopic Retrograde Cholangiopancreatography (ERCP) suffer from low sensitivity and poor diagnostic accuracy. Probe-based confocal laser endomicroscopy (pCLE) has been shown to be sensitive for malignant strictures characterization (98%) but lacks specificity (67%) due to inflammatory conditions inducing false positives. Methods. Six pCLE experts validated the Paris Classification, designed for diagnosing inflammatory biliary strictures, using a set of 40 pCLE sequences obtained during the prospective registry (19 inflammatory, 6 benign, and 15 malignant). The 4 criteria used included (1) multiple thin white bands, (2) dark granular pattern with scales, (3) increased space between scales, and (4) thickened reticular structures. Interobserver agreement was further calculated on a separate set of 18 pCLE sequences. Results. Overall accuracy was 82.5% (n = 40 retrospectively diagnosed) versus 81% (n = 89 prospectively collected) for the registry, resulting in a sensitivity of 81.2% (versus 98% for the prospective study) and a specificity of 83.3% (versus 67% for the prospective study). The corresponding interobserver agreement for 18 pCLE clips was fair (k = 0.37). Conclusion. Specificity of pCLE using the Paris Classification for the characterization of indeterminate bile duct stricture was increased, without impacting the overall accuracy. PMID:25866506

  9. Successful salvage of kidney allografts threatened by ureteral stricture using pyelovesical bypass.

    PubMed

    Azhar, R A; Hassanain, M; Aljiffry, M; Aldousari, S; Cabrera, T; Andonian, S; Metrakos, P; Anidjar, M; Paraskevas, S

    2010-06-01

    Ureteral stricture is the most common urologic complication after renal transplantation. When endourologic management fails, open ureteral reconstruction remains the standard treatment. The complexity of some of these procedures makes it necessary to explore other means of repair. This study evaluated the intermediate-term outcome of subcutaneous pyelovesical bypass graft (SPBG) on renal transplant recipients. We reviewed 8 patients (6 male and 2 female; mean age 52 years) with refractory ureteral strictures postrenal transplantation, who received SPBG as salvage therapy. All patients failed endourologic management and half failed open management of their strictures. After a mean follow-up of 19.4 months, 7 out of 8 renal grafts have good function with mean GFR of 58.5 mL/min/1.73 m(2), without evidence of obstruction or infection. One patient lost his graft due to persistent infection of the SPBG and one patient developed a recurrent urinary tract infection managed with long-term antibiotics. SPBG offers a last resort in the treatment of ureteral stricture after renal transplantation refractory to conventional therapy.

  10. Isolated Ileal Stricture Secondary to Antigen-Negative GI Histoplasmosis in a Patient on Immunosuppressive Therapy

    PubMed Central

    Green, Michael; Nehme, Fredy; Tofteland, Nathan

    2017-01-01

    We present a case of antigen-negative disseminated histoplasmosis manifesting as an isolated ileal stricture in a patient on chronic infliximab and methotrexate. Diagnosis can be challenging due to imperfect tests, and this condition should remain in the differential, even with negative testing. Mortality of untreated disseminated histoplasmosis can be as high as 80%. PMID:28144615

  11. Prophylactic steroid administration for strictures after endoscopic resection of large superficial esophageal squamous cell carcinoma

    PubMed Central

    Kadota, Tomohiro; Yano, Tomonori; Kato, Tomoji; Imajoh, Maomi; Noguchi, Masaaki; Morimoto, Hiroyuki; Osera, Shozo; Yoda, Yusuke; Oono, Yasuhiro; Ikematsu, Hiroaki; Ohtsu, Atsushi; Kaneko, Kazuhiro

    2016-01-01

    Background and study aims: One of the major complications after endoscopic resection (ER) for large superficial esophageal squamous cell carcinoma (ESCC) is benign esophageal stricture, which can reduce quality of life even if ESCC achieves a cure without organ resection. Recently, steroid administration has been reported as a prophylactic treatment to prevent esophageal strictures. This retrospective study evaluated the stricture rate according to the different width of mucosal defects due to ER and compared it to that seen with prophylactic steroid administration. Patients and methods: Between June 2007 and December 2013, we enrolled patients with ESCC who had 3/4 or larger circumferential mucosal defects due to ER. In December 2009, steroid injections (triamcinolone acetonide 50 mg) into the ulcer bed due to ER were introduced. Beginning in November 2012, we commenced oral steroid administration (prednisolone 30 mg/day, tapered gradually for 8 weeks) in addition to steroid injection. Patients were classified into 3 groups according to the width of mucosal defect after ER (Group A, ≥ 3/4 and < 7/8; Group B, ≥ 7/8 and less than the entire circumference; and Group C, the entire circumference). We retrospectively evaluated the stricture rate by comparing no treatment, steroid injection, or steroid injection followed by oral steroid according to the width of mucosal defect. Results: A total of 115 patients met the selection criteria. In Group B, no treatment had a significantly higher stricture rate (100 %, vs. steroid injection: 56 % P = 0.015; vs steroid injection followed by oral steroid: 20 % P < 0.001). Conversely, in Group C, the stricture rate was high, regardless of treatment (no treatment: 100 %; steroid injection: 100 %; steroid injection followed by oral steroid: 71 %). Conclusions: Although prophylactic steroid administration is effective to prevent strictures for 7/8 circumference or larger mucosal defects, it is

  12. Benign esophageal stricture after thermal injury treated with esophagectomy and ileocolon interposition

    PubMed Central

    Kitajima, Toshihiro; Momose, Kota; Lee, Seigi; Haruta, Shusuke; Shinohara, Hisashi; Ueno, Masaki; Fujii, Takeshi; Udagawa, Harushi

    2014-01-01

    Thermal injuries of the esophagus are rare causes of benign esophageal stricture, and all published cases were successfully treated with conservative management. A 28-year-old Japanese man with a thermal esophageal injury caused by drinking a cup of hot coffee six months earlier was referred to our hospital. The hot coffee was consumed in a single gulp at a party. Although the patient had been treated conservatively at another hospital, his symptoms of dysphagia gradually worsened after discharge. An upper gastrointestinal endoscopy and computed tomography revealed a pin-hole like area of stricture located 19 cm distally from the incisors to the esophagogastric junction, as well as circumferential stenosis with notable wall thickness at the same site. The patient underwent a thoracoscopic esophageal resection with reconstruction using ileocolon interposition. The pathological findings revealed wall thickening along the entire length of the esophagus, with massive fibrosis extending to the muscularis propria and adventitia at almost all levels. Treatment with balloon dilation for long areas of stricture is generally difficult, and stent placement in patients with benign esophageal stricture, particularly young patients, is not yet widely accepted due to the incidence of late adverse events. Considering the curability and quality-of-life associated with a long expected prognosis, we determined that surgery was the best treatment option for this young patient. In this case, we decided to perform an esophagectomy and reconstruction with ileocolon interposition in order to preserve the reservoir function of the stomach and to avoid any problems related to the reflux of gastric contents. In conclusion, resection of the esophagus is a treatment option in patients with benign esophageal injury, especially in cases involving young patients with refractory esophageal stricture. In addition, ileocolon interposition may help to improve the quality-of-life of patients. PMID

  13. Single stage circumferential lingual mucosal graft urethroplasty in near obliterative bulbar urethra stricture: A novel technique

    PubMed Central

    Sharma, Umesh; Yadav, Sher Singh; Tomar, Vinay; Garg, Amit

    2016-01-01

    Aims: This is a prospective study of the use and efficacy of a novel technique of circumferential tubularised lingual mucosal graft (LMG) in obliterative and near obliterative bulbar urethral stricture of >2 cm where excisional and augmented anastomotic urethroplasty are not feasible. Materials and Methods: The stenotic urethral segment was opened dorsally in midline and fibrosed urethra was excised taking care to preserve the healthy spongiosum tissue. LMG (av. Length 3 cm) was placed from one end of corporal body towards spongy tissue in a circumferential manner. Another LMG was placed in similar manner to deal with longer stricture. The urethra was tubularised over 14 Fr silicone catheter. Results: A total of 12 men, of mean age 47 years underwent this procedure. The mean follow up period was 11 months starting from July 2014 till manuscript submission. Follow up included voiding cystourethrogram at 3 weeks, cystoscopy at 3 months (one patient didn’t turned up) and subsequent follow up. Mean stricture length was 4.66 cm (range, 3–8.5 cm) and mean operative time was 195 min. (range, 160 to 200 min.). The technique was successful (normal voiding with no need for any post-operative procedure) in 11(91.6%) patients. One patient developed early recurrence at 4 month of surgery and had anastomotic stricture which was successfully managed by direct visual internal urethrotomy. Conclusion: Single stage circumferential tubularised graft urethroplasty is an excellent technique for strictures that include segments of obliterative and near obliterative diseased urethra. It provide a wider neourethra than patch graft urethroplasty. PMID:27141182

  14. The role of stents in the treatment of Crohn’s disease strictures

    PubMed Central

    Loras Alastruey, Carme; Andújar Murcia, Xavier; Esteve Comas, Maria

    2016-01-01

    Background and aims: Stenosis is one of the most frequent local complications in Crohn’s disease (CD). Surgery is not the ideal treatment because of the high rate of postoperative recurrence. Endoscopic balloon dilation (EBD) currently is the current treatment of choice for short strictures amenable to the procedure. However, it is not applicable or effective in all the cases, and it is not without related complications. Our goal was to summarize the published information regarding the use and the role of the stents in the treatment of CD stricture. A Medline search was performed on the terms “stricture,” “stenosis,” “stent” and “Crohn’s disease.” Results: a total of 19 publications met our search criteria for an overall number of 65 patients. Placing a self-expanding metal stent (SEMS) may be a safe and effective alternative to EBD and/or surgical intervention in the treatment of short stenosis in patients with CD. Indications are the same as those for EBD. In addition, SEMS may be useful in stenosis refractory to EBD and may be suitable in the treatment of longer or more complex strictures that cannot be treated by EBD. With the current information, it seems that the best treatment option is the placement of a fully covered stent for a mean time of 4 weeks. Regarding the use of biodegradable stents, the information is limited and showing poor results. Conclusions: the use of stents in the treatment of strictures in CD should be taken into account either as a first endoscopic therapy or in case of EBD failure. PMID:27014743

  15. Amniotic Membrane Grafts for the Prevention of Esophageal Stricture after Circumferential Endoscopic Submucosal Dissection

    PubMed Central

    Barret, Maximilien; Pratico, Carlos Alberto; Camus, Marine; Beuvon, Frédéric; Jarraya, Mohamed; Nicco, Carole; Mangialavori, Luigi; Chaussade, Stanislas; Batteux, Frédéric; Prat, Frédéric

    2014-01-01

    Background and Aims The prevention of esophageal strictures following circumferential mucosal resection remains a major clinical challenge. Human amniotic membrane (AM) is an easily available material, which is widely used in ophthalmology due to its wound healing, anti-inflammatory and anti-fibrotic properties. We studied the effect of AM grafts in the prevention of esophageal stricture after endoscopic submucosal dissection (ESD) in a swine model. Animals and Methods In this prospective, randomized controlled trial, 20 swine underwent a 5 cm-long circumferential ESD of the lower esophagus. In the AM Group (n = 10), amniotic membrane grafts were placed on esophageal stents; a subgroup of 5 swine (AM 1 group) was sacrificed on day 14, whereas the other 5 animals (AM 2 group) were kept alive. The esophageal stent (ES) group (n = 5) had ES placement alone after ESD. Another 5 animals served as a control group with only ESD. Results The prevalence of symptomatic strictures at day 14 was significantly reduced in the AM group and ES groups vs. the control group (33%, 40% and 100%, respectively, p = 0.03); mean esophageal diameter was 5.8±3.6 mm, 6.8±3.3 mm, and 2.6±1.7 mm for AM, ES, and control groups, respectively. Median (range) esophageal fibrosis thickness was 0.87 mm (0.78–1.72), 1.19 mm (0.28–1.95), and 1.65 mm (0.7–1.79) for AM 1, ES, and control groups, respectively. All animals had developed esophageal strictures by day 35. Conclusions The anti-fibrotic effect of AM on esophageal wound healing after ESD delayed the development of esophageal stricture in our model. However, this benefit was of limited duration in the conditions of our study. PMID:24992335

  16. Newly designed “pieced” stent in a rabbit model of benign esophageal stricture

    PubMed Central

    Liu, Jin; Shang, Liang; Liu, Ji-Yong; Qin, Cheng-Yong

    2015-01-01

    AIM: To investigate a newly designed stent and its dilatation effect in a rabbit model of benign esophageal stricture. METHODS: Thirty-four New Zealand white rabbits underwent a corrosive injury in the middle esophagus for esophageal stricture formation. Thirty rabbits with a successful formation of esophageal strictures were randomly allocated into two groups. The control group (n = 15) was implanted with a conventional stent, and the study group (n = 15) was implanted with a detachable “pieced” stent. The study stent (30 mm in length, 10 mm in diameter) was composed of three covered metallic pieces connected by surgical suture lines. The stent was collapsed by pulling the suture lines out of the mesh. Two weeks after stricture formation, endoscopic placement of a conventional stent or the new stent was performed. Endoscopic extraction was carried out four weeks later. The extraction rate, ease of extraction, migration, complications, and survival were evaluated. RESULTS: Stent migration occurred in 3/15 (20%) animals in the control group and 2/15 (13%) animals in the study group; the difference between the two groups was not statistically significant. At the end of four weeks, the remaining stents were successfully extracted with the endoscope in 100% (11/11) of the animals in the study group, and 60% (6/10) of the animals in the control group; this difference was statistically significant (P < 0.05). There was no difference in the mean number of follow-up days between the control and study groups (25.33 vs 25.85). Minor bleeding was reported in five cases in the study group and four in the control group. There were no severe complications directly associated with stent implantation or extraction in either of the two groups. CONCLUSION: In this experimental protocol of benign esophageal strictures, the novel “pieced” stent demonstrated a superior removal rate with a similar migration rate compared to a conventional stent. PMID:26229404

  17. Diabetes and elevated urea level predict for uretero-ileal stricture after radical cystectomy and ileal conduit formation

    PubMed Central

    Hoag, Nathan; Papa, Nathan; Beharry, Bhawanie Koonj; Lawrentschuk, Nathan; Chiu, Danny; Sengupta, Shomik; Bolton, Damien

    2017-01-01

    Introduction Benign uretero-ileal anastomotic stricture is a significant complication following radical cystectomy and ileal conduit urinary diversion after radical cystectomy. We examined risk factors for stricture formation to predict those at greatest stricture risk. Methods A retrospective chart review was conducted for patients undergoing radical cystectomy and ileal conduit diversion between 2002 and 2012. Demographic data and patient variables were analyzed to determine risk factors for uretero-ileal stricture using multivariate logistic regression. Results Over the study period, 133 patients underwent cystectomy and ileal conduit formation, with 14 (10.5%) developing uretero-ileal anastomotic stricture. Diabetes and elevated serum urea level (defined as >7.1 mmol/L) were associated with increased risk for development of uretero-ileal stricture (odds ratio 4.31 and 4.28, respectively; p<0.05 for each). Conclusions In this patient cohort, diabetes and elevated serum urea level were predictive for the development of uretero-ileal anastomotic stricture. Further prospective study with larger patient samples is required. PMID:28360953

  18. Learning for an Unknown Future

    ERIC Educational Resources Information Center

    Barnett, Ronald

    2004-01-01

    What is it to learn for an unknown future? It might be said that the future has always been unknown but our opening question surely takes on a new pedagogical challenge if not urgency in the contemporary age. Indeed, it could be said that our opening question has never been generally acknowledged to be a significant motivating curricular and…

  19. Headlines Previous Editions

    Science.gov Websites

    Previous Editions: Volume 17 Volume 16 Volume 15 Volume 14 Volume 13 FEB 2017 JAN 2017 DEC 2016 NOV 2016 OCT 2016 SEP 2016 AUG 2016 JUL 2016 JUN 2016 MAY 2016 APR 2016 MAR 2016 FEB ...

  20. Docetaxel Inhibits Urethral Stricture Formation, an Initial Study in Rabbit Model

    PubMed Central

    Fu, Delai; Chong, Tie; Li, Hecheng; Zhang, Huibo; Wang, Ziming

    2014-01-01

    Introduction Urethral stricture, a frequent source of lower urinary tract disorders in men, is still a difficult problem for urologists. Based the anti-restenosis effect of paclitaxel on coronary artery, the role of docetaxel, a semi-synthetic analogue of paclitaxel, in limiting urethral stricture formation was studied. Methods Forty adult New Zealand male rabbits were involved in this study, which were randomly assigned into 3 groups, namely a high dose docetaxel (DH, 0.1 mg/d), a low dose docetaxel (DL, 0.01 mg/d) and a control (C) group, with 16, 16, 8 rabbits in each group, respectively. All animals underwent a 10 mm-long circumferential electrocoagulation of the bulbar urethra with a 13Fr pediatric resectoscope. Drugs were given by urethral irrigation daily and continuous for 28 days. Stricture formation was assessed by retrograde urethrography and videourethroscopy. Urethra pathology was evaluated by hematoxylin and eosin staining and Sirius red staining. Results At the end of this study, 15, 14 and 7 rabbits remained for evaluation in DH, DL and C group, respectively. Urethral diameters in DH, DL and C group were (7.17±1.63) mm, (6.55±0.62) mm, (3.23±1.36) mm, with a normal urethral diameter of (9.08±1.29) mm. Lumen reduction in DH, DL and C group were (36.93±11.58)%, (48.03±7.89)% and (84.66±14.95)%, respectively. Statistically difference could be found between every two groups (p<0.05) both in urethral diameters and in lumen reduction, except for compare of urethral diameters between DH and DL group. Histological examination confirmed mass fibrous tissue and collagen content at the stricture sit in C group, whereas less in docetaxel treated rabbits. Conclusions Docetaxel could limit urethral stricture formation, which may be due to inhibition of fibrous tissue and collagen expression. Docetaxel may become a new choice in the prevention of urethral stricture formation. PMID:25375859

  1. Endoscopic characteristics and usefulness of endoscopic dilatation of anastomotic stricture following pancreaticojejunostomy: case series and a review of the literature

    PubMed Central

    Kida, Akihiko; Shirota, Yukihiro; Houdo, Yuji; Wakabayashi, Tokio

    2016-01-01

    The incidence of pancreatitis induced by anastomotic stricture following pancreaticodigestive tract anastomosis as a late-onset adverse event has been reported to be 3% or lower, but some cases repeatedly relapse and are difficult to treat. Endoscopic identification and treatment of the anastomotic site are considered to be difficult, and only a small number of cases have been reported. We present three cases with recurrent pancreatitis induced by anastomotic stricture following pancreaticojejunostomy applied after pancreaticoduodenectomy. We successfully identified the anastomotic site and performed endoscopic dilatation of the anastomotic stricture, and pancreatitis has not recurred. We characterized endoscopic features of the anastomotic site, understanding of which is essential to identify the site, and investigated useful techniques to identify the site and perform cannulation for pancreatography. Furthermore, we showed the safety and usefulness of endoscopic dilatation for anastomotic stricture following pancreaticojejunostomy according to our three cases and a review of the literature. PMID:27803744

  2. In-vivo laser induced urethral stricture animal model for investigating the potential of LDR-brachytherapy

    NASA Astrophysics Data System (ADS)

    Sroka, Ronald; Lellig, Katja; Bader, Markus; Stief, Christian; Weidlich, Patrick; Wechsel, G.; Assmann, Walter; Becker, R.; Fedorova, O.; Khoder, Wael

    2015-02-01

    Purpose: Treatment of urethral strictures is a major challenge in urology. For investigation of different treatment methods an animal model was developed by reproducible induction of urethral strictures in rabbits to mimic the human clinical situation. By means of this model the potential of endoluminal LDR brachytherapy using β-irradiation as prophylaxis of recurrent urethral strictures investigated. Material and Methods: A circumferential urethral stricture was induced by energy deposition using laser light application (wavelength λ=1470 nm, 10 W, 10 s, applied energy 100 J) in the posterior urethra of anaesthetized New Zealand White male rabbits. The radial light emitting fiber was introduced by means of a children resectoscope (14F). The grade of urethral stricture was evaluated in 18 rabbits using videourethroscopy and urethrography at day 28 after stricture induction. An innovative catheter was developed based on a β-irradiation emitting foil containing 32P, which was wrapped around the application system. Two main groups (each n=18) were separated. The "internal urethrotomy group" received after 28days of stricture induction immediately after surgical urethrotomy of the stricture the radioactive catheter for one week in a randomized, controlled and blinded manner. There were 3 subgroups with 6 animals each receiving 0 Gy, 15 Gy and 30 Gy. In contrast animals from the "De Nuovo group" received directly after the stricture induction (day 0) the radioactive catheter also for the duration of one week divided into the same dose subgroups. In order to determine the radiation tolerance of the urethral mucosa, additional animals without any stricture induction received a radioactive catheter applying a total dose of 30 Gy (n=2) and 15 Gy (n=1). Cystourethrography and endoscopic examination of urethra were performed on all operation days for monitoring treatment progress. Based on these investigation a classification of the stricture size was performed and

  3. Improved Accuracy of Percutaneous Biopsy Using “Cross and Push” Technique for Patients Suspected with Malignant Biliary Strictures

    SciTech Connect

    Patel, Prashant; Rangarajan, Balaji; Mangat, Kamarjit E-mail: kamarjit.mangat@nhs.net

    2015-08-15

    PurposeVarious methods have been used to sample biliary strictures, including percutaneous fine-needle aspiration biopsy, intraluminal biliary washings, and cytological analysis of drained bile. However, none of these methods has proven to be particularly sensitive in the diagnosis of biliary tract malignancy. We report improved diagnostic accuracy using a modified technique for percutaneous transluminal biopsy in patients with this disease.Materials and MethodsFifty-two patients with obstructive jaundice due to a biliary stricture underwent transluminal forceps biopsy with a modified “cross and push” technique with the use of a flexible biopsy forceps kit commonly used for cardiac biopsies. The modification entailed crossing the stricture with a 0.038-in. wire leading all the way down into the duodenum. A standard or long sheath was subsequently advanced up to the stricture over the wire. A Cook 5.2-Fr biopsy forceps was introduced alongside the wire and the cup was opened upon exiting the sheath. With the biopsy forceps open, within the stricture the sheath was used to push and advance the biopsy cup into the stricture before the cup was closed and the sample obtained. The data were analysed retrospectively.ResultsWe report the outcomes of this modified technique used on 52 consecutive patients with obstructive jaundice secondary to a biliary stricture. The sensitivity and accuracy were 93.3 and 94.2 %, respectively. There was one procedure-related late complication.ConclusionWe propose that the modified “cross and push” technique is a feasible, safe, and more accurate option over the standard technique for sampling strictures of the biliary tree.

  4. [Leiomyoma of the urethra - cause of an obstruction misdiagnosed as hereditary urethral stricture in a young man].

    PubMed

    Seseke, S; Schweyer, S; Reissig, K; Seseke, F

    2008-03-01

    Leiomyomas are benign neoplasms arising from smooth muscle cells. We describe the case of a 17-year-old boy admitted with progressive severe obstructive voiding symptoms. Retrograde urethrography showed a bulbous urethral stricture which was resected with primary urethral anastomosis. Histopathological examination confirmed the very rare case of a leiomyoma of the urethra. In patients with urethral stricture, leiomyoma should be included in the diagnostic considerations.

  5. Management of cervical esophageal strictures with self-expanding metalic stents.

    PubMed

    Cindoruk, Mehmet; Karakan, Tarkan

    2006-12-01

    Esophageal strictures due to malignant diseases are treated with self-expanding metalicic stents. However, experience is limited with these metalic stents in the cervical esophagus. Due to technical difficulties and procedure-related complications, the cervical esophagus has been assigned as a risky area for stenting procedures. Another encountered problem is patient discomfort after the procedure. In this case report, we present three patients with cervical esophageal strictures who were successfully treated with self-expandable metalic stents. Two of these patients had inoperable esophageal carcinoma and the third had benign stenosis due to radiotherapy of larynx carcinoma. The two patients with malignant disease survived four and six months, respectively, after the procedure. The last patient with benign disease is still alive and has been without dysphagia symptom for six months.

  6. New species and previously unknown males of neotropical cleptobiotic stingless bees (Hymenoptera, Apidae, Lestrimelitta)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Three new species of cleptobiotic stingless bees of the genus Lestrimelitta Friese, L. opita sp. n. and L. huilensis sp. n. from Colombia and L. catira sp. n. from Venezuela, are described and figured. The males of the Central American species L. chamelensis, L. danuncia, and L. mourei are also desc...

  7. Absolute lymphocyte count as a predictor of Pneumocystis pneumonia in patients previously unknown to have HIV.

    PubMed

    Omene, Aghogho A; Ferguson, Robert P

    2012-01-01

    This is a retrospective review of patients admitted to an inner city community hospital with community-acquired pneumonia who were ultimately diagnosed with AIDS and Pneumocystis. Absolute lymphocyte count in our hospital is available immediately. In contrast, it can take 48 hours or longer to obtain more specific CD-4 counts and AIDS enzyme-linked immunosorbent assay (ELISA) serology. The association of lymphopenia with ultimate diagnosis of AIDS and Pneumocystis supports immediate empiric treatment for pneumocystis carinii pneumonia (PCP) in our highly HIV prevalent hospital.

  8. Using an epiphytic moss to identify previously unknown sources of atmospheric cadmium pollution.

    PubMed

    Donovan, Geoffrey H; Jovan, Sarah E; Gatziolis, Demetrios; Burstyn, Igor; Michael, Yvonne L; Amacher, Michael C; Monleon, Vicente J

    2016-07-15

    Urban networks of air-quality monitors are often too widely spaced to identify sources of air pollutants, especially if they do not disperse far from emission sources. The objectives of this study were to test the use of moss bio-indicators to develop a fine-scale map of atmospherically-derived cadmium and to identify the sources of cadmium in a complex urban setting. We collected 346 samples of the moss Orthotrichum lyellii from deciduous trees in December, 2013 using a modified randomized grid-based sampling strategy across Portland, Oregon. We estimated a spatial linear model of moss cadmium levels and predicted cadmium on a 50m grid across the city. Cadmium levels in moss were positively correlated with proximity to two stained-glass manufacturers, proximity to the Oregon-Washington border, and percent industrial land in a 500m buffer, and negatively correlated with percent residential land in a 500m buffer. The maps showed very high concentrations of cadmium around the two stained-glass manufacturers, neither of which were known to environmental regulators as cadmium emitters. In addition, in response to our findings, the Oregon Department of Environmental Quality placed an instrumental monitor 120m from the larger stained-glass manufacturer in October, 2015. The monthly average atmospheric cadmium concentration was 29.4ng/m(3), which is 49 times higher than Oregon's benchmark of 0.6ng/m(3), and high enough to pose a health risk from even short-term exposure. Both stained-glass manufacturers voluntarily stopped using cadmium after the monitoring results were made public, and the monthly average cadmium levels precipitously dropped to 1.1ng/m(3) for stained-glass manufacturer #1 and 0.67ng/m(3) for stained-glass manufacturer #2.

  9. Comment on "Chemical and Toxicological Investigations of a Previously Unknown Poisonous European Mushroom Tricholoma terreum".

    PubMed

    Davoli, Paolo; Floriani, Marco; Assisi, Francesca; Kob, Karl; Sitta, Nicola

    2016-04-11

    Recent findings casting doubts over the edibility of the European mushroom Tricholoma terreum are questioned on the basis of mycological and mycotoxicological considerations. Accordingly, T. terreum should remain listed among edible mushroom species.

  10. Two previously unknown Phytophthora species associated with brown rot of Pomelo (Citrus grandis) fruits in Vietnam

    PubMed Central

    Schena, Leonardo; Jung, Thomas; Evoli, Maria; Pane, Antonella; Van Hoa, Nguyen; Van Tri, Mai; Wright, Sandra; Ramstedt, Mauritz; Olsson, Christer; Faedda, Roberto; Magnano di San Lio, Gaetano

    2017-01-01

    Two distinct Phytophthora taxa were found to be associated with brown rot of pomelo (Citrus grandis), a new disease of this ancestral Citrus species, in the Vinh Long province, Mekong River Delta area, southern Vietnam. On the basis of morphological characters and using the ITS1-5.8S-ITS2 region of the rDNA and the cytochrome oxidase subunit 1 (COI) as barcode genes, one of the two taxa was provisionally named as Phytophthora sp. prodigiosa, being closely related to but distinct from P. insolita, a species in Phytophthora Clade 9, while the other one, was closely related to but distinct from the Clade 2 species P. meadii and was informally designated as Phytophthora sp. mekongensis. Isolates of P. sp. prodigiosa and P. sp. mekongensis were also obtained from necrotic fibrous roots of Volkamer lemon (C. volkameriana) rootstocks grafted with ‘King’ mandarin (Citrus nobilis) and from trees of pomelo, respectively, in other provinces of the Mekong River Delta, indicating a widespread occurrence of both Phytophthora species in this citrus-growing area. Koch’s postulates were fulfilled via pathogenicity tests on fruits of various Citrus species, including pomelo, grapefruit (Citrus x paradisi), sweet orange (Citrus x sinensis) and bergamot (Citrus x bergamia) as well as on the rootstock of 2-year-old trees of pomelo and sweet orange on ‘Carrizo’ citrange (C. sinensis ‘Washington Navel’ x Poncirus trifoliata). This is the first report of a Phytophthora species from Clade 2 other than P. citricola and P. citrophthora as causal agent of fruit brown rot of Citrus worldwide and the first report of P. insolita complex in Vietnam. Results indicate that likely Vietnam is still an unexplored reservoir of Phytophthora diversity. PMID:28208159

  11. Psorophora (Grabhamia) varinervis (Diptera: Culicidae) morphological description including pupa and fourth-stage larva previously unknown.

    PubMed

    Rossi, Gustavo C; Stein, Marina; Almirón, Walter R

    2008-05-01

    Psorophora (Grabhamia) varinervis Edwards (Diptera: Culicidae) is redescribed in the adult stage. Pupa and fourth-stage larva are described and illustrated for the first time. Information about distribution, bionomics, and taxonomy also is included. Adults of Ps. varinervis can be separated from the closely related species Ps. (Gra.) discolor (Coquillett) on the basis of the wing characters, and the larva by the siphon and antenna characters.

  12. 1979J3 - Discovery of a previously unknown satellite of Jupiter

    NASA Technical Reports Server (NTRS)

    Synnott, S. P.

    1981-01-01

    During a detailed search of Voyager 1 frames for additional observations of the satellite 1979J1, two small dark spots were observed in transit in several consecutive wide-angle frames of the Jovian atmosphere. The size, spacing, and motion of these pairs of dark spots indicated that they were the images of 1979J1 and its shadow. Subsequent analysis of images spanning 6 days, however, proved that the satellite observed in these Voyager 1 frames would have been occulted by Jupiter at the times of the Voyager 2 images of 1979J1 and was, therefore, a new satellite. It was subsequently found in transit on Voyager 2 images within 13 deg of the Voyager 1 prediction. Its period is 7 hrs 4 min 30 sec + or - 3 sec, and its mean distance is 1.793 Jupiter radii (Jupiter radius = 71,400 km). The observable profile appears to be roughly circular with a diameter of 40 km, and the albedo is approximately 0.05, similar to Amalthea's.

  13. A population genomic scan in Chorthippus grasshoppers unveils previously unknown phenotypic divergence.

    PubMed

    Berdan, Emma L; Mazzoni, Camila J; Waurick, Isabelle; Roehr, Johannes T; Mayer, Frieder

    2015-08-01

    Understanding the genetics of speciation and the processes that drive it is a central goal of evolutionary biology. Grasshoppers of the Chorthippus species group differ strongly in calling song (and corresponding female preferences) but are exceedingly similar in other characteristics such as morphology. Here, we performed a population genomic scan on three Chorthippus species (Chorthippus biguttulus, C. mollis and C. brunneus) to gain insight into the genes and processes involved in divergence and speciation in this group. Using an RNA-seq approach, we examined functional variation between the species by calling SNPs for each of the three species pairs and using FST -based approaches to identify outliers. We found approximately 1% of SNPs in each comparison to be outliers. Between 37% and 40% of these outliers were nonsynonymous SNPs (as opposed to a global level of 17%) indicating that we recovered loci under selection. Among the outliers were several genes that may be involved in song production and hearing as well as genes involved in other traits such as food preferences and metabolism. Differences in food preferences between species were confirmed with a behavioural experiment. This indicates that multiple phenotypic differences implicating multiple evolutionary processes (sexual selection and natural selection) are present between the species.

  14. U.S. navy diver/aviator/skydiver with AGE from a previously unknown PFO.

    PubMed

    Wyland, J; Krulak, D

    2005-01-01

    A 32 year old US Naval aerospace physiologist with dive, jump and flight qualifications presented to a US Navy hyperbaric medicine department complaining of nausea, unsteadiness and left hand and forearm paresthesia that began almost immediately after completing a 28ft/ 40min recreational dive. Following an abbreviated history and physical examination the patient was diagnosed to be suffering from an arterial gas embolism. He was treated with hyperbaric therapy during which his symptoms resolved. Follow-on transesophageal echocardiography revealed an atrial septal aneurysm with a patent foramen ovale resulting in a right-to-left shunt after Valsalva maneuver, but no evidence of ventricular dysfunction, wall motion abnormalities, or abnormal ejection. His episode was attributed to paradoxical air embolism and he was disqualified from further special duty. In order to regain his dive, jump and flight qualifications, the patient elected to undergo repair of the cardiac defect with a device that is relatively new in the operational military setting. The procedure was a success, he was granted waivers for his prior qualifications, and remains in that status to this day. This is the first known case where an atrial septal occluder has been used to preserve these special duty qualifications.

  15. New nanocrystalline materials: a previously unknown simple cubic phase in the SnS binary system.

    PubMed

    Rabkin, Alexander; Samuha, Shmuel; Abutbul, Ran E; Ezersky, Vladimir; Meshi, Louisa; Golan, Yuval

    2015-03-11

    We report a new phase in the binary SnS system, obtained as highly symmetric nanotetrahedra. Due to the nanoscale size and minute amounts of these particles in the synthesis yield, the structure was exclusively solved using electron diffraction methods. The atomic model of the new phase (a = 11.7 Å, P2(1)3) was deduced and found to be associated with the rocksalt-type structure. Kramers-Kronig analysis predicted different optical and electronic properties for the new phase, as compared to α-SnS.

  16. Efficacy of multiple biliary stenting for refractory benign biliary strictures due to chronic calcifying pancreatitis

    PubMed Central

    Ohyama, Hiroshi; Mikata, Rintaro; Ishihara, Takeshi; Sakai, Yuji; Sugiyama, Harutoshi; Yasui, Shin; Tsuyuguchi, Toshio

    2017-01-01

    AIM To investigate endoscopic therapy efficacy for refractory benign biliary strictures (BBS) with multiple biliary stenting and clarify predictors. METHODS Ten consecutive patients with stones in the pancreatic head and BBS due to chronic pancreatitis who underwent endoscopic therapy were evaluated. Endoscopic insertion of a single stent failed in all patients. We used plastic stents (7F, 8.5F, and 10F) and increased stents at intervals of 2 or 3 mo. Stents were removed approximately 1 year after initial stenting. BBS and common bile duct (CBD) diameter were evaluated using cholangiography. Patients were followed for ≥ 6 mo after therapy, interviewed for cholestasis symptoms, and underwent liver function testing every visit. Patients with complete and incomplete stricture dilations were compared. RESULTS Endoscopic therapy was completed in 8 (80%) patients, whereas 2 (20%) patients could not continue therapy because of severe acute cholangitis and abdominal abscess, respectively. The mean number of stents was 4.1 ± 1.2. In two (20%) patients, BBS did not improve; thus, a biliary stent was inserted. BBS improved in six (60%) patients. CBD diameter improved more significantly in the complete group than in the incomplete group (6.1 ± 1.8 mm vs 13.7 ± 2.2 mm, respectively, P = 0.010). Stricture length was significantly associated with complete stricture dilation (complete group; 20.5 ± 3.0 mm, incomplete group; 29.0 ± 5.1 mm, P = 0.011). Acute cholangitis did not recur during the mean follow-up period of 20.6 ± 7.3 mo. CONCLUSION Sequential endoscopic insertion of multiple stents is effective for refractory BBS caused by chronic calcifying pancreatitis. BBS length calculation can improve patient selection procedure for therapy. PMID:28101303

  17. Gall bladder emptying in patients with corrosive-induced esophageal strictures.

    PubMed

    Khan, Bilal A; Kochhar, Rakesh; Nagi, Birender; Raja, Kaiser; Singh, Kartar

    2005-01-01

    Ingestion of corrosive substances can lead to strictures of the esophagus and stomach. Cicatrization of the lower part of the esophagus can entrap vagal fibers in the process of fibrosis. The aim of the present study was to evaluate gallbladder dysfunction as a sequel to vagal damage in patients with corrosive-induced esophageal strictures. The cephalic phase of gallbladder emptying was stimulated by modified sham feeding according to the chew-and-spit method. Gallbladder volume was measured by ultrasonography using the ellipsoid method after an overnight fast and every 15 min for a period of 90 min after sham feeding in 22 patients and 10 controls. Mean fasting gallbladder volume was significantly greater in patients than in controls (22.09 +/- 9.78 vs. 14.61 +/- 4.42 ml; P = 0.025). After sham feeding the gallbladder ejection fraction was significantly lower in patients than in controls (32.86 +/- 17.21 vs. 49.40 +/- 7.86%; P = 0.007). Patients with cicatrization in the distal one-third of the esophagus had a greater basal gallbladder volume (24.57 +/- 9.2 ml) and significantly lower ejection fraction (20.47 +/- 8.9%) than patients with strictures at other sites (gallbladder volume, 18.50 +/- 10.69 ml; ejection fraction, 47.48 +/- 13.3%; P = 0.001). In conclusion, patients with corrosive-induced esophageal strictures, especially those in the distal one-third, had an increased fasting gallbladder volume and decreased cephalic phase of gallbladder emptying, pointing to impaired vagal cholinergic transmission, possibly due to vagal entrapment in the cicatrization process.

  18. Efficacy of Retrievable Metallic Stent with Fixation String for Benign Stricture after Upper Gastrointestinal Surgery

    PubMed Central

    Kim, Jeong-Eun; Lee, Myungsu; Hur, Saebeom; Kim, Minuk; Lee, Sang Hwan; Cho, Soo Buem; Kim, Chan Sun; Han, Joon Koo

    2016-01-01

    Objective To determine the efficacy of retrievable metallic stent with fixation string for benign anastomotic stricture after upper gastrointestinal (UGI) surgery. Materials and Methods From June 2009 to May 2015, a total of 56 retrievable metallic stents with fixation string were placed under fluoroscopy guidance in 42 patients who were diagnosed with benign anastomotic stricture after UGI surgery. Clinical success was defined as achieving normal regular diet (NRD). Results The clinical success rate after the first stent placement was 57.1% (24/42). After repeated stent placement and/or balloon dilation, the clinical success rate was increased to 83.3% (35/42). Six (14.3%) patients required surgical revision to achieve NRD. One (2.4%) patient failed to achieve NRD. Stent migration occurred in 60.7% (34/56) of patients. Successful rate of removing the stent using fixation string and angiocatheter was 94.6% (53/56). Distal migration occurred in 12 stents. Of the 12 stents, 10 (83.3%) were successfully removed whereas 2 could not be removed. No complication occurred regarding distal migration. Conclusion Using retrievable metallic stent with a fixation string is a feasible option for managing early benign anastomotic stricture after UGI surgery. It can reduce complications caused by distal migration of the stent. PMID:27833405

  19. Palliation of Postoperative Gastrointestinal Anastomotic Malignant Strictures with Flexible Covered Metallic Stents: Preliminary Results

    SciTech Connect

    Lee, Jeong-Min; Han, Young Min; Lee, Sang Yong; Kim, Chong Soo; Yang, Doo Hyun; Lee, Seung Ok

    2001-01-15

    Purpose: To evaluate the efficacy of the placement of covered metallic stents for palliation of gastrointestinal anastomotic strictures secondary to recurrent gastric cancer.Methods: Under fluoroscopic guidance, placement of one or two self-expandable covered metallic stents was attempted perorally in 11 patents (aged 48-76 years) with anastomotic stenoses due to recurrent gastric malignancies. The strictures involved both the afferent and efferent loops in three patients. All patients had poor peroral food intake with severe nausea and vomiting after ingestion. The technical and clinical success was evaluated.Results: Placement of the covered stent was technically successful in 13 of 15 (87%) attempts in ten patients. After the procedure, 9 of 11 (82%) patients overall were able to ingest at least a liquid diet and had markedly decreased incidence of vomiting. During the follow-up of 2-31 weeks (mean 8.5 weeks) there were no major complications.Conclusion: These preliminary results suggest that flexible, covered stents may provide effective palliation of malignant anastomotic stricture secondary to recurrent gastric cancer.

  20. Development of a Swine Benign Biliary Stricture Model Using Endoscopic Biliary Radiofrequency Ablation

    PubMed Central

    2016-01-01

    The large animal model with benign biliary stricture (BBS) is essential to undergo experiment on developing new devices and endoscopic treatment. This study conducted to establish a clinically relevant porcine BBS model by means of endobiliary radiofrequency ablation (RFA). Endoscopic retrograde cholangiography (ERC) was performed on 12 swine. The animals were allocated to three groups (60, 80, and 100 W) according to the electrical power level of RFA electrode. Endobiliary RFA was applied to the common bile duct for 60 seconds using an RFA catheter that was endoscopically inserted. ERC was repeated two and four weeks, respectively, after the RFA to identify BBS. After the strictures were identified, histologic evaluations were performed. On the follow-up ERC two weeks after the procedure, a segmental bile duct stricture was observed in all animals. On microscopic examination, severe periductal fibrosis and luminal obliteration with transmural inflammation were demonstrated. Bile duct perforations occurred in two pigs (100 W, n = 1; 80 W, n = 1) but there were no major complications in the 60 W group. The application of endobiliary RFA with 60 W electrical power resulted in a safe and reproducible swine model of BBS. PMID:27510388

  1. Endoscopic and retrograde cholangiographic appearance of hepaticojejunostomy strictures: A practical classification

    PubMed Central

    Mönkemüller, Klaus; Jovanovic, Ivan

    2011-01-01

    AIM: To study the endoscopic and radiological characteristics of patients with hepaticojejunostomy (HJ) and propose a practical HJ stricture classification. METHODS: In a retrospective observational study, a balloon-assisted enteroscopy (BAE)-endoscopic retrograde cholangiography was performed 44 times in 32 patients with surgically-altered gastrointestinal (GI) anatomy. BAE-endoscopic retrograde cholangio pancreatography (ERCP) was performed 23 times in 18 patients with HJ. The HJ was carefully studied with the endoscope and using cholangiography. RESULTS: The authors observed that the hepaticojejunostomies have characteristics that may allow these to be classified based on endoscopic and cholangiographic appearances: the HJ orifice aspect may appear as small (type A) or large (type B) and the stricture may be short (type 1), long (type 2) and type 3, intrahepatic biliary strictures not associated with anastomotic stenosis. In total, 7 patients had type A1, 4 patients A2, one patient had B1, one patient had B (large orifice without stenosis) and one patient had type B3. CONCLUSION: This practical classification allows for an accurate initial assessment of the HJ, thus potentially allowing for adequate therapeutic planning, as the shape, length and complexity of the HJ and biliary tree choice may mandate the type of diagnostic and therapeutic accessories to be used. Of additional importance, a standardized classification may allow for better comparison of studies of patients undergoing BAE-ERCP in the setting of altered upper GI anatomy. PMID:22110837

  2. Useful strategies to prevent severe stricture after endoscopic submucosal dissection for superficial esophageal neoplasm

    PubMed Central

    Uno, Kaname; Iijima, Katsunori; Koike, Tomoyuki; Shimosegawa, Tooru

    2015-01-01

    The minimal invasiveness of endoscopic submucosal dissection (ESD) prompted us to apply this technique to large-size early esophageal squamous cell carcinoma and Barrett’s adenocarcinoma, despite the limitations in the study population and surveillance duration. A post-ESD ulceration of greater than three-fourths of esophageal circumference was advocated as an important risk factor for refractory strictures that require several sessions of dilation therapy. Most of the preoperative conditions are asymptomatic, but dilatation treatment for dysphagia associated with the stricture has potential risks of severe complications and a worsening of quality of life. Possible mechanisms of dysphasia were demonstrated based on dysmotility and pathological abnormalities at the site: (1) delayed mucosal healing; (2) severe inflammation and disorganized fibrosis with abundant extracellular matrices in the submucosa; and (3) atrophy in the muscularis proper. However, reports on the administration of anti-scarring agents, preventive dilation therapies, and regenerative medicine demonstrated limited success in stricture prevention, and there were discrepancies in the study designs and protocols of these reports. The development and consequent long-term assessments of new prophylactic technologies on the promotion of wound healing and control of the inflammatory/tumor microenvironment will require collaboration among various research fields because of the limited accuracy of preoperative staging and high-risk of local recurrence. PMID:26109798

  3. Using transurethral Ho:YAG-laser resection to treat urethral stricture and bladder neck contracture

    NASA Astrophysics Data System (ADS)

    Bo, Juanjie; Dai, Shengguo; Huang, Xuyuan; Zhu, Jing; Zhang, Huiguo; Shi, Hongmin

    2005-07-01

    Objective: Ho:YAG laser had been used to treat the common diseases of urinary system such as bladder cancer and benign prostatic hyperplasia in our hospital. This study is to assess the efficacy and safety of transurethral Ho:YAG-laser resection to treat the urethral stricture and bladder neck contracture. Methods: From May 1997 to August 2004, 26 cases of urethral stricture and 33 cases of bladder neck contracture were treated by transurethral Ho:YAG-laser resection. These patients were followed up at regular intervals after operation. The uroflow rate of these patients was detected before and one-month after operation. The blood loss and the energy consumption of holmium-laser during the operation as well as the complications and curative effect after operation were observed. Results: The therapeutic effects were considered successful, with less bleeding and no severe complications. The Qmax of one month postoperation increased obviously than that of preoperation. Of the 59 cases, restenosis appeared in 11 cases (19%) with the symptoms of dysuria and weak urinary stream in 3-24 months respectively. Conclusions: The Ho:YAG-laser demonstrated good effect to treat the obstructive diseases of lower urinary tract such as urethral stricture and bladder neck contracture. It was safe, minimal invasive and easy to operate.

  4. Robot-Assisted Radical Prostatectomy After Previous Prostate Surgery

    PubMed Central

    Tugcu, Volkan; Sahin, Selcuk; Kargi, Taner; Gokhan Seker, Kamil; IlkerComez, Yusuf; IhsanTasci, Ali

    2015-01-01

    Background and Objectives: Our objective is to clarify the effect of previous transurethral resection of the prostate (TURP) or open prostatectomy (OP) on surgical, oncological, and functional outcomes after robot-assisted radical prostatectomy (RARP). Methods: Between August 1, 2009, and March 31, 2013, 380 patients underwent RARP. Of these, 25 patients had undergone surgery for primary bladder outlet obstruction (TURP, 20 patients; OP, 5 patents) (group 1). A match-paired analysis was performed to identify 36 patients without a history of prostate surgery with equivalent clinicopathologic characteristics to serve as a control group (group 2). Patients followed up for 12 months were assessed. Results: Both groups were similar with respect to preoperative characteristics, as mean age, body mass index, median prostate-specific antigen, prostate volume, clinical stage, the biopsy Gleason score, D'Amico risk, the American Society of Anesthesiologists (ASA) classification score, the International Prostate Symptom Score, continence, and potency status. RARP resulted in longer console and anastomotic time, as well as higher blood loss compared with surgery-naive patients. We noted a greater rate of urinary leakage (pelvic drainage, >4 d) in group 1 (12% vs 2,8%). The anastomotic stricture rate was significantly higher in group 1 (16% vs 2.8%). No difference was found in the pathologic stage, positive surgical margin, and nerve-sparing procedure between the groups. Biochemical recurrence was observed in 12% (group 1) and 11.1% (group 2) of patients, respectively. No significant difference was found in the continence and potency rates. Conclusions: RARP after TURP or OP is a challenging but oncologically promising procedure with a longer console and anastomosis time, as well as higher blood loss and higher anastomotic stricture rate. PMID:26648678

  5. Main Bile Duct Stricture Occurring After Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

    SciTech Connect

    Miyayama, Shiro Yamashiro, Masashi; Okuda, Miho; Yoshie, Yuichi; Nakashima, Yoshiko; Ikeno, Hiroshi; Orito, Nobuaki; Notsumata, Kazuo; Watanabe, Hiroyuki; Toya, Daisyu; Tanaka, Nobuyoshi; Matsui, Osamu

    2010-12-15

    The purpose of this study was to evaluate the clinical course of main bile duct stricture at the hepatic hilum after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Among 446 consecutive patients with HCC treated by TACE, main bile duct stricture developed in 18 (4.0%). All imaging and laboratory data, treatment course, and outcomes were retrospectively analyzed. All patients had 1 to 2 tumors measuring 10 to 100 mm in diameter (mean {+-} SD 24.5 {+-} 5.4 mm) near the hepatic hilum fed by the caudate arterial branch (A1) and/or medial segmental artery (A4) of the liver. During the TACE procedure that caused bile duct injury, A1 was embolized in 8, A4 was embolized in 5, and both were embolized in 5 patients. Nine patients (50.0%) had a history of TACE in either A1 or A4. Iodized oil accumulation in the bile duct wall was seen in all patients on computed tomography obtained 1 week later. Bile duct dilatation caused by main bile duct stricture developed in both lobes (n = 9), in the right lobe (n = 3), in the left lobe (n = 4), in segment (S) 2 (n = 1), and in S3 (n = 1). Serum levels of alkaline phosphatase and {gamma}-glutamyltranspeptidase increased in 13 patients. Biloma requiring drainage developed in 2 patients; jaundice developed in 4 patients; and metallic stents were placed in 3 patients. Complications after additional TACE sessions, including biloma (n = 3) and/or jaundice (n = 5), occurred in 7 patients and were treated by additional intervention, including metallic stent placement in 2 patients. After initial TACE of A1 and/or A4, 8 patients (44.4%), including 5 with uncontrollable jaundice or cholangitis, died at 37.9 {+-} 34.9 months after TACE, and 10 (55.6%) have survived for 38.4 {+-} 37.9 months. Selective TACE of A1 and/or A4 carries a risk of main bile duct stricture at the hepatic hilum. Biloma and jaundice are serious complications associated with bile duct strictures.

  6. Learning from the Unknown Student

    ERIC Educational Resources Information Center

    Barlow, Angela T.; Gerstenschlager, Natasha E.; Harmon, Shannon E.

    2016-01-01

    In this article, three instructional situations demonstrate the value of using an "unknown" student's work to allow the advancement of students' mathematical thinking as well as their engagement in the mathematical practice of critiquing the reasoning of others: (1) introducing alternative solution strategies; (2) critiquing inaccuracies…

  7. Noninvasive evaluation of active pan-ulcerative colitis with multiple strictures using Fluorine-18-Fluorodeoxyglucose positron emission tomography/computed tomography.

    PubMed

    Santhosh, Sampath; Bhattacharya, Anish; Rana, Surinder Singh; Bhasin, Deepak Kumar; Gupta, Rajesh; Mittal, Bhagwant Rai

    2016-01-01

    Ulcerative colitis (UC) is an inflammatory bowel disease characterized by waxing and waning inflammation that changes in severity and extent and may progress to neoplasia, especially in the presence of strictures. When patients have nonnegotiable strictures or severe inflammation with ulcers, colonoscopy is difficult and carries the risk of perforation. The authors present a patient with pan-UC with multiple strictures, in whom fluorodeoxyglucose positron emission tomography/computed tomography was used to noninvasively evaluate the extent and severity of the disease.

  8. Massive ascites of unknown origin

    PubMed Central

    Yuan, Shi-Min

    2014-01-01

    Massive ascites of unknown origin is an uncommon condition, which represent a diagnostic challenge. Patients with delayed diagnosis and treatment may have a poor prognosis. A 22-year-old female was referred to this hospital due to a 4-year progressive abdominal distension with massive ascites of unknown origin. By thorough investigations, she was eventually diagnosed as chronic calcified constrictive pericarditis. She received pericardiectomy and had an uneventful postoperative course. With a few day paracentesis, ascites did not progress any more. She was doing well at 5-month follow-up and has returned to work. Extracardiac manifestations, such as massive ascites and liver cirrhosis, were rare in patients with constrictive pericarditis. Pericardiectomy can be a radical solution for the treatment of chronic constrictive pericarditis. In order to avoid delayed diagnosis and treatment, physicians have to bear in mind this rare manifestation of chronic calcified constrictive pericarditis. PMID:24600502

  9. Long-Term Results of Percutaneous Bilioenteric Anastomotic Stricture Treatment in Liver-Transplanted Children

    SciTech Connect

    Moreira, Airton Mota Carnevale, Francisco Cesar; Tannuri, Uenis; Suzuki, Lisa; Gibelli, Nelson; Maksoud, Joao Gilberto; Cerri, Giovanni Guido

    2010-02-15

    The purpose of this study was to evaluate the mid- and long-term results of percutaneous transhepatic cholangiography (PTC) and biliary drainage in children with isolated bilioenteric anastomotic stenosis (BAS) after pediatric liver transplantation. Sixty-four children underwent PTC from March 1993 to May 2008. Nineteen cholangiograms were normal; 10 showed intrahepatic biliary stenosis and BAS, and 35 showed isolated BAS. Cadaveric grafts were used in 19 and living donor grafts in 16 patients. Four patients received a whole liver, and 31 patients received a left lobe or left lateral segment. Roux-en-Y hepaticojejunostomy was performed in all patients. Indication for PTC was based on clinical, laboratory, and histopathologic findings. In patients with isolated BAS, dilation and biliary catheter placement, with changes every 2 months, were performed. Patients were separated into 4 groups according to number of treatment sessions required. The drainage catheter was removed if cholangiogram showed no significant residual stenosis and normal biliary emptying time after a minimum of 6 months. The relationship between risk factors (recipient's weight <10 kg, previous exposure to Cytomegalovirus, donor-recipient sex and weight relations, autoimmune disease as indication for transplantion, previous Kasai's surgery, use of reduced liver grafts, chronic or acute rejection occurrence) and treatment was evaluated. Before PTC, fever was observed in 46%, biliary dilation in 23%, increased bilirubin in 57%, and increased gamma-glutamyltransferase (GGT) in 100% of patients. In the group with BAS, 24 of 35 (69%) patients had histopathologic findings of cholestasis as did 9 of 19 (47%) patients in the group with normal PTC. Of the 35 patients, 23 (65.7%) needed 1 (group I), 7 needed 2 (group II), 4 needed 3 (group III), and 1 needed 4 treatment sessions (group IV). The best results were observed after 1 treatment session, and the mean duration of catheter placement and replacement

  10. Ureteroiliac Artery Fistula Caused by a Metallic Memokath Ureteral Stent in a Radiation-Induced Ureteral Stricture

    PubMed Central

    Das, Krishanu; Ordones, Flavio; Welikumbura, Sumudu

    2016-01-01

    Abstract Background: Memokath 051™ stents are increasingly used for management of benign and malignant ureteral strictures refractory to management with single or tandem polymeric Double-J ureteral stents. Migration, encrustation, and difficulty in extraction during stent exchange are the chief problems reported so far with these thermoexpandable metallic stents. We report an unusual complication of ureteroexternal iliac artery fistula (UEAF) caused by Memokath stent inserted for radiation-induced ureteral stricture. Case Presentation: A 71-year-old male with history of colorectal cancer (underwent extirpative surgery + chemoradiotherapy) and subsequently radiation-induced ureteral stricture had bilateral Memokath ureteral stents inserted. Three months later, he presented with sepsis and hemodynamic instability secondary to UEAF, confirmed on angiography. A covered vascular stent was inserted as an immediate management. Conclusion: Memokath stent insertion in radiation-induced ureteral strictures may be associated with an increased risk of erosion and the rare potential complication of UEAF. This potential risk needs to be considered in the overall setting of such strictures and the difficulty in treating them. Prompt imaging (angiography) and placement of an endovascular stent are the ideal immediate options in such cases. PMID:27785465

  11. Cell Sheet Transplantation for Esophageal Stricture Prevention after Endoscopic Submucosal Dissection in a Porcine Model

    PubMed Central

    Pidial, Laetitia; Camilleri, Sophie; Bellucci, Alexandre; Casanova, Amaury; Viel, Thomas; Tavitian, Bertrand; Cellier, Christophe; Clement, Olivier

    2016-01-01

    Background & Aims Extended esophageal endoscopic submucosal dissection (ESD) is highly responsible for esophageal stricture. We conducted a comparative study in a porcine model to evaluate the effectiveness of adipose tissue-derived stromal cell (ADSC) double cell sheet transplantation. Methods Twelve female pigs were treated with 5 cm long hemi-circumferential ESD and randomized in two groups. ADSC group (n = 6) received 4 double cell sheets of allogenic ADSC on a paper support membrane and control group (n = 6) received 4 paper support membranes. ADSC were labelled with PKH-67 fluorophore to allow probe-based confocal laser endomicroscopie (pCLE) monitoring. After 28 days follow-up, animals were sacrificed. At days 3, 14 and 28, endoscopic evaluation with pCLE and esophagography were performed. Results One animal from the control group was excluded (anesthetic complication). Animals from ADSC group showed less frequent alimentary trouble (17% vs 80%; P = 0.08) and higher gain weight on day 28. pCLE demonstrated a compatible cell signal in 4 animals of the ADSC group at day 3. In ADSC group, endoscopy showed that 1 out of 6(17%) animals developed a severe esophageal stricture comparatively to 100% (5/5) in the control group; P = 0.015. Esophagography demonstrated a decreased degree of stricture in the ADSC group on day 14 (44% vs 81%; P = 0.017) and day 28 (46% vs 90%; P = 0.035). Histological analysis showed a decreased fibrosis development in the ADSC group, in terms of surface (9.7 vs 26.1 mm²; P = 0.017) and maximal depth (1.6 vs 3.2 mm; P = 0.052). Conclusion In this model, transplantation of allogenic ADSC organized in double cell sheets after extended esophegeal ESD is strongly associated with a lower esophageal stricture’s rate. PMID:26930409

  12. Double-Layered PTFE-Covered Nitinol Stents: Experience in 32 Patients with Malignant Esophageal Strictures

    SciTech Connect

    Park, Jung Gu; Jung, Gyoo-Sik Oh, Kyung Seung; Park, Seon-Ja

    2010-08-15

    We evaluated the effectiveness of a double-layered polytetrafluoroethylene (PTFE)-covered nitinol stent in the palliative treatment of malignant esophageal strictures. A double-layered PTFE-covered nitinol stent was designed to reduce the propensity to migration of conventional covered stent. The stent consists of an inner PTFE-covered stent and an outer uncovered nitinol stent tube. With fluoroscopic guidance, the stent was placed in 32 consecutive patients with malignant esophageal strictures. During the follow-up period, the technical and clinical success rates, complications, and cumulative patient survival and stent patency were evaluated. Stent placement was technically successful in all patients, and no procedural complications occurred. After stent placement, the symptoms of 30 patients (94%) showed improvement. During the mean follow-up of 103 days (range, 9-348 days), 11 (34%) of 32 patients developed recurrent symptoms due to tumor overgrowth in five patients (16%), tumor ingrowth owing to detachment of the covering material (PTFE) apart from the stent wire in 3 (9%), mucosal hyperplasia in 2 (6%), and stent migration in 1 (3%). Ten of these 11 patients were treated by means of placing a second covered stent. Thirty patients died, 29 as a result of disease progression and 1 from aspiration pneumonia. The median survival period was 92 days. The median period of primary stent patency was 190 days. The double-layered PTFE-covered nitinol stent seems to be effective for the palliative treatment of malignant esophageal strictures. We believe that the double-layer configuration of this stent can contribute to decreasing the stent's migration rate.

  13. Primary tuberculosis of urethra presenting as stricture urethra and watering can perineum: A rarity

    PubMed Central

    Prakash, Gaurav; Singh, Vishwajeet; Sinha, Rahul Janak; Babu, Suresh; Jhanwar, Ankur; Mehrotra, C. N.

    2016-01-01

    A young man presented with irritative lower urinary tract symptoms and multiple fistulae (watering can) in the perineum since 6 months. Micturating cystourethrogram and retrograde urethrogram was performed after 12 weeks following suprapubic cystostomy which showed bulbar urethral stricture with multiple urethrocutaneous fistulae. He underwent anastomotic urethroplasty and excision of the urethrocutaneous fistulae. Histopathology of the excised fistulous tract showed granulomatous pathology suggestive of tuberculosis. Antitubercular treatment was given for 9 months. The patient is voiding well at 12 months follow-up. PMID:28058001

  14. Treatment of a Ruptured Anastomotic Esophageal Stricture Following Bougienage with a Dacron-Covered Nitinol Stent

    SciTech Connect

    Heindel, Walter; Gossmann, Axel; Fischbach, Roman; Michel, Olaf; Lackner, Klaus

    1996-11-15

    A patient suffering from esophagorespiratory fistula after bougienage of a benign stricture at the site of the anastomosis between a jejunal interposition and the esophagus was referred for interventional treatment. A prototype nitinol stent centrally covered with Dacron was implanted under regional anesthesia and fluoroscopic guidance. The self-expanding prosthesis dilated the stenosis completely and closed the fistula, with consequent improvement in respiratory and nutritional status and thus the general quality of life. The patient was able to eat and drink normally until death 3 months later due to progression of his underlying malignant disease.

  15. Outcome of buccal mucosa and lingual mucosa graft urethroplasty in the management of urethral strictures: A comparative study

    PubMed Central

    Chauhan, Sharad; Yadav, Sher Singh; Tomar, Vinay

    2016-01-01

    Objective: The objective of the study was to compare the outcome of buccal and lingual mucosa graft (LMG) augmentation urethroplasty along with donor sites morbidities in anterior urethra stricture. Subjects and Methods: From September 2010 to January 2014, 125 patients underwent single stage augmentation urethroplasty. They were randomly divided into two groups to receive either buccal mucosa graft (BMG) or LMG. The patients were prospectively followed for complications and outcome. Results: Baseline characteristics such as mean age, etiology, stricture length, and location were comparable in both groups. Overall success rate for Group 1 and Group 2 were 69.2% and 80%, respectively. Mean follow-up periods were 28.2 and 25 months in Group 1 and Group 2, respectively. Conclusions: LMG provides the better outcome with fewer immediate and delayed complications as compared to BMG. The length of stricture and width of graft were main factors affecting the outcome. PMID:26834399

  16. Topical application of mitomycin C in the treatment of esophageal and tracheobronchial stricture: a report of 2 cases.

    PubMed

    Daher, Paul; Riachy, Edward; Georges, Beyrouthy; Georges, Dabar; Adib, Moukarzel

    2007-09-01

    We present 2 cases of successful treatment of recurrent anastomotic strictures using a topical application of mitomycin C. In the first case, a 4-year-old boy had a cervical cyst excised, which appeared to be an ectopic gastric mucosa. He consequently presented severe stenosis at the origin of the cervical esophagus that needed repeated balloon dilatations. The second case is about a 12-year-old girl who presented a traumatic complete rupture of the right mainstem bronchus managed by primary repair, with subsequent anastomotic stricture. Both patients were successfully managed with topical application of mitomycin C (1 mg/mL), and needed no more dilatations.

  17. [THE TREATMENT OF POSTOPERATIVE STRICTURE OF BILIARY DUCTS: A 15-YEARS EXPERIENCE AND OBSERVATIONS FROM THE PRACTICE].

    PubMed

    Tishchenko, A M; Boyko, V V; Smachilo, R M; Skoriy, D I

    2015-09-01

    Experience of performance of 160 operations for injuries and stricture of biliary ducts, was analyzed. In 36 patients before admittance to hospital there were performed interventions, which provide correction of injuries or their consequences. In majority (141) of patients hepaticojejunoanastomosis in accordance to Roux method or its reconstruction were performed. Other interventions (right-sided hemihepatectomy) were rarely performed. The procedure of anastomosis formation, permitting to connect the mucosae of joining organs in precision, was proposed. Clinical observations of correction of the biliary ducts stricture were presented.

  18. Treatment of Complete Anal Stricture after Diverting Colostomy for Fournier's Gangrene

    PubMed Central

    Kubota, Tadao; Lefor, Alan Kawarai; Mizokami, Ken

    2017-01-01

    Background. Anal stenosis is a rare but serious complication of anorectal surgery. Severe anal stenosis is a challenging condition. Case Presentation. A 70-year-old Japanese man presented with a ten-hour history of continuous anal pain due to incarcerated hemorrhoids. He had a history of reducible internal hemorrhoids and was followed for 10 years. He had a fever and nonreducible internal hemorrhoids surrounding necrotic soft tissues. He was diagnosed as Fournier's gangrene and treated with debridement and diverting colostomy. He needed temporary continuous renal replacement therapy and was discharged on postoperative day 39. After four months, severe anal stenosis was found on physical examination, and total colonoscopy showed a complete anal stricture. The patient was brought to the operating room and underwent colostomy closure and anoplasty. He recovered without any complications. Conclusion. We present a first patient with a complete anal stricture after diverting colostomy treated with anoplasty and stoma closure. This case reminds us of the assessment of distal bowel conduit and might suggest that anoplasty might be considered in the success of the colostomy closure. PMID:28255493

  19. [Recognition and identification of unknown infectious agents].

    PubMed

    Berche, P

    1994-04-01

    The recognition and the identification of previously unrecognized infectious agents require a multidisciplinary approach to specify the nosologic entity of the disease and the epidemiological data, especially the modes of transmission and the risk factors, as well as to discover the microorganism in the laboratory. In the past 20 years, significant breakthroughs have been achieved in cellular cultures (growth factors), in immunology (monoclonal antibodies), and moreover in molecular biology, which have been widely used in the field of infectious diseases. Whereas the classical methods used to grow microorganisms remain of major interest in many cases, innovating strategies have been recently designed to identify previously unknown pathogens. The genomic amplification by polymerase chain reaction (PCR) of highly conserved bacterial genes (as those coding for ribosomal RNA), from tissue biopsies for example, allow to recognize unknown bacteria. The evolutionary distance between a newly recognized pathogen and known microorganisms can be calculated through sequencing of these genes, as described for Rochalimaea henselae or Tropheryma whipplelii. The constitution of cDNA banks from infected tissues is also a novel approach allowing to clone and sequence viral genes, such as those from hepatitis C or from hepatitis E. In the near future, noteworthy improvements will be achieved to rapidly detect microorganisms with highly sensitive and specific tests using monoclonal antibodies, molecular probes (including branched DNA) and with PCR (including Q beta replicase and ligase chain reaction), and to determine the genetic diversity of microbial pathogens by new methods as pulse field gel electrophoresis or arbitrarily primed PCR. This will result in a better knowledge of the pathophysiology of infectious diseases, in a better recognition of a typical, previously unrecognized clinical expression of pathogenicity, and also in a more precise assessment of the actual impact of a

  20. Optimal linear estimation under unknown nonlinear transform

    PubMed Central

    Yi, Xinyang; Wang, Zhaoran; Caramanis, Constantine; Liu, Han

    2016-01-01

    Linear regression studies the problem of estimating a model parameter β* ∈ℝp, from n observations {(yi,xi)}i=1n from linear model yi = 〈xi, β*〉 + εi. We consider a significant generalization in which the relationship between 〈xi, β*〉 and yi is noisy, quantized to a single bit, potentially nonlinear, noninvertible, as well as unknown. This model is known as the single-index model in statistics, and, among other things, it represents a significant generalization of one-bit compressed sensing. We propose a novel spectral-based estimation procedure and show that we can recover β* in settings (i.e., classes of link function f) where previous algorithms fail. In general, our algorithm requires only very mild restrictions on the (unknown) functional relationship between yi and 〈xi, β*〉. We also consider the high dimensional setting where β* is sparse, and introduce a two-stage nonconvex framework that addresses estimation challenges in high dimensional regimes where p ≫ n. For a broad class of link functions between 〈xi, β*〉 and yi, we establish minimax lower bounds that demonstrate the optimality of our estimators in both the classical and high dimensional regimes.

  1. Percutaneous Transhepatic Use of a Cutting Balloon in the Treatment of a Benign Common Bile Duct Stricture

    SciTech Connect

    Kakani, Nirmal K.; Puckett, Mark; Cooper, Martin; Watkinson, Anthony

    2006-06-15

    Benign biliary strictures (BBS) are difficult to treat. The majority of them are treated either endoscopically or using percutaneous techniques either with stents or conventional angioplasty balloons. To our knowledge we present the first case of use of a cutting balloon in the treatment of BBS through a percutaneous approach.

  2. Application of novel optical diffuser for urethral stricture treatment (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Nguyen, Trung Hau; Rhee, Yun-Hee; Ahn, Jin-Chul; Kang, Hyun Wook

    2016-02-01

    Optical fibers have frequently been used for photothermal laser therapy due to its efficiency to deliver laser energy directly to tissue. The aim of the current study was to develop a diffusing optical fiber to achieve radially uniform light irradiation for endoscopically treating urethral stricture. The optical diffuser was fabricated by micro-machining helical patterns on the fiber surface using CO2 laser light at 5 W. Visible light emission (632 nm) and spatial emissions (including polar, azimuthal, and longitudinal emissions) of the fiber tip were evaluated to validate the performance of the fabricated diffuser. Prior to tissue tests, numerical simulation on heat distribution was developed to estimate the degree of tissue coagulation depth during interstitial coagulation. Due to a high absorption coefficient by tissue water, 1470 nm laser was used for photothermal therapy treatment of urethral stricture to obtain a more precise depth profile. For in vitro tissue tests, porcine liver tissue was irradiated with three different power levels (3, 6, and 9 W) at various irradiation times. Porcine urethral tissue was also tested with the diffuser for 10 sec at 6 W to validate the feasibility of circumferential photothermal treatment. The treated tissue was stained with hematoxylin and eosin (H and E) and then imaged with an optical transmission microscope. The spatial emission characteristics of the diffusing optical fiber presented an almost uniform power distribution along the diffuser tip (less than 10% deviation) and around its circumference (less than 5% deviation). The peak temperature in simulation model at the tissue interface between the glass-cap and the tissue was 373 K that was higher than that at the distal end. The tissue tests showed that higher power levels resulted in lower coagulation thresholds (e.g., 1 sec at 9 W vs 8 sec at 3 W). Furthermore, the coagulation depth was approximately 20% thinner than the simulation results (p<0.001). The extent of

  3. Eosinophils and IL-33 perpetuate chronic inflammation and fibrosis in a pediatric population with stricturing Crohn’s ileitis

    PubMed Central

    Masterson, Joanne C.; Capocelli, Kelley E.; Hosford, Lindsay; Biette, Kathryn; McNamee, Eóin N.; de Zoeten, Edwin F; Harris, Rachel; Fernando, Shahan D.; Jedlicka, Paul; Protheroe, Cheryl; Lee, James J.; Furuta, Glenn T.

    2015-01-01

    Background Fibrostenosis and stricture are well-recognized endpoints in Crohn’s disease (CD). We hypothesized that stricturing-CD is characterized by eosinophilia and epithelial-IL-33. We proposed that eosinophil exposure to IL-33 would perpetuate inflammatory chronicity and subsequent fibrostenosis. Methods We performed a retrospective study of 74 children with inflammatory and stricturing ileal-CD comparing clinicopathological features to immunohistochemical measures of eosinophilia and IL-33. To scrutinize eosinophil patterns we developed a novel eosinophil-peroxidase (EPX)-score encompassing number, distribution and degranulation. Human eosinophils and intestinal fibroblasts were cultured with IL-33 and IL-13 and inflammatory and remodeling parameters were assessed. Anti-eosinophil therapy was also administered to the Crohn’s-like ileitis model (SAMP1/SkuSlc). Results Our novel EPX-score was more sensitive than H&E-staining, revealing significant differences in eosinophil patterns, comparing inflammatory and stricturing pediatric CD. A significant relationship between ileal-eosinophilia and complicated clinical/histopathological phenotype including fibrosis was determined. IL-33 induced significant eosinophil EPX-secretion and IL-13 production. Exposure to eosinophils in the presence of IL-33, ‘primed’ fibroblasts to increase pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), eosinophil-associated chemokines (CCL24, CCL26) and IL-13Rα2 production. Production of fibrogenic molecules (collagen 1A2, fibronectin and periostin) increased following exposure of ‘primed’-fibroblasts to IL-13. Epithelial-IL-33 was increased in pediatric Crohn’s-ileitis and strongly associated with clinical and histopathological activity, ileal eosinophilia and complicated, fibrostenotic disease. SAMP1/SkuSlc eosinophil-targeted treatment resulted in significant improvements in inflammation and remodeling. Conclusions Our study of specimens from pediatric patients with

  4. [Urethroplasty with buccal mucosa graft or penile skin graft for anterior urethral stricture?].

    PubMed

    Rojas, Alejandro; Saavedra, Alvaro

    2015-06-04

    Currently the treatment for urethral stricture considers various techniques, including augmentation urethroplasty using tissue from different parts of the body. The more used are the buccal mucosa and penile skin, but are there any differences in success between both tissues? Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified one systematic review including 18 primary studies addressing this question, six of them prospective. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded there is uncertainty about the superiority of one technique over another because the certainty of the evidence is very low. A new systematic review is urgently needed on this topic as randomized studies have been published after the most recent review, which could provide greater certainty.

  5. Feasibility of CEUS and strain elastography in one case of ileum Crohn stricture and literature review.

    PubMed

    Giannetti, Andrea; Biscontri, Marco; Matergi, Marco; Stumpo, Michela; Minacci, Chiara

    2016-09-01

    Contrast-enhanced ultrasonography (CEUS) and strain elastography (SE) are diagnostic imaging methods, which are still not routinely used in the clinical management of inflammatory bowel diseases. However, there are studies in the literature reporting on the use of both CEUS and SE in patients with bowel obstruction due to Crohn's disease, documenting the usefulness of these two methods in the differentiation between inflammation and fibrosis affecting the bowel wall. The aim of this case report is to evaluate the usefulness of CEUS and SE performed in a patient with Crohn's disease, who was admitted to hospital with bowel obstruction due to terminal ileal stricture and submitted to ileocecal resection. CEUS and SE identified and to some extent also characterized the inflammatory and fibrotic processes affecting the bowel wall. Macroscopic and microscopic examinations of the surgical specimen confirmed the presence of inflammatory phenomena (exudates, ulcers, and fistulas) and fibrosis as suggested by ultrasound (US) imaging methods.

  6. Complications after treating esophageal strictures with prostheses and stents – 20 years’ experience

    PubMed Central

    Brzeziński, Daniel; Rębowski, Marek; Kozak, Józef

    2016-01-01

    Introduction Over 80% of patients with esophageal cancer are qualified only for palliative treatment. The main goal of the therapy is to eliminate symptoms of dysphagia. Aim To analyze complications after insertion of prostheses and stents in patients with inoperable cancer of the esophagus/cardia. Material and methods From 1996 to 2015 prostheses of the esophagus were implanted in 1309 patients. In the strictures of the lower part of the esophagus, Barbin-Mousseau prostheses (102 cases) and Häring prostheses (324 cases) were placed. In the strictures of the upper and middle part of the esophagus, Wilson-Cook prostheses (65 cases) and Sumi prostheses (51 cases) were implanted using rigid oesophagoscopy. Since 2001, 867 esophageal stents have been implanted. Results Complications occurred in 146 (11%) patients, including 7 (0.6%) cases of death. The most common complication was the recurrence of swallowing disorders (74 patients). In 51 patients, tumor overgrowth over the stent/prosthesis was responsible for that symptom, and in 23 patients its clogging. A fistula (22 cases) and the passage of the prosthesis/stent (25 cases) were the second most common group of complications. Compression of the trachea, bleeding, and dehiscence of wounds occurred in a total of 18 patients. Complications were mostly treated through the repositioning of the prosthesis/stent or the insertion of an additional one. Conclusions The most common complications after esophageal prosthetics are the recurrence of dysphagia, a fistula and the displacement of the prosthesis/stent. The basic treatment of complications is the repositioning or insertion of an additional prosthesis. PMID:28194251

  7. Noninvasive evaluation of active pan-ulcerative colitis with multiple strictures using Fluorine-18-Fluorodeoxyglucose positron emission tomography/computed tomography

    PubMed Central

    Santhosh, Sampath; Bhattacharya, Anish; Rana, Surinder Singh; Bhasin, Deepak Kumar; Gupta, Rajesh; Mittal, Bhagwant Rai

    2016-01-01

    Ulcerative colitis (UC) is an inflammatory bowel disease characterized by waxing and waning inflammation that changes in severity and extent and may progress to neoplasia, especially in the presence of strictures. When patients have nonnegotiable strictures or severe inflammation with ulcers, colonoscopy is difficult and carries the risk of perforation. The authors present a patient with pan-UC with multiple strictures, in whom fluorodeoxyglucose positron emission tomography/computed tomography was used to noninvasively evaluate the extent and severity of the disease. PMID:26917901

  8. Optimal programmable unambiguous discriminator between two unknown latitudinal states

    NASA Astrophysics Data System (ADS)

    Sunian, XiaoBing; Li, YuWei; Zhou, Tao

    2016-10-01

    Two unknown states can be unambiguously distinguished by a universal programmable discriminator, which has been widely discussed in previous works and the optimal solution has also been obtained. In this paper, we investigate the programmable unambiguous discriminator between two unknown "latitudinal" states, which lie in a subspace of the total state space. By equivalence of unknown pure states to known average mixed states, the optimal solution for this problem is systematically derived, and the analytical success probabilities for the optimal unambiguous discrimination are obtained. It is beyond one's expectation that the optimal setting for the programmable unambiguous discrimination between two unknown "latitudinal" states is the same as that for the universal ones. The results in this work can be used for the realization of the programmable discriminator in laboratory.

  9. Fever of unknown origin: a clinical approach.

    PubMed

    Cunha, Burke A; Lortholary, Olivier; Cunha, Cheston B

    2015-10-01

    Fevers of unknown origin remain one of the most difficult diagnostic challenges in medicine. Because fever of unknown origin may be caused by over 200 malignant/neoplastic, infectious, rheumatic/inflammatory, and miscellaneous disorders, clinicians often order non-clue-based imaging and specific testing early in the fever of unknown origin work-up, which may be inefficient/misleading. Unlike most other fever-of-unknown-origin reviews, this article presents a clinical approach. Characteristic history and physical examination findings together with key nonspecific test abnormalities are the basis for a focused clue-directed fever of unknown origin work-up.

  10. Differentiation of Inflammatory from Fibrotic Ileal Strictures among Patients with Crohn's Disease through Analysis of Time-Intensity Curves Obtained after Microbubble Contrast Agent Injection.

    PubMed

    Quaia, Emilio; Gennari, Antonio Giulio; van Beek, Edwin J R

    2017-04-03

    The aim of the study described here was to assess whether the analysis of time-intensity curves obtained after microbubble contrast agent injection could differentiate inflammatory from fibrotic ileal strictures among patients with Crohn's disease. Sixty-five consecutive patients (40 male and 25 female; mean age ± SD, 42.2 ± 12.22 y) with stricture of the terminal ileal loop from Crohn's disease were scanned after microbubble injection. Time-intensity curves were obtained from quantitative analysis, and peak enhancement, rise time, time to peak, area under the time-intensity curve (AUC), AUC during wash-in (AUCWI) and AUC during wash-out (AUCWO) were compared between patients with inflammatory strictures and patients with fibrotic strictures. Inflammatory (n = 40) and fibrotic (n = 25) strictures differed (p < 0.05) in peak enhancement, wash-in rate, wash-in perfusion index, AUC, AUCWI and AUCWO. The quantitative analysis of small bowel wall contrast enhancement after microbubble contrast agent injection may differentiate inflammatory from fibrotic ileal strictures in patients with Crohn's disease.

  11. Transplantation of tissue-engineered cell sheets for stricture prevention after endoscopic submucosal dissection of the oesophagus

    PubMed Central

    Sjöqvist, Sebastian; Elbe, Peter; Kanai, Nobuo; Enger, Jenny; Haas, Stephan L; Mohkles-Barakat, Ammar; Okano, Teruo; Takagi, Ryo; Ohki, Takeshi; Yamamoto, Masakazu; Kondo, Makoto; Markland, Katrin; Lim, Mei Ling; Yamato, Masayuki; Nilsson, Magnus; Permert, Johan; Blomberg, Pontus; Löhr, J-Matthias

    2016-01-01

    Background and objective Endoscopic mucosal dissection (ESD) is a treatment option for oesophagus tumours localized to the mucosa enabling en bloc removal of large lesions. The resulting larger mucosal defects have resulted in an increase in the occurrence of post-treatment strictures. Transplantation of autologous cell sheets, cultured from oral mucosa, has been shown to prevent post-ESD strictures. The aim of the study was to assess the efficacy and safety of cell sheet transplantation after oesophageal ESD in a Western patient population where reflux-associated pre-malignant and malignant conditions predominate. Methods Patients with Barrett’s oesophagus associated high-grade dysplasia or early adenocarcinoma where ESD entailed a resection >3 cm in length and ≥75% of the circumference were eligible for treatment under hospital exemption. Cell sheets were cultured from buccal mucosa according to Good Manufacturing Practice and were endoscopically applied to the post-ESD defect directly after resection. Patients were followed with weekly endoscopy examinations, including confocal laser microscopy, for a total of four weeks. Results Five patients were treated. ESD was extensive with resections being circumferential in three patients and 9–10 cm in length in two. The number of transplanted cell sheets ranged from two to six. Three patients developed strictures requiring two to five dilatation sessions. Conclusions Cell sheet transplantation shows to be safe and feasible in a Western population. Results suggest that transplantation has a protective effect on the mucosal defect after ESD, decreasing both the risk for and extent of stricture formation.

  12. Diversity of patient profile, urethral stricture, and other disease manifestations in a cohort of adult men with lichen sclerosus

    PubMed Central

    Kirk, Peter Stanford; Yi, Yooni; Hadj-Moussa, Miriam

    2016-01-01

    Purpose Lichen sclerosus (LS) in men is poorly understood. Though uncommon, it is often severe and leads to repeated surgical interventions and deterioration in quality of life. We highlight variability in disease presentation, diagnosis, and patient factors in male LS patients evaluated at a tertiary care center. Materials and Methods We retrospectively reviewed charts of male patients presenting to our reconstructive urology clinic with clinical or pathologic diagnosis of LS between 2004 and 2014. Relevant clinical and demographic information was abstracted and descriptive statistics calculated. Subgroup comparisons were made based on body mass index (BMI), urethral stricture, and pathologic confirmation of disease. Results We identified 94 patients with clinical diagnosis of LS. Seventy percent (70%) of patients in this cohort had BMI >30 kg/m2, and average age was 51.5 years. Lower BMI patients were more likely to suffer from urethral stricture disease compared to overweight counterparts (p=0.037). Patients presenting with stricture disease were more likely to be younger (p=0.003). Thirty percent (30%) of this cohort had a pathologic diagnosis of LS. Conclusions Urethral stricture is the most common presentation for men with LS. Many patients endure skin scarring and have numerous comorbidities. Patient profile is diverse, raising the concern that not all patients with clinical diagnosis of LS are suffering from identical disease processes. The rate of pathologic confirmation at a tertiary care institution is alarmingly low. Our findings support a role for increased focus on pathologic confirmation and further delineation of the subtype of disease based on location and clinical manifestations. PMID:27195319

  13. Testicular tumor with clinical picture of febricity of unknown etiology.

    PubMed

    Andjelic, Sladjana

    2010-01-01

    We present a typical example of a previously healthy boy, whose febricity of unknown etiology lasting for several months was not taken seriously, regardless of the presence of general symptoms of the disease. He was treated as an outpatient with antibiotics and antipyretics under different diagnoses until he was admitted to the Department for Febrile Conditions of Unknown Etiology of the Institute for Infectious Diseases of the Clinical Center of Serbia. At that point, a diagnosis of testicular tumor of extragonadal origin with bilateral metastatic changes of lung parenchyma and retroperitoneal lymph nodes was made, after which the appropriate treatment was administered.

  14. A comparative study of lingual mucosal graft urethroplasty with buccal mucosal graft urethroplasty in urethral stricture disease: An institutional experience

    PubMed Central

    Pal, Dilip Kumar; Gupta, Depak Kumar; Ghosh, Bastab; Bera, Malay Kumar

    2016-01-01

    Aims: A prospective study to compare the outcomes of lingual versus buccal mucosal graft urethroplasty in patients with long segment anterior urethral strictures disease. Materials and Methods: The study included 30 patients for buccal mucosal graft urethroplasty (group I) and 30 patients for lingual mucosal graft urethroplasty (group II) for treatment of long segment (>3 cm) incomplete anterior urethral stricture disease using single-stage dorsal onlay free oral mucosal graft urethroplasty by Barbagli's technique between February 2013 to September 2014. All patients underwent complete evaluation of the stricture including inspection of the oral cavity. Results: The results of urethroplasty in between two group were not significant (P > 0.05) in terms of Qmax (P = 0.63), mean postoperative AUA symptom score (P = 0.83), operative time (P = 0.302) intra operative blood loss (P = 0.708), duration of postoperative hospitalization (P = 0.83), but slurring of speech complications was seen in group II, but not in group I. Long-term complications of salivary disturbance, tightness of the mouth, persistent pain at graft site, perioral numbness, seen only in group I (BMGU). Conclusion: LMG urethroplasty is an excellent alternative to BMG urethroplasty with comparable results of urethroplasty and minimal donor site complications. PMID:27141184

  15. No Previous Public Services Required

    ERIC Educational Resources Information Center

    Taylor, Kelley R.

    2009-01-01

    In 2007, the Supreme Court heard a case that involved the question of whether a school district could be required to reimburse parents who unilaterally placed their child in private school when the child had not previously received special education and related services in a public institution ("Board of Education v. Tom F."). The…

  16. Expandable polyester silicon-covered stent for malignant esophageal strictures before neoadjuvant chemoradiation: a pilot study.

    PubMed

    Siddiqui, Ali A; Loren, David; Dudnick, Robert; Kowalski, Thomas

    2007-03-01

    Patients with resectable esophageal cancer often require placement of a surgical jejunostomy tube prior to receiving chemoradiation so as to maintain adequate nutrition due to their inability to swallow and eat. This study reports a single institutional experience with the Polyflex self-expanding silicone stent (Riisch; Kernen. Germany) in patients with malignant stenosis receiving chemoradiation prior to esophagectomy. This was a retrospective, nonrandomized study of 6 patients who underwent Polyflex esophageal stent placement across a malignant stricture prior to receiving neoadjuvant chemoradiation. The study assessed procedural success, restoration of oral nutrition, migration, and removal of the Polyflex stent. The outcomes measured were the efficacy of treatment, stent-related complications, and changes in the nutritional status of the patient after stent placement. Stent placement was successful in 5 of 6 patients (83%). Restoration of oral nutrition after stent placement occurred in 5 of 5 patients (100%). Migration of the stent into the stomach occurred in 3 patients (60%) without occurrence of gastric outlet obstruction; there was no proximal migration. Stents were successfully removed endoscopically or at the time of esophagectomy. This early experience suggests that the removable silicone Polyflex stent is an effective alternative to a surgical jejunostomy tube for the management of malignant esophageal stenosis in patients for whom neoadjuvant chemoradiation is planned prior to esophagectomy.

  17. Percutaneous “Y” biliary stent placement in palliative treatment of type 4 malignant hilar stricture

    PubMed Central

    Centore, Luca; Soreca, Emilio; Corvino, Antonio; Farbo, Vincenzo; Bencivenga, Alfonso

    2016-01-01

    Background This study evaluated the technical and clinical efficacy of percutaneous bilateral biliary stent-in-stent (SIS) deployment technique with a “Y” configuration using open-cell-design stents in type 4 Klatskin tumor patients. Methods Retrospective evaluation ten patients with type IV Bismuth malignant hilar stricture (MHS) treated with percutaneous bilateral “Y” SIS deployment technique placement followed in our institution between March of 2012 and November of 2014. Results Bilateral SIS deployment was technically successful in all patients. One patient (10%) had major complications (episode of cholangitis); one patient (10%) had minor complications, including self-limiting hemobilia. Successful internal drainage was achieved in nine (90%) patients. Stent occlusion by tumor overgrowth and sludge formation occurred in two patient (20%). The median survival and stent patency time were 298 and 315 days respectively. Conclusions Percutaneous bilateral metal stenting using a Y-stent is a valid option for the palliative treatment of type 4 Bismuth MHS, improving quality patient’ life. PMID:27034794

  18. A simplified protocol for evaluating and monitoring urethral stricture patients minimizes cost without compromising patient outcome.

    PubMed

    Okorie, Chukwudi O; Pisters, Louis L; Ndasi, Henry T; Fekadu, Arega

    2010-07-01

    Uroflowmetry, urethrocystoscopy and urethrography are either not readily available or the cost is prohibitive for many patients in low-resource countries. This paper examines the use of clinical history in post-urethroplasty follow-up. We retrospectively reviewed the outcome of 54 post-urethroplasty patients. Preoperative diagnostic work-up included simple blood tests and a retrograde urethrography, and postoperatively we did not perform any immediate diagnostic work-up. Follow-up of these patients was done through mobile phone calls and personal contacts. Eighty-nine per cent of our patients reported acceptable voiding over a mean follow-up period of 48.4 months - 79.6% were followed using mobile phone contact. In the majority of the urethral strictures cases, diagnostic work up can be kept to a minimum, thereby reducing cost. Follow-up can be done via phone calls and personal contact in many African countries where compliance is frequently less than encouraging. The spread of mobile phone networks across the continent has been remarkable.

  19. [Success of internal urethrotomy as the 1st operation in male urethral stricture].

    PubMed

    Esch, W; Latal, D

    1983-11-01

    A follow-up examination was possible on 179 out of 226 patients operated on for urethrostenosis using sight urethrotomy according to Sachse. The results are classification according to the observation period, ranging from 3 months to 3 years. The most important criteria of a successful operation were lack of discomfort and a rise in uroflow to over 10 ml. Relapses occur more frequently than average in patients who had recidive infections of the urinary tract before the operation. Where the operation was successful the urinary tract infection almost always subsided. Recidive strictures occurred frequently in patients over 70 years. However, internal urethrotomy is often the only suitable method of operation at that age. Long prior bouginage makes prognosis worse. In terms of aetiology, iatrogenic stenoses give the worst results, bulbar ring stenoses, the best. In cases of long stenoses, particularly in the penile part of the urethra, the results of the operation are clearly worse than average, so that another method of operation should be considered, especially if the patients are young.

  20. Parallel path planning in unknown terrains

    NASA Astrophysics Data System (ADS)

    Prassler, Erwin A.; Milios, Evangelos E.

    1991-03-01

    We present a parallel processing approach to path planning in unknown terrains which combines map-based and sensor-based techniques into a real-time capable navigation system. The method is based on massively parallel computations in a grid of simple processing elements denoted as cells. In the course of a relaxation process a potential distribution is created in the grid which exhibits a monotonous slope from a start cell to the cell corresponding to the robot''s goal position. A shortest path is determined by means of a gradient descent criterion which settles on the steepest descent in the potential distribution. Like high-level path planning algorithms our approach is capable of planning shortest paths through an arbitrarily cluttered large-scale terrain on the basis of its current internal map. Sequentially implemented its complexity is in the order of efficient classical path planning algorithms. Unlike these algorithms however the method is also highly responsive to new obstacles encountered in the terrain. By continuing the planning process during the robot''s locomotion information about previously unknown obstacles immediately affects further path planning without a need to interrupt the ongoing planning process. New obstacles cause distortions of the potential distribution which let the robot find proper detours. By ensuring a monotonous slope in the overall distribution we avoid local minimum effects which may trap a robot in the proximity of an obstacle configuration before it has reached its goal. 1 Until the recent past research on path planning in the presence of obstacles can be assigned to two major categories: map-based high-level planning approaches and sensor-based low-level conLrol approaches. In work such as 12 path planning is treated as a high-level planning task. Assuming that an (accnrae) precompiled map of the terrain is available high-level path planners provide paths which guarantee a collision-free locomotion through an arbitrary

  1. Exploration of unknown mechanical assemblies through manipulation

    NASA Technical Reports Server (NTRS)

    Kumar, Vijay R.; Yun, Xiaoping; Bajcsy, Ruzena

    1990-01-01

    If robots must function in unstructured environments, they must also possess the ability to acquire information and construct appropriate models of the unknown environment. This paper addresses the automatic generation of kinematic models of unknown objects with movable parts in the environment. If the relative motion between moving parts must be observed and characterized, vision alone cannot suffice. An approach in which manipulation is used with vision for sensing is better suited to the task of determining kinematic properties. In this paper, algorithms for constructing models of unknown mechanical assemblies and characterizing the relative motion are developed. Results of a simulation are described to demonstrate the role of manipulation in such an endeavor.

  2. 53. Photographer unknown, date unknown. E.C. COLLIER under sail, dredging ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    53. Photographer unknown, date unknown. E.C. COLLIER under sail, dredging oysters. Please credit Chesapeake Bay Maritime Museum, St. Michaels, Maryland. - Two-Sail Bateau E. C. COLLIER, Chesapeake Bay Maritime Museum, Mills Street, Saint Michaels, Talbot County, MD

  3. Quantum circuits cannot control unknown operations

    NASA Astrophysics Data System (ADS)

    Araújo, Mateus; Feix, Adrien; Costa, Fabio; Brukner, Časlav

    2014-09-01

    One of the essential building blocks of classical computer programs is the ‘if’ clause, which executes a subroutine depending on the value of a control variable. Similarly, several quantum algorithms rely on applying a unitary operation conditioned on the state of a control system. Here we show that this control cannot be performed by a quantum circuit if the unitary is completely unknown. The task remains impossible even if we allow the control to be done modulo a global phase. However, this no-go theorem does not prevent implementing quantum control of unknown unitaries in practice, as any physical implementation of an unknown unitary provides additional information that makes the control possible. We then argue that one should extend the quantum circuit formalism to capture this possibility in a straightforward way. This is done by allowing unknown unitaries to be applied to subspaces and not only to subsystems.

  4. Unknown, placeholder, or variable: what is x?

    NASA Astrophysics Data System (ADS)

    Ely, Robert; Adams, Anne E.

    2012-03-01

    One of the most significant steps in learning algebra is understanding the change in the role of letters in mathematical expressions from unknowns to variables. We describe the historical development of this change in usage, starting with the ancient use of mathematical unknowns, detailing several important changes in practice that allowed for the idea of the placeholder, the birth of symbolic algebra, and the development of the variable. Focusing on these changes in practice, we interpret some classroom examples of 8th-grade students who interpret letters in terms of their experience with unknowns, rather than in terms of variables, to the confusion and dismay of the teachers. We also discuss how particular curricular and pedagogical treatments can support student learning by deliberately focusing on these changes in practice in the transition from unknowns to variables in the middle grades.

  5. Eosinophilic cholangitis is a potentially underdiagnosed etiology in indeterminate biliary stricture

    PubMed Central

    Walter, Dirk; Hartmann, Sylvia; Herrmann, Eva; Peveling-Oberhag, Jan; Bechstein, Wolf O; Zeuzem, Stefan; Hansmann, Martin-Leo; Friedrich-Rust, Mireen; Albert, Jörg G

    2017-01-01

    AIM To investigate presence and extent of eosinophilic cholangitis (EC) as well as IgG4-related disease in patients with indeterminate biliary stricture (IBS). METHODS All patients with diagnosis of sclerosing cholangitis (SC) and histopathological samples such as biopsies or surgical specimens at University Hospital Frankfurt from 2005-2015 were included. Histopathological diagnoses as well as further clinical course were reviewed. Tissue samples of patients without definite diagnosis after complete diagnostic work-up were reviewed regarding presence of eosinophilic infiltration and IgG4 positive plasma cells. Eosinophilic infiltration was as well assessed in a control group of liver transplant donors and patients with primary sclerosing cholangitis. RESULTS one hundred and thirty-five patients with SC were included. In 10/135 (13.5%) patients, no potential cause of IBS could be identified after complete diagnostic work-up and further clinical course. After histopathological review, a post-hoc diagnosis of EC was established in three patients resulting in a prevalence of 2.2% (3/135) of all patients with SC as well as 30% (3/10) of patients, where no cause of IBS was identified. 2/3 patients with post-hoc diagnosis of EC underwent surgical resection with suspicion for malignancy. Diagnosis of IgG4-related cholangitis was observed in 7/135 patients (5.1%), whereas 3 cases were discovered in post-hoc analysis. 6/7 cases with IgG4-related cholangitis (85.7%) presented with eosinophilic infiltration in addition to IgG4 positive plasma cells. There was no patient with eosinophilic infiltration in the control group of liver transplant donors (n = 27) and patients with primary sclerosing cholangitis (n = 14). CONCLUSION EC is an underdiagnosed benign etiology of SC and IBS, which has to be considered in differential diagnosis of IBS. PMID:28246478

  6. SIU/ICUD Consultation on Urethral Strictures: Anterior urethra-lichen sclerosus.

    PubMed

    Stewart, Laurence; McCammon, Kurt; Metro, Michael; Virasoro, Ramon

    2014-03-01

    We reviewed the current literature on lichen sclerosus as it related to urethral stricture disease using MEDLINE and PubMed (U.S. National Library of Medicine, National Institutes of Health) up to the current time. We identified 65 reports, 40 of which were considered relevant and form the basis of this review. Lichen sclerosus is now the accepted term, and balanitis xerotica obliterans is no longer acceptable. This common chronic inflammatory skin condition, mainly affecting the genitalia, remains an enigma, with uncertain etiology, varied presentation, and multiple treatments. In the early stages of the condition, a short course of steroids may be beneficial for some patients. If persistent, patients need long-term surveillance because of the potential development of squamous cell carcinoma. If diagnosed early, lichen sclerosus can be controlled, preventing progression. But once the disease has progressed, it is very difficult to treat. Surgical treatment by circumcision can be curative if the disease is treated early when still localized. Once progression to urethral involvement has occurred, treatment is much more difficult. Meatal stenosis alone is likely to require meatotomy or meatoplasty. Treatment of the involved urethra requires urethroplasty. Single-stage and multiple-stage procedures using oral mucosa have both been reported to give acceptable results, but the use of skin, genital or nongenital, is not recommended, because being skin, it remains prone to lichen sclerosus. With extensive disease, affecting the full length of the urethra, consideration should be given to perineal urethrostomy. A significant number of patients may prefer this simpler option.

  7. Basic investigation of laser therapy for the ureteral stricture using ultraviolet argon laser and multifiber catheter

    NASA Astrophysics Data System (ADS)

    Daidoh, Yuichiro; Arai, Tsunenori; Murai, Masaru; Suda, Akira; Kikuchi, Makoto; Nakamura, Hiroshi; Komime, Yukikuni; Utsumi, Atsushi

    1992-06-01

    In order to develop new, easy, and safe treatment for urinary tract stricture, we investigated the laser plasty using a combination of an uv Ar laser for ablation and a novel multi-fiber catheter for laser delivery. To investigate the characteristics of the uv Ar laser ablation to ureteral tissue, the experiment in vitro was performed. The ureter was clearly ablated with sufficient thin coagulation layer. The proper laser power for the tissue ablation was about 0.5 W for 0.4 mm core-diameter fiber. The multi-fiber catheter (1.6 mm in outer diameter) consisted of 13 pixels of silica glass fibers (0.2 mm in core diameter) for laser delivery and a through lumen (0.9 mm in inner diameter) for guidewire. The catheter was inserted into a canine ureter under the general anesthesia. The ureter and urinary tract were irradiated using about 0.6 W of laser power at the catheter tip with 40s duration. The irradiated urinary tract tissues were histologically investigated. The ureter was ablated up to the submucosa layer. The urinary tract endotherium was eliminated by the laser ablation without the carbonization. No perforation was found at various irradiation conditions. To investigate the ureteral tissue damage of the uv Ar laser irradiation, the serosa temperature was measured by a thermocouple. The temperature elevation of the serosa could be restricted up to 60 degree(s)C, at which the protein was not coagulated. We concluded that the combination of uv Ra laser and multi-fiber catheter offered easy, reliable therapy for coronary structure.

  8. Biliary strictures after liver transplantation: risk factors and prevention by donor treatment with epoprostenol.

    PubMed

    Pirenne, J; Monbaliu, D; Aerts, R; Desschans, B; Liu, Q; Cassiman, D; Laleman, W; Verslype, C; Magdy, M; Van Steenbergen, W; Nevens, F

    2009-10-01

    Biliary strictures (BS), a major complication after orthotopic liver transplantation (OLT), cause morbidity, mortality, graft loss, and increased costs. The virtually unchanged incidence of BS (approximately 10%-25%) suggests that they are not simply "technical" in origin, but probably represent a mucosa ischemic injury inherent in the transplantation procedure. To study risk factors for BS, we analyzed 403 OLTs performed between January 1, 1997 and December 31, 2006, at a single center, excluding cases of regraft or death within 1 month. The average time to the diagnosis of the BS was 253 days (range, 7-1002 days). Upon univariate analysis, the absence of flushing of donor bile ducts, an imported versus a locally procured liver, and rejection were risk factors for BS. In contrast, the following factors were protective: donor cardiac arrest followed by resuscitation (suggesting an ischemic preconditioning effect) as well as addition of epoprostenol to and pressurization of the preservation solution. Patients with higher postoperative peak values of transaminases, bilirubin, alkaline phosphatase, and gamma glutamyl transpeptidase were at greater risk for later development of BS. Donor hypotension, donor age, donor intensive care unit (ICU) stay, type of preservation, positive cross-match, cold and warm ischemia times, sequential versus simultaneous portal/arterial reperfusion, as well as cytomegalovirus (CMV) infection were not risk factors for BS. Upon multivariate analysis, only epoprostenol and pressurization offered protection from BS. In conclusion, this study 2 novel points: (1) patients with high(er) transaminase values and cholestasis early postoperatively are at greater risk to develop later BS and require close monitoring and (2) donor maneuvers for better flushing and preserving peribiliary vascular plexus and biliary mucosa (epoprostenol and pressurization of preservation solution) offer protection from BS.

  9. Prevention of esophageal stricture after endoscopic submucosal dissection using RNA-based silencing of carbohydrate sulfotransferase 15 in a porcine model.

    PubMed

    Sato, Hiroki; Sagara, Seiji; Nakajima, Nao; Akimoto, Teppei; Suzuki, Kenji; Yoneyama, Hiroyuki; Terai, Shuji; Yahagi, Naohisa

    2017-03-06

    Background and study aims Endoscopic submucosal dissection (ESD) for esophageal carcinoma frequently causes fibrotic strictures that require treatment. A possible preventive effect of small interfering RNA (siRNA) targeting carbohydrate sulfotransferase 15 (CHST15) on esophageal stricture formation after ESD was investigated in 3 pigs. Materials and methods Two half-circumferential ESD ulcers were created in the oral and anal ends of the esophagus. CHST15 siRNA was injected submucosally in one of the two ESD ulcers. Endoscopic, macroscopic, histological, and polymerase chain reaction analyses were performed. Results On post-operative day 14, the non-treated ulcers were found to show histological fibrosis and increased expression of the CHST15 messenger RNA. A single endoscopic injection of CHST15 siRNA alleviated stricture development in post-ESD ulcers with significant reduction in the mucosal contraction rate. The deposition of collagen and accumulation of fibroblasts and myofibroblasts were diminished in ulcers treated with CHST15 siRNA, where significant suppression of CHST15, transforming growth factor-beta (TGF-β), and collagen-1 messenger RNAs was also seen. Conclusion CHST15 siRNA alleviated esophageal post-ESD stricture formation via repression of fibrosis, revealing a novel therapeutic role for antifibrotic agents in the prevention of post-ESD strictures.

  10. Response to the "Comment on Chemical and Toxicological Investigations of a Previously Unknown Poisonous European Mushroom Tricholoma terreum".

    PubMed

    Yin, Xia; Feng, Tao; Li, Zheng-Hui; Liu, Ji-Kai

    2016-04-11

    Recently, Dr. Paolo Davoli and his colleagues stated that the conclusions drawn by us were misleading from a mycotoxicological perspective, as they cast doubts on the edibility of a mushroom species (Tricholoma terreum) that has been always recognized as safe. Unfortunately, they made a mistake, and seriously misinterpreted our data, which resulted in scepticism of our research. Saponaceolides B and M were tested for their stabilities heating directly on and boiling in water. It is undoubted that both saponaceolides B and M are capable of withstanding prolonged heating during cooking.

  11. Urethral stricture vaporization with the KTP laser provides evidence for a favorable impact of laser surgery on wound healing

    NASA Astrophysics Data System (ADS)

    Schmidlin, Franz R.; Venzi, Giordano; Jichlinski, Patrice; Oswald, Michael; Delacretaz, Guy P.; Gabbiani, Giulio; Leisinger, Hans-Juerg; Graber, Peter

    1997-12-01

    The objective of this study was to evaluate and compare the safety and efficacy of the KTP 532 laser to direct vision internal urethrotomy (DVIU) in the management of urethral strictures. A total of 32 patients were randomized prospectively in this study, 14 DVIU and 18 KTP 532 laser. Patients were evaluated postoperatively with flowmetry and in the case of recurrence with cystourethrography at 3, 12, 24 weeks. With the KTP 532 laser complete symptomatic and uredynamic success was achieved in 15 (83%) patients at 12 and 24 weeks. Success rate was lower in the DVIU group with 9 (64%) patients at 12 weeks and 8 (57%) patients at 24 weeks. Mean preoperative peak-flow was improved from 6 cc/s to 20 cc/s at 3, 12 and 24 weeks with the KTP laser. With DVIU mean preoperative peak-flow was improved from 5.5 cc/s to 20 cc/s at 3 weeks followed by a steady decrease to 13 cc/s at 12 weeks and to 12 cc/s 24 weeks. No complication was observed in either group of patients. Our results confirm that stricture vaporization with the KTP 532 laser is a safe and efficient procedure. The better results after laser surgery make it also a valuable alternative in the endoscopic treatment of urethral strictures. These findings suggest a favorable influence of laser surgery on wound healing with less wound contraction and scarring. The lack of contraction of laser wounds might be related to the absence and the lack of organization of myofibroblasts in laser induced lesions.

  12. A severe case of esophageal ulcer causing a tight stricture despite long-term D-penicillamine treatment.

    PubMed

    Yapali, Suna; Turan, Ilker; Ozutemiz, Omer; Tekesin, Oktay

    2014-12-01

    D-penicillamine has long been used in the management of rheumatic diseases due to the effects on inhibition of collagen synthesis. Herein, we report a severe case of esophageal ulcer causing a tight stricture extending through the distal esophagus despite the long-term D-penicillamine treatment in a patient with Wilson's disease. D-penicillamine would theoretically be expected to contribute to the healing of an esophageal ulcer. However, the drug failed to have a favorable outcome, which is notable and worth reporting.

  13. Bayesian modeling of unknown diseases for biosurveillance.

    PubMed

    Shen, Yanna; Cooper, Gregory F

    2009-11-14

    This paper investigates Bayesian modeling of unknown causes of events in the context of disease-outbreak detection. We introduce a Bayesian approach that models and detects both (1) known diseases (e.g., influenza and anthrax) by using informative prior probabilities and (2) unknown diseases (e.g., a new, highly contagious respiratory virus that has never been seen before) by using relatively non-informative prior probabilities. We report the results of simulation experiments which support that this modeling method can improve the detection of new disease outbreaks in a population. A key contribution of this paper is that it introduces a Bayesian approach for jointly modeling both known and unknown causes of events. Such modeling has broad applicability in medical informatics, where the space of known causes of outcomes of interest is seldom complete.

  14. Creating a Superposition of Unknown Quantum States.

    PubMed

    Oszmaniec, Michał; Grudka, Andrzej; Horodecki, Michał; Wójcik, Antoni

    2016-03-18

    The superposition principle is one of the landmarks of quantum mechanics. The importance of quantum superpositions provokes questions about the limitations that quantum mechanics itself imposes on the possibility of their generation. In this work, we systematically study the problem of the creation of superpositions of unknown quantum states. First, we prove a no-go theorem that forbids the existence of a universal probabilistic quantum protocol producing a superposition of two unknown quantum states. Second, we provide an explicit probabilistic protocol generating a superposition of two unknown states, each having a fixed overlap with the known referential pure state. The protocol can be applied to generate coherent superposition of results of independent runs of subroutines in a quantum computer. Moreover, in the context of quantum optics it can be used to efficiently generate highly nonclassical states or non-Gaussian states.

  15. Metastatic adenocarcinoma of unknown primary origin.

    PubMed

    Hammar, S P

    1998-12-01

    Adenocarcinomas account for up to 60% of all metastatic neoplasms of unknown primary origin. In general, adenocarcinomas are the most difficult metastatic tumor to accurately identify the primary site. Some metastatic adenocarcinomas have distinctive histological features that allow for their site determination (eg, colonic adenocarcinoma, bronchioloalveolar cell carcinoma), although the majority of metastatic adenocarcinomas have histological features that are not distinctive enough to allow for a specific diagnosis of their origin. For this reason, electron microscopy and immunohistochemistry have been used to help identify the exact type (origin) of metastatic adenocarcinomas. Relatively specific ultrastructural features used to diagnose metastatic adenocarcinomas of unknown primary origin include tubular myelin, intranuclear surfactant apoprotein tubular inclusions, Clara cell granules, uniform short microvilli with filamentous cores and core rootlets, Langerhans cells associated with neoplastic cells, cytoplasmic hyaline globules, lipid droplets, glycogen, and cytoplasmic crystals. Only a few of these ultrastructural features are absolutely specific. Relatively specific immunohistochemical tests used to diagnose metastatic adenocarcinomas of unknown primary origin include prostate-specific antigen, thyroglobulin, estrogen and progesterone receptor proteins, thyroid transcription factor-I, and surfactant apoproteins. Of these, prostate-specific antigen and thyroglobulin are the most specific. The purpose of this article is to discuss the use of electron microscopy and immunohistochemistry in the site-specific diagnosis of metastatic adenocarcinomas of unknown primary origin.

  16. Fever of unknown origin, with a twist

    PubMed Central

    Lobo, Ronstan; Meany, Brendan; O'Hanlon, Rory; Kiernan, Thomas John

    2013-01-01

    The authors present a case of an 81-year-old man with fever of unknown origin. The case report is illustrated with the images which clarified the diagnosis in this challenging case. The cardiac MR images were of critical importance in arriving at a diagnosis of aortic root mycotic pseudoaneurysm with rupture into the right ventricle. PMID:23345531

  17. Method for genetic identification of unknown organisms

    DOEpatents

    Colston, Jr., Billy W.; Fitch, Joseph P.; Hindson, Benjamin J.; Carter, Chance J.; Beer, Neil Reginald

    2016-08-23

    A method of rapid, genome and proteome based identification of unknown pathogenic or non-pathogenic organisms in a complex sample. The entire sample is analyzed by creating millions of emulsion encapsulated microdroplets, each containing a single pathogenic or non-pathogenic organism sized particle and appropriate reagents for amplification. Following amplification, the amplified product is analyzed.

  18. Conquering the Unknown: Exploring the Options

    ERIC Educational Resources Information Center

    Baker, Lynne M.

    2012-01-01

    There are many challenges that lie ahead for families of children with special needs. It is indeed a time for conquering the unknown and diligently exploring the options in an effort to locate, understand, and ultimately embrace the as yet undiscovered beauties of the new setting. This paper will consider some of the issues relevant for parents,…

  19. 13C Metabolomics: NMR and IROA for Unknown Identification

    PubMed Central

    Clendinen, Chaevien S.; Stupp, Gregory S.; Wang, Bing; Garrett, Timothy J.; Edison, Arthur S.

    2016-01-01

    Abstract: Background Isotopic Ratio Outlier Analysis (IROA) is an untargeted metabolomics method that uses stable isotopic labeling and LC-HRMS for identification and relative quantification of metabolites in a biological sample under varying experimental conditions. Objective We demonstrate a method using high-sensitivity 13C NMR to identify an unknown metabolite isolated from fractionated material from an IROA LC-HRMS experiment. Methods IROA samples from the nematode Caenorhabditis elegans were fractionated using LC-HRMS using 5 repeated injections and collecting 30 sec fractions. These were concentrated and analyzed by 13C NMR. Results We isotopically labeled samples of C. elegans and collected 2 adjacent LC fractions. By HRMS, one contained at least 2 known metabolites, phenylalanine and inosine, and the other contained tryptophan and an unknown feature with a monoisotopic mass of m/z 380.0742 [M+H]+. With NMR, we were able to easily verify the known compounds, and we then identified the spin system networks responsible for the unknown resonances. After searching the BMRB database and comparing the molecular formula from LC-HRMS, we determined that the fragments were a modified anthranilate and a glucose modified by a phosphate. We then performed quantum chemical NMR chemical shift calculations to determine the most likely isomer, which was 3’-O-phospho-β-D-glucopyranosyl-anthranilate. This compound had previously been found in the same organism, validating our approach. Conclusion We were able to dereplicate previously known metabolites and identify a metabolite that was not in databases by matching resonances to NMR databases and using chemical shift calculations to determine the correct isomer. This approach is efficient and can be used to identify unknown compounds of interest using the same material used for IROA. PMID:28090435

  20. 14. Photocopy of photograph (source unknown) photographer unknown pre1885 NORTH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. Photocopy of photograph (source unknown) photographer unknown pre-1885 NORTH SIDE AND WEST FRONT (NOTE ABSENCE OF DORMER ON GAMBREL ROOF OF ELL) (Illustration #6 of Data Report included in Field Records) - Narbonne House, 71 Essex Street, Salem, Essex County, MA

  1. Infectious causes of fever of unknown origin.

    PubMed

    McGregor, Alastair C; Moore, David A

    2015-06-01

    The causes of fever of unknown origin (FUO) are changing because advances in clinical practice and diagnostics have facilitated the identification of some infections. A variety of bacterial infections can cause FUO, and these can be divided into those that are easy to identify using culture and those that require serological or molecular tests for identification. A number of viral, parasitic and fungal infections can also cause prolonged fever. This article summarises the clinical features and diagnostic strategy of these infections.

  2. Neurofunctional Signature of Hyperfamiliarity for Unknown Faces

    PubMed Central

    Negro, Elisa; D’Agata, Federico; Caroppo, Paola; Coriasco, Mario; Ferrio, Federica; Celeghin, Alessia; Diano, Matteo; Rubino, Elisa; de Gelder, Beatrice; Rainero, Innocenzo; Pinessi, Lorenzo; Tamietto, Marco

    2015-01-01

    Hyperfamiliarity for unknown faces is a rare selective disorder that consists of the disturbing and abnormal feeling of familiarity for unknown faces, while recognition of known faces is normal. In one such patient we investigated with a multimodal neuroimaging design the hitherto undescribed neural signature associated with hyperfamiliarity feelings. Behaviorally, signal detection methods revealed that the patient’s discrimination sensitivity between familiar and unfamiliar faces was significantly lower than that of matched controls, and her response criterion for familiarity decisions was significantly more liberal. At the neural level, while morphometric analysis and single-photon emission CT (SPECT) showed the atrophy and hypofunctioning of the left temporal regions, functional magnetic resonance imaging (fMRI) revealed that hyperfamiliarity feelings were selectively associated to enhanced activity in the right medial and inferior temporal cortices. We therefore characterize the neurofunctional signature of hyperfamiliarity for unknown faces as related to the loss of coordinated activity between the complementary face processing functions of the left and right temporal lobes. PMID:26154253

  3. Anatomy-shaped design of a fully-covered, biliary, self-expandable metal stent for treatment of benign distal biliary strictures

    PubMed Central

    Weigt, Jochen; Kandulski, Arne; Malfertheiner, Peter

    2016-01-01

    Background and study aims: The treatment success of benign biliary strictures with fully covered metal stents (CSEMS) is altered by high stent dislocation rates. We aimed to evaluate a new stent design to prevent dislocation. Patients and methods: Patients with benign biliary strictures were treated with a newly designed double-coned stent (dcSEMS). Mechanical analysis of the new stent was performed and it was compared with a cylindrical stent. Results: A total of 13 dcCSEMS were implanted in 11 patients (2 female, 9 male, median age 47, range 33 – 71). All patients had distal biliary strictures due to chronic pancreatitis. No stent migration occurred. In all but one patient the stents were removed. One patient refused stent extraction and was lost to follow up. Stent occlusion occurred twice leading to cholangitis in both cases. The duration of stent treatment was 170 days (range 61 – 254). After extraction only one patient had early recurrent stricture and received the same stent again. Three stents showed minimal tissue granulation at the papilla. One stent presented ingrowth at the proximal end and was removed after implantation of a second fully covered stent. Mechanical examination revealed significantly lower radial expansion force of the new stent as compared to the cylindrical stent. Conclusions: The new stent design has a low rate of migration. Biomechanical properties may explain this effect. PMID:26793789

  4. Modeling the Biomechanical Influence of Epilaryngeal Stricture on the Vocal Folds: A Low-Dimensional Model of Vocal-Ventricular Fold Coupling

    ERIC Educational Resources Information Center

    Moisik, Scott R.; Esling, John H.

    2014-01-01

    Purpose: Physiological and phonetic studies suggest that, at moderate levels of epilaryngeal stricture, the ventricular folds impinge upon the vocal folds and influence their dynamical behavior, which is thought to be responsible for constricted laryngeal sounds. In this work, the authors examine this hypothesis through biomechanical modeling.…

  5. Stricture Rate after Laparoscopic Roux-en-Y Gastric Bypass with a 21-mm Circular Stapler versus a 25-mm Linear Stapler

    PubMed Central

    Vunnamadala, Kalyan; Sakharpe, Aniket; Wilhelm, B. Jakub; Aksade, Artun

    2015-01-01

    Background: Obesity is estimated to affect more than one and a half billion adults. Laparoscopic Roux-en-Y gastric bypass (LRYGB) has become one of the preferred weight loss procedures. However, complications can occur. Strictures at the gastrojejunal anastomosis lead to clinical symptoms such as vomiting, dysphagia, and patient discomfort. The stricture rate has been correlated with the size and type of stapler used. Methods: A retrospective review of the clinical records of patients who underwent LRYGB was performed between 2003 and 2010. A comparison was made between a 21-mm circular stapler technique and a 25-mm linear stapler technique. Results: The stricture rate for the 21-mm circular stapler group was 7.12% and comparable to the national average. Using the 25-mm linear stapler, this complication rate significantly decreased to 1.09% (p<0.0004; odds ratio 6.5; [95% confidence interval 1.96–33.83]). Conclusions: Stricture after LRYGB is a serious complication. This study found that with a change in technique, this complication can be decreased considerably. PMID:25830078

  6. Identifying known unknowns using the US EPA's CompTox ...

    EPA Pesticide Factsheets

    Chemical features observed using high-resolution mass spectrometry can be tentatively identified using online chemical reference databases by searching molecular formulae and monoisotopic masses and then rank-ordering of the hits using appropriate relevance criteria. The most likely candidate “known unknowns,” which are those chemicals unknown to an investigator but contained within a reference database or literature source, rise to the top of a chemical list when rank-ordered by the number of associated data sources. The U.S. EPA’s CompTox Chemistry Dashboard is a curated and freely available resource for chemistry and computational toxicology research, containing more than 720,000 chemicals of relevance to environmental health science. In this research, the performance of the Dashboard for identifying “known unknowns” was evaluated against that of the online ChemSpider database, one of the primary resources used by mass spectrometrists, using multiple previously studied datasets reported in the peer-reviewed literature totaling 162 chemicals. These chemicals were examined using both applications via molecular formula and monoisotopic mass searches followed by rank-ordering of candidate compounds by associated references or data sources. A greater percentage of chemicals ranked in the top position when using the Dashboard, indicating an advantage of this application over ChemSpider for identifying known unknowns using data source ranking. Addition

  7. Outcomes of Percutaneous Management of Anastomotic Ureteral Strictures in Renal Transplantation: Chronic Nephroureteral Stent Placement with and without Balloon Dilatation

    SciTech Connect

    Uflacker, A. Sheeran, D. Khaja, M.

    2015-06-15

    PurposeThis study was designed o evaluate outcomes of percutaneous management of anastomotic ureteral strictures in renal transplants using nephroureteral stents with or without balloon dilatation.MethodsA retrospective audit of 1,029 consecutive renal transplants was performed. Anastomotic ureteral strictures were divided into two groups: nephroureteral stent only (NUS) and NUS+PTA (nephroureteral stent plus percutaneous transluminal angioplasty), with each cohort subdivided into early versus late presentation (obstructive uropathy occurring <90 day or >90 days from transplant, respectively). Overall and 6-month technical success were defined as removal of NUS any time with <30 % residual stenosis (any time lapse less or more than 6 months) and at >6 months, respectively. Patency was evaluated from NUS removal to last follow-up for both groups and compared.ResultsSixty-seven transplant patients with 70 ureteric anastomotic strictures (6.8 %, n = 70/1,029) underwent 72 percutaneous treatments. 34 % were late (>90 days, n = 24/70), and 66 % were early (<90 days, n = 46/70). Overall technical success was 82 % (n = 59/72) and 6-month success was 58 % (n = 42/72). Major and minor complications were 2.8 % (n = 2/72), and 12.5 % (n = 9/72). NUS+PTA did not improve graft survival (p = 0.354) or patency (p = 0.9) compared with NUS alone. There was no difference in graft survival between treated and nontreated groups (p = 0.74).ConclusionsThere is no advantage to PTA in addition to placement of NUS, although PTA did not negatively impact graft survival or long-term patency and both interventions were safe and effective. Neither the late or early groups benefited from PTA in addition to NUS. Earlier obstructions showed greater improvement in serum creatinine than later obstructions.

  8. Correction: Prospective pilot study of fully covered self-expandable metal stents for refractory benign pancreatic duct strictures: long-term outcomes

    PubMed Central

    Matsubara, Saburo; Sasahira, Naoki; Isayama, Hiroyuki; Takahara, Naminatsu; Mizuno, Suguru; Kogure, Hirofumi; Yamamoto, Natsuyo; Nakai, Yousuke; Tada, Minoru; Koike, Kazuhiko

    2016-01-01

    Background and study aims: Background and study aims: Temporary placement of a fully covered self-expandable metal stent (FCSEMS) has recently emerged as a treatment option for pancreatic duct strictures due to chronic pancreatitis refractory to conventional plastic stenting. However, there are no data about long-term outcomes with this therapeutic option. The aims of the current study were to estimate the feasibility, safety, efficacy, and long-term outcomes of temporary FCSEMS placement for refractory pancreatic duct strictures. Patients and methods: This was a prospective, single-center feasibility study. Ten patients with refractory pancreatic duct strictures due to chronic pancreatitis underwent FCSEMS placement for 3 months. We evaluated the rate of recurrent symptoms after stent removal during long-term follow-up, as well as adverse events (AEs). Results: Two patients required early (within 1 week) stent removal because of intolerable pain or pancreatitis. In the remaining 8 patients, the recurrence rate of any symptoms after FCSEMS removal was 63% during 35 months of follow up. The causes of recurrent symptoms were as follows: recurrence of stricture in 2; stent-induced stricture in 1; impaction of pancreatic stones in 1; and development of a pseudocyst in 1. When limited to stricture, the recurrence rate was 38%. Additional endoscopic treatments were required in 4 patients: a second FCSEMS placement in 1; plastic stent (PS) placement in 1; stone extraction in 1; and endoscopic ultrasound–guided pseudocyst drainage in 1. Asymptomatic stent migration occurred in 2 patients. Suppurative pancreatic ductitis due to food impaction in the FCSEMS occurred in 2 patients, and endoscopic pancreatic duct drainage was performed. Stent-induced ductal changes developed in 2 patients and PS treatment was required in 1 patient for pain relief. Conclusion: The FCSEMS appears to be a feasible and potentially effective option for the management of refractory pancreatic duct

  9. [Morphogenesis of connective tissue in patients with hydronephrosis caused by stricture of ureteric-pelvic segment of various etiology].

    PubMed

    Savenkov, V I

    2015-02-01

    In patients, suffering hydronephrosis stages II-III, caused by the ureteric-pelvic segment (UPS) obstruction due to inborn failures of urinary system, the collagen types I and III ratio reduction, and in acquired obstruction--its enhancement, are noted in interstitium, renal parenchyma vessels and the UPS walls. While obstruction in patients due to inborn failures in vascular basal membranes a deficiency of collagen type IV and appearance of nontypical for vascular basal membranes intersticial collagen type Il are observed. In the acquired UPS, obstruction the, enhancement of content of collagen type IV is revealed only. These disorders are mostly pronounced in patients with the disease recurrence. There was proposed diagnostic coefficient of ratio between collagens types I and III in patients, suffering hydronephrosis, caused by obstruction of various etiology. In hydronephrosis, caused by the UPS stricture, the cytokines disbalance occurs, impacting processes of collagen formation.

  10. 77 FR 70176 - Previous Participation Certification

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... URBAN DEVELOPMENT Previous Participation Certification AGENCY: Office of the Chief Information Officer... programs. The information will be used to evaluate participants' previous participation in government...: Previous Participation Certification. OMB Approval Number: 2502-0118. Form Numbers: HUD-2530 ....

  11. Vaginal-sparing ventral buccal mucosal graft urethroplasty for female urethral stricture: A novel modification of surgical technique

    PubMed Central

    Gani, Johan; Chee, Justin

    2016-01-01

    Purpose To present a novel modification of surgical technique to treat female urethral stricture (FUS) by a vaginal-sparing ventral buccal mucosal urethroplasty. Recurrent FUS represents an uncommon, though difficult clinical scenario to manage definitively. A variety of surgical techniques have been described to date, yet a lack of consensus on the optimal procedure persists. Materials and Methods We present a 51-year-old female with urethral stricture involving the entire urethra. Suspected etiology was iatrogenic from cystoscopy 17 years prior. Since then, the patient had undergone at least 25 formal urethral dilations and periods of self-dilation. In lithotomy position, the urethra was dilated to accommodate forceps, and ventral urethrotomy carried out sharply, exposing a bed of periurethral tissue. Buccal mucosa was harvested, and a ventral inlay technique facilitated by a nasal speculum, was used to place the graft from the proximal urethra/bladder neck to urethral meatus without a vaginal incision. Graft was sutured into place, and urethral Foley catheter inserted. Results The vaginal-sparing ventral buccal mucosal graft urethroplasty was deemed successful as of last follow-up. Flexible cystoscopy demonstrated patency of the repair at 6 months. At 10 months of follow-up, the patient was voiding well, with no urinary incontinence. No further interventions have been required. Conclusions This case describes a novel modification of surgical technique for performing buccal mucosal urethroplasty for FUS. By avoiding incision of the vaginal mucosa, benefits may include reduced: morbidity, urinary incontinence, and wound complications including urethro-vaginal fistula. PMID:27437540

  12. A Physician's Nightmare: Fever of Unknown Origin

    PubMed Central

    Anwer, Farrukh

    2016-01-01

    Fever of unknown origin (FUO) remains to be a challenge despite advancement in diagnostic technologies and procedures. FUO is considered when fever presents intermittently without an explanation. It has been linked to various etiologies, which makes it difficult to diagnose. We present the case of 18-month-old female with recurrent fever, splenomegaly, abdominal pain, and constipation. The workup for her symptoms revealed wandering spleen. Wandering spleen is a result from excessive laxity or absence of splenic ligaments. The patient underwent splenectomy and was advised to continue on Senna, Miralax, and high fiber diet. Her mother reported that the fever is no longer present and there is marked improvement in her constipation and abdominal pain after splenectomy. PMID:27433363

  13. Autonomous exploration and mapping of unknown environments

    NASA Astrophysics Data System (ADS)

    Owens, Jason; Osteen, Phil; Fields, MaryAnne

    2012-06-01

    Autonomous exploration and mapping is a vital capability for future robotic systems expected to function in arbitrary complex environments. In this paper, we describe an end-to-end robotic solution for remotely mapping buildings. For a typical mapping system, an unmanned system is directed to enter an unknown building at a distance, sense the internal structure, and, barring additional tasks, while in situ, create a 2-D map of the building. This map provides a useful and intuitive representation of the environment for the remote operator. We have integrated a robust mapping and exploration system utilizing laser range scanners and RGB-D cameras, and we demonstrate an exploration and metacognition algorithm on a robotic platform. The algorithm allows the robot to safely navigate the building, explore the interior, report significant features to the operator, and generate a consistent map - all while maintaining localization.

  14. Unknown components of the plastidial permeome

    PubMed Central

    Pick, Thea R.; Weber, Andreas P. M.

    2014-01-01

    Beyond their role in photosynthesis plastids provide a plethora of additional metabolic functions to plant cells. For example, they harbor complete biosynthetic pathways for the de novo synthesis of carotenoids, fatty acids, and amino acids. Furthermore plastids contribute important reactions to multi-compartmentalized pathways, such as photorespiration or plant hormone syntheses, and they depend on the import of essential molecules that they cannot synthesize themselves, such as ascorbic acid. This causes a high traffic of metabolites across the plastid envelope. Although it was recently shown that non-polar substrates could be exchanged between the plastid and the ER without involving transporters, various essential transport processes are mediated by highly selective but still unknown metabolite transporters. This review focuses on selected components of the plastidial permeome that are predicted to exist but that have not yet been identified as molecular entities, such as the transporters for isopentenyl diphosphate (IPP) or ascorbic acid. PMID:25191333

  15. Education Through Exploration: Evaluating the Unknown

    NASA Astrophysics Data System (ADS)

    Anbar, A. D.

    2015-12-01

    Mastery of the peculiar and powerful practices of science is increasingly important for the average citizen. With the rise of the Internet, most of human knowledge is at our fingertips. As content becomes a commodity, success and survival aren't about who knows the most, but who is better able to explore the unknown, actively applying and extending knowledge through critical thinking and hypothesis-driven problem-solving. This applies to the economic livelihoods of individuals and to society at large as we grapple with climate change and other science-infused challenges. Unfortunately, science is too often taught as an encyclopedic collection of settled facts to be mastered rather than as a process of exploration that embraces curiosity, inquiry, testing, and communication to reduce uncertainty about the unknown. This problem is exacerbated by the continued prevalence of teacher-centric pedagogy, which promotes learning-from-authority and passive learning. The initial wave of massively open online courses (MOOCs) generally mimic this teaching style in virtual form. It is hypothesized that emerging digital teaching technologies can help address this challenge at Internet scale in "next generation" MOOCs and flipped classroom experiences. Interactive simulations, immersive virtual field trips, gamified elements, rapid adaptive feedback, intelligent tutoring systems, and personalized pathways, should motivate and enhance learning. Through lab-like projects and tutorials, students should be able to construct knowledge from interactive experiences, modeling the authentic practice of science while mastering complex concepts. Freed from lecturing, teaching staff should be available for direct and intense student-teacher interactions. These claims are difficult to evaluate with traditional assessment instruments, but digital technologies provide powerful new ways to evaluate student learning and learn from student behaviors. We will describe ongoing experiences with such

  16. Shading-based Surface Detail Recovery under General Unknown Illumination.

    PubMed

    Xu, Di; Duan, Qi; Zheng, Jianmin; Zhang, Juyong; Cai, Jianfei; Cham, Tat-Jen

    2017-02-17

    Reconstructing the shape of a 3D object from multi-view images under unknown, general illumination is a fundamental problem in computer vision and high quality reconstruction is usually challenging especially when fine detail is needed and the albedo of the object is non-uniform. This paper introduces vertex overall illumination vectors to model the illumination effect and presents a total variation (TV) based approach for recovering surface details using shading and multi-view stereo (MVS). Behind the approach are the two important observations: (1) the illumination over the surface of an object often appears to be piece wise smooth and (2) the recovery of surface orientation is not sufficient for reconstructing the surface, which was often overlooked previously. Thus we propose to use TV to regularize the overall illumination vectors and use visual hull to constrain partial vertices. The reconstruction is formulated as a constrained TV-minimization problem that simultaneously treats the shape and illumination vectors as unknowns. An augmented Lagrangian method is proposed to quickly solve the TV-minimization problem. As a result, our approach is robust, stable and is able to efficiently recover high quality of surface details even when starting with a coarse model obtained using MVS. These advantages are demonstrated by extensive experiments on the state-of-the-art MVS database, which includes challenging objects with varying albedo.

  17. Multigrain indexing of unknown multiphase materials

    PubMed Central

    Wejdemann, Christian; Poulsen, Henning Friis

    2016-01-01

    A multigrain indexing algorithm for use with samples comprising an arbitrary number of known or unknown phases is presented. No a priori crystallographic knowledge is required. The algorithm applies to data acquired with a monochromatic beam and a conventional two-dimensional detector for diffraction. Initially, candidate grains are found by searching for crystallographic planes, using a Dirac comb convoluted with a box function as a filter. Next, candidate grains are validated and the unit cell is optimized. The algorithm is validated by simulations. Simulations of 500 cementite grains and ∼100 reflections per grain resulted in 99.2% of all grains being indexed correctly and 99.5% of the reflections becoming associated with the right grain. Simulations with 200 grains associated with four mineral phases and 50–700 reflections per grain resulted in 99.9% of all grains being indexed correctly and 99.9% of the reflections becoming associated with the right grain. The main limitation is in terms of overlap of diffraction spots and computing time. Potential areas of use include three-dimensional grain mapping, structural solution and refinement studies of complex samples, and studies of dilute phases. PMID:27047308

  18. Graves' disease presenting as pyrexia of unknown origin.

    PubMed Central

    Shaked, Y.; Samra, Y.; Zwas, S. T.

    1988-01-01

    Fever is a common clinical manifestation of inflammatory processes of the thyroid and thyroid crisis. On the other hand, fever alone as a presenting symptom of thyrotoxicosis, without other manifestations, is extremely rare. A female patient is described in whom fever persisted for two months prior to hospitalization, but without clinical symptoms or signs to lead to suspicion of thyroid disease. After exhaustive investigation it was found that the patient was suffering from hyperthyroidism. Fever disappeared gradually on antithyroid therapy, recurred when the drugs were withdrawn for a rechallenge trial, and cleared up again after renewal. Four other cases of persistent fever as a presenting symptom of hyperthyroidism were found on a review of previous publications. Thyrotoxicosis should, therefore, be included in the differential diagnosis of pyrexia of unknown origin. Images Figure 1 PMID:3050943

  19. [Structural analyses of unknown red dyes detected in dried strawberry].

    PubMed

    Shindo, Tetsuya; Sadamasu, Yuki; Suzuki, Keiko; Tanaka, Yasukazu; Togawa, Akiko; Nakajima, Junichi; Nakazato, Mitsuo; Uematsu, Yoko

    2012-01-01

    We examined two unknown red dyes (designated as red dyes "A" and "B") from a dried strawberry package with a label that indicated the presence of food red No. 40 (R40). Red dye "A" was identified as trisodium 3-hydroxy-4-[(2'-methoxy-5'-methyl-4'-sulfonatophenyl)azo]-2,7-naphthalenedisulfonate (CSA-R) by HPLC, UV-VIS spectra and MS spectra. This compound is one of the four reported subsidiary colors of R40. Detailed analyses of red dye "B" by MS and NMR demonstrated that its structure was disodium 3-hydroxy-4-[(2'-methoxy-5'-methyl-4'-sulfonatophenyl)azo]-2-naphthalenesulfonate. Red dye "B" is a structural isomer of R40, that has not been reported previously. Our results suggest that the two minor red dyes were subsidiary colors contained in R40, which had been added to the dried strawberries.

  20. Phase shift estimation in interferograms with unknown phase step

    NASA Astrophysics Data System (ADS)

    Dalmau, Oscar; Rivera, Mariano; Gonzalez, Adonai

    2016-08-01

    We first present two closed formulas for computing the phase shift in interferograms with unknown phase step. These formulas obtain theoretically the exact phase step in fringe pattern without noise and only require the information in two pixels of the image. The previous formulas allows us to define a functional that yields an estimate of the phase step in interferograms corrupted by noise. In the experiment we use the standard Least Square formulation which also yields a closed formula, although the general formulation admits a robust potential. We provide two possible implementations of our approach, one in which the sites can be randomly selected and the other in which we can scan the whole image. The experiments show that the proposed algorithm presents the best results compared with state of the art algorithms.

  1. Perianal Crohn’s Disease is associated with distal colonic disease, stricturing disease behavior, IBD-associated serologies and genetic variation in the JAK-STAT pathway

    PubMed Central

    Kaur, Manreet; Panikkath, Deepa; Yan, Xiaofei; Liu, Zhenqiu; Berel, Dror; Li, Dalin; Vasiliauskas, Eric A.; Ippoliti, Andrew; Dubinsky, Marla; Shih, David Q.; Melmed, Gil Y.; Haritunians, Talin; Fleshner, Phillip; Targan, Stephan R.; McGovern, Dermot P.B.

    2016-01-01

    BACKGROUND Perianal Crohn’s Disease (pCD) is a particularly severe phenotype associated with poor quality of life with a reported prevalence of 12%–40%. Previous studies investigating the etiology of pCD have been limited in the numbers of subjects and the intensity of genotyping. The aim of this study was to identify clinical, serological and genetic factors associated with pCD. METHODS We performed a case-control study comparing patients with (pCD+) and without perianal (pCD−) involvement in CD; defined as the presence of perianal abscesses or fistulae. Data on demographics and clinical features were obtained by chart review. IBD related serology were determined by ELISA. Genetic data were generated using Illumina genotyping platforms RESULTS We included 1721 patients with CD of which 524 (30.4%) were pCD+ and 1197 were pPCD−. Perianal CD was associated with distal colonic disease (OR 5.54 [3.23–9.52], p < 0.001), stricturing disease behavior (1.44 [1.14–1.81], p= 0.002) and family history of inflammatory bowel disease (4.98 [3.30–7.46], p < 0.001). Perianal CD was associated with higher ASCA IgA (p <0.001) and OmpC (p= 0.008) antibody levels. Perianal CD was associated with known IBD loci including KIF3B; CRTC3; TRAF3IP2; JAZF1; NRIP1; MST1; FUT2; and PTGER (all p<0.05). We also identified genetic association with genes involved in autophagy (DAPK1, p=5.11×10−5); TNF alpha pathways (NUCB2, p=8.68×10−5; DAPK1); IFNg pathways (DAPK1; NDFIP2, p=8.74×10−5) and extracellular matrix and scaffolding proteins (USH1C, p=8.68×10−5; NDFIP2; TMC07, p=8.87×10−5). Pathway analyses implicated the JAK/Stat pathway (pc = 3.72 × 10−5). CONCLUSION We have identified associations between perianal Crohn’s disease, more distal colonic inflammation, Crohn’s disease-associated serologies, and genetic variation in the JAK/Stat pathway PMID:26937622

  2. Glory on Venus cloud tops and the unknown UV absorber

    NASA Astrophysics Data System (ADS)

    Markiewicz, W. J.; Petrova, E.; Shalygina, O.; Almeida, M.; Titov, D. V.; Limaye, S. S.; Ignatiev, N.; Roatsch, T.; Matz, K. D.

    2014-05-01

    We report on the implications of the observations of the glory phenomenon made recently by Venus Express orbiter. Glory is an optical phenomenon that poses stringent constraints on the cloud properties. These observations thus enable us to constrain two properties of the particles at the cloud tops (about 70 km altitude) which are responsible for a large fraction of the solar energy absorbed by Venus. Firstly we obtain a very accurate estimate of the cloud particles size to be 1.2 μm with a very narrow size distribution. We also find that for the two observations presented here the clouds are homogenous, as far as cloud particles sizes are concerned, on scale of at least 1200 km. This is in contrast to previous estimates that were either local, from entry probes data, or averaged over space and time from polarization data. Secondly we find that the refractive index for the data discussed here is higher than that of sulfuric acid previously proposed for the clouds composition (Hansen, J.E., Hovenier, J.W. [1974]. J. Atmos. Sci. 31, 1137-1160; Ragent, B. et al. [1985]. Adv. Space Res. 5, 85-115). Assuming that the species contributing to the increase of the refractive index is the same as the unknown UV absorber, we are able to constrain the list of candidates. We investigated several possibilities and argue that either small ferric chloride (FeCl3) cores inside sulfuric acid particles or elemental sulfur coating their surface are good explanations of the observation. Both ferric chloride and elemental sulfur have been suggested in the past as candidates for the as yet unknown UV absorber (Krasnopolsky, V.A. [2006]. Planet. Space Sci. 54, 1352-1359; Mills, F.P. et al. [2007]. In: Esposito, L.W., Stofan, E.R., Cravens, T.E. (Eds.), Exploring Venus as a Terrestrial Planet, vol. 176. AGU Monogr. Ser., Washington, DC, pp. 73-100).

  3. Fracture pain-Traveling unknown pathways.

    PubMed

    Alves, Cecília J; Neto, Estrela; Sousa, Daniela M; Leitão, Luís; Vasconcelos, Daniel M; Ribeiro-Silva, Manuel; Alencastre, Inês S; Lamghari, Meriem

    2016-04-01

    An increase of fracture incidence is expected for the next decades, mostly due to the undeniable increase of osteoporotic fractures, associated with the rapid population ageing. The rise in sports-related fractures affecting the young and active population also contributes to this increased fracture incidence, and further amplifies the economical burden of fractures. Fracture often results in severe pain, which is a primary symptom to be treated, not only to guarantee individual's wellbeing, but also because an efficient management of fracture pain is mandatory to ensure proper bone healing. Here, we review the available data on bone innervation and its response to fracture, and discuss putative mechanisms of fracture pain signaling. In addition, the common therapeutic approaches to treat fracture pain are discussed. Although there is still much to learn, research in fracture pain has allowed an initial insight into the mechanisms involved. During the inflammatory response to fracture, several mediators are released and will putatively activate and sensitize primary sensory neurons, in parallel, intense nerve sprouting that occurs in the fracture callus area is also suggested to be involved in pain signaling. The establishment of hyperalgesia and allodynia after fracture indicates the development of peripheral and central sensitization, still, the underlying mechanisms are largely unknown. A major concern during the treatment of fracture pain needs to be the preservation of proper bone healing. However, the most common therapeutic agents, NSAIDS and opiates, can cause significant side effects that include fracture repair impairment. The understanding of the mechanisms of fracture pain signaling will allow the development of mechanisms-based therapies to effectively and safely manage fracture pain.

  4. Newly Designed Y-configured Single-Catheter Stenting for the Treatment of Hilar-Type Nonanastomotic Biliary Strictures After Orthotopic Liver Transplantation

    SciTech Connect

    Wang Changming; Li Xuan; Song Shibing; Lv Xianjun; Luan Jingyuan; Dong Guoxiang

    2012-02-15

    Purpose: This study was designed to introduce our novel technique of percutaneous single catheter placement into the hilar bile ducts strictures while fulfilling the purpose of bilateral biliary drainage and stenting. We investigated the efficacy and safety of the technique for the treatment of hilar nonanastomotic biliary strictures. Methods: Ten patients who were post-orthotopic liver transplantation between July 2000 and July 2010 were enrolled in this study. Percutaneous Y-configured single-catheter stenting for bilateral bile ducts combined with balloon dilation was designed as the main treatment approach. Technical success rate, clinical indicators, complications, and recurrent rate were analyzed. Results: Technical success rate was 100%. Nine of the ten patients had biochemical normalization, cholangiographic improvement, and clinical symptoms relief. None of them experienced recurrence in a median follow-up of 26 months after completion of therapy and removal of all catheters. Complications were minor and limited to two patients. The one treatment failure underwent a second liver transplantation but died of multiple system organ failure. Conclusions: Percutaneous transhepatic Y-configured single-catheter stenting into the hilar bile ducts is technically feasible. The preliminary trial of this technique combined with traditional PTCD or choledochoscopy for the treatment of hilar biliary strictures after orthotopic liver transplantation appeared to be effective and safe. Yet, further investigation is needed.

  5. Transplantation of epidermal cell sheets by endoscopic balloon dilatation to avoid esophageal re-strictures: initial experience in a porcine model

    PubMed Central

    Kobayashi, Shinichiro; Kanai, Nobuo; Tanaka, Nobuyuki; Maeda, Masanori; Hosoi, Takahiro; Fukai, Fumio; Eguchi, Susumu; Yamato, Masayuki

    2016-01-01

    Background and study aims: Epidermal cell sheet (ECS) transplantation immediately after aggressive endoscopic submucosal dissection (ESD) has been shown to be safe and effective in the prevention of esophageal strictures. This study evaluated the feasibility of ECS transplantation after endoscopic balloon dilation (EBD) in a porcine model. Methods: Six pigs underwent circumferential esophageal ESD under general anesthesia. Two weeks later, two pigs underwent EBD and transplantation of an autologous ECS, two underwent EBD alone, and two underwent endoscopic observation only (control). Results: The two pigs in the transplantation group underwent six ECS transplants after EBD with five of the six (83 %) being successful, as shown by engraftment of transplanted ECSs after 7 days. No adverse events were observed. Stricture rates were lower in the two transplanted pigs (55 % and 60 %) than in the control (92.2 % and 87.7 %) and EBD-treated (71.7 % and 78.2 %) pigs. Infiltration of inflammatory cells was significantly lower in the transplanted pigs than in the control and EBD-treated pigs. Conclusion: Preliminary results indicate the stability of the ECS transplantation procedure and the engraftment of transplanted ECS in the tears after EBD. This proof-of-concept study suggests that covering tears with ECSs after EBD may avoid re-strictures. PMID:27853736

  6. Esophageal stricture secondary to drug-induced toxic epidermal necrolysis presenting in an adult: an unusual complication of a rare disease.

    PubMed

    Njei, Basile; Schoenfeld, Adam; Vaziri, Haleh

    2013-10-01

    Toxic epidermal necrolysis (TEN) is an idiosyncratic, potentially life-threatening skin disease characterized by widespread inflammation and necrosis of the epidermis and mucous membranes. It may result in narrowing of the esophageal lumen through fibrosis and esophageal stricture in rare situations, mostly encountered in children. To the best of our knowledge, we report the first case of esophageal stricture secondary to allopurinol-induced TEN in an adult patient. A 70-year-old male presented to our clinic with severe dysphagia secondary to allopurinol-induced TEN involving his mouth and esophagus. At the time of presentation the patient had a percutaneous endoscopic gastrostomy feeding tube and was unable to handle his oral secretions. Endoscopy revealed near complete proximal esophageal stricture. A bidirectional esophageal dilatation procedure via the mouth and percutaneous endoscopic gastrostomy site was successfully performed over a guidewire for treatment of this patient. The patient tolerated the procedure well. Esophagogastroduodenoscopy with dilation was performed in a regular anterograde fashion five times over the next three months. Triamcinolone acetonide was injected using Carr-Locke injection needle from ultrasound endoscopy during the last three sessions. He currently tolerates a regular diet without difficulty.

  7. Statistical methods for clinical verification of dose response parameters related to esophageal stricture and AVM obliteration from radiotherapy

    NASA Astrophysics Data System (ADS)

    Mavroidis, Panayiotis; Lind, Bengt K.; Theodorou, Kyriaki; Laurell, Göran; Fernberg, Jan-Olof; Lefkopoulos, Dimitrios; Kappas, Constantin; Brahme, Anders

    2004-08-01

    The purpose of this work is to provide some statistical methods for evaluating the predictive strength of radiobiological models and the validity of dose-response parameters for tumour control and normal tissue complications. This is accomplished by associating the expected complication rates, which are calculated using different models, with the clinical follow-up records. These methods are applied to 77 patients who received radiation treatment for head and neck cancer and 85 patients who were treated for arteriovenous malformation (AVM). The three-dimensional dose distribution delivered to esophagus and AVM nidus and the clinical follow-up results were available for each patient. Dose-response parameters derived by a maximum likelihood fitting were used as a reference to evaluate their compatibility with the examined treatment methodologies. The impact of the parameter uncertainties on the dose-response curves is demonstrated. The clinical utilization of the radiobiological parameters is illustrated. The radiobiological models (relative seriality and linear Poisson) and the reference parameters are validated to prove their suitability in reproducing the treatment outcome pattern of the patient material studied (through the probability of finding a worse fit, area under the ROC curve and khgr2 test). The analysis was carried out for the upper 5 cm of the esophagus (proximal esophagus) where all the strictures are formed, and the total volume of AVM. The estimated confidence intervals of the dose-response curves appear to have a significant supporting role on their clinical implementation and use.

  8. mRNA expression of CDH3, IGF2BP3, and BIRC5 in biliary brush cytology specimens is a useful adjunctive tool of cytology for the diagnosis of malignant biliary stricture

    PubMed Central

    Kim, Tae Ho; Chang, Jae Hyuck; Lee, Hee Jin; Kim, Jean A; Lim, Yeon Soo; Kim, Chang Whan; Han, Sok Won

    2016-01-01

    Abstract Although advances have been made in diagnostic tools, the distinction between malignant and benign biliary strictures still remains challenging. Intraductal brush cytology is a convenient and safe method that is used for the diagnosis of biliary stricture, but, low sensitivity limits its usefulness. This study aimed to demonstrate the usefulness of mRNA expression levels of target genes in brush cytology specimens combined with cytology for the diagnosis of malignant biliary stricture. Immunohistochemistry for cadherin 3 (CDH3), p53, insulin-like growth factor II mRNA-binding protein 3 (IGF2BP3), homeobox B7 (HOXB7), and baculoviral inhibitor of apoptosis repeat containing 5 (BIRC5) was performed in 4 benign and 4 malignant bile duct tissues. Through endoscopic or interventional radiologic procedures, brush cytology specimens were prospectively obtained in 21 and 35 paitents with biliary strictures. In the brush cytology specimens, the mRNA expressions levels of 5 genes were determined by real-time polymerase chain reaction. Immunohistochemistry for CDH3, p53, IGF2BP3, HOXB7, and BIRC5 all showed positive staining in malignant tissues in contrast to benign tissues, which were negative. In the brush cytology specimens, the mRNA expression levels of CDH3, IGF2BP3, HOXB7, and BIRC5 were significantly higher in cases of malignant biliary stricture compared with cases of benign stricture (P = 0.006, P < 0.001, P < 0.001, and P = 0.001). The receiver-operating characteristic curves of these 4 mRNAs demonstrated that mRNA expression levels are useful for the prediction of malignant biliary stricture (P = 0.006, P < 0.001, P < 0.001, and P = 0.002). The sensitivity and specificity, respectively, for malignant biliary stricture were 57.1% and 100% for cytology, 57.1% and 64.3% for CDH3, 76.2% and 100% for IGF2BP3, 71.4% and 57.1% for HOXB7, and 76.2% and 64.3% for BIRC5. When cytology was combined with the mRNA levels of CDH3, IGF2BP3, or BIRC5, the

  9. 68. Water Delivery Pipes for Menzie Cone, date unknown Historic ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    68. Water Delivery Pipes for Menzie Cone, date unknown Historic Photograph, Photographer Unknown; Collection of William Everett, Jr. (Wilkes-Barre, PA), photocopy by Joseph E.B. Elliot - Huber Coal Breaker, 101 South Main Street, Ashley, Luzerne County, PA

  10. 1. Historic American Buildings Survey Photographer Unknown. Furnished by Mrs ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Historic American Buildings Survey Photographer Unknown. Furnished by Mrs Mecia, Tombstone, Arizona. Date Unknown GENERAL VIEW MAIN CHURCH (SOUTHEAST ELEVATION). - San Xavier del Bac Mission, Mission Road, Tucson, Pima County, AZ

  11. 51. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    51. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print Co., Los Angeles, CA, Photographer, Date unknown EXTERIOR, ELEVATION DETAILS - Richfield Oil Building, 555 South Flower Street, Los Angeles, Los Angeles County, CA

  12. 53. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    53. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print Co., Los Angeles, CA, Photographer, Date unknown DETAILS OF CORRIDORS ON SECOND - TWELFTH FLOORS - Richfield Oil Building, 555 South Flower Street, Los Angeles, Los Angeles County, CA

  13. 44. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    44. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print Co., Los Angeles, CA, Photographer, Date unknown FIRST FLOOR PLAN - Richfield Oil Building, 555 South Flower Street, Los Angeles, Los Angeles County, CA

  14. 47. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    47. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print Co., Los Angleles, CA, Photographer, Date unknown WEST ELEVATION - Richfield Oil Building, 555 South Flower Street, Los Angeles, Los Angeles County, CA

  15. 45. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    45. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print Co., Los Angeles, CA, Photographer, Date unknown SECOND FLOOR PLAN - Richfield Oil Building, 555 South Flower Street, Los Angeles, Los Angeles County, CA

  16. 50. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    50. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print Co., Los Angleles, CA, Photographer, Date unknown ENTRANCE AND TYPICAL BAY ON FLOWER STREET - Richfield Oil Building, 555 South Flower Street, Los Angeles, Los Angeles County, CA

  17. 49. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    49. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print Co., Los Angeles, CA, Photographer, Date unknown SECTION THROUGH BUILDING, LOOKING EAST - Richfield Oil Building, 555 South Flower Street, Los Angeles, Los Angeles County, CA

  18. 48. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    48. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print Co., Los Angeles, CA., Photographer, Date unknown SECTION THROUGH BUILDING, LOOKING NORTH - Richfield Oil Building, 555 South Flower Street, Los Angeles, Los Angeles County, CA

  19. 46. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    46. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print Co., Los Angeles, CA, Photographer, Date unknown NORTH ELEVATION - Richfield Oil Building, 555 South Flower Street, Los Angeles, Los Angeles County, CA

  20. 52. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    52. Photocopy of drawing (Source unknown, 1928) Rapid Blue Print Co., Los Angeles, CA, Photographer, Date unknown DETAILS OF MAIN FLOOR ELEVATOR LOBBY - Richfield Oil Building, 555 South Flower Street, Los Angeles, Los Angeles County, CA

  1. 14. Photo copy of photograph (location of original print unknown) ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. Photo copy of photograph (location of original print unknown) c.1932, photographer unknown Historic view of bridge - Bridge at Mouth of Rogue River, Spanning Rogue River on Oregon Coast Highway, Gold Beach, Curry County, OR

  2. Prevalence of unknown thyroid disorders in a Sardinian cohort

    PubMed Central

    Delitala, Alessandro P.; Pilia, Maria Grazia; Ferreli, Liana; Loi, Francesco; Curreli, Nicolò; Balaci, Lenuta; Schlessinger, David; Cucca, Francesco

    2015-01-01

    Objective To assess thyroid function, the presence of thyroid antibodies, as well as the presence of goiter and/or nodules in subjects without a prior diagnosis of thyroid disorders, in a region with mild to moderate iodine deficiency. Design and methods This cross-sectional study is based on data coming from first and third visits of participants in the SardiNIA survey. We performed two different analyses. In one we assessed the prevalence of unknown thyroid dysfunctions among 6,252 subjects who had a medical examination and blood collection for assays of thyrotropin, free thyroxine, and antibodies against thyroperoxidase (AbTPO) and against thyroglobulin (AbTG). In a second analysis, we evaluated the frequency of undiagnosed goiter and nodules among 3,377 subjects who had a thyroid ultrasound scan. Subjects were excluded if they had a previous history of thyroid disorders or presence of goiter and/or nodules, or thyroid surgery, or if they were taking drugs that could impair thyroid function. Results We found a low prevalence of overt thyroid dysfunction (hyperthyroidism 0.4%, hypothyroidism 0.7%). The rates of subclinical hypothyroidism and hyperthyroidism were 4.7% and 2.4%, respectively. Almost 16% of individuals were positive for at least one antibody, and 5.2% for both AbTG and AbTPO. Nodules were detected in 17.4% of the subjects, and the prevalence of goiter was 22.1%. Conclusions Undiagnosed biochemical thyroid dysfunctions, unknown nodules and goiter were common in subjects living in a mild to moderate iodine deficient area. In this community, thyroid disorders often go undetected and screening could be reasonable in subjects at higher risk. PMID:24917664

  3. PHYLOGENOMICS - GUIDED VALIDATION OF FUNCTION FOR CONSERVED UNKNOWN GENES

    SciTech Connect

    V, DE CRECY-LAGARD; D, HANSON A

    2012-01-03

    Identifying functions for all gene products in all sequenced organisms is a central challenge of the post-genomic era. However, at least 30-50% of the proteins encoded by any given genome are of unknown function, or wrongly or vaguely annotated. Many of these 'unknown' proteins are common to prokaryotes and plants. We accordingly set out to predict and experimentally test the functions of such proteins. Our approach to functional prediction is integrative, coupling the extensive post-genomic resources available for plants with comparative genomics based on hundreds of microbial genomes, and functional genomic datasets from model microorganisms. The early phase is computer-assisted; later phases incorporate intellectual input from expert plant and microbial biochemists. The approach thus bridges the gap between automated homology-based annotations and the classical gene discovery efforts of experimentalists, and is much more powerful than purely computational approaches to identifying gene-function associations. Among Arabidopsis genes, we focused on those (2,325 in total) that (i) are unique or belong to families with no more than three members, (ii) are conserved between plants and prokaryotes, and (iii) have unknown or poorly known functions. Computer-assisted selection of promising targets for deeper analysis was based on homology .. independent characteristics associated in the SEED database with the prokaryotic members of each family, specifically gene clustering and phyletic spread, as well as availability of functional genomics data, and publications that could link candidate families to general metabolic areas, or to specific functions. In-depth comparative genomic analysis was then performed for about 500 top candidate families, which connected ~55 of them to general areas of metabolism and led to specific functional predictions for a subset of ~25 more. Twenty predicted functions were experimentally tested in at least one prokaryotic organism via reverse

  4. Bacterial Motility Reveals Unknown Molecular Organization.

    PubMed

    Duchesne, Ismaël; Rainville, Simon; Galstian, Tigran

    2015-11-17

    The water solubility of lyotropic liquid crystals (LCs) makes them very attractive to study the behavior of biological microorganisms in an environment where local symmetry is broken (as often encountered in nature). Several recent studies have shown a dramatic change in the behavior of flagellated bacteria when swimming in solutions of the lyotropic LC disodium cromoglycate (DSCG). In this study, the movements of Escherichia coli bacteria in DSCG-water solutions of different concentrations are observed to improve our understanding of this phenomenon. In addition, the viscosity of DSCG aqueous solutions is measured as a function of concentration at room temperature. We also experimentally identify a previously undescribed isotropic pretransition zone where bacteria start sticking to each other and to surfaces. Simple estimations show that the unbalanced osmotic pressure induced depletion force might be responsible for this sticking phenomenon. An estimate of the bacteria propulsive force and the DSCG aggregates length (versus concentration) are calculated from the measured viscosity of the medium. All these quantities are found to undergo a strong increase in the pretransition zone, starting at a threshold concentration of 6±1 wt % DSCG that is well below the known isotropic-LC transition (∼10 wt %). This study also shines light on the motility of flagellated bacteria in realistic environments, and it opens new avenues for interesting applications such as the use of motile microorganisms to probe the physical properties of their host or smart bandages that could guide bacteria out of wounds.

  5. Bacterial Motility Reveals Unknown Molecular Organization

    PubMed Central

    Duchesne, Ismaël; Rainville, Simon; Galstian, Tigran

    2015-01-01

    The water solubility of lyotropic liquid crystals (LCs) makes them very attractive to study the behavior of biological microorganisms in an environment where local symmetry is broken (as often encountered in nature). Several recent studies have shown a dramatic change in the behavior of flagellated bacteria when swimming in solutions of the lyotropic LC disodium cromoglycate (DSCG). In this study, the movements of Escherichia coli bacteria in DSCG-water solutions of different concentrations are observed to improve our understanding of this phenomenon. In addition, the viscosity of DSCG aqueous solutions is measured as a function of concentration at room temperature. We also experimentally identify a previously undescribed isotropic pretransition zone where bacteria start sticking to each other and to surfaces. Simple estimations show that the unbalanced osmotic pressure induced depletion force might be responsible for this sticking phenomenon. An estimate of the bacteria propulsive force and the DSCG aggregates length (versus concentration) are calculated from the measured viscosity of the medium. All these quantities are found to undergo a strong increase in the pretransition zone, starting at a threshold concentration of 6 ± 1 wt % DSCG that is well below the known isotropic-LC transition (∼10 wt %). This study also shines light on the motility of flagellated bacteria in realistic environments, and it opens new avenues for interesting applications such as the use of motile microorganisms to probe the physical properties of their host or smart bandages that could guide bacteria out of wounds. PMID:26588572

  6. Completed Suicides and their Previous Attempts

    ERIC Educational Resources Information Center

    Lester, David; Beck, Aaron T.

    1976-01-01

    Investigates the reliability of the findings of Ovenstone and Krietman (some completed suicides have attempted suicide previously, whereas other completed suicides have no such history) with a sample of completed suicides in the United States. (Author/RK)

  7. [Unknown pathogens from the human oral microflora of interest for otorhinolaryngology].

    PubMed

    Tets, V V; Tets, G V; Vikina, D S; Vecherovskaia, M F; Kharlamova, V V

    2014-01-01

    The identification of microorganisms from the human oral cavity is a topical problem in many clinical disciplines including otorhinolaryngology. Many bacterial species of oral microbiota are causative agents of ENT diseases, and poor conditions of the oral cavity, unhealthy teeth and gums increase the risk of the spread of infection. The objective of the present study was to distinguish and identify poorly explored and previously unknown aerobic opportunistic pathogenic microorganisms responsible for various ENT disorders. The normal microflora remains to be thoroughly studied with the use of the new culturing techniques that ensure the isolation of pure microbial cultures. The present publication reports for the first time isolation of the stable mixed microbial biofilms formed by unrelated bacterial species and containing the yet unknown microorganisms. The isolated bacteria were identified as previously unknown or poorly unexplored anaerobic opportunistic species capable of inducing ENT pathology; their sensitivity to antibiotics was evaluated.

  8. Influence of a previous neck sprain on recovery after whiplash injury.

    PubMed

    Nee, Patrick A

    2008-12-01

    The impact of a previous neck sprain on recovery from whiplash injury is unknown as published studies have produced conflicting results. This article reviews the literature on the prognosis of a second whiplash injury, distinguishing between previous injuries with and without complete recovery. The best available evidence suggests that a previous injury with incomplete recovery represents an adverse prognostic indicator. However, where there has been complete recovery, the prior injury does not influence the prognosis.

  9. Control design for the SISO system with the unknown order and the unknown relative degree.

    PubMed

    Zhao, Chunzhe; Li, Donghai

    2014-07-01

    For the uncertain system whose order, relative degree and parameters are unknown in the control design, new research is still in need on the parameter tuning and close-loop stability. During the last 10 years, much progress is made in the application and theory research of the active disturbance rejection control (ADRC) for the uncertain system. In this study, the necessary and sufficient conditions are established for building the ADRC for the minimum-phase system and the open-loop stable system when the plant parameters, orders and relative degrees are unknown, the corresponding ideal dynamics are analyzed, and the theoretical results are verified by the simulations. Considering the wide application and the long history of the PID/PI controller, a method is given to design ADRC quickly based on the existing (generalized or conventional) PID/PI controller. A plenty of simulations are made to illustrate this PID/PI-based design method and the corresponding close-loop performances. The simulation examples include the minimum/nonminimum-phase plants, the stable/integrating plants, the high/low-order plant, and the plants with time delays. Such plants are from a wider scope than the theoretical result, and representative of many kinds of the industrial processes. That leads to a new way to simplify the ADRC design via absorbing the engineering experience in designing the PID/PI controller.

  10. Fatal Metacestode Infection in Bornean Orangutan Caused by Unknown Versteria Species

    PubMed Central

    Gendron-Fitzpatrick, Annette; Deering, Kathleen M.; Wallace, Roberta S.; Clyde, Victoria L.; Lauck, Michael; Rosen, Gail E.; Bennett, Andrew J.; Greiner, Ellis C.; O’Connor, David H.

    2014-01-01

    A captive juvenile Bornean orangutan (Pongo pygmaeus) died from an unknown disseminated parasitic infection. Deep sequencing of DNA from infected tissues, followed by gene-specific PCR and sequencing, revealed a divergent species within the newly proposed genus Versteria (Cestoda: Taeniidae). Versteria may represent a previously unrecognized risk to primate health. PMID:24377497

  11. Fatal metacestode infection in Bornean orangutan caused by unknown Versteria species.

    PubMed

    Goldberg, Tony L; Gendron-Fitzpatrick, Annette; Deering, Kathleen M; Wallace, Roberta S; Clyde, Victoria L; Lauck, Michael; Rosen, Gail E; Bennett, Andrew J; Greiner, Ellis C; O'Connor, David H

    2014-01-01

    A captive juvenile Bornean orangutan (Pongo pygmaeus) died from an unknown disseminated parasitic infection. Deep sequencing of DNA from infected tissues, followed by gene-specific PCR and sequencing, revealed a divergent species within the newly proposed genus Versteria (Cestoda: Taeniidae). Versteria may represent a previously unrecognized risk to primate health.

  12. Comparing the Effects of Unknown-Known Ratios on Word Reading Learning versus Learning Rates

    ERIC Educational Resources Information Center

    Joseph, Laurice M.; Nist, Lindsay M.

    2006-01-01

    An extension of G. L. Cates et al. (2003) investigation was conducted to determine if students' cumulative learning rates would be superior for words read under a traditional drill and practice condition (as they were for spelling in the previous study) than under interspersal conditions of varying ratios of unknown to known words. Participants…

  13. Concomitant and previous osteoporotic vertebral fractures

    PubMed Central

    Lenski, Markus; Büser, Natalie; Scherer, Michael

    2017-01-01

    Background and purpose Patients with osteoporosis who present with an acute onset of back pain often have multiple fractures on plain radiographs. Differentiation of an acute osteoporotic vertebral fracture (AOVF) from previous fractures is difficult. The aim of this study was to investigate the incidence of concomitant AOVFs and previous OVFs in patients with symptomatic AOVFs, and to identify risk factors for concomitant AOVFs. Patients and methods This was a prospective epidemiological study based on the Registry of Pathological Osteoporotic Vertebral Fractures (REPAPORA) with 1,005 patients and 2,874 osteoporotic vertebral fractures, which has been running since February 1, 2006. Concomitant fractures are defined as at least 2 acute short-tau inversion recovery (STIR-) positive vertebral fractures that happen concomitantly. A previous fracture is a STIR-negative fracture at the time of initial diagnostics. Logistic regression was used to examine the influence of various variables on the incidence of concomitant fractures. Results More than 99% of osteoporotic vertebral fractures occurred in the thoracic and lumbar spine. The incidence of concomitant fractures at the time of first patient contact was 26% and that of previous fractures was 60%. The odds ratio (OR) for concomitant fractures decreased with a higher number of previous fractures (OR =0.86; p = 0.03) and higher dual-energy X-ray absorptiometry T-score (OR =0.72; p = 0.003). Interpretation Concomitant and previous osteoporotic vertebral fractures are common. Risk factors for concomitant fractures are a low T-score and a low number of previous vertebral fractures in cases of osteoporotic vertebral fracture. An MRI scan of the the complete thoracic and lumbar spine with STIR sequence reduces the risk of under-diagnosis and under-treatment. PMID:28056595

  14. Laboratory Grouping Based on Previous Courses.

    ERIC Educational Resources Information Center

    Doemling, Donald B.; Bowman, Douglas C.

    1981-01-01

    In a five-year study, second-year human physiology students were grouped for laboratory according to previous physiology and laboratory experience. No significant differences in course or board examination performance were found, though correlations were found between predental grade-point averages and grouping. (MSE)

  15. [Diagnosis of fever of unknown origin: use of Bayes theorem].

    PubMed

    Campanella, N; Pergolini, M; Daher, W; Moraca, A; Borgognoni, C; Morosini, P

    1999-01-01

    Sophisticated tests and time are needed to establish the diagnosis of fever of unknown origin (FUO). Bayes theorem can guide the clinician to early probabilistic diagnosis. The authors had estimated the a priori probabilities in a previous study yet. In this paper the diagnostic probabilities of four clinical signs (arthralgias, myalgias, splenomegaly, multiple micro-lymphoadenopathies) and the probabilities of abnormalities of some routine laboratory tests (neutrophils count, lymphocytes count, platelets count, hemoglobin, lactic-dehydrogenase, C3 and C4 complement subunits and fibrinogen plasma concentrations, erythrocyte sedimentation rate) and of the positive bacterial cultures, were estimated in the main groups of FUO disease (indefinite, aspecific bacteria infections, non-bacterial or specific bacteria infections, neoplasias, connective tissue diseases, miscellaneous group). The data suggest that the a priori probability is not affected by the clinical signs. Arthralgias increase the probability of connective tissue diseases. Normal erythrocyte sedimentation rate and plasma fibrinogen concentrations increase the probability of paraneoplastic and indefinite fever. Thrombocytosis increases the probability of paraneoplastic fever. Over 1200 U/l serum lactic-dehydrogenase serum concentrations guide to non-bacterial or specific bacteria infectious diseases and to malignancies. Neutrophilia decreases the probability of indefinite diagnosis, even though it is not specific. The heterogeneity of the miscellaneous group makes the interpretations of the data very hard.

  16. N-acetylcysteine for the prevention of stricture after circumferential endoscopic submucosal dissection of the esophagus: a randomized trial in a porcine model

    PubMed Central

    2012-01-01

    Background Circumferential endoscopic submucosal dissection (CESD) of the esophagus would allow for both the eradication of Barrett’s esophagus and its related complications, such as advanced neoplasia. However, such procedures generally induce inflammatory repair resulting in a fibrotic stricture. N-acetylcysteine (NAC) is an antioxidant that has shown some efficacy against pulmonary and hepatic fibrosis. The aim of our study was to evaluate the benefit of NAC in the prevention of esophageal cicatricial stricture after CESD in a swine model. Animals and methods Two groups of six pigs each were subjected to general anesthesia and CESD: after randomization, a first group received an oral NAC treatment regimen of 100 mg/kg/day, initiated one week before the procedure, whereas a second group was followed without any prophylactic treatment. Follow-up endoscopies took place seven, fourteen, twenty-one, and twenty-eight days after CESD. Necropsy, histological assessment of esophageal inflammation, and fibrosis were performed on day 28. Results The median esophageal lumen diameter on day 21 (main judgment criterion) was 4 mm (range 2 to 5) in group 1 and 3 mm (range 1 to 7) in group 2 (P = 0.95). No significant difference was observed between the two groups regarding clinical evaluation (time before onset of clinically significant esophageal obstruction), number of dilations, esophageal inflammation and fibrosis, or oxidative stress damage on immunohistochemistry. Conclusions Despite its antioxidant effect, systemic administration of NAC did not show significant benefit on esophageal fibrosis in our animal model of esophageal wound healing within the experimental conditions of this study. Since the administered doses were relatively high, it seems unlikely that NAC might be a valuable option for the prevention of post-endoscopic esophageal stricture. PMID:22640979

  17. 16. Historic photograph, photographer unknown, 1943. VIEW OF BRIDGE UNDER ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    16. Historic photograph, photographer unknown, 1943. VIEW OF BRIDGE UNDER CONSTRUCTION, LOOKING WEST. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  18. Photocopy of photograph (source and date unknown) FRONT ELEVATION ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph (source and date unknown) FRONT ELEVATION - Merion Friends Meeting House, 615 Montgomery Avenue (changed from Montgomery Avenue & Meetinghouse Lane), Narberth, Montgomery County, PA

  19. 34. photographer unknown undated PARTIALLY CONSTRUCTED CRIB NO. 9. NOTE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    34. photographer unknown undated PARTIALLY CONSTRUCTED CRIB NO. 9. NOTE CONTOURING TO FIT IRREGULARITIES OF RIVER BOTTOM. - Bonneville Project, Bonneville Dam, Columbia River, Bonneville, Multnomah County, OR

  20. 56. photographer unknown 14 October 1935 CONCRETE BLOCKS OF SOUTH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    56. photographer unknown 14 October 1935 CONCRETE BLOCKS OF SOUTH HALF OF SPILLWAY SHOWING STEEL REINFORCING OF BAFFLES. - Bonneville Project, Bonneville Dam, Columbia River, Bonneville, Multnomah County, OR

  1. Primary systemic amyloidosis presenting as a colonic stricture: successful treatment with left hemicolectomy followed by autologous hematopoietic stem-cell transplantation: report of a case.

    PubMed

    Rives, S; Pera, M; Rosiñol, L; Vidal, O; Miquel, R; Solé, M; García-Valdecasas, J; Bladé, J

    2002-09-01

    Intestinal tract involvement by primary systemic amyloidosis is frequent but usually asymptomatic. Ischemic colitis caused by amyloid infiltration of wall blood vessels can occasionally be observed. We report a 62-year-old female with primary systemic amyloidosis who presented with intestinal obstruction caused by ischemic stricture of the sigmoid colon, secondary to submucosal amyloid deposition. The patient was successfully treated with surgical resection followed by high-dose chemotherapy and hematopoietic stem-cell transplantation. The clinical manifestations and differential diagnosis of gastrointestinal involvement of primary systemic amyloidosis, as well as its current treatment, are discussed.

  2. Inspections of Previously Monitored Coastal Structures.

    DTIC Science & Technology

    1999-03-01

    Facility Breakwater, Hawaii .... 12 Yaquina Bay North Jetty, Oregon 14 Siuslaw River Jetties, Oregon 17 Umpqua River Training Jetty, Oregon 21...Facility breakwater, Hawaii 4 Yaquina Bay north jetty, Oregon 5 Siuslaw River jetties, Oregon 6 Umpqua River training jetty, Oregon 7 Crescent City...and the jetty spur head as previously discussed. Umpqua River Training Jetty, Oregon The Federal Navigation Project at the Umpqua River lies within

  3. Froissart bound on inelastic cross section without unknown constants

    NASA Astrophysics Data System (ADS)

    Martin, André; Roy, S. M.

    2015-04-01

    Assuming that axiomatic local field theory results hold for hadron scattering, André Martin and S. M. Roy recently obtained absolute bounds on the D wave below threshold for pion-pion scattering and thereby determined the scale of the logarithm in the Froissart bound on total cross sections in terms of pion mass only. Previously, Martin proved a rigorous upper bound on the inelastic cross-section σinel which is one-fourth of the corresponding upper bound on σtot, and Wu, Martin, Roy and Singh improved the bound by adding the constraint of a given σtot. Here we use unitarity and analyticity to determine, without any high-energy approximation, upper bounds on energy-averaged inelastic cross sections in terms of low-energy data in the crossed channel. These are Froissart-type bounds without any unknown coefficient or unknown scale factors and can be tested experimentally. Alternatively, their asymptotic forms, together with the Martin-Roy absolute bounds on pion-pion D waves below threshold, yield absolute bounds on energy-averaged inelastic cross sections. For example, for π0π0 scattering, defining σinel=σtot-(σπ0π0→π0π0+σπ0π0→π+π-) , we show that for c.m. energy √{s }→∞, σ¯ inel(s ,∞)≡s ∫s∞d s'σinel(s')/s'2≤(π /4 )(mπ)-2[ln (s /s1)+(1 /2 )ln ln (s /s1)+1 ]2 where 1 /s1=34 π √{2 π }mπ-2 . This bound is asymptotically one-fourth of the corresponding Martin-Roy bound on the total cross section, and the scale factor s1 is one-fourth of the scale factor in the total cross section bound. The average over the interval (s,2s) of the inelastic π0π0 cross section has a bound of the same form with 1 /s1 replaced by 1 /s2=2 /s1.

  4. Considering Unknown Unknowns: Reconstruction of Nonconfoundable Causal Relations in Biological Networks

    PubMed Central

    Moffa, Giusi; Spang, Rainer

    2013-01-01

    Abstract Our current understanding of cellular networks is rather incomplete. We over look important but so far unknown genes and mechanisms in the pathways. Moreover, we often only have a partial account of the molecular interactions and modifications of the known players. When analyzing the cell, we look through narrow windows leaving potentially important events in blind spots. Network reconstruction is naturally confined to what we have observed. Little is known on how the incompleteness of our observations confounds our interpretation of the available data. Here we ask which features of a network can be confounded by incomplete observations and which cannot. In the context of nested effects models, we show that in the presence of missing observations or hidden factors a reliable reconstruction of the full network is not feasible. Nevertheless, we can show that certain characteristics of signaling networks like the existence of cross-talk between certain branches of the network can be inferred in a nonconfoundable way. We derive a test for inferring such nonconfoundable characteristics of signaling networks. Next, we introduce a new data structure to represent partially reconstructed signaling networks. Finally, we evaluate our method both on simulated data and in the context of a study on early stem cell differentiation in mice. PMID:24195708

  5. Considering unknown unknowns: reconstruction of nonconfoundable causal relations in biological networks.

    PubMed

    Sadeh, Mohammad J; Moffa, Giusi; Spang, Rainer

    2013-11-01

    Our current understanding of cellular networks is rather incomplete. We over look important but so far unknown genes and mechanisms in the pathways. Moreover, we often only have a partial account of the molecular interactions and modifications of the known players. When analyzing the cell, we look through narrow windows leaving potentially important events in blind spots. Network reconstruction is naturally confined to what we have observed. Little is known on how the incompleteness of our observations confounds our interpretation of the available data. Here we ask which features of a network can be confounded by incomplete observations and which cannot. In the context of nested effects models, we show that in the presence of missing observations or hidden factors a reliable reconstruction of the full network is not feasible. Nevertheless, we can show that certain characteristics of signaling networks like the existence of cross-talk between certain branches of the network can be inferred in a nonconfoundable way. We derive a test for inferring such nonconfoundable characteristics of signaling networks. Next, we introduce a new data structure to represent partially reconstructed signaling networks. Finally, we evaluate our method both on simulated data and in the context of a study on early stem cell differentiation in mice.

  6. Efficacy of holmium laser urethrotomy and intralesional injection of Santosh PGI tetra-inject (Triamcinolone, Mitomycin C, Hyaluronidase and N-acetyl cysteine) on the outcome of urethral strictures

    PubMed Central

    Kishore, Lalit; Sharma, Aditya Prakash; Garg, Nitin; Singh, Shrawan Kumar

    2015-01-01

    Introduction To study the efficacy of holmium laser urethrotomy with intralesional injection of Santosh PGI tetra-inject (Triamcinolone, Mitomycin C, Hyaluronidase and N-acetyl cysteine) in the treatment of urethral strictures. Material and methods A total of 50 patients with symptomatic urethral stricture were evaluated by clinical history, physical examination, uroflowmetry and retrograde urethrogram preoperatively. All patients were treated with holmium laser urethrotomy, followed by injection of tetra-inject at the urethrotomy site. Tetra-inject was prepared by diluting acombination of 40 mg Triamcinolone, 2 mg Mitomycin, 3000 UHyaluronidase and 600 mg N-acetyl cysteine in 5–10 ml of saline, according to the stricture length. An indwelling 18 Fr silicone catheter was left in place for 7–10 days.All patients were followed-up for 6-18 months postoperatively by history, uroflowmetry, and if required, retrograde urethrogram and micturating urethrogram every 3 months. Results 41 (82%) patients had asuccessful outcome,whereas 9 (18%) had recurrences during a follow-up ranging from 6–18 months. In <1 cm length strictures, the success rate was 100%, while in 1–3 cm and >3 cm lengthsthe success rates were 81.2% and 66.7% respectively. This modality, thus, has an encouraging success rate, especially in those with short segment urethral strictures (<3 cm). Conclusions Holmium laser urethrotomy with intralesional injection ofSantosh PGI tetra-inject (Triamcinolone, Mitomycin C, Hyaluronidase, N-acetyl cysteine) is a safe and effective minimally-invasive therapeutic modality for short segment urethral strictures. PMID:26855803

  7. 15. Photo copy of photograph (location of original print unknown) ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Photo copy of photograph (location of original print unknown) c.1932, photographer unknown Historic view of cartouche detail at center of arch - Bridge at Mouth of Rogue River, Spanning Rogue River on Oregon Coast Highway, Gold Beach, Curry County, OR

  8. 37 CFR 381.9 - Unknown copyright owners.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Unknown copyright owners. 381.9 Section 381.9 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS... EDUCATIONAL BROADCASTING § 381.9 Unknown copyright owners. If PBS and its stations, NPR and its stations,...

  9. 37 CFR 253.9 - Unknown copyright owners.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Unknown copyright owners. 253.9 Section 253.9 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT... NONCOMMERCIAL EDUCATIONAL BROADCASTING § 253.9 Unknown copyright owners. If PBS and its stations, NPR and...

  10. 37 CFR 260.7 - Unknown copyright owners.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Unknown copyright owners. 260.7 Section 260.7 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT... TRANSMISSIONS OF SOUND RECORDINGS AND MAKING OF EPHEMERAL PHONORECORDS § 260.7 Unknown copyright owners. If...

  11. 37 CFR 381.9 - Unknown copyright owners.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Unknown copyright owners. 381.9 Section 381.9 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS... EDUCATIONAL BROADCASTING § 381.9 Unknown copyright owners. If PBS and its stations, NPR and its stations,...

  12. 37 CFR 382.7 - Unknown copyright owners.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Unknown copyright owners. 382.7 Section 382.7 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS... SATELLITE DIGITAL AUDIO RADIO SERVICES Preexisting Subscription Services § 382.7 Unknown copyright...

  13. 37 CFR 260.7 - Unknown copyright owners.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Unknown copyright owners. 260.7 Section 260.7 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT... TRANSMISSIONS OF SOUND RECORDINGS AND MAKING OF EPHEMERAL PHONORECORDS § 260.7 Unknown copyright owners. If...

  14. 37 CFR 381.9 - Unknown copyright owners.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Unknown copyright owners. 381.9 Section 381.9 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS... EDUCATIONAL BROADCASTING § 381.9 Unknown copyright owners. If PBS and its stations, NPR and its stations,...

  15. 37 CFR 260.7 - Unknown copyright owners.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Unknown copyright owners. 260.7 Section 260.7 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT... TRANSMISSIONS OF SOUND RECORDINGS AND MAKING OF EPHEMERAL PHONORECORDS § 260.7 Unknown copyright owners. If...

  16. 37 CFR 253.9 - Unknown copyright owners.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Unknown copyright owners. 253.9 Section 253.9 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT... NONCOMMERCIAL EDUCATIONAL BROADCASTING § 253.9 Unknown copyright owners. If PBS and its stations, NPR and...

  17. 37 CFR 253.9 - Unknown copyright owners.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Unknown copyright owners. 253.9 Section 253.9 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT... NONCOMMERCIAL EDUCATIONAL BROADCASTING § 253.9 Unknown copyright owners. If PBS and its stations, NPR and...

  18. 37 CFR 381.9 - Unknown copyright owners.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Unknown copyright owners. 381.9 Section 381.9 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS... EDUCATIONAL BROADCASTING § 381.9 Unknown copyright owners. If PBS and its stations, NPR and its stations,...

  19. 37 CFR 382.7 - Unknown copyright owners.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Unknown copyright owners. 382.7 Section 382.7 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS... SATELLITE DIGITAL AUDIO RADIO SERVICES Preexisting Subscription Services § 382.7 Unknown copyright...

  20. 37 CFR 382.7 - Unknown copyright owners.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Unknown copyright owners. 382.7 Section 382.7 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS... SATELLITE DIGITAL AUDIO RADIO SERVICES Preexisting Subscription Services § 382.7 Unknown copyright...

  1. 37 CFR 253.9 - Unknown copyright owners.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Unknown copyright owners. 253.9 Section 253.9 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT... NONCOMMERCIAL EDUCATIONAL BROADCASTING § 253.9 Unknown copyright owners. If PBS and its stations, NPR and...

  2. 37 CFR 381.9 - Unknown copyright owners.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Unknown copyright owners. 381.9 Section 381.9 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS... EDUCATIONAL BROADCASTING § 381.9 Unknown copyright owners. If PBS and its stations, NPR and its stations,...

  3. 37 CFR 260.7 - Unknown copyright owners.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Unknown copyright owners. 260.7 Section 260.7 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT... TRANSMISSIONS OF SOUND RECORDINGS AND MAKING OF EPHEMERAL PHONORECORDS § 260.7 Unknown copyright owners. If...

  4. 48. Northwest Side of Breaker, from Culm Bank, date unknown ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    48. Northwest Side of Breaker, from Culm Bank, date unknown Historic Photograph, Photographer Unknown; Collection of William Everett, Jr. (Wilkes-Barre,PA), photocopy by Joseph E.B. Elliot - Huber Coal Breaker, 101 South Main Street, Ashley, Luzerne County, PA

  5. Students' Conscious Unknowns about Artefacts and Natural Objects

    ERIC Educational Resources Information Center

    Vaz-Rebelo, Piedade; Fernandes, Paula; Morgado, Julia; Monteiro, António; Otero, José

    2016-01-01

    This study attempts to characterise what 7th- and 12th-grade students believe they do not know about artefacts and natural objects, as well as the dependence of what is unknown on a knowledge of these objects. The students were asked to make explicit through questioning what they did not know about a sample of objects. The unknowns generated were…

  6. 16 CFR 303.14 - Products containing unknown fibers.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Products containing unknown fibers. 303.14... RULES AND REGULATIONS UNDER THE TEXTILE FIBER PRODUCTS IDENTIFICATION ACT § 303.14 Products containing unknown fibers. (a) Where a textile fiber product is made from miscellaneous scraps, rags, odd...

  7. 16 CFR 303.14 - Products containing unknown fibers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Products containing unknown fibers. 303.14... RULES AND REGULATIONS UNDER THE TEXTILE FIBER PRODUCTS IDENTIFICATION ACT § 303.14 Products containing unknown fibers. (a) Where a textile fiber product is made from miscellaneous scraps, rags, odd...

  8. 15. Photocopy of photograph (Courtesy of Lawrence D. Thornton) Unknown, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Photocopy of photograph (Courtesy of Lawrence D. Thornton) Unknown, Photographer, Date Unknown PERPSECTIVE VIEW (WEST) OF ENTRANCE HALL SHOWING FRONT DOOR WITH FANLIGHT AND ORIGINAL SIDELIGHTS - Hamilton Grange, (Moved From) 237 West 141 Street to 141st Street & Amsterdam, New York County, NY

  9. Previous Open Rotor Research in the US

    NASA Technical Reports Server (NTRS)

    VanZante, Dale

    2011-01-01

    Previous Open Rotor noise experience in the United States, current Open Rotor noise research in the United States and current NASA prediction methods activities were presented at a European Union (EU) X-Noise seminar. The invited attendees from EU industries, research establishments and universities discussed prospects for reducing Open Rotor noise and reviewed all technology programs, past and present, dedicated to Open Rotor engine concepts. This workshop was particularly timely because the Committee on Aviation Environmental Protection (CAEP) plans to involve Independent Experts in late 2011 in assessing the noise of future low-carbon technologies including the open rotor.

  10. Efficacy and Toxicity of Chemoradiotherapy Using Intensity-Modulated Radiotherapy for Unknown Primary of Head and Neck

    SciTech Connect

    Sher, David J.; Balboni, Tracy A.; Haddad, Robert I.; Norris, Charles M.; Posner, Marshall R.; Wirth, Lori J.; Goguen, Laura A.; Annino, Donald; Tishler, Roy B.

    2011-08-01

    Purpose: No single standard treatment paradigm is available for head-and-neck squamous cell carcinoma of an unknown primary (HNCUP). Bilateral neck radiotherapy with mucosal axis irradiation is widely used, with or without chemotherapy and/or surgical resection. Intensity-modulated radiotherapy (IMRT) is a highly conformal method for delivering radiation that is becoming the standard of care and might reduce the long-term treatment-related sequelae. We report the Dana-Farber Cancer Institute experience with IMRT-based treatment for HNCUP. Patients and Materials: A retrospective study of all patients treated at the Dana-Farber Cancer Institute for HNCUP with IMRT between August 2004 and January 2009. The primary endpoint was overall survival; the secondary endpoints were locoregional and distant control, and acute and chronic toxicity. Results: A total of 24 patients with HNCUP were included. Of these patients, 22 had Stage N2 disease or greater. All patients underwent neck computed tomography, positron emission tomography-computed tomography, and examination under anesthesia with directed biopsies. Of the 24 patients, 22 received concurrent chemotherapy, and 7 (29%) also underwent induction chemotherapy. The median involved nodal dose was 70 Gy, and the median mucosal dose was 60 Gy. With a median follow-up of 2.1 years, the 2-year actuarial overall survival and locoregional control rate was 92% and 100%, respectively. Only 25% of the patients had Grade 2 xerostomia, although 11 patients (46%) required esophageal dilation for stricture. Conclusion: In a single-institution series, IMRT-based chemoradiotherapy for HNCUP was associated with superb overall survival and locoregional control. The xerostomia rates were promising, but the aggressive therapy was associated with significant rates of esophageal stenosis.

  11. Application of Wnt Pathway Inhibitor Delivering Scaffold for Inhibiting Fibrosis in Urethra Strictures: In Vitro and in Vivo Study

    PubMed Central

    Zhang, Kaile; Guo, Xuran; Zhao, Weixin; Niu, Guoguang; Mo, Xiumei; Fu, Qiang

    2015-01-01

    Objective: To evaluate the mechanical property and biocompatibility of the Wnt pathway inhibitor (ICG-001) delivering collagen/poly(l-lactide-co-caprolactone) (P(LLA-CL)) scaffold for urethroplasty, and also the feasibility of inhibiting the extracellular matrix (ECM) expression in vitro and in vivo. Methods: ICG-001 (1 mg (2 mM)) was loaded into a (P(LLA-CL)) scaffold with the co-axial electrospinning technique. The characteristics of the mechanical property and drug release fashion of scaffolds were tested with a mechanical testing machine (Instron) and high-performance liquid chromatography (HPLC). Rabbit bladder epithelial cells and the dermal fibroblasts were isolated by enzymatic digestion method. (3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay) and scanning electron microscopy (SEM) were used to evaluate the viability and proliferation of the cells on the scaffolds. Fibrolasts treated with TGF-β1 and ICG-001 released medium from scaffolds were used to evaluate the anti-fibrosis effect through immunofluorescence, real time PCR and western blot. Urethrography and histology were used to evaluate the efficacy of urethral implantation. Results: The scaffold delivering ICG-001 was fabricated, the fiber diameter and mechanical strength of scaffolds with inhibitor were comparable with the non-drug scaffold. The SEM and MTT assay showed no toxic effect of ICG-001 to the proliferation of epithelial cells on the collagen/P(LLA-CL) scaffold with ICG-001. After treatment with culture medium released from the drug-delivering scaffold, the expression of Collagen type 1, 3 and fibronectin of fibroblasts could be inhibited significantly at the mRNA and protein levels. In the results of urethrography, urethral strictures and fistulas were found in the rabbits treated with non-ICG-001 delivering scaffolds, but all the rabbits treated with ICG-001-delivering scaffolds showed wide caliber in urethras. Histology results showed less collagen but more

  12. Bayesian methods for characterizing unknown parameters of material models

    DOE PAGES

    Emery, J. M.; Grigoriu, M. D.; Field Jr., R. V.

    2016-02-04

    A Bayesian framework is developed for characterizing the unknown parameters of probabilistic models for material properties. In this framework, the unknown parameters are viewed as random and described by their posterior distributions obtained from prior information and measurements of quantities of interest that are observable and depend on the unknown parameters. The proposed Bayesian method is applied to characterize an unknown spatial correlation of the conductivity field in the definition of a stochastic transport equation and to solve this equation by Monte Carlo simulation and stochastic reduced order models (SROMs). As a result, the Bayesian method is also employed tomore » characterize unknown parameters of material properties for laser welds from measurements of peak forces sustained by these welds.« less

  13. Bayesian methods for characterizing unknown parameters of material models

    SciTech Connect

    Emery, J. M.; Grigoriu, M. D.; Field Jr., R. V.

    2016-02-04

    A Bayesian framework is developed for characterizing the unknown parameters of probabilistic models for material properties. In this framework, the unknown parameters are viewed as random and described by their posterior distributions obtained from prior information and measurements of quantities of interest that are observable and depend on the unknown parameters. The proposed Bayesian method is applied to characterize an unknown spatial correlation of the conductivity field in the definition of a stochastic transport equation and to solve this equation by Monte Carlo simulation and stochastic reduced order models (SROMs). As a result, the Bayesian method is also employed to characterize unknown parameters of material properties for laser welds from measurements of peak forces sustained by these welds.

  14. Penile Circular Fasciocutaneous (McAninch) Flap as an Option for Complex Anterior Urethral Stricture in Case of Non-Viable Buccal Mucosal Graft

    PubMed Central

    Vijayganapathy, Sundaramoorthy; Mallya, Ashwin; Sreenivas, Jayaram

    2016-01-01

    The penile circular fasciocutaneous flap (FCF) is employed in the successful single stage reconstruction of long segment complex anterior urethral strictures especially when buccal mucosa is unavailable due to various reasons. A 65-year-old gentleman, chronic smoker and tobacco chewer, hypertensive on treatment, presented with obstructive lower urinary tract symptoms for 8 months. He had no prior urethral catheterization. On examination, he had circumcised penis, with stenosis of the external urethral meatus. Glans had no changes suggesting balanitis xerotica obliterans. Suprapubic cystostomy was done as he developed acute urinary retention during evaluation. Retrograde urethrogram (RGU) showed pan-anterior urethral stricture. He was planned for substitution urethroplasty. On oral cavity examination, he had moderate trismus with oral submucous fibrosis. As buccal mucosal graft was unavailable, he was planned for FCF. A ventral onlay tubularization FCF urethroplasty from meatus to bulbar urethra based on dartos dorsal pedicle was done. His postoperative recovery was uneventful. Pericatheter RGU did not show extravastion and he voided well with Qmax 14 ml/second. He is doing well at follow-up. PMID:27630900

  15. Books Average Previous Decade of Economic Misery

    PubMed Central

    Bentley, R. Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

    2014-01-01

    For the 20th century since the Depression, we find a strong correlation between a ‘literary misery index’ derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade. PMID:24416159

  16. Books average previous decade of economic misery.

    PubMed

    Bentley, R Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

    2014-01-01

    For the 20(th) century since the Depression, we find a strong correlation between a 'literary misery index' derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade.

  17. Obinutuzumab for previously untreated chronic lymphocytic leukemia.

    PubMed

    Abraham, Jame; Stegner, Mark

    2014-04-01

    Obinutuzumab was approved by the Food and Drug Administration in late 2013 for use in combination with chlorambucil for the treatment of patients with previously untreated chronic lymphocytic leukemia (CLL). The approval was based on results of an open-label phase 3 trial that showed improved progression-free survival (PFS) with the combination of obinutuzumab plus chlorambucil compared with chlorambucil alone. Obinutuzumab is a monoclonal antibody that targets CD20 antigen expressed on the surface of pre B- and mature B-lymphocytes. After binding to CD20, obinutuzumab mediates B-cell lysis by engaging immune effector cells, directly activating intracellular death signaling pathways, and activating the complement cascade. Immune effector cell activities include antibody-dependent cellular cytotoxicity and antibody-dependent cellular phagocytosis.

  18. Hyperprolactinemia after laparoscopic ovarian drilling: An unknown phenomenon

    PubMed Central

    Parsanezhad, Mohammad E; Alborzi, Saeed; Zolghadri1, Jaleh; Parsa-Nezhad, Maryam; Keshavarzi, Gholamreza; Omrani, Gholamhossein R; Schmidt, Ernst H

    2005-01-01

    Background The effects of ovarian drilling on the serum levels of gonadotropins and androgens have been studied previously. The aim of this study is to evaluate the effects of ovarian drilling on the serum prolactin levels and its relation to ovulation in women with polycystic ovary syndrome. Methods This is a prospective controlled study. Thirty-six women with PCOS underwent ovarian electrocauterization in university hospitals. Control group consisted of 35 ovulatory women with unexplained infertility. Hormonal assessment performed in early follicular phase of spontaneous or induced cycle before operation in the two groups and repeated one week after operation. Hormonal assay was also performed in the early follicular phase of the first post-operative menstruation, folliculometry and progesterone assay were also performed in the same cycle. Data were analyzed by "repeated measurement design, discriminant analysis, correlation coefficient, and Fisher exact test". Results Six to ten weeks after operation the serum mean +/- SD prolactin levels increased from 284.41 +/- 114.32 mIU/ml to 354.06 +/- 204.42 mIU/ml (P = 0.011). The same values for the control group were 277.73 +/- 114.65 to 277.4 +/- 111.4 (P = 0.981) respectively. Approximately 45% of subjects in PCOS group remained anovulatory in spite of decreased level of LH and testosterone. Prolactin level remained elevated in 73.2% of women who did not ovulate 6–10 weeks after the procedure. Conclusion Hyperprolactinemia after ovarian cauterization may be considered as a possible cause of anovulation in women with polycystic ovaries and improved gonadotropin and androgen levels. The cause of hyperprolactinemia is unknown. Hormonal assay particularly PRL in anovulatory patients after ovarian cauterization is recommended. PMID:16083511

  19. Mining the Unknown: A Systems Approach to Metabolite Identification Combining Genetic and Metabolic Information

    PubMed Central

    Krumsiek, Jan; Suhre, Karsten; Evans, Anne M.; Mitchell, Matthew W.; Mohney, Robert P.; Milburn, Michael V.; Wägele, Brigitte; Römisch-Margl, Werner; Illig, Thomas; Adamski, Jerzy; Gieger, Christian; Theis, Fabian J.; Kastenmüller, Gabi

    2012-01-01

    Recent genome-wide association studies (GWAS) with metabolomics data linked genetic variation in the human genome to differences in individual metabolite levels. A strong relevance of this metabolic individuality for biomedical and pharmaceutical research has been reported. However, a considerable amount of the molecules currently quantified by modern metabolomics techniques are chemically unidentified. The identification of these “unknown metabolites” is still a demanding and intricate task, limiting their usability as functional markers of metabolic processes. As a consequence, previous GWAS largely ignored unknown metabolites as metabolic traits for the analysis. Here we present a systems-level approach that combines genome-wide association analysis and Gaussian graphical modeling with metabolomics to predict the identity of the unknown metabolites. We apply our method to original data of 517 metabolic traits, of which 225 are unknowns, and genotyping information on 655,658 genetic variants, measured in 1,768 human blood samples. We report previously undescribed genotype–metabotype associations for six distinct gene loci (SLC22A2, COMT, CYP3A5, CYP2C18, GBA3, UGT3A1) and one locus not related to any known gene (rs12413935). Overlaying the inferred genetic associations, metabolic networks, and knowledge-based pathway information, we derive testable hypotheses on the biochemical identities of 106 unknown metabolites. As a proof of principle, we experimentally confirm nine concrete predictions. We demonstrate the benefit of our method for the functional interpretation of previous metabolomics biomarker studies on liver detoxification, hypertension, and insulin resistance. Our approach is generic in nature and can be directly transferred to metabolomics data from different experimental platforms. PMID:23093944

  20. Mining the unknown: a systems approach to metabolite identification combining genetic and metabolic information.

    PubMed

    Krumsiek, Jan; Suhre, Karsten; Evans, Anne M; Mitchell, Matthew W; Mohney, Robert P; Milburn, Michael V; Wägele, Brigitte; Römisch-Margl, Werner; Illig, Thomas; Adamski, Jerzy; Gieger, Christian; Theis, Fabian J; Kastenmüller, Gabi

    2012-01-01

    Recent genome-wide association studies (GWAS) with metabolomics data linked genetic variation in the human genome to differences in individual metabolite levels. A strong relevance of this metabolic individuality for biomedical and pharmaceutical research has been reported. However, a considerable amount of the molecules currently quantified by modern metabolomics techniques are chemically unidentified. The identification of these "unknown metabolites" is still a demanding and intricate task, limiting their usability as functional markers of metabolic processes. As a consequence, previous GWAS largely ignored unknown metabolites as metabolic traits for the analysis. Here we present a systems-level approach that combines genome-wide association analysis and Gaussian graphical modeling with metabolomics to predict the identity of the unknown metabolites. We apply our method to original data of 517 metabolic traits, of which 225 are unknowns, and genotyping information on 655,658 genetic variants, measured in 1,768 human blood samples. We report previously undescribed genotype-metabotype associations for six distinct gene loci (SLC22A2, COMT, CYP3A5, CYP2C18, GBA3, UGT3A1) and one locus not related to any known gene (rs12413935). Overlaying the inferred genetic associations, metabolic networks, and knowledge-based pathway information, we derive testable hypotheses on the biochemical identities of 106 unknown metabolites. As a proof of principle, we experimentally confirm nine concrete predictions. We demonstrate the benefit of our method for the functional interpretation of previous metabolomics biomarker studies on liver detoxification, hypertension, and insulin resistance. Our approach is generic in nature and can be directly transferred to metabolomics data from different experimental platforms.

  1. Bile duct stricture

    MedlinePlus

    ... occur after surgery to remove the gallbladder. Other causes of this condition include: Cancer of the bile duct, liver or pancreas Damage and scarring due to a gallstone in the bile duct Damage or scarring after ...

  2. Adaptive interferometric null testing for unknown freeform optics metrology.

    PubMed

    Huang, Lei; Choi, Heejoo; Zhao, Wenchuan; Graves, Logan R; Kim, Dae Wook

    2016-12-01

    We report an adaptive interferometric null testing method for overcoming the dynamic range limitations of conventional null testing approaches during unknown freeform optics metrology or optics manufacturing processes that require not-yet-completed surface measurements to guide the next fabrication process. In the presented adaptive method, a deformable mirror functions as an adaptable null component for an unknown optical surface. The optimal deformable mirror's shape is determined by the stochastic parallel gradient descent algorithm and controlled by a deflectometry system. An adaptive interferometric null testing setup was constructed, and its metrology data successfully demonstrated superb adaptive capability in measuring an unknown surface.

  3. All optical measurement of an unknown wideband microwave frequency

    NASA Astrophysics Data System (ADS)

    Kumar, A.; Priye, V.; Raj Singh, R.

    2016-12-01

    A novel all optical measurement scheme is proposed to measure wideband microwave frequencies up to 30 GHz. The proposed method is based on a four-wave mixing (FWM) approach in a semiconductor optical amplifier (SOA) of both even order side-bands generated by an unknown microwave frequency modulating an optical carrier. The optical power of a generated FWM signal depends on frequency spacing between extracted side-bands. A mathematical relation is established between FWM power and frequency of an unknown signal. A calibration curve is drawn based on the mathematical relation which predicts the unknown frequency from power withdrawn after FWM.

  4. Preseason Perceived Physical Capability and Previous Injury

    PubMed Central

    Sciascia, Aaron; Haegele, Lauren E.; Lucas, Jean; Uhl, Timothy L.

    2015-01-01

    Context  Patient opinion about the ability to perform athletic maneuvers is important after injury; however, prospective assessment of self-perceived physical capability for athletes before the beginning of a season is lacking. Objective  To perform a descriptive analysis of knee, shoulder, and elbow self-perceived measures of physical capability specific to athletics and to compare the measures between athletes with and without a history of injury. Design  Cross-sectional study. Setting  Preparticipation physical examinations. Patients or Other Participants  A total of 738 collegiate athletes (486 men, 251 women; age = 19 ± 1 years) were administered questionnaires after receiving medical clearance to participate in their sports. Of those athletes, 350 reported a history of injury. Main Outcome Measure(s)  Athletes self-reported a history of knee, shoulder, or elbow injury. Perceived physical capability of the 3 joints was evaluated using the Knee Injury and Osteoarthritis Outcome Score Sport and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score. We conducted nonparametric analysis to determine if scores differed between athletes with and without a history of injury. Results  Median values for the Knee Injury and Osteoarthritis Outcome Score Sports and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score for all athletes were 100. Median values for perceived physical capability of athletes with a history of injury were 3 to 12 points lower for each questionnaire before the start of the season (P < .001). Conclusions  Our study provided descriptive values for individual perceived knee, shoulder, and elbow physical capability of collegiate athletes participating in 19 sports. Athletes who did not report previous injuries perceived their physical capabilities to be nearly perfect, which could set the

  5. CAMS confirmation of previously reported meteor showers

    NASA Astrophysics Data System (ADS)

    Jenniskens, P.; Nénon, Q.; Gural, P. S.; Albers, J.; Haberman, B.; Johnson, B.; Holman, D.; Morales, R.; Grigsby, B. J.; Samuels, D.; Johannink, C.

    2016-03-01

    Leading up to the 2015 IAU General Assembly, the International Astronomical Union's Working List of Meteor Showers included 486 unconfirmed showers, showers that are not certain to exist. If confirmed, each shower would provide a record of past comet or asteroid activity. Now, we report that 41 of these are detected in the Cameras for Allsky Meteor Surveillance (CAMS) video-based meteor shower survey. They manifest as meteoroids arriving at Earth from a similar direction and orbit, after removing the daily radiant drift due to Earth's motion around the Sun. These showers do exist and, therefore, can be moved to the IAU List of Established Meteor Showers. This adds to 31 previously confirmed showers from CAMS data. For each shower, finding charts are presented based on 230,000 meteors observed up to March of 2015, calculated by re-projecting the drift-corrected Sun-centered ecliptic coordinates into more familiar equatorial coordinates. Showers that are not detected, but should have, and duplicate showers that project to the same Sun-centered ecliptic coordinates, are recommended for removal from the Working List.

  6. Sebacinales Everywhere: Previously Overlooked Ubiquitous Fungal Endophytes

    PubMed Central

    Weiß, Michael; Sýkorová, Zuzana; Garnica, Sigisfredo; Riess, Kai; Martos, Florent; Krause, Cornelia; Oberwinkler, Franz; Bauer, Robert; Redecker, Dirk

    2011-01-01

    Inconspicuous basidiomycetes from the order Sebacinales are known to be involved in a puzzling variety of mutualistic plant-fungal symbioses (mycorrhizae), which presumably involve transport of mineral nutrients. Recently a few members of this fungal order not fitting this definition and commonly referred to as ‘endophytes’ have raised considerable interest by their ability to enhance plant growth and to increase resistance of their host plants against abiotic stress factors and fungal pathogens. Using DNA-based detection and electron microscopy, we show that Sebacinales are not only extremely versatile in their mycorrhizal associations, but are also almost universally present as symptomless endophytes. They occurred in field specimens of bryophytes, pteridophytes and all families of herbaceous angiosperms we investigated, including liverworts, wheat, maize, and the non-mycorrhizal model plant Arabidopsis thaliana. They were present in all habitats we studied on four continents. We even detected these fungi in herbarium specimens originating from pioneering field trips to North Africa in the 1830s/40s. No geographical or host patterns were detected. Our data suggest that the multitude of mycorrhizal interactions in Sebacinales may have arisen from an ancestral endophytic habit by specialization. Considering their proven beneficial influence on plant growth and their ubiquity, endophytic Sebacinales may be a previously unrecognized universal hidden force in plant ecosystems. PMID:21347229

  7. Previous gastric bypass surgery complicating total thyroidectomy.

    PubMed

    Alfonso, Bianca; Jacobson, Adam S; Alon, Eran E; Via, Michael A

    2015-03-01

    Hypocalcemia is a well-known complication of total thyroidectomy. Patients who have previously undergone gastric bypass surgery may be at increased risk of hypocalcemia due to gastrointestinal malabsorption, secondary hyperparathyroidism, and an underlying vitamin D deficiency. We present the case of a 58-year-old woman who underwent a total thyroidectomy for the follicular variant of papillary thyroid carcinoma. Her history included Roux-en-Y gastric bypass surgery. Following the thyroid surgery, she developed postoperative hypocalcemia that required large doses of oral calcium carbonate (7.5 g/day), oral calcitriol (up to 4 μg/day), intravenous calcium gluconate (2.0 g/day), calcium citrate (2.0 g/day), and ergocalciferol (50,000 IU/day). Her serum calcium levels remained normal on this regimen after hospital discharge despite persistent hypoparathyroidism. Bariatric surgery patients who undergo thyroid surgery require aggressive supplementation to maintain normal serum calcium levels. Preoperative supplementation with calcium and vitamin D is strongly recommended.

  8. View of an unknown industrial building in the Dolphin Jute ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View of an unknown industrial building in the Dolphin Jute Mill Complex, looking southwest. Note Garret Mountain at upper left and historic Dexter-Lambert smokestack. - Dolphin Manufacturing Company, Spruce & Barbour Streets, Paterson, Passaic County, NJ

  9. 39. Historic photograph, photographer unknown, c. 1944. VIEW SHOWING SHEEP ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    39. Historic photograph, photographer unknown, c. 1944. VIEW SHOWING SHEEP CROSSING BRIDGE, LOOKING WEST FROM CORRAL AT EAST APPROACH TO WALKWAY. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  10. 40. Historic photograph, photographer unknown, c. 1954. VIEW OF SHEARING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    40. Historic photograph, photographer unknown, c. 1954. VIEW OF SHEARING SHEEP IN SHED NEAR WEST END OF THE BRIDGE. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  11. 37. Historic photograph, photographer unknown, c. 1942. PHOTOGRAPH OF B. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    37. Historic photograph, photographer unknown, c. 1942. PHOTOGRAPH OF B. L. 'LES' SMITH, SON OF GEORGE W. SMITH, REPAIRING HORSESHOE DAM SITE BRIDGE - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  12. 35. Historic photograph, photographer unknown, c. 1941. VIEW OF HORSESHOE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    35. Historic photograph, photographer unknown, c. 1941. VIEW OF HORSESHOE DAM SITE BRIDGE, SHOWING WALKWAY WITH CHARLES WILLIS (WITH HAT) AND FAMILY. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  13. 29. Historic photographer, photographer unknown, c. 1944. VIEW OF BRIDGE, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    29. Historic photographer, photographer unknown, c. 1944. VIEW OF BRIDGE, LOOKING EAST FROM TOP OF WEST TOWER. SHEEP CROSSING BRIDGE. NOTE SWAY CABLES. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  14. 41. Historic photograph, photographer unknown, c. 1954. VIEW OF LOADING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    41. Historic photograph, photographer unknown, c. 1954. VIEW OF LOADING SACKS OF FLEECES ONTO TRUCK AT JUNCTION OF SEVEN SPRINGS ROAD AND TANGLE CREEK ROAD. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  15. 34. Historic photograph, photographer unknown, October 10, 1944. VIEW SHOWING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    34. Historic photograph, photographer unknown, October 10, 1944. VIEW SHOWING HORSESHOE DAM UNDER CONSTRUCTION, LOOKING WEST. ONLY THE BRIDGE TOWERS REMAIN. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  16. 32. Historic photograph, photographer unknown, c. 1943. VIEW OF HORSESHOE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    32. Historic photograph, photographer unknown, c. 1943. VIEW OF HORSESHOE DAM SITE BRIDGE, LOOKING NORTH, SHOWING BRIDGE SPANNING THE VERDE RIVER BEFORE DAM WAS BUILT. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  17. 18. Historic photograph, photographer unknown, 1943. VIEW OF BRIDGE, LOOKING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. Historic photograph, photographer unknown, 1943. VIEW OF BRIDGE, LOOKING EAST. EAST TOWER ON SKYLINE HAS NOT BEEN REINFORCED WITH CONCRETE. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  18. 38. Historic photograph, photographer unknown, c. 1944. VIEW SHOWING BURROS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    38. Historic photograph, photographer unknown, c. 1944. VIEW SHOWING BURROS (OR MULES) CROSSING BRIDGE, LOOKING NORTHEAST. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  19. The Unknown Computer Viruses Detection Based on Similarity

    NASA Astrophysics Data System (ADS)

    Liu, Zhongda; Nakaya, Naoshi; Koui, Yuuji

    New computer viruses are continually being generated and they cause damage all over the world. In general, current anti-virus software detects viruses by matching a pattern based on the signature; thus, unknown viruses without any signature cannot be detected. Although there are some static analysis technologies that do not depend on signatures, virus writers often use code obfuscation techniques, which make it difficult to execute a code analysis. As is generally known, unknown viruses and known viruses share a common feature. In this paper we propose a new static analysis technology that can circumvent code obfuscation to extract the common feature and detect unknown viruses based on similarity. The results of evaluation experiments demonstrated that this technique is able to detect unknown viruses without false positives.

  20. 22. Photocopy of drawing Delineator unknown, ca. 1931 Wright Studio, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. Photocopy of drawing Delineator unknown, ca. 1931 Wright Studio, photographer View from Kellogg Blvd. - St. Paul City Hall & Ramsey County Courthouse, 15 West Kellogg Boulevard, Saint Paul, Ramsey County, MN

  1. 356. Delineator Unknown March 1946 STATE OF CALIFORNIA; DEPARTMENT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    356. Delineator Unknown March 1946 STATE OF CALIFORNIA; DEPARTMENT OF PUBLIC WORKS; SAN FRANCISCO - OAKLAND BAY BRIDGE; GENERAL DATA; PLAT III - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  2. 15. photographer unknown undated JACKHAMMERS DRILLING AT WEST END OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. photographer unknown undated JACKHAMMERS DRILLING AT WEST END OF BOAT ROCK, SITE LATER ABANDONED. - Bonneville Project, Columbia River, 1 mile Northeast of Exit 40, off Interstate 84, Bonneville, Multnomah County, OR

  3. 2. Photocopy of photograph (from Reading Co. Archives) Photographer unknown ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. Photocopy of photograph (from Reading Co. Archives) Photographer unknown ca. 1937 NORTHEAST FRONT AND SOUTHEAST SIDE - Philadelphia & Reading Railroad, Terminal Station, 1115-1141 Market Street, Philadelphia, Philadelphia County, PA

  4. 13. Photocopy of color photograph (Photographer unknown, 1974) INTERIOR OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. Photocopy of color photograph (Photographer unknown, 1974) INTERIOR OF SACRISTY LOOKING NORTHEAST, SHOWING FURRING AND METAL LATH PUT IN DURING 1974 RESTORATION - Church of the Holy Cross, State Route 261, Stateburg, Sumter County, SC

  5. 10. Photocopy of map (from Benicia Historical Society) Delineator unknown ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. Photocopy of map (from Benicia Historical Society) Delineator unknown May 1, 1894, revised to Mar. 27, 1918 'MAP OF BENICIA ARSENAL RESERVATION' - Benicia Arsenal, Benicia Industrial Park, Benicia, Solano County, CA

  6. 51. BOILER ROOM. SMALL BOILER ON LEFT OF UNKNOWN MANUFACTURE, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    51. BOILER ROOM. SMALL BOILER ON LEFT OF UNKNOWN MANUFACTURE, WITH INDUCTION MOTORS. HARTLEY BOILER, MONTGOMERY, ALABAMA, ON RIGHT. - Prattville Manufacturing Company, Number One, 242 South Court Street, Prattville, Autauga County, AL

  7. 47. Photocopy of postcard (Pentran file), photographer unknown. Hampton's Old ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    47. Photocopy of postcard (Pentran file), photographer unknown. Hampton's Old Point Comfort electric trolley in 1921. - Newport News & Old Point Railway & Electric Company, Trolley Barn & Administration Building, 3400 Victoria Boulevard, Hampton, Hampton, VA

  8. Photographic copy of photograph, photographer unknown, 1908 (original print located ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 1908 (original print located at National Archives and Records Administration, Denver, Colorado). "HANDLING ROCK - BOISE RIVER DIVERSION DAM." - Boise Project, Boise River Diversion Dam, Across Boise River, Boise, Ada County, ID

  9. Photographic copy of photograph, photographer unknown, 1908 (original print located ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 1908 (original print located at National Archives and Records Administration, Denver, Colorado). "CONSTRUCTION - BOISE RIVER DIVERSION DAM." - Boise Project, Boise River Diversion Dam, Across Boise River, Boise, Ada County, ID

  10. Photographic copy of photograph, photographer unknown, 1908 (original print located ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 1908 (original print located at National Archives and Records Administration, Denver, Colorado). "CONSTRUCTION - BOISE RIVER DAM" WITH FOOT BRIDGE IN FOREGROUND - Boise Project, Boise River Diversion Dam, Across Boise River, Boise, Ada County, ID

  11. Photographic copy of photograph, photographer unknown, 23 May 1912 (original ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 23 May 1912 (original print located at National Archives and Records Administration, Denver, Colorado). "SWITCHBOARD IN POWER PLANT AT DIVERSION DAM" - Boise Project, Boise River Diversion Dam, Across Boise River, Boise, Ada County, ID

  12. Photographic copy of photograph, photographer unknown, 17 April 1912 (original ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 17 April 1912 (original print located at National Archives and Records Administration, Denver, Colorado). "POWER PLANT CONSTRUCTION AT DIVERSION DAM" - Boise Project, Boise River Diversion Dam, Across Boise River, Boise, Ada County, ID

  13. Photographic copy of photograph, photographer unknown, 20 March 1913 (original ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 20 March 1913 (original print located at National Archives and Records Administration, Denver, Colorado). "ROLLING DAM AT DIVERSION DAM" - Boise Project, Boise River Diversion Dam, Across Boise River, Boise, Ada County, ID

  14. Photographic copy of photograph, photographer unknown, 20 March 1913 (original ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 20 March 1913 (original print located at National Archives and Records Administration, Denver, Colorado). "ROLLING DAM IN SPILLWAY AT DIVERSION DAM" - Boise Project, Boise River Diversion Dam, Across Boise River, Boise, Ada County, ID

  15. Photographic copy of photograph, photographer unknown, 20 March 1912 (original ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 20 March 1912 (original print located at National Archives and Records Administration, Denver, Colorado). "INTERIOR OF POWER HOUSE BEFORE COMPLETION" - Boise Project, Boise River Diversion Dam, Across Boise River, Boise, Ada County, ID

  16. Photographic copy of photograph, photographer unknown, 20 March 1912 (original ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 20 March 1912 (original print located at National Archives and Records Administration, Denver, Colorado). "DIVERSION WORKS AND POWER HOUSE CONSTRUCTION" - Boise Project, Boise River Diversion Dam, Across Boise River, Boise, Ada County, ID

  17. Photographic copy of photograph, photographer unknown, 23 May 1912 (original ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 23 May 1912 (original print located at National Archives and Records Administration, Denver, Colorado). "GENERATORS IN POWER PLANT; DIVERSION DAM" - Boise Project, Boise River Diversion Dam, Across Boise River, Boise, Ada County, ID

  18. 22. Photographic copy of photograph, circa 1928, photographer unknown (original ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. Photographic copy of photograph, circa 1928, photographer unknown (original in Rundell Library, Rochester, New York) AUDITORIUM AND STAGE DECORATED FOR POLITICAL CONVENTION, VIEW FROM BALCONY LOOKING SOUTHWEST - New York State Arsenal, 75 Woodbury Boulevard, Rochester, Monroe County, NY

  19. 39. Photocopy of photograph (Pentran file), photographer and date unknown. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    39. Photocopy of photograph (Pentran file), photographer and date unknown. Bus garage to left now demolished. VIEW SOUTH - Newport News & Old Point Railway & Electric Company, Trolley Barn & Administration Building, 3400 Victoria Boulevard, Hampton, Hampton, VA

  20. 6. Photographic copy of photograph (date unknown, original print in ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. Photographic copy of photograph (date unknown, original print in the possession of the Wisconsin Veterans Museums). COTTAGES, INCLUDING 'J.P. McPHERSON POST NO. 27 CAFE GENEVA'. - Wisconsin Home for Veterans, King, Waupaca County, WI

  1. 35. Photocopy of photograph. Photographer unknown, 1904 NEWLY COMPLETED OFFICE, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    35. Photocopy of photograph. Photographer unknown, 1904 NEWLY COMPLETED OFFICE, SUBSTATION, CAR BARN. VIEW TO NORTHEAST. - Milwaukee Light, Heat & Traction Company, 8336 West Lapham Street, West Allis, Milwaukee County, WI

  2. 37. Photocopy of photograph. Photographer unknown, 1904 FRONT FACADE AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    37. Photocopy of photograph. Photographer unknown, 1904 FRONT FACADE AND EAST SIDE OF NEWLY COMPLETED BUILDING. VIEW TO WEST-NORTHWEST. - Milwaukee Light, Heat & Traction Company, 8336 West Lapham Street, West Allis, Milwaukee County, WI

  3. 36. Photocopy of photograph. Photographer unknown, 1904 FRONT FACADE AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    36. Photocopy of photograph. Photographer unknown, 1904 FRONT FACADE AND WEST SIDE OF NEWLY COMPLETED BUILDING. VIEW TO EAST-NORTHEAST. - Milwaukee Light, Heat & Traction Company, 8336 West Lapham Street, West Allis, Milwaukee County, WI

  4. 28. photographer unknown undated SIDE VIEW OF PARTIALLY CONSTRUCTED CRIB ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    28. photographer unknown undated SIDE VIEW OF PARTIALLY CONSTRUCTED CRIB NO. 13. NOTE CONTOURING TO FIT IRREGULARITIES OF RIVER BOTTOM. - Bonneville Project, Bonneville Dam, Columbia River, Bonneville, Multnomah County, OR

  5. 26. photographer unknown 19 August 1935 SOUNDING BARGE USED TO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    26. photographer unknown 19 August 1935 SOUNDING BARGE USED TO DETERMINE RIVER-BOTTOM CONTOURS. - Bonneville Project, Columbia River, 1 mile Northeast of Exit 40, off Interstate 84, Bonneville, Multnomah County, OR

  6. Method for identifying known materials within a mixture of unknowns

    DOEpatents

    Wagner, John S.

    2000-01-01

    One or both of two methods and systems are used to determine concentration of a known material in an unknown mixture on the basis of the measured interaction of electromagnetic waves upon the mixture. One technique is to utilize a multivariate analysis patch technique to develop a library of optimized patches of spectral signatures of known materials containing only those pixels most descriptive of the known materials by an evolutionary algorithm. Identity and concentration of the known materials within the unknown mixture is then determined by minimizing the residuals between the measurements from the library of optimized patches and the measurements from the same pixels from the unknown mixture. Another technique is to train a neural network by the genetic algorithm to determine the identity and concentration of known materials in the unknown mixture. The two techniques may be combined into an expert system providing cross checks for accuracy.

  7. System for identifying known materials within a mixture of unknowns

    DOEpatents

    Wagner, John S.

    1999-01-01

    One or both of two methods and systems are used to determine concentration of a known material in an unknown mixture on the basis of the measured interaction of electromagnetic waves upon the mixture. One technique is to utilize a multivariate analysis patch technique to develop a library of optimized patches of spectral signatures of known materials containing only those pixels most descriptive of the known materials by an evolutionary algorithm. Identity and concentration of the known materials within the unknown mixture is then determined by minimizing the residuals between the measurements from the library of optimized patches and the measurements from the same pixels from the unknown mixture. Another technique is to train a neural network by the genetic algorithm to determine the identity and concentration of known materials in the unknown mixture. The two techniques may be combined into an expert system providing cross checks for accuracy.

  8. A Method for Finding Unknown Signals Using Reinforcement FFT Differencing

    SciTech Connect

    Charles R. Tolle; John W. James

    2009-12-01

    This note addresses a simple yet powerful method of discovering the spectral character of an unknown but intermittent signal buried in a background made up of a distribution of other signals. Knowledge of when the unknown signal is present and when it is not, along with samples of the combined signal when the unknown signal is present and when it is not are all that is necessary for this method. The method is based on reinforcing Fast Fourier Transform (FFT) power spectra when the signal of interest occurs and subtracting spectra when it does not. Several examples are presented. This method could be used to discover spectral components of unknown chemical species within spectral analysis instruments such as Mass Spectroscopy, Fourier Transform Infrared Spectroscopy (FTIR) and Gas Chromatography. In addition, this method can be used to isolate device loading signatures on power transmission lines.

  9. 1. PHOTOCOPY OF HISTORIC DRAWING OF SHIP SECTION, UNKNOWN DELINEATOR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. PHOTOCOPY OF HISTORIC DRAWING OF SHIP SECTION, UNKNOWN DELINEATOR AND DATE, SOURCE: BISHOP MUSEUM, HONOLULU, HI. - Ship "Falls of Clyde", Hawaii Maritime Center,Pier 7, Honolulu, Honolulu County, HI

  10. 44. Reinforcement construction to Pleasant Dam. Photographer unknown, 1935. Source: ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    44. Reinforcement construction to Pleasant Dam. Photographer unknown, 1935. Source: Huber Collection, University of California, Berkeley, Water Resources Library. - Waddell Dam, On Agua Fria River, 35 miles northwest of Phoenix, Phoenix, Maricopa County, AZ

  11. 41. Upstream end of emergency spillway excavation. Photographer unknown, 1929. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    41. Upstream end of emergency spillway excavation. Photographer unknown, 1929. Source: Arizona Department of Water Resources (ADWR). - Waddell Dam, On Agua Fria River, 35 miles northwest of Phoenix, Phoenix, Maricopa County, AZ

  12. 30. Upstream face of construction effort. Photographer unknown, January 29, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    30. Upstream face of construction effort. Photographer unknown, January 29, 1927. Source: Fritz Seifritz. - Waddell Dam, On Agua Fria River, 35 miles northwest of Phoenix, Phoenix, Maricopa County, AZ

  13. 1. Historic American Buildings Survey, Copy, Photographer unknown 1900 (a) ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Historic American Buildings Survey, Copy, Photographer unknown 1900 (a) Old Photo showing Kilns about 1900 (from original print found at site) - Charcoal Kilns, Valley Road, Pelham, Hampshire County, MA

  14. 53. photographer unknown October 1935 WORK ON SOUTH HALF SPILLWAY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    53. photographer unknown October 1935 WORK ON SOUTH HALF SPILLWAY SHOWING REINFORCING STEEL AND PLACING CONCRETE. COFFERDAM IN BACKGROUND. - Bonneville Project, Bonneville Dam, Columbia River, Bonneville, Multnomah County, OR

  15. 62. photographer unknown undated ERECTING FORMS, PLACING REINFORCING STEEL, AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    62. photographer unknown undated ERECTING FORMS, PLACING REINFORCING STEEL, AND CONCRETING DRAFT PIER OF POWERHOUSE. - Bonneville Project, Powerhouse No.1, Spanning Bradford Slough, from Bradford Island, Bonneville, Multnomah County, OR

  16. Genetics Experts Unite to I.D. Unknown Katrina Victims

    MedlinePlus

    ... Current Issue Past Issues Research News From NIH Genetics Experts Unite to I.D. Unknown Katrina Victims ... in the recent Advances in molecular biology and genetics," says team member Stephen Sherry, Ph.D., of ...

  17. 1. Site of Mormon Flat Dam looking upstream. Photographer unknown, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Site of Mormon Flat Dam looking upstream. Photographer unknown, 1923. Source: Salt River Project. - Mormon Flat Dam, On Salt River, Eastern Maricopa County, east of Phoenix, Phoenix, Maricopa County, AZ

  18. 27. Photographic copy of undated photo; Photographer unknown; Original owned ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    27. Photographic copy of undated photo; Photographer unknown; Original owned by Waterloo Community Development Board, Waterloo, Iowa; SPLITTING CATTLE CARCASSES WITH RECIPROCATING SAW - Rath Packing Company, Beef Killing Building, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

  19. 29. photographer unknown 27 August 1935 GRAVEL AND SAND HOPPERS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    29. photographer unknown 27 August 1935 GRAVEL AND SAND HOPPERS IN CONCRETE PLANT. - Bonneville Project, Columbia River, 1 mile Northeast of Exit 40, off Interstate 84, Bonneville, Multnomah County, OR

  20. 4. Photocopy of photograph, date unknown DETAIL, DECORATIVE SWAG OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. Photocopy of photograph, date unknown DETAIL, DECORATIVE SWAG OF EARS OF CORN - Thomas Asylum for Orphan & Destitute Indians, Dining Hall, Route 438, Cattaraugas Reservation, Irving, Chautauqua County, NY

  1. 25. Photocopy of photograph (Source unknown, c. 19231925) EXTERIOR, CLOSEUP ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    25. Photocopy of photograph (Source unknown, c. 1923-1925) EXTERIOR, CLOSE-UP OF SOUTH FRONT OF MISSION AFTER RESTORATION, C. 1923-1925 - Mission San Francisco Solano de Sonoma, First & Spain Streets, Sonoma, Sonoma County, CA

  2. [Diagnostic approach of recurrent fevers of unknown origin in adults].

    PubMed

    Zenone, T

    2015-07-01

    Recurrent fever of unknown origin is probably the most difficult to diagnose subtype of fever of unknown origin. It represents between 18 and 42% of the cases in large series of patients with fever of unknown origin. The limited literature data do not allow one to construct a diagnostic algorithm. However, the diagnostic strategy is different from classic fever of unknown origin. The spectrum of causative disorders is different from continuous fever with less infections and tumors. Among systemic inflammatory diseases, adult-onset Still's disease is the most common cause. More than 50% of the cases remain unexplained. Hereditary recurrent fevers, the prototype of autoinflammatory diseases, are now more easily discuss in a young adult.

  3. System for identifying known materials within a mixture of unknowns

    DOEpatents

    Wagner, J.S.

    1999-07-20

    One or both of two methods and systems are used to determine concentration of a known material in an unknown mixture on the basis of the measured interaction of electromagnetic waves upon the mixture. One technique is to utilize a multivariate analysis patch technique to develop a library of optimized patches of spectral signatures of known materials containing only those pixels most descriptive of the known materials by an evolutionary algorithm. Identity and concentration of the known materials within the unknown mixture is then determined by minimizing the residuals between the measurements from the library of optimized patches and the measurements from the same pixels from the unknown mixture. Another technique is to train a neural network by the genetic algorithm to determine the identity and concentration of known materials in the unknown mixture. The two techniques may be combined into an expert system providing cross checks for accuracy. 37 figs.

  4. 15. Photocopy, photographer unknown, c. 194041 SOUTH ELEVATION WITH ORIGINAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Photocopy, photographer unknown, c. 1940-41 SOUTH ELEVATION WITH ORIGINAL PORCH REMOVED - White Deer Lake Camp, Chimney Cabin, Cyrus H. McCormick Experimental Forest, Champion, Marquette County, MI

  5. 15. Photocopy, photographer unknown, c. 1933 INTERIOR OF LIVING ROOM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Photocopy, photographer unknown, c. 1933 INTERIOR OF LIVING ROOM LOOKING EAST-NORTHEAST - White Deer Lake Camp, Living Room Cabin, Cyrus H. McCormick Experimental Forest, Champion, Marquette County, MI

  6. Characterisation and Next-generation Sequencing Analysis of Unknown Arboviruses

    DTIC Science & Technology

    2012-09-01

    using techniques such as PCR-select subtraction and next-generation sequencing. Preliminary analysis of the four sequenced viruses has shown that they...HOJV) and Harrison Dam virus (HARDV), and two unknown bunyaviruses, Buffalo Creek Virus (BCV) and Maprik virus (MPKV). It describes the techniques such...unknown viruses with greater speed and at lower cost. The rapid advancement of new generation sequencing techniques allows for highly specific acquisition

  7. 8. VIEW SHOWING THE DEMOSSING OF GRAND CANAL LOCATION UNKNOWN. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. VIEW SHOWING THE DEMOSSING OF GRAND CANAL LOCATION UNKNOWN. AT TEAM OF HORSES ON OPPOSITE BANKS OF THE CANAL DRAG A CHAIN BETWEEN THEM ALONG THE BOTTOM OF THE CANAL, WHICH PULLS THE MOSS AND WEEDS LOOSE. THE PLANS THEN FLOAT DOWN THE CANAL AND ARE CAUGHT IN A SCREEN AND REMOVED. Photographer unknown, 1923 - Grand Canal, North side of Salt River, Tempe, Maricopa County, AZ

  8. Chinese unknown word recognition for PCFG-LA parsing.

    PubMed

    Huang, Qiuping; He, Liangye; Wong, Derek F; Chao, Lidia S

    2014-01-01

    This paper investigates the recognition of unknown words in Chinese parsing. Two methods are proposed to handle this problem. One is the modification of a character-based model. We model the emission probability of an unknown word using the first and last characters in the word. It aims to reduce the POS tag ambiguities of unknown words to improve the parsing performance. In addition, a novel method, using graph-based semisupervised learning (SSL), is proposed to improve the syntax parsing of unknown words. Its goal is to discover additional lexical knowledge from a large amount of unlabeled data to help the syntax parsing. The method is mainly to propagate lexical emission probabilities to unknown words by building the similarity graphs over the words of labeled and unlabeled data. The derived distributions are incorporated into the parsing process. The proposed methods are effective in dealing with the unknown words to improve the parsing. Empirical results for Penn Chinese Treebank and TCT Treebank revealed its effectiveness.

  9. Redescription of the adults and new descriptions of the previously unknown immature stages of Culex (Culex) articularis Philippi, 1865 (Diptera: Culicidae) from central Chile.

    PubMed

    González, Christian R; Reyes, Carolina; Rada, Viviana

    2015-05-05

    Male and female adults of Culex (Culex) articularis Philippi are redescribed, and the 4th-instar larva and pupa are described and illustrated for the first time. Culex articularis is compared with other species of the subgenus Culex. Illustrations of diagnostic characters of the female, male genitalia, 4th-instar larva, and pupa are also provided.

  10. DNA sequencing and analysis of a 24.7 kb segment encompassing centromere CEN11 of Saccharomyces cerevisiae reveals nine previously unknown open reading frames.

    PubMed

    Düsterhöft, A; Philippsen, P

    1992-09-01

    A 24.7 kb segment of the cosmid clone pUKG047 containing a Sau3AI-partial fragment from the centromere region of Saccharomyces cerevisiae chromosome XI was sequenced and analysed. A mixed strategy of directed methods including exonuclease III nested deletion, restriction fragment subcloning and oligonucleotide-directed sequences was carried out. Exclusive use was made of the Applied Biosystems Taq DyeDeoxy Terminator Cycle technology and a laser-based AB1373A sequencing system for reactions, gel electrophoresis and automated reading. A total of 12 open reading frames (ORFs) was found. Nine new ORFs (YK102 to YK110) were identified, three of which (YK102, YK107, YK108) showed homologies to proteins of known function from other organisms. In addition, sequence analysis revealed three recently functionally characterized genes (MET14, VPS/SPO15, PAP1), which could be joined to the earlier published CEN11 region.

  11. Changes in dissolved organic matter during the treatment processes of a drinking water plant in Sweden and formation of previously unknown disinfection byproducts.

    PubMed

    Gonsior, Michael; Schmitt-Kopplin, Philippe; Stavklint, Helena; Richardson, Susan D; Hertkorn, Norbert; Bastviken, David

    2014-11-04

    The changes in dissolved organic matter (DOM) throughout the treatment processes in a drinking water treatment plant in Sweden and the formation of disinfection byproducts (DBPs) were evaluated by using ultra-high-resolution mass spectrometry (resolution of ∼500,000 at m/z 400) and nuclear magnetic resonance (NMR). Mass spectrometric results revealed that flocculation induced substantial changes in the DOM and caused quantitative removal of DOM constituents that usually are associated with DBP formation. While half of the chromophoric DOM (CDOM) was removed by flocculation, ∼4-5 mg L(-1) total organic carbon remained in the finished water. A conservative approach revealed the formation of ∼800 mass spectrometry ions with unambiguous molecular formula assignments that contained at least one halogen atom. These molecules likely represented new DBPs, which could not be prevented by the flocculation process. The most abundant m/z peaks, associated with formed DBPs, could be assigned to C5HO3Cl3, C5HO3Cl2Br, and C5HO3ClBr2 using isotope simulation patterns. Other halogen-containing formulas suggested the presence of halogenated polyphenolic and aromatic acid-type structures, which was supported by possible structures that matched the lower molecular mass range (maximum of 10 carbon atoms) of these DBPs. 1H NMR before and after disinfection revealed an ∼2% change in the overall 1H NMR signals supporting a significant change in the DOM caused by disinfection. This study underlines the fact that a large and increasing number of people are exposed to a very diverse pool of organohalogens through water, by both drinking and uptake through the skin upon contact. Nontarget analytical approaches are indispensable for revealing the magnitude of this exposure and to test alternative ways to reduce it.

  12. Implications of the colonic deposition of free hemoglobin-alpha chain: a previously unknown tissue by-product in inflammatory bowel disease

    PubMed Central

    Myers, Jeremy N.; Schäffer, Michael W.; Korolkova, Olga Y.; Williams, Amanda D.; Gangula, Pandu R.; M’Koma, Amosy E.

    2014-01-01

    Purpose We analyzed inflamed mucosal/submucosal layers of ulcerative colitis (UC=63) and Crohn’s colitis (CC=50) and unexpectedly we unveiled a pool of free-hemoglobin-alpha (Hb-α) chain. Patients with colitides have increased ROS, DNA-oxidation products, free-iron in mucosa, in pre-neoplastic, and in colitis-cancers and increased risks of developing colorectal-cancer (CRC). All IBD-related-CRC lesions are found in segments with colitis. Linking this information we investigated whether free-Hb-α is key transformational stepping that increases colitis-related-CRC vulnerability. Methods UC/CC samples were profiled using MALDI-MS; protein identification was made by LCM. Diverticulitis (DV) was used as control (Ctrl). The presence of Hb(n) (n=α, β and hemin)/Hb was validated by Western blotting (WB) and immunohistochemistry (IHC). We tested for DNA-damage (DNAD) by exposing normal colonic-epithelial-cell-line, NCM460, to 10μM and 100μM of Hb(n)/Hb, individually for 2 h, 6 h, and 12 h. Quantification of Hb-α-staining was done by Nikon Elements Advance Research Analysis software. ROS was measured by the production of 8-OHdG. DNAD was assessed by Comet-assay. Colonic tissue homogenate antioxidants Nrf2-, CAT-, SOD- and GPx-expressions was analyzed densitometrically/ normalized by β-actin. Results IHC of CC/UC mucosal/submucosal-compartments stained strongly positive for Hb-α and significantly higher vs. Ctrl. NCM460 exposed to Hb(n)/Hb exhibited steadily-increasing ROS and subsequent DNAD. DNAD was higher in 10μM than 100μM in Hb-β/hemin the first 2 h then plateaued followed by DNAD-repair. This may be likely due to apoptosis in the later concentration. Nrf2 enzyme activities among UC, CC and UCAC were observed impaired in all IBD subjects. Decreased levels of Nrf2 among UC vs. CC patients with active disease was insignificant as well as vs. Ctrls but significantly lower in UCAC vs. Ctrl. SOD was decreased in UC and UCAC and GPx in CC but statistically not significant. Comparing CC vs. UC, SOD was significantly lower in CC (p< 0.05). CAT was observed increased among CC/UC/UCAC patients and GPx in UC and UCAC vs. Ctrl, respectively, and significantly increased in CC vs. Ctrl (p< 0.01) Conclusion In the colitides mucosal/submucosal tissue microenvironments demonstrated pool of free-Hb-α-chain. In vitro exposure of NCM460-cells to Hb(n)/Hb induced ROS and DNAD. Toxic effect of free-Hb-α, in colonic epithelial cells is therefore through production of ROS-formation modulated by impairment of antioxidant effects. Targeting reduction-oxidation-sensitive pathways and transcription factors may offer options for IBD-management and colitis-related-cancer prevention. PMID:25078150

  13. A meta-analysis and systematic review: Success of endoscopic ultrasound guided biliary stenting in patients with inoperable malignant biliary strictures and a failed ERCP

    PubMed Central

    Moole, Harsha; Bechtold, Matthew L.; Forcione, David; Puli, Srinivas R.

    2017-01-01

    Abstract Background: In patients with inoperable malignant biliary strictures, endoscopic retrograde cholangiopancreatography (ERCP) guided biliary stenting fails in 5% to 10% patients due to difficult anatomy/inability to cannulate the papilla. Recently, endoscopic ultrasound guided biliary drainage (EUS-BD) has been described. Primary outcomes were to evaluate the biliary drainage success rates with EUS and compare it to percutaneous transhepatic biliary drainage (PTBD). Secondary outcomes were to evaluate overall procedure related complications. Methods: Study selection criteria: Studies evaluating the efficacy of EUS-BD and comparing EUS-BD versus PTBD in inoperable malignant biliary stricture patients with a failed ERCP were included in this analysis. Data collection and extraction: Articles were searched in Medline, PubMed, and Ovid journals. Two authors independently searched and extracted data. The study design was written in accordance to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Subgroup analyses of prospective studies and EUS-BD versus PTBD were performed. Statistical method: Pooled proportions were calculated using fixed and random effects model. I2 statistic was used to assess heterogeneity among studies. Results: Initial search identified 846 reference articles, of which 124 were selected and reviewed. Sixteen studies (N = 528) that met the inclusion criteria were included in this analysis. In the pooled patient population, the percentage of patients that had a successful biliary drainage with EUS was 90.91% (95% CI = 88.10–93.38). The proportion of patients that had overall procedure related complications with EUS-PD was 16.46% (95% CI = 13.20–20.01). The pooled odds ratio for successful biliary drainage in EUS-PD versus PTBD group was 3.06 (95% CI = 1.11–8.43). The risk difference for overall procedure related complications in EUS-PD versus PTBD group was −0.21 (95% CI = −0

  14. Recurrent arthralgias in a patient with previous Mayaro fever infection.

    PubMed

    Taylor, Shawn F; Patel, Paresh R; Herold, Thomas J S

    2005-04-01

    Mayaro fever is an acute, self-limited, febrile, mosquito-borne viral disease manifested by fever, chills, headache, myalgias, and arthralgias. The virus belongs to the family Togaviridae and the genus Alphavirus. Five other mosquito-borne viruses have been described as causing a similar dengue-like illness. The virus was first isolated in 1954, and the first epidemics were described in 1955 in Brazil and Bolivia. Other cases have been reported in Suriname, Brazil, Peru, French Guiana, and Trinidad. Up to 10 to 15% of febrile illnesses in endemic areas have been attributed to Mayaro virus. The exact pathogenesis and pathophysiology among humans is unknown. Animal models have demonstrated necrosis of skeletal muscle, periosteum, perichondrial tissues, and evidence of meningitis and encephalitis. All previous cases of Mayaro fever describe a self-limited illness. No reports of recurrent symptoms exist in the literature. This report describes a case of recurrent arthralgias in a military service member presenting to the emergency department.

  15. MoCha: Molecular Characterization of Unknown Pathways.

    PubMed

    Lobo, Daniel; Hammelman, Jennifer; Levin, Michael

    2016-04-01

    Automated methods for the reverse-engineering of complex regulatory networks are paving the way for the inference of mechanistic comprehensive models directly from experimental data. These novel methods can infer not only the relations and parameters of the known molecules defined in their input datasets, but also unknown components and pathways identified as necessary by the automated algorithms. Identifying the molecular nature of these unknown components is a crucial step for making testable predictions and experimentally validating the models, yet no specific and efficient tools exist to aid in this process. To this end, we present here MoCha (Molecular Characterization), a tool optimized for the search of unknown proteins and their pathways from a given set of known interacting proteins. MoCha uses the comprehensive dataset of protein-protein interactions provided by the STRING database, which currently includes more than a billion interactions from over 2,000 organisms. MoCha is highly optimized, performing typical searches within seconds. We demonstrate the use of MoCha with the characterization of unknown components from reverse-engineered models from the literature. MoCha is useful for working on network models by hand or as a downstream step of a model inference engine workflow and represents a valuable and efficient tool for the characterization of unknown pathways using known data from thousands of organisms. MoCha and its source code are freely available online under the GPLv3 license.

  16. Long term follow up of through-the-scope balloon dilation as compared to strictureplasty and bowel resection of intestinal strictures in crohn’s disease

    PubMed Central

    Krauss, Ekaterina; Agaimy, Abbas; Gottfried, Angelina; Maiss, Juergen; Weidinger, Thomas; Albrecht, Heinz; Hartmann, Arndt; Hohenberger, Werner; Neurath, Markus F; Kessler, Hermann; Mudter, Jonas

    2014-01-01

    Background & aims: Ileo-colonic strictures are common complication of Crohn’s disease (CD), and may result in repeated endoscopic or surgical therapy with a risk of further complications, such as perforation or short bowel syndrome. Strictures develop as a consequence of tissue remodelling and fibrosis due to chronic inflammation. This study compares the outcome of CD patients undergoing primarily endoscopic treatment with those undergoing surgery at an university hospital. Methods: In this study we retrospectively included 88 CD patients with intestinal strictures (37 males, 51 females, mean age 40 years, range 19-65 years) of both our medical and our surgical department, who underwent either surgical or endoscopic therapy between January 2002 and January 2006 with prospective, controlled follow-up, extended till January 2010 (mean follow-up period: 5 years; range 4-8 years). The primary end-point was operation- and symptom-free time. Patients were primarily divided into four groups: only surgical therapy, only endoscopic therapy, endoscopy with subsequent surgery, and initial surgical therapy followed by endoscopic dilations. Results: 53% of all patients remained surgery-free with mean follow-up of 49 months; a single endoscopic dilation was sufficient enough in 9 patients to achieve a surgery-free time of 51 months, other patients required up to 5 dilations. The average interval between first and second dilation was 6.5 months, between second and third 10.5 months. In the group of patients with only endoscopic therapy, surgery- and symptom-free time was shorter, as compared to the group of only surgical therapy. We found that stenoses in the surgical group with an average length of 6.5 cm were as expected longer, as compared to the endoscopic group (3 cm, ranging from 2-4 cm). The surgery-free time was 49 months (42-71 months, P = 0.723) with a symptom-free time of 12 months (4.5-46 months, P = 0.921). In the group of only surgically treated patients, 68.4% of

  17. Placement of a new fully covered self-expanding metal stent for postoperative biliary strictures and leaks not responding to plastic stenting.

    PubMed

    Luigiano, Carmelo; Bassi, Marco; Ferrara, Francesco; Fabbri, Carlo; Ghersi, Stefania; Morace, Carmela; Consolo, Pierluigi; Maimone, Antonella; Galluccio, Gabriella; D'Imperio, Nicola; Cennamo, Vincenzo

    2013-04-01

    Fully covered self-expanding metal stents (FCSEMSs) are now being used to treat postoperative biliary strictures (BSs) and biliary leaks (BLs). The aim of this study was to assess the safety and effectiveness of a new FCSEMS (Wallflex) in patients with postoperative BSs and BLs after failure of traditional endoscopic treatment. Between January 2010 and December 2011, 16 patients (10 patients with postcholecystectomy BSs, 4 with postcholecystectomy BLs, and 2 with postorthotopic liver transplantation BSs) were enrolled. The technical and clinical success rate was 100%. All FCSEMSs were removed after a mean of 141 days. Complications occurred in 7 cases: 2 postprocedure pain, 2 mild pancreatitis, 1 early distal, and 2 late proximal FCSEMS migration. The overall long-term clinical success rate was 94% after a mean follow-up of 13 months. In our experience, the placement of FCSEMSs is an effective and secure method of treating refractory postoperative BSs or BLs.

  18. Central suboptimal H ∞ controller design for linear time-varying systems with unknown parameters

    NASA Astrophysics Data System (ADS)

    Basin, Michael V.; Soto, Pedro; Calderon-Alvarez, Dario

    2011-05-01

    This article presents the central finite-dimensional H ∞ controller for linear time-varying systems with unknown parameters, that is suboptimal for a given threshold γ with respect to a modified Bolza-Meyer quadratic criterion including the attenuation control term with the opposite sign. In contrast to the previously obtained results, this article reduces the original H ∞ controller problem to the corresponding H 2 controller problem, using the technique proposed in Doyle et al. [Doyle, J.C., Glover, K., Khargonekar, P.P., and Francis, B.A. (1989), 'State-space Solutions to Standard H 2 and H Infinity Control Problems', IEEE Transactions Automatic Control, 34, 831-847]. This article yields the central suboptimal H ∞ controller for linear systems with unknown parameters in a closed finite-dimensional form, based on the corresponding H 2 controller obtained in Basin and Calderon-Alvarez [Basin, M.V., and Calderon-Alvarez, D. (2008), 'Optimal LQG Controller for Linear Systems with Unknown Parameters', Journal of The Franklin Institute, 345, 293-302]. Numerical simulations are conducted to verify performance of the designed central suboptimal controller for uncertain linear systems with unknown parameters against the conventional central suboptimal H ∞ controller for linear systems with exactly known parameter values.

  19. The Use of Biodegradable Stents in Malignant Oesophageal Strictures for the Treatment of Dysphagia Before Neoadjuvant Treatment or Radical Radiotherapy: A Feasibility Study

    SciTech Connect

    Krokidis, Miltiadis Burke, Chris; Spiliopoulos, Stavros; Gkoutzios, Panos; Hynes, Orla; Ahmed, Irfan; Dourado, Renato; Sabharwal, Tarun; Mason, Robert; Adam, Andreas

    2013-08-01

    PurposeTo evaluate the clinical results of the use of biodegradable oesophageal stents in malignant strictures.MethodsEleven patients were included in this prospective analysis in which a woven polydioxanone biodegradable oesophageal stent was used. The inclusion criterion was that the patient underwent neoadjuvant treatment or radical radiotherapy after the stent insertion. Primary end points were dysphagia score at discharge, stent patency, and complication rate. Secondary end points were overall survival and surgical outcome of surgery.ResultsThere was a 100 % procedure technical success rate. Early complications occurred in three patients resulting in failure to restore oral nutrition. In the remaining eight patients, dysphagia was significantly improved at discharge. Mean stent patency rate in this group was 71.5 days. Stent dysfunction occurred in five of eight patients (62.5 %); in two of five patients this was due to local inflammatory reaction, and in three of five patients it was due to tumour growth after a mean time of 97.8 days, and a new metallic stent was consequently placed in four of five patients. One patient was successfully treated with esophagectomy. At the end of follow-up (mean time 102.1 days), three of eight stents were patent. The overall patient survival rate was 81.8 %.ConclusionAlthough short-term dysphagia scores improved, biodegradable stents do not appear to offer a clear beneficial effect in most cases of malignant strictures, particularly due to a local inflammatory reaction that may be induced. Technical improvement of the device and delineation of the patient group that would benefit from its use is necessary if further studies are to be conducted in the future.

  20. Molecular toolbox for the identification of unknown genetically modified organisms.

    PubMed

    Ruttink, Tom; Demeyer, Rolinde; Van Gulck, Elke; Van Droogenbroeck, Bart; Querci, Maddalena; Taverniers, Isabel; De Loose, Marc

    2010-03-01

    Competent laboratories monitor genetically modified organisms (GMOs) and products derived thereof in the food and feed chain in the framework of labeling and traceability legislation. In addition, screening is performed to detect the unauthorized presence of GMOs including asynchronously authorized GMOs or GMOs that are not officially registered for commercialization (unknown GMOs). Currently, unauthorized or unknown events are detected by screening blind samples for commonly used transgenic elements, such as p35S or t-nos. If (1) positive detection of such screening elements shows the presence of transgenic material and (2) all known GMOs are tested by event-specific methods but are not detected, then the presence of an unknown GMO is inferred. However, such evidence is indirect because it is based on negative observations and inconclusive because the procedure does not identify the causative event per se. In addition, detection of unknown events is hampered in products that also contain known authorized events. Here, we outline alternative approaches for analytical detection and GMO identification and develop new methods to complement the existing routine screening procedure. We developed a fluorescent anchor-polymerase chain reaction (PCR) method for the identification of the sequences flanking the p35S and t-nos screening elements. Thus, anchor-PCR fingerprinting allows the detection of unique discriminative signals per event. In addition, we established a collection of in silico calculated fingerprints of known events to support interpretation of experimentally generated anchor-PCR GM fingerprints of blind samples. Here, we first describe the molecular characterization of a novel GMO, which expresses recombinant human intrinsic factor in Arabidopsis thaliana. Next, we purposefully treated the novel GMO as a blind sample to simulate how the new methods lead to the molecular identification of a novel unknown event without prior knowledge of its transgene

  1. Sectioning and super-resolution using unknown random patterns

    NASA Astrophysics Data System (ADS)

    Hoffman, Zachary R.; DiMarzio, Charles A.

    2016-03-01

    Random structured illumination patterns are used to demonstrate effective sectioning as well as super-resolution images in conjunction with an incoherent light source. By projecting patterns of varied spatial frequencies and using blind deconvolution of an unknown point spread function, super-resolution is achieved. Random patterns produce more consistent sectioning and super-resolution given an unknown optical transfer function. Further, using a randomly distributed pattern provides a low cost solution to obtaining information similar to that produced in confocal microscopy and other methods of structured illumination, without the requirement of precise projection patterns, coherent light sources, or fluorescence.

  2. 17. Photographic copy of photograph. Location unknown but assumed to ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. Photographic copy of photograph. Location unknown but assumed to be uper end of canal. Features no longer extant. (Source: U.S. Department of Interior. Office of Indian Affairs. Indian Irrigation service. Annual Report, Fiscal Year 1925. Vol. I, Narrative and Photographs, Irrigation District #4, California and Southern Arizona, RG 75, Entry 655, Box 28, National Archives, Washington, DC.) Photographer unknown. MAIN (TITLED FLORENCE) CANAL, WASTEWAY, SLUICEWAY, & BRIDGE, 1/26/25. - San Carlos Irrigation Project, Marin Canal, Amhurst-Hayden Dam to Picacho Reservoir, Coolidge, Pinal County, AZ

  3. On Known Unknowns: Fluency and the Neural Mechanisms of Illusory Truth.

    PubMed

    Wang, Wei-Chun; Brashier, Nadia M; Wing, Erik A; Marsh, Elizabeth J; Cabeza, Roberto

    2016-05-01

    The "illusory truth" effect refers to the phenomenon whereby repetition of a statement increases its likelihood of being judged true. This phenomenon has important implications for how we come to believe oft-repeated information that may be misleading or unknown. Behavioral evidence indicates that fluency, the subjective ease experienced while processing information, underlies this effect. This suggests that illusory truth should be mediated by brain regions previously linked to fluency, such as the perirhinal cortex (PRC). To investigate this possibility, we scanned participants with fMRI while they rated the truth of unknown statements, half of which were presented earlier (i.e., repeated). The only brain region that showed an interaction between repetition and ratings of perceived truth was PRC, where activity increased with truth ratings for repeated, but not for new, statements. This finding supports the hypothesis that illusory truth is mediated by a fluency mechanism and further strengthens the link between PRC and fluency.

  4. Estimating unknown input parameters when implementing the NGA ground-motion prediction equations in engineering practice

    USGS Publications Warehouse

    Kaklamanos, James; Baise, Laurie G.; Boore, David M.

    2011-01-01

    The ground-motion prediction equations (GMPEs) developed as part of the Next Generation Attenuation of Ground Motions (NGA-West) project in 2008 are becoming widely used in seismic hazard analyses. However, these new models are considerably more complicated than previous GMPEs, and they require several more input parameters. When employing the NGA models, users routinely face situations in which some of the required input parameters are unknown. In this paper, we present a framework for estimating the unknown source, path, and site parameters when implementing the NGA models in engineering practice, and we derive geometrically-based equations relating the three distance measures found in the NGA models. Our intent is for the content of this paper not only to make the NGA models more accessible, but also to help with the implementation of other present or future GMPEs.

  5. 36. Historic photograph, photographer unknown, c. 1943. PHOTOGRAPH OF GEORGE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    36. Historic photograph, photographer unknown, c. 1943. PHOTOGRAPH OF GEORGE E. SMITH (RIGHT), ONE OF THE PRINCIPAL BUILDERS OF THE VERDE RIVER SHEEP BRIDGE AND HIS SON, B. L. 'LES' SMITH. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  6. 33. Historic photograph, photographer unknown, February 13, 1944. VIEW OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    33. Historic photograph, photographer unknown, February 13, 1944. VIEW OF HORSESHOE DAM SITE BRIDGE, LOOKING WEST, SHOWING BRIDGE SPANNING THE VERDE RIVER JUST AS WORK ON THE DAM IS BEGINNING. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  7. 15. Photocopy of color photograph (Photographer unknown, 1974) SACRISTY ATTIC, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Photocopy of color photograph (Photographer unknown, 1974) SACRISTY ATTIC, LOOKING SOUTHWEST. NOTE RAMMED EARTH WALL (NORTH WALL OF CHANCEL) AT LEFT; HOLES WERE LEFT BY WOODEN BRACES USED TO HOLD WALL FORMS DURING CONSTRUCTION - Church of the Holy Cross, State Route 261, Stateburg, Sumter County, SC

  8. 22. Photographic copy of photograph, photographer unknown, 17 August 1907 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. Photographic copy of photograph, photographer unknown, 17 August 1907 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "Keechelus Crib Dam. View dam from right bank of river, showing downstream face and apron of dam". - Keechelus Dam, Yakima River, 10 miles northwest of Easton, Easton, Kittitas County, WA

  9. 10. PHOTOCOPY OF PHOTOGRAPH: WEST FRONT AT NIGHT, Date unknown. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. PHOTOCOPY OF PHOTOGRAPH: WEST FRONT AT NIGHT, Date unknown. from FOURTH CHURCH OF CHRIST, SCIENTIST ARCHIVE (used with permission) E. S. Cheney and R. B. Bird, Photographers Cheney Photo Adv. Co., Oakland, California - Fourth Church of Christ, Scientist, 1330 Lakeshore Avenue, Oakland, Alameda County, CA

  10. 14. PHOTOCOPY OF PHOTOGRAPH: DOMED CEILING OF AUDITORIUM, Date unknown. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. PHOTOCOPY OF PHOTOGRAPH: DOMED CEILING OF AUDITORIUM, Date unknown. from FOURTH CHURCH OF CHRIST, SCIENTIST ARCHIVE (used with permission) E. S. Cheney and R. B. Bird, Photographers, Cheney Photo Adv. Co., Oakland, California. - Fourth Church of Christ, Scientist, 1330 Lakeshore Avenue, Oakland, Alameda County, CA

  11. 41. Photocopy of progress photograph ca. 1974, photographer unknown. Original ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    41. Photocopy of progress photograph ca. 1974, photographer unknown. Original photograph Property of United States Air Force, 21" Space Command. This is the source for views 41 to 47. CAPE COD AIR STATION PAVE PAWS FACILITY - SHOWING BUILDING "RED IRON" STEEL STRUCTURE NEARING COMPLETION. - Cape Cod Air Station, Technical Facility-Scanner Building & Power Plant, Massachusetts Military Reservation, Sandwich, Barnstable County, MA

  12. 39. Photocopy of building model photograph, ca. 1974, photographer unknown. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    39. Photocopy of building model photograph, ca. 1974, photographer unknown. Original photograph property of United States Air Force, 21" Space Command. CAPE COD AIR STATION PAVE PAWS FACILITY MODEL - SHOWING "A" AND "B" FACES. - Cape Cod Air Station, Technical Facility-Scanner Building & Power Plant, Massachusetts Military Reservation, Sandwich, Barnstable County, MA

  13. 40. Photocopy of building model photograph, ca., 1974, photographer unknown. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    40. Photocopy of building model photograph, ca., 1974, photographer unknown. Original photograph property of United States Air Force, 21" Space Command. CAPE COD AIR STATION PAVE PAWS FACILITY MODEL - ELEVATION SHOWING FLOOR AND EQUIPMENT LAYOUT. - Cape Cod Air Station, Technical Facility-Scanner Building & Power Plant, Massachusetts Military Reservation, Sandwich, Barnstable County, MA

  14. Unknown input observer design and analysis for networked control systems

    NASA Astrophysics Data System (ADS)

    Taha, Ahmad F.; Elmahdi, Ahmed; Panchal, Jitesh H.; Sun, Dengfeng

    2015-05-01

    The insertion of communication networks in the feedback loops of control systems is a defining feature of modern control systems. These systems are often subject to unknown inputs in a form of disturbances, perturbations, or attacks. The objective of this paper is to design and analyse an observer for networked dynamical systems with unknown inputs. The network effect can be viewed as either a perturbation or time-delay to the exchanged signals. In this paper, we (1) review an unknown input observer (UIO) design for a non-networked system, (2) derive the networked unknown input observer (NetUIO) dynamics, (3) design a NetUIO such that the effect of higher delay order terms are nullified and (4) establish stability-guaranteeing bounds on the networked-induced time-delay and perturbation. The formulation and results derived in this paper can be generalised to scenarios and applications where the signals are perturbed due to a different source of perturbation or delay.

  15. 390. Delineator Unknown October 1933 STATE OF CALIFORNIA; DEPARTMENT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    390. Delineator Unknown October 1933 STATE OF CALIFORNIA; DEPARTMENT OF PUBLIC WORKS; SAN FRANCISCO - OAKLAND BAY BRIDGE; SUPERSTRUCTURE - EAST BAY CROSSING; SPANS YBI TO El - E9 TO El ; TYPICAL CROSSSECTION; CONTRACT NO. 7; SUP. DRAWING NO. 82 - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  16. 375. Delineator Unknown June 1933 STATE OF CALIFORNIA; DEPARTMENT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    375. Delineator Unknown June 1933 STATE OF CALIFORNIA; DEPARTMENT OF PUBLIC WORKS; SAN FRANCISCO - OAKLAND BAY BRIDGE; YERBA BUENA CROSSING; ANCHORAGE TUNNELS; CONTRACT NO. 5; DRAWING NO. 10A - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  17. 379. Delineator Unknown December 1932 STATE OF CALIFORNIA; DEPARTMENT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    379. Delineator Unknown December 1932 STATE OF CALIFORNIA; DEPARTMENT OF PUBLIC WORKS; SAN FRANCISCO - OAKLAND BAY BRIDGE; CABLES AND ATTACHMENTS - WEST BAY CROSSING; SPLAY CASTINGS; CONTRACT NO. 6A; DRAWING NO. 4 - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  18. 385. Delineator Unknown December 1932 STATE OF CALIFORNIA; DEPARTMENT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    385. Delineator Unknown December 1932 STATE OF CALIFORNIA; DEPARTMENT OF PUBLIC WORKS; SAN FRANCISCO - OAKLAND BAY BRIDGE; SUPERSTRUCTURE - WEST BAY CROSSING; ROCKER POSTS AND BEARING; CONTRACT NO. 6; DRAWINGS NO. 42 - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  19. 380. Delineator Unknown December 1932 STATE OF CALIFORNIA; DEPARTMENT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    380. Delineator Unknown December 1932 STATE OF CALIFORNIA; DEPARTMENT OF PUBLIC WORKS; SAN FRANCISCO - OAKLAND BAY BRIDGE; CABLES & ATTACHMENTS WEST BAY CROSSING; CABLE BANDS; CONTRACT NO. 6A; DRAWING NO. 3 - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  20. 37 CFR 253.9 - Unknown copyright owners.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Unknown copyright owners. 253.9 Section 253.9 Patents, Trademarks, and Copyrights U.S. COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT ARBITRATION ROYALTY PANEL RULES AND PROCEDURES USE OF CERTAIN COPYRIGHTED WORKS IN CONNECTION...

  1. 37 CFR 260.7 - Unknown copyright owners.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Unknown copyright owners. 260.7 Section 260.7 Patents, Trademarks, and Copyrights U.S. COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT ARBITRATION ROYALTY PANEL RULES AND PROCEDURES RATES AND TERMS FOR PREEXISTING...

  2. 4. VIEW NORTHEAST, radar tower (unknown function), prime search radar ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. VIEW NORTHEAST, radar tower (unknown function), prime search radar tower, emergency power building, and height finder radar tower - Fort Custer Military Reservation, P-67 Radar Station, .25 mile north of Dickman Road, east of Clark Road, Battle Creek, Calhoun County, MI

  3. 5. VIEW EAST, height finder radar towers, radar tower (unknown ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. VIEW EAST, height finder radar towers, radar tower (unknown function), prime search radar tower, operations building, and central heating plant - Fort Custer Military Reservation, P-67 Radar Station, .25 mile north of Dickman Road, east of Clark Road, Battle Creek, Calhoun County, MI

  4. Oral cancer, fever of unknown origin, and listeriosis.

    PubMed

    Morritt, A N; Mclean, N R; Snow, M H

    2002-10-01

    Listeriosis is a rare cause of fever of unknown origin in patients with oral cancer. We report two patients who, because of pain and discomfort, ate large quantities of soft cheeses; this caused listeriosis and fever. Both cases responded to high doses of amoxycillin.

  5. 17. Historic photograph, photographer unknown, 1943. ENLARGEMENT OF PORTION OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. Historic photograph, photographer unknown, 1943. ENLARGEMENT OF PORTION OF PHOTOGRAPH AZ-10-16, SHOWING WOOD TOWER BEFORE CONCRETE WAS ADDED. NOTE GUY CABLE CONNECTED TO TOP RIGHT OF TOWER. - Verde River Sheep Bridge, Spanning Verde River (Tonto National Forest), Cave Creek, Maricopa County, AZ

  6. 402. Delineator Unknown May 2, 1933 STUDY FOR SUSPENSION TOWERS; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    402. Delineator Unknown May 2, 1933 STUDY FOR SUSPENSION TOWERS; SAN FRANCISCO - OAKLAND BAY BRIDGE; TIMOTHY L. PFLUEGER, ARTHUR BROWN JR., JOHN J. DONOVAN; BOARD OF CONSULTING ARCHITECTS; SCHEME 1A - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  7. 404. Delineator Unknown June 1, 1933 STUDY FOR TOP OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    404. Delineator Unknown June 1, 1933 STUDY FOR TOP OF SUSPENSION TOWERS; SAN FRANCISCO OAKLAND BAY BRIDGE; TIMOTHY L. PFLUEGER, ARTHUR BROWN JR., JOHN J. DONOVAN; BOARD OF CONSULTING ARCHITECTS; SCHEME 7-A - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  8. 407. Delineator Unknown July 11, 1933 PERSPECTIVE STUDY OF SAN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    407. Delineator Unknown July 11, 1933 PERSPECTIVE STUDY OF SAN FRANCISCO ANCHORAGE; SAN FRANCISCO - OAKLAND BAY BRIDGE; TIMOTHY L. PFLUEGER, ARTHUR BROWN JR., JOHN J. DONOVAN; BOARD OF CONSULTING ARCHITECTS; SHEET 12 - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  9. 403. Delineator Unknown May 2, 1933 STUDY FOR SUSPENSION TOWERS; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    403. Delineator Unknown May 2, 1933 STUDY FOR SUSPENSION TOWERS; SAN FRANCISCO - OAKLAND BAY BRIDGE; TIMOTHY L. PFLUEGER, ARTHUR BROWN JR., JOHN J. DONOVAN; BOARD OF CONSULTING ARCHITECTS; SCHEME 2 - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  10. 406. Delineator Unknown April 19, 1933 ELEVATION STUDY FOR SAN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    406. Delineator Unknown April 19, 1933 ELEVATION STUDY FOR SAN FRANCISCO ANCHORAGE; SAN FRANCISCO - OAKLAND BAY BRIDGE; BOARD OF CONSULTING ARCHITECTS; TIMOTHY L. PFLUEGER, ARTHUR BROWN JR., JOHN J. DONOVAN; SHEET 23 - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  11. 408. Delineator Unknown September 19, 1933 SAN FRANCISCO OAKLAND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    408. Delineator Unknown September 19, 1933 SAN FRANCISCO - OAKLAND BAY BRIDGE; STUDY FOR SAN FRANCISCO ANCHORAGE; TIMOTHY L. PFLUEGER, ARTHUR BROWN JR., JOHN J. DONOVAN; BOARD OF CONSULTING ARCHITECTS; SHEET NO. 26 - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  12. Photographic copy of photograph, photographer unknown, July 1911 (original print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, July 1911 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "ORANGE-PEEL EXCAVATOR DREDGING OUTLET CHANNEL" - Kachess Dam, Inlet Channel, Kachess River, 1.5 miles north of Interstate 90, Easton, Kittitas County, WA

  13. Photographic copy of photograph, photographer unknown, 4 April 1911 (original ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 4 April 1911 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "LOOKING SOUTH FROM INTAKE OF CONDUIT. LIDGERWOOD EXCAVATOR WORKING ON TRENCH EXCAVATION. TEMPORARY TOWER ON RIGHT" - Kachess Dam, Inlet Channel, Kachess River, 1.5 miles north of Interstate 90, Easton, Kittitas County, WA

  14. 27. Photographic copy of photograph, photographer unknown, 15 October 1913 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    27. Photographic copy of photograph, photographer unknown, 15 October 1913 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "Pile driver driving piling for core-wall. Moving for the next pile." - Keechelus Dam, Yakima River, 10 miles northwest of Easton, Easton, Kittitas County, WA

  15. 38. Photocopy of photograph (Pentran file), photographer unknown. Bus garage ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    38. Photocopy of photograph (Pentran file), photographer unknown. Bus garage to left now demolished. Trolley car drivers, maintenance personnel and management staff in 1915. VIEW SOUTH - Newport News & Old Point Railway & Electric Company, Trolley Barn & Administration Building, 3400 Victoria Boulevard, Hampton, Hampton, VA

  16. 45. Photocopy of photograph (Pentran file), photographer and date unknown ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    45. Photocopy of photograph (Pentran file), photographer and date unknown (circa 1900). A single truck, solid mahagony car which ran between Hampton, Phoebus and Old Point Comfort. - Newport News & Old Point Railway & Electric Company, Trolley Barn & Administration Building, 3400 Victoria Boulevard, Hampton, Hampton, VA

  17. Photographic copy of photograph, photographer unknown, September 1912 (original print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, September 1912 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "BLASTING IN LAKE (DREDGE) HT. 500'." - Kachess Dam, Inlet Channel, Kachess River, 1.5 miles north of Interstate 90, Easton, Kittitas County, WA

  18. 18. Photocopy of photograph. Horgan, date unknown. Original negative can ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. Photocopy of photograph. Horgan, date unknown. Original negative can be found in D & H collection of the Anthracite Heritage Museum, Scranton, Pennsylvania. DETAIL VIEW OF SLUSH TROUGH FROM BREAKER NO. 2 TO BOREHOLE UNDER NORTH END OF BOILER HOUSE NO. 2, LOOKING SOUTH - Marvine Colliery, Breaker No. 2, West side Boulevard Avenue, between East Parker Street & Route 380, Scranton, Lackawanna County, PA

  19. 192. Photocopy of drawing, Twin Falls Canal Company, date unknown. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    192. Photocopy of drawing, Twin Falls Canal Company, date unknown. TOPOGRAPHICAL MAP (DAM DRAWN IN), MILNER SITE, TWIN FALLS COUNTY, MILNER, IDAHO; RIGHT SIDE OF MAP (LEFT ON ID-15-183). - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

  20. 187. Photocopy of drawing, Twin Falls Canal Company, date unknown. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    187. Photocopy of drawing, Twin Falls Canal Company, date unknown. TOPOGRAPHICAL MAP OF MILNER DAM LOCATION, TWIN FALLS COUNTY, MILNER, IDAHO; BLUEPRINT MAP. - Milner Dam & Main Canal: Twin Falls Canal Company, On Snake River, 11 miles West of city of Burley, Idaho, Twin Falls, Twin Falls County, ID

  1. 2. Historic American Buildings Survey Photographer Unknown. PHOTOGRAPH OF AN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. Historic American Buildings Survey Photographer Unknown. PHOTOGRAPH OF AN AERIAL PHOTOGRAPH BOUGHT AT THE KIMO CURIO SHOP IN ALBUQUERQUE N.M. IN 1928. SHOWS ENTIRE VILLAGE AND THE CHURCH. - Pueblo of Acoma, Casa Blanca vicinity, Acoma Pueblo, Cibola County, NM

  2. Photographic copy of photograph, photographer unknown, 1908 (original print located ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 1908 (original print located at National Archives and Records Administration, Denver, Colorado). "CONSTRUCTION - BOISE RIVER DIVERSION DAM" WITH OVERFLOW SECTION IN FOREGROUND - Boise Project, Boise River Diversion Dam, Across Boise River, Boise, Ada County, ID

  3. Concentration for unknown atomic entangled states via cavity decay

    SciTech Connect

    Cao Zhuoliang; Yang Ming; Zhang Lihua

    2006-01-15

    We present a physical scheme for entanglement concentration of unknown atomic entangled states via cavity decay. In the scheme, the atomic state is used as a stationary qubit and the photonic state as a flying qubit, and a close maximally entangled state can be obtained from pairs of partially entangled states probabilistically.

  4. Photocopy of photograph (from NBPPNSY) photographer unknown, 1988 view east ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph (from NBP-PNSY) photographer unknown, 1988 view east of marine railway (Haer no. Pa-387-W). The railway was being dismantled at the time this photograph was taken. - Naval Base Philadelphia-Philadelphia Naval Shipyard, League Island, Philadelphia, Philadelphia County, PA

  5. 6. Photographic copy of photograph. No date. Photographer unknown. (Source: ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. Photographic copy of photograph. No date. Photographer unknown. (Source: SCIP office, Coolidge, AZ) CHINA WASH FLUME UNDER CONSTRUCTION - San Carlos Irrigation Project, China Wash Flume, Main (Florence-Case Grande) Canal at Station 137+00, T4S, R10E, S14, Coolidge, Pinal County, AZ

  6. 17. Photographic copy of photograph dated ca. 1937; Photographer unknown; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. Photographic copy of photograph dated ca. 1937; Photographer unknown; Original in Rath collection at Grout Museum, Waterloo, Iowa; Filed uner: Rath Packing Company, Box 4; POWER PLANT (BUILDING 27), LEFT; LARD REFINERY (BUILDING 93), CENTER; AND MANUFACTURING BUILDING (BUILDING 88), RIGHT - Rath Packing Company, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

  7. Photocopy of photograph (from NBPPNSY) photographer unknown, April 13, 1964. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph (from NBP-PNSY) photographer unknown, April 13, 1964. View south of drydock no. 2 (Haer no. Pa-387-B) with the destroyer U.S.S Vesole (DD-878) undergoing a fleet moderinzation and repair modernization (frame). - Naval Base Philadelphia-Philadelphia Naval Shipyard, League Island, Philadelphia, Philadelphia County, PA

  8. A Size Exclusion Chromatography Laboratory with Unknowns for Introductory Students

    ERIC Educational Resources Information Center

    McIntee, Edward J.; Graham, Kate J.; Colosky, Edward C.; Jakubowski, Henry V.

    2015-01-01

    Size exclusion chromatography is an important technique in the separation of biological and polymeric samples by molecular weight. While a number of laboratory experiments have been published that use this technique for the purification of large molecules, this is the first report of an experiment that focuses on purifying an unknown small…

  9. Deriving Unknown Word Meaning from Context: Is It Reliable?

    ERIC Educational Resources Information Center

    Kaivanpanah, Shiva; Alavi, Mohammad

    2008-01-01

    Language teachers often encourage L2 readers to guess the meaning of unknown words in texts. This paper argues that before any statements about the value of guessing can be made, it is necessary to show how reliable learners' guesses are. To this end, the present study investigates how accurately EFL learners assess their understanding of unknown…

  10. Photocopy of photograph (from NBPPNSY) photographer unknown, September 23, 1941 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph (from NBP-PNSY) photographer unknown, September 23, 1941 view northwest of caisson for drydock no. 2 (Haer no. Pa-387-B) in drydock no. 1 (Haer no. PA-387-A) for overhaul and repair of rubber gasket. - Naval Base Philadelphia-Philadelphia Naval Shipyard, League Island, Philadelphia, Philadelphia County, PA

  11. 374. Delineator Unknown June 1933 STATE OF CALIFORNIA; DEPARTMENT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    374. Delineator Unknown June 1933 STATE OF CALIFORNIA; DEPARTMENT OF PUBLIC WORKS; SAN FRANCISCO - OAKLAND BAY BRIDGE; YERBA BUENA CROSSING; EYE BAR CHAIN; CONTRACT NO. 5; SUP. DRAWING NO. 12A - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  12. 362. Delineator Unknown June 1933 STATE OF CALIFORNIA; DEPARTMENT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    362. Delineator Unknown June 1933 STATE OF CALIFORNIA; DEPARTMENT OF PUBLIC WORKS; SAN FRANCISCO - OAKLAND BAY BRIDGE; SAN FRANCISCO ANCHORAGE; EYE BAR ANCHOR CHAIN; CONTRACT NO. 3; SUP. DRAWING NO. 11-A - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  13. 10 CFR 71.83 - Assumptions as to unknown properties.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Assumptions as to unknown properties. 71.83 Section 71.83 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL... fissile material in any package is not known, the licensee shall package the fissile material as if...

  14. 15. Photographic copy of photograph dated ca. 1929; Photographer unknown; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Photographic copy of photograph dated ca. 1929; Photographer unknown; Original in Rath collection at Grout Museum, Waterloo, Iowa; Filed under: Rath Packing Company, Box 4; THE RATH COMPLEX IN THE LATE 1920S; LOOKING WEST FROM 18TH STREET; LARGE BUILDING AT CENTER IS HOG KILL (BUILDING 40) - Rath Packing Company, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

  15. The Unknowns and Possible Implications of Mandatory Labeling.

    PubMed

    McFadden, Brandon R

    2017-01-01

    The National Bioengineered Food Disclosure Standard requires a mandatory label for genetically modified (GM) food. Currently, some aspects of the bill are unknown, including what constitutes a food to be considered GM. The costs associated with this legislation will depend on how actors in the food value chain respond.

  16. 1. Drop Structure on the Arizona Crosscut Canal. Photographer unknown, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Drop Structure on the Arizona Crosscut Canal. Photographer unknown, no date. Note that caption is incorrect: in relation to Camelback Mountain (rear), this can only be the Old Crosscut. Source: reprinted from the 13th Annual Report of the U.S. Geological Survey, 1893. - Old Crosscut Canal, North Side of Salt River, Phoenix, Maricopa County, AZ

  17. Photographic copy of photograph, photographer unknown, 1912 (original print located ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 1912 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "LINING OF OUTLET TUNNEL BELOW THE DAM" - Kachess Dam, Outlet Channel, Kachess River, 1.5 miles north of Interstate 90, Easton, Kittitas County, WA

  18. 9. Photocopy of photograph (location of original negative unknown) Thomas ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. Photocopy of photograph (location of original negative unknown) Thomas G. Pratt, Photographer, c. 1890 PERSPECTIVE VIEW OF WEST (FRONT) AND SOUTH SIDE AS LOCATED AND ALTERED AT PRESENT SITE - Hamilton Grange, (Moved From) 237 West 141 Street to 141st Street & Amsterdam, New York County, NY

  19. 6. Photographic copy of historic photograph (date and photograph unknown) ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. Photographic copy of historic photograph (date and photograph unknown) of upper dam showing retaining walls (original in possession of United States Department of Agriculture-Forest Service-Allegheny National Forest). VIEW WEST - Loleta Recreation Area, Upper Dam, 6 miles Southeast of interesection of State Route 24041 & State Route 66, Loleta, Elk County, PA

  20. Photographic copy of photograph, photographer unknown, ca. 1915 (original print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, ca. 1915 (original print located at Southern Ute Agency, Bureau of Indian Affairs Office, Ignacio, Colorado). Overall view of Southern Ute Agency Boarding School, with main building (boy's dormitory) at right. - Southern Ute Boarding School, Boy's Dormitory, Ouray & Capote Drives, Ignacio, La Plata County, CO

  1. Photographic copy of photograph, photographer unknown, 1942 (original print located ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 1942 (original print located at Southern UTE Agency, Bureau of Indian Affairs Office, Ignacio, Colorado). East rear and north side of boy's dormitory. - Southern Ute Boarding School, Boy's Dormitory, Ouray & Capote Drives, Ignacio, La Plata County, CO

  2. Photographic copy of photograph, photographer unknown, ca. 1930 (original print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, ca. 1930 (original print located at Colorado Historical Society, Denver, Colorado). Overall view of Southern UTE Agency Boarding School, with boys dormitory at center. - Southern Ute Boarding School, Boy's Dormitory, Ouray & Capote Drives, Ignacio, La Plata County, CO

  3. Photographic copy of photograph, photographer unknown, ca. 1930 (original print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, ca. 1930 (original print located at Colorado Historical Society, Denver, Colorado). Overall views of Southern Ute Agency Boarding School, with boys' dormitory at left of lower view. - Southern Ute Boarding School, Boy's Dormitory, Ouray & Capote Drives, Ignacio, La Plata County, CO

  4. Photographic copy of photograph, photographer unknown, 1942 (original print located ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, photographer unknown, 1942 (original print located at Southern UTE Agency, Bureau of Indian Affairs Office, Ignacio, Colorado). West front and south side of boy's dormitory. - Southern Ute Boarding School, Boy's Dormitory, Ouray & Capote Drives, Ignacio, La Plata County, CO

  5. 178. Photocopy of photograph, photographer unknown, 1927 (original print located ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    178. Photocopy of photograph, photographer unknown, 1927 (original print located at Rocky Mountain Arsenal, Commerce City, Colorado). MAURER CHILDREN. - Rocky Mountain Arsenal, Bounded by Ninety-sixth Avenue & Fifty-sixth Avenue, Buckley Road, Quebec Street & Colorado Highway 2, Commerce City, Adams County, CO

  6. 15. UPSTREAM VIEW (PHOTOGRAPHER UNKNOWN) SHOWING BIG DALTON DAM NEAR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. UPSTREAM VIEW (PHOTOGRAPHER UNKNOWN) SHOWING BIG DALTON DAM NEAR FULL CAPACITY AFTER CONSTRUCTION. PICTURE WAS DEVELOPED FROM COPY NEGATIVES WHICH WERE TAKEN ON 2-15-1973 BY PHOTOGRAPHER D. MEIER OF L.A. COUNTY PUBLIC WORKS. - Big Dalton Dam, 2600 Big Dalton Canyon Road, Glendora, Los Angeles County, CA

  7. 44. Photocopy of photograph, photographer unknown, 1415 June 1929 (original ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    44. Photocopy of photograph, photographer unknown, 14-15 June 1929 (original print located at Utah State Historical Society Photograph Collection, Salt Lake City UT). DEDICATION CEREMONY AT BRIDGE. - Navajo Bridge, Spanning Colorado River at U.S. Highway 89 Alternate, Page, Coconino County, AZ

  8. Unknown Gases: Student-Designed Experiments in the Introductory Laboratory.

    ERIC Educational Resources Information Center

    Hanson, John; Hoyt, Tim

    2002-01-01

    Introductory students design and carry-out experimental procedures to determine the identity of three unknown gases from a list of eight possibilities: air, nitrogen, oxygen, argon, carbon dioxide, helium, methane, and hydrogen. Students are excited and motivated by the opportunity to come up with their own experimental approach to solving a…

  9. 48. Photographic copy of photograph, photographer unknown, 5 September 1916 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    48. Photographic copy of photograph, photographer unknown, 5 September 1916 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "Piling logs with Washington donkey." - Keechelus Dam, Yakima River, 10 miles northwest of Easton, Easton, Kittitas County, WA

  10. 8. Photocopy of photograph, date unknown (original print on file ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. Photocopy of photograph, date unknown (original print on file at U.S. Army Intelligence Security Command, Fort Belvoir, Virginia). VIEW OF SULLINS COLLEGE, BRISTOL, VIRGINIA. SULLINS COLLEGE PRESIDENT WILLIAM MARTIN FOUNDED ARLINGTON HALL JUNIOR COLLEGE, AND APPEARS TO HAVE LOOSELY BASED THE DESIGN OF THE NEW SCHOOL'S BUILDINGS UPON THOSE AT SULLINS. - Arlington Hall Station, 4000 Arlington Boulevard, Arlington, Arlington County, VA

  11. 25. Photographic copy of undated photo; Photographer unknown; Original in ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    25. Photographic copy of undated photo; Photographer unknown; Original in Rath collection at Iowa State University Libraries, Ames, Iowa; Filed under: Rath Packing Company, Printed Photographs, Symbol M, Box 2; REMOVING HIDES ON THE SKINNING TABLE; CARCASSES IN HALF-HOIST POSITION; LOOKING SOUTH - Rath Packing Company, Beef Killing Building, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

  12. 24. Photographic copy of undated photo; Photographer unknown; Original in ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    24. Photographic copy of undated photo; Photographer unknown; Original in Rath collection at Iowa State University Libraries, Ames, Iowa; Filed under: Rath Packing Company, Printed Photographs, Symbol M, Box 2; REMOVING HIDES ON THE MOVING SKINNING TABLE; LOOKING NORTH - Rath Packing Company, Beef Killing Building, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

  13. 26. Photographic copy of undated photo; Photographer unknown; Original in ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    26. Photographic copy of undated photo; Photographer unknown; Original in Rath collection at Iowa State University Libraries, Ames, Iowa; Filed under: Rath Packing Company, Printed Photographs, Symbol M, Box 2; EVISCERATING CATTLE CARCASSES INSIDE BUILDING 149 - Rath Packing Company, Beef Killing Building, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

  14. 28. Photographic copy of undated photo; Photographer unknown; Original in ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    28. Photographic copy of undated photo; Photographer unknown; Original in Rath collection at Iowa State University Libraries, Ames, Iowa; Filed under: Rath Packing Company, Printed Photographs, Symbol M, Box 2; WORKERS STACKING HIDES IN THE CELLAR OF BUILDING 149 - Rath Packing Company, Beef Killing Building, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

  15. Detection of Answer Copying with Unknown Item and Trait Parameters.

    ERIC Educational Resources Information Center

    Wollack, James A.; Cohen, Allan S.

    1998-01-01

    Investigated empirical Type I error rates and the power of omega (index of answer copying developed by J. Wollack, 1997) when item and trait (theta) parameters were unknown and estimated from datasets of 100 and 500 examinees. Type I error was unaffected by estimating item parameters, with power slightly lower for the smaller sample. (SLD)

  16. 19. Photographer unknown, circa 1950 'THE LOOP OVER' BRIDGE WAS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    19. Photographer unknown, circa 1950 'THE LOOP OVER' BRIDGE WAS CONSTRUCTED ON NEWFOUND GAP ROAD TO REPLACE A SERIES OF DANGEROUS SWITCHBACKS. THIS ENGINEERING FEATURE QUICKLY BECAME A POPULAR TOURIST ATTRACTION. - Great Smoky Mountains National Park Roads & Bridges, Gatlinburg, Sevier County, TN

  17. Photographic copy of photograph, date unknown (original print located at ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, date unknown (original print located at the History Office, U.S. Army South, Fort Clayton, Republic of Panama). Early view of Fort Sherman from boat dock with theater in background, facing southwest. - Fort Sherman, Toro Point on Limon Bay, Colon, Former Panama Canal Zone, CZ

  18. 47. Photocopy of photograph, dated March 26, 1969, photographer unknown. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    47. Photocopy of photograph, dated March 26, 1969, photographer unknown. Original photograph property of the U.S. Coast Guard. STARBOARD SIDE OF BOW. - U.S. Coast Guard Cutter WHITE LUPINE, U.S. Coast Guard Station Rockland, east end of Tillson Avenue, Rockland, Knox County, ME

  19. 43. Photocopy of photograph, dated July 1, 1947, photographer unknown. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    43. Photocopy of photograph, dated July 1, 1947, photographer unknown. Original photograph property of the U.S. Coast Guard. PORT SIDE VIEW WHILE IN U.S. NAVY SERVICE AS YF 445. NOTE GRAY PAINT. - U.S. Coast Guard Cutter WHITE HEATH, USGS Integrated Support Command Boston, 427 Commercial Street, Boston, Suffolk County, MA

  20. 44. Photocopy of photograph, dated June 19, 1959, photographer unknown. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    44. Photocopy of photograph, dated June 19, 1959, photographer unknown. Original photograph property of the U.S. Coast Guard. PORT SIDE VIEW IN HARBOR. - U.S. Coast Guard Cutter WHITE LUPINE, U.S. Coast Guard Station Rockland, east end of Tillson Avenue, Rockland, Knox County, ME