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Sample records for retrograd intrarenal stenkirurgi en

  1. Miniperc and retrograde intrarenal surgery: when and how?

    PubMed

    Ramón de Fata, F; Hauner, K; Andrés, G; Angulo, J C; Straub, M

    2015-09-01

    Extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PCNL) are consolidated procedures for the treatment of kidney stones; however, their primary weak points are the lower efficacy of ESWL, especially for lower calyx stones, and the morbidity of PCNL resulting from the creation and dilation of the percutaneous trajectory. The increasing miniaturization of percutaneous surgery instrumentation and the development of retrograde intrarenal surgery (RIRS) are recent innovations. A structured nonsystematic review was conducted through a literature search of articles published between 1997 and 2013, using the terms kidney stones, miniperc, mini-PCNL, RIRS and flexible ureteroscopy in the PubMed, Google Scholar and Scopus databases. RIRS requires greater surgical time, several procedures for voluminous stones and higher hospital costs, due in part to the relative fragility of the instruments. On the other hand, miniperc requires a longer hospital stay, an increased need for postoperative analgesia and a greater reduction in hemoglobin levels, although these do not translate into an increased rate of transfusions. The current treatment of kidney stones uses minimally invasive procedures such as miniperc and RIRS. The 2 procedures are equivalent in terms of efficacy (stone clearance) and are associated with minimal complications. Comparative prospective studies are necessary to determine the position of each of these techniques in the treatment of kidney stones. In our experience, the 2 techniques are complementary and should be part of the current urological therapeutic arsenal. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Intraparenchymal hematoma as a late complication of retrograde intrarenal surgery.

    PubMed

    Yahsi, Sedat; Tonyali, Senol; Ceylan, Cavit; Yildiz, Kenan Y; Ozdal, Levent

    2017-01-01

    A 34 year-old woman was admitted to our hospital with left flank pain. A non-contrast enhanced computerized tomography (NCCT) revealed a 1.5x2cm left proximal ureter stone. Patient was scheduled for ureterorenoscopy (URS) and stone removal. She was submitted to retrograde intrarenal surgery (RIRS). At the postoperative 1st day, the patient began to suffer from left flank pain. A NCCT was taken, which revealed a subcapsular hematoma and perirenal fluid. The patient was managed conservatively with intravenous fluid, antibiotic and non-steroidal anti-inflammatory drug therapy and was discharged at the postoperative 6th day. Two weeks after the discharge the patient was admitted to emergency department with severe left flank pain, palpitation and malaise. KUB (kidney-ureter-bladder) radiography showed double-J stent (DJS) to be repositioned to the proximal ureter. Patient was evaluated with contrast enhanced CT which revealed an 8cm intraparenchymal hematoma/abscess in the middle part of the kidney. A percutaneous drainage catheter was inserted into the collection. The percutaneous drainage catheter and the DJS were removed at the 10th day of second hospitalization. RIRS surgery is an effective and feasible choice for renal stones with high success and acceptable complication rates. However, clinician should be alert to possible complications.

  3. Is routine ureteral stenting really necessary after retrograde intrarenal surgery?

    PubMed

    Ozyuvali, Ekrem; Resorlu, Berkan; Oguz, Ural; Yildiz, Yildiray; Sahin, Tolga; Senocak, Cagri; Bozkurt, Omer Faruk; Damar, Erman; Yildirim, Murat; Unsal, Ali

    2015-03-31

    To investigate the situations in which ureteral double-J stent should be used after retrograde intrarenal surgery (RIRS). Patients with no ureteral double-J stent after RIRS constituted Group 1, and those with double- J stent after RIRS constituted Group 2. Patients' age and gender, renal stone characteristics (location and dimension), stone-free status, VAS score 8 hours after surgery, post-procedural renal colic attacks, length of hospitalization, requirement for re-hospitalization, time to rehospitalization and secondary procedure requirements were analyzed. RIRS was performed on 162 renal units. Double-J stent was used in 121 (74.6%) of these after RIRS, but not in the other 41 (25.4%). At radiological monitoring at the first month postoperatively after RIRS, complete stone-free status was determined in 122 (75.3%) renal units, while residual stone was present in 40 (24.6%). No significant differences were observed between the groups in terms of duration of fluoroscopy (p = 0.142), operation (p = 0.108) or hospitalization times (p = 0.798). VAS values determined routinely on the evening of surgery were significantly higher in Group 1 than in Group 2 (p = 0.025). Twenty-eight (17.2%) presentations were made to the emergency clinic due to renal colic within 1 month after surgery. Double-J catheter was present in 24 (85.7%) of these patients. Routine double-J stent insertion after RIRS is not essential since it increases costs, morbidity and operation time.

  4. [Shock wave lithotripsy, retrograde intrarenal surgery or percutaneous nephrolithotomy for lower pole renal stones?].

    PubMed

    Rojas, Alejandro; Gallegos, Héctor; Salvadó, José A

    2015-09-09

    Among the therapeutic alternatives available for the treatment of lower pole renal calculi are extracorporeal lithotripsy, percutaneous nephrolithotomy and retrograde intrarenal surgery. There is controversy about which of these techniques is more effective, especially for stones smaller than 20 mm. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified four systematic reviews including 11 pertinent randomized controlled trials overall. We combined the evidence and generated a summary of findings following the GRADE approach. We concluded percutaneous nephrolithotomy probably increases success rate, but it is not clear if it decreases the need of retreatment compared to extracorporeal shock wave lithotripsy. In comparison to retrograde intrarenal surgery, it may increase success rate, but it is not clear if it decreases the need of retreatment. Retrograde intrarenal surgery may increase success rate, and probably decreases need of retreatment compared to extracorporeal shock wave lithotripsy.

  5. Retrograde intrarenal surgery and micro-percutaneous nephrolithotomy for renal lithiasis smaller than 2 CM.

    PubMed

    Cepeda, M; Amón, J H; Mainez, J A; de la Cruz, B; Rodríguez, V; Alonso, D; Martínez-Sagarra, J M

    2017-10-01

    Microperc is the upgraded form of percutaneous nephrolithotomy miniaturization. The aim of this study is to compare prospectively microperc and retrograde intrarenal surgery for the treatment of renal stones smaller than 2 cm. A comparative prospective study of both techniques was carried out between January 2014 and June 2015. Thirty-five patients were divided in two groups: Group A, 17 patients treated by retrograde intrarenal surgery and Group B, 18 patients treated by microperc. Stone clearance was assessed using CT scan 3 months after surgery. Both groups were statistically comparable as demographic variables and stone size was similar (16.76 mm Group A vs 15.72 mm Group B). Success rate, hospital stay and JJ stenting were similar for both groups. There was no statistically significant difference regarding post-operatory complications: 17.64% Group A vs 5.56% Group B (p=0,062), all of them Clavien I and II. Surgical time was statistically different (63.82 min Group A vs 103.24 min Group B) as well as hemoglobin drop (0.62 g/dl Group A and 1.89 g/dl Group B). Microperc is an effective and safe procedure for the treatment of renal lithiasis smaller than 2 cm, which makes it a good alternative to retrograde intrarenal surgery for this stone size. However, more prospective studies that include a larger cohort are necessary to confirm our results. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Efficacy of retrograde ureteropyeloscopic holmium laser lithotripsy for intrarenal calculi >2 cm.

    PubMed

    Bader, M J; Gratzke, C; Walther, S; Weidlich, P; Staehler, M; Seitz, M; Sroka, R; Reich, O; Stief, C G; Schlenker, B

    2010-10-01

    The objectives of this study are to assess the efficacy and safety of retrograde ureteroscopic holmium laser lithotripsy for intrarenal calculi greater than 2 cm in diameter. A total of 24 patients with a stone burden >2 cm were treated with retrograde ureteroscopic laser lithotripsy. Primary study endpoints were number of treatments until the patient was stone free and perioperative complications with a follow-up of at least 3 months after intervention. In 24 patients (11 women and 13 men, 20-78 years of age), a total of 40 intrarenal calculi were treated with retrograde endoscopic procedures. At the time of the initial procedure, calculi had an average total linear diameter of 29.75 ± 1.57 mm and an average stone volume of 739.52 ± 82.12 mm(3). The mean number of procedures per patient was 1.7 ± 0.8 (range 1-3 procedures). The overall stone-free rate was 92%. After 1, 2 and 3 procedures 54, 79 and 92% of patients were stone free, respectively. There were no major complications. Minor postoperative complications included pyelonephritis in three cases (7.5%), of whom all responded immediately to parenteral antibiotics. In one patient the development of steinstrasse in the distal ureter required ureteroscopic fragment disruption and basketing. Ureteroscopy with holmium laser lithotripsy represents an efficient treatment option and allows the treatment of large intrarenal calculi of all compositions and throughout the whole collecting system even for patients with a stone burden of more than 2 cm size.

  7. Subcapsular Renal-Infected Hematoma After Retrograde Intrarenal Surgery: A Rare but Serious Complication

    PubMed Central

    Consigliere, Lucas; Gallegos, Hector; Rojas, Francisco; Astroza, Gastón

    2016-01-01

    Abstract We report a case of a 53-year-old woman affected by a left kidney stone and persistent positive urinary culture treated by retrograde intrarenal surgery. During postoperative day 1, she developed a sudden back pain associated with a decrease in hemoglobin. CT scan showed a subcapsular hematoma giving the impression of partial compression of kidney and upper urinary tract. For that reason, in the first instance, a Double-J ureteral stent was installed. Unfortunately, an open surgical drainage was necessary because a secondary infection of the hematoma was evident during the following days. PMID:27579416

  8. Retrograde intrarenal surgery for lower pole renal calculi smaller than one centimeter

    PubMed Central

    Shah, Hemendra Navinchandra

    2008-01-01

    Objectives: Recently there has been an increasing interest in the application of retrograde intrarenal surgery (RIRS) for managing renal calculi. In this review we discuss its application for the management of lower calyceal (LC) stones less than 10 mm in maximum dimension. Materials and Methods: Literature was reviewed to summarize the technical development in flexible ureterorenoscopy and its accessories. Further, the indications, outcome and limitations of RIRS for LC calculi < 1 cm were reviewed. Results: Use of access sheath and displacement of LC stone to a more favorable location is increasingly employed during RIRS. Patients who are anticoagulated or obese; those with adverse stone composition and those with concomitant ureteral calculi are ideally suited for RIRS. It is used as a salvage therapy for shock wave lithotripsy (SWL) refractory calculi but with a lower success rate (46-62%). It is also increasingly being used as a primary modality for treating LC calculi, with a stone-free rate ranging from 50-90.9%. However, the criteria for defining stone-free status are not uniform in the literature. The impact of intrarenal anatomy on stone-free rates after RIRS is unclear; however, unfavorable lower calyceal anatomy may hamper the efficacy of the procedure. The durability of flexible ureteroscopes remains an important issue. Conclusions: RIRS continues to undergo significant advancements and is emerging as a first-line procedure for challenging stone cases. The treatment of choice for LC calculi < 1 cm depends on patient's preference and the individual surgeon's preference and level of expertise. PMID:19468515

  9. Retrograde Intrarenal Surgery in Patients Who Previously Underwent Open Renal Stone Surgery

    PubMed Central

    Alkan, Erdal; Saribacak, Ali; Ozkanli, Ahmet Oguz; Başar, Mehmet Murad; Acar, Oguz; Balbay, Mevlana Derya

    2015-01-01

    Purpose. To ascertain whether retrograde intrarenal surgery (RIRS) is as effective in patients treated previously with open renal stone surgery (ORSS) on the same kidney as in patients with no previous ORSS. Methods. There were 32 patients with renal stones who had previous ORSS and were treated with RIRS in the study group (Group 1). A total of 38 patients with renal stones who had no previous ORSS and were treated with RIRS were selected as the control group (Group 2). Recorded data regarding preoperative characteristics of the patients, stone properties, surgical parameters, outcomes, SFRs (no fragments or small fragments <4 mm), and complications between groups were compared. Results. Mean age, mean BMI, mean hospital stay, and mean operative time were not statistically different between groups. Mean stone size (10.1 ± 5.6 versus 10.3 ± 4.2; p = 0.551) and mean stone burden (25.4 ± 14.7 versus 23.5 ± 9.9; p = 0.504) were also similar between groups. After the second procedures, SFRs were 100% and 95% in groups 1 and 2, respectively (p = 0.496). No major perioperative complications were seen. Conclusion. RIRS can be safely and effectively performed with acceptable complication rates in patients treated previously with ORSS as in patients with no previous ORSS. PMID:26357570

  10. Results of retrograde intrarenal surgery in the treatment of renal stones greater than 2 cm.

    PubMed

    Palmero, J L; Castelló, A; Miralles, J; Nuño de La Rosa, I; Garau, C; Pastor, J C

    2014-05-01

    To analyze the results of retrograde intrarenal surgery (RIRS) in patients with ≥2 cm stones treated in our center. A retrospective review of 106 patients with renal calculi underwent RIRS ≥2 cm (period January 2009-December 2011). The procedures were performed under general anesthesia as a source of fragmentation using the holmium laser (30 W Litho Quantasystem) and flexible ureteroscopes (X2 Flex Storz, Olympus P5) through ureteral access sheaths. It discusses demographic variables (age, medical history, antiplatelet or anticoagulant treatment, treatment of urolithiasis, BMI, ASA), treated stones variables (size, number, Hounsfield units, biochemical composition) and intra-and postoperative variables (operative time, number of pulses, hospital stay, complications) with the completion of a descriptive analysis of the same. To define our results we consider success to the complete absence of fragments or residual <5 mm posterior imaging tests. The mean stone size was 2.46 cm treated, being the only stone in 87.7% of cases. The most frequent location was the renal pelvis stones (44%) followed by the lower calyx (39%). The postoperative complication rate was 6.7%, with all of little relevance. The success rate with a single procedure was 79.4% to 94.1% with retreatment. RIRS is a valid alternative for the treatment of kidney stones ≥2 cm for its high success rate and few complications if performed in specialized centers. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  11. External validation of Resorlu-Unsal stone score as predictor of outcomes after retrograde intrarenal surgery.

    PubMed

    Sfoungaristos, Stavros; Gofrit, Ofer N; Mykoniatis, Ioannis; Landau, Ezekiel H; Katafigiotis, Ioannis; Pode, Dov; Constantinides, Constantinos A; Duvdevani, Mordechai

    2016-08-01

    To externally validate Resorlu-Unsal stone score (RUSS) and to evaluate its predictive accuracy. Data of patients who underwent retrograde intrarenal surgery (RIRS) between October 2013 and June 2015 were collected. RUSS was applied to all patients, and the nomogram was externally validated. Area under the curve (AUC) was used for clinical validity assessment. A total of 85 patients were included in the study. Mean patient age was 54.3 ± 16.5, and mean stone size was 12.0 ± 6.21 mm. After applying RUSS, 56.5, 28.2, 9.41, and 5.88 % had score 0, 1, 2, and 3, respectively. RUSS was significantly associated with stone location and size. Postoperative stone-free rate was 74.1 %. Postoperative outcomes were significantly associated with RUSS and stone size. RUSS was found to be the only significant independent predictor in multivariate analysis, while it provided high predictive accuracy with an estimated AUC of 0.707. RUSS is a simple scoring system that may predict postoperative stone-free rate after RIRS with great efficacy and accuracy.

  12. Pediatric retrograde intra-renal surgery for renal stones <2 cm in solitary kidney

    PubMed Central

    Gamal, Wael Mohamed; Hussein, Mohamed M.; Rashed, El Nisr; Mohamed, Al-Dahshoury; Mmdouh, Ahmed; Fawzy, Farag

    2016-01-01

    Introduction: Management of renal stones in children with a solitary kidney is a challenge. In the current study, the efficacy and safety of retrograde intrarenal surgery (RIRS) in these children were determined. Patients and Methods: Records of children with renal stones who were treated at our institute between August 2011 and August 2014 were retrospectively assessed. Inclusion criteria were: Children with single renal stone <2 cm size, in a solitary kidney. A 7.5 Fr flexible ureteroscope (FURS) was introduced into the ureter over a hydrophilic guidewire under visual and fluoroscopic guidance - applying a back-loading technique. The stone was completely dusted using 200 μm laser fiber (0.2–0.8 joules power and 10–30 Hz frequency). At the end of the maneuver, a 5 Fr JJ stent was inserted into the ureter. The children were discharged home 24 h postoperative - provided that no complications were detected. Results: Fourteen children (3 girls and 11 boys) with median age 9.5 years (range 6–12) were included. The mean stone burden was 12.2 ± 1.5 mm (range 9–20). Stones were successfully accessed in all of the cases by the FURS except for 2 cases in whom a JJ stent was inserted into the ureter and left in place for 2 weeks to achieve passive dilatation. All of the stones were dusted completely. The immediate postoperative stone-free rate (SFR) was 79%, and the final SFR was 100% after 3 weeks. No intraoperative complications were observed. Conclusions: RIRS for renal stone <2 cm in children with a solitary kidney is a single-session procedure with a high SFR, low complication rate, and is a minimally invasive, natural orifice technique. PMID:27843213

  13. Treatment Outcomes of Retrograde Intrarenal Surgery for Renal Stones and Predictive Factors of Stone-Free

    PubMed Central

    Lim, Soo Hyun; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo

    2010-01-01

    Purpose The aim of this study was to evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) for the treatment of renal stones and to analyze the predictive factors for stone-free. Materials and Methods We retrospectively reviewed the records of patients who underwent RIRS for renal stones from January 2000 to July 2009. We identified 66 RIRSs (63 patients with 3 bilateral renal stones) and collected data. Stone-free and success were respectively defined as no visible stones and clinically insignificant residual stones less than 3 mm on postoperative imaging; predictive factors for stone-free were evaluated. Results Of the 66 renal stones, 18 stones (27.3%) were located in the upper pole or midpole or renal pelvis and 48 (72.7%) in the lower pole with or without others, respectively. The mean cumulative stone burden was 168.9±392.5 mm2. The immediate postoperative stone-free rate was 69.7%, and it increased to 72.7% at 1 month after surgery. The success rate was 80.3% both immediately after the operation and 1 month later. In the multivariate analysis, stone location except at the lower pole (p=0.049) and small cumulative stone burden (p=0.002) were significantly favorable predictive factors for the immediate postoperative stone-free rate. The overall complication rate was 6%. Conclusions RIRS is a safe and effective treatment for renal stones. The stone-free rate of RIRS was particularly high for renal stones with a small burden, except for those located in the lower pole. RIRS could be considered in selective patients with renal stones. PMID:21165199

  14. Safety and efficacy of retrograde intrarenal surgery in patients of different age groups.

    PubMed

    Tolga-Gulpinar, M; Resorlu, B; Atis, G; Tepeler, A; Ozyuvali, E; Oztuna, D; Resorlu, M; Akbas, A; Sancak, E B; Unsal, A

    2015-01-01

    To assess the efficacy and safety of retrograde intrarenal surgery (RIRS) to treat renal stones in different age groups of patients. We performed a retrospective analysis of 947 patients who underwent RIRS for renal calculi between January 2008 and January 2014. Age at RIRS was analysed both as a continuous and categorical variable and patients were categorized into three age groups; aged ≤ 15 years at surgery (group i, n=51), 16 - 60 years (group Ii, n=726) and>60 years (group iii, n=170). We compared the 3 groups with the regard to stone characteristics, operative parameters and postoperative outcomes. The stone-free rate was 78.4% in group i, 77.5% in group ii, and 81.1% in group iii (P=.587). A multivariate logistic regression analysis showed that only stone size and stone number had significant influence on the stone-free rates after RIRS. Intraoperative complications occurred 13.7% in group i, 5.6% group ii, and 7.6% in group iii. Overall complication rates in children were higher than adult patients but the differences were not statistically significant. We found that only operation time was associated with the increased risk of intraoperative complications. Peroperative medical complications developed in 8 patients (.8%) in group ii and 2 patients (1.1%) in group iii. A 48-year-old man died from septic shock 5 days after the surgery. RIRS was observed to be a safe and effective procedure in all age groups of patients with stone disease, therefore age should not be considered as a limiting factor. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. A Comparison of Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy for Management of Renal Stones ?2 CM.

    PubMed

    Sari, Sercan; Ozok, Hakki Ugur; Cakici, Mehmet Caglar; Ozdemir, Harun; Bas, Okan; Karakoyunlu, Nihat; Sagnak, Levent; Senturk, Aykut Bugra; Ersoy, Hamit

    2017-01-18

    In this retrospective study, we aimed to compare the outcomes in patients who have been treated withpercutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) on renal stones ≥ 2 cm size. We evaluated patients who underwent PNL or RIRS for renal stones ≥ 2 cm size betweenNovember 2011 and November 2014. Stone size, operation, fluoroscopy and hospitalization time, success rates,stone-free rates and complication rates were compared in both groups. Patients were followed for three months. 254 patients were in the PNL Group. 185 patients were in the RIRS Group. The mean age was 46.88 and48.04 years in PNL and RIRS groups, respectively.The patient and stone characteristics (age, gender, Body Mass Index, kidney anomaly, SWL history and stoneradioopacity) were similar between two groups.The mean stone size preoperatively was significantly larger in patients who were treated with PNL (26.33mm.vs24.04mm.; P = .006). In the RIRS group, the mean stone number was significantly higher than PNL group (P <.001).The mean operative, fluoroscopy and hospitalization time were significantly higher in PNL group (P < .001). Thestone-free rate was 93.3% for the PNL group and 73.5% for the RIRS group after first procedure (P < .001). Nomajor complication (Clavien III-V) occurred in the RIRS group. Although the primary treatment method for renal stones ≥ 2cm size is PNL, serious complicationscan be seen. Therefore, RIRS can be an alternative treatment option in the management of renal stones ≥2 cm size.

  16. Retrograde intrarenal surgery with holmium-YAG laser lithotripsy in the primary treatment of renal lithiasis.

    PubMed

    Redondo, C; Ramón de Fata, F; Gimbernat, H; Meilán, E; Andrés, G; Angulo, J C

    2015-06-01

    retrograde intrarenal surgery (RIRS) appears as a safe and effective technique as well as a good therapeutic alternative to extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PNL). descriptive study in 50 patients surgically treated between November 2012 and April 2013. Demographic, operative and postoperative data as well as early and late complications data were collected. The minimum follow-up of patients was one year. Surgery was performed under general anesthesia. Flexible ureteroscopy with ureteral access sheath and laser fragmentation were employed. Surgery success was defined as stone free rate in postoperative control test and at three months after surgery (simple radiography, abdominal ultrasound or CT without contrast). mean age was 51.1±15.5 years old. The highest-frequency location was the lower calyceal group (26%), single stones were described in 58% of patients whilst multiple lithiasis were found in the 42%. Regarding the stone burden in 44% of the patients was low (<2 cm), and high (>3 cm) in 22% of the patients. The stone clearance rate was 89.7±17.5. Average surgery time was 96.6±35.2min. Complications were reported in 4 patients (8%), all of them early ones and minor in nature. RIRS is an effective and safe option whose results are comparable to ESWL and PCNL. RIRS can be considered as first-line treatment. These results are corroborated by numerous studies. To strengthen these findings, prospective studies focusing on quality of life, length of stay, complications and cost-effectiveness of different treatments are needed. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Is it necessary to actively remove stone fragments during retrograde intrarenal surgery?

    PubMed Central

    Lee, You Jin; Bak, Dong Jae; Chung, Jae-Wook; Lee, Jun Nyung; Kim, Hyun Tae; Yoo, Eun Sang

    2016-01-01

    Purpose Based on the experiences of our center, we sought to verify the necessity of actively removing stones during retrograde intrarenal surgery (RIRS) for the management of renal stones. Materials and Methods From March 2010 to March 2015, 248 patients underwent RIRS at our center. We classified these patients into 2 groups according to the performance of active stone removal; group A (n=172) included the patients whose stones were actively removed using a stone basket, and group B (n=76) included the patients whose stones were fragmented with laser lithotripsy without active removal of the fragments. We retrospectively compared the operation time, success rate, and complication rate between the 2 groups. Results There were no significant differences between groups A and B in terms of mean age (56.1 years vs. 58.6 years), male to female ratio (115:57 vs. 46:30), mean body mass index (24.5 kg/m2 vs. 25.0 kg/m2), mean preoperative size of stone (11.1 mm vs. 11.1 mm), the ratio of unilateral and bilateral stones (136:36 vs. 64:12), success rate (89.0% vs. 86.8%), operation time (82.5 minutes vs. 82.1 minutes), overall complication rate (9.9% vs. 11.8%), incidence of febrile urinary tract infection (6.4% vs. 2.6%), gross hematuria (1.7% vs. 2.6%), or postoperative de novo hydronephrosis (2.9% vs. 5.3%). Conclusions This study demonstrated that during RIRS, fragmentation only, without the active removal of stones, is a safe and effective technique in which the surgical outcomes are comparable to those of procedures involving the active removal of stones. PMID:27437537

  18. Comparison of Retrograde Intrarenal Surgery and Micro-Percutaneous Nephrolithotomy in Moderately Sized Pediatric Kidney Stones.

    PubMed

    Baş, Okan; Dede, Onur; Aydogmus, Yasin; Utangaç, Mazhar; Yikilmaz, Taha Numan; Damar, Erman; Nalbant, İsmail; Bozkurt, Ömer Faruk

    2016-07-01

    To compare the effectiveness and reliability of retrograde intrarenal surgery (RIRS) and micro-percutaneous nephrolithotomy (micro-perc) for the management of kidney stones in pediatric patients. A retrospective analysis was made of pediatric patients aged <18 years with kidney stones that ranged from 10 to 20 mm in size, who underwent RIRS (n = 36) or micro-perc (n = 45) in referral centers. In the RIRS group, the mean age of patients was 8.39 ± 4.72 years and in the micro-perc group, it was 5.62 ± 4.50 years (p = 0.01). The mean stone size was 12.80 ± 3.03 mm in the RIRS group and 13.97 ± 3.46 mm in the micro-perc group (p = 0.189). The success rate was 86.2% (n = 31) in the RIRS group and 80.0% (n = 36) in the micro-perc group (p = 0.47). The mean complication rate was 16.6% and 13.3% in the RIRS and micro-perc groups, respectively (p = 0.675). Hospital stay and radiation exposure were significantly lower in the RIRS group (all p < 0.001). The mean anesthesia session was 1.94 in the RIRS group and 1.26 in the micro-perc group (p < 0.001). The mean hemoglobin drop was 0.53 ± 0.87 g/dL in the micro-perc group, and none of the cases required blood transfusion. The results of this study suggested that micro-perc and RIRS were highly effective methods for the treatment of moderately sized renal stones in children, with comparable success and complication rates. Patients and their parents should be informed about the currently available treatment options, and of their efficacy and safety. However, further clinical trials are needed to support these results.

  19. [Retrograde intrarenal surgery (RIRS). Technical complement for cases of acute lithiasis].

    PubMed

    Amón, J H; Cepeda, M; Conde, C; Alonso, D; González, V; Martínez-Sagarra, J M

    2011-02-01

    Washing the renal cavities using minipercutaneous surgery shaft is an ideal technical procedure for retrograde intrarenal surgery (RIRS) when lithiasic fragmentation is significant or if the anatomy of the renal cavities may obstruct the spontaneous elimination of fragments. we performed 37 RIRS on 35 patients with renal lithiasis (14 men, 21 women) with a mean age of 56 (range 33-72) years, divided into two groups in accordance with the size of their kidney stones. Group A, 23 patients with lithiasis <1.5 cm; Group B, 12 cases with lithiasis >1.5 cm. 28 patients had a single kidney stone and 7 had multiple stones. Flexible uretrorenoscopy, 7.5 Fr (Flex-X(®, Karl Storz) by means of a ureteral access sheath. Holmium laser lithotripsy (Calculase®, Karl Storz) using 200 and 365 micrometer fibres. Fragment extraction with 1.7 Fr nitinol baskets (N-gage, Cook). In cases of significant fragmented stone burden, the renal cavities were washed with low-pressure fluid irrigation using a ureteral access sheath, which was collected together with the stone fragments carried by the "mini-perc" sheath (Ultrax-x® 18Fr, Cook; Rusch, 14 Fr) placed under radiologic and endoscopic control at the level of the calyx-papilla selected for fragment drainage. the mean diameter for group A was 9.13 (range 5-13) mm and 20.25 (range 16-28) mm for group B. The overall mean operating time was 81 (range 30-160) min. Group A required 66.43±35.18 min. and group B 107.5±46.73 min. (p=0.006). The rate of absence of stones immediately after surgery was 83.2%, 93.1% at 3 months (95.6% for A and 83.3% for B; p=0.217). In no case was ureteral stenosis observed as a result of the use of ureteral access sheaths. In 7 group B patients (58.3%) with acute lithiasis and/or alteration in their pyelocaliceal anatomy, we performed active lavage of the renal cavities applying the aforementioned percutaneous technique. The mean post-surgery hospital stay was 2.1 (range 1-4) days. There were post

  20. Retrograde intrarenal surgery for the treatment of renal stones in children: factors influencing stone clearance and complications.

    PubMed

    Azili, Mujdem Nur; Ozcan, Fatma; Tiryaki, Tugrul

    2014-07-01

    Retrograde intrarenal surgery (RIRS) is a known option for the treatment of upper tract calculi with an excellent success. However, the reports of RIRS in prepubertal children are limited. In this study, we evaluated the factors which affected the success rate and the complications of RIRS at renal stone treatment in childhood. We retrospectively reviewed the records of children under 14 years old who underwent RIRS for renal stone disease between January 2009 and December 2012. Patients' age, gender, body mass index (BMI), stone size, stone location, stone number, intraoperative complications, stone free status, postoperative complications were recorded. There were 80 ureterorenoscopic procedures performed in 58 renal units of 47 children (23 males and 24 females). The patients' ages ranged from 8 months to 14 years (mean age 4.7 ± 3.4 years). There was a difference in the distribution of symptoms in age groups. UTI was higher in the 1-4 years age group, abdominal pain was seen mostly in children aged 5-14 years. Multiple stones (included staghorn stone) were noted in 60.4% of patients. In 27.6% of patients, ureteral stones were accompanied by renal stones in our series. In the infancy group, cystine and staghorn stones were more frequently seen, mostly bilateral. After a single ureteroscopic procedure for intrarenal stones in children, we achieved stone free status in 50.9% of the ureters (n=26). After the repeated sessions, the stone clearance rate reached to 85.1%. Retrograde intrarenal surgery can be used as a first line therapy to treat renal stones in children. This is especially important if an associated ureteral stone is present that requires treatment; or in patients with cystinuria, which is not favorably treated with ESWL. Complications were seen more frequently in patients with cystine stones. Extravasation was noted more frequently in patients admitted with UTIs. There was a significant relationship between the conversion to open procedures and the

  1. Retrograde intrarenal surgery monotherapy versus shock wave lithotripsy for stones 10 to 20 mm in preschool children: a prospective, randomized study.

    PubMed

    Mokhless, Ibrahim A; Abdeldaeim, Hussein M; Saad, Ashraf; Zahran, Abdel Rahman

    2014-05-01

    We compared the outcome of retrograde intrarenal surgery monotherapy vs shock wave lithotripsy for stones 10 to 20 mm in preschool children. This prospective study included 60 children with a mean ± SD age of 2.4 ± 1.3 years. Patients were randomly divided into 2 groups. Group 1 underwent shock wave lithotripsy and group 2 underwent retrograde intrarenal surgery as monotherapy. Retrograde intrarenal surgery was started using a 7.5Fr semirigid ureteroscope (Storz®) and the holmium laser, and completed by the Flex X™2 flexible ureterorenoscope. A ureteral access sheath was not used and only hydrodilatation was performed. Patients were evaluated preoperatively by ultrasound and plain abdominopelvic x-ray. Followup was 3 months. The stone-free rate after a single session treatment was 70% and 86.6% in groups 1 and 2, respectively. Mean operative time was 27.9 ± 3.5 and 40 ± 7.8 minutes, mean fluoroscopy exposure time was 60 ± 42 and 50 ± 35 seconds, and mean hospital stay was 6 ± 2 and 12 ± 8 hours, respectively. No major complication occurred in either group and no child in either group received blood transfusion. Nine group 1 patients needed a second shock wave lithotripsy session, of whom 2 required a third session. At 3 months the overall stone-free rate was 93.3% and 96.6% in groups 1 and 2, respectively. Retrograde intrarenal surgery is an option for treating medium sized renal stones in preschool children with results comparable to those of shock wave lithotripsy and a safe short-term outcome. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  2. Retrograde Intrarenal Surgery versus Percutaneous Lithotripsy to Treat Renal Stones 2-3 cm in Diameter

    PubMed Central

    Zengin, Kursad; Tanik, Serhat; Sener, Nevzat Can; Albayrak, Sebahattin; Tuygun, Can; Bakirtas, Hasan; Imamoglu, M. Abdurrahim; Gurdal, Mesut

    2015-01-01

    Objective. Retrograde intrarenal surgery (RIRS) performed using a flexible ureterorenoscope marked the beginning of a new era in urology. Today, even staghorn stones are successfully treated via RIRS. The recommended treatment for larger stones is percutaneous nephrolithotomy (PNL). However, the question of whether PNL or RIRS should be the first-line treatment option for larger stones remains controversial. In this study, we contribute to the debate by comparing the success and complication rates of PNL and RIRS that were used to treat renal pelvis stones 2-3 cm in diameter. Materials and Methods. The medical records of 154 patients (74 PNL, 80 RIRS) were retrospectively evaluated. PNL patients were placed in Group 1 and RIRS patients in Group 2. Results. The complete stone-free rates were 95.5% in the PNL group and 80.6% in the RIRS group 1 month postoperatively (P = 0.061). The respective complication rates (evaluated using the Clavien system) were 13.5% and 8.8% (P = 0.520). Conclusions. RIRS affords a comparable success rate, causes fewer complications than PNL, and seems to be a promising alternative to PNL when larger stones are to be treated. Prospective randomized controlled trials are needed to confirm these findings. PMID:25821828

  3. Retrograde intrarenal surgery versus percutaneous lithotripsy to treat renal stones 2-3 cm in diameter.

    PubMed

    Zengin, Kursad; Tanik, Serhat; Karakoyunlu, Nihat; Sener, Nevzat Can; Albayrak, Sebahattin; Tuygun, Can; Bakirtas, Hasan; Imamoglu, M Abdurrahim; Gurdal, Mesut

    2015-01-01

    Retrograde intrarenal surgery (RIRS) performed using a flexible ureterorenoscope marked the beginning of a new era in urology. Today, even staghorn stones are successfully treated via RIRS. The recommended treatment for larger stones is percutaneous nephrolithotomy (PNL). However, the question of whether PNL or RIRS should be the first-line treatment option for larger stones remains controversial. In this study, we contribute to the debate by comparing the success and complication rates of PNL and RIRS that were used to treat renal pelvis stones 2-3 cm in diameter. The medical records of 154 patients (74 PNL, 80 RIRS) were retrospectively evaluated. PNL patients were placed in Group 1 and RIRS patients in Group 2. The complete stone-free rates were 95.5% in the PNL group and 80.6% in the RIRS group 1 month postoperatively (P = 0.061). The respective complication rates (evaluated using the Clavien system) were 13.5% and 8.8% (P = 0.520). RIRS affords a comparable success rate, causes fewer complications than PNL, and seems to be a promising alternative to PNL when larger stones are to be treated. Prospective randomized controlled trials are needed to confirm these findings.

  4. Comparison of retrograde intrarenal surgery, shockwave lithotripsy, and percutaneous nephrolithotomy for treatment of medium-sized radiolucent renal stones.

    PubMed

    Resorlu, Berkan; Unsal, Ali; Ziypak, Tevfik; Diri, Akif; Atis, Gokhan; Guven, Selcuk; Sancaktutar, Ahmet Ali; Tepeler, Abdulkadir; Bozkurt, Omer Faruk; Oztuna, Derya

    2013-12-01

    To compare the outcomes of shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PNL), and retrograde intrarenal surgery (RIRS) for 10-20 mm radiolucent renal calculi by evaluating stone-free rates and associated complications. A total of 437 patients at 7 institutions who underwent SWL (n = 251), PNL (n = 140), or RIRS (n = 46) were enrolled in our study. Clinical success was defined as stone-free status or asymptomatic insignificant residual fragments <3 mm. The success rates, auxiliary procedures, and complications were compared in each group. Success rates were 66.5, 91.4, and 87% for SWL, PNL, and RIRS (p < 0.001). The need for auxiliary procedures was more common after SWL than PNL and RIRS (21.9 vs 5.7 vs 8.7%, respectively; p < 0.001). The overall complication rates for the SWL, PNL, and RIRS were 7.6, 22.1, and 10.9%, respectively (p < 0.001). Thirteen patients in PNL group received blood transfusions, while none of the patients in RIRS and SWL groups transfused. Hospitalization time per patient was 1.3 ± 0.5 days in the RIRS group, while it was 2.6 ± 0.9 days in the PNL group (p < 0.001). Fluoroscopy and operation time were significantly longer in the PNL group compared to RIRS (145.7 ± 101.7 vs 28.7 ± 18.7 s, and 57.5 ± 22.1 vs 43.1 ± 17 min, respectively). For treatment of moderate-sized radiolucent renal stones, RIRS and PNL provide significantly higher success and lower retreatment rate compared with SWL. Although PNL is effective, its biggest drawback is its invasiveness. Blood loss, radiation exposure, hospital stay, and morbidities of PNL can be significantly reduced with RIRS technique.

  5. Comparative study of retrograde intrarenal surgery and micropercutaneous nephrolithotomy in the treatment of intermediate-sized kidney stones.

    PubMed

    Ramón de Fata, F; García-Tello, A; Andrés, G; Redondo, C; Meilán, E; Gimbernat, H; Angulo, J C

    2014-11-01

    Retrograde intrarenal surgery (RIRS) has proven efficacy with minimal morbidity in the treatment of intermediate-sized kidney stones. The aim of this study was to examine the feasibility of micropercutaneous nephrolithotomy (microperc) for this indication and evaluate its results compared with those of RIRS. From September to December 2013, we performed a comparative prospective study between RIRS and microperc, with 20 consecutive patients with intermediate-sized (1-3cm) kidney stones. We employed a flexible dual-channel ureteroscope (Cobra, Richard Wolf GmbH) and a Microperc 4.85/8 Fr (with the patient supine) with flexible fiberoptics (0.9mm, 120° and 10,000 pixels) (PolyDiagnost GmbH). The study variables were demographic data, stone characteristics, percentage of stone elimination, complications (Clavien-Dindo), surgical time, hospital stay and need for auxiliary procedures. The patients underwent RIRS (n=12) or microperc (n=8). There were no differences in the demographics or stone characteristics between the 2 groups. The percentage of stone elimination with RIRS and microperc was 91.7% and 87.5% (P=1), respectively. One of the patients who underwent RIRS (8.3%) experienced postoperative fever; one of the patients who underwent microperc (12.5%) experienced postoperative colic pain (both cases were classified as Clavien I). The operative times were similar: 120min (111.2-148.7) and 120 (88.7-167.5) min for RIRS and microperc (P=.8), respectively. None of the patients required a blood transfusion. The hospital stays were also equivalent: 1 day (1-2) and 1.5 days (1-3.5) for RIRS and microperc (P=.33), respectively. Two patients treated with microperc (25%) required auxiliary procedures (simultaneous RIRS and flexible nephroscopy after percutaneous trajectory dilation to treat, in both cases, a significant fragment that had migrated to an inaccessible calyx), and 1 patient in the RIRS group (8.3%) required percutaneous nephrolithotomy due to unfavorable

  6. Combined Minimally Invasive Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for Staghorn Calculi in Patients with Solitary Kidney

    PubMed Central

    Lai, Dehui; He, Yongzhong; Dai, Yuping; Li, Xun

    2012-01-01

    Background To present our experience with simultaneous combined minimally invasive percutaneous nephrolithotomy (MPCNL) and retrograde intrarenal surgery (RIRS) to manage patients with staghorn calculi in solitary kidney, and evaluate the safety, efficiency and feasibility of this approach. Methodology/Principal Findings The study included 20 patients with staghorn calculi in solitary kidney. Demographic characteristics, stone location and surface area were recorded. After informed consent, the patients underwent one stage MPCNL firstly. Combined second stage MPCNL and RIRS simultaneously were performed at postoperative 5–7 days. Operative parameters, stone-free rate (SFR), stone analyses and complications were evaluated. Serum creatinine (Scr), glomerular filtration rate (GFR) and chronic kidney disease (CKD) were measured preoperatively, postoperatively at 1 month, and each follow-up visit. All patients had staghorn stones involving multiple calyces. The mean stone burden was 1099.9±843.95 mm2. All patients had only one percutaneous access tract. The mean whole operative duration was 154.37±32.45 min. The mean blood loss was 64 (12–140) ml. The final SFR was 90%. During the 1-month follow-up study period, four patients improved in CKD stage. Two patients who had CKD (stage 5) still needed dialysis postoperatively. Mean Scr of the rest patients preoperatively was 187.16±94.12 compared to 140.99±57.92 umol/L by the end of 1-month follow-up period (p = 0.019). The same findings were observed in GFR in that preoperatively it was 43.80±24.74 ml/min and by the end of the 1-month follow-up it was 49.55±21.18 ml/min (p = 0.05). Conclusions/Significance Combined MPCNL and RIRS management effectively decrease the number and size of percutaneous access tracts, which is safe, feasible, and efficient for managing staghorn calculi in solitary kidney with satisfactory SFR and reducing blood loss, potential morbidity associated with multiple tracts. The

  7. A prospective, randomized comparison of shock wave lithotripsy, retrograde intrarenal surgery and miniperc for treatment of 1 to 2 cm radiolucent lower calyceal renal calculi: a single center experience.

    PubMed

    Kumar, Anup; Kumar, Niraj; Vasudeva, Pawan; Kumar Jha, Sanjeev; Kumar, Rohit; Singh, Harbinder

    2015-01-01

    A prospective, randomized comparison of shock wave lithotripsy, retrograde intrarenal surgery and miniperc for the treatment of 1 to 2 cm radiolucent lower calyceal renal calculi was done to evaluate the safety and efficacy of these procedures. Patients with a single 1 to 2 cm radiolucent lower calyceal renal stone who underwent treatment between January 2012 and May 2013 were included in study. They were randomized to shock wave lithotripsy, retrograde intrarenal surgery and miniperc groups. Patient demographic profiles, success and re-treatment rates, auxiliary procedures and complications were analyzed. A total of 45 patients were enrolled in each of the shock wave lithotripsy, retrograde intrarenal surgery and miniperc groups. Three, 2 and 4 patients, respectively, were excluded from final analysis due to a matrix stone diagnosis. Mean procedure and fluoroscopy times were significantly greater in the miniperc group than in the other groups. Hospital stay (3.1 days vs 3.1 hours and 1.3 days, p = 0.01) and the blood transfusion rate (13.3% vs 0% and 0%, p = 0.03) were significantly higher for miniperc vs shock wave lithotripsy and retrograde intrarenal surgery, respectively. The re-treatment rate (63.4% vs 2.1% and 2.2%, p <0.001) and the auxiliary procedure rate (20.2% vs 8.8% and 6.6%, p = 0.02) were significantly greater for shock wave lithotripsy than for retrograde intrarenal surgery and miniperc, respectively. The 3-month stone-free rate of shock wave lithotripsy, retrograde intrarenal surgery and miniperc was 73.8% (31 of 42 patients), 86.1% (37 of 43) and 95.1% (39 of 41), respectively (p = 0.01). Miniperc and retrograde intrarenal surgery were more effective than shock wave lithotripsy to treat 1 to 2 cm radiolucent lower calyceal renal calculi in terms of a better stone-free rate, and lesser auxiliary and re-treatment rates. However, miniperc resulted in more complications, greater operative time and radiation exposure, and a longer hospital stay

  8. A comparison of micro-PERC and retrograde intrarenal surgery results in pediatric patients with renal stones.

    PubMed

    Sen, Haluk; Seckiner, Ilker; Bayrak, Omer; Dogan, Kazim; Erturhan, Sakip

    2017-06-19

    With advancements in endoscopic surgery, open surgical techniques for urinary system stones have paved the way for the application of less invasive treatment modalities in patients with pediatric kidney stone disease. These treatment options include extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and retrograde intrarenal surgery (RIRS). We aimed to compare the efficacy and safety of RIRS and micro-PCNL techniques in the surgical treatment of kidney stones in pediatric patients. A total of 48 pediatric patients, who underwent RIRS or micro-PERC for pediatric kidney stone disease, were retrospectively analyzed. Urinalysis, urine culture, serum creatinine (Cr), blood urea nitrogen (BUN), calcium, phosphorus, parathyroid hormone, 24-hour urine sample, complete blood count (CBC), urinary system X-ray, kidney ureter bladder (KUB), and urinary system ultrasonography (USG) test results were evaluated prior to the procedure. Intravenous pyelography (IVP), non-contrast computed tomography (CT), and renal scintigraphy evaluations were also performed, if necessary. The patients were divided into two groups: micro-PERC group (n = 25) and RIRS group (n = 23). Data relating to the duration of the operation, duration of fluoroscopy, length of hospitalization, complication rates, and stone-free rates were recorded. The mean ages of the micro-PERC and RIRS groups were 4 ± 2.3 and 10.9 ± 3 years, respectively (p = 0.001). However, the mean stone sizes were 12.2 ± 2.8 and 13.7 ± 3.5 mm, respectively (p > 0.05). The mean duration of operation was 75.1 ± 18.9 min in the micro-PERC group and 62.3 ± 15.3 min in the RIRS group (p > 0.05). In addition, the mean duration of fluoroscopy was 115 ± 35.4 s in the micro-PERC group and 39.9 ± 15.3 s in the RIRS group. The stone-free rates in the micro-PERC and RIRS groups following the procedure were reported to be 84% (21/25) and 82.6% (19/23), respectively (p > 0

  9. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones.

    PubMed

    Srisubat, Attasit; Potisat, Somkiat; Lojanapiwat, Bannakij; Setthawong, Vasun; Laopaiboon, Malinee

    2014-11-24

    Stones in the urinary tract are a common medical problem in the general population. At present, the great expansion in minimally invasive techniques has led to the decrease in open surgery. Extracorporeal shock wave lithotripsy (ESWL) has been introduced as an alternative approach which disintegrates stones in the kidney and upper urinary tract through the use of shock waves. Nevertheless, as there are limitations with the success rate in ESWL, other minimally invasive modalities for kidney stones such as percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) are also widely applied. This is an update of a review first published in 2009. This review aimed to assess the effectiveness and complications of ESWL for kidney stones compared with PCNL or RIRS. We searched the Cochrane Renal Group's Specialised Register to 3 March 2014 through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Randomised controlled trials (RCTs) assessing the use of ESWL compared to PCNL or RIRS for kidney stone management. Two authors independently assessed all the studies for inclusion. Statistical analyses were performed using the random effects model and the results expressed as risk ratio (RR) for dichotomous outcomes or mean difference (MD) for continuous data with 95% confidence intervals (CI). Five studies (338 patients) were included, four studies compared ESWL to PCNL and one compared ESWL with RIRS. Random sequence generation was reported in three studies and unclear in two. Allocation concealment was not reported in any of the included studies. Blinding of participants and investigators could not be undertaken due to the nature of the interventions; blinding of outcome assessors was not reported. Reporting bias was judged to be low risk in all studies. One study was funded by industry and in one study the number of participants in each group was unbalanced.The success of treatment at three months was significantly

  10. Percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of kidney stones up to 2 cm in patients with solitary kidney: a single centre experience.

    PubMed

    Bai, Yunjin; Wang, Xiaoming; Yang, Yubo; Han, Ping; Wang, Jia

    2017-01-18

    To compare the treatment outcomes between percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for the management of stones larger than 2 cm in patients with solitary kidney. One hundred sixteen patients with a solitary kidney who underwent RIRS (n = 56) or PCNL (n = 60) for large renal stones (>2 cm) between Jan 2010 and Nov 2015 have been considered. The patients' characteristics, stone characteristics, operative time, incidence of complications, hospital stay, and stone-free rates (SFR) have been evaluated. SFRs after one session were 19.6% and 35.7% for RIRS and PCNL respectively (p = 0.047), but the SFR at 3 months follow-up comparable in both groups (82.1% vs. 88.3%, p = 0.346). The calculated mean operative time for RIRS was longer (p < 0.001), but the mean postoperatively hospital stay was statistically significantly shorter (p < 0.001) and average drop in hemoglobin level was less (p = 0.040). PCNL showed a higher complication rate, although this difference was not statistically significant. Satisfactory stone clearance can be achieved with multi-session RIRS in the treatment of renal stones larger than 2 cm in patients with solitary kidney. RIRS can be considered as an alternative to PCNL in selected cases.

  11. Comparison between retrograde intrarenal surgery and extracorporeal shock wave lithotripsy in the treatment of lower pole kidney stones up to 15 mm. Prospective, randomized study.

    PubMed

    Vilches, R M; Aliaga, A; Reyes, D; Sepulveda, F; Mercado, A; Moya, F; Ledezma, R; Hidalgo, J P; Olmedo, T; Marchant, F

    2015-05-01

    Extracorporeal Shock Wave Lithotripsy (ESWL) is currently the recommended treatment for intra-renal calculi smaller than 2 cm. However the low Stone Free Rate (SFR) in lower pole calculi gives rise to new techniques, such us retrograde intrarenal surgery (RIRS), for improve the surgery outcomes. To compare the efficacy of a treatment with ESWL with RIRS, in terms of SFR after surgery, in patients with kidney stones up to 15 mm in the lower pole. A prospective study was carried out in order to assess the results of ESWL and RIRS in patients with lower pole stones less than 15 mm. Among a total of 55 patients, 31 were underwent to ESWL (Group 1) and the remaining 24 to RIRS (Group 2). Clinical data recorded, including general characteristics of each patient, were: calculi size, side, operative time, complications according to Clavien scale, SFR and the presence of residual fragments at 2 months post-treatment assessed by a CT scan. STATA 11 was used to perform the statistical analysis. There were no differences for general descriptors among groups with the exception of a significantly longer operative time for RIRS. The rates of SFR and residual fragments lesser than 3 mm. were lower in the RIRS group than in ESWL ones. RIRS also showed a lower rate of clinically significant fragments (0% vs 42.3%. P < .05). In the subgroup of patients with stones between 10/15 mm RIRS showed higher SFR (75% vs. 41.2%) and a lower rate of stones>3 mm (0% vs. 58.8%), being statistically significant (P < .05). Clavien III or higher complications were not reported in any of the groups. In the treatment of lower pole stone RIRS has the same results than ESWL in terms of SFR. Regarding absence of a clinically significant residual fragment, RIRS was superior to ESWL. A bigger sample size is required in order to confirm this results. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Comparison of retrograde intrarenal surgery and mini-percutaneous nephrolithotomy in management of lower-pole renal stones with a diameter of smaller than 15 mm.

    PubMed

    Kirac, Mustafa; Bozkurt, Ömer Faruk; Tunc, Lutfi; Guneri, Cagri; Unsal, Ali; Biri, Hasan

    2013-06-01

    The aim of this study was to compare the outcomes of retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mini-PNL) in management of lower-pole renal stones with a diameter smaller than 15 mm. Between December 2009 and July 2012, the patients with the diagnosis of lower-pole stones were evaluated by ultrasonography, intravenous pyelography and computed tomography. The records of 73 evaluable patients who underwent mini-PNL (n = 37) or RIRS (n = 36) for lower-pole (LP) stones with diameter smaller than 15 mm were reviewed retrospectively. Of the 73 patients, 37 underwent mini-PNL and 36 underwent RIRS. The stone-free rates were 89.1 and 88.8 % for mini-PNL and RIRS groups, respectively. The mean operation time was 53.7 ± 14.5 in the mini-PNL group but 66.4 ± 15.8 in the RIRS group (P = 0.01). The mean fluoroscopy times and hospitalization times were significantly higher in the mini-PNL group. There was no major complication in any patient. RIRS and mini-PNL are safe and effective methods for treatment of LP calculi with a diameter smaller than 15 mm. RIRS is a non-invasive and feasible treatment option, and has also short hospitalization time, low morbidity and complication rate. It may be an alternative of mini-PNL in the treatment LP calculi with smaller than 15 mm.

  13. The efficacy of performing shockwave lithotripsy before retrograde intrarenal surgery in the treatment of multiple or large (≥1.5 cm) nephrolithiasis: A propensity score matched analysis

    PubMed Central

    Shim, Myungsun; Park, Myungchan

    2017-01-01

    Purpose To investigate the effect of performing shockwave lithotripsy (SWL) before retrograde intrarenal surgery (RIRS) on the treatment outcomes of patients with nephrolithiasis. Materials and Methods The data of 189 patients with renal stones who underwent RIRS from July 2007 to July 2014 was reviewed retrospectively. Patients with stones larger than 1.5 cm were recommended to undergo SWL before RIRS. Patients were divided into 2 groups based on whether the preoperative SWL was performed (group 1, n=68) or not (group 2, n=121). The cohorts of the 2 groups cohorts were matched 1:1 using propensity score analysis. Patient, stone characteristics, operative parameters, and stone-free rates were compared. Results Patients in groups 1 and 2 were matched with respect to stone size, number, and location, leaving 57 patients in each group. After matching, no differences were identified between the 2 groups regarding age, body mass index, sex, stone composition, density and multiplicity. Compared to group 2 patients, patients in group 1 had fewer number of procedures performed (1.10 vs. 1.26, p=0.045) and higher stone-free rate (89.4% vs.73.6%, p=0.039). In multivariate analysis, Non lower calyceal location (odd ratio [OR], 8.215; 95% confidence interval [CI], 1.782–21.982; p=0.041), stone size (OR, 6.932; 95% CI, 1.022–18.283; p<0.001), and preoperative SWL (OR, 2.210; 95% CI, 1.058–7.157; p=0.019) were independent factors predicting a stone-free state after RIRS. Conclusions Performing SWL before RIRS may favor stone eliminations during surgery and increase the stone-free rate in selected patients. PMID:28097265

  14. Bilateral single-session retrograde intra-renal surgery: A safe option for renal stones up to 1.5 cm

    PubMed Central

    Bansal, Punit; Bansal, Neeru; Sehgal, Anand; Singla, Subhash

    2016-01-01

    Introduction: Assessment of treatment outcomes in patients undergoing bilateral single-session retrograde intra-renal surgery (RIRS) for bilateral renal stones up to 1.5 cm. Materials and Methods: Retrospective analysis of 74 patients was done with bilateral renal calculi, who underwent bilateral single-session RIRS at our stone referral hospital from December 2011 to May 2014. The selection criteria for this intervention were patient's preference, failure of other treatments and stone up to 1.5 cm. Patients with creatinine more than 2, pyonephrosis sepsis, bilateral impacted pelviureteric junction calculi were excluded from study. All patients were evaluated with serum biochemistry, urinalysis, urine culture, plain radiography of kidney-ureter-bladder, intravenous urography, renal ultrasonography (USG) and/or computed tomography (CT). Follow-up evaluation included serum biochemistry and postoperative plain film and renal USG. The success rate was defined as patients who were stone-free or only had a residual fragment of less than 4 mm. CT was conducted only in patients with residual stones, which were present in seven patients. Results: A total of 74 patients (50 male, 24 female) with a mean age 39.2 ± 15.2 were included in the present study. The mean stone size was 11.7 ± 2.4 mm. The stone-free rates were 86.84% and 97.29% after the first and second procedures, respectively. In eight patients (10.8%), minor complications were observed, whereas no major complications were noted in the studied group. There was no significant difference in pre- and post-operative serum creatinine levels. Conclusion: In patients with bilateral renal stones up to 1.5 cm bilateral single-session RIRS with flexible ureteroscope can be safely performed with low complication rate. PMID:26834403

  15. Systematic review and meta-analysis of the clinical effectiveness of shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy for lower-pole renal stones.

    PubMed

    Donaldson, James F; Lardas, Michael; Scrimgeour, Duncan; Stewart, Fiona; MacLennan, Steven; Lam, Thomas B L; McClinton, Samuel

    2015-04-01

    The prevalence of urolithiasis is increasing. Lower-pole stones (LPS) are the most common renal calculi and the most likely to require treatment. A systematic review comparing shock wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS), and percutaneous nephrolithotomy (PNL) in the treatment of ≤20 mm LPS in adults was performed. Comprehensive searches revealed 2741 records; 7 randomised controlled trials (RCTs) recruiting 691 patients were included. Meta-analyses for stone-free rate (SFR) at ≤3 mo favoured PNL over SWL (risk ratio [RR]: 2.04; 95% confidence interval [CI], 1.50-2.77) and RIRS over SWL (RR: 1.31; 95% CI, 1.08-1.59). Stone size subgroup analyses revealed PNL and RIRS were considerably more effective than SWL for >10 mm stones, but the magnitude of benefit was markedly less for ≤10 mm stones. The quality of evidence (Grading of Recommendations Assessment, Development, and Evaluation [GRADE]) for SFR was moderate for these comparisons. The median SFR from reported RCTs suggests PNL is more effective than RIRS. The findings regarding other outcomes were inconclusive because of limited and inconsistent data. Well-designed, prospective, comparative studies that measure these outcomes using standardised definitions are required, particularly for the direct comparison of PNL and RIRS. This systematic review, which used Cochrane methodology and GRADE quality-of-evidence assessment, provides the first level 1a evidence for the management of LPS. We thoroughly examined the literature to compare the benefits and harms of the different ways of treating kidney stones located at the lower pole. PNL and RIRS were superior to SWL in clearing the stones within 3 mo, but we were unable to make any conclusions regarding other outcomes. More data is required from reliable studies before firm recommendations can be made. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  16. Retrograde intrarenal surgery vs extracorporeal shock wave lithotripsy for intermediate size inferior pole calculi: a prospective assessment of objective and subjective outcomes.

    PubMed

    Singh, Bhupendra Pal; Prakash, Jai; Sankhwar, Satya Narayan; Dhakad, Urmila; Sankhwar, Pushp Lata; Goel, Apul; Kumar, Manoj

    2014-05-01

    To assess objective and subjective outcomes of retrograde intrarenal surgery (RIRS) and extracorporeal shock wave lithotripsy (SWL) for the treatment of intermediate size (1-2 cm) inferior calyceal (IC) stones in a prospective randomized fashion. Between March 2011 and January 2013, 70 symptomatic adults who had isolated IC stone between 10 and 20 mm underwent RIRS or SWL by computer-generated pseudorandom assignment (1:1). Success rate, mean procedure time, hospital stay, pain score on day 1 and 2 using visual analog scale, analgesic requirement after discharge, complications, retreatment rate, auxiliary procedure, and patient-reported outcomes (using self-made nonvalidated questionnaire) were compared. Baseline parameters and mean stone size (SWL 16.45 ± 2.28 mm, RIRS 15.05 ± 3.56 mm; P = .0542) were comparable. Success rate was significantly higher after a single session of RIRS compared with 3 sessions of SWL (85% vs 54%; P = .008). Retreatment rate (65% vs 5.7%; P = .0001) and auxiliary procedure (45% vs 8%; P = .0009) were significantly higher in SWL. Pain score on postoperative day 1 and 2 was significantly higher in RIRS, but patients with SWL required significantly more analgesics afterward. Most of the complications were of Clavien grade I and/or II in both groups. Average time to return to normal activity and voiding symptoms were significantly higher in RIRS. Overall satisfaction score (2.17 ± 1.24 vs 2.82 ± 1.17; P = .026) was significantly higher in RIRS than SWL. For the treatment of intermediate size IC calculi, RIRS is superior to SWL in terms of objective and subjective outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Cumulative Sum Analysis for Experiences of a Single-Session Retrograde Intrarenal Stone Surgery and Analysis of Predictors for Stone-Free Status

    PubMed Central

    Cho, Sung Yong; Choo, Min Soo; Jung, Jae Hyun; Jeong, Chang Wook; Oh, Sohee; Lee, Seung Bae; Son, Hwancheol; Jeong, Hyeon

    2014-01-01

    Introduction This study investigated the learning curve of a single-session retrograde intrarenal surgery (RIRS) in patients with mid-sized stones. Competence and trainee proficiency for RIRS was assessed using cumulative sum analysis (CUSUM). Materials and Methods The study design and the use of patients' information stored in the hospital database were approved by the Institutional Review Board of our institution. A retrospective review was performed for 100 patients who underwent a single-session RIRS. Patients were included if the main stone had a maximal diameter between 10 and 30 mm. The presence of a residual stone was checked on postoperative day 1 and at one-month follow-up visit. Fragmentation efficacy was calculated “removed stone volume (mm3) divided by operative time (min)”. CUSUM analysis was used for monitoring change in fragmentation efficacy, and we tested whether or not acceptable surgical outcomes were achieved. Results The mean age was 54.7±14.8 years. Serum creatinine level did not change significantly. Estimated GFR and hemoglobin were within normal limits postoperatively. The CUSUM curve tended to be flat until the 25th case and showed a rising pattern but declined again until the 56th case. After that point, the fragmentation efficacy reached a plateau. The acceptable level of fragmentation efficacy was 25 ml/min. Multivariate logistic regression analyses showed that stone-free rate was significantly lower for cases with multiple stones than those with a single stone (OR = 0.147, CI 0.032 – 0.674, P value  = 0.005) and for cases with higher number of sites (OR = 0.676, CI 0.517 – 0.882, P value  = 0.004). Conclusions The statistical analysis of RIRS learning experience revealed that 56 cases were required for reaching a plateau in the learning curve. The number of stones and the number of sites were significant predictors for stone-free status. PMID:24454757

  18. Stone volume is best predictor of operative time required in retrograde intrarenal surgery for renal calculi: implications for surgical planning and quality improvement.

    PubMed

    Sorokin, Igor; Cardona-Grau, Diana K; Rehfuss, Alexandra; Birney, Alan; Stavrakis, Costas; Leinwand, Gabriel; Herr, Allen; Feustel, Paul J; White, Mark D

    2016-11-01

    Retrograde intrarenal surgery (RIRS) is highly successful at eliminating renal stones of various sizes and compositions. As urologists are taking on more complex procedures using RIRS, this has led to an increase in operative (OR) times. Our objective was to determine the best predictor of OR time in patients undergoing RIRS. We retrospectively reviewed the records of patients undergoing unilateral RIRS for solitary stones over a 10 year time span. Stones were fragmented and actively extracted using a basket. Variables potentially affecting OR time such as patient age, sex, BMI, lower pole stone location, volume, Hounsfield units (HU), composition, ureteral access sheath (UAS) use, and pre-operative stenting were collected. Multivariable linear and stepwise regression was used to evaluate the predictors of OR time. There were 118 patients that met inclusion criteria. The median stone volume was 282.6 mm(3) (IQR 150.7-644.7) and the mean OR time was 50 min (±25.9 SD). On univariate linear regression, stone volume had a moderate correlation with OR time (y = 0.022x + 38.2, r (2) = 0.363, p < 0.01). On multivariable stepwise regression, stone volume had the strongest impact on OR time, increasing time by 2.0 min for each 100 mm(3) increase in stone volume (p < 0.001). UAS added 13.5 (SE 3.9, p = 0.001) minutes and renal lower pole location added 9 min (SE 4.3, p = 0.03) in each case they were used. Pre-operative stenting, HU, calcium oxalate stone composition, sex, and age had no significant effect on OR time. Amongst the main stone factors in RIRS, stone volume has the strongest impact on operative time. This can be used to predict the length of the procedure by roughly adding 2 min per 100 mm(3) increase in stone volume.

  19. Comparison of retrograde intrarenal surgery versus a single-session percutaneous nephrolithotomy for lower-pole stones with a diameter of 15 to 30 mm: A propensity score-matching study

    PubMed Central

    Jung, Gyoo Hwan; Jung, Jae Hyun; Ahn, Tae Sik; Lee, Joong Sub; Cho, Sung Yong; Jeong, Chang Wook; Lee, Seung Bae; Kim, Hyeon Hoe

    2015-01-01

    Purpose To investigate surgical outcomes between retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) groups for a main stone sized 15 to 30 mm and located in the lower-pole calyx. Materials and Methods Patients who underwent PNL or RIRS for a main stone sized 15 to 30 mm and located in the lower-pole calyx were retrospectively reviewed. Each patient in the RIRS group was matched to one in the PNL group on the basis of calculated propensity scores by use of age, sex, body mass index, previous treatment history, stone site, maximum stone size, and stone volume. We compared perioperative outcomes between the unmatched and matched groups. Results Patients underwent PNL (n=87, 66.4%) or RIRS (n=44, 33.6%). After matching, 44 patients in each group were included. Mean patient age was 54.4±13.7 years. Perioperative hemoglobin drop was significantly higher and the hospital stay was longer in the PNL group than in the RIRS group. The operative time was significantly longer in the RIRS group than in the PNL group. Stone-free rates were higher and complications rates were lower in the RIRS group than in the PNL group without statistical significance. The presence of a stone located in the lower-anterior minor calyx was a predictor of stone-free status. Conclusions RIRS and single-session PNL for patients with a main stone of 15 to 30 mm located in the lower-pole calyx showed comparable surgical results. However, RIRS can be performed more safely than PNL with less bleeding. Stones in the lower-anterior minor calyx should be carefully removed during these procedures. PMID:26175872

  20. Comparison of retrograde intrarenal surgery versus a single-session percutaneous nephrolithotomy for lower-pole stones with a diameter of 15 to 30 mm: A propensity score-matching study.

    PubMed

    Jung, Gyoo Hwan; Jung, Jae Hyun; Ahn, Tae Sik; Lee, Joong Sub; Cho, Sung Yong; Jeong, Chang Wook; Lee, Seung Bae; Kim, Hyeon Hoe; Oh, Seung-June

    2015-07-01

    To investigate surgical outcomes between retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) groups for a main stone sized 15 to 30 mm and located in the lower-pole calyx. Patients who underwent PNL or RIRS for a main stone sized 15 to 30 mm and located in the lower-pole calyx were retrospectively reviewed. Each patient in the RIRS group was matched to one in the PNL group on the basis of calculated propensity scores by use of age, sex, body mass index, previous treatment history, stone site, maximum stone size, and stone volume. We compared perioperative outcomes between the unmatched and matched groups. Patients underwent PNL (n=87, 66.4%) or RIRS (n=44, 33.6%). After matching, 44 patients in each group were included. Mean patient age was 54.4 ± 13.7 years. Perioperative hemoglobin drop was significantly higher and the hospital stay was longer in the PNL group than in the RIRS group. The operative time was significantly longer in the RIRS group than in the PNL group. Stone-free rates were higher and complications rates were lower in the RIRS group than in the PNL group without statistical significance. The presence of a stone located in the lower-anterior minor calyx was a predictor of stone-free status. RIRS and single-session PNL for patients with a main stone of 15 to 30 mm located in the lower-pole calyx showed comparable surgical results. However, RIRS can be performed more safely than PNL with less bleeding. Stones in the lower-anterior minor calyx should be carefully removed during these procedures.

  1. Advanced intrarenal ureteroscopic procedures.

    PubMed

    Monga, Manoj; Beeman, William W

    2004-02-01

    The role of flexible ureteroscopy in the management of intrarenal pathology has undergone a dramatic evolution, powered by improvements in flexible ureteroscope design; deflection and image quality; diversification of small, disposable instrumentation; and the use of holmium laser lithotripsy. This article reviews the application of flexible ureteroscopy for advanced intrarenal procedures.

  2. 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.

  3. Yeast as a tool to study mitochondrial retrograde pathway en route to cell stress response.

    PubMed

    Ždralević, Maša; Guaragnella, Nicoletta; Giannattasio, Sergio

    2015-01-01

    Mitochondrial retrograde signaling is a mitochondria-to-nucleus communication pathway, conserved from yeast to humans, by which dysfunctional mitochondria relay signals that lead to cell stress adaptation in physiopathological conditions by changes in nuclear gene expression. The best comprehension of components and regulation of retrograde signaling have been obtained in Saccharomyces cerevisiae, where retrograde target gene expression is regulated by RTG genes. In this chapter, we describe the methods to measure mitochondrial retrograde pathway activation in yeast cells by monitoring the mRNA levels of RTG target genes, such as those encoding for peroxisomal citrate synthase, aconitase, and NAD(+)-specific isocitrate dehydrogenase subunit 1, as well as the phosphorylation status of Rtg1/3p transcriptional factor which controls RTG target gene transcription.

  4. Resection or reduction? The dilemma of managing retrograde intussusception after Roux-en-Y gastric bypass.

    PubMed

    Varban, Oliver; Ardestani, Ali; Azagury, Dan; Lautz, David B; Vernon, Ashley H; Robinson, Malcolm K; Tavakkoli, Ali

    2013-01-01

    Retrograde intussusception (RI) at the jejunojejunostomy can occur after Roux-en-Y gastric bypass (RYGB). Although this complication is rare, it has been encountered more frequently as the number of bariatric procedures have increased. Little data is available to assist surgeons with the optimal management of this condition. Our objectives were to identify the risk factors for RI after RYGB and report on outcomes after surgical intervention at a tertiary academic surgical unit. We used our prospective longitudinal institutional bariatric surgical database to identify patients with post-RYGB RI from 1996 to 2011. We identified 28 post-RYGB RI cases. The median interval between RYGB and RI was 52 months, and the median percentage of excess weight loss was 75%. Patients presented with acute symptoms in 36% of the cases. All patients underwent surgical exploration, including resection and revision of the jejunojejunostomy (46%) or operative reduction with or without enteropexy (54%). Those undergoing resection had a longer hospital stay but similar 30-day complication rates. At a median follow-up of 9 months, only 1 recurrence was documented. RI is a rare and late complication of RYGB and typically occurs after significant weight loss. In the presence of ischemia or nonreducible RI, resection and revision of the jejunojejunostomy is recommended. In less acute patients, laparoscopic management with reduction and/or enteropexy offers a reduced hospital length of stay while maintaining equivalent morbidity and low recurrence compared with resection. Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  5. Intrarenal stone manipulation: summary of recent experience.

    PubMed

    Ball, T P

    1978-01-01

    Since first described in 1975, non-operative external manipulation of small intrarenal calculi has been done on 30 individuals. This procedure has facilitated stone passage successfully in 80 per cent of the cases and, thus far, has been free of significant complication. Fluoroscopic control and materials available in most radiology departments allow for intrarenal manipulation to dislodge small calculi in virtually any calix, permitting spontaneous and usually asymptomatic passage. The procedure and subsequent management are described in detail.

  6. Intrarenal use of the holmium laser.

    PubMed

    Das, A; Erhard, M J; Bagley, D H

    1997-01-01

    We investigated the safety, effectiveness, and techniques of the holmium (Ho:YAG) laser intrarenally. Data are presented on 52 patients who were treated with the Ho:YAG laser intrarenally for urinary calculi or neoplasms. The Ho:YAG laser has a wavelength of 2,100 nm, which is delivered in pulsed fashion via a small flexible quartz fiber (365 microns), which is placed through a working channel (> 2.2 Fr) of a small diameter endoscope. Sixty-three intrarenal procedures were performed with the Ho:YAG laser for calculi and neoplasms. Twenty-four procedures were performed for intrarenal neoplasms. Average total energy used in these patients was 2.61 kilojoules (kJ) with a maximum of 15.28 kJ. Thirty-nine procedures were performed for intrarenal calculi; 7/39 procedures were approached percutaneously. Average total energy in stone patients was 5.41 kJ with a maximum of 37.77 kJ. The Ho:YAG laser can be used safely and effectively to treat intrarenal calculi or neoplasms. All types of calculi were fragmented and all patients with intrarenal tumor were treated successfully. There were no vascular or renal injuries and there was no evidence of renal loss. No intrarenal strictures were seen on follow-up. The Ho:YAG laser energy can be delivered through a small flexible quartz fiber passed through a small diameter endoscope. The techniques and applications of the Ho:YAG laser make it well suited for urologic application.

  7. Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi.

    PubMed

    Cohen, Jacob; Cohen, Seth; Grasso, Michael

    2013-03-01

    Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Large upper tract urinary calculi, greater than 2 cm, have historically been treated with percutaneous nephrostolithotomy. In general, there has been a growing interest in employing retrograde, flexible ureteroscopy and laser lithotripsy in select patients who are either poor medical candidates for percutaneous lithotripsy or who may prefer a less invasive intervention. Properly selecting patients for this approach, designing specific treatments based on complex stone presentation and offering general information with regard to long-term outcomes and surgical risks have historically been based on results from small, multicentre series lacking uniformity of technique and long-term outcomes. Our initial multicentre experience employing ureteroscopic techniques to treat large upper urinary tract calculi was presented in 1998. This current work represented the largest single-centre experience, accrued prospectively over 10 years, where there was uniformity of technique and treatment algorithms. This study frames an argument for retrograde ureteroscopic lithotripsy not only in those who are at high risk for percutaneous nephrostolithotomy but in all who present with large, non-infected stone burdens. To define the safety and efficacy of retrograde ureteroscopic lithotripsy in treating large, non-infectious intrarenal and proximal ureteral stone burdens. Between 2000 and 2011, 145 patients with 164 large (2 cm or greater in diameter on standard imaging) non-infectious upper intrarenal and proximal ureteral calculi were chosen for retrograde ureteroscopic lithotripsy. Patients were treated with small diameter flexible fibre-optic ureteroscopes and holmium laser lithotripsy by a single surgeon. Second-look ureteroscopy was performed in patients with the largest calculi in whom there was a high index of suspicion of significant residual fragments. Stone clearance

  8. [Retrograde ejaculation].

    PubMed

    Malossini, G; Ficarra, V; Caleffi, G

    1999-06-01

    Antegrade ejaculation requires intact anatomy and innervation of the bladder neck. Retrograde ejaculation is an uncommon cause of infertility and can be defined as the escape of seminal fluid from the posterior urethra into the bladder. This pathological condition can result from disturbances at the bladder neck due to anatomical lesions, neuropathic disorders or pharmacological influences. Also congenital and idiophatic causes have been described. The diagnosis may be confirmed by findings sperm in post-coital specimens of urine. Pharmacological manipulation, electro-ejaculation and vibro-ejaculation can be utilized to recovery ejaculation. When anterograde ejaculation in this patients cannot be restored artificial insemination using sperm recovered from the antegrade post-coital urine is indicated. The aim of this paper is to evaluate the data of literature on aetiology and therapy of retrograde ejaculation.

  9. Laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography (ERCP) after Roux-en-Y gastric bypass: technical features.

    PubMed

    Facchiano, Enrico; Quartararo, Giovanni; Pavoni, Vittorio; Liscia, Gadiel; Naspetti, Riccardo; Sturiale, Alessandro; Lucchese, Marcello

    2015-02-01

    Laparoscopic gastric bypass is one of the most performed bariatric operations worldwide. The exclusion of stomach and duodenum after this operation makes the access to the biliary tree, in order to perform an endoscopic retrograde cholangiopancreatography (ERCP), very difficult. This procedure could be more often required than in overall population due to the increased incidence of gallstones after bariatric operations. Among the different techniques proposed to overcome this drawback, laparoscopic access to the excluded stomach has been described by many authors with a high rate of success reported. We herein describe our technique to perform laparoscopic transgastric ERCP. A gastrotomy on the excluded stomach is performed to introduce a 15-mm trocar. Two stitches are passed through the abdominal wall and placed at the two sides of the gastrotomy for traction. The intragastric trocar is used to pass a side-viewing endoscope to access the biliary tree. In patients with a past history of Roux-en-Y gastric bypass (RYGB), the present technique allows us a standardized, safe, and reproducible access to the major papilla and the biliary tree using a transgastric access. This will lead to simplify the procedure and reduce the risk of peritoneal contamination.

  10. Single balloon enteroscopy (SBE) assisted therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in patients with roux-en-y anastomosis.

    PubMed

    Tomizawa, Yutaka; Sullivan, Caitlin T; Gelrud, Andres

    2014-02-01

    Endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y anastomosis is a complex challenge. Long length of afferent limb after an acute angle at the jejunojejunostomy and altered location of the biliary orifice make biliary cannulation difficult. Single balloon enteroscopy assisted ERCP (SBE-ERCP) is a promising alternative to conventional approaches. The purpose of this study was to assess the efficacy and safety of SBE-ERCP in patients with Roux-en-Y reconstruction at a high volume tertiary referral center. This is a retrospective cohort study. All procedures were performed by a single, experienced pancreatobiliary endoscopist. Patient demographics and related clinical data were obtained. The rate of procedure successes and complications were determined. Fourteen patients (nine women) with a median age of 63 years (range 35-83 years) underwent 22 SBE-ERCP procedures from March 2009 to May 2011. Surgically altered anatomy consisted of Whipple procedure (n = 4), hepaticojejunostomy (n = 9) and partial gastrectomy (n = 1). Indications for SBE-ERCP were obstructive jaundice (n = 10), cholangitis (n = 7), post-PTC internalization (n = 3) and biliary stent extraction/exchange (n = 2). The hepaticojejunostomy site (HJS) was reached in 15 (68 %) procedures. Successful interventions were performed in 11 (73 %) of 15 cases, including balloon dilation of biliary strictures (n = 3), insertion of biliary stents (n = 7), retrieval of biliopancreatic stents (n = 4) and biliary stone extraction (n = 4). The mean procedural time for successful interventions was 97.6 min (range 73-147 min). No procedural complications occurred during the median follow-up of 501 days (range 22-1,242 days). SBE-ERCP is safe and carries an acceptable success rate in experienced hands.

  11. Intrarenal distribution of trimethoprim and sulfamethoxazole.

    PubMed Central

    Trottier, S; Bergeron, M G; Lessard, C

    1980-01-01

    In the present study, rats were given trimethoprim (TMP, 10 mg/kg), sulfamethoxazole (SMZ, 50 mg/kg), or a combination of the respective doses of TMP and SMZ. Thirty-six rats received each of the drugs studied. Six recipients of a compound (or mixture) were evaluated hourly, from 1 to 6 h after intraperitoneal injection of the agent. At each timed interval, serum, urine, cortex, medulla, and papilla were analyzed for drug content. Peak serum values of 1.1 microgram of TMP and 131.1 microgram of active SMZ (nonacetylated sulfonamide) per ml were observed after injection of the combination TMP-SMZ. Although the cortical, medullary, and papillary TMP concentrations were severalfold higher than the respective serum values (P < 0.01), microbiologically active SMZ did not concentrate in the renal parenchyma and was found in lower concentration there than in the serum (P < 0.01). The levels of SMZ in all parts of the kidney of animals which received the mixture SMZ-TMP were lower than those detected in the animals which were given SMZ alone. The average ratio of active SMZ to TMP within the medulla and the papilla was less than 20 to 1 in the first 2 h. The intrarenal distribution of these drugs may have therapeutic implications. PMID:7425603

  12. Comparison of double-balloon and single-balloon enteroscope for therapeutic endoscopic retrograde cholangiography after Roux-en-Y small bowel surgery.

    PubMed

    De Koning, Michael; Moreels, Tom G

    2016-08-22

    Roux-en-Y reconstructive surgery excludes the biliopancreatic system from conventional endoscopic access. Balloon-assisted enteroscopy allows therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in these patients, avoiding rescue surgery. The objective of the current study is to compare success and complication rate of double-balloon (DBE) and single-balloon enteroscope (SBE) to perform ERCP in Roux-en-Y patients. Seventy three Roux-en-Y patients with suspected biliary tract pathology underwent balloon-assisted enteroscopy in a tertiary-care center. Retrospective analysis of 95 consecutive therapeutic ERCP procedures was performed to define and compare success and complication rate of DBE and SBE. Male-female ratio was 28/45 with a mean age of 58 ± 2 years. 30 (32 %) procedures were performed with DBE and 65 (68 %) with SBE. Overall ERCP success rate was 73 % for DBE and 75 % for SBE (P = 0.831). Failure was due to inability to reach or cannulate the intact papilla or bilioenteric anastomosis. Success rate was significantly higher when performed at the bilioenteric anastomosis (80 % success in 56 procedures) or at the intact papilla in short-limb Roux-en-Y (80 % in 15 procedures) as compared to the intact papilla in long-limb (58 % in 24 procedures; P = 0.040). Adverse event rates were 10 % (DBE) and 8 % (SBE) (P = 0.707) and mostly dealt with conservatively. ERCP after Roux-en-Y altered small bowel anatomy is feasible and safe using both DBE and SBE. Both techniques are equally competent with high success rates and acceptable adverse events rates. ERCP at the level of the intact papilla in long limb Roux-en-Y is less successful as compared to short-limb or bilioenteric anastomosis.

  13. Retrograde intrarenal surgery in the management of symptomatic calyceal diverticular stones: a single center experience.

    PubMed

    Chen, Xiong; Li, Dongjie; Dai, Yuanqing; Bai, Yao; Luo, Qizhan; Zhao, Zhongwei; Chen, Hequn; Zhang, Xiaobo

    2015-11-01

    To evaluate the outcome of RIRS in managing symptomatic calyceal diverticular as a minimally invasive option, we retrospectively reviewed the records of 43 patients who underwent RIRS from 2005 to 2014 for symptomatic calyceal diverticular stones. A month after the initial operation, the success rate was (81.4%, 35 patients) of which 21 (48.83%) patients were stone free and 14 (32.6%) patients had clinically insignificant residual fragments (CIRFs), and 90% patients were symptom free. Eight patients (16.6%) had significant residual fragments (>3 mm), five of them became completely stone free after the second procedure, other three patients were symptom free and underwent a routine follow-up. The final treatment success rate was 93.0%. The initial success rate in the lower calyx was significantly lower than the other calices (P = 0.040). In addition, the association between the stone size and the initial treatment success was significant (P = 0.036). There was no association between any of our other variables and the success rate. The mean first operative time was 60.95 ± 12.43 min (range 34-92). No major complication (Clavien III-V) occurred, although there were five minor complications (11.6%) (Clavien I-II). There were no admissions to intensive care or deaths in our series, the mean hospitalization time was 1.77 ± 0.80 days. The management of calyceal diverticular calculus with RIRS is highly effective and can be accomplished with low morbidity.

  14. Retrograde gastroesophageal intussusception.

    PubMed

    David, S; Barkin, J S

    1992-01-01

    This is an initial report of spontaneous retrograde gastroesophageal intussusception in an adult. The patient is a 72-yr-old women with a history of ovarian cancer and hiatal hernia, who presented with symptoms of upper gastrointestinal obstruction. Retrograde intussusception was diagnosed endoscopically and confirmed radiographically with an upper gastrointestinal series. Heightened awareness of this entity may lead to its more frequent diagnosis.

  15. Functional (dissociative) retrograde amnesia.

    PubMed

    Markowitsch, H J; Staniloiu, A

    2017-01-01

    Retrograde amnesia is described as condition which can occur after direct brain damage, but which occurs more frequently as a result of a psychiatric illness. In order to understand the amnesic condition, content-based divisions of memory are defined. The measurement of retrograde memory is discussed and the dichotomy between "organic" and "psychogenic" retrograde amnesia is questioned. Briefly, brain damage-related etiologies of retrograde amnesia are mentioned. The major portion of the review is devoted to dissociative amnesia (also named psychogenic or functional amnesia) and to the discussion of an overlap between psychogenic and "brain organic" forms of amnesia. The "inability of access hypothesis" is proposed to account for most of both the organic and psychogenic (dissociative) patients with primarily retrograde amnesia. Questions such as why recovery from retrograde amnesia can occur in retrograde (dissociative) amnesia, and why long-term new learning of episodic-autobiographic episodes is possible, are addressed. It is concluded that research on retrograde amnesia research is still in its infancy, as the neural correlates of memory storage are still unknown. It is argued that the recollection of episodic-autobiographic episodes most likely involves frontotemporal regions of the right hemisphere, a region which appears to be hypometabolic in patients with dissociative amnesia.

  16. The intrarenal renin-angiotensin system in hypertension.

    PubMed

    Carey, Robert M

    2015-05-01

    The renin-angiotensin system (RAS) is a well-studied hormonal cascade controlling fluid and electrolyte balance and blood pressure through systemic actions. The classical RAS includes renin, an enzyme catalyzing the conversion of angiotensinogen to angiotensin (Ang) I, followed by angiotensin-converting enzyme (ACE) cleavage of Ang I to II, and activation of AT1 receptors, which are responsible for all RAS biologic actions. Recent discoveries have transformed the RAS into a far more complex system with several new pathways: the (des-aspartyl(1))-Ang II (Ang III)/AT2 receptor pathway, the ACE-2/Ang (1-7)/Mas receptor pathway, and the prorenin-renin/prorenin receptor/mitogen-activated protein kinase pathway, among others. Although the classical RAS pathway induces Na(+) reabsorption and increases blood pressure, several new pathways constitute a natriuretic/vasodilator arm of the system, opposing detrimental actions of Ang II through Ang II type 1 receptors. Instead of a simple circulating RAS, several independently functioning tissue RASs exist, the most important of which is the intrarenal RAS. Several physiological characteristics of the intrarenal RAS differ from those of the circulating RAS, autoamplifying the activity of the intrarenal RAS and leading to hypertension. This review will update current knowledge on the RAS with particular attention to the intrarenal RAS and its role in the pathophysiology of hypertension. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  17. Flexible robotic retrograde renoscopy: description of novel robotic device and preliminary laboratory experience.

    PubMed

    Desai, Mihir M; Aron, Monish; Gill, Inderbir S; Pascal-Haber, Georges; Ukimura, Osamu; Kaouk, Jihad H; Stahler, Gregory; Barbagli, Federico; Carlson, Christopher; Moll, Fredric

    2008-07-01

    To describe a novel flexible robotic system for performing retrograde intrarenal surgery. Remote robotic flexible ureterorenoscopy was performed bilaterally in 5 acute swine (10 kidneys). A novel 14F robotic catheter system, which manipulated a passive optical fiberscope mounted on a remote catheter manipulator was used. The technical feasibility, efficiency, and reproducibility of accessing all calices were assessed. Additionally, laser lithotripsy of calculi and laser ablation of renal papillae were performed. The robotic catheter system could be introduced de novo in eight ureters; two ureters required balloon dilation. The ureteroscope could be successfully manipulated remotely into 83 (98%) of the 85 calices. The time required to inspect all calices within a given kidney decreased with experience from 15 minutes in the first kidney to 49 seconds in the last (mean 4.6 minutes). On a visual analog scale (1, worst to 10, best), the reproducibility of caliceal access was rated at 8, and instrument tip stability was rated at 10. A renal pelvic perforation constituted the solitary complication. Histologic examination of the ureter showed changes consistent with acute dilation without areas of necrosis. A novel robotic catheter system is described for performing retrograde ureterorenoscopy. The potential advantages compared with conventional manual flexible ureterorenoscopy include an increased range of motion, instrument stability, and improved ergonomics. Ongoing refinement is likely to expand the role of this technology in retrograde intrarenal surgery in the near future.

  18. The absence of intrarenal ACE protects against hypertension

    PubMed Central

    Gonzalez-Villalobos, Romer A.; Janjoulia, Tea; Fletcher, Nicholas K.; Giani, Jorge F.; Nguyen, Mien T.X.; Riquier-Brison, Anne D.; Seth, Dale M.; Fuchs, Sebastien; Eladari, Dominique; Picard, Nicolas; Bachmann, Sebastian; Delpire, Eric; Peti-Peterdi, Janos; Navar, L. Gabriel; Bernstein, Kenneth E.; McDonough, Alicia A.

    2013-01-01

    Activation of the intrarenal renin-angiotensin system (RAS) can elicit hypertension independently from the systemic RAS. However, the precise mechanisms by which intrarenal Ang II increases blood pressure have never been identified. To this end, we studied the responses of mice specifically lacking kidney angiotensin-converting enzyme (ACE) to experimental hypertension. Here, we show that the absence of kidney ACE substantially blunts the hypertension induced by Ang II infusion (a model of high serum Ang II) or by nitric oxide synthesis inhibition (a model of low serum Ang II). Moreover, the renal responses to high serum Ang II observed in wild-type mice, including intrarenal Ang II accumulation, sodium and water retention, and activation of ion transporters in the loop of Henle (NKCC2) and distal nephron (NCC, ENaC, and pendrin) as well as the transporter activating kinases SPAK and OSR1, were effectively prevented in mice that lack kidney ACE. These findings demonstrate that ACE metabolism plays a fundamental role in the responses of the kidney to hypertensive stimuli. In particular, renal ACE activity is required to increase local Ang II, to stimulate sodium transport in loop of Henle and the distal nephron, and to induce hypertension. PMID:23619363

  19. The absence of intrarenal ACE protects against hypertension.

    PubMed

    Gonzalez-Villalobos, Romer A; Janjoulia, Tea; Fletcher, Nicholas K; Giani, Jorge F; Nguyen, Mien T X; Riquier-Brison, Anne D; Seth, Dale M; Fuchs, Sebastien; Eladari, Dominique; Picard, Nicolas; Bachmann, Sebastian; Delpire, Eric; Peti-Peterdi, Janos; Navar, L Gabriel; Bernstein, Kenneth E; McDonough, Alicia A

    2013-05-01

    Activation of the intrarenal renin-angiotensin system (RAS) can elicit hypertension independently from the systemic RAS. However, the precise mechanisms by which intrarenal Ang II increases blood pressure have never been identified. To this end, we studied the responses of mice specifically lacking kidney angiotensin-converting enzyme (ACE) to experimental hypertension. Here, we show that the absence of kidney ACE substantially blunts the hypertension induced by Ang II infusion (a model of high serum Ang II) or by nitric oxide synthesis inhibition (a model of low serum Ang II). Moreover, the renal responses to high serum Ang II observed in wild-type mice, including intrarenal Ang II accumulation, sodium and water retention, and activation of ion transporters in the loop of Henle (NKCC2) and distal nephron (NCC, ENaC, and pendrin) as well as the transporter activating kinases SPAK and OSR1, were effectively prevented in mice that lack kidney ACE. These findings demonstrate that ACE metabolism plays a fundamental role in the responses of the kidney to hypertensive stimuli. In particular, renal ACE activity is required to increase local Ang II, to stimulate sodium transport in loop of Henle and the distal nephron, and to induce hypertension.

  20. Intrarenal role of angiotensin II in controlling sodium excretion during dehydration in dogs.

    PubMed

    Trippodo, N C; Hall, J E; Lohmeier, T E; Guyton, A C

    1977-05-01

    1. The intrarenal role of angiotensin II in controlling sodium excretion was examined in anaesthetized, dehydrated dogs by infusing the angiotensin II antagonist Sar1-Ile8-angiotensin II directly into the renal artery. Comparisons were made with dehydrated dogs receiving only sodium chloride solution intrarenally. 2. Intrarenal angiotensin II blockade resulted in significant increases in urinary sodium excretion and urine flow rate. 3. The results indicate that during the high-renin state of dehydration endogenous angiotensin II has intrarenal effects which lead to salt and water retention.

  1. Retrograde ejaculation: simpler treatment.

    PubMed

    Leiva, Rene

    2007-07-01

    To report a case of successful treatment of complete retrograde ejaculation by use of a novel, simple, and noninvasive home-based protocol. Case report. Private family medicine clinic. A couple with primary infertility due to the male's complete retrograde ejaculation due to childhood's bladder surgery. The woman was healthy with normal menstrual cycles. After intercourse, the male patient voided a urine-semen mixture from a previously alkalinized urine and proceeded to inseminate it intravaginally into his wife. Determination of best time for intercourse was done by use of the ovulation (Billings) method. This protocol has been used successfully by this couple to conceive two healthy children. To our knowledge, this is the second reported case of successful management of infertility through this protocol. It might be appropriate to try this method first on select patients with retrograde ejaculation.

  2. Stimulation of renin release by intrarenal calcium infusion.

    PubMed

    Lahera, V; Fiksen-Olsen, M J; Romero, J C

    1990-02-01

    The effects of intrarenal infusions of calcium gluconate (10 and 100 micrograms Ca/kg/min) on renin secretion were studied in anesthetized mongrel dogs. In one group, the two doses of calcium were infused for 30 minutes each (1 ml/min). In a second group, the same doses were administered 30 minutes after the start of infusion of prostaglandin synthesis inhibitors (indomethacin 10 micrograms/kg/min intrarenal or injection of meclofenamate 5 mg/kg i.v. bolus). Mean arterial pressure, renal blood flow, and glomerular filtration rate remained unchanged during the infusion of calcium in both groups. The infusion of 10 micrograms Ca/kg/min increased renin secretion 77% and sodium excretion 123%. During the infusion of 100 micrograms Ca/kg/min, renin secretion was not different from precalcium values, whereas urinary 6-keto-PGF1 alpha, urine flow, sodium, potassium, and calcium excretion rates were increased (p less than 0.05). During the administration of prostaglandin synthesis inhibitors, the urinary 6-keto-PGF1 alpha levels were reduced, and the infusion of 10 micrograms Ca/kg/min failed to increase renin secretion, sodium excretion, or 6-keto-PGF1 alpha excretion rates. The infusion of 100 micrograms Ca/kg/min during prostaglandin synthesis inhibition did not modify urine flow or sodium excretion; however, potassium and calcium excretions increased. It is concluded that 1) the intrarenal infusion of small doses of calcium gluconate is capable of stimulating renin secretion through a prostaglandin-mediated mechanism, and 2) the stimulation of renin secretion as well as the increase in sodium excretion induced by calcium are independent of hemodynamic alterations.

  3. Intrarenal blood flow distribution during endotoxemia in dogs.

    PubMed

    Neiberger, R E; Passmore, J C

    1978-01-01

    Intrarenal blood flow distribution during the stages of endotoxemia in the dog was studied using radioactive inert gas washout. Intrarenal blood flow distribution was determined: a) at control, b) 0.5 hours following injection of a lethal dose (3 mg/kg) of E coli endotoxin, and c) 2.5 hours following endotoxin injection in control dogs and dogs pretreated with 4 mg/kg of phenoxybenzamine. One-half hour following endotoxin injection, components I and II of the inert gas washout curve fused. Presumably this fusion occurred because component I flow decreased to a level indistinguishable from that of component II. Following 2.5 hours of endotoxemia, components I and II were both present. Pretreatment with phenoxybenzamine completely prevented the fusion of components I and II, although the mean arterial blood pressure was substantially lower than in dogs not pretreated with phenoxybenzamine. After 2.5 hours of endotoxemia, four of the five phenoxybenzamine pretreated dogs still had two clearly defined washout components. It is concluded that the renal cortical vascular response in endotoxemia is similar to that reported following hemorrhage and that the alpha-adrenergic nervous system plays a major role in decreasing renal cortical blood flow.

  4. Nutritional status and intrarenal resistive indices after kidney transplantation.

    PubMed

    Kolonko, A; Chudek, J; Kujawa-Szewieczek, A; Wiȩcek, A

    2013-05-01

    Obesity predicts vascular stiffness, which is prevalent among kidney transplant patients. However, the influence of obesity has not been established on parameters of renal vascular resistance variation. The aim of this study was to analyze the influence of nutritional status on intrarenal resistive parameters as measured in the early period after successful kidney transplantation by Doppler ultrasound. Both pulsatility index (PI) and resistance index (RI) in the kidney graft were measured by Doppler sonography twice: at 2 to 4 days and before hospital discharge (mean 22 days; 95% confidence interval 21-23) after transplantation. Nutritional status was scored according to World Health Organization criteria. Among 513 patients, 29 were underweight; 280, normal; 166, overweight; and 38, obese. Both PI and RI values were significantly increased consistent with recipient nutritional status (analysis of variance: P < .001). Post hoc analysis showed significant differences in PI and RI measurements for obese versus underweight or normal weight groups. Multivariate analysis revealed an influence of body mass index on PI and RI measurements before hospital discharge to be independent of other variables, including recipient age, prior delayed graft function and cold ischemia time. Excessive nutritional status was associated with increased renal vascular resistance among kidney transplant patients. Nutritional status should be considered for the proper interpretation of intrarenal Doppler measurements. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. The importance of the intrarenal renin-angiotensin system.

    PubMed

    Velez, Juan Carlos Q

    2009-02-01

    Evidence suggests that virtually every organ system in the human body possesses a local renin-angiotensin system (RAS). These local systems seem to be independently regulated and compartmentalized from the plasma circulation, perhaps with the exception of the vascular endothelial system, which is responsible for maintaining physiological plasma levels of RAS components. Among these local RASs, the kidney RAS--the focus of this Review--seems to be of critical importance for the regulation of blood pressure and salt balance. Indeed, overactivation of the intrarenal RAS in certain disease states constitutes a pathogenic mechanism that leads to tissue injury, proliferation, fibrosis and ultimately, end-organ damage. Intrarenal levels of angiotensin peptides are considerably higher than those in plasma or any other organ tissue. Moreover, the kidney has a unique capacity to degrade angiotensin peptides, perhaps to maintain its intrinsic homeostasis. Interestingly, each local RAS has a distinct enzymatic profile resulting in different patterns of angiotensin fragment generation in different tissues. A better understanding of the autocrine and paracrine mechanisms involved in the renal RAS and other local RASs might direct future organ-specific therapy.

  6. Physiology and Pathophysiology of the Intrarenal Renin-Angiotensin System: An Update.

    PubMed

    Yang, Tianxin; Xu, Chuanming

    2017-04-01

    The renin-angiotensin system (RAS) has a pivotal role in the maintenance of extracellular volume homeostasis and blood pressure through complex mechanisms. Apart from the well known systemic RAS, occurrence of a local RAS has been documented in multiple tissues, including the kidney. A large body of recent evidence from pharmacologic and genetic studies, particularly those using various transgenic approaches to manipulate intrarenal levels of RAS components, has established the important role of intrarenal RAS in hypertension. Recent studies have also begun to unravel the molecular mechanisms that govern intrarenal RAS activity. This local system is under the control of complex regulatory networks consisting of positive regulators of (pro)renin receptor, Wnt/β-catenin signaling, and PGE2/PGE2 receptor EP4 subtype, and negative regulators of Klotho, vitamin D receptor, and liver X receptors. This review highlights recent advances in defining the regulation and function of intrarenal RAS as a unique entity separate from systemic angiotensin II generation.

  7. Role of the intrarenal renin-angiotensin system in the progression of renal disease.

    PubMed

    Urushihara, Maki; Kagami, Shoji

    2016-07-05

    The intrarenal renin-angiotensin system (RAS) has many well-documented pathophysiologic functions in both blood pressure regulation and renal disease development. Angiotensin II (Ang II) is the major bioactive product of the RAS. It induces inflammation, renal cell growth, mitogenesis, apoptosis, migration, and differentiation. In addition, Ang II regulates the gene expression of bioactive substances and activates multiple intracellular signaling pathways that are involved in renal damage. Activation of the Ang II type 1 (AT1) receptor pathway results in the production of proinflammatory mediators, intracellular formation of reactive oxygen species, cell proliferation, and extracellular matrix synthesis, which in turn facilities renal injury. Involvement of angiotensinogen (AGT) in intrarenal RAS activation and development of renal disease has previously been reported. Moreover, studies have demonstrated that the urinary excretion rates of AGT provide a specific index of the intrarenal RAS status. Enhanced intrarenal AGT levels have been observed in experimental models of renal disease, supporting the concept that AGT plays an important role in the development and progression of renal disease. In this review, we focus on the role of intrarenal RAS activation in the pathophysiology of renal disease. Additionally, we explored the potential of urinary AGT as a novel biomarker of intrarenal RAS status in renal disease.

  8. Comparison of shock wave lithotripsy (SWL) and retrograde intrarenal surgery (RIRS) for treatment of stone disease in horseshoe kidney patients

    PubMed Central

    Gokce, Mehmet Ilker; Tokatli, Zafer; Suer, Evren; Hajiyev, Parviz; Akinci, Aykut; Esen, Baris

    2016-01-01

    ABSTRACT Objectives In this study it is aimed to compare the success and complication rates of SWL and RIRS in treatment of HSK stone disease. Materials and methods In this retrospective study data of 67 patients treated with either SWL (n=44) or RIRS (n=23) for stone disease in HSK between May 2003 to August 2014 was investigated. age, gender, stone size and multiplicity, stone free status, renal colic episodes and complication rates of the SWL and RIRS groups were compared. Results Mean age of the population was 42.5±8.2 (range: 16-78) years and mean stone size was 16.9±4.1 mm. SWL and RIRS groups were similar with regard to demographic characteristics and stone related characteristics. SFR of the SWL and RIRS groups were 47.7%(21/44 patients) and 73.9% (17/23 patients) respectively (p=0.039).Renal colic episodes were observed in 3 and 16 patients in the RIRS and SWL groups respectively (p=0.024). No statistically significant complications were observed between the SWL (8/44 patients) and RIRS (4/23) groups (p=0.936). Conclusions In HSK patients with stone disease, both SWL and RIRS are effective and safe treatment modalities. However RIRS seems to maintain higher SFRs with comparable complication rates. PMID:27136473

  9. Focal retrograde amnesia documented with matching anterograde and retrograde procedures.

    PubMed

    Manning, Lilianne

    2002-01-01

    Focal retrograde amnesia is an unusual and theoretically challenging form of memory disorder. The case of a 65-year-old woman presenting with focal retrograde amnesia is reported. Following a cardiac arrest and subsequent hypoxia she remained in a coma for 24 h with evidence of epileptiform activity during the early recovery period. MR scans, 4 and 7 months post-onset, showed mild bifrontal atrophic changes mainly affecting white matter areas. An [18F]fluorodeoxyglucose resting PET scan 1-year post-onset demonstrated right occipito-temporo-parietal hypometabolism. We were able to document the patient's performance on an extensive range of anterograde and retrograde tests and to monitor her recovery of function by assessing her performance at 4, 12 and 24 months post-onset. Spared anterograde memory was observed on a range of verbal and non-verbal tests, including matched tasks that compared pre-illness and post-illness onset recollections. In contrast, her performance on retrograde memory tests, using detailed autobiographical and public events verbal and photographic tasks, showed a temporally-graded retrograde amnesia, more particularly affecting memory for autobiographical episodes. Possible mechanisms underlying CH's focal retrograde amnesia are discussed in terms of Damasio's time-locked multiregional retroactivation model.

  10. Iloperidone-induced retrograde ejaculation.

    PubMed

    Freeman, Scott A

    2013-05-01

    This case series describes the development of retrograde ejaculation with the antipsychotic iloperidone. Iloperidone is a relatively new antipsychotic and has a strong α-1 receptor antagonism, which may explain this rare adverse effect.

  11. Chloroplast signaling: retrograde regulation revelations.

    PubMed

    Beale, Samuel I

    2011-05-24

    Developing chloroplasts are able to communicate their status to the nucleus and regulate expression of genes whose products are needed for photosynthesis. Heme is revealed to be a signaling molecule for this retrograde communication.

  12. Intrarenal angiotensin II and its contribution to the genesis of chronic hypertension

    PubMed Central

    Navar, L Gabriel; Prieto, Minolfa C; Satou, Ryousuke; Kobori, Hiroyuki

    2011-01-01

    The increased activity of intrarenal renin–angiotensin system (RAS) in a setting of elevated arterial pressure elicits renal vasoconstriction, increased sodium reabsorption, proliferation, fibrosis and renal injury. Increases in intrarenal and interstitial angiotensin (Ang) II levels are due to increased AT1 receptor mediated Ang II uptake and stimulation of renal angiotensinogen (AGT) mRNA and protein expression. Augmented proximal tubule AGT production increases tubular AGT secretion and spillover of AGT into the distal nephron and urine. Increased renin formation by principal cells of the collecting ducts forms Ang I from AGT thus increasing Ang II. The catalytic actions of renin and prorenin are enhanced by prorenin receptors (PRRs) on the intercalated cells. The resultant increased intrarenal Ang II levels contribute to the genesis of chronic hypertension. PMID:21339086

  13. Intrarenal distribution of inorganic mercury and albumin after coadministration

    SciTech Connect

    Zalups, R.K. ); Barfuss, D.W. )

    1993-01-01

    The renal disposition and the intrarenal distribution of albumin and mercury were studied simultaneously in rats co-injected with a 0.5-[mu]mol/kg dose of albumin and a 0.25-[mu]mol/kg dose of inorganic mercury at 2, 5, 30, and 180 min after injection. These studies were carried out to test the hypothesis that one of the mechanisms involved in the renal tubular uptake of inorganic mercury is cotransport with albumin. By the end of the first 2 min after injection, the ratio of inorganic mercury to albumin in the renal cortex and outer strip of the outer medulla was approximately 2.6 and 1.6, respectively. Both the cortex and outer stripe contain segments of the proximal tubule, and it is these segments that have been shown to be principally involved in the renal tubular uptake of both albumin and inorganic mercury. The ration increased slightly in these two zones after 5 and 20 min after injection. These data demonstrate that there is a relatively close relationship in the renal content of inorganic mercury and albumin. However, the ratios are significantly greater than the ratio of inorganic mercury of albumin in the injection solution, which was 0.5. After 180 min following co-injection, the ratio increased to about 38 in the cortex and 15 in the outer stripe. This increase in the ratio is probably related to the metabolism of albumin. Based on the ratios of inorganic mercury to albumin in the renal cortex and outer stripe of the outer medulla, it appears that some proximal tubular uptake of inorganic mercury occurs by mechanisms other than endocytotic cotransport of inorganic mercury with albumin. However, since the ratios were small during the early times after injection, cotransport of inorganic mercury with albumin cannot be excluded as one of the mechanisms involved in the proximal tubular uptake of inorganic mercury. 32 refs., 12 figs., 4 tabs.

  14. Emergency presentation of retrograde intussusception as a late complication of gastric bypass

    PubMed Central

    Pande, R; Fraser, I; Harmston, C

    2012-01-01

    Retrograde intussusception is a rare complication of a Roux-en-Y gastric bypass. With the rising number of gastric bypass operations being performed in the UK, the incidence of retrograde intussusception is likely to increase. We report the first case in the UK and highlight its insidious presentation and the importance of considering intussusception in any patient with a history of a Roux-en-Y gastric bypass. PMID:22507706

  15. ECIRS (Endoscopic Combined Intrarenal Surgery) in the Galdakao-modified supine Valdivia position: a new life for percutaneous surgery?

    PubMed

    Cracco, Cecilia Maria; Scoffone, Cesare Marco

    2011-12-01

    Percutaneous nephrolithotomy (PNL) is still the gold-standard treatment for large and/or complex renal stones. Evolution in the endoscopic instrumentation and innovation in the surgical skills improved its success rate and reduced perioperative morbidity. ECIRS (Endoscopic Combined IntraRenal Surgery) is a new way of affording PNL in a modified supine position, approaching antero-retrogradely to the renal cavities, and exploiting the full array of endourologic equipment. ECIRS summarizes the main issues recently debated about PNL. The recent literature regarding supine PNL and ECIRS has been reviewed, namely about patient positioning, synergy between operators, procedures, instrumentation, accessories and diagnostic tools, step-by-step standardization along with versatility of the surgical sequence, minimization of radiation exposure, broadening to particular and/or complex patients, limitation of post-operative renal damage. Supine PNL and ECIRS are not superior to prone PNL in terms of urological results, but guarantee undeniable anesthesiological and management advantages for both patient and operators. In particular, ECIRS requires from the surgeon a permanent mental attitude to synergy, standardized surgical steps, versatility and adherence to the ongoing clinical requirements. ECIRS can be performed also in particular cases, irrespective to age or body habitus. The use of flexible endoscopes during ECIRS contributes to minimizing radiation exposure, hemorrhagic risk and post-PNL renal damage. ECIRS may be considered an evolution of the PNL procedure. Its proposal has the merit of having triggered the critical analysis of the various PNL steps and of patient positioning, and of having transformed the old static PNL into an updated approach.

  16. Intrarenal manipulation of flexible ureteroscopes: a comparative study.

    PubMed

    Monga, Manoj; Weiland, Derek; Pedro, Renato N; Lynch, Alexandria C; Anderson, Kyle

    2007-07-01

    To compare the relative ease of manipulation around a calyceal model in the hands of experienced ureteroscopists of four flexible ureteroscopes (FUs), as new-generation FUs provide exaggerated active deflection to facilitate intrarenal manipulation. Four FUs of <7.5 F were tested: the FlexVision U-500 (SF) (Stryker Endoscopy, San Jose, CA, USA), the Dur-8 Elite (D8E) (ACMI, Southborough, MA, USA), the Viper (Richard Wolf Medical Instruments, Vernon Hills, IL, USA) and the URF-P3 (Olympus Surgical, Orangeburg, NY, USA). Eight experienced ureteroscopists, each with a minimum of 100 flexible ureteroscopies over the preceding 3 years, assessed the FUs. The Mediskills calyceal model represents a moderately hydronephrotic collecting system, with a renal pelvic width of 2 cm, infundibular widths of 1 cm and infundibular lengths of 2 cm. The middle calyx infundibular angle was 80 degrees and the lower calyx infundibular angle was 100 degrees . The model does not allow for significant passive secondary deflection. The surgeons manoeuvred systematically around a four-point course, from the pelvi-ureteric junction, to anterior lower calyx, to anterior middle calyx, to posterior lower calyx, to posterior middle calyx, touching a metal sensor with an fulguration electrode, to trigger an automated signal at each calyx. The order of FU used by each surgeon was randomized. Each surgeon performed the course twice with each FU, ending with the first FU they started with, to diminish the impact of "learning the course". There were significant differences in the mean (sd) total time for manipulation through the four-point course, for the Viper, SF, D8E and URF-P3, at 29 (11), 37 (23), 38 (20) and 50 (24) s, respectively (P = 0.034). The URF-P3 took longer to reach the posterior lower pole, at 18.1 (14.5) s than the Viper, SF and D8E, at 6.3 (2.8) (P = 0.004), 6.6 (3.3) (P = 0.008) and 7.7 (4.9) (P = 0.008), respectively. The Viper was quicker to reach the posterior middle pole, at 7

  17. Laparoscopic transgastric endoscopic retrograde cholangiopancreatography after biliopancreatic diversion.

    PubMed

    Molina Romero, Francesc Xavier; Morón Canis, José Miguel; Llompart Rigo, Alfredo; Rodríguez Pino, José Carlos; Morales Soriano, Rafael; González Argente, Francesc Xavier

    2015-11-01

    Endoscopic retrograde cholangiopancreatography may be difficult in patients that have undergone Roux-en-Y gastric bypass. Due to the fact that prevalence of morbid obesity is increasing, and laparoscopic procedures for its treatment have increased, the incidence of biliary tract problems in patients of altered anatomy is also growing. We describe a laparoscopic technique to access the biliary tree by endoscope, through the excluded stomach.

  18. Intrarenal pressure and irrigation flow with commonly used ureteric access sheaths and instruments

    PubMed Central

    Wright, Anna; Williams, Kevin; Somani, Bhaskar

    2015-01-01

    Introduction Flexible ureterorenoscopy is becoming a first-line treatment for many intrarenal stones. Ureteric access sheaths are commonly used to aid access, stone removal and reduce intrarenal pressure. We evaluated the effects of two commonly used access sheaths on irrigation flow and intrarenal pressure during flexible ureterorenoscopy. We measured the effect of scope instrumentation on flow and pressure. Material and methods We utilized a 10/12F and 12/14F, 35 cm Re-Trace™ access sheath with a FlexX2 scope in a cadaveric porcine kidney. We evaluated the effect of four Nitinol baskets (1.3F, 1.5F, 1.9F, 2.2F), three different 200 µm laser fibres and a hand-held pump. Measurements of irrigation flow and intrarenal pressure were recorded and compared between the different sized access sheaths. Results Flow rates varied widely between access sheaths. Without instrumentation, mean flow was 17 mls/min (10/12F access sheath), versus 33 mls/min (12/14F sheath) (p <0.0001). Increasing basket size produced a gradual reduction in flow and pressure in both access sheaths. Reassuringly, pressures were low overall (<40 cm H2O). Pressures were significantly reduced when using the larger 12/14F sheath, with and without all instrumentations (p <0.0001). Hand-held pump devices have a marked effect on flow and pressure in both sheaths; with pressures rising up to 121 cm H2O with a 10/12F sheath, versus 29 cm H2O (12/14F) (p <0.0001). Conclusions A 12/14F access sheath offered significantly improved irrigation whilst maintaining significantly lower intrarenal pressure, when compared to a 10/12F access sheath in a cadaveric porcine model. Scope instrumentation affects irrigation flow and pressure in both sized sheaths. Furthermore, there should be caution with hand-held pump devices, especially with smaller sized sheaths, as intrarenal pressure can be very high. PMID:26855796

  19. The Annual Retrograde Nutation Variability

    NASA Astrophysics Data System (ADS)

    Gattano, C.; Lambert, S.; Bizouard, C.

    2016-12-01

    Very Long Baseline Interferometry is the only technique that can estimate Earth nutations with an accuracy under the milliarcsecond level. With 35 years of geodetic VLBI observations, the principal nutation terms caused by luni-solar tides and geophysical response have been estimated. We focus on the variability. Two of them present very significant amplitude and phase variations: the retrograde Free Core Nutation (FCN) with a period of around 430 days and the Annual Retrograde Nutation (ARN). Despite progress made in global circulation models, the atmospheric and ocean excitation cannot account for that. In particular the ARN shows an amplitude modulation of approximately six years, reminiscent of the six-year geomagnetic oscillation in the Length-of-Day (LOD). As to the latter, we suggest that the nutation term variability may have deep Earth causes, and we estimate an order of magnitude of Earth internal structure parameters to explain this variability.

  20. Making your own retrograde carrier.

    PubMed

    Chai, W L; Ngeow, W C

    1999-02-01

    One of the problems faced by manufacturers is the difficulty in constructing a robust and reliable, angled applicator tip. This can be overcome by handmaking your own retrograde carrier. The applicator tip may be bent to about 50 degrees and, if a kink occurs while bending the tip, it can be replaced easily by a new modified needle. Because the wire used is flexible, it can adapt to the bend without a problem. Narrower carriers can also be made using a 20-G needle, perhaps more suitable for retrograde fillings of molar apices. Because the carrier is designed to be used once only, the problems of it being difficult to load and liable to blockages should not arise.

  1. Retrograde ejaculation in a stallion.

    PubMed

    Brinsko, S P

    2001-02-15

    Retrograde ejaculation was diagnosed in a 10-year-old Arabian stallion. Despite behavioral signs consistent with ejaculation, the collection receptacle of an artificial vagina remained devoid of semen on numerous occasions. Catheterization of the urinary bladder yielded large numbers of spermatozoa, even when an ejaculate was obtained, whereas low numbers (< 1 X 10(6)/ml) of spermatozoa are found in the bladder of clinically normal stallions after ejaculation. Endoscopic examination of the urethra, seminal colliculus, and bladder failed to reveal abnormalities. Medical treatment with imipramine hydrochloride apparently resulted in improvement initially, but was not curative. Further diagnostic and treatment measures were declined and the stallion was castrated. For stallions that seemingly fail to ejaculate or for ejaculates that contain lower seminal volumes or numbers of spermatozoa than expected, obtaining a urine sample after ejaculation via bladder catheterization is a simple diagnostic procedure that may be used to investigate the possibility of retrograde ejaculation.

  2. A simple method to ensure homogeneous drug distribution during intrarenal infusion.

    PubMed

    Postnov, Dmitry D; Salomonsson, Max; Sorensen, Charlotte M; Sosnovtseva, Olga

    2017-03-01

    Intrarenal drug infusion plays an important role in renal experimental research. Laminar flow of the blood can cause streaming and inhomogeneous intrarenal distribution of infused drugs. We suggest a simple method to achieve a homogeneous intravascular distribution of drugs infused into the renal artery of anesthetized rats. The method employs a multiple sidehole catheter inserted into the renal artery, which enables an efficient drug mixing with the arterial blood. To verify the efficiency of this method, we use laser speckle imaging and renal artery flowmetry. The results show that, compared with the conventional single-hole catheter, the multiple sidehole catheter provides a more uniform drug distribution and a homogenous vascular response on the surface of the kidney. Copyright © 2017 the American Physiological Society.

  3. Receptor-Induced Dilatation in the Systemic and Intrarenal Adaptation to Pregnancy in Rats

    PubMed Central

    Ferreira, Vanessa M.; Gomes, Thiago S.; Reis, Luciana A.; Ferreira, Alice T.; Razvickas, Clara V.; Schor, Nestor; Boim, Mirian A.

    2009-01-01

    Normal pregnancy is associated with systemic and intrarenal vasodilatation resulting in an increased glomerular filtration rate. This adaptive response occurs in spite of elevated circulating levels of angiotensin II (Ang II). In the present study, we evaluated the potential mechanisms responsible for this adaptation. The reactivity of the mesangial cells (MCs) cultured from 14-day-pregnant rats to Ang II was measured through changes in the intracellular calcium concentration ([Cai]). The expression levels of inducible nitric oxide synthase (iNOS), the Ang II-induced vasodilatation receptor AT2, and the relaxin (LGR7) receptor were evaluated in cultured MCs and in the aorta, renal artery and kidney cortex by real time-PCR. The intrarenal distribution of LGR7 was further analyzed by immunohistochemistry. The MCs displayed a relative insensitivity to Ang II, which was paralleled by an impressive increase in the expression level of iNOS, AT2 and LGR7. These results suggest that the MCs also adapt to the pregnancy, thereby contributing to the maintenance of the glomerular surface area even in the presence of high levels of Ang II. The mRNA expression levels of AT2 and LGR7 also increased in the aorta, renal artery and kidney of the pregnant animals, whereas the expression of the AT1 did not significantly change. This further suggests a role of these vasodilatation-induced receptors in the systemic and intrarenal adaptation during pregnancy. LGR7 was localized in the glomeruli and on the apical membrane of the tubular cells, with stronger labeling in the kidneys of pregnant rats. These results suggest a role of iNOS, AT2, and LGR7 in the systemic vasodilatation and intrarenal adaptation to pregnancy and also suggest a pivotal role for relaxin in the tubular function during gestation. PMID:19287481

  4. Control of glomerular filtration rate: role of intrarenally formed angiotensin II.

    PubMed

    Kastner, P R; Hall, J E; Guyton, A C

    1984-06-01

    This study was designed to investigate the role of intrarenally formed angiotensin II (ANG II) in controlling glomerular filtration rate (GFR) during reduction of renal artery pressure (RAP). The experimental design prevented renin released by the kidney from entering the systemic circulation and therefore prevented changes in circulating ANG II from influencing GFR control. In dogs with only a functional intrarenal renin-angiotensin system (RAS), GFR and renal blood flow (RBF) were not significantly altered by RAP reduction to 70 mmHg. After blockade of intrarenal ANG II formation with SQ 14225, reduction of RAP to 70 mmHg decreased GFR and filtration fraction to 75.6 +/- 7.0 and 59.0 +/- 4.1% of control, respectively, while RBF remained at 129.3 +/- 8.8% of control. Calculated efferent arteriolar resistance decreased considerably more when RAP was reduced after SQ 14225, whereas preglomerular resistance decreased to about the same level as observed prior to SQ 14225 infusion. After return of endogenously produced ANG II by recirculation of the renal venous blood or after infusion of ANG II (following SQ 14225) at a rate that restored RBF to the control level (with RAP held at 70 mmHg in each case), GFR, filtration fraction, and calculated efferent resistance were restored to control levels, but preglomerular resistance did not change. These results suggest that intrarenal ANG II formation plays an important role in maintaining GFR during reductions in RAP by constricting efferent arterioles.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Targeting of Rho kinase ameliorates impairment of diabetic endothelial function in intrarenal artery.

    PubMed

    Yin, Hongping; Ru, Hailong; Yu, Liping; Kang, Yanhua; Lin, Guohua; Liu, Chuanfei; Sun, Lixian; Shi, Liyun; Sun, Qinghua; Liu, Cuiqing

    2013-10-14

    Endothelial dysfunction in kidney vasculature is the initial and key element for nephropathy in diabetes mellitus. Accumulating evidence suggests the protective role of Rho kinase inhibitors in endothelial dysfunction via modulating eNOS activity and NO production. However, the role of Rho kinase in diabetes-related endothelial dysfunction in kidney vasculature and the relevant mechanisms remain unknown. We assessed whether pharmacological inhibition of Rho kinase attenuates endothelial dysfunction in intrarenal arteries from type 1 diabetic rats. Fasudil, a Rho kinase inhibitor effectively decreased the phosphorylated level of MYPT1 without affecting the expression of ROCKs in the kidney. Fasudil treatment showed no improvement in diabetes-related abnormality in metabolic indices, but it significantly ameliorated endothelial dysfunction in intrarenal arteries and lessened the mesangial matrix expansion in the kidney cortex. Mechanistically, superoxide production in the intrarenal artery and NOX4 member of NADPH oxidase in the renal cortex that contribute to diabetic nephropathy were also prevented by the Rho kinase inhibitor. In conclusion, the present results indicate that Rho kinase is involved in endothelial dysfunction in type 1 diabetes via enhancement of oxidative stress and provides new evidence for Rho kinase inhibitors as potential therapeutic agents for the treatment of diabetic nephropathy.

  6. Intrarenal distribution of mercury in the rat: effect of administered dose of mercuric chloride

    SciTech Connect

    Zalups, R.K.; Diamond, G.L.

    1987-01-01

    The authors recently observed that the distribution of mercury in the hypertrophied remnant kidneys of uninephrectomized rats was different from that in the kidneys of sham-operated rats when given the same non-toxic dose of mercuric chloride (HgCl/sub 2/; 0.5 ..mu..mol/kg). These observations are quite significant, since the altered intrarenal distribution of mercury in uninephrectomized rats may cause uninephrectomized rats to develop more severe tubular necrosis in the outer medulla than sham-operated rats. In the experiments described above, the mercury burden of the hypertrophied remnant kidneys from the uninephrectomized rats was approximately twice that of each of the kidneys from the sham-operated rats. Thus, the altered intrarenal distribution of mercury in the uninephrectomized rats may be, in part, the result of the remnant kidney being exposed to more mercury. Implicit in this hypothesis is the idea that the manner in which the kidney accumulates mercury is dependent on the amount of mercury it is exposed to. If this is the case, then one would predict that the intrarenal accumulation of mercury in rats with two kidneys would change as the administered dose of HgCl/sub 2/ is increased from the dose of 0.5 ..mu..mol/kg. The principal aim of this study was to test this hypothesis.

  7. Retrograde traffic in the biosynthetic-secretory route

    PubMed Central

    Neumüller, Josef; Ellinger, Adolf

    2008-01-01

    In the biosynthetic-secretory route from the rough endoplasmic reticulum, across the pre-Golgi intermediate compartments, the Golgi apparatus stacks, trans Golgi network, and post-Golgi organelles, anterograde transport is accompanied and counterbalanced by retrograde traffic of both membranes and contents. In the physiologic dynamics of cells, retrograde flow is necessary for retrieval of molecules that escaped from their compartments of function, for keeping the compartments’ balances, and maintenance of the functional integrities of organelles and compartments along the secretory route, for repeated use of molecules, and molecule repair. Internalized molecules may be transported in retrograde direction along certain sections of the secretory route, and compartments and machineries of the secretory pathway may be misused by toxins. An important example is the toxin of Shigella dysenteriae, which has been shown to travel from the cell surface across endosomes, and the Golgi apparatus en route to the endoplasmic reticulum, and the cytosol, where it exerts its deleterious effects. Most importantly in medical research, knowledge about the retrograde cellular pathways is increasingly being utilized for the development of strategies for targeted delivery of drugs to the interior of cells. Multiple details about the molecular transport machineries involved in retrograde traffic are known; a high number of the molecular constituents have been characterized, and the complicated fine structural architectures of the compartments involved become more and more visible. However, multiple contradictions exist, and already established traffic models again are in question by contradictory results obtained with diverse cell systems, and/or different techniques. Additional problems arise by the fact that the conditions used in the experimental protocols frequently do not reflect the physiologic situations of the cells. Regular and pathologic situations often are intermingled, and

  8. Endoscopic retrograde sphincterotomy in swine.

    PubMed

    Gholson, C F; Provenza, J M; Doyle, J T; Bacon, B R

    1991-10-01

    Endoscopic retrograde sphincterotomy was performed on four sedated pigs, ages 3-4 months, using a standard human duodenoscope and papillotome. Sphincterotomies, 1 cm in length, were well-tolerated, and all animals recovered promptly, spontaneously regained gastrointestinal function, and gained weight. The first three animals were sacrificed after one week, and autopsy revealed no complications. The fourth animal was sacrificed immediately following the procedure, and no evidence of perforation was found. These observations demonstrate that the pig is a valid experimental model for endoscopic sphincterotomy. Its use in training is limited by technical and anatomic differences from humans. Potential uses of this technique in research are discussed.

  9. Aberrant Activation of the Intrarenal Renin-Angiotensin System in the Developing Kidneys of Type 2 Diabetic Rats

    PubMed Central

    Fan, Y.-Y.; Kobori, H.; Nakano, D.; Hitomi, H.; Mori, H.; Masaki, T.; Sun, Y.-X.; Zhi, N.; Zhang, L.; Huang, W.; Zhu, B.; Li, P.; Nishiyama, A.

    2013-01-01

    We have previously reported that intrarenal angiotensin II (Ang II) levels are increased long before diabetes becomes apparent in obese Otsuka-Long-Evans-Tokushima-Fatty (OLETF) rats, a model of type 2 diabetes. In this study, we examined the changes in intrarenal renin-angiotensin system (RAS) activity in the developing kidneys of OLETF rats. Ang II contents and mRNA levels of RAS components were measured in male OLETF and control Long-Evans Tokushima (LETO) rats at postnatal days (PND) 1, 5, and 15, and at 4–30 weeks of age. In both LETO and OLETF rats, kidney Ang II levels peaked at PND 1, then decreased during the pre- and post-weaning periods. However, Ang II levels and gene expression of RAS components, including angiotensinogen (AGT), renin, and angiotensin-converting enzyme (ACE), were not significantly different between LETO and OLETF rats. Intrarenal Ang II contents further decreased during puberty (from 7 to 11 weeks of age) in LETO rats, bur not in OLETF rats. At 11 weeks of age, kidney Ang II levels, urinary AGT excretion, and mRNA levels of AGT and renin were higher in OLETF rats than in LETO rats, while blood glucose levels were not significantly different between these groups of rats. These data indicate that continued intrarenal expression of Ang II during pubescence contributes to the increases in intrarenal Ang II levels in prediabetic OLETF rats, and is associated with increased intrarenal AGT and renin expression. Inappropriate activation of the intrarenal RAS in the prediabetic stage may facilitate the onset and development of diabetic nephropathy in later life. PMID:23322513

  10. Evaluation of intrarenal mesenchymal stem cell injection for treatment of chronic kidney disease in cats: a pilot study.

    PubMed

    Quimby, Jessica M; Webb, Tracy L; Gibbons, Debra S; Dow, Steven W

    2011-06-01

    The feasibility of autologous intrarenal mesenchymal stem cell (MSC) therapy in cats with chronic kidney disease (CKD) was investigated. Six cats (two healthy, four with CKD) received a single unilateral intrarenal injection of autologous bone marrow-derived or adipose tissue-derived MSC (bmMSC or aMSC) via ultrasound guidance. Minimum database and glomerular filtration rate (GFR) via nuclear scintigraphy were determined pre-injection, at 7 days and at 30 days post-injection. Intrarenal injection did not induce immediate or long-term adverse effects. Two cats with CKD that received aMSC experienced modest improvement in GFR and a mild decrease in serum creatinine concentration. Despite the possible benefits of intrarenal MSC injections for CKD cats, the number of sedations and interventions required to implement this approach would likely preclude widespread clinical application. We concluded that MSC could be transferred safely by ultrasound-guided intrarenal injection in cats, but that alternative sources and routes of MSC therapy should be investigated. Copyright © 2011 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

  11. Chloroplast retrograde signal regulates flowering

    PubMed Central

    Feng, Peiqiang; Guo, Hailong; Chi, Wei; Chai, Xin; Sun, Xuwu; Xu, Xiumei; Ma, Jinfang; Rochaix, Jean-David; Leister, Dario; Wang, Haiyang; Lu, Congming; Zhang, Lixin

    2016-01-01

    Light is a major environmental factor regulating flowering time, thus ensuring reproductive success of higher plants. In contrast to our detailed understanding of light quality and photoperiod mechanisms involved, the molecular basis underlying high light-promoted flowering remains elusive. Here we show that, in Arabidopsis, a chloroplast-derived signal is critical for high light-regulated flowering mediated by the FLOWERING LOCUS C (FLC). We also demonstrate that PTM, a PHD transcription factor involved in chloroplast retrograde signaling, perceives such a signal and mediates transcriptional repression of FLC through recruitment of FVE, a component of the histone deacetylase complex. Thus, our data suggest that chloroplasts function as essential sensors of high light to regulate flowering and adaptive responses by triggering nuclear transcriptional changes at the chromatin level. PMID:27601637

  12. Endoscopic Retrograde Cholangiopancreatography in Bilioenteric Anastomosis

    PubMed Central

    Park, Eun Taek

    2016-01-01

    For diagnosis and treatment of pancreatobiliary diseases, endoscopic retrograde cholangiopancreatography (ERCP) is useful method nowadays and its technically success rate is usually in about 90%-95% of patients with normal gastric and pancreaticobiliary anatomy. Recently ERCP is significantly challenging after intestinal reconstruction, particularly in patients who have undergone pancreaticoduodenectomy (PD, classic Whipple’s operation) or pylorus-preserving pancreatoduodenectomy (PPPD) with reconstruction. PD and PPPD relate to numerous techniques have been presented for reconstruction of the digestive tract and pancreaticobiliary tree during the resection bilioenteric stricture commonly occurs later in the postoperative course and developed in 5-year cumulative probability of biliary stricture rate of 8.2% and pancreaticoenteric stricture of 4.6%. This complication was no difference in incidence between patients with benign or malignant disease. In PD or PPPD with reconstruction, short pancreatobiliary limb with biliojejunal anastomosis site is made usually, modestly success rate of intubation to blind loop and cannulation with conventional endoscope. However, in combined Reux-en-Y anastomosis, longer pancreatobiliary limb and additional Reux limb are obstacle to success intubation and cannulation by using conventional endoscope. In this situation, new designed enetroscope with dedicated accessories is efficient. PMID:27838918

  13. Chronic intrarenal insulin replacement reverses diabetes mellitus-induced natriuresis and diuresis.

    PubMed

    Manhiani, M Marlina; Duggan, A Daniel; Wilson, Hunter; Brands, Michael W

    2012-02-01

    We showed recently that sustained natriuresis in type 1 diabetic dogs was attributed to the decrease in insulin rather than the hyperglycemia alone. The sodium-retaining action of insulin appeared to require hyperglycemia, and it completely reversed the diabetic natriuresis and diuresis. This study tested whether the sodium-retaining effect was attributed to direct intrarenal actions of insulin. Alloxan-treated dogs (D; n=7) were maintained normoglycemic using 24-h/d IV insulin replacement. After control measurements, IV insulin was decreased to begin a 6-day diabetic period. Blood glucose increased from 84±6 mg/dL to an average of 428 mg/dL on days 5 and 6, sodium excretion increased from 74±8 to 98±7 meq/d over the 6 days, and urine volume increased from 1645±83 to 2198±170 mL/d. Dir dogs (n=7) were subjected to the same diabetic regimen, but, in addition, insulin was infused continuously into the renal artery at 0.3 mU/kg per minute during the 6-day period. This did not affect plasma insulin. Blood glucose increased from 94±10 mg/dL to an average of 380 mg/dL on days 5 and 6, but sodium excretion averaged 76±5 and 69±8 meq/d during control and diabetes mellitus, respectively. The diuresis also was prevented. Glomerular filtration rate increased only in Dir dogs, and there was no change in mean arterial pressure in either group. This intrarenal insulin infusion had no effect on sodium or volume excretion in normal dogs. Intrarenal insulin replacement in diabetic dogs caused a sustained increase in tubular reabsorption that completely reversed diabetic natriuresis. Insulin plus glucose may work to prevent salt wasting in uncontrolled type 2 diabetes mellitus.

  14. Chronic Intra-Renal Insulin Replacement Reverses Diabetes-Induced Natriuresis and Diuresis

    PubMed Central

    Manhiani, M. Marlina; Duggan, A. Daniel; Wilson, Hunter; Brands, Michael W.

    2012-01-01

    We recently showed that sustained natriuresis in Type I diabetic dogs was due to the decrease in insulin rather than the hyperglycemia alone. The sodium retaining action of insulin appeared to require hyperglycemia and it completely reversed the diabetic natriuresis and diuresis. This study tested whether the sodium retaining effect was due to direct intrarenal actions of insulin. Alloxan-treated dogs (D; n=7) were maintained normoglycemic using 24hr/day i.v. insulin replacement. After control measurements, i.v. insulin was decreased to begin a 6-day diabetic period. Blood glucose increased from 84±6 to an average of 428 mg/dL on days 5 and 6, sodium excretion increased from 74±8 to 98±7 mEq/day over the 6 days, and urine volume increased from 1645±83 to 2198±170 mL/day. Other dogs (DIr, n=7) were subjected to the same diabetic regimen, but in addition, insulin was infused continuously into the renal artery at 0.3 mU/kg/min during the 6-day period. This did not affect plasma insulin. Blood glucose increased from 94±10 to an average of 380 mg/dL on days 5 and 6, but sodium excretion averaged 76±5 and 69±8 mEq/day during control and diabetes, respectively. The diuresis also was prevented. GFR increased only in Dir dogs, and there was no change in MAP in either group. This intra-renal insulin infusion had no effect on sodium or volume excretion in normal dogs. Intra-renal insulin replacement in diabetic dogs caused a sustained increase in tubular reabsorption that completely reversed diabetic natriuresis. Insulin+glucose may work to prevent salt wasting in uncontrolled Type II diabetes. PMID:22215718

  15. Screening of seeds prepared from retrograded potato starch to increase retrogradation rate of maize starch.

    PubMed

    Lian, Xijun; Liu, Lizeng; Guo, Junjie; Li, Lin; Wu, Changyan

    2013-09-01

    In this paper, retrograded potato starches treated by oxalic, hydrochloric and citric acids and/with amylase respectively, as seed crystals, are added into maize starch paste to increase maize starch retrogradation rate. The results show that addition of seed accelerates maize starch retrogradation greatly. Seed prepared from retrograded potato starch treated by oxalic acid increases maize starch retrogradation rate most, from 1.5% to 49%. The results of IR spectra of retrograded maize starch derived from different seeds show that double helix, not hydrogen bond, probably forms at stage of seed growth during retrogradation. The results of IR spectra, X-ray and SEM indicate that treatment of retrograded potato starch with oxalic acid leads to formation of more hydrogen bonds and an increase of seed crystal planes, which markedly promotes the growth of the seed. Retrogradation of maize starch by seeding method surely includes a stage of crystal growth through double helix in a way different from normal maize starch retrogradation. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Wideband Doppler Ultrasound-guided Mini-endoscopic Combined Intrarenal Surgery as an Effective and Safe Procedure for Management of Large Renal Stones: A Preliminary Report.

    PubMed

    Inoue, Takaaki; Kinoshita, Hidefumi; Okada, Shinsuke; Hamamoto, Shuzo; Taguchi, Makoto; Murota, Takashi; Matsuda, Tadashi

    2016-09-01

    To evaluate the efficacy and safety of wideband Doppler ultrasound-guided mini-endoscopic combined intrarenal surgery (mini-ECIRS) for large renal stones. This study included 41 patients with large renal stones (>30 mm) treated by mini-ECIRS using a retrograde flexible ureteroscope and miniature nephroscope by wideband Doppler ultrasound guidance in the modified Valdivia position from January 2013 to September 2015. Surgical parameters, including the stone-free rate, operative time, complications (especially hemorrhagic complications), and hemoglobin drop were recorded and analyzed. Univariate analysis was performed to identify risk factors for a hemoglobin drop of ≥1 g/dL. The mean stone size, including staghorn calculi in 41.4% of cases, was 45.5 ± 14.7 mm. Percutaneous access into the calices using wideband Doppler ultrasound was successful in all cases. The mean total operative time was 158.4 ± 51.3 minutes. The mean mini-ECIRS time (from first percutaneous puncture to end of procedure) was 106.2 ± 36.0 minutes. The initial stone-free rate was 73.2% (n = 30). The final stone-free rate after auxiliary treatment was 97.5% (n = 40). The mean hemoglobin drop was 0.54 ± 0.65 g/dL. Three (7.3%) postoperative modified Clavien grade II complications occurred. Univariate analysis revealed no significant risk factors for a hemoglobin drop of ≥1 g/dL. Wideband Doppler ultrasound-guided renal puncture is safe and feasible. Wideband Doppler ultrasound-guided mini-ECIRS is a beneficial, versatile, and safe treatment option for management of large renal stones of >30 mm. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Successful treatment of retrograde ejaculation with amezinium.

    PubMed

    Ichiyanagi, O; Sasagawa, I; Suzuki, Y; Matsuki, S; Itoh, K; Miura, M; Tomita, Y

    2003-01-01

    The effect of amezinium, a new type of antihypotensive agent, on retrograde ejaculation was evaluated in 3 patients with retrograde ejaculation. The patients received 10 mg amezinium orally once a day. All patients achieved antegrade ejaculation. Semen analyses revealed 6-50 x 10(6)/mL (mean 28.7 x 10(6)/mL) sperm with a motility of 20-50% (mean 36.7%). The wives of 2 patients became pregnant within 6 months of the initial treatment. None of the patients had any side effects. It would appear that amezinium is a useful treatment for retrograde ejaculation.

  18. Endogenous angiotensin concentrations in specific intrarenal fluid compartments of the rat.

    PubMed

    Seikaly, M G; Arant, B S; Seney, F D

    1990-10-01

    To examine angiotensin (ANG) concentrations in fluid compartments near known intrarenal ANG receptors, we measured ANG concentrations in glomerular filtrate (GF), star vessel plasma (SVP), and luminal fluid from the early, mid, and late proximal tubule (E, M, and L PT). Samples were collected from euvolemic Munich-Wistar rats by free-flow micropuncture; ANG concentrations were measured by RIA. In one group of rats, concentrations of total immunoreactive ANG (reflecting ANG II and lesser amounts of three fragments) in GF and E, M, and L PT fluid averaged 29-40 nM compared with 32 pM in systemic plasma. In a second group, immunoreactive ANG concentrations in SVP also exceeded systemic levels by a factor of 1,000. In a final group, samples of GF and LPT fluid were purified by HPLC before RIA to measure ANG II and III concentrations specifically: their respective concentrations were 6-8 nM and 14-25 nM. We interpret these results to indicate that substantial amounts of ANG peptides are released into or generated within intrarenal fluid compartments, in which local ANG is likely to effect regulation of renal function independently of systemic ANG.

  19. Significance of intrarenal concentrations of gentamicin for the outcome of experimental pyelonephritis in rats.

    PubMed

    Bergeron, M G; Bastille, A; Lessard, C; Gagnon, P M

    1982-07-01

    The significance of continuous intrarenal levels of gentamicin in the treatment of acute pyelonephritis due to Echerichia coli was investigated in rats. Treatment was started 24 hr after E. coli was injected into the left kidney. A single dose or three successive doses (10 mg/kg of body weight) of gentamicin administered ip every 8 hr could not sterilize the kidneys. Injections of gentamicin (10 mg/kg) every 12 hr for seven or 14 days resulted in continuous levels of the drug in the medulla that persisted above the minimal inhibitory concentration for E. coli (1.6 microgram/ml) for six months or more. Whereas greater than or equal to 73% of the right kidneys or urine specimens were found to be sterile up to six months following a week of therapy, only 23% of the left kidneys were sterile. Two weeks of treatment sterilized greater than or equal to 86% of the left kidneys, right kidneys, and urine specimens. Concentrations of drug in serum and urine were poor predictors of both the intrarenal distribution of drug and the outcome of pyelonephritis.

  20. Effects of Intrarenal and Intravenous Infusion of the Phosphodiesterase 3 Inhibitor Milrinone on Renin Secretion

    NASA Technical Reports Server (NTRS)

    Kumagai, Kazuhiro; Reid, Ian A.

    1994-01-01

    We have reported that administration of the phosphodiesterase III inhibitor milrinone increases renin secretion in conscious rabbits. The aim of the present study was to determine if the increase in renin secretion results from a direct renal action of milrinone, or from an indirect extrarenal effect of the drug. This was accomplished by comparing the effects of intrarenal and intravenous infusion of graded doses of milrinone on plasma renin activity in unilaterally nephrectomized conscious rabbits. Milrinone was infused into the renal artery in doses of 0.01, 0.1 and 1.0 micro-g/kg/min, and intravenously in the same rabbits in doses of 0.01, 0.1, 1.0 and 10 micro-g/kg/min. Each dose was infused for 15 min. No intrarenal dose of milrinone altered plasma renin activity or arterial pressure, although at the highest dose, there was a small increase in heart rate. Intravenous infusion of milrinone at 1.0 micro-g/kg/min increased plasma renin activity to 176 +/- 55% of the control value (P less than 0.05). Heart rate increased but arterial pressure did not change. Intravenous infusion of milrinone at 1O micro-g/kg/min increased plasma renin activity to 386 +/- 193% of control in association with a decrease in arterial pressure and an increase in heart rate. These results confirm that milrinone increases renin secretion, and indicate that the stimulation is due to an extrarenal effect of the drug.

  1. Intrarenal site of action of calcium on renin secretion in dogs.

    PubMed

    Watkins, B E; Davis, J O; Lohmeier, T E; Freeman, R H

    1976-12-01

    We studied the effects of intrarenal calcium infusion on renin secretion in sodium-depleted dogs in an attempt to elucidate the major site of calcium-induced inhibition of renin release. Both calcium chloride and calcium gluconate reduced renal blood flow and renin secretion while renal perfusion pressure was unchanged. These data indicate that calcium inhibition of renin secretion did not occur primarily at the renal vascular receptor; decreased renal blood flow is usually associated with increased renin secretion. Calcium chloride infusion increased urinary chloride excretion without affecting sodium excretion, and calcium gluconate failed to increase either sodium or chloride excretion. Also, the filtered loads of sodium and chloride were unchanged during the calcium infusions. These results give no indication that calcium inhibited renin secretion by increasing the sodium or chloride load at the macula densa. The effects of intrarenal calcium infusion on renin release were also assessed in dogs with a nonfiltering kidney in which renal tubular mechanisms could not influence renin secretion. The observation that calcium still suppressed renin release in these dogs provides additional evidence that the the major effect of calcium involved nontubular mechanisms. Thus, it appears likely that calcium acted directly on the juxtaglomerular cells to inhibit renin secretion.

  2. Retrograde arterialized venous flap: an experimental study.

    PubMed

    Moshammer, Harald E T; Schwarzl, Franz X; Haas, Franz M; Maechler, Heinrich; Pierer, Gerhard; Wiltgen, Marco; Koch, Horst

    2003-01-01

    An experimental model was established to study circulation in retrograde arterialized venous flaps (RAVF). Venous flaps measuring 7 x 4 cm with a matching venous system were harvested from both forearms of 10 fresh human cadavers. In each trial, both flaps were simultaneously perfused with heparinized human blood driven by a pulsatile circulation model. In each trial there was one flap with retrograde perfusion, and one flap with antegrade perfusion. Clinical assessment, measurement of outflow, and angiographic examination with digitally assisted assessment after 3 h of perfusion showed better results for retrograde perfusion in 8 of the 10 trials. This study indicates that blood circulation in the periphery of arterialized venous flaps can be enhanced by retrograde arterialization. Copyright 2003 Wiley-Liss, Inc.

  3. Does Perceptual Learning Suffer from Retrograde Interference?

    PubMed Central

    Aberg, Kristoffer C.; Herzog, Michael H.

    2010-01-01

    In motor learning, training a task B can disrupt improvements of performance of a previously learned task A, indicating that learning needs consolidation. An influential study suggested that this is the case also for visual perceptual learning [1]. Using the same paradigm, we failed to reproduce these results. Further experiments with bisection stimuli also showed no retrograde disruption from task B on task A. Hence, for the tasks tested here, perceptual learning does not suffer from retrograde interference. PMID:21151868

  4. Visualization of intrarenal vessels by 3.0-T MR angiography in comparison with digital subtraction angiography using renal specimens.

    PubMed

    Schenk, Jens-Peter; Friebe, Björn; Ley, Sebastian; Baudendistel, Klaus; Schoebinger, Max; Hähnel, Stefan; Mehrabi, Arianeb; Tröger, Jochen; Hallscheidt, Peter

    2006-10-01

    MRI at 3.0 T enables high-spatial resolution for renal MR angiography. Evaluation of an arterial tree model in animal kidney specimens with comparison of digital subtraction angiography (DSA) and high-field MRI to find out the maximum spatial resolution of intrarenal vessels. It was considered that objective quantitation of angiogram quality could be achieved. A total of 27 pig kidney specimens were examined by MR angiography (flash 3D) using a 3.0-T scanner (TRIO; Siemens, Erlangen, Germany) with an eight-channel head coil and a voxel size of 0.9x0.9x1.1 mm in the early arterial phase after implantation of a 4F catheter in the renal artery. DSA (Integris, Philips, Best, The Netherlands) was performed immediately after the MRI. With the help of semiautomated segmentation, all vessels were marked for comparison of the vessel trees. The Wilcoxon rank test was used for statistical evaluation of vessel numbers and branching depths. Objective comparison between DSA and MR angiography was achieved. High-field MR angiography had the ability to depict vessels up to the seventh branching on average. Significant differences in vessel delineation and counts were found from the fifth level of intrarenal branching onwards with DSA showing an advantage. High-field MRI has great potential in the detection of intrarenal arteries and is comparable to DSA in visualization of the central intrarenal vessel tree.

  5. Can We Provide Low Intrarenal Pressures with Good Irrigation Flow by Decreasing the Size of Ureteral Access Sheaths?

    PubMed

    Emre Sener, Tarik; Cloutier, Jonathan; Villa, Luca; Marson, Francesco; Butticè, Salvatore; Doizi, Steeve; Traxer, Olivier

    2016-01-01

    Flexible ureterorenoscopy (F-URS) plays a major role in the management of kidney stones. Ureteral access sheaths (UAS) are important tools for F-URS. In this study, we aimed to evaluate the difference in intrarenal pressures between different flexible ureteroscopes while using the same UAS and to calculate the irrigation flow variance. Eight different flexible ureteroscopes were tested with five different UAS on an artificial kidney model to measure intrarenal pressures and irrigation flow. Irrigation at 60 cmH2O pressure was performed; the pressure and the irrigation flow amount were recorded with different states of the operator channel: Free, with the laser fiber (272 μm), and with the nitinol basket (1.9F) inside. The highest pressure recorded was 46.68 cmH2O with Wolf Boa and 9.5/11.5F Cook Medical UAS. All the ureteroscopes that fit inside the 10/12F Coloplast ReTrace provided pressures below 40 cmH2O. The inner diameter of the 10/12F Rocamed Bi-Flex is actually 11F, so intrarenal pressures were lower and irrigation flow was higher. With the 11/13F Boston Scientific Navigator HD and 12/14F Coloplast ReTrace, the pressures were very low. The irrigation flow measurements were in concordance with pressure measurements. The ureteroscope sizes diminished with advancements in technology. Small-sized ureteroscopes can provide low intrarenal pressures with good irrigation flow when used with convenient small-sized access sheaths. The compatibility between the ureteroscopes and UASs should be anticipated by all endourologists and considered during F-URS. The advantages of 10/12 UASs in terms of intrarenal pressure and irrigational flow should make these access sheaths an interesting first-line choice.

  6. Retrogradation enthalpy does not always reflect the retrogradation behavior of gelatinized starch

    PubMed Central

    Wang, Shujun; Li, Caili; Zhang, Xiu; Copeland, Les; Wang, Shuo

    2016-01-01

    Starch retrogradation is a term used to define the process in which gelatinized starch undergoes a disorder-to-order transition. A thorough understanding of starch retrogradation behavior plays an important role in maintaining the quality of starchy foods during storage. By means of DSC, we have demonstrated for the first time that at low water contents, the enthalpy change of retrograded starch is higher than that of native starch. In terms of FTIR and Raman spectroscopic results, we showed that the molecular order of reheated retrograded starch samples is lower than that of DSC gelatinized starch. These findings have led us to conclude that enthalpy change of retrograded starch at low water contents involves the melting of recrystallized starch during storage and residual starch crystallites after DSC gelatinization, and that the endothermic transition of retrograded starch gels at low water contents does not fully represent the retrogradation behavior of starch. Very low or high water contents do not favor the occurrence of starch retrogradation. PMID:26860788

  7. Retrogradation enthalpy does not always reflect the retrogradation behavior of gelatinized starch.

    PubMed

    Wang, Shujun; Li, Caili; Zhang, Xiu; Copeland, Les; Wang, Shuo

    2016-02-10

    Starch retrogradation is a term used to define the process in which gelatinized starch undergoes a disorder-to-order transition. A thorough understanding of starch retrogradation behavior plays an important role in maintaining the quality of starchy foods during storage. By means of DSC, we have demonstrated for the first time that at low water contents, the enthalpy change of retrograded starch is higher than that of native starch. In terms of FTIR and Raman spectroscopic results, we showed that the molecular order of reheated retrograded starch samples is lower than that of DSC gelatinized starch. These findings have led us to conclude that enthalpy change of retrograded starch at low water contents involves the melting of recrystallized starch during storage and residual starch crystallites after DSC gelatinization, and that the endothermic transition of retrograded starch gels at low water contents does not fully represent the retrogradation behavior of starch. Very low or high water contents do not favor the occurrence of starch retrogradation.

  8. Nutritional status and intrarenal arterial stiffness in cardiorenal syndrome: a pilot study.

    PubMed

    Gigante, A; Di Mario, F; Barbano, B; Rosato, E; Di Lazzaro Giraldi, G; Pofi, R; Gasperini, M L; Amoroso, D; Cianci, R; Laviano, A

    2017-01-01

    Cardio-Renal Syndrome (CRS) is a condition, which is more frequently observed in clinical practice. The aim of this study is to explore nutritional status and intrarenal arterial stiffness in patients affected by CRS. 14 consecutive CRS patients, screened for anthropometry, biochemistry, nutritional and metabolic status underwent renal Doppler ultrasound and whole-body bioimpedance spectroscopy (BIS). We found a positive correlation between phase angle (PA) and CKD-EPI and MDRD (p=0.011 and p=0.007), and between body mass index and renal resistive index (RRI) (p=0.002). Finally, we found a negative correlation between fat-free mass and RRI (p=0.024). Body composition assessment may improve the care of patients with chronic kidney disease (CKD). Also, BIS may help identify changes in hydration status in CKD patients resulting as a significant predictor of mortality.

  9. Intrarenal and Urinary Th9 and Th22 Cytokine Gene Expression in Lupus Nephritis.

    PubMed

    Luk, Cathy Choi-Wan; Tam, Lai-Shan; Kwan, Bonnie Ching-Ha; Wong, Priscilla Ching-Han; Ma, Terry King-Wing; Chow, Kai-Ming; Lai, Fernand Mac-Moune; Li, Philip Kam-Tao; Szeto, Cheuk-Chun

    2015-07-01

    We studied the urinary sediment mRNA level of Th9- and Th22-related cytokines in patients with systemic lupus erythematosus (SLE). We quantified urinary mRNA levels of interleukin (IL) 9, IL-10, IL-22, and their corresponding transcription factors in 73 patients with active lupus nephritis, 13 patients with hypertensive nephrosclerosis (HTN), and 25 healthy subjects. There was no detectable IL-9 mRNA in all samples. Patients with proliferative lupus nephritis had significantly lower urinary IL-22 mRNA levels than those with nonproliferative nephritis (2.2 ± 5.4 vs 8.6 ± 20.0 copies, p = 0.019), and urinary IL-22 mRNA level inversely correlated with the histological activity index (r = -0.427, p < 0.0001). In contrast, patients with lupus nephritis had significantly higher urinary IL-10 mRNA levels than patients with HTN (7.8 ± 18.5 vs 1.9 ± 4.0 copies, p = 0.012), and urinary IL-10 mRNA levels correlated with its intrarenal mRNA levels (r = 0.337, p = 0.004) and SLE disease activity index (r = 0.277, p = 0.018). Urinary IL-10 mRNA level was significantly lower among patients who achieved complete remission than those with partial remission or no response (4.1 ± 6.5 vs 14.1 ± 28.0 copies, p = 0.036). Urinary IL-22 mRNA level is decreased in patients with SLE with proliferative nephritis, while urinary IL-10 mRNA levels correlates with its intrarenal mRNA level and disease activity. Urinary IL-10 mRNA levels may also predict treatment response. These results suggest that urinary mRNA levels of IL-10 and IL-22 might be used as biomarkers for assessing disease activity and risk stratification in lupus nephritis.

  10. Intrarenal blood flow distributions from first transit recordings of Tc-99m radiochelates

    SciTech Connect

    Conrad, G.R.; Wesolowski, C.; Kirchner, P.T.

    1985-05-01

    A computer-assisted curve stripping technique was used to derive renal transit times and flow fractions from the first transit aortic and renal recordings of Tc-99m radiochelate (DTPA, GHA, MDP) following peripheral bolus injection. Mean values +- 1 S.D. for 40 normal kidneys: first and second component transit times: T1=6.8 +- 2.4 sec., T2=12.8 +- 3.2 sec; flow fractions: fl=67 +- 9%, f2=17 +- 10%; residual fraction (slower components and filtration): Rf=16 +- 9%. A tumor population of 11 patients without known renal disease was studied prior to chemotherapy. Mean fl was diminished, and mean f2, T1, and Rf were elevated (p<.05). 18 hypertensive patients evaluated with angiography, renal vein renins, and scintigraphy were also reviewed. The mean f1 was decreased and the mean f2,T1, T2, and Rf were increased in this population (p<.01). The fl:T1 ratio proved to be a sensitive indicator asymmetric renal disease. The mean left-to-right ratio (L/R) of f1/T1 in normals was 1.02 +- 0.10 (r=.93) and 1.6 +- 1.5(r=.50) in the hypertensives. A L/R fl/T1 <.82 or >1.22 had a sensitivity of 85%, specificity of 80%, and positive prediction value of 92% for the presence of an arterial lesion (stenosis of >70%). The sensitivity, specificity, and predictive value for lateralized or bilaterally elevated renins were 73%, 50%, and 73%, respectively. The authors conclude that intrarenal blood flow distributions can be derived non-invasively and simultaneously for both kidneys, that the results obtained are similar to those previously reported with the invasive xenon washout technique, and that disease tends to produce intrarenal flow shifts and prolongation of transit times.

  11. Intrarenal and urinary oxygenation during norepinephrine resuscitation in ovine septic acute kidney injury.

    PubMed

    Lankadeva, Yugeesh R; Kosaka, Junko; Evans, Roger G; Bailey, Simon R; Bellomo, Rinaldo; May, Clive N

    2016-07-01

    Norepinephrine is the principal vasopressor used to restore blood pressure in sepsis, but its effects on intrarenal oxygenation are unknown. To clarify this, we examined renal cortical, medullary, and urinary oxygenation in ovine septic acute kidney injury and the response to resuscitation with norepinephrine. A renal artery flow probe and fiberoptic probes were placed in the cortex and medulla of sheep to measure tissue perfusion and oxygenation. A probe in the bladder catheter measured urinary oxygenation. Sepsis was induced in conscious sheep by infusion of Escherichia coli for 32 hours. At 24 to 30 hours of sepsis, either norepinephrine, to restore mean arterial pressure to preseptic levels or vehicle-saline was infused (8 sheep per group). Septic acute kidney injury was characterized by a reduction in blood pressure of ∼12 mm Hg, renal hyperperfusion, and oliguria. Sepsis reduced medullary perfusion (from an average of 1289 to 628 blood perfusion units), medullary oxygenation (from 32 to 16 mm Hg), and urinary oxygenation (from 36 to 24 mm Hg). Restoring blood pressure with norepinephrine further reduced medullary perfusion to an average of 331 blood perfusion units, medullary oxygenation to 8 mm Hg and urinary oxygenation to 18 mm Hg. Cortical perfusion and oxygenation were preserved. Thus, renal medullary hypoxia caused by intrarenal blood flow redistribution may contribute to the development of septic acute kidney injury, and resuscitation of blood pressure with norepinephrine exacerbates medullary hypoxia. The parallel changes in medullary and urinary oxygenation suggest that urinary oxygenation may be a useful real-time biomarker for risk of acute kidney injury.

  12. Retrograde at the Operational Level of War,

    DTIC Science & Technology

    1987-05-15

    north with forces under Montgomery. There was no mention of a retrograde plan. The first enemy main thrust was along the Eifel region o4 the Ardennes...He planned a detailed retrograde prior to the Chinese attack in 2 anuar- 1to~ he wa;:;s aoin~ to ti-cns ’outr, ceI co a Of ’Seoul if the U.N. Taorces...34Lessons From Korea." Report. Ft. Benning: USAIS. 1954. Liddell Hart. B.H. The German Generals Talk. New York: William Morrow & Co .. 1948

  13. Process for forming retrograde profiles in silicon

    DOEpatents

    Weiner, K.H.; Sigmon, T.W.

    1996-10-15

    A process is disclosed for forming retrograde and oscillatory profiles in crystalline and polycrystalline silicon. The process consisting of introducing an n- or p-type dopant into the silicon, or using prior doped silicon, then exposing the silicon to multiple pulses of a high-intensity laser or other appropriate energy source that melts the silicon for short time duration. Depending on the number of laser pulses directed at the silicon, retrograde profiles with peak/surface dopant concentrations which vary are produced. The laser treatment can be performed in air or in vacuum, with the silicon at room temperature or heated to a selected temperature.

  14. Process for forming retrograde profiles in silicon

    DOEpatents

    Weiner, Kurt H.; Sigmon, Thomas W.

    1996-01-01

    A process for forming retrograde and oscillatory profiles in crystalline and polycrystalline silicon. The process consisting of introducing an n- or p-type dopant into the silicon, or using prior doped silicon, then exposing the silicon to multiple pulses of a high-intensity laser or other appropriate energy source that melts the silicon for short time duration. Depending on the number of laser pulses directed at the silicon, retrograde profiles with peak/surface dopant concentrations which vary from 1-1e4 are produced. The laser treatment can be performed in air or in vacuum, with the silicon at room temperature or heated to a selected temperature.

  15. The Origin of Retrograde Hot Jupiters

    NASA Astrophysics Data System (ADS)

    Naoz, Smadar; Farr, W.; Lithwick, Y.; Rasio, F.; Teyssandier, J.

    2011-09-01

    The search for extra-solar planets has led to the surprising discovery of many Jupiter-like planets in very close proximity to their host star, the so-called ``hot Jupiters'' (HJ). Even more surprisingly, many of these HJs have orbits that are eccentric or highly inclined with respect to the equator of the star, and some (about 25%) even orbiting counter to the spin direction of the star. This poses a unique challenge to all planet formation models. We show that secular interactions between Jupiter-like planet and another perturber in the system can easily produce retrograde HJ orbits. We show that in the frame of work of secular hierarchical triple system (the so-called Kozai mechanism) the inner orbit's angular momentum component parallel to the total angular momentum (i.e., the z-component of the inner orbit angular momentum) need not be constant. In fact, it can even change sign, leading to a retrograde orbit. A brief excursion to very high eccentricity during the chaotic evolution of the inner orbit allows planet-star tidal interactions to rapidly circularize that orbit, decoupling the planets and forming a retrograde hot Jupiter. We estimate the relative frequencies of retrograde orbits and counter to the stellar spin orbits using Monte Carlo simulations, and find that the they are consistent with the observations. The high observed incidence of planets orbiting counter to the stellar spin direction may suggest that planet--planet secular interactions are an important part of their dynamical history.

  16. Studies of retrograde memory: A long-term view

    PubMed Central

    Warrington, Elizabeth K.

    1996-01-01

    Studies of retrograde amnesia are reviewed. First, the issues of temporal gradients of retrograde amnesia are discussed. Second, the question of the anatomical substrates of this syndrome are considered. Finally, some evidence for fractionation of different classes of memoranda within the retrograde time period are presented. PMID:8942966

  17. Retrograde Jejunojejunal Intussusception After Gastrectomy: Report of Four Cases.

    PubMed

    Yoshiya, Shohei; Nakanoko, Tomonori; Koga, Tadashi; Inokuchi, Shoichi; Hirose, Kohsuke; Hirayama, Yoshie; Taketani, Kenji; Yoshida, Rintaro; Minagawa, Ryosuke; Kai, Masanori; Kajiyama, Kiyoshi; Maehara, Yoshihiko

    2015-12-01

    Retrograde intussusception of the small bowel is extremely rare. We experienced four cases of retrograde jejunojejunal intussusception that needed emergency surgery. The aim of the present report was to expand awareness of retrograde jejunojejunal intussusception as an urgent complication following gastrectomy. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  18. Left Ventricular Mass and Intrarenal Arterial Stiffness as Early Diagnostic Markers in Cardiorenal Syndrome Type 5 due to Systemic Sclerosis

    PubMed Central

    Gigante, Antonietta; Barilaro, Giuseppe; Barbano, Biagio; Romaniello, Antonella; Di Mario, Francesca; Quarta, Silvia; Gasperini, Maria Ludovica; Di Lazzaro Giraldi, Gianluca; Laviano, Alessandro; Amoroso, Antonio; Cianci, Rosario; Rosato, Edoardo

    2016-01-01

    Background Cardiorenal syndrome type 5 (CRS-5) includes a group of conditions characterized by a simultaneous involvement of the heart and kidney in the course of a systemic disease. Systemic sclerosis (SSc) is frequently involved in the etiology of acute and chronic CRS-5 among connective tissue diseases. In SSc patients, left ventricular mass (LVM) can be used as a marker of nutritional status and fibrosis, while altered intrarenal hemodynamic parameters are suggestive of early kidney involvement. Methods Forty-two consecutive patients with a diagnosis of SSc without cardiac and/or renal impairment were enrolled to assess whether cardiac muscle mass can be related to arterial stiffness. Thirty subjects matched for age and sex were also enrolled as healthy controls (HC). All patients performed echocardiography and renal ultrasound. Results Doppler indices of intrarenal stiffness and echocardiographic indices of LVM were significantly increased in SSc patients compared to HC. A positive correlation exists between LVM/body surface area and pulsatile index (p < 0.05, r = 0.36), resistive index (p < 0.05, r = 0.33) and systolic/diastolic ratio (p < 0.05, r = 0.38). Doppler indices of intrarenal stiffness and LVM indices were significantly higher in SSc patients with digital ulcers than in SSc patients without a digital ulcer history. Conclusions SSc is characterized by the presence of microvascular and multiorgan injury. An early cardiac and renal impairment is very common. LVM and intrarenal arterial stiffness can be considered as early markers of CRS onset. The clinical use of these markers permits a prompt identification of organ damage. An early diagnosis allows the appropriate setting of pharmacological management, by slowing disease progression. © 2016 S. Karger AG, Basel PMID:27022332

  19. Retrograde jejunogastric intussusception with jejunojejunal intussusception (double telescoping)

    PubMed Central

    Sahoo, Manash Ranjan; Bhaskar, Ved; Mohapatra, Vedavyas

    2013-01-01

    A 55-year-old woman presented with features of gastric outlet obstruction not responding to conservative treatment at a peripheral hospital. She had gastric surgery 15 years before. On examination, there was a globular mass palpable in the epigastrium. Ultrasound and endoscopy findings were suggestive of retrograde jejunogastric intussusception. After initial resuscitation, emergency laparotomy was undertaken which revealed a jejunogastric intussusception at the previous retrocolic gastrojejunostomy site. After manual reduction of the intussuscepted loop by gentle traction, another segment of the jejunum was seen to be telescoping within this loop. On reduction, this jejunal loop was seen to measure around 20 cm and the apex of the intussusceptum was found to be gangrenous and perforated. Resection of the involved segment was done followed by a Roux-en-y anastomosis to restore the continuity. PMID:23682086

  20. Regulation of postsynaptic retrograde signaling by presynaptic exosome release

    PubMed Central

    Korkut, Ceren; Li, Yihang; Koles, Kate; Brewer, Cassandra; Ashley, James; Yoshihara, Motojiro; Budnik, Vivian

    2013-01-01

    SUMMARY Retrograde signals from postsynaptic targets are critical during development and plasticity of synaptic connections. These signals serve to adjust the activity of presynaptic cells according to postsynaptic cell outputs and to maintain synaptic function within a dynamic range. Despite their importance, the mechanisms that trigger the release of retrograde signals and the role of presynaptic cells in this signaling event are unknown. Here we show that a retrograde signal mediated by Synaptotagmin 4 (Syt4) is transmitted to the postsynaptic cell through anterograde delivery of Syt4 via exosomes. Thus, by transferring an essential component of retrograde signaling through exosomes, presynaptic cells enable retrograde signaling. PMID:23522040

  1. Doppler-guided retrograde catheterization system

    NASA Astrophysics Data System (ADS)

    Frazin, Leon J.; Vonesh, Michael J.; Chandran, Krishnan B.; Khasho, Fouad; Lanza, George M.; Talano, James V.; McPherson, David D.

    1991-05-01

    The purpose of this study was to investigate a Doppler guided catheterization system as an adjunctive or alternative methodology to overcome the disadvantages of left heart catheterization and angiography. These disadvantages include the biological effects of radiation and the toxic and volume effects of iodine contrast. Doppler retrograde guidance uses a 20 MHz circular pulsed Doppler crystal incorporated into the tip of a triple lumen multipurpose catheter and is advanced retrogradely using the directional flow information provided by the Doppler waveform. The velocity detection limits are either 1 m/second or 4 m/second depending upon the instrumentation. In a physiologic flow model of the human aortic arch, multiple data points revealed a positive wave form when flow was traveling toward the catheter tip indicating proper alignment for retrograde advancement. There was a negative wave form when flow was traveling away from the catheter tip if the catheter was in a branch or bent upon itself indicating improper catheter tip position for retrograde advancement. In a series of six dogs, the catheter was able to be accurately advanced from the femoral artery to the left ventricular chamber under Doppler signal guidance without the use of x-ray. The potential applications of a Doppler guided retrograde catheterization system include decreasing time requirements and allowing safer catheter guidance in patients with atherosclerotic vascular disease and suspected aortic dissection. The Doppler system may allow left ventricular pressure monitoring in the intensive care unit without the need for x-ray and it may allow left sided contrast echocardiography. With pulse velocity detection limits of 4 m/second, this system may allow catheter direction and passage into the aortic root and left ventricle in patients with aortic stenosis. A modification of the Doppler catheter may include transponder technology which would allow precise catheter tip localization once the

  2. Safety and Feasibility of Salvage Endoscopic Combined Intrarenal Surgery in Embolized Kidney

    PubMed Central

    Nicolosi, Federico; Lughezzani, Giovanni; Buffi, Nicolò Maria; Casale, Paolo; Hurle, Rodolfo; Lazzeri, Massimo; Cardone, Pasquale; Guazzoni, Giorgio; Saita, Alberto

    2016-01-01

    Abstract Background: Although endoscopic combined intrarenal surgery (ECIRS) is well established as primary approach to complex lithiasis, no evidences are still available on its use in salvage context. Case Presentation: A male patient, of 55 years of age, underwent many unsuccessful surgical procedures to treat large and multiple right kidney stones, including percutaneous nephrolithotomy (PCNL). The latter was complicated by severe postoperative hemorrhage, managed with super-selective renal artery embolization (SRAE). Therefore he came to our institution to achieve a complete resolution of the urolithiasis. Preoperative evaluation included CT scan and renal scintigraphy to establish kidney and stone morphologic features and residual renal function. Salvage ECIRS was performed and postoperative assessment showed a complete resolution of lithiasis and absence of renal function impairment. Conclusion: To our knowledge, this is the first case of salvage ECIRS reported in literature after previous failed PCNL. Even after SRAE, this procedure appears as safe and as efficacious as standard salvage PCNL when performed by experienced hands. PMID:27579440

  3. A Preliminary Study Into the Significance of Intrarenal Reflux in BK Virus Nephropathy After Kidney Transplantation

    PubMed Central

    Kawanishi, Kunio; Honda, Kazuho; Koike, Junki; Hattori, Motoshi; Fuchinoue, Shouhei; Tanabe, Kazunari; Oda, Hideaki; Nagashima, Yoji

    2016-01-01

    Background The BK virus typically colonizes the lower urinary tract and is the causative agent in BK virus nephropathy (BKVN), which can progress to allograft dysfunction and graft loss. Urinary reflux in kidney allografts is induced by vesicoureteral reflux or disturbances in intrarenal reflux (IRR), believed to be associated with BKVN. This study was designed to elucidate the relationship between BKVN and IRR. Methods We examined 30 renal transplant recipients histologically diagnosed with BKVN using anti-Simian virus 40 immunohistochemistry and 60 clinically matched control recipients. The BKVN patients were divided into stable (n = 12) and progressive (n = 18) groups according to allograft kidney function 1 year after diagnosis. Histological rejection scores according to the pathological classification of rejection in renal allografts (Banff classification), histological BKVN stages, and histological polyomavirus load levels (pvl) proposed by the Banff working group were evaluated. The IRR was quantified by histological reflux scores defined with retention and reflux of immunostained Tamm-Horsfall protein in renal tubules and glomeruli. Results Higher reflux scores were observed in the BKVN group compared with that in the control group. No differences in clinical parameters were observed between the BKVN and control groups. Reflux scores and pvl were significantly higher in the progressive group than in the stable BKVN group with no significant difference in BK stage observed between groups. Reflux scores were found to be significantly correlated with pvl. Conclusions Our preliminary study suggested that IRR might be a predisposing and prognostic factor in BKVN. PMID:27500256

  4. Association of Serum CXCL13 with Intrarenal Ectopic Lymphoid Tissue Formation in Lupus Nephritis

    PubMed Central

    Chen, Wen Li; Long, Kang Xia; Zhang, Xiao

    2016-01-01

    Aims. To assess the concentrations of serum CXCL13 and intrarenal ectopic lymphoid tissue (ELT) profiles and their correlation in the patients with lupus nephritis (LN). Methods. Serum CXCL13 levels were measured using enzyme-linked immunosorbent assays (ELISA). The expression of CD3, CD20, and CD21 in renal biopsy specimens was tested using immunohistochemical methods. Results. Serum CXCL13 levels were significantly higher in the LN group than those in the SLE group without LN and also in the type III and IV LN patients than in type V LN patients. LN patients with positive CD20 expression (CD20+ LN) had a longer disease course and poorer response to combination therapy and higher serum CXCL13 levels than CD20− LN patients. Moreover, the serum CXCL13 level was positively correlated with the number of B cells/HP in the renal tissue of LN patients. The coexpression patterns of CD3, CD20, and CD21 in the renal tissue of LN patients with different WHO pathological types were significantly different. Serum CXCL13 levels were significantly higher in ELT-2 type LN patients than in 0 or 1 type LN patients. Conclusions. This study suggested that increased serum levels of CXCL13 might be involved in renal ELT formation and renal impairment process in LN. PMID:27990444

  5. Correlation of ultrasonographic measurement of intrarenal arterial resistance index with microalbuminuria in nonhypertensive, nondiabetic obese patients.

    PubMed

    Han, Fang; Hou, Ningning; Miao, Wei; Sun, Xiaodong

    2013-08-01

    To determine whether intrarenal arterial resistance index (RI) value is related to increased urinary albumin excretion and whether RI value is an independent good indicator to evaluate early renal damage in nonhypertensive, nondiabetic obese subjects. Sixty-four nonhypertensive, nondiabetic obese patients (OB) and 35 age- and sex-matched normal healthy subjects were involved in this study. Clinical characteristics and blood biochemistry of all the subjects were measured. Urinary albumin/creatinine ratio (ACR) and sonographic evaluation of renal blood flow were determined. ACR and interlobar arterial RI were significantly higher in obese patients than those of normal healthy subjects. Interlobar arterial RI value was higher in patients with microalbuminuria than those with normoalbuminuria. Correlation analysis showed interlobar artery RI value had a positive correlation with ACR (r = 0.615, p < 0.01) and plasma free fatty acids (FFAs, r = 0.407, p < 0.01). ACR had a positive correlation with BMI (r = 0.380, p < 0.01), waist circumference (r = 0.414, p < 0.01), plasma FFAs (r = 0.537, p < 0.01). Multivariate regression analyses showed that ACR was best predicted by interlobar artery RI value even when body mass index, waist circumference, FFAs, and high-sensitive C reaction protein were added in the statistical analysis. Interlobar arterial RI may be an independent predictor of microalbuminuria in nonhypertensive, nondiabetic obese patients, and interlobar arterial RI could be a useful tool for assessment early renal damage in obese patients.

  6. Functional retrograde amnesia: a multiple case study.

    PubMed

    Fujiwara, Esther; Brand, Matthias; Kracht, Lutz; Kessler, Josef; Diebel, Andrea; Netz, Johannes; Markowitsch, Hans J

    2008-01-01

    Functional retrograde amnesia (RA) is a rare pathology and has been rarely studied in detail across different patients. We extensively examined five functional RA patients and compared their neuropsychological profile including anterograde and retrograde memory performance, executive functions, emotional processing, and formally assessed psychiatric symptoms. Across patients, neuropsychological deficits beyond RA were most consistently seen in executive functions and attention suggesting that these dysfunctions contribute to the remote memory deficit. In a majority of the patients, problems in social cognition and emotional behaviour were reflected in Theory of Mind deficits and accompanying psychiatric symptoms. Aberrances in a measure of social desirability were detected, pointing to repressive tendencies in three out of the five patients. Future studies of functional RA patients may investigate more specifically which frontal-lobe associated (dys-) functions contribute to the memory retrieval deficit. Moreover, studying more closely the interaction between social cognition, repressive personality style and memory inhibition in this disease seems worthwhile pursuing.

  7. Retrograde transport on the COG railway.

    PubMed

    Ungar, Daniel; Oka, Toshihiko; Krieger, Monty; Hughson, Frederick M

    2006-02-01

    The conserved oligomeric Golgi (COG) complex is essential for establishing and/or maintaining the structure and function of the Golgi apparatus. The Golgi apparatus, in turn, has a central role in protein sorting and glycosylation within the eukaryotic secretory pathway. As a consequence, COG mutations can give rise to human genetic diseases known as congenital disorders of glycosylation. We review recent results from studies of yeast, worm, fly and mammalian COG that provide evidence that COG might function in retrograde vesicular trafficking within the Golgi apparatus. This hypothesis explains the impact of COG mutations by postulating that they impair the retrograde flow of resident Golgi proteins needed to maintain normal Golgi structure and function.

  8. Treatment of retrograde ejaculation and anejaculation.

    PubMed

    Kamischke, A; Nieschlag, E

    1999-01-01

    Treatment of retrograde ejaculation and anejaculation The various options for the treatment of retrograde ejaculation (RE) and anejaculation (AE) are discussed systematically in this review. A total of 88 studies dealing with patients with RE emphasize medical treatment for reversal of RE and retrieval of spermatozoa from urine. In 136 studies concerning patients with AE, the main emphasis is on medical treatment, electroejaculation (EE) and electrovibration stimulation (EVS) for the reversal of AE. Sperm quality in patients with RE and AE is often impaired. However, with the help of assisted reproduction techniques (ART) available today, both ejaculation disorders can be considered as treatable diseases. The major problem when analysing the studies was the uneven methodological quality of the original articles and the difficulties presented by different drugs and dosages, equipment and techniques, along with different criteria for success. In conclusion, controlled clinical trials comparing different treatment options appear urgently warranted.

  9. Retrograde signaling for climbing fiber synapse elimination.

    PubMed

    Uesaka, Naofumi; Uchigashima, Motokazu; Mikuni, Takayasu; Hirai, Hirokazu; Watanabe, Masahiko; Kano, Masanobu

    2015-02-01

    Neurons form exuberant synapses with target cells early in development. Then, necessary synapses are selectively strengthened whereas unnecessary connections are weakened and eventually eliminated during postnatal development. This process is known as synapse elimination and is a crucial step for shaping immature neural circuits into functionally mature versions. Accumulating evidence suggests that retrograde signaling from postsynaptic cells regulates synapse elimination, but the underlying mechanisms remain unknown. Here, we show that semaphorin3A (Sema3A) and semaphorin7A (Sema7A) mediate retrograde signals for elimination of redundant climbing fiber (CF) to Purkinje cell (PC) synapses in the developing cerebellum, a representative model of synapse elimination in the central nervous system. We picked up candidate retrograde signaling molecules that are expressed in PCs during the period of CF synapse elimination and the receptors of these candidate molecules that are present in CFs. We then assessed the effects of lentivirus-mediated RNAi-knockdown of these molecules on CF synapse elimination. By this systematic screening, we found that knockdown of Sema3A in PCs or its co-receptor, plexinA4 (PlxnA4), in CFs accelerated CF synapse elimination and decreased CF-mediated synaptic inputs. Conversely, knockdown of Sema7A in PCs or either of the two receptors for Sema7A, plexinC1 (PlxnC1) and integrinB1 (ItgB1), in CFs impaired CF synapse elimination. Importantly, the effect of Sema7A involves signaling by type 1 metabotropic glutamate receptor (mGluR1), a canonical pathway in PCs for the final stage of CF synapse elimination. These results demonstrate that specific semaphorins act as retrograde signaling molecules and regulate distinct processes of CF synapse elimination during postnatal cerebellar development.

  10. Retrograde weight implantation for correction of lagophthalmos.

    PubMed

    Kao, Chuan-Hsiang; Moe, Kris S

    2004-09-01

    Gold weight implantation is the most commonly used method for surgical correction of paralytic lagophthalmos. Numerous techniques for placement of the weight have been described, yet complications with these methods continue to occur (implant migration or extrusion, wound infection, failure to correct the lagophthalmos, and excessive postoperative ptosis). We developed a retrograde, postlevator aponeurosis method for implantation to improve the placement and fixation of the weight. This study describes the rationale, technique, and surgical outcome of the retrograde approach. Retrospective analysis. Data maintained and collected on 25 consecutive cases of retrograde upper lid weight implantation for paralytic lagophthalmos. Pre- and postoperative photographs were obtained, and patients were followed for at least 6 months. All procedures were performed by or under the direction of a single surgeon at tertiary academic medical centers (University of California, San Diego and University of Zurich, Switzerland). Twenty-five consecutive patients were evaluated, 16 male and 9 female, ranging in age from 27 to 86 years. There were no surgical failures or perioperative complications and no instances of implant migration or extrusion. One patient developed a delayed infection requiring removal of the implant, and one patient required replacement of the gold weight with a platinum chain implant to better fit the contour of her eyelid. Retrograde implantation allows more accurate placement of the weight while creating a permanent circumferential seal for fixation. The procedure is minimally invasive, less traumatic than previous methods, and produces an excellent cosmetic result. The efficacy has been demonstrated in the outcome of the 25 cases described in this study.

  11. Retrograde femoral interlocking nail in complex fractures.

    PubMed

    Anup, Khare; Mehra, M M

    2002-06-01

    Retrograde interlocking nail was used as the method of fixation in 35 different cases of combination of complex femoral fractures. We performed this procedure in fractures of femoral shaft associated with fracture neck femur, pathological fractures of proximal third of femur with trochanteric pathology, ipsilateral fracture of femur and tibia in polytrauma cases with multiple other injuries, in highly obese patients with fracture shaft femur. This technique was also used in cases of pregnancy with fracture shaft femur and in unstable pelvic fracture or dislocation hip associated with fracture shaft femur. Operative technique involved with retrograde insertion of un-reamed, non-cannulated custom made nail through entrance portal in intercondylar notch was applied for fixation of the shaft femur fracture. The other associated fracture around hip was stabilized separately using suitable implant according to type of fracture. In cases of ipsilateral fracture of femur and tibia, femur was stabilized by retrograde interlocking nail and tibia was stabilized by antigrade interlocking nail through same incision at the same sitting. The case was followed up for three years; the average union time was 12 to 18 weeks. Out of 35 cases, 31 cases regained full knee movement. Out of the remaining 4 cases, 2 cases could regain up to 90 degrees of movement, these were old fractures and non-cooperative patients. In one case, patellofemoral arthritis was developed because of an operative error where a nail was not put inside the articular surface. Mal-union was observed in an early case of the series and implant failure was nil. Retrograde interlocking nail was used as the method of fixation in complex fracture problems. Multiple fractures of long bones can be stabilized in one stage, preventing multiple operations at different stages in polytraumatized patients. This resulted in early recovery, lesser hospital stay, and early rehabilitation of patient with good results and is

  12. Intrarenal signaling mediated by CCK plays a role in salt intake-induced natriuresis.

    PubMed

    Takahashi-Iwanaga, Hiromi; Kimura, Shunsuke; Konno, Kohtarou; Watanabe, Masahiko; Iwanaga, Toshihiko

    2017-03-15

    The natriuretic hormone CCK exhibits its gene transcripts in total kidney extracts. To test the possibility of CCK acting as an intrarenal mediator of sodium excretion, we examined mouse kidneys by: (i) an in situ hybridization technique for CCK mRNA in animals fed a normal or a high-sodium diet; (ii) immuno-electron microscopy for the CCK peptide, (iii) an in situ hybridization method and immunohistochemistry for the CCK-specific receptor CCKAR; (iv) confocal image analysis of receptor-mediated Ca2+ responses in isolated renal tubules; and (v) metabolic cage experiments for the measurement of urinary sodium excretion in high salt-fed mice either treated or untreated with the CCKAR antagonist lorglumide. Results showed the CCK gene to be expressed intensely in the inner medulla and moderately in the inner stripe of the outer medulla, with the expression in the latter being enhanced by high sodium intake. Immunoreactivity for the CCK peptide was localized to the rough endoplasmic reticulum of the medullary interstitial cells in corresponding renal regions, confirming it as a secretory protein. Gene transcripts, protein products, and the functional activity for CCKAR were consistently localized to the late proximal tubule segments (S2 and S3) in the medullary rays, and the outer stripe of the outer medulla. Lorglumide significantly diminished natriuretic responses of mice to a dietary sodium load without altering the glomerular filtration rate. These findings suggest that the medullary interstitial cells respond to body fluid expansion by CCK release for feedback regulation of the late proximal tubular reabsorption.

  13. Characterization of the intrarenal renin-angiotensin system in experimental alport syndrome.

    PubMed

    Bae, Eun Hui; Konvalinka, Ana; Fang, Fei; Zhou, Xiaohua; Williams, Vanessa; Maksimowski, Nicholas; Song, Xuewen; Zhang, Shao-Ling; John, Rohan; Oudit, Gavin Y; Pei, York; Scholey, James W

    2015-05-01

    Blockade of the renin-angiotensin system attenuates the progression of experimental and clinical Alport syndrome (AS); however, the underlying mechanism(s) remains largely unknown. We evaluated the renin-angiotensin system in 4- and 7-week-old homozygous for collagen, type IV, α3 gene (Col4A3(-/-)) and wild-type mice, a model of AS characterized by proteinuria and progressive renal injury. Renal angiotensin (Ang) II levels increased, whereas renal Ang-(1-7) levels decreased in 7-week-old Col4a3(-/-) mice compared with age-matched controls; these changes were partially reversed by recombinant angiotensin-converting enzyme 2 (ACE2) treatment. The expression of both the angiotensinogen and renin protein increased in Col4a3(-/-) compared with wild-type mice. Consistent with the Ang-(1-7) levels, the expression and activity of kidney ACE2 decreased in 7-week-old Col4a3(-/-) mice. The urinary excretion rate of ACE2 paralleled the decline in tissue expression. Expression of an Ang II-induced gene, heme oxygenase-1, was up-regulated in the kidneys of 7-week-old Col4a3(-/-) mice compared with wild-type mice by microarray analysis. Heme oxygenase-1 (HO-1) protein expression was increased in kidneys of Col4a3(-/-) mice and normalized by treatment with ACE inhibitor. Urinary HO-1 excretion paralleled renal HO-1 expression. In conclusion, progressive kidney injury in AS is associated with changes in expression of intrarenal renin Ang system components and Ang peptides. HO-1 and ACE2 may represent novel markers of AS-associated kidney injury, whereas administration of recombinant ACE2 and/or Ang-(1-7) may represent novel therapeutic approaches in AS. Copyright © 2015 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  14. ROLE OF ANGIOTENSIN AT2 RECEPTORS IN NATRIURESIS: INTRARENAL MECHANISMS AND THERAPEUTIC POTENTIAL

    PubMed Central

    Carey, Robert M.; Padia, Shetal H.

    2014-01-01

    SUMMARY The renin-angiotensin system is a coordinated hormonal cascade critical for the regulation of blood pressure (BP) and kidney function. Angiotensin II (Ang II), the major angiotensin effector peptide, binds to two major receptors, type-1 (AT1Rs) and type-2 (AT2Rs). AT1Rs engender antinatriuresis and raise BP, whereas AT2Rs oppose these effects, inducing natriuresis and reducing BPAT2Rs are highly expressed in the adult kidney, especially in the proximal tubule. In AT2R-null mice, long-term Ang II infusion results in pressor and antinatriuretic hypersensivivity compared to responses in wild-type animals.The major endogenous receptor ligand for AT2R-mediated natriuretic responses appears to be des-aspartyl1-Ang II (Ang III) instead of Ang II. Recent studies have demonstrated that Ang II requires metabolism to Ang III by aminopeptidase A in order to induce natriuresis and that inhibition of aminopeptidase N increases intrarenal Ang III and augments Ang III-induced natriuresis.The renal dopaminergic system is another important natriuretic pathway. Renal proximal tubule D1-like receptors (D1LIKERs) control approximately 50% of basal sodium (Na+) excretion. We have recently found that natriuresis induced by proximal tubule D1LIKERs requires AT2R activation and that D1LIKER stimulation induces recruitment of AT2Rs to the apical plasma membrane via a cyclic AMP-dependent mechanism.Initial studies employing potent AT2R non-peptide agonist Compound 21 demonstrate natriuresis in both the presence and absence of AT1R blockade indicating the therapeutic potential of this compound in fluid retaining states and hypertension. PMID:23336117

  15. Effect of hemorrhage and retransfusion on intrarenal distribution of blood flow in dogs

    PubMed Central

    Aukland, Knut; Wolgast, Mats

    1968-01-01

    Distribution of intrarenal blood flow was studied in 12 dogs anesthetized with Nembutal. Medullary blood flow was estimated by local clearance of hydrogen gas from the outer medulla measured polarographically with needleshaped platinum electrodes, and by local clearance of 85Kr and mean transit time of 32P-labeled erythrocytes measured with a small semiconductor detector placed in the outer medulla. Cortical blood flow was estimated from cortical red cell transit time and from total renal blood flow measured by electromagnetic flowmeter. Bleeding to a mean arterial pressure of 50-65 mm Hg in the course of 8-20 min reduced cortical and medullary blood flow on the average to the same extent. In half of the experiments both cortical and medullary blood flow were reduced proportionately less than mean arterial pressure during the first half hour of bleeding. Maintenance of mean arterial pressure at 50-65 mm Hg in all cases led to progressive reduction of both cortical and medullary blood flow, out of proportion to the reduction of arterial pressure. A two step bleeding procedure used in two experiments also led to uniform reduction of renal blood flow. Reinfusion of blood after 2-3 hr of hypotension increased total renal blood flow to an average of 82% and outer medullary hydrogen clearance to an average of 92% of control values. All dogs survived the experiment without evidence of renal failure. It is concluded that hemorrhagic hypotension in dogs leads to a progressive and fairly uniform rise in renal vascular resistance, without any selective hemodynamic response in the juxtamedullary circulation. PMID:5637138

  16. Role of angiotensin AT(2) receptors in natriuresis: Intrarenal mechanisms and therapeutic potential.

    PubMed

    Carey, Robert M; Padia, Shetal H

    2013-08-01

    The renin-angiotensin system is a coordinated hormonal cascade critical for the regulation of blood pressure (BP) and kidney function. Angiotensin (Ang) II, the major angiotensin effector peptide, binds to two major receptors, namely AT1 and AT2 receptors. The AT1 receptors engender antinatriuresis and raise BP, whereas AT2 receptors oppose these effects, inducing natriuresis and reducing BP. There is high AT2 receptor expression in the adult kidney, especially in the proximal tubule. In AT2 receptor-null mice, long-term AngII infusion results in pressor and antinatriuretic hypersensivivity compared with responses in wild-type mice. The major endogenous receptor ligand for AT2 receptor-mediated natriuretic responses appears to be des-aspartyl(1) -AngII (AngIII) instead of AngII. Recent studies have demonstrated that AngII requires metabolism to AngIII by aminopeptidase A to induce natriuresis and that inhibition of aminopeptidase N increases intrarenal AngIII and augments AngIII-induced natriuresis. The renal dopaminergic system is another important natriuretic pathway. Renal proximal tubule the D1 and D5 receptor subtypes (D1 -like receptors (D1LIKE R)) control approximately 50% of basal sodium excretion. Recently, we have found that natriuresis induced by proximal tubule D1LIKE R requires AT2 receptor activation and that D1LIKE R stimulation induces recruitment of AT2 receptors to the apical plasma membrane via a cAMP-dependent mechanism. Initial studies using the potent AT2 receptor non-peptide agonist Compound 21 demonstrate natriuresis in both the presence and absence of AT1 receptor blockade, indicating the therapeutic potential of this compound in fluid-retaining states and hypertension.

  17. Intrarenal dopamine D1-like receptor stimulation induces natriuresis via an angiotensin type-2 receptor mechanism.

    PubMed

    Salomone, Leslie J; Howell, Nancy L; McGrath, Helen E; Kemp, Brandon A; Keller, Susanna R; Gildea, John J; Felder, Robin A; Carey, Robert M

    2007-01-01

    We explored the effects of direct renal interstitial stimulation of dopamine D(1)-like receptors with fenoldopam, a selective D(1)-like receptor agonist, on renal sodium excretion and angiotensin type-2 (AT(2)) receptor expression and cellular distribution in rats on a high-sodium intake. In contrast to vehicle-infused rats, sodium excretion increased in fenoldopam-infused rats during each of three 1-hour experimental periods (<0.001). Blood pressure was unaffected by vehicle or fenoldopam. In plasma membranes of renal cortical cells, fenoldopam increased D(1) receptor expression by 38% (P<0.05) and AT(2) receptor expression by 69% (P<0.01). In plasma membranes of renal proximal tubule cells, fenoldopam increased AT(2) receptor expression by 108% (P<0.01). In outer apical membranes of proximal tubule cells, fenoldopam increased AT(2) receptor expression by 59% (P<0.01). No significant change in total AT(2) receptor protein expression was detectable in response to fenoldopam. Fenoldopam-induced natriuresis was abolished when either PD-123319, a specific AT(2) receptor antagonist, or SCH-23390, a potent D(1)-like receptor antagonist, was coinfused with F (P<0.001). In summary, direct renal D(1)-like receptor activation increased urinary sodium excretion and the plasma membrane expression of AT(2) receptors in renal cortical and proximal tubule cells. D(1)-like receptor-induced natriuresis was abolished by intrarenal AT(2) receptor inhibition. These findings suggest that dopaminergic regulation of sodium excretion involves recruitment of AT(2) receptors to the outer plasma membranes of renal proximal tubule cells and that dopamine-induced natriuresis requires AT(2) receptor activation.

  18. Hypercalcemia stimulates expression of intrarenal phospholipase A2 and prostaglandin H synthase-2 in rats. Role of angiotensin II AT1 receptors.

    PubMed Central

    Mangat, H; Peterson, L N; Burns, K D

    1997-01-01

    In chronic hypercalcemia, inhibition of thick ascending limb sodium chloride reabsorption is mediated by elevated intrarenal PGE2. The mechanisms and source of elevated PGE2 in hypercalcemia are not known. We determined the effect of hypercalcemia on intrarenal expression of cytosolic phospholipase A2 (cPLA2), prostaglandin H synthase-1 (PGHS-1), and prostaglandin H synthase-2 (PGHS-2), enzymes important in prostaglandin production. In rats fed dihydrotachysterol to induce hypercalcemia, Western blot analysis revealed significant upregulation of both cPLA2 and PGHS-2 in the kidney cortex and the inner and outer medulla. Immunofluorescence localized intrarenal cPLA2 and PGHS-2 to interstitial cells of the inner and outer medulla, and to macula densa and cortical thick ascending limbs in both control and hypercalcemic rats. Hypercalcemia had no effect on intrarenal expression of PGHS-1. To determine if AT1 angiotensin II receptor activation was involved in the stimulation of cPLA2 and PGHS-2 in hypercalcemia, we treated rats with the AT1 receptor antagonist, losartan. Losartan abolished the polydipsia associated with hypercalcemia, prevented the increase in cPLA2 protein in all regions of the kidney, and diminished PGHS-2 expression in the inner medulla. In addition, losartan completely prevented the increase in urinary PGE2 excretion in hypercalcemic rats. Intrarenal levels of angiotensin II were unchanged in hypercalcemia. These data indicate that hypercalcemia stimulates intrarenal cPLA2 and PGHS-2 protein expression. Our results further support a role for angiotensin II, acting on AT1 receptors, in mediating this stimulation. PMID:9329957

  19. Retrograde intraaxonal transport of horseradish peroxidase by neurons in octopus.

    PubMed

    Monsell, E M; Cottee, L J

    1980-01-13

    While retrograde axonal transport is the basis of a widely used neuroanatomical method, it has been rigorously demonstrated in vivo only in a few vertebrate species and not yet in an invertebrate. Evidence is presented that motor neurons of the octopus stellate ganglion are capable of retrograde intraaxonal transport of horeseradish peroxidase. This demonstration shows that retrograde transport occurs in widely divergent groups of animals, and may be a general property of neurons.

  20. Pregnancy and delivery in women with renovascular hypertension due to multiple intrarenal microaneurysms: a report of two cases.

    PubMed

    Miyagawa, Kazuya; Iwasa, Naoko; Nakayama, Kazuhiko; Hirata, Ken-ichi; Emoto, Noriaki

    2014-01-01

    We herein report two cases of pregnant women who had chronic hypertension caused by renovascular hypertension due to multiple intrarenal microaneurysms from unknown causes, who had similar clinical courses. During the first pregnancy, both women developed uncontrollable severe hypertension that finally led to superimposed preeclampsia; however, during the second pregnancy, the blood pressure was controlled well, and the clinical courses were uneventful. These cases suggest that an uneventful term delivery may be achieved with adequate blood pressure control in pregnant women with chronic hypertension caused by renovascular hypertension, and a prior eventful clinical course of delivery does not affect the subsequent clinical course.

  1. Comparison of intrarenal renin-angiotensin system activity in diabetic versus non-diabetic patients with overt proteinuria.

    PubMed

    Park, Ji Hyeon; Jang, Hye Ryoun; Lee, Jong-Ho; Lee, Jung Eun; Huh, Wooseong; Lee, Kyu-Beck; Kwon, Young-Joo; Do, Jun Young; Kim, Hye Young; Kim, Yoon-Goo

    2015-04-01

    The intrarenal renin-angiotensin system (RAS) has been reported to be activated in chronic proteinuria patients. This study aimed to compare intrarenal RAS activity between diabetic nephropathy (DN) and non-diabetic nephropathy (NDN) patients with overt proteinuria. A multicenter, cross-sectional study was conducted in 116 patients with overt proteinuria (urinary protein/creatinine ratio [uPCR] > 1 mg/mg Cr). To estimate intrarenal RAS activity we measured urinary excretion of angiotensinogen (uAGT) and renin (uRenin) in patients with DN (n = 38) and NDN (n = 78). Both natural logarithms of uAGT/urinary creatinine (ln[uAGT/uCr]) and uRenin (ln[uRenin/uCr]) levels were significantly higher in patients with DN compared with those with NDN (ln[uAGT/uCr]: 4.16 ± 1.13 in DN vs. 3.52 ± 1.21 in NDN, P = 0.007; ln[uRenin/uCr]: 5.66 ± 1.60 in DN vs. 4.29 ± 1.48 in NDN, P < 0.001), when estimated glomerular filtration rate (eGFR) and uPCR showed no significant difference between the two groups. In a subgroup analysis, according to amount of proteinuria, both uAGT and uRenin were higher in DN in patients with subnephrotic-range proteinuria (uPCR < 3.5 mg/mg Cr). However, in patients with nephrotic-range proteinuria (uPCR ≥ 3.5 mg/mg Cr), only uRenin was higher in DN compared to NDN. In a multiple regression analysis, diabetes showed independent association with uRenin. Consistently elevated uRenin in DN, regardless of the amount of proteinuria, indicates that intrarenal RAS activity may be higher in DN compared to NDN in patients with overt proteinuria. © 2014 Asian Pacific Society of Nephrology.

  2. Dynamical lifetimes of asteroids in retrograde orbits

    NASA Astrophysics Data System (ADS)

    Kankiewicz, Paweł; Włodarczyk, Ireneusz

    2017-07-01

    The population of known minor bodies in retrograde orbits (i > 90°) that are classified as asteroids is still growing. The aim of our study was to estimate the dynamical lifetimes of these bodies using the latest observational data, including astrometry and physical properties. We selected 25 asteroids with the best-determined orbital elements. We studied their dynamical evolution in the past and future for ±100 Myr (±1 Gyr for three particular cases). We first used orbit determination and cloning to produce swarms of test particles. These swarms were then input into long-term numerical integrations, and the orbital elements were averaged. Next, we collected the available thermal properties of our objects and we used them in an enhanced dynamical model with Yarkovsky forces. We also used a gravitational model for comparison. Finally, we estimated the median lifetimes of 25 asteroids. We found three objects whose retrograde orbits were stable with a dynamical lifetime τ ˜ 10-100 Myr. A large portion of the objects studied displayed smaller values of τ (τ ˜ 1 Myr). In addition, we studied the possible influence of the Yarkovsky effect on our results. We found that the Yarkovsky effect can have a significant influence on the lifetimes of asteroids in retrograde orbits. Because of the presence of this effect, it is possible that the median lifetimes of these objects are extended. Additionally, the changes in orbital elements, caused by Yarkovsky forces, appear to depend on the integration direction. To explain this more precisely, the same model based on new physical parameters, determined from future observations, will be required.

  3. Retrograde ejaculation, painful ejaculation and hematospermia

    PubMed Central

    Parnham, Arie

    2016-01-01

    Although there has been an increased interest on premature ejaculation in the recent years, our understanding regarding the disorders of retrograde ejaculation, painful ejaculation and hematospermia remain limited. All three of these conditions require a keen clinical acumen and willingness to engage in thinking outside of the standard established treatment paradigm. The development of novel investigational techniques and treatments has led to progress in the management of these conditions symptoms; however, the literature almost uniformly is limited to small series and rare randomised trials. Further investigation and randomised controlled trials are needed for progress in these often challenging cases. PMID:27652230

  4. Retrograde ejaculation, painful ejaculation and hematospermia.

    PubMed

    Parnham, Arie; Serefoglu, Ege Can

    2016-08-01

    Although there has been an increased interest on premature ejaculation in the recent years, our understanding regarding the disorders of retrograde ejaculation, painful ejaculation and hematospermia remain limited. All three of these conditions require a keen clinical acumen and willingness to engage in thinking outside of the standard established treatment paradigm. The development of novel investigational techniques and treatments has led to progress in the management of these conditions symptoms; however, the literature almost uniformly is limited to small series and rare randomised trials. Further investigation and randomised controlled trials are needed for progress in these often challenging cases.

  5. Terminal retrograde turn of rolling rings

    NASA Astrophysics Data System (ADS)

    Jalali, Mir Abbas; Sarebangholi, Milad S.; Alam, Mohammad-Reza

    2015-09-01

    We report an unexpected reverse spiral turn in the final stage of the motion of rolling rings. It is well known that spinning disks rotate in the same direction of their initial spin until they stop. While a spinning ring starts its motion with a kinematics similar to disks, i.e., moving along a cycloidal path prograde with the direction of its rigid body rotation, the mean trajectory of its center of mass later develops an inflection point so that the ring makes a spiral turn and revolves in a retrograde direction around a new center. Using high speed imaging and numerical simulations of models featuring a rolling rigid body, we show that the hollow geometry of a ring tunes the rotational air drag resistance so that the frictional force at the contact point with the ground changes its direction at the inflection point and puts the ring on a retrograde spiral trajectory. Our findings have potential applications in designing topologically new surface-effect flying objects capable of performing complex reorientation and translational maneuvers.

  6. Subtrochanteric fractures after retrograde femoral nailing

    PubMed Central

    Mounasamy, Varatharaj; Mallu, Sathya; Khanna, Vishesh; Sambandam, Senthil

    2015-01-01

    Secondary fractures around femoral nails placed for the management of hip fractures are well known. We report, two cases of a fracture of the femur at the interlocking screw site in the subtrochanteric area after retrograde femoral nailing of a femoral shaft fracture. Only a few reports in the existing literature have described these fractures. Two young men after sustaining a fall presented to us with pain, swelling and deformity in the upper thigh region. On enquiring, examining and radiographing them, peri-implant fractures of subtrochanteric nature through the distal interlocking screws were revealed in both patients who also had histories of previous falls for which retrograde intramedullary nailing was performed for their respective femora. Both patients were managed with similar surgical routines including removal of the existing hardware, open reduction and ace cephallomedullary antegrade nailing. The second case did show evidence of delayed healing and was additionally stabilized with cerclage wires. Both patients had uneventful postoperative outcomes and union was evident at the end of 6 mo postoperatively with a good range of motion at the hip and knee. Our report suggests that though seldom reported, peri-implant fractures around the subtrochanteric region can occur and pose a challenge to the treating orthopaedic surgeon. We suggest these be managed, after initial stabilization and resuscitation, by implant removal, open reduction and interlocking intramedullary antegrade nailing. Good results and progression to union can be expected in these patients by adhering to basic principles of osteosynthesis. PMID:26495251

  7. Terminal retrograde turn of rolling rings.

    PubMed

    Jalali, Mir Abbas; Sarebangholi, Milad S; Alam, Mohammad-Reza

    2015-09-01

    We report an unexpected reverse spiral turn in the final stage of the motion of rolling rings. It is well known that spinning disks rotate in the same direction of their initial spin until they stop. While a spinning ring starts its motion with a kinematics similar to disks, i.e., moving along a cycloidal path prograde with the direction of its rigid body rotation, the mean trajectory of its center of mass later develops an inflection point so that the ring makes a spiral turn and revolves in a retrograde direction around a new center. Using high speed imaging and numerical simulations of models featuring a rolling rigid body, we show that the hollow geometry of a ring tunes the rotational air drag resistance so that the frictional force at the contact point with the ground changes its direction at the inflection point and puts the ring on a retrograde spiral trajectory. Our findings have potential applications in designing topologically new surface-effect flying objects capable of performing complex reorientation and translational maneuvers.

  8. Intrarenal cells, not bone marrow–derived cells, are the major source for regeneration in postischemic kidney

    PubMed Central

    Lin, Fangming; Moran, Ashley; Igarashi, Peter

    2005-01-01

    Ischemic injury to the kidney produces acute tubular necrosis and apoptosis followed by tubular regeneration and recovery of renal function. Although mitotic cells are present in the tubules of postischemic kidneys, the origins of the proliferating cells are not known. Bone marrow cells (BMCs) can differentiate across lineages to repair injured organs, including the kidney. However, the relative contribution of intrarenal cells and extrarenal cells to kidney regeneration is not clear. We produced transgenic mice that expressed enhanced GFP (EGFP) specifically and permanently in mature renal tubular epithelial cells. Following ischemia/reperfusion injury (IRI), EGFP-positive cells showed incorporation of BrdU and expression of vimentin, which provides direct evidence that the cells composing regenerating tubules are derived from renal tubular epithelial cells. In BMC-transplanted mice, 89% of proliferating epithelial cells originated from host cells, and 11% originated from donor BMCs. Twenty-eight days after IRI, the kidneys contained 8% donor-derived cells, of which 8.4% were epithelial cells, 10.6% were glomerular cells, and 81% were interstitial cells. No renal functional improvement was observed in mice that were transplanted with exogenous BMCs. These results show that intrarenal cells are the main source of renal repair, and a single injection of BMCs does not make a significant contribution to renal functional or structural recovery. PMID:16007252

  9. Phytochrome and retrograde signalling pathways coverage to antogonistically regulate a light-induced transcription network

    USDA-ARS?s Scientific Manuscript database

    Plastid-to-nucleus retrograde signals emitted by dysfunctional chloroplasts impact photomorphogenic development, but the molecular link between retrograde and photosensory-receptor signaling has remained undefined. Here, we show that the phytochrome (phy) and retrograde signaling pathways converge a...

  10. Using Kinesthetic Activities to Teach Ptolemaic and Copernican Retrograde Motion

    ERIC Educational Resources Information Center

    Richards, Ted

    2012-01-01

    This paper describes a method for teaching planetary retrograde motion, and the Ptolemaic and Copernican accounts of retrograde motion, by means of a series kinesthetic learning activities (KLAs). In the KLAs described, the students literally walk through the motions of the planets in both systems. A retrospective statistical analysis shows that…

  11. Using Kinesthetic Activities to Teach Ptolemaic and Copernican Retrograde Motion

    ERIC Educational Resources Information Center

    Richards, Ted

    2012-01-01

    This paper describes a method for teaching planetary retrograde motion, and the Ptolemaic and Copernican accounts of retrograde motion, by means of a series kinesthetic learning activities (KLAs). In the KLAs described, the students literally walk through the motions of the planets in both systems. A retrospective statistical analysis shows that…

  12. [Prevalence of retrograde ejaculation in infertility associated to hypospermia].

    PubMed

    Juárez-Bengoa, Armando; Bagnarello-González, Fiorella; Rodríguez-Perdomo, David Francisco; Rodríguez-Yee, Emmanuel

    2011-02-01

    Approximately 14% of couples of reproductive age have a fertility problem, defined as the inability to achieve pregnancy after a year of frequent intercourse without contraceptive protection. To determine the prevalence of retrograde ejaculation in infertile patients with hypospermia and to establish the effects of the treatment. Comparative study. A semen analysis of 207 patients with male infertility with hypospermia was performed. The patients with retrograde ejaculation were identified and its prevalence was calculated. Semen parameters were compared before and after treatment by means of a paired-t test. Hormonal levels also were compared between groups with and without retrograde ejaculation by means of a Mann-Whitney U test. Prevalence of retrograde ejaculation was 3.2% out of 2587 infertile patients. Within the group of 207 patients with hypospermia, 84 had retrograde ejaculation. After the treatment the seminal volume increased (from 1.2 to 1.5 milliliters) and the number of mobile cells increased (from 47.2 to 62.5 millions). The number of sperm in urine decreased (from 22 to 10 per high-power field). The patients with retrograde ejaculation had lower levels of follicle-stimulating hormone, luteinizing hormone and testosterone than those without retrograde ejaculation. Retrograde ejaculation and hypospermia are both considered infrequent but important alterations in infertility. Prevalence of retrograde ejaculation in patients with hypospermia is 40.5%. Treatment increased seminal volume and the number of mobile cells in the ejaculated semen. It is necessary to perform future studies in order to determine the impact of severity of retrograde ejaculation on infertility.

  13. Distant retrograde orbits for the Moon's exploration

    NASA Astrophysics Data System (ADS)

    Sidorenko, Vladislav

    We discuss the properties of the distant retrograde orbits (which are called quasi-satellite orbits also) around Moon. For the first time the distant retrograde orbits were described by J.Jackson in studies on restricted three body problem at the beginning of 20th century [1]. In the synodic (rotating) reference frame distant retrograde orbit looks like an ellipse whose center is slowly drifting in the vicinity of minor primary body while in the inertial reference frame the third body is orbiting the major primary body. Although being away the Hill sphere the third body permanently stays close enough to the minor primary. Due to this reason the distant retrograde orbits are called “quasi-satellite” orbits (QS-orbits) too. Several asteroids in solar system are in a QS-orbit with respect to one of the planet. As an example we can mention the asteroid 2002VE68 which circumnavigates Venus [2]. Attention of specialists in space flight mechanics was attracted to QS-orbits after the publications of NASA technical reports devoted to periodic moon orbits [3,4]. Moving in QS-orbit the SC remains permanently (or at least for long enough time) in the vicinity of small celestial body even in the case when the Hill sphere lies beneath the surface of the body. The properties of the QS-orbit can be studied using the averaging of the motion equations [5,6,7]. From the theoretical point of view it is a specific case of 1:1 mean motion resonance. The integrals of the averaged equations become the parameters defining the secular evolution of the QS-orbit. If the trajectory is robust enough to small perturbations in the simplified problem (i.e., restricted three body problem) it may correspond to long-term stability of the real-world orbit. Our investigations demonstrate that under the proper choice of the initial conditions the QS-orbits don’t escape from Moon or don’t impact Moon for long enough time. These orbits can be recommended as a convenient technique for the large

  14. [Retrograde nailing in a tibial fracture].

    PubMed

    Valls-Mellado, M; Martí-Garín, D; Fillat-Gomà, F; Marcano-Fernández, F A; González-Vargas, J A

    2014-01-01

    We describe a case of a severely comminuted type iiia open tibial fracture, with distal loss of bone stock (7 cm), total involvement of the tibial joint surface, and severe instability of the fibular-talar joint. The treatment performed consisted of thorough cleansing, placing a retrograde reamed calcaneal-talar-tibial nail with proximal and distal blockage, as well as a fibular-talar Kirschner nail. Primary closure of the skin was achieved. After 3 weeks, an autologous iliac crest bone graft was performed to fill the bone defect, and the endomedullary nail, which had protruded distally was reimpacted and dynamized distally. The bone defect was eventually consolidated after 16 weeks. Currently, the patient can walk without pain the tibial-astragal arthrodesis is consolidated. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  15. Evidence for retrograde lithospheric subduction on Venus

    NASA Technical Reports Server (NTRS)

    Sandwell, David T.; Schubert, Gerald

    1992-01-01

    Annular moats and outer rises around large Venus coronas such as Artemis, Latona, and Eithinoha are similar in arcuate planform and topography to the trenches and outer rises of terrestrial subduction zones. On earth, trenches and outer rises are modeled as the flexural response of a thin elastic lithosphere to the bending moment of the subducted slab; this lithospheric flexure model also accounts for the trenches and outer rises outboard of the major coronas on Venus. Accordingly, it is proposed that retrograde lithospheric subduction may be occurring on the margins of the large Venus coronas while compensating back-arc extension is occurring in the expanding coronas interiors. Similar processes may be taking place at other deep arcuate trenches or chasmata on Venus such as those in the Dali-Diana chasmata area of aestern Aphrodite Terra.

  16. Asteroids in Retrograde Orbits: Interesting Cases

    NASA Astrophysics Data System (ADS)

    Kankiewicz, Paweł; Włodarczyk, Ireneusz

    2014-12-01

    We present the most interesting examples of the orbital evolution of asteroids in retrograde orbits (i > 90°). First, we used the latest observational data to determine nominal and averaged orbital elements of these objects. Next, the equations of motion of these asteroids were integrated backward 1 My, taking into account the propagation of observational errors. We used so-called 'cloning' procedure to reproduce the reliability of initial data. We obtained some possible scenarios of the orbit inversion in the past, what is often caused by the long-term influence of outer planets. For two most interesting cases (Apollo and Amor type) we did additional calculations: 100 My in the future. Additionally, we investigated the potential influence of Yarkovski/YORP effects on the long-time orbital evolution.

  17. Selective retrograde transsynaptic transfer of a protein, tetanus toxin, subsequent to its retrograde axonal transport

    PubMed Central

    Schwab, ME; Suda, K; Thoenen, H

    1979-01-01

    The fate of tetanus toxin (mol wt 150,000) subsequent to its retrograde axonal transport in peripheral sympathetic neurons of the rat was studied by both electron microscope autoradiography and cytochemistry using toxin-horseradish peroxidase (HRP) coupling products, and compared to that of nerve growth factor (NGF), cholera toxin, and the lectins wheat germ agglutinin (WGA), phytohaemagglutinin (PHA), and ricin. All these macromolecules are taken up by adrenergic nerve terminals and transported retrogradely in a selective, highly efficient manner. This selective uptake and transport is a consequence of the binding of these macromolecules to specific receptive sites on the nerve terminal membrane. All these ligands are transported in the axons within smooth vesicles, cisternae, and tubules. In the cell bodies these membrane compartments fuse and most of the transported macromolecules are finally incorporated into lysosomes. The cell nuclei, the parallel golgi cisternae, and the extracellular space always remain unlabeled. In case the tetanus toxin, however, a substantial fraction of the labeled material appears in presynaptic cholinergic nerve terminals which innervate the labeled ganglion cells. In these terminals tetanus toxin-HRP is localized in 500-1,000 A diam vesicles. In contrast, such a retrograde transsynaptic transfer is not at all or only very rarely detectable after retrograde transport of cholera toxin, NGF, WGA, PHA, or ricin. An atoxic fragment of the tetanus toxin, which contains the ganglioside-binding site, behaves like intact toxin. With all these macromolecules, the extracellular space and the glial cells in the ganglion remain unlabeled. We conclude that the selectivity of this transsynaptic transfer of tetanus toxin is due to a selective release of the toxin from the postsynaptic dendrites. This release is immediately followed by an uptake into the presynaptic terminals. PMID:92475

  18. Low-protein diet supplemented with ketoacids ameliorates proteinuria in 3/4 nephrectomised rats by directly inhibiting the intrarenal renin-angiotensin system.

    PubMed

    Zhang, Jia-Ying; Yin, Ying; Ni, Li; Long, Quan; You, Li; Zhang, Qian; Lin, Shan-Yan; Chen, Jing

    2016-11-01

    Low-protein diet plus ketoacids (LPD+KA) has been reported to decrease proteinuria in patients with chronic kidney diseases (CKD). However, the mechanisms have not been clarified. As over-activation of intrarenal renin-angiotensin system (RAS) has been shown to play a key role in the progression of CKD, the current study was performed to investigate the direct effects of LPD+KA on intrarenal RAS, independently of renal haemodynamics. In this study, 3/4 subtotal renal ablated rats were fed 18 % normal-protein diet (Nx-NPD), 6 % low-protein diet (Nx-LPD) or 5 % low-protein diet plus 1 % ketoacids (Nx-LPD+KA) for 12 weeks. Sham-operated rats fed NPD served as controls. The level of proteinuria and expression of renin, angiotensin II (AngII) and its type 1 receptors (AT1R) in the renal cortex were markedly higher in Nx-NPD group than in the sham group. LPD+KA significantly decreased the proteinuria and inhibited intrarenal RAS activation. To exclude renal haemodynamic impact on intrarenal RAS, the serum samples derived from the different groups were added to the culture medium of mesangial cells. It showed that the serum from Nx-NPD directly induced higher expression of AngII, AT1R, fibronectin and transforming growth factor-β1 in the mesangial cells than in the control group. Nx-LPD+KA serum significantly inhibited these abnormalities. Then, proteomics and biochemical detection suggested that the mechanisms underlying these beneficial effects of LPD+KA might be amelioration of the nutritional metabolic disorders and oxidative stress. In conclusion, LPD+KA could directly inhibit the intrarenal RAS activation, independently of renal haemodynamics, thus attenuating the proteinuria in CKD rats.

  19. Impaired endogenous nighttime melatonin secretion relates to intrarenal renin-angiotensin system activation and renal damage in patients with chronic kidney disease.

    PubMed

    Ishigaki, Sayaka; Ohashi, Naro; Isobe, Shinsuke; Tsuji, Naoko; Iwakura, Takamasa; Ono, Masafumi; Sakao, Yukitoshi; Tsuji, Takayuki; Kato, Akihiko; Miyajima, Hiroaki; Yasuda, Hideo

    2016-12-01

    Activation of the intrarenal renin-angiotensin system (RAS) plays a critical role in the pathophysiology of chronic kidney disease (CKD) and hypertension. The circadian rhythm of intrarenal RAS activation leads to renal damage and hypertension, which are associated with diurnal blood pressure (BP) variation. The activation of intrarenal RAS following reactive oxygen species (ROS) activation, sympathetic hyperactivity and nitric oxide (NO) inhibition leads to the development of renal damage. Melatonin is a hormone regulating the circadian rhythm, and has multiple functions such as anti-oxidant and anti-adrenergic effects and enhancement of NO bioavailability. Nocturnal melatonin concentrations are lower in CKD patients. However, it is not known if impaired endogenous melatonin secretion is related to BP, intrarenal RAS, or renal damage in CKD patients. We recruited 53 CKD patients and conducted 24-h ambulatory BP monitoring. urine was collected during the daytime and nighttime. We investigated the relationship among the melatonin metabolite urinary 6-sulphatoxymelatonin (U-aMT6s), BP, renal function, urinary angiotensinogen (U-AGT), and urinary albumin (U-Alb). Patients' U-aMT6s levels were significantly and negatively correlated with clinical parameters such as renal function, systolic BP, U-AGT, and U-Alb, during both day and night. Multiple regression analyses for U-aMT6s levels were performed using age, gender, renal function, and each parameter (BPs, U-AGT or U-Alb), at daytime and nighttime. U-aMT6s levels were significantly associated with U-AGT (β = -0.31, p = 0.044) and U-Alb (β = -0.25, p = 0.025) only at night. Impaired nighttime melatonin secretion may be associated with nighttime intrarenal RAS activation and renal damage in CKD patients.

  20. Endoscopic retrograde cholangiopancreatography in patients with surgically altered gastrointestinal anatomy.

    PubMed

    Amer, Syed; Horsley-Silva, Jennifer L; Menias, Christine O; Pannala, Rahul

    2015-10-01

    Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered upper gastrointestinal anatomy, such as Roux-en-Y gastric bypass (RYGB), can be more challenging compared to those with a normal anatomy. Detailed assessment of cross-sectional imaging features by the radiologist, especially the pancreaticobiliary anatomy, strictures, and stones, is very helpful to the endoscopist in planning the procedure. In addition, any information on enteral anastomoses (for e.g., gastrojejunal strictures and afferent limb obstruction) is also very useful. The endoscopist should review the operative note to understand the exact anatomy prior to procedure. RYGB, which is performed for medically complicated obesity, is the most commonly encountered altered anatomy ERCP procedure. Other situations include patients who have had a pancreaticoduodenectomy or a hepaticojejunostomy. Balloon-assisted deep enteroscopy (single and double-balloon enteroscopy) or rotational endoscopy is often used to traverse the length of the intestine to reach the papilla. In addition, ERCP in these patients is further challenging due to the oblique orientation of the papilla relative to the forward viewing endoscope and the limited enteroscopy-length therapeutic accessories that are currently available. Overall, reported therapeutic success is approximately 70-75% with a complication rate of 3-4%. Alternative approaches include percutaneous transhepatic cholangiography, laparoscopy-assisted ERCP, or surgery. Given the complexity, ERCP in patients with surgically altered anatomy should be performed in close collaboration with body imagers, interventional radiology, and surgical services.

  1. Strict angiotensin blockade prevents the augmentation of intrarenal angiotensin II and podocyte abnormalities in type 2 diabetic rats with microalbuminuria

    PubMed Central

    Nishiyama, Akira; Nakagawa, Toshitaka; Kobori, Hiroyuki; Nagai, Yukiko; Okada, Noriyuki; Konishi, Yoshio; Morikawa, Takashi; Okumura, Michiaki; Meda, Isseiki; Kiyomoto, Hideyasu; Hosomi, Naohisa; Mori, Takefumi; Ito, Sadayoshi; Imanishi, Masahito

    2008-01-01

    Objectives Beneficial effects of angiotensin II type 1 receptor blockers have been indicated for patients with diabetic nephropathy. We investigated the effects of an angiotensin II type 1 receptor blocker, telmisartan, on intrarenal angiotensin II levels and the progression of albuminuria or glomerular injury in type 2 diabetic Otsuka Long–Evans Tokushima Fatty rats with microalbuminuria. Methods and Results Otsuka Long–Evans Tokushima Fatty rats were randomly treated with telmisartan (10 mg/kg/day, orally), hydralazine (25 mg/kg/day in drinking water) or vehicle from the initiation of albuminuria (13 weeks old). At this age, Otsuka Long–Evans Tokushima Fatty rats showed low but detectable albuminuria (1.0±0.1 mg/day) and higher systolic blood pressure, postprandial blood glucose and kidney angiotensin II levels than age-matched nondiabetic Long–Evans Tokushima Otsuka rats. At 35 weeks of age, vehicle-treated Otsuka Long–Evans Tokushima Fatty rats did not show apparent glomerular injury or tubulointerstitial fibrosis but did exhibit severe albuminuria (72.6±5.9 mg/day) and accumulation of cytoplasmic granules containing albumin in podocytes. Otsuka Long–Evans Tokushima Fatty rats also showed higher systolic blood pressure, postprandial blood glucose, collagen gene expression, desmin staining (a marker of podocyte injury) and angiotensin II levels than Long–Evans Tokushima Otsuka rats. Treatment with telmisartan did not affect postprandial blood glucose but decreased systolic blood pressure, collagen gene expression, desmin staining and angiotensin II levels. Telmisartan also prevented the development of albuminuria (0.6±0.1 mg/day at 35 weeks old) and accumulation of cytoplasmic granules. Hydralazine treatment resulted in a similar reduction in systolic blood pressure and partially attenuated the albuminuria (35.4±1.8 mg/day at 35 weeks old) but did not affect the other parameters. Conclusion The present results suggest the contribution of

  2. Intra-renal delivery of mesenchymal stem cells and endothelial progenitor cells attenuates hypertensive cardiomyopathy in experimental renovascular hypertension

    PubMed Central

    Eirin, Alfonso; Zhu, Xiang-Yang; Ebrahimi, Behzad; Krier, James D.; Riester, Scott M.; van Wijnen, Andre J.; Lerman, Amir; Lerman, Lilach O.

    2015-01-01

    Background Renovascular hypertension (RVH) leads to left ventricular (LV) hypertrophy and diastolic dysfunction, associated with increased cardiovascular mortality. Intra-renal delivery of endothelial progenitor cells (EPCs) and mesenchymal stem cells (MSCs) improves kidney function in porcine RVH, and the potent anti-inflammatory properties of MSCs may serve to blunt inflammatory mediators in the cardio-renal axis. However, their relative efficacy in attenuating cardiac injury and dysfunction remains unknown. This study tested the hypothesis that the cardio-protective effect of EPCs and MSCs delivered into the stenotic-kidney in experimental RVH are comparable. Methods Pigs (n=7 per group) were studied after 10 weeks of RVH or control untreated or treated with a single intra-renal infusion of autologous EPCs or MSCs 4 weeks earlier. Cardiac and renal function (fast-CT) and stenotic-kidney release of inflammatory mediators (ELISA) were assessed in-vivo, and myocardial inflammation, remodeling, and fibrosis ex-vivo. Results After 10 weeks of RVH, blood pressure was not altered in cell-treated groups, yet stenotic-kidney glomerular filtration rate (GFR), blunted in RVH, improved in RVH+EPC and normalized in RVH+MSC. Stenotic-kidney release of monocyte chemoattractant protein (MCP)-1 and its myocardial expression were elevated in RVH+EPC, but normalized only in RVH+MSC pigs. RVH-induced LV hypertrophy was normalized in both EPC and MSC-treated pigs, while diastolic function (E/A ratio) was restored to normal levels exclusively in RVH+MSC. RVH-induced myocardial fibrosis and collagen deposition decreased in RVH+EPC, but further decreased in RVH+MSC-treated pigs. Conclusions Intra-renal delivery of EPCs or MSCs attenuates RVH-induced myocardial injury, yet MSCs restore diastolic function more effectively than EPCs, possibly by greater improvement in renal function or reduction of MCP-1 release from the stenotic-kidney. These observations suggest a therapeutic potential

  3. Antibody-mediated inhibition of ricin toxin retrograde transport.

    PubMed

    Yermakova, Anastasiya; Klokk, Tove Irene; Cole, Richard; Sandvig, Kirsten; Mantis, Nicholas J

    2014-04-08

    Ricin is a member of the ubiquitous family of plant and bacterial AB toxins that gain entry into the cytosol of host cells through receptor-mediated endocytosis and retrograde traffic through the trans-Golgi network (TGN) and endoplasmic reticulum (ER). While a few ricin toxin-specific neutralizing monoclonal antibodies (MAbs) have been identified, the mechanisms by which these antibodies prevent toxin-induced cell death are largely unknown. Using immunofluorescence confocal microscopy and a TGN-specific sulfation assay, we demonstrate that 24B11, a MAb against ricin's binding subunit (RTB), associates with ricin in solution or when prebound to cell surfaces and then markedly enhances toxin uptake into host cells. Following endocytosis, however, toxin-antibody complexes failed to reach the TGN; instead, they were shunted to Rab7-positive late endosomes and LAMP-1-positive lysosomes. Monovalent 24B11 Fab fragments also interfered with toxin retrograde transport, indicating that neither cross-linking of membrane glycoproteins/glycolipids nor the recently identified intracellular Fc receptor is required to derail ricin en route to the TGN. Identification of the mechanism(s) by which antibodies like 24B11 neutralize ricin will advance our fundamental understanding of protein trafficking in mammalian cells and may lead to the discovery of new classes of toxin inhibitors and therapeutics for biodefense and emerging infectious diseases. IMPORTANCE Ricin is the prototypic member of the AB family of medically important plant and bacterial toxins that includes cholera and Shiga toxins. Ricin is also a category B biothreat agent. Despite ongoing efforts to develop vaccines and antibody-based therapeutics against ricin, very little is known about the mechanisms by which antibodies neutralize this toxin. In general, it is thought that antibodies simply prevent toxins from attaching to cell surface receptors or promote their clearance through Fc receptor (FcR)-mediated uptake

  4. PRODUCTION OF NEAR-EARTH ASTEROIDS ON RETROGRADE ORBITS

    SciTech Connect

    Greenstreet, S.; Gladman, B.; Ngo, H.; Granvik, M.; Larson, S.

    2012-04-20

    While computing an improved near-Earth object (NEO) steady-state orbital distribution model, we discovered in the numerical integrations the unexpected production of retrograde orbits for asteroids that had originally exited from the accepted main-belt source regions. Our model indicates that {approx}0.1% (a factor of two uncertainty) of the steady-state NEO population (perihelion q < 1.3 AU) is on retrograde orbits. These rare outcomes typically happen when asteroid orbits flip to a retrograde configuration while in the 3:1 mean-motion resonance with Jupiter and then live for {approx}0.001 to 100 Myr. The model predicts, given the estimated near-Earth asteroid (NEA) population, that a few retrograde 0.1-1 km NEAs should exist. Currently, there are two known MPC NEOs with asteroidal designations on retrograde orbits which we therefore claim could be escaped asteroids instead of devolatilized comets. This retrograde NEA population may also answer a long-standing question in the meteoritical literature regarding the origin of high-strength, high-velocity meteoroids on retrograde orbits.

  5. Endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy

    PubMed Central

    Wang, Fei; Xu, Boming; Li, Quanpeng; Zhang, Xiuhua; Jiang, Guobing; Ge, Xianxiu; Nie, Junjie; Zhang, Xiuyun; Wu, Ping; Ji, Jie; Miao, Lin

    2016-01-01

    Abstract Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is challenging. Results of ERCP in those patients varied. The aim of our study was to evaluate the safety and effectiveness of various endoscopes-assisted ERCP in patients with surgically altered anatomy. Fifty-two patients with Billroth II reconstruction (group A), 20 patients with subtotal or total gastrectomy with Roux-en-Y anastomosis (group B), 25 patients with pancreatoduodenectomy or Roux-en-Y hepaticojejunostomy reconstruction (group C) were included. Gastroscope, duodenoscope, colonoscope, and double-balloon enteroscope were used. The endoscope insertion success rate of groups A, B, C was 96.2% (50/52), 85.0% (17/20), 80% (20/25), respectively. χ2 test showed that there was no significant difference between the 3 groups (P = 0.068). The mean insertion time was 36.7, 68.4, and 84.0 minutes, respectively. One-way ANOVA showed that the insertion time of group C was significantly longer than that of groups B and C (both P <0.001). The endoscopic cannulation success rates of groups A, B, C were 90%, 82.4%, and 100%, respectively. χ2 test showed that there was no significant difference between the 3 groups (P = 0.144). The mean cannulation time was 19.4, 28.1, and 20.4 minutes, respectively. One-way ANOVA showed that the cannulation time of group B was longer than that of groups A and C (P <0.001, P = 0.001, respectively). In total, 74 patients with successful biliary cannulation achieved the therapeutic goal; thus, the clinical success rate was 76.3% (74/97). Our study showed that ERCP in patients with surgically altered anatomy was safe and feasible. PMID:28033284

  6. Using Kinesthetic Activities to Teach Ptolemaic and Copernican Retrograde Motion

    NASA Astrophysics Data System (ADS)

    Richards, Ted

    2012-06-01

    This paper describes a method for teaching planetary retrograde motion, and the Ptolemaic and Copernican accounts of retrograde motion, by means of a series kinesthetic learning activities (KLAs). In the KLAs described, the students literally walk through the motions of the planets in both systems. A retrospective statistical analysis shows that students who participated in these activities performed better on examination questions pertaining to retrograde motion than students who did not. Potential explanations for this result, including the breaking of classroom routine, the effect of body movement on conceptual memory, and egocentric spatial proprioception, are considered.

  7. Retrograde ejaculation following open ureteric reimplantation: a case report.

    PubMed

    Au, Eleanor; Dasgupta, Ranan; Dasgupta, Prokar

    2009-08-18

    Retrograde ejaculation is not a recognized complication of ureteric reimplantation surgery. We describe this unusual complication in a 25-year-old man, with no other cause for his ejaculatory dysfunction. A 25-year-old Caucasian man presented with left hydronephrosis ascribed to a megaureter. Following open reimplantation of the ureter, the patient developed retrograde ejaculation that did not respond to medical therapy. The key result reported here is that retrograde ejaculation is a possible complication of open pelvic surgery, for which patients should receive counselling. This is relevant for both urologists and general physicians who consult relatively young men with ejaculatory difficulties.

  8. Retrograde ejaculation following open ureteric reimplantation: a case report

    PubMed Central

    2009-01-01

    Introduction Retrograde ejaculation is not a recognized complication of ureteric reimplantation surgery. We describe this unusual complication in a 25-year-old man, with no other cause for his ejaculatory dysfunction. Case presentation A 25-year-old Caucasian man presented with left hydronephrosis ascribed to a megaureter. Following open reimplantation of the ureter, the patient developed retrograde ejaculation that did not respond to medical therapy. Conclusion The key result reported here is that retrograde ejaculation is a possible complication of open pelvic surgery, for which patients should receive counselling. This is relevant for both urologists and general physicians who consult relatively young men with ejaculatory difficulties. PMID:19918274

  9. Transfer and capture into distant retrograde orbits

    NASA Astrophysics Data System (ADS)

    Scott, Christopher J.

    This dissertation utilizes theory and techniques derived from the fields of dynamical systems theory, astrodyanamics, celestial mechanics, and fluid mechanics to analyze the phenomenon of satellite capture and interrelated spacecraft transfers in restricted three-body systems. The results extend current knowledge and understanding of capture dynamics in the context of astrodynamics and celestial mechanics. Manifold theory, fast Lyapunov indicator maps, and the classification of space structure facilitate an analysis of the transport of objects from the chaotic reaches of the solar system to the distant retrograde region in the sun-Jupiter system. Apart from past studies this dissertation considers the role of the complex lobe structure encompassing stable regions in the circular restricted three-body problem. These structures are shown to be responsible for the phenomenon of sticky orbits and the transport of objects among stable regions. Since permanent capture can only be achieved through a change in energy, fast Lyapunov indicator maps and other methods which reveal the structure of the conservative system are used to discern capture regions and identify the underpinnings of the dynamics. Fast Lyapunov indicator maps provide an accurate classification of orbits of permanent capture and escape, yet monopolize computational resources. In anticipation of a fully three-dimensional analysis in the dissipative system a new mapping parameter is introduced based on energy degradation and averaged velocity. Although the study specifically addresses the sun-Jupiter system, the qualitative results and devised techniques can be applied throughout the solar system and to capture about extrasolar planets. Extending the analysis beyond the exterior of the stable distant retrograde region fosters the construction of transfer orbits from low-Earth orbit to a stable periodic orbit at the center of the stable distant retrograde region. Key to this analysis is the predictability of

  10. Protective effect of intrarenal calcium membrane blockers before or after renal ischemia. Functional, morphological, and mitochondrial studies.

    PubMed Central

    Burke, T J; Arnold, P E; Gordon, J A; Bulger, R E; Dobyan, D C; Schrier, R W

    1984-01-01

    The present study examined whether a pre- or postischemic infusion of verapamil (V) or a postischemic infusion of nifedipine (N), drugs which block calcium (Ca++) influx across plasma membranes, provides protection against ischemic acute renal failure (ARF) in dogs. Renal hemodynamics and excretory function were examined 1 h (initiation phase) and 24 h (maintenance phase) after a 40-min intrarenal infusion of norepinephrine (NE). In each case, the uninfused contralateral kidney served as control. Four groups were studied: (a) dogs receiving NE alone; (b) dogs receiving an intrarenal infusion of V for 30 min before NE (V + NE); (c) dogs in which intrarenal V was infused for 2 h, beginning immediately after completion of NE infusion (NE + V); and (d) dogs in which intrarenal N was infused for 2 h, beginning immediately after completion of NE infusion (NE + N). Glomerular filtration rate (GFR) in the NE kidneys, as assessed by inulin clearance, at 1 and 24 h averaged 2.4 +/- 1.1 and 5.0 +/- 2.0 ml/min, respectively, as compared with control kidney GFRs of 28.0 +/- 3.5 and 43.8 +/- 5.0 ml/min, respectively (both at least P less than 0.01). In the V + NE group, GFR at 1 and 24 h averaged 15.0 +/- 5.5 and 31.0 +/- 4.5 ml/min, respectively, both at least P less than 0.05 as compared with values from NE kidneys. GFRs in the NE + V group averaged 15.0 +/- 2.4 and 16.3 +/- 3.6 ml/min at 1 and 24 h, both at least P less than 0.02 as compared with values from NE kidneys. GFR in the NE + N group averaged 18.6 +/- 6.0 ml/min at 24 h (P less than 0.05 as compared with GFRs in the NE kidneys). In addition, function of cortical mitochondria (Mito) was examined at the end of the 40-min NE infusion and after 1 and 24 h of reperfusion in the NE alone and NE + V groups. Mito respiration, assessed by acceptor control ratios, was reduced at each period in the NE alone kidneys. After 24 h, these Mito had accumulated Ca++ and exhibited reduced Ca++ uptake and increased Ca++ release rates

  11. Using balloon-overtube-assisted enteroscopy for postoperative endoscopic retrograde cholangiopancreatography

    PubMed Central

    Skinner, Matthew; Velázquez-Aviña, Jacobo

    2014-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is technically more challenging in patients with postsurgical anatomy such as Roux-en-Y anastomosis, frequently mandating an operative intervention. Although limited, there is growing evidence that ERCP can be performed using the balloon-overtube-assisted enteroscopy (BOAE) in patients with complex postoperative anatomy. We present the technical aspects of performing ERCP with the BOAE in patients presenting with complex postsurgical anatomy having biliary problems. ERCP using the BOAE is feasible in patients with complex postsurgical anatomy, permitting diagnostic and therapeutic interventions in 80% of patients. PMID:25364385

  12. Intrarenal Dopamine Attenuates DOCA/HS-Induced Blood Pressure Elevation in Part through Activation of a Medullary COX-2 Pathway

    PubMed Central

    Yao, Bing; Harris, Raymond C.; Zhang, Ming-Zhi

    2009-01-01

    Locally produced dopamine in the renal proximal tubule inhibits salt and fluid reabsorption, and a dysfunctional intrarenal dopaminergic system has been reported in essential hypertension and experimental hypertension models. Using catechol-O-methyl-transferase knockout (COMT−/−) mice, which have increased renal dopamine due to deletion of the major renal dopamine metabolizing enzyme, we investigated the effect of intrarenal dopamine on the development of hypertension in the deoxycorticosterone acetate/high salt (DOCA/HS) model. DOCA/HS led to significant increases in systolic blood pressure (SBP) in wild type mice (from 115 ± 2 to 153 ± 4 mmHg), which was significantly attenuated in COMT−/− mice (from 114 ± 2 to 135 ± 3 mmHg). In DOCA/HS COMT−/− mice, the D1-like receptor antagonist SCH-23390 increased SBP (156 ± 2 mmHg). DOCA/HS COMT−/− mice also exhibited more urinary sodium excretion (COMT−/− vs. wild type: 3038 ± 430 vs. 659 ± 102 μM/24 h, P < 0.01). Furthermore, DOCA/HS-induced renal oxidative stress was significantly attenuated in COMT−/− mice. COX-2-derived prostaglandins in the renal medulla promote sodium excretion, and dopamine stimulates medullary prostaglandin production. Renal medullary COX-2 expression and urinary PGE2 excretion were significantly higher in COMT−/− than wild type mice after DOCA/HS treatment. In DOCA/HS treated COMT−/− mice, the COX-2 inhibitor SC-58236 reduced urinary sodium and PGE2 excretion and increased SBP (153 ± 2 mmHg). These studies indicate that an activated renal dopaminergic system attenuates the development of hypertension, at least in large part through activating medullary COX-2 expression/activity and also decreases oxidative stress resulting from DOCA/HS. PMID:19770404

  13. Aging has small effects on initial ischemic acute kidney injury development despite changing intrarenal immunologic micromilieu in mice.

    PubMed

    Jang, Hye Ryoun; Park, Ji Hyeon; Kwon, Ghee Young; Park, Jae Berm; Lee, Jung Eun; Kim, Dae Joong; Kim, Yoon-Goo; Kim, Sung Joo; Oh, Ha Young; Huh, Wooseong

    2016-02-15

    Inflammatory process mediated by innate and adaptive immune systems is a major pathogenic mechanism of renal ischemia-reperfusion injury (IRI). There are concerns that organ recipients may be at increased risk of developing IRI after receiving kidneys from elder donors. To reveal the effects of aging on the development of renal IRI, we compared the immunologic micromilieu of normal and postischemic kidneys from mice of three different ages (9 wk, 6 mo, and 12 mo). There was a higher number of total T cells, especially effector memory CD4/CD8 T cells, and regulatory T cells in the normal kidneys of old mice. On day 2 after IRI, the proportion of necrotic tubules and renal functional changes were comparable between groups although old mice had a higher proportion of damaged tubule compared with young mice. More T cells, but less B cells, trafficked into the postischemic kidneys of old mice. The infiltration of NK T cells was similar across the groups. Macrophages and neutrophils were comparable between groups in both normal kidneys and postischemic kidneys. The intrarenal expressions of TNF-α and VEGF were decreased in normal and postischemic kidneys of aged mice. These mixed effects of aging on lymphocytes and cytokines/chemokines were not different between the two groups of old mice. Our study demonstrates that aging alters the intrarenal micromilieu but has small effects on the development of initial renal injury after IRI. Further study investigating aging-dependent differences in the repair process of renal IRI may be required. Copyright © 2016 the American Physiological Society.

  14. A comparative study of percutaneous nephrolithotomy in supine position and endoscopic combined intrarenal surgery with flexible instrument.

    PubMed

    Nuño de la Rosa, I; Palmero, J L; Miralles, J; Pastor, J C; Benedicto, A

    2014-01-01

    To compare the results obtained in percutaneous nephrolithotomy after introduction of flexible ureteroscopy/nephroscopy (endoscopic combined intrarenal surgery - ECIRS) with nephrolitomies with only rigid nephroscopy (standard percutaneous nephrolithotomy; sPCNL). A retrospective study of 171 sPCNL in Galdakao position performed between January 2005 and December 2011 was conducted. We compared the results obtained in those procedures in which endoscopic combined intrarenal surgery (ECIRS) was performed with those in which only the rigid nephroscopy (sPCNL) was used. Specific and global success, percentage of lithiasic load eliminated, days of hospital stay and complications derived were calculated. We defined success by complete absence of lithiasis or residual presence of<5mm. We differentiated specific success, that only achieved with percutaneous surgery, from global success, or that achieved after a second line of treatment. In 73 procedures (42.4%) ECIRS was performed with flexible endoscopy while in 98 (57.6%) it was done with sPCNL. Both groups were comparable in regards to demographic parameters and characteristics of the lithiasis. The success rates in the first procedure and global success were superior for the ECIRS group (75.3% vs 40.8% and 93.1% vs 74.5%), the differences being statistically significant (P<.05). No statistically significant differences were found in regards to the complications (28.8% vs 28.3% P=.86) or days of hospital stay (4.5 vs 5.0 P=.18). Use of the flexible ureteroscopy/nephroscopy in sPCNL (ECIRS) improves the success rates and elimination of lithiasic load, making it possible to perform the surgery with a single access in most of the cases. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  15. Sequential activation of the intrarenal renin-angiotensin system in the progression of hypertensive nephropathy in Goldblatt rats.

    PubMed

    Kim, Yang Gyun; Lee, Sang Ho; Kim, Se-Yun; Lee, Arah; Moon, Ju Young; Jeong, Kyung-Hwan; Lee, Tae Won; Lim, Sung Jig; Sohn, Il Suk; Ihm, Chun-Gyoo

    2016-07-01

    The intrarenal renin-angiotensin system (RAS) has an important role in generating and maintaining hypertension in two-kidney, one-clip (2K1C) rats. This study evaluated how various intrarenal RAS components contributed to hypertension not only in the maintenance period (5w; 5 wk after operation) but also earlier (2w; 2 wk after operation). We inserted a 2.5-mm clip into the left renal artery of Sprague-Dawley rats and euthanized them at 2w and 5w following the operation. Systolic blood pressure increased within 1 wk after the operation, and left ventricular hypertrophy occurred in 2K1C rats. At 2w, juxtaglomerular apparatus (JGA) and collecting duct (CD) renin increased in clipped kidney (CK) of 2K1C rats. The tubular angiotensin I-converting enzyme (ACE) was not changed, but peritubular ACE2 decreased in nonclipped kidney (NCK) and CK of 2K1C rats. At 5w, ACE and CD renin were enhanced, and ACE2 was still lessened in both kidneys of 2K1C rats. However, plasma renin activity (PRA) was not different from that in sham rats. In proximal tubules of CK, the ANG II type 1 receptor (AT1R) was not suppressed, but the Mas receptor (MasR) was reduced; thus the AT1R/MasR ratio was elevated. Although hypoxic change in CK could not be excluded, the JGA renin of CK and CD renin in both kidneys was highly expressed independent of time. Peritubular ACE2 changed in the earlier period, and uninhibited AT1R in proximal tubules of CK was presented in the maintenance period. In 2K1C rats, attenuated ACE2 seems to contribute to initiating hypertension while upregulated ACE in combination with unsuppressed AT1R may have a key role in maintaining hypertension.

  16. Inhibition of retrograde transport protects mice from lethal ricin challenge.

    PubMed

    Stechmann, Bahne; Bai, Siau-Kun; Gobbo, Emilie; Lopez, Roman; Merer, Goulven; Pinchard, Suzy; Panigai, Laetitia; Tenza, Danièle; Raposo, Graça; Beaumelle, Bruno; Sauvaire, Didier; Gillet, Daniel; Johannes, Ludger; Barbier, Julien

    2010-04-16

    Bacterial Shiga-like toxins are virulence factors that constitute a significant public health threat worldwide, and the plant toxin ricin is a potential bioterror weapon. To gain access to their cytosolic target, ribosomal RNA, these toxins follow the retrograde transport route from the plasma membrane to the endoplasmic reticulum, via endosomes and the Golgi apparatus. Here, we used high-throughput screening to identify small molecule inhibitors that protect cells from ricin and Shiga-like toxins. We identified two compounds that selectively block retrograde toxin trafficking at the early endosome-TGN interface, without affecting compartment morphology, endogenous retrograde cargos, or other trafficking steps, demonstrating an unexpected degree of selectivity and lack of toxicity. In mice, one compound clearly protects from lethal nasal exposure to ricin. Our work discovers the first small molecule that shows efficacy against ricin in animal experiments and identifies the retrograde route as a potential therapeutic target.

  17. Plant Intracellular Transport: Tracing Functions of the Retrograde Kinesin.

    PubMed

    Müller, Sabine

    2015-09-21

    Adding to its varied repertoire of functions in cell morphogenesis and cell division, a molecular motor protein of the kinesin-14 class has recently been implicated in rapid retrograde transport along cellular tracks in moss.

  18. Difficult retrograde endotracheal intubation: the utility of a pharyngeal loop.

    PubMed

    Arya, Virendra K; Dutta, Amitabh; Chari, Pramila; Sharma, Ramesh K

    2002-02-01

    Direct laryngoscopy and tracheal intubation remains the technique of choice to achieve control of the airway. Alternative or additional techniques of airway control are required whenever an airway is deemed difficult because of anatomical and/or technical reasons. The retrograde intubation technique is an important option for gaining airway access from below the vocal cords in such situations (1). We report successful management and the problems encountered while gaining the upper airway by the retrograde catheter method in a patient having bilateral fibrous ankylosis of the temporomandibular joint (TMJ). A 30-yr-old woman presented for redo-release of bilateral temporomandibular joint ankylosis under general anesthesia. During the previous anesthetic for primary release of ankylosis, tracheostomy was done, as conventional blind nasotracheal and retrograde intubation attempts failed several times. This case report describes the method for overcoming the difficulties of a retrograde intubation procedure in removing the guiding catheter nasally by using a pharyngeal loop assembly.

  19. Prostatic urethra malformation associated with retrograde ejaculation: a case report.

    PubMed

    Zhao, Kai; Zhang, Jianzhong; Xu, Aiming; Zhang, Cheng; Wang, Zengjun

    2016-12-21

    Retrograde ejaculation can have anatomical, neurogenic, or pharmacological causes. Among these factors, malformation of the prostatic urethra is an uncommon cause. We describe a 29-year-old Han Chinese man with absence of his verumontanum combined with ejaculatory duct cysts, and no other cause for ejaculatory dysfunction. His verumontanum was replaced by a deep groove adjacent to his bladder neck, which could significantly influence bladder neck contraction. In addition, the large cysts in the ejaculatory duct could obstruct the anterior outlet of his prostatic urethra and prevent seminal fluid flow in an anterograde direction. There are few reports of retrograde ejaculation associated with congenital malformations of the posterior urethra. Malformations associated with bladder neck laxity and increased tone of the prostatic urethral outlet can contribute to retrograde ejaculation. Malformation of the prostatic urethra is an uncommon cause of retrograde ejaculation, and can be difficult to treat.

  20. Fundamental studies of retrograde reactions in direct liquefaction

    SciTech Connect

    Serio, M.A.; Solomon, P.R.; Bassilakis, R.; Kroo, E.

    1989-01-01

    Most of the proposed processing schemes for improving liquefaction yields involve favoring bond-breaking and radical stabilization reactions over the retrograde reactions. The retrograde reactions are often encountered before liquefaction temperatures are reached. The objective of this program is to elucidate and model the retrograde reaction chemistry in direct coal liquefaction through the application of experimental techniques and theoretical models which have been successfully employed at Advanced Fuel Research (AFR) and SRI International (a subcontractor) to understand and predict coal reaction behavior. The study of retrograde reactions is being done using an integrated approach using extensive characterization of the liquefaction chemistry of three kinds of systems: (1) model polymers; (2) coal; and (3) modified coals.

  1. The 'SAFARI' Technique Using Retrograde Access Via Peroneal Artery Access

    SciTech Connect

    Zhuang, Kun Da; Tan, Seck Guan; Tay, Kiang Hiong

    2012-08-15

    The 'SAFARI' technique or subintimal arterial flossing with antegrade-retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal artery has not been described and has a risk of continued bleeding, leading to compartment syndrome due to its deep location. We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially give more options for endovascular interventions in lower limb CTOs.

  2. A reappraisal of retrograde cerebral perfusion

    PubMed Central

    2013-01-01

    Brain protection during aortic arch surgery by perfusing cold oxygenated blood into the superior vena cava was first reported by Lemole et al. In 1990 Ueda and associates first described the routine use of continuous retrograde cerebral perfusion (RCP) in thoracic aortic surgery for the purpose of cerebral protection during the interval of obligatory interruption of anterograde cerebral flow. The beneficial effects of RCP may be its ability to sustain brain hypothermia during hypothermic circulatory arrest (HCA) and removal of embolic material from the arterial circulation of the brain. RCP can offer effective brain protection during HCA for about 40 to 60 minutes. Animal experiments revealed that RCP provided inadequate cerebral perfusion and that neurological recovery was improved with selective antegrade cerebral perfusion (ACP), however, both RCP and ACP provide comparable clinical outcomes regarding both the mortality and stroke rates by risk-adjusted and case-matched comparative study. RCP still remains a valuable adjunct for brain protection during aortic arch repair in particular pathologies and patients. PMID:23977600

  3. San Andreas Fault tremor and retrograde metamorphism

    NASA Astrophysics Data System (ADS)

    Fagereng, Åke; Diener, Johann F. A.

    2011-12-01

    Tectonic tremor is an enigmatic low-frequency seismic phenomenon mainly observed in subduction zones, but also documented along the deep extension of the central San Andreas Fault. The physical mechanisms behind this unusual seismic event are not yet determined for any tectonic setting; however, low effective stress conditions arising from metamorphic fluid production are commonly inferred for subduction-related tremor. We investigate the petrologic conditions at which the San Andreas tectonic tremor is inferred to occur through calculations of the pressure - temperature - time evolution of stable mineral assemblages and their water content in the dominant lithologies of the Franciscan Complex. We find that tremor locations around Parkfield and Cholame are currently experiencing retrograde metamorphic conditions. Within the temperature-depth conditions of observed tremor activity, at approximately 500°C and 20 km depth, several mineralogical transitions may occur in cooling greywacke and mafic rocks, leading to localised, significant removal of free water and an associated volume decrease. This indicates that, contrary to subduction-related tremor, tremor on the San Andreas Fault is not linked to prograde, crustal metamorphic fluid production within the fault zone; rather it might be related to mantle-derived fluids from below the tremor zone, and/or fault zone weakening that occurs as phyllosilicates replace more competent and granular mineral phases.

  4. Complications of internal jugular vein retrograde catheterization.

    PubMed

    Gemma, M; Beretta, L; De Vitis, A; Mattioli, C; Calvi, M R; Antonino, A; Rizzi, B; Crippa, L; D'Angelo, A

    1998-01-01

    We report on the incidence of complications of 172 internal jugular vein retrograde catheterizations (IJVRCs) performed on 126 patients. Standard cannulation and X-ray control of the catheter tip placement were performed. Difficulties encountered during the manouvre were registered. Patients with a jugular catheter in place for more than one day had neck echography on catheter removal and one week later. Carotid artery puncture occurred in 20 (12%) cases and lymphatic vessel puncture in one. In 13 (8%) cases IJVRC failed due to difficulties in advancing the guide. X-ray films documented catheter misplacement in 39 (23%) cases: loop into the internal jugular vein in 11 (6%); paravertebral venous plexus cannulated in one; other extracranial jugular afferent cannulated in 4 (2%); catheter tip into the jugular lumen in 10 (6%); catheter tip beyond the jugular bulb in 13 (8%). First neck echography documented: one perivascular hematoma (absent one week later); 3 (4%) jugular vein thrombosis (2 asymptomatic and absent one week later; one symptomatic and still evident one week later). Positive neck echography was not associated with difficulties, length of catheterization, diameter of the catheter. IJVRC is a simple and safe procedure with a low incidence of serious complications.

  5. Distant retrograde orbits and the asteroid hazard

    NASA Astrophysics Data System (ADS)

    Perozzi, Ettore; Ceccaroni, Marta; Valsecchi, Giovanni B.; Rossi, Alessandro

    2017-08-01

    Distant Retrograde Orbits (DROs) gained a novel wave of fame in space mission design because of their numerous advantages within the framework of the US plans for bringing a large asteroid sample in the vicinity of the Earth as the next target for human exploration. DROs are stable solutions of the three-body problem that can be used whenever an object, whether of natural or artificial nature, is required to remain in the neighborhood of a celestial body without being gravitationally captured by it. As such, they represent an alternative option to Halo orbits around the collinear Lagrangian points L1 and L2. Also known under other names ( e.g., quasi-satellite orbits, cis-lunar orbits, family- f orbits) these orbital configurations found interesting applications in several mission profiles, like that of a spacecraft orbiting around the small irregularly shaped satellite of Mars Phobos or the large Jovian moon Europa. In this paper a basic explanation of the DRO dynamics is presented in order to clarify some geometrical properties that characterize them. Their accessibility is then discussed from the point of view of mission analysis under different assumptions. Finally, their relevance within the framework of the present asteroid hazard protection programs is shown, stressing the significant increase in warning time they would provide in the prediction of impactors coming from the direction of the Sun.

  6. Retrograde Melting and Internal Liquid Gettering in Silicon

    SciTech Connect

    Hudelson, Steve; Newman, Bonna K.; Bernardis, Sarah; Fenning, David P.; Bertoni, Mariana I.; Marcus, Matthew A.; Fakra, Sirine C.; Lai, Barry; Buonassisi, Tonio

    2011-07-01

    Retrograde melting (melting upon cooling) is observed in silicon doped with 3d transition metals, via synchrotron-based temperature-dependent X-ray microprobe measurements. Liquid metal-silicon droplets formed via retrograde melting act as efficient sinks for metal impurities dissolved within the silicon matrix. Cooling results in decomposition of the homogeneous liquid phase into solid multiple-metal alloy precipitates. These phenomena represent a novel pathway for engineering impurities in semiconductor-based systems.

  7. Pleuropancreatic fistula: endoscopic retrograde cholangiopancreatography and computed tomography

    SciTech Connect

    McCarthy, S.; Pellegrini, C.A.; Moss, A.A.; Way, L.W.

    1984-06-01

    The complementary use of endoscopic retrograde cholangiopancreatography and computed tomography in the diagnosis and management of pleuropancreatic fistulas is described in relation to four cases in which computed tomography revealedthe thoracic extension of a pancreatic fistula not demonstrable by endoscopic retrograde cholangiopancreatography, although the latter indicated an abnormal pancreatic duct. The complementary use of both techniques may be necessary to define the pathologic anatomy so that the appropriate therapy, particularly the surgical approach, can be decided.

  8. An unusual cause of retrograde ejaculation and hypertension.

    PubMed

    Widjaja, A; Truss, M C; Rademaker, J; Stief, C B; von zur Mühlen, A

    2000-06-01

    A 39-year-old man presented with a 1-year history of retrograde ejaculation and a 10-year history of drug-resistant hypertension. Diagnostic abdominal ultrasound revealed an open bladder neck during the filling phase and a retroperitoneal tumor. After surgical excision histology revealed an extra-adrenal pheochromocytoma, which should be included in the differential diagnosis of patients presenting with retrograde ejaculation and hypertension.

  9. The inherent catastrophic traps in retrograde CTO PCI.

    PubMed

    Wu, Eugene B; Tsuchikane, Etsuo

    2017-05-04

    When we learn to drive, our driving instructor tells us how to check the side mirror and turn your head to check the blind spot before changing lanes. He tells us how to stop at stop signs, how to drive in slippery conditions, the safe stopping distances, and these all make our driving safe. Similarly, when we learn PCI, our mentors teach us to seat the guiding catheter co-axially, to wire the vessel safely, to deliver balloon and stents over the wire, to watch the pressure of the guiding, in order that we perform PCI safely and evade complications. In retrograde CTO PCI, there is no such published teaching. Also many individual mentors have not had the wide experience to see all the possible complications of retrograde CTO PCI and, therefore, may not be able to warn their apprentice. As the number of retrograde procedures increase worldwide, there is a corresponding increase in catastrophic complications, many of which, we as experts, can see are easily avoidable. To breach this gap in knowledge, this article describes 12 commonly met inherent traps in retrograde CTO PCI. They are inherent because by arranging our equipment in the manner to perform retrograde CTO PCI, these complications are either induced directly or happen easily. We hope this work will enhance safety of retrograde CTO PCI and avoid many catastrophic complications for our readers and operators. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  10. Increased sinusoidal volume and solute extraction during retrograde liver perfusion

    SciTech Connect

    Bass, N.M.; Manning, J.A.; Weisiger, R.A.

    1989-06-01

    Retrograde isolated liver perfusion has been used to probe acinar functional heterogeneity, but the hemodynamic effects of backward flow have not been characterized. In this study, extraction of a long-chain fatty acid derivative, 12-N-methyl-7-nitrobenzo-2-oxa-1,3-diazol-amino stearate (12-NBDS), was greater during retrograde than during anterograde perfusion of isolated rat liver. To determine whether hemodynamic differences between anterograde and retrograde perfused livers could account for this finding, the hepatic extracellular space was measured for both directions of flow by means of (/sup 14/C)sucrose washout during perfusion as well as by direct measurement of (/sup 14/C)sucrose entrapped during perfusion. A three- to fourfold enlargement of the total hepatic extracellular space was found during retrograde perfusion by both approaches. Examination of perfusion-fixed livers by light microscopy and morphometry revealed that marked distension of the sinusoids occurred during retrograde perfusion and that this accounts for the observed increase in the (/sup 14/C)sucrose space. These findings support the hypothesis that maximum resistance to perfusate flow in the isolated perfused rat liver is located at the presinusoidal level. In addition, increased transit time of perfusate through the liver and greater sinusoidal surface area resulting from sinusoidal distension may account for the higher extraction of 12-NBDS and possibly other compounds by retrograde perfused liver.

  11. Efficacy of treatment with pseudoephedrine in men with retrograde ejaculation.

    PubMed

    Shoshany, O; Abhyankar, N; Elyaguov, J; Niederberger, C

    2017-07-01

    The use of pseudoephedrine, an alpha agonist, for the treatment of retrograde ejaculation is well-known, however, there is no clear consensus from the literature regarding its efficacy and treatment protocol. We evaluated the efficacy of pseudoephedrine treatment in patients with retrograde ejaculation, utilizing a yet undescribed short-period treatment protocol. Twenty men were medically treated with pseudoephedrine for retrograde ejaculation between January 2010 and May 2016 (12 with complete retrograde ejaculation and 8 with partial retrograde ejaculation). All patients had a semen analysis and post-ejaculatory urinalysis before and after treatment. The treatment protocol consisted of 60 mg of pseudoephedrine every 6 h on the day before semen analysis and two more 60 mg doses on the day of the semen analysis. Diabetes was the most common etiology for complete retrograde ejaculation (60%), whereas an idiopathic cause was the most common etiology for partial retrograde ejaculation (82%). Of the 12 complete retrograde ejaculation patients treated with pseudoephedrine prior to semen analysis, 7 (58.3%) recovered spermatozoa in the antegrade ejaculate, with a mean total sperm count of 273.5 ± 172.5 million. Of the eight patients with partial retrograde ejaculation, five (62.5%) had a ≥50% increase in the antegrade total sperm count. In this group, the mean total sperm count increased from 26.9 ± 8.5 million before treatment to 84.2 ± 24.6 million after treatment, whereas the percentage of spermatozoa in the urine declined from 43.2 ± 9% to 17 ± 10%, respectively (both p < 0.05). Overall, in men with retrograde ejaculation treated with a pseudoephedrine regimen prior to ejaculation, some improvement in seminal parameters occurred in 14 (70%) patients, with 10 patients (38.5% of all patients) achieving antegrade total sperm counts over 39 million. © 2017 American Society of Andrology and European Academy of Andrology.

  12. Retrograde ejaculation after anterior lumbar spine surgery.

    PubMed

    Lindley, Emily M; McBeth, Zachary L; Henry, Sarah E; Cooley, Robert; Burger, Evalina L; Cain, Christopher M J; Patel, Vikas V

    2012-09-15

    A retrospective cohort study. To compare the incidence of retrograde ejaculation (RE) after anterior lumbar spine surgery with disc replacement versus fusion with the use of recombinant human bone morphogenetic protein-2 (BMP). Anterior lumbar interbody fusion (ALIF) has become a popular choice for treating a number of pathologies, largely because it preserves the posterior paravertebral muscles and ligaments. Despite these advantages, the anterior approach is also associated with various complications, one of which is RE. A recent study has questioned whether the risk of RE is increased by the use of BMP in ALIF procedures rather than by the approach alone. We conducted a retrospective review of all male patients who received ALIF using BMP or artificial disc replacement (ADR) on at least the L5-S1 level between 2004 and 2011. Medical records were evaluated for the occurrence of RE, and patients were contacted via the phone to obtain current information. The incidence of RE was then compared between the 2 anterior lumbar surgery procedures. Of the 95 cases of anterior surgery including L5-S1, 54 patients underwent ALIF with BMP (56.8%) and 41 patients were treated with ADR (43.2%). Postoperative RE occurred in 4 of the 54 ALIF patients (7.4%) and in 4 of the 41 ADR patients (9.8%). The incidence of RE was not significantly different between groups (P = 0.7226). At latest follow-up, 1 ALIF and 1 ADR patient reported resolution of the RE. This study found that RE occurred at a similar rate in patients treated with ADR and ALIF with BMP. The overall rate of RE after retroperitoneal anterior lumbar surgery was higher than expected, which underscores the importance of counseling patients about this risk and specifically questioning patients about the symptoms of RE at postoperative visits.

  13. Intrarenal CYP-450 metabolites of arachidonic acid in the regulation of the nonclipped kidney function in two-kidney, one-clip Goldblatt hypertensive rats

    PubMed Central

    Walkowska, Agnieszka; Thumová, Monika; Škaroupková, Petra; Husková, Zuzana; Vaňourková, Zdenka; Chábová, Věra Čertíková; Tesař, Vladimír; Kramer, Herbert J.; Falck, John R.; Imig, John D.; Kompanowska-Jezierska, Elzbieta; Sadowski, Janusz; Červenka, Luděk

    2010-01-01

    Objective The contribution of cytochrome P-450 (CYP) metabolites of arachidonic acid: epoxyeicosatrienoic acids (EETs) and 20-hydroxyeicosatetraenoic acid (20-HETE) in the regulation of nonclipped kidney function in two-kidney, one-clip (2K1C) Goldblatt hypertensive rats during the phases of initial and stable hypertension (7 or 27 days after clipping, respectively) were investigated. Methods Male Hannover-Sprague Dawley rats had the right renal artery clipped or had a sham-operation. Urinary excretion of EETs, their inactive metabolites (DHETEs), and 20-HETE were measured. Intrarenal CYP protein expression and the activities of epoxygenase, ω-hydroxylase and soluble epoxide hydrolase (sEH) were also determined. The responses of renal hemodynamics and electrolyte excretion of the non-clipped kidney to left renal artery infusions of inhibitors of EETs or 20-HETE formation (MS-PPOH and DDMS, respectively) were measured. Results In 2K1C rats the urinary EETs excretion was lower and 20-HETE excretion was higher than in sham-operated animals. Intrarenal inhibition of EETs significantly decreased renal hemodynamics and sodium excretion in sham-operated but not in 2K1C rats. Intrarenal inhibition of 20-HETE decreased sodium excretion in sham-operated rats but elicited increases in renal hemodynamics and sodium excretion in 2K1C rats. Conclusions The results indicate that the nonclipped kidney of Goldblatt 2K1C rats in the phase of sustained hypertension exhibits decreased intrarenal EETs and elevated 20-HETE levels as compared with the kidney of sham-operated animals. This suggests that altered production and action of CYP-derived metabolites in this phase contributes to the mechanism of Goldblatt 2K1C hypertension. PMID:19940786

  14. Interferon-γ Plays Protective Roles in Sodium Arsenite-Induced Renal Injury by Up-Regulating Intrarenal Multidrug Resistance-Associated Protein 1 Expression

    PubMed Central

    Kimura, Akihiko; Ishida, Yuko; Hayashi, Takahito; Wada, Takashi; Yokoyama, Hitoshi; Sugaya, Takeshi; Mukaida, Naofumi; Kondo, Toshikazu

    2006-01-01

    Subcutaneous injection of sodium arsenite (NaAs, 12.5 mg/kg) into BALB/c [wild-type (WT)] mice causes acute renal dysfunction characterized by severe hemorrhages, acute tubular necrosis, and cast formation, with increases in serum blood urea nitrogen and creatinine levels. Concomitant enhancement in intrarenal interferon (IFN)-γ expression prompted us to examine its roles in this pathology. IFN-γ-deficient (IFN-γ−/−) mice exhibited higher serum blood urea nitrogen and creatinine levels and exaggerated histopathological changes, compared with WT mice. Eventually, IFN-γ−/− mice exhibited a high mortality (87.5%) within 24 hours after NaAs challenge, whereas most WT mice survived. The intrarenal arsenic concentration was significantly higher in IFN-γ−/− mice later than 10 hours after NaAs treatment, with attenuated intrarenal expression of multidrug resistance-associated protein (MRP) 1, a main transporter for NaAs efflux, compared with WT mice. NF-E2-related factor (Nrf) 2 protein, a transcription factor crucial for MRP1 gene expression, was similarly increased in the kidneys of both strains of mice after NaAs treatment. In contrast, the absence of IFN-γ augmented transforming growth factor-β-Smad3 signal pathway and eventually enhanced the expression of activating transcription factor 3, which is presumed to repress Nrf2-mediated MRP1 gene expression. Thus, IFN-γ can protect against NaAs-induced acute renal injury, probably by maintaining Nrf2-mediated intrarenal MRP1 gene expression. PMID:17003472

  15. Tips and tricks of double-balloon endoscopic retrograde cholangiopancreatography (with video).

    PubMed

    Hatanaka, Hisashi; Yano, Tomonori; Tamada, Kiichi

    2015-06-01

    Although endoscopic retrograde cholangiopancreatography (ERCP) is technically difficult in patients with altered gastrointestinal tract, double-balloon endoscopy (DBE) allows endoscopic access to pancreato-biliary system in such patients. Balloon dilation of biliary stricture and extraction of bile duct stones, placement of biliary stent in patients with Roux-en-Y or Billroth-II reconstruction, using DBE have been reported. However, two major technical parts are required for double-balloon ERCP (DB-ERCP). One is insertion of DBE and the other is an ERCP-related procedure. The important point of DBE insertion is a sure approach to the afferent limb with Roux-en-Y reconstruction or Braun anastomosis. Short type DBE with working length 152 cm is beneficial for DB-ERCP because it is short enough for most biliary accessory devices. In this paper, we introduce our tips and tricks for successful DB-ERCP. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  16. Axoplasmic importins enable retrograde injury signaling in lesioned nerve.

    PubMed

    Hanz, Shlomit; Perlson, Eran; Willis, Dianna; Zheng, Jun-Qi; Massarwa, R'ada; Huerta, Juan J; Koltzenburg, Martin; Kohler, Matthias; van-Minnen, Jan; Twiss, Jeffery L; Fainzilber, Mike

    2003-12-18

    Axoplasmic proteins containing nuclear localization signals (NLS) signal retrogradely by an unknown mechanism in injured nerve. Here we demonstrate that the importin/karyopherin alpha and beta families underlie this process. We show that importins are found in axons at significant distances from the cell body and that importin beta protein is increased after nerve lesion by local translation of axonal mRNA. This leads to formation of a high-affinity NLS binding complex that traffics retrogradely with the motor protein dynein. Trituration of synthetic NLS peptide at the injury site of axotomized dorsal root ganglion (DRG) neurons delays their regenerative outgrowth, and NLS introduction to sciatic nerve concomitantly with a crush injury suppresses the conditioning lesion induced transition from arborizing to elongating growth in L4/L5 DRG neurons. These data suggest a model whereby lesion-induced upregulation of axonal importin beta may enable retrograde transport of signals that modulate the regeneration of injured neurons.

  17. Yarkovsky effect in the motion of asteroids in retrograde orbits

    NASA Astrophysics Data System (ADS)

    Kankiewicz, Paweł; Włodarczyk, Ireneusz

    2016-06-01

    Since the last few years, many small bodies in retrograde orbits was discovered, classified as asteroids. %Most of these orbits are located in peripherals of the Solar System. Main aim of our work is the analysis of their dynamical past and future. For 56 asteroids in retrograde orbits (i > 90) we studied the orbital evolution and calculated median dynamical lifetimes. Due to important role of the Yarkovsky effect in the motion of small bodies, we decided to apply the model with the Yarkovsky forces. Because the physical properties of these objects are still not well determined, we collected thermal parameters from literature or calculated from available formulas. The complete set of 'thermal' properties of each body is still not available from observational data, so our approach is a kind of approximation. Results obtained with these parameters allowed us to estimate the influence of the Yarkovsky effect on the stability of retrograde orbits.

  18. Retrograde resonance in the planar three-body problem

    NASA Astrophysics Data System (ADS)

    Morais, M. H. M.; Namouni, F.

    2013-12-01

    We continue the investigation of the dynamics of retrograde resonances initiated in Morais and Giuppone (Mon Notices R Astron Soc 424:52-64, doi:10.1111/j.1365-2966.2012.21151.x, 2012). After deriving a procedure to deduce the retrograde resonance terms from the standard expansion of the three-dimensional disturbing function, we concentrate on the planar problem and construct surfaces of section that explore phase-space in the vicinity of the main retrograde resonances (2/1, 1/1 and 1/2). In the case of the 1/1 resonance for which the standard expansion is not adequate to describe the dynamics, we develop a semi-analytic model based on numerical averaging of the unexpanded disturbing function, and show that the predicted libration modes are in agreement with the behavior seen in the surfaces of section.

  19. Fundamental studies of retrograde reactions in direct liquefaction

    SciTech Connect

    Serio, M.A.; Solomon, P.R.; Kroo, E.; Charpenay, S.; Bassilakis, R.

    1991-12-17

    The overall objective of the program was to improve the understanding of retrograde reactions and their dependencies on coal rank and structure, and/or coal modifications and reaction conditions. Because retrograde reactions are competitive with bond breaking reactions, an understanding of both is required to shift the competition in favor of the latter. Related objectives were to clarify the conflicting observations reported in literature on such major topics as the role of oxygen groups in retrograde reactions and to provide a bridge from very fundamental studies on pure compounds to phenomenological studies on actual coal. This information was integrated into the FG-DVC model, which was improved and extended to the liquefaction context.

  20. Association between the intrarenal renin-angiotensin system and renal injury in chronic kidney disease of dogs and cats.

    PubMed

    Mitani, Sawane; Yabuki, Akira; Taniguchi, Kazuyuki; Yamato, Osamu

    2013-02-01

    The association of renin and angiotensin II, which are potent components of the renin-angiotensin system, with the severity of chronic renal disease was investigated immunohistochemically in dogs and cats. Immunoreactivities of renin and angiotensin II were evaluated quantitatively, and their correlations with the degrees of glomerulosclerosis, glomerular hypertrophy, interstitial cell infiltration and interstitial fibrosis were statistically analyzed. Immunoreactivities for renin were detected in afferent arteries in both dogs and cats. The score of renin-positive signals showed no correlation with plasma creatinine concentration or any of the histopathological parameters, except for the diameter of glomeruli in dogs. Immunoreactivities for angiotensin II were detected in tubules (primarily proximal tubules) and interstitial mononuclear cells in both dogs and cats. The score of tubular angiotensin II correlated with glomerulosclerosis and cell infiltration in cats but not in dogs. The score of interstitial angiotensin II correlated with plasma creatinine concentration, glomerulosclerosis, cell infiltration and fibrosis in dogs and with glomerulosclerosis and cell infiltration in cats. In conclusion, the results of the study suggest that intrarenal renin-angiotensin system is correlated with the severity of kidney disease, with the underlying mechanism differing between dogs and cats.

  1. THE INTRARENAL DISTRIBUTION OF TRITIATED PARA-AMINOHIPPURIC ACID DETERMINED BY A MODIFIED TECHNIQUE OF SECTION FREEZE-DRY RADIOAUTOGRAPHY

    PubMed Central

    Bordier, Betrand; Ornstein, Leonard; Wedeen, Richard P.

    1970-01-01

    Section freeze-dry radioautography has been used to examine the intrarenal distribution of a water-soluble organic acid (para-aminohippuric acid (PAH-3H)) under constant-infusion, steady-state conditions in mouse and rat kidney in vivo. The technique described here has the following advantages: (a) Sectioning and freeze-drying are accomplished in a closed cryostat at temperatures below -40°C; (b) Handling of the section is facilitated by mounting of the section-to-be on adhesive-coated Saran Wrap prior to cutting; (c) Unembedded freeze-dried sections are attached to photographic film at ambient temperature in the dark room; (d) Fixation follows completion of radioautographic exposure and precedes photographic development; (e) Permanent close contact is maintained between tissue and film. Morphologic preservation compared favorably with that obtained by optimal fixation techniques, which, however, permit diffusion. Cellular accumulation of PAH-3H during secretion was demonstrated in the proximal tubule under steady-state conditions in vivo. The cellular concentration of PAH-3H was uniform throughout the length of the proximal tubule in mouse and rat kidney. PMID:4349130

  2. Renal systolic time intervals derived from intra-renal artery Doppler as a novel predictor of adverse cardiac outcomes

    PubMed Central

    Lee, Wen-Hsien; Hsu, Po-Chao; Chu, Chun-Yuan; Chen, Szu-Chia; Lee, Hung-Hao; Lee, Meng-Kuang; Lee, Chee-Siong; Yen, Hsueh-Wei; Lin, Tsung-Hsien; Voon, Wen-Chol; Lai, Wen-Ter; Sheu, Sheng-Hsiung; Kuo, Po-Lin; Su, Ho-Ming

    2017-01-01

    The aim of this study was to evaluate the use of renal systolic time intervals measured by electrocardiographic gated Doppler ultrasonography for predicting adverse cardiac events. This longitudinal observation study enrolled 205 patients. Renal systolic time intervals, including pre-ejection period (PEP) and ejection time (ET), and ratio of renal PEP to ET, were measured by electrocardiographic gated Doppler ultrasound. The 14 adverse cardiac events identified in this population included 9 cardiac deaths and 5 hospitalizations for heart failure during an average follow up of 30.9 months (25th–75th percentile: 30–33 months). Renal PEP (hazard ratio = 1.023, P = 0.001), renal ET (hazard ratio = 0.975, P = 0.001) and renal PEP/ET (per 0.01 unit increase, hazard ratio = 1.060, P < 0.001) were associated with poor cardiac outcomes. The addition of renal PEP/ET to a Cox model containing important clinical variables and renal resistive index further improved the value in predicting adverse cardiac events (Chi-square increase, 9.996; P = 0.002). This study showed that parameters of intra-renal hemodynamics were potential predictors of adverse cardiac outcomes. However, the generalizability of these indicators need to be investigated in future large-scale studies. PMID:28266644

  3. The adipose renin-angiotensin system modulates sysemic markers of insulin sensitivity activates the intrarenal renin-angiotensin system

    SciTech Connect

    Kim, Suyeon; Soltani-Bejnood, Morvarid; Quignard-Boulange, Annie; Massiera, Florence; Teboul, Michele; Ailhaud, Gerard; Kim, Jung; Moustaid-Moussa, Naima; Voy, Brynn H

    2006-07-01

    BACKGROUND: A growing body of data provides increasing evidence that the adipose tissue renin-angiotensin system (RAS) contributes to regulation of fat mass. Beyond its paracrine actions within adipose tissue, adipocyte-derived angiotensin II (Ang II) may also impact systemic functions such as blood pressure and metabolism. METHODS AND RESULTS: We used a genetic approach to manipulate adipose RAS activity in mice and then study the consequences on metabolic parameters and on feedback regulation of the RAS. The models included deletion of the angiotensinogen (Agt) gene (Agt-KO), its expression solely in adipose tissue under the control of an adipocyte-specific promoter (aP2-Agt/ Agt-KO), and overexpression in adipose tissue of wild type mice (aP2-Agt). Total body weight, epididymal fat pad weight, and circulating levels of leptin, insulin and resistin were significantly decreased in Agt-KO mice, while plasma adiponectin levels were increased. Overexpression of Agt in adipose tissue resulted in increased adiposity and plasma leptin and insulin levels compared to wild type (WT) controls. Angiotensinogen and type I Ang II receptor protein levels were also markedly elevated in kidney of aP2-Agt mice, suggesting that hypertension in these animals may be in part due to stimulation of the intrarenal RAS. CONCLUSIONS: Taken together, the results from this study demonstrate that alterations in adipose RAS activity significantly alter both local and systemic physiology in a way that may contribute to the detrimental health effects of obesity.

  4. Dynein is the motor for retrograde axonal transport of organelles

    SciTech Connect

    Schnapp, B.J.; Reese, T.S.

    1989-03-01

    Vesicular organelles in axons of nerve cells are transported along microtubules either toward their plus ends (fast anterograde transport) or toward their minus ends (retrograde transport). Two microtubule-based motors were previously identified by examining plastic beads induced to move along microtubules by cytosol fractions from the squid giant axon: (i) an anterograde motor, kinesin, and (ii) a retrograde motor, which is characterized here. The retrograde motor, a cytosolic protein previously termed HMW1, was purified from optic lobes and extruded axoplasm by nucleotide-dependent microtubule affinity and release; microtubule gliding was used as the assay of motor activity. The following properties of the retrograde motor suggest that it is cytoplasmic dynein: (i) sedimentation at 20-22 S with a heavy chain of Mr greater than 200,000 that coelectrophoreses with the alpha and beta subunits of axonemal dynein, (ii) cleavage by UV irradiation in the presence of ATP and vanadate, and (iii) a molecular structure resembling two-headed dynein from axonemes. Furthermore, bead movement toward the minus end of microtubules was blocked when axoplasmic supernatants were treated with UV/vanadate. Treatment of axoplasmic supernatant with UV/vanadate also blocks the retrograde movement of purified organelles in vitro without changing the number of anterograde moving organelles, indicating that dynein interacts specifically with a subgroup of organelles programmed to move toward the cell body. However, purified optic lobe dynein, like purified kinesin, does not by itself promote the movement of purified organelles along microtubules, suggesting that additional axoplasmic factors are necessary for retrograde as well as anterograde transport.

  5. Retrograde tibial nail: anatomical implantation and surgical feasibility study.

    PubMed

    Kuhn, S; Appelmann, P; Pairon, P; Gruszka, D; Rommens, P M

    2015-01-01

    PURPOSE OF THE STUDY The treatment of distal tibial fractures requires a stable fixation while minimizing the secondary trauma to the soft tissues by the surgical approach and implant. The experimental Retrograde Tibial Nail is currently investigated as a minimally invasive alternative to plating and antegrade nailing. The purpose of this study was to evaluate the surgical feasibility in a cadaver model for all distal tibial fracture types generally considered treatable by nailing. MATERIAL AND METHODS Five different fracture types (AO/OTA 43-A1/A2/A3 and 43-C1/C2) were created on separate cadaveric limbs. In simple fractures (AO/OTA 43-A1/A2/A3) primary nailing was performed. In intraarticular fractures (AO/OTA 43-C1/2) reduction of the articular block and lag screw fixation was performed before nailing. Intraoperative complications, quality of reduction, fluoroscopy duration and operative time were evaluated. RESULTS Retrograde intramedullary nailing is feasible in simple fracture types by closed manual reduction and percutaneous reduction forceps. Retrograde nailing is possible in fractures with simple intraarticular involvement after primary lag screw fixation. The duration of surgery averaged 51.8 minutes (range 40-62 min). No major complications occurred during nailing. CONCLUSIONS The minimally invasive retrograde nail combines a minimally invasive local osteosynthesis with the ability to adequately fix extraarticular and simple intraarticular distal tibial fractures. The results suggests that retrograde tibia nailing is a promising new concept for the treatment of distal tibia fractures. Key words: minimally invasive surgery, tibia, metaphyseal fractures, intramedullary nailing, retrograde nailing.

  6. Orbital Evolution and Impact Hazard of Asteroids on Retrograde Orbits

    NASA Astrophysics Data System (ADS)

    Kankiewicz, P.; Włodarczyk, I.

    2014-07-01

    We present the past evolutional scenarios of known group of asteroids in retrograde orbits. Applying the latest observational data, we determined their nominal and averaged orbital elements. Next, we studied the behaviour of their orbital motion 1~My in the past (100~My in the future for two NEAs) taking into account the limitations of observational errors. It has been shown that the influence of outer planets perturbations in many cases can import small bodies on high inclination or retrograde orbits into the inner Solar System.

  7. Physiology and pathology of endosome-to-Golgi retrograde sorting.

    PubMed

    Burd, Christopher G

    2011-08-01

    Bidirectional traffic between the Golgi apparatus and the endosomal system sustains the functions of the trans-Golgi network (TGN) in secretion and organelle biogenesis. Export of cargo from the TGN via anterograde trafficking pathways depletes the organelle of sorting receptors, processing proteases, SNARE molecules, and other factors, and these are subsequently retrieved from endosomes via the retrograde pathway. Recent studies indicate that retrograde trafficking is vital to early metazoan development, nutrient homeostasis, and for processes that protect against Alzheimer's and other neurological diseases.

  8. [Subcapsular hepatic hematoma: an uncommon complication of endoscopic retrograde cholangiopancreatography].

    PubMed

    Baudet, Juan-Salvador; Arguiñarena, Xabier; Redondo, Ignacio; Tadeo, Eva; Navazo, Lucía; Mendiz, Javier; Montiel, Raquel

    2011-02-01

    This report describes the case of a patient who developed a subcapsular hepatic hematoma 48 hours after endoscopic retrograde cholangiopancreatography. She was treated by embolizing the sites of bleeding and by surgically resecting the area. We review the literature and discuss the potential mechanisms that cause this complication.

  9. Light intensity-dependent retrograde signalling in higher plants.

    PubMed

    Szechyńska-Hebda, Magdalena; Karpiński, Stanisław

    2013-11-15

    Plants are able to acclimate to highly fluctuating light environment and evolved a short- and long-term light acclimatory responses, that are dependent on chloroplasts retrograde signalling. In this review we summarise recent evidences suggesting that the chloroplasts act as key sensors of light intensity changes in a wide range (low, high and excess light conditions) as well as sensors of darkness. They also participate in transduction and synchronisation of systemic retrograde signalling in response to differential light exposure of distinct leaves. Regulation of intra- and inter-cellular chloroplast retrograde signalling is dependent on the developmental and functional stage of the plastids. Therefore, it is discussed in following subsections: firstly, chloroplast biogenic control of nuclear genes, for example, signals related to photosystems and pigment biogenesis during early plastid development; secondly, signals in the mature chloroplast induced by changes in photosynthetic electron transport, reactive oxygen species, hormones and metabolite biosynthesis; thirdly, chloroplast signalling during leaf senescence. Moreover, with a help of meta-analysis of multiple microarray experiments, we showed that the expression of the same set of genes is regulated specifically in particular types of signals and types of light conditions. Furthermore, we also highlight the alternative scenarios of the chloroplast retrograde signals transduction and coordination linked to the role of photo-electrochemical signalling. Copyright © 2013 Elsevier GmbH. All rights reserved.

  10. Selected properties of acetylated adipate of retrograded starch.

    PubMed

    Zięba, T; Gryszkin, A; Kapelko, M

    2014-01-01

    Native potato starch (NS) and retrograded starch (R - obtained via freezing and defrosting of a starch paste) were used to prepare starch acetates: NS-A and R-A, and then acetylated distarch adipates: NS-ADA and R-ADA. The chemically-modified preparations produced from retrograded starch (R-A; R-ADA) were characterized by a higher degree of esterification compared to the modified preparations produced under the same conditions from native potato starch (NS-A; NS-ADA). Starch resistance to amylolysis was observed to increase (to 30-40 g/100 g) as a result of starch retrogradation and acetylation. Starch cross-linking had a significant impact on the increased viscosity of the paste in the entire course of pasting characteristics and on the increased values of rheological coefficients determined from the equations describing flow curves. The produced preparation of acetylated retrograded starch cross-linked with adipic acid (R-ADA) may be deemed an RS3/4 preparation to be used as a food thickening agent.

  11. Water dynamics and retrogradation of ultrahigh pressurized wheat starch.

    PubMed

    Doona, Christopher J; Feeherry, Florence E; Baik, Moo-Yeol

    2006-09-06

    The water dynamics and retrogradation kinetics behavior of gelatinized wheat starch by either ultrahigh pressure (UHP) processing or heat are investigated. Wheat starch completely gelatinized in the condition of 90, 000 psi at 25 degrees C for 30 min (pressurized gel) or 100 degrees C for 30 min (heated gel). The physical properties of the wheat starches were characterized in terms of proton relaxation times (T2 times) measured using time-domain nuclear magnetic resonance spectroscopy and evaluated using commercially available continuous distribution modeling software. Different T2 distributions in both micro- and millisecond ranges between pressurized and heated wheat starch gels suggest distinctively different water dynamics between pressurized and heated wheat starch gels. Smaller water self-diffusion coefficients were observed for pressurized wheat starch gels and are indicative of more restricted translational proton mobility than is observed with heated wheat starch gels. The physical characteristics associated with changes taking place during retrogradation were evaluated using melting curves obtained with differential scanning calorimetry. Less retrogradation was observed in pressurized wheat starch, and it may be related to a smaller quantity of freezable water in pressurized wheat starch. Starches comprise a major constituent of many foods proposed for commercial potential using UHP, and the present results furnish insight into the effect of UHP on starch gelatinization and the mechanism of retrogradation during storage.

  12. The management of retrograde ejaculation: a systematic review and update.

    PubMed

    Jefferys, Amanda; Siassakos, Dimitrios; Wardle, Peter

    2012-02-01

    To determine the best management of retrograde ejaculation to optimize the chance of conception. Systematic review. Tertiary reproductive medicine center. Subfertile men with retrograde ejaculation. Systematic search of studies using search terms "management" or "therapy" or "treatment" and "retrograde ejaculation." We excluded case reports and papers not in English. Pregnancy and live birth rates and rates of achievement of antegrade ejaculation. Thirty-four studies met our criteria. Studies were mostly observational. Descriptions of predictive and confounding variables were often insufficient. The treatment options included urinary sperm retrieval and medical management with anticholinergics and sympathomimetics. Successful pregnancies and live births were also achieved using surgical techniques and electroejaculation; however, numbers were small. Many treatment options exist in the management of retrograde ejaculation; however, current literature is insufficient to allow firm comparisons between interventions. Treatment should be tailored, therefore, to the individual. Our findings support the need for further research in this area-including large randomized controlled trials. However, these would be difficult logistically and may not be possible. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Chloroplast Retrograde Regulation of Heat Stress Responses in Plants

    PubMed Central

    Sun, Ai-Zhen; Guo, Fang-Qing

    2016-01-01

    It is well known that intracellular signaling from chloroplast to nucleus plays a vital role in stress responses to survive environmental perturbations. The chloroplasts were proposed as sensors to heat stress since components of the photosynthetic apparatus housed in the chloroplast are the major targets of thermal damage in plants. Thus, communicating subcellular perturbations to the nucleus is critical during exposure to extreme environmental conditions such as heat stress. By coordinating expression of stress specific nuclear genes essential for adaptive responses to hostile environment, plants optimize different cell functions and activate acclimation responses through retrograde signaling pathways. The efficient communication between plastids and the nucleus is highly required for such diverse metabolic and biosynthetic functions during adaptation processes to environmental stresses. In recent years, several putative retrograde signals released from plastids that regulate nuclear genes have been identified and signaling pathways have been proposed. In this review, we provide an update on retrograde signals derived from tetrapyrroles, carotenoids, reactive oxygen species (ROS) and organellar gene expression (OGE) in the context of heat stress responses and address their roles in retrograde regulation of heat-responsive gene expression, systemic acquired acclimation, and cellular coordination in plants. PMID:27066042

  14. Retrograde Oxygen Persufflation of Kidney - Experiment on an Animal.

    PubMed

    Moláček, Jiri; Opatrný, Václav; Matějka, Roman; Baxa, Jan; Třeška, Vladislav

    There is still a lack of organs for transplantation purposes. In the field of kidney and liver transplantation, one available solution is the use of organs from so-called marginal donors. These donors can be e.g. non-heart-beating donors. In these cases, perfusion and preservation of organs intended for transplantation is generally more difficult. Retrograde oxygen persufflation (ROP) may be a possible solution to this issue. This method is based on retrograde perfusion by oxygen through the renal vein thus reconditioning the organ. We operated on 10 animals (porcine models). Ischemic injury of the right kidney was simulated in all animals. In group A (N=5), kidneys were perfused with retrograde oxygen persufflation after explantation. In group B (N=5), kidneys were perfused intrarterially as in usual clinical practice. After perfusion all kidneys were transplanted to the original donor animal. Quality of graft restitution was evaluated by the urea level obtained from the renal vein and by histopathological analysis after explantation. We found no statistically significant differences between groups A and B in urea levels after transplantation, nor did we find any significant differences in quality of kidney parenchyma restoration between these groups. Retrograde oxygen persufflation is able to protect and restore kidney parenchyma. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  15. Analysis of retrograde ejaculation using color Doppler ultrasonography before and after transurethral collagen injection.

    PubMed

    Nagai, A; Nasu, Y; Watanabe, M; Tsugawa, M; Iguchi, H; Kumon, H

    2004-10-01

    Transurethral bladder neck collagen injection therapy was performed in a patient with retrograde ejaculation. The phenomenon of retrograde ejaculation and its correction after the therapy were clearly demonstrated by color Doppler ultrasonography. To our knowledge this is the first report showing successful observation of retrograde ejaculation using color Doppler ultrasonography.

  16. Retrograde fluids in granulites: Stable isotope evidence of fluid migration

    SciTech Connect

    Morrison, J. ); Valley, J.W. )

    1991-07-01

    Widespread retrograde alteration assemblages document the migration of mixed H{sub 2}O-CO{sub 2} fluids into granulite facies rocks in the Adirondack Mountains. Fluid migration is manifest by (1) veins and patchy intergrowths of chlorite {plus minus} sericite {plus minus} calcite, (2) small veins of calcite, many only identifiable by cathodoluminescence, and (3) high-density, CO{sub 2}-rich or mixed H{sub 2}O-CO{sub 2} fluid inclusions. The distinct and varied textural occurrences of the alteration minerals indicate that fluid-rock ratios were low and variable on a local scale. Stable isotope ratios of C, O, and S have been determined in retrograde minerals from samples of the Marcy anorthosite massif and adjacent granitic gneisses (charnockites). Retrograde calcite in the anorthosite has a relatively small range in both {delta}{sup 18}O{sub SMOW} and {delta}{sup 13}C{sub PDB} (8.6 to 14.9% and {minus}4.1 to 0.4%, respectively), probably indicating that the hydrothermal fluids that precipitated the calcite had exchanged with a variety of crustal lithologies including marbles and orthogneisses, and that calcite was precipitated over a relatively narrow temperature interval. Values of {delta}{sup 34}S{sub CDT} that range from 2.8 to 8.3% within the anorthosite can also be interpreted to reflect exchange between orthogneisses and metasediments. The recognition of retrograde fluid migration is particularly significant in granulite facies terranes because the controversy surrounding the origin of granulites arises in part from differing interpretations of fluid inclusion data, specifically, the timing of entrapment of high-density, CO{sub 2}-rich inclusions. Results indicate that retrograde fluid migration, which in some samples may leave only cryptic petrographic evidence, is a process capable of producing high-density, CO{sub 2}-rich fluid inclusions.

  17. Acute eprosartan-induced intrarenal vasodilation in hypertensive humans is not influenced by dietary sodium intake or angiotensin II co-infusion.

    PubMed

    van Twist, Daan J L; Houben, Alfons J H M; de Leeuw, Peter W; Kroon, Abraham A

    2016-08-01

    Angiotensin II (Ang II) is thought to play an important role in the development of hypertension. Nevertheless, knowledge on the angiotensin II type-1-receptors (AT1Rs) in the hypertensive kidney and the influence of sodium intake and renin-angiotensin system activity on intrarenal AT1R blockade is scarce. To improve our understanding of renal AT1Rs in hypertensive patients, we studied the effects of acute, local administration of AT1R-blocker eprosartan in kidneys of patients with essential hypertension (off medication). In 73 hypertensive patients who were scheduled for diagnostic renal angiography, we measured renal blood flow (Xenon washout method) before and during intrarenal infusion of two incremental doses of eprosartan (3 and 10 μg/kg/min for 15 min per dose). We hypothesized that the vasodilatory effects of eprosartan would be enhanced by low sodium intake and would be reduced during Ang II co-infusion. Therefore, we allocated the patients to either a high or a low sodium diet and coinfused Ang II (1 ng/kg/min) in a subgroup. Eprosartan infusion resulted in intrarenal vasodilation in all groups. No differences in the magnitude of this effect were found between the groups. No correlation was found between 24-h urinary sodium excretion (a proxy for dietary sodium intake) and the effect of eprosartan. Eprosartan-induced vasodilation is not influenced by sodium intake and/or co-infusion of Ang II. These rather unexpected findings could be explained by differences between circulating and tissue Ang II levels, variations in AT1R expression, and/or stimulation of other vasodilatory pathways.

  18. Dietary sodium intake modulates renal excretory responses to intrarenal angiotensin (1-7) administration in anesthetized rats.

    PubMed

    O'Neill, Julie; Corbett, Alan; Johns, Edward J

    2013-02-01

    Angiotensin II at the kidney regulates renal hemodynamic and excretory function, but the actions of an alternative metabolite, angiotensin (1-7), are less clear. This study investigated how manipulation of dietary sodium intake influenced the renal hemodynamic and excretory responses to intrarenal administration of angiotensin (1-7). Renal interstitial infusion of angiotensin (1-7) in anesthetized rats fed a normal salt intake had minimal effects on glomerular filtration rate but caused dose-related increases in urine flow and absolute and fractional sodium excretions ranging from 150 to 200%. In rats maintained for 2 wk on a low-sodium diet angiotensin (1-7) increased glomerular filtration rate by some 45%, but the diuretic and natriuretic responses were enhanced compared with those in rats on a normal sodium intake. By contrast, renal interstitial infusion of angiotensin (1-7) in rats maintained on a high-sodium intake had no effect on glomerular filtration rate, whereas the diuresis and natriuresis was markedly attenuated compared with those in rats fed either a normal or low-sodium diet. Plasma renin and angiotensin (1-7) were highest in the rats on the low-sodium diet and depressed in the rats on a high-sodium diet. These findings demonstrate that the renal hemodynamic and excretory responses to locally administered angiotensin (1-7) is dependent on the level of sodium intake and indirectly on the degree of activation of the renin-angiotensin system. The exact way in which angiotensin (1-7) exerts its effects may be dependent on the prevailing levels of angiotensin II and its receptor expression.

  19. Zonal heterogeneity in action of angiotensin-converting enzyme inhibitor on renal microcirculation: role of intrarenal bradykinin.

    PubMed

    Matsuda, H; Hayashi, K; Arakawa, K; Naitoh, M; Kubota, E; Honda, M; Matsumoto, A; Suzuki, H; Yamamoto, T; Kajiya, F; Saruta, T

    1999-11-01

    The present study examined the role of intrarenal bradykinin in angiotensin-converting enzyme inhibitor (ACEI)-induced dilation of renal afferent (AFF) and efferent arterioles (EFF) in vivo, and further evaluated whether ACEI-stimulated bradykinin activity differed in superficial (SP) and juxtamedullary nephrons (JM). Arterioles of canine kidneys were visualized with an intravital charge-coupled device camera microscope. E4177 (an angiotensin receptor antagonist, 30 microg/kg) dilated AFF and EFF in SP (15 +/- 3% and 19 +/- 5%) and JM (15 +/- 3% and 18 +/- 4%). Subsequently, cilazaprilat (30 microg/kg) caused further dilation of both AFF (29 +/- 4%) and EFF (36 +/- 4%) in JM, whereas in SP it dilated only EFF (29 +/-3%). Similarly, in the presence of E4177, cilazaprilat caused further increases in sodium excretion. This cilazaprilat-induced vasodilation and natriuresis was abolished by a bradykinin antagonist (N(alpha)-adamantaneacetyl-D-Arg-[Hyp3,Thi5,8,D-Phe7]b radykinin). In parallel with these results, cilazaprilat increased renal bradykinin content, more greatly in the medulla than in the cortex (5.7 +/- 0.4 versus 4.6 +/- 0.1 ng/g). Similarly, cilazaprilat elicited greater bradykinin-dependent increases of nitrite/nitrate in the medulla. In conclusion, zonal heterogeneity in renal bradykinin/nitric oxide levels and segmental differences in reactivity to bradykinin contribute to the diverse responsiveness of renal AFF and EFF to ACEI. ACEI-enhanced kinin action would participate in the amelioration of glomerular hemodynamics and renal sodium excretion by ACEI.

  20. Renal accumulation and intrarenal distribution of inorganic mercury in the rabbit: Effect of unilateral nephrectomy and dose of mercuric chloride

    SciTech Connect

    Zalups, R.K. )

    1991-06-01

    The effects of unilateral nephrectomy and dose of mercuric chloride on the short-term renal accumulation and intrarenal distribution of inorganic mercury were studied in the rabbit. The renal accumulation of inorganic mercury, on a per gram basis, was increased in uninephrectomized (NPX) rabbits compared with that in sham-operated (SO) rabbits 24 h after the animals received either a nontoxic 2.0 mumol/kg or nephrotoxic 4.0 mumol/kg dose of mercuric chloride. In the NPX rabbits given the 2.0 mumol/kg dose of mercuric chloride, the increased accumulation of inorganic mercury was due to increased accumulation of mercury in the outer stripe of the outer medulla. In the NPX rabbits given the 4.0 mumol/kg dose of mercuric chloride, the increased renal accumulation of mercury appeared to be due to increased accumulation of mercury in both the renal cortex and outer stripe of the outer medulla. Interestingly, no differences in the renal accumulation of inorganic mercury were found between NPX and SO rabbits given a low nontoxic 0.5 mumol/kg dose of mercuric chloride. As the dose of mercuric chloride was increased from 0.5 to 4.0 mumol/kg, the percent of the administered dose of mercury that accumulated in each gram of renal tissue decreased substantially. The findings in the present study indicate that the renal accumulation of inorganic mercury increases after unilateral nephrectomy when certain nontoxic and nephrotoxic doses of mercuric chloride are administered. In addition, they indicate that the percent of the administered dose of mercury that accumulates in the renal tissue of both NPX and SO rabbits decreases as the dose of mercuric chloride is increased.

  1. Predisposing conditions for retrograde peri-implantitis, and treatment suggestions.

    PubMed

    Quirynen, Marc; Vogels, Roel; Alsaadi, Ghada; Naert, Ignace; Jacobs, Reinhilde; van Steenberghe, Daniel

    2005-10-01

    Recent case reports introduced the term retrograde peri-implantitis as a lesion (radiolucency) around the most apical part of an osseointegrated implant. It develops within the first months after insertion. This retrospective study aimed to find predisposing conditions for such peri-apical lesions and to evaluate treatment strategies. All single implants (426 in the upper, 113 in the lower jaw, all Brånemark system type) placed at the department of Periodontology of the University Hospital (Catholic University Leuven) were included in this retrospective evaluation to check the incidence of retrograde peri-implantitis. Eventual predisposing factors such as patient characteristics (age, medical history), recipient site (local bone quality and quantity, cause of tooth loss), periodontal and endodontic conditions of neighboring teeth, implant characteristics (length, surface characteristics), and surgical aspects (guided bone regeneration, osseous fenestration, or dehiscency) were considered. Moreover, implants with retrograde peri-implantitis were followed longitudinally to verify their treatment outcome by means of different parameters (Periotest values (PTV), marginal bone level, radiological size of peri-apical defect). Seven implants in the upper (1.6%) and 3 in the lower jaw (2.7%) showed retrograde peri-implantitis, before or at abutment connection. In comparison with successful implants, such peri-apical lesions occurred preferably at sites with a history of an obvious endodontic pathology of the extracted tooth to be replaced. The incidence of retrograde peri-implantitis was significantly higher (P<0.0001) for TiUnite implants when compared with the machined implants (8/80 vs. 2/459). The machined implant surface, however, showed a higher failure rate (6.8%) than the TiUnite implants (2.5%). Failures with machined surfaces preferably occurred at extraction sites of teeth with a history of endodontic pathology or sites adjacent to teeth with an obvious

  2. Effects of inulin with different degree of polymerization on gelatinization and retrogradation of wheat starch.

    PubMed

    Luo, Denglin; Li, Yun; Xu, Baocheng; Ren, Guangyue; Li, Peiyan; Li, Xuan; Han, Sihai; Liu, Jianxue

    2017-08-15

    The effects of three types of inulin, including FS (DP≤10), FI (DP of 2-60) and FXL (DP≥23), on the gelatinization and retrogradation characteristics of wheat starch were investigated. As the concentration of inulin added into starch increased, the gelatinization temperature increased whereas the breakdown value decreased, and the value of setback first decreased and then increased slightly. The three types of inulin with lower concentrations (<15%) all showed obvious suppression effects on the short-term retrogradation of wheat starch. After 7days of storage, the three types of inulin showed a significant suppression of starch retrogradation in the addition range of 5-7.5%. They can all inhibit amylose retrogradation, but accelerate amylopectin retrogradation. Inulin with lower DP has stronger effects on the starch retrogradation. Generally, the three types of inulin can all retard the retrogradation performance of wheat starch to some extent in the long-term storage. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Effects of chitin nano-whiskers on the gelatinization and retrogradation of maize and potato starches.

    PubMed

    Ji, Na; Liu, Chengzhen; Zhang, Shuangling; Yu, Jing; Xiong, Liu; Sun, Qingjie

    2017-01-01

    Starch is very prone to retrogradation after gelatinization. Inhibition of starch retrogradation has been an important factor in improving the quality of food. For the first time, we investigated the effect of nano-materials, represented by chitin nano-whiskers (CNWs), on the short- and long-term retrogradation of maize and potato starches. Rapid Visco-Analyser results showed that the addition of CNWs significantly decreased the setback values of maize and potato starches, which suggested that CNWs could retard the short-term retrogradation of starch. Differential scanning calorimetry and X-ray diffraction results showed that the percentage of retrogradation of maize and potato starches significantly decreased (P<0.05), suggesting the inhibition of long-term retrogradation. The CNWs could be used as a new inhibitor of starch retrogradation to develop starch-based food with longer shelf life. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Retrograde amnesia following carbon monoxide poisoning: a case report.

    PubMed

    Acland, Peter R; Heaver, Catriona

    2008-07-01

    Retrograde amnesia is a recognised neurological complication of carbon monoxide poisoning. This article describes the case of a female found dead in her bath where initial post-mortem findings and the surrounding circumstances raised strong suspicions of homicide, especially when there was contradictory evidence from her husband who was the only other person present. He was later diagnosed as having retrograde amnesia between his two visits to the bathroom to attend to his wife which caused him to merge them into one event, thus arousing suspicions of foul play. The discussion explores the current clinical views on non-fatal carbon monoxide poisoning as well as problems of interpretation of information derived from case work.

  5. Photosynthetic light reactions: integral to chloroplast retrograde signalling.

    PubMed

    Gollan, Peter J; Tikkanen, Mikko; Aro, Eva-Mari

    2015-10-01

    Chloroplast retrograde signalling is ultimately dependent on the function of the photosynthetic light reactions and not only guides the acclimation of the photosynthetic apparatus to changing environmental and metabolic cues, but has a much wider influence on the growth and development of plants. New information generated during the past few years about regulation of photosynthetic light reactions and identification of the underlying regulatory proteins has paved the way towards better understanding of the signalling molecules produced in chloroplasts upon changes in the environment. Likewise, the availability of various mutants lacking regulatory functions has made it possible to address the role of excitation energy distribution and electron flow in the thylakoid membrane in inducing the retrograde signals from chloroplasts to the nucleus. Such signalling molecules also induce and interact with hormonal signalling cascades to provide comprehensive information from chloroplasts to the nucleus.

  6. WLS retrograde transport to the endoplasmic reticulum during Wnt secretion.

    PubMed

    Yu, Jia; Chia, Joanne; Canning, Claire Ann; Jones, C Michael; Bard, Frédéric A; Virshup, David M

    2014-05-12

    Wnts are transported to the cell surface by the integral membrane protein WLS (also known as Wntless, Evi, and GPR177). Previous studies of WLS trafficking have emphasized WLS movement from the Golgi to the plasma membrane (PM) and then back to the Golgi via retromer-mediated endocytic recycling. We find that endogenous WLS binds Wnts in the endoplasmic reticulum (ER), cycles to the PM, and then returns to the ER through the Golgi. We identify an ER-targeting sequence at the carboxyl terminus of native WLS that is critical for ER retrograde recycling and contributes to Wnt secretory function. Golgi-to-ER recycling of WLS requires the COPI regulator ARF as well as ERGIC2, an ER-Golgi intermediate compartment protein that is also required for the retrograde trafficking of the KDEL receptor and certain toxins. ERGIC2 is required for efficient Wnt secretion. ER retrieval is an integral part of the WLS transport cycle.

  7. Retrograde Lacrimal Duct Airflow During Nasal Positive Pressure Ventilation

    PubMed Central

    Zandieh, Stephanie; Katz, Eliot S.

    2010-01-01

    Noninvasive ventilation is widely used for chronic respiratory failure in children with neuromuscular disorders, thus avoiding the need for tracheostomy. However, the pressures required to support ventilation in these children may be considerably higher than those necessary to treat obstructive sleep apnea. The complications of nasal positive airway pressure are numerous, including skin breakdown, conjunctivitis, nasal congestion, airway dryness, pneumothorax, and bowel obstruction. Ophthalmologic complaints are particularly common, largely attributed to an air leak in the mask. In the present case, we demonstrate, through two modalities—video and CT scan—retrograde airflow through the nasolacrimal duct causing sleep disruption and eye irritation in a profoundly hypotonic 14-month-old boy with chronic respiratory failure on bilevel ventilation during sleep. Citation: Zandieh S; Katz ES. Retrograde lacrimal duct airflow during nasal positive pressure ventilation. J Clin Sleep Med 2010;6(6):603-604. PMID:21206550

  8. Retrograde amnesia induced by drugs acting on different molecular systems.

    PubMed

    Rossato, Janine I; Bonini, Juliana S; Coitinho, Adriana S; Vianna, Monica R M; Medina, Jorge H; Cammarota, Martín; Izquierdo, Iván

    2004-06-01

    The gamma aminobutyric acid-A (GABA-sub(A)) agonist, muscimol, the glutamate N-methyl-D-aspartate (NMDA) receptor antagonist, D-2-amino-5-phosphonopentanoic acid (AP5), and the inhibitor of the extracellularly regulated kinases (ERKs), UO 126, cause retrograde amnesia when administered to the hippocampus. In the present study, the authors found that they all cause retrograde amnesia for 1-trial inhibitory avoidance, not only when infused into the dorsal CA1 region of the hippocampus, but also when infused into the basolateral amygdala or the entorhinal, parietal, and posterior cingulate cortices. The posttraining time course of the effect of each drug was, however, quite different across brain structures. Thus, in all of them, NMDA receptors and the ERK pathway are indispensable for memory consolidation, and GABA-sub(A) receptor activation inhibits memory consolidation: but in each case, their influence is interwoven differently.

  9. The Management of Retrograde Peri-Implantitis: A Case Report

    PubMed Central

    Mohamed, Jumshad B; Alam, Md Nazish; Singh, Gurudeep; Chandrasekaran, S. C.

    2012-01-01

    Peri-Implantitis is defined as an inflammatory reaction with the loss of the supporting bone in the tissues which surround a functioning implant. The peri-implantitis lesions are often asymptomatic and they are usually detected during the routine recall appointments. Careful probing around the teeth and the implants should be done routinely along with the radiologic evaluation during these check-up appointments. Retrograde peri-implantitis may sometimes prove even more difficult to identify, resulting in the loss of the implant. This paper presents a report of the extensive and the meticulous management of retrograde peri-implantitis and the implant being finally restored to health and the full functional status. PMID:23285472

  10. Ureteroscopy-Assisted Retrograde Nephrostomy (UARN) after Anatrophic Nephrolithotomy.

    PubMed

    Kawahara, Takashi; Ito, Hiroki; Terao, Hideyuki; Kato, Yoshitake; Ogawa, Takehiko; Uemura, Hiroji; Kubota, Yoshinobu; Matsuzaki, Junichi

    2012-01-01

    Introduction. Open surgical anatrophic nephrolithotomy (ANL) had been the standard treatment for large renal calculi prior to the development of endoscopic devices and endoscopic techniques. A previous report described the efficacy of ureteroscopy-assisted retrograde nephrostomy (UARN) and presented a case of renal calculi successfully treated with UARN during percutaneous nephrolithotomy (PCNL) in a patient after ANL. Case Presentation. A 61-year-old male with left renal calculi was referred for further treatment. The patient was placed under general and epidural anesthesia, in a Galdakao-modified Valdivia position. A flexible ureteroscope (URS) was inserted, and a Lawson retrograde nephrostomy puncture wire was advanced into the flexible URS. The puncture wire then followed the route from the renal pelvis to the exit skin. Calculus fragmentation was undertaken using a pneumatic lithotripter. Conclusions. UARN for PCNL was therefore found to be a safe, effective, and appropriate treatment for a patient presenting with renal calculi after undergoing ANL.

  11. Ureteroscopy assisted retrograde nephrostomy for complete staghorn renal calculi.

    PubMed

    Kawahara, Takashi; Ito, Hiroki; Terao, Hideyuki; Ogawa, Takehiko; Uemura, Hiroji; Kubota, Yoshinobu; Matsuzaki, Junichi

    2012-09-01

    Complete staghorn calculi are typically managed with percutaneous nephrolithotomy (PCNL). However, dilating nephrostomy and inserting a nephro access sheath can be difficult to perform without hydronephrosis. We reported the procedure of ureteroscopy-assisted retrograde nephrostomy (UARN) during PCNL. UARN is effective without dilating the renal collecting system in cases of complete staghorn calculi. A 63-year old female with a left complete staghorn renal calculus was referred to our hospital. Under general and epidural anesthesia, the patient was placed in a modified-Valdivia position. A flexible ureteroscope was inserted and a Lawson retrograde nephrostomy puncture wire was advanced into the flexible ureteroscope. The puncture wire was forwarded along the route from the renal pelvis to the exit skin. Calculus fragmentation was done using a pneumatic lithotripter and the Ho: YAG laser. UARN during PCNL was effective for the treatment of a complete staghorn calculus.

  12. Ureteroscopy Assisted Retrograde Nephrostomy for Complete Staghorn Renal Calculi

    PubMed Central

    Kawahara, Takashi; Ito, Hiroki; Terao, Hideyuki; Ogawa, Takehiko; Uemura, Hiroji; Kubota, Yoshinobu; Matsuzaki, Junichi

    2012-01-01

    Complete staghorn calculi are typically managed with percutaneous nephrolithotomy (PCNL). However, dilating nephrostomy and inserting a nephro access sheath can be difficult to perform without hydronephrosis. We reported the procedure of ureteroscopy-assisted retrograde nephrostomy (UARN) during PCNL. UARN is effective without dilating the renal collecting system in cases of complete staghorn calculi. A 63-year old female with a left complete staghorn renal calculus was referred to our hospital. Under general and epidural anesthesia, the patient was placed in a modified-Valdivia position. A flexible ureteroscope was inserted and a Lawson retrograde nephrostomy puncture wire was advanced into the flexible ureteroscope. The puncture wire was forwarded along the route from the renal pelvis to the exit skin. Calculus fragmentation was done using a pneumatic lithotripter and the Ho: YAG laser. UARN during PCNL was effective for the treatment of a complete staghorn calculus. PMID:24917723

  13. Ureteroscopy-Assisted Retrograde Nephrostomy (UARN) after Anatrophic Nephrolithotomy

    PubMed Central

    Kawahara, Takashi; Ito, Hiroki; Terao, Hideyuki; Kato, Yoshitake; Ogawa, Takehiko; Uemura, Hiroji; Kubota, Yoshinobu; Matsuzaki, Junichi

    2012-01-01

    Introduction. Open surgical anatrophic nephrolithotomy (ANL) had been the standard treatment for large renal calculi prior to the development of endoscopic devices and endoscopic techniques. A previous report described the efficacy of ureteroscopy-assisted retrograde nephrostomy (UARN) and presented a case of renal calculi successfully treated with UARN during percutaneous nephrolithotomy (PCNL) in a patient after ANL. Case Presentation. A 61-year-old male with left renal calculi was referred for further treatment. The patient was placed under general and epidural anesthesia, in a Galdakao-modified Valdivia position. A flexible ureteroscope (URS) was inserted, and a Lawson retrograde nephrostomy puncture wire was advanced into the flexible URS. The puncture wire then followed the route from the renal pelvis to the exit skin. Calculus fragmentation was undertaken using a pneumatic lithotripter. Conclusions. UARN for PCNL was therefore found to be a safe, effective, and appropriate treatment for a patient presenting with renal calculi after undergoing ANL. PMID:22924043

  14. Retrograde trafficking of AB₅ toxins: mechanisms to therapeutics.

    PubMed

    Mukhopadhyay, Somshuvra; Linstedt, Adam D

    2013-10-01

    Bacterial AB5 toxins are a clinically relevant class of exotoxins that include several well-known members such as Shiga, cholera, and pertussis toxins. Infections with toxin-producing bacteria cause devastating human diseases that affect millions of individuals each year and have no definitive medical treatment. The molecular targets of AB5 toxins reside in the cytosol of infected cells, and the toxins reach the cytosol by trafficking through the retrograde membrane transport pathway that avoids degradative late endosomes and lysosomes. Focusing on Shiga toxin as the archetype member, we review recent advances in understanding the molecular mechanisms involved in the retrograde trafficking of AB5 toxins and highlight how these basic science advances are leading to the development of a promising new therapeutic approach based on inhibiting toxin transport.

  15. Clinical application of the retrograde arterialized venous flap.

    PubMed

    Koch, Horst; Scharnagl, Erwin; Schwarzl, Franz X; Haas, Franz M; Hubmer, Martin; Moshammer, Harald E T

    2004-01-01

    Retrograde arterialized venous flaps were applied to skin and soft-tissue defects in 13 patients with an average age of 34.4 years. Ten defects were located on the hand, and three on the lower leg. All flaps were harvested from the flexor aspect of the forearm; they ranged in size from 2 x 1 to 11 x 7 cm. There was venous congestion with superficial epidermolysis in six flaps, but not in the other seven. Partial skin necrosis in two of the lower-extremity flaps necessitated secondary skin grafts. Our results suggest that retrograde perfusion enhances blood flow in the periphery of arterialized venous flaps and gives good results in terms of flap survival, especially on the upper extremity. Copyright 2004 Wiley-Liss, Inc.

  16. TRANSIT TIMING VARIATIONS FOR INCLINED AND RETROGRADE EXOPLANETARY SYSTEMS

    SciTech Connect

    Payne, Matthew J.; Ford, Eric B.; Veras, Dimitri

    2010-03-20

    We perform numerical calculations of the expected transit timing variations (TTVs) induced on a hot-Jupiter by an Earth-mass perturber. Motivated by the recent discoveries of retrograde transiting planets, we concentrate on an investigation of the effect of varying relative planetary inclinations, up to and including completely retrograde systems. We find that planets in low-order (e.g., 2:1) mean-motion resonances (MMRs) retain approximately constant TTV amplitudes for 0 deg. < i < 170 deg., only reducing in amplitude for i>170 deg. Systems in higher order MMRs (e.g., 5:1) increase in TTV amplitude as inclinations increase toward 45 deg., becoming approximately constant for 45 deg. < i < 135 deg., and then declining for i>135 deg. Planets away from resonance slowly decrease in TTV amplitude as inclinations increase from 0 deg. to 180 deg., whereas planets adjacent to resonances can exhibit a huge range of variability in TTV amplitude as a function of both eccentricity and inclination. For highly retrograde systems (135 deg. < i {<=} 180 deg.), TTV signals will be undetectable across almost the entirety of parameter space, with the exceptions occurring when the perturber has high eccentricity or is very close to an MMR. This high inclination decrease in TTV amplitude (on and away from resonance) is important for the analysis of the known retrograde and multi-planet transiting systems, as inclination effects need to be considered if TTVs are to be used to exclude the presence of any putative planetary companions: absence of evidence is not evidence of absence.

  17. Propofol use in endoscopic retrograde cholangiopancreatography and endoscopic ultrasound

    PubMed Central

    Cheriyan, Danny G; Byrne, Michael F

    2014-01-01

    Compared to standard endoscopy, endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are often lengthier and more complex, thus requiring higher doses of sedatives for patient comfort and compliance. The aim of this review is to provide the reader with information regarding the use, safety profile, and merits of propofol for sedation in advanced endoscopic procedures like ERCP and EUS, based on the current literature. PMID:24833847

  18. Formation Flying in Earth, Libration, and Distant Retrograde Orbits

    NASA Technical Reports Server (NTRS)

    Folta, David C.

    2004-01-01

    This slide presentation examines the current and future state of formation flying, LEO formations, control strategies for flight in the vicinity of the libration points, and distant retrograde orbit formations. This discussion of LEO formations includes background on perturbation theory/accelerations and LEO formation flying. The discussion of strategies for formation flight in the vicinity of the libration points includes libration missions and natural and controlled libration orbit formations. A reference list is included.

  19. Life threatening hemobilia after endoscopic retrograde cholangiopancreatography (ERCP).

    PubMed

    El Hajj, Ihab I; Sherman, Stuart; Pyko, Maximilian; Lehman, Glen A

    2017-09-11

    Arterial vascular complication from endoscopic retrograde cholangiopancreatography (ERCP) is exceedingly rare. This report describes a life threatening hemobilia, from a pseudoaneurysm of the right hepatic artery (RHA), which occurred post ERCP. The pseudoaneurysm and the active bleed were diagnosed by selective angiography of the RHA, and successfully treated with stenting. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. Side Effects of alpha-Blocker Use: Retrograde Ejaculation.

    PubMed

    Kaplan, Steven A

    2009-01-01

    There are currently 5 alpha-blockers that are approved by the US Food and Drug Administration to treat lower urinary tract symptoms (LUTS). The American Urological Association guidelines committee believes that all alpha-blockers are equally effective. However, alpha-blockers differ in their likelihood of causing abnormal ejaculation. This article discusses the effects on ejaculatory function, and specifically retrograde ejaculation, of the currently available alpha-blockers being used to treat men with LUTS due to benign prostatic hyperplasia.

  1. A retrograde co-orbital asteroid of Jupiter.

    PubMed

    Wiegert, Paul; Connors, Martin; Veillet, Christian

    2017-03-29

    Recent theoretical work in celestial mechanics has revealed that an asteroid may orbit stably in the same region as a planet, despite revolving around the Sun in the sense opposite to that of the planet itself. Asteroid 2015 BZ509 was discovered in 2015, but with too much uncertainty in its measured orbit to establish whether it was such a retrograde co-orbital body. Here we report observations and analysis that demonstrates that asteroid 2015 BZ509 is indeed a retrograde co-orbital asteroid of the planet Jupiter. We find that 2015 BZ509 has long-term stability, having been in its current, resonant state for around a million years. This is long enough to preclude precise calculation of the time or mechanism of its injection to its present state, but it may be a Halley-family comet that entered the resonance through an interaction with Saturn. Retrograde co-orbital asteroids of Jupiter and other planets may be more common than previously expected.

  2. A retrograde co-orbital asteroid of Jupiter

    NASA Astrophysics Data System (ADS)

    Wiegert, Paul; Connors, Martin; Veillet, Christian

    2017-03-01

    Recent theoretical work in celestial mechanics has revealed that an asteroid may orbit stably in the same region as a planet, despite revolving around the Sun in the sense opposite to that of the planet itself. Asteroid 2015 BZ509 was discovered in 2015, but with too much uncertainty in its measured orbit to establish whether it was such a retrograde co-orbital body. Here we report observations and analysis that demonstrates that asteroid 2015 BZ509 is indeed a retrograde co-orbital asteroid of the planet Jupiter. We find that 2015 BZ509 has long-term stability, having been in its current, resonant state for around a million years. This is long enough to preclude precise calculation of the time or mechanism of its injection to its present state, but it may be a Halley-family comet that entered the resonance through an interaction with Saturn. Retrograde co-orbital asteroids of Jupiter and other planets may be more common than previously expected.

  3. Huge biloma after endoscopic retrograde cholangiopancreatography and endoscopic biliary sphincterotomy

    PubMed Central

    Alkhateeb, Harith M.; Aljanabi, Thaer J.; Al-azzawi, Khairallh H.; Alkarboly, Taha A.

    2015-01-01

    Background Biliary leak can occur as a complication of biliary surgery, endoscopic retrograde cholangiopancreatography manipulations and endoscopic biliary sphincterotomy. Consequently, bile may collect in the abdominal cavity, a condition called biloma. Rarely, it may reach a massive size. Case presentation A 72-year-old man presented with gastric upset with gradual abdominal distension reaching a large size due to intra-abdominal bile collection (biloma) after endoscopic retrograde cholangiopancreatography plus endoscopic biliary sphincterotomy and stenting for post laparoscopic cholecystectomy common bile duct stricture. This huge biloma was treated by percutaneous insertion of a tube drain for a few days, evacuating the collection successfully without recurrence. Discussion This patient might sustain injury to the common bile duct either by the guide wire or stent, or the injury occurred at the angle between the common bile duct and duodenum during sphincterotomy of the ampulla. Although any of these rents may lead to a bile leak, causing a huge biloma, they could be successfully treated by percutaneous drainage. Conclusions (1) Following endoscopic retrograde cholangiopancreatography, a patient’s complaints should not be ignored. (2) A massive biloma can occur due to such procedures. (3) Conservative treatment with minimal invasive technique can prove to be effective. PMID:26402876

  4. Osteochondritis Dissecans Involving the Trochlear Groove Treated With Retrograde Drilling

    PubMed Central

    Kaji, Yoshio; Nakamura, Osamu; Yamaguchi, Konosuke; Yamamoto, Tetsuji

    2015-01-01

    Abstract Osteochondritis dissecans (OCD) occurs frequently in the humeral capitellum of the upper extremity, whereas OCD involving the trochlear groove (trochlear groove OCD) is rarely reported. A standard treatment for trochlear groove OCD has therefore not been determined, although several methods have been tried. The case of a 14-year-old male gymnast with bilateral trochlear groove OCD is presented. Retrograde drilling from the lateral condyle of the humerus was applied for the OCD lesion of the left elbow, since it was larger in size than that in the right elbow and was symptomatic. Conversely, since the right lesion was small and asymptomatic, it was managed conservatively. After treatment, consolidation of the OCD lesions was observed in both elbows. However, the time to healing was shorter in the left elbow treated surgically than in the right elbow managed conservatively. In conclusion, retrograde drilling is a very simple and minimally invasive treatment. This case suggests that retrograde drilling for trochlear groove OCD may be a useful procedure that may accelerate the healing process for OCD lesions. PMID:26356703

  5. Novel Class of Potential Therapeutics that Target Ricin Retrograde Translocation

    PubMed Central

    Redmann, Veronika; Gardner, Thomas; Lau, Zerlina; Morohashi, Keita; Felsenfeld, Dan; Tortorella, Domenico

    2013-01-01

    Ricin toxin, an A-B toxin from Ricinus communis, induces cell death through the inhibition of protein synthesis. The toxin binds to the cell surface via its B chain (RTB) followed by its retrograde trafficking through intracellular compartments to the ER where the A chain (RTA) is transported across the membrane and into the cytosol. Ricin A chain is transported across the ER membrane utilizing cellular proteins involved in the disposal of aberrant ER proteins by a process referred to as retrograde translocation. Given the current lack of therapeutics against ricin intoxication, we developed a high-content screen using an enzymatically attenuated RTA chimera engineered with a carboxy-terminal enhanced green fluorescent protein (RTAE177Qegfp) to identify compounds that target RTA retrograde translocation. Stabilizing RTAE177Qegfp through the inclusion of proteasome inhibitor produced fluorescent peri-nuclear granules. Quantitative analysis of the fluorescent granules provided the basis to discover compounds from a small chemical library (2080 compounds) with known bioactive properties. Strikingly, the screen found compounds that stabilized RTA molecules within the cell and several compounds limited the ability of wild type RTA to suppress protein synthesis. Collectively, a robust high-content screen was developed to discover novel compounds that stabilize intracellular ricin and limit ricin intoxication. PMID:24366208

  6. Novel class of potential therapeutics that target ricin retrograde translocation.

    PubMed

    Redmann, Veronika; Gardner, Thomas; Lau, Zerlina; Morohashi, Keita; Felsenfeld, Dan; Tortorella, Domenico

    2013-12-23

    Ricin toxin, an A-B toxin from Ricinus communis, induces cell death through the inhibition of protein synthesis. The toxin binds to the cell surface via its B chain (RTB) followed by its retrograde trafficking through intracellular compartments to the ER where the A chain (RTA) is transported across the membrane and into the cytosol. Ricin A chain is transported across the ER membrane utilizing cellular proteins involved in the disposal of aberrant ER proteins by a process referred to as retrograde translocation. Given the current lack of therapeutics against ricin intoxication, we developed a high-content screen using an enzymatically attenuated RTA chimera engineered with a carboxy-terminal enhanced green fluorescent protein (RTA(E177Q)egfp) to identify compounds that target RTA retrograde translocation. Stabilizing RTA(E177Q)egfp through the inclusion of proteasome inhibitor produced fluorescent peri-nuclear granules. Quantitative analysis of the fluorescent granules provided the basis to discover compounds from a small chemical library (2080 compounds) with known bioactive properties. Strikingly, the screen found compounds that stabilized RTA molecules within the cell and several compounds limited the ability of wild type RTA to suppress protein synthesis. Collectively, a robust high-content screen was developed to discover novel compounds that stabilize intracellular ricin and limit ricin intoxication.

  7. Intrarenal alterations of the angiotensin-converting enzyme type 2/angiotensin 1-7 complex of the renin-angiotensin system do not alter the course of malignant hypertension in Cyp1a1-Ren-2 transgenic rats.

    PubMed

    Husková, Zuzana; Kopkan, Libor; Červenková, Lenka; Doleželová, Šárka; Vaňourková, Zdeňka; Škaroupková, Petra; Nishiyama, Akira; Kompanowska-Jezierska, Elzbieta; Sadowski, Janusz; Kramer, Herbert J; Červenka, Luděk

    2016-04-01

    The role of the intrarenal renin-angiotensin system (RAS) in the pathophysiology of malignant hypertension is not fully understood. Accumulating evidence indicates that the recently discovered vasodilator axis of the RAS, angiotensin-converting enzyme (ACE) type 2 (ACE2)/angiotensin 1-7 (ANG 1-7), constitutes an endogenous system counterbalancing the hypertensiogenic axis, ACE/angiotensin II (ANG II)/AT1 receptor. This study aimed to evaluate the role of the intrarenal vasodilator RAS axis in the pathophysiology of ANG II-dependent malignant hypertension in Cyp1a1-Ren-2 transgenic rats. ANG II-dependent malignant hypertension was induced by 13 days' dietary administration of indole-3-carbinol (I3C), a natural xenobiotic that activates the mouse renin gene in Cyp1a1-Ren-2 transgenic rats. It was hypothesized that pharmacologically-induced inhibition of the ACE2/ANG 1-7 complex should aggravate, and activation of this axis should attenuate, the course of ANG II-dependent malignant hypertension. Blood pressure (BP) was monitored by radiotelemetry. ACE2 inhibitor (DX 600, 0.2 μg/day) and ACE2 activator (DIZE, 1 mg/day) were administrated via osmotic minipumps. Even though ACE2 inhibitor significantly decreased and ACE2 activator increased intrarenal ANG 1-7 concentrations, the course of BP, as well as of albuminuria, cardiac hypertrophy and renal glomerular damage, were not altered. It was shown that intrarenal alterations in the ACE2/ANG 1-7 complex did not significantly modify the course of malignant hypertension in I3C-induced Cyp1a1-Ren-2 transgenic rats. Thus, in our experimental setting alterations of this intrarenal vasodilator complex of the RAS do not significantly modify the form of malignant hypertension that clearly depends on the inappropriately increased activity of the ACE/ANG II/AT1 receptor axis. © 2016 John Wiley & Sons Australia, Ltd.

  8. The "Lantern" Procedure to Simplify Treatment of Retrograde Type A Dissection After Thoracic Endograft Stenting.

    PubMed

    Tsai, Chung-Lin

    2016-04-01

    The emergency repair of retrograde type A aortic dissection after thoracic endovascular aortic repair is a complex and challenging surgical procedure and carries a surgical challenge. Previous studies have reported a significant mortality in the complex repair of retrograde type A aortic dissection after thoracic endovascular aortic repair. We devised a simplified hybrid method-the "Lantern" procedure-to solve this retrograde type A aortic dissection complication.

  9. Intermittent rate-dependent retrograde conduction over a concealed atrioventricular accessory pathway: what is the mechanism?

    PubMed

    Rordorf, Roberto; Vicentini, Alessandro; Petracci, Barbara; Landolina, Maurizio

    2009-02-01

    Intermittent retrograde conduction over an accessory pathway (AP) is quite an uncommon phenomenon. We describe the case of a 60-year-old woman with recurrent episodes of palpitations. Atrioventricular re-entry tachycardia was diagnosed at electrophysiological study. Interestingly, retrograde conduction over the AP was detectable only when ventricular pacing was performed at fast rate. Supernormal retrograde conduction over the AP was considered the most likely explanation of this unusual finding.

  10. The Role of Central and Enteric Nervous Systems in the Control of the Retrograde Giant Contraction.

    PubMed

    Lang, Ivan M

    2016-04-30

    The role of the enteric (ENS) and central (CNS) nervous systems in the control of the retrograde giant contraction (RGC) associated with vomiting is unknown. The effects of myotomy or mesenteric nerve transection (MNT) on apomorphine-induced emesis were investigated in 18 chronically instrumented dogs. Neither surgery affected the RGC orad of the surgical site or the velocity of the RGC over the entire small intestine. Myotomy blocked the RGC for 17 ± 5 cm aborad of the myotomy, and the velocity of the RGC from 100 to 70 cm from the pylorus slowed (18.1 ± 3.0 to 9.0 ± 0.8 cm/sec) such that the RGC orad and aborad of the myotomy occurred simultaneously. After MNT, the RGC was unchanged up to 66 ± 6 cm from the pylorus, and the sequence of the RGC across the denervated intestine was unaltered. The velocity of the RGC from 100 to 70 cm from the pylorus increased from 12.8 ± 1.6 to 196 ± 116 cm/sec. After myotomy or MNT, the percent occurrence and magnitude of the RGC across the intestine 100 to 70 cm from the pylorus decreased. The CNS activates the RGC 10 to 20 cm aborad of its innervation of the intestine and controls the RGC sequence. On the other hand, the ENS plays a role in initiation and generation of the RGC.

  11. Successful rescue of a perforated chronic total occlusion using retrograde technique.

    PubMed

    Nah, Jong Chun; Cho, Wook Hyun; Choi, Suk Koo

    2009-06-01

    Percutaneous coronary intervention of chronic total occlusion (CTO) is one of the greatest challenges in coronary interventions. Retrograde wiring is suggested as a solution to improve the success rate of intervention for CTO. We experienced the coronary perforation during antegrade wiring at the CTO lesion and sealed it using retrograde wiring and antegrade stenting in a patient who underwent coronary arterial bypass grafting. We found that, in selected cases, the retrograde wire technique may provide a valuable rescue option for perforated CTO in a patient having a retrogradely accessible conduit vessel.

  12. Changing Strategies of the Retrograde Approach for Chronic Total Occlusion During the Past 7 Years

    PubMed Central

    Muramatsu, Toshiya; Tsukahara, Reiko; Ito, Yoshiaki; Ishimori, Hiroshi; Park, Seung-Jung; Winter, Robert; Shokry, Khaled; Wang, Lefeng; Chen, Jiyan; Wang, Haichang

    2013-01-01

    Objective We reviewed the technical changes and results achieved with the retrograde approach since we introduced it 7 years ago. Subjects and Methods The subjects were 1,268 patients who were treated for CTO between January 2004 and December 2010. They were investigated with respect to the success rate, the frequency of employing the retrograde approach and its outcome, and other factors. Results The retrograde approach was employed in ∼30% of chronic total occlusion (CTO) patients (n = 281) and the retrograde guidewire success rate was 81.1%. The kissing wire technique was substituted for the retrograde approach in 126 of the 281 patients, with antegrade crossing of a guidewire being successful in 88 of them (70%). The retrograde approach was combined with the CART and reverse controlled antegrade retrograde tracking (CART) techniques in 22 and 21 patients, respectively. Among 83 patients treated with Corsair catheters, crossing of the CTO was achieved in 63. The overall procedural success rate was 79.7% (224 patients). Complications of the retrograde approach included collateral channel dissection (2.1%), channel perforation (1.7%), CTO perforation (1.7%), and donor artery occlusion (1.1%). Conclusion The success rate and safety of the retrograde approach are both satisfactory if the appropriate devices and techniques are selected. © 2012 Wiley Periodicals, Inc. PMID:22517670

  13. Physicochemical and release kinetics of natural and retrograded starch of Indian palmyrah shoots.

    PubMed

    Kumar Varma, Ch Ashok; Panpalia, S G; Kumar, K Jayaram

    2014-05-01

    Starch was isolated from the shoots of Indian palmyrah (Borassus flabellifer L.) and it was subjected to the process of retrogradation. The influence of retrogradation on morphological, physicochemical and drug release properties was studied. Retrogradation of native starch changed its morphology from oval, elliptical to crystalline rods. Due to retrogradation there is an increase in amylose content and better hydration capacity, swelling and solubility power. The micromeritic properties of native and retrograded starch uncover its usage as excipients in tablet manufacturing. The retrograded starch showed better powder characteristics to that of native starch. The characteristic peaks for d-glucopyranosyl ring confirms the carbohydrate nature of starch. The TGA data reveals that the retrograded starch shows less bound water to that of native starch during the first decomposition step. In-vitro release study reveals that the retrograded starch attained a better release retardant property and was best explained by Hixson-Crowell model. The result showed that retrograded starches can be used for the preparation of sustained release tablets.

  14. Prevention of retrograde calculus migration with the Stone Cone.

    PubMed

    Pardalidis, N P; Papatsoris, A G; Kosmaoglou, E V

    2005-02-01

    Retrograde calculus migration during ureteroscopic lithotripsy remains a problem in 5-40% of cases. We assessed the safety and efficacy of the Stone Cone device, in comparison with the standard flat wire basket. A total of 56 consecutive patients with ureteral calculi, suitable for ureteroscopic extraction and/or lithotripsy, where included in this prospective study. Patients were randomly allocated into two groups. In group A (30 patients), we used the Stone Cone, while in group B (26 patients) we used the standard flat wire basket. The Stone Cone was placed through a cystoscope under fluoroscopic guidance, or when necessary under direct ureteroscopic control. Whenever necessary, intracorporeal electrohydraulic lithotripsy took place in both groups. Statistical significance was assessed by the paired t-test. The mean operative time was 48.5 min in group A, and 42.4 min in group B. Intact calculus extraction was possible in 16.6% in group A, and in 7.6% in group B (P < 0.01). Retrograde stone migration was revealed in 23% in group B only (P < 0.001). Also, residual fragments > 3 mm were recorded in 30.7% in group B only (P < 0.001). None of the patients in group A required auxiliary procedures, in contrary to 23% in group B (P < 0.001). No major complications were recorded in group A, while in group B a case of major ureteral mucosal abrasion was recorded. The Stone Cone is safe and efficient in preventing retrograde stone migration and in minimizing residual fragments during ureteroscopic lithotripsy in comparison with the flat wire basket.

  15. Hemodynamic changes and retrograde flow in LVAD failure.

    PubMed

    Giridharan, Guruprasad A; Koenig, Steven C; Soucy, Kevin G; Choi, Young; Pirbodaghi, Tohid; Bartoli, Carlo R; Monreal, Gretel; Sobieski, Michael A; Schumer, Erin; Cheng, Allen; Slaughter, Mark S

    2015-01-01

    In the event of left ventricular assist device (LVAD) failure, we hypothesized that rotary blood pumps will experience significant retrograde flow and induce adverse physiologic responses. Catastrophic LVAD failure was investigated in computer simulation with pulsatile, axial, and centrifugal LVAD, mock flow loop with pulsatile (PVAD) and centrifugal (ROTAFLOW), and healthy and chronic ischemic heart failure bovine models with pulsatile (PVAD), axial (HeartMate II), and centrifugal (HVAD) pumps. Simulated conditions were LVAD "off" with outflow graft clamped (baseline), LVAD "off" with outflow graft unclamped (LVAD failure), and LVAD "on" (5 L/min). Hemodynamics (aortic and ventricular blood pressures, LVAD flow, and left ventricular volume), echocardiography (cardiac volumes), and end-organ perfusion (regional blood flow microspheres) were measured and analyzed. Retrograde flow was observed with axial and centrifugal rotary pumps during LVAD failure in computer simulation (axial = -3.4 L/min, centrifugal = -2.8 L/min), mock circulation (pulsatile = -0.1 L/min, centrifugal = -2.7 L/min), healthy (pulsatile = -1.2 ± 0.3 L/min, axial = -2.2 ± 0.2 L/min, centrifugal = -1.9 ± 0.3 L/min), and ischemic heart failure (centrifugal = 2.2 ± 0.7 L/min) bovine models for all test conditions (p < 0.05). Differences between axial and centrifugal LVAD were statistically indiscernible. Retrograde flow increased ventricular end-systolic and end-diastolic volumes and workload, and decreased myocardial and end-organ perfusion during LVAD failure compared with baseline, LVAD support, and pulsatile LVAD failure.

  16. A chloroplast retrograde signal regulates nuclear alternative splicing

    PubMed Central

    Petrillo, Ezequiel; Herz, Micaela A. Godoy; Fuchs, Armin; Reifer, Dominik; Fuller, John; Yanovsky, Marcelo J.; Simpson, Craig; Brown, John W. S.; Barta, Andrea; Kalyna, Maria; Kornblihtt, Alberto R.

    2015-01-01

    Light is a source of energy and also a regulator of plant physiological adaptations. We show here that light/dark conditions affect alternative splicing of a subset of Arabidopsis genes preferentially encoding proteins involved in RNA processing. The effect requires functional chloroplasts and is also observed in roots when the communication with the photosynthetic tissues is not interrupted, suggesting that a signaling molecule travels through the plant. Using photosynthetic electron transfer inhibitors with different mechanisms of action we deduce that the reduced pool of plastoquinones initiates a chloroplast retrograde signaling that regulates nuclear alternative splicing and is necessary for proper plant responses to varying light conditions. PMID:24763593

  17. From Hard to Harder: Iraq Retrograde Lessons for Afghanistan

    DTIC Science & Technology

    2013-04-01

    major commands of Multi-National Force-Iraq ( MNF -I), Multi-National Corps-Iraq (MNC-I), and Multi-National Security Transition Command-Iraq (MNSTC-I...into a single 2 headquarters—US Forces-Iraq (USF-I)—to facilitate the mission change.3 The transition from MNF -I to USF-I was made easier by the...of the MNF -I, MNC-I, and MNSTC-I into USF-I into a single operational chain of command. In support of this retrograde operation, CENTCOM assigned

  18. Utility of retrograde ureterocelogram in management of complex ureterocele.

    PubMed

    Arevalo, M K; Prieto, J C; Cost, N; Nuss, G; Brown, B J; Baker, L A

    2017-02-01

    Symptomatic pediatric ureterocele has diverse manifestations, making evidence-based management impractical. Thus, detailed visualization of ureterocele anatomy prior to first surgical incision is invaluable. Retrograde ureterocelogram (RUC) is a simple, underutilized radiologic technique that can be performed during cystoscopy. This study sought to determine whether RUC changes surgical management by more accurately depicting the complex ureteral and ureterocele anatomy, compared with renal ultrasound (US) and voiding cystourethrography (VCUG). Patients who underwent surgical management of ureterocele from 2003 to 2015 were identified; those who received concomitant fluoroscopic RUC were selected for the case series. Data collected included: demographics, pre-operative evaluation, surgical interventions, and outcomes. The RUC images were individually examined, and the anatomic impression compared with previous renal US and VCUG. Novel RUC findings not previously appreciated by the pre-operative evaluation were noted. The RUC was performed by cystoscopically inserting a needle into the ureterocele and injecting contrast retrograde. If indicated, simultaneous PIC (Positioning the Instillation of Contrast) cystography was performed. Of the 43 patients that underwent surgery for suspected ureterocele, 28 underwent cystoscopy + RUC (10 M: 18 F) at a median age of 4.6 months and median follow-up of 37.0 months. All patients had prior US, 25 had prior VCUG, and 20 had prior radionuclide studies. Ureteroceles were either duplex system (n = 21) or single system (n = 7); 17 were ectopic into the bladder neck or urethra; seven were intravesical; and four were pseudoureteroceles. Fourteen patients underwent concomitant transurethral incision of the ureterocele (TUIU); two were deferred for surgery; and 11 received concomitant definitive surgery (e.g., nephrectomy). The RUC illuminated novel aspects of the anatomy in 20 of the 28 patients. No adverse events occurred

  19. Postcholecystectomy syndrome: evaluation using biliary scintigraphy and endoscopic retrograde cholangiopancreatography

    SciTech Connect

    Zeman, R.K.; Burrell, M.I.; Dobbins, J.; Jaffe, M.K.; Choyke, P.L.

    1985-09-01

    The authors prospectively studied 30 patients with postcholecystectomy syndrome to determine the efficacy of biliary scintigraphy in the detection of stenosis of the sphincter of Oddi. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP). Biliary scintigraphy disclosed stenosis of the sphincter by agreement with the ERCP or surgical findings in nine (90%) of ten patients and in eight (100%) of eight patients with biliary obstruction from other causes. Retention of activity at 2 hours in visually prominent ducts was the best predictor of abnormal biliary drainage. Biliary scintigraphy is a useful, noninvasive screening test for the detection of postcholecystectomy biliary obstruction.

  20. Side Effects of α-Blocker Use: Retrograde Ejaculation

    PubMed Central

    Kaplan, Steven A

    2009-01-01

    There are currently 5 α-blockers that are approved by the US Food and Drug Administration to treat lower urinary tract symptoms (LUTS). The American Urological Association guidelines committee believes that all α-blockers are equally effective. However, α-blockers differ in their likelihood of causing abnormal ejaculation. This article discusses the effects on ejaculatory function, and specifically retrograde ejaculation, of the currently available α-blockers being used to treat men with LUTS due to benign prostatic hyperplasia. PMID:20126607

  1. Filling defects in the pancreatic duct on endoscopic retrograde pancreatography.

    PubMed

    Taylor, A J; Carmody, T J; Schmalz, M J; Wiedmeyer, D A; Stewart, E T

    1992-12-01

    Filling defects in the pancreatic duct are a frequent finding during endoscopic retrograde pancreatography (ERP) and have a variety of causes. Some filling defects may be artifactual or related to technical factors and, once their origin is recognized, can be disregarded. Others may be due to acute changes of pancreatitis and should prompt more careful injection of contrast material into the duct. Intraluminal masses may represent calculi or a neoplasm, either of which may require surgery or endoscopic intervention. The exact nature of these filling defects may not be apparent on radiographs, and other studies may be needed. This article reviews our approach to the evaluation of filling defects in the pancreatic duct.

  2. CYP epoxygenase-derived H2O2 is involved in the endothelium-derived hyperpolarization (EDH) and relaxation of intrarenal arteries.

    PubMed

    Muñoz, Mercedes; López-Oliva, Maria Elvira; Pinilla, Estéfano; Martínez, María Pilar; Sánchez, Ana; Rodríguez, Claudia; García-Sacristán, Albino; Hernández, Medardo; Rivera, Luis; Prieto, Dolores

    2017-05-01

    Reactive oxygen species (ROS) like hydrogen peroxide (H2O2) are involved in the in endothelium-derived hyperpolarization (EDH)-type relaxant responses of coronary and mesenteric arterioles. The role of ROS in kidney vascular function has mainly been investigated in the context of harmful ROS generation associated to kidney disease. The present study was sought to investigate whether H2O2 is involved in the endothelium-dependent relaxations of intrarenal arteries as well the possible endothelial sources of ROS generation involved in these responses. Under conditions of cyclooxygenase (COX) and nitric oxide (NO) synthase inhibition, acetylcholine (ACh) induced relaxations and stimulated H2O2 release that were reduced by catalase and by the glutathione peroxidase (GPx) mimetic ebselen in rat renal interlobar arteries, suggesting the involvement of H2O2 in the endothelium-dependent responses. ACh relaxations were also blunted by the CYP2C inhibitor sulfaphenazole and by the NADPH oxidase inhibitor apocynin. Acetylcholine stimulated both superoxide (O2(•-)) and H2O2 production that were reduced by sulfaphenazole and apocynin. Expression of the antioxidant enzyme CuZnSOD and of the H2O2 reducing enzymes catalase and GPx-1 was found in both intrarenal arteries and renal cortex. On the other hand, exogenous H2O2 relaxed renal arteries by decreasing vascular smooth muscle (VSM) intracellular calcium concentration [Ca(2+)]i and markedly enhanced endothelial KCa currents in freshly isolated renal endothelial cells. CYP2C11 and CYP2C23 epoxygenases were highly expressed in interlobar renal arteries and renal cortex, respectively, and were co-localized with eNOS in renal endothelial cells. These results demonstrate that H2O2 is involved in the EDH-type relaxant responses of renal arteries and that CYP 2C epoxygenases are physiologically relevant endothelial sources of vasodilator H2O2 in the kidney. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Intrarenal dopamine attenuates deoxycorticosterone acetate/high salt-induced blood pressure elevation in part through activation of a medullary cyclooxygenase 2 pathway.

    PubMed

    Yao, Bing; Harris, Raymond C; Zhang, Ming-Zhi

    2009-11-01

    Locally produced dopamine in the renal proximal tubule inhibits salt and fluid reabsorption, and a dysfunctional intrarenal dopaminergic system has been reported in essential hypertension and experimental hypertension models. Using catechol-O-methyl-transferase knockout (COMT(-/-)) mice, which have increased renal dopamine because of deletion of the major renal dopamine-metabolizing enzyme, we investigated the effect of intrarenal dopamine on the development of hypertension in the deoxycorticosterone acetate/high-salt (DOCA/HS) model. DOCA/HS led to significant increases in systolic blood pressure in wild-type mice (from 115+/-2 to 153+/-4 mm Hg), which was significantly attenuated in COMT(-/-) mice (from 114+/-2 to 135+/-3 mm Hg). In DOCA/HS COMT(-/-) mice, the D1-like receptor antagonist SCH-23390 increased systolic blood pressure (156+/-2 mm Hg). DOCA/HS COMT(-/-) mice also exhibited more urinary sodium excretion (COMT(-/-) versus wild-type: 3038+/-430 versus 659+/-102 micromol/L per 24 hours; P<0.01). Furthermore, DOCA/HS-induced renal oxidative stress was significantly attenuated in COMT(-/-) mice. COX-2-derived prostaglandins in the renal medulla promote sodium excretion, and dopamine stimulates medullary prostaglandin production. Renal medullary COX-2 expression and urinary prostaglandin E2 excretion were significantly higher in COMT(-/-) than in wild-type mice after DOCA/HS treatment. In DOCA/HS-treated COMT(-/-) mice, the COX-2 inhibitor SC-58236 reduced urinary sodium and prostaglandin E(2) excretion and increased systolic blood pressure (153+/-2 mm Hg). These studies indicate that an activated renal dopaminergic system attenuates the development of hypertension, at least in large part through activating medullary COX-2 expression/activity, and also decreases oxidative stress resulting from DOCA/HS.

  4. Retrograde bilin signaling enables Chlamydomonas greening and phototrophic survival.

    PubMed

    Duanmu, Deqiang; Casero, David; Dent, Rachel M; Gallaher, Sean; Yang, Wenqiang; Rockwell, Nathan C; Martin, Shelley S; Pellegrini, Matteo; Niyogi, Krishna K; Merchant, Sabeeha S; Grossman, Arthur R; Lagarias, J Clark

    2013-02-26

    The maintenance of functional chloroplasts in photosynthetic eukaryotes requires real-time coordination of the nuclear and plastid genomes. Tetrapyrroles play a significant role in plastid-to-nucleus retrograde signaling in plants to ensure that nuclear gene expression is attuned to the needs of the chloroplast. Well-known sites of synthesis of chlorophyll for photosynthesis, plant chloroplasts also export heme and heme-derived linear tetrapyrroles (bilins), two critical metabolites respectively required for essential cellular activities and for light sensing by phytochromes. Here we establish that Chlamydomonas reinhardtii, one of many chlorophyte species that lack phytochromes, can synthesize bilins in both plastid and cytosol compartments. Genetic analyses show that both pathways contribute to iron acquisition from extracellular heme, whereas the plastid-localized pathway is essential for light-dependent greening and phototrophic growth. Our discovery of a bilin-dependent nuclear gene network implicates a widespread use of bilins as retrograde signals in oxygenic photosynthetic species. Our studies also suggest that bilins trigger critical metabolic pathways to detoxify molecular oxygen produced by photosynthesis, thereby permitting survival and phototrophic growth during the light period.

  5. Retrograde bilin signaling enables Chlamydomonas greening and phototrophic survival

    PubMed Central

    Duanmu, Deqiang; Casero, David; Dent, Rachel M.; Gallaher, Sean; Yang, Wenqiang; Rockwell, Nathan C.; Martin, Shelley S.; Pellegrini, Matteo; Niyogi, Krishna K.; Merchant, Sabeeha S.; Grossman, Arthur R.; Lagarias, J. Clark

    2013-01-01

    The maintenance of functional chloroplasts in photosynthetic eukaryotes requires real-time coordination of the nuclear and plastid genomes. Tetrapyrroles play a significant role in plastid-to-nucleus retrograde signaling in plants to ensure that nuclear gene expression is attuned to the needs of the chloroplast. Well-known sites of synthesis of chlorophyll for photosynthesis, plant chloroplasts also export heme and heme-derived linear tetrapyrroles (bilins), two critical metabolites respectively required for essential cellular activities and for light sensing by phytochromes. Here we establish that Chlamydomonas reinhardtii, one of many chlorophyte species that lack phytochromes, can synthesize bilins in both plastid and cytosol compartments. Genetic analyses show that both pathways contribute to iron acquisition from extracellular heme, whereas the plastid-localized pathway is essential for light-dependent greening and phototrophic growth. Our discovery of a bilin-dependent nuclear gene network implicates a widespread use of bilins as retrograde signals in oxygenic photosynthetic species. Our studies also suggest that bilins trigger critical metabolic pathways to detoxify molecular oxygen produced by photosynthesis, thereby permitting survival and phototrophic growth during the light period. PMID:23345435

  6. Laser fluorescence angiography reveals perfusion defects in retrograde cardioplegia.

    PubMed

    Gorki, H; Patel, N C; Balacumaraswami, L; Pillai, J B; Subramanian, V A

    2011-11-01

    Adequate perfusion of the right ventricle with retrograde cardioplegia has always been questioned. However, clinical studies suggested sufficient protection and, up to now, intraoperative assessment of cardioplegia distribution has been difficult. As a pilot study in 14 patients, we used indocyanine green laser fluorescence angiography (ICGLA) to assess vascular and myocardial perfusion of different areas of the right anterior ventricular wall. Regions of interest were analyzed quantitatively using a new software package. ICGLA allowed rapid and reliable visualization of cardioplegic flow and distribution. Retrograde cardioplegia revealed perfusion defects in the territory of the right anterior cardiac veins when compared to antegrade delivery and to areas close to the left anterior descending vein(s), confirmed by quantitative analyses of maximal fluorescence intensity. Five patients were excluded from quantitative analyses. The learning curve, pitfalls, limitations and special image details are described. A larger study is necessary to examine the relevance of perfusion defects to metabolic changes in affected myocytes and to global right ventricular function.

  7. Searching for the anatomical basis of retrograde amnesia.

    PubMed

    Markowitsch, H J; Calabrese, P; Haupts, M; Durwen, H F; Liess, J; Gehlen, W

    1993-11-01

    The case of a patient with profound retrograde and minor anterograde amnesia is described and used to discuss the kind of brain damage which will most likely result in persistent retrograde amnesia as the principal symptom. The patient was an industrial manager who had fallen off a horse four years prior to the present neuropsychological and neuroradiological investigation. MRI examination revealed an injury to both temporal poles and to the latero-ventral portion of the right prefrontal cortex. The prefrontal and temporal cortical damage on the right side deeply invaded the white matter while the temporal cortical damage on the left side was much smaller; here, however, portions of the temporo-parietal transition zone were affected as well. The patient was of average intelligence. His attention, short-term memory, and learning ability were average or somewhat below average. His old memories were severely affected in the personal-episodic domain, and much less so in that of semantic remote memory. We conclude from this case that the necessary anatomical substrate for the retrieval of old episodic memories lies within the anterior temporal regions (including deeper situated fiber projections) and possibly involves an interaction with the prefrontal cortex, and that this damage is dissociable from the medial temporal-lobe damage leading to anterograde amnesia.

  8. Role of phospholipase A(2) in retrograde transport of ricin.

    PubMed

    Klokk, Tove Irene; Lingelem, Anne Berit Dyve; Myrann, Anne-Grethe; Sandvig, Kirsten

    2011-09-01

    Ricin is a protein toxin classified as a bioterror agent, for which there are no known treatment options available after intoxication. It is composed of an enzymatically active A-chain connected by a disulfide bond to a cell binding B-chain. After internalization by endocytosis, ricin is transported retrogradely to the Golgi and ER, from where the ricin A-chain is translocated to the cytosol where it inhibits protein synthesis and thus induces cell death. We have identified cytoplasmic phospholipase A(2) (PLA(2)) as an important factor in ricin retrograde transport. Inhibition of PLA(2) protects against ricin challenge, however the toxin can still be endocytosed and transported to the Golgi. Interestingly, ricin transport from the Golgi to the ER is strongly impaired in response to PLA(2) inhibition. Confocal microscopy analysis shows that ricin is still colocalized with the trans-Golgi marker TGN46 in the presence of PLA(2) inhibitor, but less is colocalized with the cis-Golgi marker GM130. We propose that PLA(2) inhibition results in impaired ricin transport through the Golgi stack, thus preventing it from reaching the ER. Consequently, ricin cannot be translocated to the cytosol to exert its toxic action.

  9. Retrograde replacement, reaction-driven cracking and rheology

    NASA Astrophysics Data System (ADS)

    Kelemen, P. B.; Hirth, G.

    2011-12-01

    Retrograde reactions involve hydration, carbonation and/or oxidation of volatile-poor, high grade metamorphic and igneous rocks. They can increase solid volume, via increasing solid mass and decreasing solid density, provided fluid is supplied in an open system, and dissolution does not remove significant solid mass. Increasing solid volume can create deviatoric stress, causing fractures to form. This can be a positive feedback, maintaining or increasing permeability and reactive surface area. Alternatively, high viscosity host rock can act as a rigid container. Transient stress rise due to initial volume change causes nearly equal volumetric rates of precipitation and pressure solution. Retrograde reactions can be self-limiting, consuming fluid that is required both as a reactant and as a catalyst, filling pore space with newly crystallized material, and armoring reactive surface areas. However, retrograde products, such as serpentine, talc and clays are common, and have important controls on crustal rheology and physical properties, e.g., in the "cold nose" above subduction zones, in subducting plates, and in fault zones. The best-known retrograde processes are hydration and carbonation of olivine, in igneous rocks and residual mantle peridotite, e.g. near the seafloor. Fully hydrated (serpentinites) or carbonated (listwanites) peridotites show that retrograde reactions can proceed to completion. It is common to find that replacement is nearly isochemical, with the exception of H2O and CO2, suggesting that large-scale dissolution did not take place and solid volume expansion was significant. The free energy changes driving hydration and carbonation of olivine could generate overpressures of 100's to 1000's of MPa. These thermodynamic upper bounds can be compared to estimates based on microstructure. Evans (Int Geol Rev 2004) and Jamtveit et al. (EPSL 2008) provide microphotographs of igneous troctolites, with interstitial plagioclase surrounding rounded olivine

  10. Anterograde and Retrograde Amnesia of Place Discrimination in Retrosplenial Cortex and Hippocampal Lesioned Rats

    ERIC Educational Resources Information Center

    Haijima, Asahi; Ichitani, Yukio

    2008-01-01

    Retrograde and anterograde amnesic effects of excitotoxic lesions of the rat retrosplenial cortex (RS) and hippocampus (HPC) were investigated. To test retrograde amnesia, rats were trained with two-arm place discrimination in a radial maze 4 wk and 1 d before surgery with a different arm pair, respectively. In the retention test 1 wk after…

  11. Anterograde and Retrograde Amnesia of Place Discrimination in Retrosplenial Cortex and Hippocampal Lesioned Rats

    ERIC Educational Resources Information Center

    Haijima, Asahi; Ichitani, Yukio

    2008-01-01

    Retrograde and anterograde amnesic effects of excitotoxic lesions of the rat retrosplenial cortex (RS) and hippocampus (HPC) were investigated. To test retrograde amnesia, rats were trained with two-arm place discrimination in a radial maze 4 wk and 1 d before surgery with a different arm pair, respectively. In the retention test 1 wk after…

  12. Giant hydronephrosis of a duplex system associated with ureteral ectopia: a cause of retrograde ejaculation.

    PubMed

    Lee, S S; Sun, G H; Yu, D S; Chen, H I; Chang, S Y

    2000-01-01

    Retrograde ejaculation is an extremely rare complication of the ectopic ureter or ectopic ureterocele. In the literature, only two cases have been reported worldwide. In this article the authors describe a patient who has a completely duplicated collecting system with massive dilatation of the upper pole system, which has manifested as a huge abdominal and retroperitoneal mass, complicated by retrograde ejaculation.

  13. Splenic Subcapsular Hematoma After Endoscopic Retrograde Cholangiopancreatography in a Liver Transplant Recipient: Case Report and Literature Review.

    PubMed

    Montenovo, Martin; Javed, Emran; Bakthavatsalam, Ramasamy; Reyes, Jorge

    2017-02-01

    Splenic injuries after an endoscopic retrograde cholangiopancreatography are a rare but lethal complication. We describe a subcapsular splenic hematoma requiring emergent splenectomy after an endoscopic retrograde cholangiopancreatography in a liver transplant recipient.

  14. The effect of branched limit dextrin on corn and waxy corn gelatinization and retrogradation.

    PubMed

    Wang, Lili; Xu, Jin; Fan, Xuerong; Wang, Qiang; Wang, Ping; Yuan, Jiugang; Yu, Yuanyuan; Zhang, Ying; Cui, Li

    2017-08-02

    The effect of branched limit dextrins (BLDs) on the gelatinization and retrogradation properties of corn and waxy corn starch was investigated using differential scanning calorimetry (DSC), wide X-ray diffraction (WXRD). The DSC data showed that the presence of BLDs increased the gelatinization and decreased the gelatinization enthalpy (ΔHgel). The retrogradation of corn and waxy corn starch were retarded by BLDs. The BLD with the lowest molecular weight had the best influence on corn and waxy corn starch retrogradation. The result of WXRD confirmed it. Avrami equation was used to analyze the enthalpies of retrograded corn and waxy corn starch. Starch recrystallization rate (k) reduced with the addition of BLDs, indicating that BLDs reduced the kinetics of starch retrogradation. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Retrograded starches as potential anodes in lithium-ion rechargeable batteries.

    PubMed

    Lian, Xijun; Wen, Yan; Zhu, Wei; Li, Lin; Zhang, Kunsheng; Wang, Wanyu

    2012-11-01

    Retrograded starch is a crystal formed by starch molecules with hydrogen bonds. Many literatures have reported its physicochemical character, but its crystal structure is so far unclear. As we isolate amylose and amylopectin from retrograded maize, sweet potato and potato starches in 4.0 M KOH solutions and make them retrograde alone in neutral solution (adjusted by HCl) to form crystal, a new phenomenon appears, crystals of KCl do not appear in retrograded potato amylose, potato amylopectin, and maize amylose, indicating that those crystals may absorb K⁺ and (or) Cl⁻, and those ions probably act with aldehyde of starch or hydroxy of fatty acid attached in starch, such characteristic may make retrograded starches replace graphite as anode with high-capacity in lithium-ion rechargeable batteries. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. Case report: A healthy live birth following icsi with retrograde ejaculated sperm.

    PubMed

    Yakass, Michael B; Woodward, Bryan; Otoo, Mary A; Hiadzi, Edem K

    2014-12-01

    Retrograde ejaculation, sometimes called dry orgasm, refers to the medical condition when semen enters the urinary bladder (retrograde) instead of emerging through the penis after orgasm (antegrade). In some instances, a very minute quantity of antegrade semen appears in the ejaculate and may or may not be devoid of spermatozoa. Complete retrograde ejaculation causes male infertility. Intracytoplasmic sperm injection (ICSI) has been employed to achieve fertilization in some cases of male subfertility, e.g., severe oligoasthenoteratozoospermia. Assisted reproductive techniques to aid conception in cases of retrograde ejaculation have been described extensively elsewhere but there is paucity of knowledge on the occurrence and treatment in Africa. This case report describes the identification and successful treatment of a couple where the male partner suffered from retrograde ejaculation.

  17. A Switch in Retrograde Signaling from Survival to Stress in Rapid Onset Neurodegeneration

    PubMed Central

    Perlson, Eran; Jeong, Goo-Bo; Ross, Jenny L.; Dixit, Ram; Wallace, Karen E.; Kalb, Robert G.; Holzbaur, Erika L.F.

    2011-01-01

    Retrograde axonal transport of cellular signals driven by dynein is vital for neuronal survival. Mouse models with defects in the retrograde transport machinery including the Loa mouse (point mutation in dynein) and the Tgdynamitin mouse (overexpression of dynamitin) exhibit mild neurodegenerative disease. Transport defects have also been observed in more rapidly progressive neurodegeneration, such as that observed in the SOD1G93A transgenic mouse model for familial ALS. Here we test the hypothesis that alterations in retrograde signaling lead to neurodegeneration. In-vivo, in-vitro and live cell imaging motility assays show mis-regulation of transport and inhibition of retrograde signaling in the SOD1G93A model. However, similar inhibition is also seen in the Loa and Tgdynamitin mouse models. Thus, slowing of retrograde signaling leads only to mild degeneration and cannot explain ALS etiology. To further pursue this question, we used a proteomics approach to investigate dynein-associated retrograde signaling. These data indicate a significant decrease in retrograde survival factors including P-Trk and P-Erk1/2, and an increase in retrograde stress factor signaling, including P-JNK, Caspase-8 and p75NTR cleavage fragment in the SOD1G93A model; similar changes are not seen in the Loa mouse. Co-cultures of motor neurons and glia expressing mutant SOD1 (mSOD1) in compartmentalized chambers indicate that inhibition of retrograde stress signaling is sufficient to block activation of cellular stress pathways and to rescue motor neurons from mSOD1-induced toxicity. Hence, a shift from survival-promoting to death-promoting retrograde signaling may be key to the rapid onset of neurodegeneration seen in ALS. PMID:19657041

  18. Myosin IIA dependent retrograde flow drives 3D cell migration.

    PubMed

    Shih, Wenting; Yamada, Soichiro

    2010-04-21

    Epithelial cell migration is an essential part of embryogenesis and tissue regeneration, yet their migration is least understood. Using our three-dimensional (3D) motility analysis, migrating epithelial cells formed an atypical polarized cell shape with the nucleus leading the cell front and a contractile cell rear. Migrating epithelial cells exerted traction forces to deform both the anterior and posterior extracellular matrix toward the cell body. The cell leading edge exhibited a myosin II-dependent retrograde flow with the magnitude and direction consistent with surrounding network deformation. Interestingly, on a two-dimensional substrate, myosin IIA-deficient cells migrated faster than wild-type cells, but in a 3D gel, these myosin IIA-deficient cells were unpolarized and immobile. In contrast, the migration rates of myosin IIB-deficient cells were similar to wild-type cells. Therefore, myosin IIA, not myosin IIB, is required for 3D epithelial cell migration.

  19. Inhibition of wheat starch retrogradation by tea derivatives.

    PubMed

    Zhang, Haihua; Sun, Binghua; Zhang, Shikang; Zhu, Yuejin; Tian, Yaoqi

    2015-12-10

    The effect of four industrial tea derivatives (tea polyphenols [TPS], tea water-soluble extracts [TSE], tea polysaccharides [TSS], and green tea powder [GTP]), on the retrogradation of wheat starch was investigated using texture profile analysis (TPA), differential scanning calorimetry (DSC), rapid viscosity analysis (RVA), and the α-amylase-iodine method. The addition of the four tea derivatives resulted in decreased hardness and increased cohesiveness of the starch gel as shown by the TPA test. The DSC data demonstrated an increase in the enthalpy change of starch gelatinization and a decrease in the enthalpy change of starch recrystallite dissociation. The RVA results indicated that the peak viscosity, representing the intermolecular forces of wheat starch, was reduced after addition of TPS, TSE, and TSS, respectively, but was increased by GTP. Furthermore, the half crystallization time in the Avrami equation almost doubled after the separate addition of the tea derivatives.

  20. CONFIRMATION OF A RETROGRADE ORBIT FOR EXOPLANET WASP-17b

    SciTech Connect

    Bayliss, Daniel D. R.; Sackett, Penny D.; Winn, Joshua N.; Mardling, Rosemary A.

    2010-10-20

    We present high-precision radial velocity observations of WASP-17 throughout the transit of its close-in giant planet, using the MIKE spectrograph on the 6.5 m Magellan Telescope at Las Campanas Observatory. By modeling the Rossiter-McLaughlin effect, we find the sky-projected spin-orbit angle to be {lambda} = 167.4 {+-} 11.2 deg. This independently confirms the previous finding that WASP-17b is on a retrograde orbit, suggesting it underwent migration via a mechanism other than just the gravitational interaction between the planet and the disk. Interestingly, our result for {lambda} differs by 45 {+-} 13 deg from the previously announced value, and we also find that the spectroscopic transit occurs 15 {+-} 5 minutes earlier than expected, based on the published ephemeris. The discrepancy in the ephemeris highlights the need for contemporaneous spectroscopic and photometric transit observations whenever possible.

  1. [Hindfoot fusion for Charcot osteoarthropathy with a curved retrograde nail].

    PubMed

    Pyrc, J; Fuchs, A; Zwipp, H; Rammelt, S

    2015-01-01

    Charcot osteoarthropathy of the hindfoot with considerable dislocation and instability represents a therapeutic dilemma. The treatment goal is a plantigrade, stable foot that is free of infection and ulceration with the ability to ambulate in special footwear. Over a period of 6 years, we performed 23 hindfoot fusions in 21 patients with manifest Charcot arthropathy with the help of a curved retrograde nail (HAN). All patients suffered from insulin-dependent diabetes mellitus with polyneuropathy; 12 patients had additional peripheral vasculopathy. An average of 3.5 previous surgeries had been performed prior to hindfoot fusion. Complete tibiotalocalcaneal fusion was obtained in 16 of 21 patients (76 %). Of these 21 patients, 18 (86 %) were followed clinically and radiologically for an average of 2 years. Overall, 16 patients (89 %) reported a substantial subjective improvement compared to the preoperative state. Hardware failure occurred in 7 cases (30 %) that could be brought to consolidation with exchange of the locking bolts or the complete nail. In 5 cases (22 %), a postoperative hematoma had to be removed and in 8 cases (35 %) wound edge necrosis was treated with local wound care. In 2 cases (9 %), a secondary or reactivated osteitis occurred that finally required below knee amputation. Tibiotalocalcaneal fusion with a curved retrograde intramedullary nail (HAN) is an effective treatment option in highly unstable and deforming Charcot osteoarthropathy of the hindfoot. It is an alternative to external or other internal fixation methods and helps to avoid below knee amputation in more than 90 % of cases.

  2. Endoscopic retrograde cholangiopancreatography associated pancreatitis: A 15-year review

    PubMed Central

    Woods, Kevin E; Willingham, Field F

    2010-01-01

    The aim of this article is to review the literature regarding post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. We searched for and evaluated all articles describing the diagnosis, epidemiology, pathophysiology, morbidity, mortality and prevention of post-ERCP pancreatitis (PEP) in adult patients using the PubMed database. Search terms included endoscopic retrograde cholangiopancreatography, pancreatitis, ampulla of vater, endoscopic sphincterotomy, balloon dilatation, cholangiography, adverse events, standards and utilization. We limited our review of articles to those published between January 1, 1994 and August 15, 2009 regarding human adults and written in the English language. Publications from the reference sections were reviewed and included if they were salient and fell into the time period of interest. Between the dates queried, seventeen large (> 500 patients) prospective and four large retrospective trials were conducted. PEP occurred in 1%-15% in the prospective trials and in 1%-4% in the retrospective trials. PEP was also reduced with pancreatic duct stent placement and outcomes were improved with endoscopic sphincterotomy compared to balloon sphincter dilation in the setting of choledocholithiasis. Approximately 34 pharmacologic agents have been evaluated for the prevention of PEP over the last fifteen years in 63 trials. Although 22 of 63 trials published during our period of review suggested a reduction in PEP, no pharmacologic therapy has been widely accepted in clinical use in decreasing the development of PEP. In conclusion, PEP is a well-recognized complication of ERCP. Medical treatment for prevention has been disappointing. Proper patient selection and pancreatic duct stenting have been shown to reduce the complication rate in randomized clinical trials. PMID:21160744

  3. Antibiotic prophylaxis in retrograde ureteroscopy: what strategy should we adopt?

    PubMed Central

    Pricop, Cătălin; Dorobăt¸, Carmen; Puia, Dragoş; Orsolya, Martha

    2013-01-01

    Background Retrograde ureteroscopy as a minimally invasive treatment of ureteral calculi can be complicated by the occurrence of urinary tract infections. Fever is considered the main indicator of such postoperative complications and we aimed to study its incidence in patients with and without preoperative antibiotic prophylaxis. Methods We included all patients who underwent retrograde ureteroscopy for ureteric stones in the Iaşi and Tg Mureş Urology Clinics from 2009 to 2012. Data were statistically analyzed using the EpiInfo 7 software. Indicative of a statistically significant difference was a p value <0.05. Results We recorded fever in a total of 108 cases, accounting for 22.83% of all subjects in the study. Group 1 included patients who received antibiotic prophylaxis; 48 of 147 (32.65%) were febrile, compared with Group 2 (no antibiotic prophylaxis), where we recorded febrile syndrome in 60 (18.40%) cases, p=0.0009. Comparing the two groups based on calculus size, for stones with diameters of 0.6-0.8 cm 38.71% of patients were febrile in Group 1, compared with 10.88% in Group 2 (p=0.0008). Secondary ureterohydronephrosis did not statistically influence the frequency of fever in any of the studied groups. Conclusion Less than half of all febrile patients had positive urine cultures, which may point to other causes, such as noninfectious factors (aseptic kidney inflammation). This study did not prove the efficiency of preoperative antibiotic prophylaxis; however, based on the clinical experience of the past 120 years, infectious complications are known to be associated with urological maneuvers and prophylaxis could be indicated. PMID:24432295

  4. Conscious Sedation for Endoscopic Retrograde Cholangiopancreatography: Dexmedetomidine Versus Midazolam

    PubMed Central

    Kilic, Neslihan; Sahin, Sukran; Aksu, Hale; Yavascaoglu, Belgin; Gurbet, Alp; Turker, Gurkan; Kadioglu, Asli Guler

    2011-01-01

    Objective: Midazolam and dexmedetomidine, which are used for sedation during endoscopic retrograde cholangiopancreatography, were compared to evaluate the differences in efficacy, hemodynamics, and side effects. Materials and Methods: Fifty patients aged between 18 and 80 were randomly assigned to two groups according to American Society of Anesthesiologists (ASA) classification: Group M received midazolam with an initial bolus infusion of 0.04 mg/kg intravenously (i.v.), followed by additional doses of 0.5 mg i.v. midazolam, titrated to achieve a Ramsay sedation scale score of 3–4. Group D received dexmedetomidine with an initial bolus infusion of 1 mcg/kg/hr i.v. over 10 minutes, followed by a continuous infusion of 0.2–0.7 mcg/kg/hr, titrated to achieve an RSS of 3–4. A Mini Mental Status Examination (MMSE) was performed prior to sedation and in the recovery room once the Modified Aldrete Score (MAS) reached 9–10. Patient heart rates, arterial pressure and pain were evaluated. Results: Patients in Group D had lower heart rates at 20, 25, 30, 35 and 40 minutes following the initiation of sedation (p<0.05). There was no statistical difference in arterial pressure, RSS, MMSE or respiratory rate between the two groups. Coughing, nausea and vomiting occurred in 3 patients in Group M (12%), whereas no patient in Group D experienced these symptoms. The procedure elicited a gag response in 7 patients in Group M (28%) and in 4 patients in Group D (16%), with no significant difference between groups (p>0.05). When patient and surgeon satisfaction was compared between the two groups, Group D showed higher surgeon satisfaction scores (p<0.05). Conclusion: The use of dexmedetomidine for conscious sedation during short, invasive procedures, such as endoscopic retrograde cholangiopancreatography, could be a superior alternative to the use of midazolam. PMID:25610153

  5. Rab9-dependent retrograde transport and endosomal sorting of the endopeptidase furin

    PubMed Central

    Chia, Pei Zhi Cheryl; Gasnereau, Isabelle; Lieu, Zi Zhao; Gleeson, Paul A.

    2011-01-01

    The endopeptidase furin and the trans-Golgi network protein TGN38 are membrane proteins that recycle between the TGN and plasma membrane. TGN38 is transported by a retromer-dependent pathway from early endosomes to the TGN, whereas the intracellular transport of furin is poorly defined. Here we have identified the itinerary and transport requirements of furin. Using internalisation assays, we show that furin transits the early and late endosomes en route to the TGN. The GTPase Rab9 and the TGN golgin GCC185, components of the late endosome-to-TGN pathway, were required for efficient TGN retrieval of furin. By contrast, TGN38 trafficking was independent of Rab9 and GCC185. To identify the sorting signals for the early endosome-to-TGN pathway, the trafficking of furin–TGN38 chimeras was investigated. The diversion of furin from the Rab9-dependent late-endosome-to-TGN pathway to the retromer-dependent early-endosome-to-TGN pathway required both the transmembrane domain and cytoplasmic tail of TGN38. We present evidence to suggest that the length of the transmembrane domain is a contributing factor in endosomal sorting. Overall, these data show that furin uses the Rab9-dependent pathway from late endosomes and that retrograde transport directly from early endosomes is dependent on both the transmembrane domain and the cytoplasmic tail. PMID:21693586

  6. Improved techniques for double-balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography

    PubMed Central

    Osoegawa, Takashi; Motomura, Yasuaki; Akahoshi, Kazuya; Higuchi, Naomi; Tanaka, Yoshimasa; Hisano, Terumasa; Itaba, Souichi; Gibo, Junya; Yamada, Mariko; Kubokawa, Masaru; Sumida, Yorinobu; Akiho, Hirotada; Ihara, Eikichi; Nakamura, Kazuhiko

    2012-01-01

    AIM: To investigate the clinical outcome of double balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (DB-ERCP) in patients with altered gastrointestinal anatomy. METHODS: Between September 2006 and April 2011, 47 procedures of DB-ERCP were performed in 28 patients with a Roux-en-Y total gastrectomy (n = 11), Billroth II gastrectomy (n = 15), or Roux-en-Y anastomosis with hepaticojejunostomy (n = 2). DB-ERCP was performed using a short-type DBE combined with several technical innovations such as using an endoscope attachment, marking by submucosal tattooing, selectively applying contrast medium, and CO2 insufflations. RESULTS: The papilla of Vater or hepaticojejunostomy site was reached in its entirety with a 96% success rate (45/47 procedures). There were no significant differences in the success rate of reaching the blind end with a DBE among Roux-en-Y total gastrectomy (96%), Billroth II reconstruction (94%), or pancreatoduodenectomy (100%), respectively (P = 0.91). The total successful rate of cannulation and contrast enhancement of the target bile duct in patients whom the blind end was reached with a DBE was 40/45 procedures (89%). Again, there were no significant differences in the success rate of cannulation and contrast enhancement of the target bile duct with a DBE among Roux-en-Y total gastrectomy (88 %), Billroth II reconstruction (89%), or pancreatoduodenectomy (100%), respectively (P = 0.67). Treatment was achieved in all 40 procedures (100%) in patients whom the contrast enhancement of the bile duct was successful. Common endoscopic treatments were endoscopic biliary drainage (24 procedures) and extraction of stones (14 procedures). Biliary drainage was done by placement of plastic stents. Stones extraction was done by lithotomy with the mechanical lithotripter followed by extraction with a basket or by the balloon pull-through method. Endoscopic sphincterotomy was performed in 14 procedures with a needle precutting

  7. Is retrograde drilling really useful for osteochondral lesion of talus with subchondral cyst?

    PubMed Central

    Jeong, Seong-Yup; Kim, Jong-Kil; Lee, Kwang-Bok

    2016-01-01

    Abstract Rationale: Retrograde drilling is a well accepted procedure for osteochondral lesion of the talus and subchondral cyst with intact overlying cartilage. It has good results in most reports. Compared to anterograde drilling, retrograde drilling can protect the integrity of the articular cartilage. The purpose of this study was to evaluate the suitability of using retrograde drilling for osteochondral lesion with subchondral cyst and discuss the mechanism involved in the development of subchondral cyst. Patient concerns: We report a 53-year-old man who had complained left ankle pain that lasted over 6 months which was exacerbated by walking. Diagnoses: We diagnosed it as osteochondral lesion of the talus with subchondral cyst. Interventions: Plain X-ray, computed tomography, and magnetic resonance imaging (MRI) of the ankle. Outcomes: He undertook retrograde drilling without debridement of cartilage. After the surgery, the pain had been subsided for 1 year, although arthritic change had progressed. However, after 5 years of retrograde drilling, he revisited our hospital due to severe ankle pain. Plain X-ray and MRI showed arthritic change of the ankle and multiple cystic formation of talus. Lessons: Retrograde drilling has some problem because this procedure is not theoretically correct when the development of a subchondral cyst in osteochondral lesion of the talus is considered. In addition, retrograde drilling may impair uninjured bone marrow of the talus, resulting in the development of multiple cystic formations. PMID:27930520

  8. Effects of protein in wheat flour on retrogradation of wheat starch.

    PubMed

    Xijun, Lian; Junjie, Guo; Danli, Wang; Lin, Li; Jiaran, Zhu

    2014-08-01

    Albumins, globulins, gliadins, and glutenins were isolated from wheat flour and the effects of those proteins on retrogradation of wheat starch were investigated. The results showed that only glutenins retarded retrogradation of wheat starch and other 3 proteins promoted it. The results of IR spectra proved that no S-S linkage formed during retrogradation of wheat starch blended with wheat proteins. Combination of wheat starch and globulins or gliadins through glucosidic bonds hindered the hydrolysis of wheat starch by α-amylase. The melting peak temperatures of retrograded wheat starch attached to different proteins were 128.46, 126.14, 132.03, 121.65, and 134.84 °C for the control with no protein, albumins, glutenins, globulins, gliadins groups, respectively, and there was no second melting temperature for albumins group. Interaction of wheat proteins and starch in retrograded wheat starch greatly decreased the endothermic enthalpy (△H) of retrograded wheat starch. Retrograded wheat starch bound to gliadins might be a new kind of resistant starch based on glycosidic bond between starch and protein.

  9. The retromer complex and clathrin define an early endosomal retrograde exit site.

    PubMed

    Popoff, Vincent; Mardones, Gonzalo A; Tenza, Danièle; Rojas, Raúl; Lamaze, Christophe; Bonifacino, Juan S; Raposo, Graça; Johannes, Ludger

    2007-06-15

    Previous studies have indicated a role for clathrin, the clathrin adaptors AP1 and epsinR, and the retromer complex in retrograde sorting from early/recycling endosomes to the trans Golgi network (TGN). However, it has remained unclear whether these protein machineries function on the same or parallel pathways. We show here that clathrin and the retromer subunit Vps26 colocalize at the ultrastructural level on early/recycling endosomes containing Shiga toxin B-subunit, a well-studied retrograde transport cargo. As previously described for clathrin, we find that interfering with Vps26 expression inhibits retrograde transport of the Shiga toxin B-subunit to the TGN. Under these conditions, endosomal tubules that take the Shiga toxin B-subunit out of transferrin-containing early/recycling endosomes appear to be stabilized. This situation differs from that previously described for low-temperature incubation and clathrin-depletion conditions under which Shiga toxin B-subunit labeling was found to overlap with that of the transferrin receptor. In addition, we find that the Shiga toxin B-subunit and the transferrin receptor accumulate close to multivesicular endosomes in clathrin-depleted cells, suggesting that clathrin initiates retrograde sorting on vacuolar early endosomes, and that retromer is then required to process retrograde tubules. Our findings thus establish a role for the retromer complex in retrograde transport of the B-subunit of Shiga toxin, and strongly suggest that clathrin and retromer function in consecutive retrograde sorting steps on early endosomes.

  10. Is retrograde drilling really useful for osteochondral lesion of talus with subchondral cyst?: A case report.

    PubMed

    Jeong, Seong-Yup; Kim, Jong-Kil; Lee, Kwang-Bok

    2016-12-01

    Retrograde drilling is a well accepted procedure for osteochondral lesion of the talus and subchondral cyst with intact overlying cartilage. It has good results in most reports. Compared to anterograde drilling, retrograde drilling can protect the integrity of the articular cartilage. The purpose of this study was to evaluate the suitability of using retrograde drilling for osteochondral lesion with subchondral cyst and discuss the mechanism involved in the development of subchondral cyst. We report a 53-year-old man who had complained left ankle pain that lasted over 6 months which was exacerbated by walking. We diagnosed it as osteochondral lesion of the talus with subchondral cyst. Plain X-ray, computed tomography, and magnetic resonance imaging (MRI) of the ankle. He undertook retrograde drilling without debridement of cartilage. After the surgery, the pain had been subsided for 1 year, although arthritic change had progressed. However, after 5 years of retrograde drilling, he revisited our hospital due to severe ankle pain. Plain X-ray and MRI showed arthritic change of the ankle and multiple cystic formation of talus. Retrograde drilling has some problem because this procedure is not theoretically correct when the development of a subchondral cyst in osteochondral lesion of the talus is considered. In addition, retrograde drilling may impair uninjured bone marrow of the talus, resulting in the development of multiple cystic formations.

  11. The Yeast Retrograde Response as a Model of Intracellular Signaling of Mitochondrial Dysfunction

    PubMed Central

    Jazwinski, S. Michal; Kriete, Andres

    2012-01-01

    Mitochondrial dysfunction activates intracellular signaling pathways that impact yeast longevity, and the best known of these pathways is the retrograde response. More recently, similar responses have been discerned in other systems, from invertebrates to human cells. However, the identity of the signal transducers is either unknown or apparently diverse, contrasting with the well-established signaling module of the yeast retrograde response. On the other hand, it has become equally clear that several other pathways and processes interact with the retrograde response, embedding it in a network responsive to a variety of cellular states. An examination of this network supports the notion that the master regulator NFκB aggregated a variety of mitochondria-related cellular responses at some point in evolution and has become the retrograde transcription factor. This has significant consequences for how we view some of the deficits associated with aging, such as inflammation. The support for NFκB as the retrograde response transcription factor is not only based on functional analyses. It is bolstered by the fact that NFκB can regulate Myc–Max, which is activated in human cells with dysfunctional mitochondria and impacts cellular metabolism. Myc–Max is homologous to the yeast retrograde response transcription factor Rtg1–Rtg3. Further research will be needed to disentangle the pro-aging from the anti-aging effects of NFκB. Interestingly, this is also a challenge for the complete understanding of the yeast retrograde response. PMID:22629248

  12. Diagnosis of Acute Appendicitis by Endoscopic Retrograde Appendicitis Therapy (ERAT): Combination of Colonoscopy and Endoscopic Retrograde Appendicography.

    PubMed

    Li, Yingchao; Mi, Chen; Li, Weizhi; She, Junjun

    2016-11-01

    Acute appendicitis is the most common abdominal emergency, but the diagnosis of appendicitis remains a challenge. Endoscopic retrograde appendicitis therapy (ERAT) is a new and minimally invasive procedure for the diagnosis and treatment of acute appendicitis. To investigate the diagnostic value of ERAT for acute appendicitis by the combination of colonoscopy and endoscopic retrograde appendicography (ERA). Twenty-one patients with the diagnosis of suspected uncomplicated acute appendicitis who underwent ERAT between November 2014 and January 2015 were included in this study. The main outcomes, imaging findings of acute appendicitis including colonoscopic direct-vision imaging and fluoroscopic ERA imaging, were retrospectively reviewed. Secondary outcomes included mean operative time, mean hospital stay, rate of complication, rate of appendectomy during follow-up period, and other clinical data. The diagnosis of acute appendicitis was established in 20 patients by positive ERA (5 patients) or colonoscopy (1 patient) alone or both (14 patients). The main colonoscopic imaging findings included mucosal inflammation (15/20, 75 %), appendicoliths (14/20, 70 %), and maturation (5/20, 25 %). The key points of ERA for diagnosing acute appendicitis included radiographic changes of appendix (17/20, 85 %), intraluminal appendicoliths (14/20, 70 %), and perforation (1/20, 5 %). Mean operative time of ERAT was 49.7 min, and mean hospital stay was 3.3 days. No patient converted to emergency appendectomy. Perforation occurred in one patient after appendicoliths removal was not severe and did not require invasive procedures. During at least 1-year follow-up period, only one patient underwent laparoscopic appendectomy. ERAT is a valuable procedure of choice providing a precise yield of diagnostic information for patients with suspected acute appendicitis by combination of colonoscopy and ERA.

  13. RAB-6.1 and RAB-6.2 Promote Retrograde Transport in C. elegans

    PubMed Central

    Zhang, Donglei; Dubey, Jyoti; Koushika, Sandhya P.; Rongo, Christopher

    2016-01-01

    Retrograde transport is a critical mechanism for recycling certain membrane cargo. Following endocytosis from the plasma membrane, retrograde cargo is moved from early endosomes to Golgi followed by transport (recycling) back to the plasma membrane. The complete molecular and cellular mechanisms of retrograde transport remain unclear. The small GTPase RAB-6.2 mediates the retrograde recycling of the AMPA-type glutamate receptor (AMPAR) subunit GLR-1 in C. elegans neurons. Here we show that RAB-6.2 and a close paralog, RAB-6.1, together regulate retrograde transport in both neurons and non-neuronal tissue. Mutants for rab-6.1 or rab-6.2 fail to recycle GLR-1 receptors, resulting in GLR-1 turnover and behavioral defects indicative of diminished GLR-1 function. Loss of both rab-6.1 and rab-6.2 results in an additive effect on GLR-1 retrograde recycling, indicating that these two C. elegans Rab6 isoforms have overlapping functions. MIG-14 (Wntless) protein, which undergoes retrograde recycling, undergoes a similar degradation in intestinal epithelia in both rab-6.1 and rab-6.2 mutants, suggesting a broader role for these proteins in retrograde transport. Surprisingly, MIG-14 is localized to separate, spatially segregated endosomal compartments in rab-6.1 mutants compared to rab-6.2 mutants. Our results indicate that RAB-6.1 and RAB-6.2 have partially redundant functions in overall retrograde transport, but also have their own unique cellular- and subcellular functions. PMID:26891225

  14. RAB-6.1 and RAB-6.2 Promote Retrograde Transport in C. elegans.

    PubMed

    Zhang, Donglei; Dubey, Jyoti; Koushika, Sandhya P; Rongo, Christopher

    2016-01-01

    Retrograde transport is a critical mechanism for recycling certain membrane cargo. Following endocytosis from the plasma membrane, retrograde cargo is moved from early endosomes to Golgi followed by transport (recycling) back to the plasma membrane. The complete molecular and cellular mechanisms of retrograde transport remain unclear. The small GTPase RAB-6.2 mediates the retrograde recycling of the AMPA-type glutamate receptor (AMPAR) subunit GLR-1 in C. elegans neurons. Here we show that RAB-6.2 and a close paralog, RAB-6.1, together regulate retrograde transport in both neurons and non-neuronal tissue. Mutants for rab-6.1 or rab-6.2 fail to recycle GLR-1 receptors, resulting in GLR-1 turnover and behavioral defects indicative of diminished GLR-1 function. Loss of both rab-6.1 and rab-6.2 results in an additive effect on GLR-1 retrograde recycling, indicating that these two C. elegans Rab6 isoforms have overlapping functions. MIG-14 (Wntless) protein, which undergoes retrograde recycling, undergoes a similar degradation in intestinal epithelia in both rab-6.1 and rab-6.2 mutants, suggesting a broader role for these proteins in retrograde transport. Surprisingly, MIG-14 is localized to separate, spatially segregated endosomal compartments in rab-6.1 mutants compared to rab-6.2 mutants. Our results indicate that RAB-6.1 and RAB-6.2 have partially redundant functions in overall retrograde transport, but also have their own unique cellular- and subcellular functions.

  15. Coronary perforation with tamponade successfully managed by retrograde and antegrade coil embolization.

    PubMed

    Boukhris, Marouane; Tomasello, Salvatore Davide; Azzarelli, Salvatore; Elhadj, Zied Ibn; Marzà, Francesco; Galassi, Alfredo Ruggero

    2015-07-01

    In recent years, retrograde approach for chronic total occlusions has rapidly evolved, enabling a higher rate of revascularization success. Compared to septal channels, epicardial collaterals tend to be more tortuous, more difficult to negotiate, and more prone to rupture. Coronary perforation is a rare but potentially life-threatening complication of coronary angioplasty, often leading to emergency cardiac surgery. We report a case of a retrograde chronic total occlusion revascularization through epicardial collaterals, complicated by both retrograde and antegrade coronary perforation with tamponade, and successfully managed by coil embolization.

  16. TCTEX1D2 mutations underlie Jeune asphyxiating thoracic dystrophy with impaired retrograde intraflagellar transport

    PubMed Central

    Schmidts, Miriam; Hou, Yuqing; Cortés, Claudio R.; Mans, Dorus A.; Huber, Celine; Boldt, Karsten; Patel, Mitali; van Reeuwijk, Jeroen; Plaza, Jean-Marc; van Beersum, Sylvia E. C.; Yap, Zhi Min; Letteboer, Stef J. F.; Taylor, S. Paige; Herridge, Warren; Johnson, Colin A.; Scambler, Peter J.; Ueffing, Marius; Kayserili, Hulya; Krakow, Deborah; King, Stephen M.; Beales, Philip L.; Al-Gazali, Lihadh; Wicking, Carol; Cormier-Daire, Valerie; Roepman, Ronald; Mitchison, Hannah M.; Witman, George B.; Al-Turki, Saeed; Anderson, Carl; Anney, Richard; Antony, Dinu; Asimit, Jennifer; Ayub, Mohammad; Barrett, Jeff; Barroso, Inês; Bentham, Jamie; Bhattacharya, Shoumo; Blackwood, Douglas; Bobrow, Martin; Bochukova, Elena; Bolton, Patrick; Boustred, Chris; Breen, Gerome; Brion, Marie-Jo; Brown, Andrew; Calissano, Mattia; Carss, Keren; Chatterjee, Krishna; Chen, Lu; Cirak, Sebhattin; Clapham, Peter; Clement, Gail; Coates, Guy; Collier, David; Cosgrove, Catherine; Cox, Tony; Craddock, Nick; Crooks, Lucy; Curran, Sarah; Daly, Allan; Danecek, Petr; Smith, George Davey; Day-Williams, Aaron; Day, Ian; Durbin, Richard; Edkins, Sarah; Ellis, Peter; Evans, David; Farooqi, I. Sadaf; Fatemifar, Ghazaleh; Fitzpatrick, David; Flicek, Paul; Floyd, Jamie; Foley, A. Reghan; Franklin, Chris; Futema, Marta; Gallagher, Louise; Gaunt, Tom; Geschwind, Daniel; Greenwood, Celia; Grozeva, Detelina; Guo, Xiaosen; Gurling, Hugh; Hart, Deborah; Hendricks, Audrey; Holmans, Peter; Huang, Jie; Humphries, Steve E.; Hurles, Matt; Hysi, Pirro; Jackson, David; Jamshidi, Yalda; Jewell, David; Chris, Joyce; Kaye, Jane; Keane, Thomas; Kemp, John; Kennedy, Karen; Kent, Alastair; Kolb-Kokocinski, Anja; Lachance, Genevieve; Langford, Cordelia; Lee, Irene; Li, Rui; Li, Yingrui; Ryan, Liu; Lönnqvist, Jouko; Lopes, Margarida; MacArthur, Daniel G.; Massimo, Mangino; Marchini, Jonathan; Maslen, John; McCarthy, Shane; McGuffin, Peter; McIntosh, Andrew; McKechanie, Andrew; McQuillin, Andrew; Memari, Yasin; Metrustry, Sarah; Min, Josine; Moayyeri, Alireza; Morris, James; Muddyman, Dawn; Muntoni, Francesco; Northstone, Kate; O'Donovan, Michael; O'Rahilly, Stephen; Onoufriadis, Alexandros; Oualkacha, Karim; Owen, Michael; Palotie, Aarno; Panoutsopoulou, Kalliope; Parker, Victoria; Parr, Jeremy; Paternoster, Lavinia; Paunio, Tiina; Payne, Felicity; Perry, John; Pietilainen, Olli; Plagnol, Vincent; Quail, Michael A.; Quaye, Lydia; Raymond, Lucy; Rehnström, Karola; Brent Richards, J.; Ring, Sue; Ritchie, Graham R S; Savage, David B.; Schoenmakers, Nadia; Semple, Robert K.; Serra, Eva; Shihab, Hashem; Shin, So-Youn; Skuse, David; Small, Kerrin; Smee, Carol; Soler, Artigas María; Soranzo, Nicole; Southam, Lorraine; Spector, Tim; St Pourcain, Beate; St. Clair, David; Stalker, Jim; Surdulescu, Gabriela; Suvisaari, Jaana; Tachmazidou, Ioanna; Tian, Jing; Timpson, Nic; Tobin, Martin; Valdes, Ana; van Kogelenberg, Margriet; Vijayarangakannan, Parthiban; Wain, Louise; Walter, Klaudia; Wang, Jun; Ward, Kirsten; Wheeler, Ellie; Whittall, Ros; Williams, Hywel; Williamson, Kathy; Wilson, Scott G.; Wong, Kim; Whyte, Tamieka; ChangJiang, Xu; Zeggini, Eleftheria; Zhang, Feng; Zheng, Hou-Feng

    2015-01-01

    The analysis of individuals with ciliary chondrodysplasias can shed light on sensitive mechanisms controlling ciliogenesis and cell signalling that are essential to embryonic development and survival. Here we identify TCTEX1D2 mutations causing Jeune asphyxiating thoracic dystrophy with partially penetrant inheritance. Loss of TCTEX1D2 impairs retrograde intraflagellar transport (IFT) in humans and the protist Chlamydomonas, accompanied by destabilization of the retrograde IFT dynein motor. We thus define TCTEX1D2 as an integral component of the evolutionarily conserved retrograde IFT machinery. In complex with several IFT dynein light chains, it is required for correct vertebrate skeletal formation but may be functionally redundant under certain conditions. PMID:26044572

  17. Independent predictors of retrograde failure in CTO-PCI after successful collateral channel crossing.

    PubMed

    Suzuki, Yoriyasu; Muto, Makoto; Yamane, Masahisa; Muramatsu, Toshiya; Okamura, Atsunori; Igarashi, Yasumi; Fujita, Tsutomu; Nakamura, Shigeru; Oida, Akitsugu; Tsuchikane, Etsuo

    2017-07-01

    To evaluate factors for predicting retrograde CTO-PCI failure after successful collateral channel crossing. Successful guidewire/catheter collateral channel crossing is important for the retrograde approach in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). A total of 5984 CTO-PCI procedures performed in 45 centers in Japan from 2009 to 2012 were studied. The retrograde approach was used in 1656 CTO-PCIs (27.7%). We investigated these retrograde procedures to evaluate factors for predicting retrograde CTO-PCI failure even after successful collateral channel crossing. Successful guidewire/catheter collateral crossing was achieved in 77.1% (n = 1,276) of 1656 retrograde CTO-PCI procedures. Retrograde procedural success after successful collateral crossing was achieved in 89.4% (n = 1,141). Univariate analysis showed that the predictors for retrograde CTO-PCI failure were in-stent occlusion (OR = 1.9829, 95%CI = 1.1783 - 3.3370 P = 0.0088), calcified lesions (OR = 1.9233, 95%CI = 1.2463 - 2.9679, P = 0.0027), and lesion tortuosity (OR = 1.5244, 95%CI = 1.0618 - 2.1883, P = 0.0216). On multivariate analysis, lesion calcification was an independent predictor of retrograde CTO-PCI failure after successful collateral channel crossing (OR = 1.3472, 95%CI = 1.0614 - 1.7169, P = 0.0141). The success rate of retrograde CTO-PCI following successful guidewire/catheter collateral channel crossing was high in this registry. Lesion calcification was an independent predictor of retrograde CTO-PCI failure after successful collateral channel crossing. Devices and techniques to overcome complex CTO lesion morphology, such as lesion calcification, are required to further improve the retrograde CTO-PCI success rate. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Materials for retrograde filling in root canal therapy.

    PubMed

    Ma, Xiangyu; Li, Chunjie; Jia, Liuhe; Wang, Yan; Liu, Wenwen; Zhou, Xuedong; Johnson, Trevor M; Huang, Dingming

    2016-12-17

    Root canal therapy is a sequence of treatments involving root canal cleaning, shaping, decontamination and obturation. It is conventionally performed through a hole drilled into the crown of the affected tooth, namely orthograde root canal therapy. For teeth that cannot be treated with orthograde root canal therapy, or for which it has failed, retrograde root filling, which seals the root canal from the root apex, is a good alternative. Many materials, such as amalgam, zinc oxide eugenol and mineral trioxide aggregate (MTA), are generally used. Since none meets all the criteria an ideal material should possess, selecting the most efficacious material is of utmost importance. To determine the effects of different materials used for retrograde filling in children and adults for whom retrograde filling is necessary in order to save the tooth. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 13 September 2016); the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8) in the Cochrane Library (searched 13 September 2016); MEDLINE Ovid (1946 to 13 September 2016); Embase Ovid (1980 to 13 September 2016); LILACS BIREME Virtual Health Library (1982 to 13 September 2016); and OpenSIGLE (1980 to 2005). ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. We also searched Chinese BioMedical Literature Database (in Chinese, 1978 to 20 September 2016); VIP (in Chinese, 1989 to 20 September 2016); China National Knowledge Infrastructure (in Chinese, 1994 to 20 September 2016); and Sciencepaper Online (in Chinese, to 20 September 2016). No restrictions were placed on the language or date of publication when searching the electronic databases. We selected randomised controlled trials (RCTs) only that compared different retrograde filling materials, with reported success rate that was assessed by clinical or

  19. Different roles of TiR8/Sigirr on toll-like receptor signaling in intrarenal antigen-presenting cells and tubular epithelial cells.

    PubMed

    Lech, M; Garlanda, C; Mantovani, A; Kirschning, C J; Schlöndorff, D; Anders, H-J

    2007-07-01

    Toll-like receptors (TLRs) exist on both myeloid and intrinsic renal cells contributing to the initiation of innate immunity during renal infection with uropathogenic Escherichia coli. Toll-interleukin 1 receptor (IL-1R) (TIR)8/SIGIRR is an orphan receptor of the TLR/IL-1R family, which suppresses TLR signaling of immune cells and is highly expressed in the kidney. Lack of TIR8/SIGIRR is associated with enhanced renal chemokine signaling upon exposure to lipopolysaccharide (LPS). This was because of TIR8/SIGIRR expression on resident intrarenal myeloid cells rather than tubular epithelial cells which express it on basolateral and luminal membranes. The lack of TIR8/SIGIRR does not enhance TLR/IL-1R signaling in tubular epithelial cells as was observed in monocytes. TIR8/SIGIRR is induced in monocytes treated with LPS or tumor necrosis factor and interferon-gamma in a dose-dependent manner but was downregulated in treated tubule epithelial cells. This cell type-specific regulation and function did not relate to mRNA splice variants but was associated with N- and O-glycosylation of the receptor in renal cells of myeloid and nonmyeloid origin. Our studies show that resident myeloid cells contribute to TLR-mediated antimicrobial immunity in the kidney and that this function is controlled by Tir8/sigirr. TIR8/SIGIRR does not suppress TLR signaling in tubular epithelial cells, which supports their role as sensors of microbial infection in the kidney.

  20. A Narrow QRS Complex Tachycardia With An Apparently Concentric Retrograde Atrial Activation Sequence

    PubMed Central

    Arias, Miguel A; Castellanos, Eduardo; Puchol, Alberto; Pachon, Marta

    2009-01-01

    The retrograde atrial activation sequence constitutes an initial important clue to elucidate the tachycardia mechanism during diagnostic electrophysiological testing in patients with supraventricular tachycardia. However, in some cases its correct analysis is challenging. PMID:19308284

  1. A photographic approach to the possible mechanism of retrogradation of sweet potato starch.

    PubMed

    Lian, Xijun; Zhao, Shuyi; Liu, Qinsheng; Zhang, Xu

    2011-01-01

    Although the subject of starch retrogradation has been studied for about 20 years, the mechanism of starch retrogradation seems not yet to be completely established. In this paper, the possible retrogradation mechanism of sweet potato starch was postulated from four optical micrographs at the stages of melting of the starch granules, autoclaving treatment and aging. The possible process of retrogradation consists of three stages. Firstly, starch granules was swelled and melted with loss of X-ray crystallinity and formation of both crystalline and amorphous lamellae; secondly, in crystalline lamellae, amylopectin began to form nucleation when they were autoclaved; finally, the nucleus grew up to great rod-like crystals as the result of congregating of amylose on plates which were composed of and prolongated by amylopectin.

  2. Fiberoptic Guided Retrograde Intubation in an Anticipated Difficult Airway: Revival of an Antiquated Technique

    PubMed Central

    Ninu, Marie; Yunus, Md.; Syiemiong, Newstar

    2016-01-01

    Retrograde intubation is an invaluable technique which can be helpful in anticipated difficult airway situation. In this advanced era where fiberoptic intubation and video laryngoscopes are in abundant use, retrograde intubation is a forgotten technique. However, it may be useful in various difficult airway situations in this advanced era. In our case the patient had a bitter experience with previous fiberoptic intubation. Owing to that we had planned and performed a fiber optic guided retrograde intubation, where we had kept the fiberoptic bronchoscope in the pharynx keeping larynx and vocal cords in the focus to facilitate the emergence of guide wire through one of the nostrils as well as direct visual confirmation of intubation. This fiber optic guided retrograde intubation is a first reported case of its kind in a predicted difficult airway which can be beneficial in different difficult airway situations. PMID:27891428

  3. Retrograde left ventricular catheterization in patients with an aortic valve prosthesis.

    PubMed

    Karsh, D L; Michaelson, S P; Langou, R A; Cohen, L S; Wolfson, S

    1978-05-01

    Twenty-seven consecutive patients with an aortic valve prosthesis were evaluated with retrograde left ventricular catheterization. The prosthesis was successfully crossed, permitting hemodynamic and angiographic evaluation of function of the prosthetic valve, left ventricle and mitral valve in all 27 cases. No complications were encountered. In patients with active endocarditis or recent embolization, the retrograde technique was avoided when possible, and attempts were made to utilize other techniques for study. However, three such patients were evaluated with the retrograde technique without complication. Examination of pressure tracings and cineangiographic films suggested only minor interference with valve poppet movement induced by the catheter transversing the valve. In three cases, hemodynamic data were recorded with the catheter crossing the prosthesis at one time and a paraprosthetic valve defect at another time. Identical gradients were recorded. This series documents the safety and efficacy of the retrograde approach, which is proposed as an alternative to the transseptal technique and left ventricular puncture.

  4. Reducing retrogradation and lipid oxidation of normal and glutinous rice flours by adding mango peel powder.

    PubMed

    Siriamornpun, Sirithon; Tangkhawanit, Ekkarat; Kaewseejan, Niwat

    2016-06-15

    Green and ripe mango peel powders (MPP) were added to normal rice flour (NRF) and glutinous rice flour (GRF) at three levels (400, 800 and 1200 ppm) and their effects on physicochemical properties and lipid oxidation inhibition were investigated. Overall, MPP increased the breakdown viscosity and reduced the final viscosity in rice flours when compared to the control. Decreasing in retrogradation was observed in both NRF and GRF with MPP added of all levels. MPP addition also significantly inhibited the lipid oxidation of all flours during storage (30 days). Retrogradation values were strongly negatively correlated with total phenolic and flavonoid contents, but not with fiber content. The hydrogen bonds and hydrophilic interactions between phenolic compounds with amylopectin molecule may be involved the decrease of starch retrogradation, especially GRF. We suggest that the addition of MPP not only reduced the retrogradation but also inhibited the lipid oxidation of rice flour.

  5. Analysis of human ejaculation using color Doppler ultrasonography: a comparison between antegrade and retrograde ejaculation.

    PubMed

    Nagai, Atsushi; Watanabe, Masami; Nasu, Yasutomo; Iguchi, Hiroki; Kusumi, Norihiro; Kumon, Hiromi

    2005-02-01

    To observe the phenomenon of human ejaculation dynamically using color Doppler ultrasonography. Human ejaculation was observed using transrectal color Doppler ultrasonography in a healthy man and a patient with retrograde ejaculation. Ejaculation was induced manually with audiovisual sexual stimulation. The ejaculatory phenomenon was analyzed and compared with that of retrograde ejaculation. In the healthy man, the prostatic urethra flattened slightly and the bladder neck contracted just before expulsion. The ejaculatory stream spurted from the seminal vesicles to the bulbous urethra through the ejaculatory duct. In the patient with retrograde ejaculation, the ejaculatory stream from the seminal vesicles and inframontanal and distal prostatic urethras distended into a globular-shaped sac filled with semen. No seminal flow toward the bulbous urethra occurred. The semen remaining in the prostatic urethra began flowing slowly into the bladder. Differences between antegrade and retrograde ejaculation can be clearly detected by color Doppler ultrasonography, providing a noninvasive method to diagnose ejaculatory disorders.

  6. Fundamental studies of retrograde reactions in direct liquefaction. Topical report, September 30, 1988--September 30, 1989

    SciTech Connect

    Serio, M.A.; Solomon, P.R.; Bassilakis, R.; Kroo, E.

    1989-12-31

    Most of the proposed processing schemes for improving liquefaction yields involve favoring bond-breaking and radical stabilization reactions over the retrograde reactions. The retrograde reactions are often encountered before liquefaction temperatures are reached. The objective of this program is to elucidate and model the retrograde reaction chemistry in direct coal liquefaction through the application of experimental techniques and theoretical models which have been successfully employed at Advanced Fuel Research (AFR) and SRI International (a subcontractor) to understand and predict coal reaction behavior. The study of retrograde reactions is being done using an integrated approach using extensive characterization of the liquefaction chemistry of three kinds of systems: (1) model polymers; (2) coal; and (3) modified coals.

  7. Pancreatitis with an unusual fatal complication following endoscopic retrograde cholangiopancreaticography: a case report

    PubMed Central

    Kanen, Boris; Loffeld, Ruud JLF

    2008-01-01

    Introduction Endoscopic retrograde cholangiopancreaticography has been the treatment of choice for stones in the common bile duct. Although the procedure is usually safe, procedure-related complications do occur. Case presentation A case of pancreatitis following endoscopic retrograde cholangiopancreaticography is described in a 55-year-old woman. After an uneventful recovery the patient's condition deteriorated rapidly 16 days after the endoscopic retrograde cholangiopancreaticography, and the patient died within 1 hour. Post-mortem examination revealed massive intrapulmonary fat embolism. The complications of endoscopic retrograde cholangiopancreaticography and pancreatitis are described. Conclusion Fat embolism can occur after the remission of pancreatitis and pancreatic necrosis may be overlooked on contrast-enhanced computed tomography scanning. PMID:18577211

  8. Veiled right kidney sign in retroperitoneal duodenal perforation after endoscopic retrograde cholangiopancreatography.

    PubMed

    Banerji, John Samuel

    2011-08-01

    Retropneumoperitoneum due to duodenal perforation after endoscopic retrograde cholangiopancreatography is rare. Recognizing the presence of free air, which outlines the right kidney, is essential for its early diagnosis and appropriate management.

  9. Retrograde transport of toxins across the endoplasmic reticulum membrane.

    PubMed

    Lord, J M; Deeks, E; Marsden, C J; Moore, K; Pateman, C; Smith, D C; Spooner, R A; Watson, P; Roberts, L M

    2003-12-01

    Several protein toxins, including the A chain of the plant protein ricin (RTA), enter mammalian cells by endocytosis and catalytically modify cellular components to disrupt essential cellular processes. In the case of ricin, the process inhibited is protein synthesis. In order to reach their cytosolic substrates, several toxins undergo retrograde transport to the ER (endoplasmic reticulum) before translocating across the ER membrane. To achieve this export, these toxins exploit the ERAD (ER-associated protein degradation) pathway but must escape, at least in part, the normal degradative fate of ERAD substrates in order to intoxicate the cell. Toxins that translocate from the ER have an unusually low lysine content that reduces the likelihood of ubiquitination and ubiquitin-mediated proteasomal degradation. We have changed the two lysyl residues normally present in RTA to arginyl residues. Their replacement in RTA did not have a significant stabilizing effect on the protein, suggesting that the endogenous lysyl residues are not sites for ubiquitin attachment. However, when four additional lysyl residues were introduced into RTA in a way that did not compromise the activity, structure or stability of the toxin, degradation was significantly enhanced. Enhanced degradation resulted from ubiquitination that predisposed the toxin to proteasomal degradation. Treatment with the proteasomal inhibitor lactacystin increased the cytotoxicity of the lysine-enriched RTA to a level approaching that of wild-type RTA.

  10. Role of endoscopic retrograde cholangiopancreatography after orthotopic liver transplantation.

    PubMed Central

    O'Connor, H J; Vickers, C R; Buckels, J A; McMaster, P; Neuberger, J M; West, R J; Elias, E

    1991-01-01

    Twelve of 178 (7%) liver transplant patients underwent endoscopic retrograde cholangiopancreatography (ERCP) after transplantation. The indications for ERCP were persistent or late onset cholestasis, recurrent cholangitis, and suspected biliary leaks or strictures. The time between transplantation and ERCP ranged from 44 to 330 days (median 153 days). Biliary complications diagnosed by ERCP included biliary sludge in the form of casts, calculi, or debris (n = 7); bile leaks (n = 2); a biliary stricture (n = 1), and complete biliary obstruction (n = 1). One patient had a normal cholangiogram after transplantation. Biliary sludge was detected by ultrasound before ERCP in only one of six patients. Eight patients underwent endoscopic papillotomy, followed by clearance of biliary sludge in four and dilatation of a biliary stricture in one. Two patients bled after papillotomy but neither required surgical intervention. At a median follow up of 1.2 years (range 0.5-2.8 years), nine patients are well and three have died. ERCP provides both accurate diagnosis of biliary complications after liver transplantation and treatment that obviates the need for additional surgery in selected patients. Images Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 PMID:2026341

  11. Radiation exposure to personnel performing endoscopic retrograde cholangiopancreatography

    PubMed Central

    Naidu, L; Singhal, S; Preece, D; Vohrah, A; Loft, D

    2005-01-01

    Background: Endoscopic retrograde cholangiopancreatography (ERCP) relies on the use of ionising radiation but risks to operator and patient associated with radiation exposure are unclear. The aim of this prospective study was to estimate the radiation dose received by personnel performing fluoroscopic endoscopic procedures, mainly ERCP. Methods: Consecutive procedures over a two month period were included. The use of thermoluminescent dosimeters to measure radiation exposure to the abdomen, thyroid gland, and hands of the operator permitted an estimation of the annual whole body effective dose equivalent. Results: During the study period 66 procedures (61 ERCP) were performed and the estimated annual whole body effective dose equivalent received by consultant operators ranged between 3.35 and 5.87 mSv. These values are similar to those received by patients undergoing barium studies and equate to an estimated additional lifetime fatal cancer risk between 1 in 7000 and 1 in 3500. While within legal safety limits for radiation exposure to personnel, these doses are higher than values deemed acceptable for the general public. Conclusions: It is suggested that personnel as well as patients may be exposed to significant values of radiation during ERCP. The study emphasises the need to carefully assess the indication for, and to use measures that minimise radiation exposure during any fluoroscopic procedure. PMID:16210465

  12. Subcapsular hepatic haematoma after endoscopic retrograde cholangiopancreatography: an unusual case.

    PubMed

    Fei, Bao-Ying; Li, Cai-Hong

    2013-03-07

    Subcapsular hepatic haematoma is a rare complication of endoscopic retrograde cholangiopancreatography (ERCP), and there are few reports about this unusual complication worldwide. The primary symptom of most cases reported in the literature is abdominal pain. We report an unusual case with the primary symptom of fever. A 56-year-old man who had a six-month history of recurrent episodes of upper abdominal pain was diagnosed with a common bile duct stone by magnetic resonance cholangiopancreatography. Endoscopic biliary sphincterotomy was performed, and stones from the common bile duct were successfully extracted with a basket. The patient had a persistent fever after ERCP, and treatment with intravenous antibiotics was unsuccessful. Computed tomography showed a 13 cm × 6 cm subcapsular hepatic haematoma filled with air and liquid on the surface of the right hepatic lobe. The patient was successfully treated with peritoneal drainage under B-ultra guidance. Subcapsular liver haematoma should be considered when hard-to- explain symptoms persist in the early period after ERCP. Percutaneous drainage is an effective treatment.

  13. Early Results of Retrograde Transpopliteal Angioplasty of Iliofemoral Lesions

    SciTech Connect

    Saha, Saumitra; Gibson, Matthew; Magee, Timothy R.; Galland, Robert B.; Torrie, E. Peter H.

    2001-12-15

    Purpose: To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA).Methods: Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr post procedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks.Results: The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder.Stenoses (single or multiple) were present in 24 and occlusion in 15.The superficial femoral artery (SFA) was the commonest segment affected(36) followed by common femoral artery (CFA) in four and iliac artery in four. Technical success was achieved in 38 of 39 limbs where angioplasty was carried out. In one limb no lesion was found.Immediate complications were distal embolization in two and thrombosis in one. None of these required immediate surgery. There were no puncture site hematomas or popliteal arteriovenous fistulae.Symptomatic patency at 6 weeks was 85%. Further reconstructive surgery was required in three limbs and amputation in two.Conclusion: The transpopliteal approach has a high technical success rate and a low complication rate with a potential to develop into an outpatient procedure. It should be considered for flush SFA occulsions or iliac disease with tandem CFA/SFA disease where the contralateral femoral approach is often technically difficult.

  14. Retrograde dacryocystography (RDC) utilizing a round-tipped needle.

    PubMed

    Kosaka, Masaaki; Kamiishi, Hiroshi

    2001-09-01

    Because the application of conventional anterograde dacryocystography has been restricted in cases with an intact lacrimal punctum, the indications are rather limited. The authors developed a new method for retrograde dacryocystography (RDC) using a hand-made round-tipped needle inserted directly into the orifice of the nasolacrimal duct. A 60 mm long aluminum tube (3 mm in diameter) was used to prepare the round-tipped needle. The distal portion of the tube was bent to an angle of about 80 degrees. The tip was then coated with synthetic resin adhesive to make it round. Following the insertion of the round-tipped needle directly into the inferior meatus, the tip was moved back and forth to find the orifice without visual observation. The complete insertion of the tip of the needle into the nasolacrimal duct was recognized by a fixed sensation of the tip. Contrast medium was then injected, and PA radiography was carried out. In the present paper, the authors report the usefulness of RDC, which is applicable even in cases of injury or obstruction in the upper lacrimal system. In 16 of 20 patients, the quality of the RDC images was judged as excellent. RDC can be carried out within a few seconds after acquiring the technical skills, and is thought to be a useful method, especially in cases of upper lacrimal injury.

  15. Management of endoscopic retrograde cholangiopancreatography-related perforations

    PubMed Central

    Kim, Byung Seup; Kim, In-Gyu; Ryu, Byoung Yoon; Kim, Jong Hyeok; Yoo, Kyo Sang; Baik, Gwang Ho; Kim, Jin Bong

    2011-01-01

    Purpose The purpose of this study is to analyze the treatment strategies of patients with endoscopic retrograde cholangiopancreatography (ERCP)-related perforations. This is a retrospective study. Methods We experienced 13 perforations associated with ERCP. We reviewed the medical recordsand classified ERCP-related perforations according to mechanism of injury in terms of perforating device. Injury by endoscopic tip or insertion tube was classified as type I, injury by cannulation catheter or sphincterotomy knife as type II, and injury by guidewire as type III. Results Of four type I injuries, one case was managed by conservative management after primary closure with a hemoclip during ERCP. The other three patients underwent surgical treatments such as primary closure orpancreatico-duodenectomy. Of five type II injuries, two patients underwent conservative management and the other three cases were managed by surgical treatment such as duodenojejunostomy, duodenal diverticulization and pancreatico-duodenectomy. Of four type III injuries, three patients were managed conservatively and the remaining patient was managed by T-tube choledochostomy. Conclusion Type I injuries require immediate surgical management after EPCP or immediate endoscopic closure during ERCP whenever possible. Type II injuries require surgical or conservative treatment according to intra- and retro-peritoneal dirty fluid collection findings following radiologic evaluation. Type III injuries almost always improve after conservative treatment with endoscopic nasobilliary drainage. PMID:22066121

  16. [Knowing an infrequent complication of endoscopic retrograde cholangiopancreatography].

    PubMed

    Barreda Cevasco, Luis; Targarona Modena, Javier; Marcos Enriquez, Juan Carlos; Arroyo Basto, Carlos; Morón, Elizabeth

    2017-01-01

    Describe the clinical and tomographic characteristics in relation to the extra peritoneal distribution of collections and air in patients with periampullary perforation after performing endoscopic retrograde cholangiopancreatography (ERCP) with or without sphincterotomy. Observational, descriptive study in patients with periampullary perforation after ERCP with or without sphincterotomy, treated in the Pancreas Surgery Service at Edgardo Rebagliati Martins Hospital, Lima, Peru between January 2013 and January 2015. Ten patients with periampullary perforation after ERCP were included. 40% were male. The mean age was 47.2 years. 100% showed abdominal pain, fever 70%, 60% had jaundice, oral intolerance and vomiting. In 100% of cases the description of the procedure was for choledocolithiasis. Difficult cannulation is described in 80% of cases. Air or fluid was found in 90% in the right anterior pararenal space and the right perirenal, and the place where air or liquid is distributed less frequently was right extraperitoneal pelvis with 20%, in no caserevealed air in the mediastinum. The finding of a liquid collection and / or air in the retroperitoneal space right after ERCP without further involvement of the pancreatic gland should make us think of periampullary perforation, especially if you are in the right anterior pararenal space and perirenal space. This entity we call bilioretroperitoneo.

  17. Failed Ventriculoperitoneal Shunt: Is Retrograde Ventriculosinus Shunt a Reliable Option?

    PubMed

    Oliveira, Matheus Fernandes de; Teixeira, Manoel Jacobsen; Reis, Rodolfo Casimiro; Petitto, Carlo Emanuel; Gomes Pinto, Fernando Campos

    2016-08-01

    Currently, the treatment of hydrocephalus is mainly carried out through a ventriculoperitoneal shunt (VPS) insertion. However, in some cases, there may be surgical revisions and requirement of an alternative distal site for shunting. There are several described distal sites, and secondary options after VPS include ventriculopleural and ventriculoatrial shunt, which have technical difficulties and harmful complications. In this preliminary report we describe our initial experience with retrograde ventriculosinus shunt (RVSS) after failed VPS. In 3 consecutive cases we applied RVSS to treat hydrocephalus in shunt-dependent patients who had previously undergone VPS revision and in which peritoneal space was full of adhesions and fibrosis. RVSS was performed as described by Shafei et al., with some modifications to each case. All 3 patients kept the same clinical profile after RVSS, with no perioperative or postoperative complications. However, revision surgery was performed in the first operative day in 1 out of 3 patients, in which the catheter was not positioned in the superior sagittal sinus. We propose that in cases where VPS is not feasible, RVSS may be a safe and applicable second option. Nevertheless, the long-term follow-up of patients and further learning curve must bring stronger evidence. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Statistical mechanical description of supercritical fluid extraction and retrograde condensation

    NASA Astrophysics Data System (ADS)

    Park, S. J.; Kwak, T. Y.; Mansoori, G. A.

    1987-07-01

    The phenomena of supercritical fluid extraction (SFE) and its reverse effect, which is known as retrograde condensation (RC), have found new and important applications in industrial separation of chemical compounds and recovery and processing of natural products and fossil fuels. Full-scale industrial utilization of SFE/RC processes requires knowledge about thermodynamic and transport characteristics of the asymmetric mixtures involved and the development of predictive modeling and correlation techniques for performance of the SFE/RC system under consideration. In this report, through the application of statistical mechanical techniques, the reasons for the lack of accuracy of existing predictive approaches are described and they are improved. It is demonstrated that these techniques also allow us to study the effect of mixed supercritical solvents on the solubility of heavy solutes (solids) at different compositions of the solvents, pressures, and temperatures. Fluid phase equilibrium algorithms based on the conformal solution van der Waals mixing rules and different equations of state are presented for the prediction of solubilities of heavy liquid in supercritical gases. It is shown that the Peng-Robinson equation of state based on conformal solution theory can predict solubilites of heavy liquid in supercritical gases more accurately than the van der Waals and Redlich-Kwong equations of state.

  19. Characterization of the human GARP (Golgi associated retrograde protein) complex

    SciTech Connect

    Liewen, Heike; Meinhold-Heerlein, Ivo; Oliveira, Vasco; Schwarzenbacher, Robert; Luo Guorong; Wadle, Andreas; Jung, Martin; Pfreundschuh, Michael; Stenner-Liewen, Frank . E-mail: stenlie@t-online.de

    2005-05-15

    The Golgi associated retrograde protein complex (GARP) or Vps fifty-three (VFT) complex is part of cellular inter-compartmental transport systems. Here we report the identification of the VFT tethering factor complex and its interactions in mammalian cells. Subcellular fractionation shows that human Vps proteins are found in the smooth membrane/Golgi fraction but not in the cytosol. Immunostaining of human Vps proteins displays a vesicular distribution most concentrated at the perinuclear envelope. Co-staining experiments with endosomal markers imply an endosomal origin of these vesicles. Significant accumulation of VFT complex positive endosomes is found in the vicinity of the Trans Golgi Network area. This is in accordance with a putative role in Golgi associated transport processes. In Saccharomyces cerevisiae, GARP is the main effector of the small GTPase Ypt6p and interacts with the SNARE Tlg1p to facilitate membrane fusion. Accordingly, the human homologue of Ypt6p, Rab6, specifically binds hVps52. In human cells, the 'orphan' SNARE Syntaxin 10 is the genuine binding partner of GARP mediated by hVps52. This reveals a previously unknown function of human Syntaxin 10 in membrane docking and fusion events at the Golgi. Taken together, GARP shows significant conservation between various species but diversification and specialization result in important differences in human cells.

  20. Retrograde angiography and the risk of arteriovenous fistula perforation.

    PubMed

    Salman, Loay; Asif, Arif; Beathard, Gerald A

    2009-01-01

    Assessment of the inflow segment of an arteriovenous fistula is mandatory for optimum access evaluation. Retrograde angiography (RA) is routinely used to image this region of the access system. Traditionally, RA is performed by manually occluding the outflow track of an arteriovenous fistula (AVF) and forcing the radiocontrast into the inflow segment against arterial pressure. While this technique is largely successful in visualizing the juxta-anastomotic region, anastomosis and a portion of the feeding artery, the approach carries a potential risk of vascular rupture between the occluded portion of the fistula and the anastomosis. This article presents six cases of fistulas that suffered vascular rupture during RA. In three cases, vascular damage occurred prior to the application of angioplasty. The remaining cases suffered perforation after angioplasty. Balloon tamponade was successful in salvaging two fistulas. Another AVF with a perforation did not require any intervention to maintain flow. The complication was successfully managed in one AVF by the insertion of an endovascular stent graft. Two fistulas were lost due to vascular damage. This report demonstrates that RA performed by occluding the outflow track of an AVF to assess the results of angioplasty of an inflow stenosis can result in vascular rupture. There is a risk of such adversity even before the application of angioplasty in this region. It is suggested that the first of these be avoided and the latter be done with care.

  1. Retrograde guidewire fracture complicated with pericardial tamponade in chronic total occlusive coronary lesion.

    PubMed

    Park, Sang-Ho; Rha, Seung-Woon; Her, Keun

    2015-10-01

    Along with various coronary devices progress, there is a now growing trend to percutaneous coronary intervention for chronic total occlusion (CTO). However, the risk of guidewire fracture rate might be increased in complex lesion such as tortuous, calcific lesion or retrograde route. We report a case of successful surgical removal of fractured and entrapped guidewire in a septal channel during retrograde CTO intervention in a patient complicated with pericardial tamponade by delayed penetration of broken guidewire into pericardium.

  2. Surgical Repair of Retrograde Type A Aortic Dissection after Thoracic Endovascular Aortic Repair

    PubMed Central

    Kim, Chang-Young; Kim, Yeon Soo; Ryoo, Ji Yoon

    2014-01-01

    It is expected that the stent graft will become an alternative method for treating aortic diseases or reducing the extent of surgery; therefore, thoracic endovascular aortic repair has widened its indications. However, it can have rare but serious complications such as paraplegia and retrograde type A aortic dissection. Here, we report a surgical repair of retrograde type A aortic dissection that was performed after thoracic endovascular aortic repair. PMID:24570865

  3. Pulmonary arterial intimal sarcoma with retrograde extension: report of a case and review of literature.

    PubMed

    Vaideeswar, Pradeep; Pillai, Raji

    2013-01-01

    Most of the pulmonary arterial sarcomas arise from multi-potential mesenchymal intimal cells and are designated as intimal sarcomas. These tumors grow in the direction of blood flow into peripheral arteries producing clinical features mimicking pulmonary thromboembolism. Retrograde extension is rare. We report one such case of intimal sarcoma that had a retrograde extension into the right ventricular outflow tract, and review such a presentation in the last ten years.

  4. Successful Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varix Mainly Draining into the Pericardiophrenic Vein

    SciTech Connect

    Kageyama, Ken; Nishida, N. Matsui, H.; Yamamoto, A.; Nakamura, K.; Miki, Y.

    2012-02-15

    Two cases of gastric varices were treated by balloon-occluded retrograde transvenous obliteration via the pericardiophrenic vein at our hospital, and both were successful. One case developed left hydrothorax. Gastric varices did not bled and esophageal varices were not aggravated in both cases for 24-30 months thereafter. These outcomes indicate the feasibility of balloon-occluded retrograde transvenous obliteration via the pericardiophrenic vein.

  5. Retrogradation of Waxy Rice Starch Gel in the Vicinity of the Glass Transition Temperature

    PubMed Central

    Charoenrein, Sanguansri; Udomrati, Sunsanee

    2013-01-01

    The retrogradation rate of waxy rice starch gel was investigated during storage at temperatures in the vicinity of the glass transition temperature of a maximally concentrated system (Tg′), as it was hypothesized that such temperatures might cause different effects on retrogradation. The Tg′ value of fully gelatinized waxy rice starch gel with 50% water content and the enthalpy of melting retrograded amylopectin in the gels were investigated using differential scanning calorimetry. Starch gels were frozen to −30°C and stored at 4, 0, −3, −5, and −8°C for 5 days. The results indicated that the Tg′ value of gelatinized starch gel annealed at −7°C for 15 min was −3.5°C. Waxy rice starch gels retrograded significantly when stored at 4°C with a decrease in the enthalpy of melting retrograded starch in samples stored for 5 days at −3, −5, and −8°C, respectively, perhaps due to the more rigid glass matrix and less molecular mobility facilitating starch chain recrystallization at temperatures below Tg′. This suggests that retardation of retrogradation of waxy rice starch gel can be achieved at temperature below Tg′. PMID:26904602

  6. Clathrin adaptor epsinR is required for retrograde sorting on early endosomal membranes.

    PubMed

    Saint-Pol, Agnès; Yélamos, Belén; Amessou, Mohamed; Mills, Ian G; Dugast, Marc; Tenza, Danièle; Schu, Peter; Antony, Claude; McMahon, Harvey T; Lamaze, Christophe; Johannes, Ludger

    2004-04-01

    Retrograde transport links early/recycling endosomes to the trans-Golgi network (TGN), thereby connecting the endocytic and the biosynthetic/secretory pathways. To determine how internalized molecules are targeted to the retrograde route, we have interfered with the function of clathrin and that of two proteins that interact with it, AP1 and epsinR. We found that the glycosphingolipid binding bacterial Shiga toxin entered cells efficiently when clathrin expression was inhibited. However, retrograde transport of Shiga toxin to the TGN was strongly inhibited. This allowed us to show that for Shiga toxin, retrograde sorting on early/recycling endosomes depends on clathrin and epsinR, but not AP1. EpsinR was also involved in retrograde transport of two endogenous proteins, TGN38/46 and mannose 6-phosphate receptor. In conclusion, our work reveals the existence of clathrin-independent and -dependent transport steps in the retrograde route, and establishes a function for clathrin and epsinR at the endosome-TGN interface.

  7. New concept for CTO recanalization using controlled antegrade and retrograde subintimal tracking: the CART technique.

    PubMed

    Surmely, Jean-François; Tsuchikane, Etsuo; Katoh, Osamu; Nishida, Yasunori; Nakayama, Mutsuo; Nakamura, Shigeru; Oida, Akitsugu; Hattori, Eijiro; Suzuki, Takahiko

    2006-07-01

    To demonstrate the safety and feasibility of a new concept for CTO recanalization using a controlled antegrade and retrograde subintimal tracking technique (CART technique). A successful percutaneous recanalization of chronic coronary occlusions results in improved survival, as well as enhanced left ventricular function, reduction in angina, and improved exercise tolerance. However, successful recanalization of CTOs is still not optimal, and needs further improvements. Ten patients with a CTO underwent the CART procedure. This technique combines the simultaneous use of the antegrade and retrograde approaches. A subintimal dissection is created antegradely and retrogradely, which allows the operator to limit the extension of the subintimal dissection in the CTO portion. A retrograde approach means that the occlusion site is approached in a retrograde fashion through the best collateral channel from any other patent coronary artery. The occlusion site was located in the RCA in 9 patients, and in the LAD in 1 patient. CTO duration varied from 7 to 84 months. Vessel recanalization was achieved in all patients. In all cases, the subintimal dissection was limited to the CTO region. No complications occurred in the collateral channel used for the retrograde approach. There were no in-hospital major adverse cardiac events. The CART technique is feasible, safe, and has a high success rate.

  8. Impaired motoneuronal retrograde transport in two models of SBMA implicates two sites of androgen action.

    PubMed

    Kemp, Michael Q; Poort, Jessica L; Baqri, Rehan M; Lieberman, Andrew P; Breedlove, S Marc; Miller, Kyle E; Jordan, Cynthia L

    2011-11-15

    Spinal and bulbar muscular atrophy (SBMA) impairs motor function in men and is linked to a CAG repeat mutation in the androgen receptor (AR) gene. Defects in motoneuronal retrograde axonal transport may critically mediate motor dysfunction in SBMA, but the site(s) where AR disrupts transport is unknown. We find deficits in retrograde labeling of spinal motoneurons in both a knock-in (KI) and a myogenic transgenic (TG) mouse model of SBMA. Likewise, live imaging of endosomal trafficking in sciatic nerve axons reveals disease-induced deficits in the flux and run length of retrogradely transported endosomes in both KI and TG males, demonstrating that disease triggered in muscle can impair retrograde transport of cargo in motoneuron axons, possibly via defective retrograde signaling. Supporting the idea of impaired retrograde signaling, we find that vascular endothelial growth factor treatment of diseased muscles reverses the transport/trafficking deficit. Transport velocity is also affected in KI males, suggesting a neurogenic component. These results demonstrate that androgens could act via both cell autonomous and non-cell autonomous mechanisms to disrupt axonal transport in motoneurons affected by SBMA.

  9. Post-Golgi anterograde transport requires GARP-dependent endosome-to-TGN retrograde transport.

    PubMed

    Hirata, Tetsuya; Fujita, Morihisa; Nakamura, Shota; Gotoh, Kazuyoshi; Motooka, Daisuke; Murakami, Yoshiko; Maeda, Yusuke; Kinoshita, Taroh

    2015-09-01

    The importance of endosome-to-trans-Golgi network (TGN) retrograde transport in the anterograde transport of proteins is unclear. In this study, genome-wide screening of the factors necessary for efficient anterograde protein transport in human haploid cells identified subunits of the Golgi-associated retrograde protein (GARP) complex, a tethering factor involved in endosome-to-TGN transport. Knockout (KO) of each of the four GARP subunits, VPS51-VPS54, in HEK293 cells caused severely defective anterograde transport of both glycosylphosphatidylinositol (GPI)-anchored and transmembrane proteins from the TGN. Overexpression of VAMP4, v-SNARE, in VPS54-KO cells partially restored not only endosome-to-TGN retrograde transport, but also anterograde transport of both GPI-anchored and transmembrane proteins. Further screening for genes whose overexpression normalized the VPS54-KO phenotype identified TMEM87A, encoding an uncharacterized Golgi-resident membrane protein. Overexpression of TMEM87A or its close homologue TMEM87B in VPS54-KO cells partially restored endosome-to-TGN retrograde transport and anterograde transport. Therefore GARP- and VAMP4-dependent endosome-to-TGN retrograde transport is required for recycling of molecules critical for efficient post-Golgi anterograde transport of cell-surface integral membrane proteins. In addition, TMEM87A and TMEM87B are involved in endosome-to-TGN retrograde transport.

  10. Real-time Visualization and Quantification of Retrograde Cardioplegia Delivery using Near Infrared Fluorescent Imaging

    PubMed Central

    Rangaraj, Aravind T.; Ghanta, Ravi K.; Umakanthan, Ramanan; Soltesz, Edward G.; Laurence, Rita G.; Fox, John; Cohn, Lawrence H.; Bolman, R. M.; Frangioni, John V.; Chen, Frederick Y.

    2009-01-01

    Background and Aim of the Study Homogeneous delivery of cardioplegia is essential for myocardial protection during cardiac surgery. Presently, there exist no established methods to quantitatively assess cardioplegia distribution intraoperatively and determine when retrograde cardioplegia is required. In this study, we evaluate the feasibility of near infrared (NIR) imaging for real-time visualization of cardioplegia distribution in a porcine model. Methods A portable, intraoperative, real-time NIR imaging system was utilized. NIR fluorescent cardioplegia solution was developed by incorporating indocyanine green (ICG) into crystalloid cardioplegia solution. Real-time NIR imaging was performed while the fluorescent cardioplegia solution was infused via the retrograde route in 5 ex-vivo normal porcine hearts and in 5 ex-vivo porcine hearts status post left anterior descending (LAD) coronary artery ligation. Horizontal cross-sections of the hearts were obtained at proximal, middle, and distal LAD levels. Videodensitometry was performed to quantify distribution of fluorophore content. Results The progressive distribution of cardioplegia was clearly visualized with NIR imaging. Complete visualization of retrograde distribution occurred within 4 minutes of infusion. Videodensitometry revealed that retrograde cardioplegia primarily distributed to the left ventricle and anterior septum. In hearts with LAD ligation, antegrade cardioplegia did not distribute to the anterior left ventricle. This deficiency was compensated for with retrograde cardioplegia supplementation. Conclusions Incorporation of ICG into cardioplegia allows real-time visualization of cardioplegia delivery via NIR imaging. This technology may prove useful in guiding intraoperative decisions pertaining to when retrograde cardioplegia is mandated. PMID:19016995

  11. Retrograde reactions in coal processing: The behavior of ether and sulfide model compounds

    SciTech Connect

    Buchanan, A.C. III; Britt, P.F.; Skeen, J.T.

    1997-04-01

    Retrograde reactions that produce more refractory molecular structures are undesirable in coal liquefaction. The authors previously found that restricted mass transport, induced by immobilization on a silica support, promotes retrograde reactions for 1,2-diphenylethane (C{sub 6}H{sub 5}CH{sub 2}CH{sub 2}C{sub 6}H{sub 5}) by both skeletal rearrangement and ring growth (cyclization-dehydrogenation) pathways involving free-radical intermediates. They are now examining the influence of heteroatoms on the retrograde pathways for the corresponding surface-immobilized ether (C{sub 6}H{sub 5}OCH{sub 2}C{sub 6}H{sub 5}) and sulfide (C{sub 6}H{sub 5}SCH{sub 2}C{sub 6}H{sub 5}) model compounds at 275--350 C. Cyclization-dehydrogenation pathways are not detected for either model compound. However, retrograde skeletal rearrangements involving 1,2-phenyl shifts in C{sub 6}H{sub 5}XCH{center_dot}C{sub 6}H{sub 5} (X = O,S) are found to be significant under restricted diffusion, and for X = O, radical coupling at ring carbons to form benzylphenols is also observed as a major pathway. For surface-immobilized benzyl phenyl ether, the two retrograde processes account for ca. 50% of the thermolysis products, and also generate reactive hydroxyl and keto functionalities that can be involved in additional retrograde reactions.

  12. Successful treatment of retrograde ejaculation with sperm recovered from bladder washings. A report of two cases.

    PubMed

    Silva, P D; Larson, K M; Van Every, M J; Silva, D E

    2000-11-01

    Retrograde ejaculation causes < 2% of male infertility but is the leading cause of aspermia. The incidence of retrograde ejaculation is increasing due to the aggressiveness of modern urologic cancer surgery and an increase in diabetes mellitus. Generally, the only adverse effect is on fertility. Various approaches have been proposed for treatment, ranging from insemination with sperm-rich urine obtained after masturbation to intracytoplasmic sperm injection (ICSI). We used a protocol involving bladder washing. Case 1 involved a man with retrograde ejaculation secondary to a successful right orchiectomy and retroperitoneal lymph node dissection for stage B1 embryonal cell carcinoma. He was treated with bladder washing and intrauterine insemination. He fathered three children from six insemination cycles. Case 2 involved a man with idiopathic retrograde ejaculation and a wife with ovulatory dysfunction. He received treatment similar to that in case 1 and fathered one child from two insemination cycles. Larger studies need to be done specifically comparing treatments. Our method resulted in four normal infants in two couples over eight total insemination cycles and, taken together with other results from the literature, seems a good choice for clinicians who are treating retrograde ejaculation for the first time. We agree with others who have recommended that in vitro fertilization/ICSI not be the first step for treating the usual couples with retrograde ejaculation.

  13. Ureteroscopy-assisted retrograde nephrostomy for lower calyx calculi in horseshoe kidney: two case reports.

    PubMed

    Kawahara, Takashi; Ito, Hiroki; Terao, Hideyuki; Tanaka, Katsuyuki; Ogawa, Takehiko; Uemura, Hiroji; Kubota, Yoshinobu; Matsuzaki, Junichi

    2012-07-10

    We previously reported on the effectiveness of ureteroscopy-assisted retrograde nephrostomy during percutaneous nephrolithotomy and report two cases of lower calyx calculi in horseshoe kidney that were successfully treated with ureteroscopy-assisted retrograde nephrostomy. During the ureteroscopy-assisted retrograde nephrostomy procedure, a ureteroscope is advanced in the desired calyx and a Lawson retrograde nephrostomy puncture wire is inserted. The wire is advanced through the calyx to exit the skin. The wire is then used for the percutaneous dilation. Case 1 was a 68-year-old man who was shown on radiography to have left lower calyx calculi (19 × 15mm, 7 × 5mm, and 7 × 3mm) in horseshoe kidney. Case 2 was a 36-year-old woman shown on radiography to have a left lower calyx calculus (10 × 8mm) in horseshoe kidney. Both patients were stone-free after ureteroscopy-assisted retrograde nephrostomy during percutaneous nephrolithotomy. Ureteroscopy-assisted retrograde nephrostomy is a promising procedure for safely and effectively treating lower calyx stones in horseshoe kidney.

  14. Ureteroscopy-assisted retrograde nephrostomy for lower calyx calculi in horseshoe kidney: two case reports

    PubMed Central

    2012-01-01

    Introduction We previously reported on the effectiveness of ureteroscopy-assisted retrograde nephrostomy during percutaneous nephrolithotomy and report two cases of lower calyx calculi in horseshoe kidney that were successfully treated with ureteroscopy-assisted retrograde nephrostomy. During the ureteroscopy-assisted retrograde nephrostomy procedure, a ureteroscope is advanced in the desired calyx and a Lawson retrograde nephrostomy puncture wire is inserted. The wire is advanced through the calyx to exit the skin. The wire is then used for the percutaneous dilation. Case presentation Case 1 was a 68-year-old man who was shown on radiography to have left lower calyx calculi (19 × 15mm, 7 × 5mm, and 7 × 3mm) in horseshoe kidney. Case 2 was a 36-year-old woman shown on radiography to have a left lower calyx calculus (10 × 8mm) in horseshoe kidney. Conclusions Both patients were stone-free after ureteroscopy-assisted retrograde nephrostomy during percutaneous nephrolithotomy. Ureteroscopy-assisted retrograde nephrostomy is a promising procedure for safely and effectively treating lower calyx stones in horseshoe kidney. PMID:22781754

  15. Post-Golgi anterograde transport requires GARP-dependent endosome-to-TGN retrograde transport

    PubMed Central

    Hirata, Tetsuya; Fujita, Morihisa; Nakamura, Shota; Gotoh, Kazuyoshi; Motooka, Daisuke; Murakami, Yoshiko; Maeda, Yusuke; Kinoshita, Taroh

    2015-01-01

    The importance of endosome-to–trans-Golgi network (TGN) retrograde transport in the anterograde transport of proteins is unclear. In this study, genome-wide screening of the factors necessary for efficient anterograde protein transport in human haploid cells identified subunits of the Golgi-associated retrograde protein (GARP) complex, a tethering factor involved in endosome-to-TGN transport. Knockout (KO) of each of the four GARP subunits, VPS51–VPS54, in HEK293 cells caused severely defective anterograde transport of both glycosylphosphatidylinositol (GPI)-anchored and transmembrane proteins from the TGN. Overexpression of VAMP4, v-SNARE, in VPS54-KO cells partially restored not only endosome-to-TGN retrograde transport, but also anterograde transport of both GPI-anchored and transmembrane proteins. Further screening for genes whose overexpression normalized the VPS54-KO phenotype identified TMEM87A, encoding an uncharacterized Golgi-resident membrane protein. Overexpression of TMEM87A or its close homologue TMEM87B in VPS54-KO cells partially restored endosome-to-TGN retrograde transport and anterograde transport. Therefore GARP- and VAMP4-dependent endosome-to-TGN retrograde transport is required for recycling of molecules critical for efficient post-Golgi anterograde transport of cell-surface integral membrane proteins. In addition, TMEM87A and TMEM87B are involved in endosome-to-TGN retrograde transport. PMID:26157166

  16. Rotational assisted endoscopic retrograde cholangiopancreatography in patients with reconstructive gastrointestinal surgical anatomy

    PubMed Central

    Zouhairi, Majed El; Watson, James B; Desai, Svetang V; Swartz, David K; Castillo-Roth, Alejandra; Haque, Mahfuzul; Jowell, Paul S; Branch, Malcolm S; Burbridge, Rebecca A

    2015-01-01

    AIM: To evaluate the success rates of performing therapy utilizing a rotational assisted enteroscopy device in endoscopic retrograde cholangiopancreatography (ERCP) in surgically altered anatomy patients. METHODS: Between June 1, 2009 and November 8, 2012, we performed 42 ERCPs with the use of rotational enteroscopy for patients with altered anatomy (39 with gastric bypass Roux-en-Y, 2 with Billroth II gastrectomy, and 1 with hepaticojejunostomy associated with liver transplant). The indications for ERCP were: choledocholithiasis: 13 of 42 (30.9%), biliary obstruction suggested on imaging: 20 of 42 (47.6%), suspected sphincter of Oddi dysfunction: 4 of 42 (9.5%), abnormal liver enzymes: 1 of 42 (2.4%), ascending cholangitis: 2 of 42 (4.8%), and bile leak: 2 of 42 (4.8%). All procedures were completed with the Olympus SIF-Q180 enteroscope and the Endo-Ease Discovery SB overtube produced by Spirus Medical. RESULTS: Successful visualization of the major ampulla was accomplished in 32 of 42 procedures (76.2%). Cannulation of the bile duct was successful in 26 of 32 procedures reaching the major ampulla (81.3%). Successful therapeutic intervention was completed in 24 of 26 procedures in which the bile duct was cannulated (92.3%). The overall intention to treat success rate was 64.3%. In terms of cannulation success, the intention to treat success rate was 61.5%. Ten out of forty two patients (23.8%) required admission to the hospital after procedure for abdominal pain and nausea, and 3 of those 10 patients (7.1%) had a diagnosis of post-ERCP pancreatitis. The average hospital stay was 3 d. CONCLUSION: It is reasonable to consider an attempt at rotational assisted ERCP prior to a surgical intervention to alleviate biliary complications in patients with altered surgical anatomy. PMID:25789100

  17. Otilonium bromide as spasmolytic during endoscopic retrograde cholangiopancreatography.

    PubMed

    Karahan, Ömer; Sevinç, Barış; Okuş, Ahmet; Ay, Serden; Aksoy, Nergis

    2015-08-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is commonly used in both the diagnosis and the treatment of biliary and pancreatic disorders. The aim of this study is to evaluate the effects of OB usage during ERCP on duodenal motility, the tolerability of the procedure (by patients) and the difficulty of the procedure (by the endoscopist). The study was conducted in Konya Training and Research Hospital General Surgery Endoscopy Unit in randomized prospective pattern. The patients were divided into the two groups as spasmolytic and control groups. The procedure was performed under topical anesthesia and sedation. There were 100 cases included into the study (50 cases in each group). The mean duodenal motility score was found to be 1.9 ± 0.5 in the study group and 3 ± 0.6 in the control group. In the study group, the tolerability of the procedure score by the endoscopist was moderate in 16 % and well/very well in 78 % of the cases. On the other hand, in the control group, the scores were poor in 21 %, moderate in 71 %, and well/very well in 24 % of the cases. In terms of patient satisfaction, in study group 42 % of the cases reported the procedure as moderate and 58 % reported as well/very well. However, in the control group 16 % of the cases reported the procedure as poor, 58 % moderate, and 26 % as well/very well. Otilonium bromide is a safe agent with low side effects. It can be used before the ERCP procedure to decrease the duodenal motility. It eases the procedure, moreover, it increases the patients' satisfaction.

  18. Outcome of endoscopic retrograde cholangiopancreatography during live endoscopy demonstrations.

    PubMed

    Ridtitid, Wiriyaporn; Rerknimitr, Rungsun; Treeprasertsuk, Sombat; Kongkam, Pradermchai; Khor, Christopher J L; Kullavanijaya, Pinit

    2012-07-01

    A number of factors may result in lower than expected success rates for endoscopic retrograde cholangiopancreatography (ERCP) performed by overseas experts during live demonstrations (LDs). Stratifying the degree of ERCP difficulty may help in the assessment of procedure outcomes, but no prior reports have done so. This study aimed to compare the success rate and complications of ERCP between procedures performed in live demonstrations and for matched control subjects. From 2004 to 2011, a total of 82 patients who underwent ERCP during live demonstrations at the Endoscopy Unit of King Chulalongkorn Memorial Hospital were reviewed. The control for each patient was a patient admitted to the same ERCP unit with matched indications at the time closest to the demonstration course who had matching gender and techniques in therapeutic interventions during ERCP. The success rates and complications between the two groups were compared based on the grading scale for the degree of difficulty according to Cotton and colleagues. For standard ERCP cases (levels 1-2), the success rate, complication rate, and duration of the procedure (DOP) did not differ significantly. In contrast, the success rate for complex ERCPs (levels 3-4) performed during LD was significantly lower (73% vs. 90%; P = 0.006). The complication rates and DOP were not significantly different (P = 0.31 and 0.23, respectively). The overall success rate was significantly lower for LD procedures than for control procedures (81% vs. 91%; P = 0.02). In this series, the standard ERCP performed during LD was associated with success and complication rates similar to those for the control subjects. Complex ERCP cases were, however, associated with lower success rates than those for the control subjects. A high proportion of complex ERCP cases during live demonstration can influence the overall success rate of ERCPs performed by overseas experts.

  19. Retrograde degeneration of retinal ganglion cells in homonymous hemianopsia

    PubMed Central

    Herro, Angela M; Lam, Byron L

    2015-01-01

    Background The aim of this study was to demonstrate the relationship between topographic reduction in macular ganglion cell complex (GCC) thickness as detected with spectral-domain optical coherence tomography and visual field defects caused by ischemic occipital cortical injury. Methods This study was a retrospective review of all patients who presented to our eye institution between January 2012 and July 2014 with visual field defects secondary to ischemic cortical injury. The visual field defect pattern and mean deviation were analyzed. Retinal nerve fiber layer (RNFL) and macular GCC were both assessed with spectral-domain optical coherence tomography. Patients with any ocular pathology that could affect these measurements were excluded. The topographic relationship of visual field defect to reduction in GCC was specifically analyzed. Results Nine patients met the inclusion criteria. Their average age was 65 (57–73) years; eight were men and six had right hemianopsias. The laterality of the visual field defect was used to assign an affected and unaffected side of analysis for RNFL and GCC layer thickness. A right hemianopsia meant that the nasal fibers of the right eye and temporal fibers of the left eye were assigned as the “affected side”, and the temporal fibers of the right eye and nasal fibers of the left eye were assigned as “unaffected”. There was no statistically significant difference between affected and unaffected RNFL. However, there was a significant difference in GCC layer reduction between the affected and unaffected sides (P=0.029). Conclusion There is evidence of retrograde trans-synaptic retinal ganglion cell loss in patients with homonymous hemianopsias from cortical visual impairment. This relationship is reflected in thinning of the GCC and maintains the topographic relationship of the visual field defect. PMID:26089638

  20. Can Rectal Diclofenac Prevent Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis?

    PubMed

    Lua, Guan Way; Muthukaruppan, Raman; Menon, Jayaram

    2015-10-01

    Non steroidal anti-inflammatory drugs (NSAIDs) have been shown to reduce the incidence of post endoscopic retrograde cholangiopancreatography pancreatitis (PEP). There were various trials using different routes and dosages of NSAIDs but meta-analysis revealed inconsistent results. The aims of this study were to determine the efficacy of rectal diclofenac in preventing PEP and to evaluate any adverse events. This was a randomized, open-label, two-arm, prospective clinical trial. Only patients at high risk of developing PEP were recruited. They received 100 mg rectal diclofenac or no intervention immediately after ERCP. The patients were reviewed 30 days after discharge to evaluate any adverse event. Among 144 recruited patients, 69 (47.9%) received diclofenac and 75 (52.1%) had no intervention. Eleven patients (7.6%) developed PEP, in which seven were from the diclofenac group and four were in the control group. Eight cases of PEP (5.5%) were mild and three cases (2.1%) were moderate. The differences in pancreatitis incidence and severity between both groups were not statistically significant. There were 11 adverse events reported. Clinically significant bleeding happened in four patients (2.8%): one from the diclofenac group and three from the control group. Other events included cholangitis: two patients (2.9%) from the diclofenac group and four (5.3%) from the control group. One patient from the diclofenac group (1.4%) had a perforation which was treated conservatively. In summary, prophylactic rectal diclofenac did not significantly decrease the incidence of PEP among patients at high risk for developing PEP. However, the administration of diclofenac was fairly safe with few clinical adverse events.

  1. Procedure for decellularization of porcine heart by retrograde coronary perfusion.

    PubMed

    Remlinger, Nathaniel T; Wearden, Peter D; Gilbert, Thomas W

    2012-12-06

    Perfusion-based whole organ decellularization has recently gained interest in the field of tissue engineering as a means to create site-specific extracellular matrix scaffolds, while largely preserving the native architecture of the scaffold. To date, this approach has been utilized in a variety of organ systems, including the heart, lung, and liver (1-5). Previous decellularization methods for tissues without an easily accessible vascular network have relied upon prolonged exposure of tissue to solutions of detergents, acids, or enzymatic treatments as a means to remove the cellular and nuclear components from the surrounding extracellular environment(6-8). However, the effectiveness of these methods hinged upon the ability of the solutions to permeate the tissue via diffusion. In contrast, perfusion of organs through the natural vascular system effectively reduced the diffusion distance and facilitated transport of decellularization agents into the tissue and cellular components out of the tissue. Herein, we describe a method to fully decellularize an intact porcine heart through coronary retrograde perfusion. The protocol yielded a fully decellularized cardiac extracellular matrix (c-ECM) scaffold with the three-dimensional structure of the heart intact. Our method used a series of enzymes, detergents, and acids coupled with hypertonic and hypotonic rinses to aid in the lysis and removal of cells. The protocol used a Trypsin solution to detach cells from the matrix followed by Triton X-100 and sodium deoxycholate solutions to aid in removal of cellular material. The described protocol also uses perfusion speeds of greater than 2 L/min for extended periods of time. The high flow rate, coupled with solution changes allowed transport of agents to the tissue without contamination of cellular debris and ensured effective rinsing of the tissue. The described method removed all nuclear material from native porcine cardiac tissue, creating a site-specific cardiac ECM

  2. A possible structure of retrograded maize starch speculated by UV and IR spectra of it and its components.

    PubMed

    Lian, Xijun; Zhang, Kunsheng; Luo, Qingfeng; Wang, Chen; Liu, Xueyan

    2012-01-01

    "Retrogradation" has been used to describe the changes that occur in starch after gelatinization, from an initially amorphous state to a more ordered or crystalline state, which has a significant impact on starch application in food, textiles and materials fields. But mechanism of starch retrogradation is still unclear until now and there is no breakthrough in this area. Here we are speculating a possible structure of retrograded maize starch by UV (binding with iodine) and IR spectra of it and its compositions. We speculate that nucleation of retrograded starch origins from combination of reducing end of amylopectin and non-reducing end of amylose, and retrogradation terminates at combining of non-reducing end of amylopectin and reducing end of amylose. The chain length of resistant digestion retrograded starch should be nearly same. The hydroxyl associated with sixth carbon atoms of glucan must form hydrogen bond with other hydroxyl of starch.

  3. Effects of soy protein hydrolysates on maize starch retrogradation studied by IR spectra and ESI-MS analysis.

    PubMed

    Lian, Xijun; Zhu, Wei; Wen, Yan; Li, Lin; Zhao, Xiaoshuang

    2013-08-01

    Starch retrogradation is the main cause of quality deterioration of starch-containing foods during storage. The purpose of this study is to find out whether certain soy protein polypeptide in hydrolysates will retard maize starch retrogradation. The results show that all soy protein hydrolysates retard maize starch retrogradation to a certain extent. The IR spectra of hydrolysates and the blends of hydrolysates and maize starch show that the polypeptides might act with reducing end of maize starch during retrogradation. The results of electrospray ionization-mass spectrometry [ESI-MS] show that the polypeptide (m/z 863) is present in all three hydrolysates remarkedly retarding maize starch retrogradation and its relative abundence is also the highest. So the polypeptide containing seven amino acids probably is the key component to significantly inhibit maize starch retrogradation. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. Percutaneous radiologically guided gastrostomy tube placement: comparison of antegrade transoral and retrograde transabdominal approaches

    PubMed Central

    Haber, Zachary M.; Charles, Hearns W.; Gross, Jonathan S.; Pflager, Daniel; Deipolyi, Amy R.

    2017-01-01

    PURPOSE We aimed to compare the antegrade transoral and the retrograde transabdominal approaches for fluoroscopy-guided percutaneous gastrostomy tube (G-tube) placement. METHODS Following institutional review board approval, all G-tubes at two academic hospitals (January 2014 to May 2015) were reviewed retrospectively. Retrograde approach was used at Hospital 1 and both antegrade and retrograde approaches were used at Hospital 2. Chart review determined type of anesthesia used during placement, dose of radiation used, fluoroscopy time, procedure time, medical history, and complications. RESULTS A total of 149 patients (64 women, 85 men; mean age, 64.4±1.3 years) underwent G-tube placement, including 93 (62%) placed via the retrograde transabdominal approach and 56 (38%) placed via the antegrade transoral approach. Retrograde placement entailed fewer anesthesiology consultations (P < 0.001), less overall procedure time (P = 0.023), and less fluoroscopy time (P < 0.001). A comparison of approaches for placement within the same hospital demonstrated that the retrograde approach led to significantly reduced radiation dose (P = 0.022). There were no differences in minor complication rates (13%–19%; P = 0.430), or major complication rates (6%–7%; P = 0.871) between the two techniques. CONCLUSION G-tube placement using the retrograde transabdominal approach is associated with less fluoroscopy time, procedure time, radiation exposure, and need for anesthesiology consultation with similar safety profile compared with the antegrade transoral approach. Additionally, it is hypothesized that decreased procedure time and anesthesiology consultation using the transoral approach are likely associated with reduced cost. PMID:27911264

  5. Inhibition of gelatinized rice starch retrogradation by rice bran protein hydrolysates.

    PubMed

    Niu, Liya; Wu, Leiyan; Xiao, Jianhui

    2017-11-01

    The retrogradation of gelatinized rice starch (GRS) during the shelf life of a product is the biggest barrier related to starch-containing foods. The objective of this study was to produce rice bran protein hydrolysate (RBPH) using proteolytic enzymes (alcalase, flavourzyme, protamex, neutrase, bromelain, papain and trypsin) to suppress the retrogradation of GRS and understand the physical phenomena underlying the reduced retrogradation of GRS by RBPH during short- and long-term storage. Mixtures of GRS incorporated with Protamex-hydrolyzed rice bran protein at 1h (PRBPH-1) at a degree of hydrolysis of 15.1% were still fresh after storage at 4°C for 14 d. The dynamic time sweep results obtained at 4°C for 180min showed that PRBPH-1 reduced the storage modulus to a greater extent, indicating that PRBPH-1 suppressed the short-term retrogradation of GRS. Differential scanning calorimetry (DSC) clearly showed that PRBPH-1 significantly decreased the retrogradation enthalpy during the 28-d storage at 4°C, and the retrogradation kinetics were analyzed by the Avrami model. In addition, the recrystallization of GRS based on X-ray diffraction spectroscopy was reduced from 15.41% to 4.86% when the GRS: PRBPH-1mass ratio increased from 100:0 to 100:12. Confocal laser scanning microscopy, atomic force microscopy and scanning electron microscopy demonstrated that PRBPH-1 dispersed between GRS molecules to block the formation of hydrogen bonds to inhibit the recrystallization of GRS. These findings suggested that PRBPH-1 inhibited the short- and long-term retrogradation of GRS, and can be potently employed as a natural alternatives for improving the quality and nutrition of starch-containing foods. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Endothelin-1 impairs retrograde axonal transport and leads to axonal injury in rat optic nerve.

    PubMed

    Taniguchi, Takazumi; Shimazawa, Masamitsu; Sasaoka, Masaaki; Shimazaki, Atsushi; Hara, Hideaki

    2006-05-01

    The purpose of this study was to examine the effects of endothelin-1 (ET-1) on retrograde axonal transport in the rat optic nerve. Vehicle or ET-1 (0.2, 1, or 5 pmol/eye) were injected into the vitreous body in Sprague-Dawley rats. Retinal vessels were observed, using a fundus camera, before, and at 10 min, 3 days and 7 days after a single intravitreous injection. Two days after the injection, a neuronal tracer, fluoro gold, was administered via the superior colliculi to retrogradely label active retinal ganglion cells (RGCs). Five days after the tracer administration, retrogradely labeled RGCs were evaluated in the flat-mounted retina, and cross sections from each optic nerve were graded for injury by four independent, masked observers. ET-1 at 5 pmol/eye caused a significant constriction of retinal vessels (versus the vehicle-treated group) at 10 min after the injection. Intravitreous injection of ET-1 caused a dose-related decrease in the number of retrogradely labeled RGCs. Injection of 5 pmol/eye ET-1 led to a statistically significant decrease in the number of retrogradely labeled RGCs (versus the vehicle-treated group). ET-1 at 1 and 5 pmol/eye caused histological optic nerve damage (evaluated using a graded scale). The histological optic nerve damage correlated with the number of retrogradely labeled RGCs. In conclusion, a single intravitreous injection of ET-1 impaired retrograde axonal transport in the rat optic nerve and this impairment correlated with the histological optic nerve damage.

  7. On remembering and forgetting our autobiographical pasts: retrograde amnesia and Andrew Mayes's contribution to neuropsychological method.

    PubMed

    Kopelman, M D; Bright, P

    2012-11-01

    Andrew Mayes's contribution to the neuropsychology of memory has consisted in steadily teasing out the nature of the memory deficit in the amnesic syndrome. This has been done with careful attention to matters of method at all stages. This particularly applies to his investigations of forgetting rates in amnesia and to his studies of retrograde amnesia. Following a brief outline of his work, the main current theories of retrograde amnesia are considered: consolidation theory, episodic-to-semantic shift theory, and multiple trace theory. Findings across the main studies in Alzheimer dementia are reviewed to illustrate what appears to be consistently found, and what is much more inconsistent. A number of problems and issues in current theories are then highlighted--including the nature of the temporal gradient, correlations with the extent of temporal lobe damage, what we would expect 'normal' remote memory curves to look like, how they would appear in focal retrograde amnesia, and whether we can pinpoint retrograde amnesia to hippocampal/medial temporal damage on the basis of existing studies. A recent study of retrograde amnesia is re-analysed to demonstrate temporal gradients on recollected episodic memories in hippocampal/medial temporal patients. It is concluded that there are two requirements for better understanding of the nature of retrograde amnesia: (i) a tighter, Mayesian attention to method in terms of both the neuropsychology and neuroimaging in investigations of retrograde amnesia; and (ii) acknowledging that there may be multiple factors underlying a temporal gradient, and that episodic and semantic memory show important interdependencies at both encoding and retrieval. Such factors may be critical to understanding what is remembered and what is forgotten from our autobiographical pasts. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Micro-computed tomographic analysis of the radial geometry of intrarenal artery-vein pairs in rats and rabbits: Comparison with light microscopy.

    PubMed

    Ngo, Jennifer P; Le, Bianca; Khan, Zohaib; Kett, Michelle M; Gardiner, Bruce S; Smith, David W; Melhem, Mayer M; Maksimenko, Anton; Pearson, James T; Evans, Roger G

    2017-08-10

    We assessed the utility of synchrotron-radiation micro-computed tomography (micro-CT) for quantification of the radial geometry of the renal cortical vasculature. The kidneys of nine rats and six rabbits were perfusion fixed and the renal circulation filled with Microfil. In order to assess shrinkage of Microfil, rat kidneys were imaged at the Australian Synchrotron immediately upon tissue preparation and then post fixed in paraformaldehyde and reimaged 24 hours later. The Microfil shrank only 2-5% over the 24 hour period. All subsequent micro-CT imaging was completed within 24 hours of sample preparation. After micro-CT imaging, the kidneys were processed for histological analysis. In both rat and rabbit kidneys, vascular structures identified in histological sections could be identified in two-dimensional (2D) micro-CT images from the original kidney. Vascular morphology was similar in the two sets of images. Radial geometry quantified by manual analysis of 2D images from micro-CT was consistent with corresponding data generated by light microscopy. However, due to limited spatial resolution when imaging a whole organ using contrast-enhanced micro-CT, only arteries ≥100 and ≥60 μm in diameter, for the rat and rabbit respectively, could be assessed. We conclude that it is feasible and valid to use micro-CT to quantify vascular geometry of the renal cortical circulation in both the rat and rabbit. However, a combination of light microscopic and micro-CT approaches are required to evaluate the spatial relationships between intrarenal arteries and veins over an extensive range of vessel size. © 2017 John Wiley & Sons Australia, Ltd.

  9. Addition of hydrochlorothiazide to angiotensin receptor blocker therapy can achieve a lower sodium balance with no acceleration of intrarenal renin angiotensin system in patients with chronic kidney disease

    PubMed Central

    Fuwa, Daisuke; Fukuda, Michio; Ogiyama, Yoshiaki; Sato, Ryo; Mizuno, Masashi; Miura, Toshiyuki; Abe-Dohmae, Sumiko; Michikawa, Makoto; Kobori, Hiroyuki; Ohte, Nobuyuki

    2016-01-01

    Objective Angiotensin receptor blockers (ARBs) produce a lower sodium (Na) balance, and the natriuretic effect is enhanced under Na deprivation, despite falls in blood pressure (BP) and glomerular filtration rate (GFR). Methods The effect of additional hydrochlorothiazide (HCTZ; 12.5 mg/day) to ARB treatment (valsartan; 80 mg/day) on glomerulotubular Na balance was evaluated in 23 patients with chronic kidney disease. Results Add-on HCTZ decreased GFR, tubular Na load, and tubular Na reabsorption (tNa), although 24-hour urinary Na excretion (UNaV) remained constant. Daily urinary angiotensinogen excretion (UAGTV, 152±10→82±17 μg/g Cre) reduced (p=0.02). Changes in tubular Na load (r2=0.26) and tNa (r2=0.25) correlated with baseline 24-hour UAGTV. Changes in filtered Na load correlated with changes in nighttime systolic BP (r2=0.17), but not with changes in daytime systolic BP. The change in the tNa to filtered Na load ratio was influenced by the change in daytime UNaV (β=−0.67, F=16.8), rather than the change in nighttime UNaV. Conclusions Lower Na balance was produced by add-on HCTZ to ARB treatment without an increase of intra-renal renin-angiotensin system activity, leading to restoration of nocturnal hypertension. A further study is needed to demonstrate that the reduction of UAGTV by additional diuretics to ARBs prevents the progression of nephropathy or cardiovascular events. PMID:27283968

  10. Retrograde approach to an ostial left anterior descending chronic total occlusion through a left internal mammary artery graft.

    PubMed

    Hari, Pawan; Kirtane, Ajay J; Bangalore, Sripal

    2016-05-01

    Retrograde approach to chronic total occlusions (CTO) has been described via saphenous vein grafts, septal and epicardial collaterals. We report for the first time a successful retrograde approach to an ostial left anterior descending (LAD) artery CTO through a failed left internal mammary artery (LIMA) to LAD anastamosis. This case demonstrates the technical aspects of using a LIMA conduit as a retrograde approach to CTO. © 2015 Wiley Periodicals, Inc.

  11. The use of a cutting balloon in contemporary reverse controlled antegrade and retrograde subintimal tracking (reverse CART) technique.

    PubMed

    Nakabayashi, Keisuke; Okada, Hisayuki; Oka, Toshiaki

    2016-07-11

    The key concept of reverse controlled antegrade and retrograde tracking (CART) technique is retrograde puncture with a tapered wire to an antegrade balloon (contemporary reverse CART) or new connections between the antegrade and retrograde subintimal space (classical reverse CART). In our case, a 75-year-old man with severe chronic total occlusion of the right coronary artery, reverse CART with conventional balloons could not be accomplished. Externalization wiring was completed by contemporary reverse CART using a cutting balloon as an antegrade balloon to improve the fenestration force of the retrograde guidewire. Thus, the use of a cutting balloon for contemporary reverse CART might be promising.

  12. The retrogradation properties of glutinous rice and buckwheat starches as observed with FT-IR, 13C NMR and DSC.

    PubMed

    Lian, Xijun; Wang, Changjun; Zhang, Kunsheng; Li, Lin

    2014-03-01

    The experiment was conducted to study the retrogradation properties of glutinous rice and buckwheat starch with wavelengths of maximum absorbance, FT-IR, (13)C NMR, and DSC. The results show that the starches in retrograded glutinous rice starch and glutinous rice amylopectin could not form double helix. The IR results show that protein inhabits in glutinous rice and maize starches in a different way and appearance of C-H symmetric stretching vibration at 2852 cm(-1) in starch might be appearance of protein. Retrogradation untied the protein in glutinous amylopectin. Enthalpies of sweet potato and maize granules are higher than those of their retrograded starches. The (13)C NMR results show that retrogradation of those two starches leads to presence of β-anomers and retrogradation might decompose lipids in glutinous rice amylopectin into small molecules. Glutinous rice starch was more inclined to retrogradation than buckwheat starch. The DSC results show that the second peak temperatures for retrograded glutinous rice and buckwheat starches should be assigned to protein. The SEM results show that an obvious layer structure exists in retrograded glutinous rice amylopectin.

  13. Retrograde ejaculation after anterior lumbar interbody fusion: transperitoneal versus retroperitoneal exposure.

    PubMed

    Sasso, Rick C; Kenneth Burkus, J; LeHuec, Jean-Charles

    2003-05-15

    In this multicenter, prospective, 2-year study, 146 male patients underwent a single-level anterior lumbar interbody fusion with a tapered threaded titanium fusion device. All the patients were advised before surgery of the risk for retrograde ejaculation. After surgery, any case of retrograde ejaculation was recorded as an adverse event, and the patient was observed up for the remainder of the study. To determine the incidence of retrograde ejaculation in male patients treated for single-level degenerative lumbar disc disease at L4-L5 or L5-S1 with a stand-alone anterior interbody fusion using tapered, threaded titanium fusion cages. The incidence of retrograde ejaculation in men after anterior lumbosacral spinal surgery has been reported to range from 0.42% to 5.9%. Various risk factors that increase the chance of retrograde ejaculation have been proposed. In this prospective study, 146 male patients underwent an open surgical exposure of the lumbosacral junction and a single-level interbody fusion at either L4-L5 or L5-S1. Assessment of a patient's clinical outcome was based on written questionnaires at 6 weeks and then 3, 6, 12, and 24 months after surgery. Patients were questioned about adverse events at each of these assessments, and any case of retrograde ejaculation was recorded and followed. Retrograde ejaculation developed in 6 of the 146 men after open anterior lumbar interbody fusion surgery. Two cases (1.7%; 2/116) involved patients who underwent a retroperitoneal surgical exposure. Four cases (13.3%; 4/30) involved patients who had a transperitoneal surgical exposure. This difference is statistically significant according to Fisher's exact test (P = 0.017). At 12 months after surgery, 2 patients had resolution of their symptoms: 1 in the retroperitoneal approach group and 1 in the transperitoneal group. At the final 2-year follow-up, no changes in symptoms were reported. One patient in the retroperitoneal approach group (0.86%) and three patients in

  14. Hypothermic perfusion with retrograde outflow during right hepatectomy is safe and feasible.

    PubMed

    Reiniers, Megan J; Olthof, Pim B; van Golen, Rowan F; Heger, Michal; van Beek, Adriaan A; Meijer, Ben; Leen, René; van Kuilenburg, André B P; Mearadji, Banafsche; Bennink, Roelof J; Verheij, Joanne; van Gulik, Thomas M

    2017-07-01

    In situ hypothermic perfusion during liver resection performed under vascular inflow occlusion decreases hepatic ischemia-reperfusion injury, but technical limitations have restricted its widespread use. In situ hypothermic perfusion with retrograde outflow circumvents these impediments and thus could extend the applicability of in situ hypothermic perfusion. The safety and feasibility of in situ hypothermic perfusion with retrograde outflow were analyzed in selected patients undergoing right (extended) hepatectomy and compared to intermittent vascular inflow occlusion, the gold standard method, in this randomized pilot study. Patients were first screened for parenchymal liver disease (exclusion criteria: steatosis ≥30%, cirrhosis, or cholestasis). Study participants were randomized intraoperatively to undergo in situ hypothermic perfusion with retrograde outflow (n = 9) or intermittent vascular inflow occlusion (n = 9). The target liver core temperature during in situ hypothermic perfusion with retrograde outflow was 28°C. The primary end point was ischemia-reperfusion injury (expressed by peak postoperative transaminase levels). Secondary outcomes included functional liver regeneration (assessed by hepatobiliary scintigraphy) and clinical outcomes. Peak transaminase levels, total bilirubin, and the international normalized ratio were similar between both groups, although a trend toward more rapid normalization of bilirubin levels was noted for the in situ hypothermic perfusion with retrograde outflow group. Functional liver regeneration as evaluated by hepatobiliary scintigraphy was improved on postoperative day 3 fafter in situ hypothermic perfusion with retrograde outflow but not after intermittent vascular inflow occlusion. Furthermore, in situ hypothermic perfusion with retrograde outflow (requiring continuous ischemia) was comparable to intermittent vascular inflow occlusion for all clinical outcomes, including postoperative complications and hospital

  15. Retrogradation of Maize Starch after High Hydrostatic Pressure Gelation: Effect of Amylose Content and Depressurization Rate

    PubMed Central

    Yang, Zhi; Swedlund, Peter; Gu, Qinfen; Hemar, Yacine; Chaieb, Sahraoui

    2016-01-01

    High hydrostatic pressure (HHP) has been employed to gelatinize or physically modify starch dispersions. In this study, waxy maize starch, normal maize starch, and two high amylose content starch were processed by a HHP of the order of 600 MPa, at 25°C for 15min. The effect of HHP processing on the crystallization of maize starches with various amylose content during storage at 4°C was investigated. Crystallization kinetics of HHP treated starch gels were investigated using rheology and FTIR. The effect of crystallization on the mechanical properties of starch gel network were evaluated in terms of dynamic complex modulus (G*). The crystallization induced increase of short-range helices structures were investigated using FTIR. The pressure releasing rate does not affect the starch retrogradation behaviour. The rate and extent of retrogradation depends on the amylose content of amylose starch. The least retrogradation was observed in HHP treated waxy maize starch. The rate of retrogradation is higher for HHP treated high amylose maize starch than that of normal maize starch. A linear relationship between the extent of retrogradation (phase distribution) measured by FTIR and G* is proposed. PMID:27219066

  16. Exercise intensity modulates brachial artery retrograde blood flow and shear rate during leg cycling in hypoxia

    PubMed Central

    Iwamoto, Erika; Katayama, Keisho; Ishida, Koji

    2015-01-01

    The purpose of this study was to elucidate the effect of exercise intensity on retrograde blood flow and shear rate (SR) in an inactive limb during exercise under normoxic and hypoxic conditions. The subjects performed two maximal exercise tests on a semi-recumbent cycle ergometer to estimate peak oxygen uptake (O2peak) while breathing normoxic (inspired oxygen fraction [FIO2 = 0.21]) and hypoxic (FIO2 = 0.12 or 0.13) gas mixtures. Subjects then performed four exercise bouts at the same relative intensities (30 and 60% O2peak) for 30 min under normoxic or hypoxic conditions. Brachial artery diameter and blood velocity were simultaneously recorded, using Doppler ultrasonography. Retrograde SR was enhanced with increasing exercise intensity under both conditions at 10 min of exercise. Thereafter, retrograde blood flow and SR in normoxia returned to pre-exercise levels, with no significant differences between the two exercise intensities. In contrast, retrograde blood flow and SR in hypoxia remained significantly elevated above baseline and was significantly greater at 60% than at 30% O2peak. We conclude that differences in exercise intensity affect brachial artery retrograde blood flow and SR during prolonged exercise under hypoxic conditions. PMID:26038470

  17. Exercise intensity modulates brachial artery retrograde blood flow and shear rate during leg cycling in hypoxia.

    PubMed

    Iwamoto, Erika; Katayama, Keisho; Ishida, Koji

    2015-06-01

    The purpose of this study was to elucidate the effect of exercise intensity on retrograde blood flow and shear rate (SR) in an inactive limb during exercise under normoxic and hypoxic conditions. The subjects performed two maximal exercise tests on a semi-recumbent cycle ergometer to estimate peak oxygen uptake (V˙O2peak) while breathing normoxic (inspired oxygen fraction [FIO2 = 0.21]) and hypoxic (FIO2 = 0.12 or 0.13) gas mixtures. Subjects then performed four exercise bouts at the same relative intensities (30 and 60% V˙O2peak) for 30 min under normoxic or hypoxic conditions. Brachial artery diameter and blood velocity were simultaneously recorded, using Doppler ultrasonography. Retrograde SR was enhanced with increasing exercise intensity under both conditions at 10 min of exercise. Thereafter, retrograde blood flow and SR in normoxia returned to pre-exercise levels, with no significant differences between the two exercise intensities. In contrast, retrograde blood flow and SR in hypoxia remained significantly elevated above baseline and was significantly greater at 60% than at 30% V˙O2peak. We conclude that differences in exercise intensity affect brachial artery retrograde blood flow and SR during prolonged exercise under hypoxic conditions. © 2015 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  18. Effect of storage time on the retrogradation of banana starch extrudate.

    PubMed

    Bello-Pérez, L A; Ottenhof, M-A; Agama-Acevedo, E; Farhat, I A

    2005-02-23

    Starch was isolated from banana starch and the retrogradation phenomenon was studied using diverse techniques, including an enzymatic measurement. Wide-angle X-ray scattering (WAXS) showed that the sample stored for 7 h presented small peaks and when the storage time increased the peaks increased in intensity. The type of diffraction pattern found in banana extrudates is typical of the A-type crystal polymorph. The crystallinity index from the diffractograms, showed a plateau after approximately 20 h of storage. The short-range order measurement with Fourier transform infrared (FTIR) spectroscopy showed that banana starch retrogradation reached a maximum value at approximately 11 h of storage, a value that agrees with the results obtained with differential scanning calorimetry (DSC), because the maximum enthalpy value (approximately 5 J/g) was calculated in the stored sample for 8 h, without changes in the stored samples for more time. Retrograded resistant starch values did not change after 12 h of storage, obtaining the maximum starch retrogradation level. FTIR, DSC, and the enzymatic technique showed the changes at the molecular level in starch during storage; in the case of WAXS, they determine the long-range order that explains the differences found in the starch retrogradation pattern measurement in banana starch.

  19. Profound loss of general knowledge in retrograde amnesia: evidence from an amnesic artist.

    PubMed

    Gregory, Emma; McCloskey, Michael; Landau, Barbara

    2014-01-01

    Studies of retrograde amnesia have focused on autobiographical memory, with fewer studies examining how non-autobiographical memory is affected. Those that have done so have focused primarily on memory for famous people and public events-relatively limited aspects of memory that are tied to learning during specific times of life and do not deeply tap into the rich and extensive knowledge structures that are developed over a lifetime. To assess whether retrograde amnesia can also cause impairments to other forms of general world knowledge, we explored losses across a broad range of knowledge domains in a newly-identified amnesic. LSJ is a professional artist, amateur musician and history buff with extensive bilateral medial temporal and left anterior temporal damage. We examined LSJ's knowledge across a range of everyday domains (e.g., sports) and domains for which she had premorbid expertise (e.g., famous paintings). Across all domains tested, LSJ showed losses of knowledge at a level of breadth and depth never before documented in retrograde amnesia. These results show that retrograde amnesia can involve broad and deep deficits across a range of general world knowledge domains. Thus, losses that have already been well-documented (famous people and public events) may severely underestimate the nature of human knowledge impairment that can occur in retrograde amnesia.

  20. The effect of partial gelatinization of corn starch on its retrogradation.

    PubMed

    Fu, Zong-qiang; Wang, Li-jun; Li, Dong; Zhou, Yu-guang; Adhikari, Benu

    2013-09-12

    The objective of this work was to investigate the effect of partial gelatinization of starch on its retrogradation using differential scanning calorimetry (DSC) and X-ray diffraction (XRD) techniques. The Avrami equation was used to predict the evolution of starch retrogradation kinetics. The degree of retrogradation in starch samples partially gelatinized 64°C (S64), 68°C (S68) and 70°C (S70) and control (S25) increased with storage time. The retrogradation enthalpies of S68 and S70 were almost four times as high as that of S64. The S25 and S64 had dominant A-type crystalline pattern while S68 and S70 showed dominant B-type crystalline pattern. The growth of remainder crystals was faster in S25 and S64, while both the nucleation and growth rates of new crystals were faster in S68 and S70. The Avrami model was found to represent the retrogradation kinetics data of these partially gelatinized starch samples quite satisfactorily (R(2)>0.95). Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Mechanisms influencing retrograde flow in the atrioventricular canal during early embryonic cardiogenesis.

    PubMed

    Bulk, Alexander; Bark, David; Johnson, Brennan; Garrity, Deborah; Dasi, Lakshmi Prasad

    2016-10-03

    Normal development of the heart is regulated, in part, by mechanical influences associated with blood flow during early stages of embryogenesis. Specifically, the potential for retrograde flow at the atrioventricular canal (AVC) is particularly important in valve development. However, the mechanisms causing this retrograde flow have received little attention. In this study, a numerical analysis was performed on images of the embryonic zebrafish heart between 48 and 55hpf. During these stages, normal retrograde flow is prevalent. To manipulate this flow, zebrafish were placed in a centrifuge and subjected to a hypergravity environment to alter the cardiac preload at various six-hour intervals between 24 and 48hpf. Parameters of the pumping mechanics were then analyzed through a spatiotemporal analysis of processed image sequences. We find that the loss of retrograde flow in experimentally manipulated embryos occurs in part because of a greater resistance in the form of atrial and AVC contractile closure. Additionally, during retrograde flow, these embryos exhibit significantly greater pressure difference across the AVC based on calculations of expansive and contractile rates of the atrium and ventricle. These results elucidated that the developing heart is highly sensitive to small changes in pumping mechanics as it strives to maintain normal hemodynamic conditions necessary for later cardiac development.

  2. Preparation of chitosan oligomers COS and their effect on the retrogradation of intermediate amylose rice starch.

    PubMed

    Wu, Yue; Lin, Qin Lu; Chen, Zheng Xing; Wu, Wei; Xiao, Hua Xi

    2012-12-01

    Chitosan oligomers (COS) were obtained by enzymatic hydrolysis and H2O2 oxidative treatment, and then separated into different fractions using ultra-filtration membranes. Each COSM fraction prepared using enzymatic hydrolysis retained its structure, especially the reduced end residue (-NH2 group), and had a peak for molecular weight. On the other hand, each COSH fraction prepared by oxidative treatment had partly damaged -NH2 groups and two peaks for molecular weight. These results indicate that the same COS fractions prepared by the two methods differ in their amino groups and in their molecular weights, though they can both pass through the same size ultra-filtration membrane. The effect of COS on the retrogradation of intermediate amylose rice starch (IA-RS) was also investigated. The 5 k < COSM < 10 k fraction had the best anti-retrogradation ability; the retrogradation ratio of IA-RS with this fraction was reduced by 14.5%, compared to the control, and its relative crystallinity was only 59.69%. 10 k < COSM < 30 k fraction was second best, while the COSM < 5 k fraction had no effect. Therefore, the molecular size of COS determined its anti-retrogradation capability. All COSH fractions from oxidative treatment had no effect on the retrogradation.

  3. Characterization of the primary spinal afferent innervation of the mouse colon using retrograde labelling.

    PubMed

    Robinson, D R; McNaughton, P A; Evans, M L; Hicks, G A

    2004-02-01

    Visceral pain is the most common form of pain produced by disease and is thus of interest in the study of gastrointestinal (GI) complaints such as irritable bowel syndrome, in which sensory signals perceived as GI pain travel in extrinsic afferent neurones with cell bodies in the dorsal root ganglia (DRG). The DRG from which the primary spinal afferent innervation of the mouse descending colon arises are not well defined. This study has combined retrograde labelling and immunohistochemistry to identify and characterize these neurones. Small to medium-sized retrogradely labelled cell bodies were found in the DRG at levels T8-L1 and L6-S1. Calcitonin gene-related peptide (CGRP)- and P2X3-like immunoreactivity (LI) was seen in 81 and 32%, respectively, of retrogradely labelled cells, and 20% bound the Griffonia simplicifolia-derived isolectin IB4. CGRP-LI and IB4 were co-localized in 22% of retrogradely labelled cells, whilst P2X3-LI and IB4 were co-localized in 7% (vs 34% seen in the whole DRG population). Eighty-two per cent of retrogradely labelled cells exhibited vanilloid receptor 1-like immunoreactivity (VR1-LI). These data suggest that mouse colonic spinal primary afferent neurones are mostly peptidergic CGRP-containing, VR1-LI, C fibre afferents. In contrast to the general DRG population, a subset of neurones exist that are P2X3 receptor-LI but do not bind IB4.

  4. Retrograde versus Antegrade Approach for the Management of Large Proximal Ureteral Stones

    PubMed Central

    Mykoniatis, Ioannis; Isid, Ayman; Gofrit, Ofer N.; Rosenberg, Shilo; Hidas, Guy; Landau, Ezekiel H.; Pode, Dov; Duvdevani, Mordechai

    2016-01-01

    Objective. To evaluate and compare the efficacy and safety of retrograde versus antegrade ureteroscopic lithotripsy for the treatment of large proximal ureteral stones. Patients and Methods. We retrospectively analyzed the medical records of patients with proximal ureteral stones >15 mm, treated in our institution from January 2011 to January 2016. Intraoperative parameters, postoperative outcomes, and complications were recorded and compared between the two techniques. Results. Our analysis included 57 patients. Thirty-four patients (59.6%) underwent retrograde and 23 patients (40.4%) underwent antegrade ureteroscopy. There was no significant difference in patients' demographics and stone characteristics between the groups. Stone-free rate was significantly higher (p = 0.033) in the antegrade group (100%) compared to retrograde one (82.4%). Fluoroscopy time, procedure duration, and length of hospitalization were significantly (p < 0.001) lower in retrograde approach. On the other hand, the need for postoperative stenting was significantly lower in the antegrade group (p < 0.001). No difference was found between the groups (p = 0.745) regarding postoperative complications. Conclusions. Antegrade ureteroscopy is an efficient and safe option for the management of large proximal ureteral stones. It may achieve high stone-free rates compared to retrograde ureteroscopy with the drawback of longer operative time, fluoroscopy time, and length of hospitalization. PMID:27766263

  5. Profound loss of general knowledge in retrograde amnesia: evidence from an amnesic artist

    PubMed Central

    Gregory, Emma; McCloskey, Michael; Landau, Barbara

    2014-01-01

    Studies of retrograde amnesia have focused on autobiographical memory, with fewer studies examining how non-autobiographical memory is affected. Those that have done so have focused primarily on memory for famous people and public events—relatively limited aspects of memory that are tied to learning during specific times of life and do not deeply tap into the rich and extensive knowledge structures that are developed over a lifetime. To assess whether retrograde amnesia can also cause impairments to other forms of general world knowledge, we explored losses across a broad range of knowledge domains in a newly-identified amnesic. LSJ is a professional artist, amateur musician and history buff with extensive bilateral medial temporal and left anterior temporal damage. We examined LSJ's knowledge across a range of everyday domains (e.g., sports) and domains for which she had premorbid expertise (e.g., famous paintings). Across all domains tested, LSJ showed losses of knowledge at a level of breadth and depth never before documented in retrograde amnesia. These results show that retrograde amnesia can involve broad and deep deficits across a range of general world knowledge domains. Thus, losses that have already been well-documented (famous people and public events) may severely underestimate the nature of human knowledge impairment that can occur in retrograde amnesia. PMID:24834048

  6. Retrogradation of Maize Starch after High Hydrostatic Pressure Gelation: Effect of Amylose Content and Depressurization Rate.

    PubMed

    Yang, Zhi; Swedlund, Peter; Gu, Qinfen; Hemar, Yacine; Chaieb, Sahraoui

    2016-01-01

    High hydrostatic pressure (HHP) has been employed to gelatinize or physically modify starch dispersions. In this study, waxy maize starch, normal maize starch, and two high amylose content starch were processed by a HHP of the order of 600 MPa, at 25°C for 15min. The effect of HHP processing on the crystallization of maize starches with various amylose content during storage at 4°C was investigated. Crystallization kinetics of HHP treated starch gels were investigated using rheology and FTIR. The effect of crystallization on the mechanical properties of starch gel network were evaluated in terms of dynamic complex modulus (G*). The crystallization induced increase of short-range helices structures were investigated using FTIR. The pressure releasing rate does not affect the starch retrogradation behaviour. The rate and extent of retrogradation depends on the amylose content of amylose starch. The least retrogradation was observed in HHP treated waxy maize starch. The rate of retrogradation is higher for HHP treated high amylose maize starch than that of normal maize starch. A linear relationship between the extent of retrogradation (phase distribution) measured by FTIR and G* is proposed.

  7. Clinical efficacy of intermittent pressure augmented-retrograde cerebral perfusion.

    PubMed

    Endo, Hidehito; Kubota, Hiroshi; Tsuchiya, Hiroshi; Yoshimoto, Akihiro; Takahashi, Yu; Inaba, Yusuke; Sudo, Kenichi

    2013-03-01

    During aortic surgery under hypothermic circulatory arrest, retrograde cerebral perfusion (RCP) is commonly used as a cerebroprotective method to extend the duration of circulatory arrest safely. Kitahori and colleagues described a novel protocol of RCP using intermittent pressure augmented (IPA)-RCP in 2005. The aim of the present study was to determine the clinical effectiveness of this novel protocol. A total of 20 consecutive patients undergoing total replacement of the aortic arch were assigned to a conventional RCP (n = 10) or an IPA-RCP group (n = 10). Cerebral perfusion was provided at a continuous venous pressure of 25 mm Hg in the conventional RCP, and venous pressure was intermittently provided at 20 mm Hg for 120 seconds and at 45 mm Hg for 30 seconds in the IPA-RCP group. The clinical outcomes were compared between the 2 groups. Regional cerebral oxygen saturation (rSO(2)) was measured using near infrared spectroscopy every 10 minutes from the beginning of RCP initiation. To represent the brain oxygen consumption, the decline ratio of rSO(2) was calculated. There was no surgical mortality or major neurologic complications in either group. The interval from the end of surgery to full wakefulness was significantly shorter in the IPA-RCP group (85 ± 64 minutes) than in the conventional RCP group (310 ± 282 minutes; P < .05). Although the initial rSO(2) value did not show significant difference in both groups, the rSO(2) with IPA-RCP was greater than that with conventional RCP from 10 to 70 minutes (P < .05). The decline ratio of rSO(2) was lower in the IPA-RCP group than in the RCP perfusion group at all points (P < .05). IPA-RCP might provide more homogenous cerebral perfusion and a more effective oxygen supply to the brain with better clinical results than conventional RCP. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  8. Pharmacological prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis.

    PubMed

    Pande, Hemant; Thuluvath, Paul

    2003-01-01

    The incidence of clinically significant pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) ranges from 1-13.5%. It is more common after therapeutic procedures such as sphincterotomy or balloon dilatation of the sphincter, and diagnostic procedures such as biliary or pancreatic manometry. The severity of post-ERCP pancreatitis may vary from very mild to extremely severe disease with multiple organ failure and fatal outcome. Several factors including papillary oedema, injection of hyperosmolar contrast-material, introduction of previously activated enzymes during repeated cannulation, bacterial contamination and thermal injury from endoscopic sphincterotomy have been implicated as triggering factors that initiate the sequential cascade of pancreatic autodigestion and release of proinflammatory cytokines leading to acute pancreatitis. Recovery from post-ERCP pancreatitis is usually rapid when the injury is confined to the pancreas. However, systemic production of inflammatory mediators may lead to the development of more serious manifestations including multiorgan failure.A wide range of pharmacological agents has been tested in experimental and clinical trials, but the results have been largely disappointing. Several drugs are discussed in this review, but only somatostatin and gabexate (gabexate mesilate) have consistently shown a moderate beneficial effect. In clinical trials, both gabexate and somatostatin appear equally effective in reducing the incidence of pancreatitis by two-thirds compared with controls. However, both drugs need to be given by continuous infusion for about 12 hours and this makes them less cost-effective than conventional treatment. One potential strategy is to reserve these drugs for high-risk patients undergoing ERCP. Preliminary studies have shown encouraging results with nitroglycerin, antibacterials and heparin. However, these observations need to be corroborated in a rigorous fashion in large, randomised, double

  9. Retrograde binaries of massive black holes in circumbinary accretion discs

    NASA Astrophysics Data System (ADS)

    Amaro-Seoane, Pau; Maureira-Fredes, Cristián; Dotti, Massimo; Colpi, Monica

    2016-06-01

    accretion only explores the late evolution stages of the binary in an otherwise unperturbed retrograde disc to illustrate how eccentricity evolves with time in relation to the shape of the underlying surface density distribution.

  10. GBT Reveals Satellite of Milky Way in Retrograde Orbit

    NASA Astrophysics Data System (ADS)

    2003-05-01

    New observations with National Science Foundation's Robert C. Byrd Green Bank Telescope (GBT) suggest that what was once believed to be an intergalactic cloud of unknown distance and significance, is actually a previously unrecognized satellite galaxy of the Milky Way orbiting backward around the Galactic center. Path of Complex H Artist's rendition of the path of satellite galaxy Complex H (in red) in relation to the orbit of the Sun (in yellow) about the center of the Milky Way Galaxy. The outer layers of Complex H are being stripped away by its interaction with the Milky Way. The hydrogen atmosphere (in blue) is shown surrounding the visible portion (in white) of the Galaxy. CREDIT: Lockman, Smiley, Saxton; NRAO/AUI Jay Lockman of the National Radio Astronomy Observatory (NRAO) in Green Bank, West Virginia, discovered that this object, known as "Complex H," is crashing through the outermost parts of the Milky Way from an inclined, retrograde orbit. Lockman's findings will be published in the July 1 issue of the Astrophysical Journal, Letters. "Many astronomers assumed that Complex H was probably a distant neighbor of the Milky Way with some unusual velocity that defied explanation," said Lockman. "Since its motion appeared completely unrelated to Galactic rotation, astronomers simply lumped it in with other high velocity clouds that had strange and unpredictable trajectories." High velocity clouds are essentially what their name implies, fast-moving clouds of predominately neutral atomic hydrogen. They are often found at great distances from the disk of the Milky Way, and may be left over material from the formation of our Galaxy and other galaxies in our Local Group. Over time, these objects can become incorporated into larger galaxies, just as small asteroids left over from the formation of the solar system sometimes collide with the Earth. Earlier studies of Complex H were hindered because the cloud currently is passing almost exactly behind the outer disk of

  11. Failure of conventional retrograde cystography to detect bladder ruptures in pelvic trauma.

    PubMed

    Berber, O; Emeagi, C; Perry, M; Rickman, M S

    2011-03-01

    Conventional retrograde cystography is often used to investigate patients with suspected bladder ruptures in pelvic trauma. Clinical indicators suggestive of a rupture include haematuria and suprapubic tenderness and should increase the suspicion of bladder and urinary tract injury and prompt the clinician to undertake further investigations. Two patients with high-energy pelvic fractures had bladder ruptures detected intraoperatively despite normal preoperative retrograde cystogram. Both patients had significant clinical indicators suggestive of underlying bladder and urinary tract injury. In both cases, a routine conventional retrograde cystogram was performed but failed to identify the full extent of the bladder injury. A possible reason for misdiagnosis in these cases is the delay between injury and investigation due to tertiary referral of care.

  12. The effects of electrolysis at room temperature on retrogradation of sweet potato starch.

    PubMed

    Xijun, Lian; Kunsheng, Zhang; Qingfeng, Luo; Xu, Zhang; Shuyi, Zhao

    2012-01-01

    The effects of electrolysis at room temperature on formation of sweet potato retrograded starch were studied by photographic method in the paper. The optimal parameters of electrolytic preparation of sweet potato retrograded starch were determined. The ratio between sweet potato starch and water was 10 g/100 mL with addition of NaCl 1.0 g/100 mL, pH value of the solution was 6.0 and the solution was electrolyzed for 30 min at 90 V at room temperature, then it was stored at 4°C for 24h after being autoclaved for 30 min at 120°C, the retrogradation rate of sweet potato starch at this condition was 33.1%, which is 138% higher than that of control group. Four possible reasons are put forward to explain the results. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

  13. Transport According to GARP: Receiving Retrograde Cargo at the Trans-Golgi Network

    PubMed Central

    Bonifacino, Juan S.; Hierro, Aitor

    2010-01-01

    Tethering factors are large protein complexes that capture transport vesicles and enable their fusion with acceptor organelles at different stages of the endomembrane system. Recent studies have shed new light on the structure and function of a heterotetrameric tethering factor named Golgi-associated retrograde protein (GARP), which promotes fusion of endosome-derived, retrograde transport carriers to the trans-Golgi network (TGN). X-ray crystallography of the Vps53 and Vps54 subunits of GARP has revealed that this complex is structurally related to other tethering factors such as the exocyst, COG and Dsl1, indicating that they all might work by a similar mechanism. Loss of GARP function compromises the growth, fertility and/or viability of the defective organisms, underscoring the essential nature of GARP-mediated retrograde transport. PMID:21183348

  14. Selective retrograde labeling of cholinergic neurons with (/sup 3/H)choline

    SciTech Connect

    Bagnoli, P.; Beaudet, A.; Stella, M.; Cuenod, M.

    1981-07-01

    Evidence is presented which is consistent with a specific retrograde labeling of cholinergic neurons following (/sup 3/H)choline application in their zone of termination. (/sup 3/H)Choline injection in the rat hippocampus leads to perikaryal retrograde labeling in the ipsilateral medial septal nuclease and nucleus of the diagonal band, thus delineating an established cholinergic pathway, while only diffuse presumably anterograde labeling was observed in the lateral septum, the entorhinal cortex, and the opposite hippocampus. After (/sup 3/H)choline injection in the pigeon visual Wulst, only the ipsilateral thalamic relay, of all inputs, showed similar perikaryal retrograde labeling, an observation supporting the suggestion that at least some thalamo-Wulst neurons are cholinergic.

  15. Retrograde semaphorin signaling regulates synapse elimination in the developing mouse brain.

    PubMed

    Uesaka, Naofumi; Uchigashima, Motokazu; Mikuni, Takayasu; Nakazawa, Takanobu; Nakao, Harumi; Hirai, Hirokazu; Aiba, Atsu; Watanabe, Masahiko; Kano, Masanobu

    2014-05-30

    Neural circuits are shaped by elimination of early-formed redundant synapses during postnatal development. Retrograde signaling from postsynaptic cells regulates synapse elimination. In this work, we identified semaphorins, a family of versatile cell recognition molecules, as retrograde signals for elimination of redundant climbing fiber to Purkinje cell synapses in developing mouse cerebellum. Knockdown of Sema3A, a secreted semaphorin, in Purkinje cells or its receptor in climbing fibers accelerated synapse elimination during postnatal day 8 (P8) to P18. Conversely, knockdown of Sema7A, a membrane-anchored semaphorin, in Purkinje cells or either of its two receptors in climbing fibers impaired synapse elimination after P15. The effect of Sema7A involves signaling by metabotropic glutamate receptor 1, a canonical pathway for climbing fiber synapse elimination. These findings define how semaphorins retrogradely regulate multiple processes of synapse elimination. Copyright © 2014, American Association for the Advancement of Science.

  16. Effect of high-speed jet on flow behavior, retrogradation, and molecular weight of rice starch.

    PubMed

    Fu, Zhen; Luo, Shun-Jing; BeMiller, James N; Liu, Wei; Liu, Cheng-Mei

    2015-11-20

    Effects of high-speed jet (HSJ) treatment on flow behavior, retrogradation, and degradation of the molecular structure of indica rice starch were investigated. Decreasing with the number of HSJ treatment passes were the turbidity of pastes (degree of retrogradation), the enthalpy of melting of retrograded rice starch, weight-average molecular weights and weight-average root-mean square radii of gyration of the starch polysaccharides, and the amylopectin peak areas of SEC profiles. The areas of lower-molecular-weight polymers increased. The chain-length distribution was not significantly changed. Pastes of all starch samples exhibited pseudoplastic, shear-thinning behavior. HSJ treatment increased the flow behavior index and decreased the consistency coefficient and viscosity. The data suggested that degradation of amylopectin was mainly involved and that breakdown preferentially occurred in chains between clusters.

  17. Transport according to GARP: receiving retrograde cargo at the trans-Golgi network.

    PubMed

    Bonifacino, Juan S; Hierro, Aitor

    2011-03-01

    Tethering factors are large protein complexes that capture transport vesicles and enable their fusion with acceptor organelles at different stages of the endomembrane system. Recent studies have shed new light on the structure and function of a heterotetrameric tethering factor named Golgi-associated retrograde protein (GARP), which promotes fusion of endosome-derived, retrograde transport carriers to the trans-Golgi network (TGN). X-ray crystallography of the Vps53 and Vps54 subunits of GARP has revealed that this complex is structurally related to other tethering factors such as the exocyst, the conserved oligomeric Golgi (COG) and Dsl1 (dependence on SLY1-20) complexes, indicating that they all might work by a similar mechanism. Loss of GARP function compromises the growth, fertility and/or viability of the defective organisms, emphasizing the essential nature of GARP-mediated retrograde transport.

  18. Subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) and rertograde access for critical limb ischemia.

    PubMed

    Hendricks, Nicholas J; Sabri, Saher S

    2014-09-01

    Retrograde access techniques involve the addition of a retrograde access into the distal target vessel to aid in recanalization of chronic total occlusions. Many patients with critical limb ischemia are also poor surgical candidates because of comorbidities or lack of suitable landing zone for bypass procedures. This approach may be helpful in the setting of chronic occlusions that cannot be crossed via conventional antegrade true-lumen approaches. Subintimal arterial flossing with antegrade-retrograde intervention technique can be used when the occlusion was crossed in the subintimal plane and antegrade re-entry techniques failed. It may also be useful for flush superficial femoral artery occlusions or those lesions that extend into the trifurcation vessels. Proficiency in these techniques allows limb salvage in patients who lack surgical options and would otherwise undergo amputation.

  19. The outcome of intracytoplasmic sperm injection in patients with retrograde ejaculation.

    PubMed

    Nikolettos, N; Al-Hasani, S; Baukloh, V; Schöpper, B; Demirel, L C; Baban, N; Sturm, R; Rudolf, K; Tomalak, K; Tinneberg, H R; Diedrich, K

    1999-09-01

    The objective of this retrospective clinical study was to assess the benefit of assisted fertilization in cases of anejaculatory infertility due to retrograde ejaculation. We report the outcome of intracytoplasmic sperm injection (ICSI) treatment. In 16 couples in which the men suffered from retrograde ejaculation. We performed 35 cycles of ICSI with spermatozoa retrieved from post-ejaculatory urine. The patients had been instructed to alkalinize the urine by ingesting sodium bicarbonate before the procedure. The fertilization rate averaged 51.2%. Seven clinical pregnancies were achieved. Three spontaneous first trimester abortions occurred, but three live offspring were delivered and one pregnancy is ongoing. In conclusion, the use of ICSI may be feasible for patients with retrograde ejaculation who are resistant to medical treatment and whose sperm quality is so low or unpredictable that intrauterine insemination or conventional methods of in-vitro fertilization are not possible.

  20. Healthy live birth using theophylline in a case of retrograde ejaculation and absolute asthenozoospermia.

    PubMed

    Ebner, Thomas; Shebl, Omar; Mayer, Richard Bernhard; Moser, Marianne; Costamoling, Walter; Oppelt, Peter

    2014-02-01

    To analyze whether the use of ready-to-use theophylline is a feasible option in a case of retrograde ejaculation and absolute asthenozoospermia. Case report. In vitro fertilization unit of a public hospital. Thirty-one-year-old nulliparous woman, and 39-year-old male with retrograde ejaculation and absolute asthenozoospermia. Retrieval of postejaculatory urine, restoration of motility using a methylxanthine, intracytoplasmic sperm injection, single-embryo transfer. Sperm motility, fertilization, embryo quality, live birth. Successful fertilization and a single-embryo transfer resulted in a healthy live birth. Theophylline turned out to be a safe, efficient agent for stimulating immotile spermatozoa in patients with retrograde ejaculation. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Retrograde Ejaculation: A Rare Presenting Symptom of Type 1 Diabetes Mellitus.

    PubMed

    Kam, Jonathan; Tsang, Venessa H; Chalasani, Venu

    2017-01-01

    A 19 year old presented with a progressive decline in ejaculate volume over 2 weeks, followed by a complete absence of ejaculate emission. A post-ejaculatory urine specimen demonstrated spermatozoa confirming a diagnosis of retrograde ejaculation. Investigations revealed a raised blood glucose level of 24.5 mmol/L and HbA1c >15%, with positive tests for anti-GAD antibodies and anti-IA2 antibodies consistent with a diagnosis of Type 1 diabetes mellitus. Retrograde ejaculation in diabetes is associated with autonomic neuropathy and is a late feature of the disease. This case is unique with retrograde ejaculation being the primary presenting symptom of Type 1 diabetes mellitus.

  2. Fundamental studies of retrograde reactions in direct liquefaction. Final report, September 20, 1988--November 20, 1990

    SciTech Connect

    Serio, M.A.; Solomon, P.R.; Kroo, E.; Charpenay, S.; Bassilakis, R.

    1991-12-17

    The overall objective of the program was to improve the understanding of retrograde reactions and their dependencies on coal rank and structure, and/or coal modifications and reaction conditions. Because retrograde reactions are competitive with bond breaking reactions, an understanding of both is required to shift the competition in favor of the latter. Related objectives were to clarify the conflicting observations reported in literature on such major topics as the role of oxygen groups in retrograde reactions and to provide a bridge from very fundamental studies on pure compounds to phenomenological studies on actual coal. This information was integrated into the FG-DVC model, which was improved and extended to the liquefaction context.

  3. Retrograded maize starch used as a medium to enrich Monascus from the air in winter.

    PubMed

    Liu, Lizeng; Wang, Danli; Lian, Xijun; Wu, Hong

    2014-06-01

    Red pigments extracted from fungus Monascus are used for food coloration in China. Wild-growing Monascus spores are usually enriched in the yeast and mold media in the air, but those media are also favorable for yeast and bacteria. In the paper, Monascus species have grown in retrograded maize starch lain in air outdoors in winter, molds, yeast or bacteria colonies have been absent. Then a medium of the retrograded maize starch for enriching Monascus in the air is explored and its physicochemical properties are determined by ordinary camera photos, NMR, SEM spectra and X-ray diffraction. The lamellar structure of frozen retrograded maize starch, whose interlamellar spacing is about 2μm, provides a favorable condition for Monascus spore to germinate and grow. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Retrograde diurnal motion of the instantaneous rotation axis observed by a large ring laser gyroscope

    NASA Astrophysics Data System (ADS)

    Tian, W.

    2017-01-01

    Ring laser gyroscope technique directly senses the Earth's instantaneous rotation pole (IRP), whose polar motion contains strong retrograde diurnal components induced by external torques due to the gravitational attraction of the Moon and Sun. The first direct measurement of this retrograde diurnal motion with three large ring lasers was reported by Schreiber et al. (J Geophys Res 109(B18):B06405, significant increase in precision and stability of ring laser gyroscopes; however, precise determination of amplitude and phase at main partial waves has not been given in the literature. In this paper, I will report on determination of the retrograde diurnal motion of the IRP at main partial waves (Oo_1, J_1, K_1, M_1, O_1, Q_1) by the ring laser "G", located in Wettzell, Germany, which is the most stable one amongst the currently running large ring laser gyroscopes.

  5. Balloon-occluded retrograde transvenous obliteration for recurrent fundal gastric variceal bleeding in an adolescent.

    PubMed

    Rosen, Danya; Chu, Jaime; Patel, Rahul; Moon, Jang; Iyer, Kishore; Arnon, Ronen

    2014-09-01

    Gastric variceal bleeding is associated with high morbidity and mortality. Balloon-occluded retrograde transvenous obliteration is a relatively new treatment used to control bleeding gastric varices that involves transvenous sclerosis of gastric varices through a spontaneous gastrorenal shunt. Here, we report on a 14-yr-old patient that underwent balloon-occluded retrograde transvenous obliteration for refractory bleeding fundal varices in the setting of esophageal varices and cirrhosis, which did not respond to medical management or endoscopic injection. This case report serves as a reminder that balloon-occluded retrograde transvenous obliteration can successfully control fundal variceal bleeding in pediatric patients and may serve as a bridge to liver transplantation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Mycalolide B dissociates dynactin and abolishes retrograde axonal transport of dense-core vesicles.

    PubMed

    Cavolo, Samantha L; Zhou, Chaoming; Ketcham, Stephanie A; Suzuki, Matthew M; Ukalovic, Kresimir; Silverman, Michael A; Schroer, Trina A; Levitan, Edwin S

    2015-07-15

    Axonal transport is critical for maintaining synaptic transmission. Of interest, anterograde and retrograde axonal transport appear to be interdependent, as perturbing one directional motor often impairs movement in the opposite direction. Here live imaging of Drosophila and hippocampal neuron dense-core vesicles (DCVs) containing a neuropeptide or brain-derived neurotrophic factor shows that the F-actin depolymerizing macrolide toxin mycalolide B (MB) rapidly and selectively abolishes retrograde, but not anterograde, transport in the axon and the nerve terminal. Latrunculin A does not mimic MB, demonstrating that F-actin depolymerization is not responsible for unidirectional transport inhibition. Given that dynactin initiates retrograde transport and that amino acid sequences implicated in macrolide toxin binding are found in the dynactin component actin-related protein 1, we examined dynactin integrity. Remarkably, cell extract and purified protein experiments show that MB induces disassembly of the dynactin complex. Thus imaging selective retrograde transport inhibition led to the discovery of a small-molecule dynactin disruptor. The rapid unidirectional inhibition by MB suggests that dynactin is absolutely required for retrograde DCV transport but does not directly facilitate ongoing anterograde DCV transport in the axon or nerve terminal. More generally, MB's effects bolster the conclusion that anterograde and retrograde axonal transport are not necessarily interdependent. © 2015 Cavolo et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  7. Analysis of articulation between clathrin and retromer in retrograde sorting on early endosomes.

    PubMed

    Popoff, Vincent; Mardones, Gonzalo A; Bai, Siau-Kun; Chambon, Valérie; Tenza, Danièle; Burgos, Patricia V; Shi, Anbing; Benaroch, Philippe; Urbé, Sylvie; Lamaze, Christophe; Grant, Barth D; Raposo, Graça; Johannes, Ludger

    2009-12-01

    Clathrin and retromer have key functions for retrograde trafficking between early endosomes and the trans-Golgi network (TGN). Previous studies on Shiga toxin suggested that these two coat complexes operate in a sequential manner. Here, we show that the curvature recognition subunit component sorting nexin 1 (SNX1) of retromer interacts with receptor-mediated endocytosis-8 (RME-8) protein, and that RME-8 and SNX1 colocalize on early endosomes together with a model cargo of the retrograde route, the receptor-binding B-subunit of Shiga toxin (STxB). RME-8 has previously been found to bind to the clathrin uncoating adenosine triphosphatase (ATPase) Hsc70, and we now report that depletion of RME-8 or Hsc70 affects retrograde trafficking at the early endosomes-TGN interface of STxB and the cation-independent mannose 6-phosphate receptor, an endogenous retrograde cargo protein. We also provide evidence that retromer interacts with the clathrin-binding protein hepatocyte growth factor-regulated tyrosine kinase substrate (Hrs) not only via SNX1, as previously published (Chin Raynor MC, Wei X, Chen HQ, Li L. Hrs interacts with sorting nexin 1 and regulates degradation of epidermal growth factor receptor. J Biol Chem 2001;276:7069-7078), but also via the core complex component Vps35. Hrs codistributes at the ultrastructural level with STxB on early endosomes, and interfering with Hrs function using antibodies or mild overexpression inhibits retrograde transport. Our combined data suggest a model according to which the functions in retrograde sorting on early endosomes of SNX1/retromer and clathrin are articulated by RME-8, and possibly also by Hrs.

  8. Retrograde Gene Delivery to Hypoglossal Motoneurons Using Adeno-Associated Virus Serotype 9

    PubMed Central

    ElMallah, Mai K.; Falk, Darin J.; Lane, Michael A.; Conlon, Thomas J.; Lee, Kun-Ze; Shafi, Nadeem I.; Reier, Paul J.

    2012-01-01

    Abstract Retrograde viral transport (i.e., muscle to motoneuron) enables targeted gene delivery to specific motor pools. Recombinant adeno-associated virus serotype 9 (AAV9) robustly infects motoneurons, but the retrograde transport capabilities of AAV9 have not been systematically evaluated. Accordingly, we evaluated the retrograde transduction efficiency of AAV9 after direct tongue injection in 129SVE mice as well as a mouse model that displays neuromuscular pathology (Gaa−/−). Hypoglossal (XII) motoneurons were histologically evaluated 8 weeks after tongue injection with AAV9 encoding green fluorescent protein (GFP) with expression driven by the chicken β-actin promoter (1×1011 vector genomes). On average, GFP expression was detected in 234±43 XII motoneurons 8 weeks after AAV9-GFP tongue injection. In contrast, tongue injection with a highly efficient retrograde anatomical tracer (cholera toxin β subunit, CT-β) resulted in infection of 818±88 XII motoneurons per mouse. The retrograde transduction efficiency of AAV9 was similar between the 129SVE mice and those with neuromuscular disease (Gaa−/−). Routine hematoxylin and eosin staining and cluster of differentiation (CD) immunostaining for T cells (CD3) indicated no persistent inflammation within the tongue or XII nucleus after AAV9 injection. Additional experiments indicated no adverse effects of AAV9 on the pattern of breathing. We conclude that AAV9 can retrogradely infect a significant portion of a given motoneuron pool in normal and dystrophic mice, and that its transduction efficiency is approximately 30% of what can be achieved with CT-β. PMID:22693957

  9. Twelve months follow-up after retrograde recanalization of superficial femoral artery chronic total occlusion

    PubMed Central

    Wojtasik-Bakalarz, Joanna; Arif, Salech; Chyrchel, Michał; Rakowski, Tomasz; Bartuś, Krzysztof; Dudek, Dariusz

    2017-01-01

    Introduction Fifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO) of the superficial femoral artery (SFA). Ten–fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown. Aim To assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA. Material and methods We included patients after at least one unsuccessful percutaneous antegrade recanalization of the SFA. Patients were evaluated for the procedural and clinical follow-up of mean time 13.9 months. Results The study included 17 patients (7 females, 10 males) who underwent percutaneous retrograde recanalization of the SFA from June 2011 to June 2015. The mean age of patients was 63 ±7 years. Retrograde puncture of the distal SFA was successful in all cases. A retrograde procedure was performed immediately after antegrade failure in 4 (23.5%) patients and after a previously failed attempt in 13 (76.5%) patients. The procedure was successful in 15 (88.2%) patients, and unsuccessful in 2 (11.8%) patients. Periprocedural complications included 1 peripheral distal embolization (successfully treated with aspiration thrombectomy), 1 bleeding event from the puncture site and 7 puncture site hematomas. During follow-up the all-cause mortality rate was 5.8% (1 patient, non-cardiac death). The primary patency rate at 12 months was 88.2% and secondary patency 100%. Conclusions The retrograde SFA puncture seems to be a safe and successful technique for CTO recanalization and is associated with a low rate of perioperative and long-term follow-up complications. PMID:28344617

  10. A novel fluorescent retrograde neural tracer: cholera toxin B conjugated carbon dots

    NASA Astrophysics Data System (ADS)

    Zhou, Nan; Hao, Zeyu; Zhao, Xiaohuan; Maharjan, Suraj; Zhu, Shoujun; Song, Yubin; Yang, Bai; Lu, Laijin

    2015-09-01

    The retrograde neuroanatomical tracing method is a key technique to study the complex interconnections of the nervous system. Traditional tracers have several drawbacks, including time-consuming immunohistochemical or immunofluorescent staining procedures, rapid fluorescence quenching and low fluorescence intensity. Carbon dots (CDs) have been widely used as a fluorescent bio-probe due to their ultrasmall size, excellent optical properties, chemical stability, biocompatibility and low toxicity. Herein, we develop a novel fluorescent neural tracer: cholera toxin B-carbon dot conjugates (CTB-CDs). It can be taken up and retrogradely transported by neurons in the peripheral nervous system of rats. Our results show that CTB-CDs possess high photoluminescence intensity, good optical stability, a long shelf-life and non-toxicity. Tracing with CTB-CDs is a direct and more economical way of performing retrograde labelling experiments. Therefore, CTB-CDs are reliable fluorescent retrograde tracers.The retrograde neuroanatomical tracing method is a key technique to study the complex interconnections of the nervous system. Traditional tracers have several drawbacks, including time-consuming immunohistochemical or immunofluorescent staining procedures, rapid fluorescence quenching and low fluorescence intensity. Carbon dots (CDs) have been widely used as a fluorescent bio-probe due to their ultrasmall size, excellent optical properties, chemical stability, biocompatibility and low toxicity. Herein, we develop a novel fluorescent neural tracer: cholera toxin B-carbon dot conjugates (CTB-CDs). It can be taken up and retrogradely transported by neurons in the peripheral nervous system of rats. Our results show that CTB-CDs possess high photoluminescence intensity, good optical stability, a long shelf-life and non-toxicity. Tracing with CTB-CDs is a direct and more economical way of performing retrograde labelling experiments. Therefore, CTB-CDs are reliable fluorescent retrograde

  11. Brachial artery retrograde flow increases with age: relationship to physical function

    PubMed Central

    Credeur, Daniel P.; Dobrosielski, Devon A.; Arce-Esquivel, Arturo A.; Welsch, Michael A.

    2010-01-01

    The purpose of this study was to examine the flow velocity pattern of the brachial artery and to determine its relationship to measures of physical function. Subjects from the Louisiana Healthy Aging Study (n = 95; age = 84 ± 10 years) were evaluated. Brachial artery flow velocities and dimensions were measured using high-resolution ultrasonography. The continuous scale of physical function and performance test (CS-PFP10) was used to assess physical function. This test is based on the performance of 11 activities of daily living. Total CS-PFP10 score was 39.51 ± 21.21 U. Mean antegrade and retrograde velocities at rest were 14.2 ± 4.7 and 3.6 ± 2.2 cm/s, respectively. Ante-/retrograde ratio was 5.5 ± 4.6. Brachial artery diameter was 4.3 ± 0.7 mm. Pulse pressure and vascular conductance were 66 ± 18 mmHg, and 0.9 ± 0.5 ml/min/mmHg, respectively. Vascular conductance (r = −0.34), ante-/retrograde ratio (r = −0.42) and CS-PFP10 (r = −0.65) were inversely and retrograde velocity (r = 0.40) and pulse pressure (r = 0.36), were directly associated with age. Retrograde velocity was inversely related to vascular conductance (r = −0.27) and CS-PFP10 total score (r = −0.45). A MANOVA revealed that those with the higher CS-PFP10 scores had a lower retrograde velocity (P = 0.0001), but this association was, in part, age-dependent. Among nonagenarians (n = 52), those in the lower tertiles of the CS-PFP10 scores had significantly higher retrograde velocities compared to those in the higher tertiles (P = 0.035). These data indicate an increase in brachial retrograde velocity with age. These hemodynamic changes are related to a decline in physical function. PMID:19565260

  12. The Orbital Evolution of 2007 VA85, an Amor-type Asteroid on a Retrograde Orbit.

    NASA Astrophysics Data System (ADS)

    Kankiewicz, P.; Włodarczyk, I.

    2010-06-01

    Among the known population of asteroids on retrograde orbits (i > 90°) we found an object classified as an Amor-type asteroid. During the analysis of the first results of astrometry, we found some possible Earth-impact solutions for this asteroid. After taking into account the latest observations, we excluded any significant impact solution. However, this asteroid is the first known example of potentially hazardous object on a retrograde orbit. We also investigated the orbital evolution of 2007 VA85 (1 My in the past), obtaining possible scenarios of its dynamical origin.

  13. Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography.

    PubMed

    Brand, Martin; Bizos, Damon; O'Farrell, Peter

    2010-10-06

    The use of prophylactic antibiotics before endoscopic retrograde cholangiopancreatography (ERCP) is recommended by all major international gastroenterological societies, especially in the presence of an obstructed biliary system. Their use is intended to decrease or eliminate the incidence of complications following the procedure, namely cholangitis, cholecystitis, septicaemia, and pancreatitis. To assess the benefits and harms of antibiotics before elective ERCP in patients without evidence of acute or chronic cholecystitis, or acute or chronic cholangitis, or severe acute pancreatitis. We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and LILACS until March 2010. Relevant medical and surgical international conference proceedings were also searched. Only randomised clinical trials were included in the analyses, irrespective of blinding, language, or publication status. Participants were patients that underwent elective ERCP that were not on antibiotics, without evidence of acute or chronic cholecystitis, cholangitis, or severe acute pancreatitis before the procedure. We compared patients that received prophylactic antibiotics before the procedure with patients that were given placebo or no intervention before the procedure. The review was conducted according to the recommendations of The Cochrane Collaboration as well as the Cochrane Hepato-Biliary Group. Review Manager 5 was used employing fixed-effect and random-effects models meta-analyses. Nine randomised clinical trials (1573 patients) were included in the analyses. The majority of the trials had risks of bias. When all patients providing data for a certain outcome were included, the fixed-effect meta-analyses significantly favoured the use of prophylactic antibiotics in preventing cholangitis (relative risk (RR) 0.54, 95% CI 0.33 to 0.91), septicaemia

  14. Sustained inhibition of brotizolam induced anterograde amnesia by norharmane and retrograde amnesia by L-glutamic acid in mice.

    PubMed

    Anand, Akshay; Saraf, Manish Kumar; Prabhakar, Sudesh

    2007-08-22

    Benzodiazepines such as diazepam, lorazepam, are reported to produce anterograde amnesia but these do not affect the retrieval mechanism. Triazodiazepines such as alprazolam, triazolam and brotizolam produce both anterograde and retrograde amnesia. Because benzodiazepine receptor antagonists are known to reverse anterograde amnesia, we wanted to test if inverse agonist can also improve learning and memory. The present study was designed to investigate the effect of norharmane (benzodiazepine receptor inverse agonist) and L-glutamic acid (glutamate receptor agonist) on brotizolam induced anterograde and retrograde amnesia using Morris water maze task in mice. Norharmane reversed anterograde amnesia induced by brotizolam and did not reverse retrograde amnesia induced by it. L-Glutamic acid attenuated retrograde amnesia but did not affect anterograde amnesia induced by brotizolam. These results provide an opportunity to understand the mechanisms of anterograde and retrograde amnesia which may occur with interaction of presynaptic molecules or LTP modulation.

  15. Retrograde shear rate in formerly preeclamptic and healthy women before and after exercise training: relationship with endothelial function.

    PubMed

    Scholten, Ralph R; Spaanderman, Marc E A; Green, Daniel J; Hopman, Maria T E; Thijssen, Dick H J

    2014-08-01

    Blood flow patterns in conduit arteries characterized by high levels of retrograde shear stress can be detrimental for vascular health. In this study we examined whether retrograde shear rate and endothelial function are related in healthy and formerly preeclamptic (PE) women and whether this relationship is altered by exercise training. Formerly PE women (32 ± 4 yr, n = 20) and controls (32 ± 4 yr, n = 20), all 6-12 mo postpartum, performed 12-wk aerobic exercise training. We measured brachial artery shear rate (SR) and endothelial function by flow-mediated dilation (FMD, echo-Doppler). We additionally performed power spectral analysis of heart rate variability and calculated low-frequency/high-frequency (LF/HF) ratio. Antegrade SR was not different between groups, while retrograde SR was significantly higher and FMD% lower in PE women compared with controls (both P < 0.05). Retrograde shear correlated strongly with FMD% in PE women and controls (P < 0.05). LF/HF ratio inversely correlated with brachial artery retrograde SR and FMD% (both P < 0.05) in PE women and controls. Exercise training reduced retrograde shear, improved FMD%, and reduced LF/HF ratios similarly in both groups (all P < 0.05). Training-induced changes in retrograde SR correlated with changes in FMD% and LF/HF ratio. A higher brachial artery retrograde SR relates to lower brachial artery endothelial function, in both controls and formerly PE women. Exercise training improves retrograde SR, while the magnitude of this change correlated strongly with improvements in FMD and reductions in LF/HF ratio. Therefore, the impact of PE and exercise training on endothelial health may, at least partly, be related to retrograde shear rate.

  16. Effect of cross-linking degree on selected properties of retrograded starch adipate.

    PubMed

    Kapelko, M; Zięba, T; Michalski, A; Gryszkin, A

    2015-01-15

    The aim of this study was to determine the effects of the concentration of paste used to produce retrograded starch, and esterification degree, on selected properties of the resultant distarch adipate. Starch paste was prepared from native potato starch (1, 4, 10, 18 or 30 g/100g), frozen, defrosted and dried. Thus produced preparations of retrograded starch were cross-linked with various doses of a cross-linking agent (0.125, 0.25, 0.5, 1.0 or 2.0 ml per 100g of starch). Properties of the produced adipates depended on both the concentration of paste used to produce retrograded starch and the degree of substitution with adipic acid residues. Solubility in water and swelling power of the cross-linked preparations of retrograded starch, as well as pasting temperature and viscosity of produced pastes, all decreased along with the increasing degree of substitution with adipic acid residues. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Behavioral and Functional Neuroanatomical Correlates of Anterograde Autobiographical Memory in Isolated Retrograde Amnesic Patient M. L.

    ERIC Educational Resources Information Center

    Levine, Brian; Svoboda, Eva; Turner, Gary R.; Mandic, Marina; Mackey, Allison

    2009-01-01

    Patient M. L. [Levine, B., Black, S. E., Cabeza, R., Sinden, M., Mcintosh, A. R., Toth, J. P., et al. (1998). "Episodic memory and the self in a case of isolated retrograde amnesia." "Brain", "121", 1951-1973], lost memory for events occurring before his severe traumatic brain injury, yet his anterograde (post-injury) learning and memory appeared…

  18. A Hands-on Exploration of the Retrograde Motion of Mars as Seen from the Earth

    ERIC Educational Resources Information Center

    Pincelli, M. M.; Otranto, S.

    2013-01-01

    In this paper, we propose a set of activities based on the use of a celestial simulator to gain insights into the retrograde motion of Mars as seen from the Earth. These activities provide a useful link between the heliocentric concepts taught in schools and those tackled in typical introductory physics courses based on classical mechanics for…

  19. A comparison of Er, Cr: YSGG laser with ultrasonic preparation on the seal of retrograde cavities

    PubMed Central

    Roghanizad, Nasrin; Kalhori, Katayoun AM; Khalilak, Zohreh; Esmaeili, Maryam Ali; de Fatima Zanirato Lizarelli, Rosane

    2015-01-01

    Background and aim: The aim of this in vitro study was to compare Er, Cr: YSGG laser with ultrasonic preparation on the seal of retrograde cavities. Materials and methods: Twenty-eight maxillary anterior teeth were used in this study. After removing the crowns, the canals were prepared with the step-back technique and filled with guttapercha. Three millimeters below the apex; each root was cut with a fissure diamond bur. The root surfaces were then covered with nail polish and three millimeters deep retrograde class I cavities were prepared, using Er, Cr: YSGG laser (group L=12 roots) or ultrasonic retro-tip (group U=12 roots). Four roots were arranged for negative and positive control groups. Retrograde cavities were then filled with mineral trioxide aggregate (MTA) and teeth were placed in 2% methylene blue dye for 72 hours. The amount of dye penetration in sagittal sections of each tooth was measured with a stereomicroscope. An independent sample t-test was used for statistical analysis. Results: Cavities prepared with the Er, Cr: YSGG laser (1.61 + 0.81) showed significantly less micro-leakage than those prepared with the ultrasound (2.55+ 1.84) (P value =0.02). Conclusions: Under the conditions of this research, the use of Er, Cr: YSGG laser for retrograde cavity preparation causes significantly less apical leakage and may increase the success rate of endodontic surgeries. PMID:25941423

  20. Structure of waxy maize starch hydrolyzed by maltogenic alpha-amylase in relation to its retrogradation

    USDA-ARS?s Scientific Manuscript database

    Maltogenic a-amylase is widely used as an antistaling agent in bakery foods. The objective of this study was to determine the degree of hydrolysis (DH) and starch structure after maltogenic amylase treatments in relation to its retrogradation. Waxy maize starch was cooked and hydrolyzed to different...

  1. Modal Selection Analysis of Depot Level Reparable Asset Retrograde Shipments Within the Continental United States

    DTIC Science & Technology

    2003-03-14

    21 Review of Modal Choice Theory Relative to the Civilian Sector...choice in the Air Force retrograde logistics pipeline, the focus of this particular thesis. 26 Review of Modal Choice Theory Relative to the...However, the author feels it is at least noteworthy to introduce some of the nuances of modal choice theory as it relates to the civilian sector. A

  2. [Subcapsular hepatic hematoma after endoscopic retrograde cholangiopancreatography: case report and literature review].

    PubMed

    Petit-Laurent, Fabien; Scalone, Olivia; Penigaud, Marianne; Barbeys, Jean

    2007-01-01

    Subcapsular hepatic hematoma is a rare complication of endoscopic retrograde cholangiopancreatography. The mechanism of this lesion has not been clearly established. The following observation clarifies the physiopathology, as well as providing a review of the various cases described in the literature.

  3. A Hands-on Exploration of the Retrograde Motion of Mars as Seen from the Earth

    ERIC Educational Resources Information Center

    Pincelli, M. M.; Otranto, S.

    2013-01-01

    In this paper, we propose a set of activities based on the use of a celestial simulator to gain insights into the retrograde motion of Mars as seen from the Earth. These activities provide a useful link between the heliocentric concepts taught in schools and those tackled in typical introductory physics courses based on classical mechanics for…

  4. Retrogradation behavior of corn starch treated with 1,4-α-glucan branching enzyme.

    PubMed

    Li, Wenwen; Li, Caiming; Gu, Zhengbiao; Qiu, Yijing; Cheng, Li; Hong, Yan; Li, Zhaofeng

    2016-07-15

    The retrogradation behavior of corn starch treated with 1,4-α-glucan branching enzyme (GBE) was investigated using rheometry, pulsed nuclear magnetic resonance (PNMR), differential scanning calorimetry (DSC) and Fourier transform infrared spectroscopy (FTIR). Dynamic time sweep analysis confirmed that the storage modulus (G') of corn starch stored at 4 °C decreased with increasing GBE treatment time. PNMR analysis demonstrated that the transverse relaxation times (T2) of corn starches treated with GBE were higher than that of control during the storage at 4 °C. DSC results demonstrated that the retrogradation enthalpy (ΔHr) of corn starch was reduced by 22.3% after GBE treatment for 10h. Avrami equation analysis showed that GBE treatment reduced the rate of starch retrogradation. FTIR analysis revealed that GBE treatment led to a decrease in hydrogen bonds within the starch. Overall, these results demonstrate that both short- and long-term retrogradation of corn starch were retarded by GBE treatment.

  5. Effects of HIV-1 Nef on retrograde transport from the plasma membrane to the endoplasmic reticulum.

    PubMed

    Johannes, Ludger; Pezo, Valérie; Mallard, Frédéric; Tenza, Danièle; Wiltz, Aimée; Saint-Pol, Agnès; Helft, Julie; Antony, Claude; Benaroch, Philippe

    2003-05-01

    HIV-1 Nef protein down-regulates several important immunoreceptors through interactions with components of the intracellular sorting machinery. Nef expression is also known to induce modifications of the endocytic pathway. Here, we analyzed the effects of Nef on retrograde transport, from the plasma membrane to the endoplasmic reticulum using Shiga toxin B-subunit (STxB). Nef expression inhibited access of STxB to the endoplasmic reticulum, but did not modify the surface expression level of STxB receptor, Gb3, nor its internalization rate as measured with a newly developed assay. Mutation of the myristoylation site or of a di-leucine motif of Nef involved in the interaction with the clathrin adaptor complexes AP1 and AP2 abolished the inhibition of retrograde transport. In contrast, mutations of Nef motifs known to interact with PACS-1, beta COP or a subunit of the v-ATPase did not modify the inhibitory activity of Nef on retrograde transport. Ultrastructural analysis revealed that Nef was present in clusters located on endosomal or Golgi membranes together with internalized STxB. Furthermore, in strongly Nef-expressing cells, STxB accumulated in endosomal structures that labeled with AP1. Our observations show that Nef perturbs retrograde transport between the early endosome and the endoplasmic reticulum. The potential transport steps targeted by Nef are discussed.

  6. Effect of phospholipids transesterified enzymatically with polyunsaturated fatty acids on gelatinization and retrogradation of starch.

    PubMed

    Siswoyo, L A; Morita, N

    2000-10-01

    The effects of phospholipids (PLs) transesterified with polyunsaturated fatty acids (PUFAs) with lipase (Aspergillus niger) on gelatinization and retrogradation of starch during storage were studied by differential scanning calorimetry (DSC). The resulting transesterified PLs were rich in PUFAs and linoleic acid, while the total percentage of PUFAs incorporated was 20.2%. The addition of PLs or PLs enzymatically transesterified with PUFAs (PUFA-PLs) to the starch sample decreased the gelatinization enthalpy of starch (deltah(g)) slightly, but clearly increased the starch-lipid complexes (deltah(s-1)) by DSC. After 21 days of storage, the percent of retrogradation of starch became lower by the addition of 4%, PLs or 4% PUFA-PLs to the starch sample when compared with the control. These results suggest that PLs retard retrogradation of starch during storage, whereas PUFA-PLs retard it greatly. The addition of PLs or PUFA-PLs increased the amount of deltah(s-1), while re-gelatinization enthalpy decreased during storage, which suggests that PLs or PUFA-PLs could retard the retrogradation of starch.

  7. Self-repair in a bidirectionally coupled astrocyte-neuron (AN) system based on retrograde signaling

    PubMed Central

    Wade, John; McDaid, Liam; Harkin, Jim; Crunelli, Vincenzo; Kelso, Scott

    2012-01-01

    In this paper we demonstrate that retrograde signaling via astrocytes may underpin self-repair in the brain. Faults manifest themselves in silent or near silent neurons caused by low transmission probability (PR) synapses; the enhancement of the transmission PR of a healthy neighboring synapse by retrograde signaling can enhance the transmission PR of the “faulty” synapse (repair). Our model of self-repair is based on recent research showing that retrograde signaling via astrocytes can increase the PR of neurotransmitter release at damaged or low transmission PR synapses. The model demonstrates that astrocytes are capable of bidirectional communication with neurons which leads to modulation of synaptic activity, and that indirect signaling through retrograde messengers such as endocannabinoids leads to modulation of synaptic transmission PR. Although our model operates at the level of cells, it provides a new research direction on brain-like self-repair which can be extended to networks of astrocytes and neurons. It also provides a biologically inspired basis for developing highly adaptive, distributed computing systems that can, at fine levels of granularity, fault detect, diagnose and self-repair autonomously, without the traditional constraint of a central fault detect/repair unit. PMID:23055965

  8. Structure of Waxy Maize Starch Hydrolyzed by Maltogenic α-Amylase in Relation to Its Retrogradation.

    PubMed

    Grewal, Navneet; Faubion, Jon; Feng, Guohua; Kaufman, Rhett C; Wilson, Jeff D; Shi, Yong-Cheng

    2015-04-29

    Maltogenic α-amylase is widely used as an antistaling agent in bakery foods. The objective of this study was to determine the degree of hydrolysis (DH) and starch structure after maltogenic amylase treatments in relation to its retrogradation. Waxy maize starch was cooked and hydrolyzed to different degrees by a maltogenic amylase. High-performance anion-exchange chromatography and size exclusion chromatography were used to determine saccharides formed and the molecular weight (Mw) distributions of the residual starch structure, respectively. Chain length (CL) distributions of debranched starch samples were further related to amylopectin (AP) retrogradation. Differential scanning calorimetry (DSC) results showed the complete inhibition of retrogradation when starches were hydrolyzed to >20% DH. Mw and CL distributions of residual AP structure indicated that with an increase in %DH, a higher proportion of unit chains with degree of polymerization (DP) ≤9 and a lower proportion of unit chains with DP ≥17 were formed. A higher proportion of short outer AP chains that cannot participate in the formation of double helices supports the decrease in and eventual inhibition of retrogradation observed with the increase in %DH. These results suggest that the maltogenic amylase could play a powerful role in inhibiting the staling of baked products even at limited starch hydrolysis.

  9. In vitro analyses of resistant starch in retrograded waxy and normal corn starches.

    PubMed

    Zhou, Xing; Chung, Hyun-Jung; Kim, Jong-Yea; Lim, Seung-Taik

    2013-04-01

    Gelatinized waxy and normal corn starches (40% starch) were subjected to temperature cycling between 4 and 30°C (1 day at each temperature) or isothermal storage (4°C) to induce retrogradation. The in vitro analysis methods that are currently used for the measurement of resistant starch (RS), i.e. Englyst, AACC 32-40 and Goni methods, were compared with homogenized retrograded starch gels and freeze-dried powders of the gels. RS contents obtained by the three analysis methods were in the following order: Goni>Englyst>AACC. Although different RS values were obtained among the analysis methods, similar trends in regards to the starch type and storage conditions could be observed. Little or no RS was found in freeze-dried powders of the retrograded starch gels and storage conditions had no effect, indicating that the physical state for RS analysis is important. More RS was found in normal corn starch gels than in waxy corn starch gels under identical storage conditions and in the gels stored under temperature cycling than those under isothermal storage (4°C), indicating that the presence of amylose inhibits starch digestion and the level of crystalline structure of re-crystallized amylopectin also affects the RS formation during retrogradation.

  10. Excimer laser coronary atherectomy in septal collaterals during retrograde recanalization of a chronic total occlusion

    PubMed Central

    Ohlow, Marc-Alexander; Lotze, Ullrich; Lauer, Bernward

    2011-01-01

    Management of chronic total occlusions has been refined through the development of a retrograde approach via collateral pathways. We describe here the use of excimer laser coronary atherectomy in the septal collaterals. This appraoch was not yet described in the literature. PMID:22355487

  11. Mitochondrial retrograde signaling induces epithelial-mesenchymal transition and generates breast cancer stem cells.

    PubMed

    Guha, M; Srinivasan, S; Ruthel, G; Kashina, A K; Carstens, R P; Mendoza, A; Khanna, C; Van Winkle, T; Avadhani, N G

    2014-11-06

    Metastatic breast tumors undergo epithelial-to-mesenchymal transition (EMT), which renders them resistant to therapies targeted to the primary cancers. The mechanistic link between mtDNA (mitochondrial DNA) reduction, often seen in breast cancer patients, and EMT is unknown. We demonstrate that reducing mtDNA content in human mammary epithelial cells (hMECs) activates Calcineurin (Cn)-dependent mitochondrial retrograde signaling pathway, which induces EMT-like reprogramming to fibroblastic morphology, loss of cell polarity, contact inhibition and acquired migratory and invasive phenotype. Notably, mtDNA reduction generates breast cancer stem cells. In addition to retrograde signaling markers, there is an induction of mesenchymal genes but loss of epithelial markers in these cells. The changes are reversed by either restoring the mtDNA content or knockdown of CnAα mRNA, indicating the causal role of retrograde signaling in EMT. Our results point to a new therapeutic strategy for metastatic breast cancers targeted to the mitochondrial retrograde signaling pathway for abrogating EMT and attenuating cancer stem cells, which evade conventional therapies. We report a novel regulatory mechanism by which low mtDNA content generates EMT and cancer stem cells in hMECs.

  12. On Common Ground: Jost's (1897) Law of Forgetting and Ribot's (1881) Law of Retrograde Amnesia

    ERIC Educational Resources Information Center

    Wixted, John T.

    2004-01-01

    T. Ribot's (1881) law of retrograde amnesia states that brain damage impairs recently formed memories to a greater extent than older memories, which is generally taken to imply that memories need time to consolidate. A. Jost's (1897) law of forgetting states that if 2 memories are of the same strength but different ages, the older will decay more…

  13. Lrp4 is a retrograde signal for presynaptic differentiation at neuromuscular synapses.

    PubMed

    Yumoto, Norihiro; Kim, Natalie; Burden, Steven J

    2012-09-20

    Motor axons receive retrograde signals from skeletal muscle that are essential for the differentiation and stabilization of motor nerve terminals. Identification of these retrograde signals has proved elusive, but their production by muscle depends on the receptor tyrosine kinase, MuSK (muscle, skeletal receptor tyrosine-protein kinase), and Lrp4 (low-density lipoprotein receptor (LDLR)-related protein 4), an LDLR family member that forms a complex with MuSK, binds neural agrin and stimulates MuSK kinase activity. Here we show that Lrp4 also functions as a direct muscle-derived retrograde signal for early steps in presynaptic differentiation. We demonstrate that Lrp4 is necessary, independent of MuSK activation, for presynaptic differentiation in vivo, and we show that Lrp4 binds to motor axons and induces clustering of synaptic-vesicle and active-zone proteins. Thus, Lrp4 acts bidirectionally and coordinates synapse formation by binding agrin, activating MuSK and stimulating postsynaptic differentiation, and functioning in turn as a muscle-derived retrograde signal that is necessary and sufficient for presynaptic differentiation.

  14. The planetary increase of brightness during retrograde motion: An explanandum constructed ad explanantem.

    PubMed

    Carman, Christián Carlos

    2015-12-01

    In Ancient Greek two models were proposed for explaining the planetary motion: the homocentric spheres of Eudoxus and the Epicycle and Deferent System. At least in a qualitative way, both models could explain the retrograde motion, the most challenging phenomenon to be explained using circular motions. Nevertheless, there is another explanandum: during retrograde motion the planets increase their brightness. It is natural to interpret a change of brightness, i.e., of apparent size, as a change in distance. Now, while according to the Eudoxian model the planet is always equidistant from the earth, according to the epicycle and deferent system, the planet changes its distance from the earth, approaching to it during retrograde motion, just as observed. So, it is usually affirmed that the main reason for the rejection of Eudoxus' homocentric spheres in favor of the epicycle and deferent system was that the first cannot explain the manifest planetary increase of brightness during retrograde motion, while the second can. In this paper I will show that this historical hypothesis is not as firmly founded as it is usually believed to be. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Superselective retrograde lymphatic duct embolization for management of postoperative lymphatic leak.

    PubMed

    Arslan, Bülent; Masrani, Abdulrahman; Tasse, Jordan Cameron; Stenson, Kerstin; Turba, Ülkü Cenk

    2017-01-01

    Lymphatic leak is a well-documented complication following neck dissection surgeries. When conservative methods fail to control the leak, thoracic duct embolization becomes an option. Transabdominal access is the standard for this procedure; however, it is not always feasible. We discuss a technique of selective lymphatic vessel embolization utilizing retrograde transvenous access.

  16. Superselective retrograde lymphatic duct embolization for management of postoperative lymphatic leak

    PubMed Central

    Arslan, Bülent; Masrani, Abdulrahman; Tasse, Jordan Cameron; Stenson, Kerstin; Turba, Ülkü Cenk

    2017-01-01

    Lymphatic leak is a well-documented complication following neck dissection surgeries. When conservative methods fail to control the leak, thoracic duct embolization becomes an option. Transabdominal access is the standard for this procedure; however, it is not always feasible. We discuss a technique of selective lymphatic vessel embolization utilizing retrograde transvenous access. PMID:28724508

  17. Behavioral and Functional Neuroanatomical Correlates of Anterograde Autobiographical Memory in Isolated Retrograde Amnesic Patient M. L.

    ERIC Educational Resources Information Center

    Levine, Brian; Svoboda, Eva; Turner, Gary R.; Mandic, Marina; Mackey, Allison

    2009-01-01

    Patient M. L. [Levine, B., Black, S. E., Cabeza, R., Sinden, M., Mcintosh, A. R., Toth, J. P., et al. (1998). "Episodic memory and the self in a case of isolated retrograde amnesia." "Brain", "121", 1951-1973], lost memory for events occurring before his severe traumatic brain injury, yet his anterograde (post-injury) learning and memory appeared…

  18. Compatibility of DAPl and silver staining for combined anterograde and retrograde tracing of neural connections.

    PubMed

    Rhoades, R W

    1980-11-10

    The geniculocortical and corticogeniculate pathways in hamster were used to test the compatibility of 4'6 diamidino-2 phenylindole 2HCl (DAPl)6,10 and anterograde degeneration techniques for tracing reciprocal connections in the brain. The two methods were compatible within a single brain and, with some loss of sensitivity in the retrograde labeling, within a single section.

  19. The role of the dynein light intermediate chain in retrograde IFT and flagellar function in Chlamydomonas.

    PubMed

    Reck, Jaimee; Schauer, Alexandria M; VanderWaal Mills, Kristyn; Bower, Raqual; Tritschler, Douglas; Perrone, Catherine A; Porter, Mary E

    2016-08-01

    The assembly of cilia and flagella depends on the activity of two microtubule motor complexes, kinesin-2 and dynein-2/1b, but the specific functions of the different subunits are poorly defined. Here we analyze Chlamydomonas strains expressing different amounts of the dynein 1b light intermediate chain (D1bLIC). Disruption of D1bLIC alters the stability of the dynein 1b complex and reduces both the frequency and velocity of retrograde intraflagellar transport (IFT), but it does not eliminate retrograde IFT. Flagellar assembly, motility, gliding, and mating are altered in a dose-dependent manner. iTRAQ-based proteomics identifies a small subset of proteins that are significantly reduced or elevated in d1blic flagella. Transformation with D1bLIC-GFP rescues the mutant phenotypes, and D1bLIC-GFP assembles into the dynein 1b complex at wild-type levels. D1bLIC-GFP is transported with anterograde IFT particles to the flagellar tip, dissociates into smaller particles, and begins processive retrograde IFT in <2 s. These studies demonstrate the role of D1bLIC in facilitating the recycling of IFT subunits and other proteins, identify new components potentially involved in the regulation of IFT, flagellar assembly, and flagellar signaling, and provide insight into the role of D1bLIC and retrograde IFT in other organisms.

  20. Phytochrome and retrograde signalling pathways converge to antagonistically regulate a light-induced transcriptional network.

    PubMed

    Martín, Guiomar; Leivar, Pablo; Ludevid, Dolores; Tepperman, James M; Quail, Peter H; Monte, Elena

    2016-05-06

    Plastid-to-nucleus retrograde signals emitted by dysfunctional chloroplasts impact photomorphogenic development, but the molecular link between retrograde- and photosensory-receptor signalling has remained unclear. Here, we show that the phytochrome and retrograde signalling (RS) pathways converge antagonistically to regulate the expression of the nuclear-encoded transcription factor GLK1, a key regulator of a light-induced transcriptional network central to photomorphogenesis. GLK1 gene transcription is directly repressed by PHYTOCHROME-INTERACTING FACTOR (PIF)-class bHLH transcription factors in darkness, but light-activated phytochrome reverses this activity, thereby inducing expression. Conversely, we show that retrograde signals repress this induction by a mechanism independent of PIF mediation. Collectively, our data indicate that light at moderate levels acts through the plant's nuclear-localized sensory-photoreceptor system to induce appropriate photomorphogenic development, but at excessive levels, sensed through the separate plastid-localized RS system, acts to suppress such development, thus providing a mechanism for protection against photo-oxidative damage by minimizing the tissue exposure to deleterious radiation.

  1. F-actin polymerization and retrograde flow drive sustained PLCγ1 signaling during T cell activation

    PubMed Central

    Babich, Alexander; Li, Shuixing; O'Connor, Roddy S.; Milone, Michael C.; Freedman, Bruce D.

    2012-01-01

    Activation of T cells by antigen-presenting cells involves assembly of signaling molecules into dynamic microclusters (MCs) within a specialized membrane domain termed the immunological synapse (IS). Actin and myosin IIA localize to the IS, and depletion of F-actin abrogates MC movement and T cell activation. However, the mechanisms that coordinate actomyosin dynamics and T cell receptor signaling are poorly understood. Using pharmacological inhibitors that perturb individual aspects of actomyosin dynamics without disassembling the network, we demonstrate that F-actin polymerization is the primary driver of actin retrograde flow, whereas myosin IIA promotes long-term integrity of the IS. Disruption of F-actin retrograde flow, but not myosin IIA contraction, arrested MC centralization and inhibited sustained Ca2+ signaling at the level of endoplasmic reticulum store release. Furthermore, perturbation of retrograde flow inhibited PLCγ1 phosphorylation within MCs but left Zap70 activity intact. These studies highlight the importance of ongoing actin polymerization as a central driver of actomyosin retrograde flow, MC centralization, and sustained Ca2+ signaling. PMID:22665519

  2. Reexposure to the Amnestic Agent Alleviates Cycloheximide-Induced Retrograde Amnesia for Reactivated and Extinction Memories

    ERIC Educational Resources Information Center

    Briggs, James F.; Olson, Brian P.

    2013-01-01

    We investigated whether reexposure to an amnestic agent would reverse amnesia for extinction of learned fear similar to that of a reactivated memory. When cycloheximide (CHX) was administered immediately after a brief cue-induced memory reactivation (15 sec) and an extended extinction session (12 min) rats showed retrograde amnesia for both…

  3. Phytochrome and retrograde signalling pathways converge to antagonistically regulate a light-induced transcriptional network

    PubMed Central

    Martín, Guiomar; Leivar, Pablo; Ludevid, Dolores; Tepperman, James M.; Quail, Peter H.; Monte, Elena

    2016-01-01

    Plastid-to-nucleus retrograde signals emitted by dysfunctional chloroplasts impact photomorphogenic development, but the molecular link between retrograde- and photosensory-receptor signalling has remained unclear. Here, we show that the phytochrome and retrograde signalling (RS) pathways converge antagonistically to regulate the expression of the nuclear-encoded transcription factor GLK1, a key regulator of a light-induced transcriptional network central to photomorphogenesis. GLK1 gene transcription is directly repressed by PHYTOCHROME-INTERACTING FACTOR (PIF)-class bHLH transcription factors in darkness, but light-activated phytochrome reverses this activity, thereby inducing expression. Conversely, we show that retrograde signals repress this induction by a mechanism independent of PIF mediation. Collectively, our data indicate that light at moderate levels acts through the plant's nuclear-localized sensory-photoreceptor system to induce appropriate photomorphogenic development, but at excessive levels, sensed through the separate plastid-localized RS system, acts to suppress such development, thus providing a mechanism for protection against photo-oxidative damage by minimizing the tissue exposure to deleterious radiation. PMID:27150909

  4. The role of the dynein light intermediate chain in retrograde IFT and flagellar function in Chlamydomonas

    PubMed Central

    Reck, Jaimee; Schauer, Alexandria M.; VanderWaal Mills, Kristyn; Bower, Raqual; Tritschler, Douglas; Perrone, Catherine A.; Porter, Mary E.

    2016-01-01

    The assembly of cilia and flagella depends on the activity of two microtubule motor complexes, kinesin-2 and dynein-2/1b, but the specific functions of the different subunits are poorly defined. Here we analyze Chlamydomonas strains expressing different amounts of the dynein 1b light intermediate chain (D1bLIC). Disruption of D1bLIC alters the stability of the dynein 1b complex and reduces both the frequency and velocity of retrograde intraflagellar transport (IFT), but it does not eliminate retrograde IFT. Flagellar assembly, motility, gliding, and mating are altered in a dose-dependent manner. iTRAQ-based proteomics identifies a small subset of proteins that are significantly reduced or elevated in d1blic flagella. Transformation with D1bLIC-GFP rescues the mutant phenotypes, and D1bLIC-GFP assembles into the dynein 1b complex at wild-type levels. D1bLIC-GFP is transported with anterograde IFT particles to the flagellar tip, dissociates into smaller particles, and begins processive retrograde IFT in <2 s. These studies demonstrate the role of D1bLIC in facilitating the recycling of IFT subunits and other proteins, identify new components potentially involved in the regulation of IFT, flagellar assembly, and flagellar signaling, and provide insight into the role of D1bLIC and retrograde IFT in other organisms. PMID:27251063

  5. Reexposure to the Amnestic Agent Alleviates Cycloheximide-Induced Retrograde Amnesia for Reactivated and Extinction Memories

    ERIC Educational Resources Information Center

    Briggs, James F.; Olson, Brian P.

    2013-01-01

    We investigated whether reexposure to an amnestic agent would reverse amnesia for extinction of learned fear similar to that of a reactivated memory. When cycloheximide (CHX) was administered immediately after a brief cue-induced memory reactivation (15 sec) and an extended extinction session (12 min) rats showed retrograde amnesia for both…

  6. Influence of chronic endurance exercise training on conduit artery retrograde and oscillatory shear in older adults.

    PubMed

    Casey, Darren P; Schneider, Aaron C; Ueda, Kenichi

    2016-10-01

    With aging, there tends to be an increase in retrograde and oscillatory shear in peripheral conduit arteries of humans. Whether the increase in shear rate is due to the aging process or an effect of a less active lifestyle that often accompanies aging is unknown. Therefore, we examined whether chronic endurance exercise training attenuates conduit artery retrograde and oscillatory shear in older adults. Brachial and common femoral artery mean blood velocities and diameter were determined via Doppler ultrasound under resting conditions, and shear rate was calculated in 13 young (24 ± 2 years), 17 older untrained (66 ± 3 years), and 16 older endurance exercise-trained adults (66 ± 7 years). Brachial artery retrograde (-9.1 ± 6.4 vs. -12.6 ± 9.4 s(-1); P = 0.35) and oscillatory (0.14 ± 0.08 vs. 0.14 ± 0.08 arbitrary units; P = 0.99) shear were similar between the older trained and untrained groups, whereas brachial artery retrograde and oscillatory shear were greater in older untrained compared to young adults (-5.0 ± 3.4, 0.08 ± 0.05 s(-1) arbitrary units, P = 0.017 and 0.048, respectively). There was no difference between the young and older trained brachial retrograde (P = 0.29) and oscillatory (P = 0.07) shear. Common femoral artery retrograde (-6.3 ± 2.9 s(-1)) and oscillatory (0.21 ± 0.08 arbitrary units) shear were reduced in older trained compared to the older untrained group (-10.4 ± 4.1 and 0.30 ± 0.09 s(-1) arbitrary units, both P = 0.005 and 0.006, respectively), yet similar to young adults (-7.1 ± 3.5 and 0.19 ± 0.06 s(-1) arbitrary units, P = 0.81 and 0.87, respectively). Our results suggest that chronic endurance exercise training in older adults ameliorates retrograde and oscillatory shear rate patterns, particularly in the common femoral artery.

  7. Influence of chronic endurance exercise training on conduit artery retrograde and oscillatory shear in older adults

    PubMed Central

    Schneider, Aaron C.; Ueda, Kenichi

    2017-01-01

    Purpose With aging, there tends to be an increase in retrograde and oscillatory shear in peripheral conduit arteries of humans. Whether the increase in shear rate is due to the aging process or an effect of a less active lifestyle that often accompanies aging is unknown. Therefore, we examined whether chronic endurance exercise training attenuates conduit artery retrograde and oscillatory shear in older adults. Methods Brachial and common femoral artery mean blood velocities and diameter were determined via Doppler ultrasound under resting conditions, and shear rate was calculated in 13 young (24 ± 2 years), 17 older untrained (66 ± 3 years), and 16 older endurance exercise-trained adults (66 ± 7 years). Results Brachial artery retrograde (−9.1 ± 6.4 vs. −12.6 ± 9.4 s−1; P = 0.35) and oscillatory (0.14 ± 0.08 vs. 0.14 ± 0.08 arbitrary units; P = 0.99) shear were similar between the older trained and untrained groups, whereas brachial artery retrograde and oscillatory shear were greater in older untrained compared to young adults (−5.0 ± 3.4, 0.08 ± 0.05 s−1 arbitrary units, P = 0.017 and 0.048, respectively). There was no difference between the young and older trained brachial retrograde (P = 0.29) and oscillatory (P = 0.07) shear. Common femoral artery retrograde (−6.3 ± 2.9 s−1) and oscillatory (0.21 ± 0.08 arbitrary units) shear were reduced in older trained compared to the older untrained group (−10.4 ± 4.1 and 0.30 ± 0.09 s−1 arbitrary units, both P = 0.005 and 0.006, respectively), yet similar to young adults (−7.1 ± 3.5 and 0.19 ± 0.06 s−1 arbitrary units, P = 0.81 and 0.87, respectively). Conclusion Our results suggest that chronic endurance exercise training in older adults ameliorates retrograde and oscillatory shear rate patterns, particularly in the common femoral artery. PMID:27497720

  8. Partial melting during exhumation of Paleozoic retrograde eclogite in North Qaidam, western China

    NASA Astrophysics Data System (ADS)

    Cao, Yu-ting; Liu, Liang; Chen, Dan-ling; Wang, Chao; Yang, Wen-qiang; Kang, Lei; Zhu, Xiao-hui

    2017-10-01

    Ultrahigh pressure (UHP) rocks are often overprinted by high pressure (HP) granulite-facies metamorphism during exhumation. Here we investigate retrograde eclogite from the Lvliangshan area in North Qaidam which is associated with abundant felsic veins. The eclogite adjacent to the vein shows conversion to garnet amphibolite. Petrographic, mineralogical, geochemical, geochronological data suggest that the eclogite has been experienced peak eclogite facies metamorphism at c. 440 Ma, followed by granulite facies retrogression at c. 420 Ma, and amphibolite facies overprinting at <420 Ma. The retrograde eclogite has microstructural records for partial melting with elongated plagioclase grains occurring as veinlets along the garnet-ilmenite grain boundaries and interspersed in clinopyroxene. Moreover, highly cuspate, wedge-shaped and triangular plagioclase grains are distributed along the garnet boundaries, and banded felsic veins (Pl + Qz) occur along the boundaries of amphibole in garnet amphibolite. Whole-rock geochemistry suggests that the felsic veins have 438.1-1106 ppm Sr and 2.87-12.18 ppm Y with Sr/Y ratios from 81.98-166.2, exhibit pronounced positive Eu anomaly, and depletion of HREE, resembling those of adakitic rocks. Felsic veins contain zircon grains with an U-Pb age of ∼422 Ma, similar to the age of HP granulite-facies metamorphism (420 Ma) of retrograde eclogite. Combined with the identical Hf isotope compositions between the granulite-facies zircon grains from the host retrograde eclogite and those from the felsic vein, we infer closed system partial melting during HP granulite facies retrogression of the retrograde eclogite. The tonalitic (high Sr/Y ratio and enrichment of LREE) chemical feature, low Rb/Sr and high Ba/Rb ratios of the felsic veins suggest that zoisite and sodic amphibolite dehydration-melting together account for the formation of felsic veins during exhumation from the eclogite-facies to granulite-facies stages.

  9. Continuous butanol fermentation and feed starch retrogradation: butanol fermentation sustainability using Clostridium beijerinckii BA101.

    PubMed

    Ezeji, T C; Qureshi, N; Blaschek, H P

    2005-01-26

    Use of starch solution as feed for butanol bioconversion processes employing Clostridium beijerinckii BA101 may have added economic advantage over the use of glucose. Acetone butanol ethanol (ABE) was produced from 30 gL(-1) starch solution using a continuous process. The bioreactor was fed at a dilution rate of 0.02 h(-1) and starch solution/feed volume (3 L) was replaced every 72 h. The continuous reactor fed with cornstarch solution (feed temperature 19 degrees C) produced approximately 6.0 gL(-1) total ABE. Increasing the feed storage temperature to 37 degrees C improved ABE production to 7.2 gL(-1) suggesting that retrogradation was occurring more rapidly at 19 degrees C. In both these cases the fermentation drifted toward acid production after approximately 260 h, consistent with the retrogradation of starch overtime. The use of soluble starch, which is less prone to retrogradation, resulted in the production of 9.9 gL(-1) ABE at 37 degrees C feed storage temperature, as compared to 7.2 gL(-1) ABE when cornstarch was used. It should be noted that gelatinized starch retrogradation takes place after sterilization and prior to use of the feed medium, and does not occur during long-term storage of the raw corn material in the months leading up to processing. The degree of hydrolysis of gelatinized starch decreased from 68.8 to 56.2% in 3 days when stored at 37 degrees C. Soluble starch which does not retrograde demonstrated no change in the degree of hydrolysis.

  10. Non-Cell-Autonomous Regulation of Retrograde Motoneuronal Axonal Transport in an SBMA Mouse Model

    PubMed Central

    Halievski, Katherine; Kemp, Michael Q.; Breedlove, S. Marc; Miller, Kyle E.

    2016-01-01

    Abstract Defects in axonal transport are seen in motoneuronal diseases, but how that impairment comes about is not well understood. In spinal bulbar muscular atrophy (SBMA), a disorder linked to a CAG/polyglutamine repeat expansion in the androgen receptor (AR) gene, the disease-causing AR disrupts axonal transport by acting in both a cell-autonomous fashion in the motoneurons themselves, and in a non-cell-autonomous fashion in muscle. The non-cell-autonomous mechanism is suggested by data from a unique “myogenic” transgenic (TG) mouse model in which an AR transgene expressed exclusively in skeletal muscle fibers triggers an androgen-dependent SBMA phenotype, including defects in retrograde transport. However, motoneurons in this TG model retain the endogenous AR gene, leaving open the possibility that impairments in transport in this model also depend on ARs in the motoneurons themselves. To test whether non-cell-autonomous mechanisms alone can perturb retrograde transport, we generated male TG mice in which the endogenous AR allele has the testicular feminization mutation (Tfm) and, consequently, is nonfunctional. Males carrying the Tfm allele alone show no deficits in motor function or axonal transport, with or without testosterone treatment. However, when Tfm males carrying the myogenic transgene (Tfm/TG) are treated with testosterone, they develop impaired motor function and defects in retrograde transport, having fewer retrogradely labeled motoneurons and deficits in endosomal flux based on time-lapse video microscopy of living axons. These findings demonstrate that non-cell-autonomous disease mechanisms originating in muscle are sufficient to induce defects in retrograde transport in motoneurons. PMID:27517091

  11. Non-Cell-Autonomous Regulation of Retrograde Motoneuronal Axonal Transport in an SBMA Mouse Model.

    PubMed

    Halievski, Katherine; Kemp, Michael Q; Breedlove, S Marc; Miller, Kyle E; Jordan, Cynthia L

    2016-01-01

    Defects in axonal transport are seen in motoneuronal diseases, but how that impairment comes about is not well understood. In spinal bulbar muscular atrophy (SBMA), a disorder linked to a CAG/polyglutamine repeat expansion in the androgen receptor (AR) gene, the disease-causing AR disrupts axonal transport by acting in both a cell-autonomous fashion in the motoneurons themselves, and in a non-cell-autonomous fashion in muscle. The non-cell-autonomous mechanism is suggested by data from a unique "myogenic" transgenic (TG) mouse model in which an AR transgene expressed exclusively in skeletal muscle fibers triggers an androgen-dependent SBMA phenotype, including defects in retrograde transport. However, motoneurons in this TG model retain the endogenous AR gene, leaving open the possibility that impairments in transport in this model also depend on ARs in the motoneurons themselves. To test whether non-cell-autonomous mechanisms alone can perturb retrograde transport, we generated male TG mice in which the endogenous AR allele has the testicular feminization mutation (Tfm) and, consequently, is nonfunctional. Males carrying the Tfm allele alone show no deficits in motor function or axonal transport, with or without testosterone treatment. However, when Tfm males carrying the myogenic transgene (Tfm/TG) are treated with testosterone, they develop impaired motor function and defects in retrograde transport, having fewer retrogradely labeled motoneurons and deficits in endosomal flux based on time-lapse video microscopy of living axons. These findings demonstrate that non-cell-autonomous disease mechanisms originating in muscle are sufficient to induce defects in retrograde transport in motoneurons.

  12. Contraction of the Ventral Abdomen Potentiates Extracardiac Retrograde Hemolymph Propulsion in the Mosquito Hemocoel

    PubMed Central

    Andereck, Jonathan W.; King, Jonas G.; Hillyer, Julián F.

    2010-01-01

    Background Hemolymph circulation in mosquitoes is primarily controlled by the contractile action of a dorsal vessel that runs underneath the dorsal midline and is subdivided into a thoracic aorta and an abdominal heart. Wave-like peristaltic contractions of the heart alternate in propelling hemolymph in anterograde and retrograde directions, where it empties into the hemocoel at the terminal ends of the insect. During our analyses of hemolymph propulsion in Anopheles gambiae, we observed periodic ventral abdominal contractions and hypothesized that they promote extracardiac hemolymph circulation in the abdominal hemocoel. Methodology/Principal Findings We devised methods to simultaneously analyze both heart and abdominal contractions, as well as to measure hemolymph flow in the abdominal hemocoel. Qualitative and quantitative analyses revealed that ventral abdominal contractions occur as series of bursts that propagate in the retrograde direction. Periods of ventral abdominal contraction begin only during periods of anterograde heart contraction and end immediately following a heartbeat directional reversal, suggesting that ventral abdominal contractions function to propel extracardiac hemolymph in the retrograde direction. To test this functional role, fluorescent microspheres were intrathoracically injected and their trajectory tracked throughout the hemocoel. Quantitative measurements of microsphere movement in extracardiac regions of the abdominal cavity showed that during periods of abdominal contractions hemolymph flows in dorsal and retrograde directions at a higher velocity and with greater acceleration than during periods of abdominal rest. Histochemical staining of the abdominal musculature then revealed that ventral abdominal contractions result from the contraction of intrasegmental lateral muscle fibers, intersegmental ventral muscle bands, and the ventral transverse muscles that form the ventral diaphragm. Conclusions/Significance These data show that

  13. Contraction of the ventral abdomen potentiates extracardiac retrograde hemolymph propulsion in the mosquito hemocoel.

    PubMed

    Andereck, Jonathan W; King, Jonas G; Hillyer, Julián F

    2010-09-23

    Hemolymph circulation in mosquitoes is primarily controlled by the contractile action of a dorsal vessel that runs underneath the dorsal midline and is subdivided into a thoracic aorta and an abdominal heart. Wave-like peristaltic contractions of the heart alternate in propelling hemolymph in anterograde and retrograde directions, where it empties into the hemocoel at the terminal ends of the insect. During our analyses of hemolymph propulsion in Anopheles gambiae, we observed periodic ventral abdominal contractions and hypothesized that they promote extracardiac hemolymph circulation in the abdominal hemocoel. We devised methods to simultaneously analyze both heart and abdominal contractions, as well as to measure hemolymph flow in the abdominal hemocoel. Qualitative and quantitative analyses revealed that ventral abdominal contractions occur as series of bursts that propagate in the retrograde direction. Periods of ventral abdominal contraction begin only during periods of anterograde heart contraction and end immediately following a heartbeat directional reversal, suggesting that ventral abdominal contractions function to propel extracardiac hemolymph in the retrograde direction. To test this functional role, fluorescent microspheres were intrathoracically injected and their trajectory tracked throughout the hemocoel. Quantitative measurements of microsphere movement in extracardiac regions of the abdominal cavity showed that during periods of abdominal contractions hemolymph flows in dorsal and retrograde directions at a higher velocity and with greater acceleration than during periods of abdominal rest. Histochemical staining of the abdominal musculature then revealed that ventral abdominal contractions result from the contraction of intrasegmental lateral muscle fibers, intersegmental ventral muscle bands, and the ventral transverse muscles that form the ventral diaphragm. These data show that abdominal contractions potentiate extracardiac retrograde

  14. Control of Autophagosome Axonal Retrograde Flux by Presynaptic Activity Unveiled Using Botulinum Neurotoxin Type A

    PubMed Central

    Wang, Tong; Martin, Sally; Papadopulos, Andreas; Harper, Callista B.; Mavlyutov, Timur A.; Niranjan, Dhevahi; Glass, Nick R.; Cooper-White, Justin J.; Sibarita, Jean-Baptiste; Choquet, Daniel; Davletov, Bazbek; Meunier, Frédéric A.

    2015-01-01

    Botulinum neurotoxin type A (BoNT/A) is a highly potent neurotoxin that elicits flaccid paralysis by enzymatic cleavage of the exocytic machinery component SNAP25 in motor nerve terminals. However, recent evidence suggests that the neurotoxic activity of BoNT/A is not restricted to the periphery, but also reaches the CNS after retrograde axonal transport. Because BoNT/A is internalized in recycling synaptic vesicles, it is unclear which compartment facilitates this transport. Using live-cell confocal and single-molecule imaging of rat hippocampal neurons cultured in microfluidic devices, we show that the activity-dependent uptake of the binding domain of the BoNT/A heavy chain (BoNT/A-Hc) is followed by a delayed increase in retrograde axonal transport of BoNT/A-Hc carriers. Consistent with a role of presynaptic activity in initiating transport of the active toxin, activity-dependent uptake of BoNT/A in the terminal led to a significant increase in SNAP25 cleavage detected in the soma chamber compared with nonstimulated neurons. Surprisingly, most endocytosed BoNT/A-Hc was incorporated into LC3-positive autophagosomes generated in the nerve terminals, which then underwent retrograde transport to the cell soma, where they fused with lysosomes both in vitro and in vivo. Blocking autophagosome formation or acidification with wortmannin or bafilomycin A1, respectively, inhibited the activity-dependent retrograde trafficking of BoNT/A-Hc. Our data demonstrate that both the presynaptic formation of autophagosomes and the initiation of their retrograde trafficking are tightly regulated by presynaptic activity. PMID:25878289

  15. Does Slow Slip and Tremor Require High Fluid Pressure? Thoughts From Observations in Retrograde Faults

    NASA Astrophysics Data System (ADS)

    Fagereng, A.; Diener, J. F. A.; Stenvall, C.

    2016-12-01

    Subduction zone tremor and slow slip appear spatially correlated with elevated pore fluid pressures related to prograde dehydration reactions in water-saturated subducting rocks. However, tremor and slow slip have also been observed in other tectonic settings, notably on the San Andreas and Alpine faults, where displacement of previously dehydrated rocks occurs along trajectories of decreasing temperature and pressure. Here, fluids are not produced by local dehydration reactions, and external fluids introduced to the fault may be consumed by retrograde hydration reactions. Thus, we suggest that tremor and slow slip in retrograde shear zones imply weakening and strain localization without high fluid pressures, and test this hypothesis against observations in an exhumed, retrograde, continental shear zone. The Kuckaus Mylonite Zone (KMZ), Namibia, accommodated crustal scale strike-slip displacement of granitoid gneisses and migmatites at 450 - 480°C and 270 - 420 MPa, conditions representative of the continuation of continental fault zones below the base of the crustal seismogenic zone. High strain zones within the KMZ comprise fine grained retrograde mineral assemblages requiring rehydration of the original high temperature mineral assemblages in the host rock. Lack of local fluid sources implies that rehydration required influx of an external fluid. We see only minor evidence for hydrothermal vein formation related to this fluid, but note metasomatic alteration and local evidence for dissolution-precipitation. We propose that the main contribution of the fault zone fluid was to allow growth of retrograde, weak, mineral phases, and facilitate grain size reduction through nucleation of new grains, activating grain-size sensitive creep at low driving stresses. Tremor and slow slip observed on active faults under similar conditions may also not require high fluid pressures, but rather be explained by reaction weakening under hydrostatic fluid pressure conditions.

  16. Retrograde blood flow in the brachial and axillary arteries during routine radial arterial catheter flushing.

    PubMed

    Murphy, Glenn S; Szokol, Joseph W; Marymont, Jesse H; Avram, Michael J; Vender, Jeffery S; Kubasiak, John

    2006-09-01

    Flushing of radial arterial catheters may be associated with retrograde embolization of air or thrombus into the cerebral circulation. For embolization into the central circulation to occur, sufficient pressure must be generated during the flushing process to reverse antegrade blood flow in the arterial blood vessels of the upper extremity. This ultrasound study was designed to examine whether routine radial catheter flushing practices produce retrograde blood flow patterns in the brachial and proximal axillary arteries. Duplex ultrasound examinations of the brachial and axillary arteries were conducted in 100 surgical patients to quantify direction and velocity of blood flow during catheter flushing. After obtaining Doppler spectral images of brachial and axillary arterial flow patterns, manual flushing was performed by injecting 10 ml flush solution using a syringe at a rate reflecting standard clinical practices. The flow-regulating device on the pressurized (300 mmHg) arterial flushing-sampling system was then opened for 10 s to deliver a rapid bolus of fluid (flush valve opening). The rate of manual flush solution injection through the radial arterial catheter was related to the probability of retrograde flow in the axillary artery (P < 0.001). Reversed arterial flow was noted in the majority of subjects (33 of 51) at a manual flush rate of less than 9 s and in no subjects (0 of 48) at a rate 9 s or greater. Retrograde flow was observed less frequently during flush valve opening (2 of 99 patients; P < 0.001 vs. manual flushing). Rapid manual flushing of radial arterial catheters at rates faster than 1 ml/s produces retrograde flow in the proximal axillary artery.

  17. Morphology and Immunoreactivity of Retrogradely Double-Labeled Ganglion Cells in the Mouse Retina

    PubMed Central

    Wu, Samuel M.

    2011-01-01

    Purpose. To examine the specificity and reliability of a retrograde double-labeling technique that was recently established for identification of retinal ganglion cells (GCs) and to characterize the morphology of displaced (d)GCs (dGs). Methods. A mixture of the gap-junction–impermeable dye Lucifer yellow (LY) and the permeable dye neurobiotin (NB) was applied to the optic nerve stump for retrograde labeling of GCs and the cells coupled with them. A confocal microscope was adopted for morphologic observation. Results. GCs were identified by LY labeling, and they were all clearly labeled by NB. Cells coupled to GCs contained a weak NB signal but no LY. LY and NB revealed axon bundles, somas and dendrites of GCs. The retrogradely identified GCs numbered approximately 50,000 per retina, and they constituted 44% of the total neurons in the ganglion cell layer (GCL). Somas of retrogradely identified dGs were usually negative for glycine, ChAT (choline acetyltransferase), bNOS (brain-type nitric oxidase), GAD (glutamate decarboxylase), and glial markers, and occasionally, they were weakly GABA-positive. dGs averaged 760 per retina and composed 1.7% of total GCs. Sixteen morphologic subtypes of dGs were encountered, three of which were distinct from known GCs. dGs sent dendrites to either sublaminas of the IPL, mostly sublamina a. Conclusions. The retrograde labeling is reliable for identification of GCs. dGs participate in ON and OFF light pathways but favor the OFF pathway. ChAT, bNOS, glycine, and GAD remain reliable AC markers in the GCL. GCs may couple to GABAergic ACs, and the gap junctions likely pass NB and GABA. PMID:21482641

  18. Intrarenal Renin Angiotensin System Revisited

    PubMed Central

    Pohl, Marcus; Kaminski, Henriette; Castrop, Hayo; Bader, Michael; Himmerkus, Nina; Bleich, Markus; Bachmann, Sebastian; Theilig, Franziska

    2010-01-01

    The existence of a local renin angiotensin system (RAS) of the kidney has been established. Angiotensinogen (AGT), renin, angiotensin-converting enzyme (ACE), angiotensin receptors, and high concentrations of luminal angiotensin II have been found in the proximal tubule. Although functional data have documented the relevance of a local RAS, the dualism between biosynthesis and endocytotic uptake of its components and their cellular processing has been incompletely understood. To resolve this, we have selectively analyzed their distribution, endocytosis, transcytosis, and biosynthesis in the proximal tubule. The presence of immunoreactive AGT, restricted to the early proximal tubule, was due to its retrieval from the ultrafiltrate and storage in endosomal and lysosomal compartments. Cellular uptake was demonstrated by autoradiography of radiolabeled AGT and depended on intact endocytosis. AGT was identified as a ligand of the multiple ligand-binding repeats of megalin. AGT biosynthesis was restricted to the proximal straight tubule, revealing substantial AGT mRNA expression. Transgenic AGT overexpression under the control of an endogenous promoter was also restricted to the late proximal tubule. Proximal handling of renin largely followed the patterns of AGT, whereas its local biosynthesis was not significant. Transcytotic transport of AGT in a proximal cell line revealed a 5% recovery rate after 1 h. ACE was expressed along late proximal brush-border membrane, whereas ACE2 was present along the entire segment. Surface expression of ACE and ACE2 differed as a function of endocytosis. Our data on the localization and cellular processing of RAS components provide new aspects of the functional concept of a “self-contained” renal RAS. PMID:20966072

  19. Retrograde Intramedullary Nailing for Humerus Fracture in a Supine Position: Performing an Unfamiliar Procedure in a Familiar Position.

    PubMed

    Yi, Jin Woong; Lee, Jae Sin; Cho, Hyung Jun

    2017-09-01

    Intramedullary (IM) nailing for humeral shaft fracture has provided excellent outcomes in terms of fracture biology and cosmetic appearance because of the relatively small incision involved. However, antegrade nailing causes issues such as iatrogenic rotator cuff injury. Retrograde nail fixation method could avoid cuff injury, but has shortcomings such as the need for the prone or lateral decubitus position during surgery. We report that the retrograde IM nail fixation technique performed in a supine position and some ancillary techniques for minimizing scars or complications can provide the advantages of both retrograde nailing and supine position during surgery.

  20. [The evaluation of the retrograde memory in the Quebec population aged: PUB-40 and PUB-12].

    PubMed

    Langlois, Roxane; Joubert, Sven; Benoit, Sophie; Dostie, Valérie; Rouleau, Isabelle

    2015-09-01

    Memory assessment represents an important part of the clinical neuropsychologist's duties in a geriatric context. In fact, in Canada, about one-third of seniors report memory complaints, with different causes. Based on the underlying etiology, different components of memory may be affected in older adults. Nonautobiographical retrograde memory (public or semantic) is an important aspect of memory to assess; nevertheless, there is currently no reliable and standardized clinical tool to evaluate this aspect of memory in the elderly Quebecer population. The aims of this research were therefore: (1) to develop a protocol specifically aimed at assessing non-autobiographical retrograde memory in this population, the PUB-40; (2) to obtain reference data among 105 healthy subjects; and (3) to develop a short version based on the items which discriminated a group of 20 patients with amnestic Mild cognitive impairment (aMCI) from older healthy subjects.

  1. Effects of salts on the gelatinization and retrogradation properties of maize starch and waxy maize starch.

    PubMed

    Wang, Wei; Zhou, Hongxian; Yang, Hong; Zhao, Siming; Liu, Youming; Liu, Ru

    2017-01-01

    The objective of this study was to evaluate the effects of salts on the gelatinization and retrogradation of maize and waxy maize starch. Experimental results showed that the salting-out or structure-making ions, such as F(-) and SO4(2-), decreased the swelling power, solubility and transparency of both starches, but increased the gelatinization temperature, enthalpy, and syneresis, due to the tendency of these ions to protect the hydrogen bond links among starch molecules. On the other hand, the salting-in or structure-breaking ions, such as I(-) and SCN(-), exhibited the opposite effects. Microscopic observations confirmed such effects of salts on both starches. Furthermore, the effects of salts were more significant on waxy maize and on normal maize starch. Generally, salts could significantly influence on the gelatinization and retrogradation of maize and waxy maize starch, following the order of the Hofmeister series. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Retrograde accretion discs in high-mass Be/X-ray binaries

    NASA Astrophysics Data System (ADS)

    Christodoulou, D. M.; Laycock, S. G. T.; Kazanas, D.

    2017-09-01

    We have compiled a comprehensive library of all X-ray observations of Magellanic pulsars carried out by XMM-Newton, Chandra and RXTE in the period 1997-2014. In this work, we use the data from 53 high-mass Be/X-ray binaries in the Small Magellanic Cloud to demonstrate that the distribution of spin-period derivatives versus spin periods of spinning-down pulsars is not at all different from that of the accreting spinning-up pulsars. The inescapable conclusion is that the up and down samples were drawn from the same continuous parent population; therefore, Be/X-ray pulsars that are spinning down over periods spanning 18 yr are, in fact, accreting from retrograde discs. The presence of prograde and retrograde discs in roughly equal numbers supports a new evolutionary scenario for Be/X-ray pulsars in their spin period-period derivative diagram.

  3. Adrenocortical hemorrhagic necrosis: the role of catecholamines and retrograde medullary-cell embolism

    SciTech Connect

    Szabo, S.; McComb, D.J.; Kovacs, K.; Huettner, I.

    1981-10-01

    We investigated the pathogenesis of adrenal necrosis using animal models of the disease (induced by administration of acrylonitrile, cysteamine, or pyrazole) and human cases. Results of electron-microscopic and histochemical time-response studies with rat models revealed an early, retrograde embolization of medullary cells and cell fragments in the cortical capillaries that showed prominent endothelial injury. The experimental adrenal lesions were prevented by surgical removal of the medulla one month before administration of adrenocorticolytic chemicals, or by the administration of the alpha-adrenergic antagonist phenoxybenzamine hydrochloride. Histochemical staining for medullary (argyrophil) granules in human cases of adrenal necrosis demonstrated tissue fragments that stained positively for silver in vascular cortical spaces in nine of ten autopsy specimens and in all four surgical cases we reviewed. Thus, catecholamines released from the adrenal medulla and from the retrograde medullary emboli in the cortex may have a role in the pathogenesis of adrenocortical necrosis.

  4. CEUS Retrograde Cystography Is Helpful in Percutaneous Drainage of Complex Posttransplant Lymphocele.

    PubMed

    Di Domenico, Stefano; Patti, Valentina; Fazio, Federico; Moggia, Elisabetta; Fontana, Iris; Valente, Umberto

    2012-01-01

    After monolateral dual kidney transplantation, a 69 years old male patient developed symptomatic lymphocele with mild hydroureteronephrosis, impaired renal function, and right inferior limb oedema. A percutaneous ultrasound-guided drainage of the fluid collection was planned, but the complex mutual relations between the collection and the renal hilus did not allow to identify a suitable route for a safe drainage insertion during conventional ultrasound examination. A retrograde cystography using echographic contrast agent was, therefore, performed, and it clarified the position of both ureters and the renal vessels, permitting an harmless ultrasound-guided percutaneous lymphocele drainage. In conclusion contrast-enhanced ultrasound retrograde cystography may be helpful in percutaneous drainage of complex posttransplant lymphocele.

  5. LRRK2 regulates retrograde synaptic compensation at the Drosophila neuromuscular junction

    PubMed Central

    Penney, Jay; Tsurudome, Kazuya; Liao, Edward H.; Kauwe, Grant; Gray, Lindsay; Yanagiya, Akiko; R. Calderon, Mario; Sonenberg, Nahum; Haghighi, A. Pejmun

    2016-01-01

    Parkinson's disease gene leucine-rich repeat kinase 2 (LRRK2) has been implicated in a number of processes including the regulation of mitochondrial function, autophagy and endocytic dynamics; nevertheless, we know little about its potential role in the regulation of synaptic plasticity. Here we demonstrate that postsynaptic knockdown of the fly homologue of LRRK2 thwarts retrograde, homeostatic synaptic compensation at the larval neuromuscular junction. Conversely, postsynaptic overexpression of either the fly or human LRRK2 transgene induces a retrograde enhancement of presynaptic neurotransmitter release by increasing the size of the release ready pool of vesicles. We show that LRRK2 promotes cap-dependent translation and identify Furin 1 as its translational target, which is required for the synaptic function of LRRK2. As the regulation of synaptic homeostasis plays a fundamental role in ensuring normal and stable synaptic function, our findings suggest that aberrant function of LRRK2 may lead to destabilization of neural circuits. PMID:27432119

  6. Retrograde intubation in a case of ankylosing spondylitis posted for correction of deformity of spine

    PubMed Central

    Raval, Chetankumar; Patel, Heena; Patel, Pranoti; Kharod, Utpala

    2010-01-01

    Ankylosing spondylitis (AS) patients are most challenging. These patient present the most serious array of intubation and difficult airway imaginable, secondary to decrease or no cervical spine mobility, fixed flexion deformity of thoracolumbar spine and possible temporomandibular joint disease. Sound clinical judgment is critical for timing and selecting the method for airway intervention. The retrograde intubation technique is an important option when fiberoptic bronchoscope is not available, and other method is not applicable for gaining airway access for surgery in prone position. We report a case of AS with fixed flexion deformity of thoracic and thoracolumbar spine, fusion of posterior elements of cervical spine posted for lumbar spinal osteotomy with anticipated difficult intubation. An awake retrograde oral intubation with light sedation and local block is performed. PMID:20668567

  7. Effect of retrogradation time on preparation and characterization of proso millet starch nanoparticles.

    PubMed

    Sun, Qingjie; Gong, Min; Li, Ying; Xiong, Liu

    2014-10-13

    Starch nanoparticles were prepared from proso millet starch using a green and facile method combined with enzymolysis and recrystallization. Scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), differential scanning calorimeter (DSC) and thermal gravimetric analysis (TGA) were used to characterize the morphology and crystal structure of the starch nanoparticles prepared with different retrogradation time (0.5, 4, 12, and 24h). The results showed that the sizes of the starch nanoparticles were between 20 nm and 100 nm. The crystal pattern changed from A-type (native starch) to B-type (nanoparticles), and the relative crystallinity of the nanoparticles increased obviously, as compared with the native starch. The nanoparticles prepared with the 12h retrogradation time had the highest degree of crystallinity (47.04%). Compared to conventional acid hydrolysis to make starch nanoparticles, the present approach has the advantage of being quite rapid and presenting a higher yield (about 55%).

  8. A light microscope-based double retrograde tracer strategy to chart central neuronal connections.

    PubMed

    Ruigrok, Tom J H; Apps, Richard

    2007-01-01

    This protocol describes a double retrograde tracing method to chart divergent projections in the CNS using light microscope techniques. It is based on immunohistochemical visualization of retrograde transport of cholera toxin b-subunit (CTb) and silver enhancement of a gold-lectin conjugate. Production of the gold-lectin is explained in detail, and a technique is offered to record through the injection pipettes, to help guide accurate placement of injections. Visualization of the two tracers results in light brown staining of CTb-labeled neurons and labeling by black particles of gold-lectin-containing neurons. Both types of label are easily recognized in the same neuron. The labeling is permanent and is well suited for studies in which large areas of the brain need to be surveyed. The whole procedure (excluding survival time) takes approximately 5-7 d to complete.

  9. Primary pulmonary artery sarcoma extending retrograde into the superior vena cava.

    PubMed

    Portillo-Sanchez, José; Hessein-Abdou, Yasser; Puga-Alcalde, Eugenio; Perez-Martinez, Maria Angeles; Del Carmen Jimenez-Meneses, Maria; Camacho-Pedrero, Agustín; Valdepeñas-Herrero, Luís Ruíz

    2011-01-01

    Primary pulmonary artery sarcoma is a rare tumor that is highly fatal. It can be misdiagnosed as acute or chronic pulmonary thromboembolic disease. Herein, we report the case of a 22-year-old woman with a preoperative diagnosis of pulmonary embolism and superior vena caval thrombosis. Intraoperatively, an extensive sarcoma was seen to extend retrograde from the pulmonary artery, past the right ventricle and right atrium, and into the superior vena cava. Surgical resection of the tumor and reconstruction of the central pulmonary arteries, followed by adjuvant chemotherapy, relieved the clinical symptoms. The patient remained free of cancer at 14 months postoperatively. We believe that this is the 1st report of a primary pulmonary artery sarcoma that extended retrograde into the superior vena cava.

  10. Retrograde axonal transport of ciliary neurotrophic factor is increased by peripheral nerve injury.

    PubMed

    Curtis, R; Adryan, K M; Zhu, Y; Harkness, P J; Lindsay, R M; DiStefano, P S

    1993-09-16

    Ciliary neurotrophic factor (CNTF) promotes the survival of several populations of neurons, including sensory and motor neurons. Although CNTF is abundant in adult sciatic nerve, the mature protein lacks a signal sequence and is not secreted; therefore, it has been proposed to act as a lesion factor. The identification of a functional CNTF receptor revealed ligand-specific phosphorylation cascades and gene induction. However, it is not clear how these signal-transducing events are elicited in neuronal cell bodies that may be distant from the source of CNTF. We report here that CNTF can be retrogradely transported by adult sensory neurons. More importantly, sensory and motor neurons both show greatly increased transport of CNTF following peripheral nerve lesion. Axotomy-induced increases in retrograde transport of neurotrophic factors may be an important response of neuronal cell bodies during regeneration.

  11. Air embolism after endoscopic retrograde cholangiopancreatography in a patient with budd Chiari syndrome.

    PubMed

    Wills-Sanin, Beatriz; Cárdenas, Yenny R; Polanco, Lucas; Rivero, Oscar; Suarez, Sebastian; Buitrago, Andrés F

    2014-01-01

    Endoscopic retrograde cholangiopancreatography is a procedure commonly used for the diagnosis and treatment of various pancreatic and biliary diseases. Air embolism is a rare complication, which may be associated with this procedure. This condition can be manifested as cardiopulmonary instability and/or neurological symptoms. Known risk factors include: sphincterotomy; application of air with high intramural pressure; anatomic abnormalities; and chronic hepatobiliary inflammation. It is important for the health-care staff, including anesthesiologists, interventional gastroenterologists, and critical care specialists, amongst others, to promptly recognize air embolism and to initiate therapy in a timely fashion, thus preventing potentially fatal outcomes. We submit a brief review of the literature and a case report of air embolism which occurred in the immediate postoperative stage of an endoscopic retrograde cholangiopancreatography, performed in a woman with a history of liver transplantation due to Budd Chiari syndrome and biliary stricture.

  12. Air Embolism after Endoscopic Retrograde Cholangiopancreatography in a Patient with Budd Chiari Syndrome

    PubMed Central

    Wills-Sanin, Beatriz; Cárdenas, Yenny R.; Polanco, Lucas; Rivero, Oscar; Suarez, Sebastian; Buitrago, Andrés F.

    2014-01-01

    Endoscopic retrograde cholangiopancreatography is a procedure commonly used for the diagnosis and treatment of various pancreatic and biliary diseases. Air embolism is a rare complication, which may be associated with this procedure. This condition can be manifested as cardiopulmonary instability and/or neurological symptoms. Known risk factors include: sphincterotomy; application of air with high intramural pressure; anatomic abnormalities; and chronic hepatobiliary inflammation. It is important for the health-care staff, including anesthesiologists, interventional gastroenterologists, and critical care specialists, amongst others, to promptly recognize air embolism and to initiate therapy in a timely fashion, thus preventing potentially fatal outcomes. We submit a brief review of the literature and a case report of air embolism which occurred in the immediate postoperative stage of an endoscopic retrograde cholangiopancreatography, performed in a woman with a history of liver transplantation due to Budd Chiari syndrome and biliary stricture. PMID:25478242

  13. Combined retrograde labeling and calcium imaging in spinal cord and brainstem neurons of the lamprey.

    PubMed

    McClellan, A D; McPherson, D; O'Donovan, M J

    1994-11-07

    Neurons in the brainstem and spinal cord of the lamprey were retrogradely labeled with Calcium Green-dextran, an indicator dye that increases its fluorescence when intracellular calcium levels increase. Optical signals could be recorded from these labeled neurons during spinal cord stimulation, nerve stimulation, or spontaneous activity, up to 4 days after dye application and for distances of 5-14 mm away from the application site. Optical signals were enhanced by 4-AP, a potassium channel blocker, and blocked by cadmium, a calcium channel blocker. Taken together, the results suggest that the optical signals recorded from labeled neurons were due to calcium influx during electrical activity. Thus, retrograde labeling with calcium indicator dyes may provide a general purpose method for simultaneously monitoring the activity-related changes of intracellular calcium in anatomically identified groups of neurons in the lamprey nervous system.

  14. How High Can You Go?: Retrograde Nailing of Proximal Femur Fractures.

    PubMed

    Kuhn, Kevin M; Cannada, Lisa K; Watson, J Tracy; Ali, Ashley; Boudreau, John A; Mir, Hassan R; Bauer, Jennifer M; Mullis, Brian; Hymes, Robert; Genova, Renee; Tucker, Michael; Schlatter, Daniel

    2017-01-01

    There are no data-supported recommendations on how proximal is too proximal for retrograde nailing (RGN). At six level 1 trauma centers, patients with femur fractures within the proximal one-third of the femur treated with RGN were included. This article describes a proximal segment capture ratio (PSCR) and nail segment capture ratio to evaluate RGN of proximal fractures. The study included 107 patients. The average follow-up was 44 weeks. There were two nonunions and three malunions. There was no significant difference between PSCR of 0.3 or less and need for secondary procedures or time to full weight bearing (p>.05). In this study, a smaller (< 0.3) PSCR was not associated with an increased number of complications. A higher Orthopaedic Trauma Association classification was predictive of malunion and increased time to union. These data demonstrate that retrograde nailing is safe and effective for the treatment of supraisthmal femur fractures.

  15. The electromotor system of the electric eel investigated with horseradish peroxidase as a retrograde tracer.

    PubMed

    Bennett, M V; Sandri, C

    1989-05-29

    The electromotor system of the electric eel, Electrophorus electricus, was studied by injection of horseradish peroxidase as a retrograde tracer. The electromotor neurons, which innervate the electrocytes, comprise a midline nucleus, largely dorsal to the spinal canal. Spinal motoneurons lie ventrolaterally. The electromotor and skeletal motor neuron populations correspond to the acetylcholinesterase-negative and -positive cells previously described. The medullary relay neurons were labeled following HRP injection into the spinal cord at a level where electromotor neurons occurred, but not after injection into the cord in the abdominal region rostral to these cells. Other medullary neurons, presumably bulbospinal motor fibers, were labeled after both levels of spinal cord injection. The results suggest that these axosomatic synapses, which are electrically transmitting but morphologically mixed, take up retrograde tracers in a manner similar to chemical synapses and that tracer uptake is at least largely at terminal regions.

  16. Trans-synaptic Retrograde Degeneration in the Human Visual System: Slow, Silent, and Real.

    PubMed

    Dinkin, Marc

    2017-02-01

    Degeneration of neuron and axons following injury to cells with which they synapse is termed trans-synaptic degeneration. This phenomenon may be seen in postsynaptic neurons (anterograde) or in presynaptic neurons (retrograde). Retrograde trans-synaptic degeneration (RTSD) of the retinal ganglion cells and retinal nerve fiber layer following injury to the occipital lobe has been well documented histologically in animal studies, but its occurrence in the human retina was, for many years, felt to be limited to cases of neonatal injury during a critical period of neuronal development. Over the last decade, imaging techniques such as MRI and optical coherence tomography have allowed us to visualize and quantify RTSD and analyze its time course and relationship to degree of vision loss and age of cortical injury. A deeper understanding of RTSD in the human visual system may allow us to interfere with its occurrence, potentially allowing for greater recovery following visual cortex injury.

  17. Dominant-negative myosin Va impairs retrograde but not anterograde axonal transport of large dense core vesicles.

    PubMed

    Bittins, Claudia Margarethe; Eichler, Tilo Wolf; Hammer, John A; Gerdes, Hans-Hermann

    2010-04-01

    Axonal transport of peptide and hormone-containing large dense core vesicles (LDCVs) is known to be a microtubule-dependent process. Here, we suggest a role for the actin-based motor protein myosin Va specifically in retrograde axonal transport of LDCVs. Using live-cell imaging of transfected hippocampal neurons grown in culture, we measured the speed, transport direction, and the number of LDCVs that were labeled with ectopically expressed neuropeptide Y fused to EGFP. Upon expression of a dominant-negative tail construct of myosin Va, a general reduction of movement in both dendrites and axons was observed. In axons, it was particularly interesting that the retrograde speed of LDCVs was significantly impaired, although anterograde transport remained unchanged. Moreover, particles labeled with the dominant-negative construct often moved in the retrograde direction but rarely in the anterograde direction. We suggest a model where myosin Va acts as an actin-dependent vesicle motor that facilitates retrograde axonal transport.

  18. Diagnostic and therapeutic role of endoscopic retrograde cholangiopancreatography in biliary rhabdomyosarcoma

    PubMed Central

    Himes, Ryan W; Raijman, Isaac; Finegold, Milton J; Russell, Heidi V; Fishman, Douglas S

    2008-01-01

    Biliary rhabdomyosarcoma (BRMS) is an uncommon childhood malignancy which has been managed surgically. We present a case of a 3-year-old boy with BRMS, in whom endoscopic retrograde cholangiopancreatography (ERCP) was successfully used both diagnostically and therapeutically, thus obviating the need for surgery and its attendant risks of morbidity and mortality. We conclude that ERCP is an effective alternative to surgery for BRMS in some patients. PMID:18720547

  19. Antidromic Atrioventricular Reciprocating Tachycardia Using a Concealed Retrograde Conducting Left Lateral Accessory Pathway.

    PubMed

    Gonzalez, Jaime E; Zipse, Matthew M; Nguyen, Duy T; Sauer, William H

    2016-03-01

    Atrioventricular reciprocating tachycardia is a common cause of undifferentiated supraventricular tachycardia. In patients with manifest or concealed accessory pathways, it is imperative to assess for the presence of other accessory pathways. Multiple accessory pathways are present in 4% to 10% of patients and are more common in patients with structural heart disease. In rare cases, multiple accessory pathways can act as the anterograde and retrograde limbs of the tachycardia.

  20. Retrograde Stent Placement for Coil Embolization of a Wide-Necked Posterior Inferior Cerebellar Artery Aneurysm

    PubMed Central

    Roh, Hong Gee; Choi, Jin Woo; Cho, Joon; Moon, Won-Jin; Solander, Sten

    2012-01-01

    Wide-necked aneurysms of the posterior inferior cerebellar artery (PICA) are infrequently encountered in cerebrovascular practice, and endovascular treatment is difficult or impossible even with the use of several neck remodeling techniques. We present the case of a patient with a wide-necked aneurysm of the PICA, which was treated by the retrograde stenting through the contralateral vertebral artery and vertebrobasilar junction with antegrade coil embolization. PMID:22778576

  1. Transmission of Salmonella enteritidis after endoscopic retrograde cholangiopancreatography because of inadequate endoscope decontamination.

    PubMed

    Robertson, Paul; Smith, Andrew; Anderson, Margaret; Stewart, Jackie; Hamilton, Kate; McNamee, Sandra; Curran, Evonne T

    2017-04-01

    We report a historic nosocomial outbreak of Salmonella enteritidis affecting 4 inpatients who underwent endoscopic retrograde cholangiopancreatography. The cause was attributed to inadequate decontamination of an on-loan endoscope used over a weekend. This report highlights the risks of using on-loan endoscopes, particularly regarding their commissioning and adherence to disinfection protocols. In an era of increasing antibiotic resistance, transmission of Enterobacteriaceae by endoscopes remains a significant concern.

  2. Retrograde Inversion Stripping as a Complication of the Clarivein® Mechanochemical Venous Ablation Procedure

    PubMed Central

    Moore, HM; Franklin, IJ; Davies, AH

    2015-01-01

    The endovenous revolution has accelerated the development of new techniques and devices for the treatment of varicose veins. The ClariVein® mechanochemical ablation device offers tumescentless treatment with a rotating ablation tip that can theoretically become stuck in tissue. We present the first report of retrograde stripping of the small saphenous vein without anaesthesia following attempted use of the ClariVein® device, without adverse sequelae. PMID:25723675

  3. Functional relationship between mTERF4 and GUN1 in retrograde signaling

    PubMed Central

    Sun, Xuwu; Xu, Duorong; Liu, Zhixin; Kleine, Tatjana; Leister, Dario

    2016-01-01

    Plastid-to-nucleus retrograde signaling plays an important role in regulating the expression of photosynthesis-associated nuclear genes (PhANGs) in accordance with physiological demands on chloroplast biogenesis and function. Despite its fundamental importance, little is known about the molecular nature of the plastid gene expression (PGE)-dependent type of retrograde signaling. PGE is a multifaceted process, and several factors, including pentatricopeptide repeat (PPR) proteins, are involved in its regulation. The PPR protein GUN1 plays a central role in PGE-dependent retrograde signaling. In this study, we isolated a mutant exhibiting up-regulation of CHLOROPHYLL A/B-BINDING PROTEIN (CAB) under normal growth conditions (named coe1 for CAB overexpression 1). The coe1 mutant has a single-base mutation in the gene for mitochondrial transcription termination factor 4 (mTERF4)/BSM/RUG2, which plays a role in regulating the processing of certain plastid transcripts. Defects in GUN1 or mTERF4 de-repressed the expression of specific plastid mRNAs in the presence of lincomycin (LIN). In wild-type plants, treatment with LIN or spectinomycin (SPE) inhibited processing of plastid transcripts. Comparative analysis revealed that in gun1 and coe1/mterf4, but not in wild-type, gun4, or gun5 plants, the processing of plastid transcripts and expression levels of Lhcb1 mRNA were affected in opposite ways when plants were grown in the presence of LIN or SPE. In addition, the coe1 mutation affected the intracellular accumulation and distribution of GUN1, as well as its plastid signaling activity. Taken together, these results suggest that GUN1 and COE1 cooperate in PGE and retrograde signaling. PMID:26685190

  4. Percutaneous Retrograde Sclerotherapy for Refractory Bleeding of Jejunal Varices: Direct Injection via Superficial Epigastric Vein

    SciTech Connect

    Nakata, Manabu Nakata, Waka; Isoda, Norio Yoshizawa, Mitsuyo; Sugimoto, Hideharu

    2012-02-15

    Small-bowel varices are rare and almost always occur in cases with portal hypertension. We encountered a patient with bleeding jejunal varices due to liver cirrhosis. Percutaneous retrograde sclerotherapy was performed via the superficial epigastric vein. Melena disappeared immediately after treatment. Disappearance of jejunal varices was confirmed by contrast-enhanced computed tomography. After 24 months of follow-up, no recurrent melena was observed.

  5. Role of Retrograde Trafficking in Stress Response, Host Cell Interactions, and Virulence of Candida albicans

    PubMed Central

    Liu, Yaoping; Solis, Norma V.; Heilmann, Clemens J.; Phan, Quynh T.; Mitchell, Aaron P.; Klis, Frans M.

    2014-01-01

    In Saccharomyces cerevisiae, the vacuolar protein sorting complexes Vps51/52/53/54 and Vps15/30/34/38 are essential for efficient endosome-to-Golgi complex retrograde transport. Here we investigated the function of Vps15 and Vps51, representative members of these complexes, in the stress resistance, host cell interactions, and virulence of Candida albicans. We found that C. albicans vps15Δ/Δ and vps51Δ/Δ mutants had abnormal vacuolar morphology, impaired retrograde protein trafficking, and dramatically increased susceptibility to a variety of stressors. These mutants also had reduced capacity to invade and damage oral epithelial cells in vitro and attenuated virulence in the mouse model of oropharyngeal candidiasis. Proteomic analysis of the cell wall of the vps51Δ/Δ mutant revealed increased levels of the Crh11 and Utr2 transglycosylases, which are targets of the calcineurin signaling pathway. The transcript levels of the calcineurin pathway members CHR11, UTR2, CRZ1, CNA1, and CNA2 were elevated in the vps15Δ/Δ and vps51Δ/Δ mutants. Furthermore, these strains were highly sensitive to the calcineurin-specific inhibitor FK506. Also, deletion of CHR11 and UTR2 further increased the stress susceptibility of these mutants. In contrast, overexpression of CRH11 and UTR2 partially rescued their defects in stress resistance, but not host cell interactions. Therefore, intact retrograde trafficking in C. albicans is essential for stress resistance, host cell interactions, and virulence. Aberrant retrograde trafficking stimulates the calcineurin signaling pathway, leading to the increased expression of Chr11 and Utr2, which enables C. albicans to withstand environmental stress. PMID:24363364

  6. Septic Complication After Balloon-Occluded Retrograde Transvenous Obliteration of Duodenal Variceal Bleeding

    SciTech Connect

    Akasaka, Thai; Shibata, Toshiya Isoda, Hiroyoshi; Taura, Kojiro; Arizono, Shigeki; Shimada, Kotaro; Togashi, Kaori

    2010-12-15

    We report a 64-year-old woman with duodenal varices who underwent balloon-occluded retrograde transvenous obliteration (B-RTO) complicated by intraprocedural variceal rupture. The patient developed shivering and a fever higher than 40{sup o}C 3 days after the B-RTO procedure. A blood culture grew Entereobacter cloacoe. This case represents a rare septic complication of B-RTO for duodenal varices.

  7. Anterolateral Popliteal Puncture Technique: A Novel Retrograde Approach for Chronic Femoropopliteal Occlusions.

    PubMed

    Tan, Michinao; Urasawa, Kazushi; Koshida, Ryoji; Haraguchi, Takuya; Kitani, Shunsuke; Igarashi, Yasumi; Sato, Katsuhiko

    2017-08-01

    To describe the feasibility and safety of an anterolateral popliteal puncture technique as a retrograde access to chronic total occlusions (CTOs) in the femoropopliteal segment. Twenty consecutive patients (mean age 75.1±10.9 years; 13 women) with symptomatic femoropopliteal occlusive disease underwent endovascular therapy via a retrograde access using the anterolateral popliteal puncture technique. With the patient supine, the P3 segment of the popliteal artery was accessed with a sheathless technique intended to provide minimally invasive access. Subsequent to a wire rendezvous technique in the CTO, the antegrade guidewire was advanced to the below-the-knee artery. Hemostasis across the P3 segment was secured with balloon inflation alone or combined with thrombin-blood patch (TBP) injection. Both the anterolateral popliteal puncture technique and subsequent revascularization were successful in all patients. Mean hemostasis time for balloon inflation only was 7.73±4.03 vs 4.78±0.78 minutes for balloon inflation with TBP injection. There were no in-hospital deaths or complications, including pseudoaneurysms, arteriovenous fistulas, hematomas, embolic complications, or nerve damage. The anterolateral popliteal puncture technique is useful as an alternative retrograde access vs a conventional transpopliteal approach for CTOs in the femoropopliteal segment if antegrade recanalization has failed. This technique may become one option for retrograde access in patients with severe below-the-knee lesions or with CTOs that extend to the P2 segment of the popliteal artery. Furthermore, this technique has the added benefit of allowing patients to remain in the supine position throughout treatment.

  8. [Dilatation of the common bile duct without visible obstruction at endoscopic retrograde cholangiography. Description and development].

    PubMed

    Seyrig, J A; Liguory, C; Buffet, C; Fabre, M; Fritsch, J; Choury, A; Ladouch-Badre, A; Liguory-Brunaud, M D; Etienne, J P

    1988-05-01

    The aim of this study was to specify the signs and course of patients with a dilated common bile duct without obstruction. We included patients with a dilated common bile duct of more than 12 mm on endoscopic retrograde cholangiography, and we excluded patients with stones, tumor or other visible obstruction. Two hundred and seven patients (8.4 p. 100 of endoscopic retrograde cholangiography) were included. One hundred and nineteen (57.5 p. 100) had undergone cholecystectomy. Sixty-five p. 100 of patients had signs suggesting biliary tract disease, and 78 p. 100 had biological signs of cholestasis. The size of the common bile duct was not different whether the patient had been cholecystectomized (16.2 +/- 0.3 mm.M +/- SEM) or not (16.2 +/- 0.4 mm). Forty-one patients in the non cholecystectomized group had gallbladder stones. Thus, 47 of our 207 patients (23 p. 100) had neither gallbladder stones nor previous cholecystectomy. Endoscopic retrograde cholangiography was completed by endoscopic sphincterotomy in 130 patients, either in the intent of not missing obstruction, or for therapeutic purposes. Follow-up more than one month after endoscopic retrograde cholangiography was available for 159 patients (77 p. 100). The median survival was 73 months. One hundred and ten patients (69 p. 100) were asymptomatic, 36 (23 p. 100) had atypical abdominal pain while 13 (8 p. 100) patients had episodes of biliary colic and/or fever and/or jaundice. During follow-up, an initially unrecognized obstacle was discovered in 8 patients: 5 common bile duct stones, 2 ampullary tumors and one pancreatic tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. The movement of membranous organelles in axons. Electron microscopic identification of anterogradely and retrogradely transported organelles

    PubMed Central

    1980-01-01

    To identify the structures to be rapidly transported through the axons, we developed a new method to permit local cooling of mouse saphenous nerves in situ without exposing them. By this method, both anterograde and retrograde transport were successfully interrupted, while the structural integrity of the nerves was well preserved. Using radioactive tracers, anterogradely transported proteins were shown to accumulate just proximal to the cooled site, and retrogradely transported proteins just distal to the cooled site. Where the anterogradely transported proteins accumulated, the vesiculotubular membranous structures increased in amount inside both myelinated and unmyelinated axons. Such accumulated membranous structures showed a relatively uniform diameter of 50--80 nm, and some of them seemed to be continuous with the axonal smooth endoplasmic reticulum (SER). Thick sections of nerves selectively stained for the axonal membranous structures revealed that the network of the axonal SER was also packed inside axons proximal to the cooled site. In contrast, large membranous bodies of varying sizes accumulated inside axons just distal to the cooled site, where the retrogradely transported proteins accumulated. These bodies were composed mainly of multivesicular bodies and lamellated membranous structures. When horseradish peroxidase was administered in the distal end of the nerve, membranous bodies showing this activity accumulated, together with unstained membranous bodies. Hence, we are led to propose that, besides mitochondria, the membranous components in the axon can be classified into two systems from the viewpoint of axonal transport: "axonal SER and vesiculotubular structures" in the anterograde direction and "large membranous bodies" in the retrograde direction. PMID:6153657

  10. Retrograde Coronary Venous Ethanol Infusion for Ablation of Refractory Ventricular Tachycardia.

    PubMed

    Kreidieh, Bahij; Rodríguez-Mañero, Moisés; Schurmann, Paul; Ibarra-Cortez, Sergio Hugo; Dave, Amish S; Valderrábano, Miguel

    2016-07-01

    Radiofrequency ablation (RFA) of ventricular tachycardia (VT) can fail because of inaccessibility to the VT substrate. Transarterial coronary ethanol ablation can be effective but entails arterial instrumentation risk. We hypothesized that retrograde coronary venous ethanol ablation can be an alternative bail-out approach to failed VT RFA. Out of 334 consecutive patients undergoing VT/premature ventricular contraction ablation, 7 patients underwent retrograde coronary venous ethanol ablation. Six out of 7 patients had failed RFA attempts (including epicardial in 3). Coronary venogram-guided venous mapping was performed using a 4F quadripolar catheter or an alligator-clip-connected angioplasty wire. Targeted veins included those with early presystolic potentials and pace-maps matching VT/premature ventricular contraction. An angioplasty balloon (1.5-2×6 mm) was used to deliver 1 to 4 cc of 98% ethanol into a septal branch of the anterior interventricular vein in 5 patients with left ventricular summit VT, a septal branch of the middle cardiac vein, and a posterolateral coronary vein (n=1 each). The clinical VT was successfully ablated acutely in all patients. There were no complications of retrograde coronary venous ethanol ablation, but 1 patient developed pericardial and pleural effusion attributed to pericardial instrumentation. On follow-up of 590±722 days, VT recurred in 4 out of 7 patients, 3 of whom were successfully reablated with RFA. Retrograde coronary venous ethanol ablation is safe and feasible as a bail-out approach to failed VT RFA, particularly those originating from the left ventricular summit. © 2016 American Heart Association, Inc.

  11. Successful Treatment of Mesenteric Varices After Living Donor Liver Transplantation with Retrograde Transvenous Obliteration Via an Abdominal Wall Vein

    SciTech Connect

    Ikeda, Osamu Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki; Okajima, Hideaki; Asonuma, Katsuhiro; Inomata, Yukihiro

    2010-06-15

    Balloon-occluded retrograde transvenous obliteration is an established treatment for gastric varices; it has been used more rarely to treat mesenteric varices. We report a 12-year-old girl who had received a living donor liver transplant and suffered melena due to ruptured mesenteric varices. We addressed treatment of the mesenteric varices by retrograde transvenous obliteration of an abdominal wall collateral vein detected by superior mesenteric arteriography.

  12. Acoustic determination of dewpoints in natural gas mixtures and retrograde condensates. Annual report, January 1-December 31, 1990

    SciTech Connect

    Colgate, S.O.

    1991-01-01

    In a continuation of verification studies of the acoustic resonance technique for phase boundary determinations, the critical point and some neighboring dewpoints and bubble points of a complex mixture, the recombined Hobart Ranch retrograde condensate, are to be measured and compared to earlier visual technique measurements (D.B. Robinson, et al.). A new high performance FFT-ARS spherical resonator assembly was designed, fabricated and tested. Measurements on the retrograde condensate system are ready to begin.

  13. Manipulation of arterial stiffness, wave reflections, and retrograde shear rate in the femoral artery using lower limb external compression.

    PubMed

    Heffernan, Kevin S; Lefferts, Wesley K; Kasprowicz, Ari G; Tarzia, Brendan J; Thijssen, Dick H; Brutsaert, Tom D

    2013-07-01

    Exposure of the arterial wall to retrograde shear acutely leads to endothelial dysfunction and chronically contributes to a proatherogenic vascular phenotype. Arterial stiffness and increased pressure from wave reflections are known arbiters of blood flow in the systemic circulation and each related to atherosclerosis. Using distal external compression of the calf to increase upstream retrograde shear in the superficial femoral artery (SFA), we examined the hypothesis that changes in retrograde shear are correlated with changes in SFA stiffness and pressure from wave reflections. For this purpose, a pneumatic cuff was applied to the calf and inflated to 0, 35, and 70 mmHg (5 min compression, randomized order, separated by 5 min) in 16 healthy young men (23 ± 1 years of age). Doppler ultrasound and wave intensity analysis was used to measure SFA retrograde shear rate, reflected pressure wave intensity (negative area [NA]), elastic modulus (Ep), and a single-point pulse wave velocity (PWV) during acute cuff inflation. Cuff inflation resulted in stepwise increases in retrograde shear rate (P < 0.05 for main effect). There were also significant cuff pressure-dependent increases in NA, Ep, and PWV across conditions (P < 0.05 for main effects). Change in NA, but not Ep or PWV, was associated with change in retrograde shear rate across conditions (P < 0.05). In conclusion, external compression of the calf increases retrograde shear, arterial stiffness, and pressure from wave reflection in the upstream SFA in a dose-dependent manner. Wave reflection intensity, but not arterial stiffness, is correlated with changes in peripheral retrograde shear with this hemodynamic manipulation.

  14. Multiple-indicator dilution technique for characterization of normal and retrograde flow in once-through rat liver perfusions

    SciTech Connect

    St-Pierre, M.V.; Schwab, A.J.; Goresky, C.A.; Lee, W.F.; Pang, K.S.

    1989-02-01

    The technique of normal and retrograde rat liver perfusion has been widely used to probe zonal differences in drug-metabolizing activities. The validity of this approach mandates the same tissue spaces being accessed by substrates during both normal and retrograde perfusions. Using the multiple-indicator dilution technique, we presently examine the extent to which retrograde perfusion alters the spaces accessible to noneliminated references. A bolus dose of 51Cr-labeled red blood cells, 125I-albumin, 14C-sucrose and 3H2O was injected into the portal (normal) or hepatic (retrograde) vein of rat livers perfused at 10 ml per min per liver. The outflow perfusate was serially collected over 220 sec to characterize the transit times and the distribution spaces of the labels. During retrograde perfusion, red blood cells, albumin and sucrose profiles peaked later and lower than during normal perfusion, whereas the water curves were similar. The transit times of red blood cells, albumin and sucrose were longer (p less than 0.005), whereas those for water did not change. Consequently, retrograde flow resulted in significantly larger sinusoidal blood volumes (45%), albumin Disse space (42%) and sucrose Disse space (25%) than during normal flow, whereas the distribution spaces for total and intracellular water remained unaltered. The distension of the vascular tree was confirmed by electron microscopy, by which occasional isolated foci of widened intercellular recesses and spaces of Disse were observed. Cellular ultrastructure was otherwise unchanged, and there was no difference found between normal and retrograde perfusion for bile flow rates, AST release, perfusion pressure, oxygen consumption and metabolic removal of ethanol, a substrate with flow-limited distribution, which equilibrates rapidly with cell water (hepatic extraction ratios were virtually identical: normal vs. retrograde, 0.50 vs. 0.48 at 6 to 7.4 mM input concentration).

  15. Retrograde and anterograde memory following selective damage to the dorsolateral entorhinal cortex.

    PubMed

    Gervais, Nicole J; Barrett-Bernstein, Meagan; Sutherland, Robert J; Mumby, Dave G

    2014-12-01

    Anatomical and electrophysiological evidence suggest the dorsolateral entorhinal cortex (DLEC) is involved in processing spatial information, but there is currently no consensus on whether its functions are necessary for normal spatial learning and memory. The present study examined the effects of excitotoxic lesions of the DLEC on retrograde and anterograde memory on two tests of allocentric spatial learning: a hidden fixed-platform watermaze task, and a novelty-preference-based dry-maze test. Deficits were observed on both tests when training occurred prior to but not following n-methyl d-aspartate (NMDA) lesions of DLEC, suggesting retrograde memory impairment in the absence of anterograde impairments for the same information. The retrograde memory impairments were temporally-graded; rats that received DLEC lesions 1-3 days following training displayed deficits, while those that received lesions 7-10 days following training performed like a control group that received sham surgery. The deficits were not attenuated by co-infusion of tetrodotoxin, suggesting they are not due to disruption of neural processing in structures efferent to the DLEC, such as the hippocampus. The present findings provide evidence that the DLEC is involved in the consolidation of allocentric spatial information.

  16. Apicoectomies with the erbium laser: a complementary technique for retrograde endodontic treatment.

    PubMed

    Angiero, Francesca; Benedicenti, Stefano; Signore, Antonio; Parker, Steven; Crippa, Rolando

    2011-12-01

    The purpose of this study was to evaluate the efficacy of erbium lasers for retrograde endodontic treatment, in terms of clinical outcome and therapeutic success. Apicoectomy with retrograde filling is a well-established surgical procedure to treat teeth affected by persistent periapical lesions. The apical root end is generally removed with burs, and the adjacent periapical tissue curetted, or alternatively treated with ultrasound or laser. Between 2000 and 2010, 65 apicoectomies were performed on necrotic teeth that presented apical lesions (29 men, 36 women). The lasers used in the study were the erbium:yttrium-aluminum-garnet (Er:YAG) laser, wavelength 2940 nm, and the erbium,chromium-doped:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser, wavelength 2780 nm. Of the 65 teeth in the study, failure only occurred in 9 CASES, MANIFESTING AFTER DIFFERENT TIMES. THE REMAINING PATIENTS, 86.15%, experienced no complications, and their treatment followed a positive course. Laser-assisted surgery increases the range of therapeutic approaches in the sphere of retrograde endodontic treatment. The results of this study show that the erbium laser, used for apicoectomy, results in a high success rate with considerable benefit in terms of clinical outcome and therapeutic success.

  17. Retrograde axonal transport of VZV: kinetic studies in hESC-derived neurons.

    PubMed

    Grigoryan, Sergei; Kinchington, Paul R; Yang, In Hong; Selariu, Anca; Zhu, Hua; Yee, Michael; Goldstein, Ronald S

    2012-12-01

    Retrograde axonal transport of the neurotropic alphaherpesvirus Varicella zoster virus (VZV) from vesicles at the skin results in sensory neuron infection and establishment of latency. Reactivation from latency leads to painful herpes zoster. The lack of a suitable animal model of these processes for the highly human-restricted VZV has resulted in a dearth of knowledge regarding the axonal transport of VZV. We recently demonstrated VZV infection of distal axons, leading to subsequent capsid transport to the neuronal somata, and replication and release of infectious virus using a new model based on neurons derived from human embryonic stem cells (hESC). In the present study, we perform a kinetic analysis of the retrograde transport of green fluorescent protein-tagged ORF23 in VZV capsids using hESC-derived neurons compartmentalized microfluidic chambers and time-lapse video microscopy. The motion of the VZV was discontinuous, showing net retrograde movement with numerous short pauses and reversals in direction. Velocities measured were higher 1 h after infection than 6 h after infection, while run lengths were similar at both time points. The hESC-derived neuron model was also used to show that reduced neuronal spread by a VZV loss-of-function mutant for ORF7 is not due to the prevention of axonal infection and transport of the virus to the neuronal somata. hESC-derived neurons are, therefore, a powerful model for studying axonal transport of VZV and molecular characteristics of neuronal infection.

  18. WD60/FAP163 is a dynein intermediate chain required for retrograde intraflagellar transport in cilia.

    PubMed

    Patel-King, Ramila S; Gilberti, Renée M; Hom, Erik F Y; King, Stephen M

    2013-09-01

    Retrograde intraflagellar transport (IFT) is required for assembly of cilia. We identify a Chlamydomonas flagellar protein (flagellar-associated protein 163 [FAP163]) as being closely related to the D1bIC(FAP133) intermediate chain (IC) of the dynein that powers this movement. Biochemical analysis revealed that FAP163 is present in the flagellar matrix and is actively trafficked by IFT. Furthermore, FAP163 copurified with D1bIC(FAP133) and the LC8 dynein light chain, indicating that it is an integral component of the retrograde IFT dynein. To assess the functional role of FAP163, we generated an RNA interference knockdown of the orthologous protein (WD60) in planaria. The Smed-wd60(RNAi) animals had a severe ciliary assembly defect that dramatically compromised whole-organism motility. Most cilia were present as short stubs that had accumulated large quantities of IFT particle-like material between the doublet microtubules and the membrane. The few remaining approximately full-length cilia had a chaotic beat with a frequency reduced from 24 to ∼10 Hz. Thus WD60/FAP163 is a dynein IC that is absolutely required for retrograde IFT and ciliary assembly.

  19. Retrograde Lymph Flow Leads to Chylothorax in Transgenic Mice with Lymphatic Malformations.

    PubMed

    Nitschké, Maximilian; Bell, Alexander; Karaman, Sinem; Amouzgar, Meelad; Rutkowski, Joseph M; Scherer, Philipp E; Alitalo, Kari; McDonald, Donald M

    2017-09-01

    Chylous pleural effusion (chylothorax) frequently accompanies lymphatic vessel malformations and other conditions with lymphatic defects. Although retrograde flow of chyle from the thoracic duct is considered a potential mechanism underlying chylothorax in patients and mouse models, the path chyle takes to reach the thoracic cavity is unclear. Herein, we use a novel transgenic mouse model, where doxycycline-induced overexpression of vascular endothelial growth factor (VEGF)-C was driven by the adipocyte-specific promoter adiponectin (ADN), to determine how chylothorax forms. Surprisingly, 100% of adult ADN-VEGF-C mice developed chylothorax within 7 days. Rapid, consistent appearance of chylothorax enabled us to examine the step-by-step development in otherwise normal adult mice. Dynamic imaging with a fluorescent tracer revealed that lymph in the thoracic duct of these mice could enter the thoracic cavity by retrograde flow into enlarged paravertebral lymphatics and subpleural lymphatic plexuses that had incompetent lymphatic valves. Pleural mesothelium overlying the lymphatic plexuses underwent exfoliation that increased during doxycycline exposure. Together, the findings indicate that chylothorax in ADN-VEGF-C mice results from retrograde flow of chyle from the thoracic duct into lymphatic tributaries with defective valves. Chyle extravasates from these plexuses and enters the thoracic cavity through exfoliated regions of the pleural mesothelium. Copyright © 2017 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  20. Mozart, Mozart Rhythm and Retrograde Mozart Effects: Evidences from Behaviours and Neurobiology Bases

    PubMed Central

    Xing, Yingshou; Xia, Yang; Kendrick, Keith; Liu, Xiuxiu; Wang, Maosen; Wu, Dan; Yang, Hua; Jing, Wei; Guo, Daqing; Yao, Dezhong

    2016-01-01

    The phenomenal finding that listening to Mozart K.448 enhances performance on spatial tasks has motivated a continuous surge in promoting music education over the past two decades. But there have been inconsistent reports in previous studies of the Mozart effect. Here conducted was a systematic study, with Mozart and retrograde Mozart music, Mozart music rhythm and pitch, behaviours and neurobiology tests, rats and humans subjects. We show that while the Mozart K.448 has positive cognitive effects, the retrograde version has a negative effect on rats’ performance in the Morris water maze test and on human subjects’ performance in the paper folding and cutting test and the pencil-and-paper maze test. Such findings are further confirmed by subsequent immunohistochemical analyses in rats on the neurogenesis and protein levels of BDNF and its receptor, TrkB. Furthermore, when the rhythm and pitch of the normal and retrograde Mozart music are manipulated independently, the learning performance of the rats in the Morris water maze test indicated that rhythm is a crucial element in producing the behavioural effects. These findings suggest that the nature of Mozart effect is the Mozart rhythm effect, and indicate that different music may have quite different to opposite effects. Further study on rhythm effect may provide clues to understand the common basis over animals from rats to humans. PMID:26795072

  1. Mozart, Mozart Rhythm and Retrograde Mozart Effects: Evidences from Behaviours and Neurobiology Bases.

    PubMed

    Xing, Yingshou; Xia, Yang; Kendrick, Keith; Liu, Xiuxiu; Wang, Maosen; Wu, Dan; Yang, Hua; Jing, Wei; Guo, Daqing; Yao, Dezhong

    2016-01-21

    The phenomenal finding that listening to Mozart K.448 enhances performance on spatial tasks has motivated a continuous surge in promoting music education over the past two decades. But there have been inconsistent reports in previous studies of the Mozart effect. Here conducted was a systematic study, with Mozart and retrograde Mozart music, Mozart music rhythm and pitch, behaviours and neurobiology tests, rats and humans subjects. We show that while the Mozart K.448 has positive cognitive effects, the retrograde version has a negative effect on rats' performance in the Morris water maze test and on human subjects' performance in the paper folding and cutting test and the pencil-and-paper maze test. Such findings are further confirmed by subsequent immunohistochemical analyses in rats on the neurogenesis and protein levels of BDNF and its receptor, TrkB. Furthermore, when the rhythm and pitch of the normal and retrograde Mozart music are manipulated independently, the learning performance of the rats in the Morris water maze test indicated that rhythm is a crucial element in producing the behavioural effects. These findings suggest that the nature of Mozart effect is the Mozart rhythm effect, and indicate that different music may have quite different to opposite effects. Further study on rhythm effect may provide clues to understand the common basis over animals from rats to humans.

  2. The sealing ability of novel Kryptonite adhesive bone cement as a retrograde filling material

    PubMed Central

    Uzun, İsmail; Keskin, Cangül; Güler, Buğra

    2016-01-01

    Background. This study evaluated the ability of Kryptonite bone cement in sealing retrograde cavities. Methods. The root canals of one hundred extracted human maxillary incisor teeth were instrumented up to master apical file #40 using Mtwo rotary system and obturated with gutta-percha and AHPlus sealer by cold lateral compaction method. The specimens were assigned to one control group and four experimental groups based on the retrograde filling materials (n=20). The specimens were immersed in 0.5% Rhodamine B solution for 48h. Then the specimens were divided longitudinally into two parts and the depth of dye penetration was assessed under ×10 magnification. Data were analyzed using one-way ANOVA and Bonferroni tests. Results. There were statistically significant difference between the experimental groups and the control group (P<0.05). There were no statistically significant differences between the experimental groups in dye penetration scores (P>0.05). Conclusion. Kryptonite cement provided optimal apical seal in a manner similar to MTA, amalgam and IRM when used as a retrograde filling cement. PMID:27651886

  3. Innovations in the Endovascular Management of Critical Limb Ischemia: Retrograde Tibiopedal Access and Advanced Percutaneous Techniques.

    PubMed

    Mustapha, Jihad A; Diaz-Sandoval, Larry J; Saab, Fadi

    2017-08-01

    Retrograde tibiopedal access and interventions have contributed to advance of endovascular techniques to treat critical limb ischemia (CLI) patients. This review encompasses the spectrum from advanced diagnostic imaging and technical therapeutic approaches for infrapopliteal occlusions, to a discussion of current standards and future directions. Contemporary studies of infrapopliteal angioplasty show suboptimal short-term and 1-year clinical outcomes. Comparative data is needed to shift the focus from PTA to disruptive treatment modalities that can further improve outcomes. Retrograde pedal access has emerged as an important tool to facilitate successfully percutaneous revascularization and limb salvage in patients with CLI. To efficiently approach the complexity of CLI, new thought processes are needed to change the reigning paradigms. Retrograde tibial-pedal access has shown improvement in the rate of successful revascularizations and is an important tool in the amputation-prevention armamentarium. Additional technologies may further improve success rates. Drug-eluting stents have shown better outcomes than PTA in patients with focal infrapopliteal lesions. Registry data have demonstrated the advantage of several atherectomy devices in the tibial arteries. More recently, bioresorbable vascular scaffolds have been used successfully, and further studies with drug-coated balloons are underway. Interventional operators are now even working in the inframalleolar space to reconstitute the plantar arch. Well-conducted studies are needed to generate high-quality evidence in the field of critical limb ischemia management.

  4. Unraveling retrograde signaling pathways: finding candidate signaling molecules via metabolomics and systems biology driven approaches.

    PubMed

    Caldana, Camila; Fernie, Alisdair R; Willmitzer, Lothar; Steinhauser, Dirk

    2012-01-01

    A tight coordination of biological processes between cellular compartments and organelles is crucial for the survival of any eukaryotic organism. According to cellular requirements, signals can be generated within organelles, such as chloroplasts and mitochondria, modulating the nuclear gene expression in a process called retrograde signaling. Whilst many research efforts have been focused on dissecting retrograde signaling pathways using biochemical and genetics approaches, metabolomics and systems biology driven studies have illustrated their great potential for hypotheses generation and for dissecting signaling networks in a rather unbiased or untargeted fashion. Recently, integrative genomics approaches, in which correlation analysis has been applied on transcript and metabolite profiling data of Arabidopsis thaliana, revealed the identification of metabolites which are putatively acting as mediators of nuclear gene expression. Complimentary, the continuous technological developments in the field of metabolomics per se has further demonstrated its potential as a very suitable readout to unravel metabolite-mediated signaling processes. As foundation for these studies here we outline and discuss recent advances in elucidating retrograde signaling molecules and pathways with an emphasis on metabolomics and systems biology driven approaches.

  5. Geldanamycin Enhances Retrograde Transport of Shiga Toxin in HEp-2 Cells.

    PubMed

    Dyve Lingelem, Anne Berit; Hjelseth, Ieva Ailte; Simm, Roger; Torgersen, Maria Lyngaas; Sandvig, Kirsten

    2015-01-01

    The heat shock protein 90 (Hsp90) inhibitor geldanamycin (GA) has been shown to alter endosomal sorting, diverting cargo destined for the recycling pathway into the lysosomal pathway. Here we investigated whether GA also affects the sorting of cargo into the retrograde pathway from endosomes to the Golgi apparatus. As a model cargo we used the bacterial toxin Shiga toxin, which exploits the retrograde pathway as an entry route to the cytosol. Indeed, GA treatment of HEp-2 cells strongly increased the Shiga toxin transport to the Golgi apparatus. The enhanced Golgi transport was not due to increased endocytic uptake of the toxin or perturbed recycling, suggesting that GA selectively enhances endosomal sorting into the retrograde pathway. Moreover, GA activated p38 and both inhibitors of p38 or its substrate MK2 partially counteracted the GA-induced increase in Shiga toxin transport. Thus, our data suggest that GA-induced p38 and MK2 activation participate in the increased Shiga toxin transport to the Golgi apparatus.

  6. Percutaneous balloon aortic valvuloplasty: antegrade transseptal vs. conventional retrograde transarterial approach.

    PubMed

    Sakata, Yoshihito; Syed, Zubair; Salinger, Michael H; Feldman, Ted

    2005-03-01

    Percutaneous balloon aortic valvuloplasty (BAV) has been limited predominantly to a palliative treatment for poor surgical candidates with critical aortic stenosis and multiple high-risk or comorbid conditions. The most commonly used technique for BAV is the retrograde approach, in which the balloon is passed via the femoral artery using 12-14 Fr sheaths. We compared an antegrade transseptal approach using the Inoue balloon vs. the retrograde transarterial approach using conventional balloons. The antegrade group had an improved acute hemodynamic outcome, including 20% additional increase of aortic valve area and 20% greater reduction of transaortic valve gradient compared to the retrograde approach. Preclosure with the Perclose device was used for the 14 Fr venous access sites, resulting in immediate hemostasis, minimizing the need for transfusion, and diminishing the period of bed rest. The improved acute efficacy and relative ease of venous access for the antegrade approach facilitate BAV by eliminating the need for large-caliber arterial access sheaths. The antegrade approach also incorporates technical elements necessary for percutaneous aortic valve replacement and may have expanded applications as an adjunct to this developing therapy. The impact of improved acute results on the long-term clinical outcome for this patient group will require further study.

  7. NUMERICAL SIMULATIONS OF NATURALLY TILTED, RETROGRADELY PRECESSING, NODAL SUPERHUMPING ACCRETION DISKS

    SciTech Connect

    Montgomery, M. M.

    2012-02-15

    Accretion disks around black hole, neutron star, and white dwarf systems are thought to sometimes tilt, retrogradely precess, and produce hump-shaped modulations in light curves that have a period shorter than the orbital period. Although artificially rotating numerically simulated accretion disks out of the orbital plane and around the line of nodes generate these short-period superhumps and retrograde precession of the disk, no numerical code to date has been shown to produce a disk tilt naturally. In this work, we report the first naturally tilted disk in non-magnetic cataclysmic variables using three-dimensional smoothed particle hydrodynamics. Our simulations show that after many hundreds of orbital periods, the disk has tilted on its own and this disk tilt is without the aid of radiation sources or magnetic fields. As the system orbits, the accretion stream strikes the bright spot (which is on the rim of the tilted disk) and flows over and under the disk on different flow paths. These different flow paths suggest the lift force as a source to disk tilt. Our results confirm the disk shape, disk structure, and negative superhump period and support the source to disk tilt, source to retrograde precession, and location associated with X-ray and He II emission from the disk as suggested in previous works. Our results identify the fundamental negative superhump frequency as the indicator of disk tilt around the line of nodes.

  8. Retrograde intramedullary fixation of long bone fractures through ipsilateral traumatic amputation sites.

    PubMed

    Wagner, Scott C; Chi, Benjamin B; Gordon, Wade T; Potter, Benjamin K

    2015-06-01

    The technique of retrograde intramedullary fixation of fractures through open traumatic amputations has not been previously described. We performed a retrospective case series at a tertiary-care military hospital setting. Ten patients met inclusion criteria. All were male, and all were injured through improvised explosive device. Outcome measures included the incidence of fracture nonunion, osteomyelitis or acute infection, heterotopic ossification (HO), as well as successful prosthesis fitting and ambulation. Average time to fixation after injury and amputation closure was 11.7 and 12.2 days, respectively. Follow-up averaged 20.2 months. The radiographic union rate was 100%, and time to osseous union averaged 7.5 months. One patient had an amputation site infection requiring revision, but none of the nails was removed for infectious reasons. HO occurred in 7 patients, and 2 patients required revision for symptomatic HO. All patients were successfully fitted with prostheses and able to ambulate. To our knowledge, this is the only series in the literature to specifically describe retrograde intramedullary fixation of long bone fractures through the zone of traumatic amputation sites. The infectious risk is relatively low, whereas the union rate (100%) and successful prosthesis fitting are high. For patients with similar injuries, retrograde intramedullary fixation through the zone of amputation is a viable treatment option.

  9. Subintimal Recanalization of Long Superficial Femoral Artery Occlusions Through the Retrograde Popliteal Approach

    SciTech Connect

    Yilmaz, Saim; Sindel, Timur; Ceken, Kagan; Alimoglu, Emel; Lueleci, Ersin

    2001-05-15

    Purpose: To investigate the value of the retrograde popliteal artery approach for the percutaneous intentional extraluminal recanalization (PIER) of long superficial femoral artery (SFA) occlusions.Methods: During a period of 17 months, PIER through ultrasound-guided retrograde popliteal artery puncture was performed for 39 long SFA occlusions in 37 patients. In six patients, six additional iliac artery stenoses were also treated via the popliteal approach.Results: The procedure was technically successful in 32 (82%) of 39 SFA occlusions; in 29, lesions were treated with balloon angioplasty alone, and in three, stents were also used. Cumulative patency rate was 66% at 6 months, 62% at 1 year, and 59% at 18 months. Additional iliac artery stenoses were successfully treated in the same session. Complications included two minor hematomas and two SFA ruptures, which required no treatment.Conclusion: PIER through retrograde popliteal puncture is a safe and effective method in the treatment of long femoropopliteal occlusions, with a high technical success, low complication rate and a reasonable short-term patency rate. The technique offers an alternative in cases where standard PIER is unsuccessful or contraindicated.

  10. Rabies virus envelope glycoprotein targets lentiviral vectors to the axonal retrograde pathway in motor neurons.

    PubMed

    Hislop, James N; Islam, Tarin A; Eleftheriadou, Ioanna; Carpentier, David C J; Trabalza, Antonio; Parkinson, Michael; Schiavo, Giampietro; Mazarakis, Nicholas D

    2014-06-06

    Rabies pseudotyped lentiviral vectors have great potential in gene therapy, not least because of their ability to transduce neurons following their distal axonal application. However, very little is known about the molecular processes that underlie their retrograde transport and cell transduction. Using multiple labeling techniques and confocal microscopy, we demonstrated that pseudotyping with rabies virus envelope glycoprotein (RV-G) enabled the axonal retrograde transport of two distinct subtypes of lentiviral vector in motor neuron cultures. Analysis of this process revealed that these vectors trafficked through Rab5-positive endosomes and accumulated within a non-acidic Rab7 compartment. RV-G pseudotyped vectors were co-transported with both the tetanus neurotoxin-binding fragment and the membrane proteins thought to mediate rabies virus endocytosis (neural cell adhesion molecule, nicotinic acetylcholine receptor, and p75 neurotrophin receptor), thus demonstrating that pseudotyping with RV-G targets lentiviral vectors for transport along the same pathway exploited by several toxins and viruses. Using motor neurons cultured in compartmentalized chambers, we demonstrated that axonal retrograde transport of these vectors was rapid and efficient; however, it was not able to transduce the targeted neurons efficiently, suggesting that impairment in processes occurring after arrival of the viral vector in the soma is responsible for the low transduction efficiency seen in vivo, which suggests a novel area for improvement of gene therapy vectors.

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