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Sample records for balloon-occluded retrograde transvenous

  1. Balloon occluded retrograde transvenous obliteration of bleeding stomal varices using sodium tetradecyl sulfate foam: A case report

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    Kim, Ji Chang; Yang, Po Sang; Lee, Yeon Soo; Kim, Hyun Jeong; Park, Gun [Dept. of Radiology, The Catholic University of Korea College of Medicine, Daejeon St. Mary' s Hospital, Daejeon (Korea, Republic of)

    2015-05-15

    A small varix is an uncommon complication with a high mortality rate occurring secondary to portal hypertension in patients with a stoma. We describe a case of recurrent stomal varix bleeding successfully managed by balloon occluded retrograde transvenous obliteration using sodium tetradecyl sulfate foam.

  2. Balloon occluded retrograde transvenous obliteration of bleeding stomal varices using sodium tetradecyl sulfate foam: A case report

    International Nuclear Information System (INIS)

    A small varix is an uncommon complication with a high mortality rate occurring secondary to portal hypertension in patients with a stoma. We describe a case of recurrent stomal varix bleeding successfully managed by balloon occluded retrograde transvenous obliteration using sodium tetradecyl sulfate foam.

  3. Balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding patient

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    Kim, Young Hwan; Seong, Chang Kyu; Kim, Yong Joo; Park, Noh Hyuk [Kyungpook National University School of Medicine, Daegu (Korea, Republic of); Shin, Tae Beom [Dong-A University Medical Center, Pusan (Korea, Republic of); Choi, Jin Soo [Soonchunhyang University College of Medicine, Asan (Korea, Republic of)

    2003-03-01

    To evaluate the technical feasibility and clinical efficacy of balloon-occluded retrograde transvenous obliteration (BRTO) in the treatment of gastric variceal bleeding. Between September 2001 and March 2002, ten patients with gastric variceal bleeding and gastrorenal shunt, underwent BRTO. Three of the ten also had hepatic encephalopathy. To evaluated the gastrorenal shunt and exclude portal vein thrombosis, all patients underwent pre-procedural CT scanning. An occlusion balloon catheter was inserted from the right internal jugular vein and on ballooning was wedged into the left adrenal vein. A sclerosing agent (5% ethanolamine oleate-lipiodol mixture) was injected until the varices were completely filled. In four patients, the collateral veins seen at balloon-occluded adrenal venography were embolized with coils prior to sclerotherapy. Post-procedural follow-up CT (n=3) or endoscopy (n=8) was performed 1-4 weeks later, and both before and after the procedure, hepatic function was also monitored. Treatment was successful in nine cases: the failure involed rupture of the occlusion balloon during inflation, and a transjugular intrahepatic portosystemic shunt was performed. The cessation of bleeding was confirmed endoscopically or clinically; in three patients, follow-up CT showed complete obliteration of the varices. Hepatic function improved in eight patients, but three weeks after the procedure, one expired due to progressive infiltrative hepatoma. The clinical symptoms of the three patients with hepatic encephalopathy showed remarkable improvement. Although more extensive studies and long-term follow up are needed to overcome the limitations of our study, we believe that BRTO is a technically feasible and clinically effective treatment for gastric varices and hepatic encephalopathy.

  4. Efficacy and safety of balloon-occluded retrograde transvenous obliteration with sodium tetradecyl sulfate liquid sclerotherapy

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    Chang, Il Soo; Park, Sang Woo; Kwon, So Young; Cheo, Won Hyeok; Cheon, Young Koog; Shim, Chan Sup; Lee, Tae Yoon; Kim, Jeong Han [Digestive Disease Center, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2016-04-15

    To evaluate the efficacy and safety of balloon-occluded retrograde transvenous obliteration (BRTO) with sodium tetradecyl sulfate (STS) liquid sclerotherapy of gastric varices. Between February 2012 and August 2014, STS liquid sclerotherapy was performed in 17 consecutive patients (male:female = 8:9; mean age 58.6 years, range 44-86 years) with gastric varices. Retrograde venography was performed after occlusion of the gastrorenal shunt using a balloon catheter and embolization of collateral draining veins using coils or gelfoam pledgets, to evaluate the anatomy of the gastric varices. We prepared 2% liquid STS by mixing 3% STS and contrast media in a ratio of 2:1. A 2% STS solution was injected into the gastric varices until minimal filling of the afferent portal vein branch was observed (mean 19.9 mL, range 6-33 mL). Patients were followed up using computed tomography (CT) or endoscopy. Technical success was achieved in 16 of 17 patients (94.1%). The procedure failed in one patient because the shunt could not be occluded due to the large diameter of gastrorenal shunt. Complete obliteration of gastric varices was observed in 15 of 16 patients (93.8%) with follow-up CT or endoscopy. There was no rebleeding after the procedure. There was no procedure-related mortality. BRTO using STS liquid can be a safe and useful treatment option in patients with gastric varices.

  5. The Incidence of Hepatocellular Carcinoma after Balloon-Occluded Retrograde Transvenous Obliteration

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    Keiji Yokoyama

    2015-01-01

    Full Text Available Balloon-occluded retrograde transvenous obliteration (BRTO is a highly effective therapy for gastric varices with liver cirrhosis. We have investigated the incidence of hepatocellular carcinoma (HCC after BRTO. We enrolled 71 patients with viral hepatitis in which HCC had not appeared with liver imaging findings at the time of BRTO. The overall survival rate after BRTO was 86.8%, 76.1%, and 50.5% at 1, 3, and 5 years. The occurrence rate of HCC after BRTO was 20.9%, 41.1%, and 60.7% at 1, 3, and 5 years, especially showing a higher occurrence of HCC at one year. Meanwhile, the occurrence rate of HCC after treatment which excluded BRTO for esophagogastric varices in patients was 6.3%, 19.2%, and 42.5% at 1, 3, and 5 years. The log-rank test revealed that the occurrence rate of HCC after treatment was significantly higher in the BRTO group compared with that in the non-BRTO group (P=0.0447. The recurrence rate of HCC after BRTO was 35.8% and 80.0% at 1 and 3 years. The present study demonstrated a high incidence of HCC after BRTO in liver cirrhosis patients with viral hepatitis infection. We have suggested the potential for BRTO to accelerate hepatocarcinogenesis.

  6. Thrombocytopenia in Patients with Gastric Varices and the Effect of Balloon-occluded Retrograde Transvenous Obliteration on the Platelet Count

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    W E Saad

    2014-01-01

    Full Text Available Objectives: Gastric varices primarily occur in cirrhotic patients with portal hypertension and splenomegaly and thus are probably associated with thrombocytopenia. However, the prevalence and severity of thrombocytopenia are unknown in this clinical setting. Moreover, one-third of patients after balloon-occluded retrograde transvenous obliteration (BRTO have aggravated splenomegaly, which potentially may cause worsening thrombocytopenia. The aim of the study is to determine the prevalence and degree of thrombocytopenia in patients with gastric varices associated with gastrorenal shunts undergoing BRTO, to determine the prognostic factors of survival after BRTO (platelet count included, and to assess the effect of BRTO on platelet count over a 1-year period. Materials and Methods: This is a retrospective review of 35 patients who underwent BRTO (March 2008-August 2011. Pre- and post-BRTO platelet counts were noted. Potential predictors of bleeding and survival (age, gender, liver disease etiology, platelet count, model for end stage liver disease [MELD]-score, presence of ascites or hepatocellular carcinoma were analyzed (multivariate analysis. A total of 91% (n = 32/35 of patients had thrombocytopenia (90% of patients in patients undergoing BRTO. However, BRTO (with occlusion of the gastrorenal shunt has little effect on the platelet count. Long-term outcomes of BRTO for bleeding gastric varices using sodium tetradecyl sulfate in the USA are impressive with a 4-year variceal rebleed rate and transplant-free survival rate of 9% and 76%, respectively. Platelet count is not a predictor of higher rebleeding or patient survival after BRTO.

  7. A case of liver cirrhosis with bleeding from stomal varices successfully treated using balloon-occluded retrograde transvenous obliteration.

    Science.gov (United States)

    Takano, Masashi; Imai, Yukinori; Nakazawa, Manabu; Chikayama, Taku; Ando, Satsuki; Sugawara, Kayoko; Nakayama, Nobuaki; Mochida, Satoshi

    2016-06-01

    A 66-year-old male patient with liver cirrhosis because of alcohol intake underwent a Hartmann's procedure for rectal cancer. Four months later, bleeding from the sigmoid stoma occurred and persisted for 2 months. A colonoscopic examination revealed bleeding from stomal varices. Three-dimensional computed tomography (CT) imaging demonstrated the inferior mesenteric vein and left superficial epigastric vein as the feeding and drainage vessels, respectively. Balloon-occluded retrograde transvenous obliteration (B-RTO) through the left epigastric vein was performed using a microballoon catheter inserted from the right femoral vein according to the Seldinger method. A CT examination performed 2 days after the B-RTO procedure revealed that the blood flow had disappeared, with thrombosis formation in both the stomal varices and the feeding vein. No recurrent bleeding from the stoma occurred. B-RTO using a microballoon catheter is useful as a therapeutic procedure for stomal varices to prevent bleeding, since the procedure can be performed with minimal invasion using the Seldinger method. PMID:27048279

  8. Ruptured high flow gastric varices with an intratumoral arterioportal shunt treated with balloon-occluded retrograde transvenous obliteration during temporary balloon occlusion of a hepatic artery

    Institute of Scientific and Technical Information of China (English)

    Motoki Nakai; Morio Sato; Hirohiko Tanihata; Tetsuo Sonomura; Shinya Sahara; Nobuyuki Kawai; Masashi Kimura; Masaki Terada

    2006-01-01

    A patient presented with hematemesis due to gastric variceal bleeding with an intratumoral arterioportal shunt. Contrast-enhanced CT revealed gastric varices and hepatocellular carcinoma with tumor thrombi in the right portal vein. Angiography and angio-CT revealed a marked intratumoral arterioportal shunt accompanied with reflux into the main portal vein and gastric varices. Balloon-occluded retrograde venography from the gastro-renal shunt showed no visualization of gastric varices due to rapid blood flow through the intratumoral arterioportal shunt. The hepatic artery was temporarily occluded with a balloon catheter to reduce the blood flow through the arterioportal shunt, and then concurrent balloon-occluded retrograde transvenous obliteration (BRTO) was achieved. Vital signs stabilized immediately thereafter, and contrast-enhanced CT revealed thrombosed gastric varices. Worsening of hepatic function was not recognized. BRTO combined with temporary occlusion of the hepatic artery is a feasible interventional procedure for ruptured high flow gastric varices with an intratumoral arterioportal shunt.

  9. Balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding: its feasibility compared with transjugular intrahepatic portosystemic shunt

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    Choi, Young Ho; Yoon, Chang Jin; Park, Jae Hyung; Chung, Jin Wook; Kwon, Jong Won [Seoul Natioonal University College of Medicine, Seoul (Korea, Republic of); Choi, Guk Myung [Cheju National University College of Medicine, Jeju (Korea, Republic of)

    2003-06-01

    To assess the feasibility of balloon-occluded retrograde transvenous obliteration (BRTO) in active gastric variceal bleeding, and to compare the findings with those of transjugular intrahepatic portosystemic shunt (TIPS). Twenty-one patients with active gastric variceal bleeding due to liver cirrhosis were referred for radiological intervention. In 15 patients, contrast-enhanced CT scans demonstrated gastrorenal shunt, and the remaining six (Group 1) underwent TIPS. Seven of the 15 with gastrorenal shunt (Group 2) were also treated with TIPS, and the other eight (Group 3) underwent BRTO. All patients were followed up for 6 to 21 (mean, 14.4) months. For statistical inter-group comparison of immediate hemostasis, rebleeding and encephalopathy, Fisher's exact test was used. Changes in the Child-Pugh score before and after each procedure in each group were statistically analyzed by means of Wilcoxon's signed rank test. One patient in Group 1 died of sepsis, acute respiratory distress syndrome, and persistent bleeding three days after TIPS, while the remaining 20 survived the procedure with immediate hemostasis. Hepatic encephalopathy developed in four patients (one in Group 1, three in Group 2, and none in Group 3); one, in Group 2, died while in an hepatic coma 19 months after TIPS. Rebleeding occurred in one patient, also in Group 2. Except for transient fever in two Group-3 patients, no procedure-related complication occurred. In terms of immediate hemostasis, rebleeding and encephalopathy, there were no statistically significant differences between the groups (p > 0.05). In Group 3, the Child-Pugh score showed a significant decrease after the procedure (p = 0.02). BRTO can effectively control active gastric variceal bleeding, and because of immediate hemostasis, the absence of rebleeding, and improved liver function, is a good alternative to TIPS in patients in whom such bleeding, accompanied by gastrorenal shunt, occurs.

  10. Development of Thrombus in a Systemic Vein after Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices

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    Yoshimatsu, Rika; Yamagami, Takuji; Tanaka, Osamu; Miura, Hiroshi; Nishimura, Tsunehiko [Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto (Japan); Okuda, Kotaro; Hashiba, Mitsuoki [Fukuchiyama City Hospital, Kyoto (Japan)

    2012-06-15

    To retrospectively evaluate the frequency and risk factors for developing thrombus in a systemic vein such as the infrarenal inferior vena cava or the iliac vein, in which a balloon-occluded retrograde transvenous obliteration (B-RTO) catheter was indwelled. Forty-nine patients who underwent B-RTO for gastric varices were included in this study. The B-RTO procedure was performed from the right femoral vein, and the B-RTO catheter was retained overnight in all patients. Pre- and post-procedural CT scans were retrospectively compared in order to evaluate the development of thrombus in the systemic vein in which the catheter was indwelled. Additionally, several variables were analyzed to assess risk factors for thrombus in a systemic vein. In all 49 patients (100%), B-RTO was technically successful, and in 46 patients (94%), complete thrombosis of the gastric varices was achieved. In 6 patients (12%), thrombus developed in the infrarenal inferior vena cava or the right common-external iliac vein. All thrombi lay longitudinally on the right side of the inferior vena cava or the right iliac vein. One of the aforementioned 6 patients required anticoagulation therapy. No symptoms suggestive of pulmonary embolism were observed. Prothrombin time-international normalized ratio and the addition of 5% ethanolamine oleate iopamidol, on the second day, were related to the development of thrombus. Development of a thrombus in a systemic vein such as the inferior vena cava or iliac vein, caused by indwelling of the B-RTO catheter, is relatively frequent. Physicians should be aware of the possibility of pulmonary embolism due to iliocaval thrombosis.

  11. Transhepatic catheter-directed thrombolysis for portal vein thrombosis after partial splenic embolization in combination with balloon-occluded retrograde transvenous obliteration of splenorenal shunt

    Institute of Scientific and Technical Information of China (English)

    Motoki Nakai; Morio Sato; Shinya Sahara; Nobuyuki Kawai; Masashi Kimura; Yoshimasa Maeda; Yumiko Ibata; Katsuhiko Higashi

    2006-01-01

    A 66-year-old woman underwent partial splenic embolization (PSE) for hypersplenism with idiopathic portal hypertension (IPH). One week later, contrastenhanced CT revealed extensive portal vein thrombosis (PVT) and dilated portosystemic shunts. The PVT was not dissolved by the intravenous administration of urokinase.The right portal vein was canulated via the percutaneous transhepatic route under ultrasonic guidance and a 4Fr. straight catheter was advanced into the portal vein through the thrombus. Transhepatic catheter-directed thrombolysis was performed to dissolve the PVT and a splenorenal shunt was concurrently occluded to increase portal blood flow, using balloon-occluded retrograde transvenous obliteration (BRTO) technique. Subsequent contrast-enhanced CT showed good patency of the portal vein and thrombosed splenorenal shunt.Transhepatic catheter-directed thrombolysis combined with BRTO is feasible and effective for PVT with portosystemic shunts.

  12. Comparison of Coil Embolization and Sclerotherapy of Collateral Veins during Balloon Occluded Retrograde Transvenous Obliteration: Its Long Term Effect for Gastric Varix Treatment

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    An, Eun Jung; Kim, Young Hwan; Kim, Seee Hyung [Dept. of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2011-10-15

    We compared the long term effect gastric varix treatment between coil embolization and sclerotherapy of collateral veins during balloon occluded retrograde transvenous obliteration (BRTO). Between February 2004 and November 2008 48 patients with gastric varix bleeding successfully treated with BRTO 23 underwent embolization of collateral veins during BRTO were enrolled in this study. In patients, collateral veins were embolized with the use of microcoil (group 1). Agent (5% ethanolamine oleate + lipiodol) was used in the remaining 7 patients (Group 2). Recurrence and rebleeding of gastric varix were evaluated by endoscopy or CT. Gastric varix recurred in 4 patients (17.4%) and rebleeding occurred in 2 (8.7%). Recurrence (57.1%, p 0.001) and rebleeding (28.6%, p = 0.029) of gastric occurred in group 2. CT finding within 6 months in partial or complete thrombosis without lipiodol uptake in gastric varix, gastric varix recurred on follow up CT. Coil embolization of collateral veins during BRTO may promote complete obliteration of gastric varix, provide lower recurrence and rebleeding rates of gastric sclerosing agent on long term follow-up.

  13. Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and Outcomes

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    Fumio Uchiyama

    2013-01-01

    Full Text Available Our aim was to evaluate the long-term efficacy and safety of percutaneous transhepatic obliteration (PTO alone and combined with balloon-occluded retrograde transvenous obliteration (BRTO for gastroesophageal varices refractory to BRTO alone. Between July 1999 and December 2010, 13 patients with gastroesophageal varices refractory to BRTO were treated with PTO (n = 6 or a combination of PTO and BRTO (n = 7. We retrospectively investigated the rates of survival, recurrence, or worsening of the varices; hepatic function before and after the procedure; and complications. The procedure achieved complete obliteration or significant reduction of the varices in all 13 patients without major complications. During follow-up, the varices had recurred in 2 patients, of which one had hepatocellular carcinoma, and the other died suddenly from variceal rebleeding 7 years after PTO. The remaining 11 patients did not experience worsening of the varices and showed significant improvements in the serum ammonia levels and prothrombin time. The mean follow-up period was 90 months, and the cumulative survival rate at 1, 3, and 5 years was 92.9%, 85.7%, and 85.7%, respectively. Both PTO and combined PTO and BRTO seem as safe and effective procedures for the treatment of gastroesophageal varices refractory to BRTO alone.

  14. Efficacy of balloon-occluded retrograde transvenous obliteration,percutaneous transhepatic obliteration and combined techniques for the management of gastric fundal varices

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    Hirotaka Arai; Takehiko Abe; Hitoshi Takagi; Masatomo Mori

    2006-01-01

    AIM: To evaluate the effect of three interventional treatments involving transvenous obliteration for the treatment of gastric varices, and to compare the efficacy and adverse effects of these methods.METHODS: From 1995 to 2004, 93 patients with gastric fundal varices underwent interventional radiologic embolotherapy at our hospital. Of the 93 patients, 75 were treated with the balloon-occluded retrograde transvenous obliteration (BRTO) procedure; 8 were with the percutaneous transhepatic obliteration (PTO)procedure; and 10 were with the combined BRTO and PTO therapy. A follow-up evaluation examined the rates of survival, recurrence and rebleeding of the gastric varices, worsening of esophageal varices and complications in each group.RESULTS: The BRTO, PTO, and combined therapy were technically successful in 81% (75/93), 44% (8/18),and 100% (10/10) patients, respectively. Recurrence of gastric varices was found in 3 patients in the BRTO group and in 3 patients in the PTO group. Rebleeding was observed in 1 patient in the BRTO group and in 1 patient in the PTO group. The 1- and 3-year survival rates were 98% and 87% in the patients without hepatocellular carcinoma (HCC) in the BRTO group, 100% and 100% in the PTO group, and 90% and 75% in the combined therapy group, respectively.CONCLUSION: Combined BRTO and PTO therapy may rescue cases with uncontrollable gastric fundal varices that remained even after treatment with BRTO and/or PTO, though there were limitations of our study,including retrospective nature and discrepancy in sample size between the BRTO, PTO and combined therapy groups.

  15. Management of Gastric Varices in the Pediatric Population with Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) Utilizing Sodium Tetradecyl Sulfate Foam Sclerosis with or without Partial Splenic Artery Embolization

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    Saad, Wael E. A., E-mail: wspikes@yahoo.com; Anderson, Curtis L., E-mail: dranderson@southfloridavascular.com [University of Virginia Health System, Department of Radiology, Division of Vascular Interventional Radiology (United States); Patel, Rahul S., E-mail: patelr516@gmail.com [Icahn School of Medicine at Mount Sinai, Division of Interventional Radiology (United States); Schwaner, Sandra, E-mail: sls5c@virginia.edu [University of Virginia Health System, Department of Radiology, Division of Vascular Interventional Radiology (United States); Caldwell, Stephen, E-mail: shc5c@virginia.edu [University of Virginia Health System, Department of Medicine, Division of Gastroenterology (United States); Pelletier, Shawn, E-mail: sjp7t@virginia.edu; Angle, John, E-mail: jfa2h@virginia.edu; Matsumoto, Alan H., E-mail: ahm4d@virginia.edu [University of Virginia Health System, Department of Radiology, Division of Vascular Interventional Radiology (United States); Fischman, Aaron M., E-mail: aaron.fischman@mountsinai.org [Icahn School of Medicine at Mount Sinai, Division of Interventional Radiology (United States)

    2015-02-15

    It is unknown whether spontaneous gastrorenal shunts actually develop in the pediatric population. The minimum age documented in studies from Asia is 32 (range 32–44) years. This study describes three pediatric patients undergoing balloon-occluded retrograde transvenous obliteration (BRTO) for bleeding gastric varices with two of the three patients undergoing combined partial splenic embolization. The first BRTO is a selective-BRTO via a surgical splenorenal shunt (15 years old) and the other two patients underwent conventional-BRTO via a spontaneous gastrorenal shunt (8 and 14 years old). The recurrent significant bleeding that they exhibited before the combined endovascular therapy did not recur for an average of 7.1 (range 1.4–14) months. In the second patient, quantitative digitally subtracted angiography was utilized to evaluate the inline portal venous flow before and after BRTO.

  16. Duodenal variceal bleeding after balloon-occluded retrograde transverse obliteration: Treatment with transjugular intrahepatic portosystemic shunt

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    Min Joung Kim; Byoung Kuk Jang; Woo Jin Chung; Jae Seok Hwang; Young Hwan Kim

    2012-01-01

    We report a case of duodenal varix bleeding as a long term complication of balloon occluded retrograde transvenous obliteration (BRTO),which was successfully treated with a transjugular intrahepatic portosystemic shunt (TIPS).A 57-year-old man was admitted to the emergency room suffering from melena.He had undergone BRTO to treat gastric varix bleeding 5 mo before admission.Endoscopy and a computed tomography (cr) scan showed complete obliteration of the gastric varix,but the nodular varices in the second portion of the duodenum expanded after BRTO,and spurting blood was seen.TIPS was performed for treatment of duodenal variceal bleeding,because attempts at endoscopic varix ligation were unsuccessful.The postoperative course was uneventful and the patient was discharged without complications.A follow up CT scan obtained 21 mo after TIPS revealed a patent TIPS tract and complete obliteration of duodenal varices,but multinodular hepatocellular carcinoma had developed.He died of hepatic failure 28 mo after TIPS.

  17. Balloon-Occluded Antegrade Transvenous Sclerotherapy to Treat Rectal Varices: A Direct Puncture Approach to the Superior Rectal Vein Through the Greater Sciatic Foramen Under CT Fluoroscopy Guidance

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    Ono, Yasuyuki, E-mail: onoyasy@hirakata.kmu.ac.jp; Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp; Yoshida, Rie, E-mail: yagir@hirakata.kmu.ac.jp; Kono, Yumiko, E-mail: kohnoy@hirakata.kmu.ac.jp; Kan, Naoki, E-mail: kanna@takii.kmu.ac.jp; Ueno, Yutaka, E-mail: uenoyut@hirakata.kmu.ac.jp; Komemushi, Atsushi, E-mail: komemush@takii.kmu.ac.jp; Tanigawa, Noboru, E-mail: tanigano@hirakata.kmu.ac.jp [Kansai Medical University, Department of Radiology (Japan)

    2015-10-15

    Rectal varices occur in 44.5 % of patients with ectopic varices caused by portal hypertension, and 48.6 % of these patients are untreated and followed by observation. However, bleeding occurs in 38 % and shock leading to death in 5 % of such patients. Two patients, an 80-year-old woman undergoing treatment for primary biliary cirrhosis (Child-Pugh class A) and a 63-year-old man with class C hepatic cirrhosis (Child-Pugh class A), in whom balloon-occluded antegrade transvenous sclerotherapy was performed to treat rectal varices are reported. A catheter was inserted by directly puncturing the rectal vein percutaneously through the greater sciatic foramen under computed tomographic fluoroscopy guidance. In both cases, the rectal varices were successfully treated without any significant complications, with no bleeding from rectal varices after embolization.

  18. Three benefits of microcatheters for retrograde transvenous obliteration of gastric varices

    Institute of Scientific and Technical Information of China (English)

    Tetsuo Sonomura; Wataru Ono; Morio Sato; Shinya Sahara; Kouhei Nakata; Hiroki Sanda; Nobuyuki Kawai

    2012-01-01

    AIM:To evaluate the usefulness of the microcatheter techniques in balloon-occluded retrograde transvenous obliteration (BRTO) of gastric varices.METHODS:Fifty-six patients with gastric varices underwent BRTOs using microcatheters.A balloon catheter was inserted into gastrorenal or gastrocaval shunts.A microcatheter was navigated close to the varices,and sclerosant was injected into the varices through the microcatheter during balloon occlusion.The next morning,thrombosis of the varices was evaluated by contrast enhanced computed tomography (CE-CT).In patients with incomplete thrombosis of the varices,a second BRTO was performed the following day.Patients were followed up with CE-CT and endoscopy.RESULTS:In all 56 patients,sclerosant was selectively injected through the microcatheter close to the varices.In 9 patients,microcoil embolization of collateral veins was performed using a microcatheter.In 12 patients with incomplete thrombosis of the varices,additional injection of sclerosant was performed through the microcatheter that remained inserted overnight.Complete thrombosis of the varices was achieved in 51 of 56 patients,and the remaining 5 patients showed incomplete thrombosis of the varices.No recurrence of the varices was found in the successful 51 patients after a median follow up time of 10.5 mo.We experienced one case of liver necrosis,and the other complications were transient.CONCLUSION:The microcatheter techniques are very effective methods for achieving a higher success rate of BRTO procedures.

  19. The clinical results of balloon-occluded retrograde transvenous obliteration in treatment of gastric varices compared with transjugular intrahepatic portosystemic shunt

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    Lee, Nam Kyung; Kim, Chang Won; Jeon, Ung Bae; Kim, Suk; Lee, Jun Woo; Jo, Mong; Heo, Jeong [Pusan National University School of Medicine, Busan (Korea, Republic of)

    2007-03-15

    To compare the clinical results of BRTO in the gastric varices with those of TIPS. From January 2004 to March 2006, eight patients who had been followed up for more than 1 month after BRTO were enrolled in this study. This study compared the clinical efficacy of BRTO with than of TIPS in 13 patients who had undergone TIPS from January 2000 to March 2006. The change in laboratory parameters before and after each procedure and the incidence of rebleeding, encephalopathy, asictes and varices were analyzed after each procedure. In the BRTO group, the level of albumin increased, and the levels of ammonia and the Child-Pugh score decreased. The TIPS group showed no improvement in the liver function. In the BRTO group, the gastric varices were eradicated in 7 patients. Gastric variceal rebleeding and encephalopathy did not occur. However, the esophageal varices worsened in 6 patients. In the TIPS group, rebleeding (n = 4), encephalopathy (n = 7) and a worsening of the gastric (n = 5) or esophageal varices (n = 2) occurred. BRTO improves the metabolic activity of the liver and has a lower incidence of encephalopathy. Hence, BRTO is a good alternative to TIPS in the gastric varices accompanied by a gastrorenal shunt although a treatment for a worsening of the esophageal varices may be needed after BRTO.

  20. Visualization of gastric varices using angiographic C-arm CT during retrograde transvenous sclerotherapy

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    Iwazawa Jin

    2010-01-01

    Full Text Available During retrograde transvenous sclerotherapy for gastric varices, sufficient opacification of the target varices on venography is essential for successful treatment. However, venography sometimes cannot identify target varices due to overlapping adjacent collateral vessels or leakage of contrast medium to other outflow veins. We report how C-arm CT images acquired using a flat-panel detector angiography system helped to identify target varices and predict the distribution of a sclerosant, which resulted in safer sclerotherapy and increased operator confidence.

  1. Vascular plug-assisted retrograde transvenous obliteration of portosystemic shunts for refractory hepatic encephalopathy: a case report.

    Science.gov (United States)

    Park, Jonathan K; Cho, Sung-Ki; Kee, Stephen; Lee, Edward W

    2014-01-01

    While balloon-assisted retrograde transvenous obliteration (BRTO) has been used for two decades in Asia for the management of gastric variceal bleeding, it is still an emerging therapy elsewhere. Given the shunt closure brought about by the procedure, BRTO has also been used for the management of portosystemic encephalopathy with promising results. Modified versions of BRTO have been developed, including plug-assisted retrograde transvenous obliteration (PARTO), where a vascular plug is deployed within a portosystemic shunt. To our knowledge, we present the first North American case of PARTO in the setting of a large splenorenal shunt for the management of portosystemic encephalopathy. PMID:24744943

  2. The Retrograde Transvenous Push-Through Method: A Novel Treatment of Peripheral Arteriovenous Malformations with Dominant Venous Outflow

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    Wohlgemuth, Walter A., E-mail: walter.wohlgemuth@ukr.de; Müller-Wille, René, E-mail: Rene.Mueller-Wille@ukr.de; Teusch, Veronika I., E-mail: Veronika.Teusch@gmx.de [University Medical Center Regensburg, Department of Radiology (Germany); Dudeck, Oliver, E-mail: Oliver.Dudeck@med.ovgu.de [University of Magdeburg, Department of Radiology and Nuclear Medicine (Germany); Cahill, Anne M., E-mail: Cahill@email.chop.edu [Perelman School of Medicine of the University of Pennsylvania, Division of Interventional Radiology, Department of Radiology, Children’s Hospital of Philadelphia (United States); Alomari, Ahmad I., E-mail: Ahmad.Alomari@childrens.harvard.edu [Boston Children’s Hospital and Harvard Medical School, Division of Vascular and Interventional Radiology (United States); Uller, Wibke, E-mail: Wibke.Uller@ukr.de [University Medical Center Regensburg, Department of Radiology (Germany)

    2015-06-15

    PurposeTo evaluate the efficacy and safety of a novel retrograde transvenous embolization technique of peripheral arteriovenous malformations (AVMs) using Onyx.Materials and MethodsWe conducted a retrospective analysis of all patients who underwent transvenous retrograde Onyx embolization of peripheral AVMs with dominant venous outflow over a 29-month period. The embolization is aimed at retrograde filling of the nidus after building a solid plug in the dominant venous outflow (push-through). Classification, clinical signs, technical aspects, clinical and technical success rates, and complications were recorded. Short-term outcome was assessed.Results11 Symptomatic patients (8 female; mean age 31.4 years) were treated at our Vascular Anomalies Center with this method between January 2012 and May 2014. The AVMs were located on the upper extremity (n = 3), pelvis (n = 2), buttock (n = 2), and lower extremity (n = 4). Retrograde embolization was successfully carried out after preparatory transarterial-flow reduction in eight cases (73 %) and venous-flow reduction with Amplatzer Vascular Plugs in four cases (36 %). Complete devascularization (n = 10; 91 %) or 95 % devascularization (n = 1; 9 %) led to complete resolution (n = 8; 73 %) or improvement of clinical symptoms (n = 3; 27 %). One minor complication occurred (pain and swelling). During a mean follow-up time of 8 months, one clinically asymptomatic recurrence of AVM was detected.ConclusionInitial results suggest that retrograde transvenous Onyx embolization of peripheral AVMs with dominant venous outflow is a safe and effective novel technique with a low complication rate.

  3. Plug-assisted retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Min Yung; Kim, Man Deuk; Shin, Won Seon; Shin, Min Woo; Kim, Gyoung Min; Won, Jong Yun; Park, Sung Il; Lee, Do Yun [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Tae Hwan [Dept. of Radiology, National Health Insurance Serivce Ilsan Hospital, Goyang (Korea, Republic of)

    2016-04-15

    To evaluate the feasibility, safety, and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) to treat gastric variceal hemorrhage in patients with portal hypertension. From May 2012 to June 2014, 19 patients (11 men and 8 women, median age; 61, with history of gastric variceal hemorrhage; 17, active bleeding; 2) who underwent PARTO using a vascular plug and a gelfoam pledget were retrospectively analyzed. Clinical and laboratory data were examined to evaluate primary (technical and clinical success, complications) and secondary (worsening of esophageal varix [EV], change in liver function) end points. Median follow-up duration was 11 months, from 6.5 to 18 months. The Wilcoxon signed-rank test was used to compare laboratory data before and after the procedure. Technical success (complete occlusion of the efferent shunt and complete filling of gastric varix [GV] with a gelfoam slurry) was achieved in 18 of 19 (94.7%) patients. The embolic materials could not reach the GV in 1 patient who had endoscopic glue injection before our procedure. The clinical success rate (no recurrence of gastric variceal bleeding) was the same because the technically failed patient showed recurrent bleeding later. Acute complications included fever (n = 2), fever and hypotension (n = 2; one diagnosed adrenal insufficiency), and transient microscopic hematuria (n = 3). Ten patients underwent follow-up endoscopy; all exhibited GV improvement, except 2 without endoscopic change. Five patients exhibited aggravated EV, and 2 of them had a bleeding event. Laboratory findings were significantly improved after PARTO. PARTO is technically feasible, safe, and effective for gastric variceal hemorrhage in patients with portal hypertension.

  4. Isolated Gastric Varices and Use of Balloon-occlusive Retrograde Transvenous Obliteration: A Case Report and Literature Review.

    Science.gov (United States)

    McCarty, Thomas R; Bakhit, Mena; Rustagi, Tarun

    2016-03-01

    Isolated gastric varices are far less prevalent in Western countries where the rate of splenic thrombosis is much lower. However, in Asian countries the entity is more common and therefore a more robust treatment approach has been developed. Balloon-occlusive retrograde transvenous obliteration (BRTO) was first described in 1984 and then revived in 1996. The procedure, while uncommon in the U.S. and not recognized by the AASLD practice guidelines, allows for direct exclusion from the portosystemic system. Here we describe the case of a patient with alcoholic cirrhosis decompensated by bleeding gastric varices treated with BRTO.

  5. Balloon occlusion retrograde transvenous obliteration of gastric varices in two-cirrhotic patients with portal vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Borhei, Peyman; Kim, Seung Kwon; Zukerman, Darryl A [Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (United States)

    2014-02-15

    This report describes two non-cirrhotic patients with portal vein thrombosis who underwent successful balloon occlusion retrograde transvenous obliteration (BRTO) of gastric varices with a satisfactory response and no complications. One patient was a 35-year-old female with a history of Crohn's disease, status post-total abdominal colectomy, and portal vein and mesenteric vein thrombosis. The other patient was a 51-year-old female with necrotizing pancreatitis, portal vein thrombosis, and gastric varices. The BRTO procedure was a useful treatment for gastric varices in non-cirrhotic patients with portal vein thrombosis in the presence of a gastrorenal shunt.

  6. Balloon-occluded percutaneous transheptic obliteration of isolated vesical varices causing gross hematuria

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Dong Hoon; Kim, Dong Hyun; Kim, Min Seok; Kim, Chul Sung [Department of Urology, College of Medicine, Chosun University, Gwangju (Korea, Republic of)

    2013-01-15

    Gross hematuria secondary to vesical varices is an unusual presentation. We report such a case recurrent gross hematuria in a male patient who had a history of bladder substitution with ileal segments that had been treated by balloon-occluded percutaneous transhepatic obliteration of vesical varices.

  7. Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Mitsunari, E-mail: mitunari@med-shimane.u.ac.jp; Yoshizako, Takeshi, E-mail: yosizako@med.shimane-u.ac.jp; Nakamura, Tomonori, E-mail: t-naka@med.shimane-u.ac.jp; Nakamura, Megumi, E-mail: megumi@med.shimane-u.ac.jp; Yoshida, Rika, E-mail: yoshidar@med.shimane-u.ac.jp; Kitagaki, Hajime, E-mail: kitagaki@med.shimane-u.ac.jp [Shimane University Faculty of Medicine, Department of Radiology (Japan)

    2016-03-15

    PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation.

  8. Splenic and renal shunt vein post-transplantation:treatment with vascular plug assisted retrograde transvenous obliteration%肝移植术后残留脾肾分流的逆行介入封堵治疗

    Institute of Scientific and Technical Information of China (English)

    王浩; 陈光; 高海军; 伊正甲; 温连芳; 王鹏辉; 杨颐馨; 张莉

    2016-01-01

    目的:探讨经静脉逆向封堵治疗肝移植术后残留脾肾分流的技术安全性和临床有效性。方法回顾性分析3例肝移植术后残留脾肾分流患者的资料,所有患者均行经皮肝门静脉穿刺造影、测压,经股静脉逆向于脾肾分流道远端植入房间隔封堵器,对患者临床资料、影像随访资料、介入治疗的并发症和预后等情况进行总结。结果介入治疗的技术成功率为100%,无介入相关并发症发生。术后复查CT发现脾肾分流静脉完全闭塞,且术后1周及1个月复查超声显示门静脉血流量较术前明显增加。其中1例患者因胆道并发症接受二次肝移植,在平均4个月的随访中,该2例患者的肝功能、门静脉血流均较术前明显改善。结论经静脉逆向封堵治疗肝移植术后残留脾肾分流是一种安全、有效且微创的治疗方法。%Objective To evaluate the therapeutic results of vascular plug-assisted retrograde transvenous obliteration(RTO) for treatment of splenic and renal shunt vein following liver transplantation.Methods3 patients who had undergone vascular plug-assisted RTO were etrospectively evaluated from August2015 to February 2016. Percutaneous transhepatic angiography of the portal vein was performed in all patients,and then retrograde transvenous placement of a vascular plug in the shunt vein. The clinical data, imaging follow-up data, complications of interventional treatment and prognosis was summarized.Results In all patients,the percutaneous transhepatic angioplasty and placement of the vascular plug successfully, with no procedure-related complications. Follow-up CT after vascular plug-assisted RTO showed complete thrombosis of shunts in all patients,follow-up ultrasonic doppler within1 week and1 month the portal vein blood flow increase obviously.1 patient received second liver transplantation because of the biliary tract complications. Improvement in Child-Pugh score was

  9. Improved transvenous liver biopsy needle

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Matzen, P; Christoffersen, P;

    1979-01-01

    A modified type of the standard transvenous cholangiography biopsy needle is described. The modified tranvenous liver biopsy needle caused only minimal artefactual changes of the liver biopsy specimens. The new type of biopsy needle is a modified Menghini needle. The conventional Menghini needle...... should be avoided for transvenous catheter biopsies because of risk of leaving catheter fragments in the liver....

  10. Permanent transvenous pacemaker implantation in forty dogs

    International Nuclear Information System (INIS)

    Permanent transvenous cardiac pacemakers were implanted in 40 dogs. Electrocardiographic diagnoses included persistent atrial standstill (3 dogs), sick sinus syndrome (8 dogs), and high-grade second-degree or third-degree atrioventricular (AV) block (29 dogs). Thirteen dogs were alive and well 4 to 42 months after pacemaker implantation (mean, 16.9 months). The mean and median survival times of the 26 dogs that died or were euthanatized during the study were 17.9 months and 13 months, respectively. Most of these dogs succumbed to problems unrelated to the arrhythmia and pacemaker implant. One dog was lost to follow-up. Complications associated with permanent transvenous pacemaker implantation included lead dislodgement, infection, hematoma formation, skeletal muscle stimulation, ventricular arrhythmia, migration of the pulse generator, and skin erosion. Lead dislodgement was the most common complication, occurring in 7 of 9 dogs paced using untined electrode leads and in 6 of 30 dogs paced using tined leads. Lead dislodgement did not occur in the only dog paced using an actively fixed endocardial lead. It was concluded that permanent transvenous cardiac pacing is a feasible, less traumatic alternative to epimyocardial pacing in dogs, but that successful use of this technique requires careful implantation technique and anticipation of the potential complications

  11. Transvenous closure of large aortopulmonary collateral

    Directory of Open Access Journals (Sweden)

    Parag W Barwad

    2014-01-01

    Full Text Available Aortopulmonary collaterals (APCs are occluded either preoperatively or at the time of cardiac surgery in patients with pulmonary atresia and ventricular septal defect (PAVSD. If left untreated, APCs are an important cause of deterioration in the early postoperative period. We present here an unusual case with a large residual APC causing refractory low-output state in the early postoperative period. Usual arterial approach failed due to extensive angulation with ostial narrowing. The large residual APC was successfully closed with an Amplatzer duct occluder (ADO device delivered through the transvenous route.

  12. Ureteral retrograde brush biopsy

    Science.gov (United States)

    Biopsy - brush - urinary tract; Retrograde ureteral brush biopsy cytology; Cytology - ureteral retrograde brush biopsy ... to be biopsied is rubbed with the brush. Biopsy forceps may be used instead to collect a ...

  13. Dissociation between Anterograde and Retrograde Conduction during Transvenous Cryoablation of Parahissian Accessory Pathways

    NARCIS (Netherlands)

    Sorgente, A.; Paparella, G.; Chierchia, G.B.; Sarkozy, A.; Asmundis, C. de; Muller-Burri, S.A.; Yazaki, Y.; Capulzini, L.; Brugada, P.

    2011-01-01

    Ablation of parahissian accessory pathways (APs) is a challenging procedure because of the high risk to provoke "iatrogenic" atrioventricular (AV) nodal block. The feasibility and safety of cryoablation (CA) have been already demonstrated both in patients with AV nodal reentry tachycardia and in tho

  14. Percutaneous Extraction of Transvenous Permanent Pacemaker/Defibrillator Leads

    Directory of Open Access Journals (Sweden)

    Stylianos Paraskevaidis

    2014-01-01

    Full Text Available Background. Widespread use of cardiovascular implantable electronic devices has inevitably increased the need for lead revision/replacement. We report our experience in percutaneous extraction of transvenous permanent pacemaker/defibrillator leads. Methods. Thirty-six patients admitted to our centre from September 2005 through October 2012 for percutaneous lead extraction were included. Lead removal was attempted using Spectranetics traction-type system (Spectranetics Corp., Colorado, CO, USA and VascoExtor countertraction-type system (Vascomed GmbH, Weil am Rhein, Germany. Results. Lead extraction was attempted in 59 leads from 36 patients (27 men, mean ± SD age 61±5 years, with permanent pacemaker (n=25, defibrillator (n=8, or cardiac resynchronisation therapy (n=3 with a mean ± SD implant duration of 50±23 months. The indications for lead removal included pocket infection (n=23, endocarditis (n=2, and ventricular (n=10 and atrial lead dysfunction (n=1. Traction device was used for 33 leads and countertraction device for 26 leads. Mean ± SD fluoroscopy time was 4±2 minutes/lead for leads implanted 48 months (n=21, P=0.03. Complete procedural success rate was 91.7% and clinical procedural success rate was 100%, while lead procedural success rate was 95%. Conclusions. In conclusion, percutaneous extraction of transvenous permanent pacemaker/defibrillator leads using dedicated removal tools is both feasible and safe.

  15. A method for permanent transvenous left ventricular pacing.

    Science.gov (United States)

    Blanc, J J; Benditt, D G; Gilard, M; Etienne, Y; Mansourati, J; Lurie, K G

    1998-11-01

    LV-based pacing has recently been reported to be of benefit in patients with severe cardiac failure and left bundle branch block. LV permanent pacing has been reported using epicardial leads but the surgical mortality is excessive. A transvenous approach is now favored. In this regard, cannulation of the coronary sinus and of one of its tributaries using only the permanent electrode is feasible but technically challenging. We describe a "long guiding sheath" method using catheterization, and a long radiopaque and peelable sheath. Once the coronary sinus is cannulated with the electrophysiological catheter, the long sheath is advanced to the mid-part of the coronary sinus. The permanent pacing electrode is then placed through the sheath and into a tributary of the coronary sinus. This method has been attempted in 10 patients and was successful in 8, with an average lead insertion time of 21 +/- 5.5 minutes and an average fluoroscopic time of 11 +/- 5.5 minutes. In conclusion, although transvenous left ventricular pacing remains a challenge, the "long guiding sheath" approach appears to facilitate this procedure with both a high success rate and an acceptable procedure time. PMID:9826852

  16. Transvenous coronary angiography in humans with synchrotron radiation

    International Nuclear Information System (INIS)

    The transvenous coronary angiography project at the National Synchrotron Light Source (NSLS) is presently undergoing a significant upgrade to the hardware and software in the synchrotron medical facility. When completed, the project will have reached a level of maturity in the imaging technology which will allow the research team to begin to concentrate on medical research programs. This paper will review the status of the project and imaging technology and will discuss the current upgrades and future advanced technology initiatives. The advantages of using the radiation from a synchrotron, over that from a standard x-ray source, were the motivation for the project. A total of 23 human imaging sessions have been carried out with in the project. The primary goals have been to establish the imaging parameters and protocol necessary to obtain clinically useful images

  17. Temporary transvenous pacemaker placement in the Emergency Department.

    Science.gov (United States)

    Harrigan, Richard A; Chan, Theodore C; Moonblatt, Steven; Vilke, Gary M; Ufberg, Jacob W

    2007-01-01

    Emergency Department placement of a temporary transvenous cardiac pacemaker offers potential life-saving benefits, as the device can definitively control heart rate, ensure effective myocardial contractility, and provide adequate cardiac output in select circumstances. The procedure begins with establishment of central venous access, usually by a right internal jugular or left subclavian vein approach, although the femoral vein is an acceptable alternative, especially in patients who are more likely to bleed should vascular access become complicated. The indications for the procedure, as well as the equipment needed, are reviewed. Both blind and ECG-guided techniques of insertion are described. Methods of verification of pacemaker placement and function are discussed, as are the early complications of the procedure. PMID:17239740

  18. Interventional radiology in the management of portal hypertension

    International Nuclear Information System (INIS)

    From being a mere (though important) diagnostic tool, radiology has evolved to become an integral part of therapy in portal hypertension today. Various procedures are currently available, the choice depending on the etiology and location of disease, the pathoanatomy, and the symptomatology. The main aim of any procedure is to reduce the portal pressure by either direct or indirect methods. This can be achieved with transjugular intrahepatic portosystemic shunt (TIPS), recanalization of the hepatic vein outflow, recanalization of the portal vein and its tributaries, recanalization of dysfunctional portosystemic shunts, partial splenic embolization, and embolization of arterioportal shunts. When any of these procedures cannot be performed due to anatomical or physiological reasons, the symptoms can often be controlled effectively with embolization of varices or balloon-occluded retrograde transvenous obliteration of varices (BRTO). This article briefly describes the procedures, their results, and their current status in the treatment of portal hypertension

  19. Permanent transvenous pacemaker implantation in a patient with Cor triatriatum dextrum

    Institute of Scientific and Technical Information of China (English)

    Kun; Xiang; George; V; Moukarbel; Blair; Grubb

    2015-01-01

    Cor triatriatum dextrum is an extremely rare congenital heart abnormality in which the right atrium is separatedinto two chambers by a persistent fibrous membrane. A transvenous approach to place a dual-chamber pacemaker in such patients is technically challenging. We report the first case of a transvenous permanent pacemaker placement in a patient with cor triatriatum dextrum. An 87-year-old woman was diagnosed with paroxysmal atrial fibrillation. She was accidentally found to have cor triatriatum dextrum during the transesophageal echocardiography(TEE) prior to cardioversion. Later during her hospital stay, it was indicated to place a permanant pacemaker due to high grade atrioventricular block. After thorough reviewing TEE imagings, a transvenous catheter-based approach was decided feasible. Patient successfully received a dual chamber pacemaker through left subclavian venous approach. Furthermore in our case, using specially designed pacemaker leads and cautious intra-procedural maneuvering under fluoroscopic guidance ensured procedural success. In summary, a thorough pre-operative evaluation with transesophageal echocardiography is critical for the planning and eventual success of the transvenous placement of rightsided leads.

  20. Transvenous embolization of a dural arteriovenous fistula of the laterocavernous sinus through the pterygoid plexus

    International Nuclear Information System (INIS)

    We present a novel access for transvenous embolization of a dural arteriovenous fistula of the laterocavernous sinus through the external jugular vein and the pterygoid plexus. The anatomy of the laterocavernous sinus is reviewed, and its clinical implications discussed in light of the case of a patient whose management was modified after identifying this anatomical variation. (orig.)

  1. Transvenous Coil Embolization for Dural Arteriovenous Fistulas of the Ophthalmic Sheath: Report of Two Cases and Review of the Literature

    Science.gov (United States)

    Hwang, Juyoung; Jo, Kyung-Il; Yeon, Je Young; Hong, Seung-Chyul

    2016-01-01

    We present two patients with a dural arteriovenous fistula (dAVF) of the ophthalmic sheath who developed progressive exophthalmos, conjunctival chemosis, and visual loss. These symptoms mimic those of cavernous sinus dAVFs. Dural AVFs of the ophthalmic sheath are extremely rare and their clinical management is controversial. We successfully treated these two patients by transvenous coil embolization. Transvenous embolization appears to be a safe and effective method to treat dAVFs of the ophthalmic sheath.

  2. Endovascular obliteration of bleeding duodenal varices in patients with liver cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Zamora, Carlos Armando; Sugimoto, Koji; Tsurusaki, Masakatsu; Izaki, Kenta; Fukuda, Tetsuya; Matsumoto, Shinichi; Kawasaki, Ryota; Taniguchi, Takanori; Sugimura, Kazuro [Kobe University School of Medicine, Department of Radiology, Kobe-shi, Hyogo-ken (Japan); Kuwata, Yoichiro [Nishi-Kobe Medical Center, Department of Radiology, Kobe-shi, Hyogo-ken (Japan); Hirota, Shozo [Hyogo Medical College, Department of Radiology, Nishinomiya-shi, Hyogo-ken (Japan)

    2006-01-01

    The purpose of this paper is to describe our experience with endovascular obliteration of duodenal varices in patients with liver cirrhosis and portal hypertension. Balloon-occluded transvenous retrograde and percutaneous transhepatic anterograde embolizations were performed for duodenal varices in five patients with liver cirrhosis, portal hypertension, and decreased liver function. All patients had undergone previous endoscopic treatments that failed to stop bleeding and were poor surgical candidates. Temporary balloon occlusion catheters were used to achieve accumulation of an ethanolamine oleate-iopamidol mixture inside the varices. Elimination of the varices was successful in all patients. Retrograde transvenous obliteration via efferent veins to the inferior vena cava was enough to achieve adequate sclerosant accumulation in three patients. A combined anterograde-retrograde embolization was used in one patient with balloon occlusion of afferent and efferent veins. Transhepatic embolization through the afferent vein was performed in one patient under balloon occlusion of both efferent and afferent veins. There was complete variceal thrombosis and no bleeding was observed at follow-up. No major complications were recorded. Endovascular obliteration of duodenal varices is a feasible and safe alternative procedure for managing patients with portal hypertension and hemorrhage from this source. (orig.)

  3. Defect in Lung Perfusion and Ventilation Scanning of Patients with Permanent Transvenous Implantable Pacemaker

    OpenAIRE

    Matsuura, Yuichiro; Tamura, Mutsuo; Yamashina, Hideki; Higo, Masanori; Fujii, Takanori; Shimamoto, Hiroyuki; Kinoshita, Hirofumi

    1984-01-01

    Lung perfusion and ventilation scanning with 99mTc-MAA and 81mKr-Gass were studied in 138 patients with permanent transvenous implantable pacemaker. There were observed segmental or subsegmental defects in lung perfusion and ventilation scanning which were considered to be probably lung embolism of 47 cases. The incidence of lung embolism was high during the first postoperative 6 months, and it also increased progressively with aging. The patient with ischemic heart disease or va...

  4. Our First Experience on Percutaneous Transvenous Mitral Commissurotomy (PTMC: Case Report

    Directory of Open Access Journals (Sweden)

    Aziz Karabulut

    2005-01-01

    Full Text Available Rheumatic heart disease remains a significant healt problem especially in devaloping countries. In rheumatic heart disease, mitral valve is affected in nearly all cases; mitral stenosis is the most common lesion. Percutaneous Transvenous Mitral Commissurotomy (PTMC is an important tool in the treatment of rheumatic mitral stenosis. In this study, our first PTMC case is presented, and the PTMC indications and the comparison of patients underwent PTMC with those patients underwent surgical intervention is discussed with the literature.

  5. One-Year Follow-Up of Patients Undergoing Transvenous Extraction of Pacemaker and Defibrillator Leads.

    Directory of Open Access Journals (Sweden)

    Maciej Kempa

    Full Text Available The number of pacemaker and ICD implantations has increased substantially in the recent years. Therefore, complications are also observed in a greater number. In many cases, transvenous extraction of the previously implanted device (pacemaker or ICD is the only solution. One may find in the literature information about the efficacy and safety of that procedure, but data concerning the results of long-term follow up are still limited.The aim of the study was to assess the one-year mortality in the cohort of patients undergoing transvenous lead extraction procedures in our centre.Records of the patients undergoing transvenous lead removal in the Department of Cardiology and Electrotherapy of the Medical University of Gdańsk were analyzed. We collected detailed information about 192 patients that had undergone the procedure from January 2003 until June 2012. Data were collected from medical and surgical records. We analyzed concomitant diseases, indications, and possible complications. Long-term follow-up data were gathered in the follow-up ambulatory records and over-the-phone interviews with patients or families. In several cases, we consulted the database of the Polish National Health Fund.During the early post-operative period 5 patients died, although none of those deaths was associated with the procedure itself. No other major complications were observed. During one-year follow-up other 5 patients died, which gave the overall one-year survival rate of 92.7%. Heart failure, renal failure and an infective indication showed significant association with increased mortality.Results of transvenous lead extraction, a relatively safe procedure, should be assessed over time extending beyond the sole perioperative period. Some complications may be delayed in their nature, and may be observed only during the long-term follow up.

  6. Laparoscopic retrograde (fundus first cholecystectomy

    Directory of Open Access Journals (Sweden)

    Kelly Michael D

    2009-12-01

    Full Text Available Abstract Background Retrograde ("fundus first" dissection is frequently used in open cholecystectomy and although feasible in laparoscopic cholecystectomy (LC it has not been widely practiced. LC is most simply carried out using antegrade dissection with a grasper to provide cephalad fundic traction. A series is presented to investigate the place of retrograde dissection in the hands of an experienced laparoscopic surgeon using modern instrumentation. Methods A prospective record of all LCs carried out by an experienced laparoscopic surgeon following his appointment in Bristol in 2004 was examined. Retrograde dissection was resorted to when difficulties were encountered with exposure and/or dissection of Calot's triangle. Results 1041 LCs were carried out including 148 (14% emergency operations and 131 (13% associated bile duct explorations. There were no bile duct injuries although conversion to open operation was required in six patients (0.6%. Retrograde LC was attempted successfully in 11 patients (1.1%. The age ranged from 28 to 80 years (mean 61 and there were 7 males. Indications were; fibrous, contracted gallbladder 7, Mirizzi syndrome 2 and severe kyphosis 2. Operative photographs are included to show the type of case where it was needed and the technique used. Postoperative stay was 1/2 to 5 days (mean 2.2 with no delayed sequelae on followup. Histopathology showed; chronic cholecystitis 7, xanthogranulomatous cholecystitis 3 and acute necrotising cholecystitis 1. Conclusions In this series, retrograde laparoscopic dissection was necessary in 1.1% of LCs and a liver retractor was needed in 9 of the 11 cases. This technique does have a place and should be in the armamentarium of the laparoscopic surgeon.

  7. Retrograde signaling: Organelles go networking.

    Science.gov (United States)

    Kleine, Tatjana; Leister, Dario

    2016-08-01

    The term retrograde signaling refers to the fact that chloroplasts and mitochondria utilize specific signaling molecules to convey information on their developmental and physiological states to the nucleus and modulate the expression of nuclear genes accordingly. Signals emanating from plastids have been associated with two main networks: 'Biogenic control' is active during early stages of chloroplast development, while 'operational' control functions in response to environmental fluctuations. Early work focused on the former and its major players, the GUN proteins. However, our view of retrograde signaling has since been extended and revised. Elements of several 'operational' signaling circuits have come to light, including metabolites, signaling cascades in the cytosol and transcription factors. Here, we review recent advances in the identification and characterization of retrograde signaling components. We place particular emphasis on the strategies employed to define signaling components, spanning the entire spectrum of genetic screens, metabolite profiling and bioinformatics. This article is part of a Special Issue entitled 'EBEC 2016: 19th European Bioenergetics Conference, Riva del Garda, Italy, July 2-6, 2016', edited by Prof. Paolo Bernardi. PMID:26997501

  8. Transvenous embolization of indirect carotid-cavernous fistula via upper ophthalmic/facial vein - Case report and literature review

    International Nuclear Information System (INIS)

    Indirect carotid-cavernous fistula or dural arterio-venous fistula of cavernous sinus is relatively rare pathologic finding. Different classifications of carotid-cavernous fistulae are proposed. Now days more and more they are treated by endovascular approach. A case of authors' practice of transvenous embolization of carotid-cavernous fistula via upper ophthalmic vein in 52 year old female is presented with review of the literature. A week later ocular symptoms of the patient regressed. Control angiography at the third month follow up does not visualize fistula. The transvenous approach in management of carotid cavernous fistulae is safe and effective in cases direct arterial approach is absent or technically impossible. Key words: Indirect Carotid-Cavernous Fistula. Embolization. Transvenous Approach

  9. Erfahrung mit der Extraktion von transvenösen Kardioverter-Defibrillator (ICD Sonden

    Directory of Open Access Journals (Sweden)

    Dörnberger V

    1999-01-01

    Full Text Available Die ICD-Therapie ist ein bewährtes Verfahren zur Behandlung lebensbedrohlicher ventrikulärer Herzrhythmusstörungen. Defekte der komplex aufgebauten transvenösen Sondensysteme sind beschrieben. Meist ist eine komplette Entfernung defekter Sonden sinnvoll. Wir berichten über unsere Erfahrung mit der Entfernung von 13 transvenösen Elektrodensystemen. In 7 Fällen handelt es sich um eine Endotak C 0072 Sonde (CPI/Guidant und in 6 Fällen um eine Medtronic Transvene 6936 Elektrode. Das Sondenalter zum Zeitpunkt der Extraktion lag zwischen 1,5 und 77,6 Monaten (Mittelwert 36,3 ± 18. Als Extraktionshilfen wurden das VascoExtor Stylet S (Vascomed in 6 Fällen und das Byrd Locking-Stylet 0.017 (0.018 inches (Cook in 4 Fällen verwendet. Alle Extraktionen erfolgten unter transösophagealem Echokardiographie-Monitoring (TEE und Herz-Lungenmaschinen-Bereitschaft (HLM. Ohne Dilatations-Sheath war eine Extraktion nur innerhalb der ersten 3 Monate nach Implantation möglich (n = 3. Ein besonderes Problem stellt der im Vergleich zum Sondenkörper größere Durchmesser der Schockwendel dar, da die Sonde im Verlauf von einem Bindegewebsmantel fest umschlossen und mit der Venenwand verwachsen ist. Mit dem Byrd Dilatator-Schleusenset 10,0 Fr, 11,5 Fr und 13,0 Fr war in allen Fällen eine Lösung von der Venenwand möglich. Eine Extraktion einer Sonde (Medtronic Transvene war nach auswärtigen Vorversuchen mit Zerstörung der inneren Wendel nicht mehr möglich. In einem weiteren Fall konnten zwar die venösen Wandadhäsionen gelöst werden, die distale Schockwendel war jedoch in voller Länge mit dem Endokard verwachsen und konnte nur in einer offenen Herzoperation entfernt werden. In keinem Fall kam es zu einem bedeutsamen Perikarderguß. Kein Patient verstarb in Folge der Sondenextraktion. Zusammenfassend ist die Extraktion von ICD Sonden auch lange nach Implantation möglich. Trotz unserer relativ guten Erfahrung mit der Extraktion von ICD Sonden sollte

  10. Recovery of opthalmoplegia associated with cavernous sinus dural arteriovenous fistulas after transvenous cavernous sinus packing

    Energy Technology Data Exchange (ETDEWEB)

    Lv Xianli; Jiang Chuhan; Li Youxiang; Yang Xinjian [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China)

    2010-08-15

    Background: We report the recovery of ophthalmoplegia in 11 patients with cavernous sinus dural arteriovenous fistula (CSDAVF) after sinus packing at follow-up. Methods: Of 18 patients with CSDAVF treated with transvenous cavernous sinus packing between August 2002 and December 2007 at Beijing Tiantan Hospital, there were 9 patients with initial CNIII or CNVI dysfunction and 2 patients with CNVI dysfunction immediately after cavernous sinus packing selected and reevaluated. Results: Of 11 patients with CNIII or CNVI palsy, recovery was complete in 10. In 1 patient, complete CNVI palsy was unchanged because the CSDAVF was not cured. There were 6 men and 5 women with a mean age of 52.9 years. In 5 patients, CNVI palsy was associated with chemosis, proptosis and pulsatile tinnitus. Timing of treatment after onset of symptoms was from 4 to 35 days in 9 patients. All CSDAVFs were Barrow type D. Mean follow-up after treatment was 17.7 months (range, 2-54 months). Conclusion: CSDAVF-induced CNIII or CNVI palsies can be cured after cavernous sinus packing transvenously in most patients.

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

    OpenAIRE

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

    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 ...

  12. 20. Immediate EIN-hospital results of percutaneous transvenous mitral commissurotomy in patients with mitral restenosis after closed mitral commissurotomy

    OpenAIRE

    D.M.T. Rahman

    2016-01-01

    Rheumatic mitral stenosis is a very common problem in our population having an incidence of 54 percent among rheumatic heart disease with a female preponderance of 2:1. Percutaneous transvenous initral conimissurotomy (PTMC) using an Inoue balloon catheter is of established efficacy and safety and is an alternative to surgical valvotomy in selected patients with rheumatic mitral stenosis. Nine hundred and ninety (990) patients with rheumatic mitral stenosis who underwent PTMC were evaluated c...

  13. Management of cardiac device infections: A retrospective survey of a non-surgical approach combining antibiotic therapy with transvenous removal.

    Science.gov (United States)

    Tascini, C; Bongiorni, M G; Gemignani, G; Soldati, E; Leonildi, A; Arena, G; Doria, R; Giannola, G; La Pira, F; Tagliaferri, E; Caravelli, P; Dell'Anna, R; Menichetti, F

    2006-04-01

    Pacemakers (PMs) and implantable cardioverter defibrillators (ICDs) have become life-saving therapeutic tools for patients with cardiac arrhythmia. Complications include thrombosis, embolism and infections at a highly variable rate. Surgical removal of the infected device has been perceived as the only way to guarantee a successful outcome and to reduce the high risk of mortality. Recently, a transvenous extraction method has been developed to remove infected intracardiac leads without sternotomy. This survey was designed to evaluate the outcome of an approach combining antibiotic therapy with non-surgical transvenous complete removal for the management of cardiac device infections (CDIs). We reviewed case-histories of 121 patients (105 with PM and 16 with ICD infections). The aim of our retrospective survey was to ascertain that a non-invasive transvenous complete removal of the infected devices is safe and effective when associated with appropriate antibiotic therapy starting 10 days before the procedure and extending to at least three weeks after. The infected devices were successfully removed in all patients with a non-surgical transvenous technique. The infections were most frequently caused by coagulase-negative staphylococci (70%), Staphylococcus aureus (14%), and Gram-negative rods (12%). Polymicrobial infections were documented in 19 patients and represent 16% of all device-related infections. The removal of the devices was done during antibiotic therapy, administered for a median of 26 days (range 23 to 45 days). Neither fatalities nor relapse of infections were recorded in the patient population during the one-year follow-up visits. According to our experience, CDIs can be treated with antibiotic therapy and non-surgical removal of the entire infected device, thus allowing a successful reimplantation. This procedure prevents recurrent infections and operative mortality. PMID:16736884

  14. Transvenous cardiac resynchronization therapy in complex congenital heart diseases: dextrocardia with transposition of the great arteries after Mustard operation.

    Science.gov (United States)

    Zartner, Peter A; Wiebe, Walter; Volkmer, Marius; Thomas, Daniel; Schneider, Martin

    2009-04-01

    Cardiac resynchronization therapy revealed first promising results in patients with a congenital heart disease and a systemic right ventricle. Contrast-enhanced magnetic resonance imaging showed accessibility of the coronary sinus in an 18-year-old male patient with mirror dextrocardia, d-transposition of the great arteries and ventricular septal defect (VSD) after Mustard operation and VSD patch closure. In literatures, transvenous lead placement is discussed in this anatomical setting, with opposed position of the ventricular leads and reliable lead characteristics.

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

    Science.gov (United States)

    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.

  16. Recovery from retrograde amnesia: a learning process.

    Science.gov (United States)

    Schneider, A M; Tyler, J; Jinich, D

    1974-04-01

    Retrograde amnesia was produced in rats by electroconvulsive shock. Memory recovered if the animals were given repeated test trials. Memory did not recover if steps were taken to reduce the conditioning properties of the test trials; the manipulations included eliminating the response, altering the apparatus cues, or extinguishing conditioned "fear" by confining animals to the apparatus during the first test trial.

  17. Retrograde Renal Cooling to Minimize Ischemia

    Directory of Open Access Journals (Sweden)

    Janet L. Colli

    2013-01-01

    Full Text Available Objective: During partial nephrectomy, renal hypothermia has been shown to decrease ischemia induced renal damage which occurs from renal hilar clamping. In this study we investigate the infusion rate required to safely cool the entire renal unit in a porcine model using retrograde irrigation of iced saline via dual-lumen ureteral catheter. Materials and Methods: Renal cortical, renal medullary, bowel and rectal temperatures during retrograde cooling in a laparoscopic porcine model were monitored in six renal units. Iced normal saline was infused at 300 cc/hour, 600 cc/hour, 1000 cc/hour and gravity (800 cc/hour for 600 seconds with and without hilar clamping. Results: Retrograde cooling with hilar clamping provided rapid medullary renal cooling and significant hypothermia of the medulla and cortex at infusion rates ≥ 600 cc/hour. With hilar clamping, cortical temperatures decreased at -0.9° C/min. reaching a threshold temperature of 26.9° C, and medullary temperatures decreased at -0.90 C/min. reaching a temperature of 26.1° C over 600 seconds on average for combined data at infusion rates ≥ 600 cc/hour. The lowest renal temperatures were achieved with gravity infusion. Without renal hilum clamping, retrograde cooling was minimal at all infusion rates. Conclusions: Significant renal cooling by gravity infusion of iced cold saline via a duel lumen catheter with a clamped renal hilum was achieved in a porcine model. Continuous retrograde irrigation with iced saline via a two way ureteral catheter may be an effective method to induce renal hypothermia in patients undergoing robotic assisted and/or laparoscopic partial nephrectomy.

  18. Cognitive improvement following transvenous adipose-derived mesenchymal stem cell transplantation in a rat model of traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    Dongfei Li; Chun Yang; Rongmei Qu; Huiying Yang; Meichun Yu; Hui Tao; Jingxing Dai; Lin Yuan

    2011-01-01

    The effects of adipose-derived mesenchymal stem cell (ADMSC) transplantation for the repair of traumatic brain injury remain poorly understood. The present study observed neurological functional changes in a rat model of traumatic brain injury following ADMSC transplantation via the tail vein.Cell transplants were observed in injured cerebral cortex, and expression of brain-derived nerve growth factor was significantly increased in the injured hippocampus following transplantation. Results demonstrated that transvenous ADMSC transplants migrated to the injured cerebral cortex and significantly improved cognitive function.

  19. Cranial Nerve Dysfunction Associated with Cavernous Dural Arteriovenous Fistulas After Transvenous Embolization with Onyx

    Energy Technology Data Exchange (ETDEWEB)

    Li, Chuanhui; Wang, Yang; Li, Youxiang; Jiang, Chuhan; Wu, Zhongxue; Yang, Xinjian, E-mail: yang-xj@163.net [Capital Medical University, Beijing Neurosurgical Institute and Beijing Tiantan Hospital (China)

    2015-10-15

    PurposeCranial nerve dysfunction (CND) is not uncommon in patients with cavernous dural arteriovenous fistulas (cDAVFs), and may represent an initial manifestation or a complication after endovascular treatment. This study evaluated the outcome of CND associated with cDAVFs after transvenous embolization (TVE) using Onyx.Materials and MethodsForty-one patients with cDAVFs were treated with TVE in our department between April 2009 and October 2013. For each patient, clinical and radiologic records were retrospectively reviewed and evaluated, with an emphasis placed on evaluating the outcomes of the pre-existing cDAVF-induced CND and the TVE-induced CND.ResultsOf the 41 cases, 25 had a history of preoperative CND. Postoperatively, gradual remission to complete recovery (CR) within 8 months was observed in 17 of these cases, transient aggravation in 7, and significant improvement to be better than preoperative function but no CR in 1. All aggravation of CND occurred immediately or within 1 day after TVE and resolved completely within 5 months. Nine patients developed new CND after TVE. New CND occurred during the perioperative period in 8 cases, but all cases resolved completely within 15 days–6 months. Delayed CND was observed in 3 cases with a time lag of 3–25 months after TVE. Two of these completely resolved within 20 days–1 month and the remaining case significantly improved.ConclusionBoth the pre-existing cDAVF-induced CND and the TVE-induced new or aggravated CND completely resolved in almost all cases after embolization with Onyx.

  20. Experimental study on the mechanism of intrapulmonary kinetics of 123I-IMP in balloon occluded bronchus of rabbit

    International Nuclear Information System (INIS)

    To investigate the mechanism of intrapulmonary kinetics of N-isopropyl-p-123I-iodoamphetamine (123I-IMP), we performed lung scanning with 123I-IMP in 13 rabbits in which a unilateral bronchus was occluded by a balloon catheter. In 9 rabbits, on the delayed distribution images, an abnormal accumulation of 123I-IMP was detected in the hypoperfusion area of the peripheral lung field of the occluded bronchus, which was detected on lung perfusion images with 99mTc-MAA. Comparison of early (a summation image during 20 seconds immediately after injection) and delayed (a summation image from 70 to 90 minutes after injection) distribution images confirmed that during this period, 123I-IMP accumulated in the area of reduced distribution of 123I-IMP. Moreover, at the site of abnormal accumulation, washout of 123I-IMP from the lung was delayed compared with that in the normal lung field. We find this experimental study is similar to the results in 63 clinical cases, which we have reported previously, and confirm that pulmonary arterial perfusion, especially hypoperfusion, influences the intrapulmonary kinetics of 123I-IMP. (author)

  1. Deep sedation for endoscopic retrograde cholangiopacreatography

    OpenAIRE

    Chainaki, Irene G; Manolaraki, Maria M; Paspatis, Gregorios A.

    2011-01-01

    Sedation and analgesia comprise an important element of unpleasant and often prolonged endoscopic retrograde cholangiopacreatography (ERCP), contributing, however, to better patient tolerance and compliance and to the reduction of injuries during the procedure due to inappropriate co-operation. Although most of the studies used a moderate level of sedation, the literature has revealed the superiority of deep sedation and general anesthesia in performing ERCP. The anesthesiologist’s presence i...

  2. Retrograde amnesia for semantic information in Alzheimer's disease

    OpenAIRE

    Meeter, M.; Kollen, A.; Scheltens, P

    2005-01-01

    Patients with mild to moderate Alzheimer's disease and normal controls were tested on a retrograde amnesia test with semantic content (Neologism and Vocabulary Test, or NVT), consisting of neologisms to be defined. Patients showed a decrement as compared to normal controls, pointing to retrograde amnesia within semantic memory. No evidence for a gradient within this amnesia was found, although one was present on an autobiographic test of retrograde amnesia that had a wider time scale. Several...

  3. Anterograde and Retrograde Amnesia following Bitemporal Infarction

    Directory of Open Access Journals (Sweden)

    A. Schnider

    1994-01-01

    Full Text Available A patient suffered very severe anterograde and retrograde amnesia following infarction of both medial temporal lobes (hippocampus and adjacent cortex and the left inferior temporo-occipital area. The temporal stem and the amygdala were intact; these structures do not appear to be critical for new learning in humans. Extension of the left-sided infarct into the inferior temporo-occipital lobe, an area critically involved in visual processing, appears to be responsible for our patient's loss of remote memories.

  4. A phantom gallbladder on endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Various complications have been related to laparoscopic cholecystectomy but most occur shortly after the procedure. In this report, we present a case with very late complications in which an abscess developed within the gallbladder fossa 6 years after laparoscopic cholecystectomy. The abscess resolved after treatment with CT-guided extrahepatic aspiration. However, 4 years later, an endoscopic retrograde cholangiopancreatography (ERCP) performed for choledocholithiasis demonstrated a "gallbladder" which communicated with the common bile duct via a patent cystic duct. This unique case indicates that a cystic duct stump may communicate with the gallbladder fossa many years following cholecystectomy.

  5. [Interventional radiology for portal hypertension. PTO.TIO].

    Science.gov (United States)

    Tajiri, T; Onda, M; Yamashita, K; Kim, D Y; Umehara, M; Kojima, T; Matsuzaki, S; Kumazaki, T

    1996-01-01

    Percutaneous transhepatic obliteration (PTO) and transileocolic vein obliteration (TIO) are techniques of interventional radiology for embolization of collaterals due to portal hypertension 1) We can obtain good results from the precise selection of these techniques in accordance with the patient's hemodynamics and general condition. 2) Endoscopic injection sclerotherapy (EIS) combined with PTO or TIO for esophageal varices proves to be superior in reliability and durability to EIS alone, and the time before retreatment is much longer when this combination therapy is used. 3) In the intractable EIS only cases, a distinct improvement in results and prognosis appears in using PTO or TIO and also in adding more EIS thereafter. 4) After treatment with EIS and PTO or TIO for cardiac varices, we obtain better results in the disappearance rate as well as in the recurrence rate compared with EIS alone. 5) Gastric varices disappear and hepatic encephalopathy due to porto-systemic shunt is improved after PTO or TIO or using these with balloon occluded retrograde transvenous obliteration (BRTO). Thus PTO and TIO would be analogous to surgical devascularization or ligation. Therefore it is concluded that the best results would be obtained with PTO or TIO with other nonsurgical treatments.

  6. CT Findings after BRTO in Patients with Gastric Varix Bleeding: Can We Predict Varix Recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Joo Hwan; Kim, Young Hwan; An, Eun Jung; Kim, See Hyung; Choi, Jin Soo [Dongsan Medical Center, Keimyung University, College of Medicine, Daegu (Korea, Republic of)

    2011-02-15

    We wanted to retrospectively evaluate the CT findings after balloon occluded retrograde transvenous obliteration (BRTO) to determine whether the CT findings can predict varix recurrence. Of the 48 patients with gastric varix that was bleeding successfully treated with BRTO between February 2004 and November 2008, 35 of them who underwent follow-up endoscopy and CT were enrolled in this study. The morphologic changes of the gastric varix, including gastrorenal shunt and an afferent vein, were evaluated with the use of CT. Gastric varix recurred in 4 patients and rebleeding occurred in 2. In 22 of 25 patients who underwent CT within 6 months, complete thrombosis of the gastric varix filled with lipiodol was noted, and the gastric varix disappeared without recurrence in all the patients during the long term follow up period. In the other 3 patients who only had thrombosis without lipiodol in the gastric varix, the gastric varices recurred (p=0.0001). The existence of lipiodol, as seen on CT within 6 months after BRTO, was useful to predict complete obliteration of gastric varices without recurrence during the long term follow up period

  7. Retrograde intrarenal surgery in pediatric patients.

    Science.gov (United States)

    Resorlu, Berkan; Sancak, Eyup Burak; Resorlu, Mustafa; Gulpinar, Murat Tolga; Adam, Gurhan; Akbas, Alpaslan; Ozdemir, Huseyin

    2014-11-01

    Urinary tract stone disease is seen at a level of 1%-2% in childhood (stone disease, particularly in adolescence. A carbohydrate- and salt-heavy diet and a more sedentary lifestyle are implicated in this increase. Although stone disease is rare in childhood, its presence is frequently associated with metabolic or anatomical disorders or infectious conditions, for which reason there is a high possibility of post-therapeutic recurrence. Factors such as a high possibility of recurrence and increasing incidence further enhance the importance of minimally invasive therapeutic options in children, with their expectations of a long life. In children in whom active stone removal is decided on, the way to achieve the highest level of success with the least morbidity is to select the most appropriate treatment modality. Thanks to today's advanced technology, renal stones that were once treated only by surgery can now be treated with minimally invasive techniques, from invasion of the urinary system in an antegrade (percutaneous nephrolithotomy) or retrograde (retrograde intrarenal surgery) manner or shock wave lithotripsy to laparoscopic stone surgery. This compilation study examined studies involving the RIRS procedure, the latest minimally invasive technique, in children and compared the results of those studies with those from other techniques.

  8. Retrograde intrarenal surgery in pediatric patients.

    Science.gov (United States)

    Resorlu, Berkan; Sancak, Eyup Burak; Resorlu, Mustafa; Gulpinar, Murat Tolga; Adam, Gurhan; Akbas, Alpaslan; Ozdemir, Huseyin

    2014-11-01

    Urinary tract stone disease is seen at a level of 1%-2% in childhood (stone disease, particularly in adolescence. A carbohydrate- and salt-heavy diet and a more sedentary lifestyle are implicated in this increase. Although stone disease is rare in childhood, its presence is frequently associated with metabolic or anatomical disorders or infectious conditions, for which reason there is a high possibility of post-therapeutic recurrence. Factors such as a high possibility of recurrence and increasing incidence further enhance the importance of minimally invasive therapeutic options in children, with their expectations of a long life. In children in whom active stone removal is decided on, the way to achieve the highest level of success with the least morbidity is to select the most appropriate treatment modality. Thanks to today's advanced technology, renal stones that were once treated only by surgery can now be treated with minimally invasive techniques, from invasion of the urinary system in an antegrade (percutaneous nephrolithotomy) or retrograde (retrograde intrarenal surgery) manner or shock wave lithotripsy to laparoscopic stone surgery. This compilation study examined studies involving the RIRS procedure, the latest minimally invasive technique, in children and compared the results of those studies with those from other techniques. PMID:25374812

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

    Science.gov (United States)

    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. Retrograde amnesia for semantic information in Alzheimer's disease

    NARCIS (Netherlands)

    Meeter, M.; Kollen, A.; Scheltens, P.

    2005-01-01

    Patients with mild to moderate Alzheimer's disease and normal controls were tested on a retrograde amnesia test with semantic content (Neologism and Vocabulary Test, or NVT), consisting of neologisms to be defined. Patients showed a decrement as compared to normal controls, pointing to retrograde am

  11. Disrupting circadian rhythms in rats induces retrograde amnesia

    NARCIS (Netherlands)

    Fekete, Mátyás; Ree, J.M. van; Niesink, Raymond J.M.; Wied, D. de

    1985-01-01

    Disrupting circadian organization in rats by phase-shifting the illumination cycle or by exposure to a reversed day/night cycle or to continuous light, resulted in retrograde amnesia for passive avoidance behavior. This retrograde amnesia induced by phase-shifting lasted at least 2 days, and gradual

  12. Our experiences on retrograde intrarenal surgery

    Directory of Open Access Journals (Sweden)

    Namık Kemal Hatipoğlu

    2014-03-01

    Full Text Available Objective: To evaluate outcomes of the cases who had undergone retrograde intrarenal surgery (RIRS in our clinics. Methods: Outcomes of 100 cases who had undergone RIRS because of renal stones between February 2012, and May 2013 were retrospectively evaluated. Results: Study population consisted of 35 female and 65 male patients with a mean age of 36.81(1-76 years. RIRS was performed with the indication of rest double J (D-J stent (n=1, and renal stone (n=99. Mean stone size was 15.26 (5-27 mm. Preoperatively, 61 cases (61% had preexisting D-J stents, while 39 (39% cases were stentless. Access sheaths were used in 86 (86% cases, while in 14 (14% cases the procedure was applied without using an access sheath. Mean operative, and fluoroscopy times were 52.72 (10-120 minus, and 57.32 (10-180 seconds, respectively. Postoperatively D-J stents were implanted in 88 (88% cases, and 12 (12% cases were stent-free. Mean hospital time was 1.3 (1-7 days. After one month postoperatively, stone-free rate was achieved in 87 (87% patients. Clinically insignificant residual stone fragments (CIRF 6 (6%, and residual stones 7 (7% were also detected. The latter group consisted of cases with horseshoe kidney (n=1, pelvic kidney (n=1, and kyphoscoliosis (n=1. Also in two case procedure was terminated prematurely, because of blurring of the vision secondary to bleeding. Apart from these patients, any preoperative complication did not develop. During follow-up period, urinary tract infection developed in 3 patients with resultant renal parenchymal damage in one patient. In one patient, D-J stent migrated into ureter. Conclusion: Retrograde intrarenal surgery is an effective and safe technique in the management of renal stones.

  13. Endovascular treatment of a cavernous sinus dural arteriovenous fistula by transvenous embolisation through the superior ophthalmic vein via cannulation of a frontal vein

    International Nuclear Information System (INIS)

    We describe a new approach for transvenous embolisation of cavernous sinus dural arteriovenous fistulae through the superior ophthalmic vein (SOV), i.e., via percutaneous cannulation of a frontal vein. Modern neurointerventional angiographic materials make it possible to reach the SOV in this way without puncturing it in the orbit or a surgical exposure. Orbital phlebography should still be in the repertoire of interventional neuroradiology units in large centres. (orig.)

  14. Relationship between seasonal weather changes, risk of dehydration, and incidence of severe bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population

    Science.gov (United States)

    Palmisano, Pietro; Accogli, Michele; Zaccaria, Maria; Vergari, Alessandra; De Luca De Masi, Gabriele; Negro, Luca; De Blasi, Sergio

    2014-09-01

    There is little information on any seasonal variations or meteorological factors associated with symptomatic bradyarrhythmias requiring cardiac pacing. The aim of this single-center study was to investigate the seasonal distribution of the incidence of severe, life-threatening bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population. Consecutive patients who underwent urgent temporary transvenous cardiac pacing between 2007 and 2012 were enrolled. The baseline characteristics of the patients and some meteorological parameters, including the calculation the daily heat index (HI), were recorded. During the study period, 79 consecutive patients (mean age 82 ± 8 years, 41 % male) underwent urgent temporary transvenous cardiac pacing, mainly for third-degree atrioventricular block (79 %). The incidence of bradyarrhythmias was significantly higher in summer than in the other seasons ( P 90 °F for >3 h per day for at least 10 days ( P increased incidence of severe bradyarrhythmias in an elderly population during the hottest months of the year. In these months, in subjects characterized by increased susceptibility to dehydration, the risk of developing bradyarrhythmias was increased significantly.

  15. High-Pressure Transvenous Perfusion of the Upper Extremity in Human Muscular Dystrophy: A Safety Study with 0.9% Saline.

    Science.gov (United States)

    Fan, Zheng; Kocis, Keith; Valley, Robert; Howard, James F; Chopra, Manisha; Chen, Yasheng; An, Hongyu; Lin, Weili; Muenzer, Joseph; Powers, William

    2015-09-01

    We evaluated safety and feasibility of high-pressure transvenous limb perfusion in an upper extremity of adult patients with muscular dystrophy, after completing a similar study in a lower extremity. A dose escalation study of single-limb perfusion with 0.9% saline was carried out in nine adults with muscular dystrophies under intravenous analgesia. Our study demonstrates that it is feasible and definitely safe to perform high-pressure transvenous perfusion with 0.9% saline up to 35% of limb volume in the upper extremities of young adults with muscular dystrophy. Perfusion at 40% limb volume is associated with short-lived physiological changes in peripheral nerves without clinical correlates in one subject. This study provides the basis for a phase 1/2 clinical trial using pressurized transvenous delivery into upper limbs of nonambulatory patients with Duchenne muscular dystrophy. Furthermore, our results are applicable to other conditions such as limb girdle muscular dystrophy as a method for delivering regional macromolecular therapeutics in high dose to skeletal muscles of the upper extremity. PMID:25953425

  16. PRODUCTION OF NEAR-EARTH ASTEROIDS ON RETROGRADE ORBITS

    Energy Technology Data Exchange (ETDEWEB)

    Greenstreet, S.; Gladman, B. [Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia (Canada); Ngo, H. [Department of Physics, Engineering Physics, and Astronomy, Queen' s University, Kingston, Ontario (Canada); Granvik, M. [Department of Physics, University of Helsinki, Helsinki (Finland); Larson, S., E-mail: sarahg@phas.ubc.ca [Department of Planetary Sciences, University of Arizona, Tucson, Arizona (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Au Eleanor

    2009-08-01

    Full Text Available Abstract 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.

  18. The formation of retrograde planetary orbits by close stellar encounters

    Directory of Open Access Journals (Sweden)

    Ford E. B.

    2011-02-01

    Full Text Available We consider the growing number of observations of the RossiterMcLaughlin effect in transiting planets, which seem to suggest that ~30% of transiting planets are in highly inclined or retrograde orbits. We consider the dense cluster environment in which stars are born and investigate whether perturbations from passing stars can drive planetary systems into retrograde configurations. We find that fly-bys can result in significantly more inclination excitation than might naively be expected from impulse approximations, leading to several percent of stellar systems possessing planets in retrograde orbits.

  19. Retrograde intrarenal surgery in cross-fused ectopic kidney.

    Science.gov (United States)

    Resorlu, Mustafa; Kabar, Mucahit; Resorlu, Berkan; Doluoglu, Omer Gokhan; Kilinc, Muhammet Fatih; Karakan, Tolga

    2015-02-01

    Cross-fused renal ectopia is a rare congenital anomaly in which both kidneys are fused and located on the same side. We report a case of right-to-left cross-fused renal ectopia and nephrolithiasis, in whom retrograde intrarenal surgery was used to treat the stone disease. To our knowledge, this is the first case of retrograde intrarenal surgery of a crossed-fused ectopic kidney. PMID:25481231

  20. Evaluation of Sperm Parameters of Infertile Men with Retrograde Ejaculation

    Institute of Scientific and Technical Information of China (English)

    Hong-xing ZHONG; Wei-jie ZHU; Jing LI

    2006-01-01

    Objective To investigate sperm parameters of infertile men with retrograde ejaculation.Methods Twelve infertile men with retrograde ejaculation (group A) were enrolled into this study. Sperm samples were obtained from the postejaculation urine. After sperm recovery and washing procedure, sperm parameters were assessed. Twelve semen samples from normospermic donors were used as the control (group B).Results In all retrograde cases, motile sperm with forward movement were observed in the medium. Motility of group A was significantly lower than that of group B (P<0. 01).In group A, sperm motility ranged from 11% to 56%, sperm with intact both head and tail membranes was 42.2 ± 12.3%, sperm count ranged (13-85)×106/ml, and the sperm survival time was highly shortened. Sperm with normal morphology and intact acrosome were observed in retrograde specimens.Conclusion Sperm parameters recovered from retrograde specimens were highly variable between subjects. The toxicity of urine caused deleterious to sperm functions.Motile sperm could be collected by sperm recovery procedure. Sperm parameters could meet the requirement for the use of assisted reproductive techniques for treating infertile men with retrograde ejaculation.

  1. Transvenous DSA: ECG-controlled cardial effects and venous complications after pre-atrial injection of nonionic contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Arlart, I.P.; Sigel, H.

    1986-09-01

    Transvenous DSA is a diagnostic technique for ambulatory examination that is well tolerated by patients, although it is commonly known that bolus injection of contrast medium for examination of the cardiovascular system may affect the cardiovascular hemodynamic process. The prospective study described was intended to reveal in 100 patients the effects on ECG data, as well as clinical symptoms of non-tolerance of contrast medium (nonionic, with high iodine content, Iopamidol 370), applied by central pre-atrial injection. In addition, catheterization-induced complications in the venous system of the arm were studied in 130 patients. Change of heart rate was the most frequent effect observed (increase in 49% of patients pretreated with Buscopan, decrease in 36% of non-pretreated patients). The second next effects were supraventricular and ventricular ES (20%), minor prolongations of PQ and QRS intervals (14%), and ST lowering (3%), without clinical symptons. In one case, an attack of Angina pectoris was observed, another patient developed a cutane allergy. After catheterization of brachial vein, thromboses were observed in 3% of patients, as well as local inflammations in 6%, short attacks of fever in 2.3%. The complications were observed for the most part in cases where re-sterilised catheters had been used.

  2. Continuous normothermic retrograde cardioplegia for valve surgery.

    Science.gov (United States)

    Martella, A T; Hoffman, D M; Nakao, T; Frater, R W

    1994-07-01

    We have studied warm heart surgery, deemed as continuous warm blood cardioplegia and normothermic cardiopulmonary bypass (CPB), as an alternative to the technique of intermittent cold cardioplegia for valvular surgery. Between August 1990 and January 1994, 137 consecutive patients underwent valve repair or replacement using normothermic CPB. Eighty-six of these patients received continuous normothermic retrograde blood cardioplegia via the coronary sinus (CNRC). Fifty-one patients received intermittent cold blood cardioplegia (ICBC). All procedures were performed by the same surgeon (RWMF). The two groups were matched for age, sex, NYHA class, preoperative ejection fraction, diagnosis, procedure and activated clotting time. Warm blood cardioplegia was delivered continuously via the coronary sinus after antegrade arrest (oxygenated blood 1:4 to 1:3, 37 degrees C, 250-300 ml/min, maintaining coronary sinus pressures of 40-60 mmHg. Perioperative myocardial infarction was significantly less prevalent (4.6 vs. 8.0%; p < 0.05) in the warm cardioplegia group. Cardiac output immediately after bypass was significantly higher than before bypass only in the CNRC group (4.1 +/- 0.8 to 5.2 +/- 0.9 L/min; p < 0.01). CNRC patients had significantly higher incidence of spontaneous resumption of sinus rhythm at cross-clamp removal (80 of 86, 93%) compared to the hypothermic patients (14 of 51, 27%, p < 0.001). The time from removal of the aortic cross-clamp to discontinuation of CPB (reperfusion time) was significantly shorter in the warm cardioplegia group (43 +/- 7.4 versus 75 +/- 10.2 min; p < 0.001.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Pancreatits after endoscopic retrograde cholangio-pancreatography

    Institute of Scientific and Technical Information of China (English)

    Ayman M Abdel Aziz; Glen A Lehman

    2007-01-01

    Pancreatitis is the most common complication after endoscopic retrograde cholangio-pancreatography (ERCP); the reported incidence of this complication varies from less than 1% to 40%, but a rate of 4%-8% is reported in most prospective studies involving nonselected patients. Differences in criteria for defining pancreatitis, methods of data collection, and patient populations (i.e. number of high-risk patients included in the published series) are factors that are likely to affect the varying rates of post-ERCP pancreatitis. The severity of post-ERCP pancreatitis (PEP) can range from a minor inconvenience with one or two days of added hospitalization with full recovery to a devastating illness with pancreatic necrosis, multiorgan failure, permanent disability, and even death. Although, most episodes of PEP are mild (about 90%), a small percentage of patients (about 10%) develop moderate or severe pancreatitis. In the past, PEP was often viewed as an unpredictable and unavoidable complication, with no realistic strategy for its avoidance. New data have aided in stratification of patients into PEP risk categories and new measures have been introduced to decrease the risk of PEP. As most ERCPs are performed on an outpatient basis, the majority of patients will not develop PEP and can be discharged. Alternatively, early detection of those patients who will go on to develop PEP can guide decisions regarding hospital admission and aggressive management. In the last decade, great efforts have been addressed toward prevention of this complication. Points of emphasis have included technical measures, pharmacological prophylaxis, and patient selection. This review provides a comprehensive, evidence-based assessment of published data on PEP and current suggestions for its avoidance.

  4. Stable retrograde orbits around the triple system 2001 SN263

    CERN Document Server

    Araujo, R A N; Prado, A F B A

    2015-01-01

    The NEA 2001 SN263 is the target of the ASTER MISSION - First Brazilian Deep Space Mission. Araujo et al. (2012), characterized the stable regions around the components of the triple system for the planar and prograde cases. Knowing that the retrograde orbits are expected to be more stable, here we present a complementary study. We now considered particles orbiting the components of the system, in the internal and external regions, with relative inclinations between $90^{\\circ}< I \\leqslant180^{\\circ}$, i.e., particles with retrograde orbits. Our goal is to characterize the stable regions of the system for retrograde orbits, and then detach a preferred region to place the space probe. For a space mission, the most interesting regions would be those that are unstable for the prograde cases, but stable for the retrograde cases. Such configuration provide a stable region to place the mission probe with a relative retrograde orbit, and, at the same time, guarantees a region free of debris since they are expect...

  5. Large retrograde Centaurs: visitors from the Oort cloud?

    CERN Document Server

    Marcos, C de la Fuente

    2014-01-01

    Among all the asteroid dynamical groups, Centaurs have the highest fraction of objects moving in retrograde orbits. The distribution in absolute magnitude, H, of known retrograde Centaurs with semi-major axes in the range 6-34 AU exhibits a remarkable trend: 10% have H 12 mag. The largest objects, namely (342842) 2008 YB3, 2011 MM4 and 2013 LU28, move in almost polar, very eccentric paths; their nodal points are currently located near perihelion and aphelion. In the group of retrograde Centaurs, they are obvious outliers both in terms of dynamics and size. Here, we show that these objects are also trapped in retrograde resonances that make them unstable. Asteroid 2013 LU28, the largest, is a candidate transient co-orbital to Uranus and it may be a recent visitor from the trans-Neptunian region. Asteroids 342842 and 2011 MM4 are temporarily submitted to various high-order retrograde resonances with the Jovian planets but 342842 may be ejected towards the trans-Neptunian region within the next few hundred kyr....

  6. The stability of grounding lines on retrograde slopes

    Directory of Open Access Journals (Sweden)

    G. H. Gudmundsson

    2012-12-01

    Full Text Available The stability of marine ice sheets grounded on beds that slope upwards in the overall direction of flow is investigated numerically in two horizontal dimensions. We give examples of stable grounding lines on such retrograde slopes illustrating that marine ice sheets are not unconditionally unstable in two horizontal dimensions. Retrograde bed slopes at the grounding lines of marine ice sheets, such as the West Antarctic Ice Sheet (WAIS, do not per se imply an instability, nor do they imply that these regions are close to a threshold of instability. We therefore question those estimates of the potential near-future contribution of WAIS to global sea level change based solely on the notion that WAIS, resting on a retrograde slope, must be inherently unstable.

  7. The stability of grounding lines on retrograde slopes

    Directory of Open Access Journals (Sweden)

    G. H. Gudmundsson

    2012-07-01

    Full Text Available The stability of marine ice sheets grounded on beds that slope upwards in the overall direction of flow is investigated numerically in two horizontal dimensions. We give examples of stable grounding lines on such retrograde slopes illustrating that marine ice sheets are not unconditionally unstable in two-horizontal dimensions. Retrograde bed slopes at the grounding lines of maritime ice sheets, such as the West Antarctic Ice Sheet (WAIS, do not per se imply an instability, nor do they imply that these regions are close to a threshold of instability. We therefore question those estimates of the potential near-future contribution of WAIS to global sea level change based solely on the notion that WAIS, resting on retrograde slope, must be inherently unstable.

  8. Fundamental studies of retrograde reactions in direct liquefaction

    Energy Technology Data Exchange (ETDEWEB)

    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.

  9. Persistent knee complaints after retrograde unreamed nailing of femoral shaft fractures

    NARCIS (Netherlands)

    El Moumni, Mostafa; Schraven, Pim; ten Duis, Henk Jan; Wendt, Klaus

    2010-01-01

    Retrograde nailing is an attractive method for stabilisation of femoral shaft fractures in cases of polytrauma, ipsilateral pelvic, acetabular, tibial and femoral neck fractures, bilateral femoral fractures, obese and pregnant patients. However, retrograde nailing may result in complaints about the

  10. Retrograde ejaculation and sexual dysfunction in men with diabetes mellitus

    DEFF Research Database (Denmark)

    Fedder, J; Kaspersen, Maja Døvling; Brandslund, I;

    2013-01-01

    Retrograde ejaculation (RE) and erectile dysfunction may be caused by diabetes mellitus (DM), but the prevalence of RE among DM patients is unknown. A prospective, blinded case-control study comparing men with DM with matched controls according to RE and erectile dysfunction was performed. Twenty...

  11. Retrograde pylorogastric intussusception – Case report and review

    Directory of Open Access Journals (Sweden)

    Efrat Avinadav

    2016-07-01

    Full Text Available A case of gastric outlet obstruction in an infant due to retrograde intussusception of the pylorus into the stomach is presented. This anomaly is extremely rare, with almost no reports in the literature. The patient underwent formal Heineke-Mikulicz pyloroplasty with an uneventful recovery and resumed full enteral feeding.

  12. Chloroplast retrograde regulation of heat stress responses in plants

    Directory of Open Access Journals (Sweden)

    Ai-Zhen eSun

    2016-03-01

    Full Text Available 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 primary susceptible 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. Such diverse metabolic and biosynthetic functions require efficient communication between plastids and the nucleus. 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.

  13. Rutinemaessig endoskopisk retrograd kolangiopankreatikografi kan ikke anbefales ved galdestenspankreatitis

    DEFF Research Database (Denmark)

    Ainsworth, Alan Patrick; Svendsen, Lars Bo

    2009-01-01

    Danish guidelines recommend that patients with presumed severe gallstone-induced acute pancreatitis (GAP) should receive endoscopic retrograde cholangiopancreatography (ERCP) within 72 hours. The results of a newly performed meta-analysis show that acute ERCP in patients with GAP does not reduce...

  14. Fatal cerebral arterial gas embolism after endoscopic retrograde cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    Rangappa Pradeep

    2009-01-01

    Full Text Available We report the case of a 50-year-old woman undergoing elective endoscopic retrograde cholangiopancreatography, who developed coma and hemiparesis secondary to severe cerebral artery gas embolism. Despite prompt diagnosis and early hyperbaric oxygen therapy (HBO 2 she developed severe cerebral edema and died within 24 h.

  15. Treatment of lower extremity arterial occlusive through retrograde access

    International Nuclear Information System (INIS)

    Objective: To explore the clinical significance of retrograde access for the interventional treatment of lower extremity arterial occlusive diseases when the occluded segment of lower extremity artery could not be reached through antegrade access. Methods: Twenty-seven cases (male 17, female 10; age range 32-89 years) were retrospectively investigated, including 18 with lower limb arteriosclerosis obliterans, 7 with diabetic foot and 2 with thromboangiitis obliterans. According to the Fontaine staging, 6 cases were classified as Fontaine Ⅱ, 11 were classified as Fontaine Ⅲ and 10 were classified as Fontaine Ⅳ. All cases underwent endovascular operation through antegrade access first with an attempt to cross the occlusive segment, but in vain. So retrograde access was tried via puncture of pedis dorsalis or posterior tibial artery or exposure of lateral branches of posterior tibial artery, peroneal artery or dorsal artery by open surgery,which followed by Percutaneous transluminal angiography and (or) stenting. Results: The operation through retrograde access was successful in all cases with obvious improvement of ischemic symptoms. Hematoma at the puncture site occurred in 3 patients, and paresthesia of toes occurred in 1 after dorsalis pedis arteriotomy. No severe perioperative complication occurred. The average ankle brachial index increased from 0.37 ± 0.11 preoperatively to 0.85 ± 0.12 postoperatively. Conclusions: Retrograde access could be used as an alternative strategy in lower extremity arterial occlusive diseases when the occluded segment could not reach through antegrade access. (authors)

  16. Chloroplast Retrograde Regulation of Heat Stress Responses in Plants.

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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. PMID:27507508

  18. Learning the Languages of the Chloroplast: Retrograde Signaling and Beyond.

    Science.gov (United States)

    Chan, Kai Xun; Phua, Su Yin; Crisp, Peter; McQuinn, Ryan; Pogson, Barry J

    2016-04-29

    The chloroplast can act as an environmental sensor, communicating with the cell during biogenesis and operation to change the expression of thousands of proteins. This process, termed retrograde signaling, regulates expression in response to developmental cues and stresses that affect photosynthesis and yield. Recent advances have identified many signals and pathways-including carotenoid derivatives, isoprenes, phosphoadenosines, tetrapyrroles, and heme, together with reactive oxygen species and proteins-that build a communication network to regulate gene expression, RNA turnover, and splicing. However, retrograde signaling pathways have been viewed largely as a means of bilateral communication between organelles and nuclei, ignoring their potential to interact with hormone signaling and the cell as a whole to regulate plant form and function. Here, we discuss new findings on the processes by which organelle communication is initiated, transmitted, and perceived, not only to regulate chloroplastic processes but also to intersect with cellular signaling and alter physiological responses. PMID:26735063

  19. Role of endoscopic retrograde cholangiopancreatography in acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is a useful tool in the evaluation and management of acute pancreatitis. This review will focus on the role of ERCP in specific causes of acute pancreatitis, including microlithiasis and gallstone disease, pancreas divisum, Sphincter of Oddi dysfunction, tumors of the pancreaticobiliary tract, pancreatic pseudocysts, and pancreatic duct injury. Indications for endoscopic techniques such as biliary and pancreatic sphincterotomy, stenting, stricture dilation, treatment of duct leaks, drainage of fluid collections and stone extraction will also be discussed in this review. With the advent of less invasive and safer diagnostic modalities including endoscopic ultrasound (EUS) and magnetic retrograde cholangiopancreatography (MRCP), ERCP is appropriately becoming a therapeutic rather than diagnostic tool in the management of acute pancreatitis and its complications.

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

    Science.gov (United States)

    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.

  1. Ureteroscopy-Assisted Retrograde Nephrostomy (UARN after Anatrophic Nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Takashi Kawahara

    2012-01-01

    Full Text Available 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.

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

    Science.gov (United States)

    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.

  3. Prograde and Retrograde Black Holes: Whose Jet is More Powerful?

    CERN Document Server

    Tchekhovskoy, Alexander

    2012-01-01

    We study prograde and retrograde disc accretion on rapidly spinning black holes (BHs) via global 3D time-dependent non-radiative general relativistic magnetohydrodynamic simulations. Our discs contain more large-scale vertical magnetic flux than the accreting gas can push into the BH. As a result, the BH becomes saturated with flux, and strong centrally concentrated large-scale magnetic fields form that obstruct the accretion and lead to a magnetically arrested disc. We show that the efficiency with which such accretion systems generate steady outflows depends only on the dimensionless BH spin, a, and accretion disc angular thickness, h/r. Prograde BHs with thick discs (h/r ~ 0.3-0.6) generate jets and outflows several times more efficiently than retrograde BHs, for the same absolute value of spin. Both orientations can reach high values of outflow efficiency, eta ~ 100%, with higher efficiency values for thicker discs.

  4. Role of endoscopic retrograde cholangiopancreatography in acute pancreatitis

    OpenAIRE

    Canlas, Karen R; Malcolm S. Branch

    2007-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is a useful tool in the evaluation and management of acute pancreatitis. This review will focus on the role of ERCP in specific causes of acute pancreatitis, including microlithiasis and gallstone disease, pancreas divisum, Sphincter of Oddi dysfunction, tumors of the pancreaticobiliary tract, pancreatic pseudocysts, and pancreatic duct injury. Indications for endoscopic techniques such as biliary and pancreatic sphincterotomy, stenting, s...

  5. Electrocardiographic Changes in Elderly Patients During Endoscopic Retrograde Cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    NG Kounis

    2003-01-01

    Full Text Available BACKGROUND: Cardiorespiratory complications may occur during gastrointestinal endoscopy, and elderly people seem to be more vulnerable to these complications during endoscopic procedures involving the manipulation of abdominal viscera. OBJECTIVES: To determine the incidence of cardiac arrhythmias, changes in oxygen saturation, heart rate and blood pressure during endoscopic retrograde cholangiopancreatography (ERCP via Holter monitoring in elderly patients older than 70 years of age.

  6. Role of endoscopic retrograde cholangiopancreatography in pancreatic diseases

    OpenAIRE

    Christodoulou, Dimitrios K; Tsianos, Epameinondas V.

    2010-01-01

    Over the last 15 years, endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a diagnostic tool to one that is primarily used to provide therapy. This development occurred first for biliary disorders and subsequently to a lesser extent for pancreatic diseases. Computed tomography, magnetic resonance imaging, magnetic resonance cholangiopancreatography and endoscopic ultrasonography suggest a diagnosis in the majority of patients with pancreatic diseases today and can help phy...

  7. [Successful recanalisation of RCA CTO using retrograde approach].

    Science.gov (United States)

    Król, Marek; Skwarna, Bartosz; Buszman, Paweł

    2009-03-01

    A 51-year-old female two years after CABG presented with unstable angina and inferior wall ischaemia. Coronary angiography revealed occluded graft to RCA and chronic total occlusion of RCA with good collateral flow from distal LAD to RCA. The CTO was successfully crossed and dilated through epicardial collaterals from distal LAD (retrograde approach). Finally, antegrade angioplasty with two stents implantation was performed achieving TIMI 3 flow.

  8. Retrograde interlocking intramedullary nailing under arthroscopy for supracondylar femoral fracture

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To evaluate the therapeutic effects of retrograde interlocking intramedullary nailing under arthroscopy on supracondylar femoral fractures.   Methods: From June 1999 to December 2000, 17 patients with supracondylar femoral fracture were treated with arthroscopically assisted implantation of retrograde interlocking intramedullary nail and close reduction.   Results: More than 6-month follow-up study after operation in 11 patients revealed that the average healing time was 3 months. Average range of the knee motion for all the patients was more than 90 degrees. There was no implant breakage and infection.   Conclusions: This new method, combining the advantage of arthroscope and retrograde interlocking intramedullary nail, can provide a stable and reliable fixation, and meanwhile is less invasive to the soft tissue and knee, less operative time and blood loss, minimal disruption of the blood supply in fracture site. It is conducive to the fracture healing and the functional recovery of the knee joint and worthwhile to be recommended.

  9. Retrogradation behaviour of high-amylose rice starch prepared by improved extrusion cooking technology.

    Science.gov (United States)

    Zhang, Yanjun; Liu, Wei; Liu, Chengmei; Luo, Shunjing; Li, Ti; Liu, Yunfei; Wu, Di; Zuo, Yanna

    2014-09-01

    Native rice starch (NRS, amylose/28.9%) was gelatinized by improved extrusion cooking technology (IECT) and retrograded (RRS) after low temperature storage (4 °C). The retrogradation behaviour of RRS was changed to low retrogradation percentage and low retrogradation rate. The retrogradation resulted in a high compact morphology. The melt enthalpy change and percentage of retrogradation of RRS was 3.68 J/g and 37.7%, respectively, compared to those of NRS (9.75 J/g, 100%). The retrogradation percentage for RRS was low during storage as shown as a low retrogradation rate (0.21 d(-1)) and a high Avrami exponent (0.89). The pattern of rice starch changed from A-type to amorphous and B-type. Both the relative crystallinity of RRS (12.7%) by the X-ray diffractograms and the ratio of the band height (0.63) in the FTIR spectra were low. The analysis of retrogradation structure and short-range molecular order further confirmed the retrogradation behaviour of rice starch after IECT treatment. PMID:24731339

  10. Evidence-based clinical practice guidelines for liver cirrhosis 2015.

    Science.gov (United States)

    Fukui, Hiroshi; Saito, Hidetsugu; Ueno, Yoshiyuki; Uto, Hirofumi; Obara, Katsutoshi; Sakaida, Isao; Shibuya, Akitaka; Seike, Masataka; Nagoshi, Sumiko; Segawa, Makoto; Tsubouchi, Hirohito; Moriwaki, Hisataka; Kato, Akinobu; Hashimoto, Etsuko; Michitaka, Kojiro; Murawaki, Toshikazu; Sugano, Kentaro; Watanabe, Mamoru; Shimosegawa, Tooru

    2016-07-01

    The Japanese Society of Gastroenterology revised the evidence-based clinical practice guidelines for liver cirrhosis in 2015. Eighty-three clinical questions were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. Manual searching of the latest important literature was added until August 2015. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This digest version in English introduces selected clinical questions and statements related to the management of liver cirrhosis and its complications. Branched-chain amino acids relieve hypoalbuminemia and hepatic encephalopathy and improve quality of life. Nucleoside analogues and peginterferon plus ribavirin combination therapy improve the prognosis of patients with hepatitis B virus related liver cirrhosis and hepatitis C related compensated liver cirrhosis, respectively, although the latter therapy may be replaced by direct-acting antivirals. For liver cirrhosis caused by primary biliary cirrhosis and active autoimmune hepatitis, urosodeoxycholic acid and steroid are recommended, respectively. The most adequate modalities for the management of variceal bleeding are the endoscopic injection sclerotherapy for esophageal varices and the balloon-occluded retrograde transvenous obliteration following endoscopic obturation with cyanoacrylate for gastric varices. Beta-blockers are useful for primary prophylaxis of esophageal variceal bleeding. The V2 receptor antagonist tolvaptan is a useful add-on therapy in careful diuretic therapy for ascites. Albumin infusion is useful for the prevention of paracentesis-induced circulatory disturbance and renal failure. In addition to disaccharides, the nonabsorbable antibiotic rifaximin is useful for the management of encephalopathy. Anticoagulation therapy is proposed for

  11. Percutaneous Transportal Sclerotherapy with N-Butyl-2-Cyanoacrylate for Gastric Varices: Technique and Clinical Efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Hyo Sung; Han, Young Min [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2008-12-15

    This study was deigned to evaluate the technique and clinical efficacy of the use of percutaneous transportal sclerotherapy with N-butyl-2-cyanoacrylate (NBCA) for patients with gastric varices. Seven patients were treated by transportal sclerotherapy with the use of NBCA. For transportal sclerotherapy, portal vein catheterization was performed with a 6-Fr sheath by the transhepatic approach. A 5-Fr catheter was introduced into the afferent gastric vein and a microcatheter was advanced through the 5-Fr catheter into the varices. NBCA was injected through the microcatheter in the varices by use of the continuous single-column injection technique. After the procedure, postcontrast computed tomography (CT) was performed on the next day and then every six months. Gastroendoscopy was performed at one week, three months, and then every six months after the procedure. The technical success rate of the procedure was 88%. In six patients, gastric varices were successfully obliterated with 1-8 mL (mean, 5.4 mL) of a NBCA-Lipiodol mixture injected via a microcatheter. No complications related to the procedure were encountered. As seen on the follow-up endoscopy and CT imaging performed after six months, the presence of gastric varcies was not seen in any of the patients after treatment with the NBCA-Lipiodol mixture and the use of microcoils. Recurrence of gastric varices was not observed during the followup period. Worsening of esophageal varices occurred in four patients after transportal sclerotherapy. The serum albumin level increased, the ammonia level decreased and the prothrombin time increased at six months after the procedure (p < 0.05). Percutaneous transportal sclerotherapy with NBCA is useful to obliterate gastric varices if it is not possible to perform balloon-occluded retrograde transvenous obliteration.

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

    Science.gov (United States)

    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.

  13. Recruitment of actin modifiers to TrkA endosomes governs retrograde NGF signaling and survival

    OpenAIRE

    Harrington, Anthony W.; Hillaire, Coryse St.; Zweifel, Larry S.; Glebova, Natalia O.; Philippidou, Polyxeni; Halegoua, Simon; Ginty, David D.

    2011-01-01

    NGF and NT3 collaborate to support development of sympathetic neurons. Although both neurotrophins activate TrkA-dependent axonal extension, NGF is unique in its ability to promote retrograde transport of TrkA endosomes and retrograde survival. Here, we report that actin depolymerization is essential for initiation of NGF/TrkA endosome trafficking and that a Rac1–cofilin signaling module associated with TrkA early endosomes supports their maturation to retrograde transport-competent endosomes...

  14. Fallbericht: Perkutane transpopliteale retrograde Rekanalisation der A. femoralis superficialis

    Directory of Open Access Journals (Sweden)

    Wallner H

    2008-01-01

    Full Text Available bVorgeschichte/bbr Bei der 53 Jahre alten Patientin erfolgte bei Claudicatio- Beschwerden der rechten unteren Extremität eine auswärtige MR-Angiographie mit langstreckigem Verschluss der A. femoralis superficialis. Die Patientin wurde auch bei einer Gehstrecke von unter 100 m symptomatisch und der Knöchelarmindex betrug 0,7 auf der betroffenen Seite. An Risikofaktoren bestanden ein chronischer Nikotinabusus, eine behandelte arterielle Hypertonie und Hypercholesterinämie sowie ein pathologischer Glukosetoleranztest bei Adipositas. Nachdem angiomorphologisch kein Gefäßstumpf für eine antegrade Crossover-Rekanalisation erkennbar war, erfolgte die Durchführung einer perkutanen retrograden transpoplitealen Rekanalisation des betroffenen Gefäßes, da auch eine chirurgische Revaskularisation abgelehnt wurde. Nachdem ein arterieller Zugang (6-French-Schleuse über die rechte A. femoralis communis zur Kontrastmittelinjektion gelegt wurde, wurde die Patientin in Bauchlage gebracht und gezielt die rechte A. poplitea punktiert. Hierbei erfolgte die problemlose Drahtrekanalisation, anschließende Angioplastie und 2-fach-Stentimplantation des Gefäßes.br b Zusammenfassung/bbr Die endovaskuläre Therapie von Verschlüssen peripherer Gefäße nimmt bei verbesserter Technik und verbesserten Materialien einen immer größeren Stellenwert ein. Dargestellt ist die retrograde Rekanalisation der A. femoralis superficialis bei langstreckigem Verschluss und fehlendem Gefäßstumpf. Das Gefäß konnte erfolgreich retrograd transpopliteal eröffnet werden. Sollte bei der retrograden Rekanalisation und subintimaler Angioplastie ein Anschluss an das proximale offene Gefäßsegment nicht erzielt werden, ist der Einsatz eines Reentry- Katheters, eventuell Ultraschall-gestützt, hilfreich. Generell haben wir die Erfahrung gemacht, dass die retrograde Rekanalisation technisch deutlich einfacher ist als die antegrade Vorgehensweise.

  15. Retrograde jejunoduodenogastric intussusception due to a replacement percutaneous gastrostomy tube presenting as upper gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Percutaneous endoscopic gastrostomy (PEG) tube complications can be serious or life threatening.Retrograde intussusception is a very rare complication of PEG tubes with only 9 cases reported in the literature.We describe a case of retrograde intussusception,associated with the use of a Foley catheter as a replacement gastrostomy tube, presenting with upper gastrointestinal bleeding. To our knowledge, this is the first reported case of PEG-related retrograde intussusception successfully managed in a non-surgical manner. Retrograde intussusception likely occurred due to migration of the replacement tube with resultant securing and invagination of the proximal jejunum when the gastrostomy tube was anchored to the abdominal wall.

  16. Dietary approaches following endoscopic retrograde cholangiopancreatography: A survey of selected endoscopists

    OpenAIRE

    Ferreira, Lincoln EVVC; Topazian, Mark D.; Harmsen, William S.; Zinsmeister, Alan R.; Baron, Todd H

    2010-01-01

    AIM: To describe the dietary recommendations of experienced endoscopists for patients who have undergone endoscopic retrograde cholangiopancreatography (ERCP) and the factors that influence these recommendations.

  17. Endoscopic retrograde cholangiopancreatography-related adverse events: general overview.

    Science.gov (United States)

    Rustagi, Tarun; Jamidar, Priya A

    2015-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) represents a monumental advance in the management of patients with pancreaticobiliary diseases, but is a complex and technically demanding procedure with the highest inherent risk of adverse events of all routine endoscopic procedures. Overall adverse event rates for ERCP are typically reported as 5-10%. The most commonly reported adverse events include post-ERCP pancreatitis, bleeding, perforation, infection (cholangitis), and cardiopulomary or "sedation related" events. This article evaluates patient-related and procedure-related risk factors for ERCP-related adverse events, and discusses strategies for the prevention, diagnosis and management of these events.

  18. Retrograde Intrarenal Surgery for Small Renal Calyx Stones

    Directory of Open Access Journals (Sweden)

    Nevzat Sener

    2014-04-01

    Full Text Available Lower pole kidney stones are one of the most common problems is urology practice. For this group of patients, shock wave lithotripsy (SWL and retrograde intrarenal surgery (RIRS are established treatments with low morbidity and high efficacy. SWL has relatively lower success rates for lower pole stones. On the other hand, RIRS has as high as 100% success rates for lower pole stones. With advances in technology and experience we believe RIRS may be the first treatment option over SWL in the following years.

  19. Modified Technique of Retrograde Intubation in TMJ Ankylosis

    Directory of Open Access Journals (Sweden)

    Shaila Kamat

    2008-01-01

    Full Text Available We are presenting a case report on the anaesthetic management of a case of ankylosis of temporomandibular joint for corrective surgery in a 7 year old child. Anticipated difficult airway in paediatric population has always been a perplexing problem, awake fibreoptic intubation almost impossible due to obvious difficulties with co-operation. Here we are describing a new approach to this problem, in which the patients were kept under GA with spontaneous ventilation while retrograde intubation was done quite comfortably by the conventional method.

  20. Pancreas imaging by computed tomography after endoscopic retrograde pancreatography

    International Nuclear Information System (INIS)

    A method using CT after endoscopic retrograde pancreatography (CT-ERP) is described for pancreatic imaging. When using an ERP technique in the canine model comparable to that used in humans, small amounts of contrast material in peripheral pancreatic radicles resulted in enhancement of the pancreas on CT scans. Nine patients were also studied by CT-ERP images. The main pancreatic duct was seen on delayed images. In cases of chronic pancreatitis (n = 2), pancreatic opacification was patchy and heterogeneous. There was no contrast-material enhancement in areas of pancreatic carcimomas (n = 2). CT-ERP showed the true extent of carcinoma better than ERP alone

  1. Eclogites of the Dabie Region: Retrograde Metamorphism and Fluid Evolution

    Institute of Scientific and Technical Information of China (English)

    顾连兴; 杜建国; 翟建平; 赵成浩; 范建国; 张文兰

    2002-01-01

    Based upon fluid effects, retrograde metamorphism of eclogites in the Dabie region can be divided into the fluid-poor, fluid-bearing and fluid-rich stages. The fluid-poor stage is marked by polymorphic inversion, recrystallization and exsolution of solid solutions, and is thought to represent eclogite-facies retrograde environments. The fluid-bearing stage is likely to have occurred at the late stage of ecologite-facies diaphthorosis and is represented by kyanite porphyroblasts, rutile, and sodic pyroxene in association with high-pressure hydrous minerals such as phengite and zoisite (clinozoisite) without significant amount of hydrous minerals such as amphibole, epidote and biotite. The fluid-rich stage might have commenced concomitantly with lower amphibolite-facies diaphthoresis and persisted all the way towards the near-surface environment. The product of this stage is characterized by plentiful hydrous and volatile-bearing phases.The dissemination-type rutile mineralizations in eclogites might have formed by preferential shearing-induced pressure solution of gangue minerals at the fluid-bearing stage. The accompanying vein rutile was precipitated from fluids of this stage after local transport and concentration, and may hence represent proximal mobilization of titanium from the eclogite. Therefore, rutile veins can be used as an exploration indicator for dissemination-type rutile deposits.

  2. Retrograde approach for the recanalization of coronary chronic total occlusion: preliminary experience of a single center

    Institute of Scientific and Technical Information of China (English)

    GE Lei; XU Shi-kun; ZHANG Feng; WANG Xiang-fei; WANG Qi-bing; FAN Bing; YAN Yan; FENG Qi; WANG Hao; SHEN An; ZHU Ming-hui; QIAN Ju-ying; GE Jun-bo; LIU Xue-bo; QIN Qing; CUI Shan-jing; YAO Kang; SHEN Li; MA Jian-ying; HUANG Dong

    2010-01-01

    Background The success rate of antegrade approach for chronic total occlusions (CTO) recanalization has not dramatically increased, especially in complex CTO subset. The retrograde technique may hold great promise. This report aimed to describe our experience of retrograde recanalization for CTO, focusing on its safety and feasibility. Methods We identified 42 patients who underwent revascularization in CTO with retrograde approach from July 2005 to November 2009 in our center.Results Three kinds of strategy were applied: retrograde as primary strategy (50.0%), retrograde immediately after antegrade failure (26.2%) and repeat procedure after previous antegrade failure (23.8%). Septal collaterals were more frequently used as the retrograde access route (92.9%). Overall success rate was 88.1%. In patients with successful retrograde wire crossing collateral channel to the distal cap of CTO, the success rate of recanalization was 94.1%. In patient with failure to cross the collaterals, the success rate was 62.5%. Eight different kinds of retrograde techniques were used: kissing wire technique (35.3%), wire trapped and reverse wire trapped technique (17.6%), back-end balloon and microcatherer reversal technique (14.7%), controlled antegrade and retrograde subintimal tracking (CART) technique (8.8%), reverse CART and modified reverse CART technique (8.8%), retrograde wire crossing technique (2.9%). There were 4 complications occurred without in-hospital major adverse cardiac events (MACE). In-hospital MACE was 7.7%. All of them were non-Q wave myocardial infarction. There were no cases of death or target vessel revascularization, either surgery or percutaneous.Conclusions The retrograde approach can be an effective tool for increasing the success rate of recanalization in the very complex CTO. To ensure the success and safety of the approach, careful case selection and device handling by experienced operators is essential.

  3. Сorrection of retrograde ejaculation in patients with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    D. G. Kurbatov

    2014-11-01

    Full Text Available This article describes a new technique of correction of the retrograde ejaculation in patients with type 1 diabetes mellitus. Currently, treated 12 patients with type 1 diabetes mellitus and retrograde ejaculation as a manifestation of urogenital form of autonomic diabetic neuropathy. The positive effect of the operation was achieved in 11 of 12 treated patients. Registered 2 cases of physiological pregnancy.

  4. Сorrection of retrograde ejaculation in patients with type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    D. G. Kurbatov

    2013-01-01

    Full Text Available This article describes a new technique of correction of the retrograde ejaculation in patients with type 1 diabetes mellitus. Currently, treated 12 patients with type 1 diabetes mellitus and retrograde ejaculation as a manifestation of urogenital form of autonomic diabetic neuropathy. The positive effect of the operation was achieved in 11 of 12 treated patients. Registered 2 cases of physiological pregnancy.

  5. Defibrillation lead placement using a transthoracic transatrial approach in a case without transvenous access due to lack of the right superior vena cava.

    Science.gov (United States)

    Otsuka, Yosuke; Okamura, Hideo; Sato, Syunsuke; Nakajima, Ikutaro; Ishibashi, Kohei; Miyamoto, Kouji; Noda, Takashi; Aiba, Takeshi; Kamakura, Shiro; Kobayashi, Junjiro; Yasuda, Satoshi; Ogawa, Hisao; Kusano, Kengo

    2015-06-01

    A 65-year-old woman with a history of syncope was diagnosed with hypertrophic cardiomyopathy. She had previously undergone mastectomy of the left breast owing to breast cancer. Holter electrocardiogram (ECG) and monitor ECG revealed sick sinus syndrome (Type II) and non-sustained ventricular tachycardia. Sustained ventricular tachycardia and ventricular fibrillation were induced in an electrophysiological study. Although the patient was eligible for treatment with a dual chamber implantable cardioverter defibrillator (ICD), venography revealed lack of the right superior vena cava (R-SVC). Lead placement from the left subclavian vein would have increased the risk of lymphedema owing to the patient׳s mastectomy history. Consequently, the defibrillation lead was placed in the right ventricle by direct puncture of the right auricle through the tricuspid valve. The atrial lead was sutured to the atrial wall, and the postoperative course was unremarkable. Defibrillation lead placement using a transthoracic transatrial approach can be an alternative method in cases where a transvenous approach for lead placement is not feasible.

  6. Retrograde transport of protein toxins through the Golgi apparatus

    DEFF Research Database (Denmark)

    Sandvig, Kirsten; Skotland, Tore; van Deurs, Bo;

    2013-01-01

    A number of protein toxins from plants and bacteria take advantage of transport through the Golgi apparatus to gain entry into the cytosol where they exert their action. These toxins include the plant toxin ricin, the bacterial Shiga toxins, and cholera toxin. Such toxins bind to lipids or proteins...... at the cell surface, and they are endocytosed both by clathrin-dependent and clathrin-independent mechanisms. Sorting to the Golgi and retrograde transport to the endoplasmic reticulum (ER) are common to these toxins, but the exact mechanisms turn out to be toxin and cell-type dependent. In the ER......, the enzymatically active part is released and then transported into the cytosol, exploiting components of the ER-associated degradation system. In this review, we will discuss transport of different protein toxins, but we will focus on factors involved in entry and sorting of ricin and Shiga toxin into and through...

  7. Inhibition of wheat starch retrogradation by tea derivatives.

    Science.gov (United States)

    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.

  8. Retrograde nailing for distal femur fractures in the elderly

    Directory of Open Access Journals (Sweden)

    Giddie Jasdeep

    2015-01-01

    Full Text Available Introduction: We report the results of treating a series of 56 fractures in 54 elderly patients with a distal femur fracture with a retrograde femoral nail. Methods: Fifty-four of the nails were inserted percutaneously with a closed reduction. After surgery all patients were allowed to weight bear as tolerated. Four fractures were supported in a temporary external splint. Results: The mean age of patients was 80.6 years (range 51–103 years, 52/54 (96% were females. There were no cases of nail related complications and no re-operations were required. One patient was lost to follow up. The 30-day mortality was 5/54 (9.3% and the one year mortality was 17/54 (31.5%. Conclusions: Distal femoral nail fixation provides a good method of fixation allowing immediate mobilisation for this group of patients.

  9. Retrograde versus Prograde Models of Accreting Black Holes

    Directory of Open Access Journals (Sweden)

    David Garofalo

    2013-01-01

    Full Text Available There is a general consensus that magnetic fields, accretion disks, and rotating black holes are instrumental in the generation of the most powerful sources of energy in the known universe. Nonetheless, because magnetized accretion onto rotating black holes involves both the complications of nonlinear magnetohydrodynamics that currently cannot fully be treated numerically, and uncertainties about the origin of magnetic fields that at present are part of the input, the space of possible solutions remains less constrained. Consequently, the literature still bears witness to the proliferation of rather different black hole engine models. But the accumulated wealth of observational data is now sufficient to meaningfully distinguish between them. It is in this light that this critical paper compares the recent retrograde framework with standard “spin paradigm” prograde models.

  10. Inhibition of wheat starch retrogradation by tea derivatives.

    Science.gov (United States)

    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. PMID:26428142

  11. Portal vein cannulation: An uncommon complication of endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Evangelos Kalaitzakis; Nicholas Stern; Richard Sturgess

    2011-01-01

    Portal vein cannulation is a rare complication of endoscopic retrograde cholangiopancreatography (ERCP). It has been reported that it usually occurs after endoscopic sphincterotomy, whereas in cases without prior sphincterotomy, the presence of portobiliary fistulas has been shown. Here, we present a case in which cannulation of the portal vein occurred despite careful wire-guided cannulation and the absence of sphincterotomy. Although fatal cases of cerebral and pulmonary air and/or bile embolism have been reported in patients with combined portal and hepatic vein trauma after ERCP and sphincterotomy, isolated portal vein cannulation, as in the current case, does not usually result in mortality or serious morbidity. However, awareness of this rare complication is important so that no further intervention is performed.

  12. Effect of pullulan on the short-term and long-term retrogradation of rice starch.

    Science.gov (United States)

    Chen, Long; Ren, Fei; Zhang, Zipei; Tong, Qunyi; Rashed, Marwan M A

    2015-01-22

    The effect of pullulan (PUL) on the retrogradation of rice starch (RS) was investigated by means of rapid visco-analyzer (RVA), rotational rheometer, differential scanning calorimetry (DSC), and X-ray diffraction (XRD). RVA results showed that addition of pullulan significantly decreased the breakdown and setback values, which meant that the short-term retrogradation of RS was inhibited. The dynamic time sweep of samples also proved the retarding effect of pullulan on the retrogradation of RS. DSC curves showed clearly that pullulan significantly reduced the retrogradation enthalpy of amylopectin, and the kinetics of retrogradation was analyzed using the Avrami model. XRD results showed that recrystallinity of RS was reduced from 11.565% to 8.841% with the addition of pullulan and this was in line with the DSC results. It could be concluded that the addition of pullulan apparently influenced not only the short-term retrogradation of amylose, but also the long-term retrogradation of amylopectin. PMID:25439913

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

    Science.gov (United States)

    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.

  14. Identification of the main retrogradation-related properties of rice starch.

    Science.gov (United States)

    Lian, Xijun; Kang, Haiqi; Sun, Haibo; Liu, Lizeng; Li, Lin

    2015-02-11

    The retrogradation of rice in shelf life is the biggest barrier to the industrial production of traditional foods using rice as material. Many rice breeders have tried their best to screen low-retrogradation rice cultivars without a specific indicator. To identify the main retrogradation-related properties of rice, the starch, amylose, and amylopectin from 16 rice cultivars were extracted from rice powder and their physicochemical properties, such as visible absorbance, infrared, average molecule weight (amylopectin), chain-length distribution (amylopectin), X-ray diffraction, and differential scanning calorimetry, were determined. The correlation between starch retrogradation rates and those physicochemical properties was investigated. The results show that a significant positive correlation (R(2) = 0.85; r = 0.926; p 10] in amylopectin and the retrogradation rates of different rice starches. The findings in the paper offer a shortcut for rice breeders to screen cultivars with a low retrogradation rate. Because the genes related to the branching enzyme control the DP of amylopectin, they can be exploited as molecular markers to screen low-retrogradation rice cultivars. PMID:25615262

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

    Directory of Open Access Journals (Sweden)

    S. Michal eJazwinski

    2012-05-01

    Full Text Available 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 NFkB 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 NFkB as the retrograde response transcription factor is not only based on functional analyses. It is bolstered by the fact that NFkB 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 NFkB. Interestingly, this is also a challenge for the complete understanding of the yeast retrograde response.

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

    Directory of Open Access Journals (Sweden)

    Donglei Zhang

    Full Text Available 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.

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

    Science.gov (United States)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, Kun Da, E-mail: zkunda@gmail.com [Singapore General Hospital, Interventional Radiology Centre (Singapore); Tan, Seck Guan [Singapore General Hospital, Department of General Surgery (Singapore); Tay, Kiang Hiong [Singapore General Hospital, Interventional Radiology Centre (Singapore)

    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.

  19. Kinematical evolution of tidally limited star clusters: the role of retrograde stellar orbits

    CERN Document Server

    Tiongco, Maria; Varri, Anna Lisa

    2016-01-01

    The presence of an external tidal field often induces significant dynamical evolutionary effects on the internal kinematics of star clusters. Previous studies investigating the restricted three-body problem with applications to star cluster dynamics have shown that unbound stars on retrograde orbits (with respect to the direction of the cluster's orbit) are more stable against escape than prograde orbits, and predicted that a star cluster might acquire retrograde rotation through preferential escape of stars on prograde orbits. In this study we present evidence of this prediction, but we also illustrate that there are additional effects that cannot be accounted for by the preferential escape of prograde orbits alone. Specifically, in the early evolution, initially underfilling models increase their fraction of retrograde stars without losing significant mass, and acquire a retrograde angular velocity. We attribute this effect to the development of preferentially eccentric/radial orbits in the outer regions of...

  20. Retrograde amnesia in patients with rupture and surgical repair of anterior communicating artery aneurysms.

    Science.gov (United States)

    O'Connor, Margaret G; Lafleche, Ginette M C

    2004-03-01

    The retrograde amnesia of patients with memory loss related to rupture and surgical repair of anterior communicating artery (ACoA) aneurysms is compared with the retrograde amnesia of temporal amnesic patients and nonamnesic control participants. Two tests which focus on popular culture but which differ according to extent of news exposure and the cognitive processes necessary for task performance were used to measure retrograde memory. ACoA patients demonstrated more significant retrograde memory problems than did nonamnesic controls; however, the severity and pattern of their memory loss was less severe than that seen in association with temporal amnesia. Different factors influenced the remote memory loss of respective groups: ACoA patients' problems were related to impaired lexical retrieval whereas temporal amnesic patients had problems secondary to both retrieval and storage deficits. PMID:15012842

  1. Reconsidering the nature and mode of action of metabolite retrograde signals from the chloroplast

    Directory of Open Access Journals (Sweden)

    Gonzalo Martín Estavillo

    2013-01-01

    Full Text Available Plant organelles produce retrograde signals to alter nuclear gene expression in order to coordinate their biogenesis, maintain homeostasis or optimize their performance under adverse conditions. Many signals of different chemical nature have been described in the past decades, including chlorophyll intermediates, reactive oxygen species and adenosine derivatives. While the effects of retrograde signalling on gene expression are well understood, the initiation and transport of the signals and their mode of action have either not been resolved, or are a matter of speculation. Moreover, retrograde signalling should be consider as part of a broader cellular network, instead of as separate pathways, required to adjust to changing physiologically relevant conditions. Here we summarize current plastid retrograde signalling models in plants, with a focus on new signalling pathways, SAL1-PAP, MEcPP and β- cyclocitral, and outline missing links or future areas of research that we believe need to be addressed to have a better understanding of plant intracellular signalling networks.

  2. Retrograde Tibiopedal Access as a Bail-Out Procedure for Endovascular Intervention Complications

    Directory of Open Access Journals (Sweden)

    Ahmed Amro

    2016-01-01

    Full Text Available Introduction. Retrograde pedal access has been well described in the literature as a secondary approach for limb salvage in critical limb ischemia (CLI patients. In this manuscript we are presenting a case where retrograde tibiopedal access has been used as a bail-out procedure for the management of superficial femoral artery (SFA intervention complications. Procedure/Technique. After development of a perforation while trying to cross the totally occluded mid SFA using the conventional CFA access, we were able to cross the mid SFA lesion after accessing the posterior tibial artery in a retrograde fashion and delivered a self-expanding stent which created a flap that sealed the perforation without the need for covered stent. Conclusion. Retrograde tibiopedal access is a safe and effective approach for delivery of stents from the distal approach and so can be used as a bail-out technique for SFA perforation.

  3. Hippocampal lesions produce both nongraded and temporally graded retrograde amnesia in the same rat.

    Science.gov (United States)

    Winocur, Gordon; Sekeres, Melanie J; Binns, Malcolm A; Moscovitch, Morris

    2013-05-01

    Rats were administered contextual fear conditioning and trained on a water-maze, spatial memory task 28 days or 24 h before undergoing hippocampal lesion or control surgery. When tested postoperatively on both tasks, rats with hippocampal lesions exhibited retrograde amnesia for spatial memory at both delays but temporally graded retrograde amnesia for the contextual fear response. In demonstrating both types of retrograde amnesia in the same animals, the results parallel similar observations in human amnesics with hippocampal damage and provide compelling evidence that the nature of the task and the type of information being accessed are crucial factors in determining the pattern of retrograde memory loss associated with hippocampal damage. The results are interpreted as consistent with our transformation hypothesis (Winocur et al. (2010a) Neuropsychologia 48:2339-2356; Winocur and Moscovitch (2011) J Int Neuropsychol Soc 17:766-780) and at variance with standard consolidation theory and other theoretical models of memory. PMID:23401223

  4. Acute pulmonary embolism during an endoscopic retrograde cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    Nate P Painter

    2014-01-01

    Full Text Available A 76-year-old female patient presented for an endoscopic retrograde cholangiopancreatography (ERCP for the removal of a biliary stent and lithotripsy. During the procedure, an acute drop in the end-tidal CO 2 , followed by cardiovascular collapse prompted the initiation of the advanced cardiac life support protocol. Transesophageal echocardiography (TEE demonstrated direct evidence of pulmonary embolism. The patient was promptly treated with thrombolytic therapy and subsequently discharged home on oral warfarin therapy, with no noted sequelae. Although, there have been case reports of air embolism during an ERCP presenting with cardiovascular collapse, to the best of our knowledge, there are no reported cases of acute pulmonary embolus during this procedure. While the availability of TEE in the operating suites is quite common, quick access and interpretation capabilities in remote locations may not be as common. With the expansion of anesthesia services outside of the operating rooms, it may be prudent to develop rapid response systems that incorporate resources such as TEE and trained personnel to deal with such emergent situations.

  5. Acute pulmonary embolism during an endoscopic retrograde cholangiopancreatography.

    Science.gov (United States)

    Painter, Nate P; Kumar, Priya A; Arora, Harendra

    2014-01-01

    A 76-year-old female patient presented for an endoscopic retrograde cholangiopancreatography (ERCP) for the removal of a biliary stent and lithotripsy. During the procedure, an acute drop in the end-tidal CO 2 , followed by cardiovascular collapse prompted the initiation of the advanced cardiac life support protocol. Transesophageal echocardiography (TEE) demonstrated direct evidence of pulmonary embolism. The patient was promptly treated with thrombolytic therapy and subsequently discharged home on oral warfarin therapy, with no noted sequelae. Although, there have been case reports of air embolism during an ERCP presenting with cardiovascular collapse, to the best of our knowledge, there are no reported cases of acute pulmonary embolus during this procedure. While the availability of TEE in the operating suites is quite common, quick access and interpretation capabilities in remote locations may not be as common. With the expansion of anesthesia services outside of the operating rooms, it may be prudent to develop rapid response systems that incorporate resources such as TEE and trained personnel to deal with such emergent situations. PMID:24732617

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

    International Nuclear Information System (INIS)

    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

  7. Endoscopic retrograde pancreatography: When should we do it?

    Institute of Scientific and Technical Information of China (English)

    Renáta; Bor; László; Madácsy; Anna; Fábián; Attila; Szepes; Zoltán; Szepes

    2015-01-01

    Endoscopic retrograde pancreatography(ERP) is an accurate imaging modality in the diagnosis of pancreatobiliary diseases. However, its use has been substantially reduced due to the invasiveness of procedure, the risk of complications and the widespread availability of non-invasive cross-section imaging techniques(computed tomography, magnetic resonance imaging, and endoscopic ultrasound). Since the introduction of endoscopic sphincterotomy, ERP has transformed from diagnostic method to an almost exclusively therapeutic procedure. Pancreatic duct injection substantially increased the risk of post-ERP pancreatitis(1.6%-15.7%); therefore, according to international guidelines ERP is recommended only in cases where biliary intervention is required. However, the role of ERP in the management of pancreatic diseases is currently not clearly defined, but in some cases the filling of pancreatic duct may provide essential information complementing the results of non-invasive imaging techniques. The aim of this publication is to systematically summarize the literature dealing with the diagnostic yield of ERP. We would like to define the precise indications of ERP and overview a diagnostic protocol of pancreatic diseases depending on international guidelines and the opinion of Hungarian experts, because it may improve the diagnostic accuracy, minimize of burden of patients and reduce the risk of procedure related complications.

  8. A rare etiology of post-endoscopic retrograde cholangiopancreatography pneumoperitoneum

    Institute of Scientific and Technical Information of China (English)

    Stelios F Assimakopoulos; Konstantinos C Thomopoulos; Sofia Giali; Christos Triantos; Dimitrios Siagris; Charalambos Gogos

    2008-01-01

    Major complications of endoscopic retrograde cholangiopancreatography (ERCP) include pancreatitis,hemorrhage, cholangitis, and duodenal perforation.The occurrence of free air in the peritoneal cavity postERCP is a rare event (< 1%), which is usually the result of duodenal or ductal perforation related to therapeutic ERCP with sphincterotomy. We describe for the first time a different aetiology of pneumoperitoneum, in an 84-year-old woman with pancreatic cancer and a large hepatic metastasis, after ERCP with common bile duct stent deployment. Our patient developed,pneumoperitoneum due to air leakage from rupture of intrahepatic bile ducts and Glisson's capsule in the area of a peripheral large hepatic metastasis. The potential mechanism underlying this complication might be postERCP pneumobilia and increased pressure of intrahepatic bile ducts leading to rupture of intrahepatic bile ducts in the liver metastatic mass owing to neoplastic tissue friability. This case indicates the need for close clinical and radiological observation of patients with hepatic masses (primary or metastatic) subjected to ERCP. In such patients, avoidance of excessive air insufflation during ERCP and/or placement of a nasogastric tube for bowel decompression immediately after ERCP might be a reasonable strategy to prevent such unusual complications.

  9. Retrograde solubility of formamidinium and methylammonium lead halide perovskites enabling rapid single crystal growth

    KAUST Repository

    Saidaminov, Makhsud I.

    2015-10-20

    Here we show the retrograde solubility of various hybrid perovskites through the correct choice of solvent(s) and report their solubility curves. Retrograde solubility enables to develop inverse temperature crystallization of FAPbX3 (FA = HC(NH2)2+, X = Br−/I−). FAPbI3 crystals exhibit a 1.4 eV bandgap – considerably narrower than their polycrystalline counterparts.

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

    OpenAIRE

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

    2015-01-01

    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 th...

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

    OpenAIRE

    Kayserili Karabey, Hülya; Schmidts, Miriam; Hou, Yuqing; Cortes, 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; Krakow, Deborah; King, Stephen M.; Beales, Philip L.; Al-Gazali, Lihadh; Wicking, Carol; Cormier-Daire, Valerie; Roepman, Ronald; Mitchison, Hannah M.; Witman, George B.

    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. W...

  12. Interventricular Septal Hematoma and Coronary-Ventricular Fistula: A Complication of Retrograde Chronic Total Occlusion Intervention

    Directory of Open Access Journals (Sweden)

    Abdul-rahman R. Abdel-karim

    2016-01-01

    Full Text Available Interventricular septal hematoma is a rare complication of retrograde chronic total occlusion (CTO percutaneous coronary interventions (PCI with a typically benign course. Here we report two cases of interventricular septal hematoma and coronary-cameral fistula development after right coronary artery (RCA CTO-PCI using a retrograde approach. Both were complicated by development of ST-segment elevation and chest pain. One case was managed actively and the other conservatively, both with a favorable outcome.

  13. Interventricular Septal Hematoma and Coronary-Ventricular Fistula: A Complication of Retrograde Chronic Total Occlusion Intervention

    Science.gov (United States)

    Abdel-karim, Abdul-rahman R.; Main, Michael L.

    2016-01-01

    Interventricular septal hematoma is a rare complication of retrograde chronic total occlusion (CTO) percutaneous coronary interventions (PCI) with a typically benign course. Here we report two cases of interventricular septal hematoma and coronary-cameral fistula development after right coronary artery (RCA) CTO-PCI using a retrograde approach. Both were complicated by development of ST-segment elevation and chest pain. One case was managed actively and the other conservatively, both with a favorable outcome. PMID:27668097

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

    Science.gov (United States)

    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

  15. Ureteroscopy-assisted retrograde nephrostomy for lower calyx calculi in horseshoe kidney: two case reports

    Directory of Open Access Journals (Sweden)

    Kawahara Takashi

    2012-07-01

    Full Text Available Abstract 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.

  16. Focal retrograde amnesia: voxel-based morphometry findings in a case without MRI lesions.

    Directory of Open Access Journals (Sweden)

    Bernhard Sehm

    Full Text Available Focal retrograde amnesia (FRA is a rare neurocognitive disorder presenting with an isolated loss of retrograde memory. In the absence of detectable brain lesions, a differentiation of FRA from psychogenic causes is difficult. Here we report a case study of persisting FRA after an epileptic seizure. A thorough neuropsychological assessment confirmed severe retrograde memory deficits while anterograde memory abilities were completely normal. Neurological and psychiatric examination were unremarkable and high-resolution MRI showed no neuroradiologically apparent lesion. However, voxel-based morphometry (VBM-comparing the MRI to an education-, age-and sex-matched control group (n = 20 disclosed distinct gray matter decreases in left temporopolar cortex and a region between right posterior parahippocampal and lingual cortex. Although the results of VBM-based comparisons between a single case and a healthy control group are generally susceptible to differences unrelated to the specific symptoms of the case, we believe that our data suggest a causal role of the cortical areas detected since the retrograde memory deficit is the preeminent neuropsychological difference between patient and controls. This was paralleled by grey matter differences in central nodes of the retrograde memory network. We therefore suggest that these subtle alterations represent structural correlates of the focal retrograde amnesia in our patient. Beyond the implications for the diagnosis and etiology of FRA, our results advocate the use of VBM in conditions that do not show abnormalities in clinical radiological assessment, but show distinct neuropsychological deficits.

  17. Continued evidence for safety of endoscopic retrograde cholangiopancreatography during pregnancy

    Institute of Scientific and Technical Information of China (English)

    Sean; Fine; Joshua; Beirne; Silvia; Delgi-Esposti; Fadlallah; Habr

    2014-01-01

    AIM: To report the safety of continued use of endoscopic retrograde cholangiopancreatography(ERCP) during pregnancy at various maternal ages.METHODS: A retrospective chart review of pregnant patients who underwent ERCP at a tertiary academic center was undertaken between 2002 and 2012. Pertinent past medical history and initial presenting laboratory data were collected. Review of the procedure note for each ERCP performed provided documentation of lead shielding, type of sedation, fluoroscopy time, and post-procedure complications. Patients’ clinical courses were reviewed until the time of delivery and pregnancy complications with fetal outcomes were examined. Data was stratified based upon the mother’s age at the time of ERCP: 18-21, 22-29, and ≥ 30 years of age.RESULTS: Twenty pregnant patients who underwent ERCP between 2002 and 2012 were identified. The mean age at the time of ERCP was 26.4 years(18-38 years) and the average trimester was the second. The indications for ERCP were choledocholithiasis in 17 patients, gallstone pancreatitis in 2 patients, and cholangitis in 1 patient. The mean fluoroscopy time of ERCP was 3.8 min(0.3-23.6 min). Sphincterotomy was performed in 18 patients with therapeutic intent and not as a prophylactic measure to prevent recurrences. Clinical documentation of use of protective shielding was found in only 8 notes(40%). Post procedure complications were limited to two cases of post-ERCP pancreatitis(10%). Elective cholecystectomy was performed shortly after ERCP in 11 of the pregnant patients. Birth records were available for 16 patients, of which 15 had fullterm pregnancies. Cesarean sections were performed in 5(31%) patients. Term birth weight was greater than 2500 g in all cases except one in which the mother had a known hypercoagulable state. CONCLUSION: ERCP during pregnancy is both safe and efficacious regardless of maternal age or trimester.

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

    Directory of Open Access Journals (Sweden)

    Ekrem Ozyuvali

    2015-03-01

    Full Text Available Objectives: To investigate the situations in which ureteral double-J stent should be used after retrograde intrarenal surgery (RIRS. Patients and Methods: 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. Results: 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. Conclusions: Routine double-J stent insertion after RIRS is not essential since it increases costs, morbidity and operation time.

  19. Combination treatment of transjugular retrograde obliteration and endoscopic embolization for portosystemic encephalopathy with esophageal varices.

    Science.gov (United States)

    Chikamori, Fumio; Kuniyoshi, Nobutoshi; Shibuya, Susumu; Takase, Yasuhiro

    2004-01-01

    The treatment of chronic portosystemic encephalopathy with esophageal varices has not yet been established. We were able to control a case of chronic portosystemic encephalopathy with esophageal varices using a combination treatment of transjugular retrograde obliteration and endoscopic embolization. A 57-year-old man came to our hospital in a confused, apathetic and tremulous state. The grade of encephalopathy was II. The plasma ammonia level was abnormally elevated to 119 microg/dL, and the ICGR15 was 59%. Endoscopic examination revealed nodular esophageal varices with cherry-red spots. There were no gastric varices. Ultrasonography and CT revealed liver cirrhosis with a splenorenal shunt. We first applied endoscopic embolization for the esophageal varices before transjugular retrograde obliteration. We injected 5% ethanolamine oleate with iopamidol retrogradely into the esophageal varices and their associated blood routes under fluoroscopy and obliterated the palisade vein, the cardiac venous plexus and left gastric vein. Transjugular retrograde obliteration was performed 14 days after endoscopic embolization. Retrograde shunt venography visualized the splenorenal shunt and communicating route to the retroperitoneal vein. There was no communicating route to the azygos vein. After obliteration of the communicating route to the retroperitoneal vein with absolute ethanol, 5% ethanolamine oleate with iopamidol was injected into the splenorenal shunt as far as the root of the posterior gastric vein. After transjugular retrograde obliteration, the encephalopathy improved to grade 0 even without the administration of lactulose and branched-chain amino acid. The plasma ammonia level and ICGR15 were reduced to 62 microg/dL and 26%. We conclude that combination treatment of transjugular retrograde obliteration and endoscopic embolization is a rational, effective and safe treatment for chronic portosystemic encephalopathy complicated with esophageal varices. PMID:15362757

  20. On remembering and forgetting our autobiographical pasts: retrograde amnesia and Andrew Mayes's contribution to neuropsychological method.

    Science.gov (United States)

    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.

  1. On remembering and forgetting our autobiographical pasts: retrograde amnesia and Andrew Mayes's contribution to neuropsychological method.

    Science.gov (United States)

    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. PMID:22884958

  2. The retrogradation properties of glutinous rice and buckwheat starches as observed with FT-IR, 13C NMR and DSC.

    Science.gov (United States)

    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.

  3. Retrograde binaries of massive black holes in circumbinary accretion discs

    Science.gov (United States)

    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.

  4. Endoscopic retrograde cholangiopancreatography forsuspected choledocholithiasis: From guidelines to clinicalpractice

    Institute of Scientific and Technical Information of China (English)

    Joana Magalh?es; Bruno Rosa; José Cotter

    2015-01-01

    AIM: To study the practical applicability of the AmericanSociety for Gastrointestinal Endoscopy guidelinesin suspected cases of choledocholithiasis.METHODS: This was a retrospective single centerstudy, covering a 4-year period, from January 2010to December 2013. All patients who underwentendoscopic retrograde cholangiopancreatography(ERCP) for suspected choledocholithiasis were included.Based on the presence or absence of predictors ofcholedocholithiasis (clinical ascending cholangitis,common bile duct (CBD) stones on ultrasonography(US), total bilirubin 〉 4 mg/dL, dilated CBD on US,total bilirubin 1.8-4 mg/dL, abnormal liver functiontest, age 〉 55 years and gallstone pancreatitis),patients were stratified in low, intermediate or highrisk for choledocholithiasis. For each predictor andrisk group we used the χ 2 to evaluate the statisticalassociations with the presence of choledocolithiasisat ERCP. Statistical analysis was performed usingSPSS version 21.0. A P value of less than 0.05 wasconsidered statistically significant.RESULTS: A total of 268 ERCPs were performed forsuspected choledocholithiasis. Except for gallstonepancreatitis (P = 0.063), all other predictors of cho-ledocholitiasis (clinical ascending cholangitis, P = 0.001;CBD stones on US, P ≤ 0.001; total bilirubin 〉 4 mg/dL, P = 0.035; total bilirubin 1.8-4 mg/dL, P = 0.001;dilated CBD on US, P ≤ 0.001; abnormal liver functiontest, P = 0.012; age 〉 55 years, P = 0.002) showed astatistically significant association with the presence ofcholedocholithiasis at ERCP. Approximately four fifthsof patients in the high risk group (79.8%, 154/193patients) had confirmed choledocholithiasis on ERCP,vs 34.2% (25/73 patients) and 0 (0/2 patients) in theintermediate and low risk groups, respectively. Thedefinition of "high risk group" had a sensitivity of 86%,positive predictive value 79.8% and specificity 56.2%for the presence of choledocholithiasis at ERCP

  5. Mitochondrial retrograde regulation tuning fork in nuclear genes expressions of higher plants

    Institute of Scientific and Technical Information of China (English)

    Jinghua Yang; Mingfang Zhang; Jingquan Yu

    2008-01-01

    In plant cells, there are three organelles: the nucleus, chloroplast, and mitochondria that store genetic information. The nucleus possesses the majority of genetic information and controls most aspects of organelles gene expression, growth, and development. In return,organdies also send signals back to regulate nuclear gene expression, a process defined as retrograde regulation. The best studies of organelles to nucleus retrograde regulation exist in plant chloroplast-to-nuclear regulation and yeast mitochondria-to-nuclear regulation. In this review, we summarize the recent understanding of mitochondrial retrograde regulation in higher plant, which involves multiple potential signaling pathway in relation to cytoplasmic male-sterility, biotic stress, and abiotie stress. With respect to mitochondrial retrograde regulation signal pathways involved in cytoplasmic male-sterility, we consider that nuclear transcriptional factor genes are the targeted genes regulated by mitoehondria to determine the abnormal reproductive development, and the MAPK signaling pathway may be involved in this regulation in Brassica juncea. When plants suffer biotic and abiotie stress, plant cells will initiate cell death or other events directed toward recovering from stress. During this process, we propose that mitochondria may determine how plant cell responds to a given stress through retrograde regulation. Meanwhile, several transducer molecules have also been discussed here. In particular, thePaepe research group reported that leaf mitochondrial modulated whole cell redox homeostasis, set antioxidant capacity, and determinedstress resistance through altered signaling and diurnal regulation, which is an indication of plant mitochondria with more active function than ever.

  6. Recruitment of actin modifiers to TrkA endosomes governs retrograde NGF signaling and survival

    Science.gov (United States)

    Harrington, Anthony W.; Hillaire, Coryse St.; Zweifel, Larry S.; Glebova, Natalia O.; Philippidou, Polyxeni; Halegoua, Simon; Ginty, David D.

    2012-01-01

    Summary NGF and NT3 collaborate to support development of sympathetic neurons. Although both neurotrophins activate TrkA-dependent axonal extension, NGF is unique in its ability to promote retrograde transport of TrkA endosomes and retrograde survival. Here, we report that actin depolymerization is essential for initiation of NGF/TrkA endosome trafficking and that a Rac1–cofilin signaling module associated with TrkA early endosomes supports their maturation to retrograde transport-competent endosomes. Moreover, the actin-regulatory endosomal components are absent from NT3-formed TrkA endosomes, explaining the failure of NT3 to support retrograde TrkA transport and survival. The inability of NT3 to activate Rac1-GTP–cofilin signaling is likely due to the labile nature of NT3/TrkA complexes within the acidic environment of TrkA early endosomes. Thus, TrkA endosomes associate with actin-modulatory proteins to promote F-actin disassembly enabling their maturation into transport-competent signaling endosomes. Differential control of this process explains how NGF in final targets, but not NT3 from intermediate targets, supports retrograde survival of sympathetic neurons. PMID:21816277

  7. The effect of partial gelatinization of corn starch on its retrogradation.

    Science.gov (United States)

    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). PMID:23911478

  8. Retrogradation of Maize Starch after High Hydrostatic Pressure Gelation: Effect of Amylose Content and Depressurization Rate

    KAUST Repository

    Yang, Zhi

    2016-05-24

    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.

  9. Exercise intensity modulates brachial artery retrograde blood flow and shear rate during leg cycling in hypoxia.

    Science.gov (United States)

    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. PMID:26038470

  10. Kinematical evolution of tidally limited star clusters: the role of retrograde stellar orbits

    Science.gov (United States)

    Tiongco, Maria A.; Vesperini, Enrico; Varri, Anna Lisa

    2016-09-01

    The presence of an external tidal field often induces significant dynamical evolutionary effects on the internal kinematics of star clusters. Previous studies investigating the restricted three-body problem with applications to star cluster dynamics have shown that unbound stars on retrograde orbits (with respect to the direction of the cluster's orbit) are more stable against escape than prograde orbits, and predicted that a star cluster might acquire retrograde rotation through preferential escape of stars on prograde orbits. In this study, we present evidence of this prediction, but we also illustrate that there are additional effects that cannot be accounted for by the preferential escape of prograde orbits alone. Specifically, in the early evolution, initially underfilling models increase their fraction of retrograde stars without losing significant mass, and acquire a retrograde angular velocity. We attribute this effect to the development of preferentially eccentric/radial orbits in the outer regions of star clusters as they are expanding into their tidal limitation. We explore the implications of the evolution of the fraction of prograde and retrograde stars for the evolution of the cluster internal rotation, and its dependence on the initial structural properties. Although all the systems studied here evolve towards an approximately solid-body internal rotation with angular velocity equal to about half of the angular velocity of the cluster orbital motion around the host galaxy, the evolutionary history of the radial profile of the cluster internal angular velocity depends on the cluster initial structure.

  11. Retrograde versus Antegrade Approach for the Management of Large Proximal Ureteral Stones

    Science.gov (United States)

    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

  12. GBT Reveals Satellite of Milky Way in Retrograde Orbit

    Science.gov (United States)

    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

  13. Fundamental studies of retrograde reactions in direct liquefaction. Final report, September 20, 1988--November 20, 1990

    Energy Technology Data Exchange (ETDEWEB)

    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.

  14. Retrograde diurnal motion of the instantaneous rotation axis observed by a large ring laser gyroscope

    Science.gov (United States)

    Tian, W.

    2016-07-01

    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, 2004). Since then many technical improvements led to a 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.

  15. Retrograde vascularisation of fibula free flap in composite oro-mandibular reconstruction

    Directory of Open Access Journals (Sweden)

    G I Nambi

    2013-01-01

    Full Text Available We present a case of composite oromandibular reconstruction with fibula free flap in which the vascularity to the flap was established in a retrograde direction through the distal end of the peroneal pedicle vessels. The flap was initially designed in such a way so as to anastomose with superior thyroid artery. However after initial good flow, the superior thyroid artery flow became insufficient. Therefore, an attempt was made to vascularise the flap by anastomosing the distal end of peroneal vessels with the facial artery and a tributary of the internal jugular vein so that the flap was perfused in a retrograde direction. This was successful and the retrograde flow was adequate to ensure flap survival. We believe this to be the first successful case of reverse vascular flow reported for composite oromandibular reconstruction with the fibula free flap.

  16. The sealing ability of novel Kryptonite adhesive bone cement as a retrograde filling material

    Science.gov (United States)

    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 (P0.05). 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

  17. Transesophageal echocardiographic evaluation of an intraoperative retrograde acute aortic dissection: case report

    Directory of Open Access Journals (Sweden)

    Reiter Charles G

    2006-04-01

    Full Text Available Abstract Background We report an intraoperative retrograde dissection of the aorta and its subsequent evaluation by transesophageal echocardiography (TEE. Case presentation A 78 year old woman with an ascending aortic aneurysm without dissection and coronary artery disease was brought to the operating room for aneurysm repair and coronary artery bypass grafting. After initiation of cardiopulmonary bypass through a femoral artery cannula, aortic dissection was noted and subsequently imaged by TEE. Conclusion Retrograde aortic dissection through the femoral artery is life-threatening. Intraoperative TEE can be used to diagnose this uncommon event, and should be considered after initiation of bypass.

  18. A novel fluorescent retrograde neural tracer: cholera toxin B conjugated carbon dots

    Science.gov (United States)

    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

  19. Endoscopic retrograde cholangiopancreatography (ERCP)-related adverse events: post-ERCP pancreatitis.

    Science.gov (United States)

    Rustagi, Tarun; Jamidar, Priya A

    2015-01-01

    Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP), and not uncommonly is the reason behind ERCP-related lawsuits. Patients at high risk for PEP include young women with abdominal pain, normal liver tests, and unremarkable imaging. Procedure-related factors include traumatic and persistent cannulation attempts, multiple injections of the pancreatic duct, pancreatic sphincterotomy, and, possibly, use of precut sphincterotomy. Aggressive hydration, use of rectal indomethacin, and prophylactic pancreatic stenting can diminish the risk (and likely severity) of PEP. Though hugely beneficial, these measures do not supersede careful patient selection and technique.

  20. Paradoxical air embolus during endoscopic retrograde cholangiopancreatography: an uncommon fatal complication.

    Science.gov (United States)

    Markin, Nicholas W; Montzingo, Candice R

    2015-04-01

    Air embolism during endoscopic retrograde cholangiopancreatography is a rare but potentially fatal complication. A 66-year-old man underwent endoscopic retrograde cholangiopancreatography and remained stable until the end of the procedure, when he was found to have mottling on his right side and became hypoxic and unresponsive. Transesophageal echocardiography showed air within the left ventricle, consistent with systemic air embolism. Mortality resulted from significant cardiac and cerebral ischemia. The literature suggests that capnography is helpful in early diagnosis of air embolus, but it could not be used in this case because the patient's trachea was not intubated. PMID:25827860

  1. Hypotonic duodenography and endoscopic retrograde pancreatography in the diagnosis of pancreatic disease

    International Nuclear Information System (INIS)

    Hypotonic duodenography and endoscopic retrograde pancreatography were performed in 45 non-icteric patients with suggested pancreatic disease or long-standing upper gastrointestinal symptoms. The accuracy of each method in the diagnosis of pancreatic disease was compared. Hypotonic duodenography revealed pancreatitis in 48 per cent and ERP in 83 per cent of the cases. All 6 pancreatic tumours were detected at ERP and 3 at duodenography. The role of hypotonic duodenography and endoscopic retrograde pancreatography in the diagnosis of pancreatic disease is discussed. (Auth.)

  2. The use of technetium-99m hexamethylpropylene amine oxime labelled granulocytes with single-photon emission tomography imaging in the detection and follow-up of recurrence of infective endocarditis complicating transvenous endocardial pacemaker

    Energy Technology Data Exchange (ETDEWEB)

    Ramackers, J.M. [Department of Nuclear Medicine, CHU E. Herriot, Lyon (France); Kotzki, P.O. [Department of Nuclear Medicine, CHU Lapeyronie et A. de Villeneuve, Montpellier (France); Couret, I. [Department of Nuclear Medicine, CHU Lapeyronie et A. de Villeneuve, Montpellier (France); Messner-Pellenc, P. [Department of Cardiology, CHU Lapeyronie et A. Villeneuve, Montpellier (France); Davy, J.M. [Department of Cardiology, CHU Lapeyronie et A. Villeneuve, Montpellier (France); Rossi, M. [Department of Nuclear Medicine, CHU Lapeyronie et A. de Villeneuve, Montpellier (France)

    1995-11-01

    In this case report we present a patient with a recurrence of subacute bacterial infectious endocarditis (IE) complicating a transvenous endocardial pacemaker. Technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) labelled granulocytes were used for diagnosis and follow-up under medical treatment only, since surgical removal of the pacemaker lead was ruled out because of the general condition of the patient. Single-photon emission tomography (SPET) imaging displayed the active lesion previously suspected on echography. At the end of antibiotic therapy, SPET indicated a favourable disease outcome whereas echocardiographic abnormalities remained nearly unchanged. The medical treatment had eradicated the IE, and the patient did well for more than 1 year thereafter. (orig.)

  3. A study of retrograde degeneration of median nerve forearm segment in carpal tunnel syndrome of variable severities

    Directory of Open Access Journals (Sweden)

    Mona Mokhtar El Bardawil

    2014-12-01

    Conclusions: Retrograde degeneration exists in patients with CTS. Forearm median motor NCV and median mixed conduction study are valid electrophysiologic tools for the assessment of RGD in patients with CTS. Retrograde degeneration is not related to grade of severity of CTS.

  4. Treatment of Functional Retrograde Ejaculation with Acupuncture and TCM Herbal Drugs

    Institute of Scientific and Technical Information of China (English)

    肖远辉

    2002-01-01

    @@ Acupuncture at the Taichong (LR 3), Sanyinjiao (SP 6) and Ciliao (BL 32) points combined with TCM drugs for soothing the liver, replenishing the kidney, freeing the seminal passage, and eliminating the stasis showed effective for functional retrograde ejaculation in 25 cases. The total effective rate of 68.0% was significantly better than imipramine used in the control group (P<0.05).

  5. Persistence and variability of ice-stream grounding lines on retrograde bed slopes

    Science.gov (United States)

    Robel, Alexander A.; Schoof, Christian; Tziperman, Eli

    2016-08-01

    In many ice streams, basal resistance varies in space and time due to the dynamically evolving properties of subglacial till. These variations can cause internally generated oscillations in ice-stream flow. However, the potential for such variations in basal properties is not considered by conventional theories of grounding-line stability on retrograde bed slopes, which assume that bed properties are static in time. Using a flow-line model, we show how internally generated, transient variations in ice-stream state interact with retrograde bed slopes. In contrast to predictions from the theory of the marine ice-sheet instability, our simulated grounding line is able to persist and reverse direction of migration on a retrograde bed when undergoing oscillations in the grounding-line position. In turn, the presence of a retrograde bed may also suppress or reduce the amplitude of internal oscillations in ice-stream state. We explore the physical mechanisms responsible for these behaviors and discuss the implications for observed grounding-line migration in West Antarctica.

  6. A Hands-on Exploration of the Retrograde Motion of Mars as Seen from the Earth

    Science.gov (United States)

    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…

  7. Atrial activation during atrioventricular nodal reentrant tachycardia: Studies on retrograde fast pathway conduction

    NARCIS (Netherlands)

    D.G. Katritsis; K.A. Ellenbogen; A.E. Becker

    2006-01-01

    BACKGROUND Detailed right and left septal mapping of retrograde atrial activation during typical atrioventricutar nodal reentrant tachycardia (AVNRT) has not been undertaken and may provide insight into the complex physiology of AVNRT, especially the anatomic localization of the fast and stow pathwa

  8. Reexposure to the Amnestic Agent Alleviates Cycloheximide-Induced Retrograde Amnesia for Reactivated and Extinction Memories

    Science.gov (United States)

    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…

  9. Retrogradation behavior of corn starch treated with 1,4-α-glucan branching enzyme.

    Science.gov (United States)

    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. PMID:26948619

  10. The role of the dynein light intermediate chain in retrograde IFT and flagellar function in Chlamydomonas.

    Science.gov (United States)

    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. PMID:27251063

  11. Retrograde ejaculation associated spontaneous sperm cystolithiasis in four Rhesus Macaques (Macaca mulatta)

    OpenAIRE

    Gumber, Sanjeev; Courtney, Cynthia L; Strait, Karen R; Sharma, Prachi; Freebersyser, Julie E; Crane, Maria M

    2013-01-01

    Retrograde ejaculation (RE) has been reported in humans and animals but RE with subsequent sperm calculi has rarely been reported. This report documents clinical and pathological findings of spontaneous sperm cystolithiasis in four rhesus macaques. While this condition has been associated with repeated electroejaculation, spontaneous sperm cystolithiasis is highly unusual. The animals presented with either stranguria, dysuria, hematuria, distended abdomen or lethargy. Ultras...

  12. Differential proteomics reveals multiple components in retrogradely transported axoplasm after nerve injury.

    Science.gov (United States)

    Perlson, Eran; Medzihradszky, Katalin F; Darula, Zsuzsanna; Munno, David W; Syed, Naweed I; Burlingame, Alma L; Fainzilber, Mike

    2004-05-01

    Information on axonal damage is conveyed to neuronal cell bodies by a number of signaling modalities, including the post-translational modification of axoplasmic proteins. Retrograde transport of a subset of such proteins is thought to induce or enhance a regenerative response in the cell body. Here we report the use of a differential 2D-PAGE approach to identify injury-correlated retrogradely transported proteins in nerves of the mollusk Lymnaea. A comprehensive series of gels at different pI ranges allowed resolution of approximately 4000 spots by silver staining, and 172 of these were found to differ between lesioned versus control nerves. Mass spectrometric sequencing of 134 differential spots allowed their assignment to over 40 different proteins, some belonging to a vesicular ensemble blocked by the lesion and others comprising an up-regulated ensemble highly enriched in calpain cleavage products of an intermediate filament termed RGP51 (retrograde protein of 51 kDa). Inhibition of RGP51 expression by RNA interference inhibits regenerative outgrowth of adult Lymnaea neurons in culture. These results implicate regulated proteolysis in the formation of retrograde injury signaling complexes after nerve lesion and suggest that this signaling modality utilizes a wide range of protein components.

  13. Comparative evaluations of endoscopic retrograde cholangiopancreaticography, angiography and scintiscanning in the diagnosis of pancreatic diseases

    International Nuclear Information System (INIS)

    Endoscopic retrograde cholangiopancreaticography (ERCP) proved to be the appropriate diagnostic method in chronic pancreatitis which can be diagnosed angiographically in advanced stages only. In suspecting pancreatic carcinoma both ERCP and angiography should be performed. Scintiscanning takes the lowest place value in the diagnosis of pancreatic diseases

  14. The Review of Retrograde Amnesia%逆行性遗忘研究综述

    Institute of Scientific and Technical Information of China (English)

    黄晓雪

    2015-01-01

    Retrograde amnesia has great important influence on internal memory of the human, especially in cognitive neuro-science. Through literature analysis, the temporal graded retrograde amnesia is the most extensive type. The characteristics of retro-grade amnesia is different and graded, and it is also featured with the full implicit memory. It mainly stems from the brain injury such as medial temporal lobe, diencephalon, and frontal lobe. In addition, drinking, lacking of vitamin B1 and trauma can also cause the symptoms. Now the main methods of memory rehabilitation are operation therapy, implicit memory rehabilitation and error-less learning. In the future, the memory rehabilitation about retrograde amnesia will more effectively promote the progress of the treatment.%遗忘症主要分为逆行性遗忘和顺行性遗忘。逆行性遗忘指病人失去提取脑损伤前事件记忆的能力,即能学习新东西和编码新事件,但是不能回忆发生在脑损伤前的经历和事件。它具有逆行期的梯度性、差异性,语义记忆、内隐记忆正常等特点;受伤脑区多与颞叶内侧、额叶、间脑损伤相关联。

  15. Persistent cell migration and adhesion rely on retrograde transport of β(1) integrin.

    Science.gov (United States)

    Shafaq-Zadah, Massiullah; Gomes-Santos, Carina S; Bardin, Sabine; Maiuri, Paolo; Maurin, Mathieu; Iranzo, Julian; Gautreau, Alexis; Lamaze, Christophe; Caswell, Patrick; Goud, Bruno; Johannes, Ludger

    2016-01-01

    Integrins have key functions in cell adhesion and migration. How integrins are dynamically relocalized to the leading edge in highly polarized migratory cells has remained unexplored. Here, we demonstrate that β1 integrin (known as PAT-3 in Caenorhabditis elegans), but not β3, is transported from the plasma membrane to the trans-Golgi network, to be resecreted in a polarized manner. This retrograde trafficking is restricted to the non-ligand-bound conformation of β1 integrin. Retrograde trafficking inhibition abrogates several β1-integrin-specific functions such as cell adhesion in early embryonic development of mice, and persistent cell migration in the developing posterior gonad arm of C. elegans. Our results establish a paradigm according to which retrograde trafficking, and not endosomal recycling, is the key driver for β1 integrin function in highly polarized cells. These data more generally suggest that the retrograde route is used to relocalize plasma membrane machinery from previous sites of function to the leading edge of migratory cells.

  16. Is the 'Trondsen Discriminant Function' useful in patients referred for endoscopic retrograde cholangiopancreatography?

    DEFF Research Database (Denmark)

    Ainsworth, A P; Pless, T; Mortensen, M B;

    2003-01-01

    BACKGROUND: Ideally, patients should only be referred to endoscopic retrograde cholangiopancreatography (ERCP) if therapy is indicated. The aim of this study was to evaluate whether or not the 'Trondsen Discriminant Function' (DF) could be used for selecting patients directly for ERCP. METHODS: T...

  17. The therapeutic effect of crocin on ketamine-induced retrograde amnesia in rats

    Directory of Open Access Journals (Sweden)

    Namdar Yousefvand

    2016-09-01

    Full Text Available Introduction: The glutamatergic system plays an important role in learning and memory. Administration of crocus sativus (Saffron or its constituent, crocin, facilitates the formation of memory. This research investigated the effect of crocin on antagonizing retrograde amnesia induced by ketamine, a glutamatergic receptor antagonist, in rats by shuttle box. Methods: Male Wistar rats were tested to measure their learning behavior in the passive avoidance task. All animals were trained by a 1 mA shock. The drugs were injected immediately after the training was successfully performed. The animals were tested 24h after training to measure Step Through Latency (STL. Results: On the test day, administration of ketamine (12 mg/kg, ip impaired the memory after training. Different doses of crocin (2, 5 or 10 mg/kg, ip were injected 30 min after ketamine, but only 2 mg/kg crocin could improve retrograde amnesia and 5 and 10 mg/kg doses did not have any significant effect on retrograde amnesia. Moreover, administration of crocin (2, 5 or 10 mg/kg, ip after training had no significant impact on passive avoidance memory by itself. Conclusion: Considering the therapeutic effect of post-training administration of crocin on ketamine-induced retrograde amnesia, it can be argued that crocin has an interaction with glutamatergic system in formation of passive avoidance memory in rats.

  18. Neuroanatomy of cardiac activity-regulating circuitry : A transneuronal retrograde viral labelling study in the rat

    NARCIS (Netherlands)

    TerHorst, GJ; Hautvast, RWM; DeJongste, MJL; Korf, J

    1996-01-01

    The anatomy of cardiac activity-regulating circuitry was studied with retrograde transneuronal viral labelling after pseudorabies virus injections into different parts of the rat heart. Transection of the spinal cord at Th1 was used to reveal selectively the parasympathetic neuronal networks. Virus-

  19. Non-Cell-Autonomous Regulation of Retrograde Motoneuronal Axonal Transport in an SBMA Mouse Model

    Science.gov (United States)

    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

  20. Contraction of the ventral abdomen potentiates extracardiac retrograde hemolymph propulsion in the mosquito hemocoel.

    Directory of Open Access Journals (Sweden)

    Jonathan W Andereck

    Full Text Available 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

  1. Retrograde approach for the recanalization of coronary chronic total occlusion: collateral selection and collateral related complication

    Institute of Scientific and Technical Information of China (English)

    MA Jian-ying; QIAN Ju-ying; GE Lei; FAN Bing; WANG Qi-bing; YAN Yan; ZHANG Feng

    2013-01-01

    Background The retrograde approach through collaterals has been applied in the treatment of chronic total occlusion (CTO) lesions during percutaneous recanalization of coronary arteries.This study was to investigate the success rate of recanalization and collateral related complications in patients when using the retrograde approach.Methods Eighty-four cases subjected to retrograde approach identified from July 2005 to July 2012 were included in this study.Patient characteristics,procedural outcomes and in-hospital clinical events were evaluated.Results Mean age of the patient was (59.6±11.2) years old and 91.7% were men.The target CTO lesions were distributed among the left anterior descending artery in 45 cases (53.5%),left circumflex artery in one case (1.2%),right coronary artery in 34 cases (40.5%),and left main in four cases (4.8%).The overall success rate of recanalization was 79.8%.The septal collateral was three times more frequently used for retrograde access than the epicardial collateral,68/84 (81%) vs.16/84 (19%).Successful wire passage through the collateral channel was achieved in 58 (72.6%)patients.The success rate of recanalization was 93.1% (54/58) in patients with and 50% (13/26) in patients without successful retrograde wire passage of the collateral channel (P <0.01).Successful retrograde wire passage through the collaterals was achieved in 49 of 68 septal collaterals (72.1%) and in 9 of 16 epicardial collaterals (56.3%) (P=NS).There was no significant difference between the septal collateral group and the epicardial group in the success rate of recanalization after retrograde wire crossing the collaterals (91.8% vs.100%,P >0.05).CART or reverse CART technique was used in 15 patients,and 14 patients (93.3%) were recanalized successfully.Collateral related perforation occurred in three (18.8%) cases with the epicardial collateral as the first choice (compared with the septal collateral group (0),P <0

  2. Pre-treatment hemodynamic features involved with long-term survival of cirrhotic patients after embolization of gastric fundal varices

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Hitoshi, E-mail: maru-cib@umin.ac.j [Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670 (Japan); Okugawa, Hidehiro, E-mail: hideun@yahoo.co.j [Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670 (Japan); Kobayashi, Satoshi, E-mail: kobakobakopa@yahoo.co.j [Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670 (Japan); Yoshizumi, Hiroaki, E-mail: yossih04@yahoo.co.j [Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670 (Japan); Yokosuka, Osamu, E-mail: yokosukao@faculty.chiba-u.j [Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670 (Japan)

    2010-08-15

    Purpose: To clarify the pre-treatment hemodynamic features involved in the long-term survival of cirrhotic patients with gastric fundal varices (FV) after balloon-occluded retrograde transvenous obliteration (B-RTO). Materials and methods: Eighty-one cirrhotic patients with medium- or large-grade FV treated by B-RTO were enrolled in this retrospective study. Pre-treatment flow volume ratio between gastric vein and portal trunk (GP-R) was obtained by Doppler ultrasound. Results: The cumulative survival rate was 90% at 1 year, 74.8% at 3 years, 57.2% at 5 years, and 45.8% at 7 years without recurrence in a median period of 1148.5 days The survival was poorer in patients with HCC (47% at 3 years, 9.4% at 5 years, p < 0.0001) than without (89.2% at 3 years, 81.9% at 5 years, 67.5% at 7 years), in patients with Child B/C (57.7% at 3 years, 42.1% at 5 years, 28.1% at 7 years, p = 0.0016) than with Child A (91.8% at 3 years, 71.5% at 5 years, 62.1% at 7 years), and in patients with GP-R {>=} 1.0 (58.9% at 3 years, p = 0.0485) than with GP-R < 1.0 (76.3% at 3 years, 62% at 5 years, 49.6% at 7 years). Multivariate analysis identified the presence of HCC (hazard ratio, 12.486; 95% CI, 4.08-38.216; p < 0.0001), Child B/C (hazard ratio, 3.41; 95% CI, 1.594-7.15; p = 0.0051) and GP-R {>=} 1.0 (hazard ratio, 2.701; 95% CI, 1.07-6.15; p = 0.0221) as independent factors for poor prognosis. Conclusion: GP-R {>=} 1.0 on Doppler ultrasound before B-RTO may be a predictive indicator for poor prognosis in cirrhotic patients with FV after B-RTO, in addition to the presence of HCC and severe liver damage.

  3. Retrograde tracing of fluorescent gold after autogenous nerve transplantation on spinal cord injured in rats

    DEFF Research Database (Denmark)

    Lin, X; Liu, W; Ding, Ming;

    2016-01-01

    Objective To investigate the changes of the fluorescent gold retrograde tracing autogenous nerve transplantation on spinal cord injured in rats. Methods The animals were divided into two groups, with modified Allen impact method to establish model of spinal cord injury. After 4 weeks......, the transplantation group using autologous sural nerve graft to repair spinal cord injury period and non-transplantation group was only exposed incision without treatment. In the 4, 6 and 8 weeks after operation, the retrograde tracing of FG Fluoro-Gold was performed to discover the recovery of the axial plasma.......01). Conclusion After spinal cord injury, autologous nerve graft was repaired and survived well and promote the recovery of spinal cord injury segment shaft pulp transportation function....

  4. Relative importance of moisture migration and amylopectin retrogradation for pound cake crumb firming.

    Science.gov (United States)

    Luyts, A; Wilderjans, E; Van Haesendonck, I; Brijs, K; Courtin, C M; Delcour, J A

    2013-12-15

    Moisture migration largely impacts cake crumb firmness during storage at ambient temperature. To study the importance of phenomena other than crumb to crust moisture migration and to exclude moisture and temperature gradients during baking, crustless cakes were baked using an electrical resistance oven (ERO). Cake crumb firming was evaluated by texture analysis. First, ERO cakes with properties similar to those baked conventionally were produced. Cake batter moisture content (MC) was adjusted to ensure complete starch gelatinisation in the baking process. In cakes baked conventionally, most of the increase in crumb firmness during storage was caused by moisture migration. Proton nuclear magnetic resonance ((1)H NMR) showed that the population containing protons of crystalline starch grew during cake storage. These and differential scanning calorimetry (DSC) data pointed to only limited amylopectin retrogradation. The limited increase in amylopectin retrogradation during cake storage cannot solely account for the significant firming of ERO cakes and, hence, other phenomena are involved in cake firming.

  5. Laparotomy enables retrograde dilatation and stent placement for malignant esophago-respiratory fistula

    Directory of Open Access Journals (Sweden)

    Iskender Özcan

    2008-01-01

    Full Text Available Abstract Background Malignant esophageal stenosis with complete obstruction and esophagorespiratory fistula (ERF is difficult to treat with standard endoscopic techniques. Case presentation We report a patient in whom with local recurrence of esophageal carcinoma an esophagotracheal fistula occurred. Initially the patient had undergone esophageal resection with interposition of a gastric tube. Due to complete obstruction of the lumen by recurrent tumor conventional transoral stent placement failed. For retrograde dilatation a laparotomy was performed. Via a duodenal incision endoscopic access to the gastric tube was achieved. Using a guidewire the esophageal obstruction was traversed and dilated. Then it was possible to place an esophageal stent via an antegrade approach. Conclusion Open surgery enables a safe access for retrograde endoscopic therapy in patients who had undergone esophageal resection with gastric interposition.

  6. Effect of retrogradation time on preparation and characterization of proso millet starch nanoparticles.

    Science.gov (United States)

    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%).

  7. Relative importance of moisture migration and amylopectin retrogradation for pound cake crumb firming.

    Science.gov (United States)

    Luyts, A; Wilderjans, E; Van Haesendonck, I; Brijs, K; Courtin, C M; Delcour, J A

    2013-12-15

    Moisture migration largely impacts cake crumb firmness during storage at ambient temperature. To study the importance of phenomena other than crumb to crust moisture migration and to exclude moisture and temperature gradients during baking, crustless cakes were baked using an electrical resistance oven (ERO). Cake crumb firming was evaluated by texture analysis. First, ERO cakes with properties similar to those baked conventionally were produced. Cake batter moisture content (MC) was adjusted to ensure complete starch gelatinisation in the baking process. In cakes baked conventionally, most of the increase in crumb firmness during storage was caused by moisture migration. Proton nuclear magnetic resonance ((1)H NMR) showed that the population containing protons of crystalline starch grew during cake storage. These and differential scanning calorimetry (DSC) data pointed to only limited amylopectin retrogradation. The limited increase in amylopectin retrogradation during cake storage cannot solely account for the significant firming of ERO cakes and, hence, other phenomena are involved in cake firming. PMID:23993572

  8. Percutaneous reconstruction of the innominate bifurcation using the retrograde 'kissing stents' technique

    Energy Technology Data Exchange (ETDEWEB)

    Nagata, Shun-ichi; Kazekawa, Kiyoshi; Matsubara, Shuko [Fukuoka University Chikushi Hospital, Department of Neurosurgery, Chikushino, Fukuoka (Japan); Sugata, Sei [Bironoki Neurosurgical Hospital, Shibushi, Kagoshima (Japan)

    2006-08-15

    Obstructions of the supraaortic vessels are an important cause of morbidity associated with a variety of symptoms. Percutaneous transluminal angioplasty has evolved as an effective and safe treatment modality for occlusive lesions of the supraaortic vessels. However, the endovascular management of an innominate bifurcation has not previously been reported. A 53-year-old female with a history of systematic hypertension, diabetes mellitus and hypercholesterolemia presented with left hemiparesis and dysarthria. Angiography of the innominate artery showed a stenosis of the innominate bifurcation. The lesion was successfully treated using the retrograde kissing stent technique via a brachial approach and an exposed direct carotid approach. The retrograde kissing stent technique for the treatment of a stenosis of the innominate bifurcation was found to be a safe and effective alternative to conventional surgery. (orig.)

  9. Treatment of femur supracondylar fracture with retrograde interlocking intramedullary nails in elderly patients

    Institute of Scientific and Technical Information of China (English)

    Yiheng Liu; Haiying Zhang; Hongmin Zang; Junchang Cheng

    2006-01-01

    Objective: To report 32 cases of femur supracondylar fracture treated with retrograde interlocking inramedullary nails in elderly patients. Methods: According to the AO classification, all of 32 cases were classified as extra-articular type A. 32 cases were treated with interlocking intramedullary nail by closed insertion from intercondylar fossa of the knee. All cases accepted CPM exercise as early as possible after operation. Results: Following up 5 to 15 months, all fractures united within an average duration of 5.3 months (4-7 months). According to the Shelbourne scale, the excellent rate of the knee function was 86.3%. Conclusion: Retrograde interlocking intramedullary nail is useful alternative implant for the treatment of osteoporotic supracondylar fracture of femur, particularly of the type A fracture in the elderly population. Its merits include stable fixation,high rate of fracture union and few complications.

  10. [Retrograde root filling utilizing resin and a dentin bonding agent: indication and applications].

    Science.gov (United States)

    Rud, J; Rud, V; Munksgaard, E C

    1989-05-01

    With Gluma a methacrylate-based resin may be chemically bonded to dentin with considerable strength. Resin may therefore be used for retrograde root fillings. Whereas a retrograde amalgam filling demands a box-like preparation, retroplast (Gluma and resin) may be applied to a slightly concave root surface. It may therefore be employed in areas normally inaccessible with amalgam technique. Retroplast can thus be used on roots of all molars and to restore root perforations, root resorptions, cracks, grooves and defects of the root. In addition on lateral canals, on extremely thin roots and to cover perforating root canal posts, this technique can also be used. Dentin/root-cement transplantation may be performed for the purpose of reattachment. The article discusses the technique and its applications with examples showing that it may result in satisfactory healing. PMID:2696126

  11. 经内科外科两种途径拔除感染性永久起搏器电极导线的比较分析%Comparative Analysis Between Surgical and Trans-venous Lead Retraction in Patients With Infection Caused by Cardiac Implantable Electronic Devices

    Institute of Scientific and Technical Information of China (English)

    王德; 熊辉; 华伟; 陈柯萍; 刘志敏

    2015-01-01

      结果:开胸组和经静脉组两组患者性别、年龄未见明显差异。经静脉组以单纯囊袋感染为主(41/49例),开胸组以感染性心内膜炎或赘生物形成为主(7/10例),两组比较差异有统计学意义(P  结论:临床经静脉途径已能有效地拔除多数起搏器电极导线,首选内科途径。外科开胸手术拔除起搏器电极导线适用于下列患者:①赘生物过大,易导致肺栓塞者;②经静脉途径拔除起搏器电极导线困难者;③合并其它心脏疾病,需要同期行心脏外科手术;④由于感染性心内膜炎造成三尖瓣功能障碍。%Objective: To investigate the clinical indication of cardiac implantable electronic devices (CIED) lead retraction between surgical and trans-venous approaches in patients with CIED infection, and to explore the principles for surgical CIED retraction. Methods: A total of 59 consecutive patients with CIED infection treated in our hospital from 2002-01 to 2014-04 were retrospectively studied. The patients were divided into 2 groups: Surgical group, n=10 and Trans-venous group, n=49. The clinical characteristics and prognosis were analyzed and compared between 2 groups. Results: There were no real differences in gender and age between 2 groups. The patients in Trans-venous group mainly suffered from pocket infection (41/49), while in Surgical group mainly had infective endocarditis or lead vegetation (7/10), P Conclusion: CIED lead retraction can be electively performed by trans-venous approach, it may work as the ifrst choice in clinicl practice. The surgical lead retraction was suitable for the following patients:①with extra large vegetation which may cause pulmonary embolism,②with dififculty for trans-venous lead retraction,③combining with other cardiac diseases which need operation at meanwhile and④with tricuspid valve malfunction incurred by infective endocarditis.

  12. Cost-effectiveness of endoscopic ultrasonography, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in patients suspected of pancreaticobiliary disease

    DEFF Research Database (Denmark)

    Ainsworth, A P; Rafaelsen, S R; Wamberg, P A;

    2004-01-01

    BACKGROUND: It is not known whether initial endoscopic ultrasonography (EUS) or magnetic resonance cholangiopancreatography (MRCP) is more cost effective than endoscopic retrograde cholangiopancreatography (ERCP). METHODS: A cost-effectiveness analysis of EUS, MRCP and ERCP was performed on 163 p...

  13. Temporary Capture of Asteroids by a Planet: Dependence of Prograde/Retrograde Capture on Asteroids' Semimajor Axes

    CERN Document Server

    Higuchi, Arika

    2015-01-01

    We have investigated the dependence of the prograde/retrograde temporary capture of asteroids by a planet on their original heliocentric semimajor axes through analytical arguments and numerical orbital integrations in order to discuss the origins of irregular satellites of giant planets. We found that capture is mostly retrograde for the asteroids near the planetary orbit and is prograde for those from further orbits. An analytical investigation reveals the intrinsic dynamics of these dependences and gives boundary semimajor axes for the change in prograde/retrograde capture. The numerical calculations support the idea of deriving the analytical formulae and confirm their dependence. Our numerical results show that the capture probability is much higher for bodies from the inner region than for outer ones. These results imply that retrograde irregular satellites of Jupiter are most likely to be captured bodies from the nearby orbits of Jupiter that may have the same origin as Trojan asteroids, while prograde...

  14. Intrahepatic cholangiocarcinoma diagnosed via endoscopic retrograde cholangiopancreatography with a short double-balloon enteroscope

    OpenAIRE

    Ikeura, Tsukasa; Shimatani, Masaaki; Takaoka, Makoto; Matsushita, Mitsunobu; Miyoshi, Hideaki; Kurishima, Akiko; Sumimoto, Kimi; Miyamoto, Sachi; Okazaki, Kazuichi

    2013-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) using a double-balloon enteroscope (DBE) in patients with bowel reconstruction due to a previous abdominal surgery is now widely accepted. In particular, a short DBE, which has a 2.8-mm working channel and 152-cm working length, is useful for ERCP because of its good rotational and straightening ability and the availability of various conventional ERCP accessories through the working channel. Herein we report a case of intrahepatic cholang...

  15. Mozart, Mozart Rhythm and Retrograde Mozart Effects: Evidences from Behaviours and Neurobiology Bases

    OpenAIRE

    Yingshou Xing; Yang Xia; Keith Kendrick; Xiuxiu Liu; Maosen Wang; Dan Wu; Hua Yang; Wei Jing; Daqing Guo; Dezhong Yao

    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 ef...

  16. Retrograde osteochondral grafting for osteochondral lesion of the talus: a new technique eliminating malleolar osteotomy

    OpenAIRE

    Kilicoglu, Onder; Taser, Omer

    2004-01-01

    Osteochondral grafting is one of the most effective treatment options for osteochondral lesions of the talus. However, the necessity for a medial malleolar osteotomy is the major drawback of the technique. This report presents a case treated with retrograde osteochondral grafting that eliminated the need for a medial malleolar osteotomy. An osteochondral lesion of the medial talus was detected in a 49-year-old woman. Under arthroscopic guidance, the talus was entered from the sinus tarsi regi...

  17. Nafamostat for Prophylaxis against Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Compared with Gabexate

    OpenAIRE

    Chang, Jae Hyuck; Lee, In Seok; Kim, Hyung Keun; Cho, Yu Kyung; Park, Jae Myung; Kim, Sang Woo; Choi, Myung-Gyu; Chung, In-Sik

    2009-01-01

    Background/Aims The protease inhibitors, nafamostat and gabexate, have been used to prevent pancreatitis related to endoscopic retrograde cholangiopancreatography (ERCP). In vitro, nafamostat inhibits the pancreatic protease activities 10-100 times more potently than gabexate. We evaluated the efficacy of nafamostat for prophylaxis against post-ERCP pancreatitis in comparison with gabexate. Methods Five hundred patients (208 patients in the nafamostat-treated group and 292 in the gabexate-tre...

  18. Penile fracture and its treatment:Is retrograde urethrograghy necessary for management of penile fracture?

    Institute of Scientific and Technical Information of China (English)

    Hassan Ahmadnia; Mehdi Younesi Rostami; Ali Kamalati; Mohammad Mehdi Imani

    2014-01-01

    Objective: Penile fracture, being defined as rupture of the tunica albuginea of the corpus cavernosum, is uncommon. Here, we analyze findings on our patients during a 10-year period and evaluate the role of retrograde urethrography. Methods: From February 2002 to April 2012, 116 patients were admitted with penile fracture at Ghaem Medical Center. Patient history and physical examination were taken at their admittance to detect probable urethral injury. Before surgery, retrograde urethrography was performed in all patients. The size and site of the tunical rupture were recorded. Then the rupture of tunica albuginea was sutured with nonabsorbable (3-0 nylon) sutures and the ties were placed on the internal surface (continuous method). All patients were followed up for 12 months. Results: Patients' mean age was (32.78±10.61) years and ranged (16-62) years. The mechanism of trauma was sexual intercourse in 103 patients (89%) and masturbation in 13 patients (11%). The most common site of injury found after exploration was right (55%) and lateral (74%) of the corpus cavernosum. The size of the tunical rupture was from 0.5 to 3.0 cm (mean 1.88±0.72). Three of the patients had Marphan's syndrome. Urethral injury was detected by retrograde urethrography in 4 patients (3%) who had macroscopic hematuria and urethrorrhagia. During 12 months follow-up, no complication was seen. Conclusion: There is no need to perform retrograde urethrography unless the patients have gross hematuria or urethrorrhagia. The key to success in treatment of penile fracture is to achieve a rapid diagnosis based on history and a physical examination, avoid unnecessary imaging tests and perform immediate surgery to reconstruct the site of injury.

  19. Retrograde Colonic Stent Implantation Assisted by Percutaneous Colostomy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyoung Gun; Han, Hyun Young; Chun, Tong Jin [Eulji Medical Center, Seoul (Korea, Republic of)

    2009-10-15

    We present a patient with disseminated pancreatic cancer who presented with symptoms of acute obstruction of the sigmoid colon. It was not possible to pass the region of the obstruction with a guide wire under colonoscopy and fluoroscopy. Consequently retrograde implantation of stents was performed successfully with the assistance of a minimally-sized colostomy when compared with a previously described procedure in the literature.

  20. Biliary and pancreatic stenting: Devices and insertion techniques in therapeutic endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography

    OpenAIRE

    Mangiavillano, Benedetto; Pagano, Nico; Baron, Todd H; Arena, Monica; Iabichino, Giuseppe; Consolo, Pierluigi; Opocher, Enrico; Luigiano, Carmelo

    2016-01-01

    Stents are tubular devices made of plastic or metal. Endoscopic stenting is the most common treatment for obstruction of the common bile duct or of the main pancreatic duct, but also employed for the treatment of bilio-pancreatic leakages, for preventing post- endoscopic retrograde cholangiopancreatography pancreatitis and to drain the gallbladder and pancreatic fluid collections. Recent progresses in techniques of stent insertion and metal stent design are represented by new, fully-covered l...

  1. Functional relationship between mTERF4 and GUN1 in retrograde signaling.

    Science.gov (United States)

    Sun, Xuwu; Xu, Duorong; Liu, Zhixin; Kleine, Tatjana; Leister, Dario

    2016-06-01

    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

  2. Effect of exercise on retrograde transport in a mouse model of amyotrophic lateral sclerosis

    OpenAIRE

    Whitney, Darryl Campbell

    2007-01-01

    The potential for exercise to improve function and delay disease progression in a mouse model of amyotrophic lateral sclerosis (ALS) has been examined in some detail. Recent studies have shown that retrograde transport is diminished throughout disease progression in this mouse model. The finding that exercise plus viral delivery of IGF-1 significantly improves lifespan of the G93A transgenic mouse highlights the need to investigate the mechanisms by which exercise may alter factors associated...

  3. Urethro-venous intravasation during retrograde urethrography (report of 5 cases.

    Directory of Open Access Journals (Sweden)

    Gupta S

    1991-04-01

    Full Text Available Five instances of urethro-venous intravasation during retrograde urethrography are reported. Four cases were of urethral strictures and one case was of urethral hemangioma. All patients had post procedural bleeding while one patient got allergic reactions, another showed chills and rigors. Anatomy of the drainage veins is described. Factors responsible for this complication and its clinical implications are discussed. It is suggested that urethro-venous intravasation should be considered a diagnostic sign of urethral inflammation.

  4. Diaanostic and therapeutic role of endoscopic retrograde cholangiopancreatography in biliary rhabdomyosarcoma

    Institute of Scientific and Technical Information of China (English)

    Ryan W Himes; Isaac Raijman; Hilton J Finegold; Heidi V Russell; Douglas S Fishman

    2008-01-01

    Biliary rhabdomyosarcoma (BRHS) is an uncommon childhood malignancy which has been managed surgically.We present a case of a 3-year-old boy with BRHS,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 BRHS in some patients.

  5. Engineering Predictions in Industrial and Power Flows Using the Retrograde Condensation Curve. Part I-Methodology

    OpenAIRE

    Labinov, Mark S.

    2014-01-01

    Industrial and power systems rely on engineering predictions of the flow properties of working fluids. The paper proposes a way of the utilization of the vapor quality values along the new retrograde condensation curve in the generation of the void fraction design guidelines and reliable prediction of the saturated liquid specific volumes/densities. The new procedure eliminates the involvement of semi-empirical relationships like rectilinear diameter and other similar models.

  6. Retrograde intussusception seven years after a laparoscopic Roux-en-Y gastric bypass

    Directory of Open Access Journals (Sweden)

    Leon D Boudourakis

    2013-01-01

    Full Text Available Intussusception after Roux-en-Y gastric bypass is more common than previously believed. It usually occurs between one and three years post-operatively, though we present a case that presented with a retrograde intussusception necessitating bowel resection seven years after a laparoscpic Roux-en-Y gastric bypass. The diagnosis and etiological theories are discussed based on findings from the literature.

  7. Migration of massive black hole binaries in self--gravitating accretion discs: Retrograde versus prograde

    CERN Document Server

    Roedig, Constanze

    2013-01-01

    We study the interplay between mass transfer, accretion and gravitational torques onto a black hole binary migrating in a self-gravitating, retrograde circumbinary disc. A direct comparison with an identical prograde disc shows that: (i) because of the absence of resonances, the cavity size is a factor a(1+e) smaller for retrograde discs; (ii) nonetheless the shrinkage of a circular binary semi--major axis, a, is identical in both cases; (iii) a circular binary in a retrograde disc remains circular while eccentric binaries grow more eccentric. For non-circular binaries, we measure the orbital decay rates and the eccentricity growth rates to be exponential as long as the binary orbits in the plane of its disc. Additionally, for these co-planar systems, we find that interaction (~ non--zero torque) stems only from the cavity edge plus a(1+e) in the disc, i.e. for dynamical purposes, the disc can be treated as a annulus of small radial extent. We find that simple 'dust' models in which the binary- disc interacti...

  8. Mozart, Mozart Rhythm and Retrograde Mozart Effects: Evidences from Behaviours and Neurobiology Bases.

    Science.gov (United States)

    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

  9. A modified technique of retrograde intubation dacryocystorhinostomy for proximal canalicular obstruction

    Directory of Open Access Journals (Sweden)

    Nikolaos Trakos

    2009-11-01

    Full Text Available Nikolaos Trakos, Emmanouil Mavrikakis, Kostas G Boboridis, Marselos Ralidis, George Dimitriadis, Ioannis MavrikakisOculoplastic Service, Metropolitan Hospital, Athens, GreecePurpose: To describe a modification of the retrograde intubation dacryocystorhinostomy (DCR in patients with proximal canalicular obstruction.Materials and methods: Interventional case report of a 43-year-old female with a nine-month history of left epiphora following a road traffic accident involving the proximal lower canaliculus. An external DCR approach was performed. Following the creation of a lower canalicular pseudopunctum, the O’Donoghue silicone stent was introduced through the common ostium, out through the pseudopunctum of the lower canaliculus, and returned through the punctum of the normal upper canaliculus down through the common ostium into the nose.Results: The patient experienced complete resolution of symptoms and on her last follow-up, two years later, her lower canaliculus was patent to syringing.Conclusion: This modification of the retrograde intubation DCR is an effective technique which decreases the intraoperative time needed to insert the tubes and minimises further trauma to the newly created punctal area.Keywords: retrograde dacryocystorhinostomy, proximal canalicular obstruction, midcanalicular obstruction, conjuctivodacryocystorhinostomy

  10. Mozart, Mozart Rhythm and Retrograde Mozart Effects: Evidences from Behaviours and Neurobiology Bases.

    Science.gov (United States)

    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.

  11. Gynecologic-tract sparing extra peritoneal retrograde radical cystectomy with neobladder

    Directory of Open Access Journals (Sweden)

    Jagdeesh N. Kulkarni

    2008-03-01

    Full Text Available OBJECTIVE: We report on a series of female patients with transitional cell carcinoma of the bladder who underwent extraperitoneal retrograde radical cystectomy sparing the female reproductive organs with neobladder creation. MATERIALS AND METHODS: 14 female patients between the ages of 45 and 72 years who underwent gynecologic-tract sparing cystectomy (GTSC with neobladder between 1997 and 2002 were retrospectively reviewed. Our surgical technique is also described. Radical cystectomy is accomplished by a retrograde method sparing the uterus, adnexa, vagina and distal urethra. An orthotopic neobladder was constructed using small bowel or sigmoid colon, brought extraperitoneally, and anastomosed to the distal urethra. RESULTS: Operating time ranged from 4.5 to six hours with a mean of 5.3 hours. Ten patients were able to void satisfactorily while four required self-catheterization for complete emptying of the bladder. Seven patients were continent day and night and another 7 reported varying degrees of daytime and nighttime incontinence. One patient died of metastases and another of pelvic recurrence. There were no urethral recurrences. Patient satisfaction with the procedure was high. CONCLUSIONS: Gynecologic-tract sparing cystectomy with orthotopic neobladder is a viable alternative in female patients with muscle invasive traditional cell carcinoma of the bladder, providing oncological safety with improved quality of life. Our extraperitoneal technique, which is an extension of our successful experience with retrograde extraperitoneal radical cystectomy in men, minimizes intraoperative complications and simplifies the management of post-operative morbidity with the neobladder.

  12. A role for nitric oxide-driven retrograde signaling in the consolidation of a fear memory

    Directory of Open Access Journals (Sweden)

    Kathie A Overeem

    2010-02-01

    Full Text Available In both invertebrate and vertebrate models of synaptic plasticity, signaling via the putative “retrograde messenger” nitric oxide (NO has been hypothesized to serve as a critical link between functional and structural alterations at pre- and postsynaptic sites. However, while in vitro models of synaptic plasticity have consistently implicated NO signaling in linking postsynaptic induction mechanisms with accompanying presynaptic changes, a convincing role of such “retrograde signaling” in mammalian memory formation has remained elusive. Using auditory Pavlovian fear conditioning, we show that synaptic plasticity and NO signaling in the lateral nucleus of the amygdala (LA regulate the expression of the ERK-driven immediate early gene early growth response gene I (EGR-1 in regions of the auditory thalamus that are presynaptic to the LA. Further, antisense knockdown of EGR-1 in the auditory thalamus impairs both fear memory consolidation and the training-induced elevation of two presynaptically localized proteins in the LA. These findings indicate that synaptic plasticity and NO signaling in the LA during auditory fear conditioning promote alterations in ERK-driven gene expression in auditory thalamic neurons that are required for both fear memory consolidation as well as presynaptic correlates of fear memory formation in the LA, and provide general support for a role of NO as a “retrograde signal” in mammalian memory formation.

  13. WD60/FAP163 is a dynein intermediate chain required for retrograde intraflagellar transport in cilia.

    Science.gov (United States)

    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. PMID:23864713

  14. Chemoradiotherapy using retrograde superselective intra-arterial infusion for advanced oral cancer

    International Nuclear Information System (INIS)

    Concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion demonstrates good local control and overall survival rates due to the advantage of simultaneous infusion of anticancer agent with the synergistic effects of chemotherapy and radiotherapy. This study evaluated the therapeutic results, overall survival and local control rates in patients with advanced oral cancer treated with definitive concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion. A total of 688 patients with carcinoma of the head and neck were referred to our institution between January 2001 and December 2006. Among them, 175 patients with carcinoma of the oral cavity underwent definitive concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion. Treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m2, cisplatin, total 125-150 mg/m2) and daily concurrent radiotherapy (total 50-60 Gy) for 5-6 weeks. Four weeks after the completion of all treatments, patients underwent biopsy of the primary lesion and radiological examinations. Complete response (CR) of the primary site was achieved in 160 (91.4%) of the 175 patients. Residual disease at the primary site was seen in 15 patients (8.6%), and 14 patients (8.0%) showed local recurrence during follow-up. Five-year survival and local control rates were 71.6% and 82.2%, respectively. (author)

  15. Risk of septic knee following retrograde intramedullary nailing of open and closed femur fractures

    Directory of Open Access Journals (Sweden)

    Halvorson Jason J

    2012-02-01

    Full Text Available Abstract Background One potential complication of retrograde femoral nailing in the treatment of femur fractures is the risk of septic knee. This risk theoretically increases in open fractures as a contaminated fracture site has the potential to seed the instrumentation being passed in and out of the sterile intraarticular starting point. There are few studies examining this potential complication in a relatively commonly practiced technique. Methods All patients who received a retrograde femoral nail for femur fracture between September 1996 and November 2006 at a Level 1 trauma center were retrospectively reviewed. This yielded 143 closed fractures, 38 open fractures and 4 closed fractures with an ipsilateral traumatic knee arthrotomy. Patient follow-up records were reviewed for documentation of septic knee via operative notes, wound culture or knee aspirate data, or the administration of antibiotics for suspected septic knee. Results No evidence of septic knee was found in the 185 fractures examined in the dataset. Utilizing the Wilson confidence interval, the rate of septic knee based on our population was no greater than 2%, with that of the open fracture group alone being 9%. Conclusions Based on these results and review of the literature, the risk of septic knee in retrograde femoral nailing of both open and closed femoral shaft fractures appears low but potentially not insignificant. Funding There was no outside source of funding from either industry or other organization for this study.

  16. WD60/FAP163 is a dynein intermediate chain required for retrograde intraflagellar transport in cilia

    Science.gov (United States)

    Patel-King, Ramila S.; Gilberti, Renée M.; Hom, Erik F. Y.; King, Stephen M.

    2013-01-01

    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. PMID:23864713

  17. MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Kerimaa, Pekka; Ojala, Risto; Markkanen, Paula; Tervonen, Osmo; Blanco Sequeiros, Roberto [Oulu University Hospital, Department of Radiology, Oulu (Finland); Sinikumpu, Juha-Jaakko; Korhonen, Jussi [Oulu University Hospital, Department of Paediatric Surgery, Oulu (Finland); Hyvoenen, Pekka [Oulu University Hospital, Department of Surgery, Oulu (Finland)

    2014-07-15

    The purpose of this study was to evaluate the feasibility of MRI guidance for percutaneous retrograde drilling in the treatment of osteochondritis dissecans of the talus (OCDT). Four patients, one juvenile and three adults, with one OCDT lesion each and persisting ankle pain after conservative treatment, were treated with MRI-guided retrograde drilling. All lesions were stable and located in the middle or posterior medial third of the talar dome. Pain relief and the ability to return to normal activities were assessed during clinical follow-up. MRI and plain film radiographs were used for imaging follow-up. Technical success was 100 % with no complications and with no damage to the overlying cartilage. All patients experienced some clinical benefit, although only one had complete resolution of pain and one had a relapse leading to surgical treatment. Changes in the pathological imaging findings were mostly very slight during the follow-up period. MRI guidance seems accurate, safe and technically feasible for retrograde drilling of OCDT. Larger series are needed to reliably assess its clinical value. (orig.)

  18. Endosome-mediated retrograde axonal transport of P2X3 receptor signals in primary sensory neurons

    Institute of Scientific and Technical Information of China (English)

    Xu-Qiao Chen; BinWang; Chengbiao Wu; Jin Pan; Bo Yuan; Yuan-Yuan Su; Xing-Yu Jiang; Xu Zhang; Lan Bao

    2012-01-01

    Neurotrophins and their receptors adopt signaling endosomes to transmit retrograde signals.However,the mechanisms of retrograde signaling for other ligand/receptor systems are poorly understood.Here,we report that the signals of the purinergic (P)2X3 receptor,an ATP-gated ion channel are retrogradely transported in dorsal root ganglion (DRG) neuron axons.We found that Rab5,a small GTPase,controls the early sorting of P2X3 receptors into endosomes,while Rab7 mediates the fast retrograde transport of P2X3 receptors.Intraplantar injection and axonal application into the microfluidic chamber of α,β-methylene-ATP (α,β-MeATP),a P2X selective agonist,enhanced the endocytosis and retrograde transport of P2X3 receptors.The α,β-MeATP-induced Ca2+ influx activated a pathway comprised of protein kinase C,rat sarcoma viral oncogene and extracellular signal-regulated protein kinase (ERK),which associated with endocytic P2X3 receptors to form signaling endosomes.Disruption of the lipid rafts abolished the α,β-MeATP-induced ERK phosphorylation,endocytosis and retrograde transport of P2X3 receptors.Furthermore,treatment of peripheral axons with α,β-MeATP increased the activation level of ERK and cAMP response element-binding protein in the cell bodies of DRG neurons and enhanced neuronal excitability.Impairment of either microtubule-based axonal transport in vivo or dynein function in vitro blocked α,β-MeATP-induced retrograde signals.These results indicate that P2X3 receptor-activated signals are transmitted via retrogradely transported endosomes in primary sensory neurons and provide a novel signaling mechanism for ligand-gated channels.

  19. A single-center experience with retrograde reperfusion in liver transplantation.

    Science.gov (United States)

    Kniepeiss, Daniela; Iberer, Florian; Grasser, Barbara; Schaffellner, Silvia; Stadlbauer, Vanessa; Tscheliessnigg, Karl-Heinz

    2003-10-01

    Poor graft function secondary to injury by ischemia and reperfusion remains a major problem with regard to morbidity and mortality in clinical liver transplantation (LTX). Up to one fifth of patients suffer from poor initial liver function due to severe damage to hepatocytes. This situation leads either to primary nonfunction described in approximately 6% of LTX or to slow recovery. We present a new method of reperfusion during LTX. From July 1998 to July 2002, 42 LTX in 39 recipients, (10 female, 52 years old (26-70) were performed. LTX was carried out in piggy-back technique. After completing the piggy-back anastomosis, the caval vein was declamped immediately, and retrograde low pressure reperfusion of the graft with low oxygenated venous blood was established. Portal anastomosis was performed using a running suture. In order to provide optimal retrograde liver perfusion, no clamping of the donor portal vein was done. After completing portal anastomosis, the recipient portal vein was declamped immediately. During arterial anastomosis, the transplanted liver was antegradely perfused via the portal vein. After completing hepatic artery anastomosis, declamping of the hepatic artery was done and arterial perfusion started. No backtable or in-situ-flushing except the described reperfusion technique was performed. Forty-two LTX in 39 recipients using piggy-back technique and retrograde reperfusion via the caval vein followed by antegrade reperfusion via the portal vein were performed; 38 out of 39 patients (97.44%) were alive and well at day 8 after LTX. One patient (2.56%) died of a pre-existing portal vein thrombosis on day 2 after LTX. Three patients had to undergo retransplantation for hepatic artery thrombosis (7.14%). Liver enzymes, bilirubine, prothrombine time and AT III on day 1, 3, 5 and 8 after LTX showed favourable values. Median aspartate aminotransferase (ASAT) was 219 U/l on day 1 after LTX. One-month survival rate was 95.23%, and 1-year survival rate

  20. Radionuclide assessment of left ventricular diastolic function in patients with mitral stenosis before and after percutaneous transvenous mitral commissurotomy; Use of list mode method in patients with atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Seishi; Iwasaka, Toshiji; Kimura, Yutaka; Ohkubo, Naohiko; Matsuura, Takashi; Inada, Mitsuo; Shiraishi, Tomokuni (Kansai Medical School, Moriguchi, Osaka (Japan))

    1991-07-01

    To evaluate the effect of percutaneous transvenous mitral commissurotomy (PTMC), equilibrium radionuclide angiocardiography was performed in eight patients with mitral stenosis who had atrial fibrillation. Accurate cardiac function in patients with atrial fibrillation is difficult to assess, since the wide fluctation of cardiac cycle makes the ventricular hemodynamics variable. A new processing algorhythm was devised to make multiple gated images discriminated from a heart rate distribution histogram. We obtained about 1,000 beats data by list mode acquisition, and processed a heart rate distribution histogram. The data in the area {+-}5% of the most frequent heart rate were converted into frame mode and a representative time activity curve was derived. Mitral valve area calculated by echocardiography increased from 1.3{+-}0.5 to 2.0{+-}0.6 (cm{sup 2}) significantly (p<0.01). The mean transmitral pressure gradient measured by catheterization decreased from 12.4{+-}5.9 to 4.9{+-}3.7 (mmHg) significantly (p<0.01) and the clinical symptoms improved in all patients. The change in left ventricular ejection fraction from 43{+-}9 to 48{+-}13 (%) was not statistically significant, but peak filling rate (PFR) derived from the time activity curve increased from 1.5{+-}0.3 to 2.0{+-}0.4 (EDV/sec) significantly (p<0.01). Thus PFR is a noninvasive parameter that can evaluate the effect of PTMC. (author).

  1. A retrograde apoptotic signal originating in NGF-deprived distal axons of rat sympathetic neurons in compartmented cultures

    Institute of Scientific and Technical Information of China (English)

    Sue-Ann Mok; Karen Lund; Robert B Campenot

    2009-01-01

    Previous investigations of retrograde survival signaling by nerve growth factor (NGF) and other neurotrophins have supported diverse mechanisms, but all proposed mechanisms have in common the generation of survival sig-nals retrogradely transmitted to the neuronal cell bodies. We report the finding of a retrograde apoptotic signal in axons that is suppressed by local NGF signaling. NGF withdrawal from distal axons alone was sufficient to activate the pro-apoptotic transcription factor, c-jnn, in the cell bodies. Providing NGF directly to cell bodies, thereby restor-ing a source of NGF-induced survival signals, could not prevent c-jun activation caused by NGF withdrawal from the distal axons. This is evidence that c-jun is not activated due to loss of survival signals at the cell bodies. Moreover, blocking axonal transport with colchicine inhibited c-jun activation caused by NGF deprivation suggesting that a retrogradely transported pro-apoptotic signal, rather than loss of a retrogradely transported survival signal, caused c-jun activation. Additional experiments showed that activation of c-jun, pro-caspase-3 cleavage, and apoptosis were blocked by the protein kinase C inhibitors, rottlerin and chelerythrine, only when applied to distal axons suggesting that they block the axon-specific pro-apoptotic signal. The rottlerin-sensitive mechanism was found to regulate glyco-gen synthase kinase 3 (GSK3) activity. The effect of siRNA knockdown, and pharmacological inhibition of GSK3 sug-gests that GSK3 is required for apoptosis caused by NGF deprivation and may function as a retrograde carrier of the axon apoptotic signal. The existence of a retrograde death signaling system in axons that is suppressed by neurotro-phins has broad implications for neurodevelopment and for discovering treatments for neurodegenerative diseases and neurotrauma.

  2. Retrograde pedal access with a 20-gauge intravenous cannula after failed antegrade recanalization of a tibialis anterior artery in a diabetic patient: a case report

    OpenAIRE

    Colkesen, Yucel

    2015-01-01

    Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions. In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable. The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position. We report a retrograde puncturing technique in patients with chronic total occlusions. After failed antegrade recanalizatio...

  3. Diagnostic and treatment of retrograde ejaculation as a manifestation of urogenital form of autonomic diabetic polyneuropathy

    Directory of Open Access Journals (Sweden)

    Dmitry Gennadyevich Kurbatov

    2015-07-01

    Full Text Available Background. Retrograde ejaculation in patients with type 1 diabetes mellitus is a complication of autonomic neuropathy that causes excretory infertility. It can be partial (reduction of ejaculate or total (absence of ejaculate and occurs in 10%–20% of men with type 1 diabetes mellitus.Aim. The aim of the study was to assess the effectiveness of a new endoscopic method for retrograde ejaculation correction and antegrade ejaculation restoration.Materials and methods. We included 30 patients with type 1 diabetes mellitus who had spermatozoa present in their post-orgasmic urine and ultrasonographic evidence of impaired or absent bladder neck closure. The mean age of participants was 32 (30–35 years, mean duration of diabetes was 17 (12–22 years and mean preoperative glycated haemoglobin level was 7.4% (6.9%–8.0%. All participants had total retrograde ejaculation. We used conventional irrigated urethrocystoscopy under local anaesthesia. During urethroscopy, bladder neck gaping was observed in all cases. Biocompatible material was injected at three points under the mucous layer of the posterior urethra, reaching the closing of the opposite edges of the urethra. A spermiogram was examined 1 week after the operation.Results. Restoration of antegrade ejaculation was achieved for 22 patients (73%, and the effects persisted for a mean of 7 (2–12 months. The spouses of four men became pregnant after surgery. In one case, the pregnancy resulted in a spontaneous abortion at gestational week 8, but the other three cases continued normally.Conclusion.This new method provides a highly effective means of restoring the physiological passage of the ejaculate. The operation is a low-invasive endoscopic procedure that does not disrupt urination, and it is possible to receive ejaculate of sufficient.

  4. Retrograde optogenetic characterization of the pontospinal module of the locus coeruleus with a canine adenoviral vector.

    Science.gov (United States)

    Li, Yong; Hickey, Louise; Perrins, Ray; Werlen, Emilie; Patel, Amisha A; Hirschberg, Stefan; Jones, Matt W; Salinas, Sara; Kremer, Eric J; Pickering, Anthony E

    2016-06-15

    Noradrenergic neurons of the brainstem extend projections throughout the neuraxis to modulate a wide range of processes including attention, arousal, autonomic control and sensory processing. A spinal projection from the locus coeruleus (LC) is thought to regulate nociceptive processing. To characterize and selectively manipulate the pontospinal noradrenergic neurons in rats, we implemented a retrograde targeting strategy using a canine adenoviral vector to express channelrhodopsin2 (CAV2-PRS-ChR2-mCherry). LC microinjection of CAV2-PRS-ChR2-mCherry produced selective, stable, transduction of noradrenergic neurons allowing reliable opto-activation in vitro. The ChR2-transduced LC neurons were opto-identifiable in vivo and functional control was demonstrated for >6 months by evoked sleep-wake transitions. Spinal injection of CAV2-PRS-ChR2-mCherry retrogradely transduced pontine noradrenergic neurons, predominantly in the LC but also in A5 and A7. A pontospinal LC (ps:LC) module was identifiable, with somata located more ventrally within the nucleus and with a discrete subset of projection targets. These ps:LC neurons had distinct electrophysiological properties with shorter action potentials and smaller afterhyperpolarizations compared to neurons located in the core of the LC. In vivo recordings of ps:LC neurons showed a lower spontaneous firing frequency than those in the core and they were all excited by noxious stimuli. Using this CAV2-based approach we have demonstrated the ability to retrogradely target, characterise and optogenetically manipulate a central noradrenergic circuit and show that the ps:LC module forms a discrete unit. This article is part of a Special Issue entitled SI: Noradrenergic System. PMID:26903420

  5. Impairment of retrograde neuronal transport in oxaliplatin-induced neuropathy demonstrated by molecular imaging.

    Directory of Open Access Journals (Sweden)

    Dawid Schellingerhout

    Full Text Available BACKGROUND AND PURPOSE: The purpose of our study was to utilize a molecular imaging technology based on the retrograde axonal transport mechanism (neurography, to determine if oxaliplatin-induced neurotoxicity affects retrograde axonal transport in an animal model. MATERIALS AND METHODS: Mice (n = 8/group were injected with a cumulative dose of 30 mg/kg oxaliplatin (sufficient to induce neurotoxicity or dextrose control injections. Intramuscular injections of Tetanus Toxin C-fragment (TTc labeled with Alexa 790 fluorescent dye were done (15 ug/20 uL in the left calf muscles, and in vivo fluorescent imaging performed (0-60 min at baseline, and then weekly for 5 weeks, followed by 2-weekly imaging out to 9 weeks. Tissues were harvested for immunohistochemical analysis. RESULTS: With sham treatment, TTc transport causes fluorescent signal intensity over the thoracic spine to increase from 0 to 60 minutes after injection. On average, fluorescence signal increased 722%+/-117% (Mean+/-SD from 0 to 60 minutes. Oxaliplatin treated animals had comparable transport at baseline (787%+/-140%, but transport rapidly decreased through the course of the study, falling to 363%+/-88%, 269%+/-96%, 191%+/-58%, 121%+/-39%, 75%+/-21% with each successive week and stabilizing around 57% (+/-15% at 7 weeks. Statistically significant divergence occurred at approximately 3 weeks (p≤0.05, linear mixed-effects regression model. Quantitative immuno-fluorescence histology with a constant cutoff threshold showed reduced TTc in the spinal cord at 7 weeks for treated animals versus controls (5.2 Arbitrary Units +/-0.52 vs 7.1 AU +/-1.38, p0.56, T-test. CONCLUSION: We show-for the first time to our knowledge-that neurographic in vivo molecular imaging can demonstrate imaging changes in a model of oxaliplatin-induced neuropathy. Impaired retrograde neural transport is suggested to be an important part of the pathophysiology of oxaliplatin-induced neuropathy.

  6. RETROGRADE INTRAMEDULLARY INTERLOCKING NAIL: AN OPTIMAL TOOL FOR THE TREATMENT OF SUPRACONDYLAR FEMORAL FRACTURES

    Directory of Open Access Journals (Sweden)

    Kamareddy

    2014-10-01

    Full Text Available : BACKGROUND: This prospective consecutive case series was done to evaluate indications, technical pearls and pitfalls and functional outcomes of distal femoral supracondylar fractures treated with retrograde intramedullary nailing. METHODS: The surgical outcome of 80 patients (59 males and 21 females who were treated with retrograde intramedullary nailing for. Patients were followed-up both clinically and radiologically every 6 weeks for a mean duration of 20 (12 – 24 months. The patients were assessed based on Schatzker and Lambert criteria. RESULTS: The mechanism of injury was motor vehicle accident in 48 (60% patients and fall in 32 (40% patients. Sixty four (80% fractures were closed and 16 (20% fractures were compound. Average operation time was 2 hours and average blood loss was 300 ml. The mean union time was 5.6 months (5 – 7 months. Knee flexion of more than 120 degree was achieved in 60 patients, 110 degree in 16 patients and 100 degree in 2 patients. Six patients had anterior knee pain of transient nature which subsided within one year after rehabilitation, full weight bearing and self exercises. By the end of 1 year, overall outcome was excellent in 59 patients (74%, good in 12 patients (15% and fair in 8 (10% patients. CONCLUSION: Retrograde intramedullary femoral nailing is an optimal tool in the treatment of AO/ASIF type A and type C distal femur (supracondylar fractures. It provides rigid fixation in a region of femur where, wide canal, thin cortices and frequently poor bone stock make fracture fixation difficult. It also provides excellent results in selected comminuted fractures of the distal femur with a low complication rate.

  7. Annexin A1 and A2: roles in retrograde trafficking of Shiga toxin.

    Directory of Open Access Journals (Sweden)

    Lionel Tcatchoff

    Full Text Available Annexins constitute a family of calcium and membrane binding proteins. As annexin A1 and A2 have previously been linked to various membrane trafficking events, we initiated this study to investigate the role of these annexins in the uptake and intracellular transport of the bacterial Shiga toxin (Stx and the plant toxin ricin. Once endocytosed, both toxins are retrogradely transported from endosomes to the Golgi apparatus and the endoplasmic reticulum before being targeted to the cytosol where they inhibit protein synthesis. This study was performed to obtain new information both about toxin transport and the function of annexin A1 and annexin A2. Our data show that depletion of annexin A1 or A2 alters the retrograde transport of Stx but not ricin, without affecting toxin binding or internalization. Knockdown of annexin A1 increases Golgi transport of Stx, whereas knockdown of annexin A2 slightly decreases the same transport step. Interestingly, annexin A1 was found in proximity to cytoplasmic phospholipase A2 (cPLA(2, and the basal as well as the increased Golgi transport of Stx upon annexin A1 knockdown is dependent on cPLA(2 activity. In conclusion, annexin A1 and A2 have different roles in Stx transport to the trans-Golgi network. The most prominent role is played by annexin A1 which normally works as a negative regulator of retrograde transport from the endosomes to the Golgi network, most likely by complex formation and inhibition of cPLA(2.

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

    Science.gov (United States)

    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. PMID:20204341

  9. MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Ojala, Risto; Kerimaa, Pekka; Tervonen, Osmo; Blanco-Sequeiros, Roberto [Oulu University Hospital, Department of Radiology, Oulu (Finland); Lakovaara, Martti [Oulu Deaconess Institute, Department of Surgery, Oulu (Finland); Hyvoenen, Pekka; Lehenkari, Petri [Oulu University Hospital, Department of Surgery, Oulu (Finland)

    2011-06-15

    The purpose of this study was to evaluate the feasibility of a new method for osteochondritis dissecans (OCD) treatment. Ten OCD lesions of the knee unresponsive to conservative management were treated with MRI-guided percutaneous retrograde drilling to reduce symptoms and promote ossification of the lesion. All lesions were located in distal femoral condyles. Only stable OCD lesions were included (preprocedural MRI grade I or II). Five lesions were of juvenile type and five lesions were of adult type OCD. All the patients had severe limitation of activity due to the OCD-related pain. By using a 0.23 T open MRI scanner and spinal anesthesia, percutaneous retrograde drilling of the OCD lesions was performed (3 mm cylindrical drill, one to three channels). Optical tracking and MRI imaging were used to guide instruments during the procedure. Mean postprocedural clinical follow-up time was 3 years. Eight patients had a post-procedural follow-up MRI within 1 year. All the OCD lesions were located and drilled using the 0.23 T open MRI scanner without procedural complications. All the patients had pain relief, mean visual analog score (VAS) declined from 6 to 2. Follow-up MRI showed ossification in all lesions. Eight patients could return to normal physical activity with no or minor effect on function (Hughston score 3-4). Treatment failed in two cases where the continuation of symptoms led to arthroscopy and transchondral fixation. MR-guided retrograde OCD lesion drilling is an accurate, feasible, and effective cartilage-sparing techique in OCD management. (orig.)

  10. Retrograde Percutaneous Coronary Intervention for Left Anterior Descending Chronic Total Occlusion Via an Ipsilateral Intraseptal Collateral Channel Using a Single Guiding Catheter.

    Science.gov (United States)

    Chon, Min Ku; Kim, Jeong Su; Chun, Kook Jin

    2016-06-01

    Successful recanalization of chronic total occlusion (CTO) of coronary arteries has improved symptoms and mortality. In CTO cases, retrograde approach from opposite coronary artery has a better chance of procedural success. But the retrograde approach from opposite site is not always suitable. In certain CTO cases, the distal left anterior descending (LAD) artery is supplied from the intraseptal collateral channel. Controlled antegrade and retrograde tracking (CART) strategy has been developed to improve guidewire crossing and successful recanalization. We report a case of the retrograde percutaneous coronary intervention for the LAD CTO lesion via an ipsilateral intraseptal collateral channel, which was successfully revascularized with reverse CARTtechnique using a single 8-French guiding catheter.

  11. A dispersive wave pattern on Jupiter's fastest retrograde jet at 20°S

    Science.gov (United States)

    Rogers, J. H.; Fletcher, L. N.; Adamoli, G.; Jacquesson, M.; Vedovato, M.; Orton, G. S.

    2016-10-01

    A compact wave pattern has been identified on Jupiter's fastest retrograding jet at 20°S (the SEBs) on the southern edge of the South Equatorial Belt. The wave has been identified in both reflected sunlight from amateur observations between 2010 and 2015, thermal infrared imaging from the Very Large Telescope and near infrared imaging from the Infrared Telescope Facility. The wave pattern is present when the SEB is relatively quiescent and lacking large-scale disturbances, and is particularly notable when the belt has undergone a fade (whitening). It is generally not present when the SEB exhibits its usual large-scale convective activity ('rifts'). Tracking of the wave pattern and associated white ovals on its southern edge over several epochs have permitted a measure of the dispersion relationship, showing a strong correlation between the phase speed (-43.2 to -21.2 m/s) and the longitudinal wavelength, which varied from 4.4 to 10.0° longitude over the course of the observations. Infrared imaging sensing low pressures in the upper troposphere suggest that the wave is confined to near the cloud tops. The wave is moving westward at a phase speed slower (i.e., less negative) than the peak retrograde wind speed (-62 m/s), and is therefore moving east with respect to the SEBs jet peak. Unlike the retrograde NEBn jet near °N, which is a location of strong vertical wind shear that sometimes hosts Rossby wave activity, the SEBs jet remains retrograde throughout the upper troposphere, suggesting the SEBs pattern cannot be interpreted as a classical Rossby wave. 2D windspeeds and thermal gradients measured by Cassini in 2000 are used to estimate the quasi-geostrophic potential vorticity gradient as a means of understanding the origin of the a wave. We find that the vorticity gradient is dominated by the baroclinic term and becomes negative (changes sign) in a region near the cloud-top level (400-700 mbar) associated with the SEBs. Such a sign reversal is a necessary (but

  12. Retrograde ureteroscopic holmium laser endopyelotomy in a selected population of patients with ureteropelvic junction obstruction

    DEFF Research Database (Denmark)

    Stilling, Nicolaj; Jung, Helene; Nørby, Bettina;

    2009-01-01

    Objective. Significant controversy remains concerning the best way to treat ureteropelvic junction obstruction (UPJO). This study evaluates subjective and objective outcomes of retrograde holmium laser endopyelotomy in a selected population with UPJO. Material and methods. Forty-seven patients...... follow-up 110 weeks). Success criteria were defined as symptom relief and improved or preserved renal function. Results. Twenty-nine patients (66%) experienced complete symptom resolution and 10 patients (23%) had significant symptom improvement (i.e. no need for pain-killing medication). Five patients...

  13. Endoscopic retrograde cholangiopancreatography, endoscopic esphinterotomy and laparoscopic cholecystectomy in a patient with choledocolitiasis and cholelitiasis

    International Nuclear Information System (INIS)

    The case report of a 30 year-old presumably healthy patient, who attended the Gastroenterology Department from 'Dr Juan Bruno Zayas Alfonso' Teaching General Hospital in Santiago de Cuba, and suffering from biliary cholic, ictero, choluria, nausea, vomit and loss of appetite is presented. The complementary examinations confirmed the choledocolitiasis and cholelitiasis diagnosis, reason why it was necessary to carry out a endoscopic retrograde cholangiopancreatography, endoscopic esphinterotomy and ambulatory laparoscopic cholecystectomy, in a single anesthetic injection. The postoperative clinical course was favorable and she was discharged without complications 24 hours before the intervention

  14. Endoscopic retrograde cholangiopancreatography in pancreatic and biliary tract disease in Korean children

    Institute of Scientific and Technical Information of China (English)

    Joo; Young; Jang; Chong; Hyun; Yoon; Kyung; Mo; Kim

    2010-01-01

    AIM:To assess the indications,findings,therapeutic procedures,safety,and complications of endoscopic retrograde cholangiopancreatography(ERCP) performed in Korean children.METHODS:The demographic characteristics,indications for ERCP,findings,therapeutic procedures,and complications of 122 pediatric patients who underwent 245 ERCPs in the Asan Medical Center between June 1994 and March 2008 were investigated.RESULTS:The mean age of the 122 patients was 8.0 ± 4.2 years.Indications were biliary pathology in 78...

  15. Therapeutic endoscopic retrograde cholangiopancreatography and related modalities have many roles in hepatobiliary hydatid disease

    Institute of Scientific and Technical Information of China (English)

    Ersan (O)zaslan

    2006-01-01

    The authors report their experience about 8 cases of intrabiliary rupture of hepatobiliary hydatid disease, and add an algorithm for treatment. To our opinion, the use of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in the management of hepatobiliary hydatid disease was not stated properly in their proposed algorithm. According to the algorithm, the use of ERCP and related modalities was only stated in the case of postoperative biliary fistulae. We think that postoperative persistant fistula is not a sole indication, there are many indications for ERCP and related techniques namely sphincterotomy, extraction, nasobiliary drainage and stenting, in the treatment algorithm before or after surgery.

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

    Science.gov (United States)

    Salvadó, José A; Consigliere, Lucas; Gallegos, Hector; Rojas, Francisco; Astroza, Gastón

    2016-01-01

    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

  17. CLINICAL ANALYSIS ON TREATMENT OF LUMBAR VERTEBRAL RETROGRADE AFFECTION WITH ACUPUNCTURE, TDP-IRRADIATION AND CUPPING

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yi

    2002-01-01

    In the present paper, 70 cases of retrograde affection of the lumbar vertebrae are randomly and evenly divided into treatment group and control group. Shenshu (BL 23), Qihaishu (BL 24), Dachangshu (BL 25),Weizhong (BL 40), Jiaji (EX-B 2), etc. are used. In treatment group, acupuncture, TDP irradiation and cupping are performed, and in control group, only acupuncture is given. After 30 sessions (3 therapeutic courses) of treatment, in treatment and control groups, the total effective rates are 91.43 % and 71.43 % respectively. The therapeutic effect of comprehensive treatment is significantly superior to that of simple acupuncture therapy (P < 0.05).

  18. Retrograde intrarenal stone surgery for extracorporeal shock-wave lithotripsy-resistant kidney stones

    DEFF Research Database (Denmark)

    Jung, Helene; Nørby, Bettina; Osther, Palle Jörn

    2006-01-01

    OBJECTIVE: The newer flexible ureteroscopes, 150-200-microm holmium YAG laser fibres and superflexible Dormia baskets have made it possible to reach and treat stones in all parts of the kidney. The object of this evaluation was to study the outcome of retrograde intrarenal stone surgery (RIRS......) for extracorporeal shock-wave lithotripsy (ESWL)-resistant kidney stones. MATERIAL AND METHODS: A total of 38 consecutive patients (18 males, 20 females) participated in the study. All patients had undergone ESWL prior to RIRS without success. In all cases the stones could be reached with the endoscope. Calculi...

  19. Phase-contrast magnetic resonance imaging reveals net retrograde aqueductal flow in idiopathic normal pressure hydrocephalus.

    Science.gov (United States)

    Ringstad, Geir; Emblem, Kyrre Eeg; Eide, Per Kristian

    2016-06-01

    OBJECT The objective of this study was to assess the net aqueductal stroke volume (ASV) and CSF aqueductal flow rate derived from phase-contrast MRI (PC-MRI) in patients with probable idiopathic normal pressure hydrocephalus (iNPH) before and after ventriculoperitoneal shunt surgery, and to compare observations with intracranial pressure (ICP) scores. METHODS PC-MRI at the level of the sylvian aqueduct was undertaken in patients undergoing assessment for probable iNPH. Aqueductal flow in the craniocaudal direction was defined as positive, or antegrade flow, and net ASV was calculated by subtracting retrograde from antegrade aqueductal flow. Aqueductal flow rate per minute was calculated by multiplying net ASV by heart rate. During the same hospital admission, clinical examination was performed using NPH score and overnight continuous ICP monitoring. Twelve patients were followed prospectively 12 months after shunt placement with clinical assessment and a second PC-MRI. The study also included 2 healthy controls. RESULTS Among 21 patients examined for iNPH, 17 (81%) received a shunt (shunt group), and 4 were treated conservatively (conservative group). Among the patients with shunts, a clinical improvement was observed in 16 (94%) of the 17. Net ASV was negative in 16 (76%) of 21 patients before shunt placement and in 5 (42%) of 12 patients after shunt placement, and increased from a median of -5 μl (range -175 to 27 μl) to a median of 1 μl (range -61 to 30 μl; p = 0.04). Among the 12 patients with PC-MRI after shunt placement, 11 were shunt responders, and in 9 of these 11 either a reduced magnitude of retrograde aqueductal flow, or a complete reversal from retrograde to antegrade flow, occurred. Net ASV was significantly lower in the shunt group than in the conservative group (p = 0.01). The aqueductal flow rate increased from -0.56 ml/min (range -12.78 to 0.58 ml/min) to 0.06 ml/min (range -4.51 to 1.93 ml/min; p = 0.04) after shunt placement. CONCLUSIONS In

  20. Repair of Late Retrograde Type A Aortic Dissection After TEVAR: Causes and Management.

    Science.gov (United States)

    Mosquera, Victor X; Marini, Milagros; Fraga-Manteiga, Daniel; Gulias, Daniel; Cuenca, Jose J

    2016-03-01

    One of the most feared complications of thoracic endovascular aortic repair (TEVAR) and hybrid arch repair is retrograde type A aortic dissection (RTAD). More than two-thirds of RTAD occurs in the immediate postoperative period and first postoperative month. In presentations beyond that point, progression of the native aortopathy must be considered. We report a late presentation of an RTAD seven months after hybrid repair of an aortic intramural hematoma with an ulcer-like projection, and review the causes and management of this TEVAR complication.

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

    OpenAIRE

    Schmidts, M.; Hou, Y; Cortes, C.R.; Mans, D. A.; Huber, C.; Boldt, K.; M. Patel; Van Reeuwijk, J; Plaza, J.M.; Beersum, S.E.C; Yap, Z.M.; Letteboer, S.J.F.; Taylor, S. P.; Herridge, W; Johnson, C A

    2015-01-01

    ARTICLE Received 1 Oct 2014 | Accepted 31 Mar 2015 | Published 5 June 2015 TCTEX1D2 mutations underlie Jeune asphyxiating thoracic dystrophy with impaired retrograde intraflagellar transport Miriam Schmidts1,2,3,4,*, Yuqing Hou5,*, Claudio R. Corte´s6, Dorus A. Mans2,3, Celine Huber7, Karsten Boldt8, Mitali Patel1, Jeroen van Reeuwijk2,3, Jean-Marc Plaza9, Sylvia E.C. van Beersum2,3, Zhi Min Yap1, Stef J.F. Letteboer2,3, S Paige Taylor10, Warren Herridge11, Colin A. Johns...

  2. Phase-contrast magnetic resonance imaging reveals net retrograde aqueductal flow in idiopathic normal pressure hydrocephalus.

    Science.gov (United States)

    Ringstad, Geir; Emblem, Kyrre Eeg; Eide, Per Kristian

    2016-06-01

    OBJECT The objective of this study was to assess the net aqueductal stroke volume (ASV) and CSF aqueductal flow rate derived from phase-contrast MRI (PC-MRI) in patients with probable idiopathic normal pressure hydrocephalus (iNPH) before and after ventriculoperitoneal shunt surgery, and to compare observations with intracranial pressure (ICP) scores. METHODS PC-MRI at the level of the sylvian aqueduct was undertaken in patients undergoing assessment for probable iNPH. Aqueductal flow in the craniocaudal direction was defined as positive, or antegrade flow, and net ASV was calculated by subtracting retrograde from antegrade aqueductal flow. Aqueductal flow rate per minute was calculated by multiplying net ASV by heart rate. During the same hospital admission, clinical examination was performed using NPH score and overnight continuous ICP monitoring. Twelve patients were followed prospectively 12 months after shunt placement with clinical assessment and a second PC-MRI. The study also included 2 healthy controls. RESULTS Among 21 patients examined for iNPH, 17 (81%) received a shunt (shunt group), and 4 were treated conservatively (conservative group). Among the patients with shunts, a clinical improvement was observed in 16 (94%) of the 17. Net ASV was negative in 16 (76%) of 21 patients before shunt placement and in 5 (42%) of 12 patients after shunt placement, and increased from a median of -5 μl (range -175 to 27 μl) to a median of 1 μl (range -61 to 30 μl; p = 0.04). Among the 12 patients with PC-MRI after shunt placement, 11 were shunt responders, and in 9 of these 11 either a reduced magnitude of retrograde aqueductal flow, or a complete reversal from retrograde to antegrade flow, occurred. Net ASV was significantly lower in the shunt group than in the conservative group (p = 0.01). The aqueductal flow rate increased from -0.56 ml/min (range -12.78 to 0.58 ml/min) to 0.06 ml/min (range -4.51 to 1.93 ml/min; p = 0.04) after shunt placement. CONCLUSIONS In

  3. NEXT GENERATION OF TELESCOPES OR DYNAMICS REQUIRED TO DETERMINE IF EXO-MOONS HAVE PROGRADE OR RETROGRADE ORBITS

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, Karen M.; Fujii, Yuka [Earth-Life Science Institute (WPI-ELSI), Tokyo Institute of Technology, Ookayama, Meguro district, Tokyo 152-8551 (Japan)

    2014-08-20

    We survey the methods proposed in the literature for detecting moons of extrasolar planets in terms of their ability to distinguish between prograde and retrograde moon orbits, an important tracer of the moon formation channel. We find that most moon detection methods, in particular, sensitive methods for detecting moons of transiting planets, cannot observationally distinguishing prograde and retrograde moon orbits. The prograde and retrograde cases can only be distinguished where the dynamical evolution of the orbit due to, e.g., three body effects is detectable, where one of the two cases is dynamically unstable, or where new observational facilities, which can implement a technique capable of differentiating the two cases, come online. In particular, directly imaged planets are promising targets because repeated spectral and photometric measurements, which are required to determine moon orbit direction, could also be conducted with the primary interest of characterizing the planet itself.

  4. Valve Replacement Performed on the Beating Heart with Continuous Retrograde Coronary Sinus Isothermic Blood Perfusion Combined with Coronary Bypass

    Directory of Open Access Journals (Sweden)

    Orhan Saim Demirtürk

    2012-12-01

    Full Text Available An operation on the beating heart was planned for a 60-year-old woman who applied to our clinic with aortic stenosis, three vessel coronary artery disease and poor left ventricular function. There are reports about beating heart valve surgery perfomed alone or combined with coronary artery bypass operations using continuous retrograde coronary sinus isothermic blood perfusion in patients with poor ventricle. We performed a coronary revascularization process for three-vessel disease on the pump beating heart and aortic valve replacement under cross-clamp using continuous retrograde coronary sinus isothermic blood perfusion in the same session. She was discharged on the sixth postoperative day after an uneventful recovery. She is well and active 24 months after the operation. Valve replacement using the retrograde coronary sinus isothermic blood perfusion technique due to its protective effect on the already borderline myocardial functions in patients with poor ventricles is a useful and clinically successful method.

  5. NEXT GENERATION OF TELESCOPES OR DYNAMICS REQUIRED TO DETERMINE IF EXO-MOONS HAVE PROGRADE OR RETROGRADE ORBITS

    International Nuclear Information System (INIS)

    We survey the methods proposed in the literature for detecting moons of extrasolar planets in terms of their ability to distinguish between prograde and retrograde moon orbits, an important tracer of the moon formation channel. We find that most moon detection methods, in particular, sensitive methods for detecting moons of transiting planets, cannot observationally distinguishing prograde and retrograde moon orbits. The prograde and retrograde cases can only be distinguished where the dynamical evolution of the orbit due to, e.g., three body effects is detectable, where one of the two cases is dynamically unstable, or where new observational facilities, which can implement a technique capable of differentiating the two cases, come online. In particular, directly imaged planets are promising targets because repeated spectral and photometric measurements, which are required to determine moon orbit direction, could also be conducted with the primary interest of characterizing the planet itself

  6. Distant Retrograde Orbits for space-based Near Earth Objects detection

    Science.gov (United States)

    Stramacchia, Michele; Colombo, Camilla; Bernelli-Zazzera, Franco

    2016-09-01

    We analyse a concept for the detection of Potentially Hazardous Asteroids (PHAs) from a space-based network of telescopes on retrograde Distant Periodic Orbits. Planar periodic orbits are designed in the Sun-Earth circular restricted three-body problem, starting from initial conditions in the Hill's problem available from the literature. A family of retrograde orbits centred at the Earth is selected as baseline, based on their maximum distance from Earth, larger than the Earth-L2 distance. Indeed, spacecraft on such orbits can detect PHAs incoming from the Sun direction, which could not otherwise be monitored from current Earth-based systems. A trade-off on the orbit amplitude, asteroid diameter to be detected, and the constellation size is performed considering current visible sensor telescope technology. The Chelyabinsk meteor scenario is studied and the potential warning time that could be gained with a space-based survey system with respect to an Earth based-survey system is shown.

  7. Arthroscopic retrograde osteochondral autologous transplantation to chondral lesion in femoral head.

    Science.gov (United States)

    Cetinkaya, Sarper; Toker, Berkin; Taser, Omer

    2014-06-01

    This report describes the treatment of 2 cases of full-thickness cartilage defect of the femoral head. The authors performed osteochondral autologous transplantation with a different technique that has not been reported to date. One patient was 37 years old, and the other was 42 years old. Both presented with hip pain. In both patients, radiograph and magnetic resonance imaging scan showed a focal chondral defect on the weight-bearing area of the femoral head and acetabular impingement. A retrograde osteochondral autologous transplantation technique combined with hip arthroscopy and arthroscopic impingement treatment was performed. After a 2-month recovery period, the symptoms were resolved. In the first year of follow-up, Harris Hip scores improved significantly (case 1, 56.6 to 87.6; case 2, 58.6 to 90). The technique described yielded good short- and midterm clinical and radiologic outcomes. To the authors' knowledge, this report is the first to describe a retrograde osteochondral transplantation technique performed with hip arthroscopy in the femoral head. PMID:24972445

  8. [Successful selective electrical ablation of the retrograde pathway in atrioventricular nodal reentry tachycardia associated with syncope].

    Science.gov (United States)

    Lukl, J; Cíhalík, C

    1992-01-01

    A 55-year-old man was admitted to the intensive care unit on account of repeatedly occurring syncopes which developed at the peak of physical exertion. The attack was reproduced by exercise on a bicycle ergometer: the patient developed paroxysmal tachycardia with a narrow QRS and a frequency of 160/min leading after 20 sec. to severe hypotension and loss of consciousness. The same tachycardia caused by programmed atrial stimulation caused a drop of tension in the recumbent position by 30 mmHg and after more detailed analysis during electrophysiological examination it was evaluated as atrioventricular nodal reentrant tachycardia. By an electric discharge of 300 J administered by means of a stimulation electrode 7F USCI into the area of the AV node the retrograde conduction through the perinodal rapid pathways was completely interrupted and 1st. degree atrioventricular block developed. Repeated electrophysiological examination and exercise tests on a bicycle ergometer provided evidence of the disappearance of the retrograde pathway and the impossibility to elicit AVNRT. The authors express the view that the rapid perinodal pathway is interrupted in successful cases in both directions and the 1st. degree AV block is due to conduction along a slow pathway and not incidental slowing of conduction along the rapid pathway which is the generally accepted interpretation. Modification of the atrioventricular conduction by interruption of the rapid pathway by fulguration is according to data in the literature and the described patient a method which makes is possible to cure severe atrioventricular nodal reentrant tachycardias.

  9. Alterations of mitochondrial dynamics allow retrograde propagation of locally initiated axonal insults.

    Science.gov (United States)

    Lassus, Benjamin; Magifico, Sebastien; Pignon, Sandra; Belenguer, Pascale; Miquel, Marie-Christine; Peyrin, Jean-Michel

    2016-01-01

    In chronic neurodegenerative syndromes, neurons progressively die through a generalized retraction pattern triggering retrograde axonal degeneration toward the cell bodies, which molecular mechanisms remain elusive. Recent observations suggest that direct activation of pro-apoptotic signaling in axons triggers local degenerative events associated with early alteration of axonal mitochondrial dynamics. This raises the question of the role of mitochondrial dynamics on both axonal vulnerability stress and their implication in the spreading of damages toward unchallenged parts of the neuron. Here, using microfluidic chambers, we assessed the consequences of interfering with OPA1 and DRP1 proteins on axonal degeneration induced by local application of rotenone. We found that pharmacological inhibition of mitochondrial fission prevented axonal damage induced by rotenone, in low glucose conditions. While alteration of mitochondrial dynamics per se did not lead to spontaneous axonal degeneration, it dramatically enhanced axonal vulnerability to rotenone, which had no effect in normal glucose conditions, and promoted retrograde spreading of axonal degeneration toward the cell body. Altogether, our results suggest a mitochondrial priming effect in axons as a key process of axonal degeneration. In the context of neurodegenerative diseases, like Parkinson's and Alzheimer's, mitochondria fragmentation could hasten neuronal death and initiate spatial dispersion of locally induced degenerative events. PMID:27604820

  10. Cardioplegia retrógrada seqüencial Sequencial retrograde cardioplegy

    Directory of Open Access Journals (Sweden)

    Otoni M Gomes

    1996-09-01

    extracorporeal circulation established. The following routes were employed for cardioplegic perfusion: 1 Antegrade - through ascending aortic canullation bellow the aortic occlusion clamp;2 Selective retrograde - through coronary synus (Co.S - 25 mmHg using a self-inflating ballooned cannula; 3 Total retrograde, (Co.S - 40 mmHg - through a cannula inserted in the right atrium (RA; 4 Sequencial retrograde, Co.S-RA - with the CS flowing first through the coronary synus lowering the interventricular septal temperature to 16 ºC and after through the RA cannula as in the total retrograde technique with the pulmonary artery occluded and;5 Sequencial retrograde, Co.S-RV - the RV chamber being directly cannulated through the tricuspid valve and perfused, instead of the RA in the latter technique. The temperature variation of the myocardium in the left ventricule (LV, RVt RA and sinus node region (SN was controlled employing an Omega needle termistor and thermometer. With the antegrade technique (70 mmHg pressure the most uniform myocardial cooling, the lowest CS volume and perfusion time duration was observed, followed In excelence by the Co.S-RA Sequencial retrograde technique and the Co.S-RV sequencial technique. The present data indicate that sequencial retrograde cardioplegic perfusion techinique is significantly better than the usual Co.S or RA total retrograde technique alone for myocardial protection when compared with the aortic root antegrade perfusion technique.

  11. Properties of retrograded and acetylated starch produced via starch extrusion or starch hydrolysis with pullulanase.

    Science.gov (United States)

    Kapelko, M; Zięba, T; Gryszkin, A; Styczyńska, M; Wilczak, A

    2013-09-12

    The aim of the present study was to determine the impact of serial modifications of starch, including firstly starch extrusion or hydrolysis with pullulanase, followed by retrogradation (through freezing and defrosting of pastes) and acetylation (under industrial conditions), on its susceptibility to amylolysis. The method of production had a significant effect on properties of the resultant preparations, whilst the direction and extent of changes depended on the type of modification applied. In the produced starch esters, the degree of substitution, expressed by the per cent of acetylation, ranged from 3.1 to 4.4 g/100 g. The acetylation had a significant impact on contents of elements determined with the atomic emission spectrometry, as it contributed to an increased Na content and decreased contents of Ca and K. The DSC thermal characteristics enabled concluding that the modifications caused an increase in temperatures and a decrease in heat of transition (or its lack). The acetylation of retrograded starch preparations increased their solubility in water and water absorbability. The modifications were found to exert various effects on the rheological properties of pastes determined based on the Brabender's pasting characteristics and flow curves determined with the use of an oscillatory-rotating viscosimeter. All starch acetates produced were characterized by ca. 40% resistance to amylolysis.

  12. Gelatinization and retrogradation phenomena in starch/montmorillonite nanocomposites plasticized with different glycerol/water ratios.

    Science.gov (United States)

    Lara, Sandra Camila; Salcedo, Felipe

    2016-10-20

    This study aims to gain insights into the intermolecular interactions present in thermoplastic starch (TPS)/montmorillonite (MMT) nanocomposites prepared using water and/or glycerol as plasticizers. Specifically, the impact of using different glycerol/water proportions on the nature of gelatinization and retrogradation processes is studied. Nanocomposites were characterized by rheometry, scanning electron microscopy (SEM) and X-rays diffraction (XRD). It is shown that clay tactoids preferentially interact with glycerol molecules rather than starch macromolecules. Consequently, the effects of MMT incorporation strongly depend on the glycerol/water ratio; when a ratio of 0.5 is used minor variations were observed on the starch gelatinization process-although stronger clays-starch interactions were evident-whereas at higher ratios the addition of clays significantly increased the gelatinization temperature, up to values over 100°C. In the gelatinization process of starch in TPS samples having only glycerol as a plasticizer, the leaching of amylose and the melting of amylopectin crystalline domains seem to occur simultaneously. This different gelatinization mechanism produces a TPS having a substantially different morphology, which exhibited reduced retrogradation characteristics. PMID:27474559

  13. Percutaneous nephrolithotomy with and without retrograde pyelography: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Ali Tabibi

    2007-02-01

    Full Text Available OBJECTIVE: Since the introduction of percutaneous nephrolithotomy (PCNL, many changes have been added regarding the entrance to pyelocalyceal system such as insertion of the needle pointed to an opaque stone as a guided landmark. We aim at comparing the outcomes of managing renal calculi with and without retrograde pyelography. MATERIALS AND METHODS: In a randomized clinical trial, 55 cases with opaque renal calculi candidates for PCNL with stone in one calyce, in the pelvis or both in one calyce and the pelvis simultaneously were included in a nine-month study. They were randomized into 2 groups, noncatheterized (n = 28 and catheterized (n = 27, called intervention and control groups, respectively. RESULTS: The 2 groups had similar distributions regarding gender, age, duration of operation, length of hospital stay, past history of any surgical procedures on kidney, and stone size. Outcome (residual stone based on aforementioned management was evaluated with plain X-ray on the morning following the operation. Postoperative hemoglobin decrease was significantly higher in controls than in the intervention group (p < 0.001 (with no clinical significance. No difference in outcome, postoperative fever, duration of surgery, duration of hospital stay and radiation exposure was observed between the 2 groups. CONCLUSION: Our findings showed no differences in major clinical outcomes between the 2 groups (with and without catheter insertion for retrograde pyelography.

  14. [Successful selective electrical ablation of the retrograde pathway in atrioventricular nodal reentry tachycardia associated with syncope].

    Science.gov (United States)

    Lukl, J; Cíhalík, C

    1992-01-01

    A 55-year-old man was admitted to the intensive care unit on account of repeatedly occurring syncopes which developed at the peak of physical exertion. The attack was reproduced by exercise on a bicycle ergometer: the patient developed paroxysmal tachycardia with a narrow QRS and a frequency of 160/min leading after 20 sec. to severe hypotension and loss of consciousness. The same tachycardia caused by programmed atrial stimulation caused a drop of tension in the recumbent position by 30 mmHg and after more detailed analysis during electrophysiological examination it was evaluated as atrioventricular nodal reentrant tachycardia. By an electric discharge of 300 J administered by means of a stimulation electrode 7F USCI into the area of the AV node the retrograde conduction through the perinodal rapid pathways was completely interrupted and 1st. degree atrioventricular block developed. Repeated electrophysiological examination and exercise tests on a bicycle ergometer provided evidence of the disappearance of the retrograde pathway and the impossibility to elicit AVNRT. The authors express the view that the rapid perinodal pathway is interrupted in successful cases in both directions and the 1st. degree AV block is due to conduction along a slow pathway and not incidental slowing of conduction along the rapid pathway which is the generally accepted interpretation. Modification of the atrioventricular conduction by interruption of the rapid pathway by fulguration is according to data in the literature and the described patient a method which makes is possible to cure severe atrioventricular nodal reentrant tachycardias. PMID:1561778

  15. Glucocorticoids aggravate retrograde memory deficiency associated with traumatic brain injury in rats.

    Science.gov (United States)

    Chen, Xin; Zhang, Ke-Li; Yang, Shu-Yuan; Dong, Jing-Fei; Zhang, Jian-Ning

    2009-02-11

    Administration of glucocorticoid to patients with head injury has previously been demonstrated to impair memory. We hypothesize that glucocorticoids promote post-traumatic hippocampal apoptosis, resulting in retrograde memory deficiency associated with traumatic brain injury (TBI). In the present study, we tested this hypothesis by measuring spatial memory deficiency in rats subjected to fluid percussion injury (FPI) and receiving dexamethasone (DXM at 0.5-10 mg/kg) or methylprednisolone (MP at 5-30 mg/kg); we also examined neuronal apoptosis in hippocampus. Adult male Wistar rats were trained for the acquisition of spatial memory, then subjected to FPI and tested for spatial reference memory on post-injury days 7 and 14 using the Morris Water Maze. Brain tissue from injured rats was examined 24 h to 2 weeks after injury. The percent time in the goal quadrant, which measures spatial reference memory, was significantly lower in injured rats receiving either high-dose DXM or MP than in control groups. TUNEL-positive cells in hippocampus were first detected 24 h post-injury, plateauing at 48h. The number of TUNEL-positive cells was significantly higher in injured rats treated with either DXM or MP. The data suggest that glucocorticoid therapy for TBI may increase neuronal apoptosis in hippocampus and, as a result, aggravate retrograde memory deficits induced by TBI.

  16. Slit2 as a β-catenin/Ctnnb1-dependent retrograde signal for presynaptic differentiation.

    Science.gov (United States)

    Wu, Haitao; Barik, Arnab; Lu, Yisheng; Shen, Chengyong; Bowman, Andrew; Li, Lei; Sathyamurthy, Anupama; Lin, Thiri W; Xiong, Wen-Cheng; Mei, Lin

    2015-07-10

    Neuromuscular junction formation requires proper interaction between motoneurons and muscle cells. β-Catenin (Ctnnb1) in muscle is critical for motoneuron differentiation; however, little is known about the relevant retrograde signal. In this paper, we dissected which functions of muscle Ctnnb1 are critical by an in vivo transgenic approach. We show that Ctnnb1 mutant without the transactivation domain was unable to rescue presynaptic deficits of Ctnnb1 mutation, indicating the involvement of transcription regulation. On the other hand, the cell-adhesion function of Ctnnb1 is dispensable. We screened for proteins that may serve as a Ctnnb1-directed retrograde factor and identified Slit2. Transgenic expression of Slit2 specifically in the muscle was able to diminish presynaptic deficits by Ctnnb1 mutation in mice. Slit2 immobilized on beads was able to induce synaptophysin puncta in axons of spinal cord explants. Together, these observations suggest that Slit2 serves as a factor utilized by muscle Ctnnb1 to direct presynaptic differentiation.

  17. Human papillomavirus type 16 entry: retrograde cell surface transport along actin-rich protrusions.

    Directory of Open Access Journals (Sweden)

    Mario Schelhaas

    Full Text Available The lateral mobility of individual, incoming human papillomavirus type 16 pseudoviruses (PsV bound to live HeLa cells was studied by single particle tracking using fluorescence video microscopy. The trajectories were computationally analyzed in terms of diffusion rate and mode of motion as described by the moment scaling spectrum. Four distinct modes of mobility were seen: confined movement in small zones (30-60 nm in diameter, confined movement with a slow drift, fast random motion with transient confinement, and linear, directed movement for long distances. The directed movement was most prominent on actin-rich cell protrusions such as filopodia or retraction fibres, where the rate was similar to that measured for actin retrograde flow. It was, moreover, sensitive to perturbants of actin retrograde flow such as cytochalasin D, jasplakinolide, and blebbistatin. We found that transport along actin protrusions significantly enhanced HPV-16 infection in sparse tissue culture, cells suggesting a role for in vivo infection of basal keratinocytes during wound healing.

  18. Adenosine Triphosphate (ATP Is a Candidate Signaling Molecule in the Mitochondria-to-Nucleus Retrograde Response Pathway

    Directory of Open Access Journals (Sweden)

    Zhengchang Liu

    2013-03-01

    Full Text Available Intracellular communication from the mitochondria to the nucleus is achieved via the retrograde response. In budding yeast, the retrograde response, also known as the RTG pathway, is regulated positively by Rtg1, Rtg2, Rtg3 and Grr1 and negatively by Mks1, Lst8 and two 14-3-3 proteins, Bmh1/2. Activation of retrograde signaling leads to activation of Rtg1/3, two basic helix-loop-helix leucine zipper transcription factors. Rtg1/3 activation requires Rtg2, a cytoplasmic protein with an N-terminal adenosine triphosphate (ATP binding domain belonging to the actin/Hsp70/sugar kinase superfamily. The critical regulatory step of the retrograde response is the interaction between Rtg2 and Mks1. Rtg2 binds to and inactivates Mks1, allowing for activation of Rtg1/3 and the RTG pathway. When the pathway is inactive, Mks1 has dissociated from Rtg2 and bound to Bmh1/2, preventing activation of Rtg1/3. What signals association or disassociation of Mks1 and Rtg2 is unknown. Here, we show that ATP at physiological concentrations dissociates Mks1 from Rtg2 in a highly cooperative fashion. We report that ATP-mediated dissociation of Mks1 from Rtg2 is conserved in two other fungal species, K. lactis and K. waltii. Activation of Rtg1/3 upregulates expression of genes encoding enzymes catalyzing the first three reactions of the Krebs cycle, which is coupled to ATP synthesis through oxidative phosphorylation. Therefore, we propose that the retrograde response is an ATP homeostasis pathway coupling ATP production with ATP-mediated repression of the retrograde response by releasing Mks1 from Rtg2.

  19. THE EFFECT OF PROSTAGLANDIN E1 ON PULMONARY BLOOD FLOW AFTER RETROGRADE FLUSH AND COLD STORAGE OF LUNGS

    Institute of Scientific and Technical Information of China (English)

    陈长志; 赵洪; 陆佩中

    2000-01-01

    ReSllm6 Objectif Nos studes Precedentes out montrd une panne fonCtion de la greffe pulmonaire traitde Prdalablementper perfusion forcde retrograde et un stockage d froid inns ~. L' etude Prdsente a pour but de determiner l' effet de ~ surlefiot mngUin du poumon trait4 Prdalablement per perfusion retrograde forcde et un stockage d froid. met~. 12poumons donneurs canins out ate trait4s per perfusion r4tFograde de solution UW. Chez 6 animaux du grouch A, 250ng furent injectes dans l' artrdre pulmonaire avant l...

  20. A retrograde double-labeling technique for light microscopy A combination of axonal transport of cholera toxin B-subunit and a gold-lectin conjugate

    NARCIS (Netherlands)

    T.J.H. Ruigrok (Tom); T.M. Teune (Thea); J. van der Burg (Johannes); H. Sabel-Goedknegt (H.)

    1995-01-01

    textabstractA light microscopical, non-fluorescent, retrograde double-labeling technique is described. Cholera toxin B-subunit (CTb) and a conjugate of wheatgerm agglutinin and bovine serum albumin coupled to 10 nm gold particles (gold-lectin) are both excellent retrograde tracers and, when visualiz

  1. Poorly expandable common bile duct with stones on endoscopic retrograde cholangiography

    Institute of Scientific and Technical Information of China (English)

    Chi-Liang Cheng; Yung-Kuan Tsou; Cheng-Hui Lin; Jui-Hsiang Tang; Chien-Fu Hung; Kai-Feng Sung; Ching-Song Lee

    2012-01-01

    AIM:To describe characteristics of a poorly expandable (PE) common bile duct (CBD) with stones on endoscopic retrograde cholangiography.METHODS:A PE bile duct was characterized by a rigid and relatively narrowed distal CBD with retrograde dilatation of the non-PE segment.Between 2003 and 2006,endoscopic retrograde cholangiography (ERC) images and chart reviews of 1213 patients with newly diagnosed CBD stones were obtained from the computer database of Therapeutic Endoscopic Center in Chang Gung Memorial Hospital.Patients with characteristic PE bile duct on ERC were identified from the database.Data of the patients as well as the safety and technical success of therapeutic ERC were collected and analyzed retrospectively.RESULTS:A total of 30 patients with CBD stones and characteristic PE segments were enrolled in this study.The median patient age was 45 years (range,20 to 92 years); 66.7% of the patients were men.The diameters of the widest non-PE CBD segment,the PE segment,and the largest stone were 14.3 ± 4.9 mm,5.8 ± 1.6 mm,and 11.2 ± 4.7 mm,respectively.The length of the PE segment was 39.7±15.4 mm (range,12.3 mm to 70.9 mm).To remove the CBD stone(s) completely,mechanical lithotripsy was required in 25 (83.3%) patients even though the stone size was not as large as were the difficult stones that have been described in the literature.The stone size and stone/PE segment diameter ratio were associated with the need for lithotripsy.Post-ERC complications occurred in 4 cases:pancreatitis in 1,cholangitis in 2,and an impacted Dormia basket with cholangitis in 1.Two (6.7%)of the 28 patients developed recurrent CBD stones at follow-up (50 ± 14 mo) and were successfully managed with therapeutic ERC.CONCLUSION:Patients with a PE duct frequently require mechanical lithotripsy for stones extraction.To retrieve stones successfully and avoid complications,these patients should be identified during ERC.

  2. Integrating bio-prosthetic valves in the Fontan operation - Novel treatment to control retrograde flow in caval veins

    Science.gov (United States)

    Vukicevic, Marija; Conover, Timothy; Zhou, Jian; Hsia, Tain-Yen; Figliola, Richard

    2012-11-01

    For a child born with only one functional heart ventricle, the sequence of palliative surgeries typically culminates in the Fontan operation. This procedure is usually successful initially, but leads to later complications, for reasons not fully understood. Examples are respiratory-dependent retrograde flows in the caval and hepatic veins, and increased pulmonary vascular resistance (PVR), hypothesized to be responsible for elevated pressure in the liver and disease of the liver and intestines. Here we study the parameters responsible for retrograde flows in the inferior vena cava (IVC) and hepatic vein (HV), and investigate two novel interventions to control retrograde flow: implanting either a Medtronic Contegra valved conduit or an Edwards lifescience pericardial aortic valve in the IVC or HV. We performed the experiments in a multi-scale, patient specific mock circuit, with normal and elevated PVR, towards the optimization of the Fontan circulation. The results show that both valves can significantly reduce retrograde flows in the veins, suggesting potential advantages in the treatment of the patients with congenital heart diseases. Fondation Leducq

  3. Hippocampus and Retrograde Amnesia in the Rat Model: A Modest Proposal for the Situation of Systems Consolidation

    Science.gov (United States)

    Sutherland, Robert J.; Sparks, Fraser T.; Lehmann, Hugo

    2010-01-01

    The properties of retrograde amnesia after damage to the hippocampus have been explicated with some success using a rat model of human medial temporal lobe amnesia. We review the results of this experimental work with rats focusing on several areas of consensus in this growing literature. We evaluate the theoretically significant hypothesis that…

  4. RETROGRADE CEREBRAL PERFUSION AS METHOD OF BRAIN PROTECTION DURING OPERATIONS ON ASCENDING AND TRANSVERSE AORTA WITH HYPOTHERMIC CIRCULATORY ARREST

    Directory of Open Access Journals (Sweden)

    N. N. Tarabarko

    2011-01-01

    Full Text Available There is no optimal approach to cerebral protection during ascending and transverse aortic arch repairs in our days. This study was designed to analyze experience of using retrograde cerebral perfusion as method of brain protection during operations on ascending and transverse aorta with hypothermic circulatory arrest. 

  5. Predictors of Successful Clinical and Laboratory Outcomes in Patients with Primary Sclerosing Cholangitis Undergoing Endoscopic Retrograde Cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    R Enns

    2003-01-01

    Full Text Available Endoscopic retrograde cholangiopancreatography (ERCP in patients with primary sclerosing cholangitis (PSC can be a challenging and sometimes gratifying opportunity for therapeutic intervention. Although there often appears to be initial radiological improvement after ERCP, the benefit as measured by serial estimations of subsequent liver enzymes is questionable. The fluctuating course of the inflammatory process makes the interpretation of serology even more difficult.

  6. Serotonergic projections from the raphe nuclei to the subthalamic nucleus; a retrograde- and anterograde neuronal tracing study

    DEFF Research Database (Denmark)

    Reznitsky, Martin; Plenge, Per; Hay-Schmidt, Anders

    2016-01-01

    the 5-HT1A and 5-HT2A not were present. Retrograde tracer FluoroGold or Choleratoxin subunit B were iontophoretically delivered in the STN and combined with immunohistochemistry for 5-HT in order to map the topographic organization in the dorsal raphe system. The study showed that approximately 320...

  7. Kinesin-3 and dynein cooperate in long-range retrograde endosome motility along a nonuniform microtubule array

    NARCIS (Netherlands)

    Schuster, M.; Kilaru, S.; Fink, G.; Collemare, J.A.R.; Roger, Y.; Steinberg, G.

    2011-01-01

    The polarity of microtubules (MTs) determines the motors for intracellular motility, with kinesins moving to plus ends and dynein to minus ends. In elongated cells of Ustilago maydis, dynein is thought to move early endosomes (EEs) toward the septum (retrograde), whereas kinesin-3 transports them to

  8. Deficiency in the Lipid Exporter ABCA1 Impairs Retrograde Sterol Movement and Disrupts Sterol Sensing at the Endoplasmic Reticulum.

    Science.gov (United States)

    Yamauchi, Yoshio; Iwamoto, Noriyuki; Rogers, Maximillian A; Abe-Dohmae, Sumiko; Fujimoto, Toyoshi; Chang, Catherine C Y; Ishigami, Masato; Kishimoto, Takuma; Kobayashi, Toshihide; Ueda, Kazumitsu; Furukawa, Koichi; Chang, Ta-Yuan; Yokoyama, Shinji

    2015-09-25

    Cellular cholesterol homeostasis involves sterol sensing at the endoplasmic reticulum (ER) and sterol export from the plasma membrane (PM). Sterol sensing at the ER requires efficient sterol delivery from the PM; however, the macromolecules that facilitate retrograde sterol transport at the PM have not been identified. ATP-binding cassette transporter A1 (ABCA1) mediates cholesterol and phospholipid export to apolipoprotein A-I for the assembly of high density lipoprotein (HDL). Mutations in ABCA1 cause Tangier disease, a familial HDL deficiency. Several lines of clinical and experimental evidence suggest a second function of ABCA1 in cellular cholesterol homeostasis in addition to mediating cholesterol efflux. Here, we report the unexpected finding that ABCA1 also plays a key role in facilitating retrograde sterol transport from the PM to the ER for sterol sensing. Deficiency in ABCA1 delays sterol esterification at the ER and activates the SREBP-2 cleavage pathway. The intrinsic ATPase activity in ABCA1 is required to facilitate retrograde sterol transport. ABCA1 deficiency causes alternation of PM composition and hampers a clathrin-independent endocytic activity that is required for ER sterol sensing. Our finding identifies ABCA1 as a key macromolecule facilitating bidirectional sterol movement at the PM and shows that ABCA1 controls retrograde sterol transport by modulating a certain clathrin-independent endocytic process.

  9. Effects of charge-carrying amino acids on the gelatinization and retrogradation properties of potato starch.

    Science.gov (United States)

    Chen, Wenting; Zhou, Hongxian; Yang, Hong; Cui, Min

    2015-01-15

    The objective of this study was to evaluate the effects of charge-carrying amino acids (lysine (Lys), arginine (Arg), aspartic acid (Asp) and glutamic acid (Glu)) on the gelatinization and retrogradation properties of potato starch. Acidic amino acids (Asp and Glu) showed a decreasing trend in swelling power and granule size of potato starch, but increased amylose leaching and gelatinization temperature. Alkaline amino acid (Arg) showed an increasing trend in swelling power and granule size of potato starch, but decreasing amylose leaching and gelatinization temperature. Lys had no effect on the swelling power of potato starch, except at a high content (0.2 mol/kg). Like other two acidic amino acids, Lys also increased gelatinization temperature. Moreover, the addition of alkaline amino acids (Arg) decreased syneresis value of potato starch but acidic amino acids (Asp and Glu) increased it. Compared to Arg, the syneresis of potato starch with Lys was similar to that of its native starch.

  10. NSAIDs for prevention of pancreatitis after endoscopic retrograde cholangiopancreatography: Ready for prime time?

    Institute of Scientific and Technical Information of China (English)

    Mansour A Parsi

    2012-01-01

    Acute pancreatitis is the most common and the most fearful complication of endoscopic retrograde cholangiopancreatography (ERCP).Prevention of post-ERCP pancreatitis has therefore been of great interest to endoscopists performing ERCP procedures.So far,only pancreatic duct stenting during ERCP and rectal administration of a non-steroidal anti-inflammatory drug (NSAID) prior to or immediately after ERCP have been consistently shown to be effective for prevention of post-ERCP pancreatitis.This commentary focuses on a short discussion about the rates,mechanisms,and risk factors for post-ERCP pancreatitis,and effective means for its prevention with emphasis on the use of NSAIDs including a recent clinical trial published in The New England Journal of Medicine by Elmunzer et al[11].

  11. Retrograde delivery of stem cells: promising delivery strategy for myocardial regenerative therapy.

    Science.gov (United States)

    Wu, Kaihong; Mo, Xuming; Lu, Shihong; Han, Zhongchao

    2011-01-01

    Heart failure is a leading cause of morbidity and mortality worldwide. The current strategies for treatment are limited, and new therapeutic approaches are needed. Experimental studies and clinical trials suggest that stem cell transplantation may improve cardiac function and prevent cardiac remodeling of the injured heart. Although the results of the studies were exciting, many problems remain to be resolved such as the best method of delivering the targeted cells. Direct injection into the myocardium and intracoronary artery infusion are the two most used methods of delivery in clinical settings. However, in a portion of patients with occluded coronary arteries and poor collaterals, transplanted cells may not reach the target ischemic lesion. To resolve this problem, we hypothesize that retrograde coronary venous delivery of stem cells may be a promising therapeutic strategy for the patients with occluded coronary arteries and poor collaterals.

  12. Gravitational Loss-Cone Instability in Stellar Systems with Retrograde Orbit Precession

    CERN Document Server

    Polyachenko, E V; Shukhman, I G

    2006-01-01

    We examine disk and spherical stellar systems of nearly radial orbits with retrograde orbit precession. Such systems are stable to the well known radial orbit instability. If there is a loss cone at low angular momentum, an instability similar to loss-cone instability in plasma may occur. Examples of systems with loss cone are the centers of galaxies or star clusters containing a massive black hole. The instability can cause an inward flux of stars to the galactic center fuelling nuclear activity. The study is based on simple characteristic equations describing small perturbations in a disk or a sphere of stellar orbits highly elongated in radius. These characteristic equations are derived from the linearized Vlasov equations (combining the collisionless Boltzmann kinetic equation and the Poisson equation), using the action - angle variables. We use two techniques for analyzing the characteristic equations: the first one is based on preliminary finding of neutral modes, and the second one employs a counterpar...

  13. Dual Targeting and Retrograde Translocation: Regulators of Plant Nuclear Gene Expression Can Be Sequestered by Plastids

    Directory of Open Access Journals (Sweden)

    Karin Krupinska

    2012-09-01

    Full Text Available Changes in the developmental or metabolic state of plastids can trigger profound changes in the transcript profiles of nuclear genes. Many nuclear transcription factors were shown to be controlled by signals generated in the organelles. In addition to the many different compounds for which an involvement in retrograde signaling is discussed, accumulating evidence suggests a role for proteins in plastid-to-nucleus communication. These proteins might be sequestered in the plastids before they act as transcriptional regulators in the nucleus. Indeed, several proteins exhibiting a dual localization in the plastids and the nucleus are promising candidates for such a direct signal transduction involving regulatory protein storage in the plastids. Among such proteins, the nuclear transcription factor WHIRLY1 stands out as being the only protein for which an export from plastids and translocation to the nucleus has been experimentally demonstrated. Other proteins, however, strongly support the notion that this pathway might be more common than currently believed.

  14. Ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography in the morphologic diagnosis of pancreatic disease

    Energy Technology Data Exchange (ETDEWEB)

    Swobodnik, W.; Meyer, W.; Brecht-Kraus, D.; Wechsler, J.G.; Geiger, S.; Malfertheiner, P.; Junge, U.; Ditschuneit, H.

    1983-03-15

    From February to November 1981 the diagnostic relevance of ultrasound (US), computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) was compared prospectively in 75 patients with suspected pancreatic disease. Final diagnosis was confirmed by autopsy, surgery, clinical course, and further laboratory data. Thus it was possible to exclude pancreatic disorders in 32 patients. By ERCP we diagnosed all tumors; sensitivity was 100%. Sensitivity of US and CT were 63% each. In five cases US made the false positive diagnosis' pancreatic malignant tumor' (specifity 93%), CT and ERCP in two cases (specifity 97% each). In chronic pancreatitis specifity of US and ERCP were 100% and specifity of CT was 98%. Sensitivity of ERCP amounted to 93%, CT and US revealed 74% and 52%, respectively. We conclude that ERCP is the best morphologic diagnostic tool in differentiating chronic pancreatitis from pancreatic carcinoma. US is a good screening method and CT reveals good diagnostic results in acute pancreatitis.

  15. Diclofenac Is Associated With a Reduced Incidence of Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis

    DEFF Research Database (Denmark)

    Leerhøy, Bonna; Nordholm-Carstensen, Andreas; Novovic, Srdan;

    2014-01-01

    with a native papilla Vateri subjected to ERCP during 2010 (control group, n = 218) and 2012 (diclofenac group, n = 182) were included. Patients with a history of chronic pancreatitis or recent acute pancreatitis were excluded. From January 2012, a rectal suppository containing 100 mg of diclofenac......OBJECTIVE: The aim of this study was to assess the clinical effect of diclofenac administered as a single dose for the prevention of postprocedure pancreatitis in a consecutive series of patients who had undergone endoscopic retrograde cholangiopancreatography (ERCP). METHODS: Patients...... was administered immediately after endoscopy in all patients. The primary outcome of post-ERCP pancreatitis was assessed retrospectively by reviewing the patients' charts. RESULTS: The overall incidence of post-ERCP pancreatitis was 32 (14.7%) of the 218 patients in the control group and 9 (4.9%) of the 182...

  16. Early endoscopic retrograde cholangiopancreatography after laparoscopic cholecystectomy can strain the occurrence of trocar site hernia

    Institute of Scientific and Technical Information of China (English)

    Fatih; Sumer; Cuneyt; Kayaalp; Mehmet; Ali; Yagci; Emrah; Otan; Huseyin; Kocaaslan

    2014-01-01

    This study reports a 69-year-old, obese, female patientpresenting with a biliary leakage after laparoscopiccholecystectomy for cholelithiasis. Closure of the um-bilical trocar site had been neglected during the lapa-roscopic cholecystectomy. Early, on postoperative dayfive, endoscopic retrograde cholangiopancreatography(ERCP) requirement after laparoscopic cholecystectomyresolved the biliary leakage problem but resulted with amore complicated clinical picture with an intestinal ob-struction and severe abdominal pain. Computed tomog-raphy revealed a strangulated hernia from the umbilicaltrocar site. Increased abdominal pressure during ERCPhad strained the weak umbilical trocar site. Emergencysurgical intervention through the umbilicus revealed anischemic small bowel segment which was treated withresection and anastomosis. This report demonstratesthat negligence of trocar site closure can result in veryearly herniation, particularly if an endoscopic interven-tion is required in the early postoperative period.

  17. Management of the dry ejaculate: a systematic review of aspermia and retrograde ejaculation.

    Science.gov (United States)

    Mehta, Akanksha; Sigman, Mark

    2015-11-01

    A dry ejaculate (aspermia), may occur either because of an inability to transport semen (anejaculation) or because of an inability to ejaculate in an antegrade direction (retrograde ejaculation). The treatment of aspermia varies with underlying etiology and includes medical therapy with sympathomimetics, urinary sperm retrieval, bladder neck reconstruction, prostatic massage, penile vibratory stimulation, electroejaculation, and surgical sperm retrieval. A systematic review of the current literature was performed for articles on ejaculatory dysfunction related to dry ejaculate. However, the data are insufficient to allow firm comparisons between treatment options. Treatments must be tailored to the individual patient, and treatment decisions should involve consideration of ease of administration, degree of invasiveness, and anticipated success. PMID:26432530

  18. Fatal air embolism during endoscopic retrograde cholangiopancreatography (ERCP): An 'impossible' diagnosis for the forensic pathologist.

    Science.gov (United States)

    Marchesi, Matteo; Battistini, Alessio; Pellegrinelli, Moira; Gentile, Guendalina; Zoja, Riccardo

    2016-01-01

    Fatal air embolism related to endoscopic retrograde cholangiopancreatography is a very rare phenomenon. The authors describe the case of a 51-year-old female patient who developed this mortal complication; a computed tomography (CT) examination was performed in articulo mortis by the physicians. Autopsy was unreliable because of bizarre post-mortem changes (reabsorption of intra-cardiac gas vs. conservation of intra-cranial gas) and a lack of strong diagnostic value of histological findings. The right diagnosis was possible thanks only to the CT examination that permitted the assumption of this possible cause of death before the autopsy and to prepare the necessary procedures to recognise and probe air embolism. This case exemplifies how early post-mortem imaging can be crucial to avoid a wrong diagnosis.

  19. Early endoscopic retrograde cholangiopancreatography after laparoscopic cholecystectomy can strain the occurrence of trocar site hernia.

    Science.gov (United States)

    Sumer, Fatih; Kayaalp, Cuneyt; Yagci, Mehmet Ali; Otan, Emrah; Kocaaslan, Huseyin

    2014-11-16

    This study reports a 69-year-old, obese, female patient presenting with a biliary leakage after laparoscopic cholecystectomy for cholelithiasis. Closure of the umbilical trocar site had been neglected during the laparoscopic cholecystectomy. Early, on postoperative day five, endoscopic retrograde cholangiopancreatography (ERCP) requirement after laparoscopic cholecystectomy resolved the biliary leakage problem but resulted with a more complicated clinical picture with an intestinal obstruction and severe abdominal pain. Computed tomography revealed a strangulated hernia from the umbilical trocar site. Increased abdominal pressure during ERCP had strained the weak umbilical trocar site. Emergency surgical intervention through the umbilicus revealed an ischemic small bowel segment which was treated with resection and anastomosis. This report demonstrates that negligence of trocar site closure can result in very early herniation, particularly if an endoscopic intervention is required in the early postoperative period. PMID:25400872

  20. Retrograde Labeling of Adult Rat Retinal Ganglion Cells with the Flurogold

    Institute of Scientific and Technical Information of China (English)

    Wei Huang; Yannian Hui; Miaoli Zhang

    2000-01-01

    Purpose: To study the densities and distribution of retinal ganglion cells(RGC) in adult rat retinae with flurogold(FG) labeling retogradely.Methods: FG was injected to the superior colliculi(SC) and dorsal lateral geniculate nuclei (dLGN) in adult rats and the retinae were examined by fluorescence microscopy at various periods of time.Results: FG-labelled RGC were observed in the retina as early as 3 days after application of FG. The labelled cells gradually increased in density, reached 95% of the maximal number on days 7 and the maximal number on days 30. The density of labelled cells was higher in the posterior pole than in the peripheral area. The fluorescence intensity in labelled cells maintained up to 60 days.Conclusion: The FG retrograde labeling method is reliable and effective for quantity of RGC. Eye Science 2000; 16:29 ~ 33.

  1. Retrograde Labeling of Adult Rat Retinal Ganglion Cells with the Flurogold

    Institute of Scientific and Technical Information of China (English)

    WeiHuang; YannianHui; 等

    2002-01-01

    Purpose:To study the densities and distribution of retinal ganglion cells(RGC) in adult rat retinae with flurogold(FG) labeling retogradely.Methods:FG was injected to the superior colliculid(SC) and dorsal lateral geniculate nuclei(dLGN) in adult rats and the retinae were examined by fluorescence microscopy at various periods of time.Results:FG-labelled RGC were observed in the retina as early as 3 days after application of FG.The labeled cells gradually increased in density,reached 95% of the maximal number on days 7 and the maximal nuber on days 30.The density of labeled cells was higher in the posterior pole than in the peripheral area.The fluorescence intensity in labeled cells maintained up to 60 days.Conclusion:The FG retrograde labeling method is reliable and effective for quantity of RGC.Eye Science 2000;46:29-33.

  2. Biliary and pancreatic stenting: Devices and insertion techniques in therapeutic endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography.

    Science.gov (United States)

    Mangiavillano, Benedetto; Pagano, Nico; Baron, Todd H; Arena, Monica; Iabichino, Giuseppe; Consolo, Pierluigi; Opocher, Enrico; Luigiano, Carmelo

    2016-02-10

    Stents are tubular devices made of plastic or metal. Endoscopic stenting is the most common treatment for obstruction of the common bile duct or of the main pancreatic duct, but also employed for the treatment of bilio-pancreatic leakages, for preventing post- endoscopic retrograde cholangiopancreatography pancreatitis and to drain the gallbladder and pancreatic fluid collections. Recent progresses in techniques of stent insertion and metal stent design are represented by new, fully-covered lumen apposing metal stents. These stents are specifically designed for transmural drainage, with a saddle-shape design and bilateral flanges, to provide lumen-to-lumen anchoring, reducing the risk of migration and leakage. This review is an update of the technique of stent insertion and metal stent deployment, of the most recent data available on stent types and characteristics and the new applications for biliopancreatic stents. PMID:26862364

  3. Indomethacin for post-endoscopic retrograde cholangiopancreatography pancreatitis prophylaxis: Is it the magic bullet?

    Institute of Scientific and Technical Information of China (English)

    Dennis Yang; Peter V Draganov

    2012-01-01

    Acute pancreatitis is a common complication of endoscopic retrograde cholangiopancreatography (ERCP).Pancreatic duct stent insertion after ERCP has been widely accepted as the standard of care for the prevention of this complication in high-risk patients.Unfortunately,the placement of pancreatic stents requires higher level of endoscopic expertise and is not always feasible due to anatomic considerations.Therefore,effective non-invasive pharmacologic prophylaxis remains appealing,particularly if it is inexpensive,easily administered,has a low risk side effect profile and is widely available.There have been multiple studies evaluating potential pharmacologic candidates for post-ERCP pancreatitis (PEP) prophylaxis,most of them yielding disappointing results.A recently published large,multicenter,randomized controlled trial reported that in high risk patients a single dose of rectal indomethacin administered immediately after the ERCP significantly decreased the incidence of PEP compare to placebo.

  4. Regeneration of unmyelinated and myelinated sensory nerve fibres studied by a retrograde tracer method

    DEFF Research Database (Denmark)

    Lozeron, Pierre; Krarup, Christian; Schmalbruch, Henning

    2004-01-01

    Regeneration of myelinated and unmyelinated sensory nerve fibres after a crush lesion of the rat sciatic nerve was investigated by means of retrograde labelling. The advantage of this method is that the degree of regeneration is estimated on the basis of sensory somata rather than the number of...... axons. Axonal counts do not reflect the number of regenerated neurons because of axonal branching and because myelinated axons form unmyelinated sprouts. Two days to 10 weeks after crushing, the distal sural or peroneal nerves were cut and exposed to fluoro-dextran. Large and small dorsal root ganglion...... large neurons after crush and regeneration than in controls, indicating that regeneration of small neurons was less complete than that of large ones. This contrasted with the fact that unmyelinated axons in the regenerated sural nerve after 74 days were only slightly reduced....

  5. The apical leakage of mineral trioxide aggregate as the retrograde filling material with various mixing agents

    Directory of Open Access Journals (Sweden)

    Ema Mulyawati

    2010-06-01

    Full Text Available Background: Mineral trioxide aggregate (MTA is relatively considered as a new material in endodontic. It even has been used as retrograde filling material due to its biocompatibility, antibacterial effect, sealing ability and anti-moist effect. Some materials have been used as mixing agent to achieve an appropiate setting of MTA. Purpose: The aim of this study is to investigate the effect of the mixing agents of MTA towards the apical leakage when they are used together as retrograde filling materials. Method: The samples of this research consist of 30 human extracted upper central incisors. First, the crown of each tooth is sectioned. The root canals are prepared by using the conventional technique and then are obturated with gutta percha. After cutting the root apex, 2 mm from apical, class 1 cavities are prepared by using fissure bur with the depth of 3 mm. The samples then are divided into 3 groups with 10 teeth for each. Group I uses aquabidest as mixing agent of MTA (MTA-aquabidest, group II uses saline (MTA-saline, while group III uses 0.12% chlorhexidine (MTA-chlorhexidine. The apex of each group then is filled with the mixing MTA determined already. Afterwards, clearing method is used to evaluate the apical leakage. The apical leakage actually is determined by measuring the depth of methylene blue penetration with stereomicroscope. The statictical analyses of the linear dye penetration then are performed with analysis of varians ANOVA. Result: The dye penetration for both MTA-aquadest and MTA-saline groups indicates the lowest penetration, and there is even a significant difference compared with MTA-0.12% chlorhexidine group (p<0.005. Conclusion: It can be concluded that aquabidest and saline as mixing agents of MTA produce less apical leakage compared with 0.12% chlorhexidine.Latar belakang: Mineral trioxide aggregate (MTA merupakan bahan yang relatif baru dalam bidang endodontik. Bahan tersebut diindikasikan sebagai bahan pengisi

  6. Tension pneumothorax complicating endoscopic retrograde cholangiopancreatography: case report and systematic literature review.

    Science.gov (United States)

    Al-Ashaal, Yousef I; Hefny, Ashraf F; Safi, Farouk; Abu-Zidan, Fikri M

    2011-01-01

    Perforation of the duodenum, which is usually retroperitoneal, is a known complication of endoscopic retrograde cholangiopancreatography (ERCP). Association of the duodenal perforation with pneumothorax is rare and the development of tension pneumothorax is even rarer. We report a case of tension pneumothorax following an ERCP, which we successfully treated with chest tube insertion and laparotomy, and systematically review the other 10 cases reported in the literature. Four of these 10 cases had tension pneumothorax. All were to the right side of the chest. Patients were mainly female (7/10). The median (range) age was 70.5 (55-89) years. Four patients required surgery (40%) and one patient, who was not operated on, died (10%). Clinicians should be aware of this serious complication. Unexplained chest pain, dyspnoea, and oxygen desaturation with abdominal distension during ERCP must raise this possibility. Early clinical recognition and prompt management is essential to improve the outcome.

  7. Cateterismo retrógrado em neuro-radiologia Retrograde catheterization in Neuro-radiology

    Directory of Open Access Journals (Sweden)

    Sérgio F. Raupp

    1970-06-01

    Full Text Available The bases and technical cares for the neuro-radiological study of the aorto-cervical and spinal vessels employing the retrograde catheterization according to Seldinger technic and with the Odman-Ledin catheters are reported. The authors recommend type II neuroleptanalgesia as anesthesical sedative and the use of percutaneous punction of the femoral artery or, by choice, of the axilar or humeral artery. For the selective catheterization by femoral via, they make previously an aortography, in order to know the anatomy of the supra-aortic vessels, with control through the image-inten-sifier or fluoroscopy. They employ manual injection for the study of the supra-aortic vessels and a Gidlung injector for the contrast of the ascending aorta. Complications are discussed.

  8. Post–Endoscopic Retrograde Cholangiopancreaticography complications in liver transplanted patients, a single-center experience

    DEFF Research Database (Denmark)

    Ambrus, R B; Svendsen, Lars Bo; Hillingsø, J G;

    2015-01-01

    BACKGROUND: Complications in the biliary tract occur in 5%-30% after liver transplantation and the main part of the complications is successfully managed with endoscopic retrograde cholangiopancreaticography (ERCP). The incidence and risk factors for post-ERCP complications in liver transplantation...... patients are not well described. Our objective was to define the frequency of post-ERCP complications in liver transplantation patients at the Abdominal Center, Rigshospitalet, the only Liver Transplantation Center in Denmark. METHODS: Retrospective study of all ERCPs performed in liver transplantation...... cholangitis occurred after two procedures, respectively. Multivariate analysis concerning overall complications identified biliary sphincterotomy (p = 0.006) and time since liver transplantation within 90 days postoperatively (p = 0.044) as risk factors for post-ERCP complications. Specifically concerning...

  9. Percutaneous Retrograde Recanalization of a Chronic Total Coronary Artery Occlusion in a 7 Year Old

    Energy Technology Data Exchange (ETDEWEB)

    Natal-Hernandez, Luz; Meadows, Jeffery; Shunk, Kendrick A.; Boyle, Andrew J., E-mail: aboyle@medicine.ucsf.edu

    2013-03-15

    The arterial switch operation for correction of transposition of the great arteries can be complicated by late stenosis or occlusion of the coronary arteries that are re-implanted to the new aorta. We report the case of a young boy who underwent this operation as a neonate and was found to have an occluded anomalous left anterior descending artery (LAD) before age 3. Subsequent bypass surgery was complicated by anastomotic stricture and kinking of the left internal mammary artery graft to the LAD. At age 7, the LAD territory showed reversible ischemia on nuclear perfusion testing and he was referred for percutaneous coronary intervention. A combined approach with pediatric and adult interventional cardiologists resulted in successful retrograde PCI to recanalize the chronic total occlusion of the LAD. Important features of this technique in pediatric patients are discussed.

  10. Fatal air embolism during endoscopic retrograde cholangiopancreatography (ERCP): An 'impossible' diagnosis for the forensic pathologist.

    Science.gov (United States)

    Marchesi, Matteo; Battistini, Alessio; Pellegrinelli, Moira; Gentile, Guendalina; Zoja, Riccardo

    2016-01-01

    Fatal air embolism related to endoscopic retrograde cholangiopancreatography is a very rare phenomenon. The authors describe the case of a 51-year-old female patient who developed this mortal complication; a computed tomography (CT) examination was performed in articulo mortis by the physicians. Autopsy was unreliable because of bizarre post-mortem changes (reabsorption of intra-cardiac gas vs. conservation of intra-cranial gas) and a lack of strong diagnostic value of histological findings. The right diagnosis was possible thanks only to the CT examination that permitted the assumption of this possible cause of death before the autopsy and to prepare the necessary procedures to recognise and probe air embolism. This case exemplifies how early post-mortem imaging can be crucial to avoid a wrong diagnosis. PMID:26209631

  11. Oral allopurinol to prevent hyperamylasemia and acute pancreatitis after endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Hector Martinez-Torres; Xochilt Rodriguez-Lomeli; Carlos Davalos-Cobian; Jesus Garcia-Correa; Juan Manuel Maldonado-Martinez; Fabiola Medrano-Mu(n)oz; Clotilde Fuentes-Orozco; Alejandro Gonzalez-Ojeda

    2009-01-01

    AIM: To assess the efficacy of allopurinol to prevent hyperamylasemia and pancreatitis after endoscopic retrograde cholangiopancreatography (PEP). METHODS: One hundred and seventy patients were enrolled and randomized to two groups: a study group ( n = 85) who received 300 mg of oral allopurinol at 15 h and 3 h before endoscopic retrograde cholangiopancreatography (ERCP) and a control group ( n = 85) receiving an oral placebo at the same times. Main Outcome Measurements included serum amylase levels and the number severity of the episodes of pancreatitis. Serum amylase levels were classified as normal (<150 IU/L) or hyperamylasemia (>151 IU/L). Episodes of PEP were classified following Ranson's criteria and CT severity index. RESULTS: Gender distribution was similar between groups. Mean age was 53.5 ± 18.9 years for study group and 52.8 ± 19.8 years for controls. Also, the distribution of benign pathology was similar between groups. Hyperamylasemia was more common in the control group ( P = 0.003). Mild PEP developed in two patients from the study group (2.3%) and eight (9.4%) from control group ( P = 0.04), seven episodes were observed in high-risk patients of the control group (25%) and one in the allopurinol group (3.3%, P = 0.02). Risk factors for PEP were precut sphincterotomy ( P = 0.02),pancreatic duct manipulation ( P = 0.002) and multiple procedures ( P = 0.000). There were no deaths or side effects.CONCLUSION: Oral allopurinol before ERCP decreased the incidences of hyperamylasemia and pancreatitis in patients submitted to high-risk procedures.

  12. Uncoupling High Light Responses from Singlet Oxygen Retrograde Signaling and Spatial-Temporal Systemic Acquired Acclimation.

    Science.gov (United States)

    Carmody, Melanie; Crisp, Peter A; d'Alessandro, Stefano; Ganguly, Diep; Gordon, Matthew; Havaux, Michel; Albrecht-Borth, Verónica; Pogson, Barry J

    2016-07-01

    Distinct ROS signaling pathways initiated by singlet oxygen ((1)O2) or superoxide and hydrogen peroxide have been attributed to either cell death or acclimation, respectively. Recent studies have revealed that more complex antagonistic and synergistic relationships exist within and between these pathways. As specific chloroplastic ROS signals are difficult to study, rapid systemic signaling experiments using localized high light (HL) stress or ROS treatments were used in this study to uncouple signals required for direct HL and ROS perception and distal systemic acquired acclimation (SAA). A qPCR approach was chosen to determine local perception and distal signal reception. Analysis of a thylakoidal ascorbate peroxidase mutant (tapx), the (1)O2-retrograde signaling double mutant (ex1/ex2), and an apoplastic signaling double mutant (rbohD/F) revealed that tAPX and EXECUTER 1 are required for both HL and systemic acclimation stress perception. Apoplastic membrane-localized RBOHs were required for systemic spread of the signal but not for local signal induction in directly stressed tissues. Endogenous ROS treatments revealed a very strong systemic response induced by a localized 1 h induction of (1)O2 using the conditional flu mutant. A qPCR time course of (1)O2 induced systemic marker genes in directly and indirectly connected leaves revealed a direct vascular connection component of both immediate and longer term SAA signaling responses. These results reveal the importance of an EXECUTER-dependent (1)O2 retrograde signal for both local and long distance RBOH-dependent acclimation signaling that is distinct from other HL signaling pathways, and that direct vascular connections have a role in spatial-temporal SAA induction. PMID:27288360

  13. Pilot acute study of feedback-controlled retrograde peristalsis invoked by neural gastric electrical stimulation

    International Nuclear Information System (INIS)

    Neural gastric electrical stimulation (NGES) is a new method for invoking gastric contractions under microprocessor control. However, optimization of this technique using feedback mechanisms to minimize power consumption and maximize effectiveness has been lacking. The present pilot study proposes a prototype feedback-controlled neural gastric electric stimulator for the treatment of obesity. Both force-based and inter-electrode impedance-based feedback neurostimulators were implemented and tested. Four mongrel dogs (2 M, 2 F, weight 14.9 ± 2.3 kg) underwent subserosal implantation of two-channel, 1 cm, bipolar electrode leads and two force transducers in the distal antrum. Two of the dogs were stimulated with a force feedback system utilizing the force transducers, and the other two animals were stimulated utilizing an inter-electrode impedance-based feedback system utilizing the proximal electrode leads. Both feedback systems were able to recognize erythromycin-driven contractions of the stomach and were capable of overriding them with NGES-invoked retrograde contractions which exceeded the magnitudes of the erythromycin-driven contractions by an average of 100.6 ± 33.5% in all animals. The NGES-invoked contractions blocked the erythromycin-driven contractions past the proximal electrode pair and induced temporary gastroparesis in the vicinity of the distal force transducer despite the continuing erythromycin infusion. The amplitudes of the erythromycin-invoked contractions in the vicinity of the proximal force transducer decreased abruptly by an average of 47.9 ± 6.3% in all four dogs after triggering-invoked retrograde contractions, regardless of the specific feedback-controlled mechanism. The proposed technique could be helpful for retaining food longer in the stomach, thus inducing early satiety and diminishing food intake

  14. Technical difficulties and success of endoscopic retrograde colangiopancreatography in a group of patients

    Directory of Open Access Journals (Sweden)

    Pedro Juan Vázquez González

    2011-04-01

    Full Text Available Background: Endoscopic Retrograde Cholangiopancreatography has been effective in the diagnosis and treatment of diseases of the biliopancreatic system. Objective: To determine the grade of technical difficulties and the success of cholangiopancreatography in a group of patients. Methods: prospective, descriptive, observational study that included all the patients who were tested through this procedure from January to December 2009 in the hospital “Dr. Gustavo Aldereguía Lima” from Cienfuegos. Inclusion and exclusion criteria were applied so the sample was composed by 34 patients. In order to define the technical difficulty of this test Madhotra’s difficulty modified test was used. Results: 67,6 % of the patients were males. Age comprised the interval from 31 to 90 years old patients with a mean age of 60.8±16 years. Cholestatic icterus was the predominant medical indication in (55,9 %, followed by choledocholitiasis (26,5 %. Echogram showed normal results in 41,2 % of the patients. The most frequent diagnosis of this test was postcholecystectomy with dilated biliary tract (17,6 % followed by choledocho and cholelithiasis (14,7 % each one. The grade of technical difficulty was 1 in 91,2 %, grade 2 in 8,8 %. A complete technical success was obtained in 55,9 %, partial success was obtained in 32,3 % and the attempt failed in 11,8 % of the patients. Conclusion: the grade of technical difficulty can influence upon the success of Endoscopic Retrograde Cholangiopancreatography. Its usefulness has been demonstrated with a minimum amount of complications for the patient.

  15. Synthesis of partial stabilized cement–gypsum as new dental retrograde filling material

    International Nuclear Information System (INIS)

    The study describes the sol–gel synthesis of a new dental retrograde filling material partial stabilized cement (PSC)–gypsum by adding different weight percentage of gypsum (25% PSC + 75% gypsum, 50% PSC + 50% gypsum and 75% PSC + 25% gypsum) to the PSC. The crystalline phase and hydration products of PSC–gypsum were characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM) analysis. The handling properties such as setting time, viscosity, tensile strength, porosity and pH, were also studied. The XRD and microstructure analysis demonstrated the formation of hydroxyapatite and removal of calcium dihydrate during its immersion in simulated body fluid (SBF) on day 10 for 75% PSC + 25% gypsum. The developed PSC–gypsum not only improved the setting time but also greatly reduced the viscosity, which is very essential for endodontic surgery. The cytotoxic and cell proliferation studies indicated that the synthesized material is highly biocompatible. The increased alkaline pH of the PSC–gypsum also had a remarkable antibacterial activity. - Highlights: ► A new dental retrograde filling material PSC–gypsum was developed. ► PSC–gypsum cement has shown excellent initial and final setting time as 15–35 min. ► It not only improved the setting time but also retain the viscosity, 2 Pa·s. ► High alkaline pH of the cement had a remarkable antibacterial activity. ► Cytotoxicity studies revealed that the synthesized material is highly biocompatible.

  16. MICROLEAKAGE ASSOCIATED WITH RETROGRADE FILLING AFTER ROOT END RESECTION (in vitro study

    Directory of Open Access Journals (Sweden)

    Elka Radeva

    2014-09-01

    Full Text Available The purpose of the study is to compare microleakage after root end resection of the two materials (MTA and Biodentine for two different apical cavity preparation using the method of penetration of dye - 0, 2 % Rodamine B. Materials and Methods: Forty-eight extracted single-rooted human teeth were used in this study. The resection was made at 3 mm from the root tip with a high speed diamond bur at an angle of 90 degree to the long axis of the tooth. For the retrofilling, ProRoot MTA and Biodentine were used. The teeth were divided into 5 groups: 1st group (10 teeth – the apical cavity was prepared with stainless steel fissure bur #10 at 3 mm depth in the root canal parallel to the long axis of the tooth and is filled retrograde with MTA. 3rd group (10 teeth - retrofilling with Biodentine. 2 nd group (10 teeth - with a round bur apical cavity was prepared with a concave shape and cavity along the root canal with a depth of 3 mm and retrograde obturation with MTA. 4th group (10 teeth - retrofilling with Biodentine. 5th group (8 teeth - control group - with preparation of the cavity after resection without retrofilling. The outer surface of the root is covered with two layers of varnish, with the exception of the apical 3 mm then immersed in 0.2% Rodamine B for 72 h. The degree of penetration of the dye is measured in millimeters. Results: Relative highest median value of penetration of the dye in mm is in the control group. MTA group has a higher value in mm versus the Biodentine. The apical preparation with a concave shape and cavity along the root canal with a depth of 3 mm after apicoectomy is important to reduce apical microleakage. Conclusion: Different apical cavity preparations in both types of material have led to the microleakage dye, but to varying degrees.

  17. Quantification of retrograde axonal transport in the rat optic nerve by fluorogold spectrometry.

    Directory of Open Access Journals (Sweden)

    Christian van Oterendorp

    Full Text Available PURPOSE: Disturbed axonal transport is an important pathogenic factor in many neurodegenerative diseases, such as glaucoma, an eye disease characterised by progressive atrophy of the optic nerve. Quantification of retrograde axonal transport in the optic nerve usually requires labour intensive histochemical techniques or expensive equipment for in vivo imaging. Here, we report on a robust alternative method using Fluorogold (FG as tracer, which is spectrometrically quantified in retinal tissue lysate. METHODS: To determine parameters reflecting the relative FG content of a sample FG was dissolved in retinal lysates at different concentrations and spectra were obtained. For validation in vivo FG was injected uni- or bilaterally into the superior colliculus (SC of Sprague Dawley rats. The retinal lysate was analysed after 3, 5 and 7 days to determine the time course of FG accumulation in the retina (n = 15. In subsequent experiments axona transport was impaired by optic nerve crush (n = 3, laser-induced ocular hypertension (n = 5 or colchicine treatment to the SC (n = 10. RESULTS: Spectrometry at 370 nm excitation revealed two emission peaks at 430 and 610 nm. We devised a formula to calculate the relative FG content (c(FG, from the emission spectrum. c(FG is proportional to the real FG concentration as it corrects for variations of retinal protein concentration in the lysate. After SC injection, c(FG monotonously increases with time (p = 0.002. Optic nerve axonal damage caused a significant decrease of c(FG (crush p = 0.029; hypertension p = 0.025; colchicine p = 0.006. Lysates are amenable to subsequent protein analysis. CONCLUSIONS: Spectrometrical FG detection in retinal lysates allows for quantitative assessment of retrograde axonal transport using standard laboratory equipment. It is faster than histochemical techniques and may also complement morphological in vivo analyses.

  18. Rabies Virus Hijacks and accelerates the p75NTR retrograde axonal transport machinery.

    Science.gov (United States)

    Gluska, Shani; Zahavi, Eitan Erez; Chein, Michael; Gradus, Tal; Bauer, Anja; Finke, Stefan; Perlson, Eran

    2014-08-01

    Rabies virus (RABV) is a neurotropic virus that depends on long distance axonal transport in order to reach the central nervous system (CNS). The strategy RABV uses to hijack the cellular transport machinery is still not clear. It is thought that RABV interacts with membrane receptors in order to internalize and exploit the endosomal trafficking pathway, yet this has never been demonstrated directly. The p75 Nerve Growth Factor (NGF) receptor (p75NTR) binds RABV Glycoprotein (RABV-G) with high affinity. However, as p75NTR is not essential for RABV infection, the specific role of this interaction remains in question. Here we used live cell imaging to track RABV entry at nerve terminals and studied its retrograde transport along the axon with and without the p75NTR receptor. First, we found that NGF, an endogenous p75NTR ligand, and RABV, are localized in corresponding domains along nerve tips. RABV and NGF were internalized at similar time frames, suggesting comparable entry machineries. Next, we demonstrated that RABV could internalize together with p75NTR. Characterizing RABV retrograde movement along the axon, we showed the virus is transported in acidic compartments, mostly with p75NTR. Interestingly, RABV is transported faster than NGF, suggesting that RABV not only hijacks the transport machinery but can also manipulate it. Co-transport of RABV and NGF identified two modes of transport, slow and fast, that may represent a differential control of the trafficking machinery by RABV. Finally, we determined that p75NTR-dependent transport of RABV is faster and more directed than p75NTR-independent RABV transport. This fast route to the neuronal cell body is characterized by both an increase in instantaneous velocities and fewer, shorter stops en route. Hence, RABV may employ p75NTR-dependent transport as a fast mechanism to facilitate movement to the CNS.

  19. Retrograde pedal access with a 20-gauge intravenous cannula after failed antegrade recanalization of a tibialis anterior artery in a diabetic patient: a case report.

    Science.gov (United States)

    Colkesen, Yucel

    2015-01-01

    Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions. In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable. The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position. We report a retrograde puncturing technique in patients with chronic total occlusions. After failed antegrade recanalization, puncturing and cannulation of a tiny dorsalis pedis artery with a narrow bore [20-gauge (0.8 mm)] intravenous cannula is described. PMID:26257023

  20. Retrograde pedal access with a 20-gauge intravenous cannula after failed antegrade recanalization of a tibialis anterior artery in a diabetic patient: a case report

    Directory of Open Access Journals (Sweden)

    Yucel Colkesen

    2015-08-01

    Full Text Available Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions. In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable. The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position. We report a retrograde puncturing technique in patients with chronic total occlusions. After failed antegrade recanalization, puncturing and cannulation of a tiny dorsalis pedis artery with a narrow bore [20-gauge (0.8 mm] intravenous cannula is described.

  1. Ankle fusion with a retrograde locked intramedullary nail for sequela of lower extremity compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    WANG Xu; MA Xin; ZHANG Chao; HUANG Jia-zhang; GU Xiang-jie; JIANG Jian-yuan

    2012-01-01

    Objective: To assess the value of ankle fusion with a retrograde locked intramedullary nail in the treatment of sequela of lower extremity compartment syndrome.Methods:Thirty-five cases of equinus deformity following tibiofibular compartment syndrome treated by means of ankle fusion with a retrograde locked intramedullary nail from January 2001 to December 2010 were retrospectively reviewed.The complications,the time needed for bony fusion of the ankle joint assessed by anteroposterior and lateral X-ray photographs as well as patients' subjective evaluation were recorded and analysed.Results: Among the 35 patients,15 had previously undergone surgical treatment twice on the same limb,13 had thrice and 7 had to be operated on four times before ankle fusion.An anterior midpoint approach to the ankle joint was adopted in 29 cases,while anterior midpoint approach plus a small incision on the posterior ankle joint was made in 17 cases,whereas lateral approach in 6 cases.Tarsus joint fusion was performed on 4 cases.The follow-up period ranged 6-124 months,averaged 40.6 months.Bone grafting was not performed in this series.Preoperative tibial shaft fracture occurred in one patient and was healed after conservative treatment.Incision dehiscence located at previous Achilles tendon incision was found in two patients.As a result,one received an intramedullary nail emplacement at calcaneoplantar part while the wound at anterosuperior part of the other one was healed by dressing change.Two patients failed to bony union 5 months postoperatively,in which one healed 10 weeks after retrieval of proximal tibial nail and another by iliac grafting.Terminal necrosis of the toe due to blood supply dysfunction was not found in this series.All the patients were satisfied with the ankle joint function postoperatively.The time for bony union on X-rays was 9.8 weeks on average.Except for one patient who demanded removal of intramedullary nail,all the intramedullary nails were not retrieved at

  2. Proficiency of virtual reality simulator training in flexible retrograde ureteroscopy renal stone management

    Institute of Scientific and Technical Information of China (English)

    CAI Jian-liang; ZHANG Yi; SUN Guo-feng; LI Ning-chen; YUAN Xue-li; NA Yan-qun

    2013-01-01

    Background Minimally invasive flexible ureteroscopy techniques have widely adopted in the management of patients with renal stones.We performed this study to investigate the value of virtual reality simulator training in retrograde flexible ureteroscopy renal stone treatment for catechumen.Methods Thirty catechumen,included 17 attending physicians and 13 associate chief physicians,were selected for study.The trainees first underwent 1-hour basic training to get familiar with the instrument and basic procedures,then followed by 4-hour practice on virtual reality simulators.Before and after the 4-hour training,all trainees undertake an assessment with task 7 program (right low pole calyces stone management).We documented for each trainee the total time of procedure,time of progressing from the orifice to stone,stone translocation and fragmentation time,laser operate proficiency scale,total laser energy,maximal size of residual stone fragments,number of trauma from the scopes and tools,damage to the scope and global rating scale (GRS).The proficiency of this training program was analyzed by the comparison of the first and second assessment outcomes.Results Significant improvement was observed in retrograde flexible ureteroscopy management of renal stone on virtual reality simulators after finishing the 4 hour special-purpose training.This was demonstrated by improvement in total procedure time ((18.37±2.59) minutes vs.(38.67±1.94) minutes),progressing time from the orifice to stone ((4.00±1.08) minutes vs.(13.80±2.01) minutes),time of stone translocation ((1.80±0.71) minutes vs.(6.57±1.01) minutes),fragmentation time ((4.43±1.25) minutes vs.(13.53±1.46) minutes),laser operate proficiency scale (8.47±0.73 vs.3.77±0.77),total laser energy ((3231.6±401.4) W vs.(5329.8±448.9) W),maximal size of residual stone fragments ((2.66±0.39) mm vs.(5.77±0.63) mm),number of trauma from the scopes and tools (3.27±1.01 vs.10.37±3.02),damage to the scope (0 vs.0.97±0

  3. Management of a large periapical lesion using Biodentine™ as retrograde restoration with eighteen months evident follow up

    Science.gov (United States)

    Pawar, Ajinkya M; Kokate, Sharad R; Shah, Reema A

    2013-01-01

    Injury to anterior teeth is a common event. It requires a treatment approach that assures the complete biologic healing and functional restoration of the tooth or teeth involved. A cystic lesion, which is unable to heal nonsurgically, heals well with surgical intervention and use of mineral trioxide aggregate (MTA) as retrograde filling has been reported in literature. Another material with largely improved handling properties; Biodentine™ (Septodont, St. Maurdes Fossés, France) was introduced in 2011. It is a calcium silicate based material and manufacturers claim that it can be used for crown and root dentin repair treatment, repair of perforations or resorptions, apexification, and root end fillings. This article presents a case report of surgical management of a large cystic lesion using Biodentine™ as retrograde filling material which has not been reported in literature so far. Eighteen months radiographic follow-up exhibited completely healed cystic lesion. PMID:24347897

  4. Analytical solutions of actin-retrograde-flow in a circular stationary cell: a mechanical point of view.

    Science.gov (United States)

    Ghasemi, V A; Firoozabadi, B; Saidi, M S

    2014-03-01

    The network of actin filaments in the lamellipodium (LP) of stationary and migrating cells flows in a retrograde direction, from the membrane periphery toward the cell nucleus. We have theoretically studied this phenomenon in the circular stationary (fully spread) cells. Adopting a continuum view on the LP actin network, new closed-form solutions are provided for the actin-retrograde-flow (ARF) in a polar coordinate system. Due to discrepancy in the mechanical models of the actin network in the ARF regime, solutions are provided for both assumptions of solid and fluid behavior. Other involved phenomena, including polymerizing machine at the membrane periphery, cytosol drag, adhesion friction, and membrane tension, are also discussed to provide an overall quantitative view on this problem.

  5. PENGARUH PERBEDAAN EKSTRAKSI LIPID TERHADAP GELATINASASI DAN RETROGRADASI TEPUNG MLINJO (Gnetum gnemon [Effects of Different Lipid Extractions on Gelatinization and Retrogradation of Bitter Nuts (Gnetum gnemon Starch

    Directory of Open Access Journals (Sweden)

    Tri Agus Siswoyo

    2004-08-01

    Full Text Available The effect of different lipid extraction on gelatinization and retrogradation of bitter nuts (Gnetum gnemon starch was studied by the measurement of starch-lipids complex formation using differential scanning calorimetry. The bitter nuts samples were extracted sequentially with hexane for surface lipid starch (SL and hot water-saturated butanol for internal lipid starch (IL. The gelatinization enthalpies of starch increased significantly with extracting step, but the starch-lipid complex enthalpies of SL and IL were statistically lower, when compared with the native starch. According to the Avrami equation, the retrogradation rate of native bitter nuts starch was slower than that of the SL or IL, whereas the retrogradation rate of IL was slower than SL. High number of starch-lipids complex could retard the retrogradation of bitter nuts starch during storage

  6. Endoscopic Retrograde Cholangiopancreatography as a Risk Factor for Pancreatic Panniculitis in a Post-Liver Transplant Patient

    OpenAIRE

    Sharma, Mithun; Reddy, Duvurru Nageshwar; Kiat, Tan Chee

    2014-01-01

    Post endoscopic retrograde cholangiopancreatography (ERCP) pancreatic panniculitis is a rare condition caused by fat necrosis following release of pancreatic enzymes into the bloodstream. No previous reports of pancreatic panniculitis have been reported in post-liver transplant subjects undergoing ERCP. We present a 63-year-old cryptogenic cirrhotic female post-cadaveric liver transplant who underwent ERCP for suspected biliary stricture and subsequently developed pancreatic panniculitis.

  7. Massive hemobilia due to hepatic arteriobiliary fistula during endoscopic retrograde cholangiopancretography: An extremely rare guidewir-related complication

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Jeong Gu; Seo, Young Woo; Hwang, Jae Cheol; Weon, Young Cheol; Kang, Byeong Seong; Bang, Sung Jo; Bang, Min Seo [Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan (Korea, Republic of)

    2015-05-15

    Although endoscopic retrograde cholangiopancreatography (ERCP) is an effective modality for diagnosis and treatment of biliary and pancreatic diseases, the risk for procedure-related complications is high. Hemorrhage is one of major complications of ERCP. Most ERCP-associated bleeding is primarily a complication related to sphincterotomy rather than diagnostic ERCP. We are reporting a case of massive hemobilia due to hepatic arteriobiliary fistula caused by guidewire-associated injury during ERCP, which was successfully treated with transarterial embolization of the hepatic artery.

  8. Thylakoid redox signals are integrated into organellar-gene-expression-dependent retrograde signalling in the prors1-1 mutant

    Directory of Open Access Journals (Sweden)

    Luca eTadini

    2012-12-01

    Full Text Available Perturbations in organellar gene expression (OGE and the thylakoid redox state (TRS activate retrograde signalling pathways that adaptively modify nuclear gene expression (NGE, according to developmental and metabolic needs. The prors1-1 mutation in Arabidopsis down-regulates the expression of the nuclear gene Prolyl-tRNA Synthetase1 (PRORS1 which acts in both plastids and mitochondria, thereby impairing protein synthesis in both organelles and triggering OGE-dependent retrograde signalling. Because the mutation also affects thylakoid electron transport, TRS-dependent signals may likewise have an impact on the changes in NGE observed in this genotype. In this study, we have investigated whether signals related to TRS are actually integrated into the OGE-dependent retrograde signalling pathway. To this end, the chaos mutation (for chlorophyll a/b binding protein harvesting-organelle specific, which shows a partial loss of PSII antennae proteins and thus a reduction in PSII light absorption capability, was introduced into the prors1-1 mutant background. The resulting double mutant displayed a prors1-1-like reduction in plastid translation rate and a chaos-like decrease in PSII antenna size, whereas the hyper-reduction of the thylakoid electron transport chain, caused by the prors1-1 mutation, was alleviated, as determined by monitoring chlorophyll (Chl fluorescence and thylakoid phosphorylation. Interestingly, a substantial fraction of the nucleus-encoded photosynthesis genes down-regulated in the prors1-1 mutant are expressed at nearly wild-type rates in prors1-1 chaos leaves, and this recovery is reflected in the steady-state levels of their protein products in the chloroplast. We therefore conclude that signals related to photosynthetic electron transport and TRS, and indirectly to carbohydrate metabolism and energy balance, are indeed fed into the OGE-dependent retrograde pathway to modulate NGE and adjust the abundance of chloroplast proteins.

  9. Ciliary Abnormalities Due to Defects in the Retrograde Transport Protein DYNC2H1 in Short-Rib Polydactyly Syndrome

    OpenAIRE

    Merrill, Amy E.; Merriman, Barry; Farrington-Rock, Claire; CAMACHO, NATALIA; Sebald, Eiman T.; Funari, Vincent A.; Schibler, Matthew J.; Firestein, Marc H.; Cohn, Zachary A; Priore, Mary Ann; Thompson, Alicia K.; Rimoin, David L.; Nelson, Stanley F.; Cohn, Daniel H.; Krakow, Deborah

    2009-01-01

    The short-rib polydactyly (SRP) syndromes are a heterogenous group of perinatal lethal skeletal disorders with polydactyly and multisystem organ abnormalities. Homozygosity by descent mapping in a consanguineous SRP family identified a genomic region that contained DYNC2H1, a cytoplasmic dynein involved in retrograde transport in the cilium. Affected individuals in the family were homozygous for an exon 12 missense mutation that predicted the amino acid substitution R587C. Compound heterozygo...

  10. Comparative analysis of uniplanar external fixator and retrograde intramedullary nailing for ankle arthrodesis in diabetic Charcot′s neuroarthropathy

    Directory of Open Access Journals (Sweden)

    Nakul S Shah

    2011-01-01

    Results: All five (100% patients treated by intramedullary nailing achieved radiological union on an average follow-up of 16 weeks. The external fixation group had significantly higher rate of complications with one amputation, four non unions (66.7% and a delayed union which went on to full osseous union. Conclusion: The retrograde intramedullary nailing for tibio-talar arthrodesis in Charcot′s neuroarthropathy yielded significantly better outcomes as compared to the use of uniplanar external fixator.

  11. Endoscopic ultrasound-guided choledochoduodenostomy in patients with failed endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Takao Itoi; Fumihide Itokawa; Atsushi Sofuni; Toshio Kurihara; Takayoshi Tsuchiya; Kentaro Ishii; Shujiro Tsuji; Nobuhito Ikeuchi; Fuminori Moriyasu

    2008-01-01

    Endoscopic ultrasonography (EUS)-guided biliary drainage was performed for treatment of patients who have obstructive jaundice in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). In the present study, we introduced the feasibility and outcome of EUS-guided choledochoduodenostomy in four patients who failed in ERCP. We performed the procedure in 2 papilla of Vater, including one resectable case, and 2 cases of cancer of the head of pancreas. Using a curved linear array echoendoscope, a 19 G needle or a needle knife was punctured transduodenally into the bile duct under EUS visualization. Using a biliary catheter for dilation, or papillary balloon dilator, a 7-Fr plastic stent was inserted through the choledochoduodenostomy site into the extrahepatic bile duct. In 3 (75%) of 4 cases, an indwelling plastic stent was placed, and in one case in which the stent could not be advanced into the bile duct, a naso-biliary drainage tube was placed instead. In all cases, the obstructive jaundice rapidly improved after the procedure. Focal peritonitis and bleeding not requiring blood transfusion was seen in one case. In this case, pancreatoduodenectomy was performed and the surgical findings revealed severe adhesion around the choledochoduodenostomy site. Although further studies and development of devices are mandatory, EUS-guided choledochoduodenostomy appears to be an effective alternative to ERCP in selected cases.

  12. A dispersive wave pattern on Jupiter's fastest retrograde jet at $20^\\circ$S

    CERN Document Server

    Rogers, J H; Adamoli, G; Jacquesson, M; Vedovato, M; Orton, G S

    2016-01-01

    A compact wave pattern has been identified on Jupiter's fastest retrograding jet at 20S (the SEBs) on the southern edge of the South Equatorial Belt. The wave has been identified in both reflected sunlight from amateur observations between 2010 and 2015, thermal infrared imaging from the Very Large Telescope and near infrared imaging from the Infrared Telescope Facility. The wave pattern is present when the SEB is relatively quiescent and lacking large-scale disturbances, and is particularly notable when the belt has undergone a fade (whitening). It is generally not present when the SEB exhibits its usual large-scale convective activity ('rifts'). Tracking of the wave pattern and associated white ovals on its southern edge over several epochs have permitted a measure of the dispersion relationship, showing a strong correlation between the phase speed (-43.2 to -21.2 m/s) and the longitudinal wavelength, which varied from 4.4-10.0 deg. longitude over the course of the observations. Infrared imaging sensing low...

  13. Enhanced osteoclastogenesis by mitochondrial retrograde signaling through transcriptional activation of the cathepsin K gene.

    Science.gov (United States)

    Guha, Manti; Srinivasan, Satish; Koenigstein, Alexander; Zaidi, Mone; Avadhani, Narayan G

    2016-01-01

    Mitochondrial dysfunction has emerged as an important factor in wide ranging human pathologies. We have previously defined a retrograde signaling pathway that originates from dysfunctional mitochondria (Mt-RS) and causes a global nuclear transcriptional reprograming as its end point. Mitochondrial dysfunction causing disruption of mitochondrial membrane potential and consequent increase in cytosolic calcium [Ca(2) ](c) activates calcineurin and the transcription factors NF-κB, NFAT, CREB, and C/EBPδ. In macrophages, this signaling complements receptor activator of nuclear factor kappa-B ligand (RANKL)-induced osteoclastic differentiation. Here, we show that the Mt-RS activated transcriptional coactivator heterogeneous ribonucleoprotein A2 (hnRNP A2) is induced by hypoxia in murine macrophages. We demonstrate that the cathepsin K gene (Ctsk), one of the key genes upregulated during osteoclast differentiation, is transcriptionally activated by Mt-RS factors. HnRNP A2 acts as a coactivator with nuclear transcription factors, cRel, and C/EBPδ for Ctsk promoter activation under hypoxic conditions. Notably, our study shows that hypoxia-induced activation of the stress target factors mediates effects similar to that of RANKL with regard to Ctsk activation. We therefore suggest that mitochondrial dysfunction and activation of Mt-RS, induced by various pathophysiologic conditions, is a potential risk factor for osteoclastogenesis and bone loss.

  14. Mitochondria Retrograde Signaling and the UPRmt: Where Are We in Mammals?

    Directory of Open Access Journals (Sweden)

    Thierry Arnould

    2015-08-01

    Full Text Available Mitochondrial unfolded protein response is a form of retrograde signaling that contributes to ensuring the maintenance of quality control of mitochondria, allowing functional integrity of the mitochondrial proteome. When misfolded proteins or unassembled complexes accumulate beyond the folding capacity, it leads to alteration of proteostasis, damages, and organelle/cell dysfunction. Extensively studied for the ER, it was recently reported that this kind of signaling for mitochondrion would also be able to communicate with the nucleus in response to impaired proteostasis. The mitochondrial unfolded protein response (UPRmt is activated in response to different types and levels of stress, especially in conditions where unfolded or misfolded mitochondrial proteins accumulate and aggregate. A specific UPRmt could thus be initiated to boost folding and degradation capacity in response to unfolded and aggregated protein accumulation. Although first described in mammals, the UPRmt was mainly studied in Caenorhabditis elegans, and accumulating evidence suggests that mechanisms triggered in response to a UPRmt might be different in C. elegans and mammals. In this review, we discuss and integrate recent data from the literature to address whether the UPRmt is relevant to mitochondrial homeostasis in mammals and to analyze the putative role of integrated stress response (ISR activation in response to the inhibition of mtDNA expression and/or accumulation of mitochondrial mis/unfolded proteins.

  15. Simultaneous endoscopic ultrasound fine needle aspiration and endoscopic retrograde cholangio-pancreatography:Evaluation of safety

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To investigate the rate of complications of endoscopic retrograde cholangio-pancreatography (ERCP)performed immediately after endoscopic ultrasound fine needle aspiration (EUS-FNA) in a large series of patients.METHODS: Patients with the following conditions were considered candidates for EUS-FNA and ERCP: diagnosis of locally advanced or metastatic pancreatic lesion not eligible for surgery, and patients with pancreatic lesion of unknown nature causing jaundice. Data were prospectively collected on the following parameters:indication for FNA, EUS findings, pathological diagnosis,procedure duration of EUS-FNA and combined EUS-FNA and ERCP, and immediate and late complications.RESULTS: From January 2004 to October 2006, 72 patients were deemed eligible for combined EUS and ERCP. In 25/72 EUS-FNA was performed to obtain a pathology diagnosis of lesions causing biliary obstruction,and ERCP sequentially performed to drain the biliary system. No immediate complications occurred except for two mild bleeding episodes post sphincterotomy. No late complications were recorded except for one patient who experienced fever, promptly recovered with antibiotic therapy.CONCLUSION: Simultaneous approach appears to be feasible and safe. When possible, this can be considered the reference standard to avoid double sedation and reduce duration of the procedure and hospital stay.

  16. Retrosplenial Cortical Contributions to Anterograde and Retrograde Memory in the Monkey.

    Science.gov (United States)

    Buckley, Mark J; Mitchell, Anna S

    2016-06-01

    Primate retrosplenial cortex (RSC) is important for memory but patient neuropathologies are diffuse so its key contributions to memory remain elusive. This study provides the first causal evidence that RSC in macaque monkeys is crucial for postoperative retention of preoperatively and postoperatively acquired memories. Preoperatively, monkeys learned 300 object-in-place scene discriminations across sessions. After RSC removal, one-trial postoperative retention tests revealed significant retrograde memory loss for these 300 discriminations relative to unoperated control monkeys. Less robust evidence was found for a deficit in anterograde memory (new postoperative learning) after RSC lesions as new learning to criterion measures failed to reveal any significant learning impairment. However, after achieving ≥90% learning criterion for the postoperatively presented novel 100 object-in-place scene discriminations, short-term retention (i.e., measured after 24 h delay) of this well-learnt set was impaired in the RSC monkeys relative to controls. A further experiment assessed rapid "within" session acquisition of novel object-in-place scene discriminations, again confirming that new learning per se was unimpaired by bilateral RSC removal. Primate RSC contributes critically to memory by supporting normal retention of information, even when this information does not involve an autobiographical component. PMID:26946129

  17. Post-endoscopic retrograde cholangio-pancreatography pancreatitis: Is time for a new preventive approach?

    Institute of Scientific and Technical Information of China (English)

    Stella Tammaro; Roberta Caruso; Francesco Pallone; Giovanni Monteleone

    2012-01-01

    Acute pancreatitis is the most common serious complication of endoscopic retrograde cholangio-pancreatography (ERCP) and its incidence may exceed 25% in some high-risk patient subsets.In some patients,pancreatitis may follow a severe course with pancreatic necrosis,multiorgan failure,permanent disability and even death.Hence,approaches which minimize both the incidence and severity of post-ERCP pancreatitis are worth pursuing.Pancreatic stents have been used with some success in the prevention of post-ERCP,while so far pharmacological trials have yielded disappointing results.A recent multicenter,randomized,placebocontrolled,double-blind trial has shown that rectally administered indomethacin is effective in reducing the incidence of post-ERCP pancreatitis,the occurrence of episodes of moderate-to-severe pancreatitis and the length of hospital stay in high-risk patients.These results together with the demonstration that rectal administration of indomethacin is not associated with enhanced risk of bleeding strongly support the use of this drug in the prophylaxis of post-ERCP pancreatitis.

  18. Retrograde ejaculation associated spontaneous sperm cystolithiasis in four rhesus macaques (Macaca mulatta).

    Science.gov (United States)

    Gumber, Sanjeev; Courtney, Cynthia L; Strait, Karen R; Sharma, Prachi; Freebersyser, Julie E; Crane, Maria M

    2013-11-01

    Retrograde ejaculation (RE) has been reported in humans and animals but RE with subsequent sperm calculi has rarely been reported. This report documents clinical and pathological findings of spontaneous sperm cystolithiasis in four rhesus macaques. While this condition has been associated with repeated electroejaculation, spontaneous sperm cystolithiasis is highly unusual. The animals presented with either stranguria, dysuria, hematuria, distended abdomen or lethargy. Ultrasound examination revealed several hyperechoic masses within the lumen of the urinary bladder. The animals were euthanized due to poor prognosis or study end points. Postmortem examination revealed multiple angular, amorphous, soft to firm, pale yellow to greenish-brown and variably sized calculi in the lumen of the urinary bladder or prostatic/penile urethra. Histologically, the calculi were composed of numerous sperm embedded in abundant brightly eosinophilic matrix. Based on gross and histologic findings, RE associated sperm cystolithiasis was diagnosed, with ulcerative urethritis as the major primary apparent etiology. To the authors' knowledge, this is the first report of four spontaneous cases of sperm cystolithiasis in rhesus macaques. PMID:23735542

  19. Retrograde intramedullary nailing in treatment of diaphysical femoral fractures in patients between 6 and 12 years

    International Nuclear Information System (INIS)

    A descriptive, prospective, longitudinal study was carried out, with the object of determine the clinical evolution and surgical timing of treatment of diaphysical femoral fractures in patients between 6 and 12 years of age using retrograde flexible intramedullary nailing. We followed 62 fractures in 62 patients (46 boys and 16 girls). The average follow-up time was 6 months (range 4 to 20 months). Average age of patients was 8.3 years. The time of duration for the surgical procedure averaged 52.6 minutes. Average in-hospital stay was 7.8 days. We did not have any cases of deep infection. There were 4 cases of superficial skin infection and 3 patients required reoperation due to protrusion of the medial nail under the skin. None of the patients had complications such as loss of range of motion, non-union, hardware failure, injury to the neither distal femoral physis nor heterotopic ossification. In conclusion we recommend this method as an excellent treatment modally for diaphyseal fractures of the femur in patients between 6 and 12 years of age

  20. Systemic and local responses to repeated HL stress-induced retrograde signaling in Arabidopsis

    Directory of Open Access Journals (Sweden)

    Matthew John Gordon

    2013-01-01

    Full Text Available Chloroplasts of leaves under high light stress initiate signals to the nuclei of both exposed and distal leaves in order to acclimate against the potential threat of oxidative damage: a process known as high light systemic acquired acclimation (HL SAA. This study explores the nature of HL SAA, synergistic interactions with other environmental stresses, and the impact of repeated HL stress on the acclimation response of exposed and distal leaves. This necessitated the development of novel experimental systems to investigate the initiation, perception and response to HL SAA. These systems were used to investigate the HL SAA response by monitoring the induction of mRNA in distal leaves not exposed to the HL stress. Acclimation to HL is induced within minutes and the response is proportionally dependent on the quality and quantity of light. HL SAA treatments in conjunction with variations in temperature and humidity reveal HL SAA is influenced by fluctuations in humidity. These treatments also result in changes in auxin accumulation and auxin-responsive genes. A key question in retrograde signaling is the extent to which transient changes in light intensity result in a memory of the event leading to acclimation responses. Repeated exposure to short term HL resulted in acclimation of the exposed tissue and that of emerging and young leaves (but not older leaves to HL and oxidative stress.

  1. Role of ciprofloxacin in patients with cholestasis after endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Thawee Ratanachu-ek; Pitchaya Prajanphanit; Kawin Leelawat; Suchart Chantawibul; Sukij Panpimanmas; Somboon Subwongcharoen; Jerasak Wannaprasert

    2007-01-01

    AIM: To determine the role of ciprofloxacin in reducing cholangitis in cholestatic patients with adequate biliary drainage after endoscopic retrograde cholangiopancreatography (ERCP).METHODS: A randomized, controlled trial was performed in 48 cholestatic patients at Rajavithi Hospital (Tertiary Referral Center for ERCP: 600 cases per year). All the 48 patients received 200 mg ciprofloxacin intravenous injection for 30 min before starting any procedures, and then were randomly divided in two groups. Twenty-two patients in study group continually received ciprofloxacin until 48 h after ERCP. Causes of biliary obstruction, bacteriology of bile and blood (in cholangitis) and clinical cholangitis were recorded.RESULTS: Forty-eight patients were enrolled and divided into continuous ciprofloxacin treatment group (n = 22) and discontinuous ciprofloxacin treatment group (n = 26). During ERCP, stones were found in 22 patients,malignant diseases in 24 patients and other pathologic lesions in 5 patients. One (4.5%) of the 22 patients who received ciprofloxacin and 2 (6.3%) of the 26 patients who discontinued ciprofloxacin after ERCP developed cholangitis (relative risk = 0.71; 95% CI = 0.14-3.65;P = 0.88). Bacterobilia was found in 27 (56.3%) out of 48 patients. E. coli and Streptococcus viridans were the most common organisms.CONCLUSION: Continual use of ciprofloxacin in patients with cholestasis after adequate biliary drainage procedures plays no role in reducing cholangitis.

  2. Visceral response to acute retrograde gastric electrical stimulation in healthy human

    Institute of Scientific and Technical Information of China (English)

    Shu-Kun Yao; Mei-Yun Ke; Zhi-Feng Wang; Da-Bo Xu; Yan-Li Zhang

    2005-01-01

    AIM: To investigate the visceral response to acute retrograde gastric electrical stimulation (RGES) in healthy humans and to derive optimal parameters for treatment of patients with obesity.METHODS: RGES with a series of effective parameters were performed via a bipolar mucosal electrode implanted along the great curvature 5 cm above pylorus of stomach in 12 healthy human subjects. Symptoms associated with dyspepsia and other discomfort were observed and graded during RGES at different settings, including long pulse and pulse train. Gastric myoelectrical activity at baseline and during different settings of stimulation was recorded by a multi-channel electrogastrography.RESULTS: The gastric slow wave was entrained in all the subjects at the pacing parameter of 9 cpm in frequency, 500 ms in pulse width, and 5 mA in amplitude.The frequently appeared symptoms during stimulation were satiety, bloating, discomfort, pain, sting, and nausea. The total symptom score for each subject significantly increased as the amplitude or pulse width was adjusted to a higher scale in both long pulse and pulse train. There was a wide diversity of visceral responses to RGES among individuals.CONCLUSION: Acute RGES can result in a series of symptoms associated with dyspepsia, which is beneficial to the treatment of obesity. Optimal parameter should be determined according to the individual sensitivity to electrical stimulation.

  3. Retrosplenial Cortical Contributions to Anterograde and Retrograde Memory in the Monkey.

    Science.gov (United States)

    Buckley, Mark J; Mitchell, Anna S

    2016-06-01

    Primate retrosplenial cortex (RSC) is important for memory but patient neuropathologies are diffuse so its key contributions to memory remain elusive. This study provides the first causal evidence that RSC in macaque monkeys is crucial for postoperative retention of preoperatively and postoperatively acquired memories. Preoperatively, monkeys learned 300 object-in-place scene discriminations across sessions. After RSC removal, one-trial postoperative retention tests revealed significant retrograde memory loss for these 300 discriminations relative to unoperated control monkeys. Less robust evidence was found for a deficit in anterograde memory (new postoperative learning) after RSC lesions as new learning to criterion measures failed to reveal any significant learning impairment. However, after achieving ≥90% learning criterion for the postoperatively presented novel 100 object-in-place scene discriminations, short-term retention (i.e., measured after 24 h delay) of this well-learnt set was impaired in the RSC monkeys relative to controls. A further experiment assessed rapid "within" session acquisition of novel object-in-place scene discriminations, again confirming that new learning per se was unimpaired by bilateral RSC removal. Primate RSC contributes critically to memory by supporting normal retention of information, even when this information does not involve an autobiographical component.

  4. Evaluation of radiation doses in patient and medical staff during endoscopic retrograde cholangio-pancreatography procedures

    International Nuclear Information System (INIS)

    The radiation exposure dose must be optimised because the hazard resulting from an interventional radiology procedure is long term depending on the patient. The aim of this study was to measure the radiation doses received by the patients and medical staff during endoscopic retrograde cholangio-pancreatography (ERCP) procedures. Data were collected during 126 ERCP procedures, including the dose-area product (DAP), entrance dose (ED), effective dose (E), fluoroscopy time (T) and number of digital radiographs (F). The medical staff members each wore a personal thermoluminescence dosemeter to monitor exposure during ERCP procedures. The mean DAP, ED, E and T were 47.06 Gy cm2, 196.06 mGy, 8.93 mSv, 7.65 min and 9.21 images, respectively. The mean dose to the staff was 0.175 mSv and that to the assistant was 0.069 mSv. The dose to the medical staff was minimal when appropriate protective measures were used. The large variation in the patient doses must be further investigated. (authors)

  5. An unusual case of prolonged post-endoscopic retrograde cholangiopancreatography jaundice

    Institute of Scientific and Technical Information of China (English)

    Georgios Tziatzios; Paraskevas Gkolfakis; Ioannis S Papanikolaou; George Dimitriadis; Konstantinos Triantafyllou

    2016-01-01

    ABSTRACT:Despite the effectiveness of endoscopic retro-grade cholangiopancreatography (ERCP) for the treatment of choledocholithiasis, various complications have been described. We herein report the ifrst case of prolonged post-ERCP jaundice due to toxicity of the contrast agent Iobitridol (®XENETIX, Guerbet, Roissy CdG Cedex, France) in a patient who underwent ERCP with sphincterectomy and common bile duct stone removal. While clinical improvement and nor-malization of aminotransferases and cholestatic enzymes after the procedure, an unexplained increase of direct bilirubin was noticed. A second ERCP was performed one week later, exclud-ing possible remaining choledocholithiasis. Nevertheless, se-rum direct bilirubin increased further up to 15 mg/dL. Other potential causes of direct hyperbilirubinemia were ruled out and patient’s liver biopsy was compatible with drug-induced liver toxicity. Additionally, the cause-result time connection between the use of Iobitridol and bilirubin increase indicated the possibility of a toxic effect related to the repeated use of the particular contrast agent. Iobitridol, a contrast agent, can induce prolonged direct hyperbilirubinemia.

  6. Kinetics on the turbidity change of wheat starch during its retrogradation.

    Science.gov (United States)

    Fukuzawa, Soma; Ogawa, Takenobu; Nakagawa, Kyuya; Adachi, Shuji

    2016-08-01

    Wheat starch dispersions of 10-40% (w/w) were gelatinized and the change in turbidity of each solution during storage was measured in the 400-1100 nm wavelength range. The relative transmittance, defined as the ratio of transmittance at any storage time to that at the initial time, decreased when the solutions were stored at 5 and 30 °C; the decrease, reflecting the progress of retrogradation, was larger at 5 °C than at 30 °C. Most of the changes in relative transmission taking place over 14 days were achieved during the first 90 min. The change in the relative transmittance is inversely proportional to the energy required for deformation. The kinetics on change in relative transmittance can be expressed by Weibull equation. The larger rate constant at higher starch concentration could be ascribed to the state of the starch granules, which depended on starch concentration. PMID:27088718

  7. Failed biliary cannulation: Clinical and technical outcomes after tertiary referral endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Michael P Swan; Michael J Bourke; Stephen J Williams; Sina Alexander; Alan Moss; Rick Hope; David Ruppin

    2011-01-01

    AIM: Prospective evaluation of repeat endoscopic retrograde cholangiopancreatography (ERCP) for failed Schutz grade 1 biliary cannulation in a high-volume center.METHODS: Prospective intention-to-treat analysis of patients referred for biliary cannulation following recent unsuccessful ERCP.RESULTS: Fifty-one patients (35 female; mean age: 62.5 years; age range: 40-87 years) with previous failed biliary cannulation were referred for repeat ERCP. The indication for ERCP was primarily choledocholithiasis (45%) or pancreatic malignancy (18%). Successful biliary cannulation was 100%. The precut needle knife sphincterotomy (NKS) rate was 27.4%. Complications occurred in 3.9% (post-ERCP pancreatitis). An identifiable reason for initial unsuccessful biliary cannulation was present in 55% of cases. Compared to a cohort of 940 na?ve papilla patients (female 61%; mean age: 59.9 years; age range: 18-94 years) who required sphincterotomy over the same time period, there was no statistical difference in the cannulation success rate (100% vs 98%) or post-ERCP pancreatitis (3.1% vs 3.9%). Precut NKS use was more frequent (27.4% vs 12.7%) (P = 0.017).CONCLUSION: Referral to a high-volume center following unsuccessful ERCP is associated with high technical success, with a favorable complication rate, compared to routine ERCP procedures.

  8. The Spin of the Black Hole GS 1124-683: Observation of a Retrograde Accretion Disk?

    CERN Document Server

    Morningstar, Warren R; Reis, Rubens C; Ebisawa, Ken

    2014-01-01

    We re-examine archival Ginga data for the black hole binary system GS 1124-683, obtained when the system was undergoing its 1991 outburst. Our analysis estimates the dimensionless spin parameter a=cJ/GM^2 by fitting the X-ray continuum spectra obtained while the system was in the "Thermal Dominant" state. For likely values of mass and distance, we find the spin to be a=-0.25 (-0.64, +0.05) (90% confidence), implying that the disk is retrograde (i.e. rotating antiparallel to the spin axis of the black hole). We note that this measurement would be better constrained if the distance to the binary and the mass of the black hole were more accurately determined. This result is unaffected by the model used to fit the hard component of the spectrum. In order to be able to recover a prograde spin, the mass of the black hole would need to be at least 15.25 Msun, or the distance would need to be less than 4.5 kpc, both of which disagree with previous determinations of the black hole mass and distance. If we allow f_col ...

  9. Parameters That May Be Used for Predicting Failure during Endoscopic Retrograde Cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    Emre Balik

    2013-01-01

    Full Text Available Aim. Endoscopic retrograde cholangiopancreatography (ERCP is frequently used for the diagnosis and treatment of hepatic, biliary tract, and pancreatic disorders. However, failure during cannulation necessitates other interventions. The aim of this study was to establish parameters that can be used to predict failure during ERCP. Methods. A total of 5884 ERCP procedures performed on 5079 patients, between 1991 and 2006, were retrospectively evaluated. Results. Cannulation was possible in 4482 (88.2% patients. For each one-year increase in age, the cannulation failure rate increased by 1.01-fold (. A history of previous hepatic biliary tract surgery caused the cannulation failure rate to decrease by 0.487-fold (. A tumor infiltrating the ampulla, the presence of pathology obstructing the gastrointestinal passage, and peptic ulcer increased the failure rate by 78-, 28-, and 3.47-fold, respectively (. Conclusions.Patient gender and duodenal diverticula do not influence the success of cannulation during ERCP. Billroth II and Roux-en-Y gastrojejunostomy surgeries, a benign or malignant obstruction of the gastrointestinal system, and duodenal ulcers decrease the cannulation success rate, whereas a history of previous hepatic biliary tract surgery increases it. Although all endoscopists had equal levels of experience, statistically significant differences were detected among them.

  10. Adverse reactions to iodinated contrast media administered at the time of endoscopic retrograde cholangiopancreatography (ERCP).

    Science.gov (United States)

    Pan, Jen-Jung; Draganov, Peter V

    2009-03-01

    Adverse reactions after intravascular administration of iodine contrast media are common and prophylactic regiments consisting of the use of steroids and low osmolality contrast media are highly effective in significantly decreasing the adverse reactions rate. The same type of contrast media are also used for opacification of the biliary tree and the pancreatic duct at the time of endoscopic retrograde cholangiopancreatography (ERCP). Systemic absorption of contrast media after ERCP routinely occurs. Although the adverse reaction rate appears to be very low the exact incidence remains unknown due to the retrospective nature of all reports. Despite the lack of formal recommendations, numerous prophylactic regiments are routinely used prior to ERCP in patients with history of prior reaction to intravascular contrast media. Moreover, the use of prophylaxis has even expanded to patients with no prior reaction to intravascular contrast media who are somehow perceived to be at increase risk (e.g. shellfish allergy). Recently, the first large scale prospective study reported exceedingly low incidence of adverse reaction to high oslmolality iodine-containing contrast media administered at the time of ERCP done without prophylactic premedication even in patients considered to be at the highest risk (prior severe reaction to intravascular contrast media administration). These data suggest that the use of prophylactic regiments prior to ERCP appears to be unnecessary. PMID:19275689

  11. Mitochondria Retrograde Signaling and the UPR mt: Where Are We in Mammals?

    Science.gov (United States)

    Arnould, Thierry; Michel, Sébastien; Renard, Patricia

    2015-08-06

    Mitochondrial unfolded protein response is a form of retrograde signaling that contributes to ensuring the maintenance of quality control of mitochondria, allowing functional integrity of the mitochondrial proteome. When misfolded proteins or unassembled complexes accumulate beyond the folding capacity, it leads to alteration of proteostasis, damages, and organelle/cell dysfunction. Extensively studied for the ER, it was recently reported that this kind of signaling for mitochondrion would also be able to communicate with the nucleus in response to impaired proteostasis. The mitochondrial unfolded protein response (UPR(mt)) is activated in response to different types and levels of stress, especially in conditions where unfolded or misfolded mitochondrial proteins accumulate and aggregate. A specific UPR(mt) could thus be initiated to boost folding and degradation capacity in response to unfolded and aggregated protein accumulation. Although first described in mammals, the UPR(mt) was mainly studied in Caenorhabditis elegans, and accumulating evidence suggests that mechanisms triggered in response to a UPR(mt) might be different in C. elegans and mammals. In this review, we discuss and integrate recent data from the literature to address whether the UPR(mt) is relevant to mitochondrial homeostasis in mammals and to analyze the putative role of integrated stress response (ISR) activation in response to the inhibition of mtDNA expression and/or accumulation of mitochondrial mis/unfolded proteins.

  12. The Endoscopic Retrograde Cholangiopancreatographic Manifestations of Histopathologically Diagnosed Hepatocellular Carcinoma with Obstructive Jaundice

    Institute of Scientific and Technical Information of China (English)

    赵秋; 龚彪; 卢乃熙; 刘南植

    2002-01-01

    Summary: To study the manifestations of endoscopic retrograde cholangiopancreatography (ERCP) in patients of obstructive jaundice associated with HCC, 32 cases of histopathologically diagnosed HCC with obstructive jaundice were successfully examined with routine ERCP. 31 pa tients were demonstrated by ERCP as having malignant obstructive jaundice. Among them, 19were hepatic perihilar bile duct stricture, 7 bile ductile tumorous thrombus, 3 perihilar bile duct stricture complicated with thrombus, 2 metastasis to hilar lymph node, and 1 common bile duct stone as proven by sphincterotomy. The malignant perihilar stricture was all of type Ⅲ and IV by Bismuth standard of Klastin tumor. In patients identified as having bile duct tumor thrombus, by the Ueda classification, none was of type I and I ; 1 type Ⅲ a; 4 Ⅲ b; 2 type IV. HCC with ob structive jaundice was mainly caused by the malignant infiltration of tumor, and most stricture was of serious nature. When major extra-hepatic bile duct was involved by tumor thrombus, obstructive jaundice might develop. Malignant perihilar stricture and tumor thrombus might coexist in some patients. Jaundice was rarely caused by hepatic hilar lymph node metastasis. Jaundice was not necessarily caused by tumors and sometimes, it might be caused by common bile stones. Care should be exercised in differentiation diagnosis in such patients.

  13. Evaluation of ultrasonic and ErCr:YSGG laser retrograde cavity preparation.

    Science.gov (United States)

    Batista de Faria-Junior, Norberto; Tanomaru-Filho, Mário; Guerreiro-Tanomaru, Juliane Maria; de Toledo Leonardo, Renato; Camargo Villela Berbert, Fábio Luiz

    2009-05-01

    Root end cavity preparation techniques aim to create a clean and properly shaped cavity in a short time. Although the use of ultrasonics has been widely recommended, a laser can also be used. This study evaluated the time required and quality of retrograde cavity preparations using ultrasonics or ErCr:YSGG laser. Thirty single-rooted teeth were instrumented, root filled, submitted to apicectomies, and grouped. Root end cavities were prepared by using the following: group 1 (G1): CVD (6.1107-6) ultrasonic retrotips (CVD-Vale, São José dos Campos, Brazil); group 2 (G2): EMS (DT-060/Berutti) ultrasonic retrotips (EMS, LeSentier, Switzerland); and group 3 (G3): ErCr:YSGG (G6/Waterlase; Biolase Technology, San Clemente, CA) laser tips. The time taken to complete the preparation was recorded. Epoxy resin replicas of the root apices were examined under a scanning electron microscope. The parameters for evaluation were the presence of fractures, and the quality of the preparations. The Waterlase showed the highest mean time for preparation of the root end cavities (p 0.05). Fractures in the cavosurface angle occurred only in G2. G1 and G2 showed better scores for quality of preparation than G3 (p < 0.05). These results suggest that root end cavities should be prepared by ultrasonic tips.

  14. VPS35 regulates developing mouse hippocampal neuronal morphogenesis by promoting retrograde trafficking of BACE1

    Directory of Open Access Journals (Sweden)

    Chun-Lei Wang

    2012-10-01

    VPS35, a major component of the retromer, plays an important role in the selective endosome-to-Golgi retrieval of membrane proteins. Dysfunction of retromer is a risk factor for neurodegenerative disorders, but its function in developing mouse brain remains poorly understood. Here we provide evidence for VPS35 promoting dendritic growth and maturation, and axonal protein transport in developing mouse hippocampal neurons. Embryonic hippocampal CA1 neurons suppressing Vps35 expression by in utero electroporation of its micro RNAs displayed shortened apical dendrites, reduced dendritic spines, and swollen commissural axons in the neonatal stage, those deficits reflecting a defective protein transport/trafficking in developing mouse neurons. Further mechanistic studies showed that Vps35 depletion in neurons resulted in an impaired retrograde trafficking of BACE1 (β1-secretase and altered BACE1 distribution. Suppression of BACE1 expression in CA1 neurons partially rescued both dendritic and axonal deficits induced by Vps35-deficiency. These results thus demonstrate that BACE1 acts as a critical cargo of retromer in vitro and in vivo, and suggest that VPS35 plays an essential role in regulating apical dendritic maturation and in preventing axonal spheroid formation in developing hippocampal neurons.

  15. Significance of C-reactive Protein in the Endoscopic Retrograd Cholangiopancreatography Related Pancreatitis

    Directory of Open Access Journals (Sweden)

    Mete Akin

    2016-01-01

    Full Text Available Aim: Endoscopic retrograde cholangiopancreatography (ERCP may be related with complications such as pancreatitis. C-reactive protein (CRP can be provides reliable informations about post-ERCP complications and their severity. In our study, the role of CRP levels in the follow-up post-ERCP pancreatitis was investigated. Material and Method: 476 patients, whom performed ERCP for different indications, were retrospectively evaluated. 136 patients with measurement of serum amylase, lipase and CRP levels before and 12-24 hours after the procedure were included the study. Alterations of these parameters in complicated and uncomplicated patiens were investigated. The role of CRP in the follow-up and prediction of severity of pancreatitis was investigated in 22 complicated patients with measurement of serum amylase, lypase and CRP levels 36-48 hours after the procedure. Pancreatitis were classified as mild, moderate, or severe. Results: Post-ERCP pancreatitis occured in 23 (17% patients (9 mild and 14 moderate pancreatitis. The mean CRP levels (mg/l at 12 to 24 hours were 23,5 ± 24,18 in uncomplicated patients, and 59,2 ± 44,87 in patiens with pancreatitis (p

  16. Venous arterialization for the treatment of large-area foot skin retrograde avulsion.

    Science.gov (United States)

    Xiao, Wan-an; Jiang, Jia-xi; Tian, Feng; Li, Xiao-chuan; Tian, Li-jie

    2013-08-01

    Between 2009 and 2011, three patients with large-area foot skin retrograde avulsion (more than 1% of the body surface area) underwent venous arterialization. Anastomosis of the artery in the wound surface with the vein in the skin flap and an appropriate number of venous end-to-end anastomoses were performed. The skin flaps survived in all 3 patients. Six months postoperatively, the flap elasticity and appearance were close to that of normal skin, and foot function was better without scar contracture. When venous arterialization is used to treat foot avulsion, the following points should be noted. Surgical indications include no fresh bleeding from the wound edge of the avulsed skin after debridement, more complete avulsed skin, and superficial veins that do not completely separate from the avulsed skin. Venous arterialization is not suitable to avulsion with fresh bleeding, avulsed skin in small fragments, and avulsion with a subcutaneous venous network embolism. During debridement, the subcutaneous venous network should be protected to avoid exposing the vein stems outside the fat layer. If the avulsion is less than 1% of the body surface area, arterial-venous anastomosis can provide adequate blood supply. Venous-venous anastomosis is performed as much as possible to enhance venous return and decrease microcirculatory pressure, which is conducive to the establishment of effective blood circulation.

  17. Assessment of patient dose and radiogenic risks during endoscopic retrograde cholangiopancreatography

    Energy Technology Data Exchange (ETDEWEB)

    Sulieman, A.; Elzaki, M. [Sudan University of Science and Technology, College of Medical Radiologic Science, P. O. Box 1908, Khartoum 11111 (Sudan); Alkhorayef, M.; Babikir, E. [King Saud University, College of Applied Sciences, Radiological Sciences Department, P. O. Box 10219, Riyadh 11433 (Saudi Arabia); Abuzaid, M. [University of Sharjah, College of Health Sciences, Medical Diagnostic Imaging Department, Sharjah (United Arab Emirates); Dalton, A.; Bradley, D., E-mail: Abdelmoneim_a@yahoo.com [University of Surrey, Centre for Nuclear and Radiation Physics, Department of Physics, GU2-7XH, Guildford, Surrey (United Kingdom)

    2015-10-15

    Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive technique that has been used for over 30 years in the diagnosis and management of pancreaticobiliary disorders. The objectives of this study were to evaluate the patient entrance surface air kerma doses (ESAK) and estimate the organ and effective doses during ERCP in three hospitals in Khartoum. A total of 55 patients were examined in three hospitals in Khartoum state, Sudan. Calibrated thermoluminescence dosimeters (TLD)-Gr-200-A)) were used to measure patients ESAK. The overall mean of ESAK for all ERCP procedures was 42.4 mGy. The mean patient ESAK in Fedail, Soba and Ibn sena centers were 26.7 mGy, 26.0 mGy, 72.4 mGy, respectively. The effective doses in three centers were 1.6, 1.56 and 2.67 mSv in that order and the overall mean effective dose was 2.01 mSv. Patient radiation doses vary widely among the different hospitals. Patient ESAK is low compared to previous studies in the light of the current practice. Patient dose was decreased significantly in the last two decades. (Author)

  18. Retrograde endovenous laser ablation through saphenopopliteal junctional area for incompetent small saphenous vein; Comparison with antegrade approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jun Seok; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Chee, Hyun Keun; Hwang, Jin Ho [Konkuk University Hospital, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    To evaluate the safety and efficacy of retrograde endovenous laser ablation (EVLA) and to compare it with the conventional antegrade EVLA for incompetent small saphenous vein (SSV). Small saphenous vein was cannulated via two approaches under ultrasound-guidance. One method involved puncturing the SSV cranially at mid-calf (the antegrade group). If the antegrade puncture into the SSV failed twice, the other approach for puncture was selected that involved puncturing the SSV toward the ankle (the retrograde group). Patients were evaluated in terms of technical and clinical success, closure rates of the SSV, and complications including pain, bruising, or paresthesia at all follow-up visits. The 1470 nm endovenous laser was used in all limbs. Technical success was seen in all limbs in both groups (100%). Closure rate in both groups showed about 95%, without significant difference (p = 0.685). Similar linear endovenous energy density was supplied during the EVLA in both groups (p = 0.876). Three frequent complications including bruising, pain, and paresthesia did not show statistical significance between groups (p = 0.465, 0.823, 1.000, respectively). Major complications were absent in both groups. The EVLA for the incompetent SSV using a retrograde approach is safe and effective and should be considered the alternative method if the antegrade access fails due to vasospasm or small SSV diameter.

  19. Retrograde coronary sinus versus aortic root perfusion with cold cardioplegia: randomized study of levels of cardiac enzymes in 40 patients

    Energy Technology Data Exchange (ETDEWEB)

    Guiraudon, G.M.; Campbell, C.S.; McLellan, D.G.; Kostuk, W.J.; Purves, P.D.; MacDonald, J.L.; Cleland, A.G.; Tadros, N.B.

    1986-11-01

    Myocardial injury was assessed with the use of enzyme indexes in 40 patients randomly assigned to one of two groups undergoing coronary artery bypass surgery. Twenty patients received cold cardioplegia delivered by retrograde coronary sinus perfusion and 20 received cardioplegic solution by anterograde aortic root perfusion. Creatine kinase isoenzyme MB and lactate dehydrogenese isoenzyme 1 and isoenzyme 2 assays were carried out on blood samples obtained from the coronary sinus before aortic cross-clamping and 0, 5, and 30 min after aortic unclamping. Levels of these enzymes were also obtained from venous blood samples before aortic cross-clamping and 3, 8, 14, and 20 hr after aortic unclamping and 2, 3, 4, and 5 days after surgery. Preoperative and postoperative hemodynamic measurements (Swan-Ganz catheter) and radionuclide wall motion studies were also obtained for comparison. There was no overall significant difference between the two groups postoperatively in terms of enzyme indexes, hemodynamic measurements, or results of wall motion studies. We conclude that retrograde coronary sinus perfusion is an alternative to aortic root perfusion in delivering cold cardioplegia. More studies are required to determine which subgroup of patients with coronary artery disease may benefit from retrograde coronary perfusion.

  20. Retrograde Tracing with Recombinant Rabies Virus Reveals Correlations Between Projection Targets and Dendritic Architecture in Layer 5 of Mouse Barrel Cortex

    OpenAIRE

    Larsen, DeLaine D.; Wickersham, Ian R.; Edward M Callaway

    2008-01-01

    A recombinant rabies virus was used as a retrograde tracer to allow complete filling of the axonal and dendritic arbors of identified projection neurons in layer 5 of mouse primary somatosensory cortex (S1) in vivo. Previous studies have distinguished three types of layer 5 pyramids in S1: tall-tufted, tall-simple, and short. Layer 5 pyramidal neurons were retrogradely labeled from several known targets: contralateral S1, superior colliculus, and thalamus. The complete dendritic arbors of lab...

  1. An investigational study of minimum rotational pump speed to avoid retrograde flow in three centrifugal blood pumps in a pediatric extracorporeal life support model.

    Science.gov (United States)

    Clark, Joseph B; Guan, Yulong; McCoach, Robert; Kunselman, Allen R; Myers, John L; Undar, Akif

    2011-05-01

    During extracorporeal life support with centrifugal blood pumps, retrograde pump flow may occur when the pump revolutions decrease below a critical value determined by the circuit resistance and the characteristics of the pump. We created a laboratory model to evaluate the occurrence of retrograde flow in each of three centrifugal blood pumps: the Rotaflow, the CentriMag, and the Bio-Medicus BP-50. At simulated patient pressures of 60, 80, and 100 mmHg, each pump was evaluated at speeds from 1000 to 2200 rpm and flow rates were measured. Retrograde flow occurred at low revolution speeds in all three centrifugal pumps. The Bio-Medicus pump was the least likely to demonstrate retrograde flow at low speeds, followed by the Rotaflow pump. The CentriMag pump showed the earliest transition to retrograde flow, as well as the highest degree of retrograde flow. At every pump speed evaluated, the Bio-Medicus pump delivered the highest antegrade flow and the CentriMag pump delivered the least.

  2. Retrograde-viewing device improves adenoma detection rate in colonoscopies for surveillance and diagnostic workup

    Institute of Scientific and Technical Information of China (English)

    Peter D Siersema; Amit Rastogi; Anke M Leufkens; Paul A Akerman; Kassem Azzouzi; Richard I Rothstein; Frank P Vleggaar

    2012-01-01

    AIM:To determine which patients might benefit most from retrograde viewing during colonoscopy through subset analysis of randomized,controlled trial data.METHODS:The Third Eye(R) Retroscope(R) Randomized Clinical Evaluation (TERRACE) was a randomized,controlled,multicenter trial designed to evaluate the efficacy of a retrograde-viewing auxiliary imaging device that is used during colonoscopy to provide a second video image which allows viewing of areas on the proximal aspect of haustral folds and flexures that are difficult to see with the colonoscope's forward view.We performed a post-hoc analysis of the TER-RACE data to determine whether certain subsets of the patient population would gain more benefit than others from use of the device.Subjects were patients scheduled for colonoscopy for screening,surveillance or diagnostic workup,and each underwent same-day tandem examinations with standard colonoscopy (SC)and Third Eye colonoscopy (TEC),randomized to SC followed by TEC or vice versa.RESULTS:Indication for colonoscopy was screening in 176/345 subjects (51.0%),surveillance after previous polypectomy in 87 (25.2%) and diagnostic workup in 82 (23.8%).In 4 subjects no indication was specified.Previously reported overall results had shown a net additional adenoma detection rate (ADR) with TEC of 23.2% compared to SC.Relative risk (RR) of missing adenomas with SC vs TEC as the initial procedure was 1.92 (P =0.029).Post-hoc subset analysis shows additional ADRs for TEC compared to SC were 4.4% for screening,35.7% for surveillance,55.4% for diagnostic and 40.7% for surveillance and diagnostic combined.The RR of missing adenomas with SC vs TEC was 1.11 (P =0.815) for screening,3.15 (P =0.014) for surveillance,8.64 (P =0.039) for diagnostic and 3.34(P =0.003) for surveillance and diagnostic combined.Although a multivariate Poisson regression suggested gender as a possibly significant factor,subset analysis showed that the difference between genders was

  3. When the past is lost: focal retrograde amnesia. Focus on the "functional" form.

    Science.gov (United States)

    Stracciari, Andrea; Fonti, Cristina; Guarino, Maria

    2008-01-01

    We report the clinical findings and neuropsychological profiles of a sample of patients exhibiting a focal retrograde amnesia (FRA) seen consecutively during the period 1992-2007. The cohort comprised 13 patients, five males, with a mean age of 30 years (range 16-49). They were given a neurologic examination, psychiatric interview and formal neuropsychological examination (all but one) during the amnesic phase, underwent neuroimaging, and were followed up for six months to ten years. All presented with an acute amnesia characterized by an impaired recollection of memories predating the acute event, with spared or minimally and transiently affected anterograde memory, thus consistent with FRA. The events triggering FRA varied widely: mild to severe head injury, road accident without head injury, seizure, dissociative fugue, BDZ overdose, posttraumatic headache, syncope, migraine attack, acute distress. The neuropsychological hallmark of FRA was a selective or prominent impairment of autobiographical memory. The defect was often so severe as to cover most or all of the patients' lives and, in some cases, to erase the knowledge of their own identity. Conventional neuroimaging (brain CT and MRI) was unimpressive. Cerebral SPECT/PET disclosed unilateral frontal hypoperfusion in three (two left). All but one patient fully recovered, time of recovery ranging from three days to six months. FRA is a condition reflecting a block of memory function triggered by heterogeneous events, including both physical and psychic insults. Analogies shared with the more frequently encountered and better known condition of transient global amnesia suggests common pathogenetic mechanisms. A tentative nosographic classification of FRA is finally offered. PMID:19641249

  4. Lawsonite Lu-Hf geochronology from prograde and retrograde blueschist of the Franciscan Complex, California

    Science.gov (United States)

    Mulcahy, S. R.; Vervoort, J. D.

    2012-12-01

    Studies of ancient and active subduction zones are critically important to understanding processes of interplate coupling, crust-mantle recycling, and arc magmatism. Dating subduction metamorphism in order to constrain such processes, however, has proven extremely difficult. Lu-Hf dating of lawsonite, a critical index mineral of high-pressure, low-temperature metamorphism associated with subduction zones, provides a potentially powerful new tool for constraining subduction zone processes in a pressure-temperature window where few successful geochronometers exist. Broad application of lawsonite Lu-Hf geochronology requires constraining the role of pressure-temperature path and lawsonite forming reactions on the Lu and Hf systematics within lawsonite and other blueschist facies minerals. We are working to address the role of the metamorphic path on the applicability of lawsonite Lu-Hf geochronology within the Franciscan Complex of California. The Franciscan Complex preserves mafic high-grade exotic blocks in mélange that underwent a counterclockwise pressure-temperature path wherein garnet, which strongly partitions heavy rare-earth elements, formed prior to lawsonite. Coherent mafic rocks within the Franciscan Complex, however, underwent a clockwise pressure-temperature path and lawsonite growth occurred prior to garnet. We sampled two exotic blocks of lawsonite blueschist from the Berkeley Hills and Tiburon Peninsula of California. We collected four samples from coherent lawsonite blueschist from across the lawsonite - pumpellyite - epidote isograds in Ward Creek, near Cazadero California. Samples from retrograde exotic blocks contain lawsonite formed by garnet breakdown reactions that exhibit elevated Lu concentrations (>0.5 - 1.3 ppm) and 176Lu/177Hf ratios (low Lu concentrations and low 176Lu/177Hf ratios (low temperature lawsonite formed via the prograde breakdown of zeolite minerals may not be suitable for Lu-Hf geochronology.

  5. ν Octantis: a conjectured S-type retrograde planet in a spectroscopic binary system

    Science.gov (United States)

    Nelson, Benjamin E.; Ramm, David; Endl, Michael

    2016-01-01

    ν Octantis is a single-lined spectroscopic binary system consisting of a K-giant primary and a secondary orbiting near 1050 days. Radial velocity observations reveal an additional ~400 day periodicity with a semi-amplitude of 40 m/s. If this signal is planetary in nature, the ν Octantis system would be unique amongst all known exoplanet systems in that long-term stability can only be achieved if the orbit is retrograde with respect to the stellar companions (i.e. mutual inclination ~ 180°).Spectral line analyses suggest this signal is unlikely to be due to surface activity or pulsations (Ramm 2015). We also rule out an exotic scenario where the secondary itself is a binary.We report an analysis of 1437 radial velocity measurements taken with HERCULES at the Mt. John Observatory spanning nearly 13 years, 1180 being new iodine iodine-cell velocities (2009-2013). The sensitive orbital dynamics of the two-companion model allow us to constrain the three-dimensional orbital architecture directly from the observations. Posterior samples obtained from an n-body Markov chain Monte Carlo (Nelson et al. 2014) yields a mutual inclination of 158.4 ± 1.2°. None of these are dynamically stable beyond 106 years. However, a grid search around the posterior sample suggests that they are in close proximity to a region of parameter space that is stable for at least 106 years.If real, the tight orbital architecture here imposes a considerable challenge for formation of this dynamically extreme system.

  6. More support for the extreme S-type retrograde planet in the spectroscopic binary ν Octantis

    Science.gov (United States)

    Nelson, Benjamin Earl; Ramm, David; Endl, Michael; Gunn, Fraser; Hearnshaw, John; Kilmartin, Pam; Bergmann, Christoph; Brogt, Erik

    2015-12-01

    ν Octantis is a single-lined spectroscopic binary system consisting of a K-giant primary and a secondary orbiting near 1050 days. Radial velocity observations reveal an additional ~400 day periodicity with a semi-amplitude of 40 m/s. If this signal is planetary in nature, the ν Octantis system would be unique amongst all known exoplanet systems in that long-term stability can only be achieved if the orbit is retrograde with respect to the stellar companions (i.e. mutual inclination ~ 180°).Spectral line analyses suggest this signal is unlikely to be due to surface activity or pulsations (Ramm 2015). We also rule out an exotic scenario where the secondary itself is a binary.We report an analysis of 1437 radial velocity measurements taken with HERCULES at the Mt. John Observatory spanning nearly 13 years, 1180 being new iodine iodine-cell velocities (2009-2013). The sensitive orbital dynamics of the two-companion model allow us to constrain the three-dimensional orbital architecture directly from the observations. Posterior samples obtained from an n-body Markov chain Monte Carlo (Nelson et al. 2014) yields a mutual inclination of 158.4 ± 1.2°. None of these are dynamically stable beyond 106 years. However, a grid search around the posterior sample suggests that they are in close proximity to a region of parameter space that is stable for at least 106 years.If real, the tight orbital architecture here imposes a considerable challenge for formation of this dynamically extreme system.

  7. Magnetic resonance cholangiography compared with endoscopic retrograde cholangiography in the diagnosis of primary sclerosing cholangitis

    Directory of Open Access Journals (Sweden)

    Hossein Ahrar

    2014-01-01

    Full Text Available Background: Magnetic resonance cholangiography (MRC has gained popularity for diagnosing primary sclerosing cholangitis (PSC. We determined the accuracy of MRC compared with endoscopic retrograde cholangiography (ERC for diagnosing PSC. Materials and Methods: This retrospective case-control study was conducted on patients referred to an outpatient gastroenterology clinic from 2001 to 2013. Patients with established diagnosis of PSC who had undergone MRC and ERC within a 6-month interval were included. Controls were selected from patients who had undergone imaging for reasons other than PSC evaluation. Disease outcome at the study time and liver biochemistry data at diagnosis and 1-year thereafter were retrieved. Diagnostic accuracy of MRC in comparison with ERC was evaluated. Results: A total of 46 definite PSC patients (age at diagnosis = 36.8 ± 11.6 years, 33 male were found. Diagnostic imaging for PSC was ERC alone in 12, MRC alone in 23, and ERC plus MRC in 11 patients. Controls were 89 patients mostly with bile stones. The sensitivity, specificity, and positive and negative likelihood ratios of MRC was 90.9%, 95.5%, 20.23, and 0.10, respectively. Early PSC was found more frequently by MRC compared with ERC (30.4% vs. 8.3%, P = 0.146. No significant difference was found between imaging modalities with regards to patients′ outcome (P = 0.786 or liver biochemistry at diagnosis or 1-year thereafter (P >0.05. Conclusion: Starting diagnostic imaging for PSC with MRC seems better and may provide diagnosis of PSC at its earlier phase. Further studies with larger sample of patients and longer follow-ups are warranted.

  8. Application of retrograde dissection method for isolation of bone marrow cells from rat femurs and tibiae.

    Science.gov (United States)

    Li, C M; Fu, B M; Zhang, L C; Tang, B; Zhu, L; Zhao, Y; Zhang, J

    2016-01-01

    Currently, there is no practical and efficient method for the isolation of bone marrow cells (BMCs) from rat femurs and tibiae. Here, we attempted to develop a rapid, simple, effective, and non-contaminating method for the isolation of BMCs from rat femurs and tibiae. Rat femurs and tibiae were dissected from the ankle to the hip joint; subsequently, a three-step "locate-slide-twist" procedure was performed using scissors and forceps to remove the femurs and tibiae completely, from the surrounding musculature. The bones were flushed with phosphate-buffered saline to harvest BMCs. The femurs and tibiae were dissected in 1.8 ± 0.6 min, and the BMC suspension preparation time was 13.1 ± 2.3 min. The bone marrow cavities did not incur any fractures or injuries during the isolation. Culture of harvested BMCs for 72 h led to a significant increase in cell number from 4.4 ± 0.3 x 106 to 6.9 ± 0.7 x 10(6) (P 0.05). Microscopic examination of the isolated BMCs after the 72-h incubation period revealed the no-microbial or muscle cell contamination. Furthermore, flow cytometry revealed that cultured BMCs (72-h culture) grew well. Here, we have reported a rapid, simple, effective, and non-contaminating method for the isolation of BMCs from rat femurs and tibiae by using retrograde dissection. This method can be used to harvest a large number of viable BMCs without the risk of contamination from muscle and connective tissues. PMID:27323101

  9. Impact of retrograde flexible ureteroscopy and intracorporeal lithotripsy on kidney functional outcomes

    Directory of Open Access Journals (Sweden)

    Nicolas Hoarau

    2015-10-01

    Full Text Available ABSTRACT Objective: The aim of the study was to evaluate renal function and to identify factors associated with renal function deterioration after retrograde intrarenal surgery (RIRS for kidney stones. Materials and Methods: We retrospectively analyzed patients with renal stones treated by RIRS between January 2010 and June 2013 at a single institute. We used the National Kidney Foundation classification of chronic kidney disease (CKD to classify Glomerular Filtration Rate (GFR in 5 groups. The baseline creatinine level was systematically pre-operatively and post-operatively evaluated. All patients had a creatinine blood measurement in June 2013. A change toward a less or a more favorable GFR group following RIRS was considered significant. Results: We included 163 patients. There were 86 males (52.8% and 77 females (47.3% with a mean age of 52.8±17 years. After a mean follow-up of 15.5±11.5 months, median GFR was not significantly changed from 84.3±26.2 to 84.9±24.5 mL/min (p=0.675. Significant renal function deterioration occurred in 8 cases (4.9% and significant renal function amelioration occurred in 23 cases (14.1%. In univariate analysis, multiple procedures (p=0.023; HR: 5.4 and preoperative CKD (p=0.011; HR: 6.8 were associated with decreased renal function. In multivariate analysis these factors did not remain as predictive factors. Conclusion: Stone management with RIRS seems to have favorable outcomes on kidney function; however, special attention should be given to patients with multiple procedures and preoperative chronic kidney disease.

  10. Long-term Cre-mediated Retrograde Tagging of Neurons Using a Novel Recombinant Pseudorabies Virus

    Directory of Open Access Journals (Sweden)

    Hassana eOyibo

    2014-09-01

    Full Text Available Brain regions contain diverse populations of neurons that project to different long-range targets. The study of these subpopulations in circuit function and behavior requires a toolkit to characterize and manipulate their activity in vivo. We have developed a novel set of reagents based on Pseudorabies Virus (PRV for efficient and long-term genetic tagging of neurons based on their projection targets. By deleting IE180, the master transcriptional regulator in the PRV genome, we have produced a mutant virus capable of infection and transgene expression in neurons but unable to replicate in or spread from those neurons. IE180-null mutants showed no cytotoxicity, and infected neurons exhibited normal physiological function more than 45 days after infection, indicating the utility of these engineered viruses for chronic experiments. To enable rapid and convenient construction of novel IE180-null recombinants, we engineered a bacterial artificial chromosome (BAC shuttle-vector system for moving new constructs into the PRV IE180-null genome. Using this system we generated an IE180-null recombinant virus expressing the site-specific recombinase Cre. This Cre-expressing virus (PRV-hSyn-Cre efficiently and robustly infects neurons in vivo and activates transgene expression from Cre-dependent vectors in local and retrograde projecting populations of neurons in the mouse. We also generated an assortment of recombinant viruses expressing fluorescent proteins (mCherry, EGFP, ECFP. These viruses exhibit long-term labeling of neurons in vitro but transient labeling in vivo. Together these novel IE180-null PRV reagents expand the toolkit for targeted gene expression in the brain, facilitating functional dissection of neuronal circuits in vivo.

  11. Synthesis and characterization of retrograded starch nanoparticles through homogenization and miniemulsion cross-linking.

    Science.gov (United States)

    Ding, Yongbo; Zheng, Jiong; Zhang, Fusheng; Kan, Jianquan

    2016-10-20

    A new and convenient route to synthesizing retrograded starch nanoparticles (RS3NPs) through homogenization combined with a water-in-oil miniemulsion cross-linking technique was developed. The RS3NPs were optimized using Box-Behnken experimental design. Homogenization pressure (X1), oil/water ratio (X2), and surfactant (X3) were selected as independent variables, whereas particle size was considered as a dependent variable. Results indicated that homogenization pressure was the main contributing variable for particle size. The optimum values for homogenization pressure, oil/water ratio, and surfactant were 30MPa, 9.34:1, and 2.54g, respectively, whereas the particle size was predicted to be 288.2 nm. Morphological, physical, chemical, and functional properties of the RS3NPs were the assessed. Scanning electron microscopy and dynamic light scattering images showed that RS3NP granules were broken down to size of about 222.2nm. X-ray diffraction results revealed a disruption in crystallinity. The RS3NPs exhibited a slight decrease in To, but Tp and Tc increased and narrowest Tc-To. The solubility and swelling power were also increased. New peaks at 1594.84 and 1403.65cm(-1) were observed in the FTIR graph. However, homogenization minimally influenced the antidigestibility of RS3NPs. The absorption properties improved, and the adsorption kinetic described the contact time on the adsorption of captopril onto RS3NPs. In vitro release experiment indicated that the drug was released as follows: 21% after 2h in SGF, 42.78% at the end of 8h (2h in SGF and 6h in SIF), and 92.55% after 12h in SCF. These findings may help better utilize RS3NP in biomedical applications as a drug delivery material. PMID:27474611

  12. The Retrograde Ventriculosinusal Shunt in an Animal Experimental Model of Hydrocephalus.

    Science.gov (United States)

    Pinto, Fernando Campos Gomes; Becco, Rodrigo; Alho, Eduardo Joaquim Lopes; Poli-de-Figueiredo, Luiz Francisco; Souza, Podalyro Amaral de; Oliveira, Matheus Fernandes de; Teixeira, Manoel Jacobsen

    2016-01-01

    Currently, hydrocephalus treatment is performed mainly with ventriculoperitoneal shunting. This experimental study aims at assessing whether the experimental model of hydrocephalus in dogs is applicable to the laboratory study of the retrograde ventriculosinusal shunt (RVSS). Four mongrel dogs were assessed. After randomization, the animals were divided into two groups: an experimental group that underwent the induction of hydrocephalus/RVSS and a control group, for the measurement of the mean arterial pressure, intracranial pressure and pressure in the superior sagittal sinus (SSS). The controls presented a mean arterial pressure of 68 mm Hg (71 and 65), an intracranial pressure of 163 mm H2O (149.6 and 176.8) and a pressure at the SSS of 40 mm H2O (40 and 40). The kaolin injection into the cisterna magna at a concentration of 0.3 mg/ml was capable of inducing the clinical and radiological mechanism of hydrocephalus (intracranial pressure = 250 mm H2O, pressure at the SSS = 50 mm H2O). The caliber of the SSS was 2.5 ± 1.0 mm. The fact that the SSS caliber of the dog was the same size as the external diameter of the catheter used resulted in the complete obstruction of the SSS when the catheter was inserted. We believe we could design and perform an experimental model to test the RVSS. It is applicable and feasible. The model of hydrocephalus, the surgical apparatus and the scenario were adequate, but the shunt system needs to be proportionally made to the canine anatomy.

  13. Preliminary diagnostic reference levels for endoscopic retrograde cholangio-pancreatography in Greece.

    Science.gov (United States)

    Tsapaki, V; Delinikolas, P; Paraskeva, K D; Paspatis, I A G; Scotiniotis, H; Georgopoulos, P; Voudoukis, E; Finou, P; Athanasopoulos, N; Lydakis, I; Giannakopoulos, A; Mathou, N; Angelogiannakopoulou, N; Triantopoulou, C; Karagiannis, J A

    2016-04-01

    The main objective of this study was to determine the preliminary Diagnostic Reference Levels (DRLs) in terms of Kerma Area Product (KAP) and fluoroscopy time (Tf) during Endoscopic Retrograde Cholangio-Pancreatography (ERCP) procedures. Additionally, an investigation was conducted to explore the statistical relation between KAP and Tf. Data from a set of 200 randomly selected patients treated in 4 large hospitals in Greece (50 patients per hospital) were analyzed in order to obtain preliminary DRLs for KAP and Tf during therapeutic ERCP procedures. Non-parametric statistic tests were performed in order to determine a statistically significant relation between KAP and Tf. The resulting third quartiles for KAP and Tf for hospitals (A, B, C and D) were found as followed: KAPA=10.7Gycm(2), TfA=4.9min; KAPB=7.5Gycm(2), TfB=5.0min; KAPC=19.0Gycm(2), TfC=7.3min; KAPD=52.4Gycm(2), TfD=15.8min. The third quartiles, calculated for the total 200 cases sample, are: KAP=18.8Gycm(2) and Tf=8.2min. For 3 out of 4 hospitals and for the total sample, p-values of statistical indices (correlation of KAP and Tf) are less than 0.001, while for the Hospital A p-values are ranging from 0.07 to 0.08. Using curve fitting, we finally determine that the relation of Tf and KAP is deriving from a power equation (KAP=Tf(1.282)) with R(2)=0.85. The suggested Preliminary DRLs (deriving from the third quartiles of the total sample) for Greece are: KAP=19Gycm(2) and Tf=8min, while the relation between KAP and Tf is efficiently described by a power equation. PMID:27068273

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

    Science.gov (United States)

    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

  15. Additive effects of forgetting and fornix transfection in the temporal gradient of retrograde amnesia.

    Science.gov (United States)

    Gaffan, D

    1993-10-01

    Nine Rhesus monkeys (Macaca mulatta) learned to discriminate among 320 complex naturalistic scenes (Set A) for food reward. Six months later they learned to discriminate among a further 192 scenes (Set B). Immediately after learning Set B the animals were given a preoperative retention test of both sets, consisting of a single trial with every scene they had learned. Three monkeys were then operated upon to transect the fornix, the other six forming an unoperated control group. Two weeks after operation the scenes were presented once each in a postoperative retention test. The animals with fornix transection showed significantly poorer memory than the control animals at the postoperative retention test. Furthermore, within the fornix-transected animals' performance, postoperative amnesia for Set B was more marked than amnesia for Set A, by comparison with the animals' own preoperative retention of the two sets. However, a similar pattern of performance was also seen within the control animals' results, in that they forgot more of Set B than of Set A in the interval between the preoperative and postoperative retention tests. There was no significant difference between the groups in the gradient of forgetting, defined as the difference between forgetting of Set B and forgetting of Set A in the interval between the preoperative and postoperative retention tests. These results give no support to the idea that the severity of retrograde amnesia is graded as a function of the remoteness of the memory at the onset of amnesia, and they give some indication of possible reasons why the impression of such a gradient is frequently reported clinically. PMID:8290022

  16. Double-balloon-enteroscopy-based endoscopic retrograde cholangiopancreatography in post-surgical patients

    Institute of Scientific and Technical Information of China (English)

    Martin Raithel; Harald Dormann; Andreas Naegel; Frank Boxberger; Eckhart G Hahn; Markus F Neurath; Juergen Maiss

    2011-01-01

    AIM: To evaluate double balloon enteroscopy (DBE) in post-surgical patients to perform endoscopic retrograde cholangiopancreatography (ERCP) and interventions. METHODS: In 37 post-surgical patients, a stepwise approach was performed to reach normal papilla or enteral anastomoses of the biliary tract/pancreas. When conventional endoscopy failed, DBE-based ERCP was performed and standard parameters for DBE, ERCP and interventions were recorded.RESULTS: Push-enteroscopy (overall, 16 procedures) reached enteral anastomoses only in six out of 37 post-surgical patients (16.2%). DBE achieved a high rate of luminal access to the biliary tract in 23 of the remaining 31 patients (74.1%) and to the pancreatic duct (three patients). Among all DBE-based ERCPs (86 procedures), 21/23 patients (91.3%) were successfully treated. Interventions included ostium incision or papillotomy in 6/23 (26%) and 7/23 patients (30.4%),respectively. Biliary endoprosthesis insertion and regular exchange was achieved in 17/23 (73.9%) and 7/23 patients (30.4%), respectively. Furthermore, bile duct stone extraction as well as ostium and papillary dilation were performed in 5/23 (21.7%) and 3/23 patients (13.0%), respectively. Complications during DBE-based procedures were bleeding (1.1%), perforation (2.3%) and pancreatitis (2.3%), and minor complications occurred in up to 19.1%.CONCLUSION: The appropriate use of DBE yields a high rate of luminal access to papilla or enteral anastomoses in more than two-thirds of post-surgical patients, allowing important successful endoscopic therapeutic interventions.

  17. Locking plate versus retrograde intramedullary nail fixation for tibiotalocalcaneal arthrodesis A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Chi Zhang

    2015-01-01

    Full Text Available Background: Tibiotalocalcaneal arthrodesis (TTCA surgery is indicated for the end-stage disease of the tibiotalar and subtalar joints.Although different fixation technique of TTCA has been proposed to achieve high fusion rate and low complication rate, there is still no consensus upon this point. The purpose of this study is to compare the clinical efficacy of retrograde intramedullary nail fixation (RINF and locking plate fixation (LPF for TTCA. Materials and Methods: Fifty four patients who underwent TTCA through the lateral approach with lateral fibular osteotomy using RINF (32 patients, 18 male/14 female, mean age: 48 or LPF (22 patients, 12 male/10 female, mean age: 51 between January 2007 and January 2010 were retrospectively analyzed. Demographic and clinical characteristics, surgery (operation time, blood loss outcomes (postoperative fusion rates, visual analog scale and foot and ankle surgery score and complications were compared. Results: The LPF group had a shorter operation time (72.3 ± 9.2 vs. 102.8 ± 11.1 min, P < 0.001, less blood loss (75.9 ± 20.2 vs. 140.0 ± 23.8 ml, P < 0.001 and less intraoperative fluoroscopy sessions (3.6 ± 0.9 vs. 8.4 ± 1.3, P < 0.001 than the RINF group. Patients were followed up for 12-24 months (mean of 16.2 months. Both groups had similar postoperative fusion rates (90.6% and 95.4% and the LPF group showed a nonsignificant lower complication rate (18.2% vs. 28.1% respectively. Patients at higher risk on nonunion due to rheumatoid diseases may have a lower nonunion rate with LPF than RINF (one out of eight vs. three out of nine, P < 0.001. Conclusions: The LPF for TTCA was simpler to perform compared with RINF, but with similar postoperative outcomes and complication rates.

  18. The Retrograde Ventriculosinusal Shunt in an Animal Experimental Model of Hydrocephalus.

    Science.gov (United States)

    Pinto, Fernando Campos Gomes; Becco, Rodrigo; Alho, Eduardo Joaquim Lopes; Poli-de-Figueiredo, Luiz Francisco; Souza, Podalyro Amaral de; Oliveira, Matheus Fernandes de; Teixeira, Manoel Jacobsen

    2016-01-01

    Currently, hydrocephalus treatment is performed mainly with ventriculoperitoneal shunting. This experimental study aims at assessing whether the experimental model of hydrocephalus in dogs is applicable to the laboratory study of the retrograde ventriculosinusal shunt (RVSS). Four mongrel dogs were assessed. After randomization, the animals were divided into two groups: an experimental group that underwent the induction of hydrocephalus/RVSS and a control group, for the measurement of the mean arterial pressure, intracranial pressure and pressure in the superior sagittal sinus (SSS). The controls presented a mean arterial pressure of 68 mm Hg (71 and 65), an intracranial pressure of 163 mm H2O (149.6 and 176.8) and a pressure at the SSS of 40 mm H2O (40 and 40). The kaolin injection into the cisterna magna at a concentration of 0.3 mg/ml was capable of inducing the clinical and radiological mechanism of hydrocephalus (intracranial pressure = 250 mm H2O, pressure at the SSS = 50 mm H2O). The caliber of the SSS was 2.5 ± 1.0 mm. The fact that the SSS caliber of the dog was the same size as the external diameter of the catheter used resulted in the complete obstruction of the SSS when the catheter was inserted. We believe we could design and perform an experimental model to test the RVSS. It is applicable and feasible. The model of hydrocephalus, the surgical apparatus and the scenario were adequate, but the shunt system needs to be proportionally made to the canine anatomy. PMID:26942592

  19. Efficacy and safety of emergency endoscopic retrograde cholangiopancreatography for acute cholangitis in the elderly

    Science.gov (United States)

    Tohda, Gen; Ohtani, Masahiro; Dochin, Masaki

    2016-01-01

    AIM To investigate the efficacy and safety of emergency endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with acute cholangitis. METHODS From June 2008 to May 2016, emergency ERCPs were performed in 207 cases of acute cholangitis at our institution. Patients were classified as elderly if they were aged 80 years and older (n = 102); controls were under the age of 80 years (n = 105). The patients’ medical records were retrospectively reviewed for comorbidities, laboratory data, etiology of cholangitis (presence of biliary stones, biliary stricture and malignancy), details of the ERCP (therapeutic approaches, technical success rates, procedure duration), ERCP-related complications and mortality. RESULTS The frequency of comorbidities was higher in the elderly group than the control group (91.2% vs 67.6%). Periampullary diverticulum was observed in the elderly group at a higher frequency than the control group (24.5% vs 13.3%). Between the groups, there was no significant difference in the technical success rates (95.1% vs 95.2%) or endoscopic procedure durations. With regard to the frequency of ERCP-related complications, there was no significant difference between the two groups (6.9% vs 6.7%), except for a lower rate of post-ERCP pancreatitis in the elderly group than in the control group (1.0% vs 3.8%). Neither angiographic nor surgical intervention was required in any of the cases with ERCP-related complications. There was no mortality during the observational periods. CONCLUSION Emergency ERCP for acute cholangitis can be performed safely even in elderly patients aged 80 years and older. PMID:27729744

  20. Retrograde wire-track based percutaneous transcatheter closure of persistent duct arteriosus: a new application

    International Nuclear Information System (INIS)

    Objective: To explore the value and technique key point of retrograde wire-track based new application in percutaneous transcatheter closure of persistent duct arteriosus (PDA). Methods: From May 1998 to July 2005, 831 patients with PDA underwent transcatheter closure, 11 cases ( about 1.3% ) with anatomy too difficult to be antegradely approached and were closed by building femoral artery-PDA- pulmonary artery-femoral vein wire-track. The mean age of the 11 patients was (42±20) years (ranged from 8 to 76 years), the mean weight was (61±23) kg (ranged from 20 to 100 kg); the mean diameter of PDA was (4.1±1.9) mm (ranged from 1.6 to 6.7). Results: Wire-track were smoothly built up in all the 10 patients and then finished deployment according to Amplatzer method. The size of occluders were 6/4 mm (3 cases), 8/6 mm(4 cases), 10/8 mm(2 cases), 12/10 mm( 1 case), 14/12 mm(1 case). There was complete closure in 10 patients immediately, and tiny residual shunt in only 1 patient at the descending aortography. Twenty minutes later, the tiny residual shunt disappeared. There were no other complications. Conclusion: Deformed ostium and difficult anatomy of PDA leads to failure to track the delivery system to cross the ductus from the pulmonary artery. This new application by building femoral artery-PDA-pulmonary artery-femoral vein wire-track can overcome the technical difficulty safely and effectively. (authors)

  1. Treatment of distal femoral nonunion and delayed union by using a retrograde intramedullary interlocking nail

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To analyze the causes of distal femoral nonunion and delayed union and assess the outcome of the corresponding treatment, retrograde intramedullary interlocking nail (RIIN).   Methods: From June 1995 to December 1998, 15 patients (9 males and 6 females) with distal femoral nonunion and delayed union were treated with RIIN. The average age of the patients was 34.5 years (23-46 years). Bone grafting was performed in 10 patients, closed reaming was done in the other 5 patients. Correction osteotomy was performed in 2 patients, and intra-articular release of knee adhesion in 11 patients. X-ray examination and knee society clinical rating system (KSS) were used to evaluate the results.   Results: All fractures were followed up for at least 9 months with average follow-up duration of 14.5 months (9-33 months). Solid union was documented in all patients at 6.4 months on average. There were no infections or malunions in this series. Based on the final follow-up data, acceptable functional range of motion (ROM) of over 90° was achieved in most patients. The average ROM was 93.5° with significant improvement of 28° (42.7%, P<0.05) compared with the preoperative ROM. The average knee score was 96. Excellent ROM emerged in 13 patients. The knee function score was 90.5 on average.   Conclusions: The main causes of distal femoral nonunion and delayed union are improper indications and improper use of the implants. RIIN is an effective alternative for treatment of distal femoral nonunion and delayed union because it can provide a stable and reliable fixation which is beneficial for early functional exercise of knee. Bone grafting, closed reaming and intra-articular release of knee adhesion should be considered in order to enhance the bone healing and improve ROM and the knee function.

  2. N-acetylcysteine does not prevent post-endoscopic retrograde cholangiopancreatography hyperamylasemia and acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Janusz Milewski; Grazyna Rydzewska; Malgorzata Degowska; Maciej Kierzkiewicz; Andrzej Rydzewski

    2006-01-01

    AIM: Acute pancreatitis (AP) is the most common and often severe complication of endoscopic retrograde cholangiopancreatography (ERCP). The early step in the pathogenesis of acute pancreatitis is probably the capil lary endothelial injury mediated by oxygen-derived freeradicals. N-acetylcysteine - a free radical scavenger may be potentially effective in preventing post-ERCP acute pancreatitis and it is also known that N-acetylcysteine (ACC) can reduce the severity of disease in experimental model of AP.METHODS: One hundred and six patients were randomly allocated to two groups. Fifty-five patients were given N-acetylcysteine (two 600 mg doses orally 24 and 12 h before ERCP and 600 mg was given iv, twice a day for two days after the ERCP). The control group consisted of 51 patients who were given iv. isotonic saline twice a day for two days after the ERCP. Serum and urine amylase activities were measured before ERCP and 8 and 24 h after the procedure. The primary outcome parameter was post-ERCP acute pancreatitis and the secondary outcome parameters were differences between groups in serum and urine amylase activity.RESULTS: There were no significant differences in the rate of post-ERCP pancreatitis between two groups (10patients overall, 4 in the ACC group and 6 in the control group). There were also no significant differences in baseline and post-ERCP serum and urine amylase activity between ACC group and control group.CONCLUSION: N-acetylcysteine fails to demonstrate any significant preventive effect on post-ERCP pancreatitis, as well as on serum and urine amylase activity.

  3. Immune dysfunction in patients with obstructive jaundice before and after endoscopic retrograde cholangiopancreatography.

    Science.gov (United States)

    Chowdhury, Abeed H; Camara, Miguel; Martinez-Pomares, Luisa; Zaitoun, Abed M; Eremin, Oleg; Aithal, Guruprasad P; Lobo, Dileep N

    2016-09-01

    This prospective observational study investigated monocyte cytokine responses to lipopolysaccharide (LPS) in patients with obstructive jaundice (OJ) before and after endoscopic biliary drainage. Dendritic cell (DC) subsets and their expression of co-stimulatory molecules were also studied. Forty patients with OJ and ten non-jaundiced patients with normal gastroscopy findings were recruited. Ten healthy volunteers provided control blood samples for immunological assays. Patients with OJ had blood and duodenal mucosa sampled at the time of endoscopic retrograde cholangiopancreatography (ERCP) and further blood sampled during the recovery phase. Monocyte cytokine responses to LPS, DC subsets and co-stimulatory molecule expression were compared with controls. Duodenal morphology and occludin expression were also assessed. Monocytes obtained before ERCP from jaundiced patients demonstrated reduced cytokine responses to endotoxin compared with controls (IL-1β: 2678 compared with 4631 pg/ml, P=0.04 and IL-6: 3442 compared with 6157 pg/ml, P=0.002). Monocytes from patients with malignancy had poorer responses to endotoxin than from those with benign OJ (IL-1β: 2025 compared with 3332 pg/ml, P=0.001). After ERCP, the secretion of inflammatory cytokines by monocytes obtained from jaundiced patients increased (IL-1β: 2150 compared with 2520 pg/ml, P=0.03 and IL-6: 2488 compared with 3250 pg/ml, P=0.01). Occludin expression (85 compared with 95%, P=0.004) and mean duodenal villus height (334 compared with 404 μm, P=0.03) were lower in jaundiced patients. Before biliary drainage, patients with OJ had a higher percentage of myeloid dendritic cells (mDCs) and greater mDC expression of CD40 (P=0.04) and CD86 (P=0.04). Monocytes from patients with OJ had lower proinflammatory cytokine secretion in response to LPS, an effect reversed following biliary drainage. PMID:27252406

  4. Experimental study and clinical application of retrograde liberated highlyselective vagotomy for the treatment of duodenal ulcer

    Institute of Scientific and Technical Information of China (English)

    Dao Da Chen; Xiao Ming Lu; Wei You; Jian Ying Chen; Zhi Yi Luo; Jian Hua Liu

    2000-01-01

    AIM We introduce a new highly selective vagotomy (HSV) procedure which can completely destroy anyexisting variant vagal fibers innervating the proximal stomach.METHODS Twenty-eight dogs were divided into three groups: group A had retrograde liberated highlyselective vagotomy (RLHSV), group B had traditional HSV and group C as control group. Gastric acidsecretion function was tested and gastric parasympathetic and sympathetic enervation were studied byretrograde tracing the horseradish peroxidase (HRP) or by histochemical staining. After being convincedthat the modified procedure was an easier and more effective HSV on animal model, we applied thetechnique to the treatment of duodenal ulcers in 100 patients.RESULTS Significant decrease of acid secretion was found in operated dogs in both group A and B. After injection of HRP subserously into the fundus and body, no HRP positive cells were found in the vagal dorsalnucleus in group A and B but were in group C. When HRP was injected into the antrum, HRP stained cellswere found in dorsal nucleus in all three groups. The negative histochemical staining of AchE and the positivefluorescence in the fundus and body in group A and B indicate that parasympathetic nerve fibers weredestroyed completely while norepinephrinergic nerve fibers were intact. When the operation was applied topatients, no severe complications or operative mortality occurred. Patients were followed up for 6- 84months. They all had complete gastric emptying function. Ninety-four patients were graded as Visick I orⅡ. Six as Visick Ⅲ and Ⅳ. Eighty patients had been followed up with gastroscopy for two years afteroperation. Four patients had recurrent ulcers. Among them two patients were asymptomatic and the othertwo had symptoms and were treated with partial gastrectomy.CONCLUSION Compared to the classic HSV, our modified procedure is more effective clinically andconvenient technically.

  5. Rotational assisted endoscopic retrograde cholangiopancreatography in patients with reconstructivegastrointestinal surgical anatomy

    Institute of Scientific and Technical Information of China (English)

    Majed El Zouhairi; James B Watson; Svetang V Desai; David K Swartz; Alejandra Castillo-Roth; Mahfuzul Haque; Paul S Jowell; Malcolm S Branch; Rebecca A Burbridge

    2015-01-01

    AIM: To evaluate the success rates of performingtherapy utilizing a rotational assisted enteroscopy devicein endoscopic retrograde cholangiopancreatography(ERCP) in surgically altered anatomy patients.METHODS: Between June 1, 2009 and November8, 2012, we performed 42 ERCPs with the use ofrotational enteroscopy for patients with alteredanatomy (39 with gastric bypass Roux-en-Y, 2 withBillroth Ⅱ gastrectomy, and 1 with hepaticojejunostomyassociated with liver transplant). The indications forERCP were: choledocholithiasis: 13 of 42 (30.9%),biliary obstruction suggested on imaging: 20 of 42(47.6%), suspected sphincter of Oddi dysfunction: 4 of42 (9.5%), abnormal liver enzymes: 1 of 42 (2.4%),ascending cholangitis: 2 of 42 (4.8%), and bile leak: 2of 42 (4.8%). All procedures were completed with theOlympus SIF-Q180 enteroscope and the Endo-EaseDiscovery SB overtube produced by Spirus Medical.RESULTS: Successful visualization of the majorampulla was accomplished in 32 of 42 procedures(76.2%). Cannulation of the bile duct was successfulin 26 of 32 procedures reaching the major ampulla(81.3%). Successful therapeutic intervention wascompleted 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.

  6. Anterograde transport blockade precedes deficits in retrograde transport in the visual projection of the DBA/2J mouse model of glaucoma

    Directory of Open Access Journals (Sweden)

    Christine M Dengler-Crish

    2014-09-01

    Full Text Available Axonal transport deficits have been reported as an early pathology in several neurodegenerative disorders, including glaucoma. However, the progression and mechanisms of these deficits are poorly understood. Previous work suggests that anterograde transport is affected earlier and to a larger degree than retrograde transport, yet this has never been examined directly in vivo. Using combined anterograde and retrograde tract tracing methods, we examined the time-course of anterograde and retrograde transport deficits in the retinofugal projection in pre-glaucomatous (3 month-old and glaucomatous (9-13 month old DBA/2J mice. DBA/2J-Gpnmb+ mice were used as a control strain and were shown to have similar retinal ganglion cell densities as C57BL/6J control mice—a strain commonly investigated in the field of vision research. Using cholera toxin-B injections into the eye and FluoroGold injections into the superior colliculus (SC, we were able to measure anterograde and retrograde transport in the primary visual projection. In DBA/2J, anterograde transport from the retina to superior colliculus (SC was decreased by 69% in the 9-10 month-old age group, while retrograde transport was only reduced by 23% from levels seen in pre-glaucomatous mice. Despite this minor reduction, retrograde transport remained largely intact in these glaucomatous age groups until 13-months of age. These findings indicate that axonal transport deficits occur in semi-functional axons that are still connected to their brain targets. Structural persistence as determined by presence of estrogen-related receptor beta label in the superficial SC was maintained beyond time-points where reductions in retrograde transport occurred, also supporting that transport deficits may be due to physiological or functional abnormalities as opposed to overt structural loss.

  7. Scanning electron microscopy (SEM) evaluation of sealing ability of MTA and EndoSequence as root-end filling materials with chitosan and carboxymethyl chitosan (CMC) as retrograde smear layer removing agents

    OpenAIRE

    Bolla Nagesh; Eppala Jeevani; Varri Sujana; Bharagavi Damaraju; Kaluvakolanu Sreeha; Penumaka Ramesh

    2016-01-01

    Aim: The purpose of this study was to evaluate the sealing ability of mineral trioxide aggregate (MTA) and EndoSequence with chitosan and carboxymethyl chitosan (CMC) as retrograde smear layer removing agents using scanning electron microscopy (SEM). Materials and Methods: Forty human single rooted teeth were taken. Crowns were decoronated and canals were obturated. Apically roots were resected and retrograde cavities were done. Based on the type of retrograde material placed and the typ...

  8. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Chi-Tuan; Blanc, Raphael; Pistocchi, Silvia; Bartolini, Bruno; Piotin, Michel [Fondation Rothschild Hospital, Department of Interventional Neuroradiology, Paris (France); Lumbroso-Le Rouic, Livia [Institut Curie, Department of Ocular Oncology, Paris (France)

    2012-08-15

    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  9. Femoral Condyles Tangential Views: An Effective Method to Detect the Screw Penetration of Femoral Condyles After Retrograde Nailing

    Institute of Scientific and Technical Information of China (English)

    Zhan-Le Zheng; Xian Yu; Wei Chen; Yue-Ju Liu; Kun-Lun Yu; Tao Wu; Ying-Ze Zhang

    2015-01-01

    Background: Postoperative knee soft tissue irritation is a common complication after retrograde nail fixation of femoral fractures.Distal locking screw prominence is one of the causes for soft tissue irritation.This study aimed to determine whether the use of the femoral condyles tangential views improve the diagnostic accuracy compared with anteroposterior (A-P) view in detecting distal locking screw penetrations during retrograde femoral nailing.Methods: The angle between the sagittal plane and lateral aspect of the condyle and the angle between the sagittal plane and medial aspect of condyle were measured on computed tomography (CT) images.After the angles were measured and recorded, cadaveric femurs were used in a simulated surgical procedure.The retrograde femoral nail was inserted into the femur and placed distal locking screws, which were left 2, 4, and 6 mm proud of the medial and lateral condyles for each femur.A-P view, lateral condyle tangential view and medial condyle tangential view were obtained.All fluoroscopic images were recorded and sent to three observers blinded to the experimental procedure to determine whether screws penetrated the condyle cortex or not.Results: According to the results of CT scan, the lateral condyle view was 20.88 ± 0.98° and the medial condyle view was 40.46 ± 3.14°.In the A-P view, we detected 0% at 2 mm penetration, 16.7% (lateral condyle screw) and 25.0% (medial condyle screw) at 4 mm, and 41.7% (lateral condyle screw) and 58.3% (medial condyle screw) at 6 mm.In the lateral tangential view, we detected 91.7% at 2 mm penetration of the lateral condyle and 100% at 4 mm and 6 mm.In the medial tangential view, we detected 66.7% at 2 mm penetration of the medial condyle and 100% at 4 mm and 6 mm.The femoral condyle tangential views provided significant improvement in detecting screw penetrations at all lengths (2, 4, and 6 mm) compared with the A-P view (P < 0.05).Conclusions: The femoral condyles

  10. Femoral Condyles Tangential Views: An Effective Method to Detect the Screw Penetration of Femoral Condyles After Retrograde Nailing

    Directory of Open Access Journals (Sweden)

    Zhan-Le Zheng

    2015-01-01

    Full Text Available Background: Postoperative knee soft tissue irritation is a common complication after retrograde nail fixation of femoral fractures. Distal locking screw prominence is one of the causes for soft tissue irritation. This study aimed to determine whether the use of the femoral condyles tangential views improve the diagnostic accuracy compared with anteroposterior (A-P view in detecting distal locking screw penetrations during retrograde femoral nailing. Methods: The angle between the sagittal plane and lateral aspect of the condyle and the angle between the sagittal plane and medial aspect of condyle were measured on computed tomography (CT images. After the angles were measured and recorded, cadaveric femurs were used in a simulated surgical procedure. The retrograde femoral nail was inserted into the femur and placed distal locking screws, which were left 2, 4, and 6 mm proud of the medial and lateral condyles for each femur. A-P view, lateral condyle tangential view and medial condyle tangential view were obtained. All fluoroscopic images were recorded and sent to three observers blinded to the experimental procedure to determine whether screws penetrated the condyle cortex or not. Results: According to the results of CT scan, the lateral condyle view was 20.88 ± 0.98° and the medial condyle view was 40.46 ± 3.14°. In the A-P view, we detected 0% at 2 mm penetration, 16.7% (lateral condyle screw and 25.0% (medial condyle screw at 4 mm, and 41.7% (lateral condyle screw and 58.3% (medial condyle screw at 6 mm. In the lateral tangential view, we detected 91.7% at 2 mm penetration of the lateral condyle and 100% at 4 mm and 6 mm. In the medial tangential view, we detected 66.7% at 2 mm penetration of the medial condyle and 100% at 4 mm and 6 mm. The femoral condyle tangential views provided significant improvement in detecting screw penetrations at all lengths (2, 4, and 6 mm compared with the A-P view (P < 0.05. Conclusions: The femoral condyles

  11. Short-and long-term outcomes of kidney transplants with kidneys lavaged by retrograde perfusion technique

    Institute of Scientific and Technical Information of China (English)

    Xiu-Wu Han; Xiao-Dong Zhang; Yong Wang; Xi-Quan Tian; Jian-Wen Wang; Bu-He Amin; Wei Yan

    2015-01-01

    Objective: To evaluate the clinical safety and efficacy of the retrograde perfusion technique in kidney transplantation.Methods: Between January 2001 and June 2011, 24 cases of kidney transplantation with kidneys perfused using the retrograde perfusion technique due to renal artery variations or injury were selected as the observation group (retrograde perfussion roup, RP group).Twenty-two cases of kidney transplantation via conventional perfusion were chosen as the control group (antegrade perfussion group, AP group).There were no statistically significant differences in donor data between the two groups.Cold ischemia time, warm ischemia time, renal perfusion time, amount of perfusion fluid, acute renal tubular necrosis, wound infection, urinary fistula, graft kidney function, and the 1-year, 3-year, and 5-year survival rates for the grafted kidney in both groups were observed and recorded.Results: The kidney perfusion time was shorter in the RP group than that in the AP group (3.14 ± 1.00 vs.5.02 ± 1.15 min, P =0.030).There were 10 cases of acute renal tubule necrosis in the RP group and 5 in the AP group.The length of hospital stay was 40 ± 14 d in the RP group and 25 ± 12 d in the AP group.The follow-up time was 3.5-8.5 years (mean 6.25 years).The 1-, 3-, and 5-year survival rates for the grafted kidney were 95.8%, 75.5%, and 65.5% in the RP group and 97.1%, 82.5%, and 68.4% in the AP group, respectively (P>0.05).Conclusions: This study indicates that retrograde perfusion is safe and practicable for cadaveric kidney harvesting and can be regarded as a better alternative or remedial measure for a poorly perfused kidney due to vascular deformity or injury.Copyright 2015, Chinese Medical Association Production.Production and hosting by Elsevier B.V.on behalf of KeAi Communications Co., Ltd.This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

  12. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    International Nuclear Information System (INIS)

    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  13. Carbon dioxide insufflation for endoscopic retrograde cholangiopancreatography: A meta-analysis and systematic review

    Institute of Scientific and Technical Information of China (English)

    Yao Cheng; Xian-Ze Xiong; Si-Jia Wu; Jiong Lu; Yi-Xin Lin; Nan-Sheng Cheng; Tai-Xiang Wu

    2012-01-01

    AIM:To assess the safety and efficacy of carbon dioxide (CO2) insufflation during endoscopic retrograde cholangiopancreatography (ERCP).METHODS:The Cochrane Library,Medical Literature Analysis and Retrieval System Online,Excerpta Medica Database,Science Citation Index Expanded,Chinese Biomedical Literature Database,and references in relevant publications were searched up to December 2011 to identify randomized controlled trials (RCTs)comparing CO2 insufflation with air insufflation during ERCP.The trials were included in the review irrespective of sample size,publication status,or language.Study selection and data extraction were performed by two independent authors.The meta-analysis was performed using Review Manager 5.1.6.A randomeffects model was used to analyze various outcomes.Sensitivity and subgroup analyses were performed if necessary.RESULTS:Seven double-blind RCTs involving a total of 818 patients were identified that compared CO2insuftlation (n =404) with air insufflation (n =401)during ERCR There were a total of 13 post-randomization dropouts in four RCTs.Six RCTs had a high risk of bias and one had a low risk of bias.None of the RCTs reported any severe gas-related adverse events in either group.A meta-analysis of 5 RCTs (n =459)indicated that patients in the CO2 insufflation group had less post-ERCP abdominal pain and distension for at least 1 h compared with patients in the air insufflation group.There were no significant differences in mild cardiopulmonary complications [risk ratio (RR) =0.43,95% CI:0.07-2.66,P =0.36],cardiopulmonary (e.g.,blood CO2 level) changes [standardized mean difference (SMD) =-0.97,95% CI:-2.58-0.63,P =0.23],cost analysis (mean difference =3.14,95% CI:-14.57-20.85,P =0.73),and total procedure time (SMD=-0.05,95% CI:-0.26-0.17,P =0.67) between the two groups.CONCLUSION:CO2 insufflation during ERCP appears to be safe and reduces post-ERCP abdominal pain and discomfort.

  14. New precut sphincterotomy for endoscopic retrograde cholangiopancreatography in difficult biliary duct cannulation

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To retrospectively investigate the effect and safety of various new type precut sphincterotomy techniques (VNTPST) in endoscopic retrograde cholangiopancreatography (ERCP) due to difficult biliary duct cannulation (DBC).METHODS: A plough-like pull-type sphincterotome (PLPTS) or improved short nose sphincterotome or improved needle knife was applied. VNTPST was carried out in 30 of 280 patients, whose biliary tract could not be exposed well or deep cannulation was difficult to perform during ERCP with traditional methods. Patients were followed up for short-term complications and the therapeutic effect of VNTPS was observed and compared with that of traditional endoscopic sphincterotomy (EST).RESULTS: A total 280 patients underwent ERCP, of which 3 failed in operation because of pathological features in stomch or duodenum, 247 successfully underwent traditional ERCP (89.1%, 247/277), 30 failed (10.8%, 30/277). VNTPS technique succeeded in 24(80%, 24/30) of 30 cases. The successful rate of deep biliary duct cannulation increased 8.6% (24/277), the total cannulation successful rate following precut was 97.7%. There was a significant difference between the two groups (97.7% vs 89.1%, χ2= 17.1, P < 0.01).The incidence of complications was 9.3% (26/277) for traditional ERCP group and 13.3% (4/30) for VNTPS technique group. Guideline tip was broken in pancreatic duct (KPDGP) of one patient, and there was no pancreatitis, slight or moderate bleeding postoperatively occurred in 2 patients, 1 patient had bleeding during operation (PDWN). There were no differences between VNTPS technique group and traditional ERCP(TRERCP)group (13.3% vs 9.3%,χ2 = 0.478, P > 0.05).CONCLUSION: VNTPS procedure and Deng's precut are highly effective methods to get biliary access during ERCP with DBC. With skillful techniques, it can increase the successful rate for deep cannulation of biliary duct and decrease complications. VNTPS technique, especially Deng's precut is as effective and

  15. Microbial profile and antibiotic sensitivity pattern in bile cultures from endoscopic retrograde cholangiography patients

    Institute of Scientific and Technical Information of China (English)

    Muhsin Kaya; Remzi Bestas; Fatma Bacalan; Ferhat Bacakslz; Esma Gülsun Arslan; Mehmet Ali Kaplan

    2012-01-01

    AIM:To identify the frequency of bacterial growth,the most commonly grown bacteria and their antibiotic susceptibility,and risk factors for bacterial colonization in bile collected from patients with different biliary diseases.METHODS:This prospective study was conducted between April 2010 and August 2011.Patients with various biliary disorders were included.Bile was aspirated by placing a single-use,5F,standard sphincterotome catheter into the bile duct before the injection of contrast agent during endoscopic retrograde cholangiopancreaticography (ERCP).Bile specimens were transported to the microbiology laboratory in blood culture bottles within an anaerobic transport system.Bacteria were cultured and identified according to the standard protocol used in our clinical microbiology laboratory.The susceptibilities of the organisms recovered were identified using antimicrobial disks,chosen according to the initial gram stain of the positive cultures.RESULTS:Ninety-one patients (27% male,mean age 53.7 ± 17.5 years,range:17-86 years) were included in the study.The main indication for ERCP was benign biliary disease in 79 patients and malignant disease in 12 patients.The bile culture was positive for bacterial growth in 46 out of 91 (50.5%) patients.The most frequently encountered organisms were Gram-negative bacteria including Escherichia coli (28.2%),Pseudomonas (17.3%) and Stenotrophomonas maltophilia (15.2%).There were no significant differences between patients with malignant and benign disease (58% vs 49%,P =0.474),patients with acute cholangitis and without acute cholangitis (52.9% vs 50%,P =0.827),patients who were empirically administered antibiotics before intervention and not administered (51.4% vs 60.7%,P =0.384),with regard to the bacteriobilia.We observed a large covering spectrum or low resistance to meropenem,amikacin and imipenem.CONCLUSION:We did not find a significant risk factor for bacteriobilia in patients with biliary

  16. Re: Percutaneous Nephrolithotomy Versus Retrograde Intrarenal Surgery: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    De S

    2016-03-01

    Full Text Available Debate still goes on about minimally invasive treatment of urolithiasis. Meta-analysis is very important in decision-making; the level of evidence 1a represents evidence obtained from meta-analysis of randomized trials. This meta-analysis represented by De et al. reviewed the results of ten studies comparing minimicro percutaneous nephrolithotomy (mmPNL with retrograde intrarenal surgery (RIRS. A subgroup analysis was performed comparing standard PCNL and minimally invasive percutaneous procedures (MIPPs including mini-PCNL and micro-PCNL with RIRS, separately. Half of the studies were from Turkey. All stone burdens in these studies were lower than 2 cm except in two studies. Similarly, single stone was treated in all except for two studies. There were major differences between studies in terms of surgical techniques, follow-up procedure and imaging and definition of stone free or, in other words, clinically insignificant residual fragment. Operation time was same for RIRS and sPNL which might be because of the smaller size of stones for PNL, a debatable point. In patients with single stone about 2 cm, not surprisingly, sPNL was the leading one in stone free rates. There was a statistical confusion for other methods. According to original paper, RIRS was second one but if searched again; we can see the ‘corrigendum’ which reflected that stone free rate of mmPNL was higher than RIRS due to the correction of statistical mistake. In a special comparison between mmPNL and RIRS; RIRS had lower morbidity with lower stone free rates. Thus, as a conclusion, if the question is stone free rate, sPNL should be chosen but RIRS had the lowest morbidity with very close stone free rates to mmPNL. Although this type of studies are very important; this study did not meet expectations in decision making. It should be better to follow the European Association of Urology guidelines recommendations with evaluating whole criteria, such as comorbidities of the

  17. Diagnosis of pancreatic tumors : comparison of MR pancreatography(MRP) and endoscopic retrograde pancreatography(ERP)

    International Nuclear Information System (INIS)

    Magnetic resonance pancreatography(MRP) is a non-invasive imaging technique for visualization of the pancreatic duct system, and is similar to those obtained by means of endoscopic retrograde pancreatography(ERP). To determine the role of MRP in the diagnosis of pancreatic tumors, the diagnostic confidence and imaginal difference of MRP and ERP were compared. Twenty patients(13 male and 7 female, mean age 59 years) with pancreatic tumors underwent MRP and ERP. The former involved the use of a single shot fast spin-echo sequence on a 1.5T system. All images were retrospectively reviewed by a radiologist and a gastroenterologist, working together. Both MRP and ERP were compared for separate visualization of the head, body and tail portion of the pancreatic duct, and scored as excellent (4), good (3), fair (2), poor (1), or no visualization (0). In addition, the overall diagnostic confidence of both modalities was graded subjectively from non-diagnoses (0) to definite information (4). The final diagnoses derived from surgical findings (n=9) or imaging findings and clinical follow-up (n=7) were as follows : pancreatic cancer (n=12), mucin-producing pancreatic cancer (n=2), mucinous ductectatic tumor (n=4), serous cystadenoma (n=2). To assess the statistical significance of difference, the paired t-test was used. Mean scores of visualization of the pancreatic duct by MRP and ERP were 2.91 and 3.15 in the pancreatic head (p=NS), 3.11 and 2.18 in the pancreatic body (p=NS), and 3.07 and 1.09 in the pancreatic tail (p<0.01). The mean score of diagnostic confidence was 4.03 for MRP and 2.51 for ERP, a statistically significant difference (p<0.05). In 11 patients with obstruction of the pancreatic duct due to malignant lesions, MRP visualized the duct both proximally and distally to the site of obstruction, while ERP visualized only the distal duct to the site of obstruction. MRP was also better at defining the extent of tumor by visualization of surrounding pancreatic

  18. Computer animation in teaching science: Effectiveness in teaching retrograde motion to 9th graders

    Science.gov (United States)

    Klenk, Kristin Elmstrom

    The purpose of this study is to determine whether an instructional approach which includes computer animations is more effective than a traditional textbook-only approach in helping ninth grade students learn an abstract concept, in this case planetary retrograde motion. This investigation uses a quasi-experimental design with convenient sampling. The independent variable is the type of instruction provided to students; traditional text-based instruction (control group) compared to traditional instruction which also includes the viewing of 4 computer animations (treatment). Two conditions of the treatment examine the relative advantage of the order of the presentation of the animations and text-based instruction, as well as the quality of understanding and the retention of the learning over time. The dependent variable is student achievement which is measured using an instrument designed specifically for this study. Comparison of the independent variable to the dependent variable based upon the results from a Repeated Measure Factorial Design in ANOVA indicates that the treatment is an effective instructional technique. The posttest1 mean score of the treatment groups was significantly greater than the posttest1 mean score of the control group. Further posthoc tests indicate that there was no significant difference between the two treatments (1 and 2); read/animation versus animation/read. However, there was a significant difference in the mean score depending on the pathway, students enrolled in the A pathway achieved a significantly higher mean score after the treatment than students in the B pathway. The A pathway (n = 185) represent the larger heterogeneous population of students as compared to the B pathway (n=16) which includes students with lower cognitive abilities and special needs. When all of the students are included in the analysis the results indicate that students do not retain their understanding of the concept. However, when the students in the B

  19. DEĞİŞİK RETROGRAD DOLGU MADDELERİNİN MİKROSIZINTI YÖNÜNDEN DEĞERLENDİRİLMESİ* MICROLEAKAGE OF DIFFERENT RETROGRADE MATERIALS

    OpenAIRE

    Haznedaroğlu, Faruk; SÜBAY, RÜSTEM KEMAL; Tank, Kutlu; Aşcı, Selmin

    2012-01-01

    ÖzetBu çalışma, retrograd dolgu uygulamalarında kullanılan kavite vernikli amal gam, gümüş cam iyonomer simam, güçlendirilmiş çinko oksit öjenol simam ve düşük ısılı enjekte termoplastik güta perkanın apikal sız-dırmazlık özelliklerini incelemek amacıyla planlandı. Kök kanalları genişletildi ve dolduruldu. Kök uçları re-zeke edildi ve retrograd dolgular için kaviteler hazırlandı. Dişler her hiri 10 dişten oluşan dört gruba ayrıldı. Ayrıca beş diş negatif kontrol, beş diş ise pozitif kontrol i...

  20. A mechanistic approach to studies of the possible digestion of retrograded starch by α-amylase revealed using a log of slope (LOS) plot.

    Science.gov (United States)

    Patel, Hamung; Day, Richard; Butterworth, Peter J; Ellis, Peter R

    2014-11-26

    The rate and extent of digestibility of starch were analysed using the logarithm of the slope (LOS) method. Digestibility curves with α-amylase were obtained for starches in their native, gelatinised and 24h retrograded form. A LOS plot of the digestibility curves was then constructed, which allowed the rate constant (k) and the concentration of the product at the end of the reaction (C∞) to be calculated. It also allowed the identification of rapid and slow phases in starch digestion. Upon gelatinisation, both k and C∞ increased with dramatic changes notably in C∞; however after starch samples had been stored for 24h at room temperature, k was not affected but C∞ decreased. This suggests that retrograded starch is virtually inert to amylase action. Both k and C∞ were strongly related to the increase in degree of order of the α-glucan chains, monitored by FTIR-ATR spectroscopy, in retrograded starch.

  1. Biodegradable and non-retrogradable eco-films based on starch-glycerol with citric acid as crosslinking agent.

    Science.gov (United States)

    Seligra, Paula González; Medina Jaramillo, Carolina; Famá, Lucía; Goyanes, Silvia

    2016-03-15

    Biodegradable and non-retrogradable starch-glycerol based films were obtained using citric acid (CA) as crosslinking agent at 75°C. This material allowed decreasing water vapor permeability (WVP) more than 35%, remained amorphous for at least 45 days as a result of the network formed by the CA that avoided starch retrogradation and maintained the degradability in compost, occurring only six days after the films without citric acid. A simulation of the gelatinization process of starch-glycerol with and without CA, using a differential thermal analysis device, showed that the system with CA completed the gelatinization 5°C before than the other and, CA first reacted with glycerol and then starch-glycerol-CA reaction occurred. The temperature at which the gelatinization process was carried out was critical to obtain the best results. An increase of gelatinization process temperature at 85°C in system with CA, led to a worsening on WVP and its integrity after a swelling process with dimethylsulphoxide (DMSO), compared to the films processed at 75°C.

  2. Effect of emulsifiers on complexation and retrogradation characteristics of native and chemically modified White sorghum (Sorghum bicolor) starch

    International Nuclear Information System (INIS)

    Highlights: ► Sorghum starches were chemically modified. ► Starch–lipid complexes were studied in the presence of emulsifiers. ► Type II complexes were also detected in native and oxidized starches on adding GMS. ► Starch–lipid complexes sharply reduced retrogradation in modified starches. - Abstract: The effect of emulsifiers on complexation and retrogradation characteristics of native and chemically modified white sorghum starches was studied. Complex forming tendency of white sorghum starch with commercially available emulsifiers GMS and DATEM improved after acetylation. Presence of emulsifiers reduced λmax (wavelength of maximum absorbance) both for native and modified sorghum starches suggesting lower availability of amylose chains to complex with iodine. In native white sorghum starch (NWSS) and oxidized white sorghum starch (OWSS), both Type I and Type II starch–lipid complexes were observed on addition of 1.0% GMS prior to gelatinization. Acetylated-oxidized white sorghum starch (AOWSS) formed weakest complexes among all the modified starches. The results revealed that antistaling characteristics of modified sorghum starches were enhanced when used in combination with emulsifiers. The most prominent decline in reassociative capability among modified starches was observed for acetylated starches.

  3. Rabies virus glycoprotein pseudotyping of lentiviral vectors enables retrograde axonal transport and access to the nervous system after peripheral delivery.

    Science.gov (United States)

    Mazarakis, N D; Azzouz, M; Rohll, J B; Ellard, F M; Wilkes, F J; Olsen, A L; Carter, E E; Barber, R D; Baban, D F; Kingsman, S M; Kingsman, A J; O'Malley, K; Mitrophanous, K A

    2001-09-15

    In this report it is demonstrated for the first time that rabies-G envelope of the rabies virus is sufficient to confer retrograde axonal transport to a heterologous virus/vector. After delivery of rabies-G pseudotyped equine infectious anaemia virus (EIAV) based vectors encoding a marker gene to the rat striatum, neurons in regions distal from but projecting to the injection site, such as the dopaminergic neurons of the substantia nigra pars compacta, become transduced. This retrograde transport to appropriate distal neurons was also demonstrated after delivery to substantia nigra, hippocampus and spinal cord and did not occur when vesicular stomatitis virus glycoprotein (VSV-G) pseudotyped vectors were delivered to these sites. In addition, peripheral administration of rabies-G pseudotyped vectors to the rat gastrocnemius muscle leads to gene transfer in motoneurons of lumbar spinal cord. In contrast the same vector pseudotyped with VSV-G transduced muscle cells surrounding the injection site, but did not result in expression in any cells in the spinal cord. Long-term expression was observed after gene transfer in the nervous system and a minimal immune response which, together with the possibility of non-invasive administration, greatly extends the utility of lentiviral vectors for gene therapy of human neurological disease. PMID:11590128

  4. Adeno-Associated Virus-Mediated Gene Transfer to Renal Tubule Cells via a Retrograde Ureteral Approach

    Directory of Open Access Journals (Sweden)

    Daniel C. Chung

    2011-11-01

    Full Text Available Background/Aims: Gene therapy involves delivery of exogenous DNA to provide a therapeutic protein. Ideally, a gene therapy vector should be non-toxic, non-immunogenic, easy to produce, and efficient in protecting and delivering DNA into target cells. Methods: Adeno-associated virus (AAV offers these advantages and few, if any, disadvantages, and over 100 isolates exist. We previously showed that AAV-mediated gene therapy can be used to restore vision to patients with Leber’s congenital amaurosis, a disease of childhood blindness. Results: Here we show that novel recombinant AAV2/8 and AAV2/9 transduce kidney tubule cells with high efficiency both in vitroin cell culture and in vivoin mice. In addition, we adapted and modified a retrograde approach to allow for optimal transgene delivery to renal tubular cells that further minimizes the risk of an immunogenic reaction. Conclusions: We believe that recombinant AAV2, especially AAV2/8, gene delivery to renal tubule cells via a retrograde approach represents a viable method for gene therapy for a multitude of renal disorders ranging from autosomal dominant polycystic kidney disease to acute kidney injury.

  5. Comparative dynamics of retrograde actin flow and focal adhesions: formation of nascent adhesions triggers transition from fast to slow flow.

    Directory of Open Access Journals (Sweden)

    Antonina Y Alexandrova

    Full Text Available Dynamic actin network at the leading edge of the cell is linked to the extracellular matrix through focal adhesions (FAs, and at the same time it undergoes retrograde flow with different dynamics in two distinct zones: the lamellipodium (peripheral zone of fast flow, and the lamellum (zone of slow flow located between the lamellipodium and the cell body. Cell migration involves expansion of both the lamellipodium and the lamellum, as well as formation of new FAs, but it is largely unknown how the position of the boundary between the two flow zones is defined, and how FAs and actin flow mutually influence each other. We investigated dynamic relationship between focal adhesions and the boundary between the two flow zones in spreading cells. Nascent FAs first appeared in the lamellipodium. Within seconds after the formation of new FAs, the rate of actin flow decreased locally, and the lamellipodium/lamellum boundary advanced towards the new FAs. Blocking fast actin flow with cytochalasin D resulted in rapid dissolution of nascent FAs. In the absence of FAs (spreading on poly-L-lysine-coated surfaces retrograde flow was uniform and the velocity transition was not observed. We conclude that formation of FAs depends on actin dynamics, and in its turn, affects the dynamics of actin flow by triggering transition from fast to slow flow. Extension of the cell edge thus proceeds through a cycle of lamellipodium protrusion, formation of new FAs, advance of the lamellum, and protrusion of the lamellipodium from the new base.

  6. Comparative dynamics of retrograde actin flow and focal adhesions: formation of nascent adhesions triggers transition from fast to slow flow.

    Science.gov (United States)

    Alexandrova, Antonina Y; Arnold, Katya; Schaub, Sébastien; Vasiliev, Jury M; Meister, Jean-Jacques; Bershadsky, Alexander D; Verkhovsky, Alexander B

    2008-01-01

    Dynamic actin network at the leading edge of the cell is linked to the extracellular matrix through focal adhesions (FAs), and at the same time it undergoes retrograde flow with different dynamics in two distinct zones: the lamellipodium (peripheral zone of fast flow), and the lamellum (zone of slow flow located between the lamellipodium and the cell body). Cell migration involves expansion of both the lamellipodium and the lamellum, as well as formation of new FAs, but it is largely unknown how the position of the boundary between the two flow zones is defined, and how FAs and actin flow mutually influence each other. We investigated dynamic relationship between focal adhesions and the boundary between the two flow zones in spreading cells. Nascent FAs first appeared in the lamellipodium. Within seconds after the formation of new FAs, the rate of actin flow decreased locally, and the lamellipodium/lamellum boundary advanced towards the new FAs. Blocking fast actin flow with cytochalasin D resulted in rapid dissolution of nascent FAs. In the absence of FAs (spreading on poly-L-lysine-coated surfaces) retrograde flow was uniform and the velocity transition was not observed. We conclude that formation of FAs depends on actin dynamics, and in its turn, affects the dynamics of actin flow by triggering transition from fast to slow flow. Extension of the cell edge thus proceeds through a cycle of lamellipodium protrusion, formation of new FAs, advance of the lamellum, and protrusion of the lamellipodium from the new base. PMID:18800171

  7. Surface composition and dynamical evolution of two retrograde objects in the outer solar system: 2008 YB3 and 2005 VD

    CERN Document Server

    Pinilla-Alonso, N; Melita, M D; Lorenzi, V; Licandro, J; Carvano, J; Lazzaro, D; Carraro, G; Ali-Lagoa, V; Costa, E; Hasselmann, P H; 10.1051/0004-6361/201220030

    2013-01-01

    Most of the objects in the trans-Neptunian belt (TNb) and related populations move in prograde orbits with low eccentricity and inclination. However, the list of icy minor bodies moving in orbits with an inclination above 40 deg. has increased in recent years. The origin of these bodies, and in particular of those objects in retrograde orbits, is not well determined, and different scenarios are considered. In this paper, we present new observational and dynamical data of two objects in retrograde orbits, 2008 YB3 and 2005 VD. We find that the surface of these extreme objects is depleted of ices and does not contain the 'ultra-red' matter typical of some Centaurs. Despite small differences, these objects share common colors and spectral characteristics with the Trojans, comet nuclei, and the group of grey Centaurs. All of these populations are supposed to be covered by a mantle of dust responsible for their reddish- to neutral-color. To investigate if the surface properties and dynamical evolution of these bod...

  8. Evaluation of inferior alveolar nerve regeneration by bifocal distraction osteogenesis with retrograde transportation of horseradish peroxidase in dogs.

    Directory of Open Access Journals (Sweden)

    Yosuke Shogen

    Full Text Available BACKGROUND: Bifocal distraction osteogenesis has been shown to be a reliable method for reconstructing segmental mandibular defects. However, there are few reports regarding the occurrence of inferior alveolar nerve regeneration during the process of distraction. Previously, we reported inferior alveolar nerve regeneration after distraction, and evaluated the regenerated nerve using histological and electrophysiological methods. In the present study, we investigated axons regenerated by bifocal distraction osteogenesis using retrograde transportation of horseradish peroxidase in the mandibles of dogs to determine their type and function. METHODS AND FINDINGS: Using a bifocal distraction osteogenesis method, we produced a 10-mm mandibular defect, including a nerve defect, in 11 dogs and distracted using a transport disk at a rate of 1 mm/day. The regenerated inferior alveolar nerve was evaluated by retrograde transportation of HRP in all dogs at 3 and 6 months after the first operation. At 3 and 6 months, HRP-labeled neurons were observed in the trigeminal ganglion. The number of HRP-labeled neurons in each section increased, while the cell body diameter of HRP-labeled neurons was reduced over time. CONCLUSIONS: We found that the inferior alveolar nerve after bifocal distraction osteogenesis successfully recovered until peripheral tissue began to function. Although our research is still at the stage of animal experiments, it is considered that it will be possible to apply this method in the future to humans who have the mandibular defects.

  9. THE 10,000 FOLD EFFECT OF RETROGRADE NEUROTRANSMISSION, A NEW CONCEPT FOR STROKE REVIVAL: USE OF INTRACAROTID SODIUM NITROPRUSSIDE

    Directory of Open Access Journals (Sweden)

    Vinod

    2014-05-01

    Full Text Available BACKGROUND: Tissue Plasminogen Activator (tPA showed a level 1 benefit in acute stroke (within 3-6 hrs. Intracarotid sodium nitroprusside (ICSNP has been studied in this context with a wide treatment window, fast recovery and affordability. This work proposes two mechanisms for acute cases and one mechanism for chronic cases, which are interrelated, for physiological recovery. RETROGRADE NEUROTRANSMISSION (acute cases: Normal excitatory impulse: at the synaptic level, glutamate activates NMDA receptors, with nitric oxide synthetase (NOS on the postsynaptic membrane, for further propagation by the calcium-calmodulin complex. Nitric oxide (NO, produced by NOS travels backward across the chemical synapse and binds the axon-terminal NO receptor/sGC of a presynaptic neuron, regulating anterograde neurotransmission (ANT via retrograde neurotransmission (RNT. Heme is the ligand-binding site of the NO receptor/sGC. Heme exhibits >10, 000-fold higher affinity for NO than for oxygen (the 10, 000-fold effect and is completed in 20 msec

  10. Biomechanical analysis of a synthetic femoral spiral fracture model: Do end caps improve retrograde flexible intramedullary nail fixation?

    Directory of Open Access Journals (Sweden)

    Wessel Lucas M

    2011-09-01

    Full Text Available Abstract Background Elastic Stable intramedullary Nailing (ESIN of dislocated diaphyseal femur fractures has become an accepted method for the treatment in children and adolescents with open physis. Studies focused on complications of this technique showed problems regarding stability, usually in complex fracture types such as spiral fractures and in older children weighing > 40 kg. Biomechanical in vitro testing was performed to evaluate the stability of simulated spiral femoral fractures after retrograde flexible titanium intramedullary nail fixation with and without End caps. Methods Eight synthetic adolescent-size femoral bone models (Sawbones® with a medullar canal of 10 mm and a spiral fracture of 100 mm length identically sawn by the manufacturer were used for each group. Both groups underwent retrograde fixation with two 3.5 mm Titanium C-shaped nails inserted from medial and lateral entry portals. In the End Cap group the ends of the nails of the eight specimens were covered with End Caps (Synthes Company, Oberdorf, Switzerland at the distal entry. Results Beside posterior-anterior stress (4.11 Nm/mm vs. 1.78 Nm/mm, p Conclusion In this biomechanical study the use of End Caps did not improve the stability of the intramedullary flexible nail osteosynthesis.

  11. Structural optimization of a retrograde trafficking inhibitor that protects cells from infections by human polyoma- and papillomaviruses.

    Science.gov (United States)

    Carney, Daniel W; Nelson, Christian D S; Ferris, Bennett D; Stevens, Julia P; Lipovsky, Alex; Kazakov, Teymur; DiMaio, Daniel; Atwood, Walter J; Sello, Jason K

    2014-09-01

    Human polyoma- and papillomaviruses are non-enveloped DNA viruses that cause severe pathologies and mortalities. Under circumstances of immunosuppression, JC polyomavirus causes a fatal demyelinating disease called progressive multifocal leukoencephalopathy (PML) and the BK polyomavirus is the etiological agent of polyomavirus-induced nephropathy and hemorrhagic cystitis. Human papillomavirus type 16, another non-enveloped DNA virus, is associated with the development of cancers in tissues like the uterine cervix and oropharynx. Currently, there are no approved drugs or vaccines to treat or prevent polyomavirus infections. We recently discovered that the small molecule Retro-2(cycl), an inhibitor of host retrograde trafficking, blocked infection by several human and monkey polyomaviruses. Here, we report diversity-oriented syntheses of Retro-2(cycl) and evaluation of the resulting analogs using an assay of human cell infections by JC polyomavirus. We defined structure-activity relationships and also discovered analogs with significantly improved potency as suppressors of human polyoma- and papillomavirus infection in vitro. Our findings represent an advance in the development of drug candidates that can broadly protect humans from non-enveloped DNA viruses and toxins that exploit retrograde trafficking as a means for cell entry.

  12. Randomized controlled trial of pancreatic stenting to prevent pancreatitis after endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Yoshiaki Kawaguchi; Masami Ogawa; Fumio Omata; Hiroyuki Ito; Tooru Shimosegawa; Tetsuya Mine

    2012-01-01

    AIM:To determine the effectiveness of pancreatic duct (PD) stent placement for the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in high risk patients.METHODS:Authors conducted a single-blind,randomized controlled trial to evaluate the effectiveness of a pancreatic spontaneous dislodgement stent against post-ERCP pancreatitis,including rates of spontaneous dislodgement and complications.Authors defined high risk patients as having any of the following:sphincter of Oddi dysfunction,difficult cannulation,prior history of post-ERCP pancreatitis,pre-cut sphincterotomy,pancreatic ductal biopsy,pancreatic sphincterotomy,intraductal ultrasonography,or a procedure time of more than 30 min.Patients were randomized to a stent group (n =60) or to a non-stent group (n =60).An abdominal radiograph was obtained daily to assess spontaneous stent dislodgement.Post-ERCP pancreatitis was diagnosed according to consensus criteria.RESULTS:The mean age (± standard deviation) was 67.4 ± 13.8 years and the male:female ratio was 68:52.In the stent group,the mean age was 66 ± 13years and the male:female ratio was 33:27,and in the non-stent group,the mean age was 68 ± 14 years and the male:female ratio was 35:25.There were no significant differences between groups with respect to age,gender,final diagnosis,or type of endoscopic intervention.The frequency of post-ERCP pancreatitis in PD stent and non-stent groups was 1.7% (1/60) and 13.3% (8/60),respectively.The severity of pancreatitis was mild in all cases.The frequency of post-ERCP pancreatitis in the stent group was significantly lower than in the non-stent group (P =0.032,Fisher's exact test).The rate of hyperamylasemia were 30% (18/60) and 38.3% (23 of 60) in the stent and non-stent groups,respectively (P =0.05,x2 test).The placement of a PD stent was successful in all 60 patients.The rate of spontaneous dislodgement by the third day was 96.7% (58/60),and the median (range) time to

  13. Bispectral index monitoring as an adjunct to nurse-administered combined sedation during endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    Se Young Jang; Hyun Gu Park; Min Kyu Jung; Chang Min Cho; Soo Young Park; Seong Woo Jeon; Won Young Tak

    2012-01-01

    AIM:TO determine whether bispectral index (BIS)monitoring is useful for propofol administration for deep sedation during endoscopic retrograde cholangiopancreatography (ERCP).METHODS:Fifty-nine consecutive patients with a variety of reasons for ERCP who underwent the procedure at least twice between 1 July 2010 and 30 November 2010.This was a randomized cross-over study,in which each patient underwent ERCP twice,once with BIS monitoring and once with control monitoring.Whether BIS monitoring was done during the first or second ERCP procedure was random.Patients were intermittently administered a mixed regimen including midazolam,pethidine,and propofol by trained nurses.The nurse used a routine practice to monitor sedation using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale or the BIS monitoring.The total amount of midazolam and propofol used and serious side effects were compared between the BIS and control groups.RESULTS:The mean total propofol dose administered was 53.1 ± 32.2 mg in the BIS group and 54.9± 30.8 mg in the control group (P =0.673).The individual propofol dose received per minute during the ERCP procedure was 2.90 ± 1.83 mg/min in the BIS group and 3.44 ± 2.04 mg in the control group (P =0.103).The median value of the MOAA/S score during the maintenance phase of sedation was comparable for the two groups.The mean BIS values throughout the procedure (from insertion to removal of the endoscope) were 76.5 ± 8.7 for all 59 patients in using the BIS monitor.No significant differences in the frequency of < 80% oxygen saturation,hypotension (< 80 mmHg),or bradycardia (< 50 beats/min) were observed between the two study groups.Four cases of poor cooperation occurred,in which the procedure should be stopped to add the propofol dose.After adding the propofol,the procedure could be conducted successfully (one case in the BIS group,three cases in the control group).The endoscopist rated patient sedation as excellent for

  14. The analgesic effect on neuropathic pain of retrogradely transported botulinum neurotoxin A involves Schwann cells and astrocytes.

    Directory of Open Access Journals (Sweden)

    Sara Marinelli

    Full Text Available In recent years a growing debate is about whether botulinum neurotoxins are retrogradely transported from the site of injection. Immunodetection of cleaved SNAP-25 (cl-SNAP-25, the protein of the SNARE complex targeted by botulinum neurotoxin serotype A (BoNT/A, could represent an excellent approach to investigate the mechanism of action on the nociceptive pathways at peripheral and/or central level. After peripheral administration of BoNT/A, we analyzed the expression of cl-SNAP-25, from the hindpaw's nerve endings to the spinal cord, together with the behavioral effects on neuropathic pain. We used the chronic constriction injury of the sciatic nerve in CD1 mice as animal model of neuropathic pain. We evaluated immunostaining of cl-SNAP-25 in the peripheral nerve endings, along the sciatic nerve, in dorsal root ganglia and in spinal dorsal horns after intraplantar injection of saline or BoNT/A, alone or colocalized with either glial fibrillar acidic protein, GFAP, or complement receptor 3/cluster of differentiation 11b, CD11b, or neuronal nuclei, NeuN, depending on the area investigated. Immunofluorescence analysis shows the presence of the cl-SNAP-25 in all tissues examined, from the peripheral endings to the spinal cord, suggesting a retrograde transport of BoNT/A. Moreover, we performed in vitro experiments to ascertain if BoNT/A was able to interact with the proliferative state of Schwann cells (SC. We found that BoNT/A modulates the proliferation of SC and inhibits the acetylcholine release from SC, evidencing a new biological effect of the toxin and further supporting the retrograde transport of the toxin along the nerve and its ability to influence regenerative processes. The present results strongly sustain a combinatorial action at peripheral and central neural levels and encourage the use of BoNT/A for the pathological pain conditions difficult to treat in clinical practice and dramatically impairing patients' quality of life.

  15. The Analgesic Effect on Neuropathic Pain of Retrogradely Transported botulinum Neurotoxin A Involves Schwann Cells and Astrocytes

    Science.gov (United States)

    Ricordy, Ruggero; Uggenti, Carolina; Tata, Ada Maria; Luvisetto, Siro; Pavone, Flaminia

    2012-01-01

    In recent years a growing debate is about whether botulinum neurotoxins are retrogradely transported from the site of injection. Immunodetection of cleaved SNAP-25 (cl-SNAP-25), the protein of the SNARE complex targeted by botulinum neurotoxin serotype A (BoNT/A), could represent an excellent approach to investigate the mechanism of action on the nociceptive pathways at peripheral and/or central level. After peripheral administration of BoNT/A, we analyzed the expression of cl-SNAP-25, from the hindpaw’s nerve endings to the spinal cord, together with the behavioral effects on neuropathic pain. We used the chronic constriction injury of the sciatic nerve in CD1 mice as animal model of neuropathic pain. We evaluated immunostaining of cl-SNAP-25 in the peripheral nerve endings, along the sciatic nerve, in dorsal root ganglia and in spinal dorsal horns after intraplantar injection of saline or BoNT/A, alone or colocalized with either glial fibrillar acidic protein, GFAP, or complement receptor 3/cluster of differentiation 11b, CD11b, or neuronal nuclei, NeuN, depending on the area investigated. Immunofluorescence analysis shows the presence of the cl-SNAP-25 in all tissues examined, from the peripheral endings to the spinal cord, suggesting a retrograde transport of BoNT/A. Moreover, we performed in vitro experiments to ascertain if BoNT/A was able to interact with the proliferative state of Schwann cells (SC). We found that BoNT/A modulates the proliferation of SC and inhibits the acetylcholine release from SC, evidencing a new biological effect of the toxin and further supporting the retrograde transport of the toxin along the nerve and its ability to influence regenerative processes. The present results strongly sustain a combinatorial action at peripheral and central neural levels and encourage the use of BoNT/A for the pathological pain conditions difficult to treat in clinical practice and dramatically impairing patients’ quality of life. PMID:23110146

  16. Value of portal venous system radiological indices in predicting esophageal varices

    Directory of Open Access Journals (Sweden)

    Gaduputi V

    2015-02-01

    Full Text Available Vinaya Gaduputi,1 Harish Patel,1 Sailaja Sakam,1 Srivani Neshangi,1 Rafeeq Ahmed,1 Michael Lombino,2 Sridhar Chilimuri11Department of Medicine, 2Department of Radiology, Bronx Lebanon Hospital Center New York, NY, USAIntroduction: Portal hypertension results from increased resistance to portal blood flow and has the potential complications of variceal bleeding and ascites. The splenoportal veins increase in caliber with worsening portal hypertension, and partially decompress by opening a shunt with systemic circulation, ie, a varix. In the event of portosystemic shunting, there is a differential decompression across the portal vein and splenic vein (portal vein > splenic vein, with a resultant decrease in the ratio of portal vein diameter to that of splenic vein. Portal vein to splenic vein diameter ratio and gradient could be valuable tools in predicting the presence of portosystemic shunting.Methods: We retrospectively reviewed patients with cirrhosis who underwent esophagogastroduodenoscopy (EGD for variceal screening and had a computerized tomogram (CT of the abdomen within 6 months of the index endoscopic study, between January 2009 and December 2013. Patients on nonselective beta blockers, patients with presinusoidal portal hypertension (portal vein thrombosis or extrinsic compression, and patients who had undergone portosystemic shunting procedures (transjugular intrahepatic portosystemic shunt [TIPS] or balloon-occluded retrograde transvenous obliteration (BRTO were excluded from the study. Splenic and portal vein diameters were measured (in mm just proximal and distal to the splenomesenteric venous confluence, respectively.Results: A total of 164 patients were included in the study; of these, 60% (n=98 were male and 40% (n=66 were female. The mean age of the study population was 58.7 years. A total of 126 patients (77% had varices, while 38 patients (33% did not. The mean Model for End-Stage Liver Disease (MELD score was 5.9 for those

  17. Current Status and Prospect of Portal Hypertension%门静脉高压治疗现状与展望

    Institute of Scientific and Technical Information of China (English)

    车小双; 彭心宇; 张示杰; 吴向未; 吕海龙

    2013-01-01

    门静脉高压症是一种主要因肝脏病变而引起门静脉系统循环异常为主要特点的病症,经过100多年的研究与探索,门静脉高压症的诊断和治疗手段均得到了不断的发展和完善.如非选择性β受体阻断剂和内镜下曲张静脉套扎术对预防有中、重度静脉曲张的患者首次静脉曲张出血均具有各自的优势,气囊阻断经静脉逆行栓塞术对曲张的食管胃底静脉的具有良好疗效,部分性脾栓塞术已成为肝硬化门脉高压脾亢血液病的最主要非手术治疗措施,外科治疗方面联合手术的优势已经逐步体现出来,但门静脉高压症最根本的治疗措施仍是肝移植.但选择何种方式治疗,仍要根据患者肝功能状况及病情变化而定,本文将就门静脉高压治疗现状与展望做一综述.%Portal hypertension is a major liver lesions caused by abnormal portal venous system circulation as the main features of the syndrome. After 100 years of research and exploration, diagnosis and treatment of patients with portal hypertension has also been a constant improvement and innovation. Non-selective beta block-ers in preventing first variceal hemorrhage has the exact effect in patients with moderate to severe esophageal va-rices, EVL has its unique advantages in the prevention of first hemorrhage, Balloon occluded retrograde transve-nous obliteration (B-RTO)'s clear efficacy of the treatment of esophageal and gastric varicose vein will win the re-cognition of the growing number of scholars.Partial splenic embolization (PSE) has been increasingly performed as a non-surgical treatment by IVR procedure for the treatment of hematological disorders caused by hyperspleni-sm. Surgical treatment: The advantages of combined surgery has been gradually reflected. But the most fundamental treatment is liver transplantation. To choose which way to treat, is still based on the change of the status and con-dition of the liver function in patients

  18. Magnetic Resonance Imaging (MRI) with retrograde intralumen contrast enhancement of the rectum in diagnostics of rectovaginal fistulas after combination therapy of rectal cancer. Experience of application

    Science.gov (United States)

    Usova, A.; Frolova, I.; Afanasev, S.; Tarasova, A.; Molchanov, S.

    2016-02-01

    Experiment of use of MRI in diagnostics of rectovaginal fistulas after combination therapy of rectal cancer is shown on clinical examples. We used retrograde contrasting of a rectum with 150ml ultrasonic gel to make MRI more informative in case of low diagnostic efficiency of ultrasound, colonoscopy and gynecological examination.

  19. Target ballon-assisted antegrade and retrograde approach for recanalization of thrombosed fem-pop bypass graft using the outbreak catheter

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Jung Won; Chung, Hwan Hoon; Lee, Seung Hwa; Yeom, Suk Keu; Cha, Sang Hoon [Dept. of Radiology, Korea University College of Medicine, Ansan Hospital, Ansan (Korea, Republic of)

    2016-01-15

    The subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique is reportedly effective in severe peripheral vascular disease that cannot be treated with standard endovascular techniques including subintimal angioplasty. In this report, we used a target balloon with the Outback catheter to recanalize a thrombosed bypass graft that could not be treated successfully with SAFARI.

  20. Application of a snare technique in retrograde chronic total occlusion percutaneous coronary intervention – a step by step practical approach and an observational study

    Science.gov (United States)

    Fang, Hsiu-Yu; Lee, Wei-Chieh; Fang, Chih-Yuan; Wu, Chiung-Jen

    2016-01-01

    Abstract Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has recently become popular among interventional cardiologists. CTO originating from the ostium has been one of the most difficult CTO lesions to treat with PCI for a number of reasons. Our aim was to illustrate a specific technique during retrograde CTO PCI referred to as the “snare technique.” We retrospectively examined the use of “snare technique” among 371 consecutive retrograde CTO PCIs performed at our institution between 2006 and 2015. “Snare technique” was used in 10 patients among the 371 retrograde CTO PCIs. The baseline clinical and angiographic characteristics of patients with or without “snare technique” were similar. The “snare technique” group had significantly fewer side branches at occlusion (30.0% vs 71.2%, P = 0.01) and a higher incidence of externalization (90% vs 25.5%, P CTO PCI, especially in cases of difficult coronary engagement in cases such as ostial occlusion, challenging coronary anatomy, or retrograde guidewire cannot get in antegrade guiding catheter. PMID:27741138

  1. Retrograde rotation of the large-scale flow in turbulent rotating Rayleigh-Benard convection with high Rossby number

    Science.gov (United States)

    Zhong, Jin-Qiang; Li, Hui-Min; Wang, Xue-Ying

    2015-11-01

    We present measurements of the azimuthal orientation θ (t) of the large-scale circulation (LSC) for turbulent Rayleigh-Bénard convection in the presence of week rotations Ω . Linear retrograde rotations of the LSC circulating plane are observed over the entire Rossby-number range (1 / Ω remains nearly a constant 0.12 in the range of (1 80 . When Ro ~= 300 , γ approaches a value of 0.36 close to the prediction from previous theoretical models. In a background of linear rotations, erratic changes in θ (t) accompanied by decreasing in the LSC amplitude δ are observed. These small- δ events give rise to the increasing γ with very high Ro numbers (80 LSC azimuthal motion due to turbulent viscosity and provide theoretical interpretations of the experimental results. Work supported by NSFC Grant No. 11202151.

  2. The diameter of main pancreatic duct on endoscopic retrograde pancreatography and the appearance of main pancreatic duct on computed tomography

    International Nuclear Information System (INIS)

    We have carried out a comparative study of the diameter of main pancreatic duct (MPD) on endoscopic retrograde pancreatography (ERP) with the fequency of detection of MPD by computed tomography (CT) in order to clarify the importance of MPD appearance on CT in the pancreatic and biliary diseases. The normal MPD on ERP was demonstrated by CT in a low frequency. MPD was most frequently observed in the pancreatic body on CT. The dilatation of MPD on ERP was found in both moderate and advanced pancreatitis group. However, the significant demonstration of MPD by CT was found in advanced group alone. We observed that CT finding of dilated duct correlated with that on ERP in advanced group alone. (author)

  3. Preserved Renal Function in Kidney Transplantation over a Thrombosed Aortobifemoral Bypass Graft: The Role of Retrograde Flow and Early Thrombolysis

    Directory of Open Access Journals (Sweden)

    Saúl Pampa-Saico

    2016-01-01

    Full Text Available Aortobifemoral bypass (ABFB thrombosis is not uncommon, and when the artery of a renal graft is implanted on a bypass the risk of graft loss is high. We report the case of a 48-year-old woman with a previous history of ABFB under antiplatelet therapy and a kidney allograft implanted on the vascular prosthesis, who presented with acute limb ischemia and severe renal impairment. Imaging techniques revealed a complete thrombosis of the proximal left arm of the ABFB. However, a faint retrograde flow over the graft was observed thanks to the recanalization of distal left bypass by collateral native arteries. This unusual situation not previously reported in a kidney transplant setting, together with an early diagnosis, allowed graft survival until an early local thrombolysis resolved the problem. Two years later, renal function remains normal.

  4. Ciliary abnormalities due to defects in the retrograde transport protein DYNC2H1 in short-rib polydactyly syndrome.

    Science.gov (United States)

    Merrill, Amy E; Merriman, Barry; Farrington-Rock, Claire; Camacho, Natalia; Sebald, Eiman T; Funari, Vincent A; Schibler, Matthew J; Firestein, Marc H; Cohn, Zachary A; Priore, Mary Ann; Thompson, Alicia K; Rimoin, David L; Nelson, Stanley F; Cohn, Daniel H; Krakow, Deborah

    2009-04-01

    The short-rib polydactyly (SRP) syndromes are a heterogeneous group of perinatal lethal skeletal disorders with polydactyly and multisystem organ abnormalities. Homozygosity by descent mapping in a consanguineous SRP family identified a genomic region that contained DYNC2H1, a cytoplasmic dynein involved in retrograde transport in the cilium. Affected individuals in the family were homozygous for an exon 12 missense mutation that predicted the amino acid substitution R587C. Compound heterozygosity for one missense and one null mutation was identified in two additional nonconsanguineous SRP families. Cultured chondrocytes from affected individuals showed morphologically abnormal, shortened cilia. In addition, the chondrocytes showed abnormal cytoskeletal microtubule architecture, implicating an altered microtubule network as part of the disease process. These findings establish SRP as a cilia disorder and demonstrate that DYNC2H1 is essential for skeletogenesis and growth.

  5. Prophylactic effect of glyceryl trinitrate on post-endoscopic retrograde cholangiopancreatography pancreatitis: A randomized placebo-controlled trial

    Institute of Scientific and Technical Information of China (English)

    Jian-Yu Hao; Dong-Fang Wu; Yue-Zeng Wang; Ying-Xin Gao; Hai-Po Lang; Wei-Zhen Zhou

    2009-01-01

    AIM: To examine the prophy lacticef fect of glyceryl trinitrate on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and hyperamylasemia.METHODS: Patients scheduled for ERCP were randomly divided into study group and placebo group. Patients in study group and placebo group were treated with 5 mg glyceryl trinitrate and 100 mg vitamin C, respectively, 5 min before endoscopic maneuvers.RESULTS: A total of 74 patients were enrolled in the final analysis. Post-ERCP pancreatitis occurred in 3 patients (7.9%) of the study group and 9 patients (25%) in the placebo group ( P = 0.012).Hyperamylasemia occurred in 8 patients of the study group (21.1%) and 13 patients (36.1%) of the placebo group ( P = 0.037).CONCLUSION: Glyceryl trinitrate before ERCP can effectively prevent post-ERCP and hyperamylasemia.

  6. Retrograde Percutaneous Drilling for Osteochondritis Dissecans of the Head of the Talus: Case Report and Review of the Literature.

    Science.gov (United States)

    Corominas, Laura; Sanpera, Ignacio; Masrouha, Karim; Sanpera-Iglesias, Julia

    2016-01-01

    Osteochondral lesions of the talus might be a more common cause of pain than previously recognized, especially among those involved in athletic activities. However, the location of an osteochondral lesion on the talar head is much less common than such lesions localized to the dome of the talus and can pose diagnostic difficulties. We present the case of a 14-year-old soccer player who complained of longstanding pain in his left foot. After unsuccessful conservative treatment consisting of rest and bracing, he was ultimately treated with retrograde percutaneous drilling of the talar head performed by a medial approach. This was followed by casting and non-weightbearing for 6 weeks, after which physical therapy was undertaken. He was able to return to full activity and remained asymptomatic during a 5-year observation period. Although rare, osteochondritis dissecans of the talar head should be considered in young athletes with persistent foot pain that is unresponsive to reasonable therapy.

  7. Mg chelatase in chlorophyll synthesis and retrograde signaling in Chlamydomonas reinhardtii: CHLI2 cannot substitute for CHLI1.

    Science.gov (United States)

    Brzezowski, Pawel; Sharifi, Marina N; Dent, Rachel M; Morhard, Marius K; Niyogi, Krishna K; Grimm, Bernhard

    2016-06-01

    The oligomeric Mg chelatase (MgCh), consisting of the subunits CHLH, CHLI, and CHLD, is located at the central site of chlorophyll synthesis, but is also thought to have an additional function in regulatory feedback control of the tetrapyrrole biosynthesis pathway and in chloroplast retrograde signaling. In Arabidopsis thaliana and Chlamydomonas reinhardtii, two genes have been proposed to encode the CHLI subunit of MgCh. While the role of CHLI1 in A. thaliana MgCh has been substantially elucidated, different reports provide inconsistent results with regard to the function of CHLI2 in Mg chelation and retrograde signaling. In the present report, the possible functions of both isoforms were analyzed in C. reinhardtii Knockout of the CHLI1 gene resulted in complete loss of MgCh activity, absence of chlorophyll, acute light sensitivity, and, as a consequence, down-regulation of tetrapyrrole biosynthesis and photosynthesis-associated nuclear genes. These observations indicate a phenotypical resemblance of chli1 to the chlh and chld C. reinhardtii mutants previously reported. The key role of CHLI1 for MgCh reaction in comparison with the second isoform was confirmed by the rescue of chli1 with genomic CHLI1 Because CHLI2 in C. reinhardtii shows lower expression than CHLI1, strains overexpressing CHLI2 were produced in the chli1 background. However, no complementation of the chli1 phenotype was observed. Silencing of CHLI2 in the wild-type background did not result in any changes in the accumulation of tetrapyrrole intermediates or of chlorophyll. The results suggest that, unlike in A. thaliana, changes in CHLI2 content observed in the present studies do not affect formation and activity of MgCh in C. reinhardtii. PMID:26809558

  8. Prograde and retrograde growth of monazite in migmatites:An example from the Nagercoil Block, southern India

    Institute of Scientific and Technical Information of China (English)

    Tim E. Johnson; Chris Clark; Richard J.M. Taylor; M. Santosh; Alan S. Collins

    2015-01-01

    Data from a migmatised metapelite raft enclosed within charnockite provide quantitative constraints on the pressureetemperatureetime (PeTet) evolution of the Nagercoil Block at the southernmost tip of peninsular India. An inferred peak metamorphic assemblage of garnet, K-feldspar, sillimanite, plagioclase, magnetite, ilmenite, spinel and melt is consistent with peak metamorphic pressures of 6e8 kbar and temperatures in excess of 900 ?C. Subsequent growth of cordierite and biotite record high-temperature retrograde decompression to around 5 kbar and 800 ?C. SHRIMP UePb dating of magmatic zircon cores suggests that the sedimentary protoliths were in part derived from felsic igneous rocks with Palae-oproterozoic crystallisation ages. New growth of metamorphic zircon on the rims of detrital grains con-strains the onset of melt crystallisation, and the minimum age of the metamorphic peak, to around 560 Ma. The data suggest two stages of monazite growth. The first generation of REE-enriched monazite grew during partial melting along the prograde path at around 570 Ma via the incongruent breakdown of apatite. Relatively REE-depleted rims, which have a pronounced negative europium anomaly, grew during melt crystallisation along the retrograde path at around 535 Ma. Our data show the rocks remained at suprasolidus temperatures for at least 35 million years and probably much longer, supporting a long-lived high-grade metamorphic history. The metamorphic conditions, timing and duration of the implied clockwise PeTet path are similar to that previously established for other regions in peninsular India during the Ediacaran to Cambrian assembly of that part of the Gondwanan supercontinent.

  9. Outcome analysis of retrograde nailing and less invasive stabilization system in distal femoral fractures: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Christian Hierholzer

    2011-01-01

    Full Text Available Background: Two major therapeutic principles can be employed for the treatment of distal femoral fractures: retrograde intramedullary (IM nailing (RN or less invasive stabilization on system (LISS. Both operative stabilizing systems follow the principle of biological osteosynthesis. IM nailing protects the soft-tissue envelope due to its minimally invasive approach and closed reduction techniques better than distal femoral locked plating. The purpose of this study was to evaluate and compare outcome of distal femur fracture stabilization using RN or LISS techniques. Materials and Methods: In a retrospective study from 2003 to 2008, we analyzed 115 patients with distal femur fracture who had been treated by retrograde IM nailing (59 patients or LISS plating (56 patients. In the two cohort groups, mean age was 54 years (17-89 years. Mechanism of injury was high energy impact in 57% (53% RN, 67% LISS and low-energy injury in 43% (47% RN, 33% LISS, respectively. Fractures were classified according to AO classification: there were 52 type A fractures (RN 31, LISS 21 and 63 type C fractures (RN 28, LISS 35; 32% (RN and 56% (LISS were open and 68% (RN and 44% (LISS were closed fractures, respectively. Functional and radiological outcome was assessed. Results: Clinical and radiographic evaluation demonstrated osseous healing within 6 months following RN and following LISS plating in over 90% of patients. However, no statistically significant differences were found for the parameters time to osseous healing, rate of nonunion, and postoperative complications. The following complications were treated: hematoma formation (one patient RN and three patients LISS, superficial infection (one patient RN and three patients LISS, deep infection (2 patients LISS. Additional secondary bone grafting for successful healing 3 months after the primary operation was required in four patients in the RN (7% of patients and six in the LISS group (10% of patients

  10. Role of intravenously administered hyoscine butyl bromide in retrograde terminal ileoscopy: A randomized, double-blinded, placebo-controlled trial

    Institute of Scientific and Technical Information of China (English)

    SP Misra; M Dwivedi

    2007-01-01

    AIM:To evaluated the role of hyoscine butyl bromide in facilitating retrograde ileoscopy.METHODS:Retrograde terminal ileoscopy was attempted in 200 consecutive patients undergoing colonoscopy. After intubation of the cecum and visualization of the ileocecal valve,butyl bromide injection or normal saline was given intravenously to the patients in a double blind random fashion. The pulse rate and oxygen saturation were measured continuously. After completion of the procedure,endoscopists were then asked to score the ease of intubation and the ease of visualization of the terminal ileum on a visual scale of 1 to 10. The patients were also asked to score the pain after receiving hyoscine butyl bromide injection on a score of 1 to 10.RESULTS:Terminal ileoscopy could be performed in 188 patients. The mean (SD) visual analogue score for the ease of intubation of the cecum was 7.4 (0.65) in the injection group and 5.9 (0.8) in the placebo group (P<0.001). The mean (SD) length of ileum visualized in the injection group was 14.4 (3.3) cm and 10.4 (2.7) cm in the placebo group (P<0.001). The mean (SD) visual analogue score for ease of visualization of the terminal ileum was 7.5 (0.69) in the injection group and 5.9 (0.7) in the placebo group (P<0.001). The pain score experienced by the patients was 6.5 (0.7) in the injection group and 6.7 (0.69) in the placebo group (P<0.008). Although the pulse rate increased significantly in patients receiving the drug,no statistically significant difference was noted in the oxygen saturation between the two groups either before or after administration of the drug. No complications were observed in either of the groups.CONCLUSION:Hyoscine butyl bromide injection is a useful adjunct in helping the intubation and visualizationof terminal ileum during colonoscopy.

  11. Successful Revascularization of an LCx CTO Lesion by Retrograde Approach From an Acute Thrombotic SVG Without Protection Device in an ACS Patient.

    Science.gov (United States)

    Lin, Mei Mei; Wang, Ji Hung

    2016-05-25

    We describe a patient who underwent coronary artery bypass grafting (CABG) surgery with the presentation of acute coronary syndrome (ACS). The diagnostic coronary angiogram showed acute thrombotic and occluded saphenous vein graft (SVG) and proximal right coronary artery (RCA) drug eluting stent (DES) instent restenosis (ISR) with chronic total occlusion (CTO). Our strategy was to recanalize the native left circumflex coronary artery (LCx) CTO instead of SVG or RCA instent CTO. After heparinization for 5 days, the LCx antegrade approach and the retrograde approach from left anterior descending coronary artery (LAD) septal branches were first attempted but failed, and the LCx CTO was successfully revascularized retrogradely via the acute thrombotic SVG without an embolic protection device (EPD).

  12. Periprosthetic supracondylar femoral fractures following total knee arthroplasty: clinical comparison and related complications of the femur plate system and retrograde-inserted supracondylar nail

    OpenAIRE

    Gondalia, Viral; Choi, Duck Hyun; Lee, Su Chan; Nam, Chang Hyun; Hwang, Bo Hyun; Ahn, Hye Sun; Ong, Alvin C.; Park, Ha Young; Jung, Kwang Am

    2014-01-01

    Background The purpose of this study is to analyze the clinical results and related complications of the femur plate system (FP) and the retrograde-inserted supracondylar nail (RISN). Materials and methods The study included 42 cases of periprosthetic supracondylar femoral fractures (PSF) proximal to posterior stabilized total knee arthroplasty between 2005 and 2009. Twenty-four cases of PSF were treated with the FP, and the other 18 cases were treated with the RISN. This study cohort was div...

  13. Extracorporeal shock waves lithotripsy versus retrograde ureteroscopy: is radiation exposure a criterion when we choose which modern treatment to apply for ureteric stones?

    OpenAIRE

    Catalin Pricop; Adrian Maier; Dragos Negru; Ovidiu Malau; Martha Orsolya; Daniel Radavoi; Serban, Dragomir R.

    2014-01-01

    The aim of this study is to compare two major urological procedures in terms of patient exposure to radiation. We evaluated 175 patients, that were subjected to retrograde ureteroscopy (URS) and extracorporeal shock waves lithotripsy (ESWL) for lumbar or pelvic ureteral lithiasis, at two urological departments. The C-arm Siemens (produced in 2010 by Siemens AG, Germany) was used for ureteroscopy. The radiological devices of the lithotripters used in this study in the two clinical centers had ...

  14. Provenance of metasedimentary rocks from the Ceará Central Domain of Borborema Province, NE Brazil: implications for the significance of associated retrograded eclogites

    Science.gov (United States)

    Ancelmi, Matheus Fernando; Santos, Ticiano José Saraiva dos; Amaral, Wagner da Silva; Fuck, Reinhardt Adolfo; Dantas, Elton Luiz; Zincone, Stefano Albino

    2015-03-01

    In the Forquilha area (NE Brazil), in NW Borborema Province, high to ultra-high pressure rocks are an important geological key to understanding West Gondwana amalgamation. U-Pb geochronological data for a retrograded eclogite sample yielded an upper intercept age of ca. 1520 Ma and a lower intercept age of ca. 620 Ma. These ages most likely represent the crystallization age of the basaltic protolith and the regional metamorphism, respectively. The retrograded eclogites are enclosed in migmatized quartz-feldspathic gneiss and sillimanite (after kyanite)-garnet-biotite gneiss. Detrital U-Pb zircon data for these paragneisses show only Paleoproterozoic zircon grains with ages clustering from ca. 1800 Ma (the maximum depositional age) to ca. 2480 Ma, and frequency peaks at 2.2-2.0 Ga. Combined with Nd isotopic data from the Forquilha paragneisses, one can assume a single Paleoproterozoic source. Basement rocks of the Ceará Central and the Rio Grande do Norte domains are the most likely candidates. The absence of Meso- and Neoproterozoic zircon grains suggest that the retrograded eclogite bodies possibly do not represent slivers of oceanic rocks captured in active margin sequences during subduction. It was identified that the high-pressure rocks of the Forquilha area are in tectonic contact with high-pressure granulite facies rocks of the Ceará Complex (Independência unit) that present detrital zircon records of an active margin setting, with ages ranging from ca. 660 Ma to 2200 Ma. Metamorphism of this sequence occurred at ca. 650 Ma. Considering previous studies, field relationships, and metamorphic paragenesis, a tectonic scenario is inferred, in which the Forquilha retrograded eclogites represent Mesoproterozoic basaltic rocks of an extensional event that were metamorphosed under eclogite facies conditions during Late Neoproterozoic continental subduction/collision, and juxtaposed to an active margin sequence during the exhumation process.

  15. PENGARUH PERBEDAAN EKSTRAKSI LIPID TERHADAP GELATINASASI DAN RETROGRADASI TEPUNG MLINJO (Gnetum gnemon) [Effects of Different Lipid Extractions on Gelatinization and Retrogradation of Bitter Nuts (Gnetum gnemon) Starch

    OpenAIRE

    Tri Agus Siswoyo

    2004-01-01

    The effect of different lipid extraction on gelatinization and retrogradation of bitter nuts (Gnetum gnemon) starch was studied by the measurement of starch-lipids complex formation using differential scanning calorimetry. The bitter nuts samples were extracted sequentially with hexane for surface lipid starch (SL) and hot water-saturated butanol for internal lipid starch (IL). The gelatinization enthalpies of starch increased significantly with extracting step, but the starch-lipid complex e...

  16. Endoscopic Ultrasound-Guided Biliary Drainage Using a Fully Covered Metallic Stent after Failed Endoscopic Retrograde Cholangiopancreatography.

    Science.gov (United States)

    Guo, Jintao; Sun, Siyu; Liu, Xiang; Wang, Sheng; Ge, Nan; Wang, Guoxin

    2016-01-01

    Background and Study Aims. Endoscopic ultrasound- (EUS-) guided biliary drainage (EUS-BD) is an alternative treatment for biliary obstruction after failed endoscopic retrograde cholangiopancreatography (ERCP). In this study, we present the outcomes of inpatients with obstructive jaundice treated with EUS-BD using a fully covered metallic stent after failed ERCP. Patients and Methods. A total of 21 patients with biliary obstruction due to malignant tumors and prior unsuccessful ERCP underwent EUS via an intra- or extrahepatic approach with fully covered metallic stent between March 2014 and October 2015. A single endoscopist performed all procedures. Results. Seven patients underwent hepatogastrostomy (HGS) and 14 underwent choledochoduodenostomy (CDS). The technical and clinical success rates were both 100%. There was no difference in efficacy between HGS and CDS. Adverse events occurred in three patients, including two in the HGS group (1 bile leakage and 1 sepsis) and one in the CDS group (sepsis). Four patients died as a result of their primary tumors during a median follow-up period of 13 months (range: 3-21 months). No patient presented with stent migration. Conclusion. EUS-BD using a fully covered metallic stent appears to be a safe and effective method for the treatment of obstructive jaundice. PMID:27594881

  17. U-Pb isotopic systematics of zircons from prograde and retrograde transition zones in high-grade orthogneisses, Sri Lanka

    Energy Technology Data Exchange (ETDEWEB)

    Baur, N.; Liew, T.C.; Todt, W.; Hofmann, A.W. (Max-Planck-Institut fuer Chemie, Mainz (West Germany)); Kroener, A. (Univ. Mainz (West Germany)); Williams, I.S. (Australian National Univ., Canberra (Australia))

    1991-07-01

    The authors present U-Pb zircon isotopic data from locally restricted prograde (arrested in situ charnockitization) and retrograde metamorphic transition zones, which are well exposed in Proterozoic orthogneisses tectonically interbanded with granulite facies supracrustal rocks of the Highland Group in Sri Lanka. These granitoid rocks yield apparent ages of 1942 {plus minus} 22 Ma, {approximately} 770 Ma, {approximately} 660 Ma, and {approximately} 560 Ma. All samples show severe Pb-loss some 550-560 Ma ago. The main phase of granulite-formation could not be dated unambiguously but is bracketed between {approximately} 660 Ma and {approximately} 550 Ma. The pervasive Pb-loss event around 550-560 Ma reflects the end of this period of high-grade metamorphism and was associated with widespread igneous activity and retrogression. This is constrained by the 550 {plus minus} 3 Ma intrusion age for a post-tectonic granite. They relate this late phase of thermal activity to crustal uplift of the Sri Lankan granulites. This data unambiguously prove the high-grade history of the Sri Lanka gneisses to be a late Precambrian event that may be related to the Pan-African evolution along the eastern part of Africa.

  18. Rewiring AMPK and mitochondrial retrograde signaling for metabolic control of aging and histone acetylation in respiratory-defective cells.

    Science.gov (United States)

    Friis, R Magnus N; Glaves, John Paul; Huan, Tao; Li, Liang; Sykes, Brian D; Schultz, Michael C

    2014-04-24

    Abnormal respiratory metabolism plays a role in numerous human disorders. We find that regulation of overall histone acetylation is perturbed in respiratory-incompetent (ρ(0)) yeast. Because histone acetylation is highly sensitive to acetyl-coenzyme A (acetyl-CoA) availability, we sought interventions that suppress this ρ(0) phenotype through reprogramming metabolism. Nutritional intervention studies led to the discovery that genetic coactivation of the mitochondrion-to-nucleus retrograde (RTG) response and the AMPK (Snf1) pathway prevents abnormal histone deacetylation in ρ(0) cells. Metabolic profiling of signaling mutants uncovered links between chromatin-dependent phenotypes of ρ(0) cells and metabolism of ATP, acetyl-CoA, glutathione, branched-chain amino acids, and the storage carbohydrate trehalose. Importantly, RTG/AMPK activation reprograms energy metabolism to increase the supply of acetyl-CoA to lysine acetyltransferases and extend the chronological lifespan of ρ(0) cells. Our results strengthen the framework for rational design of nutrient supplementation schemes and drug-discovery initiatives aimed at mimicking the therapeutic benefits of dietary interventions.

  19. Rewiring AMPK and Mitochondrial Retrograde Signaling for Metabolic Control of Aging and Histone Acetylation in Respiratory-Defective Cells

    Directory of Open Access Journals (Sweden)

    R. Magnus N. Friis

    2014-04-01

    Full Text Available Abnormal respiratory metabolism plays a role in numerous human disorders. We find that regulation of overall histone acetylation is perturbed in respiratory-incompetent (ρ0 yeast. Because histone acetylation is highly sensitive to acetyl-coenzyme A (acetyl-CoA availability, we sought interventions that suppress this ρ0 phenotype through reprogramming metabolism. Nutritional intervention studies led to the discovery that genetic coactivation of the mitochondrion-to-nucleus retrograde (RTG response and the AMPK (Snf1 pathway prevents abnormal histone deacetylation in ρ0 cells. Metabolic profiling of signaling mutants uncovered links between chromatin-dependent phenotypes of ρ0 cells and metabolism of ATP, acetyl-CoA, glutathione, branched-chain amino acids, and the storage carbohydrate trehalose. Importantly, RTG/AMPK activation reprograms energy metabolism to increase the supply of acetyl-CoA to lysine acetyltransferases and extend the chronological lifespan of ρ0 cells. Our results strengthen the framework for rational design of nutrient supplementation schemes and drug-discovery initiatives aimed at mimicking the therapeutic benefits of dietary interventions.

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

    Science.gov (United States)

    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

  1. Coordinated regulation of endocannabinoid-mediated retrograde synaptic suppression in the cerebellum by neuronal and astrocytic monoacylglycerol lipase

    Science.gov (United States)

    Liu, Xiaojie; Chen, Yao; Vickstrom, Casey R.; Li, Yan; Viader, Andreu; Cravatt, Benjamin F.; Liu, Qing-song

    2016-01-01

    The endocannabinoid 2-arachidonoylglycerol (2-AG) mediates retrograde synaptic depression including depolarization-induced suppression of excitation (DSE) and inhibition (DSI). 2-AG is degraded primarily by monoacylglycerol lipase (MAGL), which is expressed in neurons and astrocytes. Using knockout mice in which MAGL is deleted globally or selectively in neurons or astrocytes, we investigated the relative contribution of neuronal and astrocytic MAGL to the termination of DSE and DSI in Purkinje cells (PCs) in cerebellar slices. We report that neuronal MAGL plays a predominant role in terminating DSE at climbing fiber (CF) to PC synapses, while both neuronal and astrocytic MAGL significantly contributes to the termination of DSE at parallel fiber (PF) to PC synapses and DSI at putative Stellate cell to PC synapses. Thus, DSE and DSI at different synapses is not uniformly affected by global and cell type-specific knockout of MAGL. Additionally, MAGL global knockout, but not cell type-specific knockout, caused tonic activation and partial desensitization of the CB1 receptor at PF-PC synapses. This tonic CB1 activation is mediated by 2-AG since it was blocked by the diacylglycerol lipase inhibitor DO34. Together, these results suggest that both neuronal and astrocytic MAGL contribute to 2-AG clearance and prevent CB1 receptor over-stimulation in the cerebellum. PMID:27775008

  2. [Thoracoabdominal CT scan: a useful tool for the diagnosis of air embolism during an endoscopic retrograde cholangiopancreatography].

    Science.gov (United States)

    Tan, B K; Saunier, C-F; Cotton, F; Gueugniaud, P-Y; Piriou, V

    2008-03-01

    We report the case of an 82-year-old woman treated with biliary stents for an ampulloma of Vater's papilla, with recurrent stenosis of the common bile duct. She was hospitalized with a cholestasis. An endoscopic retrograde cholangiopancreatography (ERCP) was scheduled to change the biliary stent for a metallic one, under general anaesthesia, with oral intubation. The ERCP was performed initially without any complication, but as the metallic biliary stent was placed, an air embolism occurred and a cardiac arrest happened immediately. The etiologic diagnosis was quickly confirmed by an injected multislice body-scan, which showed liver, right heart and brain gas embolism. Cardiopulmonary resuscitation allowed a complete haemodynamic recovery but a poor neurological recovery. The patient was transferred in intensive care unit, were she died 12 days after, despite hyperbaric oxygen therapy and the disappearance of the air embolism on the following computed tomography scan. This case may be useful to recall the utility of a body-scan for the diagnosis, treatment and follow-up of an air embolism during ERCP. PMID:18313255

  3. COMPARISON BETWEEN RETROGRADE INTRARENAL SURGERY (RIRS AND PERCUTANEOUS NEPHROLITHOTOMY (PCNL IN THE TREATMENT OF SINGLE RENAL STONE 2 - 3CM

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    Deepak

    2015-07-01

    Full Text Available CONTEXT: Open surgery has given way to endoscopic surgeries. PCNL makes its way puncturing renal parenchyma where there is an unknown factor of damaging a major blood vessel. This may be overcome by retrograde intrarenal surgeries (RIRS but the instrument has to traverse a long way through natural orifice and lumen. Which is less harmful and more hel pful. AIM: To compare results from RIRS and PCNL in treating renal calculi of 2 to 3cm. MATERIALS AND METHODS: Retrospective analysis of consecutive patients who underwent PCNL or RIRS for stones with 20 – 30mm diameter, in a single institution between Janua ry 2008 and December 2014. RESULTS: Mean operative time for PCNL is significantly less as compared to RIRS (p=0.001. Hemoglobin drop was significantly high in PCNL group 1.2gm%. Stone clearance rate was much higher in PCNL group with 95.7% of the patients requiring only single procedure. CONCLUSION: PCNL is more effective than RIRS for stones between 2 – 3cm at a cost of longer hospital stay, increased blood loss, increased need for transfustions.

  4. Tartary buckwheat (Fagopyrum tataricum Gaertn.) starch, a side product in functional food production, as a potential source of retrograded starch.

    Science.gov (United States)

    Gao, Jinfeng; Kreft, Ivan; Chao, Guimei; Wang, Ying; Liu, Xiaojin; Wang, Li; Wang, Pengke; Gao, Xiaoli; Feng, Baili

    2016-01-01

    A starch rich fraction is a side product in Tartary buckwheat processing. This study investigated the fractions that are of technological and nutritional interest. Tartary buckwheat starch granules had a diameter of 3-14 μm, and presented a typical type "A" X-ray diffraction pattern. They contained nearly 39.0% amylose. The solubility of Tartary buckwheat starch was much lower at 70-90 °C (ranging within 9.9-10.4% at 90 °C) than that in maize (up to 49.3%) and potato (up to 85.0%) starch. The starch of one variety of Tartary buckwheat had significantly lower solubility at 70 °C and 80 °C than that of common buckwheat. The starch peak viscosity and breakdown were higher and pasting time was shorter in Tartary buckwheat than in that of the starch of common buckwheat. Tartary buckwheat starch had unique pasting and physicochemical properties, and is thereby capable of being exploited as a suitable raw material of retrograded starch in food processing. PMID:26213009

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

    Directory of Open Access Journals (Sweden)

    Kursad Zengin

    2015-01-01

    Full Text Available 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.

  6. Biodentine versus Mineral Trioxide Aggregate versus Intermediate Restorative Material for Retrograde Root End Filling: An Invitro Study.

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    Saravanapriyan Soundappan

    2014-04-01

    Full Text Available The aim of this study was to evaluate the marginal adaptation of Biodentine in comparison with Mineral Trioxide Aggregate (MTA and Intermediate Restorative Material (IRM, as a root end filling material, using Scanning Electron Microscopy (SEM.Thirty permanent maxillary central incisors were chemo-mechanically prepared and obturated. Three millimetres of the root end were resected and 3mm retro cavity preparation was done using ultrasonic retrotips. The samples were randomly divided into three groups (n=10 and were restored with root end filling materials: Group I - MTA, Group II - Biodentine, Group III - IRM. The root ends were sectioned transversely at 1mm and 2mm levels and evaluated for marginal adaptation using SEM. The gap between dentin and retro filling material was measured at four quadrants. The mean gap at 1mm level and 2mm level from the resected root tip and combined mean were calculated. The data were statistically analyzed, using one-way ANOVA and Tukey's HSD post hoc test for intergroup analysis and paired t-test for intragroup analysis.The overall results showed no statistically significant difference between MTA and IRM but both were superior when compared to Biodentine. At 1mm level there was no statistically significant difference among any of the tested materials. At 2mm level MTA was superior to both IRM and Biodentine.In overall comparison, MTA and IRM were significantly superior when compared to Biodentine in terms of marginal adaptation, when used as retrograde filling material.

  7. Diagnosis of mild chronic pancreatitis (Cambridge classification): Comparative study using secretin injection-magnetic resonance cholangiopancreatography and endoscopic retrograde pancreatography

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To investigate the usefulness of secretin injection MRCP for the diagnosis of mild chronic pancreatitis. METHODS: Sixteen patients having mild chronic pancreatitis according to the Cambridge classification and 12 control subjects with no abnormal findings on the pancreatogram were examined for the diagnostic accuracy of secretin injection-MRCP regarding abnormal branch pancreatic ducts associated with mild chronic pancreatitis (Cambridge Classification), using endoscopic retrograde cholangiopancreatography (ERCP) for comparison. RESULTS: The sensitivity and specificity for abnormal branch pancreatic ducts determined by two reviewers were respectively 55%-63% and 75%-83% in the head, 57%-64% and 82%-83% in the body, and 44%-44%and 72%-76% in the tail of the pancreas. The sensitivity and specificity for mild chronic pancreatitis were 56%-63% and 92%-92%, respectively. Interobserver abnormal branch pancreatic duct and of mild chronic pancreatitis was good to excellent. CONCLUSION: Secretin injection-MRCP might be useful for the diagnosis of mild chronic pancreatitis.

  8. Usefulness of Interventional Treatment for Dysfunctional Hemodialysis Shunts of the Upper Arm by Means of the Retrograde Transradial Approach

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    Shin, Hwa Seon; Shin, Tae Beom; Na, Jae Beom; Jung, Seong Hoon; Kim, Hyun Jung; Lee, Jung Eun [Gyeongsang National University Hospital College of Medicine, Jinju (Korea, Republic of); Song, Yun Gyu [Masan Samsung Hospital, Sungkyunkwan University College of Medicine, Masan (Korea, Republic of); Jung, Gyoo Sik [Kosin University Hospital College of Medicine, Busan (Korea, Republic of)

    2010-11-15

    This study was designed to evaluate the technical feasibility and clinical outcome of endovascular intervention using the retrograde transradial approach to treat dysfunctional hemodialysis shunts of the upper arms. During the last 3 years, sixteen procedures were performed by the transradial approach in 13 patients with dysfunctional hemodialysis shunts of the upper arms. The radial artery was accessed with the use of 20-gauge needle and a 6-Fr sheath. Angiography was performed using a 5-Fr catheter placed in the brachial artery, and then the interventional procedure was performed. The technical and clinical success rates, complications and patency rates were evaluated. Fistulography and percutaneous transluminal angioplasty via the transradial approach were performed in 16 cases of the 13 patients. Fistulography demonstrated stenosis in 7 cases and occlusions in 9 cases. Lesion multiplicity was identified in 9 out of 16 cases. Balloon angioplasty was performed in all cases and a stent was placed to overcome restenosis or to treat venous rupture in two cases. The technical success rate of balloon angioplasty was 87.5% (14/16) and the technical success rate with including stent insertion was 100% (16/16). The clinical success rate was 93.8%. There was one procedural-related complication. The primary patency rates at 6 and 12 months were 84.6% and 74%, respectively. The transradial approach seems to be technically feasible and effective for the management of insufficient hemodialysis shunts of the upper arms

  9. Tartary buckwheat (Fagopyrum tataricum Gaertn.) starch, a side product in functional food production, as a potential source of retrograded starch.

    Science.gov (United States)

    Gao, Jinfeng; Kreft, Ivan; Chao, Guimei; Wang, Ying; Liu, Xiaojin; Wang, Li; Wang, Pengke; Gao, Xiaoli; Feng, Baili

    2016-01-01

    A starch rich fraction is a side product in Tartary buckwheat processing. This study investigated the fractions that are of technological and nutritional interest. Tartary buckwheat starch granules had a diameter of 3-14 μm, and presented a typical type "A" X-ray diffraction pattern. They contained nearly 39.0% amylose. The solubility of Tartary buckwheat starch was much lower at 70-90 °C (ranging within 9.9-10.4% at 90 °C) than that in maize (up to 49.3%) and potato (up to 85.0%) starch. The starch of one variety of Tartary buckwheat had significantly lower solubility at 70 °C and 80 °C than that of common buckwheat. The starch peak viscosity and breakdown were higher and pasting time was shorter in Tartary buckwheat than in that of the starch of common buckwheat. Tartary buckwheat starch had unique pasting and physicochemical properties, and is thereby capable of being exploited as a suitable raw material of retrograded starch in food processing.

  10. A new endoscopic therapeutic method for acute obstructive suppurative cholangitis post Roux-en-Y anastomosis: endoscopic retrograde cholangiography through jejunostomy

    Directory of Open Access Journals (Sweden)

    Zhuo YANG

    2012-01-01

    Full Text Available  Objective  To probe the value of endoscopic retrograde cholangiography (ERC through jejunostomy in patients in whom ERC could not be performed via the mouth after Roux-en-Y anastomosis on the upper gastrointestinal tract. Methods  In two patients suffering from acute obstructive suppurative cholangitis after a radical operation for cholangiocarcinoma, ERC could not be performed through the mouth due to the presence of a long non-functional jejunal loop. A jejunostomy was first done in the afferent loop of the jejunum, and a gastroscope was then inserted via the jejunostomy and passed retrogradely, to find the stoma of the cholangiointestinal anastomosis. ERC was then successfully performed, and followed by endoscopic retrograde biliary drainage (ERBD. Results  The operation was successful. It was found that cholangio-jejunostomy stoma was narrow, and a large amount of purulent mucus was present in the enlarged intrahepatic duct. ERC was done to enlarge the stoma, and a stent was placed into the main branch of the intrahepatic duct. Two patients achieved surgical success and smooth recovery after the operation. Conclusion  ERC through a jejunostomy in the patients who had Roux-en-Y cholangiojejunostomy following radical resection for cholangiocarcinoma, is a safe and effective surgical procedure.

  11. Single-particle tracking uncovers dynamics of glutamate-induced retrograde transport of NF-κB p65 in living neurons.

    Science.gov (United States)

    Widera, Darius; Klenke, Christin; Nair, Deepak; Heidbreder, Meike; Malkusch, Sebastian; Sibarita, Jean-Baptiste; Choquet, Daniel; Kaltschmidt, Barbara; Heilemann, Mike; Kaltschmidt, Christian

    2016-10-01

    Retrograde transport of NF-κB from the synapse to the nucleus in neurons is mediated by the dynein/dynactin motor complex and can be triggered by synaptic activation. The caliber of axons is highly variable ranging down to 100 nm, aggravating the investigation of transport processes in neurites of living neurons using conventional light microscopy. We quantified for the first time the transport of the NF-κB subunit p65 using high-density single-particle tracking in combination with photoactivatable fluorescent proteins in living mouse hippocampal neurons. We detected an increase of the mean diffusion coefficient ([Formula: see text]) in neurites from [Formula: see text] to [Formula: see text] after stimulation with glutamate. We further observed that the relative amount of retrogradely transported p65 molecules is increased after stimulation. Glutamate treatment resulted in an increase of the mean retrograde velocity from [Formula: see text] to [Formula: see text], whereas a velocity increase from [Formula: see text] to [Formula: see text] was observed for anterogradely transported p65. This study demonstrates for the first time that glutamate stimulation leads to an increased mobility of single NF-κB p65 molecules in neurites of living hippocampal neurons. PMID:27226975

  12. Retrograde Approach Using Surgical Cutdown Technique for Limb Salvage in a Case of Critical Limb Ischemia With Severely Calcified Tibial Occlusive Disease.

    Science.gov (United States)

    Shiraki, Tatsuya; Iida, Osamu; Suemitsu, Kotaro; Tsuji, Yoriko; Uematsu, Masaaki

    2016-05-01

    We here report a successful angioplasty for tibial artery occlusion using direct tibial puncture and subsequent retrograde approach under surgical cutdown technique. An 82-year-old man with ulcer/gangrene in first and second digits was referred to our hospital for endovascular therapy (EVT) of lower extremity ischemia. Diagnostic angiogram revealed anterior tibial artery (ATA) occlusion with severe calcification. Subintimal angioplasty was attempted using a 0.014-inch hydrophilic guidewire but was unsuccessful. A retrograde approach was subsequently attempted for ATA recanalization. However, because of severe calcification of dorsal pedis artery (DPA), percutaneous distal puncture was also unsuccessful. Direct puncture under surgical cutdown technique for DPA was subsequently performed and was successful. A 0.014-inch hydrophilic wire was advanced in retrograde fashion across the ATA occlusion and was used to access the microcatheter positioned at the proximal ATA via antegrade approach. Angioplasty of the ATA occlusion was performed using a 2.5-/3.0-mm tapered balloon. Completion angiogram revealed restoration of flow without dissection. Skin perfusion pressure was dramatically improved. Complete wound healing was achieved 5 months after EVT. PMID:27207678

  13. 冷藏条件下荞麦淀粉回生规律的研究%Study on the retrogradation law of buckwheat in cold storage

    Institute of Scientific and Technical Information of China (English)

    张坤生; 周雪; 连喜军; 吴常燕

    2013-01-01

    荞麦食品一般在冷藏条件下贮藏,研究冷藏贮藏过程荞麦淀粉的回生规律有利于确定荞麦食品适宜的贮藏条件.本实验以荞麦淀粉为原料,研究淀粉乳浓度和冷藏时间对荞麦淀粉回生的影响.实验结果表明,当荞麦淀粉浓度为1%和10%时,0℃贮藏荞麦淀粉回生率较高,达到30%以上,5%、15%和20%浓度下2℃和6℃下贮藏淀粉回生率高.荞麦淀粉浓度高于5%时冷藏容易回生.电镜图片显示,荞麦淀粉呈现不规则块状,有凸起和凹陷截面,颗粒直径为1~10μm,部分颗粒表面有针扎状小孔.荞麦回生淀粉呈粘状结构.荞麦淀粉吸附碘后的最大可见吸收波长为564nm,而回生后荞麦淀粉没有最大可见吸收波长.%Most of the buckwheat foods were kept at cold storage,and the research on cold storage process of buckwheat starch retrogradation rule was beneficial to determine suitable storage conditions for the buckwheat food.In this experiment,the buckwheat starch was used as raw materials,the effect of starch concentration and storage time on buckwheat starch retrogradation were investigated.The experimental results showed that,when the buckwheat starch concentrations were 1% and 10%,the buckwheat starch retrogradation rate was higher at 0℃ storage,reaching above 30%.For concentrations of 5%,15% and 20%,the retrogradation rates at 2℃ and 6℃ were higher.The buckwheat starch inclined to retrograde when its concentrations was in excess of 5% in cold storage.Electron microscopy images showed that buckwheat starch granule was irregular block with a rising or falling in surface,its particle diameter was of 1~10μm.Some of the granule surface had needle shaped holes.Retrograded buckwheat starch had adhesive structure.The maximum visible absorption of buckwheat starch attached with l2/Kl was 564nm and its retrograded ones had no maximum absorption.

  14. Detection of K-ras point mutation and telomerase activity during endoscopic retrograde cholangiopancreatography in diagnosis of pancreatic cancer

    Institute of Scientific and Technical Information of China (English)

    Guo-Xiong Zhou; Jie-Fei Huang; Zhao-Shen Li; Guo-Ming Xu; Feng Liu; Hong Zhang

    2004-01-01

    AIM: To study the value of monitoring K-ras point mutation at codon 12 and telomerase activity in exfoliated cells obtained from pancreatic duct brushings during endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of pancreatic cancer.METHODS: Exfoliated cells obtained from pancreatic duct brushings during ERCP were examined in 27 patients: 23with pancreatic cancers, 4 with chronic pancreatitis. K-fas point mutation was detected with the polymerase chain reaction and restriction fragment-length polymorphism (PCR-RFLP). Telomerase activity was detected by PCR and telomeric repeat amplification protocol assay (PCR-TRAPELISA).RESULTS: The telomerase activities in 27 patients were measured in 21 exfoliated cell samples obtained from pancreatic duct brushings. D450 value of telomerase activities in pancreatic cancer and chronic pancreatitis were 0.446±0.27and 0.041±0.0111, respectively. Seventy-seven point eight percent (14/18) of patients with pancreatic cancer and none of the patients with chronic pancreatitis showed telomerase activity in cells collected from pancreatic duct brushings when cutoff value of telomerase activity was set at 2.0. The K-ras gene mutation rate (72.2%) in pancreatic cancer was higher than that in chronic pancreatitis (33.3%)(P<0.05). In considering of both telomerase activities and K-ras point mutation, the total positive rate was 83.3%(15/18), and the specificity was 100%.CONCLUSION: Changes of telomerase activities and K-ras point mutation at codon 12 may be an early event of malignant progression in pancreatic cancer. Detection of telomerase activity and K-ras point mutation at codon 12may be complementary to each other, and is useful in diagnosis of pancreatic cancer.

  15. Sclerosing cholangitis with autoimmune pancreatitis versus primary sclerosing cholangitis: comparison on endoscopic retrograde cholangiography, MR cholangiography, CT, and MRI

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    Kim; Jin Hee; Byun, Jae Ho; Kim, So Yeon; Lee, Seung Soo; Kim, Hyoung Jung; Lee, Moon-Gyu [Dept. of Radiology and Research Inst. of Radiology, Univ. of Ulsan Coll. of Medicine, Asan Medical Center, Seoul (Korea, Republic of)], e-mail: jhbyun@amc.seoul.kr; Kim, Myung-Hwan [Dept. of Internal Medicine, Univ. of Ulsan Coll. of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2013-07-15

    Background: It is essential to differentiate sclerosing cholangitis with autoimmune pancreatitis (SC-AIP) from primary sclerosing cholangitis (PSC) as the treatment and prognosis of the two diseases are totally different. Purpose: To compare image findings of SC-AIP and PSC on endoscopic retrograde cholangiography (ERC), magnetic resonance cholangiography (MRC), computed tomography (CT), and magnetic resonance imaging (MRI). Material and Methods: Two radiologists retrospectively reviewed ERC, MRC, CT, and MRI in 28 SC-AIP and 23 PSC patients in consensus. Factors evaluated included the length, location, and multiplicity of bile duct stricture, the presence of characteristic cholangiographic features of PSC on ERC and MRC, and the presence, location, thickness, and pattern of bile duct wall thickening on CT and MRI. Results: On ERC, focal stricture, multifocal and intrahepatic bile duct stricture, and beaded, pruned-tree, and diverticulum-like appearance were more frequent in PSC than in SC-AIP patients (P = 0.006). On MRC, multifocal and intrahepatic bile duct stricture and pruned-tree appearance were more frequent in PSC than in SC-AIP patients (P = 0.044). On CT and MRI, the bile duct wall was thicker (5.1 mm vs. 3.1 mm; P = 0.033 and 4.3 mm vs. 3.0 mm; P = 0.01, respectively) in SC-AIP than in PSC patients. PSC was more frequently associated with intrahepatic bile duct wall thickening on both CT (93% vs. 50%; P = 0.024) and MRI (100% vs. 50%; P = 0.023) than SC-AIP. Conclusion: The combination of ERC or MRC with cross-sectional images, including CT and MRI, may be helpful in differentiating between SC-AIP and PSC.

  16. Effectiveness of ultrasonography and plain abdominal graphy in the follow-up of patients after retrograde intrarenal surgery

    Directory of Open Access Journals (Sweden)

    Mustafa Reşorlu

    2012-09-01

    Full Text Available Objectives: It was aimed to evaluate the effectivenessof combined use of ultrasonography (US and plain radiography(PR in the postoperative follow-up of patientsundergoing retrograde intrarenal surgery (RIRS.Materials and methods: The charts of 207 patients whounderwent RIRS for renal stones in a 3-years-periodwere retrospectively reviewed. Fifty-eight patients wereincluded to study who were evaluated with combinationof urinary US, PR and computed tomography (CT at 1month after surgery.Results: Of 58 procedures with perioperative completestone fragmentation, 49 were completely stone-free(84.4%, while fragments (≥ 3 mm were observed in 9patients and hydronephrosis was detected in 5 patients(8.6% on the CT. Of the 9 residual stones and 5 hydronephrosis,the radiologists truly diagnosed 6 stones (66.6%and 5 hydronephrosis (100% by using the combination ofUS and PR. The sensitivity, specificity, positive and negativepredictive values of US and PR for detecting presenceof residual stone and hydronephrosis were 66.6%and 100%, 98% and 98%, 85.7% and 83.3%, 94.2% and100%, respectively.Conclusions: A combination of urinary US and plain filmhas clear advantages about lack of radiation exposureover CT scan and it is a highly specific and sensitive testfor detecting hydronephrosis. However this procedurehas limited accuracy for detecting small residual stones,so we believe that CT scan is only necessary when patienthas persistent pain or sonographic evidence of hydronephrosisis present.Key words: Renal stone, plain abdominal film, retrogradeintrarenal surgery, ultrasonography

  17. Factors Affecting the Efficacy of Nonsteroidal Anti-inflammatory Drugs in Preventing Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis

    Science.gov (United States)

    Rustagi, Tarun; Njei, Basile

    2016-01-01

    Objectives To identify the factors affecting the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing post–endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Methods We systematically searched databases for relevant studies published from inception to November 2013. Results A meta-analysis of 11 randomized trials (n = 2497) revealed a significant reduction in PEP in patients who received NSAIDs compared with that in patients who received placebo (relative risk [RR], 0.59; 95% confidence interval [CI], 0.41–0.85; P = 0.005). In subgroup analysis by treatment type, indomethacin had no significant effect (RR, 0.66; 95% CI, 0.38–1.15; P = 0.14), whereas other NSAIDs showed significant benefit (RR, 0.51; 95% CI, 0.29–0.91; P = 0.02). Only rectal administration significantly reduced the incidence of PEP (RR, 0.43; 95% CI, 0.32–0.58; P < 0.00001). The risk for PEP was the lowest among patients who received NSAIDs before ERCP (RR, 0.48; 95% CI, 0.29–0.78; P = 0.003). NSAIDs did not significantly reduce the risk of PEP in men (RR, 0.61; 95% CI, 0.34–1.09), patients with sphincter of Oddi dysfunction (RR, 0.98; 95% CI, 0.38–2.54), or patients with pancreatic duct injection (RR, 0.64; 95% CI, 0.35–1.18). Conclusions Rectal administration of NSAIDs (especially diclofenac), before ERCP, seemed to be the most effective strategy for preventing PEP. PMID:26168316

  18. Diagnosis of primary sclerosing cholangitis: prospective comparison of MR cholangiography with endoscopic retrograde cholangiography; Diagnostik der primaer sklerosierenden Cholangitis: prospektiver Vergleich von MR-Cholangiographie mit endoskopisch retrograder Cholangiographie

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    Oberholzer, K.; Mildenberger, P.; Grebe, P.; Bantelmann, M.; Thelen, M. [Mainz Univ. (Germany). Klinik fuer Radiologie; Lohse, A.W. [Mainz Univ. (Germany). Inst. fuer Innere Medizin; Schadeck, T.

    1998-12-01

    Purpose: To assess the accuracy of MR cholangiography (MRC) in the diagnosis of primary sclerosing cholangitis (PSC) in comparison to endoscopic retrograde cholangiography (ERC). Method: 20 patients with PSC were examined by ERC and MRC (1.0 T. HASTE sequence). Visualization and pathologic changes of the extra- and intrahepatic bile ducts were evaluated with both methods. Results: Mural irregularities of the common bile duct were seen with MRC in 6/7 cases, stenoses and dilatation of the common bile duct were detected correctly in all patients. Diffuse, multifocal strictures of the intrahepatic bile duct were the most common intrahepatic findings and correctly diagnosed in all patients. Mural irregularities of the intrahepatic ducts in early stages may be missed by MRC because of the limited spatial resolution. MRC is superior to ERC in visualization of nonopacified intrahepatic ducts. Conclusions: MRC is a reliable, non-invasive method to detect typical diagnostic features of PSC. It should be considered as an adjunct to ERC in patients with suspected PSC for primary diagnosis and as an alternate method for follow-up studies. (orig.) [Deutsch] Ziel: Ueberpruefung der MR-Cholangiographie (MRC) als alternative Methode zur endoskopisch retrograden Cholangiographie (ERC) bei der Diagnostik der primaer sklerosierenden Cholangitis (PSC). Patienten und Methoden: 20 Patienten mit PSC wurden mit der ERC und MRC (1.0 T, HASTE-Sequenz) untersucht. Die Untersuchungen wurden hinsichtlich Darstellbarkeit und pathologischer Veraenderungen des extra- und intrahepatischen Gallengangsystems ausgewertet. Ergebnisse: Wandunregelmaessigkeiten des D. choledochus und hepaticus wurden mit der MRC in 6/7 Faellen richtig beurteilt, Stenosen oder Dilatationen sind bei allen Patienten richtig erkannt worden. Diffuse, multifokale Strikturen und Dilatationen intrahepatischer Gallengaenge konnten mit der MRC ueberlegen praesentiert werden, waehrend mit der ERC aufgrund unzureichender

  19. Definition of a core module for the nuclear retrograde response to altered organellar gene expression identifies GLK overexpressors as gun mutants.

    Science.gov (United States)

    Leister, Dario; Kleine, Tatjana

    2016-07-01

    Retrograde signaling can be triggered by changes in organellar gene expression (OGE) induced by inhibitors such as lincomycin (LIN) or mutations that perturb OGE. Thus, an insufficiency of the organelle-targeted prolyl-tRNA synthetase PRORS1 in Arabidopsis thaliana activates retrograde signaling and reduces the expression of nuclear genes for photosynthetic proteins. Recently, we showed that mTERF6, a member of the so-called mitochondrial transcription termination factor (mTERF) family, is involved in the formation of chloroplast (cp) isoleucine-tRNA. To obtain further insights into its functions, co-expression analysis of MTERF6, PRORS1 and two other genes for organellar aminoacyl-tRNA synthetases was conducted. The results suggest a prominent role of mTERF6 in aminoacylation activity, light signaling and seed storage. Analysis of changes in whole-genome transcriptomes in the mterf6-1 mutant showed that levels of nuclear transcripts for cp OGE proteins were particularly affected. Comparison of the mterf6-1 transcriptome with that of prors1-2 showed that reduced aminoacylation of proline (prors1-2) and isoleucine (mterf6-1) tRNAs alters retrograde signaling in similar ways. Database analyses indicate that comparable gene expression changes are provoked by treatment with LIN, norflurazon or high light. A core OGE response module was defined by identifying genes that were differentially expressed under at least four of six conditions relevant to OGE signaling. Based on this module, overexpressors of the Golden2-like transcription factors GLK1 and GLK2 were identified as genomes uncoupled mutants. PMID:26876646

  20. Definition of a core module for the nuclear retrograde response to altered organellar gene expression identifies GLK overexpressors as gun mutants.

    Science.gov (United States)

    Leister, Dario; Kleine, Tatjana

    2016-07-01

    Retrograde signaling can be triggered by changes in organellar gene expression (OGE) induced by inhibitors such as lincomycin (LIN) or mutations that perturb OGE. Thus, an insufficiency of the organelle-targeted prolyl-tRNA synthetase PRORS1 in Arabidopsis thaliana activates retrograde signaling and reduces the expression of nuclear genes for photosynthetic proteins. Recently, we showed that mTERF6, a member of the so-called mitochondrial transcription termination factor (mTERF) family, is involved in the formation of chloroplast (cp) isoleucine-tRNA. To obtain further insights into its functions, co-expression analysis of MTERF6, PRORS1 and two other genes for organellar aminoacyl-tRNA synthetases was conducted. The results suggest a prominent role of mTERF6 in aminoacylation activity, light signaling and seed storage. Analysis of changes in whole-genome transcriptomes in the mterf6-1 mutant showed that levels of nuclear transcripts for cp OGE proteins were particularly affected. Comparison of the mterf6-1 transcriptome with that of prors1-2 showed that reduced aminoacylation of proline (prors1-2) and isoleucine (mterf6-1) tRNAs alters retrograde signaling in similar ways. Database analyses indicate that comparable gene expression changes are provoked by treatment with LIN, norflurazon or high light. A core OGE response module was defined by identifying genes that were differentially expressed under at least four of six conditions relevant to OGE signaling. Based on this module, overexpressors of the Golden2-like transcription factors GLK1 and GLK2 were identified as genomes uncoupled mutants.

  1. Late results of retrograd intramedullary Küntscher nailing on children between 3-12 years old -Changes on growth of proximal femur-

    OpenAIRE

    Caniklioglu, Mustafa; Yigit, Acarhan; Yazici, Nuzhet; Yalaman, Okan; Parmaksizoglu, Atilla; Mirzanli, Cuneyt

    2004-01-01

    In our clinic, 33 children between 3-12 ages old had been treated by open reduction and retrograd intramedullary Küntscher nailing. Patients were followed up approxiamately 47 months (range 18-84 months). Growth changes and length differences of the proximal femur were evaluated by gage's medhod. All fractures had united and no early complication was seen.On eight patients, no leg lenght discrepancy developed but on the others, mean 9.7 miıimeters (mostly 25 milimeters) length increase develo...

  2. On the role of protein disulfide isomerase in the retrograde cell transport of secreted phospholipases A2.

    Directory of Open Access Journals (Sweden)

    Jernej Oberčkal

    Full Text Available Following the finding that ammodytoxin (Atx, a neurotoxic secreted phospholipase A2 (sPLA2 in snake venom, binds specifically to protein disulfide isomerase (PDI in vitro we show that these proteins also interact in living rat PC12 cells that are able to internalize this group IIA (GIIA sPLA2. Atx and PDI co-localize in both differentiated and non-differentiated PC12 cells, as shown by fluorescence microscopy. Based on a model of the complex between Atx and yeast PDI (yPDI, a three-dimensional model of the complex between Atx and human PDI (hPDI was constructed. The Atx binding site on hPDI is situated between domains b and b'. Atx interacts hPDI with an extensive area on its interfacial binding surface. The mammalian GIB, GIIA, GV and GX sPLA2s have the same fold as Atx. The first three sPLA2s have been detected intracellularly but not the last one. The models of their complexes with hPDI were constructed by replacement of Atx with the respective mammalian sPLA2 in the Atx-hPDI complex and molecular docking of the structures. According to the generated models, mammalian GIB, GIIA and GV sPLA2s form complexes with hPDI very similar to that with Atx. The contact area between GX sPLA2 and hPDI is however different from that of the other sPLA2s. Heterologous competition of Atx binding to hPDI with GV and GX sPLA2s confirmed the model-based expectation that GV sPLA2 was a more effective inhibitor than GX sPLA2, thus validating our model. The results suggest a role of hPDI in the (pathophysiology of some snake venom and mammalian sPLA2s by assisting the retrograde transport of these molecules from the cell surface. The sPLA2-hPDI model constitutes a valuable tool to facilitate further insights into this process and into the (pathophysiology of sPLA2s in relation to their action intracellularly.

  3. Combined minimally invasive percutaneous nephrolithotomy and retrograde intrarenal surgery for staghorn calculi in patients with solitary kidney.

    Directory of Open Access Journals (Sweden)

    Dehui Lai

    Full Text Available 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 mm(2. 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

  4. Mid-crustal shear zone development under retrograde conditions: pressure-temperature-fluid constraints from the Kuckaus Mylonite Zone, Namibia

    Science.gov (United States)

    Diener, Johann F. A.; Fagereng, Åke; Thomas, Sukey A. J.

    2016-09-01

    contribution of the fluid was to produce retrograde mineral phases and facilitate grain-size reduction. Features such as tectonic tremor, which are observed on active faults under similar conditions as described here, may not require high fluid pressure, but could be explained by reaction weakening under hydrostatic fluid pressure conditions.

  5. Diagnosis of mucin-producing tumor of the pancreas by balloon-catheter endoscopic retrograde pancreatography--compression study.

    Science.gov (United States)

    Maeshiro, K; Nakayama, Y; Yasunami, Y; Furuta, K; Ikeda, S

    1998-01-01

    The procedure of choice for the treatment of mucin-producing pancreatic tumor (MPPT) remains controversial, since it includes not only malignant but also benign lesions. The purpose of the present study was to characterize 53 consecutive cases of MPPT and to elucidate the characteristics of benign or malignant MPPT according to the findings of an improved method of endoscopic retrograde pancreatography (ERP), namely balloon-catheter ERP-compression study (balloon ERP-CS), as well as endoscopic ultrasonography (EUS), in comparison with a histological examination. There were 37 male and 16 female cases with a median age of 63+/-11 (mean+/-SD). The balloon ERP-CS was performed in all cases, and the obtained pancreatograms were classified into two types: Main Duct type and Branch Duct type. The latter was further divided into subtypes A and B. The Branch Duct A type showed only cystic dilatation of the branch duct. If the main pancreatic duct downstream to a cyst showed more than a 5 mm dilatation, this was classified as a Branch Duct B type. Seventeen out of 19 Main duct types (89%) were histologically diagnosed as neoplasms including 13 lesions of cancer and 4 of adenoma. All the Branch Duct A type cases were diagnosed as hyperplasias. 23 Branch Duct B type cases contained 7 cancers, 8 adenomas, and 8 hyperplasias. In the Main Duct type, benign or malignant, the diagnostic ability of balloon ERP-CS was calculated as sensitivity 100%, specificity 40%, and accuracy 84%; in the Branch Duct type, sensitivity 73%, specificity 86%, and accuracy 82%. On EUS, it was found that the size of the tumor in the cyst, with respect to the maximum diameter as well as height, correlated well with the grade of malignancy. All tumors (n=35) greater than 20 mm in diameter were found to be cancerous. These findings indicate that the MPPT is highly suggestive of neoplasms when the dilatation of the main pancreatic duct is detected by balloon ERP-CS and when, in a case without dilatation of

  6. 小学低年级识字回生现象及解决路径%Phenomenon and solution ways of the literacy retrogradation phenomenon of lower grade of primary school

    Institute of Scientific and Technical Information of China (English)

    李爽; 王安全

    2013-01-01

    The new curriculum reform, primary school lower grade literacy amount increases in literacy, pressure, low grade primary school students have read retrogradation phenomenon.This comprehensive literacy retrogradation phenomenon is analyzed, that the reason mainly has:literacy retrogradation of teachers' literacy, light to read and write, literacy teaching mode, lack of innovation, the students review not properly consolidate method. According to the author read retrogradation phenomenon of read-write combination, diversified literacy method, optimization of review and consolidate the lower literacy retrogradation rate.%  新课程改革后,小学低年级识字量增大,在识字压力增大的情况下,小学低年级学生出现了识字回生现象。本文针对识字回生现象进行了综合分析,认为出现识字回生的原因主要有:教师重识字,轻读写、识字教学模式化,缺乏创新性、学生复习巩固方法不得当。针对识字回生现象笔者提出了通过读写结合、多元化的识字方法、优化复习巩固降低识字回生率。

  7. Scanning electron microscopy (SEM evaluation of sealing ability of MTA and EndoSequence as root-end filling materials with chitosan and carboxymethyl chitosan (CMC as retrograde smear layer removing agents

    Directory of Open Access Journals (Sweden)

    Bolla Nagesh

    2016-01-01

    Full Text Available Aim: The purpose of this study was to evaluate the sealing ability of mineral trioxide aggregate (MTA and EndoSequence with chitosan and carboxymethyl chitosan (CMC as retrograde smear layer removing agents using scanning electron microscopy (SEM. Materials and Methods: Forty human single rooted teeth were taken. Crowns were decoronated and canals were obturated. Apically roots were resected and retrograde cavities were done. Based on the type of retrograde material placed and the type of smear layer removal agent used for retrograde cavities, they were divided into four groups (N = 10: Group I chitosan with EndoSequence, group II chitosan with MTA, group III CMC with EndoSequence, and Group IV CMC with MTA. All the samples were longitudinally sectioned, and the SEM analysis was done for marginal adaptation. Statistical Analysis: Kruskal-Wallis and Mann-Witney analysis tests. Results: SEM images showed the presence of less gaps in group III, i.e., CMC with EndoSequence when compared to other groups with statistically significant difference. Conclusion: Within the limited scope of this study, it was concluded that EndoSequence as retrograde material showed better marginal sealing ability.

  8. Anejaculation and retrograde ejaculation

    DEFF Research Database (Denmark)

    Ohl, D.A.; Quallich, S.A.; Brackett, N.L.;

    2008-01-01

    Anejaculatory infertility is a challenge for the treating physician. Accurate diagnosis and choice of treatment plan must carefully proceed to maximize success rates while maintaining cost-effectiveness. In this article the authors review ejaculatory infertility evaluation and treatment Udgivelse...

  9. Primary hip spica with crossed retrograde intramedullary rush pins for the management of diaphyseal femur fractures in children: A prospective, randomized study

    Directory of Open Access Journals (Sweden)

    Mohammad Ruhullah

    2014-01-01

    Full Text Available Background: Femoral fractures are common in children aged between 2 and 12 yearsand 75% of the lesions affect the femoral shaft. Traction followed by a plaster cast is universally accepted as a conservative treatment. We compared primary hip spica or traction followed by hip spica with closed reduction and fixation with retrogradely passed crossed Rush pins for diaphyseal femur fracture in 25 children of the age group 3-12 years, randomly distributed in each group. Materials and Methods: Fifty children (age: 3-13 years, mean; 9 years with femoral fractures were evaluated; 25 of them underwent the conservative treatment using immediate hip spica (group A and 25 underwent treatment with crossed retrograde Rush pins (group B. Results: Mean duration of fracture union was within 15 weeks in group A and 12 weeks in group B. Mean duration of weight bearing was 14weeks in group A and 7 weeks in group A. Mean hospital stay were 4 days in group A and 8days in group B. The man follow-up period was 16 months in group A and 17 months in group B. Complications like angulation, shortening and infection were compared. Bursitis and penetration of pins at the site of Rush pin insertion is a complication associated with this method of treatment. Conclusion: Closed reduction and internal fixation with crossed Rush pins was a superior treatment method in terms of early weight bearing and restoration of normal anatomy.

  10. The Diagnostic Value of Endoscopic Balloon Catheter Usage for Detecting Early-Stage Primary Sclerosing Cholangitis in Endoscopic Retrograde Cholangiopancreatography:A Case Report

    Directory of Open Access Journals (Sweden)

    Burhan Ozdil

    2010-02-01

    Full Text Available A 34-year-old woman was admitted to our clinic with abdominal pain, jaundice and pruritus. Endoscopic retrograde cholangiopancreatography was performed for cholestasis. Endoscopic retrograde cholangiopancreatography (ERCP was judged as normal, after a standard ERCP cannula was used for the cholangiogram. However, marked canalicular irregularities were identified in cholangiography when pressurized contrast agent was administrated via balloon catheter. This cholangiographic view was thought to reveal an early-stage alteration of sclerosing cholangitis. Primary sclerosing cholangitis (PSC is a chronic cholestatic liver disease characterized by destruction and fibrosis of the bile ducts. The diagnosis of PSC is based on typical cholangiographic findings, supported by nonspecific clinical signs and symptoms, cholestatic liver biochemical tests, and liver biopsy. Cholangiography is considered to be the gold standard for the diagnosis of PSC. The diagnosis is easy when diffuse multifocal biliary strictures, the hallmarks of the disease, resulting in a ‘beaded’ appearance on ERCP is detected. However, it may reveal a normal image in an early stage of the disease when bile duct changings are not prominent. We think that balloon catheter ERCP appears to facilitate the diagnosis of early-stage primary sclerosing cholangitis.

  11. Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for stage III and IV oral cancer: Analysis of therapeutic results in 112 cases

    International Nuclear Information System (INIS)

    Purpose: To evaluate the therapeutic results and rate of organ preservation in patients with stage III or IV oral cancer treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy. Materials and methods: One hundred and twelve patients with stage III and IV oral squamous cell carcinoma underwent intra-arterial chemoradiotherapy. Catheterization from the superficial temporal and occipital arteries was performed. Treatment consisted of superselective intra-arterial chemotherapy (docetaxel, total 60 mg/m2, cisplatin, total 150 mg/m2) and daily concurrent radiotherapy (total of 60 Gy) for 6 weeks. Results: The median follow-up for all patients was 46.2 months (range, 10–76 months). After intra-arterial chemoradiotherapy, primary site complete response was achieved in 98 (87.5%) of 112 cases. Five-year survival and local control rates were 71.3% and 79.3%, respectively. Grade 3 or 4 toxicities included mucositis in 92.0%, neutropenia in 30.4%, dermatitis in 28.6%, anemia in 26.8%, and thrombocytopenia in 7.1% of patients. Grade 3 toxicities included dysphagia in 72.3%, nausea/vomiting in 21.4%, fever in 8.0%, and renal failure in 0.9% of patients. Conclusion: Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for stage III and IV oral cancer provided good overall survival and local control

  12. Microstructural records of multiple retrograde local H2O supplement in the pelitic gneiss, Lützow-Holm Complex at Akarui Point, East Antarctica

    Science.gov (United States)

    Nakamura, Aya; Kitamura, Masao; Kawakami, Tetsuo

    2014-04-01

    The alkali-feldspar and biotite in the sillimanite-biotite-garnet gneiss from East Antarctica preserves characteristic microstructural evidence of multi-stage H2O supplement during the retrograde metamorphism. The first microstructural evidence is the "zoned feldspar," in which the mesoperthitic zone, the anti-perthitic zone, and lamella-free plagioclase zone coexist within a single crystal. They are occasionally found next to biotite, and are always depleted in orthoclase (Or) component toward the biotite. The formation process of this microstructure could be explained by the diffusion that oversteps the solvus. The second microstructural evidence is the serrate boundary between alkali-feldspar and biotite. The projections of biotite are selectively developed next to Or lamellae of alkali-feldspar every 3-5 μm. These two microstructures would have formed as the biotite grew by consuming potash in alkali-feldspar when H2O-bearing fluid locally passed through the grain boundaries. The former microstructure was formed at 825-900 °C before lamella formation, and the latter microstructure was formed after the lamella formation. These microstructures are the indicators of fluid pathways formed under two different temperature conditions. The common coexistence of these microstructures implies that the fluid used similar pathways during the retrograde metamorphism.

  13. Femoral shaft fractures Retrograde versus antegrade approach%股骨干骨折--逆行穿钉与顺行穿钉的探讨

    Institute of Scientific and Technical Information of China (English)

    Tim Pohlemann; David Ring; Hartmut R. Siebert; 陈滨; 姜小惟

    2005-01-01

    It appears that both the retrograde and antegrade approaches to treating emoral fractures yield high union and similar malunion rates. Those receiving antegrade nailing may heal faster although this is not consistent. Knee pain appears common after retrograde nailing, whereas there are consistent findings in hip pain and heterotopic ossification predominating in those patients receiving antegrade nailing. Neither appears to significantly increase the risk of other complications. Functional outcomes cannot be determined.%在对股骨骨折进行逆行和顺行置入髓内钉治疗时,两种治疗方法产生很高的愈合率和相近的畸形愈合率.虽然未经过一致的认定,但那些接受顺行穿钉治疗的患者愈合较快.患者在接受逆行穿钉治疗后膝关节疼痛频繁出现,然而髋关节疼痛和异位骨化现象却在接受顺行穿钉治疗的患者中存在.患其它并发症的几率也无显著增长.因此不能决定功能结果.

  14. A role of Rab29 in the integrity of the trans-Golgi network and retrograde trafficking of mannose-6-phosphate receptor.

    Directory of Open Access Journals (Sweden)

    Shicong Wang

    Full Text Available Rab29 (also referred as Rab7L1 is a novel Rab protein, and is recently demonstrated to regulate phagocytosis and traffic from the Golgi to the lysosome. However, its roles in membrane trafficking have not been investigated extensively. Our results in this study revealed that Rab29 is associated with the trans-Golgi network (TGN, and is essential for maintaining the integrity of the TGN, because inhibition of the activity of Rab29 or depletion of Rab29 resulted in fragmentation of the TGN marked by TGN46. Expression of the dominant negative form Rab29T21N or shRNA-Rab29 also altered the distribution of mannose-6-phosphate receptor (M6PR, and interrupted the retrograde trafficking of M6PR through monitoring the endocytosis of CD8-tagged calcium dependent M6PR (cdM6PR or calcium independent M6PR (ciM6PR, but without significant effects on the anterograde trafficking of vesicular stomatitis virus G protein (VSV-G. Our results suggest that Rab29 is essential for the integrity of the TGN and participates in the retrograde trafficking of M6PRs.

  15. A Role of Rab29 in the Integrity of the Trans-Golgi Network and Retrograde Trafficking of Mannose-6-Phosphate Receptor

    Science.gov (United States)

    Wang, Shicong; Ma, Zexu; Xu, Xiaohui; Wang, Zhen; Sun, Lixiang; Zhou, Yunhe; Lin, Xiaosi; Hong, Wanjin; Wang, Tuanlao

    2014-01-01

    Rab29 (also referred as Rab7L1) is a novel Rab protein, and is recently demonstrated to regulate phagocytosis and traffic from the Golgi to the lysosome. However, its roles in membrane trafficking have not been investigated extensively. Our results in this study revealed that Rab29 is associated with the trans-Golgi network (TGN), and is essential for maintaining the integrity of the TGN, because inhibition of the activity of Rab29 or depletion of Rab29 resulted in fragmentation of the TGN marked by TGN46. Expression of the dominant negative form Rab29T21N or shRNA-Rab29 also altered the distribution of mannose-6-phosphate receptor (M6PR), and interrupted the retrograde trafficking of M6PR through monitoring the endocytosis of CD8-tagged calcium dependent M6PR (cdM6PR) or calcium independent M6PR (ciM6PR), but without significant effects on the anterograde trafficking of vesicular stomatitis virus G protein (VSV-G). Our results suggest that Rab29 is essential for the integrity of the TGN and participates in the retrograde trafficking of M6PRs. PMID:24788816

  16. Evaluation on myocardial perfusion of coronary heart disease percutaneous coronary intervention pre and post by the transvenous myocardial contrast echocardiography%实时心肌声学造影评价冠心病介入治疗前后心肌灌注

    Institute of Scientific and Technical Information of China (English)

    吴向军

    2011-01-01

    Objective To evaluate myocardial perfusion of coronary heart disease percutaneous coronary intervention ( PCI ) pre and post. Methods 42 cases were selected by doctors in department of cardiology who are confirmed coronary artery normal subjects and have coronary artery stenosis subjects by the coronary angiography, transvenous myocardial contrast echocardiography were conducted pre and post PCI in patients with coronary artery stenosis and coronary artery normal, quantitative diagnosis of coronary microcir-culation perfusion through the extent of myocardial development and record images, will be comparative analysis pre and post treatment and coronary artery normal subjects, evaluate surgical efficacy, estimate prognosis of patients. Results After PCI treatment to 23 cases, the correlation-myocardial segments to the partial cross sectional area of all the capillaries( A ), blood flow velocity( β ), myocardial blood flow volume correlation-myocardial segments group compared to the coronary artery normal subjects of the correlationmyocardial segments group, the partial cross sectional area of all the capillaries( A ), blood flow velocity ( β ), myocatrlial blood flow volume( A·β )still all decreased, correlation analysis showed, follow-up period EF values and wall motion score index incwased significantly compared with those of preoperative and after treatment with PCI in A, β, A · β good correlation. Conclusion Transvenous myocardial contrast echocardiography examination for the diagnosis and treatment of coronary heart disease areas provide an accurate, noninvasive evaluation of myocardial microcirculation and clinical test; further evaluate the treatment of percutaneous coronary intervention in patients with myocardial infarction to improve myocardial perfusion effectively. Those patients without reperfusion therapy and angina pectofis or myocardial infarction should be treated with delayed PCI as early as possible, to save the ischemic myocardial

  17. Retrograde transdorsal-to-plantar or transplantar-to-dorsal intraluminal re-entry treatment following unsuccessful subintimal angioplasty for below-the-ankle arterial occlusion

    International Nuclear Information System (INIS)

    Objective: To assess the technical feasibility and efficacy of transdorsal-to-plantar (TDP) or transplantar-to-dorsal (TPD) intraluminal re-entry procedure following unsuccessful subintimal angioplasty for the treatment of arterial occlusion below the ankle. Methods: TDP or TPD retrograde intraluminal re-entry angioplasty was carried out in 8 diseased limbs of 8 diabetic patients (5 males and 3 females, aged 62∼81 years with a mean age of 75±8 years), who were accompanied with chronic below-the-ankle arterial occlusive disease, after the standard transtibial subintimal angioplasty had failed. Both before and after the procedure the clinical symptoms, dorsal or plantar arterial pulse volume scores and ankle-brachial indexes (ABI) were determined in all patients, the results were compared and statistically analysed. During the follow-up period, the degree of pain relief, the healing of the wound, the salvage of the diseased limb and the restenosis occurrence of the target vessels were evaluated. Results: Of the total 8 patients, TDP or TPD retrograde intraluminal re-entry angioplasty was successfully performed in 5(62.5%). After the treatment the foot pain was markedly relieved, the median pulse volume scores and ankle-brachial indexes were increased from 0.60±0.55 and 0.32±0.20 before the procedure to 2.40±0.55 and 0.75±0.12 after the procedure, respectively (P<0.01 for both). At the end of the follow-up lasting for twelve months, the visual analogue scale was apparently improved, the scores decreased from preoperative 7.40±1.14 to 2.20±1.48 (P=0.002). Of two cases with intractable skin ulcer, the skin lesion was completely healed in one and was significantly decreased in size in another. No amputation surgery was needed in all successfully treated patients. Magnetic resonance angiography revealed that one target vessel developed re-stenosis. Conclusion: TDP and TDP retrograde intraluminal re-entry techniques are clinically feasible and effective for the

  18. Study on the Mechanism of Starch Retrogradation of MiGao%米制松糕回生机理的研究

    Institute of Scientific and Technical Information of China (English)

    纪莹; 周恵明

    2012-01-01

    The object of the research is to characterize changes in starch of MiGao during storage.The most significant change in the pasting curve is the increase in peak viscosity over time measured with a Rapid Visco Analyser.FT-IR indicates a reduced amount of amorphous material,giving a more organised starch because retrogradation commenced.Differential scanning calorimetry is used to follow changes of starch retrogradation in MiGao crumb,as we expected,retrogradation enthalpy increased with the storage time.All the results show that the main mechanism underlying the changes in properties is suggested be slow amylopectin crystallization.%通过对米制松糕贮存过程的热特性和结晶特性的研究,探讨松糕的回生机理。从样品的粘度特性分析可知,松糕的峰值粘度、低谷粘度、崩解值、最终粘度和回复值随贮存时间的延长逐渐增大,峰值时间随贮存时间的延长而逐渐减少,糊化温度降低;松糕淀粉主要的红外光谱说明淀粉颗粒中无定形分子迅速减少,有序分子逐渐增多,即淀粉的结晶度增加。通过热力学性质的分析表明,早期的重结晶融化顶点温度略高于后期的重结晶融化顶点温度,随着储藏时间的延长,融化支链淀粉重结晶所需的热焓增加,表明淀粉回生程度增加。

  19. Discovery of A New Retrograde Trans-Neptunian Object: Hint of A Common Orbital Plane for Low Semi-Major Axis, High Inclination TNOs and Centaurs

    Science.gov (United States)

    Chen, Ying-Tung; Lin, Hsing-Wen; Holman, Matthew J.; Payne, Matthew John; Fraser, Wesley Cristopher; Lacerda, Pedro; Ip, Wing-Huen; Pan-STARRS 1 Builders

    2016-10-01

    The origin of high inclination objects beyond Jupiter, including trans-Neptunian objects (TNOs) and Centaurs, remains uncertain. We report the discovery of a retrograde TNO, which we nickname "Niku", detected by the Pan-STARRS 1 Outer Solar System Survey. The numerical integrations show that the orbital dynamics of Niku are very similar to those of 2008 KV42 (Drac), with a half-life of ~ 500 Myr and analogous orbital evolution. Comparing similar high inclination members announced by the Minor-Planet Center (q > 10 AU, a 60), we find these objects exhibit a surprising clustering of ascending node, populating a common orbital plane. The statistical significance of 3.8-sigma suggests it is unlikely to be coincidental. An unknown mechanism is required to explain the observed clustering. This discovery may provide a pathway to investigating a possible reservoir of high-inclination objects.

  20. Discovery of A New Retrograde Trans-Neptunian Object: Hint of A Common Orbital Plane for Low Semi-Major Axis, High Inclination TNOs and Centaurs

    CERN Document Server

    Chen, Ying-Tung; Holman, Matthew J; Payne, Matthew J; Fraser, Wesley C; Lacerda, Pedro; Ip, Wing-Huen; Chen, Wen-Ping; Kudritzki, Rolf-Peter; Jedicke, Robert; Wainscoat, Richard J; Tonry, John L; Magnier, Eugene A; Waters, Christopher; Kaiser, Nick; Wang, Shiang-Yu; Lehner, Matthew

    2016-01-01

    Although the majority of Centaurs are thought to have originated in the scattered disk, with the high-inclination members coming from the Oort cloud, the origin of the high inclination component of trans-Neptunian objects (TNOs) remains uncertain. We report the discovery of a retrograde TNO, which we nickname "Niku", detected by the Pan-STARRS 1 Outer Solar System Survey. Our numerical integrations show that the orbital dynamics of Niku are very similar to that of 2008 KV$_{42}$ (Drac), with a half-life of $\\sim 500$ Myr. Comparing similar high inclination TNOs and Centaurs ($q > 10$ AU, $a 60^\\circ$), we find that these objects exhibit a surprising clustering of ascending node, and occupy a common orbital plane. This orbital configuration has high statistical significance: 3.8-$\\sigma$. An unknown mechanism is required to explain the observed clustering. This discovery may provide a pathway to investigate a possible reservoir of high-inclination objects.

  1. Structure of a C-terminal fragment of its Vps53 subunit suggests similarity of Golgi-associated retrograde protein (GARP) complex to a family of tethering complexes

    Energy Technology Data Exchange (ETDEWEB)

    Vasan, Neil; Hutagalung, Alex; Novick, Peter; Reinisch, Karin M. (Yale); (UCLJ)

    2010-08-13

    The Golgi-associated retrograde protein (GARP) complex is a membrane-tethering complex that functions in traffic from endosomes to the trans-Golgi network. Here we present the structure of a C-terminal fragment of the Vps53 subunit, important for binding endosome-derived vesicles, at a resolution of 2.9 {angstrom}. We show that the C terminus consists of two {alpha}-helical bundles arranged in tandem, and we identify a highly conserved surface patch, which may play a role in vesicle recognition. Mutations of the surface result in defects in membrane traffic. The fold of the Vps53 C terminus is strongly reminiscent of proteins that belong to three other tethering complexes - Dsl1, conserved oligomeric Golgi, and the exocyst - thought to share a common evolutionary origin. Thus, the structure of the Vps53 C terminus suggests that GARP belongs to this family of complexes.

  2. Thalamic posterior ventral neurons with bifurcating axons to the first and second somatosensory areas in the cat, demonstrated by the fluorescent retrograde double labeling technique.

    Directory of Open Access Journals (Sweden)

    Yanagihara,Mamoru

    1987-12-01

    Full Text Available The thalamic posterior ventral neurons with bifurcating axons to both the first and second somatosensory cortical areas (SI and SII in the cat were examined by the fluorescent retrograde double labeling technique. After injection of Evans blue (EB into the SI, and of 4',6-diamidino-2-phenylindol.2HCl (DAPI into the SII of the same hemisphere, EB- and DAPI-labeled cells were observed predominantly in both the posterolateral ventral and the posteromedial ventral nuclei of the thalamus. Although EB single-labeled and DAPI single-labeled cells tended to occupy separate regions within the posterior ventral nuclei, a small number of cells double-labeled with both EB and DAPI were detected in the border zone between two single-labeled cell groups. These observations indicate that some cells in the posteromedial and posterolateral ventral nuclei project both to the SI and SII by bifurcating axons.

  3. Similar cerebral protective effectiveness of antegrade and retrograde cerebral perfusion during deep hypothermic circulatory arrest in aortic surgery: a meta-analysis of 7023 patients.

    Science.gov (United States)

    Guo, Shasha; Sun, Yanhua; Ji, Bingyang; Liu, Jinping; Wang, Guyan; Zheng, Zhe

    2015-04-01

    In aortic arch surgery, deep hypothermic circulatory arrest (DHCA) combined with cerebral perfusion is employed worldwide as a routine practice. Even though antegrade cerebral perfusion (ACP) is more widely used than retrograde cerebral perfusion (RCP), the difference in benefit and risk between ACP and RCP during DHCA is uncertain. The purpose of this meta-analysis is to compare neurologic outcomes and early mortality between ACP and RCP in patients who underwent aortic surgery during DHCA. PubMed, EMBASE, and the Cochrane Library were searched using the key words "antegrade," "retrograde," "cerebral perfusion," "cardiopulmonary bypass," "extracorporeal circulation," and "cardiac surgery" for studies reporting on clinical endpoints including early mortality, stroke, temporary neurologic dysfunction (TND), and permanent neurologic dysfunction (PND) in aortic surgery requiring DHCA with ACP or RCP. Heterogeneity was analyzed with the Cochrane Q statistic and I(2) statistic. Publication bias was tested with Begg's funnel plot and Egger's test. Thirty-four studies were included in this meta-analysis, with 4262 patients undergoing DHCA + ACP and 2761 undergoing DHCA + RCP. The overall pooled relative risk for TND was 0.722 (95% CI = [0.579, 0.900]), and the z-score for overall effect was 2.9 (P = 0.004). There was low heterogeneity (I(2) = 18.7%). The analysis showed that patients undergoing DHCA + ACP had better outcomes than those undergoing DHCA + RCP in terms of TND, while there were no significant differences between groups in terms of PND, stroke, and early mortality. This meta-analysis indicates that DHCA + ACP has an advantage over DHCA + RCP in terms of TND, while the two methods show similar results in terms of PND, early mortality, and stroke.

  4. Dexamethasone rapidly increases GABA release in the dorsal motor nucleus of the vagus via retrograde messenger-mediated enhancement of TRPV1 activity.

    Directory of Open Access Journals (Sweden)

    Andrei V Derbenev

    Full Text Available Glucocorticoids influence vagal parasympathetic output to the viscera via mechanisms that include modulation of neural circuitry in the dorsal vagal complex, a principal autonomic regulatory center. Glucocorticoids can modulate synaptic neurotransmitter release elsewhere in the brain by inducing release of retrograde signalling molecules. We tested the hypothesis that the glucocorticoid agonist dexamethasone (DEX modulates GABA release in the rat dorsal motor nucleus of the vagus (DMV. Whole-cell patch-clamp recordings revealed that DEX (1-10 µM rapidly (i.e. within three minutes increased the frequency of tetrodotoxin-resistant, miniature IPSCs (mIPSCs in 67% of DMV neurons recorded in acutely prepared slices. Glutamate-mediated mEPSCs were also enhanced by DEX (10 µM, and blockade of ionotropic glutamate receptors reduced the DEX effect on mIPSC frequency. Antagonists of type I or II corticosteroid receptors blocked the effect of DEX on mIPSCs. The effect was mimicked by application of the membrane-impermeant BSA-conjugated DEX, and intracellular blockade of G protein function with GDP βS in the recorded cell prevented the effect of DEX. The enhancement of GABA release was blocked by the TRPV1 antagonists, 5'-iodoresiniferatoxin or capsazepine, but was not altered by the cannabinoid type 1 receptor antagonist AM251. The DEX effect was prevented by blocking fatty acid amide hydrolysis or by inhibiting anandamide transport, implicating involvement of the endocannabinoid system in the response. These findings indicate that DEX induces an enhancement of GABA release in the DMV, which is mediated by activation of TRPV1 receptors on afferent terminals. The effect is likely induced by anandamide or other 'endovanilloid', suggesting activation of a local retrograde signal originating from DMV neurons to enhance synaptic inhibition locally in response to glucocorticoids.

  5. Postischemic fish oil treatment restores long-term retrograde memory and dendritic density: An analysis of the time window of efficacy.

    Science.gov (United States)

    Bacarin, Cristiano Correia; Godinho, Jaqueline; de Oliveira, Rúbia Maria Weffort; Matsushita, Makoto; Gohara, Aline Kirie; Cardozo-Filho, Lúcio; Lima, Jéssica de Carvalho; Previdelli, Isolde Santos; Melo, Silvana Regina; Ribeiro, Matheus Henrique Dal Molin; Milani, Humberto

    2016-09-15

    We reported that fish oil (FO) prevented the loss of spatial memory caused by transient, global cerebral ischemia (TGCI), provided the treatment covered the first days prior to and after ischemia. Continuing these studies, trained rats were subjected to TGCI, and FO was administered for 10days, with a time window of efficacy (TWE) of 4, 8 or 12h post-ischemia. Retrograde memory was assessed up to 43days after TGCI. In another experiment, ischemic rats received FO with a 4- or 12-h TWE, and dendritic density was assessed in the hippocampus and cerebral cortex. The brain lipid profile was evaluated in sham-operated and ischemic rats that were treated with FO or vehicle with a 4-h TWE. Ischemia-induced retrograde amnesia was prevented by FO administration that was initiated with either a 4- or 8-h TWE. Fish oil was ineffective after a 12-h TWE. Independent of the TWE, FO did not prevent ischemic neuronal death. In the hippocampus, but not cerebral cortex, TGCI-induced dendritic loss was prevented by FO with a 4-h TWE but not 12-h TWE. The level of docosahexaenoic acid almost doubled in the hippocampus in ischemic, FO-treated rats (4-h TWE). The data indicate that (i) the anti-amnesic effect of FO can be observed with a TWE of up to 8h, (ii) the stimulation of dendritic neuroplasticity may have contributed to this effect, and (iii) DHA in FO may be the main active constituent in FO that mediates the cognitive and neuroplasticity effects on TGCI. PMID:27235715

  6. Retrograde study of CART- or NPY-neuronal projection from the hypothalamic arcuate nucleus to the dorsal raphe and/or the locus coeruleus in the rat.

    Science.gov (United States)

    Yoon, Ye S; Lee, Ji S; Lee, Hyun S

    2013-06-26

    The present study was designed to reveal cocaine- and amphetamine-regulated transcript (CART)- or neuropeptide Y (NPY)-immunoreactive neuronal projections from the hypothalamic arcuate nucleus (Arc) to the dorsal raphe (DR) and/or the locus coeruleus (LC) in the rat. Our results demonstrated that CART or NPY axon terminals formed close appositions to the neuronal profiles in the DR and the LC. Thus, arcuate sections were immunostained for the CART or NPY after the injections of green RetroBeads(™) into the DR and red tracer into the LC (or vice versa). First, retrogradely-labeled CART cells were mainly observed in the lateral Arc without colchicine. Of the total population of arcuate CART neurons, DR- and LC-projecting cells were 5.7% ± 0.9% and 6.6% ± 0.7%, respectively. In addition, a subset (3.3% ± 0.7%) of CART neurons provided divergent axon collaterals to the DR and the LC. Second, retrogradely-labeled NPY cells were observed in lateral or ventral borders of the medial Arc only after colchicine injection. Of the entire NPY cell population, DR- and LC-projecting neurons were 1.5% ± 0.3% and 1.3% ± 0.3%, respectively. Only a scanty proportion (0.1% ± 0.0%) sent axon collaterals to the DR and the LC. These observations suggested that arcuate CART or NPY system might have a potential influence on the brainstem monoaminergic nuclei, modulating their roles in feeding, nociception, emotional behaviors, arousal, and stress responses. Furthermore, a portion of arcuate CART neurons (along with only a few NPY cells) sending divergent axon collaterals to the DR/LC might have a simultaneous (and possibly more efficient) way to exert their specific influences on the monoaminergic nuclei.

  7. Screening of different wheat protease hydrolysates inhibiting retrogradation of corn starch%抑制玉米淀粉回生的面粉蛋白酶解液筛选

    Institute of Scientific and Technical Information of China (English)

    郭俊杰; 康海岐; 孙海波; 连喜军; 李琳

    2014-01-01

    为防止玉米淀粉食品会因回生而降低品质,该文利用酸性、中性和碱性3种蛋白酶水解小麦面粉中的球蛋白、谷蛋白和醇溶蛋白,研究酶解物中混合多肽对玉米淀粉回生的影响。研究结果表明,酸性蛋白酶水解谷蛋白所得多肽混合液能强烈抑制玉米淀粉回生,使玉米淀粉回生率由14.0%降低到8.0%。其他2种水解物促进玉米淀粉回生,促进最多的是碱性蛋白酶水解醇溶蛋白,使玉米淀粉回生率由14.0%升高到19.5%。通过红外和核磁分析了混合多肽抑制或促进玉米淀粉回生的可能机理。研究成果为控制淀粉回生提供一条全新的途径。%Retrogradation is the molecular interaction that occurs between glucan molecules in gelatinized starch during cooling. It profoundly affects quality, acceptability, and shelf-life of starch-containing foods. Corn starch is cheap and is widely used in foods such as instant noodles, sausages, pastries, etc. But the quality of these foods in hardness, digestion, compatibility, etc, becomes deteriorated during storage due to starch retrogradation. Wheat gluten is a kind of nutritious, high quality, and inexpensive plant-based protein. It is often suggested that gluten has an anti-firming effect in bread, but the reason for this is not clear. There are four kinds of proteins in wheat flour:albumin, globulin, glutenin, and gliadin. In order to find the peptides with the ability of hindering corn starch retrogradation, these proteins were hydrolyzed by acid, neutral, and alkali proteases. The effects of these peptides in hydrolysate of globulin, glutenin, and gliadin on the retrogradation of corn starch were carried out in this paper. The results showed that the peptides from hydrolysis of glutenin by acid protease strongly inhibited retrogradation of corn starch, lowering the retrogradation rate of corn starch from 14.0%to 8.0%. Other hydrolysis promoted the retrogradation of corn starch

  8. Effect of Treatment of Endodontic and Periodontal for Retrograde Pulpitis%牙髓牙周联合治疗逆行性牙髓炎的效果

    Institute of Scientific and Technical Information of China (English)

    张冬鹰

    2015-01-01

    目的:探讨分析牙髓牙周联合治疗逆行性牙髓炎的临床治疗效果,对该类疾病治疗提供参考。方法2012年~2014年我院共接收了149例逆行性牙髓炎患者,共有患牙151颗,我们为患者进行了牙髓、牙周兼顾治疗的方式,对临床治疗效果进行观察分析。结果全部151颗患牙有132颗治疗有效,有效率为87.42%,共19颗治疗无效,占总数的12.58%,治疗有效病例的患牙,其牙髓炎症状得到了改善,咬合情况良好,疼痛缓解,和传统牙髓以及牙周单一治疗方式比较,效果更优秀,见效更快速。结论逆行性牙髓炎是因为牙周组织感染所致,病情延伸至牙髓部分,因此该疾病既有牙髓疾病的特点,也有牙周疾病的特点,使用牙髓联合治疗见效快,治疗效果突出。%Objective To investigate the effect of combined endodontic with periodontal for retrograde pulpitis,provide reference for the treatment.Methods Selected 149 cases of retrograde pulpitis from 2012 to 2014 in our hospital,a total of 151 teeth. We conducted endodontic with periodontal treatment approach for patients. Clinical outcomes were observed and analyzed.Results A total of 132 teeth treatment were effective,efficient was 87.42%,19 cases of invalid,accounting for 12.58% of the total,effective treatment of cases,their pulpitis symptoms had improved,bite in good condition,pain relief,compared with traditional single treatment,the effect was more outstanding,effective and faster.Conclusion Retrograde pulpitis is caused by periodontal tissue infections,part of the disease extends to the pulp. Therefore,both the characteristics of the endodontic and periodontal,the use of endodontic therapy was effective,the treatment effect is prominent.

  9. Retrograde T-t Histories From Pelitic Migmatites Reflect Structural Distance From the Gwillim Creek Shear Zone, Valhalla Complex, British Columbia

    Science.gov (United States)

    Hallett, B. W.; Spear, F. S.

    2008-12-01

    Diffusion-zoned garnets from pelitic migmatites from the Valhalla metamorphic core complex, southeastern B.C. record relatively fast cooling rates that vary with distance above the Gwillim Creek shear zone (GCSZ). Fast cooling was caused by thrusting onto a cold footwall, where rocks closest to the fault began at the highest temperatures and conductively cooled at the fastest rate. Pelitic migmatites adjacent to and structurally above the GCSZ contain garnet with core to rim zoning of Fe/(Fe+Mg), controlled mainly by diffusion during progress of the retrograde net transfer reaction (ReNTR) Grt + Kfs + Melt = Bt + Sil + Plg. Where biotite is present in contact with garnet, retrograde Fe/Mg exchange has resulted in additional increased Fe/(Fe+Mg). A strongly foliated pelitic migmatite with pervasive 2-5mm-thick leucosomes from ~1.5 km structurally above the GCSZ contains garnet with Fe/(Fe+Mg) ranging from 0.72 to 0.93 and Xsps zoning with a uniform core (~0.02) and a near rim increase (to ~0.04). Interdiffusion of Fe+Mg was modeled with garnet radius varying linearly with temperature. This finite difference model calculates Fe-Mg interdiffusivity and generates a diffusion profile based on changing garnet rim boundary conditions governed by the ReNTR. Model fits to measured profiles require a 1-5 m.y. period of slow to moderate cooling (5-25°C/ m.y.) followed by a brief period (displacement on the Slocan Lake normal fault. 2-D thermal modeling of a low angle thrust ramp yields different T-t histories for hanging wall rocks based on their distance from the thrust. Model results show that transport on the order of cm/yr up a 10-20°-dipping thrust fault can produce cooling rates that are consistent with those calculated from garnet diffusion, and that the duration of initial slow cooling increases with distance from the fault.

  10. Differential diagnosis of sclerosing cholangitis with autoimmune pancreatitis and periductal infiltrating cancer in the common bile duct at dynamic CT, endoscopic retrograde cholangiography and MR cholangiography

    International Nuclear Information System (INIS)

    To compare findings at dynamic computed tomography (CT), endoscopic retrograde cholangiography (ERC) and magnetic resonance cholangiography (MRC) in patients with sclerosing cholangitis with autoimmune pancreatitis (SC-AIP) and periductal infiltrating cancer in the common bile duct (CBD), and to evaluate the diagnostic performance of ERC and MRC in differentiating between the two diseases. Bile duct changes at dynamic CT, ERC and MRC were compared in 58 patients with SC-AIP and CBD involvement and 93 patients with periductal infiltrating CBD cancer. Two radiologists rated their confidence in differentiating between the two diseases and the diagnostic performances of ERC and MRC were compared. At CT, SC-AIP was more frequently associated with intrapancreatic CBD involvement, thinner CBD walls, concentric wall thickening, smooth outer margins, and lower degrees of upstream ductal dilatation and contrast enhancement (P ≤ 0.05) than CBD cancer. At ERC and MRC, SC-AIP was more frequently associated with smooth margins, gradual and symmetric narrowing, multifocal involvement and hourglass appearance (P ≤ 0.027) than CBD cancer. MRC showed good diagnostic performance comparable to ERC. Dynamic CT, ERC and MRC can be helpful in distinguishing SC-AIP from periductal infiltrating CBD cancer. MRC may be a useful diagnostic alternative to ERC in differentiating between the two diseases. (orig.)

  11. Differential diagnosis of sclerosing cholangitis with autoimmune pancreatitis and periductal infiltrating cancer in the common bile duct at dynamic CT, endoscopic retrograde cholangiography and MR cholangiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hee; Byun, Jae Ho; Lee, So Jung; Park, Seong Ho; Kim, Hyoung Jung; Lee, Seung Soo; Lee, Moon-Gyu [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Asanbyeongwon-gil 86, Songpa-Gu, Seoul (Korea, Republic of); Kim, Myung-Hwan [University of Ulsan College of Medicine, Asan Medical Center, Department of Internal Medicine, Asanbyeongwon-gil 86, Songpa-Gu, Seoul (Korea, Republic of); Kim, Jihun [University of Ulsan College of Medicine, Asan Medical Center, Department of Diagnostic Pathology, Asanbyeongwon-gil 86, Songpa-Gu, Seoul (Korea, Republic of)

    2012-11-15

    To compare findings at dynamic computed tomography (CT), endoscopic retrograde cholangiography (ERC) and magnetic resonance cholangiography (MRC) in patients with sclerosing cholangitis with autoimmune pancreatitis (SC-AIP) and periductal infiltrating cancer in the common bile duct (CBD), and to evaluate the diagnostic performance of ERC and MRC in differentiating between the two diseases. Bile duct changes at dynamic CT, ERC and MRC were compared in 58 patients with SC-AIP and CBD involvement and 93 patients with periductal infiltrating CBD cancer. Two radiologists rated their confidence in differentiating between the two diseases and the diagnostic performances of ERC and MRC were compared. At CT, SC-AIP was more frequently associated with intrapancreatic CBD involvement, thinner CBD walls, concentric wall thickening, smooth outer margins, and lower degrees of upstream ductal dilatation and contrast enhancement (P {<=} 0.05) than CBD cancer. At ERC and MRC, SC-AIP was more frequently associated with smooth margins, gradual and symmetric narrowing, multifocal involvement and hourglass appearance (P {<=} 0.027) than CBD cancer. MRC showed good diagnostic performance comparable to ERC. Dynamic CT, ERC and MRC can be helpful in distinguishing SC-AIP from periductal infiltrating CBD cancer. MRC may be a useful diagnostic alternative to ERC in differentiating between the two diseases. (orig.)

  12. Effect of Acetylation on Stability to Retrogradation of Starch Extracted from Wild Polynesian Arrowroot (Tacca leontopetaloides (L. Kuntze for Utilization as Adhesive on Paper

    Directory of Open Access Journals (Sweden)

    Hamza Abba

    2014-01-01

    Full Text Available Starch was isolated from T. leontopetaloides tubers, chemically modified by acetylation with varying amounts of acetic anhydride. Monolayer of the ten acetylated and control starch powders was exposed on roof top for five weeks and pastes of both exposed and unexposed (control samples were prepared with distilled water (1 : 3 w/w. The effects of acetylation, degree of substitution (DS, and exposure to sunlight were investigated to evaluate the retrogradation tendency of the adhesive pastes from changes in syneresis, tack strength, optical clarity, viscosity, gelation time, and drying time. The results obtained showed that all the adhesive properties studied were affected by both DS and exposure to sunlight. While tack strength, viscosity, and drying time were found to increase with increase in DS, syneresis, optical clarity, and gelation time were found to decrease with increase in DS. Increase in tack strength and reduction in syneresis imply that the acetylation treatment has made T. leontopetaloides starch more suitable for use in remoistenable adhesive applications. The reduction in syneresis, optical clarity, and gelation time with increase in DS was attributed to the strengthening of the bonds between the amylose and amylopectin molecules, preventing water leaching out of the starch granules.

  13. 逆行射精致男性不育的临床治疗现状%Treatment of Male Infertility Resulted from Retrograde Ejaculation

    Institute of Scientific and Technical Information of China (English)

    赵邦荣; 于俊荣

    2006-01-01

    逆行射精(retrograde ejaculation)是指在性交射精时,有射精动作及快感、高潮,精液未射出,而是逆向流入膀胱,可引起男性不育。正常射精是在神经支配下,由膀胱颈关闭和尿道外括约肌松弛协调完成的。任何由于解剖学的损害、神经性障碍以及药物的影响使膀胱颈功能发生紊乱以及尿道狭窄,均可造成逆行射精。诊断要点是性交持续时问正常,有射精动作及快感、高潮,无精液射出,性交后尿中有精子和果糖;彩超可清晰的观察到射精时精液逆流入膀胱的过程。现就逆行射精所致男性不育的治疗现状综述如下。

  14. The conjectured S-type retrograde planet in nu Octantis: more evidence including four years of iodine-cell radial velocities

    CERN Document Server

    Ramm, D J; Endl, M; Hearnshaw, J B; Wittenmyer, R A; Gunn, F; Bergmann, C; Kilmartin, P; Brogt, E

    2016-01-01

    We report 1212 radial-velocity (RV) measurements obtained in the years 2009-2013 using an iodine cell for the spectroscopic binary nu Octantis (K1III/IV). This system (a_bin~2.6 au, P~1050 days) is conjectured to have a Jovian planet with a semi-major axis half that of the binary host. The extreme geometry only permits long-term stability if the planet is in a retrograde orbit. Whilst the reality of the planet (P~415 days) remains uncertain, other scenarios (stellar variability or apsidal motion caused by a yet unobserved third star) continue to appear substantially less credible based on CCF bisectors, line-depth ratios and many other independent details. If this evidence is validated but the planet is disproved, the claims of other planets using RVs will be seriously challenged. We also describe a significant revision to the previously published RVs and the full set of 1437 RVs now encompasses nearly 13 years. The sensitive orbital dynamics allow us to constrain the three-dimensional architecture with a bro...

  15. Retrograde Cerebral Perfusion Results in Better Perfusion to the Striatum Than the Cerebral Cortex During Deep Hypothermic Circulatory Arrest: A Microdialysis Study.

    Science.gov (United States)

    Liang, Meng-Ya; Chen, Guang-Xian; Tang, Zhi-Xian; Rong, Jian; Yao, Jian-ping; Wu, Zhong-Kai

    2016-03-01

    It remains controversial whether contemporary cerebral perfusion techniques, utilized during deep hypothermic circulatory arrest (DHCA), establish adequate perfusion to deep structures in the brain. This study aimed to investigate whether selective antegrade cerebral perfusion (SACP) or retrograde cerebral perfusion (RCP) can provide perfusion equally to various anatomical positions in the brain using metabolic evidence obtained from microdialysis. Eighteen piglets were randomly assigned to 40 min of circulatory arrest (CA) at 18°C without cerebral perfusion (DHCA group, n = 6) or with SACP (SACP group, n = 6) or RCP (RCP group, n = 6). Microdialysis parameters (glucose, lactate, pyruvate, and glutamate) were measured every 30 min in cortex and striatum. After 3 h of reperfusion, brain tissue was harvested for Western blot measurement of α-spectrin. After 40 min of CA, the DHCA group showed marked elevations of lactate and glycerol and a reduction in glucose in the microdialysis perfusate (all P spectrin expression in brain tissue were similar between cortex and striatum in the SACP group (all P > 0.05). In the RCP group, the cortex exhibited lower glucose, higher lactate, and higher glycerol in the perfusate and higher α-spectrin expression in brain tissue compared with the striatum (all P 0.05). In summary, SACP provided uniform and continuous cerebral perfusion to most anatomical sites in the brain, whereas RCP resulted in less sufficient perfusion to the cortex but better perfusion to the striatum. PMID:26333187

  16. Extracorporeal shock waves lithotripsy versus retrograde ureteroscopy: is radiation exposure a criterion when we choose which modern treatment to apply for ureteric stones?

    Directory of Open Access Journals (Sweden)

    Catalin Pricop

    2014-10-01

    Full Text Available The aim of this study is to compare two major urological procedures in terms of patient exposure to radiation. We evaluated 175 patients, that were subjected to retrograde ureteroscopy (URS and extracorporeal shock waves lithotripsy (ESWL for lumbar or pelvic ureteral lithiasis, at two urological departments. The C-arm Siemens (produced in 2010 by Siemens AG, Germany was used for ureteroscopy. The radiological devices of the lithotripters used in this study in the two clinical centers had similar characteristics. We evaluated patient exposure to ionizing radiation by using a relevant parameter, the air kerma-area product (PKA; all values in cGy cm2, calculated from the radiation dose values recorded by the fluoroscopy device. PKA depends on technical parameters that change due to anatomical characteristics of each case examined, such as body mass index (BMI, waist circumference, and stone location. For the patients subjected to ESWL for lumbar ureteral lithiasis the mean of PKA (cGy cm2 was 509 (SD=180, while for those treated for pelvic ureteral lithiasis the mean of PKA was 342 (SD=201. In the URS group for lumbar ureteral lithiasis, the mean of PKA (cGy cm2 was 892 (SD=436, while for patients with pelvic ureteral lithiasis, the mean of PKA was 601 (SD=429. The patients treated by URS had higher exposure to ionizing radiation dose than patients treated by ESWL. The risk factors of higher radiation doses were obesity, exposure time, and localization of the stones.

  17. Evaluation of staff, patient and foetal radiation doses due to endoscopic retrograde cholangio-pancreatography (ERCP) procedures in a pregnant patient

    International Nuclear Information System (INIS)

    The use of endoscopic retrograde cholangio-pancreatography (ERCP) in pregnant patients is not rare. Most studies on the safety and efficacy of these procedures report short- and long-term pregnancy outcomes and but not foetal absorbed doses. This investigation reports on an ERCP procedure for a 40-y-old woman who was 32-34 weeks pregnant. Thermoluminescent dosemeters (TLD 100) were used to measure doses received by the patient and the staff. Additionally, Monte Carlo calculations were performed using a 3D computational phantom representing a 9-month pregnant patient to estimate the foetal absorbed dose. The results show that the spleen of the mother received the largest absorbed dose of 12.18 mGy since it was closer to the source than other internal organs. For the foetus and uterus, the lowest absorbed dose was found to be 0.01 mGy to the foetal brain, while the largest absorbed dose was estimated to be 0.13 mGy to the placenta. (authors)

  18. Comparison of Isocentric C-Arm 3-Dimensional Navigation and Conventional Fluoroscopy for Percutaneous Retrograde Screwing for Anterior Column Fracture of Acetabulum: An Observational Study.

    Science.gov (United States)

    He, Jiliang; Tan, Guoqing; Zhou, Dongsheng; Sun, Liang; Li, Qinghu; Yang, Yongliang; Liu, Ping

    2016-01-01

    Percutaneous screw insertion for minimally displaced or reducible acetabular fracture using x-ray fluoroscopy and computer-assisted navigation system has been advocated by some authors. The purpose of this study was to compare intraoperative conditions and clinical results between isocentric C-arm 3-dimensional (Iso-C 3D) fluoroscopy and conventional fluoroscopy for percutaneous retrograde screwing of acetabular anterior column fracture.A prospective cohort study was conducted. A total of 22 patients were assigned to 2 different groups: 10 patients in the Iso-C 3D navigation group and 12 patients in the conventional group. The operative time, fluoroscopic time, time of screw insertion, blood loss, and accuracy were analyzed between the 2 groups.There were significant differences in operative time, screw insertion time, fluoroscopy time, and mean blood loss between the 2 groups. Totally 2 of 12 (16.7%) screws were misplaced in the conventional fluoroscopy group, and all 10 screws were in safe zones in the navigation group. Percutaneous screw fixation using the Iso-C 3D computer-assisted navigation system significantly reduced the intraoperative fluoroscopy time and blood loss in percutaneous screwing for acetabular anterior column fracture.The Iso-C 3D computer-assisted navigation system provided a reliable and effective method for percutaneous screw insertion in acetabular anterior column fractures compared to conventional fluoroscopy.

  19. Effects of pinaverium bromide in the premedication of endoscopic retrograde cholangio-pancreatography and on motor activity of the sphincter of Oddi.

    Science.gov (United States)

    Lamazza, A; Tofi, A; Bolognese, A; Fontana, B; De Masi, E; Frontespezi, S

    1986-01-01

    A double-blind study was carried out in 18 patients with biliary and pancreatic disease to assess the use of pinaverium bromide in premedication for endoscopic retrograde cholangio-pancreatography and its effects on motor activity of the sphincter of Oddi. Patients were divided at random into three groups. One group received 100 mg pinaverium bromide twice daily for 3 days before and then 100 mg 1 hour before the examination, the second group received placebo, and the third had no medication. All patients received 10 to 20 mg diazepam intravenously 10 minutes before endoscopy. Assessments were made of the transit time of various endoscopic phases and patients' tolerance of the procedure. The effects of treatment on the sphincter of Oddi were estimated by means of endoscopic manometry. The results showed that pinaverium bromide allowed transit time reduction in endoscopic procedure, a greater tolerance on the part of the patient and marked reduction in the amplitude and duration of the phasic activity of the sphincter. PMID:3780291

  20. Discovery of a New Retrograde Trans-Neptunian Object: Hint of a Common Orbital Plane for Low Semimajor Axis, High-inclination TNOs and Centaurs

    Science.gov (United States)

    Chen, Ying-Tung; Lin, Hsing Wen; Holman, Matthew J.; Payne, Matthew J.; Fraser, Wesley C.; Lacerda, Pedro; Ip, Wing-Huen; Chen, Wen-Ping; Kudritzki, Rolf-Peter; Jedicke, Robert; Wainscoat, Richard J.; Tonry, John L.; Magnier, Eugene A.; Waters, Christopher; Kaiser, Nick; Wang, Shiang-Yu; Lehner, Matthew

    2016-08-01

    Although the majority of Centaurs are thought to have originated in the scattered disk, with the high-inclination members coming from the Oort cloud, the origin of the high-inclination component of trans-Neptunian objects (TNOs) remains uncertain. We report the discovery of a retrograde TNO, which we nickname “Niku,” detected by the Pan-STARRS 1 Outer Solar System Survey. Our numerical integrations show that the orbital dynamics of Niku are very similar to that of 2008 KV42 (Drac), with a half-life of ˜500 Myr. Comparing similar high-inclination TNOs and Centaurs (q > 10 au, a 60°), we find that these objects exhibit a surprising clustering of ascending node, and occupy a common orbital plane. This orbital configuration has high statistical significance: 3.8-σ. An unknown mechanism is required to explain the observed clustering. This discovery may provide a pathway to investigating a possible reservoir of high-inclination objects.