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Sample records for complex major abdominal

  1. Effect of Dex medetomidine on Neuromuscular Blockade in Patients Undergoing Complex Major Abdominal or Pelvic Surgery

    International Nuclear Information System (INIS)

    El-Awady, G.A.; Abdelhalim, J.M.K.; Azer, M.S.

    2003-01-01

    Dex medetomidine is a highly selective α2 agonist with anesthetic, analgesic and sympatholytic properties. Its neuromuscular effects in humans are unknown. This study evaluates the effect of dex medetomidine on neuromuscular block and hemodynamics during thiopental/ isoflurane anesthesia for patients with complex abdominal or pelvic surgery. Patients and methods: During thiopental/isoflurane anesthesia, the rocuronium infusion rate was adjusted in 20 complex surgery patients to maintain a stable first response (T1) in the train of four sequence of 50% ± 3 of the pre-rocuronium value. Dex medetomidine was then administered by infusion pump, targeting a plasma dex medetomidine concentration of 0.6 ng/dL for 45 min. The evoked mechanical responses of the adductor pollicis responses (T1 response and T4/T1 ratio), systolic blood pressure, diastolic blood pressure and heart rate (HR) were measured during the dex medetomidine infusion using repeated measures analysis of variance. Plasma levels ranged from 0.73 to 1.38 ng/mL. Results: T1 values decreased during the infusion from 55(ρ2 to 38±9 ((ρ< 0.05). T4/Tl values did not change during the infusion. Dex medetomidine increased SBP (ρ< 0.001) and decreased HR ((ρ< 0.05) (10 min median values) during the infusion compared with values before the infusion. This study demonstrated that dex medetomidine decreased T1, increased SBP and decreased HR during thiopental/isoflurane anesthesia. Conclusion: We conclude that dex medetomidine induced direct vasoconstriction may alter pharmacokinetics of rocuronium, therefore increasing plasma rocuronium concentration. Although these effects were statistically significant, further studies should be held for understanding and characterizing the peripheral vasoconstrictive effects of a2 agonists that allow better management and determination of drug dosing regimens

  2. Major Abdominal Surgical Complications : Innovative Approaches

    NARCIS (Netherlands)

    G.S.A. ter Hoeve-Boersema (Simone)

    2017-01-01

    markdownabstractIn this thesis the focus was on three major complications after abdominal surgery: incisional hernia (IH), prolonged postoperative ileus (PPOI), and colorectal anastomotic leakage (CAL). The results were summarized in three parts: _Part 1_ focused on prediction and detection of

  3. Plasma osmotic changes during major abdominal surgery.

    Science.gov (United States)

    Malone, R A; McLeavey, C A; Arens, J F

    1977-12-01

    Fluid balance across the capillary membrane is maintained normally by a balance of hydrostatic and colloid osmotic pressures (COP). In 12 patients having major intra-abdominal procedures, the COP was followed during the operative and immediate postoperative periods. The patients' intraoperative fluid management consisted of replacing shed blood with blood and following Shires' concept of crystalloid replacement. Significant decreases in COP to approximately two thirds of the initial value occurred in patients having intra-abdominal procedures versus only a 10 percent decrease in those having peripheral procedures (greater than .001). As a result of this decrease in COP, the balance between hydrostatic and colloid osmotic pressures is lost and risk of pulmonary intersitial edema is increased.

  4. Transversus Abdominis Plane Catheter Bolus Analgesia after Major Abdominal Surgery

    Directory of Open Access Journals (Sweden)

    Nils Bjerregaard

    2012-01-01

    Full Text Available Purpose. Transversus abdominis plane (TAP blocks have been shown to reduce pain and opioid requirements after abdominal surgery. The aim of the present case series was to demonstrate the use of TAP catheter injections of bupivacaine after major abdominal surgery. Methods. Fifteen patients scheduled for open colonic resection surgery were included. After induction of anesthesia, bilateral TAP catheters were placed, and all patients received a bolus dose of 20 mL bupivacaine 2.5 mg/mL with epinephrine 5 μg/mL through each catheter. Additional bolus doses were injected bilaterally 12, 24, and 36 hrs after the first injections. Supplemental pain treatment consisted of paracetamol, ibuprofen, and gabapentin. Intravenous morphine was used as rescue analgesic. Postoperative pain was rated on a numeric rating scale (NRS, 0–10 at regular predefined intervals after surgery, and consumption of intravenous morphine was recorded. Results. The TAP catheters were placed without any technical difficulties. NRS scores were ≤3 at rest and ≤5 during cough at 4, 8, 12, 18, 24, and 36 hrs after surgery. Cumulative consumption of intravenous morphine was 28 (23–48 mg (median, IQR within the first 48 postoperative hours. Conclusion. TAP catheter bolus injections can be used to prolong analgesia after major abdominal surgery.

  5. Abdominal wall closure in bladder exstrophy complex repair by ...

    African Journals Online (AJOL)

    Background and Objectives: The Exstrophy Complex (EC) is a serious malformation of midline abdominal wall. Wide pubis prevents approximating the lateralized rectus muscle and leads to dehiscence and fi stula formation. Our aim was to recommend an easier method for abdominal wall closure in the Bladder Exstrophy ...

  6. Dehydration and fluid volume kinetics before major open abdominal surgery.

    Science.gov (United States)

    Hahn, R G; Bahlmann, H; Nilsson, L

    2014-11-01

    Assessment of dehydration in the preoperative setting is of potential clinical value. The present study uses urine analysis and plasma volume kinetics, which have both been validated against induced changes in body water in volunteers, to study the incidence and severity of dehydration before open abdominal surgery begins. Thirty patients (mean age 64 years) had their urine analysed before major elective open abdominal surgery for colour, specific weight, osmolality and creatinine. The results were scored and the mean taken to represent a 'dehydration index'. Thereafter, the patients received an infusion of 5 ml/kg of Ringer's acetate intravenously for over 15 min. Blood was sampled for 70 min and the blood haemoglobin concentration used to estimate the plasma volume kinetics. Distribution of fluid occurred more slowly (P dehydrated as compared with euhydrated patients. The dehydration index indicated that the fluid deficit in these patients corresponded to 2.5% of the body weight, whereas the deficit in the others was 1%. In contrast, the 11 patients who later developed postoperative nausea and vomiting had a very short elimination half-life, only 9 min (median, P dehydration before major surgery was modest as evidenced both by urine sampling and volume kinetic analysis. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Abdominal binders may reduce pain and improve physical function after major abdominal surgery - a systematic review

    DEFF Research Database (Denmark)

    Rothman, Josephine Philip; Gunnarsson, Ulf; Bisgaard, Thue

    2014-01-01

    INTRODUCTION: Evidence for the effect of post-operative abdominal binders on post-operative pain, seroma formation, physical function, pulmonary function and increased intra-abdominal pressure among patients after surgery remains largely un-investigated. METHODS: A systematic review was conducted...... formation and physical function. RESULTS: A total of 50 publications were identified; 42 publications were excluded leaving eight publications counting a total of 578 patients for analysis. Generally, the scientific quality of the studies was poor. Use of abdominal binder revealed a non-significant tendency...... to reduce seroma formation after laparoscopic ventral herniotomy and a non-significant reduction in pain. Physical function was improved, whereas evidence supports a beneficial effect on psychological distress after open abdominal surgery. Evidence also supports that intra-abdominal pressure increases...

  8. The comparative study of epidural levobupivacaine and bupivacaine in major abdominal surgeries

    Directory of Open Access Journals (Sweden)

    Ali Uzuner

    2011-01-01

    Conclusions: The results of our study suggest that same concentration of epidural levobupivacaine and bupivacaine with fentanyl provide stable postoperative analgesia and both were found safe for the patients undergoing major abdominal surgery.

  9. Angiographic anatomy of major branches of the abdominal aorta

    International Nuclear Information System (INIS)

    Kim, K. W.; Suh, J. H.; Park, C. Y.

    1980-01-01

    These paper is an analyses of 110 patients who received abdominal aortography and selective organ angiography from July 1977 to August 1979 at the Department of Radiology of Yonsei Medical Center. 1. The most frequent site of bifurcation of the abdominal aorta was the 4th intervertebral disc level, occurring in 22 of 50 cases (42.3%). 2. The celiac trunk arose most frequently at the level of the 12th thoracic intervertebral disc, occurring in 11 of 52 cases (21.2%). 3. The superior mesenteric artery arose most frequent at the level of the upper third of the 1st lumbar vertebra, occurring in 8 of 30 cases (26.7%). 4. The right renal artery most frequently arose at the level of the middle third of the 1st lumbar vertebra, occurring in 17 of 70 cases (24.3%) and the left renal artery occurred most frequently in 1st lumbar vertebral disc level, 14 of 70 cases (20%). 5. Both renal arteries most commonly arose symmetrically as seen in 37 of 70 cases (52.6%). Case in which the rights arose at a higher level than the left occurred in 28 of 70 cases (40.6%). 6. Accessory renal arteries occurred in 19 of 70 cases (27.1%). 7. The most common form of the celiac trunk in which it divides into left gastric, splenic and common hepatic arteries was seen in 30 of 38 cases (78.9%). 8. The normal hepatic artery pattern in which it arise from the common hepatic artery and divides into right, middle and left hepatic artery occurred in 23 of 38 cases (60.5%0. A replaced right hepatic artery was seen in 2 of 35 cases (5.3%), and an accessory right hepatic artery also in 2 of 38 cases (5.3%).

  10. Predicting mortality in damage control surgery for major abdominal ...

    African Journals Online (AJOL)

    has increased the survival rate after major trauma to over. 50%.1-6. The term ... Package for the Social Sciences (SPSS) for Windows, ver- sion 12.0 (SAS .... J Surg 2004; 91: 1095-1101. 8. American College of Surgeon's Committee on Trauma. Advanced Trauma. Life Support Manual. Chicago: ACS, 1997: 11-242. Table Iv.

  11. Imaging of small bowel-related complications following major abdominal surgery

    International Nuclear Information System (INIS)

    Sandrasegaran, Kumaresan; Maglinte, Dean D.T.

    2005-01-01

    To recognize and document the small bowel reactions following major abdominal surgery is an important key for a correct diagnosis. Usually, plain abdominal radiography is the initial imaging examination requested in the immediate postoperative period, whereas gastrointestinal contrast studies are used to look for specific complications. In some countries, especially in Europe, sonography is widely employed to evaluate any acute affection of the abdomen. CT is commonly used to assess postoperative abdominal complications; in our institution also CT enteroclysis is often performed, to provide additional important informations. Radiologist should be able to diagnose less common types of obstruction, such as afferent loop, closed loop, strangulating obstruction as well as internal hernia. This knowledge may assume a critical importance for surgeons to decide on therapy. In this article, we focus our attention on the imaging (particularly CT) in small bowel complications following abdominal surgery

  12. Circadian distribution of sleep phases after major abdominal surgery

    DEFF Research Database (Denmark)

    Gogenur, I.; Wildschiotz, G.; Rosenberg, J.

    2008-01-01

    Background. It is believed that the severely disturbed night-time sleep architecture after surgery is associated with increased cardiovascular morbidity with rebound of rapid eye movement (REM). The daytime sleep pattern of patients after major general surgery has not been investigated before. We...... nights after operation. Sleep was scored independently by two blinded observers and the recordings were reported as awake, light sleep (LS, stages I and II), slow wave sleep (SWS, stages III and IV), and REM sleep. Results. There was significantly increased REM sleep (P=0.046), LS (P=0.020), and reduced...... time awake (P=0.016) in the postoperative daytime period compared with the preoperative daytime period. Five patients had REM sleep during the daytime after surgery. Three of these patients did not have REM sleep during the preceding postoperative night. There was significantly reduced night-time REM...

  13. Laparoscopy in major abdominal emergency surgery seems to be a safe procedure

    DEFF Research Database (Denmark)

    Nielsen, Liv Bjerre Juul; Tengberg, Line Toft; Bay-Nielsen, Morten

    2017-01-01

    INTRODUCTION: Laparoscopy is well established in the majority of elective procedures in abdominal surgery. In contrast, it is primarily used in minor surgery such as appendectomy or cholecystectomy in the emergent setting. This study aimed to analyze the safety and effectiveness of a laparoscopic...

  14. Post-operative analgesia for major abdominal surgery and its effectiveness in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Aliya Ahmed

    2013-01-01

    Conclusion: Epidural, PCIA and opioid infusions are used for pain relief after major abdominal surgeries at our hospital. Although there is limited drug availability, regular assessments and appropriate dose adjustments by acute pain management service (APMS and use of multimodal analgesia led to a high level of patient satisfaction. We recommend that feedback to the primary anesthesiologists by APMS is of utmost importance to enable improvement in practice.

  15. Differential Effects of Intraoperative Positive End-expiratory Pressure (PEEP) on Respiratory Outcome in Major Abdominal Surgery Versus Craniotomy

    DEFF Research Database (Denmark)

    de Jong, Myrthe A C; Ladha, Karim S; Melo, Marcos F Vidal

    2015-01-01

    OBJECTIVES: In this study, we examined whether (1) positive end-expiratory pressure (PEEP) has a protective effect on the risk of major postoperative respiratory complications in a cohort of patients undergoing major abdominal surgeries and craniotomies, and (2) the effect of PEEP is differed......: Within the entire study population (major abdominal surgeries and craniotomies), we found an association between application of PEEP ≥5 cmH2O and a decreased risk of postoperative respiratory complications compared with PEEP 5 cmH2O was associated with a significant lower...... undergoing major abdominal surgery. Our data suggest that default mechanical ventilator settings should include PEEP of 5-10 cmH2O during major abdominal surgery....

  16. ANGIOGRAPHIC ANATOMY OF THE MAJOR ABDOMINAL ARTERIAL BLOOD SUPPLY IN THE DOG.

    Science.gov (United States)

    Culp, William T N; Mayhew, Philipp D; Pascoe, Peter J; Zwingenberger, Allison

    2015-01-01

    Vascular-based interventional radiology (IR) procedures are being more regularly performed in veterinary patients for both diagnostic and therapeutic purposes. A complete description of the fluoroscopic arterial anatomy of the canine abdominal cavity has not been published. This information is essential for performance of IR procedures to allow for improved preparation before and during a particular procedure. The primary purpose of this study was to provide a fluoroscopic description of the vascular branching from the abdominal aorta in a ventro-dorsal projection with a secondary goal of producing pictorial reference images of the major abdominal arterial blood vessels. Five healthy female hound type dogs were enrolled and underwent fluoroscopic arteriography. During fluoroscopy, both nonselective and selective arteriography were performed. The nonselective arteriograms were obtained in the aorta at four locations: cranial to the celiac artery, cranial to the renal arteries, cranial to the caudal mesenteric artery, and cranial to the branching of the external iliac arteries. Selective arteriography was conducted by performing injections into the following arteries: celiac, splenic, common hepatic, cranial mesenteric, left and right renal, and caudal mesenteric. Fluoroscopic arteriography allowed for excellent characterization of the aortic ostia and the location of the lower order vascular branches. Future evaluation of vascular-based treatment options will likely increase as the understanding of the normal and pathologic anatomy improves. © 2015 American College of Veterinary Radiology.

  17. The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report

    OpenAIRE

    Theodoraki, Kassiani; Markatou, Maria; Rizos, Demetrios; Fassoulaki, Argyro

    2014-01-01

    Blood transfusion is associated with well-known risks. We investigated the difference between a restrictive versus a liberal transfusion strategy on the immune response, as expressed by the production of inflammatory mediators, in patients subjected to major abdominal surgery procedures. Fifty-eight patients undergoing major abdominal surgery were randomized preoperatively to either a restrictive transfusion protocol or a liberal transfusion protocol (with transfusion if hemoglobin dropped be...

  18. The Major Histocompatibility Complex in Transplantation

    Directory of Open Access Journals (Sweden)

    Marco Antonio Ayala García

    2012-01-01

    Full Text Available The transplant of organs is one of the greatest therapeutic achievements of the twentieth century. In organ transplantation, the adaptive immunity is considered the main response exerted to the transplanted tissue, since the principal target of the immune response is the MHC (major histocompatibility complex molecules expressed on the surface of donor cells. However, we should not forget that the innate and adaptive immunities are closely interrelated and should be viewed as complementary and cooperating. When a human transplant is performed, HLA (human leukocyte antigens molecules from a donor are recognized by the recipient's immune system triggering an alloimmune response Matching of donor and recipient for MHC antigens has been shown to have a significant positive effect on graft acceptance. This paper will present MHC, the innate and adaptive immunities, and clinical HLA testing.

  19. NUTRITIONAL ASSESSMENT IN PATIENTS PREDICTED TO MAJOR ABDOMINAL SURGERY AT THE GENERAL HOSPITAL CELJE

    Directory of Open Access Journals (Sweden)

    Ernest Novak

    2001-12-01

    Full Text Available Background. Malnutrition has serious implications for recovery after surgery. Early detection of malnutrition with nutritional support minimizes postoperative complications. Nutritional assessment tools need to be simple and suitable for use in everyday practice. In our study we wanted to determine, how many patients might benefit from nutritional support.Methods. From April to August 1999 fifty consecutively admitted patients predicted to major abdominal surgery have been examined. We used Mini nutritional assessment (MNA, Buzby’s nutrition risk index (NRI, blood albumin level and weight loss in the last 3 months period prior to the examination, to assess nutritional status.Results. We examined 50 patients (27 males and 23 females, age 76.5 ± 16.5 and confirmed malnutrition in 40% of patients with MNA and serum albumin level. The increased risk for nutrition-associated complications was confirmed by NRI and weight loss in 44%.Conclusions. A confident diagnosis of malnutrition and increased risk for nutrition-associated complications can be established by using a combination of simple methods like MNA, NRI, weight loss and serum albumin level. Almost half of the patients admitted for major abdominal surgery in General hospital Celje suffer from malnutrition and they may benefit with early nutritional intervention.

  20. Intraperitoneal And Incisional Bupivacaine Analgesia For Major Abdominal/Gynecologic Surgery: A Placebocontrolled

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    R. Azarfarin

    2006-05-01

    Full Text Available Background:Postoperative pain is an important surgical problem. Recent studies in pain pathophysiology have led to the hypothesis that with perioperative administration of analgesics (pre-emptive analgesia it may be possible to prevent or reduce postoperative pain. This study was planned to investigate the efficacy of pre-emptive analgesia on postoperative pain after major gynecologic abdominal surgeries. Methods: In this prospective, double-blinded, randomized, and placebocontrolled trial, 60 ASA physical status I and II patients undergoing major abdominal gynecologic surgeries were randomized to receive 45 mL of bupivacaine 0.375% or 45mL of normal saline; 30 mL and 15 mL of the treatment solution was administered into the peritoneal cavity and incision, respectively, before wound closure. The pain score of the patients was evaluated by the visual analogue scale (VAS on awakening, and at 6, 12, and 24h after surgery. Time to first analgesia request and total analgesic requirements in the first 24h were recorded. Results: Pain scores were significantly higher in the placebo group than in the bupivacaine group on awakening (5.98±1.01 v.s 1.05±1.05; p<0.001, and at 6h after surgery (5.37±0.85 vs. 2.51±1.02; p<0.001. First request to analgesia was significantly longer in the bupivacaine patients than in the placebo group (5.87±3.04 h vs.1.35±0.36; p<0.001.Meperidine consumption over 24h was 96.00 ±17.53 mg in the placebo group compared with 23.28 ±14.89 mg in the bupivacaine patients (p<0.001.Conclusion:A combination of intraperitoneal and incisional bupivacaine infiltration at the end of abdominal gynecologic surgeries reduces postoperative pain on awakening and for 6 hours after surgery, and provides significant opioidsparing analgesia for 24 h after gynecologic abdominal surgeries.

  1. Thoracic epidural analgesia reduces myocardial injury in ischemic patients undergoing major abdominal cancer surgery

    Directory of Open Access Journals (Sweden)

    Mohamad MF

    2017-04-01

    Full Text Available Mohamad Farouk Mohamad,1 Montaser A Mohammad,1 Diab F Hetta,1 Eman Hasan Ahmed,2 Ahmed A Obiedallah,3 Alaa Ali M Elzohry1 1Department of Anesthesia, ICU and Pain Relief, 2Department of Clinical Pathology, South Egypt Cancer Institute, 3Department of Internal Medicine, Faculty of Medicine, Assiut University, Arab Republic of Egypt Background and objectives: Major abdominal cancer surgeries are associated with significant perioperative mortality and morbidity due to myocardial ischemia and infarction. This study examined the effect of perioperative patient controlled epidural analgesia (PCEA on occurrence of ischemic cardiac injury in ischemic patients undergoing major abdominal cancer surgery.Patients and methods: One hundred and twenty patients (American Society of Anesthesiologists grade II and III of either sex were scheduled for elective upper gastrointestinal cancer surgeries. Patients were allocated randomly into two groups (60 patients each to receive, besides general anesthesia: continuous intra and postoperative intravenous (IV infusion with fentanyl for 72 h postoperatively (patient controlled intravenous analgesia [PCIA] group or continuous intra and postoperative epidural infusion with bupivacaine 0.125% and fentanyl (PCEA group for 72 h postoperatively. Perioperative hemodynamics were recorded. Postoperative pain was assessed over 72 h using visual analog scale (VAS. All patients were screened for occurrence of myocardial injury (MI by electrocardiography, echocardiography, and cardiac troponin I serum level. Other postoperative complications as arrhythmia, deep venous thrombosis (DVT, pulmonary embolism, pneumonia, and death were recorded.Results: There was a significant reduction in overall adverse cardiac events (myocardial injury, arrhythmias, angina, heart failure and nonfatal cardiac arrest in PCEA group in comparison to PCIA group. Also, there was a significant reduction in dynamic VAS pain score in group PCEA in comparison

  2. Adrenal gland volume, intra-abdominal and pericardial adipose tissue in major depressive disorder.

    Science.gov (United States)

    Kahl, Kai G; Schweiger, Ulrich; Pars, Kaweh; Kunikowska, Alicja; Deuschle, Michael; Gutberlet, Marcel; Lichtinghagen, Ralf; Bleich, Stefan; Hüper, Katja; Hartung, Dagmar

    2015-08-01

    Major depressive disorder (MDD) is associated with an increased risk for the development of cardio-metabolic diseases. Increased intra-abdominal (IAT) and pericardial adipose tissue (PAT) have been found in depression, and are discussed as potential mediating factors. IAT and PAT are thought to be the result of a dysregulation of the hypothalamus-pituitary-adrenal axis (HPAA) with subsequent hypercortisolism. Therefore we examined adrenal gland volume as proxy marker for HPAA activation, and IAT and PAT in depressed patients. Twenty-seven depressed patients and 19 comparison subjects were included in this case-control study. Adrenal gland volume, pericardial, intraabdominal and subcutaneous adipose tissue were measured by magnetic resonance imaging. Further parameters included factors of the metabolic syndrome, fasting cortisol, fasting insulin, and proinflammatory cytokines. Adrenal gland and pericardial adipose tissue volumes, serum concentrations of cortisol and insulin, and serum concentrations tumor-necrosis factor-α were increased in depressed patients. Adrenal gland volume was positively correlated with intra-abdominal and pericardial adipose tissue, but not with subcutaneous adipose tissue. Our findings point to the role of HPAA dysregulation and hypercortisolism as potential mediators of IAT and PAT enlargement. Further studies are warranted to examine whether certain subtypes of depression are more prone to cardio-metabolic diseases. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. THE SIGNIFICANCE OF CUMULATIVE WATER BALANCE IN THE DEVELOPMENT OF EARLY COMPLICATIONS AFTER MAJOR ABDOMINAL SURGERY.

    Science.gov (United States)

    Musaeva, T S; Karipidi, M K; Zabolotskikh, I B

    2016-11-01

    a comprehensive assessment of the water balance on the basis of daily, cumulative balance and 10% of the body weight gain and their role in the development of early complications after major abdominal surgery. A retrospective study of the perioperative period in 150 patients who underwent major abdomi- nal surgery was performed. The physical condition of the patients corresponded to ASA 3 class. The average age was 46 (38-62) years. The following stages ofresearch: an analysis of daily balance and cumulative balance in complicated and uncomplicated group and their role in the development of complications; the timing of development ofcomplications and possible relationship with fluid overload and the development of complications; changes in the level of albumin within 10 days of the postoperative period. The analysis of complications didn't show significant differences between complicated and uncomplicated groups according to the water balance during the surgery and by the end of the first day. When constructing the area under the ROC curve (A UROC) low resolution ofthe balance in intraoperative period and the first day and the balance on the second day to predict complications was shown. Significant diferences according to the cumulative balance was observed from the third day of the postoperative period Also with the third day of the postoperative period there is a good resolution for prediction ofpostoperative complications according to the cumulative balance with the cut-offpoint > of 50,7 ml/kg. the excessive infusion therapy is a predictor of adverse outcome in patients after major abdominal surgery. Therefore, after 3 days of postoperative period it is important to maintain mechanisms for the excretion of excess fluid or limitations of infusion therapy.

  4. Lack of circadian variation in the activity of the autonomic nervous system after major abdominal operations

    DEFF Research Database (Denmark)

    Gögenur, Ismail; Rosenberg-Adamsen, Susan; Lie, Claus

    2002-01-01

    OBJECTIVE: Most sudden postoperative deaths occur during the night and we conjectured that this was associated with circadian variations in the autonomic nervous tone, reflected in heart rate variability. DESIGN: Prospective clinical study. SETTINGS: University hospital, Denmark. SUBJECTS: 44...... OUTCOME MEASURES: Heart rate and heart rate variability. RESULTS: Circadian variation calculated from the SDNN (p = 0.43) the pNN50 (p = 0.11), the RMSSD (p = 0.47), and mean NN:SDNN ratio (p = 0.13) was absent postoperatively. Circadian variation in the heart rate was present but was set on a higher...... level compared with reference values. CONCLUSION: After major abdominal operations there was a lack of circadian variation in the autonomic nervous tone....

  5. New Insight in Loss of Gut Barrier during Major Non-Abdominal Surgery.

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    Joep P M Derikx

    Full Text Available Gut barrier loss has been implicated as a critical event in the occurrence of postoperative complications. We aimed to study the development of gut barrier loss in patients undergoing major non-abdominal surgery.Twenty consecutive children undergoing spinal fusion surgery were included. This kind of surgery is characterized by long operation time, significant blood loss, prolonged systemic hypotension, without directly leading to compromise of the intestines by intestinal manipulation or use of extracorporeal circulation. Blood was collected preoperatively, every two hours during surgery and 2, 4, 15 and 24 hours postoperatively. Gut mucosal barrier was assessed by plasma markers for enterocyte damage (I-FABP, I-BABP and urinary presence of tight junction protein claudin-3. Intestinal mucosal perfusion was measured by gastric tonometry (P(rCO2, P(r-aCO2-gap. Plasma concentration of I-FABP, I-BABP and urinary expression of claudin-3 increased rapidly and significantly after the onset of surgery in most children. Postoperatively, all markers decreased promptly towards baseline values together with normalisation of MAP. Plasma levels of I-FABP, I-BABP were significantly negatively correlated with MAP at (1/2 hour before blood sampling (-0.726 (p<0.001, -0.483 (P<0.001, respectively. Furthermore, circulating I-FABP correlated with gastric mucosal P(rCO2, P(r-aCO2-gap measured at the same time points (0.553 (p = 0.040, 0.585 (p = 0.028, respectively.This study shows the development of gut barrier loss in children undergoing major non-abdominal surgery, which is related to preceding hypotension and mesenterial hypoperfusion. These data shed new light on the potential role of peroperative circulatory perturbation and intestinal barrier loss.

  6. New Insight in Loss of Gut Barrier during Major Non-Abdominal Surgery

    Science.gov (United States)

    Derikx, Joep P. M.; van Waardenburg, Dick A.; Thuijls, Geertje; Willigers, Henriëtte M.; Koenraads, Marianne; van Bijnen, Annemarie A.; Heineman, Erik; Poeze, Martijn; Ambergen, Ton; van Ooij, André; van Rhijn, Lodewijk W.; Buurman, Wim A.

    2008-01-01

    Background Gut barrier loss has been implicated as a critical event in the occurrence of postoperative complications. We aimed to study the development of gut barrier loss in patients undergoing major non-abdominal surgery. Methodology/Principal Findings Twenty consecutive children undergoing spinal fusion surgery were included. This kind of surgery is characterized by long operation time, significant blood loss, prolonged systemic hypotension, without directly leading to compromise of the intestines by intestinal manipulation or use of extracorporeal circulation. Blood was collected preoperatively, every two hours during surgery and 2, 4, 15 and 24 hours postoperatively. Gut mucosal barrier was assessed by plasma markers for enterocyte damage (I-FABP, I-BABP) and urinary presence of tight junction protein claudin-3. Intestinal mucosal perfusion was measured by gastric tonometry (PrCO2, Pr-aCO2-gap). Plasma concentration of I-FABP, I-BABP and urinary expression of claudin-3 increased rapidly and significantly after the onset of surgery in most children. Postoperatively, all markers decreased promptly towards baseline values together with normalisation of MAP. Plasma levels of I-FABP, I-BABP were significantly negatively correlated with MAP at ½ hour before blood sampling (−0.726 (p<0.001), −0.483 (P<0.001), respectively). Furthermore, circulating I-FABP correlated with gastric mucosal PrCO2, Pr-aCO2-gap measured at the same time points (0.553 (p = 0.040), 0.585 (p = 0.028), respectively). Conclusions/Significance This study shows the development of gut barrier loss in children undergoing major non-abdominal surgery, which is related to preceding hypotension and mesenterial hypoperfusion. These data shed new light on the potential role of peroperative circulatory perturbation and intestinal barrier loss. PMID:19088854

  7. Feasibility of real-time location systems in monitoring recovery after major abdominal surgery.

    Science.gov (United States)

    Dorrell, Robert D; Vermillion, Sarah A; Clark, Clancy J

    2017-12-01

    Early mobilization after major abdominal surgery decreases postoperative complications and length of stay, and has become a key component of enhanced recovery pathways. However, objective measures of patient movement after surgery are limited. Real-time location systems (RTLS), typically used for asset tracking, provide a novel approach to monitoring in-hospital patient activity. The current study investigates the feasibility of using RTLS to objectively track postoperative patient mobilization. The real-time location system employs a meshed network of infrared and RFID sensors and detectors that sample device locations every 3 s resulting in over 1 million data points per day. RTLS tracking was evaluated systematically in three phases: (1) sensitivity and specificity of the tracking device using simulated patient scenarios, (2) retrospective passive movement analysis of patient-linked equipment, and (3) prospective observational analysis of a patient-attached tracking device. RTLS tracking detected a simulated movement out of a room with sensitivity of 91% and specificity 100%. Specificity decreased to 75% if time out of room was less than 3 min. All RTLS-tagged patient-linked equipment was identified for 18 patients, but measurable patient movement associated with equipment was detected for only 2 patients (11%) with 1-8 out-of-room walks per day. Ten patients were prospectively monitored using RTLS badges following major abdominal surgery. Patient movement was recorded using patient diaries, direct observation, and an accelerometer. Sensitivity and specificity of RTLS patient tracking were both 100% in detecting out-of-room ambulation and correlated well with direct observation and patient-reported ambulation. Real-time location systems are a novel technology capable of objectively and accurately monitoring patient movement and provide an innovative approach to promoting early mobilization after surgery.

  8. The major histocompatibility complex in the chicken

    DEFF Research Database (Denmark)

    Guillemot, F; Kaufman, J F; Skjoedt, K

    1989-01-01

    The chicken B complex is the first non-mammalian MHC characterized at the molecular level. It differs from the human HLA and murine H-2 complexes in the small size of the class I (B-F) and class II (B-L) genes and their close proximity. This proximity accounts for the absence of recombination...

  9. Sclerotic bone lesions at abdominal magnetic resonance imaging in children with tuberous sclerosis complex

    International Nuclear Information System (INIS)

    Boronat, Susana; Barber, Ignasi; Pargaonkar, Vivek; Chang, Joshua; Thiele, Elizabeth A.

    2016-01-01

    Sclerotic bone lesions are often seen on chest CT in adults with tuberous sclerosis complex. To characterize bone lesions at abdominal MRI in children with tuberous sclerosis complex. This retrospective review included 70 children with tuberous sclerosis complex who had undergone abdominal MRI for renal imaging. An additional longitudinal study was performed in 50 children who had had two or more MRI scans. Abdominal CT (eight children) and radiographs (three children) were reviewed and compared with MRI. A total of 173 sclerotic bone lesions were detected in 51/70 children (73%; 95% confidence interval: 0.61-0.82) chiefly affecting vertebral pedicles. New lesions appeared in 20 children and growth of previous sclerotic bone lesions was documented in 14 children. Sclerotic bone lesions were more frequent in girls and in children with more extensive renal involvement. Sclerotic bone lesions are commonly detected by abdominal MRI in children with tuberous sclerosis complex. They usually affect posterior vertebral elements and their number and size increase with age. As current recommendations for tuberous sclerosis complex surveillance include renal MR performed in childhood, recognition of these lesions is useful. (orig.)

  10. Sclerotic bone lesions at abdominal magnetic resonance imaging in children with tuberous sclerosis complex

    Energy Technology Data Exchange (ETDEWEB)

    Boronat, Susana [Massachusetts General Hospital, Department of Neurology, Boston, MA (United States); Universitat Autonoma de Barcelona, Department of Pediatric Neurology, Vall d' Hebron Hospital, Barcelona (Spain); Barber, Ignasi [Universitat Autonoma de Barcelona, Department of Pediatric Radiology, Vall d' Hebron Hospital, Barcelona (Spain); Pargaonkar, Vivek [Massachusetts General Hospital, Department of Radiology, Boston, MA (United States); Chang, Joshua; Thiele, Elizabeth A. [Massachusetts General Hospital, Department of Neurology, Boston, MA (United States)

    2016-05-15

    Sclerotic bone lesions are often seen on chest CT in adults with tuberous sclerosis complex. To characterize bone lesions at abdominal MRI in children with tuberous sclerosis complex. This retrospective review included 70 children with tuberous sclerosis complex who had undergone abdominal MRI for renal imaging. An additional longitudinal study was performed in 50 children who had had two or more MRI scans. Abdominal CT (eight children) and radiographs (three children) were reviewed and compared with MRI. A total of 173 sclerotic bone lesions were detected in 51/70 children (73%; 95% confidence interval: 0.61-0.82) chiefly affecting vertebral pedicles. New lesions appeared in 20 children and growth of previous sclerotic bone lesions was documented in 14 children. Sclerotic bone lesions were more frequent in girls and in children with more extensive renal involvement. Sclerotic bone lesions are commonly detected by abdominal MRI in children with tuberous sclerosis complex. They usually affect posterior vertebral elements and their number and size increase with age. As current recommendations for tuberous sclerosis complex surveillance include renal MR performed in childhood, recognition of these lesions is useful. (orig.)

  11. Positive correlation of employment and psychological well-being for veterans with major abdominal surgery.

    Science.gov (United States)

    Horner, David J; Wendel, Christopher S; Skeps, Raymond; Rawl, Susan M; Grant, Marcia; Schmidt, C Max; Ko, Clifford Y; Krouse, Robert S

    2010-11-01

    Intestinal stomas (ostomies) have been associated negatively with multiple aspects of health-related quality of life. This article examines the relationship between employment status and psychological well-being (PWB) in veterans who underwent major bowel procedures with or without ostomy. Veterans from 3 Veterans Affairs (VA) medical centers were surveyed using the City of Hope ostomy-specific questionnaire and the Short Form 36 item Veteran's version (SF-36V). Response rate was 48% (511 of 1,063). Employment and PWB relationship was assessed using multiple regression with age, income, SF-36V physical component summary (PCS), and employment status as independent variables. Employed veterans reported higher PWB compared with unemployed veterans (P = .003). Full-time workers also reported higher PWB than part-time or unemployed workers (P = .001). Ostomy was not an independent predictor of PWB. Employment among veterans after major abdominal surgery may have intrinsic value for PWB. Patients should be encouraged to return to work, or do volunteer work after recovery. Published by Elsevier Inc.

  12. Intra-operative remifentanil might influence pain levels in the immediate postoperative period after major abdominal surgery

    DEFF Research Database (Denmark)

    Hansen, EG; Duedahl, Tina H; Rømsing, Janne

    2005-01-01

    Remifentanil, a widely used analgesic agent in anaesthesia, has a rapid onset and short duration of action. In clinical settings, this requires an appropriate pain strategy to prevent unacceptable pain in the post-operative period. The aim of this study was to investigate whether remifentanil had...... any impact on post-operative pain and opioid consumption after major abdominal surgery....

  13. Health-Related Quality of Life, Cachexia and Overall Survival After Major Upper Abdominal Surgery: A Prospective Cohort Study.

    Science.gov (United States)

    Aahlin, E K; Tranø, G; Johns, N; Horn, A; Søreide, J A; Fearon, K C; Revhaug, A; Lassen, K

    2017-03-01

    Major upper abdominal surgery is often associated with reduced health-related quality of life and reduced survival. Patients with upper abdominal malignancies often suffer from cachexia, represented by preoperative weight loss and sarcopenia (low skeletal muscle mass) and this might affect both health-related quality of life and survival. We aimed to investigate how health-related quality of life is affected by cachexia and how health-related quality of life relates to long-term survival after major upper abdominal surgery. From 2001 to 2006, 447 patients were included in a Norwegian multicenter randomized controlled trial in major upper abdominal surgery. In this study, six years later, these patients were analyzed as a single prospective cohort and survival data were retrieved from the National Population Registry. Cachexia was derived from patient-reported preoperative weight loss and sarcopenia as assessed from computed tomography images taken within three months preoperatively. In the original trial, self-reported health-related quality of life was assessed preoperatively at trial enrollment and eight weeks postoperatively with the health-related quality of life questionnaire Short Form 36. A majority of the patients experienced improved mental health-related quality of life and, to a lesser extent, deteriorated physical health-related quality of life following surgery. There was a significant association between preoperative weight loss and reduced physical health-related quality of life. No association between sarcopenia and health-related quality of life was observed. Overall survival was significantly associated with physical health-related quality of life both pre- and postoperatively, and with postoperative mental health-related quality of life. The association between health-related quality of life and survival was particularly strong for postoperative physical health-related quality of life. Postoperative physical health-related quality of life

  14. Predictive Value of C-Reactive Protein for Major Complications after Major Abdominal Surgery: A Systematic Review and Pooled-Analysis.

    Directory of Open Access Journals (Sweden)

    Jennifer Straatman

    Full Text Available Early diagnosis and treatment of complications after major abdominal surgery can decrease associated morbidity and mortality. Postoperative CRP levels have shown a strong correlation with complications. Aim of this systematic review and pooled-analysis was to assess postoperative values of CRP as a marker for major complications and construct a prediction model.A systematic review was performed for CRP levels as a predictor for complications after major abdominal surgery (MAS. Raw data was obtained from seven studies, including 1427 patients. A logit regression model assessed the probability of major complications as a function of CRP levels on the third postoperative day. Two practical cut-offs are proposed: an optimal cut-off for safe discharge in a fast track protocol and another for early identification of patients with increased risk for major complications.A prediction model was calculated for major complications as a function of CRP levels on the third postoperative day. Based on the model several cut-offs for CRP are proposed. For instance, a two cut-off system may be applied, consisting of a safe discharge criterion with CRP levels below 75 mg/L, with a negative predictive value of 97.2%. A second cut-off is set at 215 mg/L (probability 20% and serves as a predictor of complications, indicating additional CT-scan imaging.The present study provides insight in the interpretation of CRP levels after major abdominal surgery, proposing a prediction model for major complications as a function of CRP on postoperative day 3. Cut-offs for CRP may be implemented for safe early-discharge in a fast-track protocol and, secondly as a threshold for additional examinations, such as CT-scan imaging, even in absence of clinical signs, to confirm or exclude major complications. The prediction model allows for setting a cut-off at the discretion of individual surgeons or surgical departments.

  15. Qureshi-5 Catheter for Complex Supra- and Abdominal-Aortic Catheterization.

    Science.gov (United States)

    Qureshi, Adnan I; Xiao, WeiGang; Liu, HongLiang

    2015-10-01

    The use of previously described catheter technique was expanded to complex supra- and abdominal- aortic catheterizations. A new (Qureshi 5) catheter with curved shape at the distal end that has two lumens was used. One of lumens can accommodate a 0.035-inch guide wire and the second lumen can accommodate a 0.018-inch guide wire and terminates at the beginning of the distal curve of the first lumen. The manipulation and engagement of the curved distal end catheter was facilitated by rotation and movement of the J-shaped 0.018-inch guide wire extended coaxial and beyond the distal end of catheter. Subsequently, either contrast was injected or a 0.035-inch guide wire advanced into the target artery. The catheters were used in one patient to perform diagnostic cerebral and abdominal angiography through a 6F introducer sheath placed in the right common femoral artery. The catheterization was complex because of severe tortuosity of arch and descending aorta secondary to kyphosis. The left and right internal carotid arteries and left and right vertebral arteries, left renal artery, and superior mesenteric artery were catheterized in patient (fluoroscopy time 19:46 min). No complications were observed in the patient. The Qureshi-5 catheter was successful in complex supra- and abdominal-aortic catheterizations.

  16. Comparison of caudal ropivacaine-morphine and paravertebral catheter for major upper abdominal surgery in infants.

    Science.gov (United States)

    Sato, Makoto; Iida, Takafumi; Kikuchi, Chika; Sasakawa, Tomoki; Kunisawa, Takayuki

    2017-05-01

    The caudal epidural block is one of the most commonly used regional anesthetic techniques in children. Administration of morphine via caudal injection enables analgesia, even for upper abdominal surgery. The thoracic paravertebral block has also been successfully used to treat perioperative pain during upper abdominal procedures in pediatric patients. In the current study, we compared the two regional techniques for upper abdominal surgery in infants to determine whether one of them was preferable to the other. Consecutive patients under 12 months of age who underwent upper abdominal surgery were retrospectively divided according to the chosen postoperative analgesia: Group C, caudal ropivacaine-morphine; Group P, paravertebral catheter. We analyzed the following outcomes: requirement for additional analgesics, pain scores, need for mechanical ventilation and oxygen dosage, postoperative blood pressure and heart rate, time to pass first stool, time until first full meal, and complications. Twenty-one consecutive patients were included: 10 in Group C and 11 in Group P. Median age at surgery was 80 (47.5-270.0) and 84.5 (34.3-287.5) days, respectively. No difference was found between the two groups in requirement for additional analgesics at 24 h after surgery (median 1 in Group C vs 1 in Group P, P = 0.288, 95% CI: -2 to 1). BOPS pain scores were only lower in Group P when compared to Group C at 24 h after surgery (median 1 vs 2, P = 0.041, 95% CI: -2 to 0). None of the patients had perioperative complications. In this small series, there was no significant difference between caudal ropivacaine-morphine and paravertebral catheter for postoperative care in infants undergoing upper abdominal surgery. Further prospective studies are needed to compare the efficacy and incidence of complications of caudal block and paravertebral catheter for postoperative analgesia. © 2017 John Wiley & Sons Ltd.

  17. Reliability of trans-abdominal ultrasonography in determining exact location of placenta in patients of placenta previa major

    International Nuclear Information System (INIS)

    Zafar, M.; Hayat, N; Gul, U.

    2017-01-01

    Objective: To determine the reliability of trans-abdominal ultrasonographical localization of placenta in cases of placenta previa major, by taking peroperative finding as gold standard. Study Design: Validation study. Place and Duration of Study: Maternity ward, Obstetrics and Gynecology department, Military Hospital Rawalpindi from 2007 to 2008. Patients and Methods: A total of 100 patients fulfilling the inclusion and exclusion criteria were recruited for the study. These patients were admitted to the maternity ward, where trans-abdominal ultrasound was performed, site of the placenta and its relation to the internal os was documented. These patients under went elective cesarean section, during which the site and relation of the placenta to the internal os was confirmed. Results: The mean age of patients was 34.23 +- 6.76 years. Transabdominal ultrasound had a sensitivity of 93.4 percent in localizing major placenta previa while the specificity was 83 percent. Positive predictive value was 94.7 percent, negative predictive value was 80 percent and accuracy 91 percent. Conclusion: Trans-abdominal ultrasound was found highly effective in diagnosing and localizing placenta previa. (author)

  18. Outcome of intraoperative goal-directed therapy using Vigileo/FloTrac in high-risk patients scheduled for major abdominal surgeries: A prospective randomized trial

    Directory of Open Access Journals (Sweden)

    Mohammed A. Elgendy

    2017-07-01

    Conclusion: The applied protocol for intraoperative GDT provided significant reduction of PO morbidities, ICU and hospital LOS but couldn‘t significantly reduce mortality rates in high risk patients scheduled for major abdominal surgeries.

  19. Robotic Transversus Abdominis Release (TAR: is it possible to offer minimally invasive surgery for abdominal wall complex defects?

    Directory of Open Access Journals (Sweden)

    MARIA VITÓRIA FRANÇA DO AMARAL

    Full Text Available ABSTRACT We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes. Two patients required laparoscopic re-intervention, since one developed hernia by peritoneal migration of the mesh and one had mesh extrusion. The procedure proved to be technically feasible, with a still long surgical time. Considering the potential advantages of robotic surgery and those related to TAR and the results obtained when these two techniques are associated, we conclude that they seem to be a good option for the correction of complex abdominal wall defects.

  20. The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report

    Directory of Open Access Journals (Sweden)

    Kassiani Theodoraki

    2014-01-01

    Full Text Available Blood transfusion is associated with well-known risks. We investigated the difference between a restrictive versus a liberal transfusion strategy on the immune response, as expressed by the production of inflammatory mediators, in patients subjected to major abdominal surgery procedures. Fifty-eight patients undergoing major abdominal surgery were randomized preoperatively to either a restrictive transfusion protocol or a liberal transfusion protocol (with transfusion if hemoglobin dropped below 7.7 g dL−1 or 9.9 g dL−1, respectively. In a subgroup of 20 patients randomly selected from the original allocation groups, blood was sampled for measurement of IL-6, IL-10, and TNFα. Postoperative levels of IL-10 were higher in the liberal transfusion group on the first postoperative day (49.82±29.07 vs. 15.83±13.22 pg mL−1, P<0.05. Peak postoperative IL-10 levels correlated with the units of blood transfused as well as the mean duration of storage and the storage time of the oldest unit transfused (r2=0.38, P=0.032, r2=0.52, P=0.007, and r2=0.68, P<0.001, respectively. IL-10 levels were elevated in patients with a more liberal red blood cell transfusion strategy. The strength of the association between anti-inflammatory IL-10 and transfusion variables indicates that IL-10 may be an important factor in transfusion-associated immunomodulation. This trial is registered under ClinicalTrials.gov Identifier: NCT02020525.

  1. Diagnostic value of C-reactive protein to rule out infectious complications after major abdominal surgery: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Gans, Sarah L.; Atema, Jasper J.; van Dieren, Susan; Groot Koerkamp, Bas; Boermeester, Marja A.

    2015-01-01

    Infectious complications occur frequently after major abdominal surgery and have a major influence on patient outcome and hospital costs. A marker that can rule out postoperative infectious complications (PICs) could aid patient selection for safe and early hospital discharge. C-reactive protein

  2. Subxiphoid complex uniportal video-assisted major pulmonary resections.

    Science.gov (United States)

    Gonzalez-Rivas, Diego; Lirio, Francisco; Sesma, Julio; Abu Akar, Firas

    2017-01-01

    In recent years, the search for a less invasive and thus, less painful approach has driven technical innovation in modern thoracic surgery. In this context, subxiphoid uniportal approach has emerged as an alternative to avoid intercostal space manipulation and decrease postoperative pain and intercostal nerve chronic impairment. Subxiphoid uniportal major lung resections have been safe and effective procedures when performed by experienced surgeons even in complex cases or unexpected intraoperative situations. We present six of these surgical scenarios such as big tumors, incomplete or absent fissures, hilar calcified lymph nodes, active bleeding and massive adhesions to show the feasibility of subxiphoid approach to manage even these conditions.

  3. Hazards of nuclear reactors and other major industrial complexes

    International Nuclear Information System (INIS)

    Farmer, F.R.

    1982-01-01

    Some of the problems of quantified risk analysis of the hazards of nuclear reactors and other major industrial complexes are raised particularly as seen by the proponents and opponents of atomic energy. These are exemplified by discussing the chemical accidents at Flixborough and Canvey Island and the Light Water Reactor Studies. The role of risk analysis in improving knowledge of the systems studies, improving methods of analysis, identifying weaknesses in systems and in improving engineering/maintenance/operation is also stressed. (U.K.)

  4. The cardiac cycle is a major contributor to variability in size measurements of abdominal aortic aneurysms by ultrasound

    DEFF Research Database (Denmark)

    Grøndal, Nikolaj Fibiger; Bramsen, Morten; Thomsen, Marie Dahl

    2012-01-01

    The objective of the study was to evaluate the impact of the cardiac cycle on ultrasound measurements of abdominal aortic aneurysm (AAA) diameters.......The objective of the study was to evaluate the impact of the cardiac cycle on ultrasound measurements of abdominal aortic aneurysm (AAA) diameters....

  5. Association of Major Dietary Patterns with General and Abdominal Obesity in Iranian Patients with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Ghane Basiri, Marjan; Sotoudeh, Gity; Djalali, Mahmood; Reza Eshraghian, Mohammad; Noorshahi, Neda; Rafiee, Masoumeh; Nikbazm, Ronak; Karimi, Zeinab; Koohdani, Fariba

    2015-01-01

    The aim of this study was to identify dietary patterns associated with general and abdominal obesity in type 2 diabetic patients. We included 728 patients (35 - 65 years) with type 2 diabetes mellitus in this cross-sectional study. The usual dietary intake of individuals over 1 year was collected using a validated semi-quantitative food frequency questionnaire. Weight, height, and waist circumference were measured according to standard protocol. The two major dietary patterns identified by factor analysis were healthy and unhealthy dietary patterns. After adjustment for potential confounders, subjects in the highest quintile of the healthy dietary pattern scores had a lower odds ratio for the general obesity when compared to the lowest quintile (OR = 0.45, 95 % CI = 0.26 - 0.79, P for trend = 0.02), while patients in the highest quintile of the unhealthy dietary pattern scores had greater odds for the general obesity (OR = 3.2, 95 % CI = 1.8 - 5.9, P for trend diabetes mellitus, a healthy dietary pattern is inversely associated and an unhealthy dietary pattern is directly associated with general obesity.

  6. Postoperative analgesia with intramuscular morphine at fixed rate versus epidural morphine or sufentanil and bupivacaine in patients undergoing major abdominal surgery

    NARCIS (Netherlands)

    Broekema, AA; Veen, A; Fidler, [No Value; Gielen, MJM; Hennis, PJ

    1998-01-01

    We assessed the efficacy and side effects of postoperative analgesia with three different pain regimens in 90 patients undergoing major abdominal surgery. The patients were randomly assigned to one of three groups: epidural morphine (EM) or sufentanil (ES), both combined with bupivacaine, or IM

  7. Olfactory fingerprints for major histocompatibility complex-determined body odors.

    Science.gov (United States)

    Schaefer, M L; Young, D A; Restrepo, D

    2001-04-01

    Recognition of individual body odors is analogous to human face recognition in that it provides information about identity. Individual body odors determined by differences at the major histocompatibility complex (MHC or H-2) have been shown to influence mate choice, pregnancy block, and maternal behavior in mice. Unfortunately, the mechanism and extent of the main olfactory bulb (MOB) and accessory olfactory bulb (AOB) involvement in the discrimination of animals according to H-2-type has remained ambiguous. Here we study the neuronal activation patterns evoked in the MOB in different individuals on exposure to these complex, biologically meaningful sensory stimuli. We demonstrate that body odors from H-2 disparate mice evoke overlapping but distinct maps of neuronal activation in the MOB. The spatial patterns of odor-evoked activity are sufficient to be used like fingerprints to predict H-2 identity using a novel computer algorithm. These results provide functional evidence for discrimination of H-2-determined body odors in the MOB, but do not preclude a role for the AOB. These data further our understanding of the neural strategies used to decode socially relevant odors.

  8. Genetic Divergence of the Rhesus Macaque Major Histocompatibility Complex

    Science.gov (United States)

    Daza-Vamenta, Riza; Glusman, Gustavo; Rowen, Lee; Guthrie, Brandon; Geraghty, Daniel E.

    2004-01-01

    The major histocompatibility complex (MHC) is comprised of the class I, class II, and class III regions, including the MHC class I and class II genes that play a primary role in the immune response and serve as an important model in studies of primate evolution. Although nonhuman primates contribute significantly to comparative human studies, relatively little is known about the genetic diversity and genomics underlying nonhuman primate immunity. To address this issue, we sequenced a complete rhesus macaque MHC spanning over 5.3 Mb, and obtained an additional 2.3 Mb from a second haplotype, including class II and portions of class I and class III. A major expansion of from six class I genes in humans to as many as 22 active MHC class I genes in rhesus and levels of sequence divergence some 10-fold higher than a similar human comparison were found, averaging from 2% to 6% throughout extended portions of class I and class II. These data pose new interpretations of the evolutionary constraints operating between MHC diversity and T-cell selection by contrasting with models predicting an optimal number of antigen presenting genes. For the clinical model, these data and derivative genetic tools can be implemented in ongoing genetic and disease studies that involve the rhesus macaque. PMID:15289473

  9. Molecular Genotype Identification of Different Chickens: Major Histocompatibility Complex

    Directory of Open Access Journals (Sweden)

    Hongzhi Wang

    2014-09-01

    Full Text Available Chicken is a main poultry in China. Molecular breeding for disease resistance plays an important role in the control of diseases, especially infectious diseases. Choice of genes for disease resistance is the key technology of molecular breeding. The major histocompatibility complex (MHC is of great interest to poultry breeding scientists for its extraordinary polymorphism and close relation with traits of resistance against infectious diseases. The MHC-B haplotype plays an important role in the study of disease resistance in chicken. The traditional chicken MHC-B haplotype is commonly defined by serologic reactions of erythrocytes and the majority of studies have been conducted in Leghorn and broiler but study about other chicken breeds is little. In this study, firstly, the microsatellite marker LEI0258 which is located within the MHC was sequenced by using target sequence capture assay in different chicken breeds, and then according to the number of repeated structures and polymorphic sequences in microsatellite, sequence information for the region defined by LEI0258 was obtained for different haplotypes. Afterwards, we identified the relation between MHC-B haplotypes and disease resistance. Collectively, these observed results provided the reference data for disease-resistant breeding association with blood type and for further study of MHC gene function in poultry.

  10. Value of a step-up diagnosis plan: CRP and CT-scan to diagnose and manage postoperative complications after major abdominal surgery

    Directory of Open Access Journals (Sweden)

    Jennifer Straatman

    2014-12-01

    Full Text Available Postoperative complications frequently follow major abdominal surgery and are associated with increased morbidity and mortality. Early diagnosis and treatment of complications is associated with improved patient outcome. In this study we assessed the value of a step-up diagnosis plan by C-reactive protein and CT-scan (computed tomography-scan imaging for detection of postoperative complications following major abdominal surgery. An observational cohort study was conducted of 399 consecutive patients undergoing major abdominal surgery between January 2009 and January 2011. Indication for operation, type of surgery, postoperative morbidity, complications according to the Clavien-Dindo classification and mortality were recorded. Clinical parameters were recorded until 14 days postoperatively or until discharge. Regular C-reactive protein (CPR measurements in peripheral blood and on indication -enhanced CT-scans were performed. Eighty-three out of 399 (20.6 % patients developed a major complication in the postoperative course after a median of seven days (IQR 4-9 days. One hundred and thirty two patients received additional examination consisting of enhanced CT-scan imaging, and treatment by surgical reintervention or intensive care observation. CRP levels were significantly higher in patients with postoperative complications. On the second postoperative day CRP levels were on average 197.4 mg/L in the uncomplicated group, 220.9 mg/L in patients with a minor complication and 280.1 mg/L in patients with major complications (p < 0,001. CT-scan imaging showed a sensitivity of 91.7 % and specificity of 100 % in diagnosis of major complications. Based on clinical deterioration and the increase of CRP, an additional enhanced CT-scan offered clear discrimination between patients with major abdominal complications and uncomplicated patients. Adequate treatment could then be accomplished.

  11. Health outcomes in US children with abdominal pain at major emergency departments associated with race and socioeconomic status.

    Science.gov (United States)

    Wang, Louise; Haberland, Corinna; Thurm, Cary; Bhattacharya, Jay; Park, K T

    2015-01-01

    Over 9.6 million ED visits occur annually for abdominal pain in the US, but little is known about the medical outcomes of these patients based on demographics. We aimed to identify disparities in outcomes among children presenting to the ED with abdominal pain linked to race and SES. Data from 4.2 million pediatric encounters of abdominal pain were analyzed from 43 tertiary US children's hospitals, including 2.0 million encounters in the emergency department during 2004-2011. Abdominal pain was categorized as functional or organic abdominal pain. Appendicitis (with and without perforation) was used as a surrogate for abdominal pain requiring emergent care. Multivariate analysis estimated likelihood of hospitalizations, radiologic imaging, ICU admissions, appendicitis, appendicitis with perforation, and time to surgery and hospital discharge. Black and low income children had increased odds of perforated appendicitis (aOR, 1.42, 95% CI, 1.32- 1.53; aOR, 1.20, 95% CI 1.14 - 1.25). Blacks had increased odds of an ICU admission (aOR, 1.92, 95% CI 1.53 - 2.42) and longer lengths of stay (aHR, 0.91, 95% CI 0.86 - 0.96) than Whites. Minorities and low income also had lower rates of imaging for their appendicitis, including CT scans. The combined effect of race and income on perforated appendicitis, hospitalization, and time to surgery was greater than either separately. Based on race and SES, disparity of health outcomes exists in the acute ED setting among children presenting with abdominal pain, with differences in appendicitis with perforation, length of stay, and time until surgery.

  12. Olfactory cues associated with the major histocompatibility complex.

    Science.gov (United States)

    Eggert, F; Müller-Ruchholtz, W; Ferstl, R

    Besides its immunological function of self/non-self discrimination the major histocompatibility complex (MHC) has been recognized as a possible source of individual specific body odors. Dating back to speculations on the role of the extraordinary polymorphism of the MHC as background of an individual chemosensory identity and to early observations of MHC-dependent mate choice in inbred strains of mice, systematic experimental studies revealed a first evidence for H-2 related body odors in this species. Meanwhile a large number of animal studies with rodents and a series of field studies and experiments with humans have extended our knowledge of MHC-related odor signals and substantiated the hypothesis of immunogenetic associated odor types. These results suggest that the most prominent feature of the MHC, its extraordinary genetic diversity, seems in part to be selectively maintained by behavioral mechanisms which operate in contemporary natural populations. The high degree of heterozygosity found in natural populations of most species seems to be promoted by non-disease-based selection such as mating preferences and selective block of pregnancy.

  13. Anesthesia for major abdominal surgery in patients in poor physical condition. The combination of surface anesthesia with bilateral intercostal nerve block

    OpenAIRE

    Safar, Peter

    2014-01-01

    An anesthetic technique for major abdominal surgery is described, which consists of liqht general anesthesia, combined with bilateral intercostal nerveblock from T6 to T11 blocks are performed just behind the midaxillary line on the unconscious patient. This technique proved to be particulary valuable for patients in very poor conditions, with is in agreement with previous experiences of other authors. The technique is easy to leam, and when some proficiency is acquired, the patient can be re...

  14. Diagnostic value of C-reactive protein to rule out infectious complications after major abdominal surgery: a systematic review and meta-analysis.

    Science.gov (United States)

    Gans, Sarah L; Atema, Jasper J; van Dieren, Susan; Groot Koerkamp, Bas; Boermeester, Marja A

    2015-07-01

    Infectious complications occur frequently after major abdominal surgery and have a major influence on patient outcome and hospital costs. A marker that can rule out postoperative infectious complications (PICs) could aid patient selection for safe and early hospital discharge. C-reactive protein (CRP) is a widely available, fast, and cheap marker that might be of value in detecting PIC. Present meta-analysis evaluates the diagnostic value of CRP to rule out PIC following major abdominal surgery, aiding patient selection for early discharge. A systematic literature search of Medline, PubMed, and Cochrane was performed identifying all prospective studies evaluating the diagnostic value of CRP after abdominal surgery. Meta-analysis was performed according to the PRISMA statement. Twenty-two studies were included for qualitative analysis of which 16 studies were eligible for meta-analysis, representing 2215 patients. Most studies analyzed the value of CRP in colorectal surgery (eight studies). The pooled negative predictive value (NPV) improved each day after surgery up to 90% at postoperative day (POD) 3 for a pooled CRP cutoff of 159 mg/L (range 92-200). Maximum predictive values for PICs were reached on POD 5 for a pooled CRP cutoff of 114 mg/L (range 48-150): a pooled sensitivity of 86% (95% confidence interval (CI) 79-91%), specificity of 86% (95% CI 75-92%), and a positive predictive value of 64% (95% CI 49-77%). The pooled sensitivity and specificity were significantly higher on POD 5 than on other PODs (p < 0.001). Infectious complications after major abdominal surgery are very unlikely in patients with a CRP below 159 mg/L on POD 3. This can aid patient selection for safe and early hospital discharge and prevent overuse of imaging.

  15. Improving Project Management of Complex or Major Systems

    Science.gov (United States)

    2016-05-05

    Major Automated Information Systems (MAIS) 3 1 Joint Program; Army-Led 2 Joint Program; USMC Led 3 Over 90% expended; non-reporting 4 Limited...funding available through vehicle Mod-lines --- shared across various motor transport programs PB-17 $M (including OCO) Program ACAT FYDP (FY17

  16. 454 sequencing reveals extreme complexity of the class II Major Histocompatibility Complex in the collared flycatcher

    Directory of Open Access Journals (Sweden)

    Gustafsson Lars

    2010-12-01

    Full Text Available Abstract Background Because of their functional significance, the Major Histocompatibility Complex (MHC class I and II genes have been the subject of continuous interest in the fields of ecology, evolution and conservation. In some vertebrate groups MHC consists of multiple loci with similar alleles; therefore, the multiple loci must be genotyped simultaneously. In such complex systems, understanding of the evolutionary patterns and their causes has been limited due to challenges posed by genotyping. Results Here we used 454 amplicon sequencing to characterize MHC class IIB exon 2 variation in the collared flycatcher, an important organism in evolutionary and immuno-ecological studies. On the basis of over 152,000 sequencing reads we identified 194 putative alleles in 237 individuals. We found an extreme complexity of the MHC class IIB in the collared flycatchers, with our estimates pointing to the presence of at least nine expressed loci and a large, though difficult to estimate precisely, number of pseudogene loci. Many similar alleles occurred in the pseudogenes indicating either a series of recent duplications or extensive concerted evolution. The expressed alleles showed unambiguous signals of historical selection and the occurrence of apparent interlocus exchange of alleles. Placing the collared flycatcher's MHC sequences in the context of passerine diversity revealed transspecific MHC class II evolution within the Muscicapidae family. Conclusions 454 amplicon sequencing is an effective tool for advancing our understanding of the MHC class II structure and evolutionary patterns in Passeriformes. We found a highly dynamic pattern of evolution of MHC class IIB genes with strong signals of selection and pronounced sequence divergence in expressed genes, in contrast to the apparent sequence homogenization in pseudogenes. We show that next generation sequencing offers a universal, affordable method for the characterization and, in perspective

  17. Childhood abdominal cystic lymphangioma

    Energy Technology Data Exchange (ETDEWEB)

    Konen, Osnat; Rathaus, Valeria; Shapiro, Myra [Department of Diagnostic Imaging, Meir General Hospital, Sapir Medical Centre, Kfar Saba (Israel); Dlugy, Elena [Department of Paediatric Surgery, Schneider Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Freud, Enrique [Department of Paediatric Surgery, Sapir Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Kessler, Ada [Department of Diagnostic Imaging, Sourasky Medical Centre, Tel-Aviv (Israel); Horev, Gadi [Department of Diagnostic Imaging, Schneider Medical Centre, Tel-Aviv (Israel)

    2002-02-01

    Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two

  18. Childhood abdominal cystic lymphangioma

    International Nuclear Information System (INIS)

    Konen, Osnat; Rathaus, Valeria; Shapiro, Myra; Dlugy, Elena; Freud, Enrique; Kessler, Ada; Horev, Gadi

    2002-01-01

    Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two. Conclusions: US

  19. Signal transduction by the major histocompatibility complex class I molecule

    DEFF Research Database (Denmark)

    Pedersen, A E; Skov, Svend; Bregenholt, S

    1999-01-01

    Ligation of cell surface major histocompatibility class I (MHC-I) proteins by antibodies, or by their native counter receptor, the CD8 molecule, mediates transduction of signals into the cells. MHC-I-mediated signaling can lead to both increased and decreased activity of the MHC-I-expressing cell...... and functioning, MHC-I molecules might be of importance for the maintenance of cellular homeostasis not only within the immune system, but also in the interplay between the immune system and other organ systems....

  20. Dynamics of major histocompatibility complex class I association with the human peptide-loading complex.

    Science.gov (United States)

    Panter, Michaela S; Jain, Ankur; Leonhardt, Ralf M; Ha, Taekjip; Cresswell, Peter

    2012-09-07

    Although the human peptide-loading complex (PLC) is required for optimal major histocompatibility complex class I (MHC I) antigen presentation, its composition is still incompletely understood. The ratio of the transporter associated with antigen processing (TAP) and MHC I to tapasin, which is responsible for MHC I recruitment and peptide binding optimization, is particularly critical for modeling of the PLC. Here, we characterized the stoichiometry of the human PLC using both biophysical and biochemical approaches. By means of single-molecule pulldown (SiMPull), we determined a TAP/tapasin ratio of 1:2, consistent with previous studies of insect-cell microsomes, rat-human chimeric cells, and HeLa cells expressing truncated TAP subunits. We also report that the tapasin/MHC I ratio varies, with the PLC population comprising both 2:1 and 2:2 complexes, based on mutational and co-precipitation studies. The MHC I-saturated PLC may be particularly prevalent among peptide-selective alleles, such as HLA-C4. Additionally, MHC I association with the PLC increases when its peptide supply is reduced by inhibiting the proteasome or by blocking TAP-mediated peptide transport using viral inhibitors. Taken together, our results indicate that the composition of the human PLC varies under normal conditions and dynamically adapts to alterations in peptide supply that may arise during viral infection. These findings improve our understanding of the quality control of MHC I peptide loading and may aid the structural and functional modeling of the human PLC.

  1. Myocardial injury after surgery is a risk factor for weaning failure from mechanical ventilation in critical patients undergoing major abdominal surgery.

    Directory of Open Access Journals (Sweden)

    Shu Li

    Full Text Available Myocardial injury after noncardiac surgery (MINS is a newly proposed concept that is common among adults undergoing noncardiac surgery and associated with substantial mortality. We analyzed whether MINS was a risk factor for weaning failure in critical patients who underwent major abdominal surgery.This retrospective study was conducted in the Department of Critical Care Medicine of Peking University People's Hospital. The subjects were all critically ill patients who underwent major abdominal surgery between January 2011 and December 2013. Clinical and laboratory parameters during the perioperative period were investigated. Backward stepwise regression analysis was performed to evaluate MINS relative to the rate of weaning failure. Age, hypertension, chronic renal disease, left ventricular ejection fraction before surgery, Acute Physiologic and Chronic Health Evaluation II score, pleural effusion, pneumonia, acute kidney injury, duration of mechanical ventilation before weaning and the level of albumin after surgery were treated as independent variables.This study included 381 patients, of whom 274 were successfully weaned. MINS was observed in 42.0% of the patients. The MINS incidence was significantly higher in patients who failed to be weaned compared to patients who were successfully weaned (56.1% versus 36.5%; P<0.001. Independent predictive factors of weaning failure were MINS, age, lower left ventricular ejection fraction before surgery and lower serum albumin level after surgery. The MINS odds ratio was 4.098 (95% confidence interval, 1.07 to 15.6; P = 0.04. The patients who were successfully weaned had shorter hospital stay lengths and a higher survival rate than those who failed to be weaned.MINS is a risk factor for weaning failure from mechanical ventilation in critical patients who have undergone major abdominal surgery, independent of age, lower left ventricular ejection fraction before surgery and lower serum albumin levels after

  2. Major intrinsic proteins (MIPs) in plants: a complex gene family with major impacts on plant phenotype.

    Science.gov (United States)

    Forrest, Kerrie L; Bhave, Mrinal

    2007-10-01

    The ubiquitous cell membrane proteins called aquaporins are now firmly established as channel proteins that control the specific transport of water molecules across cell membranes in all living organisms. The aquaporins are thus likely to be of fundamental significance to all facets of plant growth and development affected by plant-water relations. A majority of plant aquaporins have been found to share essential structural features with the human aquaporin and exhibit water-transporting ability in various functional assays, and some have been shown experimentally to be of critical importance to plant survival. Furthermore, substantial evidence is now available from a number of plant species that shows differential gene expression of aquaporins in response to abiotic stresses such as salinity, drought, or cold and clearly establishes the aquaporins as major players in the response of plants to conditions that affect water availability. This review summarizes the function and regulation of these genes to develop a greater understanding of the response of plants to water insufficiency, and particularly, to identify tolerant genotypes of major crop species including wheat and rice and plants that are important in agroforestry.

  3. A multi-step method with signal quality assessment and fine-tuning procedure to locate maternal and fetal QRS complexes from abdominal ECG recordings

    International Nuclear Information System (INIS)

    Liu, Chengyu; Li, Peng; Zhao, Lina; Di Maria, Costanzo; Zhang, Henggui; Chen, Zhiqing

    2014-01-01

    Non-invasive monitoring of fetal electrocardiogram (fECG) plays an important role in detecting and diagnosing fetal diseases. This study aimed to develop a multi-step method for locating both maternal and fetal QRS complexes from abdominal ECG (aECG) recordings. The proposed method included four major steps: abdominal ECG pre-processing, maternal QRS complex locating, maternal ECG cancellation and fetal QRS complex locating. Signal quality assessment (SQA) and fine-tuning for maternal ECG (FTM) were implemented in the first and third steps, respectively. The method was then evaluated using 75 non-invasive 4-channel aECG recordings provided by the PhysioNet/Computing in Cardiology Challenge 2013. The F 1 measure, which is a new index introduced by Behar et al (2013 Proc. Comput. Cardiol. 40 297–300), was used to assess the locating accuracy. The other two indices, mean squared error of heart rate (MSE H R) between the fetal HR signals estimated from the reference and our method (MSE H R in bpm 2 ) and root mean squared difference between the corresponding fetal RR intervals (MSE R R in ms) were also used to assess the locating accuracy. Overall, for the maternal QRS complex, the F 1 measure was 98.4% from the method without the implementation of SQA, and it was improved to 99.8% with SQA. For the fetal QRS complex, the F 1 measure, MSE H R and MSE R R were 84.9%, 185.6 bpm 2 and 19.4 ms for the method without both SQA and FTM procedures. They were improved to 93.9%, 47.5 bpm 2 and 7.6 ms with both SQA and FTM procedures. These improvements were observed from each individual subject. It can be concluded that implementing both SQA and FTM procedures could achieve better performance for locating both maternal and fetal QRS complexes. (paper)

  4. Tuberculosis abdominal Abdominal tuberculosis

    OpenAIRE

    T. Rubio; M. T. Gaztelu; A. Calvo; M. Repiso; H. Sarasíbar; F. Jiménez Bermejo; A. Martínez Echeverría

    2005-01-01

    La tuberculosis abdominal cursa con un cuadro inespecífico, con difícil diagnóstico diferencial respecto a otras entidades de similar semiología. Presentamos el caso de un varón que ingresa por presentar dolor abdominal, pérdida progresiva y notoria de peso corporal y fiebre de dos meses de evolución. El cultivo de la biopsia de colon mostró presencia de bacilo de Koch.Abdominal tuberculosis develops according to a non-specific clinical picture, with a difficult differential diagnosis with re...

  5. Influence of non-dietary factors on the prevalence of abdominal obesity as a major component of the metabolic syndrome among 17-18-year-old youth.

    Science.gov (United States)

    Piotrowska, Ewa; Broniecka, Anna; Biernat, Jadwiga; Wyka, Joanna; Bronkowska, Monika

    2015-01-01

    Youth nutrition and their nutritional status are conditioned by many factors, some of the main ones being: economic, social, climatic, cultural, and psychological factors as well as nutritional knowledge. With the growing problem of overweight and obesity among children and young people, the incidence of the metabolic syndrome is also increasing. The aim of the study was to assess the impact of demographic, sociological and psychological factors on the incidence of obesity among 17-18-year-old adolescents from Wroclaw and vicinity as a major risk factor for the development of the metabolic syndrome. The study was conducted in three upper-secondary schools in Wroclaw, Poland. In the surveyed group (17-18 years old, n = 269) girls accounted for 59.5% and boys constituted 40.5%. Majority of young people were Wroclaw citizens (72.9%). Centile charts elaborated by the Children's Memorial Health Institute were adopted for the evaluation of anthropometric parameters. Evaluation of the impact of non-dietary factors on the manner of nutrition was carried out using own questionnaire. Based on the tests, abdominal obesity was determined among 34.5% of adolescents aged 17 years and among 65.5% of these aged 18 years. Obesity was more common in girls carrying genetic burden of the disease. Youth with the largest waist circumference most often declared to use slimming diets - 6.7%, and the lowest hunger sensation in stress - 3.4%. In addition, 30.5% of the adolescents with the smallest waist circumference and 11.5% with the largest waist circumference declared to be non-smoking. Occasional alcohol consumption was declared by 30.1% of young people with the smallest waist circumference, and 13.4% with the largest waist circumference. Youth with abdominal obesity significantly more likely than those with normal waist circumference applied slimming diets. Significant impact on the formation of abdominal obesity among girls had inherited disease burden.

  6. Abdominal emergencies

    International Nuclear Information System (INIS)

    Raissaki, M.

    2012-01-01

    children and young individuals with abdominal pain. Sensitivity and specificity for US in diagnosing intussusception, midgut volvulus, urinary tract abnormalities and appendicitis is over 90%. US, occasionally with x-rays, usually suffice for an accurate diagnosis. Upper GI contrast studies are indicated in suspected malrotation, volvulus and atypical high obstruction cases. Lower GI contrast studies are indicated in low/colonic obstruction. CT and/or MRI should be reserved for atypical, complex cases when US and conventional radiography are equivocal or inconclusive. The radiologist should engage oneself to act immediately, consider and actively exclude those diagnoses that could be a threat to the child's health or life. The appropriate modality should be chosen and proper technique should be applied. Radiologists should function as clinicians, take initiative and discuss options and alternative diagnoses. Lack of experience should not delay performance of tests. Our job is finished when a diagnostic test has a written report provided that we make sure the child is managed properly.

  7. The impact of a massive transfusion protocol (1:1:1) on major hepatic injuries: does it increase abdominal wall closure rates?

    Science.gov (United States)

    Ball, Chad G; Dente, Christopher J; Shaz, Beth; Wyrzykowski, Amy D; Nicholas, Jeffrey M; Kirkpatrick, Andrew W; Feliciano, David V

    2013-10-01

    Massive transfusion protocols (MTPs) using high plasma and platelet ratios for exsanguinating trauma patients are increasingly popular. Major liver injuries often require massive resuscitations and immediate hemorrhage control. Current published literature describes outcomes among patients with mixed patterns of injury. We sought to identify the effects of an MTP on patients with major liver trauma. Patients with grade 3, 4 or 5 liver injuries who required a massive blood component transfusion were analyzed. We compared patients with high plasma:red blood cell:platelet ratio (1:1:1) transfusions (2007-2009) with patients injured before the creation of an institutional MTP (2005-2007). Among 60 patients with major hepatic injuries, 35 (58%) underwent resuscitation after the implementation of an MTP. Patient and injury characteristics were similar between cohorts. Implementation of the MTP significantly improved plasma: red blood cell:platelet ratios and decreased crystalloid fluid resuscitation (p = 0.026). Rapid improvement in early acidosis and coagulopathy was superior with an MTP (p = 0.009). More patients in the MTP group also underwent primary abdominal fascial closure during their hospital stay (p = 0.021). This was most evident with grade 4 injuries (89% vs. 14%). The mean time to fascial closure was 4.2 days. The overall survival rate for all major liver injuries was not affected by an MTP (p = 0.61). The implementation of a formal MTP using high plasma and platelet ratios resulted in a substantial increase in abdominal wall approximation. This occurred concurrently to a decrease in the delivered volume of crystalloid fluid.

  8. Outcomes of fenestrated and branched endovascular repair of complex abdominal and thoracoabdominal aortic aneurysms.

    Science.gov (United States)

    Schanzer, Andres; Simons, Jessica P; Flahive, Julie; Durgin, Jonathan; Aiello, Francesco A; Doucet, Danielle; Steppacher, Robert; Messina, Louis M

    2017-09-01

    More than 80% of infrarenal aortic aneurysms are treated by endovascular repair. However, adoption of fenestrated and branched endovascular repair for complex aortic aneurysms has been limited, despite high morbidity and mortality associated with open repair. There are few published reports of consecutive outcomes, inclusive of all fenestrated and branched endovascular repairs, starting from the inception of a complex aortic aneurysm program. Therefore, we examined a single center's consecutive experience of fenestrated and branched endovascular repair of complex aortic aneurysms. This is a single-center, prospective, observational cohort study evaluating 30-day and 1-year outcomes in all consecutive patients who underwent fenestrated and branched endovascular repair of complex aortic aneurysms (definition: requiring one or more fenestrations or branches). Data were collected prospectively through an Institutional Review Board-approved registry and a physician-sponsored investigational device exemption clinical trial (G130210). We performed 100 consecutive complex endovascular aortic aneurysm repairs (November 2010 to March 2016) using 58 (58%) commercially manufactured custom-made devices and 42 (42%) physician-modified devices to treat 4 (4%) common iliac, 42 (42%) juxtarenal, 18 (18%) pararenal, and 36 (36%) thoracoabdominal aneurysms (type I, n = 1; type II, n = 4; type III, n = 12; type IV, n = 18; arch, n = 1). The repairs included 309 fenestrations, branches, and scallops (average of 3.1 branch arteries/case). All patients had 30-day follow-up for 30-day event rates: three (3%) deaths; six (6%) target artery occlusions; five (5%) progressions to dialysis; eight (8%) access complications; one (1%) paraparesis; one (1%) bowel ischemia; and no instances of myocardial infarction, paralysis, or stroke. Of 10 type I or type III endoleaks, 8 resolved (7 with secondary intervention, 1 without intervention). Mean follow-up time was 563 days (interquartile range

  9. Ringer's lactate, but not hydroxyethyl starch, prolongs the food intolerance time after major abdominal surgery; an open-labelled clinical trial.

    Science.gov (United States)

    Li, Yuhong; He, Rui; Ying, Xiaojiang; Hahn, Robert G

    2015-05-06

    The infusion of large amounts of Ringer's lactate prolongs the functional gastrointestinal recovery time and increases the number of complications after open abdominal surgery. We performed an open-labelled clinical trial to determine whether hydroxyethyl starch or Ringer's lactate exerts these adverse effects when the surgery is performed by laparoscopy. Eighty-eight patients scheduled for major abdominal cancer surgery (83% by laparoscopy) received a first-line fluid treatment with 9 ml/kg of either 6% hydroxyethyl starch 130/0.4 (Voluven) or Ringer's lactate, just after induction of anaesthesia; this was followed by a second-line infusion with 12 ml/kg of either starch or Ringer's lactate over 1 hour. Further therapy was managed at the discretion of the attending anaesthetist. Outcome data consisted of postoperative gastrointestinal recovery time, complications and length of hospital stay. The order of the infusions had no impact on the outcome. Both the administration of ≥ 2 L of Ringer's lactate and the development of a surgical complication were associated with a longer time period of paralytic ileus and food intolerance (two-way ANOVA, P food intolerance time amounted to 2 days each. The infusion of ≥ 1 L of hydroxyethyl starch did not adversely affect gastrointestinal recovery. Ringer's lactate, but not hydroxyethyl starch, prolonged the gastrointestinal recovery time in patients undergoing laparoscopic cancer surgery. Surgical complications prolonged the hospital stay.

  10. Differential analgesic effects of low-dose epidural morphine and morphine-bupivacaine at rest and during mobilization after major abdominal surgery

    DEFF Research Database (Denmark)

    Dahl, J B; Rosenberg, J; Hansen, B L

    1992-01-01

    In a double-blind, randomized study, epidural infusions of low-dose morphine (0.2 mg/h) combined with low-dose bupivacaine (10 mg/h) were compared with epidural infusions of low-dose morphine (0.2 mg/h) alone for postoperative analgesia at rest and during mobilization and cough in 24 patients after...... elective major abdominal surgery. All patients in addition received systemic piroxicam (20 mg daily). No significant differences were observed between the groups at any assessment of pain at rest (P greater than 0.05), whereas pain in the morphine/bupivacaine group was significantly reduced during...... mobilization from the supine into the sitting position 12 and 30 h after surgical incision and during cough 8, 12, and 30 h after surgical incision (P less than 0.05). We conclude, that low-dose epidural bupivacaine potentiates postoperative low-dose epidural morphine analgesia during mobilization and cough...

  11. Differential changes in free and total insulin-like growth factor I after major, elective abdominal surgery

    DEFF Research Database (Denmark)

    Skjærbæk, Christian; Frystyk, Jan; Ørskov, Hans

    1998-01-01

    Major surgery is accompanied by extensive proteolysis of insulin-like growth factor (IGF)-binding protein-3 (IGFBP-3). Proteolysis of IGFBP-3 is generally believed to increase IGF bioavailability due to a diminished affinity of the IGFBP-3 fragments for IGFs. We have investigated 18 patients...... undergoing elective ileo-anal J-pouch surgery. Patients were randomized to treatment with GH (12 IU/day; n = 9) or placebo (n = 9) from 2 days before to 7 days after operation. Free IGF-I and IGF-II were measured by ultrafiltration of serum, and IGFBP-3 proteolytic activity was determined by a [125I...

  12. Long-term safety of left renal vein division and ligation to expedite complex abdominal aortic surgery.

    Science.gov (United States)

    Samson, Russell H; Lepore, Michael R; Showalter, David P; Nair, Deepak G; Lanoue, Julien B

    2009-09-01

    Left renal vein division and ligation (LRVDAL) is performed to facilitate complex abdominal aortic surgery. Surgeons restore continuity of the vein due to concern that ligation could cause renal compromise or hematuria. However, we report the short and long-term safety of left renal vein division and ligation. Between 1992 and 2007, we divided the left renal vein in 56 patients (40 males, 16 females) ages 57 to 84 (average 74-years-old) who were treated for aortic occlusive disease (9) or abdominal aortic aneurysm (47). Patients requiring concomitant renal artery reconstruction were excluded from this review. Suprarenal cross-clamp was used in 51 patients with temporary vessel-loop control of the renal arteries. Creatinine (Cr) and glomerular filtration rates (eGFR) were measured pre-, post-, and long-term after surgery. Outpatient records of all patients that had survived more than 12 months were also reviewed in order to evaluate the late effects on renal function or symptoms possibly related to LRVDAL. Median procedure duration was 157 (61-375) minutes. Median cross-clamp time was 16 (10-45) minutes. Median intensive care unit (ICU) and hospital length of stays were 2 (1-11) days and 7 (4-58) days, respectively. There were no deaths. There were no complications directly related to renal vein ligation. Hematuria, seen in 2 patients, was a result of traumatic insertion of a Foley catheter. Median pre-op and discharge Cr levels were 1.1 mg/dL (0.7-2.4 mg/dL) and 1.1 mg/dL (0.6-2.1 mg/dL), respectively (P 2.0 mg/dL remained unchanged post-op. Only 2 patients with a Cr of 2.0 mg/dL and both returned to normal by day 3 post-op. Thirty-six patients have been followed for more than a year (median 34.5 months, maximum 144 months) and Cr has remained stable in all but 2 patients. These 2 patients, both with a pre-op Cr of 1.5 mg/dL, subsequently developed Cr levels of 2.1 mg/dL and 2.4 mg/dL but maintained baseline Cr levels for 25 and 34 months, respectively, before

  13. Cognitive complexity of the medical record is a risk factor for major adverse events.

    Science.gov (United States)

    Roberson, David; Connell, Michael; Dillis, Shay; Gauvreau, Kimberlee; Gore, Rebecca; Heagerty, Elaina; Jenkins, Kathy; Ma, Lin; Maurer, Amy; Stephenson, Jessica; Schwartz, Margot

    2014-01-01

    Patients in tertiary care hospitals are more complex than in the past, but the implications of this are poorly understood as "patient complexity" has been difficult to quantify. We developed a tool, the Complexity Ruler, to quantify the amount of data (as bits) in the patient’s medical record. We designated the amount of data in the medical record as the cognitive complexity of the medical record (CCMR). We hypothesized that CCMR is a useful surrogate for true patient complexity and that higher CCMR correlates with risk of major adverse events. The Complexity Ruler was validated by comparing the measured CCMR with physician rankings of patient complexity on specific inpatient services. It was tested in a case-control model of all patients with major adverse events at a tertiary care pediatric hospital from 2005 to 2006. The main outcome measure was an externally reported major adverse event. We measured CCMR for 24 hours before the event, and we estimated lifetime CCMR. Above empirically derived cutoffs, 24-hour and lifetime CCMR were risk factors for major adverse events (odds ratios, 5.3 and 6.5, respectively). In a multivariate analysis, CCMR alone was essentially as predictive of risk as a model that started with 30-plus clinical factors. CCMR correlates with physician assessment of complexity and risk of adverse events. We hypothesize that increased CCMR increases the risk of physician cognitive overload. An automated version of the Complexity Ruler could allow identification of at-risk patients in real time.

  14. The value of true-FISP sequence added to conventional gadolinium-enhanced MRA of abdominal aorta and its major branches

    Energy Technology Data Exchange (ETDEWEB)

    Iozzelli, Andrea [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: andrea.iozzelli@poste.it; D' Orta, Giovanni [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: ammos@tiscali.it; Aliprandi, Alberto [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: a.aliprandi@grupposandonato.it; Secchi, Francesco [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: francisecchi@virgilio.it; Di Leo, Giovanni [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: gianni.dileo77@virgilio.it; Sardanelli, Francesco [University of Milan School of Medicine, Department of Medical and Surgical Sciences, Radiology Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Milan (Italy)], E-mail: f.sardanelli@grupposandonato.it

    2009-12-15

    To test true-fast imaging with steady-state precession (true-FISP) added to gadolinium-based MR angiography (Gd-MRA) for imaging abdominal aorta and major abdominal vessels, 35 consecutive patients (age 67 {+-} 11 years) with known or suspected abdominal and/or peripheral vascular disease were studied with sagittal and axial 2D true-FISP during free breathing and coronal 3D fast low-angle shot (FLASH) Gd-MRA (breath-holding, 0.2 mmol/kg of Gd-DOTA at 2 ml/s). We evaluated: suprarenal aorta, celiac trunk, superior mesenteric artery, right renal artery, left renal artery, infrarenal aorta, inferior mesenteric artery, aortic bifurcation/common iliac arteries, lumbar arteries and aortic atheromasia. The possible presence of accessory renal arteries, collateral vasculature and vascular prosthesis/stent was evaluated. A quality four-point score was assigned to each item on both sequences, from 0 (not visible) to 3 (good-to-excellent image quality) and Wilcoxon test was used. Main diagnoses resulted: normal or atheromasic aorta (n = 25); aortic aneurysm (n = 2); patent aorto-iliac surgical prosthesis (n = 2); patent vascular iliac stent (n = 2); aneurysm of iliac artery (n = 1); patent aortic endovascular prosthesis (n = 1); patent aorto-femural bypass (n = 1) and aorto-iliac surgical prosthesis endoleak (n = 1). We also found three patients with accessory renal arteries, two with collateral circulation, and three with surgical aorto-iliac prosthesis. The score of true-FISP (25.9 {+-} 4.1, median 27) was significantly higher (p = 0.003) than that of Gd-MRA (23.9 {+-} 3.6, median 24). True-FISP was superior for visualizing inferior mesenteric artery (score 2.5 {+-} 1.1 vs. 1.0 {+-} 1.4; p < 0.001) and atheromasic plaques (2.5 {+-} 1.1 vs. 1.2 {+-} 1.1; p < 0.001). One collateral vasculature was demonstrated only with Gd-MRA. Summarizing, true-FISP is a power and fast non-breath-hold sequence to be added to Gd-MRA, obtaining an information increase.

  15. Examining the evidence for major histocompatibility complex-dependent mate selection in humans and nonhuman primates

    Czech Academy of Sciences Publication Activity Database

    Winternitz, Jamie Caroline; Abbate, J. L.

    2015-01-01

    Roč. 6, 13 May (2015), s. 73-88 ISSN 1179-7274 Institutional support: RVO:68081766 Keywords : major histocompatibility complex * sexual selection * olfaction * facial attraction * parasite resistance * inbreeding avoidance Subject RIV: EB - Genetics ; Molecular Biology

  16. Unusual causes of abdominal pain: sickle cell anemia.

    Science.gov (United States)

    Ahmed, Shahid; Shahid, Rabia K; Russo, Linda A

    2005-04-01

    Sickle cell disease is characterized by chronic hemolytic anemia and vaso-occlusive painful crises. The vascular occlusion in sickle cell disease is a complex process and accounts for the majority of the clinical manifestation of the disease. Abdominal pain is an important component of vaso-occlusive painful crises. It often represents a substantial diagnostic challenge in this population of patients. These episodes are often attributed to micro-vessel occlusion and infarcts of mesentery and abdominal viscera. Abdominal pain due to sickle cell vaso-occlusive crisis is often indistinguishable from an acute intra-abdominal disease process such as acute cholecystitis, acute pancreatitis, hepatic infarction, ischemic colitis and acute appendicitis. In the majority of cases, however, no specific cause is identified and spontaneous resolution occurs. This chapter will focus on etiologies, pathophysiology and management of abdominal pain in patients with sickle cell disease.

  17. Measuring and improving the quality of postoperative epidural analgesia for major abdominal surgery using statistical process control charts.

    Science.gov (United States)

    Duncan, Fiona; Haigh, Carol

    2013-10-01

    To explore and improve the quality of continuous epidural analgesia for pain relief using Statistical Process Control tools. Measuring the quality of pain management interventions is complex. Intermittent audits do not accurately capture the results of quality improvement initiatives. The failure rate for one intervention, epidural analgesia, is approximately 30% in everyday practice, so it is an important area for improvement. Continuous measurement and analysis are required to understand the multiple factors involved in providing effective pain relief. Process control and quality improvement Routine prospectively acquired data collection started in 2006. Patients were asked about their pain and side effects of treatment. Statistical Process Control methods were applied for continuous data analysis. A multidisciplinary group worked together to identify reasons for variation in the data and instigated ideas for improvement. The key measure for improvement was a reduction in the percentage of patients with an epidural in severe pain. The baseline control charts illustrated the recorded variation in the rate of several processes and outcomes for 293 surgical patients. The mean visual analogue pain score (VNRS) was four. There was no special cause variation when data were stratified by surgeons, clinical area or patients who had experienced pain before surgery. Fifty-seven per cent of patients were hypotensive on the first day after surgery. We were able to demonstrate a significant improvement in the failure rate of epidurals as the project continued with quality improvement interventions. Statistical Process Control is a useful tool for measuring and improving the quality of pain management. The applications of Statistical Process Control methods offer the potential to learn more about the process of change and outcomes in an Acute Pain Service both locally and nationally. We have been able to develop measures for improvement and benchmarking in routine care that

  18. Plasma levels of plasmin-antiplasmin-complexes are predictive for small abdominal aortic aneurysms expanding to operation-recommendable sizes

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Jørgensen, B; Fasting, H

    2001-01-01

    Three proteolytic systems seem involved in the aneurysmal degradation of the aortic wall. Plasmin is a common activator of the systems and could thus be predictive for the progression of abdominal aortic aneurysms (AAAs).......Three proteolytic systems seem involved in the aneurysmal degradation of the aortic wall. Plasmin is a common activator of the systems and could thus be predictive for the progression of abdominal aortic aneurysms (AAAs)....

  19. Collaborative Management of Complex Major Construction Projects: AnyLogic-Based Simulation Modelling

    Directory of Open Access Journals (Sweden)

    Na Zhao

    2016-01-01

    Full Text Available Complex supply chain system collaborative management of major construction projects effectively integrates the different participants in the construction project. This paper establishes a simulation model based on AnyLogic to reveal the collaborative elements in the complex supply chain management system and the modes of action as well as the transmission problems of the intent information. Thus it is promoting the participants to become an organism with coordinated development and coevolution. This study can help improve the efficiency and management of the complex system of major construction projects.

  20. Cost-analysis of robotic-assisted laparoscopic hysterectomy versus total abdominal hysterectomy for women with endometrial cancer and atypical complex hyperplasia

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Palle, Connie; Møller, Ann M.

    2016-01-01

    INTRODUCTION: The aim of this study was to analyse the hospital cost of treatment with robotic-assisted laparoscopic hysterectomy and total abdominal hysterectomy for women with endometrial cancer or atypical complex hyperplasia and to identify differences in resource use and cost. MATERIAL...... AND METHODS: This cost analysis was based on two cohorts: women treated with robotic-assisted laparoscopic hysterectomy (n = 202) or with total abdominal hysterectomy (n = 158) at Copenhagen University Hospital, Herlev, Denmark. We conducted an activity-based cost analysis including consumables and healthcare...... professionals' salaries. As cost-drivers we included severe complications, duration of surgery, anesthesia and stay at the post-anesthetic care unit, as well as number of hospital bed-days. Ordinary least-squares regression was used to explore the cost variation. The primary outcome was cost difference...

  1. CD1 and major histocompatibility complex II molecules follow a different course during dendritic cell maturation

    NARCIS (Netherlands)

    van der Wel, Nicole N.; Sugita, Masahiko; Fluitsma, Donna M.; Cao, Xaiochun; Schreibelt, Gerty; Brenner, Michael B.; Peters, Peter J.

    2003-01-01

    The maturation of dendritic cells is accompanied by the redistribution of major histocompatibility complex (MHC) class II molecules from the lysosomal MHC class IT compartment to the plasma membrane to mediate presentation of peptide antigens. Besides MHC molecules, dendritic cells also express CD1

  2. Correlation in chicken between the marker LEI0258 alleles and Major Histocompatibility Complex sequences

    DEFF Research Database (Denmark)

    Chazara, Olympe; Juul-Madsen, Helle Risdahl; Chang, Chi-Seng

    Background The LEI0258 marker is located within the B region of the chicken Major Histocompatibility Complex (MHC), and is surprisingly well associated with serology. Therefore, the correlation between the LEI0258 alleles and the MHC class I and the class II alleles at the level of sequences is w...

  3. Pathogen burden, co-infection and major histocompatibility complex variability in the European badger (Meles meles)

    NARCIS (Netherlands)

    Sin, Yung Wa; Annavi, Geetha; Dugdale, Hannah L.; Newman, Chris; Burke, Terry; MacDonald, David W.

    2014-01-01

    Pathogen-mediated selection is thought to maintain the extreme diversity in the major histocompatibility complex (MHC) genes, operating through the heterozygote advantage, rare-allele advantage and fluctuating selection mechanisms. Heterozygote advantage (i.e. recognizing and binding a wider range

  4. Isolation and characterization of major histocompatibility complex class IIB genes from the nurse shark.

    OpenAIRE

    Bartl, S; Weissman, I L

    1994-01-01

    The major histocompatibility complex (MHC) contains a set of linked genes which encode cell surface proteins involved in the binding of small peptide antigens for their subsequent recognition by T lymphocytes. MHC proteins share structural features and the presence and location of polymorphic residues which play a role in the binding of antigens. In order to compare the structure of these molecules and gain insights into their evolution, we have isolated two MHC class IIB genes from the nurse...

  5. NetMHCcons: a consensus method for the major histocompatibility complex class I predictions

    DEFF Research Database (Denmark)

    Karosiene, Edita; Lundegaard, Claus; Lund, Ole

    2012-01-01

    A key role in cell-mediated immunity is dedicated to the major histocompatibility complex (MHC) molecules that bind peptides for presentation on the cell surface. Several in silico methods capable of predicting peptide binding to MHC class I have been developed. The accuracy of these methods depe...... at www.cbs.dtu.dk/services/NetMHCcons, and allows the user in an automatic manner to obtain the most accurate predictions for any given MHC molecule....

  6. Structural requirements and biological significance of interactions between peptides and the major histocompatibility complex

    DEFF Research Database (Denmark)

    Grey, H M; Buus, S; Colon, S

    1989-01-01

    Previous studies indicate that T cells recognize a complex between the major histocompatibility complex (MHC) restriction-element and peptide-antigen fragments. Two aspects of this complex formation are considered in this paper: (1) what is the nature of the specificity of the interactions that a...... of binding to Ia (i.e. determinant selection was operative), we found that about 40% of Ia-binding peptides were not immunogenic (i.e. there were also 'holes in the T-cell repertoire')....... responsiveness, we present data that suggest both mechanisms operate in concert with one another. Thus only about 30% of a collection of peptides that in sum represent the sequence of a protein molecule were found to bind to Ia. Although immunogenicity was restricted to those peptides that were capable...

  7. Lipofection indirectly increases expression of endogenous major histocompatibility complex class I molecules on tumor cells.

    Science.gov (United States)

    Fox, B A; Drury, M; Hu, H M; Cao, Z; Huntzicker, E G; Qie, W; Urba, W J

    1998-01-01

    Direct intratumoral injection of a lipid/DNA complex encoding an allogeneic major histocompatibility complex (MHC) class I molecule leads to regression of both an immunogenic murine tumor and also melanoma lesions in some patients. We have sought to understand the mechanism(s) for this augmentation of antitumor activity. While optimizing parameters for in vitro gene transfer into the D5 subclone of B16BL6, it was noted that lipofected tumors not only expressed the new alloantigen but also exhibited increased expression of endogenous MHC class I, both H-2 Kb and H-2 Db. This increase in expression was not restricted to the small percentage of cells that expressed the transfected gene, but appeared to affect the majority of cells in culture. Class I expression was not increased by lipopolysaccharide, DNA alone, lipid, or lipid/lipopolysaccharide mixtures. Enhanced class I expression required a DNA/lipid complex and was greatest when parameters optimized for gene transfer of the alloantigen were used. All DNA plasmids tested had this effect, including one plasmid whose DNA was not transcribed because it lacked an expression cassette. Because of the critical role that MHC class I antigens play in immune recognition, we propose that lipid complex-mediated gene transfer may provide immunological advantages beyond those that are attributable to expression of the specific gene transferred.

  8. Comparison of Intravenous Infusion of Tramadol Alone with Combination of Tramadol and Paracetamol for Postoperative Pain after Major Abdominal Surgery in Children.

    Science.gov (United States)

    Ali, Shayesta; Sofi, Khalid; Dar, Abdul Qayoom

    2017-01-01

    of tramadol in a dose of 0.25 mg/kg/h in the first 24 h after surgery, in combination with a regular per rectal paracetamol in a daily dose of 90 mg/kg/day in four divided doses for children after major abdominal surgery. However, a close nursing supervision is essential to increase the safety profile.

  9. Abdominal trauma

    International Nuclear Information System (INIS)

    Giordany, B.R.

    1985-01-01

    Abdominal injury is an important cause of morbidity and mortality in childhood. Ten percent of trauma-related deaths are due to abdominal injury. Thousands of children are involved in auto accidents annually; many suffer severe internal injury. Child abuse is a second less frequent but equally serious cause of internal abdominal injury. The descriptions of McCort and Eisenstein and their associates in the 1960s first brought to attention the frequency and severity of visceral injury as important manifestations of the child abuse syndrome. Blunt abdominal trauma often causes multiple injuries; in the past, many children have been subjected to exploratory surgery to evaluate the extent of possible hidden injury. Since the advent of noninvasive radiologic imaging techniques including radionuclide scans and ultrasound and, especially, computed tomography (CT), the radiologist has been better able to assess (accurately) the extent of abdominal injury and thus allow conservative therapy in many cases. Penetrating abdominal trauma occurs following gunshot wounds, stabbing, and other similar injury. This is fortunately, a relatively uncommon occurrence in most pediatric centers and will not be discussed specifically here, although many principles of blunt trauma diagnosis are valid for evaluation of penetrating abdominal trauma. If there is any question that a wound has extended intraperitonelly, a sinogram with water-soluble contrast material allows quick, accurate diagnosis. The presence of large amounts of free intraperitoneal gas suggests penetrating injury to the colon or other gas-containing viscus and is generally considered an indication for surgery

  10. Abdominal Pain

    Science.gov (United States)

    ... I find more information and related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). Gastro Kids , a ...

  11. Abdominal epilepsy

    International Nuclear Information System (INIS)

    Hasan, N.; Razzaq, A.

    2004-01-01

    Abdominal epilepsy (AE) is a rather uncommon clinical entity in children that might create diagnostic confusion especially when it lacks the typical manifestations of an epileptic seizure. We report the case of a young boy having apparently unexplained episodes of paroxysmal abdominal symptoms with no other suggestion of an underlying epileptic disorder. The case also explains how the clinical presentation can be misleading unless a high index of suspicion is maintained to reach the ultimate diagnosis. (author)

  12. Objective measures of renal mass anatomic complexity predict rates of major complications following partial nephrectomy.

    Science.gov (United States)

    Simhan, Jay; Smaldone, Marc C; Tsai, Kevin J; Canter, Daniel J; Li, Tianyu; Kutikov, Alexander; Viterbo, Rosalia; Chen, David Y T; Greenberg, Richard E; Uzzo, Robert G

    2011-10-01

    The association between tumor complexity and postoperative complications after partial nephrectomy (PN) has not been well characterized. We evaluated whether increasing renal tumor complexity, quantitated by nephrometry score (NS), is associated with increased complication rates following PN using the Clavien-Dindo classification system (CCS). We queried our prospectively maintained kidney cancer database for patients undergoing PN from 2007 to 2010 for whom NS was available. All patients underwent PN. Tumors were categorized into low- (NS: 4-6), moderate- (NS: 7-9), and high-complexity (NS: 10-12) lesions. Complication rates within 30 d were graded (CCS: I-5), stratified as minor (CCS: I or 2) or major (CCS: 3-5), and compared between groups. A total of 390 patients (mean age: 58.0 ± 11.9 yr; 66.9% male) undergoing PN (44.6% open, 55.4% robotic) for low- (28%), moderate- (55.6%), and high-complexity (16.4%) tumors (mean tumor size: 3.74 ± 2.4 cm; median: 3.2 cm) from 2007 to 2010 were identified. Tumor size, estimated blood loss, and ischemia time all significantly differed (prenal tumors. Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  13. Oriented coupling of major histocompatibility complex (MHC) to sensor surfaces using light assisted immobilisation technology

    DEFF Research Database (Denmark)

    Snabe, Torben; Røder, Gustav Andreas; Neves-Petersen, Maria Teresa

    2005-01-01

    Controlled and oriented immobilisation of proteins for biosensor purposes is of extreme interest since this provides more efficient sensors with a larger density of active binding sites per area compared to sensors produced by conventional immobilisation. In this paper oriented coupling of a major...... histocompatibility complex (MHC class I) to a sensor surface is presented. The coupling was performed using light assisted immobilisation--a novel immobilisation technology which allows specific opening of particular disulphide bridges in proteins which then is used for covalent bonding to thiol-derivatised surfaces...... via a new disulphide bond. Light assisted immobilisation specifically targets the disulphide bridge in the MHC-I molecule alpha(3)-domain which ensures oriented linking of the complex with the peptide binding site exposed away from the sensor surface. Structural analysis reveals that a similar...

  14. Comparison of multi-modal early oral nutrition for the tolerance of oral nutrition with conventional care after major abdominal surgery: a prospective, randomized, single-blind trial.

    Science.gov (United States)

    Sun, Da-Li; Li, Wei-Ming; Li, Shu-Min; Cen, Yun-Yun; Xu, Qing-Wen; Li, Yi-Jun; Sun, Yan-Bo; Qi, Yu-Xing; Lin, Yue-Ying; Yang, Ting; Lu, Qi-Ping; Xu, Peng-Yuan

    2017-02-10

    Early oral nutrition (EON) has been shown to improve recovery of gastrointestinal function, length of stay and mortality after abdominal surgery; however, early oral nutrition often fails during the first week after surgery. Here, a multi-modal early oral nutrition program is introduced to promote recovery of gastrointestinal function and tolerance of oral nutrition. Consecutive patients scheduled for abdominal surgery were randomized to the multimodal EON group or a group receiving conventional care. The primary endpoint was the time of first defecation. The secondary endpoints were outcomes and the cost-effectiveness ratio in treating infectious complications. The rate of infectious-free patients was regarded as the index of effectiveness. One hundred seven patients were randomly assigned to groups. Baseline characteristics were similar for both groups. In intention-to-treat analysis, the success rate of oral nutrition during the first week after surgery in the multimodal EON group was 44 (83.0%) versus 31 (57.4%) in the conventional care group (P = 0.004). Time to first defecation, time to flatus, recovery time of bowel sounds, and prolonged postoperative ileus were all less in the multimodal EON group (P oral nutrition group (P oral nutrition program was an effective way to improve tolerance of oral nutrition during the first week after surgery, decrease the length of stay and improve cost-effectiveness after abdominal surgery. Registration number: ChiCTR-TRC-14004395 . Registered 15 March 2014.

  15. Restriction fragment polymorphisms in the major histocompatibility complex of diabetic BB rats

    DEFF Research Database (Denmark)

    Kastern, W.; Dyrberg, T.; Scholler, J.

    1984-01-01

    DNA isolated from diabetic BB (BB/Hagedorn) rats was examined for restriction fragment length differences within the major histocompatibility complex (MHC) as compared with nondiabetic (W-subline) BB rats. Polymorphisms were detected using a mouse class I MHC gene as probe. Specifically, a 2-kb Bam......HI fragment was present in all the nondiabetic rats examined, but absent in the diabetic rats. Similar polymorphisms were observed with various other restriction enzymes, particularly XbaI, HindII, and SacI. There were no polymorphisms detected using either a human DR-alpha (class II antigen heavy chain...

  16. The major histocompatibility complex and perfumers' descriptions of human body odors

    OpenAIRE

    Wedekind, C.; Escher, S.; Van de Waal, M.; Frei, E.

    2007-01-01

    The MHC (major histocompatibility complex) is a group of genes that play a crucial role in immune recognition and in tolerance of tissue grafting. The MHC has also been found to influence body odors, body odor preferences, and mate choice in mice and humans. Here we test whether verbal descriptions of human body odors can be linked to the MHC. We asked 45 male students to live as odor neutral as possible for two consecutive days and to wear a T-shirt during the nights. The odors of these T-sh...

  17. Allogeneic major histocompatibility complex-mismatched equine bone marrow-derived mesenchymal stem cells are targeted for death by cytotoxic anti-major histocompatibility complex antibodies.

    Science.gov (United States)

    Berglund, A K; Schnabel, L V

    2017-07-01

    Allogeneic mesenchymal stem cells (MSCs) are a promising cell source for treating musculoskeletal injuries in horses. Controversy exists, however, over whether major histocompatibility complex (MHC)-mismatched MSCs are recognised by the recipient immune system and targeted for death by a cytotoxic antibody response. To determine if cytotoxic anti-MHC antibodies generated in vivo following MHC-mismatched MSC injections are capable of initiating complement-dependent cytotoxicity of MSCs. Experimental controlled study. Antisera previously collected at Days 0, 7, 14 and 21 post-injection from 4 horses injected with donor MHC-mismatched equine leucocyte antigen (ELA)-A2 haplotype MSCs and one control horse injected with donor MHC-matched ELA-A2 MSCs were utilised in this study. Antisera were incubated with ELA-A2 MSCs before adding complement in microcytotoxicity assays and cell death was analysed via eosin dye exclusion. ELA-A2 peripheral blood leucocytes (PBLs) were used in the assays as a positive control. Antisera from all 4 horses injected with MHC-mismatched MSCs contained antibodies that caused the death of ELA-A2 haplotype MSCs in the microcytotoxicity assays. In 2 of the 4 horses, antibodies were present as early as Day 7 post-injection. MSC death was consistently equivalent to that of ELA-A2 haplotype PBL death at all time points and antisera dilutions. Antisera from the control horse that was injected with MHC-matched MSCs did not contain cytotoxic ELA-A2 antibodies at any of the time points examined. This study examined MSC death in vitro only and utilized antisera from a small number of horses. The cytotoxic antibody response induced in recipient horses following injection with donor MHC-mismatched MSCs is capable of killing donor MSCs in vitro. These results suggest that the use of allogeneic MHC-mismatched MSCs must be cautioned against, not only for potential adverse events, but also for reduced therapeutic efficacy due to targeted MSC death. © 2016 The

  18. Cytotoxicity and Phototoxicity of Chlorophyll a/Hydroxypropyl-γ-cyclodextrin Complex on Leishmania Major Promastigotes

    Directory of Open Access Journals (Sweden)

    Azam Jafari Parizi

    2011-06-01

    Full Text Available Introduction: Cutaneous leishmaniasis (CL is a widespread disease that is epidemic in Iran, too. Photodynamic therapy (PDT is an attractive modality to treat cancer and hyper proliferative diseases based on the use of a photosensitizer in the presence of oxygen and proper wavelength of light. In consideration of lesion location, lack of systemic involvement and inefficiency of current treatments, nowadays this modality is purposed for treating Leishmaniasis. In this paper, efficacy of PDT using a natural dye (chlorophyll a on Leishmania major promastigotes is reported. Material and Methods: The experiments was done on Leishmania major parasites (MRHO/IR/75/ER in the presence of Chlorophyll a /Hydroxypropyl-γ-cyclodextrin(chl a/CD complex as a photosensitizer. At first, dye uptake by promastigotes was evaluated via fluorimetric assessments after different incubation periods. Then dye cytotoxicity was evaluated at different concentration after 24 h incubation. Finally PDT experiments were designed with two doses of light and 10 µM of photosensitizer. Considering all possible controls, the percentage of the parasite survival at 24 hours post treatment was assessed by MTS method. All experiments were repeated at least three times. Results: On the basis of the dye uptake data, 24h was considered for incubating of photosensitizer with promastigotes. IC50 of chl a/CD complex was about 42.6 µM. After parasites irradiation by light at 248 j/cm2, more than 50% of cell death was recorded that is significant in comparing with similar groups without dye, without light, and lower dose of light. In these conditions, ED50 of PDT on promastigotes is determined nearly 246 J/cm2. Discussion and Conclusion: Considering low cytotoxicity in darkness and adequate phototoxicity of chl a/CD complex in comparison with other photosensitizers such as AlPhtalocyanine chloride, it can be introduced as a promising candidate for futher use in PDT experiments on amastigotes

  19. Reconstructing an ancestral mammalian immune supercomplex from a marsupial major histocompatibility complex.

    Directory of Open Access Journals (Sweden)

    Katherine Belov

    2006-03-01

    Full Text Available The first sequenced marsupial genome promises to reveal unparalleled insights into mammalian evolution. We have used the Monodelphis domestica (gray short-tailed opossum sequence to construct the first map of a marsupial major histocompatibility complex (MHC. The MHC is the most gene-dense region of the mammalian genome and is critical to immunity and reproductive success. The marsupial MHC bridges the phylogenetic gap between the complex MHC of eutherian mammals and the minimal essential MHC of birds. Here we show that the opossum MHC is gene dense and complex, as in humans, but shares more organizational features with non-mammals. The Class I genes have amplified within the Class II region, resulting in a unique Class I/II region. We present a model of the organization of the MHC in ancestral mammals and its elaboration during mammalian evolution. The opossum genome, together with other extant genomes, reveals the existence of an ancestral "immune supercomplex" that contained genes of both types of natural killer receptors together with antigen processing genes and MHC genes.

  20. A plant virus movement protein forms ringlike complexes with the major nucleolar protein, fibrillarin, in vitro.

    Science.gov (United States)

    Canetta, Elisabetta; Kim, Sang Hyon; Kalinina, Natalia O; Shaw, Jane; Adya, Ashok K; Gillespie, Trudi; Brown, John W S; Taliansky, Michael

    2008-02-29

    Fibrillarin, one of the major proteins of the nucleolus, has methyltransferase activity directing 2'-O-ribose methylation of rRNA and snRNAs and is required for rRNA processing. The ability of the plant umbravirus, groundnut rosette virus, to move long distances through the phloem, the specialized plant vascular system, has been shown to strictly depend on the interaction of one of its proteins, the ORF3 protein (protein encoded by open reading frame 3), with fibrillarin. This interaction is essential for several stages in the groundnut rosette virus life cycle such as nucleolar import of the ORF3 protein via Cajal bodies, relocalization of some fibrillarin from the nucleolus to cytoplasm, and assembly of cytoplasmic umbraviral ribonucleoprotein particles that are themselves required for the long-distance spread of the virus and systemic infection. Here, using atomic force microscopy, we determine the architecture of these complexes as single-layered ringlike structures with a diameter of 18-22 nm and a height of 2.0+/-0.4 nm, which consist of several (n=6-8) distinct protein granules. We also estimate the molar ratio of fibrillarin to ORF3 protein in the complexes as approximately 1:1. Based on these data, we propose a model of the structural organization of fibrillarin-ORF3 protein complexes and discuss potential mechanistic and functional implications that may also apply to other viruses.

  1. Latissimus dorsi free flap reconstruction of major abdominal defect in treatment of giant Marjolin’s ulcer: a short report focused on preoperative imaging

    International Nuclear Information System (INIS)

    Steffensen, Signe Muus; Thomassen, Anders; Jensen, Jesper Poul Naested; Soerensen, Jens Ahm

    2014-01-01

    We present a case of a 56-year-old man with a giant carcinoma in the abdominal wall. Based on positron emission tomography/computed tomography (PET/CT) scan there were FDG-avid lymph nodes in the ipsilateral axillary and groin, suspicious for metastases. At contrast-enhanced CT the parietal peritoneum seemed free of tumor invasion, which was essential to radical surgery planning. The tumor was completely removed with clear margins of resection and no metastasis in the resected lymph nodes. The PET/CT scan was repeated after 4 months, showing no signs of recurrence

  2. Abdominal Sepsis.

    Science.gov (United States)

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy.

  3. A recombinant antibody with the antigen-specific, major histocompatibility complex-restricted specificity of T cells

    DEFF Research Database (Denmark)

    Andersen, P S; Stryhn, A; Hansen, B E

    1996-01-01

    Specific recognition of peptide/major histocompatibility complex (MHC) molecule complexes by the T-cell receptor is a key reaction in the specific immune response. Antibodies against peptide/MHC complexes would therefore be valuable tools in studying MHC function and T-cell recognition and might ...

  4. A prospective, randomised, controlled, double-blind phase I-II clinical trial on the safety of A-Part® Gel as adhesion prophylaxis after major abdominal surgery versus non-treated group

    Directory of Open Access Journals (Sweden)

    Weis Christine

    2010-07-01

    Full Text Available Abstract Background Postoperative adhesions occur when fibrous strands of internal scar tissue bind anatomical structures to one another. The most common cause of intra-abdominal adhesions is previous intra-abdominal surgical intervention. Up to 74% of intestinal obstructions are caused by post surgical adhesions. Although a variety of methods and agents have been investigated to prevent post surgical adhesions, the problem of peritoneal adhesions remains largely unsolved. Materials serving as an adhesion barrier are much needed. Methods/Design This is a prospective, randomised, controlled, patient blinded and observer blinded, single centre phase I-II trial, which evaluates the safety of A-Part® Gel as an adhesion prophylaxis after major abdominal wall surgery, in comparison to an untreated control group. 60 patients undergoing an elective median laparotomy without prior abdominal surgery are randomly allocated into two groups of a 1:1- ratio. Safety parameter and primary endpoint of the study is the occurrence of wound healing impairment or peritonitis within 28 (+10 days after surgery. The frequency of anastomotic leakage within 28 days after operation, occurrence of adverse and serious adverse events during hospital stay up to 3 months and the rate of adhesions along the scar within 3 months are defined as secondary endpoints. After hospital discharge the investigator will examine the enrolled patients at 28 (+10 days and 3 months (±14 days after surgery. Discussion This trial aims to assess, whether the intra-peritoneal application of A-Part® Gel is safe and efficacious in the prevention of post-surgical adhesions after median laparotomy, in comparison to untreated controls. Trial registration NCT00646412

  5. Polarisation of Major Histocompatibility Complex II Host Genotype with Pathogenesis of European Brown Hare Syndrome Virus

    DEFF Research Database (Denmark)

    Iacovakis, Christos; Mamuris, Zissis; Moutou, Katerina A

    2013-01-01

    A study was conducted in order to determine the occurrence of European Brown Hare Syndrome virus (EBHSV) in Denmark and possible relation between disease pathogenesis and Major Histocompatibility Complex (MHC) host genotype. Liver samples were examined from 170 brown hares (hunted, found sick...... were found to be EBHSV-positive (RT-PCR, VP60 gene). In order to investigate associations between viral pathogenesis and host genotype, variation within the exon 2 DQA gene of MHC was assessed. DQA exon 2 analysis revealed the occurrence of seven different alleles in Denmark. Consistent with other...... populations examined so far in Europe, observed heterozygosity of DQA (H o = 0.1180) was lower than expected (H e = 0.5835). The overall variation for both nucleotide and amino acid differences (2.9% and 14.9%, respectively) were lower in Denmark than those assessed in other European countries (8.3% and 16...

  6. Isolation and characterization of major histocompatibility complex class II B genes in cranes.

    Science.gov (United States)

    Kohyama, Tetsuo I; Akiyama, Takuya; Nishida, Chizuko; Takami, Kazutoshi; Onuma, Manabu; Momose, Kunikazu; Masuda, Ryuichi

    2015-11-01

    In this study, we isolated and characterized the major histocompatibility complex (MHC) class II B genes in cranes. Genomic sequences spanning exons 1 to 4 were amplified and determined in 13 crane species and three other species closely related to cranes. In all, 55 unique sequences were identified, and at least two polymorphic MHC class II B loci were found in most species. An analysis of sequence polymorphisms showed the signature of positive selection and recombination. A phylogenetic reconstruction based on exon 2 sequences indicated that trans-species polymorphism has persisted for at least 10 million years, whereas phylogenetic analyses of the sequences flanking exon 2 revealed a pattern of concerted evolution. These results suggest that both balancing selection and recombination play important roles in the crane MHC evolution.

  7. Porcine major histocompatibility complex (MHC) class I molecules and analysis of their peptide-binding specificities

    DEFF Research Database (Denmark)

    Pedersen, Lasse Eggers; Harndahl, Mikkel; Rasmussen, Michael

    2011-01-01

    a HLA-I molecule (HLA-A*11:01), thereby generating recombinant human/swine chimeric MHC-I molecules as well as the intact SLA-1*0401 molecule. Biochemical peptide-binding assays and positional scanning combinatorial peptide libraries were used to analyze the peptide-binding motifs of these molecules....... A pan-specific predictor of peptide–MHC-I binding, NetMHCpan, which was originally developed to cover the binding specificities of all known HLA-I molecules, was successfully used to predict the specificities of the SLA-1*0401 molecule as well as the porcine/human chimeric MHC-I molecules. These data......In all vertebrate animals, CD8+ cytotoxic T lymphocytes (CTLs) are controlled by major histocompatibility complex class I (MHC-I) molecules. These are highly polymorphic peptide receptors selecting and presenting endogenously derived epitopes to circulating CTLs. The polymorphism of the MHC...

  8. Multiple major histocompatibility complex class I genes in Asian anurans: Ontogeny and phylogeny.

    Science.gov (United States)

    Didinger, Chelsea; Eimes, John A; Lillie, Mette; Waldman, Bruce

    2017-05-01

    Amphibians, as the first terrestrial vertebrates, offer a window into early major histocompatibility complex (MHC) evolution. We characterized the MHC class I of two Korean amphibians, the Asiatic toad (Bufo gargarizans) and the Japanese tree frog (Hyla japonica). We found at least four transcribed MHC class I (MHC I) loci, the highest number confirmed in any anuran to date. Furthermore, we identified MHC I transcripts in terrestrial adults, and possibly in aquatic larvae, of both species. We conducted a phylogenetic analysis based on MHC I sequence data and found that B. gargarizans and H. japonica cluster together in the superfamily Nobleobatrachia. We further identified three supertypes shared by the two species. Our results reveal substantial variation in the number of MHC I loci in anurans and suggest that certain supertypes have particular physiochemical properties that may confer pathogen resistance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Characterisation of major histocompatibility complex class I transcripts in an Australian dragon lizard.

    Science.gov (United States)

    Hacking, Jessica; Bertozzi, Terry; Moussalli, Adnan; Bradford, Tessa; Gardner, Michael

    2018-07-01

    Characterisation of squamate major histocompatibility complex (MHC) genes has lagged behind other taxonomic groups. MHC genes encode cell-surface glycoproteins that present self- and pathogen-derived peptides to T cells and play a critical role in pathogen recognition. Here we characterise MHC class I transcripts for an agamid lizard (Ctenophorus decresii) and investigate the evolution of MHC class I in Iguanian lizards. An iterative assembly strategy was used to identify six full-length C. decresii MHC class I transcripts, which were validated as likely to encode classical class I MHC molecules. Evidence for exon shuffling recombination was uncovered for C. decresii transcripts and Bayesian phylogenetic analysis of Iguanian MHC class I sequences revealed a pattern expected under a birth-and-death mode of evolution. This work provides a stepping stone towards further research on the agamid MHC class I region. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. The Major Histocompatibility Complex and Perfumers' Descriptions of Human Body Odors

    Directory of Open Access Journals (Sweden)

    Claus Wedekind

    2007-04-01

    Full Text Available The MHC (major histocompatibility complex is a group of genes that play a crucial role in immune recognition and in tolerance of tissue grafting. The MHC has also been found to influence body odors, body odor preferences, and mate choice in mice and humans. Here we test whether verbal descriptions of human body odors can be linked to the MHC. We asked 45 male students to live as odor neutral as possible for two consecutive days and to wear a T-shirt during the nights. The odors of these T-shirts were then described by five evaluators: two professional perfumers and three laymen. One of the perfumers was able to describe the T-shirt odors in such a way that some of the allelic specificity of the MHC was significantly revealed (after Bonferroni correction for multiple testing. This shows that, although difficult, some people are able to describe MHC-correlated body odor components.

  11. Expression of major histocompatibility complex class II and costimulatory molecules in oral carcinomas in vitro.

    Science.gov (United States)

    Villarroel-Dorrego, Mariana; Speight, Paul M; Barrett, A William

    2005-01-01

    Recognition in the 1980 s that keratinocytes can express class II molecules of the Major Histocompatibility Complex (MHC) first raised the possibility that these cells might have an immunological function, and may even act as antigen presenting cells (APC). For effective T lymphocyte activation, APC require, in addition to MHC II, appropriate costimulatory signals. The aim of this study was to determine the expression of MHC class II and the co-stimulatory molecules CD40, CD80 and CD86 in keratinocytes derived from healthy oral mucosa and oral carcinomas. Using flow cytometry, it was confirmed that oral keratinocytes, switch on, expression of MHC class II molecules after stimulation with IFNgamma in vitro. All keratinocyte lines expressed CD40 constitutively; by contrast, CD80 and CD86 were universally absent. Loss of CD80 and CD86 may be one means whereby tumours escape immunological surveillance.

  12. Characterisation of four major histocompatibility complex class II genes of the koala (Phascolarctos cinereus).

    Science.gov (United States)

    Lau, Quintin; Jobbins, Sarah E; Belov, Katherine; Higgins, Damien P

    2013-01-01

    Major histocompatibility complex (MHC) class II molecules have an integral role in the adaptive immune response, as they bind and present antigenic peptides to T helper lymphocytes. In this study of koalas, species-specific primers were designed to amplify exon 2 of the MHC class II DA and DB genes, which contain much of the peptide-binding regions of the α and β chains. A total of two DA α1 domain variants and eight DA β1 (DAB), three DB α1 and five DB β1 variants were amplified from 20 koalas from two free-living populations from South East Queensland and the Port Macquarie region in northern New South Wales. We detected greater variation in the β1 than in the α1 domains as well as evidence of positive selection in DAB. The present study provides a springboard to future investigation of the role of MHC in disease susceptibility in koalas.

  13. High-Resolution Patterns of Meiotic Recombination across the Human Major Histocompatibility Complex

    Science.gov (United States)

    Cullen, Michael; Perfetto, Stephen P.; Klitz, William; Nelson, George; Carrington, Mary

    2002-01-01

    Definitive characteristics of meiotic recombination events over large (i.e., >1 Mb) segments of the human genome remain obscure, yet they are essential for establishing the haplotypic structure of the genome and for efficient mapping of complex traits. We present a high-resolution map of recombination at the kilobase level across a 3.3-Mb interval encompassing the major histocompatibility complex (MHC). Genotyping of 20,031 single sperm from 12 individuals resulted in the identification and fine mapping of 325 recombinant chromosomes within genomic intervals as small as 7 kb. Several principal characteristics of recombination in this region were observed: (1) rates of recombination can differ significantly between individuals; (2) intense hot spots of recombination occur at least every 0.8 Mb but are not necessarily evenly spaced; (3) distribution in the location of recombination events can differ significantly among individuals; (4) between hot spots, low levels of recombination occur fairly evenly across 100-kb segments, suggesting the presence of warm spots of recombination; and (5) specific sequence motifs associate significantly with recombination distribution. These data provide a plausible model for recombination patterns of the human genome overall. PMID:12297984

  14. DNA variation of the mammalian major histocompatibility complex reflects genomic diversity and population history

    International Nuclear Information System (INIS)

    Yuhki, Naoya; O'Brien, S.J.

    1990-01-01

    The major histocompatibility complex (MHC) is a multigene complex of tightly linked homologous genes that encode cell surface antigens that play a key role in immune regulation and response to foreign antigens. In most species, MHC gene products display extreme antigenic polymorphism, and their variability has been interpreted to reflect an adaptive strategy for accommodating rapidly evolving infectious agents that periodically afflict natural populations. Determination of the extent of MHC variation has been limited to populations in which skin grafting is feasible or for which serological reagents have been developed. The authors present here a quantitative analysis of restriction fragment length polymorphism of MHC class I genes in several mammalian species (cats, rodents, humans) known to have very different levels of genetic diversity based on functional MHC assays and on allozyme surveys. When homologous class I probes were employed, a notable concordance was observed between the extent of MHC restriction fragment variation and functional MHC variation detected by skin grafts or genome-wide diversity estimated by allozyme screens. These results confirm the genetically depauperate character of the African cheetah, Acinonyx jubatus, and the Asiatic lion, Panthera leo persica; further, they support the use of class I MHC molecular reagents in estimating the extent and character of genetic diversity in natural populations

  15. Increased Treatment Complexity for Major Depressive Disorder for Inpatients With Comorbid Personality Disorder.

    Science.gov (United States)

    Wiegand, Hauke F; Godemann, Frank

    2017-05-01

    The study examined inpatient treatment for major depressive disorder (MDD) when it is complicated by comorbid personality disorder. In this descriptive analysis of a large data sample from 2013 (German VIPP data set) of 58,913 cases from 75 hospitals, three groups were compared: patients with MDD, patients with MDD and a comorbid personality disorder, and patients with a main diagnosis of personality disorder. Compared with MDD patients, those with comorbid personality disorder had higher rates of recurrent depression and nearly twice as many readmissions within one year, despite longer mean length of stay. Records of patients with comorbidities more often indicated accounting codes for "complex diagnostic procedures," "crisis intervention," and "constant observation." Patients with comorbid disorders differed from patients with a main diagnosis of personality disorder in treatment indicator characteristics and distribution of personality disorder diagnoses. Personality disorder comorbidity made MDD treatment more complex, and recurrence of MDD episodes and hospital readmission occurred more often than if patients had a sole MDD diagnosis.

  16. DNA variation of the mammalian major histocompatibility complex reflects genomic diversity and population history

    Energy Technology Data Exchange (ETDEWEB)

    Yuhki, Naoya; O' Brien, S.J. (National Cancer Institute, Frederick, MD (USA))

    1990-01-01

    The major histocompatibility complex (MHC) is a multigene complex of tightly linked homologous genes that encode cell surface antigens that play a key role in immune regulation and response to foreign antigens. In most species, MHC gene products display extreme antigenic polymorphism, and their variability has been interpreted to reflect an adaptive strategy for accommodating rapidly evolving infectious agents that periodically afflict natural populations. Determination of the extent of MHC variation has been limited to populations in which skin grafting is feasible or for which serological reagents have been developed. The authors present here a quantitative analysis of restriction fragment length polymorphism of MHC class I genes in several mammalian species (cats, rodents, humans) known to have very different levels of genetic diversity based on functional MHC assays and on allozyme surveys. When homologous class I probes were employed, a notable concordance was observed between the extent of MHC restriction fragment variation and functional MHC variation detected by skin grafts or genome-wide diversity estimated by allozyme screens. These results confirm the genetically depauperate character of the African cheetah, Acinonyx jubatus, and the Asiatic lion, Panthera leo persica; further, they support the use of class I MHC molecular reagents in estimating the extent and character of genetic diversity in natural populations.

  17. Gene duplication and fragmentation in the zebra finch major histocompatibility complex.

    Science.gov (United States)

    Balakrishnan, Christopher N; Ekblom, Robert; Völker, Martin; Westerdahl, Helena; Godinez, Ricardo; Kotkiewicz, Holly; Burt, David W; Graves, Tina; Griffin, Darren K; Warren, Wesley C; Edwards, Scott V

    2010-04-01

    Due to its high polymorphism and importance for disease resistance, the major histocompatibility complex (MHC) has been an important focus of many vertebrate genome projects. Avian MHC organization is of particular interest because the chicken Gallus gallus, the avian species with the best characterized MHC, possesses a highly streamlined minimal essential MHC, which is linked to resistance against specific pathogens. It remains unclear the extent to which this organization describes the situation in other birds and whether it represents a derived or ancestral condition. The sequencing of the zebra finch Taeniopygia guttata genome, in combination with targeted bacterial artificial chromosome (BAC) sequencing, has allowed us to characterize an MHC from a highly divergent and diverse avian lineage, the passerines. The zebra finch MHC exhibits a complex structure and history involving gene duplication and fragmentation. The zebra finch MHC includes multiple Class I and Class II genes, some of which appear to be pseudogenes, and spans a much more extensive genomic region than the chicken MHC, as evidenced by the presence of MHC genes on each of seven BACs spanning 739 kb. Cytogenetic (FISH) evidence and the genome assembly itself place core MHC genes on as many as four chromosomes with TAP and Class I genes mapping to different chromosomes. MHC Class II regions are further characterized by high endogenous retroviral content. Lastly, we find strong evidence of selection acting on sites within passerine MHC Class I and Class II genes. The zebra finch MHC differs markedly from that of the chicken, the only other bird species with a complete genome sequence. The apparent lack of synteny between TAP and the expressed MHC Class I locus is in fact reminiscent of a pattern seen in some mammalian lineages and may represent convergent evolution. Our analyses of the zebra finch MHC suggest a complex history involving chromosomal fission, gene duplication and translocation in the

  18. Genes of the major histocompatibility complex highlight interactions of the innate and adaptive immune system

    Directory of Open Access Journals (Sweden)

    Barbara Lukasch

    2017-08-01

    Full Text Available Background A well-functioning immune defence is crucial for fitness, but our knowledge about the immune system and its complex interactions is still limited. Major histocompatibility complex (MHC molecules are involved in T-cell mediated adaptive immune responses, but MHC is also highly upregulated during the initial innate immune response. The aim of our study was therefore to determine to what extent the highly polymorphic MHC is involved in interactions of the innate and adaptive immune defence and if specific functional MHC alleles (FA or heterozygosity at the MHC are more important. Methods To do this we used captive house sparrows (Passer domesticus to survey MHC diversity and immune function controlling for several environmental factors. MHC class I alleles were identified using parallel amplicon sequencing and to mirror immune function, several immunological tests that correspond to the innate and adaptive immunity were conducted. Results Our results reveal that MHC was linked to all immune tests, highlighting its importance for the immune defence. While all innate responses were associated with one single FA, adaptive responses (cell-mediated and humoral were associated with several different alleles. Discussion We found that repeated injections of an antibody in nestlings and adults were linked to different FA and hence might affect different areas of the immune system. Also, individuals with a higher number of different FA produced a smaller secondary response, indicating a disadvantage of having numerous MHC alleles. These results demonstrate the complexity of the immune system in relation to the MHC and lay the foundation for other studies to further investigate this topic.

  19. Genes of the major histocompatibility complex highlight interactions of the innate and adaptive immune system.

    Science.gov (United States)

    Lukasch, Barbara; Westerdahl, Helena; Strandh, Maria; Winkler, Hans; Moodley, Yoshan; Knauer, Felix; Hoi, Herbert

    2017-01-01

    A well-functioning immune defence is crucial for fitness, but our knowledge about the immune system and its complex interactions is still limited. Major histocompatibility complex (MHC) molecules are involved in T-cell mediated adaptive immune responses, but MHC is also highly upregulated during the initial innate immune response. The aim of our study was therefore to determine to what extent the highly polymorphic MHC is involved in interactions of the innate and adaptive immune defence and if specific functional MHC alleles (FA) or heterozygosity at the MHC are more important. To do this we used captive house sparrows ( Passer domesticus ) to survey MHC diversity and immune function controlling for several environmental factors. MHC class I alleles were identified using parallel amplicon sequencing and to mirror immune function, several immunological tests that correspond to the innate and adaptive immunity were conducted. Our results reveal that MHC was linked to all immune tests, highlighting its importance for the immune defence. While all innate responses were associated with one single FA, adaptive responses (cell-mediated and humoral) were associated with several different alleles. We found that repeated injections of an antibody in nestlings and adults were linked to different FA and hence might affect different areas of the immune system. Also, individuals with a higher number of different FA produced a smaller secondary response, indicating a disadvantage of having numerous MHC alleles. These results demonstrate the complexity of the immune system in relation to the MHC and lay the foundation for other studies to further investigate this topic.

  20. Detection of autoreactive CD4 T cells using major histocompatibility complex class II dextramers

    Directory of Open Access Journals (Sweden)

    Kuszynski Charles

    2011-07-01

    Full Text Available Abstract Background Tetramers are useful tools to enumerate the frequencies of antigen-specific T cells. However, unlike CD8 T cells, CD4 T cells - especially self-reactive cells - are challenging to detect with major histocompatibility complex (MHC class II tetramers because of low frequencies and low affinities of their T cell receptors to MHC-peptide complexes. Here, we report the use of fluorescent multimers, designated MHC dextramers that contain a large number of peptide-MHC complexes per reagent. Results The utility of MHC dextramers was evaluated in three autoimmune disease models: 1 proteolipid protein (PLP 139-151-induced experimental autoimmune encephalomyelitis in SJL/J (H-2s mice; 2 myelin oligodendrocyte glycoprotein (MOG 35-55-induced experimental autoimmune encephalomyelitis in C57Bl/6 (H-2b mice; and 3 cardiac myosin heavy chain (Myhc-α 334-352-induced experimental autoimmune myocarditis in A/J (H-2a mice. Flow cytometrically, we demonstrate that IAs/PLP 139-151, IAb/MOG 35-55 and IAk/Myhc-α 334-352 dextramers detect the antigen-sensitized cells with specificity, and with a detection sensitivity significantly higher than that achieved with conventional tetramers. Furthermore, we show that binding of dextramers, but not tetramers, is less dependent on the activation status of cells, permitting enumeration of antigen-specific cells ex vivo. Conclusions The data suggest that MHC dextramers are useful tools to track the generation and functionalities of self-reactive CD4 cells in various experimental systems.

  1. The evolution of the dystroglycan complex, a major mediator of muscle integrity

    Directory of Open Access Journals (Sweden)

    Josephine C. Adams

    2015-09-01

    Full Text Available Basement membrane (BM extracellular matrices are crucial for the coordination of different tissue layers. A matrix adhesion receptor that is important for BM function and stability in many mammalian tissues is the dystroglycan (DG complex. This comprises the non-covalently-associated extracellular α-DG, that interacts with laminin in the BM, and the transmembrane β-DG, that interacts principally with dystrophin to connect to the actin cytoskeleton. Mutations in dystrophin, DG, or several enzymes that glycosylate α-DG underlie severe forms of human muscular dystrophy. Nonwithstanding the pathophysiological importance of the DG complex and its fundamental interest as a non-integrin system of cell-ECM adhesion, the evolution of DG and its interacting proteins is not understood. We analysed the phylogenetic distribution of DG, its proximal binding partners and key processing enzymes in extant metazoan and relevant outgroups. We identify that DG originated after the divergence of ctenophores from porifera and eumetazoa. The C-terminal half of the DG core protein is highly-conserved, yet the N-terminal region, that includes the laminin-binding region, has undergone major lineage-specific divergences. Phylogenetic analysis based on the C-terminal IG2_MAT_NU region identified three distinct clades corresponding to deuterostomes, arthropods, and mollusks/early-diverging metazoans. Whereas the glycosyltransferases that modify α-DG are also present in choanoflagellates, the DG-binding proteins dystrophin and laminin originated at the base of the metazoa, and DG-associated sarcoglycan is restricted to cnidarians and bilaterians. These findings implicate extensive functional diversification of DG within invertebrate lineages and identify the laminin-DG-dystrophin axis as a conserved adhesion system that evolved subsequent to integrin-ECM adhesion, likely to enhance the functional complexity of cell-BM interactions in early metazoans.

  2. Abdominal ultrasonography, 2nd Ed

    International Nuclear Information System (INIS)

    Goldberg, B.B.

    1984-01-01

    This volume is a new and updated edition of an extensively illustrated text and reference on the capabilities and imaging of gray scale ultrasonography for each major abdominal organ. Each major organ system is treated separately, including liver, gallbladder and bile ducts, pancreas, kidney, retroperitoneum, abdominal vasculature, and more. There are over 500 illustrations and ten pages of full color plates for cross sectional anatomy

  3. Restriction fragment length polymorphism of the major histocompatibility complex of the dog.

    Science.gov (United States)

    Sarmiento, U M; Storb, R F

    1988-01-01

    Human major histocompatibility complex (HLA) cDNA probes were used to analyze the restriction fragment length polymorphism (RFLP) of the DLA-D region in dogs. Genomic DNA from peripheral blood leucocytes of 23 unrelated DLA-D-homozygous dogs representing nine DLA-D types (defined by mixed leucocyte reaction) was digested with restriction enzymes (Bam HI, Eco RI, Hind III, Pvu II, Taq I, Rsa I, Msp I, Pst I, and Bgl II), separated by agarose gel electrophoresis, and transferred onto Biotrace membrane. The Southern blots were successively hybridized with radiolabeled HLA cDNA probes corresponding to DR, DQ, DP, and DO beta genes. The autoradiograms for all nine enzyme digests displayed multiple bands with the DRb, DQb, and DPb probes while the DOb probe hybridized with one to two bands. The RFLP patterns were highly polymorphic but consistent within each DLA-D type. Standard RFLP patterns were established for nine DLA-D types which could be discriminated from each other by using two enzymes (Rsa I and Pst I) and the HLA-DPb probe. Cluster analysis of the polymorphic restriction fragments detected by the DRb probe revealed four closely related supertypic groups or DLA-DR families: Dw3 + Dw4 + D1, Dw8 + D10, D7 + D16 + D9, and Dw1. This study provides the basis for DLA-D genotyping at a population level by RFLP analysis. These results also suggest that the genetic organization of the DLA-D region may closely resemble that of the HLA complex.

  4. Conditional analysis identifies three novel major histocompatibility complex loci associated with psoriasis.

    Science.gov (United States)

    Knight, Jo; Spain, Sarah L; Capon, Francesca; Hayday, Adrian; Nestle, Frank O; Clop, Alex; Barker, Jonathan N; Weale, Michael E; Trembath, Richard C

    2012-12-01

    Psoriasis is a common, chronic, inflammatory skin disorder. A number of genetic loci have been shown to confer risk for psoriasis. Collectively, these offer an integrated model for the inherited basis for susceptibility to psoriasis that combines altered skin barrier function together with the dysregulation of innate immune pathogen sensing and adap-tive immunity. The major histocompatibility complex (MHC) harbours the psoriasis susceptibility region which exhibits the largest effect size, driven in part by variation contained on the HLA-Cw*0602 allele. However, the resolution of the number and genomic location of potential independent risk loci are hampered by extensive linkage disequilibrium across the region. We leveraged the power of large psoriasis case and control data sets and the statistical approach of conditional analysis to identify potential further association signals distributed across the MHC. In addition to the major loci at HLA-C (P = 2.20 × 10(-236)), we observed and replicated four additional independent signals for disease association, three of which are novel. We detected evidence for association at SNPs rs2507971 (P = 6.73 × 10(-14)), rs9260313 (P = 7.93 × 10(-09)), rs66609536 (P = 3.54 × 10(-07)) and rs380924 (P = 6.24 × 10(-06)), located within the class I region of the MHC, with each observation replicated in an independent sample (P ≤ 0.01). The previously identified locus is close to MICA, the other three lie near MICB, HLA-A and HCG9 (a non-coding RNA gene). The identification of disease associations with both MICA and MICB is particularly intriguing, since each encodes an MHC class I-related protein with potent immunological function.

  5. Gene duplication and fragmentation in the zebra finch major histocompatibility complex

    Directory of Open Access Journals (Sweden)

    Burt David W

    2010-04-01

    Full Text Available Abstract Background Due to its high polymorphism and importance for disease resistance, the major histocompatibility complex (MHC has been an important focus of many vertebrate genome projects. Avian MHC organization is of particular interest because the chicken Gallus gallus, the avian species with the best characterized MHC, possesses a highly streamlined minimal essential MHC, which is linked to resistance against specific pathogens. It remains unclear the extent to which this organization describes the situation in other birds and whether it represents a derived or ancestral condition. The sequencing of the zebra finch Taeniopygia guttata genome, in combination with targeted bacterial artificial chromosome (BAC sequencing, has allowed us to characterize an MHC from a highly divergent and diverse avian lineage, the passerines. Results The zebra finch MHC exhibits a complex structure and history involving gene duplication and fragmentation. The zebra finch MHC includes multiple Class I and Class II genes, some of which appear to be pseudogenes, and spans a much more extensive genomic region than the chicken MHC, as evidenced by the presence of MHC genes on each of seven BACs spanning 739 kb. Cytogenetic (FISH evidence and the genome assembly itself place core MHC genes on as many as four chromosomes with TAP and Class I genes mapping to different chromosomes. MHC Class II regions are further characterized by high endogenous retroviral content. Lastly, we find strong evidence of selection acting on sites within passerine MHC Class I and Class II genes. Conclusion The zebra finch MHC differs markedly from that of the chicken, the only other bird species with a complete genome sequence. The apparent lack of synteny between TAP and the expressed MHC Class I locus is in fact reminiscent of a pattern seen in some mammalian lineages and may represent convergent evolution. Our analyses of the zebra finch MHC suggest a complex history involving

  6. Abdominal angina

    International Nuclear Information System (INIS)

    Becker, G.J.; Stewart, J.; Holden, R.W.; Yune, H.Y.; Mail, J.T.; Klatte, E.C.

    1988-01-01

    Abdominal angina due to occlusive disease of the mesenteric arteries has been the to become clinically manifest only in the presence of severe disease in at least two of the following vessels: celiac, SMA, and IMA. Still, many patients who gradually develop significant two-vessel disease have few or no associated symptoms. Differences in collateral circulation and in cardiac index account for some of the clinical variation. The usual clinical manifestations include severe post-prandial pain, sitophobia (fear of eating because of the anticipated symptoms), and profound weight loss. Uncommonly, diarrhea, nausea, or vomiting may be encountered. Smoking is a common historical feature. Most series document a female predilection. Aside from occasional abdominal bruits and (more commonly) findings of peripheral vascular occlusive disease, the physical exam discloses only cachexia. But the differential diagnosis of profound weight loss is extensive. Therefore, abdominal angina has always created a diagnostic challenge. Multiple imaging modalities are often employed, and a seemingly negative evaluation often culminates in biplane aortography. The latter typically reveals stenoses and/or occlusions in at least two of the three mesenteric arteries. The authors discuss how a variety of surgical treatments, including thromboendarterectomy and bypass grafting, have evolved. Recently reported results have been excellent

  7. Zika Virus Escapes NK Cell Detection by Upregulating Major Histocompatibility Complex Class I Molecules.

    Science.gov (United States)

    Glasner, Ariella; Oiknine-Djian, Esther; Weisblum, Yiska; Diab, Mohammad; Panet, Amos; Wolf, Dana G; Mandelboim, Ofer

    2017-11-15

    NK cells are innate lymphocytes that participate in many immune processes encompassing cancer, bacterial and fungal infection, autoimmunity, and even pregnancy and that specialize in antiviral defense. NK cells express inhibitory and activating receptors and kill their targets when activating signals overpower inhibitory signals. The NK cell inhibitory receptors include a uniquely diverse array of proteins named killer cell immunoglobulin-like receptors (KIRs), the CD94 family, and the leukocyte immunoglobulin-like receptor (LIR) family. The NK cell inhibitory receptors recognize mostly major histocompatibility complex (MHC) class I (MHC-I) proteins. Zika virus has recently emerged as a major threat due to its association with birth defects and its pandemic potential. How Zika virus interacts with the immune system, and especially with NK cells, is unclear. Here we show that Zika virus infection is barely sensed by NK cells, since little or no increase in the expression of activating NK cell ligands was observed following Zika infection. In contrast, we demonstrate that Zika virus infection leads to the upregulation of MHC class I proteins and consequently to the inhibition of NK cell killing. Mechanistically, we show that MHC class I proteins are upregulated via the RIGI-IRF3 pathway and that this upregulation is mediated via beta interferon (IFN-β). Potentially, countering MHC class I upregulation during Zika virus infection could be used as a prophylactic treatment against Zika virus. IMPORTANCE NK cells are innate lymphocytes that recognize and eliminate various pathogens and are known mostly for their role in controlling viral infections. NK cells express inhibitory and activating receptors, and they kill or spare their targets based on the integration of inhibitory and activating signals. Zika virus has recently emerged as a major threat to humans due to its pandemic potential and its association with birth defects. The role of NK cells in Zika virus

  8. Isolation and characterization of major histocompatibility complex class IIB genes from the nurse shark.

    Science.gov (United States)

    Bartl, S; Weissman, I L

    1994-01-04

    The major histocompatibility complex (MHC) contains a set of linked genes which encode cell surface proteins involved in the binding of small peptide antigens for their subsequent recognition by T lymphocytes. MHC proteins share structural features and the presence and location of polymorphic residues which play a role in the binding of antigens. In order to compare the structure of these molecules and gain insights into their evolution, we have isolated two MHC class IIB genes from the nurse shark, Ginglymostoma cirratum. Two clones, most probably alleles, encode proteins which differ by 13 amino acids located in the putative antigen-binding cleft. The protein structure and the location of polymorphic residues are similar to their mammalian counterparts. Although these genes appear to encode a typical MHC protein, no T-cell-mediated responses have been demonstrated in cartilaginous fish. The nurse shark represents the most phylogenetically primitive organism in which both class IIA [Kasahara, M., Vazquez, M., Sato, K., McKinney, E.C. & Flajnik, M.F. (1992) Proc. Natl. Acad. Sci USA 89, 6688-6692] and class IIB genes, presumably encoding the alpha/beta heterodimer, have been isolated.

  9. Quantitative disease resistance: to better understand parasite-mediated selection on major histocompatibility complex.

    Science.gov (United States)

    Westerdahl, Helena; Asghar, Muhammad; Hasselquist, Dennis; Bensch, Staffan

    2012-02-07

    We outline a descriptive framework of how candidate alleles of the immune system associate with infectious diseases in natural populations of animals. Three kinds of alleles can be separated when both prevalence of infection and infection intensity are measured--qualitative disease resistance, quantitative disease resistance and susceptibility alleles. Our descriptive framework demonstrates why alleles for quantitative resistance and susceptibility cannot be separated based on prevalence data alone, but are distinguishable on infection intensity. We then present a case study to evaluate a previous finding of a positive association between prevalence of a severe avian malaria infection (GRW2, Plasmodium ashfordi) and a major histocompatibility complex (MHC) class I allele (B4b) in great reed warblers Acrocephalus arundinaceus. Using the same dataset, we find that individuals with allele B4b have lower GRW2 infection intensities than individuals without this allele. Therefore, allele B4b provides quantitative resistance rather than increasing susceptibility to infection. This implies that birds carrying B4b can mount an immune response that suppresses the acute-phase GRW2 infection, while birds without this allele cannot and may die. We argue that it is important to determine whether MHC alleles related to infections are advantageous (quantitative and qualitative resistance) or disadvantageous (susceptibility) to obtain a more complete picture of pathogen-mediated balancing selection.

  10. Odour-based discrimination of similarity at the major histocompatibility complex in birds.

    Science.gov (United States)

    Leclaire, Sarah; Strandh, Maria; Mardon, Jérôme; Westerdahl, Helena; Bonadonna, Francesco

    2017-01-11

    Many animals are known to preferentially mate with partners that are dissimilar at the major histocompatibility complex (MHC) in order to maximize the antigen binding repertoire (or disease resistance) in their offspring. Although several mammals, fish or lizards use odour cues to assess MHC similarity with potential partners, the ability of birds to assess MHC similarity using olfactory cues has not yet been explored. Here we used a behavioural binary choice test and high-throughput-sequencing of MHC class IIB to determine whether blue petrels can discriminate MHC similarity based on odour cues alone. Blue petrels are seabirds with particularly good sense of smell, they have a reciprocal mate choice and are known to preferentially mate with MHC-dissimilar partners. Incubating males preferentially approached the odour of the more MHC-dissimilar female, whereas incubating females showed opposite preferences. Given their mating pattern, females were, however, expected to show preference for the odour of the more MHC-dissimilar male. Further studies are needed to determine whether, as in women and female mice, the preference varies with the reproductive cycle in blue petrel females. Our results provide the first evidence that birds can use odour cues only to assess MHC dissimilarity. © 2017 The Author(s).

  11. Effects of major histocompatibility complex class II knockout on mouse bone mechanical properties during development

    Science.gov (United States)

    Simske, Steven J.; Bateman, Ted A.; Smith, Erin E.; Ferguson, Virginia L.; Chapes, Stephen K.

    2002-01-01

    We investigated the effect of major histocompatibility complex class II (MHC II) knockout on the development of the mouse peripheral skeleton. These C2D mice had less skeletal development at 8, 12 and 16 weeks of age compared to wild-type C57BL/6J (B6) male mice. The C2D mice had decreased femur mechanical, geometric and compositional measurements compared to wild type mice at each of these ages. C2D femur stiffness (S), peak force in 3-pt bending (Pm), and mineral mass (Min-M) were 74%, 64% and 66%, respectively, of corresponding B6 values at 8 weeks of age. Similar differences were measured at 12 weeks (for which C2D femoral S, Pm and Min-M were 71%, 72% and 73%, respectively, of corresponding B6 values) and at 16 weeks (for which C2D femoral S, Pm and Min-M were 80%, 66% and 61%, respectively, of corresponding B6 values). MHC II knockout delays the development of adult bone properties and is accompanied by lower body mass compared to wild-type controls.

  12. Spatial variation and low diversity in the major histocompatibility complex in walrus (Odobenus rosmarus)

    Science.gov (United States)

    Sonsthagen, Sarah A.; Fales, Krystal; Jay, Chadwick V.; Sage, George K.; Talbot, Sandra L.

    2014-01-01

    Increased global temperature and associated changes to Arctic habitats will likely result in the northward advance of species, including an influx of pathogens novel to the Arctic. How species respond to these immunological challenges will depend in part on the adaptive potential of their immune response system. We compared levels of genetic diversity at a gene associated with adaptive immune response [Class II major histocompatibility complex (MHC), DQB exon 2] between populations of walrus (Odobenus rosmarus), a sea ice-dependent Arctic species. Walrus was represented by only five MHC DQB alleles, with frequency differences observed between Pacific and Atlantic populations. MHC DQB alleles appear to be under balancing selection, and most (80 %; n = 4/5) of the alleles were observed in walruses from both oceans, suggesting broad scale differences in the frequency of exposure and diversity of pathogens may be influencing levels of heterozygosity at DQB in walruses. Limited genetic diversity at MHC, however, suggests that walrus may have a reduced capacity to respond to novel immunological challenges associated with shifts in ecological communities and environmental stressors predicted for changing climates. This is particularly pertinent for walrus, since reductions in summer sea ice may facilitate both northward expansion of marine species and associated pathogens from more temperate regions, and exchange of marine mammals and associated pathogens through the recently opened Northwest Passage between the Atlantic and Pacific Oceans in the Canadian high Arctic.

  13. Cyclophilin C Participates in the US2-Mediated Degradation of Major Histocompatibility Complex Class I Molecules.

    Science.gov (United States)

    Chapman, Daniel C; Stocki, Pawel; Williams, David B

    2015-01-01

    Human cytomegalovirus uses a variety of mechanisms to evade immune recognition through major histocompatibility complex class I molecules. One mechanism mediated by the immunoevasin protein US2 causes rapid disposal of newly synthesized class I molecules by the endoplasmic reticulum-associated degradation pathway. Although several components of this degradation pathway have been identified, there are still questions concerning how US2 targets class I molecules for degradation. In this study we identify cyclophilin C, a peptidyl prolyl isomerase of the endoplasmic reticulum, as a component of US2-mediated immune evasion. Cyclophilin C could be co-isolated with US2 and with the class I molecule HLA-A2. Furthermore, it was required at a particular expression level since depletion or overexpression of cyclophilin C impaired the degradation of class I molecules. To better characterize the involvement of cyclophilin C in class I degradation, we used LC-MS/MS to detect US2-interacting proteins that were influenced by cyclophilin C expression levels. We identified malectin, PDIA6, and TMEM33 as proteins that increased in association with US2 upon cyclophilin C knockdown. In subsequent validation all were shown to play a functional role in US2 degradation of class I molecules. This was specific to US2 rather than general ER-associated degradation since depletion of these proteins did not impede the degradation of a misfolded substrate, the null Hong Kong variant of α1-antitrypsin.

  14. Crystal structure of spinach major light-harvesting complex at 2.72Å resolution

    Science.gov (United States)

    Liu, Zhenfeng; Yan, Hanchi; Wang, Kebin; Kuang, Tingyun; Zhang, Jiping; Gui, Lulu; An, Xiaomin; Chang, Wenrui

    2004-03-01

    The major light-harvesting complex of photosystem II (LHC-II) serves as the principal solar energy collector in the photosynthesis of green plants and presumably also functions in photoprotection under high-light conditions. Here we report the first X-ray structure of LHC-II in icosahedral proteoliposome assembly at atomic detail. One asymmetric unit of a large R32 unit cell contains ten LHC-II monomers. The 14 chlorophylls (Chl) in each monomer can be unambiguously distinguished as eight Chla and six Chlb molecules. Assignment of the orientation of the transition dipole moment of each chlorophyll has been achieved. All Chlb are located around the interface between adjacent monomers, and together with Chla they are the basis for efficient light harvesting. Four carotenoid-binding sites per monomer have been observed. The xanthophyll-cycle carotenoid at the monomer-monomer interface may be involved in the non-radiative dissipation of excessive energy, one of the photoprotective strategies that have evolved in plants.

  15. The major histocompatibility complex genes impact pain response in DA and DA.1U rats.

    Science.gov (United States)

    Guo, Yuan; Yao, Fan-Rong; Cao, Dong-Yuan; Li, Li; Wang, Hui-Sheng; Xie, Wen; Zhao, Yan

    2015-08-01

    Our recent studies have shown that the difference in basal pain sensitivity to mechanical and thermal stimulation between Dark-Agouti (DA) rats and a novel congenic DA.1U rats is major histocompatibility complex (MHC) genes dependent. In the present study, we further used DA and DA.1U rats to investigate the role of MHC genes in formalin-induced pain model by behavioral, electrophysiological and immunohistochemical methods. Behavioral results showed biphasic nociceptive behaviors increased significantly following the intraplantar injection of formalin in the hindpaw of DA and DA.1U rats. The main nociceptive behaviors were lifting and licking, especially in DA rats (PDA rats were significantly higher than those in DA.1U rats in both phases of the formalin test (PDA rats was significantly higher than that of DA.1U rats (PDA was greater than that in DA.1U rats (PDA rats was significantly higher than that in DA.1U rats in the respective experimental group (PDA and DA.1U rats exhibited nociceptive responses in formalin-induced pain model and DA rats were more sensitive to noxious chemical stimulus than DA.1U rats, indicating that MHC genes might contribute to the difference in pain sensitivity. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Complex suppression patterns distinguish between major energy loss effects in Quark–Gluon Plasma

    Energy Technology Data Exchange (ETDEWEB)

    Djordjevic, Magdalena, E-mail: magda@ipb.ac.rs

    2016-12-10

    Interactions of high momentum partons with Quark–Gluon Plasma created in relativistic heavy-ion collisions provide an excellent tomography tool for this new form of matter. Recent measurements for charged hadrons and unidentified jets at the LHC show an unexpected flattening of the suppression curves at high momentum, exhibited when either momentum or the collision centrality is changed. Furthermore, a limited data available for B probes indicate a qualitatively different pattern, as nearly the same flattening is exhibited for the curves corresponding to two opposite momentum ranges. We here show that the experimentally measured suppression curves are well reproduced by our theoretical predictions, and that the complex suppression patterns are due to an interplay of collisional, radiative energy loss and the dead-cone effect. Furthermore, for B mesons, we predict that the uniform flattening of the suppression indicated by the limited dataset is in fact valid across the entire span of the momentum ranges, which will be tested by the upcoming experiments. Overall, the study presented here, provides a rare opportunity for pQCD theory to qualitatively distinguish between the major energy loss mechanisms at the same (nonintuitive) dataset.

  17. Recombinational hotspot specific to female meiosis in the mouse major histocompatibility complex.

    Science.gov (United States)

    Shiroishi, T; Hanzawa, N; Sagai, T; Ishiura, M; Gojobori, T; Steinmetz, M; Moriwaki, K

    1990-01-01

    The wm7 haplotype of the major histocompatibility complex (MHC), derived from the Japanese wild mouse Mus musculus molossinus, enhances recombination specific to female meiosis in the K/A beta interval of the MHC. We have mapped crossover points of fifteen independent recombinants from genetic crosses of the wm7 and laboratory haplotypes. Most of them were confined to a short segment of approximately 1 kilobase (kb) of DNA between the A beta 3 and A beta 2 genes, indicating the presence of a female-specific recombinational hotspot. Its location overlaps with a sex-independent hotspot previously identified in the Mus musculus castaneus CAS3 haplotype. We have cloned and sequenced DNA fragments surrounding the hotspot from the wm7 haplotype and the corresponding regions from the hotspot-negative B10.A and C57BL/10 strains. There is no significant difference between the sequences of these three strains, or between these and the published sequences of the CAS3 and C57BL/6 strains. However, a comparison of this A beta 3/A beta 2 hotspot with a previously characterized hotspot in the E beta gene revealed that they have a very similar molecular organization. Each hotspot consists of two elements, the consensus sequence of the mouse middle repetitive MT family and the tetrameric repeated sequences, which are separated by 1 kb of DNA.

  18. Red Queen Processes Drive Positive Selection on Major Histocompatibility Complex (MHC Genes.

    Directory of Open Access Journals (Sweden)

    Maciej Jan Ejsmond

    2015-11-01

    Full Text Available Major Histocompatibility Complex (MHC genes code for proteins involved in the incitation of the adaptive immune response in vertebrates, which is achieved through binding oligopeptides (antigens of pathogenic origin. Across vertebrate species, substitutions of amino acids at sites responsible for the specificity of antigen binding (ABS are positively selected. This is attributed to pathogen-driven balancing selection, which is also thought to maintain the high polymorphism of MHC genes, and to cause the sharing of allelic lineages between species. However, the nature of this selection remains controversial. We used individual-based computer simulations to investigate the roles of two phenomena capable of maintaining MHC polymorphism: heterozygote advantage and host-pathogen arms race (Red Queen process. Our simulations revealed that levels of MHC polymorphism were high and driven mostly by the Red Queen process at a high pathogen mutation rate, but were low and driven mostly by heterozygote advantage when the pathogen mutation rate was low. We found that novel mutations at ABSs are strongly favored by the Red Queen process, but not by heterozygote advantage, regardless of the pathogen mutation rate. However, while the strong advantage of novel alleles increased the allele turnover rate, under a high pathogen mutation rate, allelic lineages persisted for a comparable length of time under Red Queen and under heterozygote advantage. Thus, when pathogens evolve quickly, the Red Queen is capable of explaining both positive selection and long coalescence times, but the tension between the novel allele advantage and persistence of alleles deserves further investigation.

  19. MAJOR HYSTOCOMPATIBILITY COMPLEX: STRUKTUR, FUNGSI, HUBUNGAN DENGAN PENYAKIT DAN PEMANFAATAN DALAM RESPON IMUN

    Directory of Open Access Journals (Sweden)

    Basundari Sri Utama

    2012-10-01

    Full Text Available Respon imun terhadap antigen asing dapat terjadi karena kemampuan dari organisme untuk membedakan "non self" dengan "self", sehingga dapat terhindar dari efek patogen dari antigen yang masuk. Hal ini terjadi karena kemampuan polimorfisme dari komponen molekul yang terdapat pada permukaan sel presentan pada saat proses respon imun terjadi. Komponen molekul tersebut disebut MHC (Major Hystocompatibility Complex pada tikus diberi kode H-2 atau HLA (Human Leucocyt Antifen pada manusia. Pengkode genetik MHC pada tikus terletak pada kromosom 17, pada manusia terletak pada kromosom 6. MHC tersebar pada hampir semua permukaan sel tubuh. Pada tikus MHC kelas 1 terdapat sel-sel yang berinti, platelet dan sel darah merah. Pada manusia terdapat pada sel-sel yang berinti dan platelet. MHC pada tikus terutama terdapat pada sel B, makrofag, sel epithel, sel limfosit T. Pada manusia terutama terdapat pada sel B dan makrofag. Fungsi MHC kelas I diantaranya adalah reaksi penolakan jaringan, stimulasi produksi antibodi, proses interaksi antigen dengan sel T. MHC kelas II diperlukan dalam proses presentasi antigen. Pengetahuan tentang MHC/HLA seseorang, dapat dipakai untuk memperkirakan risiko seseorang mendapatkan penyakit yang bersifat herediter atau kelainan imunologik. Dengan mengetahui bahwa MHC/HLA hanya dapat mengikat peptida, hal ini dapat dimanfaatkan untuk pencegahan reaksi alergi.

  20. Identification of naturally processed hepatitis C virus-derived major histocompatibility complex class I ligands.

    Directory of Open Access Journals (Sweden)

    Benno Wölk

    Full Text Available Fine mapping of human cytotoxic T lymphocyte (CTL responses against hepatitis C virus (HCV is based on external loading of target cells with synthetic peptides which are either derived from prediction algorithms or from overlapping peptide libraries. These strategies do not address putative host and viral mechanisms which may alter processing as well as presentation of CTL epitopes. Therefore, the aim of this proof-of-concept study was to identify naturally processed HCV-derived major histocompatibility complex (MHC class I ligands. To this end, continuous human cell lines were engineered to inducibly express HCV proteins and to constitutively express high levels of functional HLA-A2. These cell lines were recognized in an HLA-A2-restricted manner by HCV-specific CTLs. Ligands eluted from HLA-A2 molecules isolated from large-scale cultures of these cell lines were separated by high performance liquid chromatography and further analyzed by electrospray ionization quadrupole time of flight mass spectrometry (MS/tandem MS. These analyses allowed the identification of two HLA-A2-restricted epitopes derived from HCV nonstructural proteins (NS 3 and 5B (NS3₁₄₀₆₋₁₄₁₅ and NS5B₂₅₉₄₋₂₆₀₂. In conclusion, we describe a general strategy that may be useful to investigate HCV pathogenesis and may contribute to the development of preventive and therapeutic vaccines in the future.

  1. Managing the Organizational and Cultural Precursors to Major Events — Recognising and Addressing Complexity

    International Nuclear Information System (INIS)

    Taylor, R. H.; Carhart, N.; May, J.; Wijk, L. G. A. van

    2016-01-01

    been identified as particular vulnerabilities. Initial work on modelling has shown that the factors involved are both complex and inter-related, but learning from the research is being used to develop good practice. Examples will be given of the use of SD to provide new insights into the dynamics and complexity involved, and to provide new tools for assessing the implications of making changes (‘flight simulation’). It should also enable more informed choices to be made about the most useful indicators to measure before actions are taken which can have unintended consequences — leading, in the worst scenarios, to major events. (author)

  2. Economics of abdominal wall reconstruction.

    Science.gov (United States)

    Bower, Curtis; Roth, J Scott

    2013-10-01

    The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Adaptive molecular evolution of the Major Histocompatibility Complex genes, DRA and DQA, in the genus Equus.

    Science.gov (United States)

    Kamath, Pauline L; Getz, Wayne M

    2011-05-18

    Major Histocompatibility Complex (MHC) genes are central to vertebrate immune response and are believed to be under balancing selection by pathogens. This hypothesis has been supported by observations of extremely high polymorphism, elevated nonsynonymous to synonymous base pair substitution rates and trans-species polymorphisms at these loci. In equids, the organization and variability of this gene family has been described, however the full extent of diversity and selection is unknown. As selection is not expected to act uniformly on a functional gene, maximum likelihood codon-based models of selection that allow heterogeneity in selection across codon positions can be valuable for examining MHC gene evolution and the molecular basis for species adaptations. We investigated the evolution of two class II MHC genes of the Equine Lymphocyte Antigen (ELA), DRA and DQA, in the genus Equus with the addition of novel alleles identified in plains zebra (E. quagga, formerly E. burchelli). We found that both genes exhibited a high degree of polymorphism and inter-specific sharing of allele lineages. To our knowledge, DRA allelic diversity was discovered to be higher than has ever been observed in vertebrates. Evidence was also found to support a duplication of the DQA locus. Selection analyses, evaluated in terms of relative rates of nonsynonymous to synonymous mutations (dN/dS) averaged over the gene region, indicated that the majority of codon sites were conserved and under purifying selection (dN

  4. Adaptive molecular evolution of the Major Histocompatibility Complex genes, DRA and DQA, in the genus Equus

    Directory of Open Access Journals (Sweden)

    Getz Wayne M

    2011-05-01

    Full Text Available Abstract Background Major Histocompatibility Complex (MHC genes are central to vertebrate immune response and are believed to be under balancing selection by pathogens. This hypothesis has been supported by observations of extremely high polymorphism, elevated nonsynonymous to synonymous base pair substitution rates and trans-species polymorphisms at these loci. In equids, the organization and variability of this gene family has been described, however the full extent of diversity and selection is unknown. As selection is not expected to act uniformly on a functional gene, maximum likelihood codon-based models of selection that allow heterogeneity in selection across codon positions can be valuable for examining MHC gene evolution and the molecular basis for species adaptations. Results We investigated the evolution of two class II MHC genes of the Equine Lymphocyte Antigen (ELA, DRA and DQA, in the genus Equus with the addition of novel alleles identified in plains zebra (E. quagga, formerly E. burchelli. We found that both genes exhibited a high degree of polymorphism and inter-specific sharing of allele lineages. To our knowledge, DRA allelic diversity was discovered to be higher than has ever been observed in vertebrates. Evidence was also found to support a duplication of the DQA locus. Selection analyses, evaluated in terms of relative rates of nonsynonymous to synonymous mutations (dN/dS averaged over the gene region, indicated that the majority of codon sites were conserved and under purifying selection (dN dS. However, the most likely evolutionary codon models allowed for variable rates of selection across codon sites at both loci and, at the DQA, supported the hypothesis of positive selection acting on specific sites. Conclusions Observations of elevated genetic diversity and trans-species polymorphisms supported the conclusion that balancing selection may be acting on these loci. Furthermore, at the DQA, positive selection was

  5. Blood parasites shape extreme major histocompatibility complex diversity in a migratory passerine.

    Science.gov (United States)

    Biedrzycka, Aleksandra; Bielański, Wojciech; Ćmiel, Adam; Solarz, Wojciech; Zając, Tadeusz; Migalska, Magdalena; Sebastian, Alvaro; Westerdahl, Helena; Radwan, Jacek

    2018-06-01

    Pathogens are one of the main forces driving the evolution and maintenance of the highly polymorphic genes of the vertebrate major histocompatibility complex (MHC). Although MHC proteins are crucial in pathogen recognition, it is still poorly understood how pathogen-mediated selection promotes and maintains MHC diversity, and especially so in host species with highly duplicated MHC genes. Sedge warblers (Acrocephalus schoenobaenus) have highly duplicated MHC genes, and using data from high-throughput MHC genotyping, we were able to investigate to what extent avian malaria parasites explain temporal MHC class I supertype fluctuations in a long-term study population. We investigated infection status and infection intensities of two different strains of Haemoproteus, that is avian malaria parasites that are known to have significant fitness consequences in sedge warblers. We found that prevalence of avian malaria in carriers of specific MHC class I supertypes was a significant predictor of their frequency changes between years. This finding suggests that avian malaria infections partly drive the temporal fluctuations of the MHC class I supertypes. Furthermore, we found that individuals with a large number of different supertypes had higher resistance to avian malaria, but there was no evidence for an optimal MHC class I diversity. Thus, the two studied malaria parasite strains appear to select for a high MHC class I supertype diversity. Such selection may explain the maintenance of the extremely high number of MHC class I gene copies in sedge warblers and possibly also in other passerines where avian malaria is a common disease. © 2018 John Wiley & Sons Ltd.

  6. Low major histocompatibility complex class II DQA diversity in the Giant Panda (Ailuropoda melanoleuca

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    Ruan Xiang-Dong

    2007-06-01

    Full Text Available Abstract Background The giant panda (Ailuropoda melanoleuca is one of the most endangered animals due to habitat fragmentation and loss. Although the captive breeding program for this species is now nearly two decades old, researches on the genetic background of such captive populations, especially on adaptive molecular polymorphism of major histocompatibility complex (MHC, are still limited. In this study, we characterized adaptive variation of the giant panda's MHC DQA gene by PCR amplification of its antigen-recognizing region (i.e. the exon 2 and subsequent single-strand conformational polymorphism (SSCP and sequence analyses. Results The results revealed a low level of DQA exon 2 diversity in this rare animal, presenting 6 alleles from 61 giant panda individuals. The observed polymorphism was restricted to 9 amino acid substitutions, all of which occurred at and adjacent to positions forming the functionally important antigen-binding sites. All the samples were in Hardy-Weinberg proportions. A significantly higher rate of non-synonymous than synonymous substitutions at the antigen-binding sites indicated positive selection for diversity in the locus. Conclusion The DQA allelic diversity of giant pandas was low relative to other vertebrates. Nonetheless, the pandas exhibited more alleles in DQA than those in DRB, suggesting the alpha chain genes would play a leading role when coping with certain pathogens and thus should be included in conservation genetic investigation. The microsatellite and MHC loci might predict long-term persistence potential and short-term survival ability, respectively. Consequently, it is recommended to utilize multiple suites of microsatellite markers and multiple MHC loci to detect overall genetic variation in order to design unbiased conservation strategies.

  7. Introgression from domestic goat generated variation at the major histocompatibility complex of Alpine ibex.

    Directory of Open Access Journals (Sweden)

    Christine Grossen

    2014-06-01

    Full Text Available The major histocompatibility complex (MHC is a crucial component of the vertebrate immune system and shows extremely high levels of genetic polymorphism. The extraordinary genetic variation is thought to be ancient polymorphisms maintained by balancing selection. However, introgression from related species was recently proposed as an additional mechanism. Here we provide evidence for introgression at the MHC in Alpine ibex (Capra ibex ibex. At a usually very polymorphic MHC exon involved in pathogen recognition (DRB exon 2, Alpine ibex carried only two alleles. We found that one of these DRB alleles is identical to a DRB allele of domestic goats (Capra aegagrus hircus. We sequenced 2489 bp of the coding and non-coding regions of the DRB gene and found that Alpine ibex homozygous for the goat-type DRB exon 2 allele showed nearly identical sequences (99.8% to a breed of domestic goats. Using Sanger and RAD sequencing, microsatellite and SNP chip data, we show that the chromosomal region containing the goat-type DRB allele has a signature of recent introgression in Alpine ibex. A region of approximately 750 kb including the DRB locus showed high rates of heterozygosity in individuals carrying one copy of the goat-type DRB allele. These individuals shared SNP alleles both with domestic goats and other Alpine ibex. In a survey of four Alpine ibex populations, we found that the region surrounding the DRB allele shows strong linkage disequilibria, strong sequence clustering and low diversity among haplotypes carrying the goat-type allele. Introgression at the MHC is likely adaptive and introgression critically increased MHC DRB diversity in the genetically impoverished Alpine ibex. Our finding contradicts the long-standing view that genetic variability at the MHC is solely a consequence of ancient trans-species polymorphism. Introgression is likely an underappreciated source of genetic diversity at the MHC and other loci under balancing selection.

  8. Evolution of major histocompatibility complex class I and class II genes in the brown bear

    Science.gov (United States)

    2012-01-01

    Background Major histocompatibility complex (MHC) proteins constitute an essential component of the vertebrate immune response, and are coded by the most polymorphic of the vertebrate genes. Here, we investigated sequence variation and evolution of MHC class I and class II DRB, DQA and DQB genes in the brown bear Ursus arctos to characterise the level of polymorphism, estimate the strength of positive selection acting on them, and assess the extent of gene orthology and trans-species polymorphism in Ursidae. Results We found 37 MHC class I, 16 MHC class II DRB, four DQB and two DQA alleles. We confirmed the expression of several loci: three MHC class I, two DRB, two DQB and one DQA. MHC class I also contained two clusters of non-expressed sequences. MHC class I and DRB allele frequencies differed between northern and southern populations of the Scandinavian brown bear. The rate of nonsynonymous substitutions (dN) exceeded the rate of synonymous substitutions (dS) at putative antigen binding sites of DRB and DQB loci and, marginally significantly, at MHC class I loci. Models of codon evolution supported positive selection at DRB and MHC class I loci. Both MHC class I and MHC class II sequences showed orthology to gene clusters found in the giant panda Ailuropoda melanoleuca. Conclusions Historical positive selection has acted on MHC class I, class II DRB and DQB, but not on the DQA locus. The signal of historical positive selection on the DRB locus was particularly strong, which may be a general feature of caniforms. The presence of MHC class I pseudogenes may indicate faster gene turnover in this class through the birth-and-death process. South–north population structure at MHC loci probably reflects origin of the populations from separate glacial refugia. PMID:23031405

  9. Evolution of major histocompatibility complex class I and class II genes in the brown bear

    Directory of Open Access Journals (Sweden)

    Kuduk Katarzyna

    2012-10-01

    Full Text Available Abstract Background Major histocompatibility complex (MHC proteins constitute an essential component of the vertebrate immune response, and are coded by the most polymorphic of the vertebrate genes. Here, we investigated sequence variation and evolution of MHC class I and class II DRB, DQA and DQB genes in the brown bear Ursus arctos to characterise the level of polymorphism, estimate the strength of positive selection acting on them, and assess the extent of gene orthology and trans-species polymorphism in Ursidae. Results We found 37 MHC class I, 16 MHC class II DRB, four DQB and two DQA alleles. We confirmed the expression of several loci: three MHC class I, two DRB, two DQB and one DQA. MHC class I also contained two clusters of non-expressed sequences. MHC class I and DRB allele frequencies differed between northern and southern populations of the Scandinavian brown bear. The rate of nonsynonymous substitutions (dN exceeded the rate of synonymous substitutions (dS at putative antigen binding sites of DRB and DQB loci and, marginally significantly, at MHC class I loci. Models of codon evolution supported positive selection at DRB and MHC class I loci. Both MHC class I and MHC class II sequences showed orthology to gene clusters found in the giant panda Ailuropoda melanoleuca. Conclusions Historical positive selection has acted on MHC class I, class II DRB and DQB, but not on the DQA locus. The signal of historical positive selection on the DRB locus was particularly strong, which may be a general feature of caniforms. The presence of MHC class I pseudogenes may indicate faster gene turnover in this class through the birth-and-death process. South–north population structure at MHC loci probably reflects origin of the populations from separate glacial refugia.

  10. Evolution of major histocompatibility complex class I and class II genes in the brown bear.

    Science.gov (United States)

    Kuduk, Katarzyna; Babik, Wiesław; Bojarska, Katarzyna; Sliwińska, Ewa B; Kindberg, Jonas; Taberlet, Pierre; Swenson, Jon E; Radwan, Jacek

    2012-10-02

    Major histocompatibility complex (MHC) proteins constitute an essential component of the vertebrate immune response, and are coded by the most polymorphic of the vertebrate genes. Here, we investigated sequence variation and evolution of MHC class I and class II DRB, DQA and DQB genes in the brown bear Ursus arctos to characterise the level of polymorphism, estimate the strength of positive selection acting on them, and assess the extent of gene orthology and trans-species polymorphism in Ursidae. We found 37 MHC class I, 16 MHC class II DRB, four DQB and two DQA alleles. We confirmed the expression of several loci: three MHC class I, two DRB, two DQB and one DQA. MHC class I also contained two clusters of non-expressed sequences. MHC class I and DRB allele frequencies differed between northern and southern populations of the Scandinavian brown bear. The rate of nonsynonymous substitutions (dN) exceeded the rate of synonymous substitutions (dS) at putative antigen binding sites of DRB and DQB loci and, marginally significantly, at MHC class I loci. Models of codon evolution supported positive selection at DRB and MHC class I loci. Both MHC class I and MHC class II sequences showed orthology to gene clusters found in the giant panda Ailuropoda melanoleuca. Historical positive selection has acted on MHC class I, class II DRB and DQB, but not on the DQA locus. The signal of historical positive selection on the DRB locus was particularly strong, which may be a general feature of caniforms. The presence of MHC class I pseudogenes may indicate faster gene turnover in this class through the birth-and-death process. South-north population structure at MHC loci probably reflects origin of the populations from separate glacial refugia.

  11. Introgression from Domestic Goat Generated Variation at the Major Histocompatibility Complex of Alpine Ibex

    Science.gov (United States)

    Grossen, Christine; Keller, Lukas; Biebach, Iris; Croll, Daniel

    2014-01-01

    The major histocompatibility complex (MHC) is a crucial component of the vertebrate immune system and shows extremely high levels of genetic polymorphism. The extraordinary genetic variation is thought to be ancient polymorphisms maintained by balancing selection. However, introgression from related species was recently proposed as an additional mechanism. Here we provide evidence for introgression at the MHC in Alpine ibex (Capra ibex ibex). At a usually very polymorphic MHC exon involved in pathogen recognition (DRB exon 2), Alpine ibex carried only two alleles. We found that one of these DRB alleles is identical to a DRB allele of domestic goats (Capra aegagrus hircus). We sequenced 2489 bp of the coding and non-coding regions of the DRB gene and found that Alpine ibex homozygous for the goat-type DRB exon 2 allele showed nearly identical sequences (99.8%) to a breed of domestic goats. Using Sanger and RAD sequencing, microsatellite and SNP chip data, we show that the chromosomal region containing the goat-type DRB allele has a signature of recent introgression in Alpine ibex. A region of approximately 750 kb including the DRB locus showed high rates of heterozygosity in individuals carrying one copy of the goat-type DRB allele. These individuals shared SNP alleles both with domestic goats and other Alpine ibex. In a survey of four Alpine ibex populations, we found that the region surrounding the DRB allele shows strong linkage disequilibria, strong sequence clustering and low diversity among haplotypes carrying the goat-type allele. Introgression at the MHC is likely adaptive and introgression critically increased MHC DRB diversity in the genetically impoverished Alpine ibex. Our finding contradicts the long-standing view that genetic variability at the MHC is solely a consequence of ancient trans-species polymorphism. Introgression is likely an underappreciated source of genetic diversity at the MHC and other loci under balancing selection. PMID:24945814

  12. Major Histocompatibility Complex, demographic, and environmental predictors of antibody presence in a free-ranging mammal.

    Science.gov (United States)

    Ruiz-López, María José; Monello, Ryan J; Schuttler, Stephanie G; Lance, Stacey L; Gompper, Matthew E; Eggert, Lori S

    2014-12-01

    Major Histocompatibility Complex (MHC) variability plays a key role in pathogen resistance, but its relative importance compared to environmental and demographic factors that also influence resistance is unknown. We analyzed the MHC II DRB exon 2 for 165 raccoons (Procyon lotor) in Missouri (USA). For each animal we also determined the presence of immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies to two highly virulent pathogens, canine distemper virus (CDV) and parvovirus. We investigated the role of MHC polymorphism and other demographic and environmental factors previously associated with predicting seroconversion. In addition, using an experimental approach, we studied the relative importance of resource availability and contact rates. We found important associations between IgG antibody presence and several MHC alleles and supertypes but not between IgM antibody presence and MHC. No effect of individual MHC diversity was found. For CDV, supertype S8, one allele within S8 (Prlo-DRB(∗)222), and a second allele (Prlo-DRB(∗)204) were positively associated with being IgG+, while supertype S4 and one allele within the supertype (Prlo-DRB(∗)210) were negatively associated with being IgG+. Age, year, and increased food availability were also positively associated with being IgG+, but allele Prlo-DRB(∗)222 was a stronger predictor. For parvovirus, only one MHC allele was negatively associated with being IgG+ and age and site were stronger predictors of seroconversion. Our results show that negative-frequency dependent selection is likely acting on the raccoon MHC and that while the role of MHC in relation to other factors depends on the pathogen of interest, it may be one of the most important factors predicting successful immune response. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. A Recombinant Antibody with the Antigen-Specific, Major Histocompatibility Complex-Restricted Specificity of T Cells

    Science.gov (United States)

    Andersen, Peter S.; Stryhn, Anette; Hansen, Bjarke E.; Fugger, Lars; Engberg, Jan; Buus, Soren

    1996-03-01

    Specific recognition of peptide/major histocompatibility complex (MHC) molecule complexes by the T-cell receptor is a key reaction in the specific immune response. Antibodies against peptide/MHC complexes would therefore be valuable tools in studying MHC function and T-cell recognition and might lead to novel approaches in immunotherapy. However, it has proven difficult to generate antibodies with the specificity of T cells by conventional hybridoma techniques. Here we report that the phage display technology is a feasible alternative to generate antibodies recognizing specific, predetermined peptide/MHC complexes.

  14. Polarisation of major histocompatibility complex II host genotype with pathogenesis of European Brown Hare syndrome virus.

    Directory of Open Access Journals (Sweden)

    Christos Iacovakis

    Full Text Available A study was conducted in order to determine the occurrence of European Brown Hare Syndrome virus (EBHSV in Denmark and possible relation between disease pathogenesis and Major Histocompatibility Complex (MHC host genotype. Liver samples were examined from 170 brown hares (hunted, found sick or dead, collected between 2004 and 2009. Macroscopical and histopathological findings consistent with EBHS were detected in 24 (14.1% hares; 35 (20.6% had liver lesions not typical of the syndrome, 50 (29.4% had lesions in other tissues and 61 (35.9% had no lesions. Sixty five (38.2% of 170 samples were found to be EBHSV-positive (RT-PCR, VP60 gene. In order to investigate associations between viral pathogenesis and host genotype, variation within the exon 2 DQA gene of MHC was assessed. DQA exon 2 analysis revealed the occurrence of seven different alleles in Denmark. Consistent with other populations examined so far in Europe, observed heterozygosity of DQA (H o = 0.1180 was lower than expected (H e = 0.5835. The overall variation for both nucleotide and amino acid differences (2.9% and 14.9%, respectively were lower in Denmark than those assessed in other European countries (8.3% and 16.9%, respectively. Within the peptide binding region codons the number of nonsynonymous substitutions (dN was much higher than synonymous substitutions (dS, which would be expected for MHC alleles under balancing selection. Allele frequencies did not significantly differ between EBHSV-positive and -negative hares. However, allele Leeu-DQA*30 was detected in significantly higher (P = 0.000006 frequency among the positive hares found dead with severe histopathological lesions than among those found sick or apparently healthy. In contrast, the latter group was characterized by a higher frequency of the allele Leeu-DQA*14 as well as the proportion of heterozygous individuals (P = 0.000006 and P = 0.027. These data reveal a polarisation between EBHSV

  15. The Combined Effects of Obesity, Abdominal Obesity and Major Depression/Anxiety on Health-Related Quality of Life : the LifeLines Cohort Study

    NARCIS (Netherlands)

    Nigatu, Yeshambel T; Reijneveld, Sijmen A; de Jonge, Peter; van Rossum, Elisabeth; Bültmann, Ute

    2016-01-01

    Background Obesity and major depressive disorder (MDD)/anxiety disorders often co-occur and aggravate each other resulting in adverse health-related outcomes. As little is known about the potential effects of interaction between obesity and MDD and/or anxiety disorders on health-related quality of

  16. Distribution of class ii major histocompatibility complex antigenexpressing cells in human dental pulp with carious lesions

    Directory of Open Access Journals (Sweden)

    Tetiana Haniastuti

    2012-09-01

    Full Text Available Background: Dental caries is a bacterial infection which causes destruction of the hard tissues of the tooth. Exposure of the dentin to the oral environment as a result of caries inevitably results in a cellular response in the pulp. The major histocompatibility complex (MHC is a group of genes that code for cell-surface histocompatibility antigens. Cells expressing class II MHC molecules participate in the initial recognition and the processing of antigenic substances to serve as antigen-presenting cells. Purpose: The aim of the study was to elucidate the alteration in the distribution of class II MHC antigen-expressing cells in human dental pulp as carious lesions progressed toward the pulp. Methods: Fifteen third molars with caries at the occlusal site at various stages of decay and 5 intact third molars were extracted and used in this study. Before decalcifying with 10% EDTA solution (pH 7.4, all the samples were observed by micro-computed tomography to confirm the lesion condition three-dimensionally. The specimens were then processed for cryosection and immunohistochemistry using an anti-MHC class II monoclonal antibody. Results: Class II MHC antigen-expressing cells were found both in normal and carious specimens. In normal tooth, the class II MHC-immunopositive cells were observed mainly at the periphery of the pulp tissue. In teeth with caries, class II MHC-immunopositive cells were located predominantly subjacent to the carious lesions. As the caries progressed, the number of class II MHC antigen-expressing cells was increased. Conclusion: The depth of carious lesions affects the distribution of class II MHC antigen-expressing cells in the dental pulp.Latar belakang: Karies merupakan penyakit infeksi bakteri yang mengakibatkan destruksi jaringan keras gigi. Dentin yang terbuka akibat karies akan menginduksi respon imun seluler pada pulpa. Kompleks histokompatibilitas utama (MHC merupakan sekumpulan gen yang mengkode histokompatibilitas

  17. Circulating growth hormone (GH)-binding protein complex: a major constituent of plasma GH in man

    International Nuclear Information System (INIS)

    Baumann, G.; Amburn, K.; Shaw, M.A.

    1988-01-01

    The recent discovery of a specific binding protein for human GH (hGH) in human plasma suggests that hGH circulates in part as a complex in association with the binding protein(s). However, the magnitude of the complexed fraction prevailing under physiological conditions is unknown because of 1) dissociation of the complex during analysis and 2) potential differences in the binding characteristics of radiolabeled and native hGH. We conducted experiments designed to minimize dissociation during analysis (gel filtration in prelabeled columns, frontal analysis, and batch molecular sieving) with both native and radioiodinated hGH. All three methods yielded similar estimates for the complexed fraction. In normal plasma the bound fraction for 22 K hGH averaged 50.1% (range, 39-59%), that for 20 K hGH averaged 28.5% (range, 26-31%). Above a hGH level of about 20 ng/ml the bound fraction declines in concentration-dependent manner due to saturation of the binding protein. We conclude that a substantial part of circulating hGH is complexed with carrier proteins. This concept has important implications for the metabolism, distribution, and biological activity of hGH

  18. Overall major histocompatibility complex class I expression is not downregulated in cervix cancer, as detected by immunoelectron microscopy

    NARCIS (Netherlands)

    van Eijkeren, MA; Roovers, JP; Oorschot, [No Value; Geuze, HJ

    2004-01-01

    Downregulation of major histocompatibility complex (MHC) class I molecules in cervix cancer has been proposed as a mechanism for cancer cells to escape immunodetection. By means of light microscopic immunohistochemistry, it has been shown that in 20-70% of cervix cancers MHC class I is

  19. Major conformations of the ligand skeleton of a tetranuclear dysprosium (3) tartrate complex

    International Nuclear Information System (INIS)

    Chevela, V.V.; Semenov, V.Eh.; Bezryadin, S.G.; Savitskaya, T.V.; Kolesar, I.R.; Matveev, S.N.; Shamov, G.A.

    1999-01-01

    By the molecular mechanics method (MIND program, stoichiometry was studied and basic conformations of ligand frame of dysprosium (3) tetranuclear complex bis-(d-tartrato) bis-(l-tartrato)tetradysprosiate (3) - anion Dy 4 (d-L) 2 (l-L) 2 4- (1) (d-H 4 L = d-tartaric acid, l-H 4 L = l - tartaric acid) were revealed. It is shown that theoretically calculated mP τ constants for so-called compact conformations of 1, where tartratoligands are in gosh conformation, agree with experimentally obtained constant of paramagnetic birefringence (mP e ) of complex 1 [ru

  20. Assembly of the Major Light-Harvesting Complex II in Lipid Nanodiscs.

    NARCIS (Netherlands)

    Pandit, A.; Shirzad-Wasei, N.; Wlodarczyk, L.M.; Roon, H. van; Boekema, E.J.; Dekker, J.P.; Grip, W.J. de

    2011-01-01

    Self-aggregation of isolated plant light-harvesting complexes (LHCs) upon detergent extraction is associated with fluorescence quenching and is used as an in vitro model to study the photophysical processes of nonphotochemical quenching (NPQ). In the NPQ state, in vivo induced under excess solar

  1. Assembly of the Major Light-Harvesting Complex II in Lipid Nanodiscs

    NARCIS (Netherlands)

    Pandit, Anjali; Shirzad-Wasei, Nazhat; Wlodarczyk, Lucyna M.; van Roon, Henny; Boekema, Egbert J.; Dekker, Jan P.; de Grip, Willem J.; Brown, Leonid S.

    2011-01-01

    Self-aggregation of isolated plant light-harvesting complexes (LHCs) upon detergent extraction is associated with fluorescence quenching and is used as an in vitro model to study the photophysical processes of nonphotochemical quenching (NPQ). In the NPQ state, in vivo induced under excess solar

  2. Carotenoid-binding sites of the major light-harvesting complex II of higher plants

    NARCIS (Netherlands)

    Croce, Roberta; Weiss, Saskia; Bassi, Roberto

    1999-01-01

    Recombinant light-harvesting complex II (LHCII) proteins with modified carotenoid composition have been obtained by in vitro reconstitution of the Lhcb1 protein overexpressed in bacteria. The monomeric protein possesses three xanthophyll-binding sites. The L1 and L2 sites, localized by electron

  3. Lateral gene transfer of an ABC transporter complex between major constituents of the human gut microbiome

    Directory of Open Access Journals (Sweden)

    Meehan Conor J

    2012-11-01

    Full Text Available Abstract Background Several links have been established between the human gut microbiome and conditions such as obesity and inflammatory bowel syndrome. This highlights the importance of understanding what properties of the gut microbiome can affect the health of the human host. Studies have been undertaken to determine the species composition of this microbiome and infer functional profiles associated with such host properties. However, lateral gene transfer (LGT between community members may result in misleading taxonomic attributions for the recipient organisms, thus making species-function links difficult to establish. Results We identified a peptides/nickel transport complex whose components differed in abundance based upon levels of host obesity, and assigned the encoded proteins to members of the microbial community. Each protein was assigned to several distinct taxonomic groups, with moderate levels of agreement observed among different proteins in the complex. Phylogenetic trees of these proteins produced clusters that differed greatly from taxonomic attributions and indicated that habitat-directed LGT of this complex is likely to have occurred, though not always between the same partners. Conclusions These findings demonstrate that certain membrane transport systems may be an important factor within an obese-associated gut microbiome and that such complexes may be acquired several times by different strains of the same species. Additionally, an example of individual proteins from different organisms being transferred into one operon was observed, potentially demonstrating a functional complex despite the donors of the subunits being taxonomically disparate. Our results also highlight the potential impact of habitat-directed LGT on the resident microbiota.

  4. Omphalocele, exstrophy of cloaca, imperforate anus, and spinal defect complex, multiple major reconstructive surgeries needed

    Directory of Open Access Journals (Sweden)

    Nada Neel

    2018-01-01

    Full Text Available OEIS complex is a rare combination of serious birth defects including omphalocele, exstrophy of cloaca, imperforate anus, and spinal defects. The aim of managements has shifted from merely providing survival to improve patient outcomes and quality of life with higher level of physical and social independence. Multiple complicated reconstructive surgeries always needed for achieving the goals of treatment. In this case report, we aimed to present our surgical approach for this rare abnormality to achieve functionally and socially acceptable outcome.

  5. Functional abdominal pain disorders in children

    NARCIS (Netherlands)

    Rajindrajith, Shaman; Zeevenhooven, Judith; Devanarayana, Niranga Manjuri; Perera, Bonaventure Jayasiri Crispus; Benninga, Marc A.

    2018-01-01

    Chronic abdominal pain is a common problem in pediatric practice. The majority of cases fulfill the Rome IV criteria for functional abdominal pain disorders (FAPDs). At times, these disorders may lead to rather serious repercussions. Area covered: We have attempted to cover current knowledge on

  6. Shared fine specificity between T-cell receptors and an antibody recognizing a peptide/major histocompatibility class I complex

    DEFF Research Database (Denmark)

    Stryhn, A; Andersen, P S; Pedersen, L O

    1996-01-01

    Cytotoxic T cells recognize mosaic structures consisting of target peptides embedded within self-major histocompatibility complex (MHC) class I molecules. This structure has been described in great detail for several peptide-MHC complexes. In contrast, how T-cell receptors recognize peptide...... each other showing that peptide residues 1, 3, 4, 6, and 7 were exposed on the MHC surface and recognized by the T cells. Thus, the majority, and perhaps all, of the side chains of the non-primary anchor residues may be available for T-cell recognition, and contribute to the stringent specificity of T...... cells. A striking similarity between the specificity of the T cells and that of the pSAN antibody was found and most of the peptide residues, which could be recognized by the T cells, could also be recognized by the antibody....

  7. High-resolution metagenomics targets major functional types in complex microbial communities

    Energy Technology Data Exchange (ETDEWEB)

    Kalyuzhnaya, Marina G.; Lapidus, Alla; Ivanova, Natalia; Copeland, Alex C.; McHardy, Alice C.; Szeto, Ernest; Salamov, Asaf; Grigoriev, Igor V.; Suciu, Dominic; Levine, Samuel R.; Markowitz, Victor M.; Rigoutsos, Isidore; Tringe, Susannah G.; Bruce, David C.; Richardson, Paul M.; Lidstrom, Mary E.; Chistoserdova, Ludmila

    2009-08-01

    Most microbes in the biosphere remain uncultured and unknown. Whole genome shotgun (WGS) sequencing of environmental DNA (metagenomics) allows glimpses into genetic and metabolic potentials of natural microbial communities. However, in communities of high complexity metagenomics fail to link specific microbes to specific ecological functions. To overcome this limitation, we selectively targeted populations involved in oxidizing single-carbon (C{sub 1}) compounds in Lake Washington (Seattle, USA) by labeling their DNA via stable isotope probing (SIP), followed by WGS sequencing. Metagenome analysis demonstrated specific sequence enrichments in response to different C{sub 1} substrates, highlighting ecological roles of individual phylotypes. We further demonstrated the utility of our approach by extracting a nearly complete genome of a novel methylotroph Methylotenera mobilis, reconstructing its metabolism and conducting genome-wide analyses. This approach allowing high-resolution genomic analysis of ecologically relevant species has the potential to be applied to a wide variety of ecosystems.

  8. A major light rare-earth element (LREE) resource in the Khanneshin carbonatite complex, southern Afghanistan

    Science.gov (United States)

    Tucker, Robert D.; Belkin, Harvey E.; Schulz, Klaus J.; Peters, Stephen G.; Horton, Forrest; Buttleman, Kim; Scott, Emily R.

    2012-01-01

    The rapid rise in world demand for the rare-earth elements (REEs) has expanded the search for new REE resources. We document two types of light rare-earth element (LREE)-enriched rocks in the Khanneshin carbonatite complex of southern Afghanistan: type 1 concordant seams of khanneshite-(Ce), synchysite-(Ce), and parisite-(Ce) within banded barite-strontianite alvikite, and type 2 igneous dikes of coarse-grained carbonatite, enriched in fluorine or phosphorus, containing idiomorphic crystals of khanneshite-(Ce) or carbocernaite. Type 1 mineralized barite-strontianite alvikite averages 22.25 wt % BaO, 4.27 wt % SrO, and 3.25 wt % ∑ LREE2O3 (sum of La, Ce, Pr, and Nd oxides). Type 2 igneous dikes average 14.51 wt % BaO, 5.96 wt % SrO, and 3.77 wt % ∑ LREE2O3. A magmatic origin is clearly indicated for the type 2 LREE-enriched dikes, and type 1 LREE mineralization probably formed in the presence of LREE-rich hydrothermal fluid. Both types of LREE mineralization may be penecontemporaneous, having formed in a carbonate-rich magma in the marginal zone of the central vent, highly charged with volatile constituents (i.e., CO2, F, P2O5), and strongly enriched in Ba, Sr, and the LREE. Based on several assumptions, and employing simple geometry for the zone of LREE enrichment, we estimate that at least 1.29 Mt (million metric tonnes) of LREE2O3 is present in this part of the Khanneshin carbonatite complex.

  9. Evaluation of two approaches to genotyping major histocompatibility complex class I in a passerine—CE-SSCP and 454 pyrosequencing

    Czech Academy of Sciences Publication Activity Database

    Promerová, Marta; Babik, W.; Bryja, Josef; Albrecht, Tomáš; Stuglik, M.; Radwan, J.

    2012-01-01

    Roč. 12, č. 2 (2012), s. 285-292 ISSN 1755-098X R&D Projects: GA AV ČR IAA600930608; GA ČR GA206/06/0851; GA ČR GAP505/10/1871 Institutional research plan: CEZ:AV0Z60930519 Keywords : avian * Carpodacus erythrinus * major histocompatibility complex * next-generation sequencing * scarlet rosefinch Subject RIV: EG - Zoology Impact factor: 7.432, year: 2012

  10. Efficient assembly of recombinant major histocompatibility complex class I molecules with preformed disulfide bonds

    DEFF Research Database (Denmark)

    Ostergaard Pedersen, L; Nissen, Mogens Holst; Hansen, N J

    2001-01-01

    The expression of major histocompatibility class I (MHC-I) crucially depends upon the binding of appropriate peptides. MHC-I from natural sources are therefore always preoccupied with peptides complicating their purification and analysis. Here, we present an efficient solution to this problem....... Recombinant MHC-I heavy chains were produced in Escherichia coli and subsequently purified under denaturing conditions. In contrast to common practice, the molecules were not reduced during the purification. The oxidized MHC-I heavy chain isoforms were highly active with respect to peptide binding....... This suggests that de novo folding of denatured MHC-I molecules proceed efficiently if directed by preformed disulfide bond(s). Importantly, these molecules express serological epitopes and stain specific T cells; and they bind peptides specifically. Several denatured MHC-I heavy chains were analyzed and shown...

  11. A complex RARE is required for the majority of Nedd9 embryonic expression.

    Science.gov (United States)

    Knutson, Danielle C; Clagett-Dame, Margaret

    2015-02-01

    Neural precursor cell expressed, developmentally down-regulated 9 (Nedd9, Casl, Hef1, p105cas, Ef1) is a scaffolding protein that assembles complexes involved in regulating cell adhesion, migration, division, and survival. Nedd9 is found very early in the developing embryonic nervous system. A highly conserved complex retinoic acid response element (RARE) is located 485 base pairs (bp) upstream of exon 2B in the promoter of the Nedd9 gene. Mice transgenic for a 5.2 kilobase (kb) region of the 2B Nedd9 promoter containing the RARE upstream of a lacZ reporter gene [Nedd9(RARE)-lacZ] show a large subset of the normal endogenous Nedd9 expression including that in the caudal hindbrain neuroepithelium, spinal cord, dorsal root ganglia (drg) and migrating neural crest (ncc). However, the transgenic mice do not recapitulate the native Nedd9 expression pattern in presumptive rhombomeres (pr) 3 and 5 of the early hindbrain, the base of the neuroepithelium in the midbrain, nor the forebrain telencephalon. Thus, the 5.2 kb region containing the intact RARE drives a large subset of Nedd9 expression, with additional sequences outside of this region needed to define the full complement of expression. When the 5.2 kb construct is modified (eight point mutations) to eliminate responsiveness of the RARE to all-trans retinoic acid (atRA) [Nedd9(mutRARE)-lacZ], virtually all β-galactosidase (β-gal, lacZ) expression is lost. Exposure of Nedd9(RARE)-lacZ transgenic embryos to excess atRA at embryonic day 8.0 (E8.0) leads to rostral ectopic transgene expression within 6 h whereas the Nedd9(mutRARE)-lacZ mutant does not show this effect. Thus the RARE upstream of the Nedd9 2B promoter is necessary for much of the endogenous gene expression during early development as well as ectopic expression in response to atRA.

  12. The outermost N-terminal region of tapasin facilitates folding of major histocompatibility complex class I

    DEFF Research Database (Denmark)

    Røder, Gustav Andreas; Geironson, Linda; Darabi, Anna

    2009-01-01

    ). Using a biochemical peptide-MHC-I-binding assay, recombinant Tpn(1-87) was found to specifically facilitate peptide-dependent folding of HLA-A*0201. Furthermore, we used Tpn(1-87) to generate a monoclonal antibody, alphaTpn(1-87)/80, specific for natural human Tpn and capable of cellular staining of ER......Tapasin (Tpn) is an ER chaperone that is uniquely dedicated to MHC-I biosynthesis. It binds MHC-I molecules, integrates them into peptide-loading complexes, and exerts quality control of the bound peptides; only when an "optimal peptide" is bound will the MHC-I be released and exported to the cell...... surface for presentation to T cells. The exact mechanisms of Tpn quality control and the criteria for being an optimal peptide are still unknown. Here, we have generated a recombinant fragment of human Tpn, Tpn(1-87) (representing the 87 N-terminal and ER-luminal amino acids of the mature Tpn protein...

  13. Thoracic epidural anaesthesia for major abdominal surgeries ...

    African Journals Online (AJOL)

    The pulse rate, blood pressure and oxygen saturation were monitored throughout the procedure and recorded. Data were obtained from the ... In a previous study, Consani et al.3 documented the feasibility of thoracic epidural ... thoracostomy and mastectomy in high-risk patients.2,6 Since TEA places less demand on drugs, ...

  14. Complexity of major UK companies between 2006 and 2010: Hierarchical structure method approach

    Science.gov (United States)

    Ulusoy, Tolga; Keskin, Mustafa; Shirvani, Ayoub; Deviren, Bayram; Kantar, Ersin; Çaǧrı Dönmez, Cem

    2012-11-01

    This study reports on topology of the top 40 UK companies that have been analysed for predictive verification of markets for the period 2006-2010, applying the concept of minimal spanning tree and hierarchical tree (HT) analysis. Construction of the minimal spanning tree (MST) and the hierarchical tree (HT) is confined to a brief description of the methodology and a definition of the correlation function between a pair of companies based on the London Stock Exchange (LSE) index in order to quantify synchronization between the companies. A derivation of hierarchical organization and the construction of minimal-spanning and hierarchical trees for the 2006-2008 and 2008-2010 periods have been used and the results validate the predictive verification of applied semantics. The trees are known as useful tools to perceive and detect the global structure, taxonomy and hierarchy in financial data. From these trees, two different clusters of companies in 2006 were detected. They also show three clusters in 2008 and two between 2008 and 2010, according to their proximity. The clusters match each other as regards their common production activities or their strong interrelationship. The key companies are generally given by major economic activities as expected. This work gives a comparative approach between MST and HT methods from statistical physics and information theory with analysis of financial markets that may give new valuable and useful information of the financial market dynamics.

  15. Comparative Evaluation of Pain, Stress, Neuropeptide Y, ACTH, and Cortisol Levels Between a Conventional Postoperative Care Protocol and a Fast-Track Recovery Program in Patients Undergoing Major Abdominal Surgery.

    Science.gov (United States)

    Kapritsou, Maria; Papathanassoglou, Elizabeth D; Bozas, Evangelos; Korkolis, Dimitrios P; Konstantinou, Evangelos A; Kaklamanos, Ioannis; Giannakopoulou, Margarita

    2017-03-01

    Fast-track (FT) postoperative protocol in oncological patients after major abdominal surgery reduces complications and length of postoperative stay compared to the conventional (CON) protocol. However, stress and pain responses have not been compared between the two protocols. To compare stress, pain, and related neuropeptidic responses (adrenocorticotropic hormone [ACTH], cortisol, and neuropeptide Y [NPY]) between FT and CON protocols. A clinical trial with repeated measurements was conducted (May 2012 to May 2014) with a sample of 63 hepatectomized or pancreatectomized patients randomized into two groups: FT ( n = 29) or CON ( n = 34). Demographic and clinical data were collected, and pain (Visual Analog Scale [VAS] and Behavioral Pain Scale [BPS]) and stress responses (3 self-report questions) assessed. NPY, ACTH, and cortisol plasma levels were measured at T1 = day of admission, T2 = day of surgery, and T3 = prior to discharge. ACTH T1 and ACTH T2 levels were positively correlated with self-reported stress levels (ρ = .43 and ρ = .45, respectively, p .05). Neuropeptidic levels were higher in the FT group. Future research should evaluate this association further, as these biomarkers might serve as objective indicators of postoperative pain and stress.

  16. Evaluating the complexity of online patient education materials about brain aneurysms published by major academic institutions.

    Science.gov (United States)

    Gupta, Raghav; Adeeb, Nimer; Griessenauer, Christoph J; Moore, Justin M; Patel, Apar S; Kim, Christopher; Thomas, Ajith J; Ogilvy, Christopher S

    2017-08-01

    OBJECTIVE Health care education resources are increasingly available on the Internet. A majority of people reference these resources at one point or another. A threshold literacy level is needed to comprehend the information presented within these materials. A key component of health literacy is the readability of educational resources. The National Institutes of Health (NIH) and the American Medical Association have recommended that patient education materials be written between a 4th- and a 6th-grade education level. The authors assessed the readability of online patient education materials about brain aneurysms that have been published by several academic institutions across the US. METHODS Online patient education materials about brain aneurysms were downloaded from the websites of 20 academic institutions. The materials were assessed via 8 readability scales using Readability Studio software (Oleander Software Solutions), and then were statistically analyzed. RESULTS None of the patient education materials were written at or below the NIH's recommended 6th-grade reading level. The average educational level required to comprehend the texts across all institutions, as assessed by 7 of the readability scales, was 12.4 ± 2.5 (mean ± SD). The Flesch Reading Ease Scale classified the materials as "difficult" to understand, correlating with a college-level education or higher. An ANOVA test found that there were no significant differences in readability among the materials from the institutions (p = 0.215). CONCLUSIONS Brain aneurysms affect 3.2% of adults 50 years or older across the world and can cause significant patient anxiety and uncertainty. Current patient education materials are not written at or below the NIH's recommended 4th- to 6th-grade education level.

  17. Characterization and 454 pyrosequencing of Major Histocompatibility Complex class I genes in the great tit reveal complexity in a passerine system

    Directory of Open Access Journals (Sweden)

    Sepil Irem

    2012-05-01

    Full Text Available Abstract Background The critical role of Major Histocompatibility Complex (Mhc genes in disease resistance and their highly polymorphic nature make them exceptional candidates for studies investigating genetic effects on survival, mate choice and conservation. Species that harbor many Mhc loci and high allelic diversity are particularly intriguing as they are potentially under strong selection and studies of such species provide valuable information as to the mechanisms maintaining Mhc diversity. However comprehensive genotyping of complex multilocus systems has been a major challenge to date with the result that little is known about the consequences of this complexity in terms of fitness effects and disease resistance. Results In this study, we genotyped the Mhc class I exon 3 of the great tit (Parus major from two nest-box breeding populations near Oxford, UK that have been monitored for decades. Characterization of Mhc class I exon 3 was adopted and bidirectional sequencing was carried using the 454 sequencing platform. Full analysis of sequences through a stepwise variant validation procedure allowed reliable typing of more than 800 great tits based on 214,357 reads; from duplicates we estimated the repeatability of typing as 0.94. A total of 862 alleles were detected, and the presence of at least 16 functional loci was shown - the highest number characterized in a wild bird species. Finally, the functional alleles were grouped into 17 supertypes based on their antigen binding affinities. Conclusions We found extreme complexity at the Mhc class I of the great tit both in terms of allelic diversity and gene number. The presence of many functional loci was shown, together with a pseudogene family and putatively non-functional alleles; there was clear evidence that functional alleles were under strong balancing selection. This study is the first step towards an in-depth analysis of this gene complex in this species, which will help

  18. Nutritional risk in major abdominal surgery: NURIMAS Liver (DRKS00010923 – protocol of a prospective observational trial to evaluate the prognostic value of different nutritional scores in hepatic surgery

    Directory of Open Access Journals (Sweden)

    Pascal Probst

    Full Text Available Background: Malnutrition is commonly known as a risk factor in surgical procedures. The nutritional status seems particularly relevant to the clinical outcome of patients undergoing hepatic resection. Thus, identifying affected individuals and taking preventive therapeutic actions before surgery is an important task. However, there are only very few studies, that investigate which existing nutritional assessment score (NAS is suited best to predict the postoperative outcome in liver surgery. Objective: Nutritional Risk in Major Abdominal Surgery (NURIMAS Liver is a prospective observational trial that analyses the predictive value of 12 different NAS for postoperative morbidity and mortality after liver resection. Methods: After admission to the surgical department of the University Hospital in Heidelberg or the municipal hospital of Karlsruhe, all patients scheduled for elective liver resection will be screened for eligibility. Participants will fill in a questionnaire and undergo a physical examination in order to evaluate nutritional status according to Nutritional Risk Index, Nutritional Risk Screening Score, Subjective Global Assessment, Malnutrition Universal Screening Tool, Mini Nutritional Assessment, Short Nutritional Assessment Questionnaire, Imperial Nutritional Screening System, Imperial Nutritional Screening System II, Nutritional Risk Classification and the ESPEN malnutrition criteria. Postoperative morbidity and mortality will be tracked prospectively throughout the postoperative course. The association of malnutrition according to each score and occurrence of at least one major complication will be analysed using both chi-squared tests and a multivariable logistic regression analysis. Already established risk factors in liver surgery will be added as covariates. Discussion: NURIMAS Liver is a bicentric, prospective observational trial. The aim of this study is to investigate the predictive value of clinical nutritional assessment

  19. One Stage Emergency Pancreatoduodenectomy for Isolated Injury to Pancreatic Head Following Blunt Abdominal Trauma: Case Report and Review of Literature

    OpenAIRE

    Sumanta Kumar Ghosh

    2013-01-01

    Major pancreatic injury following blunt abdominal trauma by itself is a relatively rare occurrence, and in vast majority of cases (95%) it is associated with injury to adjacent major vessels and organs; thus making isolated major pancreatic injury even rarer. While most pancreatic injuries are managed by simple measures like debridement and drainage, complex proximal injury poses surgical challenge regarding surgical skill and judgement. Disproportionate approach at any stage of management ...

  20. Abdominal wall hernia and pregnancy

    DEFF Research Database (Denmark)

    Jensen, K K; Henriksen, N A; Jorgensen, L N

    2015-01-01

    PURPOSE: There is no consensus as to the treatment strategy for abdominal wall hernias in fertile women. This study was undertaken to review the current literature on treatment of abdominal wall hernias in fertile women before or during pregnancy. METHODS: A literature search was undertaken in Pub......Med and Embase in combination with a cross-reference search of eligible papers. RESULTS: We included 31 papers of which 23 were case reports. In fertile women undergoing sutured or mesh repair, pain was described in a few patients during the last trimester of a subsequent pregnancy. Emergency surgery...... of incarcerated hernias in pregnant women, as well as combined hernia repair and cesarean section appears as safe procedures. No major complications were reported following hernia repair before or during pregnancy. The combined procedure of elective cesarean section and abdominal wall hernia repair was reported...

  1. Abdominal Aortic Aneurysm (AAA)

    Science.gov (United States)

    ... Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis or plaque buildup causes the ... weak and bulge outward like a balloon. An AAA develops slowly over time and has few noticeable ...

  2. Abdominal wall fat pad biopsy

    Science.gov (United States)

    Amyloidosis - abdominal wall fat pad biopsy; Abdominal wall biopsy; Biopsy - abdominal wall fat pad ... is the most common method of taking an abdominal wall fat pad biopsy . The health care provider cleans the ...

  3. Clinical, immunological and genetic features in eleven Algerian patients with major histocompatibility complex class II expression deficiency

    Directory of Open Access Journals (Sweden)

    Djidjik Réda

    2012-08-01

    Full Text Available Abstract Presenting processed antigens to CD4+ lymphocytes during the immune response involves major histocompatibility complex class II molecules. MHC class II genes transcription is regulated by four transcription factors: CIITA, RFXANK, RFX5 and RFXAP. Defects in these factors result in major histocompatibility complex class II expression deficiency, a primary combined immunodeficiency frequent in North Africa. Autosomal recessive mutations in the RFXANK gene have been reported as being the principal defect found in North African patients with this disorder. In this paper, we describe clinical, immunological and genetic features of 11 unrelated Algerian patients whose monocytes display a total absence of MHC class II molecules. They shared mainly the same clinical picture which included protracted diarrhoea and respiratory tract recurrent infections. Genetic analysis revealed that 9 of the 11 patients had the same RFXANK founder mutation, a 26 bp deletion (named I5E6-25_I5E6+1, also known as 752delG26. Immunological and genetic findings in our series may facilitate genetic counselling implementation for Algerian consanguineous families. Further studies need to be conducted to determine 752delG26 heterozygous mutation frequency in Algerian population.

  4. The economics of nuclear energy revisited: lessons from the use of a complex technology subject to major accidents

    International Nuclear Information System (INIS)

    Finon, D.

    2012-01-01

    The Fukushima accident again raises the issue of the social and economic viability of nuclear technology. To reassess this viability, we analyze the methods used to internalize the external costs of nuclear energy. These have over time become increasingly complex technologically and specifically affected by major accidents. This combination has served to upset the classical learning curve, calling into question nuclear cost base, social acceptance in the face of climate change and profitability for investors. It has become essential to put in place independent institutions to regulate the safety aspect of nuclear technology and these form a hindrance to its standardization, in turn affecting competitiveness. Nevertheless, the paper argues that the new sequence of internalization of external costs triggered by Fukushima will have limited effects on overall costs, because of previous measures already taken to improve safety. The complexity of nuclear technology is reaching its asymptote: the challenge of 'learning from major accidents' will decrease. On the other hand, the independence and competence of nuclear safety authorities in all countries must be revamped to maximize safety and minimize residual risks. This cannot just be done by decree. However, it is the only way to preserve this global public good - the social acceptance of nuclear technology

  5. Hard wiring of T cell receptor specificity for the major histocompatibility complex is underpinned by TCR adaptability

    Energy Technology Data Exchange (ETDEWEB)

    Burrows, Scott R.; Chen, Zhenjun; Archbold, Julia K.; Tynan, Fleur E.; Beddoe, Travis; Kjer-Nielsen, Lars; Miles, John J.; Khanna, Rajiv; Moss, Denis J.; Liu, Yu Chih; Gras, Stephanie; Kostenko, Lyudmila; Brennan, Rebekah M.; Clements, Craig S.; Brooks, Andrew G.; Purcell, Anthony W.; McCluskey, James; Rossjohn, Jamie (Monash); (Queensland Inst. of Med. Rsrch.); (Melbourne)

    2010-07-07

    {alpha}{beta} T cell receptors (TCRs) are genetically restricted to corecognize peptide antigens bound to self-major histocompatibility complex (pMHC) molecules; however, the basis for this MHC specificity remains unclear. Despite the current dogma, evaluation of the TCR-pMHC-I structural database shows that the nongermline-encoded complementarity-determining region (CDR)-3 loops often contact the MHC-I, and the germline-encoded CDR1 and -2 loops frequently participate in peptide-mediated interactions. Nevertheless, different TCRs adopt a roughly conserved docking mode over the pMHC-I, in which three MHC-I residues (65, 69, and 155) are invariably contacted by the TCR in one way or another. Nonetheless, the impact of mutations at these three positions, either individually or together, was not uniformly detrimental to TCR recognition of pHLA-B*0801 or pHLA-B*3508. Moreover, when TCR-pMHC-I recognition was impaired, this could be partially restored by expression of the CD8 coreceptor. The structure of a TCR-pMHC-I complex in which these three (65, 69, and 155) MHC-I positions were all mutated resulted in shifting of the TCR footprint relative to the cognate complex and formation of compensatory interactions. Collectively, our findings reveal the inherent adaptability of the TCR in maintaining peptide recognition while accommodating changes to the central docking site on the pMHC-I.

  6. The combination of major histocompatibility complex (MHC) and non-MHC genes influences murine lymphocytic choriomeningitis virus pathogenesis

    DEFF Research Database (Denmark)

    Eyler, Y L; Pfau, C J; Broomhall, K S

    1989-01-01

    with the recessive disease phenotype. In all cases, susceptibility was dominant. In backcross progeny obtained from matings of parental strains differing in both major histocompatibility complex (MHC) and non-MHC (SWR; C3H), 90% of the challenged mice died, indicating that at least three loci controlled...... susceptibility to the disease. When the parental strains carried similar MHC haplotypes but dissimilar background genes (B10.BR; CBA), 78% of the backcross mice succumbed, indicating that at least two non-MHC loci influenced disease susceptibility. It is unlikely, however, that the same two non-MHC loci...... are critical in all genetic combinations, since F1 produced from two H-2 identical, resistant strains (B10.BR; C3H) were found to be fully susceptible. When congenic mice, differing only in the D-end of the MHC region, were analysed, 50% of the backcross animals died, indicating that one gene in the MHC region...

  7. Evidence of major genes affecting stress response in rainbow trout using Bayesian methods of complex segregation analysis

    DEFF Research Database (Denmark)

    Vallejo, R L; Rexroad III, C E; Silverstein, J T

    2009-01-01

    As a first step toward the genetic mapping of QTL affecting stress response variation in rainbow trout, we performed complex segregation analyses (CSA) fitting mixed inheritance models of plasma cortisol by using Bayesian methods in large full-sib families of rainbow trout. To date, no studies have...... been conducted to determine the mode of inheritance of stress response as measured by plasma cortisol response when using a crowding stress paradigm and CSA in rainbow trout. The main objective of this study was to determine the mode of inheritance of plasma cortisol after a crowding stress....... The results from fitting mixed inheritance models with Bayesian CSA suggest that 1 or more major genes with dominant cortisol-decreasing alleles and small additive genetic effects of a large number of independent genes likely underlie the genetic variation of plasma cortisol in the rainbow trout families...

  8. In vivo immunologic selection of class I major histocompatibility complex gene deletion variants from the B16-BL6 melanoma.

    Science.gov (United States)

    Talmadge, J E; Talmadge, C B; Zbar, B; McEwen, R; Meeker, A K; Tribble, H

    1987-06-01

    The mechanism by which tumor allografts escape host immunologic attack was investigated. B16-BL6 cells (the bladder 6 subline of the B16 melanoma) (H-2b) were transfected with a gene (Dd) encoding an allogeneic class I major histocompatibility complex antigen. Clones that expressed Dd antigen were injected into the footpads of nonimmune syngeneic mice, syngeneic immune mice, and nude mice. Under conditions of immunologic selection a clone that contained multiple copies of the transfected gene formed variants that lacked the transfected gene. Primary tumors and pulmonary metastases of immunized mice and pulmonary metastases of nonimmunized mice had lost the Dd gene and, in most cases, all of the associated plasmid. In contrast, in immunodeficient nude mice, primary tumors and pulmonary metastases retained the Dd gene and the associated plasmid. Deletion of genes encoding cell surface antigens may be one of the mechanisms by which allogeneic tumors escape immunologic attack.

  9. New horizons in mouse immunoinformatics: reliable in silico prediction of mouse class I histocompatibility major complex peptide binding affinity.

    Science.gov (United States)

    Hattotuwagama, Channa K; Guan, Pingping; Doytchinova, Irini A; Flower, Darren R

    2004-11-21

    Quantitative structure-activity relationship (QSAR) analysis is a main cornerstone of modern informatic disciplines. Predictive computational models, based on QSAR technology, of peptide-major histocompatibility complex (MHC) binding affinity have now become a vital component of modern day computational immunovaccinology. Historically, such approaches have been built around semi-qualitative, classification methods, but these are now giving way to quantitative regression methods. The additive method, an established immunoinformatics technique for the quantitative prediction of peptide-protein affinity, was used here to identify the sequence dependence of peptide binding specificity for three mouse class I MHC alleles: H2-D(b), H2-K(b) and H2-K(k). As we show, in terms of reliability the resulting models represent a significant advance on existing methods. They can be used for the accurate prediction of T-cell epitopes and are freely available online ( http://www.jenner.ac.uk/MHCPred).

  10. Major histocompatibility complex harbors widespread genotypic variability of non-additive risk of rheumatoid arthritis including epistasis.

    Science.gov (United States)

    Wei, Wen-Hua; Bowes, John; Plant, Darren; Viatte, Sebastien; Yarwood, Annie; Massey, Jonathan; Worthington, Jane; Eyre, Stephen

    2016-04-25

    Genotypic variability based genome-wide association studies (vGWASs) can identify potentially interacting loci without prior knowledge of the interacting factors. We report a two-stage approach to make vGWAS applicable to diseases: firstly using a mixed model approach to partition dichotomous phenotypes into additive risk and non-additive environmental residuals on the liability scale and secondly using the Levene's (Brown-Forsythe) test to assess equality of the residual variances across genotype groups per marker. We found widespread significant (P 5e-05) vGWAS signals within the major histocompatibility complex (MHC) across all three study cohorts of rheumatoid arthritis. We further identified 10 epistatic interactions between the vGWAS signals independent of the MHC additive effects, each with a weak effect but jointly explained 1.9% of phenotypic variance. PTPN22 was also identified in the discovery cohort but replicated in only one independent cohort. Combining the three cohorts boosted power of vGWAS and additionally identified TYK2 and ANKRD55. Both PTPN22 and TYK2 had evidence of interactions reported elsewhere. We conclude that vGWAS can help discover interacting loci for complex diseases but require large samples to find additional signals.

  11. Genomic polymorphism, recombination, and linkage disequilibrium in human major histocompatibility complex-encoded antigen-processing genes.

    Science.gov (United States)

    van Endert, P M; Lopez, M T; Patel, S D; Monaco, J J; McDevitt, H O

    1992-01-01

    Recently, two subunits of a large cytosolic protease and two putative peptide transporter proteins were found to be encoded by genes within the class II region of the major histocompatibility complex (MHC). These genes have been suggested to be involved in the processing of antigenic proteins for presentation by MHC class I molecules. Because of the high degree of polymorphism in MHC genes, and previous evidence for both functional and polypeptide sequence polymorphism in the proteins encoded by the antigen-processing genes, we tested DNA from 27 consanguineous human cell lines for genomic polymorphism by restriction fragment length polymorphism (RFLP) analysis. These studies demonstrate a strong linkage disequilibrium between TAP1 and LMP2 RFLPs. Moreover, RFLPs, as well as a polymorphic stop codon in the telomeric TAP2 gene, appear to be in linkage disequilibrium with HLA-DR alleles and RFLPs in the HLA-DO gene. A high rate of recombination, however, seems to occur in the center of the complex, between the TAP1 and TAP2 genes. Images PMID:1360671

  12. Human major histocompatibility complex contains a minimum of 19 genes between the complement cluster and HLA-B

    International Nuclear Information System (INIS)

    Spies, T.; Bresnahan, M.; Strominger, J.L.

    1989-01-01

    A 600-kilobase (kb) DNA segment from the human major histocompatibility complex (MHC) class III region was isolated by extension of a previous 435-kb chromosome walk. The contiguous series of cloned overlapping cosmids contains the entire 555-kb interval between C2 in the complement gene cluster and HLA-B. This region is known to encode the tumor necrosis factors (TNFs) α and β, B144, and the major heat shock protein HSP70. Moreover, a cluster of genes, BAT1-BAT5 (HLA-B-associated transcripts) have been localized in the vicinity of the genes for TNFα and TNFβ. An additional four genes were identified by isolation of corresponding cDNA clones with cosmid DNA probes. These genes for BAT6-BAT9 were mapped near the gene for C2 within a 120-kb region that includes a HSP70 gene pair. These results, together with complementary data from a similar recent study, indicated the presence of a minimum of 19 genes within the C2-HLA-B interval of the MHC class III region. Although the functional properties of most of these genes are yet unknown, they may be involved in some aspects of immunity. This idea is supported by the genetic mapping of the hematopoietic histocompatibility locus-1 (Hh-1) in recombinant mice between TNFα and H-2S, which is homologous to the complement gene cluster in humans

  13. Child with Abdominal Pain.

    Science.gov (United States)

    Iyer, Rajalakshmi; Nallasamy, Karthi

    2018-01-01

    Abdominal pain is one of the common symptoms reported by children in urgent care clinics. While most children tend to have self-limiting conditions, the treating pediatrician should watch out for underlying serious causes like intestinal obstruction and perforation peritonitis, which require immediate referral to an emergency department (ED). Abdominal pain may be secondary to surgical or non-surgical causes, and will differ as per the age of the child. The common etiologies for abdominal pain presenting to an urgent care clinic are acute gastro-enteritis, constipation and functional abdominal pain; however, a variety of extra-abdominal conditions may also present as abdominal pain. Meticulous history taking and physical examination are the best tools for diagnosis, while investigations have a limited role in treating benign etiologies.

  14. Abdominal Compartment Syndrome

    Directory of Open Access Journals (Sweden)

    Pınar Zeyneloğlu

    2015-04-01

    Full Text Available Intraabdominal hypertension and Abdominal compartment syndrome are causes of morbidity and mortality in critical care patients. Timely diagnosis and treatment may improve organ functions. Intra-abdominal pressure monitoring is vital during evaluation of the patients and in the management algorithms. The incidence, definition and risk factors, clinical presentation, diagnosis and management of intraabdominal hypertension and Abdominal compartment syndrome were reviewed here.

  15. Physicians' Abdominal Auscultation

    DEFF Research Database (Denmark)

    John, Gade; Peter, Kruse; Andersen, Ole Trier

    1998-01-01

    Background: Abdominal auscultation has an important position in the physical examination of the abdomen. Little is known about rater agreement. The aim of this study was to describe rater agreement and thus, indirectly, the value of the examination. Methods: In a semi-virtual setup 12 recordings...... subjects and in patients with intestinal obstruction was acceptable for a clinical examination. Abdominal auscultation is a helpful clinical examination in patients with acute abdominal pain....

  16. Availability of endogenous peptides limits expression of an M3a-Ld major histocompatibility complex class I chimera

    Science.gov (United States)

    1994-01-01

    Taking advantage of our understanding of the peptide specificity of the major histocompatibility complex class I-b molecule M3a, we sought to determine why these molecules are poorly represented on the cell surface. To this end we constructed a chimeric molecule with the alpha 1 and alpha 2 domains of M3a and alpha 3 of Ld thereby allowing use of available monoclonal antibodies to quantify surface expression. Transfected, but not control, B10.CAS2 (H-2M3b) cells were lysed readily by M3a-restricted monoclonal cytotoxic T lymphocytes. Thus, the chimera bound, trafficked, and presented endogenous mitochondrial peptides. However, despite high levels of M3a-Ld mRNA, transfectants were negative by surface staining. This finding was consistent with inefficient trafficking to the cell surface. Incubation at 26 degrees C, thought to permit trafficking of unoccupied heavy (H) chains, resulted in detectable cell surface expression of chimeric molecules. Incubation with exogenous peptide at 26 degrees C (but not at 37 degrees C) greatly enhanced expression of M3a-Ld molecules in a dose- dependent manner, suggesting stabilization of unoccupied molecules. Stable association of beta 2-microglobulin with the chimeric H chain was observed in labeled cell lysates only in the presence of exogenous specific peptide, indicating that peptide is required for the formation of a ternary complex. These results indicate that surface expression of M3a-Ld is limited largely by the steady-state availability of endogenous peptides. Since most known M3a-binding peptides are N- formylated, native M3a may normally be expressed at high levels only during infection by intracellular bacteria. PMID:8270862

  17. Genetic variation in the extended major histocompatibility complex and susceptibility to childhood acute lymphoblastic leukemia: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Kevin Y Urayama

    2013-12-01

    Full Text Available The enduring suspicion that infections and immunologic response may play a role in the etiology of childhood leukemia, particularly acute lymphoblastic leukemia (ALL, is now supported, albeit still indirectly, by numerous epidemiological studies. The cumulative evidence includes, for example, descriptive observations of a peculiar peak incidence at age 2-5 years for ALL in economically developed countries, clustering of cases in situations of population mixing associated with unusual patterns of personal contacts, associations with various proxy measures for immune modulatory exposures early in life, and genetic susceptibility conferred by variation in genes involved in the immune system. In this review, our focus is the extended major histocompatibility complex (xMHC, an approximately 7.6 megabase region that is well-known for its high density of expressed genes, extensive polymorphisms exhibiting complex linkage disequilibrium patterns, and its disproportionately large number of immune-related genes, including human leukocyte antigen (HLA. First discovered through the role they play in transplant rejection, the classical HLA class I (HLA-A, -B, and -C and class II (HLA-DR, HLA-DQ, and HLA-DP molecules reside at the epicenter of the immune response pathways and are now the targets of many disease susceptibility studies, including those for childhood leukemia. The genes encoding the HLA molecules are only a minority of the over 250 expressed genes in the xMHC, and a growing number of studies are beginning to evaluate other loci through targeted investigations or utilizing a mapping approach with a comprehensive screen of the entire region. Here, we review the current epidemiologic evidence available to date regarding genetic variation contained within this highly unique region of the genome and its relationship with childhood ALL risk.

  18. Imaging in the diagnosis of a patient with an intra-abdominal mass

    International Nuclear Information System (INIS)

    Funston, M.R.

    1985-01-01

    There have been rapid and significant developments in the imaging techniques available to the radiologist during the last decade. The clinician investigating an abdominal mass is often baffled by what examinations to request and in what sequence. An attempt is made to simplify this complex problem by outlining the broad principles of the imaging approach. The development of and advances in ultrasonography and CT, both non-invasive techniques, have had a major impact on the pre-operative diagnosis of abdominal masses. Both examinations are rapidly performed and eliminate the wasted man-hours and preparation requested for barium and other contrast-medium examinations. Other techniques discussed are visceral angiography radioisotope scanning and percutaneous fine-needle biopsies. A teamwork approach is advocated because it eliminates unnecessary and costly studies and results in a diagnosis being made with a minimum of hazard, cost and inconvenience to the patient. The author also presents a table of the more common abdominal masses

  19. Two putative subunits of a peptide pump encoded in the human major histocompatability complex class 2 region

    International Nuclear Information System (INIS)

    Bahram, S.; Arnold, D.; Bresnahan, M.; Strominger, J.L.; Spies, T.

    1991-01-01

    The class 2 region of the human major histocompatibility complex (MHC) may encode several genes controlling the processing of endogenous antigen and the presentation of peptide epitopes by MHC class 1 molecules to cytotoxic T lymphocytes. A previously described peptide supply factor (PSF1) is a member of the multidrug-resistance family of transporters and may pump cytosolic peptides into the membrane-bound compartment where class 1 molecules assemble. A second transporter gene, PSF2, was identified 10 kilobases (kb) from PSF1, near the class 2 DOB gene. The complete sequences of PSF1 and PSF2 were determined from cDNA clones. The translation products are closely related in sequence and predicted secondary structure. Both contain a highly conserved ATP-binding fold and share 25% homology in a hydrophobic domain with a tentative number of eight membrane-spanning segments. Based on the principle dimeric organization of these two domains in other transporters, PSF1 and PSF2 may function as complementary subunits, independently as homodimers, or both. Taken together with previous genetic evidence, the coregulation of PSF1 and PSF2 by γ interferon and the to-some-degree coordinate transcription of these genes suggest a common role in peptide-loading of class 1 molecules, although a distinct function of PSF2 cannot be ruled out

  20. Genetic variation of the major histocompatibility complex (MHC class II B gene in the threatened Hume's pheasant, Syrmaticus humiae.

    Directory of Open Access Journals (Sweden)

    Weicai Chen

    Full Text Available Major histocompatibility complex (MHC genes are the most polymorphic genes in vertebrates and encode molecules that play a crucial role in pathogen resistance. As a result of their diversity, they have received much attention in the fields of evolutionary and conservation biology. Here, we described the genetic variation of MHC class II B (MHCIIB exon 2 in a wild population of Hume's pheasant (Syrmaticus humiae, which has suffered a dramatic decline in population over the last three decades across its ranges in the face of heavy exploitation and habitat loss. Twenty-four distinct alleles were found in 73 S. humiae specimens. We found seven shared alleles among four geographical groups as well as six rare MHCIIB alleles. Most individuals displayed between one to five alleles, suggesting that there are at least three MHCIIB loci of the Hume's pheasant. The dN ⁄ dS ratio at putative antigen-binding sites (ABS was significantly greater than one, indicating balancing selection is acting on MHCIIB exon 2. Additionally, recombination and gene conversion contributed to generating MHCIIB diversity in the Hume's pheasant. One to three recombination events and seventy-five significant gene conversion events were observed within the Hume's pheasant MHCIIB loci. The phylogenetic tree and network analysis revealed that the Hume's pheasant alleles do not cluster together, but are scattered through the tree or network indicating a trans-species evolutionary mode. These findings revealed the evolution of the Hume's pheasant MHC after suffering extreme habitat fragmentation.

  1. Signal one and two blockade are both critical for non-myeloablative murine HSCT across a major histocompatibility complex barrier.

    Directory of Open Access Journals (Sweden)

    Kia J Langford-Smith

    Full Text Available Non-myeloablative allogeneic haematopoietic stem cell transplantation (HSCT is rarely achievable clinically, except where donor cells have selective advantages. Murine non-myeloablative conditioning regimens have limited clinical success, partly through use of clinically unachievable cell doses or strain combinations permitting allograft acceptance using immunosuppression alone. We found that reducing busulfan conditioning in murine syngeneic HSCT, increases bone marrow (BM:blood SDF-1 ratio and total donor cells homing to BM, but reduces the proportion of donor cells engrafting. Despite this, syngeneic engraftment is achievable with non-myeloablative busulfan (25 mg/kg and higher cell doses induce increased chimerism. Therefore we investigated regimens promoting initial donor cell engraftment in the major histocompatibility complex barrier mismatched CBA to C57BL/6 allo-transplant model. This requires full myeloablation and immunosuppression with non-depleting anti-CD4/CD8 blocking antibodies to achieve engraftment of low cell doses, and rejects with reduced intensity conditioning (≤75 mg/kg busulfan. We compared increased antibody treatment, G-CSF, niche disruption and high cell dose, using reduced intensity busulfan and CD4/8 blockade in this model. Most treatments increased initial donor engraftment, but only addition of co-stimulatory blockade permitted long-term engraftment with reduced intensity or non-myeloablative conditioning, suggesting that signal 1 and 2 T-cell blockade is more important than early BM niche engraftment for transplant success.

  2. Signal one and two blockade are both critical for non-myeloablative murine HSCT across a major histocompatibility complex barrier.

    Science.gov (United States)

    Langford-Smith, Kia J; Sandiford, Zara; Langford-Smith, Alex; Wilkinson, Fiona L; Jones, Simon A; Wraith, J Ed; Wynn, Robert F; Bigger, Brian W

    2013-01-01

    Non-myeloablative allogeneic haematopoietic stem cell transplantation (HSCT) is rarely achievable clinically, except where donor cells have selective advantages. Murine non-myeloablative conditioning regimens have limited clinical success, partly through use of clinically unachievable cell doses or strain combinations permitting allograft acceptance using immunosuppression alone. We found that reducing busulfan conditioning in murine syngeneic HSCT, increases bone marrow (BM):blood SDF-1 ratio and total donor cells homing to BM, but reduces the proportion of donor cells engrafting. Despite this, syngeneic engraftment is achievable with non-myeloablative busulfan (25 mg/kg) and higher cell doses induce increased chimerism. Therefore we investigated regimens promoting initial donor cell engraftment in the major histocompatibility complex barrier mismatched CBA to C57BL/6 allo-transplant model. This requires full myeloablation and immunosuppression with non-depleting anti-CD4/CD8 blocking antibodies to achieve engraftment of low cell doses, and rejects with reduced intensity conditioning (≤75 mg/kg busulfan). We compared increased antibody treatment, G-CSF, niche disruption and high cell dose, using reduced intensity busulfan and CD4/8 blockade in this model. Most treatments increased initial donor engraftment, but only addition of co-stimulatory blockade permitted long-term engraftment with reduced intensity or non-myeloablative conditioning, suggesting that signal 1 and 2 T-cell blockade is more important than early BM niche engraftment for transplant success.

  3. Major histocompatibility complex class II compatibility, but not class I, predicts mate choice in a bird with highly developed olfaction.

    Science.gov (United States)

    Strandh, Maria; Westerdahl, Helena; Pontarp, Mikael; Canbäck, Björn; Dubois, Marie-Pierre; Miquel, Christian; Taberlet, Pierre; Bonadonna, Francesco

    2012-11-07

    Mate choice for major histocompatibility complex (MHC) compatibility has been found in several taxa, although rarely in birds. MHC is a crucial component in adaptive immunity and by choosing an MHC-dissimilar partner, heterozygosity and potentially broad pathogen resistance is maximized in the offspring. The MHC genotype influences odour cues and preferences in mammals and fish and hence olfactory-based mate choice can occur. We tested whether blue petrels, Halobaena caerulea, choose partners based on MHC compatibility. This bird is long-lived, monogamous and can discriminate between individual odours using olfaction, which makes it exceptionally well suited for this analysis. We screened MHC class I and II B alleles in blue petrels using 454-pyrosequencing and quantified the phylogenetic, functional and allele-sharing similarity between individuals. Partners were functionally more dissimilar at the MHC class II B loci than expected from random mating (p = 0.033), whereas there was no such difference at the MHC class I loci. Phylogenetic and non-sequence-based MHC allele-sharing measures detected no MHC dissimilarity between partners for either MHC class I or II B. Our study provides evidence of mate choice for MHC compatibility in a bird with a high dependency on odour cues, suggesting that MHC odour-mediated mate choice occurs in birds.

  4. Generation of a genomic tiling array of the human Major Histocompatibility Complex (MHC and its application for DNA methylation analysis

    Directory of Open Access Journals (Sweden)

    Ottaviani Diego

    2008-05-01

    Full Text Available Abstract Background The major histocompatibility complex (MHC is essential for human immunity and is highly associated with common diseases, including cancer. While the genetics of the MHC has been studied intensively for many decades, very little is known about the epigenetics of this most polymorphic and disease-associated region of the genome. Methods To facilitate comprehensive epigenetic analyses of this region, we have generated a genomic tiling array of 2 Kb resolution covering the entire 4 Mb MHC region. The array has been designed to be compatible with chromatin immunoprecipitation (ChIP, methylated DNA immunoprecipitation (MeDIP, array comparative genomic hybridization (aCGH and expression profiling, including of non-coding RNAs. The array comprises 7832 features, consisting of two replicates of both forward and reverse strands of MHC amplicons and appropriate controls. Results Using MeDIP, we demonstrate the application of the MHC array for DNA methylation profiling and the identification of tissue-specific differentially methylated regions (tDMRs. Based on the analysis of two tissues and two cell types, we identified 90 tDMRs within the MHC and describe their characterisation. Conclusion A tiling array covering the MHC region was developed and validated. Its successful application for DNA methylation profiling indicates that this array represents a useful tool for molecular analyses of the MHC in the context of medical genomics.

  5. Major Histocompatibility Complex I Mediates Immunological Tolerance of the Trophoblast during Pregnancy and May Mediate Rejection during Parturition

    Directory of Open Access Journals (Sweden)

    Anna Rapacz-Leonard

    2014-01-01

    Full Text Available During pregnancy in larger mammals, the maternal immune system must tolerate the fetus for months while resisting external infection. This tolerance is facilitated by immunological communication between the fetus and the mother, which is mediated by Major Histocompatibility Complex I (MHC I proteins, by leukocytes, and by the cytokines secreted by the leukocytes. Fetal-maternal immunological communication also supports pregnancy by inducing physiological changes in the mother. If the mother “misunderstands” the signal sent by the fetus during pregnancy, the fetus will be miscarried or delivered preterm. Unlike any other maternal organ, the placenta can express paternal antigens. At parturition, paternal antigens are known to be expressed in cows and may be expressed in horses, possibly so that the maternal immune system will reject the placenta and help to expel it. This review compares fetal-maternal crosstalk that is mediated by the immune system in three species with pregnancies that last for nine months or longer: humans, cattle, and horses. It raises the possibility that immunological communication early in pregnancy may prepare the mother for successful expulsion of fetal membranes at parturition.

  6. Major histocompatibility complex-unrestricted cytolytic activity of human T cells: analysis of precursor frequency and effector phenotype

    International Nuclear Information System (INIS)

    Patel, S.S.; Thiele, D.L.; Lipsky, P.E.

    1987-01-01

    The frequency and phenotype of human T cells that mediate major histocompatibility complex (MHC)-unrestricted cytolysis were analyzed. T cell clones were generated by culturing adherent cell-depleted peripheral blood mononuclear cells at a density of 0.3 cell/well with phytohemagglutinin, recombinant interleukin 2 (rIL-2), and irradiated autologous peripheral blood mononuclear cells and/or Epstein-Barr virus-transformed lymphoblastoid cell lines. All of the 198 clones generated by this method were T cells (CD2 + , CD3 + , CD4 + or CD2 + , CD3 + , CD8 + ) that possessed potent lytic activity against K562, an erythroleukemia line sensitive to lysis by human natural killer cells, and Cur, a renal carcinoma cell line resistant to human natural killer activity. Cytolysis, measured by 51 Cr release, was MHC-unrestricted, since the clones were able to lyse MHC class I or class II negative targets, as well as MHC class I and class II negative targets. Although the clones produced tissue necrosis factor/lymphotoxin-like molecules, lysis of Cur of K562 was not mediated by a soluble factor secreted by the clones. These data indicate that the capacity for MHC-unrestricted tumoricidal activity and expression of NKH1 and CD11b, but not CD 16, are properties common to all or nearly all human peripheral blood-derived T cell clones regardless of CD4 or CD8 phenotype

  7. Health Systems Research in a Complex and Rapidly Changing Context: Ethical Implications of Major Health Systems Change at Scale.

    Science.gov (United States)

    MacGregor, Hayley; Bloom, Gerald

    2016-12-01

    This paper discusses health policy and systems research in complex and rapidly changing contexts. It focuses on ethical issues at stake for researchers working with government policy makers to provide evidence to inform major health systems change at scale, particularly when the dynamic nature of the context and ongoing challenges to the health system can result in unpredictable outcomes. We focus on situations where 'country ownership' of HSR is relatively well established and where there is significant involvement of local researchers and close ties and relationships with policy makers are often present. We frame our discussion around two country case studies with which we are familiar, namely China and South Africa and discuss the implications for conducting 'embedded' research. We suggest that reflexivity is an important concept for health system researchers who need to think carefully about positionality and their normative stance and to use such reflection to ensure that they can negotiate to retain autonomy, whilst also contributing evidence for health system change. A research process informed by the notion of reflexive practice and iterative learning will require a longitudinal review at key points in the research timeline. Such review should include the convening of a deliberative process and should involve a range of stakeholders, including those most likely to be affected by the intended and unintended consequences of change. © 2016 The Authors Developing World Bioethics Published by John Wiley & Sons Ltd.

  8. Mate choice for major histocompatibility complex genetic divergence as a bet-hedging strategy in the Atlantic salmon (Salmo salar)

    Science.gov (United States)

    Evans, Melissa L.; Dionne, Mélanie; Miller, Kristina M.; Bernatchez, Louis

    2012-01-01

    Major histocompatibility complex (MHC)-dependent mating preferences have been observed across vertebrate taxa and these preferences are expected to promote offspring disease resistance and ultimately, viability. However, little empirical evidence linking MHC-dependent mate choice and fitness is available, particularly in wild populations. Here, we explore the adaptive potential of previously observed patterns of MHC-dependent mate choice in a wild population of Atlantic salmon (Salmo salar) in Québec, Canada, by examining the relationship between MHC genetic variation and adult reproductive success and offspring survival over 3 years of study. While Atlantic salmon choose their mates in order to increase MHC diversity in offspring, adult reproductive success was in fact maximized between pairs exhibiting an intermediate level of MHC dissimilarity. Moreover, patterns of offspring survival between years 0+ and 1+, and 1+ and 2+ and population genetic structure at the MHC locus relative to microsatellite loci indicate that strong temporal variation in selection is likely to be operating on the MHC. We interpret MHC-dependent mate choice for diversity as a likely bet-hedging strategy that maximizes parental fitness in the face of temporally variable and unpredictable natural selection pressures. PMID:21697172

  9. Clinical, Immunological, and Molecular Findings in Five Patients with Major Histocompatibility Complex Class II Deficiency from India

    Directory of Open Access Journals (Sweden)

    Jahnavi Aluri

    2018-02-01

    Full Text Available Major histocompatibility complex (MHC class II deficiency is a rare autosomal recessive form of primary immunodeficiency disorder (PID characterized by the deficiency of MHC class II molecules. This deficiency affects the cellular and humoral immune response by impairing the development of CD4+ T helper (Th cells and Th cell-dependent antibody production by B cells. Affected children typically present with severe respiratory and gastrointestinal tract infections. Hematopoietic stem cell transplantation (HSCT is the only curative therapy available for treating these patients. This is the first report from India wherein we describe the clinical, immunological, and molecular findings in five patients with MHC class II deficiency. Our patients presented with recurrent lower respiratory tract infection as the most common clinical presentation within their first year of life and had a complete absence of human leukocyte antigen-antigen D-related (HLA-DR expression on B cells and monocytes. Molecular characterization revealed novel mutations in RFAXP, RFX5, and CIITA genes. Despite genetic heterogeneity, these patients were clinically indistinguishable. Two patients underwent HSCT but had a poor survival outcome. Detectable level of T cell receptor excision circles (TRECs were measured in our patients, highlighting that this form of PID may be missed by TREC-based newborn screening program for severe combined immunodeficiency.

  10. HUBUNGAN ANTARA PERTUMBUHAN DENGAN KEBERADAAN GEN TAHAN PENYAKIT MAJOR HISTOCOMPATIBILITY COMPLEX (MHC PADA IKAN MAS (Cyprinus carpio

    Directory of Open Access Journals (Sweden)

    Erma Primanita Hayuningtyas

    2016-04-01

    Full Text Available Wabah penyakit koi herpes virus (KHV di Indonesia yang terjadi sejak tahun 2002 merupakan salah satu faktor yang memicu kemerosotan produksi ikan mas budidaya. Pembentukan strain unggul ikan mas tahan KHV dapat menjadi solusi bagi permasalahan tersebut. Pemilihan genotip ikan mas tahan KHV dengan marka molekuler gen major histocompatibility complex class II (MHC-II, khususnya pada alel Cyca DAB 1*05 akan membantu dalam kegiatan seleksi. Penelitian ini bertujuan untuk mengetahui keberadaan gen MHC-II pada populasi dasar G0 ikan mas strain Rajadanu dan hubungannya dengan pertumbuhan (bobot. Metode deteksi keberadaan gen MHC-II pada dua kelompok ikan dengan ukuran berbeda dilakukan dengan teknik PCR. Hubungan antara pertumbuhan ikan mas dengan persentase kemunculan gen MHC-II dianalisis dengan menggunakan program SPSS (Statistical Package for the Social Sciences, sehingga diperoleh korelasi di antara keduanya. Hasil penelitian menunjukkan bahwa hubungan antara pertumbuhan dengan persentase keberadaan gen MHC-II berkorelasi negatif dengan nilai R = -0,742. Hal ini mengindikasikan bahwa semakin cepat pertumbuhan populasi ikan mas maka semakin sedikit persentase individu yang mempunyai gen MHC-II pada setiap populasi ikan mas. Sehingga populasi ikan mas yang pertumbuhannya lambat memiliki tingkat persentase positif MHC-II lebih tinggi (85,71%-100% dibandingkan populasi ikan mas yang pertumbuhannya cepat (42,86%-85,71%.

  11. Treatment strategy for ruptured abdominal aortic aneurysms.

    Science.gov (United States)

    Davidovic, L

    2014-07-01

    Rupture is the most serious and lethal complication of the abdominal aortic aneurysm. Despite all improvements during the past 50 years, ruptured abdominal aortic aneurysms are still associated with very high mortality. Namely, including patients who die before reaching the hospital, the mortality rate due to abdominal aortic aneurysm rupture is 90%. On the other hand, during the last twenty years, the number of abdominal aortic aneurysms significantly increased. One of the reasons is the fact that in majority of countries the general population is older nowadays. Due to this, the number of degenerative AAA is increasing. This is also the case for patients with abdominal aortic aneurysm rupture. Age must not be the reason of a treatment refusal. Optimal therapeutic option ought to be found. The following article is based on literature analysis including current guidelines but also on my Clinics significant experience. Furthermore, this article show cases options for vascular medicine in undeveloped countries that can not apply endovascular procedures at a sufficient level and to a sufficient extent. At this moment the following is evident. Thirty-day-mortality after repair of ruptured abdominal aortic aneurysms is significantly lower in high-volume hospitals. Due to different reasons all ruptured abdominal aortic aneurysms are not suitable for EVAR. Open repair of ruptured abdominal aortic aneurysm should be performed by experienced open vascular surgeons. This could also be said for the treatment of endovascular complications that require open surgical conversion. There is no ideal procedure for the treatment of AAA. Each has its own advantages and disadvantages, its own limits and complications, as well as indications and contraindications. Future reductions in mortality of ruptured abdominal aortic aneurysms will depend on implementation of population-based screening; on strategies to prevent postoperative organ injury and also on new medical technology

  12. Giant panda BAC library construction and assembly of a 650-kb contig spanning major histocompatibility complex class II region

    Directory of Open Access Journals (Sweden)

    Pan Hui-Juan

    2007-09-01

    Full Text Available Abstract Background Giant panda is rare and endangered species endemic to China. The low rates of reproductive success and infectious disease resistance have severely hampered the development of captive and wild populations of the giant panda. The major histocompatibility complex (MHC plays important roles in immune response and reproductive system such as mate choice and mother-fetus bio-compatibility. It is thus essential to understand genetic details of the giant panda MHC. Construction of a bacterial artificial chromosome (BAC library will provide a new tool for panda genome physical mapping and thus facilitate understanding of panda MHC genes. Results A giant panda BAC library consisting of 205,800 clones has been constructed. The average insert size was calculated to be 97 kb based on the examination of 174 randomly selected clones, indicating that the giant panda library contained 6.8-fold genome equivalents. Screening of the library with 16 giant panda PCR primer pairs revealed 6.4 positive clones per locus, in good agreement with an expected 6.8-fold genomic coverage of the library. Based on this BAC library, we constructed a contig map of the giant panda MHC class II region from BTNL2 to DAXX spanning about 650 kb by a three-step method: (1 PCR-based screening of the BAC library with primers from homologous MHC class II gene loci, end sequences and BAC clone shotgun sequences, (2 DNA sequencing validation of positive clones, and (3 restriction digest fingerprinting verification of inter-clone overlapping. Conclusion The identifications of genes and genomic regions of interest are greatly favored by the availability of this giant panda BAC library. The giant panda BAC library thus provides a useful platform for physical mapping, genome sequencing or complex analysis of targeted genomic regions. The 650 kb sequence-ready BAC contig map of the giant panda MHC class II region from BTNL2 to DAXX, verified by the three-step method, offers a

  13. Major Histocompatibility Complex Genes Map to Two Chromosomes in an Evolutionarily Ancient Reptile, the Tuatara Sphenodon punctatus.

    Science.gov (United States)

    Miller, Hilary C; O'Meally, Denis; Ezaz, Tariq; Amemiya, Chris; Marshall-Graves, Jennifer A; Edwards, Scott

    2015-05-07

    Major histocompatibility complex (MHC) genes are a central component of the vertebrate immune system and usually exist in a single genomic region. However, considerable differences in MHC organization and size exist between different vertebrate lineages. Reptiles occupy a key evolutionary position for understanding how variation in MHC structure evolved in vertebrates, but information on the structure of the MHC region in reptiles is limited. In this study, we investigate the organization and cytogenetic location of MHC genes in the tuatara (Sphenodon punctatus), the sole extant representative of the early-diverging reptilian order Rhynchocephalia. Sequencing and mapping of 12 clones containing class I and II MHC genes from a bacterial artificial chromosome library indicated that the core MHC region is located on chromosome 13q. However, duplication and translocation of MHC genes outside of the core region was evident, because additional class I MHC genes were located on chromosome 4p. We found a total of seven class I sequences and 11 class II β sequences, with evidence for duplication and pseudogenization of genes within the tuatara lineage. The tuatara MHC is characterized by high repeat content and low gene density compared with other species and we found no antigen processing or MHC framework genes on the MHC gene-containing clones. Our findings indicate substantial differences in MHC organization in tuatara compared with mammalian and avian MHCs and highlight the dynamic nature of the MHC. Further sequencing and annotation of tuatara and other reptile MHCs will determine if the tuatara MHC is representative of nonavian reptiles in general. Copyright © 2015 Miller et al.

  14. Selection, trans-species polymorphism, and locus identification of major histocompatibility complex class IIβ alleles of New World ranid frogs

    Science.gov (United States)

    Kiemnec-Tyburczy, Karen M.; Richmond, Jonathan Q.; Savage, Anna E.; Zamudio, Kelly R.

    2010-01-01

    Genes encoded by the major histocompatibility complex (MHC) play key roles in the vertebrate immune system. However, our understanding of the evolutionary processes and underlying genetic mechanisms shaping these genes is limited in many taxa, including amphibians, a group currently impacted by emerging infectious diseases. To further elucidate the evolution of the MHC in frogs (anurans) and develop tools for population genetics, we surveyed allelic diversity of the MHC class II ??1 domain in both genomic and complementary DNA of seven New World species in the genus Rana (Lithobates). To assign locus affiliation to our alleles, we used a "gene walking" technique to obtain intron 2 sequences that flanked MHC class II?? exon 2. Two distinct intron sequences were recovered, suggesting the presence of at least two class II?? loci in Rana. We designed a primer pair that successfully amplified an orthologous locus from all seven Rana species. In total, we recovered 13 alleles and documented trans-species polymorphism for four of the alleles. We also found quantitative evidence of selection acting on amino acid residues that are putatively involved in peptide binding and structural stability of the ??1 domain of anurans. Our results indicated that primer mismatch can result in polymerase chain reaction (PCR) bias, which influences the number of alleles that are recovered. Using a single locus may minimize PCR bias caused by primer mismatch, and the gene walking technique was an effective approach for generating single-copy orthologous markers necessary for future studies of MHC allelic variation in natural amphibian populations. ?? 2010 Springer-Verlag.

  15. Major Histocompatibilty Complex-Restricted Adaptive Immune Responses to CT26 Colon Cancer Cell Line in Mixed Allogeneic Chimera.

    Science.gov (United States)

    Lee, K W; Choi, B; Kim, Y M; Cho, C W; Park, H; Moon, J I; Choi, G-S; Park, J B; Kim, S J

    2017-06-01

    Although the induction of mixed allogeneic chimera shows promising clinical tolerance results in organ transplantation, its clinical relevance as an anti-cancer therapy is yet unknown. We introduced a mixed allogenic chimera setting with the use of a murine colon cancer cell line, CT26, by performing double bone marrow transplantation. We analyzed donor- and recipient-restricted anti-cancer T-cell responses, and phenotypes of subpopulations of T cells. The protocol involves challenging 1 × 10 5 cells of CT26 cells intra-hepatically on day 50 after bone marrow transplantation, and, by use of CT26 lysates and an H-2L d -restricted AH1 pentamer, flow cytometric analysis was performed to detect the generation of cancer-specific CD4 + and CD8 + T cells at various time points. We found that immunocompetence against tumors depends heavily on cancer-specific CD8 + T-cell responses in a major histocompatibility complex-restricted manner; the evidence was further supported by the increase of interferon-γ-secreting CD4 + T cells. Moreover, we demonstrated that during the effector immune response to CT26 cancer challenge, there was a presence of central memory cells (CD62L hi CCR7 + ) as well as effector memory cells (CD62L lo CCR7 - ). Moreover, mixed allogeneic chimeras (BALB/c to C56BL/6 or vice versa) showed similar or heightened immune responses to CT26 cells compared with that of wild-type mice. Our results suggest that the responses of primary immunocompetency and of pre-existing memory T cells against allogeneic cancer are sustained and preserved long-term in a mixed allogeneic chimeric environment. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Genetic wealth, population health: Major histocompatibility complex variation in captive and wild ring-tailed lemurs (Lemur catta).

    Science.gov (United States)

    Grogan, Kathleen E; Sauther, Michelle L; Cuozzo, Frank P; Drea, Christine M

    2017-10-01

    Across species, diversity at the major histocompatibility complex (MHC) is critical to individual disease resistance and, hence, to population health; however, MHC diversity can be reduced in small, fragmented, or isolated populations. Given the need for comparative studies of functional genetic diversity, we investigated whether MHC diversity differs between populations which are open, that is experiencing gene flow, versus populations which are closed, that is isolated from other populations. Using the endangered ring-tailed lemur ( Lemur catta ) as a model, we compared two populations under long-term study: a relatively "open," wild population ( n  = 180) derived from Bezà Mahafaly Special Reserve, Madagascar (2003-2013) and a "closed," captive population ( n  = 121) derived from the Duke Lemur Center (DLC, 1980-2013) and from the Indianapolis and Cincinnati Zoos (2012). For all animals, we assessed MHC-DRB diversity and, across populations, we compared the number of unique MHC-DRB alleles and their distributions. Wild individuals possessed more MHC-DRB alleles than did captive individuals, and overall, the wild population had more unique MHC-DRB alleles that were more evenly distributed than did the captive population. Despite management efforts to maintain or increase genetic diversity in the DLC population, MHC diversity remained static from 1980 to 2010. Since 2010, however, captive-breeding efforts resulted in the MHC diversity of offspring increasing to a level commensurate with that found in wild individuals. Therefore, loss of genetic diversity in lemurs, owing to small founder populations or reduced gene flow, can be mitigated by managed breeding efforts. Quantifying MHC diversity within individuals and between populations is the necessary first step to identifying potential improvements to captive management and conservation plans.

  17. Novel full-length major histocompatibility complex class I allele discovery and haplotype definition in pig-tailed macaques.

    Science.gov (United States)

    Semler, Matthew R; Wiseman, Roger W; Karl, Julie A; Graham, Michael E; Gieger, Samantha M; O'Connor, David H

    2017-11-13

    Pig-tailed macaques (Macaca nemestrina, Mane) are important models for human immunodeficiency virus (HIV) studies. Their infectability with minimally modified HIV makes them a uniquely valuable animal model to mimic human infection with HIV and progression to acquired immunodeficiency syndrome (AIDS). However, variation in the pig-tailed macaque major histocompatibility complex (MHC) and the impact of individual transcripts on the pathogenesis of HIV and other infectious diseases is understudied compared to that of rhesus and cynomolgus macaques. In this study, we used Pacific Biosciences single-molecule real-time circular consensus sequencing to describe full-length MHC class I (MHC-I) transcripts for 194 pig-tailed macaques from three breeding centers. We then used the full-length sequences to infer Mane-A and Mane-B haplotypes containing groups of MHC-I transcripts that co-segregate due to physical linkage. In total, we characterized full-length open reading frames (ORFs) for 313 Mane-A, Mane-B, and Mane-I sequences that defined 86 Mane-A and 106 Mane-B MHC-I haplotypes. Pacific Biosciences technology allows us to resolve these Mane-A and Mane-B haplotypes to the level of synonymous allelic variants. The newly defined haplotypes and transcript sequences containing full-length ORFs provide an important resource for infectious disease researchers as certain MHC haplotypes have been shown to provide exceptional control of simian immunodeficiency virus (SIV) replication and prevention of AIDS-like disease in nonhuman primates. The increased allelic resolution provided by Pacific Biosciences sequencing also benefits transplant research by allowing researchers to more specifically match haplotypes between donors and recipients to the level of nonsynonymous allelic variation, thus reducing the risk of graft-versus-host disease.

  18. Role of major histocompatibility complex class II in resistance of mice to naturally acquired infection with Syphacia obvelata

    Science.gov (United States)

    Stewart, Patricia W.; Chapes, Stephen K.

    2003-01-01

    Genetics plays a substantial role in host resistance in many host-parasite interactions. We examined the prevalence of naturally acquired infection with Syphacia obvelata in a number of mouse strains housed in a non-barrier facility. These mice, which included cross-bred and congenic, inbred strains on various genetic backgrounds, differ in the loci for the immune function genes--major histocompatibility complex class II (MHCII), toll-like receptor 4 (Tlr4), and solute carrier family 11, member 1 (Slc11a1)--which allowed comparisons of the impact of these genes on resistance to pinworm infection. Male and female mice of various ages were sampled over an 18-month period; infection was determined by use of the cellophane tape test. Results indicated that mice that were MHCII+/+ had a significantly lower prevalence of infection than did mice that were MHCII-/-. Differences were not seen between male and female mice. Although MHCII+/+ mice had an age-associated decrease in infection prevalence, such decrease was not seen in MHCII-/- mice. In contrast, infection prevalence in mice with the normal Tlr4 gene (Tlr4(LPS-n/LPS-n)) gene did not differ significantly compared with that in mice that were homozygous for either the point mutation (Tlr4(LPS-d/LPS-d)) or deletion (Tlr4(LPS-del/LPS-del)) of that gene. Likewise, the presence (Sle11a1r/r) or absence (Slc11a1s/s) of functional alleles for Slc11a1 had no effect on the prevalence of infection with S. obvelata. In conclusion, presence of MHCII, but not Tlr4 or Slc11a1 significantly influences prevalence of naturally acquired infection with S. obvelata. These data justify further comprehensive analyses of the immune components that are involved in pinworm resistance.

  19. Chronic Abdominal Wall Pain.

    Science.gov (United States)

    Koop, Herbert; Koprdova, Simona; Schürmann, Christine

    2016-01-29

    Chronic abdominal wall pain is a poorly recognized clinical problem despite being an important element in the differential diagnosis of abdominal pain. This review is based on pertinent articles that were retrieved by a selective search in PubMed and EMBASE employing the terms "abdominal wall pain" and "cutaneous nerve entrapment syndrome," as well as on the authors' clinical experience. In 2% to 3% of patients with chronic abdominal pain, the pain arises from the abdominal wall; in patients with previously diagnosed chronic abdominal pain who have no demonstrable pathological abnormality, this likelihood can rise as high as 30% . There have only been a small number of clinical trials of treatment for this condition. The diagnosis is made on clinical grounds, with the aid of Carnett's test. The characteristic clinical feature is strictly localized pain in the anterior abdominal wall, which is often mischaracterized as a "functional" complaint. In one study, injection of local anesthesia combined with steroids into the painful area was found to relieve pain for 4 weeks in 95% of patients. The injection of lidocaine alone brought about improvement in 83-91% of patients. Long-term pain relief ensued after a single lidocaine injection in 20-30% of patients, after repeated injections in 40-50% , and after combined lidocaine and steroid injections in up to 80% . Pain that persists despite these treatments can be treated with surgery (neurectomy). Chronic abdominal wall pain is easily diagnosed on physical examination and can often be rapidly treated. Any physician treating patients with abdominal pain should be aware of this condition. Further comparative treatment trials will be needed before a validated treatment algorithm can be established.

  20. Impact of Surgihoney Reactive Oxygen on surgical site infection (SSI after complex abdominal wall reconstruction (AWR of grade 3 and 4 ventral Hernias: A single arm pilot study

    Directory of Open Access Journals (Sweden)

    Sam Parker

    2017-01-01

    Conclusions: This study will provide an assessment of methods and feasibility of recruiting and following up patients who are treated with SHRO. On the basis of this pilot trial, a full trial may be proposed in the future which will provide additional, robust evidence on the clinical and cost effectiveness of SHRO in wound management following AWR. This may act as a model for the management of wounds in complex patients undergoing AWR.

  1. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. ... help diagnose the cause of abdominal or pelvic pain and diseases of the internal organs, small bowel ...

  2. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... the liver, kidneys, pancreas, ovaries and bladder as well as lymphoma. kidney and bladder stones. abdominal aortic ... and properly administer radiation treatments for tumors as well as monitor response to chemotherapy. top of page ...

  3. CT of abdominal abscesses

    International Nuclear Information System (INIS)

    Korobkin, M.T.

    1987-01-01

    The imaging search for a suspected abdominal abscess is common in hospitalized patients, especially after recent abdominal surgery. This paper examines the role of CT in the detection, localization, and treatment of abdominal abscess. The accuracy, limitations, and technical aspects of CT in this clinical setting are discussed. The diagnosis of an abscess is based on the demonstration of a circumscribed abnormal fluid collection. Although percutaneous aspiration with gram stain and culture is usually indicated to differentiate abscess from other fluid collections, the CT-based detection of extraluminal gas bubbles makes the diagnosis of an abscess highly likely. CT is compared with conventional radiographic studies, US, and radio-nuclide imaging. Specific CT and clinical features of abscesses in the following sites are emphasized: subphrenic space, liver, pancreas, kidneys, psoas muscle, appendix, and colonic diverticula. Most abdominal abscesses can be successfully treated with percutaneous drainage techniques. The techniques, results, and limitations of percutaneous abscess drainage are reviewed

  4. Abdominal and Pelvic CT

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    Full Text Available ... intravenous contrast indicate mothers should not breastfeed their babies for 24-48 hours after contrast medium is ... preferred for evaluation of acute abdominal conditions in babies, such as vomiting or blood in stool. For ...

  5. Abdominal and Pelvic CT

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    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much ... CT scan, an experienced radiologist can diagnose many causes of abdominal pain or injury from trauma with ...

  6. Abdominal x-ray

    Science.gov (United States)

    Abdominal film; X-ray - abdomen; Flat plate; KUB x-ray ... There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most ...

  7. Abdominal cocoon: sonographic features.

    Science.gov (United States)

    Vijayaraghavan, S Boopathy; Palanivelu, Chinnusamy; Sendhilkumar, Karuppusamy; Parthasarathi, Ramakrishnan

    2003-07-01

    An abdominal cocoon is a rare condition in which the small bowel is encased in a membrane. The diagnosis is usually established at surgery. Here we describe the sonographic features of this condition.

  8. Abdominal and Pelvic CT

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    Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... GI) contrast exams and ultrasound are preferred for evaluation of acute abdominal conditions in babies, such as ...

  9. Abdominal ultrasound (image)

    Science.gov (United States)

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X- ... use high frequency sound waves to produce an image and do not expose the individual to radiation. ...

  10. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... abdominal conditions in babies, such as vomiting or blood in stool. For some conditions, including but not limited to some liver, kidney, pancreatic, uterine or ... Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  11. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... for tumors as well as monitor response to chemotherapy. top of page How should I prepare? You ... of acute abdominal conditions in babies, such as vomiting or blood in stool. For some conditions, including ...

  12. Abdominal tuberculosis: Imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Jose M. [Department of Radiology, Hospital de S. Joao, Porto (Portugal)]. E-mail: jmpjesus@yahoo.com; Madureira, Antonio J. [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Vieira, Alberto [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Ramos, Isabel [Department of Radiology, Hospital de S. Joao, Porto (Portugal)

    2005-08-01

    Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis.

  13. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as lymphoma. kidney and bladder stones. abdominal aortic aneurysms (AAA), injuries ...

  14. Abdominal tuberculosis: Imaging features

    International Nuclear Information System (INIS)

    Pereira, Jose M.; Madureira, Antonio J.; Vieira, Alberto; Ramos, Isabel

    2005-01-01

    Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis

  15. Major histocompatibility complex (MHC) class III genetics in two Amerindian tribes from southern Brazil: the Kaingang and the Guarani.

    Science.gov (United States)

    Weg-Remers, S; Brenden, M; Schwarz, E; Witzel, K; Schneider, P M; Guerra, L K; Rehfeldt, I R; Lima, M T; Hartmann, D; Petzl-Erler, M L; de Messias, I J; Mauff, G

    1997-10-01

    Population genetic studies of the major histocompatibility complex (MHC) class III region, comprising C2, BF and C4 phenotypes, and molecular genetic data are rarely available for populations other than Caucasoids. We have investigated three Amerindian populations from Southern Brazil: 131 Kaingang from Ivaí (KIV), 111 Kaingang (KRC) and 100 Guarani (GRC) from Rio das Cobras. Extended MHC haplotypes were derived after standard C2, BF, C4 phenotyping and restriction fragment length polymorphism (RFLP) analysis with TaqI, together with HLA data published previously by segregation analysis. C2 and BF frequencies corresponded to other Amerindian populations. C4B*Q0 frequency was high in the GRC (0.429) but low in the Kaingang. Unusual C4 alleles were found, viz. C4A*58, A*55 and C4B*22 (presumably non-Amerindian) and aberrant C4A*3 of Amerindian origin occurring with a frequency of 0.223 in the GRC. C4A*3 bands of homo- and heterozygous individuals carrying this variant were Rodgers 1 positive and Chido 1,3 positive, showed a C4A specific lysis type and a C4A like alpha-chain. Polymerase chain reaction studies and sequencing showed that this is based on a C4A*3 duplication with a regular C4A*3 and a partially converted C4A*0304 carrying the C4B specific epitopes Ch 6 and Ch 1,3. Associations of class III haplotypes with particular RFLP patterns were similar to those reported for Caucasoids. The previously described association between combined C4A and CYP21P deletions and the 6.4 kb TaqI fragment was not seen in these Amerindians. This fragment occurred within a regular two locus gene structure in the Kaingang, representing a "short" gene at C4 locus I. C4 and CYP21 duplications were frequently observed. The distribution of extended MHC haplotypes provides evidence for a close relationship between the KIV and KRC and a larger genetic distance between the two Kaingang groups and the GRC.

  16. Abdominal cerebrospinal fluid pseudocyst

    International Nuclear Information System (INIS)

    Pathi, Ramon; Sage, Michael; Slavotinek, John; Hanieh, Ahmad

    2004-01-01

    A case of an abdominal cerebrospinal fluid (CSF) pseudocyst in a patient with a ventriculoperitoneal shunt is reported to illustrate this known but rare complication. In the setting of a VP shunt, the frequency of abdominal CSF pseudocyst formation is approximately 3.2%, often being precipitated by a recent inflammatory or infective process or recent surgery. Larger pseudocysts tend to be sterile, whereas smaller pseudocysts are more often infected. Ultrasound and CTeach have characteristic findings Copyright (2004) Blackwell Publishing Asia Pty Ltd

  17. Imaging in Tuberculosis abdominal

    International Nuclear Information System (INIS)

    Suarez, Tatiana; Garcia, Vanessa; Tamara, Estrada; Acosta, Federico

    2010-01-01

    In this article we illustrate and discuss imaging features resulting from Tuberculosis abdominal affectation. We present patients evaluated with several imaging modalities who had abdominal symptoms and findings suggestive of granulomatous disease. Diagnosis was confirm including hystopatology and clinical outgoing. Cases involved presented many affected organs such as lymphatic system, peritoneum, liver, spleen, pancreas, kidneys, ureters, adrenal glands and pelvic organs Tuberculosis, Tuberculosis renal, Tuberculosis hepatic, Tuberculosis splenic Tomography, x-ray, computed

  18. A wolf in wolf's clothing the abdominal compartment syndrome

    African Journals Online (AJOL)

    abdomen. These findings are consistent with the diagnosis of intra-abdominal compartment syndrome. In 1 case trauma was remote from the abdomen .... although they tend to develop most often in those who have undergone major vascular operations or suffered abdominal trauma. The effects of the pressure on the bowel ...

  19. Penetrating abdominal injury cases admitted in University of Benin ...

    African Journals Online (AJOL)

    The incidence of penetrating abdominal injuries especially through gunshot injuries is on the increase and is a major cause of morbidity and mortality in our community. Control measures and ways of reducing morbidity and mortality are suggested. Keywords: penetrating abdominal injuries, gun shot injuries. Annals of ...

  20. Connective tissue alteration in abdominal wall hernia

    DEFF Research Database (Denmark)

    Henriksen, N A; Yadete, D H; Sørensen, Lars Tue

    2011-01-01

    The aetiology and pathogenesis of abdominal wall hernia formation is complex. Optimal treatment of hernias depends on a full understanding of the pathophysiological mechanisms involved in their formation. The aim of this study was to review the literature on specific collagen alterations in abdom...

  1. Abdominal emergencies in pediatrics.

    Science.gov (United States)

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  2. Photoprotection in Plants Involves a Change in Lutein 1 Binding Domain in the Major Light-harvesting Complex of Photosystem II

    NARCIS (Netherlands)

    Ilioaia, C.; Johnson, M.P.; Liao, P.N.; Pascal, A.A.; van Grondelle, R.; Walla, P.J.; Ruban, A.V.; Robert, B.

    2011-01-01

    Nonphotochemical quenching (NPQ) is the fundamental process by which plants exposed to high light intensities dissipate the potentially harmful excess energy as heat. Recently, it has been shown that efficient energy dissipation can be induced in the major light-harvesting complexes of photosystem

  3. Chicken major histocompatibility complex-encoded B-G antigens are found on many cell types that are important for the immune system

    DEFF Research Database (Denmark)

    Salomonsen, J; Dunon, D; Skjødt, K

    1991-01-01

    B-G antigens are a polymorphic multigene family of cell surface molecules encoded by the chicken major histocompatibility complex (MHC). They have previously been described only on cells of the erythroid lineage. By using flow cytometry, section staining, and immunoprecipitation with monoclonal a...

  4. Systemic lupus erythematosus : abdominal radiologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jae Cheon; Cho, On Koo; Lee, Yong Joo; Bae, Jae Ik; Kim, Yong Soo; Rhim, Hyun Chul; Ko, Byung Hee [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-06-01

    Systemic lupus erythematosus(SLE) is a systemic disease of unknown etiology. Its main pathology is vasculitis and serositis, due to deposition of the immune complex or antibodies. Most findings are nonspecific ; abdominal manifestations include enteritis, hepatomegaly, pancreatic enlargement, serositis, lymphadenopathy, splenomegaly, nephritis, interstitial cystitis, and thrombophlebitis. We described radiologic findings of various organ involvement of SLE; digestive system, serosa, reticuloendothelial system, urinary system, and venous system. Diagnosis of SLE was done according to the criteria of American Rheumatism Association. Understanding of the variable imaging findings in SLE may be helpful for the early detection of abdominal involvement and complications.

  5. Aortic arch/elephant trunk procedure with Sienna(TM) graft and endovascular stenting of thoraco-abdominal aorta for treatment of complex chronic dissection.

    Science.gov (United States)

    Wong, Randolph H L; Baghai, Max; Yu, Simon C H; Underwood, Malcolm J

    2013-05-01

    Aneurismal dilatation of the remaining thoracic aorta after ascending aortic interposition grafting for type 'A' aortic dissection is not uncommon. For such complex cases, one treatment option is total arch replacement and elephant trunk procedure with the Sienna(TM) collared graft (Vascutek, Inchinnan, UK) technique followed by a staged thoracic endovascular aortic repair (TEVAR). The video illustrates our technique in a 56-year-old man with an extensive aortic arch and descending thoracic aortic dissecting aneurysm. For the 'open' procedure femoral arterial and venous cannulation was used along with systemic cooling and circulatory arrest at 22 °C. Upon circulatory arrest, the aortic arch was incised and antegrade cerebral perfusion achieved via selective cannulation to the right brachiocephalic and left common carotid artery, keeping flow rates at 10-15 mL/kg/min and perfusion pressure at 50-60 mmHg. Arch replacement with an elephant trunk component was then performed and after completion of the distal aortic anastomosis antegrade perfusion via a side-arm in the graft was started and the operation completed using a variation of the 'sequential' clamping technique to maximize cerebral perfusion. The second endovascular stage was performed two weeks after discharge. Two covered stents were landing from the elephant trunk to the distal descending thoracic aorta, to secure the distal landing a bare stent of was placed to cover the aorta just distal to the origin of the celiac axis. The left subclavian artery was embolised with fibre coils. Post TEVAR angiogram showed no endoleak Although re-operative total arch replacement and elephant trunk procedure and subsequent TEVAR remained a challenging procedure, we believe excellent surgical outcome can be achieved with carefully planned operative strategy.

  6. Evaluation of abdominal CT in the initial treatment of abdominal trauma

    International Nuclear Information System (INIS)

    Watanabe, Shinsuke; Ishii, Takashi; Kuwata, Katsuya; Yoneyama, Chihiro; Kitamura, Kazuya; Sasaki, Yoshifumi; Kamachi, Masahiro; Nishiguchi, Hiroyasu.

    1986-01-01

    During the last four years 102 patients with abdominal trauma were examined by CT for preoperative evaluation in our hospital. In 35 patients (34 %), the CT scans revealed no abnormal findings. They were all managed conservatively except for one case of perforated small bowel. In 67 patients (66 %) CT revealed evidences of substantial abdominal or retroperitoneal trauma. In 30 of them CT findings were confirmed by surgery. Hepatic injury is usually easily recognized by CT. CT is also useful for the detection of renal or splenic injuries. The majority of those parenchymatous organ injuries were successfully managed with conservative therapy, despite apparent traumatic lesions revealed by CT. Repeat CT scans is proved to be very useful to follow the changes of these traumatic lesions. In conclusion, application of abdominal CT is extremely useful for the initial decision making in treatment of patients with abdominal trauma and for the follow-up observation of injured lesions. (author)

  7. Abdominal pregnancy - Case presentation.

    Science.gov (United States)

    Bohiltea, R; Radoi, V; Tufan, C; Horhoianu, I A; Bohiltea, C

    2015-01-01

    Abdominal pregnancy, a rare diagnosis, belongs to the ectopic pregnancy group, the leading cause of pregnancy related exitus. The positive diagnosis is very difficult to establish most often in an acute setting, leading to a staggering percent of feto-maternal morbidity and mortality. We present the case of 26-weeks-old abdominal pregnancy with partial feto-placental detachment in a patient, after hysteroscopy and in vitro fertilization, which until the acute symptoms that led to emergency laparotomy went unrecognized. The patient recovered completely and satisfactorily after surgery and, due to the high risk of uterine rupture with regard to a second pregnancy, opted for a surrogate mother. Abdominal pregnancy can be regarded as a difficult to establish diagnosis, with a greater chance in case of increased awareness. It is compulsory to be well informed in order not to be surprised by the diagnosis and to apply the correct treatment immediately as the morbidity and mortality rate is elevated.

  8. T cell responses affected by aminopeptidase N (CD13)-mediated trimming of major histocompatibility complex class II-bound peptides

    DEFF Research Database (Denmark)

    Larsen, S L; Pedersen, L O; Buus, S

    1996-01-01

    Endocytosed protein antigens are believed to be fragmented in what appears to be a balance between proteolysis and MHC-mediated epitope protection, and the resulting peptide-MHC complexes are transported to the surface of the antigen-presenting cells (APC) and presented to T cells. The events tha...

  9. The Mr 30,000-33,000 major protein components of the lateral elements of synaptonemal complexes of the rat

    NARCIS (Netherlands)

    Lammers, H.

    1999-01-01

    Synaptonemal complexes (SCs) are intranuclear structures which are formed during meiotic prophase between homologous chromosomes. The SC consists of two protein-rich axes, either of which is found at the basis of one of the homologous chromosomes. These axes, called lateral elements (LEs),

  10. Laparoscopic surgery in children: abdominal wall complications

    Directory of Open Access Journals (Sweden)

    Vaccaro S.

    2017-06-01

    Full Text Available Minimal invasive surgery has become the standard of care for operations involving the thoracic and abdominal cavities for all ages. Laparoscopic complications can occur as well as more invasive surgical procedures and we can classify them into non-specific and specific. Our goal is to analyze the most influential available scientific literature and to expose important and recognized advices in order to reduce these complications. We examined the mechanism, risk factors, treatment and tried to outline how to prevent two major abdominal wall complications related to laparoscopy: bleeding and port site herniation .

  11. Abdominal paracentesis and thoracocentesis.

    Science.gov (United States)

    Lee, Ser Yee; Pormento, James G; Koong, Heng Nung

    2009-04-01

    Abdominal paracentesis and thoracocentesis are common bedside procedures with diagnostic, therapeutic and palliative roles. We describe a useful and familiar a useful and familiar technique with the use of a multiple lumen catheter commonly used for central venous line insertion for drainage of ascites or moderate to large pleural effusions. The use of a multiple lumen catheter allows easier and more rapid aspiration of fluid with a smaller probability of the side holes being blocked as compared to the standard needle or single catheter methods. This is particularly useful in situations where the dedicated commercial kits for thoracocentesis and abdominal paracentesis are not readily available.

  12. Ultrasonography in abdominal emergencies

    International Nuclear Information System (INIS)

    Risi, D.; Alessi, G.; Meli, C.; Marzano, M.; Fiori, E.; Caterino, S.

    1989-01-01

    From February 1986 to March 1988 113 abdominal US exams were performed in emergency situation to evaluate the accuracy of this methodology: 13 were blunt traumas, 18 post-operative complications. A real-time scanner with a linear probe of 5 MHz was employed. The results were confirmed by surgical and/or clinical and instrumental evaluation. In 81% of the examinations, ultrasonography allowed a diagnosis to be made. Gallbladder and biliary pathologies were the most common findings. The results (sensibility 96%, specificity 88%, accuracy 95%) confirm the affidability of ultrasonography in abdominal emergencies, as shown in literature

  13. Conflicting Ideologies and Language Policy in Adult ESL: Complexities of Language Socialization in a Majority-L1 Classroom

    Science.gov (United States)

    Mori, Miki

    2014-01-01

    This study looks at how language ideologies affect and are revealed in language socialization practices in a majority-L1 adult ESL classroom, particularly looking at language use and policy. It draws on recent theories and critiques of language socialization (Bayley & Langman, 2011; Bronson & Watson-Gegeo, 2008; Garrett &…

  14. Staged abdominal re-operation for abdominal trauma.

    Science.gov (United States)

    Taviloglu, Korhan

    2003-07-01

    To review the current developments in staged abdominal re-operation for abdominal trauma. To overview the steps of damage control laparotomy. The ever increasing importance of the resuscitation phase with current intensive care unit (ICU) support techniques should be emphasized. General surgeons should be familiar to staged abdominal re-operation for abdominal trauma and collaborate with ICU teams, interventional radiologists and several other specialties to overcome this entity.

  15. Abdominal Tuberculosis Mimicking Intra-abdominal Malignancy: A ...

    African Journals Online (AJOL)

    TNHJOURNALPH

    BACKGROUND. Abdominal TB usually presents with nonspecific findings and may thus m.,mw a multitude of gastrointestinal disorders. Abdominal tuberculosis may therefore present as large and palpable intra-abdominal masses usually arising from lymphadenopathy which may mimic lymphomas and other malignancies.

  16. Abdominal tuberculosis mimicking intra-abdominal malignancy: A ...

    African Journals Online (AJOL)

    Background: Abdominal TB usually presents with nonspecific findings and may thus mimic a multitude of gastrointestinal disorders. Abdominal tuberculosis may therefore present as large and palpable intra-abdominal masses usually arising from lymphadenopathy which may mimic lymphomas and other malignancies.

  17. [Effect of β-cyclodextrin inclusion complex on transport of major components of Xiangfu Siwu decoction essential oil in Caco-2 cell monolayer model].

    Science.gov (United States)

    Xi, Jun-zuan; Qian, Da-wei; Duan, Jin-ao; Liu, Pei; Zhu, Yue; Zhu, Zhen-hua; Zhang, Li

    2015-08-01

    Although the essential oil of Xiangfu Siwu decoction (XFSWD) has strong pharmacological activity, its special physical and chemical properties restrict the clinical application and curative effect. In this paper, Xiangfu Siwu decoction essential oil (XFS-WO) was prepared by forming inclusion complex with β-cyclodextrin (β-CD). The present study is to investigate the effect of β-CD inclusion complex on the transport of major components of XFSWO using Caco-2 cell monolayer model, thus to research the effect of this formation on the absorption of drugs with low solubility and high permeability, which belong to class 2 in biopharmaceutics classification system. A sensitive and rapid UPLC-MS/MS method was developed for simultaneous quantification of senkyunolide A, 3-n-butylphthalide, Z-ligustilide, dehydrocostus lactone and α-cyperone, which are active compounds in XFSWO. The transport parameters were analyzed and compared in free oil and its β-CD inclusion complex. The result revealed that the formation of XFSWO/β-CD inclusion complex has significantly increased the transportation and absorption of major active ingredients than free oil. Accordingly, it can be speculated that cyclodextrin inclusion complex can improve bioavailability of poorly water-soluble drugs. Above all these mentioned researches, it provided foundation and basis for physiological disposition and pharmaceutical study of XFSWD.

  18. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... as ulcerative colitis or Crohn's disease , pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as ... injuries to abdominal organs such as the spleen, liver, kidneys or other internal organs in cases of ...

  19. Functional abdominal pain.

    Science.gov (United States)

    Grover, Madhusudan; Drossman, Douglas A

    2010-10-01

    Functional abdominal pain syndrome (FAPS) is a relatively less common functional gastrointestinal (GI) disorder defined by the presence of constant or frequently recurring abdominal pain that is not associated with eating, change in bowel habits, or menstrual periods (Drossman Gastroenterology 130:1377-1390, 2006), which points to a more centrally targeted (spinal and supraspinal) basis for the symptoms. However, FAPS is frequently confused with irritable bowel syndrome and other functional GI disorders in which abdominal pain is associated with eating and bowel movements. FAPS also differs from chronic abdominal pain associated with entities such as chronic pancreatitis or chronic inflammatory bowel disease, in which the pain is associated with peripherally acting factors (eg, gut inflammation or injury). Given the central contribution to the pain experience, concomitant psychosocial disturbances are common and strongly influence the clinical expression of FAPS, which also by definition is associated with loss of daily functioning. These factors make it critical to use a biopsychosocial construct to understand and manage FAPS, because gut-directed treatments are usually not successful in managing this condition.

  20. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... as ulcerative colitis or Crohn's disease , pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and ... abdominal conditions in babies, such as vomiting or blood in stool. For some conditions, including but not limited to some liver, kidney, pancreatic, uterine or ... Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  1. Abdominal wall surgery

    Science.gov (United States)

    ... as liposuction , which is another way to remove fat. But, abdominal wall surgery is sometimes combined with liposuction. ... from the middle and lower sections of your abdomen to make it firmer ... removes excess fat and skin (love handles) from the sides of ...

  2. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... an experienced radiologist can diagnose many causes of abdominal pain or injury from trauma with very high accuracy, ... Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes ... Ultrasound - Abdomen X-ray (Radiography) - Lower GI Tract X-ray ( ...

  3. Abdominal Aortic Aneurysm

    Science.gov (United States)

    ... AAAs don’t cause symptoms unless they leak, tear, or rupture. If this happens, you may experience: sudden pain in your abdomen, groin, back, legs, or buttocks nausea and vomiting abnormal stiffness in your abdominal muscles problems with urination or bowel movements clammy, sweaty ...

  4. Adult abdominal hernias.

    LENUS (Irish Health Repository)

    Murphy, Kevin P

    2014-06-01

    Educational Objectives and Key Points. 1. Given that abdominal hernias are a frequent imaging finding, radiologists not only are required to interpret the appearances of abdominal hernias but also should be comfortable with identifying associated complications and postrepair findings. 2. CT is the imaging modality of choice for the assessment of a known adult abdominal hernia in both elective and acute circumstances because of rapid acquisition, capability of multiplanar reconstruction, good spatial resolution, and anatomic depiction with excellent sensitivity for most complications. 3. Ultrasound is useful for adult groin assessment and is the imaging modality of choice for pediatric abdominal wall hernia assessment, whereas MRI is beneficial when there is reasonable concern that a patient\\'s symptoms could be attributable to a hernia or a musculoskeletal source. 4. Fluoroscopic herniography is a sensitive radiologic investigation for patients with groin pain in whom a hernia is suspected but in whom a hernia cannot be identified at physical examination. 5. The diagnosis of an internal hernia not only is a challenging clinical diagnosis but also can be difficult to diagnose with imaging: Closed-loop small-bowel obstruction and abnormally located bowel loops relative to normally located small bowel or colon should prompt assessment for an internal hernia.

  5. Giant abdominal cystic lymphangioma

    International Nuclear Information System (INIS)

    Vazquez, V.; Florencio, I.; Boluda, F.

    1996-01-01

    We present a case of giant abdominal cystic lymphangioma in a 10-year-old boy. Despite numerous consultations with physicians to identify the underlying problem, it had originally been attributed to ascites of unknown cause. We review the characteristics of this lesion and the diagnostic features that aid in differentiating it from ascites

  6. Endometriosis Abdominal wall

    International Nuclear Information System (INIS)

    Alvarez, M.; Carriquiry, L.

    2003-01-01

    Endometriosis of abdominal wall is a rare entity wi ch frequently appears after gynecological surgery. Case history includes three cases of parietal endometriosis wi ch were treated in Maciel Hospital of Montevideo. The report refers to etiological diagnostic aspects and highlights the importance of total resection in order to achieve definitive healing

  7. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... particularly valuable for evaluating abdominal, pelvic or scrotal pain in children. Preparation will depend on the type ... help a physician determine the source of abdominal pain, such as gallstones, kidney stones, abscesses or an ...

  8. Cell cycle effects of L-sulforaphane, a major antioxidant from cruciferous vegetables: The role of the anaphase promoting complex.

    Science.gov (United States)

    Shelley, Zhaoping; Royce, Simon G; Ververis, Katherine; Karagiannis, Tom C

    2014-01-01

    L-sulforaphane (LSF) is a natural isothiocyanate found in cruciferous vegetables particularly broccoli. LSF has been identified as a potent antioxidant and anti-cancer agent and is widely known to regulate phase II detoxifying enzymes and induce cell cycle arrest or apoptosis in malignant cells in vitro and in vivo. Previous studies have found significant G2/M cell cycle arrest in response to LSF in various model of cancer and results have mainly been attributed to increased cyclin B1 protein levels and increased p21expression. Using genome-wide mRNA-Seq analysis we provide insights into the molecular mechanisms of action of LSF to identify a key pathway in cell cycle progression - the role of the anaphase promoting complex (APC) pathway. We evaluated gene expression changes in human erythroleukemic K562 cells following treatment with 15 μM LSF for 48h and compared them to immortalized human keratinocytes, human microvascular endothelial cells (HMEC-1) cells and normal human umbilical endothelial cells (HUVEC). We identified disparate gene expression changes in response to LSF between malignant and normal cells and immortalized cell lines. The results highlight significant down-regulation of kinase CDK1 which is suggestive that the existence and activity of APC/CDC20 complex will be inhibited along with its associated down-stream degradation of key cell cycle regulators preventing cell cycle progression from mitotic exit.

  9. Engineering a pH-Regulated Switch in the Major Light-Harvesting Complex of Plants (LHCII): Proof of Principle.

    Science.gov (United States)

    Liguori, Nicoletta; Natali, Alberto; Croce, Roberta

    2016-12-15

    Under excess light, photosynthetic organisms employ feedback mechanisms to avoid photodamage. Photoprotection is triggered by acidification of the lumen of the photosynthetic membrane following saturation of the metabolic activity. A low pH triggers thermal dissipation of excess absorbed energy by the light-harvesting complexes (LHCs). LHCs are not able to sense pH variations, and their switch to a dissipative mode depends on stress-related proteins and allosteric cofactors. In green algae the trigger is the pigment-protein complex LHCSR3. Its C-terminus is responsible for a pH-driven conformational change from a light-harvesting to a quenched state. Here, we show that by replacing the C-terminus of the main LHC of plants with that of LHCSR3, it is possible to regulate its excited-state lifetime solely via protonation, demonstrating that the protein template of LHCs can be modified to activate reversible quenching mechanisms independent of external cofactors and triggers.

  10. High resolution X-ray structures of mouse major urinary protein nasal isoform in complex with pheromones

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Miller, Samantha; Zou, Qin; Novotny, Milos V.; Hurley, Thomas D. (Indiana-Med); (Indiana)

    2010-09-07

    In mice, the major urinary proteins (MUP) play a key role in pheromonal communication by binding and transporting semiochemicals. MUP-IV is the only isoform known to be expressed in the vomeronasal mucosa. In comparison with the MUP isoforms that are abundantly excreted in the urine, MUP-IV is highly specific for the male mouse pheromone 2-sec-butyl-4,5-dihydrothiazole (SBT). To examine the structural basis of this ligand preference, we determined the X-ray crystal structure of MUP-IV bound to three mouse pheromones: SBT, 2,5-dimethylpyrazine, and 2-heptanone. We also obtained the structure of MUP-IV with 2-ethylhexanol bound in the cavity. These four structures show that relative to the major excreted MUP isoforms, three amino acid substitutions within the binding calyx impact ligand coordination. The F103 for A along with F54 for L result in a smaller cavity, potentially creating a more closely packed environment for the ligand. The E118 for G substitution introduces a charged group into a hydrophobic environment. The sidechain of E118 is observed to hydrogen bond to polar groups on all four ligands with nearly the same geometry as seen for the water-mediated hydrogen bond network in the MUP-I and MUP-II crystal structures. These differences in cavity size and interactions between the protein and ligand are likely to contribute to the observed specificity of MUP-IV.

  11. A new method for comparing rankings through complex networks: Model and analysis of competitiveness of major European soccer leagues

    Science.gov (United States)

    Criado, Regino; García, Esther; Pedroche, Francisco; Romance, Miguel

    2013-12-01

    In this paper, we show a new technique to analyze families of rankings. In particular, we focus on sports rankings and, more precisely, on soccer leagues. We consider that two teams compete when they change their relative positions in consecutive rankings. This allows to define a graph by linking teams that compete. We show how to use some structural properties of this competitivity graph to measure to what extend the teams in a league compete. These structural properties are the mean degree, the mean strength, and the clustering coefficient. We give a generalization of the Kendall's correlation coefficient to more than two rankings. We also show how to make a dynamic analysis of a league and how to compare different leagues. We apply this technique to analyze the four major European soccer leagues: Bundesliga, Italian Lega, Spanish Liga, and Premier League. We compare our results with the classical analysis of sport ranking based on measures of competitive balance.

  12. To revisit economics of nuclear technology. Lessons from the learning of a complex technology by major accidents

    International Nuclear Information System (INIS)

    Finon, Dominique

    2012-05-01

    The Fukushima accident raises again the issue of the social and economic viability of nuclear technology. To re-evaluate this viability, we analyse the past process of internalisation of external costs of nuclear energy, which present the specificities to be chanted by accidents and has had a constant effect of complexification. This process has provoked a de-organisation of the classical learning process reflected in constant cost increases and the change of social preferences, to end up by the lack of competitiveness before climate policies. Independent institutions of safety regulation have become essential elements of the social embeddedness of nuclear technology at the expense of technology stability and standardization, condition of its competitiveness. In this perspective, the paper argues that the new sequence of social costs' internalization opened by Fukushima will have limited effects on costs, because of anterior steps of safety improvements. Nuclear technology complexification reaches its asymptote: it is being to overcome the challenge of 'learning by major accidents'. On the other hand nuclear institutions must be re-designed in such a way that it could guarantee maximum safety records and minimum residual risks by going to the other root of the safety issue, the degree of independence and capabilities of the safety authorities in every country, what cannot be decreed. It is nevertheless at this price that could be preserved the global public good of the social acceptance of nuclear technology by limiting drastically chance of new accidents. (author)

  13. Plain abdominal radiographs in acute medical emergencies: an abused investigation?

    Science.gov (United States)

    Feyler, S; Williamson, V; King, D

    2002-02-01

    Plain abdominal radiographs are commonly requested for acute medical emergencies on patients with non-specific abdominal symptoms and signs. In this study 131 plain abdominal radiographs performed on the day of admission were prospectively analysed. In only 16 cases (12%) the reasons for requests conformed to the recommended guidelines by the Royal College of Radiologists. The reason for the request was stated in the case notes in only three cases. In 62 cases (47%), there was no comment made on the film by the requesting clinician. There was a discrepancy in the interpretation of the radiograph between the clinician and the radiologist in 31 cases (24%). The clinical management was influenced by plain abdominal radiographs in only nine cases (7%). The majority of plain abdominal radiographs requested on acute medical emergencies is inappropriate. There is a need to ensure guidelines are followed to prevent unnecessary exposure of patients to radiation as well as preventing expenditure on irrelevant investigations.

  14. Population Dynamics Among six Major Groups of the Oryza rufipogon Species Complex, Wild Relative of Cultivated Asian Rice.

    Science.gov (United States)

    Kim, HyunJung; Jung, Janelle; Singh, Namrata; Greenberg, Anthony; Doyle, Jeff J; Tyagi, Wricha; Chung, Jong-Wook; Kimball, Jennifer; Hamilton, Ruaraidh Sackville; McCouch, Susan R

    2016-12-01

    Understanding population structure of the wild progenitor of Asian cultivated rice (O. sativa), the Oryza rufipogon species complex (ORSC), is of interest to plant breeders and contributes to our understanding of rice domestication. A collection of 286 diverse ORSC accessions was evaluated for nuclear variation using genotyping-by-sequencing (113,739 SNPs) and for chloroplast variation using Sanger sequencing (25 polymorphic sites). Six wild subpopulations were identified, with 25 % of accessions classified as admixed. Three of the wild groups were genetically and geographically closely related to the O. sativa subpopulations, indica, aus and japonica, and carried O. sativa introgressions; the other three wild groups were genetically divergent, had unique chloroplast haplotypes, and were located at the geographical extremes of the species range. The genetic subpopulations were significantly correlated (r 2  = 0.562) with traditional species designations, O. rufipogon (perennial) and O. nivara (annual), differentiated based on morphology and life history. A wild diversity panel of 95 purified (inbred) accessions was developed for future genetic studies. Our results suggest that the cultivated aus subpopulation is most closely related to an annual wild relative, japonica to a perennial wild relative, and indica to an admixed population of diverse annual and perennial wild ancestors. Gene flow between ORSC and O. sativa is common in regions where rice is cultivated, threatening the identity and diversity of wild ORSC populations. The three geographically isolated ORSC populations harbor variation rarely seen in cultivated rice and provide a unique window into the genetic composition of ancient rice subpopulations.

  15. Pooled analysis of menstrual irregularities from three major clinical studies evaluating everolimus for the treatment of tuberous sclerosis complex.

    Directory of Open Access Journals (Sweden)

    Steven Sparagana

    Full Text Available To determine the impact of everolimus on female fertility, including menstrual irregularities, secondary amenorrhea, and luteinizing and follicle stimulating hormone levels in female patients.A pooled analysis from 3 prospective studies consisting of a core phase (≥6 months and a long-term follow-up open-label extension.One phase 2 single-center and two phase 3 multicenter studies.Data were obtained from female participants, restricted to those between 10 and 55 years of age, during 1 of 3 of the described clinical trials of everolimus. Patients had received ≥ 1 dose of everolimus.Incidence of fertility events.A total of 43/112 patients (38.4% experienced at least 1 menstrual irregularity. The most common events were amenorrhea (24.1% and irregular menstruation (17.0%. Seven patients (6.3% experienced grade 3/4 amenorrhea. When only the longest duration period of amenorrhea for each patient was considered, the median duration was 291 days. Fifteen patients attained menarche during the treatment period in any of the pooled studies. The mean age of menarche for this group was 12.4 years, similar to that of patients who were postmenarche at study entry (12.2 years. A total of 19/92 patients (20.7% who were postmenarche at baseline or during the study experienced an irregular menstruation event. An increased luteinizing hormone level was reported as an adverse event in 3/112 patients (3%, and follicle-stimulating hormone levels were within normal limits for these patients.No new safety concerns emerged regarding endocrine function and menstruation in female patients with tuberous sclerosis complex-associated subependymal giant cell astrocytoma or angiomyolipoma, who were receiving everolimus.ClinicalTrials.gov NCT00411619, NCT00789828, NCT00790400.

  16. Obesity-Associated Abdominal Elephantiasis

    Directory of Open Access Journals (Sweden)

    Ritesh Kohli

    2013-01-01

    Full Text Available Abdominal elephantiasis is a rare entity. Abdominal elephantiasis is an uncommon, but deformative and progressive cutaneous disease caused by chronic lymphedema and recurrent streptococcal or Staphylococcus infections of the abdominal wall. We present 3 cases of patients with morbid obesity who presented to our hospital with abdominal wall swelling, thickening, erythema, and pain. The abdominal wall and legs were edematous, with cobblestone-like, thickened, hyperpigmented, and fissured plaques on the abdomen. Two patients had localised areas of skin erythema, tenderness, and increased warmth. There was purulent drainage from the abdominal wall in one patient. They were managed with antibiotics with some initial improvement. Meticulous skin care and local keratolytic treatment for the lesions were initiated with limited success due to their late presentation. All three patients refused surgical therapy. Conclusion. Early diagnosis is important for the treatment of abdominal elephantiasis and prevention of complications.

  17. ABDOMINAL TRAUMA- CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Vanaja Ratnakumari Billa

    2017-08-01

    Full Text Available BACKGROUND In the recent times there has been increased incidence of abdominal trauma cases due to several causes. Quick and prompt intervention is needed to decrease the mortality of the patients. So we conducted a study to assess the cause and the management of abdominal trauma cases in our institution. The aim of this study was to know the incidence of blunt and penetrating injuries and their causes, age and sex incidence, importance of various investigations, mode of treatment offered and post-operative complications. To study the cause of death and evolve better management. MATERIALS AND METHODS The present study comprises of patients admitted to and operated in various surgical units in the Department of Surgery at Government General Hospital, attached to Guntur Medical College Guntur, from August 2014 to October 2016. RESULTS Increase incidence seen in age group 20-29 years (30%. Male predominance 77.5%. Mechanism of injury–road traffic accidents 65%. Isolated organ injury–colon and rectum 40%. Other associated injuries–chest injuries with rib fractures 7.5%. Complications–wound infection 17.5%. Duration of hospital stay 8–14 days. Bowel injury management–closure of perforation 84.6%. Resection anastomosis 15.38%. CONCLUSION Thorough clinical examination, diagnostic paracentesis, plain X-ray erect abdomen and ultrasound proved to be very helpful in the diagnosis of intra-abdominal injuries. Spleen is the commonest organ involved in blunt trauma and colon is the commonly injured organ in penetrating abdominal trauma, many patients have associated extremity and axial skeleton injuries. With advances in diagnosis and intensive care technologies, most patients of solid visceral injuries with hemodynamic stability can be managed conservatively. Surgical site infection is the most common complication following surgery. The mortality is high; reason might be patient reaching the hospital late, high incidence of postoperative septic

  18. CT of abdominal tumor

    International Nuclear Information System (INIS)

    Endo, Satoshi; Yamada, Kenji; Ito, Masatoshi; Ito, Hisao; Yamaura, Harutsugu

    1981-01-01

    CT findings in 33 patients who had an abdominal tumor were evaluated. CT revealed a tumor in 31 cases. The organ from which the tumor originated was correctly diagnosed in 18 patients. Whether the tumor was solid or cystic was correctly predicted in 28 patients. The diagnosis malignant or benign nature of tumor was correct, incorrect and impossible, in 23, 3, and five patiens, respectively. (Kondo, M.)

  19. The adeno-associated virus major regulatory protein Rep78-c-Jun-DNA motif complex modulates AP-1 activity

    International Nuclear Information System (INIS)

    Prasad, C. Krishna; Meyers, Craig; Zhan Dejin; You Hong; Chiriva-Internati, Maurizio; Mehta, Jawahar L.; Liu Yong; Hermonat, Paul L.

    2003-01-01

    Multiple epidemiologic studies show that adeno-associated virus (AAV) is negatively associated with cervical cancer (CX CA), a cancer which is positively associated with human papillomavirus (HPV) infection. Mechanisms for this correlation may be by Rep78's (AAV's major regulatory protein) ability to bind the HPV-16 p97 promoter DNA and inhibit transcription, to bind and interfere with the functions of the E7 oncoprotein of HPV-16, and to bind a variety of HPV-important cellular transcription factors such as Sp1 and TBP. c-Jun is another important cellular factor intimately linked to the HPV life cycle, as well as keratinocyte differentiation and skin development. Skin is the natural host tissue for both HPV and AAV. In this article it is demonstrated that Rep78 directly interacts with c-Jun, both in vitro and in vivo, as analyzed by Western blot, yeast two-hybrid cDNA, and electrophoretic mobility shift-supershift assay (EMSA supershift). Addition of anti-Rep78 antibodies inhibited the EMSA supershift. Investigating the biological implications of this interaction, Rep78 inhibited the c-Jun-dependent c-jun promoter in transient and stable chloramphenicol acetyl-transferase (CAT) assays. Rep78 also inhibited c-Jun-augmented c-jun promoter as well as the HPV-16 p97 promoter activity (also c-Jun regulated) in in vitro transcription assays in T47D nuclear extracts. Finally, the Rep78-c-Jun interaction mapped to the amino-half of Rep78. The ability of Rep78 to interact with c-Jun and down-regulate AP-1-dependent transcription suggests one more mechanism by which AAV may modulate the HPV life cycle and the carcinogenesis process

  20. Comparative sequence analyses of the major quantitative trait locus phosphorus uptake 1 (Pup1) reveal a complex genetic structure.

    Science.gov (United States)

    Heuer, Sigrid; Lu, Xiaochun; Chin, Joong Hyoun; Tanaka, Juan Pariasca; Kanamori, Hiroyuki; Matsumoto, Takashi; De Leon, Teresa; Ulat, Victor Jun; Ismail, Abdelbagi M; Yano, Masahiro; Wissuwa, Matthias

    2009-06-01

    The phosphorus uptake 1 (Pup1) locus was identified as a major quantitative trait locus (QTL) for tolerance of phosphorus deficiency in rice. Near-isogenic lines with the Pup1 region from tolerant donor parent Kasalath typically show threefold higher phosphorus uptake and grain yield in phosphorus-deficient field trials than the intolerant parent Nipponbare. In this study, we report the fine mapping of the Pup1 locus to the long arm of chromosome 12 (15.31-15.47 Mb). Genes in the region were initially identified on the basis of the Nipponbare reference genome, but did not reveal any obvious candidate genes related to phosphorus uptake. Kasalath BAC clones were therefore sequenced and revealed a 278-kbp sequence significantly different from the syntenic regions in Nipponbare (145 kb) and in the indica reference genome of 93-11 (742 kbp). Size differences are caused by large insertions or deletions (INDELs), and an exceptionally large number of retrotransposon and transposon-related elements (TEs) present in all three sequences (45%-54%). About 46 kb of the Kasalath sequence did not align with the entire Nipponbare genome, and only three Nipponbare genes (fatty acid alpha-dioxygenase, dirigent protein and aspartic proteinase) are highly conserved in Kasalath. Two Nipponbare genes (expressed proteins) might have evolved by at least three TE integrations in an ancestor gene that is still present in Kasalath. Several predicted Kasalath genes are novel or unknown genes that are mainly located within INDEL regions. Our results highlight the importance of sequencing QTL regions in the respective donor parent, as important genes might not be present in the current reference genomes.

  1. Abdominal emergencies during pregnancy.

    Science.gov (United States)

    Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B

    2015-12-01

    Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management. Copyright © 2015. Published by Elsevier Masson SAS.

  2. Detoxification in Abdominal Sepsis

    Directory of Open Access Journals (Sweden)

    A. F. Potapov

    2005-01-01

    Full Text Available Objective. To comparatively analyze the efficiency of methods for extracorporeal detoxification (ED of the body in abdominal sepsis (AS and to choose the optimum detoxifying methods in relation to the level of endotoxicosis.Material and methods. 56 patients (41 males and 15 females; mean age 39.4±12.2 years with surgical abdominal infection of various genesis, complicated by the development of sepsis whose treatment included ED methods, were examined. The level of intoxication and the efficiency of detoxification were evaluated by general clinical and biochemical blood parameters, the leukocytic intoxication index, the levels of low and medium molecular-weight substances in the body’s media. Hemosorption, plasmapheresis, hemodialysis, hemodiafiltration, and hemofiltration were used for detoxification.Results. Surgical abdominal infection is accompanied by endotoxemia that has no clear nosological specificity, but it depends on the pattern of a clinical course of the disease and is most pronounced in the septic syndrome. In AS, 80.4% of the patients are observed to have an irreversible decompensation phase and a terminal degree of endotoxicosis, which require detoxification. The use of different ED methods according to the level of intoxication may reduce the level of endotoxicosis and yield a persistent beneficial effect in 85.2% of cases of its application. Conclusion. Filtration and dialysis techniques (hemodialysis, hemofiltration, and hemodiafiltration are the methods of choice in AS. Hemosorption and plasmapheresis may be recommended for use at the early stages of endotoxicosis development and in preserved renal excretory function.

  3. Abdominal aspergillosis: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Yeom, Suk Keu, E-mail: pagoda20@hanmail.net [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Hye Jin, E-mail: kimhyejin@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Byun, Jae Ho, E-mail: jhbyun@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Ah Young, E-mail: aykim@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Lee, Moon-Gyu, E-mail: mglee@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Ha, Hyun Kwon, E-mail: hkha@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of)

    2011-03-15

    Objective: In order to retrospectively evaluate the CT findings of abdominal aspergillosis in immunocompromised patients. Materials and methods: CT scans were reviewed with regard to the sites, number, morphologic appearance, attenuation, and the contrast enhancement patterns of the lesions in six patients (5 women, 1 man; mean age, 43.4 years; range, 23-59 years) with pathologically proved abdominal aspergillosis by two gastrointestinal radiologists in consensus. Medical records were also reviewed to determine each patient's clinical status and outcome. Results: All patients were immunocompromised state: 4 patients received immunosuppressive therapy for solid organ transplantation and 2 patients received chemotherapy for acute myeloid leukemia. Aspergillosis involved blood vessels (n = 3), liver (n = 2), spleen (n = 2), gastrointestinal tract (n = 2), native kidney (n = 1), transplanted kidney (n = 1), peritoneum (n = 1), and retroperitoneum (n = 1). CT demonstrated solid organ or bowel infarction or perforation secondary to vascular thrombosis or pseudoaneurysm, multiple low-attenuating lesions of solid organs presenting as abscesses, concentric bowel wall thickening mimicking typhlitis, or diffuse or nodular infiltration of the peritoneum and retroperitoneum. Conclusion: Familiarity with findings commonly presenting as angioinvasive features or abscesses on CT, may facilitate the diagnosis of rare and fatal abdominal aspergillosis.

  4. The accuracy of combined physical examination and ultrasonography for the detection of abdominal aorta aneurysm.

    Science.gov (United States)

    Cârstea, Doina; Streba, Letiţia Adela Maria; Glodeanu, Adina; Cârstea, A P; Vancu, Mihaela; Ninulescu, Ana-Maria

    2008-01-01

    Atherosclerosis is the most frequent cause in the appearance of an abdominal aorta aneurysm (AAA) and plays an important role in his development. Most AAA does not cause any symptoms, especially when talking about elderly patients, however, many of those aneurysms can be detected during physical examination. Their detection is very important because the natural evolution and the major reason in treating AAA is their tendency to rupture. We present the case of an adult man with a complex clinical pathology, but not related to the AAA. The diagnosis of the AAA has been suspicion through palpation, and the abdominal ultrasound exam confirmed it. This case is particular interesting, as the AAA requires surgical intervention, while patient's health status was poor. An essential issue is establishing the importance of the AAA screening, when there are no symptoms present. For now, there are not satisfactory studies to be used as a guide.

  5. Functional abdominal pain and irritable bowel syndrome in children and adolescents

    Science.gov (United States)

    Chiou, Eric; Nurko, Samuel

    2011-01-01

    Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are both associated with recurrent abdominal pain and are among the most commonly diagnosed medical problems in pediatrics. The majority of patients with mild complaints improve with reassurance and time. For a distinct subset of patients with more severe and disabling illness, finding effective treatment for these disorders remains a challenge. Based on the biopsychosocial model of functional disease, the Rome III criteria have helped frame FAP and IBS in terms of being a positive diagnosis and not a diagnosis of exclusion. However, the lack of a single, proven intervention highlights the complex interplay of pathologic mechanisms likely involved in the development of childhood FAP and IBS and the need for a multidisciplinary, integrated approach. This article discusses the epidemiology, proposed mechanisms, clinical approach and therapeutic options for the management of FAP and IBS in children and adolescents. PMID:21731470

  6. Computed tomography and nonoperative treatment for blunt abdominal trauma

    International Nuclear Information System (INIS)

    Watanabe, Shinsuke; Ishi, Takashi; Kamachi, Masahiro; Takahashi, Toshio.

    1990-01-01

    Studies were undertaken to determine if computed tomography (CT) could reliably assist physical examination in the initial assessment of blunt abdominal trauma, and also to examine how various abdominal injuries were managed with the guidance of CT. A total of 255 patients underwent emergency abdominal CT following blunt abdominal trauma over a period of seven years. One hundred and fifty two patients had abnormal CT scans, including 58 hepatic, 36 renal, 25 splenic and 9 pancreatic injuries as well as 67 patients with intra-abdominal hemorrhage and 21 patients with free abdominal air. A comparative study on the detection of pneumoperitoneum revealed CT to be far superior to plain radiography. One hundred and three patients had normal CT scans, all of whom were managed nonoperatively, except for three false-negative cases and two nontherapeutic cases. The patients with injury to the parenchymal organs were given nonoperative treatment if they had stable vital signs and no evidence of associated injuries demanding immediate surgery and the majority of these patients were managed well nonoperatively. CT was thus found to be a useful adjunct in the management of victims of blunt abdominal trauma, since in a rapid and noninvasive fashion, CT accurately defined the extent of parenchymal organ injury and also disclosed any other abdominal injuries. (author)

  7. Computed tomography and nonoperative treatment for blunt abdominal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Shinsuke; Ishi, Takashi; Kamachi, Masahiro [Saiseikai Shiga Hospital, Shiga (Japan); Takahashi, Toshio

    1990-01-01

    Studies were undertaken to determine if computed tomography (CT) could reliably assist physical examination in the initial assessment of blunt abdominal trauma, and also to examine how various abdominal injuries were managed with the guidance of CT. A total of 255 patients underwent emergency abdominal CT following blunt abdominal trauma over a period of seven years. One hundred and fifty two patients had abnormal CT scans, including 58 hepatic, 36 renal, 25 splenic and 9 pancreatic injuries as well as 67 patients with intra-abdominal hemorrhage and 21 patients with free abdominal air. A comparative study on the detection of pneumoperitoneum revealed CT to be far superior to plain radiography. One hundred and three patients had normal CT scans, all of whom were managed nonoperatively, except for three false-negative cases and two nontherapeutic cases. The patients with injury to the parenchymal organs were given nonoperative treatment if they had stable vital signs and no evidence of associated injuries demanding immediate surgery and the majority of these patients were managed well nonoperatively. CT was thus found to be a useful adjunct in the management of victims of blunt abdominal trauma, since in a rapid and noninvasive fashion, CT accurately defined the extent of parenchymal organ injury and also disclosed any other abdominal injuries. (author).

  8. MALDI-TOF MS enables the rapid identification of the major molecular types within the Cryptococcus neoformans/C. gattii species complex.

    Directory of Open Access Journals (Sweden)

    Carolina Firacative

    Full Text Available BACKGROUND: The Cryptococcus neoformans/C. gattii species complex comprises two sibling species that are divided into eight major molecular types, C. neoformans VNI to VNIV and C. gattii VGI to VGIV. These genotypes differ in host range, epidemiology, virulence, antifungal susceptibility and geographic distribution. The currently used phenotypic and molecular identification methods for the species/molecular types are time consuming and expensive. As Matrix-Assisted Laser Desorption Ionization-Time-of-Flight Mass Spectrometry (MALDI-TOF MS offers an effective alternative for the rapid identification of microorganisms, the objective of this study was to examine its potential for the identification of C. neoformans and C. gattii strains at the intra- and inter-species level. METHODOLOGY: Protein extracts obtained via the formic acid extraction method of 164 C. neoformans/C. gattii isolates, including four inter-species hybrids, were studied. RESULTS: The obtained mass spectra correctly identified 100% of all studied isolates, grouped each isolate according to the currently recognized species, C. neoformans and C. gattii, and detected potential hybrids. In addition, all isolates were clearly separated according to their major molecular type, generating greater spectral differences among the C. neoformans molecular types than the C. gattii molecular types, most likely reflecting a closer phylogenetic relationship between the latter. The number of colonies used and the incubation length did not affect the results. No spectra were obtained from intact yeast cells. An extended validated spectral library containing spectra of all eight major molecular types was established. CONCLUSIONS: MALDI-TOF MS is a rapid identification tool for the correct recognition of the two currently recognized human pathogenic Cryptococcus species and offers a simple method for the separation of the eight major molecular types and the detection of hybrid strains within this

  9. Value of ultrasound in the evaluation of blunt abdominal trauma

    International Nuclear Information System (INIS)

    Jayanthi, Shri Krishna

    2008-01-01

    Trauma is a major cause of morbidity and mortality in an age group including from teenagers to young adults, in a male dominant proportion, resulting in great economic and social impact. Within the complex of trauma, blunt abdominal trauma (BAT) is frequent event and presents difficulty in the evaluation and management since the clinical examination shows low sensitivity and specificity. The detection of hemo peritoneum is one of the methods of evaluation of possible indirect intra-abdominal injuries, initially using direct diagnostic abdominal paracentesis and posteriorly the diagnostic peritoneal lavage, that despite the effectiveness, have drawbacks such as invasiveness and the inability of hemo peritoneum quantification and the lesion staging, resulting in non-therapeutic laparotomies. Imaging methods provide useful information in the investigation of abdominal injuries, such as conventional and contrast radiology, ultrasound (US) and computed tomography (CT), which is the best effective method, but has its own drawbacks, such as cost, accessibility, use of ionizing radiation and contrast media and the displacement of the patient to the machine. US presents itself as an alternative in the initial evaluation of these patients as noninvasive method, with lack of harmfulness, low cost, fast answer and portability. Nevertheless, this method also has its limitations, as in cases of abdominal injuries without free fluid. This study was conducted in order to establish the performance of the US in this setting, allowing to rationalise the use of CT. For this purpose we studied 163 patients treated in the ER of HC/FMUSP, with the completion of consecutive US and CT. The population fits the usual profile of trauma victims, with 83% male, 56% in the age group between 20 and 39 years and in 73% of cases victims of traffic accidents. They were brought to the service in an average time of 51 minutes, mainly stable and with satisfactory level of consciousness. US took on

  10. An abdominal tuberculosis case mimicking an abdominal mass

    African Journals Online (AJOL)

    An abdominal tuberculosis case mimicking an abdominal mass. Derya Erdog˘ an a. , Yasemin Ta ¸scı Yıldız b. , Esin Cengiz Bodurog˘lu c and Naciye Go¨nu¨l Tanır d. Abdominal tuberculosis is rare in childhood. It may be difficult to diagnose as it mimics various disorders. We present a 12-year-old child with an unusual ...

  11. Abdominal Compartment Syndrome Secondary to Chronic Constipation

    Directory of Open Access Journals (Sweden)

    Helene Flageole

    2011-01-01

    Full Text Available Abdominal compartment syndrome (ACS is defined as an elevated intraabdominal pressure with evidence of organ dysfunction. The majority of published reports of ACS are in neonates with abdominal wall defects and in adults following trauma or burns, but it is poorly described in children. We describe the unusual presentation of an 11-year-old boy with a long history of chronic constipation who developed acute ACS requiring resuscitative measures and emergent disimpaction. He presented with a 2-week history of increasing abdominal pain, nausea, diminished appetite and longstanding encopresis. On exam, he was emaciated with a massively distended abdomen with a palpable fecaloma. Abdominal XR confirmed these findings. Within 24 hours of presentation, he became tachycardic and oliguric with orthostatic hypotension. Following two enemas, he acutely deteriorated with severe hypotension, marked tachycardia, acute respiratory distress, and a declining mental status. Endotracheal intubation, fluid boluses, and vasopressors were commenced, followed by emergent surgical fecal disimpaction. This resulted in rapid improvement in vital signs. He has been thoroughly investigated and no other condition apart from functional constipation has been identified. Although ACS secondary to constipation is extremely unusual, this case illustrates the need to actively treat constipation and what can happen if it is not.

  12. Overview of the taxonomy and of the major secondary metabolites and their biological activities related to human health of the Laurencia complex (Ceramiales, Rhodophyta from Brazil

    Directory of Open Access Journals (Sweden)

    Mutue T. Fujii

    2011-04-01

    Full Text Available In Brazil, the Laurencia complex is represented by twenty taxa: Laurencia s.s. with twelve species, Palisada with four species (including Chondrophycus furcatus now that the proposal of its transference to Palisada is in process, and Osmundea and Yuzurua with two species each. The majority of the Brazilian species of the Laurencia complex have been phylogenetically analyzed by 54 rbcL sequences, including five other Rhodomelacean species as outgroups. The analysis showed that the Laurencia complex is monophyletic with high posterior probability value. The complex was separated into five clades, corresponding to the genera: Chondrophycus, Laurencia, Osmundea, Palisada, and Yuzurua. A bibliographical survey of the terpenoids produced by Brazilian species showed that only six species of Laurencia and five of Palisada (including C. furcatcus have been submitted to chemical analysis with 48 terpenoids (47 sesquiterpenes and one triterpene isolated. No diterpenes were found. Of the total, 23 sesquiterpenes belong to the bisabolane class and eighteen to the chamigrene type, whose biochemical precursor is bisabolane, two are derived from lauranes and four are triquinols. Despite the considerable number of known terpenes and their ecological and pharmacological importance, few experimental biological studies have been performed. In this review, only bioactivities related to human health were considered.

  13. Antibodies against major histocompatibility complex class II antigens directly inhibit the growth of T cells infected with Theileria parva without affecting their state of activation

    OpenAIRE

    Eichhorn, M; Prospero, T D; Heussler, Volker; Dobbelaere, D A

    1993-01-01

    We have analyzed the effect of antibodies (Abs) directed against major histocompatibility complex (MHC) class II Abs on the proliferation of Theileria parva-infected (Tpi) T cells. Anti-MHC class II Abs exert a direct effect on Tpi T cells causing an acute block in their proliferation. The inhibition does not involve apoptosis and is also entirely reversible. The rapid arrest of DNA synthesis caused by anti- MHC class II Abs is not due to interference with the state of activation of the T cel...

  14. Functional isotypes are not encoded by the constant region genes of the beta subunit of the T cell receptor for antigen/major histocompatibility complex

    OpenAIRE

    1984-01-01

    Human T cell clones and a cDNA probe specific for constant regions of the beta subunit of the antigen/major histocompatibility complex (MHC) receptor, TiC beta 1 and TiC beta 2, were employed to determine whether these genes were differentially used by functional classes of T lymphocytes. DNA from 10 interleukin-2-dependent T cell clones including class I and class II MHC-specific cytotoxic T lymphocytes (n = 6), T4+ inducer T lymphocytes (n = 2), and T8+ suppressor T lymphocytes (n = 2) show...

  15. Size polymorphism of chicken major histocompatibility complex-encoded B-G molecules is due to length variation in the cytoplasmic heptad repeat region

    DEFF Research Database (Denmark)

    Kaufman, J; Salomonsen, J; Skjødt, K

    1990-01-01

    B-G antigens are cell-surface molecules encoded by a highly polymorphic multigene family located in the chicken major histocompatibility complex (MHC). Rabbit antisera to B-G molecules immunoprecipitate 3-6 bands from iodinated erythrocytes by sodium dodecyl sulfate (SDS) gels under reducing......, which bear intrachain disulfide bonds. All 3-6 bands have different mobilities in SDS gels between different haplotypes, ranging from 30 to 55 kDa. This size polymorphism is not affected by glycosidase treatment or addition of protease inhibitors. Partial proteolysis of cell surface-iodinated B...

  16. [Differential diagnosis of abdominal pain].

    Science.gov (United States)

    Frei, Pascal

    2015-09-02

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain.

  17. Abdominal wall blocks in adults

    DEFF Research Database (Denmark)

    Børglum, Jens; Gögenür, Ismail; Bendtsen, Thomas F

    2016-01-01

    been introduced with success. Future research should also investigate the effect of specific abdominal wall blocks on neuroendocrine and inflammatory stress response after surgery.  Summary USG abdominal wall blocks in adults are commonplace techniques today. Most abdominal wall blocks are assigned......Purpose of review Abdominal wall blocks in adults have evolved much during the last decade; that is, particularly with the introduction of ultrasound-guided (USG) blocks. This review highlights recent advances of block techniques within this field and proposes directions for future research.......  Recent findings Ultrasound guidance is now considered the golden standard for abdominal wall blocks in adults, even though some landmark-based blocks are still being investigated. The efficiency of USG transversus abdominis plane blocks in relation to many surgical procedures involving the abdominal wall...

  18. Congenital Abdominal Wall Defects

    DEFF Research Database (Denmark)

    Risby, Kirsten; Jakobsen, Marianne Skytte; Qvist, Niels

    2016-01-01

    related complications; and post-discharge gastrointestinal surgery. RESULTS: GDM was placed in 34 (gastroschisis=27, omphalocele=7) patients during the study period. Complete closure of the fascia was obtained in one patient with omphalocele and in 22 patients with gastroschisis. Mesh related surgical...... complications were seen in five (15%) children: four had detachment of the mesh and one patient developed abdominal compartment syndrome. Mesh related clinical infection was observed in five children. In hospital mortality occurred in four cases (2 gastroschisis and 2 omphalocele) and was not procedure...

  19. Abdominal imaging: An introduction

    International Nuclear Information System (INIS)

    Frick, M.P.; Feinberg, S.B.

    1986-01-01

    This nine-chapter book gives an overview of the integrated approach to abdominal imaging. Chapter 1 provides an introduction to the physics used in medical imaging; chapter 2 is on the selection of imaging modalities. These are followed by four chapters that deal, respectively, with plain radiography, computed tomographic scanning, sonography, and nuclear imaging, as applied to the abdomen. Two chapters then cover contrast material-enhanced studies of the gastrointestinal (GI) tract: one focusing on technical considerations; the other, on radiologic study of disease processes. The final chapter is a brief account of different interventional procedures

  20. Abdominal Aortic Emergencies.

    Science.gov (United States)

    Lech, Christie; Swaminathan, Anand

    2017-11-01

    This article discusses abdominal aortic emergencies. There is a common thread of risk factors and causes of these diseases, including age, male gender, hypertension, dyslipidemia, and connective tissue disorders. The most common presenting symptom of these disorders is pain, usually in the chest, flank, abdomen, or back. Computed tomography scan is the gold standard for diagnosis of pathologic conditions of the aorta in the hemodynamically stable patient. Treatment consists of a combination of blood pressure and heart rate control and, in many cases, emergent surgical intervention. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Chronic abdominal wall pain misdiagnosed as functional abdominal pain.

    Science.gov (United States)

    van Assen, Tijmen; de Jager-Kievit, Jenneke W A J; Scheltinga, Marc R; Roumen, Rudi M H

    2013-01-01

    The abdominal wall is often neglected as a cause of chronic abdominal pain. The aim of this study was to identify chronic abdominal wall pain syndromes, such as anterior cutaneous nerve entrapment syndrome (ACNES), in a patient population diagnosed with functional abdominal pain, including irritable bowel syndrome, using a validated 18-item questionnaire as an identification tool. In this cross-sectional analysis, 4 Dutch primary care practices employing physicians who were unaware of the existence of ACNES were selected. A total of 535 patients ≥18 years old who were registered with a functional abdominal pain diagnosis were approached when they were symptomatic to complete the questionnaire (maximum 18 points). Responders who scored at least the 10-point cutoff value (sensitivity, 0.94; specificity, 0.92) underwent a diagnostic evaluation to establish their final diagnosis. The main outcome was the presence and prevalence of ACNES in a group of symptomatic patients diagnosed with functional abdominal pain. Of 535 patients, 304 (57%) responded; 167 subjects (31%) recently reporting symptoms completed the questionnaire. Of 23 patients who scored above the 10-point cutoff value, 18 were available for a diagnostic evaluation. In half of these subjects (n = 9) functional abdominal pain (including IBS) was confirmed. However, the other 9 patients were suffering from abdominal wall pain syndrome, 6 of whom were diagnosed with ACNES (3.6% prevalence rate of symptomatic subjects; 95% confidence interval, 1.7-7.6), whereas the remaining 3 harbored a painful lipoma, an abdominal herniation, and a painful scar. A clinically relevant portion of patients previously diagnosed with functional abdominal pain syndrome in a primary care environment suffers from an abdominal wall pain syndrome such as ACNES.

  2. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) abdominal ultrasound imaging produces pictures ...

  3. Laparoscopic management of abdominal cocoon

    Directory of Open Access Journals (Sweden)

    Makam Ramesh

    2008-01-01

    Full Text Available "Peritonitis fibrosa incapsulata", first described in 1907, is a condition characterized by encasement of the bowel with a thick fibrous membrane. This condition was renamed as "abdominal cocoon" in 1978. It presents as small bowel obstruction clinically. 35 cases of abdominal cocoon have been reported in the literature over the last three decades. Abdominal cocoon is more common in adolescent girls from tropical countries. Various etiologies have been described, including tubercular. It is treated surgically by releasing the entrapped bowel. We report a laparoscopic experience of tubercular abdominal cocoon and review the literature.

  4. Ligation of major histocompatibility complex class I antigens (MHC-I) prevents apoptosis induced by Fas or SAPK/JNK activation in T-lymphoma cells

    DEFF Research Database (Denmark)

    Lamberth, K; Claesson, M H

    2001-01-01

    Early apoptosis in Jurkat T-lymphoma cells was induced by agonistic anti-Fas Ab or by anisomycin which activates the stress kinases SAPK/JNK. Apoptosis was inhibited by ligation of major histocompatibility complex class I antigens (MHC-I). MHC-I ligation induced upregulation of the anti-apoptotic......Early apoptosis in Jurkat T-lymphoma cells was induced by agonistic anti-Fas Ab or by anisomycin which activates the stress kinases SAPK/JNK. Apoptosis was inhibited by ligation of major histocompatibility complex class I antigens (MHC-I). MHC-I ligation induced upregulation of the anti......-apoptotic Bcl-2 protein and stabilized the mitochondrial membrane potential (Deltapsim). MHC-I ligation also prevented downregulation of Bcl-2 and destabilization of Deltapsim induced by anti-Fas Ab treatment or anisomycin exposure. Studies on three different Jurkat cell mutants deficient for src p56(lck), ZAP......-70 kinase, or TCR/CD3 gamma-chain showed that the cells undergo apoptosis after Fas ligation. Anisomycin exposure induced apoptosis in the src p56(lck)-deficient cell line but not in the two other mutant cell lines. Simultaneous cross-linking of MHC-I and Fas ligation inhibited apoptosis in the ZAP...

  5. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    Energy Technology Data Exchange (ETDEWEB)

    Marincek, B. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2002-09-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  6. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    International Nuclear Information System (INIS)

    Marincek, B.

    2002-01-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  7. Laparoscopy in unexplained abdominal pain: surgeon's perspective

    International Nuclear Information System (INIS)

    Abdullah, M.T.; Waqar, S.H.; Zahid, M.A.

    2016-01-01

    Unexplained abdominal pain is a common but difficult presenting feature faced by the clinicians. Such patients can undergo a number of investigations with failure to reach any diagnosis. The objective of this study was to evaluate the use of laparoscopy in the diagnosis and management of patients with unexplained abdominal pain. Methods: This cross-sectional study was conducted at Pakistan Institute of Medical Sciences Islamabad from January 2009 to December 2013. This study included 91 patients of unexplained abdominal pain not diagnosed by routine clinical examination and investigations. These patients were subjected to diagnostic laparoscopy for evaluation of their conditions and to confirm the diagnosis. These patients presented 43% of patients undergoing investigations for abdominal pain. Patients diagnosed with gynaecological problems were excluded to see surgeon's perspective. The findings and the outcomes of the laparoscopy were recorded and data was analyzed. Results: Unexplained abdominal pain is common in females than in males. The most common laparoscopic findings were abdominal tuberculosis followed by appendicitis. Ninety percent patients achieved pain relief after laparoscopic intervention. Conclusion: Laparoscopy is both beneficial and safe in majority of patients with unexplained abdominal pain. General surgeons should acquire training and experience in laparoscopic surgery to provide maximum benefit to these difficult patients. (author)

  8. The efficacy of adhesiolysis on chronic abdominal pain

    DEFF Research Database (Denmark)

    Gerner-Rasmussen, Jonas; Burcharth, Jakob; Gögenur, Ismail

    2015-01-01

    INTRODUCTION: Abdominal adhesions are a frequent reason for chronic abdominal pain. The purpose of this systematic review was to investigate the evidence of performing laparoscopic adhesiolysis as a treatment for patients with chronic abdominal pain. METHODS: Medline, Embase, and The Cochrane Cen...... Central Register of Controlled Trials were searched for trials performing lysis of adhesions on patients suffering from chronic abdominal pain. Clinical studies on patients being treated for chronic abdominal pain with surgical adhesiolysis were included. The main outcome of the study...... chronic abdominal pain. A total of 22 trials were identified as case-series and included no control group. Three studies were identified as randomized controlled trials (RCT). A benefit of the intervention varied from 16 to 88 % in the non-randomized studies, with the majority reporting pain relief...... no difference between the intervention and control group. CONCLUSION: The identified studies showed promising but preliminary results of laparoscopic adhesiolysis as a treatment of chronic abdominal pain. The evidence for laparoscopic adhesiolysis is not sufficient to make definitive conclusions....

  9. Abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Lindholt, Jes S.

    2010-01-01

    Although the number of elective operations for abdominal aortic aneurysms (AAA) is increasing, the sex- and age-standardised mortality rate of AAAs continues to rise, especially among men aged 65 years or more. The lethality of ruptured AAA continues to be 80-95%, compared with 5-7% by elective...... surgery of symptomfree AAA. In order to fulfil all WHO, European, and Danish criteria for screening, a randomised hospitalbased screening trial of 12,639 65-73 year old men in Viborg County (Denmark) was initiated in 1994. It seemed that US screening is a valid, suitable and acceptable method of screening...... patients without previous hospital discharge diagnoses due to cardiovascular disease than among similar men without AAA. The absolute risk difference after 5 years was 16%. So, they will benefit from general cardiovascular preventive action as smoking cessation, statins and low-dose aspirin, which could...

  10. Abdominal Burkitt lymphoma

    International Nuclear Information System (INIS)

    Alvarez, Romina J.; Villavicencio, Roberto L.; Oxilia, Hector G.

    2004-01-01

    Purpose: As scarce information is available, in this research we have tried to describe the imaging findings of the Burkitt's lymphoma. Retrospective analysis of the clinical and imaging presentation of a 4 years old boy, is given. Biopsy confirmed the BL. Different imaging techniques were combined. The X-rays were negative. The US revealed a moderate hepatomegaly with multiple hypoechoic nodules and free fluid in the abdominal cavity. The CT showed the hepatomegaly as well as solid nodules in great number and different sizes(due to the densitometric behaviour and to post contrast enhancement), a scarce amount of ascites and a density increase of the mesentery fat. The MRI characterized and revealed in detail the US and the CT findings. The Burkitt's lymphoma is a rare entity; several methods are needed to approach the diagnosis. It represents a great clinical and imaging challenge. (author)

  11. Functional abdominal pain syndrome.

    Science.gov (United States)

    Clouse, Ray E; Mayer, Emeran A; Aziz, Qasim; Drossman, Douglas A; Dumitrascu, Dan L; Mönnikes, Hubert; Naliboff, Bruce D

    2006-04-01

    Functional abdominal pain syndrome (FAPS) differs from the other functional bowel disorders; it is less common, symptoms largely are unrelated to food intake and defecation, and it has higher comorbidity with psychiatric disorders. The etiology and pathophysiology are incompletely understood. Because FAPS likely represents a heterogeneous group of disorders, peripheral neuropathic pain mechanisms, alterations in endogenous pain modulation systems, or both may be involved in any one patient. The diagnosis of FAPS is made on the basis of positive symptom criteria and a longstanding history of symptoms; in the absence of alarm symptoms, an extensive diagnostic evaluation is not required. Management is based on a therapeutic physician-patient relationship and empirical treatment algorithms using various classes of centrally acting drugs, including antidepressants and anticonvulsants. The choice, dose, and combination of drugs are influenced by psychiatric comorbidities. Psychological treatment options include psychotherapy, relaxation techniques, and hypnosis. Refractory FAPS patients may benefit from a multidisciplinary pain clinic approach.

  12. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B

    1994-01-01

    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553...... patients, 51 (9%) of whom died within the first 48 hours. Of the 502 patients who survived for more than 48 hours, 109 required ICU therapy for more than 48 hours, whereas 393 patients were in the ICU for less than 48 hours. The incidence of preoperative risk factors was similar for the two groups...... combined failed to permit identification of patients in whom the perioperative survival rate was 0%. Even 20% of patients with multiorgan failure survived for 6 months. Of those patients who needed ICU therapy for more than 48 hours, 41 (38%) were alive at the end of 1988. In response to a questionnaire...

  13. Abdominal epilepsy in a Nigerian child S

    African Journals Online (AJOL)

    Abdominal epilepsy is an exceptionally rare cause of abdominal pain that is more likely to ... We report on a child with episodic paroxysmal abdominal pain, accompanied by ... causes for the presenting complaints, work-up should proceed.

  14. Activation of Stat-3 is involved in the induction of apoptosis after ligation of major histocompatibility complex class I molecules on human Jurkat T cells

    DEFF Research Database (Denmark)

    Skov, S; Nielsen, M; Bregenholt, S

    1998-01-01

    Activation of Janus tyrosine kinases (Jak) and Signal transducers and activators of transcription (Stat) after ligation of major histocompatibility complex class I (MHC-I) was explored in Jurkat T cells. Cross-linking of MHC-I mediated tyrosine phosphorylation of Tyk2, but not Jak1, Jak2, and Jak3......-probe derived from the interferon-gamma activated site (GAS) in the c-fos promoter, a common DNA sequence for Stat protein binding. An association between hSIE and Stat-3 after MHC-I ligation was directly demonstrated by precipitating Stat-3 from nuclear extracts with biotinylated hSIE probe and avidin......-coupled agarose. To investigate the function of the activated Stat-3, Jurkat T cells were transiently transfected with a Stat-3 isoform lacking the transactivating domain. This dominant-negative acting Stat-3 isoform significantly inhibited apoptosis induced by ligation of MHC-I. In conclusion, our data suggest...

  15. Ligation of major histocompatibility complex class I antigens (MHC-I) prevents apoptosis induced by Fas or SAPK/JNK activation in T-lymphoma cells

    DEFF Research Database (Denmark)

    Lamberth, K; Claesson, M H

    2001-01-01

    Early apoptosis in Jurkat T-lymphoma cells was induced by agonistic anti-Fas Ab or by anisomycin which activates the stress kinases SAPK/JNK. Apoptosis was inhibited by ligation of major histocompatibility complex class I antigens (MHC-I). MHC-I ligation induced upregulation of the anti......-apoptotic Bcl-2 protein and stabilized the mitochondrial membrane potential (Deltapsim). MHC-I ligation also prevented downregulation of Bcl-2 and destabilization of Deltapsim induced by anti-Fas Ab treatment or anisomycin exposure. Studies on three different Jurkat cell mutants deficient for src p56(lck), ZAP......-70 kinase, or TCR/CD3 gamma-chain showed that the cells undergo apoptosis after Fas ligation. Anisomycin exposure induced apoptosis in the src p56(lck)-deficient cell line but not in the two other mutant cell lines. Simultaneous cross-linking of MHC-I and Fas ligation inhibited apoptosis in the ZAP...

  16. T-cell activation. VI. Inhibitory and stimulatory effects of anti-major histocompatibility complex class I antibodies in allogeneic mixed lymphocyte culture

    DEFF Research Database (Denmark)

    Röpke, M; Röpke, C; Claesson, Mogens Helweg

    1993-01-01

    Murine T splenocytes stimulated in primary allogeneic mixed lymphocyte culture (MLC) were incubated with soluble anti-major histocompatibility complex (MHC) class I monoclonal antibodies. These antibodies induced inhibition in the cytotoxicity of the responding population and this inhibition...... was not dependent on the domain on class I molecules recognized by the antibodies. Cross-reactivity of the antibodies between the responder and stimulating cell population caused a marked reduction in the inhibitory effect compared to systems where no such cross-reactivity was present. Saturating levels...... of the antibodies caused a reduction in generation of T-cell cytotoxicity, whereas low concentrations stimulated the same response. These results demonstrate that the MHC class I molecules of T cells are of significant importance in antigen-induced signal transduction....

  17. Automated Analysis of Flow Cytometry Data to Reduce Inter-Lab Variation in the Detection of Major Histocompatibility Complex Multimer-Binding T Cells

    DEFF Research Database (Denmark)

    Pedersen, Natasja Wulff; Chandran, P. Anoop; Qian, Yu

    2017-01-01

    Manual analysis of flow cytometry data and subjective gate-border decisions taken by individuals continue to be a source of variation in the assessment of antigen-specific T cells when comparing data across laboratories, and also over time in individual labs. Therefore, strategies to provide...... automated analysis of major histocompatibility complex (MHC) multimer-binding T cells represent an attractive solution to decrease subjectivity and technical variation. The challenge of using an automated analysis approach is that MHC multimer-binding T cell populations are often rare and therefore...... laboratories. We used three different methods, FLOw Clustering without K (FLOCK), Scalable Weighted Iterative Flow-clustering Technique (SWIFT), and ReFlow to analyze flow cytometry data files from 28 laboratories. Each laboratory screened for antigen-responsive T cell populations with frequency ranging from 0...

  18. VACUUM THERAPY VERSUS ABDOMINAL EXERCISES ON ABDOMINAL OBESITY

    Directory of Open Access Journals (Sweden)

    Nevein Mohammed Mohammed Gharib

    2016-06-01

    Full Text Available Background: Obesity is a medical condition that may adversely affect wellbeing and leading to increased incidence of many health problems. Abdominal obesity tends to be associated with weight gain and obesity and it is significantly connected with different disorders like coronary heart disease and type II diabetes mellitus.This study was conducted to investigate the efficacy of vacuum therapy as compared to abdominal exercises on abdominal obesity in overweight and obese women. Methods: Thirtyoverweight and obese women participated in this study with body mass index > 25 kg/m2andwaist circumference ≥ 85 cm. Their ages ranged from 28 - 40 years old.The subjects were excluded if they have diabetes, abdominal infection diseases or any physical limitation restricting exercise ability. They were randomly allocated into two equal groups; group I and group II. Group I received vacuum therapy sessions (by the use of LPG device in addition to aerobic exercise training. Group II received abdominal exercises in addition to the same aerobic exercisesgiven to group I. This study was extended for successive 8 weeks (3 sessions/ week. All subjects were assessed for thickness ofnthe abdominal skin fold, waist circumference and body mass index. Results: The results of this study showeda significant difference between group I and group II post-interventionas regarding to the mean values of waist circumference and abdominal skin fold thickness (p<0.05. Conclusion: It can be concluded that aerobic exercises combined with vacuum therapy (for three sessions/week for successive 8 weeks have a positive effect on women with abdominal obesity in terms of reducing waist circumference and abdominal skin fold thickness.

  19. Abdominal injuries in communal crises: The Jos experience

    Directory of Open Access Journals (Sweden)

    Emmanuel Olorundare Ojo

    2016-01-01

    Full Text Available Background: Abdominal injuries contribute significantly to battlefield trauma morbidity and mortality. This study sought to determine the incidence, demographics, clinical features, spectrum, severity, management, and outcome of abdominal trauma during a civilian conflict. Materials and Methods: A prospective analysis of patients treated for abdominal trauma during the Jos civil crises between December 2010 and May 2012 at the Jos University Teaching Hospital. Results: A total of 109 victims of communal conflicts with abdominal injuries were managed during the study period with 89 (81.7% males and 20 (18.3% females representing about 12.2% of the total 897 combat related injuries. The peak age incidence was between 21 and 40 years (range: 3–71 years. The most frequently injured intra-abdominal organs were the small intestine 69 (63.3%, colon 48 (44%, and liver 41 (37.6%. Forty-four (40.4% patients had extra-abdominal injuries involving the chest in 17 (15.6%, musculoskeletal 12 (11%, and the head in 9 (8.3%. The most prevalent weapon injuries were gunshot 76 (69.7%, explosives 12 (11%, stab injuries 11 (10.1%, and blunt abdominal trauma 10 (9.2%. The injury severity score varied from 8 to 52 (mean: 20.8 with a fatality rate of 11 (10.1% and morbidity rate of 29 (26.6%. Presence of irreversible shock, 3 or more injured intra-abdominal organs, severe head injuries, and delayed presentation were the main factors associated with mortality. Conclusion: Abdominal trauma is major life-threatening injuries during conflicts. Substantial mortality occurred with loss of nearly one in every 10 hospitalized victims despite aggressive emergency room resuscitation. The resources expenditure, propensity for death and expediency of timing reinforce the need for early access to the wounded in a concerted trauma care systems.

  20. Engineering chimeric human and mouse major histocompatibility complex (MHC) class I tetramers for the production of T-cell receptor (TCR) mimic antibodies

    Science.gov (United States)

    Bentley, Carol; Yates, Jenna; Salimi, Maryam; Greig, Jenny; Wiblin, Sarah; Hassanali, Tasneem; Banham, Alison H.

    2017-01-01

    Therapeutic monoclonal antibodies targeting cell surface or secreted antigens are among the most effective classes of novel immunotherapies. However, the majority of human proteins and established cancer biomarkers are intracellular. Peptides derived from these intracellular proteins are presented on the cell surface by major histocompatibility complex class I (MHC-I) and can be targeted by a novel class of T-cell receptor mimic (TCRm) antibodies that recognise similar epitopes to T-cell receptors. Humoural immune responses to MHC-I tetramers rarely generate TCRm antibodies and many antibodies recognise the α3 domain of MHC-I and β2 microglobulin (β2m) that are not directly involved in presenting the target peptide. Here we describe the production of functional chimeric human-murine HLA-A2-H2Dd tetramers and modifications that increase their bacterial expression and refolding efficiency. These chimeric tetramers were successfully used to generate TCRm antibodies against two epitopes derived from wild type tumour suppressor p53 (RMPEAAPPV and GLAPPQHLIRV) that have been used in vaccination studies. Immunisation with chimeric tetramers yielded no antibodies recognising the human α3 domain and β2m and generated TCRm antibodies capable of specifically recognising the target peptide/MHC-I complex in fully human tetramers and on the cell surface of peptide pulsed T2 cells. Chimeric tetramers represent novel immunogens for TCRm antibody production and may also improve the yield of tetramers for groups using these reagents to monitor CD8 T-cell immune responses in HLA-A2 transgenic mouse models of immunotherapy. PMID:28448627

  1. Errors in abdominal computed tomography

    International Nuclear Information System (INIS)

    Stephens, S.; Marting, I.; Dixon, A.K.

    1989-01-01

    Sixty-nine patients are presented in whom a substantial error was made on the initial abdominal computed tomography report. Certain features of these errors have been analysed. In 30 (43.5%) a lesion was simply not recognised (error of observation); in 39 (56.5%) the wrong conclusions were drawn about the nature of normal or abnormal structures (error of interpretation). The 39 errors of interpretation were more complex; in 7 patients an abnormal structure was noted but interpreted as normal, whereas in four a normal structure was thought to represent a lesion. Other interpretive errors included those where the wrong cause for a lesion had been ascribed (24 patients), and those where the abnormality was substantially under-reported (4 patients). Various features of these errors are presented and discussed. Errors were made just as often in relation to small and large lesions. Consultants made as many errors as senior registrar radiologists. It is like that dual reporting is the best method of avoiding such errors and, indeed, this is widely practised in our unit. (Author). 9 refs.; 5 figs.; 1 tab

  2. Magnetism mediated by a majority of [Fe³⁺ + VO²⁻] complexes in Fe-doped CeO₂ nanoparticles.

    Science.gov (United States)

    Paidi, V K; Ferreira, N S; Goltz, D; van Lierop, J

    2015-08-26

    We examine the role of Fe(3+) and vacancies (V(O)) on the magnetism of Fe-doped CeO2 nanoparticles. Magnetic nanoparticles of Ce(100-x)Fe(x)O2 (x  =  0, 0.26, 1.82, 2.64, 5.26, 6.91, and 7.22) were prepared by a co-precipitation method, and their structural, compositional and magnetic properties were investigated. The CeO2 nanoparticles had a mixed valance of Ce(4+) and Ce(3+) ions, and doping introduced Fe(3+) ions. The decrease in Ce(3+) and increase in Fe(3+) concentrations indicated the presence of more [Fe(3+) + V(O)(2-)] complexes with Fe loading in the particles. Charge neutralization, Fe(3+) + V(O)(2-) + 2Ce(4+) ↔ 2Ce(3+) + Fe(3+), identified the impact of V(O) on the magnetism, where our results suggest that the Fe-doped CeO2 nanoparticle magnetism is mediated by a majority of [Fe(3+) + V(O)(2-)]-Ce(3+) -[Fe(3+) + V(O)(2-)] complexes.

  3. Three-Year Major Clinical Outcomes of Angiography-Guided Single Stenting Technique in Non-Complex Left Main Coronary Artery Diseases.

    Science.gov (United States)

    Kim, Yong Hoon; Her, Ae-Young; Rha, Seung-Woon; Choi, Byoung Geol; Shim, Minsuk; Choi, Se Yeon; Byun, Jae Kyeong; Li, Hu; Kim, Woohyeun; Kang, Jun Hyuk; Choi, Jah Yeon; Park, Eun Jin; Park, Sung Hun; Lee, Sunki; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo

    2017-10-12

    There is limited long-term comparative clinical outcome data concerning angiography- versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in non-complex left main coronary artery (LMCA) disease treated with the single stenting technique in the drug-eluting stent (DES) era.The aim of this study was to investigate whether angiography-guided stenting is comparable to IVUS-guided stenting during 3-year clinical follow-up periods in patients with non-complex LM disease treated with the single stenting technique.A total of 196 patients treated with either angiography-guided (n = 74) or IVUS-guided (n = 122) PCI were included. The primary outcome was the occurrence of major adverse cardiac events (MACE) defined as total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and non-target vessel revascularization (Non-TVR). To adjust for any potential confounders, propensity score (PS) adjusted analysis was performed.During 3-year follow-up, the PS adjusted Cox-proportional hazard ratio (HR) was not significantly different between the two groups for total death, cardiac death, and MI. Also, TLR and the combined rates of TVR and non-TVR were not significantly different. Finally, MACE was not significantly different between the two groups (HR: 0.63, 95% Confidence interval (CI): 0.33-1.17; P = 0.149).Angiography-guided PCI for non-complex LMCA diseases treated with the single stenting technique showed comparable results compared with IVUS-guided PCI in reducing clinical events during 3-year clinical follow-up in the DES era. Although IVUS guided PCI is the ideal strategy, angiography-guided PCI can be an option for LMCA PCI in some selected cases.

  4. Low Major Histocompatibility Complex Class II Variation in the Endangered Indo-Pacific Humpback Dolphin (Sousa chinensis): Inferences About the Role of Balancing Selection.

    Science.gov (United States)

    Zhang, Xiyang; Lin, Wenzhi; Zhou, Ruilian; Gui, Duan; Yu, Xinjian; Wu, Yuping

    2016-03-01

    It has been widely reported that the major histocompatibility complex (MHC) is under balancing selection due to its immune function across terrestrial and aquatic mammals. The comprehensive studies at MHC and other neutral loci could give us a synthetic evaluation about the major force determining genetic diversity of species. Previously, a low level of genetic diversity has been reported among the Indo-Pacific humpback dolphin (Sousa chinensis) in the Pearl River Estuary (PRE) using both mitochondrial marker and microsatellite loci. Here, the expression and sequence polymorphism of 2 MHC class II genes (DQB and DRB) in 32 S. chinensis from PRE collected between 2003 and 2011 were investigated. High ratios of non-synonymous to synonymous substitution rates, codon-based selection analysis, and trans-species polymorphism (TSP) support the hypothesis that balancing selection acted on S. chinensis MHC sequences. However, only 2 haplotypes were detected at either DQB or DRB loci. Moreover, the lack of deviation from the Hardy-Weinberg expectation at DRB locus combined with the relatively low heterozygosity at both DQB locus and microsatellite loci suggested that balancing selection might not be sufficient, which further suggested that genetic drift associated with historical bottlenecks was not mitigated by balancing selection in terms of the loss of MHC and neutral variation in S. chinensis. The combined results highlighted the importance of maintaining the genetic diversity of the endangered S. chinensis. © The American Genetic Association 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Association of a specific major histocompatibility complex class IIβ single nucleotide polymorphism with resistance to lactococcosis in rainbow trout, Oncorhynchus mykiss (Walbaum).

    Science.gov (United States)

    Colussi, S; Prearo, M; Bertuzzi, S A; Scanzio, T; Peletto, S; Favaro, L; Modesto, P; Maniaci, M G; Ru, G; Desiato, R; Acutis, P L

    2015-01-01

    Major histocompatibility complex (MHC) loci encode glycoproteins that bind to foreign peptides and initiate immune responses through their interaction with T cells. MHC class II molecules are heterodimers consisting of α and β chains encoded by extremely variable genes; variation in exon 2 is responsible for the majority of observed polymorphisms, mostly concentrated in the codons specifying the peptide-binding region. Lactococcus garvieae is the causative agent of lactococcosis, a warm-water bacterial infection pathogenic for cultured freshwater and marine fish. It causes considerable economic losses, limiting the profitability and development of fish industries in general and the intensive production of rainbow trout, Oncorhynchus mykiss (Walbaum), in particular. The disease is currently controlled with vaccines and antibiotics; however, vaccines have short-term efficacy, and increasing concerns regarding antibiotic residues have called for alternative strategies. To explore the involvement of the MHC class II β-1 domain as a candidate gene for resistance to lactococcosis, we exposed 400 rainbow trout to naturally contaminated water. One single nucleotide polymorphism (SNP) and one haplotype were associated with resistance (P trout resistant to lactococcosis. © 2014 John Wiley & Sons Ltd.

  6. Abdominal elephantiasis: a case report.

    Science.gov (United States)

    Hanna, Dominique; Cloutier, Richard; Lapointe, Roch; Desgagné, Antoine

    2004-01-01

    Elephantiasis is a well-known condition in dermatology usually affecting the legs and external genitalia. It is characterized by chronic inflammation and obstruction of the lymphatic channels and by hypertrophy of the skin and subcutaneous tissues. The etiology is either idiopathic or caused by a variety of conditions such as chronic filarial disease, leprosy, leishmaniasis, and chronic recurrent cellulites. Elephantiasis of the abdominal wall is very rare. A complete review of the English and French literature showed only two cases reported in 1966 and 1973, respectively. We report a third case of abdominal elephantiasis and we briefly review this entity. We present the case of a 51-year-old woman who had progressively developed an enormous pediculated abdominal mass hanging down her knees. The skin was thickened, hyperpigmented, and fissured. She had a history of multiple abdominal cellulites. She underwent an abdominal lipectomy. Histopathology of the specimen confirmed the diagnosis of abdominal elephantiasis. Abdominal elephantiasis is a rare disease that represents end-stage failure of lymph drainage. Lipectomy should be considered in the management of this condition.

  7. Penetrating abdominal trauma.

    Science.gov (United States)

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  8. A Newborn With Abdominal Pain.

    Science.gov (United States)

    Alwan, Riham; Drake, Meredith; Gurria Juarez, Juan; Emery, Kathleen H; Shaaban, Aimen F; Szabo, Sara; Sobolewski, Brad

    2017-11-01

    A previously healthy 3-week-old boy presented with 5 hours of marked fussiness, abdominal distention, and poor feeding. He was afebrile and well perfused. His examination was remarkable for localized abdominal tenderness and distention. He was referred to the emergency department in which an abdominal radiograph revealed gaseous distention of the bowel with a paucity of gas in the pelvis. Complete blood cell count and urinalysis were unremarkable. His ongoing fussiness and abnormal physical examination prompted consultation with surgery and radiology. Our combined efforts ultimately established an unexpected diagnosis. Copyright © 2017 by the American Academy of Pediatrics.

  9. Simultaneous repair of abdominal aortic aneurysm and resection of unexpected, associated abdominal malignancies.

    Science.gov (United States)

    Illuminati, Giulio; Calio', Francesco G; D'Urso, Antonio; Lorusso, Riccardo; Ceccanei, Gianluca; Vietri, Francesco

    2004-12-15

    The management of unexpected intra-abdominal malignancy, discovered at laparotomy for elective treatment of an abdominal aortic aneurysm (AAA), is controversial. It is still unclear whether both conditions should be treated simultaneously or a staged approach is to be preferred. To contribute in improving treatment guidelines, we retrospectively reviewed the records of patients undergoing laparotomy for elective AAA repair. From January 1994 to March 2003, 253 patients underwent elective, trans-peritoneal repair of an AAA. In four patients (1.6%), an associated, unexpected neoplasm was detected at abdominal exploration, consisting of one renal, one gastric, one ileal carcinoid, and one ascending colon tumor. All of them were treated at the same operation, after aortic repair and careful isolation of the prosthetic graft. The whole series' operative mortality was 3.6%. None of the patients simultaneously treated for AAA and tumor resection died in the postoperative period. No graft-related infections were observed. Simultaneous treatment of AAA and tumor did not prolong significantly the mean length of stay in the hospital, compared to standard treatment of AAA alone. Except for malignancies of organs requiring major surgical resections, simultaneous AAA repair and resection of an associated, unexpected abdominal neoplasm can be safely performed, in most of the patients, sparing the need for a second procedure. Endovascular grafting of the AAA can be a valuable tool in simplifying simultaneous treatment, or in staging the procedures with a very short delay.

  10. CT of hemodynamically unstable abdominal trauma

    International Nuclear Information System (INIS)

    Petridis, A.; Pilavaki, M.; Vafiadis, E.; Palladas, P.; Finitsis, S.; Drevelegas, A.

    1999-01-01

    This article is an appraisal of the use of CT in the management of patients with unstable abdominal trauma. We examined 41 patients with abdominal trauma using noncontrast dynamic CT. In 17 patients a postcontrast dynamic CT was also carried out. On CT, 25 patients had hemoperitoneum. Thirteen patients had splenic, 12 hepatic, 6 pancreatic, 8 bowel and mesenteric, 12 renal and 2 vascular injuries. Seven patients had retroperitoneal and 2 patients adrenal hematomas. All but five lesions (three renal, one pancreatic, and one splenic) were hypodense when CT was performed earlier than 8 h following the injury. Postcontrast studies (n = 17), revealed 4 splenic, 3 hepatic, 1 pancreatic, 3 renal, and 2 bowel and mesenteric injuries beyond what was found on noncontrast CT. Surgical confirmation (n = 21) was obtained in 81.81 % of splenic, 66.66 % of hepatic, 83.33 % of pancreatic, 100 % of renal, 100 % of retroperitoneal, and 85.71 % of bowel and mesenteric injuries. The majority of false diagnoses was obtained with noncontrast studies. Computed tomography is a remarkable method for evaluation and management of patients with hemodynamically unstable abdominal trauma, but only if it is revealed in the emergency room. Contrast injection, when it could be done, revealed lesions that were not suspected on initial plain scans. (orig.)

  11. CT of hemodynamically unstable abdominal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Petridis, A.; Pilavaki, M.; Vafiadis, E.; Palladas, P.; Finitsis, S.; Drevelegas, A. [Department of Radiology, General Hospital ``G. Papanikolaou,`` Thessaloniki (Greece)

    1999-03-01

    This article is an appraisal of the use of CT in the management of patients with unstable abdominal trauma. We examined 41 patients with abdominal trauma using noncontrast dynamic CT. In 17 patients a postcontrast dynamic CT was also carried out. On CT, 25 patients had hemoperitoneum. Thirteen patients had splenic, 12 hepatic, 6 pancreatic, 8 bowel and mesenteric, 12 renal and 2 vascular injuries. Seven patients had retroperitoneal and 2 patients adrenal hematomas. All but five lesions (three renal, one pancreatic, and one splenic) were hypodense when CT was performed earlier than 8 h following the injury. Postcontrast studies (n = 17), revealed 4 splenic, 3 hepatic, 1 pancreatic, 3 renal, and 2 bowel and mesenteric injuries beyond what was found on noncontrast CT. Surgical confirmation (n = 21) was obtained in 81.81 % of splenic, 66.66 % of hepatic, 83.33 % of pancreatic, 100 % of renal, 100 % of retroperitoneal, and 85.71 % of bowel and mesenteric injuries. The majority of false diagnoses was obtained with noncontrast studies. Computed tomography is a remarkable method for evaluation and management of patients with hemodynamically unstable abdominal trauma, but only if it is revealed in the emergency room. Contrast injection, when it could be done, revealed lesions that were not suspected on initial plain scans. (orig.) With 6 figs., 5 tabs., 20 refs.

  12. Abdominal aortic feminism.

    Science.gov (United States)

    Mortimer, Alice Emily

    2014-11-14

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer. 2014 BMJ Publishing Group Ltd.

  13. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... not use ionizing radiation, has no known harmful effects, and is particularly valuable for evaluating abdominal, pelvic or scrotal pain in children. Preparation will depend on the type of examination. ...

  14. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... child's abdominal ultrasound examination. Doppler ultrasound , also called color Doppler ultrasonography, is a special ultrasound technique that ... and processes the sounds and creates graphs or color pictures that represent the flow of blood through ...

  15. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Children's (pediatric) ... uterus Abdominal ultrasound images can be used to help diagnose appendicitis in children. Except for traumatic injury, ...

  16. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... children. Except for traumatic injury, appendicitis is the most common reason for emergency abdominal surgery. Ultrasound imaging ... of page How is the procedure performed? For most ultrasound exams, you will be positioned lying face- ...

  17. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... of an apparent enlarged abdominal organ identify the location of abnormal fluid in the abdomen help determine ... places the transducer on the skin in various locations, sweeping over the area of interest or angling ...

  18. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... arteries and veins in the abdomen, arms, legs, neck and/or brain (in infants and children) or ... help a physician determine the source of abdominal pain, such as gallstones, kidney stones, abscesses or an ...

  19. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... for traumatic injury, appendicitis is the most common reason for emergency abdominal surgery. Ultrasound imaging can also: ... be necessary. Your doctor will explain the exact reason why another exam is requested. Sometimes a follow- ...

  20. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... kidneys. top of page What are some common uses of the procedure? Abdominal ultrasound imaging is performed ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...

  1. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... ultrasound images are captured in real-time, they can show the structure and movement of the body's ... kidneys bladder testicles ovaries uterus Abdominal ultrasound images can be used to help diagnose appendicitis in children. ...

  2. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... apparent enlarged abdominal organ identify the location of abnormal fluid in the abdomen help determine causes of ... are used to extract sample cells from an abnormal area for laboratory testing. Ultrasound may also be ...

  3. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... imaging produces pictures of the internal organs and blood vessels located within a child's abdomen. A Doppler ultrasound study may be part of a child's abdominal ultrasound ...

  4. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... kidneys. top of page What are some common uses of the procedure? Abdominal ultrasound imaging is performed ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  5. Intra-abdominal tuberculous peritonitis

    International Nuclear Information System (INIS)

    Schneider, G.; Ahlhelm, F.; Altmeyer, K.; Kramann, B.; Hennes, P.; Pueschel, W.; Karadiakos, N.

    2001-01-01

    We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies. (orig.)

  6. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... not use ionizing radiation, has no known harmful effects, and is particularly valuable for evaluating abdominal, pelvic ... of the reflected sound waves (called the Doppler effect). A computer collects and processes the sounds and ...

  7. Linking Abdominal Obesity and Dyslipidemia

    Directory of Open Access Journals (Sweden)

    Pedro Enrique Miguel Soca

    2011-10-01

    Full Text Available Considering as a start point the discussion of an article published by this same journal (Finlay in its previous issue, this letter deals with some alterations associating abdominal obesity and dyslipidemia.

  8. Intra-abdominal tuberculous peritonitis

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, G.; Ahlhelm, F.; Altmeyer, K.; Kramann, B. [Dept. of Diagnostic Radiology, University Hospital, Homburg (Germany); Hennes, P. [Dept. of Pediatrics, University Hospital, Homburg (Germany); Pueschel, W. [Dept. of Pathology, University Hospital, Homburg (Germany); Karadiakos, N. [Dept. of Pediatric Surgery, University Hospital, Homburg (Germany)

    2001-07-01

    We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies. (orig.)

  9. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... various body organs such as the liver or kidneys. top of page What are some common uses ... appendix stomach/ pylorus liver gallbladder spleen pancreas intestines kidneys bladder testicles ovaries uterus Abdominal ultrasound images can ...

  10. Recovery after abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim

    2017-01-01

    Incisional hernia is a common long-term complication to abdominal surgery, occurring in more than 20% of all patients. Some of these hernias become giant and affect patients in several ways. This patient group often experiences pain, decreased perceived body image, and loss of physical function......, which results in a need for surgical repair of the giant hernia, known as abdominal wall reconstruction. In the current thesis, patients with a giant hernia were examined to achieve a better understanding of their physical and psychological function before and after abdominal wall reconstruction. Study...... was lacking. Study II was a case-control study of the effects of an enhanced recovery after surgery pathway for patients undergoing abdominal wall reconstruction for a giant hernia. Sixteen consecutive patients were included prospectively after the implementation of a new enhanced recovery after surgery...

  11. HIV Controllers Exhibit Enhanced Frequencies of Major Histocompatibility Complex Class II Tetramer+ Gag-Specific CD4+ T Cells in Chronic Clade C HIV-1 Infection.

    Science.gov (United States)

    Laher, Faatima; Ranasinghe, Srinika; Porichis, Filippos; Mewalal, Nikoshia; Pretorius, Karyn; Ismail, Nasreen; Buus, Søren; Stryhn, Anette; Carrington, Mary; Walker, Bruce D; Ndung'u, Thumbi; Ndhlovu, Zaza M

    2017-04-01

    Immune control of viral infections is heavily dependent on helper CD4 + T cell function. However, the understanding of the contribution of HIV-specific CD4 + T cell responses to immune protection against HIV-1, particularly in clade C infection, remains incomplete. Recently, major histocompatibility complex (MHC) class II tetramers have emerged as a powerful tool for interrogating antigen-specific CD4 + T cells without relying on effector functions. Here, we defined the MHC class II alleles for immunodominant Gag CD4 + T cell epitopes in clade C virus infection, constructed MHC class II tetramers, and then used these to define the magnitude, function, and relation to the viral load of HIV-specific CD4 + T cell responses in a cohort of untreated HIV clade C-infected persons. We observed significantly higher frequencies of MHC class II tetramer-positive CD4 + T cells in HIV controllers than progressors ( P = 0.0001), and these expanded Gag-specific CD4 + T cells in HIV controllers showed higher levels of expression of the cytolytic proteins granzymes A and B. Importantly, targeting of the immunodominant Gag41 peptide in the context of HLA class II DRB1*1101 was associated with HIV control ( r = -0.5, P = 0.02). These data identify an association between HIV-specific CD4 + T cell targeting of immunodominant Gag epitopes and immune control, particularly the contribution of a single class II MHC-peptide complex to the immune response against HIV-1 infection. Furthermore, these results highlight the advantage of the use of class II tetramers in evaluating HIV-specific CD4 + T cell responses in natural infections. IMPORTANCE Increasing evidence suggests that virus-specific CD4 + T cells contribute to the immune-mediated control of clade B HIV-1 infection, yet there remains a relative paucity of data regarding the role of HIV-specific CD4 + T cells in shaping adaptive immune responses in individuals infected with clade C, which is responsible for the majority of HIV

  12. Characterization of major histocompatibility complex class I, and class II DRB loci of captive and wild Indian leopards (Panthera pardus fusca).

    Science.gov (United States)

    Parmar, Drashti R; Mitra, Siuli; Bhadouriya, Snehalata; Rao, Tirupathi; Kunteepuram, Vaishnavi; Gaur, Ajay

    2017-12-01

    The major histocompatibility complex (MHC), in vertebrate animals, is a multi-genic protein complex that encodes various receptors. During a disease, MHC interacts with the antigen and triggers a cascade of adaptive immune responses to overcome a disease outbreak. The MHC is very important region from immunological point of view, but it is poorly characterized among Indian leopards. During this investigation, we examined genetic diversity for MHC class I (MHC-I) and MHC class II-DRB (MHC-II) among wild and captive Indian leopards. This study estimated a pool of 9 and 17 alleles for MHC-I and MHC-II, respectively. The wild group of individuals showed higher nucleotide diversity and amino acid polymorphism compared to the captive group. A phylogenetic comparison with other felids revealed a clustering in MHC-I and interspersed presence in MHC-II sequences. A test for selection also revealed a deviation from neutrality at MHC-II DRB loci and higher non-synonymous substitution rate (dN) among the individuals from wild group. Further, the wild individuals showed higher dN for both MHC I and II genes compared to the group that was bred under captive conditions. These findings suggest the role of micro-evolutionary forces, such as pathogen-mediated selection, to cause MHC variations among the two groups of Indian leopards, because the two groups have been bred in two different environments for a substantial period of time. Since, MHC diversity is often linked with the quality of immunological health; the results obtained from this study fill the gap of knowledge on disease predisposition among wild and captive Indian leopards.

  13. Ectopic intra-abdominal fascioliasis

    OpenAIRE

    ÖNGÖREN, Ali Ulvi

    2009-01-01

    Human fascioliasis, caused by Fasciola hepatica, is emerging as an important chronic zoonotic disease in many areas of the world, including Turkey. It primarily involves the liver and may also cause severe damage in the tissue. Herein we report on a patient with ectopic intra-abdominal fascioliasis that presented to our clinic with abdominal pain and distention. Physical and radiological examination as well as an exploratory laparotomy revealed a 10 × 10-cm mass in the splenic flexura of the ...

  14. CT findings in abdominal actinomycosis

    International Nuclear Information System (INIS)

    Lee, In Jae; Ha, Hyun Kwon; Lee, Moon Gyu; Kim, Pyo Nyun; Auh, Yong Ho

    1999-01-01

    Abdominal actinomycosis is a chronic, progressive, suppurative disease with a favorable response to intravenous treatment with penicillin. In many instances, however, its clinical and radiological findings may overlap with those of other inflammatory and neoplastic conditions, and the familiarity with the various radiological features can thus avoid diagnostic delays. The purpose of this paper is to describe and discuss the CT findings of abdominal actinomycosis

  15. Characterization of major histocompatibility complex (MHC DRB exon 2 and DRA exon 3 fragments in a primary terrestrial rabies vector (Procyon lotor.

    Directory of Open Access Journals (Sweden)

    Sarrah Castillo

    Full Text Available The major histocompatibility complex (MHC presents a unique system to explore links between genetic diversity and pathogens, as diversity within MHC is maintained in part by pathogen driven selection. While the majority of wildlife MHC studies have investigated species that are of conservation concern, here we characterize MHC variation in a common and broadly distributed species, the North American raccoon (Procyon lotor. Raccoons host an array of broadly distributed wildlife diseases (e.g., canine distemper, parvovirus and raccoon rabies virus and present important human health risks as they persist in high densities and in close proximity to humans and livestock. To further explore how genetic variation influences the spread and maintenance of disease in raccoons we characterized a fragment of MHC class II DRA exon 3 (250 bp and DRB exon 2 (228 bp. MHC DRA was found to be functionally monomorphic in the 32 individuals screened; whereas DRB exon 2 revealed 66 unique alleles among the 246 individuals screened. Between two and four alleles were observed in each individual suggesting we were amplifying a duplicated DRB locus. Nucleotide differences between DRB alleles ranged from 1 to 36 bp (0.4-15.8% divergence and translated into 1 to 21 (1.3-27.6% divergence amino acid differences. We detected a significant excess of nonsynonymous substitutions at the peptide binding region (P = 0.005, indicating that DRB exon 2 in raccoons has been influenced by positive selection. These data will form the basis of continued analyses into the spatial and temporal relationship of the raccoon rabies virus and the immunogenetic response in its primary host.

  16. Epidemiology and contemporary management of abdominal aortic aneurysms.

    Science.gov (United States)

    Ullery, Brant W; Hallett, Richard L; Fleischmann, Dominik

    2018-05-01

    Abdominal aortic aneurysm (AAA) is most commonly defined as a maximal diameter of the abdominal aorta in excess of 3 cm in either anterior-posterior or transverse planes or, alternatively, as a focal dilation ≥ 1.5 times the diameter of the normal adjacent arterial segment. Risk factors for the development of AAA include age > 60, tobacco use, male gender, Caucasian race, and family history of AAA. Aneurysm growth and rupture risk appear to be associated with persistent tobacco use, female gender, and chronic pulmonary disease. The majority of AAAs are asymptomatic and detected incidentally on various imaging studies, including abdominal ultrasound, and computed tomographic angiography. Symptoms associated with AAA may include abdominal or back pain, thromboembolization, atheroembolization, aortic rupture, or development of an arteriovenous or aortoenteric fistula. The Screening Abdominal Aortic Aneurysms Efficiently (SAAAVE) Act provides coverage for a one-time screening abdominal ultrasound at age 65 for men who have smoked at least 100 cigarettes and women who have family history of AAA disease. Medical management is recommended for asymptomatic patients with AAAs  5 mm/6 months), or presence of a fusiform aneurysm with maximum diameter of 5.5 cm or greater. Intervention for AAA includes conventional open surgical repair and endovascular aortic stent graft repair.

  17. Blunt abdominal trauma in children.

    Science.gov (United States)

    Schonfeld, Deborah; Lee, Lois K

    2012-06-01

    This review will examine the current evidence regarding pediatric blunt abdominal trauma and the physical exam findings, laboratory values, and radiographic imaging associated with the diagnosis of intra-abdominal injuries (IAI), as well as review the current literature on pediatric hollow viscus injuries and emergency department disposition after diagnosis. The importance of the seat belt sign on physical examination and screening laboratory data remains controversial, although screening hepatic enzymes are recommended in the evaluation of nonaccidental trauma to identify occult abdominal organ injuries. Focused Assessment with Sonography for Trauma (FAST) has modest sensitivity for hemoperitoneum and IAI in the pediatric trauma patient. Patients with concern for undiagnosed IAI, including bowel injury, may be considered for hospital admission and serial abdominal exams without an increased risk of complications, if an exploratory laparotomy is not performed emergently. Although the FAST exam is not recommended as the sole screening tool to rule out IAI in hemodynamically stable trauma patients, it may be used in conjunction with the physical exam and laboratory findings to identify children at risk for IAI. Children with a normal physical exam and normal abdominal CT may not require routine hospitalization after blunt abdominal trauma.

  18. Quantification of HLA-DM-Dependent Major Histocompatibility Complex of Class II Immunopeptidomes by the Peptide Landscape Antigenic Epitope Alignment Utility

    Directory of Open Access Journals (Sweden)

    Miguel Álvaro-Benito

    2018-05-01

    Full Text Available The major histocompatibility complex of class II (MHCII immunopeptidome represents the repertoire of antigenic peptides with the potential to activate CD4+ T cells. An understanding of how the relative abundance of specific antigenic epitopes affects the outcome of T cell responses is an important aspect of adaptive immunity and offers a venue to more rationally tailor T cell activation in the context of disease. Recent advances in mass spectrometric instrumentation, computational power, labeling strategies, and software analysis have enabled an increasing number of stratified studies on HLA ligandomes, in the context of both basic and translational research. A key challenge in the case of MHCII immunopeptidomes, often determined for different samples at distinct conditions, is to derive quantitative information on consensus epitopes from antigenic peptides of variable lengths. Here, we present the design and benchmarking of a new algorithm [peptide landscape antigenic epitope alignment utility (PLAtEAU] allowing the identification and label-free quantification (LFQ of shared consensus epitopes arising from series of nested peptides. The algorithm simplifies the complexity of the dataset while allowing the identification of nested peptides within relatively short segments of protein sequences. Moreover, we apply this algorithm to the comparison of the ligandomes of cell lines with two different expression levels of the peptide-exchange catalyst HLA-DM. Direct comparison of LFQ intensities determined at the peptide level is inconclusive, as most of the peptides are not significantly enriched due to poor sampling. Applying the PLAtEAU algorithm for grouping of the peptides into consensus epitopes shows that more than half of the total number of epitopes is preferentially and significantly enriched for each condition. This simplification and deconvolution of the complex and ambiguous peptide-level dataset highlights the value of the PLAt

  19. Applicability of major histocompatibility complex DRB1 alleles as markers to detect vertebrate hybridization: a case study from Iberian ibex × domestic goat in southern Spain

    Directory of Open Access Journals (Sweden)

    Alasaad Samer

    2012-09-01

    Full Text Available Abstract Background Hybridization between closely related wild and domestic species is of great concern because it can alter the evolutionary integrity of the affected populations. The high allelic variability of Major Histocompatibility Complex (MHC loci usually excludes them from being used in studies to detect hybridization events. However, if a the parental species don’t share alleles, and b one of the parental species possesses an exceptionally low number of alleles (to facilitate analysis, then even MHC loci have the potential to detect hybrids. Results By genotyping the exon2 of the MHC class II DRB1 locus, we were able to detect hybridization between domestic goats (Capra hircus and free-ranging Iberian ibex (Capra pyrenaica hispanica by molecular means. Conclusions This is the first documentation of a Capra pyrenaica × Capra hircus hybridization, which presented us the opportunity to test the applicability of MHC loci as new, simple, cost-effective, and time-saving approach to detect hybridization between wild species and their domesticated relatives, thus adding value to MHC genes role in animal conservation and management.

  20. CD54/intercellular adhesion molecule 1 and major histocompatibility complex II signaling induces B cells to express interleukin 2 receptors and complements help provided through CD40 ligation

    DEFF Research Database (Denmark)

    Poudrier, J; Owens, T

    1994-01-01

    We have examined signaling roles for CD54 intercellular adhesion molecule 1 and major histocompatibility complex (MHC) II as contact ligands during T help for B cell activation. We used a T helper 1 (Th1)-dependent helper system that was previously shown to be contact as well as interleukin 2 (IL-2......) dependent to demonstrate the relative roles of CD54, MHC II, and CD40 signaling in the events leading to the induction of B cell proliferation and responsiveness to IL-2. Paraformaldehyde-fixed activated Th1-induced expression of IL-2R alpha, IL-2R beta, and B7, and upregulated MHC II and CD54 on B cells...... resulted in the upregulated expression of MHC II and of CD54 and B7, respectively, analogous to the effect of fixed activated Th1 cells. B7 expression was further enhanced by co-cross-linking CD54 and MHC II. Cross-linking of CD40 achieved comparable effects. Strikingly, cross-linking ligation of CD54...

  1. Spatial Dynamics of the Communities and the Role of Major Countries in the International Rare Earths Trade: A Complex Network Analysis.

    Science.gov (United States)

    Wang, Xibo; Ge, Jianping; Wei, Wendong; Li, Hanshi; Wu, Chen; Zhu, Ge

    2016-01-01

    Rare earths (RE) are critical materials in many high-technology products. Due to the uneven distribution and important functions for industrial development, most countries import RE from a handful of suppliers that are rich in RE, such as China. However, because of the rapid growth of RE exploitation and pollution of the mining and production process, some of the main suppliers have gradually tended to reduce the RE production and exports. Especially in the last decade, international RE trade has been changing in the trade community and trade volume. Based on complex network theory, we built an unweighted and weighted network to explore the evolution of the communities and identify the role of the major countries in the RE trade. The results show that an international RE trade network was dispersed and unstable because of the existence of five to nine trade communities in the unweighted network and four to eight trade communities in the weighted network in the past 13 years. Moreover, trade groups formed due to the great influence of geopolitical relations. China was often associated with the South America and African countries in the same trade group. In addition, Japan, China, the United States, and Germany had the largest impacts on international RE trade from 2002 to 2014. Last, some policy suggestions were highlighted according to the results.

  2. Modulation of the major histocompatibility complex by neural stem cell-derived neurotrophic factors used for regenerative therapy in a rat model of stroke

    Directory of Open Access Journals (Sweden)

    Sun Chongran

    2010-08-01

    Full Text Available Abstract Background The relationship between functional improvements in ischemic rats given a neural stem cell (NSC transplant and the modulation of the class I major histocompatibility complex (MHC mediated by NSC-derived neurotrophins was investigated. Methods The levels of gene expression of nerve growth factor (NGF, brain-derived neurotropic factor (BDNF and neurotrophin-3 (NT-3 were assayed from cultures of cortical NSC from Sprague-Dawley rat E16 embryos. The levels of translated NGF in spent culture media from NSC cultures and the cerebral spinal fluid (CSF of rats with and without NGF injection or NSC transplant were also measured. Results We found a significant increase of NGF, BDNF and NT-3 transcripts and NGF proteins in both the NSC cultures and the CSF of the rats. The immunochemical staining for MHC in brain sections and the enzyme-linked immunosorbent assay of CSF were carried out in sham-operated rats and rats with surgically induced focal cerebral ischemia. These groups were further divided into animals that did and did not receive NGF administration or NSC transplant into the cisterna magna. Our results show an up-regulation of class I MHC in the ischemic rats with NGF and NSC administration. The extent of caspase-III immunoreactivity was comparable among three arms in the ischemic rats. Conclusion Readouts of somatosensory evoked potential and the trap channel test illustrated improvements in the neurological function of ischemic rats treated with NGF administration and NSC transplant.

  3. Major-histocompatibility-complex-associated variation in secondary sexual traits of white-tailed deer (Odocoileus virginianus): evidence for good-genes advertisement.

    Science.gov (United States)

    Ditchkoff, S S; Lochmiller, R L; Masters, R E; Hoofer, S R; Van Den Bussche, R A

    2001-03-01

    Good-genes hypotheses predict that development of secondary sexual characters can be an honest advertisement of heritable male quality. We explored this hypothesis using a cervid model (adult, male white-tailed deer, Odocoileus virginianus) to determine whether antler development could provide an honest signal of a male's genetic quality and condition to adversaries. We compared antler, morphometric, hormonal, and parasitic data collected from hunter-harvested deer to characteristics of the Mhc-DRB (Odvi), the most widely studied gene of the major histocompatibility complex (MHC) in Artiodactyla. We detected associations between genetic characteristics at Odvi-DRB and antler development and body mass, suggesting that antler development and body mass may be associated with pathogen resistance in deer and thus may be an honest signal of genetic quality. We also detected associations between Odvi-DRB characteristics and serum testosterone during the breeding season, suggesting that certain MHC characteristics may help deer cope with stresses related to breeding activity. In addition, we observed a negative relationship between degree of antler development and overall abundance of abomasal helminths. Our observations provide support for the hypothesis that antler development in white-tailed deer is an honest signal of quality.

  4. Expression and clinical value of the soluble major histocompatibility complex class I-related chain A molecule in the serum of patients with renal tumors.

    Science.gov (United States)

    Zhao, Y-K; Jia, C-M; Yuan, G-J; Liu, W; Qiu, Y; Zhu, Q-G

    2015-06-29

    We investigated the expression and clinical value of the soluble major histocompatibility complex class I-related chain A (sMICA) molecule in the serum of patients with renal tumors. Sixty patients diagnosed with renal tumors were enrolled in the experimental group, whereas 20 healthy volunteers served as the control group. The sMICA levels were measured via enzyme-linked immunosorbent assay, and the results were analyzed in combination with data from pathol-ogy examination. The experimental group had a statistically significant higher sMICA level (P < 0.05) than the control group. The sMICA level was higher in patients with malignant tumors than in those with be-nign tumors. We also observed a positive relationship among different tumor-node-metastasis (TNM) pathological stages with more advanced diseases exhibiting higher sMICA levels. As a tumor-associated antigen, MICA has a close relationship with renal tumorigenesis and immune es-cape. Our results indicated that sMICA levels were related to tumor pathol-ogy, TNM stage, and metastasis. Therefore, sMICA might be a potential marker for tumor characteristics, prognosis, and recurrence prediction.

  5. SNP association mapping across the extended major histocompatibility complex and risk of B-cell precursor acute lymphoblastic leukemia in children.

    Directory of Open Access Journals (Sweden)

    Kevin Y Urayama

    Full Text Available The extended major histocompatibility complex (xMHC is the most gene-dense region of the genome and harbors a disproportionately large number of genes involved in immune function. The postulated role of infection in the causation of childhood B-cell precursor acute lymphoblastic leukemia (BCP-ALL suggests that the xMHC may make an important contribution to the risk of this disease. We conducted association mapping across an approximately 4 megabase region of the xMHC using a validated panel of single nucleotide polymorphisms (SNPs in childhood BCP-ALL cases (n=567 enrolled in the Northern California Childhood Leukemia Study (NCCLS compared with population controls (n=892. Logistic regression analyses of 1,145 SNPs, adjusted for age, sex, and Hispanic ethnicity indicated potential associations between several SNPs and childhood BCP-ALL. After accounting for multiple comparisons, one of these included a statistically significant increased risk associated with rs9296068 (OR=1.40, 95% CI=1.19-1.66, corrected p=0.036, located in proximity to HLA-DOA. Sliding window haplotype analysis identified an additional locus located in the extended class I region in proximity to TRIM27 tagged by a haplotype comprising rs1237485, rs3118361, and rs2032502 (corrected global p=0.046. Our findings suggest that susceptibility to childhood BCP-ALL is influenced by genetic variation within the xMHC and indicate at least two important regions for future evaluation.

  6. Assembly of the Lactuca sativa, L. cv. Tizian draft genome sequence reveals differences within major resistance complex 1 as compared to the cv. Salinas reference genome.

    Science.gov (United States)

    Verwaaijen, Bart; Wibberg, Daniel; Nelkner, Johanna; Gordin, Miriam; Rupp, Oliver; Winkler, Anika; Bremges, Andreas; Blom, Jochen; Grosch, Rita; Pühler, Alfred; Schlüter, Andreas

    2018-02-10

    Lettuce (Lactuca sativa, L.) is an important annual plant of the family Asteraceae (Compositae). The commercial lettuce cultivar Tizian has been used in various scientific studies investigating the interaction of the plant with phytopathogens or biological control agents. Here, we present the de novo draft genome sequencing and gene prediction for this specific cultivar derived from transcriptome sequence data. The assembled scaffolds amount to a size of 2.22 Gb. Based on RNAseq data, 31,112 transcript isoforms were identified. Functional predictions for these transcripts were determined within the GenDBE annotation platform. Comparison with the cv. Salinas reference genome revealed a high degree of sequence similarity on genome and transcriptome levels, with an average amino acid identity of 99%. Furthermore, it was observed that two large regions are either missing or are highly divergent within the cv. Tizian genome compared to cv. Salinas. One of these regions covers the major resistance complex 1 region of cv. Salinas. The cv. Tizian draft genome sequence provides a valuable resource for future functional and transcriptome analyses focused on this lettuce cultivar. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Spatial Dynamics of the Communities and the Role of Major Countries in the International Rare Earths Trade: A Complex Network Analysis.

    Directory of Open Access Journals (Sweden)

    Xibo Wang

    Full Text Available Rare earths (RE are critical materials in many high-technology products. Due to the uneven distribution and important functions for industrial development, most countries import RE from a handful of suppliers that are rich in RE, such as China. However, because of the rapid growth of RE exploitation and pollution of the mining and production process, some of the main suppliers have gradually tended to reduce the RE production and exports. Especially in the last decade, international RE trade has been changing in the trade community and trade volume. Based on complex network theory, we built an unweighted and weighted network to explore the evolution of the communities and identify the role of the major countries in the RE trade. The results show that an international RE trade network was dispersed and unstable because of the existence of five to nine trade communities in the unweighted network and four to eight trade communities in the weighted network in the past 13 years. Moreover, trade groups formed due to the great influence of geopolitical relations. China was often associated with the South America and African countries in the same trade group. In addition, Japan, China, the United States, and Germany had the largest impacts on international RE trade from 2002 to 2014. Last, some policy suggestions were highlighted according to the results.

  8. The "adjuvant effect" of the polymorphic B-G antigens of the chicken major histocompatibility complex analyzed using purified molecules incorporated in liposomes

    DEFF Research Database (Denmark)

    Salomonsen, J; Eriksson, H; Skjødt, K

    1991-01-01

    The polymorphic B-G region of the chicken major histocompatibility complex has previously been shown to mediate an "adjuvant effect" on the humoral response to other erythrocyte alloantigens. We demonstrate here that B-G molecules purified with monoclonal antibodies exert this adjuvant effect...... on the production of alloantibodies to chicken class I (B-F) molecules, when the two are in the same liposome. The adjuvant effect may in part be mediated by antibodies, since the antibody response to B-G molecules occurs much faster than the response to B-F molecules, and conditions in which antibodies to B......-G are present increase the speed of the response to B-F molecules. We also found that the presence of B-G molecules in separate liposomes results in a lack of response to B-F molecules. In the light of this and other data, we consider the possible roles for the polymorphic B-G molecules, particularly...

  9. The T-Cell Receptor Can Bind to the Peptide-Bound Major Histocompatibility Complex and Uncomplexed β2-Microglobulin through Distinct Binding Sites

    DEFF Research Database (Denmark)

    Merkle, Patrick S.; Irving, Melita; Hongjian, Song

    2017-01-01

    from molecular dynamics simulations. Using a biological assay based on TCR gene-engineered primary human T cells, we did not observe a significant effect of β2m on T-cell cytotoxicity, suggesting an alternate role for β2m binding. Overall, we show that binding of β2m to the TCR occurs in vitro and......T-Cell receptor (TCR)-mediated recognition of the peptide-bound major histocompatibility complex (pMHC) initiates an adaptive immune response against antigen-presenting target cells. The recognition events take place at the TCR-pMHC interface, and their effects on TCR conformation and dynamics...... are controversial. Here, we have measured the time-resolved hydrogen/deuterium exchange (HDX) of a soluble TCR in the presence and absence of its cognate pMHC by mass spectrometry to delineate the impact of pMHC binding on solution-phase structural dynamics in the TCR. Our results demonstrate that while TCR...

  10. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... When the image slices are reassembled by computer software, the result is a very detailed multidimensional view ... accurate. A major advantage of CT is its ability to image bone, soft tissue and blood vessels ...

  11. Abdominal and Pelvic CT

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    Full Text Available ... over time. top of page What are the benefits vs. risks? Benefits Viewing a CT scan, an experienced radiologist can ... scanning is painless, noninvasive and accurate. A major advantage of CT is its ability to image bone, ...

  12. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... scanning is painless, noninvasive and accurate. A major advantage of CT is its ability to image bone, ... us improve RadiologyInfo.org by taking our brief survey: Survey Do you have a personal story about ...

  13. Abdominal wall hernias: computed tomography findings

    International Nuclear Information System (INIS)

    D'Ippolito, Giuseppe; Rosas, George de Queiroz; Mota, Marcos Alexandre; Akisue, Sandra R. Tsukada; Galvao Filho, Mario de Melo.

    2005-01-01

    Abdominal hernias are a common clinical problem Clinical diagnosis of abdominal hernias can sometimes be challenging, particularly in obese patients or patients with previous abdominal surgery. CT scan of the abdomen allows visualization of hernias and their contents and the differentiation from other masses of the abdominal wall such as tumors, hematomas and abscesses. Moreover, CT may identify complications such as incarceration, bowel obstruction, volvulus and strangulation. This study illustrates the CT scan findings observed in different types of abdominal wall hernias. (author)

  14. Abdominal Pain-Predominant Functional Gastrointestinal Disorders in Jordanian School Children.

    Science.gov (United States)

    Altamimi, Eyad M; Al-Safadi, Mohammad H

    2014-12-01

    Recurrent abdominal pain (RAP) is a common complaint in children. Significant portion of them are of functional origin. This study aimed to assess the prevalence of abdominal pain-predominant functional gastrointestinal disorder (FGID) and its types in Jordanian school children. This is a school-based survey at south Jordan. Information using the self-reporting form of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version (QPGS-RIII) - the official Arabic translation - was collected. Classes from academic years (grades) 6 - 8 were selected. SPSS Statistical Package Version 17 (IBM, Armonk, NY, USA) was used. Categorical data were analyzed using Fisher's exact test, and continuous data were analyzed using t -test. P abdominal pain-predominant FGID. Seventy-nine (68%) of them were females. Forty-seven (10.6%) had irritable bowel syndrome (IBS). Thirty-six (8%), 17 (3.8%), 11 (2.4%) and five (1.1%) had abdominal migraine, functional abdominal pain, functional abdominal pain syndrome and functional dyspepsia, respectively. Abdominal pain-predominant FGID has become a major health issue in Jordanian children. One of four children between the ages of 11 and 15 years exhibits at least one abdominal pain-predominant FGID. The most common form of abdominal pain-predominant FGID in our children was IBS. Females are affected more often than males. Intestinal and extra-intestinal symptoms are seen regularly with abdominal pain-predominant FGIDs.

  15. A Variant in LDLR Is Associated With Abdominal Aortic Aneurysm

    NARCIS (Netherlands)

    Bradley, Declan T.; Hughes, Anne E.; Badger, Stephen A.; Jones, Gregory T.; Harrison, Seamus C.; Wright, Benjamin J.; Bumpstead, Suzannah; Baas, Annette F.; Gretarsdottir, Solveig; Burnand, Kevin; Child, Anne H.; Clough, Rachel E.; Cockerill, Gillian; Hafez, Hany; Scott, D. Julian A.; Ariens, Robert A. S.; Johnson, Anne; Sohrabi, Soroush; Smith, Alberto; Thompson, Matthew M.; van Bockxmeer, Frank M.; Waltham, Matthew; Matthiasson, Stefan E.; Thorleifsson, Gudmar; Thorsteinsdottir, Unnur; Blankensteijn, Jan D.; Teijink, Joep A. W.; Wijmenga, Cisca; de Graaf, Jacqueline; Kiemeney, Lambertus A.; Wild, John B.; Edkins, Sarah; Gwilliam, Rhian; Hunt, Sarah E.; Potter, Simon; Lindholt, Jes S.; Golledge, Jonathan; Norman, Paul E.; van Rij, Andre; Powell, Janet T.; Eriksson, Per; Stefansson, Kari; Thompson, John R.; Humphries, Steve E.; Sayers, Robert D.; Deloukas, Panos; Samani, Nilesh J.; Bown, Matthew J.

    2013-01-01

    Background Abdominal aortic aneurysm (AAA) is a common cardiovascular disease among older people and demonstrates significant heritability. In contrast to similar complex diseases, relatively few genetic associations with AAA have been confirmed. We reanalyzed our genome-wide study and carried

  16. A variant in LDLR is associated with abdominal aortic aneurysm

    DEFF Research Database (Denmark)

    Bradley, Declan T; Hughes, Anne E; Badger, Stephen A

    2013-01-01

    Abdominal aortic aneurysm (AAA) is a common cardiovascular disease among older people and demonstrates significant heritability. In contrast to similar complex diseases, relatively few genetic associations with AAA have been confirmed. We reanalyzed our genome-wide study and carried through to re...

  17. Giant panda genomic data provide insight into the birth-and-death process of mammalian major histocompatibility complex class II genes.

    Directory of Open Access Journals (Sweden)

    Qiu-Hong Wan

    Full Text Available To gain an understanding of the genomic structure and evolutionary history of the giant panda major histocompatibility complex (MHC genes, we determined a 636,503-bp nucleotide sequence spanning the MHC class II region. Analysis revealed that the MHC class II region from this rare species contained 26 loci (17 predicted to be expressed, of which 10 are classical class II genes (1 DRA, 2 DRB, 2 DQA, 3 DQB, 1 DYB, 1 DPA, and 2 DPB and 4 are non-classical class II genes (1 DOA, 1 DOB, 1 DMA, and 1 DMB. The presence of DYB, a gene specific to ruminants, prompted a comparison of the giant panda class II sequence with those of humans, cats, dogs, cattle, pigs, and mice. The results indicated that birth and death events within the DQ and DRB-DY regions led to major lineage differences, with absence of these regions in the cat and in humans and mice respectively. The phylogenetic trees constructed using all expressed alpha and beta genes from marsupials and placental mammals showed that: (1 because marsupials carry loci corresponding to DR, DP, DO and DM genes, those subregions most likely developed before the divergence of marsupials and placental mammals, approximately 150 million years ago (MYA; (2 conversely, the DQ and DY regions must have evolved later, but before the radiation of placental mammals (100 MYA. As a result, the typical genomic structure of MHC class II genes for the giant panda is similar to that of the other placental mammals and corresponds to BTNL2 approximately DR1 approximately DQ approximately DR2 approximately DY approximately DO_box approximately DP approximately COL11A2. Over the past 100 million years, there has been birth and death of mammalian DR, DQ, DY, and DP genes, an evolutionary process that has brought about the current species-specific genomic structure of the MHC class II region. Furthermore, facing certain similar pathogens, mammals have adopted intra-subregion (DR and DQ and inter-subregion (between DQ and DP

  18. Abdominal imaging in AIDS patients

    International Nuclear Information System (INIS)

    Zhao Dawei; Wang Wei; Yuan Chunwang; Jia Cuiyu; Zhao Xuan; Zhang Tong; Ma Daqing

    2007-01-01

    Objective: To evaluate abdominal imaging in AIDS. Methods: The imaging examinations (including US, CT and MR) of 6 patients with AIDS associated abdominal foci were analysed retrospectively. All the cases were performed US, and CT scan, of which 4 performed enhanced CT scan and 1 with MR. Results: Abdominal tuberculosis were found in 4 patients, including abdominal lymph nodes tuberculosis (3 cases) and pancreatic tuberculosis (1 case). The imaging of lymph nodes tuberculosis typically showed enlarged peripheral tim enhancement with central low-attenuation on contrast-enhanced CT. Pancreatic tuberculosis demonstrated low-attenuation area in pancreatic head and slightly peripheral enhancement. Disseminated Kaposi's sarcoma was seen in 1 case: CT and MRI scan demonstrated tumour infiltrated along hepatic portal vein and bronchovascular bundles. Pelvic tumor was observed in 1 case: CT scan showed large mass with thick and irregular wall and central low attenuation liquefacient necrotic area in the pelvic cavity. Conclusion: The imaging findings of AIDS with abdominal foci is extraordinarily helpful to the diagnosis of such disease. Tissue biopsy is needed to confirm the diagnosis. (authors)

  19. Key Role of Toll-Like Receptor 2 in the Inflammatory Response and Major Histocompatibility Complex Class II Downregulation in Brucella abortus-Infected Alveolar Macrophages

    Science.gov (United States)

    Ferrero, Mariana C.; Hielpos, M. Soledad; Carvalho, Natalia B.; Barrionuevo, Paula; Corsetti, Patricia P.; Giambartolomei, Guillermo H.; Oliveira, Sergio C.

    2014-01-01

    Alveolar macrophages (AM) seem to constitute the main cellular target of inhaled brucellae. Here, we show that Brucella abortus invades and replicates in murine AM without inducing cytotoxicity. B. abortus infection induced a statistically significant increase of tumor necrosis factor alpha (TNF-α), CXCL1 or keratinocyte chemoattractant (KC), interleukin-1β (IL-1β), IL-6, and IL-12 in AM from C57BL/6 mice and BALB/c mice, but these responses were generally weaker and/or delayed compared to those elicited in peritoneal macrophages. Studies using knockout mice for TLR2, TLR4, and TLR9 revealed that TNF-α and KC responses were mediated by TLR2 recognition. Brucella infection reduced in a multiplicity of infection-dependent manner the expression of major histocompatibility complex class II (MHC-II) molecules induced by gamma interferon (IFN-γ) in AM. The same phenomenon was induced by incubation with heat-killed B. abortus (HKBA) or the lipidated form of the 19-kDa outer membrane protein of Brucella (L-Omp19), and it was shown to be mediated by TLR2 recognition. In contrast, no significant downregulation of MHC-II was induced by either unlipidated Omp19 or Brucella LPS. In a functional assay, treatment of AM with either L-Omp19 or HKBA reduced the MHC-II-restricted presentation of OVA peptides to specific T cells. One week after intratracheal infection, viable B. abortus was detected in AM from both wild-type and TLR2 KO mice, but CFU counts were higher in the latter. These results suggest that B. abortus survives in AM after inhalatory infection in spite of a certain degree of immune control exerted by the TLR2-mediated inflammatory response. Both the modest nature of the latter and the modulation of MHC-II expression by the bacterium may contribute to such survival. PMID:24478078

  20. Genotyping of major histocompatibility complex Class II DRB gene in Rohilkhandi goats by polymerase chain reaction-restriction fragment length polymorphism and DNA sequencing

    Directory of Open Access Journals (Sweden)

    Kush Shrivastava

    2015-10-01

    Full Text Available Aim: To study the major histocompatibility complex (MHC Class II DRB1 gene polymorphism in Rohilkhandi goat using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP and nucleotide sequencing techniques. Materials and Methods: DNA was isolated from 127 Rohilkhandi goats maintained at sheep and goat farm, Indian Veterinary Research Institute, Izatnagar, Bareilly. A 284 bp fragment of exon 2 of DRB1 gene was amplified and digested using BsaI and TaqI restriction enzymes. Population genetic parameters were calculated using Popgene v 1.32 and SAS 9.0. The genotypes were then sequenced using Sanger dideoxy chain termination method and were compared with related breeds/species using MEGA 6.0 and Megalign (DNASTAR software. Results: TaqI locus showed three and BsaI locus showed two genotypes. Both the loci were found to be in Hardy–Weinberg equilibrium (HWE, however, population genetic parameters suggest that heterozygosity is still maintained in the population at both loci. Percent diversity and divergence matrix, as well as phylogenetic analysis revealed that the MHC Class II DRB1 gene of Rohilkhandi goats was found to be in close cluster with Garole and Scottish blackface sheep breeds as compared to other goat breeds included in the sequence comparison. Conclusion: The PCR-RFLP patterns showed population to be in HWE and absence of one genotype at one locus (BsaI, both the loci showed excess of one or the other homozygote genotype, however, effective number of alleles showed that allelic diversity is present in the population. Sequence comparison of DRB1 gene of Rohilkhandi goat with other sheep and goat breed assigned Rohilkhandi goat in divergence with Jamanupari and Angora goats.

  1. Brief review of the chicken Major Histocompatibility Complex: the genes, their distribution on chromosome 16, and their contributions to disease resistance

    Science.gov (United States)

    Miller, Marcia M.; Taylor, Robert L.

    2016-01-01

    Nearly all genes presently mapped to chicken chromosome 16 (GGA 16) have either a demonstrated role in immune responses or are considered to serve in immunity by reason of sequence homology with immune system genes defined in other species. The genes are best described in regional units. Among these, the best known is the polymorphic major histocompatibility complex-B (MHC-B) region containing genes for classical peptide antigen presentation. Nearby MHC-B is a small region containing two CD1 genes, which encode molecules known to bind lipid antigens and which will likely be found in chickens to present lipids to specialized T cells, as occurs with CD1 molecules in other species. Another region is the MHC-Y region, separated from MHC-B by an intervening region of tandem repeats. Like MHC-B, MHC-Y is polymorphic. It contains specialized class I and class II genes and c-type lectin-like genes. Yet another region, separated from MHC-Y by the single nucleolar organizing region (NOR) in the chicken genome, contains olfactory receptor genes and scavenger receptor genes, which are also thought to contribute to immunity. The structure, distribution, linkages and patterns of polymorphism in these regions, suggest GGA 16 evolves as a microchromosome devoted to immune defense. Many GGA 16 genes are polymorphic and polygenic. At the moment most disease associations are at the haplotype level. Roles of individual MHC genes in disease resistance are documented in only a very few instances. Provided suitable experimental stocks persist, the availability of increasingly detailed maps of GGA 16 genes combined with new means for detecting genetic variability will lead to investigations defining the contributions of individual loci and more applications for immunogenetics in breeding healthy poultry. PMID:26740135

  2. Brucella abortus Inhibits Major Histocompatibility Complex Class II Expression and Antigen Processing through Interleukin-6 Secretion via Toll-Like Receptor 2▿

    Science.gov (United States)

    Barrionuevo, Paula; Cassataro, Juliana; Delpino, M. Victoria; Zwerdling, Astrid; Pasquevich, Karina A.; Samartino, Clara García; Wallach, Jorge C.; Fossati, Carlos A.; Giambartolomei, Guillermo H.

    2008-01-01

    The strategies that allow Brucella abortus to survive inside macrophages for prolonged periods and to avoid the immunological surveillance of major histocompatibility complex class II (MHC-II)-restricted gamma interferon (IFN-γ)-producing CD4+ T lymphocytes are poorly understood. We report here that infection of THP-1 cells with B. abortus inhibited expression of MHC-II molecules and antigen (Ag) processing. Heat-killed B. abortus (HKBA) also induced both these phenomena, indicating the independence of bacterial viability and involvement of a structural component of the bacterium. Accordingly, outer membrane protein 19 (Omp19), a prototypical B. abortus lipoprotein, inhibited both MHC-II expression and Ag processing to the same extent as HKBA. Moreover, a synthetic lipohexapeptide that mimics the structure of the protein lipid moiety also inhibited MHC-II expression, indicating that any Brucella lipoprotein could down-modulate MHC-II expression and Ag processing. Inhibition of MHC-II expression and Ag processing by either HKBA or lipidated Omp19 (L-Omp19) depended on Toll-like receptor 2 and was mediated by interleukin-6. HKBA or L-Omp19 also inhibited MHC-II expression and Ag processing of human monocytes. In addition, exposure to the synthetic lipohexapeptide inhibited Ag-specific T-cell proliferation and IFN-γ production of peripheral blood mononuclear cells from Brucella-infected patients. Together, these results indicate that there is a mechanism by which B. abortus may prevent recognition by T cells to evade host immunity and establish a chronic infection. PMID:17984211

  3. Involvement of the major histocompatibility complex region in the genetic regulation of circulating CD8 T-cell numbers in humans.

    Science.gov (United States)

    Cruz, E; Vieira, J; Gonçalves, R; Alves, H; Almeida, S; Rodrigues, P; Lacerda, R; Porto, G

    2004-07-01

    Variability in T-lymphocyte numbers is partially explained by a genetic regulation. From studies in animal models, it is known that the Major Histocompatibility Complex (MHC) is involved in this regulation. In humans, this has not been shown yet. The objective of the present study was to test the hypothesis that genes in the MHC region influence the regulation of T-lymphocyte numbers. Two approaches were used. Association studies between T-cell counts (CD4(+) and CD8(+)) or total lymphocyte counts and HLA class I alleles (A and B) or mutations in the HFE (C282Y and H63D), the hemochromatosis gene, in an unrelated population (n = 264). A second approach was a sibpair correlation analysis of the same T-cell counts in relation to HLA-HFE haplotypes in subjects belonging to 48 hemochromatosis families (n = 456 sibpairs). In the normal population, results showed a strong statistically significant association of the HLA-A*01 with high numbers of CD8(+) T cells and a less powerful association with the HLA-A*24 with low numbers of CD8(+) T cells. Sibpair correlations revealed the most significant correlation for CD8(+) T-cell numbers for sibpairs with HLA-HFE-identical haplotypes. This was not observed for CD4(+) T cells. These results show that the MHC region is involved in the genetic regulation of CD8(+) T-cell numbers in humans. Identification of genes responsible for this control may have important biological and clinical implications.

  4. Molecular cloning and characterization of rhesus monkey platelet glycoprotein Ibα, a major ligand-binding subunit of GPIb-IX-V complex.

    Science.gov (United States)

    Qiao, Jianlin; Shen, Yang; Shi, Meimei; Lu, Yanrong; Cheng, Jingqiu; Chen, Younan

    2014-05-01

    Through binding to von Willebrand factor (VWF), platelet glycoprotein (GP) Ibα, the major ligand-binding subunit of the GPIb-IX-V complex, initiates platelet adhesion and aggregation in response to exposed VWF or elevated fluid-shear stress. There is little data regarding non-human primate platelet GPIbα. This study cloned and characterized rhesus monkey (Macaca Mullatta) platelet GPIbα. DNAMAN software was used for sequence analysis and alignment. N/O-glycosylation sites and 3-D structure modelling were predicted by online OGPET v1.0, NetOGlyc 1.0 Server and SWISS-MODEL, respectively. Platelet function was evaluated by ADP- or ristocetin-induced platelet aggregation. Rhesus monkey GPIbα contains 2,268 nucleotides with an open reading frame encoding 755 amino acids. Rhesus monkey GPIbα nucleotide and protein sequences share 93.27% and 89.20% homology respectively, with human. Sequences encoding the leucine-rich repeats of rhesus monkey GPIbα share strong similarity with human, whereas PEST sequences and N/O-glycosylated residues vary. The GPIbα-binding residues for thrombin, filamin A and 14-3-3ζ are highly conserved between rhesus monkey and human. Platelet function analysis revealed monkey and human platelets respond similarly to ADP, but rhesus monkey platelets failed to respond to low doses of ristocetin where human platelets achieved 76% aggregation. However, monkey platelets aggregated in response to higher ristocetin doses. Monkey GPIbα shares strong homology with human GPIbα, however there are some differences in rhesus monkey platelet activation through GPIbα engagement, which need to be considered when using rhesus monkey platelet to investigate platelet GPIbα function. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Autoimmunity and inflammation are independent of class II transactivator type PIV-dependent class II major histocompatibility complex expression in peripheral tissues during collagen-induced arthritis.

    Science.gov (United States)

    Waldburger, Jean-Marc; Palmer, Gaby; Seemayer, Christian; Lamacchia, Celine; Finckh, Axel; Christofilopoulos, Panayiotis; Baeten, Dominique; Reith, Walter; Gabay, Cem

    2011-11-01

    To determine the regulation of class II major histocompatibility complex (MHC) expression in fibroblast-like synoviocytes (FLS) in order to investigate their role as nonprofessional antigen-presenting cells in collagen-induced arthritis (CIA). Expression of class II MHC, class II MHC transactivator (CIITA), and Ciita isoforms PI, PIII, and PIV was examined by real-time quantitative polymerase chain reaction, immunohistochemistry, and flow cytometry in human synovial tissues, arthritic mouse joints, and human and murine FLS. CIA was induced in mice in which isoform PIV of Ciita was knocked out (PIV(-/-) ), in PIV(-/-) mice transgenic for CIITA in the thymus (K14 CIITA), and in their control littermates. HLA-DRA, total CIITA, and CIITA PIII messenger RNA levels were significantly increased in synovial tissue samples from patients with rheumatoid arthritis compared with the levels in tissue from patients with osteoarthritis. Human FLS expressed surface class II MHC via CIITA PIII and PIV, while class II MHC expression in murine FLS was entirely mediated by PIV. Mice with a targeted deletion of CIITA PIV lack CD4+ T cells and were protected against CIA. The expression of CIITA was restored in the thymus of PIV(-/-) K14 CIITA-transgenic mice, which had a normal CD4+ T cell repertoire and normal surface levels of class II MHC on professional antigen-presenting cells, but did not induce class II MHC on FLS. Synovial inflammation and immune responses against type II collagen were similar in PIV(-/-) K14 CIITA-transgenic mice and control mice with CIA, but bone erosion was significantly reduced in the absence of PIV. Overexpression of class II MHC is tightly correlated with CIITA expression in arthritic synovium and in FLS. Selective targeting of Ciita PIV in peripheral tissues abrogates class II MHC expression by murine FLS but does not protect against inflammation and autoimmune responses in CIA. Copyright © 2011 by the American College of Rheumatology.

  6. External abdominal wall hernias in Abia State University teaching ...

    African Journals Online (AJOL)

    Background: External abdominal wall hernias are common surgical conditions worldwide. In Africa, they not only make up a significant part of the surgeons workload, but are a major cause of mechanical intestinal obstruction. They are a leading cause of work loss and disability with lethal complications at times. Knowledge ...

  7. Functional abdominal pain disorders in children.

    Science.gov (United States)

    Rajindrajith, Shaman; Zeevenhooven, Judith; Devanarayana, Niranga Manjuri; Perera, Bonaventure Jayasiri Crispus; Benninga, Marc A

    2018-04-01

    Chronic abdominal pain is a common problem in pediatric practice. The majority of cases fulfill the Rome IV criteria for functional abdominal pain disorders (FAPDs). At times, these disorders may lead to rather serious repercussions. Area covered: We have attempted to cover current knowledge on epidemiology, pathophysiology, risk factors related to pathophysiology, clinical evaluation and management of children with FAPDs. Expert commentary: FAPDs are a worldwide problem with a pooled prevalence of 13.5%. There are a number of predisposing factors and pathophysiological mechanisms including stressful events, child maltreatment, visceral hypersensitivity, altered gastrointestinal motility and change in intestinal microbiota. It is possible that the environmental risk factors intricately interact with genes through epigenetic mechanisms to contribute to the pathophysiology. The diagnosis mainly depends on clinical evaluation. Commonly used pharmacological interventions do not play a major role in relieving symptoms. Centrally directed, nonpharmacological interventions such as hypnotherapy and cognitive behavioral therapy have shown both short and long term efficacy in relieving pain in children with FAPDs. However, these interventions are time consuming and need specially trained staff and therefore, not currently available at grass root level. Clinicians and researchers should join hands in searching for more pragmatic and effective therapeutic modalities to improve overall care of children with FAPDs.

  8. CT evaluation of abdominal trauma

    International Nuclear Information System (INIS)

    Huang Ruiting

    2004-01-01

    Objective: An evaluation of CT diagnosis of abdominal trauma. Methods: CT appearance of abdominal trauma was analyzed retrospectively in 95 cases. thirty-three patients were cured by operation, and the other 59 patients received conservative treatment. Fifty-one patients out of 59 were seen healed or improved by a follow up CT scan after the conservative treatment. Results: The study included: 31 cases of splenic contusion, accompanying with hemoperitoneum in 25 cases; 3 cases of hepatic laceration; 33 cases of liver and spleen compound trauma accompanying with hemoperitoneum; 18 cases of renal contusion, with subcapsular hemorrhage in 12 cases; 4 cases of midriff colic; 3 cases of mesentery breach; 3 cases of digestive tract perforation. Conclusion: CT is sensitive and precise in evaluating abdominal trauma, providing important information for treatment. (author)

  9. Abdominal radiation causes bacterial translocation

    International Nuclear Information System (INIS)

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-01-01

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa

  10. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael

    2015-01-01

    OBJECTIVE: The objective of the study was to compare long-term results of subtotal vs total abdominal hysterectomy for benign uterine diseases 14 years after hysterectomy, with urinary incontinence as the primary outcome measure. STUDY DESIGN: This was a long-term follow-up of a multicenter......, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal...... from discharge summaries from all public hospitals in Denmark. The results were analyzed as intention to treat and per protocol. Possible bias caused by missing data was handled by multiple imputation. The primary outcome was urinary incontinence; the secondary outcomes were pelvic organ prolapse...

  11. Contemporary imaging in abdominal emergencies

    International Nuclear Information System (INIS)

    Sivit, Carlos J.

    2008-01-01

    Imaging is often a fundamental part in the evaluation of an injured or ill child. A variety of imaging modalities (radiography, angiography/fluoroscopy, sonography, CT, magnetic resonance imaging and scintigraphy) are among the options. CT is worth focused attention because of its usefulness in a variety of emergency department settings, its increasing use, and its potential radiation risks. CT plays an important role in the evaluation of traumatic and nontraumatic abdominal emergencies in children. Therefore, the goal of this paper is to review current imaging approaches and controversies in the evaluation of common acute abdominal emergencies. Through discussion of various modalities, especially CT in evaluation of abdominal pain and trauma, the relative advantages and disadvantages including radiation risk will be reviewed. (orig.)

  12. Unusual initial abdominal presentations of invasive meningococcal disease.

    Science.gov (United States)

    Guiddir, Tamazoust; Gros, Marion; Hong, Eva; Terrade, Aude; Denizon, Mélanie; Deghmane, Ala-Eddine; Taha, Muhamed-Kheir

    2018-03-28

    Invasive meningococcal disease (IMD) is recognized as septicemia and/or meningitis. However, early symptoms may vary and are frequently nonspecific. Early abdominal presentations have been increasingly described. We aimed to explore a large cohort of patients with initial abdominal presentations for association with particular meningococcal strains. Confirmed IMD cases in France between 1991-2016 were screened for the presence within the 24 hours before diagnosis of at least one of the following criteria (1) abdominal pain, (2) gastro-enteritis with diarrhea and vomiting, (3) diarrhea only. Whole genome sequencing was performed on all cultured isolates. We identified 105 cases (median age 19 years) of early abdominal presentations with a sharp increase since 2014. Early abdominal pain alone was the most frequent symptom (n=67, 64%), followed by gastro-enteritis (n=26, 25%) and diarrhea alone (n=12, 11%). Twenty patients (20%) had abdominal surgery. A higher case fatality rate (24%) was observed in these cases compared to 10.4% in all IMD in France (p=0.007) with high levels of inflammation markers in the blood. Isolates of group W were significantly more predominant in these cases compared to all IMD. Most of these isolates belonged to clonal complex ST-11 (cc11) of the sublineages of the South American-UK strain. Abdominal presentations are frequently provoked by hyperinvasive isolates of meningococci. Delay in the management of these cases and the virulence of the isolates may explain the high fatality rate. Rapid recognition is a key element to improve their management.

  13. Radiological evaluation of abdominal trauma

    International Nuclear Information System (INIS)

    Ahn, K. S.; Cho, Y. H.; Kim, O.

    1982-01-01

    Simple abdomen film has played an important role in decision of emergency operations in patients with the abdominal trauma. Nowadays, it still acts as a primary and inevitable processes in emergency condition. At the Department of Radiology, Hanil Hospital, 70 patients, who were laparotomied due to penetrating or nonpernetraing abdominal trauma, were observed and analyzed with simple abdomen film after comparison with the operative findings. The results are as follows: 1. Most frequent age distribution was 10 to 39 years and marked 70%. Male was in 90% incidence. 2. Penetrating injury largely involved the small bowel and abdominal wall. Non-penetrating injury usually involved the spleen, small bowel, liver, kidney, pancreas, duodenum. 3. Single organ injury occurred in higher incidence at the small bowel and abdominal wall. Multiple organ injury occurred in higher incidence at the spleen, liver, kidney and pancreas. 4. Organ distribution was 26% in spleen, 22% in small bowel, 14% in liver, 11% in abdominal wall. 7% in pancreas, 7% in kidney. 5% in duodenum, 4% in GB and CBD, 2% in diaphragm, 2% in colon, and 1% in stomach. 5. The specific roentgen findings and their frequency which useful in differential diagnosis at abdominal trauma, were as follows: a) flank fluid; Detectable possibility was 71% in liver laceration, 69% in spleen laceration and 57% in pancreas laceration. b) ipsilateral psoas shadow obliteration; Detectable possibility was 57% in liver laceration, 57% in kidney laceration and 46% in spleen laceration. c) free air; Detactable possibility was 60% in duodenal perforation, and 36% in peroration of upper part of small bowel. d) Reflex ileus; Detectable possibility was 64% in small bowel, 50% in liver laceration and 35% in spleen laceration. e) rib fracture; Detactable possibility was 36% in liver laceration and 23% in spleen laceration. f) pleural effusion; Detectable possibility was 29% in liver laceration and 27% in spleen laceration

  14. A case study in intra-abdominal sepsis.

    Science.gov (United States)

    Paul, Jasmeet S; Ridolfi, Timothy J

    2012-12-01

    Intra-abdominal infections are a common problem for the general surgeon and major sources of morbidity and mortality in the intensive care unit. Some of these patients present with peritonitis that can rapidly progress to septic shock. The basic principles of care include prompt resuscitation, antibiotics, and source control. This article will use a detailed case study to outline the management of a patient with severe intra-abdominal infection from diverticulitis from initial resuscitation to reconstruction. Components of the Surviving Sepsis Campaign as they pertain to surgical patients are discussed and updated, and the concept of damage control general surgery is applied. Copyright © 2012. Published by Elsevier Inc.

  15. Ultrasound in the diagnosis of palpable abdominal masses in children.

    Science.gov (United States)

    Annuar, Z; Sakijan, A S; Annuar, N; Kooi, G H

    1990-12-01

    Ultrasound examinations were done to evaluate clinically palpable abdominal masses in 125 children. The examinations were normal in 21 patients. In 15 patients, the clinically palpable masses were actually anterior abdominal wall abscesses or hematomas. Final diagnosis was available in 87 of 89 patients with intraabdominal masses detected on ultrasound. The majority (71%) were retroperitoneal masses where two-thirds were of renal origin. Ultrasound diagnosis was correct in 68 patients (78%). All cases of hydronephrosis were correctly diagnosed based on characteristic ultrasound appearances. Correct diagnoses of all cases of adrenal hematoma, psoas abscess, liver hematoma, liver abscess and one case of liver metastases were achieved with correlation of relevant clinical information.

  16. Abdominal Cocoon: A Rare and Difficult Togetherness in Trauma Patient

    Directory of Open Access Journals (Sweden)

    Erkan Oymaci

    2016-07-01

    Full Text Available Abdominal cocoon, as known sclerosing encapsulating peritonitis, is a rare condition of mechanical intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane. It has been reported mainly in young adolescent women and the majority of the cases are of unknown etiology. Awareness of this rare cause of surgical emergency may prevent delay in treatment and avoid unnecessary procedures for the patient. We are presenting an operated abdominal cocoon case which can be cause difficulty in diagnose and treatment.

  17. Penetrating abdominal injuries: management controversies

    Science.gov (United States)

    Butt, Muhammad U; Zacharias, Nikolaos; Velmahos, George C

    2009-01-01

    Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries. PMID:19374761

  18. Penetrating abdominal injuries: management controversies

    Directory of Open Access Journals (Sweden)

    Velmahos George C

    2009-04-01

    Full Text Available Abstract Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries.

  19. Abdominal surgery in neonatal foals.

    Science.gov (United States)

    Bryant, James E; Gaughan, Earl M

    2005-08-01

    Abdominal surgery in foals under 30 days old has become more common with improved neonatal care. Early recognition of a foal at risk and better nursing care have increased the survival rates of foals that require neonatal care. The success of improved neonatal care also has increased the need for accurate diagnosis and treatment of gastrointestinal, umbilical, and bladder disorders in these foals. This chapter focuses on the early and accurate diagnosis of specific disorders that require abdominal exploratory surgery and the specific treatment considerations and prognosis for these disorders.

  20. CT appearances of abdominal tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, W.-K., E-mail: leewk33@hotmail.com [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Van Tonder, F.; Tartaglia, C.J.; Dagia, C. [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Cazzato, R.L. [Department of Radiology, Universita Campus Bio-Medico di Roma, Rome (Italy); Duddalwar, V.A. [Department of Radiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California (United States); Chang, S.D. [Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, British Columbia (Canada)

    2012-06-15

    The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.

  1. CT appearances of abdominal tuberculosis

    International Nuclear Information System (INIS)

    Lee, W.-K.; Van Tonder, F.; Tartaglia, C.J.; Dagia, C.; Cazzato, R.L.; Duddalwar, V.A.; Chang, S.D.

    2012-01-01

    The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.

  2. Secondary abdominal appendicular ectopic pregnancy.

    Science.gov (United States)

    Nama, Vivek; Gyampoh, Bright; Karoshi, Mahantesh; McRae, Reynold; Opemuyi, Isaac

    2007-01-01

    Although the case fatality rate for ectopic pregnancies has decreased to 0.08% in industrialized countries, it still represents 3.8% of maternal mortality in the United States alone. In developing countries, the case fatality rate varies from 3% to 27%. Laparoscopic management of tubal pregnancies is now the standard form of treatment where this technology is available. Abdominal pregnancies are rare, and secondary implantation of tubal ectopic pregnancies is the most common cause of abdominal gestations. We present an interesting case of secondary implantation of a tubal ectopic pregnancy to highlight the appendix as a possible secondary implantation site after a tubal ectopic pregnancy.

  3. Torsion of abdominal appendages presenting with acute abdominal pain

    International Nuclear Information System (INIS)

    Al-Jaberi, Tareq M.; Gharabeih, Kamal I.; Yaghan, Rami J.

    2000-01-01

    Diseases of abnormal appendages are rare causes of abdominal pain in all age groups. Nine patients with torsion and infraction of abdominal appendages were retrospectively reviewed. Four patients had torsion and infarction of the appendices epiploicae, four patients had torsion and infarction of the falciform ligament. The patient with falciform ligament disease represents the first reported case of primary torsion and infarction of the falciform ligament, and the patient with the transverse colon epiplocia represents the first reported case of vibration-induced appendix epiplocia torsion and infarction. The patient with the falciform ligament disease presented with a tender upper abdominal mass and the remaining patients were operated upon with the preoperative diagnosis of acute appendicitis. The presence of normal appendix with free serosanguinous fluid in the peritoneal cavity should raise the possibility of a disease and calls for further evaluation of the intra-abdominal organs. If the diagnosis is suspected preoperatively, CT scan and ultrasound may lead to a correct diagnosis and possibly conservative management. Laparoscopy is playing an increasing diagnostic and therapeutic role in such situations. (author)

  4. Diagnosis in acute abdominal pain and ongoing abdominal sepsis

    NARCIS (Netherlands)

    Kiewiet, J.J.S.

    2016-01-01

    Acute abdominal pain is a common reason for presentation at the emergency department. To establish a timely and adequate diagnosis, doctors use the pattern of complaints and physical examination as the basis for the evaluation of a patient. In this thesis we conducted a study that showed that

  5. Differential Aging Signals in Abdominal CT Scans.

    Science.gov (United States)

    Orlov, Nikita V; Makrogiannis, Sokratis; Ferrucci, Luigi; Goldberg, Ilya G

    2017-12-01

    Changes in the composition of body tissues are major aging phenotypes, but they have been difficult to study in depth. Here we describe age-related change in abdominal tissues observable in computed tomography (CT) scans. We used pattern recognition and machine learning to detect and quantify these changes in a model-agnostic fashion. CT scans of abdominal L4 sections were obtained from Baltimore Longitudinal Study of Aging (BLSA) participants. Age-related change in the constituent tissues were determined by training machine classifiers to differentiate age groups within male and female strata ("Younger" at 50-70 years old vs "Older" at 80-99 years old). The accuracy achieved by the classifiers in differentiating the age cohorts was used as a surrogate measure of the aging signal in the different tissues. The highest accuracy for discriminating age differences was 0.76 and 0.72 for males and females, respectively. The classification accuracy was 0.79 and 0.71 for adipose tissue, 0.70 and 0.68 for soft tissue, and 0.65 and 0.64 for bone. Using image data from a large sample of well-characterized pool of participants dispersed over a wide age range, we explored age-related differences in gross morphology and texture of abdominal tissues. This technology is advantageous for tracking effects of biological aging and predicting adverse outcomes when compared to the traditional use of specific molecular biomarkers. Application of pattern recognition and machine learning as a tool for analyzing medical images may provide much needed insight into tissue changes occurring with aging and, further, connect these changes with their metabolic and functional consequences. Published by Elsevier Inc.

  6. Intra-abdominal solid organ injuries: an enhanced management algorithm.

    Science.gov (United States)

    Kokabi, Nima; Shuaib, Waqas; Xing, Minzhi; Harmouche, Elie; Wilson, Kenneth; Johnson, Jamlik-Omari; Khosa, Faisal

    2014-11-01

    The organ injury scale grading system proposed by the American Association for the Surgery of Trauma provides guidelines for operative versus nonoperative management in solid organ injuries; however, major shortcomings of the American Association for the Surgery of Trauma injury scale may become apparent with low-grade injuries, in which conservative management may fail. Nonoperative management of common intra-abdominal solid organ injuries relies increasingly on computed tomographic findings and other clinical factors, including patient age, presence of concurrent injuries, and serial clinical assessments. Familiarity with characteristic imaging features is essential for the prompt diagnosis and appropriate treatment of blunt abdominal trauma. In this pictorial essay, the spectrum of the American Association for the Surgery of Trauma organ injury scale grading system is illustrated, and a multidisciplinary management algorithm for common intra-abdominal solid organ injuries is proposed. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  7. Immunomodulation of glioma cells after gene therapy: induction of major histocompatibility complex class I but not class II antigen in vitro.

    Science.gov (United States)

    Parsa, A T; Chi, J H; Hurley, P T; Jeyapalan, S A; Bruce, J N

    2001-09-01

    Acquired immunity has been demonstrated in Fischer rats bearing syngeneic 9L tumors after herpes simplex virus (HSV) thymidine kinase (TK) gene transfection and ganciclovir treatment. The nature of this immunity in rats and its relevance to the HSV TK/ganciclovir protocol for human subjects remain to be determined. In this study, levels of major histocompatibility complex (MHC) Class I and II antigen expression were measured before and after HSV TK transfection, in an effort to document immunomodulatory changes caused by gene therapy. Tumor cells from the 9L gliosarcoma cell line, three primary human glioma cultures, and the human glioma cell line U87 MG were transduced with HSV TK vector-containing supernatant from fibroblast-producing cells (titer of 5 x 10(6) colony-forming units/ml) and selected in G418 medium for neomycin resistance. Clones were pooled or individually selected for cell-killing assays with ganciclovir, to confirm TK expression (10(3) cells/well in a 96-well dish). Northern analyses using MHC Class I and Class II complementary deoxyribonucleic acid probes were performed on blots containing total ribonucleic acid from wild-type tumor cells and HSV TK transfectants. A beta-actin complementary deoxyribonucleic acid probe served as an internal control. Cell surface expression was confirmed with flow cytometry. The induction of MHC Class I was tested for cycloheximide and genistein sensitivity. All cell cultures exhibited increases in MHC Class I but not MHC Class II expression, as determined by Northern analysis densitometry and flow cytometry. Cycloheximide treatment did not diminish the up-regulation of MHC Class I after retroviral transfection, implicating a signal transduction pathway that does not require ongoing protein synthesis. Genistein pretreatment of cell cultures did diminish the up-regulation of MHC Class I, implicating a tyrosine kinase in the signaling cascade. Induction of MHC Class I in rat and human glioma cells after HSV TK

  8. Expression of bovine non-classical major histocompatibility complex class I proteins in mouse P815 and human K562 cells.

    Science.gov (United States)

    Parasar, Parveen; Wilhelm, Amanda; Rutigliano, Heloisa M; Thomas, Aaron J; Teng, Lihong; Shi, Bi; Davis, William C; Suarez, Carlos E; New, Daniel D; White, Kenneth L; Davies, Christopher J

    2016-08-01

    Major histocompatibility complex class I (MHC-I) proteins can be expressed as cell surface or secreted proteins. To investigate whether bovine non-classical MHC-I proteins are expressed as cell surface or secreted proteins, and to assess the reactivity pattern of monoclonal antibodies with non-classical MHC-I isoforms, we expressed the MHC proteins in murine P815 and human K562 (MHC-I deficient) cells. Following antibiotic selection, stably transfected cell lines were stained with H1A or W6/32 antibodies to detect expression of the MHC-I proteins by flow cytometry. Two non-classical proteins (BoLA-NC1*00501 and BoLA-NC3*00101) were expressed on the cell surface in both cell lines. Surprisingly, the BoLA-NC4*00201 protein was expressed on the cell membrane of human K562 but not mouse P815 cells. Two non-classical proteins (BoLA-NC1*00401, which lacks a transmembrane domain, and BoLA-NC2*00102) did not exhibit cell surface expression. Nevertheless, Western blot analyses demonstrated expression of the MHC-I heavy chain in all transfected cell lines. Ammonium-sulfate precipitation of proteins from culture supernatants showed that BoLA-NC1*00401 was secreted and that all surface expressed proteins where shed from the cell membrane by the transfected cells. Interestingly, the surface expressed MHC-I proteins were present in culture supernatants at a much higher concentration than BoLA-NC1*00401. This comprehensive study shows that bovine non-classical MHC-I proteins BoLA-NC1*00501, BoLA-NC3*00101, and BoLA-NC4*00201 are expressed as surface isoforms with the latter reaching the cell membrane only in K562 cells. Furthermore, it demonstrated that BoLA-NC1*00401 is a secreted isoform and that significant quantities of membrane associated MHC-I proteins can be shed from the cell membrane. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. The impact of sex-role reversal on the diversity of the major histocompatibility complex: insights from the seahorse (Hippocampus abdominalis).

    Science.gov (United States)

    Bahr, Angela; Wilson, Anthony B

    2011-05-10

    Both natural and sexual selection are thought to influence genetic diversity, but the study of the relative importance of these two factors on ecologically-relevant traits has traditionally focused on species with conventional sex-roles, with male-male competition and female-based mate choice. With its high variability and significance in both immune function and olfactory-mediated mate choice, the major histocompatibility complex (MHC/MH) is an ideal system in which to evaluate the relative contributions of these two selective forces to genetic diversity. Intrasexual competition and mate choice are both reversed in sex-role reversed species, and sex-related differences in the detection and use of MH-odor cues are expected to influence the intensity of sexual selection in such species. The seahorse, Hippocampus abdominalis, has an exceptionally highly developed form of male parental care, with female-female competition and male mate choice. Here, we demonstrate that the sex-role reversed seahorse has a single MH class II beta-chain gene and that the diversity of the seahorse MHIIβ locus and its pattern of variation are comparable to those detected in species with conventional sex roles. Despite the presence of only a single gene copy, intralocus MHIIβ allelic diversity in this species exceeds that observed in species with multiple copies of this locus. The MHIIβ locus of the seahorse exhibits a novel expression domain in the male brood pouch. The high variation found at the seahorse MHIIβ gene indicates that sex-role reversed species are capable of maintaining the high MHC diversity typical in most vertebrates.Whether such species have evolved the capacity to use MH-odor cues during mate choice is presently being investigated using mate choice experiments. If this possibility can be rejected, such systems would offer an exceptional opportunity to study the effects of natural selection in isolation, providing powerful comparative models for understanding the

  10. The impact of sex-role reversal on the diversity of the major histocompatibility complex: Insights from the seahorse (Hippocampus abdominalis

    Directory of Open Access Journals (Sweden)

    Wilson Anthony B

    2011-05-01

    Full Text Available Abstract Background Both natural and sexual selection are thought to influence genetic diversity, but the study of the relative importance of these two factors on ecologically-relevant traits has traditionally focused on species with conventional sex-roles, with male-male competition and female-based mate choice. With its high variability and significance in both immune function and olfactory-mediated mate choice, the major histocompatibility complex (MHC/MH is an ideal system in which to evaluate the relative contributions of these two selective forces to genetic diversity. Intrasexual competition and mate choice are both reversed in sex-role reversed species, and sex-related differences in the detection and use of MH-odor cues are expected to influence the intensity of sexual selection in such species. The seahorse, Hippocampus abdominalis, has an exceptionally highly developed form of male parental care, with female-female competition and male mate choice. Results Here, we demonstrate that the sex-role reversed seahorse has a single MH class II beta-chain gene and that the diversity of the seahorse MHIIβ locus and its pattern of variation are comparable to those detected in species with conventional sex roles. Despite the presence of only a single gene copy, intralocus MHIIβ allelic diversity in this species exceeds that observed in species with multiple copies of this locus. The MHIIβ locus of the seahorse exhibits a novel expression domain in the male brood pouch. Conclusions The high variation found at the seahorse MHIIβ gene indicates that sex-role reversed species are capable of maintaining the high MHC diversity typical in most vertebrates. Whether such species have evolved the capacity to use MH-odor cues during mate choice is presently being investigated using mate choice experiments. If this possibility can be rejected, such systems would offer an exceptional opportunity to study the effects of natural selection in isolation

  11. Major depression

    Science.gov (United States)

    Depression - major; Depression - clinical; Clinical depression; Unipolar depression; Major depressive disorder ... providers do not know the exact causes of depression. It is believed that chemical changes in the ...

  12. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... to evaluate the: appendix stomach/ pylorus liver gallbladder spleen pancreas intestines kidneys bladder testicles ovaries uterus Abdominal ultrasound images can be used to help diagnose appendicitis in children. Except for traumatic injury, appendicitis is the most common reason for emergency ...

  13. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... procedure work? How is the procedure performed? What will my child experience during and after the procedure? Who interprets the results and how do we get them? What are the benefits vs. risks? What are the limitations of Abdominal ...

  14. Dehydration related abdominal pain (drap)

    International Nuclear Information System (INIS)

    Shah, S.I.; Aurangzeb; Khan, I.; Bhatti, A.M.; Khan, A.A.

    2004-01-01

    Objective: To describe the frequency of dehydration as a medical cause of acute abdomen. Subjects and Methods: All the patients reporting with abdominal pain to the surgical outpatient department or the emergency department were reviewed in the study. The clinical findings in all these cases were studied along with the mode of their management and outcome. Results: Of all the patients presenting with abdominal pain, 3.3% (n=68) were suffering from dehydration related abdominal pain. They were predominantly males in a ratio of 8.7: 1, mostly in the 2nd and 3rd decades of their lives. All these cases were suffering from acute or chronic dehydration were provisionally diagnosed by general practitioners as 'acute abdomen' and referred for surgical consultation. Associated symptoms included vomiting in 42.6%, backache in 91.2%, headache in 95.6%, and pain in lower limbs in 97.1 % of the cases. 83.8% required indoor management with intravenous fluids. All the patients became asymptomatic with rehydration therapy. Conclusion: Dehydration is a possible cause of severe abdominal pain. There is a need to educate the general public about the benefits of adequate fluid intake. (author)

  15. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... particularly valuable for evaluating abdominal, pelvic or scrotal pain in young children. It is also valuable for evaluating the brain, spinal cord and hip joints in newborns and infants. Risks For standard diagnostic ultrasound , there are no known harmful effects on ...

  16. Chest complication after abdominal surgery

    International Nuclear Information System (INIS)

    Koh, B. H.; Choi, J. Y.; Hahm, C. K.; Kang, S. R.

    1981-01-01

    In spite of many advances in medicine, anesthetic technique and surgical managements, pulmonary problems are the most frequent postoperative complications, particularly after abdominal surgery. As postoperative pulmonary complications, atelectasis, pleural effusion, pneumonia, chronic bronchitis and lung abscess can be occurred. This study include evaluation of chest films of 2006 patients (927 male, 1079 female), who had been operated abdominal surgery from Jan. 1979 to June, 1980 in the Hanyang university hospital. The results were as follows: 1. 70 cases out of total 2006 cases (3.5%) developed postoperative chest complications, 51 cases (5.5%) in male, 19 cases (1.8%) in female. 2. The complication rate was increased according to the increase of age. The incidence of the postoperative complications over 40 years of age was higher than the overall average complications rate. 3. The most common postoperative pulmonary complication was pleural effusion, next pneumonia, atelectasis and pulmonary edema respectively. 4. The complication rate of the group of upper abdominal surgery is much higher than the group of lower abdominal surgery. 5. Complication rate was increased according to increase of the duration of operation. 6. There were significant correlations between the operation site and side of the complicated hemithorax

  17. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... is Abdominal Ultrasound Imaging? What are some common uses of the procedure? How should we prepare for an ultrasound exam? What does the ultrasound equipment look like? How does the procedure work? How is the procedure performed? What will my ...

  18. Abdominal Compartment Syndrome in Surgical Patients

    African Journals Online (AJOL)

    abdominal hypertension and abdominal compartment syndrome, affect ... timely surgical intervention is crucial. Key words: .... On the second postoperative day, he was noted to be restless ... Although surgery is very effective in managing ACS.

  19. Original Research Abdominal myomectomy: A retrospective review ...

    African Journals Online (AJOL)

    Abdominal myomectomy and outcome in Ilorin, Nigeria 37. Malawi Medical Journal 29 (1): ... rate of 3.34% has been reported for Maiduguri, northeastern. Nigeria.4 Abdominal ... of Nigeria.6. Infertility secondary to uterine fibroid is one of the.

  20. Computerized monitoring of physical activity and sleep in postoperative abdominal surgery patients

    DEFF Research Database (Denmark)

    Bisgaard, T; Kjaersgaard, M; Bernhard, A

    1999-01-01

    OBJECTIVE: Assessment of early postoperative activity is important in the documentation of improvements of peri-operative care. This study was designed to validate computerized activity-based monitoring of physical activity and sleep (actigraphy) in patients after abdominal surgery. METHODS...... physical activity and sleep-wake cycles after major abdominal surgery.......: The study included twelve hospitalized patients after major abdominal surgery studied on day 2 to 4 after operation and twelve unhospitalized healthy volunteers. Measurements were performed for 24 consecutive hours. The actigraphy measurements were compared with self-reported activity- and sleep...

  1. A reappraisal of adult abdominal surface anatomy.

    Science.gov (United States)

    Mirjalili, S Ali; McFadden, Sara L; Buckenham, Tim; Stringer, Mark D

    2012-10-01

    Descriptions of clinically important surface landmarks often vary between and within contemporary anatomical texts. The aim of this study was to investigate the surface anatomy of major abdominal vessels, kidneys, spleen, gastroesophageal junction, and duodenojejunal flexure in living adults using computed tomography (CT). After excluding patients with distorting space-occupying lesions, scoliosis, abnormal lordosis, and obvious visceromegaly, 108 abdominal CT scans of supine adults (mean age 60 years, range 18-97 years; 64 female) at end tidal inspiration were available for analysis by dual consensus reporting. Intra-observer agreement was assessed by repeat blind assessment of a random sample of scans. The vertebral level of the aortic bifurcation and almost all of its major branches, and the origin of the inferior vena cava were consistent with current descriptions. Important differences from contemporary descriptions of surface anatomy were as follows: the renal arteries were most commonly at the L1 vertebral level (left 55%, right 43%); the midpoint of the renal hila was most frequently at L2 (left 68%, right 40%); the 11th rib was a posterior relation of the left kidney in only 28% of scans; and the spleen was most frequently located between the 10th and 12th ribs (48%) with its long axis in line with the 11th rib (55%). Although the majority of vascular surface landmarks are consistent with standard descriptions, the surface anatomy of the kidneys, renal arteries, and spleen needs to be revised in accordance with observations using modern imaging techniques in vivo. Copyright © 2012 Wiley Periodicals, Inc.

  2. Internal Mammary Vessels’ Impact on Abdominal Skin Perfusion in Free Abdominal Flap Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Solveig Nergård, MD

    2017-12-01

    Conclusions:. Using the IMV in free abdominal flap breast reconstruction had a significant effect on abdominal skin perfusion and may contribute to abdominal wound healing problems. The reperfusion of the abdominal skin was a dynamic process showing an increase in perfusion in the affected areas during the postoperative days.

  3. Automated segmentation and recognition of abdominal wall muscles in X-ray torso CT images and its application in abdominal CAD

    International Nuclear Information System (INIS)

    Zhou, X.; Kamiya, N.; Hara, T.; Fujita, H.; Chen, H.; Yokoyama, R.; Hoshi, H.

    2007-01-01

    The information of abdominal wall is very important for the planning of surgical operation and abdominal organ recognition. In research fields of computer assisted radiology and surgery and computer-aided diagnosis, the segmentation and recognition of the abdominal wall muscles in CT images is a necessary pre-processing step. Due to the complexity of the abdominal wall structure and indistinctive in CT images, the automated segmentation of abdominal wall muscles is a difficult issue and has not been solved completely. We propose an approach to segment the abdominal wall muscles and divide it into three categories (front abdominal muscles including rectus abdominis; left and right side abdominal muscles including external oblique, internal oblique and transversus abdominis muscles) automatically. The approach, first, makes an initial classification of bone, fat, and muscles and organs based on the CT number. Then a layer structure is generated to describe the 3-D anatomical structures of human torso by stretching the torso region onto a thin-plate for easy recognition. The abdominal wall muscles are recognized on the layer structures using the spatial relations to the skeletal structure and CT numbers. Finally, the recognized regions are mapped back to the 3-D CT images using an inverse transformation of the stretching process. This method is applied to 20 cases of torso CT images and evaluations are based on visual comparison of the recognition results and the original CT images by an expert in anatomy. The results show that our approach can segment and recognize abdominal wall muscle regions effectively. (orig.)

  4. Determinants of splenectomy in splenic injuries following blunt abdominal trauma.

    Science.gov (United States)

    Akinkuolie, A A; Lawal, O O; Arowolo, O A; Agbakwuru, E A; Adesunkanmi, A R K

    2010-02-01

    The management of splenic injuries has shifted from splenectomy to splenic preservation owing to the risk of overwhelming post-splenectomy infection (OPSI). This study aimed to identify the factors that determine splenectomy in patients with isolated splenic injuries, with a view to increasing the rate of splenic preservation. Files of 55 patients managed for isolated splenic injuries from blunt abdominal trauma between 1998 and 2007 were retrospectively analysed using a pro forma. Management options were classified into nonoperative, operative salvage and splenectomy. The majority of patients suffered splenic injury as a result of motor vehicle accident (MVA) trauma or falls. Splenectomy was undertaken in 33 (60%) patients, 12 (22%) had non-operative management, and operative salvage was achieved in 10 (18%) patients. Significant determinants of splenectomy were grade of splenic injury, hierarchy of the surgeon, and hierarchy of the assistant. MVA injury and falls accounted for the vast majority of blunt abdominal trauma in this study. The rate and magnitude of energy transferred versus splenic protective mechanisms at the time of blunt abdominal trauma seems to determine the grade of splenic injury. Interest in splenic salvage surgery, availability of technology that enables splenic salvage surgery, and the experience of the surgeon and assistant appear to determine the surgical management. Legislation on vehicle safety and good parental control may reduce the severity of splenic injury in blunt abdominal trauma. When surgery is indicated, salvage surgery should be considered in intermediate isolated splenic injury to reduce the incidence of OPSI.

  5. Latest progress of research on acute abdominal injuries

    Directory of Open Access Journals (Sweden)

    Ionut Negoi

    2016-01-01

    Full Text Available Major abdominal trauma, both blunt and penetrating, is commonly seen nowadays, being particularly difficult to manage due to the frequent altered mental status of the patients and severity of associated injuries. The review article aims to make an uptodate study of the current strategies for therapeutic approach of abdominal injuries in polytrauma setting. Review of the medical literature is up to 2015, by using the PubMed/Medline, Science Direct, Cochrane Library and Web of Science databases. We have used different combinations of the keywords of “abdominal trauma”, “liver”, “spleen”, “renal”, to review the reference list of retrieved articles for further relevant studies. Nowadays, we are facing a major change in abdominal trauma therapeutic approach, due to the continuous extending indications and very high successful rate of selective nonoperative management, completed or not with minimally invasive techniques like angiography and angiographic embolization. New imaging methods offer a high-quality characterization of solid organ injuries, being a secure support for decision algorithm in polytrauma patients. After a continuous decrease in number of laparotomies for trauma, new techniques should be developed for maintaining and developing the trauma surgeons' skills. According to the current standards, for a low morbidity and mortality, the trauma patients may be approached by a multidisciplinary and experienced trauma team. Even if nonoperative management is continuously expanding, this may be applied only by a trained and skillful trauma surgeon, who is able to perform difficult surgical techniques at any moments.

  6. Abdominal compartment syndrome with acute reperfusion syndrome

    International Nuclear Information System (INIS)

    Maleeva, A.

    2017-01-01

    Abdominal compartment syndrome was recognized clinically in the 19th century when Marey and Burt observed its association with declines in respiratory function. Abdominal compartment syndrome is first used as a medical terminology from Fietsman in a case of ruptured abdominal aortic aneurysm. A condition caused by abnormally increased pressure within the abdomen. Causes of abdominal compartment syndrome include trauma, surgery, or infection. Common symptoms: abdominal distension, fast heart rate, insufficient urine production, or low blood pressure Medical procedure: nasogastric intubation Surgery: laparotomy Specialists: radiologist, primary care provider (PCP), surgeon, and emergency medicine doctor [6, 10]. Keywords: Stomach. Gastroparesis . Diabetes Mellitus [bg

  7. Development of a rapid in vitro protein refolding assay which discriminates between peptide-bound and peptide-free forms of recombinant porcine major histocompatibility class I complex (SLA-I)

    DEFF Research Database (Denmark)

    Oleksiewicz, M.B.; Kristensen, B.; Ladekjaer-Mikkelsen, A.S.

    2002-01-01

    The extracellular domains of swine leukocyte antigen class I (SLA-I, major histocompatibility complex protein class 1) were cloned and sequenced for two haplotypes (114 and H7) which do not share any alleles based on serological typing, and which are the most important in Danish farmed pigs...

  8. Early oral feeding after elective abdominal surgery--what are the issues?

    DEFF Research Database (Denmark)

    Bisgaard, Thue; Kehlet, Henrik

    2002-01-01

    This review analyzes the literature and the historical concerns (restrictions, traditions, nasogastric tube) and pathophysiologic factors (postoperative ileus, risk of anastomotic dehiscence, nausea and vomiting, loss of appetite) invoked for not instituting early oral feeding after major abdomin...... surgical programs in abdominal surgery provide a rational basis for future studies to investigate and facilitate enforced oral feeding after major abdominal procedures.......This review analyzes the literature and the historical concerns (restrictions, traditions, nasogastric tube) and pathophysiologic factors (postoperative ileus, risk of anastomotic dehiscence, nausea and vomiting, loss of appetite) invoked for not instituting early oral feeding after major abdominal...... procedures. It appears that several factors may promote postoperative oral feeding such as thoracic epidural analgesia, multimodal anti-emetic treatment, opioid-sparing analgesia, selective peripheral opioid antagonists, and enforced oral nutrition. Recent data from multimodal fast-track rehabilitation...

  9. Changing spleen size after blunt abdominal trauma

    International Nuclear Information System (INIS)

    Goodman, L.R.; Aprahamian, C.

    1989-01-01

    The authors studied the incidence and significance of splenic enlargement on serial CT after abdominal trauma. Spleen size and density in 44 trauma patients were studied with serial, contrast-enhanced Ct. In 58% of the patients, ≥ 10% enlargement of the spleen was seen on follow-up scans. Ten patients had >50% enlargement. In several, the initial density of the spleen was less than that of the liver. Spleen density returned to normal on subsequent scans. Correlations between splenic changes and clinical parameters (such as blood replacement, hypotension, and various trauma indexes) were weak. The author's study indicated that serial splenic enlargement was a physiologic return to normal after major trauma, not a pathologic condition requiring splenectomy

  10. Abdominal Aortic Dissection with Acute Mesenteric Ischemia in a Patient with Marfan Syndrome

    Directory of Open Access Journals (Sweden)

    Chii-Shyan Lay

    2006-07-01

    Full Text Available Marfan syndrome is an autosomal dominant inherited disorder of connective tissue, with various complications manifested primarily in the cardiovascular system. It potentially leads to aortic dissection and rupture, these being the major causes of death. We report a patient who complained of acute abdominal pain, which presented as acute mesenteric ischemia combined with abdominal aortic dissection. Echocardiography showed enlargement of the aortic root and mitral valve prolapse. Abdominal computed tomography scan revealed acute mesenteric ischemia due to abdominal aortic dissection. Finally, the patient underwent surgery of aortic root replacement and had a successful outcome. Therefore, we suggest that for optimal risk assessment and monitoring of patients with Marfan syndrome, both aortic stiffness and the diameter of the superior mesenteric vein compared with that of the superior mesenteric artery are useful screening methods to detect acute mesenteric ischemia secondary to abdominal aortic dissection. Early diagnosis and early treatment can decrease the high mortality rate of patients with Marfan syndrome.

  11. Acupuncture Treatment of Abdominal Pain

    Institute of Scientific and Technical Information of China (English)

    胡金生

    2002-01-01

    @@ Case History Mr. Li, a university student aged 23 years, paid his first visit on July 16, 2001, with the chief complaint of abdominal pain for one day. The patient stated that one day before when it happened to be the weekend, he got abdominal pain after supper, which went worse gradually and caused him to roll all over in bed. The pain was slightly alleviated half an hour later after he had taken some pain killers. Upon inquiry, the patient said that because of their newly graduation from the university, he and his classmates were so excited that they went to have a sumptuous lunch with alcoholic drinks. And in the evening he ate again a delicious supper cooked for him by his mother, after which he continued to have some fruit and dessert.

  12. Computed tomography, after abdominal surgery

    Energy Technology Data Exchange (ETDEWEB)

    Vogel, H.; Toedt, H.C.

    1985-09-01

    The CT-examinations of 131 patients were analyzed after abdominal surgery. After nephrectomy, splenectomy, partial hepatectomy and pancreatectomy a displacement of the neighbouring intraabdominal and retroperitoneal organs was seen. Scar-tissue was observed containing fat, which faciltated the differential diagnosis to tumor recurrency. The changes of the roentgenmorphology were not so obvious after gastrointestinal surgery. After vascular surgery the permeability of an anastomosis or an operated artery could be demonstrated by bolus injection. (orig.).

  13. Computed tomography, after abdominal surgery

    International Nuclear Information System (INIS)

    Vogel, H.; Toedt, H.C.; Hamburg Univ.

    1985-01-01

    The CT-examinations of 131 patients were analyzed after abdominal surgery. After nephrectomy, splenectomy, partial hepatectomy and pancreatectomy a displacement of the neighbouring intraabdominal and retroperitoneal organs was seen. Scar-tissue was observed containing fat, which fascilated the differentialdiagnosis to tumorrecurrency. The changes of the roentgenmorphology were not so abvious after gastro-intestinal surgery. After vascular surgery the permeability of an anastomosis or an operated artery could be demonstrated by bolusinjection. (orig.) [de

  14. Defectos de la pared abdominal

    Directory of Open Access Journals (Sweden)

    Adis L. Peña Cedeño

    2004-03-01

    Full Text Available Se realizó un estudio de los fetos con malformaciones congénitas, dadas por defecto de la pared abdominal (DPA, nacidos en el Hospital Universitario Ginecoobstétrico de Guanabacoa durante los años 1984 al 2000, para determinar la frecuencia de los distintos tipos de defectos de la pared abdominal y las malformaciones asociadas a éstas. Se revisaron los protocolos de necropsias e historias clínicas en este período y se obtuvieron 25 casos con DPA. La malformación más frecuente fue el onfalocele con 14 casos, seguido de la gastrosquisis con 6 casos. Se hallaron malformaciones asociadas en el 68 % de los casos, y se comprobó la efectividad del Programa Nacional de Malformaciones Congénitas, pues en el 80 % de las pacientes se interrumpió precozmente el embarazo.A study of the fetuses with congenital malformations due to defect of the abdominal wall (AWD that were born at the Gynecoobstetric Teaching Hospital of Guanabacoa from 1984 to 2000 was conducted aimed at determining the frequency of the different types of defects of the abdominal wall and the malformations associated with them. The protocosl of necropsies and medical histories corresponding to this period were reviewed and 25 cases with AWD were detected. The most common malformation was omphalocele with 14 cases, followed by gastrosquisis with 6 cases. Associated malformations were found in 68 % of the cases and it was proved the effectiveness of the National Program of Congenital Malformations, since pregnancy was interrupted early in 80 % of the patients.

  15. Neoproterozoic igneous complex emplaced along major tectonic boundary in the Kaoko Belt (NW Namibia): ion probe and LA-ICP-MS dating of magmatic and metamorphic zircons

    Czech Academy of Sciences Publication Activity Database

    Konopásek, J.; Košler, J.; Tajčmanová, L.; Ulrich, Stanislav; Kitt, S. L.

    2008-01-01

    Roč. 165, č. 1 (2008), s. 153-166 ISSN 0016-7649 Institutional research plan: CEZ:AV0Z30120515 Keywords : boundary igneous complex * Kaoko Belt * zircon Subject RIV: DB - Geology ; Mineralogy Impact factor: 2.797, year: 2008

  16. Generation of fluorescence quenchers from the triplet states of chlorophylls in the major light-harvesting complex II from green plants

    NARCIS (Netherlands)

    Barzda, V.; Vengris, M.; Valkunas, L.; van Amerongen, H.; van Grondelle, R.

    2000-01-01

    Laser flash-induced changes of the fluorescence yield were studied in aggregates of light-harvesting complex II (LHCII) on a time scale ranging from microseconds to seconds. Carotenoid (Car) and chlorophyll (Chl) triplet states, decaying with lifetimes of several microseconds and hundreds of

  17. TYK2 protein-coding variants protect against rheumatoid arthritis and autoimmunity, with no evidence of major pleiotropic effects on non-autoimmune complex traits

    NARCIS (Netherlands)

    Diogo, Dorothée; Bastarache, Lisa; Liao, Katherine P.; Graham, Robert R.; Fulton, Robert S.; Greenberg, Jeffrey D.; Eyre, Steve; Bowes, John; Cui, Jing; Lee, Annette; Pappas, Dimitrios A.; Kremer, Joel M.; Barton, Anne; Coenen, Marieke J. H.; Franke, Barbara; Kiemeney, Lambertus A.; Mariette, Xavier; Richard-Miceli, Corrine; Canhão, Helena; Fonseca, João E.; de Vries, Niek; Tak, Paul P.; Crusius, J. Bart A.; Nurmohamed, Michael T.; Kurreeman, Fina; Mikuls, Ted R.; Okada, Yukinori; Stahl, Eli A.; Larson, David E.; Deluca, Tracie L.; O'Laughlin, Michelle; Fronick, Catrina C.; Fulton, Lucinda L.; Kosoy, Roman; Ransom, Michael; Bhangale, Tushar R.; Ortmann, Ward; Cagan, Andrew; Gainer, Vivian; Karlson, Elizabeth W.; Kohane, Isaac; Murphy, Shawn N.; Martin, Javier; Zhernakova, Alexandra; Klareskog, Lars; Padyukov, Leonid; Worthington, Jane; Mardis, Elaine R.; Seldin, Michael F.; Gregersen, Peter K.; Behrens, Timothy; Raychaudhuri, Soumya; Denny, Joshua C.; Plenge, Robert M.

    2015-01-01

    Despite the success of genome-wide association studies (GWAS) in detecting a large number of loci for complex phenotypes such as rheumatoid arthritis (RA) susceptibility, the lack of information on the causal genes leaves important challenges to interpret GWAS results in the context of the disease

  18. Structure of a SARS coronavirus-derived peptide bound to the human major histocompatibility complex class I molecule HLA-B*1501

    DEFF Research Database (Denmark)

    Røder, Gustav; Kristensen, Ole; Kastrup, Jette S

    2008-01-01

    , the crystal structure of HLA-B*1501 in complex with a SARS coronavirus-derived nonapeptide (VQQESSFVM) has been determined at high resolution (1.87 A). The peptide is deeply anchored in the B and F pockets, but with the Glu4 residue pointing away from the floor in the peptide-binding groove, making...

  19. Hernia Following Blunt Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    N Aghaie

    2009-10-01

    Full Text Available Traumatic abdominal wall hernia is a rare type of hernia, which follows blunt trauma to the abdomen, where disruption of the musculature and fascia occurs with the overlying skin remaining intact. Diagnosis of this problem is very difficult and delayed. Traumatic hernia is often diagnosed during laparatomy or laparascopy, but CT scan also has a role in distinguishing this pathology. Delay in diagnosis is very dangerous and can result in gangrene and necrosis of the organs in the hernia. The case report of a 35 years old man with liftruck blunt trauma is reported. His vital signs were stable. On physical examination, tenderness of RUQ was seen. He underwent Dpl for suspected hemoprotein. Dpl was followed up by laparatomy. Laparatomy revealed that the transverse and ascending colon partially herniated in the abdominal wall defect. The colon was reduced in the abdomen and repair of abdominal hernia was done. The patient was discharged after 5 day. The etiology, pathogenesis and management are discussed.

  20. Mesh erosion after abdominal sacrocolpopexy.

    Science.gov (United States)

    Kohli, N; Walsh, P M; Roat, T W; Karram, M M

    1998-12-01

    To report our experience with erosion of permanent suture or mesh material after abdominal sacrocolpopexy. A retrospective chart review was performed to identify patients who underwent sacrocolpopexy by the same surgeon over 8 years. Demographic data, operative notes, hospital records, and office charts were reviewed after sacrocolpopexy. Patients with erosion of either suture or mesh were treated initially with conservative therapy followed by surgical intervention as required. Fifty-seven patients underwent sacrocolpopexy using synthetic mesh during the study period. The mean (range) postoperative follow-up was 19.9 (1.3-50) months. Seven patients (12%) had erosions after abdominal sacrocolpopexy with two suture erosions and five mesh erosions. Patients with suture erosion were asymptomatic compared with patients with mesh erosion, who presented with vaginal bleeding or discharge. The mean (+/-standard deviation) time to erosion was 14.0+/-7.7 (range 4-24) months. Both patients with suture erosion were treated conservatively with estrogen cream. All five patients with mesh erosion required transvaginal removal of the mesh. Mesh erosion can follow abdominal sacrocolpopexy over a long time, and usually presents as vaginal bleeding or discharge. Although patients with suture erosion can be managed successfully with conservative treatment, patients with mesh erosion require surgical intervention. Transvaginal removal of the mesh with vaginal advancement appears to be an effective treatment in patients failing conservative management.

  1. Appendicitis following blunt abdominal trauma.

    Science.gov (United States)

    Cobb, Travis

    2017-09-01

    Appendicitis is a frequently encountered surgical problem in the Emergency Department (ED). Appendicitis typically results from obstruction of the appendiceal lumen, although trauma has been reported as an infrequent cause of acute appendicitis. Intestinal injury and hollow viscus injury following blunt abdominal trauma are well reported in the literature but traumatic appendicitis is much less common. The pathophysiology is uncertain but likely results from several mechanisms, either in isolation or combination. These include direct compression/crush injury, shearing injury, or from indirect obstruction of the appendiceal lumen by an ileocecal hematoma or traumatic impaction of stool into the appendix. Presentation typically mirrors that of non-traumatic appendicitis with nausea, anorexia, fever, and right lower quadrant abdominal tenderness and/or peritonitis. Evaluation for traumatic appendicitis requires a careful history and physical exam. Imaging with ultrasound or computed tomography is recommended if the history and physical do not reveal an acute surgical indication. Treatment includes intravenous antibiotics and surgical consultation for appendectomy. This case highlights a patient who developed acute appendicitis following blunt trauma to the abdomen sustained during a motor vehicle accident. Appendicitis must be considered as part of the differential diagnosis in any patient who presents to the ED with abdominal pain, including those whose pain begins after sustaining blunt trauma to the abdomen. Because appendicitis following trauma is uncommon, timely diagnosis requires a high index of suspicion. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Management of functional abdominal pain and irritable bowel syndrome in children and adolescents.

    Science.gov (United States)

    Chiou, Eric; Nurko, Samuel

    2010-06-01

    Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are among the most commonly diagnosed medical problems in pediatrics. Symptom-based Rome III criteria for FAP and IBS have been validated and help the clinician in making a positive diagnosis. The majority of patients with mild complaints improve with reassurance and time. For a distinct subset of patients with more severe and disabling illness, finding effective treatment for these disorders remains a challenge. Over the years, a wide range of therapies have been proposed and studied. The lack of a single, proven intervention highlights the complex interplay of biopsychosocial factors probably involved in the development of childhood FAP and IBS, and the need for a multidisciplinary, integrated approach. This article reviews the current literature on the efficacy of pharmacologic, dietary and psychosocial interventions for FAP and IBS in children and adolescents.

  3. Modified sandwich vacuum pack technique for temporary closure of abdominal wounds: an African perspective.

    Science.gov (United States)

    van As, A B; Navsaria, P; Numanoglu, A; McCulloch, M

    2007-01-01

    South Africa has very high levels of accidental trauma as well as interpersonal violence. There are more admissions for trauma in South Africa than for any other disease; therefore it can be regarded as the Number 1 disease in the country. Complex abdominal injuries are common, requiring specific management techniques. The aim is to document our experience with the Modified Sandwich Vacuum Pack technique for temporary closure of abdominal wounds. After providing a short historical overview, we will demonstrate the technique which we carefully adapted over the last decade to the present Modified Sandwich Vacuum Pack technique. In the Last 5 years we utilized our Modified Sandwich Vacuum Pack technique 153 times in 69 patients. Five (5) patients were under the age of 12 years. In the patient group over 12 years the most common indication for using our technique were penetrating injuries (40), abdominal sepsis (28), visceral edema (10), abdominal compartment syndrome (9), abdominal packs (6),Abdominal wall defects (2). In the group under 12-years the 2 children had liver ruptures (posttraumatic) and 3 liver transplantations. The average cost for the materials used with our technique was ZAR 96. (10 Euro and 41 cents). In our experience the Modified Sandwich Vacuum Pack technique is an effective, cheap methodology to deal with open abdomens in the African setting.A drawback may be the technical expertise required, particular in centers dealing with low numbers of complex abdominal trauma.

  4. Increased pressure within the abdominal compartment: intra-abdominal hypertension and the abdominal compartment syndrome.

    Science.gov (United States)

    Roberts, Derek J; Ball, Chad G; Kirkpatrick, Andrew W

    2016-04-01

    This article reviews recent developments related to intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) and clinical practice guidelines published in 2013. IAH/ACS often develops because of the acute intestinal distress syndrome. Although the incidence of postinjury ACS is decreasing, IAH remains common and associated with significant morbidity and mortality among critically ill/injured patients. Many risk factors for IAH include those findings suggested to be indications for use of damage control surgery in trauma patients. Medical management strategies for IAH/ACS include sedation/analgesia, neuromuscular blocking and prokinetic agents, enteral decompression tubes, interventions that decrease fluid balance, and percutaneous catheter drainage. IAH/ACS may be prevented in patients undergoing laparotomy by leaving the abdomen open where appropriate. If ACS cannot be prevented with medical or surgical management strategies or treated with percutaneous catheter drainage, guidelines recommend urgent decompressive laparotomy. Use of negative pressure peritoneal therapy for temporary closure of the open abdomen may improve the systemic inflammatory response and patient-important outcomes. In the last 15 years, investigators have better clarified the pathogenesis, epidemiology, diagnosis, and appropriate prevention of IAH/ACS. Subsequent study should be aimed at understanding which treatments effectively lower intra-abdominal pressure and whether these treatments ultimately affect patient-important outcomes.

  5. Upper abdominal teratomas in infants: radiological findings and importance of the vascular anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Hart, Jonathan; Mazrani, Waseem; McHugh, Kieran [Great Ormond Street Hospital for Children, Radiology Department, London (United Kingdom); Jones, Niall; Kiely, Edward M. [Great Ormond Street Hospital for Children, Surgery Department, London (United Kingdom); Sebire, Neil J. [Great Ormond Street Hospital for Children, Pathology Department, London (United Kingdom)

    2008-07-15

    Primary upper abdominal teratomas are extremely rare tumours, most commonly arising in infants. The radiological literature relating to them is sparse. Surgical resection is difficult due to distortion of the vascular anatomy. To reassess the value of preoperative imaging with specific reference to the presence/absence of typical features of teratoma, anatomical location and adjacent vascular anatomy. The histopathology database was used to identify infants with upper abdominal teratoma. Pathological, surgical and radiological data were reviewed. The search of the database identified 12 infants (10 girls, 2 boys) with an abdominal/retroperitoneal teratoma during the period 1993 to 2006. All teratomas were benign. In the majority of infants, typical radiological features of teratoma were demonstrated (fat, calcium). Identification of the major abdominal vessels on CT scan (most commonly the inferior vena cava) was not possible in all infants. Distortion (and commonly encasement) of the adjacent major abdominal vessels was usually evident. Upper abdominal teratomas in infants have typical radiological features. Preoperative delineation of the major vascular anatomy is often imprecise. Significant distortion of vascular anatomy was present in all infants and awareness of this feature impacts on surgical planning. (orig.)

  6. Upper abdominal teratomas in infants: radiological findings and importance of the vascular anatomy

    International Nuclear Information System (INIS)

    Hart, Jonathan; Mazrani, Waseem; McHugh, Kieran; Jones, Niall; Kiely, Edward M.; Sebire, Neil J.

    2008-01-01

    Primary upper abdominal teratomas are extremely rare tumours, most commonly arising in infants. The radiological literature relating to them is sparse. Surgical resection is difficult due to distortion of the vascular anatomy. To reassess the value of preoperative imaging with specific reference to the presence/absence of typical features of teratoma, anatomical location and adjacent vascular anatomy. The histopathology database was used to identify infants with upper abdominal teratoma. Pathological, surgical and radiological data were reviewed. The search of the database identified 12 infants (10 girls, 2 boys) with an abdominal/retroperitoneal teratoma during the period 1993 to 2006. All teratomas were benign. In the majority of infants, typical radiological features of teratoma were demonstrated (fat, calcium). Identification of the major abdominal vessels on CT scan (most commonly the inferior vena cava) was not possible in all infants. Distortion (and commonly encasement) of the adjacent major abdominal vessels was usually evident. Upper abdominal teratomas in infants have typical radiological features. Preoperative delineation of the major vascular anatomy is often imprecise. Significant distortion of vascular anatomy was present in all infants and awareness of this feature impacts on surgical planning. (orig.)

  7. Preoperative evaluation of the abdominal aortic aneurysm using spiral CT

    International Nuclear Information System (INIS)

    Chisuwa, Hisanao; Nishimaki, Keiji; Arai, Masayuki; Honda, Haruyasu; Urata, Koichi; Miyagawa, Yusuke; Makuuchi, Masatoshi; Shimizu, Mikio; Okamoto, Kohei.

    1995-01-01

    Six patients with abdominal aortic aneurysm (AAA) were studied with three-dimensionally reconstructed CT angiography (3D-CTA) in order to evaluate its usefulness as a diagnostic tool for vascular surgery patients. Images of the intravenously contrasted abdominal aorta were obtained with spiral scan during a single breath hold. The images of the abdominal aorta and its major branches were three-dimensionally reconstructed with a shaded surface display mode. The three-dimensional image reconstruction was successful in all the six cases and performed without difficulties. Shaded surface display presented a deficit to depict the aortic wall with mural thrombus. However, multidirectional display of the abdominal aorta and its branches facilitated interpretation of the anatomical details of the lesions and planning of surgical repair. 3D-CTA is an alternative to conventional aortography for preoperative diagnosis of AAA. Moreover it was shown to be noninvasive, easy to proceed. It presented good angiographical resolution that can be used as a precise diagnostic tool in vascular surgery. (author)

  8. TYK2 protein-coding variants protect against rheumatoid arthritis and autoimmunity, with no evidence of major pleiotropic effects on non-autoimmune complex traits.

    Directory of Open Access Journals (Sweden)

    Dorothée Diogo

    Full Text Available Despite the success of genome-wide association studies (GWAS in detecting a large number of loci for complex phenotypes such as rheumatoid arthritis (RA susceptibility, the lack of information on the causal genes leaves important challenges to interpret GWAS results in the context of the disease biology. Here, we genetically fine-map the RA risk locus at 19p13 to define causal variants, and explore the pleiotropic effects of these same variants in other complex traits. First, we combined Immunochip dense genotyping (n = 23,092 case/control samples, Exomechip genotyping (n = 18,409 case/control samples and targeted exon-sequencing (n = 2,236 case/controls samples to demonstrate that three protein-coding variants in TYK2 (tyrosine kinase 2 independently protect against RA: P1104A (rs34536443, OR = 0.66, P = 2.3 x 10(-21, A928V (rs35018800, OR = 0.53, P = 1.2 x 10(-9, and I684S (rs12720356, OR = 0.86, P = 4.6 x 10(-7. Second, we show that the same three TYK2 variants protect against systemic lupus erythematosus (SLE, Pomnibus = 6 x 10(-18, and provide suggestive evidence that two of the TYK2 variants (P1104A and A928V may also protect against inflammatory bowel disease (IBD; P(omnibus = 0.005. Finally, in a phenome-wide association study (PheWAS assessing >500 phenotypes using electronic medical records (EMR in >29,000 subjects, we found no convincing evidence for association of P1104A and A928V with complex phenotypes other than autoimmune diseases such as RA, SLE and IBD. Together, our results demonstrate the role of TYK2 in the pathogenesis of RA, SLE and IBD, and provide supporting evidence for TYK2 as a promising drug target for the treatment of autoimmune diseases.

  9. Pesticide content of human abdominal fat of Filipinos

    International Nuclear Information System (INIS)

    Nuguid, Z.F.S.; Bautista, E.Rb.; Detera, S.I.

    1980-01-01

    A total of 161 abdominal fat samples of Filipinos were analyzed for DDT and its major metabolite, DDE by gas chromatography. The mean value obtained was 2.82 +- 2.18 ppm and the sample range was 0.15 - 11.53 ppm. There was no correlation between the levels of DDT and the age as well as the sex of the individuals. (author)

  10. Pesticide content of human abdominal fat of Filipinos

    International Nuclear Information System (INIS)

    Nuguid, Z.F.S.; Bautista, E.R.B.; Detera, S.D.

    1980-03-01

    A total of 161 abdominal fat samples of Filipinos were analyzed for DDT and its major metabolite, DDE by gas chromatography. The mean value obtained was 2.82 +- 2.18 ppm and the sample range was 0.15 - 11.53 ppm. There was no correlation between the level of DDT and the age as well as the sex of the individuals. (author)

  11. Emergency management of major bleeding in a case of maxillofacial trauma and anticoagulation: utility of prothrombin complex concentrates in the shock room

    Directory of Open Access Journals (Sweden)

    Alessandro Morotti

    2015-03-01

    Full Text Available Life-threatening bleeding in anticoagulation with Warfarin is an emergency challenging issue. Several approaches are available to treat bleeding in either over-anticoagulation or propeanticoagulation, including vitamin K, fresh frozen plasma and prothrombin complex concentrates (PCC administration. In coexisting trauma-induced bleeding and anticoagulation, reversal of anticoagulation must be a rapid and highly effective procedure. Furthermore the appropriate treatment must be directly available in each shock rooms to guarantee the rapid management of the emergency. PCC require a simple storage, rapid accessibility, fast administration procedures and high effectiveness. Here we report the utility of PCC in management of a craniofacial trauma in proper-anticoagulation.

  12. The use of a water-soluble formazan complex to quantitate the cell number and mitochondrial function of Leishmania major promastigotes

    DEFF Research Database (Denmark)

    Berg, K; Zhai, L; Chen, M

    1994-01-01

    in that the formazan complex precipitates inside the parasites and has to be extracted by denaturants before measurements can be performed. By using a new synthetic substrate, 3-(4,5-dimethylthiazol-2-yl)-5- (3-carboxymethoxyphenyl)-2-(4-sulfonyl)-2H-tetrazolium (MTS), the extraction procedure is eliminated...... as the formazan-like dye is released spontaneously into the medium, making it possible to perform several measurements on the same parasite culture without disturbing or killing the parasites. The measurements were shown to reflect the numbers of parasites as confirmed via comparative experiments using...

  13. Abdominal Pain in Children: From the Eternal City to the Examination Room.

    Science.gov (United States)

    Zeiter, Donna K

    2017-06-01

    Abdominal pain is a common presenting symptom in children. The differential diagnosis of abdominal pain is extensive; however, a vast majority of patients ultimately are diagnosed with functional abdominal pain disorders. Functional gastrointestinal disorders are defined using the recently released Rome IV criteria. These are not diagnoses of exclusion. If there are no alarm signs, the diagnosis may be made with a focused evaluation. Treatment of these disorders requires a biopsychosocial approach to the disorder and an individualized and multipronged treatment plan. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Evaluation of the levels of metalloproteinsase-2 in patients with abdominal aneurysm and abdominal hernias.

    Science.gov (United States)

    Antoszewska, Magdalena

    2013-05-01

    Abdominal aortic aneurysms and abdominal hernias become an important health problems of our times. Abdominal aortic aneurysm and its rupture is one of the most dangerous fact in vascular surgery. There are some theories pointing to a multifactoral genesis of these kinds of diseases, all of them assume the attenuation of abdominal fascia and abdominal aortic wall. The density and continuity of these structures depend on collagen and elastic fibers structure. Reducing the strength of the fibers may be due to changes in the extracellular matrix (ECM) by the proteolytic enzymes-matrix metalloproteinases (MMPs) that degrade extracellular matrix proteins. These enzymes play an important role in the development of many disease: malignant tumors (colon, breast, lung, pancreas), cardiovascular disease (myocardial infarction, ischemia-reperfusion injury), connective tissue diseases (Ehler-Danlos Syndrome, Marfan's Syndrome), complications of diabetes (retinopathy, nephropathy). One of the most important is matrix metalloproteinase-2 (MMP-2). The aim of the study was an estimation of the MMP-2 blood levels in patients with abdominal aortic aneurysm and primary abdominal hernia, and in patients with only abdominal aortic aneurysm. The study involved 88 patients aged 42 to 89 years, including 75 men and 13 women. Patients were divided into two groups: patients with abdominal aortic aneurysm and primary abdominal hernia (45 persons, representing 51.1% of all group) and patients with only abdominal aortic aneurysm (43 persons, representing 48,9% of all group). It was a statistically significant increase in MMP-2 blood levels in patients with abdominal aortic aneurysm and primary abdominal hernia compared to patients with only abdominal aortic aneurysm. It was a statistically significant increase in the prevalence of POCHP in patients with only abdominal aortic aneurysm compared to patients with abdominal aortic aneurysm and primary abdominal hernia. Statistically significant

  15. Abdominal manifestations of autoimmune disorders

    International Nuclear Information System (INIS)

    Triantopoulou, C.

    2015-01-01

    Full text: Immunoglobulin G4-related disease was recognized as a systemic disease since various extrapancreatic lesions were observed in patients with autoimmune pancreatitis (AIP). The real etiology and pathogenesis of IgG4-RD is still not clearly understood. Moreover the exact role of IgG4 or IgG4-positive plasma cells in this disease has not yet been elucidated. only some inconsistent biological features such as hypergammaglobulinemia or hypocomplementemia support the autoimmune nature of the disease process. various names have been ascribed to this clinicopathological entity including IgG4-related sclerosing disease, IgG4-related systemic sclerosing disease, IgG4-related disease, IgG4-related autoimmune disease, hyper-IgG4 disease and IgG4-related systemic disease. The extrapancreatic lesions of IgG4-RD also exhibit the same characteristic histologic features including dense lymphoplasmacytic infiltrate, massive storiform fibrosis, and obliterative phlebitis as seen in IgG4-related pancreatitis. Abdominal manifestations include the following organs/systems: Bile ducts: Sclerosing cholangitis; Gallbladder and liver: Acalculous sclerosis cholecytitis with diffuse wall thickening; hepatic inflammatory pseudotumorts; Kidneys: round or wedge-shaped renal cortical nodules, peripheral cortical; lesions, mass like lesions or renal pelvic involvement; Prostate, urethra, seminal vesicle, vas deferens, uterine cervix; Autoimmune prostatitis; Retroperitoneum: Retroperitoneal fibrosis. thin or mildly thick homogeneous soft tissue lesion surrounding the abdominal aorta and its branches but also bulky masses causing hydronephroureterosis; Mesentery: Sclerosing mesenteritis usually involving the root of the mesentery; Bowel: Inflammatory bowel diseases mimicking Crohn’s disease or ulcerative colitis. various types of sclerosing nodular lesions of the bowel wall; Stomach: Gastritis, gastric ulcers and focal masses mimicking submucosal tumor; omentum: Infiltration mimicking

  16. Mechanisms and management of functional abdominal pain

    OpenAIRE

    Farmer, Adam D; Aziz, Qasim

    2014-01-01

    Functional abdominal pain syndrome is characterised by frequent or continuous abdominal pain associated with a degree of loss of daily activity. It has a reported population prevalence of between 0.5% and 1.7%, with a female preponderance. The pathophysiology of functional abdominal pain is incompletely understood although it has been postulated that peripheral sensitisation of visceral afferents, central sensitisation of the spinal dorsal horn and aberrancies within descending modulatory sys...

  17. Frequency of abdominal obesity and its association with diabetes mellitus among people of peshawar

    International Nuclear Information System (INIS)

    Khan, A.; Faheem, M.; Shah, S.T.; Hadi, A.; Rafiullah; Ahmad, S.; Gul, A.M.; Shah, S.F.A.; Jan, H.; Hafizullah, M.

    2015-01-01

    Background: Increased body weight is a major risk factor for the metabolic syndrome which is a cluster of coronary heart disease risk factors, like: hypertension, diabetes mellitus and dyslipidaemia. This study was conducted to determine the frequency of abdominal obesity and diabetes mellitus in the population of Peshawar and association between them. Method: This was a cross sectional study, performed by the Cardiology Department, Lady Reading Hospital Peshawar, in the population of Peshawar. All participants were interviewed in detail regarding known risk factors for coronary artery disease. Waist circumference (=102 cm in male and =88 cm in females) was used as the surrogate marker for abdominal obesity in already diagnosed patients of type-2 diabetes mellitus. Results: A total of 2548 individuals were included, 71.1 percentage were male. Mean age was 37.94±12.59 years. Mean waist circumference was 90.25±13.4 5cm in males and 90.52±12.52 cm in females. Diabetes was present in 4.4 percentage of the participants and abdominal obesity in 56.6 percentage Among the male, abdominal obesity was present in 39.4 percentage and diabetes in 2.9 percentage. Out of 39.4 percentage males with abdominal obesity, 2 percentage were diabetic. Out of 38.6 percentage males with no abdominal obesity, 0.9 percentage was diabetic. Amongst the total 559 (21.1 percentage) female subjects, 17.2 percentage were having abdominal obesity and 1.4 percentage was diabetics. Among 123 (4.8 percentage) females with no abdominal obesity, 0.1 percentage was diabetic. A positive association was established between abdominal obesity and diabetes mellitus with a significant p-valve (<0.05). Conclusion: Abdominal obesity is more common in the local population of Peshawar and associated with type-2 diabetes mellitus. (author)

  18. Defining the abdominal radiologist based on the current U.S. job market.

    Science.gov (United States)

    Hoffman, David H; Rosenkrantz, Andrew B

    2018-03-24

    The purpose of the study is to characterize current practice patterns of abdominal radiologists based on work descriptions within job postings on numerous national radiology specialty websites. Job postings for either "abdominal" or "body" radiologists were searched weekly on five society websites (SAR, SCBT-MR, ARRS, ACR, RSNA) over a 1-year period. Postings were reviewed for various characteristics. Nine hundred and sixteen total ads for 341 unique abdominal radiologist positions were reviewed (34.6% academic, 64.2% private practice, 1.2% other). Postings occurred most commonly in March (12.3%) and least commonly in November (4.8%). States with most positions were Florida (27), California (26), and New York (24). Of postings delineating expectations of specific abdominal modalities, 67.4% mentioned MRI, 58.5% ultrasound, 41.1% fluoroscopy, 14.3% PET, and 54.0% interventions. Additional non-abdominal expectations included general radiology (28.7%), breast imaging (21.1%), and general nuclear medicine (9.7%). Additional skills included prostate MRI (7.0%), OBGYN ultrasound (5.0%), and CT colonoscopy (2.6%). 79.2% required an abdominal imaging fellowship (specifically a body MRI fellowship in 4.1%). By using job postings for abdominal radiologists, we have taken a practical approach to characterizing the current status of this subspecialty, reflecting recent job expectations and requirements. The large majority of positions required a body fellowship, and the positions commonly entailed a variety of skills beyond non-invasive diagnostic abdominal imaging. Of note, expectations of considerable minorities of positions included abdominal interventions, general radiology, and breast imaging. These insights may guide the development of abdominal radiology fellowships and mini-fellowships, as well as assist radiologists entering or returning to the job market.

  19. Major prognostic value of complex karyotype in addition to TP53 and IGHV mutational status in first-line chronic lymphocytic leukemia.

    Science.gov (United States)

    Le Bris, Yannick; Struski, Stéphanie; Guièze, Romain; Rouvellat, Caroline; Prade, Naïs; Troussard, Xavier; Tournilhac, Olivier; Béné, Marie C; Delabesse, Eric; Ysebaert, Loïc

    2017-12-01

    Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder of remarkable heterogeneity as demonstrated by cytogenetics and molecular analyses. Complex karyotype (CK), TP53 deletions and/or mutations (TP53 disruption), IGVH mutational status, and, more recently, recurrent somatic mutations have been identified as prognostic markers in CLL. On a cohort of 110 patients with CLL treated with first-line fludarabin, cyclophosphamide, and rituximab treatment compared with 33 untreated (watch and wait) patients with CLL, we report more frequent complex karyotypes (34 vs 15%; P = .05), unmutated IGHV (70 vs 21%; P < .0001), ATM deletion (25 vs 6%, P = .02), and NOTCH mutation (3 vs 17%, P = .04). Among treated patients, 39 relapsed during the follow-up period. These patients were characterized before treatment by a higher incidence of trisomy 12 (38 vs 11%, P < .001) and TP53 disruption (31 vs 4%, P = .0002). A significantly shorter 5-year overall survival was found for treated patients with CK (72.4 vs 85.8%; P = .007), unmutated IGHV (70 vs 100%; P = .04), or TP53 disruption (55.7 vs 82.7%; P < .0001). Three risk groups were defined based on the status of TP53 disruption or unmutated IGVH, which differed significantly in terms of 5-year overall survival. Moreover, the presence of CK impacted pejoratively 5-year overall survival and progression-free survival in all these 3 groups. Conventional karyotyping therefore appears to be of value, CK being an additional factor, undetectable in classical FISH, in patients with CLL at the stage when therapy becomes required. Copyright © 2016 John Wiley & Sons, Ltd.

  20. A novel nonoperative approach to abdominal compartment syndrome after abdominal wall reconstruction.

    Science.gov (United States)

    Hasan, Zeenat R; Sorensen, G Brent

    2013-01-01

    Intraabdominal hypertension and abdominal compartment syndrome have been increasingly recognized as significant causes of morbidity and mortality in both medical and surgical patients. The gold standard remains surgical intervention; however, nonoperative approaches have been investigated less. Here, we describe the successful treatment of a severe acute case by intubation, nasogastric decompression, and paralysis--a novel approach not previously described in the literature. After the patient underwent laparoscopic bilateral component separation and repair of a large recurrent ventral hernia with a 20 30-cm Strattice mesh (LifeCell Corp, Branchburg, NJ), acute renal failure developed within 12 hours postoperatively, and was associated with oliguria, hyperkalemia, and elevated peak airway and bladder pressures. The patient was treated nonoperatively with intubation, nasogastric tube decompression, and paralysis with a vecuronium drip. Rapid reversal was seen, avoiding further surgery. Within 2 hours after intubation and paralysis, our patient's urine output improved dramatically with an initial diuresis of approximately 1 L, his bladder pressures decreased, and within 12 hours his creatinine level had normalized. Although surgical intervention has traditionally been thought of as the most effective--and thus the gold standard--for abdominal compartment syndrome, this preliminary experience demonstrates nonoperative management as highly efficacious, with the added benefit of decreased morbidity. Therefore, nonoperative management could be considered first-line therapy, with laparotomy reserved for refractory cases only. This suggests a more complex pathology than the traditional teaching of congestion and edema alone.

  1. Thoracic spinal anesthesia is safe for patients undergoing abdominal cancer surgery

    OpenAIRE

    Ellakany, Mohamed Hamdy

    2014-01-01

    Aim: A double-blinded randomized controlled study to compare discharge time and patient satisfaction between two groups of patients submitted to open surgeries for abdominal malignancies using segmental thoracic spinal or general anesthesia. Background: Open surgeries for abdominal malignancy are usually done under general anesthesia, but many patients with major medical problems sometimes can’t tolerate such anesthesia. Regional anesthesia namely segmental thoracic spinal anesthesia may be b...

  2. [Diagnostic imaging and acute abdominal pain].

    Science.gov (United States)

    Liljekvist, Mads Svane; Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-19

    Acute abdominal pain is a common clinical condition. Clinical signs and symptoms can be difficult to interpret, and diagnostic imaging may help to identify intra-abdominal disease. Conventional X-ray, ultrasound (US) and computed tomography (CT) of the abdomen vary in usability between common surgical causes of acute abdominal pain. Overall, conventional X-ray cannot confidently diagnose or rule out disease. US and CT are equally trustworthy for most diseases. US with subsequent CT may enhance diagnostic precision. Magnetic resonance seems promising for future use in acute abdominal imaging.

  3. Actinomycosis mimicking abdominal neoplasm. Case report

    DEFF Research Database (Denmark)

    Waaddegaard, P; Dziegiel, Morten Hanefeld

    1988-01-01

    In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed by penicil......In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed...... by penicillin treatment gave a good result....

  4. Abdominal migraine in childhood: a review

    Directory of Open Access Journals (Sweden)

    Scicchitano B

    2014-08-01

    Full Text Available Beatrice Scicchitano,1 Gareth Humphreys,1 Sally G Mitton,2 Thiagarajan Jaiganesh1 1Children's Emergency Department, 2Department of Paediatric Gastroenterology, St Georges Hospital, St Georges Healthcare NHS Trust, Tooting, London, United Kingdom Abstract: The childhood condition of abdominal migraine has been described under many different synonyms, including "abdominal epilepsy", "recurrent abdominal pain", "cyclical vomiting syndrome", and "functional gastrointestinal disorder". In the early literature, abdominal migraine is included in the "childhood periodic syndrome", first described by Wyllie and Schlesinger in 1933. Abdominal migraine has emerged over the last century as a diagnostic entity in its own right thanks to the development of well defined diagnostic criteria and its recent inclusion in the International Headache Society's Classification of Headache disorders. Despite this progress, little is known about the pathophysiology of the condition, and the treatment options are poorly defined. Here we summarize the recent literature, with particular focus on establishing the diagnosis of abdominal migraine and its pathophysiology, and suggest an approach to management. Keywords: abdominal migraine, recurrent abdominal pain, abdominal epilepsy, cyclical vomiting

  5. Detecting Site-Specific Physicochemical Selective Pressures: Applications to the Class I HLA of the Human Major Histocompatibility Complex and the SRK of the Plant Sporophytic Self-Incompatibility System

    DEFF Research Database (Denmark)

    Sainudiin, Raazesh; Wong, Wendy Shuk Wan; Yogeeswaran, Krithika

    2005-01-01

    :transversion biases. Here, we apply this method to two positively selected receptors involved in ligand-recognition: the class I alleles of the human major histocompatibility complex (MHC) of known structure and the S-locus receptor kinase (SRK) of the sporophytic self-incompatibility system (SSI) in cruciferous...... Bayes approach is used to identify sites that may be important for ligand recognition in these proteins....

  6. Major Links.

    Science.gov (United States)

    Henderson, Tona

    1995-01-01

    Provides electronic mail addresses for resources and discussion groups related to the following academic majors: art, biology, business, chemistry, computer science, economics, health sciences, history, literature, math, music, philosophy, political science, psychology, sociology, and theater. (AEF)

  7. Major Roads

    Data.gov (United States)

    Minnesota Department of Natural Resources — This data set contains roadway centerlines for major roads (interstates and trunk highways) found on the USGS 1:24,000 mapping series. These roadways are current...

  8. Identification of neurotensin-related peptides in human thymic epithelial cell membranes and relationship with major histocompatibility complex class I molecules.

    Science.gov (United States)

    Vanneste, Y; Thome, A N; Vandersmissen, E; Charlet, C; Franchimont, D; Martens, H; Lhiaubet, A M; Schimpff, R M; Rostène, W; Geenen, V

    1997-06-01

    This study shows the expression at the cell surface of human thymic epithelial cells (TEC) of a neurotensin (NT)-like immunoreactivity. NT radio-immunoassay (RIA) revealed that cultured human TEC contain +/-5 ng immunoreactive (ir) NT/10(6) cells, of which 5% is associated with plasma cell membranes. HPLC analysis of NT-ir present in human TEC showed a major peak of NT-ir corresponding to NT1-13. NT-ir was not detected in the supernatant of human TEC cultures. Using an affinity column prepared with a anti-MHC class I monoclonal antibody, NT-ir-related peptides were retained on the column and eluted together with MHC class I-related proteins. According to the elution time on HPLC of these peptides, they correspond to intact NT1-13, as well as to smaller fragments of NT1-13.

  9. The SRCR/SID region of DMBT1 defines a complex multi-allele system representing the major basis for its variability in cancer

    DEFF Research Database (Denmark)

    Mollenhauer, Jan; Müller, Hanna; Kollender, Gaby

    2002-01-01

    Deleted in malignant brain tumors 1 (DMBT1) at 10q25.3-q26.1 has been proposed as a candidate tumor-suppressor gene for brain and epithelial cancer. DMBT1 encodes a multifunctional mucin-like protein presumably involved in epithelial differentiation and protection. The gene consists of highly...... homologous and repeating exon and intron sequences. This specifically applies to the region coding for the repetitive scavenger receptor cysteine-rich (SRCR) domains and SRCR-interspersed domains (SIDs) that constitutes the major part of the gene. This particular structure may previously have interfered...... with the delineation of DMBT1 alterations in cancer. Uncovering these, however, is of mechanistic importance. By a combined approach, we conducted a detailed mutational analysis, starting from a panel of 51 tumors, including 46 tumor cell lines and five primary tumors. Alterations in the repetitive region were present...

  10. Mechanical ventilation in abdominal surgery.

    Science.gov (United States)

    Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

    2014-01-01

    One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEPventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  11. Abdominal ultrasound in AIDS patients

    International Nuclear Information System (INIS)

    Escribano, J.; Gonzalez, J.; Alvarez, M.; Rivero, S.; Raya, J.L.; Ruza, M.

    1998-01-01

    To analyze the ultrasonography findings in abdomen in the AIDS patients in our hospital, as well as the indications for this exploration, assessing the role of abdominal ultrasound (AU). The ultrasonographic and clinical findings in 527 patients who underwent a total of 715 explorations between 1992 and 1996 were studied. Hepatomegaly and/or splenomegaly, usually homogeneous, were observed in nearly half of the studies (45%); one third of the patients with marked splenomegaly presented visceral leishmaniasis. Focal lesions in liver and/or spleen, corresponding to angiomas, abscesses, lymphomatous lesions and metastasis, were detected in 5.7% of the explorations. Thirty-five percent of the AU revealed the presence of lymphadenopathy; nodes measuring over 2.5 cm were usually related to potential treatable infection or neoplasm. Thickening of the gallbladder wall did not usually indicate the presence of acute cholecystitis unless Murphy''s sign was also detected. Bile duct dilation and wall thickening was related to opportunistic cholangitis, and the increase in the echogenicity of the renal parenchyma was linked to AIDS-related nephropathy. Despite the fact that many of findings with AU are nonspecific, we consider that this approach should be the principal diagnostic technique in AIDS patients with suspected abdominal pathology or fever of unknown origin. (Author) 43 refs,

  12. Role of laparoscopy in evaluation of abdominal pain

    International Nuclear Information System (INIS)

    Masud, M.; Adil, M.; Gondal, Z.I.; Aquil, A.

    2017-01-01

    Objective: To evaluate the diagnostic efficacy of laparoscopy in ill-defined recurrent chronic abdominal pain. Study Design: Prospective study. Place and Duration of Study: Surgical department, Military Hospital Rawalpindi, from Jul 2011 to Dec 2013. Material and Methods: A total of 102 patients who presented to surgical department with chronic recurrent abdominal pain of unknown etiology and underwent diagnostic laparoscopy were included in our study. Patients with acute onset of abdominal pain, hemodynamically unstable, pregnant or those in which diagnosis can be made by radiological techniques were excluded from our study. Patient's demographic data, clinical findings and laparoscopic findings were recorded. Finally data was analyzed by using SPSS version 21. Results: Out of 110 patients 96 were female while remaining 14 were male. The age range of the patients was 20- 70 years with mean age of 50 +- 10 years. The most common site of pain was lower abdomen while mean duration of abdominal pain was 34 weeks. Laparoscopic findings include acute recurrent appendicitis in 32 (29.09%) patients, cholecystitis with biliary sludge in 14 (12.72%), pelvic inflammatory disease in 12 (10.90%), ovarian cyst in 11(10%), adhesions in 10(9.09%), intestinal tuberculosis in 8 (7.27%), mesenteric lymphadenitis in 7 (6.36%), lymphoma in 4 (3.63%), ectopic pregnancy in 3 (2.7%), CA gallbladder in 2 (1.81%), meckels diverticulum in 2 (1.81%), endometriosis in 2 (1.81%) and crohns disease in 1 (0.9%) patients. Mean operative time was 48 min while average hospital stay was 2-3 days. No major complications were noticed. Conclusion: Laparoscopy in our clinical setup has significant role in diagnosing cases of vague abdominal pain which cannot be diagnosed by routine investigations. (author)

  13. Don't Forget the Abdominal Wall: Imaging Spectrum of Abdominal Wall Injuries after Nonpenetrating Trauma.

    Science.gov (United States)

    Matalon, Shanna A; Askari, Reza; Gates, Jonathan D; Patel, Ketan; Sodickson, Aaron D; Khurana, Bharti

    2017-01-01

    Abdominal wall injuries occur in nearly one of 10 patients coming to the emergency department after nonpenetrating trauma. Injuries range from minor, such as abdominal wall contusion, to severe, such as abdominal wall rupture with evisceration of abdominal contents. Examples of specific injuries that can be detected at cross-sectional imaging include abdominal muscle strain, tear, or hematoma, including rectus sheath hematoma (RSH); traumatic abdominal wall hernia (TAWH); and Morel-Lavallée lesion (MLL) (closed degloving injury). These injuries are often overlooked clinically because of (a) a lack of findings at physical examination or (b) distraction by more-severe associated injuries. However, these injuries are important to detect because they are highly associated with potentially grave visceral and vascular injuries, such as aortic injury, and because their detection can lead to the diagnosis of these more clinically important grave traumatic injuries. Failure to make a timely diagnosis can result in delayed complications, such as bowel hernia with potential for obstruction or strangulation, or misdiagnosis of an abdominal wall neoplasm. Groin injuries, such as athletic pubalgia, and inferior costochondral injuries should also be considered in patients with abdominal pain after nonpenetrating trauma, because these conditions may manifest with referred abdominal pain and are often included within the field of view at cross-sectional abdominal imaging. Radiologists must recognize and report acute abdominal wall injuries and their associated intra-abdominal pathologic conditions to allow appropriate and timely treatment. © RSNA, 2017.

  14. Getting an Insight into the Complexity of Major Chronic Inflammatory and Degenerative Diseases: A Potential New Systemic Approach to Their Treatment.

    Science.gov (United States)

    Biava, Pier M; Norbiato, Guido

    2015-01-01

    As the modern society is troubled by multi-factorial diseases, research has been conducted on complex realities including chronic inflammation, cancer, obesity, HIV infection, metabolic syndrome and its detrimental cardiovascular complications as well as depression and other brain disorders. Deterioration of crucial homeostatic mechanisms in such diseases invariably results in activation of inflammatory mediators, chronic inflammation, loss in immunological function, increased susceptibility to diseases, alteration of metabolism, decrease of energy production and neuro-cognitive decline. Regulation of genes expression by epigenetic code is the dominant mechanism for the transduction of environmental inputs, such as stress and inflammation to lasting physiological changes. Acute and chronic stress determines DNA methylation and histone modifications in brain regions which may contribute to neuro-degenerative disorders. Nuclear glucocorticoids receptor interacts with the epigenoma resulting in a cortisol resistance status associated with a deterioration of the metabolic and immune functions. Gonadal steroids receptors have a similar capacity to produce epigenomic reorganization of chromatine structure. Epigenomic-induced reduction in immune cells telomeres length has been observed in many degenerative diseases, including all types of cancer. The final result of these epigenetic alterations is a serious damage to the neuro-endocrine-immune-metabolic adaptive systems. In this study, we propose a treatment with stem cells differentiation stage factors taken from zebrafish embryos which are able to regulate the genes expression of normal and pathological stem cells in a different specific way.

  15. Unusual presentation of antenatal ovarian torsion: free-floating abdominal cysts. Our experience and surgical management.

    Science.gov (United States)

    Zampieri, Nicola; Scirè, Gabriella; Zambon, Carla; Ottolenghi, Alberto; Camoglio, Francesco Saverio

    2009-04-01

    Abdominal cystic formations in newborns are relatively common and often diagnostic suspicion arises before birth as a result of ultrasound scans carried out during pregnancy. Prenatal ovarian torsion is a rare condition very difficult to manage in the first days of life. We report and discuss the management of prenatal ovarian torsion with a free-floating abdominal cyst detected on prenatal ultrasound. We recorded the cases of antenatal abdominal cysts detected on ultrasound at the Department of Antenatal Diagnosis between January 2003 and January 2007. Only patients with a free-floating cyst were included in the study. Clinical and surgical findings were then recorded. Two out of 57 patients underwent surgery for a free-floating abdominal cyst during the second day of life. Postnatal ultrasound, Doppler ultrasound, and laparoscopic exploration were useful to identify an unusual presentation of antenatal ovarian torsion with a complete atresia of the Fallopian tube. The cases reported in this study suggest that a good clinical approach to all cases of abdominal cysts detected on prenatal ultrasound scans require postnatal Doppler and abdominal ultrasound with a laparoscopic exploration. Free-floating abdominal cysts are rare but, at the same time, strictly correlated with autoamputation of the ovary/Fallopian tube complex.

  16. Uso da peritoneostomia na sepse abdominal Laparostomy in abdominal sepsis

    Directory of Open Access Journals (Sweden)

    Juvenal da Rocha Torres Neto

    2007-09-01

    Full Text Available Dentre as modalidades terapêuticas da sepse abdominal, a peritoneostomia tem papel decisivo permitindo explorações e lavagens da cavidade de forma facilitada. Observamos pacientes com diagnóstico clínico de sepse abdominal internados no Serviço de Coloproctologia do Hospital Universitário da Universidade Federal de Sergipe, e que foram submetidos a peritoneostomia de janeiro de 2004 a janeiro de 2006. Foram avaliados quanto ao diagnóstico primário e secundário, tipo de peritonite secundária, antibioticoterapia, esquema de lavagens, tempo de peritoneostomia, complicações e desfecho. Estudamos 12 pacientes, com idade de 15 a 57, média de 39,3 anos. Diagnóstico primário: abdome agudo inflamatório em 6(50%, abdome agudo obstrutivo em 2(16,7%, abdome agudo perfurativo em 2(16,7%, fístula enterocutânea em 1(8,3% e abscesso intra-cavitário em 1(8,3%. Diagnóstico secundário: perfuração de cólon em 4(33,3%, abscessos intra-cavitários em 3(25%, deiscências de anastomoses em 3(25%, 1(8,3% com tumor perfurado de sigmóide e 1(8,3% com necrose de cólon abaixado. Peritonite fecal em 10(83,3% e purulenta em 2(16,7%. A antibioticoterapia teve duração média de 19 dias. Lavagens de demanda em 6(50%, programadas em 4(33,3% e regime misto em 2(16,7%. O tempo médio de peritoneostomia foi de 10,9 dias (1-36. Como complicações: evisceração em 2(16,7% e fistulização em 1(8,3%. Quatro pacientes evoluíram com óbito.Among the therapeutics approach form of abdominal sepsis, the laparostomy has a decisive role allowing cavity explorations and lavages in an easier way. We study patients with abdominal sepsis diagnoses admitted to our surgical service of Coloproctology form Sergipe´s Federal University Hospital who underwent a Bogotá Bag laparostomy associated or not with polypropylene mesh from January 2004 to January 2006. These patients were assessed as: first and second diagnosis; secondary peritonitis type; antibiotic

  17. The major egg reserve protein from the invasive apple snail Pomacea maculata is a complex carotenoprotein related to those of Pomacea canaliculata and Pomacea scalaris.

    Science.gov (United States)

    Pasquevich, M Y; Dreon, M S; Heras, H

    2014-03-01

    Snails from the genus Pomacea lay conspicuous masses of brightly colored eggs above the water. Coloration is given by carotenoproteins that also which play important roles in protection against sun radiation, stabilizing and transporting antioxidant molecules and helping to protect embryos from desiccation and predators. They seem a key acquisition, but have been little studied. Here we report the characteristics of the major carotenoprotein from Pomacea maculata and the first comparison among these egg proteins. This particle, hereafter PmPV1, represents ~52% of perivitellin fluid protein. It is a glyco-lipo-carotenoprotein responsible for the bright reddish egg coloration. With VHDL characteristics, PmPV1 apparent molecular mass is 294kDa, composed of five non-covalently bound subunits of pI 4.7-9.8 and masses between 26 and 36kDa whose N-terminal sequences were obtained. It is a glyco-lipo-carotenoprotein scarcely lipidated (strategy of Pomacea. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. CT angiography. Abdominal CT using intravenous aortography for contrast enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Nagai, J; Nakauma, Y; Egawa, J; Kawamura, M [Teikyo Univ., Tokyo (Japan). Faculty of Medicine

    1980-04-01

    To obtain imaging effects close to those of abdominal aortography and investigate a technique with little invasion to patients, intravenous aortography was applied to contrast enhancement (CE) in abdominal CT, and its usefulness was discussed. Intravenous aortography could clearly visualize lesions with rich neovascularity such as hepatocellular carcinoma and renal cell carcinoma. Differing from a drip infusion method, this method has complexities in its technique that contrast medium is injected at once, blood circulation time which is represented by the time between the injection and the time when the patients feel bitterness (10 - 12 seconds) must be measured before CE, and scanning begins 2 seconds before the patients feel bitterness. However, the invasion to patients due to this method is slight, and the capacity of this method to visualize neovascularity is superior to CE by a drip infusion method. Therefore, qualitative diagnosis by CT will be improved by using this method together with a drip infusion method.

  19. Unsupervised quantification of abdominal fat from CT images using Greedy Snakes

    Science.gov (United States)

    Agarwal, Chirag; Dallal, Ahmed H.; Arbabshirani, Mohammad R.; Patel, Aalpen; Moore, Gregory

    2017-02-01

    Adipose tissue has been associated with adverse consequences of obesity. Total adipose tissue (TAT) is divided into subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). Intra-abdominal fat (VAT), located inside the abdominal cavity, is a major factor for the classic obesity related pathologies. Since direct measurement of visceral and subcutaneous fat is not trivial, substitute metrics like waist circumference (WC) and body mass index (BMI) are used in clinical settings to quantify obesity. Abdominal fat can be assessed effectively using CT or MRI, but manual fat segmentation is rather subjective and time-consuming. Hence, an automatic and accurate quantification tool for abdominal fat is needed. The goal of this study is to extract TAT, VAT and SAT fat from abdominal CT in a fully automated unsupervised fashion using energy minimization techniques. We applied a four step framework consisting of 1) initial body contour estimation, 2) approximation of the body contour, 3) estimation of inner abdominal contour using Greedy Snakes algorithm, and 4) voting, to segment the subcutaneous and visceral fat. We validated our algorithm on 952 clinical abdominal CT images (from 476 patients with a very wide BMI range) collected from various radiology departments of Geisinger Health System. To our knowledge, this is the first study of its kind on such a large and diverse clinical dataset. Our algorithm obtained a 3.4% error for VAT segmentation compared to manual segmentation. These personalized and accurate measurements of fat can complement traditional population health driven obesity metrics such as BMI and WC.

  20. Abdominal Pain: A Comparison between Neurogenic Bowel Dysfunction and Chronic Idiopathic Constipation

    Directory of Open Access Journals (Sweden)

    Pia Møller Faaborg

    2013-01-01

    Full Text Available Introduction. Most spinal-cord-injured patients have constipation. One-third develop chronic abdominal pain 10 years or more after injury. Nevertheless, very little is known about the nature of abdominal pain after spinal cord injury (SCI. It may be neuropathic or caused by constipation. Aim. To compare characteristics of abdominal pain in SCI with able-bodied with chronic idiopathic constipation (CIC. Subjects and Methods. 21 SCI and 15 CIC patients were referred for treatment of bowel symptoms. Constipation-related symptoms were assessed with the Cleveland Constipation Scoring System and the International Spinal Cord Injury Basic Bowel Function Data Set. Characteristics of abdominal pain were described using the Brief Danish Pain Questionnaire. Total gastrointestinal transit times (GITT were measured by radiopaque markers. Results. Seventeen (81% SCI and 14 (93% CIC patients reported abdominal pain or discomfort within the last month (. Pain was considered more intense by CIC than by SCI patients (. Only minor differences were found in patient’s qualitative description of abdominal pain or in the location of pain. In neither SCI nor CIC was pain associated with GITT. Conclusion. Most characteristics of abdominal pain among SCI patients resemble those of CIC. This indicates that constipation is a major cause of pain after SCI.

  1. Evaluation of the Diagnostic Value of Peritoneal Lavage Test in Intra Abdominal Injuries Due to Abdominal Trauma and Comparison with Laparotomy and Conservative Treatment

    Directory of Open Access Journals (Sweden)

    AH Amoie

    2004-04-01

    Full Text Available Introduction: Prevalence of abdominal trauma is increasing during recent years. Abdomen is the third most affected part of body by trauma. Early diagnosis can help us select better methods for managing abdominal trauma. Even though newer imaging techniques such as CT scan are available, abdominal trauma is still a complex matter, which every doctor in the emergency department has to deal with. Physical examination for the evaluation of intra abdominal organ damage though impotant, is not enough. Material and Methods: This observational (cross-sectional study was done over a period of 24 months (1999-2001. 135 patients (99male and 36 female with abdominal trauma and no urgent laparotomy indication were included in this study. We calculated the sensitivity, specificity, positive&negative predictive values of DPL test in our cases using SPSS software. Results: Mean age of patients was 28.6 years. All of the patients were evaluated with peritoneal lavage which resulted in 70 positive and 65 negative cases. All of the 70 cases with positive results were further evaluated with laparotomy of which 63 cases have intra peritoneal injuries that needed surgical treatment, while 7 cases didn’t have any intra peritoneal injuries (False positive results. All cases with negative results of peritoneal lavage test were treated conservatively for 3-5 days and during this period of time, 3 cases needed laparotomy and surgical treatment (False negative results. Conclusion : According to the results of this study, sensitivity of peritoneal lavage test in diagnosis of abdominal trauma was 95.5% and specificity was 90%. Negative predictive value of this test was 95.4% and positive predictive value of this test was 90%. Thus, peritoneal lavage test in abdominal trauma is sensitive, specific and has high specificity. It is therefore advisable that after initial evaluation of all penetrating and blunt abdominal traumas, peritoneal lavage test should be performed.

  2. Experience with early postoperative feeding after abdominal aortic surgery.

    Science.gov (United States)

    Ko, Po-Jen; Hsieh, Hung-Chang; Liu, Yun-Hen; Liu, Hui-Ping

    2004-03-01

    Abdominal aortic surgery is a form of major vascular surgery, which traditionally involves long hospital stays and significant postoperative morbidity. Experiences with transit ileus are often encountered after the aortic surgery. Thus traditional postoperative care involves delayed oral feeding until the patients regain their normal bowel activities. This report examines the feasibility of early postoperative feeding after abdominal aortic aneurysm (AAA) open-repair. From May 2002 through May 2003, 10 consecutive patients with infrarenal AAA who underwent elective surgical open-repair by the same surgeon in our department were reviewed. All of them had been operated upon and cared for according to the early feeding postoperative care protocol, which comprised of adjuvant epidural anesthesia, postoperative patient controlled analgesia, early postoperative feeding and early rehabilitation. The postoperative recovery and length of hospital stay were reviewed and analyzed. All patients were able to sip water within 1 day postoperatively without trouble (Average; 12.4 hours postoperatively). All but one patient was put on regular diet within 3 days postoperatively (Average; 2.2 days postoperatively). The average postoperative length of stay in hospital was 5.8 days. No patient died or had major morbidity. Early postoperative feeding after open repair of abdominal aorta is safe and feasible. The postoperative recovery could be improved and the length of stay reduced by simply using adjuvant epidural anesthesia during surgery, postoperative epidural patient-controlled analgesia, early feeding, early ambulation, and early rehabilitation. The initial success of our postoperative recovery program of aortic repair was demonstrated.

  3. Case Report: Rapid staged abdominal closure using Gore-Tex® mesh as a bridge to primary omphalocele sac closure

    Directory of Open Access Journals (Sweden)

    William C. Kethman

    2016-06-01

    Full Text Available Omphaloceles present an ongoing challenge due to significant variations in presentation and associated co-morbidities. Diverse management strategies have been described to tackle many of the fundamental challenges of closure and reconstruction of the abdominal wall – this fact demonstrates a need for increasingly individualized management options for this complex disease. We describe a novel method of rapid staged abdominal wall closure using Gore-Tex® mesh as a bridge to primary omphalocele closure in an infant with partial Pentalogy of Cantrell and giant ruptured omphalocele. This strategy can be used in management of some of the most complex abdominal wall defects.

  4. Dissection of the D-region of the human major histocompatibility complex by means of induced mutations in a lymphoblastoid cell line

    International Nuclear Information System (INIS)

    DeMars, R.; Chang, C.C.; Rudersdorf, R.A.

    1983-01-01

    Twenty-six human lymphoblastoid cell mutants that had lost expressions of HLA-DR were created with a two-step procedure: (i) A mutant from which one entire haplotype had been physically deleted by gamma-rays was isolated by means of immunoselection against cells expressing a specific HLA-B antigen. (ii) This heterozygous deletion mutant was irradiated with gamma-rays or treated with ICR 191, a frameshift mutagen, and mutants that no longer expressed the remaining DR1 antigen were selected with a monoclonal antibody directed against a monomorphic DR determinant. Monoclonal antibody GENOX 3.53 was used to show that four of the gamma-ray induced DR-null mutants did not express the cis-linked MB1/MT1 locus. Since MB1/MT1 was still expressed in the other 16 gamm-ray induced and 6 ICR 191-induced DR-null mutants, the separate loss of expression of MB1/MT1 and DR1 is strong evidence that the DR1 and MB1/MT1 alloantigens are under separate genetic control in the cells we used. Since DR-null mutants bound SB2-specific monoclonal antibody ILR1, whether or not they expressed MB1/MT1, the results mean that gamma-rays resolved the genetic determinants for DR1, MB1/MT1, and SB2. Additional complexity of determinants encoded by D-region genes is indicated by the following results. The amount of MB1/MT1 antigen that was detected with ELISA tests for binding of GENOX 3.53 antibody to cells varied inversely with the number of expressed copies of DR or of a locus near DR. This could result from an increased amount of MB1/MT1 antigen or from increased binding accessibility of GENOZ 3.53-reactive antigen in DR-null mutants. Monoclonal antibodies CC 11.23 and CC 6.4 displayed patterns of binding to parental and diverse mutant cells that differed from that of GENOX 3.53, suggesting the existence of at least one additional D-region antigen that is neither SB, DR, nor MB/MT

  5. Post caesarean section anterior abdominal wall endometriosis ...

    African Journals Online (AJOL)

    Abdominal wall endometriosis is a likely sequelae of caesarean section as viable endometrial tissue are deposited in the peritoneal cavity or anterior abdominal wall. One such case to sensitize clinicians of this rare presentation of the disease is presented. The patient was a 48 year old woman who presented with a lesion ...

  6. Synovial sarcoma of the abdominal wall

    International Nuclear Information System (INIS)

    Matushita, J.P.K.; Matushita, J.S.

    1989-01-01

    A case report of synovial sarcoma arising in the abdominal wall is presented. A brief review of the clinical and radiological features of synovial sarcoma is made. Pre-operative diagnosis of an abdominal wall synovial sarcoma is virtually impossible, but should be considered when a soft tissue swelling is found to show amorphous stippled calcification X-ray. (author) [pt

  7. Actinomycosis mimicking abdominal neoplasm. Case report

    DEFF Research Database (Denmark)

    Waaddegaard, P; Dziegiel, M

    1988-01-01

    In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed by penicil...

  8. Asymptomatic Incisional Endometrioma Presenting as Abdominal ...

    African Journals Online (AJOL)

    Asymptomatic incisional endometrioma of the anterior abdominal wall is rare. Clinical diagnosis may be difficult. We present a 26 year old woman with incisional abdominal wall endometrioma discovered 5 years after caeserian section. It was painless and there was no change in size with menstruation. The patient's body ...

  9. Abdominal imaging findings in gastrointestinal basidiobolomycosis.

    Science.gov (United States)

    Flicek, Kristina T; Vikram, Holenarasipur R; De Petris, Giovanni D; Johnson, C Daniel

    2015-02-01

    To describe the abdominal imaging findings of patients with gastrointestinal Basidiobolus ranarum infection. A literature search was performed to compile the abdominal imaging findings of all reported worldwide cases of gastrointestinal basidiobolomycosis (GIB). In addition, a retrospective review at our institution was performed to identify GIB cases that had imaging findings. A radiologist aware of the diagnosis reviewed the imaging findings in detail. Additional information was obtained from the medical records. A total of 73 GIB cases have been published in the medical literature. The most common abdominal imaging findings were masses in the colon, the liver, or multiple sites and bowel wall thickening. Initially, many patients were considered to have either a neoplasm or Crohn disease. We identified 7 proven cases of GIB at our institution, of which 4 had imaging studies (4 computed tomography [CT] examinations, 4 abdominal radiographs, and an upper gastrointestinal study). Imaging studies showed abnormalities in all 4 cases. Three-fourths of our study patients had an abdominal mass at CT. Two of 3 masses involved the kidneys and included urinary obstruction. All masses showed an inflammatory component with adjacent soft tissue stranding, with or without abscess formation. Radiologists should consider GIB when a patient from an arid climate presents with abdominal pain, weight loss, and an inflammatory abdominal mass on CT. Abdominal masses of the colon or liver, bowel wall thickening, and abscesses are the most common imaging findings.

  10. PATTERN AND OUTCOME OF ABDOMINAL INJURIES AT ...

    African Journals Online (AJOL)

    hi-tech

    2006-01-01

    Jan 1, 2006 ... a significant cause of abdominal injuries in Kenyatta National Hospital (KNH). The rate-of ... of selective management of abdominal injuries in. 1960 by ..... that pays great attention to the condition of the patient. (11). To aid in ...

  11. Retrospective comparison of abdominal ultrasonography and radiography in the investigation of feline abdominal disease

    Science.gov (United States)

    Won, Wylen Wade; Sharma, Ajay; Wu, Wenbo

    2015-01-01

    Abdominal radiography and ultrasonography are commonly used as part of the initial diagnostic plan for cats with nonspecific signs of abdominal disease. This retrospective study compared the clinical usefulness of abdominal radiography and ultrasonography in 105 feline patients with signs of abdominal disease. The final diagnosis was determined more commonly with ultrasonography (59%) compared to radiography (25.7%). Ultrasonography was also able to provide additional clinically relevant information in 76% of cases, and changed or refined the diagnosis in 47% of cases. Based on these findings, ultrasonography may be sufficient as an initial diagnostic test for the investigation of feline abdominal disease. PMID:26483582

  12. Genes Outside the Major Histocompatibility Complex Locus Are Linked to the Development of Thyroid Autoantibodies and Thyroiditis in NOD.H2h4 Mice.

    Science.gov (United States)

    McLachlan, Sandra M; Lesage, Sylvie; Collin, Roxanne; Banuelos, Bianca; Aliesky, Holly A; Rapoport, Basil

    2017-04-01

    Thyroiditis and autoantibodies to thyroglobulin (TgAb) and thyroid peroxidase (TPOAb) develop spontaneously in NOD.H2h4 mice, a phenotype enhanced by dietary iodine. NOD.H2h4 mice were derived by introducing the major histocompatibility class (MHC) molecule I-Ak from B10.A(4R) mice to nonobese diabetic (NOD) mice. Apart from I-Ak, the genes responsible for the NOD.H2h4 phenotype are unknown. Extending serendipitous observations from crossing BALB/c to NOD.H2h4 mice, thyroid autoimmunity was investigated in both genders of the F1, F2, and the second-generation backcross of F1 to NOD.H2h4 (N2). Medium-density linkage analysis was performed on thyroid autoimmunity traits in F2 and N2 progeny. TgAb develop before TPOAb and were measured after 8 and 16 weeks of iodide exposure; TPOAb and thyroiditis were studied at 16 weeks. TgAb, TPOAb, and thyroiditis, absent in BALB/c and F1 mice, developed in most NOD.H2h4 and in more N2 than F2 progeny. No linkages were observed in F2 progeny, probably because of the small number of autoantibody-positive mice. In N2 progeny (equal numbers of males and females), a chromosome 17 locus is linked to thyroiditis and TgAb and is suggestively linked to TPOAb. This locus includes MHC region genes from B10.A(4R) mice (such as I-Ak and Tnf, the latter involved in thyrocyte apoptosis) and genes from NOD mice such as Satb1, which most likely plays a role in immune tolerance. In conclusion, MHC and non-MHC genes, encoded within the chromosome 17 locus from both B10.A(4R) and NOD strains, are most likely responsible for the Hashimoto disease-like phenotype of NOD.H2h4 mice. Copyright © 2017 Endocrine Society.

  13. Nutritional Factors Affecting Abdominal Fat Deposition in Poultry: A Review

    Science.gov (United States)

    Fouad, A. M.; El-Senousey, H. K.

    2014-01-01

    The major goals of the poultry industry are to increase the carcass yield and to reduce carcass fatness, mainly the abdominal fat pad. The increase in poultry meat consumption has guided the selection process toward fast-growing broilers with a reduced feed conversion ratio. Intensive selection has led to great improvements in economic traits such as body weight gain, feed efficiency, and breast yield to meet the demands of consumers, but modern commercial chickens exhibit excessive fat accumulation in the abdomen area. However, dietary composition and feeding strategies may offer practical and efficient solutions for reducing body fat deposition in modern poultry strains. Thus, the regulation of lipid metabolism to reduce the abdominal fat content based on dietary composition and feeding strategy, as well as elucidating their effects on the key enzymes associated with lipid metabolism, could facilitate the production of lean meat and help to understand the fat-lowering effects of diet and different feeding strategies. PMID:25050050

  14. Fetal abdominal magnetic resonance imaging

    International Nuclear Information System (INIS)

    Brugger, Peter C.; Prayer, Daniela

    2006-01-01

    This review deals with the in vivo magnetic resonance imaging (MRI) appearance of the human fetal abdomen. Imaging findings are correlated with current knowledge of human fetal anatomy and physiology, which are crucial to understand and interpret fetal abdominal MRI scans. As fetal MRI covers a period of more than 20 weeks, which is characterized not only by organ growth, but also by changes and maturation of organ function, a different MR appearance of the fetal abdomen results. This not only applies to the fetal intestines, but also to the fetal liver, spleen, and adrenal glands. Choosing the appropriate sequences, various aspects of age-related and organ-specific function can be visualized with fetal MRI, as these are mirrored by changes in signal intensities. Knowledge of normal development is essential to delineate normal from pathological findings in the respective developmental stages

  15. Fetal abdominal magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Brugger, Peter C. [Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Waehringerstrasse 13, 1090 Vienna (Austria)]. E-mail: peter.brugger@meduniwien.ac.at; Prayer, Daniela [Department of Radiology, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna (Austria)

    2006-02-15

    This review deals with the in vivo magnetic resonance imaging (MRI) appearance of the human fetal abdomen. Imaging findings are correlated with current knowledge of human fetal anatomy and physiology, which are crucial to understand and interpret fetal abdominal MRI scans. As fetal MRI covers a period of more than 20 weeks, which is characterized not only by organ growth, but also by changes and maturation of organ function, a different MR appearance of the fetal abdomen results. This not only applies to the fetal intestines, but also to the fetal liver, spleen, and adrenal glands. Choosing the appropriate sequences, various aspects of age-related and organ-specific function can be visualized with fetal MRI, as these are mirrored by changes in signal intensities. Knowledge of normal development is essential to delineate normal from pathological findings in the respective developmental stages.

  16. Combined laparoscopic and open technique for repair of congenital abdominal hernia

    Science.gov (United States)

    Ye, Qinghuang; Chen, Yan; Zhu, Jinhui; Wang, Yuedong

    2017-01-01

    Abstract Background: Prune belly syndrome (PBS) is a rare congenital disorder among adults, and the way for repairing abdominal wall musculature has no unified standard. Materials and methods: We described combining laparoscopic and open technique in an adult male who presented with PBS. Physical examination and radiological imaging verified the case of PBS. The deficiency of abdominal wall musculature was repaired by combining laparoscopic and open technique using a double-deck complex patch. Results: The patient successfully underwent abdominal wall repair by combining laparoscopic and open technique. Postoperative recovery was uneventful, and improvement in symptom was significant in follow-up after 3, 6, 12, and 24 months. Conclusions: Combining laparoscopic and open technique for repair of deficiency of abdominal wall musculature in PBS was an exploratory way to improve life quality. PMID:29049186

  17. [Prediction of intra-abdominal hypertension risk in patients with acute colonic obstruction under epidural analgesia].

    Science.gov (United States)

    Stakanov, A V; Potseluev, E A; Musaeva, T S

    2013-01-01

    Purpose of the study was to identify prediction possibility of direct current potential level for intra-abdominal hypertension risk in patients with acute colonic obstruction under preoperative epidural analgesia. Prospective analysis of the preoperative period was carried out in 140 patients with acute colonic obstruction caused by colon cancer. Relations between preoperative level of permanent capacity and risk of intra-abdominal hypertension was identified Direct current potential level is an independent predictor of intra-abdominal hypertension. Diagnostic significance increases from first to fifth hour of preoperative period according to AUROC data from 0.821 to 0.905 and calibration 6.9 (p > 0.37) and 4.7 (p > 0.54) by Hosmer-Lemeshou criteria. The use of epidural analgesia in the complex intensive preoperative preparation is pathogenically justified. It reduces intra-abdominal hypertension in patients with acute colonic obstruction.

  18. Acute appendicitis after blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Marjan Joudi

    2012-02-01

    Full Text Available Appendecitis is one of the most frequent surgeries. Inflammation of appendix may be due to variable causes such as fecalit, hypertrophy of Peyer’s plaques, seeds of fruits and parasites. In this study we presented an uncommon type of appendicitis which occurred after abdominal blunt trauma. In this article three children present who involved acute appendicitis after blunt abdominal trauma. These patients were 2 boys (5 and 6-year-old and one girl (8-year-old who after blunt abdominal trauma admitted to the hospital with abdominal pain and symptoms of acute abdomen and appendectomy had been done for them.Trauma can induce intramural hematoma at appendix process and may cause appendicitis. Therefore, physicians should be aware of appendicitis after blunt abdominal trauma

  19. Mechanical characterization of porcine abdominal organs.

    Science.gov (United States)

    Tamura, Atsutaka; Omori, Kiyoshi; Miki, Kazuo; Lee, Jong B; Yang, King H; King, Albert I

    2002-11-01

    Typical automotive related abdominal injuries occur due to contact with the rim of the steering wheel, seatbelt and armrest, however, the rate is less than in other body regions. When solid abdominal organs, such as the liver, kidneys and spleen are involved, the injury severity tends to be higher. Although sled and pendulum impact tests have been conducted using cadavers and animals, the mechanical properties and the tissue level injury tolerance of abdominal solid organs are not well characterized. These data are needed in the development of computer models, the improvement of current anthropometric test devices and the enhancement of our understanding of abdominal injury mechanisms. In this study, a series of experimental tests on solid abdominal organs was conducted using porcine liver, kidney and spleen specimens. Additionally, the injury tolerance of the solid organs was deduced from the experimental data.

  20. Da Vinci-assisted abdominal cerclage.

    Science.gov (United States)

    Barmat, Larry; Glaser, Gretchen; Davis, George; Craparo, Frank

    2007-11-01

    To report the first placement of an abdominal cervicoisthmic cerclage using the da Vinci robot. Case report. Tertiary-care hospital. A 39-year-old female with a history of cervical insufficiency who required a cerclage and was not a candidate for transvaginal cerclage placement. Abdominal cervicoisthmic cerclage placement using the da Vinci robot. Ability to safely and successfully place an abdominal cerclage using the da Vinci robot. Abdominal cerclage was successfully placed using the da Vinci robot. The patient had minimal blood loss and was discharged to home on the same day as surgery. Da Vinci robot-assisted abdominal cerclage placement is an innovative application of robotic surgery and may alter the standard of care for women who require this surgery.