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Sample records for distal acr enhancer

  1. ACR-1000: Enhanced response to severe accidents

    International Nuclear Information System (INIS)

    Popov, N.K.; Santamaura, P.; Shapiro, H.; Snell, V.G.

    2006-01-01

    Full text: Atomic Energy of Canada Limited (AECL) developed the Advanced CANDU Reactor-TM700 (ACR-700TM) as an evolutionary advancement of the current CANDU 6R reactor. As further advancement of the ACR design, AECL is currently developing the ACR-1000TM for the Canadian and international market. The ACR-1000 is aimed at producing electrical power for a capital cost and a unit-energy cost significantly less than that of the current generation of operating nuclear plants, while achieving shorter construction schedule, high plant capacity factor, improved operations and maintenance, increased operating life. and enhanced safety features. The reference ACR-1000 plant design is based on an integrated two-unit plant, using enriched fuel and light-water coolant, with each unit having a nominal gross output of about 1200 MWe. This paper presents the ACR-1000 features that are designed to mitigate limited core damage and severe core damage states, including core retention within vessel, core damage termination, and containment integrity maintenance. Core retention within vessel in CANDU-type reactors includes both retention within fuel channels, and retention within the calandria vessel. The moderator heavy water in the ACR-1000 calandria vessel, as in any other CANDU-type reactor, provides ample heat removal capacity in severe accidents. The ACR-1000 calandria vessel design permits for passive rejection of decay heat from the moderator to the shield water. Also, the calandria vessel will be designed for debris retention. Core damage termination is achieved by flooding of the core components with water and keeping them flooded thereafter. Successful termination can be achieved in the fuel channels, calandria vessel or calandria vault by water supply by the Long Term Cooling (LTC) pumps and by gravity feed from the Reserve Water System. The ACR-1000 containment is required to withstand external events such as earthquakes, tornados, floods and aircraft crashes. Containment

  2. Design of New Antibacterial Enhancers Based on AcrB’s Structure and the Evaluation of Their Antibacterial Enhancement Activity

    Directory of Open Access Journals (Sweden)

    Yi Song

    2016-11-01

    Full Text Available Previously, artesunate (AS and dihydroartemisinine 7 (DHA7 were found to have antibacterial enhancement activity against Escherichia coli via inhibition of the efflux pump AcrB. However, they were only effective against E. coli standard strains. This study aimed to develop effective antibacterial enhancers based on the previous work. Our results demonstrate that 86 new antibacterial enhancers were designed via 3D-SAR and molecular docking. Among them, DHA27 had the best antibacterial enhancement activity. It could potentiate the antibacterial effects of ampicillin against not only E. coli standard strain but also clinical strains, and of β-lactam antibiotics, not non-β-lactamantibiotics. DHA27 could increase the accumulation of daunomycin and nile red within E. coli ATCC 35218, but did not increase the bacterial membrane permeability. DHA27 reduced acrB’s mRNA expression of E. coli ATCC 35218 in a dose-dependent manner, and its antibacterial enhancement activity is related to the degree of acrB mRNA expression in E. coli clinical strains. The polypeptides from AcrB were obtained via molecular docking assay; the pre-incubated polypeptides could inhibit the activity of DHA27. Importantly, DHA27 had no cytotoxicity on cell proliferation. In conclusion, among newly designed antibacterial enhancers, DHA27 had favorable physical and pharmacological properties with no significant cytotoxicity at effective concentrations, and might serve as a potential efflux pump inhibitor in the future.

  3. ACR-700 advanced technologies

    International Nuclear Information System (INIS)

    Tapping, R.L.; Turner, C.W.; Yu, S.K.W.; Olmstead, R.; Speranzini, R.A.

    2004-01-01

    A successful advanced reactor plant will have optimized economics including reduced operating and maintenance costs, improved performance, and enhanced safety. Incorporating improvements based on advanced technologies ensures cost, safety and operational competitiveness of the ACR-700. These advanced technologies include modern configuration management; construction technologies; operational technology for the control centre and information systems for plant monitoring and analysis. This paper summarizes the advanced technologies used to achieve construction and operational improvements to enhance plant economic competitiveness, advances in the operational technology used for reactor control, and presents the development of the Smart CANDU suite of tools and its application to existing operating reactors and to the ACR-700. (author)

  4. Contrast enhancement of bite mark images using the grayscale mixer in ACR in Photoshop®.

    Science.gov (United States)

    Evans, Sam; Noorbhai, Suzanne; Lawson, Zoe; Stacey-Jones, Seren; Carabott, Romina

    2013-05-01

    Enhanced images may improve bite mark edge definition, assisting forensic analysis. Current contrast enhancement involves color extraction, viewing layered images by channel. A novel technique, producing a single enhanced image using the grayscale mix panel within Adobe Camera Raw®, has been developed and assessed here, allowing adjustments of multiple color channels simultaneously. Stage 1 measured RGB values in 72 versions of a color chart image; eight sliders in Photoshop® were adjusted at 25% intervals, all corresponding colors affected. Stage 2 used a bite mark image, and found only red, orange, and yellow sliders had discernable effects. Stage 3 assessed modality preference between color, grayscale, and enhanced images; on average, the 22 survey participants chose the enhanced image as better defined for nine out of 10 bite marks. The study has shown potential benefits for this new technique. However, further research is needed before use in the analysis of bite marks. © 2013 American Academy of Forensic Sciences.

  5. E2-mediated cathepsin D (CTSD) activation involves looping of distal enhancer elements.

    Science.gov (United States)

    Bretschneider, Nancy; Kangaspeska, Sara; Seifert, Martin; Reid, George; Gannon, Frank; Denger, Stefanie

    2008-08-01

    Estrogen receptor alpha (ERalpha) is a ligand dependent transcription factor that regulates the expression of target genes through interacting with cis-acting estrogen response elements (EREs). However, only a minority of ERalpha binding sites are located within the proximal promoter regions of responsive genes. Here we report the characterization of an ERE located 9kbp upstream of the TSS of the cathepsin D gene (CTSD) that up-regulates CTSD expression upon estrogen stimulation in MCF-7 cells. Using ChIP, we show recruitment of ERalpha and phosphorylated PolII at the CTSD distal enhancer region. Moreover, we determine the kinetics of transient CpG methylation on the promoter region of CTSD and for the first time, at a distal enhancer element. We show that ERalpha is crucial for long-distance regulation of CTSD expression involving a looping mechanism.

  6. Implementation of enhanced recovery programme for laparoscopic distal pancreatectomy: feasibility, safety and cost analysis.

    Science.gov (United States)

    Richardson, John; Di Fabio, Francesco; Clarke, Hannah; Bajalan, Mohammed; Davids, Joe; Abu Hilal, Mohammed

    2015-01-01

    The adoption of laparoscopy for distal pancreatectomy has proven to substantially improve short-term outcomes. Stress response after major surgery can be further minimized within an enhanced recovery programme (ERP). However, data on the potential benefit of an ERP for laparoscopic distal pancreatectomy are still lacking. The aim was to assess the feasibility, safety and cost of ERP for patients undergoing laparoscopic distal pancreatectomy. This is a case-control study from a Tertiary University Hospital. Sixty-six consecutive patients who underwent laparoscopic distal pancreatectomy were analyzed. Twenty-two patients were enrolled for the ERP and compared with previous consecutive 44 patients managed traditionally (1:2 ratio). Operative details, post-operative outcome and cost analysis were compared in the two groups. Patients enrolled in the ERP had similar intraoperative blood loss (median 165 ml vs. 200 ml; p = 0.176), operation time (225 min vs. 210 min; p = 0.633), time to remove naso-gastric tube (1 vs. 1 day; p = 0.081) but significantly shorter time to mobilization (median 1 vs. 2 days; p = 0.0001), start solid diet (2 vs. 3 days; p = 0004), and pass stools (3 vs. 5 days; p = 0.002) compared to the control group. Median length of stay was significantly shorter in the ERP group (3 vs. 6 days; p pancreatectomy with significant earlier return to normal gut function, reduced length of stay and cost saving. Copyright © 2015 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  7. Mass spectrometry for identification of proteins that specifically bind to a distal enhancer of the Oct4 gene

    Science.gov (United States)

    Bakhmet, E. I.; Nazarov, I. B.; Artamonova, T. O.; Khodorkovsky, M. A.; Tomilin, A. N.

    2017-11-01

    Transcription factor Oct4 is a marker of pluripotent stem cells and has a significant role in their self-renewal. Oct4 gene is controlled by three cis-regulatory elements - proximal promoter, proximal enhancer and distal enhancer. All of these elements are targets for binding of regulatory proteins. Distal enhancer is in our research focus because of its activity in early stages of embryonic development. There are two main sequences called site 2A and site 2B that are presented in distal enhancer. For this moment proteins which bind to a site 2A (CCCCTCCCCCC) remain unknown. Using combination of in vitro method electrophoretic mobility shift assay (EMSA) and mass spectromery we identified several candidates that can regulate Oct4 gene expression through site 2A.

  8. Distal axotomy enhances retrograde presynaptic excitability onto injured pyramidal neurons via trans-synaptic signaling.

    Science.gov (United States)

    Nagendran, Tharkika; Larsen, Rylan S; Bigler, Rebecca L; Frost, Shawn B; Philpot, Benjamin D; Nudo, Randolph J; Taylor, Anne Marion

    2017-09-20

    Injury of CNS nerve tracts remodels circuitry through dendritic spine loss and hyper-excitability, thus influencing recovery. Due to the complexity of the CNS, a mechanistic understanding of injury-induced synaptic remodeling remains unclear. Using microfluidic chambers to separate and injure distal axons, we show that axotomy causes retrograde dendritic spine loss at directly injured pyramidal neurons followed by retrograde presynaptic hyper-excitability. These remodeling events require activity at the site of injury, axon-to-soma signaling, and transcription. Similarly, directly injured corticospinal neurons in vivo also exhibit a specific increase in spiking following axon injury. Axotomy-induced hyper-excitability of cultured neurons coincides with elimination of inhibitory inputs onto injured neurons, including those formed onto dendritic spines. Netrin-1 downregulation occurs following axon injury and exogenous netrin-1 applied after injury normalizes spine density, presynaptic excitability, and inhibitory inputs at injured neurons. Our findings show that intrinsic signaling within damaged neurons regulates synaptic remodeling and involves netrin-1 signaling.Spinal cord injury can induce synaptic reorganization and remodeling in the brain. Here the authors study how severed distal axons signal back to the cell body to induce hyperexcitability, loss of inhibition and enhanced presynaptic release through netrin-1.

  9. ACR-1000: Operator - based development

    International Nuclear Information System (INIS)

    Shalaby, B.; Alizadeh, A.

    2007-01-01

    Atomic Energy of Canada Limited (AECL) has adapted the successful features of CANDU * reactors to establish Generation III + Advanced CANDU Reactor T M (ACR T M) technology. The ACR-1000 T M nuclear power plant is an evolutionary product, starting with the strong base of CANDU reactor technology, coupled with thoroughly-demonstrated innovative features to enhance economics, safety, operability and maintainability. The ACR-1000 benefits from AECL's continuous-improvement approach to design, that enabled the traditional CANDU 6 product to compile an exceptional track record of on-time, on budget product delivery, and also reliable, high capacity-factor operation. The ACR-1000 engineering program has completed the basic plant design and has entered detailed pre-project engineering and formal safety analysis to prepare the preliminary (non-project-specific) safety case. The engineering program is strongly operator-based, and encompasses much more than traditional pre-project design elements. A team of utility-experienced operations and maintenance experts is embedded in the engineering team, to ensure that all design decisions, at the system and the component level, are taken with the owner-operator interest in mind. The design program emphasizes formal review of operating feedback, along with extensive operator participation in program management and execution. Design attention is paid to layout and access of equipment, to component and material selection, and to ensuring maximum ability for on-line maintenance. This enables the ACR-1000 to offer a three-year interval between scheduled maintenance outages, with a standard 21-day outage duration. SMART CANDU T M technology allows on-line monitoring and diagnostics to further enhance plant operation. Modules of the Advanced CANDU SMART technologies are already being back-fitted to current CANDU plants. As well as reviewing the ACR-1000 design features and their supporting background, the paper describes the status of

  10. SOX2 co-occupies distal enhancer elements with distinct POU factors in ESCs and NPCs to specify cell state.

    Directory of Open Access Journals (Sweden)

    Michael A Lodato

    Full Text Available SOX2 is a master regulator of both pluripotent embryonic stem cells (ESCs and multipotent neural progenitor cells (NPCs; however, we currently lack a detailed understanding of how SOX2 controls these distinct stem cell populations. Here we show by genome-wide analysis that, while SOX2 bound to a distinct set of gene promoters in ESCs and NPCs, the majority of regions coincided with unique distal enhancer elements, important cis-acting regulators of tissue-specific gene expression programs. Notably, SOX2 bound the same consensus DNA motif in both cell types, suggesting that additional factors contribute to target specificity. We found that, similar to its association with OCT4 (Pou5f1 in ESCs, the related POU family member BRN2 (Pou3f2 co-occupied a large set of putative distal enhancers with SOX2 in NPCs. Forced expression of BRN2 in ESCs led to functional recruitment of SOX2 to a subset of NPC-specific targets and to precocious differentiation toward a neural-like state. Further analysis of the bound sequences revealed differences in the distances of SOX and POU peaks in the two cell types and identified motifs for additional transcription factors. Together, these data suggest that SOX2 controls a larger network of genes than previously anticipated through binding of distal enhancers and that transitions in POU partner factors may control tissue-specific transcriptional programs. Our findings have important implications for understanding lineage specification and somatic cell reprogramming, where SOX2, OCT4, and BRN2 have been shown to be key factors.

  11. ACR-1000 design provisions for severe accidents

    International Nuclear Information System (INIS)

    Popov, N.K.; Santamaura, P.; Shapiro, H.; Snell, V.G.

    2006-01-01

    Atomic Energy of Canada Limited (AECL) developed the Advanced CANDU Reactor-700 (ACR-700) as an evolutionary advancement of the current CANDU 6 reactor. As a further advancement of the ACR design, AECL is currently developing the ACR-1000 for the Canadian and international market. The ACR-1000 is aimed at producing electrical power for a capital cost and a unit-energy cost significantly less than that of the current generation of operating nuclear plants, while achieving enhanced safety features, shorter construction schedule, high plant capacity factor, improved operations and maintenance, and increased operating life. The reference ACR-1000 plant design is based on an integrated two-unit plant, using enriched fuel and light-water coolant, with each unit having a nominal gross output of about 1200 MWe. The ACR-1000 design meets Canadian regulatory requirements and follows established international practice with respect to severe accident prevention and mitigation. This paper presents the ACR-1000 features that are designed to mitigate limited core damage and severe core damage states, including core retention within vessel, core damage termination, and containment integrity maintenance. While maintaining existing structures of CANDU reactors that provide inherent prevention and retention of core debris, the ACR-1000 design includes additional features for prevention and mitigation of severe accidents. Core retention within vessel in CANDU-type reactors includes both retention within fuel channels, and retention within the calandria vessel. The ACR-1000 calandria vessel design permits for passive rejection of decay heat from the moderator to the shield water. Also, the calandria vessel is designed for debris retention by minimizing penetrations at the bottom periphery and by accommodating thermal and weight loads of the core debris. The ACR-1000 containment is required to withstand external events such as earthquakes, tornados, floods and aircraft crashes

  12. The ACR Model

    DEFF Research Database (Denmark)

    Bec, Frederique; Rahbek, Anders Christian; Shephard, Neil

    2008-01-01

    This paper proposes and analyses the autoregressive conditional root (ACR) time-series model. This multivariate dynamic mixture autoregression allows for non-stationary epochs. It proves to be an appealing alternative to existing nonlinear models, e.g. the threshold autoregressive or Markov...... switching class of models, which are commonly used to describe nonlinear dynamics as implied by arbitrage in presence of transaction costs. Simple conditions on the parameters of the ACR process and its innovations are shown to imply geometric ergodicity, stationarity and existence of moments. Furthermore...

  13. DISTAL MYOPATHIES

    Science.gov (United States)

    Dimachkie, Mazen M.; Barohn, Richard J.

    2014-01-01

    Over a century ago, Gowers described two young patients in whom distal muscles weakness involved the hand, foot, sternocleidomastoid, and facial muscles in the other case the shoulder and distal leg musculature. Soon after, , similar distal myopathy cases were reported whereby the absence of sensory symptoms and of pathologic changes in the peripheral nerves and spinal cord at postmortem examination allowed differentiation from Charcot-Marie-Tooth disease. In 1951, Welander described autosomal dominant (AD) distal arm myopathy in a large Scandanavian cohort. Since then the number of well-characterized distal myopathies has continued to grow such that the distal myopathies have formed a clinically and genetically heterogeneous group of disorders. Affected kindred commonly manifest weakness that is limited to foot and toe muscles even in advanced stages of the disease, with variable mild proximal leg, distal arm, neck and laryngeal muscle involvement in selected individuals. An interesting consequence of the molecular characterization of the distal myopathies has been the recognition that mutation in a single gene can lead to more than one clinical disorder. For example, Myoshi myopathy (MM) and limb girdle muscular dystrophy (LGMD) type 2B are allelic disorders due to defects in the gene that encodes dysferlin. The six well described distal myopathy syndromes are shown in Table 1. Table 2 lists advances in our understanding of the myofibrillar myopathy group and Table 3 includes more recently delineated and less common distal myopathies. In the same manner, the first section of this review pertains to the more traditional six distal myopathies followed by discussion of the myofibrillar myopathies. In the third section, we review other clinically and genetically distinctive distal myopathy syndromes usually based upon single or smaller family cohorts. The fourth section considers other neuromuscular disorders that are important to recognize as they display prominent

  14. Regulation of the neuropathy-associated Pmp22 gene by a distal super-enhancer.

    Science.gov (United States)

    Pantera, Harrison; Moran, John J; Hung, Holly A; Pak, Evgenia; Dutra, Amalia; Svaren, John

    2018-05-16

    Peripheral nerve myelination is adversely affected in the most common form of the hereditary peripheral neuropathy called Charcot-Marie-Tooth Disease. This form, classified as CMT1A, is caused by a 1.4 Mb duplication on chromosome 17, which includes the abundantly expressed Schwann cell myelin gene, Peripheral Myelin Protein 22 (PMP22). This is one of the most common copy number variants causing neurological disease. Overexpression of Pmp22 in rodent models recapitulates several aspects of neuropathy, and reduction of Pmp22 in such models results in amelioration of the neuropathy phenotype. Recently we identified a potential super-enhancer approximately 90-130 kb upstream of the Pmp22 transcription start sites. This super-enhancer encompasses a cluster of individual enhancers that have the acetylated histone H3K27 active enhancer mark, and coincides with smaller duplications identified in patients with milder CMT1A-like symptoms, where the PMP22 coding region itself was not part of the duplication. In this study, we have utilized genome editing to create a deletion of this super-enhancer to determine its role in Pmp22 regulation. Our data show a significant decrease in Pmp22 transcript expression using allele-specific internal controls. Moreover, the P2 promoter of the Pmp22 gene, which is used in other cell types, is affected, but we find that the Schwann cell-specific P1 promoter is disproportionately more sensitive to loss of the super-enhancer. These data show for the first time the requirement of these upstream enhancers for full Pmp22 expression.

  15. Transcriptional Modulation of Penicillin-Binding Protein 1b, Outer Membrane Protein P2 and Efflux Pump (AcrAB-TolC during Heat Stress Is Correlated to Enhanced Bactericidal Action of Imipenem on Non-typeable Haemophilus influenzae

    Directory of Open Access Journals (Sweden)

    Abdessalam Cherkaoui

    2018-01-01

    Full Text Available Objective: The purpose of the present study was to investigate the penicillin binding proteins (PBPs, drug influx and efflux modulations during heat stress and their effects on the bactericidal action of imipenem on non-typeable Haemophilus influenzae (NTHi.Methods: The two NTHi clinical isolates (GE47 and GE88, imipenem MICs by E-test > 32 μg/mL examined in this study were collected at Geneva University Hospitals. The imipenem killing activity was assessed after incubation of the NTHi strains at either 37 or 42°C for 3 h with increasing concentrations of imipenem. The detection of PBPs was carried out by Bocillin-FL. Global transcriptional changes were monitored by RNA-seq after pre-incubation of bacterial cells at either 37 or 42°C, and the expression levels of relevant target genes were confirmed by qRT-PCR.Results: Quantitation of NTHi viable cells after incubation with 0.25 μg/mL of imipenem for 3 h revealed more than a twofold decrease in GE47 and GE88 viable cells at 42°C as compared to 37°C. Transcriptome analysis showed that under heat stress conditions, there were 141 differentially expressed genes with a | log2(fold change| > 1, including 67 up-regulated and 74 down-regulated genes. The expression levels of ponB (encoding PBP1b and acrR (regulator of AcrAB-TolC efflux pump were significantly increased at 42°C. In contrast, the transcript levels of ompP2 (encoding the outer membrane protein P2 and acrB gene (encoding AcrB were significantly lower under heat stress condition.Conclusion: This study shows that the transcriptional modulation of ponB, ompP2, acrR, and acrB in the heat stress response is correlated to enhanced antimicrobial effects of imipenem on non-typeable H. influenzae.

  16. Steam generator design requirements for ACR-1000

    International Nuclear Information System (INIS)

    Subash, S.; Hau, K.

    2006-01-01

    Atomic Energy of Canada Limited (AECL) has developed the ACR-1000 (Advanced CANDU Reactor-1000 ) to meet market expectations for enhanced safety of plant operation, high capacity factor, low operating cost, increased operating life, simple component replacement, reduced capital cost, and shorter construction schedule. The ACR-1000 design is based on the use of horizontal fuel channels surrounded by a heavy water moderator, the same feature as in all CANDU reactors. The major innovation in the ACR-1000 is the use of low enriched uranium fuel, and light water as the coolant, which circulates in the fuel channels. This results in a compact reactor core design and a reduction of heavy water inventory, both contributing to a significant decrease in capital cost per MWe produced. The ACR-1000 plant is a two-unit, integrated plant with each unit having a nominal gross output of about 1165 MWe with a net output of approximately 1085 MWe. The plant design is adaptable to a single unit configuration, if required. This paper focuses on the technical considerations that went into developing some of the important design requirements for the steam generators for the ACR-1000 plant and how these requirements are specified in the Technical Specification, which is the governing document for the steam generator (SG) detail design. Layout of these SGs in the plant is briefly described and their impacts on the SG design. (author)

  17. Maxillary molar distalization or mandibular enhancement: a cephalometric comparison of comprehensive orthodontic treatment including the pendulum and the Herbst appliances.

    Science.gov (United States)

    Burkhardt, Donald R; McNamara, James A; Baccetti, Tiziano

    2003-02-01

    Several methods of Class II treatment that do not rely on significant patient compliance have become popular during the last decade, including several versions of the Herbst appliance and the pendulum or Pendex molar-distalization appliances. Yet, these 2 general approaches theoretically have opposite treatment effects, one presumably enhancing mandibular growth, and the other moving the maxillary teeth posteriorly. This study examined the treatment effects produced by 2 types of the Herbst appliance (acrylic splint and stainless-steel crown) followed by fixed appliances, and the pendulum appliance followed by fixed appliances. For each of the 3 treatment groups, lateral cephalograms were analyzed before the start of treatment (T1) and after the second phase of treatment (T2). Patients were matched according to age and sex. The comprehensive treatment time for the pendulum group was 31.6 months, and the acrylic and crowned Herbst groups were treated for 29.5 months and 28.0 months, respectively. Overall from T1 to T2, there were no statistically significant differences in mandibular growth among the 3 groups. Skeletal changes accounted for a larger portion of molar correction in the Herbst treatment groups than in the pendulum group. Patients in the pendulum group had an increase in the mandibular plane angle. Conversely, the mandibular plane angle in patients treated with either Herbst appliance closed slightly from T1 to T2. At T2, the chin points (pogonion) of patients in both Herbst groups, however, were located slightly more anteriorly than were the chin points of the pendulum patients. It is likely that the slight downward and backward rotation of the mandible occurring during treatment in the pendulum patients accounted for much of this difference. The treatment effects produced by the 2 types of Herbst appliance were similar at T2, in spite of their differences in design. It is important not to generalize the findings of this comparison beyond the appliance

  18. ACR appropriateness criteria jaundice.

    Science.gov (United States)

    Lalani, Tasneem; Couto, Corey A; Rosen, Max P; Baker, Mark E; Blake, Michael A; Cash, Brooks D; Fidler, Jeff L; Greene, Frederick L; Hindman, Nicole M; Katz, Douglas S; Kaur, Harmeet; Miller, Frank H; Qayyum, Aliya; Small, William C; Sudakoff, Gary S; Yaghmai, Vahid; Yarmish, Gail M; Yee, Judy

    2013-06-01

    A fundamental consideration in the workup of a jaundiced patient is the pretest probability of mechanical obstruction. Ultrasound is the first-line modality to exclude biliary tract obstruction. When mechanical obstruction is present, additional imaging with CT or MRI can clarify etiology, define level of obstruction, stage disease, and guide intervention. When mechanical obstruction is absent, additional imaging can evaluate liver parenchyma for fat and iron deposition and help direct biopsy in cases where underlying parenchymal disease or mass is found. Imaging techniques are reviewed for the following clinical scenarios: (1) the patient with painful jaundice, (2) the patient with painless jaundice, and (3) the patient with a nonmechanical cause for jaundice. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  19. Estrogen-dependent downregulation of hairy and enhancer of split homolog-1 gene expression in breast cancer cells is mediated via a 3' distal element.

    Science.gov (United States)

    Müller, Patrick; Merrell, Kenneth W; Crofts, Justin D; Rönnlund, Caroline; Lin, Chin-Yo; Gustafsson, Jan-Ake; Ström, Anders

    2009-03-01

    Regulation of hairy and enhancer of split homologue-1 (HES-1) by estradiol and all-trans retinoic acid affects proliferation of human breast cancer cells. Here, we identify and characterize cis-regulatory elements involved in HES-1 regulation. In the distal 5' promoter of the HES-1 gene, we found a retinoic acid response element and in the distal 3' region, an estrogen receptor alpha(ER)alpha binding site. The ERalpha binding site, composed of an estrogen response element (ERE) and an ERE half-site, is important for both ERalpha binding and transcriptional regulation. Chromatin immunoprecipitation assays revealed that ERalpha is recruited to the ERE and associates with the HES-1 promoter. We also show recruitment of nuclear receptor co-regulators to the ERE in response to estradiol, followed by a decrease in histone acetylation and RNA polymerase II docking in the HES-1 promoter region. Our findings are consistent with a novel type of repressive estrogen response element in the distal 3' region of the HES-1 gene.

  20. Advanced construction methods in ACR

    International Nuclear Information System (INIS)

    Elgohary, M.; Choy, E.; Yu, S.K.W.

    2002-01-01

    The ACR - Advanced CANDU Reactor, developed by Atomic Energy of Canada Limited (AECL), is designed with constructability considerations as a major requirement during all project phases from the concept design stage to the detail design stage. This necessitated a much more comprehensive approach in including constructability considerations in the design to ensure that the construction duration is met. For the ACR-700, a project schedule of 48 months has been developed for the nth replicated unit with a 36 month construction period duration from First Concrete to Fuel Load. An overall construction strategy that builds on the success of the construction methods that are proven in the construction of the Qinshan CANDU 6 project has been developed for the ACR. The overall construction strategy comprises the 'Open Top' construction technique using a Very Heavy Lift crane, parallel construction activities, with extensive modularization and prefabrication. In addition, significant applications of up to date construction technology will be implemented, e.g. large volume concrete pours, prefabricated rebar, use of climbing forms, composite structures, prefabricated permanent formwork, automatic welding, and utilization of the latest electronic technology tools such as 3D CADDs modelling yields a very high quality, clash free product to allow construction to be completed 'right the first time' and eliminates rework. Integration of 3D CADDs models and scheduling tools such as Primavera has allowed development of actual construction sequences and an iterative approach to schedule verification and improvement. Modularization and prefabrication are major features of the ACR design in order to achieve the project schedule. For the reactor building approximately 80% of the volume will be installed as modules or prefabricated assembles. This ensures critical path activities are achieved. This paper examines the advanced construction methods implemented in the design in order to

  1. Structures of Gate Loop Variants of the AcrB Drug Efflux Pump Bound by Erythromycin Substrate.

    Directory of Open Access Journals (Sweden)

    Abdessamad Ababou

    Full Text Available Gram-negative bacteria such as E. coli use tripartite efflux pumps such as AcrAB-TolC to expel antibiotics and noxious compounds. A key feature of the inner membrane transporter component, AcrB, is a short stretch of residues known as the gate/switch loop that divides the proximal and distal substrate binding pockets. Amino acid substitutions of the gate loop are known to decrease antibiotic resistance conferred by AcrB. Here we present two new AcrB gate loop variants, the first stripped of its bulky side chains, and a second in which the gate loop is removed entirely. By determining the crystal structures of the variant AcrB proteins in the presence and absence of erythromycin and assessing their ability to confer erythromycin tolerance, we demonstrate that the gate loop is important for AcrB export activity but is not required for erythromycin binding.

  2. ACR: Licensing and design readiness

    International Nuclear Information System (INIS)

    Alizadeh, A.

    2009-01-01

    Full text The Canadian nuclear technology has a long history dating back to the 1940s. In this regard, Canada is in a unique situation, shared only by a very few countries, where original nuclear power technology has been invented and further developed. Canadian Nuclear Safety Commission (CNSC), then called AECB, was established in 1946. CNSC focuses on nuclear security, nuclear safety, establishing health and safety regulations, and has also played an instrumental role in the formation of the IAEA. CNSC has provided assistance to the establishment of regulatory authorities in AECL's client countries such as Korea, Argentina, China and Romania. AECL has developed the Gen III+ ACR 1000 as evolutionary advancement of the current CANDU 6 reactor. ACR-1000 has evolved from AECL's in depth experience with CANDU systems, components, and materials, as well as the feedback received from owners and operators of CANDU plants. The ACR-1000 design retains the proven strengths and features of CANDU reactors, while incorporating innovations and state-of-the-art technology. It also features major improvements in economics, inherent safety characteristics, and performance. ACR-1000 has completed its Basic Engineering, has advanced in the licensing process in Canada, and is ready for deployment in Canadian and world markets. EC6 is an evolution of CANDU 6 and is a Gen III natural uranium fuelled reactor. Its medium size and potential for fuel localization and advanced fuel cycles is an optimal strategic solution in many markets.AECL's reactor products are shown to be compliant with a variety of licensing and regulatory requirements. These include the new CNSC DRD-337, IAEA NS-R1, and EUR. This allows the countries interested in CANDU reactor products to be confident of its licensing in their own regulatory regimes.

  3. CRISPR reveals a distal super-enhancer required for Sox2 expression in mouse embryonic stem cells.

    Directory of Open Access Journals (Sweden)

    Yan Li

    Full Text Available The pluripotency of embryonic stem cells (ESCs is maintained by a small group of master transcription factors including Oct4, Sox2 and Nanog. These core factors form a regulatory circuit controlling the transcription of a number of pluripotency factors including themselves. Although previous studies have identified transcriptional regulators of this core network, the cis-regulatory DNA sequences required for the transcription of these key pluripotency factors remain to be defined. We analyzed epigenomic data within the 1.5 Mb gene-desert regions around the Sox2 gene and identified a 13kb-long super-enhancer (SE located 100kb downstream of Sox2 in mouse ESCs. This SE is occupied by Oct4, Sox2, Nanog, and the mediator complex, and physically interacts with the Sox2 locus via DNA looping. Using a simple and highly efficient double-CRISPR genome editing strategy we deleted the entire 13-kb SE and characterized transcriptional defects in the resulting monoallelic and biallelic deletion clones with RNA-seq. We showed that the SE is responsible for over 90% of Sox2 expression, and Sox2 is the only target gene along the chromosome. Our results support the functional significance of a SE in maintaining the pluripotency transcription program in mouse ESCs.

  4. Contribution of transposable elements and distal enhancers to evolution of human-specific features of interphase chromatin architecture in embryonic stem cells.

    Science.gov (United States)

    Glinsky, Gennadi V

    2018-03-01

    regulatory complexity and functional precision of GRNs by creating predominantly a single gene (or a set of functionally linked genes) per regulatory domain structures. Collectively, present analyses reveal critical evolutionary contributions of transposable elements and distal enhancers to creation of thousands primate- and human-specific elements of a chromatin folding code, which defines the 3D context of interphase chromatin both restricting and facilitating biological functions of GRNs.

  5. Distal renal tubular acidosis

    Science.gov (United States)

    ... this disorder. Alternative Names Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA Images Kidney anatomy Kidney - blood and urine flow References Bose A, Monk RD, Bushinsky DA. Kidney ...

  6. Substrate binding accelerates the conformational transitions and substrate dissociation in multidrug efflux transporter AcrB

    Directory of Open Access Journals (Sweden)

    Beibei eWang

    2015-04-01

    Full Text Available The tripartite efflux pump assembly AcrAB-TolC is the major multidrug resistance transporter in E. coli. The inner membrane transporter AcrB is a homotrimer, energized by the proton movement down the transmembrane electrochemical gradient. The asymmetric crystal structures of AcrB with three monomers in distinct conformational states (access (A, binding (B and extrusion (E support a functional rotating mechanism, in which each monomer of AcrB cycles among the three states in a concerted way. However, the relationship between the conformational changes during functional rotation and drug translocation has not been totally understood. Here, we explored the conformational changes of the AcrB homotrimer during the ABE→BEA transition in different substrate-binding states using targeted MD simulations. It was found that the dissociation of substrate from the distal binding pocket of B monomer is closely related to the concerted conformational changes in the translocation pathway, especially the side chain reorientation of Phe628 and Tyr327. A second substrate binding at the proximal binding pocket of A monomer evidently accelerates the conformational transitions as well as substrate dissociation in B monomer. The acceleration effect of the multi-substrate binding mode provides a molecular explanation for the positive cooperativity observed in the kinetic studies of substrate efflux and deepens our understanding of the functional rotating mechanism of AcrB.

  7. 75 FR 27841 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on EPR

    Science.gov (United States)

    2010-05-18

    ... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on EPR The ACRS Subcommittee on EPR will hold a meeting on May 21, 2010, Room T-2B1, 11545 Rockville Pike, Rockville, Maryland. The entire meeting will be open to public attendance. The agenda for...

  8. 77 FR 10786 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Reliability...

    Science.gov (United States)

    2012-02-23

    ... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Reliability and PRA; Notice of Meeting The ACRS Subcommittee on Reliability and PRA will hold a... Modeling Application Guide.'' The Subcommittee will hear presentations by and hold discussions with the NRC...

  9. AECL's advanced CANDU reactor - the ACR

    International Nuclear Information System (INIS)

    Alizadeh, Ala; Allsop, Peter; Hedges, Ken; Hopwood, Jerry; Yu, Stephen

    2003-01-01

    The ACR, the next generation CANDU design, represents the next step in development of the CANDU family of designs. AECL has achieved significant incremental improvements to the mid-size CANDU 6 nuclear power plant through successive projects, both in design and in project delivery. Building on this knowledge base, AECL is continuing to adapt the CANDU design to develop the ACR. This paper summarizes the ACR design features, which include major improvements in economics, inherent safety characteristics, performance and construction methods. Aimed at producing electrical power at a capital cost significantly less than that of the current reactor designs, the ACR is an evolutionary design based on the very successful CANDU 6 reactor. The new ACR product is specifically designed to produce power at a cost competitive with other forms of power generation while achieving short construction times, improved safety, international licensability, high investor returns, and low investor risk. It achieves these targets by taking advantage of the latest advances in both pressure-tube and pressure-vessel reactor technologies and experience. The flexibility and development potential of the fuel channel approach also enables designs to be developed that address priorities identified in international long-term specification programs such as the US Department of Energy (DOE) sponsored Generation IV program and IAEA hosted INPRO program. ACR-700 can be built in 36 months with a 48 month project duration, and deliver a lifetime capacity factor in excess of 90%. Overall, the ACR design represents a balance of proven design basis and innovations to give step improvements in safety, reliability and economics. The ACR development program, now well into the detail design stage, includes parallel formal licensing in the USA and Canada. Based on the status of the ACR design and AECL's on-going experience delivering reactor projects on-time and on-budget, the first ACR could be in service by

  10. Use of a 3-Telsa magnet to perform delayed gadolinium-enhanced magnetic resonance imaging of the distal interphalangeal joint of horses with and without naturally occurring osteoarthritis.

    Science.gov (United States)

    Bischofberger, Andrea S; Fürst, Anton E; Torgerson, Paul R; Carstens, Ann; Hilbe, Monika; Kircher, Patrick

    2018-03-01

    OBJECTIVE To characterize delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) features of healthy hyaline cartilage of the distal interphalangeal joint (DIPJ) of horses, to determine whether dGEMRIC can be used to differentiate various stages of naturally occurring osteoarthritis of the DIPJ, and to correlate relaxation times determined by dGEMRIC with the glycosaminoglycan concentration, water content, and macroscopic and histologic findings of hyaline cartilage of DIPJs with and without osteoarthritis. SAMPLE 1 cadaveric forelimb DIPJ from each of 12 adult warmblood horses. PROCEDURES T1-weighted cartilage relaxation times were obtained for predetermined sites of the DIPJ before (T1 preGd ) and after (T1 postGd ) intra-articular gadolinium administration. Corresponding cartilage sites underwent macroscopic, histologic, and immunohistochemical evaluation, and cartilage glycosaminoglycan concentration and water content were determined. Median T1 preGd and T1 postGd were correlated with macroscopic, histologic, and biochemical data. Mixed generalized linear models were created to evaluate the effects of cartilage site, articular surface, and macroscopic and histologic scores on relaxation times. RESULTS 122 cartilage specimens were analyzed. Median T1 postGd was lower than the median T1 preGd for normal and diseased cartilage. Both T1 preGd and T1 postGd were correlated with macroscopic and histologic scores, whereby T1 preGd increased and T1 postGd decreased as osteoarthritis progressed. There was topographic variation of T1 preGd and T1 postGd within the DIPJ. Cartilage glycosaminoglycan concentration and water content were significantly correlated with T1 preGd and macroscopic and histologic scores but were not correlated with T1 postGd . CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dGEMRIC relaxation times varied for DIPJs with various degrees of osteoarthritis. These findings may help facilitate early detection of osteoarthritis.

  11. The far and distal enhancers in the CYP3A4 gene co-ordinate the proximal promoter in responding similarly to the pregnane X receptor but differentially to hepatocyte nuclear factor-4alpha.

    Science.gov (United States)

    Liu, Fu-Jun; Song, Xiulong; Yang, Dongfang; Deng, Ruitang; Yan, Bingfang

    2008-01-01

    CYP3A4 (cytochrome P450 3A4) is involved in the metabolism of more than 50% of drugs and other xenobiotics. The expression of CYP3A4 is induced by many structurally dissimilar compounds. The PXR (pregnane X receptor) is recognized as a key regulator for the induction, and the PXR-directed transactivation of the CYP3A4 gene is achieved through a co-ordinated mechanism of the distal module with the proximal promoter. Recently, a far module was found to support constitutive expression of CYP3A4. The far module, like the distal module, is structurally clustered by a PXR response element (F-ER6) and elements recognized by HNF-4alpha (hepatocyte nuclear receptor-4alpha). We hypothesized that the far module supports PXR transactivation of the CYP3A4 gene. Consistent with the hypothesis, fusion of the far module to the proximal promoter of CYP3A4 markedly increased rifampicin-induced reporter activity. The increase was synergistically enhanced when both the far and distal modules were fused to the proximal promoter. The increase, however, was significantly reduced when the F-ER6 was disrupted. Chromatin immunoprecipitation detected the presence of PXR in the far module. Interestingly, HNF-4alpha increased the activity of the distal-proximal fused promoter, but decreased the activity of the far-proximal fused promoter. Given the fact that induction of CYP3A4 represents an important detoxification mechanism, the functional redundancy and synergistic interaction in supporting PXR transactivation suggest that the far and distal modules ensure the induction of CYP3A4 during chemical insults. The difference in responding to HNF-4alpha suggests that the magnitude of the induction is under control through various transcriptional networks.

  12. Assessment, Cleanup and Redevelopment Exchange System (ACRES)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Assessment, Cleanup and Redevelopment Exchange System (ACRES) is an online database for Brownfields Grantees to electronically submit data directly to EPA.

  13. Brownfields/IGD: EF_ACRES

    Data.gov (United States)

    U.S. Environmental Protection Agency — EF_ACRES is a subset of facilities from FRS_INTEREST and FRS_FACILITY_SITE which are updated on a monthly basis as part of the Locational Reference Tables (LRT)...

  14. ACR Appropriateness Criteria on Resectable Rectal Cancer

    International Nuclear Information System (INIS)

    Suh, W. Warren; Blackstock, A. William; Herman, Joseph; Konski, Andre A.; Mohiuddin, Mohammed; Poggi, Matthew M.; Regine, William F.; Cosman, Bard C.; Saltz, Leonard; Johnstone, Peter A.S.

    2008-01-01

    The American College of Radiology (ACR) Appropriateness Criteria on Resectable Rectal Cancer was updated by the Expert Panel on Radiation Oncology-Rectal/Anal Cancer, based on a literature review completed in 2007

  15. The Automated Conflict Resolution System (ACRS)

    Science.gov (United States)

    Kaplan, Ted; Musliner, Andrew; Wampler, David

    1993-01-01

    The Automated Conflict Resolution System (ACRS) is a mission-current scheduling aid that predicts periods of mutual interference when two or more orbiting spacecraft are scheduled to communicate with the same Tracking and Data Relay Satellite (TDRS) at the same time. The mutual interference predicted has the potential to degrade or prevent communications. Thus the ACRS system is a useful tool for aiding in the scheduling of Space Network (SN) communications.

  16. Distal digital replantation.

    Science.gov (United States)

    Jazayeri, Leila; Klausner, Jill Q; Chang, James

    2013-11-01

    Hand surgeons have been hesitant to perform distal digital replantation because of the technical challenges and the perception of a high cost-to-benefit ratio. Recent studies, however, have shown high survival rates and excellent functional and aesthetic results, providing renewed enthusiasm for distal replantation. The authors reviewed the literature and summarize key points regarding the surgical treatment, perioperative care, and outcomes of distal digital replantation. They describe specific techniques and considerations for surgical repair in each of four distal zones as described by Sebastin and Chung. Zone 1A replantation involves an artery-only anastomosis of a longitudinal pulp artery. Venous anastomosis first becomes possible in zone 1B. Zone 1C involves periarticular amputations where arthrodesis of the distal interphalangeal joint is usually indicated. Repair of the artery, vein, and nerve is technically optimal in zone 1D, where venous anastomosis should be performed. Overall, survival rates for distal digital replantation are similar to those reported for more proximal replantation. The literature reports good outcomes regarding nail salvage, fingertip sensibility, and range of motion, with restoration of length and aesthetic appearance. Distal replantation performed at institutions that specialize in microsurgery and specifically tailored to the level of injury is associated with good survival, function, and patient satisfaction and superior aesthetic outcome. More prospective data are needed to evaluate the cost of treatment, psychological outcomes, and functional outcomes of distal replantation compared with revision amputation.

  17. Stroke Rehabilitation in Frail Elderly with the Robotic Training Device ACRE: A Randomized Controlled Trial and Cost-Effectiveness Study

    Directory of Open Access Journals (Sweden)

    M. Schoone

    2011-01-01

    Full Text Available The ACRE (ACtive REhabilitation robotic device is developed to enhance therapeutic treatment of upper limbs after stroke. The aim of this study is to assess effects and costs of ACRE training for frail elderly patients and to establish if ACRE can be a valuable addition to standard therapy in nursing home rehabilitation. The study was designed as randomized controlled trial, one group receiving therapy as usual and the other receiving additional ACRE training. Changes in motor abilities, stroke impact, quality of life and emotional well-being were assessed. In total, 24 patients were included. In this small number no significant effects of the ACRE training were found. A large number of 136 patients were excluded. Main reasons for exclusion were lack of physiological or cognitive abilities. Further improvement of the ACRE can best be focused on making the system suitable for self-training and development of training software for activities of daily living.

  18. Automatic coding method of the ACR Code

    International Nuclear Information System (INIS)

    Park, Kwi Ae; Ihm, Jong Sool; Ahn, Woo Hyun; Baik, Seung Kook; Choi, Han Yong; Kim, Bong Gi

    1993-01-01

    The authors developed a computer program for automatic coding of ACR(American College of Radiology) code. The automatic coding of the ACR code is essential for computerization of the data in the department of radiology. This program was written in foxbase language and has been used for automatic coding of diagnosis in the Department of Radiology, Wallace Memorial Baptist since May 1992. The ACR dictionary files consisted of 11 files, one for the organ code and the others for the pathology code. The organ code was obtained by typing organ name or code number itself among the upper and lower level codes of the selected one that were simultaneous displayed on the screen. According to the first number of the selected organ code, the corresponding pathology code file was chosen automatically. By the similar fashion of organ code selection, the proper pathologic dode was obtained. An example of obtained ACR code is '131.3661'. This procedure was reproducible regardless of the number of fields of data. Because this program was written in 'User's Defined Function' from, decoding of the stored ACR code was achieved by this same program and incorporation of this program into program in to another data processing was possible. This program had merits of simple operation, accurate and detail coding, and easy adjustment for another program. Therefore, this program can be used for automation of routine work in the department of radiology

  19. Licensing the ACR-700 in the USA

    International Nuclear Information System (INIS)

    Langman, V.; Ion, R.; Reid, C.; Snell, V.

    2003-01-01

    Atomic Energy of Canada Ltd. (AECL), via its 100% owned US subsidiary AECL Technologies Inc., is performing a pre-application review of the Advanced CANDU Reactor (ACR) with the US Nuclear Regulatory Commission (USNRC). Completion of this pre-application review by mid-2004, is in support of an application to the USNRC for Standard Design Certification that is targeted for the fall of 2004. The intent of the pre-application review is to deal up-front with potential issues associated with the CANDU reactor genealogy of the ACR that are different from the Light Water Reactor (LWR) and Boiling Water Reactor (BWR) regulatory framework in the USA. The focus of the paper will be to describe the pre-application review process currently underway with the NRC staff. In the context of the pre-application review this paper will provide an overview of the licensing approach being used to introduce the ACR-700 to the USA. (author)

  20. Licensing the ACR-700 in the USA

    Energy Technology Data Exchange (ETDEWEB)

    Langman, V.; Ion, R. [Atomic Energy of Canada Limited, Mississauga, Ontario (Canada); Reid, C. [Bechtel Power Corporation, San Fransisco, California (United States); Snell, V. [Atomic Energy of Canada Limited, Mississauga, Ontario (Canada)

    2003-07-01

    Atomic Energy of Canada Ltd. (AECL), via its 100% owned US subsidiary AECL Technologies Inc., is performing a pre-application review of the Advanced CANDU Reactor (ACR) with the US Nuclear Regulatory Commission (USNRC). Completion of this pre-application review by mid-2004, is in support of an application to the USNRC for Standard Design Certification that is targeted for the fall of 2004. The intent of the pre-application review is to deal up-front with potential issues associated with the CANDU reactor genealogy of the ACR that are different from the Light Water Reactor (LWR) and Boiling Water Reactor (BWR) regulatory framework in the USA. The focus of the paper will be to describe the pre-application review process currently underway with the NRC staff. In the context of the pre-application review this paper will provide an overview of the licensing approach being used to introduce the ACR-700 to the USA. (author)

  1. [Distal clavicle fracture].

    Science.gov (United States)

    Seppel, G; Lenich, A; Imhoff, A B

    2014-06-01

    Reposition and fixation of unstable distal clavicle fractures with a low profile locking plate (Acumed, Hempshire, UK) in conjunction with a button/suture augmentation cerclage (DogBone/FibreTape, Arthrex, Naples, FL, USA). Unstable fractures of the distal clavicle (Jäger and Breitner IIA) in adults. Unstable fractures of the distal clavicle (Jäger and Breitner IV) in children. Distal clavicle fractures (Jäger and Breitner I, IIB or III) with marked dislocation, injury of nerves and vessels, or high functional demand. Patients in poor general condition. Fractures of the distal clavicle (Jäger and Breitner I, IIB or III) without marked dislocation or vertical instability. Local soft-tissue infection. Combination procedure: Initially the lateral part of the clavicle is exposed by a 4 cm skin incision. After reduction of the fracture, stabilization is performed with a low profile locking distal clavicle plate. Using a special guiding device, a transclavicular-transcoracoidal hole is drilled under arthroscopic view. Additional vertical stabilization is arthroscopically achieved by shuttling the DogBone/FibreTape cerclage from the lateral portal cranially through the clavicular plate. The two ends of the FibreTape cerclage are brought cranially via adjacent holes of the locking plate while the DogBone button is placed under the coracoid process. Thus, plate bridging is achieved. Finally reduction is performed and the cerclage is secured by surgical knotting. Use of an arm sling for 6 weeks. Due to the fact that the described technique is a relatively new procedure, long-term results are lacking. In the short term, patients postoperatively report high subjective satisfaction without persistent pain.

  2. 76 FR 60938 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Power...

    Science.gov (United States)

    2011-09-30

    ... Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on...) associated with the Nine Mile Point extended power uprate application. The [[Page 60939

  3. Automating the design of resection guides specific to patient anatomy in knee replacement surgery by enhanced 3D curvature and surface modeling of distal femur shape models.

    Science.gov (United States)

    Cerveri, Pietro; Manzotti, Alfonso; Confalonieri, Norberto; Baroni, Guido

    2014-12-01

    Personalized resection guides (PRG) have been recently proposed in the domain of knee replacement, demonstrating clinical outcome similar or even superior to both manual and navigated interventions. Among the mandatory pre-surgical steps for PRG prototyping, the measurement of clinical landmarks (CL) on the bony surfaces is recognized as a key issue due to lack of standardized methodologies, operator-dependent variability and time expenditure. In this paper, we focus on the reliability and repeatability of an anterior-posterior axis, also known as Whiteside line (WL), of the distal femur proposing automatic surface processing and modeling methods aimed at overcoming some of the major concerns related to the manual identification of such CL on 2D images and 3D models. We show that the measurement of WL, exploiting the principle of mean-shifting surface curvature, is highly repeatable and coherent with clinical knowledge. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. New insights into the structural and functional involvement of the gate loop in AcrB export activity.

    Science.gov (United States)

    Ababou, Abdessamad

    2018-02-01

    AcrB is a major multidrug exporter in Escherichia coli and other Gram-negative bacteria. Its gate loop, located between the proximal and the distal pockets, have been reported to play important role in the export of many antibiotics. This loop location, rigidity and interactions with substrates have led recent reports to suggest that AcrB export mechanism operates in a sequential manner. First the substrate binds the proximal pocket in the access monomer, then it moves to bind the distal pocket in the binding monomer and subsequently it is extruded in the extrusion monomer. Recently, we have demonstrated that the gate loop is not required for the binding of Erythromycin but the integrity of this loop is important for an efficient export of this substrate. However, here we show that the antibiotic susceptibilities of the same AcrB gate loop mutants for Doxorubicin were unaffected, suggesting that this loop is not required for its export, and we demonstrate that this substrate may use principally the tunnel-1, located between transmembranes 8 and 9, more often than previously reported. To further explain our findings, here we address the gate loop mutations effects on AcrB solution energetics (fold, stability, molecular dynamics) and on the in vivo efflux of Erythromycin and Doxorubicin. Finally, we discuss the efflux and the discrepancy between the structural and the functional experiments for Erythromycin in these gate loop mutants. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Constructability - from Qinshan to the ACR

    International Nuclear Information System (INIS)

    Elgohary, M.; Fairclough, N.; Ricciuti, R.

    2003-01-01

    AECL has recognised the importance of Constructability for many years and is applying its principals to CANDU projects with increasing success. Constructability is defined as the consideration of construction knowledge and experience during all phases of a project, and recognizes that maximum benefit can be achieved during the concept phases of a project. The CANDU 6 Nuclear Power Plant has been constructed eleven times in the last 25 years, however, the last two units being completed on the Qinshan project in China have employed some very innovative construction methods that have not been used on the previous units. In order to make nuclear power generation more competitive, shorter construction schedules and reduced project costs and risks are essential objectives. The application of constructability principles is a major contributor to achieving these objectives. The success of Qinshan has increased the confidence in the new construction methods which are being implemented on the ACR (Advanced CANDU Reactor) successfully. An ACR construction strategy that utilizes advanced construction techniques has been developed by AECL. The strategy includes paralleling of activities by using extensive modularization and the vertical installation of equipment and modules into the reactor building, using a VHL (Very Heavy Lift) crane. This strategy allows short schedules to be met with a minimum risk to the project. This paper describes the latest construction methods used successfully on the Qinshan CANDU 6 project and looks at the extensive implementation of similar methods for ACR. It is concluded, based on the Qinshan success, that the ACR construction schedule is readily achievable. (author)

  6. 7 CFR 1412.44 - Notification of base acres.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Notification of base acres. 1412.44 Section 1412.44... through 2012 § 1412.44 Notification of base acres. The operator and owners of record of a farm will be notified in writing of the number of base acres eligible for enrollment in a contract, unless such operator...

  7. 7 CFR 1412.21 - Election of base acres.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Election of base acres. 1412.21 Section 1412.21... CROP REVENUE ELECTION PROGRAM FOR THE 2008 AND SUBSEQUENT CROP YEARS Establishment of Base Acres for a Farm for Covered Commodities § 1412.21 Election of base acres. (a) Subject to adjustments in paragraph...

  8. Distal finger replantation.

    Science.gov (United States)

    Scheker, Luis R; Becker, Giles W

    2011-03-01

    Reconstruction of the fingertip distal to the flexor tendon insertion by replantation remains controversial and technically challenging, but the anatomy of the fingertip has been well described and provides help in surgical planning. The open-book surgical technique is described with potential complications and is illustrated with clinical cases. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  9. Distal radioulnar joint injuries

    Directory of Open Access Journals (Sweden)

    Binu P Thomas

    2012-01-01

    Full Text Available Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint , forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments.The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis.

  10. 75 FR 12804 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on EPR; Notice...

    Science.gov (United States)

    2010-03-17

    ... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on EPR; Notice of Meeting The ACRS U.S. Evolutionary Power Reactor (EPR) Subcommittee will hold a... Chapters 11 and 16 of the Safety Evaluation Report with Open Items associated with the U.S. EPR Design...

  11. 75 FR 7633 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on EPR; Notice...

    Science.gov (United States)

    2010-02-22

    ... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on EPR; Notice of Meeting The ACRS U.S. Evolutionary Power Reactor (EPR) Subcommittee will hold a....S. EPR Design Certification Document Review. The Subcommittee will gather information, analyze...

  12. 77 FR 74696 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on AP-1000...

    Science.gov (United States)

    2012-12-17

    ... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on AP-1000; Notice of Meeting The ACRS Subcommittee on AP-1000 will hold a meeting on January 18, 2013, Room T-2B1, 11545 Rockville Pike, Rockville, Maryland. The entire meeting will be open to public...

  13. Sustained hypoxia leads to the emergence of cells with enhanced growth, migratory, and promitogenic potentials within the distal pulmonary artery wall.

    Science.gov (United States)

    Frid, Maria G; Li, Min; Gnanasekharan, Meena; Burke, Danielle L; Fragoso, Miguel; Strassheim, Derek; Sylman, Joanna L; Stenmark, Kurt R

    2009-12-01

    All forms of chronic pulmonary hypertension (PH) are characterized by structural remodeling of the pulmonary artery (PA) media, a process previously attributed solely to changes in the phenotype of resident smooth muscle cells (SMC). However, recent experimental evidence in both systemic and pulmonary circulations suggests that other cell types, including circulating and local progenitors, contribute significantly to this process. The goal of this study was to determine if hypoxia-induced remodeling of distal PA (dPA) media involves the emergence of cells with phenotypic and functional characteristics distinct from those of resident dPA SMC and fibroblasts. In vivo, in contrast to the phenotypically uniform SMC composition of dPA media in control calves, the remodeled dPA media of neonatal calves with severe hypoxia-induced PH comprised cells exhibiting a distinct phenotype, including the expression of hematopoetic (CD45), leukocytic/monocytic (CD11b, CD14), progenitor (cKit), and motility-associated (S100A4) cell markers. Consistent with these in vivo observations, primary cell cultures isolated from dPA media of hypertensive calves yielded not only differentiated SMC, but also smaller, morphologically rhomboidal (thus termed here "R") cells that transiently expressed CD11b, constitutively expressed the mesenchymal cell marker type I procollagen, expressed high mRNA levels of progenitor cell markers cKit, CD34, CD73, as well as for inflammatory mediators, IL-6 and MCP-1, and, with time in culture, gained expression of a myofibroblast marker, alpha-SM-actin. R cells exhibited highly augmented proliferative, migratory, invasive, and potent promitogenic capabilities, which were due, at least in part, to the production of PDGFs, SDF-1/CXCL12, and S100A4. These data suggest that the cellular mechanisms of dPA remodeling include the emergence of cells with phenotypic and functional characteristics markedly distinct from those of resident dPA cells.

  14. Combating obsolescence - ACR digital control systems design

    International Nuclear Information System (INIS)

    Tikku, S.; Raiskums, G.

    2006-01-01

    The ever increasing use of digital technologies and products to meet the control, automation and monitoring needs of the nuclear power plant - even though justified by the benefits it provides - comes with an increased risk of technological obsolescence happening through the course of the plant life. Some well considered strategies are being employed in the ACR design process to minimise this risk and alleviate the consequence if it happens. These include application of a modular overall architecture, adoption of international widely accepted standards to harmonise equipment qualification and software practices, production of control functional specifications that are not influenced by target platform, and careful selection of technologies and products. (author)

  15. Subtrochanteric and Distal Femur Fractures in a Patient with ...

    African Journals Online (AJOL)

    This study reports the surgical management for this rare case and the treatment ... car accident and presented closed femoral shaft fracture associated with a ... to fix the distal femur fracture, enhancing the construction stability [Figures 4 and 5].

  16. 76 FR 7883 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Power...

    Science.gov (United States)

    2011-02-11

    ... Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on... will review the staff's evaluation of the Point Beach Units 1 and 2 Extended Power Uprate application... can be made. Thirty five hard copies of each presentation or handout should be provided to the...

  17. Design features of ACR in severe accident mitigation

    International Nuclear Information System (INIS)

    Shapiro, H.; Krishnan, V.S.; Santamaura, P.; Lekakh, B.; Blahnik, C.

    2007-01-01

    failed structure would retain some capability to reduce radioactivity release into the environment. SAMDAs that enhance the capabilities for minimizing the offsite releases (venting) are being actively examined further. State-of-the art hydrogen control of igniters and passive, auto-catalytic recombiners are provided. The ACR design is not prone to core-concrete interactions by virtue of multiple, externally cooled barriers between the fuel and the containment floor as well as due to characteristics of the compartment into which the core materials would eventually penetrate (i.e., a large area for debris spread and multiple means of keeping the debris submerged in water). The instrumentation that provides reliable data to the severe accident management team is critical to successful accident mitigation. The ACR instruments provide the necessary coverage of all critical plant parameters in two locations (main control room and secondary control area). As far as practical, these instruments will be hardened to withstand the severe accident conditions. All critical instruments will be assessed for survivability under severe accident conditions. (authors)

  18. MO-AB-207-04: ACR Update in Mammography

    Energy Technology Data Exchange (ETDEWEB)

    Berns, E. [University of Colorado Health Science (United States)

    2015-06-15

    A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program.

  19. MO-AB-207-02: ACR Update in MR

    Energy Technology Data Exchange (ETDEWEB)

    Price, R. [Vanderbilt Medical Center (United States)

    2015-06-15

    A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program.

  20. MO-AB-207-01: ACR Update in CT

    Energy Technology Data Exchange (ETDEWEB)

    McNitt-Gray, M. [UCLA School of Medicine (United States)

    2015-06-15

    A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program.

  1. MO-AB-207-04: ACR Update in Mammography

    International Nuclear Information System (INIS)

    Berns, E.

    2015-01-01

    A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program

  2. MO-AB-207-02: ACR Update in MR

    International Nuclear Information System (INIS)

    Price, R.

    2015-01-01

    A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program

  3. An innovative technique to distalize maxillary molar using microimplant supported rapid molar distalizer

    Directory of Open Access Journals (Sweden)

    Meenu Goel

    2013-01-01

    Full Text Available Introduction: In recent years, enhancements in implants have made their use possible as a mode of absolute anchorage in orthodontic patients. In this paper, the authors have introduced an innovative technique to unilaterally distalize the upper left 1 st molar to obtain an ideal Class I molar relationship from a Class II existing molar relationship with an indigenous designed distalizer. Clinical Innovation: For effective unilateral diatalization of molar, a novel cantilever sliding jig assembly was utilized with coil spring supported by a buccally placed single micro implant. The results showed 3 mm of bodily distalization with 1 mm of intrusion and 2° of distal tipping of upper left 1 st molar in 1.5 months. Discussion: This appliance is relatively easy to insert, well-tolerated, and requires minimal patient cooperation compared to other present techniques of molar distalization. Moreover, it is particularly useful in cases that are Class II on one side and Class I on the other, with a minor midline discrepancy and nominal overjet. Patient acceptance level was reported to be within patients physiological and comfort limits.

  4. Comparing new diagnostic criteria of 2010 ACR/EULAR with 1987 ACR criteria in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Fatemeh Shirani

    2017-01-01

    Full Text Available Background: Rheumatoid Arthritis (RA is a chronic inflammatory disease presenting with inflammation, tenderness and destruction of the synovial joints, resulting in severe disability and early death due to complication of disease. Previous diagnostic criteria are not useful for identifying patients who need early treatment. Thus, new diagnostic criteria for faster diagnosis of disease are introduced in 2010. The aim of this study was to compared 1987 ACR (American College of Rheumatology criteria and 2010 ACR/EULAR (European League Against Rheumatism classification criteria for diagnosis of rheumatoid arthritis. Methods: In this Cohort prospective study, patients with early arthritis were evaluated   according to the old and new diagnostic criteria and followed-up every two monthly for one year (2012-2013 in Hazrat-e Rasool University Hospital, Tehran. Inclusion criteria of this study were age more than 18 year and indefinite diagnosis of arthritis. For all of patients physical examination by expert rheumatologist was done and lab data include erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, anti-cyclic citrullinated peptide (Anti-CCP and rheumatoid factor was requested. The sensitivity, specificity, positive and negative predictive values were then determined for each diagnostic criteria. Results: In this study 104 patients including 28 males (26.9% and 76 females (73.1% with the mean age of 44.2±13.7 years were included. At the end of one year follow-up, 82 were diagnosed to have RA while other 22 patients were not categorized as RA. Sensitivity for ESR, CRP, Anti-CCP and rheumatoid factor in 2010 ACR/EULAR criteria was 52%, 19%, 48%, 28% and specificity for them was 45%, 71%, 27%, 79% respectively. Number of small and large joint arthritis were more in patients with Rheumatoid Arthritis (RA rather than other arthritis (P=0.0001. Sensitivity and specificity for small joints involvement was 87% and 54% and for large joints

  5. ACR-1000TM Project - Licensing Opportunities and Challenges

    International Nuclear Information System (INIS)

    Popov, N.; Doerffer, S.; Ion, R.; Hopwood, J.

    2011-01-01

    Atomic Energy of Canada Limited (AECL) has developed the Advanced CANDU Reactor TM 1 1000 (ACR-1000 TM ) as an evolutionary advancement of the current CANDU 6 reactor. The ACR-1000 design has evolved from AECL's in-depth knowledge of CANDU TM systems, components, and materials, as well as the experience and feedback received from owners and operators of CANDU plants. The ACR design retains the proven strengths and features of CANDU reactors, while incorporating innovations and state-of-the-art technology. It also features major improvements in economics, inherent safety characteristics, and performance, while retaining the proven benefits of the CANDU family of nuclear power plants. To ensure that the ACR design is compliant with Canadian and international requirements, regulatory pre-project reviews of the ACR-1000 (and ACR-700 TM 1 with lower output) were conducted early in the design work. The regulatory feedback from these pre-project regulatory reviews helped AECL to better understand regulatory expectations in Canada, US and the UK, and to make further advancements and improvements in the ACR design to meet the Canadian and international regulatory requirements. This paper provides an overview of the key design features of the ACR-1000 reactor design, and summary of the pre-project reviews by those above-mentioned regulatory bodies, demonstrating opportunities and challenges in licensing process of and pointing to the importance of efficient vendor-regulator interaction. (author)

  6. ACRES At-Risk Task Force: Dropout Survey.

    Science.gov (United States)

    Bull, Kay S.; And Others

    This paper describes a study by the American Council on Rural Special Education (ACRES) to determine its membership's opinions on priorities and expertise regarding the dropout problem. ACRES members, primarily rural special-education teachers, parents, and collateral service workers, were surveyed about the dropout problem and what research they…

  7. Distal corporoplasty for distal cylinders extrusion after penile prosthesis implantation.

    Science.gov (United States)

    Carrino, Maurizio; Chiancone, Francesco; Battaglia, Gaetano; Pucci, Luigi; Fedelini, Paolo

    2017-02-03

    Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Several methods have been proposed for repairing a distal penile erosion. We present our preliminary experience in "Distal corporoplasty" technique. We enrolled 18 consecutive patients whose underwent a distal corporoplasty with simultaneous reimplantation of an "AMS 700 inflatable penile prosthesis (LGX)" from January 2013 to November 2015 at our hospital. All procedures were performed by a single surgical team. Intraoperative and postoperative complications have been classified and reported according to Satava6 and Clavien-Dindo (CD) system.7 Mean values with standard deviations (±SD) were computed and reported for all items. Mean age of the patients was 53.61 (±11.90) years. Mean body max index (BMI) was 24.22 (±2.51). Mean operative time was 85.2 (±13.1) minutes. Blood losses were minimal. No intraoperative complications are reported according to Satava classification. Four out of 18 patients (22.22%) experienced postoperative complications according to CD system. All patients had sexual intercourse for the first time postsurgery after a mean of 59.11 ± 2.08 days. Mean follow-up was 22.11 (±9.95). Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Distal corporoplasty was first described by Mulcahy. He reported a series of 14 patients with a follow-up of about 2 years with optimal functional outcomes. Moreover, distal corporoplasty resulted in shorter operative time, better function, less pain, and fewer recurrences than Gortex windsock repair.10 In our experience, distal corporoplasty is a simple and safe procedure in the treatment of distal cylinders extrusion when the prosthetic material is not exposed to the exterior.

  8. ACR Appropriateness Criteria® Tinnitus.

    Science.gov (United States)

    Kessler, Marcus M; Moussa, Marwan; Bykowski, Julie; Kirsch, Claudia F E; Aulino, Joseph M; Berger, Kevin L; Choudhri, Asim F; Fife, Terry D; Germano, Isabelle M; Kendi, A Tuba; Kim, Jeffrey H; Luttrull, Michael D; Nunez, Diego; Shah, Lubdha M; Sharma, Aseem; Shetty, Vilaas S; Symko, Sophia C; Cornelius, Rebecca S

    2017-11-01

    Tinnitus is the perception of sound in the absence of an external source. It is a common symptom that can be related to hearing loss and other benign causes. However, tinnitus may be disabling and can be the only symptom in a patient with a central nervous system process disorder. History and physical examination are crucial first steps to determine the need for imaging. CT and MRI are useful in the setting of pulsatile tinnitus to evaluate for an underlying vascular anomaly or abnormality. If there is concomitant asymmetric hearing loss, neurologic deficit, or head trauma, imaging should be guided by those respective ACR Appropriateness Criteria ® documents, rather than the presence of tinnitus. Imaging is not usually appropriate in the evaluation of subjective, nonpulsatile tinnitus that does not localize to one ear. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  9. Seismic design features of the ACR Nuclear Power Plant

    International Nuclear Information System (INIS)

    Elgohary, M.; Saudy, A.; Aziz, T.

    2003-01-01

    Through their worldwide operating records, CANDU Nuclear Power Plants (NPPs) have repeatedly demonstrated safe, reliable and competitive performance. Currently, there are fourteen CANDU 6 single unit reactors operating or under construction worldwide. Atomic Energy of Canada Limited's (AECL) Advanced CANDU Reactor - the ACR. - is the genesis of a new generation of technologically advanced reactors founded on the CANDU reactor concept. The ACR is the next step in the evolution of the CANDU product line. The ACR products (ACR-700 and ACR-1000) are based on CANDU 6 (700 MWe class) and CANDU 9 (900 MWe class) reactors, therefore continuing AECL's successful approach of offering CANDU plants that appeal to a broad segment of the power generation market. The ACR products are based on the proven CANDU technology and incorporate advanced design technologies. The ACR NPP seismic design complies with Canadian standards that were specifically developed for nuclear seismic design and also with relevant International Atomic Energy Agency (IAEA) Safety Design Standards and Guides. However, since the ACR is also being offered to several markets with many potential sites and different regulatory environments, there is a need to develop a comprehensive approach for the seismic design input parameters. These input parameters are used in the design of the standard ACR product that is suitable for many sites while also maintaining its economic competitiveness. For this purpose, the ACR standard plant is conservatively qualified for a Design Basis Earthquake (DBE) with a peak horizontal ground acceleration of 0.3g for a wide range of soil/rock foundation conditions and Ground Response Spectra (GRS). These input parameters also address some of the current technical issues such as high frequency content and near field effects. In this paper, the ACR seismic design philosophy and seismic design approach for meeting the safety design requirements are reviewed. Also the seismic design

  10. [New anterolateral approach of distal femur for treatment of distal femoral fractures].

    Science.gov (United States)

    Zhang, Bin; Dai, Min; Zou, Fan; Luo, Song; Li, Binhua; Qiu, Ping; Nie, Tao

    2013-11-01

    To assess the effectiveness of the new anterolateral approach of the distal femur for the treatment of distal femoral fractures. Between July 2007 and December 2009, 58 patients with distal femoral fractures were treated by new anterolateral approach of the distal femur in 28 patients (new approach group) and by conventional approach in 30 patients (conventional approach group). There was no significant difference in gender, age, cause of injury, affected side, type of fracture, disease duration, complication, or preoperative intervention (P > 0.05). The operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, hospitalization days, and Hospital for Special Surgery (HSS) score of knee were recorded. Operation was successfully completed in all patients of 2 groups, and healing of incision by first intention was obtained; no vascular and nerves injuries occurred. The operation time and intraoperative fluoroscopy frequency of new approach group were significantly less than those of conventional approach group (P 0.05). All patients were followed up 12-36 months (mean, 19.8 months). Bone union was shown on X-ray films; the fracture healing time was (12.62 +/- 2.34) weeks in the new approach group and was (13.78 +/- 1.94) weeks in the conventional approach group, showing no significant difference (t=2.78, P=0.10). The knee HSS score at last follow-up was 94.4 +/- 4.2 in the new approach group, and was 89.2 +/- 6.0 in the conventional approach group, showing significant difference between 2 groups (t=3.85, P=0.00). New anterolateral approach of the distal femur for distal femoral fractures has the advantages of exposure plenitude, minimal tissue trauma, and early function rehabilitation training so as to enhance the function recovery of knee joint.

  11. ACR appropriateness criteria blunt chest trauma.

    Science.gov (United States)

    Chung, Jonathan H; Cox, Christian W; Mohammed, Tan-Lucien H; Kirsch, Jacobo; Brown, Kathleen; Dyer, Debra Sue; Ginsburg, Mark E; Heitkamp, Darel E; Kanne, Jeffrey P; Kazerooni, Ella A; Ketai, Loren H; Ravenel, James G; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D

    2014-04-01

    Imaging is paramount in the setting of blunt trauma and is now the standard of care at any trauma center. Although anteroposterior radiography has inherent limitations, the ability to acquire a radiograph in the trauma bay with little interruption in clinical survey, monitoring, and treatment, as well as radiography's accepted role in screening for traumatic aortic injury, supports the routine use of chest radiography. Chest CT or CT angiography is the gold-standard routine imaging modality for detecting thoracic injuries caused by blunt trauma. There is disagreement on whether routine chest CT is necessary in all patients with histories of blunt trauma. Ultimately, the frequency and timing of CT chest imaging should be site specific and should depend on the local resources of the trauma center as well as patient status. Ultrasound may be beneficial in the detection of pneumothorax, hemothorax, and pericardial hemorrhage; transesophageal echocardiography is a first-line imaging tool in the setting of suspected cardiac injury. In the blunt trauma setting, MRI and nuclear medicine likely play no role in the acute setting, although these modalities may be helpful as problem-solving tools after initial assessment. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. Summary of the ACRE inaugural meeting.

    Science.gov (United States)

    Bloomgarden, Zachary T

    2009-01-01

    The charter meeting of the Association of Clinical Researchers and Educators (ACRE) provided a powerful set of arguments against assertions that physician-industry collaboration is harmful and represents a "conflict of interest." Such collaboration has, in fact, improved medical care for patients, a case made overwhelmingly by patients and patient advocacy groups at the meeting. The contentions that physician-industry collaboration is problematic are not based on evidence. They depend on unjustified generalization from inevitable, sometimes egregious, but vanishingly uncommon adverse outcomes of industry-physician interaction without reference to how so much more commonly these interactions add value. Furthermore, the claim that physician-industry collaboration is unprofessional is refuted by rational scrutiny. Indeed, the term "conflict of interest" itself is vague, inviting subjectivity and deserving to be rejected. The unwarranted success of conflict of interest regulation has prevailed because of the failure of physicians, educators, and innovators, through apathy and intimidation, to pay attention to its fallacies and resist its dangers. It has arisen from activist ambitions and from misalignment between the purposes of medical practitioners, educators, and innovators and those of administrators in medical journals and in academic medical centers. The media and politicians have not appreciated these misalignments and have accepted conflict of interest arguments at face value. Regulation emanating from conflict of interest criticism is confusing, onerous, expensive, disrespectful, and damaging. Prohibitions against speaking about medical products inhibit physician and patient education concerning rapidly emerging and complex therapies. Input by physicians cognizant of compliance requirements into such presentations should be encouraged. Restrictions to the free flow of corporate support of academic health centers, professional societies, and patient

  13. Impact of modules on the ACR construction schedule

    International Nuclear Information System (INIS)

    Choy, Ed; Elgohary, Medhat; Fairclough, Neville; Yu, Stephen; Murayama, Kouichi; Miura, Jun; Kawahata, Junichi

    2003-01-01

    The ACR (Advanced CANDU Reactor), developed by Atomic Energy of Canada Ltd. (AECL), is designed with constructability considerations as a major requirement during all project phases from the concept design stage to the detail design stage. For ACR-700, a project schedule of 48 months has been developed for the nth replicated unit with a 36 month construction period duration from First Concrete to Fuel Load. AECL, recognizing the immense benefit of collective experience, is partnering with Hitachi Ltd in the development of the ACR power plant design. AECL has gained valuable experience in implementing new construction methods at the Qinshan (Phase III) twin unit CANDU 6 plant in China, and Hitachi likewise has enjoyed success in modular construction of ABWRs in Japan. Utilizing these experiences, AECL is developing the ACR nuclear steam plant (NSP) and Hitachi is developing the Turbine Building. An overall construction strategy, which builds on the success of these construction methods from the nuclear power plant developments in China and Japan, has been developed for the ACR. The overall construction strategy comprises the 'Open Top' construction technique using a Very Heavy Lift crane, parallel construction activities, with extensive modularization and prefabrication. Modules and prefabrications are major features of the ACR design, resulting in an excess of 80% of Reactor Building internal work being completed as modules or as very streamlined traditional construction. This paper reviews the ACR construction strategy and provides examples of modules and how they impact on the ACR construction schedule. In conclusion, the ACR-700 is designed using the latest, proven construction methods to achieve a 36 month construction period for the nth replicated unit. (author)

  14. Burnup dependence of coolant void reactivity for ACR-1000 cell

    International Nuclear Information System (INIS)

    Le Tellier, R.; Marleau, G.; Hebert, A.; Roubstov, D.; Altiparmakov, D.; Irish, D.

    2008-01-01

    The Advanced Candu Reactor (ACR-1000) is light water cooled, fueled with enriched uranium and has a smaller lattice pitch than the Candu-6. As a result, the neutronic behavior of the ACR-1000 cell is expected to be somewhat different from that of the Candu-6 leading to a negative coolant void reactivity (CVR). Here we evaluate the CVR for the ACR-1000 cell using the lattice code DRAGON and compare our results with those obtained using the code WIMS-AECL. The differences observed between these two codes for the burnup dependence of the CVR is mainly explained in terms of the specific cell leakage model used by both codes. (authors)

  15. The advantages of PD1 activating chimeric receptor (PD1-ACR) engineered lymphocytes for PDL1(+) cancer therapy.

    Science.gov (United States)

    Tang, Xiaolong; Li, Qingguo; Zhu, Yongqiang; Zheng, Donghui; Dai, Jingjing; Ni, Wenxuan; Wei, Jia; Xue, Yubao; Chen, Ke; Hou, Wei; Zhang, Chao; Feng, Xiaojun; Liang, Yong

    2015-01-01

    Tumors exploit immunoregulatory checkpoints to attenuate T cell responses as a means of circumventing immunologic rejection. By activating the inhibitory costimulatory pathway of Programmed Death 1 (PD1)/PDL1 which provides tumor cells an escape mechanism from immune surveillance, Programmed Death Ligand1 (PDL1)(+) tumors hamper activated tumor-specific T cell functions and render them functionally exhausted. To overcome the inhibitory costimulatory effects of PDL1 on the adoptively transferred T cells, we sought to convert PD1 to a T cell costimulatory receptor by exchanging its transmembrane and cytoplasmic tail with CD28 and 4-1BB signaling domains (PD1-CD28-4-1BB, PD1-ACR), anticipating the genetically modified effector T lymphocytes expressing PD1-ACR would exhibit enhanced functional attributes. And the results showed that PD1-ACR expressed T cells retained the ability to bind PDL1, resulting in T cell activation as evidenced by the elevated activity of phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt), the augmentation of cytokine secretion and the increased proliferative capacity. Moreover, when systemically administered in the mouse model of glioblastoma metastases, PD1-ACR T cells localized at the area of U87 invasive tumor, which results in suppressed tumor growth and enhanced survival of mice with established U87 glioblastoma. Together, these data demonstrated that PD1-ACR has a high potential to serve as a novel strategy to overcome PDL1 mediated immunosuppression of T cells for cancer therapy.

  16. 78 FR 8202 - Meeting of the Joint ACRS Subcommittees on Thermal Hydraulic Phenomena and Materials, Metallurgy...

    Science.gov (United States)

    2013-02-05

    ... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the Joint ACRS Subcommittees on Thermal Hydraulic Phenomena and Materials, Metallurgy and Reactor Fuels; Notice of Meeting The Joint ACRS Subcommittees on Thermal Hydraulic Phenomena and Materials, Metallurgy and...

  17. Reverse Distal Transverse Palmar Arch in Distal Digital Replantation.

    Science.gov (United States)

    Wei, Ching-Yueh; Orozco, Oscar; Vinagre, Gustavo; Shafarenko, Mark

    2017-11-01

    Refinements in microsurgery have made distal finger replantation an established technique with high success rates and good functional and aesthetic outcomes. However, it still represents a technically demanding procedure due to the small vessel caliber and frequent lack of vessel length, requiring the use of interpositional venous grafts in some instances. We describe a new technique for anastomosis in fingertip replantation, whereby the need for venous grafts is eliminated. Applying the reverse distal transverse palmar arch technique, 11 cases of distal digital replantation were performed between January 2011 and July 2016. The described procedure was used for arterial anastomosis in 10 cases and arteriovenous shunting for venous drainage in 1 case. A retrospective case review was conducted. The technical description and clinical outcome evaluations are presented. Ten of the 11 replanted digits survived, corresponding to an overall success rate of 91%. One replant failed due to venous insufficiency. Blood transfusions were not required for any of the patients. Follow-up (range, 1.5-5 months) revealed near-normal range of motion and good aesthetic results. All of the replanted digits developed protective sensation. The average length of hospital admission was 5 days. All patients were satisfied with the results and were able to return to their previous work. The use of the reverse distal transverse palmar arch is a novel and reliable technique in distal digital replantation when an increase in vessel length is required, allowing for a tension-free arterial repair without the need for vein grafts.

  18. Morphometric evaluation of Arbor Acre parent stock broilers reared ...

    African Journals Online (AJOL)

    Morphometric evaluation of Arbor Acre parent stock broilers reared in ... Economic importance of morphometric parameters such as live weight and body ... (R2) value of 60.30 included forecast indices such as BL, WS, WL, TL, BG and SL.

  19. Unfolding study of a trimeric membrane protein AcrB.

    Science.gov (United States)

    Ye, Cui; Wang, Zhaoshuai; Lu, Wei; Wei, Yinan

    2014-07-01

    The folding of a multi-domain trimeric α-helical membrane protein, Escherichia coli inner membrane protein AcrB, was investigated. AcrB contains both a transmembrane domain and a large periplasmic domain. Protein unfolding in sodium dodecyl sulfate (SDS) and urea was monitored using the intrinsic fluorescence and circular dichroism spectroscopy. The SDS denaturation curve displayed a sigmoidal profile, which could be fitted with a two-state unfolding model. To investigate the unfolding of separate domains, a triple mutant was created, in which all three Trp residues in the transmembrane domain were replaced with Phe. The SDS unfolding profile of the mutant was comparable to that of the wild type AcrB, suggesting that the observed signal change was largely originated from the unfolding of the soluble domain. Strengthening of trimer association through the introduction of an inter-subunit disulfide bond had little effect on the unfolding profile, suggesting that trimer dissociation was not the rate-limiting step in unfolding monitored by fluorescence emission. Under our experimental condition, AcrB unfolding was not reversible. Furthermore, we experimented with the refolding of a monomeric mutant, AcrBΔloop , from the SDS unfolded state. The CD spectrum of the refolded AcrBΔloop superimposed well onto the spectra of the original folded protein, while the fluorescence spectrum was not fully recovered. In summary, our results suggested that the unfolding of the trimeric AcrB started with a local structural rearrangement. While the refolding of secondary structure in individual monomers could be achieved, the re-association of the trimer might be the limiting factor to obtain folded wild-type AcrB. © 2014 The Protein Society.

  20. Engineering arsenic tolerance and hyperaccumulation in plants for phytoremediation by a PvACR3 transgenic approach.

    Science.gov (United States)

    Chen, Yanshan; Xu, Wenzhong; Shen, Hongling; Yan, Huili; Xu, Wenxiu; He, Zhenyan; Ma, Mi

    2013-08-20

    Arsenic (As) pollution is a global problem, and the plant-based cleanup of contaminated soils, called phytoremediation, is therefore of great interest. Recently, transgenic approaches have been designed to develop As phytoremediation technologies. Here, we used a one-gene transgenic approach for As tolerance and accumulation in Arabidopsis thaliana . PvACR3, a key arsenite [As(III)] antiporter in the As hyperaccumulator fern Pteris vittata , was expressed in Arabidopsis , driven by the CaMV 35S promoter. In response to As treatment, PvACR3 transgenic plants showed greatly enhanced tolerance. PvACR3 transgenic seeds could even germinate and grow in the presence of 80 μM As(III) or 1200 μM arsenate [As(V)] treatments that were lethal to wild-type seeds. PvACR3 localizes to the plasma membrane in Arabidopsis and increases arsenite efflux into external medium in short-term experiments. Arsenic determination showed that PvACR3 substantially reduced As concentrations in roots and simultaneously increased shoot As under 150 μM As(V). When cultivated in As(V)-containing soil (10 ppm As), transgenic plants accumulated approximately 7.5-fold more As in above-ground tissues than wild-type plants. This study provides important insights into the behavior of PvACR3 and the physiology of As metabolism in plants. Our work also provides a simple and practical PvACR3 transgenic approach for engineering As-tolerant and -hyperaccumulating plants for phytoremediation.

  1. Validation of the 2010 ACR/EULAR classification criteria for rheumatoid arthritis: slight improvement over the 1987 ACR criteria.

    NARCIS (Netherlands)

    Britsemmer, K.; Ursum, J.; Gerritsen, M.; Tuyl, L. van; Schaardenburg, D. van

    2011-01-01

    Abstract: Background Recently, an American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) collaboration developed new classification criteria for rheumatoid arthritis (RA). Objective:To evaluate the diagnostic and discriminative ability of these new criteria compared with

  2. Modeling Human Error Mechanism for Soft Control in Advanced Control Rooms (ACRs)

    International Nuclear Information System (INIS)

    Aljneibi, Hanan Salah Ali; Ha, Jun Su; Kang, Seongkeun; Seong, Poong Hyun

    2015-01-01

    To achieve the switch from conventional analog-based design to digital design in ACRs, a large number of manual operating controls and switches have to be replaced by a few common multi-function devices which is called soft control system. The soft controls in APR-1400 ACRs are classified into safety-grade and non-safety-grade soft controls; each was designed using different and independent input devices in ACRs. The operations using soft controls require operators to perform new tasks which were not necessary in conventional controls such as navigating computerized displays to monitor plant information and control devices. These kinds of computerized displays and soft controls may make operations more convenient but they might cause new types of human error. In this study the human error mechanism during the soft controls is studied and modeled to be used for analysis and enhancement of human performance (or human errors) during NPP operation. The developed model would contribute to a lot of applications to improve human performance (or reduce human errors), HMI designs, and operators' training program in ACRs. The developed model of human error mechanism for the soft control is based on assumptions that a human operator has certain amount of capacity in cognitive resources and if resources required by operating tasks are greater than resources invested by the operator, human error (or poor human performance) is likely to occur (especially in 'slip'); good HMI (Human-machine Interface) design decreases the required resources; operator's skillfulness decreases the required resources; and high vigilance increases the invested resources. In this study the human error mechanism during the soft controls is studied and modeled to be used for analysis and enhancement of human performance (or reduction of human errors) during NPP operation

  3. Modeling Human Error Mechanism for Soft Control in Advanced Control Rooms (ACRs)

    Energy Technology Data Exchange (ETDEWEB)

    Aljneibi, Hanan Salah Ali [Khalifa Univ., Abu Dhabi (United Arab Emirates); Ha, Jun Su; Kang, Seongkeun; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)

    2015-10-15

    To achieve the switch from conventional analog-based design to digital design in ACRs, a large number of manual operating controls and switches have to be replaced by a few common multi-function devices which is called soft control system. The soft controls in APR-1400 ACRs are classified into safety-grade and non-safety-grade soft controls; each was designed using different and independent input devices in ACRs. The operations using soft controls require operators to perform new tasks which were not necessary in conventional controls such as navigating computerized displays to monitor plant information and control devices. These kinds of computerized displays and soft controls may make operations more convenient but they might cause new types of human error. In this study the human error mechanism during the soft controls is studied and modeled to be used for analysis and enhancement of human performance (or human errors) during NPP operation. The developed model would contribute to a lot of applications to improve human performance (or reduce human errors), HMI designs, and operators' training program in ACRs. The developed model of human error mechanism for the soft control is based on assumptions that a human operator has certain amount of capacity in cognitive resources and if resources required by operating tasks are greater than resources invested by the operator, human error (or poor human performance) is likely to occur (especially in 'slip'); good HMI (Human-machine Interface) design decreases the required resources; operator's skillfulness decreases the required resources; and high vigilance increases the invested resources. In this study the human error mechanism during the soft controls is studied and modeled to be used for analysis and enhancement of human performance (or reduction of human errors) during NPP operation.

  4. Functional relevance of AcrB Trimerization in pump assembly and substrate binding.

    Directory of Open Access Journals (Sweden)

    Wei Lu

    Full Text Available AcrB is a multidrug transporter in the inner membrane of Escherichia coli. It is an obligate homotrimer and forms a tripartite efflux complex with AcrA and TolC. AcrB is the engine of the efflux machinery and determines substrate specificity. Active efflux depends on several functional features including proton translocation across the inner membrane through a proton relay pathway in the transmembrane domain of AcrB; substrate binding and migration through the substrate translocation pathway; the interaction of AcrB with AcrA and TolC; and the formation of AcrB homotrimer. Here we investigated two aspects of the inter-correlation between these functional features, the dependence of AcrA-AcrB interaction on AcrB trimerization, and the reliance of substrate binding and penetration on protein-protein interaction. Interaction between AcrA and AcrB was investigated through chemical crosslinking, and a previously established in vivo fluorescent labeling method was used to probe substrate binding. Our data suggested that dissociation of the AcrB trimer drastically decreased its interaction with AcrA. In addition, while substrate binding with AcrB seemed to be irrelevant to the presence or absence of AcrA and TolC, the capability of trimerization and conduction of proton influx did affect substrate binding at selected sites along the substrate translocation pathway in AcrB.

  5. Traumatic Distal Ulnar Artery Thrombosis

    Directory of Open Access Journals (Sweden)

    Ahmet A. Karaarslan

    2014-01-01

    Full Text Available This paper is about a posttraumatic distal ulnar artery thrombosis case that has occurred after a single blunt trauma. The ulnar artery thrombosis because of chronic trauma is a frequent condition (hypothenar hammer syndrome but an ulnar artery thrombosis because of a single direct blunt trauma is rare. Our patient who has been affected by a single blunt trauma to his hand and developed ulnar artery thrombosis has been treated by resection of the thrombosed ulnar artery segment. This report shows that a single blunt trauma can cause distal ulnar artery thrombosis in the hand and it can be treated merely by thrombosed segment resection in suitable cases.

  6. Women's Leadership in the ACR, 2001-2015.

    Science.gov (United States)

    Patel, Amy K; Fielding, Julia; Macura, Katarzyna J; Applegate, Kimberly E; Zackula, Rosalee; Arleo, Elizabeth Kagan

    2017-06-01

    To assess the trends of women in voluntary leadership roles in the ACR from 2001 to 2015. Retrospective leadership records from 2001 to 2015 were collected from the ACR Membership Database based on member demographics, gender, and participation in leadership roles at the national and state level. Data were sorted by gender and year to assess the proportion of women in each leadership position relative to total member/representation counts. Overall, there were increasing numbers of women represented in ACR leadership. From 2001 to 2015, there were increasing rates of women achieving fellowship in the College (7%-11%), now at parity with male member rates. Representation by women has risen from 7% to 21% for state chapter presidents and from 14% to 18% for state councilors. Comparing rolling 5-year averages from 2001-2005 and 2011-2015 showed statistically significant increases (P leadership roles. Women members of the council steering committee rose from 13% in 2001 to 19% in 2015, peaking at 24% in 2014. The Board of Chancellors (BOC) showed the largest increase in women, from 9% to 33%, with a peak at 37% in 2014. However, no BOC chairs were women, one council speaker was a woman, two women were ACR presidents, and two women were vice presidents. Women's participation in ACR leadership has increased significantly at the state level and in fellowship recognition. Although there are increasing numbers of women on the BOC, top positions remain male-dominated at the national level. Published by Elsevier Inc.

  7. Computational Study of Correlated Domain Motions in the AcrB Efflux Transporter

    Directory of Open Access Journals (Sweden)

    Robert Schulz

    2015-01-01

    Full Text Available As active part of the major efflux system in E. coli bacteria, AcrB is responsible for the uptake and pumping of toxic substrates from the periplasm toward the extracellular space. In combination with the channel protein TolC and membrane fusion protein AcrA, this efflux pump is able to help the bacterium to survive different kinds of noxious compounds. With the present study we intend to enhance the understanding of the interactions between the domains and monomers, for example, the transduction of mechanical energy from the transmembrane domain into the porter domain, correlated motions of different subdomains within monomers, and cooperative effects between monomers. To this end, targeted molecular dynamics simulations have been employed either steering the whole protein complex or specific parts thereof. By forcing only parts of the complex towards specific conformational states, the risk for transient artificial conformations during the simulations is reduced. Distinct cooperative effects between the monomers in AcrB have been observed. Possible allosteric couplings have been identified providing microscopic insights that might be exploited to design more efficient inhibitors of efflux systems.

  8. 7 CFR 1412.23 - Base acres and Conservation Reserve Program.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Base acres and Conservation Reserve Program. 1412.23... Base Acres for a Farm for Covered Commodities § 1412.23 Base acres and Conservation Reserve Program. (a... year, adjust the base acres for covered commodities and peanuts with respect to the farm by the number...

  9. Using the ACR/NEMA standard with TCP/IP and Ethernet

    Science.gov (United States)

    Chimiak, William J.; Williams, Rodney C.

    1991-07-01

    There is a need for a consolidated picture archival and communications system (PACS) in hospitals. At the Bowman Gray School of Medicine of Wake Forest University (BGSM), the authors are enhancing the ACR/NEMA Version 2 protocol using UNIX sockets and TCP/IP to greatly improve connectivity. Initially, nuclear medicine studies using gamma cameras are to be sent to PACS. The ACR/NEMA Version 2 protocol provides the functionality of the upper three layers of the open system interconnection (OSI) model in this implementation. The images, imaging equipment information, and patient information are then sent in ACR/NEMA format to a software socket. From there it is handed to the TCP/IP protocol, which provides the transport and network service. TCP/IP, in turn, uses the services of IEEE 802.3 (Ethernet) to complete the connectivity. The advantage of this implementation is threefold: (1) Only one I/O port is consumed by numerous nuclear medicine cameras, instead of a physical port for each camera. (2) Standard protocols are used which maximize interoperability with ACR/NEMA compliant PACSs. (3) The use of sockets allows a migration path to the transport and networking services of OSIs TP4 and connectionless network service as well as the high-performance protocol being considered by the American National Standards Institute (ANSI) and the International Standards Organization (ISO) -- the Xpress Transfer Protocol (XTP). The use of sockets also gives access to ANSI's Fiber Distributed Data Interface (FDDI) as well as other high-speed network standards.

  10. Distal protection in cardiovascular medicine: current status.

    Science.gov (United States)

    Ali, Onn Akbar; Bhindi, Ravinay; McMahon, Aisling C; Brieger, David; Kritharides, Leonard; Lowe, Harry C

    2006-08-01

    Iatrogenic and spontaneous downstream microembolization of atheromatous material is increasingly recognized as a source of cardiovascular morbidity and mortality. Devising ways of reducing this distal embolization using a variety of mechanical means--distal protection--is currently under intense and diverse investigation. This review therefore summarizes the present status of distal protection. It examines the problem of distal embolization, describes the available distal protection devices, reviews those areas of cardiovascular medicine where distal protection devices are being investigated, and discusses potential future developments.

  11. Efficiency and safety of percuSurge distal protection device in acute ...

    African Journals Online (AJOL)

    user

    2011-04-25

    Apr 25, 2011 ... myocardial infarction. The long-term effects of the distal protection device are still in controversy. The enhanced myocardial efficacy and recovery by aspiration of liberated debris (EMERALD) trial failed to show the effectiveness of the distal protection device in patients with AMI (Yamada and Topol, 2000).

  12. The 2017 ACR Workforce Survey: Management Trends and Strategic Needs.

    Science.gov (United States)

    Harolds, Jay A; Bluth, Edward I

    2018-03-01

    The 2017 ACR Workforce Survey included questions for group leaders about management trends and areas in which they need more help from the ACR. Respondents identified point of care ultrasound as the area in which they need the most help. Most respondents gave positive or neutral answers regarding their role in the management of radiology allied health professionals and radiology information technology, and most believed their role and influence in decision making in the organization were not decreasing. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  13. DCS emulator development for the ACR-1000 simulator

    International Nuclear Information System (INIS)

    Nakashima, Y.; Trueman, R.; Ishii, K.

    2010-01-01

    Nuclear Power Plant (NPP) simulators are the main means for operator training and as such are a crucial part of the NPP operation life-cycle. Hitachi, Ltd., Information and Control Systems Company (henceforth 'Hitachi') is the preferred DCS and DCS emulator developer and supplier for the ACR-1000 NPP control system. Hitachi's concept for the DCS (distributed control system) portion of the ACR-1000 simulator is 'total emulation of the DCS' by software. This paper will review the current status of the technical development and the major project milestones. (author)

  14. The ACR: Advanced design features for a short construction schedule

    International Nuclear Information System (INIS)

    Elgohary, M.; Fairclough, N.

    2003-01-01

    Building on the successful CANDU construction at Qinshan, the ACR-700 is designed with constructability considerations as a major requirement during all project phases from the concept design stage to the detail design stage. A project schedule of 48 months has been developed for the nth ACR unit with a 36 months construction period from First Concrete to Fuel Load. This paper describes some of the advanced design features implemented in the reactor building design in order to achieve this short construction period. These features include large volume concrete pours, prefabricated rebar, composite structures, prefabricated permanent formwork and significant modularization and prefabrication

  15. Comparison of Urine Albumin-to-Creatinine Ratio (ACR) Between ACR Strip Test and Quantitative Test in Prediabetes and Diabetes

    Science.gov (United States)

    Cho, Seon; Kim, Suyoung; Cho, Han-Ik

    2017-01-01

    Background Albuminuria is generally known as a sensitive marker of renal and cardiovascular dysfunction. It can be used to help predict the occurrence of nephropathy and cardiovascular disorders in diabetes. Individuals with prediabetes have a tendency to develop macrovascular and microvascular pathology, resulting in an increased risk of retinopathy, cardiovascular diseases, and chronic renal diseases. We evaluated the clinical value of a strip test for measuring the urinary albumin-to-creatinine ratio (ACR) in prediabetes and diabetes. Methods Spot urine samples were obtained from 226 prediabetic and 275 diabetic subjects during regular health checkups. Urinary ACR was measured by using strip and laboratory quantitative tests. Results The positive rates of albuminuria measured by using the ACR strip test were 15.5% (microalbuminuria, 14.6%; macroalbuminuria, 0.9%) and 30.5% (microalbuminuria, 25.1%; macroalbuminuria, 5.5%) in prediabetes and diabetes, respectively. In the prediabetic population, the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of the ACR strip method were 92.0%, 94.0%, 65.7%, 99.0%, and 93.8%, respectively; the corresponding values in the diabetic population were 80.0%, 91.6%, 81.0%, 91.1%, and 88.0%, respectively. The median [interquartile range] ACR values in the strip tests for measurement ranges of 300 mg/g were 9.4 [6.3-15.4], 46.9 [26.5-87.7], and 368.8 [296.2-575.2] mg/g, respectively, using the laboratory method. Conclusions The ACR strip test showed high sensitivity, specificity, and negative predictive value, suggesting that the test can be used to screen for albuminuria in cases of prediabetes and diabetes. PMID:27834062

  16. Development of a platform for interactive training ACRs

    International Nuclear Information System (INIS)

    Gonzalvo, A.; Martin, J. E.; Herrera, J. A.

    2013-01-01

    Due to the workload of plant personnel and extension courses, you can use other methods of online learning to complement the methods of classroom learning, so that it minimizes disruption to the day job plant day. GNFE is implementing systems on-line training in ACRs based on MOODLE which has many advantages.

  17. 77 FR 4585 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Power Uprates...

    Science.gov (United States)

    2012-01-30

    ... Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on... Turkey Point, Units 3 and 4, extended power uprate application. The Subcommittee will hear presentations... possible, so that appropriate arrangements can be made. Thirty-five hard copies of each presentation or...

  18. 77 FR 28637 - Advisory Committee On Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Power Uprates...

    Science.gov (United States)

    2012-05-15

    ... Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on...) associated with the Grand Gulf Nuclear Station Unit 1 extended power uprate application. The Subcommittee... made. Thirty-five hard copies of each presentation or handout should be provided to the DFO thirty...

  19. 76 FR 32240 - Advisory Committee on Reactor Safeguards (ACRS) Meeting on the ACRS Subcommittee on Power Uprates

    Science.gov (United States)

    2011-06-03

    ... Subcommittee on Power Uprates Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on... Expanded Operating Domains-Power Distribution Validation and Pin-by-Pin Gamma Scan). The Subcommittee will... hard copies of each presentation or handout should be provided to the DFO thirty minutes before the...

  20. 76 FR 44964 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on U.S...

    Science.gov (United States)

    2011-07-27

    ... Subcommittee on U.S. Evolutionary Power Reactor; Notice of Meeting The ACRS Subcommittee on U.S. Evolutionary Power Reactor (U.S. EPR) will hold a meeting on August 18, 2011, Room T-2B3, 11545 Rockville Pike... the meeting, if possible, so that appropriate arrangements can be made. Thirty-five hard copies of...

  1. 78 FR 70596 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Power Uprates...

    Science.gov (United States)

    2013-11-26

    ... Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on... hold discussions with the licensee, (Northern States Power Company of Minnesota), the NRC staff, and... made. Thirty-five hard copies of each presentation or handout should be provided to the DFO thirty...

  2. Development of a platform for interactive training ACRs; Desarrollo de una plataforma interactiva para formacion en ACRs

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalvo, A.; Martin, J. E.; Herrera, J. A.

    2013-07-01

    Due to the workload of plant personnel and extension courses, you can use other methods of online learning to complement the methods of classroom learning, so that it minimizes disruption to the day job plant day. GNFE is implementing systems on-line training in ACRs based on MOODLE which has many advantages.

  3. Spleen-preserving distal pancreatectomy in trauma.

    Science.gov (United States)

    Schellenberg, Morgan; Inaba, Kenji; Cheng, Vincent; Bardes, James M; Lam, Lydia; Benjamin, Elizabeth; Matsushima, Kazuhide; Demetriades, Demetrios

    2018-01-01

    Traumatic injuries to the distal pancreas are infrequent. Universally accepted recommendations about the need for routine splenectomy with distal pancreatectomy do not exist. The aims of this study were to compare outcomes after distal pancreatectomy and splenectomy versus spleen-preserving distal pancreatectomy, and to define the appropriate patient population for splenic preservation. All patients who underwent distal pancreatectomy (January 1, 2007, to December 31, 2014) were identified from the National Trauma Data Bank. Patients with concomitant splenic injury and those who underwent partial splenectomy were excluded. Demographics, clinical data, procedures, and outcomes were collected. Study groups were defined by surgical procedure: distal pancreatectomy and splenectomy versus spleen-preserving distal pancreatectomy. Baseline characteristics between groups were compared with univariate analysis. Multivariate analysis was performed with logistic and linear regression to examine differences in outcomes. Over the 8-year study period, 2,223 patients underwent distal pancreatectomy. After excluding 1,381 patients with concomitant splenic injury (62%) and 8 (pancreatectomy and splenectomy, those who underwent spleen-preserving distal pancreatectomy were younger (p pancreatectomy (p = 0.017). Complications, mortality, and intensive care unit LOS were not significantly different. In young patients after blunt trauma who are not severely injured, a spleen-preserving distal pancreatectomy should be considered to allow for conservation of splenic function and a shorter hospital LOS. In all other patients, the surgeon should not hesitate to remove the spleen with the distal pancreas. Therapy, level IV.

  4. Bioinjection Performance Review for the Building 100 Area and 4.5 Acre Site at the Pinellas County, Florida, Site

    Energy Technology Data Exchange (ETDEWEB)

    Survochak, Scott [US Department of Energy, Washington, DC (United States). Office of Legacy Management; Daniel, Joe [Navarro Research and Engineering, Oak Ridge, TN (United States)

    2016-05-01

    This document provides a summary of a review of the performance of bioinjection activities at the Building 100 Area and the 4.5 Acre Site at the Pinellas County, Florida, Site since 2010, determines how best to optimize future injection events, and identifies the approach for the bioinjection event in 2016 at (1) the 4.5 Acre Site and (2) the Essentra property at the Building 100 Area. Because this document describes the next bioinjection event at the 4.5 Acre Site, it also serves as an addendum to the Interim Remedial Action Plan for Emulsified Edible Oil Injection at the 4.5 Acre Site (DOE 2013). In addition, this document revises the injection layout and injection intervals for the Essentra property that were originally described in the Interim Corrective Measure Work Plan for Source and Plume Treatment at the Building 100 Area (DOE 2014), and is a de facto update of that document. Bioinjection consists of injection of emulsified vegetable oil (EVO) and the microorganism Dehalococcoides mccartyi (DHM; formerly known as Dehalococcoides ethenogenes) into the subsurface to enhance biodegradation of trichloroethene (TCE), dichloroethene (DCE), and vinyl chloride (VC). VC is the only contaminant that exceeds its maximum contaminant level (10 micrograms per liter onsite and 1 microgram per liter onsite) on the 4.5 Acre Site and the Essentra property. Bioinjection was conducted at the 4.5 Acre Site in 2010 and 2013. Approximately 49,900 gallons of EVO and DHM were injected at 95 injection points in February 2010, and approximately 22,900 gallons of EVO and DHM were injected at 46 injection points in July 2013. The injection locations are shown on Figure 1. The goal of bioinjection at the 4.5 Acre Site is to decrease contaminant concentrations to maximum contaminant levels along the west and southwest property boundaries (to meet risk–based corrective action requirements) and to minimize the extent of the contaminant plume in the interior of the site. Bioinjection was

  5. Drug transport mechanism of the AcrB efflux pump.

    Science.gov (United States)

    Pos, Klaas M

    2009-05-01

    In Gram-negative bacteria such as Escherichia coli and Pseudomonas aeruginosa, tripartite multidrug efflux systems extrude cytotoxic substances from the cell directly into the medium bypassing periplasm and the outer membrane. In E. coli, the tripartite efflux system AcrA/AcrB/TolC is the pump that extrudes multiple antibiotics, dyes, bile salts and detergents. The inner membrane component AcrB, a member of the Resistance Nodulation cell Division (RND) family, is the major site for substrate recognition and energy transduction of the entire tripartite system. The drug/proton antiport processes in this secondary transporter are suggested to be spatially separated, a feature frequently observed for primary transporters like membrane-bound ATPases. The recently elucidated asymmetric structure of the AcrB trimer reveals three different monomer conformations proposed to represent consecutive states in a directional transport cycle. Each monomer shows a distinct tunnel system with entrances located at the boundary of the outer leaflet of the inner membrane and the periplasm through the periplasmic porter (pore) domain towards the funnel of the trimer and TolC. In one monomer a hydrophobic pocket is present which has been shown to bind the AcrB substrates minocyclin and doxorubicin. The energy conversion from the proton motive force into drug efflux includes proton binding in (and release from) the transmembrane part. The conformational changes observed within a triad of essential, titratable residues (D407/D408/K940) residing in the hydrophobic transmembrane domain appear to be transduced by transmembrane helix 8 and associated with the conformational changes seen in the periplasmic domain. From the asymmetric structure a possible peristaltic pump transport mechanism based on a functional rotation of the AcrB trimer has been postulated. The novel drug transport model combines the alternate access pump mechanism with the rotating site catalysis of F(1)F(o) ATPase as

  6. Minimally Invasive Distal Pancreatectomy: Review of the English Literature.

    Science.gov (United States)

    Wang, Kai; Fan, Ying

    2017-02-01

    Recently, the superiority of the minimally invasive approach, which results in a better cosmetic result, faster recovery, and shorter length of hospital stay, is a technique that has been progressively recognized as it has developed. And the minimally invasive approach has been applied to distal pancreatectomy (DP), which is a standard method for the treatment of benign, borderline, and part of malignant lesions of the pancreatic body and tail. This article aims to analyze the types, postoperative recovery, and outcomes of laparoscopic distal pancreatectomy (LDP). A systematic search of the scientific literature was performed using PubMed, EMBASE, online journals, and the Internet for all publications on LDP. Articles were selected if the abstract contained patients who underwent LDP for pancreatic diseases. All selected articles were reviewed and analyzed. If there were no contraindications for LDP, this operation is suitable for benign, borderline, or malignant tumors of the pancreatic body and tail, which should try to be performed with preservation of the spleen. LDP is safe and feasible under some conditions to experienced surgeon. Single-incision laparoscopic distal pancreatectomy (S-LDP) and robotic laparoscopic distal pancreatectomy (R-LDP) perioperative outcomes are similar with conventional multi-incision laparoscopic distal pancreatectomy (C-LDP). And the advantages of S-LDP and R-LDP require further exploration. With the application of enhanced recovery program (ERP), length of hospital stay and costs are reduced. LDP is safe and feasible under some conditions. Compared with open distal pancreatectomy, LDP has a lot of advantages; a trend was observed for LDP to replace traditional open surgery. LDP combined with ERP is expected to become standard in the treatment of pancreatic body and tail lesions.

  7. Geochemical exploration for phosphate in the State of Acre

    International Nuclear Information System (INIS)

    Costa, M.L. da; Melo Costa, W.A. de; Santos, A.J.M. dos

    1989-01-01

    The geochemical prospecting conducted for phosphates in Acre which could explain the good fertility of the region was charged to discover this material. The phosphates are strictly built of all the bone structures and coprolites of the several fragments of vertebrate fossils, which are widespread in the region. The phosphatic fossils are bedded in the Solimoes Formation, especially its basal to intermediary conglomeratic bed. The fossils are constituted of low crystallinity apatite, and their matrix sediments include quartz, feldspars, smectite, halloysite and calcite. The P 2 O 5 content reaches up to 5% in the sediments and up to 32% in the fragments. The fossils are enriched in U 3 O 8 and rare earth elements. There is no perspect of classic or mineral deposits but the geological knowlwdge will permit the improvement of the use of the soils in Acre. (author) [pt

  8. Identifying efficiency trends for Queensland broad-acre beef enterprises

    OpenAIRE

    Gregg, Daniel; Rolfe, John

    2010-01-01

    Productivity and efficiency improvements in agriculture have recently been targeted as Federal Government priorities in Australia. This research examined a dataset of 116 broad-acre beef enterprises from Queensland who participated in a program, Profit Probe, developed to improve management and profitability of enterprises. The aim of this research was to identify the sources, if any, of productivity growth for this sample of enterprises. Two potential sources of productivity growth were iden...

  9. Portrait of leptospirosis in the State of Acre, Brazil

    Directory of Open Access Journals (Sweden)

    Eloizy Mariana Dias de Medeiros Cirilo Costa

    2017-03-01

    Full Text Available Introduction: Leptospirosis is an acute bacterial disease, that has global distribution and manifests itself in subclinical or asymptomatic way, having mild or severe conditions that can lead to the death of the patient. Objective: To identify, among the municipalities of the state of Acre, Brazil, those with the highest incidence of leptospirosis between 2010 and 2015, and in addition, to determine the prevalence of this disease between the sexes. Methods: Descriptive study, of documentary character, with epidemiological base and quantitative approach. It was made by available documents through the Department of Informatics of the Unified Health System of Brazil (DATASUS and also by the Health Secretary of State of Acre (SESACRE. Variables were selected as sex, age and year of notification. Regarding the analysis, it is emphasized that it was quantitative and descriptive and the results were presented in tables built in Microsoft Word. Results: It was found that the capital of the state of Acre, Rio Branco, led every year, contributing to the higher proportion of notifications related to leptospirosis. Regarding gender, there was a predilection for males and among age groups, the period of 20 to 39 years contributes to the greater number of cases of the disease. Conclusion: Leptospirosis is a worldwide public health problem and in the state of Acre, the high rainfall, the agglomeration of low income combined with inadequate sanitation, collaborate to infestation of transmitters animals, providing high rates of the disease. Thus, it appears that these high numbers can probably be attributed to the ineffectiveness of preventive activities, as well as insufficient investment directed to social policies and infrastructure sectors. Keywords: Infectious Disease. Leptospirosis. Prevalence. Incidence.

  10. The radiology job market: analysis of the ACR jobs board.

    Science.gov (United States)

    Prabhakar, Anand M; Oklu, Rahmi; Harvey, H Benjamin; Harisinghani, Mukesh G; Rosman, David A

    2014-05-01

    The aim of this study was to assess the status of the radiology job market as represented by the ACR Jobs Board from October 2010 to June 2013. With the assistance of the ACR, data from the ACR Jobs Board from October 2010 through June 2013, including the numbers of monthly new job seekers, new job postings, and job posting clicks, were gathered and used to calculate a monthly competitive index, defined as the ratio of new job seekers to new job postings. During the study period, the mean number of new job seekers was 168 per month, which was significantly greater than the 84 average new job postings for any given month (P = .0002). There was no significant difference between 2011 and 2012 with regard to the number of new job seekers or job postings. Over the time period assessed, more new job seekers registered in October and November 2010, August to November 2011, and October and November 2012. These periods were also associated with the highest competitive index values. There were less job seekers in the winter and spring of 2011, 2012, and 2013, periods associated with lower competitive index values. ACR Jobs Board activity, measured by job posting clicks, was significantly higher in 2012 than in 2011 (P Jobs Board, there were consistently more new job seekers than job postings throughout the study period, and fall is the period in the year most associated with the highest competitive index for radiologist employment. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  11. Plant life management of the ACR-1000 Concrete containment structure

    International Nuclear Information System (INIS)

    Abrishami, H.H.; Ricciuti, R.; Elgohary, M.

    2009-01-01

    The Ageing of reinforced concrete structures due to service conditions, aggressive environments, or accidents may cause their strength, serviceability and durability to decrease over time. For a new plant, a Plant Life Management (PLiM) program should start in the design process and then continues through the plant operation and decommissioning. Hence, PLiM must provide not only Ageing Management program (AMP) but also provide requirements on material characteristic and design criteria as well. The purpose of this paper is to present the Plant Life Management (PLiM) strategy for the concrete containment structure of the ACR-10001 (Advanced CANDU Reactor) designed by AECL. The ACR-1000 is designed for a 100-year plant life including 60-year operating life and an additional 40-year decommissioning period. The approach adopted for the PLiM strategy of the concrete containment structure is a preventive one, key areas being: 1) design methodology, 2) material performance and 3) ageing management program. During the design phase, in addition to strength and serviceability, durability, throughout the service life and decommissioning phase of the ACR-1000 structure, is a major consideration. Factors affecting durability design include: a) concrete performance, b) structural application, and c) consideration of environmental conditions. In addition to addressing the design methodology and material performance requirements, a systematic approach for the ageing management program for the concrete containment structure is presented. (authors)

  12. 75 FR 4882 - Meeting of the ACRS Subcommittee on EPR; Notice of Meeting

    Science.gov (United States)

    2010-01-29

    ... NUCLEAR REGULATORY COMMISSION Advisory Committee On Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on EPR; Notice of Meeting The ACRS U.S. Evolutionary Power Reactor (EPR) Subcommittee will hold a... with Open Items concerning the U.S. EPR Design Certification (DCD) Application and the Calvert Cliffs...

  13. Optimization of nonribosomal peptides production by a psychrotrophic fungus: Trichoderma velutinum ACR-P1.

    Science.gov (United States)

    Sharma, Richa; Singh, Varun P; Singh, Deepika; Yusuf, Farnaz; Kumar, Anil; Vishwakarma, Ram A; Chaubey, Asha

    2016-11-01

    Trichoderma is an anamorphic filamentous fungal genus with immense potential for production of small valuable secondary metabolites with indispensable biological activities. Microbial dynamics of a psychrotrophic strain Trichoderma velutinum ACR-P1, isolated from unexplored niches of the Shiwalik region, bestowed with rich biodiversity of microflora, was investigated for production of nonribosomal peptides (NRPs) by metabolite profiling by intact-cell mass spectrometry (ICMS) employing matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometer. Being the first report on NRPs production by T. velutinum, studies on optimization of growth conditions by Response Surface Methodology (RSM) for production of NRPs by ACR-P1 was carried out strategically. Multifold enhancement in the yield of NRPs belonging to subfamily SF4 with medium chain of amino acid residues having m/z 1437.9, 1453.9, and 1452.0 at pH 5.9 at 20 °C and of subfamily SF1 with long-chain amino acid residues having m/z 1770.2, 1784.2, 1800.1, 1802.1, and 1815.1 was achieved at pH 7.0 at 25 °C. Complexities of natural mixtures were thus considerably reduced under respective optimized culture conditions accelerating the production of novel microbial natural products by saving time and resources.

  14. Posttraumatic osteolysis of the distal clavicula end

    International Nuclear Information System (INIS)

    Hermanns, P.H.; Beeger, R.; Koetter, D.; Hamburg Univ.

    1981-01-01

    Posttraumatic osteolysis of bone is rare. Its etiology is unknown. A case of posttraumatic osteolysis of the distal clavicle end is reported. Differentialdiagnostical and ethiological relations are discussed. The literature of posttraumatic osteolysis especially of distal clavicle osteolysis is reported. (orig.) [de

  15. Contemporary Management of Primary Distal Urethral Cancer

    NARCIS (Netherlands)

    Traboulsi, S.L.; Witjes, J.A.; Kassouf, W.

    2016-01-01

    Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation

  16. ACRE: Absolute concentration robustness exploration in module-based combinatorial networks

    KAUST Repository

    Kuwahara, Hiroyuki; Umarov, Ramzan; Almasri, Islam; Gao, Xin

    2017-01-01

    To engineer cells for industrial-scale application, a deep understanding of how to design molecular control mechanisms to tightly maintain functional stability under various fluctuations is crucial. Absolute concentration robustness (ACR) is a category of robustness in reaction network models in which the steady-state concentration of a molecular species is guaranteed to be invariant even with perturbations in the other molecular species in the network. Here, we introduce a software tool, absolute concentration robustness explorer (ACRE), which efficiently explores combinatorial biochemical networks for the ACR property. ACRE has a user-friendly interface, and it can facilitate efficient analysis of key structural features that guarantee the presence and the absence of the ACR property from combinatorial networks. Such analysis is expected to be useful in synthetic biology as it can increase our understanding of how to design molecular mechanisms to tightly control the concentration of molecular species. ACRE is freely available at https://github.com/ramzan1990/ACRE.

  17. ACRE: Absolute concentration robustness exploration in module-based combinatorial networks

    KAUST Repository

    Kuwahara, Hiroyuki

    2017-03-01

    To engineer cells for industrial-scale application, a deep understanding of how to design molecular control mechanisms to tightly maintain functional stability under various fluctuations is crucial. Absolute concentration robustness (ACR) is a category of robustness in reaction network models in which the steady-state concentration of a molecular species is guaranteed to be invariant even with perturbations in the other molecular species in the network. Here, we introduce a software tool, absolute concentration robustness explorer (ACRE), which efficiently explores combinatorial biochemical networks for the ACR property. ACRE has a user-friendly interface, and it can facilitate efficient analysis of key structural features that guarantee the presence and the absence of the ACR property from combinatorial networks. Such analysis is expected to be useful in synthetic biology as it can increase our understanding of how to design molecular mechanisms to tightly control the concentration of molecular species. ACRE is freely available at https://github.com/ramzan1990/ACRE.

  18. Modelling of liquid injection shutdown system (LISS) in ACR-1000

    International Nuclear Information System (INIS)

    Boubcher, M.; Colton, A.; Donnelly, J.V.

    2008-01-01

    Modelling of the Liquid Injection Shutdown System (LISS) in the ACR-1000 reactor core must account for the major phenomena that occur following its activation, namely the moderator hydraulics and core neutronics. The former requires modelling of the poison volumes, their time of entry into the reactor, and their propagation into the moderator after emission from the nozzle. The latter requires the reactivity worth of varying volumes and geometries of poisoned moderator fluid in order to simulate the reactivity effect of the injected poison. The time-dependent poison map is generated from hydraulic calculations, and then the neutronics data for standard geometries and concentrations is constructed using DRAGON. (author)

  19. Assessment of ACR moderator circulation design using CFD

    International Nuclear Information System (INIS)

    Bunama, R.; Carlucci, L.N.; Waddington, G.M.

    2004-01-01

    Assessment of the thermalhydraulic performance of the moderator circulation system for the Advanced CANDU Reactor (ACR) was carried out using the specialized Computational Fluid Dynamics (CFD) code MODTURC C LAS V2.9 IST. The assessment included modeling the moderator circulation inside the calandria vessel under nominal and isothermal flow conditions. The modeling results show that the moderator flow through the core is relatively uniform and mostly upward. The moderator temperature distribution is nearly stratified and increases monotonically from the bottom to the top of the calandria vessel. (author)

  20. MRI quality assurance using the ACR phantom in a multi-unit imaging center

    International Nuclear Information System (INIS)

    Ihalainen, Toni M.; Kuusela, Linda J.; Savolainen, Sauli E.; Loennroth, Nadja T.; Peltonen, Juha I.; Uusi-Simola, Jouni K.; Timonen, Marjut H.; Sipilae, Outi E.

    2011-01-01

    Background. Magnetic resonance imaging (MRI) instrumentation is vulnerable to technical and image quality problems, and quality assurance is essential. In the studied regional imaging center the long-term quality assurance has been based on MagNET phantom measurements. American College of Radiology (ACR) has an accreditation program including a standardized image quality measurement protocol and phantom. The ACR protocol includes recommended acceptance criteria for clinical sequences and thus provides possibility to assess the clinical relevance of quality assurance. The purpose of this study was to test the ACR MRI phantom in quality assurance of a multi-unit imaging center. Material and methods. The imaging center operates 11 MRI systems of three major manufacturers with field strengths of 3.0 T, 1.5 T and 1.0 T. Images of the ACR phantom were acquired using a head coil following the ACR scanning instructions. Both ACR T1- and T2-weighted sequences as well as T1- and T2-weighted brain sequences in clinical use at each site were acquired. Measurements were performed twice. The images were analyzed and the results were compared with the ACR acceptance levels. Results. The acquisition procedure with the ACR phantom was faster than with the MagNET phantoms. On the first and second measurement rounds 91% and 73% of the systems passed the ACR test. Measured slice thickness accuracies were not within the acceptance limits in site T2 sequences. Differences in the high contrast spatial resolution between the ACR and the site sequences were observed. In 3.0 T systems the image intensity uniformity was slightly lower than the ACR acceptance limit. Conclusion. The ACR method was feasible in quality assurance of a multi-unit imaging center and the ACR protocol could replace the MagNET phantom tests. An automatic analysis of the images will further improve cost-effectiveness and objectiveness of the ACR protocol

  1. Unravelling intention: distal intentions increase the subjective sense of agency.

    Science.gov (United States)

    Vinding, Mikkel C; Pedersen, Michael N; Overgaard, Morten

    2013-09-01

    Experimental studies investigating the contribution of conscious intention to the generation of a sense of agency for one's own actions tend to rely upon a narrow definition of intention. Often it is operationalized as the conscious sensation of wanting to move right before movement. Existing results and discussion are therefore missing crucial aspects of intentions, namely intention as the conscious sensation of wanting to move in advance of the movement. In the present experiment we used an intentional binding paradigm, in which we distinguished between immediate (proximal) intention, as usually investigated, and longer standing (distal) intention. The results showed that the binding effect was significantly enhanced for distal intentions compared to proximal intentions, indicating that the former leads to stronger sense of agency. Our finding provides empirical support for a crucial distinction between at least two types of intention when addressing the efficacy of conscious intentions. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Characterization and enzymatic properties of protein kinase ACR4 from Arabidopsis thaliana.

    Science.gov (United States)

    Zhao, Yu; Liu, Xuehe; Xu, Ziyan; Yang, Hui; Li, Jixi

    2017-07-22

    Serine/threonine-protein kinase-like protein ARABIDOPSIS CRINKLY4 (ACR4), a transmembrane protein of Arabidopsis thaliana, plays important roles in cell division and differentiation. Although accumulating studies shed light on the function of ACR4, the structure and catalytic mechanism of ACR4 remain to be elucidated. Here, we report the purification and enzymatic properties of the intracellular kinase domain (residues 464-799) of ACR4 (ACR4 IKD ). Through Ni-affinity chromatography and gel filter chromatography methods, we successfully obtain high-purity ACR4 IKD protein from Escherichia coli. Dynamic light scattering and gel-filtration methods reveal that ACR4 IKD distributes with high homogeneity and exists as a monomer in solution. In addition, the ACR4 IKD protein has typical kinase activity with myelin basic protein (MBP) as the substrate. Our study may lay the foundation for structure determination of ACR4 IKD and further functional research, for example, screening significant substrates of ACR4 in Arabidopsis thaliana. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Conceptualizing distal drivers in land use competition

    DEFF Research Database (Denmark)

    Niewhöner, Jörg; Nielsen, Jonas Ø; Gasparri, Gasparri

    2016-01-01

    This introductory chapter explores the notion of ‘distal drivers’ in land use competition. Research has moved beyond proximate causes of land cover and land use change to focus on the underlying drivers of these dynamics. We discuss the framework of telecoupling within human–environment systems...... as a first step to come to terms with the increasingly distal nature of driving forces behind land use practices. We then expand the notion of distal as mainly a measure of Euclidian space to include temporal, social, and institutional dimensions. This understanding of distal widens our analytical scope...... for the analysis of land use competition as a distributed process to consider the role of knowledge and power, technology, and different temporalities within a relational or systemic analysis of practices of land use competition. We conclude by pointing toward the historical and social contingency of land use...

  4. Distal technologies and type 1 diabetes management.

    Science.gov (United States)

    Duke, Danny C; Barry, Samantha; Wagner, David V; Speight, Jane; Choudhary, Pratik; Harris, Michael A

    2018-02-01

    Type 1 diabetes requires intensive self-management to avoid acute and long-term health complications. In the past two decades, substantial advances in technology have enabled more effective and convenient self-management of type 1 diabetes. Although proximal technologies (eg, insulin pumps, continuous glucose monitors, closed-loop and artificial pancreas systems) have been the subject of frequent systematic and narrative reviews, distal technologies have received scant attention. Distal technologies refer to electronic systems designed to provide a service remotely and include heterogeneous systems such as telehealth, mobile health applications, game-based support, social platforms, and patient portals. In this Review, we summarise the empirical literature to provide current information about the effectiveness of available distal technologies to improve type 1 diabetes management. We also discuss privacy, ethics, and regulatory considerations, issues of global adoption, knowledge gaps in distal technology, and recommendations for future directions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Genetics Home Reference: distal arthrogryposis type 1

    Science.gov (United States)

    ... 1 is a disorder characterized by joint deformities (contractures) that restrict movement in the hands and feet. ... distal arthrogryposis type 1 . However, researchers speculate that contractures may be related to problems with muscle contraction ...

  6. Potassium secretion in mammalian distal colon

    DEFF Research Database (Denmark)

    Sørensen, Mads Vaarby

    2009-01-01

    Epithelial organs adjust the „inner milieu“ of the body and are crucial for all homeostatic processes. Epithelial transport of different solutes and water is regulated phenomena. The regulation processes include both long term hormonal regulation and short term local agonist mediated regulation....... This research project is the summary of 3 original papers addressing the functional role of different regulating factors on ion transport in mouse distal colon. The first paper addresses the effect of luminal nucleotides on electrogenic Na+ absorption. The distal colon, like the distal nephron is an aldosterone......-sensitive tissue and participates in the regulation of Na+ excretion. In the distal nephron it was found that luminal nucleotides inhibit ENaC-mediated Na+ absorption. Here it was addressed whether luminal nucleotides regulate Na+ absorption and if so, which of the known luminal P2 receptors are involved. Using...

  7. MANAGEMENT OF Amburana cearensis var. acreana IN ACRE STATE, BRAZIL

    Directory of Open Access Journals (Sweden)

    Evaldo Muñoz Braz

    2014-06-01

    Full Text Available http://dx.doi.org/10.5902/1980509814586This work has as its objectives: a to assess the geographical distribution and population structure of Amburana cearensis var. acreana; b to calculate sustainable cutting rates, according to stipulated cutting cycles, and c to simulate the projected recovery potential in volume based on the calculated cutting rate. It was used data from sustainable forest management plans, and the results will contribute for future decisions about its endangered condition. The results did not corroborate the information that Amburana cearensis var. acreana is endangered in Acre state. However the management sustainability will only be feasible if considered the ideal remaining population structure and the estimative of the optimal cutting rate according to the cutting cycle.

  8. MO-AB-207-00: ACR Update in MR, CT, Nuclear Medicine, and Mammography

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program.

  9. MO-AB-207-03: ACR Update in Nuclear Medicine

    Energy Technology Data Exchange (ETDEWEB)

    Harkness, B. [Henry Ford Hospital System (United States)

    2015-06-15

    A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program.

  10. MO-AB-207-00: ACR Update in MR, CT, Nuclear Medicine, and Mammography

    International Nuclear Information System (INIS)

    2015-01-01

    A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program

  11. MO-AB-207-03: ACR Update in Nuclear Medicine

    International Nuclear Information System (INIS)

    Harkness, B.

    2015-01-01

    A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process. To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program

  12. Normal distal pulmonary vein anatomy

    Directory of Open Access Journals (Sweden)

    Wiesława Klimek-Piotrowska

    2016-01-01

    Full Text Available Background. It is well known that the pulmonary veins (PVs, especially their myocardial sleeves play a critical role in the initiation and maintenance of atrial fibrillation. Understanding the PV anatomy is crucial for the safety and efficacy of all procedures performed on PVs. The aim of this study was to present normal distal PV anatomy and to create a juxtaposition of all PV ostium variants.Methods. A total of 130 randomly selected autopsied adult human hearts (Caucasian were examined. The number of PVs ostia was evaluated and their diameter was measured. The ostium-to-last-tributary distance and macroscopic presence of myocardial sleeves were also evaluated.Results. Five hundred forty-one PV ostia were identified. Four classical PV ostia patterns (two left and two right PVs were observed in 70.8% of all cases. The most common variant was the classical pattern with additional middle right PV (19.2%, followed by the common ostium for the left superior and the inferior PVs (4.44%. Mean diameters of PV ostia (for the classical pattern were: left superior = 13.8 ± 2.9 mm; left inferior = 13.3 ± 3.4 mm; right superior = 14.3 ± 2.9 mm; right inferior = 13.7 ± 3.3 mm. When present, the additional middle right PV ostium had the smallest PV ostium diameter in the heart (8.2 ± 4.1 mm. The mean ostium-to-last-tributary (closest to the atrium distances were: left superior = 15.1 ± 4.6 mm; left inferior = 13.5 ± 4.0 mm; right superior = 11.8 ± 4.0 mm; right inferior = 11.0 ± 3.7 mm. There were no statistically significant differences between sexes in ostia diameters and ostium-to-last-tributary distances.Conclusion. Only 71% of the cases have four standard pulmonary veins. The middle right pulmonary vein is present in almost 20% of patients. Presented data can provide useful information for the clinicians during interventional procedures or radiologic examinations of PVs.

  13. Structural and functional aspects of the multidrug efflux pump AcrB.

    Science.gov (United States)

    Eicher, Thomas; Brandstätter, Lorenz; Pos, Klaas M

    2009-08-01

    The tripartite efflux system AcrA/AcrB/TolC is the main pump in Escherichia coli for the efflux of multiple antibiotics, dyes, bile salts and detergents. The inner membrane component AcrB is central to substrate recognition and energy transduction and acts as a proton/drug antiporter. Recent structural studies show that homotrimeric AcrB can adopt different monomer conformations representing consecutive states in an allosteric functional rotation transport cycle. The conformational changes create an alternate access drug transport tunnel including a hydrophobic substrate binding pocket in one of the cycle intermediates.

  14. The Prevalence of acrA and acrB Genes Among Multiple-Drug Resistant Uropathogenic Escherichia coli Isolated From Patients With UTI in Milad Hospital, Tehran

    Directory of Open Access Journals (Sweden)

    Maleki

    2016-09-01

    Full Text Available Background Urinary tract infection (UTI is one of the most common infectious diseases and nosocomial infections worldwide, and uropathogenic Escherichia coli is the primary cause of UTI. Due to increased antibiotic resistance and the emergence of multidrug resistant (MDR UPEC clones, the treatment of UTI is difficult. The occurrence of MDR in E. coli has been attributed to the AcrAB-TolC complex of efflux pumps. Objectives The aim of this study was to complete a frequency evaluation of acrA and acrB genes among UPEC MDR strains isolated from patients with UTI who were admitted to Milad hospital in Tehran. Methods For 123 UPEC strains that were isolated and diagnosed from the urine samples of patients using biochemical tests, antibiotic susceptibility was carried out using the disc diffusion method according to CLSI guidelines. Isolates that were resistant to at least one antimicrobial agent in three or more of the categories were considered to be MDR. The presence and frequency of acrA and acrB genes was determined using PCR. Results The rates of antibiotic resistance to ampicillin, cefalotin, tetracycline, cefazolin, ceftriaxone, ceftizoxime, ceftazidime, ciprofloxacin, and cotrimoxazole were 82.9%, 78.1%, 61.1%, 49.5%, 38.2%, 30.2%, 26.1%, 42.2%, and 60.1%, respectively. The isolates were most sensitive to nitrofurantoin (95.9%, gentamicin (77.2%, and amikacin (71.5%. A total of 78% of the isolates were MDR. The frequency of the acrA gene was 82.90%, the acrB gene was 95.90% and acrA + acrB was 95.90%. There was no significant difference between acrA and acrB frequency relating to bacterial antibiotic resistance. Conclusions Our results showed that ways to control the treatment of UTI for the prevention of MDR occurrence should be sought. For a better study of efflux pumps, a comprehensive and detailed study regarding the presence of efflux pumps gees is required.

  15. 75 FR 7634 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the Subcommittee on Power Uprates...

    Science.gov (United States)

    2010-02-22

    ... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the Subcommittee on Power Uprates; Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on... arrangements can be made. Thirty-five hard copies of each presentation or handout should be provided to the DFO...

  16. Sensitivity of Escherichia coli acrA Mutants to Psoralen plus Near-Ultraviolet Radiation

    DEFF Research Database (Denmark)

    Hansen, M. Trier

    1982-01-01

    The sensitivity to psoralen plus near-ultraviolet radiation (PUVA) was compared in a pair of E. coli strains differing at the acrA locus. Survival was determined for both bacteria and phage λ. AcrA mutant cells were 40 times more sensitive than wild type to the lethal effect of PUVA. Free λ phage...

  17. Desempenho de cultivares de alface no Estado do Acre Performance of lettuce cultivars in the State of Acre, Brazil

    Directory of Open Access Journals (Sweden)

    Francisco J. da S. Lédo

    2000-11-01

    Full Text Available Devido às condições ambientais verificadas no estado do Acre, caracterizado pela ocorrência de temperaturas elevadas e alta precipitação, as cultivares tradicionalmente utilizadas pelos produtores apresentam baixo rendimento e qualidade. O objetivo do presente trabalho foi avaliar o comportamento das novas cultivares de alface disponíveis no mercado, em termos de características agronômicas e rendimento, nas condições edafoclimáticas de Rio Branco, Acre. Para isso foram realizados dois ensaios no campo experimental da Embrapa Acre, em um solo do tipo Argissolo Vermelho-Escuro, textura argilosa. O primeiro de maio a julho de 1996 (período seco e o segundo de dezembro de 1996 a fevereiro de 1997 (período chuvoso. Foram avaliadas as cultivares Babá de Verão, Brisa, Carolina AG-576, Elisa, Lucy Brown, Marisa AG-216, Piracicaba 65, Regina 71, Tainá, Simpson, Vanessa e Verônica, sendo que 'Regina 71' e 'Elisa' foram incluídas apenas no ensaio do período seco. O delineamento experimental foi o de blocos casualizados, com três repetições. No período seco, as cultivares Simpson, Lucy Brown e Regina 71 apresentaram os maiores pesos médios (373; 362 e 341 g, respectivamente e produções comerciais de 49,8; 48,3 e 45,5 t/ha, respectivamente. Em geral, as cultivares dos tipos lisa sem cabeça e lisa com cabeça apresentaram maior índice de ataque de nematóide (Meloidogyne javanica quando comparadas às do tipo crespa. No ensaio realizado no período chuvoso, as cultivares Marisa AG-216, Verônica, Lucy Brown, Brisa, Tainá e Piracicaba-65 apresentaram os maiores pesos médios e produções comerciais. Entretanto, as médias obtidas foram bem inferiores às verificadas no ensaio do período seco, variando de 164 a 198 g para o peso médio, e 21,9 a 25,9 t/ha para produção comercial. Dentre as cultivares avaliadas no período seco, Regina 71 (lisa, sem cabeça e Carolina AG-576 (lisa, com cabeça destacaram-se entre as do tipo

  18. Detection of potential AcrAB-TolC multidrug efflux pump inhibitor in calyces extract of Hibiscus sabdariffa

    Directory of Open Access Journals (Sweden)

    Nehaya Al-Karablieh

    2017-12-01

    Full Text Available Aim: The aim of this study is to investigate occurrence of potential efflux pump inhibitor (EPI against AcrAB-TolC efflux pump in the methanol extract of H. sabdariffa. Materials and Methods: Calyces of H. sabdariffa were purchased from the local market in April 2014, methanol extract of H. sabdariffa was subjected to agar plate diffusion against Escherichia coli TG1 and its ∆acrB-∆tolC and thin layer chromatography (TLC bioassay. The corresponding EPI fraction was eluted by methanol. The synergistic effect of antimicrobials and EPI fraction was measured by minimum inhibitory concentration (MIC determination for E. coli and Erwinia amylovora strains, and the ability of EPI fraction to enhance EtBr accumulation was conducted. Results: E. coli TG1 was more sensitive to the methanol extracts of H. sabdariffa than E. coli ∆acrB-∆tolC, and inhibition zone corresponding to flavones on TLC bioassay plate has been formed which might be related to the fraction of potential EPI. The MIC values revealed that EPI fraction enhanced the activity of the used antimicrobials by 4 to 8 folds in E. coli TG1 and by 4 to 10 folds in E. amylovora 1189. Addition of EPI fraction in a dose-dependent manner increased the intercellular accumulation of Ethidium Bromide (EtBr in the wild type stains of E. coli TG1 and E. amylovora 1189. Conclusion: EPI fraction behaves like a multidrug efflux pump inhibitor and further investigation should be conducted for determination of the chemical structure of EPI fraction. [J Complement Med Res 2017; 6(4.000: 357-363

  19. Honey quality of Melipona sp. bees in Acre, Brazil

    Directory of Open Access Journals (Sweden)

    Marcus Augusto Damaceno do Vale

    2018-04-01

    Full Text Available Honey from stingless bees (Melipona sp. is a nutritious and medicinal product economically valued in the informal Brazilian market, driven by the growing demand for natural products; however, its physicochemical characteristics are still unknown. Thus, the aim of this study is to evaluate the physicochemical profile of the stingless bee honey produced in Cruzeiro do Sul, Acre. Honey samples were analyzed following the methodology recommended by Ministério da Agricultura, Pecuária e Abastecimento; the following parameters were established: moisture, total sugars, reducing sugars, apparent sucrose, ash, crude protein, diastase activity, Brix degrees, free acidity, lactonic acidity, total acidity, pH, hydroxymethylfurfural, electrical conductivity, color and Lugol, Lund and Fiehe reactions. Results show that these parameters are not suitable for all samples, being incompatible with established standards, indicating that the current legislation on Apis mellifera is not suitable for all characters analyzed, mainly moisture content, corroborating the need to standardize guidelines for honey from stingless bees. Moreover, there was no tampering in the honeys analyzed.

  20. Distal splenorenal shunt with partial spleen resection

    Directory of Open Access Journals (Sweden)

    Gajin Predrag

    2007-01-01

    Full Text Available Introduction: Hypersplenism is a common complication of portal hypertension. Cytopenia in hypersplenism is predominantly caused by splenomegaly. Distal splenorenal shunt (Warren with partial spleen resection is an original surgical technique that regulates cytopenia by reduction of the enlarged spleen. Objective. The aim of our study was to present the advantages of distal splenorenal shunt (Warren with partial spleen resection comparing morbidity and mortality in a group of patients treated by distal splenorenal shunt with partial spleen resection with a group of patients treated only by a distal splenorenal shunt. Method. From 1995 to 2003, 41 patients with portal hypertension were surgically treated due to hypersplenism and oesophageal varices. The first group consisted of 20 patients (11 male, mean age 42.3 years who were treated by distal splenorenal shunt with partial spleen resection. The second group consisted of 21 patients (13 male, mean age 49.4 years that were treated by distal splenorenal shunt only. All patients underwent endoscopy and assessment of oesophageal varices. The size of the spleen was evaluated by ultrasound, CT or by scintigraphy. Angiography was performed in all patients. The platelet and white blood cell count and haemoglobin level were registered. Postoperatively, we noted blood transfusion, complications and total hospital stay. Follow-up period was 12 months, with first checkup after one month. Results In the first group, only one patient had splenomegaly postoperatively (5%, while in the second group there were 13 patients with splenomegaly (68%. Before surgery, the mean platelet count in the first group was 51.6±18.3x109/l, to 118.6±25.4x109/l postoperatively. The mean platelet count in the second group was 67.6±22.8x109/l, to 87.8±32.1x109/l postoperatively. Concerning postoperative splenomegaly, statistically significant difference was noted between the first and the second group (p<0.05. Comparing the

  1. Contemporary Management of Primary Distal Urethral Cancer.

    Science.gov (United States)

    Traboulsi, Samer L; Witjes, Johannes Alfred; Kassouf, Wassim

    2016-11-01

    Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation therapy in women. There are no clear-cut indications for the choice of the most appropriate treatment modality. Organ-preserving modalities have shown effective and should be used whenever they do not compromise the oncological safety to decrease the physical and psychological trauma of dismemberment or loss of sexual/urinary function. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Spontaneous distal rupture of the plantar fascia.

    Science.gov (United States)

    Gitto, Salvatore; Draghi, Ferdinando

    2018-07-01

    Spontaneous ruptures of the plantar fascia are uncommon injuries. They typically occur at its calcaneal insertion and usually represent a complication of plantar fasciitis and local treatment with steroid injections. In contrast, distal ruptures commonly result from traumatic injuries. We describe the case of a spontaneous distal rupture of the plantar fascia in a 48-year-old woman with a low level of physical activity and no history of direct injury to the foot, plantar fasciitis, or steroid injections. © 2017 Wiley Periodicals, Inc.

  3. Torsion of wandering spleen and distal pancreas

    International Nuclear Information System (INIS)

    Sheflin, J.R.; Lee, C.M.; Kretchmar, K.A.

    1984-01-01

    Wandering spleen is the term applied to the condition in which a long pedicle allows the spleen to lie in an abnormal location. Torsion of a wandering spleen is an unusual cause of an acute abdomen and is rarely diagnosed preoperatively. Associated torsion of the distal pancreas is even more uncommon. The authors describe a patient with torsion of a wandering spleen and distal pancreas, who was correctly diagnosed, and define the merits of the imaging methods used. The initial examination should be 99 /sup m/Tc-sulfur colloid liner-spleen scanning

  4. The 2013 ACR Commission on Human Resources workforce survey.

    Science.gov (United States)

    Bluth, Edward I; Truong, Hang; Nsiah, Eugene; Hughes, Danny; Short, Bradley W

    2013-10-01

    The ACR Commission on Human Resources conducts an annual electronic survey during the first quarter of the year to better understand the present workforce situation for radiologists. We used the Practice of Radiology Environment Database (PRED) to identify 2,067 practice leaders and asked them to complete an electronic survey developed by the Commission on Human Resources. The survey asked group leaders or their designates to report the number of radiologists they currently employ or supervise, the number hired in 2012, and the number they plan to hire in 2013 and 2016. The leaders were also asked to report the subspecialty area that was used as the main reason for hiring that physician. Of the 2,067 practice leaders surveyed, 22% responded, a figure corresponding to 23% of all practicing radiologists in the United States. These results showed that 54% of radiologists are in private practice and 46% are employed by various other entities. The current workforce consists of 21% general radiologists and 79% subspecialists. The largest areas of subspecialty include general interventionalists, neuroradiologists, and body imagers. In 2012, 1,407 radiologists were hired. The greatest number of radiologists hired involved general interventional radiologists, followed by general radiologists, body imagers, and those specializing in musculoskeletal radiology, neuroradiology, and breast imaging. In 2013, 1,526 job opportunities were projected and in 2016, 1,434 job opportunities. In 2013, the most sought-after individuals will be general radiologists, general interventionalists, breast imagers, neuroradiologists, musculoskeletal radiologists, and body imagers. Based on the data collected from the responding practices, the demand for hiring radiologists in 2013 will be similar to 2012. Each of the 1,200 residents who complete their training programs each year should have a position available, but the job may not necessarily be in the subspecialty, geographic area, or type of

  5. ACR Appropriateness Criteria Assessment of Fetal Well-Being.

    Science.gov (United States)

    Simpson, Lynn; Khati, Nadia J; Deshmukh, Sandeep P; Dudiak, Kika M; Harisinghani, Mukesh G; Henrichsen, Tara L; Meyer, Benjamin J; Nyberg, David A; Poder, Liina; Shipp, Thomas D; Zelop, Carolyn M; Glanc, Phyllis

    2016-12-01

    Although there is limited evidence that antepartum testing decreases the risk for fetal death in low-risk pregnancies, women with high-risk factors for stillbirth should undergo antenatal fetal surveillance. The strongest evidence supporting antepartum testing pertains to pregnancies complicated by intrauterine fetal growth restriction secondary to uteroplacental insufficiency. The main ultrasound-based modalities to determine fetal health are the biophysical profile, modified biophysical profile, and duplex Doppler velocimetry. In patients at risk for cardiovascular compromise, fetal echocardiography may also be indicated to ensure fetal well-being. Although no single antenatal test has been shown to be superior, all have high negative predictive values. Weekly or twice-weekly fetal testing has become the standard practice in high-risk pregnancies. The timing for the initiation of assessments of fetal well-being should be tailored on the basis of the risk for stillbirth and the likelihood of survival with intervention. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (the RAND/UCLA Appropriateness Method and the Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  6. ACR Appropriateness Criteria®  Resectable Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Jones William E

    2012-09-01

    Full Text Available Abstract The management of resectable rectal cancer continues to be guided by clinical trials and advances in technique. Although surgical advances including total mesorectal excision continue to decrease rates of local recurrence, the management of locally advanced disease (T3-T4 or N+ benefits from a multimodality approach including neoadjuvant concomitant chemotherapy and radiation. Circumferential resection margin, which can be determined preoperatively via MRI, is prognostic. Toxicity associated with radiation therapy is decreased by placing the patient in the prone position on a belly board, however for patients who cannot tolerate prone positioning, IMRT decreases the volume of normal tissue irradiated. The use of IMRT requires knowledge of the patterns of spreads and anatomy. Clinical trials demonstrate high variability in target delineation without specific guidance demonstrating the need for peer review and the use of a consensus atlas. Concomitant with radiation, fluorouracil based chemotherapy remains the standard, and although toxicity is decreased with continuous infusion fluorouracil, oral capecitabine is non-inferior to the continuous infusion regimen. Additional chemotherapeutic agents, including oxaliplatin, continue to be investigated, however currently should only be utilized on clinical trials as increased toxicity and no definitive benefit has been demonstrated in clinical trials. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to

  7. Endovascular treatment of ruptured distal posterior inferior ...

    African Journals Online (AJOL)

    2014-03-01

    Mar 1, 2014 ... there are lots of reports regarding the interventional therapy of the artery aneurysms (including proximal and distal), all of which are considered to be safe and effective. All the incidences of interventional-related complications are below 10% and there is no report of injury of lower cranial nerves [11, 12].

  8. Urethral mobilization and advancement for distal hypospadias ...

    African Journals Online (AJOL)

    Background/purpose Despite the existence of numerous techniques for the repair of distal penile hypospadias, none of them is completely satisfactory. Advancing the urethra without mobilization for repair of glanular hypospadias has the advantage of avoiding a common problem occurring with other techniques: ...

  9. Technical quality assessment of breast ultrasound according to American College of Radiology (ACR) Standards

    International Nuclear Information System (INIS)

    Ko, Kyung Hee; Kim, Eun Kyung; Kim, Young Ah; Son, Eun Ju; Oh, Ki Keun; Chung, Sun Yang

    2003-01-01

    To evaluate the technical quality of breast ultrasound based on American College of Radiology(ACR) standards. Between March 2002 and July 2002, ninety three breast sonograms obtained from 73 institutions were evaluated based on ACR standards for the hardware, technical settings, labeling of the images and identification. Of 93 breast sonograms, a satisfactory compliance with all ACR standards in the performance of breast US examinations was documented in 31% while the remaining 69% did not fully meet all ACR standards. 4.3% of breast US examinations were performed with a convex transducers, and the focal zone was inappropriately positioned in 14.2%. Gray-scale gain was subjectively characterized as inappropriate in 26.9%, and the size of lesion was not measured in 7.5%. Anatomic location of lesions was inappropriately described in 9.3%. The orientation of an US transducer was not properly labeled on any images in 33.3%. Inadequate recording of patient's information was noted in 43.3%. 50% of sonograms at University medical centers and larger general hospitals fully met all ACR standards while 36.8% at radiologic clinics and 12.1% at other private clinics met all ACR standards. Overall, 69% of breast sonograms failed to meet the quality criteria of the ACR standards. Therefore, it is essential to educate the basic technical details in performing breast US for the quality control.

  10. Pinellas County, Florida Site Environmental Restoration Project Semiannual Progress Report for the 4.5 Acre Site June through November 2016 January 2017

    Energy Technology Data Exchange (ETDEWEB)

    Survochak, Scott [USDOE Office of Legacy Management, Washington, DC (United States); Daniel, Joe [Navarrao Research and Engineering, Inc., Oak Ridge, TN (United States)

    2017-01-01

    This Pinellas County, Florida, Site Environmental Restoration Project Semiannual Progress Report for the 4.5 Acre Site describes environmental restoration activities for the 4.5 Acre Site located in Pinellas County, Largo, Florida (Figure 1). The former U.S. Department of Energy (DOE) Pinellas Plant facility consisted of the 4.5 Acre Site and what is now the STAR Center (Young - Rainey Science, Technology, and Research Center). Both the 4.5 Acre Site and the STAR Center are part of the overall Pinellas County, Florida, Site (Figure 2). The 4.5 Acre Site is located immediately northwest of the STAR Center, in the northeast quarter of Section 13, Township 30 South, Range 15 East. DOE owned this parcel from 1957 to 1972, at which time it was sold to a private landowner. During the period of DOE ownership, the property was used for the disposal of drums of waste resins and solvents. As a result of this practice, the surficial aquifer was impacted by volatile organic compounds (VOCs)—trichloroethene (TCE), cis-1,2-dichloroethene (cDCE), trans-1,2-dichloroethene (tDCE), vinyl chloride (VC), and benzene. Detailed background information for the site is contained in the Long-Term Surveillance and Maintenance Plan for the Pinellas Site (DOE 2016). That document and other site-related documents can be accessed at this website: http://www.lm.doe.gov/Pinellas/Sites.aspx. Recent remediation activities consist of the injection of emulsified soybean oil and the microorganism Dehalococcoides mccartyi (formerly known as Dehalococcoides ethenogenes) into the subsurface in February 2010 and again in July 2013 to enhance contaminant biodegradation (hereafter described as bioinjection). Monitoring the performance of these actions, in the form of monitoring well sampling, is ongoing.

  11. Pinellas County, Florida Site Environmental Restoration Project Semiannual Progress Report for the 4.5 Acre Site June through November 2016 January 2017

    International Nuclear Information System (INIS)

    Survochak, Scott; Daniel, Joe

    2017-01-01

    This Pinellas County, Florida, Site Environmental Restoration Project Semiannual Progress Report for the 4.5 Acre Site describes environmental restoration activities for the 4.5 Acre Site located in Pinellas County, Largo, Florida (Figure 1). The former U.S. Department of Energy (DOE) Pinellas Plant facility consisted of the 4.5 Acre Site and what is now the STAR Center (Young - Rainey Science, Technology, and Research Center). Both the 4.5 Acre Site and the STAR Center are part of the overall Pinellas County, Florida, Site (Figure 2). The 4.5 Acre Site is located immediately northwest of the STAR Center, in the northeast quarter of Section 13, Township 30 South, Range 15 East. DOE owned this parcel from 1957 to 1972, at which time it was sold to a private landowner. During the period of DOE ownership, the property was used for the disposal of drums of waste resins and solvents. As a result of this practice, the surficial aquifer was impacted by volatile organic compounds (VOCs)-trichloroethene (TCE), cis-1,2-dichloroethene (cDCE), trans-1,2-dichloroethene (tDCE), vinyl chloride (VC), and benzene. Detailed background information for the site is contained in the Long-Term Surveillance and Maintenance Plan for the Pinellas Site (DOE 2016). That document and other site-related documents can be accessed at this website: http://www.lm.doe.gov/Pinellas/Sites.aspx. Recent remediation activities consist of the injection of emulsified soybean oil and the microorganism Dehalococcoides mccartyi (formerly known as Dehalococcoides ethenogenes) into the subsurface in February 2010 and again in July 2013 to enhance contaminant biodegradation (hereafter described as bioinjection). Monitoring the performance of these actions, in the form of monitoring well sampling, is ongoing.

  12. 76 FR 26775 - Advisory Committee on Reactor Safeguards Meeting of the ACRS Subcommittee on EPR; Cancellation to...

    Science.gov (United States)

    2011-05-09

    ... NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards Meeting of the ACRS Subcommittee on EPR; Cancellation to May 11, 2011, ACRS Meeting-- Federal Register Notice The Federal Register Notice for the ACRS Subcommittee Meeting on the design certification application review of the U.S...

  13. Genetic diversity of "Pimenta Longa" genotypes (Piper spp., Piperaceae) of the Embrapa Acre germplasm collection

    OpenAIRE

    Wadt, Lúcia Helena de Oliveira; Ehringhaus, Christiane; Kageyama, Paulo Yoshio

    2004-01-01

    The commonly known Pimenta longa is a commercially valuable natural resource found wild in Acre, Brazil. Specifically, three Piperaceae species with contested taxonomic status were studied, Piper hispidinervum, Piper aduncum, and Piper hispidum, to assesses the inter- and intra-specific genetic relationship of 49 Piper genotypes kept in the Pimenta longa germplasm collection at Embrapa Acre, using sixty six Random Amplified Polymorphic DNA (RAPD) markers. The DNA polymorphism level detected w...

  14. Breast imaging and reporting data system - Mammography. ACR BI-RADS registered -Mammography

    International Nuclear Information System (INIS)

    Fischer, U.; Helbrich, T.

    2006-01-01

    ACR BI-RADS registered mammography is an established technique in all German-speaking countries and has become a standard part of all mammographic findings. The first German-language edition three years ago made a significant contribution to this. This is the second, revised and edited edition. It is based on the fourth English-language edition of the ACR which was published in 2003. (orig.)

  15. Distal displacement of the maxilla and the upper first molar.

    Science.gov (United States)

    Baumrind, S; Molthen, R; West, E E; Miller, D M

    1979-06-01

    Data from a sample of 198 Class II cases treated with various appliances which deliver distally directed forces to the maxilla were examined to determine the frequency of absolute distal displacement of the upper first molar and of the maxilla. Analysis revealed that such distal displacement is possible and that it is, in fact, a frequent finding following treatment. Long-range stability of distal displacement was not assessed.

  16. Distal radioulnar joint: functional anatomy, including pathomechanics.

    Science.gov (United States)

    Haugstvedt, J R; Langer, M F; Berger, R A

    2017-05-01

    The distal radioulnar joint allows the human to rotate the forearm to place the hand in a desired position to perform different tasks, without interfering with the grasping function of the hand. The ulna is the stable part of the forearm around which the radius rotates; the stability of the distal radioulnar joint is provided by the interaction between ligaments, muscles and bones. The stabilizing structures are the triangular fibrocartilage complex, the ulnocarpal ligament complex, the extensor carpi ulnaris tendon and tendon sheath, the pronator quadratus, the interosseous membrane and ligament, the bone itself and the joint capsule. The purpose of this review article is to present and illustrate the current understanding of the functional anatomy and pathomechanics of this joint.

  17. Distal Stressors and Depression among Homeless Men

    OpenAIRE

    Coohey, Carol; Easton, Scott D.

    2016-01-01

    Depression is a common problem among homeless men that may interfere with functional tasks, such as securing stable housing, obtaining employment, and accessing health services. Previous research on depression among homeless men has largely focused on current psychosocial resources, substance abuse, and past victimization. Guided by Ensel and Lin’s life course stress process model, the authors examined whether distal stressors, including victimization and exposure to parent problems in childh...

  18. Validation of MCNP and WIMS-AECL/DRAGON/RFSP for ACR-1000 applications

    International Nuclear Information System (INIS)

    Bromley, Blair P.; Adams, Fred P.; Zeller, Michael B.; Watts, David G.; Shukhman, Boris V.; Pencer, Jeremy

    2008-01-01

    This paper gives a summary of the validation of the reactor physics codes WIMS-AECL, DRAGON, RFSP and MCNP5, which are being used in the design, operation, and safety analysis of the ACR-1000 R . The standards and guidelines being followed for code validation of the suite are established in CSA Standard N286.7-99 and ANS Standard ANS-19.3-2005. These codes are being validated for the calculation of key output parameters associated with various reactor physics phenomena of importance during normal operations and postulated accident conditions in an ACR-1000 reactor. Experimental data from a variety of sources are being used for validation. The bulk of the validation data is from critical experiments in the ZED-2 research reactor with ACR-type lattices. To supplement and complement ZED-2 data, qualified and applicable data are being taken from other power and research reactors, such as existing CANDU R units, FUGEN, NRU and SPERT research reactors, and the DCA critical facility. MCNP simulations of the ACR-1000 are also being used for validating WIMS-AECL/ DRAGON/RFSP, which involves extending the validation results for MCNP through the assistance of TSUNAMI analyses. Code validation against commissioning data in the first-build ACR-1000 will be confirmatory. The code validation is establishing the biases and uncertainties in the calculations of the WIMS-AECL/DRAGON/RFSP suite for the evaluation of various key parameters of importance in the reactor physics analysis of the ACR-1000. (authors)

  19. Fractures of the distal phalanx in the horse

    International Nuclear Information System (INIS)

    Yovich, J.V.

    1989-01-01

    Fractures of the distal phalanx are an important cause of lameness referable to the foot. Depending on the fracture configuration and articular involvement, conservative or surgical treatment may be required. Fractures of the distal phalanx have been divided into six categories based on fracture configuration. Discussion of clinical features, management, and prognosis for horses with distal phalangeal fractures is presented for each fracture type

  20. Nonunions of the distal tibia treated by reamed intramedullary nailing

    NARCIS (Netherlands)

    Richmond, Jeffrey; Colleran, Kevin; Borens, Olivier; Kloen, Peter; Helfet, David L.

    2004-01-01

    The purpose of this study is to determine the efficacy of reamed intramedullary nailing in the treatment of nonunions of the distal one-fourth of the tibia. Nonunions of the distal tibia are particularly difficult to treat given the short distal segment, the proximity to the ankle joint, and the

  1. Management and treatment of distal ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Andrea Calafiore

    2013-12-01

    Full Text Available Ulcerative colitis (UC is a chronic inflammatory condition that is confined to the colonic mucosa. Its main symptoms include diarrhea, rectal bleeding and abdominal pain. Approximately two-thirds of UC patients have disease confined distal to the splenic flexure, which can be treated effectively with topical therapy. This means the active drug can be delivered directly to the site of inflammation, limiting the systemic absorption and potential side effects. Topical treatment with aminosalicylates is the most effective approach in the treatment of these forms, provided that the formulation reaches the upper margin of the disease. Given this, the suppository formulation is the treatment of choice for proctitis and distal sigmoiditis. Thanks to their proximal spread, enemas, foams and gels represent the treatment of choice for proctosigmoiditis and for distal ulcerative colitis. Oral aminosalicylates are less effective than topical therapies in patients with active disease, while the combination of topical and oral treatment is more effective in patients refractory to topical or oral mono-therapy. Topically administered aminosalicylates play an important role in the maintenance of remission, but the long-term adhesion to therapy is poor. For this reason, the oral formulation is the first-line therapy in the maintenance of remission. Refractory patients can be treated with topical steroids or systemic steroids and TNF-alpha inhibitors in severe forms.

  2. Distal Embolic Protection for Renal Arterial Interventions

    International Nuclear Information System (INIS)

    Dubel, Gregory J.; Murphy, Timothy P.

    2008-01-01

    Distal or embolic protection has intuitive appeal for its potential to prevent embolization of materials generated during interventional procedures. Distal protection devices (DPDs) have been most widely used in the coronary and carotid vascular beds, where they have demonstrated the ability to trap embolic materials and, in some cases, to reduce complications. Given the frequency of chronic kidney disease in patients with renal artery stenosis undergoing stent placement, it is reasonable to propose that these devices may play an important role in limiting distal embolization in the renal vasculature. Careful review of the literature reveals that atheroembolization does occur during renal arterial interventions, although it often goes undetected. Early experience with DPDs in the renal arteries in patients with suitable anatomy suggests retrieval of embolic materials in approximately 71% of cases and renal functional improvement/stabilization in 98% of cases. The combination of platelet inhibition and a DPD may provide even greater benefit. Given the critical importance of renal functional preservation, it follows that everything that can be done to prevent atheroembolism should be undertaken including the use of DPDs when anatomically feasible. The data available at this time support a beneficial role for these devices

  3. pH-induced conformational changes of AcrA, the membrane fusion protein of Escherichia coli multidrug efflux system.

    Science.gov (United States)

    Ip, Hermia; Stratton, Kelly; Zgurskaya, Helen; Liu, Jun

    2003-12-12

    The multidrug efflux system AcrA-AcrB-TolC of Escherichia coli expels a wide range of drugs directly into the external medium from the bacterial cell. The mechanism of the efflux process is not fully understood. Of an elongated shape, AcrA is thought to span the periplasmic space coordinating the concerted operation of the inner and outer membrane proteins AcrB and TolC. In this study, we used site-directed spin labeling (SDSL) EPR (electron paramagnetic resonance) spectroscopy to investigate the molecular conformations of AcrA in solution. Ten AcrA mutants, each with an alanine to cysteine substitution, were engineered, purified, and labeled with a nitroxide spin label. EPR analysis of spin-labeled AcrA variants indicates that the side chain mobilities are consistent with the predicted secondary structure of AcrA. We further demonstrated that acidic pH induces oligomerization and conformational change of AcrA, and that the structural changes are reversible. These results suggest that the mechanism of action of AcrA in drug efflux is similar to the viral membrane fusion proteins, and that AcrA actively mediates the efflux of substrates.

  4. Maxillary molar distalization with the dual-force distalizer supported by mini-implants: a clinical study.

    Science.gov (United States)

    Oberti, Giovanni; Villegas, Carlos; Ealo, Martha; Palacio, John Camilo; Baccetti, Tiziano

    2009-03-01

    The objective of this prospective study was to describe the clinical effects of a bone-supported molar distalizing appliance, the dual-force distalizer. The study group included 16 patients (mean age, 14.3 years) with Class II molar relationships. Study models and lateral cephalograms were taken before and after the distalizing movement to record significant dental and skeletal changes (Wilcoxon test). The average distalization time was 5 months, with a movement rate of 1.2 mm per month; the distalization amounts were 5.9 +/- 1.72 mm at the crown level and 4.4 +/- 1.41 mm at the furcation level. The average molar inclination was 5.6 degrees +/- 3.7 degrees ; this was less than the amount of inclination generated by bone-supported appliances that use single distalizing forces. The correlation between inclination and distalization was not significant, indicating predominantly bodily movement. The teeth anterior to the first molar moved distally also; the second premolars distalized an average of 4.26 mm, and the incisors retruded by 0.53 mm. The dual-force distalizer is a valid alternative distalizing appliance that generates controlled molar distalization with a good rate of movement and no loss of anchorage.

  5. Robotic distal pancreatectomy versus conventional laparoscopic distal pancreatectomy: a comparative study for short-term outcomes.

    Science.gov (United States)

    Lai, Eric C H; Tang, Chung Ngai

    2015-09-01

    Robotic system has been increasingly used in pancreatectomy. However, the effectiveness of this method remains uncertain. This study compared the surgical outcomes between robot-assisted laparoscopic distal pancreatectomy and conventional laparoscopic distal pancreatectomy. During a 15-year period, 35 patients underwent minimally invasive approach of distal pancreatectomy in our center. Seventeen of these patients had robot-assisted laparoscopic approach, and the remaining 18 had conventional laparoscopic approach. Their operative parameters and perioperative outcomes were analyzed retrospectively in a prospective database. The mean operating time in the robotic group (221.4 min) was significantly longer than that in the laparoscopic group (173.6 min) (P = 0.026). Both robotic and conventional laparoscopic groups presented no significant difference in spleen-preservation rate (52.9% vs. 38.9%) (P = 0.505), operative blood loss (100.3 ml vs. 268.3 ml) (P = 0.29), overall morbidity rate (47.1% vs. 38.9%) (P = 0.73), and post-operative hospital stay (11.4 days vs. 14.2 days) (P = 0.46). Both groups also showed no perioperative mortality. Similar outcomes were observed in robotic distal pancreatectomy and conventional laparoscopic approach. However, robotic approach tended to have the advantages of less blood loss and shorter hospital stay. Further studies are necessary to determine the clinical position of robotic distal pancreatectomy.

  6. Clinical Image Evaluation of Film Mammograms in Korea: Comparison with the ACR Standard

    International Nuclear Information System (INIS)

    Gwak, Yeon Joo; Kim, Hye Jung; Kwak, Jin Young; Son, Eun Ju; Ko, Kyung Hee; Lee, Jin Hwa; Lim, Hyo Soon; Lee, You Jin; Park, Ji Won; Shin, Kyung Min; Jang, Yun-Jin

    2013-01-01

    The goal of this study is to compare the overall quality of film mammograms taken according to the Korean standards with the American College of Radiology (ACR) standard for clinical image evaluation and to identify means of improving mammography quality in Korea. Four hundred and sixty eight sets of film mammograms were evaluated with respect to the Korean and ACR standards for clinical image evaluation. The pass and failure rates of mammograms were compared by medical facility types. Average scores in each category of the two standards were evaluated. Receiver operating characteristic curve analysis was used to identify an optimal Korean standard pass mark by taking the ACR standard as the reference standard. 93.6% (438/468) of mammograms passed the Korean standard, whereas only 80.1% (375/468) passed the ACR standard (p < 0.001). Non-radiologic private clinics had the lowest pass rate (88.1%: Korean standard, 71.8%: ACR standard) and the lowest total score (76.0) by the Korean standard. Average scores of positioning were lowest (19.3/29 by the Korean standard and 3.7/5 by the ACR standard). A cutoff score of 77.0 for the Korean standard was found to correspond to a pass level when the ACR standard was applied. We suggest that tighter regulations, such as, raising the Korean pass mark, subtracting more for severe deficiencies, or considering a very low scores in even a single category as failure, are needed to improve the quality of mammography in Korea

  7. Lack of AcrB Efflux Function Confers Loss of Virulence on Salmonella enterica Serovar Typhimurium

    Directory of Open Access Journals (Sweden)

    Xuan Wang-Kan

    2017-07-01

    Full Text Available AcrAB-TolC is the paradigm resistance-nodulation-division (RND multidrug resistance efflux system in Gram-negative bacteria, with AcrB being the pump protein in this complex. We constructed a nonfunctional AcrB mutant by replacing D408, a highly conserved residue essential for proton translocation. Western blotting confirmed that the AcrB D408A mutant had the same native level of expression of AcrB as the parental strain. The mutant had no growth deficiencies in rich or minimal medium. However, compared with wild-type SL1344, the mutant had increased accumulation of Hoechst 33342 dye and decreased efflux of ethidium bromide and was multidrug hypersusceptible. The D408A mutant was attenuated in vivo in mouse and Galleria mellonella models and showed significantly reduced invasion into intestinal epithelial cells and macrophages in vitro. A dose-dependent inhibition of invasion was also observed when two different efflux pump inhibitors were added to the wild-type strain during infection of epithelial cells. RNA sequencing (RNA-seq revealed downregulation of bacterial factors necessary for infection, including those in the Salmonella pathogenicity islands 1, 2, and 4; quorum sensing genes; and phoPQ. Several general stress response genes were upregulated, probably due to retention of noxious molecules inside the bacterium. Unlike loss of AcrB protein, loss of efflux function did not induce overexpression of other RND efflux pumps. Our data suggest that gene deletion mutants are unsuitable for studying membrane transporters and, importantly, that inhibitors of AcrB efflux function will not induce expression of other RND pumps.

  8. Distal protection filter device efficacy with carotid artery stenting: comparison between a distal protection filter and a distal protection balloon.

    Science.gov (United States)

    Iko, Minoru; Tsutsumi, Masanori; Aikawa, Hiroshi; Matsumoto, Yoshihisa; Go, Yoshinori; Nii, Kouhei; Abe, Gorou; Ye, Iwae; Nomoto, Yasuyuki; Kazekawa, Kiyoshi

    2013-01-01

    This retrospective study aimed to compare the effectiveness of the embolization prevention mechanism of two types of embolic protection device (EPD)-a distal protection balloon (DPB) and a distal protection filter (DPF). Subjects were 164 patients scheduled to undergo carotid artery stenting: a DPB was used in 82 cases (DPB group) from April 2007 until June 2010, and a DPF was used in 82 cases (DPF group) from July 2010 to July 2011. Rates of positive findings on postoperative diffusion-weighted imaging (DWI) and stroke incidence were compared. Positive postoperative DWI results were found in 34 cases in the DPB group (41.4 %), but in only 22 cases in the DPF group (26.8 %), and there was only a small significant difference within the DPF group. In the DPB group, there was one case of transient ischemic attack (TIA) (1.2 %) and four cases of brain infarction (2 minor strokes, 2 major strokes; 4.9 %), compared to the DFP group with one case of TIA (1.2 %) and no cases of minor or major strokes. In this study, significantly lower rates of occurrence of DWI ischemic lesions and intraoperative embolization were associated with use of the DPF compared to the DPB.

  9. Enhanced

    Directory of Open Access Journals (Sweden)

    Martin I. Bayala

    2014-06-01

    Full Text Available Land Surface Temperature (LST is a key parameter in the energy balance model. However, the spatial resolution of the retrieved LST from sensors with high temporal resolution is not accurate enough to be used in local-scale studies. To explore the LST–Normalised Difference Vegetation Index relationship potential and obtain thermal images with high spatial resolution, six enhanced image sharpening techniques were assessed: the disaggregation procedure for radiometric surface temperatures (TsHARP, the Dry Edge Quadratic Function, the Difference of Edges (Ts∗DL and three models supported by the relationship of surface temperature and water stress of vegetation (Normalised Difference Water Index, Normalised Difference Infrared Index and Soil wetness index. Energy Balance Station data and in situ measurements were used to validate the enhanced LST images over a mixed agricultural landscape in the sub-humid Pampean Region of Argentina (PRA, during 2006–2010. Landsat Thematic Mapper (TM and Moderate Resolution Imaging Spectroradiometer (EOS-MODIS thermal datasets were assessed for different spatial resolutions (e.g., 960, 720 and 240 m and the performances were compared with global and local TsHARP procedures. Results suggest that the Ts∗DL technique is the most adequate for simulating LST to high spatial resolution over the heterogeneous landscape of a sub-humid region, showing an average root mean square error of less than 1 K.

  10. Mini-implant-supported Molar Distalization

    Directory of Open Access Journals (Sweden)

    Amit Goyal

    2012-01-01

    Full Text Available Temporary anchorage devices popularly called mini-implants or miniscrews are the latest addition to an orthodontist′s armamentarium. The following case report describes the treatment of a 16-year-old girl with a pleasant profile, moderate crowding and Angle′s Class II molar relationship. Maxillary molar distalization was planned and mini-implants were used to preserve the anterior anchorage. After 13 months of treatment, Class I molar and canine relation was achieved bilaterally and there was no anterior proclination. Thus, mini-implants provide a viable option to the clinician to carry out difficult tooth movements without any side effects.

  11. Periosteal osteoblastoma of the distal femur

    Energy Technology Data Exchange (ETDEWEB)

    Nakatani, Tetsuya; Yamamoto, Tetsuji; Akisue, Toshihiro; Marui, Takashi; Hitora, Toshiaki; Kawamoto, Teruya; Nagira, Keiko; Yoshiya, Shinichi; Kurosaka, Masahiro [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe (Japan); Fujita, Ikuo; Matsumoto, Keiji [Department of Orthopaedic Surgery, Hyogo Medical Center for Adults, Akashi, Hyogo (Japan)

    2004-02-01

    Osteoblastomas located on the surface of the cortical bone, so-called periosteal osteoblastomas, are extremely rare. We report on a case of periosteal osteoblastoma arising from the posterior surface of the right distal femur in a 17-year-old man. Roentgenographic, computed tomographic, magnetic resonance imaging, and histologic features of the case are presented. Periosteal osteoblastoma should be radiologically and histologically differentiated from myositis ossificans, avulsive cortical irregularity syndrome, osteoid osteoma, parosteal osteosarcoma, periosteal osteosarcoma, and high-grade surface osteosarcoma. Although periosteal osteoblastoma is rare, this tumor should be included in the differential diagnosis of surface-type bone tumors. (orig.)

  12. The application of ZED-2 data in the design and analysis of the ACR-1000

    International Nuclear Information System (INIS)

    Dweiri, Y.

    2011-01-01

    The presentation discusses how data obtained from experiments performed in the ZED-2 Critical Facility at Atomic Energy of Canada Limited's Chalk River Laboratories is used in the design and analysis of the ACR-1000. The ACR-1000 design is an evolutionary advancement of the well-established CANDU Reactor technology to Generation 3+. When key core physics parameters for the ACR-1000 are calculated, biases and uncertainties in using the reactor physics toolset WIMS AECL/DRAGON/RFSP and MCNP must be quantified to be able to appropriately assess safety margins in the design. A unique feature of ZED-2 is the ability to perform a wide variety of experiments which is important in providing data that is used in the design and analysis of the ACR-1000. The ACR-1000 was designed to have a small and slightly negative coolant-void-reactivity (CVR), which provides an inherent safety characteristic to mitigate the reactivity transient under any postulated loss-of-coolant accident (LOCA) scenarios. The bias and uncertainty for CVR (full and checkerboard) calculations, derived through comparisons with experimental data, is pivotal to assess the accuracy of the predicted CVR value. This bias and uncertainty is also used in important LOCA analysis to demonstrate the safety features of the ACR-1000. This crucial physics information is available through experiments performed in ZED-2. Other important data that is obtained from ZED-2 in assessing core design pertains to end-flux peaking and in-core flux detector response. The end-region configuration of ACR fuel bundles is an important component of the design, as the axial power distribution within the bundle is not uniform. Detector response in an ACR flux spectrum is important to determine the suitability of safety system detectors when used in the ACR-1000 core. These applications demonstrate the versatility of ZED-2 in providing important reactor physics data makes this critical facility indispensible in current and future R and D

  13. Usefulness of ACR MRI phantom for quality assurance of MRI instruments

    International Nuclear Information System (INIS)

    Lee, Jung Whee; Ahn, Kook Jin; Lee, Seung Koo; Na, Dong Gyu; Oh, Chang Hyun; Chang, Yong Min; Lim, Tae Hwan

    2006-01-01

    To examine whether the ACR phantom could be used in quality standards for magnetic resonance imaging (MRI) instruments in Korea. We conducted the phantom test using the ACR MRI phantom in 20 MRI instruments currently used in Korea. According to ACR criteria, we acquired the phantom images which were then assessed by the following seven tests: geometric accuracy, high spatial resolution, slice thickness accuracy, slice position accuracy, image intensity uniformity, percent signal ghosting, and low contrast object detectability. The phantom images were interpreted by three experienced radiologists according to ACR criteria. Then, we examined the failure rate of each test and evaluated the inter-observer variation in the measurements and test failure. The failure rate of each test could be broken into the following components: geometric accuracy (11-21%), high contrast spatial resolution (10-15%), slice thickness accuracy(6-22%), slice position accuracy (5-17%), image intensity uniformity (6%), percent signal ghosting (16%), and low contrast object detectability (8-10%). In this series, all the failure rates were less than 30%. In addition, no inter-observer variation was seen in the measurements and test failure. ACR MRI phantom promises to be established as the standard phantom for MRI instruments in Korea because of its objectivity in assessing the phantom images

  14. Coarse-grained Simulations of Substrate Export through Multidrug Efflux Transporter AcrB

    Science.gov (United States)

    Jewel, Yead; Dutta, Prashanta; Liu, Jin

    2017-11-01

    The treatment of bacterial infectious diseases hampered by the overexpression of multidrug resistance (MDR) systems. The MDR system actively pumps the antibiotic drugs as well as other toxic compounds out of the cells. During the pumping, AcrB (one of the key MDR components) undergoes a series of large-scale proton/substrate dependent conformational changes. In this work, we implement a hybrid coarse-grained PACE force field that couples the united-atom protein model with the coarse-grained MARTINI water/lipid, to investigate the conformational changes of AcrB. We first develop the substrate force field which is compatible with PACE, then we implement the force field to explore large scale structural changes of AcrB in microsecond simulations. The effects of the substrate and the protonation states of two key residues: Asp407 and Asp408, are investigated. Our results show that the drug export through AcrB is proton as well as substrate dependent. Our simulations explain molecular mechanisms of substrate transport through AcrB complex, as well as provide valuable insights for designing proper antibiotic drugs. Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number R01GM122081.

  15. Radiographic anatomy of the distal dural SAC

    International Nuclear Information System (INIS)

    Larsen, J.L.; Olsen, K.O.

    1991-01-01

    A radio-anatomical study was performed of the distal dural sac (DS) in 121 patients subjected to myelography. In 83.4% the termination of the DS was located from the upper half of the S1-segment to the lower half of the S2-segment. In the remaining patients the dural terminations were more distally located. The average location of the DS-termination was higher than that found in a previous anatomic study. The inference is that in patients with low-back pain and sciatica, the DS tends to terminate at a higher spinal level than in a non-selected anatomic material. The caudal reduction in sagittal diameter of the DS was less than that of the frontal diameter of the sac. The linear diminution in cross-sectional area of the DS from the level of L3 towards the lumbosacral junction was not correlated with the degree of caudal extension of the DS into the sacrum. Thus the length of the DS and its transverse diameters are independent of each other. These results supported the view that the location of the termination of the DS (and hence that of the spinal cord) is not related to stenosis of the central spinal canal. (orig.)

  16. Maxillary molar distalization with first class appliance.

    Science.gov (United States)

    Ramesh, Namitha; Palukunnu, Biswas; Ravindran, Nidhi; Nair, Preeti P

    2014-02-27

    Non-extraction treatment has gained popularity for corrections of mild-to-moderate class II malocclusion over the past few decades. The distalization of maxillary molars is of significant value for treatment of cases with minimal arch discrepancy and mild class II molar relation associated with a normal mandibular arch and acceptable profile. This paper describes our experience with a 16-year-old female patient who reported with irregularly placed upper front teeth and unpleasant smile. The patient was diagnosed to have angles class II malocclusion with moderate maxillary anterior crowding, deep bite of 4 mm on a skeletal class II base with an orthognathic maxilla and retrognathic mandible and normal growth pattern. She presented an ideal profile and so molar distalization was planned with the first-class appliance. Molars were distalised by 8 mm on the right and left quadrants and class I molar relation achieved within 4 months. The space gained was utilised effectively to align the arch and establish a class I molar and canine relation.

  17. Dermal pocketing following distal finger replantation.

    Science.gov (United States)

    Puhaindran, Mark E; Paavilainen, Pasi; Tan, David M K; Peng, Yeong Pin; Lim, Aymeric Y T

    2010-08-01

    Replantation is an ideal technique for reconstruction following fingertip amputation as it provides 'like for like' total reconstruction of the nail complex, bone pulp tissue and skin with no donor-site morbidity. However, fingertips are often not replanted because veins cannot be found or are thought to be too small to repair. Attempts at 'cap-plasty' or pocketing of replanted tips with and without microvascular anastomosis have been done in the past with varying degrees of success. We prospectively followed up a group of patients who underwent digital replantation and dermal pocketing in the palm to evaluate the outcome of this procedure. There were 10 patients with 14 amputated digits (two thumbs, five index, four middle, two ring and one little) who underwent dermal pocketing of the amputated digit following replantation. Among the 14 digits that were treated with dermal pocketing, 11 survived completely, one had partial atrophy and two were completely lost. Complications encountered included finger stiffness (two patients) and infection of the replanted fingertip with osteomyelitis of the distal phalanx (one patient). We believe that this technique can help increase the chance of survival for distal replantation with an acceptable salvage rate of 85% in our series. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Osteoid osteoma of the distal clavicle

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    Full Text Available ABSTRACT The osteoid osteoma is a bone tumor that accounts for 10% of benign tumors. It was described in 1935 by Jaffe, as a tumor that affects the young adult population, with a predominance of males. This study aims to present a case of late diagnosis of a patient with osteoid osteoma of the distal clavicle region. Female patient, 44 years old, non-professional volleyball player, reported pain in the anterior and superior region of the shoulder girdle, specifically in the acromioclavicular joint, which worsened at night and had been treated for nine months as tendinitis of the rotator cuff and acromioclavicular joint arthritis. After confirming the diagnosis, the patient underwent open surgery with resection of the distal clavicle. At two years of follow-up, the patient presents without local pain. In the radiographic evaluation, coracoclavicular distance is preserved and there are no signs of recurrence. Tumors of the shoulder girdle are rare and are often diagnosed late. A high degree of suspicion for the diagnosis of tumors of the shoulder girdle is needed in order to avoid late diagnosis.

  19. Biotin absorption by distal rat intestine

    International Nuclear Information System (INIS)

    Bowman, B.B.; Rosenberg, I.H.

    1987-01-01

    We used the in vivo intestinal loop approach, with short (10-min) and long (3-h) incubations, to examine biotin absorption in proximal jejunum, distal ileum, cecum and proximal colon. In short-term studies, luminal biotin disappearance from rat ileum was about half that observed in the jejunum, whereas absorption by proximal colon was about 12% of that in the jejunum. In 3-h closed-loop studies, the absorption of 1.0 microM biotin varied regionally. Biotin absorption was nearly complete in the small intestine after 3 h; however, only about 15% of the dose had been absorbed in the cecum and 27% in the proximal colon after 3 h. Independent of site of administration, the major fraction of absorbed biotin was recovered in the liver; measurable amounts of radioactive biotin were also present in kidney and plasma. The results support the potential nutritional significance for the rat of biotin synthesized by bacteria in the distal intestine, by demonstrating directly an absorptive capability of mammalian large bowel for this vitamin

  20. [Distal ureteral lithiasis. ESWL versus ambulatory URS].

    Science.gov (United States)

    Miján Ortiz, J L; Gutiérrez Tejero, F; López Carmona, F; Nogueras Ocaña, M; Arrabal Martín, M; Zuluaga Gómez, A

    2001-11-01

    To present the results achieved in the treatment of 1802 distal ureteral stones treated at the Lithotripsy Unit of the San Cecilio University Hospital over the last 10 years (1990-2000). Stones were treated by extracorporeal shock wave lithotripsy (ESWL) or ureteroscopy (URS). ESWL was the initial treatment in 81% of the cases (1460 calculi) and URS in the remaining 19% (342 stones). URS was performed for complication or failed ESWL (102 stones) and ESWL was performed for failed URS, basically due to stone migration (24 stones). Ureterolithotomy was required on 7 occasions. Sedation-analgesia with fentanyl and midazolam was routinely used in URS. Sedation was required in only 55% of the ESWL procedures. Elective ESWL resolved 93% of the cases, a percentage which is similar to that achieved with URS as first treatment. The ESWL retreatment rate was 1.3. URS was successful in 98% of the cases of failed ESWL. There are two treatment modalities for stones in the distal ureter: ESWL and URS. We advocate the use of outpatient URS with sedation preferably in the female patient, impacted stones, obstructive uropathy, stones larger than 2 cm and radiotransparent stones.

  1. A STUDY OF SURGICAL MANAGEMENT OF DISTAL FEMORAL FRACTURES BY DISTAL FEMORAL LOCKING COMPRESSION PLATE OSTEOSYNTHESIS

    Directory of Open Access Journals (Sweden)

    Dema Rajaiah

    2016-08-01

    Full Text Available AIMS AND OBJECTIVES To study the fractures of distal end of femur and the mechanism of injury in distal end femur fractures, the advantages and disadvantages of open reduction and internal fixation of distal end femur fractures by distal femoral locking compression plate osteosynthesis and to analyse the outcome in terms of range of Knee motion, time to union, and limb shortening. RESULTS The mean age of patient is 44 years, 85% are males, road traffic accidents account for majority (80%, right side involved in 70%, Muller’s type C fracture is common, good range of movements is seen 90% of cases and union occurred in 95% in 5 months. The results were assessed using Neer’s score, seven (35% patients had excellent results, eight (40% patients had good results, four (20% patients had fair results and one (5% patient had poor result. CONCLUSION From our study, we conclude that DF-LCP is a safe and reliable implant and has shown excellent to satisfactory results in majority of intra-articular fractures (AO type C. Fixation with locking compression plate showed more effectiveness in severely osteoporotic bones, shorter operative stay, faster recovery, faster union rates and excellent functional outcome.

  2. OCORRÊNCIA DE Hypsipyla ferrealis Hampson (LEPIDOPTERA: PYRALIDAE EM ANDIROBA NO ESTADO DO ACRE

    Directory of Open Access Journals (Sweden)

    Rodrigo Souza Santos

    2016-01-01

    Full Text Available ABSTRACT The occurrence of Hypsipyla ferrealis Hampson was reported in the state of Acre, Brazil, infesting andiroba Retirar as palavras “the county of” da frase, pois municipality é sinônimo de county, ou seja, está em duplicidade no texto esta informação in plastic trays containing moistened sand and placed into a net cage at Embrapa Entomology Laboratory in Acre state. The cage was daily inspected in order to find emerged insects which were identified as Hypsipyla ferrealis , a lepidopteran commonly associated as an andiroba seed pest. This is the first record of this species occurring in andiroba seeds in Acre state.

  3. WE-D-16A-01: ACR Radiology Leadership Institute

    International Nuclear Information System (INIS)

    Rubin, G

    2014-01-01

    The Radiology Leadership Institute (RLI) was established in 2011 by the American College of Radiology with a mission to prepare leaders who will shape the future of radiology to ensure quality, elevate service and deliver extraordinary patient care. Leadership skills are critical to medical physicists in order for them to assure that imaging and therapy are safe and of the highest quality possible. This session will provide an introduction to the RLI and its programs with an emphasis on how medical physicists can get involved and what they might expect to gain through their engagement with the RLI. The session will also provide a framework for leadership in healthcare with an emphasis on roles and opportunities for medical physicists to enhance their effectiveness as members of the healthcare, medical education, and research communities

  4. WE-D-16A-01: ACR Radiology Leadership Institute

    Energy Technology Data Exchange (ETDEWEB)

    Rubin, G [Duke Clinical Research Institute, Chapel Hill, NC (United States)

    2014-06-15

    The Radiology Leadership Institute (RLI) was established in 2011 by the American College of Radiology with a mission to prepare leaders who will shape the future of radiology to ensure quality, elevate service and deliver extraordinary patient care. Leadership skills are critical to medical physicists in order for them to assure that imaging and therapy are safe and of the highest quality possible. This session will provide an introduction to the RLI and its programs with an emphasis on how medical physicists can get involved and what they might expect to gain through their engagement with the RLI. The session will also provide a framework for leadership in healthcare with an emphasis on roles and opportunities for medical physicists to enhance their effectiveness as members of the healthcare, medical education, and research communities.

  5. Distal Communication by Chimpanzees (Pan troglodytes): Evidence for Common Ground?

    Science.gov (United States)

    Leavens, David A; Reamer, Lisa A; Mareno, Mary Catherine; Russell, Jamie L; Wilson, Daniel; Schapiro, Steven J; Hopkins, William D

    2015-01-01

    van der Goot et al. (2014) proposed that distal, deictic communication indexed the appreciation of the psychological state of a common ground between a signaler and a receiver. In their study, great apes did not signal distally, which they construed as evidence for the human uniqueness of a sense of common ground. This study exposed 166 chimpanzees to food and an experimenter, at an angular displacement, to ask, "Do chimpanzees display distal communication?" Apes were categorized as (a) proximal or (b) distal signalers on each of four trials. The number of chimpanzees who communicated proximally did not statistically differ from the number who signaled distally. Therefore, contrary to the claim by van der Goot et al., apes do communicate distally. © 2015 The Authors. Child Development © 2015 Society for Research in Child Development, Inc.

  6. Furfural and hydroxymethylfurfural tolerance in Escherichia coli ΔacrR regulatory mutants.

    Science.gov (United States)

    Luhe, Annette Lin; Lim, Chan Yuen; Gerken, Henri; Wu, Jinchuan; Zhao, Hua

    2015-01-01

    The presence of the highly toxic furfural and hydroxymethylfurfural (HMF) in the hydrolysate of lignocellulosic biomass prompted the investigation of the Escherichia coli ΔacrR regulatory mutant for higher tolerance to these compounds, to facilitate the production of biofuels and biochemicals, and further biocatalytic conversions. In comparison with the parental strain, the regulatory mutant with the upregulated efflux pump AcrAB-TolC produced moderately better growth and higher tolerance to concentrations of furfural and HMF between 1 and 2 g L(-1) . © 2014 International Union of Biochemistry and Molecular Biology, Inc.

  7. Relative biological effectiveness (RBE) and distal edge effects of proton radiation on early damage in vivo

    DEFF Research Database (Denmark)

    Sørensen, Brita Singers; Bassler, Niels; Nielsen, Steffen

    2017-01-01

    of the SOBP to behind the distal dose fall-off. Irradiations were performed with the same dose plan at all positions, corresponding to a dose of 31.25 Gy in the middle of the SOBP. Endpoint of the study was early skin damage of the foot, assessed by a mouse foot skin scoring system. RESULTS: The MDD50 values......, where LETd,z =1 was 3.3 keV/μm. CONCLUSIONS: Although there is a need to expand the current study to be able to calculate an exact enhancement ratio, an enhanced biological effect in vivo for early skin damage in the distal edge was demonstrated....

  8. Distal renal tubular acidosis and hepatic lipidosis in a cat.

    Science.gov (United States)

    Brown, S A; Spyridakis, L K; Crowell, W A

    1986-11-15

    Clinical and laboratory evidence of hepatic failure was found in a chronically anorectic cat. Simultaneous blood and urine pH determinations established a diagnosis of distal renal tubular acidosis. The cat did not respond to treatment. Necropsy revealed distal tubular nephrosis and hepatic lipidosis. The finding of distal renal tubular acidosis in a cat with hepatic lipidosis emphasizes the importance of complete evaluation of acid-base disorders in patients.

  9. Post-transplant distal limb syndrome

    Directory of Open Access Journals (Sweden)

    María Florencia Borghi Torzillo

    2017-02-01

    Full Text Available The post-transplant distal limb syndrome is a not well known entity, with a prevalence of 5% in patients with renal transplant. Its diagnosis is based on clinical symptoms, bone scintigraphy and MRI, it has a benign course and the patient recovers without sequel. We present the case of a 37-year-old male, with medical history of hypertension, Berger's disease in 1999 that required dialysis three times a week for four years (2009-2013 and renal transplant in 2013. The patient consults on January 2014 referring severe pain in both feet, with sudden onset; he remembers the exact date of the beginning of the pain and denies trauma, pain prevents ambulation. The bone scintigraphy shows pathological uptake in both feet with no difference between the two. Although there is no treatment for this disease, it has a benign course

  10. Comparison of standard laparoscopic distal pancreatectomy with minimally invasive distal pancreatectomy using the da Vinci S system.

    Science.gov (United States)

    Ito, Masahiro; Asano, Yukio; Shimizu, Tomohiro; Uyama, Ichiro; Horiguchi, Akihiko

    2014-01-01

    Minimally invasive procedures for pancreatic pathologies are increasingly being used, including distal pancreatectomy. This study aimed to assess the indications for and outcomes of the da Vinci distal pancreatectomy procedure. We reviewed the medical records of patients who underwent pancreatic head resection from April 2009 to September 2013. Four patients (mean age, 52.7 years) underwent da Vinci distal pancreatectomy and 10 (mean age, 68.0 +/- 12.1 years) underwent laparoscopic distal pancreatectomy. The mean surgical duration was 292 +/- 153 min and 306 +/- 29 min, the mean blood loss was 153 +/- 71 mL and 61.7 +/- 72 mL, and the mean postoperative length of stay was 24 +/- 11 days and 14 +/- 3 days in the da Vinci distal pancreatectomy and laparoscopic distal pancreatectomy groups, respectively. One patient who underwent da Vinci distal pancreatectomy developed a pancreatic fistula, while 2 patients in the laparoscopic distal pancreatectomy group developed splenic ischemia and gastric torsion, respectively. Laparoscopic and robotic pancreatic resection were both safe and feasible in selected patients with distal pancreatic pathologies. Further studies are necessary to clarify the role of robotic surgery in the advanced laparoscopic era.

  11. Morphometric traits in arbor-acres broiler chicken ( Gallus gallus )fed ...

    African Journals Online (AJOL)

    Fifty sixth day morphometric and body weight measurements were taken on one hundred and forty eight Arbor Acres broiler chickens reared under the Deep Litter system in the guinea savana Zone of Nigeria. This study aimed to determine the effects of substituting treated and untreated Cocoa Bean Shell (CBS) at 50 and ...

  12. SUBSURFACE DESIGN SUPPORT LOW THERMAL LOAD REPOSITORY (25 MTU/ACRE)

    International Nuclear Information System (INIS)

    T.M. Lahnalampi

    1999-01-01

    The objective of this document is to present a comparison between the Viability Assessment Design Layout and a 25 MTU/acre conceptual repository design. The scope of this analysis is comparing the linear dimensions and the quantities of the major design elements, for example, emplacement drifts, perimeter mains, exhaust mains, performance confirmation drifts, connecting ramps and vertical development

  13. Strategy for 100-year life of the ACR-1000 concrete containment structure

    International Nuclear Information System (INIS)

    Abrishami, H.; Elgohary, M.

    2006-01-01

    The purpose of this paper is to present the Plant Life Management (PLiM) strategy for the concrete containment structure of the ACR-1000 (Advanced CANDU Reactor) designed by AECL. The ACR-1000 is designed for 100-year plant life including 60-year operating life and additional 40-year decommissioning period of time. The approach adopted for the PLiM strategy of the concrete containment structure is a preventive one, key areas being: 1) design methodology, 2) material performance and 3) life cycle management and ageing management program. In the design phase, in addition to strength and serviceability, durability is a major requirement during the service life and decommissioning phase of the ACR structure. Parameters affecting durability design include: a) concrete performance, b) structural application, and c) environmental conditions. Due to the complex nature of the environmental effects acting on structures during the service life of project, it is considered that true improved performance during the service life can be achieved by improving the material characteristics. Many recent innovations in advanced concrete materials technology have made it possible to produce modern concrete such as high-performance concrete with exceptional performance characteristics. In this paper, the PLiM strategy for the ACR-1000 concrete containment is presented. In addition to addressing the design methodology and material performance areas, a systematic approach for ageing management program for the concrete containment structure is presented. (author)

  14. Family Forest Ownerships with 10+ Acres in Texas, 2011-2013

    Science.gov (United States)

    Brett J. Butler; Sarah M. Butler

    2016-01-01

    The U.S. Forest Service, Forest Inventory and Analysis program conducts the National Woodland Owner Survey in order to better understand: who owns America's forests, why they own it, what they have done with it in the past, and what they intend to do with it in the future. This document summarizes data on family forest ownerships with 10+ acres in Texas. These...

  15. Subchannel flow analysis in Candu and ACR pressure tubes with radial and axial diameter variation

    Energy Technology Data Exchange (ETDEWEB)

    Catana, A.; Prodea, L. [RAAN, Institute for Nuclear Research, Arges (Romania); Danila, N.; Prisecaru, I.; Dupleac, D. [Bucharest Univ. Politehnica(Romania)

    2007-07-01

    The Candu (Canada Deuterium Uranium) and ACR (Advanced Candu Reactor) are pressure tubes (PT) heavy water moderated reactors. Candu are heavy water and ACR are light water cooled reactors. The pressure tube is filled with 12 bundles, each consisting of 37 respectively 43 fuel rods. One Candu reactor is in operation at Cernavoda, Romania since 1996. ACR is a proposed advanced Candu. PT diameter variation has a significant impact on the thermal-hydraulic parameters. Almost all thermal-hydraulic parameters change, but some of them have a greater significance. In this work we have considered a set of radial and axial PT diameter variations both for Candu-600 and ACR-700 reactors using various types of fuel bundles. We can conclude the following: 1) some thermal-hydraulic parameters are significantly influenced: critical heat flux (CHF), pressure drop, or void fraction; 2) the most significant parameter CHF is worsening which reduces the safety margin; 3) some fuel types present a better thermal-hydraulic behavior; and 4) fuel bundles with fresh fuel or low burnup have a worse thermal-hydraulic behaviour than those at average burn-up.

  16. Subchannel flow analysis in Candu and ACR pressure tubes with radial and axial diameter variation

    International Nuclear Information System (INIS)

    Catana, A.; Prodea, L.; Danila, N.; Prisecaru, I.; Dupleac, D.

    2007-01-01

    The Candu (Canada Deuterium Uranium) and ACR (Advanced Candu Reactor) are pressure tubes (PT) heavy water moderated reactors. Candu are heavy water and ACR are light water cooled reactors. The pressure tube is filled with 12 bundles, each consisting of 37 respectively 43 fuel rods. One Candu reactor is in operation at Cernavoda, Romania since 1996. ACR is a proposed advanced Candu. PT diameter variation has a significant impact on the thermal-hydraulic parameters. Almost all thermal-hydraulic parameters change, but some of them have a greater significance. In this work we have considered a set of radial and axial PT diameter variations both for Candu-600 and ACR-700 reactors using various types of fuel bundles. We can conclude the following: 1) some thermal-hydraulic parameters are significantly influenced: critical heat flux (CHF), pressure drop, or void fraction; 2) the most significant parameter CHF is worsening which reduces the safety margin; 3) some fuel types present a better thermal-hydraulic behavior; and 4) fuel bundles with fresh fuel or low burnup have a worse thermal-hydraulic behaviour than those at average burn-up

  17. Methodology for predicting ultimate pressure capacity of the ACR-1000 containment structure

    International Nuclear Information System (INIS)

    Saudy, A.M.; Awad, A.; Elgohary, M.

    2006-01-01

    The Advanced CANDU Reactor or the ACR-1000 is developed by Atomic Energy of Canada Limited (AECL) to be the next step in the evolution of the CANDU product line. It is based on the proven CANDU technology and incorporates advanced design technologies. The ACR containment structure is an essential element of the overall defense in depth approach to reactor safety, and is a physical barrier against the release of radioactive material to the environment. Therefore, it is important to provide a robust design with an adequate margin of safety. One of the key design requirements of the ACR containment structure is to have an ultimate pressure capacity that is at least twice the design pressure Using standard design codes, the containment structure is expected to behave elastically at least up to 1.5 times the design pressure. Beyond this pressure level, the concrete containment structure with reinforcements and post-tension tendons behaves in a highly non-linear manner and exhibits a complex response when cracks initiate and propagate. To predict the structural non-linear responses, at least two critical features are involved. These are: the structural idealization by the geometry and material property models, and the adopted solution algorithm. Therefore, detailed idealization of the concrete structure is needed in order to accurately predict its ultimate pressure capacity. This paper summarizes the analysis methodology to be carried out to establish the ultimate pressure capacity of the ACR containment structure and to confirm that the structure meets the specified design requirements. (author)

  18. Family Forest Ownerships with 10+ Acres in Pennsylvania, 2011-2013

    Science.gov (United States)

    Brett J. Butler; Sarah M. Butler

    2016-01-01

    The U.S. Forest Service, Forest Inventory and Analysis program conducts the National Woodland Owner Survey in order to better understand: who owns America's forests, why they own it, what they have done with it in the past, and what they intend to do with it in the future. This document summarizes data on family forest ownerships with 10+ acres in Pennsylvania....

  19. Primeiro registro de Zaprionus indianus Gupta (Diptera: Drosophilidae no Estado do Acre

    Directory of Open Access Journals (Sweden)

    Adriana Vasconcelos

    2017-04-01

    Abstract. This work makes reference to the first record of Zaprionus indianus Gupta (Diptera: Drosophilidae found in carambola fruits (Averrhoa carambola L. in a residential yard located in the county of Rio Branco, Acre, Brazil. The emerged flies were preserved in flasks containing 70% alcohol and identified by the characteristics of the anterior left leg and the male’s genitalia.

  20. First record of Ceratitis capitata (Wiedemann (Diptera: Tephritidae in the state of Acre, Brazil

    Directory of Open Access Journals (Sweden)

    Ricardo Adaime

    2017-12-01

    Resumo. Registra-se pela primeira vez a presença de Ceratitis capitata (Wiedemann (Diptera: Tephritidae no estado do Acre, Brasil, a partir de frutos de goiabeira (Psidium guajava L. e de caramboleira (Averrhoacarambola L., aumentando o conhecimento dos registros geográficos dessa mosca na Amazônia brasileira.

  1. [Comparison of laparoscopic distal pancreatectomy and open distal pancreatectomy in pancreatic ductal adenocarcinoma].

    Science.gov (United States)

    Xu, K; Su, J J; Su, M; Yan, L; Feng, J; Xin, X L; Chen, Y L

    2017-10-23

    Objective: To compare and evaluate the curative effect of laparoscopic distal pancreatectomy(LDP) and traditional open distal pancreatectomy(ODP) in pancreatic ductal adenocarcinoma. Methods: The clinical data of 15 patients treated by LDP and 87 contemporaneous cases treated by ODP from January 2010 to November 2015 was collected, and the curative effect and prognosis of these patients were retrospectively analyzed. Results: The operation time of LDP group was (286.5±48.1) min, significantly longer than that of OPD group(226.6±56.8) min ( P 0.05). In both LDP group and ODP group, none occurred percutaneous drainage, re-admissions, second operation or perioperative death. Conclusions: Compared to ODP, LDP is much safer and more steady in perioperative periodand operation. Patients of pancreatic ductal adenocarcinoma received LDP can acquire more benefit and recovery sooner, and LDP is a safe and effective operative method.

  2. The AcrB efflux pump: conformational cycling and peristalsis lead to multidrug resistance.

    Science.gov (United States)

    Seeger, Markus A; Diederichs, Kay; Eicher, Thomas; Brandstätter, Lorenz; Schiefner, André; Verrey, François; Pos, Klaas M

    2008-09-01

    Antimicrobial resistance of human pathogenic bacteria is an emerging problem for global public health. This resistance is often associated with the overproduction of membrane transport proteins that are capable to pump chemotherapeutics, antibiotics, detergents, dyes and organic solvents out of the cell. In Gram-negative bacteria such as Escherichia coli and Pseudomonas aeruginosa, tripartite multidrug efflux systems extrude a large variety of cytotoxic substances from the cell membrane directly into the medium bypassing the periplasm and the outer membrane. In E. coli, the tripartite efflux system AcrA/AcrB/TolC is the pump in charge of the efflux of multiple antibiotics, dyes, bile salts and detergents. The trimeric outer membrane factor (OMF) TolC forms a beta-barrel pore in the outer membrane and exhibits a long periplasmic alpha-helical conduit. The periplasmic membrane fusion protein (MFP) AcrA serves as a linker between TolC and the trimeric resistance nodulation cell division (RND) pump AcrB, located in the inner membrane acting as a proton/drug antiporter. The newly elucidated asymmetric structure of trimeric AcrB reveals three different monomer conformations representing consecutive states in a transport cycle. The monomers show tunnels with occlusions at different sites leading from the lateral side through the periplasmic porter (pore) domains towards the funnel of the trimer and TolC. The structural changes create a hydrophobic pocket in one monomer, which is not present in the other two monomers. Minocyclin and doxorubicin, both AcrB substrates, specifically bind to this pocket substantiating its role as drug binding pocket. The energy transduction from the proton motive force into drug efflux includes proton binding in (and release from) the transmembrane part. The conformational changes observed within a triad of essential, titratable residues (Asp407/Asp408/Lys940) residing in the hydrophobic transmembrane domain appear to be transduced by

  3. Diversidade genética de populações de andiroba no Baixo Acre Genetic diversity structure of crabwood in Baixo Acre, Brazil

    Directory of Open Access Journals (Sweden)

    Andréa Raposo

    2007-09-01

    Full Text Available O objetivo deste trabalho foi avaliar a diversidade genética em duas populações de Carapa guianensis Aubl. (andiroba, no Estado do Acre, e comparar os parâmetros de diversidade com os observados em outras populações da espécie (no Brasil: Flona Tapajós, PA, Porto Acre, AC; e na Costa Rica. Foram avaliados 77 indivíduos adultos com sete locos polimórficos de microssatélites. Observaram-se 51 alelos nas duas populações, em que o número efetivo de alelos por loco (Âe = 3,2 foi inferior ao número médio de alelos por loco (Â = 7,3, o que indica elevado número de alelos com baixa freqüência. Os valores estimados de f não diferiram de zero, o que mostra que não ocorre endogamia nas populações. A taxa de cruzamento aparente foi alta (t a = 1,11 na população Porto Acre, e t a= 0,88 na de Rio Branco, resultado indicador de que a espécie se reproduz por alogamia. Foi observado, por meio das estimativas de Â, He (diversidade gênica e Ne (número efetivo populacional que as populações de andiroba, comparadas neste trabalho, tiveram padrões de diversidade semelhantes, porém, proporções de alelos raros diferentes.The objective of this work was to evaluate the genetic diversity of two Carapa guianensis Aubl. (crabwood populations, in the State of Acre, Brazil, and to compare the diversity estimations with those obtained in other populations of the species (in Brazil: Flona Tapajós, PA, Porto Acre, AC; and in Costa Rica. Seventy-seven individuals were assessed using seven polymorphic microsatellite loci. Fifty-one alleles were observed in the two populations, in which the effective number of alleles per locus (Âe = 3.2 was lower than the average number of alleles per locus (Â = 7.3, which indicates a high number of low frequency alleles. The estimated f values did not differ from zero, showing that inbreeding does not occur in these populations. The apparent outcrossing rate was high for both populations (t a = 1.11 in

  4. Spatial and spatio-temporal analysis of malaria in the state of Acre, western Amazon, Brazil

    Directory of Open Access Journals (Sweden)

    Leonardo Augusto Kohara Melchior

    2016-11-01

    Full Text Available Since 2005, the State of Acre, western Amazon, Brazil, has reported the highest annual parasite incidence (API of malaria among the Brazilian states. This study examines malaria incidence in Acre using spatial and spatio-temporal analysis based on an ecological time series study analyzing malaria cases and deaths for the time period 1992- 2014 and using secondary data. API indexes were calculated by age, sex, parasite species, ratio of Plasmodium vivax to P. falciparum malaria, malaria mortality rate and case fatality rate. SaTScan was used to detect spatial and spatio-temporal clusters of malaria cases and data were represented in the form of choropleth maps. A high-risk cluster of malaria was detected in Vale do Juruá and three low-risk clusters in Vale do Acre for both parasite species. Those younger than 19 years of age and females showed a high incidence of malaria in Vale do Juruá, but working-age males were the most affected in Vale do Acre. The malaria mortality rate showed a decreasing trend across the state, while the case fatality rate increased only in the micro-region of Rio Branco during the study period. We conclude that malaria is a focal disease in Acre showing different spatial and spatio-temporal patterns of cases and deaths that vary by age, sex, and parasite species. Malaria incidence is thought to be influenced by factors related to regional characteristics; therefore, appropriate disease and vector control strategies must be implemented at each locality.

  5. Comparison of neutron parameters between a CANDU and ACR reactors; Comparacao de parametros neutronicos entre um reator CANDU e um ACR

    Energy Technology Data Exchange (ETDEWEB)

    Dias, Gabriel H.P.; Silva, Clarysson A.M. da; Pereira, Claubia, E-mail: gabrielhpd@yahoo.com.br, E-mail: clarysson@nuclear.ufmg.br, E-mail: claubia@nuclear.ufmg.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear

    2017-11-01

    CANDU (Canadian Deuterium Uranium) is a type of reactor that uses heavy water (D{sub 2}O) as a moderator and as a refrigerant. Despite having chemical characteristics similar to light water (H{sub 2}O), heavy water has a high moderation ratio for neutrons. This feature enables CANDU to use natural uranium as fuel. However, research has evaluated the possibility of using H{sub 2}O as a refrigerant and D{sub 2}O as a moderator aiming at reducing the volume of heavy water. Such changes would imply the use of lightly enriched uranium due to the presence of H{sub 2}O. In this context, the concept of ACR (Advanced CANDU Reactor) has been developed. This reactor has an innovative design which combines of the current CANDU with the characteristics of PWR (Pressurized Water Reactor) type reactors. Studies by AECL (Atomic Energy Canada Limited) show that compared to CANDU, the ACR presents a cost reduction in construction, improved firing performance, improved operation safety and longer life. The present work aims to evaluate, in steady state, some of the main neutron parameters of CANDU-6 and ACR-1000. The MCNPX 2.6.0 code (Monte Carlo N-Particle eXtended -version 2.6.0) was used to simulate such types of reactors. The results show that the models configured in the MCNPX adequately reproduce the neutron behavior of the studied reactors. These models may be used in future work for analysis of fuel burn and evolution.

  6. Qualidade da castanha-do-brasil do comércio de Rio Branco, Acre Quality of Brazil nuts marketed in Rio Branco, Acre

    Directory of Open Access Journals (Sweden)

    Virgínia de Souza Álvares

    2012-06-01

    Full Text Available Este trabalho teve como objetivo avaliar a qualidade de castanhas-do-brasil beneficiadas e comercializadas em Rio Branco, Acre. Foram analisadas amostras das três marcas de castanha encontradas no mercado local quanto às variáveis: atividade de água, teor de umidade, contagem total de fungos filamentosos, quantificação de Aspergillus flavus e de A. parasiticus, bem como quantificação de aflatoxinas B1, B2, G1 e G2. As castanhas do comércio se encontravam com um teor de umidade e atividade de água adequados, o que pode ter sido responsável pela baixa contaminação por fungos e por aflatoxinas. Quanto a estas micotoxinas, as amostras estão de acordo com o recomendado pela Anvisa, podendo ser esta uma consequência da grande divulgação no Estado do uso de Boas Práticas no manejo da castanha.The goal of this paper was to evaluate the quality of Brazil nuts processed and marketed in the city of Rio Branco, in the state of Acre (Brazil. We analysed three samples for water activity, moisture content, total fungus quantification of Aspergillus flavus and A. parasiticus, as well as quantification of total aflatoxin, Afla B1, Afla B2, Afla G1 and Afla G2. The nut samples from the market showed an appropriate moisture content and water activity, which may have been responsible for the low fungus contamination and aflatoxin production. As to these mycotoxins, the samples were consistent with Anvisa's recommendations, which may be a consequence of good management of the nuts in Acre.

  7. Young Children's Sibling Relationship Quality: Distal and Proximal Correlates

    Science.gov (United States)

    Kretschmer, Tina; Pike, Alison

    2009-01-01

    Background: Relationships within families are interdependent and related to distal environmental factors. Low socioeconomic status (SES) and high household chaos (distal factors) have been linked to less positive marital and parent-child relationships, but have not yet been examined with regard to young children's sibling relationships. The…

  8. Distal clavicular osteolysis: MR evidence for subchondral fracture

    Energy Technology Data Exchange (ETDEWEB)

    Kassarjian, Ara; Palmer, William E. [Massachusetts General Hospital, Department of Radiology, Division of Musculoskeletal Radiology, Yawkey Center, Boston, MA (United States); Llopis, Eva [Hospital de la Ribera, Department of Radiology, Valencia (Spain)

    2007-01-15

    To investigate the association between distal clavicular osteolysis and subchondral fractures of the distal clavicle at MRI. This study was approved by the hospital human research committee, which waived the need for informed consent. Three radiologists retrospectively analyzed 36 shoulder MR examinations in 36 patients with imaging findings of distal clavicular osteolysis. The presence of a subchondral fracture of the distal clavicle, abnormalities of the acromioclavicular joint, rotator cuff tears and labral tears were assessed by MRI. These cases were then compared with 36 age-matched controls. At MRI, 31 of 36 patients (86%) had a subchondral line within the distal clavicular edema, consistent with a subchondral fracture. Of the 36 patients, 32 (89%) had fluid in the acromioclavicular joint, while 27 of 36 patients (75%) had cysts or erosions in the distal clavicle. There were 13 patients (36%) with associated labral tears, while eight patients (22%) had partial-thickness rotator cuff tears. In the control group one of 36 (3%) had a subchondral line (P<0.05), while ten of 36 (28%) had rotator cuff tears and 13 of 36 (36%) had labral tears. These latter two were not statistically significant between the groups. A distal clavicular subchondral fracture is a common finding in patients with imaging evidence of distal clavicular osteolysis. These subchondral fractures may be responsible for the propensity of findings occurring on the clavicular side of the acromioclavicular joint. (orig.)

  9. Distal clavicular osteolysis: MR evidence for subchondral fracture

    International Nuclear Information System (INIS)

    Kassarjian, Ara; Palmer, William E.; Llopis, Eva

    2007-01-01

    To investigate the association between distal clavicular osteolysis and subchondral fractures of the distal clavicle at MRI. This study was approved by the hospital human research committee, which waived the need for informed consent. Three radiologists retrospectively analyzed 36 shoulder MR examinations in 36 patients with imaging findings of distal clavicular osteolysis. The presence of a subchondral fracture of the distal clavicle, abnormalities of the acromioclavicular joint, rotator cuff tears and labral tears were assessed by MRI. These cases were then compared with 36 age-matched controls. At MRI, 31 of 36 patients (86%) had a subchondral line within the distal clavicular edema, consistent with a subchondral fracture. Of the 36 patients, 32 (89%) had fluid in the acromioclavicular joint, while 27 of 36 patients (75%) had cysts or erosions in the distal clavicle. There were 13 patients (36%) with associated labral tears, while eight patients (22%) had partial-thickness rotator cuff tears. In the control group one of 36 (3%) had a subchondral line (P<0.05), while ten of 36 (28%) had rotator cuff tears and 13 of 36 (36%) had labral tears. These latter two were not statistically significant between the groups. A distal clavicular subchondral fracture is a common finding in patients with imaging evidence of distal clavicular osteolysis. These subchondral fractures may be responsible for the propensity of findings occurring on the clavicular side of the acromioclavicular joint. (orig.)

  10. Intra-articular osteotomy for distal humerus malunion

    NARCIS (Netherlands)

    Marti, René K.; Doornberg, Job

    2009-01-01

    Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular

  11. Clinical relevance of distal biceps insertional and footprint anatomy

    NARCIS (Netherlands)

    van den Bekerom, Michel P J; Kodde, Izaäk F.; Aster, Asir; Bleys, Ronald L A W; Eygendaal, Denise

    2016-01-01

    Purpose: The aim of this review was to present an overview, based on a literature search, of surgical anatomy for distal biceps tendon repairs, based on the current literature. Methods: A narrative review was performed using Pubmed/Medline using key words: Search terms were distal biceps,

  12. Distal tibiofibular synostosis in a Nigerian: A case report | Owoeye ...

    African Journals Online (AJOL)

    X-ray of the bones showed an oblique fracture in the distal end of the shaft of fibula which is suggestive of post traumatic tibiofibular synostosis (TFS). Knowledge of distal TFS is important in resolving the puzzle of chronic shin pain of unknown origin and in accurate diagnosis of causes of ankle deformity and malformations.

  13. Radiographic study of distal radial physeal closure in thoroughbred horses

    International Nuclear Information System (INIS)

    Vulcano, L.C.; Mamprim, M.J.; Muniz, L.M.R.; Moreira, A.F.; Luna, S.P.L.

    1997-01-01

    Monthly radiography was performed to study distal radial physeal closure in ten male and ten female Throughbred horses. The height, thoracic circumference and metacarpus circumference were also measured, Distal radial physeal closure time was sooner in females than males, and took 701 +/- 37 and 748 +/- 55 days respectively

  14. Patient phenotypes in fibromyalgia comorbid with systemic sclerosis or rheumatoid arthritis: influence of diagnostic and screening tests. Screening with the FiRST questionnaire, diagnosis with the ACR 1990 and revised ACR 2010 criteria.

    Science.gov (United States)

    Perrot, Serge; Peixoto, Mariana; Dieudé, Philippe; Hachulla, Eric; Avouac, Jerome; Ottaviani, Sebastien; Allanore, Yannick

    2017-01-01

    Fibromyalgia (FM) may occur with rheumatoid arthritis (RA) and systemic sclerosis (SSc), and debate remains about its diagnosis. We aimed to use three FM tools (a screening tool (FiRST), diagnostic criteria (ACR 1990 and revised 2010), to compare FM prevalence between RA and SSc patients, to describe the phenotypes of patients with comorbid FM, and to analyze links between FM and secondary Sjögren's syndrome (SS). Consecutive adult patients with confirmed RA or SSc from four university hospitals were tested with the three FM tools. FiRST detected FM in 22.6% of the 172 RA patients, with confirmation in 22.1% (ACR1990) and 19.1% (ACR2010). ACR1990FM+ RA patients had more diffuse pain, whereas ACR2010FM+ RA patients had higher BMI and pain intensity, more diffuse pain, active disease, disability, and associated SS. FiRST detected FM in 27.8% of the 122 SSc patients, with confirmation in 30.3% (ACR1990) and 23.7% (ACR2010). ACR1990FM+ SSc patients had greater disability and pain intensity, and more diffuse pain, whereas ACR2010FM+ SSc patients had higher BMI, pain intensity, more disability and diffuse pain, and associated SS. Correlations between FM diagnostic and screening tool results were modest in both conditions. Secondary SS was associated with comorbid FM. The prevalence of FM is high in SSc and RA, whatever the FM diagnostic tool used. Secondary SS is associated with FM in both RA and SSc. The revised ACR 2010 FM criteria and FiRST screening tool reveal specific phenotypes potentially useful for improving disease management.

  15. Contribution of AcrAB-ToIC to multidrug resistance in an Escherichia coli sequence type 131 isolate

    NARCIS (Netherlands)

    Schuster, Sabine; Vavra, Martina; Schweigger, Tobias M.; Rossen, John W. A.; Matsumura, Yasufumi; Kern, Winfried V.

    Drug efflux by resistance-nodulation-cell division (RND)-type transporters, such as AcrAB-ToIC of Escherichia can, is an important resistance mechanism in Gram-negative bacteria; however, its contribution to multidrug resistance (MDR) in clinical isolates is poorly defined. We inactivated acrB of a

  16. A FUNCTIONAL EVALUATION STUDY OF DISTAL FEMORAL FRACTURES FIXED WITH DISTAL FEMORAL LOCKING PLATE

    Directory of Open Access Journals (Sweden)

    Manikumar C. J

    2017-04-01

    Full Text Available BACKGROUND Fractures of the distal femur present considerable challenges in management. Older patients especially women sustain fractures due to osteoporosis. Supracondylar fractures of femur have a bimodal distribution. They account for 6% of all femur fractures and 31% if hip fractures were excluded. Nearly, 50% of distal femur intra-articular fractures are open fractures. Before 1970, most supracondylar fractures were treated nonoperatively; however, difficulties were often encountered including persistent angulatory deformity, knee joint incongruity, loss of knee motion and delayed mobilisation. The trend of open reduction and internal fixation has become evident in recent years with good results being obtained with AO blade plate, dynamic condylar screw, intramedullary supracondylar nail and locking compression plate. Elderly patients and osteoporosis pose difficulty in treating intra-articular fractures of the lower end of femur. Loss of stable fixation is of great concern in these cases. Hence, locking compression plate use has an advantage in these patients. MATERIALS AND METHODS In this study, 20 patients with closed fracture of distal femur were studied. All the cases were treated at the Department of Orthopaedics, Rangaraya Medical College/Government General Hospital, Kakinada, Andhra Pradesh, between November 2013 and November 2015. The method used for fracture fixation was open reduction and internal fixation with distal femoral locking plate. The duration of follow up ranged from 3 months to 24 months. All the fractures in this series were posttraumatic. The patients were functionally evaluated with Neer’s scoring system. 1 RESULTS Twenty distal femoral fractures were treated with distal femoral locking plates. 15 patients were males and 5 patients were females. The median age was 47 years ranging from 28-70 years. 16 of the fractures were caused by road traffic accidents and 2 were due to fall, 2 were due to assault. 12 patients

  17. Rehabilitation for distal radial fractures in adults.

    Science.gov (United States)

    Handoll, Helen H G; Elliott, Joanne

    2015-09-25

    Fracture of the distal radius is a common clinical problem, particularly in older people with osteoporosis. There is considerable variation in the management, including rehabilitation, of these fractures. This is an update of a Cochrane review first published in 2002 and last updated in 2006. To examine the effects of rehabilitation interventions in adults with conservatively or surgically treated distal radial fractures. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL 2014; Issue 12), MEDLINE, EMBASE, CINAHL, AMED, PEDro, OTseeker and other databases, trial registers, conference proceedings and reference lists of articles. We did not apply any language restrictions. The date of the last search was 12 January 2015. Randomised controlled trials (RCTs) or quasi-RCTs evaluating rehabilitation as part of the management of fractures of the distal radius sustained by adults. Rehabilitation interventions such as active and passive mobilisation exercises, and training for activities of daily living, could be used on their own or in combination, and be applied in various ways by various clinicians. The review authors independently screened and selected trials, and reviewed eligible trials. We contacted study authors for additional information. We did not pool data. We included 26 trials, involving 1269 mainly female and older patients. With few exceptions, these studies did not include people with serious fracture or treatment-related complications, or older people with comorbidities and poor overall function that would have precluded trial participation or required more intensive treatment. Only four of the 23 comparisons covered by these 26 trials were evaluated by more than one trial. Participants of 15 trials were initially treated conservatively, involving plaster cast immobilisation. Initial treatment was surgery (external fixation or internal fixation) for all participants

  18. Distal Stressors and Depression among Homeless Men.

    Science.gov (United States)

    Coohey, Carol; Easton, Scott D

    2016-05-01

    Depression is a common problem among homeless men that may interfere with functional tasks, such as securing stable housing, obtaining employment, and accessing health services. Previous research on depression among homeless men has largely focused on current psychosocial resources, substance abuse, and past victimization. Guided by Ensel and Lin's life course stress process model, the authors examined whether distal stressors, including victimization and exposure to parent problems in childhood, contributed to men's depression above and beyond current (or proximal) stressors, such as substance abuse and health problems, and social resources. The sample consisted of 309 homeless men who had entered a federally funded emergency shelter. Using the Burns Depression Checklist, the authors found that one out of three men met the threshold for moderate to severe depression during the past week. The logistic regression showed that past exposure to parent problems was related to depression after accounting for current stressors and social resources (number of close adult relationships and whether their emotional support needs were met). Past victimization was not related to depression. To address men's depression, workers should concurrently provide services that meet men's basic needs (for example, housing) and address their relationship needs, including their need for emotional support.

  19. Mechanisms and Management of Diabetic Painful Distal Symmetrical Polyneuropathy

    Science.gov (United States)

    Tesfaye, Solomon; Boulton, Andrew J.M.; Dickenson, Anthony H.

    2013-01-01

    Although a number of the diabetic neuropathies may result in painful symptomatology, this review focuses on the most common: chronic sensorimotor distal symmetrical polyneuropathy (DSPN). It is estimated that 15–20% of diabetic patients may have painful DSPN, but not all of these will require therapy. In practice, the diagnosis of DSPN is a clinical one, whereas for longitudinal studies and clinical trials, quantitative sensory testing and electrophysiological assessment are usually necessary. A number of simple numeric rating scales are available to assess the frequency and severity of neuropathic pain. Although the exact pathophysiological processes that result in diabetic neuropathic pain remain enigmatic, both peripheral and central mechanisms have been implicated, and extend from altered channel function in peripheral nerve through enhanced spinal processing and changes in many higher centers. A number of pharmacological agents have proven efficacy in painful DSPN, but all are prone to side effects, and none impact the underlying pathophysiological abnormalities because they are only symptomatic therapy. The two first-line therapies approved by regulatory authorities for painful neuropathy are duloxetine and pregabalin. α-Lipoic acid, an antioxidant and pathogenic therapy, has evidence of efficacy but is not licensed in the U.S. and several European countries. All patients with DSPN are at increased risk of foot ulceration and require foot care, education, and if possible, regular podiatry assessment. PMID:23970715

  20. A comparison between robotic-assisted laparoscopic distal pancreatectomy versus laparoscopic distal pancreatectomy.

    Science.gov (United States)

    Goh, Brian K P; Chan, Chung Yip; Soh, Hui-Ling; Lee, Ser Yee; Cheow, Peng-Chung; Chow, Pierce K H; Ooi, London L P J; Chung, Alexander Y F

    2017-03-01

    This study aims to compare the early perioperative outcomes of robotic-assisted laparoscopic distal pancreatectomy (RDP) versus laparoscopic distal pancreatectomy (LDP). The clinicopathologic features of 45 consecutive patients who underwent minimally-invasive distal pancreatectomy from 2006 to 2015 were retrospectively reviewed. Thirty-nine patients who met our study criteria were included. Eight patients underwent RDP and 31 had LDP. There were 10 (25.6%) open conversions. Six (15.4%) patients had major (> grade 2) morbidities and there was no in-hospital mortality. There were 14 (35.9%) grade A and 9 (23.1%) grade B pancreatic fistulas. Comparison between RDP and LDP demonstrated no significant difference between the patients' baseline characteristics except there was increased frequency of spleen-preserving pancreatectomies (3 (37.5%) vs 25 (80.6%), P=0.016) and splenic-vessel preservation (5 (62.5%) vs 4 (12.9%), P=0.003) in RDP. Comparison between outcomes demonstrated that RDP was associated with a longer median operation time (452.5 (range, 300-685) vs 245 min (range, 85-430), P=0.001) and increased frequency of the procedure completed purely laparoscopically (8 (100%) vs 18 (58.1%), P=0.025). RDP can be safely adopted and is equivalent to LDP in most perioperative outcomes. It is also associated with a decreased frequency of the need for hand-assistance laparoscopic surgery or open conversion but needed a longer operation time. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Unilateral maxillary molar distalization with zygoma-gear appliance.

    Science.gov (United States)

    Kilkis, Dogan; Bayram, Mehmet; Celikoglu, Mevlut; Nur, Metin

    2012-08-01

    The aim of this study was to present the orthodontic treatment of a 15-year-old boy with a unilateral maxillary molar distalization system, called the zygoma-gear appliance. It consisted of a zygomatic anchorage miniplate, an inner bow, and a Sentalloy closed coil spring (GAC International, Bohemia, NY). A distalizing force of 350 g was used during the distalization period. The unilateral Class II malocclusion was corrected in 5 months with the zygoma-gear appliance. The maxillary left first molar showed distalization of 4 mm with an inclination of 3°. The maxillary premolars moved distally with the help of the transseptal fibers. In addition, there were slight decreases in overjet (-0.5 mm) and maxillary incisor inclination (-1°), indicating no anchorage loss from the zygoma-gear appliance. Preadjusted fixed appliances (0.022 × 0.028-in, MBT system; 3M Unitek, Monrovia, Calif) were placed in both arches to achieve leveling and alignment. After 14 months of unilateral distalization with the zygoma-gear appliance and fixed appliances, Class I molar and canine relationships were established with satisfactory interdigitation of the posterior teeth. Acceptable overjet and overbite were also achieved. This article shows that this new system, the zygoma-gear appliance, can be used for unilateral maxillary molar distalization without anchorage loss. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  2. Expression of the AcrAB Components of the AcrAB-TolC Multidrug Efflux Pump of Yersinia enterocolitica Is Subject to Dual Regulation by OmpR.

    Directory of Open Access Journals (Sweden)

    Adrianna Raczkowska

    Full Text Available OmpR is a transcriptional regulator implicated in the control of various cellular processes and functions in Enterobacteriaceae. This study was undertaken to identify genes comprising the OmpR regulon in the human gastrointestinal pathogen Yersinia enterocolitica. Derivatives of an ompR-negative strain with random transposon insertions creating transcriptional fusions with the reporter gene lacZ were isolated. These were supplied with the wild-type ompR allele in trans and then screened for OmpR-dependent changes in β-galactosidase activity. Using this strategy, five insertions in genes/operons positively regulated by OmpR and two insertions in genes negatively regulated by this protein were identified. Genetic analysis of one of these fusion strains revealed that the gene acrR, encoding transcriptional repressor AcrR is negatively regulated by OmpR. Differential analysis of membrane proteins by SDS-PAGE followed by mass spectrometry identified the protein AcrB, a component of the AcrAB-TolC multidrug efflux pump, as being positively regulated by OmpR. Analysis of the activity of the acrR and acrAB promoters using gfp fusions confirmed their OmpR-dependent repression and activation, respectively. The identification of putative OmpR-binding sites and electrophoretic mobility shift assays confirmed that this regulator binds specifically to both promoter regions with different affinity. Examination of the activity of the acrR and acrAB promoters after the exposure of cells to different chemicals showed that bile salts can act as an OmpR-independent inducer. Taken together, our findings suggest that OmpR positively controls the expression of the AcrAB-TolC efflux pump involved in the adaptive response of Y. enterocolitica O:9 to different chemical stressors, thus conferring an advantage in particular ecological niches.

  3. Potassium transport across guinea pig distal colon

    International Nuclear Information System (INIS)

    Rechkemmer, G.; Halm, D.R.; Frizzell, R.A.

    1986-01-01

    Active absorption and secretion of K was studied by measuring bidirectional 42 K fluxes across short-circuited guinea pig distal colon. Tissues were pretreated with mucosal (m) and serosal (s) indomethacin (1 μM) and amiloride (0.1 mM, m) to suppress spontaneous, electrogenic Cl secretion and Na absorption. Under these conditions, the short-circuit current (I/sub sc/) was 0.4 μeq/cm 2 h while electroneutral K absorption was 2.8 μeq/cm 2 h. Epinephrine (5 μM, s) stimulated electrogenic K secretion, reducing net K absorption to 1.3 μeq/cm 2 h. Bumetanide (0.1 mM, s) abolished this K secretion and restored K absorption to control values, suggesting mechanistic similarities between K and Cl secretion. K absorption was inhibited 40% by the gastric H/K ATPase inhibitor, omeprazole (0.1 mM, m), and was abolished by ouabain (0.1 mM, m). Neutral K absorption does not appear to be mediated by an apical membrane Na/K pump since: the effect of mucosal ouabain on K absorption does not require the presence of mucosal or serosal Na, unidirectional Na fluxes are not influenced by mucosal ouabain, and K absorption is not affected when Na absorption is abolished by amiloride. Net K transport is determined by the balance between electroneutral K absorption and electrogenic K secretion. The ouabain sensitivity of K absorption suggests that colonic H/K ATPase differs from its gastric counterpart

  4. Histology of the distal dural ring.

    Science.gov (United States)

    Graffeo, Christopher S; Perry, Avital; Copeland, William R; Raghunathan, Aditya; Link, Michael J

    2017-09-01

    The distal dural ring (DDR) is a conserved intracranial anatomic structure marking the boundary point at which the internal carotid artery (ICA) exits the cavernous sinus (CS) and enters the subarachnoid space. Although the CS has been well described in a range of anatomic studies, to our knowledge no prior study has analyzed the histologic relationship between the ICA and DDR. Correspondingly, our objective was to assess the relationship of the DDR to the ICA and determine whether the DDR can be dissected from the ICA and thus divided, or can only be circumferentially trimmed around the artery. The authors examined ten fresh-frozen, adult cadaveric specimens. A standard frontotemporal craniotomy, orbito-optic osteotomy, and extradural anterior clinoidectomy was performed bilaterally. The cavernous ICA, DDR, and supraclinoid ICA were harvested as an en bloc specimen. Specimens formalin-fixed and paraffin-embedded prior to routine histochemical staining with hematoxylin and eosin and Masson trichrome. In all specimens, marked microscopic investment of the DDR throughout the ICA adventitia was noted. Dural collagen fibers extensively permeated the arterial layers superficial to the muscularis propria, with no evidence of a clear separation between the DDR and arterial adventitia. Histologic analysis suggests that the ICA and DDR are highly interrelated, continuous structures, and therefore attempted intraoperative dissection between these structures may carry an elevated risk of injury to the ICA. We correspondingly recommend careful circumferential trimming of the DDR in lieu of direct dissection in cases requiring mobilization of the clinoidal ICA. Clin. Anat. 30:742-746, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  5. Two-wave propagation in in vitro swine distal ulna

    Science.gov (United States)

    Mano, Isao; Horii, Kaoru; Matsukawa, Mami; Otani, Takahiko

    2015-07-01

    Ultrasonic transmitted waves were obtained in an in vitro swine distal ulna specimen, which mimics a human distal radius, that consists of interconnected cortical bone and cancellous bone. The transmitted waveforms appeared similar to the fast waves, slow waves, and overlapping fast and slow waves measured in the specimen after removing the surface cortical bone (only cancellous bone). In addition, the circumferential waves in the cortical bone and water did not affect the fast and slow waves. This suggests that the fast-and-slow-wave phenomenon can be observed in an in vivo human distal radius.

  6. Intra-Articular Osteotomy for Distal Humerus Malunion

    Directory of Open Access Journals (Sweden)

    René K. Marti

    2009-01-01

    Full Text Available Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular necrosis of capitellum or trochlea is a major pitfall of the this technically challenging procedure. Two cases are presented which illustrate the potential problems of intra-articular osteotomy for malunion of the distal humerus.

  7. Repressive mutations restore function-loss caused by the disruption of trimerization in Escherichia coli multidrug transporter AcrB

    Directory of Open Access Journals (Sweden)

    Zhaoshuai eWang

    2015-01-01

    Full Text Available AcrAB-TolC and their homologs are major multidrug efflux systems in Gram-negative bacteria. The inner membrane component AcrB functions as a trimer. Replacement of Pro223 by Gly in AcrB decreases the trimer stability and drastically reduces the drug efflux activity. The goal of this study is to identify suppressor mutations that restore function to mutant AcrBP223G and explore the mechanism of function recovery. Two methods were used to introduce random mutations into the plasmid of AcrBP223G. Mutants with elevated drug efflux activity were identified, purified, and characterized to examine their expression level, trimer stability, interaction with AcrA, and substrate binding. Nine single-site repressor mutations were identified, including T199M, D256N, A209V, G257V, M662I, Q737L, D788K, P800S, and E810K. Except for M662I, all other mutations located in the docking region of the periplasmic domain. While three mutations, T199M, A209V, and D256N, significantly increased the trimer stability, none of them restored the trimer affinity to the wild type level. M662, the only site of mutation that located in the porter domain, was involved in substrate binding. Our results suggest that the function loss resulted from compromised AcrB trimerization could be restored through various mechanisms involving the compensation of trimer stability and substrate binding.

  8. Mediator, SWI/SNF and SAGA complexes regulate Yap8-dependent transcriptional activation of ACR2 in response to arsenate.

    Science.gov (United States)

    Menezes, Regina Andrade; Pimentel, Catarina; Silva, Ana Rita Courelas; Amaral, Catarina; Merhej, Jawad; Devaux, Frédéric; Rodrigues-Pousada, Claudina

    2017-04-01

    Response to arsenic stress in Saccharomyces cerevisiae is orchestrated by the regulatory protein Yap8, which mediates transcriptional activation of ACR2 and ACR3. This study contributes to the state of art knowledge of the molecular mechanisms underlying yeast stress response to arsenate as it provides the genetic and biochemical evidences that Yap8, through cysteine residues 132, 137, and 274, is the sensor of presence of arsenate in the cytosol. Moreover, it is here reported for the first time the essential role of the Mediator complex in the transcriptional activation of ACR2 by Yap8. Based on our data, we propose an order-of-function map to recapitulate the sequence of events taking place in cells injured with arsenate. Modification of the sulfhydryl state of these cysteines converts Yap8 in its activated form, triggering the recruitment of the Mediator complex to the ACR2/ACR3 promoter, through the interaction with the tail subunit Med2. The Mediator complex then transfers the regulatory signals conveyed by Yap8 to the core transcriptional machinery, which culminates with TBP occupancy, ACR2 upregulation and cell adaptation to arsenate stress. Additional co-factors are required for the transcriptional activation of ACR2 by Yap8, particularly the nucleosome remodeling activity of SWI/SNF and SAGA complexes. Copyright © 2017. Published by Elsevier B.V.

  9. Human intestinal parasites in crusader Acre: Evidence for migration with disease in the medieval period.

    Science.gov (United States)

    Mitchell, Piers D; Anastasiou, Evilena; Syon, Danny

    2011-12-01

    The aim of this research is to highlight the role of ancient parasites as evidence for human migration in past populations. The material analysed was soil sediment from the excavation of a medieval cesspool in the city of Acre, in Israel. Archaeological stratigraphy and radiocarbon dating of a fragment of animal bone from the cesspool confirm its use in the 13th century CE, during the crusader period. At that time Acre was located in the Frankish Kingdom of Jerusalem. Soil samples from the cesspool were analysed and eggs of the roundworm (Ascaris lumbricoides) and fish tapeworm (Diphyllobothrium latum) were identified. The fish tapeworm has only been found in the mainland Near East once before, in a latrine of the crusader Order of St. John (Knights Hospitaller). It has been absent in all earlier cesspools, latrines and coprolites so far studied in the region. In contrast to its rarity in the Levant, the fish tapeworm was common in northern Europe during the medieval period. The presence of fish tapeworm eggs in a crusader period cesspool in Acre suggests its use by crusaders or pilgrims from northern Europe who travelled to the Levant carrying these parasites in their intestines. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Keynote Address: ACR-NEMA standards and their implications for teleradiology

    Science.gov (United States)

    Horii, Steven C.

    1990-06-01

    The ACR-NEMA Standard was developed initially as an interface standard for the interconnection of two pieces of imaging equipment Essentially the Standard defmes a point-to-point hardware connection with the necessary protocol and data structure so that two differing devices which meet the specification will be able to communicate with each other. The Standard does not defme a particular PACS architecture nor does it specify a database structure. In part these are the reasons why implementers have had difficulty in using the Standard in a full PACS. Recent activity of the Working Groups formed by the Committee overseeing work on the ACR-NEMA Standard has changed some of the " flavor" of the Standard. It was realized that connection of PACS with hospital and radiology information systems (HIS and RIS) is necessary if a PACS is ever to be succesful. The idea of interconnecting heterogeneous computer systems has pushed Standards development beyond the scope of the original work. Teleradiology which inherenfly involves wide-area networking may be a direct beneficiary of the new directions taken by the Standards Working Groups. This paper will give a brief history of the ACR-NEMA effort describe the " parent" Standard and its " offspring" and describe the activity of the current Working Groups with particular emphasis on the potential impacts on teleradiology.

  11. Discos de acresção em sistemas Be-X

    Science.gov (United States)

    Lopes de Oliveira, R.; Janot-Pacheco, E.

    2003-08-01

    Alguns fenômenos de outbursts em Be-X sugerem a existência, mesmo que temporária, de um disco de acresção quando da passagem do objeto compacto pelo periastro orbital. Neste trabalho avaliamos a possibilidade de formação do disco de acresção em sistemas Be+estrela de neutrons e Be+anã branca, e a influência da excentricidade orbital na ocorrência deste fenômeno. Utilizamos a expressão analítica para o momento angular específico da matéria constituinte de um meio em expansão lenta, como é o caso do disco circunstelar das estrelas Be, proposta por Wang(1981), sob a condição básica de que o raio de circularização deva ser maior do que o raio de Alfvén. Concluímos que existe um limite para o período orbital do sistema acima do qual não é possível a formação do disco de acresção, e que este valor aumenta para sistemas com excentricidade orbital maior.

  12. WE-AB-206-02: ACR Ultrasound Accreditation: Requirements and Pitfalls

    International Nuclear Information System (INIS)

    Walter, J.

    2016-01-01

    The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging. Learning Objectives: Gain familiarity with common elements of a QA/QC program for diagnostic ultrasound imaging dentify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools Learn ACR ultrasound accreditation requirements Jennifer Walter is an employee of American College of Radiology on Ultrasound Accreditation.

  13. First report of Rhodnius stali (Hemiptera, Reduviidae, Triatominae in the State of Acre and in the Brazilian Amazon

    Directory of Open Access Journals (Sweden)

    Dionatas Ulises de Oliveira Meneguetti

    2016-06-01

    Full Text Available Abstract: INTRODUCTION: This paper reports, for the first time, the presence of Rhodnius stali in the state of Acre and in the Brazilian Amazon. METHODS: Specimens of R. stali were collected by the Federal University of Acre in Rio Branco. RESULTS: The number of Triatominae species in the State of Acre increased from five to six. This was also the first report of R. stali in the Brazilian Amazon. CONCLUSIONS: The occurrence of R. stali is worrisome, since this species has been found naturally infected by Trypanosoma cruzi and there has been evidence of its domiciliation capabilities.

  14. Combined open proximal and stent-graft distal repair for distal arch aneurysms: an alternative to total debranching.

    Science.gov (United States)

    Zierer, Andreas; Sanchez, Luis A; Moon, Marc R

    2009-07-01

    We present herein a novel, combined, simultaneous open proximal and stent-graft distal repair for complex distal aortic arch aneurysms involving the descending aorta. In the first surgical step, the transverse arch is opened during selective antegrade cerebral perfusion, and a Dacron graft (DuPont, Wilmington, DE) is positioned down the descending aorta in an elephant trunk-like fashion with its proximal free margin sutured circumferentially to the aorta just distal to the left subclavian or left common carotid artery. With the graft serving as the new proximal landing zone, subsequent endovascular repair is performed antegrade during rewarming through the ascending aorta.

  15. Evapotranspiration Cover for the 92-Acre Area Retired Mixed Waste Pits:Interim CQA Report

    International Nuclear Information System (INIS)

    2011-01-01

    This Interim Construction Quality Assurance (CQA) Report is for the 92-Acre Evapotranspiration Cover, Area 5 Waste Management Division (WMD) Retired Mixed Waste Pits, Nevada National Security Site, Nevada for the period of January 20, 2011 to May 12, 2011. This Interim Construction Quality Assurance (CQA) Report is for the 92-Acre Evapotranspiration Cover, Area 5 Waste Management Division (WMD) Retired Mixed Waste Pits, Nevada National Security Site, Nevada for the period of January 20, 2011 to May 12, 2011. Construction was approved by the Nevada Division of Environmental Protection (NDEP) under the Approval of Corrective Action Decision Document/Corrective Action Plan (CADD/CAP) for Corrective Action Unit (CAU) 111: Area 5 WMD Retired Mixed Waste Pits, Nevada National Security Site, Nevada, on January 6, 2011, pursuant to Subpart XII.8a of the Federal Facility Agreement and Consent Order. The project is located in Area 5 of the Radioactive Waste Management Complex (RWMC) at the Nevada National Security Site (NNSS), formerly known as the Nevada Test Site, located in southern Nevada, approximately 65 miles northwest of Las Vegas, Nevada, in Nye County. The project site, in Area 5, is located in a topographically closed basin approximately 14 additional miles north of Mercury Nevada, in the north-central part of Frenchman Flat. The Area 5 RWMS uses engineered shallow-land burial cells to dispose of packaged waste. The 92-Acre Area encompasses the southern portion of the Area 5 RWMS, which has been designated for the first final closure operations. This area contains 13 Greater Confinement Disposal (GCD) boreholes, 16 narrow trenches, and 9 broader pits. With the exception of two active pits (P03 and P06), all trenches and pits in the 92-Acre Area had operational covers approximately 2.4 meters thick, at a minimum, in most areas when this project began. The units within the 92-Acre Area are grouped into the following six informal categories based on physical location

  16. Evapotranspiration Cover for the 92-Acre Area Retired Mixed Waste Pits:Interim CQA Report

    Energy Technology Data Exchange (ETDEWEB)

    The Delphi Groupe, Inc., and J. A. Cesare and Associates, Inc.

    2011-06-20

    This Interim Construction Quality Assurance (CQA) Report is for the 92-Acre Evapotranspiration Cover, Area 5 Waste Management Division (WMD) Retired Mixed Waste Pits, Nevada National Security Site, Nevada for the period of January 20, 2011 to May 12, 2011. This Interim Construction Quality Assurance (CQA) Report is for the 92-Acre Evapotranspiration Cover, Area 5 Waste Management Division (WMD) Retired Mixed Waste Pits, Nevada National Security Site, Nevada for the period of January 20, 2011 to May 12, 2011. Construction was approved by the Nevada Division of Environmental Protection (NDEP) under the Approval of Corrective Action Decision Document/Corrective Action Plan (CADD/CAP) for Corrective Action Unit (CAU) 111: Area 5 WMD Retired Mixed Waste Pits, Nevada National Security Site, Nevada, on January 6, 2011, pursuant to Subpart XII.8a of the Federal Facility Agreement and Consent Order. The project is located in Area 5 of the Radioactive Waste Management Complex (RWMC) at the Nevada National Security Site (NNSS), formerly known as the Nevada Test Site, located in southern Nevada, approximately 65 miles northwest of Las Vegas, Nevada, in Nye County. The project site, in Area 5, is located in a topographically closed basin approximately 14 additional miles north of Mercury Nevada, in the north-central part of Frenchman Flat. The Area 5 RWMS uses engineered shallow-land burial cells to dispose of packaged waste. The 92-Acre Area encompasses the southern portion of the Area 5 RWMS, which has been designated for the first final closure operations. This area contains 13 Greater Confinement Disposal (GCD) boreholes, 16 narrow trenches, and 9 broader pits. With the exception of two active pits (P03 and P06), all trenches and pits in the 92-Acre Area had operational covers approximately 2.4 meters thick, at a minimum, in most areas when this project began. The units within the 92-Acre Area are grouped into the following six informal categories based on physical location

  17. Bikeability and methodological issues using the active commuting route environment scale (ACRES in a metropolitan setting

    Directory of Open Access Journals (Sweden)

    Schantz Peter

    2011-01-01

    Full Text Available Abstract Background Route environments can positively influence people's active commuting and thereby contribute to public health. The Active Commuting Route Environment Scale (ACRES was developed to study active commuters' perceptions of their route environments. However, bicycle commuters represent a small portion of the population in many cities and thus are difficult to study using population-based material. Therefore, the aim of this study is to expand the state of knowledge concerning the criterion-related validity of the ACRES and the representativity using an advertisement-recruited sample. Furthermore, by comparing commuting route environment profiles of inner urban and suburban areas, we provide a novel basis for understanding the relationship between environment and bikeability. Methods Bicycle commuters from Greater Stockholm, Sweden, advertisement- (n = 1379 and street-recruited (n = 93, responded to the ACRES. Traffic planning and environmental experts from the Municipality of Stockholm (n = 24 responded to a modified version of the ACRES. The criterion-related validity assessments were based on whether or not differences between the inner urban and the suburban route environments, as indicated by the experts and by four existing objective measurements, were reflected by differences in perceptions of these environments. Comparisons of ratings between advertisement- and street-recruited participants were used for the assessments of representativity. Finally, ratings of inner urban and suburban route environments were used to evaluate commuting route environment profiles. Results Differences in ratings of the inner urban and suburban route environments by the advertisement-recruited participants were in accord with the existing objective measurements and corresponded reasonably well with those of the experts. Overall, there was a reasonably good correspondence between the advertisement- and street-recruited participants' ratings

  18. Bikeability and methodological issues using the active commuting route environment scale (ACRES) in a metropolitan setting.

    Science.gov (United States)

    Wahlgren, Lina; Schantz, Peter

    2011-01-17

    Route environments can positively influence people's active commuting and thereby contribute to public health. The Active Commuting Route Environment Scale (ACRES) was developed to study active commuters' perceptions of their route environments. However, bicycle commuters represent a small portion of the population in many cities and thus are difficult to study using population-based material. Therefore, the aim of this study is to expand the state of knowledge concerning the criterion-related validity of the ACRES and the representativity using an advertisement-recruited sample. Furthermore, by comparing commuting route environment profiles of inner urban and suburban areas, we provide a novel basis for understanding the relationship between environment and bikeability. Bicycle commuters from Greater Stockholm, Sweden, advertisement- (n = 1379) and street-recruited (n = 93), responded to the ACRES. Traffic planning and environmental experts from the Municipality of Stockholm (n = 24) responded to a modified version of the ACRES. The criterion-related validity assessments were based on whether or not differences between the inner urban and the suburban route environments, as indicated by the experts and by four existing objective measurements, were reflected by differences in perceptions of these environments. Comparisons of ratings between advertisement- and street-recruited participants were used for the assessments of representativity. Finally, ratings of inner urban and suburban route environments were used to evaluate commuting route environment profiles. Differences in ratings of the inner urban and suburban route environments by the advertisement-recruited participants were in accord with the existing objective measurements and corresponded reasonably well with those of the experts. Overall, there was a reasonably good correspondence between the advertisement- and street-recruited participants' ratings. Distinct differences in commuting route environment

  19. early functional outcome of distal femoral fractures at kenyatta

    African Journals Online (AJOL)

    The leading cause was RTA, followed by falls from a height. ... Distal femoral fractures cause considerable morbidity .... as means and standard deviations. .... Anaesthesia. Spinal. 37 (80). General Anaesthesia (GA). 9 (20). Transfusion.

  20. Minimally invasive percutaneous plate fixation of distal tibia fractures.

    LENUS (Irish Health Repository)

    Bahari, Syah

    2007-10-01

    We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.4 weeks. All fractures united with acceptable alignment and angulation. Two cases of superficial infection were noted, with one case of deep infection. Mean SF36 score was 85 and mean AOFAS score was 90 at a mean of 19 months follow-up. We report satisfactory outcomes with the use of the AO distal tibia locking plate in treatment of unstable distal tibial fractures. Eighty-nine percent of the patients felt that they were back to their pre injury status and 95% back to their previous employment.

  1. Surgical treatment of distal biceps tendon rupture: a case report

    Directory of Open Access Journals (Sweden)

    Cristina N. Cozma

    2017-11-01

    Full Text Available Objectives. Distal biceps tendon rupture affects the functional upperextremity movement, impairing supination and flexion strength. According to age, profession and additional risks treatment might be nonoperative or surgical. Methods. We describe the case of a 43 years old male patient who sustained an injury to his right distal biceps and was diagnosed with acute right distal biceps rupture. Surgical treatment was decided and biceps tendon was reinserted to the radius tuberosity using a combination of a cortical button fixation associated with an interference screw. Results. Postoperative functional result was favorable with no complications and with no movement limitation after one month. Conclusions. When possible, distal biceps tendon repair should be realized surgically because this permits restoring of the muscle strength to near normal levels with no loss of motion. Nerve complications are common; therefore the surgery should be realized by experienced upper extremity surgeons.

  2. Ocorrência de Herminodes sp. (Lepidoptera: Noctuidae em pupunheira nos estados do Acre e Rondônia, Brasil Occurrence of Herminodes sp. (Lepidoptera: Noctuidae in peach palm in the States of Acre and Rondônia, Brazil

    Directory of Open Access Journals (Sweden)

    Marcílio José Thomazini

    2004-09-01

    Full Text Available É relatado a ocorrência de Herminodes sp. em plantas de pupunha na área experimental da Embrapa Acre, Rio Branco, AC e no Projeto Reca, Vila Nova Califórnia, RO, Brasil. São descritas as principais características deste inseto e os danos por ele causados. Este é o primeiro registro de lagartas do gênero Herminodes causando dano em pupunheiras nos estados do Acre e Rondônia.Related herein is the occurrence of Herminodes sp. in peach palm plants at experimental area of Embrapa Acre, Rio Branco, AC and at Projeto Reca, Vila Nova California, RO, Brazil. The main characteristics of this insect and the damage it causes are described. This is the first record of Herminodes caterpillars damaging peach palm in the states of Acre and Rondônia.

  3. Enclavado endomedular en fracturas del tercio distal de la tibia

    OpenAIRE

    Arroquy, Damian; Chahla, Jorge; Gomez Rodriguez, Gustavo; Cid Casteulani, Alberto; Svarzchtein, Santiago; Gomez, Diego; Pesciallo, Cesar

    2015-01-01

    Objetivo: Describir los resultados obtenidos con el enclavado endomedular acerrojado en pacientes con fractura del tercio distal de la tibia. Materiales y Métodos: Se incluyeron pacientes con fracturas desplazadas del tercio distal de la tibia, tratadas con clavo endomedular. La muestra incluyo 35 pacientes. El tiempo de seguimiento posoperatorio fue de 29.2 meses. Se evaluaron el tiempo de consolidacion, la consolidacion viciosa y las complicaciones. Los resultados funcionales se determinaro...

  4. Fractures of the Distal Tibia Treated with Polyaxial Locking Plating

    OpenAIRE

    Gao, Hong; Zhang, Chang-Qing; Luo, Cong-Feng; Zhou, Zu-Bin; Zeng, Bing-Fang

    2008-01-01

    We evaluated the healing rate, complications, and functional outcomes in 32 adult patients with very short metaphyseal fragments in fractures of the distal tibia treated with a polyaxial locking system. The average distance from the distal extent of the fracture to the tibial plafond was 11 mm. All fractures healed and the average time to union was 14 weeks. Six patients (19%) reported occasional local disturbance over the medial malleolus. There were two cases of postoperative superficial in...

  5. Leaching Studies on ACR-1000{sup R} Fuel Under Reactor Operating Conditions

    Energy Technology Data Exchange (ETDEWEB)

    Sunder, S. [Atomic Energy of Canada Limited, Fuel and Fuel Channel Safety Branch, Chalk River, Ontario, K0J 1J0 (Canada)

    2009-06-15

    ACR-1000{sup R} is the latest nuclear power reactor being developed by AECL. The ACR-1000 fuel uses a modified CANFLEX{sup R} fuel bundle that contains low-enriched uranium and pellets of burnable neutron absorbers (BNA) in a central element. Dysprosium and gadolinium are used as the burnable neutron absorbers and are present as oxides in a 'fully-stabilized' zirconia matrix. The BNA material in the centre element is designed to limit the coolant void reactivity of the reactor core during postulated loss-of-coolant accidents. As part of the ACR-1000 fuel development, the stability of the BNA material under conditions associated with defects of the Zircaloy sheathing of the BNA central element has been investigated. The results of these tests can be used to demonstrate the phase stability and leaching behaviour of the ACR-1000 fuel under reactor operating conditions. The samples were disks, about 3-4 mm thick, obtained from BNA pellets and Candu fuel (natural uranium UO{sub 2}) pellets (the UO{sub 2} measurements provide a reference point). Leaching tests were carried out in light water at 325 deg. C, above the maximum coolant temperature in an ACR-1000 fuel channel during normal operating conditions (319 deg. C). This temperature also bounds the maximum operating temperature for the current Candu reactors (311 deg. C). The initial pH of the solution (measured at room temperature) used in the leaching tests was 10.3. The leach rates were determined by monitoring the amount of metals leached into solutions. Leaching tests were also carried out with BNA pellet samples in the presence of Zr-2.5%Nb pressure tube coupons to determine the effects, if any, of the presence of pressure tube material on leach rates. Other leaching tests with BNA pellet samples and UO{sub 2} pellets were conducted at 80 deg. C to study the effects of temperature on the leach rates. The temperature of 80 deg. C was selected as representative of typical shutdown temperatures

  6. Pleiotropic effects of statins in distal human pulmonary artery smooth muscle cells

    Directory of Open Access Journals (Sweden)

    Butrous Ghazwan S

    2011-10-01

    Full Text Available Abstract Background Recent clinical data suggest statins have transient but significant effects in patients with pulmonary arterial hypertension. In this study we explored the molecular effects of statins on distal human pulmonary artery smooth muscle cells (PASMCs and their relevance to proliferation and apoptosis in pulmonary arterial hypertension. Methods Primary distal human PASMCs from patients and controls were treated with lipophilic (simvastatin, atorvastatin, mevastatin and fluvastatin, lipophobic (pravastatin and nitric-oxide releasing statins and studied in terms of their DNA synthesis, proliferation, apoptosis, matrix metalloproteinase-9 and endothelin-1 release. Results Treatment of human PASMCs with selected statins inhibited DNA synthesis, proliferation and matrix metalloproteinase-9 production in a concentration-dependent manner. Statins differed in their effectiveness, the rank order of anti-mitogenic potency being simvastatin > atorvastatin > > pravastatin. Nevertheless, a novel nitric oxide-releasing derivative of pravastatin (NCX 6550 was effective. Lipophilic statins, such as simvastatin, also enhanced the anti-proliferative effects of iloprost and sildenafil, promoted apoptosis and inhibited the release of the mitogen and survival factor endothelin-1. These effects were reversed by mevalonate and the isoprenoid intermediate geranylgeranylpyrophosphate and were mimicked by inhibitors of the Rho and Rho-kinase. Conclusions Lipophilic statins exert direct effects on distal human PASMCs and are likely to involve inhibition of Rho GTPase signalling. These findings compliment some of the recently documented effects in patients with pulmonary arterial hypertension.

  7. EnviroAtlas - Acres of crops that have no nearby pollinator habitat for the Conterminous United States

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset is a summary of crop acres without nearby pollinator habitat. Pollination habitat here is defined as trees (fruit, nut, deciduous, and evergreen). Crops...

  8. Revelation and cloning of valinomycin synthetase genes in Streptomyces lavendulae ACR-DA1 and their expression analysis under different fermentation and elicitation conditions.

    Science.gov (United States)

    Sharma, Richa; Jamwal, Vijaylakshmi; Singh, Varun P; Wazir, Priya; Awasthi, Praveen; Singh, Deepika; Vishwakarma, Ram A; Gandhi, Sumit G; Chaubey, Asha

    2017-07-10

    Streptomyces species are amongst the most exploited microorganisms due to their ability to produce a plethora of secondary metabolites with bioactive potential, including several well known drugs. They are endowed with immense unexplored potential and substantial efforts are required for their isolation as well as characterization for their bioactive potential. Unexplored niches and extreme environments are host to diverse microbial species. In this study, we report Streptomyces lavendulae ACR-DA1, isolated from extreme cold deserts of the North Western Himalayas, which produces a macrolactone antibiotic, valinomycin. Valinomycin is a K + ionophoric non-ribosomal cyclodepsipeptide with a broad range of bioactivities including antibacterial, antifungal, antiviral and cytotoxic/anticancer activities. Production of valinomycin by the strain S. lavendulae ACR-DA1 was studied under different fermentation conditions like fermentation medium, temperature and addition of biosynthetic precursors. Synthetic medium at 10°C in the presence of precursors i.e. valine and pyruvate showed enhanced valinomycin production. In order to assess the impact of various elicitors, expression of the two genes viz. vlm1 and vlm2 that encode components of heterodimeric valinomycin synthetase, was analyzed using RT-PCR and correlated with quantity of valinomycin using LC-MS/MS. Annelid, bacterial and yeast elicitors increased valinomycin production whereas addition of fungal and plant elicitors down regulated the biosynthetic genes and reduced valinomycin production. This study is also the first report of valinomycin biosynthesis by Streptomyces lavendulae. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. The role of imaging in diagnosing diseases of the distal radioulnar joint, triangular fibrocartilage complex, and distal ulna.

    Science.gov (United States)

    Squires, Judy H; England, Eric; Mehta, Kaushal; Wissman, Robert D

    2014-07-01

    The purpose of this article is to review the anatomy, biomechanics, and multimodality imaging findings of common and uncommon distal radioulnar joint (DRUJ), triangular fibrocartilage complex, and distal ulna abnormalities. The DRUJ is a common site for acute and chronic injuries and is frequently imaged to evaluate chronic wrist pain, forearm dysfunction, and traumatic forearm injury. Given the complex anatomy of the wrist, the radiologist plays a vital role in the diagnosis of wrist pain and dysfunction.

  10. Is Bone Grafting Necessary in the Treatment of Malunited Distal Radius Fractures?

    Science.gov (United States)

    Disseldorp, Dominique J. G.; Poeze, Martijn; Hannemann, Pascal F. W.; Brink, Peter R. G.

    2015-01-01

    Background Open wedge osteotomy with bone grafting and plate fixation is the standard procedure for the correction of malunited distal radius fractures. Bone grafts are used to increase structural stability and to enhance new bone formation. However, bone grafts are also associated with donor site morbidity, delayed union at bone–graft interfaces, size mismatch between graft and osteotomy defect, and additional operation time. Purpose The goal of this study was to assess bone healing and secondary fracture displacement in the treatment of malunited distal radius fractures without the use of bone grafting. Methods Between January 1993 and December 2013, 132 corrective osteotomies and plate fixations without bone grafting were performed for malunited distal radius fractures. The minimum follow-up time was 12 months. Primary study outcomes were time to complete bone healing and secondary fracture displacement. Preoperative and postoperative radiographs during follow-up were compared with each other, as well as with radiographs of the uninjured side. Results All 132 osteotomies healed. In two cases (1.5%), healing took more than 4 months, but reinterventions were not necessary. No cases of secondary fracture displacement or hardware failure were observed. Significant improvements in all radiographic parameters were shown after corrective osteotomy and plate fixation. Conclusion This study shows that bone grafts are not required for bone healing and prevention of secondary fracture displacement after corrective osteotomy and plate fixation of malunited distal radius fractures. Level of evidence Therapeutic, level IV, case series with no comparison group PMID:26261748

  11. Amphibia, Anura, Microhylidae, Chiasmocleis avilapiresae Peloso and Sturaro, 2008: First record from the state of Acre, southwestern Amazonia, Brazil

    Directory of Open Access Journals (Sweden)

    Sampaio, P. R. M.

    2010-01-01

    Full Text Available We record for the first time the presence of Chiasmocleis avilapiresae in the state of Acre, Brazil. This microhylidfrog is found throughout Amazon in Brazil and no information about its distribution in the Acre state was reported previously.An increase on sampling efforts, revision of material housed in herpetological collections, and use of diverse herpetofaunasampling methods might reveal additional localities and more information about this species.

  12. Amphibia, Anura, Microhylidae, Chiasmocleis avilapiresae Peloso and Sturaro, 2008: first record for the state of Acre, southwestern Amazonia, Brazil

    OpenAIRE

    Sampaio, Paulo; da Silva, Talisson; Peloso, Pedro

    2016-01-01

    We record for the first time the presence of Chiasmocleis avilapiresae in the state of Acre, Brazil. This microhylid frog is found throughout Amazon in Brazil and no information about its distribution in the Acre state was reported previously. An increase on sampling efforts, revision of material housed in herpetological collections, and use of diverse herpetofauna sampling methods might reveal additional localities and more information about this species.

  13. Volar plating for distal radius fractures--do not trust the image intensifier when judging distal subchondral screw length.

    Science.gov (United States)

    Park, Derek H; Goldie, Boyd S

    2012-09-01

    The use of the volar plate to treat distal radius fractures is increasing but despite the theoretical advantages of a volar approach there have been reports of extensor tendon ruptures due to prominent screw tips protruding past the dorsal cortex. The valley in the intermediate column between Lister tubercle and the sigmoid notch of the distal radius makes it difficult to rely on fluoroscopy to judge screw length. Our aim was to quantify the dimensions of this valley and to demonstrate the danger of relying on intraoperative image intensification fluoroscopy to determine lengths of distal screws. We measured the depth of this valley in the intermediate column of the distal radius in 33 patients with computed tomographic (9 patients) or magnetic resonance image (24 patients) scans of the wrist. There was a consistent valley in all images examined [average 1.8 mm (95% confidence interval, 1.6-2.0 mm)]. Thirty-nine percent of wrists had a valley depth of at least 2 mm. Standard lateral views or rotation of the forearm to obtain oblique views does not identify prominent screw tips; and whatever the rotation of the forearm, screw tips protruding beyond dorsal cortex may look as if it is within the bone when in fact it is out. When drilling we suggest noting the depth at which the drill bit just penetrates dorsal cortex and routinely downsize the distal screw length by 2 mm. We caution against relying on flourosocopy when judging the length of the distal subchondral screws.

  14. The introduction of dengue follows transportation infrastructure changes in the state of Acre, Brazil: A network-based analysis.

    Science.gov (United States)

    Lana, Raquel Martins; Gomes, Marcelo Ferreira da Costa; Lima, Tiago França Melo de; Honório, Nildimar Alves; Codeço, Cláudia Torres

    2017-11-01

    Human mobility, presence and passive transportation of Aedes aegypti mosquito, and environmental characteristics are a group of factors which contribute to the success of dengue spread and establishment. To understand this process, we assess data from dengue national and municipal basins regarding population and demographics, transportation network, human mobility, and Ae. aegypti monitoring for the Brazilian state of Acre since the first recorded dengue case in the year 2000 to the year 2015. During this period, several changes in Acre's transport infrastructure and urbanization have been started. To reconstruct the process of dengue introduction in Acre, we propose an analytic framework based on concepts used in malaria literature, namely vulnerability and receptivity, to inform risk assessments in dengue-free regions as well as network theory concepts for disease invasion and propagation. We calculate the probability of dengue importation to Acre from other Brazilian states, the evolution of dengue spread between Acrean municipalities and dengue establishment in the state. Our findings suggest that the landscape changes associated with human mobility have created favorable conditions for the establishment of dengue virus transmission in Acre. The revitalization of its major roads, as well as the increased accessibility by air to and within the state, have increased dengue vulnerability. Unplanned urbanization and population growth, as observed in Acre during the period of study, contribute to ideal conditions for Ae. aegypti mosquito establishment, increase the difficulty in mosquito control and consequently its local receptivity.

  15. The Japanese version of the modified ACR preliminary diagnostic criteria for fibromyalgia and the fibromyalgia symptom scale: reliability and validity.

    Science.gov (United States)

    Usui, Chie; Hatta, Kotaro; Aratani, Satoko; Yagishita, Naoko; Nishioka, Kenya; Kanazawa, Teruhisa; Itoh, Kenji; Yamano, Yoshihisa; Nakamura, Hiroyuki; Nakajima, Toshihiro; Nishioka, Kusuki

    2013-09-01

    The aim of this study is to investigate the reliability and validity of the Japanese version of the modified American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia (mACR 2010-J) and the Fibromyalgia Symptom Scale (mFS-J). According to the ACR 1990 classification criteria, patients with chronic pain were divided into the fibromyalgia group and nonfibromyalgia group (rheumatoid arthritis and osteoarthritis). Patients in both groups were assessed using mACR 2010-J and mFS-J. 294 of 462 (64 %) patients in the fibromyalgia group met mACR 2010-J, whereas 4 % (9/231) of the nonfibromyalgia group did, with sensitivity of 64 %, specificity of 96 %, positive predictive value of 97 %, negative predictive value of 56 %, and positive likelihood ratio of 16.3. Mean total scores on mFS-J significantly differentiated the fibromyalgia from the nonfibromyalgia group. According to the value of the Youden index, the best cutoff score for the mFS-J was 9/10. Our findings indicate that mACR 2010-J as a positive test and mFS-J as a quantification scale might be suitable for assessing fibromyalgia among Japanese chronic pain populations.

  16. Arthroplasty of the distal ulna distal in managing patients with post-traumatic disorders of the distal radioulnar joint: measurement of quality of life

    Directory of Open Access Journals (Sweden)

    Marcio Aurélio Aita

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVE: To measure the quality of life and clinical-functional results from patients diagnosed with osteoarthrosis of the distal radioulnar joint who underwent surgical treatment using the technique of total arthroplasty of the ulna, with a total or partial Ascension(r prosthesis of the distal ulna. METHODS: Ten patients were evaluated after 12 months of follow-up subsequent to total or partial arthroplasty of the distal ulna. All of them presented post-traumatic osteoarthrosis and/or chronic symptomatic instability of the distal radioulnar joint. The study was prospective. Seven patients had previously undergone wrist procedures (two cases with Darrach, three with Sauvé-Kapandji and two with ligament reconstruction of the fibrocartilage complex and three presented fractures of the distal ulna that evolved with pain, instability and osteoarthrosis of the distal radioulnar joint. The following were assessed: quality of life (DASH scale; percentage degree of palm grip strength (kgf and pronosupination range of motion in relation to the unaffected side; pain (VAS; return to work; subjective evaluation of radiography; and complications. RESULTS: The patients presented a mean range of motion of 174.5° (normal side: 180°. Quality of life was analyzed by applying the DASH questionnaire and the mean value found was 5.9. The mean pain score using the VAS was 2.3. The mean degree of palm grip strength (kgf was 50.7, which represented 90.7% of the strength on the unaffected side. The complication rate was 10%: this patient presented slight dorsal instability of the ulna and persistent pain, and did not return to work. This patient is still being followed up in the outpatient clinic and occupational therapy sector, with little improvement. He does not wish to undergo a new procedure. The mean length of follow-up was 16.8 months, with a minimum of 10 and maximum of 36 months. CONCLUSION: This concept is subject to the test of time

  17. Minimally invasive versus open distal pancreatectomy (LEOPARD): study protocol for a randomized controlled trial.

    Science.gov (United States)

    de Rooij, Thijs; van Hilst, Jony; Vogel, Jantien A; van Santvoort, Hjalmar C; de Boer, Marieke T; Boerma, Djamila; van den Boezem, Peter B; Bonsing, Bert A; Bosscha, Koop; Coene, Peter-Paul; Daams, Freek; van Dam, Ronald M; Dijkgraaf, Marcel G; van Eijck, Casper H; Festen, Sebastiaan; Gerhards, Michael F; Groot Koerkamp, Bas; Hagendoorn, Jeroen; van der Harst, Erwin; de Hingh, Ignace H; Dejong, Cees H; Kazemier, Geert; Klaase, Joost; de Kleine, Ruben H; van Laarhoven, Cornelis J; Lips, Daan J; Luyer, Misha D; Molenaar, I Quintus; Nieuwenhuijs, Vincent B; Patijn, Gijs A; Roos, Daphne; Scheepers, Joris J; van der Schelling, George P; Steenvoorde, Pascal; Swijnenburg, Rutger-Jan; Wijsman, Jan H; Abu Hilal, Moh'd; Busch, Olivier R; Besselink, Marc G

    2017-04-08

    Observational cohort studies have suggested that minimally invasive distal pancreatectomy (MIDP) is associated with better short-term outcomes compared with open distal pancreatectomy (ODP), such as less intraoperative blood loss, lower morbidity, shorter length of hospital stay, and reduced total costs. Confounding by indication has probably influenced these findings, given that case-matched studies failed to confirm the superiority of MIDP. This accentuates the need for multicenter randomized controlled trials, which are currently lacking. We hypothesize that time to functional recovery is shorter after MIDP compared with ODP even in an enhanced recovery setting. LEOPARD is a randomized controlled, parallel-group, patient-blinded, multicenter, superiority trial in all 17 centers of the Dutch Pancreatic Cancer Group. A total of 102 patients with symptomatic benign, premalignant or malignant disease will be randomly allocated to undergo MIDP or ODP in an enhanced recovery setting. The primary outcome is time (days) to functional recovery, defined as all of the following: independently mobile at the preoperative level, sufficient pain control with oral medication alone, ability to maintain sufficient (i.e. >50%) daily required caloric intake, no intravenous fluid administration and no signs of infection. Secondary outcomes are operative and postoperative outcomes, including clinically relevant complications, mortality, quality of life and costs. The LEOPARD trial is designed to investigate whether MIDP reduces the time to functional recovery compared with ODP in an enhanced recovery setting. Dutch Trial Register, NTR5188 . Registered on 9 April 2015.

  18. The effect of bioresorbable vascular scaffold implantation on distal coronary endothelial function in dyslipidemic swine with and without diabetes.

    Science.gov (United States)

    van den Heuvel, Mieke; Sorop, Oana; van Ditzhuijzen, Nienke S; de Vries, René; van Duin, Richard W B; Peters, Ilona; van Loon, Janine E; de Maat, Moniek P; van Beusekom, Heleen M; van der Giessen, Wim J; Jan Danser, A H; Duncker, Dirk J

    2018-02-01

    We studied the effect of bioresorbable vascular scaffold (BVS) implantation on distal coronary endothelial function, in swine on a high fat diet without (HFD) or with diabetes (DM+HFD). Five DM+HFD and five HFD swine underwent BVS implantation on top of coronary plaques, and were studied six months later. Conduit artery segments >5mm proximal and distal to the scaffold and corresponding segments of non-scaffolded coronary arteries, and segments of small arteries within the flow-territory of scaffolded and non-scaffolded arteries were harvested for in vitro vasoreactivity studies. Conduit segments proximal and distal of the BVS edges showed reduced endothelium-dependent vasodilation as compared to control vessels (p≤0.01), with distal segments being most prominently affected(p≤0.01). Endothelial dysfunction was only observed in DM±HFD swine and was principally due to a loss of NO. Endothelium-independent vasodilation and vasoconstriction were unaffected. Surprisingly, segments from the microcirculation distal to the BVS showed enhanced endothelium-dependent vasodilation (pswine, and did not appear to be either NO- or EDHF-mediated. Six months of BVS implantation in DM+HFD swine causes NO-mediated endothelial dysfunction in nearby coronary segments, which is accompanied by a, possibly compensatory, increase in endothelial function of the distal microcirculation. Endothelial dysfunction extending into coronary conduit segments beyond the implantation-site, is in agreement with recent reports expressing concern for late scaffold thrombosis and of early BVS failure in diabetic patients. Copyright © 2017. Published by Elsevier B.V.

  19. The correlates of urinary albumin to creatinine ratio (ACR) in a high risk Australian aboriginal community.

    Science.gov (United States)

    Wang, Zaimin; Hoy, Wendy E; Wang, Zhiqiang

    2013-08-16

    Albuminuria marks renal disease and cardiovascular risk. It was estimated to contribute 75% of the risk of all-cause natural death in one Aboriginal group. The urine albumin/creatinine ratio (ACR) is commonly used as an index of albuminuria. This study aims to examine the associations between demographic factors, anthropometric index, blood pressure, lipid-protein measurements and other biomarkers and albuminuria in a cross-sectional study in a high-risk Australian Aboriginal population. The models will be evaluated for albuminuria at or above the microalbuminuria threshold, and at or above the "overt albuminuria" threshold with the potential to distinguish associations they have in common and those that differ. This was a cross-sectional study of 598 adults aged 18-76 years. All participants were grouped into quartiles by age. Logistic regression models were used to explore the correlates of ACR categories. The significant correlates were systolic blood pressure (SBP), C-reactive protein (CRP), uric acid, diabetes, gamma-glutamyl transferase (GGT) (marginally significant, p=0.054) and serum albumin (negative association) for ACR 17+ (mg/g) for men and 25+ for women. Independent correlates were SBP, uric acid, diabetes, total cholesterol, alanine amino transferase (ALT), Cystatin C and serum albumin (negative association) for overt albuminuria; and SBP, CRP and serum albumin only for microalbuminuria. This is the most detailed modelling of pathologic albuminuria in this setting to date. The somewhat variable association with risk factors suggests that microalbuminuria and overt albuminuria might reflect different as well as shared phenomena.

  20. White paper from the ACR Task Force on Print Media in Radiology.

    Science.gov (United States)

    Duszak, Richard; Haines, G Rebecca; Van Duyn Wear, Vanessa; Lexa, Frank James; Bashir, Mustafa; D'Souza, Sharon; Carlos, Ruth; Chen, James Yen-Yu; King, Bernard F; Wald, Christoph

    2011-10-01

    The rapidly changing technological and business environment in which scientific journals are published will necessitate ongoing reassessment of operations, goals, and priorities. In this white paper, the ACR Task Force on Print Media in Radiology reviews the history and role of print media in radiology; discusses current and anticipated societal, technological, and financial challenges; and explores a variety of strategies to help ensure the relevance of professional society publishing in the future. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. Measurement of superoxide dismutase-like activity in peel and pulp of apple from Anshan acres

    Science.gov (United States)

    Zhao, Lijuan

    2018-04-01

    Pyrogallol autoxidation method was used for measurement of SOD-like activity. They are 259.56 u/g and 148.78 u/g in peel and pulp of apple from Anshan acres. The proper-conditions for this measurement was determined through experiment as following: detection wavelength of spectrophotometer 325nm, buffer system Tris-HAc, concentration of Tris-HAc solution 50 mmoL and pH8.2. The inhibition rate of SOD-L again pyrogallol antioxidation are 92% and 90% in peel and pulp of apple.

  2. A New Orthodontic Appliance with a Mini Screw for Upper Molar Distalization.

    Science.gov (United States)

    Ozkalayci, Nurhat; Yetmez, Mehmet

    2016-01-01

    The aim of this study is to present a new upper molar distalization appliance called Cise distalizer designed as intraoral device supported with orthodontic mini screw for upper permanent molar distalization. The new appliance consists of eight main components. In order to understand the optimum force level, the appliance under static loading is tested by using strain gage measurement techniques. Results show that one of the open coils produces approximately 300 gr distalization force. Cise distalizer can provide totally 600 gr distalization force. This range of force level is enough for distalization of upper first and second molar teeth.

  3. A New Orthodontic Appliance with a Mini Screw for Upper Molar Distalization

    Directory of Open Access Journals (Sweden)

    Nurhat Ozkalayci

    2016-01-01

    Full Text Available The aim of this study is to present a new upper molar distalization appliance called Cise distalizer designed as intraoral device supported with orthodontic mini screw for upper permanent molar distalization. The new appliance consists of eight main components. In order to understand the optimum force level, the appliance under static loading is tested by using strain gage measurement techniques. Results show that one of the open coils produces approximately 300 gr distalization force. Cise distalizer can provide totally 600 gr distalization force. This range of force level is enough for distalization of upper first and second molar teeth.

  4. Limited distal organelles and synaptic function in extensive monoaminergic innervation.

    Science.gov (United States)

    Tao, Juan; Bulgari, Dinara; Deitcher, David L; Levitan, Edwin S

    2017-08-01

    Organelles such as neuropeptide-containing dense-core vesicles (DCVs) and mitochondria travel down axons to supply synaptic boutons. DCV distribution among en passant boutons in small axonal arbors is mediated by circulation with bidirectional capture. However, it is not known how organelles are distributed in extensive arbors associated with mammalian dopamine neuron vulnerability, and with volume transmission and neuromodulation by monoamines and neuropeptides. Therefore, we studied presynaptic organelle distribution in Drosophila octopamine neurons that innervate ∼20 muscles with ∼1500 boutons. Unlike in smaller arbors, distal boutons in these arbors contain fewer DCVs and mitochondria, although active zones are present. Absence of vesicle circulation is evident by proximal nascent DCV delivery, limited impact of retrograde transport and older distal DCVs. Traffic studies show that DCV axonal transport and synaptic capture are not scaled for extensive innervation, thus limiting distal delivery. Activity-induced synaptic endocytosis and synaptic neuropeptide release are also reduced distally. We propose that limits in organelle transport and synaptic capture compromise distal synapse maintenance and function in extensive axonal arbors, thereby affecting development, plasticity and vulnerability to neurodegenerative disease. © 2017. Published by The Company of Biologists Ltd.

  5. Fractures of the distal radius in children: A retrospective evaluation

    Directory of Open Access Journals (Sweden)

    Selma Yazıcı

    2012-06-01

    Full Text Available Objectives: This study designed to evaluate the resultsof treatment, closed reduction and percutaneous wires, ofthe distal radius fractures in children.Materials and methods: A retrospective analysis wascarried out in children aged between 5-15 years who presentedwith a displaced fracture of the distal radius to ourhospital. They were initially treated with closed reductionand cast immobilization. If the fractures redisplaced treatedby percutaneous Kirschner (K- wire with scope undera general anaesthesia.Results: Totally 104 patients, who have distal radius fractureswere treated by closed reduction and immobilizationin a plaster cast. 13 patient who have distal radiusfractures were treated by closed reduction under generalanaesthesia and fixed by percutaneous Kirschner (K-wire. Patients with impaired the alignment of the fracturein late period were usually completely displaced fractures.(n=5, 4,3%, in early period, completely displaced fractures(n=5, 4,3% are superior to partial displaced fractures(n=2, 1,7%.Conclusion: In our study, when children with distal radiusfracture first come, they were treated by closed reductionand immobilization in a plaster cast. We thought that inredisplaced fractures patients were suitable for the closedreduction with percutaneous wire treatment.

  6. Laparoscopic versus open distal pancreatectomy for pancreatic cancer.

    Science.gov (United States)

    Riviere, Deniece; Gurusamy, Kurinchi Selvan; Kooby, David A; Vollmer, Charles M; Besselink, Marc G H; Davidson, Brian R; van Laarhoven, Cornelis J H M

    2016-04-04

    Surgical resection is currently the only treatment with the potential for long-term survival and cure of pancreatic cancer. Surgical resection is provided as distal pancreatectomy for cancers of the body and tail of the pancreas. It can be performed by laparoscopic or open surgery. In operations on other organs, laparoscopic surgery has been shown to reduce complications and length of hospital stay as compared with open surgery. However, concerns remain about the safety of laparoscopic distal pancreatectomy compared with open distal pancreatectomy in terms of postoperative complications and oncological clearance. To assess the benefits and harms of laparoscopic distal pancreatectomy versus open distal pancreatectomy for people undergoing distal pancreatectomy for pancreatic ductal adenocarcinoma of the body or tail of the pancreas, or both. We used search strategies to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Science Citation Index Expanded and trials registers until June 2015 to identify randomised controlled trials (RCTs) and non-randomised studies. We also searched the reference lists of included trials to identify additional studies. We considered for inclusion in the review RCTs and non-randomised studies comparing laparoscopic versus open distal pancreatectomy in patients with resectable pancreatic cancer, irrespective of language, blinding or publication status.. Two review authors independently identified trials and independently extracted data. We calculated odds ratios (ORs), mean differences (MDs) or hazard ratios (HRs) along with 95% confidence intervals (CIs) using both fixed-effect and random-effects models with RevMan 5 on the basis of intention-to-treat analysis when possible. We found no RCTs on this topic. We included in this review 12 non-randomised studies that compared laparoscopic versus open distal pancreatectomy (1576 participants: 394 underwent laparoscopic distal pancreatectomy and 1182

  7. Trypanosoma sp. diversity in Amazonian bats (Chiroptera; Mammalia) from Acre State, Brazil.

    Science.gov (United States)

    Dos Santos, Francisco C B; Lisboa, Cristiane V; Xavier, Samanta C C; Dario, Maria A; Verde, Rair de S; Calouro, Armando M; Roque, André Luiz R; Jansen, Ana M

    2017-11-16

    Bats are ancient hosts of Trypanosoma species and their flying ability, longevity and adaptability to distinct environments indicate that they are efficient dispersers of parasites. Bats from Acre state (Amazon Biome) were collected in four expeditions conducted in an urban forest (Parque Zoobotânico) and one relatively more preserved area (Seringal Cahoeira) in Rio Branco and Xapuri municipalities. Trypanosoma sp. infection was detected by hemoculture and fresh blood examination. Isolated parasite species were identified by the similarity of the obtained DNA sequence from 18S rDNA polymerase chain reaction and reference strains. Overall, 367 bats from 23 genera and 32 species were examined. Chiropterofauna composition was specific to each municipality, although Artibeus sp. and Carollia sp. prevailed throughout. Trypanosoma sp. infection was detected in 85 bats (23·2%). The most widely distributed and prevalent genotypes were (in order) Trypanosoma cruzi TcI, T. cruzi marinkellei, Trypanosoma dionisii, T. cruzi TcIV and Trypanosoma rangeli. At least one still-undescribed Trypanosoma species was also detected in this study. The detection of T. cruzi TcI and TcIV (the ones associated with Chagas disease in Amazon biome) demonstrates the putative importance of these mammal hosts in the epidemiology of the disease in the Acre State.

  8. Demystifying "oxi" cocaine: Chemical profiling analysis of a "new Brazilian drug" from Acre State.

    Science.gov (United States)

    da Silva Junior, Ronaldo C; Gomes, Cezar S; Goulart Júnior, Saulo S; Almeida, Fernanda V; Grobério, Tatiane S; Braga, Jez W B; Zacca, Jorge J; Vieira, Maurício L; Botelho, Elvio D; Maldaner, Adriano O

    2012-09-10

    Recent information from various sources suggests that a new illicit drug, called "oxi", is being spread across Brazil. It would be used in the smoked form and it would look like to crack cocaine: usually small yellowish or light brown stones. As fully released in the media, "oxi" would differ from crack cocaine in the sense that crack would contain carbonate or bicarbonate salts whereas "oxi" would include the addition of calcium oxide and kerosene (or gasoline). In this context, this work presents a chemical profiling comparative study between "oxi" street samples seized by the Civil Police of the State of Acre (CP/AC) and samples associated with both international and interstate drug trafficking seized by the Brazilian Federal Police in Acre (FP/AC). The outcome of this work assisted Brazilian authorities to stop inaccurate and alarmist releases on this issue. It may be of good use by the forensic community in order to better understand matters in their efforts to guide local law enforcement agencies in case such claims reach the international illicit market. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Genetic diversity of "Pimenta Longa" genotypes (Piper spp., Piperaceae of the Embrapa Acre germplasm collection

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    Lúcia Helena de Oliveira Wadt

    2004-01-01

    Full Text Available The commonly known Pimenta longa is a commercially valuable natural resource found wild in Acre, Brazil. Specifically, three Piperaceae species with contested taxonomic status were studied, Piper hispidinervum, Piper aduncum, and Piper hispidum, to assesses the inter- and intra-specific genetic relationship of 49 Piper genotypes kept in the Pimenta longa germplasm collection at Embrapa Acre, using sixty six Random Amplified Polymorphic DNA (RAPD markers. The DNA polymorphism level detected was high (96.97%, but the marker frequencies for each species showed polymorphism levels of 79.4% for Piper hispidinervum and 5.3% for P. aduncum. The genetic similarity clustering analysis resulted in three distinct groups corresponding to Piper hispidinervum, Piper aduncum, and Piper hispidum. Four and nine characteristic RAPD markers were identified for P. hispidinervum and P. aduncum, respectively, supporting the existence of two separate species. However, six genotypes collected in Tarauacá county formed a distinct subgroup within the P. hispidinervum group and may be considered as an ecotype of this species or an intermediate between the P. hispidinervum and P. aduncum groups. More extensive sampling of both P. hispidinervum and P. aduncum populations throughout the region are needed to further establish their relation and its implication for breeding efforts.

  10. Switch loop flexibility affects substrate transport of the AcrB efflux pump

    International Nuclear Information System (INIS)

    Muller, Reinke T.; Travers, Timothy; Cha, Hi-jea; Phillips, Joshua L.

    2017-01-01

    The functionally important switch-loop of the trimeric multidrug transporter AcrB separates the access and deep drug binding pockets in every protomer. This loop, comprising 11 amino acid residues, has been shown to be crucial for substrate transport, as drugs have to travel past the loop to reach the deep binding pocket and from there are transported outside the cell via the connected AcrA and TolC channels. It contains four symmetrically arranged glycine residues suggesting that flexibility is a key feature for pump activity. Upon combinatorial substitution of these glycine residues to proline, functional and structural asymmetry was observed. Proline substitutions on the PC1 proximal side completely abolished transport and reduced backbone flexibility of the switch loop, which adopted a conformation restricting the pathway towards the deep binding pocket. Here, two phenylalanine residues located adjacent to the substitution sensitive glycine residues play a role in blocking the pathway upon rigidification of the loop, since the removal of the phenyl rings from the rigid loop restores drug transport activity.

  11. Prevalence of and factors associated with overweight among university students from Rio Branco, Acre – Brazil

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    Gustavo de Souza Moretti

    2014-05-01

    The aim of this study was to determine the prevalence of and factors associated with overweight among university students from the city of Rio Branco, Acre, Brazil. A cross-sectional study was conducted on 1,104 students (mean age: 24 years from Rio Branco, Acre. Overweight was used as the dependent variable. The following independent variables were studied: socioeconomic variables (gender, age, teaching institution, period of study, marital status, income, household members, living with other people, parent’s education level, and working or not; self-reported health and morbidity variables (health perception, hypertension, diabetes, and altered cholesterol; lifestyle variables (physical activity, watching television, computer use, smoking, and alcohol consumption. The nutritional status was classified based on body mass index. Univariate analysis was performed using Pearson’s chi-squared test or Fisher’s exact test. Variables with a p value < 20% on univariate analysis were included in the multiple Poisson regression model. The prevalence of overweight was 35.6%. In the multiple regression model for male students adjusted for age, overweight was associated with marital status, household income, hypertension, and watching television every day. In the model for female students, the variables that remained associated were self-perceived health status, hypertension, and alcohol consumption in the last month. Overweight is determined by a combination of different factors which differed in the present study between men and women.

  12. [Motorcycle accidents in the municipality of Rio Branco in the State of Acre: characterization and trends].

    Science.gov (United States)

    Rocha, Greiciane da Silva; Schor, Néia

    2013-03-01

    The scope of this paper is to assess traffic accidents involving motorcycles, the victims involved and the increase in the fleet compared with other vehicles in Rio Branco, State of Acre. It is an epidemiological, descriptive and transversal study of accidents between 2005 and 2008 recorded by the Acre State Highway Department. There were 3,582 motorcycle accidents and 3,768 victims in the period. The motorcycle fleet increased by 72.8%, with involvement in accidents increasing by 42.2%, while accidents involving other vehicles only increased by 9.2%. As regards victims, there is a predominance of men, with rates of 561.1, with the age groups of between 20 and 29 and 30 and 39 being the highest, with 755.4 and 542.2, respectively. With reference to accident characteristics, the highest number of accidents - 32.4% - occurred in the afternoon, followed by the morning with 29.2% and the evening with 28.9%. 18.3% occurred on Saturdays and 15.7% on Sundays. Collisions were the commonest kind of accident, with 3,036 (84.8%) occurrences. The conclusion drawn is that it is essential to stage ongoing preventive programs and ensure greater integration among the institutions involved, with planning and campaigns to reverse the current situation.

  13. Quantification of aluminium in soil of the Solimões Formation, Acre State, Brazil

    Directory of Open Access Journals (Sweden)

    Thiago Andrade Bernini

    2013-12-01

    Full Text Available The variety of soils in the State of Acre is wide and their chemical profiles are still not fully understood. The nature of the material of origin of these soils is indicated by the high aluminium (Al content, commonly associated with high calcium (Ca and magnesium (Mg contents. The study objective was to use different methods to quantify Al in soils from toposequences formed from material of a sedimentary nature originating from the Solimões Formation, in Acre, Brazil. Trenches were opened at three distinct points in the landscape: shoulder, backslope and footslope positions. Soil samples were collected for physical, chemical, mineralogical analyses. The Al content was quantified using different methods. High Al contents were found in most of these horizons, associated with high Ca and Mg levels, representing the predominant cations in the sum of exchangeable bases. The mineralogy indicates that the soils are still in a low weathering phase, with the presence of significant quantities of 2:1 minerals. Similar Al contents were determined by the methods of NaOH titration, xylenol orange spectrometry and inductively coupled plasma optical emission spectrometry. However, no consistent data were obtained by the pyrocatechol violet method. Extraction with KCl overestimated the exchangeable Al content due to its ability to extract the non-exchangeable Al present in the smectite interlayers. It was observed that high Al contents are related to the instability of the hydroxyl-Al smectite interlayers.

  14. Toxoplasma gondii antibodies in domiciled cats from rio branco Municipality, Acre State, Brazil

    Directory of Open Access Journals (Sweden)

    Soraia Figueiredo de Souza

    2015-12-01

    Full Text Available Blood samples were collected from 89 cats to assess the prevalence of IgG antibodies against Toxoplasma gondii by indirect immunofluorescence (IIF and the possible risk factors associated with feline Toxoplasma gondii infection. An epidemiological questionnaire was developed and implemented for owners of domestic cats domiciled in Rio Branco, Acre. The results were statistically evaluated with the odds ratio and chi-square tests, considering the significance level of 5%. Of 89 animals’ samples, 22 had antibodies against Toxoplasma gondii. Among the 22 reactive animals, 15 (68.19% were female, 15 (68.19% were less than one year old and 20 (90% were cross breed. Concerning risk factors, there was no difference (p > 0.05 between the variables evaluated by the chi-square test. Moreover, 16 (72% cats were fed a mixed diet, 20 (90% of the cats had hunting habits, 18 (81% had contact with animals of another species, 11 (50% had access to the street, and 22 (95% lived in homes that had areas of grass or dirt. In conclusion, the prevalence of anti-Toxoplasma gondii in domestic cats was 22.7%, and there were no significant risk factors for feline toxoplasmosis in the municipality of Rio Branco, Acre.

  15. Breast Cancer Screening for Average-Risk Women: Recommendations From the ACR Commission on Breast Imaging.

    Science.gov (United States)

    Monticciolo, Debra L; Newell, Mary S; Hendrick, R Edward; Helvie, Mark A; Moy, Linda; Monsees, Barbara; Kopans, Daniel B; Eby, Peter R; Sickles, Edward A

    2017-09-01

    Breast cancer is the most common non-skin cancer and the second leading cause of cancer death for women in the United States. Before the introduction of widespread mammographic screening in the mid-1980s, the death rate from breast cancer in the US had remained unchanged for more than 4 decades. Since 1990, the death rate has declined by at least 38%. Much of this change is attributed to early detection with mammography. ACR breast cancer screening experts have reviewed data from RCTs, observational studies, US screening data, and other peer-reviewed literature to update our recommendations. Mammography screening has consistently been shown to significantly reduce breast cancer mortality over a variety of study designs. The ACR recommends annual mammography screening starting at age 40 for women of average risk of developing breast cancer. Our recommendation is based on maximizing proven benefits, which include a substantial reduction in breast cancer mortality afforded by regular screening and improved treatment options for those diagnosed with breast cancer. The risks associated with mammography screening are also considered to assist women in making an informed choice. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. Giant Cell Tumour of the Distal Ulna: A Rare Presentation

    Directory of Open Access Journals (Sweden)

    Ruben Jaya Kumar

    2011-07-01

    Full Text Available Giant-cell tumour (GCT of bone, a primary yet locally aggressive benign tumour, commonly affects patients between the ages of 20 and 40 years, with the peak incidence occurring in the third decade. Women are affected slightly more than men. The distal end of the ulna is an extremely uncommon site for primary bone tumours in general and giant cell tumours in particular. Wide resection of the distal ulna is the recommended treatment for GCT in such locations. Radio-ulna convergence and dorsal displacement of the ulna stump are known complications following ulna resection proximal to the insertion of the pronator quadratus. This leads to reduction in grip power and forearm rotatory motion. Stabilization of the ulna stump with extensor carpi ulnaris (ECU tendon after wide resection of the tumour has been described in the literature. We report a case of GCT of distal end of ulna treated with wide resection and stabilization with ECU tendon.

  17. Segmental reversal of distal small intestine in short bowel syndrome

    DEFF Research Database (Denmark)

    Grave, Pernille Kock; Thomsen, Sabrina Valentin; Clark, Pia Susanne

    2018-01-01

    were the influence on cell proliferation and mucosal architecture shown by histological analysis. Methods: Sixteen piglets underwent a 60% resection of the distal small intestine and were randomized into two groups. Group 1 short bowel syndrome alone (SBS) (n = 8) and group 2 with reversal of a distal...... small intestinal segment (SBS-RS) (n = 8). Body weight was measured daily and the pigs were euthanized after 1 month. Crypt depths, villus heights and muscle layers thicknesses were measured. For the evaluation of microvilli of the brush border of the epithelium and cell proliferation...... was found in the SBS group and increase in the thickness of the circular and longitudinal muscle layers in the SBS-RS group. In the distal ileal segment the longitudinal muscle layer thicknesses were increased in the SBS group. Otherwise, no significant changes were found. Conclusion: Reversal of a 20-cm...

  18. Fractures of the distal tibia treated with polyaxial locking plating.

    Science.gov (United States)

    Gao, Hong; Zhang, Chang-Qing; Luo, Cong-Feng; Zhou, Zu-Bin; Zeng, Bing-Fang

    2009-03-01

    We evaluated the healing rate, complications, and functional outcomes in 32 adult patients with very short metaphyseal fragments in fractures of the distal tibia treated with a polyaxial locking system. The average distance from the distal extent of the fracture to the tibial plafond was 11 mm. All fractures healed and the average time to union was 14 weeks. Six patients (19%) reported occasional local disturbance over the medial malleolus. There were two cases of postoperative superficial infections and evidence of delayed wound healing. Using the American Orthopaedic Foot and Ankle Society ankle score, the average functional score was 87.3 points (of 100 total possible points). Our results show the polyaxial locking plates, which offer more fixation versatility, may be a reasonable treatment option for distal tibia fractures with very short metaphyseal segments.

  19. Laparoscopic distal pancreatectomy for adenocarcinoma: safe and reasonable?

    Science.gov (United States)

    Postlewait, Lauren M.

    2015-01-01

    As a result of technological advances during the past two decades, surgeons now use minimally invasive surgery (MIS) approaches to pancreatic resection more frequently, yet the role of these approaches for pancreatic ductal adenocarcinoma resections remains uncertain, given the aggressive nature of this malignancy. Although there are no controlled trials comparing MIS technique to open surgical technique, laparoscopic distal pancreatectomy for pancreatic adenocarcinoma is performed with increasing frequency. Data from retrospective studies suggest that perioperative complication profiles between open and laparoscopic distal pancreatectomy are similar, with perhaps lower blood loss and fewer wound infections in the MIS group. Concerning oncologic outcomes, there appear to be no differences in the rate of achieving negative margins or in the number of lymph nodes (LNs) resected when compared to open surgery. There are limited recurrence and survival data on laparoscopic compared to open distal pancreatectomy for pancreatic adenocarcinoma, but in the few studies that assess long term outcomes, recurrence rates and survival outcomes appear similar. Recent studies show that though laparoscopic distal pancreatectomy entails a greater operative cost, the associated shorter length of hospital stay leads to decreased overall cost compared to open procedures. Multiple new technologies are emerging to improve resection of pancreatic cancer. Robotic pancreatectomy is feasible, but there are limited data on robotic resection of pancreatic adenocarcinoma, and outcomes appear similar to laparoscopic approaches. Additionally fluorescence-guided surgery represents a new technology on the horizon that could improve oncologic outcomes after resection of pancreatic adenocarcinoma, though published data thus far are limited to animal models. Overall, MIS distal pancreatectomy appears to be a safe and reasonable approach to treating selected patients with pancreatic ductal

  20. Neglected Distal Humeral Epiphyseal Injury - Two Case Reports

    Directory of Open Access Journals (Sweden)

    Dr. Pankaj Kumar

    2008-07-01

    Full Text Available Distal humeral epiphyseal separation is an uncommon injury in children, which can be missed or misdiagnosed at initial presentation. Awareness of this injury and appropriate radiological assessment helps in proper management. Neglected cases because of inappropriate diagnosis can result in cubitus varus deformity. Full range of movements of elbow can be achieved if properly diagnosed and managed. We present two cases of neglected distal humeral epiphyseal injury in children that resulted in cubitus varus deformity in one case. Full range of movements was achieved in both cases after proper management.

  1. Distal vertebral artery reconstruction when managing vertebrobasilar insufficiency

    Directory of Open Access Journals (Sweden)

    D. M. Galaktionov

    2017-11-01

    Full Text Available This article presents a literature review devoted to the reconstruction of the distal vertebral artery and a clinical case of successful surgical treatment of a patient suffering from vertebrobasilar insufficiency caused by occlusion of the vertebral artery in a proximal segment. The external carotid artery-distal vertebral artery bypass was performed by using the radial artery.Received 27 February 2017. Revised 25 July 2017. Accepted 3 August 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest. 

  2. Robotic spleen-preserving distal pancreatectomy. A case report.

    Science.gov (United States)

    Vasilescu, C; Sgarbura, O; Tudor, S; Herlea, V; Popescu, I

    2009-01-01

    Distal pancreatectomy (DP) is the removal of the pancreatic tissue at the left side of the superior mesenteric vein and it is traditionally approached by an open or laparoscopic exposure. Preservation of the spleen is optional but appears to have a better immunological outcome. We present the case of a 53-year old patient with a 2.4/2.2 tumor located in the tail of the pancreas, with high tumour marker values for whom we decided to perform a robotic spleen-preserving distal pancreatectomy (RSPDP). The postoperative outcome was satisfactory. In conclusion, we recommend this type of approach for small pancreatic tail lesions.

  3. Locking plates in distal humerus fractures: study of 43 patients

    Directory of Open Access Journals (Sweden)

    Gupta Rakesh Kumar

    2013-08-01

    Full Text Available 【Abstract】Objective: The treatment of multi-fragmentary, intraarticular fractures of the distal humerus is difficult, even in young patients with bone of good quality. Small distal fragment, diminished bone mineral quality and increased trauma-associated joint destruction make stable joint reconstruction more problematic. The anatomically preshaped locking plates allow angular stable fixation for these complex fractures. We evaluated functional results of patients treated with open reduction and internal fixation with distal humerus locking plates for complex distal hu-merus fractures. Methods: Forty-three consecutive patients with ar-ticular fractures of the distal humerus were treated by open reduction and internal fixation with AO distal humerus plate system and locking reconstruction plates. Forty patients were available for the final outcome analysis. According to AO/ASIF classification, there were 2 cases of type A2, 4 cases of type A3, 1 case of type B1, 1 case of type B2, 14 cases of type C1, 7 cases of type C2 and 11 cases of type C3. Open reduction with triceps splitting technique was used in all patients. The clinical and radiographic follow-up was performed and outcome measures included pain assessment, range of motion, and Mayo elbow performance score. Results: Forty patients were available for the final outcome analysis. There were 29 males and 11 females with an average age of 38.4 years (18-73 years. Clinical and ra-diological consolidation of the fracture was observed in all cases at an average of 11.6 weeks (9-14 weeks. The average follow-up was 12 months (10-18 months. Using the Mayo elbow performance score the results obtained were graded as excellent or good results in 33 patients (82.5%. One pa-tient had superficial infection, and 4 had myositis ossificans. There were no cases of primary malposition or secondary displacement, implant failure or ulnar neuropathy. Conclusion: Anatomically preshaped distal humerus locking

  4. Traumatisk distal humerus-epifysiolyse hos nyfødt

    DEFF Research Database (Denmark)

    Al-Aubaidi, Zaid; Nielsen, Keld Daubjerg

    2010-01-01

    Traumatic distal humerus epiphysiolysis (TDHE) is a rare injury in infants with an incidence of about 1:35,000 births. It is primarily a birth injury, but it is also seen in cases of battered child syndrome. Because of its rare occurrence and the diagnostic difficulties, the lesion may be overloo......Traumatic distal humerus epiphysiolysis (TDHE) is a rare injury in infants with an incidence of about 1:35,000 births. It is primarily a birth injury, but it is also seen in cases of battered child syndrome. Because of its rare occurrence and the diagnostic difficulties, the lesion may...

  5. Primary bone lymphoma of the distal tibia mimicking brodie's abscess

    International Nuclear Information System (INIS)

    Park, Jina; Lee, Seung Hun; Joo, Kyung Bin; Park, Chan Kum

    2014-01-01

    The 'penumbra sign' on an unenhanced T1-weighted image is a well-known characteristic of Brodie's abscess, and this sign is extremely helpful for discriminating subacute osteomyelitis from other bone lesions. We present a case of primary bone lymphoma of the distal tibia mimicking subacute osteomyelitis with Brodie's abscess in a 50-year-old woman. Initial radiographs and MRI showed a lesion in the distal tibia consistent with Brodie's abscess with the penumbra sign. Histopathological examination of the surgical biopsy specimen confirmed the presence of a diffuse large B-cell lymphoma involving the bone.

  6. Nontraumatic osteonecrosis of the distal pole of the scaphoid

    Directory of Open Access Journals (Sweden)

    Bhavuk Garg

    2011-01-01

    Full Text Available Post traumatic osteonecrosis of distal pole of scaphoid is very rare. We present a case of 34 years old male, drill operator by occupation with nontraumatic osteonecrosis of distal pole of the scaphoid. The patient was managed conservatively and was kept under regular follow-up every three months. The patient was also asked to change his profession. Two years later, the patient had no pain and had mild restriction of wrist movements (less than 15 degrees in either direction. The radiographs revealed normal density of the scaphoid suggesting revascularization.

  7. Osteoblastoma-like osteosarcoma of the distal tibia

    Energy Technology Data Exchange (ETDEWEB)

    Abramovici, Luigia; Steiner, German C. [Department of Pathology and Laboratory Medicine, Hospital for Joint Diseases, New York, NY (United States); Kenan, Samuel [Department of Orthopaedic Oncology Surgery, Hospital for Joint Diseases, New York, NY (United States); Hytiroglou, Prodromos [Aristotle University, Thessaloniki (Greece); Rafii, Mahvash [Department of Radiology, Hospital for Joint Diseases, New York, NY (United States)

    2002-03-01

    We report a case of a 14-year-old boy with an intracompartmental lytic lesion with poorly defined margins in the right distal tibia that was originally treated with curettage and bone grafting. Histologic examination showed an osteoblastic tumor with unusual features, which was found on consultation to be an osteoblastoma-like osteosarcoma, a rare, low-grade variant of osteosarcoma. Subsequently, the patient underwent en bloc resection of the distal tibia, which was replaced with vascularized bone graft and followed by chemotherapy. Two years later, he is alive with lung metastases. (orig.)

  8. Osteoblastoma-like osteosarcoma of the distal tibia

    International Nuclear Information System (INIS)

    Abramovici, Luigia; Steiner, German C.; Kenan, Samuel; Hytiroglou, Prodromos; Rafii, Mahvash

    2002-01-01

    We report a case of a 14-year-old boy with an intracompartmental lytic lesion with poorly defined margins in the right distal tibia that was originally treated with curettage and bone grafting. Histologic examination showed an osteoblastic tumor with unusual features, which was found on consultation to be an osteoblastoma-like osteosarcoma, a rare, low-grade variant of osteosarcoma. Subsequently, the patient underwent en bloc resection of the distal tibia, which was replaced with vascularized bone graft and followed by chemotherapy. Two years later, he is alive with lung metastases. (orig.)

  9. Distal renal tubular acidosis and amelogenesis imperfecta: A rare association

    Directory of Open Access Journals (Sweden)

    P Ravi

    2013-01-01

    Full Text Available Renal tubular acidosis (RTA is characterized by a normal anion gap with hyperchloremic metabolic acidosis. Primary distal RTA (type I is the most common RTA in children. Childhood presentation of distal RTA includes vomiting, failure to thrive, metabolic acidosis, and hypokalemia. Amelogenesis imperfecta (AI represents a condition where the dental enamel and oral tissues are affected in an equal manner resulting in the hypoplastic or hypopigmented teeth. We report a 10-year-old girl, previously asymptomatic presented with the hypokalemic paralysis and on work-up found out to have type I RTA. The discoloration of teeth and enamel was diagnosed as AI.

  10. Modified distal shoe appliance--fabrication and clinical performance.

    Science.gov (United States)

    Gujjar, Kumar Raghav; Indushekar, K R; Amith, H V; Sharma, Shefali Li

    2012-01-01

    When the primary second molar is prematurely lost, mesial movement and migration of the permanent first molar often occurs. This is one of the most difficult problems of the developing dentition confronted by pediatric dentists. Use of a space maintainer that will guide the permanent first molar into its normal position is indicated. In cases with bilateral premature loss of primary molars, the conventional design of distal shoe poses a variety of problems and, therefore, necessitates a customized design for the eruption guidance of permanent first molars. The purpose of this case report is to discuss an innovative design of a distal shoe appliance, which was used with good clinical results.

  11. Screening renal stone formers for distal renal tubular acidosis

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    A group of 110 consecutive renal stone formers were screened for distal renal tubular acidosis (RTA) using morning fasting urinary pH (mfUpH) levels followed by a short ammonium chloride loading test in patients with levels above 6.0. In 14 patients (12.7%) a renal acidification defect was noted...... RTA in renal stone formers. Regardless of whether the acidification defect is primary or secondary to stone formation, however, all renal stone formers with distal RTA can expect to benefit from prophylactic alkaline therapy and it is recommended that the screening procedure, which is easy to use...

  12. Theory on the mechanism of distal action of transcription factors: looping of DNA versus tracking along DNA

    Energy Technology Data Exchange (ETDEWEB)

    Murugan, R, E-mail: rmurugan@gmail.co [Department of Biotechnology, Indian Institute of Technology Madras, Chennai 600036 (India)

    2010-10-15

    In this paper, we develop a theory on the mechanism of distal action of the transcription factors, which are bound at their respective cis-regulatory enhancer modules on the promoter-RNA polymerase II (PR) complexes to initiate the transcription event in eukaryotes. We consider both the looping and tracking modes of their distal communication and calculate the mean first passage time that is required for the distal interactions of the complex of enhancer and transcription factor with the PR via both these modes. We further investigate how this mean first passage time is dependent on the length of the DNA segment (L, base-pairs) that connects the cis-regulatory binding site and the respective promoter. When the radius of curvature of this connecting segment of DNA is R that was induced upon binding of the transcription factor at the cis-acting element and RNAPII at the promoter in cis-positions, our calculations indicate that the looping mode of distal action will dominate when L is such that L > 2{pi}R and the tracking mode of distal action will be favored when L < 2{pi}R. The time required for the distal action will be minimum when L = 2{pi}R where the typical value of R for the binding of histones will be R {approx} 16 bps and L {approx} 10{sup 2} bps. It seems that the free energy associated with the binding of the transcription factor with its cis-acting element and the distance of this cis-acting element from the corresponding promoter of the gene of interest is negatively correlated. Our results suggest that the looping and tracking modes of distal action are concurrently operating on the transcription activation and the physics that determines the timescales associated with the looping/tracking in the mechanism of action of these transcription factors on the initiation of the transcription event must put a selection pressure on the distribution of the distances of cis-regulatory modules from their respective promoters of the genes. The computational analysis

  13. Distally based superficial sural artery flap for soft tissue coverage in the distal 2/3 of leg and foot

    Directory of Open Access Journals (Sweden)

    Kamath B

    2005-01-01

    Full Text Available Background: Skin coverage for defects in the lower 2/3 of leg, ankle region and posterior heel has always been a difficult challenge for reconstructive surgeon. Methods: We describe our experience with the distally based superficial sural artery flap coverage in 48 patients with moderate sized defects in these difficult areas. Results: One out of 48 flaps (in 48 patients was lost totally and 3 suffered marginal necrosis which did not require any secondary procedure. These complications could have been avoided by proper selection of cases and refining technical skills. Conclusion: This simple procedure could be an important and versatile tool for any reconstructive surgeon in providing skin coverage in the distal leg and proximal foot. Preservation of major arteries of the lower limb, minimal donor defect, relatively uninjured donor area in compound fracture or poly trauma involving distal leg are some of the advantages of the flap.

  14. Cloning, expression, purification, crystallization and preliminary X-ray diffraction analysis of the regulator AcrR from Escherichia coli

    International Nuclear Information System (INIS)

    Li, Ming; Qiu, Xi; Su, Chih-Chia; Long, Feng; Gu, Ruoyu; McDermott, Gerry; Yu, Edward W.

    2006-01-01

    The transcriptional regulator AcrR from Escherichia coli has been cloned, overexpressed, purified and crystallized and X-ray diffraction data have been collected to a resolution of 2.5 Å. This paper describes the cloning, expression, purification and preliminary X-ray data analysis of the AcrR regulatory protein. The Escherichia coli AcrR is a member of the TetR family of transcriptional regulators. It regulates the expression of the AcrAB multidrug transporter. Recombinant AcrR with a 6×His tag at the C-terminus was expressed in E. coli and purified by metal-affinity chromatography. The protein was crystallized using hanging-drop vapor diffusion. X-ray diffraction data were collected from cryocooled crystals at a synchrotron light source. The best crystal diffracted to 2.5 Å. The space group was determined to be P3 2 , with unit-cell parameters a = b = 46.61, c = 166.16 Å

  15. Porta-enxertos para laranjeiras-doces (Citrus sinensis (L. Osb., em Rio Branco, Acre Rootstocks for sweet orange (Citrus sinensis (L. Osb. in Rio Branco, Acre, Brazil

    Directory of Open Access Journals (Sweden)

    Ana da Silva Ledo

    1999-07-01

    Full Text Available O objetivo deste trabalho foi de avaliar o comportamento de sete cultivares de laranjeiras- doces: 'Baia 101', 'Baianinha IAC 79', 'Monte Parnaso', 'Pêra D6', 'Natal 112', 'Valência 27' e 'Aquiri', sobre diferentes porta-enxertos: limão 'Cravo', tangerinas 'Cleópatra' e 'Sunki' e citrange 'Carrizo', nas condições edafoclimáticas de Rio Branco, Acre. O delineamento experimental foi em parcelas subdivididas, com as cultivares nas parcelas, os porta-enxertos nas subparcelas e os quatro anos de avaliação como repetições. As laranjeiras 'Pêra D6', 'Natal 112' e 'Valência 27' apresentaram tendências de maior produção quando enxertadas sobre o limão 'Cravo', e a laranja 'Aquiri' quando enxertada sobre citrange 'Carrizo'. Em relação aos demais porta-enxertos, o limão 'Cravo' mostrou tendências de induzir maior produção/volume de copa e peso médio do fruto, e menor teor de sólidos solúveis totais e acidez total. As laranjas do grupo Baia ('Baia 101', 'Baianinha IAC 79' e 'Monte Parnaso' produziram frutos com baixa percentagem de suco; não são recomendadas para plantio em Rio Branco, AC. Com base nos resultados obtidos, recomendam-se os porta-enxertos citrange 'Carrizo', tangerina 'Cleópatra' e limão 'Cravo' para a laranja 'Aquiri', e o porta-enxerto limão 'Cravo' para as laranjas 'Pêra D6', 'Natal 112' e 'Valência 27'.The objective of this study was to evaluate the behaviour of seven sweet orange cultivars: 'Baia 101', 'Baianinha IAC 79', 'Monte Parnaso', 'Pêra D6', 'Natal 112', 'Valência 27' and 'Aquiri' grafted on different rootstocks: 'Rangpur' lime, 'Cleópatra' and 'Sunki' mandarins, and 'Carrizo' citrange, in the environmental conditions of Rio Branco, Acre, Brazil. The experimental design was a split-plot, with the sweet orange cultivars as the main plots, the rootstocks as the sub-plots, and the four years of evaluation as replications. The 'Pêra D6', 'Natal 112' and 'Valência 27' sweet orange cultivars tended

  16. Stress Introduction Rate Alters the Benefit of AcrAB-TolC Efflux Pumps.

    Science.gov (United States)

    Langevin, Ariel M; Dunlop, Mary J

    2018-01-01

    Stress tolerance studies are typically conducted in an all-or-none fashion. However, in realistic settings-such as in clinical or metabolic engineering applications-cells may encounter stresses at different rates. Therefore, how cells tolerate stress may depend on its rate of appearance. To address this, we studied how the rate of stress introduction affects bacterial stress tolerance by focusing on a key stress response mechanism. Efflux pumps, such as AcrAB-TolC of Escherichia coli , are membrane transporters well known for the ability to export a wide variety of substrates, including antibiotics, signaling molecules, and biofuels. Although efflux pumps improve stress tolerance, pump overexpression can result in a substantial fitness cost to the cells. We hypothesized that the ideal pump expression level would involve a rate-dependent trade-off between the benefit of pumps and the cost of their expression. To test this, we evaluated the benefit of the AcrAB-TolC pump under different rates of stress introduction, including a step, a fast ramp, and a gradual ramp. Using two chemically diverse stresses, the antibiotic chloramphenicol and the jet biofuel precursor pinene, we assessed the benefit provided by the pumps. A mathematical model describing these effects predicted the benefit as a function of the rate of stress introduction. Our findings demonstrate that as the rate of introduction is lowered, stress response mechanisms provide a disproportionate benefit to pump-containing strains, allowing cells to survive beyond the original inhibitory concentrations. IMPORTANCE Efflux pumps are ubiquitous in nature and provide stress tolerance in the cells of species ranging from bacteria to mammals. Understanding how pumps provide tolerance has far-reaching implications for diverse fields, from medicine to biotechnology. Here, we investigated how the rate of stressor appearance impacts tolerance. We focused on two distinct substrates of AcrAB-TolC efflux pumps, the

  17. Nota sobre culicídeos (Diptera: Culicidae da bacia do rio Purus, Acre, Amazônia (Brasil Note on the culicidae (Diptera: Culicidae of the River Purus Basin, Acre, Amazonian, Brazil

    Directory of Open Access Journals (Sweden)

    Delsio Natal

    1992-04-01

    Full Text Available Foram feitas coletas de mosquito (Diptera: Culicidae na área do projeto de Colonização Pedro Peixoto, no Estado do Acre, Brasil. Obteve-se um total de 4.588 exemplares pertencentes a 53 espécies ou grupos. Salienta-se a ocorrência de Anopheles (Nyssorhynchus oswaldoi.Mosquito (Diptera: Culicidae collections were made on the Pedro Peixoto Colonization Project in the State of Acre, Brazil. Four thousand, five hundred and eighty-eight (4,588 specimens were collected and fifty-three (53 species or group recognised. The occurrence of Anopheles (Nyssorhynchus oswaldoi is given special emphasis.

  18. Genetics Home Reference: CAV3-related distal myopathy

    Science.gov (United States)

    ... gene causes a peculiar form of distal myopathy. Neurology. 2002 Jan 22;58(2):323-5. Erratum in: Neurology 2002 Mar 12;58(5):839. Itoyoma Y [ ... 3 cause four distinct autosomal dominant muscle diseases. Neurology. 2004 Feb 24;62(4):538-43. Review. ...

  19. Urethral advancement procedure in the treatment of primary distal ...

    African Journals Online (AJOL)

    advancement in the repair of primary distal penile hypospadias with regard to feasibility, complication rates .... stones and growth, and any associated congenital anomaly. Meticulous local examination was performed ... with a tourniquet placed on the root of the penis. A submeatal crescent-like incision was performed a few.

  20. Neglected distal humeral epiphyseal injury - Two Case Reports ...

    African Journals Online (AJOL)

    We present two cases of neglected distal humeral epiphyseal injury in children that resulted in cubitus varus deformity in one case. Full range of movements was achieved in both cases after proper management. Keywords: Neglected epiphyseal injury; Cubitus varus; Diagnosis; Treatment Internet Journal of Medical Update ...

  1. Evaluation of Various Filling Techniques in Distal Canals of ...

    African Journals Online (AJOL)

    2017-03-06

    Mar 6, 2017 ... How to cite this article: Dumani A, Yilmaz S, Yoldas O, Kuden C. Evaluation ... Niger J. Clin Pract 2017;20:307-12. This is an open access article distributed ... in oval-shaped distal canals of mandibular molars was inadequate.

  2. Social Support Contributes to Outcomes following Distal Radius Fractures

    Directory of Open Access Journals (Sweden)

    Caitlin J. Symonette

    2013-01-01

    Full Text Available Background. Distal radius fractures are the most common fracture of the upper extremity and cause variable disability. This study examined the role of social support in patient-reported pain and disability at one year following distal radius fracture. Methods. The Medical Outcomes Study Social Support Survey was administered to a prospective cohort of 291 subjects with distal radius fractures at their baseline visit. Pearson correlations and stepwise linear regression models (F-to-remove 0.10 were used to identify whether social support contributes to wrist fracture outcomes. The primary outcome of pain and disability at one year was measured using the Patient Rated Wrist Evaluation. Results. Most injuries were low energy (67.5% and were treated nonoperatively (71.9%. Pearson correlation analysis revealed that higher reported social support correlated with improved Patient Rated Wrist Evaluation scores at 1 year, r(n=181=-0.22, P<0.05. Of the subscales within the Social Support Survey, emotional/informational support explained a significant proportion of the variance in 1-year Patient Rated Wrist Evaluation scores, R2=4.7%, F (1, 181 = 9.98, P<0.05. Conclusion. Lower emotional/informational social support at the time of distal radius fracture contributes a small but significant percentage to patient-reported pain and disability outcomes.

  3. Simultaneous bilateral distal biceps tendon repair: case report

    Directory of Open Access Journals (Sweden)

    Thiago Medeiros Storti

    Full Text Available ABSTRACT Simultaneous bilateral rupture of the distal biceps tendon is a rare clinical entity, seldom reported in the literature and with unclear therapeutic setting. The authors report the case of a 39-year-old white man who suffered a simultaneous bilateral rupture while working out. When weightlifting with elbows at 90° of flexion, he suddenly felt pain on the anterior aspect of the arms, coming for evaluation after two days. He presented bulging contour of the biceps muscle belly and ecchymosis in the antecubital fossa, extending distally to the medial aspect of the forearm, as well as a marked decrease of supination strength and pain in active elbow flexion. MRI confirmed the rupture with retraction of the distal biceps bilaterally. The authors opted for performing the tendon repairs simultaneously through the double incision technique and fixation to the bicipital tuberosity with anchors. The patient progressed quite well, with full return to labor and sports activities, being satisfied with the result after two years of surgery. In the literature search, few reports of simultaneous bilateral rupture of the distal biceps were retrieved, with only one treated in the acute phase of injury. Therefore, the authors consider this procedure to be a good option to solve this complex condition.

  4. Simultaneous bilateral distal biceps tendon repair: case report.

    Science.gov (United States)

    Storti, Thiago Medeiros; Paniago, Alexandre Firmino; Faria, Rafael Salomon Silva

    2017-01-01

    Simultaneous bilateral rupture of the distal biceps tendon is a rare clinical entity, seldom reported in the literature and with unclear therapeutic setting. The authors report the case of a 39-year-old white man who suffered a simultaneous bilateral rupture while working out. When weightlifting with elbows at 90° of flexion, he suddenly felt pain on the anterior aspect of the arms, coming for evaluation after two days. He presented bulging contour of the biceps muscle belly and ecchymosis in the antecubital fossa, extending distally to the medial aspect of the forearm, as well as a marked decrease of supination strength and pain in active elbow flexion. MRI confirmed the rupture with retraction of the distal biceps bilaterally. The authors opted for performing the tendon repairs simultaneously through the double incision technique and fixation to the bicipital tuberosity with anchors. The patient progressed quite well, with full return to labor and sports activities, being satisfied with the result after two years of surgery. In the literature search, few reports of simultaneous bilateral rupture of the distal biceps were retrieved, with only one treated in the acute phase of injury. Therefore, the authors consider this procedure to be a good option to solve this complex condition.

  5. Evaluation of various filling techniques in distal canals of mandibular ...

    African Journals Online (AJOL)

    Evaluation of various filling techniques in distal canals of mandibular molars instrumented with different single-file nickel-titanium systems. ... Comparisons between groups were applied using Student's t-test or one-way ANOVA for normally distributed data. The Mann-Whitney U-test or Kruskal-Wallis test was used when ...

  6. A unique physeal injury of the distal phalanx.

    Science.gov (United States)

    Berber, Onur; Singh, Bijayendra

    2015-01-01

    An unusual Salter-Harris Type 1 fracture variant of the distal phalanx of the index finger is described. The epiphysis was dislocated, sitting dorsally over the middle phalanx head with the articular surface facing dorsal. Reduction could only be achieved through an open procedure. The reduction was stable without supplemental fixation.

  7. Unusual migration of ventriculo peritoneal distal catheter into vagina

    Directory of Open Access Journals (Sweden)

    Sghavamedin Tavallaee

    2015-04-01

    Full Text Available VP shunt is one of the most popular methods for ICP reduction and treatment of hydrocephalus. Various complications of this method are not uncommon such as shunt malfunction, infection and unusual migration of distal catheter. I present a case of migration of the peritoneal catheter out of the vagina.

  8. Laparoscopic versus open distal pancreatectomy for pancreatic cancer

    NARCIS (Netherlands)

    Riviere, D.M.; Gurusamy, K.S.; Kooby, D.A.; Vollmer, C.M.; Besselink, M.G.; Davidson, B.R.; Laarhoven, C.J.H.M. van

    2016-01-01

    BACKGROUND: Surgical resection is currently the only treatment with the potential for long-term survival and cure of pancreatic cancer. Surgical resection is provided as distal pancreatectomy for cancers of the body and tail of the pancreas. It can be performed by laparoscopic or open surgery. In

  9. Laparoscopic versus open distal pancreatectomy for pancreatic cancer

    NARCIS (Netherlands)

    Riviere, Deniece; Gurusamy, Kurinchi Selvan; Kooby, David A.; Vollmer, Charles M.; Besselink, Marc G. H.; Davidson, Brian R.; van Laarhoven, Cornelis J. H. M.

    2016-01-01

    Surgical resection is currently the only treatment with the potential for long-term survival and cure of pancreatic cancer. Surgical resection is provided as distal pancreatectomy for cancers of the body and tail of the pancreas. It can be performed by laparoscopic or open surgery. In operations on

  10. Autosomal dominant distal myopathy: Linkage to chromosome 14

    Energy Technology Data Exchange (ETDEWEB)

    Laing, N.G.; Laing, B.A.; Wilton, S.D.; Dorosz, S.; Mastaglia, F.L.; Kakulas, B.A. [Australian Neuromuscular Research Institute, Perth (Australia); Robbins, P.; Meredith, C.; Honeyman, K.; Kozman, H.

    1995-02-01

    We have studied a family segregating a form of autosomal dominant distal myopathy (MIM 160500) and containing nine living affected individuals. The myopathy in this family is closest in clinical phenotype to that first described by Gowers in 1902. A search for linkage was conducted using microsatellite, VNTR, and RFLP markers. In total, 92 markers on all 22 autosomes were run. Positive linkage was obtained with 14 of 15 markers tested on chromosome 14, with little indication of linkage elsewhere in the genome. Maximum two-point LOD scores of 2.60 at recombination fraction .00 were obtained for the markers MYH7 and D14S64 - the family structure precludes a two-point LOD score {ge} 3. Recombinations with D14S72 and D14S49 indicate that this distal myopathy locus, MPD1, should lie between these markers. A multipoint analysis assuming 100% penetrance and using the markers D14S72, D14S50, MYH7, D14S64, D14S54, and D14S49 gave a LOD score of exactly 3 at MYH7. Analysis at a penetrance of 80% gave a LOD score of 2.8 at this marker. This probable localization of a gene for distal myopathy, MPD1, on chromosome 14 should allow other investigators studying distal myopathy families to test this region for linkage in other types of the disease, to confirm linkage or to demonstrate the likely genetic heterogeneity. 24 refs., 3 figs., 1 tab.

  11. Detection of Lateglacial distal tephra layers in the Netherlands

    NARCIS (Netherlands)

    Davies, S.M.; Hoek, W.Z.; Bohncke, S.J.P.; Lowe, J.; Pyne O'Donnle, S.; Turney, C.S.M.

    2005-01-01

    Three distal tephra layers or cryptotephras have been detected within a sedimentary sequence from the Netherlands that spans the last glacial-interglacial transition. Geochemical analyses identify one as the Vedde Ash, which represents the southernmost discovery of this mid-Younger Dryas tephra so

  12. Outcome of management of distal radius fractures in ...

    African Journals Online (AJOL)

    Background and Purpose: Distal radial fractures are common fractures of postmenopausal age group patients. They are often called fractures of osteoporosis. These fractures are considered to be one of the commonest minor injuries to cause major morbidity in the community. A lot of patient who need surgery, fail to afford ...

  13. Snodgrass repair for distal hypospadias: a review of 75 cases

    African Journals Online (AJOL)

    urologists for distal hypospadias correction. We review our cases to find out whether there was any difference in the rate of urethrocutaneous fistula after the use of single- versus double-layer tubularization, the use of thick versus thin dorsal prepuce subcutaneous flap (DPF), the use of. DPF versus the ventral dartos flap for ...

  14. Spontaneous resolution of splenic infarcts after distal splenorenal ...

    African Journals Online (AJOL)

    Background: In cases of portal hypertension with splenic infarcts, splenectomy with proximal splenorenal shunt has been recommended. We are sharing our experience with distal splenorenal shunt in these cases contrary to the popular belief. Materials and Methods: Splenic infarcts were graded as mild, moderate and ...

  15. Class II correction prior to orthodontics with the carriere distalizer.

    Science.gov (United States)

    McFarlane, Bruce

    2013-01-01

    Class II correction is a challenge in orthodontics with many existing devices being complex, too compliance-driven, or too prone to breakage. The Carriere Distalizer allows for straightforward Class II correction prior to orthodontics (fixed or clear aligners) at a time when no other mechanics interfere, and compliance is at its best.

  16. The distal shoe space maintainer chairside fabrication and clinical performance.

    Science.gov (United States)

    Brill, Warren A

    2002-01-01

    The chairside-fabricated distal shoe appliance, with a stainless steel crown as the retainer, is an efficacious and cost-effective appliance for guiding the unerupted permanent first molar into position after premature loss or extraction of the second primary molar. The fabrication technique is illustrated in this case report and data is presented on the success rate of the appliance.

  17. Minimal requirements of ACR-NEMA digital imaging and communication standards

    International Nuclear Information System (INIS)

    Wang, Y.; Horrii, S.; Lehr, J.

    1986-01-01

    The American College of Radiology-National Electrical Manufacturers Association (ACR-NEMA) Digital Imaging and Communication Standards were formally adopted in December 1985. They are intended to facilitate management and communication of digital image information regardless of source, format, or device manufacturer; to promote the development and expansion of radiologic imaging and communication systems that can also interface with other systems of hospital information; and to allow the creation of diagnostic information databases that can be interrogated by a wide variety of devices distributed geographically. The Standards specify the hardware interface, a minimum set of software commands, and a consistent set of data formats for communication across the interface between an imaging device and a network interface unit or another imaging device

  18. The ACR-program for automatic finite element model generation for part through cracks

    International Nuclear Information System (INIS)

    Leinonen, M.S.; Mikkola, T.P.J.

    1989-01-01

    The ACR-program (Automatic Finite Element Model Generation for Part Through Cracks) has been developed at the Technical Research Centre of Finland (VTT) for automatic finite element model generation for surface flaws using three dimensional solid elements. Circumferential or axial cracks can be generated on the inner or outer surface of a cylindrical or toroidal geometry. Several crack forms are available including the standard semi-elliptical surface crack. The program can be used in the development of automated systems for fracture mechanical analyses of structures. The tests for the accuracy of the FE-mesh have been started with two-dimensional models. The results indicate that the accuracy of the standard mesh is sufficient for practical analyses. Refinement of the standard mesh is needed in analyses with high load levels well over the limit load of the structure

  19. [Echinococcus vogeli cysts in paca liver (Cuniculus paca) native from the Acre State, Brazil].

    Science.gov (United States)

    Meneghelli, U G; Martinelli, A L; Velludo, M A

    1990-01-01

    Four of the patients with polycystic hydatid disease observed by us reported that they were aware of the presence of liver disease in the pacas hunted for food. The viscera of these animals were usually given to domestic dogs. All of our 7 patients reported contact with dogs that had previously ingested viscera of pacas. Examination of the liver considered to be diseased by one of the patients and removed from a paca killed in the same region (State of Acre, Brazil) from which the human cases originated showed the presence of hydatid cysts. The characteristics of the rostellar hooks of the protoscolex indicated that this was the larval form of Echinococcus vogeli. These observations confirm the participation of pacas in the biological cycle of E. vogeli and the pathway through which man may become an alternative intermediate host of this echinococcus.

  20. Heterotrophic components of soil respiration in pastures and forests in southwestern Amazonia, Acre, Brazil

    Directory of Open Access Journals (Sweden)

    Eric Atlas Davidson

    2008-12-01

    Full Text Available In this paper we present data on soil microbial biomass and heterotrophic respiration in pastures, mature and secondary forests, in order to elucidate their contribution to total CO2 flux from soil to atmosphere. The research was conducted in Southwestern Amazonia, Acre State, Brazil. Microbial biomass was estimated using a variation of the traditional fumigation-extraction method and heterotrophic respiration was measured using respirometry flasks attached to an infrared gas analyzer. Soil microbial biomass and heterotrophic respiration did not differ statistically among pastures, mature and secondary forests. These laboratory results indicate that higher CO2 fluxes from pasture soils measured in situ are probably due to higher root respiration by pasture grasses.

  1. ACR-SNM Task Force on Nuclear Medicine Training: report of the task force.

    Science.gov (United States)

    Guiberteau, Milton J; Graham, Michael M

    2011-06-01

    The expansion of knowledge and technological advances in nuclear medicine and radiology require physicians to have more expertise in functional and anatomic imaging. The convergence of these two specialties into the new discipline of molecular imaging has also begun to place demands on residency training programs for additional instruction in physiology and molecular biology. These changes have unmasked weaknesses in current nuclear medicine and radiology training programs. Adding to the impetus for change are the attendant realities of the job market and uncertain employment prospects for physicians trained in nuclear medicine but not also trained in diagnostic radiology. With this background, the ACR and the Society of Nuclear Medicine convened the Task Force on Nuclear Medicine Training to define the issues and develop recommendations for resident training.

  2. Involvement of the Acr3 and DctA anti-porters in arsenite oxidation in Agrobacterium tumefaciens 5A.

    Science.gov (United States)

    Kang, Yoon-Suk; Shi, Zunji; Bothner, Brian; Wang, Gejiao; McDermott, Timothy R

    2015-06-01

    Microbial arsenite (AsIII) oxidation forms a critical piece of the arsenic cycle in nature, though our understanding of how and why microorganisms oxidize AsIII remains rudimentary. Our model organism Agrobacterium tumefaciens 5A contains two distinct ars operons (ars1 and ars2) that are similar in their coding region content. The ars1 operon is located nearby the aio operon that is essential for AsIII oxidation. The AsIII/H(+) anti-porters encoded by acr3-1 and acr3-2 are required for maximal AsIII and antimonite (SbIII) resistance, but acr3-1 (negatively regulated by ArsR-1) appears more active in this regard and also required for AsIII oxidation and expression of aioBA. A malate-phosphate anti-porter DctA is regulated by RpoN and AsIII, and is required for normal growth with malate as a sole carbon source. Qualitatively, a ΔdctA mutant was normal for AsIII oxidation and AsIII/SbIII resistance at metalloid concentrations inhibitory to the Δacr3-1 mutant; however, aioBA induction kinetics was significantly phase-shift delayed. Acr3 involvement in AsIII/SbIII resistance is reasonably well understood, but the role of Acr3 and DctA anti-porters in AsIII oxidation and its regulation is unexpected, and suggests that controlled AsIII trafficking across the cytoplasmic membrane is important to a process understood to occur in the periplasm. © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd.

  3. Laparoscopic radical nephroureterectomy: dilemma of the distal ureter.

    Science.gov (United States)

    Steinberg, Jordan R; Matin, Surena F

    2004-03-01

    Laparoscopic nephroureterectomy has recently emerged as a safe, minimally invasive approach to upper tract urothelial cancers. The most controversial and challenging feature of laparoscopic nephroureterectomy is the management of the distal ureter. We review the most common methods of managing the distal ureter, with emphasis on contemporary oncologic outcomes, indications, advantages, and disadvantages. There are currently in excess of five different approaches to the lower ureter. These techniques often combine features of endoscopic, laparoscopic, or open management. They include open excision, a transvesical laparoscopic detachment and ligation technique, laparoscopic stapling of the distal ureter and bladder cuff, the "pluck" technique, and ureteral intussusception. Each technique has distinct advantages and disadvantages, differing not only in technical approach, but oncological principles as well. While the existing published data do not overwhelmingly support one approach over the others, the open approach remains one of the most reliable and oncologically sound procedures. The principles of surgical oncology dictate that a complete, en-bloc resection, with avoidance of tumor seeding, remains the preferred treatment of all urothelial cancers. The classical open technique of securing the distal ureter and bladder cuff achieves this principle and has withstood the test of time. Transvesical laparoscopic detachment and ligation is an oncologically valid approach in patients without bladder tumors, but is limited by technical considerations. The laparoscopic stapling technique maintains a closed system but risks leaving behind ureteral and bladder cuff segments. Both transurethral resection of the ureteral orifice (pluck) and intussusception techniques should be approached with caution, as the potential for tumor seeding exists. Additional long-term comparative outcomes are needed to solve the dilemma of the distal ureter.

  4. Distal pancreatectomy and splenectomy: a robotic or LESS approach.

    Science.gov (United States)

    Ryan, Carrie E; Ross, Sharona B; Sukharamwala, Prashant B; Sadowitz, Benjamin D; Wood, Thomas W; Rosemurgy, Alexander S

    2015-01-01

    The role and application of robotic surgery are debated, particularly given the expansion of laparoscopy, especially laparoendoscopic single-site (LESS) surgery. This cohort study was undertaken to delineate differences in outcomes between LESS and robotic distal pancreatectomy and splenectomy. With Institutional Review Board approval, patients undergoing LESS or robotic distal pancreatectomy and splenectomy from September 1, 2012, through December 31, 2014, were prospectively observed, and data were collected. The results are expressed as the median, with the mean ± SD. Thirty-four patients underwent a minimally invasive distal pancreatectomy and splenectomy: 18 with robotic and 16 with LESS surgery. The patients were similar in sex, age, and body mass index. Conversions to open surgery and estimated blood loss were similar. There were two intraoperative complications in the group that underwent the robotic approach. Time spent in the operating room was significantly longer with the robot (297 vs 254 minutes, P = .03), although operative duration (i.e., incision to closure) was not longer (225 vs 190 minutes; P = .15). Of the operations studied, 79% were undertaken for neoplastic processes. Tumor size was 3.5 cm for both approaches; R0 resections were achieved in all patients. Length of stay was similar in the two study groups (5 vs 4 days). There was one 30-day readmission after robotic surgery. Patient outcomes are similar with LESS or robotic distal pancreatectomy and splenectomy. Robotic operations require more time in the operating room. Both are safe and efficacious minimally invasive operations that follow similar oncologic principles for similar tumors, and both should be in the surgeon's armamentarium for distal pancreatectomy and splenectomy.

  5. Distal Oblique Bundle Reinforcement for Treatment of DRUJ Instability.

    Science.gov (United States)

    Brink, Peter R G; Hannemann, Pascal F W

    2015-08-01

    Background Chronic, dynamic bidirectional instability in the distal radioulnar joint (DRUJ) is diagnosed clinically, based on the patient's complaints and the finding of abnormal laxity in the vicinity of the distal ulna. In cases where malunion is ruled out or treated and there are no signs of osteoarthritis, stabilization of the DRUJ may offer relief. To this end, several different techniques have been investigated over the past 90 years. Materials and Methods In this article we outline the procedure for a new technique using a tendon graft to reinforce the distal edge of the interosseous membrane. Description of Technique A percutaneous technique is used to harvest the palmaris longus tendon and to create a tunnel, just proximal to the sigmoid notch, through the ulna and radius in an oblique direction. By overdrilling the radial cortex, the knotted tendon can be pulled through the radius and ulna and the knot blocked at the second radial cortex, creating a strong connection between the radius and ulna at the site of the distal oblique bundle (DOB). The tendon is fixed in the ulna with a small interference screw in full supination, preventing subluxation of the ulna out of the sigmoid notch during rotation. Results Fourteen patients were treated with this novel technique between 2011 and October 2013. The QuickDASH score at 25 months postoperatively (range 16-38 months) showed an improvement of 32 points. Similarly, an improvement of 33 points (67-34 months) was found on the PRWHE. Only one recurrence of chronic, dynamic bidirectional instability in the DRUJ was observed. Conclusion This simple percutaneous tenodesis technique between radius and ulna at the position of the distal edge of the interosseous membrane shows promise in terms of both restoring stability and relieving complaints related to chronic subluxation in the DRUJ.

  6. (S-5-ethynyl-anabasine, a novel compound, is a more potent agonist than other nicotine alkaloids on the nematode Asu-ACR-16 receptor

    Directory of Open Access Journals (Sweden)

    Fudan Zheng

    2017-04-01

    Here, we describe the synthesis of a novel agonist, (S-5-ethynyl-anabasine, and show that it is more potent (EC50 0.14 ± 0.01 μM than other nicotine alkaloids on Asu-ACR-16. Agonists acting on ACR-16 receptors have the potential to circumvent drug resistance to anthelmintics, like levamisole, that do not act on the ACR-16 receptors.

  7. Variación de la estructura fina de las fibras acrílicas en la hilatura

    OpenAIRE

    Gacén Guillén, Joaquín; Maillo Garrido, Josefina; Manich i Bou, Albert Mª; Ussmane, Mahomed

    2002-01-01

    Dos fibras acrílicas comerciales de diferente finura han sido transformadas en hilados en continua de hilar (3.3. dtex) y en hilatura de rotor (1.3 dtex). Los hilos resultantes han sido vaporizados y teñidos en condiciones standard. Las variaciones de la estructura producidas por las operaciones de hilatura, vaporizado y tintura han sido evaluadas a través del ensayo de solubilidad de las fibras acrílicas en una mezcla dimetilformamida/agua (95/5). Two commercial acrylic fibres of d...

  8. Variación de la estructura fina de las fibras acrílicas en la hilatura

    OpenAIRE

    Gacén Guillén, Joaquín; Maillo Garrido, Josefina; Manich i Bou, Albert Mª; Ussmane, Mahomed

    2002-01-01

    [ESP] Dos fibras acrílicas comerciales de diferente finura han sido transformadas en hilados en continua de hilar (3.3. dtex) y en hilatura de rotor (1.3 dtex). Los hilos resultantes han sido vaporizados y teñidos en condiciones standard. Las variaciones de la estructura producidas por las operaciones de hilatura, vaporizado y tintura han sido evaluadas a través del ensayo de solubilidad de las fibras acrílicas en una mezcla dimetilformamida/agua (95/5).

  9. Distribuição e impacto da sigatoka-negra na bananicultura do estado do Acre

    OpenAIRE

    Cavalcante, Maria de Jesus B.; Sá, Claudenor P. de; Gomes, Francisco C. da Rocha; Gondim, Tarcísio M. de Souza; Cordeiro, Zilton J. M.; Hessel, Jorge L.

    2004-01-01

    A sigatoka-negra (Mycosphaerella fijiensis) é a doença de maior severidade que afeta as cultivares de banana (Musa spp.) de importância econômica no mundo. Foi constatada no Brasil em 1998, no Estado do Amazonas, e tem se disseminado pelo Estado do Acre, atacando severamente as cultivares do Subgrupo Terra (AAB). Realizou-se um diagnóstico da sigatoka-negra e dos impactos econômicos causados por esta doença nos municípios do Estado do Acre. Foram visitados plantios em 16 municípios e amostras...

  10. Locked plating of distal femur fractures leads to inconsistent and asymmetric callus formation.

    Science.gov (United States)

    Lujan, Trevor J; Henderson, Chris E; Madey, Steven M; Fitzpatrick, Dan C; Marsh, J Lawrence; Bottlang, Michael

    2010-03-01

    Locked plating constructs may be too stiff to reliably promote secondary bone healing. This study used a novel imaging technique to quantify periosteal callus formation of distal femur fractures stabilized with locking plates. It investigated the effects of cortex-to-plate distance, bridging span, and implant material on periosteal callus formation. Retrospective cohort study. One Level I and one Level II trauma center. Sixty-four consecutive patients with distal femur fractures (AO types 32A, 33A-C) stabilized with periarticular locking plates. Osteosynthesis using indirect reduction and bridge plating with periarticular locking plates. Periosteal callus size on lateral and anteroposterior radiographs. Callus size varied from 0 to 650 mm2. Deficient callus (20 mm2 or less) formed in 52%, 47%, and 37% of fractures at 6, 12, and 24 weeks postsurgery, respectively. Callus formation was asymmetric, whereby the medial cortex had on average 64% more callus (P=0.001) than the anterior or posterior cortices. A longer bridge span correlated minimally with an increased callus size at Week 6 (P=0.02), but no correlation was found at Weeks 12 and 24 postsurgery. Compared with stainless steel plates, titanium plates had 76%, 71%, and 56% more callus at Week 6 (P=0.04), Week 12 (P=0.03), and Week 24 (P=0.09), respectively. Stabilization of distal femur fractures with periarticular locking plates can cause inconsistent and asymmetric formation of periosteal callus. A larger bridge span only minimally improves callus formation. The more flexible titanium plates enhanced callus formation compared with stainless steel plates.

  11. A PROSPECTIVE STUDY OF DISTAL TIBIAL FRACTURES BY MIPO (LCP

    Directory of Open Access Journals (Sweden)

    Chandra Sekharam Naidu

    2015-05-01

    Full Text Available INTRODUCTION: D istal tibial fractures represent a significant challenge to most of the surgeons even today. They constitute 1 - 10% of all lower extremity fractures . 1 The difficulty in treating the fractures of distal tibial end is exemplif ied by orthopedists, who in the first half of twentieth century, believed these injuries were so severe and fraught with so many complications, that these fractures were deemed not amenable for surgical reconstruction . 2 Conservative treatment by POP cast l ead to prolonged immobilization, leading to ankle and knee stiffness affecting quality of life of the patient . 3 Operative treatment is indicated for most tibial fractures caused by high energy trauma. Operative treatment allows early motion, and avoids sho rtening and other complications associated with prolonged immobilization . 4 The fundamental goal of treatment of distal tibial fractures is restoration of normal or near normal alignment and articular congruity and finally to obtain a well healed fracture; pain free weight bearing ; and functional ROM of ankle joint. For the past decade, plating has been successful in treating complex fractures of the lower extremity especially distal tibia . 5 Conventional ORIF have been associated with complications like infe ction and delayed or non - union due to devitalisation of bony fragments and additional damage to the soft tissues . 6 To improve fracture healing, more “biological” methods have been developed in the last decade to lessen the surgical dissection, preserving b lood supply to bony fragments and containing at least partially the fracture haematoma . 7 Recently, the trend is towards use of a Locking compression plate for treatment of fractures of the distal part of the tibia 8 . Compared with a conventional plate, a Lo cking compression plate imparts a higher degree of stability and provides better protection against primary and secondary losses of reduction and minimization of bone

  12. Theory on the mechanism of distal action of transcription factors: looping of DNA versus tracking along DNA

    International Nuclear Information System (INIS)

    Murugan, R

    2010-01-01

    In this paper, we develop a theory on the mechanism of distal action of the transcription factors, which are bound at their respective cis-regulatory enhancer modules on the promoter-RNA polymerase II (PR) complexes to initiate the transcription event in eukaryotes. We consider both the looping and tracking modes of their distal communication and calculate the mean first passage time that is required for the distal interactions of the complex of enhancer and transcription factor with the PR via both these modes. We further investigate how this mean first passage time is dependent on the length of the DNA segment (L, base-pairs) that connects the cis-regulatory binding site and the respective promoter. When the radius of curvature of this connecting segment of DNA is R that was induced upon binding of the transcription factor at the cis-acting element and RNAPII at the promoter in cis-positions, our calculations indicate that the looping mode of distal action will dominate when L is such that L > 2πR and the tracking mode of distal action will be favored when L 2 bps. It seems that the free energy associated with the binding of the transcription factor with its cis-acting element and the distance of this cis-acting element from the corresponding promoter of the gene of interest is negatively correlated. Our results suggest that the looping and tracking modes of distal action are concurrently operating on the transcription activation and the physics that determines the timescales associated with the looping/tracking in the mechanism of action of these transcription factors on the initiation of the transcription event must put a selection pressure on the distribution of the distances of cis-regulatory modules from their respective promoters of the genes. The computational analysis of the upstream sequences of promoters of various genes in the human and mouse genomes for the presence of putative cis-regulatory elements for a set of known transcription factors using

  13. Metastatic mucinous adenocarcinoma of the distal common bile duct, from transverse colon cancer presenting as obstructive jaundice.

    Science.gov (United States)

    Lee, Doo-Ho; Ahn, Young Joon; Shin, Rumi; Lee, Hae Won

    2015-08-01

    The patient was a 70-year-old male whose chief complaints were obstructive jaundice and weight loss. Abdominal imaging studies showed a 2.5 cm sized mass at the distal common bile duct, which was suggestive of bile duct cancer. Eccentric enhancing wall thickening in the transverse colon was also shown, suggesting concomitant colon cancer. A colonoscopy revealed a lumen-encircling ulcerofungating mass in the transverse colon, that was pathologically proven to be adenocarcinoma. The bile duct pathology was also adenocarcinoma. Pylorus-preserving pancreaticoduodenectomy and extended right hemicolectomy were performed under the diagnosis of double primary cancers. Postoperative histopathologic examination revealed moderately differentiated mucinous adenocarcinoma of transverse colon cancer, and mucinous adenocarcinoma of the distal common bile duct. Immunohistochemical staining studies showed that the bile duct cancer had metastasized from the colon cancer. The patient recovered uneventfully from surgery and will be undergoing chemotherapy for three months.

  14. Multicentre prospective evaluation of implant-assisted mandibular bilateral distal extension removable partial dentures: patient satisfaction

    NARCIS (Netherlands)

    Wismeijer, D.; Tawse-Smith, A.; Payne, A.G.T.

    2013-01-01

    Objective To compare the levels of patient satisfaction with either conventional mandibular bilateral distal extension partial dentures or those assisted by bilateral distal implants. Materials and methods Forty-eight participants who were dissatisfied with their existing conventional mandibular

  15. Minimally invasive versus open distal pancreatectomy (LEOPARD) : Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    de Rooij, Thijs; van Hilst, Jony; Vogel, Jantien A.; van Santvoort, Hjalmar C.; de Boer, Marieke T.; Boerma, Djamila; van den Boezem, Peter B.; Bonsing, Bert A.; Bosscha, Koop; Coene, Peter-Paul; Daams, Freek; van Dam, Ronald M.; Dijkgraaf, Marcel G.; van Eijck, Casper H.; Festen, Sebastiaan; Gerhards, Michael F.; Koerkamp, Bas Groot; Hagendoorn, Jeroen; van der Harst, Erwin; de Hingh, Ignace H.; Dejong, Cees H.; Kazemier, Geert; Klaase, Joost; de Kleine, Ruben H.; van Laarhoven, Cornelis J.; Lips, Daan J.; Luyer, Misha D.; Molenaar, I. Quintus; Nieuwenhuijs, Vincent B.; Patijn, Gijs A.; Roos, Daphne; Scheepers, Joris J.; van der Schelling, George P.; Steenvoorde, Pascal; Swijnenburg, Rutger-Jan; Wijsman, Jan H.; Abu Hilal, Moh'd; Busch, Olivier R.; Besselink, Marc G.

    2017-01-01

    Background: Observational cohort studies have suggested that minimally invasive distal pancreatectomy (MIDP) is associated with better short-term outcomes compared with open distal pancreatectomy (ODP), such as less intraoperative blood loss, lower morbidity, shorter length of hospital stay, and

  16. Multicenter comparative study of laparoscopic and open distal pancreatectomy using propensity score-matching.

    Science.gov (United States)

    Nakamura, Masafumi; Wakabayashi, Go; Miyasaka, Yoshihiro; Tanaka, Masao; Morikawa, Takanori; Unno, Michiaki; Tajima, Hiroshi; Kumamoto, Yusuke; Satoi, Sohei; Kwon, Masanori; Toyama, Hirochika; Ku, Yonson; Yoshitomi, Hideyuki; Nara, Satoshi; Shimada, Kazuaki; Yokoyama, Takahide; Miyagawa, Shinichi; Toyama, Yoichi; Yanaga, Katsuhiko; Fujii, Tsutomu; Kodera, Yasuhiro; Tomiyama, Yasuyuki; Miyata, Hiroaki; Takahara, Takeshi; Beppu, Toru; Yamaue, Hiroki; Miyazaki, Masaru; Takada, Tadahiro

    2015-10-01

    Laparoscopic distal pancreatectomy has been shown to be associated with favorable postoperative outcomes using meta-analysis. However, there have been no randomized controlled studies yet. This study aimed to compare laparoscopic and open distal pancreatectomy using propensity score-matching. We retrospectively collected perioperative data of 2,266 patients who underwent distal pancreatectomy in 69 institutes from 2006-2013 in Japan. Among them, 2,010 patients were enrolled in this study and divided into two groups, laparoscopic distal pancreatectomy and open distal pancreatectomy. Perioperative outcomes were compared between the groups using unmatched and propensity matched analysis. After propensity score-matching, laparoscopic distal pancreatectomy was associated with favorable perioperative outcomes compared with open distal pancreatectomy, including higher rate of preservation of spleen and splenic vessels (P pancreatectomy was associated with more favorable perioperative outcomes than open distal pancreatectomy. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  17. 77 FR 74697 - Meeting of the ACRS, Subcommittee on U.S. Evolutionary Power Reactor; Notice of Meeting

    Science.gov (United States)

    2012-12-17

    ..., Subcommittee on U.S. Evolutionary Power Reactor; Notice of Meeting The ACRS Subcommittee on U.S. Evolutionary Power Reactor (U.S. EPR) will hold a meeting on January 17, 2013, Room T-2B1, 11545 Rockville Pike... be made. Thirty-five hard copies of each presentation or handout should be provided to the DFO thirty...

  18. Nota sobre culicídeos (Diptera: Culicidae da bacia do rio Purus, Acre, Amazônia (Brasil

    Directory of Open Access Journals (Sweden)

    Natal Delsio

    1992-01-01

    Full Text Available Foram feitas coletas de mosquito (Diptera: Culicidae na área do projeto de Colonização Pedro Peixoto, no Estado do Acre, Brasil. Obteve-se um total de 4.588 exemplares pertencentes a 53 espécies ou grupos. Salienta-se a ocorrência de Anopheles (Nyssorhynchus oswaldoi.

  19. Impact of initial spacing on yield per acre and wood quality of unthinned loblolly pine at age 21

    Science.gov (United States)

    Alexander, III Clark; Richard F. Daniels; Lewis Jordan; Laurie Schimleck

    2010-01-01

    The market for southern pine first thinnings is soft. Thus, forest managers are planting at wider spacings, and using weed control and fertilization to grow chipping-saw and sawtimber trees in shorter rotations. A 21-year-old unthinned spacing study was sampled to determine the effect of initial spacing on wood quality and yield per acre of planted loblolly pine (

  20. Portal verification using the KODAK ACR 2000 RT storage phosphor plate system and EC films. A semiquantitative comparison.

    Science.gov (United States)

    Geyer, Peter; Blank, Hilbert; Alheit, Horst

    2006-03-01

    The suitability of the storage phosphor plate system ACR 2000 RT (Eastman Kodak Corp., Rochester, MN, USA), that is destined for portal verification as well as for portal simulation imaging in radiotherapy, had to be proven by the comparison with a highly sensitive verification film. The comparison included portal verification images of different regions (head and neck, thorax, abdomen, and pelvis) irradiated with 6- and 15-MV photons and electrons. Each portal verification image was done at the storage screen and the EC film as well, using the EC-L cassettes (both: Eastman Kodak Corp., Rochester, MN, USA) for both systems. The soft-tissue and bony contrast and the brightness were evaluated and compared in a ranking of the two compared images. Different phantoms were irradiated to investigate the high- and low-contrast resolution. To account for quality assurance application, the short-time exposure of the unpacked and irradiated storage screen by green and red room lasers was also investigated. In general, the quality of the processed ACR images was slightly higher than that of the films, mostly due to cases of an insufficient exposure to the film. The storage screen was able to verify electron portals even for low electron energies with only minor photon contamination. The laser lines were sharply and clearly visible on the ACR images. The ACR system may replace the film without any noticeable decrease in image quality thereby reducing processing time and saving the costs of films and avoiding incorrect exposures.

  1. Nota sobre culicídeos (Diptera: Culicidae da bacia do rio Purus, Acre, Amazônia (Brasil

    Directory of Open Access Journals (Sweden)

    Delsio Natal

    1992-04-01

    Full Text Available Foram feitas coletas de mosquito (Diptera: Culicidae na área do projeto de Colonização Pedro Peixoto, no Estado do Acre, Brasil. Obteve-se um total de 4.588 exemplares pertencentes a 53 espécies ou grupos. Salienta-se a ocorrência de Anopheles (Nyssorhynchus oswaldoi.

  2. The provisional ACR/EULAR definition of remission in RA: a comment on the patient global assessment criterion

    NARCIS (Netherlands)

    Vermeer, M.; Kuper, Hillechina H.; van der Bijl, Arie E.; Baan, H.; Posthumus, Marcel D.; Brus, Herman L.M.; van Riel, Piet L.C.M.; van de Laar, Mart A F J

    2012-01-01

    Objectives. The provisional ACR/European League Against Rheumatism (EULAR) definition of remission in RA requires a score of ≤1 on the patient global assessment (PGA, 0–10 scale). We explored the relation between the PGA criterion and the patient's clinical disease state in an observational dataset.

  3. Evaluation of the ACR and SLICC classification criteria in juvenile-onset systemic lupus erythematosus: a longitudinal analysis.

    Science.gov (United States)

    Lythgoe, H; Morgan, T; Heaf, E; Lloyd, O; Al-Abadi, E; Armon, K; Bailey, K; Davidson, J; Friswell, M; Gardner-Medwin, J; Haslam, K; Ioannou, Y; Leahy, A; Leone, V; Pilkington, C; Rangaraj, S; Riley, P; Tizard, E J; Wilkinson, N; Beresford, M W

    2017-10-01

    Objectives The Systemic Lupus International Collaborating Clinics (SLICC) group proposed revised classification criteria for systemic lupus erythematosus (SLICC-2012 criteria). This study aimed to compare these criteria with the well-established American College of Rheumatology classification criteria (ACR-1997 criteria) in a national cohort of juvenile-onset systemic lupus erythematosus (JSLE) patients and evaluate how patients' classification criteria evolved over time. Methods Data from patients in the UK JSLE Cohort Study with a senior clinician diagnosis of probable evolving, or definite JSLE, were analyzed. Patients were assessed using both classification criteria within 1 year of diagnosis and at latest follow up (following a minimum 12-month follow-up period). Results A total of 226 patients were included. The SLICC-2012 was more sensitive than ACR-1997 at diagnosis (92.9% versus 84.1% p < 0.001) and after follow up (100% versus 92.0% p < 0.001). Most patients meeting the SLICC-2012 criteria and not the ACR-1997 met more than one additional criterion on the SLICC-2012. Conclusions The SLICC-2012 was better able to classify patients with JSLE than the ACR-1997 and did so at an earlier stage in their disease course. SLICC-2012 should be considered for classification of JSLE patients in observational studies and clinical trial eligibility.

  4. EULAR definition of erosive disease in light of the 2010 ACR/EULAR rheumatoid arthritis classification criteria

    NARCIS (Netherlands)

    van der Heijde, Désirée; van der Helm-van Mil, Annette H. M.; Aletaha, Daniel; Bingham, Clifton O.; Burmester, Gerd R.; Dougados, Maxime; Emery, Paul; Felson, David; Knevel, Rachel; Kvien, Tore K.; Landewé, Robert B. M.; Lukas, Cédric; McInnes, Iain; Silman, Alan J.; Smolen, Josef S.; Stanislawska-Biernat, Ewa; Zink, Angela; Combe, Bernard

    2013-01-01

    The aim of this report was to propose a definition for erosive disease in the context of inflammatory arthritis in light of the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) rheumatoid arthritis (RA) criteria for use in clinical practice and studies. A EULAR

  5. The provisional ACR/EULAR definition of remission in RA : a comment on the patient global assessment criterion

    NARCIS (Netherlands)

    Vermeer, Marloes; Kuper, Hillechiena H.; van der Bijl, Arie E.; Baan, Henriette; Posthumus, Marcel D.; Brus, Herman L. M.; van Riel, Piet L. C. M.; van de Laar, Mart A. F. J.

    Objectives. The provisional ACR/European League Against Rheumatism (EULAR) definition of remission in RA requires a score of 41 on the patient global assessment (PGA, 0-10 scale). We explored the relation between the PGA criterion and the patient's clinical disease state in an observational dataset.

  6. Single absorbable polydioxanone pin fixation for distal chevron bunion osteotomies.

    Science.gov (United States)

    Deorio, J K; Ware, A W

    2001-10-01

    The distal chevron osteotomy is a well-established technique for correction of symptomatic mild to moderate metatarsus primus varus with hallux valgus deformity. Fixation of the osteotomy ranges from none to bone pegs, Kirschner wires, screws, or absorbable pins. We evaluated one surgeon's (J.K.D.) results of distal chevron osteotomy fixation with a single, nonpredrilled, 1.3-mm poly-p-dioxanone pin and analyzed any differences in patients with unilateral or bilateral symptomatic metatarsus primus varus with hallux valgus deformities. All osteotomies healed without evidence of infection, osteolysis, nonunion, or necrosis. Equal correction was achieved in unilateral and bilateral procedures. The technique is quick and easy, and adequate fixation is achieved.

  7. Osteomyelitis Caused by Candida glabrata in the Distal Phalanx

    Directory of Open Access Journals (Sweden)

    Shunichi Toki

    2014-01-01

    Full Text Available Osteomyelitis caused by Candida glabrata is rare and its optimal treatment is unknown. Here we report a case of osteomyelitis caused by C. glabrata in the distal phalanx in a 54-year-old woman. Despite partial resection of the nail and administering a 1-month course of antibiotics for paronychia, the local swelling remained and an osteolytic lesion was found. C. glabrata osteomyelitis of the distal phalanx was later diagnosed after curettage. Thereafter, the patient was treated with antifungal agents for 3 months. The infection eventually resolved, and radiological healing of the osteolytic lesion was achieved. Antifungal susceptibility testing should be performed in the case of osteomyelitis caused by nonalbicans Candida species, due to their resistance to fluconazole.

  8. Retrograde nailing for distal femur fractures in the elderly

    Directory of Open Access Journals (Sweden)

    Giddie Jasdeep

    2015-01-01

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

  9. Pendulum Therapy of Molar Distalization in Mixed Dentition.

    Science.gov (United States)

    Patil, Raju Umaji; Prakash, Amit; Agarwal, Anshu

    2016-01-01

    Early and timely pedo-orthodontic treatment is aimed at eliminating the disturbances of skeletal or dentoalveolar development, to harmonize the stomatognathic system before the full eruption of all permanent teeth. The advantages of pendulum appliance are its minimal dependence on patient's compliance (child cooperation), ease of fabrication, onetime activation and adjustment of the springs if necessary to correct minor transverse and vertical molar positions. This article reports a successful treatment method of class II malocclusion with pendulum appliance in mixed dentition phase. Distalization of maxillary molar was done, followed by guidance of canine impaction orthodontically and other dental correction using 0.022 MBT appliances. Posttreatment results were stable and remarkable. How to cite this article: Patil RU, Prakash A, Agarwal A. Pendulum Therapy of Molar Distalization in Mixed Dentition. Int J Clin Pediatr Dent 2016;9(1):67-73.

  10. Optimal fit of chairside-fabricated distal shoe space maintainer.

    Science.gov (United States)

    Nouri, M R; Kennedy, D B

    2013-10-01

    Premature loss of a primary second molar may lead to space loss in the dental arch. This space loss tends to be more severe in unfavourable malocclusions. The distal shoe space maintainer (DSSM) may be beneficial in controlling the path of eruption of an unerupted permanent first molar from the primary into the early mixed dentition. This article describes the technique for achieving optimal fit of a chairside-fabricated band and DSSM in a single visit by contouring the distal shoe blade, and by extending it to the mesial surface of the permanent first molar. Upon the eruption of the permanent first molar DSSM may be modified to a reverse band-and-loop, or replaced by a lingual holding arch.

  11. The effect of distal utility value intervention for students’ learning

    OpenAIRE

    KERA, Masaki; NAKAYA, Motoyuki

    2017-01-01

    The purpose of this study was to determine whether a utility value intervention influenced students’motivation and performance. Specifically, we examined the effect of distal utility value (i.e., the recognition of content usefulness for skill development that can improve daily and future endeavors) instruction in this study.Fifty-one Japanese undergraduate students completed an experimental session in the laboratory, in which they performed a series of logical reasoning problem-solving tasks...

  12. Epidemiology of distal forearm fractures in Oslo, Norway.

    Science.gov (United States)

    Lofthus, C M; Frihagen, F; Meyer, H E; Nordsletten, L; Melhuus, K; Falch, J A

    2008-06-01

    The population of Oslo has the highest incidence of hip fracture reported. The present study shows that the overall incidence of distal forearm fractures in Oslo is higher than in other countries and has not changed significantly when comparing the incidence of 1998/99 with 1979. The population of Oslo has the highest incidence of hip fracture reported. The present study reports the incidence of distal forearm fracture in Oslo and the fracture rates of immigrants. Patients aged > or = 20 years resident in Oslo sustaining a distal forearm fracture in a one-year period in 1998/99 were identified using electronic diagnosis registers, patient protocols, and/or X-ray registers of the clinics in Oslo. Medical records were obtained and the diagnosis verified. The age- and sex-specific incidence rates were calculated and compared with those for 1979. Data on immigrant category and country of origin of the patients were obtained. The age-adjusted fracture rates per 10,000 for the age group > or = 50 years were 109.8 and 25.4 in 1998/99 compared with 108.3 and 23.5 in 1979 for women and men, respectively (n.s.). The relative risk of fracture in Asians was 0.72 (95% CI 0.53-1.00) compared with ethnic Norwegians. The overall incidence of distal forearm fractures in Oslo is higher than in other countries and has not changed significantly when comparing the incidence of 1998/99 with 1979. Furthermore, the present data suggest that Asian immigrants in Oslo have a slightly lower fracture risk than ethnic Norwegians.

  13. Dual-port distal gastrectomy for the early gastric cancer

    OpenAIRE

    Kashiwagi, Hiroyuki; Kumagai, Kenta; Monma, Eiji; Nozue, Mutsumi

    2014-01-01

    Background Although recent trends in laparoscopic procedures have been toward minimizing the number of incisions, four or five ports are normally required to complete laparoscopic gastrectomy because of the complexity of this procedure. Multi-channel ports, such as the SILS port (Covidien, JAPAN), are now available and are crucial for performing single-incision laparoscopic surgery (SILS) or reduced port surgery (RPS). We carried out reduced port distal gastrectomy (RPDG) using a dual-port me...

  14. Factors Associated with Infection Following Open Distal Radius Fractures

    OpenAIRE

    Glueck, Dane A.; Charoglu, Constantine P.; Lawton, Jeffrey N.

    2009-01-01

    Open fractures are often classified according to a system described by Gustilo and Anderson. However, this system was applied to open long bone factures, which may not predict the incidence of infection in open metaphyseal fractures of the upper extremity. Other studies have found that wound contamination and systemic illness were the best predictors of infections in open hand fractures. Our study assessed infection in open distal radius fractures and identifies factors that are associated wi...

  15. Is nonoperative management of partial distal biceps tears really successful?

    Science.gov (United States)

    Bauer, Tyler M; Wong, Justin C; Lazarus, Mark D

    2018-04-01

    The current treatment of partial distal biceps tears is a period of nonoperative management, followed by surgery, if symptoms persist. Little is known about the success rate and outcomes of nonoperative management of this illness. We identified 132 patients with partial distal biceps tears through an International Classification of Diseases, Ninth Revision code query of our institution's database. Patient records were reviewed to abstract demographic information and confirm partial tears of the distal biceps tendon based on clinical examination findings and confirmatory magnetic resonance imaging (MRI). Seventy-four patients completed an outcome survey. In our study, 55.7% of the contacted patients who tried a nonoperative course (34 of 61 patients) ultimately underwent surgery, and 13 patients underwent immediate surgery. High-need patients, as defined by occupation, were more likely to report that they recovered ideally if they underwent surgery, as compared with those who did not undergo surgery (odds ratio, 11.58; P = .0138). For low-need patients, the same analysis was not statistically significant (P = .139). There was no difference in satisfaction scores between patients who tried a nonoperative course before surgery and those who underwent immediate surgery (P = .854). An MRI-diagnosed tear of greater than 50% was a predictor of needing surgery (odds ratio, 3.0; P = .006). This study has identified clinically relevant information for the treatment of partial distal biceps tears, including the following: the failure rate of nonoperative treatment, the establishment of MRI percent tear as a predictor of failing nonoperative management, the benefit of surgery for the high-need occupational group, and the finding that nonoperative management does not negatively affect outcome if subsequent surgery is necessary. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  16. Characterisation of osseous bodies of the distal phalanx of foals

    International Nuclear Information System (INIS)

    Kaneps, A.J.; O'Brien, T.R.; Redden, R.F.; Stover, S.M.; Pool, R.R.

    1993-01-01

    The distal phalanx and metacarpal physis of both forelimbs of 32 Thoroughbred foals 3-32 weeks of age were radiographed to identify those limbs with osseous bodies at a palmar process (PP) of the distal phalanx. Osseous bodies (ossicles) were identified radiographically in 19% of the foals. Sixteen of the 32 foals were selected for microradiographic and histological evaluation: 6 foals with radiographic evidence of ossicles and 10 foals without. Fourteen ossicles of the PP were observed radiographically. Ossicles were either a triangular bone fragment at the palmar aspect of the distal angle of the PP, or an oblong bone fragment separated from P3 by a radiolucent line extending 1-3 cm from the incisure of the PP to the solar margin. One foal had radiographic evidence of bilateral distal metacarpal physitis. Seventeen of 35 PPs examined microradiographically were considered normal, in that the dorsal and solar cortices were thin with trabecular bone orientated parallel to the cortical surfaces, and there was a depression in the dorsal cortical surface (i.e. parietal sulcus). Abnormal microradiographic findings in the other 18 PPs included a fracture line extending from the dorsal cortical surfaces and trabecular bridging of the fracture gap. The fracture line was often continuous with the parietal sulcus. Microradiographic evidence of a fracture was found in 75% of foals evaluated. Normal histological findings in 16 PPs included thin dorsal and solar cortices with trabeculae orientated parallel to the cortical surfaces, parallel-fibred dense connective tissue attachments of the deep digital flexor tendon to the solar cortical surfaces, and a neurovascular bundle associated with the parietal sulcus

  17. External jig in the placement of distal interlocking screws | Ikem ...

    African Journals Online (AJOL)

    Retrograde (52.2%) was the commonest surgical approach used for femur. The main indication for SIGN interlocking surgery was recent fracture 77.8%. Open reduction 97.8% was the commonest method of reduction used. The mean±SD bone union time was 3.58±0.56 months and range 3-5 months. Distal screw insertion ...

  18. A PROSPECTIVE STUDY OF DISTAL TIBIAL FRACTURES BY MIPO (LCP)

    OpenAIRE

    Chandra Sekharam Naidu; Ch.Murali Krishna; Sankara Rao; Dharma Rao; Ashok Kumar

    2015-01-01

    INTRODUCTION: D istal tibial fractures represent a significant challenge to most of the surgeons even today. They constitute 1 - 10% of all lower extremity fractures . 1 The difficulty in treating the fractures of distal tibial end is exemplif ied by orthopedists, who in the first half of twentieth century, believed these injuries were so severe and fraught with so many complications, that these fractures wer...

  19. Distal renal tubular acidosis in recurrent renal stone formers

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    Renal acidification ability was examined in 90 recurrent renal stone formers, using fasting morning urinary pH levels followed by a short ammonium chloride loading test in subjects with pH levels above 6.0. Fifteen patients (16.6%) revealed a distal renal tubular acidification defect: one patient......, this has important therapeutic implications. The pathological sequence in renal stone formers with dRTA is discussed....

  20. Impact of a Nationwide Training Program in Minimally Invasive Distal Pancreatectomy (LAELAPS)

    NARCIS (Netherlands)

    de Rooij, Thijs; van Hilst, Jony; Boerma, Djamila; Bonsing, Bert A.; Daams, Freek; van Dam, Ronald M.; Dijkgraaf, Marcel G.; van Eijck, Casper H.; Festen, Sebastiaan; Gerhards, Michael F.; Koerkamp, Bas Groot; van der Harst, Erwin; de Hingh, Ignace H.; Kazemier, Geert; Klaase, Joost; de Kleine, Ruben H.; van Laarhoven, Cornelis J.; Lips, Daan J.; Luyer, Misha D.; Molenaar, I. Quintus; Patijn, Gijs A.; Roos, Daphne; Scheepers, Joris J.; van der Schelling, George P.; Steenvoorde, Pascal; Vriens, Menno R.; Wijsman, Jan H.; Gouma, Dirk J.; Busch, Olivier R.; Hilal, Mohammed Abu; Besselink, Marc G.; de Boer, Marieke T.

    2016-01-01

    Objective:To study the feasibility and impact of a nationwide training program in minimally invasive distal pancreatectomy (MIDP).Summary of Background Data:Superior outcomes of MIDP compared with open distal pancreatectomy have been reported. In the Netherlands (2005 to 2013) only 10% of distal

  1. Cost-effectiveness of laparoscopic versus open distal pancreatectomy for pancreatic cancer

    NARCIS (Netherlands)

    Gurusamy, Kurinchi Selvan; Riviere, Deniece; van Laarhoven, C. J. H.; Besselink, Marc; Abu-Hilal, Mohammed; Davidson, Brian R.; Morris, Steve

    2017-01-01

    A recent Cochrane review compared laparoscopic versus open distal pancreatectomy for people with for cancers of the body and tail of the pancreas and found that laparoscopic distal pancreatectomy may reduce the length of hospital stay. We compared the cost-effectiveness of laparoscopic distal

  2. Computer tomographic assessment of postoperative peripancreatic collections after distal pancreatectomy.

    Science.gov (United States)

    Uchida, Yuichiro; Masui, Toshihiko; Sato, Asahi; Nagai, Kazuyuki; Anazawa, Takayuki; Takaori, Kyoichi; Uemoto, Shinji

    2018-03-27

    Peripancreatic collections occur frequently after distal pancreatectomy. However, the sequelae of peripancreatic collections vary from case to case, and their clinical impact is uncertain. In this study, the correlations between CT findings of peripancreatic collections and complications after distal pancreatectomy were investigated. Ninety-six consecutive patients who had undergone distal pancreatectomy between 2010 and 2015 were retrospectively investigated. The extent and heterogeneity of peripancreatic collections and background clinicopathological characteristics were analyzed. The extent of peripancreatic collections was calculated based on three-dimensional computed tomography images, and the degree of heterogeneity of peripancreatic collections was assessed based on the standard deviation of their density on computed tomography. Of 85 patients who underwent postoperative computed tomography imaging, a peripancreatic collection was detected in 77 (91%). Patients with either a large extent or a high degree of heterogeneity of peripancreatic collection had a significantly higher rate of clinically relevant pancreatic fistula than those without (odds ratio 5.95, 95% confidence interval 2.12-19.72, p = 0.001; odds ratio 8.0, 95% confidence interval 2.87-24.19, p = 0.0001, respectively). A large and heterogeneous peripancreatic collection was significantly associated with postoperative complications, especially clinically relevant postoperative pancreatic fistula. A small and homogenous peripancreatic collection could be safely observed.

  3. Total elbow arthroplasty for the treatment of distal humeral fractures.

    Science.gov (United States)

    Gallucci, G L; Larrondo Calderón, W; Boretto, J G; Castellaro Lantermo, J A; Terán, J; de Carli, P

    2016-01-01

    To report the clinical-functional outcomes of the treatment of humeral distal fractures with a total elbow prosthesis. This retrospective study was performed in two surgical centres. A total of 23patients were included, with a mean age of 79years, and of which 21 were women. The inclusion criteria were: patients with humeral distal fractures, operated on using a Coonrad-Morrey prosthesis, and with a follow-up of more than one year. According to AO classification, 15fractures were type C3, 7 C2 and 1 A2. All patients were operated on without de-insertion of the extensor mechanism. The mean follow-up was 40 months. Flexor-extension was 123-17°, with a total mobility arc of 106° (80% of the contralateral side). Pain, according to a visual analogue scale was 1. The Mayo Elbow Performance Index (MEPI) was 83 points. Excellent results were obtained in 8 patients, good in 13, medium in 1, and poor in 1. The mean DASH (disability) score was 24 points. Treatment of humeral distal fractures with total elbow arthroplasty could be a good treatment option, but indications must be limited to patients with complex fractures, poor bone quality, with osteoporosis and low functional demands. In younger patients, the use is limited to serious cases where there is no other treatment option. Level of Evidence IV. Copyright © 2016 SECOT. Published by Elsevier Espana. All rights reserved.

  4. Distal antebrachial fractures in toy-breed dogs

    International Nuclear Information System (INIS)

    Muir, P.

    1997-01-01

    Antebrachial fractures account for approximately 17% of all canine fractures, with motor vehicle trauma cited as one of the primary causes. However, antebrachial fractures in toy-breed dogs are often sustained after apparently minimal trauma, such as jumping or falling, and are usually distal. The cause of antebrachial fractures in toy breeds is not well understood. Complications after treatment of distal antebrachial fractures in toy-breed dogs, including delayed union, nonunion, and malunion, are common and are potentially serious because they may necessitate limb amputation. This article reports on distal antebrachial fractures in 26 toy-breed dogs that wee presented to the University of California, Davis, Veterinary Medical Teaching Hospital from April 1987 to March 1996. The author found that (1) these fractures typically occur in growing or adolescent dogs; (2) the presence of complications of union is typically associated with prior treatment using intramedullary pinning or external coaptation; and (3) successful healing of this type of fracture is obtained via rigid stabilization with bone plating in combination with cancellous bone autograft

  5. Suture anchor tenodesis in repair of distal Achilles tendon injuries.

    Science.gov (United States)

    Kiliçoğlu, Onder; Türker, Mehmet; Yildız, Fatih; Akalan, Ekin; Temelli, Yener

    2014-01-01

    Distal Achilles tendon avulsions are in the form of either bony and nonbony avulsion of Achilles tendon from its calcaneal insertion. Four patients with distal Achilles tendon avulsions or ruptures which were treated with tendon to bone repair using suture anchors are presented here. Operated leg was immobilized in above-knee cast for 4 weeks while the patient walked non-weight-bearing. Then, cast was changed to below knee, and full weight-bearing was allowed. Patients underwent gait analysis minimum at first postoperative year. Mean American Orthopedics Foot Ankle Society ankle/hindfoot score of patients at last visit was 88.75 (range 85-100), and Achilles tendon total rupture score was 77.75 (range 58-87). Mean passive dorsiflexion of injured ankles (14° ± 5°) was lower than uninjured ankles (23° ± 9°). All the kinematic parameters of gait analysis were comparable to the uninjured side. Maximum plantar flexion power of injured ankle was 1.40 W/kg, and this was significantly lower than the contralateral side value 2.38 W/kg; (P = 0.0143). There were no visually altered gait or problems in daily life. Suture anchor tenodesis technique of distal Achilles tendon avulsions was successful in achieving durable osteotendinous repairs.

  6. Laparoscopic distal pancreatectomy for adenocarcinoma of the pancreas

    Science.gov (United States)

    Björnsson, Bergthor; Sandström, Per

    2014-01-01

    Since the first report on laparoscopic distal pancreatectomy (LDP) appeared in the 1990s, the procedure has been performed increasingly frequently to treat both benign and malignant lesions of the pancreas. Many earlier publications have shown LDP to be a good alternative to open distal pancreatectomy for benign lesions, although this has never been studied in a prospective, randomized manner. The evidence for the use of LDP to treat adenocarcinoma of the pancreas is not as well established. The purpose of this review is to evaluate the current evidence for LDP in cases of pancreatic adenocarcinoma. We conducted a review of English language publications reporting LDP results between 1990 and 2013. All studies reporting results in patients with histologically proven pancreatic adenocarcinoma were included. Thirty-nine publications were found and included in the results for a total of 309 cases of pancreatic adenocarcinoma (potential double publications were not eliminated). Most LDP procedures are performed in selected cases and generally involve smaller tumors than open distal pancreatectomy (ODP) procedures. Some of the papers report unselected cases and include procedures on larger tumors. The number of lymph nodes harvested using LDP is comparable to the number obtained with ODP, as is the frequency of R0 resections. Current data suggest that similar short term oncological results can be obtained using LDP as those obtained using ODP. PMID:25309072

  7. Importance of early audiologic assessment in distal renal tubular acidosis

    Directory of Open Access Journals (Sweden)

    Elizabeth Norgett

    2010-12-01

    Full Text Available Anand P Swayamprakasam1, Elizabeth Stover1, Elizabeth Norgett1, Katherine G Blake-Palmer1, Michael J Cunningham2, Fiona E Karet11Department of Medical Genetics, Cambridge Institute for Medical Research, Cambridge, UK; 2Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USAAbstract: Autosomal recessive distal renal tubular acidosis is usually a severe disease of childhood, often presenting as failure to thrive in infancy. It is often, but not always, accompanied by sensorineural hearing loss, the clinical severity and age of onset of which may be different from the other clinical features. Mutations in either ATP6V1B1 or ATP6V0A4 are the chief causes of primary distal renal tubular acidosis with or without hearing loss, although the loss is often milder in the latter. We describe a kindred with compound heterozygous alterations in ATP6V0A4, where hearing loss was formally diagnosed late in both siblings such that they missed early opportunities for hearing support. This kindred highlights the importance of routine audiologic assessments of all children with distal renal tubular acidosis, irrespective either of age at diagnosis or of which gene is mutated. In addition, when diagnostic genetic testing is undertaken, both genes should be screened irrespective of current hearing status. A strategy for this is outlined.Keywords: sensorineural hearing loss, renal tubular acidosis, recessive, genetics, mutation

  8. Ionotropic GABA Receptors and Distal Retinal ON and OFF Responses

    Directory of Open Access Journals (Sweden)

    E. Popova

    2014-01-01

    Full Text Available In the vertebrate retina, visual signals are segregated into parallel ON and OFF pathways, which provide information for light increments and decrements. The segregation is first evident at the level of the ON and OFF bipolar cells in distal retina. The activity of large populations of ON and OFF bipolar cells is reflected in the b- and d-waves of the diffuse electroretinogram (ERG. The role of gamma-aminobutyric acid (GABA, acting through ionotropic GABA receptors in shaping the ON and OFF responses in distal retina, is a matter of debate. This review summarized current knowledge about the types of the GABAergic neurons and ionotropic GABA receptors in the retina as well as the effects of GABA and specific GABAA and GABAC receptor antagonists on the activity of the ON and OFF bipolar cells in both nonmammalian and mammalian retina. Special emphasis is put on the effects on b- and d-waves of the ERG as a useful tool for assessment of the overall function of distal retinal ON and OFF channels. The role of GABAergic system in establishing the ON-OFF asymmetry concerning the time course and absolute and relative sensitivity of the ERG responses under different conditions of light adaptation in amphibian retina is also discussed.

  9. Three-stage treatment protocol for recalcitrant distal femoral nonunion.

    Science.gov (United States)

    Ma, Ching-Hou; Chiu, Yen-Chun; Tu, Yuan-Kun; Yen, Cheng-Yo; Wu, Chin-Hsien

    2017-04-01

    In this study, we proposed a three-stage treatment protocol for recalcitrant distal femoral nonunion and aimed to analyze the clinical results. We retrospective reviewed 12 consecutive patients with recalcitrant distal femoral nonunion undergoing our three-stage treatment protocol from January 2010 to December 2014 in our institute. The three-stage treatment protocol comprised debridement of the nonunion site, lengthening to eliminate leg length discrepancy, deformity correction, stabilization with a locked plate, filling of the defect with cement spacer for inducing membrane formation, and bone reconstruction using a cancellous bone autograft (Masquelet technique) or free vascularized fibular bone graft. The bone union time, wound complication, lower limbs alignment, amount of lengthening, knee range of motion, and functional outcomes were evaluated. Osseous union with angular deformity lengthening was 5.88 cm (range 3.5-12 cm). Excellent or good outcomes were obtained in 9 patients. Although the current study involved only a small number of patients and the intervention comprised three stages, we believe that such a protocol may be a valuable alternative for the treatment of recalcitrant distal femoral nonunion.

  10. Avaliação da concentração de mercúrio em sedimentos e material particulado no rio Acre, estado do Acre, Brasil Mercury concentration assessment in botton sediments and suspended solids from Acre river, in the State of Acre, Brazil

    Directory of Open Access Journals (Sweden)

    Artur Fernando Silva Mascarenhas

    2004-01-01

    Full Text Available A avaliação dos teores de mercúrio em sistemas aquáticos sem influência direta de fontes antropogênicas conhecidas não tem sido conduzida com freqüência na região Amazônica. Visando contribuir para esclarecer a ocorrência de valores elevados de Hg em peixes consumidos pela população de Rio Branco - AC, o Instituto Evandro Chagas - IEC, realizou um estudo para quantificar os teores de Hg em sedimentos de fundo e material particulado no rio Acre e alguns afluentes, além da caracterização físico-química das águas entre as cidades de Brasiléia e Assis Brasil. As amostras de sedimentos foram peneiradas na fração Mercury levels assessment in aquatic systems areas without influences of antropogenic sources have not been well studied in the Amazon region. For the identification of the origin of high values of Hg in fish consumed by population of Rio Branco City - AC, the Evandro Chagas Institute - IEC, studied the mercury levels in sediments, suspended solids and studied also the physical-chemical characterization of waters, in the Acre river and also some in afluents, between Brasiléia and Assis Brasil cities. Bottom sediments samples were sieved to <250 mesh fraction after drying. The suspended solid was obtained by precipitation with Al2SO4. About 250 mg of the material was submitted the acid digestion and the determinations of Hg were made by Could Vapor Atomic Absorption Spectrometry. The physical-chemical parameters pH, electric conductivity, temperature and dissolved total solids, were studied in the field, by potenciometric methods. The Hg levels in bottom sediments range 0,018 and 0,184 mug g-1, mean of 0,054 ± 0,034 mug g-1, while the suspended solids varied between 0,067 and 0,220 mug g-1, average of 0,098 ± 0,037 mug g-1. The waters were slightly acid with pH varying among 5,80 - 6,95 and conductivity electric 151,60 - 1.151,00 muS cm-1. The mercury levels in the analyzed materials was below of standard levels for

  11. Petrology and chemistry of the Green Acres gabbro complex near Winchester, Riverside County, California

    Science.gov (United States)

    Berger, Byron R.; Morton, Douglas M.; Miller, Fred K.

    2014-01-01

    The Cretaceous Green Acres layered igneous complex, northeast of Winchester, California, is composed of a suite of olivine- and hornblende-bearing gabbros in the Peninsular Ranges batholith within the Perris tectonic block. A consistent mineral assemblage is observed throughout the complex, but there is considerable textural and modal heterogeneity. Both preclude a consistent set of principles based on appearance and mineralogy on which to delineate map units. Distinct changes in the chemistry of olivine, pyroxene, and hornblende, however, serve to define discrete mappable units, and the complex has been divided into five geochemical map units on this basis.Limited whole-rock data show the Green Acres complex is chemically comparable to other Peninsular Ranges batholith gabbroic rocks, and rare earth element (REE) concentrations and patterns are typical of magmas generated in convergent margin settings. For the complex as a whole, olivine is Fo80–35, plagioclase is An100–64, clinopyroxene is Wo49–41En48–38Fs18–6 and Wo36–26En65–42Fs30–8, and orthopyroxene is Wo5–0En78–42Fs50–21, where Fo is forsterite, An is anorthite, Wo is wollastonite, En is enstatite, and Fs is ferrosilite. The Mg/(Mg + ΣFe) atomic ratio in hornblende ranges from 0.84 to 0.50.Magmatic lineations and modal and textural layering are prevalent throughout the complex. Mineral chemistry does not change in any systematic way within and between layers in any map unit. Although the strike of layering varies, in any map unit at any given location it is the same in all units irrespective of intrusive order. Thin dikes, typically late-stage hornblende gabbro, commonly intrude parallel to layering. The strikes of magmatic lineations and modal layers are consistent with the populations of strikes of fabrics in the metamorphic basement as well as tectonic features in surrounding, postgabbro granitic rocks. These relations imply that the regional state of stress at the time of gabbro

  12. InfAcrOnt: calculating cross-ontology term similarities using information flow by a random walk.

    Science.gov (United States)

    Cheng, Liang; Jiang, Yue; Ju, Hong; Sun, Jie; Peng, Jiajie; Zhou, Meng; Hu, Yang

    2018-01-19

    Since the establishment of the first biomedical ontology Gene Ontology (GO), the number of biomedical ontology has increased dramatically. Nowadays over 300 ontologies have been built including extensively used Disease Ontology (DO) and Human Phenotype Ontology (HPO). Because of the advantage of identifying novel relationships between terms, calculating similarity between ontology terms is one of the major tasks in this research area. Though similarities between terms within each ontology have been studied with in silico methods, term similarities across different ontologies were not investigated as deeply. The latest method took advantage of gene functional interaction network (GFIN) to explore such inter-ontology similarities of terms. However, it only used gene interactions and failed to make full use of the connectivity among gene nodes of the network. In addition, all existent methods are particularly designed for GO and their performances on the extended ontology community remain unknown. We proposed a method InfAcrOnt to infer similarities between terms across ontologies utilizing the entire GFIN. InfAcrOnt builds a term-gene-gene network which comprised ontology annotations and GFIN, and acquires similarities between terms across ontologies through modeling the information flow within the network by random walk. In our benchmark experiments on sub-ontologies of GO, InfAcrOnt achieves a high average area under the receiver operating characteristic curve (AUC) (0.9322 and 0.9309) and low standard deviations (1.8746e-6 and 3.0977e-6) in both human and yeast benchmark datasets exhibiting superior performance. Meanwhile, comparisons of InfAcrOnt results and prior knowledge on pair-wise DO-HPO terms and pair-wise DO-GO terms show high correlations. The experiment results show that InfAcrOnt significantly improves the performance of inferring similarities between terms across ontologies in benchmark set.

  13. [Results After Distal Digital Replantation - Is It Worth The Effort?

    Science.gov (United States)

    Braig, David; Thiele, Jan R; Penna, Vincenzo; Stark, G Björn; Eisenhardt, Steffen U

    2017-02-01

    There are only relative indications for distal digital replantation in zones 1 and 2 according to Tamai. In contrast to primary closure for fingertip amputations, replantation is a complex procedure that requires skills in supermicrosurgical techniques, as vessels with diameters between 0.3-0.8 mm are connected. In addition the time spent in hospital and the time off from work are longer. Distal digital replantation is thus only indicated, if the expected functional and aesthetic benefits surmount those of primary closure. We retrospectively analysed all fingertip amputations in zone 1 and 2 according to Tamai between 9/2009 and 7/2014 where we attempted distal digital replantation. The success of replantation, wound healing and functional results were evaluated according to Yamano. We performed 11 distal digital replantations in the study period. There were 6 total amputations, 4 subtotal amputations and 1 avulsion of the digital pulp. Revascularisation with long-term reattachment of the amputated tissues was possible in 8 cases (73%). In 3 cases (27%) secondary amputation closure was necessary. The mean operating time was 3 h 56 min. 6 patients, which had a successful replantation, were available for follow-up examinations after a mean period of 19 months. 5 patients were satisfied with the result and would again prefer replantation over primary amputation closure. 4 patients reported a good function of the replanted digits and did not complain about any limitations in their use. 2 patients complained about restricted function. All patients could return to their previous places of employment and were free of pain. Of the 12 affected digital nerves 11 nerves had a 2-point discrimination (2-PD) of ≤15 mm, 3 of them had a 2-PD between 7 and 10 mm and 4 of them of replanted digits and nail deformities in 2 patients. Distal digital replantation is complex and technically challenging. It leads to high patient satisfaction with only minimal functional

  14. Comparison of carcass yields and meat quality between Baicheng-You chickens and Arbor Acres broilers.

    Science.gov (United States)

    Sarsenbek, A; Wang, T; Zhao, J K; Jiang, W

    2013-10-01

    This study examined carcass yields and meat quality traits between Baicheng-You (BCY) chickens and Arbor Acres (AA) broilers. Thirty birds for each strain were selected and slaughtered at market ages of 49 d for AA broilers and 120 d for BCY. The results showed that BCY chickens had lower dressing (2.99%), semi-evisceration (5.10%), breast muscle (5.80%), and abdominal fat (1.55%) than those for AA broilers (P 0.05) difference of CP content in the same muscles of the 2 strains. The intramuscular fat (IMF) content was greater (P < 0.05) in thigh muscles of BCY chickens (6.80%) than those of AA broilers (4.28%), and inosine-5'-monophosphate (IMP) content was greater (P < 0.05) in breast and thigh muscles of BCY chickens (IMP: 3.79 and 1.47 mg/g) than same muscles in AA broilers (1.42 and 0.47 mg/g). In this study, muscle from 120-d-old BCY chickens was judged to have better quality traits with regard to cooking loss, drip loss, contents of IMF, and IMP compared with meat from 42-d-old AA broilers. At the same time, greater carcass yields, greater thigh pH24, and lower IMF content were observed in AA broilers compared with the BCY chickens.

  15. Gender and the radiology workforce: results of the 2014 ACR workforce survey.

    Science.gov (United States)

    Bluth, Edward I; Bansal, Swati; Macura, Katarzyna J; Fielding, Julia; Truong, Hang

    2015-02-01

    As part of the 2014 ACR Human Resources Commission Workforce Survey, an assessment of the gender of the U.S. radiologist workforce was undertaken. Radiologist gender in relation to type of practice, work location, leadership roles, and full- versus part-time employment have not previously been assessed by this survey. The survey was completed by group leaders in radiology identified through the Practice of Radiology Environment Database. The response rate to the survey was 22%, representing 35% of all practicing radiologists. The survey found that 78% of the radiology workforce is male, and 22% female. Among the men, 58% work in private practice, and 18% in the academic/university environment; among women, percentages were 43% and 31%, respectively. Of all physician leads, 85% are men, 15% women. Of the full-time radiologists, 15% of men are practice leaders compared with 11% of women. Fewer women than men are in private practice. More women than men practice in academic/university environments. Among part-time radiologists, there are more men than women, but significantly more women work part time than men. Women are in the minority among practice leaders. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. Coupling of channel thermalhydraulics and fuel behaviour in ACR-1000 safety analyses

    International Nuclear Information System (INIS)

    Huang, F.L.; Lei, Q.M.; Zhu, W.; Bilanovic, Z.

    2008-01-01

    Channel thermalhydraulics and fuel thermal-mechanical behaviour are interlinked. This paper describes a channel thermalhydraulics and fuel behaviour coupling methodology that has been used in ACR-1000 safety analyses. The coupling is done for all 12 fuel bundles in a fuel channel using the channel thermalhydraulics code CATHENA MOD-3.5d/Rev 2 and the transient fuel behaviour code ELOCA 2.2. The coupling approach can be used for every fuel element or every group of fuel elements in the channel. Test cases are presented where a total of 108 fuel element models are set up to allow a full coupling between channel thermalhydraulics and detailed fuel analysis for a channel containing a string of 12 fuel bundles. An additional advantage of this coupling approach is that there is no need for a separate detailed fuel analysis because the coupling analysis, once done, provides detailed calculations for the fuel channel (fuel bundles, pressure tube, and calandria tube) as well as all the fuel elements (or element groups) in the channel. (author)

  17. Defueled channel experiments in ZED-2 in support of ACR-1000 ROP analysis

    Energy Technology Data Exchange (ETDEWEB)

    LaFontaine, M.W.R.; Zeller, M.B.; McPhee, G.P. [Atomic Energy of Canada Limited (Canada)

    2011-07-01

    Defueled channel experiments were performed in ZED-2 to help resolve discrepancies between calculated flux detector response during refueling in ACR-1000 according the reactor codes RFSP and MCNP. The data produced from these experiments was later used in a separate Regional-Over-Power (ROP) analysis to verify MCNP and RFSP neutron response predictions during refueling. These experiments provided information on thermal flux distributions interior and exterior to a fueled and defueled channel; and on epithermal absolute flux distributions exterior to the same channel. Critical height and moderator temperature data for fueled and defueled channel conditions were also measured. In addition, standard platinum-clad Inconel Self-Powered Detector (SPD) performance data was obtained. The following reactor physics and SPD parameters were measured in these experiments: C Radial flux distribution inside the channel of interest (fueled and defueled), C Radial flux distribution outside the channel of interest (fueled and defueled), C Epithermal radial flux distribution outside the channel of interest (fueled and defueled), and C SPD response parallel to and normal to the channel of interest (fueled and defueled).

  18. Defueled channel experiments in ZED-2 in support of ACR-1000 ROP analysis

    International Nuclear Information System (INIS)

    LaFontaine, M.W.R.; Zeller, M.B.; McPhee, G.P.

    2011-01-01

    Defueled channel experiments were performed in ZED-2 to help resolve discrepancies between calculated flux detector response during refueling in ACR-1000 according the reactor codes RFSP and MCNP. The data produced from these experiments was later used in a separate Regional-Over-Power (ROP) analysis to verify MCNP and RFSP neutron response predictions during refueling. These experiments provided information on thermal flux distributions interior and exterior to a fueled and defueled channel; and on epithermal absolute flux distributions exterior to the same channel. Critical height and moderator temperature data for fueled and defueled channel conditions were also measured. In addition, standard platinum-clad Inconel Self-Powered Detector (SPD) performance data was obtained. The following reactor physics and SPD parameters were measured in these experiments: C Radial flux distribution inside the channel of interest (fueled and defueled), C Radial flux distribution outside the channel of interest (fueled and defueled), C Epithermal radial flux distribution outside the channel of interest (fueled and defueled), and C SPD response parallel to and normal to the channel of interest (fueled and defueled).

  19. Breast imaging reporting and data system (BI-RADS) or French 'classification ACR'

    International Nuclear Information System (INIS)

    Dilhuydy, Marie Helene

    2007-01-01

    Summary: The American College of Radiology Task Force on Breast Cancer published in 2003 Fourth edition of BI-RADS for Mammography. It is a lexicon of mammography terms including illustrations of each feature described, followed by a reporting format with assessment categories according to the degree of concern. The aim is to reduce inconsistencies in mammography reports and recommendations for assessment, to facilitate outcome monitoring and to allow each radiologist to audit his own mammography practice. In France, the Societe Francaise de Radiologie acquired the rights to translate BI-RADS, word for word and without adaptation or influence. The last edition was published in 2004. Simultaneously, French Haute Autorite de Sante and National Committee for Breast Cancer Screening proposed to all community practice mammography facilities a classification of detected abnormalities stating more clearly than BI-RADS do which feature has to be included in such and such assessment category and how to manage it. This 'classification ACR' is adapted from BI-RADS but strongly influenced by the context of the French nationwide screening programme, and by European recommendations to limitate undesirable risks of screening such as false positive and overdiagnosis. The differences between the two systems are discussed

  20. Actionable findings and the role of IT support: report of the ACR Actionable Reporting Work Group.

    Science.gov (United States)

    Larson, Paul A; Berland, Lincoln L; Griffith, Brent; Kahn, Charles E; Liebscher, Lawrence A

    2014-06-01

    The ACR formed the Actionable Reporting Work Group to address the potential role of IT in the communication of imaging findings, especially in cases that require nonroutine communication because of the urgency of the findings or their unexpected nature. These findings that require special communication with referring clinicians are classified as "actionable findings." The work group defines 3 categories of actionable findings that require, respectively, communication and clinical decision within minutes (category 1), hours (category 2), or days (category 3). Although the work group does not believe that there can be definitive lists of such findings, it developed lists in each category that would apply in most general hospital settings. For each category, the work group discusses ways in which IT can assist interpreting radiologists in successfully communicating to the relevant clinicians to ensure optimal patient care. IT systems can also help document the communication and facilitate auditing of the documentation. The work group recommends that vendors develop platforms that can be customized on the basis of local preferences and needs. Whatever system is used, it should be highly reliable and fit seamlessly into radiologists' workflow. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. Release of intracellular Calcium increase production of mitochondrial reactive oxygen species in renal distal epithelial cells

    DEFF Research Database (Denmark)

    Bjerregaard, Henning F.

    peroxide (H2O2) has traditionally been regarded as toxic by-products of aerobic metabolism. However, recent findings indicate that H2O2 act as a signalling molecule. The aim of the present study was to monitor, in real time, the rates of ROS generation in order to directly determine their production......Release of intracellular Calcium increase production of mitochondrial reactive oxygen species in renal distal epithelial cells. Henning F. Bjerregaard, Roskilde University, Department of Science, Systems and Models , 4000 Roskilde, Denmark. HFB@ RUC.DK Reactive oxygen species (ROS) like, hydrogen...... to G-protein stimulation of phospholipase C and release of inositol -3 phosphate. Cd (0.4 mM) treatment of A6 cells enhanced the ROS production after one minutes incubation. The production rate was constant for at least 10 to 20 min. Experiments showed that the Cd induced increase in ROS production...

  2. AcrA suppressor alterations reverse the drug hypersensitivity phenotype of a TolC mutant by inducing TolC aperture opening

    Science.gov (United States)

    Weeks, Jon W.; Celaya-Kolb, Teresa; Pecora, Sara; Misra, Rajeev

    2010-01-01

    Summary In Escherichia coli, the TolC–AcrAB complex forms a major antibiotic efflux system with broad substrate specificity. During the complex assembly, the periplasmic helices and bottom turns of TolC are thought to interact with a hairpin helix of AcrA and hairpin loops of AcrB respectively. In the present study we show that a four-residue substitution in TolC’s turn 1, which connects outer helices 3 and 4 proximal to TolC’s periplasmic aperture, confers antibiotic hypersensitivity without affecting TolC-mediated phage or colicin infection. However, despite the null-like drug sensitivity phenotype, chemical cross-linking analysis revealed no apparent defects in the ability of the mutant TolC protein to physically interact with AcrA and AcrB. A role for TolC turn 1 residues in the functional assembly of the tripartite efflux pump complex was uncovered through isolating suppressor mutations of the mutant TolC protein that mapped within acrA and by utilizing a labile AcrA protein. The data showed that AcrA-mediated suppression of antibiotic sensitivity was achieved by dilating the TolC aperture/channel in an AcrB-dependent manner. The results underscore the importance of the periplasmic turn 1 of TolC in the functional assembly of the tripartite efflux complex and AcrA in transitioning TolC from its closed to open state. PMID:20132445

  3. Concave distal end of ulna metaphysis alone is not a sign of rickets

    Energy Technology Data Exchange (ETDEWEB)

    Oestreich, Alan E. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, 5031, Cincinnati, OH (United States)

    2015-07-15

    Statements have been made in the literature and in legal testimony that misrepresent the radiographic finding of concave distal end of the ulnar metaphysis. To demonstrate that a concave distal end of the ossified ulna in infancy can be normal. Eighty distal wrists of randomly selected infants in the first year of life with radiographic evidence that ruled out rickets were reviewed. In 16 of the cases (20%), mild or moderate concavity of the distal end of the ulna was seen. An intact metaphyseal collar of distal radius or ulna confirmed the absence of radiographic rickets. The finding of 20% of concave distal ulnas in the first year of life confirms the widely acknowledged statements that concave distal end of the ulna alone is not indicative of rickets. Statements to the contrary are not justified. (orig.)

  4. Concave distal end of ulna metaphysis alone is not a sign of rickets

    International Nuclear Information System (INIS)

    Oestreich, Alan E.

    2015-01-01

    Statements have been made in the literature and in legal testimony that misrepresent the radiographic finding of concave distal end of the ulnar metaphysis. To demonstrate that a concave distal end of the ossified ulna in infancy can be normal. Eighty distal wrists of randomly selected infants in the first year of life with radiographic evidence that ruled out rickets were reviewed. In 16 of the cases (20%), mild or moderate concavity of the distal end of the ulna was seen. An intact metaphyseal collar of distal radius or ulna confirmed the absence of radiographic rickets. The finding of 20% of concave distal ulnas in the first year of life confirms the widely acknowledged statements that concave distal end of the ulna alone is not indicative of rickets. Statements to the contrary are not justified. (orig.)

  5. Classification of fractures of the distal r[ius - Comparative evaluation of spiral CT images and X-rays

    International Nuclear Information System (INIS)

    Roehnert, W.; Nitzsche, H.; Franck, W.M.; Amlang, M.

    1998-01-01

    Within the framework of a prospective study 35 patients with fractures of the distal r[ius safely diagnosed to require surgery have been [ditionally scanned by spiral CT. For more exact diagnostic evaluation of the joint surfaces and the fractures, multiplane reconstructions have been m[e to enhance the information obtained from the primary, axial tomographic images. Two experts independently performed classification on the basis of the X-rays and the CT scans, applying the AO scheme and the method of Frykman. Classifications according to the AO scheme were found to agree for only 28.6 % of the patients, which means that 57.1 % of the fractures shown by the X-rays were more or less underassessed. Classification according to Frykman's method revealed fewer deviations and agreement in 51.4 % of the cases. Biplanar r[iography continues to be considered as the standard method for examination of distal r[ius fractures, but it is recommended to perform spiral CT scans for evaluation of more complex distal r[ius fractures because these may require different therapies according to fracture types. (orig./CB) [de

  6. Factors associated with infection following open distal radius fractures.

    Science.gov (United States)

    Glueck, Dane A; Charoglu, Constantine P; Lawton, Jeffrey N

    2009-09-01

    Open fractures are often classified according to a system described by Gustilo and Anderson. However, this system was applied to open long bone fractures, which may not predict the incidence of infection in open metaphyseal fractures of the upper extremity. Other studies have found that wound contamination and systemic illness were the best predictors of infections in open hand fractures. Our study assessed infection in open distal radius fractures and identifies factors that are associated with these infections. We hypothesize that contamination, rather than absolute wound size, is the best predictor of infection associated with open distal radius fractures. A review by CPT code yielded 42 patients with open distal radius fractures between 1997 and 2002 treated at a level one trauma center. Medical records and radiographic follow-up were reviewed to assess the time to irrigation and debridement, the number of debridements in initial treatment period, the method of operative stabilization, the Gustilo and Anderson type of fracture, the Swanson type of fracture, and description of wound contamination. Forty-two patients were followed up for an average of 15 months (range 4 to 68 months). Twenty-four fractures were classified as Gustilo and Anderson type I, ten were type II, and eight were type III, 30 were Swanson type I, and 12 were Swanson type II. Five of the 42 fractures were considered contaminated. Two were exposed to fecal contamination. The others were contaminated with tar, dirt/grass, and gravel, respectively. Three of 42 (7%) fractures developed infections. All three infected cases received a single irrigation and debridement. Two of five contaminated fractures (40%) developed a polymicrobial infection. Both were exposed to fecal contamination and, therefore, considered Swanson type II fractures. They were classified as Gustilo and Anderson type II and IIIB based solely upon the size of the wound. Both required multiple debridements and eventually wrist

  7. Left ventricular contractile function after distal protection in primary percutaneous coronary intervention Results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial

    DEFF Research Database (Denmark)

    Kofoed, K F; Kelbæk, H; Thuesen, L

    2011-01-01

    Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function.......Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function....

  8. Outcomes of Distal Femur Fracture Treated with Dynamic Condylar Screw

    International Nuclear Information System (INIS)

    Razaq, M. N. U.; Muhammad, T.; Ahmed, A.; Adeel, M.; Ahmad, S.; Ahmad, S.; Sultan, S.

    2016-01-01

    Background: Implants for open reduction and internal fixation of distal femoral fracture includes angle blade plate, rush nails, enders nail and interlocking nails. But all these devices are technically demanding and less effective in providing inter-fragmentary compression in osteoporotic bones. These problems can be solved with dynamic condylar screw (DCS).The objective of the study was to determine the frequency of different outcomes of distal femoral fracture treated with dynamic condylar screw Methods: This case series study was carried out in the Department of Trauma and Orthopaedics, Ayub Teaching Hospital Abbottabad from 1st October 2014 to August 2015, after approval of the ethical committee of the institution. Data of all patients with distal femoral fractures aged 20-70 years, recruited through emergency, OPD or consultant clinic collected on a proforma. Standard treatment of trauma was given to the patients. Detailed history was taken including the past medical and surgical history. Detailed examination including air-way, breathing and circulation, general physical examination and abdomino-pelvic examination was done in each patient. Investigations including urinalysis, haemoglobin percent, full blood count, X-ray (both AP and lateral view) of the involved femur (including hip and knee) was done. Results: Mean age of the patients was 43.18±14.647 ranging from 20 to 70 years. Mean duration of hospital stay in days was 2.21±1.111 ranging from 1 to 6 days. Patients follow-up assessment after 4 months of surgery for union of femoral fracture treated with dynamic condylar screw was found in 96 (94.1 percent), wound infection was found in 7 (6.9 percent), knee stiffness was found in 21 (20.6 percent) and limb shortening was found in 7 (6.9 percent). Conclusion: Dynamic condylar screw is an easy, scientifically less difficult and satisfying method of treatment for fractures of femur. (author)

  9. [Lithiasis of the distal ureter: ESWL or URS].

    Science.gov (United States)

    González Enguita, C; Sánchez Gómez, J; Rodríguez-Miñon Cifuentes, J L; Cabrera Pérez, J; Calahorra Fernández, F J; García Cardoso, J; García de la Peña, E; Vela Navarrete, R

    1998-10-01

    A nephritic colic is the clinical picture that evidences the presence of ureteral stones, the natural evolution being their spontaneous passing. Stones in the distal ureter are self-eliminated in about 71-80% cases. The adoption of a "watchful wait" involves an uncertain occupational and medical evolution since, although in some cases the stones will pass with no problems, in other instances they can result in severe, life threatening situations for the patient's health (intractable pain, anuria or sepsis). When a decision is made to treat the condition, there are two choices available: "in situ" SWEL (extracorporeal lithotrity), or URS (ureterorenoscopy), long-standing conflicting techniques each with its own advantages and disadvantages, which should now be considered complementary. SWEL's major disadvantage is the number of repetitions required and the long wait, sometimes even months, until the last fragment is passed. The greater strength of URS is that it can be resolutive in just one episode (95% cases), thus avoiding the obstruction problems that can arise after SWEL. In the Lithiasis-Lithotrity Unit of FJD, SWEL is the first therapeutical option for the treatment of stones in the distal ureter. SWEL and URS are equally likely to be performed although SWEL is the initial choice for efficiency reasons that are explained. We achieve 93.6% positive results with a 1.82% re-SWEL rate (retreatment), 0.60 coefficient of efficiency (EQ) and 0.69 modified coefficient of efficiency (EQM) (Chart). No serious complications were recorded. Morbidity is variable with little clinical significance. Distal ureter lithiasis can be treated with either URS and SWEL, both considered "different and complementary". The choice in each particular case and within each hospital will depend on availability of means to perform one or the other, equipment's efficiency, skill of the urologist, patient's preference and cost of each treatment.

  10. Clinicopathologic characteristics and prognosis of proximal and distal gastric cancer

    Directory of Open Access Journals (Sweden)

    Yu X

    2018-02-01

    Full Text Available Xuefeng Yu,1,* Fulan Hu,2,* Chunfeng Li,1 Qiang Yao,1 Hongfeng Zhang,1 Yingwei Xue1 1Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China; 2Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, China *These authors contributed equally to this work Background and objectives: The dismal prognosis of gastric cancer patients is a global problem. We aim to evaluate the clinicopathologic features and prognostic factors of proximal and distal gastric cancer.Materials and methods: Gastric cancer cases diagnosed and treated at the same surgical unit between 2007 and 2010 were reviewed. Follow-up data from all patients were collected for at least 5 years until 2015. A total of 964 patients were studied (distal gastric cancer [DG], n=777 and proximal gastric cancer [PG], n=187.Results: DG patients had a relatively higher percentage of females, more thorough therapy (R0 [D0/D1/D2], fewer combined organ resections, younger age, smaller tumors (<5 cm, shorter surgery durations, less blood loss during surgery, and a relatively lower percentage of nodal metastases and a TNM stage of 4 (p<0.05. A significantly higher 5-year survival rate was observed in DG patients compared to PG patients (DG: 51%, PG: 28%; p<0.001. A multivariate analysis demonstrated that tumor size, blood loss during surgery, surgery approach of lymph node dissection, treatment with palliative surgery, histopathologic type, TNM stage, and tumor location were independent predictors of poor outcome.Conclusion: The different characteristics and prognosis of DG and PG cases have implications for the development of guiding strategies for a surgical program and assessment of prognosis of gastric cancer patients based on tumor location. Keywords: gastric cancer, tumor location, clinicopathologic features, prognosis, distal gastric cancer, proximal gastric cancer 

  11. Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ Implant Arthroplasty

    Directory of Open Access Journals (Sweden)

    Amir Reza Kachooei

    2014-09-01

    Full Text Available Background:  Conventional treatments after complicated injuries of the distal radioulnar joint (DRUJ such as Darrach and Kapandji-Sauvé procedures have many drawbacks, which may eventually lead to a painful unstable distal ulna.  The development of DRUJ prosthesis has significantly evolved over the past years. In this study, we assessed the outcome results of patients after DRUJ implant arthroplasty using the Aptis (Scheker prosthesis. Methods: We identified 13 patients with 14 prosthesis during the past 10 years. Patients underwent DRUJ arthroplasty due to persistent symptoms of instability, chronic pain, and stiffness. Records and follow-up visits were reviewed to find the final post-operative symptoms, pain, range of motion, and grip strength with a mean follow-up of 12 months (range: 2-25 months. Also, patients were contacted prospectively by phone in order to  minister the disabilities of the armshoulder and hand (DASH, patient rated wrist evaluation (PRWE, and visual analogue scale (VAS, and to interview regarding satisfaction and progress in daily activities. Eleven patients out of 13 could be reached with a median followup time of 60 months (range: 2 to 102 months.  Results: No patient required removal of the prosthesis. Only two patients underwent secondary surgeries in which both required debridement of the screw tip over the radius. The median DASH score, PRWE score, VAS, and satisfaction were 1.3, 2.5, 0, and 10, respectively. The mean range of flexion, extension, supination, and pronation was 62, 54, 51, and 64, respectively. Conclusions: Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation.

  12. Medical expulsive treatment of distal ureteral stone using tamsulosin

    International Nuclear Information System (INIS)

    Ahmad, H.; Azim, W.; Akmal, M.; Murtaza, B.

    2015-01-01

    Many minimally invasive interventional techniques as well as expectant treatments exist for the management of lower ureteric calculi. This study was conducted to evaluate the efficacy of tamsulosin as an expulsive pharmacologic therapy for the treatment of distal ureteral stone. Methods: This randomized control trial included 100 patients over 18 years of age with stone Size = 8mm in distal 1/3 of ureter. Patients were randomly assigned into two groups (A and B). Group A Patients were given Capsule Tamsulosin 0.4 mg, 1 daily up to 4 weeks while group B patients were given placebo, 1 Capsule daily up to 4 weeks. The primary endpoint was expulsion rate. A written informed consent was taken from all the patients. Expulsion time, need for analgesics, need for hospitalization and drug side effects were secondary endpoints. Results: A total of 49 patients in group A and 48 patients in group B reported back, therefore 97 out of 100 patients were evaluated. Mean age of the patients was 36.34 years (range 18-57 years). Mean stone size was 5.78 mm (range 4-8 mm) in greatest dimension. A stone expulsion rate of 85.71% (42 patients) was noted in group A and 54.20% (26 patients) in group B. Group A revealed a statistically significant advantage in term of stone expulsion rate (p=0.032). Considering expulsion time in days group A showed statistically significant advantage (p=0.015). Regarding age, sex, stone size and stone lateralization (right/left), there was no significant difference between the group A and B. No drug side effects were noted in both the groups. Conclusion: By using tamsulosin a higher stone expulsion rates can be achieved in a shorter time. More randomized control trials are required to establish tamsulosin as a standard medical expulsive treatment for small distal ureteric calculus. (author)

  13. Analysis of emboli during carotid stenting with distal protection device.

    Science.gov (United States)

    Chen, Chin-I; Iguchi, Yasuyuki; Garami, Zsolt; Malkoff, Marc D; Smalling, Richard W; Campbell, Morgan S; Alexandrov, Andrei V

    2006-01-01

    The newly developed multi-frequency transcranial Doppler (TCD) is able to differentiate gaseous from solid emboli. Our goal was to apply this technology to initially characterize emboli detected during carotid stenting with distal protection. Patients undergoing carotid angiography and stenting were monitored with 2-2.5 MHz TCD (Embo-Dop, DWL) over the middle cerebral artery unilateral to stent deployment. Sonographers insured optimal signal recordings during the procedures. Automated emboli detection and classification software (MultiXLab version 2.0) was applied for offline count and analysis. Monitoring using the Filter Wire EX (Boston Scientific) and ACCUNET system (Guidant Corporation) was performed. A total of 9,649 embolic signals were detected during 11 angiographic and 10 stenting procedures. An observer confirmed the signals using the International Consensus definition. Automated software classified these events into 5,900 gaseous and 3,749 solid emboli. During contrast injections without the protection device, 1,013 emboli were detected with 28% of these being solid. With deployment of the distal protection device, 8,636 emboli were found with 40% being solid (p protection device, 7,395 emboli with 42% solids were detected (p protection device still deployed, yielded 1,241 emboli with 31% solids (NS). Only 1 patient developed transient hemiparesthesia during ballooning that reduced the flow velocity to zero for 14 s. Neither gaseous nor solid emboli resulted in a mean flow velocity decrease or clinical symptoms. Microembolization frequently occurs during stenting even with deployment of the distal protection device. More solid emboli are seen during manipulations associated with lesion crossing. Although novel TCD methods yield a high frequency of embolic signals, further validation of this technique to determine the true nature, size, and number of emboli is needed.

  14. Prevention of distal extension cantilever fracture in mandibular overdentures.

    Science.gov (United States)

    Quirynen, Thomas; Quirynen, Marc; Duyck, Joke

    2015-09-01

    Fractures of distal bar extensions, supporting a mandibular overdenture, do occur with significant functional and economic consequences for the patient. This study therefore aims to evaluate the effect of different bar cross-sectional shapes and surfaces, bar extension lengths and the placement of a support rib under the distal bar extension on fracture resistance. The 2nd moment area and static strength were calculated for 11 frequently used bar designs using finite element analysis (FEA). For two specific designs (Ackermann round Ø 1.8mm and Dolder-Y macro, the former with and without a support rib) additional physical static and fatigue strength tests were included. The FEA static strength data corresponded well to the 2nd moment area (a similar ranking when maximum allowed force was considered). The application of a rib support (Ackermann Ø 1.8mm) and limitations of the bar extension length (6mm for the Ackermann Ø 1.8mm, 8mm for the Dolder-Y macro) allowed the bars to exceed 5 × 10(6) cycles of 120 and 250N, respectively, before fracture. The region of highest stresses in FEA corresponded well with the locations of the fractures observed in static- and fatigue-testing. With some simple guidelines/modifications, the number of bar extension fractures can be reduced significantly. This study focusses on distal bar extensions which improve the positioning of an implant supported overdenture. By combining laboratory testing and finite element simulations we aim to: (1) explain why fractures occur (dependent on physical characteristics of the bar), and (2) give clinical guidelines on how to prevent such fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Fractal analysis of bone architecture at distal radius

    International Nuclear Information System (INIS)

    Tomomitsu, Tatsushi; Mimura, Hiroaki; Murase, Kenya; Sone, Teruki; Fukunaga, Masao

    2005-01-01

    Bone strength depends on bone quality (architecture, turnover, damage accumulation, and mineralization) as well as bone mass. In this study, human bone architecture was analyzed using fractal image analysis, and the clinical relevance of this method was evaluated. The subjects were 12 healthy female controls and 16 female patients suspected of having osteoporosis (age range, 22-70 years; mean age, 49.1 years). High-resolution CT images of the distal radius were acquired and analyzed using a peripheral quantitative computed tomography (pQCT) system. On the same day, bone mineral densities of the lumbar spine (L-BMD), proximal femur (F-BMD), and distal radius (R-BMD) were measured by dual-energy X-ray absorptiometry (DXA). We examined the correlation between the fractal dimension and six bone mass indices. Subjects diagnosed with osteopenia or osteoporosis were divided into two groups (with and without vertebral fracture), and we compared measured values between these two groups. The fractal dimension correlated most closely with L-BMD (r=0.744). The coefficient of correlation between the fractal dimension and L-BMD was very similar to the coefficient of correlation between L-BMD and F-BMD (r=0.783) and the coefficient of correlation between L-BMD and R-BMD (r=0.742). The fractal dimension was the only measured value that differed significantly between both the osteopenic and the osteoporotic subjects with and without vertebral fracture. The present results suggest that the fractal dimension of the distal radius can be reliably used as a bone strength index that reflects bone architecture as well as bone mass. (author)

  16. Lesiones de la sindesmosis tibioperonea distal: Review article

    OpenAIRE

    Álvarez López, Alejandro; Rodríguez Rodríguez, Eugenio; García Lorenzo, Yenima; Muñoz Infante, Arnaldo

    2008-01-01

    Se realizó una revisión bibliográfica sobre las lesiones traumáticas de la articulación tibioperonea distal. Se recuerda y actualiza sobre aspectos como: anatomía, mecanismo de producción y cuadro clínico. Reciben especial énfasis los estudios imagenológicos y se subraya el uso e interpretación de la radiografía simple. Para terminar esta revisión se exponen las variantes de tratamiento tanto para las lesiones ligamentosas aisladas o asociadas a fractura del tobillo y su manejo posoperatorio....

  17. Paediatric post-traumatic cortical defects of the distal radius

    International Nuclear Information System (INIS)

    Roach, Richard T.; Summers, Bruce N.; Cassar-Pullicino, Victor

    2002-01-01

    Paediatric post-traumatic cortical defects, although rare, are predominately seen affecting the distal radius following a greenstick or torus fracture. We review the literature and present a further two cases supported by CT and MRI. Images from an acute greenstick fracture are also presented to help understand the pathogenesis. Defects are typically solitary on plain radiographs and are usually noticed late, proximal to the site of compression. They are non-expansile in an otherwise healthy child. CT and MRI may reveal smaller multiple subperiosteal defects. Typical defects require no further management other than reassurance and advice that they may occasionally cause discomfort but resolve with time. (orig.)

  18. Proximal and distal adjustments of reaching behavior in preterm infants.

    Science.gov (United States)

    de Toledo, Aline Martins; Soares, Daniele de Almeida; Tudella, Eloisa

    2011-01-01

    The authors aimed to investigate proximal and distal adjustments of reaching behavior and grasping in 5-, 6-, and 7-month-old preterm infants. Nine low-risk preterm and 10 full-term infants participated. Both groups showed the predominance of unimanual reaching, an age-related increase in the frequency of vertical-oriented and open hand movement, and also an increase in successful grasping from 6 to 7 months. The frequency of open hand was higher in the preterm group at 6 months. Intrinsic restrictions imposed by prematurity did not seem to have impaired reaching performance of preterm infants throughout the months of age.

  19. Perimenopausal risk of falling and incidence of distal forearm fracture.

    OpenAIRE

    Winner, S. J.; Morgan, C. A.; Evans, J. G.

    1989-01-01

    A postal survey of 2000 women and 2000 men sampled from the electoral roll in Oxford was undertaken to ascertain whether changes with age in the risk of falling might explain the stepwise increases in age specific incidence rates of distal forearm fracture which occur in women at around the age of 50. Corrected response rates were 83% for women and 72% for men. In women, but not in men, there was a rise in the risk of falling from 45 years, peaking in the 55-59 year age group, and sinking to ...

  20. Giant cells tumor of radius distal end and bone reconstruction

    International Nuclear Information System (INIS)

    La O Duran, Eldis; Monzon Fernandez, Abel Nicolas; Sanz Delgado, Licett

    2009-01-01

    This is the case of a black women aged 40 presenting with a tumor of distal end of right radium with histological diagnosis of low-grade malignancy giant cells tumor and proposal of limb amputation. A conservative surgery was performed with a two-steps total exeresis of lesion sparing the oncologic margin. A fibular free-graft was used and wrist arthrodesis and internal fixation of graft using AO system. There was a good graft consolidation and an active incorporation of patient to social activities. The diagnosis, treatment, follow-up, rehabilitation and case prognosis are exposed

  1. ACR Appropriateness Criteria® growth disturbances - risk of intrauterine growth restriction.

    Science.gov (United States)

    Zelop, Carolyn M; Javitt, Marcia C; Glanc, Phyllis; Dubinsky, Theodore; Harisinghani, Mukesh G; Harris, Robert D; Khati, Nadia J; Mitchell, Donald G; Pandharipande, Pari V; Pannu, Harpreet K; Podrasky, Ann E; Shipp, Thomas D; Siegel, Cary Lynn; Simpson, Lynn; Wall, Darci J; Wong-You-Cheong, Jade J

    2013-09-01

    Fetal growth disturbances include fetuses at risk for intrauterine growth restriction. These fetuses may have an estimated fetal weight at less than the 10% or demonstrate a plateau of fetal growth with an estimated fetal growth greater than the 10%. Uteroplacental insufficiency may play a major role in the etiology of intrauterine growth restriction. Fetuses at risk for intrauterine fetal growth restriction are susceptible to the potential hostility of the intrauterine environment leading to fetal hypoxia and fetal acidosis. Fetal well-being can be assessed using biophysical profile, Doppler velocimetry, fetal heart rate monitoring, and fetal movement counting.Fetal growth disturbances include fetuses at risk for intrauterine growth restriction. These fetuses may have an estimated fetal weight at less than the 10% or demonstrate a plateau of fetal growth with an estimated fetal growth greater than the 10%. Uteroplacental insufficiency may play a major role in the etiology of intrauterine growth restriction. Fetuses at risk for intrauterine fetal growth restriction are susceptible to the potential hostility of the intrauterine environment leading to fetal hypoxia and fetal acidosis. Fetal well-being can be assessed using biophysical profile, Doppler velocimetry, fetal heart rate monitoring, and fetal movement counting.The ACR Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  2. The role of function analysis in the ACR control centre design

    International Nuclear Information System (INIS)

    Leger, R.P.; Davey, E.C.

    2006-01-01

    An essential aspect of control centre design is the need to characterize: plant functions and their inter-relationships to support the achievement of operational goals, and roles for humans and automation in sharing and exchanging the execution of functions across all operational phases. Function analysis is a design activity that has been internationally accepted as an approach to satisfy this need. It is recognized as a fundamental and necessary component in the systematic approach to control centre design and is carried out early in the design process. A function analysis can provide a clear basis for: the control centre design for the purposes of design team communication, and customer or regulatory review, the control centre display and control systems, the staffing and layout requirements of the control centre, assessing the completeness of control centre displays and controls prior and supplementary to mock-up walkthroughs or simulator evaluations, and the design of operating procedures and training programs. This paper will explore the role for function analysis in supporting the design of the control centre. The development of the ACR control room will be used as an illustrative context for the discussion. The paper will also discuss the merits of using function analysis in a goal-or function-based approach resulting in a more robust, operationally compatible, and cost-effective design over the life of the plant. Two former papers have previously outlined, the evolution in AECL's application approach and lessons learned in applying function analysis in support of control room design. This paper provides the most recent update to this progression in application refinement. (author)

  3. Porta-enxertos para laranjeiras-doces (Citrus sinensis (L. Osb., em Rio Branco, Acre

    Directory of Open Access Journals (Sweden)

    Ana da Silva Ledo

    1999-07-01

    Full Text Available O objetivo deste trabalho foi de avaliar o comportamento de sete cultivares de laranjeiras- doces: 'Baia 101', 'Baianinha IAC 79', 'Monte Parnaso', 'Pêra D6', 'Natal 112', 'Valência 27' e 'Aquiri', sobre diferentes porta-enxertos: limão 'Cravo', tangerinas 'Cleópatra' e 'Sunki' e citrange 'Carrizo', nas condições edafoclimáticas de Rio Branco, Acre. O delineamento experimental foi em parcelas subdivididas, com as cultivares nas parcelas, os porta-enxertos nas subparcelas e os quatro anos de avaliação como repetições. As laranjeiras 'Pêra D6', 'Natal 112' e 'Valência 27' apresentaram tendências de maior produção quando enxertadas sobre o limão 'Cravo', e a laranja 'Aquiri' quando enxertada sobre citrange 'Carrizo'. Em relação aos demais porta-enxertos, o limão 'Cravo' mostrou tendências de induzir maior produção/volume de copa e peso médio do fruto, e menor teor de sólidos solúveis totais e acidez total. As laranjas do grupo Baia ('Baia 101', 'Baianinha IAC 79' e 'Monte Parnaso' produziram frutos com baixa percentagem de suco; não são recomendadas para plantio em Rio Branco, AC. Com base nos resultados obtidos, recomendam-se os porta-enxertos citrange 'Carrizo', tangerina 'Cleópatra' e limão 'Cravo' para a laranja 'Aquiri', e o porta-enxerto limão 'Cravo' para as laranjas 'Pêra D6', 'Natal 112' e 'Valência 27'.

  4. MCNP Simulations of End Flux Peaking in ACR-1000, 2.4 wt % {sup 235}U Fuel Bundles

    Energy Technology Data Exchange (ETDEWEB)

    Hill, Ian; Donnelly, Jim [Atomic Energy of Canada Limited (AECL), 2251 Speakman Drive, Mississauga, ON, L5K 1B2 (Canada)

    2008-07-01

    This paper examines the end flux peaking in ACR-1000 fuel bundles. Reactor physics simulations are performed with MCNP to assess the steady state end-flux peaking in an infinite lattice of ACR fuel, as well as to quantify the peaking that occurs during refuelling. 3-dimensional MCNP models are created based on the detailed geometry of the fuel bundle. Detailed position-dependent fuel compositions are obtained from MONTEBURNS which couples MCNP and ORIGIN2.2. Axial and radial power profiles are obtained for both fresh and mid-burnup fuel bundles in an infinite lattice. Subsequently an assessment of the impact of a refuelling transient on the power profiles is performed. The refuelling transient is found to increase the end flux peaking in the region adjacent to light water. (authors)

  5. Por que um Estado com vocação florestal como o Acre não produz palmito?

    Directory of Open Access Journals (Sweden)

    Markus Erwin Brose

    2016-04-01

    Full Text Available Palm heart constitutes a major non-timber forest product within the pro poor development strategy in Acre State. The 1990s it witnessed a boom of native palm processing, that proved to be unsustainable and processing units migrated to northern Bolivia. This article aims to rescue the impacts of this process, and subsequent initiatives of peach palm cultivation, originated by public and private, which, however, experienced difficulties to access the market. Given the scarce bibliography on the topic, we seek to contribute to the debate of this productive chain in Acre as an input to the debate on strategies to support the marketing of non-wood forest products, essential to the state’s policy of providing value to the standing forest.

  6. Switch-loop flexibility affects transport of large drugs by the promiscuous AcrB multidrug efflux transporter.

    Science.gov (United States)

    Cha, Hi-jea; Müller, Reinke T; Pos, Klaas M

    2014-08-01

    Multidrug efflux transporters recognize a variety of structurally unrelated compounds for which the molecular basis is poorly understood. For the resistance nodulation and cell division (RND) inner membrane component AcrB of the AcrAB-TolC multidrug efflux system from Escherichia coli, drug binding occurs at the access and deep binding pockets. These two binding areas are separated by an 11-amino-acid-residue-containing switch loop whose conformational flexibility is speculated to be essential for drug binding and transport. A G616N substitution in the switch loop has a distinct and local effect on the orientation of the loop and on the ability to transport larger drugs. Here, we report a distinct phenotypical pattern of drug recognition and transport for the G616N variant, indicating that drug substrates with minimal projection areas of >70 Å(2) are less well transported than other substrates. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  7. Crystallization and preliminary crystallographic characterization of LmACR2, an arsenate/antimonate reductase from Leishmania major

    Energy Technology Data Exchange (ETDEWEB)

    Bisacchi, Davide [Bioinformatics and Structural Proteomics, IST-National Cancer Research Institute, Genova (Italy); Zhou, Yao; Rosen, Barry P.; Mukhopadhyay, Rita [Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, Michigan (United States); Bordo, Domenico, E-mail: domenico.bordo@istge.it [Bioinformatics and Structural Proteomics, IST-National Cancer Research Institute, Genova (Italy)

    2006-10-01

    LmACR2 from L. major is the first rhodanese-like enzyme directly involved in the reduction of arsenate and antimonate to be crystallized. Diffraction data have been collected to 1.99 Å resolution using synchrotron X-rays. Arsenic is present in the biosphere owing either to the presence of pesticides and herbicides used in agricultural and industrial activities or to leaching from geological formations. The health effects of prolonged exposure to arsenic can be devastating and may lead to various forms of cancer. Antimony(V), which is chemically very similar to arsenic, is used instead in the treatment of leishmaniasis, an infection caused by the protozoan parasite Leishmania sp.; the reduction of pentavalent antimony contained in the drug Pentostam to the active trivalent form arises from the presence in the Leishmania genome of a gene, LmACR2, coding for the protein LmACR2 (14.5 kDa, 127 amino acids) that displays weak but significant sequence similarity to the catalytic domain of Cdc25 phosphatase and to rhodanese enzymes. For structural characterization, LmACR2 was overexpressed, purified to homogeneity and crystallized in a trigonal space group (P321 or P3{sub 1}21/P3{sub 2}21). The protein crystallized in two distinct trigonal crystal forms, with unit-cell parameters a = b = 111.0, c = 86.1 Å and a = b = 111.0, c = 175.6 Å, respectively. At a synchrotron beamline, the diffraction pattern extended to a resolution limit of 1.99 Å.

  8. Crystallization and preliminary crystallographic characterization of LmACR2, an arsenate/antimonate reductase from Leishmania major

    International Nuclear Information System (INIS)

    Bisacchi, Davide; Zhou, Yao; Rosen, Barry P.; Mukhopadhyay, Rita; Bordo, Domenico

    2006-01-01

    LmACR2 from L. major is the first rhodanese-like enzyme directly involved in the reduction of arsenate and antimonate to be crystallized. Diffraction data have been collected to 1.99 Å resolution using synchrotron X-rays. Arsenic is present in the biosphere owing either to the presence of pesticides and herbicides used in agricultural and industrial activities or to leaching from geological formations. The health effects of prolonged exposure to arsenic can be devastating and may lead to various forms of cancer. Antimony(V), which is chemically very similar to arsenic, is used instead in the treatment of leishmaniasis, an infection caused by the protozoan parasite Leishmania sp.; the reduction of pentavalent antimony contained in the drug Pentostam to the active trivalent form arises from the presence in the Leishmania genome of a gene, LmACR2, coding for the protein LmACR2 (14.5 kDa, 127 amino acids) that displays weak but significant sequence similarity to the catalytic domain of Cdc25 phosphatase and to rhodanese enzymes. For structural characterization, LmACR2 was overexpressed, purified to homogeneity and crystallized in a trigonal space group (P321 or P3 1 21/P3 2 21). The protein crystallized in two distinct trigonal crystal forms, with unit-cell parameters a = b = 111.0, c = 86.1 Å and a = b = 111.0, c = 175.6 Å, respectively. At a synchrotron beamline, the diffraction pattern extended to a resolution limit of 1.99 Å

  9. Detection of the pandemic norovirus variant GII.4 Sydney 2012 in Rio Branco, state of Acre, northern Brazil

    Directory of Open Access Journals (Sweden)

    Luciana Damascena da Silva

    2013-12-01

    Full Text Available Noroviruses (NoVs are important cause of gastroenteritis in humans worldwide. Genotype GII.4 is responsible for the majority of outbreaks reported to date. This study describes, for the first time in Brazil, the circulation of NoV GII.4 variant Sydney 2012 in faecal samples collected from children aged less than or equal to eight years in Rio Branco, state of Acre, northern Brazil, during July-September 2012.

  10. Portal verification using the KODAK ACR 2000 RT storage phosphor plate system and EC registered films. A semiquantitative comparison

    International Nuclear Information System (INIS)

    Geyer, P.; Blank, H.; Alheit, H.

    2006-01-01

    Background and Purpose: the suitability of the storage phosphor plate system ACR 2000 RT (Eastman Kodak Corp., Rochester, MN, USA), that is destined for portal verification as well as for portal simulation imaging in radiotherapy, had to be proven by the comparison with a highly sensitive verification film. Material and Methods: the comparison included portal verification images of different regions (head and neck, thorax, abdomen, and pelvis) irradiated with 6- and 15-MV photons and electrons. Each portal verification image was done at the storage screen and the EC registered film as well, using the EC-L registered cassettes (both: Eastman Kodak Corp., Rochester, MN, USA) for both systems. The soft-tissue and bony contrast and the brightness were evaluated and compared in a ranking of the two compared images. Different phantoms were irradiated to investigate the high- and low-contrast resolution. To account for quality assurance application, the short-time exposure of the unpacked and irradiated storage screen by green and red room lasers was also investigated. Results: in general, the quality of the processed ACR images was slightly higher than that of the films, mostly due to cases of an insufficient exposure to the film. The storage screen was able to verify electron portals even for low electron energies with only minor photon contamination. The laser lines were sharply and clearly visible on the ACR images. Conclusion: the ACR system may replace the film without any noticeable decrease in image quality thereby reducing processing time and saving the costs of films and avoiding incorrect exposures. (orig.)

  11. EULAR definition of erosive disease in light of the 2010 ACR/EULAR rheumatoid arthritis classification criteria.

    Science.gov (United States)

    van der Heijde, Désirée; van der Helm-van Mil, Annette H M; Aletaha, Daniel; Bingham, Clifton O; Burmester, Gerd R; Dougados, Maxime; Emery, Paul; Felson, David; Knevel, Rachel; Kvien, Tore K; Landewé, Robert B M; Lukas, Cédric; McInnes, Iain; Silman, Alan J; Smolen, Josef S; Stanislawska-Biernat, Ewa; Zink, Angela; Combe, Bernard

    2013-04-01

    The aim of this report was to propose a definition for erosive disease in the context of inflammatory arthritis in light of the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) rheumatoid arthritis (RA) criteria for use in clinical practice and studies. A EULAR task force was formed including 16 rheumatologists and one rheumatology fellow. The process was both evidence based and consensus based, and included, between March 2010 and April 2012, analyses of data from two cohorts, two face-to-face meetings, one online voting and one teleconference. The Leiden Early Arthritis Cohort and the French ESPOIR cohort were used for the evidence-based part. The outcome measures, which were initiation of methotrexate therapy, or any disease-modifying antirheumatic drug therapy within the first year of disease and arthritis persistency over 5 years, were studied with the aim to give the best definition of erosive disease. A decision was made to select a definition with a high specificity and focus on patients who did not otherwise fulfil the 2010 ACR/EULAR RA criteria (definition was selected: erosive disease for use in the 2010 ACR/EULAR RA classification criteria is defined when an erosion (defined as a cortical break) is seen in at least three separate joints at any of the following sites: the proximal interphalangeal, the metacarpophalangeal, the wrist (counted as one joint) and the metatarsophalangeal joints on radiographs of both hands and feet. A highly specific definition for erosive disease has thus been formulated.

  12. Coupling of remote alternating-access transport mechanisms for protons and substrates in the multidrug efflux pump AcrB.

    Science.gov (United States)

    Eicher, Thomas; Seeger, Markus A; Anselmi, Claudio; Zhou, Wenchang; Brandstätter, Lorenz; Verrey, François; Diederichs, Kay; Faraldo-Gómez, José D; Pos, Klaas M

    2014-09-19

    Membrane transporters of the RND superfamily confer multidrug resistance to pathogenic bacteria, and are essential for cholesterol metabolism and embryonic development in humans. We use high-resolution X-ray crystallography and computational methods to delineate the mechanism of the homotrimeric RND-type proton/drug antiporter AcrB, the active component of the major efflux system AcrAB-TolC in Escherichia coli, and one most complex and intriguing membrane transporters known to date. Analysis of wildtype AcrB and four functionally-inactive variants reveals an unprecedented mechanism that involves two remote alternating-access conformational cycles within each protomer, namely one for protons in the transmembrane region and another for drugs in the periplasmic domain, 50 Å apart. Each of these cycles entails two distinct types of collective motions of two structural repeats, coupled by flanking α-helices that project from the membrane. Moreover, we rationalize how the cross-talk among protomers across the trimerization interface might lead to a more kinetically efficient efflux system.

  13. Cost-effectiveness of laparoscopic versus open distal pancreatectomy for pancreatic cancer.

    Science.gov (United States)

    Gurusamy, Kurinchi Selvan; Riviere, Deniece; van Laarhoven, C J H; Besselink, Marc; Abu-Hilal, Mohammed; Davidson, Brian R; Morris, Steve

    2017-01-01

    A recent Cochrane review compared laparoscopic versus open distal pancreatectomy for people with for cancers of the body and tail of the pancreas and found that laparoscopic distal pancreatectomy may reduce the length of hospital stay. We compared the cost-effectiveness of laparoscopic distal pancreatectomy versus open distal pancreatectomy for pancreatic cancer. Model based cost-utility analysis estimating mean costs and quality-adjusted life years (QALYs) per patient from the perspective of the UK National Health Service. A decision tree model was constructed using probabilities, outcomes and cost data from published sources. A time horizon of 5 years was used. One-way and probabilistic sensitivity analyses were undertaken. The probabilistic sensitivity analysis showed that the incremental net monetary benefit was positive (£3,708.58 (95% confidence intervals (CI) -£9,473.62 to £16,115.69) but the 95% CI includes zero, indicating that there is significant uncertainty about the cost-effectiveness of laparoscopic distal pancreatectomy versus open distal pancreatectomy. The probability laparoscopic distal pancreatectomy was cost-effective compared to open distal pancreatectomy for pancreatic cancer was between 70% and 80% at the willingness-to-pay thresholds generally used in England (£20,000 to £30,000 per QALY gained). Results were sensitive to the survival proportions and the operating time. There is considerable uncertainty about whether laparoscopic distal pancreatectomy is cost-effective compared to open distal pancreatectomy for pancreatic cancer in the NHS setting.

  14. Correction of Hallux Valgus Interphalangeus With an Osteotomy of the Distal End of the Proximal Phalanx (Distal Akin Osteotomy).

    Science.gov (United States)

    Vander Griend, Robert

    2017-02-01

    Operative correction of a symptomatic hallux valgus interphalangeus (HVI) deformity is often achieved with an osteotomy at the proximal end of the proximal phalanx (Akin osteotomy). However, the apex of the typical HVI deformity (center of rotation angle) is at the interphalangeal joint of the hallux. This study was done to evaluate the results of performing a medial closing wedge osteotomy at the distal end of the proximal phalanx. Thirty-three patients (33 feet) underwent an osteotomy at the distal end of the proximal phalanx for correction of HVI. All of the patients had other forefoot deformities which were corrected at the same time. Eight of these were revision procedures of prior forefoot operations. The length of follow-up was determined by the associated procedures with a minimum follow-up of 4 months. The preoperative hallux valgus interphalangeus angle averaged 16 degrees of valgus (range 7-32 degrees) and was corrected to an average of 2 degrees of valgus (range 5 degrees valgus to 5 degrees varus). All of the patients were satisfied with the postoperative appearance and function of the first toe. Because of simultaneous correction of numerous other forefoot problems, it was not possible to specifically isolate or evaluate the effects and benefits of this osteotomy using outcomes measures. There was one intraoperative complication resulting in a fracture extending into the adjacent IP joint. Correction of an HVI deformity can be achieved with an osteotomy at the distal end of the proximal phalanx. This was a safe technique with few complications and with good results in terms of both correction and patient satisfaction. Level IV, retrospective case series.

  15. Comparison of 3 Minimally Invasive Methods for Distal Tibia Fractures.

    Science.gov (United States)

    Fang, Jun-Hao; Wu, Yao-Sen; Guo, Xiao-Shan; Sun, Liao-Jun

    2016-07-01

    This study compared the results of external fixation combined with limited open reduction and internal fixation (EF + LORIF), minimally invasive percutaneous plate osteosynthesis (MIPPO), and intramedullary nailing (IMN) for distal tibia fractures. A total of 84 patients with distal tibia shaft fractures were randomized to operative stabilization using EF + LORIF (28 cases), MIPPO (28 cases), or IMN (28 cases). The 3 groups were comparable with respect to patient demographics. Data were collected on operative time and radiation time, union time, complications, time of recovery to work, secondary operations, and measured joint function using the American Orthopaedic Foot and Ankle Society (AOFAS) score. There was no significant difference in time to union, incidence of union status, time of recovery to work, and AOFAS scores among the 3 groups (P>.05). Mean operative time and radiation time in the MIPPO group were longer than those in the IMN or EF + LORIF groups (Pknee pain occurred frequently after IMN (32.1%), and irritation symptoms were encountered more frequently after MIPPO (46.4%). Although EF + LORIF was associated with fewer secondary procedures vs MIPPO or IMN, it was related with more pin-tract infections (14.3%). Findings indicated that EF + LORIF, MIPPO, and IMN all achieved similar good functional results. However, EF + LORIF had some advantages over MIPPO and IMN in reducing operative and radiation times, postoperative complications, and reoperation rate. [Orthopedics. 2016; 39(4):e627-e633.]. Copyright 2016, SLACK Incorporated.

  16. DIAGNOSTICS AND TREATMENT OF DISTAL RADIOULNAR JOINT INJURIES

    Directory of Open Access Journals (Sweden)

    A. V. Skoroglyadov

    2010-01-01

    Full Text Available We present the experience of treatment of 169 patients with distal radioulnar joint injuries, operated in specialized hand surgery department of the Clinic of traumatology and orthopedics of Russian State Medical University on the base of Moscow city clinical hospital № 4. We have carried out the following operations: closed osteoclasia of the distal epimetaphys fractures, osteotomy of the radius with the external fixator application in 97 (57,4% patients, percutaneous 2 Kirschner wires fixation of the ulna head to the radius after reposition of dislocation - 38 (22,5% patients, lavsanoplasty of DRUJ ligaments - 12 (7,1%, fixation of the ulna head to the radius by pin - 7 (4,1%, open reposition of dislocation of the ulna head and K-wire fixation - 8 (4,8%, osteotomy of synostosis of forearm bones, W. Darrach and Sauve-Kapandji operations - 7 (4,1%. Complications were observed in 13 (7,7% cases. Postponed results (1 year after operation were studied in 110 patients. We got good results in 95 (86,4% cases, satisfactory - in 12 (10,9% cases, unsatisfactory - in 3 (2,7% cases.

  17. Complicated distal femoral epiphyseolysis treated by Ilizarov method: Case report

    Directory of Open Access Journals (Sweden)

    Jovanović Vesna

    2010-01-01

    Full Text Available Introduction Injuries of the distal femur are rare in children; however, they are frequently associated with complications. They are almost always physeal, most frequently Salter-Harris type II epiphyseolysis. The treatment of such injuries is similar in all physeal injuries. It is intended to provide growth plate recovery by gentle reduction and stable fixation thus preventing secondary complications, and also to provide decompression of the segment to solve the compartment syndrome and recover the neurovascular structures. Case Outline A seven-year old boy presented with a right knee injury while sleigh riding. He was admitted three weeks following the injury with distal femoral epiphysiolysis associated with peroneal palsy. A day after admission to our Institute the reduction was performed using the Ilizarov device. Physical therapy was started immediately after surgery, as well as walking with weight bearing on the operated leg. Five months after surgery the patient was anatomically and functionally recovered. Conclusion The presented method is recommended in the treatment of such injuries because of several reasons; reposition is simple and complete, there is no need to open the fracture site, fixation is stable, the growth plate is preserved, there is no need for additional external immobilisation, and physical therapy involving walking with weight bearing on the operated leg may be started immediately after surgery. .

  18. Distraction lengthening of the proximal phalanx in distal thumb amputations.

    Science.gov (United States)

    Cansü, Eren; Ünal, Mehmet Bekir; Parmaksızoğlu, Fatih; Gürcan, Serkan

    2015-01-01

    Thumb amputation is a major cause of hand dysfunction, and the treatment for distal thumb amputations remains controversial. Although finger reconstruction methods using distraction lengthening are known to restore finger length and function, we found no reports in the literature regarding phalangeal lengthening in thumb amputations. We aimed to evaluate proximal phalangeal lengthening in thumb amputations at or near the interphalangeal (IP) joint. We retrospectively evaluated patients who had undergone distraction lengthening of the proximal phalanx of the thumb. All patients underwent osteotomy, either during the initial procedure or as a second-stage procedure. Distraction began 10 days after osteotomy with the use of an external fixator that remained in place until ossification of the gap occurred without bone grafting. Patients were evaluated using the QuickDASH score. Fourteen patients with a mean age of 27 years and a mean follow-up period of 7 years were enrolled. The mean phalangeal lengthening achieved was 20 mm. Ossification occurred at all distraction sites, and the fixators were maintained for a mean of 85 days. The mean healing index was 42.5 days/cm. All 14 patients achieved the desired amount of phalangeal lengthening without major complications such as nonunion, premature union, or gross infection. For reconstruction in cases of distal thumb amputations, distraction lengthening of the proximal phalanx can be used to improve absolute length, web space, and grip distance. The technique is safe and effective, improves functionality/cosmesis, and offers a low complication risk.

  19. Intramedullary Venous Drainage System for Distal Fingertip Replantations.

    Science.gov (United States)

    Purisa, Husrev; Ozturk, Muhammed Besir; Kabakas, Fatih; Mersa, Berkan; Ozcelik, Ismail Bulent; Sezer, Ilker

    2017-08-01

    The number of venous anastomoses performed during fingertip replantation is one of the most important factors affecting the success of replantation. However, because vessel diameters decrease in the zone 1 level, vessel anastomoses, especially vein anastomoses, are technically difficult and, thus, cannot be performed in most cases. Alternative venous drainage methods are crucial when any reliable vein repair is not possible. In the literature, so many artery-only replantation techniques have been defined, such as arteriovenous anastomoses, forming an arteriovenous or venocutaneous fistula, manual milking and massage, puncturing, and external bleeding via a fishmouth incision and using a medical leech. It has been shown that, in distal fingertip replantations, the medullary cavity may also be a good way for venous return. In this study, we introduce an alternative intramedullary venous drainage system we developed to facilitate venous drainage in artery-only fingertip replantations. The results of 24 fingertip replantations distal to the nail fold by using this system are presented with a literature review.

  20. Radiographic evaluation for AVN following distal metatarsal Stoffella bunion osteotomy.

    Science.gov (United States)

    Klein, Christian; Zembsch, Alexander; Dorn, Ulrich

    2009-01-01

    Avascular necrosis of the metatarsal head, delayed bone healing and nonunion are complications that may occur after distal first metatarsal osteotomies. Intraoperative damage to the extraosseous blood supply, the location of the osteotomy and postoperative vasospasm have been cited as possible causes of such changes. We evaluated Stoffella's subcapital osteotomies which were performed at our department for the correction of moderate to severe hallux valgus deformities. Standardized radiographs of 300 feet, taken 6weeks, 3 months, and 6 months postoperatively and at the final followup were examined with regard to postoperative AVN or signs of delayed bone healing. Of 228 patients, 202 were women and 26 were men. The patients' mean age was 49 years, and the mean followup was 12 months. In 278 cases the radiographs revealed an unremarkable first metatarsal head. Seventeen cases showed diffuse or localized osteopenia or small cysts in the subchondral bone. These changes fully resolved on subsequent radiographs. The X-rays of two patients revealed progressive narrowing of the joint space, irregular contours on the surface of the joint and an abnormal bone structure. The patients subsequently developed a characteristic picture of avascular necrosis, in one case combined with nonunion. Three patients had delayed bone healing, but ultimately healed successfully. Ischemic changes in bone are known to occur after distal first metatarsal osteotomies. There is a very low incidence of postoperative perfusion problems after Stoffella;s technique, even with lateral soft tissue release.

  1. DO PROXIMAL AND DISTAL GASTRIC TUMOURS BEHAVE DIFFERENTLY?

    Science.gov (United States)

    Costa, Laurence Bedin da; Toneto, Marcelo Garcia; Moreira, Luis Fernando

    2016-01-01

    Although the incidence of gastric (adenocarcinoma) cancer has been decreasing over time, it is still one of the most common malignancies worldwide, and proximal tumours tend to have a worse prognosis. To compare surgical outcomes and prognosis between proximal - excluding tumours of the cardia - and distal gastric cancer. Out of 293 cases reviewed - 209 with distal and 69 with proximal gastric cancer - were compared for clinical and pathological features, stage, surgical outcome, mortality and survival. Statistically, there was no significant difference between patients in both groups regarding mortality (p=0.661), adjuvant chemotherapy (p 0.661), and radiation (p=1.000). However, there was significant difference in the degree of lymph node dissection employed (p=0.002) and the number of positive lymph nodes resected (p=0.038) between the two groups. The odds of death at five years for patients who had a D0 dissection was three times greater (odds ratio 2.78; (95%CI 1.33-5.82) than that for patients who had a D2 dissection, while for patients who had a D1 dissection the odds ratio was only 1.41 (95%CI 0.71-2.83) compared to D2-dissected patients. Although no significant differences were found between proximal and distal gastric cancer, the increased risk of death in D0- and D1-dissected patients clearly suggests an important role of radical D2 lymph node dissection in survival. Embora a incidência do câncer gástrico esteja diminuindo nas últimas décadas, ele ainda aparece como uma das neoplasias malignas mais comuns, e tumores proximais tendem a ter pior prognóstico. Comparar os resultados cirúrgicos e o prognóstico entre o câncer gástrico proximal, excluindo os tumores da cárdia e junção esofagogástrica, e o distal. De 293 casos revistos - 209 distais e 69 proximais - foram comparados quanto aos achados clínicos e patológicos, estágio, resultados cirúrgicos, mortalidade e sobrevida. Estatisticamente não houve diferença entre pacientes em ambos

  2. Effect of multicell DRAGON calculations depends on the environment on the DONJON predictions for the ACR-1000

    International Nuclear Information System (INIS)

    Duquette, J.-S.

    2009-01-01

    For understanding the behavior of a nuclear reactor core, it is necessary to make a full core calculation in order to compute the neutrons flux. To obtain the neutrons flux, solving the Boltzmann transport equation is required. That is not a simple task and it is impossible to analytically fend the solution of the neutrons transport equation on a complex core. Following a series of approximations, it is possible to numerically solve the neutrons transport equation. The solution of this equation is done step by step. Calculations will be performed over the ACR-1000 core. The Advanced CANDU Reactor (ACR-1000) is a generation III+ heavy water moderated and light water cooled reactor. It is a 1200 MW(e) power reactor. Amongst the ACR-1000 design parameters that differ from the CANDU 6, the reduced lattice pitch and the use of light water coolant and enriched fuel are the three most important. Those features modify the behavior of the neutrons in the ACR compared to the CANDU 6. The impact of the tight lattice is that a cell is more strongly coupled to its neighbor. The objective of this work is to determine the impact of the environment on the cell properties of the ACR-1000. Those properties will be used to perform full core calculations. The neutron transport calculations are performed with DRAGON whereas for the diffusion calculation on a full core. The code DONJON will be used. The DRAGON reference transport calculation will be made on a single cell. Then, a series of calculations will be performed using DRAGON over two types of assemblies, the first modelling the core interior and the second, modelling the core periphery. Moreover, the fuel age will sometimes be homogeneous, sometimes heterogeneous. The fuel will be burned during six hundred days. One thus obtains libraries of macroscopic cross sections over a six hundred days interval for various simulations. Thereafter, we will determine the effect of a neutrons transport multicell calculation on various DONJON

  3. The Distal Humerus Axial View: Assessment of Displacement in Medial Epicondyle Fractures.

    Science.gov (United States)

    Souder, Christopher D; Farnsworth, Christine L; McNeil, Natalie P; Bomar, James D; Edmonds, Eric W

    2015-01-01

    The assessment and treatment of childhood medial epicondyle humerus fractures continues to be associated with significant debate. Several studies demonstrate that standard radiographic views are unable to accurately portray the true displacement. Without reliable ways to assess the amount of displacement, how can we debate treatment and outcomes? This study introduces a novel imaging technique for the evaluation of medial epicondyle fractures. An osteotomy of a cadaveric humerus was performed to simulate a medial epicondyle fracture. Plain radiographs were obtained with the fracture fragment displaced anteriorly in 2-mm increments between 0 and 18 mm. Anteroposterior (AP), internal oblique (IR), lateral (LAT), and distal humerus axial (AXIAL) views were performed. Axial images were obtained by positioning the central ray above the shoulder at 15 to 20 degrees from the long axis of the humerus, centered on the distal humerus. Displacement (mm) was measured by 7 orthopaedic surgeons on digital radiographs. At 10 mm displacement, AP views underestimated displacement by 5.5±0.6 mm and IR views underestimated by 3.8±2.1 mm. On LAT views, readers were not able to visualize fragments with displacement. Displacement ≥10 mm from LAT views was overestimated by 1 reader by up to 4.6 mm and underestimated by others by up to 18.0 mm. AXIAL images more closely estimated the true amount of displacement, with a mean 1.5±1.1 mm error in measurement for displacement and a mean 0.8±0.7 mm error for displacements of ≥10 mm. AXIAL measurements correlated strongly with the actual displacement (r=0.998, Pdisplacement of medial epicondyle humerus fractures. The newly described AXIAL projection more accurately and reliably demonstrated the true displacement while reducing the need for advanced imaging such as computed tomography. This simple view can be easily obtained at a clinic visit, enhancing the surgeon's ability to determine the true displacement.

  4. Salmon River Habitat Enhancement, Part 1, 1984 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Konopacky, Richard C.

    1985-06-01

    This volume contains reports on subprojects involving the determining of alternatives to enhance salmonid habitat on patented land in Bear Valley Creek, Idaho, coordination activities for habitat projects occurring on streams within fishing areas of the Shoshone-Bannock Indian Tribes, and habitat and fish inventories in the Salmon River. Separate abstracts have been prepared for individual reports. (ACR)

  5. Renal denervation beyond the bifurcation: The effect of distal ablation placement on safety and blood pressure.

    Science.gov (United States)

    Beeftink, Martine M A; Spiering, Wilko; De Jong, Mark R; Doevendans, Pieter A; Blankestijn, Peter J; Elvan, Arif; Heeg, Jan-Evert; Bots, Michiel L; Voskuil, Michiel

    2017-04-01

    Renal denervation may be more effective if performed distal in the renal artery because of smaller distances between the lumen and perivascular nerves. The authors reviewed the angiographic results of 97 patients and compared blood pressure reduction in relation to the location of the denervation. No significant differences in blood pressure reduction or complications were found between patient groups divided according to their spatial distribution of the ablations (proximal to the bifurcation in both arteries, distal to the bifurcation in one artery and distal in the other artery, or distal to the bifurcation in both arteries), but systolic ambulatory blood pressure reduction was significantly related to the number of distal ablations. No differences in adverse events were observed. In conclusion, we found no reason to believe that renal denervation distal to the bifurcation poses additional risks over the currently advised approach of proximal denervation, but improved efficacy remains to be conclusively established. ©2017 Wiley Periodicals, Inc.

  6. Radiology Jobs: Uncovering Hidden and Not-So-Hidden Opportunities From the ACR Jobs Board.

    Science.gov (United States)

    Misono, Alexander S; Saini, Sanjay; Prabhakar, Anand M

    2016-04-01

    The radiology job market remains daunting. Trainees choosing fellowships benefit from understanding employers' likely future needs. Radiology practices may similarly refine recruiting practices. This study quantitatively analyzes the current radiology job landscape. Job postings on the ACR Career Center online portal between June 2014 and June 2015 were reviewed. As entries are frequently added and removed, posts were manually collected weekly. Postings were recorded in a database and included date, practice, location, specialty/subspecialty, job type, years of experience, salary, and job description. The database was analyzed to characterize employer needs, salary, partnership track availability, and job availability by geography. A total of 1,778 jobs were posted during the study period. Of these, 1,529 (86.0%) were diagnostic; 240 (13.5%) were interventional; and 9 (0.5%) were administrative. Most jobs were in private practice (75.7%), compared with academic (16.3%) and other (7.9%). Although many did not require a specific specialty (46%), the most-frequent needs were breast (17%), neuroradiology (11%), musculoskeletal (8%), and body (7%). Of non-breast-imaging jobs, roughly 30% indicated an interest in breast-imaging skills. A minority (13%) requested prior experience of greater than 1 year, with some seeking 7-10 years of experience. Although most (87%) were full-time positions, part-time, temporary, and contractor roles were described in the remaining 13%. Salary data were rarely reported (7%), with a range of $98,967-$1,000,000. The most jobs were based in California (11%); New York (7%); Pennsylvania (7%); and Illinois (6%). However, when indexed per million population, the highest job rates were in Nevada (14.1); Washington DC (13.7); Hawaii (13.4); Montana (9.8); and Pennsylvania (9.1). Roughly 31% of postings described partnership tracks, with the highest rates in New England (58%), the Pacific Northwest (56%), the Midwest (40%), and Southern (40

  7. Locking plate fixation in distal metaphyseal tibial fractures: series of 79 patients

    OpenAIRE

    Gupta, Rakesh K.; Rohilla, Rajesh Kumar; Sangwan, Kapil; Singh, Vijendra; Walia, Saurav

    2009-01-01

    Open reduction and internal fixation in distal tibial fractures jeopardises fracture fragment vascularity and often results in soft tissue complications. Minimally invasive osteosynthesis, if possible, offers the best possible option as it permits adequate fixation in a biological manner. Seventy-nine consecutive adult patients with distal tibial fractures, including one patient with a bilateral fracture of the distal tibia, treated with locking plates, were retrospectively reviewed. The 4.5-...

  8. Intersphincteric Resection and Coloanal Anastomosis in Treatment of Distal Rectal Cancer

    OpenAIRE

    Cipe, Gokhan; Muslumanoglu, Mahmut; Yardimci, Erkan; Memmi, Naim; Aysan, Erhan

    2012-01-01

    In the treatment of distal rectal cancer, abdominoperineal resection is traditionally performed. However, the recognition of shorter safe distal resection line, intersphincteric resection technique has given a chance of sphincter-saving surgery for patients with distal rectal cancer during last two decades and still is being performed as an alternative choice of abdominoperineal resection. The first aim of this study is to assess the morbidity, mortality, oncological, and functional outcomes ...

  9. Classification of Distal Fingertip Amputation Based on the Arterial System for Replantation

    OpenAIRE

    Park, Hyun Chul; Bahar-Moni, Ahmed Suparno; Cho, Sang Hyun; Kim, Sang Soo; Park, Hyun Sik; Ahn, Sang Cheon

    2012-01-01

    During replantation of distal fingertip amputation, identification of the artery is the most important but time consuming procedure. Depending on the damaged arterial structure, we classified distal fingertip amputations into 4 zones, on the basis of three dimensional concept. Zone 1 injury was defined as damage to the proximal central pulp artery; zone 2 injury, damage to the branch of the central pulp artery; zone 3 injury, damage to the distal central pulp artery; and zone 4 injury, no inj...

  10. Reliability of radiographic measurements for acute distal radius fractures

    International Nuclear Information System (INIS)

    Watson, Narelle J.; Asadollahi, Saeed; Parrish, Frank; Ridgway, Jacqueline; Tran, Phong; Keating, Jennifer L.

    2016-01-01

    The management of distal radial fractures is guided by the interpretation of radiographic findings. The aim of this investigation was to determine the intra- and inter-observer reliability of eight traditionally reported anatomic radiographic parameters in adults with an acute distal radius fracture. Five observers participated. All were routinely involved in making treatment decisions based on distal radius fracture radiographs. Observers performed independent repeated measurements on 30 radiographs for eight anatomical parameters: dorsal shift (mm), intra-articular gap (mm), intra-articular step (mm), palmar tilt (degrees), radial angle (degrees), radial height (mm), radial shift (mm), ulnar variance (mm). Intraclass correlation coefficients (ICCs) and the magnitude of retest errors were calculated. Measurement reliability was summarised as high (ICC > 0.80), moderate (0.60–0.80) or low (<0.60). Intra-observer reliability was high for dorsal shift and palmar tilt; moderate for radial angle, radial height, ulnar variance and radial shift; and low for intra-articular gap and step. Inter-observer reliability was high for palmar tilt; moderate for dorsal shift, ulnar variance, radial angle and radial height; and low for radial shift, intra-articular gap and step. Error magnitude (95 % confidence interval) was within 1–2 mm for intra-articular gap and step, 2–4 mm for ulnar variance, 4–6 mm for radial shift, dorsal shift and radial height, and 6–8° for radial angle and palmar tilt. Based on previous reports of critical values for palmar tilt, ulnar variance and radial angle, error margins appear small enough for measurements to be useful in guiding treatment decisions. Our findings indicate that clinicians cannot reliably measure values ≤1 mm for intra-articular gap and step when interpreting radiographic parameters using the standardised methods investigated in this study. As a guide for treatment selection, palmar tilt, ulnar variance and radial angle

  11. Differences between proximal and distal portions of the male rabbit posterior urethra in the physiological role of muscarinic cholinergic receptors

    Science.gov (United States)

    Nagahama, Katsushi; Tsujii, Toshihiko; Morita, Takashi; Azuma, Hiroshi; Oshima, Hiroyuki

    1998-01-01

    The aim of the present study was to elucidate functional differences between embryologically different portions of the posterior urethra of male rabbits in response to muscarinic acetylcholine receptor (mAChR) stimulation using in vitro isometric tension experiments and radioligand binding studies. In the in vitro isometric tension experiments, carbachol, produced a dose-dependent contraction of the proximal portion under the resting state, but did not change the basal tone of the distal portion. Contraction of the proximal portion by 10−5 M noradrenaline (NA) was dose-dependently enhanced by carbachol either in the presence or absence of NG-nitro-L-arginine (NOARG). In contrast, carbachol induced relaxation of the distal portion contracted by 10−5 M NA, which was reversed to dose-dependent contraction in the presence of NOARG. Both portions of the urethra had a similar number of [3H]-quinuclidinyl benzilate ([3H]-QNB) binding sites (195.3±74.1 fmols mg−1 protein for the proximal portion and 146.5±8.5 fmols mg−1 protein for the distal portion) with similar affinities (115.0±45.4 pM for the proximal portion and 79.9± 2.9 pM for the distal portion). The concentration-response curves to carbachol in both portions were shifted to the right in a parallel manner in the presence of pirenzepine (an M1 antagonist), 11-[[2-[(diethylamino)methyl]-1-piperidinyl] acetyl]-5, 11-dihydro-6H-pyrido-2,3-b)-(1,4)-benzodiazepin-6-one (AFDX-116, an M2 antgonist) and 4-diphenyl-acetoxy-N-methyl-piperidine (4-DAMP, an M1/M3 antagonist). The pA2 values for pirenzepine, AFDX-116 and 4-DAMP were 7.5±0.1, 7.2±0.02 and 9.3±0.1 respectively for the contraction of the proximal portion, and 7.2±0.1, 7.1±0.2 and 9.1±0.2, respectively for the relaxation of the distal portion. In conclusion mAChR subtypes distribute in a similar fashion throughout the length of the male rabbit posterior urethra with the discrepant responses to carbachol attributable to the

  12. Fluorescence-based thermal shift data on multidrug regulator AcrR from Salmonella enterica subsp. entrica serovar Typhimurium str. LT2

    Directory of Open Access Journals (Sweden)

    Babu A. Manjasetty

    2016-06-01

    Full Text Available The fluorescence-based thermal shift (FTS data presented here include Table S1 and Fig. S1, and are supplemental to our original research article describing detailed structural, FTS, and fluorescence polarization analyses of the Salmonella enterica subsp. entrica serovar Typhimurium str. LT2 multidrug transcriptional regulator AcrR (StAcrR (doi:10.1016/j.jsb.2016.01.008 (Manjasetty et al., 2015 [1]. Table S1 contains chemical formulas, a Chemical Abstracts Service (CAS Registry Number (CAS no., FTS rank (a ligand with the highest rank has the largest difference in the melting temperature (ΔTm, and uses as drug molecules against various pathological conditions of sixteen small-molecule ligands that increase thermal stability of StAcrR. Thermal stability of human enolase 1, a negative control protein, was not affected in the presence of various concentrations of the top six StAcrR binders (Fig. S1.

  13. Fluorescence-based thermal shift data on multidrug regulator AcrR from Salmonella enterica subsp. entrica serovar Typhimurium str. LT2.

    Science.gov (United States)

    Manjasetty, Babu A; Halavaty, Andrei S; Luan, Chi-Hao; Osipiuk, Jerzy; Mulligan, Rory; Kwon, Keehwan; Anderson, Wayne F; Joachimiak, Andrzej

    2016-06-01

    The fluorescence-based thermal shift (FTS) data presented here include Table S1 and Fig. S1, and are supplemental to our original research article describing detailed structural, FTS, and fluorescence polarization analyses of the Salmonella enterica subsp. entrica serovar Typhimurium str. LT2 multidrug transcriptional regulator AcrR (StAcrR) (doi:10.1016/j.jsb.2016.01.008) (Manjasetty et al., 2015 [1]). Table S1 contains chemical formulas, a Chemical Abstracts Service (CAS) Registry Number (CAS no.), FTS rank (a ligand with the highest rank) has the largest difference in the melting temperature (ΔT m), and uses as drug molecules against various pathological conditions of sixteen small-molecule ligands that increase thermal stability of StAcrR. Thermal stability of human enolase 1, a negative control protein, was not affected in the presence of various concentrations of the top six StAcrR binders (Fig. S1).

  14. Joint involvement in patients with early polymyalgia rheumatica using high-resolution ultrasound and its contribution to the EULAR/ACR 2012 classification criteria for polymyalgia rheumatica.

    Science.gov (United States)

    Weigand, Sandra; Ehrenstein, Boris; Fleck, Martin; Hartung, Wolfgang

    2014-04-01

    To assess joint involvement and the contribution of musculoskeletal ultrasound (MSUS) to the novel European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) 2012 classification criteria in patients with polymyalgia rheumatic (PMR). MSUS was performed in 54 consecutive patients with recent-onset PMR. Biceps tenosynovitis of at least 1 shoulder has been observed in 70.4% of patients, and 64.8% had a bilateral biceps tenosynovitis. Subdeltoid bursitis (27.8% unilateral, 5.6% bilateral), glenohumeral synovitis (22.2% unilateral, 9.3% bilateral), and hip involvement (22.2% unilateral, 16.7% bilateral) were observed less frequently. The sensitivities of the classification criteria were 85.2% for EULAR/ACR without MSUS and 81.5% for EULAR/ACR with MSUS. The most common MSUS pathology was a biceps tenosynovitis. However, US findings had no effect on the sensitivity of the novel EULAR/ACR criteria for PMR.

  15. EnviroAtlas - Acres of USDA Farm Service Agency Conservation Reserve Program land by 12-Digit HUC for the Conterminous United States.

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset shows the acres of land enrolled in the US Department of Agriculture (USDA)'s Conservation Reserve Program (CRP). The CRP is administered by...

  16. Fractures of the bilateral distal radius and scaphoid: a case report

    Directory of Open Access Journals (Sweden)

    Ozkan Korhan

    2008-03-01

    Full Text Available Abstract Introduction Bilateral fractures of the distal radius and scaphoid are extremely rare injuries. Case presentation A patient with bilateral comminuted, displaced distal fractures of the radius and bilateral fractures of the scaphoid was treated via internal fixation of the scaphoid fractures with Herbert screws and internal fixation of the distal radius fractures with locked volar plating. Conclusion Rigid internal fixation of distal radius and scaphoid fractures is mandatory to start early active rehabilitation of the wrist without the need for wrist immobilization with a plaster or external skeletal fixation.

  17. Enhancing isoprenoid production through systematically assembling and modulating efflux pumps in Escherichia coli.

    Science.gov (United States)

    Wang, Jian-Feng; Xiong, Zhi-Qiang; Li, Shi-Yuan; Wang, Yong

    2013-09-01

    Enhancement of the cellular exportation of heterologous compounds is an important aspect to improve the product yield in microbial cell factory. Efflux pumps can expel various intra- or extra-cellular substances out of microbial hosts and increase the cellular tolerance. Thus in this study, by using the hydrophobic sesquiterpene (amorphadiene) and diterpene (kaurene) as two model compounds, we attempted to improve isoprenoid production through systematically engineering the efflux pumps in Escherichia coli BL21(DE3). The pleiotropic resistant pumps, AcrAB-TolC, MdtEF-TolC from E. coli and heterologous MexAB-OprM pump from Pseudomonas aeruginosa, were overexpressed, assembled, and finely modulated. We found that overexpression of AcrB and TolC components can effectively enhance the specific yield of amorphadiene and kaurene, e.g., 31 and 37 % improvement for amorphadiene compared with control, respectively. The heterologous MexB component can enhance kaurene production with 70 % improvement which is more effective than TolC and AcrB. The results suggest that the three components of tripartite efflux pumps play varied effect to enhance isoprenoid production. Considering the highly organized structure of efflux pumps and importance of components interaction, various component combinations were constructed and the copy number of key components AcrB and TolC was finely modulated as well. The results exhibit that the combination TolC and TolC and AcrB improved the specific yield of amorphadiene with 118 %, and AcrA and TolC and AcrB improved that of kaurene with 104 %. This study indicates that assembling and finely modulating efflux pumps is an effective strategy to improve the production of heterologous compounds in E. coli.

  18. Sarcoidosis: radiographic manifestations in the nails and distal phalanges

    Energy Technology Data Exchange (ETDEWEB)

    Albers, Brittany K.; Garner, Hillary W. [Mayo Clinic, Department of Radiology, Jacksonville, FL (United States); Sluzevich, Jason C. [Mayo Clinic, Department of Dermatology, Jacksonville, FL (United States)

    2016-05-15

    Sarcoidosis is a granulomatous disease which can affect multiple organ systems. Clinical and radiologic manifestations depend on the organ system involved and the chronicity of disease. Nail involvement in sarcoidosis is rare, but is clinically relevant as it indicates chronic systemic disease. Nail abnormalities can be identified radiographically, and when seen in patients with known or suspected sarcoidosis, should prompt careful evaluation of the underlying bone for osseous involvement. We describe a case of sarcoidosis with radiographic findings in the nails and distal phalangeal tufts, which were indicative of nail and osseous sarcoid involvement and strongly supported the presence of chronic systemic disease. Although the nail findings resolved clinically and on radiographs after treatment, the osseous findings showed only minimal improvement. To our knowledge, the radiographic findings of nail sarcoidosis have not been previously addressed in the literature. (orig.)

  19. Hand-arm vibration syndrome with distal brachial artery occlusion

    Directory of Open Access Journals (Sweden)

    Vladyslava Bazylevska

    2017-01-01

    Full Text Available Abstract             Hand-arm vibration syndrome (HAVS is a complex disorder of the peripheral extremities that is associated with occupational or recreational exposure to hand-transmitted vibration. Digital artery occlusion in HAVS is a common finding; however, proximal involvement is less likely.  We present a case of HAVS with the initial presentation of acute limb ischemia and with thrombus burden extending from the distal brachial artery and into the ulnar and radial arteries. To our knowledge, no case of HAVS syndrome of similar severity has been previously described. This case emphasizes the potential dangers of HAVS and the necessity for proper prophylactic interventions at the workplace.

  20. Morphometric variation in Plio-Pleistocene hominid distal humeri.

    Science.gov (United States)

    Lague, M R; Jungers, W L

    1996-11-01

    The magnitude and meaning of morphological variation among Plio-Pleistocene hominid distal humeri have been recurrent points of disagreement among paleoanthropologists. Some researchers have found noteworthy differences among fossil humeri that they believe merit taxonomic separation, while others question the possibility of accurately sorting these fossils into different species and/or functional groups. Size and shape differences among fossil distal humeri are evaluated here to determine whether the magnitude and patterns of these differences can be observed within large-bodied, living hominoids. Specimens analyzed in this study have been assigned to various taxa (Australopithecus afarensis, A. africanus, A. anamensis, Paranthropus, and early Homo) and include AL 288-1m, AL 288-1s, AL 137-48a, AL 322-1, Gomboré IB 7594, TM 1517, KNM-ER 739, KNM-ER 1504, KMN-KP 271 (Kanapoi), and Stw 431. Five extant hominoid populations are sampled to provide a standard by which to consider differences found between the fossils, including two modern human groups (Native American and African American), one group of Pan troglodytes, and two subspecies of Gorilla gorilla (G.g. beringei, G.g. gorilla). All possible pairwise d values (average Euclidena distances) are calculated within each of the reference populations using an exact randomization procedure. This is done using both raw linear measurements as well as scale-free shape data created as ratios of each measurement to the geometric mean. Differences between each pair of fossil humeri are evaluated by comparing their d values to the distribution of d values found within each of the reference populations. Principal coordinate analysis and an unweighted pair group method with arithmetic averages (UPGMA) cluster analysis are utilized to further assess similarities and differences among the fossils. Finally, canonical variates analysis and discriminant analysis are employed using all hominoid samples in order to control for

  1. Distal anastomotic vein adjunct usage in infrainguinal prosthetic bypasses.

    Science.gov (United States)

    McPhee, James T; Goodney, Philip P; Schanzer, Andres; Shaykevich, Shimon; Belkin, Michael; Menard, Matthew T

    2013-04-01

    Single-segment saphenous vein remains the optimal conduit for infrainguinal revascularization. In its absence, prosthetic conduit may be used. Existing data regarding the significance of anastomotic distal vein adjunct (DVA) usage with prosthetic grafts are based on small series. This is a retrospective cohort analysis derived from the regional Vascular Study Group of New England as well as the Brigham and Women's hospital database. A total of 1018 infrainguinal prosthetic bypass grafts were captured in the dataset from 73 surgeons at 15 participating institutions. Propensity scoring and 3:1 matching was performed to create similar exposure groups for analysis. Outcome measures of interest included: primary patency, freedom from major adverse limb events (MALEs), and amputation free survival at 1 year as a function of vein patch utilization. Time to event data were compared with the log-rank test; multivariable Cox proportional hazard models were used to evaluate the adjusted association between vein cuff usage and the primary end points. DVA was defined as a vein patch, cuff, or boot in any configuration. Of the 1018 bypass operations, 94 (9.2%) had a DVA whereas 924 (90.8%) did not (no DVA). After propensity score matching, 88 DVAs (25%) and 264 no DVAs (75%) were analyzed. On univariate analysis of the matched cohort, the DVA and no DVA groups were similar in terms of mean age (70.0 vs 69.0; P = .55), male sex (58.0% vs 58.3%; P > .99), and preoperative characteristics such as living at home (93.2% vs 94.3%; P = .79) and independent ambulatory status (72.7% vs 75.7%; P = .64). The DVA and no DVA groups had similar rates of major comorbidities such as hypertension chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, and dialysis dependence (P > .05 for all). Likewise, they had similar rates of distal origin grafts (13.6% vs 12.5%; P = .85), critical limb ischemia indications (P = .53), and prior arterial bypass (58% vs 47%; P = .08

  2. Sarcoidosis: radiographic manifestations in the nails and distal phalanges

    International Nuclear Information System (INIS)

    Albers, Brittany K.; Garner, Hillary W.; Sluzevich, Jason C.

    2016-01-01

    Sarcoidosis is a granulomatous disease which can affect multiple organ systems. Clinical and radiologic manifestations depend on the organ system involved and the chronicity of disease. Nail involvement in sarcoidosis is rare, but is clinically relevant as it indicates chronic systemic disease. Nail abnormalities can be identified radiographically, and when seen in patients with known or suspected sarcoidosis, should prompt careful evaluation of the underlying bone for osseous involvement. We describe a case of sarcoidosis with radiographic findings in the nails and distal phalangeal tufts, which were indicative of nail and osseous sarcoid involvement and strongly supported the presence of chronic systemic disease. Although the nail findings resolved clinically and on radiographs after treatment, the osseous findings showed only minimal improvement. To our knowledge, the radiographic findings of nail sarcoidosis have not been previously addressed in the literature. (orig.)

  3. Laparoscopic distal pancreatectomy: Up-to-date and literature review

    Science.gov (United States)

    Iacobone, Maurizio; Citton, Marilisa; Nitti, Donato

    2012-01-01

    Pancreatic surgery represents one of the most challenging areas in digestive surgery. In recent years, an increasing number of laparoscopic pancreatic procedures have been performed and laparoscopic distal pancreatectomy (LDP) has gained world-wide acceptance because it does not require anastomosis or other reconstruction. To date, English literature reports more than 300 papers focusing on LDP, but only 6% included more than 30 patients. Literature review confirms that LDP is a feasible and safe procedure in patients with benign or low grade malignancies. Decreased blood loss and morbidity, early recovery and shorter hospital stay may be the main advantages. Several concerns still exist for laparoscopic pancreatic adenocarcinoma excision. The individual surgeon determines the technical conduction of LDP, with or without spleen preservation; currently robotic pancreatic surgery has gained diffusion. Additional researches are necessary to determine the best technique to improve the procedure results. PMID:23082049

  4. Fernandez osteotomy of radio distal with mal united fracture

    International Nuclear Information System (INIS)

    Garcia Herrera, Alvaro; Bocanegra, Sergio; Suarez, Fabio

    2003-01-01

    We review prospectively our experience in the military hospital in Bogota, Colombia, with the opening-wedge osteotomy for the treatment of a mal united fracture of the distal end of the radius in fifty-six consecutive patients from 1990 to 2002. The indications for operation were pain predominantly in the radio-ulnar joint and functional limitation with grip strength loss. Preoperative radiographs revealed an average ulnar inclination of 14 degrees, an average ulnar variance of four millimeters, and increased dorsal tilt (colles deformity) that averaged 28 degrees. All patients had limited function. The average grip strength was a force of fifteen kilograms compared with a force of thirty-one kilograms in the contralateral hand. Postoperatively, all of the patients had substantial improvement in function, relief of pain and grip strength increased. The functional results were rated as very good in eleven patients, good in thirty-six, fair in nine

  5. Worry and perceived threat of proximal and distal undesirable outcomes.

    Science.gov (United States)

    Bredemeier, Keith; Berenbaum, Howard; Spielberg, Jeffrey M

    2012-04-01

    Individuals who are prone to worry tend to overestimate the likelihoods and costs of future undesirable outcomes. However, it is unclear whether these relations vary as a function of the timeframe of the event in question. In the present study, 342 undergraduate students completed a self-report measure of worry and rated the perceived probabilities and costs of 40 undesirable outcomes. Specifically, each participant estimated the probability that each of these outcomes would occur within three different timeframes: the next month, the next year, and the next 10 years. We found that the strength of the association between worry and probability estimates was strongest for the most proximal timeframe. Probability estimates were more strongly associated with worry for participants with elevated cost estimates, and this interactive effect was strongest for the most distal timeframe. Implications of these findings for understanding the etiology and treatment of excessive worry are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Amelogenesis Imperfecta with Distal Renal Tubular Acidosis: A Novel Syndrome?

    Science.gov (United States)

    Misgar, R A; Hassan, Z; Wani, A I; Bashir, M I

    2017-01-01

    Amelogenesis imperfecta (AI) is a heterogeneous group of inherited dental enamel defects. It has rarely been reported in association with multiorgan syndromes and metabolic disorders. The metabolic disorders that have been reported in association with AI include hypocalciuria, impaired urinary concentrating ability, and Bartter-like syndrome. In literature, only three cases of AI and distal renal tubular acidosis (dRTA) have been described: two cases in adults and a solitary case in the pediatric age group. Here, we report a child with AI presenting with dRTA; to the best of our knowledge, our reported case is the only second such case in pediatric age group. Our case highlights the importance of recognizing the possibility of renal abnormalities in patients with AI as it will affect the long-term prognosis.

  7. Amelogenesis imperfecta with distal renal tubular acidosis: A novel syndrome?

    Directory of Open Access Journals (Sweden)

    R A Misgar

    2017-01-01

    Full Text Available Amelogenesis imperfecta (AI is a heterogeneous group of inherited dental enamel defects. It has rarely been reported in association with multiorgan syndromes and metabolic disorders. The metabolic disorders that have been reported in association with AI include hypocalciuria, impaired urinary concentrating ability, and Bartter-like syndrome. In literature, only three cases of AI and distal renal tubular acidosis (dRTA have been described: two cases in adults and a solitary case in the pediatric age group. Here, we report a child with AI presenting with dRTA; to the best of our knowledge, our reported case is the only second such case in pediatric age group. Our case highlights the importance of recognizing the possibility of renal abnormalities in patients with AI as it will affect the long-term prognosis.

  8. Validity and reliability problems with patient global as a component of the ACR/EULAR remission criteria as used in clinical practice.

    Science.gov (United States)

    Masri, Karim R; Shaver, Timothy S; Shahouri, Shadi H; Wang, Shirley; Anderson, James D; Busch, Ruth E; Michaud, Kaleb; Mikuls, Ted R; Caplan, Liron; Wolfe, Frederick

    2012-06-01

    To investigate what factors influence patient global health assessment (PtGlobal), and how those factors and the reliability of PtGlobal affect the rate, reliability, and validity of recently published American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) rheumatoid arthritis (RA) remission criteria when used in clinical practice. We examined consecutive patients with RA in clinical practice and identified 77 who met ACR/EULAR joint criteria for remission (≤ 1 swollen joint and ≤ 1 tender joint). We evaluated factors associated with a PtGlobal > 1, because a PtGlobal ≤ 1 defined ACR/EULAR remission in this group of patients who had already met ACR/EULAR joint criteria. Of the 77 patients examined, only 17 (22.1%) had PtGlobal ≤ 1 and thus fully satisfied ACR/EULAR criteria. A large proportion of patients not in remission by ACR/EULAR criteria had high PtGlobal related to noninflammatory issues, including low back pain, fatigue, and functional limitations, and a number of patients clustered in the range of PtGlobal > 1 and ≤ 2. However, the minimal detectable difference for PtGlobal was 2.3. In addition, compared with a PtGlobal severity score, a PtGlobal activity score was 3.3% less likely to be abnormal (> 1). Noninflammatory factors contribute to the level of PtGlobal and result in the exclusion of many patients who would otherwise be in "true" remission according to the ACR/EULAR definition. Reliability problems associated with PtGlobal can also result in misclassification, and may explain the observation of low longterm remission rates in RA. As currently constituted, the use of the ACR/EULAR remission criteria in clinical practice appears to be problematic.

  9. Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin

    Directory of Open Access Journals (Sweden)

    Vittorio Imperatore

    2014-06-01

    Full Text Available Objectives: To compare the efficacy and safety of tamsulosin and silodosin in the context of medical expulsive therapy (MET of distal ureteric stones. Patients and methods: Observational data were collected retrospectively from patients who received silodosin (N = 50 or tamsulosin (N = 50 as MET from January 2012 to January 2013. Inclusion criteria were: patients aged ≥ 18 years with a single, unilateral, symptomatic, radiopaque ureteric stone of 10 mm or smaller in the largest dimension located between the lower border of the sacroiliac joint and the vesico-ureteric junction. Stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use, incidence of side effects were compared. Results: Stone-expulsion rate in the silodosin and in the tamsulosin groups were 88% and 82%, respectively (p not significant. Mean expulsion times were 6.7 and 6.5 days in the silodosin and tamsulosin group, respectively (p not significant. Mean number of pain episodes were 1.6 and 1.7 in the silodosin and tamsulosin group, respectively (p not significant. The mean number of analgesic requirement was 0.84 and 0.9 for the silodosin and tamsulosin group, respectively (p not significant. Overall, incidence of side effects was similar in both groups. Patients taking silodosin experienced an higher incidence of retrograde ejaculation but a lower incidence of side effects related to peripheral vasodilation when compared to patients taking tamsulosin. Subgroup analysis demonstrated significantly lower mean expulsion times and pain episodes in patients with stones ≤ 5 mm in both groups. Conclusions: Tamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associatd with a lower incidence of side effects related to peripheral vasodilation but an higher incidence of retrograde ejaculation when compared to tamsulosin.

  10. Contact mechanics of reverse engineered distal humeral hemiarthroplasty implants.

    Science.gov (United States)

    Willing, Ryan; King, Graham J W; Johnson, James A

    2015-11-26

    Erosion of articular cartilage is a concern following distal humeral hemiarthroplasty, because native cartilage surfaces are placed in contact with stiff metallic implant components, which causes decreases in contact area and increases in contact stresses. Recently, reverse engineered implants have been proposed which are intended to promote more natural contact mechanics by reproducing the native bone or cartilage shape. In this study, finite element modeling is used in order to calculate changes in cartilage contact areas and stresses following distal humeral hemiarthroplasty with commercially available and reverse engineered implant designs. At the ulna, decreases in contact area were -34±3% (p=0.002), -27±1% (pengineered and cartilage reverse engineered designs, respectively. Peak contact stresses increased by 461±57% (p=0.008), 387±127% (p=0.229) and 165±16% (p=0.003). At the radius, decreases in contact area were -21±3% (p=0.013), -13±2% (p0.999), 241±32% (p=0.010) and 61±10% (p=0.021). Between the three different implant designs, the cartilage reverse engineered design yielded the largest contact areas and lowest contact stresses, but was still unable to reproduce the contact mechanics of the native joint. These findings align with a growing body of evidence indicating that although reverse engineered hemiarthroplasty implants can provide small improvements in contact mechanics when compared with commercially available designs, further optimization of shape and material properties is required in order reproduce native joint contact mechanics. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Treatment of distal bronchial stenosis after bilateral lung transplantation

    Directory of Open Access Journals (Sweden)

    S. V. Golovinskiy

    2017-01-01

    Full Text Available The effi ciency of lung transplantation is considerably limited by the complications associated with the bronchial pathologies. Despite the progress of the treatment methods, bronchial complications are still remaining as an actual problem in the postoperative period with frequency of occurrence from 7 to 29%. However, the bronchial stenosis are the most common bronchial complications after lung transplantation with mortality from 2 to 4%.Aim. To study an experience of our center of bronchial stenosis treatment in lung recipients. Materials and methods. 34 patients underwent lung transplantation from September 2014 to January 2017. 6 (16% of them had a stenosis of lobar or segmental bronchi from 84 to 494 postoperative day. 5 (83% of them have demonstrated multifocal lesions. In all of the cases there was performed an endoscopic bougienage, which involved a balloon dilatation and electrocoagulated incision of granular tissue under X-ray control. After that the patients were administrated by everolimus.Results. Restenosis was formed in 132,0 ± 94,2 postoperative day after primary treatment in all patients. In four cases (67% we used nitinol stent placement under X-ray control. There were no complications. In 3 cases stents were dislocated distally, so we needed to use repeated endoscopic bougienage to replace the stent. Using of everolimus has allowed to decrease the rate of restenosis, but it need future research.Conclusion. Distal bronchial stenosis after lung transplantation can be managed with endoscopic bougienage and stent placement. Adding everolimus has not signifi cantly affected the risk of frequency of restenosis.

  12. Medical expulsive therapy for distal ureteric stones: tamsulosin versus silodosin.

    Science.gov (United States)

    Imperatore, Vittorio; Fusco, Ferdinando; Creta, Massimiliano; Di Meo, Sergio; Buonopane, Roberto; Longo, Nicola; Imbimbo, Ciro; Mirone, Vincenzo

    2014-06-30

    To compare the efficacy and safety of tamsulosin and silodosin in the context of medical expulsive therapy (MET) of distal ureteric stones. Observational data were collected retrospectively from patients who received silodosin (N = 50) or tamsulosin (N = 50) as MET from January 2012 to January 2013. Inclusion criteria were: patients aged ≥ 18 years with a single, unilateral, symptomatic, radiopaque ureteric stone of 10 mm or smaller in the largest dimension located between the lower border of the sacroiliac joint and the vesico-ureteric junction. Stone expulsion rate, stone expulsion time, number of pain episodes, need for analgesics use, incidence of side effects were compared. Stone-expulsion rate in the silodosin and in the tamsulosin groups were 88% and 82%, respectively (p not significant). Mean expulsion times were 6.7 and 6.5 days in the silodosin and tamsulosin group, respectively (p not significant). Mean number of pain episodes were 1.6 and 1.7 in the silodosin and tamsulosin group, respectively (p not significant). The mean number of analgesic requirement was 0.84 and 0.9 for the silodosin and tamsulosin group, respectively (p not significant). Overall, incidence of side effects was similar in both groups. Patients taking silodosin experienced an higher incidence of retrograde ejaculation but a lower incidence of side effects related to peripheral vasodilation when compared to patients taking tamsulosin. Subgroup analysis demonstrated significantly lower mean expulsion times and pain episodes in patients with stones ≤ 5 mm in both groups. Tamsulosin and silodosin are equally effective as MET for distal ureteric stones sized 10 mm or smaller. MET with silodosin is associatd with a lower incidence of side effects related to peripheral vasodilation but an higher incidence of retrograde ejaculation when compared to tamsulosin.

  13. Minimally invasive distal pancreatectomy for PNETs: laparoscopic or robotic approach?

    Science.gov (United States)

    Zhang, Jiaqiang; Jin, Jiabin; Chen, Shi; Gu, Jiangning; Zhu, Yi; Qin, Kai; Zhan, Qian; Cheng, Dongfeng; Chen, Hao; Deng, Xiaxing; Shen, Baiyong; Peng, Chenghong

    2017-05-16

    The most effective and radical treatment for pancreatic neuroendocrine tumors (PNETs) is surgical resection. Minimally invasive surgery has been increasingly used in pancreatectomy. Initial results in robotic distal pancreatectomy (RDP) have been encouraging. Nonetheless, data comparing outcomes of RDP with those of laparoscopic distal pancreatectomy (LDP) in treating PNETs are rare. The aim of this study was to compare the safety and efficacy of RDP and LDP for PNETs. From September 2010 to January 2017, operative parameters and perioperative outcomes in an initial experience with 43 consecutive patients undergoing RDP were collected and compared with those in 31 patients undergoing LDP. Patients undergoing RDP and LDP demonstrated equivalent age, sex, ASA score, tumor location and tumor size. Operating time, length of resected pancreas, postoperative length of hospital stay and rates of conversion to open, pancreatic fistula, transfusion and reoperation were not statistically different. Patients in the RDP group were associated with significantly higher overall (79.1 vs. 48.4 %, P = 0.006) and Kimura spleen preservation rates (72.1 vs. 16.1%, P < 0.001) and had reduced risk of excessive blood loss (50 vs. 200mL, P < 0.001). Oncological outcomes in this series were superior for the RDP group with more lymph node harvest for G2 and G3 PNETs (3.5 vs. 2, P = 0.034). Both RDP and LDP are efficacious and safe methods in treating PNETs located in the body or tail of pancreas. Robotic approach offers advantages with less intraoperative blood loss, higher spleen preservation rate and more lymph node harvest. It may be sensible to choose RDP for patients who fit indications for scheduled spleen preservation.

  14. Benefits of intracorporeal gastrointestinal anastomosis following laparoscopic distal gastrectomy

    Directory of Open Access Journals (Sweden)

    Lee Sang-Woong

    2012-12-01

    Full Text Available Abstract Background Laparoscopic gastrectomy has recently been gaining popularity as a treatment for cancer; however, little is known about the benefits of intracorporeal (IC gastrointestinal anastomosis with pure laparoscopic distal gastrectomy (LDG compared with extracorporeal (EC anastomosis with laparoscopy-assisted distal gastrectomy (LADG. Methods Between June 2000 and December 2011, we assessed 449 consecutive patients with early-stage gastric cancer who underwent LDG. The patients were classified into three groups according to the method of reconstruction LADG followed by EC hand-sewn anastomosis (LADG + EC (n = 73, using any of three anastomosis methods (Billroth-I (B-I, Billroth-II (B-II or Roux-en-Y (R-Y; LDG followed by IC B-I anastomosis (LDG + B-I (n = 248; or LDG followed by IC R-Y anastomosis (LDG + R-Y (n = 128. The analyzed parameters included patient and tumor characteristics, operation details, and post-operative outcomes. Results The tumor location was significantly more proximal in the LDG + R-Y group than in the LDG + B-I group (P P P  Conclusions Intracorporeal mechanical anastomosis by either the B-I or R-Y method following LDG has several advantages over at the LADG + EC, including small wound size, reduced invasiveness, and safe anastomosis. Although additional randomized control studies are warranted to confirm these findings, we consider that pure LDG is a useful technique for patients with early gastric cancer.

  15. Repair of the torn distal biceps tendon by endobutton fixation

    Directory of Open Access Journals (Sweden)

    Ravi K Gupta

    2012-01-01

    Full Text Available Background: A number of techniques have been described to reattach the torn distal biceps tendon to the bicipital tuberosity. We report a retrospective analysis of single incision technique using an endobutton fixation in sports persons. Materials and Methods: The present series include nine torn distal biceps tendons in eight patients, fixed anatomically to the radial tuberosity with an endobutton by using a single incision surgical technique; seven patients had suffered the injuries during contact sports. The passage of the endobutton was facilitated by using a blunt tipped pin in order to avoid injury to the posterior interosseous nerve. The patients were evaluated by Disabilities of the Arm, Shoulder and Hand (DASH score and Mayo elbow score. Results: The average age of the patients was 27.35 years (range 21-42 years. Average follow-up was 41.5 months (range 24-102 months. The final average flexion extension arc was 0°-143°, while the average pronation and supination angles were 77° (range 70°-82° and 81° (range 78°-85°, respectively at the last followup. All the patients had a Disabilities of the Arm, Shoulder and Hand (DASH score of 0 and a Mayo elbow score of 100 each. All the seven active sports persons were able to get back to their respective game. There was no nerve injury or any other complication. Conclusions: The surgical procedure used by us is a simple, safe and reproducible technique giving minimal morbidity and better cosmetic results.

  16. Distal anterior inferior cerebellar artery syndrome after acoustic neuroma surgery.

    Science.gov (United States)

    Hegarty, Joseph L; Jackler, Robert K; Rigby, Peter L; Pitts, Lawrence H; Cheung, Steven W

    2002-07-01

    To define a clinicopathologic syndrome associated with persistent cerebellar dysfunction after acoustic neuroma (AN) excision. Case series derived from radiographic and clinical chart review. Tertiary referral center. In 12 patients with AN, persistent cerebellar dysfunction developed after AN removal. Each case demonstrated abnormality in the ipsilateral cerebellar peduncle on postoperative magnetic resonance imaging. Cerebellar function and ambulatory status over the first postoperative year. On magnetic resonance imaging scans, the extent of cerebellar peduncle infarcts was variable. It ranged from focal brain injury (2 cm) spanning the full thickness of the peduncle. Peduncular infarcts were associated with large tumor size (average 3.8 cm, range 2.0-5.5 cm diameter). The long-term functional outcomes (>1 yr) varied. Dysmetria was unchanged or improved in over half of the patients (6 of 11 patients). Gait recovered to normal or to preoperative levels in 5 patients. In the 6 patients with persistent impaired mobility, 2 had mild gait disturbance, 3 required regular use of a cane, and 1 has been dependent on a walker. One patient had sustained mild motor weakness. Three of 11 patients remained dependent on others for activities of daily living. Peduncle injury most likely stems from interruption of distal branches of the anterior inferior cerebellar artery (AICA). These small vessels are intimately related to the capsule of the tumor and may supply both the neoplasm and the brain parenchyma. It has long been recognized that interruption of the proximal segment of the AICA results in severe injury to the pons, with devastating neurologic sequelae. A limited AICA syndrome caused by loss of its distal ramifications seems a more plausible explanation for peduncular infarction than either venous insufficiency or direct surgical trauma.

  17. Combinations of mutations in envZ, ftsI, mrdA, acrB and acrR can cause high-level carbapenem resistance in Escherichia coli

    DEFF Research Database (Denmark)

    Adler, Marlen; Anjum, Mehreen; Andersson, Dan I.

    2016-01-01

    of meropenem or ertapenem for similar to 60 generations. Isolated clones were whole-genome sequenced, and the order in which the identified mutations arose was determined in the passaged populations. Key mutations were reconstructed, and bacterial growth rates of populations and isolated clones and resistance...... levels to 23 antibiotics were measured. High-level resistance to carbapenems resulted from a combination of downstream effects of envZ mutation and target mutations in AcrAB-TolC-mediated drug export, together with PBP genes [mrdA (PBP2) after meropenem exposure or ftsI (PBP3) after ertapenem exposure...

  18. Loop-to-helix transition in the structure of multidrug regulator AcrR at the entrance of the drug-binding cavity

    Energy Technology Data Exchange (ETDEWEB)

    Manjasetty, Babu A.; Halavaty, Andrei S.; Luan, Chi-Hao; Osipiuk, Jerzy; Mulligan, Rory; Kwon, Keehwan; Anderson, Wayne F.; Joachimiak, Andrzej

    2016-04-01

    Multidrug transcription regulator AcrR from Salmonella enterica subsp. enterica serovar Typhimurium str. LT2 belongs to the tetracycline repressor family, one of the largest groups of bacterial transcription factors. The crystal structure of dimeric AcrR was determined and refined to 1.56 Å resolution. The tertiary and quaternary structures of AcrR are similar to those of its homologs. The multidrug binding site was identified based on structural alignment with homologous proteins and has a di(hydroxyethyl)ether molecule bound. Residues from helices a4 and a7 shape the entry into this binding site. The structure of AcrR reveals that the extended helical conformation of helix a4 is stabilized by the hydrogen bond between Glu67 (helix a4) and Gln130 (helix a7). Based on the structural comparison with the closest homolog structure, the Escherichia coli AcrR, we propose that this hydrogen bond is responsible for control of the loop-to-helix transition within helix a4. This local conformational switch of helix a4 may be a key step in accessing the multidrug binding site and securing ligands at the binding site. Solution smallmolecule binding studies suggest that AcrR binds ligands with their core chemical structure resembling the tetracyclic ring of cholesterol.

  19. Loop-to-helix transition in the structure of multidrug regulator AcrR at the entrance of the drug-binding cavity.

    Science.gov (United States)

    Manjasetty, Babu A; Halavaty, Andrei S; Luan, Chi-Hao; Osipiuk, Jerzy; Mulligan, Rory; Kwon, Keehwan; Anderson, Wayne F; Joachimiak, Andrzej

    2016-04-01

    Multidrug transcription regulator AcrR from Salmonella enterica subsp. enterica serovar Typhimurium str. LT2 belongs to the tetracycline repressor family, one of the largest groups of bacterial transcription factors. The crystal structure of dimeric AcrR was determined and refined to 1.56Å resolution. The tertiary and quaternary structures of AcrR are similar to those of its homologs. The multidrug binding site was identified based on structural alignment with homologous proteins and has a di(hydroxyethyl)ether molecule bound. Residues from helices α4 and α7 shape the entry into this binding site. The structure of AcrR reveals that the extended helical conformation of helix α4 is stabilized by the hydrogen bond between Glu67 (helix α4) and Gln130 (helix α7). Based on the structural comparison with the closest homolog structure, the Escherichia coli AcrR, we propose that this hydrogen bond is responsible for control of the loop-to-helix transition within helix α4. This local conformational switch of helix α4 may be a key step in accessing the multidrug binding site and securing ligands at the binding site. Solution small-molecule binding studies suggest that AcrR binds ligands with their core chemical structure resembling the tetracyclic ring of cholesterol. Copyright © 2016. Published by Elsevier Inc.

  20. Molecular detection of genes encoding AcrAB , Qep A efflux pumps in Klebsiella pneumoniae strains isolated from hospitalized patients in selected hospitals in Tehran

    Directory of Open Access Journals (Sweden)

    Mohsen Heidary

    2017-03-01

    Full Text Available Abstract Background and Objectives: Increasing emergence of fluoroquinolone resistance among clinical isolates of Klebsiella pneumoniae  (K. pneumoniae, has limited the treatment options for treatment of infections caused by these bacteria. The aim of this study was to investigate the dissemination of genes encoding AcrAB and QepA efflux pumps among K. pneumoniae strains. Methods: This study was carried out on 117 K. pneumoniae strains isolated from patients hospitalized in selected hospitals in Tehran city, 2015-2016, Iran. Antimicrobial susceptibility tests were performed using disk diffusion method (based on CLSI guidelines and identification of acr A, acr B and qep A genes using PCR assay. Results: In this study, colistin and tigecycline had the best effect against clinical isolates of K. pneumoniae. According to PCR results, 110 (94% isolates had acrA gene and 102 (87% isolates had acrB gene, respectively. The qepA gene was not found in any of the K. pneumoniae strains. Conclusion: According to the results of the present study, dissemination of the genes encoding AcrAB efflux pumps among K. pneumoniae strains, which cause resistance to fluoroquinolones, is a matter of concern. Therefore, infection control and prevention of the spread of drug-resistant bacteria requires careful management in drug prescription and identification of resistant isolates.

  1. SU-F-R-30: Interscanner Variability of Radiomics Features in Computed Tomography (CT) Using a Standard ACR Phantom

    Energy Technology Data Exchange (ETDEWEB)

    Shafiq ul Hassan, M; Zhang, G; Moros, E [H Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States); Department of Physics, University of South Florida, Tampa, FL (United States); Budzevich, M; Latifi, K; Hunt, D; Gillies, R [H Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States)

    2016-06-15

    Purpose: A simple approach to investigate Interscanner variability of Radiomics features in computed tomography (CT) using a standard ACR phantom. Methods: The standard ACR phantom was scanned on CT scanners from three different manufacturers. Scanning parameters of 120 KVp, 200 mA were used while slice thickness of 3.0 mm on two scanners and 3.27 mm on third scanner was used. Three spherical regions of interest (ROI) from water, medium density and high density inserts were contoured. Ninety four Radiomics features were extracted using an in-house program. These features include shape (11), intensity (22), GLCM (26), GLZSM (11), RLM (11), and NGTDM (5) and 8 fractal dimensions features. To evaluate the Interscanner variability across three scanners, a coefficient of variation (COV) is calculated for each feature group. Each group is further classified according to the COV- by calculating the percentage of features in each of the following categories: COV less than 2%, between 2 and 10% and greater than 10%. Results: For all feature groups, similar trend was observed for three different inserts. Shape features were the most robust for all scanners as expected. 70% of the shape features had COV <2%. For intensity feature group, 2% COV varied from 9 to 32% for three scanners. All features in four groups GLCM, GLZSM, RLM and NGTDM were found to have Interscanner variability ≥2%. The fractal dimensions dependence for medium and high density inserts were similar while it was different for water inserts. Conclusion: We concluded that even for similar scanning conditions, Interscanner variability across different scanners was significant. The texture features based on GLCM, GLZSM, RLM and NGTDM are highly scanner dependent. Since the inserts of the ACR Phantom are not heterogeneous in HU values suggests that matrix based 2nd order features are highly affected by variation in noise. Research partly funded by NIH/NCI R01CA190105-01.

  2. SU-F-J-143: Initial Assessment of Image Quality of An Integrated MR-Linac System with ACR Phantom

    Energy Technology Data Exchange (ETDEWEB)

    Wang, J; Fuller, C [MD Anderson Cancer Center, Houston, TX (United States); Yung, J; Kadbi, M; Ding, Y; Ibbott, G [UT MD Anderson Cancer Center, Houston, TX (United States)

    2016-06-15

    Purpose/Objective(s): To assess the image quality of an integrated MR-Linac system and compare with other MRI systems that are primarily used for diagnostic purposes. Materials/Methods: An ACR MRI quality control (QC) phantom was used to evaluate the image quality of a fully integrated 1.5T MRI-Linac system recently installed at our institution. This system has a new split magnet design which gives the magnetic field strength of 1.5T. All images were acquired with a set of phased-array surface coils which are designed to have minimal attention of radiation beam. The anterior coil rests on a coil holder which keeps the anterior coil’s position consistent for QA purposes. The posterior coil is imbedded in the patient couch. Multiple sets of T1, T2/PD images were acquired using the protocols as prescribed by the ACR on three different dates, ranging 3 months apart. Results: The geometric distortion are within 0.5 mm in the axial scans and within 1mm in the saggital (z-direction) scans. Slice thickness accuracy, image uniformity, ghosting ratio, high contrast detectability are comparable to other 1.5T diagnostic MRI scanners. The low-contrast object detectability are lower comparatively, which is a result of using the body array coil. Additionally, the beam’s-eye-view images (oblique coronal and saggital images) have minimal geometric distortion at all linac gantry angles tested. No observable changes or drift in image quality is found from images acquired 3 month apart. Conclusion: Despite the use of a body array surface coil, the image quality is comparable to that of an 1.5T MRI scanner and is of sufficient quality to pass the ACR MRI accreditation program. The geometric distortion of the MRI system of the integrated MR-Linac is within 1mm for an object size similar to the ACR phantom, sufficient for radiation therapy treatment purpose. The authors received corporate sponsored research grants from Elekta which is the vendor for the MR-Linac evaluated in this

  3. TU-F-CAMPUS-I-04: Head-Only Asymmetric Gradient System Evaluation: ACR Image Quality and Acoustic Noise

    International Nuclear Information System (INIS)

    Weavers, P; Shu, Y; Tao, S; Bernstein, M; Lee, S; Piel, J; Foo, T; Mathieu, J-B

    2015-01-01

    Purpose: A high-performance head-only magnetic resonance imaging gradient system with an acquisition volume of 26 cm employing an asymmetric design for the transverse coils has been developed. It is able to reach a magnitude of 85 mT/m at a slew rate of 700 T/m/s, but operated at 80 mT/m and 500 T/m/s for this test. A challenge resulting from this asymmetric design is that the gradient nonlinearly exhibits both odd- and even-ordered terms, and as the full imaging field of view is often used, the nonlinearity is pronounced. The purpose of this work is to show the system can produce clinically useful images after an on-site gradient nonlinearity calibration and correction, and show that acoustic noise levels fall within non-significant risk (NSR) limits for standard clinical pulse sequences. Methods: The head-only gradient system was inserted into a standard 3T wide-bore scanner without acoustic damping. The ACR phantom was scanned in an 8-channel receive-only head coil and the standard American College of Radiology (ACR) MRI quality control (QC) test was performed. Acoustic noise levels were measured for several standard pulse sequences. Results: Images acquired with the head-only gradient system passed all ACR MR image quality tests; Both even and odd-order gradient distortion correction terms were required for the asymmetric gradients to pass. Acoustic noise measurements were within FDA NSR guidelines of 99 dBA (with assumed 20 dBA hearing protection) A-weighted and 140 dB for peak for all but one sequence. Note the gradient system was installed without any shroud or acoustic batting. We expect final system integration to greatly reduce noise experienced by the patient. Conclusion: A high-performance head-only asymmetric gradient system operating at 80 mT/m and 500 T/m/s conforms to FDA acoustic noise limits in all but one case, and passes all the ACR MR image quality control tests. This work was supported in part by the NIH grant 5R01EB010065

  4. TU-F-CAMPUS-I-04: Head-Only Asymmetric Gradient System Evaluation: ACR Image Quality and Acoustic Noise

    Energy Technology Data Exchange (ETDEWEB)

    Weavers, P; Shu, Y; Tao, S; Bernstein, M [Mayo Clinic, Rochester, Minnesota (United States); Lee, S; Piel, J; Foo, T [GE Global Research, Niskayuna, NY (United States); Mathieu, J-B [GE Healthcare, Florence, SC (Italy)

    2015-06-15

    Purpose: A high-performance head-only magnetic resonance imaging gradient system with an acquisition volume of 26 cm employing an asymmetric design for the transverse coils has been developed. It is able to reach a magnitude of 85 mT/m at a slew rate of 700 T/m/s, but operated at 80 mT/m and 500 T/m/s for this test. A challenge resulting from this asymmetric design is that the gradient nonlinearly exhibits both odd- and even-ordered terms, and as the full imaging field of view is often used, the nonlinearity is pronounced. The purpose of this work is to show the system can produce clinically useful images after an on-site gradient nonlinearity calibration and correction, and show that acoustic noise levels fall within non-significant risk (NSR) limits for standard clinical pulse sequences. Methods: The head-only gradient system was inserted into a standard 3T wide-bore scanner without acoustic damping. The ACR phantom was scanned in an 8-channel receive-only head coil and the standard American College of Radiology (ACR) MRI quality control (QC) test was performed. Acoustic noise levels were measured for several standard pulse sequences. Results: Images acquired with the head-only gradient system passed all ACR MR image quality tests; Both even and odd-order gradient distortion correction terms were required for the asymmetric gradients to pass. Acoustic noise measurements were within FDA NSR guidelines of 99 dBA (with assumed 20 dBA hearing protection) A-weighted and 140 dB for peak for all but one sequence. Note the gradient system was installed without any shroud or acoustic batting. We expect final system integration to greatly reduce noise experienced by the patient. Conclusion: A high-performance head-only asymmetric gradient system operating at 80 mT/m and 500 T/m/s conforms to FDA acoustic noise limits in all but one case, and passes all the ACR MR image quality control tests. This work was supported in part by the NIH grant 5R01EB010065.

  5. Antibacterial Efficacy of Polysaccharide Capped Silver Nanoparticles Is Not Compromised by AcrAB-TolC Efflux Pump

    Directory of Open Access Journals (Sweden)

    Mitali Mishra

    2018-05-01

    Full Text Available Antibacterial therapy is of paramount importance in treatment of several acute and chronic infectious diseases caused by pathogens. Over the years extensive use and misuse of antimicrobial agents has led to emergence of multidrug resistant (MDR and extensive drug resistant (XDR pathogens. This drastic escalation in resistant phenotype has limited the efficacy of available therapeutic options. Thus, the need of the hour is to look for alternative therapeutic approaches to mitigate healthcare concerns caused due to MDR bacterial infections. Nanoparticles have gathered much attention as potential candidates for antibacterial therapy. Equipped with advantages of, wide spectrum bactericidal activity at very low dosage, inhibitor of biofilm formation and ease of permeability, nanoparticles have been considered as leading therapeutic candidates to curtail infections resulting from MDR bacteria. However, substrate non-specificity of efflux pumps, particularly those belonging to resistance nodulation division super family, have been reported to reduce efficacy of many potent antibacterial therapeutic drugs. Previously, we had reported antibacterial activity of polysaccharide-capped silver nanoparticles (AgNPs toward MDR bacteria. We showed that AgNPs inhibits biofilm formation and alters expression of cytoskeletal proteins FtsZ and FtsA, with minimal cytotoxicity toward mammalian cells. In the present study, we report no reduction in antibacterial efficacy of silver nanoparticles in presence of AcrAB-TolC efflux pump proteins. Antibacterial tests were performed according to CLSI macrobroth dilution method, which revealed that both silver nanoparticles exhibited bactericidal activity at very low concentrations. Further, immunoblotting results indicated that both the nanoparticles modulate the transporter AcrB protein expression. However, expression of the membrane fusion protein AcrA did show a significant increase after exposure to AgNPs. Our results

  6. EL ACRE Y LOS "ASUNTOS DEL PACÍFICO: BOLIVIA, BRASIL, CHILE Y ESTADOS UNIDOS, 1898-1909

    Directory of Open Access Journals (Sweden)

    Cristián Garay Vera

    2008-12-01

    Full Text Available Este trabajo sitúa el problema de la guerra del Acre en un contexto multilateral, reconociendo la vigencia del equilibrio de poder como parte del razonamiento de la conducción de las políticas exteriores en juego. Se aplica el concepto de frontera de F. J. Turner, para explicar cómo las fronteras permeables pusieron a Brasil y Bolivia en confrontación, por la maniobra boliviana de configurar una concesión a inversionistas estadounidenses, británicos y franceses, que fue interpretada por Brasil como una maniobra imperialista de Estados Unidos. Entones Brasil se acercó a Chile, y afrontaron juntos los problemas del Acre y de Antofagasta, que derivaron en las redacciones de los tratados de Petrópolis (1903 y de Paz y Amistad (1904. El artículo postula que Bolivia procedió de esta forma para impedir el avance brasileño, peruano y paraguayo sobre sus fronteras, y que la búsqueda del paraguas estadounidense fue una idea que Bolivia gestó para compensar el desequilibrio de poder.This work considers the Acre War as part of a multilateral context where the equilibrium of power was important in the reasoning behind the establishment of foreign relations. It uses the frontier concept developed by F. J. Turner to explain why their open frontier put Brazil and Bolivia in confrontation. This happened because of the Bolivian strategy of granting land to investors from the United States, Great Britain and France, which was interpreted by Brazil as an imperialist action promoted by the United States. This explains why Brazil established a cióse relationship with Chile to confront together their problems in Acre and Antofagasta, which led to the drafting of the Petrópilis (1903 and Paz y Amistad (1904 treaties. The article argues that Bolivia proceeded this way to avoid a Brazilian, Peruvian or Paraguayan territorial advance, seeking the support of the United States to compénsate the imbalance of power.

  7. The effect of core training on distal limb performance during ballistic strike manoeuvres.

    Science.gov (United States)

    Lee, Benjamin; McGill, Stuart

    2017-09-01

    Ballistic limb motion is enabled by proximal "core" stiffness. However, controversy exists regarding the best method of training this characteristic. This study sought to determine the most effective core training method to enhance distal limb athleticism. A total of 12 participants (24 ± 3 years, 1.8 ± 0.05 m, 76.8 ± 9.7 kg) consisting of Muay Thai athletes performed a core training protocol (Isometric vs. Dynamic, with Control) for 6 weeks, using a repeated measures design to assess performance (peak strike velocity, peak impact force, muscular activation) in various strikes. Isometric training increased impact force in Jab (554.4 ± 70.1 N), Cross (1895.2 ± 203.1 N), Combo (616.8 ± 54.9 N), and Knee (1240.0 ± 89.1 N) trials (P training increased strike velocity in Jab (1.3 ± 0.2 m · s -1 ), Cross (5.5 ± 0.9 m · s -1 ), Combo (0.7 ± 0.1, 2.8 ± 0.3 m · s -1 ), and Knee (3.2 ± 0.3 m · s -1 ) trials (P training increased Combo impact force 935.1 ± 100.3 N greater than Dynamic and 931.6 ± 108.5 N more than Control (P training increased Jab strike velocity 1.3 ± 0.1 m · s -1 greater than Isometric and 0.8 ± 0.1 m · s -1 more than Control (P core training are needed to enhance both velocity and force in distal limbs.

  8. Parasitóides (Hymenoptera: Braconidae de Anastrepha Schiner (Diptera: Tephritidae no estado do Acre Parasitoids (Hymenoptera: Braconidae of Anastrepha Schiner (Diptera: Tephritidae in the state of Acre, Brazil

    Directory of Open Access Journals (Sweden)

    Marcílio José Thomazini

    2009-03-01

    Full Text Available Este trabalho relata a primeira ocorrência de parasitóides em moscas-das-frutas do gênero Anastrepha Schiner no estado do Acre. No município de Bujari foram encontrados os braconídeos Opius bellus Gahan (72,5%, Doryctobracon areolatus (Szépligeti (26,8% e Utetes anastrephae (Viereck (0,7% associados a A. obliqua (Macquart em frutos de taperebá (Spondias mombin L., com parasitismo de 29,5%. No município de Rio Branco, em frutos de goiaba (Psidium guajava L., ocorreu somente D. areolatus em A. obliqua com parasitismo de 2,7%.This paper records the first parasitoids occurrence on Anastrepha Schiner fruit flies in the state of Acre, Brazil. In the Bujari County there occurred the braconids Opius bellus Gahan (72.5%, Doryctobracon areolatus (Szépligeti (26.8% e Utetes anastrephae (Viereck (0.7% associated with A. obliqua (Macquart in tapereba fruits (Spondias mombin L., with parasitism of 29.5%. In guajava fruits (Psidium guajava L. at Rio Branco County, only D. areolatus on A. obliqua occurred, with parasitism of 2.7%.

  9. Mediator-Dependent Transcriptional Activation by Estrogen Receptor Bound to Distal Enhancers

    Science.gov (United States)

    2015-06-01

    TFIIE and TFIIF were expressed in bacteria and purified as described before34. Baculovirus-expressed TFIIA was purified from insect cells, as were...The spray voltage was set at 1.9–2.2 kV. The capillary temperature was 275 °C, and ion transmission on Velos S lenses was set at 35%. The instrument

  10. Model-based aviation advice on distal volcanic ash clouds by assimilating aircraft in situ measurements

    NARCIS (Netherlands)

    Fu, G.; Heemink, A.; Lu, S.; Segers, A.; Weber, K.; Lin, H.X.

    2016-01-01

    The forecast accuracy of distal volcanic ash clouds is important for providing valid aviation advice during volcanic ash eruption. However, because the distal part of volcanic ash plume is far from the volcano, the influence of eruption information on this part becomes rather indirect and uncertain,

  11. Differences in Ureteroscopic Stone Treatment and Outcomes for Distal, Mid-, Proximal, or Multiple Ureteral Locations

    DEFF Research Database (Denmark)

    Perez Castro, Enrique; Osther, Palle J S; Jinga, Viorel

    2014-01-01

    Ureteroscopy has traditionally been the preferred approach for treatment of distal and midureteral stones, with shock wave lithotripsy used for proximal ureteral stones.......Ureteroscopy has traditionally been the preferred approach for treatment of distal and midureteral stones, with shock wave lithotripsy used for proximal ureteral stones....

  12. Miyoshi-type distal muscular dystrophy - Clinical spectrum in 24 Dutch patients

    NARCIS (Netherlands)

    Linssen, WHJP; Notermans, NC; VanderGraaf, Y; Wokke, JHJ; VanDoorn, PA; Howeler, CJ; Busch, HFM; DeJager, AEJ; DeVisser, M

    1997-01-01

    Miyoshi-type distal muscular dystrophy has now been found to be more frequent outside Japan than was previously thought. We studied 24 Dutch patients with Miyoshi-type distal muscular dystrophy and focused on its clinical expression and natural history, muscle CT-scans and muscle biopsy findings.

  13. The prevalence of an excessive prepuce and the effects of distal circumcision on premature ejaculation

    Directory of Open Access Journals (Sweden)

    Luigi Gallo

    2017-06-01

    Conclusions: An excessive prepuce is very common in patients affected by PE. Although accepted by only 13% of our patients, distal circumcision was shown to be a very effective surgical treatment for definitive treatment of PE. We therefore recommend assessing patients complaining of lifelong PE for an excessive prepuce and if they have an excessive prepuce to suggest that they undergo distal circumcision.

  14. Miyoshi-type distal muscular dystrophy. Clinical spectrum in 24 Dutch patients

    NARCIS (Netherlands)

    Linssen, W. H.; Notermans, N. C.; van der Graaf, Y.; Wokke, J. H.; van Doorn, P. A.; Höweler, C. J.; Busch, H. F.; de Jager, A. E.; de Visser, M.

    1997-01-01

    Miyoshi-type distal muscular dystrophy has now been found to be more frequent outside Japan than was previously thought. We studied 24 Dutch patients with Miyoshi-type distal muscular dystrophy and focused on its clinical expression and natural history, muscle CT-scans and muscle biopsy findings.

  15. Miyoshi-type distal muscular dystrophy. Clinical spectrum in 24 Dutch patients

    NARCIS (Netherlands)

    W.H.J.P. Linssen (Wim); N.C. Notermans (Nicolette); Y. van der Graaf (Yolanda); J.H.J. Wokke (John); P.A. van Doorn (Pieter); C.J. Höweler (Chris); H.F.M. Busch (Herman); A.E.J. de Jager (Aeiko); M. de Visser (Marianne)

    1997-01-01

    textabstractMiyoshi-type distal muscular dystrophy has now been found to be more frequent outside Japan than was previously thought. We studied 24 Dutch patients with Miyoshi-type distal muscular dystrophy and focused on its clinical expression and natural history muscle CT-scans and muscle biopsy

  16. Technical Aspects of Laparoscopic Distal Pancreatectomy for Benign and Malignant Disease: Review of the Literature

    NARCIS (Netherlands)

    de Rooij, T.; Sitarz, R.; Busch, O. R.; Besselink, M. G.; Abu Hilal, M.

    2015-01-01

    Distal pancreatectomy is the standard curative treatment for symptomatic benign, premalignant, and malignant disease of the pancreatic body and tail. The most obvious benefits of a laparoscopic approach to distal pancreatectomy include earlier recovery and shorter hospital stay. Spleen-preserving

  17. Clinical and non-clinical aspects of distal radioulnar joint instability

    NARCIS (Netherlands)

    Wijffels, M.; Brink, P.R.G.; Schipper, I.

    2012-01-01

    Untreated distal radioulnar joint (DRUJ) injuries can give rise to long lasting complaints. Although common, diagnosis and treatment of DRUJ injuries remains a challenge. The articulating anatomy of the distal radius and ulna, among others, enables an extensive range of forearm pronosupination

  18. Radiographic diagnosis of scapholunate dissociation among intra-articular fractures of the distal radius: interobserver reliability

    NARCIS (Netherlands)

    Gradl, Gertraud; Neuhaus, Valentin; Fuchsberger, Thomas; Guitton, Thierry G.; Prommersberger, Karl-Josef; Ring, David; Wahegaonkar, Abhijeet L.; Shafritz, Adam B.; Garcia, Aida E.; Caputo, Andrew E.; Terrono, Andrew L.; Spoor, Andy B.; Eschler, Anica; Vochteloo, Anne J. H.; Beumer, Annechien; Barquet, Antonio; Kristan, Anze; van der Zwan, Arnard L.; Berner, Arne; Ilyas, Asif; Jubel, Axel; Sutker, Ben; Nolan, Betsy M.; Petrisor, Brad; Cross, Brian J.; Wills, Brian P. D.; Barreto, Camilo J. R.; Fernandes, Carlos H.; Swigart, Carrie; Zalavras, Charalampos; Goldfarb, Charles A.; Cassidy, Charles; Eaton, Charles; Wilson, Chris; Cheng, Christine J.; Wall, Christopher J.; Walsh, Christopher J.; Jones, Christopher M.; Garnavos, Christos; Klostermann, Cyrus; Kirkpatrick, D. Kay; Eygendaal, Denise; Verbeek, Diederik O. F.; Beeres, Frank J. P.; Thomas, George; Ponsen, Kornelis J.; van den Bekerom, Michel P. J.; Schep, Niels; Kloen, Peter; Haverlag, Robert

    2013-01-01

    To evaluate the reliability and accuracy of diagnosis of scapholunate dissociation (SLD) among AO type C (compression articular) fractures of the distal radius. A total of 217 surgeons evaluated 21 sets of radiographs with type C fractures of the distal radius for which the status of the

  19. Cost-effectiveness of laparoscopic versus open distal pancreatectomy for pancreatic cancer

    NARCIS (Netherlands)

    Gurusamy, K.S.; Riviere, D.M.; Laarhoven, C.J.H.M. van; Besselink, M.; Abu-Hilal, M.; Davidson, B.R.; Morris, S.

    2017-01-01

    BACKGROUND: A recent Cochrane review compared laparoscopic versus open distal pancreatectomy for people with for cancers of the body and tail of the pancreas and found that laparoscopic distal pancreatectomy may reduce the length of hospital stay. We compared the cost-effectiveness of laparoscopic

  20. Intra-Operative Amylase Concentration in Peri-Pancreatic Fluid Predicts Pancreatic Fistula After Distal Pancreatectomy

    NARCIS (Netherlands)

    Nahm, C.B.; Reuver, P.R.; Hugh, T.J.; Pearson, A.; Gill, A.J.; Samra, J.S.; Mittal, A.

    2017-01-01

    Post-operative pancreatic fistula (POPF) is a potentially severe complication following distal pancreatectomy. The aim of this study was to assess the predictive value of intra-operative amylase concentration (IOAC) in peri-pancreatic fluid after distal pancreatectomy for the diagnosis of POPF.

  1. One-stage lingual augmented urethroplasty in repair of distal penile ...

    African Journals Online (AJOL)

    E. Elsayed

    Abstract. Objectives: To evaluate the outcome of augmentation of shallow urethral plate by lingual graft in repair of distal penile hypospadias. Patients and methods: Between June 2008 and May 2011, the procedure was performed on 23 patients with mean age 2.3 years (range 1–3). All patients had distal penile ...

  2. Utility of 64-row MDCT in assessment of neonates with congenital EA and distal TEF

    Directory of Open Access Journals (Sweden)

    Hosam El-Deen Galal Mohamed El-Malah

    2015-12-01

    Conclusion: Preoperative MDCT scan with MPVR, 3D TL-VR of 64-row MDCT which is a noninvasive technique could provide more accurate information about the assessment of the origin of the fistula, the distal esophageal pouches and inter-pouch distance in neonates with EA and distal TEF.

  3. RNA sequencing of kidney distal tubule cells reveals multiple mediators of chronic aldosterone action

    DEFF Research Database (Denmark)

    Poulsen, Søren Brandt; Limbutara, Kavee; Fenton, Robert Andrew

    2018-01-01

    The renal aldosterone-sensitive distal tubule (ASDT) is crucial for sodium reabsorption and blood pressure regulation. The ASDT consists of the late distal convoluted tubule (DCT2), connecting tubule (CNT) and collecting duct. Due to difficulties in isolating epithelial cells from the ASDT in lar...

  4. Symptom scoring systems to diagnose distal polyneuropathy in diabetes : the Diabetic Neuropathy Symptom score

    NARCIS (Netherlands)

    Meijer, J.W.G.; Smit, A.J.; van Sonderen, E.; Groothoff, J.W.; Eisma, W.H.; Links, T.P.

    2002-01-01

    AIMS: To provide one of the diagnostic categories for distal diabetic polyneuro-pathy,several symptom scoring systems are available, which are often extensive andlack in validation. We validated a new four-item Diabetic Neuropathy Symptom (DNS) scorefor diagnosing distal diabetic polyneuropathy.

  5. Relationship between plate removal and Soong grading following surgery for fractured distal radius

    NARCIS (Netherlands)

    Selles, Caroline A.; Reerds, Sam T. H.; Roukema, Gert; van der Vlies, Kees H.; Cleffken, Berry I.; Schep, Niels W. L.

    2018-01-01

    The aim of this study was to determine the relationship between volar plate removal and the Soong classification following fixation for fractured distal radius. In this retrospective cohort study, all consecutive patients who had volar plate fixation for a distal radius fracture in 2011-2015 were

  6. Classification and treatment of distal radius fractures: a survey among orthopaedic trauma surgeons and residents

    NARCIS (Netherlands)

    M.A.M. Mulders (Marjolein A. M.); D. Rikli; J.C. Goslings (Carel); N.W.L. Schep (Niels)

    2017-01-01

    textabstractPurpose: Classification, the definition of an acceptable reduction and indications for surgery in distal radius fracturemanagement are still subject of debate. The purpose of this study was to characterise current distal radius fracture management in Europe. Methods: During the European

  7. Imaging of the Distal Tibiofibular Syndesmosis: Anatomy in Relation to Radiological Diagnosis

    NARCIS (Netherlands)

    J.J. Hermans (John)

    2011-01-01

    textabstractInjury to the distal tibiofibular syndesmosis can occur after an ankle sprain or after an acute ankle fracture. In an estimated 1-11% of all ankle sprains, injury of the distal tibiofibular syndesmosis occurs which is known as a high ankle sprain. However, depending on the type and

  8. Cre recombinase activity is inhibited in vivo but not ex vivo by a mutation in the asymmetric spacer region of the distal loxP site.

    Science.gov (United States)

    Arguello, Tania; Moraes, Carlos T

    2015-11-01

    The cre/loxP recombination system is a valuable tool used to generate tissue specific genomic rearrangements in mouse models. The deletion of a region of interest flanked by two loxP sites is accomplished by the recombinase (cre) enzyme, which binds to the inverted repeat segments of two loxP sites and recognition of a conserved TA sequence in the asymmetric central spacer region "ATAACTTCGTATA -NNNTANNN-TATACGAAGTTAT. In vivo, we found that a single T to C mutation at position 4 of the central spacer region in the distal (3') loxP site, completely inhibited the recombination reaction in two conditional mouse models. These mice were generated using a mitochondrial methionyl-tRNA formyltransferase (Mtfmt) gene targeted construct and cre transgene under the control of tissue-specific promoters: calcium/calmodulin-dependent kinase II alpha (Camk2a-cre) and myosin light polypeptide 1 (Myl1-cre). Surprisingly, transient transfection of a plasmid expressing cre in dermal fibroblasts derived from the same mutant floxed Mtfmt((loxP/loxP)) mice line, successfully deleted the region of interest. This study demonstrates the sequence specificity required in vivo, the possibility of bypassing this limitation by expressing high levels of cre recombinase ex vivo and raises concerns related to the quality control of large scale production of gene targeted constructs and mice. genesis 53:695-700, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  9. [Distal soft-tissue procedure in hallux valgus deformity].

    Science.gov (United States)

    Arbab, D; Wingenfeld, C; Frank, D; Bouillon, B; König, D P

    2016-04-01

    Distal, lateral soft tissue release to restore mediolateral balance of the first metatarsophalangeal (MTP) joint in hallux valgus deformity. Incision of the adductor hallucis tendon from the fibular sesamoid, the lateral capsule, the lateral collateral ligament, and the lateral metatarsosesamoid ligament. Hallux valgus deformities or recurrent hallux valgus deformities with an incongruent MTP joint. General medical contraindications to surgical interventions. Painful stiffness of the MTP joint, osteonecrosis, congruent joint. Relative contraindications: connective tissue diseases (Marfan syndrome, Ehler-Danlos syndrome). Longitudinal, dorsal incision in the first intermetatarsal web space between the first and second MTP joint. Blunt dissection and identification of the adductor hallucis tendon. Release of the adductor tendon from the fibular sesamoid. Incision of the lateral capsule, the lateral collateral ligament, and the lateral metatarsosesamoid ligament. Postoperative management depends on bony correction. In joint-preserving procedures, dressing for 3 weeks in corrected position. Subsequently hallux valgus orthosis at night and a toe spreader for a further 3 months. Passive mobilization of the first MTP joint. Postoperative weight-bearing according to the osteotomy. A total of 31 patients with isolated hallux valgus deformity underwent surgery with a Chevron and Akin osteotomy and a distal medial and lateral soft tissue balancing. The mean preoperative intermetatarsal (IMA) angle was 12.3° (range 11-15°); the hallux valgus (HV) angle was 28.2° (25-36°). The mean follow-up was 16.4 months (range 12-22 months). The mean postoperative IMA correction ranged between 2 and 7° (mean 5.2°); the mean HV correction was 15.5° (range 9-21°). In all, 29 patients (93%) were satisfied or very satisfied with the postoperative outcome, while 2 patients (7%) were not satisfied due to one delayed wound healing and one recurrent hallux valgus deformity. There were no

  10. Freqüência de anemia infecciosa em eqüinos no Acre, 1986 a 1996

    Directory of Open Access Journals (Sweden)

    Santos R.M.L.

    2001-01-01

    Full Text Available Foram analisadas as fichas de 9.963 eqüídeos do Acre, submetidos ao teste de imunodifusão em gel de ágar (IDGA para anemia infecciosa eqüina (AIE, no período de 1986 a 1996. As regiões sócio-ecológicas da Bacia do Alto Juruá, Alto Acre e Alta Bacia do Purus apresentaram os maiores índices da doença, o que caracteriza a associação entre região e positividade. Essas áreas são fronteiriças com o Peru, Bolívia e o Estado do Amazonas, são distantes de Rio Branco, capital do Estado, onde muitas vezes é difícil o acesso pelas estradas, revelando serem áreas de risco. As regiões Oriental e Rio Branco apresentaram baixos índices de positividade. Não se observou diferença estatística entre animais positivos e negativos quanto à espécie, sexo, raça e idade.

  11. Characterization Report for the 92-Acre Area of the Area 5 Radioactive Waste Management Site, Nevada Test Site, Nevada

    International Nuclear Information System (INIS)

    Bechtel Nevada; U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office

    2006-01-01

    The U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office manages two low-level Radioactive Waste Management Sites at the Nevada Test Site. The Area 5 RWMS uses engineered shallow-land burial cells to dispose of packaged waste. This report summarizes characterization and monitoring work pertinent to the 92-Acre Area in the southeast part of the Area 5 Radioactive Waste Management Sites. The decades of characterization and assessment work at the Area 5 RWMS indicate that the access controls, waste operation practices, site design, final cover design, site setting, and arid natural environment contribute to a containment system that meets regulatory requirements and performance objectives for the short- and long-term protection of the environment and public. The available characterization and Performance Assessment information is adequate to support design of the final cover and development of closure plans. No further characterization is warranted to demonstrate regulatory compliance. U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office is proceeding with the development of closure plans for the six closure units of the 92-Acre Area

  12. Characterization Report for the 92-Acre Area of the Area 5 Radioactive Waste Management Site, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    Bechtel Nevada; U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office

    2006-06-01

    The U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office manages two low-level Radioactive Waste Management Sites at the Nevada Test Site. The Area 5 RWMS uses engineered shallow-land burial cells to dispose of packaged waste. This report summarizes characterization and monitoring work pertinent to the 92-Acre Area in the southeast part of the Area 5 Radioactive Waste Management Sites. The decades of characterization and assessment work at the Area 5 RWMS indicate that the access controls, waste operation practices, site design, final cover design, site setting, and arid natural environment contribute to a containment system that meets regulatory requirements and performance objectives for the short- and long-term protection of the environment and public. The available characterization and Performance Assessment information is adequate to support design of the final cover and development of closure plans. No further characterization is warranted to demonstrate regulatory compliance. U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office is proceeding with the development of closure plans for the six closure units of the 92-Acre Area.

  13. Phytoremediation of arsenic from the contaminated soil using transgenic tobacco plants expressing ACR2 gene of Arabidopsis thaliana.

    Science.gov (United States)

    Nahar, Noor; Rahman, Aminur; Nawani, Neelu N; Ghosh, Sibdas; Mandal, Abul

    2017-11-01

    We have cloned, characterized and transformed the AtACR2 gene (arsenic reductase 2) of Arabidopsis thaliana into the genome of tobacco (Nicotiana tabacum, var Sumsun). Our results revealed that the transgenic tobacco plants are more tolerant to arsenic than the wild type ones. These plants can grow on culture medium containing 200μM arsenate, whereas the wild type can barely survive under this condition. Furthermore, when exposed to 100μM arsenate for 35days the amount of arsenic accumulated in the shoots of transgenic plants was significantly lower (28μg/g d wt.) than that found in the shoots of non-transgenic controls (40μg/g d wt.). However, the arsenic content in the roots of transgenic plants was significantly higher (2400μg/g d. wt.) than that (2100μg/g d. wt.) observed in roots of wild type plants. We have demonstrated that Arabidopsis thaliana AtACR2 gene is a potential candidate for genetic engineering of plants to develop new crop cultivars that can be grown on arsenic contaminated fields to reduce arsenic content of the soil and can become a source of food containing no arsenic or exhibiting substantially reduced amount of this metalloid. Copyright © 2017 Elsevier GmbH. All rights reserved.

  14. MOLECULAR CHARACTERIZATION OF AMERICAN CUTANEOUS LEISHMANIASIS IN THE TRI‑BORDER AREA OF ASSIS BRASIL, ACRE STATE, BRAZIL

    Directory of Open Access Journals (Sweden)

    Carolina Bioni Garcia TELES

    2015-08-01

    Full Text Available SUMMARY In this study, Leishmaniaspecies were identified by Polymerase Chain Reaction (PCR. The epidemiology of patients suspected of having American Cutaneous Leishmaniasis in the municipality of Assis Brasil, Acre State, located in the Brazil/Peru/Bolivia triborder was also investigated. By PCR, the DNA of Leishmaniawas detected in 100% of the cases (37 samples and a PCR-Restriction Fragment Length Polymorphism (RFLP of the hsp 70gene identified the species in 32 samples: Leishmania (Viannia braziliensis (65.6% , L. (V. shawi (28.1% , L. (V. guyanensis (3.1% and mixed infection L. (V. guyanensis and L. (Leishmania amazonensis (3.1%This is the first report of L. (V. shawiand L. (L. amazonensis in Acre. The two predominant species were found in patients living in urban and rural areas. Most cases were found in males living in rural areas for at least three years and involved in rural work. This suggests, in most cases, a possible transmission of the disease from a rural/forest source, although some patients had not engaged in activities associated with permanence in forestall areas, which indicate a possible sandflies adaptation to the periurban setting.

  15. Does distal tibiofibular joint mobilization decrease limitation of ankle dorsiflexion?

    Science.gov (United States)

    Fujii, Misaki; Suzuki, Daisuke; Uchiyama, Eiichi; Muraki, Takayuki; Teramoto, Atsushi; Aoki, Mitsuhiro; Miyamoto, Shigenori

    2010-02-01

    Limitation of ankle motion is in many cases treated by joint mobilization (JM), a kind of manual physical therapy technique. Until now, the JM approach has mainly focused on the talocrural joint, with less attention to the distal tibiofibular joint. We applied cyclic loading to the lateral malleolus as in JM in order to clarify the relationship between the dorsiflexion angle and the excursion of the lateral malleolus. Seven normal, fresh-frozen cadaver legs were used. To each specimen, cyclic loading with a 30N force was applied 1000 times to the lateral malleolus at a speed of 15N/s. The displacement of the lateral malleolus was measured with a magnetic tracking system. The maximum dorsiflexion angle was measured before and after cyclic loading. After the first 100 and 1000 times of cyclic loading, the tibia was displaced 0.44+/-0.30mm and 0.75+/-0.36mm, respectively, and the fibula was displaced 0.44+/-0.28mm and 0.92+/-0.39mm, respectively. The average dorsiflexion angle increased from 14.36+/-7.51 degrees to 16.74+/-7.21 degrees after cyclic loading (Pankle dorsiflexion. These results suggest that tibiofibular JM would be effective for limitation of ankle dorsiflexion.

  16. Normative data for distal line bisection and baking tray task.

    Science.gov (United States)

    Facchin, Alessio; Beschin, Nicoletta; Pisano, Alessia; Reverberi, Cristina

    2016-09-01

    Line bisection is one of the tests used to diagnose unilateral spatial neglect (USN). Despite its wide application, no procedure or norms were available for the distal variant when the task was performed at distance with a laser pointer. Furthermore, the baking tray task was an ecological test aimed at diagnosing USN in a more natural context. The aim of this study was to collect normative values for these two tests in an Italian population. We recruited a sample of 191 healthy subjects with ages ranging from 20 to 89 years. They performed line bisection with a laser pointer on three different line lengths (1, 1.5, and 2 m) at a distance of 3 m. After this task, the subjects performed the baking tray task and a second repetition of line bisection to test the reliability of measurement. Multiple regression analysis revealed no significant effects of demographic variables on the performance of both tests. Normative cut-off values for the two tests were developed using non-parametric tolerance intervals. The results formed the basis for clinical use of these two tools for assessing lateralized performance of patients with brain injury and for diagnosing USN.

  17. In vivo studies of biotin absorption in distal rat intestine

    International Nuclear Information System (INIS)

    Bowman, B.B.; Rosenberg, I.H.

    1986-01-01

    The authors have extended their previous studies of biotin absorption in rat proximal jejunum (PJ) to examine biotin absorptive capacity of rat ileum (I) and proximal colon (PC) using in vivo intestinal loop technique. Intestinal loops (2.5 cm) were filled with 0.3 ml of solution containing ( 3 H)-biotin and ( 14 C)-inulin in phosphate buffer, pH 6.5. Biotin absorption was determined on the basis of luminal biotin disappearance after correction for inulin recovery and averaged (pmol/loop-10 min; X +/- SEM). In related experiments, 5-cm loops of PJ, distal I (DI), or PC were filled with 0.5 ml of solution of similar composition (1.0 μM biotin). The abdominal cavity was closed and the rats were allowed to recover from anesthesia, then sacrificed 3 hr after injection. Biotin absorption averaged 96.2% (PJ), 93.2% (DI), and 25.8% (PC) of the dose administered. These differences were reflected in the radioactive biotin content of plasma and intestinal loop, kidney, and liver. These data demonstrate significant biotin absorption in rat DI and PC, as required if the intestinal microflora are to be considered as a source of biotin for the host

  18. AO Distal Radius Fracture Classification: Global Perspective on Observer Agreement

    Science.gov (United States)

    Jayakumar, Prakash; Teunis, Teun; Giménez, Beatriz Bravo; Verstreken, Frederik; Di Mascio, Livio; Jupiter, Jesse B.

    2016-01-01

    Background The primary objective of this study was to test interobserver reliability when classifying fractures by consensus by AO types and groups among a large international group of surgeons. Secondarily, we assessed the difference in inter- and intraobserver agreement of the AO classification in relation to geographical location, level of training, and subspecialty. Methods A randomized set of radiographic and computed tomographic images from a consecutive series of 96 distal radius fractures (DRFs), treated between October 2010 and April 2013, was classified using an electronic web-based portal by an invited group of participants on two occasions. Results Interobserver reliability was substantial when classifying AO type A fractures but fair and moderate for type B and C fractures, respectively. No difference was observed by location, except for an apparent difference between participants from India and Australia classifying type B fractures. No statistically significant associations were observed comparing interobserver agreement by level of training and no differences were shown comparing subspecialties. Intra-rater reproducibility was “substantial” for fracture types and “fair” for fracture groups with no difference accounting for location, training level, or specialty. Conclusion Improved definition of reliability and reproducibility of this classification may be achieved using large international groups of raters, empowering decision making on which system to utilize. Level of Evidence Level III PMID:28119795

  19. Recurrent uranium relocations in distal turbidites emplaced in pelagic conditions

    International Nuclear Information System (INIS)

    Colley, S.; Thomson, J.

    1985-01-01

    The sediments of the Madeira Abyssal Plain, east of Great Meteor Seamount, are dominated by distal turbidite deposition. While the turbidites exhibit a wide compositional range, individual examples can be correlated over a wide area and are relatively homogeneous. Organic C oxidation, by bottom water oxygen, proceeds from the turbidite tops downwards after emplacement in pelagic conditions, and the progress of this oxidation front is marked by a sharp colour contrast in the sediments. In turbidites with Csub(org) > 0.5%, redistribution of authigenic U occurs to form a concentration peak (4 to 9 ppm U), just below the oxidation front or colour change. Several tens μg U/cm 2 may be mobilised, and in all examples studied > 60% of the remobilised U is relocated into the peak. Following burial by subsequent turbidites, such U concentration peaks are persistent as relict indicators of their extinct oxidation fronts for at least 2 x 10 5 years. In the case of thin turbidites where labile Csub(org) is almost exhausted, the U peaks may be located in underlying sedimentary units because of their relationship to the oxidation front. A redox mechanism for U peak formation is suggested from these data rather than a complexation with organic matter. (author)

  20. Myocardial Perfusion: Characteristics of Distal Intramyocardial Arteriolar Trees.

    Science.gov (United States)

    Zamir, Mair; Vercnocke, Andrew J; Edwards, Phillip K; Anderson, Jill L; Jorgensen, Steven M; Ritman, Erik L

    2015-11-01

    A combination of experimental, theoretical, and imaging methodologies is used to examine the hierarchical structure and function of intramyocardial arteriolar trees in porcine hearts to provide a window onto a region of myocardial microvasculature which has been difficult to fully explore so far. A total of 66 microvascular trees from 6 isolated myocardial specimens were analyzed, with a cumulative number of 2438 arteriolar branches greater than or equal to 40 μm lumen diameter. The distribution of flow rates within each tree was derived from an assumed power law relationship for that tree between the diameter of vessel segments and flow rates that are consistent with that power law and subject to conservation of mass along hierarchical structure of the tree. The results indicate that the power law index increases at levels of arteriolar vasculature closer to the capillary level, consistent with a concomitant decrease in shear stress acting on endothelial tissue. These results resolve a long standing predicament which could not be resolved previously because of lack of data about the 3D, interconnected, arterioles. In the context of myocardial perfusion, the results indicate that the coefficient of variation of flow rate in pre-capillary distal arterioles is high, suggesting that heterogeneity of flow rate in these arterioles is not entirely random but may be due at least in part to active control.