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Sample records for intermittent gastric outlet

  1. Prolapsing Gastric Polyp Causing Intermittent Gastric Outlet Obstruction.

    Science.gov (United States)

    Kosai, Nik Ritza; Gendeh, Hardip Singh; Norfaezan, Abdul Rashid; Razman, Jamin; Sutton, Paul Anthony; Das, Srijit

    2015-06-01

    Gastric polyps are often an incidental finding on upper gastrointestinal endoscopy, with an incidence up to 5%. The majority of gastric polyps are asymptomatic, occurring secondary to inflammation. Prior reviews discussed Helicobacter pylori (H pylori)-associated singular gastric polyposis; however, we present a rare and unusual case of recurrent multiple benign gastric polyposis post H pylori eradication resulting in intermittent gastric outlet obstruction. A 70-year-old independent male, Chinese in ethnicity, with a background of diabetes mellitus, hypertension, and a simple renal cyst presented with a combination of melena, anemia, and intermittent vomiting of partially digested food after meals. Initial gastroscopy was positive for H pylori; thus he was treated with H pylori eradication and proton pump inhibitors. Serial gastroscopy demonstrated multiple sessile gastric antral polyps, the largest measuring 4 cm. Histopathologic examination confirmed a benign hyperplastic lesion. Computed tomography identified a pyloric mass with absent surrounding infiltration or metastasis. A distal gastrectomy was performed, whereby multiple small pyloric polyps were found, the largest prolapsing into the pyloric opening, thus explaining the intermittent nature of gastric outlet obstruction. Such polyps often develop from gastric ulcers and, if left untreated, may undergo neoplasia to form malignant cells. A distal gastrectomy was an effective choice of treatment, taking into account the polyp size, quantity, and potential for malignancy as opposed to an endoscopic approach, which may not guarantee a complete removal of safer margins and depth. Therefore, surgical excision is favorable for multiple large gastric polyps with risk of malignancy.

  2. Antral hyperplastic polyp causing intermittent gastric outlet obstruction: Case report

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    Kurtkaya-Yapicier Ozlem

    2003-06-01

    Full Text Available Abstract Background Hyperplastic polyps are the most common polypoid lesions of the stomach. Rarely, they cause gastric outlet obstruction by prolapsing through the pyloric channel, when they arise in the prepyloric antrum. Case presentation A 62-year-old woman presented with intermittent nausea and vomiting of 4 months duration. Upper gastrointestinal endoscopy revealed a 30 mm prepyloric sessile polyp causing intermittent gastric outlet obstruction. Following submucosal injection of diluted adrenaline solution, the polyp was removed with a snare. Multiple biopsies were taken from the greater curvature of the antrum and the corpus. Rapid urease test for Helicobacter pylori yielded a negative result. Histopathologic examination showed a hyperplastic polyp without any evidence of malignancy. Biopsies of the antrum and the corpus revealed gastritis with neither atrophic changes nor Helicobacter pylori infection. Follow-up endoscopy after a 12-week course of proton pomp inhibitor therapy showed a complete healing without any remnant tissue at the polypectomy site. The patient has been symptom-free during 8 months of follow-up. Conclusions Symptomatic gastric polyps should be removed preferentially when they are detected at the initial diagnostic endoscopy. Polypectomy not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves radical treatment.

  3. Gastric Adenocarcinoma Presenting with Gastric Outlet Obstruction in a Child

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    Abdulrahman Al-Hussaini

    2014-01-01

    Full Text Available Gastric carcinoma is extremely rare in children representing only 0.05% of all gastrointestinal malignancies. Here, we report the first pediatric case of gastric cancer presenting with gastric outlet obstruction. Upper endoscopy revealed a markedly thickened antral mucosa occluding the pylorus and a clean base ulcer 1.5 cm × 2 cm at the lesser curvature of the stomach. The narrowed antrum and pylorus underwent balloon dilation, and biopsy from the antrum showed evidence of Helicobacter pylori gastritis. The biopsy taken from the edge of the gastric ulcer demonstrated signet-ring-cell type infiltrate consistent with gastric adenocarcinoma. At laparotomy, there were metastases to the liver, head of pancreas, and mesenteric lymph nodes. Therefore, the gastric carcinoma was deemed unresectable. The patient died few months after initiation of chemotherapy due to advanced malignancy. In conclusion, this case report underscores the possibility of gastric adenocarcinoma occurring in children and presenting with gastric outlet obstruction.

  4. Benign Strictures of the Esophagus and Gastric Outlet: Interventional Management

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hyoung; Shin, Ji Hoon; Song, Ho Young [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2010-10-15

    Benign strictures of the esophagus and gastric outlet are difficult to manage conservatively and they usually require intervention to relieve dysphagia or to treat the stricture-related complications. In this article, authors review the non-surgical options that are used to treat benign strictures of the esophagus and gastric outlet, including balloon dilation, temporary stent placement, intralesional steroid injection and incisional therapy

  5. Gastric Outlet Obstruction from Duodenal Lipoma in an Adult ...

    African Journals Online (AJOL)

    Gastric Outlet Obstruction from Duodenal Lipoma in an Adult. ... Nigerian Journal of Surgery ... Although, peptic ulcer disease remains the most common benign cause of gastric outlet obstruction (GOO), duodenal lipomas remain a rare, but possible cause of GOO and could pose a diagnostic challenge, especially in ...

  6. Ectopic pancreas causing partial gastric outlet obstruction: a case ...

    African Journals Online (AJOL)

    Ectopic pancreas causing partial gastric outlet obstruction: a case report and review of literature. ... Nigerian Journal of Surgery ... Gastric outlet obstruction resulting from ectopic pancreas in an adult is the first of its kind in our center; we, therefore, present this case to describe the challenges faced with diagnosis, treatment, ...

  7. Ectopic Pancreas Causing Partial Gastric Outlet Obstruction: A Case ...

    African Journals Online (AJOL)

    Ectopic pancreas is a rare cause of gastric outlet obstruction, perhaps rarer still among Africans. Although the entity is known, the diagnostic challenges are enormous, especially in the poor‑resource environment. Gastric outlet obstruction resulting from ectopic pancreas in an adult is the first of its kind in our center;.

  8. Gastrojejunostomy for gastric outlet obstruction in patients with ...

    African Journals Online (AJOL)

    Sixty patients were discharged from hospital having resumed normal eating. Their median survival after surgery was 9 months. Conclusion. Gastrojejunostomy offers worthwhile palliation and may prolong survival in a significant group of patients with irresectable gastric carcinoma and gastric outlet obstruction. South African ...

  9. Gastric diverticulum causing gastric outlet obstruction in the setting of duodenal atresia

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    Devashis Mukherjee

    2018-04-01

    Full Text Available Duodenal obstruction due to duodenal atresia occurs in 1 in 10,000 live births and is the most common type of intestinal obstruction in neonates [1–3]. Gastric outlet obstruction in the newborn period from causes other than hypertrophic pyloric stenosis is very uncommon [3]. Potential etiologies include gastric volvulus, antral web, and duplication cysts. Gastric diverticula in the infant is even more rare, with only a few case reports published, and only one describes a gastric diverticulum in the presence of a duodenal atresia [4–8]. In this report, we describe the first case of a gastric outlet obstruction due to a gastric diverticulum in the presence of duodenal atresia. Keywords: Duodenal atresia, Gastric diverticulum, Gastric outlet obstruction

  10. Antral hyperplastic polyp: A rare cause of gastric outlet obstruction.

    Science.gov (United States)

    Aydin, Ibrahim; Ozer, Ender; Rakici, Halil; Sehitoglu, Ibrahim; Yucel, Ahmet Fikret; Pergel, Ahmet; Sahin, Dursun Ali

    2014-01-01

    Gastric polyps are usually found incidentally during upper gastrointestinal endoscopic examinations. These polyps are generally benign, with hyperplasia being the most common. While gastric polyps are often asymptomatic, they can cause gastric outlet obstruction. A 64 years-old female patient presented to our polyclinic with a history of approximately 2 months of weakness, occasional early nausea, vomiting after meals and epigastric pain. A polypoid lesion of approximately 25mm in diameter was detected in the antral area of the stomach, which prolapsed through the pylorus into the duodenal bulbus, and subsequently caused gastric outlet obstruction, as revealed by upper gastrointestinal endoscopy of the patient. The polyp was retrieved from the pyloric canal into the stomach with the aid of a tripod, and snare polypectomy was performed. Currently, widespread use of endoscopy has led to an increase in the frequency of detecting hyperplastic polyps. While most gastric polyps are asymptomatic, they can cause iron deficiency anemia, acute pancreatitis and more commonly, gastric outlet obstruction because of their antral location. Although there are no precise principles in the treatment of asymptomatic polyps, polyps >5mm should be removed due to the possibility of malignant transformation. According to the medical evidence, polypectomy is required for gastric hyperplastic polyps because of the risks of complication and malignancy. These cases can be successfully treated endoscopically. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Gastric outlet obstruction in Northwestern Ethiopia

    African Journals Online (AJOL)

    any gastric mass for histological examination in the remaining ... Data was processed and analyzed using EPI INFO version 5 .... Selective vagotomy, originally advocated to minimise post ... attention should be given to making effective drugs.

  12. Infantile myofibromatosis: a most unusual cause of gastric outlet obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Rohrer, Kellie; Murphy, Robyn; Thresher, Caroline; Jacir, Nabil; Bergman, Kerry [Morristown Memorial Hospital, Department of Radiology, Morristown, NJ (United States)

    2005-08-01

    Non-bilious vomiting in the newborn is common. Etiologies include both surgical and medical conditions. Gastroesophageal reflux, soy or milk protein allergy, and prostaglandin-induced foveolar hyperplasia are among the medical causes. Surgical entities include gastric antral webs, pre-ampullary duodenal and pyloric atresia, and hypertrophic pyloric stenosis. We report the unique case of an 8-day-old girl who presented with gastric outlet obstruction secondary to infantile myofibromatosis. (orig.)

  13. Endoscopic stenting versus operative gastrojejunostomy for malignant gastric outlet obstruction.

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    Chandrasegaram, Manju D; Eslick, Guy D; Mansfield, Clare O; Liem, Han; Richardson, Mark; Ahmed, Sulman; Cox, Michael R

    2012-02-01

    Malignant gastric outlet obstruction represents a terminal stage in pancreatic cancer. Between 5% and 25% of patients with pancreatic cancer ultimately experience malignant gastric outlet obstruction. The aim in palliating patients with malignant gastric outlet obstruction is to reestablish an oral intake by restoring gastrointestinal continuity. This ultimately improves their quality of life in the advanced stages of cancer. The main drawback to operative bypass is the high incidence of delayed gastric emptying, particularly in this group of patients with symptomatic obstruction. This study aimed to compare surgical gastrojejunostomy and endoscopic stenting in palliation of malignant gastric outlet obstruction, acknowledging the diversity and heterogeneity of patients with this presentation. This retrospective study investigated patients treated for malignant gastric outlet obstruction from December 1998 to November 2008 at Nepean Hospital, Sydney, Australia. Endoscopic duodenal stenting was performed under fluoroscopic guidance for placement of the stent. The operative patients underwent open surgical gastrojejunostomy. The outcomes assessed included time to diet, hospital length of stay (LOS), biliary drainage procedures, morbidity, and mortality. Of the 45 participants in this study, 26 underwent duodenal stenting and 19 had operative bypass. Comparing the stenting and operative patients, the median time to fluid intake was respectively 0 vs. 7 days (P < 0.001), and the time to intake of solids was 2 vs. 9 days (P = 0.004). The median total LOS was shorter in the stenting group (11 vs. 25 days; P < 0.001), as was the median postprocedure LOS (5 vs. 10 days; P = 0.07). Endoscopic stenting is preferable to operative gastrojejunostomy in terms of shorter LOS, faster return to fluids and solids, and reduced morbidity and in-hospital mortality for patients with a limited life span.

  14. Radiological findings of gastric adenomyoma in a neonate presenting with gastric outlet obstruction.

    Science.gov (United States)

    Rhim, Jung Hyo; Kim, Woo Sun; Choi, Young Hun; Cheon, Jung-Eun; Park, Sung Hye

    2013-03-01

    Gastric adenomyoma is a rare tumour-like lesion composed of glandular components and smooth muscle bundles. We report a case of gastric adenomyoma in a 1-week-old neonate who presented with gastric outlet obstruction. To the best of our knowledge, this is the youngest child reported with gastric adenomyoma and a unique case demonstrating radiological findings of gastric adenomyoma in a young infant. At US, the lesion was seen as an asymmetrical mass-like wall-thickening of the pylorus. Upper gastrointestinal series showed findings similar to those seen in a case of hypertrophic pyloric stenosis. We suggest that gastric adenomyoma should be included in the causes of gastric outlet obstruction in neonates even though it is rare in young children.

  15. Successful Emergency Endoscopic Treatment of Gastric Outlet Obstruction due to Gastric Bezoar with Gastric Pneumatosis

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    Hirokazu Honda

    2017-11-01

    Full Text Available Gastric bezoars are rare and are usually found incidentally. They can sometimes cause severe complications, including gastric outlet obstruction (GOO or gastric pneumatosis (GP. In cases of bezoars with GP, the optimal treatment strategy has not yet been defined. We report the case of an 89-year-old man with a history of type 2 diabetes mellitus and hypertension who presented to our emergency room with a 2-day history of upper abdominal pain, nausea, and vomiting. Physical examination revealed no rebound tenderness or guarding, and laboratory values revealed no elevation of the serum lactate level. A computed tomography scan of the abdomen showed a dilated stomach with significant fluid collection, GOO, and GP due to a 42 × 40 mm mass composed of fat and air densities. Emergency esophagogastroduodenoscopy revealed two gastric bezoars, one of which was incarcerated in the pyloric region. We used various endoscopic devices to successfully break and remove the bezoars. We used endoscopic forceps and a water jet followed by an endoscopic snare to cut the bezoars into several pieces and remove them with an endoscopic net. Follow-up endoscopy confirmed that the gastric bezoar had been completely removed. As seen in this case, endoscopic treatment may be a safe and viable option for the extraction of gastric bezoars presenting with GOO and GP.

  16. Successful Emergency Endoscopic Treatment of Gastric Outlet Obstruction due to Gastric Bezoar with Gastric Pneumatosis.

    Science.gov (United States)

    Honda, Hirokazu; Ikeya, Takashi; Kashiwagi, Erika; Okada, Shuichi; Fukuda, Katsuyuki

    2017-01-01

    Gastric bezoars are rare and are usually found incidentally. They can sometimes cause severe complications, including gastric outlet obstruction (GOO) or gastric pneumatosis (GP). In cases of bezoars with GP, the optimal treatment strategy has not yet been defined. We report the case of an 89-year-old man with a history of type 2 diabetes mellitus and hypertension who presented to our emergency room with a 2-day history of upper abdominal pain, nausea, and vomiting. Physical examination revealed no rebound tenderness or guarding, and laboratory values revealed no elevation of the serum lactate level. A computed tomography scan of the abdomen showed a dilated stomach with significant fluid collection, GOO, and GP due to a 42 × 40 mm mass composed of fat and air densities. Emergency esophagogastroduodenoscopy revealed two gastric bezoars, one of which was incarcerated in the pyloric region. We used various endoscopic devices to successfully break and remove the bezoars. We used endoscopic forceps and a water jet followed by an endoscopic snare to cut the bezoars into several pieces and remove them with an endoscopic net. Follow-up endoscopy confirmed that the gastric bezoar had been completely removed. As seen in this case, endoscopic treatment may be a safe and viable option for the extraction of gastric bezoars presenting with GOO and GP.

  17. [Eleven Patients with Gastric Cancer Who Received Chemotherapy after Stent Placement for Gastric Outlet Obstruction].

    Science.gov (United States)

    Endo, Shunji; Nakagawa, Tomo; Konishi, Ken; Ikenaga, Masakazu; Ohta, Katsuya; Nakashima, Shinsuke; Matsumoto, Kenichi; Nishikawa, Kazuhiro; Ohmori, Takeshi; Yamada, Terumasa

    2017-01-01

    Endoscopic placement of self-expandable metallic stents is reportedly effective for gastric outlet obstructions due to advanced gastric cancer, and is less invasive than gastrojejunostomy. For patients who have good performance status, we administer chemotherapy after stent placement, although the safety and feasibility of this chemotherapy have not yet been discussed in full. Between 2011 and 2015, 15 patients at our institution underwent endoscopic gastroduodenal stent placement for gastric outlet obstruction due to gastric cancer. Eleven of these patients were administered chemotherapy after stent placement. In our case series, we did not observe any specific adverse event caused by stent placement plus chemotherapy. Adverse events after chemotherapy included anemia of CTCAE Grade 3 in 7 patients. Stent-in-stent placement was needed in 2 patients. Neither stent migration nor perforation was observed. Therefore, chemotherapy after stent placement for gastric outlet obstruction due to gastric cancer was considered safe and feasible. Stent placement is useful not only as palliative care for patients with terminal-stage disease, but also as one of the multimodal therapeutic strategies for gastric cancer.

  18. Gastric Outlet Obstruction Palliation: A Novel Stent-Based Solution

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    Natasha M. Rueth

    2010-06-01

    Full Text Available Gastric outlet obstruction (GOO after esophagectomy is a morbid outcome and significantly hinders quality of life for end-stage esophageal cancer patients. In the pre-stent era, palliation consisted of chemotherapy, radiation, tumor ablation, or stricture dilation. In the current era, palliative stenting has emerged as an additional tool; however, migration and tumor ingrowth are ongoing challenges. To mitigate these challenges, we developed a novel, hybrid, stent-based approach for the palliative management of GOO. We present a patient with esophageal cancer diagnosed with recurrent, metastatic disease 1 year after esophagectomy. She developed dehydration and intractable emesis, which significantly interfered with her quality of life. For palliation, we dilated the stenosis and proceeded with our stent-based solution. Using a combined endoscopic and fluoroscopic approach, we placed a 12-mm silicone salivary bypass tube across the pylorus, where it kinked slightly because of local tumor biology. To bridge this defect and ensure luminal patency, we placed a nitinol tracheobronchial stent through the silicone stent. Clinically, the patient had immediate relief from her pre-operative symptoms and was discharged home on a liquid diet. In conclusion, GOO and malignant dysphagia after esophagectomy are significant challenges for patients with end-stage disease. Palliative stenting is a viable option, but migration and tumor ingrowth are common complications. The hybrid approach presented here provides a unique solution to these potential pitfalls. The flared silicone tube minimized the chance of migration and impaired tumor ingrowth. The nitinol stent aided with patency and overcame the challenges of the soft tube. This novel strategy achieved palliation, describing another endoscopic option in the treatment of malignant GOO.

  19. Laparoscopic gastrojejunostomy versus duodenal stenting in unresectable gastric cancer with gastric outlet obstruction.

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    Min, Sa-Hong; Son, Sang-Yong; Jung, Do-Hyun; Lee, Chang-Min; Ahn, Sang-Hoon; Park, Do Joong; Kim, Hyung-Ho

    2017-09-01

    To compare the outcome between laparoscopic gastrojejunostomy (LapGJ) and duodenal stenting (DS) in terms of oral intake, nutritional status, patency duration, effect on chemotherapy and survival. Medical records of 115 patients, who had LapGJ or duodenal stent placement between July 2005 and September 2015 in Seoul National University Bundang Hospital, have been reviewed retrospectively. Oral intake was measured with Gastric Outlet Obstruction Scoring System. Serum albumin and body weight was measured as indicators of nutritional status. The duration of patency was measured until the date of reintervention. Chemotherapy effect was calculated after the procedures. Survival period and oral intake was analyzed by propensity score matching age, sex, T-stage, comorbidities, and chemotherapy status. Forty-three LapGJ patients and 58 DS patients were enrolled. Improvement in oral intake was shown in LapGJ group versus DS group (88% vs. 59%, P = 0.011). Serum albumin showed slight but significant increase after LapGJ (+0.75 mg/dL vs. -0.15 mg/dL, P = 0.002); however, there was no difference in their body weight (+5.1 kg vs. -1.0 kg, P = 0.670). Patients tolerated chemotherapy longer without dosage reduction after LapGJ (243 days vs . 74 days, P = 0.006) and maintained the entire chemotherapy regimen after the procedure longer in LapGJ group (247 days vs. 137 days, P = 0.042). LapGJ showed significantly longer survival than DS (220 vs. 114 days, P = 0.004). DS can provide faster symptom relief but LapGJ can provide improved oral intake, better compliance to chemotherapy, and longer survival. Therefore, LapGJ should be the first choice in gastric outlet obstruction patients for long-term and better quality of life.

  20. Malignant gastric outlet obstruction managed by endoscopic stenting: a prospective single-centre study

    DEFF Research Database (Denmark)

    Havemann, Maria Cecilie; Adamsen, Sven; Wøjdemann, Morten

    2008-01-01

    -to-treat principle. All patients were offered endoscopic stenting. Oral intake before and after stenting was assessed using the gastric outlet obstruction score system (GOOSS). Various lengths of duodenal Hanaro(R) self-expanding nitinol stents were delivered through a therapeutic endoscope. Outcome criteria were......Objective. Endoscopic stenting for malignant gastric outlet obstruction was chosen as the primary strategy by which to palliate this complication, which is dominated by weight loss and anorexia. Advanced upper gastrointestinal tract cancers present late and life expectancy is limited. Only smaller...... multicentre studies point to endoscopic stenting as superior to surgery in terms of clinical outcome and cost. Material and methods. Forty-five consecutive patients with gastric outlet obstruction as a result of advanced upper GI-tract malignancy were enrolled in accordance with the intention...

  1. Gastrojejunostomy for gastric outlet obstruction in patients with ...

    African Journals Online (AJOL)

    should not be performed for irresectable gastric cancer at all.6 Newer approaches .... The majority of patients were approaching a terminal state with inability to eat and ... by the disease stage being the determinant (irresectable compared with ...

  2. A CLINICAL STUDY ON GASTRIC OUTLET OBSTRUCTION IN A SOUTH INDIAN TEACHING HOSPITAL

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    Sailaja

    2015-10-01

    Full Text Available Gastric outlet obstruction is defined as a clinical and patho - physiological consequence of any disease process that produces a mechanical impediment to gastric emptying which may be extrinsic or intrinsic. Gastric outlet obstruction can be a diagnostic and treatment dilemma. Endoscopy of upper gastrointestinal tract has been a sensitive and specific investigation to study the status of gastric outlet - the pylorus and has enabled early detection of lesions of both stomach a nd duodenum. We undertook a prospective clinical study regarding incidence, etiology, investigation and management of cases of Gastric outlet obstruction in adults in a period of three years. In our study the m ost common cause of GOO is Carcinoma stomach a ntral region 46.6% , duodenal ulcer 33.3% , corrosive acid ingestion sequel 8.3%, peri ampullary carcinoma 6.6%, Ca pancreas 3.3%% , cholangio Carcinoma 1.6%. Males are more commonly involved in a ratio of M: F=3:1. Surgical procedures done varied from defini tive resections to palliative bypass or feeding jejunostomy for enteral feeding

  3. Self-expandable metal stents for malignant gastric outlet obstruction: A pooled analysis of prospective literature

    NARCIS (Netherlands)

    van Halsema, Emo E.; Rauws, Erik A. J.; Fockens, Paul; van Hooft, Jeanin E.

    2015-01-01

    To provide an overview of the clinical outcomes of self-expandable metal stent (SEMS) placement for malignant gastric outlet obstruction (MGOO). A systematic literature search was performed in PubMed of the literature published between January 2009 and March 2015. Only prospective studies that

  4. Endoscopic magnetic gastroenteric anastomosis for palliation of malignant gastric outlet obstruction: a prospective multicenter study

    NARCIS (Netherlands)

    van Hooft, Jeanin E.; Vleggaar, Frank P.; Moine, Olivier Le; Bizzotto, Alessandra; Voermans, Rogier P.; Costamagna, Guido; Devière, Jacques; Siersema, Peter D.; Fockens, Paul

    2010-01-01

    Background: Palliation of malignant gastric outlet obstruction remains challenging. Although there are 2 established treatment options, ie, surgical gastrojejunostomy and endoscopic duodenal stent insertion, there is an ongoing search for a technique that would combine the safety and rapid effect of

  5. OPERABILITY RATE OF DISTAL GASTRIC CANCER AND THE EFFECT OF GASTRIC OUTLET OBSTRUCTION IN THE OPERABILITY RATE AND POSTOPERATIVE OUTCOME- A RETROSPECTIVE STUDY

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    Rajesh T. R

    2017-10-01

    Full Text Available BACKGROUND Stomach cancer is the fourth most common malignancy in the world. 1 Except in countries where screening for stomach cancer is prevalent, most of the distal stomach tumours are diagnosed at advanced stage. Gastric outlet obstruction is usually believed to be a sign of locally-advanced disease. Complete surgical removal of the disease (R0 is the only potentially curative treatment for resectable gastric cancer. The aim of the study is to finda The operability rate of gastric cancer in our institution and the incidence of Gastric Outlet Obstruction (GOO in patients undergoing gastrectomy for distal gastric cancer. b To compare the postoperative outcome in patients with gastric outlet obstruction and those without gastric outlet obstruction. c To see if the histology of the tumour has any role in the development of GOO. MATERIALS AND METHODS This is a retrospective study. The study includes patients who were admitted with carcinoma stomach and underwent operative or nonoperative treatment in our institution during 2013 to 2015. RESULTS Overall operability rate was 45.8%. Operable patients in the GOO group were 47%. Operability in the no outlet obstruction group were 45%. Data shows a slightly increased predilection for GOO in diffuse and mixed type of tumours (statistically not significant. Intestinal tumours had significant rate of anaemia compared to diffuse tumours (p <0.005. Overall mortality was 6.7%. Mortality is higher in the GOO group (8.8%. CONCLUSION (a. Operability rate of distal gastric cancer in our institution is 45.8%. (b. Incidence of gastric outlet obstruction in patients undergoing gastrectomy is 38.2%. (c. Presence of gastric outlet obstruction does not influence operability rate (47% vs. 45%. (d. Morbidity and mortality after distal radical gastrectomy is comparable in both groups. (e. Both intestinal and diffuse histology have equal incidence of GOO. (f. Chronic blood loss and incidence of anaemia is more in

  6. Self-Expandable Metallic Stent Placement in Malignant Gastric Outlet Obstruction

    Science.gov (United States)

    Ye, Bing-Wei; Lee, Kuei-Chuan; Hsieh, Yun-Cheng; Li, Chung-Pin; Chao, Yee; Hou, Ming-Chih; Lin, Han-Chieh

    2015-01-01

    Abstract Malignant gastric outlet obstruction is a late complication of intraabdominal malignancy. Self-expandable metallic stent placement has been a safe palliative treatment to relieve obstructive symptoms. We aimed to assess the efficacy and safety of metallic stents in our patients and analyzed the clinical outcome of different brands. Seventy-one patients with inoperable gastric outlet obstruction receiving WallFlex enteral stents (WallFlex group) or Bonastents (Bonastent group) since April 2010 were analyzed retrospectively. The overall technical and clinical success rates of stent placement were 100% and 93%, respectively. The baseline characteristics and clinical outcomes including procedure-related complications, restenosis, and reintervention rates were comparable between the 2 groups. However, the Bonastent group had a higher rate of stent fracture than the WallFlex group (13.3% vs 0%, P = 0.03). The mean duration of overall stent patency was 132.7 days. The mean duration of survival was 181.9 days. Resumption of regular diet or low residual diet at day 7 after stent insertion predicted stent patency (hazard ratio [HR]: 0.28, P = 0.01). Cancer with gastric origin (HR: 0.25, P = 0.045) and poststent chemotherapy (HR: 0.38, P = 0.006) predicted lower mortality; however, peritoneal carcinomatosis (HR: 3.09, P = 0.04) correlated with higher mortality. Metallic stent placement is a safe and effective method for relieving gastric outlet obstruction. Except higher rate of stent fracture in the Bonastent group, there is no significant difference in clinical outcomes between the Bonastent group and the WallFlex group. PMID:26200641

  7. Gastric Outlet Obstruction Caused by Foley Catheter: A Complication when Substituting for Commercial Gastrostomy Tubes

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    Amanda B. Lewis

    2018-01-01

    Full Text Available The technique of using percutaneous endoscopic gastrostomy (PEG for long-term enteral feeding is well established and commonly used. While the technique is relatively safe and simple, the gastrostomy tube itself may deteriorate or malfunction, requiring a replacement tube. We present a case of a 58-year-old woman who was found to have gastric outlet obstruction from the inflated balloon of a Foley catheter being used as a replacement for her PEG tube. This case illustrates a potential complication of using a Foley catheter in place of commercially available gastrostomy tubes.

  8. The Outlet Patch: Gastric Heterotopia of the Colo-rectum and Anus.

    Science.gov (United States)

    Mannan, Abul Ala Syed Rifat; Vieth, Michael; Khararjian, Armen; Khandakar, Binny; Lam-Himlin, Dora; Heydt, David; Bhaijee, Feriyl; Venbrux, Henry J; Byrnes, Kathleen; Voltaggio, Lysandra; Barker, Norman; Yuan, Songyang; Montgomery, Elizabeth

    2018-04-18

    Gastric heterotopia (GH) has been described throughout the gastrointestinal tract. However, the colorectal region is an extremely rare location for it. We describe the clinicopathologic features of GH of the colon, rectum, and anus. We identified 33 cases in 20 males and 13 females (median age 54 years; range, 4 months to 73 years). Sites included the rectum (N=26), anus (N=4), ileocecal junction (N=1), ascending colon (N=1) and descending colon (N=1). Presenting symptoms(N=27) included hematochezia (41%) and altered bowel habits (4%); 15 patients (55%) were asymptomatic. On colonoscopy (N=31), all appeared as solitary lesions, (median size 6.5 mm, range 2 mm - 55 mm), either as polyps (61%), raised erythematous patches (23%), an ulcer(10%), within a rectal diverticulum (3%), or a hemorrhoid (3%). Patients were managed by polypectomy. One with an associated carcinoma in the area of GH underwent resection. No morbidity related to GH itself was reported following excision. Histologically, heterotopic gastric mucosa was oxyntic type (85%), mixed oxyntic and non-oxyntic type (12%), and not specified (3%). In 5 patients a pyloric gland adenoma (PGA) arose from heterotopic gastric mucosa, two of which contained a focus of invasive adenocarcinoma. One case had associated surface foveolar type low-grade dysplasia. Another had associated adenocarcinoma arising from the heterotopic mucosa. One example harbored Helicobacter pylori organisms. We highlight the features of GH in the distal GIT - the 'outlet patch'. Association with PGA, surface dysplasia and adenocarcinoma suggests that lower tract GH can undergo neoplastic transformation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Successful treatment with a combination of endoscopic injection and irrigation with coca cola for gastric bezoar-induced gastric outlet obstruction.

    Science.gov (United States)

    Lin, Chen-Sheng; Tung, Chun-Fang; Peng, Yen-Chun; Chow, Wei-Keung; Chang, Chi-Sen; Hu, Wei-Hsiung

    2008-01-01

    We report a case of gastric bezoar-induced gastric outlet obstruction that was successfully treated with a combination of endoscopic injection and irrigation with Coca Cola. A 73-year-old diabetic woman had a history of perforated peptic ulcer and had received pyloroplasty more than 20 years previously. She had been ingesting Pho Pu Zi (Cordia dichotoma Forst. f.) as an appetizer for 1 month. She presented with epigastric pain, nausea, and vomiting. Upper gastrointestinal endoscopy, performed at a local hospital, showed 2 gastric bezoars in the stomach, and 1 of them impacted at the pylorus. She was referred to our emergency department for removal of the gastric bezoars that were suspected to be causing gastric outlet obstruction. All attempts at endoscopic removal using a polypectomy snare, biopsy forceps and Dormia basket failed. We then injected Coca Cola directly into the bezoar mass, followed by irrigation with Coca Cola. Follow-up endoscopy was performed the next day, which revealed that the gastric bezoars had dissolved spontaneously.

  10. Successful Treatment with a Combination of Endoscopic Injection and Irrigation with Coca Cola for Gastric Bezoar-induced Gastric Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Chen-Sheng Lin

    2008-01-01

    Full Text Available We report a case of gastric bezoar-induced gastric outlet obstruction that was successfully treated with a combination of endoscopic injection and irrigation with Coca Cola. A 73-year-old diabetic woman had a history of perforated peptic ulcer and had received pyloroplasty more than 20 years previously. She had been ingesting Pho Pu Zi (Cordia dichotoma Forst. f. as an appetizer for 1 month. She presented with epigastric pain, nausea, and vomiting. Upper gastrointestinal endoscopy, performed at a local hospital, showed 2 gastric bezoars in the stomach, and 1 of them impacted at the pylorus. She was referred to our emergency department for removal of the gastric bezoars that were suspected to be causing gastric outlet obstruction. All attempts at endoscopic removal using a polypectomy snare, biopsy forceps and Dormia basket failed. We then injected Coca Cola directly into the bezoar mass, followed by irrigation with Coca Cola. Follow-up endoscopy was performed the next day, which revealed that the gastric bezoars had dissolved spontaneously.

  11. Fluoroscopic-guided covered metallic stent placement for gastric outlet obstruction and post-operative gastroenterostomy anastomotic stricture

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Min; Han, Young Min; Kim, Chong Soo; Lee, Sang Young; Lee, Soo Teik; Yang, Doo Hyun

    2001-07-01

    AIM: To evaluate the feasibility and safety of fluoroscopic-guided covered metallic stent placements in providing palliative care for patients with inoperable malignant gastric outlet obstruction. MATERIALS AND METHODS: Under fluoroscopic guidance, placement of self-expandable, covered stents was attempted in 20 patients with inoperable or recurrent gastric cancer (age range 36-79 years). All patients had inoperable gastric outlet obstruction, 13 with native anatomy and seven with post-operative anatomy (gastrointestinal anastomotic sites). All patients had intolerance to oral alimentation and/or vomiting after ingestion. Success was defined both technically and clinically. RESULTS: The placement of the stent was technically successful in 18 patients and failed in two patients (technical success: 90%). The cause of the technical failures was an inability to negotiate the guide wire through the obstruction sites in spite of the use of both fluoroscopic and endoscopic guidance. After stent placement, 15 patients were able to ingest at least liquids and had a markedly decreased incidence of vomiting (clinical success: 75%). During the mean follow-up of 6 weeks, there have been no stent reocclusion and no life-threatening complications except migration of two stents in one patient. CONCLUSION: Fluoroscopically guided covered metallic stent placement appears to be valuable for the palliative treatment of malignant obstruction of gastric outlet and post-operative gastrointestinal anastomoses. Lee, J.M. et al. (2001)

  12. An Assessment of Radiologically Inserted Transoral and Transgastric Gastroduodenal Stents to Treat Malignant Gastric Outlet Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Bethany H. T., E-mail: bmiller@doctors.org.uk [Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Department of Upper Gastrointestinal Surgery (United Kingdom); Griffiths, Ewen A., E-mail: Eagriffiths@doctors.org.uk [The New Queen Elizabeth Hospital, Department of Upper Gastrointestinal Surgery (United Kingdom); Pursnani, Kishore G., E-mail: Kish.Pursnani@lthtr.nhs.uk; Ward, Jeremy B., E-mail: Jeremy.Ward@lthtr.nhs.uk [Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Department of Upper Gastrointestinal Surgery (United Kingdom); Stockwell, Robert C., E-mail: Robert.Stockwell@lthtr.nhs.uk [Lancashire Teaching Hospitals NHS Foundation Trust, Chorley and South Ribble Hospital, Department of Radiology (United Kingdom)

    2013-12-15

    IntroductionSelf-expanding metallic stents (SEMS) are used to palliate malignant gastric outlet obstruction (GOO) and are useful in patients with limited life expectancy or severe medical comorbidity, which would preclude surgery. Stenting can be performed transorally or by a percutaneous transgastric technique. Our goal was to review the outcome of patients who underwent radiological SEMS insertion performed by a single consultant interventional radiologist. Methods: Patients were identified from a prospectively collected database held by one consultant radiologist. Data were retrieved from radiological reports, multidisciplinary team meetings, and the patients' case notes. Univariate survival analysis was performed. Results: Between December 2000 and January 2011, 100 patients (63 males, 37 females) had 110 gastroduodenal stenting procedures. Median age was 73 (range 39-89) years. SEMS were inserted transorally (n = 66) or transgastrically (n = 44). Site of obstruction was the stomach (n = 37), duodenum (n = 50), gastric pull-up (n = 10), or gastroenterostomy (n = 13). Seven patients required biliary stents. Technical success was 86.4 %: 83.3 % for transoral insertion, 90.9 % for transgastric insertion. Eleven patients developed complications. Median GOO severity score: 1 pre-stenting, 2 post-stenting (p = 0.0001). Median survival was 54 (range 1-624) days. Post-stenting GOO severity score was predictive of survival (p = 0.0001). Conclusions: The technical success rate for insertion of palliative SEMS is high. Insertional technique can be tailored to the individual depending on the location of the tumor and whether it is possible to access the stomach percutaneously. Patients who have successful stenting and return to eating a soft/normal diet have a statistically significant increase in survival.

  13. An Assessment of Radiologically Inserted Transoral and Transgastric Gastroduodenal Stents to Treat Malignant Gastric Outlet Obstruction

    International Nuclear Information System (INIS)

    Miller, Bethany H. T.; Griffiths, Ewen A.; Pursnani, Kishore G.; Ward, Jeremy B.; Stockwell, Robert C.

    2013-01-01

    IntroductionSelf-expanding metallic stents (SEMS) are used to palliate malignant gastric outlet obstruction (GOO) and are useful in patients with limited life expectancy or severe medical comorbidity, which would preclude surgery. Stenting can be performed transorally or by a percutaneous transgastric technique. Our goal was to review the outcome of patients who underwent radiological SEMS insertion performed by a single consultant interventional radiologist. Methods: Patients were identified from a prospectively collected database held by one consultant radiologist. Data were retrieved from radiological reports, multidisciplinary team meetings, and the patients’ case notes. Univariate survival analysis was performed. Results: Between December 2000 and January 2011, 100 patients (63 males, 37 females) had 110 gastroduodenal stenting procedures. Median age was 73 (range 39–89) years. SEMS were inserted transorally (n = 66) or transgastrically (n = 44). Site of obstruction was the stomach (n = 37), duodenum (n = 50), gastric pull-up (n = 10), or gastroenterostomy (n = 13). Seven patients required biliary stents. Technical success was 86.4 %: 83.3 % for transoral insertion, 90.9 % for transgastric insertion. Eleven patients developed complications. Median GOO severity score: 1 pre-stenting, 2 post-stenting (p = 0.0001). Median survival was 54 (range 1–624) days. Post-stenting GOO severity score was predictive of survival (p = 0.0001). Conclusions: The technical success rate for insertion of palliative SEMS is high. Insertional technique can be tailored to the individual depending on the location of the tumor and whether it is possible to access the stomach percutaneously. Patients who have successful stenting and return to eating a soft/normal diet have a statistically significant increase in survival

  14. Primary duodenal tuberculosis presenting as gastric-outlet obstruction: Its diagnosis

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    Vijai Datta Upadhyaya

    2013-01-01

    Full Text Available Introduction: Gastrointestinal tuberculosis often involves the ileocecal region. Duodenal and gastric tuberculosis found in only 1% of patients suffering from pulmonary tuberculosis with associated HIV infection in non-endemic areas. Duodenal obstruction due to tuberculosis is very rare and needs high index of suspicions for diagnosis. Mostly this entity is suspected on intraoperative findings. In this manuscript we emphasized on ways and means for establishing histopathological diagnosis before starting anti-tubercular treatment in such cases. Method and Material: All patients of suspected gastroduodenal tuberculosis presented with feature of gastric-outlet obstruction managed during Jan 2009 to June 2011 were included in the study. After proper evaluation (routine hematological and biochemical examination, microbiological examination, serological and endoscopic evaluation exploratory laparotomy was done and if there is no mesenteric lymphadenopathy or it is not safe to take biopsy form the diseased duodenum, multiple FNAC were taken from the diseased portion for histopathological and microbiological diagnosis. Result: A total of five patients were treated during this period. The most common presentation was vomiting followed by failure to thrive and weight loss; two patients had abdominal pain. Biopsy of mesenteric lymph node was possible in two cases. FNAC from diseases portion was taken in all cases. FNAC showed granulomas in four cases. Cases where even FNAC finding was non-conclusive on HPE/Microbiology was not subjected to antitubercular drug. Conclusion: Multiple intra-operative FNAC may be taken from the diseased portion of the duodenum to establish the histopathological diagnosis if diagnosis is not established by any other mean.

  15. Self-expandable metal stents for malignant gastric outlet obstruction: A pooled analysis of prospective literature.

    Science.gov (United States)

    van Halsema, Emo E; Rauws, Erik A J; Fockens, Paul; van Hooft, Jeanin E

    2015-11-21

    To provide an overview of the clinical outcomes of self-expandable metal stent (SEMS) placement for malignant gastric outlet obstruction (MGOO). A systematic literature search was performed in PubMed of the literature published between January 2009 and March 2015. Only prospective studies that reported on the clinical success of stent placement for MGOO were included. The primary endpoint was clinical success, defined according to the definition used in the original article. Data were pooled and analyzed using descriptive statistics. Subgroup analyses were performed for partially covered SEMSs (PCSEMSs) and uncovered SEMSs (UCSEMSs) using Fisher's exact test. A total of 19 studies, including 1281 patients, were included in the final analysis. Gastric (42%) and pancreatic (37%) cancer were the main causes of MGOO. UCSEMSs were used in 76% of patients and PCSEMSs in 24%. The overall pooled technical success rate was 97.3% and the clinical success rate was 85.7%. Stent dysfunction occurred in 19.6% of patients, mainly caused by re-obstruction (12.6%) and stent migration (4.3%), and was comparable between PCSEMSs and UCSEMSs (21.2% vs 19.1%, respectively, P = 0.412). Re-obstruction was more common with UCSEMSs (14.9% vs 5.1%, P stent migration was more frequent after PCSEMS placement (10.9% vs 2.2%, P stent patency ranged from 68 to 307 d in five studies. The median overall survival ranged from 49 to 183 d in 13 studies. The clinical outcomes in this large population showed that enteral stent placement was feasible, effective and safe. Therefore, stent placement is a valid treatment option for the palliation of MGOO.

  16. Outcomes of second self-expandable metallic stent insertion for malignant gastric outlet obstruction.

    Science.gov (United States)

    Kim, Chan Gyoo; Choi, Il Ju; Lee, Jong Yeul; Cho, Soo-Jeong; Kim, Soo Jin; Kim, Mi-Jung; Park, Sook Ryun; Park, Young Lee

    2014-01-01

    Self-expandable metallic stents are used widely to relieve malignant gastric outlet obstruction (GOO). However, restenosis or migration of first stents is a frequent complication. The purpose of this retrospective cohort study was to evaluate the effectiveness of second stents as an approach to manage failure of first stents in patients with malignant GOO. A total of 222 patients with gastric cancer received first stents due to inoperable GOO at National Cancer Center in Korea between January 2008 and June 2011. Monthly follow-up interviews were performed, and second stents (stent-in-stent or stent-after-migration) were inserted in 59 patients by June 2012. Technical and clinical successes and long-term complications were evaluated. The technical and immediate clinical success rates were 98.3 % (58/59) and 91.5 % (54/59), respectively. Patients who received a second stent due to late complications involving the first stent (migration, restenosis, and fracture) showed a higher clinical success rate (95.8 % [46/48]) than patients who received a second stent due to immediate clinical failure of the first stent (72.7 % [8/11], p = 0.04). The immediate clinical success rate of stent-after-migration (100 % [11/11]) was not different from that of stent-in-stent (89.6 % [43/48], p = 1.0). The stent dysfunction rate of stent-after-migration (27.3 % [3/11]) also was similar to that of stent-in-stent (29.2 % [14/48], p = 1.0). The median patencies of stent-in-stent and stent-after-migration were 27.4 and 58.4 weeks, respectively (p = 0.177). There were no significant prognostic factors for patency of second stents. Insertion of a second stent is effective for treating the first-stent failure in gastric cancer patients with GOO, especially if the immediate outcome of the first stent was successful.

  17. Gastric Outlet Obstruction--An Unexpected Complication during Coca-Cola Therapy for a Gastric Bezoar: A Case Report and Literature Review.

    Science.gov (United States)

    Lu, Lei; Zhang, Xiao-Feng

    2016-01-01

    Gastric bezoars are concretions of undigested material, and Coca-Cola therapy is an easy, efficacious and safe approach for bezoar treatment. Gastric outlet obstruction due to a migratory gastric bezoar during Coca-Cola therapy is an uncommon presentation and, to the best of our knowledge, no cases have been previously reported. We herein describe one such case with no known predisposing factors that recovered via the endoscopic technique. A thorough literature search was performed, which yielded eight relevant patients from seven publications, all of who developed gastrointestinal obstruction during dissolution treatment and recovered uneventfully after surgical intervention. In conclusion, this potential complication should be kept in mind in the event that alternative treatment is necessary.

  18. Safety and benefits of self-expandable metallic stents with chemotherapy for malignant gastric outlet obstruction.

    Science.gov (United States)

    Miyabe, Katsuyuki; Hayashi, Kazuki; Nakazawa, Takahiro; Sano, Hitoshi; Yamada, Tomonori; Takada, Hiroki; Naitoh, Itaru; Shimizu, Shuya; Kondo, Hiromu; Nishi, Yuji; Yoshida, Michihiro; Umemura, Shuichiro; Hori, Yasuki; Kato, Akihisa; Ohara, Hirotaka; Joh, Takashi

    2015-07-01

    The influence of chemotherapy on placement of self-expandable metallic stents (SEMS) for malignant gastric outlet obstruction (MGOO) has not been evaluated extensively. We investigated the influence of chemotherapy on the clinical outcomes of SEMS placement for MGOO. A total of 152 cancer patients with MGOO from a university hospital and affiliate hospitals were included. The patients were classified according to chemotherapy status and evaluated for palliative efficacy and safety of SEMS placement. Technical success rate, time to oral intake, and parameters indicating improvement of physical condition did not differ between the with- and without-chemotherapy groups after stent placement. Re-intervention and stent migration were significantly more frequent in the with-chemotherapy group than in the without-chemotherapy group after stent placement (re-intervention, 32.4% vs 7.8%, P = 0.0005; stent migration, 13.5% vs 1.7%, P = 0.0097). The frequency of adverse events did not differ between the with- and without-chemotherapy groups. Although chemotherapy after stent placement was an independent predictive factor for shortening the stent patency period (hazard ratio [HR], 3.10; P = 0.0264), the use of additional stents facilitated uneventful recovery and further prolonged survival time (HR, 0.60; P = 0.0132). Various cancer patients with MGOO can undergo SEMS placement safely regardless of chemotherapy, and concurrent chemotherapy after stent placement can prolong survival time, although re-intervention and stent migration may be increased. © 2015 The Authors. Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

  19. Self-Expandable Metallic Stent Placement in Malignant Gastric Outlet Obstruction: A Comparison Between 2 Brands of Stents.

    Science.gov (United States)

    Ye, Bing-Wei; Lee, Kuei-Chuan; Hsieh, Yun-Cheng; Li, Chung-Pin; Chao, Yee; Hou, Ming-Chih; Lin, Han-Chieh

    2015-07-01

    Malignant gastric outlet obstruction is a late complication of intraabdominal malignancy. Self-expandable metallic stent placement has been a safe palliative treatment to relieve obstructive symptoms. We aimed to assess the efficacy and safety of metallic stents in our patients and analyzed the clinical outcome of different brands. Seventy-one patients with inoperable gastric outlet obstruction receiving WallFlex enteral stents (WallFlex group) or Bonastents (Bonastent group) since April 2010 were analyzed retrospectively. The overall technical and clinical success rates of stent placement were 100% and 93%, respectively. The baseline characteristics and clinical outcomes including procedure-related complications, restenosis, and reintervention rates were comparable between the 2 groups. However, the Bonastent group had a higher rate of stent fracture than the WallFlex group (13.3% vs 0%, P = 0.03). The mean duration of overall stent patency was 132.7 days. The mean duration of survival was 181.9 days. Resumption of regular diet or low residual diet at day 7 after stent insertion predicted stent patency (hazard ratio [HR]: 0.28, P = 0.01). Cancer with gastric origin (HR: 0.25, P = 0.045) and poststent chemotherapy (HR: 0.38, P = 0.006) predicted lower mortality; however, peritoneal carcinomatosis (HR: 3.09, P = 0.04) correlated with higher mortality. Metallic stent placement is a safe and effective method for relieving gastric outlet obstruction. Except higher rate of stent fracture in the Bonastent group, there is no significant difference in clinical outcomes between the Bonastent group and the WallFlex group.

  20. Entirely Laparoscopic Gastrectomy and Colectomy for Remnant Gastric Cancer with Gastric Outlet Obstruction and Transverse Colon Invasion

    OpenAIRE

    Kim, Hyun Il; Kim, Min Gyu

    2015-01-01

    It is well known that gastrectomy with curative intent is the best way to improve outcomes of patients with remnant gastric cancer. Recently,several investigators reported their experiences with laparoscopic gastrectomy of remnant gastric cancer. We report the case of an 83-year-old female patient who was diagnosed with remnant gastric cancer with obstruction. She underwent an entirely laparoscopic distal gastrectomy with colectomy because of direct invasion of the transverse colon. The opera...

  1. Treatment of malignant gastric outlet obstruction with stents: An evaluation of the reported variables for clinical outcome

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    Medhus Asle W

    2009-06-01

    Full Text Available Abstract Background Malignant gastric outlet obstruction (GOO is commonly seen in patients with advanced gastric-, pancreatic-, duodenal, hepatobiliary or metastatic malignancies. Ten to 25% of patients with pancreatic cancer will develop duodenal obstruction during the course of the disease. Duodenal stenting with self-expandable metal stents is an alternative treatment to surgical bypass procedures. Our aim was to review the published literature regarding treatment of malignant GOO with stents to reveal whether the information provided is sufficient to evaluate the clinical effects of this treatment Methods A literature search from 2000 – 2007 was conducted in Pub Med, Embase, and Cochrane library, combining the following search terms: duodenal stent, malignant duodenal obstruction, gastric outlet obstruction, SEMS, and gastroenteroanastomosis. All publications presenting data with ≥ 15 patients and only articles written in English were included and a review focusing on the following parameters were conducted: 1 The use of graded scoring systems evaluating clinical success; 2 Assessment of Quality of life (QoL before and after treatment; 3 Information on stent-patency; 4 The use of objective criteria to evaluate the stent effect. Results 41 original papers in English were found; no RCT's. 16 out of 41 studies used some sort of graded scoring system. No studies had objectively evaluated QoL before or after stent treatment, using standardized QoL-questionnaires, 32/41 studies reported on stent patency and 9/41 performed an oral contrast examination after stent placement. Objective quantitative tests of gastric emptying had not been performed. Conclusion Available reports do not provide sufficient relevant information of the clinical outcome of duodenal stenting. In future studies, these relevant issues should be addressed to allow improved evaluation of the effect of stent treatment.

  2. Trichobezoar – A Rare Cause of Abdominal Mass and Gastric Outlet Obstruction

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    Ana Couceiro

    2016-01-01

    Full Text Available The authors present the clinical case of a 14-year old girl with weight loss, anorexia, epigastric abdominal pain and postprandial vomiting with 5 months duration. There was a background of trichophagia for 2 years without evidence of alopecia or psychiatric history. The physical examination revealed an epigastric mass motionless, stony, with poorly defined limits, painful on palpation and about 7 cm diameter. Abdominal ultrasonography showed thickening of the gastric wall and antrum with gastric distension. The abdominal tomography scan and endoscopic examination revealed the presence of a bulky trichobezoar occupying almost the entire gastric lumen. It was decided to undergo gastrotomy and extraction of the bezoar. The postoperative period was uneventful.

  3. Electrophysiological and mechanical activity of the upper gastrointestinal tract after duodenoplasty or segmental resection of benign gastric outlet stenosis.

    Science.gov (United States)

    Peiper, C; Titkova, S M; Polivoda, M; Anurov, M; Arlt, G; Ottinger, A P; Schumpelick, V

    2000-03-01

    In an animal experimental study we examined the postoperative recovery of the motility of the upper gastrointestinal tract after operative treatment of a benign gastric outlet obstruction. At 45 Days after induction, a duodenal stenosis was resected in six dogs, and resolved by Finney's duodenoplasty in another six dogs. Fourteen days after segmental resection, the gastric emptying was faster [half evacuation time (T1/2) for semisolid food = 44.4 +/- 16.8 min] than following duodenoplasty [T1/2 = 56.8 +/- 25.3). Here motor migrating complexes (MMCs) started in the antrum and could be traced down to the jejunum. After segmental resection we recognized MMC only distal to the anastomosis. The duration of the whole MMC cycle (69.0 +/- 18.6 min) as well as of the single phases was significantly shorter in the resection group than after duodenoplasty (108.0 +/- 15.1 min). At 28 days after operation the differences in the electromyographic findings were smaller (82.0 +/- 15.1 min vs. 111.4 +/- 11.2 min), but still significant. Obviously humoral transmitters and the extrinsic neural system lead to good propagation of the MMC across the anastomosis, even before the intramural pathways are reestablished. Concerning the fast recovery of the motility of the upper gastrointestinal tract, duodenoplasty is superior to segmental duodenal resection.

  4. Antro-duodenal tuberculosis causing gastric outlet obstruction--a rare presentation of a protean disease.

    Science.gov (United States)

    Gheorghe, Liana; Băncilă, Ion; Gheorghe, Cristian; Herlea, Vlad; Vasilescu, Cătălin; Aposteanu, Gabriela

    2002-06-01

    Gastroduodenal tuberculosis is a rare location of abdominal tuberculosis. It usually occurs secondary to pulmonary tuberculosis. We report a case of a 63-year-old woman admitted to the referral center for symptoms of upper gastrointestinal obstruction caused by ulcerohypertrophic antroduodenal tuberculosis. The lesion was misdiagnosed as malignancy at endoscopy. Even at surgery, the lesion was considered gastric cancer and imposed an oncologic resection. The diagnosis was established in the presence of giant-cell granulomas with caseating necrosis in the surgical resected specimens. In our case, the rare gastroduodenal location of abdominal tuberculosis occurred as primary tuberculosis, in the absence of other identifiable locations.

  5. Gastric outlet obstruction due to adenocarcinoma in a patient with Ataxia-Telangiectasia syndrome: a case report and review of the literature

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    Hammond Sue

    2009-03-01

    Full Text Available Abstract Background Ataxia-Telangiectasia syndrome is characterized by progressive cerebellar dysfunction, conjuctival and cutaneous telangiectasias, severe immune deficiencies, premature aging and predisposition to cancer. Clinical and radiographic evaluation for malignancy in ataxia-telangiectasia patients is usually atypical, leading to delays in diagnosis. Case presentation We report the case of a 20 year old ataxia-telangiectasia patient with gastric adenocarcinoma that presented as complete gastric outlet obstruction. Conclusion A literature search of adenocarcinoma associated with ataxia-telangiectasia revealed 6 cases. All patients presented with non-specific gastrointestinal complaints suggestive of ulcer disease. Although there was no correlation between immunoglobulin levels and development of gastric adenocarcinoma, the presence of chronic gastritis and intestinal metaplasia seem to lead to the development of gastric adenocarcinoma. One should consider adenocarcinoma in any patient with ataxia-telangiectasia who presents with non-specific gastrointestinal complaints, since this can lead to earlier diagnosis.

  6. A Novel Partially Covered Self-Expandable Metallic Stent with Proximal Flare in Patients with Malignant Gastric Outlet Obstruction.

    Science.gov (United States)

    Takahara, Naminatsu; Isayama, Hiroyuki; Nakai, Yousuke; Yoshida, Shuntaro; Saito, Tomotaka; Mizuno, Suguru; Yagioka, Hiroshi; Kogure, Hirofumi; Togawa, Osamu; Matsubara, Saburo; Ito, Yukiko; Yamamoto, Natsuyo; Tada, Minoru; Koike, Kazuhiko

    2017-07-15

    Endoscopic placement of self-expandable metal stents (SEMSs) has emerged as a palliative treatment for malignant gastric outlet obstruction (GOO). Although covered SEMSs can prevent tumor ingrowth, frequent migration of covered SEMSs may offset their advantages in preventing tumor ingrowth. We conducted this multicenter, single-arm, retrospective study at six tertiary referral centers to evaluate the safety and efficacy of a partially covered SEMS with an uncovered large-bore flare at the proximal end as an antimigration system in 41 patients with symptomatic malignant GOO. The primary outcome was clinical success, and the secondary outcomes were technical success, stent dysfunction, adverse events, and survival after stent placement. The technical and clinical success rates were 100% and 95%, respectively. Stent dysfunctions occurred in 17 patients (41%), including stent migration in nine (23%), tumor ingrowth in one (2%), and tumor overgrowth in four (10%). Two patients (5%) developed adverse events: one pancreatitis and one perforation. No procedure-related death was observed. A novel partially covered SEMS with a large-bore flare proximal end was safe and effective for malignant GOO but failed to prevent stent migration. Further research is warranted to develop a covered SEMS with an optimal antimigration system.

  7. A Mechanistic Model of Intermittent Gastric Emptying and Glucose-Insulin Dynamics following a Meal Containing Milk Components.

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    Priska Stahel

    Full Text Available To support decision-making around diet selection choices to manage glycemia following a meal, a novel mechanistic model of intermittent gastric emptying and plasma glucose-insulin dynamics was developed. Model development was guided by postprandial timecourses of plasma glucose, insulin and the gastric emptying marker acetaminophen in infant calves fed meals of 2 or 4 L milk replacer. Assigning a fast, slow or zero first-order gastric emptying rate to each interval between plasma samples fit acetaminophen curves with prediction errors equal to 9% of the mean observed acetaminophen concentration. Those gastric emptying parameters were applied to glucose appearance in conjunction with minimal models of glucose disposal and insulin dynamics to describe postprandial glycemia and insulinemia. The final model contains 20 parameters, 8 of which can be obtained by direct measurement and 12 by fitting to observations. The minimal model of intestinal glucose delivery contains 2 gastric emptying parameters and a third parameter describing the time lag between emptying and appearance of glucose in plasma. Sensitivity analysis of the aggregate model revealed that gastric emptying rate influences area under the plasma insulin curve but has little effect on area under the plasma glucose curve. This result indicates that pancreatic responsiveness is influenced by gastric emptying rate as a consequence of the quasi-exponential relationship between plasma glucose concentration and pancreatic insulin release. The fitted aggregate model was able to reproduce the multiple postprandial rises and falls in plasma glucose concentration observed in calves consuming a normal-sized meal containing milk components.

  8. Impact of Carcinomatosis on Clinical Outcomes after Self-Expandable Metallic Stent Placement for Malignant Gastric Outlet Obstruction.

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    Ji Eun Lee

    Full Text Available It is still unclear whether the peritoneal carcinomatosis had a negative effect on the clinical outcomes of patients who underwent self-expandable metallic stent (SEMS placement for malignant gastric outlet obstruction (GOO. Although carcinomatosis may be associated with the development of multifocal gastrointestinal (GI tract obstruction or decreased bowel movement, previous studies investigated the occurrence of stent failure only and thus had limitation in evaluating clinical outcomes of patients with carcinomatosis.Between 2009 and 2013, 155 patients (88 patients without carcinomatosis and 67 patients with carcinomatosis underwent endoscopic SEMS placement for malignant GOO. Factors affecting clinical success and obstructive symptom-free survival (time period between SEMS placement and the recurrence of obstructive symptoms due to multifocal GI tract obstruction or decreased bowel movement as well as stent failure were assessed.Patients with carcinomatosis showed higher Eastern Cooperative Oncology Group (ECOG scale than those without carcinomatosis. Clinical success rates were 88.1% in patients with carcinomatosis and 97.7% in patients without carcinomatosis. In multivariate analysis, only ECOG scale was identified as an independent predictor of clinical success. During follow-up period, patients with carcinomatosis showed significantly shorter obstructive symptom-free survival than those without carcinomatosis. In multivariate analysis, the presence of carcinomatosis, chemotherapy or radiation therapy after SEMS placement, and obstruction site were identified as independent predictors of obstructive symptom-free survival. For patient without carcinomatosis, stent failure accounted for the recurrence of obstructive symptoms in 84.6% of cases. For patients with carcinomatosis, multifocal GI tract obstruction or decreased bowel movement accounted for 37.9% of cases with obstructive symptom recurrence and stent failure accounted for 44.8% of

  9. Long-Term Palliative Effect of Stenting in Gastric Outlet Obstruction Due to Transarterial Chemoembolization with Yttrium-90 in a Patient with Metastatic Neuroendocrine Tumor

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    Erkan Caglar

    2016-09-01

    Full Text Available Internal radioembolization with yttrium-90 is a promising treatment method, predominantly for liver tumors. However, the shifting of yttrium-90-loaded spherules into the arteries and veins that supply the duodenum and stomach, leading to ulceration, hemorrhage, perforation, and outlet obstruction of these organs, is one of the major undesirable consequences of this technique. We report a case of gastric outlet obstruction (GOO due to antropyloric stenosis with ulceration, edema, and inflammation following transarterial yttrium-90 treatment for a metastatic neuroendocrine tumor in a 58-year-old man. Stenting was used for palliation in this case. GOO improved after stenting and recovery of oral intake was permanent after stent removal.

  10. Managing obstructive gastric volvulus: challenges and solutions

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    Rodriguez-Garcia HA

    2017-03-01

    Full Text Available Hector Alejandro Rodriguez-Garcia,1 Andrew S Wright,2–4 Robert B Yates1–3 1Department of Surgery, Center for Esophageal and Gastric Surgery, 2Center for Videoendoscopic Surgery, 3Hernia Center, 4Institute for Simulation and Interprofessional Studies, UWMC, University of Washington, Seattle, USA Abstract: Gastric volvulus is the abnormal torsion of the stomach along its short or long axis. Most patients who experience gastric volvulus present with mild or intermittent gastric obstructive symptoms. However, severe acute gastric volvulus can result in complete gastric outlet obstruction and ischemia. Consequently, acute gastric volvulus warrants immediate evaluation and management. The goals of management are to relieve the obstruction and prevent recurrent volvulus. Techniques to manage gastric volvulus depend on patient characteristics and the presence of gastric ischemia. In the absence of gastric ischemia, gastric volvulus can be managed with anterior abdominal wall gastropexy or paraesophageal hernia repair. If gastric ischemia is present, operative resection of the affected portion of the stomach is indicated. When operative management is indicated, many patients with gastric volvulus can be managed with minimally invasive (laparoscopic, endoscopic, or laparoendoscopic techniques. Keywords: gastric volvulus, paraesophageal hernia, hiatal hernia

  11. Palliative Therapy for Gastric Outlet Obstruction Caused by Unresectable Gastric Cancer: A Meta-analysis Comparison of Gastrojejunostomy with Endoscopic Stenting

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    Shi-Bo Bian

    2016-01-01

    Conclusions: Both GJJ and ES are effective procedures for the treatment of GOO caused by gastric cancer. ES is associated with better short-term outcomes. GJJ is preferable to ES in terms of its lower rate of stent-related complications, re-obstruction, and reintervention. GJJ should be considered a treatment option for patients with a long life expectancy and good performance status.

  12. Covered Metallic Stents With an Anti-Migration Design vs. Uncovered Stents for the Palliation of Malignant Gastric Outlet Obstruction: A Multicenter, Randomized Trial

    Science.gov (United States)

    Lee, Hyuk; Min, Byung-Hoon; Lee, Jeong Hoon; Shin, Cheol Min; Kim, Younjoo; Chung, Hyunsoo; Lee, Sang Hyub

    2015-01-01

    OBJECTIVES: Previous studies reported comparable stent patency between covered self-expandable metallic stents (SEMS) and uncovered SEMS (UCS) for palliation of malignant gastric outlet obstruction (GOO). The aim of this study was to evaluate the efficacy and safety of the newly developed WAVE-covered SEMS (WCS), which has an anti-migration design, compared with UCS in gastric cancer patients with symptomatic GOO. METHODS: A total of 102 inoperable gastric cancer patients with symptomatic GOO were prospectively enrolled from five referral centers and randomized to undergo UCS or WCS placement. Stent patency and recurrence of obstructive symptoms were assessed at 8 weeks and 16 weeks after stent placement. RESULTS: At the 8-week follow-up, both stent patency rates (72.5% vs. 62.7%) and re-intervention rates (19.6% vs. 19.6%) were comparable between the WCS and the UCS groups. Both stent stenosis (2.4% vs. 8.1%) and migration rates (9.5% vs. 5.4%) were comparable between WCS and UCS groups. At the 16-week follow-up, however, the WCS group had a significantly higher stent patency rate than the UCS group (68.6% vs. 41.2%). Re-intervention rates in the WCS and UCS groups were 23.5% and 39.2%, respectively. Compared with the UCS group, the WCS group had a significantly lower stent restenosis rate (7.1% vs. 37.8%) and a comparable migration rate (9.5% vs. 5.4%). Overall stent patency was significantly longer in the WCS group than in the UCS group. No stent-associated significant adverse events occurred in either the WCS or UCS groups. In the multivariate analysis, WCS placement and chemotherapy were identified as independent predictors of 16-week stent patency. CONCLUSIONS: WCS group showed comparable migration rate and significantly more durable long-term stent patency compared with UCS group for the palliation of GOO in patients with inoperable gastric cancer. PMID:26372507

  13. Development of a duodenal gallstone ileus with gastric outlet obstruction (Bouveret syndrome four months after successful treatment of symptomatic gallstone disease with cholecystitis and cholangitis: a case report

    Directory of Open Access Journals (Sweden)

    Winnekendonk Guido

    2010-11-01

    Full Text Available Abstract Introduction Cases of gallstone ileus account for 1% to 4% of all instances of mechanical bowel obstruction. The majority of obstructing gallstones are located in the terminal ileum. Less than 10% of impacted gallstones are located in the duodenum. A gastric outlet obstruction secondary to a gallstone ileus is known as Bouveret syndrome. Gallstones usually enter the bowel through a biliary enteral fistula. Little is known about the formation of such fistulae in the course of gallstone disease. Case presentation We report the case of a 72-year-old Caucasian woman born in Germany with a gastric outlet obstruction due to a gallstone ileus (Bouveret syndrome, with a large gallstone impacted in the third part of the duodenum. Diagnostic investigations of our patient included plain abdominal films, gastroscopy and abdominal computed tomography, which showed a biliary enteric fistula between the gallbladder and the duodenal bulb. Our patient was successfully treated by laparotomy, duodenotomy, extraction of the stone, cholecystectomy, and resection of the fistula in a one-stage surgical approach. Histopathological examination showed chronic and acute cholecystitis, with perforated ulceration of the duodenal wall and acute purulent inflammation of the surrounding fatty tissue. Four months prior to developing a gallstone ileus our patient had been hospitalized for cholecystitis, a large gallstone in the gallbladder, cholangitis and a small obstructing gallstone in the common biliary duct. She had been treated with endoscopic retrograde cholangiopancreatography, endoscopic biliary sphincterotomy, balloon extraction of the common biliary duct gallstone, and intravenous antibiotics. At the time of her first presentation, abdominal ultrasound and endoscopic examination (including esophagogastroduodenoscopy and endoscopic retrograde cholangiopancreatography had not shown any evidence of a biliary enteral fistula. In the four months preceding the

  14. Predictors of stent dysfunction after self-expandable metal stent placement for malignant gastric outlet obstruction: tumor ingrowth in uncovered stents and migration of covered stents.

    Science.gov (United States)

    Hori, Yasuki; Naitoh, Itaru; Hayashi, Kazuki; Ban, Tesshin; Natsume, Makoto; Okumura, Fumihiro; Nakazawa, Takahiro; Takada, Hiroki; Hirano, Atsuyuki; Jinno, Naruomi; Togawa, Shozo; Ando, Tomoaki; Kataoka, Hiromi; Joh, Takashi

    2017-10-01

    Endoscopic metallic stenting is widely accepted as a palliation therapy for malignant gastric outlet obstruction (GOO). However, the predictors of stent dysfunction have not been clarified. We aimed to evaluate the predictors, especially tumor ingrowth in uncovered self-expandable metallic stents (U-SEMS) and migration of covered self-expandable metallic stents (C-SEMS), which are the main causes related to the stent characteristics. In this multicenter retrospective study, we compared patients with U-SEMS and C-SEMS in terms of clinical outcomes, and predictors of stent dysfunction. In total, 252 patients (126 with U-SEMS and 126 with C-SEMS) were enrolled. There were no significant differences in technical success, clinical success, GOO score, or time to stent dysfunction. Tumor ingrowth was significantly more frequent in U-SEMS (U-SEMS, 11.90% vs. C-SEMS, 0.79%; p = 0.002), and stent migration was significantly more frequent for C-SEMS (C-SEMS, 8.73% vs. U-SEMS, 0.79%; p = 0.005). Karnofsky performance status (p = 0.04), no presence of ascites (p = 0.02), and insufficient (stent expansion (p = 0.003) were significantly associated with tumor ingrowth in U-SEMS. Meanwhile, a shorter stent length (p = 0.05) and chemotherapy (p = 0.03) were predictors of C-SEMS migration. Both U-SEMS and C-SEMS are effective with comparable patencies. Tumor ingrowth and stent migration are the main causes of stent dysfunction for U-SEMS and C-SEMS, respectively. With regard to stent dysfunction, U-SEMS might be a good option for patients receiving chemotherapy, while C-SEMS with longer stents for patients in good condition. (Clinical trial registration number: UMIN000024059).

  15. Predictors of outcomes in patients undergoing covered and uncovered self-expandable metal stent placement for malignant gastric outlet obstruction: a multicenter study.

    Science.gov (United States)

    Hori, Yasuki; Naitoh, Itaru; Hayashi, Kazuki; Ban, Tesshin; Natsume, Makoto; Okumura, Fumihiro; Nakazawa, Takahiro; Takada, Hiroki; Hirano, Atsuyuki; Jinno, Naruomi; Togawa, Shozo; Ando, Tomoaki; Kataoka, Hiromi; Joh, Takashi

    2017-02-01

    Uncovered self-expandable metal stents (U-SEMSs) and covered self-expandable metal stents (C-SEMSs) are available for palliative therapy for malignant gastric outlet obstruction (GOO). However, clinical differences and indications between the 2 types of SEMSs have not been elucidated. We retrospectively compared 126 patients with U-SEMS and 126 patients with C-SEMSs with regard to clinical outcome and factors predictive of clinical improvement after SEMSs placement. No significant difference was observed between the U-SEMS and C-SEMS groups with respect to technical success, clinical success, GOO score, or time to stent dysfunction. Stent migration was significantly more frequent in patients with C-SEMSs (U-SEMSs, .79%; C-SEMSs, 8.73%; P = .005). Karnofsky performance status, chemotherapy, peritoneal dissemination, and stent expansion ≤ 30% were associated significantly with poor GOO score improvement in multivariable analyses, but stent type was not (P = .213). In subgroup analyses, insufficient (≤30%) stent expansion was an independent factor in patients with U-SEMSs (P = .041) but not C-SEMSs. In the insufficient stent expansion subgroup, C-SEMSs was associated significantly with superior clinical improvement compared with U-SEMSs (P = .01). Insufficient stent expansion was observed more frequently in patients with GI obstruction because of anastomotic sites or metastatic cancer (44.8% [13/29], P = .001). No clinical difference, apart from stent migration, was observed between patients with U-SEMSs and C-SEMSs. GI obstruction because of an anastomotic site or metastatic cancer may be an indication for C-SEMS use to improve oral intake after SEMSs placement. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  16. Gastric Outlet Obstruction Annular pancreas

    NARCIS (Netherlands)

    de Meijer, Vincent E.; van Eijck, Casper H. J.; Koerkamp, Bas Groot

    A 72-year-old woman presented with a 6-month history of a dull, epigastric pain, 10-kg weight loss (from 52 kg to 42 kg), and a 6- to 8-week history of nausea and vomiting. Physical examination showed no notable abnormalities. Blood test results revealed anemia (hemoglobin 9.8 g/dL [to convert to

  17. Gastric Bezoar

    Directory of Open Access Journals (Sweden)

    Samer Assaf

    2017-01-01

    Full Text Available History of present illness: A 12-year-old female with no past medical history presented with abdominal pain for 3 months. The pain was intermittent, located at the epigastric region, non-radiating, fluctuating intensity up to 8/10, and had worsened over the past month. She did not have fever, nausea, vomiting, diarrhea, constipation, or blood in her stool. The patient also endorsed hair loss over the same time period and noted that her previously long hair was now short and thin. On exam, patient was noted to have shoulder-length hair, a soft, non-distended abdomen with mild tenderness to the epigastric region, and a 5cm hard mass palpated at the epigastrium. Significant findings: In the abdominal radiograph, a nonspecific and non-obstructive bowel gas pattern with no air-fluid level was noted, however the stomach was distended with soft tissue. The CT abdomen/pelvis revealed a distended stomach with undigested heterogeneous contents (presumed bezoar. Discussion: A bezoar is a mass of incompletely digested material typically originating in the stomach and consisting of vegetable fibers, hair, or drugs.1 Bezoars develop after ingested foreign material accumulates in the gastrointestinal tract due to indigestibility, gastric outlet obstruction, or intestinal stasis. Trichobezoars are comprised of hair and classically form in young females with an underlying psychiatric disorder resulting in the urge to pull one’s hair out (trichotillomania and swallow it (trichophagia.2,3 Gastric bezoars are rare with an approximate incidence of 0.3 percent of patients undergoing upper endoscopy.4 Patients tend to remain asymptomatic for long periods, but may develop abdominal pain, nausea/vomiting, early satiety, anorexia, and weight loss.5 Complications may include gastrointestinal ulcerations, perforations, intussusception, pancreatitis, obstructive jaundice, and death.6-8 The diagnosis of a gastric bezoar can be made using plain films, ultrasound, or CT, and

  18. Comparison on the Efficacy between Partially Covered Self-Expandable Metal Stent with Funnel-Shaped Enlarged Head versus Uncovered Self-Expandable Metal Stent for Palliation of Gastric Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Jung Wan Choe

    2018-01-01

    Full Text Available Background. Shape modification has been one of the methods adopted to improve stent patency but has not always translated into positive outcome. The aim of this study was to compare the efficacy of shape-modified partially covered self-expandable metal stent (SEMS that has enlarged head versus uncovered SEMS for palliation of gastric outlet obstruction (GOO. Methods. A total of 48 patients underwent insertion of either enlarged-head SEMS (n=24 or uncovered SEMS (uSEMS (n=24 for palliation of GOO from July 2009 to July 2016. Patients with inoperable or advanced malignancy were included. Technical feasibility and clinical outcomes were compared. Results. Technical success rate was 100% (24/24 and 95.8% (23/24 for enlarged-head SEMS group and uSEMS group, respectively. Clinical success rate was 87.5% (21/24 and 87.0% (20/23 for enlarged-head SEMS group and uSEMS group, respectively. The gastric outlet obstruction scoring system score significantly improved in both groups (p<0.001 for both. Mean survival was similar between the groups: enlarged-head SEMS group, 99.3 days (range, 19–358 days versus uSEMS group, 82.1 days (range, 11–231 days (p=0.418. The mean stent patency also showed no difference between the groups: enlarged-head SEMS group, 87.1 days (range, 8–358 days versus uSEMS group, 60.4 days (range, 2–231 days (p=0.204. With enlarged-head SEMS, distal migration did not occur, but proximal migration was observed in four cases. Conclusions. Distal migration was prevented by shaping the SEMS to have an enlarged head, but improvement in stent patency could not be observed.

  19. Double Outlet Right Ventricle

    Science.gov (United States)

    ... Right Ventricle Menu Topics Topics FAQs Double Outlet Right Ventricle Double outlet right ventricle (DORV) is a rare form of congenital heart disease. En español Double outlet right ventricle (DORV) is a rare form of congenital ...

  20. Energy intermittency

    CERN Document Server

    Sorensen, Bent

    2014-01-01

    The first book to consider intermittency as a key point of an energy system, Energy Intermittency describes different levels of variability for traditional and renewable energy sources, presenting detailed solutions for handling energy intermittency through trade, collaboration, demand management, and active energy storage. Addressing energy supply intermittency systematically, this practical text:Analyzes typical time-distributions and intervals between episodes of demand-supply mismatch and explores their dependence on system layouts and energy source characteristicsSimulates scenarios regar

  1. Intermittent hydronephrosis

    International Nuclear Information System (INIS)

    Knop, J.; Vogel, H.; Hupe, W.

    1981-01-01

    An intermittent hydronephrosis was observed in a 40-year old patient. This disease pattern is due to an incongruity between the formation of urine and the transport capacity in the ureteropelvic junction. The latent impediment of flow becomes manifest with increased urine secretion. Irreversible renal damage can be the result of the repeatedly occurring hydronephrotic crises. (orig.) [de

  2. AGU hydrology publication outlets

    Science.gov (United States)

    Freeze, R. Allan

    In recent months I have been approached on several occasions by members of the hydrology community who asked me which of the various AGU journals and publishing outlets would be most suitable for a particular paper or article that they have prepared.Water Resources Research (WRR) is the primary AGU outlet for research papers in hydrology. It is an interdisciplinary journal that integrates research in the social and natural sciences of water. The editors of WRR invite original contributions in the physical, chemical and biological sciences and also in the social and policy sciences, including economics, systems analysis, sociology, and law. The editor for the physical sciences side of the journal is Donald R. Nielson, LAWR Veihmeyer Hall, University of California Davis, Davis, CA 95616. The editor for the policy sciences side of the journal is Ronald G. Cummings, Department of Economics, University of New Mexico, Albuquerque, NM 87131

  3. Intermittency '93

    International Nuclear Information System (INIS)

    Bialas, A.

    1993-01-01

    The existing data definitely indicate the existence of intermittency, i.e. of self similar structures in the systems of particles created in high-energy collisions. The effect seems universal: it was found in most of the processes investigated and its measures parameters depend only weakly (if at all) on the process in question. Strong HBT effect was found, suggesting that intermittency is related to space-time structure of the pion source rather than to detailed momentum structure of the production amplitudes. There are indications that this space time structure may be fractal, but more data is needed to establish this. The theoretical explanation remains obscure: it seems that both parton cascade and hadronization play an important role. Their interrelation, however, remains a mystery. 5 figs., 19 refs

  4. Tratamiento paliativo de la obstrucción tumoral del vaciamiento gástrico con prótesis metálicas autoexpandibles insertadas endoscópicamente Palliative management of malignant gastric outlet obstruction with endoscopically inserted self-expanding metal stents

    Directory of Open Access Journals (Sweden)

    J. García-Cano

    2008-06-01

    Full Text Available Antecedentes y objetivo: la inserción de prótesis metálicas autoexpandibles para paliar la obstrucción tumoral del vaciamiento gástrico es un procedimiento mínimamente invasivo, que cada vez se utiliza con más frecuencia. Presentamos la experiencia de esta técnica en un hospital de nivel II del Sistema Nacional de Salud. Pacientes y métodos: estudio retrospectivo de un periodo de cinco años (2003-2007, en los que se trató de resolver la obstrucción tumoral del vaciamiento gástrico en 27 ocasiones a 23 pacientes (media de 0,45 procedimientos por mes, mediante la inserción endoscópica de prótesis no recubiertas (Wallstent® y Wallflex®. Resultados: la inserción fue técnicamente posible en el 100% de los 27 intentos. Se obtuvo un buen resultado clínico en 25 ocasiones (92,5%. Se utilizó sólo endoscopia 10 (37% veces y en las otras 17 (63% también fluoroscopia. Tras la inserción de la prótesis se intervino a un paciente con intención curativa y a otro, en el que la prótesis no funcionó, para realizar una derivación paliativa. Cuatro prótesis se obstruyeron por crecimiento tumoral, recanalizándose mediante la inserción de nuevas prótesis. En tres ocasiones se produjo ictericia obstructiva en prótesis que cubrían la papila de Vater. No hubo otras complicaciones. Tampoco mortalidad derivada del procedimiento. La media de supervivencia fue de 104 días (rango 28-400, DE ± 94. Conclusiones: en nuestra experiencia, la inserción endoscópica de prótesis metálicas autoexpandibles parece un método seguro y eficaz en el tratamiento paliativo de la obstrucción tumoral del vaciamiento gástrico y puede llevarse a cabo con éxito en un centro de nuestras características.Aim and background: the insertion of self-expanding metal stents to palliate malignant gastric outlet obstruction is a minimally invasive procedure that is being increasingly used. We discuss experience with this technique in a level-II hospital in the

  5. Managing obstructive gastric volvulus: challenges and solutions

    OpenAIRE

    Rodriguez-Garcia,Hector; Wright,Andrew; Yates,Robert

    2017-01-01

    Hector Alejandro Rodriguez-Garcia,1 Andrew S Wright,2–4 Robert B Yates1–3 1Department of Surgery, Center for Esophageal and Gastric Surgery, 2Center for Videoendoscopic Surgery, 3Hernia Center, 4Institute for Simulation and Interprofessional Studies, UWMC, University of Washington, Seattle, USA Abstract: Gastric volvulus is the abnormal torsion of the stomach along its short or long axis. Most patients who experience gastric volvulus present with mild or intermittent gastr...

  6. Intermittent hyperthyreosis

    International Nuclear Information System (INIS)

    Sulman, F.G.; Tal, E.; Pfeifer, Y.; Superstine, E.

    1975-01-01

    Intermittent hyperthyreosis occurs under various forms of stress, especially heat stress. The clinician may diagnose such cases as masked or apathetic hyperthyroidism or 'forme fruste' hyperthyreosis or thyroid autonomy. As most routine and standard tests may here yield inconsistent results, it is the patients' anamnesis which may provide the clue. Our Bioclimatology Unit has now seen over 100 cases in which thyroid hypersensitivity towards heat was the most prominent syndrome: 10-15% of weather-sensitive patients are affected. The patients complain before or during heat spells of such contradictory symptoms as insomnia, irritability, tension, tachycardia, palpitations, precordial pain, dyspnoe, flushes with sweating or chills, tremor, abdominal pain or diarrhea, polyuria or pollakisuria, weight loss in spite of ravenous appetite, fatigue, exhaustion, depression, adynamia, lack of concentration and confusion. Determination of urinary neurohormones allows a differential diagnosis, intermittent hyperthyreosis being characterized by three cardinal symptoms: tachycardia - every case with more than 80 pulse beats being suspect (not specific); urinary histamine - every case excreting more than 90 μg/day being suspect. Again the drawback of this test is its lack of specificity, as histamine may also be increased in cases of allergy and spondylitis; urinary thyroxine - every case excreting more than 20 μg/day T-4 being suspect. This is the only specific test. Therapy should make use of lithium carbonate and betablockers. Propyl thiouracil is rarely required. (orig.) [de

  7. Gastric candidiasis with gastric adenocarcinoma intestinal type: A rare association

    Directory of Open Access Journals (Sweden)

    Kalaivani Selvi Subramanian

    2015-01-01

    Full Text Available Candidiasis of the gastrointestinal tract most commonly involves the esophagus and rarely involves the stomach and small bowel. The association of gastric carcinoma with candidiasis is even rare and only a very few case reports are available. We present here a 40-year-old female who presented with complaints of gastric outlet obstruction who on endoscopy showed a malignant ulcer involving the lesser curvature. The histopathological examination of biopsy from the ulcer showed adenocarcinoma intestinal type along with yeast and pseudohyphae forms of candida species.

  8. Gastric cancer

    International Nuclear Information System (INIS)

    Douglass, H.O.

    1988-01-01

    This book contains 10 selections. Some of the titles are: Radiation therapy for gastric cancer; Experimental stomach cancer: Drug selection based on in vitro testing; Western surgical adjuvant trials in gastric cancers: Lessons from current trials to be applied in the future; and Chemotherapy of gastric cancer

  9. Gastric outlet obstruction in Northwestern Ethiopia | Kotisso | East ...

    African Journals Online (AJOL)

    East and Central African Journal of Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 2 (2000) >. Log in or Register to get access to full text downloads.

  10. Pancreatic Pseudocyst Causing Gastric Outlet Obstruction In A 35 ...

    African Journals Online (AJOL)

    Abdominal ultrasonography is a useful diagnostic tool with almost equal value to a computerized tomography (CT) scan. An upper gastrointestinal series with barium contrast medium is less sensitive and of secondary importance with evolution of Ct scan. Treatment includes both operative and non-operative measures.

  11. Primary duodenal tuberculosis presenting as gastric-outlet obstruction

    African Journals Online (AJOL)

    The most common presentation was vomiting followed by failure to thrive and weight loss; two patients had abdominal pain. Biopsy of mesenteric lymph node was possible in two cases. FNAC from diseases portion was taken in all cases. FNAC showed granulomas in four cases. Cases where even FNAC fi nding was ...

  12. Thoracic outlet syndrome: Case report

    International Nuclear Information System (INIS)

    Marquez, Juan Camilo; Acosta, Mauricio Fernando; Uribe Jorge Ricardo

    2009-01-01

    We report a case of vascular thoracic outlet syndrome in a young man, diagnosed with upper limb arteriography, leading to repeated arterio-arterial emboli originating from a post-stenotic subclavian artery aneurysm. It is of our interest due to its low incidence and the small number of cases reported that have been diagnosed by arteriography. The thoracic outlet is the path through which vascular and neural structures goes from the neck to the axilla, and it has three anatomical strictures, that when pronounced, can compress the brachial plexus or subclavian vessels, leading to different symptoms and signs.

  13. Acute Gastric Volvulus Causing Splenic Avulsion and Hemoperitoneum

    Directory of Open Access Journals (Sweden)

    Yana Cavanagh

    2018-01-01

    Full Text Available Gastric volvulus is an abnormal, potentially life-threatening, torsion of the stomach. The presence of complications such as hemoperitoneum increases the diagnostic urgency; however it can also mask the presentation of gastric volvulus. We encountered a 66-year-old female who presented with symptomatic gastric outlet obstruction and was found to have hemoperitoneum and splenic avulsion on imaging. In our case, hemoperitoneum was a clinical red herring as initial imaging concentrated on the presence of hemoperitoneum and was nondiagnostic of gastric volvulus. Interestingly, our patient experienced complete resolution of her presenting symptomatology following placement of a nasogastric tube. Furthermore, endoscopic evaluation revealed no overt pathology to explain outlet obstruction. In light of these findings, gastric torsion was strongly suspected. A repeat CT scan was confirmatory, elucidated reduction of the stomach to its anatomic position, retroactively diagnosing a gastric volvulus. This case is unusual in its presentation and setting. The patient presented with two rare complications of gastric volvulus, hemoperitoneum and splenic avulsion. Additionally, ten years prior to this presentation the patient had a temporary gastrostomy tube. Gastropexy with a gastrostomy is the treatment for gastric volvulus and should have been preventative of her presentation with torsion. Furthermore, the gastric volvulus was not initially recognized radiographically due to the presence of masking radiographic findings. This case serves to highlight the utility of clinical acumen and maintain a high index of suspicion for gastric volvulus in all cases presenting with Borchardt’s triad.

  14. Intermittent search strategies

    Science.gov (United States)

    Bénichou, O.; Loverdo, C.; Moreau, M.; Voituriez, R.

    2011-01-01

    This review examines intermittent target search strategies, which combine phases of slow motion, allowing the searcher to detect the target, and phases of fast motion during which targets cannot be detected. It is first shown that intermittent search strategies are actually widely observed at various scales. At the macroscopic scale, this is, for example, the case of animals looking for food; at the microscopic scale, intermittent transport patterns are involved in a reaction pathway of DNA-binding proteins as well as in intracellular transport. Second, generic stochastic models are introduced, which show that intermittent strategies are efficient strategies that enable the minimization of search time. This suggests that the intrinsic efficiency of intermittent search strategies could justify their frequent observation in nature. Last, beyond these modeling aspects, it is proposed that intermittent strategies could also be used in a broader context to design and accelerate search processes.

  15. Gastric pseudolymphoma

    International Nuclear Information System (INIS)

    Blum, U.; Hellerich, U.; Bodendoerfer, G.; Wimmer, B.; Ruf, G.; Freiburg Univ.; Freiburg Univ.

    1989-01-01

    Gastric pseudolymphoma is an uncommon benign lesion which poses a difficult problem in diagnosis and management. Lymphoid hyperplasia of the stomach, however, may occasionally precede true gastric lymphoma. Endoscopic, radiologic and pathological findings are not generally helpful in establishing the diagnosis preoperatively. Benign gastric lymphoid hyperplasia could be mistaken radiologically for ulcerated gastric carcinoma and pathologically for malignant lymphoma. Recognition of this condition is important to prevent unnecessary treatment by surgery or radiotherapy. About 140 case reports have been published to date. This paper describes the cases of two further patients. (orig.) [de

  16. Hydrologic Outlets of the Greenland Ice Sheet

    Data.gov (United States)

    National Aeronautics and Space Administration — The Hydrologic Outlets of the Greenland Ice Sheet data set contains GIS point shapefiles that include 891 observed and potential hydrologic outlets of the Greenland...

  17. Gastric cancer

    International Nuclear Information System (INIS)

    Salek, T.

    2007-01-01

    Gastric cancer is still a major health problem and a leading cause of cancer mortality despite a worldwide decline in incidence. Primarily due to early detection of the disease, the results of treatment for gastric cancer have improved in Japan, Korea and several specialized Western centres. Surgery offers excellent long-term survival results for early gastric cancer (EGC). In the Western world, however more than 80 % of patients at diagnosis have an advanced gastric cancer with a poor prognosis. The aim of surgery is the complete removal of the tumour (UICC R0-resection), which is known to be the only proven, effective treatment modality and the most important treatmentrelated prognostic factor. The prognosis after surgical treatment of gastric cancer remains poor. Neoadjuvant chemotherapy is a rising option in locally advanced gastric cancer. Adjuvant chemoradiation has been shown to be beneficial in gastric cancer patients who have undergone suboptimal surgical resection. The benefits of adjuvant chemotherapy alone seem to be very small, Untreated metastatic gastric cancer is associated with a median survival of only 3 - 4 months, but this can be increased to 8 - 10 months, associated with improved quality of life, with combination chemotherapy. Currently, no standard combination chemotherapy regimen exists, although regimens utilizing both cisplatin and 5-fluorouracil, such as epirubicin/cisplatin/fluorouracil (ECF) or docetaxel/cisplatin/fluorouracil (DCF) are amongst the most active. Newer chemotherapeutic agents, including irinotecan, oxaliplatin and taxanes, show promising activity, and are currently being tested with biologics in clinical trials. (author)

  18. Intermittency in branching models

    International Nuclear Information System (INIS)

    Chiu, C.B.; Texas Univ., Austin; Hwa, R.C.; Oregon Univ., Eugene

    1990-01-01

    The intermittency properties of three branching models have been investigated. The factorial moments show power-law behavior as function of small rapidity width. The slopes and energy dependences reveal different characteristics of the models. The gluon model has the weakest intermittency. (orig.)

  19. Gastric volvulus following left pneumonectomy in an adolescent patient

    Directory of Open Access Journals (Sweden)

    Benjamin A. Farber

    2015-10-01

    Full Text Available Gastric volvulus is a rare post-pneumonectomy complication. Although it has been described previously, published cases are limited to an older patient population. We report the youngest case of postpneumonectomy gastric volvulus to date, occurring in an 18-year-old male with a history of inflammatory myofibroblastic pseudotumor who underwent left intrapericardial pneumonectomy, and presented 13 years later with chronic intermittent mesenteroaxial gastric volvulus. While postpneumonectomy gastric volvulus is a rare occurrence, it should remain in the differential diagnosis in postoperative thoracic surgical patients presenting with chest pain.

  20. Gastric Volvulus Following Left Pneumonectomy in an Adolescent Patient

    Science.gov (United States)

    Farber, Benjamin A.; Lim, Irene Isabel P.; Murphy, Jennifer M.; Price, Anita P.; Abramson, Sara J.; La Quaglia, Michael P.

    2015-01-01

    Gastric volvulus is a rare post-pneumonectomy complication. Although it has been described previously, published cases are limited to an older patient population. We report the youngest case of postpneumonectomy gastric volvulus to date, occurring in an 18-year-old male with a history of inflammatory myofibroblastic pseudotumor who underwent left intrapericardial pneumonectomy, and presented 13 years later with chronic intermittent mesenteroaxial gastric volvulus. While postpneumonectomy gastric volvulus is a rare occurrence, it should remain in the differential diagnosis in postoperative thoracic surgical patients presenting with chest pain. PMID:26504742

  1. Gastric lactobezoar - a rare disorder?

    Directory of Open Access Journals (Sweden)

    Heinz-Erian Peter

    2012-01-01

    Full Text Available Abstract Gastric lactobezoar, a pathological conglomeration of milk and mucus in the stomach of milk-fed infants often causing gastric outlet obstruction, is a rarely reported disorder (96 cases since its first description in 1959. While most patients were described 1975-1985 only 26 children have been published since 1986. Clinically, gastric lactobezoars frequently manifest as acute abdomen with abdominal distension (61.0% of 96 patients, vomiting (54.2%, diarrhea (21.9%, and/or a palpable abdominal mass (19.8%. Respiratory (23.0% and cardiocirculatory (16.7% symptoms are not uncommon. The pathogenesis of lactobezoar formation is multifactorial: exogenous influences such as high casein content (54.2%, medium chain triglycerides (54.2% or enhanced caloric density (65.6% of infant milk as well as endogenous factors including immature gastrointestinal functions (66.0%, dehydration (27.5% and many other mechanisms have been suggested. Diagnosis is easy if the potential presence of a gastric lactobezoar is thought of, and is based on a history of inappropriate milk feeding, signs of acute abdomen and characteristic features of diagnostic imaging. Previously, plain and/or air-, clear fluid- or opaque contrast medium radiography techniques were used to demonstrate a mass free-floating in the lumen of the stomach. This feature differentiates a gastric lactobezoar from intussusception or an abdominal neoplasm. Currently, abdominal ultrasound, showing highly echogenic intrabezoaric air trapping, is the diagnostic method of choice. However, identifying a gastric lactobezoar requires an investigator experienced in gastrointestinal problems of infancy as can be appreciated from the results of our review which show that in not even a single patient gastric lactobezoar was initially considered as a possible differential diagnosis. Furthermore, in over 30% of plain radiographs reported, diagnosis was initially missed although a lactobezoar was clearly

  2. Intermittent degradation and schizotypy

    Directory of Open Access Journals (Sweden)

    Matthew W. Roché

    2015-06-01

    Full Text Available Intermittent degradation refers to transient detrimental disruptions in task performance. This phenomenon has been repeatedly observed in the performance data of patients with schizophrenia. Whether intermittent degradation is a feature of the liability for schizophrenia (i.e., schizotypy is an open question. Further, the specificity of intermittent degradation to schizotypy has yet to be investigated. To address these questions, 92 undergraduate participants completed a battery of self-report questionnaires assessing schizotypy and psychological state variables (e.g., anxiety, depression, and their reaction times were recorded as they did so. Intermittent degradation was defined as the number of times a subject’s reaction time for questionnaire items met or exceeded three standard deviations from his or her mean reaction time after controlling for each item’s information processing load. Intermittent degradation scores were correlated with questionnaire scores. Our results indicate that intermittent degradation is associated with total scores on measures of positive and disorganized schizotypy, but unrelated to total scores on measures of negative schizotypy and psychological state variables. Intermittent degradation is interpreted as potentially derivative of schizotypy and a candidate endophenotypic marker worthy of continued research.

  3. Hereditary Diffuse Gastric Cancer

    Science.gov (United States)

    ... Hereditary Diffuse Gastric Cancer Request Permissions Hereditary Diffuse Gastric Cancer Approved by the Cancer.Net Editorial Board , 10/2017 What is hereditary diffuse gastric cancer? Hereditary diffuse gastric cancer (HDGC) is a rare ...

  4. Intermittent Explosive Disorder

    Directory of Open Access Journals (Sweden)

    Lut Tamam

    2011-09-01

    Full Text Available Intermittent explosive disorder is an impulse control disorder characterized by the occurrence of discrete episodes of failure to resist aggressive impulses that result in violent assault or destruction of property. Though the prevalence intermittent explosive disorder has been reported to be relatively rare in frontier studies on the field, it is now common opinion that intermittent explosive disorder is far more common than previously thought especially in clinical psychiatry settings. Etiological studies displayed the role of both psychosocial factors like childhood traumas and biological factors like dysfunctional neurotransmitter systems and genetics. In differential diagnosis of the disorder, disorders involving agression as a symptom such as alcohol and drug intoxication, antisocial and borderline personality disorders, personality changes due to general medical conditions and behavioral disorder should be considered. A combination of pharmacological and psychotherapeutic approaches are suggested in the treatment of the disorder. This article briefly reviews the historical background, diagnostic criteria, epidemiology, etiology and treatment of intermittent explosive disorder.

  5. Intermittent heating of buildings

    Energy Technology Data Exchange (ETDEWEB)

    Kohonen, K

    1983-02-01

    Conditions for intermittent heating of buildings are considered both theoretically and experimentally. Thermal behaviour of buildings adn rooms in intermittent heating is simulated by a program based on the convective heat balance equation and by simplified RC-models. The preheat times and the heating energy savings compared with continuous heating are presented for typical lightweight, mediumweight and heavyweight classroom and office modules. Formulaes for estimating the oversizing of the radiator network, the maximum heat output of heat exchangers in district heating and the efficiency of heating boilers in intermittent heating are presented. The preheat times and heating energy savings with different heating control systems are determined also experimentally in eight existing buildings. In addition some principles for the planning and application of intermittent heating systems are suggested.

  6. Optimal intermittent search strategies

    International Nuclear Information System (INIS)

    Rojo, F; Budde, C E; Wio, H S

    2009-01-01

    We study the search kinetics of a single fixed target by a set of searchers performing an intermittent random walk, jumping between different internal states. Exploiting concepts of multi-state and continuous-time random walks we have calculated the survival probability of a target up to time t, and have 'optimized' (minimized) it with regard to the transition probability among internal states. Our model shows that intermittent strategies always improve target detection, even for simple diffusion states of motion

  7. Intelligent electrical outlet for collective load control

    Science.gov (United States)

    Lentine, Anthony L.; Ford, Justin R.; Spires, Shannon V.; Goldsmith, Steven Y.

    2015-10-27

    Various technologies described herein pertain to an electrical outlet that autonomously manages loads in a microgrid. The electrical outlet can provide autonomous load control in response to variations in electrical power generation supply in the microgrid. The electrical outlet includes a receptacle, a sensor operably coupled to the receptacle, and an actuator configured to selectively actuate the receptacle. The sensor measures electrical parameters at the receptacle. Further, a processor autonomously controls the actuator based at least in part on the electrical parameters measured at the receptacle, electrical parameters from one or more disparate electrical outlets in the microgrid, and a supply of generated electric power in the microgrid at a given time.

  8. Socioeconomic determinants of exposure to alcohol outlets.

    Science.gov (United States)

    Morrison, Christopher; Gruenewald, Paul J; Ponicki, William R

    2015-05-01

    Alcohol outlets tend to be located in lower income areas, exposing lower income populations to excess risks associated with alcohol sales through these establishments. The objective of this study was to test two hypotheses about the etiology of these differential exposures based on theories of the economic geography of retail markets: (a) outlets will locate within or near areas of high alcohol demand, and (b) outlets will be excluded from areas with high land and structure rents. Data from the 2010 National Drug Strategy Household Survey were used to develop a surrogate for alcohol demand (i.e., market potential) at two census geographies for the city of Melbourne, Australia. Bayesian conditional autoregressive Poisson models estimated multilevel spatial relationships between counts of bars, restaurants, and off-premise outlets and market potential, income, and zoning ordinances (Level 1: n = 8,914). Market potentials were greatest in areas with larger older age, male, English-speaking, high-income populations. Independent of zoning characteristics, greater numbers of outlets appeared in areas with greater market potentials and the immediately surrounding areas. Greater income excluded outlets in local and surrounding areas. These findings are consistent with the hypothesis that alcohol outlets are located in areas with high demand and are excluded from high-income areas. These processes appear to take place at relatively small geographic scales, encourage the concentration of outlets in specific low-income areas, and represent a very general economic process likely to take place in communities throughout the world.

  9. Gastric emptying of a physiologic mixed solid-liquid meal

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, R.S.; Malmud, L.S.; Bandini, P.; Rock, E.

    1982-05-01

    The purposes of this study were to use a noninvasive scintigraphic technique to measure gastric emptying of liquids and solids simultaneously, to study the interactions between emptying of the liquid and solid components of meals in normal subjects, and to employ dual isotope gastric scintigraphy to evaluate gastric emptying of liquids and solids in patients with clinical evidence of gastric outlet obstruction. The solid component of the test meal consisted of chicken liver, labeled in vivo with /sup 99m/Tc sulfur colloid, and the liquid component was water mixed with /sup 111/In DTPA. The rates of emptying were quantitated using a gamma camera on line to a digital computer. Twenty normal subjects were studied using this combined solid-liquid meal. Ten of them also ingested a liquid meal alone and ten a solid meal alone. Liquid emptied from the stomach significantly more rapidly than did solids. The emptying curve for liquids was exponential compared to a linear emptying curve for solids. The gastric emptying rate of the liquid component was slowed significantly by simultaneous ingestion of solids, but the emptying rate of solids was not affected by liquids. Several patients with clinical gastric outlet obstruction were evaluated. Both combined and selective abnormalities for gastric emptying of liquids and solids were demonstrated.

  10. Gastric emptying

    International Nuclear Information System (INIS)

    Bonaz, B.; Hostein, J.; Caravel, J.P.

    1990-01-01

    Gastric emptying (GE) of nutriments is a major function of the stomach. GE disorders are observed after gastric surgery and with various diseases, either of a strictly gastroenterologic kind or interesting other specialities (especially diabetes mellitus). Scintigraphy, which has allowed a better knowledge of GE physiological and pathological mechanisms, has now become the reference method for studying the emptying of solids and liquids. In a near future, it could well have two major applications: a diagnostic approach of functional digestive disorders and an assessment of the various effects of pharmacological drugs with digestive affinity [fr

  11. Gastric cancer

    International Nuclear Information System (INIS)

    Mineur, L.; Jaegle, E.; Pointreau, Y.; Denis, F.

    2010-01-01

    Radio-chemotherapy Gastro-intestinal inter-group study have demonstrated a convincing local control and overall survival benefit. Oncologists and GI workshops have in the present not had a major interest in the radiotherapy treatment of gastric cancer due to a number of factors. Primary because toxicities may be severe, second physicians may have low experience in definition of clinical target volume and in third perioperative chemotherapy is widely used in this indication. In Summary this issue should be used as guides for defining appropriate radiation planning treatment for the adjuvant postoperative therapy of gastric cancer. (authors)

  12. Optimal intermittent search strategies

    Energy Technology Data Exchange (ETDEWEB)

    Rojo, F; Budde, C E [FaMAF, Universidad Nacional de Cordoba, Ciudad Universitaria, X5000HUA Cordoba (Argentina); Wio, H S [Instituto de Fisica de Cantabria, Universidad de Cantabria and CSIC E-39005 Santander (Spain)

    2009-03-27

    We study the search kinetics of a single fixed target by a set of searchers performing an intermittent random walk, jumping between different internal states. Exploiting concepts of multi-state and continuous-time random walks we have calculated the survival probability of a target up to time t, and have 'optimized' (minimized) it with regard to the transition probability among internal states. Our model shows that intermittent strategies always improve target detection, even for simple diffusion states of motion.

  13. Intermittency and random matrices

    Science.gov (United States)

    Sokoloff, Dmitry; Illarionov, E. A.

    2015-08-01

    A spectacular phenomenon of intermittency, i.e. a progressive growth of higher statistical moments of a physical field excited by an instability in a random medium, attracted the attention of Zeldovich in the last years of his life. At that time, the mathematical aspects underlying the physical description of this phenomenon were still under development and relations between various findings in the field remained obscure. Contemporary results from the theory of the product of independent random matrices (the Furstenberg theory) allowed the elaboration of the phenomenon of intermittency in a systematic way. We consider applications of the Furstenberg theory to some problems in cosmology and dynamo theory.

  14. A Rare Complication of Hyperplastic Gastric Polyp

    Directory of Open Access Journals (Sweden)

    Suresh Kumar Nayudu

    2013-01-01

    Full Text Available Hyperplastic gastric polyps are incidentally diagnosed during upper gastrointestinal endoscopy. They are known to cause gastric outlet obstruction and chronic blood loss leading to iron deficiency anemia. However, hyperplastic gastric polyp presenting as acute severe upper gastrointestinal bleeding is very rare. To the best of our knowledge, there have been two cases of hyperplastic gastric polyps presenting as acute gastrointestinal bleeding in the medical literature. We present a case of a 56-year-old African American woman who was admitted to our hospital with symptomatic anemia and sepsis. The patient developed acute upper gastrointestinal bleeding during her hospital stay. She underwent emergent endoscopy, but bleeding could not be controlled. She underwent emergent laparotomy and wedge resection to control the bleeding. Biopsy of surgical specimen was reported as hyperplastic gastric polyp. We recommend that physicians should be aware of this rare serious complication of hyperplastic gastric polyps as endoscopic polypectomy has diagnostic and therapeutic benefits in preventing future complications including bleeding.

  15. Intermittent Testicular Torsion

    African Journals Online (AJOL)

    2017-06-02

    Jun 2, 2017 ... had prior episodes of testicular pain, suggesting that they may have had intermittent torsion before .... None of the patients had antecedent history of sexual exposure, fever, or urinary tract infection .... torsion of the spermatic cord portends an increased risk of acute testicular infarction. J Urol 2008;180 4 ...

  16. Socioeconomic Determinants of Exposure to Alcohol Outlets

    Science.gov (United States)

    Morrison, Christopher; Gruenewald, Paul J.; Ponicki, William R.

    2015-01-01

    Objective: Alcohol outlets tend to be located in lower income areas, exposing lower income populations to excess risks associated with alcohol sales through these establishments. The objective of this study was to test two hypotheses about the etiology of these differential exposures based on theories of the economic geography of retail markets: (a) outlets will locate within or near areas of high alcohol demand, and (b) outlets will be excluded from areas with high land and structure rents. Method: Data from the 2010 National Drug Strategy Household Survey were used to develop a surrogate for alcohol demand (i.e., market potential) at two census geographies for the city of Melbourne, Australia. Bayesian conditional autoregressive Poisson models estimated multilevel spatial relationships between counts of bars, restaurants, and off-premise outlets and market potential, income, and zoning ordinances (Level 1: n = 8,914). Results: Market potentials were greatest in areas with larger older age, male, English-speaking, high-income populations. Independent of zoning characteristics, greater numbers of outlets appeared in areas with greater market potentials and the immediately surrounding areas. Greater income excluded outlets in local and surrounding areas. Conclusions: These findings are consistent with the hypothesis that alcohol outlets are located in areas with high demand and are excluded from high-income areas. These processes appear to take place at relatively small geographic scales, encourage the concentration of outlets in specific low-income areas, and represent a very general economic process likely to take place in communities throughout the world. PMID:25978830

  17. Gastric Sleeve Surgery

    Science.gov (United States)

    ... Videos for Educators Search English Español Gastric Sleeve Surgery KidsHealth / For Teens / Gastric Sleeve Surgery What's in ... or buying healthy food ) Preparing for Gastric Sleeve Surgery Preparing for this major operation takes months of ...

  18. Alcohol outlets, social disorganization, and robberies: accounting for neighborhood characteristics and alcohol outlet types.

    Science.gov (United States)

    Snowden, Aleksandra J; Freiburger, Tina L

    2015-05-01

    We estimated spatially lagged regression and spatial regime models to determine if the variation in total, on-premise, and off-premise alcohol outlet(1) density is related to robbery density, while controlling for direct and moderating effects of social disorganization.(2) Results suggest that the relationship between alcohol outlet density and robbery density is sensitive to the measurement of social disorganization levels. Total alcohol outlet density and off-premise alcohol outlet density were significantly associated with robbery density when social disorganization variables were included separately in the models. However, when social disorganization levels were captured as a four item index, only the association between off-premise alcohol outlets and robbery density remained significant. More work is warranted in identifying the role of off-premise alcohol outlets and their characteristics in robbery incidents. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. MRI of thoracic outlet syndrome in children

    Energy Technology Data Exchange (ETDEWEB)

    Chavhan, Govind B.; Batmanabane, Vaishnavi [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Toronto, ON (Canada); Muthusami, Prakash [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Toronto, ON (Canada); The Hospital for Sick Children, Division of Image Guided Therapy, Department of Diagnostic Imaging, Toronto, ON (Canada); Towbin, Alexander J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology and Medical Imaging, Cincinnati, OH (United States); Borschel, Gregory H. [The Hospital for Sick Children and University of Toronto, Division of Plastic Surgery, Department of Pediatric Surgery, Toronto, ON (Canada)

    2017-09-15

    Thoracic outlet syndrome is caused by compression of the neurovascular bundle as it passes from the upper thorax to the axilla. The neurovascular bundle can be compressed by bony structures such as the first rib, cervical ribs or bone tubercles, or from soft-tissue abnormalities like a fibrous band, muscle hypertrophy or space-occupying lesion. Thoracic outlet syndrome commonly affects young adults but can be seen in the pediatric age group, especially in older children. Diagnosis is based on a holistic approach encompassing clinical features, physical examination findings including those triggered by various maneuvers, electromyography, nerve conduction studies and imaging. Imaging is performed to confirm the diagnosis, exclude mimics and classify thoracic outlet syndrome into neurogenic, arterial, venous or mixed causes. MRI and MR angiography are useful in this process. A complete MRI examination for suspected thoracic outlet syndrome should include the assessment of anatomy and any abnormalities using routine sequences, vessel assessment with the arms in adduction by MR angiography and assessment of dynamic compression of vessels with abduction of the arms. The purpose of this paper is to describe the anatomy of the thoracic outlet, causes of thoracic outlet syndrome, the MR imaging techniques used in its diagnosis and the principles of image interpretation. (orig.)

  20. MRI of thoracic outlet syndrome in children

    International Nuclear Information System (INIS)

    Chavhan, Govind B.; Batmanabane, Vaishnavi; Muthusami, Prakash; Towbin, Alexander J.; Borschel, Gregory H.

    2017-01-01

    Thoracic outlet syndrome is caused by compression of the neurovascular bundle as it passes from the upper thorax to the axilla. The neurovascular bundle can be compressed by bony structures such as the first rib, cervical ribs or bone tubercles, or from soft-tissue abnormalities like a fibrous band, muscle hypertrophy or space-occupying lesion. Thoracic outlet syndrome commonly affects young adults but can be seen in the pediatric age group, especially in older children. Diagnosis is based on a holistic approach encompassing clinical features, physical examination findings including those triggered by various maneuvers, electromyography, nerve conduction studies and imaging. Imaging is performed to confirm the diagnosis, exclude mimics and classify thoracic outlet syndrome into neurogenic, arterial, venous or mixed causes. MRI and MR angiography are useful in this process. A complete MRI examination for suspected thoracic outlet syndrome should include the assessment of anatomy and any abnormalities using routine sequences, vessel assessment with the arms in adduction by MR angiography and assessment of dynamic compression of vessels with abduction of the arms. The purpose of this paper is to describe the anatomy of the thoracic outlet, causes of thoracic outlet syndrome, the MR imaging techniques used in its diagnosis and the principles of image interpretation. (orig.)

  1. Quasistatic Dynamics with Intermittency

    International Nuclear Information System (INIS)

    Leppänen, Juho; Stenlund, Mikko

    2016-01-01

    We study an intermittent quasistatic dynamical system composed of nonuniformly hyperbolic Pomeau–Manneville maps with time-dependent parameters. We prove an ergodic theorem which shows almost sure convergence of time averages in a certain parameter range, and identify the unique physical family of measures. The theorem also shows convergence in probability in a larger parameter range. In the process, we establish other results that will be useful for further analysis of the statistical properties of the model.

  2. Quasistatic Dynamics with Intermittency

    Energy Technology Data Exchange (ETDEWEB)

    Leppänen, Juho; Stenlund, Mikko, E-mail: mikko.stenlund@helsinki.fi [University of Helsinki, Department of Mathematics and Statistics (Finland)

    2016-06-15

    We study an intermittent quasistatic dynamical system composed of nonuniformly hyperbolic Pomeau–Manneville maps with time-dependent parameters. We prove an ergodic theorem which shows almost sure convergence of time averages in a certain parameter range, and identify the unique physical family of measures. The theorem also shows convergence in probability in a larger parameter range. In the process, we establish other results that will be useful for further analysis of the statistical properties of the model.

  3. 14 CFR 23.977 - Fuel tank outlet.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fuel tank outlet. 23.977 Section 23.977... tank outlet. (a) There must be a fuel strainer for the fuel tank outlet or for the booster pump. This... damage any fuel system component. (b) The clear area of each fuel tank outlet strainer must be at least...

  4. A Mimicker of Gallbladder Carcinoma: Cystic Gastric Heterotopia with Intestinal Metaplasia

    Directory of Open Access Journals (Sweden)

    Gonca ÖZGÜN

    2017-01-01

    Full Text Available Heterotopic gastric mucosa in the gallbladder is an unusual entity and is usually clinically silent. We report a 75-year-old female patient who presented with intermittent upper abdomial pain radiating to the back. Abdominal imaging studies showed a sessile polypoid lesion and a gallstone in the gallbladder. Gallbladder carcinoma was suspected and cholecystectomy performed. Intraoperative frozen section examination suggested mucinous tumor, suspicious for malignancy. However, the permanent sections revealed aberrant gastric tissue consisted of gastric pyloric and fundic glands of heterotopic gastric mucosa with intestinal metaplasia in the gallbladder.

  5. A Mimicker of Gallbladder Carcinoma: Cystic Gastric Heterotopia with Intestinal Metaplasia.

    Science.gov (United States)

    Özgün, Gonca; Adim, Şaduman Balaban; Uğraş, Nesrin; Kiliçturgay, Sadık

    2017-01-01

    Heterotopic gastric mucosa in the gallbladder is an unusual entity and is usually clinically silent. We report a 75-year-old female patient who presented with intermittent upper abdomial pain radiating to the back. Abdominal imaging studies showed a sessile polypoid lesion and a gallstone in the gallbladder. Gallbladder carcinoma was suspected and cholecystectomy performed. Intraoperative frozen section examination suggested mucinous tumor, suspicious for malignancy. However, the permanent sections revealed aberrant gastric tissue consisted of gastric pyloric and fundic glands of heterotopic gastric mucosa with intestinal metaplasia in the gallbladder.

  6. Intermittency in Complex Flows

    Science.gov (United States)

    Ben Mahjoub, Otman; Redondo, Jose M.

    2017-04-01

    Experimental results of the complex turbulent wake of a cilinder in 2D [1] and 3D flows [2] were used to investigate the scaling of structure functions, similar research was also performed on wave propagation and breaking in the Ocean [3], in the the stratified Atmosphere (ABL) [4] and in a 100large flume (UPC) for both regular and irregular waves, where long time series of waves propagating and generating breaking turbulence velocity rms and higher order measurements were taken in depth. [3,5] by means of a velocimeter SONTEK3-D. The probability distribution functions of the velocity differences and their non Gaussian distribution related to the energy spectrum indicate that irregularity is an important source of turbulence. From Kolmogorov's K41 and K61 intermittency correction: the p th-order longitudinal velocity structure function δul at scale l in the inertial range of three-dimensional fully developed turbulence is related by ⟨δup⟩ = ⟨(u(x+ l)- u(x))p⟩ ˜ ɛp0/3lp/3 l where ⟨...⟩ represents the spatial average over flow domain, with ɛ0 the mean energy dissipation per unit mass and l is the separation distance. The importance of the random nature of the energy dissipation led to the K62 theory of intermittency, but locality and non-homogeneity are key issues. p p/3 p/3 ξd ⟨δul⟩ ˜ ⟨ɛl ⟩l ˜ l and ξp = p 3 + τp/3 , where now ɛl is a fractal energy dissipation at scale l, τp/3 is the scaling of and ξp is the scaling exponent of the velocity structure function of order p. Both in K41 and K62, the structure functions of third order related to skewness is ξ3 = 1. But this is not true either. We show that scaling exponents ξp do deviate from early studies that only investigated homogeneous turbulence, where a large inertial range dominates. The use of multi-fractal analysis and improvements on Structure function calculations on standard Enhanced mixing is an essential property of turbulence and efforts to alter and to control

  7. Intermittency in nuclear multifragmentation

    International Nuclear Information System (INIS)

    Ploszajczak, M.; Tucholski, A.

    1990-07-01

    Fluctuations of the fragment size distribution in a percolation model and in nuclear multifragmentation following the breakup of high energy nuclei in the nuclear emulsion are studied using the method of scaled factorial moments. An intermittent patern of fluctuations is found in the data as well as in the percolation lattice calculation. This is a consequence of both a self-similarity in the fragment size distribution and a random character for the scaling law. These fluctuations are in general well-described by percolation model. The multifractal dimensions are calculated and their relevance to the study of possible critical behaviour is pointed out. (orig.)

  8. Multidimensional intermittency in hadronic collisions

    International Nuclear Information System (INIS)

    Pan, J.; Hwa, R.C.

    1992-06-01

    The study of intermittency in high-energy hadronic collisions by the Monte Carlo code ECCO is extended to 3-dimensional phase space. Strong intermittency is found in agreement with the data. Fluctuation in the impact parameter is responsible for the intermittency in lnp T , and the transverse-momentum conservation leads to negative intermittency slopes in the azimuthal angle φ. The Ochs-Wosiek plots are linear in all dimensions having universal slopes. An exponent ν = 1.448 emerges to characterize multiparticle production in pp collisions. The properties of G moments are also examined, and the fractal dimensions determined

  9. Double-outlet right ventricle revisited.

    Science.gov (United States)

    Ebadi, Ameneh; Spicer, Diane E; Backer, Carl L; Fricker, F Jay; Anderson, Robert H

    2017-08-01

    Double-outlet right ventricle is a form of ventriculoarterial connection. The definition formulated by the International Society for Nomenclature of Paediatric and Congenital Heart Disease is based on hearts with both arterial trunks supported in their greater part by a morphologically right ventricle. Bilateral infundibula and ventricular septal defects are highly debated criteria. This study examines the anatomic controversies surrounding double-outlet right ventricle. We show that hearts with double-outlet right ventricle can have atrioventricular-to-arterial valvular continuity. We emphasize the difference between the interventricular communication and the zone of deficient ventricular septation. The hearts examined were from the University of Florida in Gainesville; Johns Hopkins All Children's Hospital, St Petersburg, Fla; and Lurie Children's Hospital, Chicago, Ill. Each specimen had at least 75% of both arterial roots supported by the morphologically right ventricle, with a total of 100 hearts examined. The morphologic method was used to assess anatomic features, including arterial-atrioventricular valvular continuity, subarterial infundibular musculature, and the location of the hole between the ventricles. Most hearts had fibrous continuity between one of the arterial valves and an atrioventricular valve, with bilateral infundibula in 23%, and intact ventricular septum in 5%. Bilateral infundibula are not a defining feature of double-outlet right ventricle, representing only 23% of the specimens in our sample. The interventricular communication can have a posteroinferior muscular rim or extend to become perimembranous (58%). Double-outlet right ventricle can exist with an intact ventricular septum. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

  10. Delayed diagnosis of intermittent mesenteroaxial volvulus of the stomach by computed tomography: a case report

    Directory of Open Access Journals (Sweden)

    Woon Colin

    2008-11-01

    Full Text Available Abstract Introduction Gastric volvulus is a rare condition. Presenting acutely, mesenteroaxial gastric volvulus has characteristic symptoms and may be easily detected with upper gastrointestinal contrast studies. In contrast, subacute, intermittent cases present with intermittent vague symptoms from episodic twisting and untwisting. Imaging in these cases is only useful if performed in the symptomatic interval. Case presentation We describe a patient with a long history of intermittent chest and epigastric pain. An earlier barium meal was not diagnostic. Diagnosis was finally secured during the current admission by a combination of (1 serum investigations, (2 endoscopy, and finally (3 computed tomography. Conclusion Non-specific and misleading symptoms and signs may delay the diagnosis of intermittent, subacute volvulus. Imaging studies performed in the well interval may be non-diagnostic. Elevated creatine kinase and aldolase of a non-cardiac cause and endoscopic findings of ischaemic ulceration and difficulty in negotiating the pylorus may raise the suspicion of gastric volvulus. In this case, abdominal computed tomography with spatial reconstruction was crucial in securing the final diagnosis.

  11. Metabolic Effects of Intermittent Fasting.

    Science.gov (United States)

    Patterson, Ruth E; Sears, Dorothy D

    2017-08-21

    The objective of this review is to provide an overview of intermittent fasting regimens, summarize the evidence on the health benefits of intermittent fasting, and discuss physiological mechanisms by which intermittent fasting might lead to improved health outcomes. A MEDLINE search was performed using PubMed and the terms "intermittent fasting," "fasting," "time-restricted feeding," and "food timing." Modified fasting regimens appear to promote weight loss and may improve metabolic health. Several lines of evidence also support the hypothesis that eating patterns that reduce or eliminate nighttime eating and prolong nightly fasting intervals may result in sustained improvements in human health. Intermittent fasting regimens are hypothesized to influence metabolic regulation via effects on (a) circadian biology, (b) the gut microbiome, and (c) modifiable lifestyle behaviors, such as sleep. If proven to be efficacious, these eating regimens offer promising nonpharmacological approaches to improving health at the population level, with multiple public health benefits.

  12. Fate in intermittent claudication

    DEFF Research Database (Denmark)

    Jelnes, Rolf; Gaardsting, O; Hougaard Jensen, K

    1986-01-01

    , or an ankle/arm pressure index below 50% were individually significantly associated with progression of the arteriosclerotic disease. These findings show the importance of peripheral blood pressure measurements in the management of patients with intermittent claudication due to arteriosclerotic disease........ The rate of clinical progression of the arteriosclerotic disease (that is, rest pain or gangrene) of the worst affected leg was 7.5% in the first year after referral. Thereafter the rate was 2.2% a year. An ankle systolic blood pressure below 70 mm Hg, a toe systolic blood pressure below 40 mm Hg...... 113 of the patients (44%) had died. Causes of death were no different from those in the general population. Mortality was twice that of the general population matched for age and sex. Mortality among the men was twice that among the women. In men under 60 mortality was four times that expected...

  13. Autoimmunity and Gastric Cancer

    Science.gov (United States)

    Bizzaro, Nicola; Antico, Antonio; Villalta, Danilo

    2018-01-01

    Alterations in the immune response of patients with autoimmune diseases may predispose to malignancies, and a link between chronic autoimmune gastritis and gastric cancer has been reported in many studies. Intestinal metaplasia with dysplasia of the gastric corpus-fundus mucosa and hyperplasia of chromaffin cells, which are typical features of late-stage autoimmune gastritis, are considered precursor lesions. Autoimmune gastritis has been associated with the development of two types of gastric neoplasms: intestinal type and type I gastric carcinoid. Here, we review the association of autoimmune gastritis with gastric cancer and other autoimmune features present in gastric neoplasms. PMID:29373557

  14. 49 CFR 178.345-11 - Tank outlets.

    Science.gov (United States)

    2010-10-01

    ... unloading of lading, as distinguished from outlets such as manhole covers, vents, vapor recovery devices... away from the loading/unloading outlet. The actuating mechanism must be corrosion-resistant and...

  15. Hydrologic Outlets of the Greenland Ice Sheet, Version 1

    Data.gov (United States)

    National Aeronautics and Space Administration — The Hydrologic Outlets of the Greenland Ice Sheet data set contains GIS point shapefiles that include 891 observed and potential hydrologic outlets of the Greenland...

  16. Stomach (Gastric) Cancer Screening

    Science.gov (United States)

    ... Stomach Cancer Prevention Stomach Cancer Screening Research Stomach (Gastric) Cancer Screening (PDQ®)–Patient Version What is screening? Go ... are called diagnostic tests . General Information About Stomach (Gastric) Cancer Key Points Stomach cancer is a disease in ...

  17. Power source with spark-safe outlet

    Energy Technology Data Exchange (ETDEWEB)

    Tsesarenko, N P; Alekhin, A V

    1982-01-01

    The invention refers to the technique of electrical monitoring and control in systems operating in a spark-safe medium (for example, in coal mines). A more accurate area of application is mobile objects with autonomous source of electricity (mine diesel locomotives, battery electric locomotives etc.). The purpose of the invention is to simplify and to improve the reliability of the planned device, and also to expand the area of application for conditions when it is powered from an autonomous generator of direct voltage. This goal is achieved because the power source with spark-safe outlet (the source contains a thyristor of advance disconnection, connected by anode to the delimiting throttle, one outlet of which is connected to the capacitor included between the controlling electrode and the anode of the thyristor, and the capacitor is connected through the resistor parallel to the outlet clamps of the source, while the thyristor of emergency protection connected parallel to the inlet clamps of the power source) is additionally equipped with a current sensor, hercon, transistor key (included in series in the power circuit) and optron, whose emitter is connected parallel to the current sensor connected in series to the inlet of the power source, while the receiver of the optron is connected in a circuit for controlling the thyristor of emergency protection. Hercon is built into the core of the delimiting throttle and is connected to the circuit for controlling the transistor key.

  18. Naftidrofuryl for intermittent claudication.

    Science.gov (United States)

    De Backer, T L M; Vander Stichele, R; Lehert, P; Van Bortel, L

    2008-04-16

    Lifestyle changes and cardiovascular prevention measures are a primary treatment for intermittent claudication (IC). Symptomatic treatment with vasoactive agents (Anatomic Therapeutic Chemical Classification (ATC) for medicines from the World Health Organisation class CO4A) is controversial. To evaluate evidence on the efficacy and safety of oral naftidrofuryl (ATC CO4 21) versus placebo on the pain-free walking distance (PFWD) of people with IC by using a meta-analysis based on individual patient data (IPD). The Cochrane Peripheral Vascular Diseases Group searched their Trials Register (last searched December 2007) and CENTRAL (last searched 2007, Issue 4). We searched MEDLINE, EMBASE, International Pharmaceutical Abstracts, the Science Citation Index and contacted the authors and checked the reference lists of retrieved articles. We asked the manufacturing company for IPD. We included only randomized controlled trials (RCTs) with low or moderate risk of bias for which the IPD were available. We collected data from the electronic data file or from the case report form and checked the data by a statistical quality control procedure. All randomized patients were analyzed following the intention-to-treat (ITT) principle. The geometric mean of the relative improvement in PFWD was calculated for both treatment groups in all identified studies. The effect of the drug was assessed compared with placebo on final walking distance (WDf) using multilevel and random-effect models and adjusting for baseline walking distance (WD0). For the responder analysis, therapeutic success was defined as an improvement of walking distance of at least 50%. We included seven studies in the IPD (n = 1266 patients). One of these studies (n = 183) was only used in the sensitivity analysis so that the main analysis included 1083 patients. The ratio of the relative improvement in PFWD (naftidrofuryl compared with placebo) was 1.37 (95% confidence interval (CI) 1.32 to 1.51, P < 0.001). The

  19. Gastric and intestinal surgery.

    Science.gov (United States)

    Fossum, Theresa W; Hedlund, Cheryl S

    2003-09-01

    Gastric surgery is commonly performed to remove foreign bodies and correct gastric dilatation-volvulus and is less commonly performed to treat gastric ulceration or erosion, neoplasia, and benign gastric outflow obstruction. Intestinal surgery, although commonly performed by veterinarians, should never be considered routine. The most common procedures of the small intestinal tract performed in dogs and cats include enterotomy and resection/anastomosis. Surgery of the large intestine is indicated for lesions causing obstruction, perforations, colonic inertia, or chronic inflammation.

  20. Analysis of the Sales Promotion in Choice Retail Outlet

    OpenAIRE

    HUMPOLCOVÁ, Michaela

    2010-01-01

    My bachelor thesis is aimed at sales promotion in a retail outlet. The main aim of this thesis is evaluate the current state of sales promotion in a selected retail outlet and based on the analysis of the current state of sales promotion in the outlet to try to propose some measures of improve.

  1. 14 CFR 25.977 - Fuel tank outlet.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fuel tank outlet. 25.977 Section 25.977... STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Fuel System § 25.977 Fuel tank outlet. (a) There must be a fuel strainer for the fuel tank outlet or for the booster pump. This strainer must— (1) For...

  2. 14 CFR 29.977 - Fuel tank outlet.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fuel tank outlet. 29.977 Section 29.977... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Fuel System § 29.977 Fuel tank outlet. (a) There must be a fuel strainer for the fuel tank outlet or for the booster pump. This strainer must— (1) For...

  3. 14 CFR 27.977 - Fuel tank outlet.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fuel tank outlet. 27.977 Section 27.977... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Fuel System § 27.977 Fuel tank outlet. (a) There must be a fuel stainer for the fuel tank outlet or for the booster pump. This strainer must— (1) For...

  4. Alcohol Outlet Density and Intimate Partner Violence in a Nonmetropolitan College Town: Accounting for Neighborhood Characteristics and Alcohol Outlet Types.

    Science.gov (United States)

    Snowden, Aleksandra J

    2016-01-01

    There is a growing evidence of an ecological association between alcohol outlet density and intimate partner violence. It is reasonable to assume, however, that not all types of alcohol outlets contribute equally to criminal behavior, and to date, most ecological studies have been of large urban cities. Using Bloomington, Indiana, block groups as units of analysis and controlling for several structural characteristics associated with violence rates, I estimated spatially lagged regression models to determine if the variation in alcohol outlet density, including total outlets and disaggregating by on- and off-premise outlets, is related to intimate partner violence density. Results suggested that total alcohol outlet density and off-premise alcohol outlet density were significantly associated with intimate partner violence density. On-premise alcohol outlet density was not significantly associated with intimate partner violence density. These results not only extend the geographic scope of this relationship beyond large metropolitan areas but also have important policy implications.

  5. Intermedia and Intermittency

    Directory of Open Access Journals (Sweden)

    Veres Bálint

    2014-12-01

    Full Text Available It is commonly known that medial reflections have been initiated by attempts to secure the borders of discrete medial forms and to define the modus operandi of each essentialized medial area. Later on, the focus of study has shifted to plurimedial formations and the interactions between predefined medial genres. In the last few decades, taxonomic approaches to various multi-, inter-, and transmedial phenomena dominated the discussions, which offered invaluable support in mapping the terrain, but at the same time hindered the analysis of the ephemeral, time-dependent aspects of plurimedial operations. While we explore the properties of each medial configuration, we lose sight of the actual historical drivers that produce ever-new configurations. My thesis is that any discourse on intermediality should be paralleled by a discourse on cultural intermittency, and consequently, media studies should involve an approach that focuses on the “ecosystem” of the constantly renewing media configurations from the point of view of their vitalizing potential and capability to trigger heightened experiences. This approach draws much inspiration from K. Ludwig Pfeiffer’s media anthropology that gives orientation in my paper.

  6. Stratification in SNR-300 outlet plenum

    International Nuclear Information System (INIS)

    Reinders, R.

    1983-01-01

    In the inner outlet plenum of the SNR-300 under steady state conditions a large toroidal vortex is expected. The main flow passes through the gap between dipplate and shield vessel to the outer annular space. Only 3% of the flow pass the 24 emergency cooling holes, situated in the shield vessel. The sodium leaves the reactor tank through the 3 symmetrically arranged outlet nozzles. For a scram flow rates and temperatures are decreased simultaneously, so it is expected, that stratification occurs in the inner outlet plenum. A measure of stratification effects is the Archimedes Number Ar, which is the relation of buoyancy forces (negative) to kinetic energy. (The Archimedes Number is nearly identical with the Richardson Number). For values Ar>1 stratification can occur. Under the assumption of stratification the code TIRE was developed, which is only applicable for the period of time after some 50 sec after scram. This code serves for long term calculations. As the equations are very simple, it is a very fast code which gives the possibility to calculate transients for some hours real time. This code mainly has to take into account the pressure difference between inner plenum and outlet annulus caused by geodatic pressure. That force is in equilibrium with the pressure drop over the gap and holes in the shield vessel. For more detailed calculations of flow pattern and temperature distribution the code MIX and INKO 2T are applied. MIX was developed and validated at ANL, INKO 2T is a development of INTERATOM. INKO 2T is under validation. Mock up experiments were carried out with water to simulate the transient behavior of the SNR-300 outlet plenum. Calculations obtained by INKO 2T for steady state and the transient are shown for the flow pattern. Results of measurements also prove that stratification begins after about 30 sec. Measurements and detailed calculations show that it is admissible to use the code TIRE for the long term calculations. Calculations for a scram

  7. Chronic Intermittent Hypoxia Induces Atherosclerosis

    OpenAIRE

    Savransky, Vladimir; Nanayakkara, Ashika; Li, Jianguo; Bevans, Shannon; Smith, Philip L.; Rodriguez, Annabelle; Polotsky, Vsevolod Y.

    2007-01-01

    Rationale: Obstructive sleep apnea, a condition leading to chronic intermittent hypoxia (CIH), is associated with hyperlipidemia, atherosclerosis, and a high cardiovascular risk. A causal link between obstructive sleep apnea and atherosclerosis has not been established.

  8. Dynamic characterizers of spatiotemporal intermittency

    OpenAIRE

    Gupte, Neelima; Jabeen, Zahera

    2006-01-01

    Systems of coupled sine circle maps show regimes of spatiotemporally intermittent behaviour with associated scaling exponents which belong to the DP class, as well as regimes of spatially intermittent behaviour (with associated regular dynamical behaviour) which do not belong to the DP class. Both types of behaviour are seen along the bifurcation boundaries of the synchronized solutions, and contribute distinct signatures to the dynamical characterizers of the system, viz. the distribution of...

  9. Psuedotumoral gastric varices

    International Nuclear Information System (INIS)

    Yoon, Yong Kyu; Kim, Choon Won

    1974-01-01

    The roentgenographic recognition of gastric varices often is difficult, even when there is a history of liver disease or splenomegaly without demonstrable esophageal varices. An apparant polypoid filling defect with exaggerated mucosal folds in proximal portion of the gastric body and funds on upper GI series, accompanied by hematemesis and splenomegly should suggest the presence of pseudotumoral gastric varices. We have an experience a case of polypoid filling defects in gastric fundus of psudotumoral gastric varices of 49 years old Korean woman, which was diagnosed by surgical and histopathological findings

  10. Operativ behandling af thoracic outlet syndrome

    DEFF Research Database (Denmark)

    Birkeland, Peter; Stiasny, Jerzy

    2012-01-01

    of the brachial plexus. At surgery, we found and severed a fibrous band that compressed the inferior trunk. Postoperatively, the pain subsided and fine hand movements improved. One patient had no cervical rib, however, in the two other cases we found rudimentary cervical ribs. Magnetic resonance imaging......We present three cases with longstanding true neurogenic thoracic outlet syndrome. All patients had aching pain in the shoulder, arm and ulnar border of the hand. On examination, we found atrophy of the hand muscles. Electromyography revealed signs of compromised function of the inferior trunk...

  11. Epidemiology and pathogenesis of thoracic outlet syndrome

    Directory of Open Access Journals (Sweden)

    Wojcik Gustaw

    2015-03-01

    Full Text Available The superior thoracic aperture is a place particularly vulnerable to the occurrence of tissue conflict and the development of a number of neurovascular changes carrying a risk of upper limb dysfunction. The triggering factor in this case is the pressure on the nerve vascular elements brought about by too large muscles of the chest and neck, clavicle fracture and dislocation of the upper ribs, anomalies in the form of ribs, in the neck, or by apex of the lung tumors. Each anatomical anomaly may be a cause of a number of lesions and lead to the development of the disease. Due to the nature of the oppressed structures, there are two basic groups: neurogenic and vascular. The most common variant giving clinical symptoms is neurogenic thoracic outlet syndrome. In this, the compression ratio, the brachial plexus, and for this reason, the vascular surface of the upper limb dysfunction is often overlooked. However, the vascular variant, and especially arterial sub-variant, is very dangerous because it can give complications even in the form of aneurysms, and even upper limb ischemia. The aim of the study is to present the most common changes in the thoracic outlet causing functional disorders of the upper limb.

  12. Intermittency in 197Au fragmentation

    International Nuclear Information System (INIS)

    Dabrowska, A.; Holynski, R.; Olszewski, A.; Szarska, M.; Wilczynska, B.; Wolter, W.; Wosiek, B.; Cherry, M.L.; Deines-Jones, P.; Jones, W.V.; Sengupta, K.; Wefel, B.

    1995-07-01

    The concept of factorial moments was applied to an analysis of the dynamical fluctuations in the charge distributions of the fragments emitted from gold nuclei with energies 10.6 and < 1.0 GeV/n interacting with emulsion nuclei. Clear evidence for intermittent fluctuations has been found in an analysis using all the particles released from the gold projectile, with a stronger effect observed below 1 GeV/n than at 10.6 GeV/n. For the full data sets, however, the intermittency effect was found to be very sensitive to the singly charged particles, and neglecting these particles strongly reduces the intermittency signal. When the analysis is restricted to the multiply charged fragments, an intermittency effect is revealed only for multifragmentation events, although one that is enhanced as compared to the analysis of all, singly and multiply charged, particles. The properties of the anomalous fractal dimensions suggest a sequential decay mechanism, rather than the existence of possible critical behaviour in the process of nuclear fragmentation. The likely influence of the charge conservation effects and the finite size of decaying systems on the observed intermittency signals was pointed out. (author). 37 refs, 9 figs, 5 tabs

  13. Gastric emptying in patients with gastric ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Harding, L.K.; Anselmi, M.; Donovan, I.A.; Alexander-Williams, J. (Dudley Road Hospital, Birmingham (UK); Birmingham General Hospital (UK))

    1982-06-01

    The estimated volume of meal in the stomach 30 mins after sup(113m)In-DTPA administration was determined in patients with gastric ulcer and normal controls by 1) relating counts in the stomach to those in the whole field of view of the gamma camera and 2) aspirations. In the normal controls there was no significant difference between the two methods but in the gastric ulcer patients, the gamma camera method predicted significantly more meal in the stomach than was recovered by aspiration. It was suggested that the large low lying stomach found in gastric ulcer disease causes extensive overlap of the small bowel and invalidates measurements of gastric emptying made by a gamma camera.

  14. Gastric emptying in patients with gastric ulcer

    International Nuclear Information System (INIS)

    Harding, L.K.; Anselmi, M.; Donovan, I.A.; Alexander-Williams, J.

    1982-01-01

    The estimated volume of meal in the stomach 30 mins after sup(113m)In-DTPA administration was determined in patients with gastric ulcer and normal controls by 1) relating counts in the stomach to those in the whole field of view of the gamma camera and 2) aspirations. In the normal controls there was no significant difference between the two methods but in the gastric ulcer patients, the gamma camera method predicted significantly more meal in the stomach than was recovered by aspiration. It was suggested that the large low lying stomach found in gastric ulcer disease causes extensive overlap of the small bowel and invalidates measurements of gastric emptying made by a gamma camera. (U.K.)

  15. Internal herniation after laparoscopic antecolic Roux-en-Y gastric bypass

    DEFF Research Database (Denmark)

    Kristensen, Sara Danshøj; Jess, Per; Floyd, Andrea Karen

    2016-01-01

    BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most common surgical treatment for morbid obesity in Denmark. Internal herniation (IH) or intermittent internal herniation (IIH) is a major late complication after LRYGB due to persistent mesenteric defects. However, the incidence...

  16. Familial Gastric Cancers.

    Science.gov (United States)

    Setia, Namrata; Clark, Jeffrey W; Duda, Dan G; Hong, Theodore S; Kwak, Eunice L; Mullen, John T; Lauwers, Gregory Y

    2015-12-01

    Although the majority of gastric carcinomas are sporadic, approximately 10% show familial aggregation, and a hereditary cause is determined in 1%-3% cases. Of these, hereditary diffuse gastric cancer is the most recognized predisposition syndrome. Although rare, the less commonly known syndromes also confer a markedly increased risk for development of gastric cancer. Identification and characterization of these syndromes require a multidisciplinary effort involving oncologists, surgeons, genetic counselors, biologists, and pathologists. This article reviews the molecular genetics, clinical and pathologic features, surveillance guidelines, and preventive measures of common and less common hereditary gastric cancer predisposition syndromes. ©AlphaMed Press.

  17. Temperature measurements at the LMFBR core outlet

    International Nuclear Information System (INIS)

    Argous, J.P.; Berger, R.; Casejuane, R.; Fournier, C.; Girard, J.P.

    1980-04-01

    Over the last few years the temperature sensors used to measure the subassembly outlet temperature in French designed LMFBRs have been modified, basically in an effort to reduce the dispersion of the chromel-alumel thermocouple time constant, and to extend the frequency spectrum of the measurement signals by adding a steel electrode to from a stainless steel-sodium thermocouple. The result of this evolution is the temperature probe immersed in sodium which will be used in the SUPER PHENIX reactor. This paper describes the tests already completed or in progress on this probe. It also presents measurement data on the two basic probe parameters: the thermoelectric power of the stainless steel-sodium thermocouple and the time constant of the chromel-alumel thermocouple

  18. Electrical Power Quality - What's Behind the Outlet?

    Science.gov (United States)

    Baird, William H.; Secrest, Jeffery; Padgett, Clifford

    2017-09-01

    Although we may consider the power outlets in our homes to be nearly ideal voltage sources, a variety of influences in and around the home can cause departures from the nominal 60 Hz, 110-120 V root-mean-square (rms) of the North American grid. Even without instrumentation, we can see that a large motor starting from rest can be sufficient to cause lights to dim momentarily (voltage sag). This dimming is due to the inrush current drawn by a stationary motor, which may be several times the current drawn at operating speed. We prepared a voltage monitoring system using a voltage divider, the construction details of which we omit in the interest of safety.

  19. Spontaneous Acute Mesenteroaxial Gastric Volvulus Diagnosed by Computed Tomography Scan in a Young Man.

    Science.gov (United States)

    Jabbour, Gaby; Afifi, Ibrahim; Ellabib, Mohamed; El-Menyar, Ayman; Al-Thani, Hassan

    2016-04-26

    Acute gastric volvulus is a surgical emergency that requires early recognition and treatment. Acute idiopathic mesenteroaxial gastric volvulus is a rare sub-type and there are few cases reported in children and there are even fewer reports in adults. We report a rare case of a 23-year-old man who presented with a 1-day history of vomiting, epigastric pain, distention, and constipation. The diagnosis for mesenteroaxial type gastric volvulus was confirmed by abdominal radiography and computed tomography. The patient was successfully treated by laparotomy with resection of the ischemic stomach wall and anastomosis. Acute spontaneous mesenteroaxial gastric volvulus is rare in adults and early diagnosis is challenging due to non-specific symptoms. A missed or delayed diagnosis may result in serious complications due to gastric obstruction. A patient presenting with severe epigastric pain and clinical evidence of gastric outlet obstruction should be considered as a surgical emergency to rule out gastric volvulus. High index of suspicion, early diagnosis and prompt surgical management are important for favorable outcome in patients with acute spontaneous gastric volvulus.

  20. Benign gastric filling defect

    International Nuclear Information System (INIS)

    Oh, K. K.; Lee, Y. H.; Cho, O. K.; Park, C. Y.

    1979-01-01

    The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

  1. Benign gastric filling defect

    Energy Technology Data Exchange (ETDEWEB)

    Oh, K. K.; Lee, Y. H.; Cho, O. K.; Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

  2. Benign gastric filling defect

    Energy Technology Data Exchange (ETDEWEB)

    Oh, K K; Lee, Y H; Cho, O K; Park, C Y [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

  3. Tobacco Retail Outlets and Vulnerable Populations in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Michael O. Chaiton

    2013-12-01

    Full Text Available Interest has been increasing in regulating the location and number of tobacco vendors as part of a comprehensive tobacco control program. The objective of this paper is to examine the distribution of tobacco outlets in a large jurisdiction, to assess: (1 whether tobacco outlets are more likely to be located in vulnerable areas; and (2 what proportion of tobacco outlets are located close to schools. Retail locations across the Province of Ontario from Ministry of Health Promotion data were linked to 2006 Census data at the neighbourhood level. There was one tobacco retail outlet for every 1,000 people over age 15 in Ontario. Density of outlets varied by public health unit, and was associated with the number of smokers. Tobacco outlets were more likely to be located in areas that had high neighbourhood deprivation, in both rural and urban areas. Outlets were less likely to be located in areas with high immigrant populations in urban areas, with the reverse being true for rural areas. Overall, 65% of tobacco retailers were located within 500 m of a school. The sale of tobacco products is ubiquitous, however, neighbourhoods with lower socio-economic status are more likely to have easier availability of tobacco products and most retailers are located within walking distance of a school. The results suggest the importance of policies to regulate the location of tobacco retail outlets.

  4. Off-premise alcohol outlet characteristics and violence.

    Science.gov (United States)

    Snowden, Aleksandra J; Pridemore, William Alex

    2014-07-01

    There is considerable evidence of an association between alcohol outlet density and violence. Although prior research reveals the importance of specific characteristics of bars on this association and that the relationship between bar density and violence may be moderated by these characteristics, there are few similar studies of the characteristics of off-premise outlets (e.g., liquor and convenience stores). We examined whether immediate environment, business practice, staff, and patron characteristics of off-premise alcohol outlets are associated with simple and aggravated assault density. Cross-sectional design using aggregate data from 65 census block groups in a non-metropolitan college town, systematic social observation, and spatial modeling techniques. We found limited effects of immediate environment, business practice, staff, and patron characteristics on simple assault density and no effect on aggravated assault density. Only two out of 17 characteristics were associated with simple assault density (i.e., nearby library and male patrons). This is the first study to examine the association between several off-premise alcohol outlet characteristics and assault. Our findings suggest that where the off-premise outlets are located, how well the immediate environment is maintained, what types of beverages the outlets sell, who visits them, and who works there matter little in their association with violence. This suggests the importance of outlet density itself as a primary driver of any association with violence. Public policies aimed at reducing alcohol outlet density or clustering may be useful for reducing violence.

  5. Alcohol Outlets and Violent Crime in Washington D.C.

    Directory of Open Access Journals (Sweden)

    Pan, William K

    2010-08-01

    Full Text Available Objective: Alcohol is more likely than any other drug to be involved in substance-related violence. In 2000 violence-related and self-directed injuries accounted for an estimated $37 billion and $33 billion in productivity losses and medical treatment, respectively. A review of emergency department data revealed violence and clinically identified trauma-related injuries have the strongest correlation among alcohol-dependent injuries. At the environmental level there is a relationship between alcohol outlet density and violent crime. A limited number of studies have examined the relationship between alcohol outlet type and the components of violent crime. The aim of this study is to examine the relationship between the aggregate components of violent crime and alcohol outlet density by type of outlet.Methods: For this study we used Washington, D.C. census tract data from the 2000 census to examine neighborhood characteristics. Alcohol outlet, violent crime, and population-level data for Washington, D.C. were drawn from various official yet publicly available sources. We developed an analytic database to examine the relationship between alcohol outlet category and four types of violent crime. After estimating spatial correlation and determining spatial dependence, we used a negative binomial regression analysis to assess the alcohol availability-violent crime association, while controlling for structural correlates of violence.Results: Independent of alternative structural correlates of violent crime, including the prevalence of weapons and illicit drugs, community-level alcohol outlet density is significantly associated with assaultive violence. Outlets were significantly related to robbery, assault, and sexual offenses. In addition, the relationship among on-premise and off-premise outlets varied across violent crime categories.Conclusion: In Washington, D.C., alcohol outlet density is significantly associated with the violent crimes. The

  6. The geography of Fast Food outlets: a review.

    Science.gov (United States)

    Fraser, Lorna K; Edwards, Kimberly L; Cade, Janet; Clarke, Graham P

    2010-05-01

    The availability of food high in fat, salt and sugar through Fast Food (FF) or takeaway outlets, is implicated in the causal pathway for the obesity epidemic. This review aims to summarise this body of research and highlight areas for future work. Thirty three studies were found that had assessed the geography of these outlets. Fourteen studies showed a positive association between availability of FF outlets and increasing deprivation. Another 13 studies also included overweight or obesity data and showed conflicting results between obesity/overweight and FF outlet availability. There is some evidence that FF availability is associated with lower fruit and vegetable intake. There is potential for land use policies to have an influence on the location of new FF outlets. Further research should incorporate good quality data on FF consumption, weight and physical activity.

  7. The Geography of Fast Food Outlets: A Review

    Directory of Open Access Journals (Sweden)

    Lorna K. Fraser

    2010-05-01

    Full Text Available The availability of food high in fat, salt and sugar through Fast Food (FF or takeaway outlets, is implicated in the causal pathway for the obesity epidemic. This review aims to summarise this body of research and highlight areas for future work. Thirty three studies were found that had assessed the geography of these outlets. Fourteen studies showed a positive association between availability of FF outlets and increasing deprivation. Another 13 studies also included overweight or obesity data and showed conflicting results between obesity/overweight and FF outlet availability. There is some evidence that FF availability is associated with lower fruit and vegetable intake. There is potential for land use policies to have an influence on the location of new FF outlets. Further research should incorporate good quality data on FF consumption, weight and physical activity.

  8. Gastric Necrosis due to Acute Massive Gastric Dilatation

    Directory of Open Access Journals (Sweden)

    Ibrahim Aydin

    2013-01-01

    Full Text Available Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature.

  9. Gastric Necrosis due to Acute Massive Gastric Dilatation.

    Science.gov (United States)

    Aydin, Ibrahim; Pergel, Ahmet; Yucel, Ahmet Fikret; Sahin, Dursun Ali; Ozer, Ender

    2013-01-01

    Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature.

  10. Gastric emptying in morbid obesity

    International Nuclear Information System (INIS)

    Venzina, W.; Chamberlain, M.; Carruthers, S.G.; Grace, D.M.; King, M.; Mowbray, R.D.; Bondy, D.C.

    1984-01-01

    Weight loss following gastroplasty had no correlation with gastric emptying rate. Patients who showed transient prolongation of gastric emptying returned to normal one year later and showed no significant difference in weight loss from those who did not have temporary delayed gastric emptying. Perhaps gatroplasty (at least temporarily) reduces the gastric volume producing early satiation without affecting the gastric emptying rate as tested by a small volume radiolabelled test meal. Longer follow-up is indicated to see if delayed weight gain occurs because of gastric pouch stretching and if this has any correlation with gastric emptying rate. (Author)

  11. Coolant mixing in the LMFBR outlet plenum

    International Nuclear Information System (INIS)

    Chen, Y.B.; Golay, M.W.

    1977-06-01

    Small scale experiments involving water flows are used to provide mean flow and turbulence field data for LMFBR outlet plenum flows. Measurements are performed at Reynolds Number (Re) values of 33000 and 70000 in a 1/15-scale FFTF geometry and at Re = 35000 in a 3/80-scale CRBR geometry. The experimental behavior is predicted using two different turbulence model computer programs, TEACH-T and VARR-II. It is found that the qualitative nature of the flow field within the plenum depends strongly upon the distribution of the mean inlet velocity field, upon the degree of inlet turbulence, and upon the turbulence momentum exchange model used in the calculations. It is found in the FFTF geometry that the TEACH-T predictions are better than that of VARR-II, and in the CRBR geometry neither code provides a good prediction of the observed behavior. From the sensitivity analysis, it is found that the production and dissipation of turbulence are the dominant terms in the transport equations for turbulent kinetic energy and turbulent energy dissipation rate, and the diffusion terms are relatively small. From the same study a new set of empirical constants for the turbulence model is evolved for the prediction of plenum flows

  12. Assessment of gastric motility using meal labeled with technetium-99m sulfur colloid

    International Nuclear Information System (INIS)

    Matolo, N.M.; Stadalnik, R.C.

    1983-01-01

    During a 2 year period, 83 patients with gastric motility problems were evaluated using radionuclide imaging. The patients presented with epigastric distress, postprandial fullness, pain, nausea, vomiting, and diarrhea; signs and symptoms suggestive of either gastroparesis or gastric outlet obstruction. Upper gastrointestinal series or endoscopy, or both, demonstrated no mechanical obstruction. After oral administration of a 300 g meal labeled with 600 muCi of technetium-99m sulfur colloid, a gastric emptying study consisting of serial images and data acquisition was performed. Of the patients studied, 52 had had peptic ulcer surgery, 17 were suspected of having gastroesophageal reflux, 8 were diabetic and suspected of having visceral enteropathy, and 6 had a history of irritable bowel syndrome. The normal mean gastric half emptying time was 77 +/- 16 minutes. Of the patients who had had gastric surgery, 90.4 percent had abnormal emptying: 69.2 percent had delayed gastric emptying and 21.2 percent had rapid gastric emptying time; 9.6 percent had normal emptying time. Of the gastroesophageal reflux group, all but two had normal gastric emptying time; 65 percent demonstrated gastroesophageal reflux within 15 minutes. Two of the patients with irritable bowel syndrome had prolonged emptying; the rest had normal emptying. All diabetic patients with gastroparesis had prolonged gastric emptying time, and all responded favorably to metoclopramide. Of the patients who previously had peptic ulcer surgery and had prolonged emptying time, 72 percent also responded favorably to metoclopramide. We conclude that radionuclide gastric imaging is a useful diagnostic test for the measurement of gastric emptying in patients with a variety of gastrointestinal motility disorders and may be helpful in assessing medical therapy and selecting those who may be candidates for surgery

  13. Pulse Packet Stochastic Model for Gastric Emptying in the Fasted State: A Physiological Approach.

    Science.gov (United States)

    Talattof, Arjang; Amidon, Gordon L

    2018-03-05

    Fasted-state gastrointestinal (GI) fluid transit is typically represented as a first-order, deterministic process (averaged and viewed as a continuous approximation). It is, however, most likely a discrete process involving fluid packets interrupted by variable time periods of little to no fluid emptying. In this report we present a physiologically based pulsed-packet gastric fluid emptying model and evaluate it with respect to recent gastrointestinal fluid volume emptying results, published gastric emptying of various dosage forms, and gastric fluid emptying as a function of GI motility. We develop the mathematical model for gastric emptying of discrete volumes emptied during intermittent pulse times of variable lengths, defined as a function of gastric motility utilizing a Poisson point process with motility-dependent intensity. We compare the simulations with observed gastric emptying results. The discrete pulse-packet gastric volumetric emptying model is a more physiologically realistic mathematical model for gastric emptying and it accounts well for the average observed emptying rates and, importantly, encompasses the variability of of observed volume and dosage form emptying rates.

  14. The Comparison of Continuous and Intermittent Enteral Nutrition In Cerebrovascular Patients

    Directory of Open Access Journals (Sweden)

    Levent Güngör

    2011-06-01

    Full Text Available OBJECTIVE: Dysphagia and malnutrition are not so rare in stroke patients, and have an unfavorable influence on recovery. Nutritional support may reduce infections, duration of hospital stay and mortality. However, there is no clear evidence about the modality of nasogastric nutrition. In this study, intermittent and continuous enteral nutrition is compared by means of pulmonary infections and gastrointestinal tolerance, among acute cerebrovascular patients. METHODS: Sixty two acute cerebrovascular patients with dysphagia were included the study. The same volume of nutrition product was infused 4 times daily to 31 patients, and continuously for 24 hours to the remaining 31. After 10 days of follow-up, the rates of pulmonary infections, diarrhea, increased gastric residual volumes, vomiting and tube occlusion were compared between two groups. RESULTS: Twenty patients developed pneumonia (32% and 8 diarrhea (13%. Mortality due to complications associated with tube feeding was 6%. Aspiration and related pneumonia was present in 11 patients in the intermittent nutrition group (35%, and in 9 patients in the continuous nutrition group (29%. The rate of pulmonary infection was not statistically different between two groups (p>0.05. Diarrhea was observed in 7 intermittently fed patients (23%, while was present only in 1 patient (3% in the continuously fed group. Diarrhea was more common in the intermittent nutrition group, just at the statistical border (p=0.05. None of the patients developed tube occlusion, vomiting and gastric retention. The rate of mortality and the interruption of feeding was not significantly different between two groups (p>0.05. CONCLUSION: Diarrhea and pulmonary infections are more prevalent with intermittent tube feeding with respect to continuous enteral nutrition, though the difference is not so conspicuous. The reason may be contamination of the equipments and the feeding solution because of frequent manipulation and

  15. The Comparison of Continuous and Intermittent Enteral Nutrition In Cerebrovascular Patients

    Directory of Open Access Journals (Sweden)

    Levent Güngör

    2011-06-01

    Full Text Available OBJECTIVE: Dysphagia and malnutrition are not so rare in stroke patients, and have an unfavorable influence on recovery. Nutritional support may reduce infections, duration of hospital stay and mortality. However, there is no clear evidence about the modality of nasogastric nutrition. In this study, intermittent and continuous enteral nutrition is compared by means of pulmonary infections and gastrointestinal tolerance, among acute cerebrovascular patients. METHODS: Sixty two acute cerebrovascular patients with dysphagia were included the study. The same volume of nutrition product was infused 4 times daily to 31 patients, and continuously for 24 hours to the remaining 31. After 10 days of follow-up, the rates of pulmonary infections, diarrhea, increased gastric residual volumes, vomiting and tube occlusion were compared between two groups. RESULTS: Twenty patients developed pneumonia (32% and 8 diarrhea (13%. Mortality due to complications associated with tube feeding was 6%. Aspiration and related pneumonia was present in 11 patients in the intermittent nutrition group (35%, and in 9 patients in the continuous nutrition group (29%. The rate of pulmonary infection was not statistically different between two groups (p>0.05. Diarrhea was observed in 7 intermittently fed patients (23%, while was present only in 1 patient (3% in the continuously fed group. Diarrhea was more common in the intermittent nutrition group, just at the statistical border (p=0.05. None of the patients developed tube occlusion, vomiting and gastric retention. The rate of mortality and the interruption of feeding was not significantly different between two groups (p>0.05. CONCLUSION: Diarrhea and pulmonary infections are more prevalent with intermittent tube feeding with respect to continuous enteral nutrition, though the difference is not so conspicuous. The reason may be contamination of the equipments and the feeding solution because of frequent manipulation and

  16. Gastric-emptying tests

    International Nuclear Information System (INIS)

    Brown, M.L.; Malagelada, J.R.

    1983-01-01

    Mechanisms regulating gastric emptying have been characterized through many decades of experimental work. Both central and peripheral mechanisms are important. Central mechanisms are related to the center of vomiting and are probably influenced by psychologic and emotional factors. Peripheral mechanisms are located at both sides of the pylorus. Gastric mechanisms are stimulatory and are triggered mainly by distention of the stomach, although hormonal mechanisms may also participate (gastrin). However, with complex, nutrient-containing meals, the intragastric volume is not the primary determinant of gastric emptying. Inhibitory mechanisms of the gut are more important. The key factors are the pH, osmolality, and nutrient content of the chyme being emptied into the duodenum. Osmotic and pH-sensitive receptors are thought to reside in the duodenum. On the other hand, receptors triggered by nutrients extend much more distally into the duodenum and are sensitive to nutrient composition and load. Protein, carbohydrates, and lipids all inhibit gastric emptying, although the lipids are probably the most potent inhibitors. If the duodenal load or the characteristics of the emptying material are not adequate, inhibitory mechanisms will reduce gastric emptying at the expense of expanding the intragastric volume. It is therefore not possible to dissociate postprandial gastric emptying from postprandial gastric secretion

  17. Retardation of gastric emptying of solid food by secretin

    Energy Technology Data Exchange (ETDEWEB)

    Kleibeuker, J.H.; Beekhuis, H.; Piers, D.A.; Schaffalitzky de Muckadell, O.B.

    1988-01-01

    The effect of secretin at nearly physiologic plasma concentrations on the gastric emptying rate of solid food was studied in 12 healthy men. A /sup 99m/Tc colloid-labeled pancake was used as the test meal. The gastric emptying rate was measured during 1 h using a dual-headed gamma-camera, and was expressed as the half-time of the emptying curve. To prevent endogenous secretin release, 400 mg of cimetidine was given before the meal. Subjects were studied under three conditions: (1) during infusion of saline; (2) during continuous infusion of secretin, 6.6 pmol/kg.h; and (3) during three intermittent 10-min periods of secretin infusion, 7.6 pmol/kg.h during each period. Both continuous and intermittent infusion of secretin increased half-emptying time, by 133% and 55%, respectively. The plasma secretin concentration in condition 1 was 0.8 pM; plateau concentration in condition 2 was 9.8 pM; and integrated mean concentration in condition 3 was 4.8 pM. It is concluded that secretin at approximately physiologic plasma concentrations retards gastric emptying of solid food in humans.

  18. MRI findings in thoracic outlet syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Aralasmak, Ayse; Sharifov, Rasul; Kilicarslan, Rukiye; Alkan, Alpay [Bezmialem Vakif University, Department of Radiology, Fatih/Istanbul (Turkey); Cevikol, Can; Karaali, Kamil; Senol, Utku [Akdeniz University, Department of Radiology, Antalya (Turkey)

    2012-11-15

    We discuss MRI findings in patients with thoracic outlet syndrome (TOS). A total of 100 neurovascular bundles were evaluated in the interscalene triangle (IS), costoclavicular (CC), and retropectoralis minor (RPM) spaces. To exclude neurogenic abnormality, MRIs of the cervical spine and brachial plexus (BPL) were obtained in neutral. To exclude compression on neurovascular bundles, sagittal T1W images were obtained vertical to the longitudinal axis of BPL from spinal cord to the medial part of the humerus, in abduction and neutral. To exclude vascular TOS, MR angiography (MRA) and venography (MRV) of the subclavian artery (SA) and vein (SV) in abduction were obtained. If there is compression on the vessels, MRA and MRV of the subclavian vessels were repeated in neutral. Seventy-one neurovascular bundles were found to be abnormal: 16 arterial-venous-neurogenic, 20 neurogenic, 1 arterial, 15 venous, 8 arterial-venous, 3 arterial-neurogenic, and 8 venous-neurogenic TOS. Overall, neurogenic TOS was noted in 69%, venous TOS in 66%, and arterial TOS in 39%. The neurovascular bundle was most commonly compressed in the CC, mostly secondary to position, and very rarely compressed in the RPM. The cause of TOS was congenital bone variations in 36%, congenital fibromuscular anomalies in 11%, and position in 53%. In 5%, there was unilateral brachial plexitis in addition to compression of the neurovascular bundle. Severe cervical spondylosis was noted in 14%, contributing to TOS symptoms. For evaluation of patients with TOS, visualization of the brachial plexus and cervical spine and dynamic evaluation of neurovascular bundles in the cervicothoracobrachial region are mandatory. (orig.)

  19. Acute Alcohol Consumption, Alcohol Outlets, and Gun Suicide

    Science.gov (United States)

    Branas, Charles C.; Richmond, Therese S.; Ten Have, Thomas R.; Wiebe, Douglas J.

    2014-01-01

    A case–control study of 149 intentionally self-inflicted gun injury cases (including completed gun suicides) and 302 population-based controls was conducted from 2003 to 2006 in a major US city. Two focal independent variables, acute alcohol consumption and alcohol outlet availability, were measured. Conditional logistic regression was adjusted for confounding variables. Gun suicide risk to individuals in areas of high alcohol outlet availability was less than the gun suicide risk they incurred from acute alcohol consumption, especially to excess. This corroborates prior work but also uncovers new information about the relationships between acute alcohol consumption, alcohol outlets, and gun suicide. Study limitations and implications are discussed. PMID:21929327

  20. Gastric bypass surgery

    Science.gov (United States)

    ... your body will not get all of the calories from the food you eat. ... to a small hole in your pouch. The food you eat will now travel ... absorb fewer calories. Gastric bypass can be done in two ways. ...

  1. Effect of drink carbohydrate content on postexercise gastric emptying, rehydration, and the calculation of net fluid balance.

    Science.gov (United States)

    Clayton, David J; Evans, Gethin H; James, Lewis J

    2014-02-01

    The purpose of this study was to examine the gastric emptying and rehydration effects of hypotonic and hypertonic glucose-electrolyte drinks after exercise-induced dehydration. Eight healthy males lost ~1.8% body mass by intermittent cycling and rehydrated (150% of body mass loss) with a hypotonic 2% (2% trial) or a hypertonic 10% (10% trial) glucose-electrolyte drink over 60 min. Blood and urine samples were taken at preexercise, postexercise, and 60, 120, 180, and 240 min postexercise. Gastric and test drink volume were determined 15, 30, 45, 60, 90, and 120 min postexercise. At the end of the gastric sampling period 0.3% (2% trial) and 42.1% (10% trial; p rehydration drink might be mediated by a slower rate of gastric emptying, but the slow gastric emptying of such solutions makes rehydration efficiency difficult to determine in the hours immediately after drinking, compromising the calculation of net fluid balance.

  2. Genetics Home Reference: hereditary diffuse gastric cancer

    Science.gov (United States)

    ... Health Conditions Hereditary diffuse gastric cancer Hereditary diffuse gastric cancer Printable PDF Open All Close All Enable Javascript ... Diffuse Gastric Cancer MedlinePlus Encyclopedia: Gastric Cancer National Cancer ... Option Overview General Information from MedlinePlus ( ...

  3. Gastric volvulus in childhood.

    Directory of Open Access Journals (Sweden)

    Karande T

    1997-04-01

    Full Text Available Gastric volvulus is an uncommon condition more so in the paediatric age group. The cause of gastric volvulus may be idiopathic or secondary to various congenital or acquired conditions. In this short series of three patients, one had volvulus which was due to ligamentous laxity and mobile spleen, second had congenital postero-lateral diaphragmatic defect and the third had hiatus hernia.

  4. Helicobacter and Gastric Malignancies

    OpenAIRE

    Ferreira, António Carlos; Isomoto, Hajime; Moriyama, Masatsugu; Fujioka, Toshio; Machado, José Carlos; Yamaoka, Yoshio

    2008-01-01

    Individuals infected with Helicobacter pylori, a stomach colonizing bacteria, have an increased risk of developing gastric malignancies. The risk for developing cancer relates to the physiologic and histologic changes that H. pylori infection induces in the stomach. In the last year numerous studies have been conducted in order to characterize the association between H. pylori infection and gastric cancer. These studies range from epidemiologic approaches aiming at the identification of envir...

  5. Giant gastric lipoma presenting as GI bleed: Enucleation or Resection?

    Directory of Open Access Journals (Sweden)

    Salah Termos

    Full Text Available Introduction: Gastric lipomas are unusual benign lesions and account for less than 1% of all tumours of the stomach and 5% of all gastrointestinal lipomas (Thompson et al.2003; Fernandez et al. 1983 [1,2]. Although predominantly asymptomatic and indolent; they may present with gastric outlet obstruction and upper gastrointestinal (GI bleeding owing to size and ulceration. Only a few cases have been reported, presenting large in size with massive GI bleeding (Alcalde Escribano et al. 1989; Johnson et al. 1981 [3,4]. Presentation of case: We report the case of a 62-year-old gentleman who presented to the emergency department with massive upper GI hemorrhage. He was initially resuscitated and stabilized. Later gastroscopy showed a large submucosal tumour (Fig. 1. Biopsy revealed adipose tissue. Computed tomography (CT scan of the abdomen and pelvis showed a huge well defined oval soft tissue lesion measuring about 16 × 8 × 8 cm. The mass noted a homogenous fat density arising from the posterior wall of stomach with no extramural infiltration (Fig. 2. The tumour was completely enucleated through an explorative gastrotomy incision (Fig. 4. Discussion and conclusion: Massive bleeding secondary to a giant gastric lipoma is a rare finding of a rare disease. The majority of cases in the literature result in major gastric resection. Familiarity with its radiological findings and a high index of suspicion can lead to proper diagnosis in the acute setting. If malignancy is carefully ruled out, stomach preserving surgery is an optimal treatment option. Keywords: Case report, Lipoma, Gastric lipoma, G I bleeding, Enucleation, Gastric resection

  6. Dynamic gastric digestion of a commercial whey protein concentrate†.

    Science.gov (United States)

    Miralles, Beatriz; Del Barrio, Roberto; Cueva, Carolina; Recio, Isidra; Amigo, Lourdes

    2018-03-01

    A dynamic gastrointestinal simulator, simgi ® , has been applied to assess the gastric digestion of a whey protein concentrate. Samples collected from the outlet of the stomach have been compared to those resulting from the static digestion protocol INFOGEST developed on the basis of physiologically inferred conditions. Progress of digestion was followed by SDS-PAGE and LC-MS/MS. By SDS-PAGE, serum albumin and α-lactalbumin were no longer detectable at 30 and 60 min, respectively. On the contrary, β-lactoglobulin was visible up to 120 min, although in decreasing concentrations in the dynamic model due to the gastric emptying and the addition of gastric fluids. Moreover, β-lactoglobulin was partly hydrolysed by pepsin probably due to the presence of heat-denatured forms and the peptides released using both digestion models were similar. Under dynamic conditions, a stepwise increase in number of peptides over time was observed, while the static protocol generated a high number of peptides from the beginning of digestion. Whey protein digestion products using a dynamic stomach are consistent with those generated with the static protocol but the kinetic behaviour of the peptide profile emphasises the effect of the sequential pepsin addition, peristaltic shaking, and gastric emptying on protein digestibility. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  7. Gastric volvulus through morgagni hernia: an easily overlooked emergency.

    Science.gov (United States)

    Sonthalia, Nikhil; Ray, Sayantan; Khanra, Dibbendhu; Saha, Avishek; Maitra, Subhasis; Saha, Manjari; Talukdar, Arunansu

    2013-06-01

    Intractable vomiting in an elderly patient is an emergency condition requiring prompt diagnosis and intervention. Acute gastric outlet obstruction due to gastric volvulus through Morgagni-type diaphragmatic hernia is an exceedingly rare cause of this nonspecific complaint. Our aim was to highlight that Morgagni hernia, although rare in adults, should be suspected in the appropriate clinical setting, and that a clue toward diagnosis often comes from routine chest and abdominal x-ray studies. In addition, we emphasize the atypical radiological findings and importance of emergency surgical intervention in such a case. We describe the case of a 78-year-old woman who presented to the Emergency Department with a 4-day history of intractable vomiting, and with no definitive clue to the diagnosis on examination. Her routine chest and abdomen x-ray studies suggested abnormal air-fluid level at right hemithorax, which prompted a computed tomography (CT) scan of the abdomen and an upper gastrointestinal contrast study. Gastric volvulus through a foramen of Morgagni was diagnosed and transthoracic reduction of the contents was performed, along with repair of the defect. A symptomatic Morgagni hernia in adults, although rare, can present with a variety of symptoms ranging from nonspecific complaints of bloating and indigestion to the more severe complaint of intestinal obstruction. Gastric volvulus and obstructive features are less frequently reported as acute complications of these hernias, which need early identification and intervention. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. PIV measurement at the blowdown pipe outlet

    International Nuclear Information System (INIS)

    Puustinen, M.; Laine, J.; Raesaenen, A.; Pyy, L.; Telkkae, J.

    2013-04-01

    This report summarizes the findings of the PIV measurement tests carried out in January - February 2013 with the scaled down PPOOLEX test facility at LUT. The main objective of the tests was to find out the operational limits of the PIV system regarding suitable test conditions and correct values of different adjustable PIV parameters. An additional objective was to gather CFD grade data for verification/validation of numerical models. Both water and steam injection tests were carried out. PIV measurements with cold water injection succeeded well. Raw images were of high quality, averaging over the whole measurement period could be done and flow fields close to the blowdown pipe outlet could be determined. In the warm water injection cases the obtained averaged velocity field images were harder to interpret, especially if the blowdown pipe was also filled with warm water in the beginning of the measurement period. The absolute values of the velocity vectors seemed to be smaller than in the cold water injection cases. With very small steam flow rates the steam/water interface was inside the blowdown pipe and quite stable in nature. The raw images were of good quality but due to some fluctuation in the velocity field averaging of the velocity images over the whole measured period couldn't be done. Condensation of steam in the vicinity of the pipe exit probably caused these fluctuations. A constant outflow was usually followed by a constant inflow towards the pipe exit. Vector field images corresponding to a certain phase of the test could be extracted and averaged but this would require a very careful analysis so that the images could be correctly categorized. With higher steam flow rates rapid condensation of large steam bubbles created small gas bubbles which were in front of the measurement area of the PIV system. They disturbed the measurements by reflecting laser light like seeding particles and therefore the raw images were of poor quality and they couldn't be

  9. 7 CFR 993.108 - Non-human consumption outlet.

    Science.gov (United States)

    2010-01-01

    ... consumption outlet means any livestock feeder or manufacturer of inedible syrup, industrial alcohol, animal... FR 8278, Sept. 2, 1961; 26 FR 8483, Sept. 9, 1961] Effective Date Note: At 70 FR 30613, May 27, 2005...

  10. Methodological Approaches to Locating Outlets of the Franchise Retail Network

    OpenAIRE

    Grygorenko Tetyana M.

    2016-01-01

    Methodical approaches to selecting strategic areas of managing the future location of franchise retail network outlets are presented. The main stages in the assessment of strategic areas of managing the future location of franchise retail network outlets have been determined and the evaluation criteria have been suggested. Since such selection requires consideration of a variety of indicators and directions of the assessment, the author proposes a scale of evaluation, which ...

  11. Primary Closure versus Gastric Resection for Perforated Gastric

    African Journals Online (AJOL)

    Perforated gastric ulcer is one of the most life‑threatening complications of peptic ulcer disease with high .... tubes were removed and oral nutrition resumed. The .... surgical approach for perforated gastric cancer: One‑stage vs. two‑stage ...

  12. Gastric volvulus with partial and complete gastric necrosis

    Science.gov (United States)

    Shukla, Ram Mohan; Mandal, Kartik Chandra; Maitra, Sujay; Ray, Amit; Sarkar, Ruchirendu; Mukhopadhyay, Biswanath; Bhattacharya, Malay

    2014-01-01

    Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature. PMID:24604987

  13. Gastric volvulus with partial and complete gastric necrosis

    Directory of Open Access Journals (Sweden)

    Ram Mohan Shukla

    2014-01-01

    Full Text Available Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature.

  14. The OTSC®-clip in revisional endoscopy against weight gain after bariatric gastric bypass surgery.

    Science.gov (United States)

    Heylen, Alex Marie Florent; Jacobs, Anja; Lybeer, Monika; Prosst, Ruediger L

    2011-10-01

    The maintenance of the restrictive component of the Fobi pouch gastric bypass is essential for permanent weight control. Dilatation of the pouch-outlet and of the pouch itself is responsible for substantial weight gain by an increased volume per meal and binge-eating due to the rapid emptying. An endoscopic over-the-scope clip (OTSC®; Ovesco AG, Tübingen, Germany) was applied in 94 patients following gastric bypass and unintended weight gain by dilated gastro-jejunostomy to narrow the pouch-outlet. The OTSC®-clip application was safe and efficient to reduce the pouch-outlet in all cases. Best clinical results were obtained by narrowing the gastro-jejunostomy by placing two clips at opposite sites, hence reducing the outlet of more than 80%. Preferably, the clip approximated the whole thickness of the wall to avoid further dilatation of the anastomosis. Between surgery and OTSC®-clip application the mean BMI dropped from 45.8 (±3.6) to 32.8 (±1.9). At the first follow-up about 3 months (mean 118 days, ±46 days) after OTSC®-clip application the mean BMI was 29.7 (±1.8). At the second follow-up about 1 year (mean 352 days, ±66 days) after OTSC®-clip application the mean BMI was 27.4 (±3.8). The OTSC®-clip for revisional endoscopy after gastric bypass is reliable and effective in treating weight gain due to a dilated pouch-outlet with favorable short- and midterm results.

  15. Redefining early gastric cancer.

    Science.gov (United States)

    Barreto, Savio G; Windsor, John A

    2016-01-01

    The problem is that current definitions of early gastric cancer allow the inclusion of regional lymph node metastases. The increasing use of endoscopic submucosal dissection to treat early gastric cancer is a concern because regional lymph nodes are not addressed. The aim of the study was thus to critically evaluate current evidence with regard to tumour-specific factors associated with lymph node metastases in "early gastric cancer" to develop a more precise definition and improve clinical management. A systematic and comprehensive search of major reference databases (MEDLINE, EMBASE, PubMed and the Cochrane Library) was undertaken using a combination of text words "early gastric cancer", "lymph node metastasis", "factors", "endoscopy", "surgery", "lymphadenectomy" "mucosa", "submucosa", "lymphovascular invasion", "differentiated", "undifferentiated" and "ulcer". All available publications that described tumour-related factors associated with lymph node metastases in early gastric cancer were included. The initial search yielded 1494 studies, of which 42 studies were included in the final analysis. Over time, the definition of early gastric cancer has broadened and the indications for endoscopic treatment have widened. The mean frequency of lymph node metastases increased on the basis of depth of infiltration (mucosa 6% vs. submucosa 28%), presence of lymphovascular invasion (absence 9% vs. presence 53%), tumour differentiation (differentiated 13% vs. undifferentiated 34%) and macroscopic type (elevated 13% vs. flat 26%) and tumour diameter (≤2 cm 8% vs. >2 cm 25%). There is a need to re-examine the diagnosis and staging of early gastric cancer to ensure that patients with one or more identifiable risk factor for lymph node metastases are not denied appropriate chemotherapy and surgical resection.

  16. Gastroscopic treatment of gastric band penetrating the gastric wall

    DEFF Research Database (Denmark)

    Jess, Per; Fonnest, G

    1999-01-01

    Gastric wall penetration of a gastric band after operation for morbid obesity is a well known late complication. The treatment is usually reoperation. In this case report we show that a band penetrating the gastric wall can be successfully treated by gastroscopic operation. This technique is more...

  17. Intrathoracic gastric volvulus in infancy

    Energy Technology Data Exchange (ETDEWEB)

    Al-Salem, A.H. [Dept. of Surgery, Qatif Central Hospital, Qatif (Saudi Arabia)

    2000-12-01

    Intrathoracic gastric volvulus is a very rare surgical emergency. Early diagnosis and treatment are of great importance to prevent gastric gangrene and perforation or gastric obstruction and dilation, which may lead to cardiorespiratory arrest. We report two infants who presented with intrathoracic gastric volvulus. This was associated with recurrent diaphragmatic hernia in one and congenital paraoesophageal hernia in the other. Aspects of diagnosis and treatment are also discussed. (orig.)

  18. Intrathoracic gastric volvulus in infancy

    International Nuclear Information System (INIS)

    Al-Salem, A.H.

    2000-01-01

    Intrathoracic gastric volvulus is a very rare surgical emergency. Early diagnosis and treatment are of great importance to prevent gastric gangrene and perforation or gastric obstruction and dilation, which may lead to cardiorespiratory arrest. We report two infants who presented with intrathoracic gastric volvulus. This was associated with recurrent diaphragmatic hernia in one and congenital paraoesophageal hernia in the other. Aspects of diagnosis and treatment are also discussed. (orig.)

  19. Evaluation of alcohol outlet density and its relation with violence

    Directory of Open Access Journals (Sweden)

    Laranjeira Ronaldo

    2002-01-01

    Full Text Available OBJECTIVES: The current study set out to investigate alcohol availability in a densely populated, residential area of suburban São Paulo associated with high levels of social deprivation and violence. Gun-related deaths and a heavy concentration of alcohol outlets are notable features of the area surveyed. Given the strong evidence for a link between alcohol availability and a number of alcohol-related problems, including violent crime, measures designed to reduce accessibility have become a favored choice for alcohol prevention programs in recent years. METHODS: The interviewers were 24 residents of the area who were trained for the study. It was selected an area of nineteen streets, covering a total distance of 3.7 km. A profile of each alcohol outlet available on the area was recorded. RESULTS: One hundred and seven alcohol outlets were recorded. The number of other properties in the same area was counted at 1,202. Two measures of outlet density may thus be calculated: the number of outlets per kilometer of roadway (29 outlets/km; and the proportion of all properties that sold alcohol (1 in 12. CONCLUSIONS: The results of this study is compared with others which are mainly from developed countries and shown that the area studied have the highest density of alcohol outlet density ever recorded in the medical literature. The implication of this data related to the violence of the region is discussed. By generating a profile of alcohol sales and selling points, it was hoped to gain a better understanding of alcohol access issues within the sample area. Future alcohol prevention policy would be well served by such knowledge.

  20. A longitudinal analysis of alcohol outlet density and domestic violence.

    Science.gov (United States)

    Livingston, Michael

    2011-05-01

    A small number of studies have identified a positive relationship between alcohol outlet density and domestic violence. These studies have all been based on cross-sectional data and have been limited to the assessment of ecological correlations between outlet density and domestic violence rates. This study provides the first longitudinal examination of this relationship. Cross-sectional time-series using aggregated data from small areas. The relationships between alcohol outlet density and domestic violence were assessed over time using a fixed-effects model. Controls for the spatial autocorrelation of the data were included in the model. The study uses data for 186 postcodes from within the metropolitan area of Melbourne, Australia for the years 1996 to 2005. Alcohol outlet density measures for three different types of outlets (hotel/pub, packaged liquor, on-premise) were derived from liquor licensing records and domestic violence rates were calculated from police-recorded crime data, based on the victim's postcode. Alcohol outlet density was associated significantly with rates of domestic violence, over time. All three licence categories were positively associated with domestic violence rates, with small effects for general (pub) and on-premise licences and a large effect for packaged liquor licences. In Melbourne, the density of liquor licences is positively associated with rates of domestic violence over time. The effects were particularly large for packaged liquor outlets, suggesting a need for licensing policies that pay more attention to o off-premise alcohol availability. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  1. The Yo-Yo intermittent recovery test

    DEFF Research Database (Denmark)

    Bangsbo, Jens; Iaia, F. Marcello; Krustrup, Peter

    2008-01-01

    The two Yo-Yo intermittent recovery (IR) tests evaluate an individual's ability to repeatedly perform intense exercise. The Yo-Yo IR level 1 (Yo-Yo IR1) test focuses on the capacity to carry out intermittent exercise leading to a maximal activation of the aerobic system, whereas Yo-Yo IR level 2...

  2. Intermittent behavior of the logistic system

    Science.gov (United States)

    Mayer-Kress, G.; Haken, H.

    1981-03-01

    In the discrete logistic model a transition to chaotic behavior via intermittency occurs in a neighborhood of periodic bands. Intermittent behavior is also induced if a stable periodic orbit is perturbed by low-level external noise, whereas alterations due to computer digitalisation produce remarkable periodicities. We compare our numerical results with the predictions of Pomeau and Manneville for the Lorenz system.

  3. Cosmic Rays in Intermittent Magnetic Fields

    International Nuclear Information System (INIS)

    Shukurov, Anvar; Seta, Amit; Bushby, Paul J.; Wood, Toby S.; Snodin, Andrew P.

    2017-01-01

    The propagation of cosmic rays in turbulent magnetic fields is a diffusive process driven by the scattering of the charged particles by random magnetic fluctuations. Such fields are usually highly intermittent, consisting of intense magnetic filaments and ribbons surrounded by weaker, unstructured fluctuations. Studies of cosmic-ray propagation have largely overlooked intermittency, instead adopting Gaussian random magnetic fields. Using test particle simulations, we calculate cosmic-ray diffusivity in intermittent, dynamo-generated magnetic fields. The results are compared with those obtained from non-intermittent magnetic fields having identical power spectra. The presence of magnetic intermittency significantly enhances cosmic-ray diffusion over a wide range of particle energies. We demonstrate that the results can be interpreted in terms of a correlated random walk.

  4. Cosmic Rays in Intermittent Magnetic Fields

    Energy Technology Data Exchange (ETDEWEB)

    Shukurov, Anvar; Seta, Amit; Bushby, Paul J.; Wood, Toby S. [School of Mathematics and Statistics, Newcastle University, Newcastle Upon Tyne NE1 7RU (United Kingdom); Snodin, Andrew P., E-mail: a.seta1@ncl.ac.uk, E-mail: amitseta90@gmail.com [Department of Mathematics, Faculty of Applied Science, King Mongkut’s University of Technology North Bangkok, Bangkok 10800 (Thailand)

    2017-04-10

    The propagation of cosmic rays in turbulent magnetic fields is a diffusive process driven by the scattering of the charged particles by random magnetic fluctuations. Such fields are usually highly intermittent, consisting of intense magnetic filaments and ribbons surrounded by weaker, unstructured fluctuations. Studies of cosmic-ray propagation have largely overlooked intermittency, instead adopting Gaussian random magnetic fields. Using test particle simulations, we calculate cosmic-ray diffusivity in intermittent, dynamo-generated magnetic fields. The results are compared with those obtained from non-intermittent magnetic fields having identical power spectra. The presence of magnetic intermittency significantly enhances cosmic-ray diffusion over a wide range of particle energies. We demonstrate that the results can be interpreted in terms of a correlated random walk.

  5. Gastric epithelioid haemangioendothelioma.

    Science.gov (United States)

    Tavares, A B; Almeida, A G; Viveiros, F A; Cidade, C N; Barbosa, J M

    2011-05-10

    Epithelioid haemangioendothelioma (EHE) is a rare tumour of vascular origin, characterised by celular proliferation, endotelial, epitelioid or hystiocitoid. It may develop in any organ, but it is more common in lung and liver. Surgery is the recommended treatment; however, in case of a potentially benign situation, an expectant attitude should be adopted. The case reports a 71-year-old female who underwent a laparotomy for a colonic adenocarcinoma. During surgery, a polypoid lesion in the dependency of the gastric wall was found incidentally, which was removed. Histopathology and immunohistochemical analysis confirmed the diagnosis of EHE. Gastric vascular neoplasms represent about 0.9-3.3% of all gastric tumours. Usually have a good prognosis, but due to the borderline biological behaviour of these tumours, it is important to have a detailed clinical evaluation at follow-up of these patients.

  6. ANISOTROPIC INTERMITTENCY OF MAGNETOHYDRODYNAMIC TURBULENCE

    International Nuclear Information System (INIS)

    Osman, K. T.; Kiyani, K. H.; Chapman, S. C.; Hnat, B.

    2014-01-01

    A higher-order multiscale analysis of spatial anisotropy in inertial range magnetohydrodynamic turbulence is presented using measurements from the STEREO spacecraft in fast ambient solar wind. We show for the first time that, when measuring parallel to the local magnetic field direction, the full statistical signature of the magnetic and Elsässer field fluctuations is that of a non-Gaussian globally scale-invariant process. This is distinct from the classic multiexponent statistics observed when the local magnetic field is perpendicular to the flow direction. These observations are interpreted as evidence for the weakness, or absence, of a parallel magnetofluid turbulence energy cascade. As such, these results present strong observational constraints on the statistical nature of intermittency in turbulent plasmas

  7. Prolonged Intermittent Renal Replacement Therapy.

    Science.gov (United States)

    Edrees, Fahad; Li, Tingting; Vijayan, Anitha

    2016-05-01

    Prolonged intermittent renal replacement therapy (PIRRT) is becoming an increasingly popular alternative to continuous renal replacement therapy in critically ill patients with acute kidney injury. There are significant practice variations in the provision of PIRRT across institutions, with respect to prescription, technology, and delivery of therapy. Clinical trials have generally demonstrated that PIRRT is non-inferior to continuous renal replacement therapy regarding patient outcomes. PIRRT offers cost-effective renal replacement therapy along with other advantages such as early patient mobilization and decreased nursing time. However, due to lack of standardization of the procedure, PIRRT still poses significant challenges, especially pertaining to appropriate drug dosing. Future guidelines and clinical trials should work toward developing consensus definitions for PIRRT and ensure optimal delivery of therapy. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  8. Genomic dysregulation in gastric tumors.

    Science.gov (United States)

    Janjigian, Yelena Y; Kelsen, David P

    2013-03-01

    Gastric cancer is among the most common human malignancies and the second leading cause of cancer-related death. The different epidemiologic and histopathology of subtypes of gastric cancer are associated with different genomic patterns. Data suggests that gene expression patterns of proximal, distal gastric cancers-intestinal type, and diffuse/signet cell are well separated. This review summarizes the genetic and epigenetic changes thought to drive gastric cancer and the emerging paradigm of gastric cancer as three unique disease subtypes. Copyright © 2012 Wiley Periodicals, Inc.

  9. http://ijmrhs.com/isolated-gastric-tuberculosis-masquerading-as-chronic-peptic-ulcer-a-case-report/

    Directory of Open Access Journals (Sweden)

    Poflee Sandhya V, Baste Balaji D, Umap Pradeep S, Shrivastava Alok C

    2015-10-01

    Full Text Available Abdominal Tuberculosis (TB most commonly affects ileo-caecal region. Isolated stomach involvement by TB, without pulmonary infection is rare. Clinical presentation of Stomach TB may be non-specific, radiological findings non-contributory and superficial endoscopic biopsies may not be able to settle the diagnosis. Many cases are diagnosed only after histopathological examination of surgical specimens. High degree of suspicion is needed for early diagnosis of gastric tuberculosis, if unnecessary surgical interventions are to be avoided. A young patient who was being treated as a case of chronic peptic ulcer for one year was referred for treatment of gastric outlet obstruction. Histopathological examination of gastrectomy specimen of the patient showed multiple caseating granulomas characteristic of tuberculosis and presence of acid-fast bacilli on Fite-Faraco staining, with no evidence of tuberculosis at pulmonary or other body sites. This case of isolated gastric TB is reported for its rarity.

  10. The Role at Rehabilitation in Treatment of Thoracic Outlet Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Hosseinian

    2003-01-01

    Full Text Available Objective: Thoracic outlet syndrome is a complex disorder caused by neurovascular irritation in the region of the thoracic outlet. The syndrome have been said to be mainly due to anomalous structures in the thoracic outlet, treatment for thoracic outlet syndrome varies among different institutions, and there has not been any standard program. In general conservative and surgical treatment can be do if necessary. Materials & Methods: The rehabilitation program consists of exercise and physiotherapy and brace designed to hold the posture in which thoracic outlet is enlarged. Exercise program was designed simple enough to be performed in the daily living or during work after minimal training and isometric exercises of Serratus anterior, Levator Scapulae and Erector Spinae muscles to be performed in one posture: flexion and elevation of scapular girdle and correction position of upper-thoracic spine. During 7 years, 131 cases of (T.O.S. were evaluated that 26 cases (20% have operated and 84 cases (64% have treated with conservative treatment and 21 cases (16% have been candidate for surgery but they didn't accepted. Results: All of the cases have treated with conservative treatment for four months. 84 cases responded well and no further treatment was needed. 47 cases were not satisfied with. The outcome of their treatment, that 26 cases have operated and 21 cases have not accepted the operation and continued the conservative treatment, they have had pain and slightly disability. 23 cases of operated group responded well and they have resumed to work, one case has had neuropraxia for about one year. Conclusion: Most cases of thoracic outlet syndrome (T.O.S. can be treated conservatively. Surgically treatment is indicated only in cases severe enough to make them disable to work. It is better all the patients undergo conservative treatment for at least four months then will decided for surgical treatment.

  11. Blunt gastric injuries.

    Science.gov (United States)

    Oncel, Didem; Malinoski, Darren; Brown, Carlos; Demetriades, Demetrios; Salim, Ali

    2007-09-01

    Gastric rupture after blunt abdominal trauma is a rare injury with few reports in the literature. The purpose of this study was to review our experience with blunt gastric injuries and compare outcomes with small bowel or colon injuries. All patients with hollow viscus perforations after blunt abdominal trauma from 1992 to 2005 at our level I trauma center were reviewed. Of 35,033 blunt trauma admissions, there were 268 (0.7%) patients with a total of 319 perforating hollow viscus injuries, 25 (0.07%) of which were blunt gastric injuries. When compared with the small bowel or colon injuries, the blunt gastric injury group had a higher Injury Severity Score (22 versus 17, P = 0.04), more patients with a chest Abbreviated Injury Score greater than 2 (36% versus 12%, P < 0.01), and a shorter interval from injury to laparotomy (221 versus 366 minutes, P = 0.017). Multivariate analysis identified five independent risk factors for mortality: age older than 55 years, head Abbreviated Injury Score greater than 2, chest Abbreviated Injury Score greater than 2, the presence of hypotension on admission, and Glasgow Coma Scale 8 or less. The results of this study suggest that mortality in patients with blunt hollow viscus injuries can be attributed to concurrent head and chest injuries, but not the specific hollow viscus organ that is injured.

  12. Gastric neuroendocrine tumours.

    Science.gov (United States)

    Crosby, David A; Donohoe, Claire L; Fitzgerald, Louise; Muldoon, Cian; Hayes, Brian; O'Toole, Dermot; Reynolds, John V

    2012-01-01

    Gastric neuroendocrine tumours (NETs) are increasingly recognised, and management decisions may be difficult due to an incomplete understanding of aetiology, natural history and optimum therapy. This article presents a current understanding based on recent advances in epidemiology, classification, molecular profiling, and treatment. Relevant medical literature was identified from searches of PubMed and references cited in appropriate articles identified. Selection of articles was based on peer review, journal and relevance. Gastric NETs may be divided into three clinical prognostic groups: type I is associated with autoimmune atrophic gastritis and hypergastrinaemia, type II is associated with Zollinger-Ellison syndrome, and type III lesions are gastrin-independent, have the greatest metastatic potential and poorest prognosis. There has been an increased frequency of gastric NETs reported. Management approaches have evolved in parallel with advances in endoscopic staging and surgery, as well as improved understanding of the biology and natural history of NETs. Gastric NETs present a spectrum of activity from indolent tumours to metastatic malignancy. Treatment decisions for patients must be individualised and are best managed by a multidisciplinary team approach. The current evidence base is limited to small series and efforts to treat patients within clinical networks of expertise are warranted. Copyright © 2012 S. Karger AG, Basel.

  13. Gastric Calcifying Fibrous Tumour

    Directory of Open Access Journals (Sweden)

    Tan Attila

    2006-01-01

    Full Text Available Intramucosal gastric tumours are most commonly found to be gastrointestinal stromal tumours or leiomyomas (smooth muscle tumours; however, a variety of other uncommon mesenchymal tumours can occur in the stomach wall. A rare benign calcifying fibrous tumour is reported and the endoscopic appearance, ultrasound findings and morphology are documented. A review of the literature found only two similar cases.

  14. Helicobacter pyloriand gastric cancer

    African Journals Online (AJOL)

    2009-05-12

    May 12, 2009 ... only common but is second to lung cancer as a leading cause of cancer-related ... in the developing world,4 although cancer records are not readily available for .... gastric cancers are identified at a late stage due to lack of ...

  15. Mastication suppresses initial gastric emptying by modulating gastric activity.

    Science.gov (United States)

    Ohmure, H; Takada, H; Nagayama, K; Sakiyama, T; Tsubouchi, H; Miyawaki, S

    2012-03-01

    Because various mastication-related factors influence gastric activity, the functional relationship between mastication and gastric function has not been fully elucidated. To investigate the influence of mastication on gastric emptying and motility, we conducted a randomized trial to compare the effects of mastication on gastric emptying and gastric myoelectrical activity under conditions that excluded the influences of food comminution, taste, and olfaction. A (13)C-acetate breath test with electrogastrography and electrocardiography was performed in 14 healthy men who ingested a test meal with or without chewing gum. Autonomic nerve activity was evaluated by fluctuation analysis of heart rate. Gastric emptying was significantly delayed in the 'ingestion with mastication' group. Gastric myoelectrical activity was significantly suppressed during mastication and increased gradually in the post-mastication phase. A decrease in the high-frequency power of heart rate variability was observed coincidentally with gastric myoelectrical activity suppression. These findings suggest that initial gastric emptying is suppressed by mastication, and that the suppression is caused by mastication-induced inhibition of gastric activity (UMIN Clinical Trial Registration no. UMIN000005351).

  16. Intermittent cranial lung herniation in two dogs.

    Science.gov (United States)

    Guglielmini, Carlo; De Simone, Antonio; Valbonetti, Luca; Diana, Alessia

    2007-01-01

    Two aged dogs with chronic obstructive airway disease were evaluated because of intermittent swelling of the ventral cervical region. Radiographs made at expiration and caudal positioning of the forelimbs allowed identification of intermittent cervical lung herniation of the left and right cranial lung lobe in both dogs. Pulmonary hyperinflation, increased expiratory effort, and chronic coughing were considered responsible for the lung herniation. Cervical lung hernia should be included in the differential diagnoses of intermittent cervical swelling in dogs with chronic respiratory disorders associated with increased expiratory effort and chronic coughing.

  17. Case Report - Diaphragmatic eventration complicated by gastric ...

    African Journals Online (AJOL)

    Eventration of the diaphragm with gastric volvulus is uncommon. Gastric perforation in these cases is rare and usually associated with acute gastric volvulus with strangulation. We describe a case of diaphragmatic eventration with chronic gastric volvulus with gastric perforation without strangulation in an elderly man.

  18. Evaluation of a simple non-invasive 13C breath test to evaluate diet effects on gastric emptying in pigs

    DEFF Research Database (Denmark)

    Jørgensen, Henry; Strathe, Anders Bjerring; Theil, Peter Kappel

    2010-01-01

    to feeding (15.5 h after the previous meal) on the day when the 5 h sample was taken. In the breath test four pregnant sows were placed in respiration chambers and the 13C marker was added in the morning meal and air samples were collected up to 18 h at the outlet from the chambers and detected on an infra...... of the gastric content. Thus, the breath test is applicable for evaluating dietary effects on gastric emptying and potentially improves the behaviour and well being of gestating sows and lends confidence to applicability in clinical human trials....

  19. Gastric inhibitory polypeptide does not inhibit gastric emptying in humans

    DEFF Research Database (Denmark)

    Meier, Juris J; Goetze, Oliver; Anstipp, Jens

    2004-01-01

    ) = 0.15, P = 0.15 for intact GIP; r(2) = 0.21, P = 0.086 for total GIP). We conclude that gastric emptying does not appear to be influenced by GIP. The secretion of GIP after meal ingestion is not suppressed by its exogenous administration. The lack of effect of GIP on gastric emptying underlines......The insulinotropic gut hormone gastric inhibitory polypeptide (GIP) has been demonstrated to inhibit gastric acid secretion and was proposed to possess "enterogastrone" activity. GIP effects on gastric emptying have not yet been studied. Fifteen healthy male volunteers (23.9 +/- 3.3 yr, body mass....... Gastric emptying was calculated from the (13)CO(2) exhalation rates in breath samples collected over 360 min. Venous blood was drawn in 30-min intervals for the determination of glucose, insulin, C-peptide, and GIP (total and intact). Statistical calculations were made by use of repeated-measures ANOVA...

  20. Intermittent sea-level acceleration

    Science.gov (United States)

    Olivieri, M.; Spada, G.

    2013-10-01

    Using instrumental observations from the Permanent Service for Mean Sea Level (PSMSL), we provide a new assessment of the global sea-level acceleration for the last ~ 2 centuries (1820-2010). Our results, obtained by a stack of tide gauge time series, confirm the existence of a global sea-level acceleration (GSLA) and, coherently with independent assessments so far, they point to a value close to 0.01 mm/yr2. However, differently from previous studies, we discuss how change points or abrupt inflections in individual sea-level time series have contributed to the GSLA. Our analysis, based on methods borrowed from econometrics, suggests the existence of two distinct driving mechanisms for the GSLA, both involving a minority of tide gauges globally. The first effectively implies a gradual increase in the rate of sea-level rise at individual tide gauges, while the second is manifest through a sequence of catastrophic variations of the sea-level trend. These occurred intermittently since the end of the 19th century and became more frequent during the last four decades.

  1. Social Smoking among Intermittent Smokers

    Science.gov (United States)

    Shiffman, Saul; Li, Xiaoxue; Dunbar, Michael S.; Ferguson, Stuart G.; Tindle, Hilary A.; Scholl, Sarah M.

    2015-01-01

    Background “Social smoking” - smoking mostly or even only with others – may be an important pattern that implies smoking motivated extrinsically by social influences. Non-daily smokers (intermittent smokers; ITS) are often assumed to be social smokers, with some authors even assuming that all ITS are social smokers (SS+). We sought to identify and characterize social smokers in a sample of ITS. Methods 204 adult ITS (smoking 4–27 days/month) recorded the circumstances of smoking in their natural settings using Ecological Momentary Assessment, while also recording their circumstances in nonsmoking moments. SS+ were defined as ITS who were with others when they smoked most of their cigarettes, and who were ≥ 50% more likely to be with others when smoking than when not. Results Only 13% of ITS were SS+. Although defined solely on the basis of presence of others, SS+ showed a distinct pattern of smoking across multiple dimensions: Compared to other ITS (who were significantly less likely to smoke when with others), SS+ smoking was more associated with socializing, being with friends and acquaintances, drinking alcohol, weekends, evening or nighttime, being in other people’s homes, but not their own home. SS+ smoking was low in the morning and increased in the evening. SS+ smoked fewer days/week and were less dependent, but did not differ demographically. Conclusions Social smoking does constitute a highly distinct smoking pattern, but is not common among adult ITS. PMID:26205313

  2. Intermittent ileocoecal intususception in adult

    International Nuclear Information System (INIS)

    Cambal, M.; Zonca, P.; Maly, T.

    2013-01-01

    Aim: Aim of our paper is to present a case-report of chronic invagination in adult patient. Material: 28-years old woman with one year history of intermittent abdominal pain with symptoms of subileus state. She has underwent abdominal ultrasonography, abdominal X-ray, colonoscopy, irigography and abdominal CT. Appendectomy indicated for diagnosis of chronic appendicitis did not improve symptoms. Consecutively during acute problems were irigography and CT performed and diagnosis of an incomplete colon transversum obstruction of uncertain origin was established. There was stated suspicion of an intususception and patient was due to a repeated gastrointestinal passage indicated for an explorative laparotomy. During operation there was identified threefold invagination – colo-colonic, ileo-colonic and ileo-ileal. As a leading point of invagination was found in terminal ileum intraluminal polypous tumor 5 cm in diameter. Because of the secondary chronic changes of right colon wall and terminal ileum wall, after partial desinvagination right hemicolectomy was performed. Results: Patient was primary healed and now is without any subjective problems. Conclusion: Invagination is an acute abdominal event of obturative-strangulative type and it mainly occurs in infantile age. It is astonishing how long were patient´s difficulties lasting without obvious acute ileus. It is necessary in clinical practice to think on these rare reasons of gastrointestinal passage disorders. (author)

  3. Endoscopic Mucosectomy in a Child Presenting with Gastric Heterotopia of the Rectum

    Directory of Open Access Journals (Sweden)

    Joana Soares

    2017-09-01

    Full Text Available Gastric mucosal heterotopia has been described in all levels of the gastrointestinal tract. Its occurrence in the rectum is uncommon. We report the case of a 4-year-old boy referred to Pediatric Gastroenterology for intermittent rectal bleeding for the past 2 years. Total ileocolonoscopy revealed a flat, well-circumscribed lesion of 4 cm, with elevated margins, localized at 10 cm from the anal verge. Histologic examination showed typical gastric mucosa of the oxyntic type. Treatment with proton pump inhibitors was started without resolution of the symptoms and, therefore, an endoscopic mucosal resection was performed. Heterotopic gastric mucosa represents a rare cause of rectal bleeding in children and endoscopic evaluation is fundamental for diagnosis. Although not usually performed in pediatric ages, endoscopic mucosectomy allows complete resolution of the problem avoiding surgery.

  4. Endoscopic Mucosectomy in a Child Presenting with Gastric Heterotopia of the Rectum.

    Science.gov (United States)

    Soares, Joana; Ferreira, Carla; Marques, Margarida; Corujeira, Susana; Tavares, Marta; Lopes, Joanne; Carneiro, Fátima; Amil Dias, Jorge; Trindade, Eunice

    2017-11-01

    Gastric mucosal heterotopia has been described in all levels of the gastrointestinal tract. Its occurrence in the rectum is uncommon. We report the case of a 4-year-old boy referred to Pediatric Gastroenterology for intermittent rectal bleeding for the past 2 years. Total ileocolonoscopy revealed a flat, well-circumscribed lesion of 4 cm, with elevated margins, localized at 10 cm from the anal verge. Histologic examination showed typical gastric mucosa of the oxyntic type. Treatment with proton pump inhibitors was started without resolution of the symptoms and, therefore, an endoscopic mucosal resection was performed. Heterotopic gastric mucosa represents a rare cause of rectal bleeding in children and endoscopic evaluation is fundamental for diagnosis. Although not usually performed in pediatric ages, endoscopic mucosectomy allows complete resolution of the problem avoiding surgery.

  5. Using marine sediment archives to reconstruct past outlet glacier variability

    DEFF Research Database (Denmark)

    Andresen, Camilla Snowman; Straneo, Fiamma; Ribergaard, Mads

    2013-01-01

    Ice-rafted debris in fjord sediment cores provides information about outlet glacier activity beyond the instrumental time period. It tells us that the Helheim Glacier, Greenland’s third most productive glacier, responds rapidly to short-term (3 to 10 years) climate changes....

  6. Gas pressure in bubble attached to tube circular outlet

    OpenAIRE

    Salonen, A; Gay, Cyprien; Maestro, A; Drenckhan, W; Rio, Emmanuelle

    2016-01-01

    In the present Supplementary notes to our work ``Arresting bubble coarsening: A two-bubble experiment to investigate grain growth in presence of surface elasticity'' (accepted in EPL), we derive the expression of the gas pressure inside a bubble located above and attached to the circular outlet of a vertical tube.

  7. Supermarket and fast-food outlet exposure in Copenhagen

    DEFF Research Database (Denmark)

    Svastisalee, Chalida Mae; Jensen, Helene Nordahl; Glumer, Charlotte

    2011-01-01

    and neighbourhood-level socio-economic indicators. Food business addresses were obtained from commercial and public business locators and geocoded using a geographic information system for all neighbourhoods in the city of Copenhagen (n 400). The regression of counts of fast-food outlets and supermarkets v...

  8. Boundary conditions for free surface inlet and outlet problems

    KAUST Repository

    Taroni, M.; Breward, C. J. W.; Howell, P. D.; Oliver, J. M.

    2012-01-01

    We investigate and compare the boundary conditions that are to be applied to free-surface problems involving inlet and outlets of Newtonian fluid, typically found in coating processes. The flux of fluid is a priori known at an inlet, but unknown

  9. Publication Outlets for School Psychology Faculty: 2010 to 2015

    Science.gov (United States)

    Hulac, David; Johnson, Natalie D.; Ushijima, Shiho C.; Schneider, Maryia M.

    2016-01-01

    Many school psychology faculty are required to publish for purposes of retention and promotion. It is useful to have an understanding of the different outlets for scholarly publications. In the present study, we investigated the peer-reviewed journals in which school psychology faculty were published between 2010 and 2015, the number of articles…

  10. Predictive factors of bladder outlet obstruction following the tension ...

    African Journals Online (AJOL)

    H. Elghamrawi

    On the other hand, multivariate analysis indicated that Qmax was the only factor independently related to postoperative bladder outlet obstruction after TVTO (p = 0.002, odds ratio = 0.658, 95% CI for odds ratio 0.507–0.855). Discussion. Stress urinary incontinence defined as the involuntary loss of urine during increases in ...

  11. “Clavicular duplication causing thoracic outlet obstruction”: Unique ...

    African Journals Online (AJOL)

    A 22‑year‑old female student reported with features of neurogenic thoracic outlet syndrome mainly involving C8‑T1 components of the brachial plexus, seemingly originating from involvement in costo‑clavicular space. Radiograph of the shoulder revealed clavicular duplication. Neuro‑physiological studies corroborated the ...

  12. Velocities of antarctic outlet glaciers determined from sequential Landsat images

    Science.gov (United States)

    MacDonald, Thomas R.; Ferrigno, Jane G.; Williams, Richard S.; Lucchitta, Baerbel K.

    1989-01-01

    Approximately 91.0 percent of the volume of present-day glacier ice on Earth is in Antarctica; Greenland contains about another 8.3 percent of the volume. Thus, together, these two great ice sheets account for an estimated 99.3 percent of the total. Long-term changes in the volume of glacier ice on our planet are the result of global climate change. Because of the relationship of global ice volume to sea level (± 330 cubic kilometers of glacier ice equals ± 1 millimeter sea level), changes in the mass balance of the antarctic ice sheet are of particular importance.Whether the mass balance of the east and west antarctic ice sheets is positive or negative is not known. Estimates of mass input by total annual precipitation for the continent have been made from scattered meteorological observations (Swithinbank 1985). The magnitude of annual ablation of the ice sheet from calving of outlet glaciers and ice shelves is also not well known. Although the velocities of outlet glaciers can be determined from field measurements during the austral summer,the technique is costly, does not cover a complete annual cycle,and has been applied to just a few glaciers. To increase the number of outlet glaciers in Antarctica for which velocities have been determined and to provide additional data for under-standing the dynamics of the antarctic ice sheets and their response to global climate change, sequential Landsat image of several outlet glaciers were measured.

  13. Improvement of seawater booster pump outlet check valve

    International Nuclear Information System (INIS)

    Li Xuning; Du Yansong; Huang Huimin

    2010-01-01

    Conventional island seawater booster pump set of QNPC 310 MWe unit are very important in the whole circulating cooling system, and the integrate function of seawater booster pump outlet check valve is the foundation of steady operation of the seawater booster pump set. The article mainly introduce that through the analyses to the reason to the problem that the seawater booster pump outlet check valve of QNPC 310 MWe unit appeared in past years by our team, and considering the influence of operation condition and circumstance, the team improve the seawater booster pump outlet check valve from swing check valve to shuttle check valve which operate more appropriately in the system. By the test of continuous practice, we make further modification to the inner structure of shuttle check valve contrapuntally, and therefore we solve the problem in seawater booster pump outlet check valve fundamentally which has troubled the security of system operation in past years, so we realize the aim of technical improvement and ensure that the system operate in safety and stability. (authors)

  14. Report of an adult with double-outlet right ventricle

    International Nuclear Information System (INIS)

    Munera E, Ana G; Florez C, Marina; Delgado de B, Jorge A and others

    2001-01-01

    The case of a 22 -year- old woman with a diagnosis of congenital heart disease, N Y H A class I, who complaints palpitations. By echocardiography, angiography and magnetic resonance imaging a diagnosis of double-outlet right ventricle was done. She was intervened for correction, creating an interventricular tunnel connecting the left ventricle to the aorta through the ventricular septal defect

  15. White adipose tissue coloring by intermittent fasting.

    Science.gov (United States)

    Kivelä, Riikka; Alitalo, Kari

    2017-11-01

    Intermittent fasting (IF) has been shown to promote metabolic health in several organisms. Two recent papers show that IF induces white adipose tissue beiging and increases thermogenesis, which improves metabolic health in mice.

  16. On-line intermittent connector anomaly detection

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper investigates a non-traditional use of differential current sensor and current sensor to detect intermittent disconnection problems in connectors. An...

  17. Intermittent chaotic chimeras for coupled rotators

    DEFF Research Database (Denmark)

    Olmi, Simona; Martens, Erik Andreas; Thutupalli, Shashi

    2015-01-01

    Two symmetrically coupled populations of N oscillators with inertia m display chaotic solutions with broken symmetry similar to experimental observations with mechanical pendulums. In particular, we report evidence of intermittent chaotic chimeras, where one population is synchronized and the other...

  18. Feigenbaum attractor and intermittency in particle collisions

    International Nuclear Information System (INIS)

    Batunin, A.V.

    1992-01-01

    The hypothesis is proposed that the Feigenbaum attractor arising as a limit set in an infinite pichfork bifurcation sequence for unimodal one-dimensional maps underlies the intermittency phenomena in particle collisions. 23 refs.; 8 figs

  19. Gastric stem cells and gastric cancer stem cells

    OpenAIRE

    Han, Myoung-Eun; Oh, Sae-Ock

    2013-01-01

    The gastric epithelium is continuously regenerated by gastric stem cells, which give rise to various kinds of daughter cells, including parietal cells, chief cells, surface mucous cells, mucous neck cells, and enteroendocrine cells. The self-renewal and differentiation of gastric stem cells need delicate regulation to maintain the normal physiology of the stomach. Recently, it was hypothesized that cancer stem cells drive the cancer growth and metastasis. In contrast to conventional clonal ev...

  20. Stomach (Gastric) Cancer—Health Professional Version

    Science.gov (United States)

    Almost all gastric cancers are adenocarcinomas. Other types of gastric cancer are gastrointestinal carcinoid tumors, gastrointestinal stromal tumors, and lymphomas. Find evidence-based information on gastric cancer treatment, causes and prevention, screening, research, and statistics.

  1. Molecular biology of gastric cancer.

    Science.gov (United States)

    Cervantes, A; Rodríguez Braun, E; Pérez Fidalgo, A; Chirivella González, I

    2007-04-01

    Despite its decreasing incidence overall, gastric cancer is still a challenging disease. Therapy is based mainly upon surgical resection when the tumour remains localised in the stomach. Conventional chemotherapy may play a role in treating micrometastatic disease and is effective as palliative therapy for recurrent or advanced disease. However, the knowledge of molecular pathways implicated in gastric cancer pathogenesis is still in its infancy and the contribution of molecular biology to the development of new targeted therapies in gastric cancer is far behind other more common cancers such as breast, colon or lung. This review will focus first on the difference of two well defined types of gastric cancer: intestinal and diffuse. A discussion of the cell of origin of gastric cancer with some intriguing data implicating bone marrow derived cells will follow, and a comprehensive review of different genetic alterations detected in gastric cancer, underlining those that may have clinical, therapeutic or prognostic implications.

  2. Targeting BRCAness in Gastric Cancer

    Science.gov (United States)

    2017-10-01

    Award Number: W81XWH-16-1-0472 TITLE: Targeting BRCAness in Gastric Cancer PRINCIPAL INVESTIGATOR: Lawrence Fong CONTRACTING ORGANIZATION...Targeting BRCAness in Gastric Cancer 5b. GRANT NUMBER W81XWH-16-1-0473 (Ashworth) 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Eric Collisson, David Quigley...for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT We performed the screen of gastric cancer cell lines for their

  3. Gastric cancer review

    Directory of Open Access Journals (Sweden)

    Lauren Peirce Carcas

    2014-01-01

    Full Text Available Gastric cancer is an aggressive disease that continues to have a daunting impact on global health. Despite an overall decline in incidence over the last several decades, gastric cancer remains the fourth most common type of cancer and is the second leading cause of cancer-related death worldwide. This review aims to discuss the global distribution of the disease and the trend of decreasing incidence of disease, delineate the different pathologic subtypes and their immunohistochemical (IHC staining patterns and molecular signatures and mutations, explore the role of the pathogen H. pylori in tumorgenesis, discuss the increasing incidence of the disease in the young, western populations and define the role of biologic agents in the treatment of the disease.

  4. Hereditary diffuse gastric cancer

    DEFF Research Database (Denmark)

    van der Post, Rachel S; Vogelaar, Ingrid P; Carneiro, Fátima

    2015-01-01

    Germline CDH1 mutations confer a high lifetime risk of developing diffuse gastric (DGC) and lobular breast cancer (LBC). A multidisciplinary workshop was organised to discuss genetic testing, surgery, surveillance strategies, pathology reporting and the patient's perspective on multiple aspects......, including diet post gastrectomy. The updated guidelines include revised CDH1 testing criteria (taking into account first-degree and second-degree relatives): (1) families with two or more patients with gastric cancer at any age, one confirmed DGC; (2) individuals with DGC before the age of 40 and (3...... the high mortality associated with invasive disease, prophylactic total gastrectomy at a centre of expertise is advised for individuals with pathogenic CDH1 mutations. Breast cancer surveillance with annual breast MRI starting at age 30 for women with a CDH1 mutation is recommended. Standardised endoscopic...

  5. Gastric emptying in chronic dyspepsia

    International Nuclear Information System (INIS)

    Sielaff, F.; Jahnel, P.; Sest, C.; Sydow, K.; Sapia, C.; Hass, A.; Buchali, K.

    1987-01-01

    Gastric emptying of a semiliquid test meal with 5 MBq /sup 99m/Tc-sulfur colloid as a marker was measured in 97 chronic dyspeptic patients and 16 healthy subjects. A comparison of half emptying time between both showed that chronic dyspeptic patients empty semiliquid meal at a significantly (p < 0.005) slower rate (at 70 +- 33 min) than healthy controls (at 52 x 20 min). The studies indicate that gastric stasis in chronic dyspepsia is not caused by inflammatory changes in gastric or duodenal mucosa nor by different gastric acid secretion. The presence of stasis cannot be predicted sufficiently by anamnestic complaints or endoscopic findings. (author)

  6. Gastric Schwannoma: a case report

    International Nuclear Information System (INIS)

    Lee, Kye Ho; Jee, Keum Nahn

    2006-01-01

    Gastric Schwannoma is a rare benign intramural tumor arising from the stomach, and it accounts for only 0.1% of all the different kinds of gastric neoplasms, and it's less than 4% of all the benign gastric tumors. This tumor is very difficult to differentiate from the other mesenchymal tumors by the clinical, endoscopic and radiologic findings. In this study, we demonstrate the appearance of this tumor on endoscopic ultrasound and contrast-enhanced abdomen CT. We also show the histopathologic findings of a surgically confirmed gastric Schwannoma that was located in the proper muscle layer

  7. and Gastric Cancers

    Directory of Open Access Journals (Sweden)

    Sebahattin Celik

    2015-01-01

    Full Text Available Purpose. To examine the relationship between esophageal and gastric cancers commonly seen in Van Lake region and the traditional eating habits of the geography. Materials and Methods. Esophageal and gastric cancer cases, who underwent surgery between January 1, 2012, and December 31, 2013, were examined. Pathology reports of the patients and presence of Helicobacter pylori (HP were recorded. Surveys were filled by face to face meeting or telephone call. Control group was created with randomly selected individuals without any cancer diagnosis having age, gender, and socioeconomic characteristics similar to patient group. All data were analyzed using SAS.9.3 statistical programme. Results. Compared with the control group, herby cheese consumption (a component of eating habits and smoking were significantly higher in the patient group (P<0.001. Tandoor exposure is compared in terms of female gender, and significant difference was found between the groups (P=0.0013. As a result of the analysis with logistic regression more than 150 gr of herby cheese consumption per day was found to increase the cancer risk (odds ratio 1.017; 95% CI: 1.012–1.022. Conclusion. A high consumption of herby cheese, cooking bread on tandoor, and heavy smoking were seen to be important risk factors for esophageal and gastric cancers.

  8. Diet and gastric cancer

    Directory of Open Access Journals (Sweden)

    Šipetić Sandra B.

    2003-01-01

    Full Text Available The aim of this case-control study, conducted in Serbia during the period 1998-2000, was to investigate whether diet was associated with the development of gastric cancer. The case group consisted of 131 patients with histologically confirmed gastric cancer, and the control group of 131 patients with orthopedics diseases and injuries. Cases and controls were individually matched by age (±± 2 years, gender, and place of residence. On the basis of multivariate logistic regression analysis, following factors were found as independent risk factors for gastric cancer: more frequent consumption of high-fat milk [Odds ratio (OR =1.45, 95% confidence interval (CI = 0.99-2.16]; mutton, lamb and/or calf meat (OR = 2.46, 95% CI = 1.11-5.47, sugar (OR = 2.13, 95% CI = 1.43-3.18, semi-white bread (OR = 2.09, 95% CI = 1.25-3.50, and salting food (OR = 5.72, 95% CI = 2.63-12.42. Factors found as protective were: more frequent consumption of margarine (OR = 0.41, 95% CI = 0.25-0.69, „other“ cheeses (OR = 0.47, 95% CI = 0.29 - 0.77, and fish (OR = 0.39, 95% CI = 0.19-0.76.

  9. Tricholithobezoar Causing Gastric Perforation

    Directory of Open Access Journals (Sweden)

    Juliana Santos Valenciano

    2012-01-01

    Full Text Available A bezoar is an intraluminal mass formed by the accumulation of undigested material in the gastrointestinal tract. Trichobezoar is a rare condition seen almost exclusively in young women with trichotillomania and trichotillophagia. When not recognized, the trichobezoar continues to grow, which increases the risk of severe complications such as gastric ulceration and even perforation. Formation of a gallstone within the trichobezoar (tricholithobezoar is an event that has not yet been described. We report the case of a 22-year-old woman admitted to the emergency room with signals and symptoms of an epigastric mass and perforative acute abdomen. Radiological study revealed bilateral pneumoperitoneum. Personal history revealed depressive syndrome, trichotillomania and trichophagia. With a diagnosis of visceral perforation, an urgent exploratory laparotomy was performed. This confirmed the diagnosis of gastric perforation due to a large trichobezoar with the formation of a gastrolith that was removed by anterior gastrotomy. Biochemical study of the gastric stone revealed that it was composed of bile salts. There were no complications. The patient was discharged on the 5th postoperative day and was referred for psychiatric treatment.

  10. Endoscopic Treatment of Early Gastric Obstruction After Sleeve Gastrectomy: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Mariana Nuno Costa

    2016-01-01

    Full Text Available Morbid obesity is an epidemic and complex disease which imposes a multidisciplinary approach. Laparoscopic sleeve gastrectomy has become a frequent procedure given its efficacy and safety compared to other surgical options. However, it isn’t free from complications. Lax gastric fixation or incorrect positioning of the stomach during surgery can result in early gastric outlet obstruction caused by a volvulus-like mechanism by rotation of the stomach around its anatomic axes. This report refers to two cases of post sleeve gastric torsion resulting in persisting vomiting after initiating oral intake. The diagnosis was confirmed by upper gastrointestinal-contrast study and gastroscopy. In both cases, a fully covered self-expandable metallic stent was inserted which prompted the gastric lumen to become permeable resulting in symptomatic resolution. The stents were removed endoscopically after two and three months. Beyond more than three years of follow-up, the patients remain asymptomatic and no recurring “stenosis” was noticed. In these cases the use of fully covered self-expandable metallic stents demonstrated to be effective and safe in the treatment of post sleeve gastric torsion.

  11. Intermittent ephemeral river-breaching

    Science.gov (United States)

    Reniers, A. J.; MacMahan, J. H.; Gallagher, E. L.; Shanks, A.; Morgan, S.; Jarvis, M.; Thornton, E. B.; Brown, J.; Fujimura, A.

    2012-12-01

    In the summer of 2011 we performed a field experiment in Carmel River State Beach, CA, at a time when the intermittent natural breaching of the ephemeral Carmel River occurred due to an unusually rainy period prior to the experiment associated with El Nino. At this time the river would fill the lagoon over the period of a number of days after which a breach would occur. This allowed us to document a number of breaches with unique pre- and post-breach topographic surveys, accompanying ocean and lagoon water elevations as well as extremely high flow (4m/s) velocities in the river mouth during the breaching event. The topographic surveys were obtained with a GPS-equipped backpack mounted on a walking human and show the evolution of the river breaching with a gradually widening and deepening river channel that cuts through the pre-existing beach and berm. The beach face is qualified as a steep with an average beach slope of 1:10 with significant reflection of the incident waves (MacMahan et al., 2012). The wave directions are generally shore normal as the waves refract over the deep canyon that is located offshore of the beach. The tide is mixed semi-diurnal with a range on the order of one meter. Breaching typically occurred during the low-low tide. Grain size is highly variable along the beach with layers of alternating fine and coarse material that could clearly be observed as the river exit channel was cutting through the beach. Large rocky outcroppings buried under the beach sand are also present along certain stretches of the beach controlling the depth of the breaching channel. The changes in the water level measured within the lagoon and the ocean side allows for an estimate of the volume flux associated with the breach as function of morphology, tidal elevation and wave conditions as well as an assessment of the conditions and mechanisms of breach closure, which occurred on the time scale of O(0.5 days). Exploratory model simulations will be presented at the

  12. Turbofan gas turbine engine with variable fan outlet guide vanes

    Science.gov (United States)

    Wood, Peter John (Inventor); LaChapelle, Donald George (Inventor); Grant, Carl (Inventor); Zenon, Ruby Lasandra (Inventor); Mielke, Mark Joseph (Inventor)

    2010-01-01

    A turbofan gas turbine engine includes a forward fan section with a row of fan rotor blades, a core engine, and a fan bypass duct downstream of the forward fan section and radially outwardly of the core engine. The forward fan section has only a single stage of variable fan guide vanes which are variable fan outlet guide vanes downstream of the forward fan rotor blades. An exemplary embodiment of the engine includes an afterburner downstream of the fan bypass duct between the core engine and an exhaust nozzle. The variable fan outlet guide vanes are operable to pivot from a nominal OGV position at take-off to an open OGV position at a high flight Mach Number which may be in a range of between about 2.5-4+. Struts extend radially across a radially inwardly curved portion of a flowpath of the engine between the forward fan section and the core engine.

  13. Boundary conditions for free surface inlet and outlet problems

    KAUST Repository

    Taroni, M.

    2012-08-10

    We investigate and compare the boundary conditions that are to be applied to free-surface problems involving inlet and outlets of Newtonian fluid, typically found in coating processes. The flux of fluid is a priori known at an inlet, but unknown at an outlet, where it is governed by the local behaviour near the film-forming meniscus. In the limit of vanishing capillary number Ca it is well known that the flux scales with Ca 2/3, but this classical result is non-uniform as the contact angle approaches π. By examining this limit we find a solution that is uniformly valid for all contact angles. Furthermore, by considering the far-field behaviour of the free surface we show that there exists a critical capillary number above which the problem at an inlet becomes over-determined. The implications of this result for the modelling of coating flows are discussed. © 2012 Cambridge University Press.

  14. Coherent Structures and Intermittency in Plasma Turbulence

    International Nuclear Information System (INIS)

    Das, Amita; Kaw, Predhiman; Sen, Abhijit

    2008-01-01

    The paper discusses some fundamental issues related to the phenomenon of intermittency in plasma turbulence with particular reference to experimental observations in fusion devices. Intermittency is typically associated with the presence of coherent structures in turbulence. Since coherent structures can play an important role in governing the transport properties of a system they have received a great deal of attention in fusion research. We review some of the experimental measurements and numerical simulation studies on the presence and formation of coherent structures in plasmas and discuss their relevance to intermittency. Intermittency, as widely discussed in the context of neutral fluid turbulence, implies multiscaling behaviour in contrast to self-similar scaling patterns observed in self organized criticality (SOC) phenomenon. The experimental evidence from plasma turbulence measurements reveal a mixed picture--while some observations support the SOC model description others indicate the presence of multiscaling behaviour. We discuss these results in the light of our present understanding of plasma turbulence and in terms of certain unique aspects of intermittency as revealed by fluid models of plasmas.

  15. Intermittency in {sup 197}Au fragmentation

    Energy Technology Data Exchange (ETDEWEB)

    Dabrowska, A; Holynski, R; Olszewski, A; Szarska, M; Wilczynska, B; Wolter, W; Wosiek, B [Institute of Nuclear Physics, Cracow (Poland); Cherry, M L; Deines-Jones, P; Jones, W V; Sengupta, K; Wefel, B [Louisiana State Univ., Baton Rouge, LA (United States). Dept. of Physics and Astronomy; Waddington, C J [Minnesota Univ., Minneapolis, MN (United States). School of Physics and Astronomy; Pozharova, E A; Skorodko, T Yu [Inst. of Theoretical and Experimental Physics, Moscow (Russian Federation); KLMM Collaboration

    1995-07-01

    The concept of factorial moments was applied to an analysis of the dynamical fluctuations in the charge distributions of the fragments emitted from gold nuclei with energies 10.6 and < 1.0 GeV/n interacting with emulsion nuclei. Clear evidence for intermittent fluctuations has been found in an analysis using all the particles released from the gold projectile, with a stronger effect observed below 1 GeV/n than at 10.6 GeV/n. For the full data sets, however, the intermittency effect was found to be very sensitive to the singly charged particles, and neglecting these particles strongly reduces the intermittency signal. When the analysis is restricted to the multiply charged fragments, an intermittency effect is revealed only for multifragmentation events, although one that is enhanced as compared to the analysis of all, singly and multiply charged, particles. The properties of the anomalous fractal dimensions suggest a sequential decay mechanism, rather than the existence of possible critical behaviour in the process of nuclear fragmentation. The likely influence of the charge conservation effects and the finite size of decaying systems on the observed intermittency signals was pointed out. (author). 37 refs, 9 figs, 5 tabs.

  16. Simulation of water flows in multiple columns with small outlets

    International Nuclear Information System (INIS)

    Suh, Yong Kweon; Li, Zi Lu; Jeong, Jong Hyun; Lee, Jun Hee

    2006-01-01

    High-pressure die casting such as thixocasting and rheocasting is an effective process in the manufacturing automotive parts. Following the recent trend in the automotive manufacturing technologies, the product design subject to the die casting becomes more and more complex. Simultaneously the injection speed is also designed to be very high to establish a short cycle-time. Thus, the requirement of the die design becomes more demanding than ever before. In some cases the product's shape can have multiple slender manifolds. In such cases, design of the inlet and outlet parts of the die is very important in the whole manufacturing process. The main issues required for the qualified products are to attain gentle and uniform flow of the molten liquid within the passages of the die. To satisfy such issues, the inlet cylinder ('bed cylinder' in this paper) must be as large as possible and simultaneously the outlet opening at the end of each passage must be as small as possible. However these in turn obviously bring additional manufacturing costs caused by re-melting of the bed cylinder and increased power due to the small outlet-openings. The purpose of this paper is to develop effective simulation methods of calculation for fluid flows in multiple columns, which mimic the actual complex design, and to get some useful information which can give some contributions to the die-casting industry. We have used a commercial code CFX in the numerical simulation. The primary parameter involved is the size of the bed cylinder. We will show how the very small opening of the outlet can be treated with the aid of the porous model provided in the code. To check the validity of the numerical results we have also conducted a simple experiment by using water

  17. Computer supervision of the core outlet sodium temperatures of FBTR

    International Nuclear Information System (INIS)

    Boopathy, C.

    1976-01-01

    Safety monitoring of the fast breeder test reactor at Kalpakkam (India) is achieved by a CDPS-on-line dual computer system which is dedicated to plant supervision. The on-line subsystem scans and supervises all the 170 core thermocouple signals every second. Organisation of the reactor core instruments, supervision of mean sodium outlet temperature and mean temperature drop across the core, detection of plugging of a fuel assembly are explained. (A.K.)

  18. Expiry of medicines in supply outlets in Uganda.

    Science.gov (United States)

    Nakyanzi, Josephine Katabaazi; Kitutu, Freddy Eric; Oria, Hussein; Kamba, Pakoyo Fadhiru

    2010-02-01

    The expiry of medicines in the supply chain is a serious threat to the already constrained access to medicines in developing countries. We investigated the extent of, and the main contributing factors to, expiry of medicines in medicine supply outlets in Kampala and Entebbe, Uganda. A cross-sectional survey of six public and 32 private medicine outlets was done using semi-structured questionnaires. The study area has 19 public medicine outlets (three non-profit wholesalers, 16 hospital stores/pharmacies), 123 private wholesale pharmacies and 173 retail pharmacies, equivalent to about 70% of the country's pharmaceutical businesses. Our findings indicate that medicines prone to expiry include those used for vertical programmes, donated medicines and those with a slow turnover. Awareness about the threat of expiry of medicines to the delivery of health services has increased. We have adapted training modules to emphasize management of medicine expiry for pharmacy students, pharmacists and other persons handling medicines. Our work has also generated more research interest on medicine expiry in Uganda. Even essential medicines expire in the supply chain in Uganda. Sound coordination is needed between public medicine wholesalers and their clients to harmonize procurement and consumption as well as with vertical programmes to prevent duplicate procurement. Additionally, national medicine regulatory authorities should enforce existing international guidelines to prevent dumping of donated medicine. Medicine selection and quantification should be matched with consumer tastes and prescribing habits. Lean supply and stock rotation should be considered.

  19. Female outlet obstruction constipation: assessment with MR defecography

    International Nuclear Information System (INIS)

    Li Min; Jiang Tao; Yang Xinqing; Peng Peng; Wang Wenchuan

    2010-01-01

    Objective: Using MR defecography to assess the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and evaluate the joint disease of' anterior and mid pelvic. Methods: One hundred and seven female patients, aged 20 to 84 years (average, 55 years), were diagnosed as outlet obstruction constipation based on clinical symptoms and signs. They all received MR defecography in our institution. The high compliance homemade balloon was inserted into rectum to simulate stool. Then relevant measurements were obtained during rest, squeezing and straining, respectively. Results: In all the 107 cases, 70 (65.4%) presented rectocele on dynamic MRI; 28 (26.2%) presented anismus; 60 (56.1%) presented cystocele; 59 presented vaginal or cervical prolapse(55.1%); and, 54 (50.5%) presented descending perineum. In 85 females (79.4%) multiple disorders were detected, involving more than one pelvic compartment. Conclusion: MR defecography allowed to accurately evaluate the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and the joint disease of anterior and mid pelvic. (authors)

  20. Mouse Models of Gastric Cancer

    Science.gov (United States)

    Hayakawa, Yoku; Fox, James G.; Gonda, Tamas; Worthley, Daniel L.; Muthupalani, Sureshkumar; Wang, Timothy C.

    2013-01-01

    Animal models have greatly enriched our understanding of the molecular mechanisms of numerous types of cancers. Gastric cancer is one of the most common cancers worldwide, with a poor prognosis and high incidence of drug-resistance. However, most inbred strains of mice have proven resistant to gastric carcinogenesis. To establish useful models which mimic human gastric cancer phenotypes, investigators have utilized animals infected with Helicobacter species and treated with carcinogens. In addition, by exploiting genetic engineering, a variety of transgenic and knockout mouse models of gastric cancer have emerged, such as INS-GAS mice and TFF1 knockout mice. Investigators have used the combination of carcinogens and gene alteration to accelerate gastric cancer development, but rarely do mouse models show an aggressive and metastatic gastric cancer phenotype that could be relevant to preclinical studies, which may require more specific targeting of gastric progenitor cells. Here, we review current gastric carcinogenesis mouse models and provide our future perspectives on this field. PMID:24216700

  1. Effect of pectin, lecithin, and antacid feed supplements (Egusin®) on gastric ulcer scores, gastric fluid pH and blood gas values in horses

    Science.gov (United States)

    2014-01-01

    Background The objectives of this study were to evaluate the effects of two commercial feed supplements, Egusin 250® [E-250] and Egusin SLH® [E-SLH], on gastric ulcer scores, gastric fluid pH, and blood gas values in stall-confined horses undergoing feed-deprivation. Methods Nine Thoroughbred horses were used in a three-period crossover study. For the three treatment groups, sweet feed was mixed with E-250, E-SLH, or nothing (control group) and fed twice daily. Horses were treated for 21 days, then an additional 7 days while on an alternating feed-deprivation model to induce or worsen ulcers (period one). In periods two and three, horses (n=6) were treated for an additional 7 days after feed-deprivation. Gastroscopies were performed on day -1 (n=9), day 21 (n=9), day 28 (n=9) and day 35 (n=6). Gastric juice pH was measured and gastric ulcer scores were assigned. Venous blood gas values were also measured. Results Gastric ulcers in control horses significantly decreased after 21 days, but there was no difference in ulcer scores when compared to the Egusin® treated horses. NG gastric ulcer scores significantly increased in E-250 and control horses on day 28 compared to day 21 as a result of intermittent feed-deprivation, but no treatment effect was observed. NG ulcer scores remained high in the control group but significantly decreased in the E-SLH- and E-250-treated horses by day 35. Gastric juice pH values were low and variable and no treatment effect was observed. Mean blood pCO2 values were significantly increased two hours after feeding in treated horses compared to controls, whereas mean blood TCO2 values increased in the 24 hour sample, but did not exceed 38 mmol/l. Conclusions The feed-deprivation model increased NG gastric ulcer severity in the horses. However, by day 35, Egusin® treated horses had less severe NG gastric ulcers compared to untreated control horses. After 35 days, Egusin® products tested here ameliorate the severity of gastric ulcers in

  2. Iris metastasis of gastric adenocarcinoma.

    Science.gov (United States)

    Celebi, Ali Riza Cenk; Kilavuzoglu, Ayse Ebru; Altiparmak, U Emrah; Cosar, C Banu; Ozkiris, Abdullah

    2016-03-08

    Iris metastasis in patients with gastric cancer is extremely rare. Herein, it is aimed to report on a patient with gastric adenocarcinoma and iris metastasis. A 65-year-old patient with the history of gastric cancer was admitted for eye pain and eye redness on his left eye. There was ciliary injection, severe +4 cells with hypopyon in the anterior chamber and a solitary, friable, yellow-white, fleshy-creamy vascularized 2 mm × 4 mm mass on the upper nasal part of the iris within the left eye. The presented patient's mass lesion in the iris fulfilled the criteria of the metastatic iris lesion's appearance. The ocular metastasis occurred during chemotherapy. Iris metastasis can masquerade as iridocyclitis with pseudohypopyon or glaucoma. In patients with a history of gastric cancer that present with an iris mass, uveitis, and high intraocular pressure, ocular metastasis of gastric cancer should be a consideration.

  3. 16 CFR Appendix E to Part 436 - Sample Item 20(4) Table-Status of Company-Owned Outlets

    Science.gov (United States)

    2010-01-01

    ... RULES DISCLOSURE REQUIREMENTS AND PROHIBITIONS CONCERNING FRANCHISING Pt. 436, App. E Appendix E to Part... 5Outlets Reacquired From Franchisees Column 6Outlets Closed Column 7Outlets Sold to Franchisees Column...

  4. Forces and energetics of intermittent swimming

    Science.gov (United States)

    Floryan, Daniel; Van Buren, Tyler; Smits, Alexander J.

    2017-08-01

    Experiments are reported on intermittent swimming motions. Water tunnel experiments on a nominally two-dimensional pitching foil show that the mean thrust and power scale linearly with the duty cycle, from a value of 0.2 all the way up to continuous motions, indicating that individual bursts of activity in intermittent motions are independent of each other. This conclusion is corroborated by particle image velocimetry (PIV) flow visualizations, which show that the main vortical structures in the wake do not change with duty cycle. The experimental data also demonstrate that intermittent motions are generally energetically advantageous over continuous motions. When metabolic energy losses are taken into account, this conclusion is maintained for metabolic power fractions less than 1.

  5. Chaos synchronization based on intermittent state observer

    Institute of Scientific and Technical Information of China (English)

    Li Guo-Hui; Zhou Shi-Ping; Xu De-Ming

    2004-01-01

    This paper describes the method of synchronizing slave to the master trajectory using an intermittent state observer by constructing a synchronizer which drives the response system globally tracing the driving system asymptotically. It has been shown from the theory of synchronization error-analysis that a satisfactory result of chaos synchronization is expected under an appropriate intermittent period and state observer. Compared with continuous control method,the proposed intermittent method can target the desired orbit more efficiently. The application of the method is demonstrated on the hyperchaotic Rossler systems. Numerical simulations show that the length of the synchronization interval rs is of crucial importance for our scheme, and the method is robust with respect to parameter mismatch.

  6. Unsteady propulsion by an intermittent swimming gait

    Science.gov (United States)

    Akoz, Emre; Moored, Keith W.

    2018-01-01

    Inviscid computational results are presented on a self-propelled swimmer modeled as a virtual body combined with a two-dimensional hydrofoil pitching intermittently about its leading edge. Lighthill (1971) originally proposed that this burst-and-coast behavior can save fish energy during swimming by taking advantage of the viscous Bone-Lighthill boundary layer thinning mechanism. Here, an additional inviscid Garrick mechanism is discovered that allows swimmers to control the ratio of their added mass thrust-producing forces to their circulatory drag-inducing forces by decreasing their duty cycle, DC, of locomotion. This mechanism can save intermittent swimmers as much as 60% of the energy it takes to swim continuously at the same speed. The inviscid energy savings are shown to increase with increasing amplitude of motion, increase with decreasing Lighthill number, Li, and switch to an energetic cost above continuous swimming for sufficiently low DC. Intermittent swimmers are observed to shed four vortices per cycle that form into groups that are self-similar with the DC. In addition, previous thrust and power scaling laws of continuous self-propelled swimming are further generalized to include intermittent swimming. The key is that by averaging the thrust and power coefficients over only the bursting period then the intermittent problem can be transformed into a continuous one. Furthermore, the intermittent thrust and power scaling relations are extended to predict the mean speed and cost of transport of swimmers. By tuning a few coefficients with a handful of simulations these self-propelled relations can become predictive. In the current study, the mean speed and cost of transport are predicted to within 3% and 18% of their full-scale values by using these relations.

  7. Laparoscopic anterior gastropexy for chronic recurrent gastric volvulus: a case report

    Directory of Open Access Journals (Sweden)

    Morelli Umberto

    2008-07-01

    Full Text Available Abstract Introduction Gastric volvulus is an uncommon clinical entity, first described by Berti in 1866. It is a rotation of all or part of the stomach through more than 180°. This rotation can occur on the longitudinal (organo-axial or transverse (mesentero-axial axis. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report the case of a patient with chronic intermittent gastric volvulus who underwent a successful laparoscopic treatment. Case presentation A 34-year-old woman presented with multiple episodes of recurrent upper abdominal pain associated with retching and vomiting, treated unsuccessfully with intramuscular metoclopramide. Endoscopic examination of the upper digestive tract showed a suspected rotation of the stomach, and a chronic recurrent gastric volvulus was revealed by barium meal. The patient was operated on successfully, with an anterior laparoscopic gastropexy performed as the first surgical approach. Conclusion Experience with laparoscopic anterior gastropexy is limited only to a few described cases. Our patient was clinically and radiologically followed-up for 2 years with no evidence of recurrence, either radiological or symptomatic. Based on this result, laparoscopic gastropexy can be seen and considered as an initial 'gold standard' for the treatment of gastric volvulus.

  8. A rare cause of gastric obstruction: Lighters swallowing.

    Science.gov (United States)

    Aday, Ulas; Tardu, Ali; Yagci, Mehmet Ali; Yonder, Huseyin

    2015-01-01

    The majority of swallowed foreign bodies are thrown spontaneously without causing complications in the digestive system. Multiple number of foreign bodies may be swallowed by psychiatric patients which delay diagnosis and increase the complication rate. Long and hard objects cannot pass through the pylorus, and may cause obstruction, ulceration, bleeding and perforation. Endoscopy is used as an effective method in such cases. An exploratory laparatomy was performed after unsuccessful endoscopic foreign object removal in a 28-year-old schizophrenic patient with gastric outlet obstruction due to multiple cigarette lighter swallowing. Ten lighters were removed from the stomach through gastrotomy and one more lighter was removed from the descending colon by milking through the anus. The aim of this paper is to discuss encountered difficulties in psychiatric patients who underwent surgery due to intake of foreign bodies.

  9. Shape of power spectrum of intermittent chaos

    International Nuclear Information System (INIS)

    So, B.C.; Mori, H.

    1984-01-01

    Power spectra of intermittent chaos are calculated analytically. It is found that the power spectrum near onset point consists of a large number of Lorentzian lines with two peaks around frequencies ω = 0 and ω = ω 0 , where ω 0 is a fundamental frequency of a periodic orbit before the onset point, and furthermore the envelope of lines around ω = 0 obeys the power law 1/ + ω +2 , whereas the envelope around ω 0 obeys 1/ + ω-ω 0 +4 . The universality of these power law dependence in a certain class of intermittent chaos are clarified from a phenomenological view point. (author)

  10. Helicobacter pylori infection, glandular atrophy and intestinal metaplasia in superficial gastritis, gastric erosion, erosive gastritis, gastric ulcer and early gastric cancer

    OpenAIRE

    Zhang, Chuan; Yamada, Nobutaka; Wu, Yun-Lin; Wen, Min; Matsuhisa, Takeshi; Matsukura, Norio

    2005-01-01

    AIM: To evaluate the histological features of gastric mucosa, including Helicobacter pylori infection in patients with early gastric cancer and endoscopically found superficial gastritis, gastric erosion, erosive gastritis, gastric ulcer.

  11. Surgical Management of Anatomic Bladder Outlet Obstruction in Males with Neurogenic Bladder Dysfunction: A Systematic Review.

    Science.gov (United States)

    Noordhoff, Toscane C; Groen, Jan; Scheepe, Jeroen R; Blok, Bertil F M

    2018-03-15

    Surgical treatment of anatomic bladder outlet obstruction (BOO) may be indicated in males with neurogenic bladder dysfunction. A bothersome complication after surgery is urinary incontinence. To identify the optimal practice in the surgical treatment of anatomic BOO in males with neurogenic bladder dysfunction, due to multiple sclerosis, Parkinson disease, spinal cord injury (SCI), spina bifida, or cerebrovascular accident (CVA). A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Medline, Embase, Cochrane controlled trial databases, Web of Science, and Google Scholar were searched for publications until January 2017. A total of 930 abstracts were screened. Eight studies were included. The types of anatomic BOO discussed were benign prostate obstruction, urethral stricture, and bladder neck sclerosis. The identified surgical treatments were transurethral resection of the prostate (TURP) in patients with Parkinson, CVA or SCI, endoscopic treatment of urethral stricture by laser ablation or urethrotomy (mainly in SCI patients), and bladder neck resection (BNR) in SCI patients. The outcome of TURP may be highly variable, and includes persistent or de novo urinary incontinence, regained normal micturition control, and urinary continence. Good results were seen in BNR and endoscopic urethrotomy studies. Laser ablation and cold knife urethrotomy resulted in restarting intermittent catheterization or adequate voiding. Overall, a high risk of bias was found. This systematic review provides an overview of the current literature on the outcome of several surgical approaches of different types of anatomic BOO in males with neurogenic bladder dysfunction. Identifying the optimal practice was impossible due to limited availability of high-quality studies. The outcome of several surgical approaches in males with neurogenic bladder dysfunction with benign prostate obstruction, urethral stricture

  12. Gastric Ulcers Syndrome in Donkeys

    Directory of Open Access Journals (Sweden)

    Abelardo Morales Briceño

    2015-09-01

    Full Text Available This study aimed to describe gastric ulcer in donkeys. 10 donkeys (Equus asinus were studied in Bodonal de la Sierra, Badajoz-Extremadura, Spain. They were referred for necropsy and dead due to non-digestive causes. 4 males and 6 females were examined. The ages were classified of 4-16 years old. The stomach and gastric mucosa was evaluated for classified Merrit, 2003. Samples of gastric tissue were collected. The samples fixed in formalin were processed by conventional histological techniques and examined by histopathology. None of the donkeys presented clinical signs for gastric ulcers syndrome. Of the 10 donkeys studied, 10% had Grade 0; 30% Grade 1; 40% Grade 2; 10% Grade 3; and 10% Grade 4. In 30% (3/10 parasites such as Gasterophilus sp. were observed. The histological slices revealed severe damage on the gastric mucosa, a loss of continuity of the gastric mucosa with corium exposure, and subchorionic edema with parakeratotic hyperkeratosis, together with a mixed lymphoplasmocytic mononuclear infiltrate. In conclusion, we reported gastric ulcers syndrome in donkeys in Spain.

  13. Availability of limited service food outlets surrounding schools in British Columbia.

    Science.gov (United States)

    Black, Jennifer L; Day, Meghan

    2012-06-05

    The purpose of this study was to provide a descriptive profile of the availability of limited service food outlets surrounding public schools in British Columbia, Canada. Data from the 2010 Canadian Business Data Files were used to identify limited service food outlets including fast food outlets, beverage and snack food stores, delis and convenience stores. The number of food outlets within 800 metres of 1,392 public schools and the distance from schools to the nearest food outlets were assessed. Multivariate regression models examined the associations between food outlet availability and school-level characteristics. In 2010, over half of the public schools in BC (54%) were located within a 10-12 minute walk from at least one limited service food outlet. The median closest distance to a food outlet was just over 1 km (1016 m). Schools comprised of students living in densely populated urban neighbourhoods and neighbourhoods characterized by lower socio-economic status were more likely to have access to limited service food outlets within walking distance. After adjusting for school-level median family income and population density, larger schools had higher odds of exposure to food vendors compared to schools with fewer students. The availability of and proximity to limited service food outlets vary widely across schools in British Columbia and school-level characteristics are significantly associated with food outlet availability. Additional research is needed to understand how food environment exposures inside and surrounding schools impact students' attitudes, food choices and dietary quality.

  14. Which factors make clean intermittent (self) catheterisation successful?

    NARCIS (Netherlands)

    Cobussen-Boekhorst, H.; Beekman, J.; Wijlick, E. van; Schaafstra, J.; Kuppevelt, D. van; Heesakkers, J.P.

    2016-01-01

    AIMS AND OBJECTIVES: To explore which factors determine successful intermittent catheterisation. BACKGROUND: Intermittent catheterisation is a safe, effective treatment and is associated with improved quality of life, although negative issues are reported. Factors which determine adherence are

  15. Fractal structures and intermittency in QCD

    International Nuclear Information System (INIS)

    Gustafson, Goesta.

    1990-04-01

    New results are presented for fractal structures and intermittency in QCD parton showers. A geometrical interpretation of the anomalous dimension in QCD is given. It is shown that model predications for factorial moments in the PEP-PETRA energy range are increased. if the properties of directly produced pions are more carefully taken into account

  16. Intermittent demand : Linking forecasting to inventory obsolescence

    NARCIS (Netherlands)

    Teunter, Ruud H.; Syntetos, Aris A.; Babai, M. Zied

    2011-01-01

    The standard method to forecast intermittent demand is that by Croston. This method is available in ERP-type solutions such as SAP and specialised forecasting software packages (e.g. Forecast Pro), and often applied in practice. It uses exponential smoothing to separately update the estimated demand

  17. Acute intermittent porphyria presenting as progressive muscular ...

    African Journals Online (AJOL)

    Acute intermittent porphyria, the most common porphyria affecting the nervous system, typically presents with neurovisceral crises followed by a motor neuropathy. We describe a 23-year-old black South African man presenting with a progressive stuttering, lower motor neuron syndrome developing over months. He had not ...

  18. Cooling tower modification for intermittent operation

    International Nuclear Information System (INIS)

    Midkiff, W.S.

    1975-03-01

    One of the cooling towers at Los Alamos Scientific Laboratory is being operated intermittently. The cooling tower has been modified to restrict air flow and to keep the tower from drying out. The modifications are relatively inexpensive, simple to operate, and have proved effective. (U.S.)

  19. Intermittent preventive treatment of malaria in pregnancy

    DEFF Research Database (Denmark)

    Mbonye, A.K.; Hansen, Kristian Schultz; Bygbjerg, Ib Christian

    2008-01-01

    The main objective of this study was to assess whether traditional birth attendants, drug-shop vendors, community reproductive health workers and adolescent peer mobilisers could administer intermittent preventive treatment (IPTp) with sulfadoxine-pyrimethamine (SP) to pregnant women. The study w...

  20. Management of patients with intermittent claudication

    NARCIS (Netherlands)

    S. Spronk (Sandra)

    2008-01-01

    textabstractIntermittent claudication is the first and mildest manifestation of peripheral arterial disease, caused by the atherosclerotic process of progressive narrowing of one or more of the arteries of the peripheral circulation.1 If the arterial system fails, it results in a progressive oxygen

  1. Intermittent resistive faults in digital cmos circuits

    NARCIS (Netherlands)

    Kerkhoff, Hans G.; Ebrahimi, Hassan

    2015-01-01

    A major threat in extremely dependable high-end process node integrated systems in e.g. Avionics are no failures found (NFF). One category of NFFs is the intermittent resistive fault, often originating from bad (e.g. Via or TSV-based) interconnections. This paper will show the impact of these faults

  2. Intermittent and global transitions in plasma turbulence

    International Nuclear Information System (INIS)

    Vlad, M.; Spineanu, F.; Itoh, K.; Itoh, S.-I.

    2003-07-01

    The dynamics of the transition processes in plasma turbulence described by the nonlinear Langevin equation (1) is studied. We show that intermittent or global transitions between metastable states can appear. The conditions for the generation of these transitions and their statistical characteristics are determined. (author)

  3. Intermittency in the particle production and in the nuclear multifragmentation

    International Nuclear Information System (INIS)

    Bozek, P.; Ploszajczak, M.

    1991-01-01

    Intermittency is a manifestation of scale invariance and randomness in physical systems. Intermittency in relativistic heavy-ion collisions and, in particular, the projectile dependence, multiplicity dependence and source-size dependence are discussed in the frame of the model of spatio-temporal intermittency. Moreover, recent theoretical results in intermittency studies of the nuclear multifragmentation are presented. (author) 35 refs., 4 figs., 1 tab

  4. PPOOLEX experiments with a modified blowdown pipe outlet

    International Nuclear Information System (INIS)

    Laine, J.; Puustinen, M.; Raesaenen, A.

    2009-08-01

    This report summarizes the results of the experiments with a modified blowdown pipe outlet carried out with the PPOOLEX test facility designed and constructed at Lappeenranta University of Technology. Steam was blown into the dry well compartment and from there through a vertical DN200 blowdown pipe to the condensation pool. Four reference experiments with a straight pipe and ten with the Forsmark type collar were carried out. The main purpose of the experiment series was to study the effect of a blowdown pipe outlet collar design on loads caused by chugging phenomena (rapid condensation) while steam is discharged into the condensation pool. The PPOOLEX test facility is a closed stainless steel vessel divided into two compartments, dry well and wet well. During the experiments the initial temperature level of the condensation pool water was either 20-25 or 50-55 deg. C. The steam flow rate varied from 400 to 1200 g/s and the temperature of incoming steam from 142 to 185 deg. C. In the experiments with 20-25 deg. C pool water, even 10 times higher pressure pulses were measured inside the blowdown pipe in the case of the straight pipe than with the collar. In this respect, the collar design worked as planned and removed the high pressure spikes from the blowdown pipe. Meanwhile, there seemed to be no suppressing effect on the loads due to the collar in the pool side in this temperature range. Registered loads in the pool were approximately in the same range (or even a little higher) with the collar as with the straight pipe. In the experiments with 50-55 deg. C pool water no high pressure pulses were measured inside the blowdown pipe either with the straight pipe or with the collar. In this case, more of the suppressing effect is probably due to the warmer pool water than due to the modified pipe outlet. It has been observed already in the earlier experiments with a straight pipe in the POOLEX and PPOOLEX facilities that warm pool water has a diminishing effect on

  5. Plasmatron with expanding channel of outlet electrode and its applications

    International Nuclear Information System (INIS)

    Chinnov, V.F.; Isakajev, E.Kh.; Ivanov, P.P.; Sinkevich, O.A.; Tyuftyaev, A.S.

    2000-01-01

    A serious industrial application is found for the plasmatron with expanding channel of outlet electrode - hardening and nitriding surface treatment of railway wheels. Several plasma installations are under operation at the engine houses of Moscow Railways. More than 12 000 wheel sets have been treated up to now. Results are evident: wheel life doubles due to plasma treatment. The plasmatron developed essentially in an empiric way is now under heavy investigation both theoretically and experimentally. High precision measurements of nitrogen emission spectra are expected to be used directly for accurate calculation of radiation heat loss term in a quasi-one dimensional flow code. (Authors)

  6. Measurement of unsteady airflow velocity at nozzle outlet

    Science.gov (United States)

    Pyszko, René; Machů, Mário

    2017-09-01

    The paper deals with a method of measuring and evaluating the cooling air flow velocity at the outlet of the flat nozzle for cooling a rolled steel product. The selected properties of the Prandtl and Pitot sensing tubes were measured and compared. A Pitot tube was used for operational measurements of unsteady dynamic pressure of the air flowing from nozzles to abtain the flow velocity. The article also discusses the effects of air temperature, pressure and relative air humidity on air density, as well as the influence of dynamic pressure filtering on the error of averaged velocity.

  7. PPOOLEX experiments with a modified blowdown pipe outlet

    Energy Technology Data Exchange (ETDEWEB)

    Laine, J.; Puustinen, M.; Raesaenen, A. (Lappeenranta Univ. of Technology, Nuclear Safety Research Unit (Finland))

    2009-08-15

    This report summarizes the results of the experiments with a modified blowdown pipe outlet carried out with the PPOOLEX test facility designed and constructed at Lappeenranta University of Technology. Steam was blown into the dry well compartment and from there through a vertical DN200 blowdown pipe to the condensation pool. Four reference experiments with a straight pipe and ten with the Forsmark type collar were carried out. The main purpose of the experiment series was to study the effect of a blowdown pipe outlet collar design on loads caused by chugging phenomena (rapid condensation) while steam is discharged into the condensation pool. The PPOOLEX test facility is a closed stainless steel vessel divided into two compartments, dry well and wet well. During the experiments the initial temperature level of the condensation pool water was either 20-25 or 50-55 deg. C. The steam flow rate varied from 400 to 1200 g/s and the temperature of incoming steam from 142 to 185 deg. C. In the experiments with 20-25 deg. C pool water, even 10 times higher pressure pulses were measured inside the blowdown pipe in the case of the straight pipe than with the collar. In this respect, the collar design worked as planned and removed the high pressure spikes from the blowdown pipe. Meanwhile, there seemed to be no suppressing effect on the loads due to the collar in the pool side in this temperature range. Registered loads in the pool were approximately in the same range (or even a little higher) with the collar as with the straight pipe. In the experiments with 50-55 deg. C pool water no high pressure pulses were measured inside the blowdown pipe either with the straight pipe or with the collar. In this case, more of the suppressing effect is probably due to the warmer pool water than due to the modified pipe outlet. It has been observed already in the earlier experiments with a straight pipe in the POOLEX and PPOOLEX facilities that warm pool water has a diminishing effect on

  8. Gastric retention and gastric ileus in diabetes mellitus

    International Nuclear Information System (INIS)

    Hoeffel, J.C.; Senot, P.; Champigneulle, B.; Drouin, P.

    1980-01-01

    Report of 2 cases of paralytic ileus of the stomach (gastric atony) and of 14 cases of gastric retention, diagnosed from the radiographs obtained from a group of 1500 diabetic patients within seven years. These disorders occur in diabetes mellitus present for many years and associated with peripheral neuropathy. The above findings often present diagnostic and therapeutic problems. Conservative drug therapy is usually sufficient management. (orig.) [de

  9. Intermittent Rivers and Biodiversity. Large scale analyses between hydrology and ecology in intermittent rivers

    OpenAIRE

    Blanchard, Q.

    2014-01-01

    Intermittent rivers are characterized by a temporary interruption of their flow which can manifest in a variety of ways, as much on a spatial scale as on a temporal one. This particular aspect of intermittent river hydrology gives rise to unique ecosystems, combining both aquatic and terrestrial habitats. Neglected for a long time by scientists and once considered biologically depauperate and ecologically unimportant, these fragile habitats are nowadays acknowledged for their rendered service...

  10. A case report of percutaneous endoscopic gastrostomy left-side gastropexy to resolve a recurrent gastric dilatation in a dog previously treated with right-side gastropexy for gastric dilatation volvulus.

    Science.gov (United States)

    Spinella, Giuseppe; Cinti, Filippo; Pietra, Marco; Capitani, Ombretta; Valentini, Simona

    2014-12-01

    A 6-year-old, large-breed, female dog was evaluated for gastric dilatation (GD). The dog was affected by GD volvulus, which had been surgically treated with gastric derotation and right incisional gastropexy. Recurrence of GD appeared 36 hours after surgery. The dilatation was immediately treated with an orogastric probe but still recurred 4 times. Therefore, a left-side gastropexy by percutaneous endoscopic gastrostomy (PEG) was performed to prevent intermittent GD. After PEG tube placement, the patient recovered rapidly without side effects. Several techniques of gastropexy have been described as a prophylactic method for gastric dilatation volvulus, but to the authors' knowledge, this is the first report of left-sided PEG gastropexy performed in a case of canine GD recurrence after an incisional right gastropexy. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. [AFP-producing gastric cancer and hepatoid gastric cancer].

    Science.gov (United States)

    Wang, Y K; Zhang, X T

    2017-11-23

    AFP-producing gastric cancer(AFPGC) and hepatoid adenocarcinoma of the stomach (HAS) are two special subtypes of gastric cancer. There are both correlation and difference between them. AFPGC is usually identified as primary gastric cancer with serum AFP level more than 20 ng/ml or showed AFP positive staining by immunohistochemistry. The diagnosis of HAS is mainly dependent on the pathological character of hepatocellular carcinoma-like differentiation of gastric cancer. The morbidity of AFPGC and HAS are rather low, especially the incidence of HAS is about 1%. The prognoses of these two subtypes are poorer than that of common gastric adenocarcinoma, due to a high incidence rate of liver metastasis and lymph node metastasis. With the development of next-generation sequencing and other genomic technologies, gastric cancers, including these two rare subtypes, are now being investigated in more detail at the molecular level. Treatment remains the biggest challenge, early diagnosis and radical resection can dramatically improve patients'prognosis. Monitoring serum AFP and abdominal imaging examination during follow-up is important for early detection of liver metastasis. In combination with local treatment methods such as transarterial chemoembolization and radiofrequency ablation of liver may further extend patients'survival time. Targeted therapy owes a great potential value in the future.

  12. Gastrointestinal complications of bariatric Roux-en-Y gastric bypass surgery

    International Nuclear Information System (INIS)

    Sandrasegaran, Kumaresan; Rajesh, Arumugam; Lall, Chandana; Maglinte, Dean D.; Gomez, Gerardo A.; Lappas, John C.

    2005-01-01

    Obesity is rapidly becoming the most important public health issue in USA and Europe. Roux-en-Y gastric bypass is now established as the gold standard for treating intractable morbid or super obesity. We reviewed the imaging findings following this surgery in 234 patients. In this pictorial essay we present the CT and upper gastrointestinal contrast study appearances of the expected postoperative anatomy as well as a range of abdominal complications. The complications are classified into leaks, fistula and obstruction. Postoperative gastric outlet and small bowel obstruction can be caused by anastomotic stenosis, mesocolic tunnel stenosis, adhesions, stomal ulcer, obturation, intussusception and internal or external hernia. Small bowel obstruction may be of a simple, closed loop and/or strangulating type. The radiologist should be able to diagnose the type and possible cause of obstruction. (orig.)

  13. Gastrointestinal complications of bariatric Roux-en-Y gastric bypass surgery

    Energy Technology Data Exchange (ETDEWEB)

    Sandrasegaran, Kumaresan; Rajesh, Arumugam; Lall, Chandana; Maglinte, Dean D. [Indiana University Medical Center, UH 0279, Department of Radiology, Indianapolis, IN (United States); Gomez, Gerardo A. [Wishard Memorial Hospital, Department of Surgery, Indianapolis (United States); Lappas, John C. [Wishard Memorial Hospital, Department of Radiology, Indianapolis (United States)

    2005-02-01

    Obesity is rapidly becoming the most important public health issue in USA and Europe. Roux-en-Y gastric bypass is now established as the gold standard for treating intractable morbid or super obesity. We reviewed the imaging findings following this surgery in 234 patients. In this pictorial essay we present the CT and upper gastrointestinal contrast study appearances of the expected postoperative anatomy as well as a range of abdominal complications. The complications are classified into leaks, fistula and obstruction. Postoperative gastric outlet and small bowel obstruction can be caused by anastomotic stenosis, mesocolic tunnel stenosis, adhesions, stomal ulcer, obturation, intussusception and internal or external hernia. Small bowel obstruction may be of a simple, closed loop and/or strangulating type. The radiologist should be able to diagnose the type and possible cause of obstruction. (orig.)

  14. [Gastric mesenchymal tumours (GIST)].

    Science.gov (United States)

    Spivach, Arrigo; Fezzi, Margherita; Sartori, Alberto; Belgrano, Manuel; Rimondini, Alessandra; Cuttin-Zernich, Roberto; Covab, Maria Assunta; Bonifacio, Daniela; Buri, Luigi; Pagani, Carlo; Zanconati, Fabrizio

    2008-01-01

    The incidence of gastrointestinal stromal tumours (GIST) has increased in recent years. A number of authors have attempted to define the actual nature of these tumours. Immunohistochemistry highlighting the positivity of tyrosine-kinase (CD117/c-Kit) has revealed the difference between gastrointestinal stromal tumours and other mesenchymal tumours and, therefore, the possibility of medical rather than surgical therapy. We retrospectively reviewed 19 patients affected by primary gastric GIST, who underwent surgery in recent years with subsequent follow-up. Gastroscopy and gastrointestinal tract radiography were used not only to obtain the diagnosis but also to establish the size, density, contours, ulceration, regional lymphadenopathy, mesenteric infiltration and the presence of metastases. The aim of this study was to evaluate the roles of endoscopy and radiology in this pathology and the advantages and limitations of each individual technique.

  15. Increased risk of gastric adenocarcinoma after treatment of primary gastric diffuse large B-cell lymphoma

    International Nuclear Information System (INIS)

    Inaba, Koji; Morota, Madoka; Mayahara, Hiroshi; Ito, Yoshinori; Sumi, Minako; Uno, Takashi; Itami, Jun; Kushima, Ryoji; Murakami, Naoya; Kuroda, Yuuki; Harada, Ken; Kitaguchi, Mayuka; Yoshio, Kotaro; Sekii, Shuhei; Takahashi, Kana

    2013-01-01

    There have been sporadic reports about synchronous as well as metachronous gastric adenocarcinoma and primary gastric lymphoma. Many reports have dealt with metachronous gastric adenocarcinoma in mucosa-associated lymphoid tissue lymphoma of stomach. But to our knowledge, there have been no reports that document the increased incidence of metachronous gastric adenocarcinoma in patients with gastric diffuse large B-cell lymphoma. This retrospective study was conducted to estimate the incidence of metachronous gastric adenocarcinoma after primary gastric lymphoma treatment, especially in diffuse large B-cell lymphoma. The retrospective cohort study of 139 primary gastric lymphoma patients treated with radiotherapy at our hospital. Mean observation period was 61.5 months (range: 3.7-124.6 months). Patients profile, characteristics of primary gastric lymphoma and metachronous gastric adenocarcinoma were retrieved from medical records. The risk of metachronous gastric adenocarcinoma was compared with the risk of gastric adenocarcinoma in Japanese population. There were 10 (7.2%) metachronous gastric adenocarcinoma patients after treatment of primary gastric lymphomas. It was quite high risk compared with the risk of gastric carcinoma in Japanese population of 54.7/100,000. Seven patients of 10 were diffuse large B-cell lymphoma and other 3 patients were mixed type of diffuse large B-cell lymphoma and mucosa associated lymphoid tissue lymphoma. Four patients of 10 metachronous gastric adenocarcinomas were signet-ring cell carcinoma and two patients died of gastric adenocarcinoma. Metachronous gastric adenocarcinoma may have a more malignant potential than sporadic gastric adenocarcinoma. Old age, Helicobacter pylori infection and gastric mucosal change of chronic gastritis and intestinal metaplasia were possible risk factors for metachronous gastric adenocarcinoma. There was an increased risk of gastric adenocarcinoma after treatment of primary gastric lymphoma

  16. Gastric Adenomyoma: The Unexpected Mimicker

    Directory of Open Access Journals (Sweden)

    Marcela Adriana Duran Álvarez

    2017-01-01

    Full Text Available Gastric adenomyoma is a rare benign tumor composed of epithelial structures and smooth muscle stroma. Here, we report an unusual case of gastric adenomyoma mostly composed of smooth muscle that was incidentally found during a laparoscopic intervention. On radiology, it mimicked an acquired hypertrophic pyloric stenosis in an adult patient, and pathologically it resembled a pure smooth muscle hamartoma. Complete submission of the lesion for histology was necessary to find the epithelial component and make the right diagnosis. As a mimicker of benign and malignant entities, gastric adenomyoma is usually an unexpected finding after surgery. The aim of this report is to analyze this adenomyoma variant in the setting of an unexplained thickening of the gastric wall, with explanations concerning histogenesis and biological potential.

  17. [Cancer of the gastric stump].

    Science.gov (United States)

    Rojas Bravo, F; Montero, L

    1992-01-01

    627 cases of gastric cancer treated surgically during the last 5 years, at the Hospital Nacional "Edgardo Rebagliati Martins" from Instituto Peruano de Seguridad Social (Lima-Perú) were revised. 4 of the patients had been operated before of hemigastrectomy or antrectomy with pyloroplasty for peptic ulcer. The time between the first operation and diagnosis of cancer of the gastric stump was more than 20 years. 3 of these cases were able to be resected. The international incidence of cancer in the gastric stump is 1.1% to 9.2% according to different authors. The risk is higher after 15 years. In the pathogenesis are advocated the lower gastric acidity, biliary reflux, the presence of bacteria, the formation of nitrosamines, intestinal metaplasia, etc. Is necessary to perform periodic endoscopic survey in patients who were treated surgically of peptic ulcer with antrectomy or hemigastrectomy with more than 15 years of evolution.

  18. Ultrasonography findings of gastric carcinoma

    International Nuclear Information System (INIS)

    Chung, Chong Ku; Choi, Ji Bai; Ko, Young Tae; Lim, Jae Hoon; Kim, Soon Young

    1985-01-01

    Stomach carcinoma is more common disease in Korea than western countries. The reported ultrasonographic findings of gastric carcinoma were thickening of gastric wall and 'pseudokidney' sign. The author analyzed ultrasonographic findings of 101 cases with gastric carcinoma who were performed ultrasonography and gastroscopy at Kyung Hee University Hospital from October 1982 to October 1985. The results were as followings; 1. Types of gastric carcinoma were consisted with infiltrative type 68 cases, infiltrative type with ulceration 16 cases, polypoid type with ulceration 1 case, infiltrative adn polypoid type 4 cases, limits plastica type 3 cases, ulcerative type 1 case and polypoid type 1 case. 2. Extent of the lesions were in body and antrum 45 cases, entire stomach 18 cases, antrum 18 cases, body 12 cases, body and fundus 6 cases. 3. Ultrasonography was useful in demonstrating the extent of the tumor and the presence of materials elsewhere in abdomen

  19. Ultrasonography findings of gastric carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Chong Ku; Choi, Ji Bai; Ko, Young Tae; Lim, Jae Hoon; Kim, Soon Young [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1985-12-15

    Stomach carcinoma is more common disease in Korea than western countries. The reported ultrasonographic findings of gastric carcinoma were thickening of gastric wall and 'pseudokidney' sign. The author analyzed ultrasonographic findings of 101 cases with gastric carcinoma who were performed ultrasonography and gastroscopy at Kyung Hee University Hospital from October 1982 to October 1985. The results were as followings; 1. Types of gastric carcinoma were consisted with infiltrative type 68 cases, infiltrative type with ulceration 16 cases, polypoid type with ulceration 1 case, infiltrative adn polypoid type 4 cases, limits plastica type 3 cases, ulcerative type 1 case and polypoid type 1 case. 2. Extent of the lesions were in body and antrum 45 cases, entire stomach 18 cases, antrum 18 cases, body 12 cases, body and fundus 6 cases. 3. Ultrasonography was useful in demonstrating the extent of the tumor and the presence of materials elsewhere in abdomen.

  20. Nuclear and intermittent renewables: Two compatible supply options? The case of the French power mix

    International Nuclear Information System (INIS)

    Cany, Camille; Mansilla, Christine; Costa, Pascal da; Mathonnière, Gilles; Duquesnoy, Thierry; Baschwitz, Anne

    2016-01-01

    The complementary features of low-carbon power sources are a central issue in designing energy transition policies. The French current electricity mix is characterised by a high share of nuclear power which equalled 76% of the total electric production in 2015. With the increase in intermittent renewable sources, nuclear flexibility is examined as part of the solution to balance electricity supply and demand. Our proposed methodology involves designing scenarios with nuclear and intermittent renewable penetration levels, and developing residual load duration curves in each case. The load modulation impact on the nuclear production cost is estimated. This article shows to which extent the nuclear annual energy production will decrease with high shares of intermittent renewables (down to load factors of 40% for proactive assumptions). However, the production cost increase could be compensated by progressively replacing the plants. Moreover, incentives are necessary if nuclear is to compete with combined-cycle gas turbines as its alternative back-up option. In order to reconcile the social planner with plant operator goals, the solution could be to find new outlets rather than reducing nuclear load factors. Nuclear flexibility could then be considered in terms of using its power to produce heat or hydrogen. - Highlights: •Nuclear flexibility is examined to balance the system with high renewables share. •Impacts of wind and solar shares on the nuclear load factor and LCOE are assessed. •Nuclear fleet replacement must be progressive to ensure competitive load-following. •Incentives are needed for nuclear to compete with CCGT gas back-up. •We recommend considering nuclear flexibility through the power use.

  1. Study the Effect of Intermittent and Continuous Ponding Depths by Using Different Heads to Leach Water

    Directory of Open Access Journals (Sweden)

    Nesrin J. AL-Mansori

    2018-03-01

    Full Text Available As results of using water for irrigated lands in a random manner in a time of shortage main water resources, Experimental work carried out to study the effect of continuous and intermittent ponding depth on the leaching processes. Sandy soil used, sourced from Hilla / Al-Jameeya, at Hilla city. Sieve analysis and hydrometer testing used to identify the properties of the soil. A model used with dimensions of 30, 30 and, 70 cm, with two different heads of water. Shatt-Al-Hilla River samples used in the leaching process.   Chemical tests carried out before the leaching process to identify changes in the proprieties in both water and soil. Leachate collected from two soil columns drained into boxes and tests carried out every 30 minutes. After the leaching process was complete, the soil was re-tested. Chemical tests on soil samples and the collected water applied after leaching for 47.5 cm and 52.5cm heads. From the results،, it can be notice that electrical conductivity for the outlet discharge from soil samples decreased faster with time, then slowing down until the end of leaching process.  The same pattern can be seen for all soil properties. In continuous leaching, a large quantity of water is required over a short leaching period, the inverse true for intermittent leaching. All parameters reduce with time in continuous leaching in comparison to intermittent leaching but when the water level in the soil column compared, it can inferred that increasing the head will reduce all the parameters for soil.

  2. Complot test section outlet CFD optimization (pre - test and dimensioning)

    International Nuclear Information System (INIS)

    Profir, M. M.; Moreau, V.; Kennedy, G.

    2013-01-01

    In the framework of the FP7 MAXSIMA European project, the COMPLOT (COMPonent LOop Testing) LBE experimental facility is employed for thermal-hydraulic experiments aimed to test and qualify, among other components, a buoyancy driven safety/control rods (SR/CR) system, as key components for the safe operation of the MYRRHA reactor. This paper focuses mainly on a simplified CFD representation of the SR test section outlet in order to optimise it for the testing program. Parametric cases, associated with different positions of the SR assembly have been set up and analysed. A quasi-static analysis has been performed for each case, accounting for the LBE volume displaced by the insertion of the SR bundle, by introducing appropriately positioned additional mass sources. Velocity and pressure fields, as well as pressure drop magnitudes and mass flow rates through relevant guide tube hole outlets have been calculated and compared. The CFD analysis proved that the outer boundary of the test section does not impact the expected performance of the SR (rapid transient downward insertion). Preliminary simulations reproducing the timely repositioning of the SR/CR in COMPLOT using procedures of automatic volume mesh regeneration, consistently with the rod imposed displacement, are illustrated. (authors)

  3. Methodological Approaches to Locating Outlets of the Franchise Retail Network

    Directory of Open Access Journals (Sweden)

    Grygorenko Tetyana M.

    2016-08-01

    Full Text Available Methodical approaches to selecting strategic areas of managing the future location of franchise retail network outlets are presented. The main stages in the assessment of strategic areas of managing the future location of franchise retail network outlets have been determined and the evaluation criteria have been suggested. Since such selection requires consideration of a variety of indicators and directions of the assessment, the author proposes a scale of evaluation, which allows generalizing and organizing the research data and calculations of the previous stages of the analysis. The most important criteria and sequence of the selection of the potential franchisees for the franchise retail network have been identified, the technique for their evaluation has been proposed. The use of the suggested methodological approaches will allow the franchiser making sound decisions on the selection of potential target markets, minimizing expenditures of time and efforts on the selection of franchisees and hence optimizing the process of development of the franchise retail network, which will contribute to the formation of its structure.

  4. A Longitudinal Analysis of Cigarette Prices in Military Retail Outlets

    Science.gov (United States)

    Haddock, Christopher Keith; Hyder, Melissa L.; Poston, Walker S. C.; Jahnke, Sara A.; Williams, Larry N.; Lando, Harry

    2014-01-01

    Objectives. We conducted a longitudinal assessment of tobacco pricing in military retail outlets, including trends within each service branch. Methods. We determined the price of a single pack of Marlboro Red cigarettes at military retail stores located in the continental United States, Alaska, and Hawaii and at their nearest Walmarts in spring 2011 and 2013 (n = 128 for pairs available at both assessments). Results. The average difference between cigarettes sold in military retail outlets and Walmarts decreased from 24.5% in 2011 to 12.5% in 2013. The decrease was partially attributable to significant price decreases at Walmarts. The largest increases in cigarette prices occurred on naval installations. Potential savings at stores on several installations remained substantial in 2013; the largest approached $6 per pack. Stores on 17 military installations decreased cigarette prices during the study period. Conclusions. Tobacco can be purchased in military retail stores at substantial savings over civilian stores. If tobacco pricing is to cease to be an incentive for use among personnel, a revised military tobacco pricing policy is needed. PMID:24524503

  5. Targeting BRCAness in Gastric Cancer

    Science.gov (United States)

    2017-10-01

    Award Number: W81XWH-16-1-0470 TITLE: Targeting BRCAness in Gastric Cancer PRINCIPAL INVESTIGATOR: Yelena Janjigian CONTRACTING ORGANIZATION...Sloan-Kettering Institute for Cancer Research New York, NY 10065 REPORT DATE: October 2017 TYPE OF REPORT: Annual PREPARED FOR: U.S. Army Medical...Targeting BRCAness in Gastric Cancer 5b. GRANT NUMBER W81XWH-16-1-0473 (Ashworth) 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Eric Collisson, David

  6. Laparoscopic stomach-partitioning gastrojejunostomy with reduced-port techniques for unresectable distal gastric cancer.

    Science.gov (United States)

    Hirahara, Noriyuki; Matsubara, Takeshi; Hyakudomi, Ryoji; Hari, Yoko; Fujii, Yusuke; Tajima, Yoshitsugu

    2014-03-01

    The improvement of quality of life is of great importance in managing patients with far-advanced gastric cancer. We report a new cure and less invasive method of creating a stomach-partitioning gastrojejunostomy in reduced-port laparoscopic surgery for unresectable gastric cancers with gastric outlet obstruction. A 2.5-cm vertical intraumbilical incision was made, and EZ Access (Hakko Co., Ltd., Tokyo, Japan) was placed. After pneumoperitoneum was created, an additional 5-mm trocar was inserted in the right upper abdomen. A gastrojejunostomy was performed in the form of an antiperistaltic side-to-side anastomosis, in which the jejunal loop was elevated in the antecolic route and anastomosed to the greater curvature of the stomach using an endoscopic linear stapler. The jejunal loop together with the stomach was dissected with additional linear staplers just proximal to the common entry hole so that a functional end-to-end gastrojejunostomy was completed. At the same time, the stomach was partitioned using a linear stapler to leave a 2-cm-wide lumen in the lesser curvature. Subsequently, jejunojejunostomy was performed 30 cm distal to the gastrojejunostomy, and the stomach-partitioning gastrojejunostomy resembling Roux-en Y anastomosis was completed. All patients resumed oral intake on the day of operation. Neither anastomotic leakage nor anastomotic stricture was observed. Our less invasive palliative operation offers the utmost priority to improve quality of life for patients with unresectable gastric cancer.

  7. DBGC: A Database of Human Gastric Cancer

    Science.gov (United States)

    Wang, Chao; Zhang, Jun; Cai, Mingdeng; Zhu, Zhenggang; Gu, Wenjie; Yu, Yingyan; Zhang, Xiaoyan

    2015-01-01

    The Database of Human Gastric Cancer (DBGC) is a comprehensive database that integrates various human gastric cancer-related data resources. Human gastric cancer-related transcriptomics projects, proteomics projects, mutations, biomarkers and drug-sensitive genes from different sources were collected and unified in this database. Moreover, epidemiological statistics of gastric cancer patients in China and clinicopathological information annotated with gastric cancer cases were also integrated into the DBGC. We believe that this database will greatly facilitate research regarding human gastric cancer in many fields. DBGC is freely available at http://bminfor.tongji.edu.cn/dbgc/index.do PMID:26566288

  8. Intermittent control: a computational theory of human control.

    Science.gov (United States)

    Gawthrop, Peter; Loram, Ian; Lakie, Martin; Gollee, Henrik

    2011-02-01

    The paradigm of continuous control using internal models has advanced understanding of human motor control. However, this paradigm ignores some aspects of human control, including intermittent feedback, serial ballistic control, triggered responses and refractory periods. It is shown that event-driven intermittent control provides a framework to explain the behaviour of the human operator under a wider range of conditions than continuous control. Continuous control is included as a special case, but sampling, system matched hold, an intermittent predictor and an event trigger allow serial open-loop trajectories using intermittent feedback. The implementation here may be described as "continuous observation, intermittent action". Beyond explaining unimodal regulation distributions in common with continuous control, these features naturally explain refractoriness and bimodal stabilisation distributions observed in double stimulus tracking experiments and quiet standing, respectively. Moreover, given that human control systems contain significant time delays, a biological-cybernetic rationale favours intermittent over continuous control: intermittent predictive control is computationally less demanding than continuous predictive control. A standard continuous-time predictive control model of the human operator is used as the underlying design method for an event-driven intermittent controller. It is shown that when event thresholds are small and sampling is regular, the intermittent controller can masquerade as the underlying continuous-time controller and thus, under these conditions, the continuous-time and intermittent controller cannot be distinguished. This explains why the intermittent control hypothesis is consistent with the continuous control hypothesis for certain experimental conditions.

  9. Ultrasonographic gastric antral area and gastric contents volume in children.

    Science.gov (United States)

    Schmitz, Achim; Thomas, Schraner; Melanie, Fruehauf; Rabia, Liamlahi; Klaghofer, Richard; Weiss, Markus; Kellenberger, Christian

    2012-02-01

    Cross-sectional gastric antral area (GAA) measurements by ultrasonography (US) have been proposed for preoperative assessment of gastric volume in adults but not been validated in children. This study investigates whether in children gastric volumes can be predicted by US performed in different patient positions. Gastric fluid and air volumes were examined by magnetic resonance imaging before or up to 120 min after ingestion of 7 ml·kg(-1) diluted raspberry syrup in healthy volunteers who had fasted overnight. GAA was measured with US three times each in supine (SUP), elevated 45° degree supine (E45) and right decubital (RDC) position using imaging planes defined by vascular landmarks. Correlation coefficients (Pearson) between GAA and gastric volumes were calculated and Bland-Altman analysis performed. Sixteen children aged from 6.4 to 12.8 (9.2) years were included in 23 examinations: 6 after overnight fasting, 3 directly after, and 14 with a delay of 74 ± 35 min after fluid intake. GAA was 221 ± 116, 218 ± 112, and 347 ± 188 mm(2) for SUP, E45, and RDC position, respectively. The best correlation between body weight corrected total gastric/gastric fluid volume (TGV(w)/GFV(w)) with GAA was found for RDC position (R = 0.79; P < 0.01/R = 0.78; P < 0.01). Bias and precision of calculated and measured GFV(w) was 0 ± 2.8 ml·kg(-1). Correlations between GAA and TGV(w) or GFV(w) in children are best in the RDC position, but not sufficient to predict GFV(w) with a given GAA. Interpretation of isolated GAA values may be misleading. © 2011 Blackwell Publishing Ltd.

  10. CONDITIONED ANALYSIS OF HIGH-LATITUDE SOLAR WIND INTERMITTENCY

    International Nuclear Information System (INIS)

    D'Amicis, R.; Consolini, G.; Bavassano, B.; Bruno, R.

    2012-01-01

    The solar wind is a turbulent medium displaying intermittency. Its intermittent features have been widely documented and studied, showing how the intermittent character is different in fast and slow wind. In this paper, a statistical conditioned analysis of the solar wind intermittency for a period of high-latitude fast solar wind is presented. In particular, the intermittent features are investigated as a function of the Alfvénic degree of fluctuations at a given scale. The results show that the main contribution to solar wind intermittency is due to non-Alfvénic structures, while Alfvénic increments are found to be characterized by a smaller level of intermittency than the previous ones. Furthermore, the lifetime statistics of Alfvénic periods are discussed in terms of a multiscale texture of randomly oriented flux tubes.

  11. Intermittent character of interplanetary magnetic field fluctuations

    International Nuclear Information System (INIS)

    Bruno, Roberto; Carbone, Vincenzo; Chapman, Sandra; Hnat, Bogdan; Noullez, Alain; Sorriso-Valvo, Luca

    2007-01-01

    Interplanetary magnetic field magnitude fluctuations are notoriously more intermittent than velocity fluctuations in both fast and slow wind. This behavior has been interpreted in terms of the anomalous scaling observed in passive scalars in fully developed hydrodynamic turbulence. In this paper, the strong intermittent nature of the interplanetary magnetic field is briefly discussed comparing results performed during different phases of the solar cycle. The scaling properties of the interplanetary magnetic field magnitude show solar cycle variation that can be distinguished in the scaling exponents revealed by structure functions. The scaling exponents observed around the solar maximum coincide, within the errors, to those measured for passive scalars in hydrodynamic turbulence. However, it is also found that the values are not universal in the sense that the solar cycle variation may be reflected in dependence on the structure of the velocity field

  12. Intermittency exponent of the turbulent energy cascade

    International Nuclear Information System (INIS)

    Cleve, J.; Greiner, M.; Pearson, B.R.; Sreenivasan, K.R.

    2006-12-01

    We consider the turbulent energy dissipation from one-dimensional records in experiments using air and gaseous helium at cryogenic temperatures, and obtain the intermittency exponent via the two-point correlation function of the energy dissipation. The air data are obtained in a number of flows in a wind tunnel and the atmospheric boundary layer at a height of about 35 m above the ground. The helium data correspond to the centerline of a jet exhausting into a container. The air data on the intermittency exponent are consistent with each other and with a trend that increases with the Taylor microscale Reynolds number, R λ , of up to about 1000 and saturates thereafter. On the other hand, the helium data cluster around a constant value at nearly all R λ , this being about half of the asymptotic value for the air data. Some possible explanation is offered for this anomaly. (author)

  13. Effects of intermittent hypoxia on running economy.

    Science.gov (United States)

    Burtscher, M; Gatterer, H; Faulhaber, M; Gerstgrasser, W; Schenk, K

    2010-09-01

    We investigated the effects of two 5-wk periods of intermittent hypoxia on running economy (RE). 11 male and female middle-distance runners were randomly assigned to the intermittent hypoxia group (IHG) or to the control group (CG). All athletes trained for a 13-wk period starting at pre-season until the competition season. The IHG spent additionally 2 h at rest on 3 days/wk for the first and the last 5 weeks in normobaric hypoxia (15-11% FiO2). RE, haematological parameters and body composition were determined at low altitude (600 m) at baseline, after the 5 (th), the 8 (th) and the 13 (th) week of training. RE, determined by the relative oxygen consumption during submaximal running, (-2.3+/-1.2 vs. -0.3+/-0.7 ml/min/kg, Ptraining phase. Georg Thieme Verlag KG Stuttgart . New York.

  14. Optimal intermittent search strategies: smelling the prey

    International Nuclear Information System (INIS)

    Revelli, J A; Wio, H S; Rojo, F; Budde, C E

    2010-01-01

    We study the kinetics of the search of a single fixed target by a searcher/walker that performs an intermittent random walk, characterized by different states of motion. In addition, we assume that the walker has the ability to detect the scent left by the prey/target in its surroundings. Our results, in agreement with intuition, indicate that the prey's survival probability could be strongly reduced (increased) if the predator is attracted (or repelled) by the trace left by the prey. We have also found that, for a positive trace (the predator is guided towards the prey), increasing the inhomogeneity's size reduces the prey's survival probability, while the optimal value of α (the parameter that regulates intermittency) ceases to exist. The agreement between theory and numerical simulations is excellent.

  15. Optimal intermittent search strategies: smelling the prey

    Energy Technology Data Exchange (ETDEWEB)

    Revelli, J A; Wio, H S [Instituto de Fisica de Cantabria, Universidad de Cantabria and CSIC, E-39005 Santander (Spain); Rojo, F; Budde, C E [Fa.M.A.F., Universidad Nacional de Cordoba, Ciudad Universitaria, X5000HUA Cordoba (Argentina)

    2010-05-14

    We study the kinetics of the search of a single fixed target by a searcher/walker that performs an intermittent random walk, characterized by different states of motion. In addition, we assume that the walker has the ability to detect the scent left by the prey/target in its surroundings. Our results, in agreement with intuition, indicate that the prey's survival probability could be strongly reduced (increased) if the predator is attracted (or repelled) by the trace left by the prey. We have also found that, for a positive trace (the predator is guided towards the prey), increasing the inhomogeneity's size reduces the prey's survival probability, while the optimal value of {alpha} (the parameter that regulates intermittency) ceases to exist. The agreement between theory and numerical simulations is excellent.

  16. Optimal Dynamics of Intermittent Water Supply

    Science.gov (United States)

    Lieb, Anna; Wilkening, Jon; Rycroft, Chris

    2014-11-01

    In many urban areas of the developing world, piped water is supplied only intermittently, as valves direct water to different parts of the water distribution system at different times. The flow is transient, and may transition between free-surface and pressurized, resulting in complex dynamical features with important consequences for water suppliers and users. These consequences include degradation of distribution system components, compromised water quality, and inequitable water availability. The goal of this work is to model the important dynamics and identify operating conditions that mitigate certain negative effects of intermittent water supply. Specifically, we will look at valve parameters occurring as boundary conditions in a network model of transient, transition flow through closed pipes. Optimization will be used to find boundary values to minimize pressure gradients and ensure equitable water availability.

  17. AN ELDERLY WOMAN WITH INTERMITTENT CLAUDICATION

    Directory of Open Access Journals (Sweden)

    Nayyer Naveed Wazir

    2006-01-01

    Full Text Available This case report illustrates the misdiagnosis of intermittent claudication in an elderly with multiple cardiac risk factors. Careful clinical evaluation and imaging shifts the diagnosis from peripheral vascular disease to spinal stenosis. The decision whether to offer conservative therapy or proceed to spinal surgery requires an accurate assessment of the severity of the symptoms without ignoring the important role of patient preferences.

  18. Long-range forecasting of intermittent streamflow

    OpenAIRE

    F. F. van Ogtrop; R. W. Vervoort; G. Z. Heller; D. M. Stasinopoulos; R. A. Rigby

    2011-01-01

    Long-range forecasting of intermittent streamflow in semi-arid Australia poses a number of major challenges. One of the challenges relates to modelling zero, skewed, non-stationary, and non-linear data. To address this, a statistical model to forecast streamflow up to 12 months ahead is applied to five semi-arid catchments in South Western Queensland. The model uses logistic regression through Generalised Additive Models for Location, Scale and Shape (GAMLSS) to determine th...

  19. Long-range forecasting of intermittent streamflow

    OpenAIRE

    F. F. van Ogtrop; R. W. Vervoort; G. Z. Heller; D. M. Stasinopoulos; R. A. Rigby

    2011-01-01

    Long-range forecasting of intermittent streamflow in semi-arid Australia poses a number of major challenges. One of the challenges relates to modelling zero, skewed, non-stationary, and non-linear data. To address this, a probabilistic statistical model to forecast streamflow 12 months ahead is applied to five semi-arid catchments in South Western Queensland. The model uses logistic regression through Generalised Additive Models for Location, Scale and Shape (GAMLSS) to determine the probabil...

  20. Computed tomography findings of acute gastric volvulus.

    Science.gov (United States)

    Millet, Ingrid; Orliac, Celine; Alili, Chakib; Guillon, Françoise; Taourel, Patrice

    2014-12-01

    To assess the diagnostic performance of CT signs of gastric volvulus in both confirmed cases and control subjects. We retrospectively reviewed CT findings in 10 patients with surgically confirmed acute gastric volvulus and 20 control subjects with gastric distension. Two radiologists independently evaluated CT images for risk factors of gastric volvulus, direct findings of gastric volvulus by assessing gastric dilatation, the presence of an antropyloric transition point, the respective position of the different stomach segments and of the greater and lesser curvatures, stenosis of the gastric segments through the oesophageal hiatus and for findings of gastric ischemia. The sensitivity and specificity of each finding were calculated. The most sensitive direct signs of gastric volvulus were an antropyloric transition point without any abnormality at the transition zone and the antrum at the same level or higher than the fundus. The presence of both these two findings as diagnostic criteria of gastric volvulus had 100% sensitivity and specificity for the diagnosis of gastric volvulus. There was no association between CT signs of ischemia and final bowel ischemia at pathology. CT is both highly sensitive and specific for diagnosing acute gastric volvulus. CT is highly reliable for diagnosing acute gastric volvulus with two findings. The two signs are gastropyloric transition zone and abnormal location of the antrum. This allows fast surgical management of this emergency.

  1. Gastric bypass surgery for treatment of hypothalamic obesity after craniopharyngioma therapy.

    Science.gov (United States)

    Inge, Thomas H; Pfluger, Paul; Zeller, Meg; Rose, Susan R; Burget, Lukas; Sundararajan, Sumana; Daniels, Stephen R; Tschöp, Matthias H

    2007-08-01

    A 14-year-old boy presented with daytime somnolence, intermittent emesis and hypothyroidism. Neuroimaging revealed a calcified suprasellar intracranial mass, suspected to be a craniopharyngioma. Subtotal resection of the tumor confirmed the diagnosis. Extreme obesity (BMI >60 kg/m(2)) and hyperinsulinemia followed tumor resection and cranial irradiation. Dietary interventions were unsuccessful, and pharmacologic intervention (i.e. octreotide) only slowed the rate of weight gain. Radiography documented the suprasellar mass. Following surgical resection and radiotherapy, hypothalamic-pituitary deficiencies were found. Preprandial and postprandial excursions of insulin, active ghrelin and leptin were measured before and after gastric bypass surgery. Panhypopituitarism, hypothalamic obesity and hyperinsulinemia following craniopharyngioma therapy. Severe caloric restriction, octreotide, and pituitary hormone replacement did not produce weight loss. Gastric bypass surgery led to reduced food cravings, significant weight loss, and amelioration of obesity-related comorbidities. Correction of fasting hyperinsulinemia, normalization of postprandial insulin responses, and reductions in active ghrelin and leptin concentrations were also observed.

  2. Segmental dilatation of the ileum covered almost entirely by gastric mucosa: report of a case.

    Science.gov (United States)

    Kobayashi, Tsutomu; Uchida, Nobuyuki; Shiojima, Masayuki; Sasamoto, Hajime; Shimura, Tatsuo; Takahasi, Atsusi; Kuwano, Hiroyuki

    2007-01-01

    A 13-year-old boy was referred to our hospital for investigation of intermittent abdominal colic pain and vomiting. He underwent an emergency laparotomy, which revealed a volvulus and segmental dilatation of the ileum. The dilated intestine was not associated with poor intestinal circulation. Because the dilated ileum did not seem to be the cause of the volvulus, we simply released the volvulus. However, after surgery, the patient still suffered from persistent abdominal pain, further episodes of volvulus, and invagination of the dilated ileum. Thus, we performed a second operation to resect the segmental dilatation of the ileum. Pathological examination revealed that most of the mucosa of the dilated ileum was composed of ectopic gastric mucosa. We postulate that the ectopic gastric mucosa led to the formation of segmental dilatation of the ileum.

  3. Efficient search by optimized intermittent random walks

    International Nuclear Information System (INIS)

    Oshanin, Gleb; Lindenberg, Katja; Wio, Horacio S; Burlatsky, Sergei

    2009-01-01

    We study the kinetics for the search of an immobile target by randomly moving searchers that detect it only upon encounter. The searchers perform intermittent random walks on a one-dimensional lattice. Each searcher can step on a nearest neighbor site with probability α or go off lattice with probability 1 - α to move in a random direction until it lands back on the lattice at a fixed distance L away from the departure point. Considering α and L as optimization parameters, we seek to enhance the chances of successful detection by minimizing the probability P N that the target remains undetected up to the maximal search time N. We show that even in this simple model, a number of very efficient search strategies can lead to a decrease of P N by orders of magnitude upon appropriate choices of α and L. We demonstrate that, in general, such optimal intermittent strategies are much more efficient than Brownian searches and are as efficient as search algorithms based on random walks with heavy-tailed Cauchy jump-length distributions. In addition, such intermittent strategies appear to be more advantageous than Levy-based ones in that they lead to more thorough exploration of visited regions in space and thus lend themselves to parallelization of the search processes.

  4. Clinicopathological study of asymptomatic gastric cancer and symptomatic gastric cancer

    International Nuclear Information System (INIS)

    Sato, Toshiteru

    2008-01-01

    Gastric cancer can be classified into two categories based on the absence or presence of symptoms at diagnosis. Differences in clinicopathological features and prognoses between asymptomatic gastric cancer (ACG) and symptomatic gastric cancer (SGC) can be used to inform diagnosis strategies and ultimately improve survival rates. All cases of gastric cancer (239 AGC, 323 SGC) diagnosed in our hospital between 1997 and 1999 were used in this study. ACG patients showed significantly higher frequency of males, cases of early cancer, cases found by a mass screening program, cases treated by endoscopic resection, cases treated by curative operation, cases of type 0 macroscopic finding, cases of histologically-differentiated type, and stage I cases. By contrast, SGC patients showed significantly higher numbers of cases treated by chemotherapy alone or best support care, cases of type 2, 3, and 4 macroscopic findings, cases occupying the whole stomach, and cases of stage II, III, IV. Statistically significant differences were also found for the 5-year survival rate (83.3% in AGC, 41.2% in SGC), the incidence of early cancer (90.1% in AGC, 83.7% in SGC), and for advanced cancer (38.7% in AGC, 22.7% in SGC). The higher incidence of advanced cases in SGC than in AGC (40.0% vs. 13.0%), coupled with the low 5-year survival rate of advanced SGC (22.7%), provides strong evidence of the importance of diagnosing gastric cancer during its asymptomatic period. (author)

  5. Laboratory services series: an electrical outlet and corded equipment inspection program

    International Nuclear Information System (INIS)

    Davis, E.A.

    1976-04-01

    A research and development laboratory has thousands of electrical outlets providing power to laboratories, offices, shops, and service areas. These outlets provide power for a wide variety of portable equipment and tools that are equipped with cord and plug. Electric safety requires a periodic check of outlet grounding capability and continuing inspection and repair of corded equipment. Personnel, equipment, reports, procedures, and schedule requirements are reported

  6. Spatial accessibility to physical activity facilities and to food outlets and overweight in French youth.

    Science.gov (United States)

    Casey, R; Chaix, B; Weber, C; Schweitzer, B; Charreire, H; Salze, P; Badariotti, D; Banos, A; Oppert, J-M; Simon, C

    2012-07-01

    Some characteristics of the built environment have been associated with obesity in youth. Our aim was to determine whether individual and environmental socio-economic characteristics modulate the relation between youth overweight and spatial accessibility to physical activity (PA) facilities and to food outlets. Cross-sectional study. 3293 students, aged 12 ± 0.6 years, randomly selected from eastern France middle schools. Using geographical information systems (GIS), spatial accessibility to PA facilities (urban and nature) was assessed using the distance to PA facilities at the municipality level; spatial accessibility to food outlets (general food outlets, bakeries and fast-food outlets) was calculated at individual level using the student home address and the food outlets addresses. Relations of weight status with spatial accessibility to PA facilities and to food outlets were analysed using mixed logistic models, testing potential direct and interaction effects of individual and environmental socio-economic characteristics. Individual socio-economic status modulated the relation between spatial accessibility to PA facilities and to general food outlets and overweight. The likelihood of being overweight was higher when spatial accessibility to urban PA facilities and to general food outlets was low, but in children of blue-collar-workers only. The odds ratio (OR) (95% confidence interval) for being overweight of blue-collar-workers children compared with non-blue-collar-workers children was 1.76 (1.25-2.49) when spatial accessibility to urban PA facilities was low. This OR was 1.86 (1.20-2.86) when spatial accessibility to general food outlets was low. There was no significant relationship of overweight with either nature PA facilities or other food outlets (bakeries and fast-food outlets). These results indicate that disparities in spatial accessibility to PA facilities and to general food outlets may amplify the risk of overweight in socio

  7. Bacteriological Analysis and Hygine Level of Food Outlets within Rufus Giwa Polytechnic, Owo, Ondo State, Nigeria.

    OpenAIRE

    Ibrahim TA; Akenroye OM; Osabiya OJ

    2013-01-01

    The bacteriological quality of three major food outlets in Rufus Giwa Polytechnic, Owo, was assessed using standard bacteriological methods. Swabs of hands of food vendors, table and plates in these outlets were assessed for total bacterial count, total coliform count and total E. coli count. A total of 789 bacterial colonies were isolated from hands of food handlers, tables and plates used for eating in the outlets. Eleven genera of bacteria were isolated and identified, they were; klebsiell...

  8. Availability of healthier options in traditional and nontraditional rural fast-food outlets

    OpenAIRE

    Creel, Jennifer S; Sharkey, Joseph R; McIntosh, Alex; Anding, Jenna; Huber, J Charles

    2008-01-01

    Abstract Background Food prepared away from home has become increasingly popular to U.S. families, and may contribute to obesity. Sales have been dominated by fast food outlets, where meals are purchased for dining away from home or in the home. Although national chain affiliated fast-food outlets are considered the main source for fast food, fast foods are increasingly available in convenience stores and supermarkets/grocery stores. In rural areas, these nontraditional fast-food outlets may ...

  9. A GIS Application to Explore Postal Retail Outlet Locations

    Directory of Open Access Journals (Sweden)

    Nikola Trubint

    2012-03-01

    Full Text Available The use of GIS in solving a wide variety of problems in postal operations is expanding. This approach provides the development and usage of new methods in spatial data analysis, as support in achieving a better quality of the decision-making process. The use of location analysis model based on GIS software is implemented in solving the Belgrade postal retail outlet problem. One of the most important experiences of model implementation is that the local environmental conditions have a significant impact on strategic as well as operational approach. A portion of the material included in the paper has resulted from the Serbian PTT and CPC (Canada Post Corporation joint project Location Analysis.

  10. Validation of turbulence models for LMFBR outlet plenum flows

    International Nuclear Information System (INIS)

    Chen, Y.B.; Golay, M.W.

    1977-01-01

    Small scale experiments involving water flows are used to provide mean flow and turbulence field data for LMFBR outlet plenum flows. Measurements are performed at Reynolds number (Re) values of 33000 and 70000 in a 1/15 - scale FFTF geometry and at Re = 35000 in a 3/80-scale CRBR geometry. The experimental behavior is predicted using two different two-equation turbulence model computer programs, TEACH-T and VARR-II. It is found that the qualitative nature of the flow field within the plenum depends strongly upon the distribution of the mean inlet flow field, importantly also upon the degree of inlet turbulence, and also upon the turbulent momentum exchange model used in the calculations. In the FFTF geometry, the TEACH-T predictions agree well with the experiments. 7 refs

  11. Supraclavicular scalenectomy for thoracic outlet syndrome--functional outcomes assessed using the DASH scoring system.

    LENUS (Irish Health Repository)

    Glynn, Ronan W

    2012-02-01

    To evaluate supraclavicular scalenectomy ± cervical rib excision for thoracic outlet syndrome (TOS), employing Disability of Arm, Shoulder, and Hand (DASH) scoring for functional assessment post-decompression.

  12. [Total pollution features of urban runoff outlet for urban river].

    Science.gov (United States)

    Luo, Hong-Bing; Luo, Lin; Huang, Gu; He, Qiang; Liu, Ping

    2009-11-01

    The urban stormwater runoff discharged to urban river, especially to rainfall source river, cannot be ignored. In this study, the Futian River watershed in Shenzhen city in a typical southern city of China is taken as the research object. In order to guide the pollution control for urban river, the eighteen rainfall events were monitored, and the total pollution features of the urban runoff outlet for this urban river were analyzed and discussed by using the process of pollutographs, the identifying to first flush, event mean concentration (EMC), etc. Results show that the concentrations of COD, SS, TN, TP and BOD5 are ten times more than the grade V of the environmental quality standards for surface water during the runoff time; the pollution caused by heavy metals (Cr, Ge, Cu, Hg and As) in runoff at a typical rainfall event is serious; the average and range of pollutant concentration at this runoff outlet in study area are evidently higher than at Shapingba in Chongqing city of China and at Silerwood in Canada, but are lower than at Shilipu in Wuhan city of China. The first flushes of COD, SS, BOD5, especially COD and SS, are evident, but the TN and TP are not. The average EMC of COD, TN, TP and BOD5 are 224.14, 571.15, 5.223, 2.04, 143.5 mg/L, respectively. To some extent, the EMC of COD is about two times of the value of the near cities, Macao and Zhuhai. The EMC of TN and TP are obviously higher than Beijing, Guangzhou and Shanghai. To compared with foreign counties, the EMC of the study area in Shenzhen is obviously much higher than the cities of Korean, USA and Canada. So the total pollution caused by the urban surface runoff in study area is serious and necessary to be treated.

  13. Your diet after gastric bypass surgery

    Science.gov (United States)

    Gastric bypass surgery - your diet; Obesity - diet after bypass; Weight loss - diet after bypass ... You had gastric bypass surgery. This surgery made your stomach smaller by closing off most of your stomach with staples. It changed the way your ...

  14. Experimental Study on Gastric Juice Secretion by ...

    African Journals Online (AJOL)

    管理平台

    2012-05-29

    May 29, 2012 ... Study on stomach physiological functions by ... mechanism of regulating gastric electrical activity and gastric juice secretion might become true by the .... samples was used in comparism among these different groups.

  15. Diaphragmatic eventration complicated by gastric volvulus with ...

    African Journals Online (AJOL)

    eventration; perforation of the stomach in gastric volvulus is rare, with very few cases reported in the .... it was a chronic volvulus and manifested owing to gastric ulcer perforation. ... without strangulation. Management in such cases without.

  16. Endoscopic appearance of irradiated gastric mucosa

    Energy Technology Data Exchange (ETDEWEB)

    De Sagher, L I; Van den Heule, B; Van Houtte, P; Engelholm, L; Balikdjan, D; Bleiberg, H

    1979-09-01

    Irradiation of the epigastric area for gastric cancer may induce actinic lesions of the stomach characterized on endoscopic examination by ulcerations, haemorrhagic gastritis, fragility of the mucosa, thickening and congestion of the gastric folds.

  17. Intrathoracic Gastric Volvulus presenting with GIT Bleed

    OpenAIRE

    Rahul Kadam; VSV Prasad

    2017-01-01

    Intrathoracic gastric volvulus in neonatal period is a life-threatening surgical emergency. We report a case of neonate with respiratory distress and GI bleeding who was diagnosed to have congenital diaphragmatic eventration with Intrathoracic gastric volvulus.

  18. Analysis of interventional therapy for progressing stage gastric cancer

    International Nuclear Information System (INIS)

    Zhu Mingde; Zhang Zijing; Ji Hongsheng; Ge Chenlin; Hao Gang; Wei Kongming; Yuan Yuhou; Zhao Xiuping

    2008-01-01

    Objective: To investigate the interventional therapy and its curative effect for progressing stage gastric cancer. Methods: two hundred and twelve patients with progressing stage gastric cancer were treated with arterial perfusion and arterial embolization. Gastric cardia cancer was treated through the left gastric artery and the left inferior phrenic artery or splenic artery. Cancers of lesser and greater gastric curvature was treated either through the left and right gastric arteries or common hepatic artery or through gastroduodenal artery, right gastroomental artery or splenic artery. Gastric antrum cancers were perfused through gastroduodenal artery or after the middle segmental embolization of right gastroomental artery. Results: One hundred and ninety three cases undergone interventional management were followed up. The CR + PR of gastric cardia cancer was 53.13%; gastric body cancer 44.44%; gastric antrum cancer 10%; recurrent cancer and remnant gastric cancer 0. There was no significant difference in outcome between gastric cardia cancer and gastric body cancer (P>0.05) but significant differences were shown both between gastric cardia cancer and gastric antrum cancer, and between gastric body cancer and gastric antrum cancer (P<0.05), with 1 year and 2 years survival rates of 81% and 56% respectively. Conclusion: The interventional therapeutic effect of progressing stage gastric cancers is different due to the different sites of the lesions in the gastric tissue. The curative effect of gastric cardia cancer and gastric body cancer is better than that of gastric antrum cancer, recurrent cancer and remnant gastric cancer. (authors)

  19. Characteristics of the mechanosensitive bladder afferent activities in relation with microcontractions in male rats with bladder outlet obstruction.

    Science.gov (United States)

    Aizawa, Naoki; Ichihara, Koji; Fukuhara, Hiroshi; Fujimura, Tetsuya; Andersson, Karl-Erik; Homma, Yukio; Igawa, Yasuhiko

    2017-08-09

    We investigated the characteristics of bladder mechanosensitive single-unit afferent activities (SAAs) in rats with a bladder outlet obstruction (BOO) and their relationship with bladder microcontractions. Male Wistar rats were divided into Sham and BOO groups. Four or 10 days after the surgery, rats were anesthetized with urethane. The SAAs of Aδ- or C-fibers from the L6 dorsal roots were recorded during bladder filling. The BOO group showed a higher number of microcontractions and lower SAAs of Aδ-fibers compared with those of the Sham group. These findings were significant at day 10 post-operatively. In contrast, SAAs of C-fibers were not significantly different between the groups at either day 4 or 10. In the BOO group at day 10, the SAAs of both Aδ- and C-fibers at the "ascending" phase of microcontractions were significantly higher than those at the other phases (descending or stationary), and a similar tendency was also observed at day 4. Taken together, during bladder filling, the bladder mechanosensitive SAAs of Aδ-fibers were attenuated, but SAAs of both Aδ- and C-fibers were intermittently enhanced by propagation of microcontractions.

  20. Comparison of Intermittent and Bolus Enteral Feeding Methods on Enteral Feeding Intolerance of Patients with Sepsis: A Triple-blind Controlled Trial in Intensive Care Units.

    Science.gov (United States)

    Nasiri, Morteza; Farsi, Zahra; Ahangari, Mojtaba; Dadgari, Fahimeh

    2017-10-01

    BACKGROUND Recent trials have shown controversial results on which enteral feeding methods has a lower risk of enteral feeding intolerance. Therefore, we aimed to compare two methods of bolus and intermittent feeding on enteral feeding intolerance of patients with sepsis. METHODS This triple-blind randomized controlled trial was conducted on 60 patients with sepsis, who were fed through tubes for at least 3 days. The patients were randomly assigned into bolus feeding, intermittent feeding, and control groups. Enteral feeding intolerance of all patients was recorded in 3 consecutive days by a researcher-made checklist including the data on gastric residual volume, vomiting, diarrhea, constipation, and abdominal distension. RESULTS There were no significant differences between the three studied groups in none of the intervention days pertaining to constipation, diarrhea, vomiting, abdominal distention, and gastric residual volume ( p > 0.05). Also, no statistically significant difference was found between all variables in the three studied groups during the 3 days ( p > 0.05). CONCLUSION As enteral feeding intolerance of patients with sepsis was similar in both bolus and intermittent feeding methods, it can be concluded that bolus method can still be used as a standard method to decrease the risk of enteral feeding intolerance if it is used properly.

  1. Congenital diaphragmatic hernia with gastric volvulus

    OpenAIRE

    Jain, Prashant; Sanghavi, Beejal; Sanghani, Hemanshi; Parelkar, S. V.; Borwankar, S. S.

    2007-01-01

    Gastric volvulus is a surgical emergency presenting in various forms. Association with diaphragmatic defect is well known. Here we describe three cases of gastric volvulus associated with diaphragmatic defect having varied presentations and their management. A rare case of gastric volvulus with complete gangrene of the stomach is also reported. Three types of gastric volvulus have been described depending on the rotation axis: organoaxial, mesentericoaxial and combination of both types. Opera...

  2. Acute mesenteroaxial gastric volvulus on computed tomography

    Directory of Open Access Journals (Sweden)

    Aadil Ahmed

    2013-03-01

    Full Text Available Acute gastric volvulus is a rare, but potentially life-threatening, cause of upper gastro-intestinal obstruction. The diagnosis can prove clinically challenging, and hence there is increased reliance on imaging. There are different types of gastric volvulus, with the variant presented in our case being the less commonly encountered mesenteroaxial gastric volvulus. Some of the CT features of gastric volvulus are described, and the usefulness of CT in assisting with the diagnosis is highlighted.

  3. ACUTE GASTRIC DILATATION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    E. Yu. D'yakonovax

    2014-01-01

    Full Text Available Acute gastric dilatation is a rare surgical condition in children, which often results from blunt abdominal trauma. This condition is characterized by the gut-brain connection disorder or gastric muscular layer damage, which results in atony. Gradual gastric stretching with fluid contents and gases in the end leads to the development of various types of intestinal obstruction. When conservative measures are not sufficient (in rare cases, it is reasonable to resort to operative intervention. Several cases of such a pathology have been published around the world. This condition has been observed not only at the blunt abdominal trauma, but also at lesions of central and peripheral nervous systems and in patients with anorexia nervosa and bulimia in the event of excessive food consumption. The article presents a clinical case study and a follow-up analysis of a child with posttraumatic acute gastric dilatation. The authors describe clinical manifestations, pathogenesis and diagnostic algorithm, which allowed establishing this rare diagnosis. Along with the conventional drugs and intensive care measures, the treatment involved a complex of mini-invasive endosurgical and endoscopic manipulations, including laparoscopic jejunostomy, which was performed in order to provide long-term enteral feeding. The clinical case study demonstrated that the use of diagnostic laparoscopy helps to establish nature of the gastric damage correctly and formulate the following optimal treatment tactics on the basis of the obtained data. 

  4. Telomerase activity in gastric cancer.

    Science.gov (United States)

    Hiyama, E; Yokoyama, T; Tatsumoto, N; Hiyama, K; Imamura, Y; Murakami, Y; Kodama, T; Piatyszek, M A; Shay, J W; Matsuura, Y

    1995-08-01

    Although many genetic alterations have been reported in gastric cancer, it is not known whether all gastric tumors are capable of indefinite proliferative potential, e.g., immortality. The expression of telomerase and stabilization of telomeres are concomitant with the attainment of immortality in tumor cells; thus, the measurement of telomerase activity in clinically obtained tumor samples may provide important information useful both as a diagnostic marker to detect immortal cancer cells in clinical materials and as a prognostic indicator of patient outcome. Telomerase activity was analyzed in 66 primary gastric cancers with the use of a PCR-based assay. The majority of tumors (85%) displayed telomerase activity, but telomerase was undetectable in 10 tumors (15%), 8 of which were early stage tumors. Most of the tumors with telomerase activity were large and of advanced stages, including metastases. Survival rate of patients of tumors with detectable telomerase activity was significantly shorter than that of those without telomerase activity. Alterations of telomere length (reduced/elongated terminal restriction fragments) were detected in 14 of 66 (21%) gastric cancers, and all 14 had telomerase activity. Cellular DNA contents revealed that all 22 aneuploid tumors had detectable telomerase activity. The present results indicate that telomerase activation may be required as a critical step in the multigenetic process of tumorigenesis, and that telomerase is frequently but not always activated as a late event in gastric cancer progression.

  5. Gastric residual volume (GRV) and gastric contents measurement by refractometry.

    Science.gov (United States)

    Chang, Wei-Kuo; McClave, Stephen A; Hsieh, Chung-Bao; Chao, You-Chen

    2007-01-01

    Traditional use of gastric residual volumes (GRVs), obtained by aspiration from a nasogastric tube, is inaccurate and cannot differentiate components of the gastric contents (gastric secretion vs delivered formula). The use of refractometry and 3 mathematical equations has been proposed as a method to calculate the formula concentration, GRV, and formula volume. In this paper, we have validated these mathematical equations so that they can be implemented in clinical practice. Each of 16 patients receiving a nasogastric tube had 50 mL of water followed by 100 mL of dietary formula (Osmolite HN, Abbott Laboratories, Columbus, OH) infused into the stomach. After mixing, gastric content was aspirated for the first Brix value (BV) measurement by refractometry. Then, 50 mL of water was infused into the stomach and a second BV was measured. The procedure of infusion of dietary formula (100 mL) and then water (50 mL) was repeated and followed by subsequent BV measurement. The same procedure was performed in an in vitro experiment. Formula concentration, GRV, and formula volume were calculated from the derived mathematical equations. The formula concentrations, GRVs, and formula volumes calculated by using refractometry and the mathematical equations were close to the true values obtained from both in vivo and in vitro validation experiments. Using this method, measurement of the BV of gastric contents is simple, reproducible, and inexpensive. Refractometry and the derived mathematical equations may be used to measure formula concentration, GRV, and formula volume, and also to serve as a tool for monitoring the gastric contents of patients receiving nasogastric feeding.

  6. 64Cu DOTA-Trastuzumab PET/CT in Studying Patients With Gastric Cancer

    Science.gov (United States)

    2017-12-11

    Adenocarcinoma of the Gastroesophageal Junction; Diffuse Adenocarcinoma of the Stomach; Intestinal Adenocarcinoma of the Stomach; Mixed Adenocarcinoma of the Stomach; Recurrent Gastric Cancer; Stage IA Gastric Cancer; Stage IB Gastric Cancer; Stage IIA Gastric Cancer; Stage IIB Gastric Cancer; Stage IIIA Gastric Cancer; Stage IIIB Gastric Cancer; Stage IIIC Gastric Cancer; Stage IV Gastric Cancer

  7. Computed tomography findings of acute gastric volvulus

    Energy Technology Data Exchange (ETDEWEB)

    Millet, Ingrid; Orliac, Celine; Alili, Chakib; Taourel, Patrice [Hopital Lapeyronie, Department of Radiology, Montpellier (France); Guillon, Francoise [University Hospital of Montpellier, Department of Surgery, Montpellier (France)

    2014-12-15

    To assess the diagnostic performance of CT signs of gastric volvulus in both confirmed cases and control subjects. We retrospectively reviewed CT findings in 10 patients with surgically confirmed acute gastric volvulus and 20 control subjects with gastric distension. Two radiologists independently evaluated CT images for risk factors of gastric volvulus, direct findings of gastric volvulus by assessing gastric dilatation, the presence of an antropyloric transition point, the respective position of the different stomach segments and of the greater and lesser curvatures, stenosis of the gastric segments through the oesophageal hiatus and for findings of gastric ischemia. The sensitivity and specificity of each finding were calculated. The most sensitive direct signs of gastric volvulus were an antropyloric transition point without any abnormality at the transition zone and the antrum at the same level or higher than the fundus. The presence of both these two findings as diagnostic criteria of gastric volvulus had 100 % sensitivity and specificity for the diagnosis of gastric volvulus. There was no association between CT signs of ischemia and final bowel ischemia at pathology. CT is both highly sensitive and specific for diagnosing acute gastric volvulus. (orig.)

  8. Computed tomography findings of acute gastric volvulus

    International Nuclear Information System (INIS)

    Millet, Ingrid; Orliac, Celine; Alili, Chakib; Taourel, Patrice; Guillon, Francoise

    2014-01-01

    To assess the diagnostic performance of CT signs of gastric volvulus in both confirmed cases and control subjects. We retrospectively reviewed CT findings in 10 patients with surgically confirmed acute gastric volvulus and 20 control subjects with gastric distension. Two radiologists independently evaluated CT images for risk factors of gastric volvulus, direct findings of gastric volvulus by assessing gastric dilatation, the presence of an antropyloric transition point, the respective position of the different stomach segments and of the greater and lesser curvatures, stenosis of the gastric segments through the oesophageal hiatus and for findings of gastric ischemia. The sensitivity and specificity of each finding were calculated. The most sensitive direct signs of gastric volvulus were an antropyloric transition point without any abnormality at the transition zone and the antrum at the same level or higher than the fundus. The presence of both these two findings as diagnostic criteria of gastric volvulus had 100 % sensitivity and specificity for the diagnosis of gastric volvulus. There was no association between CT signs of ischemia and final bowel ischemia at pathology. CT is both highly sensitive and specific for diagnosing acute gastric volvulus. (orig.)

  9. Neighbourhood fast food outlets and obesity in children and adults: the CLAN Study.

    Science.gov (United States)

    Crawford, David A; Timperio, Anna F; Salmon, Jo A; Baur, Louise; Giles-Corti, Billie; Roberts, Rebecca J; Jackson, Michelle L; Andrianopoulos, Nick; Ball, Kylie

    2008-01-01

    We examined associations between density of and proximity to fast food outlets and body weight in a sample of children (137 aged 8-9 years and 243 aged 13-15 years) and their parents (322 fathers and 362 mothers). Children's measured and parents' self-reported heights and weights were used to calculate body mass index (BMI). Locations of major fast food outlets were geocoded. Bivariate linear regression analyses examined associations between the presence of any fast food outlet within a 2 km buffer around participants' homes, fast food outlet density within the 2 km buffer, and distance to the nearest outlet and BMI. Each independent variable was also entered into separate bivariate logistic regression analyses to predict the odds of being overweight or obese. Among older children, those with at least one outlet within 2 km had lower BMI z-scores. The further that fathers lived from an outlet, the higher their BMI. Among 13-15-year-old girls and their fathers, the likelihood of overweight/obesity was reduced by 80% and 50%, respectively, if they had at least one fast food outlet within 2 km of their home. Among older girls, the likelihood of being overweight/obese was reduced by 14% with each additional outlet within 2 km. Fathers' odds of being overweight/obese increased by 13% for each additional kilometre to the nearest outlet. While consumption of fast food has been shown to be associated with obesity, this study provides little support for the concept that exposure to fast food outlets in the local neighbourhood increases risk of obesity.

  10. Out-of-home food outlets and area deprivation: case study in Glasgow, UK

    Directory of Open Access Journals (Sweden)

    Cummins Steven

    2005-10-01

    Full Text Available Abstract Background There is a popular belief that out-of-home eating outlets, which typically serve energy dense food, may be more commonly found in more deprived areas and that this may contribute to higher rates of obesity and related diseases in such areas. Methods We obtained a list of all 1301 out-of-home eating outlets in Glasgow, UK, in 2003 and mapped these at unit postcode level. We categorised them into quintiles of area deprivation using the 2004 Scottish Index of Multiple Deprivation and computed mean density of types of outlet (restaurants, fast food restaurants, cafes and takeaways, and all types combined, per 1000 population. We also estimated odds ratios for the presence of any outlets in small areas within the quintiles. Results The density of outlets, and the likelihood of having any outlets, was highest in the second most affluent quintile (Q2 and lowest in the second most deprived quintile (Q4. Mean outlets per 1,000 were 4.02 in Q2, 1.20 in Q4 and 2.03 in Q5. With Q2 as the reference, Odds Ratios for having any outlets were 0.52 (CI 0.32–0.84 in Q1, 0.50 (CI 0.31 – 0.80 in Q4 and 0.61 (CI 0.38 – 0.98 in Q5. Outlets were located in the City Centre, West End, and along arterial roads. Conclusion In Glasgow those living in poorer areas are not more likely to be exposed to out-of-home eating outlets in their neighbourhoods. Health improvement policies need to be based on empirical evidence about the location of fast food outlets in specific national and local contexts, rather than on popular 'factoids'.

  11. Lethal mechanisms in gastric volvulus.

    Science.gov (United States)

    Omond, Kimberley J; Byard, Roger W

    2017-01-01

    A 55-year-old wheelchair-bound woman with severe cerebral palsy was found at autopsy to have marked distention of the stomach due to a volvulus. The stomach was viable, and filled with air and fluid and had pushed the left dome of the diaphragm upwards causing marked compression of the left lung with a mediastinal shift to the right (including the heart). There was no evidence of gastric perforation, ischaemic necrosis or peritonitis. Removal of the organ block revealed marked kyphoscoliosis. Histology confirmed the viability of the stomach and biochemistry showed no dehydration. Death in cases of acute gastric volvulus usually occurs because of compromise of the gastric blood supply resulting in ischaemic necrosis with distention from swallowed air and fluid resulting in perforation with lethal peritonitis. Hypovolaemic shock may also occur. However, the current case demonstrates an alternative lethal mechanism, that of respiratory compromise due to marked thoracic organ compression.

  12. Gastric Mucosal Erosions - Radiologic evaluation -

    International Nuclear Information System (INIS)

    Kim, Seung Hyup

    1985-01-01

    70 cases of gastric mucosal erosions were diagnosed by double contrast upper gastrointestinal examinations and endoscopic findings. Analyzing the radiologic findings of these 70 cases of gastric mucosal erosions, the following results were obtained. 1. Among the total 70 cases, 65 cases were typical varioliform erosions showing central depressions and surrounding mucosal elevations. Remaining 5 cases were erosions of acute phase having multiple irregular depressions without surrounding elevations. 2. The gastric antrum was involved alone or in part in all cases. Duodenal bulb was involved with gastric antrum in 4 cases. 3. The majority of the cases had multiple erosions. There were only 2 cases of single erosion. 4. In 65 cases of varioliform erosions; 1) The diameter of the surrounding elevations varied from 3 to 20 mm with the majority (47 cases) between 6 and 10 mm. 2) In general, the surrounding elevations with sharp margin on double contrast films were also clearly demonstrated on compression films but those with faint margin were not. 3) The size of the central barium collections varied from pinpoint to 10 mm with the majority under 5 mm. The shape of the central barium collections in majority of the cases were round with a few cases of linear, triangular or star-shape. 5. In 5 cases of acute phase erosions; 1) All the 5 cases were females. 2) On double contrast radiography, all the cases showed multiple irregular depressed lesions without surrounding elevations. 3) 1 case had the history of hematemesis. 4) In 1 case, there was marked radiological improvement on follow-up study of 2 months interval. 6. In 23 cases, there were coexistent diseases with gastric mucosal erosions. These were 13 cases of duodenal bulb ulcers,7 cases of benign gastric ulcers and 3 others

  13. Endoscopic palliation in gastric cancer

    International Nuclear Information System (INIS)

    Valdivieso, Eduardo

    2010-01-01

    The integral search for improved living conditions for those patients with gastric cancer who have not received curative surgical treatment continues to challenge the knowledge, dexterity and ethical foundations of medical teams. The justification for palliative treatment must be based on a thorough consideration of the available options and the particular situation in each case. This article reviews endoscopic therapy with auto expandable prosthetics for palliative treatment of gastric cancer, as well as the scientific evidence that supports its use and the factors that determine its indication.

  14. Automated analysis of gastric emptying

    International Nuclear Information System (INIS)

    Abutaleb, A.; Frey, D.; Spicer, K.; Spivey, M.; Buckles, D.

    1986-01-01

    The authors devised a novel method to automate the analysis of nuclear gastric emptying studies. Many previous methods have been used to measure gastric emptying but, are cumbersome and require continuing interference by the operator to use. Two specific problems that occur are related to patient movement between images and changes in the location of the radioactive material within the stomach. Their method can be used with either dual or single phase studies. For dual phase studies the authors use In-111 labeled water and Tc-99MSC (Sulfur Colloid) labeled scrambled eggs. For single phase studies either the liquid or solid phase material is used

  15. Hovering and intermittent flight in birds

    International Nuclear Information System (INIS)

    Tobalske, Bret W

    2010-01-01

    Two styles of bird locomotion, hovering and intermittent flight, have great potential to inform future development of autonomous flying vehicles. Hummingbirds are the smallest flying vertebrates, and they are the only birds that can sustain hovering. Their ability to hover is due to their small size, high wingbeat frequency, relatively large margin of mass-specific power available for flight and a suite of anatomical features that include proportionally massive major flight muscles (pectoralis and supracoracoideus) and wing anatomy that enables them to leave their wings extended yet turned over (supinated) during upstroke so that they can generate lift to support their weight. Hummingbirds generate three times more lift during downstroke compared with upstroke, with the disparity due to wing twist during upstroke. Much like insects, hummingbirds exploit unsteady mechanisms during hovering including delayed stall during wing translation that is manifest as a leading-edge vortex (LEV) on the wing and rotational circulation at the end of each half stroke. Intermittent flight is common in small- and medium-sized birds and consists of pauses during which the wings are flexed (bound) or extended (glide). Flap-bounding appears to be an energy-saving style when flying relatively fast, with the production of lift by the body and tail critical to this saving. Flap-gliding is thought to be less costly than continuous flapping during flight at most speeds. Some species are known to shift from flap-gliding at slow speeds to flap-bounding at fast speeds, but there is an upper size limit for the ability to bound (∼0.3 kg) and small birds with rounded wings do not use intermittent glides.

  16. Hovering and intermittent flight in birds

    Energy Technology Data Exchange (ETDEWEB)

    Tobalske, Bret W, E-mail: bret.tobalske@mso.umt.ed [Field Research Station at Fort Missoula, Division of Biological Sciences, University of Montana, Missoula, MT 59812 (United States)

    2010-12-15

    Two styles of bird locomotion, hovering and intermittent flight, have great potential to inform future development of autonomous flying vehicles. Hummingbirds are the smallest flying vertebrates, and they are the only birds that can sustain hovering. Their ability to hover is due to their small size, high wingbeat frequency, relatively large margin of mass-specific power available for flight and a suite of anatomical features that include proportionally massive major flight muscles (pectoralis and supracoracoideus) and wing anatomy that enables them to leave their wings extended yet turned over (supinated) during upstroke so that they can generate lift to support their weight. Hummingbirds generate three times more lift during downstroke compared with upstroke, with the disparity due to wing twist during upstroke. Much like insects, hummingbirds exploit unsteady mechanisms during hovering including delayed stall during wing translation that is manifest as a leading-edge vortex (LEV) on the wing and rotational circulation at the end of each half stroke. Intermittent flight is common in small- and medium-sized birds and consists of pauses during which the wings are flexed (bound) or extended (glide). Flap-bounding appears to be an energy-saving style when flying relatively fast, with the production of lift by the body and tail critical to this saving. Flap-gliding is thought to be less costly than continuous flapping during flight at most speeds. Some species are known to shift from flap-gliding at slow speeds to flap-bounding at fast speeds, but there is an upper size limit for the ability to bound ({approx}0.3 kg) and small birds with rounded wings do not use intermittent glides.

  17. Remaining Life Estimation Of Secondary Superheater Outlet On Industrial Electrical Boiler

    International Nuclear Information System (INIS)

    Soedardjo; Andryansyah; Arhatari, B.D.; Natsir, Muhammad; Triyadi, Ari; Farokhi

    2001-01-01

    Remaining life estimation of secondary superheater header outlet (SSHO) on industrial electrical boiler has been carried out. Estimation conducted by the observation of microstructure cavitation development based on Neubauer and Wedel theory. The result is available for isolated cavitation development present yet. That Secondary Superheater Outlet component is in good condition after 14 years operated and predicted could be operated for 36 years again

  18. Contamination of faecal coliforms in ice cubes sampled from food outlets in Kubang Kerian, Kelantan.

    Science.gov (United States)

    Noor Izani, N J; Zulaikha, A R; Mohamad Noor, M R; Amri, M A; Mahat, N A

    2012-03-01

    The use of ice cubes in beverages is common among patrons of food outlets in Malaysia although its safety for human consumption remains unclear. Hence, this study was designed to determine the presence of faecal coliforms and several useful water physicochemical parameters viz. free residual chlorine concentration, turbidity and pH in ice cubes from 30 randomly selected food outlets in Kubang Kerian, Kelantan. Faecal coliforms were found in ice cubes in 16 (53%) food outlets ranging between 1 CFU/100mL to >50 CFU/ 100mL, while in the remaining 14 (47%) food outlets, in samples of tap water as well as in commercially bottled drinking water, faecal coliforms were not detected. The highest faecal coliform counts of >50 CFU/100mL were observed in 3 (10%) food outlets followed by 11-50 CFU/100mL and 1-10 CFU/100mL in 7 (23%) and 6 (20%) food outlets, respectively. All samples recorded low free residual chlorine concentration (contamination by faecal coliforms was not detected in 47% of the samples, tap water and commercially bottled drinking water, it was concluded that (1) contamination by faecal coliforms may occur due to improper handling of ice cubes at the food outlets or (2) they may not be the water sources used for making ice cubes. Since low free residual chlorine concentrations were observed (food outlets, including that of ice cube is crucial in ensuring better food and water for human consumption.

  19. Alcohol outlet density and alcohol consumption in Los Angeles county and southern Louisiana

    Directory of Open Access Journals (Sweden)

    Matthias Schonlau

    2008-11-01

    Full Text Available The objective of this study was to assess the relationship between alcohol availability, as measured by the density of off-premise alcohol outlets, and alcohol consumption in Los Angeles county and southern Louisiana, USA. Consumption information was collected through a telephone survey of 2,881 households in Los Angeles county and pre-Katrina southern Louisiana, nested within 220 census tracts. Respondents’ addresses were geo-coded and both neighbourhood (census tracts and buffers of varying sizes and individual (network distance to the closest alcohol outlet estimates of off-sale alcohol outlet density were computed. Alcohol outlet density was not associated with the percentage of people who were drinkers in either site. Alcohol outlet density was associated with the quantity of consumption among drinkers in Louisiana but not in Los Angeles. Outlet density within a one-mile buffer of the respondent’s home was more strongly associated with alcohol consumption than outlet density in the respondent’s census tract. The conclusion is that the relationship between neighbourhood alcohol outlet density and alcohol consumption is complex and may vary due to differences in neighbourhood design and travel patterns.

  20. Survey of Publication Outlets in Early Childhood Education: Descriptive Data, Review Processes, and Advice to Authors

    Science.gov (United States)

    Amodei, Michelle L.; Jalongo, Mary Renck; Myers, Jacqueline; Onchwari, Jacqueline; Gargiulo, Richard M.

    2013-01-01

    Publishing outlets in the field of early childhood vary widely in terms of emphasis on theory, practice, and research as they relate to the care and education of the very young; these outlets also have different readerships (i.e., primarily for teachers, the teachers of their teachers, or the fellow scholars/researchers). Included in the mixture…

  1. Validation of presence of supermarkets and fast-food outlets in Copenhagen

    DEFF Research Database (Denmark)

    Svastisalee, Chalida M; Holstein, Bjørn E; Due, Pernille

    2012-01-01

    We examined the quality of food outlet addresses provided by secondary sources and determined whether they could be physically located in the field.......We examined the quality of food outlet addresses provided by secondary sources and determined whether they could be physically located in the field....

  2. The association between the geography of fast food outlets and childhood obesity rates in Leeds, UK.

    Science.gov (United States)

    Fraser, Lorna K; Edwards, Kimberley L

    2010-11-01

    To analyse the association between childhood overweight and obesity and the density and proximity of fast food outlets in relation to the child's residential postcode. This was an observational study using individual level height/weight data and geographic information systems methodology. Leeds in West Yorkshire, UK. This area consists of 476 lower super-output areas. Children aged 3-14 years who lived within the Leeds metropolitan boundaries (n=33,594). The number of fast food outlets per area and the distance to the nearest fast food outlet from the child's home address. The weight status of the child: overweight, obese or neither. 27.1% of the children were overweight or obese with 12.6% classified as obese. There is a significant positive correlation (pfood outlets and higher deprivation. A higher density of fast food outlets was significantly associated (p=0.02) with the child being obese (or overweight/obese) in the generalised estimating equation model which also included sex, age and deprivation. No significant association between distance to the nearest fast food outlet and overweight or obese status was found. There is a positive relationship between the density of fast food outlets per area and the obesity status of children in Leeds. There is also a significant association between fast food outlet density and areas of higher deprivation. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Study on partial overheat of the isolated phase busbar outlet box in Qinshan NPP phase Ⅱ

    International Nuclear Information System (INIS)

    Tang Fangxuan; Zhang Jian; Zeng Limin; Bao Yanxing; Zhang Lie; Yang Yuemin

    2013-01-01

    This paper recommended the structure of the isolated phase busbar outlet box installed in Qinshan II. The study on partial overheat of the outlet box shows that the ultimate causes are the loss of concentrated eddy current and short of cooling. So the improvement principles of 'distributing eddy current, cutting off inductive circle current and strengthening of ventilation' were determined. A new structure test outlet box was designed and manufactured, and the temperature rising experiment was carried out. Some alterations were made in the new structure outlet box, e.g. isolating materials were added between side plates of the upper outlet box, and also between the upper and lower outlet box. Two cooling blowers were added to the upper outlet box. After putting into operation, the hot-spot temperature of the new outlet box was greatly lowered down. Thus the operation environment was improved, and the operation safety ensured. It can be useful references for analyzing and dealing with similar problems. (authors)

  4. Shopper Loyalty to Whom? Chain Versus Outlet Loyalty in the Context of Store Acquisitions

    NARCIS (Netherlands)

    van Lin, Arjen; Gijsbrechts, E.

    2014-01-01

    When patronizing stores, consumers may exhibit loyalty not only to a retail chain but also to a specific outlet. This distinction is important in a dynamic retail environment: if a store changes ownership, chain loyalty makes customers inclined to seek out another outlet of the former chain, whereas

  5. Shopper loyalty to whom? Chain versus outlet loyalty in the context of store acquisitions

    NARCIS (Netherlands)

    van Lin, A.I.J.G.; Gijsbrechts, E.

    When patronizing stores, consumers may exhibit loyalty not only to a retail chain but also to a specific outlet. This distinction is important in a dynamic retail environment: if a store changes ownership, chain loyalty makes customers inclined to seek out another outlet of the former chain, whereas

  6. Diagnosis of gastric cancers by CT

    International Nuclear Information System (INIS)

    Zhu Jianbing; Gong Jianping; Huan Jian

    1999-01-01

    Forty two cases of gastric cancers were reviewed. The cancer had been examined by CT and was confirmed by operation and pathology. The diagnostic results of gastric cancers obtained by CT were compared with that from GI and fibro-gastroscopy examination. The results showed that the preparation of gastrointestinal tract before CT examination was important in the CT diagnosis of gastric cancer. CT in diagnosis of focus of gastric cancer and organ invasion is better than Gl and Fibro-gastroscopy and accuracy in diagnosis of gastric cancers is near to that of GI examination

  7. Radiologic features of gastric leiomyosarcoma and leiomyoma

    International Nuclear Information System (INIS)

    Yang, Seoung Oh; Choi, Byung Ihn; Han, Man Chung; Kim, Chu Wan

    1985-01-01

    Smooth muscle tumors of stomach are unusual tumors, accounting for 1-3% of primary gastric malignancies. Diagnosis of these tumors is important because of the more favorable prognosis of this tumor than that of gastric carcinoma. A retrospective study was made in 18 patients who had pathology-proven gastric leiomyoma and leiomyosarcoma to identify radiologic characteristics for recent 6 years from Jan. 1978 to July. 1984 at Department of Radiology, Seoul National University Hospital. The results were as follows: 1. Age of 13 cases of gastric leiomyosarcoma ranged from 36 to 70 with average of 51 and the male to female ratio was 10 ; 3. Age of 5 cases of gastric leiomyoma ranged from 24 to 67 with average of 44 and the male to female ratio was 3 : 2. 2. Clinically, gastric leiomyosarcoma had epigastric pain in 7 cases, palpable mass in 4 cases, melena in 3 cases, haematemesis in 2 cases, 5 cases of gastric leiomyoma also had above symptoms respectively. 3. Of the 13 cases of gastric leiomyosarcoma studied by upper gastrointestinal examination, 6 cases (32%) involved the fundus, 10 cases (50%) in the body, 3 cases (18%) in the antrum. Of the 5 cases of gastric leiomyoma, 4 cases were confined to the fundus and 1 case in the body. 4. The size of the 13 gastric leiomyosarcoma ranged from 5 to more than 20 cm in diameter. The size of the 5 gastric leiomyomas ranged from 3 to 9 cm in diameter. 5. The growth type of gastric leiomysarcoma was exophytic in 8 cases, endogastric in 1 case and mixed pattern in 4 cases. The growth type of gastric leiomyoma were exophytic in 1 case, endogastric in 2 cases and mixed in 2 cases. 6. Mucosal pattern of gastric leiomyosarcoma were mainly effaced pattern in 10 cases (77%), but 3 cases (23%) showed irregular destruction. 1 case of gastric leiomyoma showed mucosal irregularity. 7. Ulceration was present in 10 cases of gastric leiomyosarcoma either single or multiple. 2 cases of gastric leiomyoma showed small ulcerations. Calciflation

  8. Renewable energies: the cost of intermittency

    International Nuclear Information System (INIS)

    Crassous, Renaud; Roques, Fabien

    2013-01-01

    The authors indicate the different adaptations which will be required for the electric system to cope with the intermittency of solar and wind energy production, and propose an approximate assessment of the associated costs. Different types of adaptation are addressed: secure production in case of absence of wind or sun (electricity imports, construction of additional power stations), use of more flexible production means (gas turbines), grid extensions (connection to offshore production sites, routing of production one part of the country to the other). They think that beyond a 20 per cent share for renewable energies, these costs could rapidly increase

  9. Spatio-temporal intermittency on the sandpile

    International Nuclear Information System (INIS)

    Erzan, A.; Sinha, S.

    1990-08-01

    The self-organized critical state exhibited by a sandpile model is shown to correspond to motion on an attractor characterized by an invariant distribution of the height variable. The largest Lyapunov exponent is equal to zero. The model nonetheless displays intermittent chaos, with a multifractal distribution of local expansion coefficients in history space. Laminar spatio-temporal regions are interrupted by chaotic bursts caused by avalanches. We introduce the concept of local histories in configuration space and show that their expansion parameters also exhibit a multifractal distribution in time and space. (author). 22 refs, 5 figs

  10. Intermittent claudication in a professional rugby player.

    Science.gov (United States)

    Bray, A E; Lewis, W A

    1992-04-01

    Intermittent claudication in a professional rugby player is described. The typical features of a delayed and difficult diagnosis of an external iliac artery stenosis were found. The noninvasive diagnostic protocol used to investigate this young patient with a minimal arterial lesion enabled accurate localization and angioplasty to be performed at the same time as diagnostic angiography. The patient was symptom free with normal arterial pressures on follow-up. It is suggested that appropriate noninvasive investigations should be performed before angiography in young people with minimal lesions.

  11. A stochastic model for intermittent search strategies

    International Nuclear Information System (INIS)

    Benichou, O; Coppey, M; Moreau, M; Suet, P H; Voituriez, R

    2005-01-01

    It is often necessary, in scientific or everyday life problems, to find a randomly hidden target. What is then the optimal strategy to reach it as rapidly as possible? In this article, we develop a stochastic theory for intermittent search behaviours, which are often observed: the searcher alternates phases of intensive search and slow motion with fast displacements. The first results of this theory have already been announced recently. Here we provide a detailed presentation of the theory, as well as the full derivation of the results. Furthermore, we explicitly discuss the minimization of the time needed to find the target

  12. Intermittent oral iron supplementation during pregnancy (Review)

    Science.gov (United States)

    Peña-Rosas, Juan Pablo; De-Regil, Luz Maria; Dowswell, Therese; Viteri, Fernando E

    2014-01-01

    Background Anaemia is a frequent condition during pregnancy, particularly among women from developing countries who have insufficient iron intake to meet increased iron needs of both the mother and the fetus. Traditionally, gestational anaemia has been prevented with the provision of daily iron supplements throughout pregnancy, but adherence to this regimen due to side effects, interrupted supply of the supplements, and concerns about safety among women with an adequate iron intake, have limited the use of this intervention. Intermittent (i.e. one, two or three times a week on non-consecutive days) supplementation with iron alone or in combination with folic acid or other vitamins and minerals has recently been proposed as an alternative to daily supplementation. Objectives To assess the benefits and harms of intermittent supplementation with iron alone or in combination with folic acid or other vitamins and minerals to pregnant women on neonatal and pregnancy outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (23 March 2012). We also searched the WHO International Clinical Trials Registry Platform (ICTRP) for ongoing studies and contacted relevant organisations for the identification of ongoing and unpublished studies (23 March 2012). Selection criteria Randomised or quasi-randomised trials. Data collection and analysis We assessed the methodological quality of trials using standard Cochrane criteria. Two review authors independently assessed trial eligibility, extracted data and conducted checks for accuracy. Main results This review includes 21 trials from 13 different countries, but only 18 trials (with 4072 women) reported on our outcomes of interest and contributed data to the review. All of these studies compared daily versus intermittent iron supplementation. Three studies provided iron alone, 12 iron+folic acid and three more iron plus multiple vitamins and minerals. Their methodological quality was mixed

  13. Salt Marshes as Monitors of Late Holocene Outlet Glacier Retreat

    Science.gov (United States)

    Wake, L. M.; Woodroffe, S.; Long, A. J.; Milne, G. A.

    2014-12-01

    New proxy sea-level records extracted from salt marshes in the vicinity of Jakobshavn Isbrae (Pakitsoq; 69.51°N, 50.74°W) and at previous sites in central western Greenland (Sisimiut; 66.47°N, 53.61°W and Aasiaat; 68.69°N, 52.88°W) are analyzed with respect to their ability to act as proximal tide gauges detecting mass balance changes in nearby outlet glaciers associated with the transition from the Little Ice Age ("LIA", 1400-1850AD) to the Industrial Period (>1850AD). Data at Pakitsoq demonstrate that sea-level rose at a rate of 3.5 ±1.7 mm/yr prior to 1850AD and slowed to 0.3 ±0.6mm/yr thereafter, producing a slowdown in sea level of 3.2 ± 1.8 mm/yr. A similar slowdown, occurring at 1600AD, is observed at Aasiaat and Sisimiut. We interpret these observed changes using a glacial isostatic adjustment model of sea-level change truncated at degree and order 4096, with an aim to determine if the sea-level data can be used to place constraints on changes in Jakobshavn Isbrae and/or Kangiata Nunaata Sermia (Nuuk fjord) during this period. Modelled sea level at Pakitsoq is insensitive to the location of thickening (thinning) associated with grounding line advance (retreat) and the rate of advance and retreat but is sensitive to the change point in time between periods of growth associated with LIA expansion (sea level rise) and the onset of 19th century recession (sea level fall) of Jakobshavn Isbrae. We conclude that the change in sea-level rate observed at Pakitsoq circa 1850AD marks the onset of post LIA retreat of this outlet glacier. Conversely, the modelled sea-level response to the retreat of Kangiata Nunaata Sermia from its LIA maximum at ca. 1761AD is below the detection threshold of the salt marsh record at Sisimiut.

  14. Pathways of warm water to the Northeast Greenland outlet glaciers

    Science.gov (United States)

    Schaffer, Janin; Timmermann, Ralph; Kanzow, Torsten; Arndt, Jan Erik; Mayer, Christoph; Schauer, Ursula

    2015-04-01

    The ocean plays an important role in modulating the mass balance of the Greenland Ice Sheet by delivering heat to the marine-terminating outlet glaciers surrounding the Greenland coast. The warming and accumulation of Atlantic Water in the subpolar North Atlantic has been suggested to be a potential driver of the glaciers' retreat over the last decades. The shelf regions thus play a critical role for the transport of Atlantic Water towards the glaciers, but also for the transfer of freshwater towards the deep ocean. A key region for the mass balance of the Greenland Ice Sheet is the Northeast Greenland Ice Stream. This large ice stream drains the second-largest basin of the Greenland Ice Sheet and feeds three outlet glaciers. The largest one is Nioghalvfjerdsfjorden (79°N-Glacier) featuring an 80 km long floating ice tongue. Both the ocean circulation on the continental shelf off Northeast Greenland and the circulation in the cavity below the ice tongue are weakly constrained so far. In order to study the relevant processes of glacier-ocean interaction we combine observations and model work. Here we focus on historic and recent hydrographic observations and on the complex bathymetry in the Northeast Greenland shelf region, which is thought to steer the flux of warm Atlantic water onto the continental shelf and into the sub-ice cavity beneath the 79°N-Glacier. We present a new global topography data set, RTopo-2, which includes the most recent surveys on the Northeast Greenland continental shelf and provides a detailed bathymetry for all around Greenland. In addition, RTopo-2 contains ice and bedrock surface topographies for Greenland and Antarctica. Based on the updated ocean bathymetry and a variety of hydrographic observations we show the water mass distribution on the continental shelf off Northeast Greenland. These maps enable us to discuss possible supply pathways of warm modified Atlantic waters on the continental shelf and thus potential ways of heat

  15. Intermittent fasting and cardiovascular disease: current evidence and unresolved questions.

    Science.gov (United States)

    Tinsley, Grant M; Horne, Benjamin D

    2018-01-01

    Intermittent fasting has produced a variety of beneficial health effects in animal models, although high-quality research in humans has been limited. This special report examines current evidences for intermittent fasting in humans, discusses issues that require further examination, and recommends new research that can improve the knowledge base in this emerging research area. While potentially useful for health improvement, intermittent fasting requires further study prior to widespread implementation for health purposes. Randomized, longer-term studies are needed to determine whether using intermittent fasting as a lifestyle rather than a diet is feasible and beneficial for the health of some members of the human population.

  16. Atomistic Model of Fluorescence Intermittency of Colloidal Quantum Dots

    KAUST Repository

    Voznyy, O.; Sargent, E. H.

    2014-01-01

    with foreign cations can stabilize the vacancies, inhibiting intermittency and improving quantum yield, providing an explanation of recent experimental observations. © 2014 American Physical Society.

  17. Scintigraphic evaluation of gastric emptying and motility

    International Nuclear Information System (INIS)

    Linke, R.

    2003-01-01

    The stomach consists of two functionally distinct parts. The fundus and upper corpus mainly serve as a reservoir and exert primarily a tonic activity, which presses ingesta towards the antrum and duodenum. The phasic contractility of the lower corpus and antrum cause mechanical breakdown and mixing of the food particels. A complex regulation of these mechanisms provides a regular gastric emptying. Various disorders such as diabetes mellitus, mixed connective tissue diseases, gastritis, tumors, dyspeptic disorders but also drugs and gastric surgery may influence or impair gastric function and may cause typical symptoms such as upper abdominal discomfort, bloating, nausea and vomiting. However, the interpretation of gastrointestinal symptoms often is difficult. Radionuclide studies of gastric emptying and motility are the most physiologic tools available for studying gastric motor function. Gastric scintigraphy is non-invasive, uses physiologic meal and is quantitative. Emptying curves generated from the gastric ROI offer information whether a disorder is accompanied by a regular, fast or slow gastric emptying. Data on gastric contractions (amplitude and frequency) provide additional information to results obtained by conventional emptying studies. Depending on the underlying disorder, gastric emptying and peristalsis showed both corresponding and discrepant findings. Therefore, both parameters should be routinely assessed to further improve characterisation of gastric dysfunction by scintigraphy. (orig.) [de

  18. A method for establishing human primary gastric epithelial cell culture from fresh surgical gastric tissues.

    Science.gov (United States)

    Aziz, Faisal; Yang, Xuesong; Wen, Qingping; Yan, Qiu

    2015-08-01

    At present, biopsy specimens, cancer cell lines and tissues obtained by gastric surgery are used in the study and analysis of gastric cancer, including the molecular mechanisms and proteomics. However, fibroblasts and other tissue components may interfere with these techniques. Therefore, the present study aimed to develop a procedure for the isolation of viable human gastric epithelial cells from gastric surgical tissues. A method was developed to culture human gastric epithelial cells using fresh, surgically excised tissues and was evaluated using immunocytochemistry, periodic acid-Schiff (PAS) staining and cell viability assays. Low cell growth was observed surrounding the gastric tissue on the seventh day of tissue explant culture. Cell growth subsequently increased, and at 12 days post-explant a high number of pure epithelial cells were detected. The gastric cancer cells exhibited rapid growth with a doubling time of 13-52 h, as compared to normal cells, which had a doubling time of 20-53 h. Immunocytochemical analyses of primary gastric cells revealed positive staining for cytokeratin 18 and 19, which indicated that the culture was comprised of pure epithelial cells and contained no fibroblasts. Furthermore, PAS staining demonstrated that the cultured gastric cells produced neutral mucin. Granulin and carbohydrate antigen 724 staining confirmed the purity of gastric cancer and normal cells in culture. This method of cell culture indicated that the gastric cells in primary culture consisted of mucin-secreting gastric epithelial cells, which may be useful for the study of gastric infection with Helicobacter pylori and gastric cancer.

  19. Localization of ectopic gastric mucosa by scintigraphy

    International Nuclear Information System (INIS)

    D'Alonzo, W.A. Jr.

    1988-01-01

    When gastric mucosal tissue occurs outside of the confines of the stomach, it is termed ectopic or heterotopic. Ectopic gastric mucosa may be found within Meckel's diverticulum, duplications of the alimentary tract, and Barrett's esophagus. In addition, a surgeon may inadvertently leave behind antral gastric mucosa while performing a partial gastrectomy for peptic ulcer disease (i.e., retained gastric antrum). It is important to detect the presence and location of ectopic mucosa because acid and pepsin secretion may cause ulceration in the adjacent tissue resulting in serious complications. The only currently available specific diagnostic technique for detecting ectopic gastric mucosa is pertechnetate Tc 99m (TcO 4- ) scintigraphy. This chapter reviews the functional anatomy of gastric mucosa, the mechanism of TcO 4 - localization, the various entities containing ectopic gastric mucosa, and the methods and results of TcO 4 - scanning for these disorders

  20. Randomized, controlled trial comparing synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in preterm infants.

    Science.gov (United States)

    Reyes, Zenaida C; Claure, Nelson; Tauscher, Markus K; D'Ugard, Carmen; Vanbuskirk, Silvia; Bancalari, Eduardo

    2006-10-01

    Prolonged mechanical ventilation is associated with lung injury in preterm infants. In these infants, weaning from synchronized intermittent mandatory ventilation may be delayed by their inability to cope with increased respiratory loads. The addition of pressure support to synchronized intermittent mandatory ventilation can offset these loads and may facilitate weaning. The purpose of this work was to compare synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in weaning from mechanical ventilation and the duration of supplemental oxygen dependency in preterm infants with respiratory failure. Preterm infants weighing 500 to 1000 g at birth who required mechanical ventilation during the first postnatal week were randomly assigned to synchronized intermittent mandatory ventilation or synchronized intermittent mandatory ventilation plus pressure support. In both groups, weaning followed a set protocol during the first 28 days. Outcomes were assessed during the first 28 days and until discharge or death. There were 107 infants enrolled (53 synchronized intermittent mandatory ventilation plus pressure support and 54 synchronized intermittent mandatory ventilation). Demographic and perinatal data, mortality, and morbidity did not differ between groups. During the first 28 days, infants in the synchronized intermittent mandatory ventilation plus pressure support group reached minimal ventilator settings and were extubated earlier than infants in the synchronized intermittent mandatory ventilation group. Total duration of mechanical ventilation, duration of oxygen dependency, and oxygen need at 36 weeks' postmenstrual age alone or combined with death did not differ between groups. However, infants in synchronized intermittent mandatory ventilation plus pressure support within the 700- to 1000-g birth weight strata had a shorter oxygen dependency. The results of this study suggest that the addition of

  1. Alcohol beverage control, privatization and the geographic distribution of alcohol outlets

    Directory of Open Access Journals (Sweden)

    Grubesic Tony H

    2012-11-01

    Full Text Available Abstract Background With Pennsylvania currently considering a move away from an Alcohol Beverage Control state to a privatized alcohol distribution system, this study uses a spatial analytical approach to examine potential impacts of privatization on the number and spatial distribution of alcohol outlets in the city of Philadelphia over a long time horizon. Methods A suite of geospatial data were acquired for Philadelphia, including 1,964 alcohol outlet locations, 569,928 land parcels, and school, church, hospital, park and playground locations. These data were used as inputs for exploratory spatial analysis to estimate the expected number of outlets that would eventually operate in Philadelphia. Constraints included proximity restrictions (based on current ordinances regulating outlet distribution of at least 200 feet between alcohol outlets and at least 300 feet between outlets and schools, churches, hospitals, parks and playgrounds. Results Findings suggest that current state policies on alcohol outlet distributions in Philadelphia are loosely enforced, with many areas exhibiting extremely high spatial densities of outlets that violate existing proximity restrictions. The spatial model indicates that an additional 1,115 outlets could open in Philadelphia if privatization was to occur and current proximity ordinances were maintained. Conclusions The study reveals that spatial analytical approaches can function as an excellent tool for contingency-based “what-if” analysis, providing an objective snapshot of potential policy outcomes prior to implementation. In this case, the likely outcome is a tremendous increase in alcohol outlets in Philadelphia, with concomitant negative health, crime and quality of life outcomes that accompany such an increase.

  2. Laboratory determination of normal operating flow rates with enlarged outlet fittings -- BDF reactors

    Energy Technology Data Exchange (ETDEWEB)

    Waters, E.D.

    1960-02-02

    Experiments have been conducted in the Hydraulics Laboratory, at the request of IPD`s Mechanical Development-A Operation, to determine the energy losses of various enlarged outlet fitting combinations. These experiments were conducted an steady state runs and allow the determination of the normal operating point (flow rate) of a reactor process channel under selected conditions of front header pressure and fuel charge. No attempt is made to make a mechanical or economic evaluation of the particular fitting combinations, although observations were noted which might bear on this evaluation. It is very important for the reader to bear in mind that changing outlet fittings will definitely affect the reactor tube power limits and outlet vater temperature limits. The size of the outlet fittings largely determines the present outlet temperature limits of the old reactors. The flow characteristics of these present fittings cause some degree of pressurization to suppress boiling on the fuel charge and also cause dual Panellit trip protection for certain flow changes and for power surges. Enlargement of the outlet fittings may actually reduce the allowable outlet coolant temperature limits. Since these effects cannot be determined on the apparatus used in these experiments, a complete discussion of this point is not included in this report. However, the seriousness of these effects should be known and carefully analyzed before a final selection of enlarged outlet fittings in made. This report will be one of a series. New reports in the series will be issued as data are obtained for other such outlet fitting combinations or for new concepts of outlet fitting assemblies such as the new nozzle being developed by C. E. Trantz for use on F-reactor stuck gunbarrel tubes.

  3. Tobacco outlet density and tobacco knowledge, beliefs, purchasing behaviours and price among adolescents in Scotland.

    Science.gov (United States)

    Tunstall, Helena; Shortt, Niamh K; Niedzwiedz, Claire L; Richardson, Elizabeth A; Mitchell, Richard J; Pearce, Jamie R

    2018-06-01

    Despite long-term falls in global adult smoking prevalence and over 50 years of tobacco control policies, adolescent smoking persists. Research suggests greater densities of tobacco retail outlets in residential neighbourhoods are associated with higher adolescent smoking rates. Policies to reduce retail outlets have therefore been identified by public health researchers as a potential 'new frontier' in tobacco control. Better understanding of the pathways linking density of tobacco retailers and smoking behaviour could support these policies. In this study we use path analysis to assess how outlet density in the home environment is related to adolescent tobacco knowledge, beliefs, retail purchases and price in Scotland. We assessed 22,049 13 and 15 year old respondents to the nationally representative cross-sectional 2010 Scottish School Adolescent Lifestyle and Substance Use Survey. Outlet density was based on Scottish Tobacco Retailers Register, 2012, data. A spatially-weighted Kernel Density Estimation measure of outlet density within 400 m of respondents' home postcode was grouped into tertiles. The analysis considered whether outlet density was associated with the number of cigarette brands adolescents could name, positive beliefs about smoking, whether smokers purchased cigarettes from shops themselves or through adult proxies and perceived cost of cigarettes. Models were stratified by adolescent smoking status. The path analyses indicated that outlet density was not associated with most outcomes, but small, significant direct effects on knowledge of cigarette brands among those who had never smoked were observed. With each increase in outlet density tertile the mean number of brands adolescents could name rose by 0.07 (mean = 1.60; SD = 1.18; range = 4). This suggests greater outlet densities may have affected adolescents' knowledge of cigarette brands but did not encourage positive attitudes to smoking, purchases from shops or lower cigarette

  4. Electronic Cigarette Retail Outlets and Proximity to Schools.

    Science.gov (United States)

    Hahn, Ellen J; Begley, Kathy; Gokun, Yevgeniya; Johnson, Andrew O; Mundy, Monica E; Rayens, Mary Kay

    2015-01-01

    To compare the retail distribution and density per population of electronic and conventional cigarettes in smoke-free communities with and without e-cigarette restrictions. A cross-sectional study with field observations of retail tobacco stores. Two Central Kentucky counties with 100% smoke-free workplace regulations; counties selected on the basis of whether e-cigarette use was restricted. Fifty-seven tobacco retailers in two counties, including conventional retailers and stand-alone e-cigarette stores. Type and location of store and products sold; addresses of stores and schools geocoded with ArcGIS. Bivariate comparisons between counties, rates and confidence intervals for frequency of tobacco retailers and e-cigarette stores per population. Fifty-three percent of tobacco retailers sold e-cigarettes. E-cigarette availability did not differ by whether smoke-free regulation covered e-cigarettes. Rates of tobacco retailers and e-cigarette distributors per 10,000 were 8.29 and 4.40, respectively, in the two-county area. Of the 40 schools, 88% had a tobacco retailer and 68% had an e-cigarette distributor within 1 mile. In this exploratory study, e-cigarette use restriction was not related to store availability. For a relatively new product, e-cigarettes were readily available in retail outlets and close to schools.

  5. Bladder outlet obstruction (BOO) in female: etiology and management

    International Nuclear Information System (INIS)

    Shaikh, N.A.; Ahuja, K.; Shaikh, G.S.; Soomro, A.K.

    2015-01-01

    To determine the etiology and management outcome of bladder outlet obstruction (BOO) in female. Methodology: From 2009 to 2012, 37 females with a mean age of 40 (range 20-65) were investigated for etiology and management outcome of BOO. Typical complaints were slow urinary flow, difficulty in emptying bladder, frequency of micturition and urgency. Mean duration of symptoms was 6 month. Results: 15 women were confirmed as atrophic urethritis, 5 had functional bladder, 3 had urethral caruncle, 5 had cystocele, 7 had complete procedentia of uterus, and 2 had impacted urethral stone. Cystoscopy was performed in all patients to exclude other pathology like vesical stone and bladder growth. 12 patients were referred to Gynecology due to complete procedentia of uterus and cystocele. Three cases of urethral caruncle were treated by excision and biopsy, 2 patients with urethral stone were treated by endoscopic push back and litholapaxy while 5 required conservative treatment and 15 cases of atrophic urethritis were kept on Hormone Replacement Therapy (HRT). Conclusion: BOO is uncommon in female and management depends upon the etiology. (author)

  6. Detention Outlet Retrofit Improves the Functionality of Existing ...

    Science.gov (United States)

    Journal Article Provide a stormwater management device for States and watershed management organizations. By discharging excess stormwater runoff at rates that more frequently exceed the critical flow for stream channel erosion, conventional detention basins often contribute to the escalated levels of instability that are common in urban and suburban streams and can be detrimental to aquatic habitat and water quality, as well as adjacent property and infrastructure. However, these ubiquitous assets, valued at ca. $600,000/km2 in a representative suburban watershed in Northern Kentucky, are ideal candidates to aid in reversing such cycles of channel degradation because improving their functionality would not necessarily require property acquisition or heavy construction. The objective of this research was to develop a simple, cost-effective device that could be installed in detention basin outlets to reduce the erosive power of the relatively frequent, but otherwise erosive, storm events (e.g. ~ ≤ 2-yr recurrence) and provide a passive bypass to maintain flood control performance during infrequent storms (e.g. 100-yr recurrence). Results from a pilot installation show that the Detain H2O device can not only meet these goals, but can also contribute to reduced flashiness and prolonged baseflows in receiving streams. When scaling the strategy across a watershed, these results suggest that substantial gains in water quality and stream channel stability could b

  7. Chaos as an intermittently forced linear system.

    Science.gov (United States)

    Brunton, Steven L; Brunton, Bingni W; Proctor, Joshua L; Kaiser, Eurika; Kutz, J Nathan

    2017-05-30

    Understanding the interplay of order and disorder in chaos is a central challenge in modern quantitative science. Approximate linear representations of nonlinear dynamics have long been sought, driving considerable interest in Koopman theory. We present a universal, data-driven decomposition of chaos as an intermittently forced linear system. This work combines delay embedding and Koopman theory to decompose chaotic dynamics into a linear model in the leading delay coordinates with forcing by low-energy delay coordinates; this is called the Hankel alternative view of Koopman (HAVOK) analysis. This analysis is applied to the Lorenz system and real-world examples including Earth's magnetic field reversal and measles outbreaks. In each case, forcing statistics are non-Gaussian, with long tails corresponding to rare intermittent forcing that precedes switching and bursting phenomena. The forcing activity demarcates coherent phase space regions where the dynamics are approximately linear from those that are strongly nonlinear.The huge amount of data generated in fields like neuroscience or finance calls for effective strategies that mine data to reveal underlying dynamics. Here Brunton et al.develop a data-driven technique to analyze chaotic systems and predict their dynamics in terms of a forced linear model.

  8. Transient analysis of intermittent multijet sprays

    Energy Technology Data Exchange (ETDEWEB)

    Panao, Miguel R.O.; Moreira, Antonio Luis N. [Universidade Tecnica de Lisboa, IN, Center for Innovation, Technology and Policy Research, Instituto Superior Tecnico, Lisboa (Portugal); Durao, Diamantino G. [Universidade Lusiada, Lisboa (Portugal)

    2012-07-15

    This paper analyzes the transient characteristics of intermittent sprays produced by the single-point impact of multiple cylindrical jets. The aim is to perform a transient analysis of the intermittent atomization process to study the effect of varying the number of impinging jets in the hydrodynamic mechanisms of droplet formation. The results evidence that hydrodynamic mechanisms underlying the physics of ligament fragmentation in 2-impinging jets sprays also apply to sprays produced with more than 2 jets during the main period of injection. Ligaments detaching from the liquid sheet, as well as from its bounding rim, have been identified and associated with distinct droplet clusters, which become more evident as the number of impinging jets increases. Droplets produced by detached ligaments constitute the main spray, and their axial velocity becomes more uniformly distributed with 4-impinging jets because of a delayed ligament fragmentation. Multijet spray dispersion patterns are geometric depending on the number of impinging jets. Finally, an analysis on the Weber number of droplets suggests that multijet sprays are more likely to deposit on interposed surfaces, thus becoming a promising and competitive atomization solution for improving spray cooling. (orig.)

  9. Impact of intermittent fasting on glucose homeostasis.

    Science.gov (United States)

    Varady, Krista A

    2016-07-01

    This article provides an overview of the most recent human trials that have examined the impact of intermittent fasting on glucose homeostasis. Our literature search retrieved one human trial of alternate day fasting, and three trials of Ramadan fasting published in the past 12 months. Current evidence suggests that 8 weeks of alternate day fasting that produces mild weight loss (4% from baseline) has no effect on glucose homeostasis. As for Ramadan fasting, decreases in fasting glucose, insulin, and insulin resistance have been noted after 4 weeks in healthy normal weight individuals with mild weight loss (1-2% from baseline). However, Ramadan fasting may have little impact on glucoregulatory parameters in women with polycystic ovarian syndrome who failed to observe weight loss. Whether intermittent fasting is an effective means of regulating glucose homeostasis remains unclear because of the scarcity of studies in this area. Large-scale, longer-term randomized controlled trials will be required before the use of fasting can be recommended for the prevention and treatment of metabolic diseases.

  10. Intermittency Statistics in the Expanding Solar Wind

    Science.gov (United States)

    Cuesta, M. E.; Parashar, T. N.; Matthaeus, W. H.

    2017-12-01

    The solar wind is observed to be turbulent. One of the open questions in solar wind research is how the turbulence evolves as the solar wind expands to great distances. Some studies have focused on evolution of the outer scale but not much has been done to understand how intermittency evolves in the expanding wind beyond 1 AU (see [1,2]). We use magnetic field data from Voyager I spacecraft from 1 to 10AU to study the evolution of statistics of magnetic discontinuities. We perform various statistical tests on these discontinuities and make connections to the physical processes occurring in the expanding wind.[1] Tsurutani, Bruce T., and Edward J. Smith. "Interplanetary discontinuities: Temporal variations and the radial gradient from 1 to 8.5 AU." Journal of Geophysical Research: Space Physics 84.A6 (1979): 2773-2787.[2] Greco, A., et al. "Evidence for nonlinear development of magnetohydrodynamic scale intermittency in the inner heliosphere." The Astrophysical Journal 749.2 (2012): 105.

  11. Chronic intermittent hypoxia predisposes to liver injury.

    Science.gov (United States)

    Savransky, Vladimir; Nanayakkara, Ashika; Vivero, Angelica; Li, Jianguo; Bevans, Shannon; Smith, Philip L; Torbenson, Michael S; Polotsky, Vsevolod Y

    2007-04-01

    Obstructive sleep apnea (OSA) is characterized by chronic intermittent hypoxia (CIH). OSA is associated with nonalcoholic steatohepatitis (NASH) in obese subjects. The aim of this study was to investigate the effects of CIH on the liver in the absence of obesity. Lean C57BL/6J mice (n = 15) on a regular chow diet were exposed to CIH for 12 weeks and compared with pair-fed mice exposed to intermittent air (IA, n = 15). CIH caused liver injury with an increase in serum ALT (224 +/- 39 U/l versus 118 +/- 22 U/l in the IA group, P fasting serum insulin levels, and mild elevation of fasting serum total cholesterol and triglycerides (TG). Liver TG content was unchanged, whereas cholesterol content was decreased. Histology showed swelling of hepatocytes, no evidence of hepatic steatosis, and marked accumulation of glycogen in hepatocytes. CIH led to lipid peroxidation of liver tissue with a malondialdehyde (MDA)/free fatty acids (FFA) ratio of 0.54 +/- 0.07 mmol/mol versus 0.30 +/- 0.01 mmol/mol in control animals (P obesity, CIH leads to mild liver injury via oxidative stress and excessive glycogen accumulation in hepatocytes and sensitizes the liver to a second insult, whereas NASH does not develop.

  12. Intermittent preventive treatment of malaria in pregnancy

    DEFF Research Database (Denmark)

    Mbonye, A.K.; Bygbjerg, Ib Christian; Magnussen, Pascal

    2008-01-01

    OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non-randomized comm......OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non......-randomized community trial was implemented in 21 community clusters (intervention) and four clusters where health units provided routine IPTp (control). The primary outcome measures were access and adherence to IPTp, number of malaria episodes, prevalence of anaemia, and birth weight. Numbers of live births, abortions......, still births, and maternal and child deaths were secondary endpoints. FINDINGS: 1404 (67.5%) of 2081 with the new delivery system received two doses of sulfadoxine-pyrimethamine versus 281 (39.9%) of 704 with health units (P malaria episodes decreased from 906 (49...

  13. Intermittent hyperthyreosis. A heat stress syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Sulman, F G; Tal, E; Pfeifer, Y; Superstine, E [Hebrew Univ., Jerusalem (Israel). Dept. of Applied Pharmacology

    1975-09-01

    Intermittent hyperthyreosis occurs under various forms of stress, especially heat stress. The clinician may diagnose such cases as masked or apathetic hyperthyroidism or 'forme fruste' hyperthyreosis or thyroid autonomy. As most routine and standard tests may here yield inconsistent results, it is the patients' anamnesis which may provide the clue. Our Bioclimatology Unit has now seen over 100 cases in which thyroid hypersensitivity towards heat was the most prominent syndrome: 10-15% of weather-sensitive patients are affected. The patients complain before or during heat spells of such contradictory symptoms as insomnia, irritability, tension, tachycardia, palpitations, precordial pain, dyspnoe, flushes with sweating or chills, tremor, abdominal pain or diarrhea, polyuria or pollakisuria, weight loss in spite of ravenous appetite, fatigue, exhaustion, depression, adynamia, lack of concentration and confusion. Determination of urinary neurohormones allows a differential diagnosis, intermittent hyperthyreosis being characterized by three cardinal symptoms: tachycardia - every case with more than 80 pulse beats being suspect (not specific); urinary histamine - every case excreting more than 90 ..mu..g/day being suspect. Again the drawback of this test is its lack of specificity, as histamine may also be increased in cases of allergy and spondylitis; urinary thyroxine - every case excreting more than 20 ..mu..g/day T-4 being suspect. This is the only specific test. Therapy should make use of lithium carbonate and betablockers. Propyl thiouracil is rarely required.

  14. Gastric cancer and obstructive uropathy

    International Nuclear Information System (INIS)

    Saida, Yukihisa; Tsunoda, H.S.; Matsueda, Kiyoshi; Kurosaki, Yoshihisa; Kuramoto, Kenmei

    1990-01-01

    In recent 5 years, we have experienced 24 cases of advanced gastric cancer associated with obstructive uropathy. Included were 19 cases of undifferentiated, 3 cases of differentiated and 2 cases of unknown histological type. Obstructive uropathy is diagnosed based on the typical radiological findings such as dilatation and delayed demonstration of the upper collecting systems. Pathologically, undifferentiated type of gastric cancer had tendency to spread infiltratively along the vessels, nerves and the lymphatics without alteration of the ordinary anatomical structures. In such cases, mucosal surface of the urinary tract tended to be spared in spite of extensive tumor invasion. It was proven that several radiological findings were characteristic of urinary tract involvement secondary to gastric cancer. Either thread-like ureteral stricture by IVU or ring-like appearance of the ureter by CT is one of those typical findings. Renal sinus involvement may occur continuously to diffuse retroperitoneal invasion and it appears as a thickened wall of renal pelvis or soft tissue mass directly extending into the fatty tissue of renal sinus by CT. In such cases IVU has less diagnostic ability because of the lack of mucosal destruction. If the urinary bladder is involved, it typically shows chestnut-bur appearance by IVU and diffuse wall thickening by CT. In cases of advanced gastric cancer, particularly in cases of histologically undifferentiated type, CT and IVU images should be carefully interpreted in consideration of the infiltrative part of tumor extention. (author)

  15. Roentgenological semiotics of gastric diseases

    International Nuclear Information System (INIS)

    Oster, A.N.; Rizaev, M.N.

    1987-01-01

    A descriptive roentgenological picture of pathological changes and identification of gastric diseases are given. Retinoscopy (shadow) symptoms are described, which can provide a concrete syndrome of diseases of different stomach sections. The necessity to choose adequate roentgenologic method of investigation for a concrete part of stomach is emphasized. Investigation results should also be compared with clinical data

  16. Gastric tissue biopsy and culture

    Science.gov (United States)

    ... symptoms may include: Loss of appetite or weight loss Nausea and vomiting Pain in the upper part of the belly Black stools Vomiting blood or coffee ground-like material A gastric tissue biopsy and culture can help detect: Cancer Infections, most commonly Helicobacter ...

  17. Genetic Determinants of Gastric Cancer

    NARCIS (Netherlands)

    S. Boccia (Stefania)

    2009-01-01

    textabstractResults show that gastric cancer risk is increased by the inheritance of the variant alleles of the metabolic genes SULT1A1 and CYP2E1 *6, especially among smokers and drinkers, respectively. An additional increased risk is conferred by the inheritance of GSTT1 null variant, especially

  18. Radiologic findings of gastric volvulus

    International Nuclear Information System (INIS)

    Han, Heon; Kim, In One; Yeon, Kyung Mo

    1987-01-01

    Gastric volvulus, organoaxial or mesenteroaxial rotation, is an uncommon cause of upper gastrointestinal obstruction in childhood. It may be suspected on plain radiographic examination of the abdomen and confirmed by upper gastrointestinal series. Six affected children are described. Symptoms were mainly acute vomiting and abdominal distension. All patients had defect in perigastric ligaments

  19. Radiologic findings of gastric volvulus

    Energy Technology Data Exchange (ETDEWEB)

    Han, Heon; Kim, In One; Yeon, Kyung Mo [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1987-12-15

    Gastric volvulus, organoaxial or mesenteroaxial rotation, is an uncommon cause of upper gastrointestinal obstruction in childhood. It may be suspected on plain radiographic examination of the abdomen and confirmed by upper gastrointestinal series. Six affected children are described. Symptoms were mainly acute vomiting and abdominal distension. All patients had defect in perigastric ligaments.

  20. gastric pneumatosis or emphysematous gastritis?

    African Journals Online (AJOL)

    A chest X-ray demonstrated a large mass adjacent to the right hemi-diaphragm. ... mediastinum (e.g. ruptured bullae or pneumothorax).2,3 These patients are usually ... gastric mucosal injury allows gas-forming organisms to gain access to.

  1. Adequacy in dialysis: intermittent versus continuous therapies.

    Science.gov (United States)

    Misra, M; Nolph, K D

    2000-01-01

    A vital conceptual difference between intermittent and continuous dialysis therapies is the difference in the relationship between Kt/V urea and dietary protein intake. For a given level of protein intake the intermittent therapies require a higher Kt/V urea due to the reasons mentioned above. The recently released adequacy guidelines by DOQI for intermittent and continuous therapies are based on these assumptions. The link between adequacy targets and patient survival is well documented for an intermittent therapy like HD. For a continuous therapy like CAPD however, the evidence linking improved peritoneal clearance to better survival is not as direct. However, present consensus allows one to extrapolate results based on HD. The concept of earlier and healthier initiation of dialysis is gaining hold and incremental dialysis forms an integral aspect of the whole concept. Tools like urea kinetic modeling give us valuable insight in making mathematical projections about the timing as well as dosing of dialysis. Daily home hemodialysis is still an underutilized modality despite offering best survival figures. Hopefully, with increasing availability of better and simpler machines its use will increase. Still several questions remain unanswered. Despite availability of data in hemodialysis patients suggesting that an increased dialysis prescription leads to a better survival, optimal dialysis dose is yet to be defined. Concerns regarding methodology of such studies and conclusions thereof has been raised. Other issues relating to design of the studies, variation in dialysis delivery, use of uncontrolled historical standards and lack of patient randomization etc also need to be considered when designing such trials. Hopefully an ongoing prospective randomized trial, namely the HEMO study, looking at two precisely defined and carefully maintained dialysis prescriptions will provide some insight into adequacy of dialysis dose and survival. In diabetic patients, the

  2. Acute Effects of Carbohydrate Supplementation on Intermittent Sports Performance.

    Science.gov (United States)

    Baker, Lindsay B; Rollo, Ian; Stein, Kimberly W; Jeukendrup, Asker E

    2015-07-14

    Intermittent sports (e.g., team sports) are diverse in their rules and regulations but similar in the pattern of play; that is, intermittent high-intensity movements and the execution of sport-specific skills over a prolonged period of time (~1-2 h). Performance during intermittent sports is dependent upon a combination of anaerobic and aerobic energy systems, both of which rely on muscle glycogen and/or blood glucose as an important substrate for energy production. The aims of this paper are to review: (1) potential biological mechanisms by which carbohydrate may impact intermittent sport performance; (2) the acute effects of carbohydrate ingestion on intermittent sport performance, including intermittent high-intensity exercise capacity, sprinting, jumping, skill, change of direction speed, and cognition; and (3) what recommendations can be derived for carbohydrate intake before/during exercise in intermittent sports based on the available evidence. The most researched intermittent sport is soccer but some sport-specific studies have also been conducted in other sports (e.g., rugby, field hockey, basketball, American football, and racquet sports). Carbohydrate ingestion before/during exercise has been shown in most studies to enhance intermittent high-intensity exercise capacity. However, studies have shown mixed results with regards to the acute effects of carbohydrate intake on sprinting, jumping, skill, change of direction speed, and cognition. In most of these studies the amount of carbohydrate consumed was ~30-60 g/h in the form of a 6%-7% carbohydrate solution comprised of sucrose, glucose, and/or maltodextrin. The magnitude of the impact that carbohydrate ingestion has on intermittent sport performance is likely dependent on the carbohydrate status of the individual; that is, carbohydrate ingestion has the greatest impact on performance under circumstances eliciting fatigue and/or hypoglycemia. Accordingly, carbohydrate ingestion before and during a game

  3. Acute Effects of Carbohydrate Supplementation on Intermittent Sports Performance

    Directory of Open Access Journals (Sweden)

    Lindsay B. Baker

    2015-07-01

    Full Text Available Intermittent sports (e.g., team sports are diverse in their rules and regulations but similar in the pattern of play; that is, intermittent high-intensity movements and the execution of sport-specific skills over a prolonged period of time (~1–2 h. Performance during intermittent sports is dependent upon a combination of anaerobic and aerobic energy systems, both of which rely on muscle glycogen and/or blood glucose as an important substrate for energy production. The aims of this paper are to review: (1 potential biological mechanisms by which carbohydrate may impact intermittent sport performance; (2 the acute effects of carbohydrate ingestion on intermittent sport performance, including intermittent high-intensity exercise capacity, sprinting, jumping, skill, change of direction speed, and cognition; and (3 what recommendations can be derived for carbohydrate intake before/during exercise in intermittent sports based on the available evidence. The most researched intermittent sport is soccer but some sport-specific studies have also been conducted in other sports (e.g., rugby, field hockey, basketball, American football, and racquet sports. Carbohydrate ingestion before/during exercise has been shown in most studies to enhance intermittent high-intensity exercise capacity. However, studies have shown mixed results with regards to the acute effects of carbohydrate intake on sprinting, jumping, skill, change of direction speed, and cognition. In most of these studies the amount of carbohydrate consumed was ~30–60 g/h in the form of a 6%–7% carbohydrate solution comprised of sucrose, glucose, and/or maltodextrin. The magnitude of the impact that carbohydrate ingestion has on intermittent sport performance is likely dependent on the carbohydrate status of the individual; that is, carbohydrate ingestion has the greatest impact on performance under circumstances eliciting fatigue and/or hypoglycemia. Accordingly, carbohydrate ingestion before

  4. Diaphragmatic eventration complicated by gastric volvulus with perforation

    OpenAIRE

    Gupta, V; Chandra, A; Gupta, P

    2012-01-01

    Eventration of the diaphragm with gastric volvulus is uncommon. Gastric perforation in these cases is rare and usually associated with acute gastric volvulus with strangulation. We describe a case of diaphragmatic eventration with chronic gastric volvulus with gastric perforation without strangulation in an elderly man.

  5. Intermittent, Non Cyclic Severe Mechanical Aortic Valve Regurgitation

    Science.gov (United States)

    Choi, Jong Hyun; Song, Seunghwan; Lee, Myung-Yong

    2013-01-01

    Mechanical aortic prosthesis dysfunction can result from thrombosis or pannus formation. We describe an unusual case of intermittent, non cyclic mechanical aortic prosthesis dysfunction due to pannus formation with thrombus in the absence of systolic restriction of disk excursion, that presented with intermittent severe aortic regurgitation. PMID:24459568

  6. Intermittent versus Continuous Physiotherapy in Children with Cerebral Palsy

    Science.gov (United States)

    Christiansen, Annette Sandahl; Lange, Christa

    2008-01-01

    The aim of this study was to compare the effect of the delivery of the same amount of intermittent versus continuous physiotherapy given to children with cerebral palsy (CP). This was organized either in an intermittent regime four times a week for 4 weeks alternating with a 6-week treatment pause, or a continuous once or twice a week regime, both…

  7. Boundary layer models for calving marine outlet glaciers

    Directory of Open Access Journals (Sweden)

    C. Schoof

    2017-10-01

    Full Text Available We consider the flow of marine-terminating outlet glaciers that are laterally confined in a channel of prescribed width. In that case, the drag exerted by the channel side walls on a floating ice shelf can reduce extensional stress at the grounding line. If ice flux through the grounding line increases with both ice thickness and extensional stress, then a longer shelf can reduce ice flux by decreasing extensional stress. Consequently, calving has an effect on flux through the grounding line by regulating the length of the shelf. In the absence of a shelf, it plays a similar role by controlling the above-flotation height of the calving cliff. Using two calving laws, one due to Nick et al. (2010 based on a model for crevasse propagation due to hydrofracture and the other simply asserting that calving occurs where the glacier ice becomes afloat, we pose and analyse a flowline model for a marine-terminating glacier by two methods: direct numerical solution and matched asymptotic expansions. The latter leads to a boundary layer formulation that predicts flux through the grounding line as a function of depth to bedrock, channel width, basal drag coefficient, and a calving parameter. By contrast with unbuttressed marine ice sheets, we find that flux can decrease with increasing depth to bedrock at the grounding line, reversing the usual stability criterion for steady grounding line location. Stable steady states can then have grounding lines located on retrograde slopes. We show how this anomalous behaviour relates to the strength of lateral versus basal drag on the grounded portion of the glacier and to the specifics of the calving law used.

  8. Effect of dopamine on bethanechol-stimulated gastric mucosal blood flow and gastric acid secretion in dogs with gastric fistula

    DEFF Research Database (Denmark)

    Hovendal, C P; Bech, K

    1982-01-01

    of gastric mucosal blood flow, whereas stimulation of beta, muscarinic, and 'gastrinergic' receptors mainly occurs indirectly via changes in parietal cell function. The main effect of dopamine seems to be on gastric motility, whereas the effect on gastric acid secretion is of minor importance.......The aim of the present study was to investigate the effect of Dopamine on bethanechol-stimulated gastric acid secretion and mucosal blood flow. dopamine was used alone and in conjunction with selective blockade of the alpha, beta, and dopaminergic receptors. An increasing and dose......-dependent stimulation of gastric acid secretion was found for dopamine at 1, 5, and 10 micrograms/kg/min. A significant inhibition of gastric acid secretion was found with the highest dose of dopamine (40 micrograms/kg/min). the stimulatory effect seems to be mediated by more than one receptor, whereas the inhibition...

  9. Availability of healthier options in traditional and nontraditional rural fast-food outlets

    Directory of Open Access Journals (Sweden)

    McIntosh Alex

    2008-11-01

    Full Text Available Abstract Background Food prepared away from home has become increasingly popular to U.S. families, and may contribute to obesity. Sales have been dominated by fast food outlets, where meals are purchased for dining away from home or in the home. Although national chain affiliated fast-food outlets are considered the main source for fast food, fast foods are increasingly available in convenience stores and supermarkets/grocery stores. In rural areas, these nontraditional fast-food outlets may provide most of the opportunities for procurement of fast foods. Methods Using all traditional and nontraditio nal fast-food outlets identified in six counties in rural Texas, the type and number of regular and healthiermenu options were surveyed using on-site observation in all food venues that were primarily fast food, supermarket/grocery store, and convenience store and compared with 2005 Dietary Guidelines. Results Traditional fast-food outlets represented 84 (41% of the 205 opportunities for procurement of fast food; 109 (53.2% were convenience stores and 12 (5.8% supermarkets/grocery stores. Although a s imilar variety of regular breakfast and lunch/dinner entrées were available in traditional fast-food outlets and convenience stores, the variety of healthier breakfast and lunch/dinner entrées was significantly greater in fast food outlets. Compared with convenience stores, supermarkets/grocery stores provided a greater variety of regular and healthier entrées and lunch/dinner side dishes. Conclusion Convenience stores and supermarkets/grocery stores more than double the potential access to fast foods in this rural area than traditional fast-food outlets alone; however, traditional fast food outlets offer greater opportunity for healthier fast food options than convenience stores. A complete picture of fast food environment and the availability of healthier fast food options are essential to understand environmental influences on diet and health

  10. The “School Foodshed”: schools and fast-food outlets in a London borough

    OpenAIRE

    Caraher, M.; Lloyd, S.; Madelin, T.

    2014-01-01

    Purpose – The purpose of this paper is to explore the location of fast-food outlets around secondary schools and the influence of fast-food availability on the food choices of school children in an inner-London borough. \\ud \\ud Design/methodology/approach – A number of methods including: mapping of outlets relative to schools; sampling food; gathering data on secondary school food policies; observing food behaviour in fast food outlets and focus groups with young people. Findings were fed bac...

  11. Intermittent metabolic switching, neuroplasticity and brain health

    Science.gov (United States)

    Mattson, Mark P.; Moehl, Keelin; Ghena, Nathaniel; Schmaedick, Maggie; Cheng, Aiwu

    2018-01-01

    During evolution, individuals whose brains and bodies functioned well in a fasted state were successful in acquiring food, enabling their survival and reproduction. With fasting and extended exercise, liver glycogen stores are depleted and ketones are produced from adipose-cell-derived fatty acids. This metabolic switch in cellular fuel source is accompanied by cellular and molecular adaptations of neural networks in the brain that enhance their functionality and bolster their resistance to stress, injury and disease. Here, we consider how intermittent metabolic switching, repeating cycles of a metabolic challenge that induces ketosis (fasting and/or exercise) followed by a recovery period (eating, resting and sleeping), may optimize brain function and resilience throughout the lifespan, with a focus on the neuronal circuits involved in cognition and mood. Such metabolic switching impacts multiple signalling pathways that promote neuroplasticity and resistance of the brain to injury and disease. PMID:29321682

  12. Compensatory mechanisms activated with intermittent energy restriction

    DEFF Research Database (Denmark)

    Coutinho, Sílvia Ribeiro; Halset, Eline Holli; Gåsbakk, Sigrid

    2018-01-01

    Background & aims: Strong compensatory responses, with reduced resting metabolic rate (RMR), increased exercise efficiency (ExEff) and appetite, are activated when weight loss (WL) is achieved with continuous energy restriction (CER), which try to restore energy balance. Intermittent energy...... restriction (IER), where short spells of energy restriction are interspaced by periods of habitual energy intake, may offer some protection in minimizing those responses. We aimed to compare the effect of IER versus CER on body composition and the compensatory responses induced by WL. Methods: 35 adults (age......: 39 ± 9 y) with obesity (BMI: 36 ± 4 kg/m2) were randomized to lose a similar weight with an IER (N = 18) or a CER (N = 17) diet over a 12 week period. Macronutrient composition and overall energy restriction (33% reduction) were similar between groups. Body weight/composition, RMR, fasting...

  13. Towards an intermittency-friendly energy system

    DEFF Research Database (Denmark)

    Blarke, Morten

    2012-01-01

    Distributed cogeneration has played a key role in the implementation of sustainable energy policies for three decades. However, increasing penetration levels of intermittent renewables is challenging that position. The paradigmatic case of West Denmark indicates that distributed operators...... are capitulating as wind power penetration levels are moving above 25%; some operators are retiring cogeneration units entirely, while other operators are making way for heat-only boilers. This development is jeopardizing the system-wide energy, economic, and environmental benefits that distributed cogeneration...... still has to offer. The solution is for distributed operators to adapt their technology and operational strategies to achieve a better co-existence between cogeneration and wind power. Four options for doing so are analysed including a new concept that integrates a high pressure compression heat pump...

  14. Scale Dependence of Spatiotemporal Intermittence of Rain

    Science.gov (United States)

    Kundu, Prasun K.; Siddani, Ravi K.

    2011-01-01

    It is a common experience that rainfall is intermittent in space and time. This is reflected by the fact that the statistics of area- and/or time-averaged rain rate is described by a mixed distribution with a nonzero probability of having a sharp value zero. In this paper we have explored the dependence of the probability of zero rain on the averaging space and time scales in large multiyear data sets based on radar and rain gauge observations. A stretched exponential fannula fits the observed scale dependence of the zero-rain probability. The proposed formula makes it apparent that the space-time support of the rain field is not quite a set of measure zero as is sometimes supposed. We also give an ex.planation of the observed behavior in tenus of a simple probabilistic model based on the premise that rainfall process has an intrinsic memory.

  15. Beneficial effects of intermittent suction and pressure treatment in intermittent claudication

    DEFF Research Database (Denmark)

    Mehlsen, J; Himmelstrup, H; Himmelstrup, Bodil

    1993-01-01

    administration. The treatment caused significant increments in the ADP thresholds for platelet aggregation, while the effects on fibrinolysis were uncertain. It is concluded that intermittent suction and pressure treatment offers a new approach for conservative treatment of intermittent claudication....... participated in an open trial investigating the possible effects of the treatment on platelet aggregation and fibrinolysis. Pain-free and maximal walking distances were measured on a treadmill, and systolic blood pressure was measured on the upper limb, the ankle, and the first toe bilaterally. The threshold...... for adenosine diphosphate (ADP)-induced platelet aggregation was tested, and the fibrinolytic activity was estimated from the euglobulin clot lysis time. Active treatment resulted in significant improvements in pain-free and maximal walking distances, whereas no changes could be found during placebo...

  16. Impact of remodeling and rehabilitation of irrigation outlets on water distribution of a canal in Punjab, Pakistan

    International Nuclear Information System (INIS)

    Bodla, H.; Latif, M.

    2009-01-01

    The study was undertaken to investigate water distribution along a distributary canal located in the southern part of the Punjab Province. It is a large size distributary having 353 cusecs of authorized discharge. This distributary was subjected to a series of problems including but not limited to (i) withdrawal of water by illegal means, (ii) design and construction flaws in the outlets, (iii) improper selection of the type of outlets and many others. The outlets were intentionally designed wrongly by using fictitious hydraulics data to provide undue benefits to the irrigators. During construction, setting of the outlets was also intentionally fixed at lower level than the designed. Investigations were carried out to evaluate hydraulic performance of all the outlets of the channel. Based on the observed data capacity statements of all the outlets were revised. The outlets were redesigned on the basis of actual hydraulic data of each outlet. Most of the non-modular outlets (Pipe and Scratchley) were converted to semi-modular outlets (OFRB and APM). With implementation of new and modified design of the outlets at the site, equity of water distribution has been improved. The results revealed that design of the outlets had a significant impact on equitable distribution of water along the distribution. (author)

  17. 16 CFR Appendix B to Part 436 - Sample Item 20(1) Table-Systemwide Outlet Summary

    Science.gov (United States)

    2010-01-01

    ... DISCLOSURE REQUIREMENTS AND PROHIBITIONS CONCERNING FRANCHISING Pt. 436, App. B Appendix B to Part 436—Sample... 1Outlet Type Column 2Year Column 3Outlets at the Start of the Year Column 4Outlets at the End of the Year...

  18. 16 CFR Appendix D to Part 436 - Sample Item 20(3) Table-Status of Franchise Outlets

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Sample Item 20(3) Table-Status of Franchise Outlets D Appendix D to Part 436 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES... Item 20(3) Table—Status of Franchise Outlets Status of Franchise Outlets For years 2004 to 2006 Column...

  19. [Intermittent Explosive Disorder: A Controversial Diagnosis].

    Science.gov (United States)

    Zapata, Juan Pablo; Palacio, Juan David

    2016-01-01

    Intermittent explosive disorder (IED) is aan externalizing externalising disorder characterized characterised by recurrent aggression episodes. Even though this disorder was described several decades ago, and it carries personal and social consequences, there is little in the medical scientific literature on this. bibliographic production about it is scanty. To perform a conceptualization conceptualisation of this disorder, through the review and bibliometric analysis of the available scientific articles. A search was performed in databases with the english English terms intermittent explosive disorder, impulse disorders control [MeSH], in combination with other terms. A bibliometric analysis in the GoPubMed® search engineer was also performed using all data obtained in the search. was also perfomed. IED prevalence ranges from 1.4% to 7%, it presents more frequently during middle adolescence, and with more noticeable repercussions in men males than in womenfemales. The psychopathological core of IED is the impulsive aggressive behaviour that presents in the form of «attacks» that occurs in response to a lower precipitating stimulus. Scientific publications about IED are few and relatively recent, and the vast majority is provided bycomes from the United States (56.56%), and headed by a single author. This fact highlights the need to replicate the findings described about the IED in order to demonstrate the validity and reliability of its diagnostic criteria. It is possible that doubts about the existence of a diagnosis lead have led to such a scant literature about the IED. Available studies about IED allow have allowed characterizing a group of subjects with episodes of impulsive aggression to be characterised, but this description requires replication in different latitudesneeds to be repeated in different areas. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  20. Managing server clusters on intermittent power

    Directory of Open Access Journals (Sweden)

    Navin Sharma

    2015-12-01

    Full Text Available Reducing the energy footprint of data centers continues to receive significant attention due to both its financial and environmental impact. There are numerous methods that limit the impact of both factors, such as expanding the use of renewable energy or participating in automated demand-response programs. To take advantage of these methods, servers and applications must gracefully handle intermittent constraints in their power supply. In this paper, we propose blinking—metered transitions between a high-power active state and a low-power inactive state—as the primary abstraction for conforming to intermittent power constraints. We design Blink, an application-independent hardware–software platform for developing and evaluating blinking applications, and define multiple types of blinking policies. We then use Blink to design both a blinking version of memcached (BlinkCache and a multimedia cache (GreenCache to demonstrate how application characteristics affect the design of blink-aware distributed applications. Our results show that for BlinkCache, a load-proportional blinking policy combines the advantages of both activation and synchronous blinking for realistic Zipf-like popularity distributions and wind/solar power signals by achieving near optimal hit rates (within 15% of an activation policy, while also providing fairer access to the cache (within 2% of a synchronous policy for equally popular objects. In contrast, for GreenCache, due to multimedia workload patterns, we find that a staggered load proportional blinking policy with replication of the first chunk of each video reduces the buffering time at all power levels, as compared to activation or load-proportional blinking policies.

  1. Effect of routine preoperative fasting on residual gastric volume and ...

    African Journals Online (AJOL)

    2016-02-10

    Feb 10, 2016 ... Key words: Fasting, myomectomy, pH, residual gastric volume. Date of Acceptance: ... gastric volume and acid in patients undergoing myomectomy. Niger J Clin ..... of gastric residual volume: A simulated, controlled study.

  2. Itopride for gastric volume, gastric emptying and drinking capacity in functional dyspepsia

    OpenAIRE

    Abid, Shahab; Jafri, Wasim; Zaman, Maseeh Uz; Bilal, Rakhshanda; Awan, Safia; Abbas, Aamir

    2017-01-01

    AIM To study the effect of itopride on gastric accommodation, gastric emptying and drinking capacity in functional dyspepsia (FD). METHODS Randomized controlled trial was conducted to check the effect of itopride on gastric accommodation, gastric emptying, capacity of tolerating nutrient liquid and symptoms of FD. We recruited a total of 31 patients having FD on the basis of ROME III criteria. After randomization, itopride was received by 15 patients while 16 patients received placebo. Gastri...

  3. Absence of pepsinogen A3 gene expression in the gastric mucosa of patients with gastric cancer.

    OpenAIRE

    Kuipers, E J; Peña, A S; Crusius, J B; Defize, J; van der Stoop, P; Meuwissen, S G; Pals, G

    1995-01-01

    AIMS--To investigate the expression of pepsinogen A3 (Pg3) encoding genes in the gastric mucosa of normal controls and subjects with atrophic gastritis and gastric cancer. METHODS--One hundred and fifty nine patients underwent upper gastrointestinal endoscopy with sampling of gastric biopsy specimens and serum. Pg3 isoproteins were determined by electrophoresis in serum and gastric mucosal biopsy specimens. Pg3 encoding genes were assessed by PCR in DNA obtained from peripheral blood. RESULTS...

  4. Metastatic Gastric Linitis Plastica from Bladder Cancer Mimicking a Primary Gastric Carcinoma: a Case Report

    International Nuclear Information System (INIS)

    Hong, Won Sun; Chung, Dong Jin; Lee, Jae Mun; Byun, Jae Ho; Hahn, Seong Tae

    2009-01-01

    Primary gastric carcinoma is the most common cause of linitis plastica. Less frequently, metastatic gastric cancer from the breast, omental metastases and non-Hodgkin lymphoma involving the stomach have been reported to show similar radiographic findings as for linitis plastica. A metastatic gastric cancer from bladder cancer is extremely rare. We present an unusual case, the first to our knowledge, of gastric linitis plastica that resulted from a metastatic urothelial carcinoma of the bladder

  5. [Gastric magnetic resonance study (methods, semiotics)].

    Science.gov (United States)

    Stashuk, G A

    2003-01-01

    The paper shows the potentialities of gastric study by magnetic resonance imaging (MRI). The methodic aspects of gastric study have been worked out. The MRI-semiotics of the unchanged and tumor-affected wall of the stomach and techniques in examining patients with gastric cancer of various sites are described. Using the developed procedure, MRI was performed in 199 patients, including 154 patients with gastric pathology and 45 control individuals who had no altered gastric wall. Great emphasis is placed on the role of MRI in the diagnosis of endophytic (diffuse) gastric cancer that is of priority value in its morphological structure. MRI was found to play a role in the diagnosis of the spread of a tumorous process both along the walls of the stomach and to its adjacent anatomic structures.

  6. Gastric and oesophageal emptying in obesity

    Energy Technology Data Exchange (ETDEWEB)

    Maddox, A.; Horowitz, M.; Wishart, J.; Collins, P. (Royal Adelaide Hospital (Australia))

    1989-01-01

    Gastric and esophageal emptying were evaluated in 31 obese patients and 31 control subjects. A double-isotope techniques was used to measure gastric emptying of a mixed solid/liquid meal, and esophageal emptying was measured as the time taken for a bolus of the solid meal to enter the stomach. Gastric emptying of the solid and the liquid meal and esophageal emptying were delayed in the obese patients compared with the control subjects. There were no significant relationships among gastric emptying, esophageal emptying, and upper gastrointestinal symptoms in the obese patients alone. However, in the total group of 62 subjects there were significant correlations between body mass index and both gastric and esophageal emptying. These results indicate that delayed gastric and esophageal emptying occurs frequently in obesity and that these abnormalties relate to body weight.

  7. Enhancement of Intermittent Androgen Ablation Therapy by Finasteride Administration in Animal Models

    National Research Council Canada - National Science Library

    Wang, Zhou

    2006-01-01

    .... Intermittent androgen ablation therapy (IAAT) may slow down the development of androgen refractory tumors because intermittent recovery of androgens can induce differentiation of prostatic epithelial cells...

  8. Enhancement of Intermittent Androgen Ablation Therapy by Finasteride Administration in Animal Models

    National Research Council Canada - National Science Library

    Wang, Zhou

    2004-01-01

    .... Intermittent androgen ablation therapy may slow down the development of androgen refractory tumors because intermittent recovery of androgens can induce differentiation of prostatic epithelial cells...

  9. Enhancement of Intermittent Androgen Ablation Therapy by Finasteride Administration in Animal Models

    National Research Council Canada - National Science Library

    Wang, Zhou

    2005-01-01

    .... Intermittent androgen ablation therapy may slow down the development of androgen refractory tumors because intermittent recovery of androgens can induce differentiation of prostatic epithelial cells...

  10. Enhancement of Intermittent Androgen Ablation Therapy by Finasteride Administration in Animal Models

    National Research Council Canada - National Science Library

    Wang, Zhou

    2003-01-01

    .... Intermittent androgen ablation therapy may slow down the development of androgen refractory tumors because intermittent recovery of androgens can induce differentiation of prostatic epithelial cells...

  11. Diversity of the Gastric Microbiota in Thoroughbred Racehorses Having Gastric Ulcer.

    Science.gov (United States)

    Dong, Hee-Jin; Ho, Hungwui; Hwang, Hyeshin; Kim, Yongbaek; Han, Janet; Lee, Inhyung; Cho, Seongbeom

    2016-04-28

    Equine gastric ulcer syndrome is one of the most frequently reported diseases in thoroughbred racehorses. Although several risk factors for the development of gastric ulcers have been widely studied, investigation of microbiological factors has been limited. In this study, the presence of Helicobacter spp. and the gastric microbial communities of thoroughbred racehorses having mild to severe gastric ulcers were investigated. Although Helicobacter spp. were not detected using culture and PCR techniques from 52 gastric biopsies and 52 fecal samples, the genomic sequences of H. pylori and H. ganmani were detected using nextgeneration sequencing techniques from 2 out of 10 representative gastric samples. The gastric microbiota of horses was mainly composed of Firmicutes (50.0%), Proteobacteria (18.7%), Bacteroidetes (14.4%), and Actinobacteria (9.7%), but the proportion of each phylum varied among samples. There was no major difference in microbial composition among samples having mild to severe gastric ulcers. Using phylogenetic analysis, three distinct clusters were observed, and one cluster differed from the other two clusters in the frequency of feeding, amount of water consumption, and type of bedding. To the best of our knowledge, this is the first study to investigate the gastric microbiota of thoroughbred racehorses having gastric ulcer and to evaluate the microbial diversity in relation to the severity of gastric ulcer and management factors. This study is important for further exploration of the gastric microbiota in racehorses and is ultimately applicable to improving animal and human health.

  12. A clinicopathological study of asymptomatic gastric cancer.

    OpenAIRE

    Matsukuma, A.; Furusawa, M.; Tomoda, H.; Seo, Y.

    1996-01-01

    The clinicopathological profiles of 419 patients with asymptomatic gastric cancer (AGC) first detected by gastric screening, were reviewed and compared with those of the 1727 patients with symptomatic gastric cancer (SGC). The incidence of AGC increased gradually and has amounted to 30% of the total resected cases in recent years. About 75% of AGC cases were of early cancer and 84% were negative for lymph node metastases. In contrast, only 33% of SGC cases were of early cancer and 57% were no...

  13. Gastric gallium-67 uptake in gastritis

    International Nuclear Information System (INIS)

    Yeh, E.L.; Tisdale, P.L.; Zielonka, J.S.

    1983-01-01

    Even though Ga-67 imaging has been used widely in the diagnosis of malignant as well as inflammatory lesions, its uptake in the stomach has been reported in the literature mainly in gastric lymphoma and carcinoma. As shown in this case, intense gastric uptake of the radionuclide may be seen in common gastritis without malignancy. Perhaps the benign gastric uptake of Ga-67 deserves more emphasis

  14. Gastric ulcer bleeding: diagnosis by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Voloudaki, Argyro; Tsagaraki, Kaliopi; Mouzas, John; Gourtsoyiannis, Nickolas

    1999-06-01

    A case of CT demonstration of a bleeding gastric ulcer is presented, in a patient with confusing clinical manifestations. Abdominal CT was performed without oral contrast medium administration, and showed extravasation of intravenous contrast into a gastric lumen distended with material of mixed attenuation. It is postulated that if radiopaque oral contrast had been given, peptic ulcer bleeding would probably have been masked. CT demonstration of gastric ulcer bleeding, may be of value in cases of differential diagnostic dilemmas.

  15. Gastric ulcer bleeding: diagnosis by computed tomography

    International Nuclear Information System (INIS)

    Voloudaki, Argyro; Tsagaraki, Kaliopi; Mouzas, John; Gourtsoyiannis, Nickolas

    1999-01-01

    A case of CT demonstration of a bleeding gastric ulcer is presented, in a patient with confusing clinical manifestations. Abdominal CT was performed without oral contrast medium administration, and showed extravasation of intravenous contrast into a gastric lumen distended with material of mixed attenuation. It is postulated that if radiopaque oral contrast had been given, peptic ulcer bleeding would probably have been masked. CT demonstration of gastric ulcer bleeding, may be of value in cases of differential diagnostic dilemmas

  16. Gut hormones and gastric bypass

    DEFF Research Database (Denmark)

    Holst, Jens J.

    2016-01-01

    Gut hormone secretion in response to nutrient ingestion appears to depend on membrane proteins expressed by the enteroendocrine cells. These include transporters (glucose and amino acid transporters), and, in this case, hormone secretion depends on metabolic and electrophysiological events elicited...... that determines hormone responses. It follows that operations that change intestinal exposure to and absorption of nutrients, such as gastric bypass operations, also change hormone secretion. This results in exaggerated increases in the secretion of particularly the distal small intestinal hormones, GLP-1, GLP-2......, oxyntomodulin, neurotensin and peptide YY (PYY). However, some proximal hormones also show changes probably reflecting that the distribution of these hormones is not restricted to the bypassed segments of the gut. Thus, cholecystokinin responses are increased, whereas gastric inhibitory polypeptide responses...

  17. Radiation therapy for gastric cancer

    International Nuclear Information System (INIS)

    Dobelbower, R.R.; Bagne, F.; Ajlouni, M.I.; Milligan, A.J.

    1988-01-01

    Adenocarcinoma of the stomach is a moderately radioresponsive neoplasm. Attempts to treat patients with unresectable disease with external beam radiation therapy alone have generally failed because of problems with tumor localization and adequate dose delivery as well as the inherent radioresponsiveness of the gastric mucosa and the organs intimately related to the stomach. Combining external beam therapy and chemotherapy (acting as a systemic agent and as a radiosensitizer) seems to be of some (albeit limited) benefit in the management of unresectable adenocarcinoma of the stomach. Optimum combinations of radiation therapy, chemotherapy, and radiation sensitizers in this situation remain to be determined. The authors discuss strides which have been made in the treatment of gastric cancer. They also address the unanswered clinical questions which remain regarding the use of radiation therapy in the treatment of this highly lethal disease

  18. Radiation therapy of gastric carcinoma

    International Nuclear Information System (INIS)

    Asakawa, Hiroshi; Yamada, Shogo

    1980-01-01

    A total of 136 cases with gastric cancer was treated with radiation and some anti-cancer drugs. The tumor responded markedly to radiation in 37% of 92 cases, irradiated more than 5000 rad and regressed completely in only 5% of them. Out of them, the permanent cure was achieved in 3% of T2-4 M0 cases. Serious complications, such as hemorrhagic gastritis, massive bleeding, chronic ulcer of the stomach and perforation, were also observed in a few per cent of them. It was suggested that in the treatment of inoperable gastric cancer, the combination treatment of radiation and chemotherapy should be chosen as a valuable therapeutic procedure to get a good palliation. (author)

  19. Gastric Osteoma in a Dog

    Directory of Open Access Journals (Sweden)

    E. Y. Kye, J. S. Park, S. K. Ku1, S. H. Yun, T. H. Oh, K.W. Lee, Y. S. Kwon and K. H. Jang*

    2012-01-01

    Full Text Available An eight year old female dog was referred with anorexia, nervousness and emaciation. At the point of time, severe lifelessness was the only symptom. Then euthanasia was done according to the owner’s decision. As a result of postmortem examination, thin white matters were found on the gastric mucosa of the greater curvature and there were no other significant gross findings. Tissue specimens were collected from the gastric wall, esophagus, gall bladder, aorta, heart, kidneys, liver, mesenteric lymph node, lungs, urinary bladder and spleen and processed for histopathology. Microscopically, the masses of stomach were consisted of well-differentiated osteoid tissues, the compact bone-osteocytes and the matured lamellated bone with Haversian system. It was diagnosed as osteoma of the stomach. Other organs were free on such histological findings.

  20. Radiation therapy of gastric carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Asakawa, H; Yamada, S [Miyagi Prefectural Adult Disease Center, Natori (Japan)

    1980-10-01

    A total of 136 cases with gastric cancer was treated with radiation and some anti-cancer drugs. The tumor responded markedly to radiation in 37% of 92 cases, irradiated more than 5000 rad and regressed completely in only 5% of them. Out of them, the permanent cure was achieved in 3% of T2-4 M0 cases. Serious complications, such as hemorrhagic gastritis, massive bleeding, chronic ulcer of the stomach and perforation, were also observed in a few per cent of them. It was suggested that in the treatment of inoperable gastric cancer, the combination treatment of radiation and chemotherapy should be chosen as a valuable therapeutic procedure to get a good palliation.

  1. The psyche and gastric functions.

    Science.gov (United States)

    Nardone, Gerardo; Compare, Debora

    2014-01-01

    Although the idea that gastric problems are in some way related to mental activity dates back to the beginning of the last century, until now it has received scant attention by physiologists, general practitioners and gastroenterologists. The major breakthrough in understanding the interactions between the central nervous system and the gut was the discovery of the enteric nervous system (ENS) in the 19th century. ENS (also called 'little brain') plays a crucial role in the regulation of the physiological gut functions. Furthermore, the identification of corticotropin-releasing factor (CRF) and the development of specific CRF receptor antagonists have permitted to characterize the neurochemical basis of the stress response. The neurobiological response to stress in mammals involves three key mechanisms: (1) stress is perceived and processed by higher brain centers; (2) the brain mounts a neuroendocrine response by way of the hypothalamic-pituitary-adrenal axis (HPA) and the autonomic nervous system (ANS), and (3) the brain triggers feedback mechanisms by HPA and ANS stimulation to restore homeostasis. Various stressors such as anger, fear, painful stimuli, as well as life or social learning experiences affect both the individual's physiologic and gastric function, revealing a two-way interaction between brain and stomach. There is overwhelming experimental and clinical evidence that stress influences gastric function, thereby outlining the pathogenesis of gastric diseases such as functional dyspepsia, gastroesophageal reflux disease and peptic ulcer disease. A better understanding of the role of pathological stressors in the modulation of disease activity may have important pathogenetic and therapeutic implications. © 2014 S. Karger AG, Basel.

  2. Targeting BRCAness in Gastric Cancer

    Science.gov (United States)

    2017-10-01

    affected in subsets of these tumors. For example, mutations in BRCA1/2 were found in about 15% of gastric cancer, loss of BRCA1 protein expression...platform   Figure 4: Nuclear-RFP tagged SNU1 cell lines after 6 days in culture . (A) Phase contrast. (B) RFP. (C) Markup image of RFP confluence...Title: Cell Cultures and Xenografts from Esophagogastric, Pancreatic, Colorectal and Neuroendocrine Tumors, IACUC protocol number 10-02-003, Protocol

  3. A Case of Primary Gastric Small-Cell Carcinoma in an Elderly Patient

    Directory of Open Access Journals (Sweden)

    Fa-Chang Yu

    2012-03-01

    Full Text Available We report a case of primary small-cell carcinoma of the stomach in a 75-year-old man. The patient was admitted to our hospital with a 1-week history of intermittent tarry stool. An upper gastrointestinal examination revealed a large stage A2 ulcer in the greater curvature of the body of the stomach, and pathological findings from biopsy specimens revealed small-cell carcinoma. The tumor cells were small-sized, composed of hyperchromatic nuclei with scant cytoplasm, and stained positive for cytokeratin, synaptophysin, and chromogranin A. The patient was diagnosed with primary small-cell carcinoma of the stomach. He declined further evaluation and received palliative management. This is a rare carcinoma of the stomach, with aggressive manifestations and a poor prognosis. The mean survival of patients with primary gastric small-cell carcinoma is reported to be 7 months. The choice of treatment for this disease is still controversial. This rare gastric tumor should be listed in the differential diagnosis of gastric carcinoma in the elderly.

  4. PIV measurement at the blowdown pipe outlet. [Particle Image Velocimetry

    Energy Technology Data Exchange (ETDEWEB)

    Puustinen, M.; Laine, J.; Raesaenen, A.; Pyy, L.; Telkkae, J. [Lappeenranta Univ. of Technology, Lappeenranta (Finland)

    2013-04-15

    This report summarizes the findings of the PIV measurement tests carried out in January - February 2013 with the scaled down PPOOLEX test facility at LUT. The main objective of the tests was to find out the operational limits of the PIV system regarding suitable test conditions and correct values of different adjustable PIV parameters. An additional objective was to gather CFD grade data for verification/validation of numerical models. Both water and steam injection tests were carried out. PIV measurements with cold water injection succeeded well. Raw images were of high quality, averaging over the whole measurement period could be done and flow fields close to the blowdown pipe outlet could be determined. In the warm water injection cases the obtained averaged velocity field images were harder to interpret, especially if the blowdown pipe was also filled with warm water in the beginning of the measurement period. The absolute values of the velocity vectors seemed to be smaller than in the cold water injection cases. With very small steam flow rates the steam/water interface was inside the blowdown pipe and quite stable in nature. The raw images were of good quality but due to some fluctuation in the velocity field averaging of the velocity images over the whole measured period couldn't be done. Condensation of steam in the vicinity of the pipe exit probably caused these fluctuations. A constant outflow was usually followed by a constant inflow towards the pipe exit. Vector field images corresponding to a certain phase of the test could be extracted and averaged but this would require a very careful analysis so that the images could be correctly categorized. With higher steam flow rates rapid condensation of large steam bubbles created small gas bubbles which were in front of the measurement area of the PIV system. They disturbed the measurements by reflecting laser light like seeding particles and therefore the raw images were of poor quality and they couldn

  5. Gastric secretion elicited by conditioning in rats.

    Science.gov (United States)

    Caboclo, José Liberato Ferreira; Cury, Francico de Assis; Borin, Aldenis Albanese; Caboclo, Luís Otávio Sales Ferreira; Ribeiro, Maria Fernanda Sales Caboclo; de Freitas, Pedro José; Andersson, Sven

    2009-01-01

    To investigate whether interdigestive gastric acid secretion can be controlled by a possible memory-related cortical mechanism. To evaluate gastric secretion in rats, we used a methodology that allows gastric juice collection in rats in their habitual conditions (without any restraining) by pairing sound as the conditioning stimulus (CS) and food as the unconditioning stimulus (US). The levels of gastric acid secretion under basal conditions and under sound stimulation were recorded and the circulating gastrin levels determined. When the gastric juice was collected in the course of the conditioning procedure, the results showed that under noise stimulation a significant increase in gastric acid secretion occurred after 10 days of conditioning (p<0.01). The significance was definitively demonstrated after 13 days of conditioning (p<0.001). Basal secretions of the conditioned rats reached a significant level after 16 days of conditioning. The levels of noise-stimulated gastric acid secretion were the highest so far described in physiological experiments carried out in rats and there were no significant increases in the circulating gastrin levels. The results point to the important role played by cortical structures in the control of interdigestive gastric acid secretion in rats. If this mechanism is also present in humans, it may be involved in diseases caused by inappropriate gastric acid secretion during the interprandial periods.

  6. Development of functional MRI in gastric cancer

    International Nuclear Information System (INIS)

    Zhang Lei; Shao Guoliang

    2013-01-01

    Gastric cancer is one of the most common malignant tumors in digestive tract functional MRI can represent the functional changes of the tumor. DWI not only provides a new way to diagnosis the gastric cancer, but also reflect the pathology changes of the tumor, which has great value to predict the therapeutic effect and prognosis of the tumor. MRS is the only method to test the chemical composition of tissues in live without injury, which has great value in the early diagnosis of gastric tumor and in the research of tumor mechanism. This review is mainly focused on the status and development of functional MRI in gastric cancer. (authors)

  7. Recent advances in gastric emptying scintigraphy

    International Nuclear Information System (INIS)

    Urbain, J.L.C.; Mayeur, S.M.

    1996-01-01

    Gastric emptying scintigraphy was introduced more than 25 years ago by Grittith and still remains the gold standard to assess gastric emptying. Test meals, radiopharmaceuticals and acquisition procedures have been refined and optimized over the years and the test procedure is now pretty well standardized. However, in its most common use, gastric emptying scintigraphy provides little information on gastric physiology. Over the last decade, modelling of the liquid and solid emptying curves have brought some insight in the complex gastric physiology. Compartmental analysis of the stomach has also provided information on the pathophysiological mechanisms of delayed gastric emptying. Over the past 5 years, the most dramatic development in gastric emptying scintigraphy has been the introduction of Digital Antral Scintigraphy (DAS). Digital Antral scintigraphy basically consists in dynamically imaging of the stomach and the use of a refined Fourier transform processing method. This new procedure allows for the visualization of antral contractions and, alike manometry, permits quantitative characterization on the frequency and amplitude of these contractions. Overall, this new procedure provides a unique, non invasive tool to characterize gastric motility, to define the pathophysiologic mechanisms of gastric motor disorders and to evaluate the effect of new gastro-kinetic compounds. (authors). 241 refs., 5 figs

  8. Gastric pseudolymphoma: Report of 3 cases

    International Nuclear Information System (INIS)

    Lee, Mi Sook; Kim, Ki Whang; Kim, Dong Ik; Lee, Jong Tae; Park, Chang Yun

    1983-01-01

    The pseudolymphoma of the stomach is known to be a benign proliferation of lymphoid tissue, which can be mistaken histologically for malignant lymphoma. The etiology of pseudo lymphoma is controversial, but it B believed to be a manifestation of chronic inflammatory process. Authors present 3 cases of gastric lymphoma. Impression of upper gastrointestinal series were as follows; lymphoma or chronic gastritis in one case, ulcerative carcinoma in another case and early gastric carcinoma in the other case. Initial endoscopic findings suggested infiltrating carcinoma, ulcerative carcinoma and two benign gastric ulcers, respectively. One case was associated with early gastric carcinoma

  9. Gastric pseudolymphoma: Report of 3 cases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Mi Sook; Kim, Ki Whang; Kim, Dong Ik; Lee, Jong Tae; Park, Chang Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1983-12-15

    The pseudolymphoma of the stomach is known to be a benign proliferation of lymphoid tissue, which can be mistaken histologically for malignant lymphoma. The etiology of pseudo lymphoma is controversial, but it B believed to be a manifestation of chronic inflammatory process. Authors present 3 cases of gastric lymphoma. Impression of upper gastrointestinal series were as follows; lymphoma or chronic gastritis in one case, ulcerative carcinoma in another case and early gastric carcinoma in the other case. Initial endoscopic findings suggested infiltrating carcinoma, ulcerative carcinoma and two benign gastric ulcers, respectively. One case was associated with early gastric carcinoma.

  10. Bladder outlet obstruction due to a small midline prostatic cyst - diagnostic imaging and interventional radiological treatment

    International Nuclear Information System (INIS)

    Hueppe, T.; Kopka, L.; Friedrich, M.; Kuehn, M.

    1992-01-01

    We describe a rare case of a bladder outlet obstruction due to a midline prostatic cyst. In the following clinical apperance, diagnostic imaging and therapy by CT-guided punction are reported. Differential diagnosis and therapy are discussed. (orig.) [de

  11. 5 CFR 591.217 - In which outlets does OPM collect prices?

    Science.gov (United States)

    2010-01-01

    ... data collection areas, accessibility by road, physical size, advertising, and other characteristics that reflect sales volume. To the extent practical, OPM prices like items in the same types of outlets...

  12. Is there an association between home-tobacco outlet proximity and smoking status in Denmark?

    DEFF Research Database (Denmark)

    Berg-Beckhoff, Gabriele; K Seid, Abdu; Stock, Christiane

    2017-01-01

    and/or tobacco outlets on smoking habits for the first time in a population based survey in Denmark. Method: Data came from the 2011 Danish national alcohol and drug survey of the Centre for Alcohol and Drug Research of Aarhus University (response rate 64%) and registries of Statistics Denmark were...... between residing close to a tobacco outlet and the prevalence of current and previous smoking. However, no significant association was found between distance from residence to tobacco outlets and smoking habits. Discussion: The prevalence of current smokers (24%) is in accordance with the 2011 annual......Abstract It is well established that exposure to point-of-sale tobacco promotion or impulse purchases and access to and distance to tobacco outlets are related to youth and adult smoking. The aim of the present study was to examine the association of distance from residence to the nearest alcohol...

  13. Is proximity to alcohol outlets associated with alcohol consumption and alcohol-related harm in Denmark?

    DEFF Research Database (Denmark)

    Kedir, Abdu; Berg-Beckhoff, Gabriele; Stock, Christiane

    2018-01-01

    Background: This study examined the associations between distance from residence to the nearest alcohol outlet with alcohol consumption as well as with alcohol-related harm. Methods: Data on alcohol consumption, alcohol-related harm and sociodemographics were obtained from the 2011 Danish Drug...... and Alcohol Survey (n=5133) with respondents aged 15–79 years. The information on distances from residence to the nearest alcohol outlets was obtained from Statistics Denmark. Multiple logistic and linear regressions were used to examine the association between distances to outlets and alcohol consumption...... whereas alcohol-related harm was analysed using negative binomial regression. Results: Among women it was found that those living closer to alcohol outlets were more likely to report alcohol-related harm (p

  14. Is proximity to alcohol outlets associated with alcohol consumption and alcohol-related harm in Denmark?

    DEFF Research Database (Denmark)

    Seid, Abdu K.; Berg-Beckhoff, Gabriele; Stock, Christiane

    2018-01-01

    Background: This study examined the associations between distance from residence to the nearest alcohol outlet with alcohol consumption as well as with alcohol-related harm. Methods: Data on alcohol consumption, alcohol-related harm and sociodemographics were obtained from the 2011 Danish Drug...... and Alcohol Survey (n = 5133) with respondents aged 15–79 years. The information on distances from residence to the nearest alcohol outlets was obtained from Statistics Denmark. Multiple logistic and linear regressions were used to examine the association between distances to outlets and alcohol consumption...... whereas alcohol-related harm was analysed using negative binomial regression. Results: Among women it was found that those living closer to alcohol outlets were more likely to report alcohol-related harm (p

  15. 46 CFR 111.81-1 - Outlet boxes and junction boxes; general.

    Science.gov (United States)

    2010-10-01

    ... fixture, wiring device, or similar item, including each separately installed connection and junction box... used. (d) As appropriate, each outlet-box or junction-box installation must meet the following...

  16. The ICS-'BPH' Study: uroflowmetry, lower urinary tract symptoms and bladder outlet obstruction

    NARCIS (Netherlands)

    Reynard, J. M.; Yang, Q.; Donovan, J. L.; Peters, T. J.; Schafer, W.; de la Rosette, J. J.; Dabhoiwala, N. F.; Osawa, D.; Lim, A. T.; Abrams, P.

    1998-01-01

    To explore the relationship between uroflow variables and lower urinary tract symptoms (LUTS): to define performance statistics (sensitivity, specificity, positive and negative predictive values) for maximum urinary flow rate (Qmax) with respect to bladder outlet obstruction (BOO) at various

  17. Numerical analysis of temperature fluctuation in core outlet region of China experimental fast reactor

    International Nuclear Information System (INIS)

    Zhu Huanjun; Xu Yijun

    2014-01-01

    The temperature fluctuation in core outlet region of China Experimental Fast Reactor (CEFR) was numerically simulated by the CFD software Star CCM+. With the core outlet temperatures, flows etc. under rated conditions given as boundary conditions, a 1/4 region model of the reactor core outlet region was established and calculated using LES method for this problem. The analysis results show that while CEFR operates under rated conditions, the temperature fluctuation in lower part of core outlet region is mainly concentrated in area over the edge components (steel components, control rod assembly), and one in upper part is remarkable in area above all the components. The largest fluctuation amplitude is 19 K and the remarkable frequency is below 5 Hz, and it belongs to typically low frequency fluctuation. The conclusion is useful for further experimental work. (authors)

  18. Gastric traumatic injuries: CT findings

    International Nuclear Information System (INIS)

    Lassandro, Francesco; Romano, Stefania; Rossi, Giovanni; Muto, Roberto; Cappabianca, Salvatore; Grassi, Roberto

    2006-01-01

    Objective: Gastric blunt traumatic injuries are uncommon and their radiological appearance has been infrequently reported in medical literature. These injuries are difficult to diagnose preoperatively, though they require immediate recognition to minimize their otherwise high mortality and morbidity. The aim of our study is to describe the radiological appearance of blunt gastric traumatic injuries. Materials and methods: Retrospective evaluation of a 25 patients series observed between January 1997 and May 2005. Results: We observed rupture of the stomach in 20% of cases, in 44% of cases a partial lesion of the stomach, in one case a necrotic post-traumatic volvulus, five patients (20%) had benign portal pneumatosis, in three patients the stomach was secondarily involved because of a diaphragmatic hernia. The fundus resulted to be the most frequently damaged part of the stomach (80%). Conclusions: Blunt traumatic injuries need a careful and systematic approach given their economical and social relevance. For these reasons uncommon lesions require attention and may be important to search for specific findings of gastric lesions

  19. Gastric traumatic injuries: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Lassandro, Francesco [Department of Diagnostic Imaging, ' A. Cardarelli' Hospital, I-80131 Naples (Italy)]. E-mail: francesco.lassandro@fastwebnet.it; Romano, Stefania [Department of Diagnostic Imaging, ' A. Cardarelli' Hospital, I-80131 Naples (Italy); Rossi, Giovanni [Department of Radiology, V. Monaldi Hospital, Naples (Italy); Muto, Roberto [Department of Radiology, V. Monaldi Hospital, Naples (Italy); Cappabianca, Salvatore [Magrassi-Lanzara Department, Institute of Radiology, Second University of Naples (Italy); Grassi, Roberto [Magrassi-Lanzara Department, Institute of Radiology, Second University of Naples (Italy)

    2006-09-15

    Objective: Gastric blunt traumatic injuries are uncommon and their radiological appearance has been infrequently reported in medical literature. These injuries are difficult to diagnose preoperatively, though they require immediate recognition to minimize their otherwise high mortality and morbidity. The aim of our study is to describe the radiological appearance of blunt gastric traumatic injuries. Materials and methods: Retrospective evaluation of a 25 patients series observed between January 1997 and May 2005. Results: We observed rupture of the stomach in 20% of cases, in 44% of cases a partial lesion of the stomach, in one case a necrotic post-traumatic volvulus, five patients (20%) had benign portal pneumatosis, in three patients the stomach was secondarily involved because of a diaphragmatic hernia. The fundus resulted to be the most frequently damaged part of the stomach (80%). Conclusions: Blunt traumatic injuries need a careful and systematic approach given their economical and social relevance. For these reasons uncommon lesions require attention and may be important to search for specific findings of gastric lesions.

  20. [Gastric band erosion: Alternative management].

    Science.gov (United States)

    Echaverry-Navarrete, Denis José; Maldonado-Vázquez, Angélica; Cortes-Romano, Pablo; Cabrera-Jardines, Ricardo; Mondragón-Pinzón, Erwin Eduardo; Castillo-González, Federico Armando

    2015-01-01

    Obesity is a public health problem, for which the prevalence has increased worldwide at an alarming rate, affecting 1.7 billion people in the world. To describe the technique employed in incomplete penetration of gastric band where endoscopic management and/or primary closure is not feasible. Laparoscopic removal of gastric band was performed in five patients with incomplete penetrance using Foley catheterization in the perforation site that could lead to the development of a gastro-cutaneous fistula. The cases presented include a leak that required surgical lavage with satisfactory outcome, and one patient developed stenosis 3 years after surgical management, which was resolved endoscopically. In all cases, the penetration site closed spontaneously. Gastric band erosion has been reported in 3.4% of cases. The reason for inserting a catheter is to create a controlled gastro-cutaneous fistula, allowing spontaneous closure. Various techniques have been described: the totally endoscopic, hybrid techniques (endoscopic/laparoscopic) and completely laparoscopic. A technique is described here that is useful and successful in cases where the above-described treatments are not viable. Copyright © 2015. Published by Masson Doyma México S.A.

  1. Intermittent hypoxia increases insulin resistance in genetically obese mice.

    Science.gov (United States)

    Polotsky, Vsevolod Y; Li, Jianguo; Punjabi, Naresh M; Rubin, Arnon E; Smith, Philip L; Schwartz, Alan R; O'Donnell, Christopher P

    2003-10-01

    Obstructive sleep apnoea, a syndrome that leads to recurrent intermittent hypoxia, is associated with insulin resistance in obese individuals, but the mechanisms underlying this association remain unknown. We utilized a mouse model to examine the effects of intermittent hypoxia on insulin resistance in lean C57BL/6J mice and leptin-deficient obese (C57BL/6J-Lepob) mice. In lean mice, exposure to intermittent hypoxia for 5 days (short term) resulted in a decrease in fasting blood glucose levels (from 173 +/- 11 mg dl-1 on day 0 to 138 +/- 10 mg dl-1 on day 5, P obese mice, short-term intermittent hypoxia led to a decrease in blood glucose levels accompanied by a 607 +/- 136 % (P intermittent hypoxia was completely abolished by prior leptin infusion. Obese mice exposed to intermittent hypoxia for 12 weeks (long term) developed a time-dependent increase in fasting serum insulin levels (from 3.6 +/- 1.1 ng ml-1 at baseline to 9.8 +/- 1.8 ng ml-1 at week 12, P intermittent hypoxia is dependent on the disruption of leptin pathways.

  2. Putting intelligent structured intermittent auscultation (ISIA) into practice.

    Science.gov (United States)

    Maude, Robyn M; Skinner, Joan P; Foureur, Maralyn J

    2016-06-01

    Fetal monitoring guidelines recommend intermittent auscultation for the monitoring of fetal wellbeing during labour for low-risk women. However, these guidelines are not being translated into practice and low-risk women birthing in institutional maternity units are increasingly exposed to continuous cardiotocographic monitoring, both on admission to hospital and during labour. When continuous fetal monitoring becomes routinised, midwives and obstetricians lose practical skills around intermittent auscultation. To support clinical practice and decision-making around auscultation modality, the intelligent structured intermittent auscultation (ISIA) framework was developed. The purpose of this discussion paper is to describe the application of intelligent structured intermittent auscultation in practice. The intelligent structured intermittent auscultation decision-making framework is a knowledge translation tool that supports the implementation of evidence into practice around the use of intermittent auscultation for fetal heart monitoring for low-risk women during labour. An understanding of the physiology of the materno-utero-placental unit and control of the fetal heart underpin the development of the framework. Intelligent structured intermittent auscultation provides midwives with a robust means of demonstrating their critical thinking and clinical reasoning and supports their understanding of normal physiological birth. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Effect of Intermittent Hypercapnia on Respiratory Control in Rat Pups

    Science.gov (United States)

    Steggerda, Justin A.; Mayer, Catherine A.; Martin, Richard J.; Wilson, Christopher G.

    2010-01-01

    Preterm infants are subject to fluctuations in blood gas status associated with immature respiratory control. Intermittent hypoxia during early postnatal life has been shown to increase chemoreceptor sensitivity and destabilize the breathing pattern; however, intermittent hypercapnia remains poorly studied. Therefore, to test the hypothesis that intermittent hypercapnia results in altered respiratory control, we examined the effects of daily exposure to intermittent hypercapnia on the ventilatory response to subsequent hypercapnic and hypoxic exposure in neonatal rat pups. Exposure cycles consisted of 5 min of intermittent hypercapnia (5% CO2, 21% O2, balance N2) followed by 10 min of normoxia. Rat pups were exposed to 18 exposure cycles each day for 1 week, from postnatal day 7 to 14. We analyzed diaphragm electromyograms (EMGs) from pups exposed to subsequent acute hypercapnic (5% CO2) and hypoxic (12% O2) challenges. In response to a subsequent hypercapnia challenge, there was no significant difference in the ventilatory response between control and intermittent hypercapnia-exposed groups. In contrast, intermittent hypercapnia-exposed rat pups showed an enhanced ventilatory response to hypoxic challenge with an increase in minute EMG to 118 ± 14% of baseline versus 107 ± 13% for control pups (p < 0.05). We speculate that prior hypercapnic exposure may increase peripheral chemoreceptor response to subsequent hypoxic exposures and result in perturbed neonatal respiratory control. PMID:19752577

  4. Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele

    OpenAIRE

    Shi, Yang; Yu, Yongjun; Zhang, Xipeng; Li, Yuwei

    2017-01-01

    Background The aim of this study was to evaluate the curative effect of transvaginal mesh repair (TVMR) and stapled transanal rectal resection (STARR) in treating outlet obstruction constipation caused by rectocele. Material/Methods Patients who had outlet obstruction constipation caused by rectocele were retrospectively analyzed and 39 patients were enrolled the study. Patients were assigned to either the TVMR or STARR group. Postoperative factors such as complications, pain, recurrence rate...

  5. Beyond Supermarkets: Food Outlet Location Selection in Four U.S. Cities Over Time.

    Science.gov (United States)

    Rummo, Pasquale E; Guilkey, David K; Ng, Shu Wen; Popkin, Barry M; Evenson, Kelly R; Gordon-Larsen, Penny

    2017-03-01

    Understanding what influences where food outlets locate is important for mitigating disparities in access to healthy food outlets. However, few studies have examined how neighborhood characteristics influence the neighborhood food environment over time, and whether these relationships differ by neighborhood-level income. Neighborhood-level data from four U.S. cities (Birmingham, AL; Chicago, IL; Minneapolis, MN; Oakland, CA) from 1986, 1993, 1996, 2001, 2006, and 2011 were used with two-step econometric models to estimate longitudinal associations between neighborhood-level characteristics (z-scores) and the log-transformed count/km 2 (density) of food outlets within real estate-derived neighborhoods. Associations were examined with lagged neighborhood-level sociodemographics and lagged density of food outlets, with interaction terms for neighborhood-level income. Data were analyzed in 2016. Neighborhood-level income at earlier years was negatively associated with the current density of convenience stores (β= -0.27, 95% CI= -0.16, -0.38, prestaurant density in low-income neighborhoods (10th percentile of income: β= -0.17, 95% CI= -0.34, -0.002, p=0.05), and the density of smaller grocery stores across all income levels (β= -0.27, 95% CI= -0.45, -0.09, p=0.003). There was a lack of policy-relevant associations between the pre-existing food environment and the current density of food outlet types, including supermarkets. Socioeconomically disadvantaged and minority populations may attract "unhealthy" food outlets over time. To support equal access to healthy food outlets, the availability of "less healthy" food outlets types may be relatively more important than the potential lack of supermarkets or full-service restaurants. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Neighborhood alcohol outlet density and genetic influences on alcohol use: evidence for gene-environment interaction.

    Science.gov (United States)

    Slutske, Wendy S; Deutsch, Arielle R; Piasecki, Thomas M

    2018-05-07

    Genetic influences on alcohol involvement are likely to vary as a function of the 'alcohol environment,' given that exposure to alcohol is a necessary precondition for genetic risk to be expressed. However, few gene-environment interaction studies of alcohol involvement have focused on characteristics of the community-level alcohol environment. The goal of this study was to examine whether living in a community with more alcohol outlets would facilitate the expression of the genetic propensity to drink in a genetically-informed national survey of United States young adults. The participants were 2434 18-26-year-old twin, full-, and half-sibling pairs from Wave III of the National Longitudinal Study of Adolescent to Adult Health. Participants completed in-home interviews in which alcohol use was assessed. Alcohol outlet densities were extracted from state-level liquor license databases aggregated at the census tract level to derive the density of outlets. There was evidence that the estimates of genetic and environmental influences on alcohol use varied as a function of the density of alcohol outlets in the community. For example, the heritability of the frequency of alcohol use for those residing in a neighborhood with ten or more outlets was 74% (95% confidence limits = 55-94%), compared with 16% (95% confidence limits = 0-34%) for those in a neighborhood with zero outlets. This moderating effect of alcohol outlet density was not explained by the state of residence, population density, or neighborhood sociodemographic characteristics. The results suggest that living in a neighborhood with many alcohol outlets may be especially high-risk for those individuals who are genetically predisposed to frequently drink.

  7. The roles of outlet density and norms in alcohol use disorder

    OpenAIRE

    Ahern, J; Balzer, L; Galea, S

    2015-01-01

    © 2015 Elsevier Ireland Ltd. Background: Alcohol outlet density and norms shape alcohol consumption. However, due to analytic challenges we do not know: (a) if alcohol outlet density and norms also shape alcohol use disorder, and (b) whether they act in combination to shape disorder. Methods: We applied a new targeted minimum loss-based estimator for rare outcomes (rTMLE) to a general population sample from New York City (N= 4000) to examine the separate and combined relations of neighborhood...

  8. Inhibitory Effect of Nasal Intermittent Positive Pressure Ventilation on Gastroesophageal Reflux.

    Directory of Open Access Journals (Sweden)

    Danny Cantin

    Full Text Available Non-invasive intermittent positive pressure ventilation can lead to esophageal insufflations and in turn to gastric distension. The fact that the latter induces transient relaxation of the lower esophageal sphincter implies that it may increase gastroesophageal refluxes. We previously reported that nasal Pressure Support Ventilation (nPSV, contrary to nasal Neurally-Adjusted Ventilatory Assist (nNAVA, triggers active inspiratory laryngeal closure. This suggests that esophageal insufflations are more frequent in nPSV than in nNAVA. The objectives of the present study were to test the hypotheses that: i gastroesophageal refluxes are increased during nPSV compared to both control condition and nNAVA; ii esophageal insufflations occur more frequently during nPSV than nNAVA. Polysomnographic recordings and esophageal multichannel intraluminal impedance pHmetry were performed in nine chronically instrumented newborn lambs to study gastroesophageal refluxes, esophageal insufflations, states of alertness, laryngeal closure and respiration. Recordings were repeated without sedation in control condition, nPSV (15/4 cmH2O and nNAVA (~ 15/4 cmH2O. The number of gastroesophageal refluxes recorded over six hours, expressed as median (interquartile range, decreased during both nPSV (1 (0, 3 and nNAVA [1 (0, 3] compared to control condition (5 (3, 10, (p < 0.05. Meanwhile, the esophageal insufflation index did not differ between nPSV (40 (11, 61 h-1 and nNAVA (10 (9, 56 h-1 (p = 0.8. In conclusion, nPSV and nNAVA similarly inhibit gastroesophageal refluxes in healthy newborn lambs at pressures that do not lead to gastric distension. In addition, the occurrence of esophageal insufflations is not significantly different between nPSV and nNAVA. The strong inhibitory effect of nIPPV on gastroesophageal refluxes appears identical to that reported with nasal continuous positive airway pressure.

  9. The association of alcohol outlet density with illegal underage adolescent purchasing of alcohol.

    Science.gov (United States)

    Rowland, Bosco; Toumbourou, John W; Livingston, Michael

    2015-02-01

    Although previous studies have suggested that greater community densities of alcohol sales outlets are associated with greater alcohol use and problems, the mechanisms are unclear. The present study examined whether density was associated with increased purchasing of alcohol by adolescents younger than the legal purchase age of 18 in Australia. The number of alcohol outlets per 10,000 population was identified within geographic regions in Victoria, Australia. A state-representative student survey (N = 10,143) identified adolescent reports of purchasing alcohol, and multilevel modeling was then used to predict the effects for different densities of outlet types (packaged, club, on-premise, general, and overall). Each extra sales outlet per 10,000 population was associated with a significant increase in the risk of underage adolescent purchasing. The strongest effect was for club density (odds ratio = 1.22) and packaged (takeaway) outlet density (odds ratio = 1.12). Males, older children, smokers, and those with substance-using friends were more likely to purchase alcohol. One mechanism by which alcohol sales outlet density may influence population rates of alcohol use and related problems is through increasing the illegal underage purchasing of alcohol. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. Using public health and community partnerships to reduce density of alcohol outlets.

    Science.gov (United States)

    Jernigan, David H; Sparks, Michael; Yang, Evelyn; Schwartz, Randy

    2013-04-11

    Excessive alcohol use causes approximately 80,000 deaths in the United States each year. The Guide to Community Preventive Services recommends reducing the density of alcohol outlets - the number of physical locations in which alcoholic beverages are available for purchase either per area or per population - through the use of regulatory authority as an effective strategy for reducing excessive alcohol consumption and related harms. We briefly review the research on density of alcohol outlets and public health and describe the powers localities have to influence alcohol outlet density. We summarize Regulating Alcohol Outlet Density: An Action Guide, which describes steps that local communities can take to reduce outlet density and the key competencies and resources of state and local health departments. These include expertise in public health surveillance and evaluation methods, identification and tracking of outcome measures, geographic information systems (GIS) mapping, community planning and development of multisector efforts, and education of community leaders and policy makers. We illustrate the potential for partnerships between public health agencies and local communities by presenting a contemporary case study from Omaha, Nebraska. Public health agencies have a vital and necessary role to play in efforts to reduce alcohol outlet density. They are often unaware of the potential of this strategy and have strong potential partners in the thousands of community coalitions nationwide that are focused on reducing alcohol-related problems.

  11. Development of a solenoid actuated planar valveless micropump with single and multiple inlet-outlet arrangements

    Science.gov (United States)

    Kumar, N.; George, D.; Sajeesh, P.; Manivannan, P. V.; Sen, A. K.

    2016-07-01

    We report a planar solenoid actuated valveless micropump with multiple inlet-outlet configurations. The self-priming characteristics of the multiple inlet-multiple outlet micropump are studied. The filling dynamics of the micropump chamber during start-up and the effects of fluid viscosity, voltage and frequency on the dynamics are investigated. Numerical simulations for multiple inlet-multiple outlet micropumps are carried out using fluid structure algorithm. With DI water and at 5.0 Vp-p, 20 Hz frequency, the two inlet-two outlet micropump provides a maximum flow rate of 336 μl min-1 and maximum back pressure of 441 Pa. Performance characteristics of the two inlet-two outlet micropump are studied for aqueous fluids of different viscosity. Transport of biological cell lines and diluted blood samples are demonstrated; the flow rate-frequency characteristics are studied. Viability of cells during pumping with multiple inlet multiple outlet configuration is also studied in this work, which shows 100% of cells are viable. Application of the proposed micropump for simultaneous pumping, mixing and distribution of fluids is demonstrated. The proposed integrated, standalone and portable micropump is suitable for drug delivery, lab-on-chip and micro-total-analysis applications.

  12. The prospects of making small retail outlets in the Townships aggressively competitive

    Directory of Open Access Journals (Sweden)

    Malefane Johannes Lebusa

    2013-12-01

    Full Text Available Historically, township Small Retail Outlets were mostly established for survival and operated under a generally closed market system where the competition was not very strong. However, with the advent of democracy many people lost their formal income through retrenchments and out of desperation, many of these people opened Small Retail Outlets thus most of the existing and new entrants into the township market were unskilled or semiskilled labourers with little or no formal skills in business or entrepreneurship. Such efforts were rarely guided by any specific and informed strategy of identifying and exploiting a gap in the market. With the consolidation of the free market system under democracy, big brand businesses such as Shoprite Checkers and Small Retail Outlets of foreign nationals with different strategies entered and competed in this township market. With fewer formal skills in business and entrepreneurship, the owners of the Small Retail Outlets struggled to compete and thrive under these relatively new economic conditions. Given this situation, I conducted semi-structured interviews with fifteen of these traditional Small Retail Outlets to find out and better understand the challenges they face and the skills that might be needed to aggressively compete in this space. Based on these findings and understandings, I further examined these issues and suggest infusions of specific entrepreneurship skills that could develop their aggressive competitiveness. Keywords: entrepreneurship, competitiveness, small retail outlets, shopping complexes, innovation

  13. Photoluminescence intermittency of semiconductor quantum dots in dielectric environments

    Energy Technology Data Exchange (ETDEWEB)

    Isaac, A.

    2006-08-11

    The experimental studies presented in this thesis deal with the photoluminescence intermittency of semiconductor quantum dots in different dielectric environments. Detailed analysis of intermittency statistics from single capped CdSe/ZnS, uncapped CdSe and water dispersed CdSe/ZnS QDs in different matrices provide experimental evidence for the model of photoionization with a charge ejected into the surrounding matrix as the source of PL intermittency phenomenon. We propose a self-trapping model to explain the increase of dark state lifetimes with the dielectric constant of the matrix. (orig.)

  14. Intermittent fasting: a "new" historical strategy for controlling seizures?

    Science.gov (United States)

    Hartman, Adam L; Rubenstein, James E; Kossoff, Eric H

    2013-05-01

    In antiquity, fasting was a treatment for epilepsy and a rationale for the ketogenic diet (KD). Preclinical data indicate the KD and intermittent fasting do not share identical anticonvulsant mechanisms. We implemented an intermittent fasting regimen in six children with an incomplete response to a KD. Three patients adhered to the combined intermittent fasting/KD regimen for 2 months and four had transient improvement in seizure control, albeit with some hunger-related adverse reactions. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Characterization of fasted human gastric fluid for relevant rheological parameters and gastric lipase activities

    DEFF Research Database (Denmark)

    Pedersen, Pernille Barbre; Vilmann, Peter; Bar-Shalom, Daniel

    2013-01-01

    be considered important during development of gastric simulated media. Further, the activity of the HGL is active even under fasted gastric conditions and might contribute to the digestion and emulsification of lipid-based drug delivery systems in the entire gastrointestinal tract. HGL should therefore......PURPOSE: To characterize human gastric fluid with regard to rheological properties and gastric lipase activity. In addition, traditional physicochemical properties were determined. METHODS: Fasted HGA were collected from 19 healthy volunteers during a gastroscopic examination. Rheological...... be considered in gastric evaluation of lipid-based drug delivery systems....

  16. Intermittent Renewable Management Pilot Phase 2

    Energy Technology Data Exchange (ETDEWEB)

    Kiliccote, Sila [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Homan, Gregory [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Anderson, Robert [Olivine, Inc., San Ramon, CA (United States); Hernandez, John [Pacific Gas & Electric Company, San Francisco, CA (United States)

    2015-04-01

    The Intermittent Renewable Management Pilot - Phase 2 (IRM2) was designed to study the feasibility of demand-side resources to participate into the California Independent System Operator (CAISO) wholesale market as proxy demand resources (PDR). The pilot study focused on understanding the issues related with direct participation of third-parties and customers including customer acceptance; market transformation challenges (wholesale market, technology); technical and operational feasibility; and value to the rate payers, DR resource owners and the utility on providing an enabling mechanism for DR resources into the wholesale markets. The customer had the option of committing to either three contiguous hour blocks for 24 days or six contiguous hours for 12 days a month with day-ahead notification that aligned with the CAISO integrated forward market. As a result of their being available, the customer was paid $10/ kilowatt (kW)-month for capacity in addition to CAISO energy settlements. The participants were limited to no more than a 2 megawatt (MW) capacity with a six-month commitment. Four participants successfully engaged in the pilot. In this report, we provide the description of the pilot, participant performance results, costs and value to participants as well as outline some of the issues encountered through the pilot. Results show that participants chose to participate with storage and the value of CAISO settlements were significantly lower than the capacity payments provided by the utility as incentive payments. In addition, this pilot revealed issues both on the participant side and system operations side. These issues are summarized in the report.The Intermittent Renewable Management Pilot - Phase 2 (IRM2) was designed to study the feasibility of demand-side resources to participate into the California Independent System Operator (CAISO) wholesale market as proxy demand resources (PDR). The pilot study focused on understanding the issues related with

  17. The role of gastric scintigraphy in primary or post surgical disorders of gastric emptying

    International Nuclear Information System (INIS)

    Jian, R.; Lemann, M.; Rain, J.D.

    1996-01-01

    Gastric scintigraphy is the gold standard for the measurement of the gastric emptying of a meal because of its reliability and its reproducibility and the respect of physiological conditions. Moreover, this technique allows to measure the emptying of solid and liquid phases simultaneously. Symptoms motivating a gastric scintigraphy, suggest either a gastric stasis (dyspepsia) or a gastric incontinence (dumping syndrome). The two most frequent clinical conditions triggering this test are motility disorders following vagotomy, a delayed emptying of solids is often associated to an accelerated emptying of liquids. Gastric scintigraphy proves quite useful in these conditions, since the diagnosis of such complex abnormalities is uneasy to establish exclusively on a clinical basis. In idiopathic dyspepsia, gastric stasis is proved only in 50 % of the patients. However, a radionuclide study of gastric emptying is seldom ordered because of the common character and good tolerance of these symptoms. In everyday practice, gastric scintigraphy is considered only when gastric or intestinal obstructive lesions have been ruled out. A suggestive clinical picture and/or absence of a deteriorated general condition allow to prescribe a symptomatic treatment. More rarely, equivocal symptoms, degradation of the general condition and unresponsiveness to symptomatic drugs call for gastric scintigraphy. (authors). 241 refs., 2 figs

  18. Assessment of two methods of gastric decompression for the initial management of gastric dilatation-volvulus.

    Science.gov (United States)

    Goodrich, Z J; Powell, L L; Hulting, K J

    2013-02-01

    To assess gastric trocarization and orogastric tubing as a means of gastric decompression for the initial management of gastric dilatation-volvulus. Retrospective review of 116 gastric dilatation-volvulus cases from June 2001 to October 2009. Decompression was performed via orogastric tubing in 31 dogs, gastric trocarization in 39 dogs and a combination of both in 46 dogs. Tubing was successful in 59 (75·5%) dogs and unsuccessful in 18 (23·4%) dogs. Trocarization was successful in 73 (86%) dogs and unsuccessful in 12 (14%) dogs. No evidence of gastric perforation was noted at surgery in dogs undergoing either technique. One dog that underwent trocarization had a splenic laceration identified at surgery that did not require treatment. Oesophageal rupture or aspiration pneumonia was not identified in any dog during hospitalization. No statistical difference was found between the method of gastric decompression and gastric compromise requiring surgical intervention or survival to discharge. Orogastric tubing and gastric trocarization are associated with low complication and high success rates. Either technique is an acceptable method for gastric decompression in dogs with gastric dilatation-volvulus. © 2013 British Small Animal Veterinary Association.

  19. Sex differences associated with intermittent swim stress.

    Science.gov (United States)

    Warner, Timothy A; Libman, Matthew K; Wooten, Katherine L; Drugan, Robert C

    2013-11-01

    Various animal models of depression have been used to seek a greater understanding of stress-related disorders. However, there is still a great need for novel research in this area, as many individuals suffering from depression are resistant to current treatment methods. Women have a higher rate of depression, highlighting the need to investigate mechanisms of sex differences. Therefore, we employed a new animal model to assess symptoms of depression, known as intermittent swim stress (ISS). In this model, the animal experiences 100 trials of cold water swim stress. ISS has already been shown to cause signs of behavioral depression in males, but has yet to be assessed in females. Following ISS exposure, we looked at sex differences in the Morris water maze and forced swim test. The results indicated a spatial learning effect only in the hidden platform task between male and female controls, and stressed and control males. A consistent spatial memory effect was only seen for males exposed to ISS. In the forced swim test, both sexes exposed to ISS exhibited greater immobility, and the same males and females also showed attenuated climbing and swimming, respectively. The sex differences could be due to different neural substrates for males and females. The goal of this study was to provide the first behavioral examination of sex differences following ISS exposure, so the stage of estrous cycle was not assessed for the females. This is a necessary future direction for subsequent experiments. The current article highlights the importance of sex differences in response to stress.

  20. Treatment of variable and intermittently flowing wastewaters.

    Science.gov (United States)

    Kocasoy, Günay

    1993-11-01

    The biological treatment of wastewaters originating from hotels and residential areas of seasonal use, flowing intermittently, is difficult due to the fact that bacteria cannot survive during periods of no-flow. An investigation has been conducted in order to develop a system which will be able to overcome the difficulties encountered. After a long investigation the following system has given satisfactory results. The wastewater was taken initially into an aeration tank operating as a sequential batch reactor. Waste was taken after the sedimentation phase of the reactor into a coagulation-flocculation tank where it was treated by chemical means, and then settled in order to separate the floes. When the population of bacteria in the aeration tank reached the required level, the physico-chemical treatment was terminated and the tank used for chemical treatment has been started to be used as an equalization tank while the aeration and sedimentation tanks have been used as an activated sludge unit. This system has been proved to be a satisfactory method for the above mentioned wastes.

  1. Mesoscopic fluctuations and intermittency in aging dynamics

    Science.gov (United States)

    Sibani, P.

    2006-01-01

    Mesoscopic aging systems are characterized by large intermittent noise fluctuations. In a record dynamics scenario (Sibani P. and Dall J., Europhys. Lett., 64 (2003) 8) these events, quakes, are treated as a Poisson process with average αln (1 + t/tw), where t is the observation time, tw is the age and α is a parameter. Assuming for simplicity that quakes constitute the only source of de-correlation, we present a model for the probability density function (PDF) of the configuration autocorrelation function. Beside α, the model has the average quake size 1/q as a parameter. The model autocorrelation PDF has a Gumbel-like shape, which approaches a Gaussian for large t/tw and becomes sharply peaked in the thermodynamic limit. Its average and variance, which are given analytically, depend on t/tw as a power law and a power law with a logarithmic correction, respectively. Most predictions are in good agreement with data from the literature and with the simulations of the Edwards-Anderson spin-glass carried out as a test.

  2. Long-range forecasting of intermittent streamflow

    Science.gov (United States)

    van Ogtrop, F. F.; Vervoort, R. W.; Heller, G. Z.; Stasinopoulos, D. M.; Rigby, R. A.

    2011-11-01

    Long-range forecasting of intermittent streamflow in semi-arid Australia poses a number of major challenges. One of the challenges relates to modelling zero, skewed, non-stationary, and non-linear data. To address this, a statistical model to forecast streamflow up to 12 months ahead is applied to five semi-arid catchments in South Western Queensland. The model uses logistic regression through Generalised Additive Models for Location, Scale and Shape (GAMLSS) to determine the probability of flow occurring in any of the systems. We then use the same regression framework in combination with a right-skewed distribution, the Box-Cox t distribution, to model the intensity (depth) of the non-zero streamflows. Time, seasonality and climate indices, describing the Pacific and Indian Ocean sea surface temperatures, are tested as covariates in the GAMLSS model to make probabilistic 6 and 12-month forecasts of the occurrence and intensity of streamflow. The output reveals that in the study region the occurrence and variability of flow is driven by sea surface temperatures and therefore forecasts can be made with some skill.

  3. Acute intermittent porphyria in Argentina: an update.

    Science.gov (United States)

    Cerbino, Gabriela Nora; Gerez, Esther Noemí; Varela, Laura Sabina; Melito, Viviana Alicia; Parera, Victoria Estela; Batlle, Alcira; Rossetti, María Victoria

    2015-01-01

    Porphyrias are a group of metabolic diseases that arise from deficiencies in the heme biosynthetic pathway. A partial deficiency in hydroxymethylbilane synthase (HMBS) produces a hepatic disorder named Acute Intermittent Porphyria (AIP); the acute porphyria is more frequent in Argentina. In this paper we review the results obtained for 101 Argentinean AIP families and 6 AIP families from foreign neighbour countries studied at molecular level at Centro de Investigaciones sobre Porfirinas y Porfirias (CIPYP). Thirty-five different mutations were found, of which 14 were described for the first time in our population. The most prevalent type of mutations was the missense mutations (43%) followed by splice defects (26%) and small deletions (20%). An odd case of a double heterozygous presentation of AIP in a foreign family from Paraguay is discussed. Moreover, it can be noted that 38 new families were found carrying the most frequent mutation in Argentina (p.G111R), increasing to 55.66% the prevalence of this genetic change in our population and adding further support to our previous hypothesis of a founder effect for this mutation in Argentina. Identification of patients with an overt AIP is important because treatment depends on an accurate diagnosis, but more critical is the identification of asymptomatic relatives to avoid acute attacks which may progress to death.

  4. Long-range forecasting of intermittent streamflow

    Directory of Open Access Journals (Sweden)

    F. F. van Ogtrop

    2011-11-01

    Full Text Available Long-range forecasting of intermittent streamflow in semi-arid Australia poses a number of major challenges. One of the challenges relates to modelling zero, skewed, non-stationary, and non-linear data. To address this, a statistical model to forecast streamflow up to 12 months ahead is applied to five semi-arid catchments in South Western Queensland. The model uses logistic regression through Generalised Additive Models for Location, Scale and Shape (GAMLSS to determine the probability of flow occurring in any of the systems. We then use the same regression framework in combination with a right-skewed distribution, the Box-Cox t distribution, to model the intensity (depth of the non-zero streamflows. Time, seasonality and climate indices, describing the Pacific and Indian Ocean sea surface temperatures, are tested as covariates in the GAMLSS model to make probabilistic 6 and 12-month forecasts of the occurrence and intensity of streamflow. The output reveals that in the study region the occurrence and variability of flow is driven by sea surface temperatures and therefore forecasts can be made with some skill.

  5. Scaling, Intermittency and Decay of MHD Turbulence

    International Nuclear Information System (INIS)

    Lazarian, A.; Cho, Jungyeon

    2005-01-01

    We discuss a few recent developments that are important for understanding of MHD turbulence. First, MHD turbulence is not so messy as it is usually believed. In fact, the notion of strong non-linear coupling of compressible and incompressible motions along MHD cascade is not tenable. Alfven, slow and fast modes of MHD turbulence follow their own cascades and exhibit degrees of anisotropy consistent with theoretical expectations. Second, the fast decay of turbulence is not related to the compressibility of fluid. Rates of decay of compressible and incompressible motions are very similar. Third, viscosity by neutrals does not suppress MHD turbulence in a partially ionized gas. Instead, MHD turbulence develops magnetic cascade at scales below the scale at which neutrals damp ordinary hydrodynamic motions. Forth, density statistics does not exhibit the universality that the velocity and magnetic field do. For instance, at small Mach numbers the density is anisotropic, but it gets isotropic at high Mach numbers. Fifth, the intermittency of magnetic field and velocity are different. Both depend on whether the measurements are done in a local system of reference oriented along the local magnetic field or in the global system of reference related to the mean magnetic field

  6. A morphological and immunohistochemical evaluation of gastric ...

    African Journals Online (AJOL)

    Background: Gastric resections for carcinoma are common, but gastric carcinoma in South Africa, and particularly within the Western Cape province, has not been well documented. Method: The objective of the study was to immunohistochemically evaluate HER2/ neu overexpression, determine aberrations in β-catenin and ...

  7. A tale of gastric layering and sieving

    NARCIS (Netherlands)

    Camps, Guido; Mars, Monica; Graaf, de Kees; Smeets, Paul A.M.

    2017-01-01

    Background: The process of gastric emptying determines how fast gastric content is delivered to the small intestine. It has been shown that solids empty slower than liquids and that a blended soup empties slower than the same soup as broth and chunks, due to the liquid fraction emptying more

  8. Characterization of Gastric Microbiota in Twins.

    Science.gov (United States)

    Dong, Quanjiang; Xin, Yongning; Wang, Lili; Meng, Xinying; Yu, Xinjuan; Lu, Linlin; Xuan, Shiying

    2017-02-01

    Contribution of host genetic backgrounds in the development of gastric microbiota has not been clearly defined. This study was aimed to characterize the biodiversity, structure and composition of gastric microbiota among twins. A total of four pairs of twins and eight unrelated individuals were enrolled in the study. Antral biopsies were obtained during endoscopy. The bacterial 16S rRNA gene was amplified and pyrosequenced. Sequences were analyzed for the composition, structure, and α and β diversities of gastric microbiota. Proteobacteria, Firmicutes, Bacteroidetes, Actinobacteria, and Fusobacteria were the most predominant phyla of gastric microbiota. Each individual, twins as well as unrelated individuals, harbored a microbiota of distinct composition. There was no evidence of additional similarity in the richness and evenness of gastric microbiota among co-twins as compared to unrelated individuals. Calculations of θ YC and PCoA demonstrated that the structure similarity of gastric microbial community between co-twins did not increase compared to unrelated individuals. In contrast, the structure of microbiota was altered enormously by Helicobacter pylori infection. These results suggest that host genetic backgrounds had little effect in shaping the gastric microbiota. This property of gastric microbiota could facilitate the studies discerning the role of microbiota from genetic grounds in the pathogenesis.

  9. Standard lymphadenectomy technique in the gastric adenocarcinoma

    International Nuclear Information System (INIS)

    Aguirre Fernandez, Roberto Eduardo; Fernandez Vazquez, Pedro Ivan; LLera Dominguez, Gerardo de la

    2012-01-01

    The surgical technique used from 1990 in the 'Celia Sanchez Manduley' Clinical Surgical Teaching Provincial Hospital in Manzanillo, Granma province to carry out the gastrectomy together with the standard lymphadenectomy in patients carriers of a gastric adenocarcinoma, allowing application of the current oncologic and surgical concepts of the Japanese Society for Research of Gastric Cancer, essential to obtain a better prognosis in these patients

  10. Gastric pain | Schellack | South African Family Practice

    African Journals Online (AJOL)

    Therefore, this article provides an overview of the aetiology, classification, risk factors, diagnostic criteria and management strategies aimed at gastric pain, and its two more distinct gastrointestinal-related manifestations, namely epigastric pain and dyspepsia. Keywords: gastric pain, epigastric pain, dyspepsia, peptic ulcer ...

  11. Gastric emptying of a solid meal

    International Nuclear Information System (INIS)

    Mannell, A.; Esser, J.D.

    1984-01-01

    A simple, non-invasive technique for measuring gastric emptying of a solid meal in clinical practice is described. Cooked chicken liver labelled with a radio-isotope is used. To establish the range of normal gastric emptying times 11 asymptomatic adults were studied. The effect of posture on solid emptying was also examined

  12. Helicobacter pylori Diversity and Gastric Cancer Risk

    Directory of Open Access Journals (Sweden)

    Timothy L. Cover

    2016-03-01

    Full Text Available Gastric cancer is a leading cause of cancer-related death worldwide. Helicobacter pylori infection is the strongest known risk factor for this malignancy. An important goal is to identify H. pylori-infected persons at high risk for gastric cancer, so that these individuals can be targeted for therapeutic intervention. H. pylori exhibits a high level of intraspecies genetic diversity, and over the past two decades, many studies have endeavored to identify strain-specific features of H. pylori that are linked to development of gastric cancer. One of the most prominent differences among H. pylori strains is the presence or absence of a 40-kb chromosomal region known as the cag pathogenicity island (PAI. Current evidence suggests that the risk of gastric cancer is very low among persons harboring H. pylori strains that lack the cag PAI. Among persons harboring strains that contain the cag PAI, the risk of gastric cancer is shaped by a complex interplay among multiple strain-specific bacterial factors as well as host factors. This review discusses the strain-specific properties of H. pylori that correlate with increased gastric cancer risk, focusing in particular on secreted proteins and surface-exposed proteins, and describes evidence from cell culture and animal models linking these factors to gastric cancer pathogenesis. Strain-specific features of H. pylori that may account for geographic variation in gastric cancer incidence are also discussed.

  13. Breed predisposition to canine gastric carcinoma

    DEFF Research Database (Denmark)

    Seim-Wikse, Tonje; Jörundsson, Einar; Nødtvedt, Ane

    2013-01-01

    Previous research has indicated a breed predisposition to gastric carcinoma in dogs. However, results to date are inconsistent since several studies have failed to prove such a predisposition. Better knowledge of breeds at risk could facilitate early detection of gastric carcinoma in dogs. The ai...

  14. Stomach (Gastric) Cancer—Patient Version

    Science.gov (United States)

    Stomach (gastric) cancer occurs when cancer cells form in the lining of the stomach. Risk factors include smoking, infection with H. pylori bacteria, and certain inherited conditions. Start here to find information on stomach (gastric) cancer treatment, causes and prevention, screening, research, and statistics.

  15. Gastric emptying of a solid meal

    Energy Technology Data Exchange (ETDEWEB)

    Mannell, A.; Esser, J.D. (University of the Witwatersrand, Johannesburg (South Africa))

    1984-09-08

    A simple, non-invasive technique for measuring gastric emptying of a solid meal in clinical practice is described. Cooked chicken liver labelled with a radio-isotope is used. To establish the range of normal gastric emptying times 11 asymptomatic adults were studied. The effect of posture on solid emptying was also examined.

  16. Calcification of peritoneal carcinomatosis from gastric carcinoma

    International Nuclear Information System (INIS)

    Matsuoka, Y.; Itai, Y.; Ohtomo, K.; Nishikawa, J.; Sasaki, Y.

    1991-01-01

    Peritoneal calcification is noted in peritoneal dissemination from serious cystoadenocarcinoma of the ovary, pseudomyxoma peritonei and meconium peritonitis. This article discusses a case of peritoneal disseminated calcification from gastric carcinoma. To the author's knowledge, this is the first report in English literature of gastric cancer showing peritoneal calcification. (author). 10 refs.; 1 fig

  17. Congenital paraesophageal hiatus hernia with gastric volvulus

    Directory of Open Access Journals (Sweden)

    Kshirsagar Ashok

    2008-01-01

    Full Text Available Paraesophageal hiatus hernia is rarely seen in the neonatal period. An intrathoracic gastric volvulus complicating such a hernia is rarer. The upper gastrointestinal tract contrast study is diagnostic. Rapid diagnosis and treatment is essential. It avoids lethal complications as gastric dilatation, gangrene and perforation, which in turn may lead to cardiopulmonary arrest.

  18. Diffuse benign gastric inflammatory hyperplastic polyps presenting ...

    African Journals Online (AJOL)

    Benign gastric inflammatory hyperplasic polyps are benign lesions that rarely occur in young age. We report a case of diffuse benign gastric inflammatory hyperplastic polyps in a 19 year old boy who presented with cough, nausea, and hematamesis. In the presented case symptoms such as nausea and vomiting are non ...

  19. Methodology for the study of gastric emptying

    International Nuclear Information System (INIS)

    Lima Ramos, P.A. de; Leal, M.A.M.

    1988-01-01

    Differents methods for the study of dynamics of the gastric flow following a critical analysis of its potencials and limitations are discussed. The methdo utilizing radiosiotopes as tracers of the standard meals for the study of the gastric flow, is presented, in detail, emphasizing the aspects that create major difficulties in its utilization. (M.A.C.) [pt

  20. Intermittency in multiparticle production analyzed by means of stochastic theories

    International Nuclear Information System (INIS)

    Bartl, A.; Suzuki, N.

    1990-01-01

    Intermittency in multiparticle production is described by means of probability distributions derived from pure birth stochastic equations. The UA1, TASSO, NA22 and cosmic ray data are analyzed. 24 refs., 1 fig. (Authors)

  1. Factors Relevant to Utility Integration of Intermittent Renewable Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Wan, Y.; Parsons, B.

    1993-08-24

    This study assesses factors that utilities must address when they integrate intermittent renewable technologies into their power-supply systems; it also reviews the literature in this area and has a bibliography containing more than 350 listings. Three topics are covered: (1) interface (hardware and design-related interconnection), (2) operability/stability, and (3) planning. This study finds that several commonly held perceptions regarding integration of intermittent renewable energy technologies are not valid. Among fmdings of the study are the following: (1) hardware and system design advances have eliminated most concerns about interface, (2) cost penalties have not occurred at low to moderate penetration levels (and high levels am feasible); and (3) intermittent renewable energy technologies can have capacity values. Obstacles still interfering with intermittent renewable technologies are also indentified.

  2. Factors relevant to utility integration of intermittent renewable technologies

    Energy Technology Data Exchange (ETDEWEB)

    Wan, Yih-huei; Parsons, B.K.

    1993-08-01

    This study assesses factors that utilities must address when they integrate intermittent renewable technologies into their power-supply systems; it also reviews the literature in this area and has a bibliography containing more than 350 listings. Three topics are covered: (1) interface (hardware and design-related interconnection), (2) operability/stability, and (3) planning. This study finds that several commonly held perceptions regarding integration of intermittent renewable energy technologies are not valid. Among findings of the study are the following: (1) hardware and system design advances have eliminated most concerns about interface; (2) cost penalties have not occurred at low to moderate penetration levels (and high levels are feasible); and (3) intermittent renewable energy technologies can have capacity values. Obstacles still interfering with intermittent renewable technologies are also identified.

  3. Isolated intermittent vertigo: A presenting feature of persistent trigeminal artery

    Directory of Open Access Journals (Sweden)

    Rajsrinivas Parthasarathy

    2016-01-01

    Full Text Available Embryonic carotid – basilar anastomosis when persistent in adult life can present with a variety of neurological symptoms. We present a patient with isolated intermittent vertigo attributable to the embryonic anastomosis and describe the different types of persistent trigeminal artery. A 76-year-old Caucasian man presented with isolated intermittent vertigo and symptoms suggestive of anterior and posterior circulation strokes. Impaired vasomotor reactivity was demonstrated on insonation of the anterior and posterior cerebral arteries in this patient with a persistent left trigeminal artery and 75% stenosis of the left internal carotid artery (ICA. The symptom of intermittent vertigo resolved with carotid endarterectomy. Decreased flow across the stenotic segment of the ICA which subserved the posterior circulation resulted in basilar insufficiency. Hypoperfusion to the flocculonodular lobe supplied by the anterior inferior cerebellar artery is a likely cause for the intermittent vertigo.

  4. Composeable Chat over Low-Bandwidth Intermittent Communication Links

    National Research Council Canada - National Science Library

    Wilcox, D. R

    2007-01-01

    Intermittent low-bandwidth communication environments, such as those encountered in U.S. Navy tactical radio and satellite links, have special requirements that do not pertain to commercial applications...

  5. Sliding Intermittent Control for BAM Neural Networks with Delays

    Directory of Open Access Journals (Sweden)

    Jianqiang Hu

    2013-01-01

    Full Text Available This paper addresses the exponential stability problem for a class of delayed bidirectional associative memory (BAM neural networks with delays. A sliding intermittent controller which takes the advantages of the periodically intermittent control idea and the impulsive control scheme is proposed and employed to the delayed BAM system. With the adjustable parameter taking different particular values, such a sliding intermittent control method can comprise several kinds of control schemes as special cases, such as the continuous feedback control, the impulsive control, the periodically intermittent control, and the semi-impulsive control. By using analysis techniques and the Lyapunov function methods, some sufficient criteria are derived for the closed-loop delayed BAM neural networks to be globally exponentially stable. Finally, two illustrative examples are given to show the effectiveness of the proposed control scheme and the obtained theoretical results.

  6. Computing moving and intermittent queue propagation in highway work zones.

    Science.gov (United States)

    2012-07-01

    Drivers may experience intermittent congestion and moving queue conditions in work zones due to several reasons such as presence of lane closure, roadway geometric changes, higher demand, lower speed, and reduced capacity. The congestion and queue ha...

  7. Sensing and characterization of EMI during intermittent connector anomalies

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper presents a new on-line methodology for detecting intermittent disconnection failures. The detection principle operates on the fundamental Lorentz Law that...

  8. Boldness and intermittent locomotion in the bluegill sunfish, Lepomis macrochirus

    OpenAIRE

    Alexander D.M. Wilson; Jean-Guy J. Godin

    2009-01-01

    Intermittent locomotion, characterized by moves interspersed with pauses, is a common pattern of locomotion in animals, but its ecological and evolutionary significance relative to continuous locomotion remains poorly understood. Although many studies have examined individual differences in both intermittent locomotion and boldness separately, to our knowledge, no study to date has investigated the relationship between these 2 traits. Characterizing and understanding this relationship is impo...

  9. Intermittent Hypoxic Episodes in Preterm Infants: Do They Matter?

    OpenAIRE

    Martin, Richard J.; Wang, Katherine; Köroğlu, Özge; Di Fiore, Juliann; Kc, Prabha

    2011-01-01

    Intermittent hypoxic episodes are typically a consequence of immature respiratory control and remain a troublesome challenge for the neonatologist. Furthermore, their frequency and magnitude are underestimated by clinically employed pulse oximeter settings. In extremely low birth weight infants the incidence of intermittent hypoxia progressively increases over the first 4 weeks of postnatal life, with a subsequent plateau followed by a slow decline beginning at weeks 6–8. Such episodic hypoxi...

  10. Mobility and cloud: operating in intermittent, austere network conditions

    OpenAIRE

    Wee, Toon Joo; Ling, Yu Xian Eldine

    2014-01-01

    Approved for public release; distribution is unlimited Cloud computing is emerging as the mainstream platform for a range of on-demand applications, services, and infrastructure. Before the benefits of cloud computing are realized, several technology challenges must be addressed. Operating in intermittent and austere network conditions is one of such challenges, which navy ships face when communicating with land-based cloud computing environments. Given limited bandwidth and intermittent c...

  11. The impact of the tobacco retail outlet environment on adult cessation and differences by neighborhood poverty.

    Science.gov (United States)

    Cantrell, Jennifer; Anesetti-Rothermel, Andrew; Pearson, Jennifer L; Xiao, Haijun; Vallone, Donna; Kirchner, Thomas R

    2015-01-01

    This study examined the impact of tobacco retail outlets on cessation outcomes over time among non-treatment-seeking smokers and assessed differences by neighborhood poverty and individual factors. Observational longitudinal cohort study using geospatial data. We used generalized estimating equations to examine cessation outcomes in relation to the proximity and density of tobacco retail outlets near the home. Eight large Designated Media Areas across the United States. A total of 2377 baseline smokers followed over three waves from 2008 to 2010. Outlet addresses were identified through North American Industry Classification System codes and proximity and density measures were constructed for each participant at each wave. Outcomes included past 30-day abstinence and pro-cessation attitudes. Smokers in high poverty census tracts living between 500 m and 1.9 km from an outlet were over two times more likely to be abstinent than those living fewer than 500 m from an outlet (P < 0.05). Density within 500 m of home was associated with reduced abstinence [odds ratio (OR) = 0.94; confidence interval (CI) = 0.90, 0.98) and lower pro-cessation attitudes (Coeff = -0.07, CI = -0.10, -0.03) only in high poverty areas. In low poverty areas, density within 500 m was associated with greater pro-cessation attitudes (OR = 0.06; CI = 0.01, 0.12). Gender, education and heaviness of smoking did not moderate the impact of outlet proximity and density on cessation outcomes. In the United States, density of tobacco outlets within 500 m of the home residence appears to be negatively associated with smoking abstinence and pro-cessation attitudes only in poor areas. © 2014 Society for the Study of Addiction.

  12. The epidemiology of gastric cancer.

    Science.gov (United States)

    Roder, David M

    2002-01-01

    Gastric cancer mortality has declined markedly around the world. In South Australia, the reduction approximated 40% over the last 20 years. Possible reasons include: better refrigeration; reduced consumption of salted, smoked, and chemically preserved foods; increased intake of fruit and vegetables; and improved living standards and a greater use of antibiotics, which may have reduced Helicobacter pylori infection. Reductions generally have been greater for intestinal than diffuse histopathologies. Gastric cancer remains the second leading cause of cancer death worldwide, probably accounting for about 10% of newly diagnosed cancers. High rates apply to Japan, China. Central and South America, Eastern Europe, and parts of the Middle East, and low rates to North America, Australia and New Zealand, Northern Europe, and India. Rates usually are higher in lower socioeconomic groups. Five-year relative survivals of around 20% or less are frequently reported. A figure of 50% or more has been cited for Japan, where there has been radiological screening, although this exceptional figure could have been affected artificially by lead-time and related effects. Male-to-female incidence ratios generally are in the 1.5-2.5 range, with higher ratios for intestinal than diffuse cancers and higher-risk populations. In South Australia, the ratio has been 1.8 to one, although higher at 4.6 to one for cardia lesions. Recent increases in cardia cancers, especially in males in populations of European extraction, often are accompanied by increases for esophageal adenocarcinoma. It is estimated that the global burden of gastric cancer could be reduced by up to 50% by dietary changes that included an increased intake of fruit and vegetables.

  13. Randomized trial of intermittent or continuous amnioinfusion for variable decelerations.

    Science.gov (United States)

    Rinehart, B K; Terrone, D A; Barrow, J H; Isler, C M; Barrilleaux, P S; Roberts, W E

    2000-10-01

    To determine whether continuous or intermittent bolus amnioinfusion is more effective in relieving variable decelerations. Patients with repetitive variable decelerations were randomized to an intermittent bolus or continuous amnioinfusion. The intermittent bolus infusion group received boluses of 500 mL of normal saline, each over 30 minutes, with boluses repeated if variable decelerations recurred. The continuous infusion group received a bolus infusion of 500 mL of normal saline over 30 minutes and then 3 mL per minute until delivery occurred. The ability of the amnioinfusion to abolish variable decelerations was analyzed, as were maternal demographic and pregnancy outcome variables. Power analysis indicated that 64 patients would be required. Thirty-five patients were randomized to intermittent infusion and 30 to continuous infusion. There were no differences between groups in terms of maternal demographics, gestational age, delivery mode, neonatal outcome, median time to resolution of variable decelerations, or the number of times variable decelerations recurred. The median volume infused in the intermittent infusion group (500 mL) was significantly less than that in the continuous infusion group (905 mL, P =.003). Intermittent bolus amnioinfusion is as effective as continuous infusion in relieving variable decelerations in labor. Further investigation is necessary to determine whether either of these techniques is associated with increased occurrence of rare complications such as cord prolapse or uterine rupture.

  14. Sinusoidal visuomotor tracking: intermittent servo-control or coupled oscillations?

    Science.gov (United States)

    Russell, D M; Sternad, D

    2001-12-01

    In visuomotor tasks that involve accuracy demands, small directional changes in the trajectories have been taken as evidence of feedback-based error corrections. In the present study variability, or intermittency, in visuomanual tracking of sinusoidal targets was investigated. Two lines of analyses were pursued: First, the hypothesis that humans fundamentally act as intermittent servo-controllers was re-examined, probing the question of whether discontinuities in the movement trajectory directly imply intermittent control. Second, an alternative hypothesis was evaluated: that rhythmic tracking movements are generated by entrainment between the oscillations of the target and the actor, such that intermittency expresses the degree of stability. In 2 experiments, participants (N = 6 in each experiment) swung 1 of 2 different hand-held pendulums, tracking a rhythmic target that oscillated at different frequencies with a constant amplitude. In 1 line of analyses, the authors tested the intermittency hypothesis by using the typical kinematic error measures and spectral analysis. In a 2nd line, they examined relative phase and its variability, following analyses of rhythmic interlimb coordination. The results showed that visually guided corrective processes play a role, especially for slow movements. Intermittency, assessed as frequency and power components of the movement trajectory, was found to change as a function of both target frequency and the manipulandum's inertia. Support for entrainment was found in conditions in which task frequency was identical to or higher than the effector's eigenfrequency. The results suggest that it is the symmetry between task and effector that determines which behavioral regime is dominant.

  15. Uncoupling of Vascular Nitric Oxide Synthase Caused by Intermittent Hypoxia

    Directory of Open Access Journals (Sweden)

    Mohammad Badran

    2016-01-01

    Full Text Available Objective. Obstructive sleep apnea (OSA, characterized by chronic intermittent hypoxia (CIH, is often present in diabetic (DB patients. Both conditions are associated with endothelial dysfunction and cardiovascular disease. We hypothesized that diabetic endothelial dysfunction is further compromised by CIH. Methods. Adult male diabetic (BKS.Cg-Dock7m +/+ Leprdb/J (db/db mice (10 weeks old and their heterozygote littermates were subjected to CIH or intermittent air (IA for 8 weeks. Mice were separated into 4 groups: IA (intermittent air nondiabetic, IH (intermittent hypoxia nondiabetic, IADB (intermittent air diabetic, and IHDB (intermittent hypoxia diabetic groups. Endothelium-dependent and endothelium-independent relaxation and modulation by basal nitric oxide (NO were analyzed using wire myograph. Plasma 8-isoprostane, interleukin-6 (IL-6, and asymmetric dimethylarginine (ADMA were measured using ELISA. Uncoupling of eNOS was measured using dihydroethidium (DHE staining. Results. Endothelium-dependent vasodilation and basal NO production were significantly impaired in the IH and IADB group compared to IA group but was more pronounced in IHDB group. Levels of 8-isoprostane, IL-6, ADMA, and eNOS uncoupling were ≈2-fold higher in IH and IADB groups and were further increased in the IHDB group. Conclusion. Endothelial dysfunction is more pronounced in diabetic mice subjected to CIH compared to diabetic or CIH mice alone. Oxidative stress, ADMA, and eNOS uncoupling were exacerbated by CIH in diabetic mice.

  16. Inactivation of Smad4 in gastric carcinomas.

    Science.gov (United States)

    Powell, S M; Harper, J C; Hamilton, S R; Robinson, C R; Cummings, O W

    1997-10-01

    Allelic loss of chromosome 18q has been noted in intestinal type gastric adenocarcinomas. Smad4 is a gene located at 18q that was recently cloned in humans and found to be significantly altered in pancreatic cancers. We sought to determine whether Smad4 genetic alterations played a significant role in gastric tumorigenesis by studying 35 gastric adenocarcinomas of all histopathological types and pathological stages. Microdissected specimens were used for mutational analysis of Smad4 at the nucleotide level, including the entire coding region and intron/exon boundaries. Allelic imbalance was also analyzed at the Smad4 locus using two nearby microsatellite markers. One case of apparent biallelic inactivation of Smad4 was found in our study of 35 gastric carcinomas. A nonsense point mutation at codon 334 was demonstrated, which, similar to other Smad4 mutations, is predicted to truncate the conserved COOH-terminal domain of this protein. This Smad4 C to T transition mutation was proven to be somatically acquired. Allelic loss was also noted on chromosome 18q at a marker near Smad4 in this mutated gastric cancer, apparently producing complete inactivation of Smad4 in this tumor. Significant 18q allelic loss (56% of 34 informative cases) was noted in our gastric carcinomas using microsatellite markers near the Smad4 locus, regardless of histological subtype or pathological stage. Additionally, three cases of microsatellite instability were observed. Thus, Smad4 inactivation was noted in our gastric carcinomas; however, this event was rare. The frequent loss of chromosomal arm 18q observed in gastric cancers suggests the presence of other tumor suppressor genes in this region that are involved in gastric tumorigenesis. Further studies are needed to identify these other targets of inactivation during gastric cancer development.

  17. Incidence of ascariasis in gastric carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Woo; Rhee, Hak Song; Bahk, Yong Whee [St Mary' s Hospital Catholic Medical College, Seoul (Korea, Republic of)

    1972-09-15

    Prompted by the finding that the radiological incidence of small bowel ascariasis in the patient with gastric carcinoma was unexpectedly lower than the incidence in the normal population, a clinical study was performed to investigate possible relationship between gastric carcinoma and intestinal ascariasis. As a preliminary survey, we reviewed the radiological incidence of ascariasis in a total of 2,446 cases of upper GI series performed at the Department of Radiology, St Mary's Hospital Catholic Medical College. These included 1,573 normal subjects, 146 gastric carcinoma patients, 100 benign gastric ulcer and 249 duodenal ulcer patients and 378 other upper GI diseases. Following the preliminary study, a more accurate parasitologic study was conducted in another 578 normal subjects and 51 gastric carcinoma patients. The radiological incidences of ascaiasis in normal subjects and gastric carcinoma patients were 15.1% and 28.1%, respectively. The incidence of overall helminthiasis including ascaris lumbricoides, trichocephalus trichiurus and trichostrongyloides orientalis in normal subjects of the present series was 73.5%. This figure is virtually the same with 69.1% of the general population incidence reported by Kim, et al. (1971), but the incidence in gastric carcinoma patients was 94.1%. The high incidence pattern of overall helminthiasis in gastric carcinoma patients is, however, reversed as for as ascariasis is concerned. Thus, the incidence of ascariasis of gastric carcinoma patients was much lower than that of normal subjects (9.8% vs 19.4%). From the present observation, it is postulated that there can be some possible antagonistic relationship between evolution of gastric carcinoma and small bowel infestation of ascaris lumbricoides.

  18. Incidence of ascariasis in gastric carcinoma

    International Nuclear Information System (INIS)

    Kim, Jong Woo; Rhee, Hak Song; Bahk, Yong Whee

    1972-01-01

    Prompted by the finding that the radiological incidence of small bowel ascariasis in the patient with gastric carcinoma was unexpectedly lower than the incidence in the normal population, a clinical study was performed to investigate possible relationship between gastric carcinoma and intestinal ascariasis. As a preliminary survey, we reviewed the radiological incidence of ascariasis in a total of 2,446 cases of upper GI series performed at the Department of Radiology, St Mary's Hospital Catholic Medical College. These included 1,573 normal subjects, 146 gastric carcinoma patients, 100 benign gastric ulcer and 249 duodenal ulcer patients and 378 other upper GI diseases. Following the preliminary study, a more accurate parasitologic study was conducted in another 578 normal subjects and 51 gastric carcinoma patients. The radiological incidences of ascaiasis in normal subjects and gastric carcinoma patients were 15.1% and 28.1%, respectively. The incidence of overall helminthiasis including ascaris lumbricoides, trichocephalus trichiurus and trichostrongyloides orientalis in normal subjects of the present series was 73.5%. This figure is virtually the same with 69.1% of the general population incidence reported by Kim, et al. (1971), but the incidence in gastric carcinoma patients was 94.1%. The high incidence pattern of overall helminthiasis in gastric carcinoma patients is, however, reversed as for as ascariasis is concerned. Thus, the incidence of ascariasis of gastric carcinoma patients was much lower than that of normal subjects (9.8% vs 19.4%). From the present observation, it is postulated that there can be some possible antagonistic relationship between evolution of gastric carcinoma and small bowel infestation of ascaris lumbricoides

  19. Gastroesophageal reflux and gastric emptying

    International Nuclear Information System (INIS)

    Rosen, P.; Treves, S.T.

    1985-01-01

    Gastroesophageal reflux (GER) may be defined as a dysfunction of the distal esophagus causing return of gastric contents into the esophagus. GER is a rather common problem during infancy, with an incidence estimated as 1 in 500 infants. Several methods are available to diagnose and quantitate GER. These include fluoroscopy after barium feedings, in conjunction with an upper gastrointestinal series; esophageal manometry; endoscopy; pH probe monitoring, in conjunction with a Tuttle Test; and extended pH probe evaluation for a 24-h period. Gastroesophageal scintigraphy has been advocated as an alternative noninvasive study requiring no sedation. Scintigraphy offers the advantages of prolonged observation, high sensitivity, and low radiation exposure

  20. Gastritis, nitrosamines, and gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Stemmermann, G.N.; Mower, H.

    1981-01-01

    Gastritis is associated with peptic ulcer, gastroenterostomy, pernicious anemia, and exposure to nitrosamines. Once established, the process may be self-perpetuating, resulting in atrophy, metaplasia, dysplasia, and neoplasia. This can be explained by the process of endogenous nitrosation of amines in the inflamed gastric mucosa. Evidence is presented to support this hypothesis. Several drugs given parenterally have been identified as mutagenic nitroso compounds in homogenates of human and canine antral mucosa. Nitrite for this process is apparently derived from the inflamed mucosa. Different amines appear to be nitrosated at different places in the antrum, suggesting the presence of site-specific enzymes that control these reactions.