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Sample records for multiple jejunal diverticulosis

  1. A Rare Cause of Acute Abdomen: Jejunal Diverticulosis with Perforation

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    Ibrahim Aydin

    2013-01-01

    Full Text Available Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.

  2. A rare cause of acute abdomen: jejunal diverticulosis with perforation.

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

    2013-01-01

    Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.

  3. Primarily Proximal Jejunal Stone Causing Enterolith Ileus in a Patient without Evidence of Cholecystoenteric Fistula or Jejunal Diverticulosis.

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    Abtar, Houssam Khodor; Mneimneh, Mostapha; Hammoud, Mazen M; Zaaroura, Ahmed; Papas, Yasmina S

    2016-01-01

    Stone formation within the intestinal lumen is called enterolith. This stone can encroach into the lumen causing obstruction and surgical emergency. Jejunal obstruction by an enterolith is a very rare entity and often missed preoperatively. To our knowledge, most cases of jejunal obstruction, secondary to stone, were associated with biliary disease (cholecystoenteric fistula), bezoar, jejunal diverticulosis, or foreign body. Hereby we present a rare case report of small bowel obstruction in an elderly man who was diagnosed lately to have primary proximal jejunal obstruction by an enterolith without evidence of a cholecystoenteric fistula or jejunal diverticulosis. This patient underwent laparotomy, enterotomy with stone extraction, and subsequent primary repair of the bowel.

  4. Jejunal Diverticulosis Presented with Acute Abdomen and Diverticulitis Complication: A Case Report

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    Fidan, Nurdan; Mermi, Esra Ummuhan; Acay, Mehtap Beker; Murat, Muammer; Zobaci, Ethem

    2015-01-01

    Jejunal diverticulosis is a rare, usually asymptomatic disease. Its incidence increases with age. If symptomatic, diverticulosis may cause life-threatening acute complications such as diverticulitis, perforation, intestinal hemorrhage and obstruction. In this report, we aimed to present a 67-year-old male patient with jejunal diverticulitis accompanying with abdominal pain and vomiting. A 67-year-old male patient complaining of epigastric pain for a week and nausea and fever for a day presented to our emergency department. Ultrasonographic examination in our clinic revealed diverticulum-like images with thickened walls adjacent to the small intestine loops, and increase in the echogenicity of the surrounding mesenteric fat tissue. Contrast-enhanced abdominal computed tomography showed multiple diverticula, thickened walls with showing contrast enhancement and adjacent jejunum in the left middle quadrant, increased density of the surrounding mesenteric fat tissue, and mesenteric lymph nodes. The patient was hospitalized by general surgery department with the diagnosis of jejunal diverticulitis. Conservative intravenous fluid administration and antibiotic therapy were initiated. Clinical symptoms regressed and the patient was discharged from hospital after 2 weeks. In cases of diverticulitis it should be kept in mind that in patients with advanced age and pain in the left quadrant of the abdomen, diverticular disease causing mortality and morbidity does not always originate from the colon but might also originate from the jejunum

  5. Primarily Proximal Jejunal Stone Causing Enterolith Ileus in a Patient without Evidence of Cholecystoenteric Fistula or Jejunal Diverticulosis

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    Houssam Khodor Abtar

    2016-01-01

    Full Text Available Stone formation within the intestinal lumen is called enterolith. This stone can encroach into the lumen causing obstruction and surgical emergency. Jejunal obstruction by an enterolith is a very rare entity and often missed preoperatively. To our knowledge, most cases of jejunal obstruction, secondary to stone, were associated with biliary disease (cholecystoenteric fistula, bezoar, jejunal diverticulosis, or foreign body. Hereby we present a rare case report of small bowel obstruction in an elderly man who was diagnosed lately to have primary proximal jejunal obstruction by an enterolith without evidence of a cholecystoenteric fistula or jejunal diverticulosis. This patient underwent laparotomy, enterotomy with stone extraction, and subsequent primary repair of the bowel.

  6. Togetherness of the Multiple Diverticulosis of the First Part of the Duodenum with Neurofibromatosis Type I: A Case Report

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    Ozgur Turk

    2014-04-01

    Full Text Available Duedonal diverticulosis is common in clinical practice. Most of duedonal diverticulosis is located at the second part of duodenum; incidence is reported as 67%, incidence of third and forth part is %20. Multiple diverticulosis of the first part of the duodenum is a rare case. There is not any knowledge togetherness of neurofibromatosis type 1 and duedonal diverticulosis. Here we reported incidentally diagnosed multiple diverticulosis of duodenum that is located in the first part in a neurofibromatosis type 1 patient with multiple neurofibromatosis nodules. Neurofibromatosis could affect various organs. Along the digestive system carcinoid tumors and neuroendocrine tumors are more encountered diseases. Endoscopic examinations and abdominal imaging may be useful for the diagnosis of gastrointestinal coexisting disease in neurofibromatosis type 1 . In conclusion neurofibromatosis type 1 could affect multiple systems and it should evaluate carefully.

  7. Analysis of age, sex, location, size and multiplicity of colonic diverticulosis in Korean

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    Son, Mi Young; Chang, Jae Chun; Kwoen, Hyuk Po; Jung, Kyung Hwa; Byun, Woo Mok; Kim, Sun Yong; Hwang, Mi Soo; Park, Bok Hwan

    1989-01-01

    Recently, colonic diverticulosis in Korea is one of rapidly increased disease in its incidence but it is different from that of western counties in the incidence or developing pattern. So, authors reviewed 1921 cases of double contrast study performed during 20 months, from Jan 1st , 1987 to Aug 30th, 1988 at the Department of Radiology. Yeungnam University Hospital to analyzed current disease pattern of the colonic diverticulosis. The results were as follows; 1. The incidence were 11.8%(226/1921) and predominant in male. 2. The mean age of patients was 48.41 years and older in female, but their incidence was not increased with advancing age over 6th decade. 3. The mean number of diverticular was 7.6 and higher in cases involving several anatomic location than limited to one location. 4. Diverticulosis more commonly involved several anatomic location than one location. 5. Left sided colonic diverticulosis was found in relatively older age group and more frequently involved descending colon than sigmoid colon most commonly seen in western people. 6. Recently, the incidence of colonic diverticulosis is increasing in both the right and left colon, which is thought to be due to various factors and partly to the routine use of double contrast study of the colon

  8. Analysis of age, sex, location, size and multiplicity of colonic diverticulosis in Korean

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    Son, Mi Young; Chang, Jae Chun; Kwoen, Hyuk Po; Jung, Kyung Hwa; Byun, Woo Mok; Kim, Sun Yong; Hwang, Mi Soo; Park, Bok Hwan [Yeungnam University College of Medicine, Chinju (Korea, Republic of)

    1989-02-15

    Recently, colonic diverticulosis in Korea is one of rapidly increased disease in its incidence but it is different from that of western counties in the incidence or developing pattern. So, authors reviewed 1921 cases of double contrast study performed during 20 months, from Jan 1st , 1987 to Aug 30th, 1988 at the Department of Radiology. Yeungnam University Hospital to analyzed current disease pattern of the colonic diverticulosis. The results were as follows; 1. The incidence were 11.8%(226/1921) and predominant in male. 2. The mean age of patients was 48.41 years and older in female, but their incidence was not increased with advancing age over 6th decade. 3. The mean number of diverticular was 7.6 and higher in cases involving several anatomic location than limited to one location. 4. Diverticulosis more commonly involved several anatomic location than one location. 5. Left sided colonic diverticulosis was found in relatively older age group and more frequently involved descending colon than sigmoid colon most commonly seen in western people. 6. Recently, the incidence of colonic diverticulosis is increasing in both the right and left colon, which is thought to be due to various factors and partly to the routine use of double contrast study of the colon.

  9. Jejunal Gastric Heterotopia causing Multiple Strictures and Perforation Peritonitis- A Case Report with Review of Literature.

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    Vani, M; Nambiar, Ajit; Geetha, K; Kundil, Byju

    2017-03-01

    Gastric heterotopias beyond the ligament of Treitz though rare, should be thought of in the differential diagnosis of polypoid lesions presenting with gastrointestinal bleed or obstructive symptoms especially in children and in the young. Here is a 24-year-old male with multifocal jejunal gastric heterotopias causing multiple strictures and perforation peritonitis. Patient presented with acute abdomen pain and an emergency laparotomy was performed revealing jejunum with multiple strictures and perforation, followed by jejunal resection. On gross examination polypoid mucosa was noted at the stricture sites which showed heterotopic gastric mucosa on microscopy. Jejunal gastric heterotopias are extremely rare with less than ten reported cases and those presenting with multiple strictures are even rarer. To our knowledge this is the second case of jejunal gastric heterotopia presenting with multiple strictures.

  10. Ruptured Jejunal Diverticulum Due to a Single-Band Small Bowel Obstruction

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    Rajaraman Durai

    2008-01-01

    Full Text Available Jejunal diverticulosis is rare and often goes unnoticed until complications occur. The diverticula are true, acquired diverticula and often asymptomatic. Jejunal diverticulosis can be associated with diverticulosis of the duodenum, ileum, and colon. Here we describe a patient with known severe diverticular disease of the large bowel, who presented acutely with abdominal pain and signs of generalised peritonitis. Laparotomy showed ruptured jejunal diverticulosis with a single band over the terminal ileum, causing small bowel obstruction. Spontaneous perforation of a jejunal diverticulum is rare and is usually an intraoperative finding. One should exclude a precipitating cause, such as coexisting distal obstruction, stricture, or a foreign body.

  11. Elderly patient with acute, left lower abdominal pain: perforated jejunal diverticulitis (2010:7b)

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    Franca, Manuela; Certo, Manuela; Varzim, Pedro; Silva, Donzilia; Peixoto, Carlos

    2010-01-01

    An elderly patient with acute, left, lower abdominal pain is described, for whom the diagnosis of perforated jejunal diverticulitis was established by computed tomography (CT). The presence of a jejunal segmental inflammatory process, with or without abscess or perforation, in the setting of jejunal diverticulosis, is very suggestive of jejunal diverticulitis. (orig.)

  12. Animal Models of Diverticulosis: Review and Recommendations.

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    Patel, Bhavesh; Guo, Xiaomei; Noblet, Jillian; Chambers, Sean; Kassab, Ghassan S

    2018-06-01

    Diverticulosis is a structural alteration of the colon tissue characterized by the development of pouch-like structures called diverticula. It afflicts a significant portion of the population in Western countries, with a higher prevalence among the elderly. Diverticulosis is believed to be the result of a synergetic interaction between inherent tissue weakness, diet, colonic microstructure, motility, and genetic factors. A validated etiology has, however, not yet been established. Non-surgical treatment is currently lacking due to this poor understanding, and surgical colon resection is the only long-term solution following recurrent complications. With rising prevalence, the burden of diverticulosis on patients and hospital resources has increased over the past several years. More efficient and less invasive treatment approaches are, thus, urgently needed. Animal models of diverticulosis are crucial to enable a preclinical assessment and evaluation of such novel approaches. This review discusses the animal models of diverticulosis that have been proposed to date. The current models require either a significant amount of time to develop diverticulosis, present a relatively low success rate, or seriously deteriorate the animals' systemic health. Recommendations are thus provided to address these pitfalls through the selection of a suitable animal and the combination of multiple risk factors for diverticulosis.

  13. Colonic diverticulosis is not a risk factor for colonic adenoma.

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    Hong, Wandong; Dong, Lemei; Zippi, Maddalena; Stock, Simon; Geng, Wujun; Xu, Chunfang; Zhou, Mengtao

    2018-01-01

    Colonic diverticulosis may represent a risk factor for colonic adenomas by virtue of the fact that evolving data suggest that these 2 conditions may share common risk factors such as Western dietary pattern and physical inactivity. This study aims to investigate the association between colonic diverticulosis and colonic adenomas in mainland China. We conducted a cross-sectional study on patients who underwent colonoscopic examination between October 2013 and December 2014 in a university hospital in mainland China. Age, gender, colonic adenomas, advanced adenomas, and distribution of diverticulosis were recorded during the procedures. Multivariate logistic regression and stratified analysis were used to evaluate the associations between the prevalence of diverticulosis and age, sex, and presence of colonic adenomas and advanced adenomas. A total of 17,456 subjects were enrolled. The prevalence of colonic diverticulosis and adenoma was 2.4% and 13.2%, respectively. With regard to distribution of diverticula, most (365/424, 86.1%) were right-sided. Multiple logistic regression analysis suggested that age and male gender were independent risk factors for adenoma and advanced adenoma. There was no relationship between diverticulosis or location of diverticulosis and presence of adenoma and advanced adenoma adjusting by age and gender. In a stratified analysis according to age and gender, similar results were also noted. There was no statistical relationship between diverticulosis and the risk of adenoma and advanced adenoma. Our results may not be generalized to the Western population due to the fact that left-sided diverticular cases were very small in our study.

  14. Diverticulosis of colon: Case report

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    Han, Chang Yul

    1972-01-01

    The authors reports 2 cases of diverticulosis involving the sacending colon and cecum: one, 55 year old, 85 kg Korean male admitted to Paik Hospital because of abdominal palm, constipation and tenderness in the right lower abdomen. The other, 48 year old, 78 kg male visited to our hospital for the routine examination. According to late European and American statistics, the colonic diverticulosis was discovered in late middle life about 20%, however, the incidence of colonic diverticulosis is rare in Korea. This paper presents a brief review of literature on the etiology, incidence and symptom

  15. Jejunal Diverticular Perforation due to Enterolith

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    Ronaldo Nonose

    2011-08-01

    Full Text Available Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations. Although there is no consensus on the management of asymptomatic jejunal diverticular disease, some complications are potentially life-threatening and require early surgical treatment. Small bowel perforation secondary to jejunal diverticulitis by enteroliths is rare. The aim of this study was to report a case of small intestinal perforation caused by a large jejunal enterolith. An 86-year-old woman was admitted with signs of diffuse peritonitis. After initial fluid recovery the patient underwent emergency laparotomy. The surgery showed that she had small bowel diverticular disease, mainly localized in the proximal jejunum. The peritonitis was due to intestinal perforation caused by an enterolith 12 cm in length, localized inside one of these diverticula. The intestinal segment containing the perforated diverticulum with the enterolith was removed and an end-to-end anastomosis was done to reconstruct the intestinal transit. The patient recovered well and was discharged from hospital on the 5th postoperative day. There were no signs of abdominal pain 1 year after the surgical procedure. Although jejunal diverticular disease with its complications, such as formation of enteroliths, is difficult to suspect in patients with peritonitis, it should be considered as a possible source of abdominal infection in the elderly patient when more common diagnoses have been excluded.

  16. Colonic diverticulosis: evaluation with double contrast barium enema

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    Ko, Jae Kook; Lee, Jong Koo; Yun, Eun Joo; Moon, Hee Jung; Shin, Hyun Ja

    1997-01-01

    To evaluate the pattern of colonic diverticulosis according to age and sex, and recent trend. The authors retrospectively reviewed 120 cases of colonic diverticulosis in 1,020 patients who had undergone a double contrast barium enema examination between January 1st, 1993, and December 31st, 1995, and analyzed the frequency, size, multiplicity and anatomical site, according to age and sex. Diverticulum size was classified into one of three groups : less than 5mm, 5-10mm, over 10mm in diameter. The overall incidence of colonic diverticulosis was 120 cases among 1,020 patients(11.8%) with an incidence 5.3 times higher in males than in females. Peak incidence was in the fifth decade, with 19 cases (15.8%) among males, and after the sixth decade, with four cases(3.3%) among females. Mean age was 57.7 years. Diverticulum size of 5-10mm in diameter was predominant (2% of cases); average diameter was 5-6mm. The incidence of colonic diverticulosis was 5.1 times more frequent in the right colon (101 cases) than in the left (20 cases). The overall incidence of colonic diverticulosis has continually increased; in addition it has also recently increased slightly in left-sided colon. This is thought to be due to various factors, both congenital and acquired, including longer life with good health care, constipation, irritable bowel syndrome, stress and the tendency of eating patterns to more closely resemble those of the west

  17. Colonic diverticulosis: evaluation with double contrast barium enema

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    Ko, Jae Kook; Lee, Jong Koo; Yun, Eun Joo; Moon, Hee Jung; Shin, Hyun Ja [Korea Veterans Hospital, Seoul (Korea, Republic of)

    1997-02-01

    To evaluate the pattern of colonic diverticulosis according to age and sex, and recent trend. The authors retrospectively reviewed 120 cases of colonic diverticulosis in 1,020 patients who had undergone a double contrast barium enema examination between January 1st, 1993, and December 31st, 1995, and analyzed the frequency, size, multiplicity and anatomical site, according to age and sex. Diverticulum size was classified into one of three groups : less than 5mm, 5-10mm, over 10mm in diameter. The overall incidence of colonic diverticulosis was 120 cases among 1,020 patients(11.8%) with an incidence 5.3 times higher in males than in females. Peak incidence was in the fifth decade, with 19 cases (15.8%) among males, and after the sixth decade, with four cases(3.3%) among females. Mean age was 57.7 years. Diverticulum size of 5-10mm in diameter was predominant (2% of cases); average diameter was 5-6mm. The incidence of colonic diverticulosis was 5.1 times more frequent in the right colon (101 cases) than in the left (20 cases). The overall incidence of colonic diverticulosis has continually increased; in addition it has also recently increased slightly in left-sided colon. This is thought to be due to various factors, both congenital and acquired, including longer life with good health care, constipation, irritable bowel syndrome, stress and the tendency of eating patterns to more closely resemble those of the west.

  18. Dietary pattern and colonic diverticulosis.

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    Tursi, Antonio

    2017-09-01

    To assess the role of dietary pattern on the occurrence of colonic diverticulosis, diverticular disease and acute diverticulitis. High-fiber diet does not prevent diverticulosis occurrence, and results about prevention/treatment of diverticular disease and acute diverticulitis are still conflicting.No association was seen between nut, corn or popcorn consumption and occurrence of diverticulosis, diverticular disease and acute diverticulitis.It seems to be a mild association between high alcohol intake and diverticulosis occurrence, whereas alcohol dependence seems to show lower risk of in-hospital mortality due to acute diverticulitis.Higher red-meat consumption shows mild increased risk of acute diverticulitis, especially when consumed as unprocessed red meat (defined as consumption of 'beef or lamb as main dish', 'pork as main dish', 'hamburger' and 'beef, pork or lamb as a sandwich or mixed dish'); higher consumption of poultry (viz. white meat) was not associated with risk of acute diverticulitis.Finally, higher fish intake was associated with reduced risk of diverticulitis in age-adjusted model, but not after further adjustment for other potential confounders. Current literature data about the role of dietary pattern on the occurrence of colonic diverticulosis, diverticular disease and acute diverticulitis are still too conflicting.

  19. Diverticulosis

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    Bhuket TP, Stollman NH. Diverticular disease of the colon. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier ...

  20. A retrospective, unicentric evaluation of complicated diverticulosis jejuni: Symptoms, treatment and postoperative course

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    Patrick eTeoule

    2015-11-01

    Full Text Available BackgroundIn contrast to the diverticulosis of the colon jejunal diverticulosis is a rare condition. The incidence is 0.06% up to 5% in large autopsy series. Complicated diverticulosis jejuni (CDJ often presents with unspecific symptoms. Therefore diagnosis is often a challenging diagnosis and due to the clinical rarity no generally valid recommendation of perioperative management exists. Patients and MethodsWe considered only patients that were operated in our centre between April 2007 and August 2014. Patients were identified by data bank search via International Statistical Classification of Diseases and Related Health Problems (ICD diagnosis code K57.10. Data was manually screened and patients with Meckel’s and duodenal diverticula were excluded from this study. Eleven consecutive patients with CDJ were finally included in this study. We analysed symptoms, diagnostic procedures, surgical treatment and postoperative morbidity and mortality. ResultsThe median age of our patients was 76 years (range 34 87. CDJ presented most frequently as intestinal bleeding or as diverticulitis. Clinical symptoms were unspecific abdominal pain, hematemesis or melena, ileus, nausea and emesis as well as patients with acute abdomen. Esophagogastroduodenoscopies confirmed CDJ in two of three patients. An abdominal CT-scan only helped to diagnose CDJ in two of ten patients. Eight (72.7% patients received an open segmental resection with primary anastomosis. In three (27.3% cases a reoperation was necessary. Overall morbidity rate was 45.5% and perioperative mortality was 9.1%. Conclusions Due to the acute character of the disease patients with CDJ are seriously ill. To diagnose patients with CDJ remains challenging as diagnostic investigations are usually not helpful in confirming diagnosis. Still, diagnosis of CDJ is most frequently confirmed intraoperatively.Keywords: complicated jejunal diverticulitis, perioperative management, acute abdomen, visceral surgery

  1. Pathogenesis of diverticulosis and diverticular disease.

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    Walker, Marjorie M; Harris, Angela K

    2017-06-01

    Diverticulosis is defined by the presence of diverticula due to herniation of mucosa and muscularis mucosa through the muscularis propria at sites of vascular penetration in the colon and is asymptomatic in the vast majority affected. There are global differences of distribution, in Western industrialized societies, the most common site is in the left colon, but in Asia right sided diverticulosis predominates. Whilst present in 17.5% of a general population and 42% of all comers at endoscopy it is seen in 71% of those aged ≥80 years. Diverticular disease is defined as clinically significant and symptomatic diverticulosis, which may have an absence of macroscopically overt colitis and in true diverticulitis there is macroscopic inflammation of diverticula with related acute or chronic complications. Whilst overall, diverticulitis affects only 4% of those with diverticulosis, in younger patients (aged 40-49 years) this peaks at 11%. Diverticulosis is one of the most common chronic diseases, yet research in this field on pathogenesis has lagged behind other common conditions such as diabetes mellitus. However, in the last decade there have been major advances in taxonomy that can be used to relate to patients' outcome and treatment in both medicine and surgery. It has been shown there is an association with age, diet, drugs and smoking. Genetic studies have shown a familial association and a specific gene, TNFSF 15 may predict severity of disease. The role of the microbiome has been explored and microbial and metabolomic signatures are also important in predicting disease severity. That diverticulosis is a chronic disease is shown by mucosal pathology with subtle chronic inflammation present in those with asymptomatic diverticulosis and inflammation may lead to muscular hypertrophy, enteric nerve remodeling with disordered motility. The diverticulitis quality of life instrument shows that this condition impacts markedly on patients' well-being and prevention and

  2. Multiple caeco-appendiceal fistulas and diverticulosis: a newly defined congenital anomaly of the appendix-report of the first case.

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    Yucel, Ahmet Fikret; Pergel, Ahmet; Kocakusak, Ahmet; Aydin, Ibrahim; Bagci, Pelin; Sahin, Dursun Ali

    2011-11-01

    Congenital anomalies of the appendix are extremely rare. They are usually found incidentally during operations other than appendectomies. Congenital appendix diverticula are even less frequent. Congenital caeco-appendiceal fistulae have not been reported until today. Herein, we present real diverticula of the appendix with multiple caeco-appendiceal fistulae which, to our knowledge, is the first in the literature.

  3. Prolapso jejunal em gastroenteroanastomose

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    Gerson Junqueira Júnior

    Full Text Available The autors report a case of jejunal mucosa prolapse after gastroenteroanastomosis, a rare postoperative complication. In the late postcholecistectomy period the patient had persistent vomit. Upper digestive endoscopy (UDE showed obstruction of the second portion of duodenum, and a gastrojejunal anastomosis was performed. Soon after that, the patient had persistent vomit and upper digestive endoscopy (UDE showed invagination of the jejunal mucosa. She was reoperated, a Roux Y gastrectomy was performed and the patient had a good evolution. The treatment for this complication is basically surgical, which intends to realieve the obstructive symptomatology.

  4. Diverticulosis of the colon and complications

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    Waldmann, D; Farthmann, E H

    1983-12-01

    Colonic diverticula in reality are herniations of the mucosa through a thickened musculature of the bowel wall where it is penetrated by the vasa recta. Their prevalence increases with western food and with age. Low-residue diet and increased intraluminal pressure are considered to be etiologic factors. Diverticular disease is characterised by inflammatory and bleeding complications. Diverticulitis may lead to peridiverticulitis and pericolitis with frank peritonitis. Uncomplicated diverticulosis warrants observation only under dietary guidance. Repeated complications indicate elective operation by one-stage-resection. Perforation, abscess and massive bleeding necessitate immediate operative treatment aimed at elimination of the involved segment.

  5. Diverticulosis of the colon and complications

    International Nuclear Information System (INIS)

    Waldmann, D.; Farthmann, E.H.

    1983-01-01

    Colonic diverticula in reality are herniations of the mucosa through a thickened musculature of the bowel wall where it is penetrated by the vasa recta. Their prevalence increases with western food and with age. Low-residue diet and increased intraluminal pressure are considered to be etiologic factors. Diverticular disease is characterised by inflammatory and bleeding complications. Diverticulitis may lead to peridiverticulitis and pericolitis with frank peritonitis. Uncomplicated diverticulosis warrants observation only under dietary guidance. Repeated complications indicate elective operation by one-stage-resection. Perforation, abscess and massive bleeding necessitate immediate operative treatment aimed at elimination of the involved segment. (orig.)

  6. Electromanometry of the rectosigmoid in colonic diverticulosis.

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    Viebig, R G; Pontes, J F; Michelsohn, N H

    1994-01-01

    In order to better understand the rectosigmoid motor activity in diverticular disease of the colon, we studied 186 patients, grouped according to their intestinal habit, the presence of diverticular disease and previous crisis of sigmoid diverticulitis. The intestinal habit was classified as: normal habit, irritable colon syndrome, diarrhea and constipation. The group of diverticulosis was classified by their intestinal habit and by diverticula localization (localized or generalized). The presence of systemic diseases or drug ingestion that could modify intestinal motility, were considered criteria for exclusion. The manometric study was preceded by food stimulus, with 650 kcal meal, by mechanic intestinal cleansing, with 500 ml of saline solution enema and by one hour resting period. A manometric catheter, was introduced by rectosigmoidoscopy, with open ended orifices situated at the sigmoid and upper rectum, respectively. The catheter was perfused by a capillary infusion system and the bowel pressures were registered for 30 minutes, in a thermal paper physiograph. We analyzed the % of activity, mean amplitude and motility index, by non parametric tests. No significant difference was observed between sexes. Difference or close to it were found for the groups with constipation, with or without diverticulosis, and for the latter in its subdivisions (localized, generalized and sigmoid diverticulitis). The rectal motor activity was similar in all groups. There was no difference for diverticulosis and its subdivision, when we take into account the several kinds of intestinal habits and the diverticula localization. The motility index averages showed low values for the sigmoid diverticulitis fact that suggests some dysfunction of this segment (hypocontractility). The key factor differentiating the groups was the presence of constipation and no influence was noted regarding the localization of diverticula or previous inflammatory process on intraluminal pressures. The

  7. Rapid duodenal and jejunal intubation

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    Nolan, D.J.

    1979-01-01

    A size 12 French radiopaque catheter, 135 cm long, suitable for rapid duodenal and jejunal intubation, is described. Its size and flexibility enable it to be passed with ease through the nose, stomach and duodenum. A guide wire is used to act as a stiffener as the catheter is passed through the stomach. The catheter is suitable for infusing barium directly into the small intestine and for performing hypotonic duodenography. The technique for duodenal and jejunal intubation is discussed. (author)

  8. Gastrointestinal bleeding secondary to ulcer in duodenal diverticulosis

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    Ramon Banos Madrid; Fernando Alberca de las Parras; Angel Vargas Acosta and others

    2006-01-01

    The reasons more frequent of high gastrointestinal bleeding are the peptic gastric and duodenal, followed by acute erosions and the varicose veins in oesophagus and stomach. The diverticulosis of the small bowel is a very rare reason of gastrointestinal bleeding, must considerate in patients with bleeding without evident reason in oesophagus and stomach, the habitual is to diagnose this entity of accidental form in the course of endoscopic procedures, radiological or surgical. The complications associated with the diverticulosis duodenal are rare; it justifies supporting a not surgical attitude at first

  9. Gastrointestinal bleeding secondary to ulcer in duodenal diverticulosis

    International Nuclear Information System (INIS)

    Banos Madrid, Ramon; Alberca de las Parras, Fernando; Vargas Acosta, Angel and others

    2006-01-01

    The reasons more frequent of high gastrointestinal bleeding are the peptic gastric and duodenal, followed by acute erosion and the varicose veins in oesophagus and stomachs. The diverticulosis of the small bowel is a very rare reason of gastrointestinal bleeding, must considerate in patients with bleeding without evident reason in oesophagus and stomach the habitual is to diagnose this entity of occidental form in the course of endoscopic procedures, radiological of surgical. The complications associated with the diverticulosis duodenal are rare; it justifies supporting a not surgical attitude at first

  10. Cross-Sectional Analysis of Obesity and Serum Analytes in Males Identifies sRAGE as a Novel Biomarker Inversely Associated with Diverticulosis

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    Comstock, Sarah S.; Lewis, Markita M.; Pathak, Dorothy R.; Hortos, Kari; Kovan, Bruce; Fenton, Jenifer I.

    2014-01-01

    Diverticulosis can lead to diverticulitis, a colon condition involving inflammation and other complications. Diverticulosis can result from biological, behavioral, or genetic causes. However, the etiology of diverticulosis is unknown. Although diet is associated with diverticulosis, recent studies suggest other factors influence risk. We sought to identify anthropometric or serum markers that were associated with the presence of diverticulosis. To determine these associations, 126 asymptomati...

  11. Painful irritable bowel syndrome and diverticulosis. One hypermotile state? Correlation of pain and hypermotility.

    NARCIS (Netherlands)

    Ritsema, Gerrit Homme

    1987-01-01

    Radiological and motility studies of the sigmoid are described in three common conditions: painful irritable bowel syndrome (IBS), diverticulosis without and diverticulosis with IBS-like pain. The phenomenon, especially studies in these patients and compared with a control group, was their left

  12. Modulatory effects of taurine on jejunal contractility

    Directory of Open Access Journals (Sweden)

    Q.Y. Yao

    2014-12-01

    Full Text Available Taurine (2-aminoethanesulfonic acid is widely distributed in animal tissues and has diverse pharmacological effects. However, the role of taurine in modulating smooth muscle contractility is still controversial. We propose that taurine (5-80 mM can exert bidirectional modulation on the contractility of isolated rat jejunal segments. Different low and high contractile states were induced in isolated jejunal segments of rats to observe the effects of taurine and the associated mechanisms. Taurine induced stimulatory effects on the contractility of isolated rat jejunal segments at 3 different low contractile states, and inhibitory effects at 3 different high contractile states. Bidirectional modulation was not observed in the presence of verapamil or tetrodotoxin, suggesting that taurine-induced bidirectional modulation is Ca2+ dependent and requires the presence of the enteric nervous system. The stimulatory effects of taurine on the contractility of isolated jejunal segments was blocked by atropine but not by diphenhydramine or by cimetidine, suggesting that muscarinic-linked activation was involved in the stimulatory effects when isolated jejunal segments were in a low contractile state. The inhibitory effects of taurine on the contractility of isolated jejunal segments were blocked by propranolol and L-NG-nitroarginine but not by phentolamine, suggesting that adrenergic β receptors and a nitric oxide relaxing mechanism were involved when isolated jejunal segments were in high contractile states. No bidirectional effects of taurine on myosin phosphorylation were observed. The contractile states of jejunal segments determine taurine-induced stimulatory or inhibitory effects, which are associated with muscarinic receptors and adrenergic β receptors, and a nitric oxide associated relaxing mechanism.

  13. Modulatory effects of taurine on jejunal contractility

    Energy Technology Data Exchange (ETDEWEB)

    Yao, Q.Y.; Chen, D.P.; Ye, D.M.; Diao, Y.P.; Lin, Y. [Dalian Medical University, Dalian, Liaoning (China)

    2014-10-14

    Taurine (2-aminoethanesulfonic acid) is widely distributed in animal tissues and has diverse pharmacological effects. However, the role of taurine in modulating smooth muscle contractility is still controversial. We propose that taurine (5-80 mM) can exert bidirectional modulation on the contractility of isolated rat jejunal segments. Different low and high contractile states were induced in isolated jejunal segments of rats to observe the effects of taurine and the associated mechanisms. Taurine induced stimulatory effects on the contractility of isolated rat jejunal segments at 3 different low contractile states, and inhibitory effects at 3 different high contractile states. Bidirectional modulation was not observed in the presence of verapamil or tetrodotoxin, suggesting that taurine-induced bidirectional modulation is Ca{sup 2+} dependent and requires the presence of the enteric nervous system. The stimulatory effects of taurine on the contractility of isolated jejunal segments was blocked by atropine but not by diphenhydramine or by cimetidine, suggesting that muscarinic-linked activation was involved in the stimulatory effects when isolated jejunal segments were in a low contractile state. The inhibitory effects of taurine on the contractility of isolated jejunal segments were blocked by propranolol and L-NG-nitroarginine but not by phentolamine, suggesting that adrenergic β receptors and a nitric oxide relaxing mechanism were involved when isolated jejunal segments were in high contractile states. No bidirectional effects of taurine on myosin phosphorylation were observed. The contractile states of jejunal segments determine taurine-induced stimulatory or inhibitory effects, which are associated with muscarinic receptors and adrenergic β receptors, and a nitric oxide associated relaxing mechanism.

  14. Modulatory effects of taurine on jejunal contractility

    International Nuclear Information System (INIS)

    Yao, Q.Y.; Chen, D.P.; Ye, D.M.; Diao, Y.P.; Lin, Y.

    2014-01-01

    Taurine (2-aminoethanesulfonic acid) is widely distributed in animal tissues and has diverse pharmacological effects. However, the role of taurine in modulating smooth muscle contractility is still controversial. We propose that taurine (5-80 mM) can exert bidirectional modulation on the contractility of isolated rat jejunal segments. Different low and high contractile states were induced in isolated jejunal segments of rats to observe the effects of taurine and the associated mechanisms. Taurine induced stimulatory effects on the contractility of isolated rat jejunal segments at 3 different low contractile states, and inhibitory effects at 3 different high contractile states. Bidirectional modulation was not observed in the presence of verapamil or tetrodotoxin, suggesting that taurine-induced bidirectional modulation is Ca 2+ dependent and requires the presence of the enteric nervous system. The stimulatory effects of taurine on the contractility of isolated jejunal segments was blocked by atropine but not by diphenhydramine or by cimetidine, suggesting that muscarinic-linked activation was involved in the stimulatory effects when isolated jejunal segments were in a low contractile state. The inhibitory effects of taurine on the contractility of isolated jejunal segments were blocked by propranolol and L-NG-nitroarginine but not by phentolamine, suggesting that adrenergic β receptors and a nitric oxide relaxing mechanism were involved when isolated jejunal segments were in high contractile states. No bidirectional effects of taurine on myosin phosphorylation were observed. The contractile states of jejunal segments determine taurine-induced stimulatory or inhibitory effects, which are associated with muscarinic receptors and adrenergic β receptors, and a nitric oxide associated relaxing mechanism

  15. Modulatory effects of taurine on jejunal contractility

    Science.gov (United States)

    Yao, Q.Y.; Chen, D.P.; Ye, D.M.; Diao, Y.P.; Lin, Y.

    2014-01-01

    Taurine (2-aminoethanesulfonic acid) is widely distributed in animal tissues and has diverse pharmacological effects. However, the role of taurine in modulating smooth muscle contractility is still controversial. We propose that taurine (5-80 mM) can exert bidirectional modulation on the contractility of isolated rat jejunal segments. Different low and high contractile states were induced in isolated jejunal segments of rats to observe the effects of taurine and the associated mechanisms. Taurine induced stimulatory effects on the contractility of isolated rat jejunal segments at 3 different low contractile states, and inhibitory effects at 3 different high contractile states. Bidirectional modulation was not observed in the presence of verapamil or tetrodotoxin, suggesting that taurine-induced bidirectional modulation is Ca2+ dependent and requires the presence of the enteric nervous system. The stimulatory effects of taurine on the contractility of isolated jejunal segments was blocked by atropine but not by diphenhydramine or by cimetidine, suggesting that muscarinic-linked activation was involved in the stimulatory effects when isolated jejunal segments were in a low contractile state. The inhibitory effects of taurine on the contractility of isolated jejunal segments were blocked by propranolol and L-NG-nitroarginine but not by phentolamine, suggesting that adrenergic β receptors and a nitric oxide relaxing mechanism were involved when isolated jejunal segments were in high contractile states. No bidirectional effects of taurine on myosin phosphorylation were observed. The contractile states of jejunal segments determine taurine-induced stimulatory or inhibitory effects, which are associated with muscarinic receptors and adrenergic β receptors, and a nitric oxide associated relaxing mechanism. PMID:25387674

  16. Transgastrostomy jejunal intubation for enteric alimentation.

    Science.gov (United States)

    McLean, G K; Rombeau, J L; Caldwell, M D; Ring, E J; Freiman, D B

    1982-12-01

    Malnourished patients who cannot maintain an adequate oral intake but have normal intestinal absorption and motility are candidates for enteric alimentation. When impaired gastric peristalsis or an increased risk for aspiration makes gastrostomy feeding unsafe, direct jejunal infusion is the preferred route of alimentation. Angiographic techniques were used to convert previously placed, simple gastrostomies to combined gastrostomy-jejunostomies in 14 patients. In 17 additional patients, a combined gastrostomy-jejunal tube was placed under local anesthesia; angiographic techniques assisted in the placement of 11 of these tubes.

  17. Isolated jejunal perforation following blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Ahmet Pergel

    2012-09-01

    Full Text Available Isolated perforation of the jejunum, following blunt abdominaltrauma, is extremely rare. These injuries aredifficult to diagnose because initial clinical signs are frequentlynonspecific and a delay in treatment increasesmortality and morbidity of the patients. Conventional radiogramsare often inadequate for diagnosing this subsetof trauma. For an accurate and timely diagnosis, thepossibility of bowel perforation and the need for repeatedexaminations should be kept in mind. Herein, we presenta 28-year-old man with isolated jejunal perforation followingblunt abdominal trauma.Key words: Blunt abdominal trauma, isolated jejunal perforation,early diagnosis

  18. Colonic epithelial ion transport is not affected in patients with diverticulosis

    DEFF Research Database (Denmark)

    Osbak, Philip S; Bindslev, Niels; Poulsen, Steen S

    2007-01-01

    BACKGROUND: Colonic diverticular disease is a bothersome condition with an unresolved pathogenesis. It is unknown whether a neuroepithelial dysfunction is present. The aim of the study was two-fold; (1) to investigate colonic epithelial ion transport in patients with diverticulosis and (2) to adapt...... a miniaturized Modified Ussing Air-Suction (MUAS) chamber for colonic endoscopic biopsies. METHODS: Biopsies were obtained from the sigmoid part of the colon. 86 patients were included. All patients were referred for colonoscopy on suspicion of neoplasia and they were without pathological findings at colonoscopy...... with diverticulosis and that the MUAS chamber can be adapted for studies of human colonic endoscopic biopsies. Udgivelsesdato: 2007-null...

  19. Lymphangioma of the jejunal mesentery and jejunal polyps presenting as an acute abdomen in a teenager.

    Science.gov (United States)

    Jayasundara, Jasb; Perera, E; Chandu de Silva, M V; Pathirana, A A

    2017-03-01

    Cystic lymphangioma of the small bowel mesentery is a rare clinical entity, especially after childhood. Medical literature reveals a limited number of such cases presenting as acute abdomen due to bowel obstruction, small bowel volvulus and bleeding into the tumour. We present the management experience of an 18-year-old woman who presented with rapid onset diffuse peritonism and raised inflammatory markers. Computed tomography showed a mass in the small bowel mesentery with suspicion of segmental bowel ischaemia. Emergency laparotomy revealed a mass in the mid-jejunal mesentery close to the bowel wall with no bowel ischaemia. The patient made an uncomplicated recovery after segmental bowel resection and end-to-end anastomosis. Histology confirmed the mass as a cystic lymphangioma involving the jejunal mesentery and two small jejunal polyps. Lymphangioma could be considered in the differential diagnosis of an acute abdomen in a young adult when the presentation is atypical.

  20. Review article: the pathophysiology and medical management of diverticulosis and diverticular disease of the colon.

    Science.gov (United States)

    Tursi, A; Papa, A; Danese, S

    2015-09-01

    The incidence of diverticulosis and diverticular disease of the colon, including diverticulitis, is increasing worldwide, and becoming a significant burden on national health systems. Treatment of patients with diverticulosis and DD is generally based on high-fibre diet and antibiotics, respectively. However, new pathophysiological knowledge suggests that further treatment may be useful. To review the current treatment of diverticulosis and diverticular disease. A search of PubMed and Medline databases was performed to identify articles relevant to the management of diverticulosis and diverticular disease. Major international conferences were also reviewed. Two randomised controlled trials (RCT) found the role of antibiotics in managing acute diverticulitis to be questionable, particularly in patients with no complicating comorbidities. One RCT found mesalazine to be effective in preventing acute diverticulitis in patients with symptomatic uncomplicated diverticular disease. The role of rifaximin or mesalazine in preventing diverticulitis recurrence, based on the results of 1 and 4 RCTs, respectively, remains unclear. RCTs found rifaximin and mesalazine to be effective in treating symptomatic uncomplicated diverticular disease. The use of probiotics in diverticular disease and in preventing acute diverticulitis occurrence/recurrence appears promising but unconclusive. Finally, the role of fibre in treating diverticulosis remains unclear. Available evidence suggests that antibiotics have a role only in the treatment of complicated diverticulitis. It appears to be some evidence for a role for rifaximin and mesalazine in treating symptomatic uncomplicated diverticular disease. Finally, there is not currently adequate evidence to recommend any medical treatment for the prevention of diverticulitis recurrence. © 2015 John Wiley & Sons Ltd.

  1. Congenital Diverticular Disease of the Entire Colon

    Directory of Open Access Journals (Sweden)

    A. Patel

    2013-01-01

    Full Text Available Congenital or true colonic diverticulosis is a rare condition typified by the preservation of the colonic wall architecture within the diverticular outpouching. Cases of multiple jejunal diverticula have been reported as well as cases of solitary giant diverticula of the colon. There have been no reports in the literature of pancolonic congenital diverticulosis.

  2. Construction of a Jejunal Pouch After Total Gastrectomy

    African Journals Online (AJOL)

    food intake and slow the transit. Reconstruction using a jejunal interposition is more complicated and less suitable than the simple classic Roux‑en‑Y reconstruction.[1]. According to several prospective randomized trials and a recent meta‑analysis, the Roux‑en‑Y jejunal pouch reconstruction [Figure 1] appears to be the ...

  3. Thromboxane synthesis inhibitors and postprandial jejunal capillary exchange capacity.

    Science.gov (United States)

    Mangino, M J; Chou, C C

    1988-05-01

    The effects of thromboxane synthesis inhibitors (imidazole and U 63557A; Upjohn) and the cyclooxygenase inhibitor, mefenamic acid, on jejunal capillary filtration coefficients (Kfc) were determined in dogs before and during the presence of predigested food in the jejunal lumen. The jejunal Kfc increased significantly soon after the placement of a predigested test food containing all major constituents of diet. The Kfc remained elevated as long as the food was present in the lumen (15 min). Mefenamic acid (10 mg/kg iv) did not significantly alter resting jejunal Kfc or alter the food-induced increase in Kfc. Imidazole (5.0 mg/min ia) or U 63557A (5.0 mg/kg iv) per se significantly increased jejunal Kfc. Placement of digested food further increased the Kfc to levels significantly higher than those observed before administration of the two thromboxane synthase inhibitors. Production of thromboxane B2 by jejunal tissue was significantly reduced and 6-ketoprostaglandin F1 alpha (the stable hydrolysis product of prostacyclin) production was significantly increased after administration of U 63557A. Our study indicates that the relative production of endogenous thromboxanes and other prostanoids modulates jejunal capillary exchange capacity in the absence or presence of digested food in the jejunal lumen.

  4. Cross-sectional analysis of obesity and serum analytes in males identifies sRAGE as a novel biomarker inversely associated with diverticulosis.

    Directory of Open Access Journals (Sweden)

    Sarah S Comstock

    Full Text Available Diverticulosis can lead to diverticulitis, a colon condition involving inflammation and other complications. Diverticulosis can result from biological, behavioral, or genetic causes. However, the etiology of diverticulosis is unknown. Although diet is associated with diverticulosis, recent studies suggest other factors influence risk. We sought to identify anthropometric or serum markers that were associated with the presence of diverticulosis. To determine these associations, 126 asymptomatic men (48-65 yr were recruited at the time of preventative screening colonoscopy. Anthropometric measures were taken, and blood was collected for serum protein analysis. Data were analyzed by logistic regression and factor analysis. Obese individuals (BMI >30 were 7.8 (CI: 2.3-26.3 times more likely than normal weight (BMI 45 inches were 8.1 (CI: 2.8-23.8 times more likely to have diverticulosis than those with a waist circumference <38 inches. Leptin was also positively associated with diverticulosis (OR = 5.5, CI: 2.0-14.7. Both low molecular weight adiponectin (LMW, OR = 0.50; CI: 0.3-0.8 and the soluble receptor for advanced glycation end products (sRAGE, OR = 0.4, CI: 0.3-0.7 were inversely related to the presence of diverticulosis. sRAGE levels were not correlated with leptin or C-peptide concentrations. The pattern of high BMI, waist circumference, leptin and C-peptide increased the odds of diverticulosis while the pattern of high levels of sRAGE and LMW adiponectin decreased the odds of diverticulosis. Associations between diverticulosis and anthropometric or serum markers may elucidate the origins of diverticulosis and may enable physicians to identify individuals at risk for diverticulitis.

  5. Perforation in a patient with stercoral colitis and diverticulosis: who did it?

    Directory of Open Access Journals (Sweden)

    Vijaya R. Bhatt

    2014-02-01

    Full Text Available Stercoral colitis with perforation of the colon is an uncommon, yet life-threatening cause of the acute abdomen. No one defining symptom exists for stercoral colitis; it may present asymptomatically or with vague symptoms. Diagnostic delay may result in perforation of the colon resulting in complications, even death. Moreover, stercoral perforation of the colon can also present with localized left lower quadrant abdominal pain masquerading as diverticulitis. Diverticular diseases and stercoral colitis share similar pathophysiology; furthermore, they may coexist, further complicating the diagnostic dilemma. The ability to decide the cause of perforation in a patient with both stercoral colitis and diverticulosis has not been discussed. We, therefore, report this case of stercoral perforation in a patient with diverticulosis and include a discussion of the epidemiology, clinical presentation, and a review of helpful diagnostic clues for a rapid differentiation to allow for accurate diagnosis and treatment.

  6. Viability of a jejunal segment after neovascularization by omentoenteropexy Viabilidade de segmento jejunal neovascularizado por omentoenteropexia

    Directory of Open Access Journals (Sweden)

    Mércia Maria Braga Rocha

    2002-01-01

    Full Text Available Omentoenteropexy was developed as an alternative technique to promote neovascularization in an isolated bowel segment. OBJECTIVE: The aim of the present protocol was to study the long-term viability of an isolated jejunal segment following neovascularization by omentoenteropexy. Long-term survival of a neovascularized bowel segment is an indication that the utilization of this segment as an intestinal graft can be successful. METHODS: To test the proposed surgical technique, 13 Wistar rats were subjected to laparotomy, the jejunum was exposed at 20 cm from the angle of Treitz and a pedicle of greater omentum was isolated. An incision of 6 cm was made along the antimesenteric jejunal border, exposing the submucosa. Omentoenteropexy was performed between the incision of the jejunum and the pedicle of the greater omentum. After seven weeks, the mesentery of the jejunal segment subjected to omentoenteropexy was ligated and isolated from the rest of the jejunum by a complete proximal and distal transversal section. Subsequently, an end-to-end anastomosis was performed to restore the continuity of the bowel. RESULTS: At 10 weeks from the first surgical intervention, the isolated jejunal segment subjected to omentoenteropexy was completely neovascularized and viable. CONCLUSION: No evidence of anatomical or functional intestinal obstruction was observed.A omentoenteropexia foi desenvolvida como uma alternativa para técnica de neovascularização em segmentos intestinais isolados, evidenciando algumas vantagens em relação a utilização de órgãos previamente descritos. OBJETIVO: Avaliar a viabilidade de um segmento jejunal neovascularizado por omentoenteropexia. MÉTODOS: Treze ratos Wistar foram submetidos a laparotomia, com exposição do jejuno vinte centímetros após o ligamento de Treitz e obtenção de um pedículo de omento. Na borda antimesentérica do jejuno foi feita uma incisão de seis centímetros com exposição da submucosa intacta

  7. Jejunal divertikulitis som årsag til akut abdomen

    DEFF Research Database (Denmark)

    Arsic, Ivan; Cuk, Pedja; Nielsen, Michael Festersen

    2014-01-01

    diverticular disease is intravenous fluids and antibiotics. If there is an occurrence of peritonitis as a complication of jejunal diverticulitis, laparatomy may be indicated. Both of the patients received a conservative treatment with intravenous fluids and antibiotics with good response....

  8. [Diverticulosis of the colon end its complications under the mask of emergency surgical abdomen--10 years experience].

    Science.gov (United States)

    Jaramov, N; Sokolov, M; Angelov, K; Toshev, S; Petrov, B

    2009-01-01

    estimating the prevalence of colonic diverticulosis and its complications studied at the clinic for 10-years period as well as the approaches for its operative treatment and analysis of the subsequent results. CASES AND APPROACHES: During the period 1998-2008 56 patients were hospitalized (31 women and 25 men) at the Surgical department of the University hospital "Alexandrovska". They had different forms of colonic diverticulosis. The average age of the patients was 66.7. The retrospective analysis divides the patients into three clinical groups: 1st group--peritonitis and pericolic abscess caused by diverticulosis--present in 49 patients. 2nd group--chronic non-specific inflammatory infiltrate and fistula--present in 5 patients. 3rd group--severe haemorrhage and anaemic syndrome--present in 2 patients Mortality-rate is 12.5% (7 patients). 10 patients with complications were registered--5 with suppuration of the surgical wound and 5 with pneumonia and pleural effusion. Colonic diverticulosis is a disease of great surgical interest because of its complicated forms requiring conventional or surgical treatment. Various forms of peritonitis which are part of the emergency surgical abdomen domain are relatively frequent complication of the gastrointestinal (in particular of the colon) diverticulosis. They are difficult to diagnose in the pre-operative period and its not easy to take a decision about the particular operative approach. All that is related with the relatively high morbidity and mortality.

  9. Acute GI bleeding by multiple jejunal gastrointestinal autonomic nerve tumour associated with neurofibromatosis type I Urgencia quirúrgica por sangrado intestinal debido a tumor intestinal de nervios autónomos asociados a neurofibromatosis tipo I

    Directory of Open Access Journals (Sweden)

    M. Keese

    2007-10-01

    Full Text Available We describe a surgical emergency due to GI-bleeding caused by gastrointestinal autonomic nerve tumours (GANT's in a patient with von Recklinghausen's disease. A 72 year old female patient with von Recklinghausen's disease was admitted with maelena. Endoscopy showed no active bleeding in the stomach and the colon. Therefore an angio-CT-scan was performed which revealed masses of the proximal jejunum as source of bleeding. Laparotomy was indicated and a 20 cm segment of jejunum which carried multiple extraluminal tumours was resected. The source of the bleeding was a 2 cm tumour which had eroded the mucosal surface. Immunohistologically, evidence of neuronal differentiation could be shown in the spindle-formed cells with positive staining for C-Kit (CD 117, CD 34, and a locally positive staining for synaptophysine and S100. This case report illustrates the association between neurofibromatosis and stromal tumours and should alert surgeons and gastroenterologist about gastrointestinal manifestations in patients with von Recklinghausen's disease.Se describe una urgencia quirúrgica por sangrado intestinal debido a tumor gastrointestinal de nervios autónomos (GANT asociado a enfermedad de von Recklinghausen. Una mujer de 72 años con neurofibromatosis fue ingresada con signos de melena. La endoscopia digestiva alta y baja fue negativa. Se indicó TAC con contraste que advirtió tumores yeyunales como causa del sangrado. Se realizó laparotomía y resección de un segmento de 20 cm de yeyuno que incluía varios tumores. La causa del sangrado activo fue lesión en mucosa intestinal por erosión tumoral. El análisis por inmunohistoquímica de la pieza mostró diferenciación neuronal, con células fusiformes con tinción positiva para el C-Kit (CD 117, CD 34. Esta nota clínica pone de manifiesto la asociación entre la neurofibromatosis y los tumores estromales y debe alertar a gastroenterólogos y cirujanos sobre las posibles manifestaciones

  10. The fraction dose absorbed, in humans, and high jejunal human permeability relationship.

    Science.gov (United States)

    Dahan, Arik; Lennernäs, Hans; Amidon, Gordon L

    2012-06-04

    The drug intestinal permeability (P(eff)) measure has been widely used as one of the main factors governing both the rate and/or extent of drug absorption (F(abs)) in humans following oral administration. In this communication we emphasize the complexity behind and the care that must be taken with this in vivo P(eff) measurement. Intestinal permeability, considering the whole of the human intestine, is more complex than generally recognized, and this can lead to misjudgment regarding F(abs) and P(eff) in various settings, e.g. drug discovery, formulation design, drug development and regulation. Setting the adequate standard for the low/high permeability class boundary, the different experimental methods for the permeability measurement, and segmental-dependent permeability throughout the human intestine due to different mechanisms are some of the main points that are discussed. Overall, the use of jejunal P(eff) as a surrogate for extent of absorption is sound and scientifically justified; a compound with high jejunal P(eff) will have high F(abs), eliminating the risk for misclassification as a BCS class I drug. Much more care should be taken, however, when jejunal P(eff) does not support a high-permeability classification; a thorough examination may reveal high-permeability after all, attributable to e.g. segmental-dependent permeability due to degree of ionization or transporter expression. In this situation, the use of multiple permeability experimental methods, including the use of metabolism, which except for luminal degradation requires absorption, is prudent and encouraged.

  11. Colonic epithelial ion transport is not affected in patients with diverticulosis

    Directory of Open Access Journals (Sweden)

    Tilotta Maria C

    2007-09-01

    Full Text Available Abstract Background Colonic diverticular disease is a bothersome condition with an unresolved pathogenesis. It is unknown whether a neuroepithelial dysfunction is present. The aim of the study was two-fold; (1 to investigate colonic epithelial ion transport in patients with diverticulosis and (2 to adapt a miniaturized Modified Ussing Air-Suction (MUAS chamber for colonic endoscopic biopsies. Methods Biopsies were obtained from the sigmoid part of the colon. 86 patients were included. All patients were referred for colonoscopy on suspicion of neoplasia and they were without pathological findings at colonoscopy (controls except for diverticulosis in 22 (D-patients. Biopsies were mounted in MUAS chambers with an exposed area of 5 mm2. Electrical responses to various stimulators and inhibitors of ion transport were investigated together with histological examination. The MUAS chamber was easy to use and reproducible data were obtained. Results Median basal short circuit current (SCC was 43.8 μA·cm-2 (0.8 – 199 for controls and 59.3 μA·cm-2 (3.0 – 177.2 for D-patients. Slope conductance was 77.0 mS·cm-2 (18.6 – 204.0 equal to 13 Ω·cm2 for controls and 96.6 mS·cm-2 (8.4 – 191.4 equal to 10.3 Ω·cm2 for D-patients. Stimulation with serotonin, theophylline, forskolin and carbachol induced increases in SCC in a range of 4.9 – 18.6 μA·cm-2, while inhibition with indomethacin, bumetanide, ouabain and amiloride decreased SCC in a range of 6.5 – 27.4 μA·cm-2, and all with no significant differences between controls and D-patients. Histological examinations showed intact epithelium and lamina propria before and after mounting for both types of patients. Conclusion We conclude that epithelial ion transport is not significantly altered in patients with diverticulosis and that the MUAS chamber can be adapted for studies of human colonic endoscopic biopsies.

  12. The Jejunal Serosal Patch Procedure: A Successful Technique for ...

    African Journals Online (AJOL)

    Background: The selection of the most appropriate technique for the repair of peptic ulcer perforations, especially when the initial attempt of closure has failed have been the concern of many surgeons. Since the experimental report regarding the jejunal serosal patch procedure by Koboldin in 1963, authors have reported its ...

  13. Retrograde jejunal intussusception after total gastrectomy: A case ...

    African Journals Online (AJOL)

    Retrograde jejunal intussusception is a rare disease. A 60‑year‑old female patient was hospitalized due to vomiting for 2 days, with a history of radical gastrectomy plus esophagus jejunum Rouxs‑en‑Y. On examination, there was a palpable wax‑like mass on the left‑hand side underneath the umbilicus. Computerized ...

  14. Retrograde jejunal intussusception after total gastrectomy: A case ...

    African Journals Online (AJOL)

    2015-11-02

    Nov 2, 2015 ... Retrograde jejunal intussusception is a rare disease. A 60-year-old female patient was hospitalized due to vomiting for 2 days, with a history of radical gastrectomy plus esophagus jejunum Rouxs-en-Y. On examination, there was a palpable wax-like mass on the left-hand side underneath the umbilicus.

  15. Jejunal perforation by swallowed ibuprofen caplet | Njoku | Nigerian ...

    African Journals Online (AJOL)

    We present a case of jejunal perforation caused by an unusual foreign body, an ibuprofen caplet in its blister packing believed to be the first of its kind, perforation of the intestine caused by an ingested medication. The patient eventually developed an enterocutaneous fistula through the weak wall of a preexisting incisional ...

  16. Palliative Percutaneous Jejunal Stent for Patients with Short Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Satoru Takayama

    2009-04-01

    Full Text Available Gastrointestinal obstruction is a common preterminal event in patients with gastric and pancreatic cancer who often undergo palliative bypass surgery. Although endoscopic palliation with self-expandable metallic stents has emerged as a safe and effective alternative to surgery, experience with this technique remains limited. In particular, a proximal jejunal obstruction requires more technical expertise than a duodenal obstruction. Palliative treatment modalities include both surgical and nonsurgical approaches. In this report, we describe the successful placement of self-expandable metallic stents at the proximal jejunum using a combination of percutaneous endoscopic, intraoperative, and transstomal stenting. Usually endoscopy is not indicated in cases of proximal jejunal obstruction, but some cases may require palliative endoscopy instead of bypass operation.

  17. A Case of Midgut Volvulus Associated with a Jejunal Diverticulum

    Directory of Open Access Journals (Sweden)

    Joseph Gutowski

    2017-01-01

    Full Text Available Midgut volvulus in adults is a rare entity that may present with intermittent colicky abdominal pain mixed with completely asymptomatic episodes. This small bowel twist may result in complications of obstruction, ischemia, hemorrhage, or perforation. With a midgut volvulus, complications may be life-threatening, and emergent surgical intervention is the mainstay of treatment. This current case involves an 80-year-old woman with intermittent abdominal pain with increasing severity and decreasing interval of time to presentation. A CAT scan revealed mesenteric swirling with possible internal hernia. A diagnostic laparoscopy followed by laparotomy revealed a midgut volvulus, extensive adhesions involving the root of the mesentery, and a large jejunal diverticulum. The adhesions were lysed enabling untwisting of the bowel, allowing placement of the small bowel in the correct anatomic position and resection of the jejunal diverticulum. This is a rare case of midgut volvulus with intermittent abdominal pain, associated with jejunal diverticulum managed successfully. A midgut volvulus should be considered in the differential diagnosis of a patient who present with a small bowel obstruction secondary to an internal hernia, especially when a swirl sign is present on the CAT scan.

  18. CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management

    International Nuclear Information System (INIS)

    Macari, M.; Faust, M.; Liang, H.; Pachter, H.L.

    2007-01-01

    Aim: To describe the imaging findings of jejunal diverticulitis as depicted at contrast-enhanced computed tomography (CT) and review the differential diagnosis and clinical management. Materials and Methods: CT and pathology databases were searched for the diagnosis of jejunal diverticulitis. Three cases were identified and the imaging and clinical findings correlated. Results: Jejunal diverticulitis presents as a focal inflammatory mass involving the proximal small bowel. A trial of medical management with antibiotics may be attempted. Surgical resection may be required if medical management is unsuccessful. Conclusion: The imaging findings at MDCT may allow a specific diagnosis of jejunal diverticulitis to be considered and may affect the clinical management of the patient

  19. Primary minute mucinous adenocarcinoma of vermiform appendix arising from appendiceal diverticulosis

    Directory of Open Access Journals (Sweden)

    Tadashi Terada, MD, PhD

    2015-03-01

    Full Text Available Primary mucinous adenocarcinoma (MA of vermiform appendix is extremely rare; only three cases have been reported in the English literature. A 77-year-old man presented with abdominal pain, and was diagnosed with acute appendicitis. Appendectomy was performed. The resected appendix showed submucosal swelling measuring 0.7×0.6×0.6 cm in the tip of appendix. The appendix showed inflammation and numerous diverticuloses. Microscopically, the submucosal swelling was a mucin lake in which adenocarcinoma cells were floating. The adenocarcinoma cells were MA in 80% and signet-ring cell carcinoma in 20%. The carcinoma cells were located in the submucosa, muscular layer and subserosa, sparing the mucosa. No apparent lymphovascular permeation was seen. The surgical margins were negative for tumor cells. The non-tumorous appendix shows numerous diverticulosis, diverticulitis, and appendicitis. Immunohistochemically, the tumor cells were positive for CK CAM5.2, CK AE1/3, CK8, CK18, CK19, CK20, EMA, CEA, CA19-9, MUC1, MUC2, MUC5AC, MUC6, NCAM, p53 and Ki-67 (labeling index = 23%. The tumor cells were negative for CK34BE12, CD5, CK6, CK7, NSE, chromogranin, synaptophysin, CA125, KIT, and PDGFRA. No metastasis has been seen 2.5 years after the operation.

  20. Jejunal hemorrhage syndrome in a Zebu cow in Brazil

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    Prhiscylla Sadanã Pires

    2015-08-01

    Full Text Available Clostridium perfringens type A has been incriminated as the etiologic agent in jejunal hemorrhage syndrome (JHS, which is a disease that affects dairy cattle. Although this microorganism is considered an important enteropathogen the pathogenesis of JHS is still not clear, and there have been no reports of its occurrence in Brazil so far. The aim of this study was to describe the occurrence of JHS by infection with a C. perfringens type A strain carrying the beta-2 toxin gene in a zebu cow in Brazil, for the first time.

  1. Jejunal diverticulitis in a healthy 91-year-old man.

    Science.gov (United States)

    Kagolanu, Deepthi Chaitanya; Subhani, Miral; Novick, Daniel; Rizvon, Kaleem

    2018-05-30

    A 91-year-old African American man was admitted with sudden onset diffuse abdominal pain which radiated to the right flank. CT of the abdomen with contrast showed diverticula in the jejunum with adjacent inflammation and microperforation that was contained. Conservative therapy similar to colonic diverticulitis was effective. Although rare, our case highlights the importance of having an early and high suspicion for jejunal diverticulitis when patients present with non-specific abdominal symptoms in order to avoid perforation. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Perforated Jejunal Diverticula Secondary to a Large Faecolith: A Rare Cause of the Acute Abdomen

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    Peter John Webster

    2014-01-01

    Full Text Available Jejunal diverticula are uncommon and usually asymptomatic. Very rarely, they can lead to acute complications such as bleeding, obstruction, and perforation. This report describes our experience of a case of jejunal diverticula perforation secondary to a large faecolith, with particular focus on the aetiology and management of this rare condition.

  3. Current Management of Patients With Diverticulosis and Diverticular Disease: A Survey From the 2nd International Symposium on Diverticular Disease.

    Science.gov (United States)

    Tursi, Antonio; Picchio, Marcello; Elisei, Walter; Di Mario, Francesco; Scarpignato, Carmelo; Brandimarte, Giovanni

    2016-10-01

    Management of diverticular disease (DD) remains a point of debate. To investigate the current opinion of participants of the 2nd International Symposium on Diverticular Disease, on real-life management of patients with DD of the colon. Twelve questions were aimed at the diagnosis, treatment, and management options for diverticulosis and symptomatic DD. In total, 115 surveys from 8 European Countries were filled out. High fiber diet was widely prescribed in diverticulosis (59.1%). Probiotics (25%) were the most frequent prescribed drug, whereas 29.8% of participants did not prescribe any treatment in diverticulosis. Colonoscopy was frequently prescribed in symptomatic patients (69.3%), whereas 72.9% of participants did not prescribe any instrumental tool in their follow-up. Rifaximin, probiotics, and mesalazine were the most frequent prescribed drugs both in symptomatic patients (28.1, 14.9%, and 11.4%, respectively) and to prevent recurrence of the disease (42.5%, 12.4%, and 28.2%, respectively). With respect to laboratory exams, 57.9% of participants prescribed them during follow-up. The majority of participants (64.9%) managed suspected acute diverticulitis at home. Rifaximin, probiotics, and mesalazine were the most frequent prescribed drugs to prevent recurrence of the disease (32.2%, 13.2%, and 11.4%, respectively), whereas 25.4% of participants did not prescribe any drugs. Finally, no differences were found among gastroenterologists, surgeons, and general practitioners in managing this disease. This surveys shows that current management of DD is similar between different medical specialities, generally in line with current literature.

  4. Handlebar Hernia With Jejunal and Duodenal Injuries: A Case Report

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    Ching-Wen Huang

    2004-09-01

    Full Text Available Traumatic abdominal wall hernia is an uncommon complication of abdominal blunt trauma. Handlebar hernia is even more infrequent. To the best of our knowledge, there are fewer than 30 cases of handlebar hernia reported in the English literature. Associated intra-abdominal injuries are infrequent. We present a case of handlebar hernia with jejunal and duodenal injuries. Emergency surgical intervention included primary repair of the disrupted musculofascial defect and injuries of the duodenum and jejunum. Bile- stained discharge from the drain tube was noted, so a second operation was performed about 7 days after the first. Leakage from the sutured jejunal perforation and another irregular perforation in the posterior wall of the fourth portion of the duodenum were noted. The two perforations were debrided and repaired. The muscular and fascial defects were debrided and closed with interrupted sutures. The patient recovered smoothly and was discharged 30 days after the blunt injury. No other major complication was noted 11 months after surgery.

  5. Presentation of GIST as jejuno-jejunal intussusception

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    Anil Kumar

    2018-03-01

    Full Text Available Gastrointestinal stromal tumours (GISTs are rare tumour. It comprises 0.2% of gastrointestinal tumours and only 0.04% of small intestinal tumours. Usually this tumour is found in people in their 60s.These tumours can be found anywhere in the gastrointestinal tract but most commonly found in the stomach (40–60%. Patients with GISTs usually have vague and nonspecific symptoms. We present a 17year-old with complain of abdominal pain, distension, and few episodes of vomiting. All laboratory investigations were normal. The ultrasonography (USG and computed tomography (CT were suggestive of jejuno-jejunal intussusception. The patient had emergency exploratory laparotomy with resection of the segment with five cm healthy margin, and end to end anastomosis. Patient was discharged after 4 days and remains well. This case report highlights the rarity of GISTs in the concern of age (17 year old, site (Jejunum as well as presentation (intussusception.

  6. Retrograde Jejuno-Jejunal Intussusception after Total Gastrectomy

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    Akira Yoneda

    2008-08-01

    Full Text Available An eighty-year-old female was transferred to the hospital after experiencing abdominal pain and nausea. She had had a history of total gastrectomy for gastric cancer 14 years previously. Abdominal X-ray revealed a localized expansion of the small bowel. Computed tomography revealed a mass with a lamellar structure in a concentric circle. With a tentative diagnosis of small bowel obstruction due to intussusception, she underwent emergency operation. Laparotomy revealed a retrograde jejuno-jejunal intussusception. Bowel resection was performed due to the severe ischemic damage. All reported intussusception cases after total gastrectomy displayed retrograde characteristics and could occur both during the early and late period after surgery. It is important to consider the possibility of intussusception for patients presenting with acute abdomen who have previously undergone gastric resection.

  7. The effect of isoperistaltic jejunal interposition upon gastric emptying

    Energy Technology Data Exchange (ETDEWEB)

    Mackie, C.R.; Hall, A.W.; Clark, J.; Wisbey, M.; Baker, P.R.; Cuschieri, A.

    1981-12-01

    Ten patients with severe postgastrectomy-postvagotomy symptoms, all of whom had the features of vasomotor dumping, underwent gastric emptying studies, using a 300 milliliter meal of 15 per cent dextrose labeled with 99mTc-sulphur colloid. Studies were repeated two to 11 months following remedial operative treatment, using a 12.5 to 15.0 centimeter isoperistaltic jejunal interposition. Preoperatively, all patients had rapid gastric emptying with a typical biphasic pattern. Following isoperistaltic interposition, the rate of gastric emptying was similar to that found in control patients. Gastric emptying reverted to a more normal pattern but, as in the preoperative studies, was best described by a double exponential function, consisting of slow and fast components. Analysis of these particular functions suggests the manner in which isoperistaltic interposition modified the underlying disorder of gastric motility.

  8. Jejuno-jejunal intussusception in a guinea pig (Cavia porcellus

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    Tara J. Fetzer

    2017-09-01

    Full Text Available An approximately four-year-old male castrated guinea pig (Cavia porcellus was presented for painful defecation with a 24-hour history of hyporexia and intermittent episodes of rolling behavior. Upon presentation the patient was quiet, alert, and responsive, and mildly hypothermic. Abdominal palpation revealed an approximately 2-cm long oblong mass within the caudal abdomen. Abdominal radiographs revealed gastric dilation without volvulus and a peritoneal mass effect. The patient was euthanized following gastric reflux of brown malodorous fluid from his nares and oral cavity. A necropsy was performed and revealed a jejuno-jejunal intussusception causing mechanical gastrointestinal ileus, and gastric dilatation without volvulus. While non-obstructive gastrointestinal stasis is common and obstructive ileus is uncommon in guinea pigs, this report shows that intestinal intussusception is a differential in guinea pigs with ileus and gastric dilatation.

  9. Small bowel volvulus with jejunal diverticulum: Primary or secondary?

    Science.gov (United States)

    Shen, Xiao-Fei; Guan, Wen-Xian; Cao, Ke; Wang, Hao; Du, Jun-Feng

    2015-09-28

    Small bowel volvulus, which is torsion of the small bowel and its mesentery, is a medical emergency, and is categorized as primary or secondary type. Primary type often occurs without any apparent intrinsic anatomical anomalies, while the secondary type is common clinically and could be caused by numerous factors including postoperative adhesions, intestinal diverticulum, and/or tumors. Here, we report a rare case of a 60-year-old man diagnosed with small bowel volvulus using multidetector computed tomography (MDCT) angiography. Further discovery by laparotomy showed one jejunal diverticulum, longer corresponding mesentery with a narrower insertion, and a lack of mesenteric fat. This case report includes several etiological factors of small bowel volvulus, and we discuss the possible cause of small bowel volvulus in this patient. We also highlight the importance of MDCT angiography in the diagnosis of volvulus and share our experience in treating this disease.

  10. GATA4 Is Sufficient to Establish Jejunal Versus Ileal Identity in the Small IntestineSummary

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    Cayla A. Thompson

    2017-05-01

    Full Text Available Background & Aims: Patterning of the small intestinal epithelium along its cephalocaudal axis establishes three functionally distinct regions: duodenum, jejunum, and ileum. Efficient nutrient assimilation and growth depend on the proper spatial patterning of specialized digestive and absorptive functions performed by duodenal, jejunal, and ileal enterocytes. When enterocyte function is disrupted by disease or injury, intestinal failure can occur. One approach to alleviate intestinal failure would be to restore lost enterocyte functions. The molecular mechanisms determining regionally defined enterocyte functions, however, are poorly delineated. We previously showed that GATA binding protein 4 (GATA4 is essential to define jejunal enterocytes. The goal of this study was to test the hypothesis that GATA4 is sufficient to confer jejunal identity within the intestinal epithelium. Methods: To test this hypothesis, we generated a novel Gata4 conditional knock-in mouse line and expressed GATA4 in the ileum, where it is absent. Results: We found that GATA4-expressing ileum lost ileal identity. The global gene expression profile of GATA4-expressing ileal epithelium aligned more closely with jejunum and duodenum rather than ileum. Focusing on jejunal vs ileal identity, we defined sets of jejunal and ileal genes likely to be regulated directly by GATA4 to suppress ileal identity and promote jejunal identity. Furthermore, our study implicates GATA4 as a transcriptional repressor of fibroblast growth factor 15 (Fgf15, which encodes an enterokine that has been implicated in an increasing number of human diseases. Conclusions: Overall, this study refines our understanding of an important GATA4-dependent molecular mechanism to pattern the intestinal epithelium along its cephalocaudal axis by elaborating on GATA4’s function as a crucial dominant molecular determinant of jejunal enterocyte identity. Microarray data from this study have been deposited into

  11. Congenital intrahepatic arterioportal and portosystemic venous fistulae with jejunal arteriovenous malformation depicted on multislice spiral CT

    International Nuclear Information System (INIS)

    Chae, Eun Jin; Goo, Hyun Woo; Yoon, Chong Hyun; Kim, Seong-Chul

    2004-01-01

    We report a symptomatic infant with very rare congenital arterioportal and portosystemic venous fistulae in the liver. Multislice CT after partial transcatheter embolisation revealed not only the complicated vascular architecture of the lesion, but also an incidental jejunal arteriovenous malformation which explained the patient's melena. The patient underwent ligation of the hepatic artery and resection of the jejunal arteriovenous malformation. Postoperative multislice CT clearly demonstrated the success of the treatment. (orig.)

  12. Thromboxane plays a role in postprandial jejunal oxygen uptake and capillary exchange.

    Science.gov (United States)

    Alemayehu, A; Chou, C C

    1990-09-01

    The effects of a thromboxane A2 (TxA2)-endoperoxide receptor antagonist, SQ 29548, on jejunal blood flow, oxygen uptake, and capillary filtration coefficient (Kfc) were determined in anesthetized dogs under resting conditions and during the presence of predigested food in the jejunal lumen in three series of experiments. In series 1, 2.0 micrograms intra-arterial administration of SQ 29548 was found to abolish completely the vasoconstrictor action of graded doses (0.05-2.0 micrograms) of intra-arterial injection of a TxA2-endoperoxide analogue, U44069. SQ 29548 (2.0 micrograms ia) per se did not significantly alter resting jejunal blood flow, oxygen uptake, capillary pressure, or Kfc. Before SQ 29548, placement of food plus bile into the jejunal lumen increased blood flow +42 +/- 9%, oxygen uptake +28 +/- 7%, and Kfc +24 +/- 6%. After SQ 29548, the food placement increased blood flow +37 +/- 8%, oxygen uptake +52 +/- 11%, and Kfc +63 +/- 20%. The food-induced increases in oxygen uptake and Kfc after SQ 29548 were significantly greater than those induced before the blocking of TxA2-endoperoxide receptors by SQ 29548. Our study indicates that endogenous thromboxane does not play a role in regulating jejunal blood flow, capillary filtration, and oxygen uptake under resting conditions. However, it plays a role in limiting the food-induced increases in jejunal oxygen uptake and capillary exchange capacity without influencing the food-induced hyperemia.

  13. Jejunal perforation caused by abdominal angiostrongyliasis Perfuração jejunal causada por angiostrongilíase abdominal

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    Jaques WAISBERG

    1999-09-01

    Full Text Available The authors describe a case of abdominal angiostrongyliasis in an adult patient presenting acute abdominal pain caused by jejunal perforation. The case was unusual, as this affliction habitually involves the terminal ileum, appendix, cecum or ascending colon. The disease is caused by the nematode Angiostrongylus costaricensis, whose definitive hosts are forest rodents while snails and slugs are its intermediate hosts. Infection in humans is accidental and occurs via the ingestion of snail or slug mucoid secretions found on vegetables, or by direct contact with the mucus. Abdominal angiostrongyliasis is clinically characterized by prolonged fever, anorexia, abdominal pain in the right-lower quadrant, and peripheral blood eosinophilia. Although usually of a benign nature, its course may evolve to more complicated forms such as intestinal obstruction or perforation likely to require a surgical approach. Currently, no efficient medication for the treatment of abdominal angiostrongyliasis is known to be available. In this study, the authors provide a review on the subject, considering its etiopathogeny, clinical picture, diagnosis and treatment.Os autores descrevem caso de angiostrongilíase abdominal em doente adulto que se manifestou como abdômen agudo devido à perfuração de alça jejunal, evento raro, uma vez que esta afecção geralmente envolve o íleo terminal, apêndice, ceco ou cólon ascendente. A doença é causada pelo nematódeo Angiostrongylus costaricensis cujos hospedeiros definitivos são roedores silvestres e os hospedeiros intermediários são caracóis e caramujos. A infecção em humanos é acidental e ocorre pela ingestão de secreção mucóide destes invertebrados presentes em vegetais ou por contato direto com o muco. A angiostrongilíase abdominal é clinicamente caracterizada pela presença de febre prolongada, anorexia, dor no quadrante inferior direito do abdômen e eosinofilia periférica. Embora a doença seja de

  14. On free jejunal and colon transfer for pharyngo-esophageal reconstruction

    International Nuclear Information System (INIS)

    Fukui, Kiyoko; Annraku, Kuniaki; Ikenoya, Shintaro; Makino, Sachio; Ito, Kazuyuki; Takubo, Kenji; Kaji, Shogo

    2013-01-01

    Free jejunal transfer is a common procedure for hypopharyngo-esophageal reconstruction. We reviewed our experience with patients who underwent free jejunal and colon transfer surgery for hypopharyngo-esophageal reconstruction in the last 20 years in our institute. A retrospective review was conducted for 31 cases of reconstruction with free jejunal and colon transfer performed at Japanese Red Cross Matsue Hospital during the period of 20 years from January 1992 to December 2011. The mean age of the patients was 66 years. There were 30 patients with hypopharynx cancer and one patient with larynx cancer. Thirty patients had received preoperative radiotherapy and chemotherapy. The average time of surgery for free jejunal transfer reconstruction was 8.8 hours, including extraction of the hypopharynx, pharynx and cervical esophagus, debridment of pars hemi-cervicalis, and grafting procedure of free jejunum. The most common recipient vessels were the transverse cervical artery and external jugular vein, but recently, vessels of free flaps are often chosen to be anastomosed with the superior thyroid artery and internal jugular vein. The free jejunal and colon grafts for reconstruction took successfully in all patients. The complication rate was 52% (16/31 cases). Complications often occurred in cases of total esophagectomy, recurrence after full-dose chemoradiotherapy, and radiation therapy administered postoperatively. (author)

  15. Phytobezoar in a jejunal diverticulum as a cause of small bowel obstruction: a case report

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    Rauf Fozia

    2011-09-01

    Full Text Available Abstract Introduction Phytobezoars are concretions of poorly digested fruit and vegetable fibers found in the alimentary tract. Previous gastric resection, gastrojejunostomy, or pyloroplasty predispose people to bezoar formation. Small-bowel bezoars normally come from the stomach, and primary small-bowel bezoars are very rare. They are seen only in patients with underlying small-bowel diseases such as diverticula, strictures, or tumors. Primary small-bowel bezoars almost always present as intestinal obstructions, although it is a very rare cause, being responsible for less than 3% of all small-bowel obstructions in one series. Jejunal diverticula are rare, with an incidence of less than 0.5%. They are usually asymptomatic pseudodiverticula of pulsion type, and complications are reported in 10% to 30% of patients. A phytobezoar in a jejunal diverticulum is an extremely rare presentation. Case presentation A 78-year-old Pakistani man presented to our clinic with small-bowel obstruction. Upon exploration, we found a primary small-bowel bezoar originating in a jejunal diverticulum and causing jejunal obstruction. Resection and anastomosis of the jejunal segment harboring the diverticulum was performed, and our patient had an uneventful recovery. Conclusion Primary small-bowel bezoars are very rare but must be kept in mind as a possible cause of small-bowel obstruction.

  16. The placement of naso-jejunal feeding tube under DSA guidance: its technology and skills

    International Nuclear Information System (INIS)

    Song Laichang; Wang Wenhui; Li Fenqiang; Su Dongjun; Li Bo

    2009-01-01

    Objective: To retrospectively analyze and summarize the manipulation and skills of the placement of naso-jejunal feeding tube under DSA guidance. Methods: After performing the spraying anesthesia of nasopharynx, the naso-jejunal feeding tube, with the help of guide wire and under DSA guidance, was placed into the proximal jejunum by passing it through the nose, pharynx, esophagus, stomach, pylorus and duodenum in order. The procedure was employed in 441 cases. Results: The mean time for performing the procedure was within five minutes. The procedure was successfully accomplished in all 441 cases and no complications occurred in this series. Conclusion: Under DSA guidance the placement of naso- jejunal feeding tube can be safely and quickly carried out with high successful rate and less sufferings to patient. It is worth popularizing this technique in clinical practice. (authors)

  17. Electroacupuncture at LI11 promotes jejunal motility via the parasympathetic pathway.

    Science.gov (United States)

    Hu, Xuanming; Yuan, Mengqian; Yin, Yin; Wang, Yidan; Li, Yuqin; Zhang, Na; Sun, Xueyi; Yu, Zhi; Xu, Bin

    2017-06-21

    Gastrointestinal motility disorder has been demonstrated to be regulated by acupuncture treatment. The mechanisms underlying the effects of acupuncture stimulation of abdominal and lower limb acupoints on gastrointestinal motility have been thoroughly studied; however, the physiology underlying the effects of acupuncture on the forelimbs to mediate gastrointestinal motility requires further exploration. The aim of this study was to determine whether electroacupuncture (EA) at LI11 promotes jejunal motility, whether the parasympathetic pathway participates in this effect, and if so, which somatic afferent nerve fibres are involved. A manometric balloon was used to observe jejunal motility. The effects and mechanisms of EA at LI11 were explored in male Sprague-Dawley rats with or without drug administration (propranolol, clenbuterol, acetylcholine, and atropine) and with or without vagotomy. Three types of male mice (β 1 β 2 receptor-knockout [β 1 β 2 -/- ] mice, M 2 M 3 receptor-knockout [M 2 M 3 -/- ] mice and wild-type [WT] mice) were also studied by using different EA intensities (1, 2, 4, 6, and 8 mA). A total of 72 rats and 56 mice were included in the study. EA at LI11 increased the contractile amplitude of jejunal motility in the majority of both rats and mice. However, EA at LI11 did not enhance jejunal motility in rats administered atropine, rats that underwent vagotomy, and M 2 M 3 -‍‍/- mice (at all intensities). In WT mice, EA at LI11 significantly increased jejunal motility at all intensities except 1 mA, and a plateau was reached at intensities greater than 4 mA. Our results suggest that EA at LI11 promotes jejunal motility primarily by exciting the parasympathetic pathway, and that Aδ-fibres and C-fibres may play important roles in the process.

  18. Jejunal Choristoma: A Very Rare Cause of Abdominal Pain in Children

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    T. A. Olajide

    2014-01-01

    Full Text Available Choristoma is development of a normal tissue in an aberrant location. This report describes jejunal salivary choristoma (JSC causing recurring episodes of abdominal discomfort in a 5-year-old girl. Exploratory laporatomy revealed a pale yellow subserosal jejunal lesion. Wedge resection of the lesion and repair of the bowel were performed. The child did well postoperatively and has since that time been free of pain at follow-up. Histopathological examination of the resected lesion revealed salivary gland choriostoma. Literature review (PUBMED search engine revealed no previous report of this rare clinicopathologic entity. We conclude that choriostoma should be considered a possible differential when evaluating abdominal complaint in children.

  19. Jejunal intussusception in a 10-year-old boy with blue rubber bleb nevus syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Beluffi, Giampiero [Section of Paediatric Radiology, Department of Radiodiagnosis, IRCCS Policlinico S. Matteo, Piazzale Golgi, 2, 27100, Pavia PV (Italy); Romano, Piero; Matteotti, Chiara; Minniti, Silvio; Ceffa, Franco [Division of Paediatric Surgery, IRCCS Policlinico S. Matteo, Pavia (Italy); Morbini, Patrizia [Department of Pathology, IRCCS Policlinico S. Matteo, Pavia (Italy)

    2004-09-01

    Jejunal intussusception in a Chinese 10-year-old boy affected by the blue rubber bleb nevus syndrome is presented and discussed. The syndrome is rare, sporadically found with possible dominant inheritance, and due to a gene mutation mapped on the short arm of chromosome 9. It presents with distinctive cutaneous and gastrointestinal malformations together with possible other organ involvement. Gastrointestinal malformations tend to bleed and lead to anaemia. Infrequent complications of the gastrointestinal malformations are volvulus, intestinal infarction and intussusception. The age of the patient and the jejunal intussusception precipitated by a vascular malformation containing calcifications (which were also found in different gut segments) make this case remarkable. (orig.)

  20. Jejunal intussusception in a 10-year-old boy with blue rubber bleb nevus syndrome

    International Nuclear Information System (INIS)

    Beluffi, Giampiero; Romano, Piero; Matteotti, Chiara; Minniti, Silvio; Ceffa, Franco; Morbini, Patrizia

    2004-01-01

    Jejunal intussusception in a Chinese 10-year-old boy affected by the blue rubber bleb nevus syndrome is presented and discussed. The syndrome is rare, sporadically found with possible dominant inheritance, and due to a gene mutation mapped on the short arm of chromosome 9. It presents with distinctive cutaneous and gastrointestinal malformations together with possible other organ involvement. Gastrointestinal malformations tend to bleed and lead to anaemia. Infrequent complications of the gastrointestinal malformations are volvulus, intestinal infarction and intussusception. The age of the patient and the jejunal intussusception precipitated by a vascular malformation containing calcifications (which were also found in different gut segments) make this case remarkable. (orig.)

  1. Jejunal varices diagnosed by capsule endoscopy in patients with post-liver transplant portal hypertension.

    Science.gov (United States)

    Bass, Lee M; Kim, Stanley; Superina, Riccardo; Mohammad, Saeed

    2017-02-01

    Portal hypertension secondary to portal vein obstruction following liver transplant occurs in 5%-10% of children. Jejunal varices are uncommon in this group. We present a case series of children with significant GI blood loss, negative upper endoscopy, and jejunal varices detected by CE. Case series of patients who had CE for chronic GI blood loss following liver transplantation. Three patients who had their initial transplants at a median age of 7 months were identified at our institution presenting at a median age of 8 years (range 7-16 years) with a median Hgb of 2.8 g/dL (range 1.8-6.8 g/dL). Upper endoscopy was negative for significant esophageal varices, gastric varices, and bleeding portal gastropathy in all three children. All three patients had significant jejunal varices noted on CE in mid-jejunum. Jejunal varices were described as large prominent bluish vessels underneath visualized mucosa, one with evidence of recent bleeding. The results led to venoplasty of the portal vein in two patients and a decompressive shunt in one patient with resolution of GI bleed and anemia. CE is useful to diagnose intestinal varices in children with portal hypertension and GI bleeding following liver transplant. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Duodenal-jejunal bypass sleeve - a potential alternative to bariatric surgery?

    DEFF Research Database (Denmark)

    Rohde, Ulrich; Gylvin, Silas; Vilmann, Peter

    2014-01-01

    Overweight and obesity are risk factors for several co-morbidities reducing life expectancy. Conservative treatment of obesity is generally ineffective in the long-term. Bariatric surgery has proven effective, but is associated with potential complications. Duodenal-jejunal bypass sleeve is a novel...

  3. Increased jejunal prostaglandin E2 concentrations in patients with acute cholera

    NARCIS (Netherlands)

    Speelman, P.; Rabbani, G. H.; Bukhave, K.; Rask-Madsen, J.

    1985-01-01

    Supraphysiologic doses of prostaglandins (PGs) mimic the effect of cholera toxin and cAMP in the small intestine, but not all observations are explicable in terms of the theory that links PGs to cAMP. Because no data exist on endogenous PGs in human cholera we measured PGE2 concentrations in jejunal

  4. Jejunal diverticula with perforation in non steroidal anti inflammatory drug user: A case report

    Directory of Open Access Journals (Sweden)

    Shobhit Gupta

    2017-01-01

    Conclusion: Jejunal diverticula are rare lesions, and their perforation never features in the list of diagnoses for acute abdomen, especially in this part of the world. Further this unique case report opens the doors for further research to prove an assosiation between NSAID use and diverticular perforation which itself is a very rare entity.

  5. Mannose-specific interaction of Lactobacillus plantarum with porcine jejunal epithelium

    NARCIS (Netherlands)

    Pretzer, G.; Meulen, van der J.; Snel, J.; Meer, van der R.; Kleerebezem, M.; Niewold, Th.; Hulst, M.M.; Smits, M.A.

    2008-01-01

    Host-microorganism interactions in the intestinal tract are complex, and little is known about specific nonpathogenic microbial factors triggering host responses in the gut. In this study, mannose-specific interactions of Lactobacillus plantarum 299v with jejunal epithelium were investigated using

  6. Duodenal Derotation and Extent Tapering Jejunoplasty as Primary Repair for Neonates With High Jejunal Atresia

    Directory of Open Access Journals (Sweden)

    Chih-Cheng Luo

    2010-10-01

    Conclusion: In very proximal high atresia, the extent of tapering is limited by the proximity of the ligament of Treitz. Duodenal derotation provides better access to the high atresia. The results of this limited experience suggest that the DDETJ procedure could provide an alternative therapy in patients with high jejunal atresia.

  7. Electrophysiological response of chicken's jejunal epithelium to increasing levels of T-2 toxin.

    Science.gov (United States)

    Yunus, Agha Waqar; Kröger, Susan; Tichy, Alexander; Zentek, Jürgen; Böhm, Josef

    2013-02-01

    The present investigations were conducted to test the effects of T-2 toxin on electrophysiological variables of jejunal epithelium of chicken. Jejunal segments of broilers were monitored in Ussing chambers in the presence of T-2 toxin at the levels of 0 (negative control), 0 (methanol/vehicle control), 0.1, 1, 5, and 10 μg/ml of buffer. T-2 toxin did not affect basal values of short circuit current (I(sc)), transmural potential difference, or tissue conductivity in the jejunal epithelium. T-2 toxin also did not statistically affect glucose-induced electrophysiological variables during the first 3 min of glucose induction. Compared to the vehicle control, the ouabain-sensitive I(sc) was negatively affected (P = 0.008) only under 5 μg of T-2 toxin/ml. Increasing levels of T-2 toxin negatively affected the ouabain-sensitive I(sc) in a cubic (P = 0.007) fashion. These data indicate that acute exposure to moderate levels of T-2 toxin may progressively impair the cation gradient across the jejunal epithelium.

  8. Vascularized pedicle jejunal graft for closure of large duodenal defect in a dog.

    Science.gov (United States)

    Massie, Anna; McFadden, Michael

    2016-11-01

    A Labrador retriever dog was presented for intestinal obstruction resulting in devitalization of portions of the duodenum. A severe perforation, accounting for 70% duodenal circumference, was present at the level of the duodenal papilla. A vascularized jejunal graft was used to close the perforation, representing novel utilization of this grafting technique.

  9. Comparison of enterotomy leak pressure among fresh, cooled, and frozen-thawed porcine jejunal segments.

    Science.gov (United States)

    Aeschlimann, Kimberly A; Mann, F A; Middleton, John R; Belter, Rebecca C

    2018-05-01

    OBJECTIVE To determine whether stored (cooled or frozen-thawed) jejunal segments can be used to obtain dependable leak pressure data after enterotomy closure. SAMPLE 36 jejunal segments from 3 juvenile pigs. PROCEDURES Jejunal segments were harvested from euthanized pigs and assigned to 1 of 3 treatment groups (n = 12 segments/group) as follows: fresh (used within 4 hours after collection), cooled (stored overnight at 5°C before use), and frozen-thawed (frozen at -12°C for 8 days and thawed at room temperature [23°C] for 1 hour before use). Jejunal segments were suspended and 2-cm enterotomy incisions were made on the antimesenteric border. Enterotomies were closed with a simple continuous suture pattern. Lactated Ringer solution was infused into each segment until failure at the suture line was detected. Leak pressure was measured by use of a digital transducer. RESULTS Mean ± SD leak pressure for fresh, cooled, and frozen-thawed segments was 68.3 ± 23.7 mm Hg, 55.3 ± 28.1 mm Hg, and 14.4 ± 14.8 mm Hg, respectively. Overall, there were no significant differences in mean leak pressure among pigs, but a significant difference in mean leak pressure was detected among treatment groups. Mean leak pressure was significantly lower for frozen-thawed segments than for fresh or cooled segments, but mean leak pressure did not differ significantly between fresh and cooled segments. CONCLUSIONS AND CLINICAL RELEVANCE Fresh porcine jejunal segments or segments cooled overnight may be used for determining intestinal leak pressure, but frozen-thawed segments should not be used.

  10. Acupuncture at heterotopic acupoints enhances jejunal motility in constipated and diarrheic rats

    Science.gov (United States)

    Qin, Qing-Guang; Gao, Xin-Yan; Liu, Kun; Yu, Xiao-Chun; Li, Liang; Wang, Hai-Ping; Zhu, Bing

    2014-01-01

    AIM: To investigate the effect and mechanism of acupuncture at heterotopic acupoints on jejunal motility, particularly in pathological conditions. METHODS: Jejunal motility was assessed using a manometric balloon placed in the jejunum approximately 18-20 cm downstream from the pylorus and filled with approximately 0.1 mL warm water in anesthetized normal rats or rats with diarrhea or constipation. The heterotopic acupoints including LI11 (Quchi), ST37 (Shangjuxu), BL25 (Dachangshu), and the homotopic acupoint ST25 (Tianshu), and were stimulated for 60 s by rotating acupuncture needles right and left at a frequency of 2 Hz. To determine the type of afferent fibers mediating the regulation of jejunal motility by manual acupuncture, the ipsilateral sciatic A or C fibers of ST37 were inactivated by local application of the A-fiber selective demyelination agent cobra venom or the C fiber blocker capsaicin. Methoctramine, a selective M2 receptor antagonist, was injected intravenously to identify a specific role for M2 receptors in mediating the effect of acupuncture on jejunal motility. RESULTS: Acupuncture at heterotopic acupoints, such as LI11 and ST37, increased jejunal motility not only in normal rats, but also in rats with constipation or diarrhea. In normal rats, manual acupuncture at LI11 or ST37 enhanced jejunal pressure from 7.34 ± 0.19 cmH2O to 7.93 ± 0.20 cmH2O, an increase of 9.05% ± 0.82% (P acupuncture at LI11 or ST37 increased intrajejunal pressure from 8.17 ± 0.31 cmH2O to 9.86 ± 0.36 cmH2O, an increase of 20.69% ± 2.10% (P 0.05), respectively. In contrast, acupuncture ST25, a homotopic acupoint, decreased not only intrajejunal pressure, but also significantly decreased frequency in normal rats and rats with constipation or diarrhea. Following demyelination of Aδ fibers, acupuncture at ST37 again augmented intrajejunal pressure to 121.48% ± 3.06% of baseline. Following capsaicin application for 24 h, acupuncture at ipsilateral ST37 increased

  11. The Effect of Combination of Radiation with 5-Fluorouracil on Mouse Jejunal Crypt Cells

    International Nuclear Information System (INIS)

    Huh, Seung Jae; Park, Charn Il

    1985-01-01

    The interaction of radiation and 5-Fluorouracil (5-FU) on mouse jejunal crypt cells was studied using the microcolony survival assay. 150mg/kg of 5-FU was injected intraperitoneally 15 minutes before irradiation and 6 hours after irradiation. Jejunal crypt cells of mouse survived more when 5-FU was given 15 minutes before irradiation than giving it 6 hours after irradiation. The mean lethal doses (Do) of each of irradiation alone group, 5-FU injection group of 15 minutes preceding irradiation, and 5-FU injection group of 6 hours post irradiation were 135, 135, and 114 rad respectively. The dose effect factor (DEF) of each of 5-FU injection groups of 15 minutes preceding irradiation and of 6 hours post irradiation were 1.13 and 1.27

  12. Jejunal Replacement of Stomach in Two Children with Total Gastric Necrosis

    Directory of Open Access Journals (Sweden)

    Onder Ozden

    2014-04-01

    Full Text Available Total gastrectomy is an extremely rare procedure in children and experience with its replacement is very limited. We present two patients who had jejunal replacement due to total gastric necrosis. The first patient was a- 2-year-old boy who admitted with a history of caustic ingestion. He was taken operation because of gastric perforation and necrosis. Anastomosis was applied by using jejunal segments. The second patient was an 11-years-old girl who left diaphragmatic hernia and acute gastric volvulus. At laparotomy, Total gastrectomy and Hunt-Lawrence type gastroesophostomy were made. Reconstruction with jejunum is thought as a good option in total gastric necrosis according to our 2 patient experiences. [Cukurova Med J 2014; 39(2.000: 403-407

  13. Single-incision, laparoscopic-assisted jejunal resection and anastomosis following a gunshot wound.

    Science.gov (United States)

    Rubin, Jacob A; Shigemoto, Reynsen; Reese, David J; Case, J Brad

    2015-01-01

    A 2 yr old castrated male Pomeranian was evaluated for a 6 wk history of chronic vomiting, intermittent anorexia, and lethargy. Physical examination revealed a palpable, nonpainful, soft-tissue mass in the midabdominal area. Abdominal radiographs and ultrasound revealed a focal, eccentric thickening of the jejunal wall with associated jejunal mural foreign body and partial mechanical obstruction. Following diagnosis of a partial intestinal obstruction as the cause of chronic vomiting, the patient underwent general anesthesia for a laparoscopic-assisted, midjejunal resection and anastomosis using a single-incision laparoscopic surgery port. The patient was discharged the day after surgery, and clinical signs abated according to information obtained during a telephone interview conducted 2 and 8 wk postoperatively. The dog described in this report is a unique case of partial intestinal obstruction treated by laparoscopic-assisted resection and anastomosis using a single-incision laparoscopic surgery port.

  14. The Combination of Gastroschisis, Jejunal Atresia, and Colonic Atresia in a Newborn

    Directory of Open Access Journals (Sweden)

    Zachary Bauman

    2015-01-01

    Full Text Available We encountered a rare case of gastroschisis associated with jejunal atresia and colonic atresia. In our case, the jejunal atresia was not discovered for 27 days after the initial abdominal wall closure. The colonic atresia was not discovered for 48 days after initial repair of the gastroschisis secondary to the rarity of the disorder. Both types of atresia were repaired with primary hand-sewn anastomoses. Other than the prolonged parenteral nutrition and hyperbilirubinemia, our patient did very well throughout his hospital course. Based on our case presentation, small bowel atresia and colonic atresia must be considered in patients who undergo abdominal wall closure for gastroschisis with prolonged symptoms suggestive of bowel obstruction. Our case report also demonstrates primary enteric anastomosis as a safe, well-tolerated surgical option for patients with types of intestinal atresia.

  15. Jejunal Perforation: A Rare Presentation of Burkitt’s Lymphoma—Successful Management

    Directory of Open Access Journals (Sweden)

    Samir Ranjan Nayak

    2014-01-01

    Full Text Available Malignant tumors of the small bowel presenting as acute abdomen are a rare occurrence. Burkitt’s lymphoma presenting as a surgical emergency needing emergency laparotomy is an uncommon presentation of this tumor. We present an interesting case of jejunal perforation as a first manifestation of Burkitt’s lymphoma which was successfully managed with surgical resection, high dose chemotherapy, and good supportive care.

  16. Substrate metabolism in isolated rat jejunal epithelium. Analysis using 14C-radioisotopes

    International Nuclear Information System (INIS)

    Mallet, R.T.

    1986-01-01

    The jejunal epithelium absorbs nutrients from the intestinal lumen and is therefore the initial site for metabolism of these compounds. The purpose of this investigation is to analyze substrate metabolism in a preparation of jejunal epithelium relatively free of other tissues. Novel radioisotopic labelling techniques allow quantitation of substrate metabolism in the TCA cycle, Embden-Meyerhof (glycolytic) pathway, and hexose monophosphate shunt. For example, ratios of 14 CO 2 production from pairs of 14 C-pyruvate, and 14 C-succinate radioisotopes (CO 2 ratios) indicate the probability of TCA cycle intermediate efflux to generate compounds other than CO 2 . With (2,3- 14 C)succinate as tracer, the ratio of 14 C in carbon 4 + 5 versus carbon 2 + 3 of citrate, the citrate labelling ratio, equals the probability of TCA intermediate flux to the acetyl CoA-derived portion of citrate versus flux to the oxaloacetate-derived portion. The principal metabolic substrates for the jejunal epithelium are glucose and glutamine. CO 2 ratios indicate that glutamine uptake and metabolism is partially Na + -independent, and is saturable, with a half-maximal rate at physiological plasma glutamine concentrations. Glucose metabolism in the jejunal epithelium proceeds almost entirely via the Embden-Meyerhof pathway. Conversion of substrates to multi-carbon products in this tissue allows partial conservation of reduced carbon for further utilization in other tissues. In summary, metabolic modeling based on 14 C labelling ratios is a potentially valuable technique for analysis of metabolic flux patterns in cell preparations

  17. Peritonitis by jejunal ulcer perforation in a child: a case report

    Directory of Open Access Journals (Sweden)

    Ndèye Aby Ndoye

    2017-01-01

    Full Text Available Ulcer perforation is a rare cause of peritonitis in children. The cases reported in the literature are caused by peptic ulcer. We report on a case of peritonitis caused by jejunal ulcer perforation, discovered in a girl's abdomen during an acute surgical procedure. The treatment consisted of a resection of the perforation followed by an end-to-end anastomosis. Postoperative period was uneventful.

  18. Preoperative determination of appropriate cutting line for proximal gastrectomy to avoid postoperative jejunal ulcer.

    Science.gov (United States)

    Takahashi, Naoto; Kashimura, Hirotaka; Nimura, Hiroshi; Watanabe, Atsushi; Yano, Kentaro; Aoki, Hiroaki; Koyama, Tomoki; Sasaki, Toshiyuki; Shida, Atsuo; Mitsumori, Norio; Aoki, Teruaki; Kashiwagi, Hideyuki; Yanaga, Katsuhiko

    2012-01-01

    Although proximal gastrectomy has become a procedure of choice for patients' early cancer in the upper third of stomach, no clinical guide for optimal gastric resection in order to avoid postoperative jejunal ulcer is available. The aim of this study was to investigate whether determining the distribution of parietal and chief cells of the stomach using Congo red test is clinically relevant. The F-line was defined as a boundary line between fundic and intermediate area of the stomach according to the pathological findings in 29 patients who underwent total gastrectomy for early gastric cancer, whereas the f-line was regarded as a boundary line between intermediate and pyloric area. In the additional 6 patients undergoing vagus-preserving proximal gastrectomy with jejunal pouch interposition, endoscopic Congo red test was preoperatively performed to determine the F-f-line. The distances from the pyloric ring to f-line on the lesser and greater curvatures were variable. Long-term outcomes of proximal gastrectomy guided by preoperative endoscopic Congo red test were favorable. It is suggested that preoperative endoscopic Congo red test is useful to determine the appropriate cutting line in order to avoid postoperative jejunal ulcer after proximal gastrectomy.

  19. Diverticulosis del colon

    Directory of Open Access Journals (Sweden)

    Augusto Salazar Sánchez

    1949-07-01

    Full Text Available Historia Clínica. L. M. C. natural de Suaita, de 36 años de edad, comerciante de profesión, consulta por dolores abdominales y fenómenos dispépticos; narra entre sus antecedentes el haber sufrido durante 20 años de una litiasis biliar, cuyas manifestaciones cedieron al serle practicada la colecistectomía hace 6 años: fue apendicitomizaclo hace 10 años: los demás antecedentes carecen de importancia. Desde hace tres años presenta marcada anorexia, cólicos iguales él los que se presentaban antes de ser operado, vómitos, estados ictéricos pasajeros, agrieras y marcada costipación. Se trata de un enfermo brevilíneo, obeso, cuyo examen clínico revela la presencia de un marcado meteorismo abdominal, sin que haya puntos dolorosos, tumefacciones, vísceras palpables ni ninguna otra anomalía. Dados sus antecedentes quirúrgicos, se hace el diagnóstico de colangitis crónica, instituyéndose en consecuencia un régimen dietético adecuado y la terapéutica médica correspondiente (colagogos, desinfectantes biliares, metionina, colina, etc al mismo tiempo que se ordena un examen coprológico y uno radiológico de vías divestivas y biliares.

  20. Diverticulitis and diverticulosis - discharge

    Science.gov (United States)

    Bhuket TP, Stollman NH. Diverticular disease of the colon. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier ...

  1. Diverticulosis and Diverticulitis

    Science.gov (United States)

    ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ...

  2. Dietary non-esterified oleic Acid decreases the jejunal levels of anorectic N-acylethanolamines

    DEFF Research Database (Denmark)

    Diep, Thi Ai; Madsen, Andreas N; Krogh-Hansen, Sandra

    2014-01-01

    mice respond to dietary fat (olive oil) by reducing levels of anorectic NAEs, and 3) whether dietary non-esterified oleic acid also can decrease levels of anorectic NAEs in mice. We are searching for the fat sensor in the intestine, which mediates the decreased levels of anorectic NAEs. METHODS: Male...... of anorectic NAEs in mice. CONCLUSIONS: These results suggest that the down-regulation of the jejunal level of anorectic NAEs by dietary fat is not restricted to rats, and that the fatty acid component oleic acid, in dietary olive oil may be sufficient to mediate this regulation. Thus, a fatty acid sensor may...

  3. Conversion of choledochojejunostomy stents to jejunal feeding tubes for postoperative enteral alimentation.

    Science.gov (United States)

    Burke, D R; Torosian, M H; McLean, G K; Meranze, S G; Rosato, E F

    1988-01-01

    The problem of protein calorie malnutrition following major gastrointestinal surgery can be treated with central venous or enteric alimentation, with the latter being preferred. The authors describe a simple technique for the conversion of biliary stents placed after pancreaticoduodenal surgery into jejunal feeding tubes when the stenting function is no longer needed. Three illustrative cases are presented. In each case, the procedure took less than 30 min and had no associated morbidity. This technique allows early conversion from central venous to enteric alimentation without the need to create a second surgical enterostomy.

  4. [Reconstruction of the hypopharynx and cervical esophagus using a free jejunal graft].

    Science.gov (United States)

    Pesko, P; Bumbasirević, M; Knezević, J; Dunjić, M; Djukić, V; Simić, A; Stojakov, D; Sabljak, P; Bjelović, M; Janković, Z; Micev, M; Saranović, D

    2000-01-01

    Extensive malignant tumors of the hypopharynx and cervical esophagus continue to challenge surgeons in respect to both type and extent of resection as well as type of reconstruction. In the period between November 1st, 1996 and November 1st, 1998, at our Department, five patients have been operated due to squamocellular carcinoma of the hypopharynx using a free jejunal graft reconstruction method. The first free jejunal graft operation due to hypopharyngeal carcinoma, at the same time the first operation of this kind ever done in our Country, was performed on November 13th, 1998. There were 4 female and one male patient, average age 47.75 years. Disfagia for solid foods was a leading symptom in all patients (mean duration of 3.5 months) and was always accompanied with weight loss (average of 8 kg for two months). In all patients barium swallow, endoscopy, CT as well as intraoperative endoscopy was performed. Radical surgical procedure was always accompanied with the bilateral modified lympf node neck dissection. As a arterial donor vessel superior thyroid artery was used in all patients. As a venous drainage in three patients a external jugular vein was used and in two facial vein. Reconstruction using a free jejunal graft of approximately 25 cm long was performed in all patients creating upper, oropharingeal, anastomosis end to side and distal, esophageal, end to end (in only one patients side to end) using 3/0 apsorbable sutures. Mean duration of the operation was six hours. The postoperative course in all patients was uneventful. On the 9th postoperative day gastrografin and three days later barium swallow radiography was performed as a standard control study. Regular check ups were done on three, six, nine months, year and two years. On all controls all patients were symptom free and feeling well. It is our opinion that in the patients with isolated carcinoma of the hypopharynx due to low morbidity and mortality rate, free jejunal graft method is the surgical

  5. Serotonin receptors influencing cell proliferation in the jejunal crypt epithelium and in colonic adenocarcinomas.

    Science.gov (United States)

    Tutton, P J; Barkla, D H

    1986-01-01

    Serotonin has previously been shown to stimulate cell proliferation in the jejunal crypt epithelium and in colonic tumours. The original classification of serotonin receptors into D and M groups was not conductive to the understanding of these observations. The more recent classification of serotonin receptors into 5HT1 and 5HT2 groups is considered in this report. On the balance of evidence it appears that similar receptors mediate the response to serotonin in the two tissues under consideration and that these receptors resemble those of the 5HT1 group. Such receptors are usually positively linked to adenylate cyclase.

  6. Refractory cytopenias secondary to copper deficiency in children receiving exclusive jejunal nutrition.

    Science.gov (United States)

    Jacobson, Amanda E; Kahwash, Samir B; Chawla, Anjulika

    2017-11-01

    Copper deficiency is a known cause of anemia and neutropenia that is easily remedied with copper supplementation. Copper is primarily absorbed in the stomach and proximal duodenum, so patients receiving enteral nutrition via methods that bypass this critical region may be at increased risk for copper deficiency. In pediatrics, postpyloric enteral feeding is increasingly utilized to overcome problems related to aspiration, severe reflux, poor gastric motility, and gastric outlet obstruction. However, little is known about the prevalence of copper deficiency in this population. We describe three pediatric patients receiving exclusive jejunal feeds who developed cytopenias secondary to copper deficiency. © 2017 Wiley Periodicals, Inc.

  7. Further studies on the effect of adenosine cyclic monophosphate derivatives on cell proliferation in the jejunal crypts of rat.

    Science.gov (United States)

    Tutton, P J; Barkla, D H

    1982-01-01

    1. Cell proliferation in the jejunal crypt epithelium of rat was measured using a stathmokinetic technique. 2. Sodium butyrate was found to promote jejunal crypt cell proliferation. 3. N6, O2'-Dibutyryl cyclic adenosine monophosphate (cAMP), N6-monobutyryl-cAMP and N6-monobutyryl-8-bromo-cAMP were found to inhibit cell proliferation when compared to sodium butyrate treated tissues. 4. 8-Chlorophenylthio-cAMP was found to inhibit cell division when compared to untreated animals. 5. O2'-Monobutyryl cAMP and 8-bromo-cAMP were not found to inhibit cell proliferation.

  8. Transepithelial transport of PAMAM dendrimers across isolated rat jejunal mucosae in ussing chambers.

    Science.gov (United States)

    Hubbard, Dallin; Ghandehari, Hamidreza; Brayden, David J

    2014-08-11

    Oral delivery remains a challenge for poorly permeable hydrophilic macromolecules. Poly(amido amine) (PAMAM) dendrimers have shown potential for their possible oral delivery. Transepithelial transport of carboxyl-terminated G3.5 and amine-terminated G4 PAMAM dendrimers was assessed using isolated rat jejunal mucosae mounted in Ussing chambers. The 1 mM FITC-labeled dendrimers were added to the apical side of mucosae. Apparent permeability coefficients (Papp) from the apical to the basolateral side were significantly increased for FITC when conjugated to G3.5 PAMAM dendrimer compared to FITC alone. Minimal signs of toxicity were observed when mucosae were exposed to both dendrimers with respect to transepithelial electrical resistance changes, carbachol-induced short circuit current stimulation, and histological changes. [(14)C]-mannitol fluxes were not altered in the presence of 1 mM dendrimers, suggesting that the paracellular pathway was not affected at this concentration in this model. These results give insight into the mechanism of PAMAM dendrimer transepithelial rat jejunal transport, as well as toxicological considerations important for oral drug delivery.

  9. An unusual presentation of a malignant jejunal tumor and a different management strategy

    Directory of Open Access Journals (Sweden)

    Parida Dillip K

    2005-01-01

    Full Text Available Abstract Background Malignant small bowel tumors are very rare and leiomyosarcoma accounts for less than 15% of the cases. Management of these tumors is challenging in view of nonspecific symptoms, unusual presentation and high incidence of metastasis. In this case report, an unusual presentation of jejunal sarcoma and management of liver metastasis with radiofrequency ablation (RFA is discussed. Case presentation A 45-year-old male presented with anemia and features of small bowel obstruction. Operative findings revealed a mass lesion in jejunum with intussusception of proximal loop. Resection of bowel mass was performed. Histopathological findings were suggestive of leiomyosarcoma. After 3-years of follow-up, the patient developed recurrence in infracolic omentum and a liver metastasis. The omental mass was resected and liver lesion was managed with radiofrequency ablation. Conclusion Jejunal leiomyosarcoma is a rare variety of malignant small bowel tumor and a clinical presentation with intussusception is unusual. We suggest that an aggressive management approach using a combination of surgery and a newer technique like RFA can be attempted in patients with limited metastatic spread to liver to prolong the long-term survival in a subset of patients.

  10. Duodenal-jejunal bypass liner implantation provokes rapid weight loss and improved glycemic control, accompanied by elevated fasting ghrelin levels

    NARCIS (Netherlands)

    Koehestanie, P.; Dogan, K.; Berends, F.; Janssen, I.; Wahab, P.J.; Groenen, M.; Müller, M.R.; Wit, de N.J.W.

    2014-01-01

    Background and study aims: Endoscopic implantation of a duodenal-jejunal bypass liner (DJBL) is a novel bariatric technique to induce weight loss and remission of type 2 diabetes mellitus. Placement of the DJBL mimics the bypass component of the Roux-en-Y gastric bypass (RYGB) procedure. In this

  11. Behandling med duodenal-jejunal bypass-sleeve ved svær overvægt

    DEFF Research Database (Denmark)

    Rohde, Ulrich; Gylvin, Silas; Vilmann, Peter

    2014-01-01

    Overweight and obesity are risk factors for several co-morbidities reducing life expectancy. Conservative treatment of obesity is generally ineffective in the long-term. Bariatric surgery has proven effective, but is associated with potential complications. Duodenal-jejunal bypass sleeve is a novel...

  12. Proteomic analysis of protein interactions between Eimeria maxima sporozoites and chicken jejunal epithelial cells by shotgun LC-MS/MS.

    Science.gov (United States)

    Huang, Jingwei; Liu, Tingqi; Li, Ke; Song, Xiaokai; Yan, Ruofeng; Xu, Lixin; Li, Xiangrui

    2018-04-04

    Eimeria maxima initiates infection by invading the jejunal epithelial cells of chicken. However, the proteins involved in invasion remain unknown. The research of the molecules that participate in the interactions between E. maxima sporozoites and host target cells will fill a gap in our understanding of the invasion system of this parasitic pathogen. In the present study, chicken jejunal epithelial cells were isolated and cultured in vitro. Western blot was employed to analyze the soluble proteins of E. maxima sporozoites that bound to chicken jejunal epithelial cells. Co-immunoprecipitation (co-IP) assay was used to separate the E. maxima proteins that bound to chicken jejunal epithelial cells. Shotgun LC-MS/MS technique was used for proteomics identification and Gene Ontology was employed for the bioinformatics analysis. The results of Western blot analysis showed that four proteins bands from jejunal epithelial cells co-cultured with soluble proteins of E. maxima sporozoites were recognized by the positive sera, with molecular weights of 70, 90, 95 and 130 kDa. The co-IP dilutions were analyzed by shotgun LC-MS/MS. A total of 204 proteins were identified in the E. maxima protein database using the MASCOT search engine. Thirty-five proteins including microneme protein 3 and 7 had more than two unique peptide counts and were annotated using Gene Ontology for molecular function, biological process and cellular localization. The results revealed that of the 35 annotated peptides, 22 (62.86%) were associated with binding activity and 15 (42.86%) were involved in catalytic activity. Our findings provide an insight into the interaction between E. maxima and the corresponding host cells and it is important for the understanding of molecular mechanisms underlying E. maxima invasion.

  13. Gastric pull-up reconstruction combined with free jejunal transfer (FJT) following total pharyngolaryngo-oesophagectomy (PLE).

    Science.gov (United States)

    Ni, Song; Zhu, Yiming; Li, Dezhi; Li, Zhengjiang; Wu, Yuehuang; Xu, Zhengang; Liu, Shaoyan

    2015-06-01

    Reconstruction following total pharyngolaryngo-oesophagectomy (PLE) still challenges surgeons because of the extreme length of removed tissue. Gastric pull-up reconstruction, one of the most common reconstructive methods after PLE, has many complications such as anastomotic fistula and gastric necrosis caused by the high anastomotic tension. However, modifications of gastric pull-up reconstruction aiming to reducing the high anastomotic tension have been less reported compared with other aspects with this technique. Here we report a modified gastric pull-up reconstruction combined with free jejunal transfer (FTJ) to reduce the anastomosis tension, and thus to reduce the risk of complications after PLE. Patients underwent a standard surgical procedure including total pharyngolaryngo-oesophagectomy and bilateral internal jugular lymph nodal clearance. A free jejunal graft about 10 cm was harvested and placed in the appropriate position between mobilized stomach and oropharynx. The anastomosis between the free jejunal graft and the gastric tube was created through a stapler. Vascular anastomosis was made between the jejunal artery and the transverse cervical artery, and between the jejunal vein and the internal jugular vein. Hand suturing technique was used in the anastomosis between jejunum and pharynx. None of the patients suffered from any complications such as anastomotic fistula. Both patients resumed early postoperative oral intake. So far, they remain free of tumor recurrence and are in good health for 46 and 18 months, respectively. Considering the tumor status and the patient condition, the gastric pull-up reconstruction combined with FJT after PLE could be a reliable choice. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  14. Laparoscopic pylorus-preserving pancreatoduodenectomy with double jejunal loop reconstruction: an old trick for a new dog.

    Science.gov (United States)

    Machado, Marcel Autran C; Makdissi, Fabio F; Surjan, Rodrigo C T; Machado, Marcel C C

    2013-02-01

    Pancreatoduodenectomy is an established procedure for the treatment of benign and malignant diseases located at the pancreatic head and periampullary region. In order to decrease morbidity and mortality, we devised a unique technique using two different jejunal loops to avoid activation of pancreatic juice by biliary secretion and therefore reduce the severity of pancreatic fistula. This technique has been used for open pancreatoduodenectomy worldwide but to date has never been described for laparoscopic pancreatoduodenectomy. This article reports the technique of laparoscopic pylorus-preserving pancreatoduodenectomy with two jejunal loops for reconstruction of the alimentary tract. After pancreatic head resection, retrocolic end-to-side pancreaticojejunostomy with duct-to-mucosa anastomosis is performed. The jejunal loop is divided with a stapler, and side-to-side jejunojejunostomy is performed with the stapler, leaving a 40-cm jejunal loop for retrocolic hepaticojejunostomy. Finally, end-to-side duodenojejunostomy is performed in an antecolic fashion. This technique has been successfully used in 3 consecutive patients with pancreatic head tumors: 2 patients underwent hand-assisted laparoscopic pylorus-preserving pancreatoduodenectomy, and 1 patient underwent totally laparoscopic pylorus-preserving pancreatoduodenectomy. One patient presented a Grade A pancreatic fistula that was managed conservatively. One patient received blood transfusion. Mean operative time was 9 hours. Mean hospital stay was 7 days. No postoperative mortality was observed. Laparoscopic pylorus-preserving pancreatoduodenectomy with double jejunal loop reconstruction is feasible and may be useful to decrease morbidity and mortality after pancreatoduodenectomy. This operation is challenging and may be reserved for highly skilled laparoscopic surgeons.

  15. Food allergy alters jejunal circular muscle contractility and induces local inflammatory cytokine expression in a mouse model

    Directory of Open Access Journals (Sweden)

    Kovanen Petri T

    2009-05-01

    Full Text Available Abstract Background We hypothesized that food allergy causes a state of non-specific jejunal dysmotility. This was tested in a mouse model. Methods Balb/c mice were epicutaneously sensitized with ovalbumin and challenged with 10 intragastric ovalbumin administrations every second day. Smooth muscle contractility of isolated circular jejunal sections was studied in organ bath with increasing concentrations of carbamylcholine chloride (carbachol. Smooth muscle layer thickness and mast cell protease-1 (MMCP-1 positive cell density were assayed histologically. Serum MMCP-1 and immunoglobulins were quantified by ELISA, and mRNA expressions of IFN-γ, IL-4, IL-6 and TGFβ-1 from jejunal and ileal tissue segments were analyzed with quantitative real-time PCR. Results Ovalbumin-specific serum IgE correlated with jejunal MMCP-1+ cell density. In the allergic mice, higher concentrations of carbachol were required to reach submaximal muscular stimulation, particularly in preparations derived from mice with diarrhoea. Decreased sensitivity to carbachol was associated with increased expression of IL-4 and IL-6 mRNA in jejunum. Smooth muscle layer thickness, as well as mRNA of IFN-γ and TGF-β1 remained unchanged. Conclusion In this mouse model of food allergy, we demonstrated a decreased response to a muscarinic agonist, and increased levels of proinflammatory IL-6 and Th2-related IL-4, but not Th1-related IFN-γ mRNAs in jejunum. IgE levels in serum correlated with the number of jejunal MMCP-1+ cells, and predicted diarrhoea. Overall, these changes may reflect a protective mechanism of the gut in food allergy.

  16. Videoradiography of free jejunal grafts for rehabilitation of speech in laryngectomized patients

    International Nuclear Information System (INIS)

    Pokieser, P.; Grasl, M.C.; Schima, W.; Uranitsch, K.; Piza-Katzer, H.; Niederle, B.; Ehrenberger, K.; Ekberg, O.; Tscholakoff, D.

    1995-01-01

    In laryngectomized patients a tracheo-esophageal artificial fistula can be used to achieve air flow from the trachea to the esophagus during speech. A one-way plastic valve is often used for the fistula. A free jejunal graft between the trachea and the esophagus can also be used. To avoid aspiration the transplant is attached to the submental area giving the graft a siphon-like shape. We performed 23 videoradiographic examinations using high-density barium in 14 such patients. The aim was to evaluate the protective function of these grafts against aspiration. Penetration of the bolus and a small amount of residual contrast material in the ascending limb of the graft was a normal finding. If the standard barium bolus reached the descending limb at any time during the examination, this was a sign of aspiration hazard. To avoid aspiration, the vertex of the speech siphon should be higher than the level of the hypopharyngeal anastomosis. (orig.)

  17. Improved cell line IPEC-J2, characterized as a model for porcine jejunal epithelium.

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    Silke S Zakrzewski

    Full Text Available Cell lines matching the source epithelium are indispensable for investigating porcine intestinal transport and barrier properties on a subcellular or molecular level and furthermore help to reduce animal usage. The porcine jejunal cell line IPEC-J2 is established as an in vitro model for porcine infection studies but exhibits atypically high transepithelial resistances (TER and only low active transport rates so that the effect of nutritional factors cannot be reliably investigated. This study aimed to properly remodel IPEC-J2 and then to re-characterize these cells regarding epithelial architecture, expression of barrier-relevant tight junction (TJ proteins, adequate TER and transport function, and reaction to secretagogues. For this, IPEC-J2 monolayers were cultured on permeable supports, either under conventional (fetal bovine serum, FBS or species-specific (porcine serum, PS conditions. Porcine jejunal mucosa was analyzed for comparison. Main results were that under PS conditions (IPEC-J2/PS, compared to conventional FBS culture (IPEC-J2/FBS, the cell height increased 6-fold while the cell diameter was reduced by 50%. The apical cell membrane of IPEC-J2/PS exhibited typical microvilli. Most importantly, PS caused a one order of magnitude reduction of TER and of trans- and paracellular resistance, and a 2-fold increase in secretory response to forskolin when compared to FBS condition. TJ ultrastructure and appearance of TJ proteins changed dramatically in IPEC-J2/PS. Most parameters measured under PS conditions were much closer to those of typical pig jejunocytes than ever reported since the cell line's initial establishment in 1989. In conclusion, IPEC-J2, if cultured under defined species-specific conditions, forms a suitable model for investigating porcine paracellular intestinal barrier function.

  18. Exogenous transforming growth factor-β1 enhances smooth muscle differentiation in embryonic mouse jejunal explants.

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    Coletta, Riccardo; Roberts, Neil A; Randles, Michael J; Morabito, Antonino; Woolf, Adrian S

    2017-01-13

    An ex vivo experimental strategy that replicates in vivo intestinal development would in theory provide an accessible setting with which to study normal and dysmorphic gut biology. The current authors recently described a system in which mouse embryonic jejunal segments were explanted onto semipermeable platforms and fed with chemically defined serum-free media. Over 3 days in organ culture, explants formed villi and they began to undergo spontaneous peristalsis. As defined in the current study, the wall of the explanted gut failed to form a robust longitudinal smooth muscle (SM) layer as it would do in vivo over the same time period. Given the role of transforming growth factor β1 (TGFβ1) in SM differentiation in other organs, it was hypothesized that exogenous TGFβ1 would enhance SM differentiation in these explants. In vivo, TGFβ receptors I and II were both detected in embryonic longitudinal jejunal SM cells and, in organ culture, exogenous TGFβ1 induced robust differentiation of longitudinal SM. Microarray profiling showed that TGFβ1 increased SM specific transcripts in a dose dependent manner. TGFβ1 proteins were detected in amniotic fluid at a time when the intestine was physiologically herniated. By analogy with the requirement for exogenous TGFβ1 for SM differentiation in organ culture, the TGFβ1 protein that was demonstrated to be present in the amniotic fluid may enhance intestinal development when it is physiologically herniated in early gestation. Future studies of embryonic intestinal cultures should include TGFβ1 in the defined media to produce a more faithful model of in vivo muscle differentiation. Copyright © 2017 The Authors Journal of Tissue Engineering and Regenerative Medicine Published by John Wiley & Sons, Ltd. Copyright © 2017 The Authors Journal of Tissue Engineering and Regenerative Medicine Published by John Wiley & Sons, Ltd.

  19. Surgery for nonobese type 2 diabetic patients: an interventional study with duodenal-jejunal exclusion.

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    Geloneze, Bruno; Geloneze, Sylka R; Fiori, Carla; Stabe, Christiane; Tambascia, Marcos A; Chaim, Elinton A; Astiarraga, Brenno D; Pareja, Jose Carlos

    2009-08-01

    A 24-week interventional prospective trial was performed to compare the benefits of open duodenal-jejunal exclusion surgery (GJB) with a matched control group on standard medical care. One-hundred eighty patients were screened for the surgical approach. Twelve patients accepted to be operated and presented the full eligibility criteria for surgery that includes overweight BMI (25-29.9 kg/m2), T2DM diagnosis for less than 15 years, insulin-treated patients, no history of major complications, preserved beta-cell function, and absence of autoimmunity. A matched control group (CG) of patients whom refused surgical treatment was placed to receive standard care. Patients had age of 50 (5) years, time of diagnosis 9 years (range, 3 to 15 years), time of insulin usage 6 months (range, 3 to 48 months), fasting glucose (FG), 9.8 (2.5) mg/dL, and glycated hemoglobin (A1C) 8.90 (2.12)%. At 24 weeks after surgery, patients experienced greater reductions on FG (14% vs. 7% on CG), A1C (from 8.78 to 7.84 in GJB-p<0.01 and 8.93 to 8.71 in CG; p<0.05 between groups) and reductions on average daily insulin requirement (93% vs. 29%, p<0.01). Ten patients stopped insulin usage in GJB but they remain taking oral medications. No differences were observed in both groups regarding BMI, body distribution and composition, blood pressure, and lipids. In conclusion, duodenal-jejunal exclusion was an effective treatment for nonobese T2DM subjects. GJB was superior to standard care in achieving better glycemic control along with reduction in insulin requirements.

  20. A functional study on small intestinal smooth muscles in jejunal atresia

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    Preeti Tyagi

    2016-01-01

    Full Text Available Aim: The present study was aimed to assess the contractile status of neonatal small intestinal smooth muscle of dilated pre-atretic part of intestinal atresia to resolve debatable issues related to mechanisms of persistent dysmotility after surgical repair. Materials and Methods: A total of 34 longitudinally sectioned strips were prepared from pre-atretic dilated part of freshly excised 8 jejunal atresia type III a cases. Spontaneous as well as acetylcholine- and histamine-induced contractions were recorded in vitro by using organ bath preparations. Chemically evoked contractions were further evaluated after application of atropine (muscarinic blocker, pheniramine (H1 blocker, and lignocaine (neuronal blocker to ascertain receptors and neuronal involvement. Histological examinations of strips were made by using Masson trichrome stain to assess the fibrotic changes. Results: All 34 strips, except four showed spontaneous contractions with mean frequency and amplitude of 5.49 ± 0.26/min and 24.41 ± 5.26 g/g wet tissue respectively. The response to ACh was nearly twice as compared to histamine for equimolar concentrations (100 μM. ACh (100 μM induced contractions were attenuated (by 60% by atropine. Histamine (100 μM-induced contractions was blocked by pheniramine (0.32 μM and lignocaine (4 μM by 74% and 78%, respectively. Histopathological examination showed varying degree of fibrotic changes in muscle layers. Conclusions: Pre-atretic dilated part of jejunal atresia retains functional activity but with definitive histopathologic abnormalities. It is suggested that excision of a length of pre-atretic part and early stimulation of peristalsis by locally acting cholinomimetic or H1 agonist may help in reducing postoperative motility problems in atresia patients.

  1. A functional study on small intestinal smooth muscles in jejunal atresia.

    Science.gov (United States)

    Tyagi, Preeti; Mandal, Maloy B; Gangopadhyay, Ajay N; Patne, Shashikant C U

    2016-01-01

    The present study was aimed to assess the contractile status of neonatal small intestinal smooth muscle of dilated pre-atretic part of intestinal atresia to resolve debatable issues related to mechanisms of persistent dysmotility after surgical repair. A total of 34 longitudinally sectioned strips were prepared from pre-atretic dilated part of freshly excised 8 jejunal atresia type III a cases. Spontaneous as well as acetylcholine- and histamine-induced contractions were recorded in vitro by using organ bath preparations. Chemically evoked contractions were further evaluated after application of atropine (muscarinic blocker), pheniramine (H1 blocker), and lignocaine (neuronal blocker) to ascertain receptors and neuronal involvement. Histological examinations of strips were made by using Masson trichrome stain to assess the fibrotic changes. All 34 strips, except four showed spontaneous contractions with mean frequency and amplitude of 5.49 ± 0.26/min and 24.41 ± 5.26 g/g wet tissue respectively. The response to ACh was nearly twice as compared to histamine for equimolar concentrations (100 μM). ACh (100 μM) induced contractions were attenuated (by 60%) by atropine. Histamine (100 μM)-induced contractions was blocked by pheniramine (0.32 μM) and lignocaine (4 μM) by 74% and 78%, respectively. Histopathological examination showed varying degree of fibrotic changes in muscle layers. Pre-atretic dilated part of jejunal atresia retains functional activity but with definitive histopathologic abnormalities. It is suggested that excision of a length of pre-atretic part and early stimulation of peristalsis by locally acting cholinomimetic or H1 agonist may help in reducing postoperative motility problems in atresia patients.

  2. Aspectos clínicos endoscópicos, relacionados con la diverticulosis de colon. Las Tunas, enero 2011 – diciembre 2012

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    Liem Fonseca Chong

    2015-12-01

    Full Text Available Se realizó un estudio descriptivo de series de casos, en el Hospital “Dr. Ernesto Guevara de la Serna” de Las Tunas, con el objetivo de caracterizar los aspectos clínicos endoscópicos de la diverticulosis del colon, en el periodo comprendido desde enero 2011 a diciembre 2012. El universo quedó constituido por todos los pacientes a los que se les realizó colonoscopia, y la muestra por todos los pacientes con diagnóstico endoscópico de enfermedad diverticular. Para la obtención de los datos primarios se revisaron los expedientes clínicos de 101 pacientes con esta enfermedad, efectuando un cuestionario, en el cual se recogieron, analizaron y tabularon las variables, utilizando como medida de resumen el porcentaje. Se procesaron los datos y se interpretaron los resultados, concluyendo que en el grupo de pacientes estudiados predominaron las mujeres de más de 65 años, con dolor abdominal como síntoma principal y las hemorroides, como enfermedad que más se asoció a esta padecimiento, siendo el colon sigmoides el más afectado.

  3. The influence of dibutyryl adenosine cyclic monophosphate on cell proliferation in the epithelium of the jejunal crypts, the colonic crypts and in colonic carcinomata of rat.

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    Tutton, P J; Barkla, D H

    1980-01-01

    1. Cell proliferation in the jejunal crypts, the colonic crypts and in dimethylhydrazine (DMH)-induced adenocarcinomata of rat colon was measured using a stathmokinetic technique. 2. Dibutryl cyclic adneosine monophosphate (dibutyryl cAMP) was found to inhibit cell proliferation in colonic crypts and in colonic adenocarcinomata. 3. Dibutryl cAMP at very high doses was found to inhibit jejunal crypt cell proliferation but at lower doses was found to accelerate jejunal crypt cell proliferation. 4. Neither bilateral adrenalectomy nor chemical sympathectomy was found to abolish the ability of dibutryl cAMP to stimulate jejunal crypt cell proliferation. 5. The present results are difficult to interpret in terms of known hormonal influences on cell proliferation in the tissues examined and of established actions, of these hormones on cyclic nucleotide metabolism in other tissues.

  4. Alterações estruturais na mucosa jejunal de camundongos infectados com Schistosoma mansoni, alimentados com dietas hipo ou hiperprotéicas

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    Couto, Janira Lúcia Assumpção; Ferreira, Haroldo da Silva; Rocha, Dinalva Bezerra da; Duarte, Maria Eugênia Leite; Assunção, Monica Lopes; Coutinho, Eridan de Medeiros

    2002-01-01

    The effects of high and low-protein diets on the structure of the jejunal mucosa were studied in Schistosoma mansoni infected mice (morphology and histomorphometry). Weaning male albino mice were infected with 80 cercariae, fed with high (20%) or low-protein (5%) diets and compared to uninfected controls under the same conditions. Mice were sacrificed 12 weeks after infection. Animals submitted to a low-protein diet showed lower weight curves, mainly when infected. In the jejunal mucosa, fing...

  5. Urticaria due to polyethylene glycol-3350 and electrolytes for oral solution in a patient with jejunal nodular lymphoid hyperplasia.

    Science.gov (United States)

    Zhang, Hongfeng; Henry, Winoah A; Chen, Lea Ann; Khashab, Mouen A

    2015-01-01

    Both jejunal nodular lymphoid hyperplasia (NLH) and polyethylene glycol (PEG)-3350 hypersensitivity are extremely rare. We describe a 30-year-old female who had previously taken a PEG-3350 bowel preparation without adverse effects, and presented for evaluation of chronic diarrhea. An upper and lower gastrointestinal endoscopy, and small bowel series were scheduled. PEG-3350 and electrolytes for oral solution was prescribed for bowel cleansing. During consumption of the bowel preparation she developed urticarial hypersensitivity. An alternative bowel preparation was used. Colonoscopy and upper endoscopy were normal, but small bowel series revealed innumerable sand-like lucencies in the jejunum. NLH was confirmed on biopsy from antegrade enteroscopy. This is the first case report on the pathological jejunal NLH in association with the PEG-3350 urticarial hypersensitivity. The potential pathophysiological etiology of this association is discussed.

  6. Effect of dietary restriction and subsequent re-alimentation on the transcriptional profile of bovine jejunal epithelium.

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    Keogh, Kate; Waters, Sinead M; Cormican, Paul; Kelly, Alan K; Kenny, David A

    2018-01-01

    Compensatory growth (CG), an accelerated growth phenomenon which occurs following a period of dietary restriction is utilised worldwide in animal production systems as a management practise to lower feed costs. The objective of this study was to evaluate the contribution of jejunal epithelial to CG in cattle through transcriptional profiling following a period of dietary restriction as well as subsequent re-alimentation induced CG. Sixty Holstein Friesian bulls were separated into two groups; RES and ADLIB, with 30 animals in each. RES animals were offered a restricted diet for 125 days (Period 1) followed by ad libitum feeding for 55 days (Period 2). ADLIB animals had ad libitum access to feed across both periods 1 and 2. At the end of each period, 15 animals from each treatment group were slaughtered, jejunal epithelium collected and RNAseq analysis performed. Animals that were previously diet restricted underwent CG, gaining 1.8 times the rate of their non-restricted counterparts. Twenty-four genes were differentially expressed in RES compared to ADLIB animals at the end of Period 1, with only one gene, GSTA1, differentially expressed between the two groups at the end of Period 2. When analysed within treatment (RES, Period 2 v Period 1), 31 genes were differentially expressed between diet restricted and animals undergoing CG. Dietary restriction and subsequent re-alimentation were associated with altered expression of genes involved in digestion and metabolism as well as those involved in cellular division and growth. Compensatory growth was also associated with greater expression of genes involved in cellular protection and detoxification in jejunal epithelium. This study highlights some of the molecular mechanisms regulating the response to dietary restriction and subsequent re-alimentation induced CG in cattle; however the gene expression results suggest that most of the CG in jejunal epithelium had occurred by day 55 of re-alimentation.

  7. Intestinal myoelectric activity and contractile motility in dogs with a reversed jejunal segment after extensive small bowel resection.

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    Uchiyama, M; Iwafuchi, M; Ohsawa, Y; Yagi, M; Iinuma, Y; Ohtani, S

    1992-06-01

    To evaluate the functioning and effectiveness of a reversed jejunal segment after extensive small bowel resection, we continuously measured the postoperative bowel motility (using bipolar electrodes and/or contractile strain gage force transducers) in interdigestive and postprandial conscious dogs at 2 to 5 weeks after surgery. The fasting duodenal migrating myoelectric (or motor) complex (MMC) occurred at markedly longer intervals in dogs with a 20-cm reversed jejunal segment created after 75% to 80% extensive small bowel resection (group 3) than in dogs that received extensive resection alone (group 2) or dogs that underwent construction of a reversed jejunal segment without bowel resection (group 1). The MMC arising from the duodenum was often interrupted at the jejunum above the proximal anastomosis and did not migrate smoothly to the reversed segment or terminal ileum in group 3. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum above the proximal anastomosis in group 3. The duration of the postprandial period without duodenal MMC activity was significantly prolonged in groups 2 and 3. These results suggest that the transit time and passage of intestinal contents were delayed and that the periodical MMC was disturbed in group 3. The delay of transit time was due to prolongation of the interval between duodenal MMCs, the interruption of MMC propagation at the jejunum above the proximal anastomosis, the dominance of MMCs that followed the inherent anatomical continuity of the bowel, and discordant movements across the proximal anastomosis. Functional obstruction could be a potential problem in a 20-cm reversed jejunal segment inserted after extensive small bowel resection.

  8. Resulting long-term intestinal motility in dogs following construction of a reversed jejunal segment after extensive small bowel resection.

    Science.gov (United States)

    Uchiyama, M; Iwafuchi, M; Ohsawa, Y; Yagi, M; Iinuma, Y; Ohtani, S

    1994-10-01

    To evaluate the long-term function and effective motility of a reversed jejunal segment after extensive small bowel resection, the authors continuously measured postoperative bowel motility during interdigestive and postprandial periods in conscious dogs 6 to 10 months after surgery. The long-term findings were compared with previously reported short-term results measured 2 to 4 weeks after the operation. In the long-term follow-up dogs with a 20-cm reversed jejunal segment constructed after extensive (75% to 80%) small bowel resection, the fasting duodenal migrating myoelectric (or motor) complex (MMC) was often interrupted in the jejunum above the reversed segment, and did not migrate smoothly to the reversed segment or terminal ileum. The MMCs arising from the duodenum predominantly propagated to the ileum through the inherent anatomic continuity of the bowel. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum, above the proximal anastomosis. These findings are similar to those of the MMC propagation pattern noted 2 to 4 weeks after surgery. However, the postprandial duration without duodenal MMC activity was significantly shorter in the dogs with long-term follow-up than in those with short-term follow-up (both were longer than in control dogs). Marked dilatation of the jejunum and reversed jejunal segment was noted across the proximal anastomosis. These results suggest that the transit time and passage of intestinal contents can be delayed and stagnated for at least 10 months after extensive small bowel resection with a 20-cm reversed jejunal segment.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. A case of incisional hernia repair using Composix mesh prosthesis after antethoracic pedicled jejunal flap reconstruction following an esophagectomy.

    Science.gov (United States)

    Yasuda, Atsushi; Yasuda, Takushi; Kato, Hiroaki; Iwama, Mitsuru; Shiraishi, Osamu; Hiraki, Yoko; Tanaka, Yumiko; Shinkai, Masayuki; Imano, Motohiro; Kimura, Yutaka; Imamoto, Haruhiko

    2017-12-01

    An incisional hernia in a case of antethoracic pedicled jejunal flap esophageal reconstruction after esophagectomy is a very rare occurrence, and this hernia was distinctive in that the reconstructed jejunum had passed through the hernial orifice; a standard surgical treatment for such a presentation has not been established. Herein, we describe a case of repair using mesh prosthesis for an atypical and distinctive incisional hernia after antethoracic pedicled jejunal flap esophageal reconstruction. A 77-year-old woman with a history of subtotal esophagectomy who had undergone antethoracic pedicled jejunal flap reconstruction complained of epigastric prominence and discomfort without pain. On examination, she had an abdominal protrusion between the xiphoid process and the umbilicus that contained the small bowel. Computed tomography showed that the fenestration of the abdominal wall that was intentionally created for jejunum pull-up was dehisced in a region measuring 9 × 15 cm and the small intestine protruded through it into the subcutaneous space without strangulation. Because the hernial orifice was too large and the reconstructed jejunum was passing through the hernial orifice in this case, we applied a parastomal hernia repair method that was modified from the inguinal hernia repair using the Lichtenstein technique. After 3 years and 5 months following surgery, the patient has recovered without hernia recurrence or other complications. We consider this to be the first case of repair using Composix mesh prosthesis for repair of an atypical and distinctive incisional hernia after an antethoracic pedicled jejunal flap reconstruction. This method seems to be useful and could potentially be widely adopted as the surgical treatment for this condition.

  10. Portal vein stenting for delayed jejunal varix bleeding associated with portal venous occlusion after hepatoiliary and pancreatic surgery

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    Hyun, Dong Ho; Park, Kwang Bo; Cho, Sung Ki; Park, Hong Suk; Shin, Sung Wook; Choo, Sung Wook; Do, Young Soo; Choo, In Wook; Choi, Dong Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-09-15

    The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery.

  11. Portal vein stenting for delayed jejunal varix bleeding associated with portal venous occlusion after hepatoiliary and pancreatic surgery

    International Nuclear Information System (INIS)

    Hyun, Dong Ho; Park, Kwang Bo; Cho, Sung Ki; Park, Hong Suk; Shin, Sung Wook; Choo, Sung Wook; Do, Young Soo; Choo, In Wook; Choi, Dong Wook

    2017-01-01

    The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery

  12. The role of the sympathetic nervous system in radiation-induced apoptosis in jejunal crypt cells of spontaneously hypertensive rats

    International Nuclear Information System (INIS)

    Matsuu, Mutsumi; Shichijo; Kazuko; Nakamura, Yasuko; Ikeda, Yuji; Naito, Shinji; Ito, Masahiro; Okaichi, Kumio; Sekine, Ichiro

    2000-01-01

    To evaluate the effect of the sympathetic nervous system on radiation-induced apoptosis in jejunal crypt cells, apoptosis levels were compared in spontaneously hypertensive rats (SHR), animals which are a genetic hyperfunction model of the sympathetic nervous system, and normotensive Wistar-Kyoto rats (WKY). SHR and WKY were exposed to whole body X-ray irradiation at doses from 0.5 to 2 Gy. The apoptotic index in jejunal crypt cells was significantly greater in SHR than in WKY at each time point after irradiation and at each dose. WKY and SHR were treated with reserpine to induce sympathetic dysfunction, and were subsequently exposed to irradiation. Reserpine administration to SHR or WKY resulted in a significant suppression of apoptosis. p53 accumulation was detected in the jejunum in both WKY and SHR after irradiation by Western blotting analysis. There were no significant differences in the levels of p53 accumulation in irradiated intestine between WKY and SHR. These findings suggested that hyperfunction of the sympathetic nervous system is involved in the mechanism of high susceptibility to radiation-induced apoptosis of the jejunal crypt cells. (author)

  13. Emergency arterial embolization of upper gastrointestinal and jejunal tumors: An analysis of 12 patients with severe bleeding.

    Science.gov (United States)

    Zandrino, F; Tettoni, S M; Gallesio, I; Summa, M

    2017-01-01

    The goal of this study was to retrospectively assess the efficacy of emergency percutaneous transcatheter arterial embolization in patients with severe bleeding due to upper gastrointestinal or jejunal tumor. Twelve patients (7 men, 5 women; mean age, 74 years±14 (SD); range: 54-86 years) with severe bleeding from the upper gastrointestinal tract, with failed endoscopic treatment not eligible for emergency surgery were treated by emergency percutaneous transcatheter arterial embolization. The bleeding cause was gastric tumor in 7 patients, duodenal tumor in 4 patients and jejunal tumor in one patient. Procedure details and follow-up were reviewed. Twelve embolization procedures were performed using various embolic agents. Embolization was achieved and bleeding was stopped in all patients. Five patients underwent surgery within the 30 days following embolization. In the remaining 7 patients, no bleeding occurred at 1 month follow-up in 6 patients and bleeding recurred in one patient at 1 month. In this later patient, endoscopic treatment was successful. The results of our study suggest that transcatheter arterial embolization is safe and effective in patients with severe arterial bleeding due to upper gastrointestinal or jejunal tumor. In some patients, transcatheter arterial embolization can be used as a bridge to surgery. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  14. Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report

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    Van De Winkel Nele

    2012-02-01

    Full Text Available Abstract Introduction Ischemic bowel disease comprises both mesenteric ischemia and colonic ischemia. Mesenteric ischemia can be divided into acute and chronic ischemia. These are two separate entities, each with their specific clinical presentation and diagnostic and therapeutic modalities. However, diagnosis may be difficult due to the vague symptomatology and subtle signs. Case presentation We report the case of a 68-year-old Caucasian woman who presented with abdominal discomfort, anorexia, melena and fever. A physical examination revealed left lower quadrant tenderness and an irregular pulse. Computed tomography of her abdomen as well as computed tomography enterography, enteroscopy, angiography and small bowel enteroclysis demonstrated an ischemic jejunal segment caused by occlusion of a branch of the superior mesenteric artery. The ischemic segment was resected and an end-to-end anastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study. Conclusion Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists. Acute and chronic mesenteric ischemia are two separate entities with their own specific clinical presentation, radiological signs and therapeutic modalities. We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology. To the best of our knowledge, this is the first report presenting a case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.

  15. Phytic acid decreases deoxynivalenol and fumonisin B1-induced changes on swine jejunal explants

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    Elisângela Olegário da Silva

    2014-01-01

    Full Text Available The purpose of the present study was to investigate the effects of phytic acid (IP6 on morphological and immunohistochemical parameters on intestinal explants exposed to deoxynivalenol (DON and fumonisin B1 (FB1. The jejunal explants were exposed for 4 h to different treatments: control, DON (10 μM, DON plus 2.5 mM or 5 mM IP6, FB1 (70 μM, and FB1 plus 2.5 mM or 5 mM IP6. Both mycotoxins induced significant intestinal lesions and decreased villi height. The presence of 2.5 mM and 5 mM IP6 significantly inhibited the morphological changes caused by the mycotoxins. DON induced a significant increase in caspase-3 (83% and cyclooxygenase-2 (71.3% expression compared with the control. The presence of 5 mM IP6 induced a significant decrease in caspase-3 (43.7% and Cox-2 (48% expression compared with the DON group. FB1 induced a significant increase in caspase-3 expression (47% compared to the control, whereas IP6 induced no significant change in this expression. A significant decrease in cell proliferation was observed when explants were exposed to 5 mM of IP6 in comparison with the DON and FB1 groups. The present data provide evidence that phytic acid modulates the toxic effects induced by DON and FB1 on intestinal tissue.

  16. Direct microvascular monitoring of a free autologous jejunal flap using microendoscopy: a case report

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    Hopper Colin

    2006-09-01

    Full Text Available Abstract Background Early identification of flap failure is an indispensable prerequisite for flap salvage. Although many technical developments of free flap monitoring have now reached clinical application, very few are considered to be reliable and non-invasive for early recognition of flap failure. Case presentation We used microendoscopic technique for microvascular monitoring of free autologous jejunal flap by the direct visualisation of the flow of erythrocytes through the capillary vasculature on both the mucosal and serosal surfaces. Blood flow was seen to be pulsatile, with individual erythrocytes visible in the capillaries. The best view was obtained when the scope was focussed directly on the capillary rather than the graft surface. The view of the unstained mucosal surface was bland apart from the fine capillary loops which were seen to fill with each pulsatile event. The microendoscopic examination of the serosal surface revealed much larger calibre vessels with obvious blood flow. Conclusion The microendoscopic monitoring technique is simple and safe with direct visualisation of blood flow. The technique may also be useful for the monitoring of other free bowel transplants.

  17. Protective Effects of Vitamin E on Methotrexate-Induced Jejunal Mucosal Damage in Rats.

    Science.gov (United States)

    Burcu, Busra; Kanter, Mehmet; Orhon, Zeynep Nur; Yarali, Oguzhan; Karabacak, Rukiye

    2016-04-01

    To investigate the possible protective effects of Vitamin E (Vit E) on oxidative stress and jejunal damage in the rat intestinal mucosa after methotrexate (MTX)-induced enterotoxicity. Rats were divided into 3 groups: control, MTX, and MTX+ Vit E; each group contained 8 animals. The control group was given physiological serum in addition to sunflower oil for 3 days. The second group was given sunflower oil with intragastric tube daily, followed by MTX injection (20 mg/kg intraperitoneally). To the third group, starting 3 days before injection, Vit E was given dissolved in sunflower oil (600 mg/kg orally) in addition to MTX injection. Four days after MTX injection the anesthetized rats were sacrificed, and the tissue samples obtained from their jejunums were investigated for histological and biochemical analysis. Vit E treatment significantly decreased the elevated tissue malondialdehyde levels and increased the reduced glutathione peroxidase and superoxide dismutase activities in comparison to the MTX-treated group. MTX treatment caused severe histopathological injury including mucosal erosions, inflammatory cell infiltration, necrosis, hemorrhage, and villous congestion. Vit E treatment significantly attenuated the severity of intestinal injury caused by MTX via inhibiting induced nitric oxide synthase levels and NF-κB p65 activation. Because of its reconstructing and antioxidant effects, Vit E pretreatment may have protective effects in the intestinal tissue of MTX-treated rats.

  18. A Rare Case of Jejunal Arterio-Venous Fistula: Treatment with Superselective Catheter Embolization with a Tracker-18 Catheter and Microcoils

    International Nuclear Information System (INIS)

    Sonnenschein, Martin J.; Anderson, Suzanne E.; Lourens, Steven; Triller, Juergen

    2004-01-01

    Arterio-venous fistulas may develop spontaneously, following trauma or infection, or be iatrogenic in nature. We present a rare case of a jejunal arterio- venous fistula in a 35-year-old man with a history of pancreatic head resection that had been performed two years previously because of chronic pancreatitis. The patient was admitted with acute upper abdominal pain, vomiting and an abdominal machinery-type bruit. The diagnosis of a jejunal arterio-venous fistula was established by MR imaging. Transfemoral angiography was performed to assess the possibility of catheter embolization. The angiographic study revealed a small aneurysm of the third jejunal artery, abnormal early filling of dilated jejunal veins and marked filling of the slightly dilated portal vein (13-14 mm). We considered the presence of segmental portal hypertension. The patient was treated with coil embolization in the same angiographic session. This case report demonstrates the importance of auscultation of the abdomen in the initial clinical examination. MR imaging and color Doppler ultrasound are excellent noninvasive tools in establishing the diagnosis. The role of interventional radiological techniques in the treatment of early portal hypertension secondary to jejunal arterio-venous fistula is discussed at a time when this condition is still asymptomatic. A review of the current literature is included

  19. Morbidity and Functional Outcomes following Free Jejunal Flap Reconstruction for Head and Neck Cancer.

    Science.gov (United States)

    Ni, Song; Zhu, Yiming; Qu, Dong; Wang, Jian; Li, Dezhi; Zhang, Bin; Xu, Zhengang; Liu, Shaoyan

    2017-01-01

    To evaluate the morbidity and fundamental functional outcomes (swallow and speech) after free jejunal flap (FJF) reconstruction following total pharyngolaryngo-esophagectomy (PLE) in China. 18 patients with FJF reconstruction after total PLE were retrospectively reviewed. Scheduled barium swallow test was performed 7-10 days postoperatively. Rehabilitation of swallowing and speech for patients was assessed by the Performance Status Scale for Head and Neck Cancer Patients. 8 patients died of tumor recurrence and 2 patients died of other reasons (cerebrovascular disease and respiratory disease, respectively). The 1-year, 2-year, and 3-year survival rates were 70.5, 49.4, and 33.8%, respectively. 83.3% of all patients could tolerate soft chewable foods, such as cooked vegetables, fish, hamburger, and small pieces of meat. 2 patients with early stenosis at upper anastomotic sites were with good swallowing function; while 2 patients with early stenosis at lower anastomotic sites were found to have difficulty in oral diet. 2 (11.1%) patients with larynx-preserving pharyngo-esophagectomy showed no compromise in speech. Only 2 (11.1%) patients underwent primary tracheoesophageal puncture for inserting an indwelling voice prosthesis for speech, and both patients achieved functional tracheoesophageal speech. The remaining 14 (77.8%) patients with total PLE did not resume functional speech. Postoperative barium swallow examination is helpful to predict long-term anastomotic stenosis. Good functional swallow rehabilitation is achieved following FJF reconstruction after total PLE or a larynx-preserving procedure. However, the speech outcomes are not satisfactory. It raises the demand of enhancement of functional recovery so that quality of life can be improved for these patients in China. © 2017 S. Karger AG, Basel.

  20. Mucormicosis yeyunal en paciente con linfoma de Hodgkin Jejunal mucormycosis in a patient with Hodgkin's lymphoma

    Directory of Open Access Journals (Sweden)

    B. Madrigal

    2008-08-01

    Full Text Available Comunicamos un caso de mucormicosis intestinal en un hombre de 46 años de edad, diagnosticado de enfermedad de Hodgkin clásica, estadio IV-B. Durante la primera fase de la quimioterapia, sufrió una hemorragia digestiva masiva secundaria a una úlcera yeyunal por zigomicosis tipo mucor, diagnosticada por biopsia endoscópica. El paciente fue tratado con antifúngicos y resección quirúrgica del intestino afectado. En la cirugía, se apreció una doble perforación yeyunal cubierta. El estudio anatomopatológico de la pieza confirmó el diagnóstico previo. Tras un año de seguimiento, el paciente está recuperado y su linfoma de Hodgkin en remisión completa. Tras una extensa revisión de la literatura, según nuestro conocimiento, este es el segundo caso publicado en la literatura de mucormicosis intestinal en un paciente con linfoma de Hodgkin.We report a case of intestinal mucormycosis in a 46-year-old male diagnosed with classical Hodgkin's disease, IV-B stage. During the first phase of chemotherapy he had a massive digestive bleeding event secondary to a jejunal ulcer, and zygomicosis mucor-type was diagnosed by endoscopic biopsy. The patient was treated with antifungal drugs and surgical resection of the intestine involved. At surgery a double covered perforation of the jejunum was seen. Pathological examination confirmed the previous diagnosis. After one year of follow-up the patient is doing well, and his lymphoma is on remission. To our best knowledge this is the second case of intestinal mucormycosis in a patient with Hodgkin's lymphoma reported in the medical literature.

  1. Jejunal brush border microvillous alterations in Giardia muris-infected mice: role of T lymphocytes and interleukin-6.

    Science.gov (United States)

    Scott, K G; Logan, M R; Klammer, G M; Teoh, D A; Buret, A G

    2000-06-01

    Intestinal colonization with the protozoan Giardia causes diffuse brush border microvillous alterations and disaccharidase deficiencies, which in turn are responsible for intestinal malabsorption and maldigestion. The role of T cells and/or cytokines in the pathogenesis of Giardia-induced microvillous injury remains unclear. The aim of this study was to assess the role of T cells and interleukin-6 (IL-6) in the brush border pathophysiology of acute murine giardiasis in vivo. Athymic nude (nu(-)/nu(-)) CD-1 mice and isogenic immunocompetent (nu(+)/nu(+)) CD-1 mice (4 weeks old) received an axenic Giardia muris trophozoite inoculum or vehicle (control) via orogastric gavage. Weight gain and food intake were assessed daily. On day 6, segments of jejunum were assessed for parasite load, brush border ultrastructure, IL-6 content, maltase and sucrase activities, villus-crypt architecture, and intraepithelial lymphocyte (IEL) infiltration. Despite similar parasitic loads on day 6, infected immunocompetent animals, but not infected nude mice, showed a diffuse loss of brush border microvillous surface area, which was correlated with a significant reduction in maltase and sucrase activities and a decrease in jejunal IL-6 concentration. In both athymic control and infected mice, jejunal brush border surface area and disaccharidases were high, but levels of tissue IL-6 were low and comparable to the concentration measured in immunocompetent infected animals. In both immunocompetent and nude mice, infection caused a small but significant increase in the numbers of IELs. These findings suggest that the enterocyte brush border injury and malfunction seen in giardiasis is, at least in part, mediated by thymus-derived T lymphocytes and that suppressed jejunal IL-6 does not necessarily accompany microvillous shortening.

  2. Jejunal feeding is followed by a greater rise in plasma cholecystokinin, peptide YY, glucagon-like peptide 1, and glucagon-like peptide 2 concentrations compared with gastric feeding in vivo in humans

    NARCIS (Netherlands)

    Luttikhold, Joanna; Norren, Van Klaske; Rijna, Herman; Buijs, Nikki; Ankersmit, Marjolein; Heijboer, Annemieke C.; Gootjes, Jeannette; Hartmann, Bolette; Holst, Jens J.; Loon, Van Luc J.C.; Leeuwen, Van P.A.M.

    2016-01-01

    Background: Jejunal feeding is preferred instead of gastric feeding in patients who are intolerant to gastric feeding or at risk of aspiration. However, the impact of gastric feeding compared with that of jejunal feeding on postprandial circulating plasma glucose and amino acid concentrations and

  3. Jejunal feeding is followed by a greater rise in plasma cholecystokinin, peptide YY, glucagon-like peptide 1, and glucagon-like peptide 2 concentrations compared with gastric feeding in vivo in humans: a randomized trial

    NARCIS (Netherlands)

    Luttikhold, Joanna; van Norren, Klaske; Rijna, Herman; Buijs, Nikki; Ankersmit, Marjolein; Heijboer, Annemieke C.; Gootjes, Jeannette; Hartmann, Bolette; Holst, Jens J.; van Loon, Luc Jc; van Leeuwen, Paul Am

    2016-01-01

    Jejunal feeding is preferred instead of gastric feeding in patients who are intolerant to gastric feeding or at risk of aspiration. However, the impact of gastric feeding compared with that of jejunal feeding on postprandial circulating plasma glucose and amino acid concentrations and the associated

  4. Novel double-stapling technique for distal oesophageal resection and oesophago-jejunal anastomosis.

    Science.gov (United States)

    Gentilli, Sergio; Portigliotti, Luca; Davoli, Fabio; Roncon, Alberto; Rena, Ottavio; Oldani, Alberto

    2016-01-01

    The restoration of the digestive tract by performing an esophago-jejunal anastomosis (EJA) is a crucial step of the total gastric and distal esophagus surgical resection for esophago-gastric junction (EGJ) cancer. We have already ideated and tested on a cadaver model an innovative technique which could be useful to minimize the risk of complications related to the phase of securing the anvil of the circular stapler prior to perform the EJA. This surgical technique was derived from the well-known "double-stapling Knight and Griffen" one that was described for the rectal resection. We used the following described technique in 20 patients with EGJ cancer and it is efficient, reliable, safe, easy to learn and easy to perform. From August 2014 to May 2015, 20 patients (14 male and 6 female) underwent surgery for esophagogastric junction cancer: In all patients a distal esophageal resection and total gastrectomy was performed. Through the trans-hiatal access, the free margins of the esophageal stump were suspended and the anvil of a circular stapler on a new dedicated and registered support bar was inserted into the lumen. Subsequently, the linear suturing stapler is closed over the bar and then fired to suture the distal stump of the esophagus; after the confirmation of a negative margin, the bar is retracted and the push-rod of the anvil is pulled out through the linear suture. Finally, the anastomosis is performed with the classic technique by using a circular stapler. No postoperative mortality occurred; postoperative course has been uneventful for 18 patients. One patient developed anastomotic fistula that has been treated conservatively with endoscopic prothesis, removed after 20 days. One patient developed in 3 POD myocardial infarction Mean Hospital stay has been 14 days (range 7-20 days). The aim of our new procedure is the insertion the anvil of a common circular stapler without handsewn securing; this is to reduce the technical difficulties related to the hand

  5. Effect of Glucagon-like Peptide 2 on Tight Junction in Jejunal Epithelium of Weaned Pigs though MAPK Signaling Pathway

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    Changsong Yu

    2014-05-01

    Full Text Available The glucagon-like peptide 2 (GLP-2 that is expressed in intestine epithelial cells of mammals, is important for intestinal barrier function and regulation of tight junction (TJ proteins. However, there is little known about the intracellular mechanisms of GLP-2 in the regulation of TJ proteins in piglets’ intestinal epithelial cells. The purpose of this study is to test the hypothesis that GLP-2 regulates the expressions of TJ proteins in the mitogen-activated protein kinase (MAPK signaling pathway in piglets’ intestinal epithelial cells. The jejunal tissues were cultured in a Dulbecco’s modified Eagle’s medium/high glucose medium containing supplemental 0 to 100 nmol/L GLP-2. At 72 h after the treatment with the appropriate concentrations of GLP-2, the mRNA and protein expressions of zonula occludens-1 (ZO-1, occludin and claudin-1 were increased (p<0.05. U0126, an MAPK kinase inhibitor, prevented the mRNA and protein expressions of ZO-1, occludin, claudin-1 increase induced by GLP-2 (p<0.05. In conclusion, these results indicated that GLP-2 could improve the expression of TJ proteins in weaned pigs’ jejunal epithelium, and the underlying mechanism may due to the MAPK signaling pathway.

  6. Autoradiographic investigations on the question of diurnal variations of cell proliferation in the jejunal crypt epithelia of mice

    International Nuclear Information System (INIS)

    Herterich, G.C.

    1982-01-01

    In this work the question was investigated whether the proliferation activity of the crypt epithelia of the small intestine of mice is subject to diurnal variations. The results published so far to settle this question are contradictory. The flow rate at the beginning and end of the S phase was measured as a function of daytime for the jejunal crypt epithelia of mice following a double labelling with 3-H and 14-C-TdR. The quotient of the cell flow rate in and out of the S phase is supposed to be = 1 over the whole day if there are no diurnal variations. The method of measurements of the cell flow rate was chosen above all because the quotient is largely independent of the variation from animal to animal. The experiments provided dues as to the presence of deviations of the quotient of cell flow rate at the end and beginning of the S phase and of the mitotic index from the daily mean value. However, on account of the relatively large statistical variations of the values at the different daytimes it is not possible to state clearly whether the cell proliferation of the jejunal epithelium is subject to diurnal variations. Should there be such variations, then they are not large at any rate. (orig./MG) [de

  7. Claudin-4 Undergoes Age-Dependent Change in Cellular Localization on Pig Jejunal Villous Epithelial Cells, Independent of Bacterial Colonization

    Directory of Open Access Journals (Sweden)

    J. Alex Pasternak

    2015-01-01

    Full Text Available Newborn piglets are immunologically naïve and must receive passive immunity via colostrum within 24 hours to survive. Mechanisms by which the newborn piglet gut facilitates uptake of colostral cells, antibodies, and proteins may include FcRn and pIgR receptor-mediated endocytosis and paracellular transport between tight junctions (TJs. In the present study, FcRn gene (FCGRT was minimally expressed in 6-week-old gut and newborn jejunum but it was expressed at significantly higher levels in the ileum of newborn piglets. pIgR was highly expressed in the jejunum and ileum of 6-week-old animals but only minimally in neonatal gut. Immunohistochemical analysis showed that Claudin-5 localized to blood vessel endothelial cells. Claudin-4 was strongly localized to the apical aspect of jejunal epithelial cells for the first 2 days of life after which it was redistributed to the lateral surface between adjacent enterocytes. Claudin-4 was localized to ileal lateral surfaces within 24 hours after birth indicating regional and temporal differences. Tissue from gnotobiotic piglets showed that commensal microbiota did not influence Claudin-4 surface localization on jejunal or ileal enterocytes. Regulation of TJs by Claudin-4 surface localization requires further investigation. Understanding the factors that regulate gut barrier maturation may yield protective strategies against infectious diseases.

  8. Preserving Duodenal-Jejunal (Foregut) Transit Does Not Impair Glucose Tolerance and Diabetes Remission Following Gastric Bypass in Type 2 Diabetes Sprague-Dawley Rat Model.

    Science.gov (United States)

    Dolo, Ponnie R; Yao, Libin; Li, Chao; Zhu, Xiaocheng; Shi, Linsen; Widjaja, Jason

    2017-11-02

    Possible mechanisms underlying diabetes remission following Roux-en-Y gastric bypass (RYGB) include eradication of putative factor(s) with duodenal-jejunal bypass. The objective of this study is to observe the effects of duodenal-jejunal transit on glucose tolerance and diabetes remission in gastric bypass rat model. In order to verify the effect of duodenal-jejunal transit on glucose tolerance and diabetes remission in gastric bypass, 22 type 2 diabetes Sprague-Dawley rat models established through high-fat diet and low-dose streptozotocin (STZ) administered intraperitoneally were assigned to one of three groups: gastric bypass with duodenal-jejunal transit (GB-DJT n = 8), gastric bypass without duodenal-jejunal transit (RYGB n = 8), and sham (n = 6). Body weight, food intake, blood glucose, as well as meal-stimulated insulin, and incretin hormone responses were assessed to ascertain the effect of surgery in all groups. Oral glucose tolerance test (OGTT) and insulin tolerance test (ITT) were conducted three and 7 weeks after surgery. Comparing our GB-DJT to the RYGB group, we saw no differences in the mean decline in body weight, food intake, and blood glucose 8 weeks after surgery. GB-DJT group exhibited immediate and sustained glucose control throughout the study. Glucagon-like peptide 1 (GLP-1) and gastric inhibitory polypeptide (GIP) levels were also significantly increased from preoperative level in the GB-DJT group (p transit does not impede glucose tolerance and diabetes remission after gastric bypass in type-2 diabetes Sprague-Dawley rat model.

  9. Endogenous growth hormone and insulin after interposition of a reversed jejunal segment in short bowel syndrome. An experimental study on pigs

    Directory of Open Access Journals (Sweden)

    Papamichail Michail

    2012-08-01

    Full Text Available Abstract Background Interposition of a reversed jejunal loop in short bowel sydrome has previously been investigated in human along with animal models and seemed able to facilitate intestinal adaptation. However, it is unclear if growth hormone and insulin, well known for their implication in short bowel pathophysiology, intervene on this effect. Findings Porcine models were randomly allocated to two cohorts: (1 short bowel (SB group (n = 8 and (2 short bowel reverse jejunal segment (SB-RS group (n = 8. Amongst other parameters serum growth hormone and insulin were measured at baseline, as well as on postoperative day 30 and 60. Conclusion Both endogenous hormones failed to demonstrate significant difference in respect to potential direct effect to mechanisms of enhanced intestinal adaptation in reversed group

  10. The effect of experimental gastric dilatation-volvulus on adenosine triphosphate content and conductance of the canine gastric and jejunal mucosa

    OpenAIRE

    Peycke, Laura E.; Hosgood, Giselle; Davidson, Jacqueline R.; Tetens, Joanne; Taylor, H. Wayne

    2005-01-01

    The objective of this study was to determine if experimental gastric dilatation volvulus (GDV) would decrease adenosine triphosphate (ATP) concentration and increase membrane conductance of the canine gastric and jejunal mucosa. Male dogs (n = 15) weighing between 20 and 30 kg were used. Dogs were randomly assigned to 1 of 3 equal groups: Group 1 was control, group 2 was GDV, and group 3 was ischemia. All dogs were anesthetized for 210 min. Group 1 had no manipulation. Group 2 had GDV experim...

  11. Therapeutic effect of recombinant human interleukin-11 and curcumin on jejunal damage in mice after neutron irradiation

    International Nuclear Information System (INIS)

    Chang Gongmin; Peng Ruiyun; Gao Yabing; Wang Shuiming; Li Yang; Xu Xinping; Wang Lifeng; Dong Ji; Zhao Li

    2010-01-01

    Objective: To explore the therapeutic effect of recombinant human interleukin (rhIL-11) and curcumin on jejunal damage in mice after neutron irradiation. Methods: 140 male BALB/c mice were randomly divided into 4 groups: 20 mice in healthy control group, 60 mice in mere irradiation group, 30 mice in IL-11 treatment group and 30 mice in curcumin treatment group. The mere irradiation group mice were wholly exposed to 3 Gy neutron irradiation. The treatment groups mice were imtraperitoneally injected with rhIL-11 at the dosage of 500 μg·kg -1 ·d -1 and ourcumin of 200 mg·kg -1 ·/ -1 through enterocoelia once a day for a d after irradiation. The mortality of the mice were observed. The mice in the control and mere irradiation groups were killed 6 h, 1, 3, and 6 d post-irradiation, respectively, and the mice of the 2 treatment groups were killed 3 and 6 d post-irradiation, respectively and the samples of jujunum were colleted. HE staining, argyrophilic of nucleolar organizer staining, Feulgen staining, and image analysis were used to observe the pathology and levels of argyrophilic proteins and DNA. Results: The mice in the mere irradiation group all died at 5 d post-irradiation, while 2 mice in the IL-11 treatment group and 3 in the curcumin group survived. Large area necrosis and exfoliation were found in the intestinal epithelial mucosa of the mere irradiated group mice since 6 h to 3 d after irradiation. Crypt cell regeneration was seen occasionally found 3 days later and much more 5 days later. Crypt cell regeneration was obviously found in the intestinal epithelial mucosa and lots of new villi were observed 5 d after irradiation in both treatment groups, however, the amounts of crypt cells and new villi of the curcumin treatment group were less than those of the IL-11 treatment group. The contents of AgNOR and DNA in the intestinal epithelial cells 5 days after irradiation of the 2 treatment groups were all significantly higher than those of the mere

  12. Different behaviour of 63Ni and 59Fe during absorption in iron-deficient and iron-adequate jejunal rat segments ex vivo

    International Nuclear Information System (INIS)

    Mueller-Fassbender, M.; Elsenhans, B.; McKie, A.T.; Schuemann, K.

    2003-01-01

    Nickel exhibits low oral toxicity. It shares the absorptive pathways for iron, though there are substantial quantitative differences in handling of both metals. To analyse these differences more closely, jejunal segments from iron-deficient and iron-adequate rats were luminally perfused ex vivo with 59 Fe and 63 Ni at six different concentrations (1-500 μmo1/l) under steady state conditions. 59 Fe over-all absorption increased 2.0-4.6-fold in iron-deficiency at luminal concentrations between 1 and 100 μmol/l, while 63 Ni absorption increased to a much lower extent (2.6-fold at 1 μmol/l and 1.5-fold at higher luminal concentrations). Moreover, there was a 5-7-fold higher concentration for 63 Ni in the jejunal tissue than in the absorbate at luminal concentrations above 50 μmol/l which was not observed at 1 μmol 63 Ni/l and not for 59 Fe. 63 Ni tissue load showed a linear and a saturable fraction. In iron-deficiency the saturable 63 Ni fraction increased 4-fold as compared to only 1.5-fold increments for 59 Fe. Moreover, a substantially higher share of 63 Ni was retained in the jejunal tissue at high as compare to low luminal concentrations after perfusion had been continued without luminal radioactivity. This was not found for 59 Fe and suggests a concentration-dependent block of 63 Ni export across the enterocytes' basolateral membrane. To explain these results one may speculate that 63 Ni may bind more tightly to tissue ligands than 59 Fe due to the higher thermodynamic and kinetic stability of nickel complexes. In particular, nickel may bind to a basolateral population of metal carriers and block its own basolateral transfer in a concentration-dependent manner. Tight 63 Ni binding to non-specific jejunal ligands is responsible for the unaltered high linear fraction of jejunal 63 Ni load in iron-deficient and iron-adequate segments. Binding of 63 Ni to food and tissue ligands in the small intestine may, thus, be a likely explanation for the low oral nickel

  13. HIV enteropathy: HAART reduces HIV-induced stem cell hyperproliferation and crypt hypertrophy to normal in jejunal mucosa.

    Science.gov (United States)

    Batman, Philip A; Kapembwa, Moses S; Belmonte, Liliana; Tudor, Gregory; Kotler, Donald P; Potten, Christopher S; Booth, Catherine; Cahn, Pedro; Griffin, George E

    2014-01-01

    To analyse the structural and kinetic response of small intestinal crypt epithelial cells including stem cells to highly active antiretroviral therapy (HAART). Crypt size and proliferative activity of transit and stem cells in jejunal mucosa were quantified using morphometric techniques. Crypt length was measured by counting the number of enterocytes along one side of a number of crypts in each biopsy specimen and the mean crypt length was calculated. Proliferating crypt cells were identified with MIB-1 monoclonal antibody, and the percentage of crypt cells in proliferation was calculated at each cell position along the length of the crypt (proliferation index). Data were obtained from 9 HIV-positive test patients co-infected with microsporidia, 34 HIV-positive patients receiving HAART and 13 control cases. Crypt length was significantly greater in test patients than in controls, but crypt length in patients receiving HAART was normal. The proliferation index was greater in test subjects than in controls in stem and transit cell compartments, and was decreased in patients treated with HAART only in the stem cell region of the crypt. Villous atrophy in HIV enteropathy is attributed to crypt hypertrophy and encroachment of crypt cells onto villi. HAART restores normal crypt structure by inhibition of HIV-driven stem cell hyperproliferation at the crypt bases.

  14. Enteroscopic Tattooing for Better Intraoperative Localization of a Bleeding Jejunal GIST Facilitates Minimally Invasive Laparoscopically-assisted Surgery.

    Science.gov (United States)

    Iacob, Razvan; Dimitriu, Anca; Stanciulea, Oana; Herlea, Vlad; Popescu, Irinel; Gheorghe, Cristian

    2016-03-01

    We present the case of a 63-year-old man that was admitted for melena and severe anemia. Upper GI endoscopy and colonoscopy failed to identify the lesion responsible for bleeding, and enteroCT scan was also non-contributive to the diagnosis. Capsule endoscopy indicated possible jejunal bleeding but could not indicate the source of bleeding, recommending anterograde enteroscopy. Single balloon enteroscopy identified a 2 cm submucosal tumour in the distal part of the jejunum, with a macroscopic appearance suggesting a gastrointestinal stromal tumour (GIST). The tumor location was marked using SPOT tattoo and subsequently easily identified by the surgeon and resected via minimally invasive laparoscopic-assisted approach. Histological and immunohistochemical analysis indicated a low risk GIST. The unusual small size of the GIST as a modality of presentation, with digestive bleeding and anemia and the ability to use VCE/enteroscopy to identify and mark the lesion prior to minimally invasive surgery, represent the particularities of the presented case.

  15. Effects of fasting at different stages of lighting regimen on the proliferation of jejunal epithelial cells during rat pup weaning.

    Science.gov (United States)

    Soares, Maria Albertina de Miranda; Okada, Monica A; Ayub, Cristina Lucia Sant'Ana C; Gomes, José Rosa

    2009-07-01

    The lifespan of intestinal epithelial cells is predetermined by the process of cell proliferation that occurs constantly in the crypt. The control of this process involves some endogenous factors, such as hormones, as well as exogenous factors, like food and natural light variations. These last two exogenous factors seem to be the major modulators of the cell proliferation process. Fasting treatment was conducted to assess the role of food and its effect on the metaphase index (MI) of the intestinal epithelium at different times and periods (light and dark) of the day. The effects of short- (5 hr) and long-term (25 hr) fasting on the MI in the jejunal epithelium of young rats were investigated at 09:00 h, 15:00 hr, 21:00 hr, and 02:00 hr using the arrested metaphases method. The present study demonstrates that 5 hr and 25 hr of fasting treatment decrease the MI at 09:00 hr. It was observed from MI analysis that there is an interaction between the fed/fasted status of the animal and the different times of the day. This result suggests that during the transition from youth to adulthood, the control of MI by the light/dark cycle seems to be more pronounced as compared with control by food intake at some periods of the day, although at other times food had a greater impact on the MI.

  16. A very feasible alternative in patients with feeding difficulties from gastrostomy: Jejunal tube advanced through the gastrostomy

    Directory of Open Access Journals (Sweden)

    Ramazan Karabulut

    2015-01-01

    Full Text Available Background: Our aim is to share our experiences regarding patients who cannot be fed effectively through the gastrostomy tube, but were inserted feeding jejunostomy through the gastrostomy orifice using scopic fluoroscopic techniques utilised by the interventional radiology. Patients and Methods: Between January 2010 and May 2013 the patients that were inserted jejunostomy tube through the gastrostomy orifice using fluoroscopic techniques were retrospectively analysed. Data including primary indication for gastrostomy, sex, concomitant disease and the requirement for gastroesophageal reflux disease (GERD were all recorded. Results: There were five patients with these criteria. They all received either medical or surgical GERD therapy; nevertheless enteral feeding failed to reach an effective level, they all had vomiting and did not gain any weight. Following conversion, all the patients gained minimum 2 kg in 2-5 months; all the patients tolerated enteral feeding and were discharged in the early period. There were neither procedure related complications such as perforation, bleeding nor sedation related complications. Procedure took no more than 30 min as a whole. There was no need for surgical intervention. However in one patient re-intervention was required due to accidental removal of the catheter. Conclusions: In case of feeding difficulties following the gastrostomy; instead of an invasive surgical intervention; physicians should consider jejunal feeding that is advanced through the gastrostomy, which does not require any anaesthesia.

  17. Long-term comparison of boomerang-shaped jejunal interposition and Billroth-I reconstruction after distal gastrectomy.

    Science.gov (United States)

    Sasaki, Kinro; Miyachi, Kazuhito; Yoda, Norihito; Onodera, Shinichi; Satomura, Hitoshi; Otsuka, Kichiro; Nakajima, Masanobu; Yamaguchi, Satoru; Sunagawa, Masakatsu; Kato, Hiroyuki

    2015-05-01

    Billroth-I (BI) is a simple, physiological method of reconstruction following distal gastrectomy. In actuality, postoperative QOL is by no means favorable due to the high incidence of post-gastrectomy syndrome. The aim of this study is to assess the safety and efficacy of boomerang-shaped jejunal interposition (BJI) after distal gastrectomy. Sixty-six patients with early gastric cancer underwent the BI procedure (n = 33) or BJI (n = 33) after distal gastrectomy, following which they were compared for 5 years. Tumor characteristics, operative details, postoperative complications and complaints, number of meals, and body weight were analyzed. Patients were followed up by endoscopy every 12 months. There were no significant differences in the incidence of postoperative complications. The incidence of heartburn (30 vs. 0 %, P = 0.0009) and oral bitterness (33 vs. 6 %, P = 0.0112) were significantly lower in the BJI cases. Endoscopic findings revealed significantly lower incidences of reflux esophagitis (24 vs. 0 %, P = 0.0051) and remnant gastritis (70 vs. 3 %, P < 0.0001) in the BJI group. The incidence of food stasis was low in both groups (12 vs. 15 %). In the BJI group, 30 patients (90 %) were eating 3 meals/day within 12 months, whereas in the BI group, 16 patients (48 %) were still eating 5 meals/day at 12 months or later. BJI is as safe as BI, but is better in terms of improvement in bile reflux and food intake without stasis. This procedure, therefore, appears to be a useful method for reconstruction after distal gastrectomy.

  18. Immunohistochemical study of jejunal graft mucosa cell populations during the initial adaptation phase in the host body in rats.

    Science.gov (United States)

    Tóth, Stefan; Jonecová, Zuzana; Varga, Ján; Staško, Pavel; Kovalčinová, Barbora; Maretta, Milan; Leško, Dušan; Veselá, Jarmila

    2013-10-01

    The character of the changes in cell populations within the jejunal graft mucosa during the initial adaptation phase in the host body was investigated. 24 adult male Wistar rats underwent intestinal heterotopic allotransplantation. Aorto-aortal and porto-caval anastomoses were performed using the end-to-side microsurgery technique. Graft tissues were compared to the intestinal tissues of the recipients. This study demonstrates that: (1) Distinct injury to the graft mucosa 1h after transplantation was accompanied by significant reduction in numbers of epithelial secretory cell populations. The injury was more intense in the mesenteric portion. Six hours after transplantation the graft mucosa was covered by a continuous epithelium, but the number of goblet and Paneth cells was found to be less than 30% of that in the recipient epithelium. (2) In comparison with recipients, myeloperoxidase-positive cell numbers increased significantly in the graft mucosa 1 h after transplantation. In the epithelial layer, denudation and destruction of villi was associated with a significant reduction in intraepithelial lymphocyte numbers. A significant decrease in mucosal mast cell numbers was detected 6 h after transplantation. They attained only 10% of the number found in the recipients. (3) Time-dependent changes in the graft mucosa revealed that CD163-positive cells increased significantly in the graft mucosa during 6 h after transplantation and reached the level found in the recipients. In contrast, the myeloperoxidase-positive cell population significantly decreased in the graft mucosa within the initial 6 h. Copyright © 2013 Elsevier GmbH. All rights reserved.

  19. Jejunal gluconeogenesis associated with insulin resistance level and its evolution after Roux-en-Y gastric bypass.

    Science.gov (United States)

    Gutierrez-Repiso, Carolina; Garcia-Serrano, Sara; Moreno-Ruiz, Francisco J; Alcain-Martinez, Guillermo; Rodriguez-Pacheco, Francisca; Garcia-Fuentes, Eduardo

    2017-04-01

    Intestinal gluconeogenesis (GNG) may play an important role in glucose homeostasis, but there is little information about the condition in humans. To study the relationship between intestinal GNG and insulin resistance, its association with the evolution of morbidly obese patients after bariatric surgery, and the effect of insulin and or leptin. Regional university hospital, Malaga (Spain). Jejunal mRNA expression of genes involved in GNG was analyzed in 3 groups of morbidly obese patients who underwent Roux-en-Y gastric bypass: with low insulin resistance (MO-low-IR), with high insulin resistance (MO-high-IR), and with type 2 diabetes treated with metformin (MO-metf-T2D). Also, intestinal epithelial cells (IEC) from MO-low-IR were incubated with different doses of insulin and or leptin. In MO-high-IR, glutaminase, phosphoenolpyruvate carboxykinase (PEPCK), glucose 6-phosphatase (G6 Pase), peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1 α), and sterol regulatory element-binding proteins 1 c (SREBP-1 c) expressions were significantly higher than in MO-low-IR. In MO-metf-T2 D, only PEPCK was significantly lower than in MO-high-IR. In IEC, an incubation with a high glucose and insulin dose produced an increase of PEPCK and SREBP-1 c, and a decrease of glutaminase, fructose 1,6-bisphosphatase (FBPase), and PGC-1 α expression. At high doses of leptin, G6 Pase and FBPase were significantly increased. The improvement of insulin resistance 3 months after bariatric surgery was positively associated with high G6 Pase and FBPase expression. mRNA expression of genes involved in GNG is increased in the jejunum of MO-high-IR, and regulated by insulin and or leptin. High mRNA expression of genes involved in GNG is associated with a better evolution of insulin resistance after bariatric surgery. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  20. Mouldy feed, mycotoxins and Shiga toxin - producing Escherichia coli colonization associated with Jejunal Hemorrhage Syndrome in beef cattle

    Directory of Open Access Journals (Sweden)

    Masson Luke

    2011-06-01

    Full Text Available Abstract Background Both O157 and non-O157 Shiga toxin - producing Escherichia coli (STECs cause serious human disease outbreaks through the consumption of contaminated foods. Cattle are considered the main reservoir but it is unclear how STECs affect mature animals. Neonatal calves are the susceptible age class for STEC infections causing severe enteritis. In an earlier study, we determined that mycotoxins and STECs were part of the disease complex for dairy cattle with Jejunal Hemorrhage Syndrome (JHS. For STECs to play a role in the development of JHS, we hypothesized that STEC colonization should also be evident in beef cattle with JHS. Aggressive medical and surgical therapies are effective for JHS, but rely on early recognition of clinical signs for optimal outcomes suggesting that novel approaches must be developed for managing this disease. The main objective of this study was to confirm that mouldy feeds, mycotoxins and STEC colonization were associated with the development of JHS in beef cattle. Results Beef cattle developed JHS after consuming feed containing several types of mycotoxigenic fungi including Fusarium poae, F. verticillioides, F. sporotrichioides, Penicillium roqueforti and Aspergillus fumigatus. Mixtures of STECs colonized the mucosa in the hemorrhaged tissues of the cattle and no other pathogen was identified. The STECs expressed Stx1 and Stx2, but more significantly, Stxs were also present in the blood collected from the lumen of the hemorrhaged jejunum. Feed extracts containing mycotoxins were toxic to enterocytes and 0.1% of a prebiotic, Celmanax Trademark, removed the cytotoxicity in vitro. The inclusion of a prebiotic in the care program for symptomatic beef calves was associated with 69% recovery. Conclusions The current study confirmed that STECs and mycotoxins are part of the disease complex for JHS in beef cattle. Mycotoxigenic fungi are only relevant in that they produce the mycotoxins deposited in the feed. A

  1. Longitudinal evaluation of efficacy, safety and nutritional status during one-year treatment with the duodenal-jejunal bypass liner.

    Science.gov (United States)

    Riedel, Nina; Laubner, Katharina; Lautenbach, Anne; Schön, Gerhard; Schlensak, Matthias; Stengel, Rainer; Eberl, Thomas; Dederichs, Frank; Aberle, Jens; Seufert, Jochen

    2018-03-09

    The endoscopic duodenal-jejunal bypass liner (DJBL) represents a novel temporary endoscopic approach for treatment of obesity-associated type 2 diabetes. Recent results from the German DJBL registry confirmed substantial positive metabolic effects of the DJBL in type 2 diabetes. However, the last Food and Drug Administration trial was stopped due to a high occurrence of hepatic abscesses (3.5%). Here, we analyzed time courses of development of co-morbidities, nutritive changes, and occurrence of adverse events during the 1-year treatment phase with the DJBL in the German DJBL registry. Sixty-six patients from the registry were analyzed for efficacy, safety, and nutritional status. Patient data sets were analyzed at implantation, 3 and 6 months after implantation, and at explantation visits. Weight, body mass index, glycated hemoglobin, and low-density lipoprotein cholesterol primarily declined during the first 3 months after implantation, whereas systolic and diastolic blood pressure were predominantly reduced during the second half of the treatment phase. Severe DJBL-associated side effects were mainly documented at the explantation visit (intestinal obstruction [1.7%], dislocation [1.7%], and liver abscess [1.7%]). Measurements of serum concentrations of ferritin, albumin, vitamin B12, folic acid, 25-hydroxyvitamin D3 (25 OH-Vit-D3), and calcium provided suggestive evidence of a possible decrease of nutritional absorption of vitamins and trace elements by the DJBL. The DJBL demonstrates high efficacy with substantial improvement of all parameters of the metabolic syndrome and the potential for reduction of comedications in overweight patients with type 2 diabetes. These registry results are important to optimize recommendations for adaptation of concomitant medication, surveillance of adverse events, nutritional status and supplementation, and adaptation of the implantation period of the DJBL. Copyright © 2018 American Society for Bariatric Surgery. Published by

  2. Electrocautery-induced localized colonic injury elicits increased levels of pro-inflammatory cytokines in small bowel and decreases jejunal alanine absorption.

    Science.gov (United States)

    Barada, Kassem; Mourad, Fadi H; Noutsi, Bakiza; Saadé, Nayef E

    2015-01-01

    Colitis is associated with functional abnormalities in proximal non-inflamed gut areas, but animal models to study small bowel dysfunction in colitis have limitations. This study aims to determine small intestinal alanine absorption and cytokine expression in a novel model of colonic ulceration induced by electro-cautery. A descending colon ulcer was induced in rats by a bipolar electro-cautery probe. Ulcer score was determined using Satoh's criteria. Jejunal alanine absorption was measured immediately and at different time intervals post ulcer induction. Levels of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) protein and m-RNA were determined in mucosal scrapings obtained from the colon, duodenum, jejunum and ileum at various time intervals after colonic ulcer induction. The mean ulcer score was 3 up to 48h, followed by healing by 96h post ulcer induction. Small bowel histology was normal throughout. Jejunal alanine absorption was reduced by 12-34% immediately and up to 72h after cautery and returned to normal at 96h. IL-1 and TNF-α mRNA increased significantly in the colon, duodenum, jejunum and ileum 3h post electro-cautery and returned to normal at 48h, while that of IL-6 increased significantly at 48h post ulcer induction. Similarly, IL-1, IL-6 and TNF-α protein levels increased in the duodenum, jejunum, ileum and colon up to 48h post ulcer induction. Electrically induced localized colonic injury increased production of pro-inflammatory cytokines in non-inflamed segments of the small intestine and was associated with derangements of jejunal absorptive function. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Effect of corn replacement with graded levels of wheat screening and enzyme supplementation on performance, blood lipids, viscosity and jejunal histomorphology of finisher broilers

    Energy Technology Data Exchange (ETDEWEB)

    Mazhari, M.; Golian, A.; Kermanshahi, H.

    2015-07-01

    An experiment was carried out to study the effect of corn replacement with five levels of wheat screening (0, 150, 300, 450 and 600 g/kg of diet) with (0.5 g/kg of diet) or without xylanase-glucanase enzyme on performance, blood lipids, viscosity and jejunal histomorphology of finisher broilers (25-42 days of age). Five hundred day-old Ross-308 male broiler chicks were fed by a standard commercial diet up to 24 days of age, then randomly assigned to 10 diets. Each diet was fed to five groups of ten chicks each. There was not significant differences in body weight gain (BWG), feed intake, and feed conversion ratio of birds fed with different levels of wheat screening (WS), whereas enzyme increased (p<0.05) BWG. Different levels of WS and enzyme did not have a significant effect on relative weights of carcass, breast, thigh, and abdominal fat of broilers. Relative weights of gizzard, pancreas, small and large intestine, and relative length of jejunum and jejunal and ileal viscosity were increased (p<0.05) by WS, while were decreased (p<0.05) by enzyme. The serum cholesterol level decreased (p<0.05) by increasing levels of WS. Jejunal histomorphological observations showed (p<0.05) shorter and thicker villus and lower crypt depth by increasing levels of WS, while addition of enzyme to the diets, affected (p<0.05) reversely to these parameters. The results showed that the addition of wheat screening up to an inclusion level of 600 g/kg of diet had no adverse effect on broiler performance in the finisher (25-42 d) phases whereas decreased serum cholesterol levels, increased viscosity and villus atrophy. The dietary administration of exogenous enzyme improved performance parameters and decreased viscosity and villus atrophy of broiler jejunum. (Author)

  4. The effect of experimental gastric dilatation-volvulus on adenosine triphosphate content and conductance of the canine gastric and jejunal mucosa.

    Science.gov (United States)

    Peycke, Laura E; Hosgood, Giselle; Davidson, Jacqueline R; Tetens, Joanne; Taylor, H Wayne

    2005-07-01

    The objective of this study was to determine if experimental gastric dilatation volvulus (GDV) would decrease adenosine triphosphate (ATP) concentration and increase membrane conductance of the canine gastric and jejunal mucosa. Male dogs (n = 15) weighing between 20 and 30 kg were used. Dogs were randomly assigned to 1 of 3 equal groups: Group 1 was control, group 2 was GDV, and group 3 was ischemia. All dogs were anesthetized for 210 min. Group 1 had no manipulation. Group 2 had GDV experimentally induced for 120 min followed by decompression, derotation, and reperfusion for 90 min. Group 3 had GDV experimentally induced for 210 min. Gastric (fundus and pylorus) and jejunal tissue was taken at 0, 120, and 210 min from all of the dogs. Tissue was analyzed for ATP concentration, mucosal conductance, and microscopic changes. The ATP concentration in the fundus did not change significantly from baseline in group 2, but decreased significantly below baseline at 210 min in group 3. The ATP concentration in the jejunum decreased significantly below baseline in groups 2 and 3 at 120 min, remaining significantly decreased in group 3 but returning to baseline at 210 min in group 2. Mucosal conductance of the fundus did not change significantly in any dog. Mucosal conductance of the jejunum increased at 120 min in groups 2 and 3, and became significantly increased above baseline at 210 min. The jejunal mucosa showed more profound cellular changes than the gastric mucosa. The jejunum showed substantial decreases in ATP concentration with an increase in mucosal conductance, suggesting cell membrane dysfunction. Dogs sustaining a GDV are likely to have a change in the activity of mucosal cells in the jejunum, which may be important in the pathophysiology of GDV.

  5. Jejunal feeding is followed by a greater rise in plasma cholecystokinin, peptide YY, glucagon-like peptide 1, and glucagon-like peptide 2 concentrations compared with gastric feeding in vivo in humans

    DEFF Research Database (Denmark)

    Luttikhold, Joanna; van Norren, Klaske; Rijna, Herman

    2016-01-01

    and the associated endocrine response in vivo in humans remains largely unexplored. OBJECTIVE: We compared the impact of administering enteral nutrition as either gastric feeding or jejunal feeding on endocrine responses in vivo in humans. DESIGN: In a randomized, crossover study design, 12 healthy young men (mean...... and a greater postprandial incremental AUC for GLP-1 and cholecystokinin (all P young men results in similar postprandial plasma amino acid and glucose concentrations....... However, the endocrine response differs substantially, with higher peak plasma cholecystokinin, PYY, GLP-1, and GLP-2 concentrations being attained after jejunal feeding. This effect may result in an improved anabolic response, greater insulin sensitivity, and an improved intestinotropic effect...

  6. Uncut Esophagojejunostomy with Double Jejunal Pouch: An Alternative Reconstruction Method that Improves the Quality of Life of Patients after Total Gastrectomy.

    Science.gov (United States)

    Gong, Jia Qing; Cao, Yong Kuan; Zhang, Guo Hu; Wang, Pei Hong; Luo, Guo De

    2017-04-01

    Currently, there is no optimal digestive tract reconstruction technique well recognized by scholars after total gastrectomy. In this study, a new reconstruction method, which is modified from the classic Roux-en-Y procedure, an uncut jejunal esophageal anastomosis with double jejunal pouch (UJEA-DJP) was established, and its advantages for improving the quality of life of patients who undergo total gastrectomy were analyzed. Altogether 160 patients with gastric cancer enrolled in our center from September 2009 to March 2012 received radical D2 total gastrectomy. According to the reconstruction methods used, these patients were divided into three groups: UJEA-DJP (n = 63), Roux-en-Y (n = 45), and P-loop with Roux-en-Y esophagojejunostomy (P-RY; n = 52). The operation time for reconstruction, complications, prognostic nutritional index (PNI), and the Visick classification among the three groups were analyzed. We found that UJEA-DJP has advantages over Roux-en-Y and P-RY regarding the time of digestive tract reconstruction, incidence rates for long-term complications, postoperative nutritional index, body weight recovery, and the Visick classification for subjective feelings (p quality of life of patients after surgical procedure.

  7. Histochemical characterization of glycoproteins present in jejunal and colonic goblet cells of pigs on different diets. A biopsy study using chemical methods and peroxidase-labelled lectins.

    Science.gov (United States)

    Moré, J; Fioramonti, J; Bénazet, F; Buéno, L

    1987-01-01

    We examined the glycoprotein composition of intestinal goblet cells in jejunal and colonic biopsies obtained from pigs on different diets. Paraffin sections were stained both chemically and with the following horseradish-peroxidase conjugated lectins: Canavalia ensiformis (Con-A), Limulus polyphemus (LPA), Lotus tetragonolobus (LTA), Arachis hypogaea (PNA), Ricinus communis (RCA1), Glycine max (SBA) and Triticum vulgaris (WGA). Using chemical staining procedures, only small quantitative differences were noted between the two organs. With respect to lectin staining, the mucus of the jejunum was characterized by the absence of Con-A binding sites, and colonic mucus consistently exhibited an absence of SBA affinity. After dietary modifications, O-acetyl sialic acid reactivity was lowered in the jejunum but was enhanced in the colon. In the jejunum, the glycoproteins became neuraminidase susceptible, whereas the colon became characterized by the absence of neutral mucins. The affinity for the tested lectins after the different diets was variable, but the most striking effects were observed after the fibreless diet (milk alone). Our data suggest the existence of marked regional variations in goblet-cell mucus and indicate significant differences between the glycoprotein components of the jejunal and colonic mucosa. Furthermore, the biosynthesis of mucins in both regions was altered by even only short-term feeding modifications.

  8. Effects of grinding method, particle size, and physical form of the diet on gastrointestinal morphology and jejunal glucose transport in laying hens.

    Science.gov (United States)

    Röhe, I; Ruhnke, I; Knorr, F; Mader, A; Boroojeni, F Goodarzi; Löwe, R; Zentek, J

    2014-08-01

    Several studies illustrated that the structure of feed, i.e., the particle size, particle-size distribution, and the physical form of the diet, affects the avian gastrointestinal function and health leading to changes in productive performance. However, investigations concerning the effects of feeding differently processed diets on laying hens are limited and primarily concentrated on bird performance. The current study examines the effect of feed processing on the gastrointestinal morphology and on the jejunal glucose transport of laying hens. In 8 replicates, a total of 384 hens (Lohmann Brown) aged 20 wk were randomly allocated to 8 different groups and fed over a period of 21 d in a 3-factorial design. Diets differed in 1) grinding method, either hammer or roller mill; 2) physical form, either mash or expandate; and 3) particle size, either coarsely or finely ground. During the experimental trial, the laying performance of each feeding group was recorded daily and the feed intake and BW determined weekly. After slaughtering, the weights of the pancreas, proventriculus, gizzard, and small intestine were measured. Villus lengths and crypt depths of the duodenum, jejunum, and ileum were determined. The jejunal electrogenic glucose transport was studied in Ussing chambers. Hens that received mash instead of expandate had higher proventriculus (P = 0.011), gizzard (P feeding of coarsely instead of finely ground diets led to higher gizzard weights (P hens showed longer duodenal (P hens had higher glucose transport rates than expandate-fed hens (P feeding of coarsely ground as well as mash diets had stimulating effects on the development of the gastrointestinal organs. Moreover, the feeding of mash influenced the intestinal microstructure of the epithelium that was accompanied by higher glucose transport capacities. © Poultry Science Association Inc.

  9. Massive rectal bleeding from colonic diverticulosis

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    Rapport De Cas: Nous mettons un cas d'un homme de 79 ans quiàprésente une hémorragie rectal massive ... cause of overt lower gastrointestinal (GI) ... vessels into the intestinal lumen results in ... placed on a high fibre diet, and intravenous.

  10. Gastric diverticulosis and ulcerations in bitches

    African Journals Online (AJOL)

    ADEYEYE

    2014-01-08

    Jan 8, 2014 ... with complaints of anorexia and persistent vomition especially after meals. History also revealed that the dog had been treated for canine parvovirus enteritis two weeks prior to presentation. The clinical signs noticed were melena, persistent emesis observed often between 20-30 minutes after meals, ...

  11. Massive rectal bleeding from colonic diverticulosis

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    barium enema studies have indicated increasing world prevalence ... Other diagnostic modalities include barium enema, computerised ... This is in contrast to the findings in our patient when colonoscopy was carried out, in which the diverticula were more at the descending colon-left sided, and were found to be bleeding.

  12. Increased cholinergic contractions of jejunal smooth muscle caused by a high cholesterol diet are prevented by the 5-HT4 agonist – tegaserod

    Directory of Open Access Journals (Sweden)

    Shaffer Eldon

    2006-02-01

    Full Text Available Abstract Background Excess cholesterol in bile and in blood is a major risk factor for the respective development of gallbladder disease and atherosclerosis. This lipid in excess negatively impacts the functioning of other smooth muscles, including the intestine. Serotonin is an important mediator of the contractile responses of the small intestine. Drugs targeting the serotonin receptor are used as prokinetic agents to manage intestinal motor disorders, in particular irritable bowel syndrome. Thus, tegaserod, acting on 5-HT4 receptor, ideally should obviate detrimental effects of excessive cholesterol on gastrointestinal smooth muscle. In this study we examined the effect of tegaserod on cholesterol-induced changes in the contractile responses of intestinal smooth muscle. Methods The effects of a high cholesterol (1% diet on the in vitro contractile responses of jejunal longitudinal smooth muscle from Richardson ground squirrels to the cholinergic agonist carbachol were examined in the presence or absence of tetrodrodotoxin (TTX. Two groups of animals, fed either low (0.03% or high cholesterol rat chow diet, were further divided into two subgroups and treated for 28 days with either vehicle or tegaserod. Results The high cholesterol diet increased, by nearly 2-fold, contractions of the jejunal longitudinal smooth muscle elicited by carbachol. These cholinergic contractions were mediated by muscarinic receptors since they were blocked by scopolamine, a muscarinic receptor antagonist, but not by the nicotinic receptor antagonist, hexamethonium. Tegaserod treatment, which did not affect cholinergic contractions of tissues from low cholesterol fed animals, abrogated the increase caused by the high cholesterol diet. With low cholesterol diet TTX enhanced carbachol-evoked contractions, whereas this action potential blocker did not affect the augmented cholinergic contractions seen with tissues from animals on the high cholesterol diet. Tegaserod

  13. Effects of Duodenal-Jejunal Exclusion and New Bilio-Pancreatic Diversion on Blood Glucose in Rats with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Weng, Shan Geng; Zhang, Bin; Wang, Xiaojian; Chen, Hao

    2017-08-01

    The current study aimed to investigate the effects of duodenal-jejunal bypass (DJB), new bilio-pancreatic diversion (NBPD), and duodenal-jejunal exclusion (DJE) on blood glucose in rats with type 2 diabetes mellitus (T2DM). Male Sprague Dawley rats were fed with high glucose, high fat food, and intraperitoneally injected with streptozotocin to establish a T2DM animal model. T2DM rats were randomly assigned into 4 groups: a sham group (n = 8), DJB group (n = 9), NBPD group (n = 10), and DJE group (n = 10). Body weight, 2-h postprandial glucose, oral glucose tolerance, fasting serum bile acid, 2-h postprandial serum bile acid, fasting insulin, 2-h postprandial insulin (INS), fasting glucagon-like peptide-1 (GLP-1), and 2-h postprandial GLP-1 were measured before and after surgery. Six weeks after surgery, the 2-h postprandial glucose in the DJB (16.1 ± 6.7 mmol/L) and NBPD (19.5 ± 5.7 mmol/L) groups decreased significantly compared to the sham group (25.8 ± 4.9 mmol/L) (P  0.05). Four weeks after surgery, fasting serum bile acid in the DJB group (60.6 ± 11.4 μmol/L) and NBPD group (54.4 ± 7.64 μmol/L) was significantly higher than that in the sham group (34.3 ± 6.98 μmol/L; P  0.05). Body weight remained stable after surgery in all 4 groups (P > 0.05). NBPD plays a major role in the therapy of T2DM with DJB. NBPD may significantly increase fasting serum bile acid in T2DM rats, an action that may be one of the mechanisms underlying the therapeutic effects of DJB on T2DM.

  14. Management of a Septic Open Abdomen Patient with Spontaneous Jejunal Perforation after Emergent C/S with Confounding Factor of Mild Acute Pancreatitis.

    Science.gov (United States)

    Yetisir, Fahri; Sarer, Akgün Ebru; Acar, Hasan Zafer; Osmanoglu, Gokhan; Özer, Mehmet; Yaylak, Faik

    2016-01-01

    Introduction. We report the management of a septic Open Abdomen (OA) patient by the help of negative pressure therapy (NPT) and abdominal reapproximation anchor (ABRA) system in pregnant woman with spontaneous jejunal perforation after emergent cesarean section (C/S) with confounding factor of mild acute pancreatitis (AP). Presentation of Case. A 29-year-old and 34-week pregnant woman with AP underwent C/S. She was arrested after anesthesia induction and responded to cardiopulmonary resuscitation (CPR). There were only ash-colored serosanguinous fluid within abdomen during C/S. After C/S, she was transferred to intensive care unit (ICU) with vasopressor support. On postoperative 1st day, she underwent reoperation due to fecal fluid coming near the drainage. Leakage point could not be identified exactly and operation had to be deliberately abbreviated due to hemodynamic instability. NPT was applied. Two days later source control was provided by conversion of enteroatmospheric fistula (EAF) to jejunostomy. ABRA was added and OA was closed. No hernia developed at 10-month follow-up period. Conclusion. NPT application in septic OA patient may gain time to patient until adequate source control could be achieved. Using ABRA in conjunction with NPT increases the fascial closure rate in infected OA patient.

  15. Management of a Septic Open Abdomen Patient with Spontaneous Jejunal Perforation after Emergent C/S with Confounding Factor of Mild Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Fahri Yetisir

    2016-01-01

    Full Text Available Introduction. We report the management of a septic Open Abdomen (OA patient by the help of negative pressure therapy (NPT and abdominal reapproximation anchor (ABRA system in pregnant woman with spontaneous jejunal perforation after emergent cesarean section (C/S with confounding factor of mild acute pancreatitis (AP. Presentation of Case. A 29-year-old and 34-week pregnant woman with AP underwent C/S. She was arrested after anesthesia induction and responded to cardiopulmonary resuscitation (CPR. There were only ash-colored serosanguinous fluid within abdomen during C/S. After C/S, she was transferred to intensive care unit (ICU with vasopressor support. On postoperative 1st day, she underwent reoperation due to fecal fluid coming near the drainage. Leakage point could not be identified exactly and operation had to be deliberately abbreviated due to hemodynamic instability. NPT was applied. Two days later source control was provided by conversion of enteroatmospheric fistula (EAF to jejunostomy. ABRA was added and OA was closed. No hernia developed at 10-month follow-up period. Conclusion. NPT application in septic OA patient may gain time to patient until adequate source control could be achieved. Using ABRA in conjunction with NPT increases the fascial closure rate in infected OA patient.

  16. Usefulness of jejunal biopsy in the study of intestinal malabsorption in the elderly Utilidad de la biopsia yeyunal en el estudio de la malabsorción intestinal en el anciano

    Directory of Open Access Journals (Sweden)

    B. Lobo

    2004-04-01

    Full Text Available Background: small bowel structure and function are not different between elderly people and young people. Thus, in principle it is advisable to perform diagnostic investigation of elderly patients as well as younger patients when they present with symptoms suggestive of intestinal malabsorption. A key test for the etiologic diagnosis of intestinal malabsorption, jejunal biopsy, has not been specifically examined to assess its usefulness and risk of complications in this advanced age patients. Aim: to establish the usefulness of jejunal biopsy with the Watson's capsule in the elderly patients with suspected intestinal malabsorption. Patients: patients older than 65 years referred to our Unit for performance of a jejunal biopsy from 1996 to 2001 for suspicion of intestinal malabsorption. Results: forty-seven patients were included. Appropriate biopsy sample was obtained in 45 cases, although in 3 patients a second try was required. Histologic findings: partial villous atrophy in 10 cases (22.2%, complete villous atrophy in 5 cases (11.1%, intraepithelial lymphocytosis in 5 cases (11.1%, and single cases of intestinal lymphangiectasia, amyloidosis, unspecific jejunitis, and Whipple's disease. Histology was normal in 19 cases (42%. Definitive diagnosis was celiac disease in 14 patients, bacterial overgrowth in 3, jejunitis in 3, Whipple's disease in 1, lymphangiectasia in 1, atrophic gastritis in 3, amyloidosis in 1, and ischemic colitis in 1. Jejunal biopsy achieved an etiologic diagnosis in 20 patients. There were no cases of perforations or bleeding. Conclusion: jejunal biopsy is a useful and safe test for the etiologic diagnosis of intestinal malabsorption in elderly patients.Fundamento: la estructura y función del intestino delgado en el anciano sano y en el joven no difieren. Por este motivo ante la sospecha clínica de malabsorción intestinal en el anciano siempre deben realizarse las pruebas necesarias para identificar su causa. Una prueba

  17. Colonic carcinoma with multiple small bowel perforations mimicking intestinal obstruction

    Directory of Open Access Journals (Sweden)

    Khanna Rahul

    2006-09-01

    Full Text Available Abstract Background Carcinoma of the colon may present with perforation proximal to the site of malignancy. Caecum is the commonest site of perforation if the ileocecal valve is patent and the jejunal and ileal perforations are very rare. Case presentation A 35 year male presented with intestinal obstruction. Emergency laparotomy revealed carcinoma of the transverse colon with multiple pinpoint perforations along antimesenteric border of ileum, which were wrapped with omentum, and no peritoneal contamination was present. Extended right hemicolectomy with jejunocolic anastomosis was done. Patient made uneventful recovery in postoperative period and was treated with adjuvant chemotherapy. Conclusion Patients with colonic carcinoma and incompetent ileocecal valve may present with intestinal perforation. Increased intraluminal pressure and closed loop obstruction may lead to ischemia and perforation of the small bowel.

  18. Influência da vitamina C e da hidrocortisona sobre a tensão anastomótica jejunal em ratos

    Directory of Open Access Journals (Sweden)

    Petroianu Andy

    2000-01-01

    Full Text Available O efeito da vitamina C e da hidrocortisona sobre os processos cicatriciais anastomóticos apresenta resultados conflitantes na literatura. Dessa forma, o presente trabalho teve o objetivo de comparar a resistência cicatricial de anastomoses jejunais em ratos, submetidos à administração de vitamina C e de hidrocortisona, em distintos períodos pós-operatórios. Foram estudados 40 ratos Wistar, submetidos a secção e subseqüente anastomose término-terminal de segmento jejunal, a 10 cm da flexura duodenojejunal. Os animais foram divididos em quatro grupos (n=10: Grupo I - controle; Grupo II - administração de vitamina C oral 100 mg/kg; Grupo III - administração de hidrocortisona intraperitoneal 10 mg/kg; Grupo IV - administração de vitamina C mais hidrocortisona nas doses e vias de administração acima. Avaliaram-se as pressões de ruptura anastomótica nos 5 º e 21º dias pós-operatórios. Os ratos que receberam vitamina C isolada ou associada a hidrocortisona tenderam a uma pressão de ruptura maior do que os demais grupos, tanto no 5º quanto no 21º dias pós-operatórios. Os resultados deste trabalho sugerem que a vitamina C contribui para aumentar a resistência das anastomoses jejunais dos ratos durante os primeiros 5 dias pós-operatórios. A resistência das anastomoses jejunais murinas foi pouco influenciada pela administração de corticóide intraperitoneal.

  19. One-Anastomosis Jejunal Interposition with Gastric Remnant Resection (Branco-Zorron Switch) for Severe Recurrent Hyperinsulinemic Hypoglycemia after Gastric Bypass for Morbid Obesity.

    Science.gov (United States)

    Zorron, Ricardo; Branco, Alcides; Sampaio, Jose; Bothe, Claudia; Junghans, Tido; Rasim, Gyurdzhan; Pratschke, Johann; Guel-Klein, Safak

    2017-04-01

    The anatomical and physiological changes after Roux-en-Y gastric bypass for morbid obesity can lead to severe hyperinsulinemic hypoglycemia with neuroglycopenia in a small percentage of patients. The exact physiologic mechanism is not completely understood. Surgical reversal to the original anatomy and distal or total pancreatectomy are current therapeutic options to reverse the hypoglycemic effect, with substantial associated morbidity. Our group reports a pilot clinical series of a novel surgical technique using one-anastomosis jejunal interposition with gastric remnant resection (Branco-Zorron Switch). Patients with severe symptomatic hyperinsulinemic hypoglycemia refractory to conservative therapy were treated using the technique. The procedure started with resection of the remnant stomach close to pylorus. The alimentary limb was sectioned at 20 cm from the gastrojejunal anastomosis, and the rest of the alimentary limb was resected until the Y-Roux anastomosis. A hand-sutured anastomosis was then performed with the proximal alimentary limb and the remnant antrum. Four patients were successfully submitted to the procedure with reversal of the symptomatology and normalization of insulin levels, postprandial glucose levels, and oral glucose tolerance test, with a mean follow-up of 24.3 months. Mean operative time was 188 min, and patients recovered without postoperative complications. Patients suffering from severe hyperinsulinemic hypoglycemia after gastric bypass may be efficiently treated by this innovative procedure, avoiding extreme surgical therapy such as pancreatectomy or restoring the gastric anatomy, while still maintaining sustained weight loss. Studies with larger series and longer follow-up are still needed to define the role of this therapy in managing this entity.

  20. Influência do ácido ascórbico em anastomoses e alças jejunais íntegras de rato Influence of ascorbic acid on anastomotic and jejunal resistance in rat

    Directory of Open Access Journals (Sweden)

    Andy PETROIANU

    2001-01-01

    Full Text Available Racional - O efeito do ácido ascórbico sobre os processos cicatriciais anastomóticos apresenta resultados conflitantes na literatura. Objetivo - Comparar a resistência cicatricial de anastomoses e de segmentos íntegros jejunais de ratos submetidos a administração de vitamina C, em distintos períodos pós-operatórios. Método - Foram estudados 50 ratos Wistar, submetidos a secção e subseqüente anastomose término-terminal de segmento jejunal, a 10 cm da flexura duodenojejunal. Os animais foram divididos em dois grupos (n = 25: Grupo I - controle; Grupo II - administração de vitamina C oral, 100 mg/kg. Avaliaram-se as pressões de ruptura anastomótica e do segmento íntegro jejunal nos 3º, 5º, 7º, 21º e 28º dias pós-operatórios. Resultados - Os ratos que receberam vitamina C apresentaram uma pressão de ruptura anastomótica maior nos 5º, 7º e 28º dias pós-operatórios. O mesmo ocorreu com as pressões de ruptura do segmento íntegro jejunal dos ratos. Conclusões - A vitamina C aumentou a resistência das anastomoses jejunais dos ratos, tanto no pós-operatório imediato, quanto no tardio. Além disso, a resistência final dos segmentos jejunais íntegros dos ratos submetidos a administração de vitamina C foi significativamente maior do que no Grupo Controle.Backgroud - The effects of vitamin C on anastomotic healing process are controversial. Objective - To compare the jejunal anastomotic tension and in the upright segment in different postoperative periods. Method - Fifty male rats weighing 250 to 400 grams were submitted to laparotomy. The jejunum was transversally cut 10 cm from the duodenojejunal flexure, and subsequently anastomosed. The rats were divided into two groups (n = 25. Group I - control, Group II - oral administration of vitamin C (100 mg/kg. The anastomotic and the upright segment resistance was determined by using bursting pressure test on the 3rd, 5th , 7th , 21st and 28th postoperative days

  1. Multiple Perspectives / Multiple Readings

    Directory of Open Access Journals (Sweden)

    Simon Biggs

    2005-01-01

    Full Text Available People experience things from their own physical point of view. What they see is usually a function of where they are and what physical attitude they adopt relative to the subject. With augmented vision (periscopes, mirrors, remote cameras, etc we are able to see things from places where we are not present. With time-shifting technologies, such as the video recorder, we can also see things from the past; a time and a place we may never have visited.In recent artistic work I have been exploring the implications of digital technology, interactivity and internet connectivity that allow people to not so much space/time-shift their visual experience of things but rather see what happens when everybody is simultaneously able to see what everybody else can see. This is extrapolated through the remote networking of sites that are actual installation spaces; where the physical movements of viewers in the space generate multiple perspectives, linked to other similar sites at remote locations or to other viewers entering the shared data-space through a web based version of the work.This text explores the processes involved in such a practice and reflects on related questions regarding the non-singularity of being and the sense of self as linked to time and place.

  2. Multiple sclerosis

    Science.gov (United States)

    ... indwelling catheter Osteoporosis or thinning of the bones Pressure sores Side effects of medicines used to treat the ... Daily bowel care program Multiple sclerosis - discharge Preventing pressure ulcers Swallowing problems Images Multiple sclerosis MRI of the ...

  3. CT features of jejunal pathology

    International Nuclear Information System (INIS)

    Hyland, R.; Chalmers, A.

    2007-01-01

    The imaging of duodenal and ileal diseases is well documented in radiological literature but the jejunum has been relatively neglected. The aim of this review is to outline the current methods of investigation of the jejunum, and provide a comprehensive review of common pathologies affecting the jejunum, with particular emphasis on investigation by computed tomography

  4. MULTIPLE OBJECTS

    Directory of Open Access Journals (Sweden)

    A. A. Bosov

    2015-04-01

    Full Text Available Purpose. The development of complicated techniques of production and management processes, information systems, computer science, applied objects of systems theory and others requires improvement of mathematical methods, new approaches for researches of application systems. And the variety and diversity of subject systems makes necessary the development of a model that generalizes the classical sets and their development – sets of sets. Multiple objects unlike sets are constructed by multiple structures and represented by the structure and content. The aim of the work is the analysis of multiple structures, generating multiple objects, the further development of operations on these objects in application systems. Methodology. To achieve the objectives of the researches, the structure of multiple objects represents as constructive trio, consisting of media, signatures and axiomatic. Multiple object is determined by the structure and content, as well as represented by hybrid superposition, composed of sets, multi-sets, ordered sets (lists and heterogeneous sets (sequences, corteges. Findings. In this paper we study the properties and characteristics of the components of hybrid multiple objects of complex systems, proposed assessments of their complexity, shown the rules of internal and external operations on objects of implementation. We introduce the relation of arbitrary order over multiple objects, we define the description of functions and display on objects of multiple structures. Originality.In this paper we consider the development of multiple structures, generating multiple objects.Practical value. The transition from the abstract to the subject of multiple structures requires the transformation of the system and multiple objects. Transformation involves three successive stages: specification (binding to the domain, interpretation (multiple sites and particularization (goals. The proposed describe systems approach based on hybrid sets

  5. Case report of severe Cushing's syndrome in medullary thyroid cancer complicated by functional diabetes insipidus, aortic dissection, jejunal intussusception, and paraneoplastic dysautonomia: remission with sorafenib without reduction in cortisol concentration.

    Science.gov (United States)

    Hammami, Muhammad M; Duaiji, Najla; Mutairi, Ghazi; Aklabi, Sabah; Qattan, Nasser; Abouzied, Mohei El-Din M; Sous, Mohamed W

    2015-09-09

    Normalization of cortisol concentration by multikinase inhibitors have been reported in three patients with medullary thyroid cancer-related Cushing's syndrome. Aortic dissection has been reported in three patients with Cushing's syndrome. Diabetes insipidus without intrasellar metastasis, intestinal intussusception, and paraneoplastic dysautonomia have not been reported in medullary thyroid cancer. An adult male with metastatic medullary thyroid cancer presented with hyperglycemia, hypernatremia, hypokalemia, hypertension, acne-like rash, and diabetes insipidus (urine volume >8 L/d, osmolality 190 mOsm/kg). Serum cortisol, adrenocorticoitropic hormone, dehydroepiandrostenedione sulfate, and urinary free cortisol were elevated 8, 20, 4.4, and 340 folds, respectively. Pituitary imaging was normal. Computed tomography scan revealed jejunal intussusception and incidental abdominal aortic dissection. Sorafenib treatment was associated with Cushing's syndrome remission, elevated progesterone (>10 fold), normalization of dehydroepiandrostenedione sulfate, but persistently elevated cortisol concentration. Newly-developed proximal lower limb weakness and decreased salivation were associated with elevated ganglionic neuronal acetylcholine receptor (alpha-3) and borderline P/Q type calcium channel antibodies. Extreme cortisol concentration may have contributed to aortic dissection and suppressed antidiuretic hormone secretion; which combined with hypokalemia due cortisol activation of mineralocorticoid receptors, manifested as diabetes insipidus. This is the first report of paraneoplastic dysautonomia and jejunal intussusception in medullary thyroid cancer, they may be related to medullary thyroid cancer's neuroendocrine origin and metastasis, respectively. Remission of Cushing's syndrome without measurable reduction in cortisol concentration suggests a novel cortisol-independent mechanism of action or assay cross-reactivity. Normalization of dehydroepiandrostenedione

  6. Multiple sclerosis

    International Nuclear Information System (INIS)

    Grunwald, I.Q.; Kuehn, A.L.; Backens, M.; Papanagiotou, P.; Shariat, K.; Kostopoulos, P.

    2008-01-01

    Multiple sclerosis is the most common chronic inflammatory disease of myelin with interspersed lesions in the white matter of the central nervous system. Magnetic resonance imaging (MRI) plays a key role in the diagnosis and monitoring of white matter diseases. This article focuses on key findings in multiple sclerosis as detected by MRI. (orig.) [de

  7. Multiple homicides.

    Science.gov (United States)

    Copeland, A R

    1989-09-01

    A study of multiple homicides or multiple deaths involving a solitary incident of violence by another individual was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, during 1983-1987. A total of 107 multiple homicides were studied: 88 double, 17 triple, one quadruple, and one quintuple. The 236 victims were analyzed regarding age, race, sex, cause of death, toxicologic data, perpetrator, locale of the incident, and reason for the incident. This article compares this type of slaying with other types of homicide including those perpetrated by serial killers. Suggestions for future research in this field are offered.

  8. Multiple Sclerosis

    Science.gov (United States)

    Multiple sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down ...

  9. Multiple myeloma.

    LENUS (Irish Health Repository)

    Collins, Conor D

    2012-02-01

    Advances in the imaging and treatment of multiple myeloma have occurred over the past decade. This article summarises the current status and highlights how an understanding of both is necessary for optimum management.

  10. Multiple mononeuropathy

    Science.gov (United States)

    ... with multiple mononeuropathy are prone to new nerve injuries at pressure points such as the knees and elbows. They should avoid putting pressure on these areas, for example, by not leaning on the elbows, crossing the knees, ...

  11. [Multiple meningiomas].

    Science.gov (United States)

    Terrier, L-M; François, P

    2016-06-01

    Multiple meningiomas (MMs) or meningiomatosis are defined by the presence of at least 2 lesions that appear simultaneously or not, at different intracranial locations, without the association of neurofibromatosis. They present 1-9 % of meningiomas with a female predominance. The occurrence of multiple meningiomas is not clear. There are 2 main hypotheses for their development, one that supports the independent evolution of these tumors and the other, completely opposite, that suggests the propagation of tumor cells of a unique clone transformation, through cerebrospinal fluid. NF2 gene mutation is an important intrinsic risk factor in the etiology of multiple meningiomas and some exogenous risk factors have been suspected but only ionizing radiation exposure has been proven. These tumors can grow anywhere in the skull but they are more frequently observed in supratentorial locations. Their histologic types are similar to unique meningiomas of psammomatous, fibroblastic, meningothelial or transitional type and in most cases are benign tumors. The prognosis of these tumors is eventually good and does not differ from the unique tumors except for the cases of radiation-induced multiple meningiomas, in the context of NF2 or when diagnosed in children where the outcome is less favorable. Each meningioma lesion should be dealt with individually and their multiple character should not justify their resection at all costs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, Egon; Stenager, E N; Knudsen, Lone

    1994-01-01

    In a cross-sectional study of 117 randomly selected patients (52 men, 65 women) with definite multiple sclerosis, it was found that 76 percent were married or cohabitant, 8 percent divorced. Social contacts remained unchanged for 70 percent, but outgoing social contacts were reduced for 45 percent......, need for structural changes in home and need for pension became greater with increasing physical handicap. No significant differences between gender were found. It is concluded that patients and relatives are under increased social strain, when multiple sclerosis progresses to a moderate handicap...

  13. Multiple myeloma

    International Nuclear Information System (INIS)

    Sohn, Jeong Ick; Ha, Choon Ho; Choi, Karp Shik

    1994-01-01

    Multiple myeloma is a malignant plasma cell tumor that is thought to originate proliferation of a single clone of abnormal plasma cell resulting production of a whole monoclonal paraprotein. The authors experienced a case of multiple myeloma with severe mandibular osteolytic lesions in 46-year-old female. As a result of careful analysis of clinical, radiological, histopathological features, and laboratory findings, we diagnosed it as multiple myeloma, and the following results were obtained. 1. Main clinical symptoms were intermittent dull pain on the mandibular body area, abnormal sensation of lip and pain due to the fracture on the right clavicle. 2. Laboratory findings revealed M-spike, reversed serum albumin-globulin ratio, markedly elevated ESR and hypercalcemia. 3. Radiographically, multiple osteolytic punched-out radiolucencies were evident on the skull, zygoma, jaw bones, ribs, clavicle and upper extremities. Enlarged liver and increased uptakes on the lesional sites in RN scan were also observed. 4. Histopathologically, markedly hypercellular marrow with sheets of plasmoblasts and megakaryocytes were also observed.

  14. Multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Jensen, K

    1988-01-01

    Forty-two (12%) of a total of 366 patients with multiple sclerosis (MS) had psychiatric admissions. Of these, 34 (81%) had their first psychiatric admission in conjunction with or after the onset of MS. Classification by psychiatric diagnosis showed that there was a significant positive correlation...

  15. Multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Knudsen, L; Jensen, K

    1991-01-01

    In a cross-sectional investigation of 116 patients with multiple sclerosis, the social and sparetime activities of the patient were assessed by both patient and his/her family. The assessments were correlated to physical disability which showed that particularly those who were moderately disabled...

  16. Multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Jensen, K

    1990-01-01

    An investigation on the correlation between ability to read TV subtitles and the duration of visual evoked potential (VEP) latency in 14 patients with definite multiple sclerosis (MS), indicated that VEP latency in patients unable to read the TV subtitles was significantly delayed in comparison...

  17. Multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Knudsen, L; Jensen, K

    1994-01-01

    In a cross-sectional study of 94 patients (42 males, 52 females) with definite multiple sclerosis (MS) in the age range 25-55 years, the correlation of neuropsychological tests with the ability to read TV-subtitles and with the use of sedatives is examined. A logistic regression analysis reveals...

  18. Multiple Sclerosis.

    Science.gov (United States)

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on multiple sclerosis is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first. The module goal and objectives are then…

  19. Parenting Multiples

    Science.gov (United States)

    ... when your babies do. Though it can be hard to let go of the thousand other things you need to do, remember that your well-being is key to your ability to take care of your babies. What Problems Can Happen? It may be hard to tell multiple babies apart when they first ...

  20. Multiple sclerosis

    International Nuclear Information System (INIS)

    Sadashima, Hiromichi; Kusaka, Hirofumi; Imai, Terukuni; Takahashi, Ryosuke; Matsumoto, Sadayuki; Yamamoto, Toru; Yamasaki, Masahiro; Maya, Kiyomi

    1986-01-01

    Eleven patients with a definite diagnosis of multiple sclerosis were examined in terms of correlations between the clinical features and the results of cranial computed tomography (CT), and magnetic resonance imaging (MRI). Results: In 5 of the 11 patients, both CT and MRI demonstrated lesions consistent with a finding of multiple sclerosis. In 3 patients, only MRI demonstrated lesions. In the remaining 3 patients, neither CT nor MRI revealed any lesion in the brain. All 5 patients who showed abnormal findings on both CT and MRI had clinical signs either of cerebral or brainstem - cerebellar lesions. On the other hand, two of the 3 patients with normal CT and MRI findings had optic-nerve and spinal-cord signs. Therefore, our results suggested relatively good correlations between the clinical features, CT, and MRI. MRI revealed cerebral lesions in two of the four patients with clinical signs of only optic-nerve and spinal-cord lesions. MRI demonstrated sclerotic lesions in 3 of the 6 patients whose plaques were not detected by CT. In conclusion, MRI proved to be more helpful in the demonstration of lesions attributable to chronic multiple sclerosis. (author)

  1. Multiple inflation

    International Nuclear Information System (INIS)

    Murphy, P.J.

    1987-01-01

    The Theory of Inflation, namely, that at some point the entropy content of the universe was greatly increased, has much promise. It may solve the puzzles of homogeneity and the creation of structure. However, no particle physics model has yet been found that can successfully drive inflation. The difficulty in satisfying the constraint that the isotropy of the microwave background places on the effective potential of prospective models is immense. In this work we have codified the requirements of such models in a most general form. We have carefully calculated the amounts of inflation the various problems of the Standard Model need for their solution. We have derived a completely model independent upper bond on the inflationary Hubble parameter. We have developed a general notation with which to probe the possibilities of Multiple Inflation. We have shown that only in very unlikely circumstances will any evidence of an earlier inflation, survive the de Sitter period of its successor. In particular, it is demonstrated that it is most unlikely that two bouts of inflation will yield high amplitudes of density perturbations on small scales and low amplitudes on large. We conclude that, while multiple inflation will be of great theoretical interest, it is unlikely to have any observational impact

  2. Gastric diverticulosis and ulcerations in bitches | Abidoye | Sokoto ...

    African Journals Online (AJOL)

    Two bitches were presented to the Small Animal Clinic Unit of the Ahmadu Bello University Veterinary Teaching Hospital Zaria, Nigeria with clinical manifestation suggestive of gastric diverticulous and ulcer. The cases were confirmed through contrast radiography (using barium meal), hemogram, and ultrasonography.

  3. Italian consensus conference for colonic diverticulosis and diverticular disease

    Science.gov (United States)

    Barbara, Giovanni; Pace, Fabio; Annese, Vito; Bassotti, Gabrio; Binda, Gian Andrea; Casetti, Tino; Colecchia, Antonio; Festi, Davide; Fiocca, Roberto; Laghi, Andrea; Maconi, Giovanni; Nascimbeni, Riccardo; Scarpignato, Carmelo; Villanacci, Vincenzo; Annibale, Bruno

    2014-01-01

    The statements produced by the Consensus Conference on Diverticular Disease promoted by GRIMAD (Gruppo Italiano Malattia Diverticolare, Italian Group on Diverticular Diseases) are reported. Topics such as epidemiology, risk factors, diagnosis, medical and surgical treatment of diverticular disease (DD) in patients with uncomplicated and complicated DD were reviewed by a scientific board of experts who proposed 55 statements graded according to level of evidence and strength of recommendation, and approved by an independent jury. Each topic was explored focusing on the more relevant clinical questions. Comparison and discussion of expert opinions, pertinent statements and replies to specific questions, were presented and approved based on a systematic literature search of the available evidence. Comments were added explaining the basis for grading the evidence, particularly for controversial areas. PMID:25360320

  4. Síndrome de intestino irritable y diverticulosis

    OpenAIRE

    Kestenberg Himelfar, Abraham; Fundación Valle de Lili

    1998-01-01

    Síndrome de intestino irritable (SII)/ ¿Cómo funciona el sistema digestivo?/¿Qué es el síndrome de intestino irritable?/¿Cuáles son los síntomas del síndrome de intestino irritable?/¿Qué causa el síndrome de intestino irritable?/¿Qué papel juega la tensión emocional en el origen del síndrome de intestino irritable?/¿Cómo saber si el problema es síndrome de intestino irritable o si es algo diferente?/¿Cómo se debe tratar el síndrome de intestino irritable?/¿Se deben evitar algunos alimentos?/¿...

  5. Understanding Diverticulosis and Diverticulitis | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... the amount of high-fiber foods in the diet. Severe cases of diverticulitis, with acute pain and complications, will likely require a hospital stay. Most cases of severe diverticulitis are treated ...

  6. Peutz-Jeghers syndrome and duodeno-jejunal adenocarcinoma: therapeutic implications Síndrome de Peutz-Jeghers y adenocarcinoma duodenal-yeyunal: implicaciones terapéuticas

    Directory of Open Access Journals (Sweden)

    J. A. Cienfuegos

    2009-12-01

    Full Text Available The Peutz-Jeghers syndrome (PJS is an autosomal dominant hamartomatous poliposis describred in 1921. Hemminki in 1997 described the presence of LKB-1 mutation tumor-suppressor gen. The patients with PJS develop a higher cumulative incidence of gastrointestinal, pancreas and extraintestinal tumors, being occasion of a renew interest on hamartomatous polyposis syndromes regarding the clinical care, cancer surveillance treatment and long term follow-up. We report the case of a 38 years old male, diagnosed of PJS who developed a multiple adenocarcinoma in duodenum and yeyunum. Surgically treated and with a long-term free disease survival of 11 years represents the sixth case reported in the spanish literature of PJS associated with a gastrointestinal tumor. A critical review, molecular alterations and the established criteria of tumor screening and surveillance are reviewed.

  7. Duodenal-jejunal bypass surgery up-regulates the expression of the hepatic insulin signaling proteins and the key regulatory enzymes of intestinal gluconeogenesis in diabetic Goto-Kakizaki rats.

    Science.gov (United States)

    Sun, Dong; Wang, Kexin; Yan, Zhibo; Zhang, Guangyong; Liu, Shaozhuang; Liu, Fengjun; Hu, Chunxiao; Hu, Sanyuan

    2013-11-01

    Duodenal-jejunal bypass (DJB), which is not routinely applied in metabolic surgery, is an effective surgical procedure in terms of type 2 diabetes mellitus resolution. However, the underlying mechanisms are still undefined. Our aim was to investigate the diabetic improvement by DJB and to explore the changes in hepatic insulin signaling proteins and regulatory enzymes of gluconeogenesis after DJB in a non-obese diabetic rat model. Sixteen adult male Goto-Kakizaki rats were randomly divided into DJB and sham-operated groups. The body weight, food intake, hormone levels, and glucose metabolism were measured. The levels of protein expression and phosphorylation of insulin receptor-beta (IR-β) and insulin receptor substrate 2 (IRS-2) were evaluated in the liver. We also detected the expression of key regulatory enzymes of gluconeogenesis [phosphoenoylpyruvate carboxykinase-1 (PCK1), glucose-6-phosphatase-alpha (G6Pase-α)] in small intestine and liver. DJB induced significant diabetic improvement with higher postprandial glucagons-like peptide 1, peptide YY, and insulin levels, but without weight loss. The DJB group exhibited increased expression and phosphorylation of IR-β and IRS-2 in liver, up-regulated the expression of PCK1 and G6Pase-α in small intestine, and down-regulated the expression of these enzymes in liver. DJB is effective in up-regulating the expression of the key proteins in the hepatic insulin signaling pathway and the key regulatory enzymes of intestinal gluconeogenesis and down-regulating the expression of the key regulatory enzymes of hepatic gluconeogenesis without weight loss. Our study helps to reveal the potential role of hepatic insulin signaling pathway and intestinal gluconeogenesis in ameliorating insulin resistance after metabolic surgery.

  8. EVOLUÇÃO DA FIBROSE BILIAR SECUNDÁRIA EM RATOS TRATADOS MEDIANTE DERIVAÇÃO BÍLIO-DUODENAL OU BÍLIO-JEJUNAL COM AL��A DE ROUX MEDINDO 5, 10 E 15 CM

    Directory of Open Access Journals (Sweden)

    Pandolfi Jr. H.

    2001-01-01

    Full Text Available A modalidade de derivação bílio-digestiva empregada no tratamento da colestase extra-hepática crônica pode influenciar na reparação das lesões hepáticas. Avaliou-se o desempenho das derivações bílio-duodenal e bílio-jejunal em Y de Roux com alça exclusa de diferentes comprimentos na reparação das lesões morfológicas e funcionais do fígado de ratos com fibrose biliar secundária. Foram utilizados ratos Wistar, com 15 dias de obstrução biliar, alocados em 5 grupos de 6 animais. O grupo OB caracterizou as alterações da fibrose biliar. Os animais remanescentes foram tratados mediante derivação com o duodeno (grupo DBD, e com o jejuno, em alça exclusa de 5cm (grupo DBJ5, 10cm (grupo DBJ10 e 15cm (grupo DBJ15, sendo reavaliados 3 meses depois. Outros 6 animais foram submetidos à intervenção simulada e considerados grupo controle (IS. Todos animais foram submetidos à avaliação morfométrica do fígado, análise bioquímica do sangue e microbiológica da bile, estudo da função mitocondrial hepática e verificação do peso úmido do fígado e do baço. Na análise estatística adotou-se o nível de significância de 5%. Houve aumento significativo do peso estimado, em g/Kg de peso corporal, dos ductos biliares, da fibrose e dos hepatócitos nos animais do grupo OB (medianas de 1,30; 10,03 e 37,0 em relação aos animais controles (IS (medianas de 0,03; zero e 29,37. Após tratamento, ocorreu regressão significativa do peso estimado dos ductos biliares e da fibrose, com valores medianos de 0,22 e 0,22 para o grupo DBD, 0,45 e 3,31 para o grupo DBJ5 e 0,22 e 5,0 para o grupo DBJ15. Houve regressão significativa do peso estimado dos hepatócitos apenas nos grupos derivados com o jejuno, com valores medianos de 31,93; 24,46 e 28,52. Ocorreu aumento significativo do peso úmido do fígado e do baço no grupo OB (medianas em g/Kg de peso corporal de 49,85 e 5,71 em relação ao grupo IS (30,0 e 3,04. Houve regress

  9. Esvaziamento gástrico e jejunal proximal em ratos submetidos ou não à gastrectomia parcial com reconstrução do trânsito intestinal em Y de Roux ou a Billroth II Gastric and proximal jejunum emptying in rats submitted or not to partial gastrectomy with Roux-en Y or Billroth II reconstruction

    Directory of Open Access Journals (Sweden)

    Flavio José Garani

    1997-03-01

    Full Text Available Estudou-se os efeitos da reconstrução gastrojejunal em Y de ROUX (YR ou a BILLROTH II (BII no esvaziamento gástrico (EG e jejunal proximal de líquido nutriente. Constitui-se quatro grupos de dez ratos Wistar machos: simulado (grupo I, antrectomia em YR (grupo II, gastrectomia subtotal em YR (grupo III e antrectomia a BII (grupo IV. O EG e jejunal proximal foram avaliados no sétimo dia de pós-operatório, 60 minutos após a introdução gástrica de ovo cru mexido marcado com Tc99m. Após esse tempo, retirou-se separadamente o estômago, intestino proximal e restante do intestino, seguindo-se da quantificação do radioisótopo presente em cada segmento, numa câmara de ionização. O EG foi mais rápido nos animais gastrectomizados do que naqueles sem gastrectomia (α The aim of this study was to determine the effects of ROUX-EN-Y or BILLROTH II gastrojejunostomy in gastric and proximal jejunal emptying of nutrient liquid meal. Four groups of ten WISTAR rats were used: sham {group I, antrectomy and ROUX-EN-Y gastrojejunostomy (group II, subtotal gastrectomy and ROUX-EN-Y gastrojejunostomy (group III and antrectomy and BILLROTH II gastrojejunostomy (group IV. The gastric and proxima! jejunal emptying were measured one week after surgery, 60 minutes after gastric introduetion of 1 ml of 99mTc labeled uncooked scrainbled egg. Afler this interval the stomach, proximal intestine, small bowell remaining and colon of each rat were excised and placed in separate containers. The absolute amounts of the radionuclide present in each segment was determined in an ionization camera. The relative amounts was calculated and compared. The gastric emplying Ín ROUX-EN-Y antrectomy group was faster than sham group and slower than ROUX-EN-Y subtotal gastrectomy group (∞ < 0,05, but didn't present a significant difference in relation to antrectomy BILLROTH II group. The ROUX limb emptying (groups II and III was not significantly different than efferent loop

  10. Multiple Input - Multiple Output (MIMO) SAR

    Data.gov (United States)

    National Aeronautics and Space Administration — This effort will research and implement advanced Multiple-Input Multiple-Output (MIMO) Synthetic Aperture Radar (SAR) techniques which have the potential to improve...

  11. [Jejunal myenteric denervation induced by benzalkonium chloride].

    Science.gov (United States)

    Ramalho, F S; Santos, G C; Ramalho, L N; Kajiwara, J K; Zucoloto, S

    1994-01-01

    The effects of benzalkonium chloride (BAC) on the number of myenteric neurons, muscle thickness and external perimeter after acute (until 10 days after BAC application) and chronic (30 and 60 days after BAC application) denervation of the proximal jejunum were determined in rats. There was a significant reduction in the number of myenteric neurons of all segments treated with BAC. The extent of denervation varied along the time, and it was reduced in the denervated segments of the chronic group in comparison with the acute group. This may be due to the neuroplasticity phenomenon appearing during the chronic phase. Myenteric denervation increased the thickness of the propria muscle layer, especially in the longitudinal muscle layer, suggesting a higher sensitivity of this layer to myenteric denervation.

  12. Multiple-Ring Digital Communication Network

    Science.gov (United States)

    Kirkham, Harold

    1992-01-01

    Optical-fiber digital communication network to support data-acquisition and control functions of electric-power-distribution networks. Optical-fiber links of communication network follow power-distribution routes. Since fiber crosses open power switches, communication network includes multiple interconnected loops with occasional spurs. At each intersection node is needed. Nodes of communication network include power-distribution substations and power-controlling units. In addition to serving data acquisition and control functions, each node acts as repeater, passing on messages to next node(s). Multiple-ring communication network operates on new AbNET protocol and features fiber-optic communication.

  13. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, Mohammad Akbar Hosain

    2014-12-04

    Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green\\'s function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green\\'s function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green\\'s function and renders the higher order internal multiple image for display on a display device.

  14. MultipleColposcopyJCO

    Science.gov (United States)

    Performing multiple biopsies during a procedure known as colposcopy—visual inspection of the cervix—is more effective than performing only a single biopsy of the worst-appearing area for detecting cervical cancer precursors. This multiple biopsy approach

  15. Salmonella Infections - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Salmonella Infections URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Salmonella Infections - Multiple Languages To use the sharing features ...

  16. Health Literacy - Multiple Languages

    Science.gov (United States)

    ... Here: Home → Multiple Languages → All Health Topics → Health Literacy URL of this page: https://medlineplus.gov/languages/ ... W XYZ List of All Topics All Health Literacy - Multiple Languages To use the sharing features on ...

  17. Cosmetic Dentistry - Multiple Languages

    Science.gov (United States)

    ... Here: Home → Multiple Languages → All Health Topics → Cosmetic Dentistry URL of this page: https://medlineplus.gov/languages/ ... W XYZ List of All Topics All Cosmetic Dentistry - Multiple Languages To use the sharing features on ...

  18. Atrial Fibrillation - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Atrial Fibrillation URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Atrial Fibrillation - Multiple Languages To use the sharing features on ...

  19. Zika Virus - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Zika Virus URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Zika Virus - Multiple Languages To use the sharing features on ...

  20. Elder Abuse - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Elder Abuse URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Elder Abuse - Multiple Languages To use the sharing features on ...

  1. Herbal Medicine - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Herbal Medicine URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Herbal Medicine - Multiple Languages To use the sharing features on ...

  2. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, Mohammad Akbar Hosain; Alkhalifah, Tariq

    2014-01-01

    Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green's function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green's function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green's function and renders the higher order internal multiple image for display on a display device.

  3. Domestic Violence - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Domestic Violence URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Domestic Violence - Multiple Languages To use the sharing features on ...

  4. Multiple Primary Tumors

    African Journals Online (AJOL)

    2017-12-05

    Dec 5, 2017 ... Multiple primary tumors occur in clinical practice causing diagnostic dilemma. It is not very .... was estrogen receptor negative, progesterone receptor negative, and ... cervical, ovarian, and urinary bladder cancers. Multiple.

  5. Diabetic Foot - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Diabetic Foot URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Diabetic Foot - Multiple Languages To use the sharing features on ...

  6. Child Abuse - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Child Abuse URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Child Abuse - Multiple Languages To use the sharing features on ...

  7. Fatigue and Multiple Sclerosis

    Science.gov (United States)

    ... to navigation Skip to content Menu Navigation National Multiple Sclerosis Society Sign In In Your Area Donate Donate ... of MS What Causes MS? Who Gets MS? Multiple Sclerosis FAQs Types of MS Related Conditions Symptoms & Diagnosis ...

  8. Rotavirus Infections - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Rotavirus Infections URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Rotavirus Infections - Multiple Languages To use the sharing features ...

  9. Neutron Multiplicity Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Frame, Katherine Chiyoko [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-06-28

    Neutron multiplicity measurements are widely used for nondestructive assay (NDA) of special nuclear material (SNM). When combined with isotopic composition information, neutron multiplicity analysis can be used to estimate the spontaneous fission rate and leakage multiplication of SNM. When combined with isotopic information, the total mass of fissile material can also be determined. This presentation provides an overview of this technique.

  10. Neutron multiplication measurement instrument

    International Nuclear Information System (INIS)

    Nixon, K.V.; Dowdy, E.J.; France, S.W.; Millegan, D.R.; Robba, A.A.

    1983-01-01

    The Advanced Nuclear Technology Group of the Los Alamos National Laboratory is now using intelligent data-acquisition and analysis instrumentation for determining the multiplication of nuclear material. Earlier instrumentation, such as the large NIM-crate systems, depended on house power and required additional computation to determine multiplication or to estimate error. The portable, battery-powered multiplication measurement unit, with advanced computational power, acquires data, calculates multiplication, and completes error analysis automatically. Thus, the multiplication is determined easily and an available error estimate enables the user to judge the significance of results

  11. Accurate scaling on multiplicity

    International Nuclear Information System (INIS)

    Golokhvastov, A.I.

    1989-01-01

    The commonly used formula of KNO scaling P n =Ψ(n/ ) for descrete distributions (multiplicity distributions) is shown to contradict mathematically the condition ΣP n =1. The effect is essential even at ISR energies. A consistent generalization of the concept of similarity for multiplicity distributions is obtained. The multiplicity distributions of negative particles in PP and also e + e - inelastic interactions are similar over the whole studied energy range. Collider data are discussed. 14 refs.; 8 figs

  12. ALICE Photon Multiplicity Detector

    CERN Multimedia

    Nayak, T

    2013-01-01

    Photon Multiplicity Detector (PMD) measures the multiplicity and spatial distribution of photons in the forward region of ALICE on a event-by-event basis. PMD is a pre-shower detector having fine granularity and full azimuthal coverage in the pseudo-rapidity region 2.3 < η < 3.9.

  13. Body Weight - Multiple Languages

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Body Weight URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Body Weight - Multiple Languages To use the sharing features on this page, ...

  14. Multiplicity in difference geometry

    OpenAIRE

    Tomasic, Ivan

    2011-01-01

    We prove a first principle of preservation of multiplicity in difference geometry, paving the way for the development of a more general intersection theory. In particular, the fibres of a \\sigma-finite morphism between difference curves are all of the same size, when counted with correct multiplicities.

  15. Applying Multiple Intelligences

    Science.gov (United States)

    Christodoulou, Joanna A.

    2009-01-01

    The ideas of multiple intelligences introduced by Howard Gardner of Harvard University more than 25 years ago have taken form in many ways, both in schools and in other sometimes-surprising settings. The silver anniversary of Gardner's learning theory provides an opportunity to reflect on the ways multiple intelligences theory has taken form and…

  16. Formation of multiple networks

    DEFF Research Database (Denmark)

    Magnani, Matteo; Rossi, Luca

    2013-01-01

    we introduce the first network formation model for multiple networks. Network formation models are among the most popular tools in traditional network studies, because of both their practical and theoretical impact. However, existing models are not sufficient to describe the generation of multiple...

  17. Orchestrating Multiple Intelligences

    Science.gov (United States)

    Moran, Seana; Kornhaber, Mindy; Gardner, Howard

    2006-01-01

    Education policymakers often go astray when they attempt to integrate multiple intelligences theory into schools, according to the originator of the theory, Howard Gardner, and his colleagues. The greatest potential of a multiple intelligences approach to education grows from the concept of a profile of intelligences. Each learner's intelligence…

  18. Assessing Children's Multiplicative Thinking

    Science.gov (United States)

    Hurst, Chris; Hurrell, Derek

    2016-01-01

    Multiplicative thinking is a "big idea" of mathematics that underpins much of the mathematics learned beyond the early primary school years. This paper reports on a current study that utilises an interview tool and a written quiz to gather data about children's multiplicative thinking. The development of the tools and some of the…

  19. Safe Dynamic Multiple Inheritance

    DEFF Research Database (Denmark)

    Ernst, Erik

    2002-01-01

    Multiple inheritance and similar mechanisms are usually only supported at compile time in statically typed languages. Nevertheless, dynamic multiple inheritance would be very useful in the development of complex systems, because it allows the creation of many related classes without an explosion...... in the size and level of redundancy in the source code. In fact, dynamic multiple inheritance is already available. The language gbeta is statically typed and has supported run-time combination of classes and methods since 1997, by means of the combination operator '&'. However, with certain combinations...

  20. A multiplicity logic unit

    International Nuclear Information System (INIS)

    Bialkowski, J.; Moszynski, M.; Zagorski, A.

    1981-01-01

    The logic diagram principle of operation and some details of the design of the multiplicity logic unit are presented. This unit was specially designed to fulfil the requirements of a multidetector arrangement for gamma-ray multiplicity measurements. The unit is equipped with 16 inputs controlled by a common coincidence gate. It delivers a linear output pulse with the height proportional to the multiplicity of coincidences and logic pulses corresponding to 0, 1, ... up to >= 5-fold coincidences. These last outputs are used to steer the routing unit working with the multichannel analyser. (orig.)

  1. Fission neutron multiplicity calculations

    International Nuclear Information System (INIS)

    Maerten, H.; Ruben, A.; Seeliger, D.

    1991-01-01

    A model for calculating neutron multiplicities in nuclear fission is presented. It is based on the solution of the energy partition problem as function of mass asymmetry within a phenomenological approach including temperature-dependent microscopic energies. Nuclear structure effects on fragment de-excitation, which influence neutron multiplicities, are discussed. Temperature effects on microscopic energy play an important role in induced fission reactions. Calculated results are presented for various fission reactions induced by neutrons. Data cover the incident energy range 0-20 MeV, i.e. multiple chance fission is considered. (author). 28 refs, 13 figs

  2. Multiple sclerosis research

    International Nuclear Information System (INIS)

    Battaglia, M.A.

    1990-01-01

    This volume proceedings contains four contributions which are in INIS scope, dealing with MRI and SPECT in the diagnosis of multiple sclerosis and assessment of disease activity. (H.W.). refs.; figs.; tabs

  3. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, M. A. H.; Alkhalifah, Tariq Ali

    2014-01-01

    Internal multiples deteriorate the image when the imaging procedure assumes only single scattering, especially if the velocity model does not have sharp contrasts to reproduce such scattering in the Green’s function through forward modeling

  4. Connecting the Production Multiple

    DEFF Research Database (Denmark)

    Lichen, Alex Yu; Mouritsen, Jan

    &OP process itself is a fluid object, but there is still possibility to organise the messy Production. There are connections between the Production multiple and the managerial technology fluid. The fluid enacted the multiplicity of Production thus making it more difficult to be organised because there were...... in opposite directions. They are all part of the fluid object. There is no single chain of circulating references that makes the object a matter of fact. Accounting fluidity means that references drift back and forth and enact new realities also connected to the chain. In this setting future research may......This paper is about objects. It follows post ANT trajectories and finds that objects are multiple and fluid. Extant classic ANT inspired accounting research largely sees accounting inscriptions as immutable mobiles. Although multiplicity of objects upon which accounting acts has been explored...

  5. Multiple sex partner

    African Journals Online (AJOL)

    User

    intercourse, about 60% reported having a single sexual partner and 40% reported having multiple ... masturbation, start having sex at a younger age, have sex with married people and/or .... sex were considered unacceptable by 89 vs.

  6. Multiple Stages 2

    DEFF Research Database (Denmark)

    Andreasen, John

    Multiple stages 2: theatrical futures, set design, community plays, cultural capitals, democracy & drama, WWII dramas, performance on adoption, promenade about emigration, qualities in political theatre, performance analysis, dramaturgical education, Toulmin Variations...

  7. Rehabilitation and multiple sclerosis

    DEFF Research Database (Denmark)

    Dalgas, Ulrik

    2011-01-01

    In a chronic and disabling disease like multiple sclerosis, rehabilitation becomes of major importance in the preservation of physical, psychological and social functioning. Approximately 80% of patients have multiple sclerosis for more than 35 years and most will develop disability at some point......, a paradigm shift is taking place and it is now increasingly acknowledged that exercise therapy is both safe and beneficial. Robot-assisted training is also attracting attention in multiple sclerosis rehabilitation. Several sophisticated commercial robots exist, but so far the number of scientific studies...... promising. This drug has been shown to improve walking ability in some patients with multiple sclerosis, associated with a reduction of patients' self-reported ambulatory disability. Rehabilitation strategies involving these different approaches, or combinations of them, may be of great use in improving...

  8. Generalized internal multiple imaging

    KAUST Repository

    Zuberi, M. A. H.

    2014-08-05

    Internal multiples deteriorate the image when the imaging procedure assumes only single scattering, especially if the velocity model does not have sharp contrasts to reproduce such scattering in the Green’s function through forward modeling. If properly imaged, internal multiples (internally scattered energy) can enhance the seismic image. Conventionally, to image internal multiples, accurate, sharp contrasts in the velocity model are required to construct a Green’s function with all the scattered energy. As an alternative, we have developed a generalized internal multiple imaging procedure that images any order internal scattering using the background Green’s function (from the surface to each image point), constructed from a smooth velocity model, usually used for conventional imaging. For the first-order internal multiples, the approach consisted of three steps, in which we first back propagated the recorded surface seismic data using the background Green’s function, then crosscorrelated the back-propagated data with the recorded data, and finally crosscorrelated the result with the original background Green’s function. This procedure images the contribution of the recorded first-order internal multiples, and it is almost free of the single-scattering recorded energy. The cost includes one additional crosscorrelation over the conventional single-scattering imaging application. We generalized this method to image internal multiples of any order separately. The resulting images can be added to the conventional single-scattering image, obtained, e.g., from Kirchhoff or reverse-time migration, to enhance the image. Application to synthetic data with reflectors illuminated by multiple scattering (double scattering) demonstrated the effectiveness of the approach.

  9. Neutron source multiplication method

    International Nuclear Information System (INIS)

    Clayton, E.D.

    1985-01-01

    Extensive use has been made of neutron source multiplication in thousands of measurements of critical masses and configurations and in subcritical neutron-multiplication measurements in situ that provide data for criticality prevention and control in nuclear materials operations. There is continuing interest in developing reliable methods for monitoring the reactivity, or k/sub eff/, of plant operations, but the required measurements are difficult to carry out and interpret on the far subcritical configurations usually encountered. The relationship between neutron multiplication and reactivity is briefly discussed and data presented to illustrate problems associated with the absolute measurement of neutron multiplication and reactivity in subcritical systems. A number of curves of inverse multiplication have been selected from a variety of experiments showing variations observed in multiplication during the course of critical and subcritical experiments where different methods of reactivity addition were used, with different neutron source detector position locations. Concern is raised regarding the meaning and interpretation of k/sub eff/ as might be measured in a far subcritical system because of the modal effects and spectrum differences that exist between the subcritical and critical systems. Because of this, the calculation of k/sub eff/ identical with unity for the critical assembly, although necessary, may not be sufficient to assure safety margins in calculations pertaining to far subcritical systems. Further study is needed on the interpretation and meaning of k/sub eff/ in the far subcritical system

  10. MULTIPLE SPINAL CANAL MENINGIOMAS

    Directory of Open Access Journals (Sweden)

    Nandigama Pratap Kumar

    2016-10-01

    Full Text Available BACKGROUND Meningiomas of the spinal canal are common tumours with the incidence of 25 percent of all spinal cord tumours. But multiple spinal canal meningiomas are rare in compare to solitary lesions and account for 2 to 3.5% of all spinal meningiomas. Most of the reported cases are both intra cranial and spinal. Exclusive involvement of the spinal canal by multiple meningiomas are very rare. We could find only sixteen cases in the literature to the best of our knowledge. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for single lesion. We analysed the literature, with illustration of our case. MATERIALS AND METHODS In September 2016, we performed a literature search for multiple spinal canal meningiomas involving exclusively the spinal canal with no limitation for language and publication date. The search was conducted through http://pubmed.com, a wellknown worldwide internet medical address. To the best of our knowledge, we could find only sixteen cases of multiple meningiomas exclusively confined to the spinal canal. Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature. We are presenting a case of multiple spinal canal meningiomas in a young patient of 17 years, who was earlier operated for solitary intradural extra medullary spinal canal meningioma at D4-D6 level, again presented with spastic quadriparesis of two years duration and MRI whole spine demonstrated multiple intradural extra medullary lesions, which were excised completely and the histopathological diagnosis was transitional meningioma. RESULTS Patient recovered from his weakness and sensory symptoms gradually and bladder and bowel symptoms improved gradually over a period of two to three weeks. CONCLUSION Multiple

  11. Multiple primary cancer

    International Nuclear Information System (INIS)

    Jung, Gyu Sik; Lee, Ouk; Kim, So Sun; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duck

    1989-01-01

    It is rare for one human being to be afflicted with more than one cancer. However with further advances in therapeutic regimens, histopathologic observation, diagnostic modalities, and increased curiosity, there are increasing number of case reports of multiple primary cancer. The present study evaluates 25 histologically confirmed cases of multiple primary cancer from 1974 to 1988 at Kosin Medical Center. The most frequent site of the first primary cancer in male was stomach and in female, uterine cervix. The first primary cancer in female occurred in endocrine-related organs (breast, uterus and thyroid) in 63.6 percent. Synchronous cancers are diagnosed simultaneously or within an interval of about six months and synchronous cancers were 16 out of 25 cases. Metachronous cancers are diagnosed at interval of more than six months. There were 9 metachronous cancers and average interval between the first and second primary cancer was 22.8 months. The incidence of multiple primary cancer was 0.11 percent. The average age was 51.9 years at the time of the first primary cancer (53.1 years in male and 50.3 years in female). CT scan was most helpful in early detection of multiple primary cancers facilitating biopsy and surgery. Multiple primary cancers are beyond the medical curiosity. Early diagnosis of the disease and careful follow-up study, based on an awareness of the possibility of second cancers, will substantially increase the survival of these patients

  12. The Future Multiple

    DEFF Research Database (Denmark)

    Spaniol, Matthew Jon; Rowland, Nicholas James

    2015-01-01

    /value – The original contribution is in demonstrating how plural futures and the singular future co-exist in practice. Thus, an eclipse of the future by futures can only ever be partial. For “futures” to be conceptually potent, “the future” must be at least provisionally believable and occasionally useful. Otherwise......, if “the future” were so preposterous an idea, then “futures” would cease to be a critical alternative to it. Futures needs the future; they are relationally bound together in a multiplicity. This paper considers what such a logical reality implies for a field that distances itself from the future and self......). Multiplicity, as a post-ANT sensibility, helps one make sense of the empirical materials. This paper examines the possibility that rather than being alternatives to one another, plural futures and the singular future might co-exist in practice, and, thus, constitute a multiplicity. Design...

  13. Hadron multiplicities at COMPASS

    Energy Technology Data Exchange (ETDEWEB)

    Du Fresne von Hohenesche, Nicolas [Institut fuer Kernphysik, Universitaet Mainz, Johann-Joachim-Becher-Weg 45, 55128 Mainz (Germany); Collaboration: COMPASS Collaboration

    2014-07-01

    Quark fragmentation functions (FF) D{sub q}{sup h}(z,Q{sup 2}) describe final-state hadronization of quarks q into hadrons h. The FFs can be extracted from hadron multiplicities produced in semi-inclusive deep inelastic scattering. The COMPASS collaboration has recently measured charged hadron multiplicities for identified pions and kaons using a 160 GeV/c muon beam impinging on an iso-scalar target. The data cover a large kinematical range and provide an important input for global QCD analyses of world data at NLO, aiming at the determination of FFs in particular in the strange quark sector. The newest results from COMPASS on pion and kaon multiplicities will be presented.

  14. Multiplicities and parton dynamics

    International Nuclear Information System (INIS)

    Knuteson, R.O.

    1987-01-01

    The production of strongly interacting particles from the annihilation of electrons and positrons at high energies is studied, with emphasis on the multiplicity, or number, of particles produced. A probabilistic branching model based on the leading log approximation in QCD is formulated to predict the evolution of particle number with the energy of collision. Direct integration of a master equation for the probabilities allows a comparison to the experimentally observed particle distribution. The production of strongly interacting particles from proton-antiproton collisions is also considered. A model for the production of particles from parton-parton collisions is presented and the growth in multiplicity with energy demonstrated

  15. Sentencing Multiple Crimes

    DEFF Research Database (Denmark)

    Most people assume that criminal offenders have only been convicted of a single crime. However, in reality almost half of offenders stand to be sentenced for more than one crime.The high proportion of multiple crime offenders poses a number of practical and theoretical challenges for the criminal......, and psychology offer their perspectives to the volume. A comprehensive examination of the dynamics involved with sentencing multiple offenders has the potential to be a powerful tool for legal scholars and professionals, particularly given the practical importance of the topic and the relative dearth of research...

  16. High-multiplicity processes

    International Nuclear Information System (INIS)

    Shelkov, G.; Sisakyan, A.; Mandzhavidze, I.

    1999-01-01

    We wish to demonstrate that investigation of asymptotically high multiplicity (AHM) hadron reactions may solve, or at least clear up, a number of problems unsolvable by other ways. We would lean upon the idea: (i) the reactions final state entropy is proportional to multiplicity and, by this reason, just in the AHM domain one may expect the equilibrium final state and (ii) the AHM final state is cold because of the energy-momentum conservation laws. This means that the collective phenomena may become important in the AHM domain. The possibility of hard processes dominance is considered also

  17. [Delivery in multiple pregnancies].

    Science.gov (United States)

    Colla, F; D'Addato, F; Grio, R

    2001-04-01

    A knowledge of clinical physiognomy in pathologies related to multiple births is indispensable for improving maternal and feto-neonatal prognosis. This study is a contribution to the solution of this problem. A meta-analysis of data for multiple births at Department B of the Gynecology and Obstetrics Clinic at the University of Turi during the decade 1989-1998 was carried out, focusing on the arrangement and presentation of fetuses, the various types of birth, the gestational age at which birth occurred, the weight of neonates, neonatal mortality and maternal morbidity. Out of 11,523 births, there were a total of 194 (1.68%) multiple births, including 190 sets of twins and 4 triplets. 154 (79.38%) premature births were reported; 20 occurred 1500 g). The perinatal mortality rate was 3.82%. Maternal complications mainly occurred during the placental state, in the immediate postpartum and in puerperio. The authors feel that a more careful medical and social assistance, preventive hospitalisation, early recognition of the risk, constant monitoring for the optimal timing of birth, and lastly, qualified medical assistance during labour (expert gynecologist, trained obstetric staff) with other medical personnel (anesthetist, neonatal specialist) represent winning strategies to solve the problems arising during multiple pregnancies.

  18. Multiple Primary Tumors

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... breast and ascending colon. KEYWORDS: Carcinoid, colorectal cancer, metachronous, synchronous. Multiple Primary Tumors. MA Adeyanju, AA Ilori. Address for correspondence: Dr. MA Adeyanju,. Department of Surgery, Federal Medical Centre, Ebute Metta,. Lagos, Nigeria. E-mail: mbadeyanju@yahoo.

  19. Back Pain - Multiple Languages

    Science.gov (United States)

    ... List of All Topics All Back Pain - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (العربية) ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated on 31 May 2018

  20. Anemia - Multiple Languages

    Science.gov (United States)

    ... XYZ List of All Topics All Anemia - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (العربية) ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated on 30 April 2018

  1. Allergy - Multiple Languages

    Science.gov (United States)

    ... XYZ List of All Topics All Allergy - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (العربية) ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated on 23 May 2018

  2. Alcohol - Multiple Languages

    Science.gov (United States)

    ... XYZ List of All Topics All Alcohol - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (العربية) ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated on 16 April 2018

  3. Immunomodulation of multiple myeloma.

    Science.gov (United States)

    Tohnya, Tanyifor M; Figg, William D

    2004-11-01

    Multiple myeloma is a multi-process disease, and these different processes are responsible for the reduced sensitivity to chemotherapy and radiotherapy, hence the relapse and refractory nature of multiple myeloma. Emphasis is now placed on the hypothesis that myeloma cell growth, inhibition of apoptosis and drug resistance are dependent on immunomodulatory cytokines such as IL-6 and pro-angiogenic factors such as VEGF. In addition to its anti-angiogenic effects, the immunomodulatory properties of thalidomide make it a possible therapy for patients with advanced multiple myeloma. This has lead to the clinical development of a number of immunomodulatory thalidomide analogues (IMiDs) which are more potent and have less side effects than the parent drug, thalidomide. In the August 15(th) issue of Journal of Clinical Oncology, Schey SA et al. suggested that an IMiD (CC-4047) maybe efficacious due to T-cell co-stimulation, and safe in patients with relapsed or refractory multiple myeloma. This article demonstrates a supporting role for IMiDs as immunomodulatory adjuvant therapy.

  4. Seizures in multiple sclerosis

    NARCIS (Netherlands)

    Koch, Marcus; Uyttenboogaart, Maarten; Polman, Susan; De Keyser, Jacques

    Seizures have long been recognized to be part of the disease spectrum of multiple sclerosis (MS). While they occur in only a minority of patients with MS, epileptic seizures can have serious consequences. The treatment of MS can be epileptogenic, and antiepileptic treatment can conversely worsen the

  5. Multiple Primary Cancer Monograph

    Science.gov (United States)

    To identify groups of cancer survivors that are at increased risk for multiple primary cancers, investigators led an effort to provide the first comprehensive population-based analysis of the risk of subsequent cancer in the U.S., resulting in a monograph.

  6. Reduced multiplication modules

    Indian Academy of Sciences (India)

    if M is a von Neumann regular module (VNM); i.e., every principal submodule of M is a summand submodule. Also if M is an injective R-module, then M is a VNM. Keywords. Multiplication module; reduced module; minimal prime submodule;. Zariski topology; extremally disconnected. 1. Introduction. In this paper all rings are ...

  7. Zinc in multiple sclerosis

    DEFF Research Database (Denmark)

    Bredholt, Mikkel; Fredriksen, Jette Lautrup

    2016-01-01

    In the last 35 years, zinc (Zn) has been examined for its potential role in the disease multiple sclerosis (MS). This review gives an overview of the possible role of Zn in the pathogenesis of MS as well as a meta-analysis of studies having measured Zn in serum or plasma in patients with MS...

  8. Visualizing Matrix Multiplication

    Science.gov (United States)

    Daugulis, Peteris; Sondore, Anita

    2018-01-01

    Efficient visualizations of computational algorithms are important tools for students, educators, and researchers. In this article, we point out an innovative visualization technique for matrix multiplication. This method differs from the standard, formal approach by using block matrices to make computations more visual. We find this method a…

  9. Multiple photon resonances

    International Nuclear Information System (INIS)

    Elliott, C.J.; Feldman, B.J.

    1979-02-01

    A detailed theoretical analysis is presented of the interaction of intense near-resonant monochromatic radiation with an N-level anharmonic oscillator. In particular, the phenomenon of multiple photon resonance, the process by which an N-level system resonantly absorbs two or more photons simultaneously, is investigated. Starting from the Schroedinger equation, diagrammatic techniques are developed that allow the resonant process to be analyzed quantitatively, in analogy with well-known two-level coherent phenomena. In addition, multiple photon Stark shifts of the resonances, shifts absent in two-level theory, are obtained from the diagrams. Insights into the nature of multiple photon resonances are gained by comparing the quantum mechanical system with classical coupled pendulums whose equations of motion possess identical eigenvalues and eigenvectors. In certain limiting cases, including that of the resonantly excited N-level harmonic oscillator and that of the equally spaced N-level system with equal matrix elements, analytic results are derived. The influence of population relaxation and phase-disrupting collisions on the multiple photon process are also analyzed, the latter by extension of the diagrammatic technique to the density matrix equations of motion. 11 figures

  10. Multiple plots in R

    DEFF Research Database (Denmark)

    Edwards, Stefan McKinnon

    2012-01-01

    In this chapter I will investigate how to combine multiple plots into a single. The scenario is a dataset of a series of measurements, on three samples in three situations. There are many ways we can display this, e.g. 3d graphs or faceting. 3d graphs are not good for displaying static data so we...

  11. Vaccines and multiple sclerosis

    DEFF Research Database (Denmark)

    Frederiksen, J. L.; Topsøe Mailand, M.

    2017-01-01

    An association between certain vaccinations and onset or relapse of multiple sclerosis (MS) has been debated. Based on PubMed, we made a thorough literature review and included all relevant studies, 51 on MS and 15 on optic neuritis (ON). Case studies were excluded. With the exception of a live...

  12. Vaccines and multiple sclerosis

    DEFF Research Database (Denmark)

    Mailand, Mia Topsøe; Frederiksen, Jette Lautrup

    2017-01-01

    on the database PubMed. The study found no change in risk of developing multiple sclerosis (MS) after vaccination against hepatitis B virus, human papillomavirus, seasonal influenza, measles–mumps–rubella, variola, tetanus, Bacillus Calmette-Guérin (BCG), polio, or diphtheria. No change in risk of relapse...

  13. Radiation Therapy - Multiple Languages

    Science.gov (United States)

    ... W XYZ List of All Topics All Radiation Therapy - Multiple Languages To use the sharing features on this page, ... Information Translations Vietnamese (Tiếng Việt) Expand Section Radiation Therapy - Tiếng Việt (Vietnamese) ... Health Information Translations Characters not displaying correctly on this page? See language display issues . Return to the MedlinePlus Health Information ...

  14. Mastering the Multiplication Facts

    Science.gov (United States)

    D'Ettorre, Jenna

    2009-01-01

    The purpose of this paper is to share the results of a six-week research project (after baseline data was collected) that focused on three different strategies (flashcards, interactive games, and music) and their effectiveness in helping fifth grade students memorize the basic multiplication facts. Many teachers face a serious problem when their…

  15. The Border Multiple

    DEFF Research Database (Denmark)

    of European borders by looking at border practices in the light of the mobility turn, and thus as dynamic, multiple, diverse and best expressed in everyday experiences of people living at and with borders, rather than focusing on static territorial divisions between states and regions at geopolitical level...

  16. Asthma - Multiple Languages

    Science.gov (United States)

    ... XYZ List of All Topics All Asthma - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (العربية) ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated on 2 May 2018

  17. Multiple preequilibrium decay processes

    International Nuclear Information System (INIS)

    Blann, M.

    1987-11-01

    Several treatments of multiple preequilibrium decay are reviewed with emphasis on the exciton and hybrid models. We show the expected behavior of this decay mode as a function of incident nucleon energy. The algorithms used in the hybrid model treatment are reviewed, and comparisons are made between predictions of the hybrid model and a broad range of experimental results. 24 refs., 20 figs

  18. Multiple Access Communications

    DEFF Research Database (Denmark)

    This book constitutes the proceedings of the 9th International Workshop on Multiple Access Communications, MACOM 2016, held in Aalborg, Denmark, in November 2016. The 10 full papers presented in this volume were carefully reviewed and selected from 12 submissions. They were organized in topical...

  19. Multiple chemical sensitivity

    DEFF Research Database (Denmark)

    Tran, Marie Thi Dao; Arendt-Nielsen, Lars; Kupers, Ron

    2013-01-01

    BACKGROUND: Multiple Chemical Sensitivity (MCS) is a chronic condition characterized by recurrent, non-specific symptoms in response to chemically unrelated exposures in non-toxic concentrations. Although the pathophysiology of MCS remains unknown, central sensitization may be an important factor...

  20. Multiple Chemical Sensitivity

    DEFF Research Database (Denmark)

    Junge, Anne Gram

    Et voksende antal mennesker i Danmark oplever at være overfølsomme over for dufte og kemikalier. Imidlertid er den tilskrevne diagnose Multiple Chemical Sensitivity (MCS) ikke medicinsk anerkendt i Danmark pga. mangel på organiske og patofysiologisk basis for symptomerne. Dette speciale bygger på...

  1. The multiple Dirichlet product and the multiple Dirichlet series

    OpenAIRE

    Onozuka, Tomokazu

    2016-01-01

    First, we define the multiple Dirichlet product and study the properties of it. From those properties, we obtain a zero-free region of a multiple Dirichlet series and a multiple Dirichlet series expression of the reciprocal of a multiple Dirichlet series.

  2. Chronic progressive multiple sclerosis

    International Nuclear Information System (INIS)

    Buffoli, A.; Micheletti, E.; Capra, R.; Mattioli, F.; Marciano', N.

    1991-01-01

    A long-lasting immunological suppression action seems to be produced by total lymphoid irradiation; some authors emphasize the favorable effect of this treatment on chronic progressive multiple sclerosis. In order to evaluate the actual role of TLI, 6 patients affected with chronic progressive multiple sclerosis were submitted to TLI with shaped and personalized fields at the Istituto del Radio, University of Brescia, Italy. The total dose delivered was 19.8 Gy in 4 weeks, 1.8 Gy/day, 5d/w; a week elapsed between the first and the second irradiation course. Disability according to Kurtzke scale was evaluated, together with blood lymphocyte count and irradiation side-effects, over a mean follow-up period of 20.8 months (range: 13-24). Our findings indicate that: a) disease progression was not markedly reduced by TLI; b) steroid hormones responsivity was restored after irradiation, and c) side-effects were mild and tolerable

  3. Curability of Multiple Myeloma

    Directory of Open Access Journals (Sweden)

    Raymond Alexanian

    2012-01-01

    Full Text Available Among 792 patients with multiple myeloma treated from 1987 to 2010 and assessed after 18 months, there were 167 patients with complete remission. For those 60 patients treated between 1987–1998 and with long followup, the latest relapse occurred after 11.8 years, so that 13 patients have remained in sustained complete remission for longer than 12 years (range 12–22 years. These results suggest that 3% of all patients treated during that period may be cured of multiple myeloma. In addition to immunofixation, more sensitive techniques for the detection of residual disease should be applied more consistently in patients with apparent complete remission in order to identify those with potential cure.

  4. Multiple time scale dynamics

    CERN Document Server

    Kuehn, Christian

    2015-01-01

    This book provides an introduction to dynamical systems with multiple time scales. The approach it takes is to provide an overview of key areas, particularly topics that are less available in the introductory form.  The broad range of topics included makes it accessible for students and researchers new to the field to gain a quick and thorough overview. The first of its kind, this book merges a wide variety of different mathematical techniques into a more unified framework. The book is highly illustrated with many examples and exercises and an extensive bibliography. The target audience of this  book are senior undergraduates, graduate students as well as researchers interested in using the multiple time scale dynamics theory in nonlinear science, either from a theoretical or a mathematical modeling perspective. 

  5. Suicide and multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E N; Stenager, Egon; Koch-Henriksen, N

    1992-01-01

    In a nationwide investigation the risk of death by suicide for patients with multiple sclerosis (MS) was assessed using records kept at the Danish Multiple Sclerosis Registry (DMSR) and the Danish National Register of Cause of Death. The investigation covers all MS patients registered with DSMR...... with an onset of the disease within the period 1953-85, or for whom MS was diagnosed in the same period. Fifty three of the 5525 cases in the onset cohort group committed suicide. Using the figures from the population death statistics by adjustment to number of subjects, duration of observation, sex, age......, and calendar year at the start of observation, the expected number of suicides was calculated to be nearly 29. The cumulative lifetime risk of suicide from onset of MS, using an actuarial method of calculation, was 1.95%. The standard mortality ratio (SMR) of suicide in MS was 1.83. It was highest for males...

  6. Multiple splenic abscesses

    Directory of Open Access Journals (Sweden)

    Harish Kumar

    2015-01-01

    Full Text Available Splenic abscess is a rare clinical entity with poor prognosis. But owing to imaging technique, diagnosis and prognosis have improved nowadays. Most patients who are presented with splenic abscess are immunocompromised due to predisposing risk factors like diabetes mellitus, intravenous drug abuse, trauma, bacterial endocarditis, human immunodeficiency virus (HIV, chemotherapy, or steroids. Here, we are presenting a rarer case of multiple splenic abscesses with its complication in an immunocompetent healthy adult male without any risk factor.

  7. Multiple Employer Welfare Arrangements

    Science.gov (United States)

    1992-01-01

    Sponsors in the Private Nonfarm Sector in the United States, 1978-79," Volume IV, Description and Analysis of Plans and Plan Sponsors, NTIS # PB81-180366...Labor finds to be collectively bargained plans, and those organized by rural electrical cooperatives and rural telephone cooperatives. Thus, except for...their existence and generally higher cost than uninsured plans no doubt contributed to the development of other types of multiple employer

  8. Treatment of Multiple Sclerosis

    OpenAIRE

    Bošnjak-Pašić, Marija; Vidrih, Branka; Miškov, Snježana; Demarin, Vida

    2009-01-01

    Multiple sclerosis is an autoimmune inflammatory demyelinating disease of the central nervous system, characterized by multifocal inflammatory destruction of myelin, axonal damage and loss of oligodendrocytes. The disease is carried through two stages: inflammatory and degenerative. The most common form of disease in approximately 85% of the cases is RRMS (relapsing-remitting form). The treatment of MS is divided into: treatment of the acute phase of illness, prevention of new relapses and di...

  9. Multiple trichodiscomas: histogenetical observations.

    Science.gov (United States)

    Requena, L; Schöendorff, C; López, M J; Yus, E S

    1991-02-01

    A 23-year-old man with multiple trichodiscomas on his face is described. Four papules were histologically examinated, and all of them showed similar findings, a dermal fibrovascular proliferation with abundant ground substance between collagen bundles and an absence of elastic fibers. We found no evidence to establish a relationship between trichodiscomas and hair disk, and, in our opinion, these lesions should be included into the spectrum of hyperplasia of the adventicial dermis.

  10. Multiple lymphatic cervical cysts

    International Nuclear Information System (INIS)

    Jordan, J.; Piotrowski, S.; Zalewska-Rzezniczak, I.

    1994-01-01

    Authors described a case of 60 year-old woman with multiple lateral neck cysts. 4 cysts were located in the supraclavicular region of lateral neck triangle. During histopathological studies of postoperative specimens a cystic hygroma diagnosis was established. The fact, that cystic lymphangioma occurred in an adult woman, was interesting. The authors stress the necessity of preoperative evaluation of tumor size in view of the possibility of its penetration into the thorax. The CT examination may be useful in these cases. (author)

  11. Midkine and multiple sclerosis

    OpenAIRE

    Takeuchi, Hideyuki

    2014-01-01

    Multiple sclerosis (MS) is an autoimmune neurological disease characterized by inflammatory demyelination with subsequent neuronal damage in the CNS. MS and its animal model, experimental autoimmune encephalomyelitis (EAE), have been thought as autoreactive Th1 and Th17 cell-mediated diseases. CD4+CD25+FoxP3+ regulatory T-cell (Treg) plays a pivotal role in autoimmune tolerance, and tolerogenic dendritic cells (DCreg) drive the development of inducible Treg cells. Thus, a dysfunction in the d...

  12. Multiple myeloma: 45 cases

    International Nuclear Information System (INIS)

    Yang, Hee Chul; Suh, Jin Suck; Park, Chang Yun

    1990-01-01

    We evaluated 45 cases of multiple myelomas retrospectively confirmed in Severance Hospital from the period of 1983-1989. In order to assess the radiologic features of the multiple myeloma and to assist in possible early diagnosis and treatment. The result were as follows: 1. IgG(41%) was the most common immunoglobulin type secreted followed by light chain(36%). IgA(19%) and IgD(2%). Two percent of the patients had non-secretory type. 89% of patients were in their stage III of the disease. 2. Among the 45 patients, 96% had abnormal plain radiographic findings with average number of 4.5 lesions. Common sites were the spine, rib, skull, pelvis, and humerus in descending orders. The findings were localized or diffuse osteolytic bone destruction(85%). osteoporosis(49%), pathologic fracture and endosteal scalloping(55%). Osteoporosis was more prominent in stage III than stage II. 3. Both plain X-ray and radioisotope study was available for comparison in 28 patients. Concordance between the two studies were 44%, lesions detected only on plain X-ray film were 51%, and lesions detected only on the radioisotope were 5%. The plain radiography was able to detect only 54% of bone lesions confirmed by bone marrow biopsy. With the above results, accurate evaluation of bone lesions in multiple myeloma may be difficult with radiologic studies only. But familiarity with these radiologic findings of the this disease entity is necessary for early suspicion of the disease, thus for early diagnosis and treatment

  13. Falls in multiple sclerosis.

    Science.gov (United States)

    Matsuda, Patricia N; Shumway-Cook, Anne; Bamer, Alyssa M; Johnson, Shana L; Amtmann, Dagmar; Kraft, George H

    2011-07-01

    To examine incidence, associated factors, and health care provider (HCP) response to falls in persons with multiple sclerosis (MS). Cross-sectional retrospective design. Community setting. Four hundred seventy-four persons with MS. Mailed survey questionnaire examined incidence, risk factors, and HCP response to falls in persons with MS who were dwelling in the community. Univariate and multiple ordinal regression analysis identified variables associated with single and multiple falls. Falls, causes and perceived reasons for falls, and HCP response. A total of 265 participants (58.2%) reported one or more falls in the previous 6 months, and 58.5% of falls were medically injurious. Trips/slips while walking accounted for 48% of falls. Factors associated with falls included use of a cane or walker (odds ratio [OR] 2.62; 95% confidence interval [CI] 1.66-4.14), income falls; recommended strategies included safety strategies (53.2%), use of gait assistive devices (42.1%), exercise/balance training (22.2%), and home modifications (16.6%). Factors associated with falls in persons with MS are similar to those in other populations with neurologic diseases. Despite the high incidence of falls, fewer than 50% of people with MS receive information about prevention of falls from an HCP. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  14. Rehabilitation in multiple sclerosis.

    Science.gov (United States)

    Kubsik-Gidlewska, Anna M; Klimkiewicz, Paulina; Klimkiewicz, Robert; Janczewska, Katarzyna; Woldańska-Okońska, Marta

    2017-07-01

    The aim of the study is to present a strategy of rehabilitation in multiple sclerosis on the basis of the latest developments in the field of physiotherapy. The publications on the problem discuss a wide range of methods of physiotherapy that can be used in order to reduce the degree of disability and alleviate the symptoms associated with the disease. The complexity of the disease, the difficulty in determining the appropriate treatment and a wide range of symptoms require a comprehensive approach to the patient, which would include both pharmacology and neurorehabilitation. Rehabilitation, which includes psychotherapy and symptomatic therapy, is regarded nowadays as the best form of treatment for multiple sclerosis. An indepth diagnostic assessment of functional status and prognosis should be carried out before the start of the rehabilitation process. The prognosis should take into account the mental state, the neurological status and the awareness of the patient. The kinesiotherapy program in multiple sclerosis is based on a gradation of physiotherapy which assumes a gradual transition from basic movements to more complex ones till global functions are obtained. The most appropriate form of treatment is functional rehabilitation combined with physical procedures. Recent reports indicate the need for aerobic training to be included in the rehabilitation program. The introduction of physical activities, regardless of the severity of the disease, will reduce the negative effects of akinesia, and thus increase the functional capabilities of all body systems.

  15. Multiples waveform inversion

    KAUST Repository

    Zhang, Dongliang

    2013-01-01

    To increase the illumination of the subsurface and to eliminate the dependency of FWI on the source wavelet, we propose multiples waveform inversion (MWI) that transforms each hydrophone into a virtual point source with a time history equal to that of the recorded data. These virtual sources are used to numerically generate downgoing wavefields that are correlated with the backprojected surface-related multiples to give the migration image. Since the recorded data are treated as the virtual sources, knowledge of the source wavelet is not required, and the subsurface illumination is greatly enhanced because the entire free surface acts as an extended source compared to the radiation pattern of a traditional point source. Numerical tests on the Marmousi2 model show that the convergence rate and the spatial resolution of MWI is, respectively, faster and more accurate then FWI. The potential pitfall with this method is that the multiples undergo more than one roundtrip to the surface, which increases attenuation and reduces spatial resolution. This can lead to less resolved tomograms compared to conventional FWI. The possible solution is to combine both FWI and MWI in inverting for the subsurface velocity distribution.

  16. Patients with multiple contact allergies

    DEFF Research Database (Denmark)

    Carlsen, Berit Christina; Andersen, Klaus Ejner; Menné, Torkil

    2008-01-01

    Patients with multiple contact allergies, also referred to as polysensitized, are more frequent than predicted from prevalence of single sensitivities. The understanding of why some people develop multiple contact allergies, and characterization of patients with multiple contact allergies...... of developing multiple contact allergies. Evidence of allergen clusters among polysensitized individuals is also reviewed. The literature supports the idea that patients with multiple contact allergies constitute a special entity within the field of contact allergy. There is no generally accepted definition...... of patients with multiple contact allergies. We suggest that contact allergy to 3 or more allergens are defined as multiple contact allergies....

  17. Multiple Entity Reconciliation

    OpenAIRE

    Samoila, Lavinia Andreea

    2015-01-01

    Living in the age of "Big Data" is both a blessing and a curse. On he one hand, the raw data can be analysed and then used for weather redictions, user recommendations, targeted advertising and more. On he other hand, when data is aggregated from multiple sources, there is no guarantee that each source has stored the data in a standardized or even compatible format to what is required by the application. So there is a need to parse the available data and convert it to the desired form. Here i...

  18. The Border Multiple

    DEFF Research Database (Denmark)

    Addressing and conceptualizing the changing character of borders in contemporary Europe, this book examines developments occurring in the light of European integration processes and an on-going tightening of Europe's external borders. Moreover, the book suggests new ways of investigating the nature...... of European borders by looking at border practices in the light of the mobility turn, and thus as dynamic, multiple, diverse and best expressed in everyday experiences of people living at and with borders, rather than focusing on static territorial divisions between states and regions at geopolitical level...

  19. Ordering, materiality and multiplicity

    DEFF Research Database (Denmark)

    van der Duim, René; Ren, Carina Bregnholm; Jóhannesson, Gunnar Thór

    2013-01-01

    In this article we discuss how ANT has been translated into tourism research and show how it has impacted the field by presenting three concepts integral to the ANT approach: ordering, materiality and multiplicity. We first introduce ANT and draw attention to current ANT studies in tourism......, followed by a discussion of how newer approaches within post-ANT urge us to face the ontological politics, which we engage in when performing tourism research. In conclusion we argue that ANT enables a radical new way at looking at tourism, tourism destinations and objects and investigations...... into the ontological condition of tourism....

  20. Multiple Chemical Sensitivity

    DEFF Research Database (Denmark)

    Dantoft, Thomas Meinertz

    Multiple chemical sensitivity (MCS) is a chronic disorder characterized by reports of symptoms from various organ systems attributed by the individuals to exposure to common odors and airborne chemicals in doses far below those known to induce toxic effects. There exists a general lack of knowledge......, significantly reduced levels of IL-13 in the MCS group and no group differences in the allergen specific IgE measures. The differences were independent of factors such as sex, age, Body Mass Index, asthma, smoking, depression, anxiety and allergen-specific IgE. In conclusion, the study identified a distinct...

  1. INDIA: Photon multiplicity detector

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    Full text: The team of Indian scientists from Calcutta's Variable Energy Cyclotron Centre, Bhubaneswar Institute of Physics, Panjab (Chandigarh), Rajasthan (Jaipur) and Jammu in collaboration with GSI Darmstadt have contributed a large and highly granular preshower photon multiplicity detector (PMD) for the WA98 experiment at the CERN SPS proton synchrotron. This experiment studies high energy collisions of lead ions and will measure both charged particle and photon multiplicity in a large overlap region. The motivation for measuring photon multiplicity in ultra-relativistic heavy ion collisions stems from theoretical predictions of changes in the relative production of photons and charged particles in the phase transition of hadronic matter to quarkgluon plasma and its subsequent hadronization. The photon multiplicity detector consists of a matrix of scintillator pads placed in light-tight boxes and mounted behind the lead converter plates. The light from the scintillator pads is transported to the readout system using wavelength shifting (WLS) fibres. Developing on the team's earlier experience with a smaller version for the WA93 experiment (September 1991, page 16), several modifications were incorporated to improve light collection and transport. Use of improved WLS fibres, short WLS pieces to minimize self-absorption, and thermal splicing with long clear fibres were some of the important changes incorporated. Tests showed signficantly improved light collection. The scintillator pads were fabricated at all the five collaborating centres in India and the complicated assembly in the detector box modules carried out at the Variable Energy Cyclotron Centre, Calcutta. More than 400 lead converter plates were machined in Calcutta to rigorous tolerances of 0.2 mm. The assembled detector box modules and lead plates were shipped to CERN in spring 1994 for tests and installation. The WA98 PMD consists of over 50,000 scintillator pads of sizes varying from 15 to

  2. INDIA: Photon multiplicity detector

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1995-01-15

    Full text: The team of Indian scientists from Calcutta's Variable Energy Cyclotron Centre, Bhubaneswar Institute of Physics, Panjab (Chandigarh), Rajasthan (Jaipur) and Jammu in collaboration with GSI Darmstadt have contributed a large and highly granular preshower photon multiplicity detector (PMD) for the WA98 experiment at the CERN SPS proton synchrotron. This experiment studies high energy collisions of lead ions and will measure both charged particle and photon multiplicity in a large overlap region. The motivation for measuring photon multiplicity in ultra-relativistic heavy ion collisions stems from theoretical predictions of changes in the relative production of photons and charged particles in the phase transition of hadronic matter to quarkgluon plasma and its subsequent hadronization. The photon multiplicity detector consists of a matrix of scintillator pads placed in light-tight boxes and mounted behind the lead converter plates. The light from the scintillator pads is transported to the readout system using wavelength shifting (WLS) fibres. Developing on the team's earlier experience with a smaller version for the WA93 experiment (September 1991, page 16), several modifications were incorporated to improve light collection and transport. Use of improved WLS fibres, short WLS pieces to minimize self-absorption, and thermal splicing with long clear fibres were some of the important changes incorporated. Tests showed signficantly improved light collection. The scintillator pads were fabricated at all the five collaborating centres in India and the complicated assembly in the detector box modules carried out at the Variable Energy Cyclotron Centre, Calcutta. More than 400 lead converter plates were machined in Calcutta to rigorous tolerances of 0.2 mm. The assembled detector box modules and lead plates were shipped to CERN in spring 1994 for tests and installation. The WA98 PMD consists of over 50,000 scintillator pads of sizes varying from 15 to 25 mm

  3. Networks amid multiple logics

    DEFF Research Database (Denmark)

    Bergenholtz, Carsten; Bjerregaard, Toke

    The present study investigates how a high-tech-small-firm (HTSF) can carry out an inter-organizational search of actors located at universities. Responding to calls to study how firms navigate multiple institutional norms, this research examines the different strategies used by a HTSF to balance...... adopted academic norm-sets, commercial imperatives and formal regulations to support formation of networks and collaborations with universities. The findings show how the significance of weak and strong ties for the formation of collaborations and networks with universities is relative...

  4. Writing on Multiple Journeys

    OpenAIRE

    Robbins, Sarah; Pullen, Ann Ellis

    2012-01-01

    In their beautifully researched study and critical edition, Nellie Arnott’s Writings on Angola, 1905–1913: Missionary Narratives Linking Africa and America (Parlor Press), authors Sarah Robbins and Ann Ellis Pullen examine in fine detail the historical record of the transnational network of literary work produced by Arnott. Tracing her legacy in the study’s third chapter, “Writing on Multiple Journeys,” the authors argue on behalf of Arnott’s capacity to create authority and celebrity as well...

  5. Multiple constant multiplication optimizations for field programmable gate arrays

    CERN Document Server

    Kumm, Martin

    2016-01-01

    This work covers field programmable gate array (FPGA)-specific optimizations of circuits computing the multiplication of a variable by several constants, commonly denoted as multiple constant multiplication (MCM). These optimizations focus on low resource usage but high performance. They comprise the use of fast carry-chains in adder-based constant multiplications including ternary (3-input) adders as well as the integration of look-up table-based constant multipliers and embedded multipliers to get the optimal mapping to modern FPGAs. The proposed methods can be used for the efficient implementation of digital filters, discrete transforms and many other circuits in the domain of digital signal processing, communication and image processing. Contents Heuristic and ILP-Based Optimal Solutions for the Pipelined Multiple Constant Multiplication Problem Methods to Integrate Embedded Multipliers, LUT-Based Constant Multipliers and Ternary (3-Input) Adders An Optimized Multiple Constant Multiplication Architecture ...

  6. Multiple capillary biochemical analyzer

    Science.gov (United States)

    Dovichi, N.J.; Zhang, J.Z.

    1995-08-08

    A multiple capillary analyzer allows detection of light from multiple capillaries with a reduced number of interfaces through which light must pass in detecting light emitted from a sample being analyzed, using a modified sheath flow cuvette. A linear or rectangular array of capillaries is introduced into a rectangular flow chamber. Sheath fluid draws individual sample streams through the cuvette. The capillaries are closely and evenly spaced and held by a transparent retainer in a fixed position in relation to an optical detection system. Collimated sample excitation radiation is applied simultaneously across the ends of the capillaries in the retainer. Light emitted from the excited sample is detected by the optical detection system. The retainer is provided by a transparent chamber having inward slanting end walls. The capillaries are wedged into the chamber. One sideways dimension of the chamber is equal to the diameter of the capillaries and one end to end dimension varies from, at the top of the chamber, slightly greater than the sum of the diameters of the capillaries to, at the bottom of the chamber, slightly smaller than the sum of the diameters of the capillaries. The optical system utilizes optic fibers to deliver light to individual photodetectors, one for each capillary tube. A filter or wavelength division demultiplexer may be used for isolating fluorescence at particular bands. 21 figs.

  7. Multiple symbol differential detection

    Science.gov (United States)

    Divsalar, Dariush (Inventor); Simon, Marvin K. (Inventor)

    1991-01-01

    A differential detection technique for multiple phase shift keying (MPSK) signals is provided which uses a multiple symbol observation interval on the basis of which a joint decision is made regarding the phase of the received symbols. In accordance with the invention, a first difference phase is created between first and second received symbols. Next, the first difference phase is correlated with the possible values thereof to provide a first plurality of intermediate output signals. A second difference phase is next created between second and third received symbols. The second difference phase is correlated with plural possible values thereof to provide a second plurality of intermediate output signals. Next, a third difference phase is created between the first and third symbols. The third difference phase is correlated with plural possible values thereof to provide a third plurality of intermediate output signals. Each of the first plurality of intermediate outputs are combined with each of the second plurality of intermediate outputs and each of the third plurality of intermediate outputs to provide a plurality of possible output values. Finally, a joint decision is made by choosing from the plurality of possible output values the value which represents the best combined correlation of the first, second and third difference values with the possible values thereof.

  8. Albumin and multiple sclerosis.

    Science.gov (United States)

    LeVine, Steven M

    2016-04-12

    Leakage of the blood-brain barrier (BBB) is a common pathological feature in multiple sclerosis (MS). Following a breach of the BBB, albumin, the most abundant protein in plasma, gains access to CNS tissue where it is exposed to an inflammatory milieu and tissue damage, e.g., demyelination. Once in the CNS, albumin can participate in protective mechanisms. For example, due to its high concentration and molecular properties, albumin becomes a target for oxidation and nitration reactions. Furthermore, albumin binds metals and heme thereby limiting their ability to produce reactive oxygen and reactive nitrogen species. Albumin also has the potential to worsen disease. Similar to pathogenic processes that occur during epilepsy, extravasated albumin could induce the expression of proinflammatory cytokines and affect the ability of astrocytes to maintain potassium homeostasis thereby possibly making neurons more vulnerable to glutamate exicitotoxicity, which is thought to be a pathogenic mechanism in MS. The albumin quotient, albumin in cerebrospinal fluid (CSF)/albumin in serum, is used as a measure of blood-CSF barrier dysfunction in MS, but it may be inaccurate since albumin levels in the CSF can be influenced by multiple factors including: 1) albumin becomes proteolytically cleaved during disease, 2) extravasated albumin is taken up by macrophages, microglia, and astrocytes, and 3) the location of BBB damage affects the entry of extravasated albumin into ventricular CSF. A discussion of the roles that albumin performs during MS is put forth.

  9. Rotator Cuff Injuries - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Rotator Cuff Injuries URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Rotator Cuff Injuries - Multiple Languages To use the sharing features ...

  10. Multiple Sclerosis and Vitamin D

    Science.gov (United States)

    ... Editors David C. Spencer, MD Steven Karceski, MD Multiple sclerosis and vitamin D Andrew J. Solomon, MD WHAT ... caused by improper immune responses (autoimmune diseases), including multiple sclerosis (MS). A recent Patient Page in Neurology provided ...

  11. Piercing and Tattoos - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Piercing and Tattoos URL of this page: https://medlineplus. ... V W XYZ List of All Topics All Piercing and Tattoos - Multiple Languages To use the sharing ...

  12. Asian American Health - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Asian American Health URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Asian American Health - Multiple Languages To use the sharing features ...

  13. Multiple Hierarchies and Organizational Control

    Science.gov (United States)

    Evans, Peter B.

    1975-01-01

    Uses a control-loss model to explore the effects of multiple channels in formal organizations, and presents an argument for the superior control properties of dual hierarchies. Two variant forms of multiple hierarchies are considered. (Author)

  14. Multiple Intelligences and quotient spaces

    OpenAIRE

    Malatesta, Mike; Quintana, Yamilet

    2006-01-01

    The Multiple Intelligence Theory (MI) is one of the models that study and describe the cognitive abilities of an individual. In [7] is presented a referential system which allows to identify the Multiple Intelligences of the students of a course and to classify the level of development of such Intelligences. Following this tendency, the purpose of this paper is to describe the model of Multiple Intelligences as a quotient space, and also to study the Multiple Intelligences of an individual in...

  15. MULTIPLE GALAXY COLLISIONS

    Science.gov (United States)

    2002-01-01

    Here is a sampling of 15 ultraluminous infrared galaxies viewed by NASA's Hubble Space Telescope. Hubble's sharp vision reveals more complexity within these galaxies, which astronomers are interpreting as evidence of a multiple-galaxy pileup. These images, taken by the Wide Field and Planetary Camera 2, are part of a three-year study of 123 galaxies within 3 billion light-years of Earth. The study was conducted in 1996, 1997, and 1999. False colors were assigned to these photos to enhance fine details within these coalescing galaxies. Credits: NASA, Kirk Borne (Raytheon and NASA Goddard Space Flight Center, Greenbelt, Md.), Luis Colina (Instituto de Fisica de Cantabria, Spain), and Howard Bushouse and Ray Lucas (Space Telescope Science Institute, Baltimore, Md.)

  16. Multiple passage cells theory

    International Nuclear Information System (INIS)

    Riva, R.

    1983-01-01

    A review of the main concepts envolved in non astigmatic multiple passes cells is presented. It is shown that these concepts can be extended to ring cavities in which the analysis of the ray propagation (in the paraxial approaching) in two separated plans is accomplished. The concepts developed are applyed to a simple ring cavity (one curve mirror and two plane ones) showing that the acquired pattern of the rays on the mirrors is the one of a Lissajours figure which allows a better use of the mirror's area and consequently a larger number of passes. The cavity has applications in optical delay lines, measurements of mirrors reflectivities and possibly in passive optical gyroscopes. (Author) [pt

  17. Multiple stage railgun

    International Nuclear Information System (INIS)

    Aaland, K.; Hawke, R.S.; Scudder, J.K.

    1982-01-01

    A multiple stage magnetic railgun accelerator for accelerating a projectile by movement of a plasma arc along the rails. The railgun is divided into a plurality of successive rail stages which are sequentially energized by separate energy sources as the projectile moves through the bore of the railgun. Propagation of energy from an energized rail stage back towards the breech end of the railgun can be prevented by connection of the energy sources to the rails through isolation diodes. Propagation of energy from an energized rail stage back towards the breech end of the railgun can also be prevented by dividing the rails into electrically isolated rail sections. In such case means are used to extinguish the arc at the end of each energized stage and a fuse or laser device is used to initiate a new plasma arc in the next energized rail stage

  18. Strategizing in multiple ways

    DEFF Research Database (Denmark)

    Larsen, Mette Vinther; Madsen, Charlotte Øland; Rasmussen, Jørgen Gulddahl

    2013-01-01

    Strategy processes are kinds of wayfaring where different actors interpret a formally defined strat-egy differently. In the everyday practice of organizations strategizing takes place in multiple ways through narratives and sensible actions. This forms a meshwork of polyphonic ways to enact one...... and the same strategy. The paper focusses on such processes as they develop in a Danish service company. It is done on the basis of an empirical and longitudinal study of a strategy process in the Service Company where the strategic purpose was to implement value-based management. The theme to be developed...... based on this development paper is whether one can understand these diver-gent strategic wayfaring processes as constructive for organizations....

  19. Multiple gas reduction strategy

    Energy Technology Data Exchange (ETDEWEB)

    A. Kurosawa [Institute of Applied Energy, Tokyo (Japan)

    2003-07-01

    Future global warming has a close relationship with the abatement potential of six greenhouse gases (GHGs), including carbon dioxide (CO{sub 2}), methane (CH{sub 4}), nitrous oxide (N{sub 2}O), hydrofluorocarbons (HFCs), perfluorocarbons (PFCs), and sulfur hexafluoride (SF6). Therefore, multiple gas reduction flexibility should be assessed. The emission of each non-CO{sub 2} GHG is calculated endogenously by the sum of the product of the emission factor and the endogenous activity index using an integrated assessment model, GRAPE (Global Relationship Assessment to Protect the Environment). The model consists of five modules dealing with issues on energy, climate, land use, macroeconomics and environmental impacts. The uncertainty in the non-CO{sub 2} GHG emission inventory and emission factors is discussed. 5 refs., 3 figs., 1 tab.

  20. Automated multiple failure FMEA

    International Nuclear Information System (INIS)

    Price, C.J.; Taylor, N.S.

    2002-01-01

    Failure mode and effects analysis (FMEA) is typically performed by a team of engineers working together. In general, they will only consider single point failures in a system. Consideration of all possible combinations of failures is impractical for all but the simplest example systems. Even if the task of producing the FMEA report for the full multiple failure scenario were automated, it would still be impractical for the engineers to read, understand and act on all of the results. This paper shows how approximate failure rates for components can be used to select the most likely combinations of failures for automated investigation using simulation. The important information can be automatically identified from the resulting report, making it practical for engineers to study and act on the results. The strategy described in the paper has been applied to a range of electrical subsystems, and the results have confirmed that the strategy described here works well for realistically complex systems

  1. Quantum Optical Multiple Scattering

    DEFF Research Database (Denmark)

    Ott, Johan Raunkjær

    . In the first part we use a scattering-matrix formalism combined with results from random-matrix theory to investigate the interference of quantum optical states on a multiple scattering medium. We investigate a single realization of a scattering medium thereby showing that it is possible to create entangled...... states by interference of squeezed beams. Mixing photon states on the single realization also shows that quantum interference naturally arises by interfering quantum states. We further investigate the ensemble averaged transmission properties of the quantized light and see that the induced quantum...... interference survives even after disorder averaging. The quantum interference manifests itself through increased photon correlations. Furthermore, the theoretical description of a measurement procedure is presented. In this work we relate the noise power spectrum of the total transmitted or reflected light...

  2. Anthropology and Multiple Modernities

    DEFF Research Database (Denmark)

    Thomassen, Bjørn

    “modernities” over the last 10 years, this paper wishes to address the analytical usefulness of this conceptual development. What is it about these concepts that make them useful as we try to capture the World today? Rather than providing any substantial definitions as to what those modernities are about (or...... what they are not about), anthropologists have used ethnographies to demonstrate how modernities are lived and constructed differently in different cultural contexts. To a very large extent, anthropologists intend these multiple modernities to refer to the interplay between local and global...... configurations. However, if the current pluralizing of modernity ultimately serves to describe the variety of cultural forms that co-exist in the World today, the analytical value of the concept risks being watered down, and little is gained in perspective. Arguably, other concepts would have served the purpose...

  3. Vaccines in Multiple Sclerosis.

    Science.gov (United States)

    Williamson, Eric M L; Chahin, Salim; Berger, Joseph R

    2016-04-01

    Vaccinations help prevent communicable disease. To be valuable, a vaccine's ability to prevent disease must exceed the risk of adverse effects from administration. Many vaccines present no risk of infection as they are comprised of killed or non-infectious components while other vaccines consist of live attenuated microorganisms which carry a potential risk of infection-particularly, in patients with compromised immunity. There are several unique considerations with respect to vaccination in the multiple sclerosis (MS) population. First, there has been concern that vaccination may trigger or aggravate the disease. Second, disease-modifying therapies (DMTs) employed in the treatment of MS may increase the risk of infectious complications from vaccines or alter their efficacy. Lastly, in some cases, vaccination strategies may be part of the treatment paradigm in attempts to avoid complications of therapy.

  4. Multiple sclerosis and suicide.

    Science.gov (United States)

    Feinstein, Anthony; Pavisian, Bennis

    2017-06-01

    Mortality rates are elevated in people with multiple sclerosis (MS) relative to the general population. There is, however, some uncertainty whether suicide contributes to this. Epidemiological data suggest that the standardized mortality ratio (SMR) for suicide in MS is approximately twice that of the general population with younger males in the first few years following diagnosis most at risk. Rates of suicidal intent, a potential harbinger of more self-destructive behavior, are also elevated, but the frequency with which intent is followed by suicide is not known. Depression, severity of depression, social isolation, and alcohol abuse are associated with thoughts of suicide. The variables linked with suicide and suicidal intent are therefore well defined and should be readily available from routine clinical inquiry. While vigilance on the part of clinicians is required, particularly in the context of high-risk patients, it is also recognized that prevention is dependent on full disclosure of intent.

  5. On Multiple Appearances

    DEFF Research Database (Denmark)

    Bork Petersen, Franziska

    2012-01-01

    reduction and epoché to focus on how dancing bodies appear in a stage context. To test these tools’ ability to explore dancing bodies from a third-person perspective, I analyse the Danish choreographer Kitt Johnson’s solo performance Drift (2011) - focussing on her shifting physical appearance. While...... phenomenology helps me to describe the multiple and radically different guises that Johnson assumes in her piece, my analysis, ultimately, does not aim to distil a truer, more real being from her appearances as is often the case in phenomenological philosophy. I complement my analytical approach...... with the Deleuzian notion of becoming animal and suggest that Johnson stages what could, in Judith Butler’s terms, be called a critical contingency of bodily appearance....

  6. Media and Multiplicity

    DEFF Research Database (Denmark)

    Blaagaard, Bolette

    2010-01-01

    In the past few years continental Europe has experienced a resurgence of right-wing party politics, nationalism and xenophobia. In this nationalist revival the media and advanced communications technologies have played a significant role, as evidenced by the debates following cases...... such as the Danish cartoon controversy, and Dutch politician Geert Wilders’s film, Fitna. Simultaneously, however, the media is more diverse and rhizomatic than ever and offers potential for cosmopolitanism, transnational ethical relations as well as radical anti-racist and anti-fascist interventions. This article...... explores the tensions within the relation between journalistic practice and the construction of the idea of the nation and the multiplicity of media and cultures which inhabit the spheres of journalism and nation....

  7. Multiple-port valve

    International Nuclear Information System (INIS)

    Doody, T.J.

    1978-01-01

    A multiple-port valve assembly is designed to direct flow from a primary conduit into any one of a plurality of secondary conduits as well as to direct a reverse flow. The valve includes two mating hemispherical sockets that rotatably receive a spherical valve plug. The valve plug is attached to the primary conduit and includes diverging passageways from that conduit to a plurality of ports. Each of the ports is alignable with one or more of a plurality of secondary conduits fitting into one of the hemispherical sockets. The other hemispherical socket includes a slot for the primary conduit such that the conduit's motion along that slot with rotation of the spherical plug about various axes will position the valve-plug ports in respect to the secondary conduits

  8. Multiple cerebral hydatid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Banzo, J.; Pina, J.I.; Abos, M.D.; Rios, G.; Garcia, D.; Marin, F.; Diaz, F.J.

    1984-12-01

    A 39-year-old woman was admitted to hospital with headaches, vomiting, psychic impairment and diplopia. Three hydatid cysts of the lung had been previously removed. An avascular mass in the left hemisphere with left-to-right displacement of the anterior cerebral arteries was noted during a brain angioscintigraphy. A cerebralthrombosis (CT) brain scan showed two cystic lesions situated in the left-frontal and occipital regions. A CT abdominal scan showed multiple cysts in the liver, spleen and both kidneys. At operation, two brain cysts were totally extirpated without rupture. The definite pathological diagnosis was secondry hydatid cysts. The headaches, vomiting and diplopia were persistent in the post-operative period. Seven days after the operation, a CT brain scan showed an infratenrorial cyst. The patient rejected any surgical intervention.

  9. Multiple Temporalities, Layered Histories

    Directory of Open Access Journals (Sweden)

    Steven Pearson

    2017-11-01

    Full Text Available In Quotational Practices: Repeating the Future in Contemporary Art, Patrick Greaney asserts, “the past matters not only because of what actually happened but also because of the possibilities that were not realized and that still could be. Quotation evokes those possibilities. By repeating the past, artists and writers may be attempting to repeat that past’s unrealized futures.”[1]  In the information age, the Internet, for instance, provides us an expanded collection of visual information—quite literally available at our fingertips—summoning together aspects of the past and possibilities of the future into a boundless present. Sketchbook Revisions (2014–2015, a series of mixed-media paintings, represents my attempt to communicate the ways in which I experience my contemporary moment constructed from multiple temporalities excavated from my past. This body of work combines fragments of representational paintings created between 1995 and 2003 and nonrepresentational renderings produced between 2003 and 2014. Using traditional tracing paper and graphic color, I randomly select moments of my previous work to transfer and layer over selected areas of already-filled pages of a sketchbook I used from 2003 to 2004. These sketches depict objects I encountered in studio art classrooms and iconic architecture on the campus of McDaniel College, and often incorporate teaching notes. The final renditions of fragmented and layered histories enact the ways that we collectively experience multiple temporalities in the present. Quoting my various bodies of work, Sketchbook Revisions challenges both material and conceptual boundaries that determine fixed notions of artistic identity.

  10. Neutron-multiplication measurement instrument

    Energy Technology Data Exchange (ETDEWEB)

    Nixon, K.V.; Dowdy, E.J.; France, S.W.; Millegan, D.R.; Robba, A.A.

    1982-01-01

    The Advanced Nuclear Technology Group of the Los Alamos National Laboratory is now using intelligent data-acquisition and analysis instrumentation for determining the multiplication of nuclear material. Earlier instrumentation, such as the large NIM-crate systems, depended on house power and required additional computation to determine multiplication or to estimate error. The portable, battery-powered multiplication measurement unit, with advanced computational power, acquires data, calculates multiplication, and completes error analysis automatically. Thus, the multiplication is determined easily and an available error estimate enables the user to judge the significance of results.

  11. Neutron-multiplication measurement instrument

    International Nuclear Information System (INIS)

    Nixon, K.V.; Dowdy, E.J.; France, S.W.; Millegan, D.R.; Robba, A.A.

    1982-01-01

    The Advanced Nuclear Technology Group of the Los Alamos National Laboratory is now using intelligent data-acquisition and analysis instrumentation for determining the multiplication of nuclear material. Earlier instrumentation, such as the large NIM-crate systems, depended on house power and required additional computation to determine multiplication or to estimate error. The portable, battery-powered multiplication measurement unit, with advanced computational power, acquires data, calculates multiplication, and completes error analysis automatically. Thus, the multiplication is determined easily and an available error estimate enables the user to judge the significance of results

  12. Multiple Levels of Suffering

    Science.gov (United States)

    Kiley, Kasey B.; Haywood, Carlton; Bediako, Shawn M.; Lanzkron, Sophie; Carroll, C. Patrick; Buenaver, Luis F.; Pejsa, Megan; Edwards, Robert R.; Haythornthwaite, Jennifer A.; Campbell, Claudia M.

    2016-01-01

    Objective: People living with sickle cell disease (SCD) experience severe episodic and chronic pain and frequently report poor interpersonal treatment within health-care settings. In this particularly relevant context, we examined the relationship between perceived discrimination and both clinical and laboratory pain. Methods: Seventy-one individuals with SCD provided self-reports of experiences with discrimination in health-care settings and clinical pain severity, and completed a psychophysical pain testing battery in the laboratory. Results: Discrimination in health-care settings was correlated with greater clinical pain severity and enhanced sensitivity to multiple laboratory-induced pain measures, as well as stress, depression, and sleep. After controlling for relevant covariates, discrimination remained a significant predictor of mechanical temporal summation (a marker of central pain facilitation), but not clinical pain severity or suprathreshold heat pain response. Furthermore, a significant interaction between experience with discrimination and clinical pain severity was associated with mechanical temporal summation; increased experience with discrimination was associated with an increased correlation between clinical pain severity and temporal summation of pain. Discussion: Perceived discrimination within health-care settings was associated with pain facilitation. These findings suggest that discrimination may be related to increased central sensitization among SCD patients, and more broadly that health-care social environments may interact with pain pathophysiology. PMID:26889615

  13. Viruses and Multiple Sclerosis

    Science.gov (United States)

    Virtanen, Jussi Oskari; Jacobson, Steve

    2016-01-01

    Multiple sclerosis (MS) is a heterogeneous disease that develops as an interplay between the immune system and environmental stimuli in genetically susceptible individuals. There is increasing evidence that viruses may play a role in MS pathogenesis acting as these environmental triggers. However, it is not known if any single virus is causal, or rather several viruses can act as triggers in disease development. Here, we review the association of different viruses to MS with an emphasis on two herpesviruses, Epstein-Barr virus (EBV) and human herpesvirus 6 (HHV-6). These two agents have generated the most impact during recent years as possible co-factors in MS disease development. The strongest argument for association of EBV with MS comes from the link between symptomatic infectious mononucleosis and MS and from seroepidemiological studies. In contrast to EBV, HHV-6 has been found significantly more often in MS plaques than in MS normal appearing white matter or non-MS brains and HHV-6 re-activation has been reported during MS clinical relapses. In this review we also suggest new strategies, including the development of new infectious animal models of MS and antiviral MS clinical trials, to elucidate roles of different viruses in the pathogenesis of this disease. Furthermore, we introduce the idea of using unbiased sequence-independent pathogen discovery methodologies, such as next generation sequencing, to study MS brain tissue or body fluids for detection of known viral sequences or potential novel viral agents. PMID:22583435

  14. Diverticulosis of the colon: A report of two cases | Olokoba | Nigerian ...

    African Journals Online (AJOL)

    There was associated history of chronic constipation dating back to over 15 years relieved with use of laxatives. There was no diarrhoea, vomiting or haematochezia. He had no history of previous surgeries. Physical examination showed mild tenderness at the left iliac fossa. Digital rectal examination was normal.

  15. Intestinal spirochetosis and colon diverticulosis Espiroquetose intestinal e diverticulose do cólon

    Directory of Open Access Journals (Sweden)

    Marcus Aurelho de Lima

    2005-02-01

    Full Text Available A case of intestinal spirochetosis in a 62-year-old white male is reported. The condition was characterized by chronic flatulence and episodes of intestinal hemorrhage, in addition to the evidence of hypotonic diverticular disease, with a large number of slender organisms in the colon epithelium and cryptae. Spirochetes were demonstrated by Whartin-Starry stain. The serologic tests for syphilis and HIV were positive. Spirochetosis was treated with penicillin G, and the patient remains free of intestinal complaints 20 months later.Um caso de espiroquetose intestinal é relatado em um homem branco de 62 anos. A condição foi caracterizada por flatulência crônica e episódios de hemorragia intestinal, além da evidência de doença diverticular hipotônica dos cólons, com numerosos organismos filamentosos no epitélio e nas criptas do cólon. Os espiroquetas foram demonstrados pela coloração de Whartin-Starry. Os testes sorológicos para sífilis e HIV foram positivos. A espiroquetose foi tratada com penicilina G e o paciente permanece sem queixas intestinais após 20 meses.

  16. Multiple exostotic hypochondroplasia: Syndrome of combined hypochondroplasia and multiple exostoses

    International Nuclear Information System (INIS)

    Dominguez, R.; Young, L.W.; Girdany, B.R.; Steele, M.W.

    1984-01-01

    This is a report of a family with major focus on the daughter who had short stature. The mother had hypochondroplasia and the father had multiple exostoses. The daughter's skeletal roentgenograms show features of both hypochondroplasia and multiple exostoses. The roentgenographic, clinical and genetic aspects of these skeletal dysplasias are reviewed and hypochrondroplasia is contrasted with achondroplasia. The genetic and counseling implications of the association of hypochondroplasia and multiple exostoses are discussed. (orig.)

  17. Multiple exostotic hypochondroplasia: Syndrome of combined hypochondroplasia and multiple exostoses

    Energy Technology Data Exchange (ETDEWEB)

    Dominguez, R.; Young, L.W.; Girdany, B.R.; Steele, M.W.

    1984-07-01

    This is a report of a family with major focus on the daughter who had short stature. The mother had hypochondroplasia and the father had multiple exostoses. The daughter's skeletal roentgenograms show features of both hypochondroplasia and multiple exostoses. The roentgenographic, clinical and genetic aspects of these skeletal dysplasias are reviewed and hypochrondroplasia is contrasted with achondroplasia. The genetic and counseling implications of the association of hypochondroplasia and multiple exostoses are discussed.

  18. Introduction: multiple myeloma.

    Science.gov (United States)

    Cook, Richard

    2008-09-01

    Multiple myeloma (MM) is the most common type of primary bone tumor, affecting approximately 50,000 patients in the United States. Although it is currently not curable, recent advancements in treatment are bringing myeloma closer to becoming a chronic disease instead of a terminal illness. To better understand the prevalence of MM as well as provide an overview of the costs associated with treatment. The goals of treatment in MM include eradicating all evidence of disease, controlling disease to prevent damage to target organs, preserving normal function and quality of life, relieving pain, and managing myeloma that is in remission. To achieve these goals, treatment must be individually tailored for each patient based on the patient's age, overall health status, symptoms, and laboratory test results. Advancements in the understanding of the pathogenesis of myeloma and the role of genetic mutations are leading to a new standard of treatment. Advancements in diagnostic technology, such as cytogenetic testing, are also being used to tailor treatment for each individual to work toward achieving better response rates, longer periods of remission, and improved quality of life. Increased costs associated with the improved therapies being used to treat MM, and the comorbid conditions associated with the disease, present a challenge to managed care. Health plans and formulary decision makers need to better understand the complexity of therapy to best use resources. The economic burden to the patient must also be considered when developing treatment strategies. Better understanding of the pathophysiology of MM, including the role of cytogenetics, is leading to the development and use of novel agents and treatment options. Head-to-head studies comparing treatments must be performed to best balance the costs associated with treatment and the benefits of improved survival rates and maintaining quality of life.

  19. Multiple intelligences in school

    Directory of Open Access Journals (Sweden)

    Alejandro Castro Solano

    2016-02-01

    Full Text Available During many years has prevailed the idea of intelligence as a single problem solving ability (factor g considered the best predictor of student’s academic achievement. Recently, researches have begun to take an alternative view of the problem, understanding it is a multidimensional construct. Multiple intelligences (MI theory proposed by Gardner (1983 takes into account seven talents or skills individuals appear to have in certain amount. These latent bio-psychological potentials are stable and they are mantained through life. Theory of MI proposes that every person learns in relation to them. MI theory has many educational applications, however, very few efforts have been made to verify such statements. The main goal of this study is to analyze the IM differential individual profile of high school and university students studying the relation between IM, academic achievement and self efficacy competence on course performance. Two studies were carried out , the first was done with high school students (N=500 and the second with military students (N=362. Based on Armstrong’s proposals to assess IM, an inventory was designed. Main results point out that there is a correspondence between academic attainment, self interest and self perception of competence in different courses students take. MI are good predictors of academic achievement considering specific areas but they don’t provide a better estimation compared to traditional assessment instruments. Students who have failed in school were those with more spatial and corporal abilities, usually relegated by traditional instruction. High achievers were those with more logical and intrapersonal skills. Different relations were found for military students. For these latter students IM theory was not a valuable predictor of successful academic attainment. 

  20. Midkine and multiple sclerosis.

    Science.gov (United States)

    Takeuchi, Hideyuki

    2014-02-01

    Multiple sclerosis (MS) is an autoimmune neurological disease characterized by inflammatory demyelination with subsequent neuronal damage in the CNS. MS and its animal model, experimental autoimmune encephalomyelitis (EAE), have been thought as autoreactive Th1 and Th17 cell-mediated diseases. CD4(+) CD25(+) FoxP3(+) regulatory T-cell (Treg) plays a pivotal role in autoimmune tolerance, and tolerogenic dendritic cells (DCreg) drive the development of inducible Treg cells. Thus, a dysfunction in the development of Treg and DCreg leads to the development of autoimmune diseases. However, the factors that regulate Treg and DCreg are largely unknown. We recently showed that removal of midkine (MK) suppressed EAE due to an expansion of the Treg cell population as well as a decrease in the numbers of autoreactive Th1 and Th17 cells. MK decreased the Treg cell population by suppressing the phosphorylation of STAT5, which is essential for the expression of Foxp3, the master transcriptional factor of Treg cell differentiation. Furthermore, MK reduces the DCreg cell population by inhibiting the phosphorylation of STAT3, which is critical for DCreg development. Blockade of MK signalling by a specific RNA aptamer significantly elevated the population of DCreg and Treg cells and ameliorated EAE without detectable adverse effects. Therefore, the inhibition of MK may provide an effective therapeutic strategy against autoimmune diseases including MS. This article is part of a themed section on Midkine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-4. © 2013 The British Pharmacological Society.

  1. Interferon Treatment of Multiple Sclerosis

    OpenAIRE

    Alajbegovic, Azra; Deljo, Dervis; Alajbegovic, Salem; Djelilovic-Vranic, Jasminka; Todorovic, Ljubica; Tiric-Campara, Merita

    2012-01-01

    Introduction: In the treatment of Multiple Sclerosis (MS) differ: treatment of relapse, treatment slow the progression of the disease (immunomodulators and immunosuppression), and symptomatic treatment. The aim: The aim of this study is to analyze the application of interferon therapy in the treatment of MS-E: Process the disease, patients with multiple sclerosis who have passed the commission for multiple sclerosis at the Neurology Clinic of Clinical Center of Sarajevo University as a refere...

  2. Superresolution Imaging Using Resonant Multiples

    KAUST Repository

    Guo, Bowen

    2017-12-22

    A resonant multiple is defined as a multiple reflection that revisits the same subsurface location along coincident reflection raypaths. We show that resonant first-order multiples can be migrated with either Kirchhoff or wave-equation migration methods to give images with approximately twice the spatial resolution compared to post-stack primary-reflection images. A moveout-correction stacking method is proposed to enhance the signal-to-noise ratios (SNRs) of the resonant multiples before superresolution migration. The effectiveness of this procedure is validated by synthetic and field data tests.

  3. Vascular comorbidities in multiple sclerosis

    DEFF Research Database (Denmark)

    Thormann, Anja; Magyari, Melinda; Koch-Henriksen, Nils

    2016-01-01

    To investigate the occurrence of vascular comorbidities before and after the clinical onset of multiple sclerosis. In this combined case-control and cohort study, all Danish born citizens with onset of multiple sclerosis 1980-2005 were identified from the Danish Multiple Sclerosis Registry...... and randomly matched with controls regarding year of birth, gender, and municipality on January 1st in the year of multiple sclerosis (MS) onset (index date). Individual-level information on comorbidities was obtained from several independent nationwide registries and linked to the study population by unique...

  4. Superresolution Imaging Using Resonant Multiples

    KAUST Repository

    Guo, Bowen; Schuster, Gerard T.

    2017-01-01

    A resonant multiple is defined as a multiple reflection that revisits the same subsurface location along coincident reflection raypaths. We show that resonant first-order multiples can be migrated with either Kirchhoff or wave-equation migration methods to give images with approximately twice the spatial resolution compared to post-stack primary-reflection images. A moveout-correction stacking method is proposed to enhance the signal-to-noise ratios (SNRs) of the resonant multiples before superresolution migration. The effectiveness of this procedure is validated by synthetic and field data tests.

  5. Multiple purpose electrical profit; Emprendimiento electrico de prestacion multiple

    Energy Technology Data Exchange (ETDEWEB)

    Assennato, H. [Electrica de Azul Ltda., Buenos Aires (Argentina)

    1986-12-31

    This paper shows the multiple purpose aspects of electrification projects in rural and isolated areas. The multiple aspects involved in the electrification process may include, over electric power supply: improvement of life quality, irrigation and rural mechanization. 4 figs., 6 tabs., 4 refs.

  6. Universal features of multiplicity distributions

    International Nuclear Information System (INIS)

    Balantekin, A.B.; Washington Univ., Seattle, WA

    1994-01-01

    Universal features of multiplicity distributions are studied and combinants, certain linear combinations of ratios of probabilities, are introduced. It is argued that they can be a useful tool in analyzing multiplicity distributions of hadrons emitted in high energy collisions and large scale structure of galaxy distributions

  7. Multiple solid-phase microextraction

    NARCIS (Netherlands)

    Koster, EHM; de Jong, GJ

    2000-01-01

    Theoretical aspects of multiple solid-phase microextraction are described and the principle is illustrated with the extraction of lidocaine from aqueous solutions. With multiple extraction under non-equilibrium conditions considerably less time is required in order to obtain an extraction yield that

  8. The ALICE forward multiplicity detector

    DEFF Research Database (Denmark)

    Holm Christensen, Christian; Gulbrandsen, Kristjan; Sogaard, Carsten

    2007-01-01

    The ALICE Forward Multiplicity Detector (FMD) is a silicon strip detector with 51,200 strips arranged in 5 rings, covering the range $-3.4......The ALICE Forward Multiplicity Detector (FMD) is a silicon strip detector with 51,200 strips arranged in 5 rings, covering the range $-3.4...

  9. More Popsicle-Stick Multiplication.

    Science.gov (United States)

    Dunkels, Andrejs

    1982-01-01

    A way to use tongue depressors in a model of multiplication is presented. The original intent was to use the sticks to teach about fractions, but "mistakes" in student responses led to new ideas. It is felt that teachers should use the model in teaching multiplication. (MP)

  10. Multiplicative properties of quantum channels

    Science.gov (United States)

    Rahaman, Mizanur

    2017-08-01

    In this paper, we study the multiplicative behaviour of quantum channels, mathematically described by trace preserving, completely positive maps on matrix algebras. It turns out that the multiplicative domain of a unital quantum channel has a close connection to its spectral properties. A structure theorem (theorem 2.5), which reveals the automorphic property of an arbitrary unital quantum channel on a subalgebra, is presented. Various classes of quantum channels (irreducible, primitive, etc) are then analysed in terms of this stabilising subalgebra. The notion of the multiplicative index of a unital quantum channel is introduced, which measures the number of times a unital channel needs to be composed with itself for the multiplicative algebra to stabilise. We show that the maps that have trivial multiplicative domains are dense in completely bounded norm topology in the set of all unital completely positive maps. Some applications in quantum information theory are discussed.

  11. Salmonella serovar-specific interaction with jejunal epithelial cells.

    Science.gov (United States)

    Razzuoli, Elisabetta; Amadori, Massimo; Lazzara, Fabrizio; Bilato, Dania; Ferraris, Monica; Vito, Guendalina; Ferrari, Angelo

    2017-08-01

    Gut is often a receptacle for many different pathogens in feed and/or the environment, such as Salmonella spp. The current knowledge about pathogenicity of Salmonella is restricted to few serotypes, whereas other important ones like S. Coeln, S. Thompson, S. Veneziana, have not been investigated yet in human and animal models. Therefore, the aim of our work was to verify the ability of widespread environmental Salmonella strains to penetrate and modulate innate immunity in pig intestinal IPEC-J2 cells. Our results outline the different ability of Salmonella strains to modulate innate immunity; the expression of the IFN-β gene was increased by S. Typhimurium, S. Ablogame and S. Diarizonae 2, that also caused an inflammatory response in terms of Interleukin (IL)-1β and/or IL-8 gene espression. In particular, IL-8 gene expression and protein release were significantly modulated by 5 Salmonella strains out of 7. Interestingly, S. Typhimurium, S. Coeln and S. Thompson strains, characterized by a peculiar ability to penetrate into IPEC-J2 cells, up-regulated both IL-8 and TNF-α gene expression. Accordingly, blocking IL-8 was shown to decrease the penetration of S. Typhimurium. On the contrary, S. Diarizonae strain 1, showing lesser invasion of IPEC-J2 cells, down-regulated the p38-MAPK pathway, and it did not induce an inflammatory response. Our results confirm that IPEC-J2 cells are a useful model to evaluate host-gut pathogen interaction and indicate IL-8 and TNF-α as possible predictive markers of invasiveness of Salmonella strains in enterocytes. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. [Surgical therapy of segmental jejunal, primary intestinal lymphangiectasia].

    Science.gov (United States)

    Kneist, W; Drescher, D G; Hansen, T; Kreitner, K F; Lang, H

    2013-06-01

    Primary intestinal lymphangiectasia (PIL) is a protein-losing, exsudative gastroenteropathy causing lymphatic obstruction. Diagnosis depends on clinical examination and histological findings. Conservative treatment modalities include a low-fat diet and enteral nutritional therapy in order to reduce enteric protein loss and to improve fat metabolism. Other treatment options consist of administration of antiplasmin or octreotide to lower lymph flow and secretion. We report on a 58-year-old patient who underwent exploratory laparotomy due to a worsening physical status, recurrent chylaskos and leg oedema under conservative dietary therapy. Intraoperative findings showed a typical PIL of the jejunum about 20 cm distal to the Treitz's ligament. Histological examinations confirmed this diagnosis. One year after segmental small bowel resection (105 cm) with end-to-end anastomosis the patient is healthy, free of symptoms, has gained weight and his serum protein level has increased. Intraabdominal ascites and leg oedema have not reoccurred since.

  13. Jejuno-jejunal intussusception secondary to smallbowel lipomatosis ...

    African Journals Online (AJOL)

    Intussusception is usually a disease of children aged between 6 months and 4 years, in which a part of a bowel telescopes into another part of the bowel. We report a case in a 60-year-old man who required resection and anastomosis. Although intussception is unusual in adults, awareness of the differences in symptoms ...

  14. Small intestinal biopsies in celiac disease: duodenal or jejunal?

    NARCIS (Netherlands)

    Meijer, JW; Wahab, PJ; Mulder, C.J.J.

    2003-01-01

    BACKGROUND: For diagnosis and follow-up of celiac disease, pediatric societies advise that intestinal mucosal specimens should be obtained using suction capsule from the jejunum. This procedure is strenuous for patients, time-consuming, expensive and requires radiographic guidance. Mucosal biopsies

  15. Duodenal versus jejunal biopsies in suspected celiac disease

    NARCIS (Netherlands)

    Thijs, WJ; van Baarlen, J; Kleibeuker, JH; Kolkman, JJ

    2004-01-01

    Background and Study Aims: In the past, small-bowel biopsies for diagnosis of celiac disease were taken from the jejunum with a suction capsule, but nowadays most physicians take endoscopic biopsies from the distal duodenum. To validate that practice we compared the diagnostic yield of endoscopic

  16. Trichobezoar obstruction after stapled jejunal anastomosis in a dog.

    Science.gov (United States)

    Carobbi, Barbara; Foale, Robert D; White, Richard A S

    2009-04-01

    To describe an unusual long-term complication of circular end-to-end anastomosis (CEEA) stapling in a dog. Clinical case report. An 11-year-old, female neutered, Labrador Retriever. The dog was referred for clinical signs of bowel obstruction. An enterectomy was performed 2 years before presentation using a CEEA stapling device. Palpation, plain radiographs, and ultrasound of the abdomen confirmed the presence of a mass in the bowel, causing obstruction, and requiring surgical approach. An exploratory celiotomy revealed a 5 cm mass in the jejunum, involving the site of the previous surgery. The mass was removed by enterectomy. Dissection of the mass revealed the presence of many staples at the previous enterectomy site, and a trichobezoar entangled in the exposed parts of the staples. An enterectomy was required to treat an intestinal obstruction caused by a trichobezoar entangled in a CEEA-stapled anastomosis. Development of trichobezoar and subsequent bowel obstruction should be considered an unusual but potential long-term complication of CEEA-stapled anastomosis.

  17. Beyond KNO multiplicative cascades and novel multiplicity scaling laws

    CERN Document Server

    Hegyi, S

    1999-01-01

    The collapse of multiplicity distributions P/sub n/ onto a universal scaling curve arises when P/sub n/ is expressed as a function of the standardized multiplicity (n-c)/ lambda with c and lambda being location and scale parameters governed by leading particle effects and the growth of average multiplicity. It is demonstrated that self- similar multiplicative cascade processes such as QCD parton branching naturally lead to a novel type of scaling behavior of P/sub n/ which manifests itself in Mellin space through a location change controlled by the degree of multifractality and a scale change governed by the depth of the cascade. Applying the new scaling rule it is shown how to restore data collapsing behavior of P/sub n/ measured in hh collisions at ISR and SPS energies. (21 refs).

  18. Multiple Improvements of Multiple Imputation Likelihood Ratio Tests

    OpenAIRE

    Chan, Kin Wai; Meng, Xiao-Li

    2017-01-01

    Multiple imputation (MI) inference handles missing data by first properly imputing the missing values $m$ times, and then combining the $m$ analysis results from applying a complete-data procedure to each of the completed datasets. However, the existing method for combining likelihood ratio tests has multiple defects: (i) the combined test statistic can be negative in practice when the reference null distribution is a standard $F$ distribution; (ii) it is not invariant to re-parametrization; ...

  19. [Future challenges in multiple sclerosis].

    Science.gov (United States)

    Fernández, Óscar

    2014-12-01

    Multiple sclerosis occurs in genetically susceptible individuals, in whom an unknown environmental factor triggers an immune response, giving rise to a chronic and disabling autoimmune disease. Currently, significant progress is being made in our knowledge of the frequency and distribution of multiple sclerosis and its risk factors, genetics, pathology, pathogenesis, diagnostic and prognostic markers, and treatment. This has radically changed patients' and clinicians' expectations of multiple sclerosis and has raised hope that there will soon be a way to control the disease. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  20. A newborn with multiple fractures

    International Nuclear Information System (INIS)

    Kantorova, E.; Kratky, L.; Nevsimal, I.; Marik, K.; Kozlowski, K.

    2008-01-01

    Sometimes newborns with multiple fractures are diagnosed as osteogenesis imperfecta in spite of absence of radiographic findings supporting this diagnosis. A newborn with multiple fractures was diagnosed as osteogenesis imperfecta. Analysis of the structure of the long bones, pattern of fractures and poorly developed muscles suggested the diagnosis of fetal akinesia deformation syndrome. This was confirmed by pregnancy history and clinical findings. Multiple fractures in a newborn may present with diagnostic radiographic features as in osteogenesis imperfecta, or as in lethal gracile bone dysplasias or achondrogenesis type IA. If those features are absent, other diseases should be considered. Radiographs should be compared with pregnancy history and clinical findings in the newborn. (authors)

  1. Sequential and simultaneous multiple explanation

    Directory of Open Access Journals (Sweden)

    Robert Litchfield

    2007-02-01

    Full Text Available This paper reports two experiments comparing variants of multiple explanation applied in the early stages of a judgment task (a case involving employee theft where participants are not given a menu of response options. Because prior research has focused on situations where response options are provided to judges, we identify relevant dependent variables that an intervention might affect when such options are not given. We use these variables to build a causal model of intervention that illustrates both the intended effects of multiple explanation and some potentially competing processes that it may trigger. Although multiple explanation clearly conveys some benefits (e.g., willingness to delay action to engage in information search, increased detail, quality and confidence in alternative explanations in the present experiments, we also found evidence that it may initiate or enhance processes that attenuate its advantages (e.g., feelings that one does not need more data if one has multiple good explanations.

  2. Cerebral metastases from multiple myeloma

    International Nuclear Information System (INIS)

    Norum, J.; Wist, E.; Dahl, I.M.; University Hospital, Tromsoe

    1991-01-01

    The authors report a patient with multiple intracerebral lesions from myeloma. The case also demonstrates that myeloma is a radiosensitive tumour and that radiotherapy is important to keep in mind when intracranial lesions are revealed. (orig.)

  3. Current concepts in multiple sclerosis

    International Nuclear Information System (INIS)

    Wiethoelter, Horst; Dichgans, Johannes

    1991-01-01

    This volume contains 9 articles dealing with the use of nuclear magnetic resonance imaging and positron emitted tomography in the diagnosis and staging of multiple sclerosis. (H.W.). refs.; figs.; tabs

  4. Multiple sclerosis and organic solvents

    DEFF Research Database (Denmark)

    Mortensen, J T; Brønnum-Hansen, Henrik; Rasmussen, K

    1998-01-01

    We investigated a possible causal relation between exposure to organic solvents in Danish workers (housepainters, typographers/printers, carpenters/cabinetmakers) and onset of multiple sclerosis. Data on men included in the Danish Multiple Sclerosis Register (3,241 men) were linked with data from......, and butchers. Over a follow-up period of 20 years, we observed no increase in the incidence of multiple sclerosis among men presumed to be exposed to organic solvents. It was not possible to obtain data on potential confounders, and the study design has some potential for selection bias. Nevertheless......, the study does not support existing hypotheses regarding an association between occupational exposure to organic solvents and multiple sclerosis....

  5. Multiple Sclerosis After Infectious Mononucleosis

    DEFF Research Database (Denmark)

    Nielsen, Trine Rasmussen; Rostgaard, Klaus; Nielsen, Nete Munk

    2007-01-01

    BACKGROUND: Infectious mononucleosis caused by the Epstein-Barr virus has been associated with increased risk of multiple sclerosis. However, little is known about the characteristics of this association. OBJECTIVE: To assess the significance of sex, age at and time since infectious mononucleosis......, and attained age to the risk of developing multiple sclerosis after infectious mononucleosis. DESIGN: Cohort study using persons tested serologically for infectious mononucleosis at Statens Serum Institut, the Danish Civil Registration System, the Danish National Hospital Discharge Register, and the Danish...... Multiple Sclerosis Registry. SETTING: Statens Serum Institut. PATIENTS: A cohort of 25 234 Danish patients with mononucleosis was followed up for the occurrence of multiple sclerosis beginning on April 1, 1968, or January 1 of the year after the diagnosis of mononucleosis or after a negative Paul...

  6. Defining active progressive multiple sclerosis

    DEFF Research Database (Denmark)

    Sellebjerg, Finn; Börnsen, Lars; Ammitzbøll, Cecilie

    2017-01-01

    BACKGROUND: It is unknown whether disease activity according to consensus criteria (magnetic resonance imaging activity or clinical relapses) associate with cerebrospinal fluid (CSF) changes in progressive multiple sclerosis (MS). OBJECTIVE: To compare CSF biomarkers in active and inactive...

  7. Geometrical model of multiple production

    International Nuclear Information System (INIS)

    Chikovani, Z.E.; Jenkovszky, L.L.; Kvaratshelia, T.M.; Struminskij, B.V.

    1988-01-01

    The relation between geometrical and KNO-scaling and their violation is studied in a geometrical model of multiple production of hadrons. Predictions concerning the behaviour of correlation coefficients at future accelerators are given

  8. Determination of multiple scattering effects

    International Nuclear Information System (INIS)

    Langevin, M.

    1981-01-01

    The integration of Sigmund and Winterbon numerical values is extended to the reduced thickness tau=2000. The diagram obtained allows a simple determination of the multiple scattering effect for different targets and projectiles [fr

  9. Rough multiple objective decision making

    CERN Document Server

    Xu, Jiuping

    2011-01-01

    Rough Set TheoryBasic concepts and properties of rough sets Rough Membership Rough Intervals Rough FunctionApplications of Rough SetsMultiple Objective Rough Decision Making Reverse Logistics Problem with Rough Interval Parameters MODM based Rough Approximation for Feasible RegionEVRMCCRMDCRM Reverse Logistics Network Design Problem of Suji Renewable Resource MarketBilevel Multiple Objective Rough Decision Making Hierarchical Supply Chain Planning Problem with Rough Interval Parameters Bilevel Decision Making ModelBL-EVRM BL-CCRMBL-DCRMApplication to Supply Chain Planning of Mianyang Co., LtdStochastic Multiple Objective Rough Decision Multi-Objective Resource-Constrained Project Scheduling UnderRough Random EnvironmentRandom Variable Stochastic EVRM Stochastic CCRM Stochastic DCRM Multi-Objective rc-PSP/mM/Ro-Ra for Longtan Hydropower StationFuzzy Multiple Objective Rough Decision Making Allocation Problem under Fuzzy Environment Fuzzy Variable Fu-EVRM Fu-CCRM Fu-DCRM Earth-Rock Work Allocation Problem.

  10. Humanizing Outgroups Through Multiple Categorization

    Science.gov (United States)

    Prati, Francesca; Crisp, Richard J.; Meleady, Rose; Rubini, Monica

    2016-01-01

    In three studies, we examined the impact of multiple categorization on intergroup dehumanization. Study 1 showed that perceiving members of a rival university along multiple versus simple categorical dimensions enhanced the tendency to attribute human traits to this group. Study 2 showed that multiple versus simple categorization of immigrants increased the attribution of uniquely human emotions to them. This effect was explained by the sequential mediation of increased individuation of the outgroup and reduced outgroup threat. Study 3 replicated this sequential mediation model and introduced a novel way of measuring humanization in which participants generated attributes corresponding to the outgroup in a free response format. Participants generated more uniquely human traits in the multiple versus simple categorization conditions. We discuss the theoretical implications of these findings and consider their role in informing and improving efforts to ameliorate contemporary forms of intergroup discrimination. PMID:26984016

  11. MULTIPLE SCALES FOR SUSTAINABLE RESULTS

    Science.gov (United States)

    This session will highlight recent research that incorporates the use of multiple scales and innovative environmental accounting to better inform decisions that affect sustainability, resilience, and vulnerability at all scales. Effective decision-making involves assessment at mu...

  12. Multiple Thymoma with Myasthenia Gravis

    Directory of Open Access Journals (Sweden)

    Dong Hyun Seo

    2017-02-01

    Full Text Available The actual incidence of multiple thymoma is unknown and rarely reported because it remains controversial whether the cases represent a disease of multicentric origin or a disease resulting from intrathymic metastasis. In this case, a patient underwent total thymectomy for multiple thymoma with myasthenia gravis via bilateral video-assisted thoracic surgery. A well-encapsulated multinodular cystic mass, measuring 57 mm×50 mm×22 mm in the right lobe of the thymus, and a well-encapsulated mass, measuring 32 mm×15 mm×14 mm in the left lobe, were found. Both tumors were type B2 thymoma. Few cases of multiple thymoma with myasthenia gravis have ever been reported in the literature. We report a case of synchronous multiple thymoma associated with myasthenia gravis.

  13. Occupational therapy for multiple sclerosis.

    NARCIS (Netherlands)

    Steultjens, E.M.J.; Dekker, J.; Bouter, L.M.; Cardol, M.; Nes, J.C.M. van de; Ende, C.H.M. van den

    2003-01-01

    Background: Multiple sclerosis (MS) patients are referred to occupational therapy with complaints about fatigue, limb weakness, alteration of upper extremity fine motor coordination, loss of sensation and spasticity that causes limitations in performance of activities of daily living and social

  14. The INEL beryllium multiplication experiment

    International Nuclear Information System (INIS)

    Smith, J.R.; King, J.J.

    1991-03-01

    The experiment to measure the multiplication of 14-MeV neutrons in bulk beryllium has been completed. The experiment consists of determining the ratio of 56 Mn activities induced in a large manganese bath by a central 14-MeV neutron source, with and without a beryllium sample surrounding the source. In the manganese bath method a neutron source is placed at the center of a totally-absorbing aqueous solution of MnSo 4 . The capture of neutrons by Mn produces a 56 Mn activity proportional to the emission rate of the source. As applied to the measurement of the multiplication of 14- MeV neutrons in bulk beryllium, the neutron source is a tritium target placed at the end of the drift tube of a small deuteron accelerator. Surrounding the source is a sample chamber. When the sample chamber is empty, the neutrons go directly to the surrounding MnSO 4 solution, and produce a 56 Mn activity proportional to the neutron emission rate. When the chamber contains a beryllium sample, the neutrons first enter the beryllium and multiply through the (n,2n) process. Neutrons escaping from the beryllium enter the bath and produce a 56 Mn activity proportional to the neutron emission rate multiplied by the effective value of the multiplication in bulk beryllium. The ratio of the activities with and without the sample present is proportional to the multiplication value. Detailed calculations of the multiplication and all the systematic effects were made with the Monte Carlo program MCNP, utilizing both the Young and Stewart and the ENDF/B-VI evaluations for beryllium. Both data sets produce multiplication values that are in excellent agreement with the measurements for both raw and corrected values of the multiplication. We conclude that there is not real discrepancy between experimental and calculated values for the multiplication of neutrons in bulk beryllium. 12 figs., 11 tabs., 18 refs

  15. Case report 383: Multiple myeloma

    International Nuclear Information System (INIS)

    Kouwenberg, J.J.; Simons, A.J.

    1986-01-01

    A unique and obviously extremely rare example of multiple myeloma has been presented, affecting the peripheral appendicular skeleton and not the hematopoietic system of the axial skeleton, radiologically and probably pathologically. Only one other similar case has been described. The radiological features were confirmed by the pathological studies: a biopsy specimen obtained from a large osteolytic lesion in a patella showed the typical stigma of multiple myeloma; a biopsy from the iliac creast showed no abnormality. (orig./SHA)

  16. [Current therapy of multiple sclerosis].

    Science.gov (United States)

    Antonio García Merino, J

    2014-12-01

    Since the introduction of interferon beta 1 b for the treatment of multiple sclerosis, there has been a progressive increase in the number of drugs available for this disease. Currently, 11 drugs have been approved in Spain, and their indications depend on specific clinical characteristics. The present article reviews these indications and also discusses other medications without official approval that have also been used in multiple sclerosis. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  17. Mediation Analysis with Multiple Mediators

    OpenAIRE

    VanderWeele, T.J.; Vansteelandt, S.

    2014-01-01

    Recent advances in the causal inference literature on mediation have extended traditional approaches to direct and indirect effects to settings that allow for interactions and non-linearities. In this paper, these approaches from causal inference are further extended to settings in which multiple mediators may be of interest. Two analytic approaches, one based on regression and one based on weighting are proposed to estimate the effect mediated through multiple mediators and the effects throu...

  18. Multiplicities and Correlations at LEP

    International Nuclear Information System (INIS)

    Sarkisyan, E.K.G.

    2002-01-01

    A brief review on recent charge multiplicity and correlation measurements at LEP is given. The measurements of un biased gluon jet multiplicity are discussed. Recent results on charged particle Bose-Einstein and Fermi-Dirac correlations at LEP1 are reported. New results on two-particle correlations of neutral pions are given. Correlations of more than two particles (high-order correlations) obtained using different methods are performed. Recent Bose-Einstein correlation measurements at LEP2 are discussed. (author)

  19. Multiplicities and correlations at LEP

    CERN Document Server

    Sarkisyan-Grinbaum, E

    2002-01-01

    A brief review on recent charge multiplicity and correlation measurements at LEP is given. The measurements of unbiased gluon jet multiplicity are discussed. Recent results on charged particle Bose- Einstein and Fermi-Dirac correlations at LEP1. are reported. New results on two-particle correlations of neutral pions are given. Correlations of more than two particles (high-order correlations) obtained using different methods are performed. Recent Bose-Einstein correlation measurements at LEP2 are discussed. (13 refs).

  20. Multiple oncocytomas and renal carcinoma

    International Nuclear Information System (INIS)

    Velasquez, G.; Glass, T.A.; D'Souza, V.J.; Formanek, A.G.

    1984-01-01

    Renal oncocytoma, although rare, is being diagnosed more frequently, and criteria to differentiate it from other tumors have been described. Multiple oncocytomas have been reported, but an association between multiple oncocytomas and renal carcinoma in the same kidney has not been described. The authors report a case with two oncocytomas and a renal carcinoma in the right kidney as well as a right adrenal adenoma

  1. Mechanisms of multiple production processes

    International Nuclear Information System (INIS)

    Dremin, I.M.

    1977-01-01

    Theoretical approaches to multiple production processes are discussed. A large number of models proceeds from the notion about common excited system produced by colliding hadrons. This class of models includes the hydrodynamical, statistical, thermodynamical and statistical bootstrap models. Sometimes the production process is due to excitation and decay of two colliding particles. The fragmentation bremsstrahlung and inelastic diffraction models belong to this group. The largest group of models describes the multiple production process as a result of formation of many excited centers. The typical example is the multiperipheral model. An interesting direction is given by the attempts to interrelate the mechanism of multiple production with internal structure of particles that is with their constituents (C-group)'-quarks, gluons, etc. Besides the models there are phenomenological (p group) attempts to connect different features of multiple production. Experimental data indicate the existence of leading and pionization particles thus giving an evidence for applications of different models. The data about increase of total and inclusive cross sections, the behaviour of the mean multiplicity and correlations at high energies provide a clue for further development of multiple production theory

  2. Multiplicity in Early Stellar Evolution

    Science.gov (United States)

    Reipurth, B.; Clarke, C. J.; Boss, A. P.; Goodwin, S. P.; Rodríguez, L. F.; Stassun, K. G.; Tokovinin, A.; Zinnecker, H.

    Observations from optical to centimeter wavelengths have demonstrated that multiple systems of two or more bodies is the norm at all stellar evolutionary stages. Multiple systems are widely agreed to result from the collapse and fragmentation of cloud cores, despite the inhibiting influence of magnetic fields. Surveys of class 0 protostars with millimeter interferometers have revealed a very high multiplicity frequency of about 2/3, even though there are observational difficulties in resolving close protobinaries, thus supporting the possibility that all stars could be born in multiple systems. Near-infrared adaptive optics observations of class I protostars show a lower binary frequency relative to the class 0 phase, a declining trend that continues through the class II/III stages to the field population. This loss of companions is a natural consequence of dynamical interplay in small multiple systems, leading to ejection of members. We discuss observational consequences of this dynamical evolution, and its influence on circumstellar disks, and we review the evolution of circumbinary disks and their role in defining binary mass ratios. Special attention is paid to eclipsing PMS binaries, which allow for observational tests of evolutionary models of early stellar evolution. Many stars are born in clusters and small groups, and we discuss how interactions in dense stellar environments can significantly alter the distribution of binary separations through dissolution of wider binaries. The binaries and multiples we find in the field are the survivors of these internal and external destructive processes, and we provide a detailed overview of the multiplicity statistics of the field, which form a boundary condition for all models of binary evolution. Finally, we discuss various formation mechanisms for massive binaries, and the properties of massive trapezia.

  3. Multiple-Input Multiple-Output OFDM with Index Modulation

    OpenAIRE

    Basar, Ertugrul

    2015-01-01

    Orthogonal frequency division multiplexing with index modulation (OFDM-IM) is a novel multicarrier transmission technique which has been proposed as an alternative to classical OFDM. The main idea of OFDM-IM is the use of the indices of the active subcarriers in an OFDM system as an additional source of information. In this work, we propose multiple-input multiple-output OFDM-IM (MIMO-OFDM-IM) scheme by combining OFDM-IM and MIMO transmission techniques. The low complexity transceiver structu...

  4. Additive versus multiplicative muon conservation

    International Nuclear Information System (INIS)

    Nemethy, P.

    1981-01-01

    Experimental elucidation of the question of muon conservation is reviewed. It is shown that neutral-current experiments have not yet yielded information about muonium-antimuonium conversion at the weak-interaction level and that all the charged-current experiments agree that there is no evidence for a multiplicative law. The best limits, from the muon-decay neutrino experiment at LAMPF and from the inverse muon-decay experiment in the CERN neutrino beam, definitely exclude multiplicative law schemes with a branching ratio R approximately 1/2. It is concluded that unless the dynamics conspire to make a multiplicative law with very small R it would appear that muon conservation obeys conserved additive lepton flavor law. (U.K.)

  5. Multiplicities in high energy interactions

    International Nuclear Information System (INIS)

    Derrick, M.

    1984-01-01

    Charged particle multiplicities in hadronic collision have been measured for all energies up to √s = 540 GeV in the center of mass. Similar measurements in e + e - annihilation cover the much smaller range - up to √s = 40 GeV. Data are also available from deep inelastic neutrino scattering up to √s approx. 10 GeV. The experiments measure the mean charged multiplicity , the rapidity density at y = O, and the distributions in prong number. The mean number of photons associated with the events can be used to measure the π 0 and eta 0 multiplicities. Some information is also available on the charged pion, kaon, and nucleon fractions as well as the K 0 and Λ 0 rates and for the higher energy data, the identically equal fraction. We review this data and consider the implications of extrapolations to SSC energies. 13 references

  6. Palliative radiotherapy for multiple myeloma

    International Nuclear Information System (INIS)

    Furusawa, Mitsuhiro; Baba, Yuji; Murakami, Ryuji; Yokoyama, Toshimi; Nishimura, Ryuichi; Uozumi, Hideaki; Takada, Chitose; Takahashi, Mutsumasa

    1995-01-01

    This study reviews the experience of palliative radiotherapy to patients with multiple myeloma to define the optimal dose for pain relief. The records of 31 patients (66 sites) with multiple myeloma irradiated for palliation at Kumamoto University hospital between 1985 and 1994 were reviewed. Total dose ranged from 8 to 50 Gy, with a mean of 32.2 Gy. Symptoms included pain (78.1%), neurological abnormalities (28.1%), and palpable masses (34.3%). Symptomatic remission was obtained in 45 of 46 evaluable sites (97.8%). Complete remission of symptoms were obtained in 28.3%, and partial remission in 69.6%. According to fraction size, there was no significant difference between 3-5 Gy and 1.8-2 Gy. The incidence of complete remission increased when a total dose of more than 20 Gy was given. When the quality of life is considered, hypofractionation was recommended for the palliative radiation therapy of multiple myeloma. (author)

  7. Multiple representations in physics education

    CERN Document Server

    Duit, Reinders; Fischer, Hans E

    2017-01-01

    This volume is important because despite various external representations, such as analogies, metaphors, and visualizations being commonly used by physics teachers, educators and researchers, the notion of using the pedagogical functions of multiple representations to support teaching and learning is still a gap in physics education. The research presented in the three sections of the book is introduced by descriptions of various psychological theories that are applied in different ways for designing physics teaching and learning in classroom settings. The following chapters of the book illustrate teaching and learning with respect to applying specific physics multiple representations in different levels of the education system and in different physics topics using analogies and models, different modes, and in reasoning and representational competence. When multiple representations are used in physics for teaching, the expectation is that they should be successful. To ensure this is the case, the implementati...

  8. The problem of multiple carcinomas

    International Nuclear Information System (INIS)

    Kegel, W.; Schmieder, A.

    1982-01-01

    This retrospective study reports on the occurrence of multiple carcinomas among the patients of our Department of Radiotherapy. Examination of 1290 patients during 1978 to 1980 showed in 76 cases (5.8%) simultaneously or successively secondary or tertiary tumours. These multiple tumours were most frequent in the mammary gland, in the female genital organs and in the respiratory system. Women had an incidence which was double of that displayed by men. Diagnosis and therapy of malignant tumours must always consider the possibility of multiplicity of carcinomas, either simultaneously or succesively, appearing spontaneously or as a result of iatrogenic influences. This applies in particular to the multicentric and bilateral occurrence of the early types of cancer of the female breast. (orig.) [de

  9. Multiple sclerosis and herpesvirus interaction

    Directory of Open Access Journals (Sweden)

    Guilherme Sciascia do Olival

    2013-09-01

    Full Text Available Multiple sclerosis is the most common autoimmune inflammatory demyelinating disease of the central nervous system, and its etiology is believed to have both genetic and environmental components. Several viruses have already been implicated as triggers and there are several studies that implicate members of the Herpesviridae family in the pathogenesis of MS. The most important characteristic of these viruses is that they have periods of latency and exacerbations within their biological sanctuary, the central nervous system. The Epstein-Barr, cytomegalovirus, human herpesvirus 6 and human herpesvirus 7 viruses are the members that are most studied as being possible triggers of multiple sclerosis. According to evidence in the literature, the herpesvirus family is strongly involved in the pathogenesis of this disease, but it is unlikely that they are the only component responsible for its development. There are probably multiple triggers and more studies are necessary to investigate and define these interactions.

  10. Hemichorea after multiple bee stings.

    Science.gov (United States)

    An, Jin Young; Kim, Ji Seon; Min, Jin Hong; Han, Kyu Hong; Kang, Jun Ho; Lee, Suk Woo; Kim, Hoon; Park, Jung Soo

    2014-02-01

    Bee sting is one of the most commonly encountered insect bites in the world. Despite the common occurrence of local and systemic allergic reactions, there are few reports of ischemic stroke after bee stings. To the best our knowledge, there have been no reports on involuntary hyperkinetic movement disorders after multiple bee stings. We report the case of a 50-year-old man who developed involuntary movements of the left leg 24 hours after multiple bee stings, and the cause was confirmed to be a right temporal infarction on a diffusion magnetic resonance imaging scan. Thus, we concluded that the involuntary movement disorder was caused by right temporal infarction that occurred after multiple bee stings.

  11. Multiple-Symbol Detection Of Multiple-Trellis-Coded MDPSK

    Science.gov (United States)

    Divsalar, Dariush; Simon, Marvin K.; Shahshahani, Mehrdad M.

    1991-01-01

    In proposed scheme for detection and decoding of multiple-trellis-coded multilevel differential-phase-shift-keyed (MDPSK) radio signals, observation time for differential detection extended from conventional 2 to larger number of symbol periods. Decreases rate of error in differential detection of uncoded MDPSK by increasing number of symbol periods.

  12. Multiple myeloma: diagnosis and treatment.

    Science.gov (United States)

    Nau, Konrad C; Lewis, William D

    2008-10-01

    Multiple myeloma, the most common bone malignancy, is occurring with increasing frequency in older persons. Typical symptoms are bone pain, malaise, anemia, renal insufficiency, and hypercalcemia. Incidental discovery on comprehensive laboratory panels is common. The disease is diagnosed with serum or urine protein electrophoresis or immunofixation and bone marrow aspirate analysis. Skeletal radiographs are important in staging multiple myeloma and revealing lytic lesions, vertebral compression fractures, and osteoporosis. Magnetic resonance imaging and positron emission tomography or computed tomography are emerging as useful tools in the evaluation of patients with myeloma; magnetic resonance imaging is preferred for evaluating acute spinal compression. Nuclear bone scans and dual energy x-ray absorptiometry have no role in the diagnosis and staging of myeloma. The differential diagnosis of monoclonal gammopathies includes monoclonal gammopathy of uncertain significance, smoldering (asymptomatic) and symptomatic multiple myeloma, amyloidosis, B-cell non-Hodgkin lymphoma, Waldenström macroglobulinemia, and rare plasma cell leukemia and heavy chain diseases. Patients with monoclonal gammopathy of uncertain significance or smoldering multiple myeloma should be followed closely, but not treated. Symptomatic multiple myeloma is treated with chemotherapy followed by autologous stem cell transplantation, if possible. Melphalan, prednisolone, dexamethasone, vincristine, doxorubicin, bortezomib, and thalidomide and its analogue lenalidomide have been used successfully. It is important that family physicians recognize and appropriately treat multiple myeloma complications. Bone pain is treated with opiates, bisphosphonates, radiotherapy, vertebroplasty, or kyphoplasty; nephrotoxic nonsteroidal anti-inflammatory drugs should be avoided. Hypercalcemia is treated with isotonic saline infusions, steroids, furosemide, or bisphosphonates. Because of susceptibility to infections

  13. Goiter and Multiple Food Allergies

    Directory of Open Access Journals (Sweden)

    Stefanie Leniszewski

    2009-01-01

    Full Text Available Severe iodine deficiency results in impaired thyroid hormone synthesis and thyroid enlargement. In the United States, adequate iodine intake is a concern for women of childbearing age and pregnant women. Beyond this high risk group iodine deficiency is not considered to be a significant problem. This case report describes a 12-year-old male with severe iodine deficiency disorder (IDD resulting from restricted dietary intake due to multiple food allergies. We describe iodine replacement for this patient and continued monitoring for iodine sufficiency. Children with multiple food allergies, in particular those with restrictions to iodized salt and seafood, should be considered high risk for severe iodine deficiency.

  14. Multiple Parton Interactions in ALICE

    CERN Multimedia

    CERN. Geneva

    2013-01-01

    We will present in detail the measurement of the charged particle multiplicity dependence of per-trigger pair yields in azimuthal direction induced by low-energetic di-jets produced in proton-proton collisions. Using two-particle angular correlations with low transverse momentum thresholds, jet properties are measured on a statistical basis down to the lowest possible jet energies. The analysis can give information about the contribution from multiple parton interactions to particle production. Moreover, the results allow to optimize the parametrization of the jet fragmentation in phenomenological mode...

  15. MULTIPLE PERSONALITY: CASE REPORT STUDY

    Directory of Open Access Journals (Sweden)

    Miloš Židanik

    2004-07-01

    Full Text Available Background. Multiple personality disorder is characterised by splited individual ego-states and splited professional community arguing whether this disorder actually exists or not.Methods. In this case report study a supportive psychodynamic psychotherapy of a patient with multiple personality disorder is presented, that lasted for 4.5 years and resulted in ego-reintegration.Conclusions. The spliting between different ego-states is powered by unneutralised aggression with the possibility of hetero- and autoaggressive behaviour. Therefore the patient in the analytically oriented psychotherapeutic process is at high risk and a safe therapeutic (e. g. in-patient setting has to be provided.

  16. Mean associative multiplicities in deep inelastic processes

    International Nuclear Information System (INIS)

    Dzhaparidze, G.Sh.; Kiselev, A.V.; Petrov, V.A.

    1981-01-01

    The associative hadron multiplicities in deep inelastic and Drell--Yan processes are studied. In particular the mean multiplicities in different hard processes in QCD are found to be determined by the mean multiplicity in parton jet [ru

  17. Multiple endocrine neoplasia type I

    International Nuclear Information System (INIS)

    Fischer, H.J.; Lois, J.F.; Gomes, A.S.

    1985-01-01

    A case of multiple endocrine neoplasia (Men) consisting of an unusual combination of an insulin-producing islet cell tumour and an adrenal adenoma is reported. CT clearly demonstrated the adrenal mass whereas the pancreatic lesion remained questionable. Conversely angiography located the pancreatic tumour but the adrenal findings were subtle. (orig.)

  18. An Application of Matrix Multiplication

    Indian Academy of Sciences (India)

    IAS Admin

    intelligence, image processing, mathematical modeling, optimization techniques, environmental science, mathematical linguistics, graph theory applications to biological networks, social networks, electrical engineering. .... diagonal of A are 0; and if G has no multiple edges, then all the entries of A are either 1 or 0.

  19. Drugs Approved for Multiple Myeloma

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for multiple myeloma and other plasma cell neoplasms. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  20. Multiple Realizability and Biological Laws

    NARCIS (Netherlands)

    Raerinne, Jani P.; Eronen, Markus I.

    2012-01-01

    We critically analyze Alexander Rosenberg's argument based on the multiple realizability of biological properties that there are no biological laws. The argument is intuitive and suggestive. Nevertheless, a closer analysis reveals that the argument rests on dubious assumptions about the nature of

  1. Multiple Segmentation of Image Stacks

    DEFF Research Database (Denmark)

    Smets, Jonathan; Jaeger, Manfred

    2014-01-01

    We propose a method for the simultaneous construction of multiple image segmentations by combining a recently proposed “convolution of mixtures of Gaussians” model with a multi-layer hidden Markov random field structure. The resulting method constructs for a single image several, alternative...

  2. Neuromyelitis optica and multiple sclerosis

    DEFF Research Database (Denmark)

    Bennett, J. L.; de Seze, J.; Lana-Peixoto, M.

    2015-01-01

    Neuromyelitis optica (NMO) is an inflammatory autoimmune disease of the central nervous system that preferentially targets the optic nerves and spinal cord. The clinical presentation may suggest multiple sclerosis (MS), but a highly specific serum autoantibody against the astrocytic water channel...

  3. Properties of truncated multiplicity distributions

    International Nuclear Information System (INIS)

    Lupia, S.

    1995-01-01

    Truncation effects on multiplicity distributions are discussed. Observables sensitive to the tail, like factorial moments, factorial cumulants and their ratio, are shown to be strongly affected by truncation. A possible way to overcome this problem by looking at the head of the distribution is suggested. (author)

  4. Properties of truncated multiplicity distributions

    Energy Technology Data Exchange (ETDEWEB)

    Lupia, S. [Turin Univ. (Italy). Dipt. di Fisica

    1995-12-31

    Truncation effects on multiplicity distributions are discussed. Observables sensitive to the tail, like factorial moments, factorial cumulants and their ratio, are shown to be strongly affected by truncation. A possible way to overcome this problem by looking at the head of the distribution is suggested. (author)

  5. [Biological treatment of multiple sclerosis

    DEFF Research Database (Denmark)

    Sorensen, P.S.; Sellebjerg, F.

    2008-01-01

    In 1996 interferon (IFN)beta was the first biopharmaceutical product to be approved for the treatment of relapsing-remitting multiple sclerosis (MS). In 2006 the more potent monoclonal antibody natalizumab was approved. Presently, a number of monoclonal antibodies are being studied, including ale...

  6. Uric acid in multiple sclerosis

    NARCIS (Netherlands)

    Koch, M; De Keyser, J

    Peroxynitrite, a reactive oxidant formed by the reaction of nitric oxide with superoxide at sites of inflammation in multiple sclerosis (MS), is capable of damaging tissues and cells. Uric acid, a natural scavenger of peroxynitrite, reduces inflammatory demyelination in experimental allergic

  7. Couple specialization in multiple equilibria

    NARCIS (Netherlands)

    Esping-Andersen, G.; Boertien, D.; Bonke, J.; Gracia, P.

    2013-01-01

    We address the issue of men’s lagged adaptation to the ongoing revolution of women’s roles. This article proposes a multiple equilibrium approach and shows how modes of couple specialization cluster around qualitatively distinct logics. We identify a traditional, egalitarian, and ‘unstable’

  8. Neutron multiplicity of fission fragments

    Energy Technology Data Exchange (ETDEWEB)

    Abdelrahman, Y S [Physics department, mu` rah university Al-Karak, (Jordan)

    1995-10-01

    The total average neutron multiplicity of the fission fragments produced by the spontaneous fission of {sup 248} Cm has been measured. This measurement has been done by using a new experimental technique. This technique mainly depends on {gamma}-{gamma} coincidence using a very high resolution high purity germanium (HPGe) detector. 2 figs.

  9. Inverse comorbidity in multiple sclerosis

    DEFF Research Database (Denmark)

    Thormann, Anja; Koch-Henriksen, Nils; Laursen, Bjarne

    2016-01-01

    onset of MS 1980-2005. We randomly matched each MS-case with five population controls. Comorbidity data were obtained from multiple, independent nationwide registries. Cases and controls were followed from January 1977 to the index date, and from the index date through December 2012. We controlled...

  10. The danish multiple sclerosis registry

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Koch-Henriksen, Nils; Stenager, Egon

    2011-01-01

    Introduction: The Danish Multiple Sclerosis (MS) Registry was established in 1956. Content: The register comprises data on all Danes who had MS in 1949 or who have been diagnosed since. Data on new cases and updated information on persons with an MS diagnosis already notified are continuously...

  11. The immunogenetics of multiple sclerosis

    DEFF Research Database (Denmark)

    Svejgaard, A.

    2008-01-01

    with complex genetic backgrounds. HLA controls immune response genes and HLA associations indicate the involvement of autoimmunity. Multiple sclerosis (MS) was one of the first conditions proven to be HLA associated involving primarily HLA class II factors. We review how HLA studies give fundamental...

  12. The Multiple-markets Problem

    DEFF Research Database (Denmark)

    Frankel, Christian

    2015-01-01

    Only few studies in the field of new new economic sociology deal with a simultaneity of multiple markets in the analysis. One central explanation of this situation is limitations inherent in the new new economic sociology. In this review essay I address such limitations as a way to develop research...

  13. Laboratory diagnosis of multiple sclerosis

    International Nuclear Information System (INIS)

    Sand, T.; Stovner, L.J.; Rinck, P.A.; Nilsen, G.; Romslo, I.

    1991-01-01

    In 26 patients with multiple sclerosis 100% responded abnormally to magnetic resonance imaging of the brain. Lesions in the posterior fossa were observed in 18 patients. The auditory brain stem response was abnormal in 15 patients, and 22 had abnormal immunoglobulins in the cerebrospinal fluid. The correlation between abnormalities of the auditory brain stem response and the magnetic resonance images was greatest in a subgroup where the two investigations were performed within a ten day interval. Results from magnetic resonance imaging, evoked potentials and cerebrospinal fluid investigations were used to reclassify 13 of 15 patients with clinically ''possible'' or ''probable''multiple sclerosis to a higher level using Poser's criteria. Evoked potentials (the auditory brain stem response in particular) correlated best with clinical multiple sclerosis category. The authors recommend that the magnetic resonance imaging is established as a first-hand investigation in evaluation of multiple sclerosis. Evoked potentials and cerebrospinal fluid investigations may prove to be more specific, however, and these investigations should also be performed as a routine. 23 refs., 2 figs., 2 tabs

  14. Clinical aspects of multiple pregnancy

    NARCIS (Netherlands)

    J.G. Santema

    1996-01-01

    textabstractThe natural wonder of multiple pregnancy and birth has fascinated mankind since ancient times and twins figure prominently in legends, folktales and myths. One of the best known traditional stories is that of Romulus and Remus, the twins who were abandoned on the banks of the Tiber and

  15. The Theory of Multiple Intelligences.

    Science.gov (United States)

    Gardner, Howard

    1987-01-01

    The multiple intelligence theory is based on cultural contexts, biological analysis, developmental theories, and a vertical theory of faculties. Seven intelligences are identified: linguistic, logical mathematical, musical, spatial, bodily kinesthetic, interpersonal, and intrapersonal. The theory's educational implications are described,…

  16. Hyper-systolic matrix multiplication

    NARCIS (Netherlands)

    Lippert, Th.; Petkov, N.; Palazzari, P.; Schilling, K.

    A novel parallel algorithm for matrix multiplication is presented. It is based on a 1-D hyper-systolic processor abstraction. The procedure can be implemented on all types of parallel systems. (C) 2001 Elsevier Science B,V. All rights reserved.

  17. The STAR Photon Multiplicity Detector

    Energy Technology Data Exchange (ETDEWEB)

    Aggarwal, M.M.; Badyal, S.K.; Bhaskar, P.; Bhatia, V.S.; Chattopadhyay, S. E-mail: sub@veccal.ernet.in; Das, S.; Datta, R.; Dubey, A.K.; Dutta Majumdar, M.R.; Ganti, M.S.; Ghosh, P.; Gupta, A.; Gupta, M.; Gupta, R.; Kaur, I.; Kumar, A.; Mahajan, S.; Mahapatra, D.P.; Mangotra, L.K.; Mishra, D.; Mohanty, B.; Nayak, S.K.; Nayak, T.K.; Pal, S.K.; Phatak, S.C.; Potukuchi, B.V.K.S.; Raniwala, R.; Raniwala, S.; Sahoo, R.; Sharma, A.; Singaraju, R.N.; Sood, G.; Trivedi, M.D.; Varma, R.; Viyogi, Y.P

    2003-03-01

    Details concerning the design, fabrication and performance of STAR Photon Multiplicity Detector (PMD) are presented. The PMD will cover the forward region, within the pseudorapidity range 2.3-3.5, behind the forward time projection chamber. It will measure the spatial distribution of photons in order to study collective flow, fluctuation and chiral symmetry restoration.

  18. Multiplicity distributions in QCD cascades

    International Nuclear Information System (INIS)

    Gustafson, G.

    1992-03-01

    Multiplicity distributions for hadrons and for jets are studied in QCD parton cascades. The colour dipole formalism is used and earlier results in the double log approximation are generalized to include terms which are suppressed by colour factors or factors of ln s. The result is a set of coupled differential equations, together with appropriate boundary conditions

  19. Health Information in Multiple Languages

    Science.gov (United States)

    ... gov/languages/languages.html Health Information in Multiple Languages To use the sharing features on this page, please enable JavaScript. Use these ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated on 4 June 2018

  20. Biosensors and multiple mycotoxin analysis

    NARCIS (Netherlands)

    Gaag, B. van der; Spath, S.; Dietrich, H.; Stigter, E.; Boonzaaijer, G.; Osenbruggen, T. van; Koopal, K.

    2003-01-01

    An immunochemical biosensor assay for the detection of multiple mycotoxins in a sample is described.The inhibition assay is designed to measure four different mycotoxins in a single measurement, following extraction, sample clean-up and incubation with an appropriate cocktail of anti-mycotoxin

  1. Fashion, Paper Dolls and Multiplicatives

    Science.gov (United States)

    Ura, Suzana Kaori; Stein-Barana, Alzira C. M.; Munhoz, Deisy P.

    2011-01-01

    The multiplicative principle is the tool allowing the counting of groups that can be described by a sequence of events. An event is a subset of sample space, i.e. a collection of possible outcomes, which may be equal to or smaller than the sample space as a whole. It is important that students understand this basic principle early on and know how…

  2. Vascular aspects of multiple sclerosis

    NARCIS (Netherlands)

    D'haeseleer, Miguel; Cambron, Melissa; Vanopdenbosch, Ludo; De Keyser, Jacques

    Three types of vascular dysfunction have been described in multiple sclerosis (MS). First, findings from epidemiological studies suggest that patients with MS have a higher risk for ischaemic stroke than people who do not have MS. The underlying mechanism is unknown, but might involve endothelial

  3. Applications of Fast Truncated Multiplication in Cryptography

    Directory of Open Access Journals (Sweden)

    Laszlo Hars

    2006-12-01

    Full Text Available Truncated multiplications compute truncated products, contiguous subsequences of the digits of integer products. For an n-digit multiplication algorithm of time complexity O(nα, with 1<α≤2, there is a truncated multiplication algorithm, which is constant times faster when computing a short enough truncated product. Applying these fast truncated multiplications, several cryptographic long integer arithmetic algorithms are improved, including integer reciprocals, divisions, Barrett and Montgomery multiplications, 2n-digit modular multiplication on hardware for n-digit half products. For example, Montgomery multiplication is performed in 2.6 Karatsuba multiplication time.

  4. Robust multiple frequency multiple power localization schemes in the presence of multiple jamming attacks.

    Directory of Open Access Journals (Sweden)

    Ahmed Abdulqader Hussein

    Full Text Available Localization of the wireless sensor network is a vital area acquiring an impressive research concern and called upon to expand more with the rising of its applications. As localization is gaining prominence in wireless sensor network, it is vulnerable to jamming attacks. Jamming attacks disrupt communication opportunity among the sender and receiver and deeply impact the localization process, leading to a huge error of the estimated sensor node position. Therefore, detection and elimination of jamming influence are absolutely indispensable. Range-based techniques especially Received Signal Strength (RSS is facing severe impact of these attacks. This paper proposes algorithms based on Combination Multiple Frequency Multiple Power Localization (C-MFMPL and Step Function Multiple Frequency Multiple Power Localization (SF-MFMPL. The algorithms have been tested in the presence of multiple types of jamming attacks including capture and replay, random and constant jammers over a log normal shadow fading propagation model. In order to overcome the impact of random and constant jammers, the proposed method uses two sets of frequencies shared by the implemented anchor nodes to obtain the averaged RSS readings all over the transmitted frequencies successfully. In addition, three stages of filters have been used to cope with the replayed beacons caused by the capture and replay jammers. In this paper the localization performance of the proposed algorithms for the ideal case which is defined by without the existence of the jamming attack are compared with the case of jamming attacks. The main contribution of this paper is to achieve robust localization performance in the presence of multiple jamming attacks under log normal shadow fading environment with a different simulation conditions and scenarios.

  5. Collectively loading programs in a multiple program multiple data environment

    Science.gov (United States)

    Aho, Michael E.; Attinella, John E.; Gooding, Thomas M.; Gooding, Thomas M.; Miller, Samuel J.

    2016-11-08

    Techniques are disclosed for loading programs efficiently in a parallel computing system. In one embodiment, nodes of the parallel computing system receive a load description file which indicates, for each program of a multiple program multiple data (MPMD) job, nodes which are to load the program. The nodes determine, using collective operations, a total number of programs to load and a number of programs to load in parallel. The nodes further generate a class route for each program to be loaded in parallel, where the class route generated for a particular program includes only those nodes on which the program needs to be loaded. For each class route, a node is selected using a collective operation to be a load leader which accesses a file system to load the program associated with a class route and broadcasts the program via the class route to other nodes which require the program.

  6. Multiple-membrane multiple-electrolyte redox flow battery design

    Science.gov (United States)

    Yan, Yushan; Gu, Shuang; Gong, Ke

    2017-05-02

    A redox flow battery is provided. The redox flow battery involves multiple-membrane (at least one cation exchange membrane and at least one anion exchange membrane), multiple-electrolyte (one electrolyte in contact with the negative electrode, one electrolyte in contact with the positive electrode, and at least one electrolyte disposed between the two membranes) as the basic characteristic, such as a double-membrane, triple electrolyte (DMTE) configuration or a triple-membrane, quadruple electrolyte (TMQE) configuration. The cation exchange membrane is used to separate the negative or positive electrolyte and the middle electrolyte, and the anion exchange membrane is used to separate the middle electrolyte and the positive or negative electrolyte.

  7. Realization of a gamma multiplicity filter and gamma multiplicity measurements

    International Nuclear Information System (INIS)

    Azgui, F.

    1981-12-01

    A gamma multiplicity filter for the study of reaction mechanism has been realised. It's composed of six NaI(Tl) counters. The flexibility of the geometry allows many configurations. This set up has been tested with gamma radioactive sources and with the 252 Cf source to resolve problems of gamma-efficiency of the NaI(Tl) counters and the contamination of neutrons in these detectors. A logical electronic unit (Encodeur) has been constructed and the around electronic has been developped. This gamma multiplicity filter has been coupled with a detector of high resolution Ge(Li), and used in two reactions: 12 C + 55 Mn at E( 12 C) = 54 MeV; α + 63 Cu at E(α) = 52 MeV. The dominant process is the fusion-evaporation. The compound nucleus 67 Ga, is formed at the same excitation energy. The values of multiplicities Msub(γ) have been extracted using a program based on the formalism of W.J. Ockels. The fractionalization of the angular momentum is well observed for some residual nuclei ( 63 Zn, 64 Zn, 65 Zn), and for each residual nucleus, the average gamma multiplicity is lower with projectile α than that with projectile 12 C. For the most strongly output channel p2n, an entry point for the 64 Zn has been determined in the reactions. All these observations are in good agreement with those published, in the same region (f-p shell) of nuclei. This set up can be coupled with different central detector as, ''X'', neutrons charged particles detectors, and will be used with the new machine SARA to make a systematic study of transfer of angular momentum to the fragments at 30 MeV/A [fr

  8. Management Challenges of Launching Multiple Payloads for Multiple Customers

    OpenAIRE

    Callen, Dave

    1999-01-01

    Orbital has provided launch services for multiple satellites as a means to provide greater economy for access to space. These include satellites from NASA, 000, commercial companies, universities, and foreign governments. While satellite customers view shared launches as a means to achieve reduced launch costs, this approach adds many complexities that a traditional launch service provider does not have to address for a dedicated launch. This paper will discuss some of the challenges associat...

  9. Multiple sclerosis in magnetic resonance

    International Nuclear Information System (INIS)

    Bekiesinska-Figatowska, M.; Walecki, J.; Stelmasiak, Z.

    1994-01-01

    The authors analyzed MR examination of 277 patients with multiple sclerosis. White matter hyperintesities in brain were found in 270 of them, in spinal cord in 32. The most frequently they were found in periventricular white matter, in subcortical localization and in the corpus callosum. MR examination allows the estimate the activity of the disease on the basis of the presence of edema around the plaques and their contrast enhancement with Gd-DTPA. About one third of all cases were accompanied by cortical brain atrophy (the most often seen in the frontal lobes), subcortical brain atrophy was less frequent. In about two third of all cases the corpus callosum atrophy was found. MR examination is a highly sensitive method of multiple sclerosis diagnosis, of the assessment of its activity and progression. (author)

  10. Emerging therapies in multiple myeloma.

    Science.gov (United States)

    El-Amm, Joelle; Tabbara, Imad A

    2015-06-01

    The treatment of multiple myeloma has evolved significantly over the past 2 decades due to the use of high-dose chemotherapy and autologous stem cell transplantation, and the subsequent introduction of the immunomodulatory agents (thalidomide and lenalidomide) and the proteasome inhibitor (bortezomib). The median overall survival of multiple myeloma patients has increased significantly with patients younger than age 50 years experiencing a 10-year survival rate of around 40%. However, despite the increased effectiveness of the first-line agents, the majority of patients will eventually relapse and become drug resistant. Promising novel therapies have recently emerged and are being used to treat relapsed and refractory patients. This review will cover the clinical data regarding these emergent therapies that include new generation of proteasome inhibitors (carfilzomib, ixazomib, oprozomib, and marizomib), immunomodulatory drugs (pomalidomide), monoclonal antibodies (elotuzumab and daratumumab), signal transduction modulator (perifosine), and histone deacetylase inhibitors (vorinostat and panobinostat).

  11. The Multiple Modernities of Europe

    DEFF Research Database (Denmark)

    Thomassen, Bjørn

    What Europe? Eric Voegelin on the Mediterranean and the Atlantic modernities. The concept ‘multiple modernities’ has during the last decade established itself in social and political theory, not least due to contributions made by Shmul Eisenstadt. The debate on multiple moderntities has served...... to question certain eurocentric assumptions about modernity and has also reignited the question of European particularity in a world historical perspective. This paper will discuss how ‘Europe’ itself can be considered a result of (at least) two different modernities, as proposed by the political theorist......, Eric Voegelin. Eric Voegelin talked of two spatio-temporal specific modernities, the Mediterranean and the Atlantic modernities. In short, for Voegelin the Atlantic modernity with its breakthroughs in the 17th and 18th centuries was a specific figuration that should not be mistaken for ‘modernity...

  12. Computerized tomography in multiple sclerosis

    International Nuclear Information System (INIS)

    Delouvrier, J.J.; Tritschler, J.L.; Desbleds, M.T.; Cambier, J.; Nahum, H.

    1980-01-01

    The double scan CT method was applied to a homogeneous population of 50 multiple sclerosis patients and the following features were studied: well defined low-density areas, localized contrast enhancements, cerebral atrophy and white matter homogeneity. The analyses of the variance of the white matter (centrum ovale) can disclose those lesions which individually do not surpass the visibility threshold. The lesions that are localized in the white matter are mainly periventricular, most often multiple, and they do not displace the neighbouring structures. By revealing a large number of clinically silent cerebral lesions, the cerebral CT becomes a highly important diagnostic tool. The value of the CT examinations seems to be of major importance each time that the clinical diagnosis is hesitant, particularly when faced with medullary signs or an initial neurological episode. (C.F.)

  13. Plume rise from multiple sources

    International Nuclear Information System (INIS)

    Briggs, G.A.

    1975-01-01

    A simple enhancement factor for plume rise from multiple sources is proposed and tested against plume-rise observations. For bent-over buoyant plumes, this results in the recommendation that multiple-source rise be calculated as [(N + S)/(1 + S)]/sup 1/3/ times the single-source rise, Δh 1 , where N is the number of sources and S = 6 (total width of source configuration/N/sup 1/3/ Δh 1 )/sup 3/2/. For calm conditions a crude but simple method is suggested for predicting the height of plume merger and subsequent behavior which is based on the geometry and velocity variations of a single buoyant plume. Finally, it is suggested that large clusters of buoyant sources might occasionally give rise to concentrated vortices either within the source configuration or just downwind of it

  14. Complex multiplication and lifting problems

    CERN Document Server

    Chai, Ching-Li; Oort, Frans

    2013-01-01

    Abelian varieties with complex multiplication lie at the origins of class field theory, and they play a central role in the contemporary theory of Shimura varieties. They are special in characteristic 0 and ubiquitous over finite fields. This book explores the relationship between such abelian varieties over finite fields and over arithmetically interesting fields of characteristic 0 via the study of several natural CM lifting problems which had previously been solved only in special cases. In addition to giving complete solutions to such questions, the authors provide numerous examples to illustrate the general theory and present a detailed treatment of many fundamental results and concepts in the arithmetic of abelian varieties, such as the Main Theorem of Complex Multiplication and its generalizations, the finer aspects of Tate's work on abelian varieties over finite fields, and deformation theory. This book provides an ideal illustration of how modern techniques in arithmetic geometry (such as descent the...

  15. Adapting playware to multiple players

    DEFF Research Database (Denmark)

    Þorsteinsson, Arnar Tumi; Lund, Henrik Hautop; Mastorakis, Nikos

    2011-01-01

    With the creation of playware as intelligent hardware and software that creates play, it is possible to adapt the play tool to the individual user, and even to multiple users playing at the same time with the play tool. In this paper, we show how it is possible to implement adaptivity in modular...... to such differences, and argues that adaptivity is needed to make games fit to the individual users in both single-player games and multi-player games. As a case study, we implemented such adaptivity on modular interactive tiles for the single-user game ColorTimer, and for the multiple-user games PingPong, in which...

  16. Skeletal surveys in multiple myeloma

    International Nuclear Information System (INIS)

    Sebes, J.I.; Niell, H.B.; Palmieri, G.M.A.; Reidy, T.J.

    1986-01-01

    Thirty-three patients with multiple myeloma were studied with serial skeletal surveys, serum immunoglobulin levels, and postabsorptive urinary hydroxyproline (Spot-HYPRO) determinations. Twenty receiving chemotherapy were also followed with skeletal surveys in order to evaluate bone response to treatment. A close association was found between skeletal findings and changes in immunoglubulin levels with positive correlation in 71% of the patients. A similar association was found between skeletal disease and Spot-HYPRO level changes in 65%. Five of 12 patients (42%) with partial or complete clinical response to chemotherapy, demonstrated improvement in the appearance of skeletal lesions. Positive correlation between the roentgenographic changes and clinical markers of myeloma as well as therapeutic response, indicates that skeletal surveys are useful and effective in monitoring patients with multiple myeloma. (orig.)

  17. [Current description of multiple sclerosis].

    Science.gov (United States)

    Río, Jordi; Montalbán, Xavier

    2014-12-01

    Multiple sclerosis is a multifocal demyelinating disease leading to progressive neurodegeneration caused by an autoimmune response in genetically predisposed individuals. In the last few years, the knowledge and management of this disease has been revolutionized by a series of findings. The present article reviews pathological features of the disease, in which cortical involvement is increasingly implicated, and aspects related to novel pathogenic mechanisms, such as the role of the microbiota in the genesis of multiple sclerosis, as well as recent contributions from the fields of epidemiology and genetics. Also reviewed are the latest diagnostic criteria, which currently allow a much earlier diagnosis, with clear therapeutic implications. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  18. Multiple imputation and its application

    CERN Document Server

    Carpenter, James

    2013-01-01

    A practical guide to analysing partially observed data. Collecting, analysing and drawing inferences from data is central to research in the medical and social sciences. Unfortunately, it is rarely possible to collect all the intended data. The literature on inference from the resulting incomplete  data is now huge, and continues to grow both as methods are developed for large and complex data structures, and as increasing computer power and suitable software enable researchers to apply these methods. This book focuses on a particular statistical method for analysing and drawing inferences from incomplete data, called Multiple Imputation (MI). MI is attractive because it is both practical and widely applicable. The authors aim is to clarify the issues raised by missing data, describing the rationale for MI, the relationship between the various imputation models and associated algorithms and its application to increasingly complex data structures. Multiple Imputation and its Application: Discusses the issues ...

  19. Cognitive deficits in multiple sclerosis

    DEFF Research Database (Denmark)

    Lund, H; Jønsson, A; Andresen, Jesper Graubæk

    2012-01-01

    of the cognitive impairment seen in MS and constitute a supplement to traditional measurement of T2 lesion volume. Materials and Methods - Fifty patients with clinically definite MS were included (38 women, 12 men). Patients were MR scanned, neuropsychologically tested, and evaluated clinically with the Kurtzke......Objectives - Although disease load in multiple sclerosis (MS) often is based on T2 lesion volumes, the changes in T2 of normal appearing brain tissue (NABT) are rarely considered. By means of magnetic resonance, (MR) we retrospectively investigated whether T2 changes in NABT explain part...... Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Impairment Scale (MSIS). Voxel-wise T2 estimates and total T2 lesion volume were tested for correlations with eight cognitive domains, a general cognitive dysfunction factor (CDF), and the two clinical scales. Results - We found distinct...

  20. Passive neutron-multiplication measurements

    International Nuclear Information System (INIS)

    Zolnay, A.S.; Barnett, C.S.; Spracklen, H.P.

    1982-01-01

    We have developed an instrument to measure neutron multiplication by statistical analysis of the timing of neutrons emitted from fissionable material. This instrument is capable of repeated analysis of the same recorded data with selected algorithms, graphical displays showing statistical properties of the data, and preservation of raw data on disk for future comparisons. In our measurements we have made a comparison of the covariance to mean and Feynman variance to mean analysis algorithms to show that the covariance avoids a bias term and measures directly the effect due to the presence of neutron chains. A spherical assembly of enriched uranium shells and acrylic resin reflector/moderator components used for the measurements is described. Preliminary experimental results of the Feynman variance to mean measurements show the expected correlation with assembly multiplication

  1. Model Pembelajaran Berbasis Penstimulasian Multiple Intelligences Siswa

    OpenAIRE

    Edy Legowo

    2017-01-01

    Tulisan ini membahas mengenai penerapan teori multiple intelligences dalam pembelajaran di sekolah. Pembahasan diawali dengan menguraikan perkembangan konsep inteligensi dan multiple intelligences. Diikuti dengan menjelaskan dampak teori multiple intelligences dalam bidang pendidikan dan pembelajaran di sekolah. Bagian selanjutnya menguraikan tentang implementasi teori multiple intelligences dalam praktik pembelajaran di kelas yaitu bagaimana pemberian pengalaman belajar siswa yang difasilita...

  2. EU Law and Multiple Discrimination

    DEFF Research Database (Denmark)

    Nielsen, Ruth

    2006-01-01

    In EU law, nationality and gender were the only equality issues on the legal agenda from the outset in 1958 and for about 40 years. Multiple discrimination was not addressed until the 1990's. The intersectionality approach which has been widely discussed outside Europe has mainly been used...... with a view to gendermainstreaming the fight against other kinds of discrimination (on grounds of ethnic origin, age, etc)....

  3. Transnational Connections and Multiple Belongings

    DEFF Research Database (Denmark)

    Galal, Lise Paulsen; Sparre, Sara Cathrine Lei

    With the purpose of presenting DIMECCE key findings, we in this paper present different aspects, potentials and challenges related to the Middle Eastern Christians transnational connections and multiple belonging. We distinguish between individual transnational connections and practices, such as ......, such as family relations, churches as transnational – or global – institutions, and other organisations and associations established to support politically, socially or culturally connections and development in the country or region of origin....

  4. Multiple sclerosis and birth order.

    Science.gov (United States)

    James, W H

    1984-01-01

    Studies on the birth order of patients with multiple sclerosis have yielded contradictory conclusions. Most of the sets of data, however, have been tested by biased tests. Data that have been submitted to unbiased tests seem to suggest that cases are more likely to occur in early birth ranks. This should be tested on further samples and some comments are offered on how this should be done. PMID:6707558

  5. Multiple sclerosis and birth order.

    OpenAIRE

    James, W H

    1984-01-01

    Studies on the birth order of patients with multiple sclerosis have yielded contradictory conclusions. Most of the sets of data, however, have been tested by biased tests. Data that have been submitted to unbiased tests seem to suggest that cases are more likely to occur in early birth ranks. This should be tested on further samples and some comments are offered on how this should be done.

  6. Protocol for multiple node network

    Science.gov (United States)

    Kirkham, Harold (Inventor)

    1995-01-01

    The invention is a multiple interconnected network of intelligent message-repeating remote nodes which employs an antibody recognition message termination process performed by all remote nodes and a remote node polling process performed by other nodes which are master units controlling remote nodes in respective zones of the network assigned to respective master nodes. Each remote node repeats only those messages originated in the local zone, to provide isolation among the master nodes.

  7. Multiple Sclerosis: Pathogenesis and Treatment

    OpenAIRE

    Loma, Ingrid; Heyman, Rock

    2011-01-01

    Multiple sclerosis (MS) is a chronic inflammatory autoimmune demyelinating disease of the central nervous system. It affects approximately 400,000 people in the United States and onset is usually during young adulthood. There are four clinical forms of MS, of which relapsing remitting type is the most common. As the etiology of MS is unknown, finding a cure will remain challenging. The main mechanism of injury appears to be inflammation and 8 agents are now FDA approved to help control MS. Th...

  8. Treatment Satisfaction in Multiple Sclerosis

    OpenAIRE

    Glanz, Bonnie I.; Musallam, Alexander; Rintell, David J.; Chitnis, Tanuja; Weiner, Howard L.; Healy, Brian C.

    2014-01-01

    Background: Disease-modifying therapies (DMTs) for the treatment of multiple sclerosis (MS) are associated with inconvenient methods of administration, significant side effects, and low adherence rates. This study was undertaken to compare treatment satisfaction in MS patients treated with interferon beta-1a intramuscular (IFNβ-1a IM), interferon beta-1a subcutaneous (IFNβ-1a SC), glatiramer acetate (GA), and natalizumab (NTZ), and to examine the associations between treatment satisfaction ra...

  9. Estrogen Treatment in Multiple Sclerosis

    OpenAIRE

    Gold, Stefan M; Voskuhl, Rhonda R

    2009-01-01

    Currently available treatments for multiple sclerosis reduce inflammatory lesions on MRI and decrease clinical relapses but have limited effects on disability. Novel treatment options that target both the inflammatory as well as the neurodegenerative component of the disease are therefore needed. A growing body of evidence from basic science and clinical studies supports the therapeutic potential of estrogens in MS. Mechanisms of action include both immunomodulatory and directly neuroprotecti...

  10. Multiplicative formulation of quantum mechanics

    International Nuclear Information System (INIS)

    Voros, A.; Leboeuf, P.

    1991-01-01

    A general semi-classical description for the eigenfunctions of the multidimensional Schroedinger operator cannot be based on the WKB method which is incompatible with classically ergodic behavior. An alternative, more general multiplicative parametrization of quantum wave functions is suggested, whereby the semi-classical behavior of eigenfunctions can be traced in the presence of classical ergodicity, in the form of diffusive patterns of phase-space zeros in the quantum wave functions. (author) 24 refs.; 4 figs

  11. Balancing Structure for Multiple Generator

    Directory of Open Access Journals (Sweden)

    LUPU Ciprian

    2014-05-01

    Full Text Available This paper presents a strategy to (rebalance a multiple generator control system structure on maintaining the global output in case of load and functioning disturbances. Applicability is proved on a control structure of the two and three sources connected in parallel to produce energy, a situation that has been encountered more and more these days especially in the renewable energy industry (wind, solar and small generators etc.

  12. Video Chat with Multiple Cameras

    OpenAIRE

    MacCormick, John

    2012-01-01

    The dominant paradigm for video chat employs a single camera at each end of the conversation, but some conversations can be greatly enhanced by using multiple cameras at one or both ends. This paper provides the first rigorous investigation of multi-camera video chat, concentrating especially on the ability of users to switch between views at either end of the conversation. A user study of 23 individuals analyzes the advantages and disadvantages of permitting a user to switch between views at...

  13. Multiple primary cancers: An enigma

    Directory of Open Access Journals (Sweden)

    Amitabh Jena

    2016-01-01

    Full Text Available Background: Incidence of multiple primary cancers though uncommon, is being frequently reported now-a-days owing to better diagnostic techniques, the prolonged life span and the increased incidence of long-term survival of cancer patients. Materials and Methods: This is a retrospective study. Cases of multiple malignancies diagnosed histopathologically were retrieved from the archives of department of surgical oncology. Clinical data were obtained from the medical records. They were categorized as synchronous malignancies if the interval between them was less or equal to 6 months and metachronous, if the interval was more than 6 months. Results: A total of 13 cases were encountered in the 5 year study period. Out of them two were in the metachronous category and the rest were synchronous as the 2nd malignancy was detected mostly during clinical evaluation of the patients for the primary malignancy. There was female predominance with age range being 43-68 years. Majority of the cases were in the 7th decade. The most common organ involved was breast, followed by cervix. Apart from bilateral breast malignancies, there were combinations like breast with uterine endometrial carcinoma, cervical carcinoma and even papillary thyroid carcinoma. Conclusion: Detection of multiple primary malignancies is becoming increasingly common in day-to-day practice. Greater awareness of this is required among both cancer patients and their treating clinicians.

  14. Magnetic resonance in multiple sclerosis

    International Nuclear Information System (INIS)

    Scotti, G.; Caputo, D.; Cazzullo, C.L.

    1986-01-01

    Magnetic Resonance Imaging was performed in more than 200 patients with clinical suspicion or knowledge of Multiple Sclerosis. One hundred and forty-seven (60 males and 87 females) had MR evidence of multiple sclerosis lesions. The MR signal of demyelinating plaques characteristically has prolonged T1 and T2 relaxation times and the T2-weighted spin-echo sequences are generally superior to the T1-weighted images because the lesions are better visualized as areas of increased signal intensity. MR is also able to detect plaques in the brainstem, cerebellum and within the cervical spinal cord. MR appears to be an important, non-invasive method for the diagnosis of Multiple Sclerosis and has proven to be diagnostically superior to CT, evoked potentials (EP) and CSF examination. In a selected group of 30 patients, with the whole battery of the relevant MS studies, MR was positive in 100%, CT in 33,3%, EP in 56% and CSF examination in 60%. In patients clinically presenting only with signs of spinal cord involvement or optic neuritis or when the clinical presentation is uncertain MR has proven to be a very useful diagnostic tool for diagnosis of MS by demonstrating unsuspected lesions in the cerebral hemispheres. (orig.)

  15. Mediation Analysis with Multiple Mediators.

    Science.gov (United States)

    VanderWeele, T J; Vansteelandt, S

    2014-01-01

    Recent advances in the causal inference literature on mediation have extended traditional approaches to direct and indirect effects to settings that allow for interactions and non-linearities. In this paper, these approaches from causal inference are further extended to settings in which multiple mediators may be of interest. Two analytic approaches, one based on regression and one based on weighting are proposed to estimate the effect mediated through multiple mediators and the effects through other pathways. The approaches proposed here accommodate exposure-mediator interactions and, to a certain extent, mediator-mediator interactions as well. The methods handle binary or continuous mediators and binary, continuous or count outcomes. When the mediators affect one another, the strategy of trying to assess direct and indirect effects one mediator at a time will in general fail; the approach given in this paper can still be used. A characterization is moreover given as to when the sum of the mediated effects for multiple mediators considered separately will be equal to the mediated effect of all of the mediators considered jointly. The approach proposed in this paper is robust to unmeasured common causes of two or more mediators.

  16. Treatment of multiple scalp cylindroma

    Directory of Open Access Journals (Sweden)

    Radmilo Rončević

    2016-07-01

    Full Text Available Cylindroma is a rare, benign adnexal tumor of the skin. The most frequent tumor location is the head, especially the scalp, and neck area. This type of tumor can occur as solitary or multiple tumors. Tumor diagnosis is relatively easy and is based on clinical findings and biopsy. The therapy of choice is surgical excision with parts or entire scalp excision depending on whether it is solitary or multiple tumor. We presented a 65-year-old male patient with multiple scalp tumors of 0.5–6 cm in diameter. An entire scalp excision was performed and the postoperative wounds (i.e., the periosteum of the skull and the fascia galea were covered with free skin graft of partial thickness. In order to prevent profuse bleeding, we placed a tourniquet around his head and performed bilateral temporary ligature of temporal artery prior to surgery. During the nine-year follow-up, there were no new tumors or tumor recurrence reported.

  17. Multiple sclerosis: current immunological aspects

    Directory of Open Access Journals (Sweden)

    Carlos Cuevas-García

    2017-02-01

    Full Text Available Multiple sclerosis is the most common inflammatory, chronic and degenerative condition of the central nervous system, and represents the first cause of disability in young adults. In Mexico, 11 to 20 out of every 100 000 people suffer from this disease. The causes of multiple sclerosis remain unknown, but several theories have been proposed on its origin: the interaction of environmental factors, viral infectious factors and genetic and immune susceptibility of each individual patient, which induce an autoimmune response and promote neuronal/axonal degeneration. In this review, the immune reaction main components and neurodegeneration present in multiple sclerosis are analyzed, as well as the inflammatory cascade associated with demyelination. Available treatments’ main purpose is to modulate aspects related to the adaptive immune response (B and T cells. The therapeutic challenge will be antigen-specific immune-tolerance induction, for example, with the use of tolerance protocols with peptides or DNA or nanoparticles vaccines. Future therapies should aim to control innate components (microglia, macrophages, astrocytes and to promote remyelination. To optimize the treatment, a combined therapeutic approach targeting the control of inflammatory and neurodegenerative components of the disease and monitoring of biomarkers will be necessary.

  18. Multipl Pregnancies and Their Complications

    Directory of Open Access Journals (Sweden)

    Volkan Turan

    2011-03-01

    Full Text Available Objective: To investigate the complications observed in multipl pregnancies which are increasing in day by day. Material and method: We reviewed 173 multiple pregnancies that were followed up in the Department of Obstetric and Gynecology in Ege University during one year period and determined the preterm delivery ratio, discordance between fetuses and investigated the complications which occurred during pregnancy. Results: 148 twin, 24 triplet and 1 quadriplet pregnancies had been followed in a year. While 56 of twin pregnancies and 4 of the triplet pregnancies occurred spontaneously, others conceived with medical treatment or with assisted reproductive technology. Cerclage was performed in 11 pregnancies. Preeclampsia, gestational diabetes mellitus and cholestasis were observed in 12,26 and 8 patients respectively. Twin-to-twin transfusion syndrome was present in 4 patients and one patient had acardiac-acephalic twin pregnancy. Four patients had emergency cesarean section due to ablatio placenta. While 54 patients were hospitalized for one week to twelve weeks because of preterm labour 36 women had preterm premature rupture of the membranes. Only 38 patients had any problem during pregnancy. Discussion: Developments in assisted reproductive technology have been increasing the number of multiple gestations and their complications. The complications due to preterm labor, increased requirement of Neonatal Intensive Care Units and hospital payments are all burden on the families as well as on the social insurance companies.

  19. Multiple equilibria of divertor plasmas

    International Nuclear Information System (INIS)

    Vu, H.X.; Prinja, A.K.

    1993-01-01

    A one-dimensional, two-fluid transport model with a temperature-dependent neutral recycling coefficient is shown to give rise to multiple equilibria of divertor plasmas (bifurcation). Numerical techniques for obtaining these multiple equilibria and for examining their stability are presented. Although these numerical techniques have been well known to the scientific community, this is the first time they have been applied to divertor plasma modeling to show the existence of multiple equilibria as well as the stability of these solutions. Numerical and approximate analytical solutions of the present one-dimensional transport model both indicate that there exists three steady-state solutions corresponding to (1) a high-temperature, low-density equilibrium, (2) a low-temperature, high-density equilibrium, and (3) an intermediate-temperature equilibrium. While both the low-temperature and the high-temperature equilibria are stable, with respect to small perturbations in the plasma conditions, the intermediate-temperature equilibrium is physically unstable, i.e., any small perturbation about this equilibrium will cause a transition toward either the high-temperature or low-temperature equilibrium

  20. Multiple intelligences: Can they be measured?

    OpenAIRE

    Kirsi Tirri; Petri Nokelainen; Erkki Komulainen

    2013-01-01

    This paper is about issues relating to the assessment of multiple intelligences. The first section introduces the authors’ work on building measures of multiple intelligences and moral sensitivities. It also provides a conceptual definition of multiple intelligences based on Multiple Intelligences theory by Howard Gardner (1983). The second section discusses the context specificity of intelligences and alternative approaches to measuring multiple intelligences. The third section analyses the ...

  1. Hydrodynamic Limit of Multiple SLE

    Science.gov (United States)

    Hotta, Ikkei; Katori, Makoto

    2018-04-01

    Recently del Monaco and Schleißinger addressed an interesting problem whether one can take the limit of multiple Schramm-Loewner evolution (SLE) as the number of slits N goes to infinity. When the N slits grow from points on the real line R in a simultaneous way and go to infinity within the upper half plane H, an ordinary differential equation describing time evolution of the conformal map g_t(z) was derived in the N → ∞ limit, which is coupled with a complex Burgers equation in the inviscid limit. It is well known that the complex Burgers equation governs the hydrodynamic limit of the Dyson model defined on R studied in random matrix theory, and when all particles start from the origin, the solution of this Burgers equation is given by the Stieltjes transformation of the measure which follows a time-dependent version of Wigner's semicircle law. In the present paper, first we study the hydrodynamic limit of the multiple SLE in the case that all slits start from the origin. We show that the time-dependent version of Wigner's semicircle law determines the time evolution of the SLE hull, K_t \\subset H\\cup R, in this hydrodynamic limit. Next we consider the situation such that a half number of the slits start from a>0 and another half of slits start from -a exact solutions, we will discuss the universal long-term behavior of the multiple SLE and its hull K_t in the hydrodynamic limit.

  2. Sequence Factorization with Multiple References.

    Directory of Open Access Journals (Sweden)

    Sebastian Wandelt

    Full Text Available The success of high-throughput sequencing has lead to an increasing number of projects which sequence large populations of a species. Storage and analysis of sequence data is a key challenge in these projects, because of the sheer size of the datasets. Compression is one simple technology to deal with this challenge. Referential factorization and compression schemes, which store only the differences between input sequence and a reference sequence, gained lots of interest in this field. Highly-similar sequences, e.g., Human genomes, can be compressed with a compression ratio of 1,000:1 and more, up to two orders of magnitude better than with standard compression techniques. Recently, it was shown that the compression against multiple references from the same species can boost the compression ratio up to 4,000:1. However, a detailed analysis of using multiple references is lacking, e.g., for main memory consumption and optimality. In this paper, we describe one key technique for the referential compression against multiple references: The factorization of sequences. Based on the notion of an optimal factorization, we propose optimization heuristics and identify parameter settings which greatly influence 1 the size of the factorization, 2 the time for factorization, and 3 the required amount of main memory. We evaluate a total of 30 setups with a varying number of references on data from three different species. Our results show a wide range of factorization sizes (optimal to an overhead of up to 300%, factorization speed (0.01 MB/s to more than 600 MB/s, and main memory usage (few dozen MB to dozens of GB. Based on our evaluation, we identify the best configurations for common use cases. Our evaluation shows that multi-reference factorization is much better than single-reference factorization.

  3. Cloaks with multiple invisible regions

    International Nuclear Information System (INIS)

    Luo, Yang; Zhu, Shouzheng; He, Lianxing; Wang, Yu

    2011-01-01

    This paper proposes a general method of extending the effective invisible regions for both the shell-like interior cloak and the complementary media exterior cloak, without affecting their original cloaking regions. The proposed method is based on layered spatial mapping instead of the intact mapping. Certain interior or exterior invisible regions can be obtained by properly using a compressed or folded transformation in each space layer. Therefore, the proposal enables the as-designed cloaks to provide multiple invisible regions of different types simultaneously. Thus objects can be hidden in the interior cavity and/or in the exterior space, or even be embedded between the cloaking shells

  4. Multiple piece turbine rotor blade

    Science.gov (United States)

    Jones, Russell B; Fedock, John A

    2013-05-21

    A multiple piece turbine rotor blade with a shell having an airfoil shape and secured between a spar and a platform with the spar including a tip end piece. a snap ring fits around the spar and abuts against the spar tip end piece on a top side and abuts against a shell on the bottom side so that the centrifugal loads from the shell is passed through the snap ring and into the spar and not through a tip cap dovetail slot and projection structure.

  5. Multiple channel programmable coincidence counter

    Science.gov (United States)

    Arnone, Gaetano J.

    1990-01-01

    A programmable digital coincidence counter having multiple channels and featuring minimal dead time. Neutron detectors supply electrical pulses to a synchronizing circuit which in turn inputs derandomized pulses to an adding circuit. A random access memory circuit connected as a programmable length shift register receives and shifts the sum of the pulses, and outputs to a serializer. A counter is input by the adding circuit and downcounted by the seralizer, one pulse at a time. The decoded contents of the counter after each decrement is output to scalers.

  6. Multiple sclerosis: a geographical hypothesis.

    Science.gov (United States)

    Carlyle, I P

    1997-12-01

    Multiple sclerosis remains a rare neurological disease of unknown aetiology, with a unique distribution, both geographically and historically. Rare in equatorial regions, it becomes increasingly common in higher latitudes; historically, it was first clinically recognized in the early nineteenth century. A hypothesis, based on geographical reasoning, is here proposed: that the disease is the result of a specific vitamin deficiency. Different individuals suffer the deficiency in separate and often unique ways. Evidence to support the hypothesis exists in cultural considerations, in the global distribution of the disease, and in its historical prevalence.

  7. Suicide attempts in multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, Elsebeth Nylev; Jensen, Børge; Stenager, Maria

    2011-01-01

    The purposes of the study were (1) to estimate the risk of suicide attempts in multiple sclerosis (MS) patients in Denmark and compare the risk to the background population in the County of Funen, Denmark; (2) to estimate the risk of suicide attempts in MS patients receiving immunomodulating...... therapy compared with untreated patients. The Danish MS Registry, the Danish MS Treatment Registry and the Suicide Attempt Registry are linked and merged together using a person identification number given to all persons residing in Denmark. Among 404 MS patients, 15 patients had attempted suicide...

  8. Percolation with multiple giant clusters

    International Nuclear Information System (INIS)

    Ben-Naim, E; Krapivsky, P L

    2005-01-01

    We study mean-field percolation with freezing. Specifically, we consider cluster formation via two competing processes: irreversible aggregation and freezing. We find that when the freezing rate exceeds a certain threshold, the percolation transition is suppressed. Below this threshold, the system undergoes a series of percolation transitions with multiple giant clusters ('gels') formed. Giant clusters are not self-averaging as their total number and their sizes fluctuate from realization to realization. The size distribution F k , of frozen clusters of size k, has a universal tail, F k ∼ k -3 . We propose freezing as a practical mechanism for controlling the gel size. (letter to the editor)

  9. [Special cases of multiple sclerosis].

    Science.gov (United States)

    Mendibe Bilbao, Mar

    2014-12-01

    Multiple sclerosis is a chronic disease that usually occurs in young people and affects them for the rest of their lives. Patients and their families usually have a series of doubts and questions on everyday matters and all types of situations that occur during the distinct stages of life and which can influence the course of the disease. The aim of this review is to provide specific answers to these questions. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  10. Symptomatic management in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Pushkar Shah

    2015-01-01

    Full Text Available Multiple sclerosis (MS is the commonest cause of disability in young adults. While there is increasing choice and better treatments available for delaying disease progression, there are still, very few, effective symptomatic treatments. For many patients such as those with primary progressive MS (PPMS and those that inevitably become secondary progressive, symptom management is the only treatment available. MS related symptoms are complex, interrelated, and can be interdependent. It requires good understanding of the condition, a holistic multidisciplinary approach, and above all, patient education and empowerment.

  11. Multiple myeloma with extramedullary disease.

    Science.gov (United States)

    Oriol, Albert

    2011-11-01

    Plasmacytoma is a tumor mass consisting of atypical plasma cells. Incidence of plasmacytomas associated with multiple myeloma range from 7% to 17% at diagnosis and from 6% to 20% during the course of the disease. In both situations, occurrence of extramedullary disease has been consistently associated with a poorer prognosis of myeloma. Extramedullary relapse or progression occurs in a variety of clinical circumstances and settings, and therefore requires individualization of treatment. Alkylating agents, bortezomib, and immunomodulatory drugs, along with corticoids, have been used to treat extramedullary relapse but, because of the relatively low frequency or detection rate of extramedullary relapse, no efficacy data are available from controlled studies in this setting.

  12. Very high multiplicity hadron processes

    International Nuclear Information System (INIS)

    Mandzhavidze, I.; Sisakyan, A.

    2000-01-01

    The paper contains a description of a first attempt to understand the extremely inelastic high energy hadron collisions, when the multiplicity of produced hadrons considerably exceeds its mean value. Problems with existing model predictions are discussed. The real-time finite-temperature S-matrix theory is built to have a possibility to find model-free predictions. This allows one to include the statistical effects into consideration and build the phenomenology. The questions to experiment are formulated at the very end of the paper

  13. Therapeutic advancements in multiple myeloma

    Directory of Open Access Journals (Sweden)

    Alessandro eGozzetti

    2014-09-01

    Full Text Available Multiple myeloma survival has significantly improved in latest years, due to a broad spectrum of novel agents available for treatment. The introduction of thalidomide, bortezomib and lenalidomide together with autologous stem cell transplantation has dramatically prolonged complete remissions rate, progression free survivals resulting ultimately in prolonged survivals in myeloma patients. Moreover, novel strategies of treatment such as consolidation and maintenance are being used to implement responses. A number of new drugs such as carfilzomib and pomalidomide are already in clinical practice, and new kids on the block are entering, making the future of myeloma patients brighter.

  14. [Multiple agenesis and prosthetic restoration].

    Science.gov (United States)

    Renault, P

    1990-03-01

    Cases of multiple agenesia present some difficulties in the treatment planing. Three situations may be encountered: limited agenesia, restored by a fixed, bonded or cemented prosthesis, multiple uni- or bimaxillary agenesia without remaining of deciduous teeth, restored by a fixed, bonded or cemented prosthesis or the partial adjacent prosthesis, multiple uni- or bimaxillary agenesia with remaining of deciduous teeth, restored by means of a supra-dental prosthesis. The first two situations have been described in dental literature and are relatively easy to treat. The same is not true for the third situation, where the decision to keep the temporary teeth considerably increases the difficulty of prosthetic restoration. This subject will be illustrated by the presentation of a clinical case of multiple bi-maxillary agenesia. The patient has: on the maxilla: an absence of 9 permanent teeth (18, 15, 14, 12, 22, 23, 24, 25, 28) and the presence of 4 deciduous teeth (62, 63, 64, 65), on the mandible: an absence of all permanent teeth, with the exception of 36 and 46, and the remaining of 4 deciduous teeth (75, 73, 83, 84). The remaining of deciduous teeth and the presence of a very high inter-arch space led to opting for dental coverage so as to keep the deciduous teeth and a proper vertical dimension. The patient wished to solve his "problem" in the maxilla first, and is not wanting to undergo the extraction of his deciduous teeth. The following therapeutic proposal was adapted: On the maxilla, a three-step procedure: first step: building of metal copings on 13, 16 and 26 and metal-ceramic crowns on 11 and 21, second step: building of telescop crowns on 16 and 26 and clasps on 13, 11 and 21, third step: casting of the removable partial denture framework and soldering to the telescop crowns and clasps. On the mandible, a provisional restoration using a supra-dental resin removable partial denture with ceramic occlusal surfaces was adopted. The aesthetic and functional

  15. Model Pembelajaran Berbasis Penstimulasian Multiple Intelligences Siswa

    Directory of Open Access Journals (Sweden)

    Edy Legowo

    2017-03-01

    Full Text Available Tulisan ini membahas mengenai penerapan teori multiple intelligences dalam pembelajaran di sekolah. Pembahasan diawali dengan menguraikan perkembangan konsep inteligensi dan multiple intelligences. Diikuti dengan menjelaskan dampak teori multiple intelligences dalam bidang pendidikan dan pembelajaran di sekolah. Bagian selanjutnya menguraikan tentang implementasi teori multiple intelligences dalam praktik pembelajaran di kelas yaitu bagaimana pemberian pengalaman belajar siswa yang difasilitasi guru dapat menstimulasi multiple intelligences siswa. Evaluasi hasil belajar siswa dari pandangan penerapan teori multiple intelligences seharusnya dilakukan menggunakan authentic assessment dan portofolio yang lebih memfasilitasi para siswa mengungkapkan atau mengaktualisasikan hasil belajarnya melalui berbagai cara sesuai dengan kekuatan jenis inteligensinya.

  16. Multiplication modules over non-commutative rings

    International Nuclear Information System (INIS)

    Tuganbaev, A A

    2003-01-01

    It is proved that each submodule of a multiplication module over a regular ring is a multiplicative module. If A is a ring with commutative multiplication of right ideals, then each projective right ideal is a multiplicative module, and a finitely generated A-module M is a multiplicative module if and only if all its localizations with respect to maximal right ideals of A are cyclic modules over the corresponding localizations of A. In addition, several known results on multiplication modules over commutative rings are extended to modules over not necessarily commutative rings

  17. Cognitive Impairment in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Farnaz Etesam

    2014-01-01

    Full Text Available Cognitive impairment can emerge in the earliest phases of multiple sclerosis. It strongly impacts different aspects of Multiple Sclerosis (MS patients' lives, like employment, social relationships and the overall quality of life; thus, its on-time recognition and treatment is mandatory. This paper discusses issues, diagnostic methods and treatment options for cognitive dysfunctions in MS. This paper is a descriptive review of the related studies in the recent 10 years, performing a keyword search in the main databases4T. Cognitive impairment mostly involves aspects of information processing, memory and executive functioning in MS. Neuropsychological tests like MACFIMS and BRB-N are recommended for its assessment. Still, there is no fully efficient treatment for cognitive impairment. Researchers have shown some positive effects, using disease-modifying therapies and cognitive rehabilitation. Depression, pain, fatigue and other factors influencing cognitive functions must be paid attention to4T. Recognizing cognitive impairment as a major symptom for MS, makes studying this subject one of the priorities in dealing with the disease. Therefore, a consecutive research for identification and management of this part of quality of life in MS patients is obligatory4T.4T

  18. The Updated Multiple Star Catalog

    Science.gov (United States)

    Tokovinin, Andrei

    2018-03-01

    The catalog of hierarchical stellar systems with three or more components is an update of the original 1997 version. For 2000 hierarchies, the new Multiple Star Catalog (MSC) provides distances, component masses and periods, and supplementary information (astrometry, photometry, identifiers, orbits, notes). The MSC content and format are explained, and its incompleteness and strong observational selection are stressed. Nevertheless, the MSC can be used for statistical studies and is a valuable source for planning observations of multiple stars. Rare classes of stellar hierarchies found in the MSC (with six or seven components, extremely eccentric orbits, planar and possibly resonant orbits, hosting planets) are briefly presented. High-order hierarchies have smaller velocity dispersion compared to triples and are often associated with moving groups. The paper concludes with an analysis of the ratio of periods and separations between inner and outer subsystems. In wide hierarchies, the ratio of semimajor axes, estimated statistically, is distributed between 3 and 300, with no evidence of dynamically unstable systems.

  19. Endovascular interventions for multiple trauma

    International Nuclear Information System (INIS)

    Kinstner, C.; Funovics, M.

    2014-01-01

    In recent years interventional radiology has significantly changed the management of injured patients with multiple trauma. Currently nearly all vessels can be reached within a reasonably short time with the help of specially preshaped catheters and guide wires to achieve bleeding control of arterial und venous bleeding. Whereas bleeding control formerly required extensive open surgery, current interventional methods allow temporary vessel occlusion (occlusion balloons), permanent embolization and stenting. In injured patients with multiple trauma preinterventional procedural planning is performed with the help of multidetector computed tomography whenever possible. Interventional radiology not only allows minimization of therapeutic trauma but also a considerably shorter treatment time. Interventional bleeding control has developed into a standard method in the management of vascular trauma of the chest and abdomen as well as in vascular injuries of the upper and lower extremities when open surgical access is associated with increased risk. Additionally, pelvic trauma, vascular trauma of the superior thoracic aperture and parenchymal arterial lacerations of organs that can be at least partially preserved are primarily managed by interventional methods. In an interdisciplinary setting interventional radiology provides a safe and efficient means of rapid bleeding control in nearly all vascular territories in addition to open surgical access. (orig.) [de

  20. AVOCADO SEEDLINGS MULTIPLE STEMS PRODUCTION

    Directory of Open Access Journals (Sweden)

    MARCUS VINICIUS SANDOVAL PAIXÃO

    2016-01-01

    Full Text Available ABSTRACT This study aimed to evaluate the potential of multi-stems in avocado seeds according to their mass as well as the adventitious rooting of multi-stem budding with or without the use of auxin. The research was carried out at the Vegetation House of Federal Institute of Espírito Santo, Campus Santa Teresa -ES, with seeds of different masses: 100 g, in which each experimental unit was made of five seeds, distributed within five repetitions, under a completely randomized design. The seeds were put to germinate and the percentage number of emergence and multiple stems were evaluated. After 150 days, the following evaluations were carried out: survival of rooted cuttings; number of leaves; stem diameter; root length; root volume; root and shoot fresh mass; root and shoot dry mass; shoot height; absolute growth and shoot growth rate; shoot dry weight/root dry mass ratio; shoot height/stem diameter ratio; shoot height/root length and Dickson's quality index ratio. Avocado seeds with mass over 100 g and between 81-100 g presented higher percentage of multiple stems. Rods over 20 cm that were not treated with IBA (indole-3-butyric acid resulted on avocado plants of better quality. The use of IBA (2000 mg L-1 does not affect the rooting and growth of avocado's multi-stem plants.

  1. Hemibody irradiation in multiple myeloma

    International Nuclear Information System (INIS)

    Tobias, J.S.; Richards, J.D.M.; Blackman, G.M.; Joannides, T.; Trask, C.W.L.; Nathan, J.I.

    1985-01-01

    Eighteen patients with multiple myeloma were treated by hemibody irradiation using large single fractions, usually to a dose of 10 Gy (lower half) and 7.5 GY (upper half). All except one patient had previously been treated by multiple courses of conventional chemotherapy with melphalan and prednisone, and were considered to be resistant to further chemotherapy. In most cases, local field irradiation had also been given for symptomatic bone pain. Of the 13 patients who had symptoms at the start of hemibody irradiation, 11 improved sufficiently for their analgesia requirement to be reduced. In eight patients, there was a significant fall in circulating immunoglobulin but no patient with Bence-Jones proteinuria had complete resolution of this biochemical abnormality. Although thrombocytopenia and neutropenia were common, only two patients required platelet transfusion and the treatment was in general extremely well tolerated. Survival following hemibody irradiation was similar to the survival reported from the use of 'second-line' chemotherapy and we feel that hemibody irradiation is a more acceptable alternative for most patients. (orig.)

  2. Multiple scroll wave chimera states

    Science.gov (United States)

    Maistrenko, Volodymyr; Sudakov, Oleksandr; Osiv, Oleksiy; Maistrenko, Yuri

    2017-06-01

    We report the appearance of three-dimensional (3D) multiheaded chimera states that display cascades of self-organized spatiotemporal patterns of coexisting coherence and incoherence. We demonstrate that the number of incoherent chimera domains can grow additively under appropriate variations of the system parameters generating thereby head-adding cascades of the scroll wave chimeras. The phenomenon is derived for the Kuramoto model of N 3 identical phase oscillators placed in the unit 3D cube with periodic boundary conditions, parameters being the coupling radius r and phase lag α. To obtain the multiheaded chimeras, we perform the so-called `cloning procedure' as follows: choose a sample single-headed 3D chimera state, make appropriate scale transformation, and put some number of copies of them into the unit cube. After that, start numerical simulations with slightly perturbed initial conditions and continue them for a sufficiently long time to confirm or reject the state existence and stability. In this way it is found, that multiple scroll wave chimeras including those with incoherent rolls, Hopf links and trefoil knots admit this sort of multiheaded regeneration. On the other hand, multiple 3D chimeras without spiral rotations, like coherent and incoherent balls, tubes, crosses, and layers appear to be unstable and are destroyed rather fast even for arbitrarily small initial perturbations.

  3. Targeted therapy of multiple myeloma.

    Science.gov (United States)

    Dolloff, Nathan G; Talamo, Giampaolo

    2013-01-01

    Multiple myeloma (MM) is a plasma cell malignancy and the second most common hematologic cancer. MM is characterized by the accumulation of malignant plasma cells within the bone marrow, and presents clinically with a broad range of symptoms, including hypercalcemia, renal insufficiency, anemia, and lytic bone lesions. MM is a heterogeneous disease associated with genomic instability, where patients may express multiple genetic abnormalities that affect several oncogenic pathways. Commonly detected genetic aberrations are translocations involving immunoglobulin heavy chain (IgH) switch regions (chromosome 14q32) and oncogenes such as c-maf [t(14:16)], cyclin D1 [t(11:14)], and FGFR3/MMSET [t(4:14)]. Advances in the basic understanding of MM and the development of novel agents, such as the immunomodulatory drugs (IMiDs) thalidomide and lenalidomide and the proteasome inhibitor bortezomib, have increased therapeutic response rates and prolonged patient survival. Despite these advances MM remains incurable in the majority of patients, and it is therefore critical to identify additional therapeutic strategies and targets for its treatment. In this chapter, we review the underlying genetic components of MM and discuss the results of recent clinical trials that demonstrate the effectiveness of targeted agents in the management of MM. In addition, we discuss experimental therapies that are currently in clinical development along with their molecular rationale in the treatment of MM.

  4. Superclusters and hadronic multiplicity distributions

    International Nuclear Information System (INIS)

    Shih, C.C.; Carruthers, P.

    1986-01-01

    The multiplicity distribution is expressed in terms of supercluster production in hadronic processes at high energy. This process creates unstable clusters at intermediate stages and hadrons in final stage. It includes Poisson-transform distributions (with the partially coherent distribution as a special case) and is very flexible for phenomenological analyses. The associated Koba, Nielson, and Olesen limit and the behavior of cumulant moments are analyzed in detail for finite and/or infinite cluster size and particle size per cluster. In general, a supercluster distribution does not need to be equivalent to a negative binomial distribution to fit experimental data well. Furthermore, the requirement of such equivalence leads to many solutions, in which the average size of the cluster is not logarithmic: e.g., it may show a power behavior instead. Superclustering is defined as a two-or multi-stage process underlying observed global multiplicity distributions. At the first stage of the production process, individual clusters are produced according to a given statistical law. For example, the clustering distribution may be described by partially coherent (oreven sub-Poissonian distribution models. At the second stage, the clusters are considered as the sources of particle production. The corresponding distribution may then be as general as the clustering distribution just mentioned. 8 refs

  5. MULTIPLE ECH LAUNCHER CONTROL SYSTEM

    International Nuclear Information System (INIS)

    GREEN, M.T.; PONCE, D.; GRUNLOH, H.J.; ELLIS, R.A.; GROSNICKLE, W.H.; HUMPHREY, R.L.

    2004-03-01

    OAK-B135 The addition of new, high power gyrotrons to the heating and current drive arsenal at DIII-D, required a system upgrade for control of fully steerable ECH Launchers. Each launcher contains two pointing mirrors with two degrees of mechanical freedom. The two flavors of motion are called facet and tilt. Therefore up to four channels of motion per launcher need to be controlled. The system utilizes absolute encoders to indicate mirror position and therefore direction of the microwave beam. The launcher movement is primarily controlled by PLC, but future iterations of design, may require this control to be accomplished by a CPU on fast bus such as Compact PCI. This will be necessary to accomplish real time position control. Safety of equipment and personnel is of primary importance when controlling a system of moving parts. Therefore multiple interlocks and fault status enunciators have been implemented. This paper addresses the design of a Multiple ECH Launcher Control System, and characterizes the flexibility needed to upgrade to a real time position control system in the future

  6. The diagnosis of multiple sclerosis

    International Nuclear Information System (INIS)

    Sanders, E.A.C.M.

    1982-01-01

    This thesis describes recently developed research methods for the diagnosis of multiple sclerosis. In Chapter X the use of the CT-scan in the detection of hemispheral or cerebellar lesions is discussed. In chapter XIII the results of the application of all methods to a group of 89 patients with definite, probable or possible multiple sclerosis and to a group of 25 purely optic neuritis patients are presented. With the aid of the CT-scan, hypo- or hyperdense areas in the white matter of the cerebral hemispheres were found in 52% of the 114 patients. Most reports ascribe these lesions to demyelinating cerebral plaques. The CT-scan showed no cerebellar or brainstem lesions. The CT-scan is independent of the duration of, and degree of incapacitation due to, the disease and can be helpful in giving a definite diagnosis in an early stage of the disease. The CT-scan will always play an important role for the differential diagnosis. (Auth.)

  7. Multiple-mirror plasma confinement

    International Nuclear Information System (INIS)

    Lichtenberg, A.J.; Lieberman, M.A.; Logan, B.G.

    1975-01-01

    A large enhancement of the confinement time can be achieved in a straight system of multiple mirrors over an equal length uniform magnetic field. The scaling is diffusive rather than that of flow, thereby scaling the square of the system length rather than linear with system length. Probably the most economic mode of operation for a reactor occurs when lambda/M is approximately l/sub c/, where lambda is the mean free path, M the mirror ratio, and l/sub c/ the length between mirrors; but where the scale length of the mirror field l/sub m/ is much less than lambda. The axial confinement time has been calculated theoretically and numerically for all important parameter regimes, and confirmed experimentally. A typical reactor calculation gives Q/sub E/ = 2 for a 400 meter system with 3000 MW(e) output. The main concern of a multiple-mirror system is stability. Linked quadrupoles can achieve average minimum-B stabilization of flute modes, and experiments have demonstrated this stabilization. Localized instabilities at finite β and enhanced diffusion resulting from the distorted flux surfaces and possibly from turbulent higher order modes still remain to be investigated

  8. Multiple Ships and Multiple Media: A Flexible Telepresence Program

    Science.gov (United States)

    Pelz, M.; Hoeberechts, M.; Riddell, D. J.; Ewing, N.

    2016-02-01

    Ocean Networks Canada (ONC) uses a number of research and exploration vessels equipped with remotely operated vehicles (ROVs) to maintain the NEPTUNE and VENUS cabled ocean observatories off the west coast of British Columbia, Canada. Maintenance expeditions range from several days to multiple weeks and encompass a range of activities including deploying new instruments, laying cable, recovering platforms, scientific sampling and conducting multibeam and visual surveys. In order to engage the widest possible participation in at-sea work, ONC uses telepresence technology to communicate from ship to shore and back with scientists, students, teachers and online viewers. In this presentation, we explore the challenge of designing a sustainable and flexible telepresence program which can be supported across multiple ship and ROV platforms, sometimes simultaneously. To meet outreach and education objectives, onboard educators conduct presentations to K-12 and post-secondary classrooms, museums and science centres on a daily basis. Online commentary by the educators, dive chief and ROV pilots accompanies the ROV dive footage and is streamed online 24/7 during underwater operations. Sharing the sights and sounds of the expeditions with students and educators ashore, including those in remote and inland communities, creates a unique learning environment for both formal and informal education audiences. As space is always a limiting factor on expeditions, the use of telepresence and other communication media enables ONC to simultaneously achieve engineering and science priorities at sea while communicating the successes and challenges of the expedition back to shore. Scientists and engineers provide guidance for operations from shore using a variety of communication technologies. We give examples from Ocean Networks Canada's most recent expedition, Fall 2015, which involved co-ordinated operations with three vessels - the R/V Thompson, the E/V Nautilus and the C/S Wave

  9. Multiple embryos, multiple nepionts and multiple equatorial layers in Cycloclypeus carpenteri.

    Science.gov (United States)

    Briguglio, Antonino; Kinoshita, Shunichi; Wolfgring, Erik; Hohenegger, Johann

    2016-04-01

    In this study, 17 specimens of Cycloclypeus carpenteri have been analyzed by means of microCT scanning. We used CT scanning technique as it enables the visualization and the quantifications of internal structures of hollow specimens without their destruction. It has been observed that many specimens possessing the natural morphology of this taxon, actually contain multiple embryos (up to 16 in one single specimen) and, in some few cases, multiple nepionts each with its own heterosteginid chambers (up to three separated nepionts). The diameter of each proloculus has been measured, and as a result, they are very variable even within the same specimen, therefore questioning the long known theory that schizonts have smaller proloculi than gamonts and also questioning the fact that proloculi in the same species should all have comparable size. Furthermore, we have observed the presence of additional equatorial planes on several specimens. Such additional planes are always connected to what seems to be the main equatorial plane. Such connections are T-shaped and are located at the junction between two equatorial layers; these junctions are made by a chamberlet, which possesses an unusually higher number of apertures. The connections between equatorial planes are always perfectly synchronized with the relative growth step and the same chamber can be therefore followed along the multiple equatorial planes. Apparently there is a perfect geometric relationship between the creation of additional equatorial planes and the position of the nepionts. Whenever the nepionts are positioned on different planes, additional planes are created and the angle of the nepionts is related to the banding angle of the equatorial planes. The presence of additional planes do not hamper the life of the cell, on the contrary, it seems that the cell is still able to build nicely shaped chamberlets and, after volumetric calculations, it seems all specimens managed to keep their logistic growth

  10. Multiple intracranial hydatid cysts: MR findings

    International Nuclear Information System (INIS)

    Pumar, J.; Alvarez, M.; Leira, R.; Prieto, J.M.; Arrojo, L.; Pereira, J.; Vidal, J.

    1992-01-01

    Multiple intracranial hydatid cysts are uncommon and usually localized in the supratentorial compartment. We report a case studied by CT and MR of multiple intracranial hydatid cysts scattered in various anatomic sites: supratentorial, infratentorial and also intraventricular. (orig.)

  11. Multiple Sclerosis: Can It Cause Seizures?

    Science.gov (United States)

    ... multiple sclerosis and epilepsy? Answers from B Mark Keegan, M.D. Epileptic seizures are more common in ... controlled with anti-seizure medication. With B Mark Keegan, M.D. Lund C, et al. Multiple sclerosis ...

  12. On Utmost Multiplicity of Hierarchical Stellar Systems

    Directory of Open Access Journals (Sweden)

    Gebrehiwot Y. M.

    2016-12-01

    Full Text Available According to theoretical considerations, multiplicity of hierarchical stellar systems can reach, depending on masses and orbital parameters, several hundred, while observational data confirm the existence of at most septuple (seven-component systems. In this study, we cross-match the stellar systems of very high multiplicity (six and more components in modern catalogues of visual double and multiple stars to find among them the candidates to hierarchical systems. After cross-matching the catalogues of closer binaries (eclipsing, spectroscopic, etc., some of their components were found to be binary/multiple themselves, what increases the system's degree of multiplicity. Optical pairs, known from literature or filtered by the authors, were flagged and excluded from the statistics. We compiled a list of hierarchical systems with potentially very high multiplicity that contains ten objects. Their multiplicity does not exceed 12, and we discuss a number of ways to explain the lack of extremely high multiplicity systems.

  13. Multiplicity distributions in inelastic reactions on nuclei

    CERN Document Server

    Caneschi, L; Schwimmer, A

    1976-01-01

    The multiplicity distribution of the number of knocked-out nucleons and the correlation of the former with the multiplicity of the produced mesons, in inelastic particle-nucleus scattering, are computed.

  14. Emotional Disorders in People with Multiple Sclerosis

    Science.gov (United States)

    ... Evidence-based Guideline for PATIENTS and their FAMILIES EMOTIONAL DISORDERS IN PEOPLE WITH MULTIPLE SCLEROSIS This fact sheet presents the current research on emotional disorders in multiple sclerosis (MS) and summarizes the ...

  15. Treatment of Cognitive Impairment in Multiple Sclerosis

    OpenAIRE

    Pierson, Susan H.; Griffith, Nathan

    2006-01-01

    Cognitive impairment in multiple sclerosis is an increasingly recognized entity. This article reviews the cognitive impairment of multiple sclerosis, its prevalence, its relationship to different types of multiple sclerosis, and its contribution to long-term functional prognosis. The discussion also focuses on the key elements of cognitive dysfunction in multiple sclerosis which distinguish it from other forms of cognitive impairment. Therapeutic interventions potentially effective for the co...

  16. Multicentric malignant transformation of multiple exostoses

    International Nuclear Information System (INIS)

    Ozaki, T.; Hillmann, A.; Winkelmann, W.; Blasius, S.; Link, T.

    1998-01-01

    We treated a patient with large multiple chondrosarcomas derived from multiple cartilaginous exostoses. One sarcoma originated in the left pubic bone and the other sarcoma in the posterior aspect of the greater trochanter of the left femur. Thirty months after hindquarter amputation, the patient is alive without relapse. This is the first report of a patient with synchronous multiple malignant transformation of multiple cartilaginous exostoses. (orig.)

  17. Spatial photon correlations in multiple scattering media

    DEFF Research Database (Denmark)

    Smolka, Stephan; Muskens, O.; Lagendijk, A.

    2010-01-01

    We present the first angle-resolved measurements of spatial photon correlations that are induced by multiple scattering of light. The correlation relates multiple scattered photons at different spatial positions and depends on incident photon fluctuations.......We present the first angle-resolved measurements of spatial photon correlations that are induced by multiple scattering of light. The correlation relates multiple scattered photons at different spatial positions and depends on incident photon fluctuations....

  18. Human Supervision of Multiple Autonomous Vehicles

    Science.gov (United States)

    2013-03-22

    AFRL-RH-WP-TR-2013-0143 HUMAN SUPERVISION OF MULTIPLE AUTONOMOUS VEHICLES Heath A. Ruff Ball...REPORT TYPE Interim 3. DATES COVERED (From – To) 09-16-08 – 03-22-13 4. TITLE AND SUBTITLE HUMAN SUPERVISION OF MULTIPLE AUTONOMOUS VEHICLES 5a...Supervision of Multiple Autonomous Vehicles To support the vision of a system that enables a single operator to control multiple next-generation

  19. Multiple-stage integrating accelerometer

    International Nuclear Information System (INIS)

    Devaney, H.F.

    1986-01-01

    An accelerometer assembly is described for use in activating a switch or the like responding to multiple acceleration pulses in series, comprising: a housing forming a chamber having a first and second end; a mass slidably disposed in the chamber and movable during acceleration from the first end toward the second end; means for biasing the movable mass toward a reset position adjacent the first end; means for damping the movement of the mass in the chamber; cam and follower means carried by the movable mass and the housing for relative movement in response to the acceleration, the cam and follower means including means for temporarily blocking the mass movement toward the second end after a first acceleration pulse; the cam and follower means cooperating together to allow continued movement toward the second end and switch activation in response to at least a second separate acceleration pulse in series with the first

  20. Multiplication circuit for particle identification

    International Nuclear Information System (INIS)

    Gerlier, Jean

    1962-01-01

    After having commented some characteristics of the particles present in a cyclotron, and their interactions, this report addresses the development and the implementation of a method and a device for selecting and counting particles. The author presents the principle and existing techniques of selection. In comparison with an existing device, the proportional counter and the scintillator are replaced by junctions: a surface barrier type junction (a silicon N layer with a very thin oxygen layer playing the role of the P layer), and lithium-based junction (a silicon P type layer made intrinsic by migration of lithium). The author then describes the developed circuit and assembly (background of the choice of a multiplication circuit), and their operation. In the next part, he presents the performed tests and discuses the obtained results. He finally outlines the benefits of the herein presented circuit [fr