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Sample records for proximal canalicular obstruction

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

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    Nikolaos Trakos

    2009-11-01

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

  2. Nonsurgical Fluoroscopically Guided Dacryocystoplasty of Common Canalicular Obstructions

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    Wilhelm, Kai E; Hofer, Ulrich; Textor, Hans J [Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Boeker, Thorsten [Department of Ophthalmology, University Hospital Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Strunk, Holger; Schild, Hans H [Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany)

    2000-01-15

    Purpose: To assess dacryocystoplasty in the treatment of epiphora due to obstructions of the common canaliculus.Methods: Twenty patients with severe epiphora due to partial (n = 16) or complete (n = 4) obstruction of the common canaliculus underwent fluoroscopically guided dacryocystoplasty. In all cases of incomplete obstruction balloon dilation was performed. Stent implantation was attempted in cases with complete obstruction. Dacryocystography and clinical follow-up was performed at intervals of 1 week, and 3, 6, 12, and 18 months after the procedure. The mean follow-up was 6 months (range 3-18 months).Results: Balloon dilation was technically successfully performed in all patients with incomplete obstructions (n = 16). In three of four patients with complete obstruction stent implantation was performed successfully. Subsequent to failure of stent implantation in one of these patients balloon dilation was performed instead. The long-term primary patency rate in patients with incomplete obstructions was 88% (n = 14/16). In three of four cases with complete obstruction long-term patency was achieved during follow-up. Severe complications, infections, or punctal splitting were not observed.Conclusion: Fluoroscopically guided balloon dacryocystoplasty is a feasible nonsurgical therapy in canalicular obstructions with good clinical results that may be used as an alternative to surgical procedures. In patients with complete obstructions stent placement is possible but further investigations are needed to assess the procedural and long-term results.

  3. Nonsurgical Fluoroscopically Guided Dacryocystoplasty of Common Canalicular Obstructions

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    Wilhelm, Kai E.; Hofer, Ulrich; Textor, Hans J.; Boeker, Thorsten; Strunk, Holger; Schild, Hans H.

    2000-01-01

    Purpose: To assess dacryocystoplasty in the treatment of epiphora due to obstructions of the common canaliculus.Methods: Twenty patients with severe epiphora due to partial (n = 16) or complete (n = 4) obstruction of the common canaliculus underwent fluoroscopically guided dacryocystoplasty. In all cases of incomplete obstruction balloon dilation was performed. Stent implantation was attempted in cases with complete obstruction. Dacryocystography and clinical follow-up was performed at intervals of 1 week, and 3, 6, 12, and 18 months after the procedure. The mean follow-up was 6 months (range 3-18 months).Results: Balloon dilation was technically successfully performed in all patients with incomplete obstructions (n = 16). In three of four patients with complete obstruction stent implantation was performed successfully. Subsequent to failure of stent implantation in one of these patients balloon dilation was performed instead. The long-term primary patency rate in patients with incomplete obstructions was 88% (n = 14/16). In three of four cases with complete obstruction long-term patency was achieved during follow-up. Severe complications, infections, or punctal splitting were not observed.Conclusion: Fluoroscopically guided balloon dacryocystoplasty is a feasible nonsurgical therapy in canalicular obstructions with good clinical results that may be used as an alternative to surgical procedures. In patients with complete obstructions stent placement is possible but further investigations are needed to assess the procedural and long-term results

  4. Endoscopic Endonasal Dacryocystorhinostomy Combined with Canaliculus Repair for the Management of Dacryocystitis with Canalicular Obstruction

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    Yunhai Tu

    2015-01-01

    Full Text Available Purpose. The aim of this study is to propose a simple and efficient combination surgery for the management of dacryocystitis with canalicular obstruction. Methods. A retrospective noncomparative case series of dacryocystitis with canalicular obstruction has been studied. Twelve patients with dacryocystitis and canalicular obstruction underwent a conventional endoscopic endonasal dacryocystorhinostomy (EE-DCR combined with a modified canalicular repair. Postoperative observations included slit lamp, fluorescein dye disappearance test, lacrimal syringing, lacrimal endoscopy, and nasal endoscopy. Results. After 6–18 months of postoperative follow-up, the symptoms of epiphora and mucopurulent discharge disappeared completely in 10 patients, and occasional or intermittent epiphora remained in 2 patients. All of the twelve patients showed an opened intranasal ostium and normal fluorescein dye disappearance test. Patent bicanalicular irrigation was achieved in 9 patients. One patient had a partial and the other two had a complete reobstruction by lacrimal irrigation to their repaired lower canaliculus; however, all of them had a patent lacrimal irrigation to upper canaliculus. The functional success rate for the combination surgery is 83% (10/12, and anatomical success rate is 75% (9/12. Conclusion. EE-DCR combined with modified canalicular repair is a simple and efficient method for the management of dacryocystitis with canalicular obstruction.

  5. Rail roading technique for intubation of the canaliculi with sutupak in cases of common canalicular duct obstruction.

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    Sahdev, S; Motwane, S

    1991-01-01

    A variety of methods and materials have been used for the treatment of the problems relating to the canalicular system. An insight into the rail roading technique for intubation of the canaliculi with sutupak in cases of common canalicular duct obstruction is presented here. About 30 patients with block at the common canalicular duct, which was detected by dacryocystography were operated for dacryocystorhinostomy with intubation of both the canaliculi with sutupak No. 0 by rail roading technique with good results.

  6. Rail roading technique for intubation of the canaliculi with sutupak in cases of common canalicular duct obstruction

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    Sahdev Saroj

    1991-01-01

    Full Text Available A variety of methods and materials have been used for the treatment of the problems relating to the canalicular system. An insight into the rail roading technique for intubation of the canaliculi with sutupak in cases of common canalicular duct obstruction is presented here. About 30 patients with block at the common canalicular duct, which was detected by dacryocystography were operated for dacryocystorhinostomy with intubation of both the canaliculi with sutupak No. 0 by rail roading technique with good results.

  7. Biliary obstruction dissipates bioelectric sinusoidal-canalicular barrier without altering taurocholate uptake

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    Cotting, J.; Zysset, T.; Reichen, J.

    1989-01-01

    To study immediate events during extrahepatic cholestasis, we investigated the effect of short-term biliary obstruction on the bioelectrical sinusoidal-canalicular barrier in the rat using molecular weight-matched uncharged and negatively charged inert solute pairs. The bioelectrical barrier averaged -22 +/- 5 and -18 +/- 4 mV (NS) using the pair carboxy-/methoxyinulin and ferrocyanide/sucrose, respectively. After a 20-min biliary obstruction both decreased by 61 and 11%, respectively, but only the large molecular weight pair (the inulins) returned to base line after release of the obstruction. Inert solute clearances were increased after short biliary obstruction depending on molecular size and negative charge (ferrocyanide greater than sucrose greater than carboxyinulin greater than inulin), suggesting that both permeability and bioelectrical barriers were affected by obstruction. The hepatic extraction in vivo of a passively transported drug not excreted into bile (D-propranolol) was not affected by obstruction, whereas that of an actively transported drug (glycocholate) decreased from 66 +/- 8 to 41 +/- 20% during biliary obstruction (P less than 0.01). Unidirectional transfer of glycocholate was not affected by short-term biliary obstruction in the situ perfused rat liver; however, 2 min after [14C]glycocholate administration, increased return was observed in hepatic venous effluent in obstructed animals. Our findings demonstrate a loss of the bioelectrical barrier immediately after short-term biliary obstruction. Decreased hepatic extraction in the view of unaltered sinusoidal uptake demonstrates regurgitation of bile into blood during short-term biliary obstruction

  8. Movement of the lacrimal canalicular wall under intracanalicular pressure changes observed with dacryoendoscopy.

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    Kakizaki, Hirohiko; Takahashi, Yasuhiro; Mito, Hidenori; Nakamura, Yasuhisa

    2015-01-01

    Movement of the lacrimal canalicular wall has been speculated to occur during blinking. Movement of the common internal ostium has been observed under nasal endoscopy, and pressure changes in the lacrimal canalicular cavity have been observed with a pressure sensor; however, lacrimal canalicular wall movement under pressure changes has not been observed. To examine movement of the lacrimal canalicular wall under intracanalicular pressure changes using dacryoendoscopy. The authors examined 20 obstruction-free lacrimal canaliculi in 10 patients. A dacryoendoscope was inserted, and water was poured into the intracanalicular cavity via the dacryoendoscope's water channel. The water was then poured or suctioned to cause positive or negative pressure changes in the intracanalicular cavity, and movement of the lacrimal canalicular wall was examined. The lacrimal canalicular wall moved flexibly with pressure changes. Under positive pressure, the intracanalicular cavity was dilated; however, it narrowed under negative pressure. The extent of movement was more dramatic in the common canalicular portion than the proximal canalicular portion. Intracanalicular pressure changes cause movement of the lacrimal canalicular wall. There was a consistent relationship between intracanalicular cavity changes and pressure changes, possibly contributing to lacrimal drainage of the canaliculus.

  9. Radiologic fallopian tube catheterization for diagnosis and treatment of proximal tubal obstruction

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    Thurmond, A.S.; Rosch, J.

    1988-01-01

    Seventy-five infertile women in whom proximal fallopian tube obstruction had been demonstrated by conventional hysterosalpingography were managed by means of fluoroscopic transcervical fallopian tube catheterization techniques. The procedure helped avoid surgery for diagnosis and/or treatment of proximal tubal obstruction in 71 women (95%). In 32 patients who had patent tube(s) following the procedure, 15 pregnancies have occurred, 14 intrauterine and one tubal (follow-up, 6 months). Fifteen patients had follow-up studies after recanalization, and 19 of 23 tubes remained patent (83%). Fluoroscopic fallopian tube catheterization improves diagnosis of fallopian tube disease and is a low-cost, nonsurgical treatment for infertility caused by proximal fallopian tube obstruction

  10. Impedance Changes Indicate Proximal Ventriculoperitoneal Shunt Obstruction In Vitro.

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    Basati, Sukhraaj; Tangen, Kevin; Hsu, Ying; Lin, Hanna; Frim, David; Linninger, Andreas

    2015-12-01

    Extracranial cerebrospinal fluid (CSF) shunt obstruction is one of the most important problems in hydrocephalus patient management. Despite ongoing research into better shunt design, robust and reliable detection of shunt malfunction remains elusive. The authors present a novel method of correlating degree of tissue ingrowth into ventricular CSF drainage catheters with internal electrical impedance. The impedance based sensor is able to continuously monitor shunt patency using intraluminal electrodes. Prototype obstruction sensors were fabricated for in-vitro analysis of cellular ingrowth into a shunt under static and dynamic flow conditions. Primary astrocyte cell lines and C6 glioma cells were allowed to proliferate up to 7 days within a shunt catheter and the impedance waveform was observed. During cell ingrowth a significant change in the peak-to-peak voltage signal as well as the root-mean-square voltage level was observed, allowing the impedance sensor to potentially anticipate shunt malfunction long before it affects fluid drainage. Finite element modeling was employed to demonstrate that the electrical signal used to monitor tissue ingrowth is contained inside the catheter lumen and does not endanger tissue surrounding the shunt. These results may herald the development of "next generation" shunt technology that allows prediction of malfunction before it affects patient outcome.

  11. Self-expandable metal stent placement versus emergency resection for malignant proximal colon obstructions

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    Amelung, F.J.; Draaisma, W.A.; Consten, E.C.; Siersema, P.D.; Borg, F. ter

    2017-01-01

    BACKGROUND: Traditionally, all patients with a malignant obstruction of the proximal colon (MOPC) are treated with emergency resection. However, recent data suggest that Self-expandable metallic stent (SEMS) placement could lower mortality and morbidity rates. This study therefore aimed to compare

  12. Impact of proximity of thermoelectric power plants on bronchial obstructive crisis rates

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    Tamara Ugarte-Avilés

    2017-01-01

    Full Text Available Abstract Background Environmental pollution is a risk factor for cardiorespiratory diseases. Energy generated by thermoelectric power plants (TEPP represents a relevant source of pollution. The aim of this study was to evaluate the relationship between living near a coal-fired TEPP and the consultation rates for bronchial obstructive crises (BOC in the province of Concepción, Chile. Methods Population-based study. The epidemiological weeks from 2012 to 2014 were analyzed. The dependent variable was the emergency consultation rate for BOC in two health centers within 5 km of a TEPP (Coronel and two that were more than 40 Km away from a TEPP (Talcahuano. The independent variables were the commune, climatological variables (air temperature and relative atmospheric humidity, environmental pollutants (PM10, PM2.5 and nitrogen oxide, weeks with the highest consultation rate and the years. Rates, Pearson’s correlation and gross risk measures were calculated and adjusted for environmental and climatological variables. Results BOC rates were significantly higher in Coronel (RR = 4.9 95% CI 4.0–5.8; p < 0.05. The PM2.5 it showed the strongest correlation with BOC rates (r = 0.3; p < 0.01 in Coronel, but not Talcahuano. Linear regression modelling indicated that proximity to a TEPP (health center location and temperature explained 26 and 18% of the variance in BOC rates, respectively. Conclusions Rates of emergency consultation for BOC were significantly higher among a population living within 5 km of a coal-fired TEPP than those living 40 km away.

  13. Proximal and distal gastro-oesophageal reflux in chronic obstructive pulmonary disease and bronchiectasis.

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    Lee, Annemarie L; Button, Brenda M; Denehy, Linda; Roberts, Stuart J; Bamford, Tiffany L; Ellis, Samantha J; Mu, Fi-Tjen; Heine, Ralf G; Stirling, Robert G; Wilson, John W

    2014-02-01

    The aims of this observational study were (i) to examine the prevalence of symptomatic and clinically silent proximal and distal gastro-oesophageal reflux (GOR) in adults with chronic obstructive pulmonary disease (COPD) or bronchiectasis, (ii) the presence of gastric aspiration, and (iii) to explore the possible clinical significance of this comorbidity in these conditions. Twenty-seven participants with COPD, 27 with bronchiectasis and 17 control subjects completed reflux symptom evaluation and dual-channel 24 h oesophageal pH monitoring. In those with lung disease, pepsin levels in sputum samples were measured using enzyme-linked immunosorbent assay, with disease severity (lung function and high-resolution computed tomography) also measured. The prevalence of GOR in COPD was 37%, in bronchiectasis was 40% and in control subjects was 18% (P = 0.005). Of those diagnosed with GOR, clinically silent reflux was detected in 20% of participants with COPD and 42% with bronchiectasis. While pepsin was found in 33% of COPD and 26% of bronchiectasis participants, the presence of pepsin in sputum was not related to a diagnosis of GOR based on oesophageal pH monitoring in either condition. Neither a diagnosis of GOR nor the presence of pepsin was associated with increased severity of lung disease in COPD or bronchiectasis. The prevalence of GOR in COPD or bronchiectasis is twice that of the control population, and the diagnosis could not be based on symptoms alone. Pepsin was detected in sputum in COPD and bronchiectasis, suggesting a possible role of pulmonary aspiration, which requires further exploration. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

  14. Radiologic Placement of Uncovered Stents for the Treatment of Malignant Colonic Obstruction Proximal to the Descending Colon

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    Yoon, Jehong; Kwon, Se Hwan, E-mail: Kwon98@khu.ac.kr [Kyung Hee University, Department of Radiology, College of Medicine (Korea, Republic of); Lee, Chang-Kyun [Kyung Hee University, Department of Internal Medicine, College of Medicine (Korea, Republic of); Park, Sun Jin [Kyung Hee University, Department of Surgery, College of Medicine (Korea, Republic of); Oh, Ji Young [Kyung Hee University Hospital at Gangdong, Department of Radiology (Korea, Republic of); Oh, Joo Hyeong [Kyung Hee University, Department of Radiology, College of Medicine (Korea, Republic of)

    2017-01-15

    PurposeTo evaluate the safety, feasibility, and patency rates of radiologic placement of uncovered stents for the treatment of malignant colonic obstruction proximal to the descending colon.Materials and MethodsThis was a retrospective, single-center study. From May 2003 to March 2015, 53 image-guided placements of uncovered stents (44 initial placements, 9 secondary placements) were attempted in 44 patients (male:female = 23:21; mean age, 71.8 years). The technical and clinical success, complication rates, and patency rates of the stents were also evaluated. Technical success was defined as the successful deployment of the stent under fluoroscopic guidance alone and clinical success was defined as the relief of obstructive symptoms or signs within 48 h of stent deployment.ResultsIn total, 12 (27.3 %) patients underwent preoperative decompression, while 32 (72.7 %) underwent decompression with palliative intent. The technical success rate was 93.2 % (41/44) for initial placement and 88.9 % (8/9) for secondary placement. Secondary stent placement in the palliative group was required in nine patients after successful initial stent placement due to stent obstruction from tumor ingrowth (n = 7) and stent migration (n = 2). The symptoms of obstruction were relieved in all successful cases (100 %). In the palliative group, the patency rates were 94.4 % at 1 month, 84.0 % at 3 months, 64.8 % at 6 months, and 48.6 % at 12 months.ConclusionsThe radiologic placement of uncovered stents for the treatment of malignant obstruction proximal to the descending colon is feasible and safe, and provides acceptable clinical results.

  15. Lacunar-canalicular network in femoral cortical bone is reduced in aged women and is predominantly due to a loss of canalicular porosity

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    A.M. Ashique

    2017-12-01

    Full Text Available The lacunar-canalicular network (LCN of bone contains osteocytes and their dendritic extensions, which allow for intercellular communication, and are believed to serve as the mechanosensors that coordinate the processes of bone modeling and remodeling. Imbalances in remodeling, for example, are linked to bone disease, including fragility associated with aging. We have reported that there is a reduction in scale for one component of the LCN, osteocyte lacunar volume, across the human lifespan in females. In the present study, we explore the hypothesis that canalicular porosity also declines with age. To visualize the LCN and to determine how its components are altered with aging, we examined samples from young (age: 20–23 y; n = 5 and aged (age: 70–86 y; n = 6 healthy women donors utilizing a fluorescent labelling technique in combination with confocal laser scanning microscopy. A large cross-sectional area of cortical bone spanning the endosteal to periosteal surfaces from the anterior proximal femoral shaft was examined in order to account for potential trans-cortical variation in the LCN. Overall, we found that LCN areal fraction was reduced by 40.6% in the samples from aged women. This reduction was due, in part, to a reduction in lacunar density (21.4% decline in lacunae number per given area of bone, but much more so due to a 44.6% decline in canalicular areal fraction. While the areal fraction of larger vascular canals was higher in endosteal vs. periosteal regions for both age groups, no regional differences were observed in the areal fractions of the LCN and its components for either age group. Our data indicate that the LCN is diminished in aged women, and is largely due to a decline in the canalicular areal fraction, and that, unlike vascular canal porosity, this diminished LCN is uniform across the cortex.

  16. Canalicular adenoma: A rare case report

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    Swati Phore

    2018-01-01

    Full Text Available Canalicular adenomas (CAs are uncommon benign salivary gland neoplasms of the oral cavity. They are typically located on the upper lip, buccal mucosa, and infrequently found on the palate and derived from minor salivary glands. Due to benign character of the tumor, CAs rarely present with bone erosion. Histologically, trabecular type of basal cell adenoma, pleomorphic adenoma, and polymorphous low-grade adenocarcinoma should be discriminated from CAs. A-36-year-old female patient with CA was presented. The lesion was managed surgically under local anesthesia, and 2 months follow-up was uneventful.

  17. The Efficacy of the Coaxial Technique Using a 6-Fr Introducer Sheath in Stent Placement for Treating the Obstructions Proximal to the Descending Colon

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    Chang, Il Soo; Park, Sang Woo; Hwang, Dae Yong; Seong, Moo Kyung; Joh, Hee Kyung; Yoon, So Young; Cho, Yo Han; Choe, Won Hyeok [Konkuk University Hospital, Seoul (Korea, Republic of)

    2011-02-15

    We wanted to evaluate the efficacy of stent placement using the coaxial technique with a stiff, long introducer sheath in patients with technical failure using an angiographic catheter for the obstructions proximal to the descending colon. Self-expandable metallic stent placement was attempted under fluoroscopy-guidance in 77 consecutive patients who had malignant colorectal obstruction. Stent placement was performed using an angiographic catheter and a guide wire. If the angiographic catheter could not be advanced over the guide wire into the obstructive lesions proximal to the descending colon, then a 6-Fr introducer sheath was used. The technical success rate, the clinical success rate and the complications were analyzed. Successful stent placement was achieved in 75 of 77 patients (97%). The angiographic catheter failed to advance into the obstructive lesions of 11 patients (M:F = 7:4: mean age, 65.5 years) whose lesions were at the level of the splenic flexure or transverse colon. Therefore, the coaxial technique was implemented in all these 11 patients using a 6-Fr stiff introducer sheath and then the stent placement was successful. There were no complications related to the use of a stiff introducer sheath. Clinical success, which was defined as relief of clinical obstructive bowel symptoms, was obtained within 24 hours in all of patients. The coaxial technique using a stiff introducer sheath can increase the technical success of fluoroscopy-guided, self-expandable metallic stent placement in patients with colonic obstruction proximal to the descending colon

  18. The Efficacy of the Coaxial Technique Using a 6-Fr Introducer Sheath in Stent Placement for Treating the Obstructions Proximal to the Descending Colon

    International Nuclear Information System (INIS)

    Chang, Il Soo; Park, Sang Woo; Hwang, Dae Yong; Seong, Moo Kyung; Joh, Hee Kyung; Yoon, So Young; Cho, Yo Han; Choe, Won Hyeok

    2011-01-01

    We wanted to evaluate the efficacy of stent placement using the coaxial technique with a stiff, long introducer sheath in patients with technical failure using an angiographic catheter for the obstructions proximal to the descending colon. Self-expandable metallic stent placement was attempted under fluoroscopy-guidance in 77 consecutive patients who had malignant colorectal obstruction. Stent placement was performed using an angiographic catheter and a guide wire. If the angiographic catheter could not be advanced over the guide wire into the obstructive lesions proximal to the descending colon, then a 6-Fr introducer sheath was used. The technical success rate, the clinical success rate and the complications were analyzed. Successful stent placement was achieved in 75 of 77 patients (97%). The angiographic catheter failed to advance into the obstructive lesions of 11 patients (M:F = 7:4: mean age, 65.5 years) whose lesions were at the level of the splenic flexure or transverse colon. Therefore, the coaxial technique was implemented in all these 11 patients using a 6-Fr stiff introducer sheath and then the stent placement was successful. There were no complications related to the use of a stiff introducer sheath. Clinical success, which was defined as relief of clinical obstructive bowel symptoms, was obtained within 24 hours in all of patients. The coaxial technique using a stiff introducer sheath can increase the technical success of fluoroscopy-guided, self-expandable metallic stent placement in patients with colonic obstruction proximal to the descending colon

  19. CT colonography for preoperative examination of the proximal colon using a transanal drainage tube for acute malignant colonic obstruction

    International Nuclear Information System (INIS)

    Sasaki, Kazuaki; Hirano, Yuji; Oono, Keisuke; Sasaki, Kazunori; Someya, Tetsufumi; Harada, Keisuke; Ezoe, Eiri; Furuhata, Tomohisa; Hirata, Koichi

    2011-01-01

    The purpose of this study was to evaluate the feasibility of CT colonography for preoperative examination of the proximal colon using a transanal drainage tube in patients with acute colon obstruction caused by colorectal cancer. Ten patients who received initial treatment for acute malignant colon obstruction at our hospital between June 2004 and December 2008 were studied. In these patients, elective surgery was possible after transanal drainage tube insertion, and the colon on the oral side from the cancer lesion was examined using a drainage tube. Air was injected through the tube into the oral side of the colon, and CT colonography was assessed for the presence or absence of lesions on the oral side. The images of the oral side of the colon were good enough to allow adequate interpretation in 9 of the 10 patients. In the first patient, the visualization of the area near the lesion was somewhat fair, although the right side colon was well visualized. There were no complications associated with this examination. The present preoperative examination using a transanal drainage tube was useful for determining the extent of intestinal resection when patients were not candidates for colonoscopy or barium enema examination. (author)

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

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

    2017-07-15

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

  1. Spermine oxidase promotes bile canalicular lumen formation through acrolein production.

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    Uemura, Takeshi; Takasaka, Tomokazu; Igarashi, Kazuei; Ikegaya, Hiroshi

    2017-11-01

    Spermine oxidase (SMOX) catalyzes oxidation of spermine to generate spermidine, hydrogen peroxide (H 2 O 2 ) and 3-aminopropanal, which is spontaneously converted to acrolein. SMOX is induced by a variety of stimuli including bacterial infection, polyamine analogues and acetaldehyde exposure. However, the physiological functions of SMOX are not yet fully understood. We investigated the physiological role of SMOX in liver cells using human hepatocellular carcinoma cell line HepG2. SMOX localized to the bile canalicular lumen, as determined by F-actin staining. Knockdown of SMOX reduced the formation of bile canalicular lumen. We also found that phospho-Akt (phosphorylated protein kinase B) was localized to canalicular lumen. Treatment with Akt inhibitor significantly reduced the formation of bile canalicular lumen. Acrolein scavenger also inhibited the formation of bile canalicular lumen. PTEN, phosphatase and tensin homolog and an inhibitor of Akt, was alkylated in a SMOX-dependent manner. Our results suggest that SMOX plays a central role in the formation of bile canalicular lumen in liver cells by activating Akt pathway through acrolein production.

  2. Proximal tubule proteins are significantly elevated in bladder urine of patients with ureteropelvic junction obstruction and may represent novel biomarkers: A pilot study.

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    Gerber, Claire; Harel, Miriam; Lynch, Miranda L; Herbst, Katherine W; Ferrer, Fernando A; Shapiro, Linda H

    2016-04-01

    Ureteropelvic junction obstruction (UPJO) is the major cause of hydronephrosis in children and may lead to renal injury and early renal dysfunction. However, diagnosis of the degree of obstruction and severity of renal injury relies on invasive and often inconclusive renal scans. Biomarkers from voided urine that detect early renal injury are highly desirable because of their noninvasive collection and their potential to assist in earlier and more reliable diagnosis of the severity of obstruction. Early in response to UPJO, increased intrarenal pressure directly impacts the proximal tubule brush border. We hypothesize that single-pass, apically expressed proximal tubule brush border proteins will be shed into the urine early and rapidly and will be reliable noninvasive urinary biomarkers, providing the tools for a more reliable stratification of UPJO patients. We performed a prospective cohort study at Connecticut Children's Medical Center. Bladder urine samples from 12 UPJO patients were obtained prior to surgical intervention. Control urine samples were collected from healthy pediatric patients presenting with primary nocturnal enuresis. We determined levels of NGAL, KIM-1 (previously identified biomarkers), CD10, CD13, and CD26 (potentially novel biomarkers) by ELISA in control and experimental urine samples. Urinary creatinine levels were used to normalize the urinary protein levels measured by ELISA. Each of the proximal tubule proteins outperformed the previously published biomarkers. No differences in urinary NGAL and KIM-1 levels were observed between control and obstructed patients (p = 0.932 and p = 0.799, respectively). However, levels of CD10, CD13, and CD26 were significantly higher in the voided urine of obstructed individuals when compared with controls (p = 0.002, p = 0.024, and p = 0.007, respectively) (Figure). Targeted identification of reliable, noninvasive biomarkers of renal injury is critical to aid in diagnosing patients at risk, guiding

  3. Safety and efficacy of self-expandable metal stents for obstructive proximal and distal large bowel cancer.

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    Mitra, V; Hu, M; Majumdar, D; Krishnan, V; Chaudhury, B; Hancock, J; Dwarakanath, D

    2017-03-01

    Self-expandable metal stents are often used to treat obstructive large bowel cancers. This study assessed the safety and efficacy of colonic stent insertion carried out in a district general hospital. Methods A retrospective review was carried out between 1 January 2007 and 28 February 2014 to identify patients who underwent stent insertion for malignant colorectal obstruction. Results Seventy-five patients (median age 75.2 years, 70.6% male) with primary colorectal cancer underwent stent insertion - 53 underwent semi-elective self-expanded metal stent insertion (for subacute bowel obstruction) and 22 had emergency stent inserted (for acute bowel obstruction). The majority (88%) had self-expanded metal stents inserted for palliation. Technical and clinical success rates were 98.7% and 91.2%, respectively. One patient had stent-related perforation; there was no procedure-related mortality. Conclusion This study shows that self-expanded metal stent insertion in malignant colorectal obstruction is safe and effective and can be successfully delivered in a district general hospital with high technical and clinical success rates.

  4. Subacute narrowing of the left main coronary artery following directional atherectomy for proximal obstructive coronary artery disease

    NARCIS (Netherlands)

    Piek, J. J.; Koch, K. T.; van der Wal, A. C.; Becker, A. E.

    1997-01-01

    Directional atherectomy is an alternative device for treatment of highly eccentric or proximal coronary lesions considered less suitable for balloon angioplasty. We report a patient with exuberant neointimal proliferation, extending into the left main coronary artery, following directional

  5. Bicarbonate sulfate exchange in canalicular rat liver plasma membrane vesicles

    International Nuclear Information System (INIS)

    Meier, P.J.; Valantinas, J.; Hugentobler, G.; Rahm, I.

    1987-01-01

    The mechanism(s) and driving forces for biliary excretion of sulfate were investigated in canalicular rat liver plasma membrane vesicles (cLPM). Incubation of cLPM vesicles in the presence of an inside-to-outside (in, out) bicarbonate gradient but not pH or out-to-in sodium gradients, stimulated sulfate uptake 10-fold compared with the absence of bicarbonate and approximately 2-fold above sulfate equilibrium (overshoot). Initial rates of this bicarbonate gradient-driven [ 35 S]-sulfate uptake were saturable with increasing concentrations of sulfate and could be inhibited by probenecid, N-(4-azido-2-nitrophenyl)-2-aminoethylsulfonate, acetazolamide, furosemide, 4-acetamideo-4'-isothiocyanostilbene-2,2'-disulfonic acid, and 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (IC 50 , ∼40 μM). Cisinhibition of initial bicarbonate gradient-stimulated sulfate uptake and transstimulation of sulfate uptake in the absence of bicarbonate were observed with sulfate, thiosulfate, and oxalate but not with chloride, nitrate, phosphate, acetate, lactate, glutamate, aspartate, cholate, taurocholate, dehydrocholate, taurodehydrocholate, and reduced or oxidized glutathione. These findings indicate the presence of a sulfate (oxalate)-bicarbonate anion exchange system in canalicular rat liver plasma membranes. These findings support the concept that bicarbonate-sensitive transport system might play an important role in bile acid-independent canalicular bile formation

  6. Quantification of Lacunar–Canalicular Interstitial Fluid Flow Through Computational Modeling of Fluorescence Recovery After Photobleaching

    OpenAIRE

    Kwon, Ronald Y.; Frangos, John A.

    2010-01-01

    Skeletal adaptation to mechanical loading has been widely hypothesized to involve the stimulation of osteocytes by interstitial fluid flow (IFF). However, direct investigation of this hypothesis has been difficult due in large part to the inability to directly measure IFF velocities within the lacunar–canalicular system. Measurements of fluorescence recovery after photobleaching (FRAP) within individual lacunae could be used to quantify lacunar–canalicular IFF when combined with mathematical ...

  7. A Para-Canalicular Abscess Resembling an Inflamed Chalazion

    Directory of Open Access Journals (Sweden)

    Diamantis Almaliotis

    2013-01-01

    Full Text Available Background. Lacrimal infections by Actinomyces are rare and commonly misdiagnosed for long periods of time. They account for 2% of all lacrimal diseases. Case Report. We report a case of a 70-year-old female patient suffering from a para-canalicular abscess in the medial canthus of the left eye, beside the lower punctum lacrimale, resembling a chalazion. Purulence exited from the punctum lacrimale due to inflammation of the inferior canaliculus (canaliculitis. When pressure was applied to the mass, a second exit of purulence was also observed under the palpebral conjunctiva below the lacrimal caruncle. A surgical excision was performed followed by administration of local antibiotic therapy. The histopathological examination of the extracted mass revealed the existence of actinomycosis. Conclusion. Persistent or recurrent infections and lumps of the eyelids should be thoroughly investigated. Actinomyces as a causative agent should be considered. Differential diagnosis is broad and should include canaliculitis, chalazion, and multiple types of neoplasias. For this reason, in nonconclusive cases, a histopathological examination should be performed.

  8. Segmentation of nanotomographic cortical bone images for quantitative characterization of the osteoctyte lacuno-canalicular network

    Energy Technology Data Exchange (ETDEWEB)

    Ciani, A.; Kewish, C. M. [Synchrotron Soleil, L’Orme des Merisiers, 91192 Saint-Aubin (France); Guizar-Sicairos, M.; Diaz, A.; Holler, M. [Paul Scherrer Institut, 5232 Villigen PSI (Switzerland); Pallu, S.; Achiou, Z.; Jennane, R.; Toumi, H.; Lespessailles, E. [Univ Orléans, I3MTO, Ea 4708, 45000 Orléans (France)

    2016-01-28

    A newly developed data processing method able to characterize the osteocytes lacuno-canalicular network (LCN) is presented. Osteocytes are the most abundant cells in the bone, living in spaces called lacunae embedded inside the bone matrix and connected to each other with an extensive network of canals that allows for the exchange of nutrients and for mechanotransduction functions. The geometrical three-dimensional (3D) architecture is increasingly thought to be related to the macroscopic strength or failure of the bone and it is becoming the focus for investigating widely spread diseases such as osteoporosis. To obtain 3D LCN images non-destructively has been out of reach until recently, since tens-of-nanometers scale resolution is required. Ptychographic tomography was validated for bone imaging in [1], showing clearly the LCN. The method presented here was applied to 3D ptychographic tomographic images in order to extract morphological and geometrical parameters of the lacuno-canalicular structures.

  9. A clinical application of laser direction in anastomosis for inferior canalicular laceration

    Institute of Scientific and Technical Information of China (English)

    LIANG Tao; ZHAO Ke-xiao; ZHANG Ling-yun

    2006-01-01

    Objective:To study the therapeutic efficiency and effecacy of laser-directing approach on searching for the nasal broken end of lacerated lacrimal canaliculus in anastomosis for canalicular laceration.Methods: Forty-nine patients ( 49 eyes ) suffering from traumatic inferior canalicular laceration were divided into control group and laser-directing group. The distance between the lacrimal punctum and the nasal broken end of lacerated lacrimal canaliculus was more than 6 mm. During the course of management of eyelid trauma, the patients were treated by canalicular anastomosis operation with traditional method and laser-directing method in searching for the nasal broken end of lacerated lacrimal canaliculus respectively. The silicone tube of 1 mm diameter was intubated in the lacrimal passage as a stent for 4 to 6months.Results: In the laser-directing group, the mean time in searching for the nasal broken end of lacerated lacrimal canaliculus was (5.75 ± 1.49) minutes and the mean time of operation was (49.21±3.37) minutes; both were significantly shorter than that of the control group(P <0.01). The cure rate of the laser-directing group was96.55 %, higher than that of the control group but without statistical significance (P > 0.05).Conclusions: The laser-directing method is much quicker and more convenient to searching for the nasal broken end of the lacerated lacrimal canaliculus than the traditional approach, and patients suffer less pain and damaging in canalicular anastomosis operation.

  10. Idiopathic Canalicular Inflammatory Disease: New Disease Description of Clinical Patterns, Investigations, Management, and Outcomes.

    Science.gov (United States)

    Ali, Mohammad Javed

    2018-01-25

    The objective of this perspective is to present a separate disease description of "idiopathic canalicular inflammatory disease" and outline the diagnostic criteria and early experiences with its investigations and management. Retrospective case series of 44 canaliculi of 22 eyes of 11 patients presenting at a tertiary care Dacryology service over a period of 2 years with typical clinical patterns of inflammatory canaliculitis and its outcomes were studied. All the patients underwent microbiological work-up with culture and sensitivity, dacryoendoscopy imaging, serial Fourier domain ocular coherence tomography, and collagen vascular profiles. Stages in the evolution of the disease were studied. All patients were treated initially with topical steroids followed by punctal dilatation and placement of mini-monoka stents. Five patients in addition had a small biopsy from the inflamed portion of the vertical canaliculus. Stents were extubated at 6 weeks. Forty-four canaliculi were diagnosed to have idiopathic canalicular inflammatory disease during the study period. There was a female preponderance (81.8%, 9/11) and the mean age at presentation was 57 years. All patients presented with unilateral epiphora without any discharge, pain, or swelling. Collagen vascular profiles and screening for autoimmune diseases were negative. Clinical picture ranged from stages 1 to 5, consisting of edema, progressive centripetal vascularization, pouting of vascularized mucosa, membrane formation, and progressive scarring. The presentation begins in 1 eye and usually involves the other eye at a mean of 6 months. Ocular coherence tomography and dacryoendoscopy were of adjunctive value in the diagnosis. Histopathological examination was suggestive of a chronic inflammation. All patients had relentless progression to end-stage disease, although delayed significantly by steroids and monoka intubation. Idiopathic canalicular inflammatory disease has a distinct and typical clinical behavior and

  11. Osteocyte-Intrinsic TGF-β Signaling Regulates Bone Quality through Perilacunar/Canalicular Remodeling

    Directory of Open Access Journals (Sweden)

    Neha S. Dole

    2017-11-01

    Full Text Available Poor bone quality contributes to bone fragility in diabetes, aging, and osteogenesis imperfecta. However, the mechanisms controlling bone quality are not well understood, contributing to the current lack of strategies to diagnose or treat bone quality deficits. Transforming growth factor beta (TGF-β signaling is a crucial mechanism known to regulate the material quality of bone, but its cellular target in this regulation is unknown. Studies showing that osteocytes directly remodel their perilacunar/canalicular matrix led us to hypothesize that TGF-β controls bone quality through perilacunar/canalicular remodeling (PLR. Using inhibitors and mice with an osteocyte-intrinsic defect in TGF-β signaling (TβRIIocy−/−, we show that TGF-β regulates PLR in a cell-intrinsic manner to control bone quality. Altogether, this study emphasizes that osteocytes are key in executing the biological control of bone quality through PLR, thereby highlighting the fundamental role of osteocyte-mediated PLR in bone homeostasis and fragility.

  12. Quantification of Lacunar-Canalicular Interstitial Fluid Flow Through Computational Modeling of Fluorescence Recovery After Photobleaching.

    Science.gov (United States)

    Kwon, Ronald Y; Frangos, John A

    2010-09-01

    Skeletal adaptation to mechanical loading has been widely hypothesized to involve the stimulation of osteocytes by interstitial fluid flow (IFF). However, direct investigation of this hypothesis has been difficult due in large part to the inability to directly measure IFF velocities within the lacunar-canalicular system. Measurements of fluorescence recovery after photobleaching (FRAP) within individual lacunae could be used to quantify lacunar-canalicular IFF when combined with mathematical modeling. In this study, we used a computational transport model to characterize the relationship between flow frequency (0.5-10 Hz), peak flow velocity (0-300 μm/s), tracer diffusion coefficient (100-300 μm(2)/s), and transport enhancement (i.e., (k/k(0)) - 1, where k and k(0) are the transport rates in the presence/absence of flow) during lacunar FRAP investigations. We show that this relationship is well described by a simple power law with frequency-dependent coefficients, and is relatively insensitive to variations in lacunar geometry. Using this power law relationship, we estimated peak IFF velocities in hindlimb mice subjected to intramedullary pressurization using values of k and k(0) previously obtained from ex vivo lacunar FRAP investigations. Together, our findings suggest that skeletal adaptation in hindlimb suspended mice subjected to dynamic intramedullary pressure occurred in the presence of IFF at levels associated with physiological loading.

  13. Quantification of Lacunar–Canalicular Interstitial Fluid Flow Through Computational Modeling of Fluorescence Recovery After Photobleaching

    Science.gov (United States)

    Kwon, Ronald Y.; Frangos, John A.

    2010-01-01

    Skeletal adaptation to mechanical loading has been widely hypothesized to involve the stimulation of osteocytes by interstitial fluid flow (IFF). However, direct investigation of this hypothesis has been difficult due in large part to the inability to directly measure IFF velocities within the lacunar–canalicular system. Measurements of fluorescence recovery after photobleaching (FRAP) within individual lacunae could be used to quantify lacunar–canalicular IFF when combined with mathematical modeling. In this study, we used a computational transport model to characterize the relationship between flow frequency (0.5–10 Hz), peak flow velocity (0–300 μm/s), tracer diffusion coefficient (100–300 μm2/s), and transport enhancement (i.e., (k/k0) − 1, where k and k0 are the transport rates in the presence/absence of flow) during lacunar FRAP investigations. We show that this relationship is well described by a simple power law with frequency-dependent coefficients, and is relatively insensitive to variations in lacunar geometry. Using this power law relationship, we estimated peak IFF velocities in hindlimb mice subjected to intramedullary pressurization using values of k and k0 previously obtained from ex vivo lacunar FRAP investigations. Together, our findings suggest that skeletal adaptation in hindlimb suspended mice subjected to dynamic intramedullary pressure occurred in the presence of IFF at levels associated with physiological loading. PMID:21076644

  14. Osteocyte-Intrinsic TGF-β Signaling Regulates Bone Quality through Perilacunar/Canalicular Remodeling.

    Science.gov (United States)

    Dole, Neha S; Mazur, Courtney M; Acevedo, Claire; Lopez, Justin P; Monteiro, David A; Fowler, Tristan W; Gludovatz, Bernd; Walsh, Flynn; Regan, Jenna N; Messina, Sara; Evans, Daniel S; Lang, Thomas F; Zhang, Bin; Ritchie, Robert O; Mohammad, Khalid S; Alliston, Tamara

    2017-11-28

    Poor bone quality contributes to bone fragility in diabetes, aging, and osteogenesis imperfecta. However, the mechanisms controlling bone quality are not well understood, contributing to the current lack of strategies to diagnose or treat bone quality deficits. Transforming growth factor beta (TGF-β) signaling is a crucial mechanism known to regulate the material quality of bone, but its cellular target in this regulation is unknown. Studies showing that osteocytes directly remodel their perilacunar/canalicular matrix led us to hypothesize that TGF-β controls bone quality through perilacunar/canalicular remodeling (PLR). Using inhibitors and mice with an osteocyte-intrinsic defect in TGF-β signaling (TβRII ocy-/- ), we show that TGF-β regulates PLR in a cell-intrinsic manner to control bone quality. Altogether, this study emphasizes that osteocytes are key in executing the biological control of bone quality through PLR, thereby highlighting the fundamental role of osteocyte-mediated PLR in bone homeostasis and fragility. Published by Elsevier Inc.

  15. Actinomycetes canaliculitis complicating congenital nasolacrimal duct obstruction in an infant

    Directory of Open Access Journals (Sweden)

    Akshay Gopinathan Nair

    2018-01-01

    Full Text Available Actinomyces israelii is a Gram-positive anaerobic organism commonly associated with canaliculitis in adults. Pediatric canaliculitis is relatively rare, especially in infancy. We report the case of an 11-month-old boy who presented with co-existing canaliculitis and congenital nasolacrimal obstruction. The presenting signs included epiphora, discharge, conjunctival congestion, and matting of lashes. On examination, punctual pouting, regurgitation, and yellow canaliculiths were noted. A punctoplasty and canalicular curettage were performed along with nasolacrimal probing. Microbiological tests confirmed the organisms to be A. israelii. We discuss the clinical features and management of Actinomyces-associated canaliculitis and review the available literature on pediatric canaliculitis.

  16. Sulindac is excreted into bile by a canalicular bile salt pump and undergoes a cholehepatic circulation in rats

    NARCIS (Netherlands)

    Bolder, U.; Trang, N. V.; Hagey, L. R.; Schteingart, C. D.; Ton-Nu, H. T.; Cerrè, C.; Elferink, R. P.; Hofmann, A. F.

    1999-01-01

    BACKGROUND & AIMS: Dihydroxy bile acids induce a bicarbonate-rich hypercholeresis when secreted into canalicular bile in unconjugated form; the mechanism is cholehepatic shunting. The aim of this study was to identify a xenobiotic that induces hypercholeresis by a similar mechanism. METHODS: Five

  17. Proximal Humerus

    NARCIS (Netherlands)

    Diercks, Ron L.; Bain, Gregory; Itoi, Eiji; Di Giacomo, Giovanni; Sugaya, Hiroyuki

    2015-01-01

    This chapter describes the bony structures of the proximal humerus. The proximal humerus is often regarded as consisting of four parts, which assists in understanding function and, more specially, describes the essential parts in reconstruction after fracture or in joint replacement. These are the

  18. Effective renal blod flow and canalicular function of kidneys obliterating endarteritis

    International Nuclear Information System (INIS)

    Davydova, L.I.; Zajtsev, V.T.; Kononenko, E.I.; Gorbenko, L.V.; Karpovich, I.P.; Troyan, V.I.; Skripko, V.A.; Belousova, L.G.; Pavlova, T.S.

    1978-01-01

    Effective renal blood flow (general and separate) as well as the secretory-evacuatory function of the canalicular system of kidneys in 39 patients with obliterating endarteritis and in 20 persons of a control group have been studied by means of hippuran 131 I. Considerable decrease in the effective renal blood flow has been revealed. The decrease in blood flow with the increase in the ischemia degree turned out to be insignificant. The total function of kidneys is reduced in the 2-5 stages of diseases. Indices of secretory - evacuatory function of canals were changed. Indices of the total function of kidneys and intrarenal hemodynamics are the most informative when studying the state of this organ

  19. Acquired Duodenal Obstruction in Children

    Directory of Open Access Journals (Sweden)

    Jen-Hung Chien

    2008-10-01

    Full Text Available Traumatic intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction in children, and a high degree of suspicion is therefore required to make an early and accurate diagnosis. We report a 6-year-old boy whose epigastrium was impacted by the handlebar of his bicycle during a traffic accident. The boy then experienced epigastralgia. Six days later, progressive bilious vomiting suggestive of gastrointestinal obstruction was noted. Imaging studies revealed a large hematoma extending from the fourth portion of the duodenum to the jejunum. Conservative methods of treatment failed to manage his condition. He underwent laparoscopic surgery to evacuate the hematoma. We also report a case of duodenal obstruction in a previously healthy 2-year-old girl who presented for the first time with acute symptoms of proximal intestinal obstruction. Contrast examinations showed apparent barium retention over the stomach and proximal duodenum. She underwent surgery due to persistent obstruction, and a mushroom-like foreign body was detected embedded in the orifice of the windsock duodenal web. After duodenoduodenostomy and removal of the bezoar, she had a smooth recovery and tolerated feeding well. We conclude that blunt abdominal trauma and incomplete duodenal obstruction, such as that caused by duodenal web, should be considered as possible causes of acquired proximal gastrointestinal obstruction in previously healthy children, despite their rarity.

  20. The small world of osteocytes: connectomics of the lacuno-canalicular network in bone

    International Nuclear Information System (INIS)

    Kollmannsberger, Philip; Kerschnitzki, Michael; Repp, Felix; Wagermaier, Wolfgang; Weinkamer, Richard; Fratzl, Peter

    2017-01-01

    Osteocytes and their cell processes reside in a large, interconnected network of voids pervading the mineralized bone matrix of most vertebrates. This osteocyte lacuno-canalicular network (OLCN) is believed to play important roles in mechanosensing, mineral homeostasis, and for the mechanical properties of bone. While the extracellular matrix structure of bone is extensively studied on ultrastructural and macroscopic scales, there is a lack of quantitative knowledge on how the cellular network is organized. Using a recently introduced imaging and quantification approach, we analyze the OLCN in different bone types from mouse and sheep that exhibit different degrees of structural organization not only of the cell network but also of the fibrous matrix deposited by the cells. We define a number of robust, quantitative measures that are derived from the theory of complex networks. These measures enable us to gain insights into how efficient the network is organized with regard to intercellular transport and communication. Our analysis shows that the cell network in regularly organized, slow-growing bone tissue from sheep is less connected, but more efficiently organized compared to irregular and fast-growing bone tissue from mice. On the level of statistical topological properties (edges per node, edge length and degree distribution), both network types are indistinguishable, highlighting that despite pronounced differences at the tissue level, the topological architecture of the osteocyte canalicular network at the subcellular level may be independent of species and bone type. Our results suggest a universal mechanism underlying the self-organization of individual cells into a large, interconnected network during bone formation and mineralization. (paper)

  1. The small world of osteocytes: connectomics of the lacuno-canalicular network in bone

    Science.gov (United States)

    Kollmannsberger, Philip; Kerschnitzki, Michael; Repp, Felix; Wagermaier, Wolfgang; Weinkamer, Richard; Fratzl, Peter

    2017-07-01

    Osteocytes and their cell processes reside in a large, interconnected network of voids pervading the mineralized bone matrix of most vertebrates. This osteocyte lacuno-canalicular network (OLCN) is believed to play important roles in mechanosensing, mineral homeostasis, and for the mechanical properties of bone. While the extracellular matrix structure of bone is extensively studied on ultrastructural and macroscopic scales, there is a lack of quantitative knowledge on how the cellular network is organized. Using a recently introduced imaging and quantification approach, we analyze the OLCN in different bone types from mouse and sheep that exhibit different degrees of structural organization not only of the cell network but also of the fibrous matrix deposited by the cells. We define a number of robust, quantitative measures that are derived from the theory of complex networks. These measures enable us to gain insights into how efficient the network is organized with regard to intercellular transport and communication. Our analysis shows that the cell network in regularly organized, slow-growing bone tissue from sheep is less connected, but more efficiently organized compared to irregular and fast-growing bone tissue from mice. On the level of statistical topological properties (edges per node, edge length and degree distribution), both network types are indistinguishable, highlighting that despite pronounced differences at the tissue level, the topological architecture of the osteocyte canalicular network at the subcellular level may be independent of species and bone type. Our results suggest a universal mechanism underlying the self-organization of individual cells into a large, interconnected network during bone formation and mineralization.

  2. Prevention of taurolithocholate-induced hepatic bile canalicular distortions by HPLC-characterized extracts of artichoke (Cynara scolymus) leaves.

    Science.gov (United States)

    Gebhardt, R

    2002-09-01

    The effects of water-soluble extracts of artichoke (Cynara scolymus L.) leaves on taurolithocholate-induced cholestatic bile canalicular membrane distortions were studied in primary cultured rat hepatocytes using electron microscopy. Artichoke extracts at concentrations between 0.08 and 0.5 mg/ml were able to prevent the formation of bizarre canalicular membrane transformations in a dose-dependent manner when added simultaneously with the bile acid. However, prevention also occurred when the hepatocytes were preincubated with the extracts, indicating that absorption of the bile acid to components of the extracts was not involved. These results demonstrate that artichoke leaf extracts exert a potent anticholestatic action at least in the case of taurolithocholate. This effect may contribute to the overall hepatoprotective influence of this herbal formulation.

  3. Association of canalicular membrane enzymes with bile acid micelles and lipid aggregates in human and rat bile.

    Science.gov (United States)

    Accatino, L; Pizarro, M; Solís, N; Koenig, C S

    1995-01-18

    This study was undertaken to gain insights into the characteristics of the polymolecular association between canalicular membrane enzymes, bile acids, cholesterol and phospholipids in bile and into the celular mechanisms whereby the enzymes are secreted into bile. With this purpose, we studied the distribution of bile acids, cholesterol, phospholipids, proteins and representative canalicular membrane enzymes (alkaline phosphatase, 5'-nucleotidase and gamma-glutamyl transpeptidase), which can be considered specific marker constituents, in bile fractions enriched in phospholipid-cholesterol lamellar structures (multilamellar and unilamellar vesicles) and bile acid-mixed micelles. These fractions were isolated by ultracentrifugation from human hepatic bile, normal rat bile and bile of rats treated with diosgenin, a steroid that induces a marked increase in biliary cholesterol secretion, and were characterized by density, lipid composition and transmission electron microscopy. These studies demonstrate that alkaline phosphatase, 5'-nucleotidase and gamma-glutamyl transpeptidase are secreted into both human and rat bile where they are preferentially associated with bile acid-mixed micelles, suggesting a role for bile acids in both release of these enzymes and lipids from the canalicular membrane and solubilization in bile. In addition, heterogeneous association of these enzymes with nonmicellar, lamellar structures in human and rat bile is consistent with the hypothesis that processes independent of the detergent effects of bile acids might also result in the release of specific intrinsic membrane proteins into bile.

  4. UPJ obstruction

    Science.gov (United States)

    ... junction obstruction; Obstruction of the ureteropelvic junction Images Kidney anatomy References Elder JS. Obstruction of the urinary tract. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, St. Geme JW, Schor NF, eds. ... The Kidney . 10th ed. Philadelphia, PA: Elsevier; 2016:chap 38. ...

  5. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ...

  6. Obstructive Sleep Apnea

    Science.gov (United States)

    ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ... find out more. Obstructive Sleep Apnea (OSA) Obstructive Sleep Apnea (OSA) Obstructive sleep apnea (OSA) is a ...

  7. Imaging of obstructive azoospermia

    Energy Technology Data Exchange (ETDEWEB)

    Cornud, F. [Clinique Radiologique, 15 Avenue Robert Schuman, F-75 007 Paris (France)]|[Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France); Belin, X. [Clinique Radiologique, 15 Avenue Robert Schuman, F-75 007 Paris (France)]|[Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France); Delafontaine, D. [Medicine de la Reproduction, 8 rue Jean Richepin, F-75 016 Paris (France); Amar, T. [Uro-Andrologist, 19 Avenue Victor Hugo, F-75016, Paris (France); Helenon, O. [Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France); Moreau, J.F. [Service de Radiologie, Hopital Necker, 169 rue de Sevres, F-75 015 Paris (France)

    1997-09-01

    Obstructive azoospermia represents approximately 10 % of cases of male hypofertility. It is classified according to the volume of ejaculate. When the latter is normal a proximal obstruction is suspected. Scrotal sonography can help to detect dilation of the epididymal head when clinical findings are equivocal. Ejaculatory duct obstruction (EDO) is suspected when the volume of ejaculate is low. The use of transrectal ultrasonography (TRUS) plays a major role in the investigation of these patients, and endorectal MRI is a very useful adjunct in selected cases. The most common cause of EDO is congenital bilateral absence of vas deferens, which is now thought to be a genital form of cystic fibrosis in 80 % of cases. Consequently, a definitive diagnosis must be made before any attempt at in vitro fertilization. TRUS accurately visualizes abnormalities of the caudal junction of the vas deferens and seminal vesicles, yielding a definitive diagnosis without scrototomy. Other causes of EDO are congenital cysts compressing the distal part of the ejaculatory ducts and inflammatory distal stenosis. The former are accurately identified by TRUS, but the latter give more or less marked signs of obstruction which are only of value in azoospermic patients with a low-volume ejaculate. More invasive imaging is required to diagnose partial obstruction of the ED. Surgical vasography is still the reference, but puncture of the seminal vesicles under TRUS guidance is an attractive alternative, as it permits aspiration of seminal fluid (to seek motile sperm) and vasography without scrototomy. Lastly, endorectal MRI well assesses the relationships between the proximal prostatic urethra and the posterior wall of the ejaculatory ducts, which need to be precisely known when endoscopic resection of the ejaculatory ducts is planned. (orig.). With 9 figs.

  8. Imaging of obstructive azoospermia

    International Nuclear Information System (INIS)

    Cornud, F.; Belin, X.; Delafontaine, D.; Amar, T.; Helenon, O.; Moreau, J.F.

    1997-01-01

    Obstructive azoospermia represents approximately 10 % of cases of male hypofertility. It is classified according to the volume of ejaculate. When the latter is normal a proximal obstruction is suspected. Scrotal sonography can help to detect dilation of the epididymal head when clinical findings are equivocal. Ejaculatory duct obstruction (EDO) is suspected when the volume of ejaculate is low. The use of transrectal ultrasonography (TRUS) plays a major role in the investigation of these patients, and endorectal MRI is a very useful adjunct in selected cases. The most common cause of EDO is congenital bilateral absence of vas deferens, which is now thought to be a genital form of cystic fibrosis in 80 % of cases. Consequently, a definitive diagnosis must be made before any attempt at in vitro fertilization. TRUS accurately visualizes abnormalities of the caudal junction of the vas deferens and seminal vesicles, yielding a definitive diagnosis without scrototomy. Other causes of EDO are congenital cysts compressing the distal part of the ejaculatory ducts and inflammatory distal stenosis. The former are accurately identified by TRUS, but the latter give more or less marked signs of obstruction which are only of value in azoospermic patients with a low-volume ejaculate. More invasive imaging is required to diagnose partial obstruction of the ED. Surgical vasography is still the reference, but puncture of the seminal vesicles under TRUS guidance is an attractive alternative, as it permits aspiration of seminal fluid (to seek motile sperm) and vasography without scrototomy. Lastly, endorectal MRI well assesses the relationships between the proximal prostatic urethra and the posterior wall of the ejaculatory ducts, which need to be precisely known when endoscopic resection of the ejaculatory ducts is planned. (orig.). With 9 figs

  9. Antegrade Colonic Lavage in Acute Colonic Obstruction

    OpenAIRE

    Foster, Michael E.; Johnson, Colin D.

    1986-01-01

    Conventional management of acute left sided colonic obstruction employs some form of proximal colostomy. Intraoperative antegrade colonic irrigation relieves proximal faecal loading and may permit safer primary resection and anastomosis. The results of a pilot study are presented, and are shown to be favourable.

  10. Obstructive uropathy

    Science.gov (United States)

    ... the kidney and causes it to become swollen ( hydronephrosis ). Obstructive uropathy can affect one or both kidneys. ... occurs during pregnancy. This condition is called idiopathic hydronephrosis of pregnancy.

  11. The cast imaging of the osteon lacunar-canalicular system and the implications with functional models of intracanalicular flow.

    Science.gov (United States)

    Pazzaglia, Ugo E; Congiu, Terenzio

    2013-02-01

    A casting technique with methyl-methacrylate (MMA) was applied to the study of the osteon lacunar-canalicular network of human and rabbit cortical bone. The MMA monomer infiltration inside the vascular canals and from these into the lacunar-canalicular system was driven by capillarity, helped by evaporation and the resulting negative pressure in a system of small pipes. There was uniform, centrifugal penetration of the resin inside some osteons, but this was limited to a depth of four to five layers of lacunae. Moreover, not all of the osteon population was infiltrated. This failure can be the result of one of two factors: the incomplete removal of organic debris from the canal and canalicular systems, and lack of drainage at the osteon external border. These data suggest that each secondary osteon is a closed system with a peripheral barrier (represented by the reversal line). As the resin advances into the osteon, the air contained inside the canalicula is compressed and its pressure increases until infiltration is stopped. The casts gave a reliable visualization of the lacunar shape, position and connections between the lacunae without the need for manipulations such as cutting or sawing. Two systems of canalicula could be distinguished, the equatorial, which connected the lacunae (therefore the osteocytes) lying on the same concentric level, and the radial, which established connections between different levels. The equatorial canalicula radiated from the lacunar border forming ramifications on a planar surface around the lacuna, whereas the radial canalicula had a predominantly straight direction perpendicular to the equatorial plane. The mean length of the radial canalicula was 40.12 ± 10.26 μm in rabbits and 38.4 ± 7.35 μm in human osteons; their mean diameter was 174.4 ± 71.12 nm and 195.7 ± 79.58 nm, respectively. The mean equatorial canalicula diameter was 237 ± 66.04 nm in rabbit and 249.7 ± 73.78 nm in human bones, both significantly larger (P

  12. Acute intestinal obstruction: an electromyographic study in dogs.

    Science.gov (United States)

    Summers, R W; Yanda, R; Prihoda, M; Flatt, A

    1983-12-01

    We have investigated the motility effects of acute experimental canine intestinal obstruction. A 30-min midjejunal obstruction was produced by clamping a Biebl loop or by inflating an intraluminal balloon. Spike bursts from serosal electrodes proximal to the site of obstruction increased markedly, while those from distal electrodes decreased. When the obstruction from an intraluminal Foley catheter was continued for 5.5 h, the inhibition persisted distally but the proximal contractile activity gradually fell to control levels. The reduced proximal activity after prolonged obstruction was largely due to clusters of regular intense spike bursts preceded and followed by lengthening periods of absent motor activity. Similar clustered contractions obliterated the lumen when the passage of barium through a Thiry-Vella loop was monitored fluoroscopically. Significant motility changes occur in intestinal obstruction, but an increased understanding of the mechanisms involved awaits future studies.

  13. Intestinal Obstruction

    Science.gov (United States)

    ... Colostomy ) is required to relieve an obstruction. Understanding Colostomy In a colostomy, the large intestine (colon) is cut. The part ... 1 What Causes Intestinal Strangulation? Figure 2 Understanding Colostomy Gastrointestinal Emergencies Overview of Gastrointestinal Emergencies Abdominal Abscesses ...

  14. Impaired activity of bile bile canalicular organic anion transporter (Mrp2/cmoat) is not the main cause of ethinylestradiol-induced cholestasis in the rat

    NARCIS (Netherlands)

    Koopen, NR; Wolters, H; Havinga, R; Vonk, RJ; Jansen, PLM; Muller, M; Kuipers, F

    To test the hypothesis that impaired activity of the bile canalicular organic anion transporting system mrp2 (cmoat) is a key event in the etiology of 17 alpha-ethinylestradiol (EE)-induced intrahepatic cholestasis in rats, EE (5 mg/kg subcutaneously daily) was administered to male normal Wistar

  15. Histomorphometric study and three-dimensional reconstruction of the osteocyte lacuno-canalicular network one hour after applying tensile and compressive forces.

    Science.gov (United States)

    Bozal, Carola B; Sánchez, Luciana M; Mandalunis, Patricia M; Ubios, Ángela M

    2013-01-01

    The occurrence of very early morphological changes in the osteocyte lacuno-canalicular network following application of tensile and/or compressive forces remains unknown to date. Thus, the aim of this study was to perform a morphological and morphometric evaluation of the changes in the three-dimensional structure of the lacuno-canalicular network and the osteocyte network of alveolar bone that take place very early after applying tensile and compressive forces in vivo, conducting static histomorphometry on bright-field microscopy and confocal laser scanning microscopy images. Our results showed that both the tensile and compressive forces induced early changes in osteocytes and their lacunae, which manifested as an increase in lacunar volume and changes in lacunar shape and orientation. An increase in canalicular width and a decrease in the width and an increase in the length of cytoplasmic processes were also observed. The morphological changes in the lacuno-canalicular and osteocyte networks that occur in vivo very early after application of tensile and compressive forces would be an indication of an increase in permeability within the system. Thus, both compressive and tensile forces would cause fluid displacement very soon after being applied; the latter would in turn rapidly activate alveolar bone osteocytes, enhancing transmission of the signals to the entire osteocyte network and the effector cells located at the bone surface. Copyright © 2013 S. Karger AG, Basel.

  16. Athermal alterations in the structure in the canalicular membrane and ATPase activity induced by thermal levels of microwave radiation

    International Nuclear Information System (INIS)

    Phelan, A.M.; Neubauer, C.F.; Timm, R.; Neirenberg, J.; Lange, D.G.

    1994-01-01

    Sprague-Dawley rats (200-250 g) were exposed 30 min/day for 4 days to thermogenic levels (rectal temperature increase of 2.2 degrees C) of microwave radiation [2.45 GHz, 80 mW/cm 2 , continuous-wave mode (CW)] or to a radiant heat source resulting in an equivalent increase in body temperature of 2.2 degrees C. On the fifth day the animals were sacrificed and their livers removed. The canalicular membranes were isolated and evaluated for adenosinetriphosphatase (ATPase) activity, total fatty acid composition and membrane fluidity characteristics. Mg ++ -ATPase activity (V max ) decreased by 48.5% in the group exposed to microwave radiation, with no significant change in the group exposed to radiant heat. The decrease in Mg ++ -ATPase was partially compensated by a concomitant increase in Na + /K + -ATPase activity (170% increase in V max over control) in animals exposed to microwave radiation, while no change occurred in the group exposed to radiant heat. This alteration in ATPase activity in the group exposed to microwave radiation is associated with a large decrease in the ratio of saturated to unsaturated fatty acids. Conversely, the group exposed to radiant heat had an increase in the ratio of saturated to unsaturated fatty acids. The most dramatic changes were found in the levels of arachidonic acid. Finally, the electron paramagnetic resonance (EPR) spin label technique used to measure the fluidity of the canalicular membranes of the animals in the three groups (sham, microwave radiation and radiant heat) indicated that the results were different in the three groups, reflecting the changes found in their fatty acid composition. The physiological response to open-quotes equivalentclose quotes thermal loads in rats is expressed differently for different types of energy sources. Possible mechanisms producing these divergent thermogenic responses are discussed. 34 refs., 3 figs., 2 tabs

  17. Defective canalicular transport and toxicity of dietary ursodeoxycholic acid in the abcb11-/- mouse: transport and gene expression studies.

    Science.gov (United States)

    Wang, Renxue; Liu, Lin; Sheps, Jonathan A; Forrest, Dana; Hofmann, Alan F; Hagey, Lee R; Ling, Victor

    2013-08-15

    The bile salt export pump (BSEP), encoded by the abcb11 gene, is the major canalicular transporter of bile acids from the hepatocyte. BSEP malfunction in humans causes bile acid retention and progressive liver injury, ultimately leading to end-stage liver failure. The natural, hydrophilic, bile acid ursodeoxycholic acid (UDCA) is efficacious in the treatment of cholestatic conditions, such as primary biliary cirrhosis and cholestasis of pregnancy. The beneficial effects of UDCA include promoting bile flow, reducing hepatic inflammation, preventing apoptosis, and maintaining mitochondrial integrity in hepatocytes. However, the role of BSEP in mediating UDCA efficacy is not known. Here, we used abcb11 knockout mice (abcb11-/-) to test the effects of acute and chronic UDCA administration on biliary secretion, bile acid composition, liver histology, and liver gene expression. Acutely infused UDCA, or its taurine conjugate (TUDC), was taken up by the liver but retained, with negligible biliary output, in abcb11-/- mice. Feeding UDCA to abcb11-/- mice led to weight loss, retention of bile acids, elevated liver enzymes, and histological damage to the liver. Semiquantitative RT-PCR showed that genes encoding Mdr1a and Mdr1b (canalicular) as well as Mrp4 (basolateral) transporters were upregulated in abcb11-/- mice. We concluded that infusion of UDCA and TUDC failed to induce bile flow in abcb11-/- mice. UDCA fed to abcb11-/- mice caused liver damage and the appearance of biliary tetra- and penta-hydroxy bile acids. Supplementation with UDCA in the absence of Bsep caused adverse effects in abcb11-/- mice.

  18. Obstructive ventriculomegaly

    International Nuclear Information System (INIS)

    Amato, M.; Howald, H.; Muralt, G. von

    1986-01-01

    Intracranial Hemorrhage (ICH) occurs primarily in premature infants, and posthemorrhagic ventricular dilatation is a well-known complication in this age-group. Blood clots within the ventricle are diagnostic of ICH but not usually seen. In our case Real-Time Ultrasonography has proved to be very helpful to identify intraventricular hematomas and to control obstructive ventriculomegaly without therapeutic intervention. (Author)

  19. Managing neonatal bowel obstruction: clinical perspectives

    Directory of Open Access Journals (Sweden)

    Desoky SM

    2018-02-01

    Full Text Available Sarah M Desoky,1 Ranjit I Kylat,2 Unni Udayasankar,1 Dorothy Gilbertson-Dahdal1 1Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ, USA; 2Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ, USA Abstract: Neonatal intestinal obstruction is a common surgical emergency and occurs in approximately 1 in 2,000 live births. The causes of obstruction are diverse with varied embryological origins, and some underlying etiologies are not yet well described. Some findings of neonatal bowel obstruction can be detected prenatally on ultrasound imaging. The obstruction is classified as “high” when the level of obstruction is proximal to the ileum, and “low” when the level of obstruction is at the ileum or colon. Early diagnosis of the type of intestinal obstruction and localization of the obstructive bowel segment guides timely and appropriate management of the underlying pathologic entity. Neonatal bowel obstructions are ideally managed at specialized centers with a large volume of neonatal surgery and dedicated pediatric surgical and anesthesia expertise. Although surgical intervention is necessary in most cases, initial management strategies often target underlying metabolic, cardiac, or respiratory abnormalities. Imaging plays a key role in early and accurate diagnosis of the abnormalities. When bowel obstruction is suspected clinically, initial imaging workup usually involves abdominal radiography, which may direct further evaluation with fluoroscopic examination such as upper gastrointestinal (UGI contrast study or contrast enema. This article provides a comprehensive review of clinical and radiological features of common and less common causes of intestinal obstruction in the neonatal age group, including esophageal atresia, enteric duplication cysts, gastric volvulus, congenital microgastria, hypertrophic pyloric stenosis, duodenal atresia

  20. Obstructive Sleep Apnoea

    African Journals Online (AJOL)

    Cheyne-Stokes respiration), obstructive sleep apnoea and mixed or complex sleep apnoea.1. Obstructive sleep apnoea (OSA) is the most common of these three disorders and is defined as airway obstruction during sleep, accompanied by at least ...

  1. Transrectal Ultrasonographic Findings of Obstructive Male Infertility

    International Nuclear Information System (INIS)

    Kim, Chang Il; Kim, Yun Hyeon; Kang, Heoung Keun; Kim, Jae Kyu; Park, Jin Gyoon; Park, Heung Il; Park, Kwang Seong

    1996-01-01

    To evaluate the usefulness of the transrectal ultrasound in infertile men with suspected obstructive lesions of sperm transport system. We performed transrectal US in 26 infertile patients in whom obstructive lesions of sperm transport system were suspected in physical examination and laboratory data. 7.0 MHz transrectal transducer was used and the content of analysis of sonographic findings was the presence of vas deferens, seminal vesicle and ejaculatory duct. Also, we measured the width of seminal vesicle and diameter of ejaculatory duct. Transrectal US revealed an accurate diagnosis in 12 infertile men who had obstructive lesions and associated abnormalities in distal sperm transport system, two of congenital bilateral absence of the vasa deferentia and seminal vesicles, two of congenital unilateral absence of the vas deferens and seminal vesicle, three of dilatation of seminal vesicles, and five of dilatation of ejaculatory ducts and proximal ducts. The other 14 patients who had normal findings on transrectal US were revealed to have testicular failure (10 patients) and obstruction of proximal sperm transport system (4 patients) which were beyond the field-of-view of transrectal US. Transrectal US is the useful diagnostic method for the evaluation of infertile men with suspected obstructive lesions of sperm transport system. It can possibly decrease the need for the invasive vasography and may be helpful in the guidance of appropriate management of male infertility

  2. Proximity credentials: A survey

    International Nuclear Information System (INIS)

    Wright, L.J.

    1987-04-01

    Credentials as a means of identifying individuals have traditionally been a photo badge and more recently, the coded credential. Another type of badge, the proximity credential, is making inroads in the personnel identification field. This badge can be read from a distance instead of being veiewed by a guard or inserted into a reading device. This report reviews proximity credentials, identifies the companies marketing or developing proximity credentials, and describes their respective credentials. 3 tabs

  3. Proximal Probes Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Proximal Probes Facility consists of laboratories for microscopy, spectroscopy, and probing of nanostructured materials and their functional properties. At the...

  4. Intracortical stiffness of mid-diaphysis femur bovine bone: lacunar-canalicular based homogenization numerical solutions and microhardness measurements.

    Science.gov (United States)

    Hage, Ilige S; Hamade, Ramsey F

    2017-09-01

    Microscale lacunar-canalicular (L-C) porosity is a major contributor to intracortical bone stiffness variability. In this work, such variability is investigated experimentally using micro hardness indentation tests and numerically using a homogenization scheme. Cross sectional rings of cortical bones are cut from the middle tubular part of bovine femur long bone at mid-diaphysis. A series of light microscopy images are taken along a line emanating from the cross-section center starting from the ring's interior (endosteum) ring surface toward the ring's exterior (periosteum) ring surface. For each image in the line, computer vision analysis of porosity is conducted employing an image segmentation methodology based on pulse coupled neural networks (PCNN) recently developed by the authors. Determined are size and shape of each of the lacunar-canalicular (L-C) cortical micro constituents: lacunae, canaliculi, and Haversian canals. Consequently, it was possible to segment and quantify the geometrical attributes of all individual segmented pores leading to accurate determination of derived geometrical measures such as L-C cortical pores' total porosity (pore volume fraction), (elliptical) aspect ratio, orientation, location, and number of pores in secondary and primary osteons. Porosity was found to be unevenly (but linearly) distributed along the interior and exterior regions of the intracortical bone. The segmented L-C porosity data is passed to a numerical microscale-based homogenization scheme, also recently developed by the authors, that analyses a composite made up of lamella matrix punctuated by multi-inclusions and returns corresponding values for longitudinal and transverse Young's modulus (matrix stiffness) for these micro-sized spatial locations. Hence, intracortical stiffness variability is numerically quantified using a combination of computer vision program and numerical homogenization code. These numerically found stiffness values of the homogenization

  5. Does performance status influence the outcome of Nd:YAG laser therapy of proximal esophageal tumors?

    NARCIS (Netherlands)

    Alexander, G. L.; Wang, K. K.; Ahlquist, D. A.; Viggiano, T. R.; Gostout, C. J.; Balm, R.

    1994-01-01

    The value of endoscopic palliative therapy for malignant obstruction in the proximal esophagus has been questioned. To assess the importance of pre-treatment performance status on treatment outcome, we reviewed the records of patients with tumors of the proximal esophagus undergoing endoscopic laser

  6. Rendezvous endoscopic recanalization for complete esophageal obstruction.

    Science.gov (United States)

    Fusco, Stefano; Kratt, Thomas; Gani, Cihan; Stueker, Dietmar; Zips, Daniel; Malek, Nisar P; Goetz, Martin

    2018-03-30

    Complete esophageal obstruction after (chemo)radiation for head and neck cancers is rare. However, inability to swallow one's own saliva strongly inflicts upon quality of life. Techniques for endoscopic recanalization in complete obstruction are not well established. We assessed the efficacy and safety of rendezvous recanalization. We performed a retrospective review of all patients who underwent endoscopic recanalization of complete proximal esophageal obstruction after radiotherapy between January 2009 and June 2016. Technical success was defined as an ability to pass an endoscope across the recanalized lumen, clinical success by changes in the dysphagia score. Adverse events were recorded prospectively. 19 patients with complete obstruction (dysphagia IV°), all of whom had failed at least one trial of conventional dilatation, underwent recanalization by endoscopic rendezvous, a combined approach through a gastrostomy and perorally under fluoroscopic control. Conscious sedation was used in all patients. In 18/19 patients (94.7%), recanalization was technically successful. In 14/18 patients (77.8%), the post-intervention dysphagia score changed to ≤ II. Three patients had their PEG removed. Factors negatively associated with success were obstruction length of 50 mm; and tumor recurrence for long-term success. No severe complications were recorded. Rendezvous recanalization for complete esophageal obstruction is a reliable and safe method to re-establish luminal patency. Differences between technical and clinical success rates highlight the importance of additional functional factors associated with dysphagia. Given the lack of therapeutic alternatives, rendezvous recanalization is a valid option to improve dysphagia.

  7. INTESTINAL OBSTRUCTION

    Science.gov (United States)

    Whipple, G. H.; Stone, H. B.; Bernheim, B. M.

    1913-01-01

    Closed duodenal loops may be made in dogs by ligatures placed just below the pancreatic duct and just beyond the duodenojejunal junction, together with a posterior gastro-enterostomy. These closed duodenal loop dogs die with symptoms like those of patients suffering from volvulus or high intestinal obstruction. This duodenal loop may simulate closely a volvulus in which there has been no vascular disturbance. Dogs with closed duodenal loops which have been washed out carefully survive a little longer on the average than animals with unwashed loops. The duration of life in the first instance is one to three days, with an average of about forty-eight hours. The dogs usually lose considerable fluid by vomiting and diarrhea. A weak pulse, low blood pressure and temperature are usually conspicuous in the last stages. Autopsy shows more or less splanchnic congestion which may be most marked in the mucosa of the upper small intestine. The peritoneum is usually clear and the closed loop may be distended with thin fluid, or collapsed, and contain only a small amount of pasty brown material. The mucosa of the loop may show ulceration and even perforation, but in the majority of cases it is intact and exhibits only a moderate congestion. Simple intestinal obstruction added to a closed duodenal loop does not modify the result in any manner, but it may hasten the fatal outcome. The liver plays no essential role as a protective agent against this poison, for a dog with an Eck fistula may live three days with a closed loop. A normal dog reacts to intraportal injection and to intravenous injection of the toxic substance in an identical manner. Drainage of this loop under certain conditions may not interfere with the general health over a period of weeks or months. Excision of the part of the duodenum included in this loop causes no disturbance. The material from the closed duodenal loops contains no bile, pancreatic juice, gastric juice, or split products from the food. It can be

  8. Live birth rates after MESA or TESE in men with obstructive azoospermia: is there a difference?

    NARCIS (Netherlands)

    van Wely, Madelon; Barbey, Natalie; Meissner, Andreas; Repping, Sjoerd; Silber, Sherman J.

    2015-01-01

    How do live birth rates compare after intracytoplasmic sperm injection (ICSI) for men with obstructive azoospermia when using sperm derived from testicular sperm extraction (TESE) versus microsurgical epididymal sperm aspiration (MESA)? Our study suggests that proximal epididymal sperm (from MESA)

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

    Science.gov (United States)

    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.

  10. Intestinal smooth muscle response to chronic obstruction : possible applications in jejunoileal atresia.

    Science.gov (United States)

    Cloutier, R

    1975-02-01

    Hyperplasia is the main change occurring in intestinal smooth muscle above a chronic obstruction and explains the functional obstruction seen in the proximal bowel of a jejunoileal atresia. With an experimental model in dogs, this hyperplasia has been shown to be reversible. However, changes are extreme in atresia, and experiments in animals with induced atresia will best evaluate various kinds of treatment.

  11. Percutaneous transhepatic cholangiographic evaluation of obstructive jaundice

    International Nuclear Information System (INIS)

    Kang, Hee Tae; Kim, Hong Soo; Kim, Jong Deok; Rhee, Hak Song

    1983-01-01

    PTC is the single most valuable diagnostic method available to evaluate the size, shape and site of the causes of obstructive jaundice among various radiological procedures. The authors reviewed and radiologically classified the PTC films of 203 cases of obstructive jaundice from July, 1977 to June, 1983 at Presbyterian Medical Center, Jeonju confirmed clinically, operatively and pathologically. The results are as follows; 1. The most common cause of obstructive jaundice was bile duct stone (64/203: 31.53%) and the other causes were bile duct cancer (43/203: 21.18%), pancreas cancer (41/203: 20.19%), biliary ascariasis and/or clonorchiasis (20/203: 9.8%), ampulla and duodenal cancer (7/203: 3.45%), fibrotic stenosis of sphincter of Oddi (6/203: 2.96%) etc. in the order. Of these primary involvement with cancer was more frequent (91/203: 44.33%) than stone. 3. The average maximal diameter of extrahepatic bile duct just proximal to the site of obstruction or stenosis by stones or by cancers was nearly equal (2.36 cm : 2.38 cm). 4. Cancers caused complete bile duct obstruction in about 75% (68/91) of cases and also were associated with intrahepatic duct dilatation about 92% (84/91) of cases. But in contrast biliary calculi showed good drainage of contrast medium in 75% (48/64) of cases and 92% (59/64) showed normal diameter

  12. Neighborhoods and manageable proximity

    Directory of Open Access Journals (Sweden)

    Stavros Stavrides

    2011-08-01

    Full Text Available The theatricality of urban encounters is above all a theatricality of distances which allow for the encounter. The absolute “strangeness” of the crowd (Simmel 1997: 74 expressed, in its purest form, in the absolute proximity of a crowded subway train, does not generally allow for any movements of approach, but only for nervous hostile reactions and submissive hypnotic gestures. Neither forced intersections in the course of pedestrians or vehicles, nor the instantaneous crossing of distances by the technology of live broadcasting and remote control give birth to places of encounter. In the forced proximity of the metropolitan crowd which haunted the city of the 19th and 20th century, as well as in the forced proximity of the tele-presence which haunts the dystopic prospect of the future “omnipolis” (Virilio 1997: 74, the necessary distance, which is the stage of an encounter between different instances of otherness, is dissipated.

  13. Proximal collagenous gastroenteritides:

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Riis, Lene Buhl; Danese, Silvio

    2014-01-01

    AIM: While collagenous colitis represents the most common form of the collagenous gastroenteritides, the collagenous entities affecting the proximal part of the gastrointestinal tract are much less recognized and possibly overlooked. The aim was to summarize the latest information through a syste...

  14. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  15. Proximate Analysis of Coal

    Science.gov (United States)

    Donahue, Craig J.; Rais, Elizabeth A.

    2009-01-01

    This lab experiment illustrates the use of thermogravimetric analysis (TGA) to perform proximate analysis on a series of coal samples of different rank. Peat and coke are also examined. A total of four exercises are described. These are dry exercises as students interpret previously recorded scans. The weight percent moisture, volatile matter,…

  16. Analysis of the patterns of bronchial obstruction at bronchography

    International Nuclear Information System (INIS)

    Huh, Suk; Kim, Yong Chul; Han, Sang Don; Lee, Yong Chul

    1981-01-01

    Of the bronchographic findings of 408 patients, performed in our hospital for recent 5 years, 108 cases showed definite bronchial obstruction, and 61 cases of those were selected and obstructive findings were evaluated. All that not confirmed were abandoned. For evaluation of the reliability of 9 braonchographic obstruction signs on applying to diagnose malignant or benign pulmonary diseases, each sign was identified and applied to each of the 61 confirmed cases. In addition, obstructed bronchi, distance of obstruction from the bifurcation site, and the direction of meniscus, if present, were evaluated. The results were follows: 1. The most frequent cause of bronchial obstruction was lung cancer (59.0%), and that of the benign obstruction was pulmonary tuberculosis (13.1%). 2. Amputation, asymmetric narrowing, thumbprint indentation, rat-tail narrowing and encasement signs were the most accurate signs of malignancy and were practically diagnostic ones. 3. The most frequent sign in lung cancer was sharp cutoff one, but it could be seen in lung abscess and in unresolved pneumonia, too. 4. Circumferential symmetric narrowing and regular concavity with a small central projection signs were specific ones to benignancy. 5. The most frequent obstruction sign in benign lung disease was gradual tapering sign, but it also could be seen in bronchogenic epidermoid and alveolar cell carcinoma. 6. Of all bronchial obstructions, 55.4% occurred at lobar bronchus and 77.4% of those were caused by lung cancer. 7. 77.2% of those obstruction which located within 3 times distance of the bronchial diameter at the nearest proximal bifurcation site, were lung cancer, but 75.0% of those located at over 3 times distance were benign pulmonary diseases. 8. There were no correlation of the direction of the meniscus at the obstructing end in differential diagnosis between benign and malignant pulmonary diseases

  17. Analysis of the patterns of bronchial obstruction at bronchography

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Suk; Kim, Yong Chul; Han, Sang Don; Lee, Yong Chul [National Medical Center, Seoul (Korea, Republic of)

    1981-12-15

    Of the bronchographic findings of 408 patients, performed in our hospital for recent 5 years, 108 cases showed definite bronchial obstruction, and 61 cases of those were selected and obstructive findings were evaluated. All that not confirmed were abandoned. For evaluation of the reliability of 9 braonchographic obstruction signs on applying to diagnose malignant or benign pulmonary diseases, each sign was identified and applied to each of the 61 confirmed cases. In addition, obstructed bronchi, distance of obstruction from the bifurcation site, and the direction of meniscus, if present, were evaluated. The results were follows: 1. The most frequent cause of bronchial obstruction was lung cancer (59.0%), and that of the benign obstruction was pulmonary tuberculosis (13.1%). 2. Amputation, asymmetric narrowing, thumbprint indentation, rat-tail narrowing and encasement signs were the most accurate signs of malignancy and were practically diagnostic ones. 3. The most frequent sign in lung cancer was sharp cutoff one, but it could be seen in lung abscess and in unresolved pneumonia, too. 4. Circumferential symmetric narrowing and regular concavity with a small central projection signs were specific ones to benignancy. 5. The most frequent obstruction sign in benign lung disease was gradual tapering sign, but it also could be seen in bronchogenic epidermoid and alveolar cell carcinoma. 6. Of all bronchial obstructions, 55.4% occurred at lobar bronchus and 77.4% of those were caused by lung cancer. 7. 77.2% of those obstruction which located within 3 times distance of the bronchial diameter at the nearest proximal bifurcation site, were lung cancer, but 75.0% of those located at over 3 times distance were benign pulmonary diseases. 8. There were no correlation of the direction of the meniscus at the obstructing end in differential diagnosis between benign and malignant pulmonary diseases.

  18. Bladder outlet obstruction

    Science.gov (United States)

    BOO; Lower urinary tract obstruction; Prostatism; Urinary retention - BOO ... these diseases increases greatly. Other common causes of BOO include: Pelvic tumors (cervix, prostate, uterus, rectum) Narrowing ...

  19. [Myosin B ATPase activity of the intestinal smooth muscle in intestinal obstruction].

    Science.gov (United States)

    Takamatsu, H

    1983-06-01

    Intestinal smooth myosin B was prepared from muscle layers around the lesion in dogs with experimental colonic stenosis and in patients with congenital intestinal obstruction. Mg2+-ATPase activity of the myosin B was compared between the proximal dilated segment and distal segment to obstruction. Experimental colonic stenosis: In early period after surgery, proximal colons showed higher activity of myosin B ATPase than distal colons, decreasing to less than distal colon as time passed. Congenital intestinal obstruction: In three cases, whose atresia might have occurred at earlier period of gestation, proximal bowels showed less activity of myosin B ATPase than distal bowels. However, in two cases, whose atresia might have occurred at later period of gestation, and two cases with intestinal stenosis, proximal bowels indicated higher activity of myosin B ATPase than distal bowels. These data suggested that the contractibility of the proximal intestine was depending on the duration of obstruction, and it was depressed in the former patients and was accelerated in the latter patients. These results suggested that the extensive resection of dilated proximal bowel in the congenital atresia is not always necessary to obtain good postoperative intestinal dynamics at the operation of the atresial lesions which may be induced at later period of gestation. They also suggested that surgery for intestinal obstruction should be performed before the depression of intestinal contractibility to get good bowel function.

  20. Quantum Proximity Resonances

    International Nuclear Information System (INIS)

    Heller, E.J.

    1996-01-01

    It is well known that at long wavelengths λ an s-wave scatterer can have a scattering cross section σ on the order of λ 2 , much larger than its physical size, as measured by the range of its potential. Very interesting phenomena can arise when two or more identical scatterers are placed close together, well within one wavelength. We show that, for a pair of identical scatterers, an extremely narrow p-wave open-quote open-quote proximity close-quote close-quote resonance develops from a broader s-wave resonance of the individual scatterers. A new s-wave resonance of the pair also appears. The relation of these proximity resonances (so called because they appear when the scatterers are close together) to the Thomas and Efimov effects is discussed. copyright 1996 The American Physical Society

  1. [Prognostic factors of mortality in the malignant biliary obstruction unresectable after the insertion of an endoscopic stent].

    Science.gov (United States)

    Hernández Guerrero, Angélica; Sánchez del Monte, Julio; Sobrino Cossío, Sergio; Alonso Lárraga, Octavio; Delgado de la Cruz, Lourdes; Frías Mendívil, M Mauricio; Frías Mendívil, C Mauricio

    2006-01-01

    To determine the factors prognostics of early mortality in the malignant billary estenosis after the endoscopic derivation. The surgical, percutaneous or endoscopic derivation is the alternative of palliative treatment in the biliary obstruction unresectable. The factors prognostic the early mortality after surgical derivation are: hemoglobin 10 mg/dL and serum albumin ictericia, pain and prurito. 61 cases of distal obstruction and 36 with proximal obstruction. Twenty deaths (25.9%) happened within the 30 later days to the treatment. The bilirubin > 14 mg/dL and the proximal location were like predicting of early mortality. The obstruction biliary more frequent is located in choledocho distal and is of pancreatic origin. The main factors associated to early mortality are: the bilirubin > of 14 mg/dL and the proximal location reason why is important the suitable selection of patient candidates to endoscopic derivation. The survival is better in the distal obstruction.

  2. Ileocolic intussusception mimicking the imaging appearance of midgut volvulus as a result of extrinsic duodenal obstruction

    International Nuclear Information System (INIS)

    Gasparini, Flavia F.; Navarro, Oscar M.; Manson, David E.; Dasgupta, Roshni; Gerstle, J. Ted; Thorner, Paul S.

    2005-01-01

    Duodenal obstruction caused by ileocolic intussusception in the absence of intestinal malrotation is extremely rare. We present and discuss the imaging findings in an infant with an intussusception secondary to a duplication cyst in whom sonography also showed inversion of the orientation of the mesenteric vessels and a distended stomach. A contrast medium study revealed a proximal duodenal obstruction with a beak appearance suggestive of midgut volvulus. At surgery, an ileocolic intussusception causing duodenal obstruction without concomitant malrotation or volvulus was found. The combination of duodenal obstruction and abnormal relationship of the mesenteric vessels as a result of ileocolic intussusception has not previously been reported in the literature. (orig.)

  3. Ileocolic intussusception mimicking the imaging appearance of midgut volvulus as a result of extrinsic duodenal obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Gasparini, Flavia F.; Navarro, Oscar M.; Manson, David E. [University of Toronto, Department of Diagnostic Imaging, Ont. (Canada); Hospital for Sick Children, Toronto, Ont. (Canada); Dasgupta, Roshni; Gerstle, J. Ted [University of Toronto, Division of General Surgery, Ont. (Canada); Hospital for Sick Children, Toronto, Ont. (Canada); Thorner, Paul S. [University of Toronto, Division of Pathology, Ont. (Canada); Hospital for Sick Children, Toronto, Ont. (Canada)

    2005-12-01

    Duodenal obstruction caused by ileocolic intussusception in the absence of intestinal malrotation is extremely rare. We present and discuss the imaging findings in an infant with an intussusception secondary to a duplication cyst in whom sonography also showed inversion of the orientation of the mesenteric vessels and a distended stomach. A contrast medium study revealed a proximal duodenal obstruction with a beak appearance suggestive of midgut volvulus. At surgery, an ileocolic intussusception causing duodenal obstruction without concomitant malrotation or volvulus was found. The combination of duodenal obstruction and abnormal relationship of the mesenteric vessels as a result of ileocolic intussusception has not previously been reported in the literature. (orig.)

  4. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... can also invite bacteria that lead to gum disease. Click here to find out more. Obstructive Sleep Apnea (OSA) Download Download the ebook for further information Obstructive sleep ... high blood pressure, heart disease and decreased libido. In addition, OSA causes daytime ...

  5. Obstructive sleep apnea therapy

    NARCIS (Netherlands)

    Hoekema, A.; Stegenga, B.; Wijkstra, P. J.; van der Hoeven, J. H.; Meinesz, A. F.; de Bont, L. G. M.

    In clinical practice, oral appliances are used primarily for obstructive sleep apnea patients who do not respond to continuous positive airway pressure (CPAP) therapy. We hypothesized that an oral appliance is not inferior to CPAP in treating obstructive sleep apnea effectively. We randomly assigned

  6. Proximity friction reexamined

    International Nuclear Information System (INIS)

    Krappe, H.J.

    1989-01-01

    The contribution of inelastic excitations to radial and tangential friction form-factors in heavy-ion collisions is investigated in the frame-work of perturbation theory. The dependence of the form factors on the essential geometrical and level-density parameters of the scattering system is exhibited in a rather closed form. The conditions for the existence of time-local friction coefficients are discussed. Results are compared to form factors from other models, in particular the transfer-related proximity friction. For the radial friction coefficient the inelastic excitation mechanism seems to be the dominant contribution in peripheral collisions. (orig.)

  7. Proximal femoral fractures.

    Science.gov (United States)

    Webb, Lawrence X

    2002-01-01

    Fractures of the proximal femur include fractures of the head, neck, intertrochanteric, and subtrochanteric regions. Head fractures commonly accompany dislocations. Neck fractures and intertrochanteric fractures occur with greatest frequency in elderly patients with a low bone mineral density and are produced by low-energy mechanisms. Subtrochanteric fractures occur in a predominantly strong cortical osseous region which is exposed to large compressive stresses. Implants used to address these fractures must be able to accommodate significant loads while the fractures consolidate. Complications secondary to these injuries produce significant morbidity and include infection, nonunion, malunion, decubitus ulcers, fat emboli, deep venous thrombosis, pulmonary embolus, pneumonia, myocardial infarction, stroke, and death.

  8. Echosonography with proximity sensors

    International Nuclear Information System (INIS)

    Thaisiam, W; Laithong, T; Meekhun, S; Chaiwathyothin, N; Thanlarp, P; Danworaphong, S

    2013-01-01

    We propose the use of a commercial ultrasonic proximity sensor kit for profiling an altitude-varying surface by employing echosonography. The proximity sensor kit, two identical transducers together with its dedicated operating circuit, is used as a profiler for the construction of an image. Ultrasonic pulses are emitted from one of the transducers and received by the other. The time duration between the pulses allows us to determine the traveling distance of each pulse. In the experiment, the circuit is used with the addition of two copper wires for directing the outgoing and incoming signals to an oscilloscope. The time of flight of ultrasonic pulses can thus be determined. Square grids of 5 × 5 cm 2 are made from fishing lines, forming pixels in the image. The grids are designed to hold the detection unit in place, about 30 cm above a flat surface. The surface to be imaged is constructed to be height varying and placed on the flat surface underneath the grids. Our result shows that an image of the profiled surface can be created by varying the location of the detection unit along the grid. We also investigate the deviation in relation to the time of flight of the ultrasonic pulse. Such an experiment should be valuable for conveying the concept of ultrasonic imaging to physical and medical science undergraduate students. Due to its simplicity, the setup could be made in any undergraduate laboratory relatively inexpensively and it requires no complex parts. The results illustrate the concept of echosonography. (paper)

  9. Children's proximal societal conditions

    DEFF Research Database (Denmark)

    Stanek, Anja Hvidtfeldt

    2018-01-01

    that is above or outside the institutional setting or the children’s everyday life, but something that is represented through societal structures and actual persons participating (in political ways) within the institutional settings, in ways that has meaning to children’s possibilities to participate, learn...... and develop. Understanding school or kindergarten as (part of) the children’s proximal societal conditions for development and learning, means for instance that considerations about an inclusive agenda are no longer simply thoughts about the school – for economic reasons – having space for as many pupils...... as possible (schools for all). Such thoughts can be supplemented by reflections about which version of ‘the societal’ we wish to present our children with, and which version of ‘the societal’ we wish to set up as the condition for children’s participation and development. The point is to clarify or sharpen...

  10. Proximity detection system underground

    Energy Technology Data Exchange (ETDEWEB)

    Denis Kent [Mine Site Technologies (Australia)

    2008-04-15

    Mine Site Technologies (MST) with the support ACARP and Xstrata Coal NSW, as well as assistance from Centennial Coal, has developed a Proximity Detection System to proof of concept stage as per plan. The basic aim of the project was to develop a system to reduce the risk of the people coming into contact with vehicles in an uncontrolled manner (i.e. being 'run over'). The potential to extend the developed technology into other areas, such as controls for vehicle-vehicle collisions and restricting access of vehicle or people into certain zones (e.g. non FLP vehicles into Hazardous Zones/ERZ) was also assessed. The project leveraged off MST's existing Intellectual Property and experience gained with our ImPact TRACKER tagging technology, allowing the development to be fast tracked. The basic concept developed uses active RFID Tags worn by miners underground to be detected by vehicle mounted Readers. These Readers in turn provide outputs that can be used to alert a driver (e.g. by light and/or audible alarm) that a person (Tag) approaching within their vicinity. The prototype/test kit developed proved the concept and technology, the four main components being: Active RFID Tags to send out signals for detection by vehicle mounted receivers; Receiver electronics to detect RFID Tags approaching within the vicinity of the unit to create a long range detection system (60 m to 120 m); A transmitting/exciter device to enable inner detection zone (within 5 m to 20 m); and A software/hardware device to process & log incoming Tags reads and create certain outputs. Tests undertaken in the laboratory and at a number of mine sites, confirmed the technology path taken could form the basis of a reliable Proximity Detection/Alert System.

  11. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

  12. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... It can also invite bacteria that lead to gum disease. Click here to find out more. Who We ... It can also invite bacteria that lead to gum disease. Click here to find out more. Obstructive Sleep ...

  13. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... The National Sleep Foundation estimates that 18 million adults have obstructive sleep apnea and it is likely ... Maxillofacial Surgeon (OMS). An estimated 18-20 million adults in the US suffer from OSA. What Is ...

  14. Wrecks and Obstructions

    Data.gov (United States)

    Department of Homeland Security — In 1981, NOAA�s National Ocean Service (NOS) implemented the Automated Wreck and Obstruction Information System (AWOIS) to assist in planning hydrographic survey...

  15. Obstructive sleep apnea - adults

    Science.gov (United States)

    ... SM. Obstructive sleep apnea: clinical features, evaluation, and principles of management. In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, ...

  16. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... Apnea (OSA) Download Download the ebook for further information Obstructive sleep apnea (OSA) is a serious and ... that can create the necessary air passageway. The information provided here is not intended as a substitute ...

  17. Obstructive Sleep Apnea

    Medline Plus

    Full Text Available ... can also invite bacteria that lead to gum disease. Click here to find out more. Who We ... can also invite bacteria that lead to gum disease. Click here to find out more. Obstructive Sleep ...

  18. Case report A Rare Cause of Sub-Acute Proximal Intestinal ...

    African Journals Online (AJOL)

    KIGZ

    A Rare Cause of Sub-Acute Proximal Intestinal Obstruction Due to Annular Pancreas. Weledji EP, Ngowe M, Mokake M. Department of Surgery, Regional Hospital Buea, Cameroon. Correspondence to: E P Weledji, P.O Box 126, Limbe, Cameroon. Email:elroypat@yahoo.co.uk. Summary. Background: Annular pancreas is a ...

  19. Imaging of obstructed defecation

    International Nuclear Information System (INIS)

    Ganeshan, A.; Anderson, E.M.; Upponi, S.; Planner, A.C.; Slater, A.; Moore, N.; D'Costa, H.; Bungay, H.

    2008-01-01

    Constipation is a common problem in the western world, which occurs as a consequence of impaired colonic transit and/or due to obstructed defecation. Imaging plays an important role in distinguishing structural from functional causes of constipation. In this article a description of common imaging techniques for diagnosing structural causes of constipation with illustrations of abnormal defecographic findings in patients with obstructive defecation are presented

  20. Imaging of obstructed defecation

    Energy Technology Data Exchange (ETDEWEB)

    Ganeshan, A. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom); Anderson, E.M. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom)], E-mail: eanderson@doctors.org.uk; Upponi, S.; Planner, A.C.; Slater, A.; Moore, N.; D' Costa, H.; Bungay, H. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom)

    2008-01-15

    Constipation is a common problem in the western world, which occurs as a consequence of impaired colonic transit and/or due to obstructed defecation. Imaging plays an important role in distinguishing structural from functional causes of constipation. In this article a description of common imaging techniques for diagnosing structural causes of constipation with illustrations of abnormal defecographic findings in patients with obstructive defecation are presented.

  1. Acute GI obstruction.

    Science.gov (United States)

    Hucl, Tomas

    2013-10-01

    Acute gastrointestinal obstruction occurs when the normal flow of intestinal contents is interrupted. The blockage can occur at any level throughout the gastrointestinal tract. The clinical symptoms depend on the level and extent of obstruction. Various benign and malignant processes can produce acute gastrointestinal obstruction, which often represents a medical emergency because of the potential for bowel ischemia leading to perforation and peritonitis. Early recognition and appropriate treatment are thus essential. The typical clinical symptoms associated with obstruction include nausea, vomiting, dysphagia, abdominal pain and failure to pass bowel movements. Abdominal distention, tympany due to an air-filled stomach and high-pitched bowel sounds suggest the diagnosis. The diagnostic process involves imaging including radiography, ultrasonography, contrast fluoroscopy and computer tomography in less certain cases. In patients with uncomplicated obstruction, management is conservative, including fluid resuscitation, electrolyte replacement, intestinal decompression and bowel rest. In many cases, endoscopy may aid in both the diagnostic process and in therapy. Endoscopy can be used for bowel decompression, dilation of strictures or placement of self-expandable metal stents to restore the luminal flow either as a final treatment or to allow for a delay until elective surgical therapy. When gastrointestinal obstruction results in ischemia, perforation or peritonitis, emergency surgery is required. Copyright © 2013. Published by Elsevier Ltd.

  2. PROXIMITY MANAGEMENT IN CRISIS CONDITIONS

    Directory of Open Access Journals (Sweden)

    Ion Dorin BUMBENECI

    2010-01-01

    Full Text Available The purpose of this study is to evaluate the level of assimilation for the terms "Proximity Management" and "Proximity Manager", both in the specialized literature and in practice. The study has two parts: the theoretical research of the two terms, and an evaluation of the use of Proximity management in 32 companies in Gorj, Romania. The object of the evaluation resides in 27 companies with less than 50 employees and 5 companies with more than 50 employees.

  3. Transcanalicular Laser-Assisted Dacryocystorhinostomy With Endonasal Augmentation in Primary Nasolacrimal Duct Obstruction: Our Experience.

    Science.gov (United States)

    Goel, Ruchi; Nagpal, Smriti; Kumar, Sushil; Meher, Ravi; Kamal, Saurabh; Garg, Sonam

    To evaluate and compare the success rate of transcanalicular laser-assisted dacryocystorhinostomy with endonasal augmentation, with and without intubation, in patients suffering from primary acquired nasolacrimal duct obstruction, at 1 year of follow up. A prospective, randomized interventional pilot study was conducted at a tertiary care center, in accordance with the guidelines of Declaration of Helsinki. Sixty eyes of 60 adult patients with primary acquired nasolacrimal duct obstruction were included. The participants were divided randomly into 2 equal groups (A and B-without and with bicanalicular intubation, respectively). An osteotomy was first created using 980 nm diode laser (set at 8W continuous mode) transcanalicularly and then enlarged intranasally using Blakesley's nasal forceps, followed by bicanalicular silicon intubation in group B patients. The tubes were removed at the end of 8 weeks. The ostium size was assessed endoscopically at 8 weeks and again at the end of follow up, at 1 year. A successful outcome was defined in terms of ostium patency at the end of 1 year. The results were analyzed at the end of a follow up of 1 year, using various statistical tests (p < 0.05). The mean age of the patients was 35.3 ± 15.89 years, with 23 male and 37 female patients, the 2 groups having a similar male:female ratio. An overall success rate of 90% was achieved at the end of 1 year with no statistically significant difference between the groups. Postoperative complications like tube displacement and punctal, canalicular injury were more in the intubated group. The average osteotomy size was 8.06 ± 5.4 mm at the end of 1 year. Transcanalicular laser-assisted dacryocysto rhinostomy, with endonasal augmentation, is a scarless, effective, daycare procedure, for treatment of primary acquired nasolacrimal duct obstruction with no additional advantage offered by silicone intubation.

  4. Radiologic evaluation of intestinal obstruction in the neonates

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hee; Kim, Dong Woo; Lee, Eun Suk; Kwon, Sun Young [Eul Ji General Hospital, Daejeon (Korea, Republic of); Lee, Sang Young [Chonbuk National University College of Medicine, Jeonju (Korea, Republic of); Kang, Hye Jeong [Eul Ji General Hospital, Seoul (Korea, Republic of)

    1995-10-15

    The purpose of this study is to evaluate the radiologic findings of the intestinal obstruction in the neonate according to the causes and to determine the findings useful for the differential diagnosis. The materials consisted of 29 neonates with surgically proven gastrointestinal tract obstruction. We analyzed simple abdominal radiography and barium study comparing with the operative findings. The causes of intestinal obstruction were gastric atresia in 1 case, duodenal atresia in 3 cases, small bowel atresia in 11 cases (jejunal; 3 cases, ileal; 8 cases), colonic atresia in 2 cases, Hirschsprung's disease in 9 cases, ano-rectal anomaly in 6 cases, midgut volvulus in 2 cases, and Meckel's diverticulum in 1 case. Vomiting was noted in the all cases. The abdominal distension was not noted in the cases of gastric atresia, duodenal atresia, and proximal jejunal atresia. The meconium passage was noted in 2 cases of ileal atresia and 3 cases of Hirschsprung's disease. On barium study, site of obstruction was predicted accurately in gastric atresia, duodenal atresia, proximal jejunal atresia, and colonic atresia but it was not possible in distal jejunal atresia and ileal atresia. The microcolon was noted in 2 cases of jejunal atresia, 4 cases of ileal atresia, and 2 cases of colonic atresia. Out of 9 Hirschsprung's disease transition zones were seen on rectum or rectosigmoid junction in 7 cases and barium study was normal in 2 cases. In the diagnosis of neonatal intestinal obstruction, the basic radiologic studies such as simple abdominal radiography and gastrointestinal contrast study was useful for the differential diagnosis of the proximal bowel loop atresia colonic atresia, and midgut volvulus.

  5. Radiologic evaluation of intestinal obstruction in the neonates

    International Nuclear Information System (INIS)

    Kim, Jin Hee; Kim, Dong Woo; Lee, Eun Suk; Kwon, Sun Young; Lee, Sang Young; Kang, Hye Jeong

    1995-01-01

    The purpose of this study is to evaluate the radiologic findings of the intestinal obstruction in the neonate according to the causes and to determine the findings useful for the differential diagnosis. The materials consisted of 29 neonates with surgically proven gastrointestinal tract obstruction. We analyzed simple abdominal radiography and barium study comparing with the operative findings. The causes of intestinal obstruction were gastric atresia in 1 case, duodenal atresia in 3 cases, small bowel atresia in 11 cases (jejunal; 3 cases, ileal; 8 cases), colonic atresia in 2 cases, Hirschsprung's disease in 9 cases, ano-rectal anomaly in 6 cases, midgut volvulus in 2 cases, and Meckel's diverticulum in 1 case. Vomiting was noted in the all cases. The abdominal distension was not noted in the cases of gastric atresia, duodenal atresia, and proximal jejunal atresia. The meconium passage was noted in 2 cases of ileal atresia and 3 cases of Hirschsprung's disease. On barium study, site of obstruction was predicted accurately in gastric atresia, duodenal atresia, proximal jejunal atresia, and colonic atresia but it was not possible in distal jejunal atresia and ileal atresia. The microcolon was noted in 2 cases of jejunal atresia, 4 cases of ileal atresia, and 2 cases of colonic atresia. Out of 9 Hirschsprung's disease transition zones were seen on rectum or rectosigmoid junction in 7 cases and barium study was normal in 2 cases. In the diagnosis of neonatal intestinal obstruction, the basic radiologic studies such as simple abdominal radiography and gastrointestinal contrast study was useful for the differential diagnosis of the proximal bowel loop atresia colonic atresia, and midgut volvulus

  6. [Pathogenic aspects of stomach ulcerogenesis in acute intestinal obstruction].

    Science.gov (United States)

    Milyukov, V E; Nguen, K K

    To identify the patterns and the correlation of morphological and functional changes in stomach wall with the dynamics of different types of acute intestinal obstruction. The study was performed on 33 adult mongrel dogs of both genders weighing 17-20 kg. All researches were conducted in accordance with the documents, such as the 'Guide for the Care and Use of laboratory animals of the National Institute of Health (National Institute of Health - NIH, Bethesda, USA)' and 'Rules of work with experimental animals'. The same methods were used to study the morphology of stomach wall in normal conditions and after intestinal obstruction simulation. We used H & E stain, Van Gieson's picrofuchsin staining combined with Mallory. The choice of histochemical methods was determined by the need to study metabolic processes in epithelial cells and gastric mucosa glands. Einarson method for detecting total nucleic acids was used. The last group of methods was statistical analysis. We determined the regularities of structural organization of microcirculation in various parts of the stomach, the correlation of morphological and functional changes in stomach wall with the dynamics of different types of acute intestinal obstruction. Our data indicate proximal-distal gradient of gastric perfusion: the most pronounced vascular network and maximum blood flow are observed in proximal stomach in both normal conditions and acute intestinal obstruction. More tenuous and reduced blood flow was revealed in the antrum, that is morphological basis of the most frequent localization of acute ulcers in this department.

  7. Occupational chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Omland, Oyvind; Würtz, Else Toft; Aasen, Tor Børvig

    2014-01-01

    Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures....

  8. ProxImaL: efficient image optimization using proximal algorithms

    KAUST Repository

    Heide, Felix; Diamond, Steven; Nieß ner, Matthias; Ragan-Kelley, Jonathan; Heidrich, Wolfgang; Wetzstein, Gordon

    2016-01-01

    domain-specific language and compiler for image optimization problems that makes it easy to experiment with different problem formulations and algorithm choices. The language uses proximal operators as the fundamental building blocks of a variety

  9. A proximal point algorithm with generalized proximal distances to BEPs

    OpenAIRE

    Bento, G. C.; Neto, J. X. Cruz; Lopes, J. O.; Soares Jr, P. A.; Soubeyran, A.

    2014-01-01

    We consider a bilevel problem involving two monotone equilibrium bifunctions and we show that this problem can be solved by a proximal point method with generalized proximal distances. We propose a framework for the convergence analysis of the sequences generated by the algorithm. This class of problems is very interesting because it covers mathematical programs and optimization problems under equilibrium constraints. As an application, we consider the problem of the stability and change dyna...

  10. Fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Brorson, Stig

    2013-01-01

    Fractures of the proximal humerus have been diagnosed and managed since the earliest known surgical texts. For more than four millennia the preferred treatment was forceful traction, closed reduction, and immobilization with linen soaked in combinations of oil, honey, alum, wine, or cerate......, classification of proximal humeral fractures remains a challenge for the conduct, reporting, and interpretation of clinical trials. The evidence for the benefits of surgery in complex fractures of the proximal humerus is weak. In three systematic reviews I studied the outcome after locking plate osteosynthesis...

  11. Experimental evaluation of furosemide renography in unobstructed and partially obstructed upper urinary tracts in pigs

    Energy Technology Data Exchange (ETDEWEB)

    Harving, N.; Christiansen, P.; Taagehoj-Jensen, F.; Frokjaer, J.; Djurhuus, J.C.; Mortensen, J. (Institute of Experimental Clinical Research, University of Aarhus (Denmark))

    1991-06-01

    To evaluate the reliability and the constancy of the furosemide renography an experimental evaluation of the test has been performed. A standardized unilateral partial proximal ureteral obstruction was applied to 11 pigs. Preoperatively and again weekly in the three weeks following obstruction a furosemide renogram (FR) was done. The furosemide renography was a very constant parameter in the unobstructed kidney (85%) and in the partly obstructed kidney (85%). A type I FR pattern (O'Reilly classification) was an exact indicator of an unobstructed pelvis. After partial ureteral obstruction, an immediate change in the FR pattern was seen either into type II or type IIIa renography. In this experimental study furosemide renography was found to be a reliable tool in the differentiation between the unobstructed normal renal pelves and the partly obstructed dilated renal pelves.

  12. Nasal obstruction and human communication.

    Science.gov (United States)

    Malinoff, R; Moreno, C

    1989-04-01

    Nasal obstruction may cause a variety of communication disorders, particularly in children. The effects of nasal obstruction on hearing, speech, language, and voice are examined. Methods for assessing the effects of nasal obstruction are delineated, and recommendations for therapeutic interventions are described.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Inducible laryngeal obstruction

    DEFF Research Database (Denmark)

    Halvorsen, Thomas; Walsted, Emil Schwarz; Bucca, Caterina

    2017-01-01

    Inducible laryngeal obstruction (ILO) describes an inappropriate, transient, reversible narrowing of the larynx in response to external triggers. ILO is an important cause of a variety of respiratory symptoms and can mimic asthma. Current understanding of ILO has been hampered by imprecise nomenc...

  15. Obstructive sleep apnea

    DEFF Research Database (Denmark)

    Jennum, Poul; Tønnesen, Philip; Ibsen, Rikke

    2017-01-01

    OBJECTIVE: Most studies have used cardiovascular and cerebrovascular disease (CVD) end-points to measure the effect of continuous positive airway pressure (CPAP), but pre-diagnostic morbidities involve a range of comorbidities that may influence the consequences of obstructive sleep apnea (OSA). We...

  16. Deliberate Perspectival Obstructions

    DEFF Research Database (Denmark)

    Mikkelsen, Henrik Hvenegaard; Rasmussen, Anders Emil

    2017-01-01

    This article discusses the collaborative use of what the authors call ‘perspectival obstructions’. Taking its outset in the events revolving around a series of challenges given to each other, as well as to their interlocutors, in Papua New Guinea, the article unfolds how obstructions may be tied...

  17. The efficacy of sleeve technique in primary nasolacrimal duct obstruction with a high lacrimal sac

    Directory of Open Access Journals (Sweden)

    Kyoung-Nam Kim

    2014-01-01

    Full Text Available Purpose: To evaluate the efficacy of a sleeve technique during endoscopic dacryocystorhinostomy (DCR in primary nasolacrimal duct obstruction (NLDO patients with a high lacrimal sac. Materials and Methods: The medical records of 45 patients (49 cases undergoing endoscopic DCR for primary NLDO with a high lacrimal sac were retrospectively reviewed. In 19 patients (21 cases, the thick maxilla covering the common canalicular opening was removed using a drill and a bicanalicular silicone tube was inserted (group 1. In 26 patients (28 cases, instead of removal of the thick maxilla, a sleeve was inserted into the bicanalicular silicone tube (group 2. At 6 months postoperatively, the success rate was evaluated and the size of the intranasal mucosal ostium was measured. Results: The success rates in group 1 and 2 was 90.5% and 96.4%, respectively (P = 0.400. The intranasal mucosal ostium in group 1 and 2 measured 1.7 ± 0.7 mm and 3.1 ± 1.0 mm, respectively, and the difference was significant (P = 0.042. Conclusions: In primary NLDO patients with a high lacrimal sac, DCR inserting a silicone tube and a sleeve together had a satisfactory success rate without using a drill. In comparison with traditional surgical methods, it helped enlarge the size of the intranasal mucosal ostium.

  18. [Production, absorption and excretion of phenols in intestinal obstruction].

    Science.gov (United States)

    Kawamoto, M

    1986-11-01

    In intestinal obstruction, phenols were produced in the distended loop proximal to obstruction by enteric bacteria. Clinically, in 17 cases of non-strangulated intestinal obstruction, phenols were detected in 15 cases and mean concentration of phenols was 4.2 +/- 9.7 micro g/ml(mean +/- 1 SD). In the fraction of phenols, p-cresol was detected in 15 cases and mean concentration was 3.8 +/- 7.7 and phenol was detected in 4 cases and mean concentration was 0.5 +/- 2.6. Phenols were decreased as clinical improvement of intestinal obstruction. Enteric bacteria in enteric juice ranged from 10(4) to 10(10)/ml and its change paralleled to phenols concentration. Mean urinary concentration of phenols in intestinal obstruction was increased to 297 +/- 415 mg/day compared to control (less than 50 mg/day). Its change also paralleled to phenols concentration in enteric juice. Closed ileal loop was made in dogs and phenols were infused in the loop. Phenols were increased in the portal vein 5 min after the infusion and in the femoral vein 60 min after the infusion. Phenols, which was thought to be toxic to the host, were proved to be produced in the distended intestine and excreted from the kidney.

  19. Preliminary study on leadership proximity

    Directory of Open Access Journals (Sweden)

    Ghinea Valentina Mihaela

    2017-07-01

    Full Text Available In general, it is agreed that effective leadership requires a certain degree of proximity, either physical or mental, which enables leaders to maintain control over their followers and communicate their vision. Although we agree with the leadership proximity principles which states that leaders are able to efficiently serve only those people with whom they interact frequently, in this article we focus instead on the disadvantages of being too close and the way in which close proximity can actually hurt the effectiveness of leadership. The main effects that we discuss regard the way in which proximity and familiarity allow followers to see the weaknesses and faults of the leader much more easily and thus diminish the leader’s heroic aura, and the emotional bias that results from a leader being too familiar with his followers which will impede the process of rational decision making. As a result, we argue that there exists a functional proximity which allows the leader the necessary space in which to perform effective identity work and to hide the backstage aspects of leadership, while also allowing him an emotional buffer zone which will enable him to maintain the ability to see clearly and make rational decisions.

  20. Defaecography and obstructed defaecation

    International Nuclear Information System (INIS)

    Schmelzer, H.; Schweiberer, L.; Muenchen Univ.; Mangel, E.; Muenchen Univ.

    1988-01-01

    Severe constipation or unexplained anorectal symptoms may be caused by obstructed defaecation due to functional pelvic floor disorders that can be identified or verified by defaecography. Based upon own experiences this paper deals with the methodology and the parameters of this late radiological technique as well as the clinical picture of the disorders encountered. The possibilities of management and operative therapy are discussed in short. (orig.) [de

  1. Endoscopic removal of a proximal urethral stent using a holmium laser: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Francisco Botelho

    2012-01-01

    Full Text Available Urethral stents were initially developed for the management of urethral strictures and obstructive voiding disorders in select patients. Urethral stent complications are common and may require stent explantation, which is often quite challenging. We present our experience with endoscopic removal of an encrusted UroLume proximal urethral stent in a 72-year-old male using a holmium laser. The literature on various management options and outcomes for urethral stent removal is reviewed. Endoscopic removal of proximal urethral stents is feasible and safe and should be considered as the primary treatment option in patients requiring stent extraction.

  2. An experimental study on renal functional disturbance in rabbits after acute ureteral obstruction with dynamic Gd-DTPA enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Kyoung Ja [Seoul Red Cross Hospital, Seoul (Korea, Republic of); Chung, Eun Chul; Rlee, Chung Sik [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    1994-05-15

    To evaluate the anatomic and functional change in acutely obstructed kidneys, and probability of functional recovery after resolving the obstruction. There were 5 animal groups (6 rabbits in each group)-normal control group, 4 acute ureteral obstruction group. Each of the latter group was imaged with Gd-DTPA enhanced dynamic MR 2, 6, 24, and 48 hours after ligation of the left proximal urter, respectively. We compared the findings of dynamic MR imaging and histopathological findings. We could observe centripetal movement of dark band pattern which could be defined as 3 phases renal cortex, outer medulla, and inner medulla in normal rabbits. The appearance of the dark band pattern was delayed or absent in ureteral obstruction group with linear relationship to the duration of the obstruction. Gd-DTPA enhanced MR can be used to differentiate acute obstructive nephropathy from other causes of nephropathy and foretell the prognosis of the obstruction.

  3. An experimental study on renal functional disturbance in rabbits after acute ureteral obstruction with dynamic Gd-DTPA enhanced MR imaging

    International Nuclear Information System (INIS)

    Shin, Kyoung Ja; Chung, Eun Chul; Rlee, Chung Sik

    1994-01-01

    To evaluate the anatomic and functional change in acutely obstructed kidneys, and probability of functional recovery after resolving the obstruction. There were 5 animal groups (6 rabbits in each group)-normal control group, 4 acute ureteral obstruction group. Each of the latter group was imaged with Gd-DTPA enhanced dynamic MR 2, 6, 24, and 48 hours after ligation of the left proximal urter, respectively. We compared the findings of dynamic MR imaging and histopathological findings. We could observe centripetal movement of dark band pattern which could be defined as 3 phases renal cortex, outer medulla, and inner medulla in normal rabbits. The appearance of the dark band pattern was delayed or absent in ureteral obstruction group with linear relationship to the duration of the obstruction. Gd-DTPA enhanced MR can be used to differentiate acute obstructive nephropathy from other causes of nephropathy and foretell the prognosis of the obstruction

  4. Association between proximity to major roads and sputum cell counts

    Science.gov (United States)

    Wallace, Julie; D’silva, Liesel; Brannan, John; Hargreave, Frederick E; Kanaroglou, Pavlos; Nair, Parameswaran

    2011-01-01

    BACKGROUND: Air pollution caused by motor vehicle emissions has been associated with exacerbations of obstructive airway diseases; however, the nature of the resulting bronchitis has not been quantified. OBJECTIVE: To examine whether proximity to major roads or highways is associated with an increase in sputum neutrophils or eosinophils, and to evaluate the effect of proximity to roads on spirometry and exacerbations in patients with asthma. METHODS: A retrospective study of 485 sputum cell counts from patients attending a tertiary chest clinic in Hamilton, Ontario, identified eosinophilic or neutrophilic bronchitis. Patients’ residences were geocoded to the street network of Hamilton using geographic information system software. Associations among bronchitis, lung function, and proximity to major roads and highways were examined using multinomial logistic and multivariate linear regression analyses adjusted for patient age, smoking status and corticosteroid medications. RESULTS: Patients living within 1000 m of highways showed an increased risk of bronchitis (OR 3.8 [95% CI 1.0 to 13.7]; Proad were at increased risk for an asthma exacerbation (OR 1.9 [95% CI 1.5 to 15.5]; Proad was associated with neutrophilic bronchitis, an increased risk of asthma diagnosis, asthma exacerbations and lower lung function. PMID:21369545

  5. Aortic obstruction: anatomy and echocardiography

    Directory of Open Access Journals (Sweden)

    Keirns Candace

    2006-09-01

    Full Text Available Abstract Echocardiography is a valuable non-invasive technique for identifying the site and type of aortic obstruction. Knowledge of the morphological details of each type of obstruction is the basis for correct interpretation of the diagnostic images and clinical decisions. This study was undertaken to correlate the echocardiographic images with anatomic specimens of equivalent valvular and supravalvular aortic obstruction. Specimens were part of the collection of the Department of Embryology. Fifty six patients were studied, and forty specimens with aortic obstruction were analyzed. Echocardiographic characteristics: Thirty one (55.3% patients were women and twenty five (44.7% men. Valvular aortic obstruction was found in Thirty six patients (64.3 % and supravalvular aortic obstruction in twenty (35.7%. Anatomic characteristics: Of the forty specimens examined, twenty one (52.5% had valvular aortic obstruction and nineteen (47.5% supravalvular aortic obstruction. The anatomoechocardiographic correlation clearly showed that the anatomic findings of the specimen hearts and aortas corresponded to echocardiographic images of valvular and supravalvular aortic obstruction and provided solid corroboration of echocardiographic diagnoses.

  6. Usefulness of flexible covered stent in malignant colorectal obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Jee Hee; Kang, Sung Gwon; Kim, Hyung Jin; Noh, Hong Gi; Woo, Jae Hong; Suh, Chang Hae [Inha Univ. Hospital, Inchon (Korea, Republic of)

    1998-07-01

    To evaluate the usefulness of flexible covered stent in the treatment of acute colorectal obstruction secondary to colorectal carcinoma. Materials and Methods : Flexible covered stents were placed in 11 patients with clinical and radiologic signs of acute colonic obstruction secondary to colorectal carcinoma. The purposes of stent insertion were pre-operative bowel preparation in seven patients and palliative treatment in four. A fistula was present in two;in one this was between the proximal jejunum and colon, and the other was rectovaginal. The usefulness of stent insertion for the purpose of preoperative bowel preparation was evaluated according to the feasibility and status of bowel preparation, as decided by the operator. Palliative treatment for the relief of symptoms of acute bowel obstruction was evaluated according to the number and amount of defecation,bowel dilatation in simple abdomen radiography, and the presence of complications. Results : Bowel preparation for the purpose of preoperative bowel cleansing was easy in seven patients;the fecal materials remaining in the colon presented no problems during surgery. In one of four patients palliative treatment involved a colostomy;this was due to recurrent stent obstruction by fecal materials after three months, and in two other patients there was stent obstruction after two and five months, respectively. The stent in one of four patients who underwent palliative treatment was removed because of stent migration three days after insertion;the stents in two patients with fistulas covered the fistulas successfully. Complications after stent insertion were anal pain in three patients, anal bleeding in three and stent migration in one. Conclusion : The flexible covered stent was an effective device for the relief of acute colonic obstruction secondary to malignant rectosigmoid neoplasia. It allowed for single-stage operation and covered the fistula. We believe however that for further evaluation of the

  7. Subtotal obstruction of the male reproductive tract

    NARCIS (Netherlands)

    Pierik, F.H.; Dohle, G.R.; Roijen, J.H. van; Vreeburg, J.T.M.; Weber, R.F.A.

    2003-01-01

    Bilateral obstruction of the male reproductive tract is suspected in men with azoospermia, normal testicular volume and normal FSH. A testicular biopsy is required to differentiate between an obstruction and a testicular insufficiency. Unilateral or subtotal bilateral obstructions and epididymal

  8. Equine recurrent airway obstruction

    Directory of Open Access Journals (Sweden)

    Artur Niedźwiedź

    2014-10-01

    Full Text Available Equine Recurrent Airway Obstruction (RAO, also known as heaves or broken wind, is one of the most common disease in middle-aged horses. Inflammation of the airway is inducted by organic dust exposure. This disease is characterized by neutrophilic inflammation, bronchospasm, excessive mucus production and pathologic changes in the bronchiolar walls. Clinical signs are resolved in 3-4 weeks after environmental changes. Horses suffering from RAO are susceptible to allergens throughout their lives, therefore they should be properly managed. In therapy the most importanthing is to eliminate dustexposure, administration of corticosteroids and use bronchodilators to improve pulmonary function.

  9. ProxImaL: efficient image optimization using proximal algorithms

    KAUST Repository

    Heide, Felix

    2016-07-11

    Computational photography systems are becoming increasingly diverse, while computational resources-for example on mobile platforms-are rapidly increasing. As diverse as these camera systems may be, slightly different variants of the underlying image processing tasks, such as demosaicking, deconvolution, denoising, inpainting, image fusion, and alignment, are shared between all of these systems. Formal optimization methods have recently been demonstrated to achieve state-of-the-art quality for many of these applications. Unfortunately, different combinations of natural image priors and optimization algorithms may be optimal for different problems, and implementing and testing each combination is currently a time-consuming and error-prone process. ProxImaL is a domain-specific language and compiler for image optimization problems that makes it easy to experiment with different problem formulations and algorithm choices. The language uses proximal operators as the fundamental building blocks of a variety of linear and nonlinear image formation models and cost functions, advanced image priors, and noise models. The compiler intelligently chooses the best way to translate a problem formulation and choice of optimization algorithm into an efficient solver implementation. In applications to the image processing pipeline, deconvolution in the presence of Poisson-distributed shot noise, and burst denoising, we show that a few lines of ProxImaL code can generate highly efficient solvers that achieve state-of-the-art results. We also show applications to the nonlinear and nonconvex problem of phase retrieval.

  10. 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.

  11. Chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Karabulut, N.

    2012-01-01

    Full text: Chronic obstructive pulmonary diseases (COPD) denote progressive lung diseases characterized by airway obstruction. COPD exhibits specific morphologic changes in the lung parenchyma, central and peripheral airways and pulmonary vasculature. A person with COPD may have either emphysema or chronic bronchitis, but most have both. Some people with COPD may also have an asthma-like or reactive component. Imaging modalities play important role in the detection or exclusion of COPD, distribution and extent of disease processes. Combined inspiratory and expiratory high resolution CT allows phenotyping of COPD (emphysema predominant, airway predominant, or mixed) and quantification of severity. Magnetic resonance imaging enables functional evaluation and demonstrates ventilation defects correlating closely with pulmonary function tests. Imaging techniques are also helpful in guiding the treatment, such as bullectomy in patients with bullous emphysema, lung volume reduction surgery or endoscopic interventions in those with severe emphysema, and smoking cessation and medical treatment designed to stop lung destruction in patients with mild or moderate emphysema or bronchiectasis.

  12. Percutaneous intervention in obstructive

    International Nuclear Information System (INIS)

    Souftas, V.

    2012-01-01

    Percutaneous intervention procedures in obstructive uropathy include percutaneous nephrostomy tube placements, nephroureteral stents, percutaneous nephrostomy combined with ureteral embolization, percutaneous management of stone disease, suprapubic tube placements into the bladder, and perinephric/retroperitoneal urinomas/abscesses drainages. Percutaneous nephrostomy is performed to relieve urinary obstruction or divert the urinary stream away from the ureter or bladder. Patients are given preprocedure antibiotics. Percutaneous nephrostomies can be emergent cases because of risk of pyuria and sepsis from a stagnant urine collection. The procedure is performed using both ultrasound and fluoroscopy (or fluoroscopy alone using anatomic landmarks, or an internal radiopaque calculus, or delayed phase excretion of the contrast into the renal collecting system) under local anesthesia or conscious sedation. Ureteral stents are placed to bypass an obstructing stone or to stent across of an area of stricture or ureteral laceration. Stents may be placed by the urologist via a transurethral approach or by the interventional radiologist via a percutaneous approach. The decision as to method of stent placement is based upon the location and accessibility of the ureteral pathology. Ureteral embolization is performed in patients with unresectable tumors of the pelvis with long-standing nephrostomy tubes and distal urine leaks refractory to other treatments. Coils, gelfoam and liquid embolic materials can be used. Ureteral embolization for ureteral fistulas and incontinence is technically successful in 100% of the patients. Complications include bleeding, infection, ureteral or renal injury, and deployment (or movement) of the coils within the renal pelvis. Percutaneous management of stone disease, including renal, ureteral, and bladder stones requires close cooperation between the urologist and interventional radiologist, because of availability of sonographic lithotripsy

  13. The Effects of Distention and Obstruction on the Accumulation of Fluid in the Lumen of Small Bowel of Dogs

    Science.gov (United States)

    Mishra, Nand K.; Appert, Hubert E.; Howard, John M.

    1974-01-01

    Fluid accumulation in either the obstructed upper or lower intestinal segments of the dog was found in most animals to be negligible. Distention pressures of 25 cm of water tended to reduce fluid accumulation within the intestinal lumen. These studies suggest that if the dog is comparable to man, the intraluminal accumulation of fluid in the obstructed small bowel of man might be due to alterations in blood supply to the intestine, rather than to obstruction per se, or the accumulated fluid originates proximal to the jejunum. PMID:4419581

  14. Pediatric ureteropelvic junction obstruction: can magnetic resonance urography identify crossing vessels?

    Energy Technology Data Exchange (ETDEWEB)

    Parikh, Kushal R.; Kraft, Kate H.; Ivancic, Vesna; Smith, Ethan A.; Dillman, Jonathan R. [Section of Pediatric Radiology, Mott Children' s Hospital, Department of Radiology, University of Michigan Health System, Ann Arbor, MI (United States); Hammer, Matthew R. [University of Texas Southwestern, Department of Radiology, Dallas, TX (United States)

    2015-11-15

    MR Urography (MRU) is an increasingly used imaging modality for the evaluation of pediatric genitourinary obstruction. To determine whether pediatric MR urography (MRU) reliably detects crossing vessels in the setting of suspected ureteropelvic junction (UPJ) obstruction. The clinical significance of these vessels was also evaluated. We identified pediatric patients diagnosed with UPJ obstruction by MRU between May 2009 and June 2014. MRU studies were evaluated by two pediatric radiologists for the presence or absence of crossing vessels. Ancillary imaging findings such as laterality, parenchymal thinning/scarring, trapped fluid in the proximal ureter, and presence of renal parenchymal edema were also evaluated. Imaging findings were compared to surgical findings. We used the Mann-Whitney U test to compare continuous data and the Fisher exact test to compare proportions. Twenty-four of 25 (96%) UPJ obstructions identified by MRU were surgically confirmed. MRU identified crossing vessels in 10 of these cases, with 9 cases confirmed intraoperatively (κ = 0.92 [95% CI: 0.75, 1.0]). Crossing vessels were determined to be the primary cause of UPJ obstruction in 7/9 children intraoperatively, while in two children the vessels were deemed incidental and noncontributory to the urinary tract obstruction. There was no significant difference in age or the proportions of ancillary findings when comparing children without and with obstructing vessels. MRU allows detection of crossing vessels in pediatric UPJ obstruction. Although these vessels are the primary cause of obstruction in some children, they are incidental and non-contributory in others. Our study failed to convincingly identify any significant predictors (e.g., age or presence of renal parenchymal edema) that indicate when a crossing vessel is the primary cause of obstruction. (orig.)

  15. Electromagnetic properties of proximity systems

    Science.gov (United States)

    Kresin, Vladimir Z.

    1985-07-01

    Magnetic screening in the proximity system Sα-Mβ, where Mβ is a normal metal N, semiconductor (semimetal), or a superconductor, is studied. Main attention is paid to the low-temperature region where nonlocality plays an important role. The thermodynamic Green's-function method is employed in order to describe the behavior of the proximity system in an external field. The temperature and thickness dependences of the penetration depth λ are obtained. The dependence λ(T) differs in a striking way from the dependence in usual superconductors. The strong-coupling effect is taken into account. A special case of screening in a superconducting film backed by a size-quantizing semimetal film is considered. The results obtained are in good agreement with experimental data.

  16. Electromagnetic properties of proximity systems

    International Nuclear Information System (INIS)

    Kresin, V.Z.

    1985-01-01

    Magnetic screening in the proximity system S/sub α/-M/sub β/, where M/sub β/ is a normal metal N, semiconductor (semimetal), or a superconductor, is studied. Main attention is paid to the low-temperature region where nonlocality plays an important role. The thermodynamic Green's-function method is employed in order to describe the behavior of the proximity system in an external field. The temperature and thickness dependences of the penetration depth lambda are obtained. The dependence lambda(T) differs in a striking way from the dependence in usual superconductors. The strong-coupling effect is taken into account. A special case of screening in a superconducting film backed by a size-quantizing semimetal film is considered. The results obtained are in good agreement with experimental data

  17. Axial torsion of meckel's diverticulum causing small bowel obstruction in adult: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Youn, In Kyung; Lee, Su Lim; Ku, Young Mi [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of)

    2016-02-15

    Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract that is prevalent in 2–3% of the population. The lifetime risk of complications is estimated at 4%. Small bowel obstruction is the second most common complication of MD. Among the causes of bowel obstruction, axial torsion of MD is the rarest complication. Urgent surgical treatment is needed in cases of small bowel obstruction associated with torsion of MD. Pre-operative diagnosis of MD as a cause of small bowel obstruction is difficult, because the diagnosis can be made only if the diverticulum is delineated at the site of obstruction. We reported a case of axial torsion of MD with necrosis that caused proximal small bowel perforation in a 21 year old male.

  18. Comparison of ultrasound evaluation of patients of obstructive jaundice with endoscopic retrograde cholangio-pancreatography findings

    International Nuclear Information System (INIS)

    Farrukh, S.Z.U.I.; Siddiqui, A.R.; Haqqi, S.A.; Muhammad, A.J.

    2017-01-01

    Ultrasonography has proven to be quite effective in differentiating hepatocellular from obstructive cause of jaundice in various studies. This study was conducted with the aim to determine the efficacy of ultrasonography and Endoscopic Retrograde Cholangio-Pancreatography (ERCP) in the diagnosis of obstructive reason of jaundice. Methods: In this descriptive case series, 200 patients with >15 years age of either gender with cholestatic liver enzymes were included, i.e., those patients who had an ultrasound prior to ERCP at the department of gastroenterology of Patel Hospital, Karachi. Patients known to have liver disease with cholestatic jaundice had imaging other than ultrasound were excluded. The results of ultrasonography and ERCPs were compared in particularly looking for the cause of obstruction. Results: Out of total 200 patients, mean age was 41.22+-12.46 years with 107 (53.5 percent) females. Ability of ultrasound in correctly diagnosing obstructive reason for stone CBD was found to be 72.5 percent, dilated CBD without reason 41.7 percent, proximal obstruction, 63.15 percent, distal CBD obstruction 60 percent, and sludge 66.7 percent. Overall ability of ultrasound in correctly diagnosing the cause of obstruction was 64.17 percent. Conclusion: Ultrasound is recommended as the initial examination, which provides a guide to choose patients for either a more advanced non-invasive imaging like MRCP or to an invasive procedure like ERCP. (author)

  19. Proximity effect at Millikelvin temperatures

    International Nuclear Information System (INIS)

    Mota, A.C.

    1986-01-01

    Proximity effects have been studied extensively for the past 25 years. Typically, they are in films several thousand angstroms thick at temperatures not so far below T/sub CNS/, the transition temperature of the NS system. Interesting is, however, the proximity effect at temperatures much lower than T/sub CNS/. In this case, the Cooper-pair amplitudes are not small and very long pair penetration lengths into the normal metal can be expected. Thus, we have observed pair penetration lengths. For these investigations very suitable specimens are commercial wires of one filament of NbTi or Nb embedded in a copper matrix. The reasons are the high transmission coefficient at the interface between the copper and the superconductor and the fact that the copper in these commercial wires is rather clean with electron free paths between 5 to 10 μm long. In this paper, the magnetic properties of thick proximity systems in the range of temperatures between T/sub CNS/ and 5 x 10/sup -4/ T/sub CNS/ in both low and high magnetic fields are discussed

  20. Management of obstructed defecation.

    Science.gov (United States)

    Podzemny, Vlasta; Pescatori, Lorenzo Carlo; Pescatori, Mario

    2015-01-28

    The management of obstructed defecation syndrome (ODS) is mainly conservative and mainly consists of fiber diet, bulking laxatives, rectal irrigation or hydrocolontherapy, biofeedback, transanal electrostimulation, yoga and psychotherapy. According to our experience, nearly 20% of the patients need surgical treatment. If we consider ODS an "iceberg syndrome", with "emerging rocks", rectocele and rectal internal mucosal prolapse, that may benefit from surgery, at least two out of ten patients also has "underwater rocks" or occult disorders, such as anismus, rectal hyposensation and anxiety/depression, which mostly require conservative treatment. Rectal prolapse excision or obliterative suture, rectocele and/or enterocele repair, retrograde Malone's enema and partial myotomy of the puborectalis muscle are effective in selected cases. Laparoscopic ventral sacral colporectopexy may be an effective surgical option. Stapled transanal rectal resection may lead to severe complications. The Transtar procedure seems to be safer, when dealing with recto-rectal intussusception. A multidisciplinary approach to ODS provides the best results.

  1. Sinusoidal obstruction syndrome.

    Science.gov (United States)

    Valla, Dominique-Charles; Cazals-Hatem, Dominique

    2016-09-01

    Sinusoidal obstruction syndrome (SOS) is characterized by damage to small hepatic vessels affecting particularly sinusoidal endothelium. Damaged sinusoids can be associated with a partial or complete occlusion of small hepatic veins, hence the previous denomination of hepatic veno-occlusive disease (VOD). Exposure to certain exogenous toxins appears to be specific to this condition and is frequently included in its definition. Typical histopathological features of SOS in a liver biopsy specimen are presented in the text. The purpose of this article is to provide an overview on the different entities corresponding to this general definition. Such entities include: (i) liver disease related to pyrrolizidine alcaloids; (ii) liver injury related to conditioning for hematopoietic stem cell transplantation; (iii) vascular liver disease occurring in patients treated with chemotherapy for liver metastasis of colorectal cancer; and (iv) other liver diseases related to toxic agents. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  2. Chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2013-01-01

    Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

  3. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

  4. Equilibrium properties of proximity effect

    International Nuclear Information System (INIS)

    Esteve, D.; Pothier, H.; Gueron, S.; Birge, N.O.; Devoret, M.

    1996-01-01

    The proximity effect in diffusive normal-superconducting (NS) nano-structures is described by the Usadel equations for the electron pair correlations. We show that these equations obey a variational principle with a potential which generalizes the Ginzburg-Landau energy functional. We discuss simple examples of NS circuits using this formalism. In order to test the theoretical predictions of the Usadel equations, we have measured the density of states as a function of energy on a long N wire in contact with a S wire at one end, at different distances from the NS interface. (authors)

  5. Equilibrium properties of proximity effect

    Energy Technology Data Exchange (ETDEWEB)

    Esteve, D.; Pothier, H.; Gueron, S.; Birge, N.O.; Devoret, M.

    1996-12-31

    The proximity effect in diffusive normal-superconducting (NS) nano-structures is described by the Usadel equations for the electron pair correlations. We show that these equations obey a variational principle with a potential which generalizes the Ginzburg-Landau energy functional. We discuss simple examples of NS circuits using this formalism. In order to test the theoretical predictions of the Usadel equations, we have measured the density of states as a function of energy on a long N wire in contact with a S wire at one end, at different distances from the NS interface. (authors). 12 refs.

  6. Collateral circulations in inferior vena cava obstruction

    International Nuclear Information System (INIS)

    Lee, Jong Beum; Park, Jae Hyung; Han, Man Chung; Park, Soo Soung

    1985-01-01

    Obstruction of the inferior vena cava (IVC) is an uncommon condition, and the collateral pathway varies according to the level, extent, duration and the cause of obstruction. Membranous obstruction of IVC in its hepatic portion might be one of the principle cause among Korean, though not reported till now. Analytical study was performed in 26 cases of IVC obstruction with various cause. 1. The level of the obstruction showed relatively even distribution as follows, upper caval in 11 cases, middle caval in 6 cases and infrarenal in 9 cases. 2. The main cause of upper caval obstruction was membranous obstruction. 3. As a whole, the main collateral pathway was the central route (22 cases: 85%). 4. Characteristic collateral pathway unique to upper caval obstruction was transhepatic venous collateral, developed between the obstructed segment and unobstructed segment of IVC. 5. Scalloping of left cardiac border produced by pericardiophrenic venous collateral was characteristic simple chest x-ray finding in IVC obstruction

  7. The infrastructure of psychological proximity

    DEFF Research Database (Denmark)

    Nickelsen, Niels Christian Mossfeldt

    2015-01-01

    Main arguments: Telemedicine offers unique opportunities to improve the accessibility of health services. It is defined as diagnosis, treatment and monitoring among doctors, nurses and patients separated by spaces, but mediated through information and communication technologies (Mort & May, 2003...... project in 2014 at four hospitals in Copenhagen in relation to 120 patients with chronic obstructive pulmonary syndrome. The material embraces 1) 13 transcribed interviews with nurses and medical doctors 2) two plenary sessions with nurses across hospitals, where photos and diaries were discussed 3...... diagnostic work when patients are not physically present (275). Oudshoorn argues that nurses need to learn to calm patients and help them to see the utility of measurements (2008, 279). Langstrup & Winthereik argues that it is pivotal to offer instruction with regard to the application of the technology...

  8. Are interstitial cells of Cajal involved in mechanical stress-induced gene expression and impairment of smooth muscle contractility in bowel obstruction?

    Directory of Open Access Journals (Sweden)

    Chester C Wu

    Full Text Available The network of interstitial cells of Cajal (ICC is altered in obstructive bowel disorders (OBD. However, whether alteration in ICC network is a cause or consequence of OBD remains unknown. This study tested the hypothesis that mechanical dilation in obstruction disrupts the ICC network and that ICC do not mediate mechanotranscription of COX-2 and impairment of smooth muscle contractility in obstruction.Medical-grade silicon bands were wrapped around the distal colon to induce partial obstruction in wild-type and ICC deficient (W/W(v mice.In wild-type mice, colon obstruction led to time-dependent alterations of the ICC network in the proximal colon segment. Although unaffected on days 1 and 3, the ICC density decreased markedly and the network was disrupted on day 7 of obstruction. COX-2 expression increased, and circular muscle contractility decreased significantly in the segment proximal to obstruction. In W/W(v control mice, COX-2 mRNA level was 4.0 (±1.1-fold higher (n=4 and circular muscle contractility was lower than in wild-type control mice. Obstruction further increased COX-2 mRNA level in W/W(v mice to 7.2 (±1.0-fold vs. W/W(v controls [28.8 (±4.1-fold vs. wild-type controls] on day 3. Obstruction further suppressed smooth muscle contractility in W/W(v mice. However, daily administration of COX-2 inhibitor NS-398 significantly improved muscle contractility in both W/W(v sham and obstruction mice.Lumen dilation disrupts the ICC network. ICC deficiency has limited effect on stretch-induced expression of COX-2 and suppression of smooth muscle contractility in obstruction. Rather, stretch-induced COX-2 plays a critical role in motility dysfunction in partial colon obstruction.

  9. Surgical management of nasal obstruction.

    Science.gov (United States)

    Moche, Jason A; Palmer, Orville

    2012-05-01

    The proper evaluation of the patient with nasal obstruction relies on a comprehensive history and physical examination. Once the site of obstruction is accurately identified, the patient may benefit from a trial of medical management. At times however, the definitive treatment of nasal obstruction relies on surgical management. Recognizing the nasal septum, nasal valve, and turbinates as possible sites of obstruction and addressing them accordingly can dramatically improve a patient's nasal breathing. Conservative resection of septal cartilage, submucous reduction of the inferior turbinate, and structural grafting of the nasal valve when appropriate will provide the optimal improvement in nasal airflow and allow for the most stable results. Copyright © 2012. Published by Elsevier Inc.

  10. Bolus obstruction by Ascaris lumbricoides

    African Journals Online (AJOL)

    In 67 cases conservative treatment was successful. ... bolus of worms, biliary ascariasis,3.6 pancreatitis and acute ... or chronic granulomatous peritonitis is rare.i These complica- ... obstruction admitted to the paediatric surgical wards of the.

  11. Bleeding 'downhill' esophageal varices associated with benign superior vena cava obstruction: case report and literature review.

    Science.gov (United States)

    Loudin, Michael; Anderson, Sharon; Schlansky, Barry

    2016-10-24

    Proximal or 'downhill' esophageal varices are a rare cause of upper gastrointestinal hemorrhage. Unlike the much more common distal esophageal varices, which are most commonly a result of portal hypertension, downhill esophageal varices result from vascular obstruction of the superior vena cava (SVC). While SVC obstruction is most commonly secondary to malignant causes, our review of the literature suggests that benign causes of SVC obstruction are the most common cause actual bleeding from downhill varices. Given the alternative pathophysiology of downhill varices, they require a unique approach to management. Variceal band ligation may be used to temporize acute variceal bleeding, and should be applied on the proximal end of the varix. Relief of the underlying SVC obstruction is the cornerstone of definitive treatment of downhill varices. A young woman with a benign superior vena cava stenosis due to a tunneled internal jugular vein dialysis catheter presented with hematemesis and melena. Urgent upper endoscopy revealed multiple 'downhill' esophageal varices with stigmata of recent hemorrhage. As there was no active bleeding, no endoscopic intervention was performed. CT angiography demonstrated stenosis of the SVC surrounding the distal tip of her indwelling hemodialysis catheter. The patient underwent balloon angioplasty of the stenotic SVC segment with resolution of her bleeding and clinical stabilization. Downhill esophageal varices are a distinct entity from the more common distal esophageal varices. Endoscopic therapies have a role in temporizing active variceal bleeding, but relief of the underlying SVC obstruction is the cornerstone of treatment and should be pursued as rapidly as possible. It is unknown why benign, as opposed to malignant, causes of SVC obstruction result in bleeding from downhill varices at such a high rate, despite being a less common etiology of SVC obstruction.

  12. Intrabilary obstruction by colorectal metastases

    OpenAIRE

    Traeger, Luke; Kiroff, George

    2018-01-01

    Abstract Intrabiliary colorectal metastases are rare. We present a case of an 84-year-old man who developed obstructive jaundice secondary to intrabiliary growth of colorectal metastases. The patient presented with three weeks of jaundice and significant weight loss in the preceding months. The patient’s background included metastatic colorectal carcinoma, with a previous right hemicolectomy and left hepatectomy for liver metastases. A MRCP showed an obstruction of the biliary tract transitio...

  13. Chronic intestinal pseudo-obstruction.

    Science.gov (United States)

    Gabbard, Scott L; Lacy, Brian E

    2013-06-01

    Chronic intestinal pseudo-obstruction (CIP) is a rare and serious disorder of the gastrointestinal (GI) tract characterized as a motility disorder with the primary defect of impaired peristalsis; symptoms are consistent with a bowel obstruction, although mechanical obstruction cannot be identified. CIP is classified as a neuropathy, myopathy, or mesenchymopathy; it is a neuropathic process in the majority of patients. The natural history of CIP is generally that of a progressive disorder, although occasional patients with secondary CIP note significant symptomatic improvement when the underlying disorder is identified and treated. Symptoms vary from patient to patient depending on the location of the luminal GI tract involved and the degree of involvement; however, the small intestine is nearly always involved. Common symptoms include dysphagia, gastroesophageal reflux, abdominal pain, nausea, vomiting, bloating, abdominal distension, constipation or diarrhea, and involuntary weight loss. Unfortunately, these symptoms are nonspecific, which can contribute to misdiagnosis or a delay in diagnosis and treatment. Since many of the symptoms and signs suggest a mechanical bowel obstruction, diagnostic tests typically focus on uncovering a mechanical obstruction, although routine tests do not identify an obstructive process. Nutrition supplementation is required for many patients with CIP due to symptoms of dysphagia, nausea, vomiting, and weight loss. This review discusses the epidemiology, etiology, pathogenesis, diagnosis, and treatment of patients with CIP, with an emphasis on nutrition assessment and treatment options for patients with nutrition compromise.

  14. The Turning Point for Morphomechanical Remodeling During Complete Intestinal Obstruction in Rats Occurs After 12-24 h.

    Science.gov (United States)

    Sun, Daming; Zhao, Jingbo; Liao, Donghua; Huang, Zhiyong; Gregersen, Hans

    2018-05-01

    Intestinal obstruction prompts luminal dilation and wall remodeling proximal to the site of obstruction. Studies on temporal and spatial morphomechanical remodeling are needed for comprehending the pathophysiology of acute intestinal obstruction. The aim was to estimate the no-load and zero-stress morphomechanical properties in circumferential and longitudinal direction at 0, 6, 12, 24, 36, and 48 h after complete intestinal obstruction. Obstruction of the distal ileum was created surgically by placement of a polyethylene ring for up to 48 h in 30 rats. Sham and normal groups were also studied (n = 12). Five 6 cm-long intestinal segments proximal to the obstruction site were used for histological, morphometric and mechanical analysis at the designated times. Morphomechanical changes were huge but only subtle changes were observed between the 5 segments during the obstruction period. Due to dilation, the serosal length and mucosal length increased continuously from 6 to 48 h (p h and beyond (p h where after the opening angle increased and the bending angle returned to pre-obstruction levels. For the residual stretch ratios and the position of the neutral axis the turning point was found after 24 h. Histologically, the thickness and area of most wall layers were quite stable for the first 12 h but with an increase at the 24 h time point that continued to the 48 h time point. The most pronounced change was found for the circumferential muscle layer (p h after creating the obstruction.

  15. Obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Steven D. Brass

    2011-11-01

    Full Text Available Obstructive sleep apnea (OSA affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual’s risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  16. Obstructive sleep apnea.

    Science.gov (United States)

    Ho, Matthew L; Brass, Steven D

    2011-11-29

    Obstructive sleep apnea (OSA) affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual's risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  17. Obstructive sleep apnea.

    Science.gov (United States)

    White, David P; Younes, Magdy K

    2012-10-01

    Obstructive sleep apnea (OSA) is a common disorder characterized by repetitive collapse of the pharyngeal airway during sleep. Control of pharyngeal patency is a complex process relating primarily to basic anatomy and the activity of many pharyngeal dilator muscles. The control of these muscles is regulated by a number of processes including respiratory drive, negative pressure reflexes, and state (sleep) effects. In general, patients with OSA have an anatomically small airway the patency of which is maintained during wakefulness by reflex-driven augmented dilator muscle activation. At sleep onset, muscle activity falls, thereby compromising the upper airway. However, recent data suggest that the mechanism of OSA differs substantially among patients, with variable contributions from several physiologic characteristics including, among others: level of upper airway dilator muscle activation required to open the airway, increase in chemical drive required to recruit the pharyngeal muscles, chemical control loop gain, and arousal threshold. Thus, the cause of sleep apnea likely varies substantially between patients. Other physiologic mechanisms likely contributing to OSA pathogenesis include falling lung volume during sleep, shifts in blood volume from peripheral tissues to the neck, and airway edema. Apnea severity may progress over time, likely due to weight gain, muscle/nerve injury, aging effects on airway anatomy/collapsibility, and changes in ventilatory control stability. © 2012 American Physiological Society

  18. Realities of proximity facility siting

    International Nuclear Information System (INIS)

    DeMott, D.L.

    1981-01-01

    Numerous commercial nuclear power plant sites have 2 to 3 reactors located together, and a group of Facilities with capabilities for fuel fabrication, a nuclear reactor, a storage area for spent fuel, and a maintenance area for contaminated equipment and radioactive waste storage are being designed and constructed in the US. The proximity of these facilities to each other provides that the ordinary flow of materials remain within a limited area. Interactions between the various facilities include shared resources such as communication, fire protection, security, medical services, transportation, water, electrical, personnel, emergency planning, transport of hazardous material between facilities, and common safety and radiological requirements between facilities. This paper will explore the advantages and disadvantages of multiple facilities at one site. Problem areas are identified, and recommendations for planning and coordination are discussed

  19. Parylene MEMS patency sensor for assessment of hydrocephalus shunt obstruction.

    Science.gov (United States)

    Kim, Brian J; Jin, Willa; Baldwin, Alexander; Yu, Lawrence; Christian, Eisha; Krieger, Mark D; McComb, J Gordon; Meng, Ellis

    2016-10-01

    Neurosurgical ventricular shunts inserted to treat hydrocephalus experience a cumulative failure rate of 80 % over 12 years; obstruction is responsible for most failures with a majority occurring at the proximal catheter. Current diagnosis of shunt malfunction is imprecise and involves neuroimaging studies and shunt tapping, an invasive measurement of intracranial pressure and shunt patency. These patients often present emergently and a delay in care has dire consequences. A microelectromechanical systems (MEMS) patency sensor was developed to enable direct and quantitative tracking of shunt patency in order to detect proximal shunt occlusion prior to the development of clinical symptoms thereby avoiding delays in treatment. The sensor was fabricated on a flexible polymer substrate to eventually allow integration into a shunt. In this study, the sensor was packaged for use with external ventricular drainage systems for clinical validation. Insights into the transduction mechanism of the sensor were obtained. The impact of electrode size, clinically relevant temperatures and flows, and hydrogen peroxide (H2O2) plasma sterilization on sensor function were evaluated. Sensor performance in the presence of static and dynamic obstruction was demonstrated using 3 different models of obstruction. Electrode size was found to have a minimal effect on sensor performance and increased temperature and flow resulted in a slight decrease in the baseline impedance due to an increase in ionic mobility. However, sensor response did not vary within clinically relevant temperature and flow ranges. H2O2 plasma sterilization also had no effect on sensor performance. This low power and simple format sensor was developed with the intention of future integration into shunts for wireless monitoring of shunt state and more importantly, a more accurate and timely diagnosis of shunt failure.

  20. TRACHEAL AND BRONCHIAL ABNORMALITIES IN PATIENTS WITH SIGNIFICANT OBSTRUCTIVE SYNDROME: ACCORDING TO BRONCHOSCOPIC

    OpenAIRE

    M. L. Shteiner

    2014-01-01

    The endobronchial pattern of significant bronchial obstructive syndrome of various etiologies was analyzed in 4,000 patients with this condition. At the same time, bronchial malformations were encountered as supplementary bronchi of the left and right basal pyramids, axillary left bronchi, supplementary and displaced tracheal bronchi, and a single case of distal transposition of the right proximal bronchus in 1.58% of cases. According to the bronchoscopic findings, supplementary bronchi and t...

  1. Pancreas-sparing duodenectomy for an obstructive adenocarcinoma of the duodenum

    OpenAIRE

    Lam, D; Croome, KP; Hernandez-Alejandro, R

    2012-01-01

    A duodenal adenocarcinoma arising from the junction of the second and third portion of the duodenum, which was resected by pancreas-sparing duodenectomy, is reported. The completely obstructing tumour was circumferential and measured 6.5cm x 3.5cm x 1.0 cm. There was no evidence of pancreas invasion, nor any lymph node metastasis. Pancreas-sparing duodenectomy was performed, with dissection of the pancreaticoduodenal lymph nodes. The proximal duodenum was transected just distal to the ampula ...

  2. Computed tomography of obstructive jaundice

    International Nuclear Information System (INIS)

    Suh, Jung Hek; Lee, Joong Suk; Chun, Beung He; Suh, Soo Jhi

    1982-01-01

    It is well known that the computed tomography (CT) is very useful in the evaluation of obstructive jaundice. We have studied 55 cases of obstructive jaundice with whole body scanner from Jun.1980 to Jun. 1981. The results were as follows: 1. The sex distribution was 36 males and 19 females, and 40 cases of obstructive jaundice were seen in fifth, sixth, and seventh decades. 2. Causes of obstructive jaundice were 25 cases of pancreas cancer, 8 cases of common duct cancer, 4 cases of gallbladder cancer, 4 cases of ampulla vater cancer, 12 cases of common duct stone, and 2 cases of common duct stricture. 3. Levels of obstruction were 8 cases of hepatic portion, 15 cases of suprapancreatic portion, 28 cases of pancreatic portion, and 4 cases of ampullary portion. 4. In tumorous condition, CT demonstrated metastasis of other organs, 9 cases of the liver, 1 case of the lung, 3 cases of the pancreas, 3 cases of the common bile duct, 1 case of the stomach, and 12 cases of adjacent lymph nodes. 5. Associated diseases were 12 cases of intrahepatic stone, 4 cases of clonorchiasis, 2 cases of pancreas pseudocyst, 1 cases of hydronephrosis, and 1 case of renal cyst

  3. Magnetic resonance in obstructive jaundice

    International Nuclear Information System (INIS)

    Gupta, R.K.; Jena, A.; Khushu, S.; Kakar, A.K.; Mishra, P.K.

    1989-01-01

    Twelve cases of obstructive jaundice in whom ultrasound failed to demonstrate the site and/or the cause of obstruction of the biliary tract were examined with magnetic resonance imaging (MRI), correctly diagnosing the site and cause of obstruction in 10 of 12 surgically proven cases. In one case of cholangiocarcinoma, the site of obstruction was well shown on MR but a definite cause could not be ascertained. In another patient who developed intermittent jaundice following surgery for choledochal cyst, MR demonstrated a solitary stone in the common hepatic duct. Surgical confirmation could not be achieved as the patient was lost to follow up. There were 6 cases of choledocholithiasis, 3 cases of gall bladder carcinoma and one case each of pancreatic adenocarcinoma and cholangiocarcinoma. It is believed that MRI will provide obstructive jaundice and will be able to minimize the use of percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP) in view of its ability to perform multiplanar imaging in multiple sequences. 11 refs., figs., 1 tab

  4. comparative proximate composition and antioxidant vitamins

    African Journals Online (AJOL)

    DR. AMINU

    Keywords: Comparative, proximate composition, antioxidant vitamins, honey. INTRODUCTION ... solution of inverted sugars and complex mixture of other saccharides ... enzymatic browning in apple slices and grape juice. (Khan, 1985).

  5. Proximate, Mineral and Phytochemical Composition of Dioscorea ...

    African Journals Online (AJOL)

    ADOWIE PERE

    Keywords: Dioscorea dumetorum, proximate composition, mineral analysis, phytochemical screening ... were analyzed using atomic absorption ... determined using a Hack Dr/200 Spectrophotometer. ... Lead Acetate. +. +. + .... cosmetics.

  6. Proximate composition and antinutrient content of pumpkin ...

    African Journals Online (AJOL)

    Proximate composition and antinutrient content of pumpkin ( Cucurbita pepo ) and sorghum ( Sorghum bicolor ) flour blends fermented with Lactobacillus plantarum , Aspergillus niger and Bacillus subtilis.

  7. Ultrasonographic Demonstration of Intestinal Obstruction

    International Nuclear Information System (INIS)

    Lee, Dong Hoo; Choi, Hyae Seoun; Kim, S. K.; Han, S.U.; Park, K. S.; Park, H. N.

    1982-01-01

    The cardinal feature of intestinal obstruction is the intraluminal fluid accumulation within the bowel segments. The presence of air simply makes it easier to find dilated fluid-filled bowel loop on plain radiographic films. Distended fluid-filed loop, however, may be obscure on X-ray film when gas is absent, secondary to vomiting, or to cessation of air swallowing. furthermore, in closed loop obstruction, air cannot enter the involved bowel, and thereby in this situation gray scale ultrasonography may be a useful device in making a rapid diagnosis. By sonographic confirmations of intestinal obstruction, a tonic, fluid-filled bowel loops usually were revealed as multiple, circular or cylindrical cystic structures with a finely irregular wall. Valvulae connivente sexhibit a characteristic key-board appearance when they project into the fluid-filled lumen

  8. Voltage dependent potassium channel remodeling in murine intestinal smooth muscle hypertrophy induced by partial obstruction.

    Science.gov (United States)

    Liu, Dong-Hai; Huang, Xu; Guo, Xin; Meng, Xiang-Min; Wu, Yi-Song; Lu, Hong-Li; Zhang, Chun-Mei; Kim, Young-chul; Xu, Wen-Xie

    2014-01-01

    Partial obstruction of the small intestine causes obvious hypertrophy of smooth muscle cells and motility disorder in the bowel proximate to the obstruction. To identify electric remodeling of hypertrophic smooth muscles in partially obstructed murine small intestine, the patch-clamp and intracellular microelectrode recording methods were used to identify the possible electric remodeling and Western blot, immunofluorescence and immunoprecipitation were utilized to examine the channel protein expression and phosphorylation level changes in this research. After 14 days of obstruction, partial obstruction caused obvious smooth muscle hypertrophy in the proximally located intestine. The slow waves of intestinal smooth muscles in the dilated region were significantly suppressed, their amplitude and frequency were reduced, whilst the resting membrane potentials were depolarized compared with normal and sham animals. The current density of voltage dependent potassium channel (KV) was significantly decreased in the hypertrophic smooth muscle cells and the voltage sensitivity of KV activation was altered. The sensitivity of KV currents (IKV) to TEA, a nonselective potassium channel blocker, increased significantly, but the sensitivity of IKv to 4-AP, a KV blocker, stays the same. The protein levels of KV4.3 and KV2.2 were up-regulated in the hypertrophic smooth muscle cell membrane. The serine and threonine phosphorylation levels of KV4.3 and KV2.2 were significantly increased in the hypertrophic smooth muscle cells. Thus this study represents the first identification of KV channel remodeling in murine small intestinal smooth muscle hypertrophy induced by partial obstruction. The enhanced phosphorylations of KV4.3 and KV2.2 may be involved in this process.

  9. Voltage dependent potassium channel remodeling in murine intestinal smooth muscle hypertrophy induced by partial obstruction.

    Directory of Open Access Journals (Sweden)

    Dong-Hai Liu

    Full Text Available Partial obstruction of the small intestine causes obvious hypertrophy of smooth muscle cells and motility disorder in the bowel proximate to the obstruction. To identify electric remodeling of hypertrophic smooth muscles in partially obstructed murine small intestine, the patch-clamp and intracellular microelectrode recording methods were used to identify the possible electric remodeling and Western blot, immunofluorescence and immunoprecipitation were utilized to examine the channel protein expression and phosphorylation level changes in this research. After 14 days of obstruction, partial obstruction caused obvious smooth muscle hypertrophy in the proximally located intestine. The slow waves of intestinal smooth muscles in the dilated region were significantly suppressed, their amplitude and frequency were reduced, whilst the resting membrane potentials were depolarized compared with normal and sham animals. The current density of voltage dependent potassium channel (KV was significantly decreased in the hypertrophic smooth muscle cells and the voltage sensitivity of KV activation was altered. The sensitivity of KV currents (IKV to TEA, a nonselective potassium channel blocker, increased significantly, but the sensitivity of IKv to 4-AP, a KV blocker, stays the same. The protein levels of KV4.3 and KV2.2 were up-regulated in the hypertrophic smooth muscle cell membrane. The serine and threonine phosphorylation levels of KV4.3 and KV2.2 were significantly increased in the hypertrophic smooth muscle cells. Thus this study represents the first identification of KV channel remodeling in murine small intestinal smooth muscle hypertrophy induced by partial obstruction. The enhanced phosphorylations of KV4.3 and KV2.2 may be involved in this process.

  10. Transverse and Longitudinal proximity effect

    Science.gov (United States)

    Jalan, Pryianka; Chand, Hum; Srianand, Raghunathan

    2018-04-01

    With close pairs (˜1.5arcmin) of quasars (QSOs), absorption in the spectra of a background quasar in the vicinity of a foreground quasar can be used to study the environment of the latter quasar at kpc-Mpc scales. For this we used a sample of 205 quasar pairs from the Sloan Digital Sky-Survey Data Release 12 (SDSS DR12) in the redshift range of 2.5 to 3.5 by studying their H I Ly-α absorption. We study the environment of QSOs both in the longitudinal as well as in the transverse direction by carrying out a statistical comparison of the Ly-α absorption lines in the quasar vicinity to that of the absorption lines caused by the inter-galactic medium (IGM). This comparison was done with IGM, matched in absorption redshift and signal-to-noise ratio (SNR) to that of the proximity region. In contrast to the measurements along the line-of-sight, the regions transverse to the quasars exhibit enhanced H I Ly-α absorption. This discrepancy can either be interpreted as due to an anisotropic emission from the quasars or as a consequence of their finite lifetime.

  11. Prosthodontic Approach to Treat Obstructive Sleep Apnea ...

    African Journals Online (AJOL)

    Prosthodontic Approach to Treat Obstructive Sleep Apnea. ... Annals of Medical and Health Sciences Research ... disordered breathing represents a continuum, ranging from simple snoring sans sleepiness, upper‑airway resistance syndrome, obstructive sleep apnea (OSA) syndrome, to hypercapnic respiratory failure.

  12. Chronic obstructive pulmonary disease - adults - discharge

    Science.gov (United States)

    ... coughing up dark mucus Your fingertips or the skin around your fingernails are blue Alternative Names COPD - adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; ...

  13. Proximal Participation: A Pathway into Work

    Science.gov (United States)

    Chan, Selena

    2013-01-01

    In a longitudinal case study of apprentices, the term proximal participation was coined to describe the entry process of young people, with unclear career destinations, into the trade of baking. This article unravels the significance of proximal participation in the decision-making processes of young people who enter a trade through initial…

  14. Bimalleolar ankle fracture with proximal fibular fracture

    NARCIS (Netherlands)

    Colenbrander, R. J.; Struijs, P. A. A.; Ultee, J. M.

    2005-01-01

    A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. The proximal fibular

  15. Effects of hepatic ischemia-reperfusion injury on the P-glycoprotein activity at the liver canalicular membrane and blood-brain barrier determined by in vivo administration of rhodamine 123 in rats.

    Science.gov (United States)

    Miah, Mohammad K; Shaik, Imam H; Bickel, Ulrich; Mehvar, Reza

    2014-04-01

    To investigate the effects of normothermic hepatic ischemia-reperfusion (IR) injury on the activity of P-glycoprotein (P-gp) in the liver and at the blood-brain barrier (BBB) of rats using rhodamine 123 (RH-123) as an in vivo marker. Rats were subjected to 90 min of partial ischemia or sham surgery, followed by 12 or 24 h of reperfusion. Following intravenous injection, the concentrations of RH-123 in blood, bile, brain, and liver were used for pharmacokinetic calculations. The protein levels of P-gp and some other transporters in the liver and brain were also determined by Western blot analysis. P-gp protein levels at the liver canalicular membrane were increased by twofold after 24 h of reperfusion. However, the biliary excretion of RH-123 was reduced in these rats by 26%, presumably due to IR-induced reductions in the liver uptake of the marker and hepatic ATP concentrations. At the BBB, a 24% overexpression of P-gp in the 24-h IR animals was associated with a 30% decrease in the apparent brain uptake clearance of RH-123. The pharmacokinetics or brain distribution of RH-123 was not affected by the 12-h IR injury. Hepatic IR injury may alter the peripheral pharmacokinetics and brain distribution of drugs that are transported by P-gp and possibly other transporters.

  16. Adult small bowel obstruction.

    Science.gov (United States)

    Taylor, Mark R; Lalani, Nadim

    2013-06-01

    Small bowel obstruction (SBO) is a clinical condition that is often initially diagnosed and managed in the emergency department (ED). The high rates of potential complications that are associated with an SBO make it essential for the emergency physician (EP) to make a timely and accurate diagnosis. The primary objective was to perform a systematic review and meta-analysis of the history, physical examination, and imaging modalities associated with the diagnosis of SBO. The secondary objectives were to identify the prevalence of SBO in prospective ED-based studies of adult abdominal pain and to apply Pauker and Kassirer's threshold approach to clinical decision-making to the diagnosis and management of SBO. MEDLINE, EMBASE, major emergency medicine (EM) textbooks, and the bibliographies of selected articles were scanned for studies that assessed one or more components of the history, physical examination, or diagnostic imaging modalities used for the diagnosis of SBO. The selected articles underwent a quality assessment by two of the authors using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Data used to compile sensitivities and specificities were obtained from these studies and a meta-analysis was performed on those that examined the same historical component, physical examination technique, or diagnostic test. Separate information on the prevalence and management of SBO was used in conjunction with the meta-analysis findings of computed tomography (CT) to determine the test and treatment threshold. The prevalence of SBO in the ED was determined to be approximately 2% of all patients who present with abdominal pain. Having a previous history of abdominal surgery, constipation, abnormal bowel sounds, and/or abdominal distention on examination were the best history and physical examination predictors of SBO. X-ray was determined to be the least useful imaging modality for the diagnosis of SBO, with a pooled positive likelihood ratio (+LR

  17. Obstructive Sleep Apnea Hypopnea Syndrome

    African Journals Online (AJOL)

    hanumantp

    Obstructive sleep apnea hypopnea syndrome (OSAHS) is an important medical condition brought to limelight in the last five decades.[1] It is a major cause of morbidity and significant cause of mortality worldwide, including developed and developing nations. A survey done in Abuja, Nigeria,[2] showed that OSAHS may be a ...

  18. Wallstents for metastatic biliary obstruction

    NARCIS (Netherlands)

    van Berkel, A. M.; Bergman, J. J.; Waxman, I.; Andres, P.; Huibregtse, K.

    1996-01-01

    In patients with obstruction of the common bile duct caused by primary pancreaticoblliary tumors, Wallstents have been shown to remain patent for a median duration of 273 days (range: 14-363). However, in one study that included both patients with primary pancreaticobillary malignancies and patients

  19. Oxidative stress in obstructive nephropathy

    NARCIS (Netherlands)

    Dendooven, Amelie; Ishola, David A.; Nguyen, Tri Q.; Van der Giezen, Dionne M.; Kok, Robbert Jan; Goldschmeding, Roel; Joles, Jaap A.

    P>Unilateral ureteric obstruction (UUO) is one of the most commonly applied rodent models to study the pathophysiology of renal fibrosis. This model reflects important aspects of inflammation and fibrosis that are prominent in human kidney diseases. In this review, we present an overview of the

  20. Obstruction theory on 8-manifolds

    Czech Academy of Sciences Publication Activity Database

    Čadek, M.; Crabb, M.; Vanžura, Jiří

    2008-01-01

    Roč. 127, č. 2 (2008), s. 167-186 ISSN 0025-2611 R&D Projects: GA ČR GA201/05/2117 Institutional research plan: CEZ:AV0Z10190503 Keywords : 8-manifolds * obstruction theory Subject RIV: BA - General Mathematics Impact factor: 0.509, year: 2008

  1. Anaesthesia and subglottic airway obstruction

    African Journals Online (AJOL)

    2009-07-14

    Jul 14, 2009 ... Introduction. Surgery on the upper airway remains challenging for both surgeon and ... from her upper airway obstruction rather than asthma.1 She had made a long ... patient was well oxygenated with oxygen saturation above. 95%. .... Difficulties relate to tidal volume measurement, CO2 detection and the.

  2. Clinical research of the obstructive interface morphology of the inferior vena cava and the method of choice for taking the 'pierce membrane'

    International Nuclear Information System (INIS)

    Wei Ning; Zu Maoheng; Xu Hao; Gu Yuming; Li Guojun; Zhang Qingqiao; Xu Wei; Liu Hongtao

    2008-01-01

    Objective: To evaluate the relation between the morphology of the obstructive interface of the inferior vena cava (IVC)and the method of choice for taking the 'pierce membrane'. Methods: Interventional therapy was performed in 155 patients with obstruction of inferior vena cave during 2003-2005. The types of proximal part and distal end of obstruction were classified on the base of inferior vane cavography and divid[d into two groups accordingly. The principle of taking 'pierce membrane' whether as accending or descending route was decided by the morphology of the obstructive interface. The complication rates of taking 'pierce membrane' were compared between the two groups including one of 2003-2005 and another of 1990 -1997 as the control. Results: 155 cases were classified to 7 types according to morphology of inferior vena cava obstruction of the distal interface, the type of membrane with hole (32 cases), the dome type (50 cases), the taper type (17 cases), the horizontal type (13 cases), the inclination type (10 cases), the irregular type (19 eases)and the type of obstruction with communicating branches (14 cases). The morphologies of the proximal part of the obstruction were mainly divided into the type of membrane with hole, dome type, taper type and horizontal type. All the cases were successfully taken 'pierce membrane', without complication of pericardial effusion and abdominal bleeding. In control group of 150 Budd-Chiari syndrome cases with obstruction of inferior vena cava, the complications of taking 'pierce membrane' included mis puncture into pericardium (16 cases) and abdominal hemorrhage because of rupturing the inferior vena cava in 2 cases. Comparing the two groups, there was statistical significance with severe complications. Conclusions: 'Pierce membrane' interventional technique for the obstruction of inferior vena eava by coinciding the morphology of the obstructive interface with suitable piercing direction can not only raise successful

  3. Fluoroscopically-guided transnasal insertion of ileus tube intestinal decompression in patients with inoperable malignant bowel obstruction

    International Nuclear Information System (INIS)

    Fang Shiming; Li Haili; Lin Qing; Mao Aiwu; Wu Shaoqiu; Jiang Haosheng; Cao Yan; Wang Zhenlei

    2011-01-01

    Objective: To assess the technical feasibility and effectiveness of fluoroscopically-guided transnasal insertion of ileus tube for intestinal decompression in the treatment of inoperable malignant bowel obstruction. Methods: A total of 211 patients with inoperable malignant bowel obstruction were enrolled in this study. The median KPS scale was 40 (ranged from 20 to 60). Under fluoroscopic guidance, transnasal insertion of ileus tube by using conventional technique or guidewire-catheter exchange technique was performed in all patients. The technical success rate, the clinical effective rate, the curative rate and adverse reactions as well as complications were documented. The correlation among the obstructive sites, obstruction causes and therapeutic effectiveness was analyzed. The ileus tube used in this study was a four-cavity and double-balloon catheter with a diameter of 16 F/18 f, which is produced by Cliny Company. Results: Transnasal drainage tube was successfully inserted into the proximal jejunum in all 211 patients with malignant bowel obstruction, and the total technical success rate was 100%. The initial technical success rate of the traditional technique and the catheter-guidewire exchange method was 85.5% (65/76) and 100% (135/135) respectively, the difference between the two was significant (P<0.05). After 24 hours, the clinical remission rate in the patients with high-level intestinal obstruction, lower-level intestinal obstruction and colorectal obstruction was 95.8% (46/48), 92.9% (117/126) and 83.8% (31/37), respectively. A follow-up of 4-245 days (mean 138 days) was conducted, and the total clinical cure rate was 27.5% (58/211). The clinical cure rate in small intestine obstruction and colorectal obstruction caused by primary tumor or recurrence was 12.7% (20/157) and 59.5% (22/37), respectively (P<0.05). The adverse reactions and complications included uncomfortable pharynx feeling or pain (99.1%, 199/221), the tube obstruction (23.2%, 49

  4. Unusual causes of obstructive jaundice. Computed tomography

    International Nuclear Information System (INIS)

    Rodriguez, E.; Pombo, F.; Cao, I.; Fernandez, R.; Riba da, M.

    1998-01-01

    The purpose of this study is to present selected computed tomography (CT) images showing unusual causes of obstructive jaundice. We reviewed retrospectively the Ct findings of obstructive jaundice in 227 patients. The most common causes of biliary obstruction were adenocarcinoma of the pancreatic head (n=77) and cholangiocarcinoma (n=65). In 13 cases (5.7%), the etiology of obstructive jaundice was unusual or exceptional: tuberculous adenitis (n=3), obstruction of afferent loop (n=2)signet ring cell adenocarcinoma (n=3); in duodenum, gallbladder and papilla of Water), Mirizzi syndrome (n=1), adenocarcinoma of the hepatic flexure (n=1), choledochal cyst (n=1) and pancreatic lymphoma (n=1). (Author) 13 refs

  5. Proximal Alternating Direction Method with Relaxed Proximal Parameters for the Least Squares Covariance Adjustment Problem

    Directory of Open Access Journals (Sweden)

    Minghua Xu

    2014-01-01

    Full Text Available We consider the problem of seeking a symmetric positive semidefinite matrix in a closed convex set to approximate a given matrix. This problem may arise in several areas of numerical linear algebra or come from finance industry or statistics and thus has many applications. For solving this class of matrix optimization problems, many methods have been proposed in the literature. The proximal alternating direction method is one of those methods which can be easily applied to solve these matrix optimization problems. Generally, the proximal parameters of the proximal alternating direction method are greater than zero. In this paper, we conclude that the restriction on the proximal parameters can be relaxed for solving this kind of matrix optimization problems. Numerical experiments also show that the proximal alternating direction method with the relaxed proximal parameters is convergent and generally has a better performance than the classical proximal alternating direction method.

  6. The angiographic demonstration of hepatic vein obstruction

    International Nuclear Information System (INIS)

    Zu Maoheng; Xu Hao; Li Guojun; Gu Yuming; Wei Ning; Wang Cheng; Xu Wei

    2004-01-01

    Objective: To evaluate the angiographic feature of hepatic vein obstruction. Methods Forty-five patients (male 23, female 22, age 9-54 years) suffered from hepatic vein obstruction. The inferior vena cavography and the hepatic venography were performed in all cases. Results: IVC was free in 37 patients with hepatic vein obstruction, both IVC and HV were obstructed in 8 patients. The local or long stenosis of IVC was found in 31 inferior vena cavography. The diameter of IVC was normal in 12 patients. The sign of membranous dome was found in hepatic vein orifice in 5 cases and in accessory hepatic vein orifice in 4 cases. Intrahepatic venous collaterals were found in 45 cases. Conclusion: Hepatic vein obstruction can be reproached primarily in inferior vena cavography, the membranous dome is a direct sign of membranous obstruction of HV and AHV in inferior vena cavography. The selected hepatic venography can provide reliable evidence to diagnose hepatic vein obstruction

  7. Proximal Hamstring Tendinosis and Partial Ruptures.

    Science.gov (United States)

    Startzman, Ashley N; Fowler, Oliver; Carreira, Dominic

    2017-07-01

    Proximal hamstring tendinosis and partial hamstring origin ruptures are painful conditions of the proximal thigh and hip that may occur in the acute, chronic, or acute on chronic setting. Few publications exist related to their diagnosis and management. This systematic review discusses the incidence, treatment, and prognosis of proximal hamstring tendinosis and partial hamstring ruptures. Conservative treatment measures include nonsteroidal anti-inflammatory drugs, physical therapy, rest, and ice. If these measures fail, platelet-rich plasma or shockwave therapy may be considered. When refractory to conservative management, these injuries may be treated with surgical debridement and hamstring reattachment. [Orthopedics. 2017; 40(4):e574-e582.]. Copyright 2017, SLACK Incorporated.

  8. Common iliac vein thrombosis as a result of proximal venous stenosis following renal transplantation: A case report

    Directory of Open Access Journals (Sweden)

    Atish Chopra

    2016-12-01

    Full Text Available Proximal iliac vein stenosis resulting in iliac vein thrombus and venous outflow obstruction in renal transplant patients is an exceedingly rare occurrence. We present a case of a 63-year-old male who underwent deceased donor renal transplantation and presented 12 days later with ipsilateral lower extremity swelling and plateauing serum creatinine. Further work-up demonstrated proximal iliac vein deep venous thrombosis and anticoagulation was initiated. However, propagation of the thrombus developed despite receiving therapeutic anticoagulation. Subsequent venography demonstrated proximal iliac venous stenosis and the patient underwent successful catheter-directed alteplase thrombolysis, inferior vena cava filter placement and iliac vein stenting with salvage of the renal allograft. A diagnostic strategy and management algorithm for iliac vein stenosis and thrombosis in a renal transplant recipient is proposed.

  9. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2012-02-01

    PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome. RECENT FINDINGS: The severity of obstructive ventilatory impairment and hyperinflation, especially the inspiratory capacity to total lung capacity (TLC) ratio, correlates with the severity of sleep-related breathing disturbances. Early treatment with continuous positive airway pressure (CPAP) improves survival, reduces hospitalization and pulmonary hypertension, and also reduces hypoxemia. Evidence of systemic inflammation and oxidative stress in COPD and sleep apnea provides insight into potential interactions between both disorders that may predispose to cardiovascular disease. Long-term outcome studies of overlap patients currently underway should provide further evidence of the clinical significance of the overlap syndrome. SUMMARY: Studies of overlap syndrome patients at a clinical, physiological and molecular level should provide insight into disease mechanisms and consequences of COPD and sleep apnea, in addition to identifying potential relationships with cardiovascular disease.

  10. Promoting proximal formative assessment with relational discourse

    Science.gov (United States)

    Scherr, Rachel E.; Close, Hunter G.; McKagan, Sarah B.

    2012-02-01

    The practice of proximal formative assessment - the continual, responsive attention to students' developing understanding as it is expressed in real time - depends on students' sharing their ideas with instructors and on teachers' attending to them. Rogerian psychology presents an account of the conditions under which proximal formative assessment may be promoted or inhibited: (1) Normal classroom conditions, characterized by evaluation and attention to learning targets, may present threats to students' sense of their own competence and value, causing them to conceal their ideas and reducing the potential for proximal formative assessment. (2) In contrast, discourse patterns characterized by positive anticipation and attention to learner ideas increase the potential for proximal formative assessment and promote self-directed learning. We present an analysis methodology based on these principles and demonstrate its utility for understanding episodes of university physics instruction.

  11. THE PROXIMATE COMPOSITION OF AFRICAN BUSH MANGO ...

    African Journals Online (AJOL)

    BIG TIMMY

    Information regarding previous studies on these physico-chemical ... This behaviour may be attributed to its high myristic acid ... The authors express deep appreciation to the. Heads of ... of a typical rural processing method on the proximate ...

  12. Proximate composition and nutritional characterization of Chia ...

    African Journals Online (AJOL)

    ... dairy product associated with several beneficial nutritional and health effects. ... The results for amino acids showed that the essential and non-essential amino ... proximate composition and nutritional (amino acids, fatty acids, and minerals ...

  13. Correlation of obstructive sleep apnoea and laryngopharyngeal reflux: phmetry study.

    Science.gov (United States)

    Elhennawi, D M; Ahmed, M R; Abou-Halawa, A S

    2016-12-01

    To study the correlation of obstructive sleep apnoea (OSA) and laryngopharyngeal reflux (LPR). A descriptive study. Suez Canal University Hospital, Ismailia, Egypt. 62 patients with polysomnography confirmed OSA. Patients were evaluated with ambulatory 24-h double channel pH monitoring. Mean reflux symptom index in the study group was 9 ± 5.5, and it was > 13 in all patients with severe OSA. Signs of LPR reflux were present in 34 (55%) patients. Abnormal reflux was detected in the distal oesophagus in 41 patients (66%) and in the proximal oesophagus in 21 patients (34%). Patients with severe OSA had significantly higher nocturnal LPR reflux episodes compared to patients with mild disease (P .05). LPR is common in patients with OSA. Patients with severe OSA have significantly higher nocturnal LPR. This should be considered when treating this group of patients. © 2016 John Wiley & Sons Ltd.

  14. Proximal focal femoral deficiency: A case report

    Directory of Open Access Journals (Sweden)

    Shashank Sharma

    2015-01-01

    Full Text Available Proximal focal femoral deficiency (PFFD is a rare congenital anomaly resulting in limb shortening and disability in young. The exact cause of the disease is not known and it may present as varying grades of affection involving the proximal femur and the acetabulum. Recognition of this rare abnormality on radiographs can help manage these cases better since early institution of therapy may help in achieving adequate growth of the femur.

  15. Flexible ureteroscopy versus laparoscopy for the treatment of patients who initially presented with obstructive pyelonephritis

    Science.gov (United States)

    Sahin, Selcuk; Resorlu, Berkan; Eksi, Mithat; Aras, Bekir; Atar, Arda; Tugcu, Volkan

    2016-01-01

    Objective: To compare the safety and effectiveness of flexible ureteroscopy (F-URS) with transperitoneal laparoscopic ureterolithotomy (TPLU) in cases of obstructive pyelonephritis secondary to large proximal ureteral stones. Methods: A series of 42 patients presenting with obstructive pyelonephritis due to proximal ureteral stones larger than 1.5 cm were included from April 2006 to February 2015 in this comparative study. After drainage of pyonephrosis and resolution of sepsis, 22 patients treated with TPLU (Group I), and 20 patients were treated with F-URS (Group II). Preoperative patient and stone characteristics, procedure-related parameters and clinical outcomes were assessed for each group. Results: It was seen that both methods were effective in the treatment of large proximal ureteral stones. However TPLU provided a higher stone- free rate (100% vs 80%. p=0.043) and lower retreatment rate. There was no difference between the groups for the operative time and complication rate. On the other hand, patients treated with F-URS had less postoperative pain (p=0.008), a shorter hospital stay (p<0.001) and a faster return to daily activities (p<0.001). Conclusions: The results of our study show that both F-URS and TPLU are safe and effective surgical procedures for treatment of large proximal ureteral stones after controlling obstructive pyelonephritis. However, TPLU has a higher stone-free rate with comparable operating time and complication rate as compared to F-URS. On the other hand F-URS has the advantages of less postoperative pain, shorter hospital stay and faster return to daily activities. PMID:27375691

  16. Proximity sensor system development. CRADA final report

    International Nuclear Information System (INIS)

    Haley, D.C.; Pigoski, T.M.

    1998-01-01

    Lockheed Martin Energy Research Corporation (LMERC) and Merritt Systems, Inc. (MSI) entered into a Cooperative Research and Development Agreement (CRADA) for the development and demonstration of a compact, modular proximity sensing system suitable for application to a wide class of manipulator systems operated in support of environmental restoration and waste management activities. In teleoperated modes, proximity sensing provides the manipulator operator continuous information regarding the proximity of the manipulator to objects in the workspace. In teleoperated and robotic modes, proximity sensing provides added safety through the implementation of active whole arm collision avoidance capabilities. Oak Ridge National Laboratory (ORNL), managed by LMERC for the United States Department of Energy (DOE), has developed an application specific integrated circuit (ASIC) design for the electronics required to support a modular whole arm proximity sensing system based on the use of capacitive sensors developed at Sandia National Laboratories. The use of ASIC technology greatly reduces the size of the electronics required to support the selected sensor types allowing deployment of many small sensor nodes over a large area of the manipulator surface to provide maximum sensor coverage. The ASIC design also provides a communication interface to support sensor commands from and sensor data transmission to a distributed processing system which allows modular implementation and operation of the sensor system. MSI is a commercial small business specializing in proximity sensing systems based upon infrared and acoustic sensors

  17. Proximity sensor system development. CRADA final report

    Energy Technology Data Exchange (ETDEWEB)

    Haley, D.C. [Oak Ridge National Lab., TN (United States); Pigoski, T.M. [Merrit Systems, Inc. (United States)

    1998-01-01

    Lockheed Martin Energy Research Corporation (LMERC) and Merritt Systems, Inc. (MSI) entered into a Cooperative Research and Development Agreement (CRADA) for the development and demonstration of a compact, modular proximity sensing system suitable for application to a wide class of manipulator systems operated in support of environmental restoration and waste management activities. In teleoperated modes, proximity sensing provides the manipulator operator continuous information regarding the proximity of the manipulator to objects in the workspace. In teleoperated and robotic modes, proximity sensing provides added safety through the implementation of active whole arm collision avoidance capabilities. Oak Ridge National Laboratory (ORNL), managed by LMERC for the United States Department of Energy (DOE), has developed an application specific integrated circuit (ASIC) design for the electronics required to support a modular whole arm proximity sensing system based on the use of capacitive sensors developed at Sandia National Laboratories. The use of ASIC technology greatly reduces the size of the electronics required to support the selected sensor types allowing deployment of many small sensor nodes over a large area of the manipulator surface to provide maximum sensor coverage. The ASIC design also provides a communication interface to support sensor commands from and sensor data transmission to a distributed processing system which allows modular implementation and operation of the sensor system. MSI is a commercial small business specializing in proximity sensing systems based upon infrared and acoustic sensors.

  18. Hg uptake in ureteral obstructions

    International Nuclear Information System (INIS)

    Desgrez, J.P.; Bourguignon, M.; Raynaud, C.; CEA, 91 - Orsay

    1976-01-01

    In the presence of a total obstruction the results obtained with the Hg uptake test, as indeed with other functional tests, inform on the value of the kidney function at the time but have no prognostic value where repair possibilities are concerned. Some preliminary results seem to show however that very soon after the obstacle is removed, by the 10th or 15th day perhaps, quantitative functional tests may once more be used to evaluate the functional prognosis. This would mean that by waiting about two weeks after the disappearance of a total obstruction the Hg uptake test may again be used in all confidence. In order to check this deduction, which is based on slender evidence but which nevertheless has important practical implications, the measurement of the Hg uptake rate during the days following removal of the obstacle appears essential. In long-standing partial obstructions the Hg uptake rate gives an accurate assessment of the functional balance and helps considerably in the choice of therapy [fr

  19. Depression and obstructive sleep apnea.

    Science.gov (United States)

    Hobzova, Milada; Prasko, Jan; Vanek, Jakub; Ociskova, Marie; Genzor, Samuel; Holubova, Michaela; Grambal, Ales; Latalova, Klara

    2017-10-01

    Obstructive sleep apnea (OSA), is described as intermittent interruptions or reductions in airflow which are initiated by an incomplete or complete collapse of the upper airways despite respiratory effort. When left untreated, OSA is connected with comorbid conditions, such as cardiovascular and metabolic illnesses. The PubMed database was used to examine papers published until April 2017 using the subsequent terms: "obstructive sleep apnea" or "obstructive sleep apnoea" and "depression" in successive combination with "CPAP (continuous positive airway pressure)", "therapy", "pharmacotherapy", "psychotherapy", "cognitive behavioral therapy" or "quality of life". After assessment for the suitability, 126 articles were chosen. The numerous evidence of a connection between OSA and depressive symptoms, as well as depressive disorder, were found. This connection may be directly or indirectly linked due to the participation of some OSA mediators consequences such as obesity, hypertension, and the decreased quality of life. Patients with the comorbid major depression and OSA reported more severe and longer episodes of depression. Nevertheless, the information on the effect of the treatment of OSA using CPAP on the depressive symptoms was limited. Still, the current state of the art suggests that this treatment decreases the severity of the comorbid depressive symptoms. It is important to evaluate the symptoms of depression in the patients with OSA. On the other side, a psychiatrist should not just treat the depression, as it is also important to screen individuals at high risk of OSA when assessing patients for depressive disorder, especially those with depression resistant to treatment.

  20. Obstructive Sleep Apnea in MPS

    Directory of Open Access Journals (Sweden)

    Abhijit Ricky Pal MBBChir, MA, MD, FRCS(ORL-HNS

    2015-11-01

    Full Text Available The mucopolysaccharidoses (MPSs are a group of inherited, metabolic disorders characterized by progressive multisystem accumulation of partially degraded glycosaminoglycans. This manifests with multilevel airway obstruction, presenting with obstructive sleep apnea (OSA. We systematically reviewed the literature to determine the severity and prevalence of OSA in MPS based on polysomnography analysis. Fifteen studies with 294 participants met the inclusion criteria for review. The pretreatment prevalence of OSA in MPS was 81% with a mean apnea–hypopnea index (AHI of 10.4. Patients with MPS I are most significantly affected, with 75% suffering with moderate to severe OSA (mean AHI, 16.6. Enzyme replacement therapy (ERT results in an almost significant reduction in OSA in MPS I ( P = .06, while adenotonsillar surgery significantly improves AHI ( P = .002. Obstructive sleep apnea least affects MPS III. There is a lack of long-term post-ERT and hematopoietic stem cell transplant data relating to OSA outcomes in this population, with further prospective studies required to determine the ongoing response to treatment.

  1. Emergency Management of Malignant Acute Left-Sided Colonic Obstruction

    Science.gov (United States)

    Trompetas, Vasileios

    2008-01-01

    INTRODUCTION The management of acute left-sided colonic obstruction still remains a challenging problem despite significant progress. METHODS A literature search was undertaken using PubMed and the Cochrane Library regarding the options in emergency management of left-sided colonic obstruction focusing on outcomes such as mortality, morbidity, long-term prognosis and cost effectiveness. DISCUSSION Colonic stenting is the best option either for palliation or as a bridge to surgery. It reduces morbidity and mortality rate and the need for colostomy formation. Stenting is likely to be cost effective, but data are variable depending on the individual healthcare system. Nevertheless, surgical management remains relevant as colonic stenting has a small rate of failure, and it is not always available. There are various surgical options. One-stage primary resection and anastomosis is the preferred choice for low-risk patients. Intra-operative colonic irrigation has no proven benefit. Subtotal colectomy is useful in cases of proximal bowel damage or synchronous tumours. Hartmann's procedure should be reserved for high-risk patients. Simple colostomy has no role other than for use in very ill patients who are not fit for any other procedure. PMID:18430330

  2. The Mirizzi syndrome: an uncommon cause of obstructive jaundice

    International Nuclear Information System (INIS)

    Marco, S.F.; Piqueras, R.M.; Jornet, J.; Gil, S.; Ambit, S.; Cervera, J.

    1997-01-01

    The Mirizzi syndromes involves obstruction of the common hepatic duct by a gallstone impacted in the bladder neck or in the cystic duct. It is accompanied by and inflammatory reaction that usually produces a biliary fistula. On rare occasions, this disorder can lead to obstructive jaundice. We reviewed nine cases of Mirizzi syndrome, comparing the findings according to different imaging techniques. All the patients underwent ultrasound study, three were assessed by computerized tomography (CT) and three by transhepatic cholangiography (THC). In eight patients, the diagnosis was confirmed intraoperatively: the remaining patient was diagnosed on the basis of the clinical evidence of obstructive jaundice, ultrasound and THC. In eight patients, ultrasound disclosed dilation of the intrahepatic bile duct. Scleroatrophic bladder with a large stone in the infundibular zone was observed in five cases, and numerous small calculi were found in the remaining four patients, two of whom presented thickening of the bladder walls: the walls were normal in the other two. Pneumobilia was observed one case. CT revealed dilation of the intrahepatic bile duct in all three cases in which it was performed. A cavity containing a calculus was observed in one case and pneumobilia in another. THC disclosed dilation of the intrahepatic bile duct and a lateral filling defect in the common hepatic duct in all three patients in whom it was performed. Two patients were found to have cholecystocholedochal fistulas. The Mirizzi syndrome should be suspected when a scleroatrophic gallbladder or gallstones compress the common hepatic duct, causing proximal, but not distal, bile duct dilation. In these case, THC should be carried out to confirm the diagnosis and determine whether or not a fistula is present since the surgical treatment varies depending on the existence of fistulas and their location. (Author) 15 refs

  3. Inferior vena cava obstruction and shock

    Directory of Open Access Journals (Sweden)

    Megri Mohammed

    2018-01-01

    Full Text Available Shock is one of the most challenging life-threatening conditions with high mortality and morbidity; the outcomes are highly dependent on the early detection and management of the condition. Septic shock is the most common type of shock in the Intensive Care Unit. While not as common as other subsets of shock, obstructive shock is a significant subtype due to well defined mechanical and pathological causes, including tension pneumothorax, massive pulmonary embolism, and cardiac tamponade. We are presenting a patient with obstructive shock due to inferior vena cava obstruction secondary to extensive deep venous thrombosis. Chance of survival from obstructive shock in our patient was small; however, there was complete and immediate recovery after treatment of the obstruction on recognizing the affected vessels. This case alerts the practicing intensivist and the emergency medicine physician to consider occlusion of the great vessels other than the pulmonary artery or aorta as causes of obstructive shock.

  4. Effect of Small Intestine Strangulation Obstruction on Clinical and Histopathological Parameters An Experimental Study in Donkeys

    Directory of Open Access Journals (Sweden)

    Heba Mohamed M. Kuraa

    2011-06-01

    Full Text Available To study clinical and histopathological changes occur within the first 12 hours of strangulating obstruction of the small intestine in equine, twenty five adult donkeys were used in an experimental study. Strangulation obstruction of the small intestine was performed for 3, 6, 9 and 12 hours, respectively. Clinical examination was done before surgery and at 3 hours intervals postoperatively. After euthanasia, histopathological examination was made 10 cm, 1, 2 and 3 meters proximal to the strangulated part. Three hours postoperatively, the animals began to show signs of abdominal pain, they were looking around, stamping the hind feet, falling down suddenly. Nine hours postoperatively, animals showed signs of depression with intermittent nervous movements in the form of circle movement. After 12 hours, the animals were lying down; There were a significant reduction in the body temperature, respiratory rate, pulse rate, heart rate with significant increase in capillary refill time. Macroscopic changes of the strangulated part were congestion, edema, and dark red discoloration of the intestinal wall and mesentery. Distension of the intestine proximal to the strangulation extended more with increase the period of strangulation. Microscopic examination showed showed severe congestion, dark brown to blackish discoloration with fibrous shreds on the strangulated segment. Peticheal hemorrhages were observed in the intestinal wall and its mesentery for a distance up to 3 meters. The severity of signs varies according to the duration of obstruction which could give a remarkable justification of the prognosis of the patient and the availability of treatment.

  5. Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine

    Directory of Open Access Journals (Sweden)

    Takashi Kato

    2012-12-01

    Full Text Available A 56-year-old woman with a history of gynecological surgery for cervical cancer 18 years previously was referred to our hospital for colicky abdominal pain, nausea and vomiting. Intestinal obstruction was diagnosed by contrast-enhanced computed tomography (CT which showed dilation of the small intestine and suggested obstruction in the terminal ileum. In addition, CT showed a thick-walled cavitary lesion communicating with the proximal jejunum. 18F-fluorodeoxyglucose positron emission tomography showed abnormal uptake at the same location as the cavitary lesion revealed by CT. The patient underwent laparotomy for the ileus and resection of the cavitary lesion. At laparotomy, we found a retained surgical sponge in the ileum 60 cm from the ileocecal valve. The cavitary tumor had two fistulae communicating with the proximal jejunum. The tumor was resected en bloc together with the transverse colon, part of the jejunum and the duodenum. Microscopic examination revealed fibrous encapsulation and foreign body giant cell reaction. Since a retained surgical sponge without radiopaque markers is extremely difficult to diagnose, retained surgical sponge should be considered in the differential diagnosis of intestinal obstruction in patients who have undergone previous abdominal surgery.

  6. Clinical and ultrasonographic observations of functional and mechanical intestinal obstruction in buffaloes (Bubalus bubalis

    Directory of Open Access Journals (Sweden)

    Arafat Khalphallah

    2016-05-01

    Full Text Available Aim: This study was designed for clinical and laboratory evaluation of intestinal obstruction (IO in buffaloes (Bubalus bubalis with special emphasis on the diagnostic value of ultrasonographic findings. Materials and Methods: A total number of 30 buffaloes were included in the study and divided into 2 groups: Healthy (n=10 and diseased group (n=20. Diseased buffaloes were admitted to the Veterinary Teaching Hospital at Assiut University, Egypt, with a history of anorexia, abdominal pain, various degrees of abdominal distention, and absence or presence of scanty mucoid faces. These animals were subjected to clinical and ultrasonographic as well as laboratory examinations. Results: Based on ultrasonographic findings, various forms of IO were diagnosed. Functional obstruction, paralytic ileus, was diagnosed in 17 cases (85% while mechanical IO was diagnosed only in 3 cases (15%. Out of 17 cases of paralytic ileus, both proximal and distal ileuses were successfully imaged in 8 and 9 cases, respectively. Proximal ileus was imaged from the right dorsal flank region as a single dilated loop of diameter >6 cm, while distal ileus was imaged as multiple dilated loops of diameter <6 cm. Mechanical obstruction due to duodenal intussusception was visualized as two concentric rings with outer echogenic wall and hypoechoic lumen. All cases of IO showed leukocytosis, hypoproteinemia, and increased activity of alkaline phosphatase and aspartate aminotransferase. Conclusion: Ultrasonography proved to be an essential tool for diagnosis and differential diagnosis of various forms of IO in buffaloes.

  7. Airways obstruction, coal mining, and disability.

    OpenAIRE

    Lapp, N L; Morgan, W K; Zaldivar, G

    1994-01-01

    It has recently been suggested that the inhalation of coal in the absence of complicated coal workers' pneumoconiosis (CWP) or smoking can lead to disabling airways obstruction. The cause of such obstruction has been variously attributed to emphysema or bronchitis. The frequency of significant airways obstruction in a group of United States coal miners seeking compensation for occupationally induced pulmonary impairment was therefore determined. In a sample of 611 "Black Lung" claimants there...

  8. Unusual causes of mechanical small bowel obstruction

    International Nuclear Information System (INIS)

    Shatnawi, Nawaf J.; Bani-Hani, Kamal E.

    2005-01-01

    We herein report our experience regarding unusual causes of bowel obstruction to increase the awareness of surgeons regarding this disease. From 1991 to 2003, we had experience at the University affiliated hospitals, northern Jordan with 24 patients with small bowel obstruction resulting from unusual causes. We retrospectively reviewed the medical records of these patients with regards to the mode of presentation, cause of obstruction, radiological and operative findings, management and outcome. We recorded 15 patients who underwent previous abdominal surgery. Preoperative diagnosis was correct in only one patient with an internal hernia, but the abdominal CT scan suggested the diagnosis in 5 of the 9 patients who had the scan. The final diagnosis was internal hernias in 11 patients, foreign bodies in 5, ischemic strictures in 3, carcinoid tumors in 2, endometriosis in 2, and metastatic deposit from interstitial bladder carcinoma in one patient. Nine of the 12 patients with recurrent obstruction had either short course or recurrence obstruction during the same hospital admission. W carried out bowel resections in 15 patients (5 resections were due to bowel strangulation). Post operative death occurred in 4 patients. Awareness of these rare causes of intestinal obstruction even in patients with previous abdominal operation might improve the outcome. The tentative diagnosis of adhesion obstruction in patients with unusual obstructive etiology might lead to a higher rate of gangrenous complications. Rigorous preoperative evaluation including careful history and early abdominal CT may show the obstructive cause. (author)

  9. A etiological factors in mechanical intestinal obstruction

    International Nuclear Information System (INIS)

    Asad, S.; Khan, H.; Khan, I.A.; Ghaffar, S.; Rehman, Z.U.

    2012-01-01

    Background: Intestinal obstruction occurs when the normal flow of intestinal contents is interrupted. The most frequent causes of intestinal obstruction are postoperative adhesions and hernias, which cause extrinsic compression of the intestine. Less frequently, tumours or strictures of the bowel can cause intrinsic blockage. Objective of the study was to find out the various a etiological factors of mechanical intestinal obstruction and to evaluate the morbidity and mortality in adult patients presenting to Surgical 'A' unit of Ayub teaching hospital with mechanical intestinal obstruction. Methods: This cross-sectional study was conducted from March 2009 to September, 2009. All patients presenting with intestinal obstruction and were above the age of 12 years were included in the study. Patients with non-mechanical obstruction were excluded from the study and those who responded to conservative measures were also excluded. Results: A total of 36 patients with age ranging from 12 to 80 years (Mean age 37.72+-19.74 years) and male to female ratio of 1.77:1, were treated for mechanical intestinal obstruction. The most common cause for mechanical intestinal obstruction was adhesions (36.1%). Intestinal tuberculosis was the second most common cause (19.4%), while hernias and sigmoid volvulus affected 13.9% patients each. Malignancies were found in 5.6% cases. Conclusion: Adhesions and Tuberculosis are the leading causes of mechanical intestinal obstruction in Pakistan. Although some patients can be treated conservatively, a substantial portion requires immediate surgical intervention. (author)

  10. Locking plate fixation for proximal humerus fractures.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2012-02-01

    Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis. The goals of surgery for proximal humeral fractures should involve minimal soft tissue dissection and achieve anatomic reduction of the head complex with sufficient stability to allow for early shoulder mobilization. This article reviews various treatment options, in particular locking plate fixation. Locking plate fixation is associated with a high complication rate, such as avascular necrosis (7.9%), screw cutout (11.6%), and revision surgery (13.7%). These complications are frequently due to the varus deformation of the humeral head. Strategic screw placement in the humeral head would minimize the possibility of loss of fracture reduction and potential hardware complications. Locking plate fixation is a good surgical option for the management of proximal humerus fractures. Complications can be avoided by using better bone stock and by careful screw placement in the humeral head.

  11. Giant proximity effect in ferromagnetic bilayers

    Science.gov (United States)

    Ramos, Silvia; Charlton, Tim; Quintanilla, Jorge; Suter, Andreas; Moodera, Jagadeesh; Prokscha, Thomas; Salman, Zaher; Forgan, Ted

    2013-03-01

    The proximity effect is a phenomenon where an ordered state leaks from a material into an adjacent one over some finite distance, ξ. For superconductors, this distance is ~ the coherence length. Nevertheless much longer-range, ``giant'' proximity effects have been observed in cuprate junctions. This surprising effect can be understood as a consequence of critical opalescence. Since this occurs near all second order phase transitions, giant proximity effects should be very general and, in particular, they should be present in magnetic systems. The ferromagnetic proximity effect has the advantage that its order parameter (magnetization) can be observed directly. We investigate the above phenomenon in Co/EuS bilayer films, where both materials undergo ferromagnetic transitions but at rather different temperatures (bulk TC of 1400K for Co and 16.6K for EuS). A dramatic increase in the range of the proximity effect is expected near the TC of EuS. We present the results of our measurements of the magnetization profiles as a function of temperature, carried out using the complementary techniques of low energy muon rotation and polarized neutron reflectivity. Work supported by EPSRC, STFC and ONR grant N00014-09-1-0177 and NSF grant DMR 0504158.

  12. Characterization of proximal pulmonary arterial cells from chronic thromboembolic pulmonary hypertension patients

    Directory of Open Access Journals (Sweden)

    Quarck Rozenn

    2012-03-01

    Full Text Available Abstract Background Chronic thromboembolic pulmonary hypertension (CTEPH is associated with proximal pulmonary artery obstruction and vascular remodeling. We hypothesized that pulmonary arterial smooth muscle (PASMC and endothelial cells (PAEC may actively contribute to remodeling of the proximal pulmonary vascular wall in CTEPH. Our present objective was to characterize PASMC and PAEC from large arteries of CTEPH patients and investigate their potential involvement in vascular remodeling. Methods Primary cultures of proximal PAEC and PASMC from patients with CTEPH, with non-thromboembolic pulmonary hypertension (PH and lung donors have been established. PAEC and PASMC have been characterized by immunofluorescence using specific markers. Expression of smooth muscle specific markers within the pulmonary vascular wall has been studied by immunofluorescence and Western blotting. Mitogenic activity and migratory capacity of PASMC and PAEC have been investigated in vitro. Results PAEC express CD31 on their surface, von Willebrand factor in Weibel-Palade bodies and take up acetylated LDL. PASMC express various differentiation markers including α-smooth muscle actin (α-SMA, desmin and smooth muscle myosin heavy chain (SMMHC. In vascular tissue from CTEPH and non-thromboembolic PH patients, expression of α-SMA and desmin is down-regulated compared to lung donors; desmin expression is also down-regulated in vascular tissue from CTEPH compared to non-thromboembolic PH patients. A low proportion of α-SMA positive cells express desmin and SMMHC in the neointima of proximal pulmonary arteries from CTEPH patients. Serum-induced mitogenic activity of PAEC and PASMC, as well as migratory capacity of PASMC, were increased in CTEPH only. Conclusions Modified proliferative and/or migratory responses of PASMC and PAEC in vitro, associated to a proliferative phenotype of PASMC suggest that PASMC and PAEC could contribute to proximal vascular remodeling in CTEPH.

  13. Proximity operations concept design study, task 6

    Science.gov (United States)

    Williams, A. N.

    1990-01-01

    The feasibility of using optical technology to perform the mission of the proximity operations communications subsystem on Space Station Freedom was determined. Proximity operations mission requirements are determined and the relationship to the overall operational environment of the space station is defined. From this information, the design requirements of the communication subsystem are derived. Based on these requirements, a preliminary design is developed and the feasibility of implementation determined. To support the Orbital Maneuvering Vehicle and National Space Transportation System, the optical system development is straightforward. The requirements on extra-vehicular activity are such as to allow large fields of uncertainty, thus exacerbating the acquisition problem; however, an approach is given that could mitigate this problem. In general, it is found that such a system could indeed perform the proximity operations mission requirement, with some development required to support extra-vehicular activity.

  14. Endomedullar nail of metacarpal and proximal phalanges

    International Nuclear Information System (INIS)

    Mendez Olaya, Francisco Javier; Sanchez Mesa, Pedro Antonio

    2002-01-01

    Prospective study, series of cases; it included patients with diaphysis fractures and union diaphysis-neck or union diaphysis-base of metacarpal and proximal phalanges, in whom was practiced anterograde intramedullary nailing previous closed reduction of the fracture, using prevent intramedullary nail of 1.6 mm. (cem 16) for the metacarpal fractures, and two nail prevent of 1.0 mm. (cem 10) for the proximal phalangeal fractures. Indications: transverse and oblique short fractures, spiral and with comminuting bicortical. Pursuit average is 5.7 months. Frequency surgical intervened patient: 2.2 each month, using this surgical technique a total of 20 (twenty) patients have been operated, 21 (twenty one) fractures; 16 (sixteen) metacarcal fractures and 5 (five) proximal phalangeal fractures, all of them tested using clinical and radiological parameters. Results: good 82%, regular 18%, and bad 0% obtaining bony consolidation and early rehabilitation with incorporation to their habitual works

  15. Correlation between social proximity and mobility similarity.

    Science.gov (United States)

    Fan, Chao; Liu, Yiding; Huang, Junming; Rong, Zhihai; Zhou, Tao

    2017-09-20

    Human behaviors exhibit ubiquitous correlations in many aspects, such as individual and collective levels, temporal and spatial dimensions, content, social and geographical layers. With rich Internet data of online behaviors becoming available, it attracts academic interests to explore human mobility similarity from the perspective of social network proximity. Existent analysis shows a strong correlation between online social proximity and offline mobility similarity, namely, mobile records between friends are significantly more similar than between strangers, and those between friends with common neighbors are even more similar. We argue the importance of the number and diversity of common friends, with a counter intuitive finding that the number of common friends has no positive impact on mobility similarity while the diversity plays a key role, disagreeing with previous studies. Our analysis provides a novel view for better understanding the coupling between human online and offline behaviors, and will help model and predict human behaviors based on social proximity.

  16. Evaluation and Management of Proximal Humerus Fractures

    Directory of Open Access Journals (Sweden)

    Ekaterina Khmelnitskaya

    2012-01-01

    Full Text Available Proximal humerus fractures are common injuries, especially among older osteoporotic women. Restoration of function requires a thorough understanding of the neurovascular, musculotendinous, and bony anatomy. This paper addresses the relevant anatomy and highlights various management options, including indication for arthroplasty. In the vast majority of cases, proximal humerus fractures may be treated nonoperatively. In the case of displaced fractures, when surgical intervention may be pursued, numerous constructs have been investigated. Of these, the proximal humerus locking plate is the most widely used. Arthroplasty is generally reserved for comminuted 4-part fractures, head-split fractures, or fractures with significant underlying arthritic changes. Reverse total shoulder arthroplasty is reserved for patients with a deficient rotator cuff, or highly comminuted tuberosities.

  17. The Life Saving Effects of Hospital Proximity

    DEFF Research Database (Denmark)

    Bertoli, Paola; Grembi, Veronica

    We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from......) increases the fatality rate by 13.84% on the sample average. This is equal to a 0.92 additional death per every 100 accidents. We show that OLS estimates provide a downward biased measure of the real effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity matters...... more when the road safety is low; the emergency service is not properly organized, and the nearest hospital has lower quality standards....

  18. Proximity functions for general right cylinders

    International Nuclear Information System (INIS)

    Kellerer, A.M.

    1981-01-01

    Distributions of distances between pairs of points within geometrical objects, or the closely related proximity functions and geometric reduction factors, have applications to dosimetric and microdosimetric calculations. For convex bodies these functions are linked to the chord-length distributions that result from random intersections by straight lines. A synopsis of the most important relations is given. The proximity functions and related functions are derived for right cylinders with arbitrary cross sections. The solution utilizes the fact that the squares of the distances between two random points are sums of independently distributed squares of distances parallel and perpendicular to the axis of the cylinder. Analogous formulas are derived for the proximity functions or geometric reduction factors for a cylinder relative to a point. This requires only a minor modification of the solution

  19. Industrial Computed Tomography using Proximal Algorithm

    KAUST Repository

    Zang, Guangming

    2016-04-14

    In this thesis, we present ProxiSART, a flexible proximal framework for robust 3D cone beam tomographic reconstruction based on the Simultaneous Algebraic Reconstruction Technique (SART). We derive the proximal operator for the SART algorithm and use it for minimizing the data term in a proximal algorithm. We show the flexibility of the framework by plugging in different powerful regularizers, and show its robustness in achieving better reconstruction results in the presence of noise and using fewer projections. We compare our framework to state-of-the-art methods and existing popular software tomography reconstruction packages, on both synthetic and real datasets, and show superior reconstruction quality, especially from noisy data and a small number of projections.

  20. Adult large bowel obstruction: A review of clinical experience

    African Journals Online (AJOL)

    Background: Adult large bowel obstruction is an infrequent cause of acute obstruction in Africa ... of obstruction varies between regions of the world. .... were obtained for bacteriological culture. ... attachment, as observed in previous studies.

  1. [Partial replantation following proximal limb injury].

    Science.gov (United States)

    Dubert, T; Malikov, S A; Dinh, A; Kupatadze, D D; Oberlin, C; Alnot, J Y; Nabokov, B B

    2000-11-01

    Proximal replantation is a technically feasible but life-threatening procedure. Indications must be restricted to patients in good condition with a good functional prognosis. The goal of replantation must be focused not only on reimplanting the amputated limb but also on achieving a good functional outcome. For the lower limb, simple terminalization remains the best choice in many cases. When a proximal amputation is not suitable for replantation, the main aim of the surgical procedure must be to reconstruct a stump long enough to permit fitting a prosthesis preserving the function of the adjacent joint. If the proximal stump beyond the last joint is very short, it may be possible to restore some length by partial replantation of spared tissues from the amputated part. We present here the results we obtained following this policy. This series included 16 cases of partial replantations, 14 involving the lower limb and 2 the upper limb. All were osteocutaneous microsurgical transfers. For the lower limb, all transfers recovered protective sensitivity following tibial nerve repair. The functional calcaeoplantar unit was used in 13 cases. The transfer of this specialized weight bearing tissue provided a stable distal surface making higher support unnecessary. In one case, we raised a 13-cm vascularized tibial segment covered with foot skin for additional length. For the upper limb, the osteocutaneous transfer, based on the radial artery, was not reinnervated, but this lack of sensitivity did not impair prosthesis fitting. One vascular failure was finally amputated. This was the only unsuccessful result. For all other patients, the surgical procedure facilitated prosthesis fitting and preserved the proximal joint function despite an initially very proximal amputation. The advantages of partial replantation are obvious compared with simple terminalization or secondary reconstruction. There is no secondary donor site and, because there is no major muscle mass in the

  2. Diagnostic Utility of Endoscopic Retrograde Cholangiography/Intraductal Ultrasound (ERC/IDUS) in Distinguishing Malignant from Benign Bile Duct Obstruction.

    Science.gov (United States)

    Chen, Lu; Lu, Yi; Wu, Jia-Chuan; Bie, Like; Xia, Lu; Gong, Biao

    2016-02-01

    Accurately differentiating malignant diseases from benign ones in patients having bile duct obstruction is of significant importance and remains a major clinical problem. This study investigated the diagnostic yield of endoscopic retrograde cholangiography/intraductal ultrasound (ERC/IDUS) in distinguishing malignant from benign bile duct obstruction and assessed some image findings from ERC/IDUS which might be useful in differentiation. From January 2008 to January 2015, patients who underwent ERC/IDUS for bile duct obstruction were enrolled. Patient's ERC/IDUS diagnosis was compared with the final diagnosis determined by pathologic findings and/or clinical outcome of follow-up. One hundred and ninety-three patients with bile duct obstruction were included. IDUS correctly identified 94 of 97 malignant diseases and 76 of 96 benign diseases with sensitivity, specificity, and accuracy rate of 96.91, 79.17, and 88.08 %, respectively. Additionally, the accuracy rate of IDUS for diagnosis of proximal bile duct obstruction was higher than that of distal bile duct obstruction (98.08 vs. 82.73 %, p = 0.006). Besides, there was a significant difference in the length at the obstruction site between benign and malignant diseases (13.76 ± 7.37 vs. 19.97 ± 11.37 mm, p 7 mm without extrinsic compression had a positive predictive value (PPV) of 100 % for including malignancy, while length ≧20 mm demonstrated a PPV of 93.44 %. ERC/IDUS is effective in distinguishing malignant from benign bile duct obstruction, thus helping in further clinical management.

  3. Gastrointestinal obstruction in penguin chicks.

    Science.gov (United States)

    Perpiñán, David; Curro, Thomas G

    2009-12-01

    A 7-day-old gentoo penguin (Pygoscelis papua) was found dead and postmortem examination revealed impaction of the ventriculus with feathers. A review of mortality in gentoo penguin chicks from 1997 to 2007 at that institution revealed another case of feather impaction of the ventriculus in a 4-week-old chick, a sibling of the previous chick. A third case of gastrointestinal impaction occurred in a 24-day-old king penguin (Aptenodytes patagonicus) with omphallitis and enteritis. In this chick, a fibrin mat produced a complete obstruction of the intestine at the level of Meckel's diverticulum.

  4. The developmental spectrum of proximal radioulnar synostosis

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, Alison M. [University of Manitoba, Winnipeg Regional Health Association Program of Genetics and Metabolism, Winnipeg, MB (Canada); University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, WRHA Program of Genetics and Metabolism, Departments of Paediatrics and Child Health, Biochemistry and Medical Genetics, Winnipeg, MB (Canada); Kibria, Lisa [University of Manitoba, Department of School of Medical Rehabilitation, Winnipeg, MB (Canada); Reed, Martin H. [University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, Department of Diagnostic Imaging, Winnipeg, MB (Canada)

    2010-01-15

    Proximal radioulnar synostosis is a rare upper limb malformation. The elbow is first identifiable at 35 days (after conception), at which stage the cartilaginous anlagen of the humerus, radius and ulna are continuous. Subsequently, longitudinal segmentation produces separation of the distal radius and ulna. However, temporarily, the proximal ends are united and continue to share a common perichondrium. We investigated the hypothesis that posterior congenital dislocation of the radial head and proximal radioulnar fusion are different clinical manifestations of the same primary developmental abnormality. Records were searched for ''proximal radioulnar fusion/posterior radial head dislocation'' in patients followed at the local Children's Hospital and Rehabilitation Centre for Children. Relevant radiographic, demographic and clinical data were recorded. Ethics approval was obtained through the University Research Ethics Board. In total, 28 patients met the inclusion criteria. The majority of patients (16) had bilateral involvement; eight with posterior dislocation of the radial head only; five had posterior radial head dislocation with radioulnar fusion and two had radioulnar fusion without dislocation. One patient had bilateral proximal radioulnar fusion and posterior dislocation of the left radial head. Nine patients had only left-sided involvement, and three had only right-sided involvement.The degree of proximal fusion varied, with some patients showing 'complete' proximal fusion and others showing fusion that occurred slightly distal to the radial head: 'partially separated.' Associated disorders in our cohort included Poland syndrome (two patients), Cornelia de Lange syndrome, chromosome anomalies (including tetrasomy X) and Cenani Lenz syndactyly. The suggestion of a developmental relationship between posterior dislocation of the radial head and proximal radioulnar fusion is supported by the fact that both anomalies

  5. Proximity effects in ferromagnet/superconductor structures

    International Nuclear Information System (INIS)

    Yu, H.L.; Sun, G.Y.; Yang, L.Y.; Xing, D.Y.

    2004-01-01

    The Nambu spinor Green's function approach is applied to study proximity effects in ferromagnet/superconductor (FM/SC) structures. They include the induced superconducting order parameter and density of states (DOS) with superconducting feature on the FM side, and spin-dependent DOS within the energy gap on the SC side. The latter indicates an appearance of gapless superconductivity and a coexistence of ferromagnetism and superconductivity in a small regime near the interface. The influence of exchange energy in FM and barrier strength at interface on the proximity effects is discussed

  6. Ultimate and proximate explanations of strong reciprocity.

    Science.gov (United States)

    Vromen, Jack

    2017-08-23

    Strong reciprocity (SR) has recently been subject to heated debate. In this debate, the "West camp" (West et al. in Evol Hum Behav 32(4):231-262, 2011), which is critical of the case for SR, and the "Laland camp" (Laland et al. in Science, 334(6062):1512-1516, 2011, Biol Philos 28(5):719-745, 2013), which is sympathetic to the case of SR, seem to take diametrically opposed positions. The West camp criticizes advocates of SR for conflating proximate and ultimate causation. SR is said to be a proximate mechanism that is put forward by its advocates as an ultimate explanation of human cooperation. The West camp thus accuses advocates of SR for not heeding Mayr's original distinction between ultimate and proximate causation. The Laland camp praises advocates of SR for revising Mayr's distinction. Advocates of SR are said to replace Mayr's uni-directional view on the relation between ultimate and proximate causes by the bi-directional one of reciprocal causation. The paper argues that both the West camp and the Laland camp misrepresent what advocates of SR are up to. The West camp is right that SR is a proximate cause of human cooperation. But rather than putting forward SR as an ultimate explanation, as the West camp argues, advocates of SR believe that SR itself is in need of ultimate explanation. Advocates of SR tend to take gene-culture co-evolutionary theory as the correct meta-theoretical framework for advancing ultimate explanations of SR. Appearances notwithstanding, gene-culture coevolutionary theory does not imply Laland et al.'s notion of reciprocal causation. "Reciprocal causation" suggests that proximate and ultimate causes interact simultaneously, while advocates of SR assume that they interact sequentially. I end by arguing that the best way to understand the debate is by disambiguating Mayr's ultimate-proximate distinction. I propose to reserve "ultimate" and "proximate" for different sorts of explanations, and to use other terms for distinguishing

  7. Infiltrating/sealing proximal caries lesions

    DEFF Research Database (Denmark)

    Martignon, S; Ekstrand, K R; Gomez, J

    2012-01-01

    This randomized split-mouth controlled clinical trial aimed at assessing the therapeutic effects of infiltration vs. sealing for controlling caries progression on proximal surfaces. Out of 90 adult students/patients assessed at university clinics and agreeing to participate, 39, each with 3...... differences in lesion progression between infiltration and placebo (P = 0.0012) and between sealing and placebo (P = 0.0269). The study showed that infiltration and sealing are significantly better than placebo treatment for controlling caries progression on proximal lesions. No significant difference...

  8. Diagnosis and surgical management of obstructive ureteral calculi in cats: 11 cases (1993-1996)

    International Nuclear Information System (INIS)

    Kyles, A.E.; Stone, E.A.; Gookin, J.; Spaulding, K.; Clary, E.M.; Wylie, K.; Spodnick, G.

    1998-01-01

    To evaluate diagnostic methods, surgical treatment, perioperative management, and renal function of cats with obstructive calcium oxalate ureteroliths. Retrospective case series. 11 cats that underwent surgery for removal of calcium oxalate ureteroliths. Medical records were reviewed, and the following information was recorded: signalment; results of physical examination, clinicopathologic analyses, and abdominal imaging; surgical procedure; postoperative management; and results of ureterolith quantitative analysis. Ureteroliths in the proximal portion of the ureter were removed from 5 cats (pyelotomy, 1 cat; unilateral ureterotomy, 2 cats; bilateral ureterotomies, 2 cats). Calculi in the middle and distal part of the ureter were removed by partial ureterectomy and ureteroneocystostomy (6 cats). Ten cats recovered from surgery and were discharged from the hospital. One cat died from unknown causes 4 months after surgery, and 1 cat had a nephrectomy elsewhere 5 weeks after ureterolith removal. Eight cats were evaluated 12 to 20 months after surgery. Of these, 2 cats that were markedly azotemic before surgery improved after surgery, and 2 cats developed nephroliths after surgery. Also, of 5 cats that had nephroliths that were not removed at the time of surgery, 4 still had visible nephroliths. One cat had recurrent ureteral obstruction from a ureterolith and persistent urinary tract infection. Ureteroliths or ultrasonographic evidence of ureteral obstruction were not detected in other cats. A combination of microsurgical techniques and intensive postoperative care is necessary to minimize morbidity of cats after removal of a ureterolith. Renal function may improve or stabilize after removal of the ureteral obstruction

  9. Urachal Cyst Causing Small Bowel Obstruction in an Adult with a Virgin Abdomen

    Directory of Open Access Journals (Sweden)

    Michael P. O’Leary

    2016-01-01

    Full Text Available Introduction. A patent urachus is a rare congenital or acquired pathology, which can lead to complications later in life. We describe a case of urachal cystitis as the etiology of small bowel obstruction in an adult without prior intra-abdominal surgery. Case Report. A 64-year-old male presented to the acute care surgery team with a 5-day history of right lower quadrant abdominal pain, distention, nausea, and vomiting. He had a two-month history of urinary retention and his past medical history was significant for benign prostate hyperplasia. On exam, he had evidence of small bowel obstruction. Computed tomography revealed high-grade small bowel obstruction secondary to presumed ruptured appendicitis. In the operating room, an infected urachal cyst was identified with adhesions to the proximal ileum. After lysis of adhesions and resection of the cyst, the patient was subsequently discharged without further issues. Conclusion. Although rare, urachal pathology should be considered in the differential diagnosis when evaluating a patient with small bowel obstruction without prior intraabdominal surgery, hernia, or malignancy.

  10. Effects of the Mueller maneuver on functional mitral regurgitation and implications for obstructive sleep apnea.

    Science.gov (United States)

    Pressman, Gregg S; Orban, Marek; Leinveber, Pavel; Parekh, Kunal; Singh, Manmeet; Kara, Tomas; Somers, Virend K

    2015-06-01

    Obstructive sleep apnea is prevalent and adversely affects cardiovascular health. However, little is known of the acute effects of an obstructive apnea on cardiovascular physiology. We hypothesized that pre-existing functional mitral regurgitation (MR) would worsen during performance of a Mueller maneuver (MM) used to simulate an obstructive apnea; 15 subjects with an ejection fraction ≤35% and pre-existing functional MR were studied with Doppler echocardiography. The radius of the proximal flow convergence was used as a measure of mitral regurgitant flow. Measurements were made at baseline, during the MM, and post-MM. Areas of all 4 chambers were also measured at these time points, both in systole and diastole. Mean flow convergence radius for the group decreased significantly during the transition from the late-MM to post-MM (0.65 → 0.57 mm, p = 0.001), implying increased MR during the MM. In addition, in 3 subjects, duration of MR increased during the MM. Right atrial (RA) areas, both systolic and diastolic, increased during the maneuver, whereas RA fractional area change decreased, indicating reduced RA emptying. Left ventricular emptying decreased early in the maneuver, probably because of the increased afterload burden, and then recovered. In conclusion, high negative intrathoracic pressure produces changes that, repeated hundreds of times per night in patients with obstructive sleep apnea, have the potential to worsen heart failure and predispose affected subjects to atrial fibrillation. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Multidetector row computed tomography in bowel obstruction. Part 2. Large bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Sinha, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)]. E-mail: rakesh.sinha@uhl-tr.nhs.uk; Verma, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)

    2005-10-01

    Large bowel obstruction may present as an emergency as high-grade colonic obstruction and can result in perforation. Perforated large bowel obstruction causes faecal peritonitis, which can result in high morbidity and mortality. Multidetector row computed tomography (MDCT) has the potential of providing an accurate diagnosis of large bowel obstruction. The rapid acquisition of images within one breath-hold reduces misregistration artefacts than can occur in critically ill or uncooperative patients. The following is a review of the various causes of large bowel obstruction with emphasis on important pathogenic factors, CT appearances and the use of multiplanar reformatted images in the diagnostic workup.

  12. Antegrade deligation of iatrogenic distal ureteric obstruction utilising a high pressure balloon dilatation technique.

    LENUS (Irish Health Repository)

    Rajendran, Simon

    2012-02-01

    BACKGROUND: Iatrogenic trauma is the leading cause of ureteric injury with an incidence in abdominal and pelvic surgery varying between 0.4 and 2.5%. CASE: We report a case of ureteric obstruction caused by a haemostatic clip. There was associated rupture of the ureter proximal to the clip with intra-peritoneal leakage of urine. The patient was unfit for surgery and was managed by a novel procedure of endoluminal balloon deligation. CONCLUSION: Ureteric injuries are rare but potentially serious complications. They require prompt diagnosis and management depends on the patients\\' clinical condition, extent of injury and interval from injury to diagnosis. We have successfully demonstrated a new technique to treat ureteric obstruction caused by a haemostatic clip with associated ureteral rupture in a patient unfit for surgery.

  13. Percutaneous drainage and stenting for palliation of malignant bile duct obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Delden, Otto M. van; Lameris, Johan S. [Academic Medical Center of the University of Amsterdam, Department of Radiology, Amsterdam (Netherlands)

    2008-03-15

    Percutaneous biliary drainage and stenting (PTBD) for palliation of malignant obstructive jaundice has evolved to a safe and effective technique. PTBD is equally effective for treatment of distal and proximal bile obstruction. Metal self-expandable stents have proved superior to plastic stents and should therefore be used. Technical success is >90% en clinical success is >75% in all major series. There are a considerable number of complications, but most can be treated conservatively and procedure-related mortality is <2% in most series. Thirty-day mortality after PTBD is >10% in many series, but this is largely due to the underlying disease. About 10-30% of patients will have recurrent jaundice at some point in their disease after PTBD and require re-intervention. (orig.)

  14. Airflow obstruction in young adults in Canada

    DEFF Research Database (Denmark)

    Al-Hazmi, Manal; Wooldrage, Kate; Anthonisen, Nicholas R.

    2007-01-01

    OBJECTIVE: Airflow obstruction is relatively uncommon in young adults, and may indicate potential for the development of progressive disease. The objective of the present study was to enumerate and characterize airflow obstruction in a random sample of Canadians aged 20 to 44 years. SETTING: The ...

  15. Is nonoperative management of adhesive intestinal obstruction ...

    African Journals Online (AJOL)

    Background: Nonoperative management of adhesive intestinal obstruction gives good results in adults but there are scant studies on its outcome in children. This study reports outcomes and experiences with nonoperative and operative management of adhesive intestinal obstruction in children in a resource-poor country.

  16. Real time ultrasonography in obstructive jaundice

    International Nuclear Information System (INIS)

    Cho, Kyung Sik; Kim, Ho Kyun; Sung, Nak Kwan; Kim, Soon Yong

    1982-01-01

    Ultrasonography is a predominantly accurate, relatively simple unique diagnostic method of obstructive jaundice. The ultrasonographic findings of obstructive jaundice are dilated intra- and extrahepatic duct with intraluminal hyper reflective echo or mass in and/ or around the bile duct. The superiority of high resolution real time ultrasonography for the diagnosis of obstructive jaundice is bases on the easy detectability of extra- and intrahepatic bile ducts by its multiple sectional images in a short time, the flexibility of probe and small crystal size. Author evaluated real time sonographic findings 46 obstructive jaundice patients confirmed by surgery or radiographical examinations. The results were: 1. Diameter of extrahepatic duct in obstructive jaundice were varied from normal to 4.0 Cm, mostly 8 to 10 mm in diameter (26%). Degree of dilatation of biliary duct appeared more prominent in cancer patients than other causes of obstruction. 2. The site of obstruction was detected in 85% (39/46) and its common site was common bile duct in 63% (29/46). 3. The diagnostic accuracy of choledocholithiasis and cancer was 82% (22/27) and 44% (4/9), respectively. Diagnostic accuracy of the real time ultrasonography in obstructive jaundice was over all 75% (34/46)

  17. A CLINICAL STUDY OF ADHESIVE INTESTINAL OBSTRUCTION

    OpenAIRE

    Haricharan; Murali Krishna; Koti Reddy; Nara Hari

    2015-01-01

    INTRODUCTION: Adhesive intestinal obstruction is an inevitable complication of abdominal surgeries. It has high morbidity with associated poor quality of life and predisposition to repeated hospitalization. Commonest cause of bowel obstruction in developed countries is postoperative adhesions with extrinsic compression of the intestine. Most of them can be managed conservatively. METHODS: A retrospective study of 30 patients admit...

  18. Danish Register of chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Lange, Peter; Tøttenborg, Sandra Søgaard; Sorknæs, Anne Dichmann

    2016-01-01

    AIM OF DATABASE: The Danish Register of Chronic Obstructive Pulmonary Disease (DrCOPD) is a nationwide database aiming to describe the quality of treatment of all patients with chronic obstructive pulmonary disease (COPD) in Denmark. STUDY POPULATION: DrCOPD comprises data on all patients...

  19. Osteoporosis in chronic obstructive pulmonary disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Niklas Rye; Schwarz, Peter

    2008-01-01

    The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

  20. 25 CFR 11.435 - Obstructing justice.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Obstructing justice. 11.435 Section 11.435 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Criminal Offenses § 11.435 Obstructing justice. A person commits a misdemeanor if, with...

  1. The baby has not come: obstructed labour

    African Journals Online (AJOL)

    Introduction. This article is about how to recognize obstructed labour and deal with it in a way that preserves the life and health of mother and child. It is for midwives and others who work in maternity care and is based on our experiences in Yei, South Sudan. Obstructed labour means that the baby is too big to pass through ...

  2. Accuracy of abdominal auscultation for bowel obstruction

    DEFF Research Database (Denmark)

    Breum, Birger Michael; Rud, Bo; Kirkegaard, Thomas

    2015-01-01

    AIM: To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction. METHODS: Bowel sounds were recorded in patients with suspected bowel obstruction using a Littmann(®) Electronic Stethoscope. The recordings were process...

  3. Gastric cancer and obstructive uropathy

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  4. Management of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2014-03-01

    Full Text Available Obstructive Sleep Apnea (OSA is an important public health problem and is associatedwith considerable morbidity and mortality. Therefore, treatment of this condition is ofparamount importance. The treatment of OSA includes general and behaviouralmeasures, mechanical measures including continuous positive airway pressure(CPAP, Bilevel positive airway pressure (BiPAP and Oral Appliances (OA,pharmacological treatment and surgical procedures. Continuous positive airwaypressure (CPAP treatment reverses the repetitive upper airway obstruction of sleepapnea and associated daytime sleepiness and is the most effective treatment for OSA.However maintaining patient adherence to CPAP therapy is a challenge. Weight lossshould be recommended to overweight patients with OSA, as it has been shown thatweight reduction has additional health benefits. Treatment of underlying medicalconditions such as hypothyroidism or acromegaly has profound effect onapnea/hypopnea index. A subset of patients with OSA may benefit from supplementaloxygen and positional therapy. Presently, there are no effective pharmacotherapeuticagents for treatment of patients with OSA and the role of surgical treatment in OSA iscontroversial. However, pharmacological treatment of persisting residual sleepiness,despite adequate positive airway pressure therapy delivery and adherence, is indicatedand may improve daytime sleepiness.Key words : CPAP, Oral appliances, Modafinil, CPAP complianceUvulopalatopharyngoplasty, positional therapy

  5. Hypertension and obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Phillips CL

    2013-05-01

    Full Text Available Craig L Phillips,1–3 Denise M O'Driscoll4,51Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia; 2National Health and Medical Research Council Center for Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; 3Discipline of Sleep Medicine, Sydney Medical School, University of Sydney, Sydney, Australia; 4Monash Lung and Sleep, Monash Medical Centre, Monash University, Melbourne, Australia; 5Department of Medicine, Southern Clinical School, Monash University, Melbourne, AustraliaAbstract: Obstructive sleep apnea (OSA is increasingly being recognized as a major health burden with strong focus on the associated cardiovascular risk. Studies from the last two decades have provided strong evidence for a causal role of OSA in the development of systemic hypertension. The acute physiological changes that occur during apnea promote nocturnal hypertension and may lead to the development of sustained daytime hypertension via the pathways of sympathetic activation, inflammation, oxidative stress, and endothelial dysfunction. This review will focus on the acute hemodynamic disturbances and associated intermittent hypoxia that characterize OSA and the potential pathophysiological mechanisms responsible for the development of hypertension in OSA. In addition the epidemiology of OSA and hypertension, as well as the role of treatment of OSA, in improving blood pressure control will be examined.Keywords: obstructive sleep apnea, hypertension, intermittent hypoxia, ambulatory blood pressure, sympathetic activation

  6. CT and ERCP diagnosis of obstructive jaundice

    International Nuclear Information System (INIS)

    Wang Dongfang; Cao Ran

    2003-01-01

    Objective: To evaluate some specific CT and ERCP findings for differentiating the nature of biliary obstructive diseases. Methods: In total 85 cases of obstructive jaundice verified by pathology were selected. The CT findings in 45 cases and ERCP features in 68 cases were retrospectively analyzed. Results: Mild dilatation of intrahepatic bile ducts were usually found in benign diseases, while moderately or severely dilated intrahepatic bile ducts were revealed in malignancies. Dilatation of intrahepatic bile ducts in vine pattern was one of the characteristic signs of malignant lesions, while 'withered branches' dilatation was usually found in benign diseases. Dilated extra-hepatic bile duct abruptly narrowed or obstructed was a typical finding in malignancies, while gradual tapering of common bile duct at the obstructed level usually indicated benign nature of the disease. Conclusion: Both CT and ERCP are valuable modalities in locating and differential diagnosis of biliary obstruction. A combined evaluation improves the accuracy of diagnosis

  7. Obstructive acute abdomen: reviewing important points

    International Nuclear Information System (INIS)

    Francisco, Marina Celli; Abud, Thiago Giansante; Reibscheid, Samuel; Szejnfeld, Jacob; Lederman, Henrique Manoel; Colleone Neto, Ramiro

    2008-01-01

    The obstructive acute abdomen is a common presentation, for which safe and effective management depends on a fast and accurate diagnosis. Conventional radiograph remains the first choice among the imaging exams because of its availability, low cost and the possibility to be done serially to follow the patient's clinical progression. The ultrasonography does not require ionizing radiation. It is a dynamic and in realtime exam. Computed tomography is used increasingly due to the provision of essential diagnostic information not apparent from radiographs, such as the confirmation of the obstruction, degree and place of the occlusion, presence of ischemia as well as the causes of the obstruction. Magnetic resonance imaging has presented great technological advances and it may play a role in the future of obstructive acute abdomen diagnosis. The objective of this pictorial essay is to review the different imaging techniques used on diagnosing obstructive acute abdomen. (author)

  8. Small Bowel Obstruction due to Intestinal Xanthomatosis

    Directory of Open Access Journals (Sweden)

    L. E. Barrera-Herrera

    2015-01-01

    Full Text Available Vast majority of bowel obstruction is due to postoperative adhesions, malignancy, intestinal inflammatory disease, and hernias; however, knowledge of other uncommon causes is critical to establish a prompt treatment and decrease mortality. Xanthomatosis is produced by accumulation of cholesterol-rich foamy macrophages. Intestinal xanthomatosis is an uncommon nonneoplastic lesion that may cause small bowel obstruction and several cases have been reported in the English literature as obstruction in the jejunum. We report a case of small intestinal xanthomatosis occurring in a 51-year-old female who presented with one day of copious vomiting and intermittent abdominal pain. Radiologic images revealed jejunal loop thickening and inflammatory changes suggestive of foreign body obstruction, diagnostic laparoscopy found two strictures at the jejunum, and a pathologic examination confirmed a segmental small bowel xanthomatosis. This case illustrates that obstruction even without predisposing factors such as hyperlipidemia or lymphoproliferative disorders.

  9. Phytochemical screening, proximate analysis and acute toxicity ...

    African Journals Online (AJOL)

    Phytochemical screening results indicate the presence of saponins, flavonoids, phytosterols and phenols. Acute toxicity study showed there was no mortality at 8000 mg/kg of the extract. The results indicate that the plant is rich in phytochemicals and is relatively safe. Key words: Phytochemicals, acute toxicity, proximate ...

  10. PROXIMATE AND ELEMENTAL COMPOSITION OF WHITE GRUBS

    African Journals Online (AJOL)

    DR. AMINU

    This study determined the proximate and mineral element composition of whole white grubs using standard methods of analysis. ... and 12.75 ± 3.65% respectively. Mineral contents of white grub in terms of relative concentration .... of intracellular Ca, bone mineralization, blood coagulation, and plasma membrane potential ...

  11. Phytochemical Screening and Proximate Analysis of Newbouldia ...

    African Journals Online (AJOL)

    The study was conducted to assess the phytochemical and proximate composition of Newboudia laevis leaves and Allium sativum bulb extracts. The leaves and bulbs extracts were analyzed for their chemical composition and antinutritional factors (ANFs) which include moisture, crude protein, crude fat, crude fiber, total ash ...

  12. Phytochemical Screening, Proximate and Mineral Composition of ...

    African Journals Online (AJOL)

    Leaves of sweet potato (Ipomoea batatas) grown in Tepi area was studied for their class of phytochemicals, mineral and proximate composition using standard analytical methods. The phytochemical screening revealed the presence of alkaloids, flavonoid, terpenoids, saponins, quinones, phenol, tannins, amino acid and ...

  13. Phytochemical screening, proximate and elemental analysis of ...

    African Journals Online (AJOL)

    Citrus sinensis was screened for its phytochemical composition and was evaluated for the proximate and elemental analysis. The phytochemical analysis indicated the presence of reducing sugar, saponins, cardiac glycosides, tannins and flavonoids. The elemental analysis indicated the presence of the following mineral ...

  14. Modified Koyanagi Technique in Management of Proximal ...

    African Journals Online (AJOL)

    xp

    Modified Koyanagi Technique in Management of Proximal Hypospadias. Adham Elsaied, Basem Saied, and Mohammed El- ... All operations were performed by the authors,using fine instruments and under 3.5X loupe ... the other needed an operation to close the fistula six months later. The case with meatal recession had ...

  15. Proximity focusing RICH with TOF capabilities

    International Nuclear Information System (INIS)

    Korpar, S.; Adachi, I.; Fujita, K.; Fukushima, T.; Gorisek, A.; Hayashi, D.; Iijima, T.; Ikado, T.; Ishikawa, T.; Kawai, H.; Kozakai, Y.; Krizan, P.; Kuratani, A.; Mazuka, Y.; Nakagawa, T.; Nishida, S.; Ogawa, S.; Pestotnik, R.; Seki, T.; Sumiyoshi, T.; Tabata, M.; Unno, Y.

    2007-01-01

    A proximity focusing RICH counter with a multi-channel micro-channel plate (MCP) PMT was tested as a time-of-flight counter. Cherenkov photons emitted in the radiator medium as well as in the entrance window of the PMT were used for the time-of-flight measurement, and an excellent performance of the counter could be demonstrated

  16. Proximate composition and mycological characterization of peanut ...

    African Journals Online (AJOL)

    SARAH

    2013-12-30

    Dec 30, 2013 ... ABSTRACT. Objective: The aim of this work was to contribute to the food safety of Ivorian consumers by investigating the proximate composition and the toxic fungal contamination of peanut butters offered for retail sale on the different markets of Abidjan. Methodology and results: Peanut butter samples (45) ...

  17. Prosthetic replacement for proximal humeral fractures.

    Science.gov (United States)

    Kontakis, George; Tosounidis, Theodoros; Galanakis, Ioannis; Megas, Panagiotis

    2008-12-01

    The ideal management of complex proximal humeral fractures continues to be debatable. Evolution of proximal humeral fracture management, during the past decade, led to the implementation of many innovations in surgical treatment. Even though the pendulum of treatment seems to swing towards new trends such as locked plating, hemiarthroplasty remains a valid and reliable option that serves the patient's needs well. Hemiarthroplasty is indicated for complex proximal humeral fractures in elderly patients with poor bone stock and when internal fixation is difficult or unreliable. Hemiarthroplasty provides a better result when it is performed early post-injury. Stem height, retroversion and tuberosity positioning are technical aspects of utmost importance. Additionally reverse total shoulder arthroplasty is an alternative new modality that can be used as a primary solution in selected patients with proximal humeral fracture treatment. Failed hemiarthroplasty and fracture sequelae can be successfully managed with reverse total shoulder arthroplasty. Individual decision-making and tailored treatment that takes into consideration the personality of the fracture and the patient's characteristics should be used.

  18. Phytochemistry and proximate composition of ginger ( Zingiber ...

    African Journals Online (AJOL)

    The results of the phytochemical screening showed that alkaloids, carbohydrates, glycosides, proteins, saponins, steroids, flavonoids and terpenoids were present, while reducing sugars, tannins, oils and acid compounds were absent. Similarly, the results of the proximate analysis of the rhizome showed that ginger ...

  19. Disability occurrence and proximity to death

    NARCIS (Netherlands)

    Klijs, Bart; Mackenbach, Johan P.; Kunst, Anton E.

    2010-01-01

    Purpose. This paper aims to assess whether disability occurrence is related more strongly to proximity to death than to age. Method. Self reported disability and vital status were available from six annual waves and a subsequent 12-year mortality follow-up of the Dutch GLOBE longitudinal study.

  20. Proximate composition, bread characteristics and sensory ...

    African Journals Online (AJOL)

    This study was carried out to investigate proximate composition, bread characteristics and sensory evaluation of cocoyam-wheat composite breads at different levels of cocoyam flour substitution for human consumption.A whole wheat bread (WWB) and cocoyam-composite breads (CCB1,CCB 2 and CCB 3) were prepared ...

  1. Oclusión canalicular con tapones de silicona de Herrick en el tratamiento del ojo seco Canicular occlusion with Herrick silicone plugs in the treatment of dry eye

    Directory of Open Access Journals (Sweden)

    Jaime Alemañy González

    2002-06-01

    Full Text Available Para evaluar la desaparición de síntomas y signos en el síndrome de ojo seco por deficiencia del componente acuoso de la película lagrimal, se estudiaron 15 pacientes que llevaban tratamiento con lágrimas artificiales, a pesar de lo cual presentaban síntomas por sequedad ocular. Se realizó oclusión canalicular de prueba con tapones de colágeno y luego definitiva con los de silicona de Herrick en el canalículo inferior. Se evaluaron por consulta hasta un año después del proceder. Se encontró que el 52 % de los casos tuvieron desaparición de los síntomas, el 40 % necesitaron añadir colirio de lágrimas artificiales ocasionalmente y el 8 % de los casos necesitaron oclusión del canalículo superior. Este tratamiento es un método sencillo y efectivo, que proporciona alivio a largo plazo a los pacientes con síndrome de ojo seco, mejorando su calidad de vida.To evaluate the disappearance of symptoms and signs in the dry eye syndrome due to deficiency of the aqueous component of the lacrimal film, 15 patients that were under treatment with artificial tears, although they still had symptoms resulting from ocular dryness, were studied. Canicular occlusion with collagen plugs was performed first as a test and then definitive occlusion with Herrick silicone plugs in the inferior canaliculus. These patients were evaluated at the physician’s office a year after the procedure. It was found that the symptoms dissappeared in 52 % of the cases, that 40 % needed to add occasionally collyrium of artificial tears and that 8 % of them required occlusion of the superior canaliculus. This treatment is a simple and effective method that provides long-term release to patients with dry eye syndrome and improves their quality of life.

  2. TRACHEAL AND BRONCHIAL ABNORMALITIES IN PATIENTS WITH SIGNIFICANT OBSTRUCTIVE SYNDROME: ACCORDING TO BRONCHOSCOPIC

    Directory of Open Access Journals (Sweden)

    M. L. Shteiner

    2014-01-01

    Full Text Available The endobronchial pattern of significant bronchial obstructive syndrome of various etiologies was analyzed in 4,000 patients with this condition. At the same time, bronchial malformations were encountered as supplementary bronchi of the left and right basal pyramids, axillary left bronchi, supplementary and displaced tracheal bronchi, and a single case of distal transposition of the right proximal bronchus in 1.58% of cases. According to the bronchoscopic findings, supplementary bronchi and transpositions of the left bronchi are the most common anatomic bronchial abnormalities (1.08%.

  3. Chronic Obstructive Pulmonary Disease Biomarkers

    Directory of Open Access Journals (Sweden)

    Tatsiana Beiko

    2016-04-01

    Full Text Available Despite significant decreases in morbidity and mortality of cardiovascular diseases (CVD and cancers, morbidity and cost associated with chronic obstructive pulmonary disease (COPD continue to be increasing. Failure to improve disease outcomes has been related to the paucity of interventions improving survival. Insidious onset and slow progression halter research successes in developing disease-modifying therapies. In part, the difficulty in finding new therapies is because of the extreme heterogeneity within recognized COPD phenotypes. Novel biomarkers are necessary to help understand the natural history and pathogenesis of the different COPD subtypes. A more accurate phenotyping and the ability to assess the therapeutic response to new interventions and pharmaceutical agents may improve the statistical power of longitudinal clinical studies. In this study, we will review known candidate biomarkers for COPD, proposed pathways of pathogenesis, and future directions in the field.

  4. Pediatric Obstructive Uropathy: Clinical Trials

    International Nuclear Information System (INIS)

    Chan, C. M. C.; Scheinman, J. I.; Roth, K. S.

    2005-01-01

    As the powerful tools of molecular biology continue to delineate new concepts of pathogenesis of diseases, new molecular-level therapeutic modalities are certain to emerge. In order to design and execute clinical trials to evaluate outcomes of these new treatment modalities, we will soon need a new supply of investigators with training and experience in clinical research. The slowly-progressive nature of chronic pediatric kidney disease often results in diagnosis being made at a time remote from initial result, and the inherently slow rate of progression makes changes difficult to measure. Thus, development of molecular markers for both diagnosis and rate of progression will be critical to studies of new therapeutic modalities. We will review general aspects of clinical trials and will use current and past studies as examples to illustrate specific points, especially as these apply to chronic kidney disease associated with obstructive uropathy in children. (author)

  5. Proximal tubular hypertrophy and enlarged glomerular and proximal tubular urinary space in obese subjects with proteinuria.

    Directory of Open Access Journals (Sweden)

    Ana Tobar

    Full Text Available BACKGROUND: Obesity is associated with glomerular hyperfiltration, increased proximal tubular sodium reabsorption, glomerular enlargement and renal hypertrophy. A single experimental study reported an increased glomerular urinary space in obese dogs. Whether proximal tubular volume is increased in obese subjects and whether their glomerular and tubular urinary spaces are enlarged is unknown. OBJECTIVE: To determine whether proximal tubules and glomerular and tubular urinary space are enlarged in obese subjects with proteinuria and glomerular hyperfiltration. METHODS: Kidney biopsies from 11 non-diabetic obese with proteinuria and 14 non-diabetic lean patients with a creatinine clearance above 50 ml/min and with mild or no interstitial fibrosis were retrospectively analyzed using morphometric methods. The cross-sectional area of the proximal tubular epithelium and lumen, the volume of the glomerular tuft and of Bowman's space and the nuclei number per tubular profile were estimated. RESULTS: Creatinine clearance was higher in the obese than in the lean group (P=0.03. Proteinuria was similarly increased in both groups. Compared to the lean group, the obese group displayed a 104% higher glomerular tuft volume (P=0.001, a 94% higher Bowman's space volume (P=0.003, a 33% higher cross-sectional area of the proximal tubular epithelium (P=0.02 and a 54% higher cross-sectional area of the proximal tubular lumen (P=0.01. The nuclei number per proximal tubular profile was similar in both groups, suggesting that the increase in tubular volume is due to hypertrophy and not to hyperplasia. CONCLUSIONS: Obesity-related glomerular hyperfiltration is associated with proximal tubular epithelial hypertrophy and increased glomerular and tubular urinary space volume in subjects with proteinuria. The expanded glomerular and urinary space is probably a direct consequence of glomerular hyperfiltration. These effects may be involved in the pathogenesis of obesity

  6. Obstructive Sleep Apnea and Aldosterone

    Science.gov (United States)

    Svatikova, Anna; Olson, Lyle J.; Wolk, Robert; Phillips, Bradley G.; Adachi, Taro; Schwartz, Gary L.; Somers, Virend K.

    2009-01-01

    Background: Obstructive sleep apnea (OSA) is a major risk factor for hypertension and has been associated with increased risk for cardiovascular morbidity. A dysregulated renin-angiotensin-aldosterone system may contribute to excess sodium retention and hypertension and may be activated in OSA. We tested the hypothesis that serum levels of aldosterone and plasma renin activity (PRA) are increased by apneic sleep in subjects without cardiovascular disease, compared to healthy control subjects. Methods and Results: Plasma aldosterone level was measured in 21 subjects with moderate to severe OSA and was compared to 19 closely matched healthy subjects. Plasma renin activity (PRA) was measured in 19 OSA patients and in 20 healthy controls. Aldosterone and PRA were measured before sleep (9pm), after 5 hrs of untreated OSA (2am) and in the morning after awakening (6am). There were no baseline (9pm) differences in serum aldosterone levels and PRA between the healthy controls and OSA patients (aldosterone: 55.2 ± 9 vs 56.0 ± 9 pg/mL; PRA: 0.99 ± 0.15 vs 1.15 ± 0.15 ng/mL/hr). Neither several hours of untreated severe OSA nor CPAP treatment affected aldosterone levels and PRA in OSA patients. Diurnal variation of both aldosterone and PRA was observed in both groups, in that morning renin and aldosterone levels were higher than those measured at night before sleep. Conclusions: Our study shows that patients with moderate to severe OSA without co-existing cardiovascular disease have plasma aldosterone and renin levels similar to healthy subjects. Neither untreated OSA nor CPAP treatment acutely affect plasma aldosterone or renin levels. Citation: Svatikova A; Olson LJ; Wolk R; Phillips BG; Adachi T; Schwartz GL; Somers VK. Obstructive sleep apnea and aldosterone. SLEEP 2009;32(12):1589-1592. PMID:20041594

  7. SINA: A test system for proximity fuses

    Science.gov (United States)

    Ruizenaar, M. G. A.

    1989-04-01

    SINA, a signal generator that can be used for testing proximity fuses, is described. The circuitry of proximity fuses is presented; the output signal of the RF circuit results from a mixing of the emitted signal and received signal that is Doppler shifted in frequency by the relative motion of the fuse with respect to the reflecting target of surface. With SINA, digitized and stored target and clutter signals (previously measured) can be transformed to Doppler signals, for example during a real flight. SINA can be used for testing fuse circuitry, for example in the verification of results of computer simulations of the low frequency Doppler signal processing. The software of SINA and its use are explained.

  8. Isolated Proximal Tibiofibular Dislocation during Soccer

    Directory of Open Access Journals (Sweden)

    Casey Chiu

    2015-01-01

    Full Text Available Proximal tibiofibular dislocations are rarely encountered in the Emergency Department (ED. We present a case involving a man presenting to the ED with left knee pain after making a sharp left turn on the soccer field. His physical exam was only remarkable for tenderness over the lateral fibular head. His X-rays showed subtle abnormalities of the tibiofibular joint. The dislocation was reduced and the patient was discharged from the ED with orthopedic follow-up.

  9. Superconducting proximity effect in topological materials

    Science.gov (United States)

    Reeg, Christopher R.

    In recent years, there has been a renewed interest in the proximity effect due to its role in the realization of topological superconductivity. In this dissertation, we discuss several results that have been obtained in the field of proximity-induced superconductivity and relate the results to the search for Majorana fermions. First, we show that repulsive electron-electron interactions can induce a non-Majorana zero-energy bound state at the interface between a conventional superconductor and a normal metal. We show that this state is very sensitive to disorder, owing to its lack of topological protection. Second, we show that Rashba spin-orbit coupling, which is one of the key ingredients in engineering a topological superconductor, induces triplet pairing in the proximity effect. When the spin-orbit coupling is strong (i.e., when the characteristic energy scale for spin-orbit coupling is comparable to the Fermi energy), the induced singlet and triplet pairing amplitudes can be comparable in magnitude. Finally, we discuss how the size of the proximity-induced gap, which appears in a low-dimensional material coupled to a superconductor, evolves as the thickness of the (quasi-)low-dimensional material is increased. We show that the induced gap can be comparable to the bulk energy gap of the underlying superconductor in materials that are much thicker than the Fermi wavelength, even in the presence of an interfacial barrier and strong Fermi surface mismatch. This result has important experimental consequences for topological superconductivity, as a sizable gap is required to isolate and detect the Majorana modes.

  10. [Proximity and breastfeeding at the maternity hospital].

    Science.gov (United States)

    Fradin-Charrier, Anne-Claire

    2015-01-01

    The establishment of breastfeeding, as well as its duration, are facilitated through the proximity of the mother with her new baby. However, in maternity hospitals, breastfeeding mothers very often leave their baby in the nursery at night time. A study carried out in 2014 in several maternity hospitals put forward suggestions and highlighted areas to improve in everyday practice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. Percutaneous treatment of critical lower limb ischemia in patients with obstruction of the crural arteries

    International Nuclear Information System (INIS)

    Falkowski, A.; Rutkowski, D.; Poncyliusz, W.; Sienko, J.

    2006-01-01

    This article describes the application of percutaneous transluminal angioplasty (PTA) in the treatment of crural artery obstruction in patients with critical lower limb ischemia. In 17 patients, 24 PTAs of crural artery obstructions were performed. The clinical material consisted of 9 men and 8 women, whose mean age was 72 years (range 54-85 years). 11 patients were classified in clinical stage Fontaine IV, and 6 in stage III. The obstructions were from 3 to 21 cm (mean 6 cm). In 8 cases, PTA of the femoropopliteal segment was also carried out. The risk factors and comorbidities included diabetes 10 cases (58.8%), hypertension 9 cases (56%), ischemic heart disease 8 cases (50%), hyperlipidaemia 7 cases (43.8%), cerebrovascular diseases 3 cases (18.8%), and cigarette smoking 6 cases (37.5%). Technical success was defined as restoration of the artery along its whole length to the foot. Pain relief at rest and healing of trophic lesions at 30-day follow-up were recognized as a good outcome. Technical success was achieved in 12 patients (70.6%). In 2 cases the patency was only restored in the proximal part of the artery (12.5%). In 3 cases (17.6%) the procedure failed. In one case acute occlusion of the artery occurred. In 2 cases the obstruction was not successfully passed with a guidewire. In 4 cases hematoma was found at the puncture site, without clinical consequences. In 13 patients (76.4%) clinical success was achieved. Percutaneous transluminal angioplasty is an effective and relatively safe method of treatment of patients with critical limb ischemia caused by obstruction of the crural arteries. (author)

  12. Proximity effects in topological insulator heterostructures

    International Nuclear Information System (INIS)

    Li Xiao-Guang; Wu Guang-Fen; Zhang Gu-Feng; Culcer Dimitrie; Zhang Zhen-Yu; Chen Hua

    2013-01-01

    Topological insulators (TIs) are bulk insulators that possess robust helical conducting states along their interfaces with conventional insulators. A tremendous research effort has recently been devoted to Tl-based heterostructures, in which conventional proximity effects give rise to a series of exotic physical phenomena. This paper reviews our recent studies on the potential existence of topological proximity effects at the interface between a topological insulator and a normal insulator or other topologically trivial systems. Using first-principles approaches, we have realized the tunability of the vertical location of the topological helical state via intriguing dual-proximity effects. To further elucidate the control parameters of this effect, we have used the graphene-based heterostructures as prototypical systems to reveal a more complete phase diagram. On the application side of the topological helical states, we have presented a catalysis example, where the topological helical state plays an essential role in facilitating surface reactions by serving as an effective electron bath. These discoveries lay the foundation for accurate manipulation of the real space properties of the topological helical state in TI-based heterostructures and pave the way for realization of the salient functionality of topological insulators in future device applications. (topical review - low-dimensional nanostructures and devices)

  13. [Augmentation technique on the proximal humerus].

    Science.gov (United States)

    Scola, A; Gebhard, F; Röderer, G

    2015-09-01

    The treatment of osteoporotic fractures is still a challenge. The advantages of augmentation with respect to primary in vitro stability and the clinical use for the proximal humerus are presented in this article. In this study six paired human humeri were randomized into an augmented and a non-augmented group. Osteosynthesis was performed with a PHILOS plate (Synthes®). In the augmented group the two screws finding purchase in the weakest cancellous bone were augmented. The specimens were tested in a 3-part fracture model in a varus bending test. The augmented PHILOS plates withstood significantly more load cycles until failure. The correlation to bone mineral density (BMD) showed that augmentation could partially compensate for low BMD. The augmentation of the screws in locked plating in a proximal humerus fracture model is effective in improving the primary stability in a cyclic varus bending test. The targeted augmentation of two particular screws in a region of low bone quality within the humeral head was almost as effective as four screws with twice the amount of bone cement. Screw augmentation combined with a knowledge of the local bone quality could be more effective in enhancing the primary stability of a proximal humerus locking plate because the effect of augmentation can be exploited more effectively limiting it to the degree required. The technique of augmentation is simple and can be applied in open and minimally invasive procedures. When the correct procedure is used, complications (cement leakage into the joint) can be avoided.

  14. A proximity effect in adults' contamination intuitions

    Directory of Open Access Journals (Sweden)

    Laura R. Kim

    2011-04-01

    Full Text Available Magical beliefs about contagion via contact (Rozin, Nemeroff, Wane, and Sherrod, 1989 may emerge when people overgeneralize real-world mechanisms of contamination beyond their appropriate boundaries (Lindeman and Aarnio, 2007. Do people similarly overextend knowledge of airborne contamination mechanisms? Previous work has shown that very young children believe merely being close to a contamination source can contaminate an item (Springer and Belk 1994; we asked whether this same hyper-avoidant intuition is also reflected in adults' judgments. In two studies, we measured adults' ratings of the desirability of an object that had made contact with a source of contamination, an object nearby that had made no contact with the contaminant, and an object far away that had also made no contact. Adults showed a clear proximity effect, wherein objects near the contamination source were perceived to be less desirable than those far away, even though a separate group of adults unanimously acknowledged that contaminants could not possibly have made contact with either the nearby or far-away object (Study 1. The proximity effect also remained robust when a third group of adults was explicitly told that no contaminating particles had made contact with the objects at any time (Study 2. We discuss implications of our findings for extending the scope of magical contagion effects beyond the contact principle, for understanding the persistence of intuitive theories despite broad acceptance of science-based theories, and for constraining interpretations of the developmental work on proximity beliefs.

  15. Species diversity regarding the presence of proximal tubular progenitor cells of the kidney

    Directory of Open Access Journals (Sweden)

    J. Hansson

    2016-02-01

    Full Text Available The cellular source for tubular regeneration following kidney injury is a matter of dispute, with reports suggesting a stem or progenitor cells as the regeneration source while linage tracing studies in mice seemingly favor the classical theory, where regeneration is performed by randomly surviving cells. We, and others have previously described a scattered cell population localized to the tubules of human kidney, which increases in number following injury. Here we have characterized the species distribution of these proximal tubular progenitor cells (PTPCs in kidney tissue from chimpanzee, pig, rat and mouse using a set of human PTPC markers. We detected PTPCs in chimpanzee and pig kidneys, but not in mouse tissue. Also, subjecting mice to the unilateral urethral obstruction model, caused clear signs of tubular injury, but failed to induce the PTPC phenotype in renal tubules.

  16. Within-breath respiratory impedance and airway obstruction in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Silva, Karla Kristine Dames da; Faria, Alvaro Camilo Dias; Lopes, Agnaldo José; Melo, Pedro Lopes de

    2015-07-01

    Recent work has suggested that within-breath respiratory impedance measurements performed using the forced oscillation technique may help to noninvasively evaluate respiratory mechanics. We investigated the influence of airway obstruction on the within-breath forced oscillation technique in smokers and chronic obstructive pulmonary disease patients and evaluated the contribution of this analysis to the diagnosis of chronic obstructive pulmonary disease. Twenty healthy individuals and 20 smokers were assessed. The study also included 74 patients with stable chronic obstructive pulmonary disease. We evaluated the mean respiratory impedance (Zm) as well as values for the inspiration (Zi) and expiration cycles (Ze) at the beginning of inspiration (Zbi) and expiration (Zbe), respectively. The peak-to-peak impedance (Zpp=Zbe-Zbi) and the respiratory cycle dependence (ΔZrs=Ze-Zi) were also analyzed. The diagnostic utility was evaluated by investigating the sensitivity, the specificity and the area under the receiver operating characteristic curve. ClinicalTrials.gov: NCT01888705. Airway obstruction increased the within-breath respiratory impedance parameters that were significantly correlated with the spirometric indices of airway obstruction (R=-0.65, pdisease patients presented significant expiratory-inspiratory differences (p90%). We conclude the following: (1) chronic obstructive pulmonary disease introduces higher respiratory cycle dependence, (2) this increase is proportional to airway obstruction, and (3) the within-breath forced oscillation technique may provide novel parameters that facilitate the diagnosis of respiratory abnormalities in chronic obstructive pulmonary disease.

  17. Within-breath respiratory impedance and airway obstruction in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Karla Kristine Dames da Silva

    2015-07-01

    Full Text Available OBJECTIVE: Recent work has suggested that within-breath respiratory impedance measurements performed using the forced oscillation technique may help to noninvasively evaluate respiratory mechanics. We investigated the influence of airway obstruction on the within-breath forced oscillation technique in smokers and chronic obstructive pulmonary disease patients and evaluated the contribution of this analysis to the diagnosis of chronic obstructive pulmonary disease. METHODS: Twenty healthy individuals and 20 smokers were assessed. The study also included 74 patients with stable chronic obstructive pulmonary disease. We evaluated the mean respiratory impedance (Zm as well as values for the inspiration (Zi and expiration cycles (Ze at the beginning of inspiration (Zbi and expiration (Zbe, respectively. The peak-to-peak impedance (Zpp=Zbe-Zbi and the respiratory cycle dependence (ΔZrs=Ze-Zi were also analyzed. The diagnostic utility was evaluated by investigating the sensitivity, the specificity and the area under the receiver operating characteristic curve. ClinicalTrials.gov: NCT01888705. RESULTS: Airway obstruction increased the within-breath respiratory impedance parameters that were significantly correlated with the spirometric indices of airway obstruction (R=−0.65, p90%. CONCLUSIONS: We conclude the following: (1 chronic obstructive pulmonary disease introduces higher respiratory cycle dependence, (2 this increase is proportional to airway obstruction, and (3 the within-breath forced oscillation technique may provide novel parameters that facilitate the diagnosis of respiratory abnormalities in chronic obstructive pulmonary disease.

  18. Role of ureteric stents in relieving obstruction in patients with obstructive uropathy

    Directory of Open Access Journals (Sweden)

    M Shehab

    2013-01-01

    Conclusion: The predictors of renal recoverability revealed that ureteral stents alone can help in regaining renal function and significant improvement of clinical condition in patients with obstructive uropathy.

  19. A Regularized Algorithm for the Proximal Split Feasibility Problem

    Directory of Open Access Journals (Sweden)

    Zhangsong Yao

    2014-01-01

    Full Text Available The proximal split feasibility problem has been studied. A regularized method has been presented for solving the proximal split feasibility problem. Strong convergence theorem is given.

  20. Treatment of proximal ulna and olecranon fractures by dorsal plating

    NARCIS (Netherlands)

    Kloen, Peter; Buijze, Geert A.

    2009-01-01

    OBJECTIVE : Anatomic reconstruction of proximal ulna and olecranon fractures allowing early mobilization and prevention of ulnohumeral arthritis. INDICATIONS : Comminuted olecranon or proximal ulna fractures (including Monteggia fractures), olecranon fractures extending distally from the coronoid

  1. Ureteral valve masquerading as obstructive megaureter

    Directory of Open Access Journals (Sweden)

    Sushmita Bhatnagar

    2017-05-01

    Full Text Available Primary obstructed megaureter is a common urological condition in the pediatric age group. It is one of the differentials for congenital anomalies of the kidney and urinary tract that include a myriad of structural anomalies of the urinary tract. The obstructive conditions are usually managed conservatively unless there is deterioration in renal function, repeated urinary tract infection, or any other symptom such as abdominal pain on ipsilateral side and hypertension. Presented here is a case of left lower ureteral valve that was diagnosed as primary obstructed megaureter with pain in abdomen and reduced ipsilateral renal function wherein ureteral valve was detected incidentally intraoperatively. Excision of the valve with end to end uretero-ureteral anastomoses over a D-J stent, without resorting to ureteric reimplantation was successful in relieving the obstruction and hydronephrosis

  2. Dams and Obstructions along Iowa's Canoe Routes

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — This dataset represents obstruction to canoe and boat users of the canoe routes of Iowa. This may represent actual dams, rock dams (natural or man made), large...

  3. Obstructive sleep apnea: Awakening the hidden truth

    African Journals Online (AJOL)

    2014-01-16

    Jan 16, 2014 ... The repetitive nocturnal hypoxemia experienced by patients with OSA is ... etiopathogenesis, epidemiology, associated systemic diseases such as cardiovascular diseases, diabetes, and dental .... Obstructive sleep apnea and cardiovascular diseases ... showing that successful treatment of sleep apnea.

  4. Genetics Home Reference: obstructive sleep apnea

    Science.gov (United States)

    ... eCollection 2014. Review. Citation on PubMed or Free article on PubMed Central de Lima FF, Mazzotti DR, Tufik S, Bittencourt L. The role inflammatory response genes in obstructive sleep apnea syndrome: a review. Sleep ...

  5. Modern imaging in patients with obstructive jaundice

    African Journals Online (AJOL)

    2007-07-19

    Jul 19, 2007 ... chronic pancreatitis, sclerosing cholangitis, benign bile duct strictures or ... ducts are obstructed, surgery or therapeutic endoscopy may be required, but ... expensive and invasive procedures, is now available for evaluating.

  6. Complications in obstructive jaundice: role of endotoxins

    NARCIS (Netherlands)

    Greve, J. W.; Gouma, D. J.; Buurman, W. A.

    1992-01-01

    Surgical treatment of patients with obstructive jaundice is associated with a high postoperative morbidity and mortality. A correlation was suggested between endotoxins and the observed complications. The mechanism by which endotoxins affect the negative outcome in operated jaundiced patients was,

  7. An obstructing endobronchial lipoma simulating COPD

    DEFF Research Database (Denmark)

    Sivapalan, Pradeesh; Gottlieb, Magnus; Christensen, Merete

    2014-01-01

    Endobronchial lipomas are rare benign tumors of the respiratory tract. Bronchial occlusion may cause parenchymal damage and lead to a misdiagnosis of chronic obstructive pulmonary disease or malignancy. Therefore, both accurate diagnosis and radical treatment of endobronchial lipomas are essentia...

  8. Chronic obstructive pulmonary disease – diagnosis and ...

    African Journals Online (AJOL)

    Chronic obstructive pulmonary disease – diagnosis and classification of ... biomass fuel exposure/household pollution, tuberculosis, HIV and mining ... There is a very high prevalence of COPD in SA and it is the third leading cause of mortality ...

  9. Acute pseudo-obstruction of the colon

    International Nuclear Information System (INIS)

    Beese, M.; Heller, M.

    1988-01-01

    The radiological correlate to the pseudo-obstruction of the colon is not specific, but it does supply a pointer to the disease of it shows dilation of the caecum, colon ascendens and colon transversum with air-pockets and reflected imaging as well as a usually not dilated colon descendens with remarkably little air. To make the diagnosis quite sure we must exclude intestinal obstruction by using X-ray contrast media or by coloscopy. (orig./GDG) [de

  10. Obstructive sleep apnoea syndrome in children

    Directory of Open Access Journals (Sweden)

    Anna Włodarska

    2016-09-01

    Full Text Available Sleep-related breathing disorders in children are a clinical problem which is more and more often diagnosed by doctors nowadays. They can be the basis for diagnosing obstructive sleep apnoea syndrome that causes a number of complications: lowering the quality of life, behavioural problems, complications involving cardiovascular system. The incidence of obstructive sleep apnoea syndrome in the paediatric population is estimated to be at the level of 2%. The symptoms of obstructive sleep apnoea syndrome can be divided into daytime and night ones. Night symptoms in children include: snoring, apnoea, breathing with open mouth (both during the day and at night, dry tongue and mouth during sleep, agitated sleep in unnatural positions. Among daytime symptoms of obstructive sleep apnoea syndrome there are: irritability, aggressiveness, hyperactivity, attention deficit disorder, delayed development and growth pattern (mainly failure to thrive, learning problems, morning headaches. Parents often do not connect the night and daytime symptoms with the possible development of obstructive sleep apnoea syndrome in their children. The main predisposing factor of obstructive sleep apnoea syndrome in children is adenotonsillar hypertrophy. Effective and in most cases preferred treatment for the management of obstructive sleep apnoea syndrome in children is adenotonsillectomy. Polysomnography and polygraphy are diagnostic tools helpful in the study of sleep-related disorders. The objective of this study was to systematise the knowledge on the epidemiology, aetiology, clinical image and prevention of obstructive sleep apnoea syndrome in children.

  11. Chronic obstructive pulmonary disease : a proteomics approach

    OpenAIRE

    Alexandre, Bruno Miguel Coelho, 1980-

    2011-01-01

    Tese de doutoramento, Biologia (Biologia Molecular), Universidade de Lisboa, Faculdade de Ciências, 2012 Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation that is not fully reversible even under bronchodilators effect, caused by a mixture of small airway disease – obstructive bronchiolitis – and parenchymal destruction – emphysema. At the present time, COPD is the fourth leading cause of death and its prevalence and mortality are expected to contin...

  12. Neonatal intestinal obstruction in Benin, Nigeria

    Directory of Open Access Journals (Sweden)

    Osifo Osarumwense

    2009-01-01

    Full Text Available Background: Intestinal obstruction is a life threatening condition in the newborn, with attendant high mortality rate especially in underserved subregion. This study reports the aetiology, presentation, and outcome of intestinal obstruction management in neonates. Materials and Methods: A prospective study of neonatal intestinal obstruction at the University of Benin Teaching Hospital, Benin, Nigeria, between January 2006-June 2008. Data were collated on a structured proforma and analysed for age, sex, weight, presentation, type/date of gestation/delivery, aetiology, clinical presentation, associated anomaly, treatment, and outcome. Results: There were 71 neonates, 52 were males and 19 were females (2.7:1. Their age range was between 12 hours and 28 days (mean, 7.9 ± 2.7 days and they weighed between 1.8 and 5.2 kg (average, 3.2 kg. The causes of intestinal obstruction were: Anorectal anomaly, 28 (39.4%; Hirschsprung′s disease, 8 (11.3%′ prematurity, 3 (4.2%; meconeum plug, 2 (2.8%; malrotation, 6 (8.5%; intestinal atresia, 8 (11.3%; necrotising enterocolitis (NEC, 4 (5.6%; obstructed hernia, 4 (5.6%; and spontaneous gut perforation, 3 (4.2%. Also, 27 (38% children had colostomy, 24 (33.8% had laparotomy, 9 (12.8% had anoplasty, while 11 (15.4% were managed nonoperatively. A total of 41 (57.7% neonates required incubator, 26 (36.6% needed total parenteral nutrition, while 15 (21.1% require d paediatric ventilator. Financial constraint, late presentation, presence of multiple anomalies, aspiration, sepsis, gut perforation, and bowel gangrene were the main contributors to death. Neonates with lower obstructions had a better outcome compared to those having upper intestinal obstruction ( P < 0.0001. Conclusion: Outcomes of intestinal obstruction are still poor in our setting; late presentation, financial constraints, poor parental motivation and lack of basic facilities were the major determinants of mortality.

  13. The genetics of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Silverman Edwin K

    2001-01-01

    Full Text Available Abstract Chronic obstructive pulmonary disease (COPD is a significant cause of global morbidity and mortality. Previous studies have shown that COPD aggregates in families, suggesting a genetic predisposition to airflow obstruction. Many candidate genes have been assessed, but the data are often conflicting. We review the genetic factors that predispose smokers to COPD and highlight the future role of genomic scans in identifying novel susceptibility genes.

  14. Obstructive Sleep Apnea Due To Extrathoracic Tracheomalacia

    OpenAIRE

    Muzumdar, Hiren; Nandalike, K.; Bent, J.; Arens, Raanan

    2013-01-01

    We report obstructive sleep apnea in a 3-year-old boy with tracheomalacia secondary to tracheotomy that resolved after placement of a metallic stent in the region of tracheomalacia. The tracheal location of obstruction during sleep in this case contrasts with the usual location in the pharynx or, less often, the larynx. This case also demonstrates the utility of polysomnography in managing decannulation of tracheostomies.

  15. Obstructive sleep apnea due to extrathoracic tracheomalacia.

    Science.gov (United States)

    Muzumdar, Hiren; Nandalike, K; Bent, J; Arens, Raanan

    2013-02-01

    We report obstructive sleep apnea in a 3-year-old boy with tracheomalacia secondary to tracheotomy that resolved after placement of a metallic stent in the region of tracheomalacia. The tracheal location of obstruction during sleep in this case contrasts with the usual location in the pharynx or, less often, the larynx. This case also demonstrates the utility of polysomnography in managing decannulation of tracheostomies.

  16. Strong Proximities on Smooth Manifolds and Vorono\\" i Diagrams

    OpenAIRE

    Peters, J. F.; Guadagni, C.

    2015-01-01

    This article introduces strongly near smooth manifolds. The main results are (i) second countability of the strongly hit and far-miss topology on a family $\\mathcal{B}$ of subsets on the Lodato proximity space of regular open sets to which singletons are added, (ii) manifold strong proximity, (iii) strong proximity of charts in manifold atlases implies that the charts have nonempty intersection. The application of these results is given in terms of the nearness of atlases and charts of proxim...

  17. MR cholangiography: usefulness in obstructive jaundice

    International Nuclear Information System (INIS)

    Bae, Sang Hoon; Lee, In Jae; Nam, Kung Sook; Hong, Myung Sun; Lee, Kyung Hwan; Yun, Ku Sub

    1994-01-01

    Three-dimensional(3D) magnetic resonance(MR) projection imaging was evaluated as a noninvasive alternative to direct cholangiography for the assessment of its reliability in patients with obstructive jaundice. A heavily T2-weighted gradient-echo sequence(PSIF) was used for 3D MR projection imaging of the biliary system in five healthy volunteers and 25 patients with obstructive jaundice. The 3D images of the bile ducts were formed by stacking consecutive coronal MR images obtained with a fast imaging method to a maximum-intensity projection algorithm. In the volunteers, MR cholangiography could demonstrate the anatomy of the biliary tract in only two subjects. The extrahepatic and intrahepatic bile ducts were well visualized in 23 patients with obstructive jaundice. The leve of obstruction and the grade of dilatation were depicted with MR cholangiography in all cases. And the cause of obstruction could be determined with MR cholangiography in 18 cases, MR cholangiography wa successful in two patients in whom ERCP failed. The gallbladder or dilated pancreatic duct not demonstrated by means of direct cholangiography was demonstrated with MR cholangiography in six cases. MR cholangiography may be a useful adjunctive tool for the noninvasive evaluation of patients with obstructive Jaundice

  18. Critical Proximity as a Methodological Move in Techno-Anthropology

    DEFF Research Database (Denmark)

    Birkbak, Andreas; Petersen, Morten Krogh; Elgaard Jensen, Torben

    2015-01-01

    proximity.’ Critical proximity offers an alternative to critical distance, especially with respect to avoiding premature references to abstract panoramas such as democratization and capitalist exploitation in the quest to conduct ‘critical’ analysis. Critical proximity implies, instead, granting the beings...

  19. 75 FR 5009 - Proximity Detection Systems for Underground Mines

    Science.gov (United States)

    2010-02-01

    ... Proximity Detection Systems for Underground Mines AGENCY: Mine Safety and Health Administration, Labor... information regarding whether the use of proximity detection systems would reduce the risk of accidents where... . Information on MSHA-approved proximity detection systems is available on the Internet at http://www.msha.gov...

  20. Obstructive sleep apnea and inflammation.

    LENUS (Irish Health Repository)

    McNicholas, Walter T

    2012-02-01

    The pathogenesis of cardiovascular complications in obstructive sleep apnea syndrome (OSAS) is not fully understood but is likely multifactorial in origin. Inflammatory processes play an important role in the pathogenesis of atherosclerosis, and circulating levels of several markers of inflammation have been associated with future cardiovascular risk. These include cell adhesion molecules such as intercellular adhesion molecule-1 and selectins, cytokines such as tumour necrosis factor alpha and interleukin 6, chemokines such as interleukin 8, and C-reactive protein. There is also increasing evidence that inflammatory processes play an important role in the cardiovascular pathophysiology of OSAS and many of the inflammatory markers associated with cardiovascular risk have been reported as elevated in patients with OSAS. Furthermore, animal and cell culture studies have demonstrated preferential activation of inflammatory pathways by intermittent hypoxia, which is an integral feature of OSAS. The precise role of inflammation in the development of cardiovascular disease in OSAS requires further study, particularly the relationship with oxidative stress, metabolic dysfunction, and obesity.

  1. Proximal sensing for soil carbon accounting

    Science.gov (United States)

    England, Jacqueline R.; Viscarra Rossel, Raphael A.

    2018-05-01

    Maintaining or increasing soil organic carbon (C) is vital for securing food production and for mitigating greenhouse gas (GHG) emissions, climate change, and land degradation. Some land management practices in cropping, grazing, horticultural, and mixed farming systems can be used to increase organic C in soil, but to assess their effectiveness, we need accurate and cost-efficient methods for measuring and monitoring the change. To determine the stock of organic C in soil, one requires measurements of soil organic C concentration, bulk density, and gravel content, but using conventional laboratory-based analytical methods is expensive. Our aim here is to review the current state of proximal sensing for the development of new soil C accounting methods for emissions reporting and in emissions reduction schemes. We evaluated sensing techniques in terms of their rapidity, cost, accuracy, safety, readiness, and their state of development. The most suitable method for measuring soil organic C concentrations appears to be visible-near-infrared (vis-NIR) spectroscopy and, for bulk density, active gamma-ray attenuation. Sensors for measuring gravel have not been developed, but an interim solution with rapid wet sieving and automated measurement appears useful. Field-deployable, multi-sensor systems are needed for cost-efficient soil C accounting. Proximal sensing can be used for soil organic C accounting, but the methods need to be standardized and procedural guidelines need to be developed to ensure proficient measurement and accurate reporting and verification. These are particularly important if the schemes use financial incentives for landholders to adopt management practices to sequester soil organic C. We list and discuss requirements for developing new soil C accounting methods based on proximal sensing, including requirements for recording, verification, and auditing.

  2. Keldysh proximity action for disordered superconductors

    International Nuclear Information System (INIS)

    Feigel'man, M.V.; Larkin, A.I.; Skvortsov, M.A.

    2005-01-01

    We review a novel approach to the superconductive proximity effect in disordered normal-superconducting (N-S) structures. The method is based on the multicharge Keldysh action and is suitable for the treatment of interaction and fluctuation effects. As an application of the formalism, we study the subgap conductance and noise in two-dimensional N-S system in the presence of the electron-electron interaction in the Cooper channel. It is shown that singular nature of the interaction correction at large scales leads to a nonmonotonous temperature, voltage and magnetic field dependence of the Andreev conductance. (author)

  3. Phonon structure in proximity tunnel junctions

    International Nuclear Information System (INIS)

    Zarate, H.G.; Carbotte, J.P.

    1985-01-01

    We have iterated to convergence, for the first time, a set of four coupled real axis Eliashberg equations for the superconducting gap and renormalization functions on each side of a proximity sandwich. We find that the phenomenological procedures developed to extract the size of the normal side electron-phonon interaction from tunneling data are often reasonable but may in some cases need modifications. In all the cases considered the superconducting phonon structure reflected on the normal side, as well as other structures, shows considerable agreement with experiment as to size, shape, and variation with barrier transmission coefficient. Finally, we study the effects of depairing on these structures

  4. Proximal iliotibial band syndrome: case report

    Directory of Open Access Journals (Sweden)

    Guilherme Guadagnini Falotico

    2013-08-01

    Full Text Available OBJECTIVE: The overuse injuries in the hip joint occur commonly in sports practitioners and currently due to technical advances in diagnostic imaging, especially magnetic resonance imaging (MRI, are often misdiagnosed. Recently, a group of people were reported, all female, with pain and swelling in the pelvic region.T2-weighted MRI showed increased signal in the enthesis of the iliotibial band (ITB along the lower border of the iliac tubercle. We report a case of a 34 year old woman, non-professional runner, with pain at the iliac crest with no history of trauma and whose MRI was compatible with the proximal iliotibial band syndrome.

  5. Noise measurements on proximity effect bridges

    International Nuclear Information System (INIS)

    Decker, S.K.; Mercereau, J.E.

    1975-01-01

    Audio frequency noise density measurements were performed on weakly superconducting proximity effect bridges on using a cooled transformer and room temperature low noise preamplifier. The noise temperature of the measuring system is approximately 4 0 K for a 0.9 Ω resistor. Noise density was measured as a function of bias current and temperature for the bridges. Excess noise above that expected from Johnson noise for a resistor equal to the dynamic resistance of the bridges was observed in the region near the critical current of the device. At high currents compared to the critical current, the noise density closely approaches that given by Johnson noise

  6. Severity of Airflow Obstruction in Chronic Obstructive Pulmonary Disease (COPD): Proposal for a New Classification.

    Science.gov (United States)

    Coton, Sonia; Vollmer, William M; Bateman, Eric; Marks, Guy B; Tan, Wan; Mejza, Filip; Juvekar, Sanjay; Janson, Christer; Mortimer, Kevin; P A, Mahesh; Buist, A Sonia; Burney, Peter G J

    2017-10-01

    Current classifications of Chronic Obstructive Pulmonary Disease (COPD) severity are complex and do not grade levels of obstruction. Obstruction is a simpler construct and independent of ethnicity. We constructed an index of obstruction severity based on the FEV 1 /FVC ratio, with cut-points dividing the Burden of Obstructive Lung Disease (BOLD) study population into four similarly sized strata to those created by the GOLD criteria that uses FEV 1 . We measured the agreement between classifications and the validity of the FEV 1 -based classification in identifying the level of obstruction as defined by the new groupings. We compared the strengths of association of each classification with quality of life (QoL), MRC dyspnoea score and the self-reported exacerbation rate. Agreement between classifications was only fair. FEV 1 -based criteria for moderate COPD identified only 79% of those with moderate obstruction and misclassified half of the participants with mild obstruction as having more severe COPD. Both scales were equally strongly associated with QoL, exertional dyspnoea and respiratory exacerbations. Severity assessed using the FEV 1 /FVC ratio is only in moderate agreement with the severity assessed using FEV 1 but is equally strongly associated with other outcomes. Severity assessed using the FEV 1 /FVC ratio is likely to be independent of ethnicity.

  7. Ultrasonography of small intestinal obstructions: a contemporary approach.

    Science.gov (United States)

    Garcia, D A A; Froes, T R; Vilani, R G D O C; Guérios, S D; Obladen, A

    2011-09-01

    To assess the accuracy of intestinal ultrasound for diagnosis of intestinal obstruction in dogs and cats. A prospective clinical study was performed. Inclusion criteria were dogs and cats with clinical signs suggestive of gastrointestinal obstruction. Animals with no obstruction detected on ultrasound were excluded if they could not be monitored for 48 hours to confirm absence of obstruction. Sonographic diagnosis of small intestinal obstruction was based on identification of at least two findings suggestive of intestinal obstruction. Ninety-two patients suspected of having intestinal obstruction were included. Correct diagnosis of intestinal obstruction was made in 21 cases (23%), and in 68 (74%) this diagnosis was excluded. Interpretation of the images on prospective analysis had sensitivity, positive predictive, specificity and negative predictive values of 100%, 87.5%, 95.8% and 100%, respectively. Ultrasonography is an excellent method for investigation of animals with gastrointestinal disorders, and is particularly useful for excluding obstructive processes. © 2011 British Small Animal Veterinary Association.

  8. Endoscopic dilation of complete oesophageal obstructions with a combined antegrade-retrograde rendezvous technique.

    Science.gov (United States)

    Bertolini, Reto; Meyenberger, Christa; Putora, Paul Martin; Albrecht, Franziska; Broglie, Martina Anja; Stoeckli, Sandro J; Sulz, Michael Christian

    2016-02-21

    To investigate the combined antegrade-retrograde endoscopic rendezvous technique for complete oesophageal obstruction and the swallowing outcome. This single-centre case series includes consecutive patients who were unable to swallow due to complete oesophageal obstruction and underwent combined antegrade-retrograde endoscopic dilation (CARD) within the last 10 years. The patients' demographic characteristics, clinical parameters, endoscopic therapy, adverse events, and outcomes were obtained retrospectively. Technical success was defined as effective restoration of oesophageal patency. Swallowing success was defined as either percutaneous endoscopic gastrostomy (PEG)-tube independency and/or relevant improvement of oral food intake, as assessed by the functional oral intake scale (FOIS) (≥ level 3). The cohort consisted of six patients [five males; mean age 71 years (range, 54-74)]. All but one patient had undergone radiotherapy for head and neck or oesophageal cancer. Technical success was achieved in five out of six patients. After discharge, repeated dilations were performed in all five patients. During follow-up (median 27 mo, range, 2-115), three patients remained PEG-tube dependent. Three of four patients achieved relevant improvement of swallowing (two patients: FOIS 6, one patient: FOIS 7). One patient developed mediastinal emphysema following CARD, without a need for surgery. The CARD technique is safe and a viable alternative to high-risk blind antegrade dilation in patients with complete proximal oesophageal obstruction. Although only half of the patients remained PEG-tube independent, the majority improved their ability to swallow.

  9. Polyurethane-Covered Self-expandable Nitinol Stent for Malignant Biliary Obstruction: Preliminary Results

    International Nuclear Information System (INIS)

    Han, Young-Min; Hwang, Seung-Bae; Lee, Soo-Teik; Lee, Jeong-Min; Chung, Gyung-Ho

    2002-01-01

    Purpose: To evaluate the immediate and long-term results in ten patients with malignant biliary obstruction using a polyurethane-covered, self-expandable nitinol stent.Methods: A nitinol stent, fully covered with high-elasticity polyurethane, with an unconstrained diameter of 10 mm and a total length of 60-80 mm, was placed transhepatically under fluoroscopic guidance in ten patients. The length of the biliary obstruction varied between 30-50 mm. The follow-up examination included a clinical assessment, serum bilirubin measurement, and ultrasound examinations at one-month intervals in all patients. Results: Initial stent deployment was successful in eight patients. Two patients experienced proximal migration,which was solved by insertion of two, uncovered Wallstents. One patient had the stent removed after two weeks because of severe nausea and vomiting. One patient had delayed migration of the covered stent after 40 weeks. The follow-up duration was 3-40 weeks (Mean: 16.9 weeks). Seven patients died(3-26 weeks) and three patients survived (24-40 weeks). The bilirubin measurements in all patients had significantly decreased one week after stent insertion. The levels of amylase and lipase had did not increase after stent insertion. Conclusions: Apolyurethane-covered, self-expandable nitinol stent can be used effectively and safely in the treatment of malignant biliary obstruction. The preliminary results are favorable, but there is a need for further large studies to determine both long-term survival and patency

  10. Accuracy of abdominal auscultation for bowel obstruction.

    Science.gov (United States)

    Breum, Birger Michael; Rud, Bo; Kirkegaard, Thomas; Nordentoft, Tyge

    2015-09-14

    To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction. Bowel sounds were recorded in patients with suspected bowel obstruction using a Littmann(®) Electronic Stethoscope. The recordings were processed to yield 25-s sound sequences in random order on PCs. Observers, recruited from doctors within the department, classified the sound sequences as either normal or pathological. The reference tests for bowel obstruction were intraoperative and endoscopic findings and clinical follow up. Sensitivity and specificity were calculated for each observer and compared between junior and senior doctors. Interobserver variation was measured using the Kappa statistic. Bowel sound sequences from 98 patients were assessed by 53 (33 junior and 20 senior) doctors. Laparotomy was performed in 47 patients, 35 of whom had bowel obstruction. Two patients underwent colorectal stenting due to large bowel obstruction. The median sensitivity and specificity was 0.42 (range: 0.19-0.64) and 0.78 (range: 0.35-0.98), respectively. There was no significant difference in accuracy between junior and senior doctors. The median frequency with which doctors classified bowel sounds as abnormal did not differ significantly between patients with and without bowel obstruction (26% vs 23%, P = 0.08). The 53 doctors made up 1378 unique pairs and the median Kappa value was 0.29 (range: -0.15-0.66). Accuracy and inter-observer agreement was generally low. Clinical decisions in patients with possible bowel obstruction should not be based on auscultatory assessment of bowel sounds.

  11. Spectrum of diseases in acute intestinal obstruction

    International Nuclear Information System (INIS)

    Masud, M.; Khan, A.; Gondal, Z.I.; Adil, M.

    2015-01-01

    To determine the etiological spectrum of acute intestinal obstruction in our clinical setup Military Hospital Rawalpindi. Study Design: Descriptive study. Place and Duration of Study: Surgical department of Military Hospital, Rawalpindi from Jul 2012 to Jul 2013, over a period of about 1 year. Material and Methods: A total of 120 patients with acute mechanical intestinal obstruction who underwent laparotomy were included in our study while those with non-mechanical intestinal obstruction like history of trauma and paralytic ileus were excluded from the study. All the patients were selected by non-probability purposive sampling technique. Emergency laparotomy was done and operative findings were recorded. Results: A total of 120 patients with mechanical intestinal obstruction were included in this study out of which 93 (69.17%) were female and remaining 27 (30.83%) were males. Male to female ratio was 1:2.24. Age range of patients was 22-85 years. Out of 120 patients operated for acute intestinal obstruction post-op adhesions were found in 37 (30.83%) patients followed by intestinal tuberculosis in 23 (19.17%) patients, obstructed inguinal hernias in 13 (10.83%), gut malignancies in 15 (12.5%) , Meckel's diverticulum with bands in 7 (5.83%), volvulus in 7 (5.83%), perforated appendix in 6 (5%), intussusception in 2 (1.7%), inflammatory bands in 5 (4.17%), trichobezoar and faecal impaction in 2 (1.7%) while in 3 (2.5%) patients no definite cause was found. Conclusion: Post-op adhesions are the commonest cause of mechanical intestinal obstruction in our setup followed by intestinal tuberculosis as second most common clinical pattern of presentation. (author)

  12. Congenital anomalies and proximity to landfill sites.

    LENUS (Irish Health Repository)

    Boyle, E

    2004-01-01

    The occurrence of congenital anomalies in proximity to municipal landfill sites in the Eastern Region (counties Dublin, Kildare, Wicklow) was examined by small area (district electoral division), distance and clustering tendancies in relation to 83 landfills, five of which were major sites. The study included 2136 cases of congenital anomaly, 37,487 births and 1423 controls between 1986 and 1990. For the more populous areas of the region 50% of the population lived within 2-3 km of a landfill and within 4-5 km for more rural areas. In the area-level analysis, the standardised prevalence ratios, empirical and full Bayesian modelling, and Kulldorff\\'s spatial scan statistic found no association between the residential area of cases and location of landfills. In the case control analysis, the mean distance of cases and controls from the nearest landfill was similar. The odds ratios of cases compared to controls for increasing distances from all landfills and major landfills showed no significant difference from the baseline value of 1. The kernel and K methods showed no tendency of cases to cluster in relationship to landfills. In conclusion, congenital anomalies were not found to occur more commonly in proximity to municipal landfills.

  13. Obesity and supermarket access: proximity or price?

    Science.gov (United States)

    Drewnowski, Adam; Aggarwal, Anju; Hurvitz, Philip M; Monsivais, Pablo; Moudon, Anne V

    2012-08-01

    We examined whether physical proximity to supermarkets or supermarket price was more strongly associated with obesity risk. The Seattle Obesity Study (SOS) collected and geocoded data on home addresses and food shopping destinations for a representative sample of adult residents of King County, Washington. Supermarkets were stratified into 3 price levels based on average cost of the market basket. Sociodemographic and health data were obtained from a telephone survey. Modified Poisson regression was used to test the associations between obesity and supermarket variables. Only 1 in 7 respondents reported shopping at the nearest supermarket. The risk of obesity was not associated with street network distances between home and the nearest supermarket or the supermarket that SOS participants reported as their primary food source. The type of supermarket, by price, was found to be inversely and significantly associated with obesity rates, even after adjusting for individual-level sociodemographic and lifestyle variables, and proximity measures (adjusted relative risk=0.34; 95% confidence interval=0.19, 0.63) Improving physical access to supermarkets may be one strategy to deal with the obesity epidemic; improving economic access to healthy foods is another.

  14. Does gastroesophageal reflux increase chronic obstructive pulmonary disease exacerbations?

    Science.gov (United States)

    Iliaz, Sinem; Iliaz, Raim; Onur, Seda Tural; Arici, Serpil; Akyuz, Umit; Karaca, Cetin; Demir, Kadir; Besisik, Fatih; Kaymakoglu, Sabahattin; Akyuz, Filiz

    2016-06-01

    The relationship between chronic obstructive pulmonary disease (COPD) exacerbations and gastroesophageal reflux (GER) has been investigated less than asthma-GER. We aimed to evaluate the presence of GER in patients with COPD and its impact on exacerbations. We included 24 patients with stable mild-moderate stage COPD and 19 volunteers as the control group. We conducted a gastroesophageal reflux disease (GERD) symptom questionnaire, gastroscopy, manometry, and an ambulatory 24-h pH-impedance study. According to the GERD questionnaire, only 5 (20.8%) patients with COPD had typical GER symptoms. According to the 24-h pH-impedance study, the mean DeMeester score (DMS) was 38.1 ± 34.6 in the COPD group and 13.3 ± 16.8 in the control group (p = 0.01). The acid reflux (DMS > 14.7) rate was higher in patients with COPD than in controls (73.9% vs 26.3%, p = 0.01). The symptom association probability positivity rate was 17.4% (n = 4) in the COPD group, which was similar to the controls (p = 0.11). The mean proximal extension rate of reflux (Z 17 cm) was 26.4 ± 12.9% in the COPD group. The proximal extent of reflux was positively correlated with the number of COPD exacerbations per year (p = 0.03, r = 0.448). In the motility results, only 2 (20%) patients in the control group had a minor motility disorder. Seventeen (70.8%) patients in the COPD group had a minor motility disorder, and 4 (16.7%) had major motility disorders (p gastroesophageal reflux was frequent in patients with COPD, but only a quarter had typical reflux symptoms. The proximal extent of reflux may trigger frequent exacerbations of COPD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Asthma and Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Yi-Xian Qiao

    2015-01-01

    Full Text Available Objective: To get a comprehensive understanding about the relationship between obstructive sleep apnea (OSA and asthma by reviewing the epidemiology, pathophysiology, and clinical manifestation and then summarizing the latest progress on diagnosis and treatment. Data Sources: Articles referred in this review were mainly collected from a comprehensive search of the PubMed published in English from 1990 to 2015 with the terms "OSA" and "asthma" as the main keywords. Highly regarded older publications were also included. Study Selection: Information about the features of the two diseases in common, the pathophysiologic association between them and their current treatments from the literature search were identified, retrieved, and summarized. Results: Both OSA and asthma are very prevalent conditions. The incidences of them have kept on rising in recent years. Asthma is often accompanied by snoring and apnea, and OSA often combines with asthma, as well. They have many predisposing and aggravating factors in common. Possible shared direct mechanistic links between them include mechanical effects, intermittent hypoxia, nerve reflex, inflammation, leptin, etc. Indirect mechanistic links include medication, nose diseases, smoking, obesity, and gastroesophageal reflux disease. Since OSA presents many similar features with nocturnal asthma, some scholars termed them as a sole syndrome - "alternative overlap syndrome," and proved that asthma symptoms in those patients could be improved through the treatment of continuous positive airway pressure. Conclusions: OSA and asthma are closely associated in pathogenesis, symptoms, and therapies. With the growing awareness of the relationship between them, we should raise our vigilance on the coexistence of OSA in those difficult-to-control asthmatic patients. Further studies are still needed to guide the clinical works.

  16. Study of gastro-oesophageal reflux disease in patients with mild-to-moderate chronic obstructive pulmonary disease in India.

    Science.gov (United States)

    Kamble, Nitish L; Khan, Naushad A; Kumar, Naresh; Nayak, Hemanta K; Daga, Mradul K

    2013-04-01

    To study the incidence and pattern of gastro-oesophageal reflux disease (GORD) in patients with mild-to-moderate chronic obstructive pulmonary disease (COPD) using dual-probe 24-h oesophageal pH recording. This was a prospective study of 50 patients with mild-to-moderate stage COPD based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. A detailed history of illness along with spirometry was done in all patients. In the study group, reflux symptoms were measured using a validated scoring system. All the patients underwent oesophageal manometry and dual-probe 24-h oesophageal pH recording. Symptoms of gastro-oesophageal reflux were present in 38 patients. Twenty-four-hour oesophageal pH monitoring revealed pathological reflux in 31 out of 38 symptomatic and 8 out of 12 asymptomatic patients. The overall rate of GORD was 78% in our study. Only distal GORD was observed in 11 (28.9%), and both distal and proximal GORD was observed in 20 (52.6%) out of the 38 symptomatic subjects. In the remaining 12 asymptomatic patients, eight had GORD. Distal GORD was present in six (50%) patients, and two (16.6%) had both distal and proximal GORD in this group. Isolated proximal GORD was not observed in any patient. There is an increased occurrence of GORD in patients with even mild-to-moderate COPD. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

  17. A CLINICAL STUDY OF ADHESIVE INTESTINAL OBSTRUCTION

    Directory of Open Access Journals (Sweden)

    Haricharan

    2015-09-01

    Full Text Available INTRODUCTION: Adhesive intestinal obstruction is an inevitable complication of abdominal surgeries. It has high morbidity with associated poor quality of life and predisposition to repeated hospitalization. Commonest cause of bowel obstruction in developed countries is postoperative adhesions with extrinsic compression of the intestine. Most of them can be managed conservatively. METHODS: A retrospective study of 30 patients admitted with the diagnosis of post - operative adhesive partial bowel obstruction was conducted by analyzing their medical records. Demographic data, clinical presentation including duration, previous surgical procedures, treatments received for the condition and successful conservative approach versus requirement of operative intervention were assesse d. RESULTS: The median age was 31yrs, most in their third decade of life. Male predominance was noted. Pelvic surgeries and gynecological surgeries (26% were found to be the most common cause of adhesive bowel obstruction followed by appendectomy (16%. M ore than two third of the patients (76.7% developed symptoms within two years of the initial surgery. Successful conservative treatment was noted in 22 patients (73.3% and discharged on fourth day of admission. Eight patients (26.6% underwent surgery. T hey all underwent adhesiolysis and had good outcome. CONCLUSIONS: The time - honored practice of expectant management of adhesive partial bowel obstruction has equally good outcome, as compared to various interventions practiced

  18. Body imaging diagnosis of obstructive jaundice

    International Nuclear Information System (INIS)

    Tanehiro, Kenji; Kuno, Nobuyoshi; Kurimoto, Kumiko; Yokota, Tetsuo; Kato, Tomoyuki

    1983-01-01

    We have evaluated the efficacy of ultrasonography (US) and computed tomography (CT) in comparison with endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), and angiography (AG), and discussed a rational diagnostic approach for the evaluation of obstructive jaundice. The subjects were 70 patients with obstructive jaundice, finally confirmed by subsequent surgery or autopsy. In this study, US and CT achieved a diagnostic accuracy of 95% and 98%, respectively, in detection of the presence and level of an obstruction. Therefore, we consider that US is the best initial procedure for evaluation of obstructive jaundice; followed by CT only when the bilialy ducts should be poorly demonstrated by US because of body habitus or gaseous distension. US might be able to identify even the specific etiology of an obstructive lesion. In tumors of the bilialy tract and the pancreas including small and resectable ones, the diagnostic rate of US was high, 91% for bilialy tract tumor and 100% for pancreatic tumor, which was almost the same as that of ERCP, PTC or AG. This result suggests that US eliminates the need of invasive procedures in some cases before making decision of therapeutic approach, while CT was not so accurate diagnostic modality as US in small lesions. But in papillary tumors, small lesions of the distal common bile duct, and gallstone diseases, either ERCP or PTC yielding almost 100% diagnostic accuracy, is the most reliable procedure, while US or CT did not show a good diagnostic accuracy. (J.P.N.)

  19. Endoscopic third ventriculostomy for obstructive hydrocephalus

    International Nuclear Information System (INIS)

    Ali, M.; Usman, M.; Khan, Z.; Khan, K.M.; Hussain, R.; Khanzada, K.

    2013-01-01

    To determine the success rate of endoscopic third ventriculostomy (ETV) for treating obstructive hydrocephalus. Study Design: Cross-sectional observational study. Place and Duration of Study: The Neurosurgery Department of PGMI, Lady Reading Hospital, Peshawar, from May 2010 to November 2011. Methodology: Patients with obstructive hydrocephalus due to aqueductal stenosis, tectal and non-tectal tumour and already shunted patients for obstructive hydrocephalus presented with blocked shunt were included in the study. Patients with congenital hydrocephalus and secondary to meningitis were excluded. Endoscopic third ventriculostomy was performed. Success, complications and mortality was noted. Data was analyzed by descriptive statistics using SPSS software version 17. Results: There were 155 patients including 72 males and 83 females with ratio of 1: 1.33. Success rate was 71%. Indication of surgery was obstructive hydrocephalus due to aqueductal stenosis, posterior fossa tumour, brain stem and CP angle tumour. Complications were seen in 18 patients including mortality in 3 patients. Conclusion: ETV is effective, safe and successful procedure in patients with obstructive hydrocephalus. It may be used as replacement procedure of ventriculo-peritoneal shunt as initial line of management in selected patients. (author)

  20. MR urography evaluation of obstructive uropathy

    International Nuclear Information System (INIS)

    Grattan-Smith, J.D.; Jones, Richard A.; Little, Stephen B.

    2008-01-01

    Hydronephrosis and the evaluation of obstructive uropathy are the most common indications for MR urography in our practice. Typically our patients fall into one of two groups: infants with antenatal hydronephrosis and older children who present with abdominal pain, hematuria or urinary tract infection. Obstruction in children is usually chronic and partial. Intermittent episodes of increased pressure occur when the urine production exceeds the capacity for drainage. MR urography uses a fluid and diuretic challenge to assess the hydronephrotic kidney. High-quality anatomic images provide a morphologic assessment of the hydronephrotic system. Although it is relatively straightforward to determine if a system is not obstructed on the basis of the renal transit time (RTT), no single parameter is adequate to fully characterize obstruction. By evaluating the changes in signal intensity in the renal parenchyma following contrast administration, the hydronephrotic systems are classified as compensated or decompensated. Delayed RTT and the presence of urine-contrast levels indicate stasis. Calyceal transit time and the difference between the volumetric and the Patlak differential renal function (vDRF-pDRF) are measures of the physiologic changes within the kidney. Additionally, MR urography provides prognostic information by assessing the quality of the renal parenchyma and identifying uropathy preoperatively. MR urography combines both anatomic and functional information in a single test and is capable of providing a comprehensive evaluation of obstructive uropathy that could ultimately help select those patients most likely to benefit from surgical intervention. (orig.)

  1. MR urography evaluation of obstructive uropathy

    Energy Technology Data Exchange (ETDEWEB)

    Grattan-Smith, J.D.; Jones, Richard A. [Emory University School of Medicine, Department of Radiology, Children' s Healthcare of Atlanta, Atlanta, GA (United States); Little, Stephen B. [Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States)

    2008-01-15

    Hydronephrosis and the evaluation of obstructive uropathy are the most common indications for MR urography in our practice. Typically our patients fall into one of two groups: infants with antenatal hydronephrosis and older children who present with abdominal pain, hematuria or urinary tract infection. Obstruction in children is usually chronic and partial. Intermittent episodes of increased pressure occur when the urine production exceeds the capacity for drainage. MR urography uses a fluid and diuretic challenge to assess the hydronephrotic kidney. High-quality anatomic images provide a morphologic assessment of the hydronephrotic system. Although it is relatively straightforward to determine if a system is not obstructed on the basis of the renal transit time (RTT), no single parameter is adequate to fully characterize obstruction. By evaluating the changes in signal intensity in the renal parenchyma following contrast administration, the hydronephrotic systems are classified as compensated or decompensated. Delayed RTT and the presence of urine-contrast levels indicate stasis. Calyceal transit time and the difference between the volumetric and the Patlak differential renal function (vDRF-pDRF) are measures of the physiologic changes within the kidney. Additionally, MR urography provides prognostic information by assessing the quality of the renal parenchyma and identifying uropathy preoperatively. MR urography combines both anatomic and functional information in a single test and is capable of providing a comprehensive evaluation of obstructive uropathy that could ultimately help select those patients most likely to benefit from surgical intervention. (orig.)

  2. Moderately T2-weighted images obtained with the single-shot fast spin-echo technique. Differentiating between malignant and benign urinary obstructions

    International Nuclear Information System (INIS)

    Obuchi, Masao; Sugimoto, Hideharu; Kubota, Hayato; Yamamoto, Wakako; Kinebuchi, Yuko; Honda, Minoru; Takahara, Taro

    2002-01-01

    The purpose of this study was to determine whether a distinction could be made between benign and malignant urinary obstructions in moderately T 2 -weighted images obtained with the single-shot fast spin-echo technique. Forty-four lesions in 39 patients with urinary obstruction were evaluated with the single-shot fast spin-echo (SSFSE) technique with an effective TE of 90-100 ms and without fat saturation. Benign and malignant lesions were compared for the presence of ureteral wall thickening and a signal intensity relative to the proximal ureteral wall. Statistically significant differences were found between benign and malignant lesions in both morphologic change (P 2 -weighted SSFSE technique without fat saturation can accurately distinguish between benign and malignant urinary obstructions. (author)

  3. Airway distensibility in Chronic Obstructive Airway Disease

    DEFF Research Database (Denmark)

    Winkler Wille, Mathilde Marie; Pedersen, Jesper Holst; Dirksen, Asger

    2013-01-01

    Rationale – Chronic Obstructive Pulmonary Disease (COPD) is a combination of chronic bronchitis and emphysema, which both may lead to airway obstruction. Under normal circumstances, airway dimensions vary as a function of inspiration level. We aim to study the influence of COPD and emphysema......-20% (mild), 20%-30% (moderate) or >30% (severe). Spirometry was performed annually and participants were divided into severity groups according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Data were analysed in a mixed effects regression model with log(airway lumen diameter...... and emphysema, respectively. Conclusions – Airway distensibility decreases significantly with increasing severity of both GOLD status and emphysema, indicating that in COPD the dynamic change in airway calibre during respiration is compromised. Chronic bronchitis and emphysema appear to be interacting...

  4. Evaluation of computed tomography for obstructive jaundice

    International Nuclear Information System (INIS)

    Matsuoka, Shoji; Toda, Hiroshi; Suzuki, Toshihiko

    1980-01-01

    Findings of computed tomography were reviewed in 54 cases where obstructive jaundice was suggested by liver function studies and computed tomography was done with the diagnosis subsequently confirmed by surgery. Dilatation of the intrahepatic bile duct was found in 49 (91%) of the cases and the site of obstruction was determined in 44 cases (82%). The cause was shown in 28 cases (52%). By disease, the cause was correctly diagnosed with gallbladder in 40%, bile duct cancer in 46%, pancreas cancer in 71%, and choledocal cyst in 100%, but cholelithiasis was diagnosed correctly in only 17%. Further, non-calcium cholelithiasis is very difficult to diagnose by computed tomography. Computed tomography is a useful tool for diagnosis of obstructive jaundice as a noninvasive means of evaluating the patient; however, concomitand use of other diagnostic studies is essential for greater accuracy of diagnosis. (author)

  5. Promoter proximal polyadenylation sites reduce transcription activity

    DEFF Research Database (Denmark)

    Andersen, Pia Kjølhede; Lykke-Andersen, Søren; Jensen, Torben Heick

    2012-01-01

    Gene expression relies on the functional communication between mRNA processing and transcription. We previously described the negative impact of a point-mutated splice donor (SD) site on transcription. Here we demonstrate that this mutation activates an upstream cryptic polyadenylation (CpA) site......, which in turn causes reduced transcription. Functional depletion of U1 snRNP in the context of the wild-type SD triggers the same CpA event accompanied by decreased RNA levels. Thus, in accordance with recent findings, U1 snRNP can shield premature pA sites. The negative impact of unshielded pA sites...... on transcription requires promoter proximity, as demonstrated using artificial constructs and supported by a genome-wide data set. Importantly, transcription down-regulation can be recapitulated in a gene context devoid of splice sites by placing a functional bona fide pA site/transcription terminator within ∼500...

  6. Children’s proximal societal conditions

    DEFF Research Database (Denmark)

    Stanek, Anja Hvidtfeldt

    or the children’s everyday life, but something that is represented through societal structures and actual persons participating (in political ways) within the institutional settings, in ways that has meaning to children’s possibilities to participate, learn and develop. Understanding school or daycare as (part of......) the children’s proximal societal conditions for development and learning, means for instance that considerations about an inclusive agenda in a (Danish) welfare state with well-developed school- and daycare system, are no longer simply thoughts about the school having space for as many pupils as possible...... (schools for all). Such thoughts can or should be supplemented by reflections about which version of ‘the societal’ we wish to present our children with, and which version of ‘the societal’ we wish to set up as the condition for children’s participation and development. These questions require an ethical...

  7. Obstructive jaundice due to hepatobiliary cystadenoma or cystadenocarcinoma

    NARCIS (Netherlands)

    Erdogan, Deha; Busch, Olivier R. C.; Rauws, Erik A. J.; van Delden, Otto M.; Gouma, Dirk J.; van-Gulik, Thomas M.

    2006-01-01

    Hepatobiliary cystadenomas (HBC) and cystadenocarcinomas are rare cystic lesions. Most patients with these lesions are asymptomatic, but presentation with obstructive jaundice may occur. The first patient presented with intermittent colicky pain and recurrent obstructive jaundice. Imaging studies

  8. Office of Coast Survey Wrecks and Obstructions Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Office of Coast Survey's Wrecks and Obstructions database contains information on the identified submerged wrecks and obstructions within the U.S. maritime...

  9. Obstruction, US, and the minimally dilated renal collecting system

    International Nuclear Information System (INIS)

    Kamholtz, R.G.; Cronan, J.J.; Dorfman, G.S.

    1987-01-01

    To assess the significance of grade 1 hydronephrosis in the diagnosis of renal obstruction, the authors retrospectively reviewed the abdominal or renal US scans in 395 patients. In 80 patients there was a question of renal obstruction. Grade I hydronephrosis was observed in 33 of the 80 patients and obstruction was confirmed in more than 45% of these. In 315 patients, US was performed for reasons other than renal obstruction. Grade I hydronephrosis was observed in 39 of 315 patients, and obstruction was confirmed in less than 6%. The authors conclude that grade I hydronephrosis is significant when the question of renal obstruction exists. As an incidental finding, however, it is unlikely to represent obstruction. In the recent radiologic and medical literature grade I hydroephrosis is often dismissed as ''normal'' even in the clinical setting of obstruction. This trend is clearly not justified

  10. Office of Coast Survey's Automated Wreck and Obstruction Information System

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Automated Wreck and Obstruction Information System (AWOIS) is an automated file that contains information on wrecks and obstructions, and other significant...

  11. Fibroepithelial ureteral polyps presenting as ureteropelvic obstruction

    Science.gov (United States)

    Cusano, Antonio; Abarzua-Cabezas, Fernando; Kesler, Stuart

    2014-01-01

    A 57-year-old woman presented with bilateral abdominal pain and flank discomfort. Imaging studies, consisting of CT scan, diethylene triamine pentaacetic acid renal scan with Lasix and a retrograde pyelogram, indicated an obstruction at the uteropelvic junction (UPJ), possibly due to fibroepithelial polyps within the ureter. A robotic pyeloplasty revealed a ureteral diverticulum and a thin, still-attached fibroepithelial polyp of approximately 2 cm in length. The patient tolerated the procedure well and was discharged one day postpyeloplasty with no reported complications. This rare clinical scenario should be considered when formulating a diagnosis for a UPJ obstruction. PMID:24759168

  12. Bronchial or Laryngeal Obstruction Induced by Exercise?

    Directory of Open Access Journals (Sweden)

    Ayoub Bey

    2017-06-01

    Full Text Available A child suspected of exercise-induced laryngeal obstruction and asthma is examined by laryngoscopy and respiratory resistance (Rrs after exercise challenge. Immediately at exercise cessation, the visualized adduction of the larynx in inspiration is reflected in a paroxystic increase in Rrs. While normal breathing has apparently resumed later on during recovery from exercise, the pattern of Rrs in inspiration is observed to reoccur following a deep breath or swallowing. The procedure may thus help diagnosing the site of exercise-induced obstruction when laryngoscopy is not available and identify re-inducers of laryngeal dysfunction.

  13. [Obstructive renal insufficiency caused by amoxicillin crystalluria].

    Science.gov (United States)

    Boursas, M; Benhassine, L; Kempf, J; Petit, B; Vuillemin, F

    1997-01-01

    A 76-year-old woman was admitted to the ICU for a meningitis with rhombencephalitis due to Listeria monocytogenes. The treatment included amoxicillin (250 mg.kg-1.day-1) and gentamicin (3 mg.kg-1.day-1 over 6 days). Neurological outcome was favourable. However at the 14th day, an acute renal failure occurred, following macroscopic haematuria and milkiness urine. CT scan and sonography confirmed the diagnosis of obstructive renal failure with bilateral ureteral obstruction. Crystalluria caused by amoxicillin was suspected. Endoscopic ureteral insertion of double-J catheters permitted the recovery of a normal renal function.

  14. Increased renal adrenomedullin expression in rats with ureteral obstruction

    DEFF Research Database (Denmark)

    Nørregaard, Rikke; Bødker, Tina; Jensen, Boye L

    2009-01-01

    Ureteral obstruction is characterized by decreased renal blood flow that is associated with hypoxia within the kidney. Adrenomedullin (AM) is a peptide hormone with tissue-protective capacity that is stimulated through hypoxia. We tested the hypothesis that ureteral obstruction stimulates...... increases in response to ureteral obstruction in agreement with expected oxygen gradients. Hypoxia acting through HIF-1alpha accumulation may be an important pathway for the renal response to ureteral obstruction....

  15. Intestinal Obstruction Due to Rectal Endometriosis: A Surgical Enigma

    Directory of Open Access Journals (Sweden)

    Razman Jarmin

    2006-07-01

    Full Text Available Obstructed rectal endometriosis is an uncommon presentation. The clinical and intraoperative presentation may present as malignant obstruction. The difficulty in making the diagnosis may delay the definitive management of the patient. We report a unique case of rectal endometriosis mimicking malignant rectal mass causing intestinal obstruction and discuss the management of the case.

  16. Gastroesophageal Reflux Symptoms in Patients with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Zlatica Goseva

    2014-09-01

    CONCLUSION: GER symptoms are more prevalent in patients with severe airways obstruction when compared to less airways obstructed group and controls. We could suggest an association between the degree of airways obstruction in patients with COPD and the increased rate of GER symptoms.

  17. Apple-peel atresia presenting as foetal intestinal obstruction ...

    African Journals Online (AJOL)

    Apple-peel atresia or Type 3 jejuno-ileal atresia (JIA) is an uncommon cause of foetal intestinal obstruction. Bowel obstruction in the foetus is diagnosed on the prenatal ultrasonography only in 50% cases. We report a case in which foetal intestinal obstruction was diagnosed on prenatal ultrasonography. The child showed ...

  18. Proximal duodenoileal anastomosis for treatment of small intestinal obstruction and volvulus in a green iguana (Iguana iguana).

    Science.gov (United States)

    Wills, Sarah; Beaufrère, Hugues; Watrous, Gwyneth; Oblak, Michelle L; Smith, Dale A

    2016-11-01

    CASE DESCRIPTION A 13-year-old female green iguana (Iguana iguana) was examined because of a 6-day history of vomiting, anorexia, and lethargy and a 4-day history of decreased fecal and urate output. CLINICAL FINDINGS Physical examination revealed a distended abdomen, signs of depression, pallor, tachycardia, harsh lung sounds, and vomiting. Abdominal radiographs revealed gas distention of the stomach and small intestine with fluid lines evident on the lateral view. Plasma biochemical analysis indicated hypochloremic metabolic alkalosis, hyperglycemia, and hyperuricemia. TREATMENT AND OUTCOME Exploratory laparotomy confirmed a diagnosis of small intestinal entrapment and 170° volvulus involving approximately 80% (20 to 30 cm) of the small intestine. The portion of the small intestine extending from the middle portion of the duodenum to the caudal extent of the ileum was resected, and end-to-end anastomosis of the remaining small intestine was performed. The iguana recovered without apparent complications and was reportedly doing well 1 year after surgery. CLINICAL RELEVANCE Findings suggested that iguanas, as hindgut fermenters, may tolerate > 70% resection of the small intestine with a good outcome and no clinical evidence of residual gastrointestinal dysfunction.

  19. Distributed Autonomous Control of Multiple Spacecraft During Close Proximity Operations

    National Research Council Canada - National Science Library

    McCamish, Shawn B

    2007-01-01

    This research contributes to multiple spacecraft control by developing an autonomous distributed control algorithm for close proximity operations of multiple spacecraft systems, including rendezvous...

  20. PROXIMAL DISABILITY AND SPINAL DEFORMITY INDEX IN PATIENTS WITH PROXIMAL FEMUR FRACTURES

    Directory of Open Access Journals (Sweden)

    Sylvio Mistro Neto

    2015-12-01

    Full Text Available Objective : To evaluate the quality of life related to the spine in patients with proximal femoral fractures. Methods : Study conducted in a tertiary public hospital in patients with proximal femoral fractures caused by low-energy trauma, through the Oswestry Disability Index questionnaire to asses complaints related to the spine at the time of life prior to the femoral fracture. The thoracic and lumbar spine of patients were also evaluated applying the radiographic index described by Gennant (Spinal Deformity Index, which assesses the number and severity of fractures. Results : Seventeen subjects completed the study. All had some degree of vertebral fracture. Patients were classified in the categories of severe and very severe disability in the questionnaire about quality of life. It was found that the higher SDI, the better the quality of life. Conclusion : There is a strong association of disability related to the spine in patients with proximal femoral fracture, and this complaint must be systematically evaluated in patients with appendicular fracture.

  1. Initial outcome and efficacy of S3 proximal humerus locking plate in the treatment of proximal humerus fractures

    International Nuclear Information System (INIS)

    Zhang Zhiming; Zhu Xuesong; Bao Zhaohua; Yang Huilin

    2012-01-01

    Objective: to explore the initial outcome and efficacy of S 3 proximal humerus locking plate in the treatment of proximal humerus fractures. Methods: Twenty-two patients with proximal humerus fracture were treated with the S 3 proximal humerus locking plate. Most of the fractures were complex, two-part (n=4), three-part (n=11) and four-part (n=7) fractures according to the Neer classification of the proximal humerus fractures. Results: All patients were followed up for 3∼15 months. There were no complications related to the implant including loosening or breakage of the plate. Good and excellent results were documented in 17 patients fair results in 4 patients according the Neer scores of shoulder. Conclusion: New design concepts of S 3 proximal humerus plate provide the subchondral support and the internal fixation support. With the addition of the proper exercise of the shoulder joint, the outcomes would be satisfied. (authors)

  2. Intestinal obstruction secondary to infantile polyarteritis nodosa ...

    African Journals Online (AJOL)

    Polyarteritis Nodosa (PAN) is a rare systemic necrotising vasculitis of medium and small-sized arteries. Patients typically present with systemic symptoms. Obstructive intestinal symptoms are described but usually resolve with treatment of the underlying vascular disease. We report a case of a one year old boy with multiple ...

  3. Snoring and obstructive sleep apnoea syndrome among ...

    African Journals Online (AJOL)

    Background: Obstructive sleep apnoea (OSA) syndrome is a common disorder in the community. Association between hypertension and sleep apnoea and /or snoring has been described. The Berlin questionnaire is a validated instrument that is used to identify individuals who are at risk for OSA. The study aim to describe ...

  4. Obstructive jaundice promotes bacterial translocation in humans.

    Science.gov (United States)

    Kuzu, M A; Kale, I T; Cöl, C; Tekeli, A; Tanik, A; Köksoy, C

    1999-01-01

    Significant bacterial translocation was demonstrated following experimental biliary obstruction, however very little is known about the importance and the prevalence of gut-origin sepsis in obstructive jaundice patients. Therefore, the aim of this study was to investigate the concept of gut-origin sepsis in obstructive jaundiced patients and its clinical importance. Twenty-one patients requiring laparotomy for obstructive jaundice (group I) and thirty patients operated on electively mainly for chronic cholecystitis (group II) were studied. Peritoneal swab, mesenteric lymph node, portal venous blood, liver wedge biopsy and bile were sampled for culture immediately after opening the peritoneum. Additionally, peripheral blood samples were taken pre- and post-operatively from all patients. Post-operatively, patients were monitored for infectious complications. The mean serum bilirubin concentration, gamma glutamyl transferase and alkaline phosphatase levels in jaundiced patients before therapeutic intervention were significantly higher than in control patients. Five patients demonstrated bacterial translocation in group I (24%), whereas only one did so in group II (3.5%, p jaundice significantly promotes bacterial translocation in humans, however, its clinical importance has yet to be defined.

  5. Extrahepatic biliary obstruction; postoperative morbidity and mortality

    International Nuclear Information System (INIS)

    Hussain, Z.; Khan, K.I.; Vaseem, M.; Rana, S.H.

    2010-01-01

    The objectives of this study are to evaluate the surgical management, both definitive and palliative, in selected patients with biliary obstruction and to find out the postoperative morbidity and mortality in these patients. Duration of the study is two years conducted from June 2002 to May 2004. The study was carried out at. the surgical. unit 4 of the Combined Military Hospital and surgical department of the Military Hospital. Thirty eight cases of biliary obstruction were included. A convenient sampling technique was followed. Data analyzed by using SPSS version 10.0 for windows on computer. Descriptive statistics like frequency, percentage, average etc were computed for data presentation. Any inferential test-was not found to be applicable for this descriptive type case series. We selected 38 patients with features of extrahepatic biliary obstruction. Out of these (n 38) 15 patients (39.5%) suffered from benign diseases while those having malignant diseases were 23 (60.5%). 19 (50%) patients died within two years of follow up while 19 (50%) were the survivors. Mortality was maximum for the malignant cases. In benign cases only one patient died. Maximum deaths 6 (31.6%) occurred in the period of up to one month of operation. 20 patients had one or another complication of operation and hence the morbidity came out to be 52%. According to our results the mortality and morbidity related to extrahepatic biliary obstruction in our patients was higher compared to other studies which can only be reduced by early detection and treatment. (author)

  6. Exceptional cause of bowel obstruction: rectal endometriosis ...

    African Journals Online (AJOL)

    Endometriosis with intestinal serosal involvement is not uncommon in women of childbearing age. However, endometriosis presenting as colon obstruction is rare and occurs in less than 1% of cases. The Lack of pathognomonic signs makes the diagnosis difficult, mostly because the main differential diagnosis is with ...

  7. Mandibular advancement appliance for obstructive sleep apnoea

    DEFF Research Database (Denmark)

    Petri, Niels; Svanholt, Palle; Solow, Beni

    2008-01-01

    The aim of this trial was to evaluate the efficacy of a mandibular advancement appliance (MAA) for obstructive sleep apnoea (OSA). Ninety-three patients with OSA and a mean apnoea-hypopnoea index (AHI) of 34.7 were centrally randomised into three, parallel groups: (a) MAA; (b) mandibular non...

  8. Management of obstructive sleep apnea in Europe

    DEFF Research Database (Denmark)

    Fietze, I; Penzel, T; Alonderis, A

    2011-01-01

    In Europe, the services provided for the investigation and management of obstructive sleep apnoea (OSA) varies from country to country. The aim of this questionnaire-based study was to investigate the current status of diagnostic pathways and therapeutic approaches applied in the treatment of OSA...

  9. Natural histories of chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Rennard, Stephen I; Vestbo, Jørgen

    2008-01-01

    Concepts relating to the natural history of chronic obstructive pulmonary disease (COPD) arise most importantly from the classic study of Fletcher and colleagues (The Natural History of Chronic Bronchitis and Emphysema, Oxford University Press, New York, 1976). This study, which evaluated working...

  10. Chronic obstructive pulmonary disease and cancer risk

    DEFF Research Database (Denmark)

    Kornum, Jette Brommann; Sværke, Claus; Thomsen, Reimar Wernich

    2012-01-01

    Little is known about the risk of cancer in patients with chronic obstructive pulmonary disease (COPD), including which cancer sites are most affected. We examined the short- and long-term risk of lung and extrapulmonary cancer in a nationwide cohort of COPD patients....

  11. Chronic obstructive pulmonary disease in Denmark

    DEFF Research Database (Denmark)

    Lykkegaard, Jesper; Kristensen, Gustav N

    2016-01-01

    BACKGROUND: During the 80s and 90s the mortality and number of hospitalisations due to chronic obstructive pulmonary disease (COPD) in the country of Denmark almost doubled. Since then there has been a plateau. OBJECTIVE: To analyse age, period, and cohort effects on rates of deaths and first...

  12. Dynamic bowel obstruction: aetiology, clinical presentation ...

    African Journals Online (AJOL)

    This study was conducted to describe in our region, the aetiology, clinical presentation, management and outcome of dynamic bowel obstruction. Data were analyzed using SPSS software system. A total of 342 patients were studied. Males outnumbered females by a ratio of 2.1: 1. The median age of patients at presentation ...

  13. Obstructive jaundice and advanced gastric carcinoma

    International Nuclear Information System (INIS)

    Saida, Yukihisa; Tsunoda, Hiroko; Kurosaki, Yoshihisa

    1989-01-01

    One hundred twenty-nine patients with far advanced or recurrent gastric carcinoma underwent computed tomography (CT) of the abdomen. There were three histologic types: differentiated (n=41), undifferentiated (n=68), and unclassified (n=20). Eighteen patients who had developed obstructive jaundice were retrospectively studied to elucidate the nature of obstruction with histologic correlation. In differentiated carcinomas tumor tended to grow in an expansive fashion. A fairly large, well-defined lymph adenopathy was observed on CT. The extrahepatic bile duct surrounded by lymph nodes appeared as ''doughnot sign'' in six of eight patients. Undifferentiated gastric carcinoma had tendency to extend infiltratively. Bile duct obstruction was only a part of diffuse spreading. In spite of the presence of obstructive jaundice, no discrete mass was demonstrated around the extrahepatic bile duct on CT. In none of nine patients was present ''doughnot sign''. The significance of lymph node dissection along the extrahepatic bile duct in patients with differentiated gastric carcinoma was emphasized. The region of hepatoduodenal and pancreatico-duodenal lymph nodes should be carefully evaluated in interpretation of abdominal CT. (author)

  14. Postoperative Adhesive Intestinal Obstruction from Gossypiboma ...

    African Journals Online (AJOL)

    We report a case of 41.year.old female admitted with features of intestinal obstruction and had a previous history of hysterectomy performed 2 months back at another hospital. Pathologists must be aware of this entity and its proper reporting as the cases are liable to go to court. Surgeons must recognize the risk factors that ...

  15. Emergency management of acute colonic cancer obstruction.

    Science.gov (United States)

    Gainant, A

    2012-02-01

    Emergency management of obstructing colonic cancer depends on both tumor location and stage, general condition of the patient and surgeon's experience. Right sided or transverse colon obstructing cancers are usually treated by right hemicolectomy-extended if necessary to the transverse colon-with primary anastomosis. For left-sided obstructing cancer, in patients with low surgical risk, primary resection and anastomosis associated with on-table irrigation or manual decompression can be performed. It prevents the confection of a loop colostomy but presents the risk of anastomotic leakage. Subtotal or total colectomy allows the surgeon to encompass distended and fecal-loaded colon, and to perform one-stage resection and anastomosis. Its disadvantage is an increased daily frequency of stools. It must be performed only in cases of diastatic colon perforation or synchronous right colonic cancer. In patients with high surgical risk, Hartmann procedure must be preferred. It allows the treatment of both obstruction and cancer, and prevents anastomotic leakage but needs a second operation to reverse the colostomy. Colonic stenting is clinically successful in up to 90% in specialized groups. It is used as palliation in patients with disseminated disease or bridge to surgery in the others. If stent insertion is not possible, loop colostomy is still indicated in patients at high surgical risk. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  16. Dynamic bowel obstruction: aetiology, clinical presentation ...

    African Journals Online (AJOL)

    2005). This makes it essential that studies are made periodically in every region to define the local causes with the idea to do work on their prevention (Adhikari et al., 2010). This study was conducted to describe in our region, the aetiology, clinical presentation, management and outcome of dynamic bowel obstruction.

  17. Genetics Home Reference: intestinal pseudo-obstruction

    Science.gov (United States)

    ... A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons. Intestinal pseudo-obstruction caused by ACTG2 gene mutations is inherited in an autosomal dominant pattern , which means one copy of the altered ...

  18. Unusual cause of neonatal intestinal obstruction | Zikavska ...

    African Journals Online (AJOL)

    There are many causes of intestinal obstruction in the neonatal age. The most common types are mechanical and result from congenital malformations of the gastrointestinal tract. However, functional disorders also occur. In some cases, diagnosis can be made prenatally but in others manifestation occurs after birth. The aim ...

  19. Cognitive complaints in obstructive sleep apnea

    NARCIS (Netherlands)

    Vaessen, T.J.A.; Overeem, S.; Sitskoorn, M.M.

    2015-01-01

    Obstructive sleep apnea (OSA) is associated with impairments in cognitive functioning. Although cognitive complaints are related to quality of life, work productivity and health care expenditures, most research and all reviews have focused exclusively on objective cognitive functioning so far. In

  20. 36 CFR 1004.13 - Obstructing traffic.

    Science.gov (United States)

    2010-07-01

    ... road, except as authorized by the Executive Director, or in the event of an accident or other condition... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Obstructing traffic. 1004.13 Section 1004.13 Parks, Forests, and Public Property PRESIDIO TRUST VEHICLES AND TRAFFIC SAFETY § 1004.13...

  1. 36 CFR 4.13 - Obstructing traffic.

    Science.gov (United States)

    2010-07-01

    ... VEHICLES AND TRAFFIC SAFETY § 4.13 Obstructing traffic. The following are prohibited: (a) Stopping or parking a vehicle upon a park road, except as authorized by the superintendent, or in the event of an accident or other condition beyond the control of the operator. (b) Operating a vehicle so slowly as to...

  2. Pulmonary biomarkers in chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Barnes, Peter J.; Chowdhury, Badrul; Kharitonov, Sergei A.; Magnussen, Helgo; Page, Clive P.; Postma, Dirkje; Saetta, Marina

    2006-01-01

    There has been increasing interest in using pulmonary biomarkers to understand and monitor the inflammation in the respiratory tract of patients with chronic obstructive pulmonary disease (COPD). In this Pulmonary Perspective we discuss the merits of the various approaches by reviewing the current

  3. Obstruction of cerebral arteries in childhood stroke

    International Nuclear Information System (INIS)

    Velkey, I.; Lombay, B.; Panczel, G.

    1992-01-01

    Middle cerebral artery obstruction in children is reviewed by our two cases. Ischemic childhood stroke was caused by moyamoya disease in the first, and by fibromuscular dysplasia in the second patient. In both cases transcranial Doppler sonography and cranial CT were performed, but the final diagnosis was made by angiography. The importance of angiography in childhood stroke is emphasized. (orig.)

  4. Proximity Operations and Docking Sensor Development

    Science.gov (United States)

    Howard, Richard T.; Bryan, Thomas C.; Brewster, Linda L.; Lee, James E.

    2009-01-01

    The Next Generation Advanced Video Guidance Sensor (NGAVGS) has been under development for the last three years as a long-range proximity operations and docking sensor for use in an Automated Rendezvous and Docking (AR&D) system. The first autonomous rendezvous and docking in the history of the U.S. Space Program was successfully accomplished by Orbital Express, using the Advanced Video Guidance Sensor (AVGS) as the primary docking sensor. That flight proved that the United States now has a mature and flight proven sensor technology for supporting Crew Exploration Vehicles (CEV) and Commercial Orbital Transport Systems (COTS) Automated Rendezvous and Docking (AR&D). NASA video sensors have worked well in the past: the AVGS used on the Demonstration of Autonomous Rendezvous Technology (DART) mission operated successfully in spot mode out to 2 km, and the first generation rendezvous and docking sensor, the Video Guidance Sensor (VGS), was developed and successfully flown on Space Shuttle flights in 1997 and 1998. 12 Parts obsolescence issues prevent the construction of more AVGS units, and the next generation sensor was updated to allow it to support the CEV and COTS programs. The flight proven AR&D sensor has been redesigned to update parts and add additional capabilities for CEV and COTS with the development of the Next Generation AVGS at the Marshall Space Flight Center. The obsolete imager and processor are being replaced with new radiation tolerant parts. In addition, new capabilities include greater sensor range, auto ranging capability, and real-time video output. This paper presents some sensor hardware trades, use of highly integrated laser components, and addresses the needs of future vehicles that may rendezvous and dock with the International Space Station (ISS) and other Constellation vehicles. It also discusses approaches for upgrading AVGS to address parts obsolescence, and concepts for minimizing the sensor footprint, weight, and power requirements

  5. Reduced upper obstructions in N3 and increased lower obstructions in REM sleep stage detected with manometry.

    Science.gov (United States)

    Wirth, Markus; Schramm, Juliane; Bautz, Maximilian; Hofauer, Benedikt; Edenharter, Günther; Ott, Armin; Heiser, Clemens

    2018-01-01

    In obstructive sleep apnea (OSA), airway obstruction occurs at different anatomic levels. The frequency and location of obstructions play a crucial role in the planning of surgical treatment. The aim of this study was to evaluate the pharyngeal obstruction levels in different sleep stages with manometry in OSA patients. In addition, the manometry results were compared with drug-induced sleep endoscopy (DISE). Forty-one patients with OSA received manometry measurements during one night of sleep. All patients were simultaneously evaluated with polysomnography. The frequency of obstructions in different sleep stages was assessed. Twenty patients were additionally studied with DISE. Obstruction levels detected with manometry were compared with DISE. The frequency of upper and to a lesser extent lower obstructions decreased in sleep stage N3. In rapid eye movement (REM) sleep, lower obstructions increased. The overall proportion of upper and lower obstructions detected with manometry corresponded with DISE in 13 of 20 cases. A significant change in the obstruction levels was detected with manometry in N3 and REM sleep. The reduction of both upper and to a lesser extent lower obstructions in N3 suggests more stable airways in slow-wave sleep. Relevant lower obstructions were not detected in DISE compared to manometry in 5 out of 20 examinations. This could be a potential reason for treatment failure of site-specific surgical OSA treatment when only performing DISE preoperatively. Therefore, manometry could be a useful complementary tool in the preoperative evaluation for OSA.

  6. Obstructive sleep apnea syndrome and growth failure.

    Science.gov (United States)

    Esteller, E; Villatoro, J C; Agüero, A; Lopez, R; Matiñó, E; Argemi, J; Girabent-Farrés, M

    2018-05-01

    Obstructive sleep apnea syndrome is a common problem among children and is recognized as a cause of significant medical morbidity. Since the 1980s, it has been suggested that obstructive sleep apnea syndrome is a risk factor for growth failure in children. In many cases, it has been shown that growth failure is reversible once the obstructive sleep apnea syndrome is resolved. The objectives of this study were to analyze and compare growth failure prevalence in a Mediterranean population of children with obstructive sleep apnea syndrome and healthy children matched in age and sex, and to assess the effectiveness of tonsillectomy and adenoidectomy in resolving growth retardation. We compared 172 children with obstructive sleep apnea syndrome (apnea-hypopnea index ≥ 3) who had undergone tonsillectomy and adenoidectomy with 172 healthy controls in terms of key anthropometric parameters. Most of the criteria used for growth failure were higher to a statistically significant degree in the study group vs the control group: height-for-age ≤ 3rd percentile (7.56% vs 2.91%; p = 0.044), weight-for-age ≤ 5th percentile (9.30% vs 2.33%; p = 0.005), weight-for-age ≤ 3rd percentile (8.14% vs 2.33%; p = 0.013) and height and/or weight for-age ≤ 5th percentile (13.95% vs 5.81%; p = 0.009). The height-for-age ≤ 5th percentile was almost at the limit of statistical significance (8.72% for the study group vs 4.65% for the control group; p = 0.097). At one-year post-surgery follow-up, 10 of 15 children with height-for-age ≤ 5th percentile had achieved catch-up growth (66.6%), and 14 of 24 children with height- and/or weight-for-age ≤ 5th percentile had normalized growth (58.33%). For children with failure to thrive or who have growth failure, physicians should consider the possibility of obstructive sleep apnea. A significant number of children with obstructive sleep apnea concurrent with growth failure could benefit from

  7. Association of chronic obstructive pulmonary disease and obstructive sleep apnea consequences

    Directory of Open Access Journals (Sweden)

    Carlos Zamarrón

    2009-01-01

    Full Text Available Carlos Zamarrón1, Vanesa García Paz1, Emilio Morete1, Felix del Campo Matías21Servicio de Neumología, Hospital Clínico Universitario de Santiago, Santiago, Spain; 2Servicio de Neumologia, Hospital Universitario Rio Ortega de Vallaclolid, Vallaclolid, SpainAbstract: Obstructive sleep apnea syndrome (OSAS and chronic obstructive pulmonary disease (COPD are two diseases that often coexist within an individual. This coexistence is known as overlap syndrome and is the result of chance rather than a pathophysiological link. Although there are claims of a very high incidence of OSAS in COPD patients, recent studies report that it is similar to the general population. Overlap patients present sleep-disordered breathing associated to upper and lower airway obstruction and a reduction in respiratory drive. These patients present unique characteristics, which set them apart from either COPD or OSAS patients. COPD and OSAS are independent risk factors for cardiovascular events and their coexistence in overlap syndrome probably increases this risk. The mechanisms underlying cardiovascular risk are still unclear, but may involve systemic inflammation, endothelial dysfunction, and tonic elevation of sympathetic neural activity. The treatment of choice for overlap syndrome in stable patients is CPAP with supplemental oxygen for correction of upper airway obstructive episodes and hypoxemia during sleep.Keywords: chronic obstructive pulmonary disease, obstructive sleep apnea syndrome, overlap syndrome, sleep, cardiovascular disease

  8. Murine model of long term obstructive jaundice

    Science.gov (United States)

    Aoki, Hiroaki; Aoki, Masayo; Yang, Jing; Katsuta, Eriko; Mukhopadhyay, Partha; Ramanathan, Rajesh; Woelfel, Ingrid A.; Wang, Xuan; Spiegel, Sarah; Zhou, Huiping; Takabe, Kazuaki

    2016-01-01

    Background With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of 3 murine models of obstructive jaundice. Methods C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models. Survival was assessed by Kaplan-Meier method. Fibrotic change was determined by Masson-Trichrome staining and Collagen expression. Results 70% (7/10) of tCL mice died by Day 7, whereas majority 67% (10/15) of pCL mice survived with loss of jaundice. 19% (3/16) of LMHL mice died; however, jaundice continued beyond Day 14, with survival of more than a month. Compensatory enlargement of the right lobe was observed in both pCL and LMHL models. The pCL model demonstrated acute inflammation due to obstructive jaundice 3 days after ligation but jaundice rapidly decreased by Day 7. The LHML group developed portal hypertension as well as severe fibrosis by Day 14 in addition to prolonged jaundice. Conclusion The standard tCL model is too unstable with high mortality for long-term studies. pCL may be an appropriate model for acute inflammation with obstructive jaundice but long term survivors are no longer jaundiced. The LHML model was identified to be the most feasible model to study the effect of long-term obstructive jaundice. PMID:27916350

  9. Obstructive sleep apnea, inflammation, and cardiopulmonary disease.

    Science.gov (United States)

    Arter, Jim L; Chi, David S; M, Girish; Fitzgerald, S Matthew; Guha, Bhuvana; Krishnaswamy, Guha

    2004-09-01

    Obstructive sleep apnea (OSA) occurs commonly in the U.S. population and is seen in both obese as well as non-obese individuals. OSA is a disease characterized by periodic upper airway collapse during sleep, which then results in either apnea, hypopnea, or both. The disorder leads to a variety of medical complications. Neuropsychiatric complications include daytime somnolence, cognitive dysfunction, and depression. Increased incidence of motor vehicle accidents has been documented in these patients and probably reflects disordered reflex mechanisms or excessive somnolence. More importantly, vascular disorders such as hypertension, stroke, congestive cardiac failure, arrhythmias, and atherosclerosis occur frequently in these patients. The lungs may be affected by pulmonary hypertension and worsening of asthma. Recent data from several laboratories demonstrate that obstructive sleep apnea is characterized by an inflammatory response. Cytokines are elaborated during the hypoxemic episodes leading to inflammatory responses as marked clinically by elevated C-reactive protein (CRP). As elevated CRP levels are considered markers of the acute phase response and characterize progression of vascular injury in coronary artery disease, it is likely that obstructive sleep apnea could lead to worsening of vasculopathy. Moreover, as inflammatory mechanisms regulate bronchial asthma, it is also likely that cytokines and superoxide radicals generated during hypoxemic episodes could exacerbate reactive airway disease. Patients with Cough, Obstructive sleep apnea, Rhinosinusitis, and Esophageal reflux clustered together can be categorized by the acronym, "CORE", syndrome. The purpose of this manuscript is to review the inflammatory responses that occur in patients with obstructive sleep apnea and relate them to the occurrence of cardiopulmonary disease.

  10. Double obstruction of ureter: A diagnostic challenge.

    Science.gov (United States)

    Halder, Pankaj; Shukla, Ram Mohan; Mandal, Kartik Chandra; Mukhopadhyay, Biswanath; Barman, Shibsankar

    2014-07-01

    Isolated obstruction of the ureteropelvic junction and the vesico-ureteric junction are the two most common causes of hydronephrosis in a pediatric population.[1] They do not pose diagnostic difficulties when are present alone but when together can be difficult to diagnose. Here, we discuss the problems we faced when we encountered these two anomalies in the same ureter and the way in which we managed them. To assess the difficulties in diagnosis of pediatric patients who present with both ureteropelvic junction obstruction (UPJO) and vesico-ureteric junction obstruction (VUJO) in the ipsilateral ureter and their management protocol. This is a retrospective study. The study period is from 1 January 2004 to 31 December 2011. Out of 254 children who were diagnosed to have hydronephrosis due to UPJO in our institute, 5 patients (in the age range of 5 to 10 years) had both UPJO and VUJO in the ipsilateral ureter. The problems we faced in diagnosing the two conditions are mentioned with a literature review. Operative intervention was used in four out of five patients; none of the patients had an accurate diagnosis before surgery. All patients were suspected of having double obstruction during pyeloplasty when appropriate size double J stent could not be negotiated through the vesicoureteric junction into the bladder. Postoperative nephrostogram confirmed the diagnosis in all patients. Children with double obstruction of the ipsilateral ureter present as a diagnostic dilemma. Because of the rarity of this condition it can escape the eye of even an astute clinician. Early diagnosis can be made if this condition is kept in mind while treating any hydronephrosis due to UPJO or UVJO.

  11. Double obstruction of ureter: A diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Pankaj Halder

    2014-01-01

    Full Text Available Introduction: Isolated obstruction of the ureteropelvic junction and the vesico-ureteric junction are the two most common causes of hydronephrosis in a pediatric population. [1] They do not pose diagnostic difficulties when are present alone but when together can be difficult to diagnose. Here, we discuss the problems we faced when we encountered these two anomalies in the same ureter and the way in which we managed them. Aim: To assess the difficulties in diagnosis of pediatric patients who present with both ureteropelvic junction obstruction (UPJO and vesico-ureteric junction obstruction (VUJO in the ipsilateral ureter and their management protocol. Materials and Methods: This is a retrospective study. The study period is from 1 January 2004 to 31 December 2011. Out of 254 children who were diagnosed to have hydronephrosis due to UPJO in our institute, 5 patients (in the age range of 5 to 10 years had both UPJO and VUJO in the ipsilateral ureter. The problems we faced in diagnosing the two conditions are mentioned with a literature review. Results: Operative intervention was used in four out of five patients; none of the patients had an accurate diagnosis before surgery. All patients were suspected of having double obstruction during pyeloplasty when appropriate size double J stent could not be negotiated through the vesicoureteric junction into the bladder. Postoperative nephrostogram confirmed the diagnosis in all patients. Conclusion: Children with double obstruction of the ipsilateral ureter present as a diagnostic dilemma. Because of the rarity of this condition it can escape the eye of even an astute clinician. Early diagnosis can be made if this condition is kept in mind while treating any hydronephrosis due to UPJO or UVJO.

  12. Iliocaval Confluence Stenting for Chronic Venous Obstructions

    Energy Technology Data Exchange (ETDEWEB)

    Graaf, Rick de, E-mail: r.de.graaf@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Wolf, Mark de, E-mail: markthewolf@gmail.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Sailer, Anna M., E-mail: anni.sailer@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Laanen, Jorinde van, E-mail: jorinde.van.laanen@mumc.nl; Wittens, Cees, E-mail: c.wittens@me.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Jalaie, Houman, E-mail: hjalaie@ukaachen.de [University Hospital Aachen, Department of Surgery (Germany)

    2015-10-15

    PurposeDifferent techniques have been described for stenting of venous obstructions. We report our experience with two different confluence stenting techniques to treat chronic bi-iliocaval obstructions.Materials and MethodsBetween 11/2009 and 08/2014 we treated 40 patients for chronic total bi-iliocaval obstructions. Pre-operative magnetic resonance venography showed bilateral extensive post-thrombotic scarring in common and external iliac veins as well as obstruction of the inferior vena cava (IVC). Stenting of the IVC was performed with large self-expandable stents down to the level of the iliocaval confluence. To bridge the confluence, either self-expandable stents were placed inside the IVC stent (24 patients, SECS group) or high radial force balloon-expandable stents were placed at the same level (16 patients, BECS group). In both cases, bilateral iliac extensions were performed using nitinol stents.ResultsRecanalization was achieved for all patients. In 15 (38 %) patients, a hybrid procedure with endophlebectomy and arteriovenous fistula creation needed to be performed because of significant involvement of inflow vessels below the inguinal ligament. Mean follow-up was 443 ± 438 days (range 7–1683 days). For all patients, primary, assisted-primary, and secondary patency rate at 36 months were 70, 73, and 78 %, respectively. Twelve-month patency rates in the SECS group were 85, 85, and 95 % for primary, assisted-primary, and secondary patency. In the BECS group, primary patency was 100 % during a mean follow-up period of 134 ± 118 (range 29–337) days.ConclusionStenting of chronic bi-iliocaval obstruction shows relatively high patency rates at medium follow-up. Short-term patency seems to favor confluence stenting with balloon-expandable stents.

  13. Proximity coupling in superconductor-graphene heterostructures

    Science.gov (United States)

    Lee, Gil-Ho; Lee, Hu-Jong

    2018-05-01

    This review discusses the electronic properties and the prospective research directions of superconductor-graphene heterostructures. The basic electronic properties of graphene are introduced to highlight the unique possibility of combining two seemingly unrelated physics, superconductivity and relativity. We then focus on graphene-based Josephson junctions, one of the most versatile superconducting quantum devices. The various theoretical methods that have been developed to describe graphene Josephson junctions are examined, together with their advantages and limitations, followed by a discussion on the advances in device fabrication and the relevant length scales. The phase-sensitive properties and phase-particle dynamics of graphene Josephson junctions are examined to provide an understanding of the underlying mechanisms of Josephson coupling via graphene. Thereafter, microscopic transport of correlated quasiparticles produced by Andreev reflections at superconducting interfaces and their phase-coherent behaviors are discussed. Quantum phase transitions studied with graphene as an electrostatically tunable 2D platform are reviewed. The interplay between proximity-induced superconductivity and the quantum-Hall phase is discussed as a possible route to study topological superconductivity and non-Abelian physics. Finally, a brief summary on the prospective future research directions is given.

  14. [Ophthalmologists in the proximity of Adolf Hitler].

    Science.gov (United States)

    Rohrbach, J M

    2012-10-01

    Adolf Hitler met or at least knew about 5 ophthalmologists. The chair of ophthalmology in Berlin, Walther Löhlein, personally examined Hitler's eyes at least two times. The chair of ophthalmology in Breslau, Walter Dieter, developed "air raid protection spectacles" with the aid of high representatives of the NS-system and probably Adolf Hitler himself. Heinrich Wilhelm Kranz became rector of the universities of Giessen and Frankfurt/Main. He was known as a very strict advocate of the NS-race hygiene. Werner Zabel made plans for Hitler's diet and tried to interfere with Hitler's medical treatment. Finally, Hellmuth Unger was an influential representative of the medical press and a famous writer. Three of his novels with medical topics were made into a film which Hitler probably saw. Hitler had, so to say, a small "ophthalmological proximity" which, however, did not play a significant role for himself or the NS-state. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Semiconductor detectors with proximity signal readout

    International Nuclear Information System (INIS)

    Asztalos, Stephen J.

    2012-01-01

    Semiconductor-based radiation detectors are routinely used for the detection, imaging, and spectroscopy of x-rays, gamma rays, and charged particles for applications in the areas of nuclear and medical physics, astrophysics, environmental remediation, nuclear nonproliferation, and homeland security. Detectors used for imaging and particle tracking are more complex in that they typically must also measure the location of the radiation interaction in addition to the deposited energy. In such detectors, the position measurement is often achieved by dividing or segmenting the electrodes into many strips or pixels and then reading out the signals from all of the electrode segments. Fine electrode segmentation is problematic for many of the standard semiconductor detector technologies. Clearly there is a need for a semiconductor-based radiation detector technology that can achieve fine position resolution while maintaining the excellent energy resolution intrinsic to semiconductor detectors, can be fabricated through simple processes, does not require complex electrical interconnections to the detector, and can reduce the number of required channels of readout electronics. Proximity electrode signal readout (PESR), in which the electrodes are not in physical contact with the detector surface, satisfies this need

  16. Imaging of rectus femoris proximal tendinopathies

    International Nuclear Information System (INIS)

    Pesquer, Lionel; Poussange, Nicolas; Meyer, Philippe; Dallaudiere, Benjamin; Feldis, Matthieu; Sonnery-Cottet, Bertrand; Graveleau, Nicolas

    2016-01-01

    The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review. (orig.)

  17. Proximal spinal muscular atrophy: current orthopedic perspective

    Directory of Open Access Journals (Sweden)

    Haaker G

    2013-11-01

    Full Text Available Gerrit Haaker, Albert Fujak Department of Orthopaedic Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany Abstract: Spinal muscular atrophy (SMA is a hereditary neuromuscular disease of lower motor neurons that is caused by a defective "survival motor neuron" (SMN protein that is mainly associated with proximal progressive muscle weakness and atrophy. Although SMA involves a wide range of disease severity and a high mortality and morbidity rate, recent advances in multidisciplinary supportive care have enhanced quality of life and life expectancy. Active research for possible treatment options has become possible since the disease-causing gene defect was identified in 1995. Nevertheless, a causal therapy is not available at present, and therapeutic management of SMA remains challenging; the prolonged survival is increasing, especially orthopedic, respiratory and nutritive problems. This review focuses on orthopedic management of the disease, with discussion of key aspects that include scoliosis, muscular contractures, hip joint disorders, fractures, technical devices, and a comparative approach of conservative and surgical treatment. Also emphasized are associated complications including respiratory involvement, perioperative care and anesthesia, nutrition problems, and rehabilitation. The SMA disease course can be greatly improved with adequate therapy with established orthopedic procedures in a multidisciplinary therapeutic approach. Keywords: spinal muscular atrophy, scoliosis, contractures, fractures, lung function, treatment, rehabilitation, surgery, ventilation, nutrition, perioperative management

  18. Imaging of rectus femoris proximal tendinopathies

    Energy Technology Data Exchange (ETDEWEB)

    Pesquer, Lionel; Poussange, Nicolas; Meyer, Philippe; Dallaudiere, Benjamin; Feldis, Matthieu [Clinique du Sport de Bordeaux, Centre d' Imagerie Osteo-articulaire, Merignac (France); Sonnery-Cottet, Bertrand [Groupe Ramsay Generale de Sante - Hopital Prive Jean Mermoz, Centre Orthopedique Santy, Lyon (France); Graveleau, Nicolas [Clinique du Sport de Bordeaux, Centre de Chirurgie Orthopedique et Sportive, Merignac (France)

    2016-07-15

    The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review. (orig.)

  19. Progress in surgical palliative treatment for malignant obstructive jaundice

    Directory of Open Access Journals (Sweden)

    LIANG Zhang

    2013-06-01

    Full Text Available Obstructive jaundice, also known as surgical jaundice, is divided into benign and malignant types. Most of the patients newly diagnosed with malignant obstructive jaundice have lost the opportunity of receiving radical surgery due to its insidious onset, so surgical palliative treatment is very important for patients with advanced malignant obstructive jaundice. This paper elaborates on various current modalities of surgical palliative treatment for malignant obstructive jaundice. Appropriate modality of surgical palliative treatment is of great significance for patients with advanced malignant obstructive jaundice.

  20. Proximate analysis of female population of wild feather back fish ...

    African Journals Online (AJOL)

    User

    2011-05-09

    May 9, 2011 ... Key words: Body composition, Notopterus notopterus, condition factor, wild fish. INTRODUCTION. Proximate body composition is the analysis of water, fat, protein and ash contents of the fish (Love, 1980). Proximate composition is a good indicator of physiology which is needed for routine analysis of ...

  1. Proximate analysis of Lentinus squarrosulus (Mont.) Singer and ...

    African Journals Online (AJOL)

    Each of the mushroom species was separated into its stipe and pileus and used for proximate analysis. There was a highly significant difference (p<0.01) in the proximate composition of the two species. P. atroumbonata had significantly higher crude protein, crude fibre and moisture content than L. squarrosulus while the ...

  2. Proximal Focal Femoral Deficiency in Ibadan a Developing ...

    African Journals Online (AJOL)

    The cultural aversion to amputation in our environment makes it difficult to employ that option of treatment. Proximal focal femoral deficiency in Ibadan a developing country's perspective and a review of the literature. Keywords: Proximal focal femoral deficiency , congenital malformations , limb malformations , lower limb ...

  3. Proximity approach to problems in topology and analysis

    CERN Document Server

    Naimpally, Somashekhar

    2009-01-01

    Dieses Buch konzentriert das aktuelle Gesamtwissen zum Proximity-Konzept und stellt es dem Leser in gut strukturierter Form dar. Hauptaugenmerk liegt auf den vielfältigen Möglichkeiten, die sich aus dem Proximity-Konzept der räumlichen Nähe und seiner Verallgemeinerung im Nearness-Konzept ergeben.

  4. Systemic calciphylaxis presenting as a painful, proximal myopathy.

    OpenAIRE

    Edelstein, C. L.; Wickham, M. K.; Kirby, P. A.

    1992-01-01

    A renal transplant patient who presented with a painful, proximal myopathy due to systemic calciphylaxis is described. The myopathy preceded the characteristic skin and soft tissue necrosis. Systemic calciphylaxis should be considered in a dialysis or a renal transplant patient presenting with a painful proximal myopathy even in the absence of necrotic skin lesions.

  5. Genetics Home Reference: proximal 18q deletion syndrome

    Science.gov (United States)

    ... characteristic features. Most cases of proximal 18q deletion syndrome are the result of a new (de novo) deletion and are not inherited from a ... J, Fox PT, Stratton RF, Perry B, Hale DE. Recurrent interstitial deletions of proximal 18q: a new syndrome involving expressive speech delay. Am J Med Genet ...

  6. Proximal soil sensors and data fusion for precision agriculture

    NARCIS (Netherlands)

    Mahmood, H.S.

    2013-01-01

    different remote and proximal soil sensors are available today that can scan entire fields and give detailed information on various physical, chemical, mechanical and biological soil properties. The first objective of this thesis was to evaluate different proximal soil sensors available today and to

  7. Two Stages repair of proximal hypospadias: Review of 33 cases

    African Journals Online (AJOL)

    HussamHassan

    Background/Purpose: Proximal hypospadias with chordee is the most challenging variant of hypospadias to reconstruct. During the last 10 years, the approach to sever hypospadias has been controversial. Materials & Methods: During the period from June 2002 to December 2009, I performed 33 cases with proximal.

  8. Percutaneous Transhepatic Duodenal Drainage as an Alternative Approach in Afferent Loop Obstruction with Secondary Obstructive Jaundice in Recurrent Gastric Cancer

    International Nuclear Information System (INIS)

    Yao, N.-S.; Wu, C.-W.; Tiu, Chui-Mei; Liu, Jacqueline M.; Whang-Peng, Jacqueline; Chen, L.-T.

    1998-01-01

    Two cases are reported of chronic, partial afferent loop obstruction with resultant obstructive jaundice in recurrent gastric cancer. The diagnosis was made by characteristic clinical presentations, abdominal computed tomography, and cholescintigraphy. Percutaneous transhepatic duodenal drainage (PTDD) provided effective palliation for both afferent loop obstruction and biliary stasis. We conclude that cholescintigraphy is of value in making the diagnosis of partial afferent loop obstruction and in differentiating the cause of obstructive jaundice in such patients, and PTDD provides palliation for those patients in whom surgical intervention is not feasible

  9. Proximity correction of high-dosed frame with PROXECCO

    Science.gov (United States)

    Eisenmann, Hans; Waas, Thomas; Hartmann, Hans

    1994-05-01

    Usefulness of electron beam lithography is strongly related to the efficiency and quality of methods used for proximity correction. This paper addresses the above issue by proposing an extension to the new proximity correction program PROXECCO. The combination of a framing step with PROXECCO produces a pattern with a very high edge accuracy and still allows usage of the fast correction procedure. Making a frame with a higher dose imitates a fine resolution correction where the coarse part is disregarded. So after handling the high resolution effect by means of framing, an additional coarse correction is still needed. Higher doses have a higher contribution to the proximity effect. This additional proximity effect is taken into account with the help of the multi-dose input of PROXECCO. The dose of the frame is variable, depending on the deposited energy coming from backscattering of the proximity. Simulation proves the very high edge accuracy of the applied method.

  10. Interactive orbital proximity operations planning system

    Science.gov (United States)

    Grunwald, Arthur J.; Ellis, Stephen R.

    1990-01-01

    An interactive graphical planning system for on-site planning of proximity operations in the congested multispacecraft environment about the space station is presented. The system shows the astronaut a bird's eye perspective of the space station, the orbital plane, and the co-orbiting spacecraft. The system operates in two operational modes: (1) a viewpoint mode, in which the astronaut is able to move the viewpoint around in the orbital plane to range in on areas of interest; and (2) a trajectory design mode, in which the trajectory is planned. Trajectory design involves the composition of a set of waypoints which result in a fuel-optimal trajectory which satisfies all operational constraints, such as departure and arrival constraints, plume impingement constraints, and structural constraints. The main purpose of the system is to present the trajectory and the constraints in an easily interpretable graphical format. Through a graphical interactive process, the trajectory waypoints are edited until all operational constraints are satisfied. A series of experiments was conducted to evaluate the system. Eight airline pilots with no prior background in orbital mechanics participated in the experiments. Subject training included a stand-alone training session of about 6 hours duration, in which the subjects became familiar with orbital mechanics concepts and performed a series of exercises to familiarize themselves with the control and display features of the system. They then carried out a series of production runs in which 90 different trajectory design situations were randomly addressed. The purpose of these experiments was to investigate how the planning time, planning efforts, and fuel expenditures were affected by the planning difficulty. Some results of these experiments are presented.

  11. Selective proximal vagotomy with and without pyloroplasty

    International Nuclear Information System (INIS)

    Brodersen, E.

    1984-01-01

    It was the aim of the study described here to gain information relevant to the well-being of patients subjected to selective proximal vagotomy with or without pyroloplasty as soon as possible after surgery. For this purpose, particular care was taken to ascertain the frequency of recidivation and the post-operative occurrence of disturbances in the emptying of gastric contents. In 35 patients solely undergoing SPV and a further 12 individuals, where both SPV and pyroloplasty had been performed, gastric emptying was monitored using a gamma camera and computer system. All patients were given a standardised test meal consisting of 500 ml ready-made milk labeled with 2 mCi 99mTc-HSA. After the patients had been assigned to different study groups according to the gastric emptying rates established in the individual cases, it became evident that there was a correlation between gastric emptying time (T/2) and the occurrence of post-operative discomfort. In the majority of patients the gastric emptying rate was found to be increased as compared to individuals with a healthy stomach. Among a total of 8 patients showing delayed gastric emptying only one, who solely underwent SPV, reported post-operative discomfort. Markedly increased rates of gastric emptying (T/2 ≤ 5 min) were predominantly determined in patients subjected to SPV in conjunction with pyroloplasty. A dumping syndrome and diarrhea were diagnosed in every third patient. Clinical follow-up studies and questionnaires distributed among the study patients showed relapses to occur with a frequency of 6.7%, the recidivation of ulcera being confined to the group of patients merely undergoing SPV. (TRV) [de

  12. Nanocrystal Bioassembly: Asymmetry, Proximity, and Enzymatic Manipulation

    Energy Technology Data Exchange (ETDEWEB)

    Claridge, Shelley A. [Univ. of California, Berkeley, CA (United States)

    2008-05-01

    Research at the interface between biomolecules and inorganic nanocrystals has resulted in a great number of new discoveries. In part this arises from the synergistic duality of the system: biomolecules may act as self-assembly agents for organizing inorganic nanocrystals into functional materials; alternatively, nanocrystals may act as microscopic or spectroscopic labels for elucidating the behavior of complex biomolecular systems. However, success in either of these functions relies heavily uponthe ability to control the conjugation and assembly processes.In the work presented here, we first design a branched DNA scaffold which allows hybridization of DNA-nanocrystal monoconjugates to form discrete assemblies. Importantly, the asymmetry of the branched scaffold allows the formation of asymmetric2assemblies of nanocrystals. In the context of a self-assembled device, this can be considered a step toward the ability to engineer functionally distinct inputs and outputs.Next we develop an anion-exchange high performance liquid chromatography purification method which allows large gold nanocrystals attached to single strands of very short DNA to be purified. When two such complementary conjugates are hybridized, the large nanocrystals are brought into close proximity, allowing their plasmon resonances to couple. Such plasmon-coupled constructs are of interest both as optical interconnects for nanoscale devices and as `plasmon ruler? biomolecular probes.We then present an enzymatic ligation strategy for creating multi-nanoparticle building blocks for self-assembly. In constructing a nanoscale device, such a strategy would allow pre-assembly and purification of components; these constructs can also act as multi-label probes of single-stranded DNA conformational dynamics. Finally we demonstrate a simple proof-of-concept of a nanoparticle analog of the polymerase chain reaction.

  13. Proximally exposed A-bomb survivors. 2

    International Nuclear Information System (INIS)

    Kamada, Nanao

    1992-01-01

    Methods for observing chromosomes can be chronologically divided into the era of non-differential staining technique (1962-1975) and the era of differential staining method (since 1976). This paper reviews the literature of chromosomal aberrations in bone marrow cells found in the two eras. Findings during the era of 1962-1975 include the frequency of chromosomal aberrations in bone marrow cells, comparison of chromosomal aberrations in bone marrow cells and T lymphocytes, and annual variation of chromosomal aberrations. The frequency of chromosomal aberrations was high in proximally exposed A-bomb survivors (90.5% and 52.6% in A-bomb survivors exposed within 500 m and at 501-1,000 m, respectively); on the contrary, it was low in those exposed far from 1,000 m (6.2% or less). The frequency of chromosomal aberrations in bone marrow cells was lower than that in T lymphocytes (21.5% vs 27.1% in those exposed within 500 m and 14.1% vs 23% in those exposed at 501-1,000 m). Annual analysis for chromosomal aberrations has shown the somewhat dependence upon medullary hematopoiesis and virus infection. The advent of differential staining technique since 1976 has made it possible to clarify the type of chromosomal aberrations and site of breakage. Of 710 bone marrow cells taken from 13 A-bomb survivors exposed within 1,000 m, 121 cells (from 11 A-bomb survivors) exhibited chromosomal aberrations. In differential staining analysis, all 121 cells but one were found to be of stable type, such as translocation and inversion. Furthermore, the site of breakage was found to be non-randomly distributed. Analysis of chromosomal aberrations in bone marrow cells has advantages of reflecting dynamic condition of these cells and determining gradual progression into leukemia. (N.K.)

  14. Hypospadias and residential proximity to pesticide applications.

    Science.gov (United States)

    Carmichael, Suzan L; Yang, Wei; Roberts, Eric M; Kegley, Susan E; Wolff, Craig; Guo, Liang; Lammer, Edward J; English, Paul; Shaw, Gary M

    2013-11-01

    Experimental evidence suggests pesticides may be associated with hypospadias. Examine the association of hypospadias with residential proximity to commercial agricultural pesticide applications. The study population included male infants born from 1991 to 2004 to mothers residing in 8 California counties. Cases (n = 690) were ascertained by the California Birth Defects Monitoring Program; controls were selected randomly from the birth population (n = 2195). We determined early pregnancy exposure to pesticide applications within a 500-m radius of mother's residential address, using detailed data on applications and land use. Associations with exposures to physicochemical groups of pesticides and specific chemicals were assessed using logistic regression adjusted for maternal race or ethnicity and age and infant birth year. Forty-one percent of cases and controls were classified as exposed to 57 chemical groups and 292 chemicals. Despite >500 statistical comparisons, there were few elevated odds ratios with confidence intervals that excluded 1 for chemical groups or specific chemicals. Those that did were for monochlorophenoxy acid or ester herbicides; the insecticides aldicarb, dimethoate, phorate, and petroleum oils; and adjuvant polyoxyethylene sorbitol among all cases; 2,6-dinitroaniline herbicides, the herbicide oxyfluorfen, and the fungicide copper sulfate among mild cases; and chloroacetanilide herbicides, polyalkyloxy compounds used as adjuvants, the insecticides aldicarb and acephate, and the adjuvant nonyl-phenoxy-poly(ethylene oxy)ethanol among moderate and severe cases. Odds ratios ranged from 1.9 to 2.9. Most pesticides were not associated with elevated hypospadias risk. For the few that were associated, results should be interpreted with caution until replicated in other study populations.

  15. Ligament augmentation for prevention of proximal junctional kyphosis and proximal junctional failure in adult spinal deformity.

    Science.gov (United States)

    Safaee, Michael M; Deviren, Vedat; Dalle Ore, Cecilia; Scheer, Justin K; Lau, Darryl; Osorio, Joseph A; Nicholls, Fred; Ames, Christopher P

    2018-05-01

    OBJECTIVE Proximal junctional kyphosis (PJK) is a well-recognized, yet incompletely defined, complication of adult spinal deformity surgery. There is no standardized definition for PJK, but most studies describe PJK as an increase in the proximal junctional angle (PJA) of greater than 10°-20°. Ligament augmentation is a novel strategy for PJK reduction that provides strength to the upper instrumented vertebra (UIV) and adjacent segments while also reducing junctional stress at those levels. METHODS In this study, ligament augmentation was used in a consecutive series of adult spinal deformity patients at a single institution. Patient demographics, including age; sex; indication for surgery; revision surgery; surgical approach; and use of 3-column osteotomies, vertebroplasty, or hook fixation at the UIV, were collected. The PJA was measured preoperatively and at last follow-up using 36-inch radiographs. Data on change in PJA and need for revision surgery were collected. Univariate and multivariate analyses were performed to identify factors associated with change in PJA and proximal junctional failure (PJF), defined as PJK requiring surgical correction. RESULTS A total of 200 consecutive patients were included: 100 patients before implementation of ligament augmentation and 100 patients after implementation of this technique. The mean age of the ligament augmentation cohort was 66 years, and 67% of patients were women. Over half of these cases (51%) were revision surgeries, with 38% involving a combined anterior or lateral and posterior approach. The mean change in PJA was 6° in the ligament augmentation group compared with 14° in the control group (p historical cohort, ligament augmentation is associated with a significant decrease in PJK and PJF. These data support the implementation of ligament augmentation in surgery for adult spinal deformity, particularly in patients with a high risk of developing PJK and PJF.

  16. Molecular Pathology of Murine Ureteritis Causing Obstructive Uropathy with Hydronephrosis

    Science.gov (United States)

    Ichii, Osamu; Otsuka, Saori; Namiki, Yuka; Hashimoto, Yoshiharu; Kon, Yasuhiro

    2011-01-01

    Primary causes of urinary tract obstruction that induces urine retention and results in hydronephrosis include uroliths, inflammation, and tumors. In this study, we analyzed the molecular pathology of ureteritis causing hydronephrosis in laboratory rodents. F2 progenies of C57BL/6 and DBA/2 mice were studied histopathologically and by comprehensive gene expression analysis of their ureters. Incidence of hydronephrosis was approximately 5% in F2 progenies. Histopathologically, this hydronephrosis was caused by stenosis of the proximal ureter, which showed fibrosis and papillary malformations of the proliferative epithelium with infiltrations of B-cell-dominated lymphocytes. Additionally, CD16-positive large granular leukocytes and eosinophils infiltrated from the ureteral mucosa to the muscular layer. Eosinophilic crystals were characteristically observed in the lumen of the ureter and the cytoplasm of large granular leukocytes, eosinophils, and transitional epithelial cells. Comprehensive gene profiling revealed remarkably elevated expression of genes associated with hyperimmune responses through activation of B cells in diseased ureters. Furthermore, diseased ureters showed dramatically higher gene expression of chitinase 3-like 3, known as Ym1, which is associated with formation both of adenomas in the transitional epithelium and of eosinophilic crystals in inflammatory conditions. The Ym1 protein was mainly localized to the cytoplasm of the transitional epithelium, infiltrated cells, and eosinophilic crystals in diseased ureters. We determined that the primary cause of hydronephrosis in F2 mice was ureteritis mediated by the local hyperimmune response with malformation of the transitional epithelium. Our data provide a novel molecular pathogenesis for elucidating causes of aseptic inflammation in human upper urinary tracts. PMID:22114694

  17. MRI anatomy of anteriorly displaced anus: what obstructs defecation?

    International Nuclear Information System (INIS)

    AbouZeid, Amr Abdelhamid; Mohammad, Shaimaa Abdelsattar; Khairy, Khaled Talaat

    2014-01-01

    Anteriorly displaced anus is an anomaly that is debated with regard to its nomenclature, diagnosis and management. To describe MRI anatomy of the anal canal in children with anteriorly displaced anus and its impact on the process of defecation. We prospectively examined ten children (7 girls, 3 boys; age range 7 months to 8 years, mean 3 years) with anteriorly displaced anus between August 2009 and April 2012. Noncontrast MRI examinations were performed on a 1.5-T magnet. T1- and T2-weighted turbo spin-echo images were acquired in axial, sagittal and coronal planes of the pelvis. The anorectal angle and the relative hiatal distance were measured in mid-sagittal images, and compared with those of a control group using the Mann-Whitney test. In children with anteriorly displaced anus, no anatomical abnormality was depicted at the level of the proximal anal canal. However, the distal anal canal was displaced anteriorly, running out its external muscle cuff, which remained un-displaced at the usual site of the anus. This changes the orientation of the central axis of the anal canal by passing across instead of along the fibers of the longitudinal muscle coat. Children with anteriorly displaced anus had a more obtuse anorectal angle (mean 112.1 ), which was significantly greater than that of the control group (mean 86.2 ). MRI is a valuable tool in studying the anatomy of the anal canal in children with anteriorly displaced anus. The abnormal orientation of the longitudinal muscle across the anal canal can explain the obstructed defecation in these children. Based on this study, it might be of interest to use MRI in studying equivocal cases and children with unexplained constipation. (orig.)

  18. MRI anatomy of anteriorly displaced anus: what obstructs defecation?

    Energy Technology Data Exchange (ETDEWEB)

    AbouZeid, Amr Abdelhamid [Ain-Shams University, Department of Pediatric Surgery, Cairo (Egypt); Mohammad, Shaimaa Abdelsattar; Khairy, Khaled Talaat [Ain-Shams University, Department of Radiodiagnosis, Cairo (Egypt)

    2014-07-15

    Anteriorly displaced anus is an anomaly that is debated with regard to its nomenclature, diagnosis and management. To describe MRI anatomy of the anal canal in children with anteriorly displaced anus and its impact on the process of defecation. We prospectively examined ten children (7 girls, 3 boys; age range 7 months to 8 years, mean 3 years) with anteriorly displaced anus between August 2009 and April 2012. Noncontrast MRI examinations were performed on a 1.5-T magnet. T1- and T2-weighted turbo spin-echo images were acquired in axial, sagittal and coronal planes of the pelvis. The anorectal angle and the relative hiatal distance were measured in mid-sagittal images, and compared with those of a control group using the Mann-Whitney test. In children with anteriorly displaced anus, no anatomical abnormality was depicted at the level of the proximal anal canal. However, the distal anal canal was displaced anteriorly, running out its external muscle cuff, which remained un-displaced at the usual site of the anus. This changes the orientation of the central axis of the anal canal by passing across instead of along the fibers of the longitudinal muscle coat. Children with anteriorly displaced anus had a more obtuse anorectal angle (mean 112.1 ), which was significantly greater than that of the control group (mean 86.2 ). MRI is a valuable tool in studying the anatomy of the anal canal in children with anteriorly displaced anus. The abnormal orientation of the longitudinal muscle across the anal canal can explain the obstructed defecation in these children. Based on this study, it might be of interest to use MRI in studying equivocal cases and children with unexplained constipation. (orig.)

  19. Palliation of gastrointestinal obstruction with expandable metallic stents: 3 case reports

    International Nuclear Information System (INIS)

    Langhorne, N.B.; Asch, M.R.; Jaffer, N.

    1997-01-01

    Interventional radiologists are often asked to assist in the care of patients with advanced malignant disease. Frequent clinical problems include dysphagia due to proximal involvement of the gastrointestinal (GI) tract or bowel obstruction as a result of more distal compression. Although a number of endoscopic and surgical options are available, the placement of expandable metallic stents in the bowel lumen has recently been reported as efficacious, safe and cost-effective. We present our experience with placement of stents in the small and large bowel, describing the clinical scenarios, the reasons for stent placement, and the technique and results in each of 3 cases and comparing our experience with those of others, as reported in the literature. (author)

  20. Pancreas-sparing duodenectomy for an obstructive adenocarcinoma of the duodenum.

    Science.gov (United States)

    Lam, D; Croome, Kp; Hernandez-Alejandro, R

    2012-08-01

    A duodenal adenocarcinoma arising from the junction of the second and third portion of the duodenum, which was resected by pancreas-sparing duodenectomy, is reported. The completely obstructing tumour was circumferential and measured 6.5cm x 3.5cm x 1.0 cm. There was no evidence of pancreas invasion, nor any lymph node metastasis. Pancreas-sparing duodenectomy was performed, with dissection of the pancreaticoduodenal lymph nodes. The proximal duodenum was transected just distal to the ampula of Vater and jejunum was transected just distal to the ligament of Treitz. A hand-sewn side-to-side anastomosis for the duodenojejunostomy was performed. There were no postoperative complications. Pathology reported a duodenal adenocarcinoma resected with negative margins. Pancreaticoduodenectomy is the treatment of choice for a duodenal adenocarcinoma, however, pancreas-sparing duodenectomy may be a safe alternative for duodenal tumours not involving the 2(nd) portion, especially in elderly patients with multiple medical comorbidities. © JSCR.

  1. Annular pancreas causing extrahepatic biliary obstruction

    International Nuclear Information System (INIS)

    Ogulin, M.; Jamar, B.

    2004-01-01

    Background. Annular pancreas is an uncommon congenital abnormality, consisting of a flat band of pancreatic tissue, which encircles duodenum or extrahepatic biliary duct. We present a case of obstructive jaundice, caused by annular pancreas. Case report. A 46 years old female was admitted because of a sudden onset of abdominal pain, vomiting and jaundice. For the last six years she occasionally noticed her skin was light yellow, in the last year she felt distension in the upper abdomen, especially after fatty meals. Conclusions. Two US examinations, the first one six months before the admission, showed dilated hepatic ducts. The reason of dilatation was unclear, even after the endoscopic US examination. At operation an almost complete obstruction of the common hepatic duct was found, caused by a narrow band of pancreatic tissue. (author)

  2. Mitral Prosthetic Valve Obstruction and Its Complications

    Directory of Open Access Journals (Sweden)

    Rajesh Rajan

    2015-12-01

    Full Text Available Prosthetic Valve Obstruction (PVO is a serious complication which is associated with increased morbidity and mortality. This could result from thrombus formation, development of pannus, or a combination of both. Patients with this complication often present with symptoms and signs of heart failure, systemic embolism, acute cardiovascular collapse, and sudden death. Transesophageal echocardiography and cine fluoroscopy play a vital role in diagnosis of this potentially lethal condition. Herein, we reported a 56-year-old male patient who presented with severe heart failure and was found to have obstructed ATS27 bileaflet mitral prosthetic valve. Thrombolysis and redo surgery are two important options for treating this condition although guidelines for choosing between the two are not very definite.

  3. Brain Structural Changes in Obstructive Sleep Apnea

    Science.gov (United States)

    Macey, Paul M.; Kumar, Rajesh; Woo, Mary A.; Valladares, Edwin M.; Yan-Go, Frisca L.; Harper, Ronald M.

    2008-01-01

    Study Objectives: Determine whether obstructive sleep apnea (OSA) subjects show indications of axonal injury. Design: We assessed fiber integrity in OSA and control subjects with diffusion tensor imaging (DTI). We acquired four whole-brain DTI series from each subject. The four series were realigned, and the diffusion tensor calculated at each voxel. Fractional anisotropy (FA), a measure of fiber integrity, was derived from the diffusion tensor, resulting in a whole brain FA “map.” The FA maps were spatially normalized, smoothed, and compared using voxel-based statistics to determine differences between OSA and control groups, with age as a covariate (P Valladares EM; Yan-Go FL; Harper RM. Brain structural changes in obstructive sleep apnea. SLEEP 2008;31(7):967-977. PMID:18652092

  4. Indicators for surgery in adhesive bowel obstruction.

    Science.gov (United States)

    Rajanikmanth, P V; Kate, V; Ananthakrishnan, N

    2001-01-01

    There is lack of data on risk factors, which, if present, would indicate the need for surgery in patients with adhesive bowel obstruction. A Cohort of 100 consecutive patients with adhesive obstruction was studied prospectively to compare clinical and investigative parameters between the operative and conservative group. It was found that female gender, previous obstetric or gynaecological procedures, pulse and BP on admission, nature of nasogastric aspirate, single distended loop on abdominal x-ray as also predominant ileal distension were independent factors indicating a high probability of surgical intervention. Patients with 2 or more risk factors had 12 times higher probability of surgery and in those with 3 or more the relative risk was 30 times. Patients with such risk factors should be monitored closely after admission and should be taken for surgery after an initial short trial of conservative measures.

  5. Health promotion in obstructive sleep apnea syndrome.

    Science.gov (United States)

    Corrêa, Camila de Castro; Blasca, Wanderléia Quinhoneiro; Berretin-Felix, Giédre

    2015-04-01

    Introduction Obstructive sleep apnea syndrome (OSAS), which is commonly underdiagnosed, has a high occurrence in the world population. Health education concerning sleep disorders and OSAS should be implemented. Objectives The objective was to identify studies related to preventive actions on sleep disorders, with emphasis on OSAS. Data Synthesis A literature review was conducted using Lilacs, Medline, PubMed, and Scopus by combining the following keywords: "Health Promotion," "Sleep Disorders," "Primary Prevention," "Health Education," and "Obstructive Sleep Apnea Syndromes." Initially, 1,055 papers, from 1968 to 2013, were located, with the majority from the Scopus database. The inclusion criteria were applied, and four articles published between 2006 and 2012 were included in the present study. Conclusions The studies on preventive actions in sleep disorders, with emphasis on OSAS, involved the general population and professionals and students in the health field and led to increased knowledge on sleep disorders and more appropriate practices.

  6. Is ursodeoxycholic acid detrimental in obstructive cholestasis? A propos of a case of malignant biliary obstruction.

    Science.gov (United States)

    Bessone, Fernando; Roma, Marcelo Gabriel

    2016-01-01

    Ursodeoxycholic acid (UDCA) is the first choice medication for most cholestatic hepatopathies, due to its capability to counteract inflammation and bile-acid-induced liver damage, two common features in cholestasis. However, UDCA is usually contraindicated in obstructive cholestasis, due to the alleged risk of biliary integrity disruption due to its choleretic effect. We report on an 83-year-old man with an unsuspected malignant biliary obstruction who received moderate doses of UDCA (8-12 mg/kg/day) for 5 weeks, because the preliminary evidence suggested he had chemotherapy-induced cholestasis. Liver integrity was extensively protected by UDCA, as indicated by a marked decrease in serum liver enzymes, despite a steady increase in the levels of bilirubin and serum bile acids due to the obstructive process. In conclusion, this report shows, for the first time in humans, that moderate UDCA doses can reduce liver injury associated with complete biliary obstruction. This may contribute to a better understanding of the risk-benefit ratio of the use of UDCA in obstructive cholangiopathies.

  7. Laparoscopic management of a small bowel obstruction secondary to Elipse intragastric balloon migration: A case report

    Directory of Open Access Journals (Sweden)

    Saud Al-Subaie

    Full Text Available Introduction: The Elipse™ intragastric balloon (IGB for weight loss is a swallowable capsule that is filled with 550 mL of fluid and resides in the stomach for four months before being excreted from the gastrointestinal tract. Although initial data showed that use of this device is safe and free from serious complications, we report for the first time the successful management of an Elipse™ IGB-related adverse event. Presentation of case: A 41-year-old woman presented to our emergency department following two days of abdominal pain, vomiting, and constipation. Her medical history included four caesarean sections and insertion of the Elipse™ IGB 16 weeks prior to presentation. The patient was vitally stable at presentation and abdominal examination revealed a mildly distended abdomen. Plain X-ray revealed a small bowel obstruction (SBO, and a double contrast computed tomography scan showed a dilated small bowel with mild free fluid proximal to a transition zone at the distal jejunum. Laparoscopic enterotomy was performed just proximal to the obstruction site, and the balloon was visualized and extracted after it had been incised and emptied. The enterotomy incision was closed with an intracorporeal continuous absorbable suture. The patient’s recovery was uneventful and she was discharged on postoperative day 4. Discussion: We discuss the possible etiologies of SBO following Elipse™ IGB insertion, and present a brief literature review regarding surgical and nonsurgical management options for such cases. Conclusion: Although initial data showed the Elipse™ IGB to be safe, complications can occur and be managed successfully. Keywords: Elipse, Intragastric balloon, Capsule, Obesity, Case report

  8. Treatment of Unstable Trochanteric Femur Fractures: Proximal Femur Nail Versus Proximal Femur Locking Compression Plate.

    Science.gov (United States)

    Singh, Ashutosh Kumar; Narsaria, Nidi; G R, Arun; Srivastava, Vivek

    Unstable trochanteric femur fractures are common fractures that are difficult to manage. We conducted a prospective study to compare functional outcomes and complications of 2 different implant designs, proximal femur nail (PFN) and proximal femur locking compression plate (PFLCP), used in internal fixation of unstable trochanteric femur fractures. On hospital admission, 48 patients with unstable trochanteric fractures were randomly assigned (using a sealed envelope method) to treatment with either PFN (24 patients) or PFLCP (24 patients). Perioperative data and complications were recorded. All cases were followed up for 2 years. The groups did not differ significantly (P > .05) in operative time, reduction quality, complications, hospital length of stay, union rate, or time to union. Compared with the PFLCP group, the PFN group had shorter incisions and less blood loss. Regarding functional outcomes, there was no significant difference in mean Harris Hip Score (P = .48) or Palmer and Parker mobility score (P = .58). Both PFN and PFLCP are effective in internal fixation of unstable trochanteric femur fractures.

  9. Pressure drop in flashing flow through obstructions

    International Nuclear Information System (INIS)

    Weinle, M.E.; Johnston, B.S.

    1985-01-01

    An experiment was designed to investigate the pressure drop for flashing flow across obstructions of different geometries at various flow rates. Tests were run using two different orifices to determine if the two-phase pressure drop could be characterized by the single phase loss coefficient and the general behavior of the two-phase multiplier. For the geometries studied, it was possible to correlate the multiplier in a geometry-independent fashion

  10. Acute respiratory tract obstruction in children

    OpenAIRE

    Ahmad, Zahoor

    1999-01-01

    35 cases of acute respiratory tract obstruction in paediatric age group who needed surgical intervention in the form of bronchoscopy, tracheostomy or both are reviewed here. All these patients were seen and managed at National Iranian Oil company Hospital Ummeidiya Khouzestan Iran, from April 1985 to April 1988. The results obtained with a review of use of instruments is described. Most of the patients presented with foreign body inhalations, some due to allergic oedema and one case had laryn...

  11. Dual pathology proximal median nerve compression of the forearm.

    LENUS (Irish Health Repository)

    Murphy, Siun M

    2013-12-01

    We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression.

  12. Dual pathology proximal median nerve compression of the forearm.

    Science.gov (United States)

    Murphy, Siun M; Browne, Katherine; Tuite, David J; O'Shaughnessy, Michael

    2013-12-01

    We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Digital contrast subtraction radiography for proximal caries diagnosis

    International Nuclear Information System (INIS)

    Kang, Byung Cheol; Yoon, Suk Ja

    2002-01-01

    To determine whether subtraction images utilizing contrast media can improve the diagnostic performance of proximal caries diagnosis compared to conventional periapical radiographic images. Thirty-six teeth with 57 proximal surfaces were radiographied using a size no.2 RVG-ui sensor (Trophy Radiology, Marne-la-Vallee, France). The teeth immersed in water-soluble contrast media and subtraction images were taken. Each tooth was then sectioned for histologic examination. The digital radiographic images and subtraction images were examined and interpreted by three dentists for proximal caries. The results of the proximal caries diagnosis were then verified with the results of the histologic examination. The proximal caries sensitivity using digital subtraction radiography was significantly higher than simply examining a single digital radiograph. The sensitivity of the proximal dentinal carious lesion when analyzed with the subtraction radiograph and the radiograph together was higher than with the subtraction radiograph or the radiograph alone. The use of subtraction radiography with contrast media may be useful for detecting proximal dentinal carious lesions.

  14. Effect of age on proximal esophageal response to swallowing

    Directory of Open Access Journals (Sweden)

    Roberto Oliveira Dantas

    2010-12-01

    Full Text Available CONTEXT: It has been demonstrated that the ageing process affects esophageal motility. OBJECTIVES: To evaluate the effect of the age on the proximal esophageal response to wet swallows. METHOD: We measured the proximal esophageal response to swallows of a 5 mL bolus of water in 69 healthy volunteers, 20 of them aged 18-30 years (group I, 27 aged 31-50 years (group II, and 22 aged 51-74 years (group III. We used the manometric method with continuous perfusion. The proximal esophageal contractions were recorded 5 cm from a pharyngeal recording site located 1 cm above the upper esophageal sphincter. The time between the onset of the pharyngeal and of the proximal esophageal recording (pharyngeal-esophageal time and the amplitude, duration and area under the curve of the proximal esophageal contraction were measured. RESULTS: The pharyngeal-esophageal time was shorter in group I subjects than in group II and III subjects (P<0.05. The duration of proximal esophageal contractions was longer in group I than in groups II and III (P<0.001. There was no differences between groups in the amplitude or area under the curve of contractions. There were no differences between groups II and III for any of the measurements. CONCLUSION: We conclude that the age may affects the response of the proximal esophagus to wet swallows.

  15. Giant proximity effect and critical opalescence in EuS

    Science.gov (United States)

    Charlton, Timothy; Ramos, Silvia; Quintanilla, Jorge; Suter, Andreas; Moodera, Jagadeesh

    2015-03-01

    The proximity effect is a type of wetting phenomenon where an ordered state, usually magnetism or superconductivity, ``leaks'' from one material into an adjacent one over some finite distance. For superconductors, the characteristic range is of the order of the coherence length, usually hundreds of nm. Nevertheless much longer, ``giant'' proximity effects have been observed in cuprate perovskite junctions. Such giant proximity effects can be understood by taking into account the divergence of the pairing susceptibility in the non-superconducting material when it is itself close to a superconducting instability: a superconducting version of critical opalescence. Since critical opalescence occurs in all second order phase transitions, giant proximity effects are expected to be general, therefor there must be a giant ferromagnetic proximity effect. Compared to its superconducting counterpart, the giant ferromagnetic proximity effect has the advantage that the order parameter (magnetization) can be observed directly. We have fabricated Co/EuS thin films and measured the magnetization profiles as a function of temperature using the complementary techniques of low energy muon relaxation and polarized neutron reflectivity. Details of the proximity effect near TCEuS will be presented.

  16. Cancer in proximity to TV towers

    International Nuclear Information System (INIS)

    Hocking, B.; Gordon, I.; Hatfield, G.

    1996-01-01

    Standard (AS2772.1). The few actual measurements available indicate even lower levels. The analysis shows no increased risk of brain cancer. An increased risk of childhood leukaemia is indicated in the municipalities close to the TV towers. The rate ratio for incidence is 1.6 (95% Cl: 1.08-2 41) and for mortality is 2.25 (95% Cl: 1.29-3.92), mainly due to lymphatic leukaemia (1.63 for incidence, 2.84 for mortality). An association between increased childhood leukaemia and proximity to TV towers is indicated. Further studies are needed to test this association and determine any dose-response relationship before firm conclusions may be reached

  17. Reoperations following proximal interphalangeal joint nonconstrained arthroplasties.

    Science.gov (United States)

    Pritsch, Tamir; Rizzo, Marco

    2011-09-01

    To retrospectively analyze the reasons for reoperations following primary nonconstrained proximal interphalangeal (PIP) joint arthroplasty and review clinical outcomes in this group of patients with 1 or more reoperations. Between 2001 and 2009, 294 nonconstrained (203 pyrocarbon and 91 metal-plastic) PIP joint replacements were performed in our institution. A total of 76 fingers (59 patients) required reoperation (50 pyrocarbon and 26 metal-plastic). There were 40 women and 19 men with an average age of 51 years (range, 19-83 y). Primary diagnoses included osteoarthritis in 35, posttraumatic arthritis in 24, and inflammatory arthritis in 17 patients. There were 21 index, 27 middle, 18 ring, and 10 small fingers. The average number of reoperations per PIP joint was 1.6 (range, 1-4). A total of 45 joints had 1 reoperation, 19 had 2, 11 had 3, and 1 had 4. Extensor mechanism dysfunction was the most common reason for reoperation; it involved 51 of 76 fingers and was associated with Chamay or tendon-reflecting surgical approaches. Additional etiologies included component loosening in 17, collateral ligament failure in 10, and volar plate contracture in 8 cases. Inflammatory arthritis was associated with collateral ligament failure. Six fingers were eventually amputated, 9 had PIP joint arthrodeses, and 2 had resection arthroplasties. The arthrodesis and amputation rates correlated with the increased number of reoperations per finger. Clinically, most patients had no or mild pain at the most recent follow-up, and the PIP joint range-of-motion was not significantly different from preoperative values. Pain levels improved with longer follow-up. Reoperations following primary nonconstrained PIP joint arthroplasties are common. Extensor mechanism dysfunction was the most common reason for reoperation. The average reoperation rate was 1.6, and arthrodesis and amputation are associated with an increasing number of operations. Overall clinical outcomes demonstrated no

  18. Subtotal obstruction of the male reproductive tract.

    Science.gov (United States)

    Dohle, G R; van Roijen, J H; Pierik, F H; Vreeburg, J T M; Weber, R F A

    2003-03-01

    Bilateral obstruction of the male reproductive tract is suspected in men with azoospermia, normal testicular volume and normal FSH. A testicular biopsy is required to differentiate between an obstruction and a testicular insufficiency. Unilateral or subtotal bilateral obstructions and epididymal dysfunction may cause severe oligozoospermia in men with a normal spermatogenesis. However, information on spermatogenesis in oligozoospermic men is lacking, since testicular biopsy is not routinely performed. Men with a sperm concentration of scoring method. A testicular biopsy was performed in 78 men with severe oligozoospermia. The medical history showed male accessory gland infection in 12.8%, previous hernia repair in 14.1% and a history of cryptorchidism in 12.8%. A normal or slightly disturbed spermatogenesis (Johnsen score >8) was present in 39/78 (50%) of the men. Hernia repair occurred more often in men with normal spermatogenesis. A varicocele was predominantly seen in men with a disturbed spermatogenesis. FSH was significantly lower ( Preproductive tract is a frequent cause of severe oligozoospermia in men with a normal testicular volume and a normal FSH. In other cases, an epididymal dysfunction might explain the oligozoospermia in men with a normal testicular biopsy score.

  19. Biliary intervention for malignant obstructive jaundice

    International Nuclear Information System (INIS)

    Naoi, Yutaka; Suzuki, Fuminao.

    1990-01-01

    Currently, diagnosis of obstructive jaundice has become easier with CT and USEG, and percutaneous transhepatic cholangialdrainage (PTCD) for obstructive jaundice has also become much safer using USEG control. We have performed PTCD in 277 cases, from December 1976 to May 1989 at Saitama Cancer Center with specially designed thin needle. And using a PTCD fistula, we have been attempted radiotherapy for 7 cases of the bile duct cancer using Remoto After Loading System (RALS), and hyperthermia for 5 cases of bile duct cancer using antenna of microwaves. From autopsy cases, we evaluated treated lesion pathologically, and we obtained the following results. Dosage of biliary RALS need up to 50 Gy at the point of 1 cm from 60 Co sourse. Biliary hyperthermia using microwave seem to be unsuccessful, and further improvement to the antenna of microwave were necessary. Furthermore, we have attempted biliary endoprosthesis 27 cases, for better quality of life to the patients with malignant obstructive jaundice. These methods seem to be effective in prolonging patient's lives, comparing of cases in which PTCD of an external fistula has been performed. (author)

  20. Lifestyle modification for obstructive sleep apnoea.

    Science.gov (United States)

    Shneerson, J; Wright, J

    2001-01-01

    Obstructive sleep apnoeas are due to transient closure of the upper airway during sleep and merge into hypopnoeas in which the airway narrows, but some airflow continues. They are due to the forces compressing the airway overcoming those which stabilise its patency. The commonest association is obesity in which fatty tissue is deposited around the airway. Exercise has been recommended as a method of losing weight, but other techniques which achieve this are also thought to improve symptoms due to sleep apnoeas. Sleep hygiene may alter the sleep structure and the control of the upper airway during sleep and thus promote its patency. The objectives of this review are to determine whether weight loss, sleep hygiene and exercise are effective in the treatment of obstructive sleep apnoeas. The Cochrane Airways Group Trials Register, MEDLINE, EMBASE, CINAHL and reference lists of review articles have been searched. Randomised, single or double blind placebo controlled, either parallel group or crossover design studies of any of these interventions were to have been included. No completed trials have been identified. No randomised trial data were available for analysis. There is a need for randomised controlled trials of these commonly used treatments in obstructive sleep apnoeas. These should identify which sub groups of patients with sleep apnoeas benefit most from each type of treatment and they should have clear and standardised outcome measures.

  1. [Anaesthesia for patients with obstructive airway diseases].

    Science.gov (United States)

    Groeben, H; Keller, V; Silvanus, M T

    2014-01-01

    Obstructive lung diseases like asthma or chronic obstructive lung diseases have a high prevalence and are one of the four most frequent causes of death. Obstructive lung diseases can be significantly influenced by the choice of anesthetic techniques and anesthetic agents. Basically, the severity of the COPD and the degree of bronchial hyperreactivity will determine the perioperative anesthetic risk. This risk has to be assessed by a thorough preoperative evaluation and will give the rationale on which to decide for the adequate anaesthetic technique. In particular, airway instrumentation can cause severe reflex bronchoconstriction. The use of regional anaesthesia alone or in combination with general anaesthesia can help to avoid airway irritation and leads to reduced postoperative complications. Prophylactic antiobstructive treatment, volatile anesthetics, propofol, opioids, and an adequate choice of muscle relaxants minimize the anesthetic risk, when general anesthesia is required In case, despite all precautions intra-operative bronchospasm occurs, deepening of anaesthesia, repeated administration of beta2-adrenergic agents and parasympatholytics, and a single systemic dose of corticosteroids represent the main treatment options.

  2. Obstructive sleep apnea and oral language disorders.

    Science.gov (United States)

    Corrêa, Camila de Castro; Cavalheiro, Maria Gabriela; Maximino, Luciana Paula; Weber, Silke Anna Theresa

    Children and adolescents with obstructive sleep apnea (OSA) may have consequences, such as daytime sleepiness and learning, memory, and attention disorders, that may interfere in oral language. To verify, based on the literature, whether OSA in children was correlated to oral language disorders. A literature review was carried out in the Lilacs, PubMed, Scopus, and Web of Science databases using the descriptors "Child Language" AND "Obstructive Sleep Apnea". Articles that did not discuss the topic and included children with other comorbidities rather than OSA were excluded. In total, no articles were found at Lilacs, 37 at PubMed, 47 at Scopus, and 38 at Web of Science databases. Based on the inclusion and exclusion criteria, six studies were selected, all published from 2004 to 2014. Four articles demonstrated an association between primary snoring/OSA and receptive language and four articles showed an association with expressive language. It is noteworthy that the articles used different tools and considered different levels of language. The late diagnosis and treatment of obstructive sleep apnea is associated with a delay in verbal skill acquisition. The professionals who work with children should be alert, as most of the phonetic sounds are acquired during ages 3-7 years, which is also the peak age for hypertrophy of the tonsils and childhood OSA. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  3. Impulse oscillometry: a measure for airway obstruction.

    Science.gov (United States)

    Vink, Geraldine R; Arets, Hubertus G M; van der Laag, Johan; van der Ent, Cornelis K

    2003-03-01

    The impulse oscillometry system (IOS) was introduced as a new technique to assess airflow obstruction in patients who are not able to perform forced breathing maneuvers, e.g., subjects with cerebral palsy or severe mental retardation, and young children. This study evaluates the sensitivity and specificity of IOS parameters to quantify changes in airflow obstruction in comparison with forced expiratory volume in the first second (FEV(1)) and peak expiratory flow (PEF) measurements. Measurements of FEV(1), PEF, and resistance (R) and reactance (X) at frequencies of 5-35 Hz were performed in 19 children with asthma before, during, and after methacholine challenge and subsequent bronchodilatation. All parameters changed significantly during tests. Values of R5 and R10 correlated with FEV(1) (r = -0.71 and -0.73, respectively, P operating characteristic (ROC) curve to predict a 15% fall in FEV(1) showed better sensitivity and specificity for R5 (area under the curve, 0.85) compared to PEF (0.79) or R10 (0.73). We conclude that IOS parameters can be easily used as an indirect measure of airflow obstruction. This might be helpful in patients who are not able to perform forced breathing maneuvers. In individual subjects, R values measured at 5 Hz showed to be superior to PEF measurements in the detection of a 15% fall in FEV(1). Copyright 2003 Wiley-Liss, Inc.

  4. Obstructive sleep apnea and oral language disorders

    Directory of Open Access Journals (Sweden)

    Camila de Castro Corrêa

    Full Text Available Abstract Introduction Children and adolescents with obstructive sleep apnea (OSA may have consequences, such as daytime sleepiness and learning, memory, and attention disorders, that may interfere in oral language. Objective To verify, based on the literature, whether OSA in children was correlated to oral language disorders. Methods A literature review was carried out in the Lilacs, PubMed, Scopus, and Web of Science databases using the descriptors “Child Language” AND “Obstructive Sleep Apnea”. Articles that did not discuss the topic and included children with other comorbidities rather than OSA were excluded. Results In total, no articles were found at Lilacs, 37 at PubMed, 47 at Scopus, and 38 at Web of Science databases. Based on the inclusion and exclusion criteria, six studies were selected, all published from 2004 to 2014. Four articles demonstrated an association between primary snoring/OSA and receptive language and four articles showed an association with expressive language. It is noteworthy that the articles used different tools and considered different levels of language. Conclusion The late diagnosis and treatment of obstructive sleep apnea is associated with a delay in verbal skill acquisition. The professionals who work with children should be alert, as most of the phonetic sounds are acquired during ages 3–7 years, which is also the peak age for hypertrophy of the tonsils and childhood OSA.

  5. Expiratory timing in obstructive sleep apnoeas.

    Science.gov (United States)

    Cibella, F; Marrone, O; Sanci, S; Bellia, V; Bonsignore, G

    1990-03-01

    Diaphragmatic electromyogram was recorded during NREM sleep in 4 patients affected by obstructive sleep apnoea (OSA) syndrome in order to evaluate the behaviour of expiratory time (TE) in the course of the obstructive apnoea-ventilation cycle. The two components of TE, i.e. time of post-inspiratory inspiratory activity (TPIIA) and time of expiratory phase 2 (TE2) were separately analysed. TPIIA showed a short duration, with only minor variations, within the apnoea, while its duration was more variable and longer in the interapnoeic periods: the longest TPIIA values were associated with the highest inspiratory volumes in the same breaths. This behaviour seemed regulated according to the need of a more or less effective expiratory flow braking, probably as a result of pulmonary stretch receptors discharge. Conversely TE2 showed a continuous gradual modulation, progressively increasing in the pre-apnoeic period, decreasing during the apnoea and increasing in the post-apnoeic period: these TE2 variations seemed related to oscillations in chemical drive. These data show that TE in the obstructive apnoea-ventilation cycle results from a different modulation in its two components and suggest that both mechanical and chemical influences play a role in its overall duration.

  6. Laparoscopic jejunostomy for obstructing upper gastrointestinal malignancies

    Science.gov (United States)

    TSUJIMOTO, HIRONORI; HIRAKI, SHUICHI; TAKAHATA, RISA; NOMURA, SHINSUKE; ITO, NOZOMI; KANEMATSU, KYOHEI; HORIGUCHI, HIROYUKI; AOSASA, SUEFUMI; YAMAMOTO, JUNJI; HASE, KAZUO

    2015-01-01

    The aim of this study was to describe a minimally invasive laparoscopic jejunostomy (Lap-J) technique for obstruction due to upper gastrointestinal malignancies and evaluate the nutritional benefit of Lap-J during neoadjuvant chemotherapy (NAC) in cases with obstructing esophageal cancer. Under general anesthesia, the jejunum 20–30 cm distant from the Treitz ligament was pulled out through an extended umbilical laparoscopic incision and a jejunal tube was inserted to 30 cm. The loop of bowel was gently returned to the abdomen and the feeding tube was drawn through the abdominal wall via the left lower incision. The jejunum was then laparoscopically sutured to the anterior abdominal wall. Lap-J was performed in 26 cases. The median operative time was 82 min. The postoperative course was uneventful. Lap-J prior to NAC was not associated with a decrease in body weight or serum total protein during NAC, compared with patients who received NAC without Lap-J. This minimally invasive jejunostomy technique may be particularly useful in patients in whom endoscopic therapy is not feasible due to obstruction from upper gastrointestinal malignancies. PMID:26807238

  7. Models of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Chung K Fan

    2004-11-01

    Full Text Available Abstract Chronic obstructive pulmonary disease (COPD is a major global health problem and is predicted to become the third most common cause of death by 2020. Apart from the important preventive steps of smoking cessation, there are no other specific treatments for COPD that are as effective in reversing the condition, and therefore there is a need to understand the pathophysiological mechanisms that could lead to new therapeutic strategies. The development of experimental models will help to dissect these mechanisms at the cellular and molecular level. COPD is a disease characterized by progressive airflow obstruction of the peripheral airways, associated with lung inflammation, emphysema and mucus hypersecretion. Different approaches to mimic COPD have been developed but are limited in comparison to models of allergic asthma. COPD models usually do not mimic the major features of human COPD and are commonly based on the induction of COPD-like lesions in the lungs and airways using noxious inhalants such as tobacco smoke, nitrogen dioxide, or sulfur dioxide. Depending on the duration and intensity of exposure, these noxious stimuli induce signs of chronic inflammation and airway remodelling. Emphysema can be achieved by combining such exposure with instillation of tissue-degrading enzymes. Other approaches are based on genetically-targeted mice which develop COPD-like lesions with emphysema, and such mice provide deep insights into pathophysiological mechanisms. Future approaches should aim to mimic irreversible airflow obstruction, associated with cough and sputum production, with the possibility of inducing exacerbations.

  8. Managing obstructive gastric volvulus: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Rodriguez-Garcia HA

    2017-03-01

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

  9. Intestinal obstruction in germ-free dogs.

    Science.gov (United States)

    Heneghan, J B; Robinson, J W; Menge, H; Winistörfer, B

    1981-08-01

    Mechanical occlusions were created in the intestines of four germ-free dogs. At the time of the operation, a control loop of mid-intestine was perfused in vivo and then excised for examinations in vitro, which included the determination of the equilibrium uptake of phenylalanine and of beta-methyl-glucoside, the influx kinetics of phenylalanine and morphometric analysis of the mucosa by microdissection and stereological techniques. Seven days after establishment of the occlusion the abdomen was reopened, and loops above and below the occlusion were perfused, and then excised for the same tests in vitro. Unlike occluded loops of conventional dogs, the intestine of the germ-free animal above the occlusion does not secrete water and electrolytes into the lumen. Its transport properties in vitro do not differ from those of the control loop, and the morphometric analyses reveal only slight changes in villus structure. The loop below the obstruction undergoes marked atrophy, as has been observed in conventional dogs. The results suggest that the copious secretion that occurs above an intestinal obstruction in normal animals is due to the presence of an abundant bacterial population in the obstruction fluid.

  10. Post-extubation airway obstruction. Literature review

    Directory of Open Access Journals (Sweden)

    Álvaro SÁNCHEZ-TABERNERO

    2017-03-01

    Full Text Available Introduction and objective: airway obstruction after extubation in any surgery is a critical event with low incidence, which may require reintubation or tracheostomy, which often otolaryngologist is required. Objective: To determine the prevalence of BVA and its causes through systematic literature review. Method: Literature review in PubMed, Scopus and Cochrane clinical trials, meta-analysis, reviews and case series and control over airway obstruction after extubation that requires reintubation in adults. Results: 6 studies and one clinical practice guidelines were selected. The most common cause of extubation failure is blocking the airway for various reasons (pharyngeal muscle weakness residual effect -often farmacologycal-, laryngospasm, vocal cord paralysis, edema of upper respiratory tract, cervical postoperative hematoma, foreign bodies or secretions. Most cases of re-intubation occurred within 2 hours after extubation. Conclusions: The most common cause of failure after general anesthesia extubation is blocking the airway generally caused by residual neuromuscular blocking effect. Airway obstruction risk increases in airway and head and neck surgery. Difficult intubation guidlines have improved performance and reduced adverse events and similar strategies must be implemented in extubation. The procedure extubation and reintubation should be documented. Working groups airway must be multidisciplinary and include specialists in otolaryngology.

  11. Proximal caries detection: Sirona Sidexis versus Kodak Ektaspeed Plus.

    Science.gov (United States)

    Khan, Emad A; Tyndall, Donald A; Ludlow, John B; Caplan, Daniel

    2005-01-01

    This study compared the accuracy of intraoral film and a charge-coupled device (CCD) receptor for proximal caries detection. Four observers evaluated images of the proximal surfaces of 40 extracted posterior teeth. The presence or absence of caries was scored using a five-point confidence scale. The actual status of each surface was determined from ground section histology. Responses were evaluated by means of receiver operating characteristic (ROC) analysis. Areas under ROC curves (Az) were assessed through a paired t-test. The performance of the CCD-based intraoral sensor was not different statistically from Ektaspeed Plus film in detecting proximal caries.

  12. [Avulsion of the Proximal Hamstring Insertion. Case Reports].

    Science.gov (United States)

    Mizera, R; Harcuba, R; Kratochvíl, J

    2016-01-01

    Proximal hamstring avulsion is an uncommon muscle injury with a lack of consensus on indications and the timing and technique of surgery. Poor clinical symptoms and difficulties in the diagnostic process can lead to a false diagnosis. The authors present three cases of proximal hamstring avulsion, two complete and one partial ruptures of the biceps femoris muscle. MRI and ultrasound scans were used for optimal treatment alignment. Acute surgery reconstruction (hamstring strength. Two interesting systematic reviews published on the treatment of proximal hamstring avulsion are discussed in the final part of the paper. Key words: hamstring, rupture, avulsion.

  13. First pass and gated blood pool in chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Vargas, F.S.; Meneguetti, J.C.; Cukier, A.; Terra Filho, M.; Tiss, E.; Romeiro Neto, M.; Camargo, E.E.

    1986-01-01

    Twenty patients with chronic obstructive lung disease were studied. The spirometry demonstrated predominantly reduction of vital capacity with signs of pulmonary hyperinflation. Obstruction of the proximal and distal airways was also noted. Total pulmonary resistance and static lung compliance were increased in the majority of these patients. Hypoxemia was present in the entire group, with no carbon dioxide retention. Various degrees of pulmonary artery dilatation were detected on the radioisotopic examination, suggesting pulmonary hypertension, confirmed by the increased mean pulmonary transit time. Regional disturbance of myocardial motility of the right ventricle was observed in 90% of the patients, being severe in 15%. The end-systolic volume was increased in 95% of the patients and the end-diastolic in 55%. These changes represent an initial functional disturbance, which does not allow to draw conclusions about reduction of the cardiac output or the ejection fraction. Left ventricular motility was normal in 85% of the patients, reduced in 15% and severely reduced in only one patient. Left ventricular volume was discrete or moderately increased in six patients (20%). The ejection fraction was decreased in one patient (5%). The increased ejection fraction observed in three patients is likely a consequence of a rise in the ejected volume by a normal myocardium. The aorta was elongated in 75% of the patients. Taking into consideration the patients' age, it could be concluded that aortosclerosis with structural changes of its caliber is the cause of the elongation. (author) [pt

  14. Urethral orifice hyaluronic acid injections: a novel animal model of bladder outlet obstruction.

    Science.gov (United States)

    Wang, Yongquan; Xiong, Zhiyong; Gong, Wei; Zhou, Zhansong; Lu, Gensheng

    2015-02-21

    We produced a novel model of bladder outlet obstruction (BOO) by periurethral injection of hyaluronic acid and compared the cystometric features, postoperative complications, and histopathological changes of that model with that of traditional open surgery. Forty female Sprague-Dawley rats were divided into three groups. Fifteen rats were subcutaneously injected with 0.2 ml hyaluronic acid at 5, 7, and 12 o'clock around the urethral orifice. Another fifteen rats underwent traditional open partial proximal urethral obstruction surgery, and 10 normal rats used as controls. After 4 weeks, filling cystometry, postoperative complications, and histopathological features were evaluated in each group. Three rats were also observed for 12 weeks after hyaluronic acid injection to evaluate the long-term effect. Hyaluronic acid periurethral injection caused increased maximum cystometric capacity, maximum bladder pressure, micturition interval, and post-void residual urine volume compared with control (p injection group had significantly shorter operative time, less incidence of incision infection and bladder stone formation compared with the surgery group (p injection and surgery bladders; these were not observed in the control group. Bladder weight and thickness of smooth muscle in the injection and surgery groups were significantly greater than those in the control group (p injection or control groups. Rats periurethrally injected hyaluronic acid were stable the compound was not fully absorbed in any rat after 12 weeks. Hyaluronic acid periurethral injection generates a simple, effective, and persistent animal model of BOO with lower complications, compared with traditional surgery.

  15. Mast Cells and MCPT4 Chymase Promote Renal Impairment after Partial Ureteral Obstruction

    Directory of Open Access Journals (Sweden)

    Maguelonne Pons

    2017-05-01

    Full Text Available Obstructive nephropathy constitutes a major cause of pediatric renal progressive disease. The mechanisms leading to disease progression are still poorly understood. Kidney fibrotic lesions are reproduced using a model of partial unilateral ureteral obstruction (pUUO in newborn mice. Based on data showing significant mast cell (MC infiltration in patients, we investigated the role of MC and murine MCPT4, a MC-released chymase, in pUUO using MC- (Wsh/sh, MCPT4-deficient (Mcpt4−/−, and wild-type (WT mice. Measurement of kidney length and volume by magnetic resonance imaging (MRI as well as postmortem kidney weight revealed hypotrophy of operated right kidneys (RKs and compensatory hypertrophy of left kidneys. Differences between kidneys were major for WT, minimal for Wsh/sh, and intermediate for Mcpt4−/− mice. Fibrosis development was focal and increased only in WT-obstructed kidneys. No differences were noticed for local inflammatory responses, but serum CCL2 was significantly higher in WT versus Mcpt4−/− and Wsh/sh mice. Alpha-smooth muscle actin (αSMA expression, a marker of epithelial–mesenchymal transition (EMT, was high in WT, minimal for Wsh/sh, and intermediate for Mcpt4−/− RK. Supernatants of activated MC induced αSMA in co-culture experiments with proximal tubular epithelial cells. Our results support a role of MC in EMT and parenchyma lesions after pUUO involving, at least partly, MCPT4 chymase. They confirm the importance of morphologic impairment evaluation by MRI in pUUO.

  16. Central Airway Obstruction: Benign Strictures, Tracheobronchomalacia, and Malignancy-related Obstruction.

    Science.gov (United States)

    Murgu, Septimiu Dan; Egressy, Katarine; Laxmanan, Balaji; Doblare, Guillermo; Ortiz-Comino, Rosamaria; Hogarth, D Kyle

    2016-08-01

    The purpose of this article is to provide an update on methods for palliating symptoms in patients with histologically benign and malignant central airway obstruction. We review the published literature within the past decade on postintubation, posttracheostomy, and TB- and transplant-related airway strictures; tracheobronchomalacia; and malignant airway obstruction. We review terminology, classification systems, and parameters that impact treatment decisions. The focus is on how airway stent insertion fits into the best algorithm of care. Several case series and cohort studies demonstrate that airway stents improve dyspnea, lung function, and quality of life in patients with airway obstruction. Airway stenting, however, is associated with high rates of adverse events and should be used only when curative open surgical interventions are not feasible or are contraindicated. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  17. Neonatal Intestinal Obstruction-Four Year Experience

    Directory of Open Access Journals (Sweden)

    D. Rathore

    2015-06-01

    Full Text Available Aim of study: To study the aetiology and frequency, sex incidence, age of presentation, management and outcome of neonatal intestinal obstruction. Material and Methods: This prospective study of 316 neonates with intestinal obstruction was conducted over a period of 4 years from November 2009 to October 2013 at single institute. These cases were managed by various surgical procedures. Their epidemiology, day of presentation, associated anomalies and outcomes were studied. Results: A total of 316 neonates (277 males and 39 females were operated for intestinal obstruction. 268(84.81% neonates presented in the 1st week of life. Imperforate anus occurred in 206 (65.19%.Small bowel atresia accounted for23 (7.27% cases while duodenal atresia was seen in19 (6.01% patients. Infantile hypertrophic pyloric stenosis and Malrotation each occurred in 14 (4.43% patients; Hirschsprung’s disease in 18(5.69%, Necrotising Enterocolitis in 12(3.79%, Meconium disease of newborn in 9(2.85% while colonic atresia was seen in one (0.3% patient. Colostomy was performed in 145(45.88%, Pouchostomy in 15(4.74% and Cutback anoplasty in 56(17.72% patients. Ramsted’s Pyloromyotomy in 13(4.11%% neonates, Laparoscopic Pyloromyotomy in 1(0.3%,Kimura’s Duodenoduodenostomy in 19(6.01% ,End to Back anastomosis in 24(7.59% , End to End anastomosis in 7(2.21% , Multiple anastomosis in 2(0.6% , Enterotomy with irrigation in 7(2.21% , Ladd’s procedure in 14(4.43% , ,Single stage transanal pull through in 8(2.53% , Ileostomy in 2(0.6% , Single stage Abdominoperineal pull through in 2(0.6%, Levelling colostomy in 6(1.89% ,Peritoneal drain insertion under Local anaesthesia in 5(1.58% . Overall mortality was 13.60%. Conclusion: Intestinal Obstruction is the most common surgical emergency in neonatal period. Early and accurate diagnosis is paramount for proper patient management. The etiology, mode of presentation, morbidity and outcome of surgery of intestinal obstruction in

  18. Interventional therapy for congenital urinary obstruction in children

    International Nuclear Information System (INIS)

    Qin Zenhui; Huang Sui; Liu Fan; Yang Jinyuan

    2005-01-01

    Objective: To investigate the interventional therapy in children's congenital urinary obstruction and its efficacy. Methods: Thirty-three children with congenital obstruction of ureteropelvic junction were treated through percutaneous dilation and/or stent placement, and 42 cases with posterior urethral valves were treated through trans-urethra dilation. Results: Thirty-three cases with upper urinary obstruction were improved with symptoms disappeared and stable efficacy on long-term follow-up of 1-7 years. Another 2 cases with the upper urethral obstruction had not been relieved of symptoms and resorted to surgical operation. For patients with posterior urethral valves, the lower urethral obstruction was totally got rid of after interventional therapy with stable efficacy on long-term follow-up of 1-10 years. Conclusions: Interventional therapy is safe , micro-invasive and efficient in treating congenital urinary obstruction with stable efficacy on long-term follow-up. (authors)

  19. Sonographic diagnosis of intestinal obstruction in the dog.

    Science.gov (United States)

    Manczur, F; Vörös, K; Vrabély, T; Wladár, S; Németh, T; Fenyves, B

    1998-01-01

    Ultrasonography was performed on 44 dogs to decide whether small bowel obstruction was present. The sonographic criteria for small bowel obstruction were (1) the presence of pendulous movement of the ingesta inside the dilated bowel, (2) observation of invaginated intestines or an ingested intraluminal foreign body, (3) observation of non-uniform peristaltic activity of the dilated intestines, or (4) observation of akinetic intestinal loops together with abdominal fluid accumulation. By using these criteria, obstruction was correctly diagnosed by ultrasonography in 11 of the 13 dogs with mechanical ileus, and obstruction was correctly excluded in 29 of the 31 non-obstructive cases. Thus, the above-mentioned sonographic criteria had 85% sensitivity and positive predictive value, and 94% specificity and negative predictive value. The present study suggests that ultrasonography is a valuable tool for diagnosing small intestinal obstruction in the dog.

  20. Intraoperative bowel irrigation improves anastomotic collagen metabolism in the left-sided colonic obstruction but not covering colostomy.

    Science.gov (United States)

    Duraker, N; Bender, O; Memişoğlu, K; Yalçiner, A

    1998-01-01

    This study investigated the effects of intraoperative colonic irrigation and proximal diverting end colostomy after segmental bowel resection in experimental left-colonic obstruction on anastomotic healing. Simple obstruction of descending colon was performed in male Sprague-Dawley rats. After 24 h we performed segmental colonic resection and anastomosis in the control group (n = 15); resection, anastomosis, and covering colostomy in the colostomy group (n = 14); resection and anastomosis after antegrade colonic lavage through cecum by using isotonic saline solution in the irrigation group (n = 13). In rats that were killed 7 days later anastomotic dehiscence and bursting pressure and tissue hydroxyproline concentration at the anastomosis were measured. No significant differences were observed between groups in terms of anastomotic dehiscence, bursting site, or pressure. The hydroxyproline concentration was significantly higher in the irrigation group than the control group (P = 0.025) and the colostomy group (P = 0.029), but no difference was noted between the control group and the colostomy group. These findings suggest that intraoperative antegrade colonic irrigation in the acute left-sided colonic obstruction positively affects collagen metabolism at the anastomotic site; if the anastomosis is performed without bowel cleansing, covering colostomy does not improve collagen metabolism.

  1. Proximity effects of high voltage electric power transmission lines on ...

    African Journals Online (AJOL)

    Yomi

    2010-08-18

    Aug 18, 2010 ... transmission lines on ornamental plant growth. Zeki Demir ... The effects of proximity to power-line on specific leaf area and seedling dbh were tested .... during vegetation season is about 72% and common wind blow.

  2. Nutritive Value Assessment of Four Crop Residues by Proximate ...

    African Journals Online (AJOL)

    Dr Grace Tona

    Ladoke Akintola University of Technology, P.M.B. 4000, Ogbomoso, Nigeria ... Abstract. This study estimated the proximate composition and in vitro gas production parameters of rice husk, bean ... farms and industries generate large quantities.

  3. Computational proximity excursions in the topology of digital images

    CERN Document Server

    Peters, James F

    2016-01-01

    This book introduces computational proximity (CP) as an algorithmic approach to finding nonempty sets of points that are either close to each other or far apart. Typically in computational proximity, the book starts with some form of proximity space (topological space equipped with a proximity relation) that has an inherent geometry. In CP, two types of near sets are considered, namely, spatially near sets and descriptivelynear sets. It is shown that connectedness, boundedness, mesh nerves, convexity, shapes and shape theory are principal topics in the study of nearness and separation of physical aswell as abstract sets. CP has a hefty visual content. Applications of CP in computer vision, multimedia, brain activity, biology, social networks, and cosmology are included. The book has been derived from the lectures of the author in a graduate course on the topology of digital images taught over the past several years. Many of the students have provided important insights and valuable suggestions. The topics in ...

  4. Population Exposure Estimates in Proximity to Nuclear Power Plants, Locations

    Data.gov (United States)

    National Aeronautics and Space Administration — The Population Exposure Estimates in Proximity to Nuclear Power Plants, Locations data set combines information from a global data set developed by Declan Butler of...

  5. Proximate composition and nutrient content of some wild and ...

    African Journals Online (AJOL)

    Proximate composition and nutrient content of some wild and cultivated ... Ca, P, K), one minor mineral (Fe) constituent and vitamin C content were determined. ... Mineral content (P and K) in the mushroom sporophores were found to be ...

  6. Effects of Fermentation and Extrusion on the Proximate Composition ...

    African Journals Online (AJOL)

    Prof. Ogunji

    protein malnutrition persists as a principal health problem among children .... Proximate analysis: Moisture content ... nitrogen by a factor of 6.25. Crude fat ... Statistical analysis: The data were ..... interaction of amino acid in maillard reactions.

  7. Proximate composition and mineral contents of Pebbly fish, Alestes ...

    African Journals Online (AJOL)

    ACSS

    /100 g) were significantly .... Proximate analysis of A. baremoze fillets according to sample sizes in a study in. Uganda .... present in the fish tissues in trace amounts. ... The zinc contents in fish samples of ..... (mercury, cadmium, lead, tin and.

  8. Effects of Planting Locations on the Proximate Compositions of ...

    African Journals Online (AJOL)

    ADOWIE PERE

    Ash, moisture, crude fat, crude fibre, carbohydrate and protein contents were determined according ... All fruits, vegetables, legumes (beans and peas), and the grains we eat ... isolate and quantify each proximate present in the plant material.

  9. On the obstructions to non-Cliffordian pin structures

    Energy Technology Data Exchange (ETDEWEB)

    Chamblin, A. (Dept. of Applied Maths and Theoretical Physics, Univ. of Cambridge (United Kingdom))

    1994-07-01

    We derive the topological obstructions to the existence of non-Cliffordian pin structures on four-dimensional spacetimes. We apply these obstructions to the study of non-Cliffordian pin-Lorentz cobordism. We note that our method of derivation applies equally well in any dimension and in any signature, and we present a general format for calculating obstructions in these situations. Finally, we interpret the breakdown of pin structure and discuss the relevance of this to aspects of physics. (orig.)

  10. Fetal tracheolaryngeal airway obstruction: prenatal evaluation by sonography and MRI

    Science.gov (United States)

    Courtier, Jesse; Poder, Liina; Wang, Zhen J.; Westphalen, Antonio C.; Yeh, Benjamin M.

    2010-01-01

    We reviewed the sonographic and MRI findings of tracheolaryngeal obstruction in the fetus. Conditions that can cause tracheolaryngeal obstruction include extrinsic causes such as lymphatic malformation, cervical teratoma and vascular rings and intrinsic causes such as congenital high airway obstruction syndrome (CHAOS). Accurate distinction of these conditions by sonography or MRI can help facilitate parental counseling and management, including the decision to utilize the ex utero intrapartum treatment (EXIT) procedure. PMID:20737145

  11. Renal Structural And Physiological Alterations Subsequent To Unilateral Ureteral Obstruction

    OpenAIRE

    El Gohary, Z. M. A. [زينب محمود احمد الجوهري

    1992-01-01

    Complete obstruction of the right ureter of male rabbits for eight weeks resulted in filling of the obstructed kidney with clear urine, no precipitation or stone formation. The calyces and pelvis were distinctly dilated with parenchymal atrophy, the medulla was almost completely destroyed and the cortex was reduced to a thin extensively sclerotic rim. When compared with the contralateral control kidney, the parenchymal weight and water content of the obstructed kidney were distinctly greater....

  12. Hypertrophic cardiomyopathy with mid-ventricular obstruction and apical aneurysm

    Directory of Open Access Journals (Sweden)

    N.D. Oryshchyn

    2016-11-01

    Full Text Available A case report of apical left ventricular aneurysm in patient with hypertrophic cardiomyopathy with mid-ventricular obstruction (diagnosis and surgical treatment is presented. We revealed apical aneurysm and mid-ventricular obstruction during echocardiography and specified anatomical characteristics of aneurysm during computer tomography. There was no evidence of obstructive coronary artery disease during coronary angiography. Taking into consideration multiple cerebral infarcts, aneurysm resection and left ventricular plastics was performed. Electronic microscopy of myocardium confirmed the diagnosis of hypertrophic cardiomyopathy.

  13. Fetal tracheolaryngeal airway obstruction: prenatal evaluation by sonography and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Courtier, Jesse; Poder, Liina; Wang, Zhen J.; Westphalen, Antonio C.; Yeh, Benjamin M.; Coakley, Fergus V. [University of California San Francisco, Department of Radiology, San Francisco, CA (United States)

    2010-11-15

    We reviewed the sonographic and MRI findings of tracheolaryngeal obstruction in the fetus. Conditions that can cause tracheolaryngeal obstruction include extrinsic causes such as lymphatic malformation, cervical teratoma and vascular rings and intrinsic causes such as congenital high airway obstruction syndrome (CHAOS). Accurate distinction of these conditions by sonography or MRI can help facilitate parental counseling and management, including the decision to utilize the ex utero intrapartum treatment (EXIT) procedure. (orig.)

  14. Cushing's syndrome in pregnancy and neonatal hypertrophic obstructive cardiomyopathy.

    Science.gov (United States)

    Fayol, L; Masson, P; Millet, V; Simeoni, U

    2004-10-01

    Cushing's syndrome is rare in pregnancy but can cause spontaneous abortion, stillbirth or premature birth. We report a case of transient hypertrophic obstructive cardiomyopathy in a newborn whose mother had hypercortisolism due to a primary adrenal lesion. There was no family history of hypertrophic obstructive cardiomyopathy. Follow-up revealed complete resolution of the cardiac abnormalities in the infant. Cushing's syndrome in the mother resolved after delivery. Although maternal hypercortisolism seldom results in symptomatic hypercortisolism in the newborn, hypertrophic obstructive cardiomyopathy can occur.

  15. A Case of Polyarteritis Nodosa with Bilateral Ureteral Obstruction

    Science.gov (United States)

    Yoo, Bin; Kim, Hong Kyu; Choi, Seung Won; Moon, Hee Bom

    1996-01-01

    We report a case of bilateral ureteral obstruction most likely caused by polyarteritis nodosa. The diagnosis was based upon muscle biopsy which showed typical necrotizing vasculitis in medium size artery in conjunction with microaneurysms in renal angiography. Ureteral obstruction is a rare manifestation of polyarteritis nodosa. This condition is thought to result from vasculitis of periureteral vessels. The patient was managed with prednisolone alone, which resulted in complete resolution of ureteral obstruction on both sides. PMID:8854655

  16. Fatal Airway Obstruction in a Man With a Cystic Hygroma.

    Science.gov (United States)

    Wygant, Cassandra Maria; Cohle, Stephen D

    2018-05-03

    We describe a 24-year-old man with a cystic hygroma of the left side of the lower neck that led to sudden death. Cystic hygroma (cystic lymphangioma) is a congenital malformation of the lymphatic system. The patient, who had a tracheostomy because of airway obstruction from the cystic hygroma, was found dead with his tracheostomy tube on the floor next to him. Complications of cystic hygroma include infiltration of the neck causing airway obstruction, dysphagia, pain, and obstructive sleep apnea.

  17. BAG3 regulates ECM accumulation in renal proximal tubular cells induced by TGF-β1.

    Science.gov (United States)

    Du, Feng; Li, Si; Wang, Tian; Zhang, Hai-Yan; Li, De-Tian; Du, Zhen-Xian; Wang, Hua-Qin; Wang, Yan-Qiu

    2015-01-01

    Previously we have demonstrated that Bcl-2-associated athanogene 3 (BAG3) is increased in renal fibrosis using a rat unilateral ureteral obstruction model. The current study investigated the role of BAG3 in renal fibrosis using transforming growth factor (TGF)-β1-treated human proximal tubular epithelial (HK-2) cells. An upregulation of BAG3 in vitro models was observed, which correlated with the increased synthesis of extracellular matrix (ECM) proteins and expression of tissue-type plasminogen activator inhibitor (PAI)-1. Blockade of BAG3 induction by shorting hairpin RNA suppressed the expression of ECM proteins but had no effect on PAI-1 expression induced by TGF-β1. Forced overexpression of BAG3 selectively increased collagens. TGF-β1-induced BAG3 expression in HK-2 cells was attenuated by ERK1/2 and JNK MAPK inhibitors. In addition, forced BAG3 overexpression blocked attenuation of collagens expression by ERK1/2 and JNK inhibitors. These data suggest that ERK1/2 and JNK signaling events are involved in modulating the expression of BAG3, which would ultimately contribute to renal fibrosis by enhancing the synthesis and deposition of ECM proteins.

  18. Inexact proximal Newton methods for self-concordant functions

    DEFF Research Database (Denmark)

    Li, Jinchao; Andersen, Martin Skovgaard; Vandenberghe, Lieven

    2016-01-01

    with an application to L1-regularized covariance selection, in which prior constraints on the sparsity pattern of the inverse covariance matrix are imposed. In the numerical experiments the proximal Newton steps are computed by an accelerated proximal gradient method, and multifrontal algorithms for positive definite...... matrices with chordal sparsity patterns are used to evaluate gradients and matrix-vector products with the Hessian of the smooth component of the objective....

  19. Hemiarthroplasty for proximal humeral fracture: restoration of the Gothic arch.

    Science.gov (United States)

    Krishnan, Sumant G; Bennion, Phillip W; Reineck, John R; Burkhead, Wayne Z

    2008-10-01

    Proximal humerus fractures are the most common fractures of the shoulder girdle, and initial management of these injuries often determines final outcome. When arthroplasty is used to manage proximal humeral fractures, surgery remains technically demanding, and outcomes have been unpredictable. Recent advances in both technique and prosthetic implants have led to more successful and reproducible results. Key technical points include restoration of the Gothic arch, anatomic tuberosity reconstruction, and minimal soft tissue dissection.

  20. Value and Accuracy of Multidetector Computed Tomography in Obstructive Jaundice

    International Nuclear Information System (INIS)

    Mathew, Rishi Philip; Moorkath, Abdunnisar; Basti, Ram Shenoy; Suresh, Hadihally B.

    2016-01-01

    Objective; To find out the role of MDCT in the evaluation of obstructive jaundice with respect to the cause and level of the obstruction, and its accuracy. To identify the advantages of MDCT with respect to other imaging modalities. To correlate MDCT findings with histopathology/surgical findings/Endoscopic Retrograde CholangioPancreatography (ERCP) findings as applicable. This was a prospective study conducted over a period of one year from August 2014 to August 2015. Data were collected from 50 patients with clinically suspected obstructive jaundice. CT findings were correlated with histopathology/surgical findings/ERCP findings as applicable. Among the 50 people studied, males and females were equal in number, and the majority belonged to the 41–60 year age group. The major cause for obstructive jaundice was choledocholithiasis. MDCT with reformatting techniques was very accurate in picking a mass as the cause for biliary obstruction and was able to differentiate a benign mass from a malignant one with high accuracy. There was 100% correlation between the CT diagnosis and the final diagnosis regarding the level and type of obstruction. MDCT was able to determine the cause of obstruction with an accuracy of 96%. MDCT with good reformatting techniques has excellent accuracy in the evaluation of obstructive jaundice with regards to the level and cause of obstruction

  1. The role of computed tomography in uncertain obstructive jaundice

    International Nuclear Information System (INIS)

    Saito, Yoshihiro; Yoshino, Toyoaki; Takayanagi, Ryuichi; Negishi, Ken; Tanaka, Teruhiko; Ito, Ichiro.

    1985-01-01

    42 patients with uncertain obstructive jaundice were examined by computed tomography (CT). CT correctly diagnosed obstructive jaundice in 97% of 37 proven cases and the accuracy of CT in determing the level of obstruction was also 97%. But the sensitivity of CT in determing the cause of obstructive jaundice was 62.5%, particularly poor in common bile duct stone (61.5%), inflammation of common bile duct (0%), and common bile duct carcinoma (50%). All cases of diagnosed malignant tumors were inoperable. (author)

  2. Obstructive sleep apnea: role of intermittent hypoxia and inflammation.

    Science.gov (United States)

    May, Anna M; Mehra, Reena

    2014-10-01

    Obstructive sleep apnea results in intermittent hypoxia via repetitive upper airway obstruction leading to partial or complete upper airway closure, apneas and hypopneas, respectively. Intermittent hypoxia leads to sympathetic nervous system activation and oxidative stress with a resultant systemic inflammatory cascade. The putative mechanism by which obstructive sleep apnea has been linked to numerous pathologic conditions including stoke, cardiovascular disease, hypertension, and metabolic derangements is through these systemic effects. Treatment of obstructive sleep apnea appears to reduce systemic markers of inflammation and ameliorates the adverse sequelae of this disease. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Apple-peel atresia presenting as foetal intestinal obstruction

    Directory of Open Access Journals (Sweden)

    Ashok Yadavrao Kshirsagar

    2011-01-01

    Full Text Available Apple-peel atresia or Type 3 jejuno-ileal atresia (JIA is an uncommon cause of foetal intestinal obstruction. Bowel obstruction in the foetus is diagnosed on the prenatal ultrasonography only in 50% cases. We report a case in which foetal intestinal obstruction was diagnosed on prenatal ultrasonography. The child showed signs of intestinal obstruction on day one after birth, for which an exploratory laparotomy was performed. Type 3 JIA was found for which resection of atretic segments with jejuno-ascending colon anastomosis was preformed.

  4. [Acid-base imbalance in acute obstructive uropathies].

    Science.gov (United States)

    Belyĭ, L E

    2007-01-01

    The aim of this study was to evaluate impairment of acid-base balance (ABB) in acute obstructive uropathies. Evaluation of acid-base balance was performed by pH, partial carbon dioxide pressure, plasma bicarbonate concentration, buffer bases, basis excess, hydrogen ion concentration. An automatic gas analyzer was used, plasma anion gap was calculated. Characteristic ABB alterations in different acute obstructive uropathies were detected. Acidotic shifts in acute obstruction of the upper urinary tracts and its inflammatory complications were assessed pathophysiologically. A comparative study of pathological acid-base disorders in acute supra- and infravesical obstructive uropathies was performed.

  5. The sooner, the better: exercise outcome proximity and intrinsic motivation.

    Science.gov (United States)

    Evans, M Blair; Cooke, Lisa M; Murray, Robyn A; Wilson, Anne E

    2014-11-01

    Despite evidence that outcomes are highly valued when they are expected sooner rather than further into the future (Ainslie, 1975), limited research effort has been devoted to understanding the role of exercise outcome proximity. The purpose of this study was to examine how temporal proximity to positive outcomes influences exercisers' intrinsic motivation. We expected that focusing people on temporally proximal exercise outcomes would increase intrinsic motivation, especially among low-frequency exercisers. This online experimental study was completed by 135 community exercisers (Mage  = 31.11, SD = 10.29; 62% female) who reported an average of 4.86 exercise bouts per week (SD = 2.12). Participants were randomly assigned to a condition that primed temporally proximal positive exercise outcomes (i.e. experienced during or directly following an exercise bout) or temporally distal outcomes (i.e. experienced after days, months, or years of regular exercise). Participants then reported perceptions of behavioral regulation in exercise. As expected, the proximal exercise outcome condition elicited increased intrinsic regulation among those participants who exercised less frequently (i.e. 1 SD below the mean). This study reveals the importance of considering proximity as an important dimension of exercise outcomes-particularly when promoting intrinsic motivation among relatively infrequent exercisers. © 2014 The International Association of Applied Psychology.

  6. Psychological responses to the proximity of climate change

    Science.gov (United States)

    Brügger, Adrian; Dessai, Suraje; Devine-Wright, Patrick; Morton, Thomas A.; Pidgeon, Nicholas F.

    2015-12-01

    A frequent suggestion to increase individuals' willingness to take action on climate change and to support relevant policies is to highlight its proximal consequences, that is, those that are close in space and time. But previous studies that have tested this proximizing approach have not revealed the expected positive effects on individual action and support for addressing climate change. We present three lines of psychological reasoning that provide compelling arguments as to why highlighting proximal impacts of climate change might not be as effective a way to increase individual mitigation and adaptation efforts as is often assumed. Our contextualization of the proximizing approach within established psychological research suggests that, depending on the particular theoretical perspective one takes on this issue, and on specific individual characteristics suggested by these perspectives, proximizing can bring about the intended positive effects, can have no (visible) effect or can even backfire. Thus, the effects of proximizing are much more complex than is commonly assumed. Revealing this complexity contributes to a refined theoretical understanding of the role that psychological distance plays in the context of climate change and opens up further avenues for future research and for interventions.

  7. HEMATOMA OF THE PROXIMAL NAIL FOLD. REPORT OF 41 CASES

    Directory of Open Access Journals (Sweden)

    Chang Patricia

    2011-04-01

    Full Text Available Background: The proximal fold is an important part of the nail apparatus it contributes to the formation of the nail plate and through the cuticle acts as an impermeable barrier protecting it from any cause.Objective: To know the proximal nail fold hematoma caused by the use of pulse oximeter.Material and Methods: A descriptive study was conducted in 41 patients with proximal nail hematoma secondary to the use of oximetry in patients hospitalized in the Intermediate and Intensive Care Unit at the Hospital General de Enfermedades from December 1, 2007 to December 31, 2010.Results: We studied 41 patients with proximal nail fold hematoma secondary to the use of oximeter, 30 (73.1% were males and 11 (26.8% females. The numbers of fingers affected by pulse oximeter were in one digit. 30 (73.1% cases, in two digits 6 (14.6%, in three digits 3 (7.3%, in 4 digits 1 (2.4% and in 5 digits 1 (2.4% case. The most affected proximal nail fold was right index: 24 (58.5%, right middle 11 (26.8%, right ring 6 (14.6%, left index 12 (29.2%, and left middle 6 (14.6% cases.Conclusions: Hematomas of the proximal nail fold may be caused by different traumatisms. The use of pulse oximeter is one of them.

  8. Fluoroscopically Guided Transcervical Fallopian Tube Recanalization of Post-Sterilization Reversal Mid-Tubal Obstructions

    International Nuclear Information System (INIS)

    Houston, J. Graeme; Anderson, David; Mills, John; Harrold, Anthony

    2000-01-01

    Purpose: To assess the technical success and early outcome of fluoroscopically guided transcervical fallopian tube recanalization (FTR) in mid-tubal occlusion following sterilization reversal surgery.Methods: From July 1995 to January 1998, patients with greater than 12 months secondary infertility underwent hysterosalpingography (HSG). FTR was performed in proximal or mid-tubal occlusion. Cases of FTR in mid-tubal occlusion were included in this study. Technical success (defined as complete tubal patency) using a standard guidewire and hydrophilic glidewire, the number of patients with at least one patent tube, and the intrauterine and ectopic pregnancy rates were determined.Results: Twenty-six infertile patients with previous sterilization reversal underwent HSG. Eight of 26 (31%) patients (mean age 32 years, range 23-37 years), had attempted FTR for mid-tubal occlusion at the site of surgical anastomosis. Fourteen tubes were attempted as there were two previous salpingectomies. Technical success was achieved in eight of 14 (57%) tubes attempted, resulting in five of eight (62%) patients having at least one patent tube. At follow-up (mean 18 months, range 12-28 months) in these five patients there was one intrauterine pregnancy. There were no ectopic pregnancies.Conclusions: FTR in mid-tubal obstruction in infertile patients following sterilization reversal surgery is technically feasible and may result in intrauterine pregnancy. In this small group there was a lower technical success rate and lower pregnancy rate than in unselected proximal tubal occlusion

  9. Chronic obstructive pulmonary disease and obstructive sleep apnea. Association, consequences and treatment.

    Science.gov (United States)

    Pronzato, C

    2010-12-01

    Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are two diseases that often co-exist within an individual. This co-existence, known as overlap syndrome (OS), is the result of chance rather than a pathophysiological linkage and epidemiological studies indicate a prevalence of 1% in adult males. Patients vith OS have a more important sleep-related O2 desaturation than COPD patients with the same degree of bronchial obstruction and show an increased risk of developing hypercapnic respiratory failure and pulmonary hypertension when compared with patients affected by only one of he diseases. COPD and OSAS are independent risk factors for cardiovascular events and their co-existence in OS probably increases this risk. Evidence of systemic inflammation in COPD and sleep apnea and consequentely OS, is interesting because it may contribute to the pathogenesis of cardiovascular diseases. Treatment consists of continuous positive airway pressure (CPAP) or non-invasive positive pressure ventilation (NIPPV), with or without associated O2, for correction of the upper airway obstructive episodes and hypoxemia during sleep.

  10. Timing Matters: Circadian Rhythm in Sepsis, Obstructive Lung Disease, Obstructive Sleep Apnea, and Cancer.

    Science.gov (United States)

    Truong, Kimberly K; Lam, Michael T; Grandner, Michael A; Sassoon, Catherine S; Malhotra, Atul

    2016-07-01

    Physiological and cellular functions operate in a 24-hour cyclical pattern orchestrated by an endogenous process known as the circadian rhythm. Circadian rhythms represent intrinsic oscillations of biological functions that allow for adaptation to cyclic environmental changes. Key clock genes that affect the persistence and periodicity of circadian rhythms include BMAL1/CLOCK, Period 1, Period 2, and Cryptochrome. Remarkable progress has been made in our understanding of circadian rhythms and their role in common medical conditions. A critical review of the literature supports the association between circadian misalignment and adverse health consequences in sepsis, obstructive lung disease, obstructive sleep apnea, and malignancy. Circadian misalignment plays an important role in these disease processes and can affect disease severity, treatment response, and survivorship. Normal inflammatory response to acute infections, airway resistance, upper airway collapsibility, and mitosis regulation follows a robust circadian pattern. Disruption of normal circadian rhythm at the molecular level affects severity of inflammation in sepsis, contributes to inflammatory responses in obstructive lung diseases, affects apnea length in obstructive sleep apnea, and increases risk for cancer. Chronotherapy is an underused practice of delivering therapy at optimal times to maximize efficacy and minimize toxicity. This approach has been shown to be advantageous in asthma and cancer management. In asthma, appropriate timing of medication administration improves treatment effectiveness. Properly timed chemotherapy may reduce treatment toxicities and maximize efficacy. Future research should focus on circadian rhythm disorders, role of circadian rhythm in other diseases, and modalities to restore and prevent circadian disruption.

  11. Obesity and chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Čekerevac Ivan

    2011-01-01

    Full Text Available Introduction. Nutritional abnormalities have one of the most important systematic effects on chronic obstructive pulmonary disease (COPD. A relationship between COPD and obesity has been observed and recognized. In COPD patients, beside changes in the total body weight, changes in body composition are also possible with the loss of fat-free mass (FFM. Objective. This study was undertaken to evaluate the impact of obesity and the change of body composition on the pulmonary function, dyspnoea level and the quality of life in COPD patients. Methods. Seventy-nine patients in the stable state of COPD were evaluated. Pulmonary function and arterial blood gas analysis were assessed. Nutritional status was analyzed according to Body Mass Index (BMI. Body composition was evaluated by using anthropometric measurement by fat free mass index (FFMI. Quality of life was assessed using the St. George Respiratory Questionnaire (SGRQ. The Visual Analogue Scale (VAS was used to evaluate dyspnoea. Results. The highest prevalence of obesity (50.0% was found in patients with mild COPD, while the lowest prevalence was detected in very severe COPD patients (10.0%. The loss of FFM occurred in 22.2% patients with normal body weight and in 9.0% of overweight COPD patients. The quality of life was lower in obese patients compared to other COPD patients. A higher dyspnoea level was also present in obese patients. The lowest airflow obstruction was in obese patients (p=0.023. We found a significant positive correlation between forced expiratory volume in the first second (FEV1% and BMI (r=0.326, p=0.003, FEV1% and FFMI (r=0.321, p=0.004. Conclusion. The highest prevalence of obesity was in patients with mild COPD. Obese patients with COPD had the lowest level of airflow obstruction, higher dyspnoea level and lower quality of life in comparison to other COPD patients.

  12. Volvulus as a complication of chronic intestinal pseudo-obstruction syndrome

    NARCIS (Netherlands)

    de Betue, Carlijn T.; Boersma, Doeke; Oomen, Matthijs W.; Benninga, Marc A.; de Jong, Justin R.

    2011-01-01

    Chronic intestinal pseudo-obstruction syndrome (CIPS) is a severe motility disorder of the gastrointestinal tract that presents with continuous or recurrent symptoms and signs of intestinal obstruction without evidence of a structural lesion occluding the intestinal lumen. Mechanical obstruction

  13. Obstructive sleep apnoea and atopy among middle aged chronic obstructive pulmonary disease and bronchial asthma patients.

    Science.gov (United States)

    Kumar, Raj; Nagar, Devender; Mallick, Adeeb; Kumar, Manoj; Tarke, Chandrakant R; Goel, Nitin

    2013-09-01

    Obstructive sleep apnoea syndrome is associated with significant morbidity. A high prevalence of obstructive sleep apnoea (OSA) symptoms has been reported in patients with asthma and chronic obstructive pulmonary disease (COPD). There are limited studies regarding relationship between atopy and OSA. To study the risk of obstructive sleep apnoea among middle aged chronic obstructive pulmonary disease and asthma patients by a home based sleep study and its association with atopy. Patients with asthma and COPD were evaluated for OSA symptoms by Epworth sleepiness scale (ESS) and Berlin questionnaire (BQ). ESS score > or = 9 was considered as high risk for OSA. Patients having high risk for OSA by ESS and BQ were further evaluated for OSA by home based sleep study. Skin prick test against common allergens was done to diagnose atopy in these patients. Among 400 patients (229, 57.25% male and 171, 42.75% female) 328 were asthmatics and 72 were COPD patients. ESS and BQ was positive in 11.25% (45/400) and 18.25% (73/400) patients respectively. ESS was positive in 10.67% (35/328) of asthma and 13.88% (10/72) of COPD patients. BQ was positive in 18.29% (60/328) of asthmatic and 18.05% (13/72) of COPD patients. Skin prick test was positive in 74.16% patients. The maximum positivity was found in asthmatics (139/155, 89.68%) compared to COPD patients (16/155, 10.32%). Skin prick test was done for 40 patients out of 73 of Asthma and COPD patients who were found positive by ESS and BQ. 72.5% patients were found to be atopic. Out of 19 patients in whom home polysomnography was done, 13 patients consented for skin prick test with common aeroallergens and 9 (69.23%) patients were found to be atopic. There is an increased risk of obstructive sleep apnoea among middle aged chronic obstructive pulmonary disease and asthma patients. Atopy could be associated with OSA. The association needs to be proved in a larger study.

  14. New noninvasive treatment for prostate outflow obstruction

    International Nuclear Information System (INIS)

    Richards, D.; Milroy, E.; Chapple, C.; Eldin, A.; Wallstein, H.

    1989-01-01

    Sixteen patients with prostatic outflow obstruction underwent implantation of the Wallstent endoprothesis, a woven mesh of fine stainless steel, mounted on a 9-F delivery system with an unconstrained diameter of 14 mm. The stent was inserted under local anesthesia, and placement was guided by linear transrectal US and flexible urethroscopy. In no patient was the distal sphincter mechanism compromised. In four, stent balloon dilation was needed. Urodynamic parameters (especially flow rate, voiding detrusor pressure, and postvoid residual) improved in all patients. Our experience showed the Wallstent endoprosthesis to be a safe, clinically acceptable, and minimally invasive alternative to prostatectomy

  15. Electrocardiographic changes in obstructive sleep apnea syndrome.

    Science.gov (United States)

    Prakasa, Kalpana; Ahmed, Jehanara; Hasan, Syed; Yousef, Mahmoud; Shridharani, Sachin

    2005-01-01

    The acute electrocardiographic changes during apneic episodes in patients with sleep apnea are well known. Long-term electro-cardiographic changes in these patients are not well studied. We conducted a retrospective case-control study to assess the electrocardiographic changes in African-American patients with established obstructive sleep apnea syndrome (OSA). A significant percentage of patients with OSA had abnormal EKGs as compared to the control group. The effect of sleep apnea on the cardiovascular system is more complex in African-Americans due to higher prevalence of co-morbid conditions. Seventy-three percent of our patients with OSA had metabolic syndrome.

  16. Biomarkers in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Sin, Don D; Vestbo, Jørgen

    2009-01-01

    Currently, with exception of lung function tests, there are no well validated biomarkers or surrogate endpoints that can be used to establish efficacy of novel drugs for chronic obstructive pulmonary disease (COPD). However, the lung function test is not an ideal surrogate for short-term drug...... trials because it (1) does not provide information regarding disease activity or the underlying pathologic process, (2) cannot separate the various phenotypes of COPD, (3) is not specific for COPD, and (4) is relatively unresponsive to known therapies that prolong survival. Accordingly, there are large...

  17. Chronic obstructive pulmonary disease and genetics

    DEFF Research Database (Denmark)

    Ingebrigtsen, T.; Thomsen, S.F.; Vestbo, J.

    2008-01-01

    Chronic obstructive pulmonary disease (COPD) is characterised by airflow limitation and is associated with an inflammatory response of the lungs primarily caused by cigarette smoking. Cigarette smoking is by far the most important environmental risk factor for COPD, but less than half of all heavy...... smokers develop COPD. This indicates a genetic contribution to the individual disease susceptibility. Although many genes have been examined, the puzzle of COPD genetics seems still largely unsolved. It is therefore important to measure phenotypes and to perform genome-wide scans of COPD patients in order...

  18. Autoimmune pancreatitis presenting as obstructive jaundice

    Directory of Open Access Journals (Sweden)

    Nurul Amin Miah

    2016-08-01

    Full Text Available A 71 years cachexic male presented with sign symptoms of biliary tract obstruction. There was a large mass in the head of pancreases with raised CA 19.9. But elevated serum lipase raised the suspicion of paocreatitis. Elevated immunoglobu­lin IgG4 confmned this case as a auto immune aetiology. Initially there was much difficulty to differentiate auto immune pancreatitis from pancreatic carcinoma but after successful stenting and a course of corticosteroids, patient improved dramatically along with nonnalisation of all the radiological, bio-chemical and immunological parameters.

  19. MR defecography for obstructed defecation syndrome

    Directory of Open Access Journals (Sweden)

    Ravikumar B Thapar

    2015-01-01

    Full Text Available Patients with obstructed defecation syndrome (ODS form an important subset of patients with chronic constipation. Evaluation and treatment of these patients has traditionally been difficult. Magnetic resonance defecography (MRD is a very useful tool for the evaluation of these patients. We evaluated the scans and records of 192 consecutive patients who underwent MRD at our center between January 2011 and January 2012. Abnormal descent, rectoceles, rectorectal intussusceptions, enteroceles, and spastic perineum were observed in a large number of these patients, usually in various combinations. We discuss the technique, its advantages and limitations, and the normal findings and various pathologies.

  20. An Unusual Cause of Biliary Obstruction

    Directory of Open Access Journals (Sweden)

    Sern Wei Yeoh

    2012-01-01

    Full Text Available Portal biliary ductopathy (PBD is a condition in which biliary and pancreatic ducts are extrinsically compressed by collateral branches of the portal venous system, which in turn have become dilated and varicosed due to portal hypertension. While the majority of patients with PBD are asymptomatic, a minority can present with symptoms of biliary obstruction and cholangitis with the potential of developing secondary chronic liver disease. This paper reports the case of a 29 year old male presenting with acute cholangitis, in whom PBD was diagnosed radiologically. A brief review of current literature regarding the diagnosis and management of this condition will also be presented.

  1. PROXIMAL: a method for Prediction of Xenobiotic Metabolism.

    Science.gov (United States)

    Yousofshahi, Mona; Manteiga, Sara; Wu, Charmian; Lee, Kyongbum; Hassoun, Soha

    2015-12-22

    Contamination of the environment with bioactive chemicals has emerged as a potential public health risk. These substances that may cause distress or disease in humans can be found in air, water and food supplies. An open question is whether these chemicals transform into potentially more active or toxic derivatives via xenobiotic metabolizing enzymes expressed in the body. We present a new prediction tool, which we call PROXIMAL (Prediction of Xenobiotic Metabolism) for identifying possible transformation products of xenobiotic chemicals in the liver. Using reaction data from DrugBank and KEGG, PROXIMAL builds look-up tables that catalog the sites and types of structural modifications performed by Phase I and Phase II enzymes. Given a compound of interest, PROXIMAL searches for substructures that match the sites cataloged in the look-up tables, applies the corresponding modifications to generate a panel of possible transformation products, and ranks the products based on the activity and abundance of the enzymes involved. PROXIMAL generates transformations that are specific for the chemical of interest by analyzing the chemical's substructures. We evaluate the accuracy of PROXIMAL's predictions through case studies on two environmental chemicals with suspected endocrine disrupting activity, bisphenol A (BPA) and 4-chlorobiphenyl (PCB3). Comparisons with published reports confirm 5 out of 7 and 17 out of 26 of the predicted derivatives for BPA and PCB3, respectively. We also compare biotransformation predictions generated by PROXIMAL with those generated by METEOR and Metaprint2D-react, two other prediction tools. PROXIMAL can predict transformations of chemicals that contain substructures recognizable by human liver enzymes. It also has the ability to rank the predicted metabolites based on the activity and abundance of enzymes involved in xenobiotic transformation.

  2. Membranous IVC Obstruction Presenting with Antegrade/Retrograde Respiratory Flow in the Intrahepatic Segment in Doppler Imaging and Prostatic and Urethral Congestion

    International Nuclear Information System (INIS)

    Sood, Dinesh; Mistry, Kewal A.; Chadha, Veenal; Sharma, Sarthak; Morey, Parikshit D.; Suthar, Pokhraj P.; Patel, Dhruv G.

    2015-01-01

    Obstruction of the inferior vena cava (IVC) is infrequent, membranous obstruction of the IVC (MOIVC) being one of its rare causes. Early diagnosis is important, as it can lead to hepatic congestion, cirrhosis and Budd-Chiari syndrome (BCS) and can predispose to development of hepatocellular carcinoma (HCC) in severe cases. We report a case of membranous IVC obstruction at the junction of hepatic and suprahepatic segments in a young male with extensive collateralization and venous aneurysms. Unique findings involved antegrade and retrograde flow during respiration in the upper part of intrahepatic IVC proximal to a large collateral vein as well as prostatic and urethral congestion leading to intermittent urinary hesitancy, which have not yet been described in such cases. MOIVC is a rare cause of IVC obstruction with typical radiological features. Early diagnosis and management is required due to risk of cirrhosis and HCC. Antegrade and retrograde flow may be seen in incomplete MOIVC above the level of a large collateral vein and it may lead to prostatic and urethral congestion

  3. Calculus Rules for V-Proximal Subdifferentials in Smooth Banach Spaces

    Directory of Open Access Journals (Sweden)

    Messaoud Bounkhel

    2016-01-01

    Full Text Available In 2010, Bounkhel et al. introduced new proximal concepts (analytic proximal subdifferential, geometric proximal subdifferential, and proximal normal cone in reflexive smooth Banach spaces. They proved, in p-uniformly convex and q-uniformly smooth Banach spaces, the density theorem for the new concepts of proximal subdifferential and various important properties for both proximal subdifferential concepts and the proximal normal cone concept. In this paper, we establish calculus rules (fuzzy sum rule and chain rule for both proximal subdifferentials and we prove the Bishop-Phelps theorem for the proximal normal cone. The limiting concept for both proximal subdifferentials and for the proximal normal cone is defined and studied. We prove that both limiting constructions coincide with the Mordukhovich constructions under some assumptions on the space. Applications to nonconvex minimisation problems and nonconvex variational inequalities are established.

  4. Identifying patients at high risk for obstructive sleep apnoea ...

    African Journals Online (AJOL)

    Background: Obstructive sleep apnoea is associated with significant health consequences. A significant proportion of hospitalized patients at risk for obstructive sleep apnoea were never identified and referred for polysomnography for diagnosis. The objective of this study was to determine the factors associated with high ...

  5. High‑risk of obstructive sleep apnea and excessive daytime ...

    African Journals Online (AJOL)

    Background: The burden of obstructive sleep apnea among commercial drivers in Nigeria is not known. Aim: To assess the prevalence of high risk of obstructive sleep apnea (OSA) and excessive daytime sleepiness (EDS) among intra‑city commercial drivers. Setting and Design: A descriptive cross‑sectional study in three ...

  6. Prevalence, awareness and reporting of symptoms of obstructive ...

    African Journals Online (AJOL)

    Background: Obstructive sleep apnoea is the most common form of sleep- disordered breathing in adults and children. It is associated with many adverse health consequences. The objectives this study were to determine the prevalence, awareness and reporting of symptoms of obstructive sleep apnoea among hospitalized ...

  7. A Surgical Treatment of Obstructive Sleep Apnoea (OSA)

    African Journals Online (AJOL)

    Snoring is now seen as one end of sleep-related breathing disorder resulting ultimately in obstructive sleep apnea. Uvulopalatopharyngoplasty (UPPP) is the first surgical procedure specifically designed to alleviate the abnormalities, although the use of laser appears to be the new trend. We present a case of Obstructive ...

  8. Cholescintigraphy in experimentally induced obstructive and parenchymatous jaundice

    International Nuclear Information System (INIS)

    Baehre, M.; Biersack, H.J.; Hofmann, S.; Winkler, C.

    1979-01-01

    Animal studies have been performed in 30 dogs in order to obtain information concerning typical patterns of cholescintigraphy in acute obstructive jaundice. In 14 the choledochus was ligated and in 16 galactosamine-hepatitis was induced as an experimental model for parenchymatous jaundice. The results suggest a number of diagnostic criteria in obstructive disease. (Auth.)

  9. Predictors of outcome among patients with obstructive jaundice at ...

    African Journals Online (AJOL)

    Despite recent advances both in preoperative diagnosis and postoperative care, obstructive jaundice still contributes significantly to high morbidity and mortality. A prospective study was undertaken to identify predictors of outcome among patients with obstructive jaundice at Bugando Medical Centre in north-western ...

  10. Operable severe obstructive jaundice: How should we use pre ...

    African Journals Online (AJOL)

    Obstructive jaundice is a common surgical problem, and surgery in jaundiced patients is associated with a higher risk of postoperative complications than surgery in non-jaundiced patients. However, the efficacy of pre-operative biliary drainage (PBD) for patients with obstructive jaundice remains controversial. Many studies ...

  11. Non-traumatic abdominal emergencies: imaging of acute intestinal obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Taourel, P.; Kessler, N.; Lesnik, A.; Blayac, P.M.; Morcos, L. [Departement d' Imagerie Medicale, Hopital Lapeyronie, 371, avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5 (France); Bruel, J.M. [Departement d' Imagerie Medicale, Hopital Saint-Eloi, 80 rue Augustin Fliche, 34295 Montpellier Cedex 5 (France)

    2002-09-01

    The purpose of this paper is to give an overview of the main clinical questions in bowel obstruction, to discuss the value of various imaging modalities, including conventional radiography, ultrasound, and CT, to underline the impact of imaging in the management of patients with suspect bowel obstruction, and then to suggest a diagnostic triage in such patients. (orig.)

  12. Old dilemma : asthma with irreversible airway obstruction or COPD

    NARCIS (Netherlands)

    Fattahi, Fatemeh; Vonk, Judith M.; Bulkmans, Nicole; Fleischeuer, Ruth; Gouw, Annette; Grunberg, Katrien; Mauad, Thais; Popper, Helmut; Felipe-Silva, Aloisio; Vrugt, Bart; Wright, Joanne L.; Yang, Hui-Min; Kocks, Janwillem W. H.; Hylkema, Machteld N.; Postma, Dirkje S.; Timens, Wim; ten Hacken, Nick H. T.

    2015-01-01

    Older asthmatic patients may develop fixed airway obstruction and clinical signs of chronic obstructive pulmonary disease (COPD). We investigated the added value of pathological evaluation of bronchial biopsies to help differentiate asthma from COPD, taking into account smoking, age, and inhaled

  13. Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Thomsen, Mette; Ingebrigtsen, Truls Sylvan; Marott, Jacob Louis

    2013-01-01

    Exacerbations of respiratory symptoms in chronic obstructive pulmonary disease (COPD) have profound and long-lasting adverse effects on patients.......Exacerbations of respiratory symptoms in chronic obstructive pulmonary disease (COPD) have profound and long-lasting adverse effects on patients....

  14. Predictors of objective cough frequency in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Sumner, Helen; Woodcock, Ashley; Kolsum, Umme

    2013-01-01

    Cough is one of the principal symptoms of chronic obstructive pulmonary disease (COPD) but the potential drivers of cough are likely to be multifactorial and poorly understood.......Cough is one of the principal symptoms of chronic obstructive pulmonary disease (COPD) but the potential drivers of cough are likely to be multifactorial and poorly understood....

  15. Inflammatory biomarkers and comorbidities in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Thomsen, Mette; Dahl, Morten; Lange, Peter

    2012-01-01

    Patients with chronic obstructive pulmonary disease (COPD) have evidence of systemic inflammation that may be implicated in the development of comorbidities.......Patients with chronic obstructive pulmonary disease (COPD) have evidence of systemic inflammation that may be implicated in the development of comorbidities....

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

  18. Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin ...

    African Journals Online (AJOL)

    Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin. AAG Jimoh, OR Balogun, Abubakar Danladi. Abstract. During a five-year period between 1st January 1995 to 31st December 1999, three hundred and twenty eight cases of obstructed labour were encountered out of a total of 12,614 deliveries managed ...

  19. Epidemiology of small-bowel obstruction beyond the neonatal period

    African Journals Online (AJOL)

    Background The aim of this study was to evaluate the etiologies causing intestinal obstruction beyond the neonatal period. Patients and methods An observational study was conducted on children between 1 month and 17 years of age who underwent surgery for small-bowel obstruction. (SBO) at this tertiary referral center ...

  20. Systematic review: the influence of nasal obstruction on sleep apnea

    Directory of Open Access Journals (Sweden)

    Debora Petrungaro Migueis

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: Obstructive sleep apnea syndrome (OSAS is a common disorder that can lead to cardiovascular morbidity and mortality, as well as to metabolic, neurological, and behavioral consequences. It is currently believed that nasal obstruction compromises the quality of sleep when it results in breathing disorders and fragmentation of sleep. However, recent studies have failed to objectively associate sleep quality and nasal obstruction. OBJECTIVE: The aim of this systematic review is to evaluate the influence of nasal obstruction on OSAS and polysomnographic indices associated with respiratory events. METHODS: Eleven original articles published from 2003 to 2013 were selected, which addressed surgical and non-surgical treatment for nasal obstruction, performing polysomnography type 1 before and after the intervention. RESULTS/CONCLUSIONS: In most trials, nasal obstruction was not related to the apnea-hypopnea index (AHI, indicating no improvement in OSAS with reduction in nasal resistance. However, few researchers evaluated other polysomnography indices, such as the arousal index and rapid eye movement (REM sleep percentage. These could change with nasal obstruction, since it is possible that the nasal obstruction does not completely block the upper airways, but can increase negative intrathoracic pressure, leading to sleep fragmentation.