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Sample records for specific endoscopic features

  1. Endoscopic ultrasound features of chronic pancreatitis

    Rana, Surinder Singh; Vilmann, Peter

    2015-01-01

    As endoscopic ultrasound (EUS) is the most sensitive imaging modality for diagnosing pancreatic disorders, it can demonstrate subtle alterations in the pancreatic parenchymal and ductal structure even before traditional imaging and functional testing demonstrate any abnormality. In spite...... of this fact and abundant literature, the exact role of EUS in the diagnosis of chronic pancreatitis (CP) is still not established. The EUS features to diagnose CP have evolved over a period from a pure qualitative approach to more advanced and complicated scoring systems incorporating multiple parenchymal...... to define the exact role of these criteria. The measurement of strain ratio using quantitative EUS elastography and thus allowing quantification of pancreatic fibrosis seems to be a promising new technique....

  2. Gastric schwannomas: radiological features with endoscopic and pathological correlation

    Hong, H.S. [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seodaemoon-gu, Seoul (Korea, Republic of); Ha, H.K. [Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of)], E-mail: hkha@amc.seoul.kr; Won, H.J.; Byun, J.H.; Shin, Y.M.; Kim, A.Y.; Kim, P.N.; Lee, M.-G. [Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of); Lee, G.H. [Internal Medicine, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of); Kim, M.J. [Pathology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of)

    2008-05-15

    Aim: To describe the radiological, endoscopic, and pathological findings of gastric schwannomas in 16 patients. Materials and methods: The radiological, endoscopic, and pathological findings of 16 surgically proven cases of gastric schwannoma were retrospectively reviewed. All patients underwent computed tomography (CT) and four patients were evaluated with upper gastrointestinal series. Two radiologists reviewed the CT and upper gastrointestinal series images by consensus with regard to tumour size, contour, margin, and growth pattern, the presence or absence of ulcer, cystic change, and the CT enhancement pattern. Endoscopy was performed in eight of these 16 patients. Six patients underwent endoscopic ultrasonography. Pathological specimens were obtained from and reviewed in all 16 patients. Immunohistochemistry was performed for c-kit, CD34, smooth muscle actin, and S-100 protein. Results: On radiographic examination, gastric schwannomas appeared as submucosal tumours with the CT features of well-demarcated, homogeneous, and uncommonly ulcerated masses. Endoscopy with endoscopic ultrasonography demonstrated homogeneous, submucosal masses contiguous with the muscularis propria in all six examined cases. On pathological examination, gastric schwannomas appeared as well-circumscribed and homogeneous tumours in the muscularis propria and consisted microscopically of interlacing bundles of spindle cells. Strong positivity for S-100 protein was demonstrated in all 16 cases on immunohistochemistry. Conclusion: Gastric schwannomas appear as submucosal tumours of the stomach and have well-demarcated and homogeneous features on CT, endoscopic ultrasonography, and gross pathology. Immunohistochemistry consistently reveals positivity for S-100 protein in the tumours.

  3. Gastric schwannomas: radiological features with endoscopic and pathological correlation

    Hong, H.S.; Ha, H.K.; Won, H.J.; Byun, J.H.; Shin, Y.M.; Kim, A.Y.; Kim, P.N.; Lee, M.-G.; Lee, G.H.; Kim, M.J.

    2008-01-01

    Aim: To describe the radiological, endoscopic, and pathological findings of gastric schwannomas in 16 patients. Materials and methods: The radiological, endoscopic, and pathological findings of 16 surgically proven cases of gastric schwannoma were retrospectively reviewed. All patients underwent computed tomography (CT) and four patients were evaluated with upper gastrointestinal series. Two radiologists reviewed the CT and upper gastrointestinal series images by consensus with regard to tumour size, contour, margin, and growth pattern, the presence or absence of ulcer, cystic change, and the CT enhancement pattern. Endoscopy was performed in eight of these 16 patients. Six patients underwent endoscopic ultrasonography. Pathological specimens were obtained from and reviewed in all 16 patients. Immunohistochemistry was performed for c-kit, CD34, smooth muscle actin, and S-100 protein. Results: On radiographic examination, gastric schwannomas appeared as submucosal tumours with the CT features of well-demarcated, homogeneous, and uncommonly ulcerated masses. Endoscopy with endoscopic ultrasonography demonstrated homogeneous, submucosal masses contiguous with the muscularis propria in all six examined cases. On pathological examination, gastric schwannomas appeared as well-circumscribed and homogeneous tumours in the muscularis propria and consisted microscopically of interlacing bundles of spindle cells. Strong positivity for S-100 protein was demonstrated in all 16 cases on immunohistochemistry. Conclusion: Gastric schwannomas appear as submucosal tumours of the stomach and have well-demarcated and homogeneous features on CT, endoscopic ultrasonography, and gross pathology. Immunohistochemistry consistently reveals positivity for S-100 protein in the tumours

  4. Eosinophilic Esophagitis: Clinical Features, Endoscopic Findings and Response to Treatment

    Robert Enns

    2010-01-01

    Full Text Available Eosinophilic esophagitis (EE is a motility disorder of the esophagus that typically presents with dysphagia. The objective of the present study was to explore patient characteristics, clinical and endoscopic features, and response to treatment of patients with EE. Patients were selected retrospectively based on a review of biopsy results from previous endoscopies performed between 2004 and 2008. A total of 54 patients (41 men and 13 women with biopsy-proven EE were included in the study. Further information regarding the patients’ clinical and endoscopic features, and response to treatment were obtained through chart reviews and patient telephone interviews. The mean age of the patients at symptom onset was 30 years. All patients complained of dysphagia, 81% had a history of bolus obstruction, 43% had a history of asthma and 70% had a history of environmental allergies. Thirty-three per cent had a family history of asthma, while 52% had a family history of food or seasonal allergies. The most common endoscopic findings were rings and/or corrugations, which were found in 63% of patients. Swallowed fluticasone therapy resulted in symptom resolution in 74% of patients; however, 79% of these patients relapsed after discontinuing fluticasone therapy and required repeat treatments. Esophageal dilation was complication free and resulted in improvement in 80% of patients. However, 83% of those reporting improvement relapsed within one year. The clinical and endoscopic findings were similar to those found in the literature, with most patients requiring ongoing, repeated therapies. Further studies are needed to assess the safety and efficacy of treatment modalities ideally suited to patients with EE.

  5. Youth job market specific features

    Evgeniya Yu. Zhuravleva

    2011-05-01

    Full Text Available The article considers youth job market peculiarities, its specific features and regulation means, determines theoretical and application tasks of qualitative and quantitative comparison of vocations, which are highly in demand at the job market.

  6. Classification of endoscopic capsule images by using color wavelet features, higher order statistics and radial basis functions.

    Lima, C S; Barbosa, D; Ramos, J; Tavares, A; Monteiro, L; Carvalho, L

    2008-01-01

    This paper presents a system to support medical diagnosis and detection of abnormal lesions by processing capsule endoscopic images. Endoscopic images possess rich information expressed by texture. Texture information can be efficiently extracted from medium scales of the wavelet transform. The set of features proposed in this paper to code textural information is named color wavelet covariance (CWC). CWC coefficients are based on the covariances of second order textural measures, an optimum subset of them is proposed. Third and forth order moments are added to cope with distributions that tend to become non-Gaussian, especially in some pathological cases. The proposed approach is supported by a classifier based on radial basis functions procedure for the characterization of the image regions along the video frames. The whole methodology has been applied on real data containing 6 full endoscopic exams and reached 95% specificity and 93% sensitivity.

  7. CORRELATION OF ENDOSCOPIC AND HISTOLOGICAL FEATURES IN ADULTS WITH SUSPECTED CELIAC DISEASE IN A REFERRAL CENTER OF MINAS GERAIS, BRAZIL

    Rodrigo Macedo ROSA

    2014-12-01

    Full Text Available Context Clinical presentation of celiac disease is extremely variable and the diagnosis relies on serologic tests, mucosal intestinal biopsy and clinic and serologic response to a gluten-free diet. Objectives To correlate the endoscopic and histological aspects of adult patients with suspicion of celiac disease and to evaluate the interobserver histological agreement. Methods Endoscopic aspects of 80 adult patients were evaluated and correlated with the histological features according the Marsh-Oberhuber classification system. The interobserver histological agreement was based on kappa values. Results The symptoms of the patients varied largely, with prominence for chronic diarrhea, present in 48 (60% patients. The endoscopic aspects related with the duodenal villous atrophy had been observed in 32 (40% patients. There were confirmed 46 cases of celiac disease, with prevalence of 57.5%. The sensitivity, specificity, positive predictive value and negative predictive value of the endoscopic markers for celiac disease diagnosis were of 60.9%, 88.2%, 87.5% and 62.5%. There was moderate interobserver histological agreement (kappa = 0.46. Conclusions The endoscopic markers of villous atrophy, although not diagnostic, had assisted in the suspicion and indication of the duodenal biopsies for diagnosis proposal. Histology is sometimes contradictory and new biopsies or opinion of another professional can provide greater diagnostic agreement.

  8. Endoscopic anatomy and features of lumbar discectomy by Destandau technique

    Keyvan Mostofi

    2017-03-01

    Full Text Available Minimally invasive spine surgery prevents alteration of paraspinal muscles and avoids traditional open surgery, so in the majority of cases, recovery is much quicker and patients have less back pain after surgery. The authors describe an endoscopic approach to lumbar disc herniation by the Destandau's method originated in Bordeaux. Destandau designed ENDOSPINE for discectomy will be inserted, and the procedure will continue using endoscopy. The Endoscopic approach to lumbar disc herniation by Destandau's method offers a convenient access to lumbar disc herniation with less complications and negligible morbidity. It gives maximum exposure to the disc space with maximal angles and minimal cutaneous incision. Contrary to other minimally invasive approaches, the visual field in discectomy by Destandau technique is broad and depending on the workability of ENDOSPINE an adequate access to lumbar disc herniation is possible.

  9. Clinical profiles, endoscopic and laboratory features and associated factors in patients with autoimmune gastritis.

    Soykan, Irfan; Yakut, Mustafa; Keskin, Onur; Bektaş, Mehmet

    2012-01-01

    Autoimmune gastritis (AIG) may predispose to gastric carcinoid tumors or adenocarcinomas and may also cause unexplained iron and/or vitamin B(12) deficiency. The aims of this study were to explore clinical manifestations, endoscopic findings and laboratory features of patients with AIG. 109 patients with AIG were enrolled into the study. In addition to demographic and clinical data, gastric lesions, serum gastrin, vitamin B(12), antiparietal cell antibody (APA), current Helicobacter pylori status, and anti-H. pylori IgG were also investigated. The mean age of the patients was 53.06 ± 12.7 years (range 24-81; 72 (66.1%) women). The most common main presenting symptom was abdominal symptoms in 51 patients, consultation for iron and/or vitamin B(12) deficiency in 36, and non-specific symptoms including intermittent diarrhea in 15 patients. Endoscopic lesions were detected in 17 patients, hyperplastic polyps in 8, gastric carcinoid tumor in 4, fundic gland polyps in 3, and adenomatous polyps in 2 patients. H. pylori was negative in all patients in biopsy specimens; however, anti-H. pylori IgG was positive in 30 (27.5%) patients. 91 patients (83.4%) were positive for APA. In patients with AIG, the main symptoms prompted for clinical investigation were: abdominal symptoms, iron/B(12) deficiency and non-specific symptoms. 20% of patients with AIG had various gastric lesions including type I gastric carcinoids. None of the patients were positive for H. pylori by means of invasive tests; however, anti-H. pylori IgG was found in 27.5% of patients. Patients referring with non-specific abdominal symptoms such as bloating, diarrhea and iron/B(12) deficiency should be investigated for the presence of AIG. Copyright © 2012 S. Karger AG, Basel.

  10. MR enterography in nonresponsive adult celiac disease: Correlation with endoscopic, pathologic, serologic, and genetic features.

    Radmard, Amir Reza; Hashemi Taheri, Amir Pejman; Salehian Nik, Elham; Kooraki, Soheil; Kolahdoozan, Shadi; Mirminachi, Babak; Sotoudeh, Masoud; Ekhlasi, Golnaz; Malekzadeh, Reza; Shahbazkhani, Bijan

    2017-10-01

    To assess small bowel abnormalities on magnetic resonance enterography (MRE) in adult patients with nonresponsive celiac disease (CD) and investigate their associations with endoscopic, histopathologic, serologic, and genetic features. This prospective study was carried out between September 2012 and August 2013. After approval by the Ethics Committee of our institution, informed consent was acquired from all participants. Forty consecutive patients with nonresponsive CD, aged 17-76 years, underwent MRE using a 1.5T unit. Sequences included T 2 -HASTE, True-FISP, pre- and postcontrast VIBE to assess the quantitative (number of ileal and jejunal folds) and qualitative (fold pattern abnormalities, mural thickening, increased enhancement, bowel dilatation, or intussusception) measures. Endoscopic manifestations were categorized as normal/mild vs. severe. Histopathological results were divided into mild and severe. Genotyping of HLA-DQ2 and DQ8 was performed. Serum levels of tissue-transglutaminase, endomysial, and gliadin antibodies were also determined. Logistic regression analysis and receiver operating characteristic (ROC) curve were used. Twenty-nine (72.5%) cases showed abnormal MRE. Reversed jejunoileal fold pattern had significant association with severe endoscopic (odds ratio [OR] = 8.38, 95% confidence interval [CI] 1.73-40.5) and pathologic features (OR = 7.36, 95% CI 1.33-40.54). An increased number of ileal folds/inch was significantly associated with severe MARSH score and positive HLA-DQ8. (P reversal on MRE is highly associated with endoscopic and pathologic features of refractory celiac disease (RCD). Increased ileal folds showed higher correlation with endoscopic-pathologic features, HLA-DQ8, and anti-transglutaminase level. MRE might be more sensitive for detection of increased ileal folds in CD rather than reduction of duodenal and jejunal folds due to better distension of ileal loops. 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017

  11. Clinical and Endoscopic Features of Undifferentiated Gastric Cancer in Patients with Severe Atrophic Gastritis.

    Kishino, Maiko; Nakamura, Shinichi; Shiratori, Keiko

    2016-01-01

    Differentiated gastric cancer generally develops in the atrophic gastric mucosa, although undifferentiated cancer is sometimes encountered in patients with severe atrophic gastritis. We characterized the endoscopic features of undifferentiated gastric cancer in patients with severe atrophic gastritis. Stage IA early gastric cancer was diagnosed in 501 patients who were admitted to our hospital between April 2003 and March 2012. The endoscopic and pathological findings were compared among 29 patients with undifferentiated cancer and severe atrophic gastritis, 104 patients with undifferentiated cancer and mild/moderate atrophic gastritis and 223 patients with well-differentiated cancer and severe atrophic gastritis. Endoscopic atrophic gastritis was classified according to the Kimura-Takemoto classification as no gastritis, C-1 and C-2 (mild), C-3 and O-1 (moderate) or O-2 and O-3 (severe). The tumors were larger and showed deeper mural invasion in the patients with undifferentiated cancer and severe atrophic gastritis than in those with well-differentiated cancer and severe gastritis or undifferentiated cancer and mild/moderate gastritis. On endoscopy, undifferentiated cancer associated with severe gastritis was often red in color. It is often difficult to diagnose early undifferentiated gastric cancer, especially in patients with severe atrophic gastritis. The present study characterized the important endoscopic features of such tumors.

  12. Sinonasal organised haematoma: clinical features and successful application of modified transnasal endoscopic medial maxillectomy.

    Suzuki, M; Nakamura, Y; Ozaki, S; Yokota, M; Murakami, S

    2017-08-01

    Although organised haematoma often induces bone thinning and destruction similar to malignant diseases, the aetiology of organised haematoma and the optimal treatment remain unclear. This paper presents the clinical features of individuals with organised haematoma, and describes cases in which a novel modified approach was successfully applied for resection of organised haematoma in the maxillary sinus. Pre-operative examination data were evaluated retrospectively. Modified transnasal endoscopic medial maxillectomy was employed. Fourteen patients with organised haematoma were treated. Contrast-enhanced computed tomography showed heterogeneous enhancement in all patients. Eight patients underwent modified transnasal endoscopic medial maxillectomy, without complications such as facial numbness, tooth numbness, facial tingling, lacrimation and eye discharge. Dissection of the apertura piriformis and anterior maxillary wall was not necessary for any of these eight patients. No recurrence was observed. Pre-operative examinations can be helpful in determining the likelihood of organised haematoma. Modified transnasal endoscopic medial maxillectomy appears to be a safe and effective method for organised haematoma resection.

  13. Automatic real-time detection of endoscopic procedures using temporal features.

    Stanek, Sean R; Tavanapong, Wallapak; Wong, Johnny; Oh, Jung Hwan; de Groen, Piet C

    2012-11-01

    Endoscopy is used for inspection of the inner surface of organs such as the colon. During endoscopic inspection of the colon or colonoscopy, a tiny video camera generates a video signal, which is displayed on a monitor for interpretation in real-time by physicians. In practice, these images are not typically captured, which may be attributed by lack of fully automated tools for capturing, analysis of important contents, and quick and easy retrieval of these contents. This paper presents the description and evaluation results of our novel software that uses new metrics based on image color and motion over time to automatically record all images of an individual endoscopic procedure into a single digitized video file. The software automatically discards out-patient video frames between different endoscopic procedures. We validated our software system on 2464 h of live video (over 265 million frames) from endoscopy units where colonoscopy and upper endoscopy were performed. Our previous classification method achieved a frame-based sensitivity of 100.00%, but only a specificity of 89.22%. Our new method achieved a frame-based sensitivity and specificity of 99.90% and 99.97%, a significant improvement. Our system is robust for day-to-day use in medical practice. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. Sensitivity and Specificity of Magnetic Resonance Cholangiopancreatography versus Endoscopic Ultrasonography against Endoscopic Retrograde Cholangiopancreatography in Diagnosing Choledocholithiasis: The Indonesian Experience

    Dadang Makmun

    2017-09-01

    Full Text Available Background/Aims Biliary stone disease is one of the most common conditions leading to hospitalization. In addition to endoscopic retrograde cholangiopancreatography (ERCP, endoscopic ultrasonography (EUS and magnetic resonance cholangiopancreatography (MRCP are required in diagnosing choledocholithiasis. This study aimed to compare the sensitivity and specificity of EUS and MRCP against ERCP in diagnosing choledocholithiasis. Methods This retrospective study was conducted after prospective collection of data involving 62 suspected choledocholithiasis patients who underwent ERCP from June 2013 to August 2014. Patients were divided into two groups. The first group (31 patients underwent EUS and the second group (31 patients underwent MRCP. Then, ERCP was performed in both groups. Sensitivity, specificity, and diagnostic accuracy of EUS and MRCP were determined by comparing them to ERCP, which is the gold standard. Results The male to female ratio was 3:2. The mean ages were 47.25 years in the first group and 52.9 years in the second group. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for EUS were 96%, 57%, 87%, 88%, and 80% respectively, and for MRCP were 81%, 40%, 68%, 74%, and 50%, respectively. Conclusions EUS is a better diagnostic tool than MRCP for diagnosing choledocholithiasis.

  15. Technical specification optimization program - engineered safety features

    Andre, G.R.; Jansen, R.L.

    1986-01-01

    The Westinghouse Technical Specification Program (TOP) was designed to evaluate on a quantitative basis revisions to Nuclear Power Plant Technical Specifications. The revisions are directed at simplifying plant operation, and reducing unnecessary transients, shutdowns, and manpower requirements. In conjunction with the Westinghouse Owners Group, Westinghouse initiated a program to develop a methodology to justify Technical Specification revisions; particularly revisions related to testing and maintenance requirements on plant operation for instrumentation systems. The methodology was originally developed and applied to the reactor trip features of the reactor protection system (RPS). The current study further refined the methodology and applied it to the engineered safety features of the RPS

  16. Segmentation of Clinical Endoscopic Images Based on the Classification of Topological Vector Features

    O. A. Dunaeva

    2013-01-01

    Full Text Available In this work, we describe a prototype of an automatic segmentation system and annotation of endoscopy images. The used algorithm is based on the classification of vectors of the topological features of the original image. We use the image processing scheme which includes image preprocessing, calculation of vector descriptors defined for every point of the source image and the subsequent classification of descriptors. Image preprocessing includes finding and selecting artifacts and equalizating the image brightness. In this work, we give the detailed algorithm of the construction of topological descriptors and the classifier creating procedure based on mutual sharing the AdaBoost scheme and a naive Bayes classifier. In the final section, we show the results of the classification of real endoscopic images.

  17. A standardised protocol for texture feature analysis of endoscopic images in gynaecological cancer

    Pattichis Marios S

    2007-11-01

    Full Text Available Abstract Background In the development of tissue classification methods, classifiers rely on significant differences between texture features extracted from normal and abnormal regions. Yet, significant differences can arise due to variations in the image acquisition method. For endoscopic imaging of the endometrium, we propose a standardized image acquisition protocol to eliminate significant statistical differences due to variations in: (i the distance from the tissue (panoramic vs close up, (ii difference in viewing angles and (iii color correction. Methods We investigate texture feature variability for a variety of targets encountered in clinical endoscopy. All images were captured at clinically optimum illumination and focus using 720 × 576 pixels and 24 bits color for: (i a variety of testing targets from a color palette with a known color distribution, (ii different viewing angles, (iv two different distances from a calf endometrial and from a chicken cavity. Also, human images from the endometrium were captured and analysed. For texture feature analysis, three different sets were considered: (i Statistical Features (SF, (ii Spatial Gray Level Dependence Matrices (SGLDM, and (iii Gray Level Difference Statistics (GLDS. All images were gamma corrected and the extracted texture feature values were compared against the texture feature values extracted from the uncorrected images. Statistical tests were applied to compare images from different viewing conditions so as to determine any significant differences. Results For the proposed acquisition procedure, results indicate that there is no significant difference in texture features between the panoramic and close up views and between angles. For a calibrated target image, gamma correction provided an acquired image that was a significantly better approximation to the original target image. In turn, this implies that the texture features extracted from the corrected images provided for better

  18. Clinical and Endoscopic Features of Gastrointestinal Kaposi Sarcoma: A Single-Center Portuguese Experience over the Last Decade

    Joana Carmo

    2017-04-01

    Full Text Available Background: Kaposi sarcoma (KS is an angioproliferative tumor caused by human herpesvirus 8 (HHV-8. Gastrointestinal (GI involvement by KS is a rare endoscopic finding, scarcely characterized in the literature. Objective: To characterize clinical and endoscopic features of patients with GI KS. Methods: This is a single-center retrospective study of GI KS cases confirmed by immunohistochemistry in the last decade (2006-2015. The following variables were analyzed: demographic data; clinical data (extraintestinal involvement, symptoms, presence and stage of HIV infection, immunosuppressive therapy; endoscopic data; stage-stratified therapeutic approach; and mortality (at 3 and 6 months. Results: Thirteen patients with GI KS were identified: 77% were men, the mean age was 55 years, and 62% of them were Native Africans. In most cases (n = 10, 77%, KS was associated with HIV. A total of 90% of the HIV patients had a CD4+ count of Conclusion: GI KS is mostly found in nontreated, stage 3, HIV patients, and particularly in men from areas where HHV-8 is endemic. Involvement of the upper digestive tract is often asymptomatic. The endoscopic appearance is variable and these patients have a poor prognosis.

  19. Clinical, endoscopic and manometric features of the primary motor disorders of the esophagus.

    Martinez, Júlio César; Lima, Gustavo Rosa de Almeida; Silva, Diego Henrique; Duarte, Alexandre Ferreira; Novo, Neil Ferreira; da Silva, Ernesto Carlos; Pinto, Pérsio Campos Correia; Maia, Alexandre Moreira

    2015-01-01

    Significant incidence, diagnostic difficulties, clinical relevance and therapeutic efficacy associated with the small number of publications on the primary esophageal motor disorders, motivated the present study. To determine the manometric prevalence of these disorders and correlate them to the endoscopic and clinical findings. A retrospective study of 2614 patients, being 1529 (58.49%) women and 1085 (41.51%) men. From 299 manometric examinations diagnosed with primary esophageal motor disorder, were sought-clinical data (heartburn, regurgitation, dysphagia, odynophagia, non-cardiac chest pain, pharyngeal globe and extra-esophageal symptoms) and/or endoscopic (hiatal hernia, erosive esophagitis, food waste) that motivated the performance of manometry. Were found 49 cases of achalasia, 73 diffuse spasm, 89 nutcracker esophagus, 82 ineffective esophageal motility, and six lower esophageal sphincter hypertension. In relation to the correlations, it was observed that in 119 patients clinical conditions were associated with dysphagia, found in achalasia more than in other conditions; in relationship between endoscopic findings and clinical conditions there was no statistical significance between data. The clinical and endoscopic findings have little value in the characterization of the primary motor disorders of the esophagus, showing even more the need for manometry, particularly in the preoperative period of gastroesophageal reflux disease.

  20. Clinical, Endoscopic, and Radiologic Features of Three Subtypes of Achalasia, Classified Using High-Resolution Manometry

    Khan, Mohammed Q.; AlQaraawi, Abdullah; Al-Sohaibani, Fahad; Al-Kahtani, Khalid; Al-Ashgar, Hamad I.

    2015-01-01

    Background/Aims: High-resolution manometry (HRM) has improved the accuracy of manometry in detecting achalasia and determining its subtypes. However, the correlation of achalasia subtypes with clinical, endoscopic, and radiologic findings has not been assessed. We aimed to evaluate and compare the clinical, endoscopic, and fluoroscopy findings associated with three subtypes of achalasia using HRM. Patients and Methods: The retrospective clinical data, HRM, endoscopy, and radiologic findings were obtained from the medical records of untreated achalasia patients. Results: From 2011 to 2013, 374 patients underwent HRM. Fifty-two patients (14%) were diagnosed with achalasia, but only 32 (8.5%) of these patients had not received treatment and were therefore included in this study. The endoscopy results were normal in 28% of the patients, and a barium swallow was inconclusive in 31% of the achalasia patients. Ten patients (31%) were classified as having type I achalasia, 17 (53%) were classified as type II, and 5 (16%) were classified as type III. Among the three subtypes, type I patients were on average the youngest and had the longest history of dysphagia, mildest chest pain, most significant weight loss, and most dilated esophagus with residual food. Chest pain was most common in type III patients, and frequently had normal fluoroscopic and endoscopic results. Conclusion: The clinical, radiologic, and endoscopic findings were not significantly different between patients with type I and type II untreated achalasia. Type III patients had the most severe symptoms and were the most difficult to diagnose based on varied clinical, radiologic, and endoscopic findings. PMID:26021774

  1. Regression of gastric malt-lymphoma under specific therapy may be predict by endoscopic ultrasound.

    Gheorghe, Cristian; Băncilă, Ion; Stoia, Răzvan; Gheorghe, Liana; Becheanu, Gabriel; Dobre, Camelia; Brescan, Raluca

    2004-06-01

    Mucosa-associated lymphoid tissue (MALT) lymphomas represent a relatively new described class of rare lymphomas, characterized by an indolent course and favourable outcome with specific therapy. Gastric MALT lymphomas are associated with chronic Helicobacter pylori (HP) infection. We report the case of a 67 year old man admitted for an 8-month history of epigastric pain, anorexia and progressive weight loss. He was diagnosed with low-grade primary gastric MALT lymphoma by endoscopy, histopathological examination of gastric mucosa (light microscopy and immunohistochemistry) and endoscopic ultrasonography (EUS). The patient received a 2-week course of anti-HP therapy and chemotherapy with Chlorambucil 0.1 mg/kg/day was started. During the follow-up, continuous improvement of clinical status, endoscopic and EUS appearance was noted. We conclude that, facing the trend toward nonsurgical treatment modalities for primary gastric lymphoma, EUS appears an important tool for staging the disease and defining cases suitable for anti-HP, radio- and chemotherapy, as well as for the detection of local recurrence.

  2. CLINICAL, ENDOSCOPIC AND MANOMETRIC FEATURES OF THE PRIMARY MOTOR DISORDERS OF THE ESOPHAGUS

    MARTINEZ, J?lio C?sar; LIMA, Gustavo Rosa de Almeida; SILVA, Diego Henrique; DUARTE, Alexandre Ferreira; NOVO, Neil Ferreira; da SILVA, Ernesto Carlos; PINTO, P?rsio Campos Correia; MAIA, Alexandre Moreira

    2015-01-01

    BACKGROUND: Significant incidence, diagnostic difficulties, clinical relevance and therapeutic efficacy associated with the small number of publications on the primary esophageal motor disorders, motivated the present study. AIM: To determine the manometric prevalence of these disorders and correlate them to the endoscopic and clinical findings. METHODS: A retrospective study of 2614 patients, being 1529 (58.49%) women and 1085 (41.51%) men. From 299 manometric examinations diagnosed with pri...

  3. Correlation of High-Resolution Manometric Findings with Symptoms of Dysphagia and Endoscopic Features in Adults with Eosinophilic Esophagitis.

    von Arnim, Ulrike; Kandulski, Arne; Weigt, Jochen; Malfertheiner, Peter

    2017-01-01

    Eosinophilic esophagitis (EoE) presents with dysphagia, but data about motility patterns using high-resolution manometry (HRM) are rare. We aimed at evaluating esophageal motility patterns in EoE and their correlation to endoscopic and dysphagia scores. Twenty-six EoE patients and 23 controls were included after 4 weeks of treatment with proton pump inhibitors. Dysphagia and endoscopic scores were evaluated before performing HRM. EoE patients were classified to have fibrostenotic (FS) or inflammatory (IF) type. HRM analysis was performed according to the Chicago classification (CC) system. According to the CC, the HRM findings in EoE and controls were normal in 11 (42%) and 20 (88.5%), p dysphagia scores in EoE subtypes. HRM findings in EoE are often diagnostic, but they are non-specific and do not correlate with the severity of dysphagia or endoscopic appearance. The clinical impact of HRM in EoE needs further evaluation. © 2017 S. Karger AG, Basel.

  4. Specific Features in Accessing European Funding

    Elena Alexandra CĂLDĂRARU

    2011-12-01

    Full Text Available Abstract: European Funds are the European Union financial instruments in order to assist Member States in reducing the existing disparities between regions and between countries, and for harmonization with the economic, social and cultural European standards. This paper intends to present some general characteristics applicable to the most important financing programs, and also to outline certain features of the main financing lines, referring to investment projects development and their implementation, based on the Applicant Guides analysis. The paper treats institutional, legal, financial, technical, social and environmental aspects and outlines proposals and recommendations to achieve a better EU funds absorption and also a higher success rate of initiated projects. In knowledge-based economy circumstances, training consultancy specialists, that represent the intellectual capital in this area, will ensure the professional management of the developing process, submission and ongoing competitive projects, and will help enhance the funds absorption at national level. Thus, the European support for investments in ensuring sustainable growth will help overcoming the difficulties encountered by our country, and will sustain the Romanian economy recovery.

  5. Genomic features of human limb specific enhancers.

    Ali, Shahid; Amina, Bibi; Anwar, Saneela; Minhas, Rashid; Parveen, Nazia; Nawaz, Uzma; Azam, Syed Sikandar; Abbasi, Amir Ali

    2016-10-01

    To elucidate important cellular and molecular interactions that regulate patterning and skeletal development, vertebrate limbs served as a model organ. A growing body of evidence from detailed studies on a subset of limb regulators like the HOXD cluster or SHH, reveals the importance of enhancers in limb related developmental and disease processes. Exploiting the recent genome-wide availability of functionally confirmed enhancer dataset, this study establishes regulatory interactions for dozens of human limb developmental genes. From these data, it appears that the long-range regulatory interactions are fairly common during limb development. This observation highlights the significance of chromosomal breaks/translocations in human limb deformities. Transcriptional factor (TF) analysis predicts that the differentiation of early nascent limb-bud into future territories entail distinct TF interaction networks. Conclusively, an important motivation for annotating the human limb specific regulatory networks is to pave way for the systematic exploration of their role in disease and evolution. Copyright © 2016. Published by Elsevier Inc.

  6. Oily skin: specific features in Chinese women.

    Nouveau-Richard, S; Zhu, W; Li, Y H; Zhang, Y Z; Yang, F Z; Yang, Z L; Lian, S; Qian, B Y; Ran, Y P; Bouillon, C; Chen, H D; de Lacharrière, O

    2007-02-01

    Inconsistent data are available on the various types of skin, their prevalence and characterization, particularly regarding Asian skins. This observation prompted to conduct a large study in China to assess the prevalence of oily skin and identify the specific factors related to that type of skin. The multicentre trial involved 1787 Chinese women in Shenyang, Harbin, Beijing, Chengdu and Suzhou, between 18 and 65 years of age. Data on history of acne, the presence of environmental factors and a detailed self-evaluation of the skin were collected using a standardized questionnaire. A clinical evaluation of facial skin oiliness was carried-out by a dermatologist at each centre. Sebum secretion was measured on the forehead using Sebumeter SM810. Statistical analysis (multiple correspondence analysis) of typology was conducted based on self-evaluation data. According to self-evaluation data, oily skin prevalence in the overall Chinese population of the study was 25.6%. Self-evaluation results were quite consistent with sebum measurements and with clinical assessment by dermatologist. Parameters associated with oily skin were (i) shiny skin and a past history of acne, (ii) irregular menstruation, and (iii) highly reactive or sensitive skin. Moreover, a clear and significant link was noted between oily skin and the ingestion of spicy or sweet food. Lastly, sebum levels were found to be twice as high in Beijing as in the other cities and were correlated to higher oily skin prevalence. The study demonstrated the capacity of women for proper self-evaluation of their skin type. It also suggests a potential link between nutritional factors such as spicy and/or sweet diets and oily skin as well as between sensitive and oily skin in this population.

  7. [Clinical and endoscopic features of a selected population with serrated colorectal adenomas in a private clinic in Lima - Peru].

    Castillo, Ofelia; Barreda, Carlos; Recavarren, Sixto; Barriga, José A; Salazar M, Fernando; Yriberry, Simón; Barriga, Eduardo; Salazar C, Fernando

    2013-01-01

    To describe the clinical and endoscopic caracteristics of a population that has only serrated polyps of colon (mainly sessile serrated adenomas) in a private clinic in Lima, Perú, from 2009-2011. Retrospective study conducted at the endoscopy center of Clinic Ricardo Palma, Lima, Peru. Olympus colonoscope was used with high definition, including NBI (narrow band imaging) and electronic magnification. Patients had pathologic diagnosis of “polyps and / or colorectal serrated adenomas” and excluded those with synchronous tubular or villous adenomas. Images were evaluated by two endoscopists and then by a third gastroenterologist. We found 201 serrated polyps in 108 patients. Women were 60.2% and overweight predominated. Eighty (74.1%) had only one serrated adenoma and 23 (21.3%) with at least one synchronous hyperplastic polyp. The average size of sessile serrated adenomas was 5.12 mm (± 3.87 DS) and the flat type was 91 (58.7%). There were significant differences in the diameter of sessile serrated adenomas between the distal and proximal colon (4.47 mm ± 2.23 vs. 6.90 mm ± 6.25; p<0.000). The common features of sessile serrated adenomas were: White (31/36, 86.1%), smooth (28/36, 77.8%) and regular margins (26/36, 72.2%). There was a relationship between vascular pattern according NBI and serrated polyp histology (p=0.024). The endoscopic features of sessile serrated adenomas can evade detection to white light. NBI is a useful tool to define some features of these lesions.

  8. Clinical features and outcomes of delayed perforation after endoscopic submucosal dissection for early gastric cancer.

    Hanaoka, N; Uedo, N; Ishihara, R; Higashino, K; Takeuchi, Y; Inoue, T; Chatani, R; Hanafusa, M; Tsujii, Y; Kanzaki, H; Kawada, N; Iishi, H; Tatsuta, M; Tomita, Y; Miyashiro, I; Yano, M

    2010-12-01

    Perforation is a major complication of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). However, there have been no reports on delayed perforation after ESD for EGC. We aimed to elucidate the incidence and outcomes of delayed perforation after ESD. Clinical courses in 1159 consecutive patients with 1329 EGCs who underwent ESD were investigated. Delayed perforation occurred in six patients (0.45 %). All these patients had complete en bloc resection without intraoperative perforation during ESD. Five of six perforations were located in the upper third of the stomach, while one lesion was found in the middle third. Symptoms of peritoneal irritation with rebound tenderness presented within 24 h after ESD in all cases. One patient did not require surgery because the symptoms were localized, and recovered with conservative antibiotic therapy by nasogastric tube placement. The remaining five patients required emergency surgery. There was no mortality in this case series. © Georg Thieme Verlag KG Stuttgart · New York.

  9. H. Pylori Positivity and Various Pathological, Endoscopic and Clinical Features Correlated with Each Other

    Coskun, A.; Yukselen, V.; Yasa, M. H.; Karaoglu, A. O.; Meteoglu, I.; Ergin, F.; Kadikoylu, G.

    2015-01-01

    Objective: To investigate the relationship between dyspepsia symptom scores and endoscopic appearances, and histopathological findings and helicobacter pylori positivity in patients having dyspepsia symptom. Methods: The study was conducted at the gastroenterology outpatient clinic of Adnan Menderes University, School of Medicine, Aydin, Turkey from April 2012 to July 2012 and comprised patients between 18-65 years of age who were admitted with dyspepsia. Glasgow dyspepsia severity scoring was done with questions posed orally to the patients. In histopathological evaluation of biopsy specimens according to Sydney criteria, chronic inflammation, activity, atrophy, intestinal metaplasia and helicobacter pylori parameters were used. Total number of eosinophils and number of mast cells were recorded. Results: Of the 60 patients with dyspepsia, 38(63.3 percent) were female and 22(36.7 percent) were male. The degree of activation and severity of inflammation increased significantly with increasing helicobacter pylori positivity(r=0.459'p<0.0001; r=0.475'p<0.0001). A significant relationship was found between inflammation, activation and the number of mast cells (p<0.05).There was no relationship between helicobacter pylori intensity and the eosinophil count (r=0.171; p=0.093). There was also a statistically significant correlation between severity of inflammation and activation and the number of eosinophils (r=0.313;p=0.002;r=0.245;p=0.016). Conclusion: Mast cell density was seen to have a role in the inflammatory processes of helicobacter pylori infection. (author)

  10. Features of electrocoagulation syndrome after endoscopic submucosal dissection for colorectal neoplasm.

    Yamashina, Takeshi; Takeuchi, Yoji; Uedo, Noriya; Hamada, Kenta; Aoi, Kenji; Yamasaki, Yasushi; Matsuura, Noriko; Kanesaka, Takashi; Akasaka, Tomofumi; Yamamoto, Sachiko; Hanaoka, Noboru; Higashino, Koji; Ishihara, Ryu; Iishi, Hiroyasu

    2016-03-01

    Endoscopic submucosal dissection (ESD) is a promising treatment for large gastrointestinal superficial neoplasms, although it is technically difficult, and perforation and delayed bleeding are well-known adverse events. However, there have been no large studies about electrocoagulation syndrome after colorectal ESD. The aim of this study was to evaluate the incidence and clinical significant risk factors of post-ESD coagulation syndrome (PECS). This was a retrospective cohort study conducted in a referral cancer center. A total of 336 patients with colorectal neoplasms (143 adenomas or serrated lesions and 193 carcinomas) underwent ESD from January 2011 to June 2013. Incidence, outcome, and factors associated with occurrence of PECS were investigated. Occurred in 32 patients (9.5%). The median time until PECS was 15.5 h, and the median period of PECS was 32.5 h. Fever (≥37.6 °C) after ESD was found in 41% of the PECS group and 9% of the non-PECS group (P < 0.001). All PECS cases were managed conservatively. On multivariate analysis, female patients (odds ratio [OR] = 3.2, P = 0.002), lesion location at ascending colon and cecum (OR = 3.5, P = 0.001), and resected specimen ≥40 mm (OR = 2.1, P = 0.05) were independent risk factors for PECS. Occurred in 32 patients (9.5%) with colorectal ESD; however, all cases had a good outcome with conservative management. Female sex, tumor location at the ascending colon and cecum, and resected specimen ≥40 mm were independently significant risk factors for PECS. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  11. Frequency of portal hypertensive gastropathy and its relationship with biochemical, haematological and endoscopic features in cirrhosis

    Abbasi, A.; Bhutto, A.R.; Butt, N.; Munir, S.M.; Dhilo, A.K.

    2011-01-01

    Objective: To determine the frequency of portal hypertensive gastropathy (PHG) and its relation with biochemical, haematological and endoscopic findings in cirrhotic patients. Study Design: Cross-sectional analytical study. Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, Ward-7, from June 2009 to December 2010. Methodology: Patients with diagnosis of cirrhosis and either undergoing screening upper gastrointestinal (GI) endoscopy or presented with acute upper GI bleeding were included in the study. Portal hypertensive gastropathy and oesophageal varices were classified using Baveno scoring system. The severity of cirrhosis was classified according to the Child-Pugh criteria. Hypersplenism was assessed by the reduction of haemoglobin, leucocytes and platelets. Results: Out of 217 patients, 148 were males (68.2%) and 69 were females (31.8%) with ages ranging from 15-85 years, (mean 48.06 years). There were 144 HCV +ve patients (66.4%), 36 HBV +ve patients (16.6%), 15 HCV/HBV co-infected patients (6.9%) and only 1 (0.5%) had co-infection of HBV/HDV. Twenty-one patients (9.7%) were classified as having cryptogenic cirrhosis. Out of 172 patients (79.27%), 56 patients (25.8%) had mild and 116 patients (53.5%) were suffering from severe PHG. Significant positive correlation was found between esophageal variceal grade and PHG (r=0.46, p < 0.001) but not with etiology (r=0.05, p=0.41) or hypersplenism (r=0.08, p=0.22). Conclusion: The frequency of PHG was 79.27% in the studied group. The grade of oesophageal varices had significant relation with PHG that is the severity of PHG increased with the grade of oesophageal varices, suggesting common pathophysiology of both entities. (author)

  12. The Correlation of Endoscopic Findings and Clinical Features in Korean Patients with Scrub Typhus: A Cohort Study.

    Lee, Jun; Kim, Dong-Min; Yun, Na Ra; Kim, Young Dae; Park, Chan Guk; Kim, Man Woo

    2016-01-01

    Scrub typhus is an infectious disease caused by Orientia tsutsugamushi-induced systemic vasculitis, but the involvement of the gastrointestinal tract and the endoscopic findings associated with scrub typhus are not well understood. We performed a prospective study and recommend performing esophagogastroduodenoscopy (EGD) for all possible scrub typhus patients, regardless of gastrointestinal symptoms. Gastrointestinal symptoms, endoscopic findings and clinical severity based on organ involvement and ICU admission were analyzed. Gastrointestinal symptoms occurred in up to 76.4% of scrub typhus patients. The major endoscopic findings were ulcers (43/127, 33.9%). Interestingly, 7.1% (9/127) of the patients presented with esophageal candidiasis. There was no correlation between the presence or absence of gastrointestinal symptoms and the endoscopic grade (P = 0.995). However, there was a positive correlation between the clinical severity and the endoscopic findings (P = 0.001). Sixty-three percent of the patients presented with erosion or ulcers on prospectively performed endoscopic evaluations, irrespective of gastrointestinal symptoms. Gastrointestinal symptoms did not reflect the need for endoscopy. Scrub typhus patients could have significant endoscopic abnormalities even in the absence of gastrointestinal symptoms.

  13. Histological and endoscopic features of the stomachs of patients with Chagas disease in the era of Helicobacter pylori

    Fernanda Machado Fonseca

    2014-12-01

    Full Text Available Introduction Most studies that have evaluated the stomachs of patients with Chagas disease were performed before the discovery of Helicobacter pylori and used no control groups. This study compared the gastric features of chagasic and non-chagasic patients and assessed whether gastritis could be associated with Chagas disease. Methods Gastric biopsy samples were taken from patients who underwent endoscopy for histological analysis according to the Updated Sydney System. H. pylori infection was assessed by histology, 16S ribosomal ribonucleic acid (rRNA polymerase chain reaction (PCR, serology and the 13C-urea breath test. Patients were considered H. pylori-negative when all of these diagnostic tests were negative. Clinical and socio-demographic data were obtained by reviewing medical records and using a questionnaire. Results The prevalence of H. pylori infection (70.3% versus 71.7% and chronic gastritis (92.2% versus 85% was similar in the chagasic and non-chagasic groups, respectively; such as peptic ulcer, atrophy and intestinal metaplasia. Gastritis was associated with H. pylori infection independent of Chagas disease in a log-binomial regression model. However, the chagasic H. pylori-negative patients showed a significantly higher grade of mononuclear (in the corpus and polymorphonuclear (PMN (in the antrum cell infiltration. Additionally, the patients with the digestive form of Chagas disease showed a significantly lower prevalence of corpus atrophy than those with other clinical forms. Conclusions The prevalence of H. pylori infection and of gastric histological and endoscopic features was similar among the chagasic and non-chagasic patients. Additionally, this is the first controlled study to demonstrate that H. pylori is the major cause of gastritis in patients with Chagas disease.

  14. Gastrointestinal Diagnosis of Classical Whipple Disease: Clinical, Endoscopic, and Histopathologic Features in 191 Patients

    Günther, Ute; Moos, Verena; Offenmüller, Gabriel; Oelkers, Gerrit; Heise, Walther; Moter, Annette; Loddenkemper, Christoph; Schneider, Thomas

    2015-01-01

    Abstract Classic Whipple disease (CWD) is a systemic infection caused by Tropheryma whipplei. Different diagnostic tools have been developed over the last decades: periodic acid-Schiff (PAS) staining, T whipplei-specific polymerase chain reaction (PCR), and T whipplei-specific immunohistochemistry (IHC). Despite all these advances, CWD is still difficult to diagnose because of a variety of clinical symptoms and possibly a long time span between first unspecific symptoms and the full-blown clinical picture of the disease. Herein, we report an observational cohort study summarizing epidemiologic data, clinical manifestations, and diagnostic parameters of 191 patients with CWD collected at our institution. Gastrointestinal manifestations are the most characteristic symptoms of CWD affecting 76% of the cohort. Although the small bowel was macroscopically conspicuous in only 27% of cases, 173 (91%) patients presented with characteristic histological changes in small bowel biopsies (in 2 patients, these changes were only seen within the ileum). However, 18 patients displayed normal small bowel histology without typical PAS staining. In 9 of these patients, alternative test were positive from their duodenal specimens (ie, T whipplei-specific PCR and/or IHC). Thus, in 182 patients (95%) a diagnostic hint toward CWD was obtained from small bowel biopsies. Only 9 patients (5%) were diagnosed solely based on positive T whipplei-specific PCR and/or IHC of extraintestinal fluids (eg, cerebrospinal fluid, synovial fluid) or extraintestinal tissue (eg, lymph node, synovial tissue), respectively. Thus, despite efforts to diagnose CWD from alternative specimens, gastroscopy with duodenal biopsy and subsequent histological and molecular–biological examination is the most reliable diagnostic tool for CWD. PMID:25881849

  15. Ethnocultural features of a linguistic persona: the specifics of the ...

    Ethnocultural features of a linguistic persona: the specifics of the representation of universal emotional concepts. ... The paper pays special attention to the ethnocultural content of emotional and lexical units, which indicate the ethnic identity of a linguistic persona and reflect typical, historically developed signs of the ethnic ...

  16. Specific features of auxiliary water supply at underground NPPs

    Pergamenshchik, B.K.; Pavlov, A.S.

    1991-01-01

    Specific features of auxiliary water supply systems for underground NPPs related to peculiarities of NPP basis equipment arrangement, are considered. Circulation water supply scheme, in which water cooling storage basin (cooling towers) with operational area corresponding to NPP power is on the surface and has traditional design, is proposed. Sufficiently high efficiency of the arrangement proposed is proved

  17. Automatic selective feature retention in patient specific elastic surface registration

    Jansen van Rensburg, GJ

    2011-01-01

    Full Text Available The accuracy with which a recent elastic surface registration algorithm deforms the complex geometry of a skull is examined. This algorithm is then coupled to a line based algorithm as is frequently used in patient specific feature registration...

  18. The Endoscopic Morphological Features of Congenital Posterior Urethral Obstructions in Boys with Refractory Daytime Urinary Incontinence and Nocturnal Enuresis.

    Nakamura, Shigeru; Hyuga, Taiju; Kawai, Shina; Kubo, Taro; Nakai, Hideo

    2016-08-01

    Purpose This study aims to evaluate the endoscopic morphological features of congenital posterior urethral obstructions in boys with refractory daytime urinary incontinence and/or nocturnal enuresis. Patients and Methods A total of 54 consecutive patients underwent endoscopy and were diagnosed with a posterior urethral valve (PUV) (types 1-4). PUV type 1 was classified as severe, moderate, or mild. A transurethral incision (TUI) was mainly performed for anterior wall lesions of the PUV. Voiding cystourethrography and pressure flow studies (PFS) were performed before and 3 to 4 months after TUI. Clinical symptoms were evaluated 6 months after TUI, and outcomes were assessed according to PFS waveform pattern groups (synergic pattern [SP] and dyssynergic pattern [DP]). Results All patients had PUV type 1 and/or 3 (i.e., n = 34 type 1, 7 type 3, and 13 types 1 and 3). There were severe (n = 1), moderate (n = 21), and mild (n = 25) cases of PUV type 1. According to PFS, SP and DP were present in 43 and 11 patients, respectively. TUI was effective in the SP group and symptoms improved in 77.4 and 69.3% of patients with daytime incontinence and nocturnal enuresis, respectively. Almost no effect was observed in the DP group. A significant decrease in the detrusor pressure was observed at maximum flow rate using PFS in the SP group. Conclusions PUV type 1 encompassed lesions with a spectrum of obstructions ranging from severe to mild, with mild types whose main obstructive lesion existed at the anterior wall of urethra occurring most frequently in boys with refractory daytime urinary incontinence and/or nocturnal enuresis. Georg Thieme Verlag KG Stuttgart · New York.

  19. Specific features of physical development in extremely premature infants

    G. A. Alyamovskaya

    2015-01-01

    Full Text Available The literature review deals with the specilic features of physical development in extremely premature infants weighing less than 1500 g at birth. It describes the regularities of an increment in basic physical development parameters (weight, height, and head circumference within the first year of life. Genetic factors, the specific features of a neonatal period, comorbidity, and different feeding types are shown to affect the increment rates of the physical development parameters. Emphasis is placed on the early initiation of enteral feeding and on the long-term use of fortified foods in low birthweight premature babies for the correction of energy deficiency resulting from preterm birth. The review shows that there is a relationship of the long-term outcomes of physical and psychomotor developments in low birthweight premature babies.

  20. The "suprasellar notch," or the tuberculum sellae as seen from below: definition, features, and clinical implications from an endoscopic endonasal perspective.

    de Notaris, Matteo; Solari, Domenico; Cavallo, Luigi M; D'Enza, Alfonso Iodice; Enseñat, Joaquim; Berenguer, Joan; Ferrer, Enrique; Prats-Galino, Alberto; Cappabianca, Paolo

    2012-03-01

    The tuberculum sellae is a bony elevation ridge that lines up the anterior aspect of the sella, dividing it from the chiasmatic groove. The recent use of the endoscopic endonasal transtuberculum approach has provided surgeons with a method to reach the suprasellar area, offering a new surgical point of view somehow "opposite" of this area. The authors of this study aimed to define the tuberculum sellae as seen from the endoscopic endonasal view while also providing CT-based systematic measurements to objectively detail the anatomical features of such a structure, which was renamed the "suprasellar notch." The authors analyzed routine skull CT scans from 24 patients with no brain pathology or fractures and measured the interoptic distance at the level of the limbus sphenoidale, the chiasmatic groove sulcal length and width, and the angle of the suprasellar notch. Indeed, the suprasellar notch was defined as the angle between 2 lines, the first passing through the tuberculum sellae midpoint and perpendicular to the cribriform plate, and a second line passing between 2 points, the midpoints of the limbus sphenoidale and the tuberculum sellae. Moreover, the authors performed on 15 cadaveric heads an endoscopic endonasal transplanum transtuberculum approach with the aid of a neuronavigator to achieve a step-by-step comparison with the radiological data. The whole CT scanning set was statistically analyzed to determine the statistical interdependency of the suprasellar notch angle with the other 3 measurements, that is, the sulcal length at the midline, the interoptic distance at the optic canal entrance, and the interoptic distance at the limbus. Based on the endoscopic endonasal view and CT imaging analysis, the authors identified a certain anatomical variability and thus introduced a new classification of the suprasellar notch: Type I, angle 138°. They then analyzed the surgical implications of the endoscopic endonasal approach to the suprasellar area, which could be

  1. A prospective study of endoscopic ultrasonography features, cyst fluid carcinoembryonic antigen, and fluid cytology for the differentiation of small pancreatic cystic neoplasms.

    Wang, Ying; Chai, Ningli; Feng, Jia; Linghu, Enqiang

    2017-08-24

    With improvements in imaging technologies, pancreatic cystic lesions (PCLs) have been increasingly identified in recent years. However, the imaging modalities used to differentiate the categories of pancreatic cysts remain limited, which may cause confusion when planning treatment. Due to progress in endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) technology, auxiliary diagnosis by the detection of cystic fluid has become a recent trend. From March 2015 to April 2016, 120 patients with PCLs were enrolled in this study. According to the results of EUS, cyst fluid carcinoembryonic antigen (CEA) analysis, and cystic fluid cytology, the patients were divided into two groups: a nonmucinous and a mucinous group. Of those, 61 patients who had undergone surgical resection were included in the analysis. The clinical features, biochemical and tumor markers of cyst fluid as well as the cytological test results of the patients were compared with histopathology results. A cyst size of 4.0 cm was used as the boundary value; a cyst ≤4.0 cm was defined as a small PCL. 87 (72.5%) lesions were ≤4.0 cm, and 33 (27.5%) lesions were >4.0 cm. Regarding the analysis of CEA and carbohydrate antigens 19-9 (CA19-9), significant differences were found between the nonmucinous and mucinous groups (P < 0.05) according to nonparametric independent samples tests. The EUS, cystic fluid CEA, and cystic fluid cytology results were compared with the tissue pathology findings using McNemar's test (P < 0.05) and showed a sensitivity of 90% and a specificity of 84%. A diagnostic combination of EUS, cyst fluid CEA, and cystic fluid cytology could be used to differentiate small pancreatic cystic neoplasms. Cystic fluid cytology analysis is helpful for planning treatment for pancreatic cystic tumors that pose a surgical risk.

  2. [Specific features of gastroesophageal reflux disease associated with obesity and overweight].

    Livzan, M A; Lapteva, I V; Krolevets, T S; Kiselev, I E

    2016-01-01

    To reveal the specific features of gastroesophageal reflux disease (GERD) associated with obesity and overweight, by investigating the clinical and endoscopic manifestations of the disease, 24-hour pH-metry scores, and leptin levels. A total of 131 patients with GERD were examined. The data about complaints and those from life and medical histories were collected; anthropometric measurements and the results of blood biochemical tests, esophagoduodenoscopy (EPDS), and pH-metry were assessed; and the serum levels of leptin and its receptor were estimated. The patients were allocated into a study group (104 obese and/or overweight patients) and a comparison one (27 normal weight people). Waist circumference, hip circumference, and blood glucose levels proved to be statistically significantly higher in the study group (pstudy group and 5.47 (3.35-7.68) ng/ml in the comparison group; the median levels of the receptors were 18.83 (14.98-25.11) ng/ml and 30.93 (24.68-33.53) ng/ml, respectively). This group showed a moderate negative correlation between these indicators (rs=-0.451; pstudy group displayed higher pH values in the gastric cardia and body (prefluxate having with a low pH value (refluxate having a pH below 4.0 (rs=0.543; preflux episodes longer than 5 minutes in the esophagus, and to the De Meester index for this indicator (rs=0.471; pdisease, which determines the specific features of the disease (alkaline or mixed refluxate) and the need for individualized therapy.

  3. [The specific microbiological and clinical features of acute otitis media].

    Gurov, A V; Levina, Yu V; Guseva, A L; Elchueva, Z G; Efimova, S P; Gordienko, M V

    The objective of the present study was to elucidate the specific features of the clinical course of acute otitis media as well as the peculiarities of the vestibular function and the microbial paysage associated with this pathological condition under the present-day conditions. The study included 135 patients presenting with acute otitis media (AOM) at different stages of the disease. The discharge obtained from the tympanic cavity of all the patients was examined with the use of polymerase chain reaction in real time, audiological and vestibulogical methods. The distinctive features of acute otitis medium associated with Streptococcus pneumoniae infection were found to be the intense pain syndrome with the symptoms of intoxication, well apparent inflammatory changes in the tympanic membrane as revealed by otoscopy, the increased frequency of sensorineural impairment of hearing, and the characteristic type B tympanometric curve. Typical of AOM associated with Haemophilus influenza infection are the mild pain syndrome, weak changes in the tympanic membrane as revealed by otoscopy, conductive hearing loss, and the type C tympanometric curve.

  4. SPECIFIC FEATURES OF DEVELOPMENT OF ORGANIC PRODUCTS MARKET IN UKRAINE

    T. Kharchenko

    2013-08-01

    Full Text Available The article is dedicated to the development of new and improvement of existing theoretical and methodological basis of forming and developing the market of organic products, its correspondence to the present-day situation, determination of problems and ways of their solving, introduction in practical activity of Ukrainian enterprises. The main objective of the article is to determine the specific features of forming and developing organic products market in Ukraine, and the perspective directions of its development based on analysis and practice of functioning of such markets in the world. The environmentally sound products market in the world is being analyzed, some information on the countries with the most commodity turnover of organic products, structure of international market of organic products, volumes of sales of organic products in the European countries is provided. As a result of studying the modern trends of economic development the authors reach a conclusion on problems of standard introduction, investigate the European norms and requirements for organic products. The conducted research allows distinguishing the basic features of Ukrainian market of organic products: it quickly grows, which makes it especially appealing for the participants of market relations, however entry into this market requires considerable capital investments and is characterized by high risk; criteria for qualifying products as environmentally sound products are unstructured and unclear. The potential for growth of organic products market in Ukraine is examined.

  5. Specific features of goal setting in road traffic safety

    Kolesov, V. I.; Danilov, O. F.; Petrov, A. I.

    2017-10-01

    Road traffic safety (RTS) management is inherently a branch of cybernetics and therefore requires clear formalization of the task. The paper aims at identification of the specific features of goal setting in RTS management under the system approach. The paper presents the results of cybernetic modeling of the cause-to-effect mechanism of a road traffic accident (RTA); in here, the mechanism itself is viewed as a complex system. A designed management goal function is focused on minimizing the difficulty in achieving the target goal. Optimization of the target goal has been performed using the Lagrange principle. The created working algorithms have passed the soft testing. The key role of the obtained solution in the tactical and strategic RTS management is considered. The dynamics of the management effectiveness indicator has been analyzed based on the ten-year statistics for Russia.

  6. Feature-specific encoding flexibility in visual working memory.

    Aki Kondo

    Full Text Available The current study examined selective encoding in visual working memory by systematically investigating interference from task-irrelevant features. The stimuli were objects defined by three features (color, shape, and location, and during a delay period, any of the features could switch between two objects. Additionally, single- and whole-probe trials were randomized within experimental blocks to investigate effects of memory retrieval. A series of relevant-feature switch detection tasks, where one feature was task-irrelevant, showed that interference from the task-irrelevant feature was only observed in the color-shape task, suggesting that color and shape information could be successfully filtered out, but location information could not, even when location was a task-irrelevant feature. Therefore, although location information is added to object representations independent of task demands in a relatively automatic manner, other features (e.g., color, shape can be flexibly added to object representations.

  7. Feature-specific encoding flexibility in visual working memory.

    Kondo, Aki; Saiki, Jun

    2012-01-01

    The current study examined selective encoding in visual working memory by systematically investigating interference from task-irrelevant features. The stimuli were objects defined by three features (color, shape, and location), and during a delay period, any of the features could switch between two objects. Additionally, single- and whole-probe trials were randomized within experimental blocks to investigate effects of memory retrieval. A series of relevant-feature switch detection tasks, where one feature was task-irrelevant, showed that interference from the task-irrelevant feature was only observed in the color-shape task, suggesting that color and shape information could be successfully filtered out, but location information could not, even when location was a task-irrelevant feature. Therefore, although location information is added to object representations independent of task demands in a relatively automatic manner, other features (e.g., color, shape) can be flexibly added to object representations.

  8. SPECIFIC FEATURES OF ANESTHESIA IN PATIENTS WITH MYASTHENIA GRAVIS.

    Spasojevic, Ivana; Hajdukovic, Danica; Komarcevic, Milena; Petrovic, Stanislava; Jovanovic, Jelena; Ciric, Aleksandra

    2016-09-01

    Myasthenia gravis is an autoimmune disease caused by antibodies leading to the destruction of nicotinic acetylcholine receptors on the neuromuscular junction. It is characterized by muscle weakness that gets aggravated with physical activity and improves at rest. Myasthenia Gravis Foundation of America made the clinical classification of Myasthenia gravis which is still in use today. "Tensilon test" is still the gold standard for the diagnosis of Myasthenia gravis. In addition to this test repeated muscular stimulation can be used as well as the analysis of specific autoantibodies. Treatment of Myasthenia Gravis. In conservative treatment of Mysthenia gravis anticholinesterases, immunosuppressants and plasmapheresis can be used. If conservative treatment does not lead to the desired remission, surgical treatment is indicated. The most accepted indication for thymectomy is the presence of thymoma with generalized form of Myasthenia gravis in adults. How to Distinguish Myasthenic From Cholinergic Crisis.'The following is important to make a difference between these two crises: knowledge of the events that preceded the crisis, the size of pupils as well as the presence of muscarinic signs and tensilon test. Specific Features of Anesthesia in Patients with Myasthienia Gravis. Mechanism of the disease development is the reason'for the increased sensitivity or resistance of these patients to certain types of drugs used in anesthesia. Protocol of Perioperative Anesthesia in Patients with Myasthenia Gravis. Based on 35 years of experience in the surgical treatment of patients with Myasthenia gravis anesthesiologists at the Department of Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina. made the protocol of anesthesia and perioperative treatment for these patients. Anesthesiologists may have to deal with a patient with myasthenia gravis in different types of surgical interventions. The protocol for anesthesia and perioperative management of these patients

  9. Endoscopic management of bile leaks after laparoscopic ...

    Endoscopic management of bile leaks after laparoscopic cholecystectomy. ... endoscopic management at a median of 12 days (range 2 - 104 days) after surgery. Presenting features included intra-abdominal collections with pain in 58 cases ...

  10. SPECIFIC CONSTITUTIONAL FEATURES OF CHILDREN INFECTED WITH TUBERCULOSIS

    Yu. A. Yarovaya

    2017-01-01

    Full Text Available In order to define specific constitutional features of the children infected with tuberculosis 222 children in the age from 1 to 14 years old have been examined: 106 children with active tuberculosis; 54 children with remaining post-tuberculosis changes; 62 children infected with tuberculous mycobacteria. The following types of diatheses were identified: lymphohypoplastic, allergic, neuroarthritic, exudative-catarrhal. It has been found out that among those with active tuberculosis the children suffering from lymphohypoplastic and neuroarthritic diatheses prevail (17.0 ± 3.7%, and allergic diathesis is less common (10.4 ± 3.0% cases. Children with lymphohypoplastic diathesis have a complicated course of tuberculosis (27.8 ± 10.6% and more intensive intoxication syndrome (55.6 ± 11.7%. The frequency of allergic diathesis is higher in the children with remaining post-tuberculosis changes (29.6 ± 6.2% and those infected with tuberculosis (33.8 ± 6.1% compared to children with active tuberculosis (10.4 ± 3.0%.

  11. A challenge-response endoscopic sinus surgery specific checklist as an add-on to standard surgical checklist: an evaluation of potential safety and quality improvement issues.

    Sommer, Doron D; Arbab-Tafti, Sadaf; Farrokhyar, Forough; Tewfik, Marc; Vescan, Allan; Witterick, Ian J; Rotenberg, Brian; Chandra, Rakesh; Weitzel, Erik K; Wright, Erin; Ramakrishna, Jayant

    2018-02-27

    The goal of this study was to develop and evaluate the impact of an aviation-style challenge and response sinus surgery-specific checklist on potential safety and equipment issues during sinus surgery at a tertiary academic health center. The secondary goal was to assess the potential impact of use of the checklist on surgical times during, before, and after surgery. This initiative is designed to be utilized in conjunction with the "standard" World Health Organization (WHO) surgical checklist. Although endoscopic sinus surgery is generally considered a safe procedure, avoidable complications and potential safety concerns continue to occur. The WHO surgical checklist does not directly address certain surgery-specific issues, which may be of particular relevance for endoscopic sinus surgery. This prospective observational pilot study monitored compliance with and compared the occurrence of safety and equipment issues before and after implementation of the checklist. Forty-seven consecutive endoscopic surgeries were audited; the first 8 without the checklist and the following 39 with the checklist. The checklist was compiled by evaluating the patient journey, utilizing the available literature, expert consensus, and finally reevaluation with audit type cases. The final checklist was developed with all relevant stakeholders involved in a Delphi method. Implementing this specific surgical checklist in 39 cases at our institution, allowed us to identify and rectify 35 separate instances of potentially unsafe, improper or inefficient preoperative setup. These incidents included issues with labeling of topical vasoconstrictor or injectable anesthetics (3, 7.7%) and availability, function and/or position of video monitors (2, 5.1%), endoscope (6, 15.4%), microdebrider (6, 15.4%), bipolar cautery (6, 15.4%), and suctions (12, 30.8%). The design and integration of this checklist for endoscopic sinus surgery, has helped improve efficiency and patient safety in the operating

  12. VVER-specific features regarding core degradation - Status Report

    Hozer, Z.; Trambauer, K.; Duspiva, J.

    1999-01-01

    The objective of this report is to compare VVER reactors to pressurised water reactors (PWRs) of Western design from the point of view of core degradation phenomena using the terminology which was applied to the systematisation of severe accident phenomena in earlier CSNI reports. In the following the acronym 'PWR' is used for a PWR of Western design. The basic design features are described and the most important parameters are summarised in order to identify the differences between the two reactor types. In some specific cases the comparison shows more similarities with boiling water reactors (BWRs) than with PWRs. The known VVER experimental support is also summarised. RBMKs are not included in this report, as this reactor type is not operated in OECD countries, furthermore its design is completely different from those of VVERs and PWRs. The scope of this report is limited to in-vessel severe fuel damage phenomena. Neither thermal hydraulic processes involving no core degradation, nor containment phenomena, are discussed in detail. The VVER (water-cooled water-moderated power reactor) is a pressurised light water reactor of Soviet design. It operates on the same principles as a Western PWR reactor and uses similar technological systems. The primary coolant is pressurised water, which heats up in the reactor core and steam is produced on the secondary side of steam generators. The comparison of basic geometrical and technological parameters pointed out some differences between a PWR and a VVER, but it should be noted that differences exist even between two Western PWRs of different design. The VVER reactors are special types of PWRs, the most important design features of which are the horizontal steam generators and the hexagonal core structure. Similarity between PWR and VVER reactors was found in the comparison of dominant accidents sequences leading to core melt. The accident progression sequence consists of the same steps for VVERs and PWRs. The larger water

  13. Impact of Endoscopic Ultrasonography on (18)F-FDG-PET/CT Upfront Towards Patient Specific Esophageal Cancer Treatment

    Hulshoff, J. B.; Mul, V. E. M.; de Boer, H. E. M.; Noordzij, W.; Korteweg, T.; van Dullemen, H. M.; Nagengast, W. B.; Oppedijk, V.; Pierie, J. P. E. N.; Plukker, John Th. M.

    INTRODUCTION: In patients with potentially resectable esophageal cancer (EC), the value of endoscopic ultrasonography (EUS) after fluorine-18 labeled fluorodeoxyglucose positron emission tomography with computed tomography ((18)F-FDG-PET/CT) is questionable. Retrospectively, we assessed the impact

  14. Hybrid Electric Energy Storages: Their Specific Features and Application (Review)

    Popel', O. S.; Tarasenko, A. B.

    2018-05-01

    The article presents a review of various aspects related to development and practical use of hybrid electric energy storages (i.e., those uniting different energy storage technologies and devices in an integrated system) in transport and conventional and renewable power engineering applications. Such devices, which were initially developed for transport power installations, are increasingly being used by other consumers characterized by pronounced nonuniformities of their load schedule. A range of tasks solved using such energy storages is considered. It is shown that, owing to the advent of new types of energy storages and the extended spectrum of their performance characteristics, new possibilities for combining different types of energy storages and for developing hybrid systems have become available. This, in turn, opens up the possibility of making energy storages with better mass and dimension characteristics and achieving essentially lower operational costs. The possibility to secure more comfortable (base) operating modes of primary sources of energy (heat engines and renewable energy source based power installations) and to achieve a higher capacity utilization factor are unquestionable merits of hybrid energy storages. Development of optimal process circuit solutions, as well as energy conversion and control devices facilitating the fullest utilization of the properties of each individual energy storage included in the hybrid system, is among the important lines of research carried out in this field in Russia and abroad. Our review of existing developments has shown that there are no universal technical solutions in this field (the specific features of a consumer have an essential effect on the process circuit solutions and on the composition of a hybrid energy storage), a circumstance that dictates the need to extend the scope of investigations in this promising field.

  15. Specific features of modern multifunctional high-rise building construction

    Manukhina, Lyubov; Samosudova, Natal'ja

    2018-03-01

    The article analyzes the main reasons for the development of high-rise building construction the most important of which-is a limitation of the urban areas and, consequently, the high price of land reserved for construction. New engineering and compositional solutions for the creation of new types of buildings are considered - complex technical designs of a large number of storeys completely meet the new requirements for safety and comfort. Some peculiarities of designing high-rise buildings and searching for optimal architectural and planning solutions are revealed since, with external architectural simplicity, high-rise buildings have complex structural and technological and space-planning solutions. We consider the specific features of a high-rise housing in various countries around the world, including Russia, such as the layout of the multi-storey residential buildings, depending on the climatic characteristics of the regions, assessment of the geological risk of the construction site, the choice of parameters and functional purpose of the sections of the territory of high-rise construction, location of the town-planning object for substantiating the overall dimensions of the building, assessment of changes aeration and engineering and hydrological conditions of the site. A special place in the article on the problems of improvement of the territory, the device of courtyards, landscaping, the device of playing and sports grounds. The main conclusion in the article is the following problem - when developing high-rise housing construction, the development of high-rise housing, and an increase in the population density in the territory of large cities of Russia, necessary to create a comfortable and safe level of residents living and not a decrease, but an improvement in the quality of the urban environment.

  16. Energy transmission transformer for a wireless capsule endoscope: analysis of specific absorption rate and current density in biological tissue.

    Shiba, Kenji; Nagato, Tomohiro; Tsuji, Toshio; Koshiji, Kohji

    2008-07-01

    This paper reports on the electromagnetic influences on the analysis of biological tissue surrounding a prototype energy transmission system for a wireless capsule endoscope. Specific absorption rate (SAR) and current density were analyzed by electromagnetic simulator in a model consisting of primary coil and a human trunk including the skin, fat, muscle, small intestine, backbone, and blood. First, electric and magnetic strength in the same conditions as the analytical model were measured and compared to the analytical values to confirm the validity of the analysis. Then, SAR and current density as a function of frequency and output power were analyzed. The validity of the analysis was confirmed by comparing the analytical values with the measured ones. The SAR was below the basic restrictions of the International Commission on Nonionizing Radiation Protection (ICNIRP). At the same time, the results for current density show that the influence on biological tissue was lowest in the 300-400 kHz range, indicating that it was possible to transmit energy safely up to 160 mW. In addition, we confirmed that the current density has decreased by reducing the primary coil's current.

  17. A Tissue Relevance and Meshing Method for Computing Patient-Specific Anatomical Models in Endoscopic Sinus Surgery Simulation

    Audette, M. A.; Hertel, I.; Burgert, O.; Strauss, G.

    This paper presents on-going work on a method for determining which subvolumes of a patient-specific tissue map, extracted from CT data of the head, are relevant to simulating endoscopic sinus surgery of that individual, and for decomposing these relevant tissues into triangles and tetrahedra whose mesh size is well controlled. The overall goal is to limit the complexity of the real-time biomechanical interaction while ensuring the clinical relevance of the simulation. Relevant tissues are determined as the union of the pathology present in the patient, of critical tissues deemed to be near the intended surgical path or pathology, and of bone and soft tissue near the intended path, pathology or critical tissues. The processing of tissues, prior to meshing, is based on the Fast Marching method applied under various guises, in a conditional manner that is related to tissue classes. The meshing is based on an adaptation of a meshing method of ours, which combines the Marching Tetrahedra method and the discrete Simplex mesh surface model to produce a topologically faithful surface mesh with well controlled edge and face size as a first stage, and Almost-regular Tetrahedralization of the same prescribed mesh size as a last stage.

  18. Specific features of epilepsy in children with brain tumors

    G. V. Kalmykova

    2015-01-01

    Full Text Available Objective: to study the specific features of epilepsy in children and adolescents with brain tumors and to define the optimal tactics of management and antiepileptic therapy after surgical treatment. Patients and methods. Sixty-one patients aged 5 months to 15 years were examined. All the patients were diagnosed as having a brain tumor found in the presence of symptomatic epilepsy. They were all followed up for 5 years postsurgery or during their lifetime (in case of death. Comprehensive examination encompassing the assessment of history data and concomitant complaints, brain magnetic resonance imaging, video-EEC monitoring, and the neurological status (the presence of cognitive impairments and eye ground changes was done in all the cases. The probability of epileptic seizures in the clinical presentation of the disease, their semiology, and frequency were studied. Results and discussion. Epileptic seizures were the major complaint in all the patients at the first visit to their doctor. The disease occurred with status epilepticus in 9% of the patients. Different types of generalized seizures were more common (53%; p≥0.05. The tumor was located above the tentorium of the cerebellum in most examinees (77% and beneath it in the others (23%; p≤0.05. The significant clinical sign of a brain tumor in the epileptic children is focal neurological symptoms (72% of the cases. MRI was performed in children who had no focal neurological symptoms in the late periods. There was cerebrospinal fluid hypertension in 51% of the patients (p≥0.05 and cognitive impairments in 33% (p<0.05. The maximum number (74% of children with psycho-speech disorders and cognitive impairments were registered in the age group of 7–15 years. Eye ground changes characteristic of intracranial hypertension were identified in 19 epileptic children; they occurred in 27 patients more than 1 year after the onset of seizures. The late (few months-to-14 years diagnosis of a brain

  19. Informational economy: specific features and challenges of monopolization

    Kotsofana, T.

    2013-01-01

    The article discusses the features of the informational economy, as well as some issues with which this economy is facing today. In particular, contemporary forms of monopoly, its causes and consequences, changing trends towards monopolization and monopolization of markets due to the high degree of automation and information of the socio-economic life were analyzed.

  20. Specific features of early post-stroke seizures

    Tatyana Valeryevna Danilova

    2012-01-01

    Full Text Available The paper presents the results of examining 101 patients (68 men and 33 women aged 48 to 89 years with seizures in the first 7 days of stroke. A control group comprised 97 patients who had experienced ischemic stroke without seizures. Early seizures more frequently occurred in the cardioembolic subtype of stroke as simple partial seizures. The neuroimaging features of ischemic foci were revealed and the cerebrovascular responsiveness was evaluated in different vascular basins in these patients.

  1. Specific features of vocal fold paralysis in functional computed tomography

    Laskowska, K.; Mackiewicz-Nartowicz, H.; Serafin, Z.; Nawrocka, E.

    2008-01-01

    Vocal fold paralysis is usually recognized in laryngological examination, and detailed vocal fold function may be established based on laryngovideostroboscopy. Additional imaging should exclude any morphological causes of the paresis, which should be treated pharmacologically or surgically. The aim of this paper was to analyze the computed tomography (CT) images of the larynx in patients with unilateral vocal fold paralysis. CT examinations of the larynx were performed in 10 patients with clinically defined unilateral vocal fold paralysis. The examinations consisted of unenhanced acquisition and enhanced 3-phased acquisition: during free breathing, Valsalva maneuver, and phonation. The analysis included the following morphologic features of the paresis.the deepened epiglottic vallecula, the deepened piriform recess, the thickened and medially positioned aryepiglottic fold, the widened laryngeal pouch, the anteriorly positioned arytenoid cartilage, the thickened vocal fold, and the filled infraglottic space in frontal CT reconstruction. CT images were compared to laryngovideostroboscopy. The most common symptoms of vocal cord paralysis in CT were the deepened epiglottic vallecula and piriform recess, the widened laryngeal pouch with the filled infraglottic space, and the thickened aryepiglottic fold. Regarding the efficiency of the paralysis determination, the three functional techniques of CT larynx imaging used did not differ significantly, and laryngovideostroboscopy demonstrated its advantage over CT. CT of the larynx is a supplementary examination in the diagnosis of vocal fold paralysis, which may enable topographic analysis of the fold dysfunction. The knowledge of morphological CT features of the paralysis may help to prevent false-positive diagnosis of laryngeal cancer. (author)

  2. Verbal component specific features of creolized internet memes

    Anikina T. V.

    2017-09-01

    Full Text Available the given article deals with Internet memes as a specific phenomenon of internet discourse. Creolized Internet memes serve to simplify and intensify communication among people. It is facilitated by such language means as language game, erratives and abbreviation

  3. Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis.

    Gong, Eun Jeong; Kim, Do Hoon; Chun, Joo Hyun; Ahn, Ji Yong; Choi, Kwi-Sook; Jung, Kee Wook; Lee, Jeong Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Jung, Hwoon-Yong; Kim, Jin Ho; Song, In Hye; Kim, Yong-Gil

    2016-07-15

    Gastrointestinal involvement in vasculitis may result in life-threatening complications. However, its variable clinical presentations and endoscopic features, and the rarity of the disease, often result in delayed diagnosis. Clinical characteristics, endoscopic features, and histopathological findings were reviewed from medical records. Of 6,477 patients with vasculitis, 148 were diagnosed as primary vasculitis with upper gastrointestinal involvement. Of these, 21 cases (14.2%) were classified as large-vessel vasculitis, 17 cases (11.5%) as medium-vessel vasculitis, and 110 cases (74.3%) as small-vessel vasculitis. According to the specific diagnosis, IgA vasculitis (Henoch-Schönlein purpura) was the most common diagnosis (56.8%), followed by Takayasu arteritis (14.1%), microscopic polyangiitis (10.1%), and polyarteritis nodosa (6.8%). Gastrointestinal symptoms were present in 113 subjects (76.4%), with abdominal pain (78.8%) the most common symptom. Erosion and ulcers were striking endoscopic features, and the second portion of the duodenum was the most frequently involved site. Biopsy specimens were obtained from 124 patients, and only eight (5.4%) presented histopathological signs of vasculitis. Diagnosis of vasculitis involving the upper gastrointestinal tract is difficult. Because of the widespread use of endoscopy, combining clinical features with endoscopic findings may facilitate making appropriate diagnoses; however, the diagnostic yield of endoscopic biopsy is low.

  4. [SPECIFIC CLINICAL FEATURES OF TYPE 1 AUTOIMMUNE POLYGLANDULAR SYNDROME].

    Mikhina, M S; Molashenko, N V; Troshina, E A; Orlova, E M; Sozaeva, L S; Eystein, S H; Breivik, S

    2015-01-01

    Autoimmune polyglandular syndrome is a primary autoimmune disorder affecting two or more peripheral endocrine glands and responsible for their incompetence. It is frequently combined with various organ-specific non-endocrine diseases. Patients with this pathology need life-long replacement therapy and dynamic observation by endocrinologists and other specialists to monitor the effectiveness of the treatment and detect new components of the disease. We report a variant of type 1 autoimmune polyglandular syndrome. Special emphasis is laid on the importance of succession of actions of endocrinologists and specialists in related medical disciplines dealing with children and adult patients.

  5. Specific features of medicines safety and pharmacovigilance in Africa

    Pal, Shanthi N.; Olsson, Sten; Dodoo, Alexander; Bencheikh, Rachida Soulayami

    2012-01-01

    The thalidomide tragedy in the late 1950s and early 1960s served as a wakeup call and raised questions about the safety of medicinal products. The developed countries rose to the challenge putting in place systems to ensure the safety of medicines. However, this was not the case for low-resource settings because of prevailing factors inherent in them. This paper reviews some of these features and the current status of pharmacovigilance in Africa. The health systems in most of the 54 countries of Africa are essentially weak, lacking in basic infrastructure, personnel, equipment and facilities. The recent mass deployment of medicines to address diseases of public health significance in Africa poses additional challenges to the health system with notable safety concerns. Other safety issues of note include substandard and counterfeit medicines, medication errors and quality of medicinal products. The first national pharmacovigilance centres established in Africa with membership of the World Health Organization (WHO) international drug monitoring programme were in Morocco and South Africa in 1992. Of the 104 full member countries in the programme, there are now 24 African countries with a further nine countries as associate members. The pharmacovigilance systems operational in African countries are based essentially on spontaneous reporting facilitated by the introduction of the new tool Vigiflow. The individual case safety reports committed to the WHO global database (Vigibase) attest to the growth of pharmacovigilance in Africa with the number of reports rising from 2695 in 2000 to over 25,000 in 2010. There is need to engage the various identified challenges of the weak pharmacovigilance systems in the African setting and to focus efforts on how to provide resources, infrastructure and expertise. Raising the level of awareness among healthcare providers, developing training curricula for healthcare professionals, provisions for paediatric and geriatric

  6. Endoscopic retrograde cholangiopancreatography and endoscopic ...

    An approach to suspected gallstone pancreatitis'based on endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) was adopted in 1976 and was followed in 29 patients. ERCp became the routine method of early biliary tract assessment when gallstone pancreatitis was suspected on ...

  7. Sector specific features of innovative development in the Russian economy

    Krasyuk I.A.

    2017-01-01

    Full Text Available The present-day development of the Russian Federation is mostly shaped by the innovative development capacity of the national economy. Industry forms the core of such development. The paper presents the study of the current state of the innovative development in industry being the source of the basic innovations, as well as identifies the limitation factors. The authors have found out that low innovative activity of the industrial enterprises holds back the implementation of innovations in the related sectors, for instance, trade. It has also been found out that the course of the innovative development in the field of trade is also shaped by the sector-specific factors, which should be considered to adjust the innovation policy of a trading enterprise.

  8. Specific feature of critical fields of inhomogeneous superconducting films

    Glazman, L.I.; Dmitrenko, I.M.; Kolin'ko, A.E.; Pokhila, A.S.; Fogel', N.Ya.; Cherkasova, V.G.

    1988-01-01

    Experimental studies on thin vanadium films (d=250-400 A) have revealed anomaly in the temperature dependence of the upper critical field H cparallel (T), when H is parallel to the sample plane. At certain temperature T 0 the dependence H cparallel 2 (T) has a sharp kink separating two linear portions. The anomalous behaviour of H cparallel (T) of thin V films can be accounted for assuming the film separation into two parallel layers having different parameters (critical temperature T c , coherence length ξ, thickness d). At temperatures above and lower T 0 the dependence H cparallel (T) is mainly dependent on the characteristics of only one layer. The kink in the dependence H cparallel 2 (T) is due to a jump-like transition of the superconducting nucleus from one layer to the other at T c . The anomalous behaviour of the dependence H cparallel (T) is also observed in sandwiches consisting of two identical films separated with a high (about 30 A) dielectric interlayer; however, the transition from one linear portion to the other is smooth. In the case of identical films a specific crossover occurs if at T-T c the critical field H cparallel (T) coinsides with that for the layer of doubled thickness, then at lowering temperature H cparallel (T) asymptotically approaches the critical field of one layer. The calculation within the model described provides a good description for the experimental results

  9. SOME SPECIFIC FEATURES OF ENERGY CONSUMPTION IN MODERN RESIDENTIAL BUILDINGS

    S. N. Osipov

    2018-01-01

    Full Text Available Over the past 20 years there have been significant changes in the customer requirements for housing in the countries of the former USSR. Besides, new materials and construction products, such as the ones for sealed windows and balcony doors have appeared in the market. The number of vacant flats with the heating off in the winter significantly increased that may cause condensation on the surfaces of interroom partitions and the formation of mold. Meanwhile, the requirements for lower energy consumption are constantly increasing, that is especially pronouncedly manifested in the growth of normative values of thermal resistance of enclosing structures of buildings and in the increased interest in the use of secondary energy resources extracted from the air and effluent wastewater. The present article describes the method to prevent moisture condensation on the fencing of adjacent premises with different temperatures containing heating systems and the use of waste heat removed from the room exhaust air. For quick emergency switching of in-house systems of heat and gas supply to outdoor mobile sources of heat and gas it is recommended to install special taps with connectors insulated in special niches in the walls or other parts of buildings considering the possibility of placing them close to the outer mobile sources of heat and gas. In the case of heating the building with the aid of a roof gas boiler or by doorto-door heaters fueled by gas, a single pipeline (collector, equipped with an additional device for the connection of emergency gas supply is being put along the wall. In order to reduce specific heat consumption for heating of buildings it is recommended to increase the net enclosure volume of buildings and to improve their form in various ways, including by combining two or more adjacent low-rise buildings in one secondary building with increasing height and with the broadening of either or each side for modernization and reconstruction

  10. Transformation of armed violence: specific features and trends

    O. B. Balatska

    2016-08-01

    Full Text Available Social transformations occurring in the world today became a result of globalization, information, changes in the international balance of power, and are reflected in all aspects of political development. One of the most pressing challenges of our time, a consequence of these processes, is the evolution of forms and methods of armed violence. This publication is devoted to determining the specific and major trends transforming the forms and methods of armed violence. Instead of the traditional military conflicts, new forms and means of armed confrontation emerge. Asymmetrical conflicts taking place with the participation of non-state parties and irregular armed groups, are quite common at the moment. «Hard power» methods associated with the use of direct violence are supplemented by means of «soft power». Violent but non-traditional (non-military means of confrontation widen, with informational and psychological influence becoming particularly prominent. Infotechnological and infopsychological methods of intervention have become an integral part of modern military-political confrontation, taking form of hybrid, network and network-centric warfare. The hybrid military conflicts are typically distinguished by asymmetry, latency, priority of small-scale combat actions and dynamic use of indirect violence. Network-centric warfare focused on achieving information superiority over the enemy, complex effects on the enemy’s physical, informational and cognitive domains, strategic flexibility and adaptability, priority of horizontal ties over traditional vertical hierarchy. Horizontal network infrastructure, consisting of multiple independent, highly specialized and geographically dispersed units, determines the effectiveness of network war strategy today. Apart from qualitative changes associated with emergence and proliferation of new forms of armed violence on a global scale, there is a definite global increase in its quantitative

  11. Impact of Endoscopic Ultrasonography on 18F-FDG-PET/CT Upfront Towards Patient Specific Esophageal Cancer Treatment.

    Hulshoff, J B; Mul, V E M; de Boer, H E M; Noordzij, W; Korteweg, T; van Dullemen, H M; Nagengast, W B; Oppedijk, V; Pierie, J P E N; Plukker, John Th M

    2017-07-01

    In patients with potentially resectable esophageal cancer (EC), the value of endoscopic ultrasonography (EUS) after fluorine-18 labeled fluorodeoxyglucose positron emission tomography with computed tomography ( 18 F-FDG-PET/CT) is questionable. Retrospectively, we assessed the impact of EUS after PET/CT on the given treatment in EC patients. During the period 2009-2015, 318 EC patients were staged as T1-4aN0-3M0 with hybrid 18 F-FDG-PET/CT or 18 F-FDG-PET with CT and EUS if applicable in a nonspecific order. We determined the impact of EUS on the given treatment in 279 patients who also were staged with EUS. EUS had clinical consequences if it changed curability, extent of radiation fields or lymph node resection (AJCC stations 2-5), and when the performed fine-needle aspiration (FNA) provided conclusive information of suspicious lymph node. EUS had an impact in 80 (28.7%) patients; it changed the radiation field in 63 (22.6%), curability in 5 (1.8%), lymphadenectomy in 48 (17.2%), and FNA was additional in 21 (7.5%). In patients treated with nCRT (n = 194), EUS influenced treatment in 53 (27.3%) patients; in 38 (19.6%) the radiation field changed, in 3 (1.5%) the curability, in 35 (18.0%) the lymphadenectomy, and in 17 (8.8%) FNA was additional. EUS influenced both the extent of radiation field and nodal resection in 31 (16.0%) nCRT patients. EUS had an impact on the given treatment in approximately 29%. In most patients, the magnitude of EUS found expression in the extent of radiotherapy target volume delineation to upper/high mediastinal lymph nodes.

  12. Specific features of the motion of neutrons in a medium with a helical magnetic structure

    Fraerman, A. A.; Udalov, O. G.

    2007-01-01

    The specific features of the motion of neutrons in a noncoplanar magnetic field are considered by an example of the magnetization distribution in the form of a conical helix. The reflection coefficients of neutrons from holmium crystals are calculated. It is shown that, for a noncoplanar distribution of a magnetic field in a crystal, the reflection coefficient of neutrons with spin flip exhibits an additional feature

  13. Top-down contingent feature-specific orienting with and without awareness of the visual input.

    Ansorge, Ulrich; Horstmann, Gernot; Scharlau, Ingrid

    2011-01-01

    In the present article, the role of endogenous feature-specific orienting for conscious and unconscious vision is reviewed. We start with an overview of orienting. We proceed with a review of masking research, and the definition of the criteria of experimental protocols that demonstrate endogenous and exogenous orienting, respectively. Against this background of criteria, we assess studies of unconscious orienting and come to the conclusion that so far studies of unconscious orienting demonstrated endogenous feature-specific orienting. The review closes with a discussion of the role of unconscious orienting in action control.

  14. Specific Features of Social Competence Development in the Future Music Teachers Working at Universities

    Dzheksembekova, Menslu I.; Ibrayeva, Kamarsulu E.; Akhmetova, Aimkul K.; Urazalieva, Moldir A.; Sultangaliyeva, Elmira S.; Issametova, Klavdiya I.

    2016-01-01

    This paper aims at analyzing specific features of social competence of future music teachers and the development of specialized techniques in order to improve the quality of motivational and cognitive components of student social competence. The sample involved 660 undergraduate students. The authors used a number of research methods, such as…

  15. Specific features of the Galician language and implications for speech technology development

    2008-01-01

    Specific features of the Galician language and implications for speech technology development correspondence: Corresponding author. (Banga, Eduardo Rodriguez) (Banga, Eduardo Rodriguez) Dpto. Filoloxia Galega. Universidade de Santiago. Santiago de Compostela. Spain - (Gonzalez, Manuel Gonzalez) Dpto. Teoria de la Se?al y Comunicaciones. Universidad de Vigo. Vigo. Spain - (Banga, Eduardo Rodriguez) SPAIN (Banga...

  16. Specific features of the REDUCE system and calculation of QCD Feynman graphs

    Dulyan, L.S.

    1990-01-01

    The ways and methods used in calculation of one class of the QCD Feynman graphs with the help of the REDUCE system are described. It is shown how by introducing new constructions and operations the user could avoid difficulties connected with specific restrictions and features of the REDUCE system

  17. Perceptual learning of basic visual features remains task specific with Training-Plus-Exposure (TPE) training.

    Cong, Lin-Juan; Wang, Ru-Jie; Yu, Cong; Zhang, Jun-Yun

    2016-01-01

    Visual perceptual learning is known to be specific to the trained retinal location, feature, and task. However, location and feature specificity can be eliminated by double-training or TPE training protocols, in which observers receive additional exposure to the transfer location or feature dimension via an irrelevant task besides the primary learning task Here we tested whether these new training protocols could even make learning transfer across different tasks involving discrimination of basic visual features (e.g., orientation and contrast). Observers practiced a near-threshold orientation (or contrast) discrimination task. Following a TPE training protocol, they also received exposure to the transfer task via performing suprathreshold contrast (or orientation) discrimination in alternating blocks of trials in the same sessions. The results showed no evidence for significant learning transfer to the untrained near-threshold contrast (or orientation) discrimination task after discounting the pretest effects and the suprathreshold practice effects. These results thus do not support a hypothetical task-independent component in perceptual learning of basic visual features. They also set the boundary of the new training protocols in their capability to enable learning transfer.

  18. Enteroclysis in adult celiac disease: diagnostic value of specific radiographic features

    Lomoschitz, F.; Schima, W.; Schober, E.; Turetschek, K.; Kaider, A.; Vogelsang, H.

    2003-01-01

    The purpose of this study was to compare the diagnostic accuracy of various radiographic findings at enteroclysis in adult patients with untreated celiac disease. Twenty-seven adult patients underwent enteroclysis because of unspecific intestinal symptoms before definitive biopsy proof of celiac disease. Enteroclysis of 123 subjects with similar clinical presentation, including abdominal pain, diarrhea, occult intestinal bleeding, and weight loss, who had a definitive diagnosis other than celiac disease, served as controls. The radiographic features previously described in the literature as indicative of adult celiac disease (i.e., fold thickening, decrease of jejunal folds, increase of ileal folds, small bowel dilatation, flocculation) were evaluated in blinded fashion in all studies and the subjective likelihood of diagnosis of celiac disease was assessed. Assessing every finding separately, each feature proved to have a high specificity (78-100%) but low sensitivity (19-59%) for celiac disease. Reversal of jejunoileal fold pattern was the single best feature (specificity 100%, 95% CI 97-100%; sensitivity 59%, 95% CI 40-78%); however, combination of criteria enables establishment of the diagnosis of celiac disease quite accurately (specificity 100%, 95% CI 98-100%; sensitivity 78%, 95% CI 58-91%). Reversal of jejunoileal fold pattern as a single finding as well as combination at least three of the following features, i.e., fold thickening, decrease of jejunal folds (''colonization''), increase of ileal folds (''jejunization''), dilatation, and flocculation, make enteroclysis an accurate tool for diagnosis of celiac disease in adult patients with suspected intestinal disease. (orig.)

  19. Specific features of using programmed hardware in emergency protection systems of NPP

    Konoplev, N.P.; Pogorelov, I.V.; Kirsanov, A.V.

    2005-01-01

    The specific features of using the microprocessor-based technical means and programmed logic integrated circuits (PLIC) in WWER reactor protection systems are considered. The basic causes of occurring the failures in programmed technical means are analyzed. The features of using PLIC in reactor protection systems are discussed. The methods permitting to decrease the probability occurring the common mode failure of programmed technical means are proposed. It is concluded that at creating of reactor protection systems with the use of microprocessors and PLIC it is necessary to apply the principle of the functional diversity [ru

  20. Clinical presentation and endoscopic features of primary gastric Burkitt lymphoma in childhood, presenting as a protein-losing enteropathy: a case report

    Chieng Jenny Hui Chia

    2009-06-01

    Full Text Available Abstract Introduction Burkitt lymphoma and B cell lymphomas in childhood may arise in many atypical locations, which on rare occasions can include gastric mucosa. A case of primary gastric Burkitt lymphoma is described in a child presenting as a protein-losing enteropathy, including the direct monitoring of the disease response by sequential endoscopic biopsy and molecular analysis. Case presentation We report a 9-year-old boy who presented with gross oedema, ascites and respiratory distress caused by a protein-losing enteropathy. Initial imaging investigations were non-diagnostic but gastroduodenal endoscopy revealed massive involvement of the gastric mucosa with a primary Burkitt lymphoma. His subsequent clinical progress and disease response were monitored directly by endoscopy and he remains in clinical remission 4 years after initial diagnosis. Conclusions This is the first case report of primary Burkitt lymphoma presenting as a protein-losing enteropathy. The clinical course and progress of the patient were monitored by sequential endoscopic biopsy, histology and molecular analysis by fluorescence in situ hybridisation.

  1. ESGE-ESGENA technical specification for process validation and routine testing of endoscope reprocessing in washer-disinfectors according to EN ISO 15883, parts 1, 4, and ISO/TS 15883-5.

    Beilenhoff, Ulrike; Biering, Holger; Blum, Reinhard; Brljak, Jadranka; Cimbro, Monica; Dumonceau, Jean-Marc; Hassan, Cesare; Jung, Michael; Neumann, Christiane; Pietsch, Michael; Pineau, Lionel; Ponchon, Thierry; Rejchrt, Stanislav; Rey, Jean-François; Schmidt, Verona; Tillett, Jayne; van Hooft, Jeanin

    2017-12-01

    1 Prerequisites. The clinical service provider should obtain confirmation from the endoscope washer-disinfector (EWD) manufacturer that all endoscopes intended to be used can be reprocessed in the EWD. 2 Installation qualification. This can be performed by different parties but national guidelines should define who has the responsibilities, taking into account legal requirements. 3 Operational qualification. This should include parametric tests to verify that the EWD is working according to its specifications. 4 Performance qualification. Testing of cleaning performance, microbiological testing of routinely used endoscopes, and the quality of the final rinse water should be considered in all local guidelines. The extent of these tests depends on local requirements. According to the results of type testing performed during EWD development, other parameters can be tested if local regulatory authorities accept this. Chemical residues on endoscope surfaces should be searched for, if acceptable test methods are available. 5 Routine inspections. National guidelines should consider both technical and performance criteria. Individual risk analyses performed in the validation and requalification processes are helpful for defining appropriate test frequencies for routine inspections. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Williams syndrome-specific neuroanatomical profile and its associations with behavioral features.

    Fan, Chun Chieh; Brown, Timothy T; Bartsch, Hauke; Kuperman, Joshua M; Hagler, Donald J; Schork, Andrew; Searcy, Yvonne; Bellugi, Ursula; Halgren, Eric; Dale, Anders M

    2017-01-01

    Williams Syndrome (WS) is a rare genetic disorder with unique behavioral features. Yet the rareness of WS has limited the number and type of studies that can be conducted in which inferences are made about how neuroanatomical abnormalities mediate behaviors. In this study, we extracted a WS-specific neuroanatomical profile from structural magnetic resonance imaging (MRI) measurements and tested its association with behavioral features of WS. Using a WS adult cohort (22 WS, 16 healthy controls), we modeled a sparse representation of a WS-specific neuroanatomical profile. The predictive performances are robust within the training cohort (10-fold cross-validation, AUC = 1.0) and accurately identify all WS individuals in an independent child WS cohort (seven WS, 59 children with diverse developmental status, AUC = 1.0). The WS-specific neuroanatomical profile includes measurements in the orbitofrontal cortex, superior parietal cortex, Sylvian fissures, and basal ganglia, and variability within these areas related to the underlying size of hemizygous deletion in patients with partial deletions. The profile intensity mediated the overall cognitive impairment as well as personality features related to hypersociability. Our results imply that the unique behaviors in WS were mediated through the constellation of abnormalities in cortical-subcortical circuitry consistent in child WS and adult WS. The robustness of the derived WS-specific neuroanatomical profile also demonstrates the potential utility of our approach in both clinical and research applications.

  3. Improving protein fold recognition by extracting fold-specific features from predicted residue-residue contacts.

    Zhu, Jianwei; Zhang, Haicang; Li, Shuai Cheng; Wang, Chao; Kong, Lupeng; Sun, Shiwei; Zheng, Wei-Mou; Bu, Dongbo

    2017-12-01

    Accurate recognition of protein fold types is a key step for template-based prediction of protein structures. The existing approaches to fold recognition mainly exploit the features derived from alignments of query protein against templates. These approaches have been shown to be successful for fold recognition at family level, but usually failed at superfamily/fold levels. To overcome this limitation, one of the key points is to explore more structurally informative features of proteins. Although residue-residue contacts carry abundant structural information, how to thoroughly exploit these information for fold recognition still remains a challenge. In this study, we present an approach (called DeepFR) to improve fold recognition at superfamily/fold levels. The basic idea of our approach is to extract fold-specific features from predicted residue-residue contacts of proteins using deep convolutional neural network (DCNN) technique. Based on these fold-specific features, we calculated similarity between query protein and templates, and then assigned query protein with fold type of the most similar template. DCNN has showed excellent performance in image feature extraction and image recognition; the rational underlying the application of DCNN for fold recognition is that contact likelihood maps are essentially analogy to images, as they both display compositional hierarchy. Experimental results on the LINDAHL dataset suggest that even using the extracted fold-specific features alone, our approach achieved success rate comparable to the state-of-the-art approaches. When further combining these features with traditional alignment-related features, the success rate of our approach increased to 92.3%, 82.5% and 78.8% at family, superfamily and fold levels, respectively, which is about 18% higher than the state-of-the-art approach at fold level, 6% higher at superfamily level and 1% higher at family level. An independent assessment on SCOP_TEST dataset showed consistent

  4. Endoscopic case

    Fernando Pereira

    2017-01-01

    Full Text Available We present the case of a ten-year-old female patient referred to Gastroenterolgy consultation for abdominal pain and cramping, usually worse after eating, recurring diarrhoea, hypochromic and microcytic anaemia with low serum iron and ferritin levels. Moderate to severe Crohn’s disease of the terminal ileum e right colon (L3 was diagnosed, based on endoscopic image and biopsy. The patient was treated with prednisone and azathioprine, but after one year of treatment she was steroids dependent and treatment was switched to infliximab. One year after beginning this treatment, the patient achieved remission (clinical and laboratorial parameters. A control colonoscopy showed mucosal healing with scars and deformation with stenosis of ileocecal valve (Figures 1-2. Surgical intervention will be probably necessary in near future.

  5. Endoscopic ampullectomy

    Michael Bourke

    2012-01-01

    Full Text Available Endoscopic ampullectomy offers a minimally invasive method of effectively treating non-invasive neoplasms of the ampulla of Vater and surrounding peri-ampullary region with high success and relative safety. These lesions would otherwise require surgical intervention, including pancreatico-duodenectomy. However, major complications may occur and a careful assessment of the patients comorbidities and their ability to tolerate adverse events needs to be factored into the treatment decision. Careful staging, often multi-modality is required, particularly for extensive lesions. Complete en-bloc excision of the entire neoplasm should be the goal with conventional papillary adenomas. Large lesions with extra-papillary extension currently require extended piecemeal excision, however with meticulous technique, recurrence is uncommon in longterm follow up.

  6. Perceptions of surgical specialists in general surgery, orthopaedic surgery, urology and gynaecology on teaching endoscopic surgery in The Netherlands

    Schijven, M. P.; Schout, B. M. A.; Dolmans, V. E. M. G.; Hendrikx, A. J. M.; Broeders, I. A. M. J.; Borel Rinkes, I. H. M.

    2008-01-01

    BACKGROUND: Specific training in endoscopic skills and procedures has become a necessity for profession with embedded endoscopic techniques in their surgical palette. Previous research indicates endoscopic skills training to be inadequate, both from subjective (resident interviews) and objective

  7. Burnout specific features in steam-water mixture annular flow in a tube

    Doroshchuk, V.E.

    1981-01-01

    Some unexplained burnout specific features in a steam-generating tube are analysed on the basis of experimental data. The following problems are considered: 1) the effect of the tube length and the state of the working medium (single-phase, two-phase) on burnout at the tube inlet; 2) the character of the specific thermal flow dependence at the moment of burnout appearance on the mass steam content q=f(x). It is found that the effect of the tube length on the burnout exists only in a relatively narrow range of the operating parameters. The run of the q=f(x) dependence is also explained [ru

  8. Full optical model of micro-endoscope with optical coherence microscopy, multiphoton microscopy and visible capabilities

    Vega, David; Kiekens, Kelli C.; Syson, Nikolas C.; Romano, Gabriella; Baker, Tressa; Barton, Jennifer K.

    2018-02-01

    While Optical Coherence Microscopy (OCM), Multiphoton Microscopy (MPM), and narrowband imaging are powerful imaging techniques that can be used to detect cancer, each imaging technique has limitations when used by itself. Combining them into an endoscope to work in synergy can help achieve high sensitivity and specificity for diagnosis at the point of care. Such complex endoscopes have an elevated risk of failure, and performing proper modelling ensures functionality and minimizes risk. We present full 2D and 3D models of a multimodality optical micro-endoscope to provide real-time detection of carcinomas, called a salpingoscope. The models evaluate the endoscope illumination and light collection capabilities of various modalities. The design features two optical paths with different numerical apertures (NA) through a single lens system with a scanning optical fiber. The dual path is achieved using dichroic coatings embedded in a triplet. A high NA optical path is designed to perform OCM and MPM while a low NA optical path is designed for the visible spectrum to navigate the endoscope to areas of interest and narrowband imaging. Different tests such as the reflectance profile of homogeneous epithelial tissue were performed to adjust the models properly. Light collection models for the different modalities were created and tested for efficiency. While it is challenging to evaluate the efficiency of multimodality endoscopes, the models ensure that the system is design for the expected light collection levels to provide detectable signal to work for the intended imaging.

  9. Corruption in the sphere of education: notion, specific features, forms and types

    Irina A. Damm

    2016-12-01

    Full Text Available Objective basing on the studied scientific literature and legislation on corruption counteraction to elaborate the concept of corruption in the education sector highlighting its specific features characteristics forms and types and attracting the attention of the scientific community to the discussion of the categorical apparatus of corruption in education and its prevention. Methods dialectical method of cognition. Results basing on the analysis of scientific literature and the Russian legislation on corruption counteraction the characteristic features of corruption in education were revealed the sphere of existence the specificity of the subjects of corruption relations in education specific features of the goals of corruption the types of corruption were classified according to various grounds depending on the types of educational organizations that implement basic educational programs the nature of authority used by the persons who have administrative powers in educational institutions the quantitative composition of the subjects the nature of the use of official position by the subjects of passive bribery in the corruption relations in education organizational structure of corruption relations in education the nature of accrued benefits the nature and degree of public danger. In the conclusion the author proposes the definition of corruption in education which is interpreted as the negative sociolegal phenomenon existing in social relations in the sphere of education and consisting in the wrongful use of an official position and status of the participants of relations in the sphere of education in order to accrue benefit of tangible and or intangible nature for themselves or third parties as well as to provide such benefits. Scientific novelty for the first time the article considers the characteristic features of corruption in education highlights its forms and types and proposed a definition of corruption in education. Practical

  10. Enteroclysis in adult celiac disease: diagnostic value of specific radiographic features

    Lomoschitz, F.; Schima, W.; Schober, E.; Turetschek, K. [Department of Radiology and Ludwig Boltzmann Institute for Clinical and Experimental Radiologic Research, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Kaider, A. [Department of Medical Computer Sciences, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Vogelsang, H. [Department of Internal Medicine IV, Division of Gastroenterology, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria)

    2003-04-01

    The purpose of this study was to compare the diagnostic accuracy of various radiographic findings at enteroclysis in adult patients with untreated celiac disease. Twenty-seven adult patients underwent enteroclysis because of unspecific intestinal symptoms before definitive biopsy proof of celiac disease. Enteroclysis of 123 subjects with similar clinical presentation, including abdominal pain, diarrhea, occult intestinal bleeding, and weight loss, who had a definitive diagnosis other than celiac disease, served as controls. The radiographic features previously described in the literature as indicative of adult celiac disease (i.e., fold thickening, decrease of jejunal folds, increase of ileal folds, small bowel dilatation, flocculation) were evaluated in blinded fashion in all studies and the subjective likelihood of diagnosis of celiac disease was assessed. Assessing every finding separately, each feature proved to have a high specificity (78-100%) but low sensitivity (19-59%) for celiac disease. Reversal of jejunoileal fold pattern was the single best feature (specificity 100%, 95% CI 97-100%; sensitivity 59%, 95% CI 40-78%); however, combination of criteria enables establishment of the diagnosis of celiac disease quite accurately (specificity 100%, 95% CI 98-100%; sensitivity 78%, 95% CI 58-91%). Reversal of jejunoileal fold pattern as a single finding as well as combination at least three of the following features, i.e., fold thickening, decrease of jejunal folds (''colonization''), increase of ileal folds (''jejunization''), dilatation, and flocculation, make enteroclysis an accurate tool for diagnosis of celiac disease in adult patients with suspected intestinal disease. (orig.)

  11. Spermatogenesis-specific features of the meiotic program in Caenorhabditis elegans.

    Diane C Shakes

    2009-08-01

    Full Text Available In most sexually reproducing organisms, the fundamental process of meiosis is implemented concurrently with two differentiation programs that occur at different rates and generate distinct cell types, sperm and oocytes. However, little is known about how the meiotic program is influenced by such contrasting developmental programs. Here we present a detailed timeline of late meiotic prophase during spermatogenesis in Caenorhabditis elegans using cytological and molecular landmarks to interrelate changes in chromosome dynamics with germ cell cellularization, spindle formation, and cell cycle transitions. This analysis expands our understanding C. elegans spermatogenesis, as it identifies multiple spermatogenesis-specific features of the meiotic program and provides a framework for comparative studies. Post-pachytene chromatin of spermatocytes is distinct from that of oocytes in both composition and morphology. Strikingly, C. elegans spermatogenesis includes a previously undescribed karyosome stage, a common but poorly understood feature of meiosis in many organisms. We find that karyosome formation, in which chromosomes form a constricted mass within an intact nuclear envelope, follows desynapsis, involves a global down-regulation of transcription, and may support the sequential activation of multiple kinases that prepare spermatocytes for meiotic divisions. In spermatocytes, the presence of centrioles alters both the relative timing of meiotic spindle assembly and its ultimate structure. These microtubule differences are accompanied by differences in kinetochores, which connect microtubules to chromosomes. The sperm-specific features of meiosis revealed here illuminate how the underlying molecular machinery required for meiosis is differentially regulated in each sex.

  12. Contingent capture can occur at specific feature values: behavioral and electrophysiological evidence.

    Jiao, Jun; Zhao, Guang; Wang, Qi; Zhang, Kan; Li, Hong; Sun, Hong-Jin; Liu, Qiang

    2013-02-01

    The notion that attentional top-down control can be tuned to a stimulus feature is widely accepted. Although previous studies suggested that the stimulus-driven attentional capture could be contingent on top-down attentional control settings, it was uncertain whether contingent capture can occur at a specific feature value. Three experiments were conducted to address this issue using both behavioral and ERPs measures. Participants were required to respond to one color singleton in the search display (target) but refrain from responding to the search display containing another color singleton (nontarget). When target and nontarget belonged to different color categories (Experiment 1), only the target-color cue and within category irrelevant-color cue elicited the significant cue validity effect (i.e. RTs were shorter when the target was presented at the same location as the preceding cue rather than at a different location); they also lead to a robust N2pc effect, indicative of attention-capture. In addition, these two cue types had similar attention-capturing capacity. However, when target and nontarget belonged to the same color category (Experiments 2 and 3), only the target-color cue elicited the significant cue validity effect and the robust N2pc effect. The same within category irrelevant-color cue no longer elicited the cue validity effect, and the N2pc effect was also attenuated. Present findings suggest that contingent capture can occur at a specific feature value. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. A systematic identification of species-specific protein succinylation sites using joint element features information

    Hasan MM

    2017-08-01

    Full Text Available Md Mehedi Hasan,1 Mst Shamima Khatun,2 Md Nurul Haque Mollah,2 Cao Yong,3 Dianjing Guo1 1School of Life Sciences and the State Key Laboratory of Agrobiotechnology, The Chinese University of Hong Kong, Shatin, New Territory, Hong Kong, People’s Republic of China; 2Laboratory of Bioinformatics, Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh; 3Department of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen Graduate School, Shenzhen, People’s Republic of China Abstract: Lysine succinylation, an important type of protein posttranslational modification, plays significant roles in many cellular processes. Accurate identification of succinylation sites can facilitate our understanding about the molecular mechanism and potential roles of lysine succinylation. However, even in well-studied systems, a majority of the succinylation sites remain undetected because the traditional experimental approaches to succinylation site identification are often costly, time-consuming, and laborious. In silico approach, on the other hand, is potentially an alternative strategy to predict succinylation substrates. In this paper, a novel computational predictor SuccinSite2.0 was developed for predicting generic and species-specific protein succinylation sites. This predictor takes the composition of profile-based amino acid and orthogonal binary features, which were used to train a random forest classifier. We demonstrated that the proposed SuccinSite2.0 predictor outperformed other currently existing implementations on a complementarily independent dataset. Furthermore, the important features that make visible contributions to species-specific and cross-species-specific prediction of protein succinylation site were analyzed. The proposed predictor is anticipated to be a useful computational resource for lysine succinylation site prediction. The integrated species-specific online tool of SuccinSite2.0 is publicly

  14. Endoscopic root canal treatment.

    Moshonov, Joshua; Michaeli, Eli; Nahlieli, Oded

    2009-10-01

    To describe an innovative endoscopic technique for root canal treatment. Root canal treatment was performed on 12 patients (15 teeth), using a newly developed endoscope (Sialotechnology), which combines an endoscope, irrigation, and a surgical microinstrument channel. Endoscopic root canal treatment of all 15 teeth was successful with complete resolution of all symptoms (6-month follow-up). The novel endoscope used in this study accurately identified all microstructures and simplified root canal treatment. The endoscope may be considered for use not only for preoperative observation and diagnosis but also for active endodontic treatment.

  15. Camouflaging in a complex environment--octopuses use specific features of their surroundings for background matching.

    Noam Josef

    Full Text Available Living under intense predation pressure, octopuses evolved an effective and impressive camouflaging ability that exploits features of their surroundings to enable them to "blend in." To achieve such background matching, an animal may use general resemblance and reproduce characteristics of its entire surroundings, or it may imitate a specific object in its immediate environment. Using image analysis algorithms, we examined correlations between octopuses and their backgrounds. Field experiments show that when camouflaging, Octopus cyanea and O. vulgaris base their body patterns on selected features of nearby objects rather than attempting to match a large field of view. Such an approach enables the octopus to camouflage in partly occluded environments and to solve the problem of differences in appearance as a function of the viewing inclination of the observer.

  16. USER EMOTION IDENTIFICATION IN TWITTER USING SPECIFIC FEATURES: HASHTAG, EMOJI, EMOTICON, AND ADJECTIVE TERM

    Yuita Arum Sari

    2014-08-01

    Full Text Available Abstract Twitter is a social media application, which can give a sign for identifying user emotion. Identification of user emotion can be utilized in commercial domain, health, politic, and security problems. The problem of emotion identification in twit is the unstructured short text messages which lead the difficulty to figure out main features. In this paper, we propose a new framework for identifying the tendency of user emotions using specific features, i.e. hashtag, emoji, emoticon, and adjective term. Preprocessing is applied in the first phase, and then user emotions are identified by means of classification method using kNN. The proposed method can achieve good results, near ground truth, with accuracy of 92%.

  17. CURRENT PHARMACOTHERAPY FOR KNEE OSTEOARTHRITIS: SPECIFIC FEATURES OF SYMPTOMATIC AND DISEASE MODIFYING EFFECTS. COMMUNICATION 1. SPECIFIC FEATURES OF THE SYMPTOMATIC EFFECTS OF CURRENT DRUGS TO TREAT KNEE OSTHEOARTHRITIS

    E. S. Tsvetkova

    2015-01-01

    Full Text Available Objective: to study the specific features of the symptomatic effect and tolerability of acetaminophen, glucosamine sulfate (GS, chondroitin sulfate (CS, and meloxicam in patents with knee osteoarthritis (OA. Subjects and methods. An 18-month open-label randomized prospective parallel-group trial enrolled 80 patients with knee OA who fulfilled the American College of Rheumatology criteria and signed the informed consent. They had Kellgren and Lawrence grades O-III OA with visual analogue scale pain intensity of ≥ 40 mm in the target knee, a body mass index of ≤ 35 kg/m2, and no clinical dysfunctions of vital organs and systems. The patients were randomized into 4 groups: 1 acetaminophen 2 g daily; 2 a standard GS regimen; 3 a standard CS regimen; 4 meloxicam 15 mg daily. The patients were followed up for 18 months. The effectiveness was evaluated by the WOMAC questionnaire, Leguesne index, and OMERACT-OARSI (D scenario during 8 visits. Laboratory and clinical examination as well as electrocardiography were performed. Adverse events were recorded during each visit.Results. After 4 weeks of treatment, symptomatic improvement was noted in all groups; however, the best effect was achieved by the use of meloxicam that ensured an obvious improvement in all patients. According to the OMERACT-OARSI criteria and changes in the WOMAC and Leguesne indices, the total efficacy of meloxicam was also highest. 20, 10, and 15% of the patients failed to respond to treatment in the acetaminophen, GS, and CS groups, respectively. Conclusion. The results of this trial suggest that it is expedient to use GS, CS, and meloxicam long, support the recent guidelines of the European Society for Clinical and Economic Aspects of Osteoporosis and OA (ESCEO, and can give proofs of the efficiency and safety of GS, CS, and meloxicam used in the treatment of knee OA.

  18. Dosimetry in endoscopic examinations

    Aldred, Martha Aurelia; Paes, Walter Siqueira; Fausto, Agnes M.F.; Nucci, Jose Roberto; Yoshimura, Elisabeth Mateus; Okuno, Emico; Maruta, Luis Massuo

    1996-01-01

    Equivalent and effective doses in occupational exposures are evaluated considering that some specific endoscopic examinations, radiographic and fluoroscopic images of patients are taken with the medical staff near to the radiation field. Examinations are simulated using an anthropomorphic phantom as a member of the medical staff. Thermoluminescent dosemeters are attached in several positions of the phantom in order to determine some organ doses. From the comparison between the doses experimentally determined and the International and the Brazilian recommended occupational dose limits, the maximum number of examination that any member of the staff can perform was calculated

  19. Clinical endoscopic management and outcome of post-endoscopic sphincterotomy bleeding.

    Wei-Chen Lin

    Full Text Available Post-endoscopic sphincterotomy bleeding is a common complication of biliary sphincterotomy, and the incidence varies from 1% to 48%. It can be challenging to localize the bleeder or to administer various interventions through a side-viewing endoscope. This study aimed to evaluate the risk factors of post-endoscopic sphincterotomy bleeding and the outcome of endoscopic intervention therapies. We retrospectively reviewed the records of 513 patients who underwent biliary sphincterotomy in Mackay Memorial Hospital between 2011 and 2016. The blood biochemistry, comorbidities, indication for sphincterotomy, severity of bleeding, endoscopic features of bleeder, and type of endoscopic therapy were analyzed. Post-endoscopic sphincterotomy bleeding occurred in 65 (12.6% patients. Forty-five patients had immediate bleeding and 20 patients had delayed bleeding. The multivariate analysis of risk factors associated with post-endoscopic sphincterotomy bleeding were liver cirrhosis (P = 0.029, end-stage renal disease (P = 0.038, previous antiplatelet drug use (P<0.001, and duodenal ulcer (P = 0.023. The complications of pancreatitis and cholangitis were higher in the bleeding group, with statistical significance. Delayed bleeding occurred within 1 to 7 days (mean, 2.5 days, and 60% (12/20 of the patients received endoscopic evaluation. In the delayed bleeding group, the successful hemostasis rate was 71.4% (5/7, and 65% (13/20 of the patients had ceased bleeding without endoscopic hemostasis therapy. Comparison of different therapeutic modalities showed that cholangitis was higher in patients who received epinephrine spray (P = 0.042 and pancreatitis was higher in patients who received epinephrine injection and electrocoagulation (P = 0.041 and P = 0.039 respectively. Clinically, post-endoscopic sphincterotomy bleeding and further endoscopic hemostasis therapy increase the complication rate of pancreatitis and cholangitis. Realizing the effectiveness of each

  20. Specific features of NDT data and processing algorithms: new remedies to old ills

    Georgel, B.

    1994-01-01

    Non destructive testing data from in-service inspections have specific features that require the most sophisticated techniques of signal and image processing. Each step in the overall information extraction process must be optimized by using recent approaches such like data decomposition and modelization, compression, sensor fusion and knowledge based systems. This can be achieved by means of wavelet transform, inverse problems formulation, standard compression algorithms, combined detection and estimation, neural networks and expert systems. These techniques are briefly presented through a number of Electricite de France applications or through recent literature results. (author). 1 fig., 20 refs

  1. Specific features of RBMK severe accidents progression and approach to the accident management

    Vasilevskij, V.P.; Nikitin, Yu.M.; Petrov, A.A.; Potapov, A.A.; Cherkashov, Yu.M.

    2001-01-01

    Fundamental construction features of the LWGR facilities (absence of common external containment shell, disintegrated circulation circuit and multichannel reactor core, positive vapor reactivity coefficient, high mass of thermally capacious graphite moderator) predetermining development of assumed heavy non-projected accidents and handling them are treated. Rating the categories of the reactor core damages for non-projected accidents and accident types producing specific grope of damages is given. Passing standard non-projected accidents, possible methods of attack accident consequences, as well as methods of calculated analysis of non-projected accidents are demonstrated [ru

  2. Application of Specific Features of Industrial Products when Forming and Developing Brands of Industrial Enterprises

    Yatsentiuk Stanislav V.

    2014-03-01

    Full Text Available The article analyses and structures approaches and principles of formulation of industrial products. It offers classification of goods and markets of industrial products by their characteristics and participants. It identifies main participants that make decisions at B2C and B2B markets and characterises their specific features and motivation when making decisions on purchase of products of industrial enterprises. It studies and analyses indicators of development of domestic markets of consumer goods and market of industrial products and dynamics of development of their relation in retrospective view.

  3. Infective endocarditis: the specific features of its course, the criteria for diagnosis, differential diagnosis (part II

    B S Belov

    2008-01-01

    Full Text Available Infective endocarditis (IE is today characterized by polyetiology due to a wide range of pathogens. The paper describes the specific features of the clinical picture of the disease in relation to the etiological agent, which have, in some cases, a crucial role in the choice of empiric antibiotic therapy. Significant clinical polymorphism, obscure symptoms, and monosyndromic onset as guises all enhance the importance of the differential diagnosis of IE, at its early stages in particular. Basic approaches to differentiating IE from the diseases in which differentially diagnostic problems arise to the utmost are outlined.

  4. Importance of radiographic monitoring of endoscopic sphincterotomy

    Greenberg, H.M.; Goldberg, H.I.; Shapiro, H.A.

    1981-01-01

    The radiographic features of endoscopic sphincterotomies performed in 44 patients were evaluated. Radiographic landmarks aided in proper sphincterotome placement and also disclosed conditions and anatomic variations that made catheter placement difficult. Fluoroscopic and radiographic monitoring not only assisted the performance of endoscopic sphincterotomy, but also confirmed successful results and revealed reasons for failure. Radiographic changes in the biliary tract after sphincterotomy, as well as potential complications of sphincterotomy, are discussed and illustrated

  5. A pursuit of lineage-specific and niche-specific proteome features in the world of archaea.

    Roy Chowdhury, Anindya; Dutta, Chitra

    2012-06-12

    Archaea evoke interest among researchers for two enigmatic characteristics -a combination of bacterial and eukaryotic components in their molecular architectures and an enormous diversity in their life-style and metabolic capabilities. Despite considerable research efforts, lineage- specific/niche-specific molecular features of the whole archaeal world are yet to be fully unveiled. The study offers the first large-scale in silico proteome analysis of all archaeal species of known genome sequences with a special emphasis on methanogenic and sulphur-metabolising archaea. Overall amino acid usage in archaea is dominated by GC-bias. But the environmental factors like oxygen requirement or thermal adaptation seem to play important roles in selection of residues with no GC-bias at the codon level. All methanogens, irrespective of their thermal/salt adaptation, show higher usage of Cys and have relatively acidic proteomes, while the proteomes of sulphur-metabolisers have higher aromaticity and more positive charges. Despite of exhibiting thermophilic life-style, korarchaeota possesses an acidic proteome. Among the distinct trends prevailing in COGs (Cluster of Orthologous Groups of proteins) distribution profiles, crenarchaeal organisms display higher intra-order variations in COGs repertoire, especially in the metabolic ones, as compared to euryarchaea. All methanogens are characterised by a presence of 22 exclusive COGs. Divergences in amino acid usage, aromaticity/charge profiles and COG repertoire among methanogens and sulphur-metabolisers, aerobic and anaerobic archaea or korarchaeota and nanoarchaeota, as elucidated in the present study, point towards the presence of distinct molecular strategies for niche specialization in the archaeal world.

  6. A pursuit of lineage-specific and niche-specific proteome features in the world of archaea

    Roy Chowdhury Anindya

    2012-06-01

    Full Text Available Abstract Background Archaea evoke interest among researchers for two enigmatic characteristics –a combination of bacterial and eukaryotic components in their molecular architectures and an enormous diversity in their life-style and metabolic capabilities. Despite considerable research efforts, lineage- specific/niche-specific molecular features of the whole archaeal world are yet to be fully unveiled. The study offers the first large-scale in silico proteome analysis of all archaeal species of known genome sequences with a special emphasis on methanogenic and sulphur-metabolising archaea. Results Overall amino acid usage in archaea is dominated by GC-bias. But the environmental factors like oxygen requirement or thermal adaptation seem to play important roles in selection of residues with no GC-bias at the codon level. All methanogens, irrespective of their thermal/salt adaptation, show higher usage of Cys and have relatively acidic proteomes, while the proteomes of sulphur-metabolisers have higher aromaticity and more positive charges. Despite of exhibiting thermophilic life-style, korarchaeota possesses an acidic proteome. Among the distinct trends prevailing in COGs (Cluster of Orthologous Groups of proteins distribution profiles, crenarchaeal organisms display higher intra-order variations in COGs repertoire, especially in the metabolic ones, as compared to euryarchaea. All methanogens are characterised by a presence of 22 exclusive COGs. Conclusions Divergences in amino acid usage, aromaticity/charge profiles and COG repertoire among methanogens and sulphur-metabolisers, aerobic and anaerobic archaea or korarchaeota and nanoarchaeota, as elucidated in the present study, point towards the presence of distinct molecular strategies for niche specialization in the archaeal world.

  7. SPECIFIC FEATURES OF THE SOCIAL INTELLIGENCE OF THE TEENAGERS MAKING USE OF SMOKING BLENDS

    Anna Leonidovna Plotnikova

    2016-02-01

    Full Text Available In this article one can find the results of the research of the teenagers social intelligence at the age of 14-15 years old, making use of narcotic smoking blends. Some specific features of their social intelligence, development level of empathy and communicative skills in comparison with nonsmoking peers are given.Purpose: to find and describe specific features of the social intelligence of the teenagers at the age of 14-15 years old making use of the narcotic smoking blends in comparison with nonsmoking peers.Method: testing, Mann – Whitney U Test.Results: the teenagers making use of narcotic smoking blends have a low level of the social intelligence, communicative skills and empathic abilities. Such elements of the social intelligence as the ability to foresee the behavioral consequences in a concrete situation (prognostic competence and the ability to logical generalization of non-verbal reactions of a person are worse developed in comparison with nonsmoking peers. There are no significant differences between smoking girls and smoking boys.Areas of use: resocialization and rehabilitation of the addicted teenagers

  8. The Advantage of Playing Home in NBA: Microscopic, Team-Specific and Evolving Features.

    Ribeiro, Haroldo V; Mukherjee, Satyam; Zeng, Xiao Han T

    2016-01-01

    The idea that the success rate of a team increases when playing home is broadly accepted and documented for a wide variety of sports. Investigations on the so-called "home advantage phenomenon" date back to the 70's and ever since has attracted the attention of scholars and sport enthusiasts. These studies have been mainly focused on identifying the phenomenon and trying to correlate it with external factors such as crowd noise and referee bias. Much less is known about the effects of home advantage in the "microscopic" dynamics of the game (within the game) or possible team-specific and evolving features of this phenomenon. Here we present a detailed study of these previous features in the National Basketball Association (NBA). By analyzing play-by-play events of more than sixteen thousand games that span thirteen NBA seasons, we have found that home advantage affects the microscopic dynamics of the game by increasing the scoring rates and decreasing the time intervals between scores of teams playing home. We verified that these two features are different among the NBA teams, for instance, the scoring rate of the Cleveland Cavaliers team is increased ≈0.16 points per minute (on average the seasons 2004-05 to 2013-14) when playing home, whereas for the New Jersey Nets (now the Brooklyn Nets) this rate increases in only ≈0.04 points per minute. We further observed that these microscopic features have evolved over time in a non-trivial manner when analyzing the results team-by-team. However, after averaging over all teams some regularities emerge; in particular, we noticed that the average differences in the scoring rates and in the characteristic times (related to the time intervals between scores) have slightly decreased over time, suggesting a weakening of the phenomenon. This study thus adds evidence of the home advantage phenomenon and contributes to a deeper understanding of this effect over the course of games.

  9. The Advantage of Playing Home in NBA: Microscopic, Team-Specific and Evolving Features.

    Haroldo V Ribeiro

    Full Text Available The idea that the success rate of a team increases when playing home is broadly accepted and documented for a wide variety of sports. Investigations on the so-called "home advantage phenomenon" date back to the 70's and ever since has attracted the attention of scholars and sport enthusiasts. These studies have been mainly focused on identifying the phenomenon and trying to correlate it with external factors such as crowd noise and referee bias. Much less is known about the effects of home advantage in the "microscopic" dynamics of the game (within the game or possible team-specific and evolving features of this phenomenon. Here we present a detailed study of these previous features in the National Basketball Association (NBA. By analyzing play-by-play events of more than sixteen thousand games that span thirteen NBA seasons, we have found that home advantage affects the microscopic dynamics of the game by increasing the scoring rates and decreasing the time intervals between scores of teams playing home. We verified that these two features are different among the NBA teams, for instance, the scoring rate of the Cleveland Cavaliers team is increased ≈0.16 points per minute (on average the seasons 2004-05 to 2013-14 when playing home, whereas for the New Jersey Nets (now the Brooklyn Nets this rate increases in only ≈0.04 points per minute. We further observed that these microscopic features have evolved over time in a non-trivial manner when analyzing the results team-by-team. However, after averaging over all teams some regularities emerge; in particular, we noticed that the average differences in the scoring rates and in the characteristic times (related to the time intervals between scores have slightly decreased over time, suggesting a weakening of the phenomenon. This study thus adds evidence of the home advantage phenomenon and contributes to a deeper understanding of this effect over the course of games.

  10. “Focal thyroid inferno” on color Doppler ultrasonography: A specific feature of focal Hashimoto's thyroiditis

    Fu, Xianshui; Guo, Limei; Zhang, Huabin; Ran, Weiqiang; Fu, Peng; Li, Zhiqiang; Chen, Wen; Jiang, Ling; Wang, Jinrui; Jia, Jianwen

    2012-01-01

    Purpose: To evaluate color-Doppler features predictive of focal Hashimoto's thyroiditis. Materials and methods: A total of 521 patients with 561 thyroid nodules that underwent surgeries or gun biopsies were included in this study. These nodules were divided into three groups: focal Hashimoto's thyroiditis (104 nodules in 101 patients), benignity other than focal Hashimoto's thyroiditis (73 nodules in 70 patients), and malignancy (358 nodules in 350 patients). On color Doppler sonography, four vascularity types were determined as: hypovascularity, marked internal flow, marked peripheral flow and focal thyroid inferno. The χ 2 test was performed to seek the potential vascularity type with the predictive ability of certain thyroid pathology. Furthermore, the gray-scale features of each nodule were also studied. Results: The vascularity type I (hypovascularity) was more often seen in focal Hashimoto's thyroiditis than other benignity and malignancy (46% vs. 20.5% and 19%). While the type II (marked internal flow) showed the opposite tendency (26.9% [focal Hashimoto's thyroiditis] vs. 45.2% [other benignity] and 52.8% [malignancy]). However, type III (marked peripheral flow) was unable to predict any thyroid pathology. Importantly, type IV (focal thyroid inferno) was exclusive to focal Hashimoto's thyroiditis. All 8 type IV nodules appeared to be solid, hypoechoic, and well-defined. Using “focal thyroid inferno” as an indicator of FHT, the diagnostic sensitivity and specificity were 7.7% and 100% respectively. Conclusions: The vascularity type of “focal thyroid inferno” is specific for focal Hashimoto thyroiditis. Recognition of this particular feature may avoid unnecessary interventional procedures for some solid hypoechoic thyroid nodules suspicious of malignancy.

  11. Endoscopic Ultrasonography in the Diagnosis of Gastric Subepithelial Lesions

    Eun Jeong Gong

    2016-09-01

    Full Text Available Subepithelial lesions occasionally found in the stomach of patients undergoing endoscopy may be either benign lesions or tumors with malignant potential. They may also appear due to extrinsic compression. Discrimination of gastric subepithelial lesions begins with meticulous endoscopic examination for size, shape, color, mobility, consistency, and appearance of the overlying mucosa. Accurate diagnosis can be achieved with endoscopic ultrasonography, which provides useful information on the exact size, layer-of-origin, and characteristic morphologic features to support a definitive diagnosis. Endoscopic ultrasonography also aids in the prediction of malignant potential, especially in gastrointestinal stromal tumors. Features of subepithelial lesions identified on endoscopic ultrasonography can be used to determine whether further diagnostic procedures such as endoscopic resection, fine needle aspiration, or core biopsy are required. Endoscopic ultrasonography is a valuable tool for diagnosis and clinical decision making during follow-up of gastric subepithelial lesions.

  12. Face processing in chronic alcoholism: a specific deficit for emotional features.

    Maurage, P; Campanella, S; Philippot, P; Martin, S; de Timary, P

    2008-04-01

    It is well established that chronic alcoholism is associated with a deficit in the decoding of emotional facial expression (EFE). Nevertheless, it is still unclear whether this deficit is specifically for emotions or due to a more general impairment in visual or facial processing. This study was designed to clarify this issue using multiple control tasks and the subtraction method. Eighteen patients suffering from chronic alcoholism and 18 matched healthy control subjects were asked to perform several tasks evaluating (1) Basic visuo-spatial and facial identity processing; (2) Simple reaction times; (3) Complex facial features identification (namely age, emotion, gender, and race). Accuracy and reaction times were recorded. Alcoholic patients had a preserved performance for visuo-spatial and facial identity processing, but their performance was impaired for visuo-motor abilities and for the detection of complex facial aspects. More importantly, the subtraction method showed that alcoholism is associated with a specific EFE decoding deficit, still present when visuo-motor slowing down is controlled for. These results offer a post hoc confirmation of earlier data showing an EFE decoding deficit in alcoholism by strongly suggesting a specificity of this deficit for emotions. This may have implications for clinical situations, where emotional impairments are frequently observed among alcoholic subjects.

  13. Constitution-specific features of perspiration and skin visco-elasticity in SCM.

    Kim, Young-Min; Ku, Boncho; Jung, Chang Jin; Kim, Jaeuk U; Jeon, Young Ju; Kim, Keun Ho; Kim, Jong Yeol

    2014-01-15

    Human skin properties have been used as an important diagnostic component in traditional medicine as they change with health conditions. Sasang constitutional medicine (SCM) puts emphasis on the recognition of the constitution-specific skin features prior to the diagnostic decision of health. In this work, in search of skin-characteristics effectively reflecting SCM features, we compared several skin properties such as perspiration, visco-elasticity, elasticity, and elasticity hysteresis, in several candidate body parts. We conducted a clinical study in which a total of 111 healthy females aged 50 - 70 years participated with their Sasang constitution (SC) types determined objectively by the Sasang constitutional analytic tool. Perspiration on the skin surface was estimated by using a capacitance sensor to measure the amount of moisture on the palm, forehead, and philtrum before and after a heating stimulus. We acquired the visco-elasticity, elasticity, and elasticity hysteresis at the forearm by Dermalab's elasticity sensing device. An analysis of covariance (ANCOVA) was conducted to evaluate the effect of SC on the nine skin features acquired. The visco-elasticity of the forearm of the Soeum-in (SE) group was significantly lower than that of the Taeeum-in (TE) group (F = 68.867, p elasticity hysteresis of the SE group was higher than that of the TE group (F = 10.364, p elasticity, elasticity hysteresis, perspiration on the forehead and philtrum. Our findings are based on a novel interpretation of the SCM literature and will contribute to developing the constitutional health status evaluation system in SCM.

  14. A highly specific phage defense system is a conserved feature of the Vibrio cholerae mobilome.

    Brendan J O'Hara

    2017-06-01

    Full Text Available Vibrio cholerae-specific bacteriophages are common features of the microbial community during cholera infection in humans. Phages impose strong selective pressure that favors the expansion of phage-resistant strains over their vulnerable counterparts. The mechanisms allowing virulent V. cholerae strains to defend against the ubiquitous threat of predatory phages have not been established. Here, we show that V. cholerae PLEs (phage-inducible chromosomal island-like elements are widespread genomic islands dedicated to phage defense. Analysis of V. cholerae isolates spanning a 60-year collection period identified five unique PLEs. Remarkably, we found that all PLEs (regardless of geographic or temporal origin respond to infection by a myovirus called ICP1, the most prominent V. cholerae phage found in cholera patient stool samples from Bangladesh. We found that PLE activity reduces phage genome replication and accelerates cell lysis following ICP1 infection, killing infected host cells and preventing the production of progeny phage. PLEs are mobilized by ICP1 infection and can spread to neighboring cells such that protection from phage predation can be horizontally acquired. Our results reveal that PLEs are a persistent feature of the V. cholerae mobilome that are adapted to providing protection from a single predatory phage and advance our understanding of how phages influence pathogen evolution.

  15. A highly specific phage defense system is a conserved feature of the Vibrio cholerae mobilome.

    O'Hara, Brendan J; Barth, Zachary K; McKitterick, Amelia C; Seed, Kimberley D

    2017-06-01

    Vibrio cholerae-specific bacteriophages are common features of the microbial community during cholera infection in humans. Phages impose strong selective pressure that favors the expansion of phage-resistant strains over their vulnerable counterparts. The mechanisms allowing virulent V. cholerae strains to defend against the ubiquitous threat of predatory phages have not been established. Here, we show that V. cholerae PLEs (phage-inducible chromosomal island-like elements) are widespread genomic islands dedicated to phage defense. Analysis of V. cholerae isolates spanning a 60-year collection period identified five unique PLEs. Remarkably, we found that all PLEs (regardless of geographic or temporal origin) respond to infection by a myovirus called ICP1, the most prominent V. cholerae phage found in cholera patient stool samples from Bangladesh. We found that PLE activity reduces phage genome replication and accelerates cell lysis following ICP1 infection, killing infected host cells and preventing the production of progeny phage. PLEs are mobilized by ICP1 infection and can spread to neighboring cells such that protection from phage predation can be horizontally acquired. Our results reveal that PLEs are a persistent feature of the V. cholerae mobilome that are adapted to providing protection from a single predatory phage and advance our understanding of how phages influence pathogen evolution.

  16. Sensitivity and specificity of ultrasonographic features of gout in intercritical and chronic phase.

    Das, Shyamashis; Ghosh, Alakendu; Ghosh, Parasar; Lahiri, Debasish; Sinhamahapatra, Pradyot; Basu, Kaushik

    2017-07-01

    This study aimed to assess the sensitivity and specificity of ultrasonographic features of gout in intercritical and chronic stages and compared ultrasonographic features of gout between patients with persistent high serum uric acid (SUA) and patients with low SUA. Adult patients with gout confirmed by demonstration of monosodium urate crystals were recruited, if they were in intercritical or chronic stage clinically. Ultrasonographic examination of the first metatarsophalangeal joints (MTPJs) and the knee joints of both sides were done by a blinded rheumatologist trained in musculoskeletal ultrasound. Sixty-two patients with gout and 30 control subjects were examined. The double contour sign (DCS) was found in 71 (57.3%) first MTPJs and tophi were found in 54 (43.5%) first MTPJs. DCS was present in 43 (69.4%) gout patients but none in the control group (P gout patients were 69.4% (56.4-80.4%) and 100% (88.3-100%), respectively, while of tophi they were 66.1% (53-77.7%) and 100% (88.3-100%), respectively. The sensitivity of DCS increased to 100% in high the SUA subgroup (SUA ≥ 7 mg/dL). The low SUA (SUA gout subgroup showed significantly higher occurrence of erosions (40%) and tophi (50%) in first MTP joints than the control group. MSUS is useful for diagnosis of gout in intercritical or chronic stages, especially in patients with persistently high SUA level. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  17. Molecular Features of Subtype-Specific Progression from Ductal Carcinoma In Situ to Invasive Breast Cancer

    Robert Lesurf

    2016-07-01

    Full Text Available Breast cancer consists of at least five main molecular “intrinsic” subtypes that are reflected in both pre-invasive and invasive disease. Although previous studies have suggested that many of the molecular features of invasive breast cancer are established early, it is unclear what mechanisms drive progression and whether the mechanisms of progression are dependent or independent of subtype. We have generated mRNA, miRNA, and DNA copy-number profiles from a total of 59 in situ lesions and 85 invasive tumors in order to comprehensively identify those genes, signaling pathways, processes, and cell types that are involved in breast cancer progression. Our work provides evidence that there are molecular features associated with disease progression that are unique to the intrinsic subtypes. We additionally establish subtype-specific signatures that are able to identify a small proportion of pre-invasive tumors with expression profiles that resemble invasive carcinoma, indicating a higher likelihood of future disease progression.

  18. Analysis of Specific Features of International Standards of Personnel Security of an Enterprise

    Otenko Iryna P.

    2014-03-01

    Full Text Available The article marks out components of personnel security of an enterprise, outlines processes of personnel management, which correspond with conditions of security of life and labour, competent, socially protected professional activity, availability of the acting system of motivation and stimulation, and possibilities for corporate conflicts resolution. The article presents basic standards, rules and legislative acts that regulate ensuring personnel security. It analyses specific features of application of standards with respect to: life security and labour protection culture at an enterprise, including managerial systems and practice, behaviour of personnel at working places and also intellectual component of personnel security, which envisages that personnel has knowledge and competences that assist in achievement of strategic goals of an enterprise.

  19. Specific feature of magnetooptical images of stray fields of magnets of various geometrical shapes

    Ivanov, V. E.; Koveshnikov, A. V.; Andreev, S. V.

    2017-08-01

    Specific features of magnetooptical images (MOIs) of stray fields near the faces of prismatic hard magnetic elements have been studied. Attention has primarily been focused on MOIs of fields near faces oriented perpendicular to the magnetic moment of hard magnetic elements. With regard to the polar sensitivity, MOIs have practically uniform brightness and geometrically they coincide with the figures of the bases of the elements. With regard to longitudinal sensitivity, MOIs consist of several sectors, the number of which is determined by the number of angles of the image. Each angle is divided by the bisectrix into two sectors of different brightnesses; therefore, the MOI of a triangular magnet consists of three sectors. A rectangle consists of four sectors separated by the bisectrices of the interior angles. In all types of figures, these lines converge at the center of the figure and form a singular point of the source or sink type.

  20. [The prevalence, causes and specific features of voice disturbances in teachers].

    Orlova, O S; Vasilenko, Iu S; Zakharova, A F; Samokhvalova, L O; Kozlova, P A

    2000-01-01

    The paper analyzes voice disturbances, their causes and specific features in teachers based on the questionnaires filled by 934 general educational school teachers. The teachers have been found to associate voice disturbances not only with changes in the voice timbre, but with different subjective feelings that make their professional activity difficult. The major factors that cause voice disturbances are the voice overloads that differ in teachers of different specialities, their inability to use the voice, psychoemotional stresses, and frequent colds, as well as a combination of several factors. The incidence of vocal apparatus diseases does not tend to decrease, which makes it necessary to implement combined medical and pedagogical prophylactic measures to prevent dysphonia.

  1. Specific features of the WWER Uranium-Gadolinium fuel behavior at BOL

    Shcheglov, A.; Proselkov, V.; Volkov, B.

    2013-01-01

    The calculated-experimental analysis of the WWER fuel behavior with 5%wt of gadolinium oxide at the beginning of life (BOL) is presented. The results are based on the data on fuel centerline temperature measurements, gas media pressure inside the cladding and fuel elongation obtained during irradiation of the test fuel rods in HBWR (Halden). Computer analysis of experimental data is performed with TOPRA-2, version 2 code. It is shown that specific features of the uranium-gadolinium fuel behavior at the early of life is due to presence of burnable absorber influencing the average linear heat rating, radial power distribution and lower thermal conductivity. In particular, the analysis of “late” relocation effect on the maximum Gd fuel temperature is presented. (authors)

  2. The construction of a library of synthetic promoters revealed some specific features of strong Streptomyces promoters

    Seghezzi, Nicolas; Amar, Patrick; Købmann, Brian

    2011-01-01

    Streptomyces are bacteria of industrial interest whose genome contains more than 73% of bases GC. In order to define, in these GC-rich bacteria, specific sequence features of strong promoters, a library of synthetic promoters of various sequence composition was constructed in Streptomyces. To do so...... cloned into the promoter-probe plasmid pIJ487 just upstream of the promoter-less aphII gene that confers resistance to neomycin. This synthetic promoter library was transformed into Streptomyces lividans, and the resulting transformants were screened for their ability to grow in the presence of different...... projects. Thirty-eight promoters were sequenced, and the sequences of the 14 weakest and 14 strongest promoters were compared using the WebLogo software with small sample correction. This comparison revealed that the −10 box, the −10 extended motif as well as the spacer of the strong Streptomyces promoters...

  3. Specifics of Gender Manifestation of Prosocial and Antisocial Features in Human Behavior

    Shatyr Yuliya Aleksandrovna

    2014-12-01

    Full Text Available The paper presents an analysis of the gender factors in the formation of prosociality – asociality in humans. A set of indicators reflecting the quantitative and qualitative terms motivational prerequisites of social behavior is presented. The estimation actualization needs are characterized as the beginning of the centripetal and focused on the involvement of the individual in society. Comparative analysis and accentuation of personality traits identified predominance of cycles, emotive and exaltation on the background of male domination of reactive aggression and masculinity. Assessment of the severity of empathy revealed the advantage of emotional and intuitive channels in the group of women relative to men. Undertaken study allowed to determine the presence of specific features of the formation of prosocial behavior of women, where the key element is the dominance of emotional factors initiation of social behavior, and situational mode, reactive response.

  4. The Specific Features of the Course of Critical Conditions in Miners

    V. V. Moroz

    2012-01-01

    Full Text Available Objective: to improve treatment results in miners, by studying the specific features of the course of their critical conditions caused by severe traumatic injuries, and to develop differentiated intensive therapeutic regimens for detected abnormalities. Subjects and methods. A total of 1107 subjects were examined during the study. Central hemodynamic function was explored in 371 healthy miners with various lengths of underground mining; a control group included 30 healthy volunteers unexposed to occupational hazards. Examinations were made in 386 severe brain injury victims, including 218 victims with no length of underground work and 115 injured miners with an underground work length of more than 5 years. A control group comprised 53 apparently healthy donors. One hundred and twenty-two miners with severe thermal injury were examined. A control group consisted of 39 apparently healthy volunteers. One hundred and six victims with acute respiratory distress syndrome in the presence of severe concomitant injury were examined under mechanical ventilation. Sixty-three injured miners formed a study group; a comparison group included 43 subjects with no length of underground mining. Conclusion. Upon longer exposure to occupational hazards, the prenosological changes occur in the miners' organs and systems, which display a regular phasic pattern, fit in the picture of general adjustment syndrome, and determine the specific features of critical conditions. The peculiarities of the critical conditions caused by severe traumatic injuries in miners are the early development and high frequency of complications, the more severe course and late recovery of the body's lost functions, unlike the victims unexposed to occupational hazards. Differentiated intensive therapy for critical conditions in miners with severe traumatic injuries makes it possible to improve treatment results and to reduce death rates. 

  5. Analysis of Specific Features of the Ukrainian Market of Natural Gas Production and Consumption

    Lelyuk Oleksiy V.

    2013-11-01

    Full Text Available The article provides results of the study of specific features of the Ukrainian market of natural gas production and consumption. It analyses dynamics of the specific weight of Ukraine in general volumes of natural gas consumption in the world, dynamics of natural gas consumption in Ukraine during 1990 – 2012 and dependence of natural gas consumption on GDP volumes by the purchasing power parity. It studies the structure of natural gas consumption by regions in 2012 and sectors of economy, resource base of natural gas in Ukraine and also dynamics of established resources of natural gas in Ukraine and dynamics of natural gas production. It analyses base rates of growth of natural gas resources and production in Ukraine. It considers dynamics of import of natural gas into Ukraine and its import prices and also the structure of natural gas import. It identifies the balance of the natural gas market in Ukraine. On the basis of the conducted analysis the article proves that Ukraine is a gas-deficit country of the world, which depends on natural gas import supplies.

  6. Minearl associated microbial communities from The Cedars, associate with specific geological features

    Rowe, A. R.; Wanger, G. P.; Bhartia, R.

    2017-12-01

    The Cedars, an area of active serpentinization located in the Russian River area of Northern California, represents one of the few terrestrial areas on Earth undergoing active serpentinization. One of the products of the serpentinization reaction is the formation of hydroxyl radicals making the springs of the Cedars some of the most alkaline natural waters on Earth. These waters, with very high pH (pH>11), low EH and, low concentrations of electron acceptors are extremely inhospitible; however microbial life has found a way to thrive and a distinct microbial community is observed in the spring waters. Previous work with environmental samples and pure culture isolates [3] derived from The Cedars has suggested the importance of minearal association to these characteristic microbes. Here we show the results combined spectroscopic and molecular studies on aseries of mineral colonization experiemnts performed with a pure culture Cedar's isolate (Serpentenamonas str. A1) and in situ at CS spring. Centimeter scale, polished coupons of a variety of mminerals were prepared in the lab, spectroscopically characterized (Green Raman, DUV Raman, and DUV Fluorescence maps) and deployed into the springs for three months. The coupons were recovered and the distribution of the microbes on the minerals was mapped using a deep-UV native fluorescent mapping sustem that allows for non-destructive mapping of organics and microbes on surfaces. Subsequently the DNA from the minerals was extracted for community structure analysis. The MOSAIC (i.e. deep UV Fluorescence) showed extensicve colonization of the minerals and in some cases we were able to correlate microbial assemblages with specific geological features. In one example, organisms tended to associate strongly with carbonate features on Chromite mineral surfaces (Figure 1). The 16s rDNA revealed the microbial assemblages from each slide was dominated by active Cedars community memebers (i.e., Serpentinamonas and Silanimonas species

  7. Endoscopically removed giant submucosal lipoma

    Jovanović Ivan

    2007-01-01

    Full Text Available Background. Although uncommon, giant submucosal colon lipomas merit attention as they are often presented with dramatic clinical features such as bleeding, acute bowel obstruction, perforation and sometimes may be mistaken for malignancy. There is a great debate in the literature as to how to treat them. Case report. A patient, 67-year old, was admitted to the Clinic due to a constipation over the last several months, increasing abdominal pain mainly localized in the left lower quadrant accompanied by nausea, vomiting and abdominal distension. Physical examination was unremarkable and the results of the detailed laboratory tests and carcinoembryonic antigen remained within normal limits. Colonoscopy revealed a large 10 cm long, and 4 to 5 cm in diameter, mobile lesion in his sigmoid colon. Conventional endoscopic ultrasound revealed 5 cm hyperechoic lesion of the colonic wall. Twenty MHz mini-probe examination showed that lesion was limited to the submucosa. Since polyp appeared too large for a single transaction, it was removed piecemeal. Once the largest portion of the polyp has been resected, it was relatively easy to place the opened snare loop around portions of the residual polyp. Endoscopic resection was carried out safely without complications. Histological examination revealed the common typical histological features of lipoma elsewhere. The patient remained stable and eventually discharged home. Four weeks later he suffered no recurrent symptoms. Conclusion. Colonic lipomas can be endoscopically removed safely eliminating unnecessary surgery.

  8. Inflation in Modern Russia: Theoretical Foundations, Specific Features of Manifestation and Regional Dimension

    Vladimir Vladimirovich Ilyashenko

    2017-06-01

    Full Text Available The purpose of the article is to characterize the development and specific features of inflation in Russia on the basis of its theoretical justification and practical analysis. The article discusses the monetarist and Keynesian approaches to the characterization of inflation. The paper shows that the equation of exchange from the quantity theory of money, which is the basis of the monetarist theory of inflation, does not allow to make an unambiguous conclusion about the direct relationship between money supply and price level in the economy. The authors give the theoretical substantiation of cost-push inflation from the position of microeconomic theory, which is denied by the representatives of the monetarist school. We characterize the specific features of inflation in the period of market transformations in Russia. The article shows the considerable role of the cost factors of cost-push inflation: the monopolization of the economy, rise in the prices of energy and raw materials. There is an absence of the direct relationship between inflation and money supply growth in large part of the period of the 2000. The authors determine the dependence between the exchange rate and inflation in the Russian economy, which is most evident during periods of significant devaluation of the national currency, as a rule, associated with a significant increase in world oil prices. The paper notes that the significant decline in aggregate demand that occurred in Russia in recent years have reduced the level of inflation in 2016. Despite this, the reduction of inflation and its transformation to slow cost-push inflation was combined with negative consequences for the economy: the decrease of investments and production development, reduction of the living standards of the population. The authors conducted the analysis of inflation on the level of the subjects of the Russian Federation, which has confirmed the significant role of causes of cost-push inflation in

  9. The clinical and endoscopic spectrum of the watermelon stomach

    Gostout, C. J.; Viggiano, T. R.; Ahlquist, D. A.; Wang, K. K.; Larson, M. V.; Balm, R.

    1992-01-01

    The watermelon stomach is an uncommon but treatable cause of chronic gastrointestinal bleeding. We report our experience with the clinical and endoscopic features of 45 consecutive patients treated by endoscopic Nd:YAG laser coagulation. The prototypic patient was a woman (71%) with an average age

  10. [The characters and specific features of new human embryonic stem cells lines].

    Krylova, T A; Kol'tsova, A M; Zenin, V V; Gordeeva, O F; Musorina, A S; Goriachaia, T S; Shlykova, S A; Kamenetskaia, Iu K; Pinaev, G P; Polianskaia, G G

    2009-01-01

    Four continuous human embryonic stem cell lines (SC1, SC2, SC3 and SC4), derived from the blastocysts has been described. The cell lines were cultivated on mitotically inactivated human feeder cells. The cell lines SC1 and SC2 have passed through 150 population doublings and the cell lines SC3 and SC4 -- near 120 populations doublings, which exceeds Hayflick limit sufficiently. These cell lines maintain high activity of alkaline phosphatase, expression of transcription factor OCT-4 and cell surface antigens (SSEA-4, TRA-1-60 and TRA-1-81), confirming their ESC status and human specificity. Immunofluorescent detection of antigens, characteristic of ectoderm, endoderm and mesoderm confirms the ability of these cells to retain their pluripotency under in vitro condition. PCR analysis revealed expression of six genes specific for pluripotent cells (OCT-4, NANOG, DPPA3/STELLA, TDGF/CRIPTO and LEFTYA). Correlation between the level of proliferative activity and the character of DNA-bound fluorescent staining was found. Fluorescent dyes, Hoechst 33342 and PI, produced diffuse staining of the nuclei in slowly proliferating cells of the SC1 and SC2 lines. In contrast, in actively proliferating cells of the SC3 and SC4 lines, the clear staining of the nuclei was observed. Upon changing the cultivation condition, proliferative activity of SC3 and SC4 lines decreased and became similar to that of SC1 and SC2 lines. The character of the fluorescent staining of all these lines was also shown to be similar. These results show that quality of the fluorescent staining with Hoechst 33342 and PI reflects the level of proliferation. Possible causes and mechanisms of this feature of human ESC are discussed.

  11. Endoscopic submucosal dissection

    Pimentel-Nunes, Pedro; Dinis-Ribeiro, Mário; Ponchon, Thierry

    2015-01-01

    evidence). 2 ESGE recommends endoscopic resection with a curative intent for visible lesions in Barrett's esophagus (strong recommendation, moderate quality evidence). ESD has not been shown to be superior to EMR for excision of mucosal cancer, and for that reason EMR should be preferred. ESD may...... RECOMMENDATIONS: 1 ESGE recommends endoscopic en bloc resection for superficial esophageal squamous cell cancers (SCCs), excluding those with obvious submucosal involvement (strong recommendation, moderate quality evidence). Endoscopic mucosal resection (EMR) may be considered in such lesions when...

  12. Modelling energy demand of developing countries: Are the specific features adequately captured?

    Bhattacharyya, Subhes C.; Timilsina, Govinda R.

    2010-01-01

    This paper critically reviews existing energy demand forecasting methodologies highlighting the methodological diversities and developments over the past four decades in order to investigate whether the existing energy demand models are appropriate for capturing the specific features of developing countries. The study finds that two types of approaches, econometric and end-use accounting, are commonly used in the existing energy demand models. Although energy demand models have greatly evolved since the early seventies, key issues such as the poor-rich and urban-rural divides, traditional energy resources and differentiation between commercial and non-commercial energy commodities are often poorly reflected in these models. While the end-use energy accounting models with detailed sectoral representations produce more realistic projections as compared to the econometric models, they still suffer from huge data deficiencies especially in developing countries. Development and maintenance of more detailed energy databases, further development of models to better reflect developing country context and institutionalizing the modelling capacity in developing countries are the key requirements for energy demand modelling to deliver richer and more reliable input to policy formulation in developing countries.

  13. [Specific features of Becker Muscular Dystrophy patients and female carriers of Duchenne Muscular Dystrophy].

    Magot, A; Mercier, S; Péréon, Y

    2015-12-01

    Becker muscular dystrophy (BMD) was first described in 1955 and linked to the DMD gene in 1987. Compared to Duchenne muscular dystrophy (DMD), clinical onset of BMD usually occurs after the age of 12 and wheelchair is required after the age of 16. BMD is characterized by generalized weakness first affecting limb girdle muscles, hypertrophy of the calves and cardiomyopathy in males. Some patients have only mild symptoms such as cramps or elevated serum creatine kinases (SCK) throughout all their lives. SCK levels are usually elevated. Muscle biopsy (immunohistochemistry or immunoblotting) shows a dystrophic pattern with abnormal dystrophin staining. Diagnosis is confirmed by DMD gene sequencing. Deletions or duplications of one or several exons are identified in the majority of cases. A multidisciplinary approach is recommended for the care management of these patients with a particular attention to the cardiomyopathy, which is typically responsible for death but can be prevented by specific treatment. X-linked dilated cardiomyopathies linked to DMD gene are a phenotypic continuum of BMD. Some female carriers of DMD mutations exhibit clinical symptoms of variable severity, often milder and beginning later than in males. The cardiomyopathy is the most frequent feature that should be especially monitored in these patients. Genetic counselling should be systematically proposed. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. Specific features of the behaviour of excess currents in tunnel diodes of n-GaAs

    Vyatkin, A.P.; Glushchenko, V.A.; Parkhomenko, R.P.; Pastor, A.P.

    1981-01-01

    The behaviour of currents in the field of a valley of volt-ampere characteristics (VAC) and the effect of 2.0 MeV electron bombardment on the characteristics of tunnel n-GaAs of TD diodes is considered. Release of tunnel and thermal current components has shown that the first component of excess currents is due to electron tunneling through intermediate states situated in a wide region of the forbidden zone. The nature of the second current component is explained by far reaching into the region of the forbidden zone tails of electron states on which energy impurity states can superimpose. Highly-alloyed TD with concentrations n>=3x10 19 cm -3 and p=(1.5-2)x10 20 cm -3 practically are not sensitive to doses up to phi approximately 2x10 17 el/cm 2 . Radiation induced defects related with electron bombardment is rather small. Specific features of the preparation of n-GaAs tunnel diodes lead to the fact that as a result of complex alloying of the p-region of the diode a relatively slow increase of excess currents as compared with the TD corresponding currents from the p-GaAs is observed

  15. Specific features of two diffraction schemes for a widely divergent X-ray beam

    Avetyan, K. T.; Levonyan, L. V.; Semerjian, H. S.; Arakelyan, M. M., E-mail: marakelyan@ysu.am; Badalyan, O. M. [Yerevan State University (Armenia)

    2015-03-15

    We investigated the specific features of two diffraction schemes for a widely divergent X-ray beam that use a circular diaphragm 30–50 μm in diameter as a point source of characteristic radiation. In one of the schemes, the diaphragm was set in front of the crystal (the diaphragm-crystal (d-c) scheme); in the other, it was installed behind the crystal (the crystal-diaphragm (c-d) scheme). It was established that the diffraction image in the c-d scheme is a topographic map of the investigated crystal area. In the d-c scheme at L = 2l (l and L are the distances between the crystal and the diaphragm and between the photographic plate and the diaphragm, respectively), the branches of hyperbolas formed in this family of planes (hkl) by the characteristic K{sub α} and K{sub β} radiations, including higher order reflections, converge into one straight line. It is experimentally demonstrated that this convergence is very sensitive to structural inhomogeneities in the crystal under study.

  16. Specific features of domestic banks activity in the factoring services market

    Trygub Olena V.

    2014-01-01

    Full Text Available The article analyses specific features of formation and development of the domestic factoring market. In the result of the study the article establishes that development of factoring in Ukraine took place due to active participation of banking institutions in this process and nowadays they are leaders in the domestic factoring services market due to possessing significant competitive advantages if compared with non-banking companies that specialise in factoring. The article detects that nowadays the banks are not only offerers of factoring services and finance factoring operations of other market participants, but also take an active part in establishment of factoring branches and are consumers of factoring services. In order to accelerate development of international factoring in Ukraine, the article offers such forms of state support of banks, which render factoring services to domestic exporters. The article recommends to focus banks’ attention, under modern conditions that are characterised with volatility of financial markets, on factoring servicing of those clients, whom they have long business relations with, without jeopardising themselves through provision of factoring services to a big number of small debtors. The article provides schemes of banks’ co-operation in the sphere of “non-classic” factoring with accredited factoring companies.

  17. Specific Features of Reflection of Information Regarding Lease Operations in the National and International Standards

    Nikolenko Nataliya V.

    2013-12-01

    Full Text Available The article identifies the degree of correspondence of the national Provisions (Standard of Business Accounting (PSBA Lease with the international standard and provides recommendations with respect to their closing up. On the results of the study the author provides specific features of international and national standards – the existing IFRS 17 Lease and national PSBA 14 Lease by the following components: definition of lease, its classification and reflection in accounting. Also the text of PSBA 31 Financial Expenditures is supplemented with provisions on capitalisation of financial expenditures prospectively, which would allow avoidance of correction of the balance of the retained income and provision of comparative information for previous periods. The article provides an algorithm of division of lease for accounting purposes on the basis of international standards. Its use would ensure correctness of reflection of lease operations in accounting and would serve as a basis for development of methodical provisions with respect to accounting. By the result of the study the author forms definition of the qualification asset as an asset which requires considerable time for its creation, preparation for target use, sales or acquisition of the ownership right. Capitalisation of such expenditures would allow non-reduction of the accounting income and also would provide a possibility to reflect financial expenditures in accordance with their economic essence.

  18. Modelling energy demand of developing countries: Are the specific features adequately captured?

    Bhattacharyya, Subhes C. [CEPMLP, University of Dundee, Dundee DD1 4HN (United Kingdom); Timilsina, Govinda R. [Development Research Group, The World Bank, Washington DC (United States)

    2010-04-15

    This paper critically reviews existing energy demand forecasting methodologies highlighting the methodological diversities and developments over the past four decades in order to investigate whether the existing energy demand models are appropriate for capturing the specific features of developing countries. The study finds that two types of approaches, econometric and end-use accounting, are commonly used in the existing energy demand models. Although energy demand models have greatly evolved since the early seventies, key issues such as the poor-rich and urban-rural divides, traditional energy resources and differentiation between commercial and non-commercial energy commodities are often poorly reflected in these models. While the end-use energy accounting models with detailed sectoral representations produce more realistic projections as compared to the econometric models, they still suffer from huge data deficiencies especially in developing countries. Development and maintenance of more detailed energy databases, further development of models to better reflect developing country context and institutionalizing the modelling capacity in developing countries are the key requirements for energy demand modelling to deliver richer and more reliable input to policy formulation in developing countries. (author)

  19. Feature-Specific Event-Related Potential Effects to Action- and Sound-Related Verbs during Visual Word Recognition.

    Popp, Margot; Trumpp, Natalie M; Kiefer, Markus

    2016-01-01

    Grounded cognition theories suggest that conceptual representations essentially depend on modality-specific sensory and motor systems. Feature-specific brain activation across different feature types such as action or audition has been intensively investigated in nouns, while feature-specific conceptual category differences in verbs mainly focused on body part specific effects. The present work aimed at assessing whether feature-specific event-related potential (ERP) differences between action and sound concepts, as previously observed in nouns, can also be found within the word class of verbs. In Experiment 1, participants were visually presented with carefully matched sound and action verbs within a lexical decision task, which provides implicit access to word meaning and minimizes strategic access to semantic word features. Experiment 2 tested whether pre-activating the verb concept in a context phase, in which the verb is presented with a related context noun, modulates subsequent feature-specific action vs. sound verb processing within the lexical decision task. In Experiment 1, ERP analyses revealed a differential ERP polarity pattern for action and sound verbs at parietal and central electrodes similar to previous results in nouns. Pre-activation of the meaning of verbs in the preceding context phase in Experiment 2 resulted in a polarity-reversal of feature-specific ERP effects in the lexical decision task compared with Experiment 1. This parallels analogous earlier findings for primed action and sound related nouns. In line with grounded cognitions theories, our ERP study provides evidence for a differential processing of action and sound verbs similar to earlier observation for concrete nouns. Although the localizational value of ERPs must be viewed with caution, our results indicate that the meaning of verbs is linked to different neural circuits depending on conceptual feature relevance.

  20. ROCK FRACTURES NEAR FAULTS: SPECIFIC FEATURES OF STRUCTURAL‐PARAGENETIC ANALYSIS

    Yu. P. Burzunova

    2017-01-01

    Full Text Available The new approach to structural‐paragenetic analysis of near‐fault fractures [Seminsky, 2014, 2015] and specific features of its application are discussed. This approach was tested in studies of fracturing in West Pribaikalie and Central Mongolia. We give some recommendations concerning collection, selection and initial processing of the data on fractures and faults. The analysis technique is briefly described, and its distinctive details are specified. Under the new approach, we compare systems of natural fractures with the standard joint sets. By analysing the mass measurements of the orientations of joint sets in a fault zone, it becomes possible to reveal the characteristics of this fault zone, such as its structure, morphogenetic type, etc. The comparative analysis is based on the identification of the main fracture paragenesis near the faults. This paragenesis is represented by a triplet of mutually perpendicular joint sets. The technique uses the qualitative approach to establish the rank hierarchy of fractures and stress fields on the basis of genetic subordination. We collect and analyse the data on tectonic fractures identified from a number of indicators, the main of which are the geometric structure of the (systematic or chaotic fracture system, and shear type of fractures. The new technique can be applied to analyse other genetic types of fractures (primary, hypergenic, provided that tectonic stresses were significantly involved in fracturing, which is evidenced by the corresponding indicators. Methods for conducting geological and structural observations are uniform for all sites and points, and increasing the number of observation points provides for a more effective use of the new technique. In our paper, we give specific parameters for constructing circle fracture diagrams. All the maximums in the diagram are involved in the analysis for comparison with the standard patterns. Errors caused by random coincidence are minimized

  1. Endoscopic Devices for Obesity.

    Sampath, Kartik; Dinani, Amreen M; Rothstein, Richard I

    2016-06-01

    The obesity epidemic, recognized by the World Health Organization in 1997, refers to the rising incidence of obesity worldwide. Lifestyle modification and pharmacotherapy are often ineffective long-term solutions; bariatric surgery remains the gold standard for long-term obesity weight loss. Despite the reported benefits, it has been estimated that only 1% of obese patients will undergo surgery. Endoscopic treatment for obesity represents a potential cost-effective, accessible, minimally invasive procedure that can function as a bridge or alternative intervention to bariatric surgery. We review the current endoscopic bariatric devices including space occupying devices, endoscopic gastroplasty, aspiration technology, post-bariatric surgery endoscopic revision, and obesity-related NOTES procedures. Given the diverse devices already FDA approved and in development, we discuss the future directions of endoscopic therapies for obesity.

  2. Specific features of phytoplankton consolidation in techno-ecosystems of nuclear and thermal power plants

    Novoselova, T.N.

    2013-01-01

    The features of forming of phytoplankton species composition and quantitative indexes in the cooling ponds of NPP TPP were considered. Causative agents of water 'flowering' registered in the phytoplankton of cooling ponds of Zaporozhskaya NPP and Khmelnitski NPP were indicated.

  3. New endoscopic indicator of esophageal achalasia: "pinstripe pattern".

    Hitomi Minami

    Full Text Available Endoscopic diagnosis of esophageal achalasia lacking typical endoscopic features can be extremely difficult. The aim of this study was to identify simple and reliable early indicator of esophageal achalasia.This single-center retrospective study included 56 cases of esophageal achalasia without previous treatment. As a control, 60 non-achalasia subjects including reflux esophagitis and superficial esophageal cancer were also included in this study. Endoscopic findings were evaluated according to Descriptive Rules for Achalasia of the Esophagus as follows: (1 esophageal dilatation, (2 abnormal retention of liquid and/or food, (3 whitish change of the mucosal surface, (4 functional stenosis of the esophago-gastric junction, and (5 abnormal contraction. Additionally, the presence of the longitudinal superficial wrinkles of esophageal mucosa, "pinstripe pattern (PSP" was evaluated endoscopically. Then, inter-observer diagnostic agreement was assessed for each finding.The prevalence rates of the above-mentioned findings (1-5 were 41.1%, 41.1%, 16.1%, 94.6%, and 43.9%, respectively. PSP was observed in 60.7% of achalasia, while none of the control showed positivity for PSP. PSP was observed in 26 (62.5% of 35 cases with shorter history < 10 years, which usually lacks typical findings such as severe esophageal dilation and tortuosity. Inter-observer agreement level was substantial for food/liquid remnant (k = 0.6861 and PSP (k = 0.6098, and was fair for abnormal contraction and white change. The accuracy, sensitivity, and specificity for achalasia were 83.8%, 64.7%, and 100%, respectively."Pinstripe pattern" could be a reliable indicator for early discrimination of primary esophageal achalasia.

  4. Endoscopic ultrasound and pancreas divisum

    Rana, Surinder S; Gonen, Can; Vilmann, Peter

    2012-01-01

    Pancreas divisum is the most common congenital anatomic variation of the pancreatic ductal anatomy and in most of the individuals it is asymptomatic. However, in minority of individuals it is presumed to cause recurrent acute pancreatitis and chronic pancreatitis. Endoscopic retrograde cholangiop......Pancreas divisum is the most common congenital anatomic variation of the pancreatic ductal anatomy and in most of the individuals it is asymptomatic. However, in minority of individuals it is presumed to cause recurrent acute pancreatitis and chronic pancreatitis. Endoscopic retrograde...... of the parenchyma also. Therefore EUS, both radial and linear, has potential for being a minimally invasive diagnostic modality for pancreas divisum. A number of EUS criteria have been suggested for the diagnosis of pancreas divisum. These criteria have varying sensitivity and specificity and hence there is a need...

  5. The specific features of Guillain–Barré syndrome in Russia: Analysis of 186 cases

    N. A. Suponeva

    2014-01-01

    Full Text Available The medical records of 186 patients diagnosed with Guillain-Barré syndrome (GBS who had been followed up at the Research Center of Neurology, Russian Academy of Medical Sciences, in 2000 to 2011 were retrospectively analyzed. Most (65 % of the patients had severe GBS; 19 % of the patients were on mechanical ventilation (MV for an average of 21 (13; 48 days. The forms of GBS, such as acute inflammatory demyelinating polyneuropathy (AIDP (n = 141; 78 %, and axonal variants, such as acute motor axonal neuropathy (AMAN, acute sensorimotor axonal neuropathy (AMSAN, i. e. AMAN / AMSAN (n = 39; 22 %, were studied separately. There was a significant difference in the seasonal revalence (p < 0.05. AIDP was encountered evenly throughout the year; AMAN / AMSAN occurred in 46 % of cases in summer. AIDP was followed by acute respiratory viral infection in 35 % of cases; diarrhea wasby the axonal forms in 36 % (p < 0.05. The axonal forms ran a severer course than AIDP: MV was performed twice more frequently (33 and 15 %, respectively; its duration was 6‑fold longer: 90 (46; 102 and 15 (10; 21 days (p < 0.05. AMAN / AMSAN was characterized by a severer neurological status and disability in the acute period, as shown by the NIS, MRCss, INCAT, R-ODS, and Barthel scales; these patients showed a poorer response to pathogenetic therapy (p < 0.05: 59 % with an insufficient effect; 15 % of those with AIDP. After six years, the majority (84 % of the patients with AIDP walked alone and only 16 % were assisted. In the same period, less than half of the patients (40 % with AMAN / AMSAN walked alone and a third (29 % could move with assistance and almost the same percentage (31 % could not walk.Thus, a number of specific features of GBS were found in a Russian population (equal age and sex distribution; a larger percentage of the axonal forms than in European countries and the United States; however, the most characteristics did not differ from the global

  6. Role of Rigid Endoscopic Detorsion in the Management of Sigmoid ...

    had emergency surgery, with gangrenous bowel noted in 43 (72%) ... of any stable patient with clinical and radiological features ... peritonitis, underwent repeat rigid sigmoidoscopy. ... endoscopic detorsion was successful in all six cases.

  7. Specific Features of Chip Making and Work-piece Surface Layer Formation in Machining Thermal Coatings

    V. M. Yaroslavtsev

    2016-01-01

    Full Text Available A wide range of unique engineering structural and performance properties inherent in metallic composites characterizes wear- and erosion-resistant high-temperature coatings made by thermal spraying methods. This allows their use both in manufacturing processes to enhance the wear strength of products, which have to operate under the cyclic loading, high contact pressures, corrosion and high temperatures and in product renewal.Thermal coatings contribute to the qualitative improvement of the technical level of production and product restoration using the ceramic composite materials. However, the possibility to have a significantly increased product performance, reduce their factory labour hours and materials/output ratio in manufacturing and restoration is largely dependent on the degree of the surface layer quality of products at their finishing stage, which is usually provided by different kinds of machining.When machining the plasma-sprayed thermal coatings, a removing process of the cut-off layer material is determined by its distinctive features such as a layered structure, high internal stresses, low ductility material, high tendency to the surface layer strengthening and rehardening, porosity, high abrasive properties, etc. When coatings are machined these coating properties result in specific characteristics of chip formation and conditions for formation of the billet surface layer.The chip formation of plasma-sprayed coatings was studied at micro-velocities using an experimental tool-setting microscope-based setup, created in BMSTU. The setup allowed simultaneous recording both the individual stages (phases of the chip formation process and the operating force factors.It is found that formation of individual chip elements comes with the multiple micro-cracks that cause chipping-off the small particles of material. The emerging main crack in the cut-off layer of material leads to separation of the largest chip element. Then all the stages

  8. Current Status of Peroral Endoscopic Myotomy.

    Cho, Young Kwan; Kim, Seong Hwan

    2018-01-01

    Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders.

  9. Current Status of Peroral Endoscopic Myotomy

    Cho, Young Kwan; Kim, Seong Hwan

    2018-01-01

    Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders. PMID:29397656

  10. Current Status of Peroral Endoscopic Myotomy

    Young Kwan Cho

    2018-01-01

    Full Text Available Peroral endoscopic myotomy (POEM has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders.

  11. Phylogeny of isolates of Prunus necrotic ringspot virus from the Ilarvirus Ringtest and identification of group-specific features.

    Hammond, R W

    2003-06-01

    Isolates of Prunus necrotic ringspot virus (PNRSV) were examined to establish the level of naturally occurring sequence variation in the coat protein (CP) gene and to identify group-specific genome features that may prove valuable for the generation of diagnostic reagents. Phylogenetic analysis of a 452 bp sequence of 68 virus isolates, 20 obtained from the European Union Ilarvirus Ringtest held in October 1998, confirmed the clustering of the isolates into three distinct groups. Although no correlation was found between the sequence and host or geographic origin, there was a general trend for severe isolates to cluster into one group. Group-specific features have been identified for discrimination between virus strains.

  12. Evaluating The State Of Financial Globalization:Ukraine’s Specific Features

    Natalia Stukalo

    2006-03-01

    Full Text Available This article presents a system for evaluating the state of financial globalization in a given country. It identifies the contemporary distinctive features of globalization in the area of finance. It also systematizes available globalization indicators at all levels of the financial system. It collects and analyzes statistical data with regard to key financial globalization indicators for Ukraine and Russia as countries that will soon become members of the World Trade Organization. Based on this analysis, the article provides an overview of the contemporary distinctive features of the financial sector in these counties in the context of globalization.

  13. Downstream Antisense Transcription Predicts Genomic Features That Define the Specific Chromatin Environment at Mammalian Promoters.

    Christopher A Lavender

    2016-08-01

    Full Text Available Antisense transcription is a prevalent feature at mammalian promoters. Previous studies have primarily focused on antisense transcription initiating upstream of genes. Here, we characterize promoter-proximal antisense transcription downstream of gene transcription starts sites in human breast cancer cells, investigating the genomic context of downstream antisense transcription. We find extensive correlations between antisense transcription and features associated with the chromatin environment at gene promoters. Antisense transcription downstream of promoters is widespread, with antisense transcription initiation observed within 2 kb of 28% of gene transcription start sites. Antisense transcription initiates between nucleosomes regularly positioned downstream of these promoters. The nucleosomes between gene and downstream antisense transcription start sites carry histone modifications associated with active promoters, such as H3K4me3 and H3K27ac. This region is bound by chromatin remodeling and histone modifying complexes including SWI/SNF subunits and HDACs, suggesting that antisense transcription or resulting RNA transcripts contribute to the creation and maintenance of a promoter-associated chromatin environment. Downstream antisense transcription overlays additional regulatory features, such as transcription factor binding, DNA accessibility, and the downstream edge of promoter-associated CpG islands. These features suggest an important role for antisense transcription in the regulation of gene expression and the maintenance of a promoter-associated chromatin environment.

  14. Working memory templates are maintained as feature-specific perceptual codes.

    Sreenivasan, Kartik K; Sambhara, Deepak; Jha, Amishi P

    2011-07-01

    Working memory (WM) representations serve as templates that guide behavior, but the neural basis of these templates remains elusive. We tested the hypothesis that WM templates are maintained by biasing activity in sensoriperceptual neurons that code for features of items being held in memory. Neural activity was recorded using event-related potentials (ERPs) as participants viewed a series of faces and responded when a face matched a target face held in WM. Our prediction was that if activity in neurons coding for the features of the target is preferentially weighted during maintenance of the target, then ERP activity evoked by a nontarget probe face should be commensurate with the visual similarity between target and probe. Visual similarity was operationalized as the degree of overlap in visual features between target and probe. A face-sensitive ERP response was modulated by target-probe similarity. Amplitude was largest for probes that were similar to the target, and decreased monotonically as a function of decreasing target-probe similarity. These results indicate that neural activity is weighted in favor of visual features that comprise an actively held memory representation. As such, our findings support the notion that WM templates rely on neural populations involved in forming percepts of memory items.

  15. The Roles of Feature-Specific Task Set and Bottom-Up Salience in Attentional Capture: An ERP Study

    Eimer, Martin; Kiss, Monika; Press, Clare; Sauter, Disa

    2009-01-01

    We investigated the roles of top-down task set and bottom-up stimulus salience for feature-specific attentional capture. Spatially nonpredictive cues preceded search arrays that included a color-defined target. For target-color singleton cues, behavioral spatial cueing effects were accompanied by cue-induced N2pc components, indicative of…

  16. Sensitivity and specificity of plain radiographic features of peripheral enthesopathy at major sites in psoriatic arthritis

    Helliwell, P.S.; Porter, G.

    2007-01-01

    It has been proposed that the defining difference between rheumatoid arthritis and spondyloarthropathy (including psoriatic arthritis) is the initial pathological lesion where the emphasis in psoriatic arthritis is on the enthesis and in rheumatoid arthritis on the synovium. Classical radiological descriptions of seronegative spondyloarthropathy include enthesopathy at major entheseal insertions characterised by erosions and exuberant new bone formation. In this study, the plain radiographic features of spondyloarthropathy are compared between psoriatic arthritis, other spondyloarthropathies and rheumatoid arthritis. The CASPAR study collected clinical, radiological and laboratory data on 588 patients with physician diagnosed psoriatic arthritis and 525 controls with other inflammatory arthritis, 70% of which had rheumatoid arthritis. Plain radiographs of the pelvis and heels were part of the study protocol, although radiographs of other potential entheseal sites such as the knee, elbow and shoulder, were interpreted if available. All radiographs were read blind by two observers working in tandem. Significant differences in entheseal erosion and entheseal new bone formation were found between psoriatic arthritis, ankylosing spondylitis, undifferentiated spondyloarthropathy, rheumatoid arthritis and other diagnoses (entheseal erosion, chi-squared 20.8, p = 0.008; entheseal new bone formation, chi-squared 24.5, p = 0.001). These differences were mainly due to a higher proportion of these features in ankylosing spondylitis. No differences in the plain radiographic features of enthesopathy were found between psoriatic arthritis and rheumatoid arthritis except in the case of entheseal new bone formation at sites of attachment of inguinal ligament, sartorius and rectus femoris muscles to the ilium (OR 3.01, 95% CI 1.13-8.02). Very few subjects with symptomatic heel involvement had radiographic changes and minimal differences were found between those with and without

  17. Sensitivity and specificity of plain radiographic features of peripheral enthesopathy at major sites in psoriatic arthritis

    Helliwell, P.S. [University of Leeds, Academic Unit of Musculoskeletal and Rehabilitation Medicine, Leeds (United Kingdom); Porter, G. [Airedale Hospital NHS Trust, Keighley, West Yorkshire (United Kingdom)

    2007-11-15

    It has been proposed that the defining difference between rheumatoid arthritis and spondyloarthropathy (including psoriatic arthritis) is the initial pathological lesion where the emphasis in psoriatic arthritis is on the enthesis and in rheumatoid arthritis on the synovium. Classical radiological descriptions of seronegative spondyloarthropathy include enthesopathy at major entheseal insertions characterised by erosions and exuberant new bone formation. In this study, the plain radiographic features of spondyloarthropathy are compared between psoriatic arthritis, other spondyloarthropathies and rheumatoid arthritis. The CASPAR study collected clinical, radiological and laboratory data on 588 patients with physician diagnosed psoriatic arthritis and 525 controls with other inflammatory arthritis, 70% of which had rheumatoid arthritis. Plain radiographs of the pelvis and heels were part of the study protocol, although radiographs of other potential entheseal sites such as the knee, elbow and shoulder, were interpreted if available. All radiographs were read blind by two observers working in tandem. Significant differences in entheseal erosion and entheseal new bone formation were found between psoriatic arthritis, ankylosing spondylitis, undifferentiated spondyloarthropathy, rheumatoid arthritis and other diagnoses (entheseal erosion, chi-squared 20.8, p = 0.008; entheseal new bone formation, chi-squared 24.5, p = 0.001). These differences were mainly due to a higher proportion of these features in ankylosing spondylitis. No differences in the plain radiographic features of enthesopathy were found between psoriatic arthritis and rheumatoid arthritis except in the case of entheseal new bone formation at sites of attachment of inguinal ligament, sartorius and rectus femoris muscles to the ilium (OR 3.01, 95% CI 1.13-8.02). Very few subjects with symptomatic heel involvement had radiographic changes and minimal differences were found between those with and without

  18. Biometric identification of cardiosynchronous waveforms utilizing person specific continuous and discrete wavelet transform features.

    Bhagavatula, Chandrasekhar; Venugopalan, Shreyas; Blue, Rebecca; Friedman, Robert; Griofa, Marc O; Savvides, Marios; Kumar, B V K Vijaya

    2012-01-01

    In this paper we explore how a Radio Frequency Impedance Interrogation (RFII) signal may be used as a biometric feature. This could allow the identification of subjects in operational and potentially hostile environments. Features extracted from the continuous and discrete wavelet decompositions of the signal are investigated for biometric identification. In the former case, the most discriminative features in the wavelet space were extracted using a Fisher ratio metric. Comparisons in the wavelet space were done using the Euclidean distance measure. In the latter case, the signal was decomposed at various levels using different wavelet bases, in order to extract both low frequency and high frequency components. Comparisons at each decomposition level were performed using the same distance measure as before. The data set used consists of four subjects, each with a 15 minute RFII recording. The various data samples for our experiments, corresponding to a single heart beat duration, were extracted from these recordings. We achieve identification rates of up to 99% using the CWT approach and rates of up to 100% using the DWT approach. While the small size of the dataset limits the interpretation of these results, further work with larger datasets is expected to develop better algorithms for subject identification.

  19. Specific features of the electrical properties in partially graphitized porous biocarbons of beech wood

    Popov, V. V.; Orlova, T. S.; Gutierrez-Pardo, A.; Ramirez-Rico, J.

    2015-09-01

    The electrical and galvanomagnetic properties of partially graphitized highly porous bioC(Ni) biocarbon matrices produced by pyrolysis (carbonization) of beech wood at temperatures T carb = 850-1600°C in the presence of a Ni-containing catalyst have been studied in comparison with their microstructural features. The temperature dependences of the resistivity, the magnetoresistance, and the Hall coefficient have been measured in the temperature range of 4.2-300 K in magnetic fields to 28 kOe. It has been shown that an additional graphite phase introduction into samples with T carb ≥ 1000°C results in an increase in the carrier mobility by a factor of 2-3, whereas the carrier (hole) concentration remains within ~1020 cm-3, as in biocarbons obtained without catalyst. An analysis of experimental data has demonstrated that the features of the conductivity and magnetoresistance of these samples are described by quantum corrections related to their structural features, i.e., the formation of a globular graphite phase of nano- and submicrometer sizes in the amorphous matrix. The quantum corrections to the conductivity decrease with increasing carbonization temperature, which indicates an increase in the degree of structure ordering and is in good agreement with microstructural data.

  20. Sensitivity of radiographic features and specificity of scintigraphic imaging in hand osteoarthritis

    Buckland-Wright, J.C.; MacFarlane, D.G.; Lynch, J.A.

    1995-01-01

    We undertook to determine which of the radiographic features most reliably detected the presence and disease progression in osteoarthritis in the hand; and which of the radiographic features corresponded with the radionuclide bone scan images. 32 patients with osteoarthritis had X5 macroradiographs taken of their wrists and hands at 6 monthly intervals over an 18 month period. The high magnification and resolution of microfocal radiography permitted quantitative detection of the extent and change in joint space width, subchondral sclerosis, osteophytosis and juxtaarticular radiolucencies. 4-hour technetium 99 m methylene bisphophonate bone scans were taken at 0 and 12 months and the activity of the tracer uptake at each joint scored. The latter was compared with the radiographic features at each visit and the changes between visits analysed. In hand OA the most sensitive radiographic parameters for detecting disease were osteophytes, subchondral sclerosis and justaarticular radiolucencies, with radionuclide imaging demonstrating the increased activity in bone formation associated with the growth and remodelling of osteophytes. Changes in the number and size of osteophytes and joint space narrowing were the only reliable and sensitive parameters for assessing disease progression. We conclude that in osteoarthritis, the bony changes progress significantly before the occurrence of radiographically evident joint space narrowing indicative of cartilage thinning. (authors). 48 refs., 2 tabs., 11 figs

  1. [Specific features of surgical anatomy of the subhyoid region with special reference to tracheostomy].

    Chernykh, A V; Mashkova, T A; Nerovnyĭ, A I; Maleev, Iu V

    2010-01-01

    Peculiarities of thyroid gland linear dimensions, volume, shape, and topographical features were investigated using the morphological material obtained from 426 human corpses of either gender with a view to using this information for planning and performing tracheostomy in residents of the Central Chernozem region, Russia. The study yielded new data on surgical anatomy of additional muscles of the subhyoid region, thyroid isthmus and pyramidal lobe. Rare and previously unknown variants of anatomical structure of the anterior cervical area are described that may play the role of risk factors of postoperative complications of tracheostomy. Relevant recommendations are provided for practicing otorhinolaryngologists.

  2. [Specific features of mammographic visualization of "small" breast tumors developing on the background of fibrocystic disease].

    Bukharin, D G; Velichko, S A; Slonimskaia, E M; Frolova, I G; Luneva, S V; Garbukov, E Iu; Doroshenko, A V

    2011-01-01

    All complications diagnosed at early stages of breast cancer were associated with small tumors, especially with those arising in the aftermath of fibrocystic disease. Hence, our task was to study the XR-semiotics of lesions of less than 15 mm in diameter and of the same origin. 100 mammograms of breast cancer patients with benign disease of the breast were studied. The presence of moderate-to-severe fibrocystic disease significantly affected the visualization of lesions of less than 10 mm in diameter. Since the XR-semiotics of small tumors failed to reveal malignancy features, all lesions visualized by mammography required additional diagnostic procedures using ultrasound and invasive radiology.

  3. SPECIFIC FEATURES OF ANTI-TUBERCULOSIS CHEMOTHERAPY TOLERANCE IN THE LIGHT OF PSYCHOLOGICAL STATUS OF PATIENTS

    N. V. Zolotova

    2017-01-01

    Full Text Available Specific features of psychological state were studied in 295 pulmonary tuberculosis patients with satisfactory tolerance to anti-tuberculosis medications and 75 patients poorly tolerating the treatment.Before the treatment start the patients who later demonstrated adverse reactions to treatment were diagnosed with more intense neurotic and hypochondriac personal features, destructive reactions and higher level of emotional tension and frustration – all the above promote dysregulation of the host adaptation. The research demonstrated the need to consider psychological aspects when studying the tolerance to anti-tuberculosis chemotherapy. 

  4. Auditory profiles of classical, jazz, and rock musicians: Genre-specific sensitivity to musical sound features

    Mari eTervaniemi

    2016-01-01

    Full Text Available When compared with individuals without explicit training in music, adult musicians have facilitated neural functions in several modalities. They also display structural changes in various brain areas, these changes corresponding to the intensity and duration of their musical training. Previous studies have focused on investigating musicians with training in Western classical music. However, musicians involved in different musical genres may display highly differentiated auditory profiles according to the demands set by their genre, i.e. varying importance of different musical sound features. This hypothesis was tested in a novel melody paradigm including deviants in tuning, timbre, rhythm, melody transpositions, and melody contour. Using this paradigm while the participants were watching a silent video and instructed to ignore the sounds, we compared classical, jazz, and rock musicians’ and non-musicians’ accuracy of neural encoding of the melody. In all groups of participants, all deviants elicited an MMN response, which is a cortical index of deviance discrimination. The strength of the MMN and the subsequent attentional P3a responses reflected the importance of various sound features in each music genre: these automatic brain responses were selectively enhanced to deviants in tuning (classical musicians, timing (classical and jazz musicians, transposition (jazz musicians, and melody contour (jazz and rock musicians. Taken together, these results indicate that musicians with different training history have highly specialized cortical reactivity to sounds which violate the neural template for melody content.

  5. Auditory Profiles of Classical, Jazz, and Rock Musicians: Genre-Specific Sensitivity to Musical Sound Features.

    Tervaniemi, Mari; Janhunen, Lauri; Kruck, Stefanie; Putkinen, Vesa; Huotilainen, Minna

    2015-01-01

    When compared with individuals without explicit training in music, adult musicians have facilitated neural functions in several modalities. They also display structural changes in various brain areas, these changes corresponding to the intensity and duration of their musical training. Previous studies have focused on investigating musicians with training in Western classical music. However, musicians involved in different musical genres may display highly differentiated auditory profiles according to the demands set by their genre, i.e., varying importance of different musical sound features. This hypothesis was tested in a novel melody paradigm including deviants in tuning, timbre, rhythm, melody transpositions, and melody contour. Using this paradigm while the participants were watching a silent video and instructed to ignore the sounds, we compared classical, jazz, and rock musicians' and non-musicians' accuracy of neural encoding of the melody. In all groups of participants, all deviants elicited an MMN response, which is a cortical index of deviance discrimination. The strength of the MMN and the subsequent attentional P3a responses reflected the importance of various sound features in each music genre: these automatic brain responses were selectively enhanced to deviants in tuning (classical musicians), timing (classical and jazz musicians), transposition (jazz musicians), and melody contour (jazz and rock musicians). Taken together, these results indicate that musicians with different training history have highly specialized cortical reactivity to sounds which violate the neural template for melody content.

  6. Common and Specific Features of Migration Flows In Russia, CIS and Far Abroad

    Tamara Vladimirovna Kuprina

    2015-06-01

    Full Text Available The article discusses the features of migration flows in Russia, CIS and abroad in terms of transnationality and translocality. Special attention is paid to migration flows from Asia, depending on the gender perception. During the analysis, the preferences of migrants of different age groups are determined. It shows their desire for a more independent financial and professional life, relationship with family responsibilities, plans for the future. The data obtained by the method of continuous selection have led to the following conclusions: migration is a multidimensional phenomenon that requires multidisciplinary research; the heterogeneity of migration flows to the socio-cultural and gender features must be taken into account; the problem of illegal migration requires special solutions; in connection with the emigration of highly skilled professionals and immigration of low-skilled personnel, a professional important indicator of migratory replacement and attracting compatriots from abroad are important. The data obtained can be used for ethnic and cultural planning in order to improve production activities that affect the quality of solving of production tasks and programming adaptation of migrants as the significant impact of intangible factors on the development of society has been noted by economists for a long time. Thus, the economic sustainability requires new thinking based on socio-cultural sustainability determined by such global phenomena as international migration flows.

  7. Stream specificity and asymmetries in feature binding and content-addressable access in visual encoding and memory.

    Huynh, Duong L; Tripathy, Srimant P; Bedell, Harold E; Ögmen, Haluk

    2015-01-01

    Human memory is content addressable-i.e., contents of the memory can be accessed using partial information about the bound features of a stored item. In this study, we used a cross-feature cuing technique to examine how the human visual system encodes, binds, and retains information about multiple stimulus features within a set of moving objects. We sought to characterize the roles of three different features (position, color, and direction of motion, the latter two of which are processed preferentially within the ventral and dorsal visual streams, respectively) in the construction and maintenance of object representations. We investigated the extent to which these features are bound together across the following processing stages: during stimulus encoding, sensory (iconic) memory, and visual short-term memory. Whereas all features examined here can serve as cues for addressing content, their effectiveness shows asymmetries and varies according to cue-report pairings and the stage of information processing and storage. Position-based indexing theories predict that position should be more effective as a cue compared to other features. While we found a privileged role for position as a cue at the stimulus-encoding stage, position was not the privileged cue at the sensory and visual short-term memory stages. Instead, the pattern that emerged from our findings is one that mirrors the parallel processing streams in the visual system. This stream-specific binding and cuing effectiveness manifests itself in all three stages of information processing examined here. Finally, we find that the Leaky Flask model proposed in our previous study is applicable to all three features.

  8. Learning endoscopic resection in the esophagus

    van Vilsteren, Frederike G. I.; Pouw, Roos E.; Herrero, Lorenza Alvarez; Bisschops, Raf; Houben, Martin; Peters, Frans T. M.; Schenk, B. E.; Weusten, Bas L. A. M.; Schoon, Erik J.; Bergman, Jacques J. G. H. M.

    Background: Endoscopic resection is the cornerstone of endoscopic management of esophageal early neoplasia. However, endoscopic resection is a complex technique requiring knowledge and expertise. Our aims were to identify the most important learning points in performing endoscopic resection in a

  9. Specific gut microbiota features and metabolic markers in postmenopausal women with obesity

    Brahe, Lena Kirchner; Le Chatelier, E; Prifti, E

    2015-01-01

    BACKGROUND: Gut microbial gene richness and specific bacterial species are associated with metabolic risk markers in humans, but the impact of host physiology and dietary habits on the link between the gut microbiota and metabolic markers remain unclear. The objective of this study was to identify...

  10. Granular cell tumour of the neurohypophysis: a rare sellar tumour with specific radiological and operative features.

    Aquilina, K

    2012-02-03

    Symptomatic granular cell tumours of the neurohypophysis are rare sellar lesions. Preoperative prediction of the diagnosis on the basis of radiological appearance is useful as these tumours carry specific surgical difficulties. This is possible when the tumour arises from the pituitary stalk, rostral to a normal pituitary gland. This has not been emphasized previously.

  11. Feature-Specific Organization of Feedback Pathways in Mouse Visual Cortex.

    Huh, Carey Y L; Peach, John P; Bennett, Corbett; Vega, Roxana M; Hestrin, Shaul

    2018-01-08

    Higher and lower cortical areas in the visual hierarchy are reciprocally connected [1]. Although much is known about how feedforward pathways shape receptive field properties of visual neurons, relatively little is known about the role of feedback pathways in visual processing. Feedback pathways are thought to carry top-down signals, including information about context (e.g., figure-ground segmentation and surround suppression) [2-5], and feedback has been demonstrated to sharpen orientation tuning of neurons in the primary visual cortex (V1) [6, 7]. However, the response characteristics of feedback neurons themselves and how feedback shapes V1 neurons' tuning for other features, such as spatial frequency (SF), remain largely unknown. Here, using a retrograde virus, targeted electrophysiological recordings, and optogenetic manipulations, we show that putatively feedback neurons in layer 5 (hereafter "L5 feedback") in higher visual areas, AL (anterolateral area) and PM (posteromedial area), display distinct visual properties in awake head-fixed mice. AL L5 feedback neurons prefer significantly lower SF (mean: 0.04 cycles per degree [cpd]) compared to PM L5 feedback neurons (0.15 cpd). Importantly, silencing AL L5 feedback reduced visual responses of V1 neurons preferring low SF (mean change in firing rate: -8.0%), whereas silencing PM L5 feedback suppressed responses of high-SF-preferring V1 neurons (-20.4%). These findings suggest that feedback connections from higher visual areas convey distinctly tuned visual inputs to V1 that serve to boost V1 neurons' responses to SF. Such like-to-like functional organization may represent an important feature of feedback pathways in sensory systems and in the nervous system in general. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. The Specific Features of Congenital and Acquired Forms of Behavior in the Postresuscitative Period (Experimental Study

    Yu. V. Zarzhetsky

    2009-01-01

    Full Text Available Academician of the USSR Academy of Medical Sciences V. A. Negovsky stated that there was an association of the pathogenesis of postresuscitative central nervous system (CNS lesions with the individual typological characteristics. Therefore the objective of the investigation was to study the early brain structural and functional changes in resuscitated rats, which were related to the baseline type of behavior. The investigation was carried out on outbred albino male rats. Circulation was stopped under ether anesthesia for 10 minutes via intrathoracic ligation of the cardiac vascular fascicle. Before clinical death simulation, the animals were divided by the types of behavior according to their behavioral activity in the elevated cross labyrinth or open field test. Postresuscitatively, the rats were found to preserve their individual typological features of behavior. At the same time the animals with baseline various behavioral patterns showed great differences in becoming familiar with a new environment. The study of conditioned reflex activities suggested the predominant impact of postresuscitative cerebral changes on different mechanisms responsible for active avoidance conditioning in rats with baseline different behavioral types. Examination of the CA1 and CA4 pyramidal cell neuronal populations of the hippocampus indicated that in the elevated cross labyrinth test, the resuscitated animals with a high baseline behavioral activity had more pronounced neurodystrophic and degenerative changes in the study brain regions than the rats with a low activity. The findings not only have supported V. A. Negovsky’s ideas on the association of the pathogenesis of postresuscitative cerebral disorders with the individual typological characteristics of the CNS, but also revealed differences in the neuropathophysiological mechanisms of these disorders, and ascertained the structural features of postresuscitative cerebral lesions in the animals with

  13. Early endoscopic realignment in posterior urethral injuries.

    Shrestha, B; Baidya, J L

    2013-01-01

    Posterior urethral injury requires meticulous tertiary care and optimum expertise to manage successfully. The aim of our study is to describe our experiences with pelvic injuries involving posterior urethra and their outcome after early endoscopic realignment. A prospective study was carried out in 20 patients with complete posterior urethral rupture, from November 2007 till October 2010. They presented with blunt traumatic pelvic fracture and underwent primary realignment of posterior urethra in our institute. The definitive diagnosis of urethral rupture was made after retrograde urethrography and antegrade urethrography where applicable. The initial management was suprapubic catheter insertion after primary trauma management in casualty. After a week of conservative management with intravenous antibiotics and pain management, patients were subjected to the endoscopic realignment. The follow up period was at least six months. The results were analyzed with SPSS software. After endoscopic realignment, all patients were advised CISC for the initial 3 months. All patients voided well after three months of CISC. However, 12 patients were lost to follow up by the end of 6 postoperative months. Out of eight remaining patients, two had features of restricture and were managed with DVU followed by CISC again. One patient with restricture had some degree of erectile dysfunction who improved significantly after phospodiesterase inhibitors. None of the patients had features of incontinence. Early endoscopic realignment of posterior urethra is a minimally invasive modality in the management of complete posterior urethral injury with low rates of incontinence and impotency.

  14. Individually specific call feature is not used to neighbour-stranger discrimination: the corncrake case.

    Michał Budka

    Full Text Available In various contexts, animals rely on acoustic signals to differentiate between conspecifics. Currently, studies examining vocal signatures use two main approaches. In the first approach, researchers search for acoustic characteristics that have the potential to be individual specific. This approach yields information on variation in signal parameters both within and between individuals and generates practical tools that can be used in population monitoring. In the second approach, playback experiments with natural calls are conducted to discern whether animals are capable of discriminating among the vocal signatures of different individuals. However, both approaches do not reveal the exact signal characteristics that are being used in the discrimination process. In this study, we tested whether an individual-specific call characteristic--namely the length of the intervals between successive maximal amplitude peaks within syllables (PPD--is crucial in neighbour-stranger discrimination by males of the nocturnal and highly secretive bird species, the corncrake (Crex crex. We conducted paired playback experiments in which corncrakes (n = 47 were exposed to artificial calls with PPD characteristics of neighbour and stranger birds. These artificial calls differed only in PPD structure. The calls were broadcast from a speaker, and we recorded the birds' behavioural responses. Although corncrakes have previously been experimentally shown to discriminate between neighbours and strangers, we found no difference in the responses to the artificial calls representing neighbours versus strangers. This finding demonstrates that even if vocal signatures are individual specific within a species, it does not automatically mean that said signatures are being crucial in discrimination among individuals. At the same time, the birds' aggressive responses to the artificial calls indicated that the information transmitted by PPDs is important in species-specific

  15. Island-specific preferences of tourists for environmental features: implications of climate change for tourism dependent states

    Uyarra, M.C.; Cote, I.M. [East Anglia Univ., Norwich (United Kingdom). Centre for Ecology, Evolution and Conservation; Gill, J.A. [East Anglia Univ., Norwich (United Kingdom). School of Environmental Sciences; Tyndall Centre for Climate Change Research, Norwich (United Kingdom); Tinch, R.T. [East Anglia Univ., Norwich (United Kingdom). School of Environmental Sciences; Macaulay Land Use Research Inst., Aberdeen (United Kingdom); Viner, D. [East Anglia Univ., Norwich (United Kingdom). Climate Research Unit; Watkinson, A.R. [East Anglia Univ., Norwich (United Kingdom). Centre for Ecology, Evolution and Conservation; East Anglia Univ., Norwich (United Kingdom). School of Environmental Sciences

    2005-03-15

    Climate change may affect important environmental components of holiday destinations, which might have repercussions for tourism-dependent economies. This study documents the importance of environmental attributes in determining the choice and holiday enjoyment of tourists visiting Bonaire and Barbados, two Caribbean islands with markedly different tourism markets and infrastructure. Three hundred and sixteen and 338 participants from Bonaire and Barbados, respectively, completed standardized questionnaires. Warm temperatures, clear waters and low health risks were the most important environmental features determining holiday destination choice. However, tourists in Bonaire thereafter prioritized marine wildlife attributes (i.e. coral and fish diversity and abundance) over other environmental features, whereas tourists in Barbados exhibited stronger preferences for terrestrial features, particularly beach characteristics. The willingness of tourists to revisit these islands was strongly linked to the state of the preferred environmental attributes. More than 80% of tourists in Bonaire and Barbados would be unwilling to return for the same holiday price in the event, respectively, of coral bleaching as a result of elevated sea surface temperatures and reduced beach area as a result of sea level rise. Climate change might have a significant impact on Caribbean tourism economy through alteration of environmental features important to destination selection. Island-specific management strategies, such as focusing resources on the protection of key marine or terrestrial features, may provide a means of reducing the environmental and economic impacts of climate change. (author)

  16. Strain-Specific Features of Extracellular Polysaccharides and Their Impact on Lactobacillus plantarum-Host Interactions.

    Lee, I-Chiao; Caggianiello, Graziano; van Swam, Iris I; Taverne, Nico; Meijerink, Marjolein; Bron, Peter A; Spano, Giuseppe; Kleerebezem, Michiel

    2016-07-01

    Lactobacilli are found in diverse environments and are widely applied as probiotic, health-promoting food supplements. Polysaccharides are ubiquitously present on the cell surface of lactobacilli and are considered to contribute to the species- and strain-specific probiotic effects that are typically observed. Two Lactobacillus plantarum strains, SF2A35B and Lp90, have an obvious ropy phenotype, implying high extracellular polysaccharide (EPS) production levels. In this work, we set out to identify the genes involved in EPS production in these L. plantarum strains and to demonstrate their role in EPS production by gene deletion analysis. A model L. plantarum strain, WCFS1, and its previously constructed derivative that produced reduced levels of EPS were included as reference strains. The constructed EPS-reduced derivatives were analyzed for the abundance and sugar compositions of their EPS, revealing cps2-like gene clusters in SF2A35B and Lp90 responsible for major EPS production. Moreover, these mutant strains were tested for phenotypic characteristics that are of relevance for their capacity to interact with the host epithelium in the intestinal tract, including bacterial surface properties as well as survival under the stress conditions encountered in the gastrointestinal tract (acid and bile stress). In addition, the Toll-like receptor 2 (TLR2) signaling and immunomodulatory capacities of the EPS-negative derivatives and their respective wild-type strains were compared, revealing strain-specific impacts of EPS on the immunomodulatory properties. Taken together, these experiments illustrate the importance of EPS in L. plantarum strains as a strain-specific determinant in host interaction. This study evaluates the role of extracellular polysaccharides that are produced by different strains of Lactobacillus plantarum in the determination of the cell surface properties of these bacteria and their capacity to interact with their environment, including their

  17. An Approach for Patient-Specific Multi-domain Vascular Mesh Generation Featuring Spatially Varying Wall Thickness Modeling

    Raut, Samarth S.; Liu, Peng; Finol, Ender A.

    2015-01-01

    In this work, we present a computationally efficient image-derived volume mesh generation approach for vasculatures that implements spatially varying patient-specific wall thickness with a novel inward extrusion of the wall surface mesh. Multi-domain vascular meshes with arbitrary numbers, locations, and patterns of both iliac bifurcations and thrombi can be obtained without the need to specify features or landmark points as input. In addition, the mesh output is coordinate-frame independent ...

  18. [Specific features of 2-methyl hydroxybenzene and 3-methyl hydroxybenzene distribution in the organism of warm-blooded animals].

    Shormanov, B K; Grishenko, V K; Astashkina, A P; Elizarova, M K

    2013-01-01

    The present work was designed to study the specific features of 2-methyl hydroxybezene and 3-methyl hydroxybenzene distribution after intragastric administration of these toxicants to warm-blooded animals (rats). They were detected in the unmetabolized form in the internal organs and blood of the animals. The levels of 2-methyl hydroxybezene were especially high in the stomach and blood whereas the maximum content of 3-methyl hydroxybenzene was found in brain, blood, small intestines of the poisoned rats.

  19. General And Specific Features In Realizing An Essay In English Language – A Case Study Of Essay On Economic Themes

    Daliana Ecaterina TASCOVICI

    2016-04-01

    Full Text Available The present paper wants to be a systematic and not only a theoretical approach on essays. This type of writing knows several points of view connecting its form, content, specific features and types, rules to be observed in its writing, structures or styles. As we know, it implies freedom of composition, originality, associations of surprising images and propensity for aphorism. We try to frame all its specifications within the economic essay, as economics is a field of exact utterance, where the speaker cannot play with the words and their meaning.

  20. Network Traffic Features for Anomaly Detection in Specific Industrial Control System Network

    Matti Mantere

    2013-09-01

    Full Text Available The deterministic and restricted nature of industrial control system networks sets them apart from more open networks, such as local area networks in office environments. This improves the usability of network security, monitoring approaches that would be less feasible in more open environments. One of such approaches is machine learning based anomaly detection. Without proper customization for the special requirements of the industrial control system network environment, many existing anomaly or misuse detection systems will perform sub-optimally. A machine learning based approach could reduce the amount of manual customization required for different industrial control system networks. In this paper we analyze a possible set of features to be used in a machine learning based anomaly detection system in the real world industrial control system network environment under investigation. The network under investigation is represented by architectural drawing and results derived from network trace analysis. The network trace is captured from a live running industrial process control network and includes both control data and the data flowing between the control network and the office network. We limit the investigation to the IP traffic in the traces.

  1. FISCAL FEATURES SPECIFIC TO INTRA-COMMUNITY TRANSACTIONS OF NEW MEANS OF TRANSPORTATION AND EXCISABLE PRODUCTS

    PALIU - POPA LUCIA

    2012-06-01

    Full Text Available With a view to our country's accession to the Community space, the Romanian legislation has undergone many changes, and we should point out among others those in the tax system, that primarily aims to ensure the functioning of the national economy in the globalization of the economic and social activities worldwide. Although at first sight the new procedures have a positive impact on the development of intra-Community commercial businesses, due to the elimination of customs formalities and hence of the fees paid to customs officials, however there are costs generated by the application of EU law, which should not be neglected. Considering the many situations that arise in carrying out intra-Community commercial transactions, that are aimed at the differentiated tax procedures from the value added tax perspective, we considered appropriate, to address below the tax features related to intra-Community acquisitions and supplies of new means of transport and excisable products, because these are two important categories of goods that generate differential tax treatments, so that after the tax analysis we should be able to draw some relevant conclusions.

  2. Specific features of ontogeny of Iris orientalis Mill. introduced to the south-east Ukraine

    Pavlova Marina Aleksandrovna

    2015-12-01

    Full Text Available The paper presents research findings on the ontogeny of Iris orientalis Mill. introduced to the Donetsk Botanical Garden. It was established, that in the course of four years, plantlets subsequently pass the following stages: germinating seedling, juvenile, immature, virginal and young generative stages, reaching mature generative stage in their fifth or sixth year. Typical features of a seedling: bond with a seed, significant structural changes in the course of the development―formation of one or two assimilative leaves, growth and branching of the main root. Juvenile age stage is indicated by formation of three-leaf fan and one or two additional roots, immature stage―by a complete leaf fan of five or seven leaves and by development of additional root system. Virginal stage is distinct due to the transition from monopodial growth to sympodial one with a primary bush formation. Generative stage is marked by biomorph formation, flowering and fruitage. Ontogeny of this species when it is cultivated is characterized by dynamic polyvariety, caused by heterogeneity of individual seedling growth rates. Based on these findings, a seed propagation of I. orientalis is suggested for obtaining a lot of high-grade planting material for landscaping in two or three years after sowing the seeds.

  3. Specific features of designs of superconducting magnets for high-energy synchrotrons

    Monoszon, N.A.

    1979-01-01

    Distinctive features of designs of synchrotron superconducting magnetic systems (SMS) are considered. Some results of testing the prototypes of the ISABELLE storage ring magnets, the DABLER energy doubler and the accelerating-storage complex project are presented. Designs of di.ooles and quadrupoles are described. It is shown that the design of the DABLER SMS considerably differs from the ISABELLE SMS. The DABLER uses nonsaturated magnetic screens which provide lesser distortions of the magnetic field distribution. For the ISABELLE project a dipole with a two-layer winding has been developed which produced a field of 6.2 T. Magnetization curves as well as training and field distribution curves for a number of DABLER dipoles are presented. To prevent local overheating provision is made for using a heater enclosed in a winding. A 1 m dipole model with a sector winding of the DABLER type has been manufactured and tested in the IHEP. During tests a short-sample current and a total value of calculated field equal to 4.45 T in the chamber centre amd 5.3 T in the winding have been achieved

  4. New endoscope shaft for endoscopic transsphenoidal pituitary surgery.

    Lindert, E.J. van; Grotenhuis, J.A.

    2005-01-01

    OBJECTIVE: To describe a new endoscope shaft developed for suction-aspiration during endoscopic transsphenoidal pituitary surgery. METHODS: A custom-made shaft for a Wolf endoscope (Richard Wolf GmbH, Knittlingen, Germany) was developed with a height of 10 mm and a width of 5 mm, allowing an

  5. Sex-specific features of emphysema among current and former smokers with COPD.

    Hardin, Megan; Foreman, Marilyn; Dransfield, Mark T; Hansel, Nadia; Han, MeiLan K; Cho, Michael H; Bhatt, Surya P; Ramsdell, Joe; Lynch, David; Curtis, Jeffrey L; Silverman, Edwin K; Washko, George; DeMeo, Dawn

    2016-01-01

    Recent studies suggest that males with chronic obstructive pulmonary disease (COPD) have more emphysema than females. It is not known if these differences persist across degrees of COPD severity. Our aim was to identify sex-specific differences in quantitative emphysema within COPD subgroups based on COPD severity.We included non-Hispanic white and African-American subjects from the COPDGene study with at least 10 pack-years of smoking and COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometry grade II or greater. We examined sex-specific differences in log-transformed emphysema (log per cent low-attenuation area (%LAA)) by GOLD spirometry grade among subjects with early-onset COPD (25% emphysema).Compared with females, males had higher log %LAA: overall (1.97±1.4 versus 1.69±1.6, β=0.32 (0.04), p=1.34×10(-14)), and among non-Hispanic white (p=8.37×10(-14)) and African-American subjects (p=0.002). Females with early-onset COPD, severe emphysema and GOLD grade IV COPD had similar emphysema as males, but markedly fewer pack-years smoking (early-onset, p=0.01; severe emphysema and GOLD grade IV, psmokers with COPD who are particularly susceptible to parenchymal destruction. Copyright ©ERS 2016.

  6. Systemic lupus erythematosus: Specific features of its course and therapy options

    Aleksandr Mikhailovich Lila

    2015-01-01

    Full Text Available The prevalence of systemic lupus erythematosus (SLE varies greatly in different regions of the world. The disease is encountered in different age groups; however it is most common in young and adolescent women (its peak incidence is in the range of 15–25 years. Familial SLE cases are known. The course of SLE in pregnant women is noted to have features due to an increased risk for complications and to pharmacotherapeutic peculiarities. Risk factors for poor pregnancy outcomes, such as high disease activity at the time of conception, active lupus nephritis, and the presence of antiphospholipid antibodies (APA, are identified in patients with SLE. The paper presents antenatal fetal death predictors: proteinuria, thrombocytopenia, APA, and hypertension. When SLE is concurrent with secondary antiphospholipid syndrome (APS, the risk of poor pregnancy outcome is 30%. Management tactics for pregnant women with APS and a dosage regimen are shown to largely depend on history data (the presence (absence of nonplacental thromboses, the number of spontaneous abortions, prior therapy, etc.. There are four patient groups: 1 patients who have only anticardiolipin antibodies without previous pregnancy or one episode of unexplained abortion at less than 10 weeks’ gestation with no history of thrombosis; 2 those who have APS with no history of nonplacental thrombosis and have anticardiolipin antibodies and a history of two or more unexplained spontaneous abortions at less than 10 weeks’ gestation; 3 those who have APS and a history of nonplacental thromboses (who have taken warfarin prior to pregnancy; 4 those in whom standard therapy is ineffective during their next pregnancy. The paper presents therapy options for each patient group.It is concluded that effective therapeutic strategy for SLE, including that in pregnant women, implies patient monitoring to long maintain remission (low disease activity.

  7. A hands-free region-of-interest selection interface for solo surgery with a wide-angle endoscope: preclinical proof of concept.

    Jung, Kyunghwa; Choi, Hyunseok; Hong, Hanpyo; Adikrishna, Arnold; Jeon, In-Ho; Hong, Jaesung

    2017-02-01

    A hands-free region-of-interest (ROI) selection interface is proposed for solo surgery using a wide-angle endoscope. A wide-angle endoscope provides images with a larger field of view than a conventional endoscope. With an appropriate selection interface for a ROI, surgeons can also obtain a detailed local view as if they moved a conventional endoscope in a specific position and direction. To manipulate the endoscope without releasing the surgical instrument in hand, a mini-camera is attached to the instrument, and the images taken by the attached camera are analyzed. When a surgeon moves the instrument, the instrument orientation is calculated by an image processing. Surgeons can select the ROI with this instrument movement after switching from 'task mode' to 'selection mode.' The accelerated KAZE algorithm is used to track the features of the camera images once the instrument is moved. Both the wide-angle and detailed local views are displayed simultaneously, and a surgeon can move the local view area by moving the mini-camera attached to the surgical instrument. Local view selection for a solo surgery was performed without releasing the instrument. The accuracy of camera pose estimation was not significantly different between camera resolutions, but it was significantly different between background camera images with different numbers of features (P solo surgeries without a camera assistant.

  8. Comparison of brucella and non-specific epididymorchitis: gray scale and color Doppler ultrasonographic features

    Ozturk, Adil; Ozturk, Ebru; Zeyrek, Fadile; Onur, Kahraman; Sirmatel, Ocal; Kat, Nurcan

    2005-01-01

    Objective: The aim of this study is to find out if it is possible to differentiate between brucellar and non-specific epididymorchitis by comparing ultrasonography (US) and color Doppler ultrasonography (CDUS) findings. Material and methods: Fifty-six patients diagnosed to have epididymorchitis both clinically and ultrasonographically were included to study. All of the patients were investigated serologically for brucella. Twenty-eight of those patients were admitted brucella epididymorchitis because of high agglutinations titers for brucella. The other 28 patients were admitted non-specific epididymorchitis because of normal agglutinations titers for brucella. Testicular size, echogenicity, hydrocele, internal echoes and/or septations within hydrocele, and scrotal skin thickness of normal and involved testis were compared by ultrasonography. Besides, pick systolic velocity, end diastolic velocity, resistive index and pick systolic velocity ratio values were measured by bilateral testicular color Doppler ultrasonography in both groups. When the p-value is <0.05, the difference between groups is accepted as statistically significant. Results: Thickening of scrotal skin was seen in 17 of 28 patients with brucella epididymorchitis (BEPO) (67%) and in 25 of 28 patients with non-specific epididymorchitis (NEPO) (89.2%) (p < 0.01). There was no difference between groups regarding presence of hydrocele. However hydrocele seen in all patients was anechoic except for two patients (8.6%). Hydrocele seen in 18 of 22 patients with BEPO and hydrocele had internal echogenicity or septation (p < 0.001). Sizes of testes and epididymis were found to be increased in involved testis compared to normal testis. Testes of all patients with NEPO were homogenous with decreased echogenicity except for five patients (17.8%). However, 23 patients with BEPO (82%) found to have heterogenous testis (p < 0.001). Spectral measurements showed increased PSV and EDV values and decreased RI values in

  9. Comparison of brucella and non-specific epididymorchitis: gray scale and color Doppler ultrasonographic features

    Ozturk, Adil [Department of Radiology, Harran University School of Medicine, Arastirma ve Uygulama Hastanesi, TR-63100 Sanliurfa (Turkey)]. E-mail: ozturka26@hotmail.com; Ozturk, Ebru [Department of Radiology, Harran University School of Medicine, Arastirma ve Uygulama Hastanesi, TR-63100 Sanliurfa (Turkey); Zeyrek, Fadile [Department of Microbiology, Harran University School of Medicine, Sanliurfa (Turkey); Onur, Kahraman [Department of Urology, SSK Sanliurfa Hastanesi, Sanliurfa (Turkey); Sirmatel, Ocal [Department of Radiology, Harran University School of Medicine, Arastirma ve Uygulama Hastanesi, TR-63100 Sanliurfa (Turkey); Kat, Nurcan [Department of Radiology, Harran University School of Medicine, Arastirma ve Uygulama Hastanesi, TR-63100 Sanliurfa (Turkey)

    2005-11-01

    Objective: The aim of this study is to find out if it is possible to differentiate between brucellar and non-specific epididymorchitis by comparing ultrasonography (US) and color Doppler ultrasonography (CDUS) findings. Material and methods: Fifty-six patients diagnosed to have epididymorchitis both clinically and ultrasonographically were included to study. All of the patients were investigated serologically for brucella. Twenty-eight of those patients were admitted brucella epididymorchitis because of high agglutinations titers for brucella. The other 28 patients were admitted non-specific epididymorchitis because of normal agglutinations titers for brucella. Testicular size, echogenicity, hydrocele, internal echoes and/or septations within hydrocele, and scrotal skin thickness of normal and involved testis were compared by ultrasonography. Besides, pick systolic velocity, end diastolic velocity, resistive index and pick systolic velocity ratio values were measured by bilateral testicular color Doppler ultrasonography in both groups. When the p-value is <0.05, the difference between groups is accepted as statistically significant. Results: Thickening of scrotal skin was seen in 17 of 28 patients with brucella epididymorchitis (BEPO) (67%) and in 25 of 28 patients with non-specific epididymorchitis (NEPO) (89.2%) (p < 0.01). There was no difference between groups regarding presence of hydrocele. However hydrocele seen in all patients was anechoic except for two patients (8.6%). Hydrocele seen in 18 of 22 patients with BEPO and hydrocele had internal echogenicity or septation (p < 0.001). Sizes of testes and epididymis were found to be increased in involved testis compared to normal testis. Testes of all patients with NEPO were homogenous with decreased echogenicity except for five patients (17.8%). However, 23 patients with BEPO (82%) found to have heterogenous testis (p < 0.001). Spectral measurements showed increased PSV and EDV values and decreased RI values in

  10. [Specific features in realization of the principle of minimum energy dissipation during individual development].

    Zotin, A A

    2012-01-01

    Realization of the principle of minimum energy dissipation (Prigogine's theorem) during individual development has been analyzed. This analysis has suggested the following reformulation of this principle for living objects: when environmental conditions are constant, the living system evolves to a current steady state in such a way that the difference between entropy production and entropy flow (psi(u) function) is positive and constantly decreases near the steady state, approaching zero. In turn, the current steady state tends to a final steady state in such a way that the difference between the specific entropy productions in an organism and its environment tends to be minimal. In general, individual development completely agrees with the law of entropy increase (second law of thermodynamics).

  11. Security Measures and some Specific Features of the Transport Police Functioning in Russia and Abroad

    Petr P. Ignatushenko

    2017-03-01

    Full Text Available In the present article specifics of the transport police work in the Russian Federation are discussed, as well as in other countries of the world (USA, Germany, Israel, etc.. Attention is drawn to the need of the role and significance of the Russian police review in the matters of railway and aviation security, as well as safety on river and sea transport. The term “transport security” is a state of security of transport and transport infrastructure, consumers of transport services (passengers from various types of threats (natural and man-made, as well as acts of unlawful interference in the activities of various modes of transport – points put the author. Transport security issues are important for the creation of the transport police system in the Russian Federation, taking into account experience of foreign countries.

  12. The bats (Chiroptera; Mammalia of Mordovia: specific structure and features of distribution

    Oleg N. Artaev

    2016-05-01

    Full Text Available This article presents the specific structure and distribution of the bats made in the territory of the Republic of Mordovia (Central Russia from the first half of the 20th century to the present. Occurence, relative abundance and patterns of distribution are briefly assessed for rare species. On this base, recommendations for inclusion these bats in the regional Red Data Book are presented. .In Mordovia twelve species of bats have been observed. There are widespread and numerous species: Pipistrellus nathusii, Myotis daubentonii, M. dasycneme, Nyctalus noctula and Vespertilio murinus. Widespread but less numerous species are: Myotis brandtii and Plecotus auritus. Finally, rare species are: Myotis nattereri, Nyctalus lasiopterus, N. leisleri, Pipistrellus pygmaeus and P. kuhlii.

  13. Problems and Specific Features of Sub-Federal Budgets Execution in 2015

    Anna Ivanovna Povarova

    2016-09-01

    Full Text Available Last year has been marked by worrying trends in the development of a budgetary crisis in Russian regions; the crisis became apparent in 2013, when regional authorities had to get into huge debts in order to provide finances for the social obligations in the framework of the presidential decrees of May 7, 2012. The budget process in 2015 was characterized by expanding negative trends in those regions that had previously been the engines of economic growth and budget donors, which contradicts the regional development strategy. The crisis response measures consist in a large-scale optimization of expenses. Despite an attempt undertaken by the Government to replace commercial borrowings with budget loans, there are still no prospects for solving the debt issue. On the contrary, expert forecasts predict a doubling of the debt stock in regions by the end of 2017. Cuts in the expenditures on human capital development should be considered as a new negative trend, naturally resulting in the deterioration of material well-being of Russians, which was expressed in the decline in their real incomes and raising poverty level. It seems that on the eve of the RF State Duma elections the social policy of the authorities ceases to be socially oriented. Under the circumstances of an aggravating budget crisis, the Government is not increasing unrepayable financial aid (it did increase it in 2009; instead, it is pursuing the opposite policy and estranges itself from providing support to regions. Moreover, the Cabinet of Ministers does not openly wish to carry out a just division of powers and obligations of governmental units, but turns it into a mechanism for financing federal budget deficit by shifting state obligations onto the regions. The paper presents the results of the analysis of sub-federal budgets execution in 2015. The main goal was to identify the features of budget process and trends in the dynamics of budget parameters. The main conclusion is that

  14. Tissue-specific features of the X chromosome and nucleolus spatial dynamics in a malaria mosquito, Anopheles atroparvus.

    Bondarenko, Semen M; Artemov, Gleb N; Sharakhov, Igor V; Stegniy, Vladimir N

    2017-01-01

    Spatial organization of chromosome territories is important for maintenance of genomic stability and regulation of gene expression. Recent studies have shown tissue-specific features of chromosome attachments to the nuclear envelope in various organisms including malaria mosquitoes. However, other spatial characteristics of nucleus organization, like volume and shape of chromosome territories, have not been studied in Anopheles. We conducted a thorough analysis of tissue-specific features of the X chromosome and nucleolus volume and shape in follicular epithelium and nurse cells of the Anopheles atroparvus ovaries using a modern open-source software. DNA of the polytene X chromosome from ovarian nurse cells was obtained by microdissection and was used as a template for amplification with degenerate oligo primers. A fluorescently labeled X chromosome painting probe was hybridized with formaldehyde-fixed ovaries of mosquitoes using a 3D-FISH method. The nucleolus was stained by immunostaining with an anti-fibrillarin antibody. The analysis was conducted with TANGO-a software for a chromosome spatial organization analysis. We show that the volume and position of the X chromosome have tissue-specific characteristics. Unlike nurse cell nuclei, the growth of follicular epithelium nuclei is not accompanied with the proportional growth of the X chromosome. However, the shape of the X chromosome does not differ between the tissues. The dynamics of the X chromosome attachment regions location is tissue-specific and it is correlated with the process of nucleus growth in follicular epithelium and nurse cells.

  15. [Endoscopic extraction of gallbladder calculi].

    Kühner, W; Frimberger, E; Ottenjann, R

    1984-06-29

    Endoscopic extraction of gallbladder stones were performed, as far as we know for the first time, in three patients with combined choledochocystolithiasis. Following endoscopic papillotomy (EPT) and subsequent mechanical lithotripsy of multiple choledochal concrements measuring up to 3 cm the gallbladder stones were successfully extracted with a Dormia basket through the cystic duct. The patients have remained free of complications after the endoscopic intervention.

  16. Measuring the relative extent of pulmonary infiltrates by hierarchical classification of patient-specific image features

    Tsevas, S.; Iakovidis, D. K.

    2011-11-01

    Pulmonary infiltrates are common radiological findings indicating the filling of airspaces with fluid, inflammatory exudates, or cells. They are most common in cases of pneumonia, acute respiratory syndrome, atelectasis, pulmonary oedema and haemorrhage, whereas their extent is usually correlated with the extent or the severity of the underlying disease. In this paper we propose a novel pattern recognition framework for the measurement of the extent of pulmonary infiltrates in routine chest radiographs. The proposed framework follows a hierarchical approach to the assessment of image content. It includes the following: (a) sampling of the lung fields; (b) extraction of patient-specific grey-level histogram signatures from each sample; (c) classification of the extracted signatures into classes representing normal lung parenchyma and pulmonary infiltrates; (d) the samples for which the probability of belonging to one of the two classes does not reach an acceptable level are rejected and classified according to their textural content; (e) merging of the classification results of the two classification stages. The proposed framework has been evaluated on real radiographic images with pulmonary infiltrates caused by bacterial infections. The results show that accurate measurements of the infiltration areas can be obtained with respect to each lung field area. The average measurement error rate on the considered dataset reached 9.7% ± 1.0%.

  17. Specific features in the behavior of electrical resistivity of the pine biocarbon preform/copper composite

    Burkov, A. T.; Orlova, T. S.; Smirnov, B. I.; Smirnov, I. A.; Misiorek, H.; Jezowski, A.

    2010-11-01

    The electrical resistivity ρ( T) of the novel type of composites prepared by infiltrating melted copper in vacuum in empty sap channels of white pine high-porosity biocarbon preforms has been measured in the temperature range 5-300 K. Biocarbon preforms have been prepared by pyrolysis of tree wood in an argon flow at two carbonization temperatures, 1000 and 2400°C. The electrical resistivity of the composites has been found to vary relatively weakly with temperature and to pass through a characteristic minimum near 40-50 K, which can be ascribed to iron and manganese impurities penetrating into copper from the carbon preform when liquid copper is infiltrated into it. It has been shown that the electrical resistivity ρ( T) of the composites is governed primarily by the specific microstructure of the preform, which is made up of parallel channels with an average diameter of about 50 μm interrupted by systems of thin capillaries. The small cross section of the copper-filled capillaries accounts for these regions providing the major contribution to the electrical resistivity of the composites. An increase in the wood carbonization temperature brings about a noticeable increase in the effective capillary cross section and a decrease in the electrical resistivity ρ( T) of the composite.

  18. Specific features of the electrophysical parameters of NTD Si treated under different conditions of heat treatment

    Gaidar, G. P., E-mail: gaydar@kinr.kiev.ua [National Academy of Sciences of Ukraine, Institute for Nuclear Research (Ukraine); Baranskii, P. I. [National Academy of Sciences of Ukraine, Lashkaryov Institute of Semiconductor Physics (Ukraine)

    2016-06-15

    The effect of thermal annealing in the temperature range 800 ⩽ T{sub ann} ⩽ 1200°C and of two cooling rates (v{sub cl} = 1 and 15°C min{sup –1}) upon a change in the concentration of charge carriers in the conduction band, their mobility, and tensoresistance in n-Si crystals doped by nuclear transmutation and doped with phosphorus impurity via the melt (during growth by the Czochralski method) was investigated. It is found that, after annealing of all of the crystals at T{sub ann} = 1050–1100°C, the concentration of charge carriers is increased by a factor of 1.3–1.7 compared to the initial concentration (irrespective of the method of doping). The specific annealing-temperature-dependent effect of cooling with a rate of 15°C min{sup –1} on the properties of transmutation-doped n-Si:P crystals is detected.

  19. Allelic Imbalance Is a Prevalent and Tissue-Specific Feature of the Mouse Transcriptome

    Pinter, Stefan F.; Colognori, David; Beliveau, Brian J.; Sadreyev, Ruslan I.; Payer, Bernhard; Yildirim, Eda; Wu, Chao-ting; Lee, Jeannie T.

    2015-01-01

    In mammals, several classes of monoallelic genes have been identified, including those subject to X-chromosome inactivation (XCI), genomic imprinting, and random monoallelic expression (RMAE). However, the extent to which these epigenetic phenomena are influenced by underlying genetic variation is unknown. Here we perform a systematic classification of allelic imbalance in mouse hybrids derived from reciprocal crosses of divergent strains. We observe that deviation from balanced biallelic expression is common, occurring in ∼20% of the mouse transcriptome in a given tissue. Allelic imbalance attributed to genotypic variation is by far the most prevalent class and typically is tissue-specific. However, some genotype-based imbalance is maintained across tissues and is associated with greater genetic variation, especially in 5′ and 3′ termini of transcripts. We further identify novel random monoallelic and imprinted genes and find that genotype can modify penetrance of parental origin even in the setting of large imprinted regions. Examination of nascent transcripts in single cells from inbred parental strains reveals that genes showing genotype-based imbalance in hybrids can also exhibit monoallelic expression in isogenic backgrounds. This surprising observation may suggest a competition between alleles and/or reflect the combined impact of cis- and trans-acting variation on expression of a given gene. Our findings provide novel insights into gene regulation and may be relevant to human genetic variation and disease. PMID:25858912

  20. Cushing's syndrome and fetal features resurgence in adrenal cortex-specific Prkar1a knockout mice.

    Isabelle Sahut-Barnola

    2010-06-01

    Full Text Available Carney complex (CNC is an inherited neoplasia syndrome with endocrine overactivity. Its most frequent endocrine manifestation is primary pigmented nodular adrenocortical disease (PPNAD, a bilateral adrenocortical hyperplasia causing pituitary-independent Cushing's syndrome. Inactivating mutations in PRKAR1A, a gene encoding the type 1 alpha-regulatory subunit (R1alpha of the cAMP-dependent protein kinase (PKA have been found in 80% of CNC patients with Cushing's syndrome. To demonstrate the implication of R1alpha loss in the initiation and development of PPNAD, we generated mice lacking Prkar1a specifically in the adrenal cortex (AdKO. AdKO mice develop pituitary-independent Cushing's syndrome with increased PKA activity. This leads to autonomous steroidogenic genes expression and deregulated adreno-cortical cells differentiation, increased proliferation and resistance to apoptosis. Unexpectedly, R1alpha loss results in improper maintenance and centrifugal expansion of cortisol-producing fetal adrenocortical cells with concomitant regression of adult cortex. Our data provide the first in vivo evidence that loss of R1alpha is sufficient to induce autonomous adrenal hyper-activity and bilateral hyperplasia, both observed in human PPNAD. Furthermore, this model demonstrates that deregulated PKA activity favors the emergence of a new cell population potentially arising from the fetal adrenal, giving new insight into the mechanisms leading to PPNAD.

  1. Left fronto-temporal dynamics during agreement processing: evidence for feature-specific computations.

    Molinaro, Nicola; Barber, Horacio A; Pérez, Alejandro; Parkkonen, Lauri; Carreiras, Manuel

    2013-09-01

    Grammatical agreement is a widespread language phenomenon that indicates formal syntactic relations between words; however, it also conveys basic lexical (e.g. grammatical gender) or semantic (e.g. numerosity) information about a discourse referent. In this study, we focus on the reading of Spanish noun phrases, violating either number or gender determiner-noun agreement compared to grammatical controls. Magnetoencephalographic activity time-locked to the onset of the noun in both types of violation revealed a left-lateralized brain network involving anterior temporal regions (~220 ms) and, later in time, ventro-lateral prefrontal regions (>300 ms). These activations coexist with dependency-specific effects: in an initial step (~170 ms), occipito-temporal regions are employed for fine-grained analysis of the number marking (in Spanish, presence or absence of the suffix '-s'), while anterior temporal regions show increased activation for gender mismatches compared to grammatical controls. The semantic relevance of number agreement dependencies was mainly reflected by left superior temporal increased activity around 340 ms. These findings offer a detailed perspective on the multi-level analyses involved in the initial computation of agreement dependencies, and theoretically support a derivational approach to agreement computation. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Clinical and immunological features of chronic non-specific non-ulcerative colitis in infants.

    Marushko RV

    2013-04-01

    Full Text Available Objective: To study the activity of cytokines for determination of their pathogenic role and effective action of the individual factors of the immune system in infants with chronic non&specific non&ulcerative colitis (CNNC. Patients and methods. It is studied 60 children in the age from 1 to 3 years with CNNC, who were under hospitalization. The control group consisted of 30 apparently healthy children of appropriate age. Immunological status of children was evaluated on the base of determination of cytokine concentration in the blood serum by the method of Enzyme-Immuno-Sorbent-Assay. Results. It is found that during the CNNC in infants and the concentration and ratio of the different groups of cytokines in the blood serum undergoes significant changes — increasing the concentration of pro&inflammatory cytokines (IL&1α, IL&6, IL&8, TNF-α and decreases the level of inflammatory cytokines (IL-4 is the IL-10, wherein the content growth factors is changing — by increased hepatocytes growth factor and reduced intestinal trefoil factor. Conclusions. Found changes of cytokines state can be regarded as a violation of the immunoregulatory mechanisms that is the basis of pathogenesis of the formation of a chronic inflammatory process in the infant's intestine.

  3. Specific Features of Transport Market Characterising the Interrelation of Logistics, Global Distribution and Traffic

    Teodor Perić

    2002-11-01

    Full Text Available If we acknowledge the role of traffic as active leaderof the sustainable economy development, then we certainlyhave to analyse the environment in which the traffic exists asa system, and therefore we have to foresee its limits which aredetermined by the specifics of the traffic system. Representingthe circulation system of economy, traffic has to eavesdrop onthe demands of the market, and has to be transformed andmodernised. The experience gained by working on the projectsand the studies related to business organisation resulted inthe conclusion that the requirements related to logistics inthe nineties were significantly greater than had been thecommon target until then -reduction of costs. In order to adjustcompletely to the market demands, with the help of advancedinformation technology, the companies apply logisticsas tools of competitiveness on the market. Extraordinmyachievements of IT, using of virtual reality enable businesspeople to communicate and contract businesses without beingphysically present. What is it that makes some companies moresuccessful than others? It is obviously a question of the advantagesof distribution realisation due to the fact that nowadayspurchase and selling are run globally in the world. The distributionof products at the right time, to the right place, at a pricewhich is favourable both to the seller and the buyer, in the rightmanner and in the appropriate quantity in the marketing senseis the prerequisite for the business success as element of businesslogistics. The development of this tool must be basedon the monitoring of the needs for the logistics managementand the tactical adaptability of the company. The solution oflogistics management of business processes must satisfy thecurrent and future customers' requirements in order to be competitive.

  4. Specific features of kukersite processing in laboratory-scale and commercial retorts

    Yefimov, V.; Kundel, H.

    1991-01-01

    The yield and properties of shale oil produced by semi coking oil shale in retorts of different design depend to a great extent on the conditions of volatiles evacuation from the high temperature zone. In externally heated laboratory retorts, where oil vapours reside in the reaction zone for a relatively long period undergoing moderate cracking, no maximum oil yields are attained. The higher the organic matter content in the oil shale, the higher is the partial pressure of the oil vapours in the retort and hence the rate of their removal from the retorting zone, resulting in increased shale oil yields and lower specific yield of hydrogen in the retort off-gases. replacing the external heating mode with direct heating by a gaseous heat carrier (carbon dioxide, in particular) leads to a considerable moderation of the volatiles pyrolysis. As a result, the shale oil produced has a higher density and molecular mass, a lower calorific value and a higher content of phenols. The presence of water vapours in the heat carrier gas also has a positive effect upon the yield of shale oil and phenols. The properties of the oil and gas produced by semi coking kukersite in the presence of free calcium oxide are similar to those of cracked products. The presence of free calcium oxide has the same effect as higher temperatures or longer residence time of the volatiles in the retorting zone: it leads to reduced yields of shale oil and phenols, to a lower density of the oil and higher yields of hydrogen and gaseous hydrocarbons. This should be taken into consideration on evaluating the efficiency of semi coking oil shale in the retorts with solid heat carrier, which contains free calcium oxide

  5. Correlation between histopathological and endoscopic findings of non-malignant gastrointestinal lesions: an experience of a tertiary care teaching hospital from Northern India

    Manpreet Kaur

    2018-04-01

    Full Text Available Background: Gastrointestinal tract endoscopy along with biopsy is an established procedure for investigating a wide range of gastrointestinal conditions especially inflammatory and malignant diseases. The aim was to study and categorizing the morphological lesions of non-malignant origin at various sites of gastrointestinal tract and to compare with its endoscopic findings.Materials and Methods: This study was conducted on 280 benign GI biopsies received in the Department of Pathology of Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India.Results: Maximum cases (39% were observed in the age group of 41-60 years. Male patients outnumbered the females (male to female ratio was 1.4:1. There were total 33 esophageal biopsies amongst which the most common lesion was non-specific esophagitis with least common being Barrett’s esophagus. Correlating the results of endoscopic and histopathological features of acute and chronic gastritis a positive predictive value of 80% with sensitivity of 44.4% was seen. Total 83 duodenal biopsies were analyzed with non-specific duodenitis being the most commonly diagnosed lesion followed by celiac disease. Correlation of endoscopic and histopathological findings in celiac disease revealed a sensitivity of 50% and positive predictive value of 42.86%. In both sigmoid colon and rectum, non-specific colitis was the commonest diagnosis followed by ulcerative colitis. Endoscopic findings were correlated with the histopathological features in ulcerative colitis, revealing a sensitivity of 57.14% along with the positive predictive value of 80%.  Conclusion: Histopathology remains the gold standard for diagnosing a case along with endoscopic findings and endoscopic findings alone cannot make the final diagnosis.

  6. SPECIFIC FEATURES OF POWER CONSUMPTION OF LED DEVICES AND ACCOUNTING THEM IN CALCULATION OF ELECTRICAL NETWORKS

    V. N. Radkevich

    2016-01-01

    Full Text Available The indicators of power consumption of lighting devices based on LEDs are studied depending on the supplied voltage. For the lamp and floodlight with LEDs active and reactive power, current and power factor as a function of voltage (which value changed in the range 200–245 V were experimentally determined. The analysis of experimental data demonstrated that due to the drivers in the specified voltage range the active power consumed by light devices remains practically unchanged. The reactive power of LED devices depends on the supplied voltage and is capacitive in its nature. In contrast with gas-discharge light sources the LED devices under study do not consume reactive power, but generate it. With the change of the supplied voltage from 200 to 245 V the value of the generated reactive power increases to 60 % for the floodlight and 50 % for the lamp. The LED floodlight has a low coefficient of active power. The current consumed by the floodlight has increased by 22 %, and by the lamp – by 13 %. The formulas for determining the maximum value of the length of the calculated section of single-phase group lines were developed, taking into account specific source data. LED light sources tend to feed by electric power by single-phase group lines. The number of lamps connected to single-phase lines is regulated by normative documents. Bearing this in mind as well as the small power of LED sources single-phase group lines are usually performed with conductors of the smallest possible cross section. The limit values of the length of the calculated section that correspond to a predetermined loss of voltage in line with ambient temperature from 15 to 60 °С were determined for them. The calculations demonstrated that for group lines that feed the LEDs, the choice of conductor cross-sections in accordance with permissible voltage loss is not critical. The determinant factor for the choice of the cross-section of the conductors of group electrical

  7. Specific features of taxation of in-dividuals in relationships with foreign elements.

    Karina Ponomareva

    2017-01-01

    material benefits, are taken into account. Exceptions to this rule are provided for in Article 217 of the Tax Code, which contains a list of income exempt from taxation.Conclusions. The author comes to the conclusion that the legal regulation of the taxation of residents and non-residents is changing rapidly. Meanwhile, in the Russian legislation, the specifics of creating and terminating the status of a tax resident are not specified in detail. At the same time, several taxation regimes have been established for foreigners. This fact allows them to pay taxes at a general rate.

  8. Specific features of a single-pulse sliding discharge in neon near the threshold for spark breakdown

    Trusov, K. K.

    2017-08-01

    Experimental data on the spatial structure of a single-pulse sliding discharge in neon at voltages below, equal to, and above the threshold for spark breakdown are discussed. The experiments were carried at gas pressures of 30 and 100 kPa and different polarities of the discharge voltage. Photographs of the plasma structure in two discharge chambers with different dimensions of the discharge zone and different thicknesses of an alumina dielectric plate on the surface of which the discharge develops are inspected. Common features of the prebreakdown discharge and its specific features depending on the voltage polarity and gas pressure are analyzed. It is shown that, at voltages below the threshold for spark breakdown, a low-current glow discharge with cathode and anode spots develops in the electrode gap. Above the breakdown threshold, regardless of the voltage polarity, spark channels directed from the cathode to the anode develop against the background of a low-current discharge.

  9. Specific features of the determination of the pellet-cladding gap of the fuel rods by non-destructive method

    Amosov, S.V.; Pavlov, S.V.

    2002-01-01

    This report describes the specific features of determining the pellet-cladding gap of the irradiated WWER-1000 fuel rods by nondestructive method. The method is based on the elastic radial deformation of the cladding up to its contact with the fuel. The value of deformation of cladding till its contacting fuel when radial force changes from F max to 0 is proposed as a measuring parameter for determination of the diametrical gap. Because of the features of compression method, the obtained gap value is not analog of the gap measured on micrograph of the fuel rod cross-section. Results of metallography can provide only qualitative evaluation of its method efficiency. Comparison of the values determined by non-destructive method and metallography for WWER-1000 fuel rods with burnup from 25 to 55 MWd/kg U testified that the results of compression method can be used as a low estimate of the pellet-cladding gap value. (author)

  10. A Primer on Endoscopic Electronic Medical Records

    Atreja, Ashish; Rizk, Maged; Gurland, Brooke

    2010-01-01

    Endoscopic electronic medical record systems (EEMRs) are now increasingly utilized in many endoscopy centers. Modern EEMRs not only support endoscopy report generation, but often include features such as practice management tools, image and video clip management, inventory management, e-faxes to referring physicians, and database support to measure quality and patient outcomes. There are many existing software vendors offering EEMRs, and choosing a software vendor can be time consuming and co...

  11. Endoscopic management of colorectal adenomas.

    Meier, Benjamin; Caca, Karel; Fischer, Andreas; Schmidt, Arthur

    2017-01-01

    Colorectal adenomas are well known precursors of invasive adenocarcinoma. Colonoscopy is the gold standard for adenoma detection. Colonoscopy is far more than a diagnostic tool, as it allows effective treatment of colorectal adenomas. Endoscopic resection of colorectal adenomas has been shown to reduce the incidence and mortality of colorectal cancer. Difficult resection techniques are available, such as endoscopic mucosal resection, endoscopic submucosal dissection and endoscopic full-thickness resection. This review aims to provide an overview of the different endoscopic resection techniques and their indications, and summarizes the current recommendations in the recently published guideline of the European Society of Gastrointestinal Endoscopy.

  12. Integrated biophotonics in endoscopic oncology

    Muguruma, Naoki; DaCosta, Ralph S.; Wilson, Brian C.; Marcon, Norman E.

    2009-02-01

    endoscopic diagnosis is likely to be impacted by a combination of biomarkers and technology, and 'endoscopic molecular imaging' should be defined as "visualization of molecular characteristics with endoscopy". These innovations will allow us not only to locate a tumor or dysplastic lesion but also to visualize its molecular characteristics (e.g., DNA mutations and polymorphisms, gene and/or protein expression), and the activity of specific molecules and biological processes that affect tumor behavior and/or its response to therapy. In the near future, these methods should be promising technologies that will play a central role in gastrointestinal oncology.

  13. Gynaecological Endoscopic Surgical Education and Assessment. A diploma programme in gynaecological endoscopic surgery.

    Campo, Rudi; Wattiez, Arnaud; Tanos, Vasilis; Di Spiezio Sardo, Attilio; Grimbizis, Grigoris; Wallwiener, Diethelm; Brucker, Sara; Puga, Marco; Molinas, Roger; O'Donovan, Peter; Deprest, Jan; Van Belle, Yves; Lissens, Ann; Herrmann, Anja; Tahir, Mahmood; Benedetto, Chiara; Siebert, Igno; Rabischong, Benoit; De Wilde, Rudy Leon

    2016-04-01

    In recent years, training and education in endoscopic surgery has been critically reviewed. Clinicians, both surgeons as gynaecologist who perform endoscopic surgery without proper training of the specific psychomotor skills are at higher risk to increased patient morbidity and mortality. Although the apprentice-tutor model has long been a successful approach for training of surgeons, recently, clinicians have recognised that endoscopic surgery requires an important training phase outside the operating theatre. The Gynaecological Endoscopic Surgical Education and Assessment programme (GESEA), recognises the necessity of this structured approach and implements two separated stages in its learning strategy. In the first stage, a skill certificate on theoretical knowledge and specific practical psychomotor skills is acquired through a high stake exam; in the second stage, a clinical programme is completed to achieve surgical competence and receive the corresponding diploma. Three diplomas can be awarded: (a) the Bachelor in Endoscopy; (b) the Minimally Invasive Gynaecological Surgeon (MIGS); and (c) the Master level. The Master level is sub-divided into two separate diplomas: the Master in Laparoscopic Pelvic Surgery and the Master in Hysteroscopy. The complexity of modern surgery has increased the demands and challenges to surgical education and the quality control. This programme is based on the best available scientific evidence and it counteracts the problem of the traditional surgical apprentice tutor model. It is seen as a major step toward standardization of endoscopic surgical training in general. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. A technical review of flexible endoscopic multitasking platforms.

    Yeung, Baldwin Po Man; Gourlay, Terence

    2012-01-01

    Further development of advanced therapeutic endoscopic techniques and natural orifice translumenal endoscopic surgery (NOTES) requires a powerful flexible endoscopic multitasking platform. Medline search was performed to identify literature relating to flexible endoscopic multitasking platform from year 2004-2011 using keywords: Flexible endoscopic multitasking platform, NOTES, Instrumentation, Endoscopic robotic surgery, and specific names of various endoscopic multitasking platforms. Key articles from articles references were reviewed. Flexible multitasking platforms can be classified as either mechanical or robotic. Purely mechanical systems include the dual channel endoscope (DCE) (Olympus), R-Scope (Olympus), the EndoSamurai (Olympus), the ANUBIScope (Karl-Storz), Incisionless Operating Platform (IOP) (USGI), and DDES system (Boston Scientific). Robotic systems include the MASTER system (Nanyang University, Singapore) and the Viacath (Hansen Medical). The DCE, the R-Scope, the EndoSamurai and the ANUBIScope have integrated visual function and instrument manipulation function. The IOP and DDES systems rely on the conventional flexible endoscope for visualization, and instrument manipulation is integrated through the use of a flexible, often lockable, multichannel access device. The advantage of the access device concept is that it allows optics and instrument dissociation. Due to the anatomical constrains of the pharynx, systems are designed to have a diameter of less than 20 mm. All systems are controlled by traction cable system actuated either by hand or by robotic machinery. In a flexible system, this method of actuation inevitably leads to significant hysteresis. This problem will be accentuated with a long endoscope such as that required in performing colonic procedures. Systems often require multiple operators. To date, the DCE, the R-Scope, the IOP, and the Viacath system have data published relating to their application in human. Alternative forms of

  15. Specific features of cytological and colposcopical pattern in pregnant women with benign cervix uteri pathology in anamnesis.

    Bysaha, Nataliya Yu

    2016-01-01

    a tendency of increasing incidence of the cervix uteri precancer and cancer in women of reproductive age is noticed recently being related to the growth of number of the sexually-transmitted infections. The cervix uteri pathology incidence in women of fertile age is 20-25%. to study the specific features of the cytological and colposcopical pattern in pregnant patients with benign cervix uteri pathology in the anamnesis and the character of its change post partum. we have examined 195 women during their pregnancy and 3-5 months post partum. All pregnant women, alongside with generally accepted clinical and laboratory examinations, were subjected to the simple and extended colposcopy, cytology of the targeted smears and, according to indications, the histological studies of bioptate. according to the results of the colcoscopical studies and the signs of the cervix uteri pathology found, the patients were divided into several groups. A control group included 49 pregnant women. The clinical and instrumental examination of 146 women with cervix uteri pathology has been carried out both during pregnancy and post partum. the structure of the clinical forms of benign and premalignant changes in the cervix uteri epithelium in pregnant patients has been found. Specific features of the cytological and colposcopical pattern in pregnant patients with benign cervix uteri pathology in anamnesis have been studied. The relationship between the parity of pregnancy, delivery, route of delivery and regress of both benign and premalignant changes in the cervix uteri epithelium 3-5 months post partum has been determined.

  16. Modeling specific phobias and posttraumatic stress disorder in rodents: the challenge to convey both cognitive and emotional features.

    Berardi, Andrea; Trezza, Viviana; Campolongo, Campolongo

    2012-01-01

    Aberrant emotional memory processing is a core, disabling feature of both specific phobias and posttraumatic stress disorder (PTSD), two psychiatric diseases of significant prevalence and morbidity whose cognitive symptoms cannot be adequately treated by current psychopharmacological tools. Elucidating the neurobiological mechanisms involved in the etiology of these diseases is of great interest for the identification of new therapeutics that improve not only the symptomatology but also the full recovery from the pathology. To this aim, several animal models have been proposed based on substantial resemblance between the behavioral alterations seen in animals and the human pathology. The purpose of this review is to describe and comment on the most commonly used rodent models of specific phobias and PTSD. A particular focus will be reserved to the cued version of fear conditioning, as the highly specific stimulus-bound conditioned fear response seems to fit well with clinical descriptions of phobic fear.Moreover, animal models of PTSD will be evaluated by referring to three elements that are considered essential ina valid model of this disease: stressor exposure, memory for the stressor, and anxiety-related behaviors. Finally, current therapeutic directions, with a focus on cannabinoid and glucocorticoid compounds, will be briefly outlined.

  17. Transaxillary Endoscopic Breast Augmentation

    Hyung-Bo Sim

    2014-09-01

    Full Text Available The axillary technique is the most popular approach to breast augmentation among Korean women. Transaxillary breast augmentation is now conducted with sharp electrocautery dissection under direct endoscopic vision throughout the entire process. The aims of this method are clear: both a bloodless pocket and a sharp non-traumatic dissection. Round textured or anatomical cohesive gel implants have been used to make predictable well-defined inframammary creases because textured surface implants demonstrated a better stability attributable to tissue adherence compared with smooth surface implants. The axillary endoscopic technique has greatly evolved, and now the surgical results are comparable to those with the inframammary approach. The author feels that this technique is an excellent choice for young patients with an indistinct or absent inframammary fold, who do not want a scar in the aesthetic unit of their chest.

  18. Transanal endoscopic microsurgery.

    Smart, Christopher J; Cunningham, Chris; Bach, Simon P

    2014-02-01

    Transanal endoscopic microsurgery (TEMS) is a well established method of accurate resection of specimens from the rectum under binocular vision. This review examines its role in the treatment of benign conditions of the rectum and the evidence to support its use and compliment existing endoscopic treatments. The evolution of TEMS in early rectal cancer and the concepts and outcomes of how it has been utilised to treat patients so far are presented. The bespoke nature of early rectal cancer treatment is changing the standard algorithms of rectal cancer care. The future of TEMS in the organ preserving treatment of early rectal cancer is discussed and how as clinicians we are able to select the correct patients for neoadjuvant or radical treatments accurately. The role of radiotherapy and outcomes from combination treatment using TEMS are presented with suggestions for areas of future research. Copyright © 2014. Published by Elsevier Ltd.

  19. [GERD: endoscopic antireflux therapies].

    Caca, K

    2006-08-02

    A couple of minimally-invasive, endoscopic antireflux procedures have been developed during the last years. Beside endoscopic suturing these included injection/implantation technique of biopolymers and application of radiofrequency. Radiofrequency (Stretta) has proved only a very modest effect, while implantation techniques have been abandoned due to lack of long-term efficacy (Gatekeeper) or serious side effects (Enteryx). While first generation endoluminal suturing techniques (EndoCinch, ESD) demonstrated a proof of principle their lack of durability, due to suture loss, led to the development of a potentially durable transmural plication technique (Plicator). In a prospective-randomized, sham-controlled trial the Plicator procedure proved superiority concerning reflux symptoms, medication use and esophageal acid exposure (24-h-pH-metry). While long-term data have to be awaited to draw final conclusions, technical improvements will drive innovation in this field.

  20. Specific Features of Formation and Distribution of the Fund of Innovation Development when Motivating Employees of Enterprises

    Kuzmin Oleh Ye.

    2014-02-01

    Full Text Available The article considers motivation activity at industrial enterprises and underlines importance of its execution under conditions of innovation activity. In order to perform it the article offers to use a number of material (bonus system by generalised grades, bonus for doing especially important work for a certain period of time with consideration of the labour process with innovation activity of the enterprise, etc. and non-material (praise, gratuity, methods of formation of collectives, etc. incentives, the source of which is application of the fund of innovation development. In order to increase effectiveness of motivation activity of an enterprise the article identifies specific features of its formation and distribution: financial and purposeful character, continuity, inclusion of individual payments only and existence of norms of deduction of its funds.

  1. Analysis of specific features of digital instrumentation and control systems and possibilities of accounting for them within PSA

    Hustak, S.

    2002-10-01

    The report is structured as follows: Basic information on the peculiarities of digital technology for the I and C system at an NPP (Digital signal; Digital communication; Communication protocols; Examples of practical tools for creation of I and C digital systems); Peculiarities of the digital I and C technology from the reliability viewpoint (Software as a new component of implementation of a system function; Problems with the assessment or demonstration of reliability of software components of an I and C system); Possibilities of accounting for the specific features of digital I and C technology within PSA (Relevant PSA components; Using PSA as a supporting tool in designing new NPPs; Categorization of NPP I and C system tasks with respect to the defence-in-depth principle). (P.A.)

  2. Some Specific Features of the Object of Prosecutorial Supervision over the Observance of Constitutional Rights of the Individual to Work

    Daniil S. Tishkov

    2017-08-01

    Full Text Available The article defines the place of supervision functions within the system of the functions of prosecution bodies of the Russian Federation as one of the priority sectors of prosecutorial supervision. The legal regulation of prosecutorial supervision of the rights and freedoms of Russian Federation citizens is examined. The Author reveals the specific features of the subject of prosecutorial supervision in compliance with the constitutional rights of the individual to work based on the results of the current legislation system analysis. The assumption of the need for changes to the Prosecutor General of the Russian Federation organizational and administrative documents in order to increase the efficiency of prosecutorial supervision over the observance of individual’s constitutional rights to work is expressed.

  3. The specific features of the diagnosis and treatment of coronary heart disease in rheumatoid arthritis (Results of the authors’ studies

    Natalya Anatolyevna Khramtsova

    2012-01-01

    Full Text Available Coronary heart disease (CHD and its complications occupy the leading place in the pattern of the causes of untimely death in rheumatoid arthritis (RA. Objective: to study the incidence, pattern, and specific features of CHD in patients with RA. Patients and methods. An analytical cross-sectional study was conducted in 257 patients with RA (ARA, 1987. The patients’ mean age was 55.4±11.6 years; RA duration was 14.7years (range 2—20 years. Results. The incidence of CHD in RA was as much as 45.9% (n = 118, including 52.5% (n = 62 for typical angina pectoris on exertion; 25.4% (n = 30 and 22.1% (n = 26 for silent ischemia and arrhythmias, respectively. A high proportion of vertebrogenic cardialgias (48.8%; n = 100 were noted in those who complained of heart pain. The authors identified traditional risk factors, such as hypertension (OR = 12.1, smoking (OR = 10.2, early menopause (OR = 3.6, decreased glomerular filtration rate (OR = 3.5, cardiovascular heredity (OR = 3.1, overweight (OR = 2.5, a heart rate of more than 70 beats/min (OR = 2.3, atherogenic dyslipidemia (OR = 2.3, hyperglycemia (OR = 2.1, and age (OR = 1.7. Along with those, the authors also ascertained CHD predictors associating with chronic inflammation consequences: use of glucocorticoids (OR = 5.0, concomitant anemia as a common complication of RA (OR = 4.7, high DAS 28 scores (OR = 3.7, visual analog scale pain scores of > 50 mm (OR = 2.6, and RA duration of >10 years (OR = 2.2. Conclusion. The specific features of CHD in RA include the frequent detection of arrhythmias and silent ischemia. The importance of the degree of inflammatory activity along with the traditional risk factors of CHD is apparent.

  4. Endoscopic tissue diagnosis of cholangiocarcinoma.

    Harewood, Gavin C

    2008-09-01

    The extremely poor outcome in patients with cholangiocarcinoma, in large part, reflects the late presentation of these tumors and the challenging nature of establishing a tissue diagnosis. Establishing a diagnosis of cholangiocarcinoma requires obtaining evidence of malignancy from sampling of the epithelium of the biliary tract, which has proven to be challenging. Although endoscopic ultrasound-guided fine needle aspiration performs slightly better than endoscopic retrograde cholangiopancreatography in diagnosing cholangiocarcinoma, both endoscopic approaches demonstrate disappointing performance characteristics.

  5. Novel methods for endoscopic training.

    Gessner, C E; Jowell, P S; Baillie, J

    1995-04-01

    The development of past, present, and future endoscopic training methods is described. A historical perspective of endoscopy training guidelines and devices is used to demonstrate support for the use of novel endoscopic training techniques. Computer simulation of endoscopy, interactive learning, and virtual reality applications in endoscopy and surgery are reviewed. The goals of endoscopic simulation and challenges facing investigators in this field are discussed, with an emphasis on current and future research.

  6. Features of CRISPR-Cas Regulation Key to Highly Efficient and Temporally-Specific crRNA Production

    Andjela Rodic

    2017-11-01

    Full Text Available Bacterial immune systems, such as CRISPR-Cas or restriction-modification (R-M systems, affect bacterial pathogenicity and antibiotic resistance by modulating horizontal gene flow. A model system for CRISPR-Cas regulation, the Type I-E system from Escherichia coli, is silent under standard laboratory conditions and experimentally observing the dynamics of CRISPR-Cas activation is challenging. Two characteristic features of CRISPR-Cas regulation in E. coli are cooperative transcription repression of cas gene and CRISPR array promoters, and fast non-specific degradation of full length CRISPR transcripts (pre-crRNA. In this work, we use computational modeling to understand how these features affect the system expression dynamics. Signaling which leads to CRISPR-Cas activation is currently unknown, so to bypass this step, we here propose a conceptual setup for cas expression activation, where cas genes are put under transcription control typical for a restriction-modification (R-M system and then introduced into a cell. Known transcription regulation of an R-M system is used as a proxy for currently unknown CRISPR-Cas transcription control, as both systems are characterized by high cooperativity, which is likely related to similar dynamical constraints of their function. We find that the two characteristic CRISPR-Cas control features are responsible for its temporally-specific dynamical response, so that the system makes a steep (switch-like transition from OFF to ON state with a time-delay controlled by pre-crRNA degradation rate. We furthermore find that cooperative transcription regulation qualitatively leads to a cross-over to a regime where, at higher pre-crRNA processing rates, crRNA generation approaches the limit of an infinitely abrupt system induction. We propose that these dynamical properties are associated with rapid expression of CRISPR-Cas components and efficient protection of bacterial cells against foreign DNA. In terms of synthetic

  7. Memory-Based Specification of Verbal Features for Classifying Animals into Super-Ordinate and Sub-Ordinate Categories

    Takahiro Soshi; Norio Fujimaki; Atsushi Matsumoto; Aya S. Ihara

    2017-01-01

    Accumulating evidence suggests that category representations are based on features. Distinguishing features are considered to define categories, because of all-or-none responses for objects in different categories; however, it is unclear how distinguishing features actually classify objects at various category levels. The present study included 75 animals within three classes (mammal, bird, and fish), along with 195 verbal features. Healthy adults participated in memory-based feature-animal m...

  8. Update on endoscopic pancreatic function testing

    Tyler Stevens; Mansour A Parsi

    2011-01-01

    Hormone-stimulated pancreatic function tests (PFTs) are considered the gold standard for measuring pancreatic exocrine function. PFTs involve the administration of intravenous secretin or cholecystokinin, followed by collection and analysis of pancreatic secretions. Because exocrine function may decline in the earliest phase of pancreatic fibrosis, PFTs are considered accurate for diagnosing chronic pancreatitis. Unfortunately, these potentially valuable tests are infrequently performed except at specialized centers, because they are time consuming and complicated. To overcome these limitations, endoscopic PFT methods have been developed which include aspiration of pancreatic secretions through the suction channel of the endoscope. The secretin endoscopic pancreatic function test (ePFT) involves collection of duodenal aspirates at 15, 30, 45 and 60 min after secretin stimulation. A bicarbonate concentration greater than 80 mmol/L in any of the samples is considered a normal result. The secretin ePFT has demonstrated good sensitivity and specificity compared with various reference standards, including the "Dreiling tube" secretin PFT, endoscopic ultrasound, and surgical histology. Furthermore, a standard autoanalyzer can be used for bicarbonate analysis, which allows the secretin ePFT to be performed at any hospital. The secretin ePFT may complement imaging tests like endoscopic ultrasound (EUS) in the diagnosis of early chronic pancreatitis.This paper will review the literature validating the use of ePFT in the diagnosis of exocrine insufficiency and chronic pancreatitis. Newer developments will also be discussed, including the feasibility of combined EUS/ePFT, the use of cholecystokinin alone or in combination with secretin, and the discovery of new protein and lipid pancreatic juice biomarkers which may complement traditionalfluid analysis.

  9. Optimal management of Barrett's esophagus: pharmacologic, endoscopic, and surgical interventions

    Konda VJA

    2011-11-01

    Full Text Available Vani JA Konda1, Kunal Dalal21Section of Gastroenterology, Department of Medicine, 2Department of Internal Medicine, University of Chicago Medical Center, Chicago, Illinois, USAAbstract: Esophageal adenocarcinoma and its precursor, Barrett's esophagus, are rapidly rising in incidence. This review serves to highlight the role of pharmacologic, endoscopic, and surgical intervention in the management of Barrett's esophagus, which requires acid suppression and endoscopic assessment. Treatment with a proton pump inhibitor may decrease acid exposure and delay the progression to dysplasia. Patients who require aspirin for cardioprotection or other indications may also benefit in terms of a protective effect against the development of esophageal cancer. However, without other indications, aspirin is not indicated solely to prevent cancer. A careful endoscopic examination should include assessment of any visible lesions in a Barrett's segment. An expert gastrointestinal pathologist should confirm neoplasia in the setting of Barrett's esophagus. For those patients with high-grade dysplasia or intramucosal carcinoma, careful consideration of endoscopic therapy or surgical therapy must be given. All visible lesions in the setting of dysplasia should be targeted with focal endoscopic mucosal resection for both accurate histopathologic diagnosis and treatment. The remainder of the Barrett's epithelium should be eradicated to address all synchronous and metachronous lesions. This may be done by tissue acquiring or nontissue acquiring means. Radiofrequency ablation has a positive benefit-risk profile for flat Barrett's esophagus. At this time, endoscopic therapy is not indicated for nondysplastic Barrett's esophagus. Esophagectomy is still reserved for selected cases with evidence of lymph node metastasis, unsuccessful endoscopic therapy, or with high-risk features of high-grade dysplasia or intramucosal carcinoma.Keywords: Barrett's esophagus, high

  10. Endoscopic Management of Peri-Pancreatic Fluid Collections.

    Yip, Hon Chi; Teoh, Anthony Yuen Bun

    2017-09-15

    In the past decade, there has been a progressive paradigm shift in the management of peri-pancreatic fluid collections after acute pancreatitis. Refinements in the definitions of fluid collections from the updated Atlanta classification have enabled better communication amongst physicians in an effort to formulate optimal treatments. Endoscopic ultrasound (EUS)-guided drainage of pancreatic pseudocysts has emerged as the procedure of choice over surgical cystogastrostomy. The approach provides similar success rates with low complications and better quality of life compared with surgery. However, an endoscopic "step up" approach in the management of pancreatic walled-off necrosis has also been advocated. Both endoscopic and percutaneous drainage routes may be used depending on the anatomical location of the collections. New-generation large diameter EUS-specific stent systems have also recently been described. The device allows precise and effective drainage of the collections and permits endoscopic necrosectomy through the stents.

  11. Benign submucosal lesions of the stomach and duodenum: Imaging characteristics with endoscopic and pathologic correlation

    Oh, Jong Young; Nam, Kyung Jin; Choi, Jong Cheol; Cho, Jin Han; Yoon, Seong Kuk; Choi, Sun Seob; Kwon, Hee Jin; Yoon, Jung Hee; Kim, Su Jin

    2008-01-01

    Benign submucosal lesions of the stomach and duodenum are occasionally encountered during endoscopy. But endoscopy has its limitations in the diagnosis and differentiation of these lesions, because submucosal lesions are often difficult to visualize at endoscopy due to minimal change of the overlying mucosa. Furthermore, endoscopic biopsy may not always yield adequate tissue for diagnosis due to the submucosal location of the lesions. For this reason, the role of radiologic imaging is important in the diagnosis of submucosal lesions of the stomach and duodenum. Recent advances in computed tomography (CT) and sonographic technology are helpful in narrowing the differential diagnosis of gastroduodenal submucosal lesions. In contrast to endoscopy and barium studies, CT or ultrasonography (US) provides information about both the gastric wall and the extragastric extent of the disease. Arterial phase contrast enhanced CT enables us to discriminate a mass of submucosal from that of a mucosal origin in the differential diagnosis of gastric or duodenal lesions. Although endoscopic sonography has been considered the better modality in the diagnosis of gastroduodenal submucosal lesions, transabdominal sonography can still be an alternative method to endoscopic sonography in assessing of the origin and character of the submucosal lesions. Some gastroduodenal submucosal lesions have similar radiologic findings that make differentiation difficult. But despite overlaps in radiologic findings, some lesions have characteristic radiologic features that may suggest a specific diagnosis. Knowledge of the differential diagnosis of benign submucosal lesions in the stomach and duodenum may promote correct diagnosis and appropriate treatment

  12. Memory-Based Specification of Verbal Features for Classifying Animals into Super-Ordinate and Sub-Ordinate Categories

    Takahiro Soshi

    2017-09-01

    Full Text Available Accumulating evidence suggests that category representations are based on features. Distinguishing features are considered to define categories, because of all-or-none responses for objects in different categories; however, it is unclear how distinguishing features actually classify objects at various category levels. The present study included 75 animals within three classes (mammal, bird, and fish, along with 195 verbal features. Healthy adults participated in memory-based feature-animal matching verification tests. Analyses included a hierarchical clustering analysis, support vector machine, and independent component analysis to specify features effective for classifications. Quantitative and qualitative comparisons for significant features were conducted between super-ordinate and sub-ordinate levels. The number of significant features was larger for super-ordinate than sub-ordinate levels. Qualitatively, the proportion of biological features was larger than cultural/affective features in both the levels, while the proportion of affective features increased at the sub-ordinate level. To summarize, the two types of features differentially function to establish category representations.

  13. Expression profile and specific network features of the apoptotic machinery explain relapse of acute myeloid leukemia after chemotherapy

    Ragusa, Marco; Consoli, Carla; Camuglia, Maria Grazia; Di Pietro, Cinzia; Milone, Giuseppe; Purrello, Michele; Avola, Giuseppe; Angelica, Rosario; Barbagallo, Davide; Guglielmino, Maria Rosa; Duro, Laura R; Majorana, Alessandra; Statello, Luisa; Salito, Loredana

    2010-01-01

    According to the different sensitivity of their bone marrow CD34+ cells to in vitro treatment with Etoposide or Mafosfamide, Acute Myeloid Leukaemia (AML) patients in apparent complete remission (CR) after chemotherapy induction may be classified into three groups: (i) normally responsive; (ii) chemoresistant; (iii) highly chemosensitive. This inversely correlates with in vivo CD34+ mobilization and, interestingly, also with the prognosis of the disease: patients showing a good mobilizing activity are resistant to chemotherapy and subject to significantly higher rates of Minimal Residual Disease (MRD) and relapse than the others. Based on its known role in patients' response to chemotherapy, we hypothesized an involvement of the Apoptotic Machinery (AM) in these phenotypic features. To investigate the molecular bases of the differential chemosensitivity of bone marrow hematopoietic stem cells (HSC) in CR AML patients, and the relationship between chemosensitivity, mobilizing activity and relapse rates, we analyzed their AM expression profile by performing Real Time RT-PCR of 84 AM genes in CD34+ pools from the two extreme classes of patients (i.e., chemoresistant and highly chemosensitive), and compared them with normal controls. The AM expression profiles of patients highlighted features that could satisfactorily explain their in vitro chemoresponsive phenotype: specifically, in chemoresistant patients we detected up regulation of antiapoptotic BIRC genes and down regulation of proapoptotic APAF1, FAS, FASL, TNFRSF25. Interestingly, our analysis of the AM network showed that the dysregulated genes in these patients are characterized by high network centrality (i.e., high values of betweenness, closeness, radiality, stress) and high involvement in drug response. AM genes represent critical nodes for the proper execution of cell death following pharmacological induction in patients. We propose that their dysregulation (either due to inborn or de novo genomic

  14. Expression profile and specific network features of the apoptotic machinery explain relapse of acute myeloid leukemia after chemotherapy

    Di Pietro Cinzia

    2010-07-01

    Full Text Available Abstract Background According to the different sensitivity of their bone marrow CD34+ cells to in vitro treatment with Etoposide or Mafosfamide, Acute Myeloid Leukaemia (AML patients in apparent complete remission (CR after chemotherapy induction may be classified into three groups: (i normally responsive; (ii chemoresistant; (iii highly chemosensitive. This inversely correlates with in vivo CD34+ mobilization and, interestingly, also with the prognosis of the disease: patients showing a good mobilizing activity are resistant to chemotherapy and subject to significantly higher rates of Minimal Residual Disease (MRD and relapse than the others. Based on its known role in patients' response to chemotherapy, we hypothesized an involvement of the Apoptotic Machinery (AM in these phenotypic features. Methods To investigate the molecular bases of the differential chemosensitivity of bone marrow hematopoietic stem cells (HSC in CR AML patients, and the relationship between chemosensitivity, mobilizing activity and relapse rates, we analyzed their AM expression profile by performing Real Time RT-PCR of 84 AM genes in CD34+ pools from the two extreme classes of patients (i.e., chemoresistant and highly chemosensitive, and compared them with normal controls. Results The AM expression profiles of patients highlighted features that could satisfactorily explain their in vitro chemoresponsive phenotype: specifically, in chemoresistant patients we detected up regulation of antiapoptotic BIRC genes and down regulation of proapoptotic APAF1, FAS, FASL, TNFRSF25. Interestingly, our analysis of the AM network showed that the dysregulated genes in these patients are characterized by high network centrality (i.e., high values of betweenness, closeness, radiality, stress and high involvement in drug response. Conclusions AM genes represent critical nodes for the proper execution of cell death following pharmacological induction in patients. We propose that their

  15. Method for radiometric calibration of an endoscope's camera and light source

    Rai, Lav; Higgins, William E.

    2008-03-01

    An endoscope is a commonly used instrument for performing minimally invasive visual examination of the tissues inside the body. A physician uses the endoscopic video images to identify tissue abnormalities. The images, however, are highly dependent on the optical properties of the endoscope and its orientation and location with respect to the tissue structure. The analysis of endoscopic video images is, therefore, purely subjective. Studies suggest that the fusion of endoscopic video images (providing color and texture information) with virtual endoscopic views (providing structural information) can be useful for assessing various pathologies for several applications: (1) surgical simulation, training, and pedagogy; (2) the creation of a database for pathologies; and (3) the building of patient-specific models. Such fusion requires both geometric and radiometric alignment of endoscopic video images in the texture space. Inconsistent estimates of texture/color of the tissue surface result in seams when multiple endoscopic video images are combined together. This paper (1) identifies the endoscope-dependent variables to be calibrated for objective and consistent estimation of surface texture/color and (2) presents an integrated set of methods to measure them. Results show that the calibration method can be successfully used to estimate objective color/texture values for simple planar scenes, whereas uncalibrated endoscopes performed very poorly for the same tests.

  16. Comparison of microscopic and endoscopic view of the internal acoustic meatus: A cadaveric study.

    Montibeller, Guilherme Ramina; Hendrix, Philipp; Fries, Fabian N; Becker, Kurt W; Oertel, Joachim

    2018-04-01

    The endoscope is thought to provide an improved exposure of the internal acoustic meatus after retrosigmoid craniotomy for microsurgical resection of intrameatal tumors. The aim of this study is to quantify the differences in internal acoustic meatus (IAM) exposure comparing microscopic and endoscopic visualization. A retrosigmoid approach was performed on 5 cadaver heads. A millimeter gauge was introduced into the internal acoustic meatus, and examinations with a surgical microscope and 0°, 30° and 70° rigid endoscopes were performed. The extent of IAM depth visualized with the microscope and the different angled endoscopes were analyzed. The microscopic view allowed an average IAM depth visualization of 2.8 mm. The endoscope allowed an improved exposure of IAM in all cases. The 0°, 30° and 70° endoscopes permitted an exposure that was respectively 96% (5.5 mm), 139% (6.7 mm) and 200% (8.4 mm) more lateral than the microscopic view. Angled optics, however, provided an image distortion, specifically the 70° endoscope. The endoscope provides a superior visualization of the IAM compared to the microscope when using a retrosigmoid approach. The 30° endoscope represented an ideal compromise of superior visualization with marginal image distortion. Additional implementation of the endoscope into microsurgery of intrameatal tumors likely facilitates complete tumor removal and might spare facial and vestibulocochlear function. Clin. Anat. 31:398-403, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  17. An Innovate Robotic Endoscope Guidance System for Transnasal Sinus and Skull Base Surgery: Proof of Concept.

    Friedrich, D T; Sommer, F; Scheithauer, M O; Greve, J; Hoffmann, T K; Schuler, P J

    2017-12-01

    Objective  Advanced transnasal sinus and skull base surgery remains a challenging discipline for head and neck surgeons. Restricted access and space for instrumentation can impede advanced interventions. Thus, we present the combination of an innovative robotic endoscope guidance system and a specific endoscope with adjustable viewing angle to facilitate transnasal surgery in a human cadaver model. Materials and Methods  The applicability of the robotic endoscope guidance system with custom foot pedal controller was tested for advanced transnasal surgery on a fresh frozen human cadaver head. Visualization was enabled using a commercially available endoscope with adjustable viewing angle (15-90 degrees). Results  Visualization and instrumentation of all paranasal sinuses, including the anterior and middle skull base, were feasible with the presented setup. Controlling the robotic endoscope guidance system was effectively precise, and the adjustable endoscope lens extended the view in the surgical field without the common change of fixed viewing angle endoscopes. Conclusion  The combination of a robotic endoscope guidance system and an advanced endoscope with adjustable viewing angle enables bimanual surgery in transnasal interventions of the paranasal sinuses and the anterior skull base in a human cadaver model. The adjustable lens allows for the abandonment of fixed-angle endoscopes, saving time and resources, without reducing the quality of imaging.

  18. Endoscopic transmission of Helicobacter pylori

    Tytgat, G. N.

    1995-01-01

    The contamination of endoscopes and biopsy forceps with Helicobacter pylori occurs readily after endoscopic examination of H. pylori-positive patients. Unequivocal proof of iatrogenic transmission of the organism has been provided. Estimates for transmission frequency approximate to 4 per 1000

  19. Novel computer-based endoscopic camera

    Rabinovitz, R.; Hai, N.; Abraham, Martin D.; Adler, Doron; Nissani, M.; Fridental, Ron; Vitsnudel, Ilia

    1995-05-01

    We have introduced a computer-based endoscopic camera which includes (a) unique real-time digital image processing to optimize image visualization by reducing over exposed glared areas and brightening dark areas, and by accentuating sharpness and fine structures, and (b) patient data documentation and management. The image processing is based on i Sight's iSP1000TM digital video processor chip and Adaptive SensitivityTM patented scheme for capturing and displaying images with wide dynamic range of light, taking into account local neighborhood image conditions and global image statistics. It provides the medical user with the ability to view images under difficult lighting conditions, without losing details `in the dark' or in completely saturated areas. The patient data documentation and management allows storage of images (approximately 1 MB per image for a full 24 bit color image) to any storage device installed into the camera, or to an external host media via network. The patient data which is included with every image described essential information on the patient and procedure. The operator can assign custom data descriptors, and can search for the stored image/data by typing any image descriptor. The camera optics has extended zoom range of f equals 20 - 45 mm allowing control of the diameter of the field which is displayed on the monitor such that the complete field of view of the endoscope can be displayed on all the area of the screen. All these features provide versatile endoscopic camera with excellent image quality and documentation capabilities.

  20. Endoscopic laser-urethroplasty

    Gilbert, Peter

    2006-02-01

    The objective was to prove the advantage of endoscopic laser-urethroplasty over internal urethrotomy in acquired urethral strictures. Patients and Method: From January, 1996 to June, 2005, 35 patients with a mean age of 66 years were submitted to endoscopic laser-urethroplasty for strictures of either the bulbar (30) or membranous (5) urethra. The operations were carried out under general anesthesia. First of all, the strictures were incised at the 4, 8 and 12 o'clock position by means of a Sachse-urethrotom. Then the scar flap between the 4 and 8 o'clock position was vaporized using a Nd:YAG laser, wavelength 1060 nm and a 600 pm bare fiber, the latter always being in contact with the tissue. The laser worked at 40W power in continuous mode. The total energy averaged 2574 J. An indwelling catheter was kept in place overnight and the patients were discharged the following day. Urinalysis, uroflowmetry and clinical examination were performed at two months after surgery and from then on every six months. Results: No serious complications were encountered. Considering a mean follow-up of 18 months, the average peak flow improved from 7.3 ml/s preoperatively to 18.7 mVs postoperatively. The treatment faded in 5 patients ( 14.3% ) who finally underwent open urethroplasty. Conclusions: Endoscopic laser-urethroplasty yields better short-term results than internal visual urethrotomy. Long-term follow-up has yet to confirm its superiority in the treatment of acquired urethral strictures.

  1. Craniopharyngioma - Transnasal Endoscopic Approach

    Sanjeev Bhagat,

    2011-01-01

    Full Text Available Craniopharyngiomas are slow growing tumours arising from remnants of the craniopharyngeal duct and occupy the sellar region. The patients may remain asymptomatic for long duration or present with headache or visual disturbances. Surgery is the mainstay of the treatment. Traditionally these tumours have been removed by neurosurgeons through the cranial approach but the advent of nasal endoscopes has opened new avenues for ENT surgeons to treat such patients. We hereby present a case of craniopharyngioma who was successfully treated by Trans-nasal Hypophysectomy.

  2. Endoscopic resection of subepithelial tumors.

    Schmidt, Arthur; Bauder, Markus; Riecken, Bettina; Caca, Karel

    2014-12-16

    Management of subepithelial tumors (SETs) remains challenging. Endoscopic ultrasound (EUS) has improved differential diagnosis of these tumors but a definitive diagnosis on EUS findings alone can be achieved in the minority of cases. Complete endoscopic resection may provide a reasonable approach for tissue acquisition and may also be therapeutic in case of malignant lesions. Small SET restricted to the submucosa can be removed with established basic resection techniques. However, resection of SET arising from deeper layers of the gastrointestinal wall requires advanced endoscopic methods and harbours the risk of perforation. Innovative techniques such as submucosal tunneling and full thickness resection have expanded the frontiers of endoscopic therapy in the past years. This review will give an overview about endoscopic resection techniques of SET with a focus on novel methods.

  3. Platyhelminth Venom Allergen-Like (VAL) proteins: revealing structural diversity, class-specific features and biological associations across the phylum

    CHALMERS, IAIN W.; HOFFMANN, KARL F.

    2012-01-01

    SUMMARY During platyhelminth infection, a cocktail of proteins is released by the parasite to aid invasion, initiate feeding, facilitate adaptation and mediate modulation of the host immune response. Included amongst these proteins is the Venom Allergen-Like (VAL) family, part of the larger sperm coating protein/Tpx-1/Ag5/PR-1/Sc7 (SCP/TAPS) superfamily. To explore the significance of this protein family during Platyhelminthes development and host interactions, we systematically summarize all published proteomic, genomic and immunological investigations of the VAL protein family to date. By conducting new genomic and transcriptomic interrogations to identify over 200 VAL proteins (228) from species in all 4 traditional taxonomic classes (Trematoda, Cestoda, Monogenea and Turbellaria), we further expand our knowledge related to platyhelminth VAL diversity across the phylum. Subsequent phylogenetic and tertiary structural analyses reveal several class-specific VAL features, which likely indicate a range of roles mediated by this protein family. Our comprehensive analysis of platyhelminth VALs represents a unifying synopsis for understanding diversity within this protein family and a firm context in which to initiate future functional characterization of these enigmatic members. PMID:22717097

  4. Spent coffee-based activated carbon: specific surface features and their importance for H2S separation process.

    Kante, Karifala; Nieto-Delgado, Cesar; Rangel-Mendez, J Rene; Bandosz, Teresa J

    2012-01-30

    Activated carbons were prepared from spent ground coffee. Zinc chloride was used as an activation agent. The obtained materials were used as a media for separation of hydrogen sulfide from air at ambient conditions. The materials were characterized using adsorption of nitrogen, elemental analysis, SEM, FTIR, and thermal analysis. Surface features of the carbons depend on the amount of an activation agent used. Even though the residual inorganic matter takes part in the H(2)S retention via salt formation, the porous surface of carbons governs the separation process. The chemical activation method chosen resulted in formation of large volume of pores with sizes between 10 and 30Å, optimal for water and hydrogen sulfide adsorption. Even though the activation process can be optimized/changed, the presence of nitrogen in the precursor (caffeine) is a significant asset of that specific organic waste. Nitrogen functional groups play a catalytic role in hydrogen sulfide oxidation. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. Specific alteration of rhythm in temperature-stressed rats possess features of abdominal pain in IBS patients

    Yasuo Itomi

    2015-09-01

    Full Text Available It is known that specific alteration of rhythm in temperature (SART stress produces somatic pain. However, it remains to be investigated whether SART stress induces visceral pain. In this study, we investigated the visceral hypersensitivity in the SART stress model by pharmacological tools and heterotopical nociception. Four-week-old Sprague–Dawley rats were exposed to repeated cold stress. Visceral pain was measured by visceromotor response to colorectal distension, and the effects of alosetron and duloxetine on visceral pain were investigated in SART rats. Heterotopical nociception was given by capsaicin injection into the left forepaw to induce diffuse noxious inhibitory controls (DNIC. SART stress induced visceral hypersensitivity that was sustained at minimum for one week. In pharmacological analysis, alosetron and duloxetine improved SART stress-induced visceral hypersensitivity. Heterotopical nociception induced DNIC in normal conditions, but was disrupted in SART rats. On the other hand, RMCP-II mRNA in distal colon was not affected by SART stress. In conclusion, SART rats exhibit several features of visceral pain in IBS, and may be a useful model for investigating the central modification of pain control in IBS.

  6. An unsupervised meta-graph clustering based prototype-specific feature quantification for human re-identification in video surveillance

    Aparajita Nanda

    2017-06-01

    Full Text Available Human re-identification is an emerging research area in the field of visual surveillance. It refers to the task of associating the images of the persons captured by one camera (probe set with the images captured by another camera (gallery set at different locations in different time instances. The performance of these systems are often challenged by some factors—variation in articulated human pose and clothing, frequent occlusion with various objects, change in light illumination, and the cluttered background are to name a few. Besides, the ambiguity in recognition increases between individuals with similar appearance. In this paper, we present a novel framework for human re-identification that finds the correspondence image pair across non-overlapping camera views in the presence of the above challenging scenarios. The proposed framework handles the visual ambiguity having similar appearance by first segmenting the gallery instances into disjoint prototypes (groups, where each prototype represents the images with high commonality. Then, a weighing scheme is formulated that quantifies the selective and distinct information about the features concerning the level of contribution against each prototype. Finally, the prototype specific weights are utilized in the similarity measure and fused with the existing generic weighing to facilitates improvement in the re-identification. Exhaustive simulation on three benchmark datasets alongside the CMC (Cumulative Matching Characteristics plot enumerate the efficacy of our proposed framework over the counterparts.

  7. On specific features of neutron spatial-energy distribution formation in a complex cell of a channel water reactor

    Yurova, L.N.; Naumov, V.I.; Belousov, N.I.

    1979-01-01

    Presented are the results of calculations of spatial-energy neutron distribution formation specific features in the cells with great amount and heterogeneous distribution of water. Considered is the two-region cylindrical cell with the central zone of 4 cm radius, consisting of moderators of different types. The calculation results show, that in the absence of absorption with the energy decrease flattening of neutron flux density by the cell takes place. Here in the case of hydrogen bearing moderator in the central zone the effect of the flux initial perturbation covers the essentially wider energy range, than in the case of hydrogenless moderator. Perturbation effect strongly depends on the composition of the peripheric zone (graphite, heavy water) and the size of the cell. The energy range, which is covered by the perturbation in the case of a hydrogen-bearing moderator in the central zone, is comparable with resonance energy range for uranium-238. A conclusion is made on the limited possibilities of the ''flat flux'' approximation for analyzing the resonance absorption in heterogeneous reactors with essential content of water in the channels

  8. Specific features of the switch-on gate current and different switch-on modes in silicon carbide thyristors

    Yurkov, S N; Mnatsakanov, T T; Levinshtein, M E; Cheng, L; Palmour, J W

    2014-01-01

    The specific features of the temperature and bias dependences of the switch-on gate current in SiC thyristors are examined analytically for two possible switching mechanisms. The so-called γ-mechanism, which is highly typical of the conventional Si thyristors, is characterized by very weak temperature and bias dependences. By contrast, the so-called α-mechanism, which is very characteristic of SiC thyristors, is highly sensitive to changes in temperature and bias. If the thyristor is switched on by the α-mechanism, the switch-on gate current density decreases very steeply with increasing temperature. As a result, the thyristor can lose its working capacity at elevated temperatures due to the instability against even very weak impacts. With decreasing the bias voltage U a , the gate switch-on current increases very steeply, which can make switching the thyristor on difficult. The unintentional shunting, which is apparently present in high-voltage SiC thyristors, causes the transition from the α- to the γ-mechanism at elevated temperatures and high biases. It can be supposed that introduction of a controllable technological shunting of the emitter–thin base junction allows stabilization of the temperature and bias parameters of SiC thyristors. The analytical results are confirmed by computer simulations performed in wide temperature and bias ranges for a 4H-SiC thyristor of the 18 kV class. (paper)

  9. Specific features of NH3 and plasma-assisted MBE in the fabrication of III-N HEMT heterostructures

    Alexeev, A. N.; Krasovitsky, D. M.; Petrov, S. I.; Chaly, V. P.; Mamaev, V. V.; Sidorov, V. G.

    2015-01-01

    The specific features of how nitride HEMT heterostructures are produced by NH 3 and plasma-assisted (PA) molecular-beam epitaxy (MBE) are considered. It is shown that the use of high-temperature AlN/AlGaN buffer layers grown with ammonia at extremely high temperatures (up to 1150°C) can drastically improve the structural perfection of the active GaN layers and reduce the dislocation density in these layers to values of 9 × 10 8 −1 × 10 9 cm −2 . The use of buffer layers of this kind makes it possible to obtain high-quality GaN/AlGaN heterostructures by both methods. At the same time, in contrast to ammonia MBE which is difficult to apply at T < 500°C (because of the low efficiency of ammonia decomposition), PA MBE is rather effective at low temperatures, e.g., for the growth of InAlN layers lattice-matched with GaN. The results obtained in the MBE growth of AlN/AlGaN/GaN/InAlN heterostructures by both PA-MBE and NH 3 -MBE with an extremely high ammonia flux are demonstrated

  10. Conventional Versus Rosemont Endoscopic Ultrasound Criteria for Chronic Pancreatitis: Comparing Interobserver Reliability and Intertest Agreement

    Bruce Kalmin

    2011-01-01

    Full Text Available BACKGROUND: The Rosemont criteria (RC were recently proposed by expert consensus to standardize endoscopic ultrasound (EUS features and thresholds for diagnosing chronic pancreatitis (CP; however, they are cumbersome and are not validated.

  11. Endoscopic approach to achalasia

    Müller, Michaela; Eckardt, Alexander J; Wehrmann, Till

    2013-01-01

    Achalasia is a primary esophageal motor disorder. The etiology is still unknown and therefore all treatment options are strictly palliative with the intention to weaken the lower esophageal sphincter (LES). Current established endoscopic therapeutic options include pneumatic dilation (PD) or botulinum toxin injection. Both treatment approaches have an excellent symptomatic short term effect, and lead to a reduction of LES pressure. However, the long term success of botulinum toxin (BT) injection is poor with symptom recurrence in more than 50% of the patients after 12 mo and in nearly 100% of the patients after 24 mo, which commonly requires repeat injections. In contrast, after a single PD 40%-60% of the patients remain asymptomatic for ≥ 10 years. Repeated on demand PD might become necessary and long term remission can be achieved with this approach in up to 90% of these patients. The main positive predictors for a symptomatic response to PD are an age > 40 years, a LES-pressure reduction to 40 years, was nearly equivalent to surgery. A new promising technique might be peroral endoscopic myotomy, although long term results are needed and practicability as well as safety issues must be considered. Treatment with a temporary self expanding stent has been reported with favorable outcomes, but the data are all from one study group and must be confirmed by others before definite recommendations can be made. In addition to its use as a therapeutic tool, endoscopy also plays an important role in the diagnosis and surveillance of patients with achalasia. PMID:23951393

  12. Peroral endoscopic myotomy

    2015-01-01

    Peroral endoscopic myotomy (POEM) incorporatesconcepts of natural orifice translumenal endoscopicsurgery and achieves endoscopic myotomy by utilizinga submucosal tunnel as an operating space.Although intended for the palliation of symptoms ofachalasia, there is mounting data to suggest it is alsoefficacious in the management of spastic esophagealdisorders. The technique requires an understanding ofthe pathophysiology of esophageal motility disorders aswell as knowledge of surgical anatomy of the foregut.POEM achieves short term response in 82% to 100% ofpatients with minimal risk of adverse events. In addition,it appears to be effective and safe even at the extremesof age and regardless of prior therapy undertaken.Although infrequent, the ability of the endoscopist tomanage an intraprocedural adverse event is critical asfailure to do so could result in significant morbidity. Themajor late adverse event is gastroesophageal refluxwhich appears to occur in 20% to 46% of patients.Research is being conducted to clarify the optimaltechnique for POEM and a personalized approach bymeasuring intraprocedural esophagogastric junctiondistensibility appears promising. In addition toesophageal disorders,POEM is being studied in themanagement of gastroparesis (gastric pyloromyotomy)with initial reports demonstrating technical feasibility.Although POEM represents a paradigm shift themanagement of esophageal motility disorders, theresults of prospective randomized controlled trials withlong-term follow up are eagerly awaited.

  13. High-quality endoscope reprocessing decreases endoscope contamination.

    Decristoforo, P; Kaltseis, J; Fritz, A; Edlinger, M; Posch, W; Wilflingseder, D; Lass-Flörl, C; Orth-Höller, D

    2018-02-24

    Several outbreaks of severe infections due to contamination of gastrointestinal (GI) endoscopes, mainly duodenoscopes, have been described. The rate of microbial endoscope contamination varies dramatically in literature. The aim of this multicentre prospective study was to evaluate the hygiene quality of endoscopes and automated endoscope reprocessors (AERs) in Tyrol/Austria. In 2015 and 2016, a total of 463 GI endoscopes and 105 AERs from 29 endoscopy centres were analysed by a routine (R) and a combined routine and advanced (CRA) sampling procedure and investigated for microbial contamination by culture-based and molecular-based analyses. The contamination rate of GI endoscopes was 1.3%-4.6% according to the national guideline, suggesting that 1.3-4.6 patients out of 100 could have had contacts with hygiene-relevant microorganisms through an endoscopic intervention. Comparison of R and CRA sampling showed 1.8% of R versus 4.6% of CRA failing the acceptance criteria in phase I and 1.3% of R versus 3.0% of CRA samples failing in phase II. The most commonly identified indicator organism was Pseudomonas spp., mainly Pseudomonas oleovorans. None of the tested viruses were detected in 40 samples. While AERs in phase I failed (n = 9, 17.6%) mainly due to technical faults, phase II revealed lapses (n = 6, 11.5%) only on account of microbial contamination of the last rinsing water, mainly with Pseudomonas spp. In the present study the contamination rate of endoscopes was low compared with results from other European countries, possibly due to the high quality of endoscope reprocessing, drying and storage. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  14. Endoscopic anatomy of the orbital floor and maxillary sinus.

    Moore, Corey C; Bromwich, Matthew; Roth, Kathy; Matic, Damir B

    2008-01-01

    Endoscopic repair of orbital blow-out fractures could become a predictable and efficient treatment alternative to traditional methods. However, maxillary sinus endoscopy provides a complex and disorienting view of the orbital floor. To be a useful and consistent technique for providing access to the orbital floor, specific knowledge of maxillary endoscopic anatomy is required. The purpose of the study was to provide an anatomic description of the orbital floor via the endoscopic approach. Objectives include defining consistent landmarks for use in endoscopic repair of orbital floor fractures. Using 0- and 30-degree rigid endoscopes, 6 fresh cadavers (12 maxillary sinuses) were examined via a standard Caldwell-Luc approach. Computed tomographic scans, plastic molds, and digital images were used to compare observable averages within bony anatomy. Potential bony landmarks were correlated with soft-tissue anatomy in fresh specimens. The maxillary ostium, orbital floor, and lateral ethmoid air cells were visualized, and their structures were described. Observations were made in relation to the anatomy of the orbital floor and maxillary sinus, including fracture pattern and force transmission pathways. An "orbitomaxillary" sinus bony thickening was identified and described for the first time. This study provides the basis for further refinement of surgical technique and opens the door for future clinical trials using endoscopic repair.

  15. [Tracheotomy-endoscop for dilatational percutaneous tracheotomy (TED)].

    Klemm, Eckart

    2006-09-01

    While surgical tracheotomies are currently performed using state-of-the-art operative techniques, percutaneous dilatational tracheostomy (PDT) is in a rapidly evolving state with regard to its technology and the number of techniques available. This has resulted in a range of new complications that are difficult to quantify on a scientific basis, given the fact that more than half of the patients who are tracheotomized in intensive care units die from their underlying disease. The new Tracheotomy Endoscope (TED) is designed to help prevent serious complications in dilatational tracheotomies and facilitate their management. The endoscope has been specifically adapted to meet the require-ments of percutaneous dilatational tracheotomies. It is fully compatible with all current techniques of PDT. The method is easy to learn. The percutaneous dilatational tracheotomy with the Tracheotomy Endoscope is a seven-step procedure: Advantages of the Tracheotomy Endoscope: Injuries to the posterior tracheal wall ar impossible (tracheoesophageal fistulas, pneumothorax). Minor bleeding sites on the tracheal mucosa can be controlled with a specially curved suction-coagulation tube introudeced through the Tracheotomy Endoscope. In cases with heavy bleeding and a risk of aspiration, the rigid indwelling Tracheotomy Endoscope provides a secure route for reintubating the patient with a cuffed endotracheal tube. It also allows for rapid conversion to an open surgical procedure if necessary. All the parts are easy to clean and are autoclavable. This type of endoscopically guided PDT creates an optimal link between the specialties of intensive care medicine and otorhinolaryngology. The Tracheotomy Endoscope (TED) increases the standard of safety in PDT.

  16. A primer on endoscopic electronic medical records.

    Atreja, Ashish; Rizk, Maged; Gurland, Brooke

    2010-02-01

    Endoscopic electronic medical record systems (EEMRs) are now increasingly utilized in many endoscopy centers. Modern EEMRs not only support endoscopy report generation, but often include features such as practice management tools, image and video clip management, inventory management, e-faxes to referring physicians, and database support to measure quality and patient outcomes. There are many existing software vendors offering EEMRs, and choosing a software vendor can be time consuming and confusing. The goal of this article is inform the readers about current functionalities available in modern EEMR and provide them with a framework necessary to find an EEMR that is best fit for their practice.

  17. Engineering aspects of a fully mirrored endoscope

    Terra, A.; Huber, A.; Schweer, B.; Mertens, Ph.; Arnoux, G.; Balshaw, N.; Brezinsek, S.; Egner, S.; Hartl, M.; Kampf, D.; Klammer, J.; Lambertz, H.T.; Morlock, C.; Murari, A.; Reindl, M.; Sanders, S.; Sergienko, G.; Spencer, G.

    2013-01-01

    Highlights: ► Replacement of JET diagnostics to match the new ITER-like Wall. ► The endoscope test ITER-like design with only mirror based optics. ► Withstanding and diagnostic capability during Plasma operation and disruptions. ► Engineering process from design to installation and procurement. -- Abstract: The development of optical diagnostics, like endoscopes, compatible with the ITER environment (metallic plasma facing components, neutron proof optics, etc.) is a challenge, but current tokamaks such as JET provide opportunities to test fully working concepts. This paper describes the engineering aspects of a fully mirrored endoscope that has recently been designed, procured and installed on JET. The system must operate in a very strict environment with high temperature, high magnetic fields up to B = 4 T and rapid field variations (∂B/∂t ∼ 100 T/s) that induce high stresses due to eddy currents in the front mirror assembly. It must be designed to withstand high mechanical loads especially during disruptions, which lead to acceleration of about 7 g at 14 Hz. For the JET endoscope, when the plasma thermal loading, direct and indirect, was added to the assumed disruption loads, the reserve factor, defined as a ratio of yield strength over summed up von Mises stresses, was close to 1 for the mirror components. To ensure reliable operation, several analyses were performed to evaluate the thermo-mechanical performance of the endoscope and a final validation was obtained from mechanical and thermal tests, before the system's final installation in May 2011. During the tests, stability of the field of view angle variation was kept below 1° despite the high thermal gradient on endoscope head (∂T/∂x ∼ 500 K/m). In parallel, to ensure long time operation and to prevent undesirable performance degradation, a shutter system was also implemented in order to reduce impurity deposition on in-vessel mirrors but also to allow in situ transmission calibration

  18. Endoscopic Transnasal Approach for Cholesterol Granuloma of the Petrous Apex

    Mohammad Samadian

    2015-01-01

    Full Text Available Cholesterol granulomas are rare round or ovoid cysts. They contain cholesterol crystals surrounded by foreign bodies of giant cells and are characterized by chronic inflammation. Large cholesterol granuloma can compress surrounding tissue especially cranial nerves. There are several types of surgery for the resection of cholesterol granuloma. We describe 4 cases of cholesterol granuloma operated on via transnasal endoscopic approach. In this report, we describe radiologic and pathologic features of this lesion and explain the advantages and disadvantages of transsphenoidal endoscopic approach for these rare lesions.

  19. Huge biloma after endoscopic retrograde cholangiopancreatography and endoscopic biliary sphincterotomy

    Harith M. Alkhateeb

    2015-01-01

    Conclusions: (1 Following endoscopic retrograde cholangiopancreatography, a patient’s complaints should not be ignored. (2 A massive biloma can occur due to such procedures. (3 Conservative treatment with minimal invasive technique can prove to be effective.

  20. Deterioration of cholestasis after endoscopic retrograde cholangiography in advanced primary sclerosing cholangitis

    Beuers, U.; Spengler, U.; Sackmann, M.; Paumgartner, G.; Sauerbruch, T.

    1992-01-01

    Complications of endoscopic retrograde cholangiography specific to patients with primary sclerosing cholangitis have not yet been reported. We observed transient rises of serum bilirubin after diagnostic endoscopic retrograde cholangiography in five of 15 patients and persistent rises in three of 15

  1. Esophageal Stricture Prevention after Endoscopic Submucosal Dissection

    Deepanshu Jain

    2016-05-01

    Full Text Available Advances in diagnostic modalities and improvement in surveillance programs for Barrett esophagus has resulted in an increase in the incidence of superficial esophageal cancers (SECs. SEC, due to their limited metastatic potential, are amenable to non-invasive treatment modalities. Endoscopic ultrasound, endoscopic mucosal resection, and endoscopic submucosal dissection (ESD are some of the new modalities that gastroenterologists have used over the last decade to diagnose and treat SEC. However, esophageal stricture (ES is a very common complication and a major cause of morbidity post-ESD. In the past few years, there has been a tremendous effort to reduce the incidence of ES among patients undergoing ESD. Steroids have shown the most consistent results over time with minimal complications although the preferred mode of delivery is debatable, with both systemic and local therapy having pros and cons for specific subgroups of patients. Newer modalities such as esophageal stents, autologous cell sheet transplantation, polyglycolic acid, and tranilast have shown promising results but the depth of experience with these methods is still limited. We have summarized case reports, prospective single center studies, and randomized controlled trials describing the various methods intended to reduce the incidence of ES after ESD. Indications, techniques, outcomes, limitations, and reported complications are discussed.

  2. Endoscopic retrograde cholanglopancreatography

    Horii, S.C.; Garra, B.S.; Zeman, R.K.; Krasner, B.H.; Lo, S.C.B.; Davros, W.J.; Silverman, P.M.; Cattau, E.L.; Fleischer, D.E.; Benjamin, S.B.S.B.

    1989-01-01

    As part of the clinical evaluation of image management and communications system (IMACS), the authors undertook a prospective study to compare conventional film versus digitized film viewed on a workstation. Twenty-five each of normal and abnormal endoscopic retrograde cholangiopancreatographic (ERCP) studies were digitized with a 1,684 x 2,048-pixel matrix and evaluated in a single-blind fashion on the workstation. The resulting interpretations were then compared with those resulting from interpretation of film (spot film and 100-mm photospot) images. They report that no significant differences were found in ability to see anatomic detail or pathology. A second study involved performing 10 ERCP studies in a lithotripsy suite equipped with biplane digital fluoroscopy. The digital video displays were comparable in quality to that of film. Progress is being made in using the IMACS for archiving and retrieval of all current ERCP images

  3. Percutaneous endoscopic gastrostomy.

    Gay, F; el Nawar, A; Van Gossum, A

    1992-01-01

    From March 87 to March 92, fifty eight patients were referred to our department for percutaneous endoscopic gastrostomy (PEG). The modality of the feeding tube insertion is described. The most common indications for placement were neurologic disorders in 62% of the cases (n = 36) and malignant diseases in 32% (n = 19). The success rate of the technique was 98.3% (n = 57). No procedure-related mortality was observed. A low rate of major complication (1.7%) and minor complication (10.5%) was noted. Feeding tubes were removed in 21% of patients (n = 12); none of them with malignant disease. Survival curve analysis demonstrated that 50% of patients died within 3 months of PEG placement. Such results raise questions about the selection of patients undergoing PEG. Our experience of patients undergoing PEG. Our experience suggests that PEG is easy and safe, even in debilitated patients, having an acceptable life expectancy.

  4. Endoscopic third ventriculostomy

    Yad Ram Yadav

    2012-01-01

    Full Text Available Endoscopic third ventriculostomy (ETV is considered as a treatment of choice for obstructive hydrocephalus. It is indicated in hydrocephalus secondary to congenital aqueductal stenosis, posterior third ventricle tumor, cerebellar infarct, Dandy-Walker malformation, vein of Galen aneurism, syringomyelia with or without Chiari malformation type I, intraventricular hematoma, post infective, normal pressure hydrocephalus, myelomeningocele, multiloculated hydrocephalus, encephalocele, posterior fossa tumor and craniosynostosis. It is also indicated in block shunt or slit ventricle syndrome. Proper Pre-operative imaging for detailed assessment of the posterior communicating arteries distance from mid line, presence or absence of Liliequist membrane or other membranes, located in the prepontine cistern is useful. Measurement of lumbar elastance and resistance can predict patency of cranial subarachnoid space and complex hydrocephalus, which decides an ultimate outcome. Water jet dissection is an effective technique of ETV in thick floor. Ultrasonic contact probe can be useful in selected patients. Intra-operative ventriculo-stomography could help in confirming the adequacy of endoscopic procedure, thereby facilitating the need for shunt. Intraoperative observations of the patent aqueduct and prepontine cistern scarring are predictors of the risk of ETV failure. Such patients may be considered for shunt surgery. Magnetic resonance ventriculography and cine phase contrast magnetic resonance imaging are effective in assessing subarachnoid space and stoma patency after ETV. Proper case selection, post-operative care including monitoring of ICP and need for external ventricular drain, repeated lumbar puncture and CSF drainage, Ommaya reservoir in selected patients could help to increase success rate and reduce complications. Most of the complications develop in an early post-operative, but fatal complications can develop late which indicate an importance of

  5. [Transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess].

    Yu, Huanxin; Liu, Gang

    2014-01-01

    To evaluate the effectiveness of transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess. Eighteen pathologically diagnosed pituitary abscess were resected through transsphenoidal endoscopic endonasal approach at Tianjing Huanhu hospital between January 2000 and December 2011.Retrospective analysis was done upon clinical presentations and imaging features. There were 6 males and 12 females. The average age was 48.5 years old and the average disease course was 5.8 years. The typical clinical manifestations included headache (13 cases), pituitary dysfunction (10 cases), Diabetes Insipidus (4 cases) visual interference (8 cases) and fever (4 cases). All cases were resected by transsphenoidal endoscopic endonasal approach with general anesthesia. The postoperative symptoms and follow-up results were recorded. All patients were followed up from 6 months to 6 years. Postoperatively, headache was recovered in 13 cases, visual was improved in 6 cases, hypopituitarism was relieved in 8 cases and polyuria was disappeared in 3 cases. One case was recurrent and cured by transsphenoidal endoscopic endonasal approach. Transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess is effective.

  6. Tension pneumothorax during peroral endoscopic myotomy for treatment of esophageal achalasia under general anesthesia

    Tsung-Shih Li

    Full Text Available Abstract More and more endoscopically gastrointestinal procedures require anesthesiologists to perform general anesthesia, such as "peroral endoscopic myotomy". Peroral endoscopic myotomy is a novel invasive treatment for the primary motility disorder of esophagus, called esophageal achalasia. Despite of its minimally invasive feature, there are still complications during the procedure which develop to critical conditions and threat patients’ lives. Herein we describe a case about tension pneumothorax subsequent to esophageal rupture during peroral endoscopic myotomy. The emergent management of the complication is stated in detail. The pivotal points of general anesthesia for patients undergoing peroral endoscopic myotomy are emphasized and discussed. Also, intraoperative and post-operative complications mentioned by literature are integrated.

  7. Endosonographic Features of Histologically Proven Gastric Ectopic Pancreas

    Jen-Wei Chou

    2014-01-01

    Full Text Available Gastric ectopic pancreas is an uncommon developmental anomaly and its histological diagnosis is usually difficult by using a conventional biopsy forceps. In the literature, most cases of gastric ectopic pancreas were usually diagnosed by gross pattern during endoscopic examination or features of endoscopic ultrasound. In contrast, this disease was seldom diagnosed by histology in clinical practice. Although the typical endoscopic ultrasonographic features of ectopic pancreas include heterogeneous echogenicity, indistinct borders, and a location within 2 or more layers, it can also exhibit hypoechoic homogeneous echogenicity and a distinct border within the fourth sonographic layer (muscularis propria similar to the endoscopic ultrasonographic features of gastrointestinal stromal tumors. In our study, we found that 53% of gastric ectopic pancreas originated within the fourth sonographic layer, demonstrating hypoechoic, homogeneous echogenicity, and distinct borders. Therefore, recognizing endoscopic ultrasonographic features, combining with deep biopsy, endoscopic ultrasound-guided fine needle aspiration/core needle biopsy can prevent conducting unnecessary resection. Surgical resection is the mainstay treatment for symptomatic gastric ectopic pancreas, but endoscopic resection using endoscopic mucosal resection or endoscopic submucosal dissection technique provides an alternative method of removing superficial-type and deep-type gastric ectopic pancreas.

  8. Solitary rectal ulcer syndrome: demographic, clinical, endoscopic and histological panorama

    Abbasi, A.; Bhutto, K. A.R.; Baloch, A.

    2015-01-01

    To assess the demographic, clinical, endoscopic and histological spectrum of Solitary Rectal Ulcer Syndrome (SRUS). Study Design: Cross-sectional observational study. Place and Duration of Study: Medical Unit-III, Civil Hospital Karachi (CHK) and Ward 7, Jinnah Postgraduate Medical Centre (JPMC), Karachi, from January 2009 to June 2012. Methodology: Patients with SRUS, based on characteristic endoscopic and histological findings, were enrolled. Patients were excluded if they had other causes of the rectal lesions (neoplasm, infection, inflammatory bowel disease, and trauma). Endoscopically, lesions were divided on the basis of number (solitary or multiple) and appearance (ulcerative, polypoidal/nodular or erythematous mucosa). Demographic, clinical and endoscopic characteristics of subjects were evaluated. Results: Forty-four patients met the inclusion criteria; 21 (47.7%) were females and 23 (52.3%) were males with overall mean age of 33.73 ±13.28 years. Symptom-wise 41 (93.2%) had bleeding per rectum, 39 (88.6%) had mucous discharge, 34 (77.3%) had straining, 34 (77.3%) had constipation, 32 (72.7%) had tenesmus, 5 (11.4%) had rectal prolapse and 2 (4.5%) had fecal incontinence. Twelve (27.27%) patients presented with hemoglobin less 10 gm/dl, 27 (61.36%) with 10 - 12 gm/dl and 05 (11.36%) subjects had hemoglobin more than 12 gm/dl. Endoscopically, 26 (59.1%) patients had mucosal ulceration, 11 (25.0%) had mucosal ulceration with polypoid characteristics; while only polypoid features were found in 7 (15.9%) subjects. Conclusion: Solitary rectal ulcer syndrome affects adults of both genders with diverse clinical presentation and nonspecific endoscopic features. (author)

  9. Contrast-enhanced endoscopic ultrasonography

    Reddy, Nischita K; Ioncica, Ana Maria; Saftoiu, Adrian

    2011-01-01

    Contrast agents are increasingly being used to characterize the vasculature in an organ of interest, to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures. We review the mechanisms of action of first, second and third generation contrast...... agents and their use in various endoscopic procedures in the gastrointestinal tract. Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy, assessment of depth of invasion of esophageal, gastric and gall bladder...

  10. Duodenal endoscopic findings and histopathologic confirmation of intestinal lymphangiectasia in dogs.

    Larson, R N; Ginn, J A; Bell, C M; Davis, M J; Foy, D S

    2012-01-01

    The diagnosis of intestinal lymphangiectasia (IL) has been associated with characteristic duodenal mucosal changes. However, the sensitivity and specificity of the endoscopic duodenal mucosal appearance for the diagnosis of IL are not reported. To evaluate the utility of endoscopic images of the duodenum for diagnosis of IL. Endoscopic appearance of the duodenal mucosal might predict histopathologic diagnosis of IL with a high degree of sensitivity and specificity. 51 dogs that underwent upper gastrointestinal (GI) endoscopy and endoscopic biopsies. Retrospective review of images acquired during endoscopy. Dogs were included if adequate biopsies were obtained during upper GI endoscopy and digital images were saved during the procedure. Images were assessed for the presence and severity of IL. Using histopathology as the gold standard, the sensitivity and specificity of endoscopy for diagnosing IL were calculated. Intestinal lymphangiectasia (IL) was diagnosed in 25/51 dogs. Gross endoscopic appearance of the duodenal mucosa had a sensitivity and specificity (95% confidence interval) of 68% (46%, 84%) and 42% (24%, 63%), respectively for diagnosis of IL. Endoscopic images in cases with lymphopenia, hypocholesterolemia, and hypoalbuminemia had a sensitivity of 80%. Endoscopic duodenal mucosa appearance alone lacks specificity and has only a moderate sensitivity for diagnosis of IL. Evaluation of biomarkers associated with PLE improved the sensitivity; however, poor specificity for diagnosis of IL supports the need for histopathologic confirmation. Copyright © 2012 by the American College of Veterinary Internal Medicine.

  11. The Post-polyketide Synthase Steps in iso-Migrastatin Biosynthesis Featuring Tailoring Enzymes with Broad Substrate Specificity

    Ma, Ming; Kwong, Thomas; Lim, Si-Kyu; Ju, Jianhua; Lohman, Jeremy R.; Shen, Ben

    2013-01-01

    The iso-migrastatin (iso-MGS) biosynthetic gene cluster from Streptomyces platensis NRRL 18993 consists of 11 genes, featuring an acyltransferase (AT)-less type I polyketide synthase (PKS) and three tailoring enzymes MgsIJK. Systematic inactivation of mgsIJK in S. platensis enabled us to (i) identify two nascent products (10 and 13) of the iso-MGS AT-less type I PKS, establishing an unprecedented novel feature for AT-less type I PKSs, and (ii) account for the formation of all known post-PKS biosynthetic intermediates (10-17) generated by the three tailoring enzymes MgsIJK, which possessed significant substrate promiscuities. PMID:23394593

  12. The Memory Is in the Details: Relations between Memory for the Specific Features of Events and Long-Term Recall during Infancy

    Bauer, Patricia J.; Lukowski, Angela F.

    2010-01-01

    The second year of life is marked by pronounced changes in the length of time over which events are remembered. We tested whether the age-related differences are related to differences in memory for the specific features of events. In our study, 16- and 20-month-olds were tested for immediate and long-term recall of individual actions and temporal…

  13. Relating Child Care during Infancy to Externalizing and Internalizing Behaviors in Toddlerhood: How Specific Features of Child Care Quality Matter Depending on a Child's Gender and Temperament

    Lemay, Lise; Bigras, Nathalie; Bouchard, Caroline

    2014-01-01

    This study explored whether the relationships between specific features of child care quality and externalizing and internalizing behaviors in 24-month-old children are moderated by gender and temperament. Questionnaires were used to record children's gender and measure their temperament. Child care quality was observed with the "Échelles…

  14. Biliary and pancreatic stenting: Devices and insertion techniques in therapeutic endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography

    Mangiavillano, Benedetto; Pagano, Nico; Baron, Todd H; Arena, Monica; Iabichino, Giuseppe; Consolo, Pierluigi; Opocher, Enrico; Luigiano, Carmelo

    2016-01-01

    Stents are tubular devices made of plastic or metal. Endoscopic stenting is the most common treatment for obstruction of the common bile duct or of the main pancreatic duct, but also employed for the treatment of bilio-pancreatic leakages, for preventing post- endoscopic retrograde cholangiopancreatography pancreatitis and to drain the gallbladder and pancreatic fluid collections. Recent progresses in techniques of stent insertion and metal stent design are represented by new, fully-covered lumen apposing metal stents. These stents are specifically designed for transmural drainage, with a saddle-shape design and bilateral flanges, to provide lumen-to-lumen anchoring, reducing the risk of migration and leakage. This review is an update of the technique of stent insertion and metal stent deployment, of the most recent data available on stent types and characteristics and the new applications for biliopancreatic stents. PMID:26862364

  15. Flexible endoscope-assisted evacuation of chronic subdural hematomas.

    Májovský, Martin; Masopust, Václav; Netuka, David; Beneš, Vladimír

    2016-10-01

    Chronic subdural hematoma (CSDH) is a common neurosurgical condition with an increasing incidence. Standard treatment of CSDHs is surgical evacuation. The objective of this study is to present a modification of standard burr-hole hematoma evacuation using a flexible endoscope and to assess the advantages and risks. Prospectively, 34 consecutive patients diagnosed with CSDH were included in the study. Epidemiological, clinical and radiographical data were collected and reviewed. All patients underwent a burr-hole evacuation of CSDH. A flexible endoscope was inserted and subdural space inspected during surgery. The surgeon was looking specifically for the presence of septations, draining catheter position and acute bleeding. Thirty-four patients underwent 37 endoscope-assisted surgeries. Presenting symptoms were hemiparesis (79%), decreased level of consciousness (18%), gait disturbances (15%), headache (12%), aphasia (6%), cognitive disturbances (6%) and epileptic seizure (3%). Average operative time was 43 min, and the average increase in operative time due to the use of the endoscope was 6 min. Recurrence rate was 8.8%, and clinical outcome was favorable (defined as mRS ≤ 2) in 97% of the cases. To our knowledge, the present cohort of 34 patients is the largest group of patients with CSDH treated using an endoscope. This technique allows decent visualization of the hematoma cavity while retaining the advantages of a minimally invasive approach under a local anesthesia. The main advantages are correct positioning of the catheter under visual control, identification of septations and early detection of cortex or vessel injury during surgery.

  16. Advances in the endoscopic management of pancreatic collections.

    Ruiz-Clavijo, David; de la Higuera, Belen González; Vila, Juan J

    2015-04-16

    Treatment of pancreatic collections has experienced great progress in recent years with the emergence of alternative minimally invasive techniques comparing to the classic surgical treatment. Such techniques have been shown to improve outcomes of morbidity vs surgical treatment. The recent emergence of endoscopic drainage is noteworthy. The advent of endoscopic ultrasonography has been crucial for treatment of these specific lesions. They can be characterized, their relationships with neighboring structures can be evaluated and the drainage guided by this technique has been clearly improved compared with the conventional endoscopic drainage. Computed tomography is the technique of choice to characterize the recently published new classification of pancreatic collections. For this reason, the radiologist's role establishing and classifying in a rigorously manner the collections according to the new nomenclature is essential to making therapeutic decisions. Ideal scenario for comprehensive treatment of these collections would be those centers with endoscopic ultrasound and interventional radiology expertise together with hepatobiliopancreatic surgery. This review describes the different types of pancreatic collections: acute peripancreatic fluid collection, pancreatic pseudocysts, acute necrotic collection and walled-off necrosis; the indications and the contraindications for endoscopic drainage, the drainage technique and their outcomes. The integrated management of pancreatic collections according to their type and evolution time is discussed.

  17. Endoscopic Management of a Primary Duodenal Carcinoid Tumor

    Albin Abraham

    2012-03-01

    Full Text Available Carcinoids are rare, slow-growing tumors originating from a variety of different neuroendocrine cell types. They are identified histologically by their affinity for silver salts and by positive reactions to neuroendocrine markers such as neuron-specific enolase, synaptophysin and chromogranin. They can present with various clinical symptoms and are difficult to diagnose. We present the case of a 43-year-old woman who was referred for evaluation of anemia. Upper endoscopy showed a duodenal bulb mass around 1 cm in size. Histopathological and immunohistochemistry staining were consistent with the diagnosis of a carcinoid tumor. Further imaging and endoscopic studies showed no other synchronous carcinoid lesions. Endoscopic ultrasound (EUS revealed a 1 cm lesion confined to the mucosa and no local lymphadenopathy. Successful endoscopic mucosal resection of the mass was performed. Follow-up surveillance 6 months later with EUS and Octreoscan revealed no new lesions suggestive of recurrence. No consensus guidelines exist for the endoscopic management of duodenal carcinoid tumors. However, endoscopic resection is safe and preferred for tumors measuring 1 cm or less with no evidence of invasion of the muscularis layer.

  18. Is Early-onset in Major Depression a Predictor of Specific Clinical Features with More Impaired Social Function?

    Liu, Yan-Hong; Chen, Lin; Su, Yun-Ai; Fang, Yi-Ru; Srisurapanont, Manit; Hong, Jin Pyo; Hatim, Ahmad; Chua, Hong Choon; Bautista, Dianne; Si, Tian-Mei

    2015-01-01

    Background: Early-onset major depressive disorder (MDD) (EOD) is often particularly malignant due to its special clinical features, accompanying impaired social function, protracted recovery time, and frequent recurrence. This study aimed to observe the effects of age onset on clinical characteristics and social function in MDD patients in Asia. Methods: In total, 547 out-patients aged 18–65 years who were from 13 study sites in five Asian countries were included. These patients had MDD diagnose according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria. Clinical features and social function were assessed using Symptom Checklist-90-revised (SCL-90-R) and Sheehan Disability Scale (SDS). Quality of life was assessed by a 36-item Short-form Health Survey (SF-36). Analyses were performed using a continuous or dichotomous (cut-off: 30 years) age-of-onset indicator. Results: Early-onset MDD (EOD, <30 years) was associated with longer illness (P = 0.003), unmarried status (P < 0.001), higher neuroticism (P ≤ 0.002) based on the SCL-90-R, and more limited social function and mental health (P = 0.006, P = 0.007) based on the SF-36 and SDS. The impairment of social function and clinical severity were more prominent at in-patients with younger onset ages. Special clinical features and more impaired social function and quality of life were associated with EOD, as in western studies. Conclusions: EOD often follows higher levels of neuroticism. Age of onset of MDD may be a predictor of clinical features and impaired social function, allowing earlier diagnosis and treatment. PMID:25758278

  19. Is Early-onset in Major Depression a Predictor of Specific Clinical Features with More Impaired Social Function?

    Yan-Hong Liu; Lin Chen; Yun-Ai Su; Yi-Ru Fang; Manit Srisurapanont; Jin Pyo Hong; Ahmad Hatim

    2015-01-01

    Background:Early-onset major depressive disorder (MDD) (EOD) is often particularly malignant due to its special clinical features,accompanying impaired social function,protracted recovery time,and frequent recurrence.This study aimed to observe the effects of age onset on clinical characteristics and social function in MDD patients in Asia.Methods:In total,547 out-patients aged 18-65 years who were from 13 study sites in five Asian countries were included.These patients had MDD diagnose according to the Diagnostic and Statistical Manual of Mental Disorders,4th Edition criteria.Clinical features and social function were assessed using Symptom Checklist-90-revised (SCL-90-R) and Sheehan Disability Scale (SDS).Quality of life was assessed by a 36-item Short-form Health Survey (SF-36).Analyses were performed using a continuous or dichotomous (cut-off:30 years)age-of-onset indicator.Results:Early-onset MDD (EOD,<30 years) was associated with longer illness (P =0.003),unmarried status (P < 0.001),higher neuroticism (P ≤ 0.002) based on the SCL-90-R,and more limited social function and mental health (P =0.006,P =0.007) based on the SF-36 and SDS.The impairment of social function and clinical severity were more prominent at in-patients with younger onset ages.Special clinical features and more impaired social function and quality of life were associated with EOD,as in western studies.Conclusions:EOD often follows higher levels of neuroticism.Age of onset of MDD may be a predictor of clinical features and impaired social function,allowing earlier diagnosis and treatment.

  20. SU-D-204-01: A Methodology Based On Machine Learning and Quantum Clustering to Predict Lung SBRT Dosimetric Endpoints From Patient Specific Anatomic Features

    Lafata, K; Ren, L; Wu, Q; Kelsey, C; Hong, J; Cai, J; Yin, F [Duke University Medical Center, Durham, NC (United States)

    2016-06-15

    Purpose: To develop a data-mining methodology based on quantum clustering and machine learning to predict expected dosimetric endpoints for lung SBRT applications based on patient-specific anatomic features. Methods: Ninety-three patients who received lung SBRT at our clinic from 2011–2013 were retrospectively identified. Planning information was acquired for each patient, from which various features were extracted using in-house semi-automatic software. Anatomic features included tumor-to-OAR distances, tumor location, total-lung-volume, GTV and ITV. Dosimetric endpoints were adopted from RTOG-0195 recommendations, and consisted of various OAR-specific partial-volume doses and maximum point-doses. First, PCA analysis and unsupervised quantum-clustering was used to explore the feature-space to identify potentially strong classifiers. Secondly, a multi-class logistic regression algorithm was developed and trained to predict dose-volume endpoints based on patient-specific anatomic features. Classes were defined by discretizing the dose-volume data, and the feature-space was zero-mean normalized. Fitting parameters were determined by minimizing a regularized cost function, and optimization was performed via gradient descent. As a pilot study, the model was tested on two esophageal dosimetric planning endpoints (maximum point-dose, dose-to-5cc), and its generalizability was evaluated with leave-one-out cross-validation. Results: Quantum-Clustering demonstrated a strong separation of feature-space at 15Gy across the first-and-second Principle Components of the data when the dosimetric endpoints were retrospectively identified. Maximum point dose prediction to the esophagus demonstrated a cross-validation accuracy of 87%, and the maximum dose to 5cc demonstrated a respective value of 79%. The largest optimized weighting factor was placed on GTV-to-esophagus distance (a factor of 10 greater than the second largest weighting factor), indicating an intuitively strong

  1. Diagnostic specificity of poor premorbid adjustment: comparison of schizophrenia, schizoaffective disorder, and mood disorder with psychotic features.

    Tarbox, Sarah I; Brown, Leslie H; Haas, Gretchen L

    2012-10-01

    Individuals with schizophrenia have significant deficits in premorbid social and academic adjustment compared to individuals with non-psychotic diagnoses. However, it is unclear how severity and developmental trajectory of premorbid maladjustment compare across psychotic disorders. This study examined the association between premorbid functioning (in childhood, early adolescence, and late adolescence) and psychotic disorder diagnosis in a first-episode sample of 105 individuals: schizophrenia (n=68), schizoaffective disorder (n=22), and mood disorder with psychotic features (n=15). Social and academic maladjustment was assessed using the Cannon-Spoor Premorbid Adjustment Scale. Worse social functioning in late adolescence was associated with higher odds of schizophrenia compared to odds of either schizoaffective disorder or mood disorder with psychotic features, independently of child and early adolescent maladjustment. Greater social dysfunction in childhood was associated with higher odds of schizoaffective disorder compared to odds of schizophrenia. Premorbid decline in academic adjustment was observed for all groups, but did not predict diagnosis at any stage of development. Results suggest that social functioning is disrupted in the premorbid phase of both schizophrenia and schizoaffective disorder, but remains fairly stable in mood disorders with psychotic features. Disparities in the onset and time course of social dysfunction suggest important developmental differences between schizophrenia and schizoaffective disorder. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Cascade detection for the extraction of localized sequence features; specificity results for HIV-1 protease and structure-function results for the Schellman loop.

    Newell, Nicholas E

    2011-12-15

    The extraction of the set of features most relevant to function from classified biological sequence sets is still a challenging problem. A central issue is the determination of expected counts for higher order features so that artifact features may be screened. Cascade detection (CD), a new algorithm for the extraction of localized features from sequence sets, is introduced. CD is a natural extension of the proportional modeling techniques used in contingency table analysis into the domain of feature detection. The algorithm is successfully tested on synthetic data and then applied to feature detection problems from two different domains to demonstrate its broad utility. An analysis of HIV-1 protease specificity reveals patterns of strong first-order features that group hydrophobic residues by side chain geometry and exhibit substantial symmetry about the cleavage site. Higher order results suggest that favorable cooperativity is weak by comparison and broadly distributed, but indicate possible synergies between negative charge and hydrophobicity in the substrate. Structure-function results for the Schellman loop, a helix-capping motif in proteins, contain strong first-order features and also show statistically significant cooperativities that provide new insights into the design of the motif. These include a new 'hydrophobic staple' and multiple amphipathic and electrostatic pair features. CD should prove useful not only for sequence analysis, but also for the detection of multifactor synergies in cross-classified data from clinical studies or other sources. Windows XP/7 application and data files available at: https://sites.google.com/site/cascadedetect/home. nacnewell@comcast.net Supplementary information is available at Bioinformatics online.

  3. SPECIFIC FEATURES OF DEFORMATION OF THE CONTINENTAL AND OCEANIC LITHOSPHERE AS A RESULT OF THE EARTH CORE NORTHERN DRIFT

    Mikhail A. Goncharov

    2012-01-01

    drifting (Figures 26, and 27.By comparing the equations that describe the model of the northern drift of the lithosphere and the model of the core drift towards the North Pole, it is possible to establish a quantitative ‘bridge’ between the structures of meridional compression of the lithosphere and the core drifting structures.Conclusions based on the model of the northern drift of the lithosphere conform to many independent data and concepts, such as disturbance of the isostatic equilibrium of the Antarctica lithosphere and its high standing; the anomalously wide shelf of the Arctic ocean (Figure 28а and the increased thickness of the sediment cover, that is rich in hydrocarbons, in combination with the ultralow velocity of spreading in Gakkel Ridge; the approximately equal areas of Antarctica and the Arctic ocean as antipodes (Figure 28б; elongation (according to GPS data of the parallels in the Southern hemisphere, and their shortening in the Northern hemisphere (Figure 26; radial (relative to the South Pole rifts and other lineaments in Antarctica (Figures 29, and 30; the sub-concentric (relative to the same pole system of spreading around Antarctica, which develops northward into the submeridional system including three ‘trunks’ at a distance of about 90° (Figure 31.Due to the higher velocity of the northern drift of the lithosphere within the band with the middle meridian 100° E – 80° W, wherein the main mass of the continental lithosphere is concentrated and whose two ‘poles’ are marked by the axes of the African and Pacific superplumes (Figures 3, 4, 5, and 32, the following specific features have developed: maximum elongation of the Antarctic continent in the Southern (‘stretched’ hemisphere (Figure 28 б; maximum shortening of the Arctic ocean in the Northern (‘compressed’ hemisphere (Figure 28а; maximum spreading velocity in the SouthEastern Indian Ridge (Figure 33; maximum northern component of the horizontal displacements velocity

  4. [Endoscopic full-thickness resection].

    Meier, B; Schmidt, A; Caca, K

    2016-08-01

    Conventional endoscopic resection techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) are powerful tools for the treatment of gastrointestinal (GI) neoplasms. However, those techniques are limited to the superficial layers of the GI wall (mucosa and submucosa). Lesions without lifting sign (usually arising from deeper layers) or lesions in difficult anatomic positions (appendix, diverticulum) are difficult - if not impossible - to resect using conventional techniques, due to the increased risk of complications. For larger lesions (>2 cm), ESD appears to be superior to the conventional techniques because of the en bloc resection, but the procedure is technically challenging, time consuming, and associated with complications even in experienced hands. Since the development of the over-the-scope clips (OTSC), complications like bleeding or perforation can be endoscopically better managed. In recent years, different endoscopic full-thickness resection techniques came to the focus of interventional endoscopy. Since September 2014, the full-thickness resection device (FTRD) has the CE marking in Europe for full-thickness resection in the lower GI tract. Technically the device is based on the OTSC system and combines OTSC application and snare polypectomy in one step. This study shows all full-thickness resection techniques currently available, but clearly focuses on the experience with the FTRD in the lower GI tract.

  5. Antibiotic prophylaxis for patients undergoing elective endoscopic ...

    Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography. M Brand, D Bisoz. Abstract. Background. Antibiotic prophylaxis for endoscopic retrograde cholangiopancreatography (ERCP) is controversial. We set out to assess the current antibiotic prescribing practice among ...

  6. Evaluation of robotically controlled advanced endoscopic instruments

    Reilink, Rob; Kappers, Astrid M.L.; Stramigioli, Stefano; Misra, Sarthak

    Background Advanced flexible endoscopes and instruments with multiple degrees of freedom enable physicians to perform challenging procedures such as the removal of large sections of mucosal tissue. However, these advanced endoscopes are difficult to control and require several physicians to

  7. Sonographic and Endoscopic Findings in Cocaine-Induced Ischemic Colitis

    Leth, Thomas; Wilkens, Rune; Bonderup, Ole Kristian

    2015-01-01

    Cocaine-induced ischemic colitis is a recognized entity. The diagnosis is based on clinical and endoscopic findings. However, diagnostic imaging is helpful in the evaluation of abdominal symptoms and prior studies have suggested specific sonographic findings in ischemic colitis. We report...

  8. Lymphocytic gastritis: a newly described entity: a retrospective endoscopic and histological study.

    Haot, J; Hamichi, L; Wallez, L; Mainguet, P

    1988-01-01

    Lymphocytic gastritis is a histopathological entity characterised by the accumulation of small lymphocytes in the surface and foveolar epithelium. In order to investigate the correlation between endoscopy and histology in this condition, 192 observations selected on the basis of a presumed diagnosis of erosive or varioliform gastritis were reviewed. Ninety two instances corresponded to lymphocytic gastritis, while 100 did not show any particular microscopic feature and were labelled non-specific gastritis. There was a good correlation (48 of 58) between the diagnosis of the so-called varioliform gastritis and the histological evidence of lymphocytic gastritis. The correlation was even better when nodules, erosions, and enlarged folds were considered. Lymphocytic gastritis has a typical endoscopical appearance consisting of nodules, erosions, and large folds predominating in the gastric body. This contrasts with non-specific gastritis, which affects the antrum and produces erosions on a flat mucosa. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 PMID:3198002

  9. Amplification of 9q34 in childhood adrenocortical tumors: a specific feature unrelated to ethnic origin or living conditions

    Figueiredo B.C.

    2000-01-01

    Full Text Available Adrenocortical tumors (ACT in children under 15 years of age exhibit some clinical and biological features distinct from ACT in adults. Cell proliferation, hypertrophy and cell death in adrenal cortex during the last months of gestation and the immediate postnatal period seem to be critical for the origin of ACT in children. Studies with large numbers of patients with childhood ACT have indicated a median age at diagnosis of about 4 years. In our institution, the median age was 3 years and 5 months, while the median age for first signs and symptoms was 2 years and 5 months (N = 72. Using the comparative genomic hybridization technique, we have reported a high frequency of 9q34 amplification in adenomas and carcinomas. This finding has been confirmed more recently by investigators in England. The lower socioeconomic status, the distinctive ethnic groups and all the regional differences in Southern Brazil in relation to patients in England indicate that these differences are not important to determine 9q34 amplification. Candidate amplified genes mapped to this locus are currently being investigated and Southern blot results obtained so far have discarded amplification of the abl oncogene. Amplification of 9q34 has not been found to be related to tumor size, staging, or malignant histopathological features, nor does it seem to be responsible for the higher incidence of ACT observed in Southern Brazil, but could be related to an ACT from embryonic origin.

  10. Endoscopic Palliation for Pancreatic Cancer

    Mihir Bakhru

    2011-04-01

    Full Text Available Pancreatic cancer is devastating due to its poor prognosis. Patients require a multidisciplinary approach to guide available options, mostly palliative because of advanced disease at presentation. Palliation including relief of biliary obstruction, gastric outlet obstruction, and cancer-related pain has become the focus in patients whose cancer is determined to be unresectable. Endoscopic stenting for biliary obstruction is an option for drainage to avoid the complications including jaundice, pruritus, infection, liver dysfunction and eventually failure. Enteral stents can relieve gastric obstruction and allow patients to resume oral intake. Pain is difficult to treat in cancer patients and endoscopic procedures such as pancreatic stenting and celiac plexus neurolysis can provide relief. The objective of endoscopic palliation is to primarily address symptoms as well improve quality of life.

  11. Endoscopic inspection of steam turbines

    Maliniemi, H.; Muukka, E.

    1990-01-01

    For over ten years, Imatran Voima Oy (IVO) has developed, complementary inspection methods for steam turbine condition monitoring, which can be applied both during operation and shutdown. One important method used periodically during outages is endoscopic inspection. The inspection is based on the method where the internal parts of the turbine is inspected through access borings with endoscope and where the magnified figures of the internal parts is seen on video screen. To improve inspection assurance, an image-processing based pattern recognition method for cracks has been developed for the endoscopic inspection of turbine blades. It is based on the deduction conditions derived from the crack shape. The computer gives an alarm of a crack detection and prints a simulated image of the crack, which is then checked manually

  12. Early Use of Magnetic Endoscopic Imaging by Novice Colonoscopists: Improved Performance without Increase in Workload

    Sylvain Coderre

    2010-01-01

    Full Text Available BACKGROUND: Magnetic endoscopic imaging represents a recent advance in colonoscopy training. This technique provides adjunct information to the endoscopist, specifically with regard to colonoscope loop formation.

  13. Endoscopic brow lifts uber alles.

    Patel, Bhupendra C K

    2006-12-01

    Innumerable approaches to the ptotic brow and forehead have been described in the past. Over the last twenty-five years, we have used all these techniques in cosmetic and reconstructive patients. We have used the endoscopic brow lift technique since 1995. While no one technique is applicable to all patients, the endoscopic brow lift, with appropriate modifications for individual patients, can be used effectively for most patients with brow ptosis. We present the nuances of this technique and show several different fixation methods we have found useful.

  14. SPECIFIC FEATURES OF TECHNOLOGY OF MANUFACTURING A ZINC-COATED TUB WIRE FOR MUZZLE (BOTTLE’ HOOD WIRE

    D. B. Zuev

    2016-01-01

    Full Text Available The paper presents the main technical specifications of galvanized low carbon wire for muzzles (bottle’hood wire, consistent with the exploitation requirements to the wire in the manufacture and use of muzzles. The main criteria when selecting the steel grade and upon selection of the technological processes are given. 

  15. «Do not change yourself, Great Russia!..»: specific features of the T. Tutchef's social political conservatism

    Елена Валентиновна Линькова

    2010-09-01

    Full Text Available The article is dedicated to the analysis of T. Tutchef's conservative doctrine, of his attitudes about the nature of statehood of Russia, the role of orthodoxy, the specificity of social development. The author analyzes Tutchef's political views and the factors that determined them.

  16. [Analysis of clinical features and allergic status of asthmatic patients with positive serum mycosis-specific IgE].

    Mou, Yan; Ye, Ling; Gong, Ying; Zhang, Zhi-feng; Jin, Mei-ling

    2013-08-01

    To improve understanding of the clinical characteristics and diagnosis of allergic bronchopulmonary mycosis (ABPM). We retrospectively analyzed the clinical data, including clinical symptoms, laboratory tests, pulmonary function tests and chest CT imaging of 95 asthmatic patients with positive serum mycosis-specific IgE from January 2010 to September 2012 in Zhongshan Hospital Affiliated to Fudan University. Of the 95 patients, 59 cases met the diagnostic criteria of ABPM. There were 34 males and 25 females, with a mean age of (53 ± 4) years and a duration of asthma for (21 ± 4) years. Thirty-six cases showed mycosis hypersensitivity (MH). There were 10 males and 26 females, with a mean age of (46 ± 6) years and a duration of asthma for (16 ± 5) years. Clinical symptoms such as wheeze (52 vs 21, χ(2) = 11.159, P = 0.001), cough (54 vs 27, χ(2) = 4.859, P = 0.030) and expectoration (43 vs 9, χ(2) = 25.731, P = 0.000) were more common in the ABPM group compared to the MH group.In the ABPM group, 58 were A. fumigatus-specific IgE antibody positive, 34 Penicillium-specific IgE antibody positive and 1 only Penicillium-specific IgE antibody positive.While in the MH group, 15 were A.fumigatus-specific IgE antibody positive, 24 Penicillium-specific IgE antibody positive and 17 only Penicillium-specific IgE antibody positive.In the ABPM group, the percentage of positive fumigatus-specific IgE antibody was higher (58 vs 15, χ(2) = 24.500, P = 0.000), while the percentages of dermatophagoides pteronyssinus(21 vs 20, χ(2) = 3.632, P = 0.045) and Dermatophagoides farinae(17 vs 21, χ(2) = 8.118, P = 0.004) were lower. Total serum IgE [(4395 ± 1437) IU/ml vs (276 ± 133) IU/ml, T = 4.384, P = 0.000], peripheral eosinophil percentage[(12.56 ± 1.20)% vs (1.30 ± 0.15)%, t = 8.175, P = 0.000] and count [(2.09 ± 0.43)×10(9)/L vs (0.19 ± 0.04)×10(9)/L, t = 7.032, P = 0.000] were higher in the ABPM group as compared to the MH group.FEV1% slightly declined in the ABPM

  17. [Specific features of nesting bird populations in forest-meadow-field landscapes of Meshchovsk Opolye reflect the diversity of their biotope connections].

    Kut'in, S D; Konstantinov, V M

    2008-01-01

    Studies on specific features of nesting bird populations in patchy landscapes were performed in Meshchovsk Opolye, Kaluga Region, from 1981 to 1990. Indices of similarity between the avifaunas of agricultural fields, lowland bogs, and small-leaved forests markedly differed from parameters of their population density in rank and value. In the series of biotopes differing in the relative amount of woodland, from central areas of small-leaved forests to forest margins and then to forest islands gradually decreasing in size, the birds segregated into two distinct groups, one characteristic of forest margins and large forest islands and the other characteristic of small and very small forest islands. Specific features of bird density distribution in forest-meadow-field landscapes of Meshchovsk Opolye reflected heterogeneity of their populations manifested in diverse connections with nesting biotopes.

  18. Language, gender, and sexual orientation: Gender-specific features of discursive styles of homosexual users of an internet forum

    Stanković Biljana

    2013-01-01

    This study seeks to determine whether and in which way homosexual people rely on gender-specific style characteristics when communicating in the internet environment. It is assumed that the basis of differences in language practices is not some identity category (either gender or sexual), that uses these practices only as a means of expression. Instead, language is seen as a resource that allows us to respond to a variety of communication situations. The methodological framework for col...

  19. SPECIFIC FEATURES OF THE MUSICAL LANGUAGE AND TEXTURE IN THE CONCERT WALTZ FOR TWO PIANOS BY OLEG NEGRUTA

    MAMALÂGA MARINA

    2017-06-01

    Full Text Available The article analyzes the Concert Waltz by Oleg Negruta written for piano duet. This work is considered in terms of form and content. Special attention is given to identifying the specificity of the musical language and texture. As a result, the conclusion is that the originality of the composer’s style is manifested in bright melody, relying on the classic-romantic harmony, enriched by jazz elements.

  20. Contribution of flow cytometry to the diagnosis of gastric lymphomas in endoscopic biopsy specimens.

    Almasri, N M; Zaer, F S; Iturraspe, J A; Braylan, R C

    1997-07-01

    Gastric lymphomas seem to have unique clinical, pathologic, and immunophenotypic features that set them apart from nodal lymphomas. Microscopic examination of endoscopic biopsy specimens is the most frequent procedure used to diagnose gastric tumors, but it is very difficult, and sometimes impossible, to recognize lymphomas in endoscopic samples by histologic or even immunohistologic methods. Because most gastric lymphomas are of B-cell origin, we used flow cytometry to assess B-cell clonality in gastric biopsy specimens containing dense lymphocytic infiltrates thought to represent lymphoma. We prepared viable cell suspensions from unfixed specimens obtained from 29 consecutive patients who had a previous microscopic diagnosis of suspicious gastric lymphoid infiltrates. We performed immunophenotypic studies with multicolor flow cytometry, and we assessed clonality by examination of immunoglobulin (Ig) light-chain expression analyzed exclusively on B cells identified by anti-CD20 or CD19 antibodies. The mean number of cells recovered was 1.04 x 10(6), from an average of 5.5 gastric biopsy fragments per patient. In 26 of the 29 patients, the number of cells was adequate for analysis. We detected B-cell monoclonality in 16 cases, including 5 in which the percentage of clonal B cells was less than 5%. Of the 16 cases, only 8 could be diagnosed as lymphomas on morphologic grounds alone; the remaining 8 patients had either suspicious lymphoid infiltrates or chronic gastritis. The three cases with an insufficient number of cells were considered non-neoplastic either on histologic grounds alone or in conjunction with Southern analysis of Ig genes. We conclude that flow cytometric immunophenotypic analysis of freshly prepared cell suspensions obtained from endoscopic biopsy specimens can be used to evaluate gastric lymphocytic infiltrates. Specifically, the analysis of surface Ig light-chain expression on B cells distinguishes between monoclonal (lymphoma) and polyclonal

  1. New Endoscopic Indicator of Esophageal Achalasia: “Pinstripe Pattern”

    Minami, Hitomi; Isomoto, Hajime; Miuma, Satoshi; Kobayashi, Yasutoshi; Yamaguchi, Naoyuki; Urabe, Shigetoshi; Matsushima, Kayoko; Akazawa, Yuko; Ohnita, Ken; Takeshima, Fuminao; Inoue, Haruhiro; Nakao, Kazuhiko

    2015-01-01

    Background and Study Aims Endoscopic diagnosis of esophageal achalasia lacking typical endoscopic features can be extremely difficult. The aim of this study was to identify simple and reliable early indicator of esophageal achalasia. Patients and Methods This single-center retrospective study included 56 cases of esophageal achalasia without previous treatment. As a control, 60 non-achalasia subjects including reflux esophagitis and superficial esophageal cancer were also included in this study. Endoscopic findings were evaluated according to Descriptive Rules for Achalasia of the Esophagus as follows: (1) esophageal dilatation, (2) abnormal retention of liquid and/or food, (3) whitish change of the mucosal surface, (4) functional stenosis of the esophago-gastric junction, and (5) abnormal contraction. Additionally, the presence of the longitudinal superficial wrinkles of esophageal mucosa, “pinstripe pattern (PSP)” was evaluated endoscopically. Then, inter-observer diagnostic agreement was assessed for each finding. Results The prevalence rates of the above-mentioned findings (1–5) were 41.1%, 41.1%, 16.1%, 94.6%, and 43.9%, respectively. PSP was observed in 60.7% of achalasia, while none of the control showed positivity for PSP. PSP was observed in 26 (62.5%) of 35 cases with shorter history achalasia were 83.8%, 64.7%, and 100%, respectively. Conclusion “Pinstripe pattern” could be a reliable indicator for early discrimination of primary esophageal achalasia. PMID:25664812

  2. New endoscopic indicator of esophageal achalasia: "pinstripe pattern".

    Minami, Hitomi; Isomoto, Hajime; Miuma, Satoshi; Kobayashi, Yasutoshi; Yamaguchi, Naoyuki; Urabe, Shigetoshi; Matsushima, Kayoko; Akazawa, Yuko; Ohnita, Ken; Takeshima, Fuminao; Inoue, Haruhiro; Nakao, Kazuhiko

    2015-01-01

    Endoscopic diagnosis of esophageal achalasia lacking typical endoscopic features can be extremely difficult. The aim of this study was to identify simple and reliable early indicator of esophageal achalasia. This single-center retrospective study included 56 cases of esophageal achalasia without previous treatment. As a control, 60 non-achalasia subjects including reflux esophagitis and superficial esophageal cancer were also included in this study. Endoscopic findings were evaluated according to Descriptive Rules for Achalasia of the Esophagus as follows: (1) esophageal dilatation, (2) abnormal retention of liquid and/or food, (3) whitish change of the mucosal surface, (4) functional stenosis of the esophago-gastric junction, and (5) abnormal contraction. Additionally, the presence of the longitudinal superficial wrinkles of esophageal mucosa, "pinstripe pattern (PSP)" was evaluated endoscopically. Then, inter-observer diagnostic agreement was assessed for each finding. The prevalence rates of the above-mentioned findings (1-5) were 41.1%, 41.1%, 16.1%, 94.6%, and 43.9%, respectively. PSP was observed in 60.7% of achalasia, while none of the control showed positivity for PSP. PSP was observed in 26 (62.5%) of 35 cases with shorter history achalasia were 83.8%, 64.7%, and 100%, respectively. "Pinstripe pattern" could be a reliable indicator for early discrimination of primary esophageal achalasia.

  3. Comparing of athletic performance and biometric features of selected teenagers based on the specific talent identification pattern of Karate with elite athletes

    seyed Ehsan Naghibi; Mehrdad Anbarian; Mohammad Reza Mahmoodkhani

    2017-01-01

    Objective: The aim of this study was to comparing the athletic performance and biometric features in elite karate players teenagers with a specific talent identification pattern of  karate in a professional gyms in Iran. Methods: Subjects available for sampling were divided into two groups teenagers karate athletes elite (n=19) and members developmental center and the Club Championship (n=19) for assessing the biometric data of the sport performance tests respectively. Shapiro-Wilk te...

  4. Benchmarking spliced alignment programs including Spaln2, an extended version of Spaln that incorporates additional species-specific features.

    Iwata, Hiroaki; Gotoh, Osamu

    2012-11-01

    Spliced alignment plays a central role in the precise identification of eukaryotic gene structures. Even though many spliced alignment programs have been developed, recent rapid progress in DNA sequencing technologies demands further improvements in software tools. Benchmarking algorithms under various conditions is an indispensable task for the development of better software; however, there is a dire lack of appropriate datasets usable for benchmarking spliced alignment programs. In this study, we have constructed two types of datasets: simulated sequence datasets and actual cross-species datasets. The datasets are designed to correspond to various real situations, i.e. divergent eukaryotic species, different types of reference sequences, and the wide divergence between query and target sequences. In addition, we have developed an extended version of our program Spaln, which incorporates two additional features to the scoring scheme of the original version, and examined this extended version, Spaln2, together with the original Spaln and other representative aligners based on our benchmark datasets. Although the effects of the modifications are not individually striking, Spaln2 is consistently most accurate and reasonably fast in most practical cases, especially for plants and fungi and for increasingly divergent pairs of target and query sequences.

  5. Peroral endoscopic myotomy for achalasia

    Bredenoord, A. J.; Rösch, T.; Fockens, P.

    2014-01-01

    Treatment of achalasia is complicated by symptom recurrence and a significant risk for severe complications. Endoscopic myotomy was developed in the search for a highly efficacious treatment with lower risks. Since its introduction in 2010, several centers have adopted the technique and published

  6. Colonic perforation following endoscopic retrograde ...

    We highlight a potentially lethal complication of acute severe pancreatitis that may not be suspected in severely ill patients. A 41-year-old woman developed acute severe pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) for suspected choledocholithiasis. When her condition deteriorated ...

  7. An Energy efficient application specific integrated circuit for electrocardiogram feature detection and its potential for ambulatory cardiovascular disease detection.

    Jain, Sanjeev Kumar; Bhaumik, Basabi

    2016-03-01

    A novel algorithm based on forward search is developed for real-time electrocardiogram (ECG) signal processing and implemented in application specific integrated circuit (ASIC) for QRS complex related cardiovascular disease diagnosis. The authors have evaluated their algorithm using MIT-BIH database and achieve sensitivity of 99.86% and specificity of 99.93% for QRS complex peak detection. In this Letter, Physionet PTB diagnostic ECG database is used for QRS complex related disease detection. An ASIC for cardiovascular disease detection is fabricated using 130-nm CMOS high-speed process technology. The area of the ASIC is 0.5 mm(2). The power dissipation is 1.73 μW at the operating frequency of 1 kHz with a supply voltage of 0.6 V. The output from the ASIC is fed to their Android application that generates diagnostic report and can be sent to a cardiologist through email. Their ASIC result shows average failed detection rate of 0.16% for six leads data of 290 patients in PTB diagnostic ECG database. They also have implemented a low-leakage version of their ASIC. The ASIC dissipates only 45 pJ with a supply voltage of 0.9 V. Their proposed ASIC is most suitable for energy efficient telemetry cardiovascular disease detection system.

  8. A methodology for Level 2 PSA evaluation with consideration of specific features for Low Power Shutdown Probabilistic Safety Assessment

    Kim, Jae Gab; Seok, Ho [KEPCO-ENC, Yongin (Korea, Republic of)

    2015-05-15

    The primary objective of the Level 2 PSA during Lower Power/Shutdown (LPSD) operation is to provide insights into potential plant vulnerabilities with regard to accident progression. The shutdown risk information can be used to provide the information to develop outage risk management guidelines. The LPSD Level 2 analysis utilizes much of the at-power Level 2 analysis for bounding, conservative treatment of severe accident phenomena. But, for some portions of the analysis including Plant Operational States (POSs), LPSD-specific evaluations such as UPC related to the containment Equipment Hatch (E/H) with 4 bolts, Reactor Coolant System (RCS) Not Intact for severe accident phenomena are desired for realistic evaluation. All POSs are evaluated for their Large Release Frequency (LRF). Some POSs are evaluated conservatively utilizing the at-power models, and other POSs are evaluated in specific analysis. The overall LPSD Level 2 model is evaluated. If the containment E/H and one of the two doors on each of the personal air locks are closed as containment is operable at reduced RCS inventory operation, LRF is expected to be less than 10% of LPSD CDF.

  9. Magnetic resonance spectroscopy markers of axons and astrogliosis in relation to specific features of white matter injury in preterm infants

    Wisnowski, Jessica L.; Panigrahy, Ashok; Schmithorst, Vincent J.; Rosser, Tena; Paquette, Lisa; Nelson, Marvin D.; Haynes, Robin L.; Painter, Michael J.; Blueml, Stefan

    2014-01-01

    Punctate white matter lesions (pWMLs) and diffuse excessive high signal intensity (DEHSI) are commonly observed signal abnormalities on MRI scans of high-risk preterm infants near term-equivalent age. To establish whether these features are indicative abnormalities in axonal development or astroglia, we compared pWMLs and DEHSI to markers of axons and astrogliosis, derived from magnetic resonance spectroscopy (MRS). Data from 108 preterm infants (gestational age at birth 31.0 weeks ± 4.3; age at scan 41.2 weeks ± 6.0) who underwent MR examinations under clinical indications were included in this study. Linear regression analyses were used to test the effects of pWMLs and DEHSI on N-acetyl-aspartate (NAA) and myoinositol concentrations, respectively. Across the full sample, pWMLs were associated with a reduction in NAA whereas moderate to severe DEHSI altered the normal age-dependent changes in myoinositol such that myoinositol levels were lower at younger ages with no change during the perinatal period. Subgroup analyses indicated that the above associations were driven by the subgroup of neonates with both pWMLs and moderate to severe DEHSI. Overall, these findings suggest that pWMLs in conjunction with moderate/severe DEHSI may signify a population of infants at risk for long-term adverse neurodevelopmental outcome due to white matter injury and associated axonopathy. The loss of normal age-associated changes in myoinositol further suggests disrupted astroglial function and/or osmotic dysregulation. (orig.)

  10. Magnetic resonance spectroscopy markers of axons and astrogliosis in relation to specific features of white matter injury in preterm infants

    Wisnowski, Jessica L.; Panigrahy, Ashok [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); University of Pittsburgh, Department of Pediatric Radiology, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); Schmithorst, Vincent J. [University of Pittsburgh, Department of Pediatric Radiology, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); Rosser, Tena [Children' s Hospital Los Angeles, Department of Pediatrics, Division of Neurology, Los Angeles, CA (United States); Paquette, Lisa [Children' s Hospital Los Angeles, Department of Pediatrics, Division of Neonatology, Los Angeles, CA (United States); Nelson, Marvin D. [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Haynes, Robin L. [Boston Children' s Hospital, Department of Pathology, Boston, MA (United States); Painter, Michael J. [University of Pittsburgh, Department of Pediatrics, Division of Neurology, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); Blueml, Stefan [Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Rudi Schulte Research Institute, Santa Barbara, CA (United States)

    2014-09-15

    Punctate white matter lesions (pWMLs) and diffuse excessive high signal intensity (DEHSI) are commonly observed signal abnormalities on MRI scans of high-risk preterm infants near term-equivalent age. To establish whether these features are indicative abnormalities in axonal development or astroglia, we compared pWMLs and DEHSI to markers of axons and astrogliosis, derived from magnetic resonance spectroscopy (MRS). Data from 108 preterm infants (gestational age at birth 31.0 weeks ± 4.3; age at scan 41.2 weeks ± 6.0) who underwent MR examinations under clinical indications were included in this study. Linear regression analyses were used to test the effects of pWMLs and DEHSI on N-acetyl-aspartate (NAA) and myoinositol concentrations, respectively. Across the full sample, pWMLs were associated with a reduction in NAA whereas moderate to severe DEHSI altered the normal age-dependent changes in myoinositol such that myoinositol levels were lower at younger ages with no change during the perinatal period. Subgroup analyses indicated that the above associations were driven by the subgroup of neonates with both pWMLs and moderate to severe DEHSI. Overall, these findings suggest that pWMLs in conjunction with moderate/severe DEHSI may signify a population of infants at risk for long-term adverse neurodevelopmental outcome due to white matter injury and associated axonopathy. The loss of normal age-associated changes in myoinositol further suggests disrupted astroglial function and/or osmotic dysregulation. (orig.)

  11. THE SPECIFIC FEATURES OF THE COURSE OF PULMONARY TUBERCULOSIS AND ITS THERAPEUTIC EFFICIENCY IN A PREGNANT WOMAN

    M. V. Pavlova

    2014-01-01

    Full Text Available Therapy in pregnant women with tuberculosis always presents certain difficulties and sets regarding not only the status of the mother, but also that of her baby. Tuberculosis and pregnancy have been mostly recently considered to be incompatible. The presented clinical case provides evidence that therapy can be performed during pregnancy and can yield a good clinical result in the course of a specific process in the mother and in the adequate intrauterine development in the baby. There is a need for adequate combination therapy with regard to the susceptibility of isolated Mycobacterium tuberculosis, the status of the mother and the baby, and the constant patient monitoring by a phthisiatrician and an obstetrician/gynecologist.

  12. Complete avian malaria parasite genomes reveal features associated with lineage-specific evolution in birds and mammals

    Böhme, Ulrike; Otto, Thomas D.; Cotton, James A.; Steinbiss, Sascha; Sanders, Mandy; Oyola, Samuel O.; Nicot, Antoine; Gandon, Sylvain; Patra, Kailash P.; Herd, Colin; Bushell, Ellen; Modrzynska, Katarzyna K.; Billker, Oliver; Vinetz, Joseph M.; Rivero, Ana; Newbold, Chris I.; Berriman, Matthew

    2018-01-01

    Avian malaria parasites are prevalent around the world and infect a wide diversity of bird species. Here, we report the sequencing and analysis of high-quality draft genome sequences for two avian malaria species, Plasmodium relictum and Plasmodium gallinaceum. We identify 50 genes that are specific to avian malaria, located in an otherwise conserved core of the genome that shares gene synteny with all other sequenced malaria genomes. Phylogenetic analysis suggests that the avian malaria species form an outgroup to the mammalian Plasmodium species, and using amino acid divergence between species, we estimate the avian- and mammalian-infective lineages diverged in the order of 10 million years ago. Consistent with their phylogenetic position, we identify orthologs of genes that had previously appeared to be restricted to the clades of parasites containing Plasmodium falciparum and Plasmodium vivax, the species with the greatest impact on human health. From these orthologs, we explore differential diversifying selection across the genus and show that the avian lineage is remarkable in the extent to which invasion-related genes are evolving. The subtelomeres of the P. relictum and P. gallinaceum genomes contain several novel gene families, including an expanded surf multigene family. We also identify an expansion of reticulocyte binding protein homologs in P. relictum, and within these proteins, we detect distinct regions that are specific to nonhuman primate, humans, rodent, and avian hosts. For the first time in the Plasmodium lineage, we find evidence of transposable elements, including several hundred fragments of LTR-retrotransposons in both species and an apparently complete LTR-retrotransposon in the genome of P. gallinaceum. PMID:29500236

  13. [Conversional and endoscopic procedures following bariatric surgery].

    Zorron, R; Bothe, C; Junghans, T; Pratschke, J; Benzing, C; Krenzien, F

    2016-10-01

    The Roux-en-Y gastric bypass (RYGB) is the therapy of choice in bariatric surgery. Sleeve gastrectomy and gastric banding are showing higher rates of treatment failure, reducing obesity-associated morbidity and body weight insufficiently. Moreover, gastroesophageal reflux disease (GERD) can occur refractory to medication. Therefore, a laparoscopic conversion to RYGB can be reasonable as long as specific conditions are fulfilled.Endoscopic procedures are currently being applied to revise bariatric procedures. Therapy failure following RYGB occurs in up to 20 % of cases. Transoral outlet reduction is the minimally invasive method of choice to reduce gastrojejunal anastomosis of the alimentary limb. The diameter of a gastric sleeve can be unwantedly enlarged as well; that can be reduced by placement of a longitudinal full-thickness suture.Severe hypoglycemic episodes can be present in patients following RYGB. Hypoglycemic episodes have to be diagnosed first and can be treated conventionally. Alternatively, a laparoscopic approach according to Branco-Zorron can be used for non-responders. Hypoglycemic episodes can thus be prevented and body weight reduction can be assured.Conversional and endoscopic procedures can be used in patients with treatment failure following bariatric surgery. Note that non-invasive approaches should have been applied intensively before a revisional procedure is performed.

  14. Contrast-enhanced harmonic endoscopic ultrasound

    Săftoiu, A; Dietrich, C F; Vilmann, P

    2012-01-01

    Second-generation intravenous blood-pool ultrasound contrast agents are increasingly used in endoscopic ultrasound (EUS) for characterization of microvascularization, differential diagnosis of benign and malignant focal lesions, and improving staging and guidance of therapeutic procedures. Although...... initially used as Doppler signal enhancers, second-generation microbubble contrast agents are now used with specific contrast harmonic imaging techniques, which benefit from the highly nonlinear behavior of the microbubbles. Contrast-specific modes based on multi-pulse technology are used to perform...... contrast-enhanced harmonic EUS based on a very low mechanical index (0.08 - 0.12). Quantification techniques based on dynamic contrast-enhanced ultrasound have been recommended for perfusion imaging and monitoring of anti-angiogenic treatment, mainly based on time-intensity curve analysis. Most...

  15. Identification of Subtype-Specific Prognostic Genes for Early-Stage Lung Adenocarcinoma and Squamous Cell Carcinoma Patients Using an Embedded Feature Selection Algorithm.

    Suyan Tian

    Full Text Available The existence of fundamental differences between lung adenocarcinoma (AC and squamous cell carcinoma (SCC in their underlying mechanisms motivated us to postulate that specific genes might exist relevant to prognosis of each histology subtype. To test on this research hypothesis, we previously proposed a simple Cox-regression model based feature selection algorithm and identified successfully some subtype-specific prognostic genes when applying this method to real-world data. In this article, we continue our effort on identification of subtype-specific prognostic genes for AC and SCC, and propose a novel embedded feature selection method by extending Threshold Gradient Descent Regularization (TGDR algorithm and minimizing on a corresponding negative partial likelihood function. Using real-world datasets and simulated ones, we show these two proposed methods have comparable performance whereas the new proposal is superior in terms of model parsimony. Our analysis provides some evidence on the existence of such subtype-specific prognostic genes, more investigation is warranted.

  16. TALE-Like Effectors Are an Ancestral Feature of the Ralstonia solanacearum Species Complex and Converge in DNA Targeting Specificity.

    Schandry, Niklas; de Lange, Orlando; Prior, Philippe; Lahaye, Thomas

    2016-01-01

    Ralstonia solanacearum, a species complex of bacterial plant pathogens divided into four monophyletic phylotypes, causes plant diseases in tropical climates around the world. Some strains exhibit a broad host range on solanaceous hosts, while others are highly host-specific as for example some banana-pathogenic strains. Previous studies showed that transcription activator-like (TAL) effectors from Ralstonia, termed RipTALs, are capable of activating reporter genes in planta, if these are preceded by a matching effector binding element (EBE). RipTALs target DNA via their central repeat domain (CRD), where one repeat pairs with one DNA-base of the given EBE. The repeat variable diresidue dictates base repeat specificity in a predictable fashion, known as the TALE code. In this work, we analyze RipTALs across all phylotypes of the Ralstonia solanacearum species complex. We find that RipTALs are prevalent in phylotypes I and IV but absent from most phylotype III and II strains (10/12, 8/14, 1/24, and 1/5 strains contained a RipTAL, respectively). RipTALs originating from strains of the same phylotype show high levels of sequence similarity (>98%) in the N-terminal and C-terminal regions, while RipTALs isolated from different phylotypes show 47-91% sequence similarity in those regions, giving rise to four RipTAL classes. We show that, despite sequence divergence, the base preference for guanine, mediated by the N-terminal region, is conserved across RipTALs of all classes. Using the number and order of repeats found in the CRD, we functionally sub-classify RipTALs, introduce a new simple nomenclature, and predict matching EBEs for all seven distinct RipTALs identified. We experimentally study RipTAL EBEs and uncover that some RipTALs are able to target the EBEs of other RipTALs, referred to as cross-reactivity. In particular, RipTALs from strains with a broad host range on solanaceous hosts cross-react on each other's EBEs. Investigation of sequence divergence between

  17. The minimally invasive endoscopic management of septated chronic subdural hematomas: surgical technique.

    Berhouma, M; Jacquesson, T; Jouanneau, E

    2014-12-01

    Fibrin membranes and compartmentalization within the subdural space are a frequent cause of failure in the treatment of chronic subdural hematomas (CSH). This specific subtype of CSH classically requires craniotomy, which carries significant morbidity and mortality rates, particularly in elderly patients. In this work, we describe a minimally invasive endoscopic alternative. Under local scalp anesthesia, a rigid endoscope is inserted through a parietal burr hole in the subdural space to collapse fibrin septa and cut the internal membrane. It also allows cauterization of active bleedings and the placement of a drain under direct visualization. The endoscopic treatment of septated CSH represents a minimally invasive alternative to craniotomy especially for the internal membranectomy.

  18. The impact of different emotional states on the memory for what, where and when features of specific events.

    Zlomuzica, Armin; Preusser, Friederike; Totzeck, Christina; Dere, Ekrem; Margraf, Jürgen

    2016-02-01

    Emotions can modulate the encoding and recollection of personal events. In the present study, we investigated the effects of different emotional states (pleasant, neutral or anxious) on episodic memory formation in a virtual reality (VR) setting. Emotional states were induced by pleasant, neutral or anxiety-inducing movie clips prior to the presentation of specific events in a VR scenario. Episodic memory performance of healthy participants in whom an anxious emotional state had been induced was inferior to those of the neutral and pleasant conditions. In the anxious condition, participants were particularly impaired regarding their memory for the location of events. A correlational analysis indicated that high levels of negative arousal were associated with poor memory for the temporal and spatial context of events. In contrast, high levels of happiness were associated with better memory for the spatial context of events. Our data provide evidence that emotional arousal can modulate memory for what happened, where and when. Copyright © 2015. Published by Elsevier B.V.

  19. Specific psychological features of adolescents suffering from respiratory tuberculosis with various parameters of the disease

    A. A. Аkhtyamova

    2016-01-01

    Full Text Available The psychological features of 100 adolescents at the age of 13-17 years old suffering from respiratory tuberculosis have been compared. Personality structure of adolescents with more expressed manifestations of the disease is confidently different regarding the prevalence of main pre-morbid characteristics promoting neurotic features, intra- and inter-psychical conflicts and also various structural and functional somatic disorders. The personal specific features of the patients have been objectivated in the rates of actual psychological status. The detected personal features are considered to be potential pathogenic psychological determinants (as a part of traditional medical, biological and social risk factors of the disease development, and aims of the targeted psychological management.

  20. Identification of S-glutathionylation sites in species-specific proteins by incorporating five sequence-derived features into the general pseudo-amino acid composition.

    Zhao, Xiaowei; Ning, Qiao; Ai, Meiyue; Chai, Haiting; Yang, Guifu

    2016-06-07

    As a selective and reversible protein post-translational modification, S-glutathionylation generates mixed disulfides between glutathione (GSH) and cysteine residues, and plays an important role in regulating protein activity, stability, and redox regulation. To fully understand S-glutathionylation mechanisms, identification of substrates and specific S-Glutathionylated sites is crucial. Experimental identification of S-glutathionylated sites is labor-intensive and time consuming, so establishing an effective computational method is much desirable due to their convenient and fast speed. Therefore, in this study, a new bioinformatics tool named SSGlu (Species-Specific identification of Protein S-glutathionylation Sites) was developed to identify species-specific protein S-glutathionylated sites, utilizing support vector machines that combine multiple sequence-derived features with a two-step feature selection. By 5-fold cross validation, the performance of SSGlu was measured with an AUC of 0.8105 and 0.8041 for Homo sapiens and Mus musculus, respectively. Additionally, SSGlu was compared with the existing methods, and the higher MCC and AUC of SSGlu demonstrated that SSGlu was very promising to predict S-glutathionylated sites. Furthermore, a site-specific analysis showed that S-glutathionylation intimately correlated with the features derived from its surrounding sites. The conclusions derived from this study might help to understand more of the S-glutathionylation mechanism and guide the related experimental validation. For public access, SSGlu is freely accessible at http://59.73.198.144:8080/SSGlu/. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Specific Features of Profile Distribution and Crystallochemistry of Phyllosilicates in Soils of the Cisbaikal Forest-Steppe

    Chizhikova, N. P.; Gamzikov, G. P.; Chechetko, E. S.

    2018-01-01

    The mineralogical composition of agrogray, dark gray, and agro-dark gray soils (Luvic Greyzemic Retic Phaeozems); agro-dark gray residual-calcareous soils (Calcaric Cambic Phaeozems); clay-illuvial agrochernozems (Luvic Chernic Phaeozems); and agrochernozems with migrational-mycelial carbonates (Haplic Chernozems) developed in the forest-steppe of Central Siberia within the Irkutsk Depression has been studied. The clay (smectite, vermiculite, and chlorite; the proportions between them change within the soil profiles. The clay fraction also contains hydromicas, kaolinite, chlorite, and some admixture of the fine-dispersed quartz. Each type of the soils is characterized by its own distribution pattern of clay material with specific alternation of layers in the mixed-layer formations. Mixed-layer minerals of the chlorite-vermiculite type predominate in the upper horizons of texture-differentiated soils. Down the soil profile, the content of mixed-layer mica-smectitic minerals increases. In the clay fraction of arable dark gray-humus soils with residual carbonates, the distribution of the clay fraction and major mineral phases in the soil profile is relatively even. An increased content of well-crystallized kaolinite is typical of these soils. The parent material of agrochernozems has a layered character: the upper horizons are generally depleted of clay, and the middle-profile and lower horizons are characterized by the considerable kaolinite content. In general, the clay material of soils of the Tulun-Irkutsk forest-steppe differs considerably from the clay material of foreststeppe soils developed from loesslike and mantle loams in the European part of Russia. In particular, this difference is seen in the proportions between major mineral phases and between biotitic and muscovitic components, as well as in the degree of crystallinity and behavior of kaolinite and chlorite.

  2. Bioclim Deliverable D3: global climatic features over the next million years and recommendation for specific situations to be considered

    2001-01-01

    The BIOCLIM project aims at assessing the possible long-term impacts of climate change on the safety of waste repositories in deep formations using climate simulations of the long-term climate in various European areas. One of the objectives of the project is to develop two strategies for representing sequential climatic changes to the geosphere-biosphere system for different sites over Europe, addressing the time scale of one million years. The results of this work will be interpreted in terms of global or regional changes of climate and of vegetation. The first strategy (hierarchical strategy) will use the full hierarchy of existing climate models (a climate model is a numerical simplified representation of the climate system behaviour and evolution). Simple models (LLN 2-D NH and threshold models; see the description here after) will simulate the overall long-term evolution of the global climate. Their results will then be used as inputs to more complex models (LMD climate models possibly coupled with vegetation models, either SECHIBA or ORCHIDE) and finally climate and vegetation cover will be determined for specific sites at specific times. A second strategy (integrated strategy) will consist in building an integrated climate model, which represents most of the physical mechanisms for studying long-term climatic variations. The results will then be interpreted on a regional scale. This deliverable is the first step of the hierarchical strategy. The purpose of this deliverable is to identify and justify some specific climatic situations amongst different long-term simulations that are of interest for assessing the safety of radioactive waste repository sites and that will be further studied with GCMs (General Circulation Model). The simple threshold (or multi-state) climate model is a modified version of the model from Paillard. It describes the time evolution of the ice volume and the CO 2 concentration. It has two distinct regimes (interglacial and glacial

  3. Transforaminal Percutaneous Endoscopic Discectomy using Transforaminal Endoscopic Spine System technique: Pitfalls that a beginner should avoid.

    Kapetanakis, Stylianos; Gkasdaris, Grigorios; Angoules, Antonios G; Givissis, Panagiotis

    2017-12-18

    Transforaminal Percutaneous Endoscopic Discectomy (TPED) is a minimally invasive technique mainly used for the treatment of lumbar disc herniation from a lateral approach. Performed under local anesthesia, TPED has been proven to be a safe and effective technique which has been also associated with shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. However, the procedure should be performed by a spine surgeon experienced in the specific technique and capable of recognizing or avoiding various challenging conditions. In this review, pitfalls that a novice surgeon has to be mindful of, are reported and analyzed.

  4. Combining eastern and western practices for safe and effective endoscopic resection of large complex colorectal lesions.

    Emmanuel, Andrew; Gulati, Shraddha; Burt, Margaret; Hayee, Bu'Hussain; Haji, Amyn

    2018-05-01

    Endoscopic resection of large colorectal polyps is well established. However, significant differences in technique exist between eastern and western interventional endoscopists. We report the results of endoscopic resection of large complex colorectal lesions from a specialist unit that combines eastern and western techniques for assessment and resection. Endoscopic resections of colorectal lesions of at least 2 cm were included. Lesions were assessed using magnification chromoendoscopy supplemented by colonoscopic ultrasound in selected cases. A lesion-specific approach to resection with endoscopic mucosal resection or endoscopic submucosal dissection (ESD) was used. Surveillance endoscopy was performed at 3 (SC1) and 12 (SC2) months. Four hundred and sixty-six large (≥20 mm) colorectal lesions (mean size 54.8 mm) were resected. Three hundread and fifty-six were resected using endoscopic mucosal resection and 110 by ESD or hybrid ESD. Fifty-one percent of lesions had been subjected to previous failed attempts at resection or heavy manipulation (≥6 biopsies). Nevertheless, endoscopic resection was deemed successful after an initial attempt in 98%. Recurrence occurred in 15% and could be treated with endoscopic resection in most. Only two patients required surgery for perforation. Nine patients had postprocedure bleeding; only two required endoscopic clips. Ninety-six percent of patients without invasive cancer were free from recurrence and had avoided surgery at last follow-up. Combining eastern and western practices for assessment and resection results in safe and effective organ-conserving treatment of complex colorectal lesions. Accurate assessment before and after resection using magnification chromoendoscopy and a lesion-specific approach to resection, incorporating ESD where appropriate, are important factors in achieving these results.

  5. Phrase-Final Words in Greek Storytelling Speech: A Study on the Effect of a Culturally-Specific Prosodic Feature on Short-Term Memory.

    Loutrari, Ariadne; Tselekidou, Freideriki; Proios, Hariklia

    2018-02-27

    Prosodic patterns of speech appear to make a critical contribution to memory-related processing. We considered the case of a previously unexplored prosodic feature of Greek storytelling and its effect on free recall in thirty typically developing children between the ages of 10 and 12 years, using short ecologically valid auditory stimuli. The combination of a falling pitch contour and, more notably, extensive final-syllable vowel lengthening, which gives rise to the prosodic feature in question, led to statistically significantly higher performance in comparison to neutral phrase-final prosody. Number of syllables in target words did not reveal substantial difference in performance. The current study presents a previously undocumented culturally-specific prosodic pattern and its effect on short-term memory.

  6. Scoping the scope: endoscopic evaluation of endoscope working channels with a new high-resolution inspection endoscope (with video).

    Barakat, Monique T; Girotra, Mohit; Huang, Robert J; Banerjee, Subhas

    2018-02-06

    Outbreaks of transmission of infection related to endoscopy despite reported adherence to reprocessing guidelines warrant scrutiny of all potential contributing factors. Recent reports from ambulatory surgery centers indicated widespread significant occult damage within endoscope working channels, raising concerns regarding the potential detrimental impact of this damage on the adequacy of endoscope reprocessing. We inspected working channels of all 68 endoscopes at our academic institution using a novel flexible inspection endoscope. Inspections were recorded and videos reviewed by 3 investigators to evaluate and rate channel damage and/or debris. Working channel rinsates were obtained from all endoscopes, and adenosine triphosphate (ATP) bioluminescence was measured. Overall endoscope working channel damage was rated as minimal and/or mild and was consistent with expected wear and tear (median 1.59 on our 5-point scale). Our predominant findings included superficial scratches (98.5%) and scratches with adherent peel (76.5%). No channel perforations, stains, or burns were detected. The extent of damage was not predicted by endoscope age. Minor punctate debris was common, and a few small drops of fluid were noted in 42.6% of endoscopes after reprocessing and drying. The presence of residual fluid predicted higher ATP bioluminescence values. The presence of visualized working channel damage or debris was not associated with elevated ATP bioluminescence values. The flexible inspection endoscope enables high-resolution imaging of endoscope working channels and offers endoscopy units an additional modality for endoscope surveillance, potentially complementing bacterial cultures and ATP values. Our study, conducted in a busy academic endoscopy unit, indicated predominately mild damage to endoscope working channels, which did not correlate with elevated ATP values. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights

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

    Glinsky, Gennadi V

    2018-03-01

    Transposable elements have made major evolutionary impacts on creation of primate-specific and human-specific genomic regulatory loci and species-specific genomic regulatory networks (GRNs). Molecular and genetic definitions of human-specific changes to GRNs contributing to development of unique to human phenotypes remain a highly significant challenge. Genome-wide proximity placement analysis of diverse families of human-specific genomic regulatory loci (HSGRL) identified topologically associating domains (TADs) that are significantly enriched for HSGRL and designated rapidly evolving in human TADs. Here, the analysis of HSGRL, hESC-enriched enhancers, super-enhancers (SEs), and specific sub-TAD structures termed super-enhancer domains (SEDs) has been performed. In the hESC genome, 331 of 504 (66%) of SED-harboring TADs contain HSGRL and 68% of SEDs co-localize with HSGRL, suggesting that emergence of HSGRL may have rewired SED-associated GRNs within specific TADs by inserting novel and/or erasing existing non-coding regulatory sequences. Consequently, markedly distinct features of the principal regulatory structures of interphase chromatin evolved in the hESC genome compared to mouse: the SED quantity is 3-fold higher and the median SED size is significantly larger. Concomitantly, the overall TAD quantity is increased by 42% while the median TAD size is significantly decreased (p = 9.11E-37) in the hESC genome. Present analyses illustrate a putative global role for transposable elements and HSGRL in shaping the human-specific features of the interphase chromatin organization and functions, which are facilitated by accelerated creation of novel transcription factor binding sites and new enhancers driven by targeted placement of HSGRL at defined genomic coordinates. A trend toward the convergence of TAD and SED architectures of interphase chromatin in the hESC genome may reflect changes of 3D-folding patterns of linear chromatin fibers designed to enhance both

  8. The specific features of self-action of high-power laser radiation propagating through a fully ionised cold plasma and the development of modulation instability

    Aleshkevich, Viktor A; Kartashev, Ya V; Vysloukh, Victor A

    2000-01-01

    The specific features of the propagation of soliton-like light beams through a fully ionised two-dimensional cold plasma are considered employing analytical and numerical methods commonly used in nonlinear optics. Exact soliton profiles for the lower and upper soliton branches are found numerically in the presence of optical bistability. It is shown that the interaction of incoherent soliton-like laser beams in such a plasma may result both in the destruction of one of the beams and in production of new ones. The regime of the modulation instability of a plane wave propagating through a cold laser-produced plasma is studied. (nonlinear optical phenomena)

  9. Contrast-enhanced endoscopic ultrasonography

    Reddy, Nischita K; Ioncică, Ana Maria; Săftoiu, Adrian

    2011-01-01

    Contrast agents are increasingly being used to characterize the vasculature in an organ of interest, to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures. We review the mechanisms of action of first, second and third generation contrast...... agents and their use in various endoscopic procedures in the gastrointestinal tract. Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy, assessment of depth of invasion of esophageal, gastric and gall bladder...... cancers and visualization of the portal venous system and esophageal varices. In addition, contrast agents can be used to differentiate pancreatic lesions. The use of color Doppler further increases the ability to diagnose and differentiate various pancreatic malignancies. The sensitivity of power Doppler...

  10. Advances in endoscopic retrograde cholangiopancreatography

    WANG Xiangping

    2018-03-01

    Full Text Available Endoscopic retrograde cholangiopancreatography (ERCP is a well-established advanced endoscopic technique for the diagnosis and treatment of pancreatobiliary diseases. New advances have been made in the treatment concept and techniques of ERCP in recent years. This article elaborates on the recent advances in ERCP, including the application of pancreatic duct stent, non-steroidal anti-inflammatory drugs, and aggressive hydration to prevent postoperative pancreatitis, covered metal stent for the treatment of benign bile duct stenosis, intraluminal radiofrequency ablation for malignant bile duct stenosis, extracorporeal shockwave lithotripsy and covered metal stent for the treatment of chronic pancreatitis, peroral choledochoscopy for qualitative diagnosis of bile duct stenosis and huge refractory stones, definition of difficult intubation, timing of pre-cut technique, and ERCP after gastrointestinal reconstruction.

  11. Sparse feature selection identifies H2A.Z as a novel, pattern-specific biomarker for asymmetrically self-renewing distributed stem cells

    Yang Hoon Huh

    2015-03-01

    Full Text Available There is a long-standing unmet clinical need for biomarkers with high specificity for distributed stem cells (DSCs in tissues, or for use in diagnostic and therapeutic cell preparations (e.g., bone marrow. Although DSCs are essential for tissue maintenance and repair, accurate determination of their numbers for medical applications has been problematic. Previous searches for biomarkers expressed specifically in DSCs were hampered by difficulty obtaining pure DSCs and by the challenges in mining complex molecular expression data. To identify such useful and specific DSC biomarkers, we combined a novel sparse feature selection method with combinatorial molecular expression data focused on asymmetric self-renewal, a conspicuous property of DSCs. The analysis identified reduced expression of the histone H2A variant H2A.Z as a superior molecular discriminator for DSC asymmetric self-renewal. Subsequent molecular expression studies showed H2A.Z to be a novel “pattern-specific biomarker” for asymmetrically self-renewing cells, with sufficient specificity to count asymmetrically self-renewing DSCs in vitro and potentially in situ.

  12. Endoscopic Endonasal Management of Craniopharyngioma.

    Zacharia, Brad E; Amine, Muhamad; Anand, Vijay; Schwartz, Theodore H

    2016-02-01

    Craniopharyngioma is a rare clinical entity that poses a significant management challenge given their location and propensity to recur. As part of a minimally disruptive treatment paradigm, the expanded endonasal approach has the potential to improve rates of resection, improve postoperative visual recovery, and minimize surgical morbidity. This article updates the otolaryngologic community on the basic principles and techniques regarding the incorporation of the endoscopic, endonasal approach in the management paradigm of craniopharyngioma. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Systems workplace for endoscopic surgery.

    Irion, K M; Novak, P

    2000-01-01

    With the advent of minimally invasive surgery (MIS) a decade ago, the requirements for operating rooms (OR) and their equipment have been increased. Compared with conventional open surgery, the new endoscopic techniques require additional tools. Television systems, for video-assisted image acquisition and visualisation, including cameras, monitors and light systems, as well as insufflators, pumps, high-frequency units, lasers and motorised therapy units, are nowadays usually made available on carts during endoscopic surgery. In conjunction with a set of endoscopic instruments, these high-tech units allow new operating techniques to be performed. The benefit for patients has become clear in recent years; however, the technical complexity of OR has also increased considerably. To minimise this problem for the OR personnel, the MIS concept 'OR1' (Operating Room 1) was developed and implemented. OR1 is a fully functional and integrated multi-speciality surgical suite for MIS. The centrepieces of the OR1 are the Storz Communication Bus (SCB) and the advanced image and data archiving system (Aida) from Karl Storz, Tuttlingen, Germany. Both components allow monitoring, access and networking of the MIS equipment and other OR facilities, as well as the acquisition, storage and display of image, patient and equipment data during the endoscopic procedure. A central user interface allows efficient, simplified operation and online clinical images. Due to the system integration, the handling of complex equipment is considerably simplified, logistical procedures in the OR are improved, procedure times are shorter and, particularly noteworthy, operative risk can be reduced through simplified device operation.

  14. Endoscopic Management of Posterior Epistaxis

    Paul, J.; Kanotra, Sohit Paul; Kanotra, Sonika

    2011-01-01

    The traditional method of management of posterior epistaxis has been with anteroposterior nasal packing. Apart from the high failure rate of 26–50% reported in various series, nasal packing is associated with marked discomfort and several complications. In order to avoid nasal packing, we started doing endoscopic cauterization in cases of posterior epistaxis. A total of 23 patients with posterior epistaxis were subjected to nasal endoscopy with the intent to stop bleeding by cauterization of ...

  15. Endoscopic treatment of esophageal achalasia.

    Esposito, Dario; Maione, Francesco; D'Alessandro, Alessandra; Sarnelli, Giovanni; De Palma, Giovanni D

    2016-01-25

    Achalasia is a motility disorder of the esophagus characterized by dysphagia, regurgitation of undigested food, chest pain, weight loss and respiratory symptoms. The most common form of achalasia is the idiopathic one. Diagnosis largely relies upon endoscopy, barium swallow study, and high resolution esophageal manometry (HRM). Barium swallow and manometry after treatment are also good predictors of success of treatment as it is the residue symptomatology. Short term improvement in the symptomatology of achalasia can be achieved with medical therapy with calcium channel blockers or endoscopic botulin toxin injection. Even though few patients can be cured with only one treatment and repeat procedure might be needed, long term relief from dysphagia can be obtained in about 90% of cases with either surgical interventions such as laparoscopic Heller myotomy or with endoscopic techniques such pneumatic dilatation or, more recently, with per-oral endoscopic myotomy. Age, sex, and manometric type by HRM are also predictors of responsiveness to treatment. Older patients, females and type II achalasia are better after treatment compared to younger patients, males and type III achalasia. Self-expandable metallic stents are an alternative in patients non responding to conventional therapies.

  16. [Risk management for endoscopic surgery].

    Kimura, Taizo

    2010-05-01

    The number of medical accidents in endoscopic surgery has recently increased. Surgical complications caused by inadequate preparation or immature technique or those resulting in serious adverse outcomes may be referred to as medical accidents. The Nationwide Survey of Endoscopic Surgery showed that bile duct injury and uncontrollable bleeding were seen in 0.68% and in 0.58%, respectively, of cholecystectomy patients; interoperative and postoperative complications in 0.84% and in 3.8%, respectively, of gastric cancer surgery patients; and operative complications in 6.74% of bowel surgery patients. Some required open repair, and 49 patients died. The characteristic causes of complications in endoscopic surgery are a misunderstanding of anatomy, handling of organs outside the visual field, burn by electrocautery, and injuries caused by forceps. Bleeding that requires a laparotomy for hemostasis is also a complication. Furthermore, since the surgery is usually videorecorded, immature techniques resulting in complications are easily discovered. To decrease the frequency of accidents, education through textbooks and seminars, training using training boxes, simulators, or animals, proper selection of the surgeon depending on the difficulty of the procedure, a low threshold for conversion to laparotomy, and use of the best optical equipment and surgical instruments are important. To avoid malpractice lawsuits, informed consent obtained before surgery and proper communication after accidents are necessary.

  17. Endoscopic treatment of esophageal achalasia

    Esposito, Dario; Maione, Francesco; D’Alessandro, Alessandra; Sarnelli, Giovanni; De Palma, Giovanni D

    2016-01-01

    Achalasia is a motility disorder of the esophagus characterized by dysphagia, regurgitation of undigested food, chest pain, weight loss and respiratory symptoms. The most common form of achalasia is the idiopathic one. Diagnosis largely relies upon endoscopy, barium swallow study, and high resolution esophageal manometry (HRM). Barium swallow and manometry after treatment are also good predictors of success of treatment as it is the residue symptomatology. Short term improvement in the symptomatology of achalasia can be achieved with medical therapy with calcium channel blockers or endoscopic botulin toxin injection. Even though few patients can be cured with only one treatment and repeat procedure might be needed, long term relief from dysphagia can be obtained in about 90% of cases with either surgical interventions such as laparoscopic Heller myotomy or with endoscopic techniques such pneumatic dilatation or, more recently, with per-oral endoscopic myotomy. Age, sex, and manometric type by HRM are also predictors of responsiveness to treatment. Older patients, females and type II achalasia are better after treatment compared to younger patients, males and type III achalasia. Self-expandable metallic stents are an alternative in patients non responding to conventional therapies. PMID:26839644

  18. Endoscopic management of posterior epistaxis.

    Paul, J; Kanotra, Sohit Paul; Kanotra, Sonika

    2011-04-01

    The traditional method of management of posterior epistaxis has been with anteroposterior nasal packing. Apart from the high failure rate of 26-50% reported in various series, nasal packing is associated with marked discomfort and several complications. In order to avoid nasal packing, we started doing endoscopic cauterization in cases of posterior epistaxis. A total of 23 patients with posterior epistaxis were subjected to nasal endoscopy with the intent to stop bleeding by cauterization of the bleeding vessel. Of these, in four cases unsuspected diagnosis was made. Of the remaining 19, in three patients, the bleeding point could not be localized accurately and these patients were managed by anteroposterior packing. The rest of the 16 patients were managed by endoscopic cauterization. In four patients, there was recurrence of bleeding within 24 h. In one of these, cauterization controlled the bleeding while in the rest nasal packing had to be resorted to. Thus, of the 23 patients of posterior epistaxis subjected to nasal endoscopy, we could avoid nasal packing in 17 (74%). To conclude, endoscopic nasal cauterization is recommended as the first line to treatment in all cases of posterior epistaxis. This will not only prevent the uncomfortable and potentially dangerous nasal packing but also help in finding the underlying pathology.

  19. [Endoscopic ultrasound guided rendezvous for biliary drainage].

    Knudsen, Marie Høxbro; Vilmann, Peter; Hassan, Hazem; Karstensen, John Gésdal

    2015-04-27

    Endoscopic retrograde cholangiography (ERCP) is currently standard treatment for biliary drainage. Endoscopic ultrasound guided rendezvous (EUS-RV) is a novel method to overcome an unsuccessful biliary drainage procedure. Under endoscopic ultrasound guidance a guidewire is passed via a needle from the stomach or duodenum to the common bile duct and from there on to the duodenum enabling ERCP. With a relatively high rate of success EUS-RV should be considered as an alternative to biliary drainage and surgical intervention.

  20. Endoscopic Medial Maxillectomy Breaking New Frontiers

    Mohanty, Sanjeev; Gopinath, M.

    2011-01-01

    Endoscopy has changed the perspective of rhinologist towards the nose. It has revolutionised the surgical management of sinonasal disorders. Sinus surgeries were the first to get the benefit of endoscope. Gradually the domain of endoscopic surgery extended to the management of sino nasal tumours. Traditionally medial maxillectomy was performed through lateral rhinotomy or mid facial degloving approach. Endoscopic medial maxillectomy has been advocated by a number of authors in the management ...

  1. New techniques in gastrointestinal endoscopic surgery

    Rafael Antonio Luengas Tello

    2012-09-01

    Full Text Available Gastrointestinal endoscopic surgery has been making great progress since the seventies in the management paradigms of conditions such as gastrointestinal bleeding, polyp resection and diagnostic and therapeutic management of the biliary tract. The current challenge is the development of techniques that allow endoscopic treatment of emerging diseases such as cancer, morbid obesity, gastro-esophageal reflux and achalasia. This article reports on new techniques and expectations for the future in the endoscopic management of these diseases.

  2. Endoscopic medial maxillectomy breaking new frontiers.

    Mohanty, Sanjeev; Gopinath, M

    2013-07-01

    Endoscopy has changed the perspective of rhinologist towards the nose. It has revolutionised the surgical management of sinonasal disorders. Sinus surgeries were the first to get the benefit of endoscope. Gradually the domain of endoscopic surgery extended to the management of sino nasal tumours. Traditionally medial maxillectomy was performed through lateral rhinotomy or mid facial degloving approach. Endoscopic medial maxillectomy has been advocated by a number of authors in the management of benign sino-nasal tumours. We present our experience of endoscopic medial maxillectomy in the management of sinonasal pathologies.

  3. Asymptomatic Esophageal Varices Should Be Endoscopically Treated

    Nib Soehendra

    1998-01-01

    Full Text Available Endoscopic treatment has generally been accepted in the management of bleeding esophageal varices. Both the control of acute variceal bleeding and elective variceal eradication to prevent recurrent bleeding can be achieved via endoscopic methods. In contrast to acute and elective treatment, the role of endoscopic therapy in asymptomatic patients who have never had variceal bleeding remains controversial because of the rather disappointing results obtained from prophylactic sclerotherapy. Most published randomized controlled trials showed that prophylactic sclerotherapy had no effect on survival. In some studies, neither survival rate nor bleeding risk was improved. In this article, the author champions the view that asymptomatic esophageal varices should be endoscopically treated.

  4. Endoscopic full-thickness resection: Current status.

    Schmidt, Arthur; Meier, Benjamin; Caca, Karel

    2015-08-21

    Conventional endoscopic resection techniques such as endoscopic mucosal resection or endoscopic submucosal dissection are powerful tools for treatment of gastrointestinal neoplasms. However, those techniques are restricted to superficial layers of the gastrointestinal wall. Endoscopic full-thickness resection (EFTR) is an evolving technique, which is just about to enter clinical routine. It is not only a powerful tool for diagnostic tissue acquisition but also has the potential to spare surgical therapy in selected patients. This review will give an overview about current EFTR techniques and devices.

  5. [Gastroesophageal reflux disease associated with duodenogastroesophageal reflux in patients with biliary pathology: the specific features of the course and esophagogastroduodenal microbial biocenosis].

    Dzhulai, G S; Sekareva, E V; Chervinets, V M; Mikhailova, E S; Dzhulai, T E

    2014-01-01

    To study the specific features of the clinical course of gastroesophageal reflux disease (GERD) associated with duodenogastroesophageal reflux (DGER) in patients with chronic acalculous cholecystitis (CAC) and cholelithiasis (CL), as well as qualitative and quantitative characteristics. The clinical, morphological, motor tonic characteristics of the esophagogastroduodenal area, mucosal microbial biocenosis in the esophagus, stomach, and duodenum were studied in detail in 83 patients with GERD that was associated with DGER and ran concurrently with CAC or CL. Impaired duodenal propulsive activity as a concomitance of the signs of gastrostasis and duodenal dyskinesia with dyscoordination of both anthroduodenal and duodenojejunal propulsion and with the development of duodenogastric reflux and DGER, which in turn determine esophageal and gastric pH values is shown to be of importance in CAC and CL, which match GERD. Abnormal microbiocenosis in the upper digestive tract is characterized by the higher quantitative and qualitative content of the mucous microflora. Opportunistic microorganisms exhibit cytotoxic, hemolytic, lecithinase, caseinolytic, urease, and RNAase activities. The found specific features of the course of GERD associated with DGER in patients with biliary tract abnormalities lead us to search for novel therapeutic approaches based on the correction of digestive motor tonic disorders and abnormal microbiocenoses of the mucous flora in the esophagus, stomach, and duodenum.

  6. [The specific features of the psycho-emotional status and the application of psychotherapy for the rehabilitative treatment of the patients presenting with rheumatoid arthritis].

    Kukshina, A A; Vereschagina, D A; Kotel'nikova, A V; Zaitsev, V P

    The relevance of the problem of rheumatoid arthritis arises from the influence of such factors as its prevalence rate, unpredictability, tendency towards the transition to the chronic form, severe pain syndrome, high levels of disability, and long-term loss of working ability, as well as the accompanying psycho-emotional disorders. The present reviews article was designed to analyze the premorbid personality characteristics, the specifics features of mental health, and the response to the disease in the patients presenting with rheumatoid arthritis. Special emphasis is placed on the discusses of the relationship between the intensity of the pain syndrome and psycho-emotional disorders. The factors responsible for the development of the depressive states associated with rheumatoid arthritis are distinguished; they are shown to be related to both pathogenesis and the clinical symptoms of the underlying pathology as well as the general course of the disease and the specific features of the patients' psychological condition. The most extensively applied psychodiagnostics techniques are described, and the commonest psychotherapeutic approaches to the combined therapy and rehabilitation of the patients presenting with rheumatoid arthritis are overviewed.

  7. 'Focal thyroid inferno' on color Doppler ultrasonography: A specific feature of focal Hashimoto's thyroiditis

    Fu, Xianshui, E-mail: fuxs1968@163.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Guo, Limei, E-mail: guolimei@bjmu.edu.cn [Department of Pathology, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Zhang, Huabin, E-mail: huabinzhang@bjmu.edu.cn [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Ran, Weiqiang, E-mail: ranwq-sina@vip.sina.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Fu, Peng, E-mail: fupeng01@gmail.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Li, Zhiqiang, E-mail: lizhq126@126.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Chen, Wen, E-mail: wendy7989@sina.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Jiang, Ling, E-mail: papayaling@yahoo.com.cn [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Wang, Jinrui, E-mail: jinrui_wang@sina.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China); Jia, Jianwen, E-mail: drjia88@sohu.com [Department of Ultrasound, Peking University Third Hospital, 49 Huayuanbeilu Road, Beijing 100191 (China)

    2012-11-15

    Purpose: To evaluate color-Doppler features predictive of focal Hashimoto's thyroiditis. Materials and methods: A total of 521 patients with 561 thyroid nodules that underwent surgeries or gun biopsies were included in this study. These nodules were divided into three groups: focal Hashimoto's thyroiditis (104 nodules in 101 patients), benignity other than focal Hashimoto's thyroiditis (73 nodules in 70 patients), and malignancy (358 nodules in 350 patients). On color Doppler sonography, four vascularity types were determined as: hypovascularity, marked internal flow, marked peripheral flow and focal thyroid inferno. The {chi}{sup 2} test was performed to seek the potential vascularity type with the predictive ability of certain thyroid pathology. Furthermore, the gray-scale features of each nodule were also studied. Results: The vascularity type I (hypovascularity) was more often seen in focal Hashimoto's thyroiditis than other benignity and malignancy (46% vs. 20.5% and 19%). While the type II (marked internal flow) showed the opposite tendency (26.9% [focal Hashimoto's thyroiditis] vs. 45.2% [other benignity] and 52.8% [malignancy]). However, type III (marked peripheral flow) was unable to predict any thyroid pathology. Importantly, type IV (focal thyroid inferno) was exclusive to focal Hashimoto's thyroiditis. All 8 type IV nodules appeared to be solid, hypoechoic, and well-defined. Using 'focal thyroid inferno' as an indicator of FHT, the diagnostic sensitivity and specificity were 7.7% and 100% respectively. Conclusions: The vascularity type of 'focal thyroid inferno' is specific for focal Hashimoto thyroiditis. Recognition of this particular feature may avoid unnecessary interventional procedures for some solid hypoechoic thyroid nodules suspicious of malignancy.

  8. The current state of per oral endoscopic myotomy for achalasia

    Smith, Shane P.

    2017-01-01

    Achalasia is an acquired neuromuscular disorder that has been treated using a variety of modalities throughout medical history. Recently, the technique of per oral endoscopic myotomy (POEM) was introduced to treat the disease using a truly minimally invasive, natural orifice technique that is rapidly being adopted across the world. This review outlines the development of POEM, the technique itself, and gives a comparison to other procedures, specifically laparoscopic Heller myotomy (LHM). PMID:29078682

  9. Robot-assisted endoscope guidance versus manual endoscope guidance in functional endonasal sinus surgery (FESS).

    Eichhorn, Klaus Wolfgang; Westphal, Ralf; Rilk, Markus; Last, Carsten; Bootz, Friedrich; Wahl, Friedrich; Jakob, Mark; Send, Thorsten

    2017-10-01

    Having one hand occupied with the endoscope is the major disadvantage for the surgeon when it comes to functional endoscopic sinus surgery (FESS). Only the other hand is free to use the surgical instruments. Tiredness or frequent instrument changes can thus lead to shaky endoscopic images. We collected the pose data (position and orientation) of the rigid 0° endoscope and all the instruments used in 16 FESS procedures with manual endoscope guidance as well as robot-assisted endoscope guidance. In combination with the DICOM CT data, we tracked the endoscope poses and workspaces using self-developed tracking markers. All surgeries were performed once with the robot and once with the surgeon holding the endoscope. Looking at the durations required, we observed a decrease in the operating time because one surgeon doing all the procedures and so a learning curve occurred what we expected. The visual inspection of the specimens showed no damages to any of the structures outside the paranasal sinuses. Robot-assisted endoscope guidance in sinus surgery is possible. Further CT data, however, are desirable for the surgical analysis of a tracker-based navigation within the anatomic borders. Our marker-based tracking of the endoscope as well as the instruments makes an automated endoscope guidance feasible. On the subjective side, we see that RASS brings a relief for the surgeon.

  10. Endoscopic approach to the infratemporal fossa

    Ahmed Youssef

    2014-06-01

    Conclusions: Endoscopic endonasal transpterygoid approach is considered one of the most useful surgical solutions to manage selected tumors that involve the infratemporal fossa. A good understanding of the endoscopic anatomy of infratemporal fossa allows safe and complete resection of lesions arising or extending to infratemporal fossa.

  11. Duodenal diverticular bleeding: an endoscopic challenge

    Eduardo Valdivielso-Cortázar

    Full Text Available Duodenal diverticula are an uncommon cause of upper gastrointestinal bleeding. Until recently, it was primarily managed with surgery, but advances in the field of endoscopy have made management increasingly less invasive. We report a case of duodenal diverticular bleeding that was endoscopically managed, and review the literature about the various endoscopic therapies thus far described.

  12. Video-based measurements for wireless capsule endoscope tracking

    Spyrou, Evaggelos; Iakovidis, Dimitris K

    2014-01-01

    The wireless capsule endoscope is a swallowable medical device equipped with a miniature camera enabling the visual examination of the gastrointestinal (GI) tract. It wirelessly transmits thousands of images to an external video recording system, while its location and orientation are being tracked approximately by external sensor arrays. In this paper we investigate a video-based approach to tracking the capsule endoscope without requiring any external equipment. The proposed method involves extraction of speeded up robust features from video frames, registration of consecutive frames based on the random sample consensus algorithm, and estimation of the displacement and rotation of interest points within these frames. The results obtained by the application of this method on wireless capsule endoscopy videos indicate its effectiveness and improved performance over the state of the art. The findings of this research pave the way for a cost-effective localization and travel distance measurement of capsule endoscopes in the GI tract, which could contribute in the planning of more accurate surgical interventions. (paper)

  13. Video-based measurements for wireless capsule endoscope tracking

    Spyrou, Evaggelos; Iakovidis, Dimitris K.

    2014-01-01

    The wireless capsule endoscope is a swallowable medical device equipped with a miniature camera enabling the visual examination of the gastrointestinal (GI) tract. It wirelessly transmits thousands of images to an external video recording system, while its location and orientation are being tracked approximately by external sensor arrays. In this paper we investigate a video-based approach to tracking the capsule endoscope without requiring any external equipment. The proposed method involves extraction of speeded up robust features from video frames, registration of consecutive frames based on the random sample consensus algorithm, and estimation of the displacement and rotation of interest points within these frames. The results obtained by the application of this method on wireless capsule endoscopy videos indicate its effectiveness and improved performance over the state of the art. The findings of this research pave the way for a cost-effective localization and travel distance measurement of capsule endoscopes in the GI tract, which could contribute in the planning of more accurate surgical interventions.

  14. Specific features of slow neutron coherent scattering by crystals with substitution impurities and selection rules for the mass operator of phonons

    Dzyub, I.P.; Kochmarskij, V.Z.

    1978-01-01

    The specific features of coherent slow-neutron scattering in the neighbourhood of the quasilocal oscillation (QLO) frequency are investigated. By means of the calculation for a simple cubic crystal containing substitutional impurities it is demonstrated that the dispersion curves are discontinuous in the QLO frequency range. This dispersion curve discontinuity is associated with one-phonon peak in the neighbourhood of the QLO frequency. The results of neutron scattering experiments on Crsub(1-x)Wsub(x) and Cusub(1-x)Ausub(x) solutions are then considered from this standpoint. Selection rules for the phonon mass operator are established which allow to determine the symmetry of QLO which contribute to the broadening and shift of one-phonon peaks in the directions of high symmetry, depending on the transfer neutron-momentum orientation with respect to the principal axes of a crystal

  15. [The specific features of the clinical course of acute suppurative otitis media of viral and mixed viral-bacterial etiology in the children of the preschool age].

    Radtsig, E Yu; Bugaichuk, O V

    The objective of the present study was to elucidate the spectrum of the pathogenic agents responsible for the development of acute suppurative otitis media in the children of the preschool age and to reveal the specific clinical features of this disease depending on its etiological factors. The study involved 138 patients (186 ears) of either sex at the age from 1 year to 84 months who presented with acute suppurative otitis media. The following methods were employed for the purpose of the study: analysis of the patients' complaints and the past medical histories, examination of the ENT organs, microbiological (bacteriological and virological) studies of secretion from the tympanic cavity, diagnostic endoscopy of the nasal cavity and nasopharynx, laboratory investigations. The study allowed to reveal the characteristic clinical manifestations of the pathology of interest depending on its etiology.

  16. Specific features of diffuse reflection of human face skin for laser and non-laser sources of visible and near-IR light

    Dolotov, L E; Sinichkin, Yu P; Tuchin, Valerii V; Al'tshuler, G B; Yaroslavskii, I V

    2011-01-01

    The specific features of diffuse reflection from different areas of human face skin for laser and non-laser sources of visible and near-IR light have been investigated to localise the closed-eye (eyelid) region. In the visible spectral range the reflection from the eyelid skin surface can be differentiated by measuring the slope of the spectral dependence of the effective optical density of skin in the wavelength range from 650 to 700nm. In the near-IR spectral range the reflectances of the skin surface at certain wavelengths, normalised to the forehead skin reflectance, can be used as a criterion for differentiating the eyelid skin. In this case, a maximum discrimination is obtained when measuring the skin reflectances at laser wavelengths of 1310 and 1470nm, which correspond to the spectral ranges of maximum and minimum water absorption. (optical technologies in biophysics and medicine)

  17. The role of specific features of the electronic structure in electrical resistivity of band ferromagnets Co2Fe Z ( Z = Al, Si, Ga, Ge, In, Sn, Sb)

    Kourov, N. I.; Marchenkov, V. V.; Perevozchikova, Yu. A.; Weber, H. W.

    2017-05-01

    The electrical resistivity ρ( T) of the band ferromagnets Co2FeZ (where Z = Al, Si, Ga, Ge, In, Sn, and Sb are s- and p-elements of Mendeleev's Periodic Table) has been investigated in the temperature range 4.2 K < T < 1100 K. It has been shown that the dependences ρ( T) of these alloys in a magnetically ordered state at temperatures T < T C are predominantly determined by the specific features of the electronic spectrum in the vicinity of the Fermi level. The processes of charge carrier scattering affect the behavior of the electrical resistivity ρ( T) only in the vicinity of the Curie temperature T C and above, as well as in the low-temperature range (at T ≪ T C).

  18. Efficacy of endoscopic histoacryl injection in treatment of gastric variceal bleeding caused by regional portal hypertension

    TANG Shanhong

    2015-08-01

    Full Text Available Objective To analyze the efficacy of endoscopic histoacryl injection in the treatment of gastric variceal bleeding caused by regional portal hypertension. Methods The endoscopic features and efficacy of endoscopic histoacryl injection were examined and compared in two groups of patients admitted to our hospital from June 2012 to December 2012. One of the groups included 6 patients with gastric variceal bleeding caused by regional portal hypertension and the other group included 6 patients with gastric variceal bleeding caused by hepatitis B cirrhosis-related portal hypertension. Between-group comparison of categorical data was made by Fisher′s test. Results In patients with regional portal hypertension, five of them had severe isolated gastric varices (IGV and one had severe IGV with mild esophageal varices. All six patients with hepatitis B cirrhosis-related portal hypertension had severe IGV and the endoscopic features were similar to those of patients with regional portal hypertension. Significant differences were observed between the group with regional portal hypertension and the group with hepatitis B cirrhosis related portal hypertension in short-term response rate (1/6 vs 6/6, P=0.015 and long-term response rate (0/6 vs 5/6, P=0.015. Conclusion The gastric varices caused by regional portal hypertension has a fast progression rate and a high bleeding risk. The efficacy of endoscopic histoacryl injection in patients with this type of gastric varices is poor.

  19. Comparison of Endoscopic and Histological Findings between Typical and Atypical Celiac Disease in Children.

    Semwal, Pooja; Gupta, Raj Kumar; Sharma, Rahul; Garg, Kapil

    2018-04-01

    Celiac disease is a common non-communicable disease with varied presentations. Purpose of this study was to find the duodeno-endoscopic features in celiac disease and to compare duodeno-endoscopic and histological findings between typical and atypical celiac disease in children. Hospital based observational study was conducted at Sir Padampat Mother and Child Health Institute, Jaipur from June 2015 to May 2016. Patients were selected and divided in two groups- typical and atypical celiac disease based upon the presenting symptoms. Upper gastrointestinal endoscopy and duodenal biopsy was performed for serology positive patients. Results were analysed using appropriate statistical test of significance. Out of 101 enrolled patients, 47.5% were male. Age ranged from 1 to 18 years. Study showed that 54.5% were typical and 45.5% were atypical. Patients presenting with atypical symptoms were predominantly of older age group. On endoscopy, scalloping, mosaic pattern, reduced fold height and absent fold height; and in histology, advanced Marsh stage were significantly higher in the typical group. Awareness of atypical presentations as well as duodeno-endoscopic features may have considerable practical importance for the diagnosis of celiac disease in children. Scalloping, mosaic pattern, reduced fold height and nodularity are main endoscopic markers of celiac disease in children. Endoscopic markers of duodenal mucosa may be important in early diagnosis of celiac disease, in children subjected to endoscopy for atypical presentations or indication other than suspected celiac disease.

  20. Endoscopic palliation in gastric cancer

    Valdivieso, Eduardo

    2010-01-01

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

  1. Assessment of use of specific features of subcutaneous insulin infusion systems and their relationship to metabolic control in patients with type 1 diabetes.

    Quirós, Carmen; Patrascioiu, Ioana; Giménez, Marga; Vinagre, Irene; Vidal, Mercè; Jansà, Margarita; Conget, Ignacio

    2014-01-01

    Patients with type 1 diabetes (T1DM) treated with continuous subcutaneous insulin infusion (CSII) have available several specific features of these devices. The aim of this study was to evaluate the relationship between real use of them and the degree of glycemic control in patients using this therapy. Forty-four T1DM patients on CSII therapy with or without real-time continuous glucose monitoring (CGM) were included. Data from 14 consecutive days were retrospectively collected using the therapy management software CareLink Personal/Pro(®) and HbA1c measurement performed at that period. The relationship between the frequency of usie of specific features of insulin pumps (non-sensor augmented or sensor-augmented) and glycemic control was analyzed. Mean HbA1c in the group was 7.5 ± .8%. Mean daily number of boluses administered was 5.1 ± 1.8, with 75.4% of them being bolus wizards (BW). Daily number of boluses was significantly greater in patients with HbA1c 7.5% (5.3 ± 1.6 vs. 4.3 ± 1.6, P=.056). There was a trend to greater use of BW in patients with better control (82.8 ± 21.4% vs. 69.9 ± 29.1%, P=.106). HbA1c was lower in patients using CGM (n=8) as compared to those not using sensor-augmented pumps (7.6 ± .8 vs 7.1 ± .7, P=.067), but the difference was not statistically significant. More frequent use of BW appears to be associated to better metabolic control in patients with T1DM using pump therapy. In standard clinical practice, augmentation of insulin pump with CGM may be associated to improved glycemic control. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  2. Endoscopic management of hilar biliary strictures

    Singh, Rajiv Ranjan; Singh, Virendra

    2015-01-01

    Hilar biliary strictures are caused by various benign and malignant conditions. It is difficult to differentiate benign and malignant strictures. Postcholecystectomy benign biliary strictures are frequently encountered. Endoscopic management of these strictures is challenging. An endoscopic method has been advocated that involves placement of increasing number of stents at regular intervals to resolve the stricture. Malignant hilar strictures are mostly unresectable at the time of diagnosis and only palliation is possible.Endoscopic palliation is preferred over surgery or radiological intervention. Magnetic resonance cholangiopancreaticography is quite important in the management of these strictures. Metal stents are superior to plastic stents. The opinion is divided over the issue of unilateral or bilateral stenting.Minimal contrast or no contrast technique has been advocated during endoscopic retrograde cholangiopancreatography of these patients. The role of intraluminal brachytherapy, intraductal ablation devices, photodynamic therapy, and endoscopic ultrasound still remains to be defined. PMID:26191345

  3. Endoscopes with latest technology and concept.

    Gotoh

    2003-09-01

    Endoscopic imaging systems that perform as the "eye" of the operator during endoscopic surgical procedures have developed rapidly due to various technological developments. In addition, since the most recent turn of the century robotic surgery has increased its scope through the utilization of systems such as Intuitive Surgical's da Vinci System. To optimize the imaging required for precise robotic surgery, a unique endoscope has been developed, consisting of both a two dimensional (2D) image optical system for wider observation of the entire surgical field, and a three dimensional (3D) image optical system for observation of the more precise details at the operative site. Additionally, a "near infrared radiation" endoscopic system is under development to detect the sentinel lymph node more readily. Such progress in the area of endoscopic imaging is expected to enhance the surgical procedure from both the patient's and the surgeon's point of view.

  4. Endoscopic findings following retroperitoneal pancreas transplantation.

    Pinchuk, Alexey V; Dmitriev, Ilya V; Shmarina, Nonna V; Teterin, Yury S; Balkarov, Aslan G; Storozhev, Roman V; Anisimov, Yuri A; Gasanov, Ali M

    2017-07-01

    An evaluation of the efficacy of endoscopic methods for the diagnosis and correction of surgical and immunological complications after retroperitoneal pancreas transplantation. From October 2011 to March 2015, 27 patients underwent simultaneous retroperitoneal pancreas-kidney transplantation (SPKT). Diagnostic oesophagogastroduodenoscopy (EGD) with protocol biopsy of the donor and recipient duodenal mucosa and endoscopic retrograde pancreatography (ERP) were performed to detect possible complications. Endoscopic stenting of the main pancreatic duct with plastic stents and three-stage endoscopic hemostasis were conducted to correct the identified complications. Endoscopic methods showed high efficiency in the timely diagnosis and adequate correction of complications after retroperitoneal pancreas transplantation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Endoscopic removal of malfunctioning biliary self-expandable metallic stents.

    Familiari, Pietro; Bulajic, Milutin; Mutignani, Massimiliano; Lee, Linda S; Spera, Gianluca; Spada, Cristiano; Tringali, Andrea; Costamagna, Guido

    2005-12-01

    Endoscopic removal of malfunctioning self-expandable metallic biliary stents (SEMS) is difficult and not well described. The aim of this study is to review the indications, the techniques, and the results of SEMS removal in a cohort of patients with malfunctioning stents. All patients who underwent an attempt at endoscopic removal of biliary SEMS over a 5-year period were retrospectively identified. The main indications for SEMS removal were the following: distal migration of the stent or impaction to the duodenum, impaction into the bile-duct wall, tissue ingrowth, and inappropriate length of the stent causing occlusion of intrahepatic ducts. SEMS were removed by using foreign-body forceps or polypectomy snares. Endoscopic removal of 39 SEMS (13 uncovered and 26 covered) was attempted in 29 patients (17 men; mean age, 66 years). SEMS extraction was attempted after a mean of 7.5 months (8.75 months standard deviation) post-SEMS insertion. Removal was successful in 20 patients (68.9%) and in 29 SEMS (74.3%). Covered SEMS were effectively removed more frequently than uncovered ones: 24 of 26 (92.3%) and 5 of 13 (38.4%), respectively (p < 0.05). No major complications were recorded. Multivariate analysis showed that the time interval between insertion and removal, SEMS length, stent-mesh design (zigzag vs. interlaced), and indication for removal were not predictive of success at stent removal. Endoscopic removal of biliary SEMS is feasible and safe in more than 70% of cases. Because only 38% of uncovered SEMS were removable, the presence of a stent covering is the only factor predictive of successful stent extraction. The presence of diffuse and severe ingrowth was the main feature limiting SEMS removal.

  6. The appearance of the pre-Achilles fat pad after endoscopic calcaneoplasty

    Wiegerinck, Johannes I.; Zwiers, Ruben; van Sterkenburg, Maayke N.; Maas, Mario M.; van Dijk, C. Niek

    2015-01-01

    To evaluate whether the imaging features of the retrocalcaneal recess normalize on a conventional radiograph after surgery for retrocalcaneal bursitis and evaluate whether it can be reused if complaints reoccur. Patients who underwent an endoscopic calcaneoplasty at least 2 years before were

  7. Therapeutic aspects of endoscopic ultrasound

    Woodward, Timothy A.

    1999-06-01

    Endoscopic ultrasound (EUS) is a technology that had been used primarily as a passive imaging modality. Recent advances have enabled us to move beyond the use of EUS solely as a staging tool to an interventional device. Current studies suggest that interventional applications of EUS will allow for minimally invasive assessment and therapies in a cost-effective manner. Endoscopic ultrasound with fine needle aspiration (EUS-FNA) has been demonstrated to be a technically feasible, relatively safe method of obtaining cytologic specimens. The clinical utility of EUS- FNA appears to be greatest in the diagnosis and staging of pancreatic cancer and in the nodal staging of gastrointestinal and pulmonary malignancies. In addition, EUS-FNA has demonstrated utility in the sampling pleural and ascitic fluid not generally appreciated or assessable to standard interventions. Interventional applications of EUS include EUS-guided pseudocyst drainage, EUS-guided injection of botulinum toxin in the treatment of achalasia, and EUS- guided celiac plexus neurolysis in the treatment of pancreatic cancer pain. Finally, EUS-guided fine-needle installation is being evaluated, in conjunction with recent bimolecular treatment modalities, as a delivery system in the treatment of certain gastrointestinal tumors.

  8. Endoscopic Transsphenoidal Resection of Craniopharyngioma.

    Liew, Kong Yew; Narayanan, Prepageran; Waran, Vicknes

    2018-02-01

    Objectives  To demonstrate, step-by-step, the technique and efficacy of endoscopic transsphenoidal approach in resection of a suprasellar craniopharyngioma. Design  The video shows a step-by-step approach to the resection, covering the exposure, access, resection, and confirmation of resection and reconstruction. Setting  The surgery was performed in the University of Malaya Medical Centre, a tertiary referral center in the capital of Malaysia. Participants  Surgery was performed jointly by Professor Prepageran from the department of otorhinolaryngology and Professor Vicknes Waran from the division of neurosurgery. Both surgeons are from the University of Malaya. Video compilation, editing, and voice narration was done by Dr. Kong Yew Liew. Main Outcome Measures  Completeness of resection and avoidance of intra- and postoperative complications. Results  Based on intraoperative views and MRI findings, the tumor was completely resected with the patient suffering only transient diabetes insipidus. Conclusion  Central suprasellar tumors can be removed completely via an endoscopic transsphenoidal approach with minimal morbidity to the patient. The link to the video can be found at: https://youtu.be/ZNIHfk12cYg .

  9. Endoscopic therapy of posttransplant biliary stenoses after right-sided adult living donor liver transplantation.

    Zoepf, Thomas; Maldonado-Lopez, Evelyn J; Hilgard, Philip; Schlaak, Joerg; Malago, Massimo; Broelsch, Christoph E; Treichel, Ulrich; Gerken, Guido

    2005-11-01

    Endoscopic treatment of biliary strictures after liver transplantation is a therapeutic challenge. In particular, outcomes of endoscopic therapy of biliary complications in the case of duct-to-duct anastomosis after living related liver transplantation are limited. The aim of this study was to evaluate the feasibility and success of an endoscopic treatment approach to posttransplant biliary strictures (PTBS) after right-sided living donor liver transplantation (RLDLT) with duct-to-duct anastomosis. Ninety patients who received adult-to-adult RLDLT in our center were screened retrospectively with respect to endoscopic treatment of PTBS. Therapy was judged as successful when cholestasis parameters returned to normal and bile duct narrowing was reduced significantly after the completion of therapy. Forty of 90 RLDLT patients received duct-to-duct anastomosis, 12 (30%) showed PTBS. Seven of 12 patients were treated successfully by endoscopy; the remaining 5 patients were treated primarily by surgery. Most patients were treated by balloon dilatation followed by insertion of endoprostheses. A median of 2.5 dilatation sessions were necessary and the median treatment duration was 8 months. One patient developed endoscopy-treatable recurrent stenosis, no surgical intervention was necessary. Mild pancreatitis occurred in 7.9% and cholangitis in 5.3% of the procedures. One minor bleeding episode occurred during sphincterotomy. Bleeding was managed endoscopically. Endoscopic therapy of adult-to-adult right living related liver transplantation with duct-to-duct anastomosis is feasible and frequently is successful. The duct-to-duct anastomosis offers the possibility of endoscopic treatment. Endoscopic treatment of posttransplant biliary strictures is safe, with a low specific complication rate.

  10. Design of a modified endoscope illuminator for spectral imaging of colorectal tissues

    Browning, Craig M.; Mayes, Samuel; Rich, Thomas C.; Leavesley, Silas J.

    2017-02-01

    The gold standard for locating colonic polyps is a white light endoscope in a colonoscopy, however, polyps smaller than 5 mm can be easily missed. Modified procedures such as narrow band imaging have shown only marginal increases in detection rates. Spectral imaging is a potential solution to improve the sensitivity and specificity of colonoscopies by providing the ability to distinguish molecular fluorescence differences in tissues. The goal of this work is to implement a spectral endoscopic light source to acquire spectral image data of colorectal tissues. A beta-version endoscope light source was developed, by retrofitting a white light endoscope light source (Olympus, CLK-4) with 16 narrow band LEDs. This redesigned, beta-prototype uses high-power LEDs with a minimum output of 500 mW to provide sufficient spectral output (0.5 mW) through the endoscope. A mounting apparatus was designed to provide sufficient heat dissipation. Here, we report recent results of our tests to characterize the intensity output through the light source and endoscope to determine the flat spectral output for imaging and intensity losses through the endoscope. We also report preliminary spectral imaging data from transverse pig colon that demonstrates the ability to result in working practical spectral data. Preliminary results of this revised prototype spectral endoscope system demonstrate that there is sufficient power to allow the imaging process to continue and potentially determine spectral differences in cancerous and normal tissue from imaging ex vivo pairs. Future work will focus on building a spectral library for the colorectal region and refining the user interface the system for in vivo use.

  11. 21 CFR 884.4100 - Endoscopic electrocautery and accessories.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endoscopic electrocautery and accessories. 884... Surgical Devices § 884.4100 Endoscopic electrocautery and accessories. (a) Identification. An endoscopic electrocautery is a device used to perform female sterilization under endoscopic observation. It is designed to...

  12. Artery of Percheron infarction after endoscopic pituitary surgery.

    Aryan, Saritha; Thakar, Sumit; Hegde, A S

    2016-10-01

    Infarction in the artery of Percheron territory is a rare phenomenon in which occlusion of an unpaired perforating artery arising from the P1 segment on one side results in infarcts in the bilateral paramedian thalami with or without midbrain infarcts. We describe the case of a 40-year-old male who developed this complication following re-exploratory trans-sphenoidal surgery for a pituitary adenoma. In this first report of its kind in endoscopic pituitary surgery, the pathogenesis and clinico-radiological features of this rare vascular event are discussed.

  13. Endoscopic approaches to treatment of achalasia

    Friedel, David; Modayil, Rani; Iqbal, Shahzad; Grendell, James H.

    2013-01-01

    Endoscopic therapy for achalasia is directed at disrupting or weakening the lower esophageal sphincter (LES). The two most commonly utilized endoscopic interventions are large balloon pneumatic dilation (PD) and botulinum toxin injection (BTI). These interventions have been extensively scrutinized and compared with each other as well as with surgical disruption (myotomy) of the LES. PD is generally more effective in improving dysphagia in achalasia than BTI, with the latter reserved for infirm older people, and PD may approach treatment results attained with myotomy. However, PD may need to be repeated. Small balloon dilation and endoscopic stent placement for achalasia have only been used in select centers. Per oral endoscopic myotomy is a newer endoscopic modality that will likely change the treatment paradigm for achalasia. It arose from the field of natural orifice transluminal endoscopic surgery and represents a scarless endoscopic approach to Heller myotomy. This is a technique that requires extensive training and preparation and thus there should be rigorous accreditation and monitoring of outcomes to ensure safety and efficacy. PMID:23503707

  14. Endoscopic management of bleeding peptic ulcers

    Farooqi, J.I.; Farooqi, R.J.

    2001-01-01

    Peptic ulcers account for more than half of the cases of non variceal upper gastrointestinal (GI) bleeding and therefore, are the focus of most of the methods of endoscopic hemostasis. Surgical intervention is now largely reserved for patients in whom endoscopic hemostasis has failed. A variety of endoscopic techniques have been employed to stop bleeding and reduce the risk of rebleeding, with no major differences in outcome between these methods. These include injection therapy, fibrin injection, heater probe, mono polar electrocautery, bipolar electrocautery, lasers and mechanical hemo clipping. The most important factor in determining outcome after gastrointestinal bleeding is rebleeding or persistent bleeding. The endoscopic appearance of an ulcer, however, provides the most useful prognostic information for bleeding. Recurrent bleeding after initial endoscopic hemostasis occurs in 15-20% of patients with a bleeding peptic ulcer. The best approach to these patients remains controversial; the current options are repeat endoscopic therapy with the same or a different technique, emergency surgery or semi elective surgery after repeat endoscopic hemostasis. The combination of epinephrine injection with thermal coagulation may be more effective than epinephrine injection alone. Newer modalities such as fibrin injection or the application of hemo clips appear promising and comparative studies are awaited. (author)

  15. Visual recognition of age class and preference for infantile features: implications for species-specific vs universal cognitive traits in primates.

    Anna Sato

    Full Text Available Despite not knowing the exact age of individuals, humans can estimate their rough age using age-related physical features. Nonhuman primates show some age-related physical features; however, the cognitive traits underlying their recognition of age class have not been revealed. Here, we tested the ability of two species of Old World monkey, Japanese macaques (JM and Campbell's monkeys (CM, to spontaneously discriminate age classes using visual paired comparison (VPC tasks based on the two distinct categories of infant and adult images. First, VPCs were conducted in JM subjects using conspecific JM stimuli. When analyzing the side of the first look, JM subjects significantly looked more often at novel images. Based on analyses of total looking durations, JM subjects looked at a novel infant image longer than they looked at a familiar adult image, suggesting the ability to spontaneously discriminate between the two age classes and a preference for infant over adult images. Next, VPCs were tested in CM subjects using heterospecific JM stimuli. CM subjects showed no difference in the side of their first look, but looked at infant JM images longer than they looked at adult images; the fact that CMs were totally naïve to JMs suggested that the attractiveness of infant images transcends species differences. This is the first report of visual age class recognition and a preference for infant over adult images in nonhuman primates. Our results suggest not only species-specific processing for age class recognition but also the evolutionary origins of the instinctive human perception of baby cuteness schema, proposed by the ethologist Konrad Lorenz.

  16. Periapical Cemento-osseous Dysplasia Is Rarely Diagnosed on Orthopantomograms of Patients with Neurofibromatosis Type 1 and Is Not a Gender-specific Feature of the Disease.

    Friedrich, Reinhard E; Reul, Anika

    2018-04-01

    Several skeletal aberrations of the skull have been described for the tumor predisposition syndrome neurofibromatosis type 1 (NF1). Recently, periapical cemental/cemento-osseous dysplasia (COD) has been described in females affected with NF1. This reactive lesion of the hard tissues in tooth-bearing areas of the jaw has been proposed to represent a gender-specific radiological feature of NF1. The aim of this study was to investigate the prevalence of COD in patients with NF1. The orthopantomograms (OPGs) of 179 patients with a confirmed diagnosis of NF1 were analyzed for COD. The results were compared to radiographic findings obtained in OPGs of age- and sex-matched controls. The NF1 patient group was further differentiated according to the evidence of facial plexiform neurofibroma. COD was a very rare finding in both groups. The extension of the diagnostic criteria including radiologically-healthy teeth and a widened periodontal gap in the periapical area only marginally increased the number of considered cases. Although there was a somewhat more common occurrence of such changes in the patient group compared to the control group and the number of affected women was greater than the number of men, none of these differences reached statistical significance. Furthermore, COD or widening of the periradicular periodontal space was not found to be associated with facial tumor type in NF1. The investigation revealed that COD is not a diagnostic feature of NF1. There is no clear association of the rare finding of COD with gender. These studies should be compared with patient groups of other ethnic backgrounds. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  17. The Implications of Endoscopic Ulcer in Early Gastric Cancer: Can We Predict Clinical Behaviors from Endoscopy?

    Yoo Jin Lee

    Full Text Available The presence of ulcer in early gastric cancer (EGC is important for the feasibility of endoscopic resection, only a few studies have examined the clinicopathological implications of endoscopic ulcer in EGC.To determine the role of endoscopic ulcer as a predictor of clinical behaviors in EGC.Data of 3,270 patients with EGC who underwent surgery between January 2005 and December 2012 were reviewed. Clinicopathological characteristics were analyzed in relation to the presence and stage of ulcer in EGC. Based on endoscopic findings, the stage of ulcer was categorized as active, healing, or scar. Logistic regression analysis was performed to analyze factors associated with lymph node metastasis (LNM.2,343 (71.7% patients had endoscopic findings of ulceration in EGC. Submucosal (SM invasion, LNM, lymphovascular invasion (LVI, perineural invasion, and undifferentiated-type histology were significantly higher in ulcerative than non-ulcerative EGC. Comparison across different stages of ulcer revealed that SM invasion, LNM, and LVI were significantly associated with the active stage, and that these features exhibited significant stage-based differences, being most common at the active stage, and least common at the scar stage. The presence of endoscopic ulcer and active status of the ulcer were identified as independent risk factors for LNM.Ulcerative EGC detected by endoscopy exhibited more aggressive behaviors than non-ulcerative EGC. Additionally, the endoscopic stage of ulcer may predict the clinicopathological behaviors of EGC. Therefore, the appearance of ulcers should be carefully evaluated to determine an adequate treatment strategy for EGC.

  18. Prospective assessment of disease-specific quality of life in adults with eosinophilic esophagitis.

    Stern, E; Taft, T; Zalewski, A; Gonsalves, N; Hirano, I

    2017-10-27

    Eosinophilic esophagitis (EoE) is an important cause of upper gastrointestinal dysfunction in children and adults. The EoE-quality of life (QOL)-A was validated as a disease-specific measure of quality of life in EoE. This study characterized the extent of QOL concerns in a cohort of adult EoE patients and delineated the relationships between QOL and other disease activity measures. One hundred sixty-seven patients enrolled in this prospective cohort study. Patients with established and suspected EoE undergoing endoscopy at a single university-based medical center were recruited. EoE was diagnosed on the basis of the clinical criteria and histologic demonstration of ≥15 eos/hpf while on proton pump inhibition therapy. Sixty five patients undergoing repeat endoscopy during the enrollment period participated twice. Patients provided demographic information and completed symptom assessments and the EoE-QOL-A. Analyses included comparisons with overall QOL as well as QOL subscales. Outcome measures included endoscopic activity using a validated instrument, the EoE Endoscopic Reference Score, and histology. Overall QOL was significantly correlated with dysphagia frequency, intensity, and severity (P food impaction in the last 30 days had significantly worse overall QOL (P = 0.009). There was no correlation between overall QOL and years since diagnosis, symptom duration, endoscopic features, or histologic findings. Patient symptoms correlated with endoscopic features of edema, rings, and stricture severity. Histologic activity was highly correlated with severity of endoscopic features. Patients who underwent repeat endoscopy with histologic response demonstrated improved eating and social QOL; however, overall QOL was unchanged. In adults with EoE, patient reported QOL is associated with symptom severity but not endoscopic or histologic features. Disease-specific QOL may complement parameters of biologic activity in the assessment of overall disease burden in EoE.

  19. [PACS-based endoscope image acquisition workstation].

    Liu, J B; Zhuang, T G

    2001-01-01

    A practical PACS-based Endoscope Image Acquisition Workstation is here introduced. By a Multimedia Video Card, the endoscope video is digitized and captured dynamically or statically into computer. This workstation realizes a variety of functions such as the endoscope video's acquisition and display, as well as the editing, processing, managing, storage, printing, communication of related information. Together with other medical image workstation, it can make up the image sources of PACS for hospitals. In addition, it can also act as an independent endoscopy diagnostic system.

  20. An examination of the relationship between the endoscopic appearance of duodenitis and the histological findings in patients with epigastric pain.

    Lewis, Stephen; Stableforth, William; Awasthi, Rachana; Awasthi, Ashish; Pitts, Narrie; Ottaway, Janet; Sherwood, Anthea; Robertson, Neil; Cochrane, Sean; Wilkinson, Stephen

    2012-01-01

    The endoscopic appearance of duodenitis is a common finding in patients undergoing endoscopy because of epigastric pain however, the relationship of the visual findings to histology is poorly defined. We set out to ascertain if there was a correlation between the endoscopic and histological appearances of the duodenal mucosa. Consecutive patients with epigastric pain referred for diagnostic gastroduodenoscopy were studied. The visual appearances of 'duodenitis' (erythema, erosions and sub-epithelial haemorrhage) were reported independently by two endoscopists. Duodenal biopsies were taken and assessed for: neutrophil infiltrate, mononuclear infiltrate, gastric metaplasia, villous atrophy and a breach in the mucosa. H pylori status was determined. Of the 93 patients with endoscopic features of duodenitis an increase in histological markers of inflammation was found in 75 (81%). However, histological inflammation was absent or minimal in 68 (73%). Conversely, biopsies from normal-looking mucosa revealed histological evidence of inflammation in 26 (27%). For patients with the endoscopic features of duodenitis the positive & negative predictive value for neutrophilic infiltrate was 39% and 98% respectively. Biopsies from erosions confirmed a breach in the mucosa in only 2 of 40 patients. Neutrophilic infiltrate occurred with NSAI ingestion and infection with H pylori. The endoscopic appearance of the duodenal mucosa is unreliable in determining the presence of histological inflammation. The endoscopic appearance of 'erosions' is not usually associated with a mucosal breach.

  1. Endoscopic Management of Pancreatic Fluid Collections in Children.

    Nabi, Zaheer; Talukdar, Rupjyoti; Reddy, D Nageshwar

    2017-07-15

    The incidence of acute pancreatitis in children has increased over the last few decades. The development of pancreatic fluid collection is not uncommon after severe acute pancreatitis, although its natural course in children and adolescents is poorly understood. Asymptomatic fluid collections can be safely observed without any intervention. However, the presence of clinically significant symptoms warrants the drainage of these fluid collections. Endoscopic management of pancreatic fluid collection is safe and effective in adults. The use of endoscopic ultrasound (EUS)-guided procedure has improved the efficacy and safety of drainage of pancreatic fluid collections, which have not been well studied in pediatric populations, barring a scant volume of small case series. Excellent results of EUS-guided drainage in adult patients also need to be verified in children and adolescents. Endoprostheses used to drain pancreatic fluid collections include plastic and metal stents. Metal stents have wider lumens and become clogged less often than plastic stents. Fully covered metal stents specifically designed for pancreatic fluid collection are available, and initial studies have shown encouraging results in adult patients. The future of endoscopic management of pancreatic fluid collection in children appears promising. Prospective studies with larger sample sizes are required to establish their definitive role in the pediatric age group.

  2. Endoscopic ultrasound, endoscopic sonoelastography, and strain ratio evaluation of lymph nodes with histology as gold standard

    Larsen, Michael Hareskov; Fristrup, Claus Wilki; Hansen, Tine Plato

    2012-01-01

    . Endoscopic sonoelastography (ESE) assesses the elasticity of lymph nodes and has been used to differentiate lymph nodes with promising results. The aim of this study was to evaluate the use of EUS, EUS - FNA, ESE, and ESE-strain ratio using histology as the gold standard. PATIENTS AND METHODS: Patients......, EUS - FNA and EUS - FNM were performed. The marked lymph node was isolated during surgery for histological examination. RESULTS: The marked lymph node was isolated for separate histological examination in 56 patients, of whom 22 (39 %) had malignant lymph nodes and 34 (61 %) had benign lymph nodes...... - FNM technique enabled the identification of a specific lymph node and thereby the use of histology as gold standard. ESE and ESE-strain ratio were no better than standard EUS in differentiating between malignant and benign lymph nodes in patients with resectable upper gastrointestinal cancer....

  3. An Integrated “Multi-Omics” Comparison of Embryo and Endosperm Tissue-Specific Features and Their Impact on Rice Seed Quality

    Marc Galland

    2017-11-01

    Full Text Available Although rice is a key crop species, few studies have addressed both rice seed physiological and nutritional quality, especially at the tissue level. In this study, an exhaustive “multi-omics” dataset on the mature rice seed was obtained by combining transcriptomics, label-free shotgun proteomics and metabolomics from embryo and endosperm, independently. These high-throughput analyses provide a new insight on the tissue-specificity related to rice seed quality. Foremost, we pinpointed that extensive post-transcriptional regulations occur at the end of rice seed development such that the embryo proteome becomes much more diversified than the endosperm proteome. Secondly, we observed that survival in the dry state in each seed compartment depends on contrasted metabolic and enzymatic apparatus in the embryo and the endosperm, respectively. Thirdly, it was remarkable to identify two different sets of starch biosynthesis enzymes as well as seed storage proteins (glutelins in both embryo and endosperm consistently with the supernumerary embryo hypothesis origin of the endosperm. The presence of a putative new glutelin with a possible embryonic favored abundance is described here for the first time. Finally, we quantified the rate of mRNA translation into proteins. Consistently, the embryonic panel of protein translation initiation factors is much more diverse than that of the endosperm. This work emphasizes the value of tissue-specificity-centered “multi-omics” study in the seed to highlight new features even from well-characterized pathways. It paves the way for future studies of critical genetic determinants of rice seed physiological and nutritional quality.

  4. Pan-cancer stratification of solid human epithelial tumors and cancer cell lines reveals commonalities and tissue-specific features of the CpG island methylator phenotype.

    Sánchez-Vega, Francisco; Gotea, Valer; Margolin, Gennady; Elnitski, Laura

    2015-01-01

    The term CpG island methylator phenotype (CIMP) has been used to describe widespread DNA hypermethylation at CpG-rich genomic regions affecting clinically distinct subsets of cancer patients. Even though there have been numerous studies of CIMP in individual cancer types, a uniform analysis across tissues is still lacking. We analyze genome-wide patterns of CpG island hypermethylation in 5,253 solid epithelial tumors from 15 cancer types from TCGA and 23 cancer cell lines from ENCODE. We identify differentially methylated loci that define CIMP+ and CIMP- samples, and we use unsupervised clustering to provide a robust molecular stratification of tumor methylomes for 12 cancer types and all cancer cell lines. With a minimal set of 89 discriminative loci, we demonstrate accurate pan-cancer separation of the 12 CIMP+/- subpopulations, based on their average levels of methylation. Tumor samples in different CIMP subclasses show distinctive correlations with gene expression profiles and recurrence of somatic mutations, copy number variations, and epigenetic silencing. Enrichment analyses indicate shared canonical pathways and upstream regulators for CIMP-targeted regions across cancer types. Furthermore, genomic alterations showing consistent associations with CIMP+/- status include genes involved in DNA repair, chromatin remodeling genes, and several histone methyltransferases. Associations of CIMP status with specific clinical features, including overall survival in several cancer types, highlight the importance of the CIMP+/- designation for individual tumor evaluation and personalized medicine. We present a comprehensive computational study of CIMP that reveals pan-cancer commonalities and tissue-specific differences underlying concurrent hypermethylation of CpG islands across tumors. Our stratification of solid tumors and cancer cell lines based on CIMP status is data-driven and agnostic to tumor type by design, which protects against known biases that have hindered

  5. Specific features of the recent accumulation of 137Cs in tree roots of forest ecosystems within the zone of radioactive contamination

    Shcheglov, Alexey; Tsvetnova, Ol'ga; Klyashtorin, Alexey; Popova, Evgenia

    2015-04-01

    Despite numerous studies of the accumulation of technogenic radionuclides in the root systems, no clear regularities of this process have been established. The tendencies found in the works of Russian and foreign researchers are rather discrepant. Some authors argue that the accumulation of radionuclides in the roots is more pronounced than that in the aboveground parts of the plants (Skovorodnikova, 2005; Romantseva, 2012; Sennerby et al., 1994; Mamikhin, 2002; Fircks et al., 2002}. Other works attest to a higher accumulation of radionuclides in the aboveground pars (Juznic et al., 1990; Chibowski, 2000; Zhianski et al., 2005), which is also typical of the stable isotopes of these elements, including 133Cs (Dong Jin Kang, YongJin Seo, Tsukasa Saito et al,2012). It is also stated that the accumulation of radionuclides in the aboveground and underground parts of plants may differ in dependence on the soil-ecological conditions and other factors (Kozhakhanov et al., 2011; Grabovskyi et al., 2013). The aim of our study was to evaluate the accumulation of 137Cs in the root systems of arboreal plants in forest ecosystems within the near zone of the Chernobyl fallout on the plots with similar soil and phytocenotic features. Pine and birch stands were studied within the 30-km-wide exclusion zone of the Chernobyl Nuclear Power Station in Ukraine in 1992-1993, when the density of the radioactive contamination of the upper (0-20 cm) layer with 137Cs reached 2153.8 kBq/m2), and in Bryansk oblast of Russia in 2013-2014, when the density of contamination varied from 1458.4 kBq/m2 (pine stand) to 2578.3 kBq/m2 (birch stand). The tree layer in these ecosystems was dominated by Pinus sylvestris (L.) and Betula pendula (Roth.), respectively. Quercus robur (L.), Picea abies (L.), and Sorbus aucuparia (L.) were also present. The specific activity of 137Cs was measured in the samples from the aboveground parts of model trees and their roots differentiated by size (0-3, 3-10, 10

  6. Myocardial deformation assessed by longitudinal strain. Chamber specific normative data for CMR-feature tracking from the German competence network for congenital heart defects

    Shang, Quanliang; Patel, Shivani; Danford, David A.; Kutty, Shelby; Steinmetz, Michael; Schuster, Andreas; Beerbaum, Philipp; Sarikouch, Samir

    2018-01-01

    Left ventricular two-dimensional global longitudinal strain (LS) is superior to ejection fraction (EF) as predictor of outcome. We provide reference data for atrial and ventricular global LS during childhood and adolescence by CMR feature tracking (FT). We prospectively enrolled 115 healthy subjects (56 male, mean age 12.4 ± 4.1 years) at a single institution. CMR consisted of standard two-dimensional steady-state free-precession acquisitions. CMR-FT was performed on ventricular horizontal long-axis images for derivation of right and left atrial (RA, LA) and right and left ventricular (RV, LV) peak global LS. End-diastolic volumes (EDVs) and EF were measured. Correlations were explored for LS with age, EDV and EF of each chamber. Mean±SD of LS (%) for RA, RV, LA and LV were 26.56±10.2, -17.96±5.4, 26.45±10.6 and -17.47±5, respectively. There was a positive correlation of LS in LA, LV, RA and RV with corresponding EF (all P<0.05); correlations with age were weak. Gender-wise differences were not significant for atrial and ventricular LS, strain rate and displacement. Inter- and intra-observer comparisons showed moderate agreements. Chamber-specific nomograms for paediatric atrial and ventricular LS are provided to serve as clinical reference, and to facilitate CMR-based deformation research. (orig.)

  7. Myocardial deformation assessed by longitudinal strain. Chamber specific normative data for CMR-feature tracking from the German competence network for congenital heart defects

    Shang, Quanliang [University of Nebraska College of Medicine, Children' s Hospital and Medical Center, Division of Pediatric Cardiology, Omaha, NE (United States); Central South University, Department of Radiology, Second Xiangya Hospital, Changsha, Hunan Province (China); Patel, Shivani; Danford, David A.; Kutty, Shelby [University of Nebraska College of Medicine, Children' s Hospital and Medical Center, Division of Pediatric Cardiology, Omaha, NE (United States); Steinmetz, Michael [Georg-August-University and German Centre for Cardiovascular Research (DZHK, Partner Site), Department of Paediatric Cardiology, Goettingen (Germany); Schuster, Andreas [Georg-August-University and German Centre for Cardiovascular Research (DZHK, Partner Site), Department of Cardiology and Pulmonology, Goettingen (Germany); Beerbaum, Philipp; Sarikouch, Samir [Hanover Medical School, Hanover (Germany)

    2018-03-15

    Left ventricular two-dimensional global longitudinal strain (LS) is superior to ejection fraction (EF) as predictor of outcome. We provide reference data for atrial and ventricular global LS during childhood and adolescence by CMR feature tracking (FT). We prospectively enrolled 115 healthy subjects (56 male, mean age 12.4 ± 4.1 years) at a single institution. CMR consisted of standard two-dimensional steady-state free-precession acquisitions. CMR-FT was performed on ventricular horizontal long-axis images for derivation of right and left atrial (RA, LA) and right and left ventricular (RV, LV) peak global LS. End-diastolic volumes (EDVs) and EF were measured. Correlations were explored for LS with age, EDV and EF of each chamber. Mean±SD of LS (%) for RA, RV, LA and LV were 26.56±10.2, -17.96±5.4, 26.45±10.6 and -17.47±5, respectively. There was a positive correlation of LS in LA, LV, RA and RV with corresponding EF (all P<0.05); correlations with age were weak. Gender-wise differences were not significant for atrial and ventricular LS, strain rate and displacement. Inter- and intra-observer comparisons showed moderate agreements. Chamber-specific nomograms for paediatric atrial and ventricular LS are provided to serve as clinical reference, and to facilitate CMR-based deformation research. (orig.)

  8. Sex-specific hormone receptors in urothelial carcinomas of the human urinary bladder: a comparative analysis of clinicopathological features and survival outcomes according to receptor expression.

    Tuygun, Can; Kankaya, Duygu; Imamoglu, Abdurrahim; Sertcelik, Ayse; Zengin, Kursad; Oktay, Murat; Sertcelik, Nurettin

    2011-01-01

    To investigate the expression of sex-specific hormone receptors in normal bladder urothelium and urothelial carcinomas (UCs) of the bladder, and to analyze clinicopathological features and survival outcomes according to receptor expression. We evaluated the clinical data and tumor specimens of 139 patients with bladder cancer (BC). In addition, 72 samples of normal urothelium were included. Immunohistochemistry was performed using streptavidin-biotin peroxidase method, a monoclonal androgen receptor (AR), and an estrogen receptor-β (ERβ) antibody on paraffin-embedded tissue sections. Expression levels of each receptor were assessed by evaluating 500 tumor cells for each case and the percentage of positively-stained nuclei was recorded. None of the 58 male control cases showed any AR and ERβ expression. Five (35, 71%) of the 14 female control cases expressed ERβ. Of the 139 patients with UCs, 71 (51, 07%) expressed AR (62 male vs. 9 female; P = 0.413) and 44 (31, 65%) (39 male vs. 5 female; P = 0.402) showed ERβ expression (P receptors alone cannot be responsible for gender differences in BC rates because they were expressed in similar rates in both sexes. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Specific features of NH{sub 3} and plasma-assisted MBE in the fabrication of III-N HEMT heterostructures

    Alexeev, A. N. [NTO ZAO (Russian Federation); Krasovitsky, D. M. [Svetlana-Rost ZAO (Russian Federation); Petrov, S. I., E-mail: petrov@semiteq.ru [NTO ZAO (Russian Federation); Chaly, V. P.; Mamaev, V. V. [Svetlana-Rost ZAO (Russian Federation); Sidorov, V. G. [St. Petersburg State Polytechnic University (Russian Federation)

    2015-01-15

    The specific features of how nitride HEMT heterostructures are produced by NH{sub 3} and plasma-assisted (PA) molecular-beam epitaxy (MBE) are considered. It is shown that the use of high-temperature AlN/AlGaN buffer layers grown with ammonia at extremely high temperatures (up to 1150°C) can drastically improve the structural perfection of the active GaN layers and reduce the dislocation density in these layers to values of 9 × 10{sup 8}−1 × 10{sup 9} cm{sup −2}. The use of buffer layers of this kind makes it possible to obtain high-quality GaN/AlGaN heterostructures by both methods. At the same time, in contrast to ammonia MBE which is difficult to apply at T < 500°C (because of the low efficiency of ammonia decomposition), PA MBE is rather effective at low temperatures, e.g., for the growth of InAlN layers lattice-matched with GaN. The results obtained in the MBE growth of AlN/AlGaN/GaN/InAlN heterostructures by both PA-MBE and NH{sub 3}-MBE with an extremely high ammonia flux are demonstrated.

  10. Cholangiography and endoscopic sphincterotomy in the ...

    Cholangiography and endoscopic sphincterotomy in the management of severe acute gallstone pancreatitis discovered at diag~osticlaparotomy. ... in these cases Included cholecystectomy and Ttube drainage (2 patients) cholecystostomy drainage (3 patients), and closure of the abdomen without drainage (2 patients).

  11. Endoscopic appearance of irradiated gastric mucosa

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

    1979-09-01

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

  12. Endoscopic third ventriculostomy versus ventriculoperitoneal shunt ...

    Patients' medical records, operative notes, and neural tube database records were used to complete a structured questionnaire. The difference in ... likely after 6 months. Keywords: obstructive hydrocephalus; endoscopic third ventriculostomy; ventriculoperitoneal shunt; children; paediatric surgery; neurosurgery; Ethiopia ...

  13. Endoscopic versus external approach dacryocystorhinostomy: A ...

    Endoscopic versus external approach dacryocystorhinostomy: A comparative analysis. Rinki Saha, Anuradha Sinha, Jyoti Prakash Phukan. Abstract. Background: Dacryocystorhinostomy (DCR) consists of creating a lacrimal drainage pathway to the nasal cavity to restore permanent drainage of previously obstructed ...

  14. Diagnosis and management of iatrogenic endoscopic perforations

    Paspatis, Gregorios A; Dumonceau, Jean-Marc; Barthet, Marc

    2014-01-01

    This Position Paper is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the diagnosis and management of iatrogenic perforation occurring during diagnostic or therapeutic digestive endoscopic procedures. Main recommendations 1 ESGE recommends that ea...

  15. PULMONARY HEMORRHAGE. ENDOSCOPIC DIAGNOSIS AND TREATMENT

    A. M. Gasanov

    2016-01-01

    Full Text Available In the article, we report the incidence and etiology of pulmonary hemorrhage, and modern classifications according to the literature data. Methods of endoscopic diagnosis and treatment of pulmonary hemorrhage are analyzed.

  16. Incidence and features of eosinophilic esophagitis in dysphagia: a prospective observational study.

    Murray, Iain Alexander; Joyce, Stephne; Palmer, Joanne; Lau, Michael; Schultz, Michael

    2016-03-01

    The incidence and symptoms associated with eosinophilic esophagitis (EoE) varies with geographic location, present in 7-15% dysphagic European or North American adults. We aimed to determine incidence and features of EoE in a dysphagic New Zealand population. 101 consecutive patients presenting with dysphagia to a New Zealand teaching hospital completed a questionnaire (demographics and history) before upper gastrointestinal endoscopy and esophageal biopsies. The incidence of EoE was 14.1% in those having esophageal biopsies. Patients with EoE were younger (median age 38 years, cohort 58 years: OR 9.2 for age ≤ 40; p dysphagia and history of allergy/atopy occurred with almost identical frequency in those with and without EoE. Classic endoscopic features of EoE had a sensitivity and specificity of 30.6 and 93.2%, respectively. EoE occurs in an adult dysphagic population in New Zealand with similar frequency to that reported in Europe and North America. Demographics and features of history associated with EoE are described and the need to take esophageal biopsies in this population emphasized by the relatively low sensitivity of endoscopic features for the condition.

  17. Current Status of Peroral Endoscopic Myotomy

    Cho, Young Kwan; Kim, Seong Hwan

    2018-01-01

    Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic ...

  18. An unusual experience with endoscopic retrograde cholangiopancreatography

    Mallikarjun Patil

    2013-01-01

    Full Text Available The endoscopic retrograde cholangiopancreatography (ERCP is known for its varied diagnostic and therapeutic utility for a variety of disorders. However it has greater likelihood of procedure related complications among the endoscopic procedures of gastrointestinal tract. The extraluminal hemorrhagic complications following ERCP are potentially life threatening though relatively rare. We present a 50 year patient with choledocholithiasis and cholelithiasis developing rare complication of subcapsular hepatic hematoma, following ERCP due to guide wire injury.

  19. Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study).

    van den Broek, Frank J C; de Graaf, Eelco J R; Dijkgraaf, Marcel G W; Reitsma, Johannes B; Haringsma, Jelle; Timmer, Robin; Weusten, Bas L A M; Gerhards, Michael F; Consten, Esther C J; Schwartz, Matthijs P; Boom, Maarten J; Derksen, Erik J; Bijnen, A Bart; Davids, Paul H P; Hoff, Christiaan; van Dullemen, Hendrik M; Heine, G Dimitri N; van der Linde, Klaas; Jansen, Jeroen M; Mallant-Hent, Rosalie C H; Breumelhof, Ronald; Geldof, Han; Hardwick, James C H; Doornebosch, Pascal G; Depla, Annekatrien C T M; Ernst, Miranda F; van Munster, Ivo P; de Hingh, Ignace H J T; Schoon, Erik J; Bemelman, Willem A; Fockens, Paul; Dekker, Evelien

    2009-03-13

    Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM). If equally effective, EMR might be a more cost-effective approach as this strategy does not require expensive equipment, general anesthesia and hospital admission. Furthermore, EMR appears to be associated with fewer complications.The aim of this study is to compare the cost-effectiveness and cost-utility of TEM and EMR for the resection of large rectal adenomas. Multicenter randomized trial among 15 hospitals in the Netherlands. Patients with a rectal adenoma > or = 3 cm, located between 1-15 cm ab ano, will be randomized to a TEM- or EMR-treatment strategy. For TEM, patients will be treated under general anesthesia, adenomas will be dissected en-bloc by a full-thickness excision, and patients will be admitted to the hospital. For EMR, no or conscious sedation is used, lesions will be resected through the submucosal plane in a piecemeal fashion, and patients will be discharged from the hospital. Residual adenoma that is visible during the first surveillance endoscopy at 3 months will be removed endoscopically in both treatment strategies and is considered as part of the primary treatment. Primary outcome measure is the proportion of patients with recurrence after 3 months. Secondary outcome measures are: 2) number of days not spent in hospital from initial treatment until 2 years afterwards; 3) major and minor morbidity; 4) disease specific and general quality of life; 5) anorectal function; 6) health care utilization and costs. A cost-effectiveness and cost-utility analysis of EMR against TEM for large rectal adenomas will be performed from a societal perspective with respectively the costs per recurrence free patient and the cost per quality adjusted life year as outcome measures. Based on comparable recurrence rates for TEM and EMR of 3.3% and considering an upper-limit of 10

  20. Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study

    Geldof Han

    2009-03-01

    Full Text Available Abstract Background Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM. If equally effective, EMR might be a more cost-effective approach as this strategy does not require expensive equipment, general anesthesia and hospital admission. Furthermore, EMR appears to be associated with fewer complications. The aim of this study is to compare the cost-effectiveness and cost-utility of TEM and EMR for the resection of large rectal adenomas. Methods/design Multicenter randomized trial among 15 hospitals in the Netherlands. Patients with a rectal adenoma ≥ 3 cm, located between 1–15 cm ab ano, will be randomized to a TEM- or EMR-treatment strategy. For TEM, patients will be treated under general anesthesia, adenomas will be dissected en-bloc by a full-thickness excision, and patients will be admitted to the hospital. For EMR, no or conscious sedation is used, lesions will be resected through the submucosal plane in a piecemeal fashion, and patients will be discharged from the hospital. Residual adenoma that is visible during the first surveillance endoscopy at 3 months will be removed endoscopically in both treatment strategies and is considered as part of the primary treatment. Primary outcome measure is the proportion of patients with recurrence after 3 months. Secondary outcome measures are: 2 number of days not spent in hospital from initial treatment until 2 years afterwards; 3 major and minor morbidity; 4 disease specific and general quality of life; 5 anorectal function; 6 health care utilization and costs. A cost-effectiveness and cost-utility analysis of EMR against TEM for large rectal adenomas will be performed from a societal perspective with respectively the costs per recurrence free patient and the cost per quality adjusted life year as outcome measures. Based on comparable recurrence rates for TEM and EMR

  1. The specific features of gold ore provinces of the south of Siberia in a magnetic field at ground height and heights of flight of satellite Champ.

    Litvinova, Tamara; Petrova, Alevtina

    2010-05-01

    The specific features of gold ore provinces of the south of Siberia in a magnetic field at ground height and heights of flight of satellite Champ. T.Litvinova -All-Russian Geological Research Institute (VSEGEI) A. Petrova - St. Petersburg, SPbF IZMIRAN, Russian Academy of Sciences, St. Petersburg For allocation of specific features known gold ore objects (Olimpiadninskoje, Suchoi Log, etc.) is executed the morphological analysis of the magnetic field received on materials of aeromagnetic data and satellite measurements at heights of 100 and 400 km. On the ground data on a map of magnetic anomalies of Russia of scale 1:2 500000 of 50 km on the extended structures crossing known gold ore deposits and promising ore units have been constructed geomagnetic and densitys sections up to depth. On geomagnetic and densitys sections to known large gold ore to deposits are dated deep synvertical the permeable zones described by a synlenticular -layered structure. Extended horizons of not magnetic formations are located on depths about 10, 12, 15-18, 30 and 40 km. On deep densitys sections reference sites ¬ the Suchoi Log, Olimpiadninskoje and Vodorazdelnoje ¬ is characterized by zones of inversion of density. Areas of the loosened breeds are dated to synvertical to deep zones of hydrothermal and fluid study of breeds inside which the loosened lenses in intervals of depths from 2 up to 5 km are formed, 8-13 km, 18-20 and 25-30 km of 35-40 km within the limits of the bottom bark. The analysis of a magnetic field has shown, that gold mineralization in researched region is dated for zones of long-living regional explosive infringements, to permeable terrigenous to thicknesses of depressions, to adjournment depression structures in units of crossing of tectonofluid zones of diagonal orientation. Terrigenous adjournment depression structures are shown on a geomagnetic section as the powerful deflections filled with low-magnetic thicknesses. These deflections are dated to

  2. Specific Features of Executive Dysfunction in Alzheimer-Type Mild Dementia Based on Computerized Cambridge Neuropsychological Test Automated Battery (CANTAB) Test Results.

    Kuzmickienė, Jurgita; Kaubrys, Gintaras

    2016-10-08

    BACKGROUND The primary manifestation of Alzheimer's disease (AD) is decline in memory. Dysexecutive symptoms have tremendous impact on functional activities and quality of life. Data regarding frontal-executive dysfunction in mild AD are controversial. The aim of this study was to assess the presence and specific features of executive dysfunction in mild AD based on Cambridge Neuropsychological Test Automated Battery (CANTAB) results. MATERIAL AND METHODS Fifty newly diagnosed, treatment-naïve, mild, late-onset AD patients (MMSE ≥20, AD group) and 25 control subjects (CG group) were recruited in this prospective, cross-sectional study. The CANTAB tests CRT, SOC, PAL, SWM were used for in-depth cognitive assessment. Comparisons were performed using the t test or Mann-Whitney U test, as appropriate. Correlations were evaluated by Pearson r or Spearman R. Statistical significance was set at p<0.05. RESULTS AD and CG groups did not differ according to age, education, gender, or depression. Few differences were found between groups in the SOC test for performance measures: Mean moves (minimum 3 moves): AD (Rank Sum=2227), CG (Rank Sum=623), p<0.001. However, all SOC test time measures differed significantly between groups: SOC Mean subsequent thinking time (4 moves): AD (Rank Sum=2406), CG (Rank Sum=444), p<0.001. Correlations were weak between executive function (SOC) and episodic/working memory (PAL, SWM) (R=0.01-0.38) or attention/psychomotor speed (CRT) (R=0.02-0.37). CONCLUSIONS Frontal-executive functions are impaired in mild AD patients. Executive dysfunction is highly prominent in time measures, but minimal in performance measures. Executive disorders do not correlate with a decline in episodic and working memory or psychomotor speed in mild AD.

  3. [Immunohistochemical study of the specific features of expression of matrix metalloproteinases 1, 9 in the photoaged skin, the foci of actinic keratosis and basal cell carcinoma].

    Kuznetsova, E V; Snarskaya, E S; Zavalishina, L E; Tkachenko, S B

    Matrix metalloproteinases (MMPs) mediate the degradation of all types of collagens and other extracellular matrix components (elastin, proteoglycans, and laminin), their synthesis and accumulation play a key role in the hydrolysis of basement membrane. MMPs are involved in a wide range of proteolytic processes in the presence of different physiological and pathological changes, including inflammation, wound healing, angiogenesis, and carcinogenesis. to study the specific features of MMP-1 and MMP-9 expression in different stages of skin photoaging, in the foci of actinic keratosis and basal cell carcinoma by immunohistochemical examination. 12 samples of the healthy skin (6 samples of the eyelid skin with Glogau grade II photoaging; 6 ones of eyelid skin with Glogau grades III-IV photoaging) and biopsies from 8 foci of actinic keratosis and from 8 ones of basal cell carcinoma were examined. A positive reaction to MMPs was shown as different brown staining intensity in the cytoplasm of keratinocytes/tumor cells. MMP-1 and MMP-9 expression was recorded in 67% of the histological specimens of the Glogau grade III photoaged skin and in 100% of those of Glogau grade IV. In the foci of actinic keratosis, the expression of MMP-1 was observed in 62.5% of cases and that of MMP-9 was seen in 87.5%. In basal cell carcinoma, the expression of MMP-1 and MMP-9 was detected in all investigated samples. The immunomorphological findings are indicative of the important role of the level of MMP-1 and MMP-9 expression that is associated with the degree of progression of skin photoaging processes. Minimal MMP-1 and MMP-9 expression was recorded even in grades III-IV photoaging and in the foci of actinic keratosis. Intense MMP-1 and MMP-9 expression was detected in malignant skin epithelial neoplasms as different clinicomorphological types of basal cell carcinoma.

  4. Management of odontogenic cysts by endonasal endoscopic techniques: A systematic review and case series.

    Marino, Michael J; Luong, Amber; Yao, William C; Citardi, Martin J

    2018-01-01

    Odontogenic cysts and tumors of the maxilla may be amendable to management by endonasal endoscopic techniques, which may reduce the morbidity associated with open procedures and avoid difficult reconstruction. To perform a systematic review that evaluates the feasibility and outcomes of endoscopic techniques in the management of different odontogenic cysts. A case series of our experience with these minimally invasive techniques was assembled for insight into the technical aspects of these procedures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to identify English-language studies that reported the use of endoscopic techniques in the management of odontogenic cysts. Several medical literature data bases were searched for all occurrences in the title or abstract of the terms "odontogenic" and "endoscopic" between January 1, 1950, and October 1, 2016. Publications were evaluated for the technique used, histopathology, complications, recurrences, and the follow-up period. A case series of patients who presented to a tertiary rhinology clinic and who underwent treatment of odontogenic cysts by an endoscopic technique was included. A systematic review identified 16 case reports or series that described the use of endoscopic techniques for the treatment of odontogenic cysts, including 45 total patients. Histopathologies encountered were radicular (n = 16) and dentigerous cysts (n = 10), and keratocystic odontogenic tumor (n = 12). There were no reported recurrences or major complications for a mean follow-up of 29 months. A case series of patients in our institution identified seven patients without recurrence for a mean follow-up of 10 months. Endonasal endoscopic treatment of various odontogenic cysts are described in the literature and are associated with effective treatment of these lesions for an average follow-up period of >2 years. These techniques have the potential to reduce morbidity associated with the resection of these

  5. Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

    F.J.C. van den Broek (Frank); E.J.R. de Graaf (Eelco); M.G.W. Dijkgraaf (Marcel); J.B. Reitsma (Johannes); J. Haringsma (Jelle); R. Timmer (Robin); B.L. Weusten (Bas); M.F. Gerhards (Michael); E.C. Consten (Esther); M.P. Schwartz (Matthijs); M.J. Boom (Maarten); E.J. Derksen (Erik); A.B. Bijnen (Bart); P.H.P. Davids (Paul); C. Hoff (Christiaan); H.M. van Dullemen (Hendrik); G.D.N. Heine (Dimitri); K. van der Linde (Klaas); J.M. Jansen (Jeroen); R.C.H. Mallant-Hent (Rosalie); R. Breumelhof (Ronald); H. Geldof (Han); J.C. Hardwick (James); P. Doornebosch (Pascal); A.C.T.M. Depla (Annekatrien); M.F. Ernst (Miranda); I.P. van Munster (Ivo); I.H.J.T. de Hingh (Ignace); E.J. Schoon (Erik); W.A. Bemelman (Willem); P. Fockens (Paul); E. Dekker (Evelien)

    2009-01-01

    textabstractBackground: Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM). If equally effective, EMR might be a more cost-effective approach as this strategy does

  6. Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

    van den Broek, Frank J. C.; de Graaf, Eelco J. R.; Dijkgraaf, Marcel G. W.; Haringsma, Jelle; Timmer, Robin; Weusten, Bas L. A. M.; Gerhards, Michael F.; Consten, Esther C. J.; Schwartz, Matthijs P.; Boom, Maarten J.; Derksen, Erik J.; Bijnen, A. Bart; Davids, Paul H. P.; Hoff, Christiaan; van Dullemen, Hendrik M.; Heine, G. Dimitri N.; van der Linde, Klaas; Jansen, Jeroen M.; Mallant-Hent, Rosalie C. H.; Breumelhof, Ronald; Geldof, Han; Hardwick, James C. H.; Doornebosch, Pascal G.; Depla, Annekatrien C. T. M.; Ernst, Miranda F.; van Munster, Ivo P.; de Hingh, Ignace H. J. T.; Schoon, Erik J.; Bemelman, Willem A.; Fockens, Paul; Dekker, Evelien; Reitsma, J.

    2009-01-01

    Background: Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM). If equally effective, EMR might be a more cost-effective approach as this strategy does not require

  7. Foot-controlled robotic-enabled endoscope holder for endoscopic sinus surgery: A cadaveric feasibility study.

    Chan, Jason Y K; Leung, Iris; Navarro-Alarcon, David; Lin, Weiyang; Li, Peng; Lee, Dennis L Y; Liu, Yun-hui; Tong, Michael C F

    2016-03-01

    To evaluate the feasibility of a unique prototype foot-controlled robotic-enabled endoscope holder (FREE) in functional endoscopic sinus surgery. Cadaveric study. Using human cadavers, we investigated the feasibility, advantages, and disadvantages of the robotic endoscope holder in performing endoscopic sinus surgery with two hands in five cadaver heads, mimicking a single nostril three-handed technique. The FREE robot is relatively easy to use. Setup was quick, taking less than 3 minutes from docking the robot at the head of the bed to visualizing the middle meatus. The unit is also relatively small, takes up little space, and currently has four degrees of freedom. The learning curve for using the foot control was short. The use of both hands was not hindered by the presence of the endoscope in the nasal cavity. The tremor filtration also aided in the smooth movement of the endoscope, with minimal collisions. The FREE endoscope holder in an ex-vivo cadaver test corroborated the feasibility of the robotic prototype, which allows for a two-handed approach to surgery equal to a single nostril three-handed technique without the holder that may reduce operating time. Further studies will be needed to evaluate its safety profile and use in other areas of endoscopic surgery. NA. Laryngoscope, 126:566-569, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  8. Measurement of distances between anatomical structures using a translating stage with mounted endoscope

    Kahrs, Lueder A.; Blachon, Gregoire S.; Balachandran, Ramya; Fitzpatrick, J. Michael; Labadie, Robert F.

    2012-02-01

    During endoscopic procedures it is often desirable to determine the distance between anatomical features. One such clinical application is percutaneous cochlear implantation (PCI), which is a minimally invasive approach to the cochlea via a single, straight drill path and can be achieved accurately using bone-implanted markers and customized microstereotactic frame. During clinical studies to validate PCI, traditional open-field cochlear implant surgery was performed and prior to completion of the surgery, a customized microstereotactic frame designed to achieve the desired PCI trajectory was attached to the bone-implanted markers. To determine whether this trajectory would have safely achieved the target, a sham drill bit is passed through the frame to ensure that the drill bit would reach the cochlea without damaging vital structures. Because of limited access within the facial recess, the distances from the bit to anatomical features could not be measured with calipers. We hypothesized that an endoscope mounted on a sliding stage that translates only along the trajectory, would provide sufficient triangulation to accurately measure these distances. In this paper, the design, fabrication, and testing of such a system is described. The endoscope is mounted so that its optical axis is approximately aligned with the trajectory. Several images are acquired as the stage is moved, and threedimensional reconstruction of selected points allows determination of distances. This concept also has applicability in a large variety of rigid endoscopic interventions including bronchoscopy, laparoscopy, and sinus endoscopy.

  9. Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohn's disease with fecal calprotectin

    Juan María Vázquez-Morón

    Full Text Available Background: Fecal biomarkers, especially fecal calprotectin, are useful for predicting endoscopic activity in Crohn's disease; however, the cut-off point remains unclear. The aim of this paper was to analyze whether faecal calprotectin and M2 pyruvate kinase are good tools for generating highly accurate scores for the prediction of the state of endoscopic activity and mucosal healing. Methods: The simple endoscopic score for Crohn's disease and the Crohn's disease activity index was calculated for 71 patients diagnosed with Crohn's. Fecal calprotectin and M2-PK were measured by the enzyme-linked immunosorbent assay test. Results: A fecal calprotectin cut-off concentration of ≥ 170 µg/g (sensitivity 77.6%, specificity 95.5% and likelihood ratio +17.06 predicts a high probability of endoscopic activity, and a fecal calprotectin cut-off of ≤ 71 µg/g (sensitivity 95.9%, specificity 52.3% and likelihood ratio -0.08 predicts a high probability of mucosal healing. Three clinical groups were identified according to the data obtained: endoscopic activity (calprotectin ≥ 170, mucosal healing (calprotectin ≤ 71 and uncertainty (71 > calprotectin < 170, with significant differences in endoscopic values (F = 26.407, p < 0.01. Clinical activity or remission modified the probabilities of presenting endoscopic activity (100% vs 89% or mucosal healing (75% vs 87% in the diagnostic scores generated. M2-PK was insufficiently accurate to determine scores. Conclusions: The highly accurate scores for fecal calprotectin provide a useful tool for interpreting the probabilities of presenting endoscopic activity or mucosal healing, and are valuable in the specific clinical context.

  10. Medical requirements for design of endoscopes for otolaryngology

    Parekh, Jai; Pankratov, Michail M.; Poe, Dennis S.; Rebeiz, Elie E.; Shapshay, Stanley M.

    1993-07-01

    Endoscopy has revolutionized the field of medicine and surgery by aiding the clinician in diagnostic and therapeutic modalities of patient care. Endoscopy in Otolaryngology has provided the surgeon with unique access to areas of the head and neck which were previously inaccessible for direct inspection in an atraumatic and minimally invasive fashion. Specific areas of Otolaryngology where endoscopy has made advances are the rhinology and otology. The relevant anatomy, clinical requirements, and `state of the art' endoscopic techniques are discussed for these areas. Further advances in endoscopy for otolaryngology requires the cooperation from both the clinical and technical standpoints.

  11. Towards automated visual flexible endoscope navigation.

    van der Stap, Nanda; van der Heijden, Ferdinand; Broeders, Ivo A M J

    2013-10-01

    The design of flexible endoscopes has not changed significantly in the past 50 years. A trend is observed towards a wider application of flexible endoscopes with an increasing role in complex intraluminal therapeutic procedures. The nonintuitive and nonergonomical steering mechanism now forms a barrier in the extension of flexible endoscope applications. Automating the navigation of endoscopes could be a solution for this problem. This paper summarizes the current state of the art in image-based navigation algorithms. The objectives are to find the most promising navigation system(s) to date and to indicate fields for further research. A systematic literature search was performed using three general search terms in two medical-technological literature databases. Papers were included according to the inclusion criteria. A total of 135 papers were analyzed. Ultimately, 26 were included. Navigation often is based on visual information, which means steering the endoscope using the images that the endoscope produces. Two main techniques are described: lumen centralization and visual odometry. Although the research results are promising, no successful, commercially available automated flexible endoscopy system exists to date. Automated systems that employ conventional flexible endoscopes show the most promising prospects in terms of cost and applicability. To produce such a system, the research focus should lie on finding low-cost mechatronics and technologically robust steering algorithms. Additional functionality and increased efficiency can be obtained through software development. The first priority is to find real-time, robust steering algorithms. These algorithms need to handle bubbles, motion blur, and other image artifacts without disrupting the steering process.

  12. Training in Endoscopy: Endoscopic Ultrasound

    Chang Min Cho

    2017-07-01

    Full Text Available Endoscopic ultrasound (EUS has been recently established as an indispensable modality for the diagnosis and management of pancreatobiliary and gastrointestinal (GI disorders. EUS proficiency requires both cognitive and technical abilities, including an understanding of the appropriate indications, the performance of appropriate evaluations before and after the procedure, and the management of procedure-related complications. An increasing demand for skills to handle a growing range of interventional EUS procedures and a continual shortage of EUS training programs are two major obstacles for EUS training. Acquiring the skills necessary to comprehend and conduct EUS often requires training beyond the scope of a standard GI fellowship program. In addition to traditional formal EUS training and preceptorships, regular short-term intensive EUS training programs that provide training at various levels may help EUS practitioners improve and maintain EUS-related knowledges and skills. Theoretical knowledge can be acquired from lectures, textbooks, atlases, slides, videotapes, digital video discs, interactive compact discs, and websites. Informal EUS training is generally based on 1- or 2-day intensive seminars, including didactic lectures, skills demonstrated by expert practitioners through live video-streaming of procedures, and hands-on learning using animal or phantom models.

  13. Endoscopic treatment of prepatellar bursitis.

    Huang, Yu-Chih; Yeh, Wen-Lin

    2011-03-01

    Operative treatment of prepatellar bursitis is indicated in intractable bursitis. The most common complication of surgical treatment for prepatellar bursitis is skin problems. For traumatic prepatellar bursitis, we propose a protocol of outpatient endoscopic surgery under local anaesthesia. From September 1996 to February 2001, 60 cases of failed nonoperative treatment for prepatellar bursitis were included. The average age was 33.5 ± 11.1 years (range 21-55). The average operation duration was 18 minutes. Two to three mini-arthroscopic portals were used in our series. No sutures or a simple suture was needed for the portals after operation. After follow-up for an average of 36.3 months, all patients are were symptom-free and had regained knee function. None of the population had local tenderness or hypo-aesthesia around their wound. Their radiographic and sonographic examinations showed no recurrence of bursitis. Outpatient arthroscopic bursectomy under local anaesthesia is an effective procedure for the treatment of post-traumatic prepatellar bursitis after failed conservative treatments. Both the cosmetic results and functional results were satisfactory.

  14. Endoscopic surgery of nasopharyngeal angiofibroma

    Machado, Silvio

    2010-06-01

    Full Text Available Introduction: Juvenile nasopharyngeal angiofibroma (NAJ is a tumor with vascular component, slow growing, benign but very aggressive because of its local invasiveness. The NAJ is rare, accounting for 0.05% of all head and neck cancers. The classic triad of epistaxis, unilateral nasal obstruction and a mass in the nasopharynx suggests the diagnosis of NAJ and is then supplemented by imaging. Over the past 10 years the treatment of this disease has been discussed with the aim of designing a management protocol. Currently, surgery appears to be the best treatment of the NAJ. Other methods such as hormone therapy, radiotherapy and chemotherapy treatment modalities are now used occasionally as complementary treatments. Objective: To present the cases of this disease in the Hospital Infantil between October 2007 and August 2008. Methods: A retrospective case study of five cases of NAJ underwent surgery solely with endoscopic technique of two surgeons. Classifieds between IIA and IIIA. All patients underwent angiography with embolization of the tumor 3-4 days before surgery. Follow-up after surgery to detect recurrence. Results: There were two relapses in the following two years after surgery. Conclusion: Given the short period of patient follow-up, there were only two relapses in one year. So there is need for further action to claim that this technique has a low recurrence rate, since the recurrence is probably related to incomplete resection the initial tumor.

  15. NOViSE: a virtual natural orifice transluminal endoscopic surgery simulator.

    Korzeniowski, Przemyslaw; Barrow, Alastair; Sodergren, Mikael H; Hald, Niels; Bello, Fernando

    2016-12-01

    Natural orifice transluminal endoscopic surgery (NOTES) is a novel technique in minimally invasive surgery whereby a flexible endoscope is inserted via a natural orifice to gain access to the abdominal cavity, leaving no external scars. This innovative use of flexible endoscopy creates many new challenges and is associated with a steep learning curve for clinicians. We developed NOViSE-the first force-feedback-enabled virtual reality simulator for NOTES training supporting a flexible endoscope. The haptic device is custom-built, and the behaviour of the virtual flexible endoscope is based on an established theoretical framework-the Cosserat theory of elastic rods. We present the application of NOViSE to the simulation of a hybrid trans-gastric cholecystectomy procedure. Preliminary results of face, content and construct validation have previously shown that NOViSE delivers the required level of realism for training of endoscopic manipulation skills specific to NOTES. VR simulation of NOTES procedures can contribute to surgical training and improve the educational experience without putting patients at risk, raising ethical issues or requiring expensive animal or cadaver facilities. In the context of an experimental technique, NOViSE could potentially facilitate NOTES development and contribute to its wider use by keeping practitioners up to date with this novel surgical technique. NOViSE is a first prototype, and the initial results indicate that it provides promising foundations for further development.

  16. Interactive navigation-guided ophthalmic plastic surgery: navigation enabling of telescopes and their use in endoscopic lacrimal surgeries

    Ali MJ

    2016-11-01

    Full Text Available Mohammad Javed Ali,1 Swati Singh,1 Milind N Naik,1 Swathi Kaliki,2 Tarjani Vivek Dave1 1The Institute of Dacryology, 2The Operation Eyesight Universal Institute for Eye Cancer, L.V. Prasad Eye Institute, Hyderabad, India Purpose: The aims of this study were to report the preliminary experience of using telescopes, which were enabled for navigation guidance, and their utility in complex endoscopic lacrimal surgeries. Methods: Navigation enabling of the telescope was achieved by using the AxiEM™ malleable neuronavigation shunt stylet. Image-guided dacryolocalization was performed in five patients using the intraoperative image-guided StealthStation™ system in the electromagnetic mode. The “look ahead” protocol software was used to assist the surgeon in assessing the intraoperative geometric location of the endoscope and what lies ahead in real time. All patients underwent navigation-guided powered endoscopic dacryocystorhinostomy. The utility of uninterrupted navigation guidance throughout the surgery with the endoscope as the navigating tool was noted. Results: Intraoperative geometric localization of the lacrimal sac and the nasolacrimal duct could be easily deciphered. Constant orientation of the lacrimal drainage system and the peri-lacrimal anatomy was possible without the need for repeated point localizations throughout the surgery. The “look ahead” features could accurately alert the surgeon of anatomical structures that exists at 5, 10 and 15 mm in front of the endoscope. Good securing of the shunt stylet with the telescope was found to be essential for constant and accurate navigation. Conclusion: Navigation-enabled endoscopes provide the surgeon with the advantage of sustained stereotactic anatomical awareness at all times during the surgery. Keywords: telescope, endoscope, image guidance, navigation, lacrimal surgery, powered endoscopic DCR

  17. Preliminary Safety Analysis of the Gorleben Site: Safety Concept and Application to Scenario Development Based on a Site-Specific Features, Events and Processes (FEP) Database - 13304

    Moenig, Joerg; Beuth, Thomas; Wolf, Jens [Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) mbH, Theodor-Heuss-Str. 4, D-38122 Braunschweig (Germany); Lommerzheim, Andre [DBE TECHNOLOGY GmbH, Eschenstr. 55, D-31224 Peine (Germany); Mrugalla, Sabine [Federal Institute for Geosciences and Natural Resources (BGR), Stilleweg 2, D-30655 Hannover (Germany)

    2013-07-01

    Based upon the German safety criteria, released in 2010 by the Federal Ministry of the Environment (BMU), a safety concept and a safety assessment concept for the disposal of heat-generating high-level waste have both been developed in the framework of the preliminary safety case for the Gorleben site (Project VSG). The main objective of the disposal is to contain the radioactive waste inside a defined rock zone, which is called containment-providing rock zone. The radionuclides shall remain essentially at the emplacement site, and at the most, a small defined quantity of material shall be able to leave this rock zone. This shall be accomplished by the geological barrier and a technical barrier system, which is required to seal the inevitable penetration of the geological barrier by the construction of the mine. The safe containment has to be demonstrated for probable and less probable evolutions of the site, while evolutions with very low probability (less than 1 % over the demonstration period of 1 million years) need not to be considered. Owing to the uncertainty in predicting the real evolution of the site, plausible scenarios have been derived in a systematic manner. Therefore, a comprehensive site-specific features, events and processes (FEP) data base for the Gorleben site has been developed. The safety concept was directly taken into account, e.g. by identification of FEP with direct influence on the barriers that provide the containment. No effort was spared to identify the interactions of the FEP, their probabilities of occurrence, and their characteristics (values). The information stored in the data base provided the basis for the development of scenarios. The scenario development methodology is based on FEP related to an impairment of the functionality of a subset of barriers, called initial barriers. By taking these FEP into account in their probable characteristics the reference scenario is derived. Thus, the reference scenario describes a

  18. Fluorescence-Raman Dual Modal Endoscopic System for Multiplexed Molecular Diagnostics

    Jeong, Sinyoung; Kim, Yong-Il; Kang, Homan; Kim, Gunsung; Cha, Myeong Geun; Chang, Hyejin; Jung, Kyung Oh; Kim, Young-Hwa; Jun, Bong-Hyun; Hwang, Do Won; Lee, Yun-Sang; Youn, Hyewon; Lee, Yoon-Sik; Kang, Keon Wook; Lee, Dong Soo; Jeong, Dae Hong

    2015-03-01

    Optical endoscopic imaging, which was recently equipped with bioluminescence, fluorescence, and Raman scattering, allows minimally invasive real-time detection of pathologies on the surface of hollow organs. To characterize pathologic lesions in a multiplexed way, we developed a dual modal fluorescence-Raman endomicroscopic system (FRES), which used fluorescence and surface-enhanced Raman scattering nanoprobes (F-SERS dots). Real-time, in vivo, and multiple target detection of a specific cancer was successful, based on the fast imaging capability of fluorescence signals and the multiplex capability of simultaneously detected SERS signals using an optical fiber bundle for intraoperative endoscopic system. Human epidermal growth factor receptor 2 (HER2) and epidermal growth factor receptor (EGFR) on the breast cancer xenografts in a mouse orthotopic model were successfully detected in a multiplexed way, illustrating the potential of FRES as a molecular diagnostic instrument that enables real-time tumor characterization of receptors during routine endoscopic procedures.

  19. Diagnosis of recurrent gastric cancer at the surgical anastomosis with endoscopic US

    Lightdale, C.J.; Botet, J.F.; Brennan, M.F.; Coit, D.G.; Knapper, W.H.; Bains, M.S.

    1988-01-01

    Endoscopic US was used to examine 40 patients following resection of gastric cancer, all with CT scans negative for recurrence in the area of the surgical anastomosis. Endoscopic US was performed with the Olympus GF-UM2/EU-M2 7.5-MHz system. There were 24 patients proved by endoscopy (n = 18) or surgery (n = six) to have anastomotic recurrence and 16 without recurrence (follow-up, 6-11 months). Endoscopic US correctly identified 23 of 24 patients with anastomotic recurrence, with one false-negative study, and absence of recurrence in 13 of 16, with three false-positive studies. The sensitivity was 95%, the specificity 80%, the positive accuracy 88%, and the negative predictive accuracy 92%

  20. Transgastric pure-NOTES peritoneoscopy and endoscopic ultrasonography for staging of gastrointestinal cancers

    Donatsky, Anders Meller; Vilmann, Peter; Meisner, Søren

    2012-01-01

    BACKGROUND: Human natural orifice transluminal endoscopic surgery (NOTES) has mainly been based on simultaneous laparoscopic assistance (hybrid NOTES), forgoing the theoretical benefits of the NOTES technique. This is due to a lack of NOTES-specific instruments and endoscopes, making pure-NOTES...... procedures difficult and time consuming. An area where pure NOTES could be adopted at its present stage of development is minimally invasive staging of gastrointestinal (GI) cancer. The aim of this study is to evaluate the feasibility of combining transgastric (TG) pure-NOTES peritoneoscopy...... and intraperitoneal endoscopic ultrasonography (ip-EUS) with intraluminal EUS (il-EUS) for peritoneal evaluation. METHODS: This was a feasibility and survival study where il-EUS followed by ip-EUS and peritoneoscopy was performed in 10 pigs subjected to TG pure NOTES. A score was given with regard to achieved...

  1. Reliability in endoscopic diagnosis of portal hypertensive gastropathy

    de Macedo, George Fred Soares; Ferreira, Fabio Gonçalves; Ribeiro, Maurício Alves; Szutan, Luiz Arnaldo; Assef, Mauricio Saab; Rossini, Lucio Giovanni Battista

    2013-01-01

    AIM: To analyze reliability among endoscopists in diagnosing portal hypertensive gastropathy (PHG) and to determine which criteria from the most utilized classifications are the most suitable. METHODS: From January to July 2009, in an academic quaternary referral center at Santa Casa of São Paulo Endoscopy Service, Brazil, we performed this single-center prospective study. In this period, we included 100 patients, including 50 sequential patients who had portal hypertension of various etiologies; who were previously diagnosed based on clinical, laboratory and imaging exams; and who presented with esophageal varices. In addition, our study included 50 sequential patients who had dyspeptic symptoms and were referred for upper digestive endoscopy without portal hypertension. All subjects underwent upper digestive endoscopy, and the images of the exam were digitally recorded. Five endoscopists with more than 15 years of experience answered an electronic questionnaire, which included endoscopic criteria from the 3 most commonly used Portal Hypertensive Gastropathy classifications (McCormack, NIEC and Baveno) and the presence of elevated or flat antral erosive gastritis. All five endoscopists were blinded to the patients’ clinical information, and all images of varices were deliberately excluded for the analysis. RESULTS: The three most common etiologies of portal hypertension were schistosomiasis (36%), alcoholic cirrhosis (20%) and viral cirrhosis (14%). Of the 50 patients with portal hypertension, 84% were Child A, 12% were Child B, 4% were Child C, 64% exhibited previous variceal bleeding and 66% were previously endoscopic treated. The endoscopic parameters, presence or absence of mosaic-like pattern, red point lesions and cherry-red spots were associated with high inter-observer reliability and high specificity for diagnosing Portal Hypertensive Gastropathy. Sensitivity, specificity and reliability for the diagnosis of PHG (%) were as follows: mosaic-like pattern

  2. Nasal encephalocele: endoscopic excision with anesthetic consideration.

    Abdel-Aziz, Mosaad; El-Bosraty, Hussam; Qotb, Mohamed; El-Hamamsy, Mostafa; El-Sonbaty, Mohamed; Abdel-Badie, Hazem; Zynabdeen, Mustapha

    2010-08-01

    Nasal encephalocele may presents as a nasal mass, its treatment is surgical and it should be done early in life. When removal is indicated, there are multiple surgical approaches; including lateral rhinotomy, a transnasal approach and a coronal flap approach. However, the treatment of a basal intranasal encephalocele using transnasal endoscopic approach could obviates the possible morbidity associated with other approaches. The aim of this study was to evaluate the efficacy of endoscopic removal of intranasal encephalocele, also to document the role of anesthetist in the operative and postoperative periods. Nine cases with nasal encephalocele were included in this study; CT and/or MRI were used in their examination. The lesions were removed via transnasal endoscopic approach. Preoperative evaluation, intervention and postoperative follow-up were presented with discussion of anesthesia used for those children. The lesions of all patients were removed successfully with no recurrence through the follow-up period of at least 21 months. No cases showed morbidity or mortality intra- or post-operatively. Endoscopic excision of intranasal encephalocele is an effective method with high success rate. Anesthetist plays an important role in the operative and postoperative period, even during the endoscopic follow up; sedation of the children is usually needed. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Endoscopic and laparoscopic treatment of gastroesophageal reflux.

    Watson, David I; Immanuel, Arul

    2010-04-01

    Gastroesophageal reflux is extremely common in Western countries. For selected patients, there is an established role for the surgical treatment of reflux, and possibly an emerging role for endoscopic antireflux procedures. Randomized trials have compared medical versus surgical management, laparoscopic versus open surgery and partial versus total fundoplications. However, the evidence base for endoscopic procedures is limited to some small sham-controlled studies, and cohort studies with short-term follow-up. Laparoscopic fundoplication has been shown to be an effective antireflux operation. It facilitates quicker convalescence and is associated with fewer complications, but has a similar longer term outcome compared with open antireflux surgery. In most randomized trials, antireflux surgery achieves at least as good control of reflux as medical therapy, and these studies support a wider application of surgery for the treatment of moderate-to-severe reflux. Laparoscopic partial fundoplication is an effective surgical procedure with fewer side effects, and it may achieve high rates of patient satisfaction at late follow-up. Many of the early endoscopic antireflux procedures have failed to achieve effective reflux control, and they have been withdrawn from the market. Newer procedures have the potential to fashion a surgical fundoplication. However, at present there is insufficient evidence to establish the safety and efficacy of endoscopic procedures for the treatment of gastroesophageal reflux, and no endoscopic procedure has achieved equivalent reflux control to that achieved by surgical fundoplication.

  4. [Natural Orifice Transluminal Endoscopic Surgery (NOTES)].

    Kim, Yong Sik; Kim, Chul Young; Chun, Hoon Jai

    2008-03-01

    Recently, the field of gastrointestinal endoscopy is developing rapidly. Once limited to the gastroinstestinal lumen, the endoscopic technology is now breaking the barriers and extending its boundary to peritoneal and pleural space. In 2004, Dr. Kalloo, a gastroenterologist, observed intraperitoneal organs of a pig using a conventional endoscope through the stomach wall. Since then, new endoscopic technique of intraperitoneal intervention with transluminal approach named the Natural Orifice Transluminal Endoscopic Surgery or NOTES has been introduced. NOTES reaches the target organ by inserting the endoscope through a natural orifice (e.g. mouth, anus, vagina, urethra) and entering the peritoneal lumen by means of making an incision on the luminal wall. After a series of successful experiences in animal studies, NOTES are now being tried on human subjects. There are still many obstacles to overcome, but bright future for this new technology is expected because of its proposed advantages of less pain, lower complication rate, short recovery time, and scarless access. In this review, we plan to learn about NOTES.

  5. Limits of the endoscopic transnasal transtubercular approach.

    Gellner, Verena; Tomazic, Peter V

    2018-06-01

    The endoscopic transnasal trans-sphenoidal transtubercular approach has become a standard alternative approach to neurosurgical transcranial routes for lesions of the anterior skull base in particular pathologies of the anterior tubercle, sphenoid plane, and midline lesions up to the interpeduncular cistern. For both the endoscopic and the transcranial approach indications must strictly be evaluated and tailored to the patients' morphology and condition. The purpose of this review was to evaluate the evidence in literature of the limitations of the endoscopic transtubercular approach. A PubMed/Medline search was conducted in January 2018 entering following keywords. Upon initial screening 7 papers were included in this review. There are several other papers describing the endoscopic transtubercular approach (ETTA). We tried to list the limitation factors according to the actual existing literature as cited. The main limiting factors are laterally extending lesions in relation to the optic canal and vascular encasement and/or unfavorable tumor tissue consistency. The ETTA is considered as a high level transnasal endoscopic extended skull base approach and requires excellent training, skills and experience.

  6. Transanal endoscopic microsurgery: a New Zealand experience.

    Bloomfield, Ian; Van Dalen, Roelof; Lolohea, Simione; Wu, Linus

    2017-12-03

    Transanal endoscopic microsurgery (TEMS) is a proven alternative therapy to either radical surgery or endoscopic mucosal resection for rectal neoplasms. It has proven benefits with lower morbidity and mortality compared with total mesorectal excision, and a lower local recurrence rate when compared to endoscopic mucosal techniques. A retrospective data collection of TEMS procedures performed through Waikato District Health Board, New Zealand, from 2010 to 2015 was conducted. Supportive follow-up data were sourced from patient records and from local centres around New Zealand. A total of 137 procedures were performed over the study period, with five being repeat procedures. Procedures were mostly performed for benign lesions (66.4%) with an overall complication rate of 15.3%, only five of which were Clavien-Dindo grade III (3.6%). Our local recurrence rate after resection of benign lesions was 5.1%. Our data set demonstrates the TEMS procedure to be safe compared to radical resection (total mesorectal excision) for sessile rectal lesions. Close endoscopic follow-up is recommended, especially for close or incomplete margins. Good therapeutic results can be obtained for appropriately selected early malignant lesions. TEMS provides better oncological results than endoscopic mucosal resection or transanal excision. © 2017 Royal Australasian College of Surgeons.

  7. 21 CFR 876.4300 - Endoscopic electrosurgical unit and accessories.

    2010-04-01

    ... Endoscopic electrosurgical unit and accessories. (a) Identification. An endoscopic electrosurgical unit and... device includes the electrosurgical generator, patient plate, electric biopsy forceps, electrode, flexible snare, electrosurgical alarm system, electrosurgical power supply unit, electrical clamp, self...

  8. Endoscopic Radial Artery Harvest for Coronary Artery Bypass Surgery

    Kuan-Ming Chiu

    2006-01-01

    Conclusion: Endoscopic harvest of the radial artery is technically demanding, but excellent results can be achieved. The endoscopic approach can provide suitable conduits in a less invasive way than the open harvest technique.

  9. Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

    Burgmans, J.P.J.

    2015-01-01

    The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair

  10. Virtual reality training for endoscopic surgery : composing a validated training program for basic skills

    van Dongen, Koen Willem

    2010-01-01

    Endoscopic surgery demands different specific psychomotor skills than open surgery. Virtual reality simulation training has the potential to be a valuable tool in training these skills, because simulation provides the opportunity to train psychomotor skills in a safe environment. In addition to

  11. Percutaneous endoscopic gastrostomy in children

    Jye Hae Park

    2011-01-01

    Full Text Available Purpose: Percutaneous endoscopic gastrostomy (PEG can improve nutritional status and reduce the amount of time needed to feed neurologically impaired children. We evaluated the characteristics, complications, and outcomes of neurologically impaired children treated with PEG. Methods: We retrospectively reviewed the records of 32 neurologically impaired children who underwent PEG between March 2002 and August 2008 at our medical center. Forty-two PEG procedures comprising 32 PEG insertions and 10 PEG exchanges, were performed. The mean follow-up time was 12.2 (6.6 months. Results: Mean patient age was 9.4 (4.5 years. The main indications for PEG insertion were swallowing difficulty with GI bleeding due to nasogastric tube placement and/or the presence of gastroesophageal reflux disease (GERD. The overall rate of complications was 47%, with early complications evident in 25% of patients and late complications in 22%. The late complications included one gastro-colic fistula, two cases of aggravated GERD, and four instances of wound infection. Among the 15 patients with histological evidence of GERD before PEG, 13 (87% had less severe GERD, experienced no new aspiration events, and showed increased body weight after PEG treatment. Conclusion: PEG is a safe, effective, and relatively simple technique affording long-term enteral nutritional support in neurologically impaired children. Following PEG treatment, the body weight of most patients increased and the levels of vomiting, GI bleeding, and aspiration fell. We suggest that PEG with post-procedural observation be considered for enteral nutritional support of neurologically impaired children.

  12. Cost-effectiveness of endoscopic ultrasonography, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in patients suspected of pancreaticobiliary disease

    Ainsworth, A P; Rafaelsen, S R; Wamberg, P A

    2004-01-01

    BACKGROUND: It is not known whether initial endoscopic ultrasonography (EUS) or magnetic resonance cholangiopancreatography (MRCP) is more cost effective than endoscopic retrograde cholangiopancreatography (ERCP). METHODS: A cost-effectiveness analysis of EUS, MRCP and ERCP was performed on 163...

  13. Endoscopic management of peripancreatic fluid collections.

    Goyal, Jatinder; Ramesh, Jayapal

    2015-07-01

    Peripancreatic fluid collections are a well-known complication of pancreatitis and can vary from fluid-filled collections to entirely necrotic collections. Although most of the fluid-filled pseudocysts tend to resolve spontaneously with conservative management, intervention is necessary in symptomatic patients. Open surgery has been the traditional treatment modality of choice though endoscopic, laparoscopic and transcutaneous techniques offer alternative drainage approaches. During the last decade, improvement in endoscopic ultrasound technology has enabled real-time access and drainage of fluid collections that were previously not amenable to blind transmural drainage. This has initiated a trend towards use of this modality for treatment of pseudocysts. In this review, we have summarised the existing evidence for endoscopic drainage of peripancreatic fluid collections from published studies.

  14. Diagnosis and treatment with endoscopic retrograde cholangiopancreatography

    Soendenaa, K.; Horn, A.; Viste, A.

    1994-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) was carried out for the first time in 1968. Five years later endoscopic sphincterotomy was performed. Since then both modalities have become established as necessary adjuncts in the diagnosis and treatment of patients with pathology in the bile duct or pancreas. The main indication is common bile duct stone, and as a consequence of this treatment fewer patients are now treated surgically. Patients with malignant bile duct obstruction can be given reasonable palliation of both jaundice and pruritus and therefore improved quality of life. Some reports indicate that endoscopic drainage may be useful for pancreatic stenosis. Complications are few, but vigilance and prompt treatment is necessary to keep morbidity at a minimum. Follow-up after several years shows that sphincterotomy is successful also in the long term. The authors discuss the present diagnostic and therapeutic situation. 31 refs., 2 tabs

  15. Endoscopic facial skeletal surgery using a neuronavigator.

    Sakai, Y; Kobayashi, S; Watanabe, E; Sekiya, S; Ohmori, K

    1996-09-01

    In the reconstruction of asymmetrical deformities of the facial skeleton, both an endoscope and a neuronavigator have been used. The endoscope allows the surgeon a wide view of the object on a television monitor, reduces the scarring, minimizes the undermined field, and reduces the need to work blind. The neuronavigator is a frameless computed tomographic stereotactic device that has been mainly used in neurosurgery. The device is easy to use and can offer the surgeon three-dimensional coordinates of the status during the operation. We have used this new technique in three clinical cases, two involving augmentation of the zygomatic bone on one side and one involving reduction of the frontal bone on one side. The surgical techniques we used and the versatility of both the endoscope and the neuronavigator are discussed herein based on our own experience.

  16. Endoscopic and Photodynamic Therapy of Cholangiocarcinoma.

    Meier, Benjamin; Caca, Karel

    2016-12-01

    Most patients with cholangiocarcinoma (CCA) have unresectable disease. Endoscopic bile duct drainage is one of the major objectives of palliation of obstructive jaundice. Stent implantation using endoscopic retrograde cholangiography is considered to be the standard technique. Unilateral versus bilateral stenting is associated with different advantages and disadvantages; however, a standard approach is still not defined. As there are various kinds of stents, there is an ongoing discussion on which stent to use in which situation. Palliation of obstructive jaundice can be augmented through the use of photodynamic therapy (PDT). Studies have shown a prolonged survival for the combinations of PDT and different stent applications as well as combinations of PDT and additional systemic chemotherapy. More well-designed studies are needed to better evaluate and standardize endoscopic treatment of unresectable CCA.

  17. Post-endoscopic biliary sphincterotomy bleeding: an interventional radiology approach.

    Dunne, Ruth

    2013-12-01

    Endoscopic sphincterotomy is an integral component of endoscopic retrograde cholangiopancreatography. Post-sphincterotomy hemorrhage is a recognized complication. First line treatment involves a variety of endoscopic techniques performed at the time of sphincterotomy. If these are not successful, transcatheter arterial embolization or open surgical vessel ligation are therapeutic considerations.

  18. Endoscopic release for carpal tunnel syndrome.

    Vasiliadis, Haris S; Georgoulas, Petros; Shrier, Ian; Salanti, Georgia; Scholten, Rob J P M

    2014-01-31

    Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extremity. It is caused by increased pressure on the median nerve between the transverse carpal ligament and the carpal bones. Surgical treatment consists of the release of the nerve by cutting the transverse carpal ligament. This can be done either with an open approach or endoscopically. To assess the effectiveness and safety of the endoscopic techniques of carpal tunnel release compared to any other surgical intervention for the treatment of CTS. More specifically, to evaluate the relative impact of endoscopic techniques in relieving symptoms, producing functional recovery (return to work and return to daily activities) and reducing complication rates. This review fully incorporates the results of searches conducted up to 5 November 2012, when we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE and EMBASE. There were no language restrictions. We reviewed the reference lists of relevant articles and contacted trial authors. We also searched trial registers for ongoing trials. We performed a preliminary screen of searches to November 2013 to identify any additional recent publications. We included any randomised controlled trials (RCTs) and quasi-RCTs comparing endoscopic carpal tunnel release (ECTR) with any other surgical intervention for the treatment of CTS. We used standard methodological procedures expected by the Cochrane Collaboration. Twenty-eight studies (2586 hands) were included. Twenty-three studies compared ECTR to standard open carpal tunnel release (OCTR), five studies compared ECTR with OCTR using a modified incision, and two studies used a three-arm design to compare ECTR, standard OCTR and modified OCTR.At short-term follow-up (three months or less), only one study provided data for overall improvement. We found no differences on the Symptom Severity Scale (SSS) (scale zero to five) (five studies, standardised mean

  19. Endoscopic monitoring the estrous phase of Arabian mares with assaying its biopsy

    Mohamed Fathi

    2017-01-01

    Full Text Available Objective: To evaluate the changes occur in the vagina, cervix and endometrium during the pre- ovulatory period in Arabian mares by using endoscope as a diagnostic tool as well as the availability of taking an endoscopic biopsy during this stage.Methods: Ten cyclic and healthy arabian mares were subjected to ultrasound scanning of their ovaries to estimate the diameter of the preovulatory follicles, collection of blood samples for estimating the hormonal levels (Estradiol-17 β and progestrone for confirming the estrous phase, endoscopic monitoring their vagina, cervix and endometrium, the availability of taking biopsical samples and histological examination of the obtained samples.Results: The obtained data revealed that, the mean diameter of the preovulatory follicles was (3.95±0.34 cm, the plasma estradiol and progestrone levels were (85.98±5.26 pg/mL and (0.73±0.23 ng/mL, respectively, endoscopic monitoring the vagina, cervix and endometrium revealed hyperemic vaginal mucous membrane, soft and opened cervical ostium with abundant estrous mucous and folding, hyperemic and edematous appearance of the endometrium, respectively and the histological features of the biopsical endometrial samples revealed that, The lamina propria-sub mucosa was packed with simple or branched tubular glands lined with simple columnar epithelium showing oval or rounded dark nuclei with different degrees of secretory activities of the glands.Conclusions: The endoscope proved to be a reliable tool for confirming the estrous phase in mares and monitoring the gross features of the vagina, the cervix and the endometrium, in addition to the availability of taking biopsical smears.

  20. ENDOSCOPIC TECHNOLOGIES IN EARLY RECTAL CANCER TREATMENT

    D. V. Samsonov

    2015-01-01

    Full Text Available Total mesorectal excision is the “golden standard” of surgical treatment for rectal cancer. Development of endoscopic technologies allowed to implement the benefits of minimally invasive surgery in early rectal cancer treatment, decrease morbidity and mortality, improve functional outcome and quality of life. Oncological safety of this method is still a subject for discussion due to lack of lymph node harvest. Endoscopic operations for early rectal cancer are being actively implemented in daily practice, but lack of experience does not allow to include this method in national clinical prac-tice guidelines.

  1. Endoscopic management of acute peptic ulcer bleeding.

    Lu, Yidan; Chen, Yen-I; Barkun, Alan

    2014-12-01

    This review discusses the indications, technical aspects, and comparative effectiveness of the endoscopic treatment of upper gastrointestinal bleeding caused by peptic ulcer. Pre-endoscopic considerations, such as the use of prokinetics and timing of endoscopy, are reviewed. In addition, this article examines aspects of postendoscopic care such as the effectiveness, dosing, and duration of postendoscopic proton-pump inhibitors, Helicobacter pylori testing, and benefits of treatment in terms of preventing rebleeding; and the use of nonsteroidal anti-inflammatory drugs, antiplatelet agents, and oral anticoagulants, including direct thrombin and Xa inhibitors, following acute peptic ulcer bleeding. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. BRAF Mutation Is Associated With a Specific Cell Type With Features Suggestive of Senescence in Ovarian Serous Borderline (Atypical Proliferative) Tumors

    Zeppernick, Felix; Ardighieri, Laura; Hannibal, Charlotte G

    2014-01-01

    features could be reproduced in cultured epithelial cells by ectopic expression of BRAF(V600E). Senescence was further established by markers such as SA-β-gal staining, expression of p16 and p21, and reduction in DNA synthesis. In conclusion, this study sheds light on the pathogenesis of this unique group...

  3. A haptic interface for virtual simulation of endoscopic surgery.

    Rosenberg, L B; Stredney, D

    1996-01-01

    Virtual reality can be described as a convincingly realistic and naturally interactive simulation in which the user is given a first person illusion of being immersed within a computer generated environment While virtual reality systems offer great potential to reduce the cost and increase the quality of medical training, many technical challenges must be overcome before such simulation platforms offer effective alternatives to more traditional training means. A primary challenge in developing effective virtual reality systems is designing the human interface hardware which allows rich sensory information to be presented to users in natural ways. When simulating a given manual procedure, task specific human interface requirements dictate task specific human interface hardware. The following paper explores the design of human interface hardware that satisfies the task specific requirements of virtual reality simulation of Endoscopic surgical procedures. Design parameters were derived through direct cadaver studies and interviews with surgeons. Final hardware design is presented.

  4. Development of automated endoscopes for dimensional micro-measurements

    Hrebabetzky, Frank

    2013-04-01

    Increasing demands for product quality and outsourcing of production in the automobile industry lead to in­ creasingly tight tolerances for the components. In the area of metal-mechanics these are largely dimensional and require frequently uncertainties in the micron region. For optical instruments this means microscopical resolu­ tion. Dimensional measurement with uncertainties of some microns is nothing new, state of the art equipment in fact goes far below. The task becomes difficult if the measurements have to be carried out in an industrial production environment - and deep inside a bore hole. This paper describes the development of an automatic measurement system for internal dimensions of brake master cylinders, specifically the development of endoscopes, illuminations for edge detection, and integration with other sensors, actuators and controllers. The most demanding part was the endoscope development, because, surprisingly, no commercial product for microscopic view and precision measurements was found on the market. As the market for such measurement machines is very small, and as the requirements were different for each endoscope, the budget allowed only the development of prototypes, using readily available optical components. Borders between faces with different orientation of metallic structures can be difficult do detect. A satisfactory metrological performance can be achieved only with carefully shaped illumination, even if the source is a simple LED (light emitting diode). The automation was responsible for the largest part of the overall cost, coming from the desire for a high throughput of the measurement machine, even when operated by not highly qualified personnel. With the safety requirements satisfied, such a device ends up as a pretty complex equipment. Nevertheless, these aspects will be mentioned only for completeness, because standard components and methods were applied.

  5. An algorithm for improving the quality of structural images of turbid media in endoscopic optical coherence tomography

    Potlov, A. Yu.; Frolov, S. V.; Proskurin, S. G.

    2018-04-01

    High-quality OCT structural images reconstruction algorithm for endoscopic optical coherence tomography of biological tissue is described. The key features of the presented algorithm are: (1) raster scanning and averaging of adjacent Ascans and pixels; (2) speckle level minimization. The described algorithm can be used in the gastroenterology, urology, gynecology, otorhinolaryngology for mucous membranes and skin diagnostics in vivo and in situ.

  6. Does Low-Field Intraoperative Magnetic Resonance Improve the Results of Endoscopic Pituitary Surgery? Experience of the Implementation of a New Device in a Referral Center.

    García, Sergio; Reyes, Luis; Roldán, Pedro; Torales, Jorge; Halperin, Irene; Hanzu, Felicia; Langdon, Cristobal; Alobid, Isam; Enseñat, Joaquim

    2017-06-01

    To assess the contribution of low-field intraoperative magnetic resonance (iMRI) to endoscopic pituitary surgery. We analyzed a prospective series of patients undergoing endoscopic endonasal surgery for pituitary macroadenomas assisted with a low-field iMRI (PoleStarN30, 0.15 T [Medtronic]). Clinical, radiologic, and surgical variables were analyzed and compared with our fully endoscopic historic cohort operated on without iMRI assistance. A bibliographic review of pituitary surgery assisted with iMRI was conducted. Thirty patients (57% female; mean age, 55 years) were prospectively analyzed. The most frequent tumor subtype was nonfunctioning macroadenoma (50%). The average Knosp grade was 2.3 and mean tumor size was 18 mm. Surgical and positioning time were 102 and 47 minutes, respectively. Hospital stay and complication rates were similar to our historical cohort for pituitary surgery. Mean follow-up was 10 months. Complete resection (CR) was achieved in 83% of patients. Seven patients (23%) benefited from iMRI assistance and achieved a CR in their surgeries. All patients except 1 experienced hormonal activity remission. iMRI sensitivity and specificity was 0.8 and 1, respectively. Although not statistically significant, CR rates were globally 11.5% superior in iMRI series compared with our historical cohort. This difference was independent of cavernous sinus invasiveness grade (CR rate increased 12.5% for Knosp grade 0-2 and 8.1% for Knosp grade 3-4). Low-field iMRI is a useful and safe assistance even in advanced surgical techniques such as endoscopy. Its contribution is limited by the intrinsic features of the tumor. Further randomized studies are required to confirm the cost-effectiveness of iMRI in pituitary surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Proposal of a Budget-Friendly Camera Holder for Endoscopic Ear Surgery.

    Ozturan, Orhan; Yenigun, Alper; Aksoy, Fadlullah; Ertas, Burak

    2018-01-01

    Endoscopic ear surgery (EES) is increasingly a preferred technique in otologic society. It offers excellent visualization of the anatomical structures directly and behind the corners with variable angled telescopes. It also provides reduced operative morbidity due to being able to perform surgical interventions with less invasive approaches. Operative preparation and setup time and cost of endoscopy system are less expensive compared with surgical microscopes. On the other hand, the main disadvantage of EES is that the surgery has to be performed with 1 single hand. It is certainly restrictive for an ear surgeon who has been operating with 2 hands under otologic microscopic views for years and certainly requires a learning period and perseverance. Holding the endoscope by a second surgeon is not executable because of insufficient surgical space.Endoscope/camera holders have been developed for those who need the comfort and convenience afforded by double-handed microscopic ear surgery. An ideal endoscope holder should be easy-to-set up, easily controlled, providing a variety of angled views, allowing the surgeon to operate with 2 hands and, budget-friendly. In this article, a commercially available 11-inch magic arm camera holder is proposed by the authors to be used in EES due to its versatile, convenient, and budget-friendly features. It allows 2-handed EES through existing technology and is affordable for surgeons looking for a low-cost and practical solution.

  8. Endoscopic management of Atypical sellar cavernous hemangioma: A case report and review of the literature

    A.M. Al-Sharydah

    2018-01-01

    Conclusion: Seller cavernous hemangioma (SCH is an extremely rare lesion that can be misdiagnosed. It is characterized by clinico-radiological features similar to those of other lesions such as pituitary macroadenoma and should be included in the differential diagnosis. The endoscopic endonasal transsphenoidal (EET approach with subtotal/total resection appears to be a feasible option for debulking, with less surgical complications. Nonetheless, combining stereotactic radiosurgery will reduce postsurgical morbidities.

  9. Neuro-fuzzy Classification System for Wireless-Capsule Endoscopic Images

    Vassilis S. Kodogiannis; John N. Lygouras

    2008-01-01

    In this research study, an intelligent detection system to support medical diagnosis and detection of abnormal lesions by processing endoscopic images is presented. The images used in this study have been obtained using the M2A Swallowable Imaging Capsule - a patented, video color-imaging disposable capsule. Schemes have been developed to extract texture features from the fuzzy texture spectra in the chromatic and achromatic domains for a selected region of interest from ...

  10. Per-oral endoscopic myotomy: Major advance in achalasia treatment and in endoscopic surgery

    Friedel, David; Modayil, Rani; Stavropoulos, Stavros N

    2014-01-01

    Per-oral endoscopic myotomy (POEM) represents a natural orifice endoscopic surgery (NOTES) approach to laparoscopy Heller myotomy (LHM). POEM is arguably the most successful clinical application of NOTES. The growth of POEM from a single center in 2008 to approximately 60 centers worldwide in 2014 with several thousand procedures having been performed attests to the success of POEM. Initial efficacy, safety and acid reflux data suggest at least equivalence of POEM to LHM, the previous gold standard for achalasia therapy. Adjunctive techniques used in the West include impedance planimetry for real-time intraprocedural luminal assessment and endoscopic suturing for challenging mucosal defect closures during POEM. The impact of POEM extends beyond the realm of esophageal motility disorders as it is rapidly popularizing endoscopic submucosal dissection in the West and spawning offshoots that use the submucosal tunnel technique for a host of new indications ranging from resection of tumors to pyloromyotomy for gastroparesis. PMID:25548473

  11. Specific features of acoustic properties of ceramic Bi1.4Pb0.6Ca2Sr2Cu3Oy

    Gajduk, A.L.; Fil', V.D.; Burma, N.G.

    1991-01-01

    Anomalies of sound velocity and attenuation, as well as of heat capacity are revealed in the Pb-stabilized Bi ceramics of the composition 2-2-2-3 atare 60 K, which are interpreted as the second-order phase transition. The sensitivity of the anomalies to the quenched magnetic flux is indicative of the magnetic nature of the transition. Similar features also observed at the same temperature in the 1-2-3* type superconducting systems

  12. Endoscope-Assisted Transoral Fixation of Mandibular Condyle Fractures: Submandibular Versus Transoral Endoscopic Approach.

    Hwang, Na-Hyun; Lee, Yoon-Hwan; You, Hi-Jin; Yoon, Eul-Sik; Kim, Deok-Woo

    2016-07-01

    In recent years, endoscope-assisted transoral approach for condylar fracture treatment has attracted much attention. However, the surgical approach is technically challenging: the procedure requires specialized instruments and the surgeons experience a steep learning curve. During the transoral endoscopic (TE) approach several instruments are positioned through a narrow oral incision making endoscope maneuvering very difficult. For this reason, the authors changed the entry port of the endoscope from transoral to submandibular area through a small stab incision. The aim of this study is to assess the advantage of using the submandibular endoscopic intraoral approach (SEI).The SEI approach requires intraoral incision for fracture reduction and fixation, and 4 mm size submandibular stab incision for endoscope and traction wires. Fifteen patients with condyle neck and subcondyle fractures were operated under the submandibular approach and 15 patients with the same diagnosis were operated under the standard TE approach.The SEI approach allowed clear visualization of the posterior margin of the ramus and condyle, and the visual axis was parallel to the condyle ramus unit. The TE approach clearly shows the anterior margin of the condyle and the sigmoid notch. The surgical time of the SEI group was 128 minutes and the TE group was 120 minutes (P >0.05). All patients in the TE endoscope group were fixated with the trocar system, but only 2 lower neck fracture patients in the SEI group required a trocar. The other 13 subcondyle fractures were fixated with an angulated screw driver (P <0.05). There were no differences in complication and surgical outcomes.The submandibular endoscopic approach has an advantage of having more space with good visualization, and facilitated the use of an angulated screw driver.

  13. Understanding Legacy Features with Featureous

    Olszak, Andrzej; Jørgensen, Bo Nørregaard

    2011-01-01

    Java programs called Featureous that addresses this issue. Featureous allows a programmer to easily establish feature-code traceability links and to analyze their characteristics using a number of visualizations. Featureous is an extension to the NetBeans IDE, and can itself be extended by third...

  14. Tracheomegaly: a complication of fetal endoscopic tracheal occlusion in the treatment of congenital diaphragmatic hernia

    McHugh, Kieran; Afaq, Asim; Roebuck, Derek J. [Great Ormond Street Hospital for Children, Radiology Department, London (United Kingdom); Broderick, Nigel [Nottingham University Hospitals, Radiology Department, Nottingham (United Kingdom); Gabra, Hany O.; Elliott, Martin J. [Great Ormond Street Hospital for Children, Department of Cardiothoracic Surgery, London (United Kingdom)

    2010-05-15

    Fetal endoscopic tracheal occlusion (FETO) is a promising treatment for severe congenital diaphragmatic hernia, a condition that carries significant morbidity and mortality. It is hypothesised that balloon occlusion of the fetal trachea leads to an improvement in lung growth and development. The major documented complications of FETO to date are related to preterm delivery. To report a series of five infants who developed tracheomegaly following FETO. Review of all children referred with tracheomegaly to the paediatric intensive care and tracheal service at two referral centres. Five neonates presented with features of respiratory distress shortly after birth and were subsequently found to have marked tracheomegaly. Two neonates had tracheomalacia in addition. There are no previous reports in the literature describing tracheomalacia, or more specifically, tracheomegaly, as a consequence of FETO. We propose that the particularly compliant fetal airway is at risk of mechanical damage from in utero balloon occlusion. This observation of a new problem in this cohort suggests a thorough evaluation of the trachea should be performed in children who have had FETO in utero. It may be that balloon occlusion of the trachea earlier in utero (before 26 weeks' gestation) predisposes to this condition. (orig.)

  15. Tracheomegaly: a complication of fetal endoscopic tracheal occlusion in the treatment of congenital diaphragmatic hernia

    McHugh, Kieran; Afaq, Asim; Roebuck, Derek J.; Broderick, Nigel; Gabra, Hany O.; Elliott, Martin J.

    2010-01-01

    Fetal endoscopic tracheal occlusion (FETO) is a promising treatment for severe congenital diaphragmatic hernia, a condition that carries significant morbidity and mortality. It is hypothesised that balloon occlusion of the fetal trachea leads to an improvement in lung growth and development. The major documented complications of FETO to date are related to preterm delivery. To report a series of five infants who developed tracheomegaly following FETO. Review of all children referred with tracheomegaly to the paediatric intensive care and tracheal service at two referral centres. Five neonates presented with features of respiratory distress shortly after birth and were subsequently found to have marked tracheomegaly. Two neonates had tracheomalacia in addition. There are no previous reports in the literature describing tracheomalacia, or more specifically, tracheomegaly, as a consequence of FETO. We propose that the particularly compliant fetal airway is at risk of mechanical damage from in utero balloon occlusion. This observation of a new problem in this cohort suggests a thorough evaluation of the trachea should be performed in children who have had FETO in utero. It may be that balloon occlusion of the trachea earlier in utero (before 26 weeks' gestation) predisposes to this condition. (orig.)

  16. Tracheomegaly: a complication of fetal endoscopic tracheal occlusion in the treatment of congenital diaphragmatic hernia

    McHugh, Kieran; Afaq, Asim; Roebuck, Derek J [Great Ormond Street Hospital for Children, Radiology Department, London (United Kingdom); Broderick, Nigel [Nottingham University Hospitals, Radiology Department, Nottingham (United Kingdom); Gabra, Hany O; Elliott, Martin J [Great Ormond Street Hospital for Children, Department of Cardiothoracic Surgery, London (United Kingdom)

    2010-05-15

    Fetal endoscopic tracheal occlusion (FETO) is a promising treatment for severe congenital diaphragmatic hernia, a condition that carries significant morbidity and mortality. It is hypothesised that balloon occlusion of the fetal trachea leads to an improvement in lung growth and development. The major documented complications of FETO to date are related to preterm delivery. To report a series of five infants who developed tracheomegaly following FETO. Review of all children referred with tracheomegaly to the paediatric intensive care and tracheal service at two referral centres. Five neonates presented with features of respiratory distress shortly after birth and were subsequently found to have marked tracheomegaly. Two neonates had tracheomalacia in addition. There are no previous reports in the literature describing tracheomalacia, or more specifically, tracheomegaly, as a consequence of FETO. We propose that the particularly compliant fetal airway is at risk of mechanical damage from in utero balloon occlusion. This observation of a new problem in this cohort suggests a thorough evaluation of the trachea should be performed in children who have had FETO in utero. It may be that balloon occlusion of the trachea earlier in utero (before 26 weeks' gestation) predisposes to this condition. (orig.)

  17. Endoscopic Endonasal Approach in the Management of Rathke's Cleft Cysts.

    Domenico Solari

    Full Text Available Rathke's cleft cysts (RCCs are quite uncommon sellar lesions that can extend or even arise in the suprasellar area. The purpose of this study is to evaluate the effectiveness of both standard and extended endoscopic endonasal approaches in the management of different located RCCs.We retrospectively analyzed a series of 29 patients (9 males, 20 females complaining of a RCC, who underwent a standard or an extended endoscopic transsphenoidal approach at the Division of Neurosurgery, Department of Neurosciences and Reproductive and Odontostomatological Sciences, of the Università degli Studi di Napoli "Federico II". Data regarding patients' demographics, clinical evaluation, cyst characteristics, surgical treatments, complications and outcomes were extracted from our electronic database (Filemaker Pro 11, File Maker Inc., Santa Clara, California, USA.A standard transsphenoidal approach was used in 19 cases, while the extended variation of the approach in 10 cases (5 purely suprasellar and 5 intra-suprasellar RCC. Cysts contents was fully drained in all the 29 cases, whilst a gross total removal, that accounts on the complete cyst wall removal, was achieved in an overall 55,1% of patients (16/29, specifically 36,8% (7/19 that received standard approach and 90% (9/10 of those that underwent to extended approach. We reported a 56.2% of recovery from headache, 38.5% of complete recovery and 53.8% of improvement from visual field defect and an overall 46.7% of improvement of the endocrine functions. Postoperative permanent DI rate was 10.3%, overall post-operative CSF leak rate 6.9%; recurrence/regrowth occurred in 4 patients (4/29, 13.8%, but only one required a second surgery.The endoscopic transsphenoidal approach for the removal of a symptomatic RCC offers several advantages in terms of visualization of the surgical field during both the exposure and removal of the lesion. The "extended" variation of the endoscopic approach provides a direct access

  18. Endoscopic submucosal dissection for locally recurrent colorectal lesions after previous endoscopic mucosal resection.

    Zhou, Pinghong; Yao, Liqing; Qin, Xinyu; Xu, Meidong; Zhong, Yunshi; Chen, Weifeng

    2009-02-01

    The objective of this study was to determine the efficacy and safety of endoscopic submucosal dissection for locally recurrent colorectal cancer after previous endoscopic mucosal resection. A total of 16 patients with locally recurrent colorectal lesions were enrolled. A needle knife, an insulated-tip knife and a hook knife were used to resect the lesion along the submucosa. The rate of the curative resection, procedure time, and incidence of complications were evaluated. Of 16 lesions, 15 were completely resected with endoscopic submucosal dissection, yielding an en bloc resection rate of 93.8 percent. Histologic examination confirmed that lateral and basal margins were cancer-free in 14 patients (87.5 percent). The average procedure time was 87.2 +/- 60.7 minutes. None of the patients had immediate or delayed bleeding during or after endoscopic submucosal dissection. Perforation in one patient (6.3 percent) was the only complication and was managed conservatively. The mean follow-up period was 15.5 +/- 6.8 months; none of the patients experienced lesion residue or recurrence. Endoscopic submucosal dissection appears to be effective for locally recurrent colorectal cancer after previous endoscopic mucosal resection, making it possible to resect whole lesions and provide precise histologic information.

  19. Endoscopic therapy of neoplasia related to Barrett's esophagus and endoscopic palliation of esophageal cancer.

    Vignesh, Shivakumar; Hoffe, Sarah E; Meredith, Kenneth L; Shridhar, Ravi; Almhanna, Khaldoun; Gupta, Akshay K

    2013-04-01

    Barrett's esophagus (BE) is the most important identifiable risk factor for the progression to esophageal adenocarcinoma. This article reviews the current endoscopic therapies for BE with high-grade dysplasia and intramucosal cancer and briefly discusses the endoscopic palliation of advanced esophageal cancer. The diagnosis of low-grade or high-grade dysplasia (HGD) is based on several cytologic criteria that suggest neoplastic transformation of the columnar epithelium. HGD and carcinoma in situ are regarded as equivalent. The presence of dysplasia, particularly HGD, is also a risk factor for synchronous and metachronous adenocarcinoma. Dysplasia is a marker of adenocarcinoma and also has been shown to be the preinvasive lesion. Esophagectomy has been the conventional treatment for T1 esophageal cancer and, although debated, is an appropriate option in some patients with HGD due to the presence of occult cancer in over one-third of patients. Endoscopic ablative modalities (eg, photodynamic therapy and cryoablation) and endoscopic resection techniques (eg, endoscopic mucosal resection) have demonstrated promising results. The significant morbidity and mortality of esophagectomy makes endoscopic treatment an attractive potential option.

  20. Rendezvous endoscopic recanalization for complete esophageal obstruction.

    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.

  1. Outcome of Endoscopic Transsphenoidal Surgery for Acromegaly.

    Kim, Jung Hee; Hur, Kyu Yeon; Lee, Jung Hyun; Lee, Ji Hyun; Se, Young-Bem; Kim, Hey In; Lee, Seung Hoon; Nam, Do-Hyun; Kim, Seong Yeon; Kim, Kwang-Won; Kong, Doo-Sik; Kim, Yong Hwy

    2017-08-01

    Endoscopic transsphenoidal surgery has recently been introduced in pituitary surgery. We investigated outcomes and complications of endoscopic surgery in 2 referral centers in Korea. We enrolled 134 patients with acromegaly (microadenomas, n = 15; macroadenomas, n = 119) who underwent endoscopic transsphenoidal surgery at Seoul National University Hospital (n = 74) and Samsung Medical Center (n = 60) between January 2009 and March 2016. Remission was defined as having a normal insulin-like growth factor-1 and a suppressed growth hormone (GH) surgery, normal pituitary function was maintained in 34 patients (25.4%). Sixty-four patients (47.7%) presented complete (n = 59, 44.0%) or incomplete (n = 5, 3.7%) recovery of pituitary function. Hypopituitarism persisted in 20 patients (14.9%) and worsened in 16 patients (11.9%). Postoperatively, transient diabetes insipidus was reported in 52 patients (38.8%) but only persisted in 2 patients (1.5%). Other postoperative complications were epistaxis (n = 2), cerebral fluid leakage (n = 4), infection (n = 1), and intracerebral hemorrhage (n = 1). Endoscopic transsphenoidal surgery for acromegaly presented high remission rates and a low incidence of endocrine deficits and complications. Regardless of surgical techniques, invasive pituitary tumors were associated with poor outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Endoscopic Surgery for Traumatic Acute Subdural Hematoma

    Hiroyuki Kon

    2014-01-01

    Full Text Available Traumatic acute subdural hematoma (ASDH is generally addressed by craniotomy under general anesthesia. We report a patient whose traumatic ASDH was treated under local anesthesia by one-burr-hole endoscopic surgery. This 87-year-old woman had undergone coil embolization for a ruptured right middle-cerebral artery aneurysm and placement of a ventriculoperitoneal shunt for normal pressure hydrocephalus 5 years earlier. Upon admission, she manifested consciousness disturbance after suffering head trauma and right hemiplegia. Her Glasgow Coma Scale score was 8 (E2V2M4. Computed tomography (CT demonstrated a thick, left-frontotemporal ASDH. Due to her advanced age and poor condition, we performed endoscopic surgery rather than craniotomy to evacuate the ASDH. Under local anesthesia, we made a burr hole in her left forehead and increased its size to 15 mm in diameter. After introducing a transparent sheath into the hematoma cavity with a rigid endoscope, the clot was evacuated with a suction tube. The arterial bleeding point was electrically coagulated. A postoperative CT scan confirmed the reduction of the hematoma. There was neither brain compression nor brain swelling. Her consciousness disturbance and right hemiplegia improved immediately. Endoscopic surgery may represent a viable method to address traumatic intracranial hematomas in some patients.

  3. Upper gastrointestinal endoscopic findings and prevalence of ...

    Upper gastrointestinal endoscopic findings and prevalence of Helicobacter pylori infection among adult patients with dyspepsia in northern Tanzania. ... Endoscopy (EGD) for initial work up. Study on antimicrobial susceptibility pattern of H. pylori is recommended to guide choices for evidence based treatment option.

  4. Update on the endoscopic treatments for achalasia

    Uppal, Dushant S; Wang, Andrew Y

    2016-01-01

    Achalasia is the most common primary motility disorder of the esophagus and presents as dysphagia to solids and liquids. It is characterized by impaired deglutitive relaxation of the lower esophageal sphincter. High-resolution manometry allows for definitive diagnosis and classification of achalasia, with type II being the most responsive to therapy. Since no cure for achalasia exists, early diagnosis and treatment of the disease is critical to prevent end-stage disease. The central tenant of diagnosis is to first rule out mechanical obstruction due to stricture or malignancy, which is often accomplished by endoscopic and fluoroscopic examination. Therapeutic options include pneumatic dilation (PD), surgical myotomy, and endoscopic injection of botulinum toxin injection. Heller myotomy and PD are more efficacious than pharmacologic therapies and should be considered first-line treatment options. Per oral endoscopic myotomy (POEM) is a minimally-invasive endoscopic therapy that might be as effective as surgical myotomy when performed by a trained and experienced endoscopist, although long-term data are lacking. Overall, therapy should be individualized to each patient’s clinical situation and based upon his or her risk tolerance, operative candidacy, and life expectancy. In instances of therapeutic failure or symptom recurrence re-treatment is possible and can include PD or POEM of the wall opposite the site of prior myotomy. Patients undergoing therapy for achalasia require counseling, as the goal of therapy is to improve swallowing and prevent late manifestations of the disease rather than to restore normal swallowing, which is unfortunately impossible. PMID:27818585

  5. Successful Endoscopic Therapy of Traumatic Bile Leaks

    Matthew P. Spinn

    2013-02-01

    Full Text Available Traumatic bile leaks often result in high morbidity and prolonged hospital stay that requires multimodality management. Data on endoscopic management of traumatic bile leaks are scarce. Our study objective was to evaluate the efficacy of the endoscopic management of a traumatic bile leak. We performed a retrospective case review of patients who were referred for endoscopic retrograde cholangiopancreatography (ERCP after traumatic bile duct injury secondary to blunt (motor vehicle accident or penetrating (gunshot trauma for management of bile leaks at our tertiary academic referral center. Fourteen patients underwent ERCP for the management of a traumatic bile leak over a 5-year period. The etiology included blunt trauma from motor vehicle accident in 8 patients, motorcycle accident in 3 patients and penetrating injury from a gunshot wound in 3 patients. Liver injuries were grade III in 1 patient, grade IV in 10 patients, and grade V in 3 patients. All patients were treated by biliary stent placement, and the outcome was successful in 14 of 14 cases (100%. The mean duration of follow-up was 85.6 days (range 54-175 days. There were no ERCP-related complications. In our case review, endoscopic management with endobiliary stent placement was found to be successful and resulted in resolution of the bile leak in all 14 patients. Based on our study results, ERCP should be considered as first-line therapy in the management of traumatic bile leaks.

  6. An observational study on oesophageal variceal endoscopic ...

    An observational study on oesophageal variceal endoscopic injection sclerotherapy in patients with portal hypertension seen at the Centre for Clinical Research, ... The report concludes that variceal injection sclerotherapy is a useful method of treating oesophageal varices and can be performed on an out patient basis.

  7. ENDOSCOPIC TREATMENT OF THE HYPOPHARYNGEAL (ZENKERS) DIVERTICULUM

    WOUTERS, B; VANOVERBEEK, JJM

    Over the years the techniques for endoscopic treatment of Zenker's diverticulum have been improved. Initially, in 1964, we used the electrocoagulation technique as described by Dohlman, but currently we prefer to sever the tissue bridge between the diverticulum and esophagus with the CO2 laser under

  8. Liver parenchumography following endoscopic retrograde cholangiopancreatography (ERCP)

    Revert, A.; Arana, E.; Pertejo, V.; Berenguer, M.; Masip, M.J.

    1998-01-01

    Focal liver opacification during endoscopic retrograde cholangiography (ERCP) is an uncommon complication caused by excessive pressure during contrast injection. In this situation, ERCP must be interrupted and the position of the cannula checked. We recommend that these images be excluded from the diagnosis of tumor or cystic cavities. 4 refs

  9. Subcutaneous endoscopically assisted ligation using miniport for ...

    miniport for the treatment of girls with inguinal hernia. Akinari Hinoki*, Ikeda ... method using subcutaneous endoscopically assisted ligation (SEAL) for the ... the open technique and an additional 2 mm miniport). A ... (unilateral, n = 9) or 42 ± 8 min (bilateral, n = 5). The mean .... Methods of laparoscopic repair have recently ...

  10. Endoscopic Third Ventriculostomy: Success and Failure.

    Deopujari, Chandrashekhar E; Karmarkar, Vikram S; Shaikh, Salman T

    2017-05-01

    Endoscopic third ventriculostomy (ETV) has now become an accepted mode of hydrocephalus treatment in children. Varying degrees of success for the procedure have been reported depending on the type and etiology of hydrocephalus, age of the patient and certain technical parameters. Review of these factors for predictability of success, complications and validation of success score is presented.

  11. Anaesthetic management of endoscopic resection of juvenile ...

    P Khanna, BR Ray, R Sinha, R Kumar, K Sikka, AC Singh ... We present the anaesthetic management of endoscopic resection of 14 JNAs, together with a review. ... Mean duration of surgery was 197.14 ± 77 minutes, and median blood loss ...

  12. An illumination system for endoscopic applications

    2013-01-01

    The present disclosure relates to an illumination system for endoscopic applications comprising at least one substantially monochromatic light source having a predefined central wavelength between 400 and 500 nm or between 500 and 550 nm, an optical transmission path adapted to guide light emanat...... for photodynamic diagnosis and/or therapy of bladder cancer is further disclosed herein....

  13. Subcutaneous endoscopically assisted ligation using miniport for ...

    Background This report describes the first miniport method using subcutaneous endoscopically assisted ligation (SEAL) for the treatment of girls with inguinal hernia. To validate its safety and efficacy, the authors evaluated their early experiences. Methods Between April 2014 and December 2014, 19 SEALs using miniport ...

  14. Endoscopic management of bile leaks after laparoscopic ...

    2013-11-04

    Nov 4, 2013 ... operative treatment is necessary, repair by a surgeon with expertise in biliary ... vascular injuries or other endoscopic findings requiring surgical or radiological intervention. Of 84 patients ..... necrosis and unrecognised distal CD injury. ... placement of multiple simultaneous stents, an alternative option.

  15. Optimization of portal placement for endoscopic calcaneoplasty

    van Sterkenburg, Maayke N.; Groot, Minke; Sierevelt, Inger N.; Spennacchio, Pietro A.; Kerkhoffs, Gino M. M. J.; van Dijk, C. Niek

    2011-01-01

    The purpose of our study was to determine an anatomic landmark to help locate portals in endoscopic calcaneoplasty. The device for optimal portal placement (DOPP) was developed to measure the distance from the distal fibula tip to the calcaneus (DFC) in 28 volunteers to determine the location of the

  16. Endoscopic management of biliary injuries and leaks

    T S Chandrasekar

    2012-01-01

    Full Text Available Bile duct injuries and subsequent leaks can occur following laparoscopic and open cholecystectomies and also during other hepatobiliary surgeries. Various patient related and technical factors are implicated in the causation of biliary injuries. Over a period of twenty five years managing such patients of biliary injuries our team has found a practical approach to assess the cause of biliary injuries based on the symptoms, clinical examination and imaging. Bismuth classification is helpful in most of the cases. Immediate referral to a centre experienced in the management of bile duct injury and timely intervention is associated with improved outcomes. Resuscitation, correcting dyselectrolytemia, aspiration of undrained biloma and antibiotics take the priority in the management. The goal is to restore the bile conduit, and to prevent short and longterm complications such as biliary fistula, intra-abdominal abscess, biliary stricture, recurrent cholangitis and secondary biliary cirrhosis. Endoscopic therapy by reducing the transpapillary pressure gradient helps in reducing the leak. Endoscopic therapy with biliary sphincterotomy alone or with additional placement of a biliary stent/ nasobiliary drainage is advocated. In our tertiary care referral unit, we found endoscopic interventions are useful in situations where there is leak with associated CBD calculus or a foreign body, peripheral bile duct injury, cystic duct stump leak and partial bile duct injury with leak/ narrowing of the lumen. Endotherapy is not useful in case of complete transection (total cut off and complete stricture involving common hepatic or common bile ducts. In conclusion, endoscopic treatment can be considered a highly effective therapy and should be the first-line therapy in such patients. Though less successful, an endoscopic attempt is warranted in patients suffering from central bile duct leakages failing which surgical management is recommended.

  17. Endoscopic sleeve gastroplasty: the learning curve.

    Hill, Christine; El Zein, Mohamad; Agnihotri, Abhishek; Dunlap, Margo; Chang, Angela; Agrawal, Alison; Barola, Sindhu; Ngamruengphong, Saowanee; Chen, Yen-I; Kalloo, Anthony N; Khashab, Mouen A; Kumbhari, Vivek

    2017-09-01

    Endoscopic sleeve gastroplasty (ESG) is gaining traction as a minimally invasive bariatric treatment. Concern that the learning curve may be slow, even among those proficient in endoscopic suturing, is a barrier to widespread implementation of the procedure. Therefore, we aimed to define the learning curve for ESG in a single endoscopist experienced in endoscopic suturing who participated in a 1-day ESG training program.  Consecutive patients who underwent ESG between February 2016 and November 2016 were included. The performing endoscopist, who is proficient in endoscopic suturing for non-ESG procedures, participated in a 1-day ESG training session before offering ESG to patients. The outcome measurements were length of procedure (LOP) and number of plications per procedure. Nonlinear regression was used to determine the learning plateau and calculate the learning rate.  Twenty-one consecutive patients (8 males), with mean age 47.7 ± 11.2 years and mean body mass index 41.8 ± 8.5 kg/m 2 underwent ESG. LOP decreased significantly across consecutive procedures, with a learning plateau at 101.5 minutes and a learning rate of 7 cases ( P  = 0.04). The number of plications per procedure also decreased significantly across consecutive procedures, with a plateau at 8 sutures and a learning rate of 9 cases ( P  < 0.001). Further, the average time per plication decreased significantly with consecutive procedures, reaching a plateau at 9 procedures ( P  < 0.001).  Endoscopists experienced in endoscopic suturing are expected to achieve a reduction in LOP and number of plications per procedure in successive cases, with progress plateauing at 7 and 9 cases, respectively.

  18. Radiological findings after endoscopic incision of ureterocele

    Cheon, Jung Eun; Kim, In One; Seok, Eul Hye; Cha, Joo Hee; Choi, Gook Myung; Kim, Woo Sun; Yeon, Kyung Mo; Kim, Kwang Myung; Choi, Hwang; Cheon, Jung Eun; Seok, Eul Hye; Cha, Joo Hee; Choi, Guk Myung

    2001-01-01

    Endoscopic incision of ureterocele is considered a simple and safe method for decompression of urinary tract obstruction above ureterocele. The purpose of this study was to evaluate the radiological findings after endoscopic incision of ureterocele. We retrospectively reviewed the radiological findings (ultrasonography (US), intravenous urography, and voiding cystourethrography(VCU)) in 16 patients with ureterocele who underwent endoscopic incision (mean age at surgery, 15 months; M:F 3:13; 18 ureteroceles). According to the postoperative results, treatment was classified as successful when medical treatment was still required, and second operation when additional surgical treatment was required. Postoperative US (n=10) showed that in all patients, urinary tract obstruction was relieved: the kidney parenchima was thicker and the ureterocele was smaller. Intravenous urography (n=8), demonstrated that in all patients, urinary tract obstruction and the excretory function of the kidney had improved. Postoperative VCU indicated that in 92% of patients (12 of 13), endoscopic incision of the ureterocele led to vesicoureteral reflux(VUR). Of these twelve, seven (58%) showed VUR of more than grade 3, while newly developed VUR was seen in five of eight patients (63%) who had preoperative VCU. Surgery was successful in four patients (25%), partially successful in three (19%), and a second operation-on account of recurrent urinary tract infection and VUR of more than grase 3 during the follow-up period-was required by nine (56%). Although endoscopic incision of a ureterocele is a useful way of relieving urinary tract obstruction, an ensuing complication may be VUR. Postoperative US and intravenous urography should be used to evaluate parenchymal change in the kidney and improvement of uronary tract obstructon, while to assess the extend of VUR during the follow-up period , postoperative VCU is required

  19. SPECIFIC FEATURES OF THE EMBODIMENT OF THE HEROIC-PATRIOTIC SUBJECT IN THE CANTATA UNDER A BANNER OF VICTORIES BY V. ZAGORSCHI

    CUZNEŢOVA NADEJDA

    2017-06-01

    Full Text Available The article is devoted to the study of V. Zagorschi’s cantata „Under the Banner of Victories” (1952, as a landmark work for his period — the 50s of the 20th century, as well as for the composer’s subsequent creation. The cantata serves as an embodiment of the heroic-patriotic themes, being, at the same time, one of the samples of the „occasional” compositions in the works of the composers from the Republic of Moldova. In the process of analyzing the cantata, its musical features are revealed, reflecting the artistic orientations of their time.

  20. Fiberoptic endoscopic evaluation of swallowing in intensive care unit patients

    Hafner, Gert; Neuhuber, Andreas; Hirtenfelder, Sylvia; Schmedler, Brigitte

    2007-01-01

    Aspiration in critically ill patients frequently causes severe co-morbidity. We evaluated a diagnostic protocol using routine FEES in critically ill patients at risk to develop aspiration following extubation. We instructed intensive care unit physicians on specific risk factors for and clinical signs of aspiration following extubation in critically ill patients and offered bedside FEES for such patients. Over a 45-month period, we were called to perform 913 endoscopic examinations in 553 patients. Silent aspiration or aspiration with acute symptoms (cough or gag reflex as the bolus passed into the trachea) was detected in 69.3% of all patients. Prolonged non-oral feeding via a naso-gastric tube was initiated in 49.7% of all patients. In 13.2% of patients, a percutaneous endoscopic gastrostomy was initiated as a result of FEES findings, and in 6.3% an additional tracheotomy to prevent aspiration had to be initiated. In 59 out of 258 patients (22.9%), tracheotomies were closed, and 30.7% of all 553 patients could be managed with the immediate onset of an oral diet and compensatory treatment procedures. Additional radiological examinations were not required. FEES in critically ill patients allows for a rapid evaluation of deglutition and for the immediate initiation of symptom-related rehabilitation or for an early resumption of oral feeding. PMID:17968575

  1. Imaging of common bile duct by linear endoscopic ultrasound

    Malay; Sharma; Amit; Pathak; Abid; Shoukat; Chittapuram; Srinivasan; Rameshbabu; Akash; Ajmera; Zeeshn; Ahamad; Wani; Praveer; Rai

    2015-01-01

    Imaging of common bile duct(CBD) can be done by many techniques. Endoscopic retrograde cholangiopancreaticography is considered the gold standard for imaging of CBD. A standard technique of imaging of CBD by endoscopic ultrasound(EUS) has not been specifically described. The available descriptions mention different stations of imaging from the stomach and duodenum. The CBD lies closest to duodenum and choice of imaging may be restricted to duodenum for many operators. Generally most operators prefer multi station imaging during EUS and the choice of selecting the initial station varies from operator to operator. Detailed evaluation of CBD is frequently the main focus of imaging during EUS and in such situations multi station imaging with a high-resolution ultrasound scanner may provide useful information. Examination of the CBD is one of the primary indications for doing an EUS and it can be done from five stations:(1) the fundus of stomach;(2) body of stomach;(3) duodenal bulb;(4) descending duodenum; and(5) antrum. Following down the upper 1/3rd of CBD can do imaging of entire CBD from the liver window and following up the lower 1/3rd of CBD can do imaging of entire CBD from the pancreatic window. This article aims at simplifying the techniques of imaging of CBD by linear EUS.

  2. Feature Article

    Home; Journals; Resonance – Journal of Science Education. Feature Article. Articles in Resonance – Journal of Science Education. Volume 1 Issue 1 January 1996 pp 80-85 Feature Article. What's New in Computers Windows 95 · Vijnan Shastri · More Details Fulltext PDF. Volume 1 Issue 1 January 1996 pp 86-89 Feature ...

  3. Quantitative analysis of the clinical data on leukemia, 5. Specificity of clinical features in acute myelocytic leukemia with 8; 21 translocation by multiple logistic discriminant analysis

    Ueoka, Hiroshi; Kamada, Nanao; Yamamoto, Hisashi; Ohtaki, Megu; Takimoto, Yasuo; Kuramoto, Atsushi; Munaka, Masaki

    1984-11-01

    In order to determine the necessity of chromosome analysis required for the evaluation of 8;21 translocation, multiple logistic discriminant analysis was made on 124 patients with acute non-lymphocytic leukemia experienced in the authors' institution. Variables which showed positive correlation with the presence of 8;21 translocation were the presence of Auer body and granular abnormality of the cells, numbers of peripheral promyelocytes, myelocytes and metamyelocytes, and bone marrow promyelocytes, myelocytes, and the sum of rods and segments. Those which showed negative correlation with 8;21 translocation were peripheral platelet count, neutrocytealkaline phosphatase (N-AP) score, numbers of eosinocytes, monocytes and erythroblasts, and erythroblasts on myelogram. Auer body, four peripheral hematological features (platelet count, N-AP score, metamyelocytes and monocytes), and three myelogram features (myelocytes, reticular cells and granulocytes/eosionocytes) were used for the multiple logistic discriminant analysis. By the analysis, 2 of the 22 patients (9.1%) with translocation were judged not to have 8;21 translocation and 3 of the 102 patients (2.9%) without translocation were judged to have it. Therefore, this multiple logistic discriminant method has proved to be simple and useful in clinically evaluating acute non-lymphocytic leukemia. (Namekawa, K.).

  4. Genomic, Epigenomic, and Transcriptomic Profiling towards Identifying Omics Features and Specific Biomarkers That Distinguish Uterine Leiomyosarcoma and Leiomyoma at Molecular Levels

    Tomoko Miyata

    2015-01-01

    Full Text Available Uterine leiomyosarcoma (LMS is the worst malignancy among the gynecologic cancers. Uterine leiomyoma (LM, a benign tumor of myometrial origin, is the most common among women of childbearing age. Because of their similar symptoms, it is difficult to preoperatively distinguish the two conditions only by ultrasound and pelvic MRI. While histopathological diagnosis is currently the main approach used to distinguish them postoperatively, unusual histologic variants of LM tend to be misdiagnosed as LMS. Therefore, development of molecular diagnosis as an alternative or confirmatory means will help to diagnose LMS more accurately. We adopted omics-based technologies to identify genome-wide features to distinguish LMS from LM and revealed that copy number, gene expression, and DNA methylation profiles successfully distinguished these tumors. LMS was found to possess features typically observed in malignant solid tumors, such as extensive chromosomal abnormalities, overexpression of cell cycle-related genes, hypomethylation spreading through large genomic regions, and frequent hypermethylation at the polycomb group target genes and protocadherin genes. We also identified candidate expression and DNA methylation markers, which will facilitate establishing postoperative molecular diagnostic tests based on conventional quantitative assays. Our results demonstrate the feasibility of establishing such tests and the possibility of developing preoperative and noninvasive methods.

  5. Endoscopic vacuum-assisted closure of anastomotic leakage following anterior resection of the rectum: a new method.

    Weidenhagen, Rolf; Gruetzner, Klaus Uwe; Wiecken, Timm; Spelsberg, Fritz; Jauch, Karl-Walter

    2008-08-01

    Conservative treatment of anastomotic leakage after anterior resection of the rectum seems to be possible in patients who have no occurrence of generalized peritonitis. This report describes a new method of endoscopic management of large anastomotic leakage in these patients. The main feature of this new method is the endoscopically assisted placement of an open-cell sponge connected to a vacuum device into the abscess cavity via an introducer device. The sponge system is changed every 48-72 h. Twenty-nine patients with an anastomotic leakage after anterior resection were treated with the endoscopic vacuum therapy. The total duration of endovac therapy was 34.4 +/- 19.4 days. The total number of endoscopic sessions per patient was 11.4 +/- 6.3. In 21 of the 29 patients, a protecting stoma was created at the primary operation. Four patients were treated successfully without the need of a secondary stoma. Definitive healing was achieved in 28 of the 29 patients. Endoscopic vacuum-assisted closure is a new efficacious modality for treating anastomotic leakage following anterior resection due to an effective control of the septic focus. Further studies will show if it is possible to reduce the high mortality rate of patients with anastomotic leakage through the avoidance of surgical reinterventions while at the same time preserving the sphincter function.

  6. Abbreviation as a Reflection of Terms Variability in Language for Specific Purposes: Translational Features (Terminology Case Study in German, English, Kazakh, and Russia)

    Beisembayeva, Gulshat Z.; Yeskindirova, Manshuk Z.; Tulebayeva, Samal A.

    2016-01-01

    The range of modern dynamic social changes, globalization of world powers' economic cooperation, acceleration of technocratic processes have widespread impact on term systems' variability in language, in particular, on terminological variability for specific purposes. This globalized extra-linguistic factor provokes avalanche growth of…

  7. The translocation (6;9) (p23;q34) shows consistent rearrangement of two genes and defines a myeloproliferative disorder with specific clinical features

    Soekarman, D.; von Lindern, M.; Daenen, S.; de Jong, B.; Fonatsch, C.; Heinze, B.; Bartram, C.; Hagemeijer, A.; Grosveld, G.

    1992-01-01

    Translocation (6;9)(p23;q34) is a cytogenetic aberration that can be found in specific subtypes of both acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). This translocation is associated with an unfavourable prognosis. Recently, the genes involved in the t(6;9) were isolated and

  8. SPECIFIC FEATURE OF HORMONAL PROFILE IN PATIENTS WITH PRIMARY AND RECURRENT BREAST CANCER AND THEIR ROLE IN THE EFFICIENCY OF CHEMOTHERAPY

    M. B. Kozlova

    2009-01-01

    Full Text Available The hormonal background was studied in 32 menopausal patients who had primary breast cancer (Stage III or its recurrence in the postoperative scar. The patients with the primary process, unlike those with a recurrence, were found to have increased adrenocortical cortisol-forming activity and changed thyroid homeostasis. In both types of the neoplastic process, the blood concentrations of estradi- ol, testosterone, prolactin, follicle-stimulating and luteinizing hormones were disturbed in a substantial number of cases; the distinc- tive feature of the primary process and its recurrence lies in the opposite direction. An association of individual differences in the con- centrations of estradiol and testosterone with the efficiency of neoadjuvant chemotherapy was analyzed in patients with recurrent can- cer.

  9. Cytology evaluation for brushing in biliary and pancreatic stenosis during endoscopic cholangiopancreatography

    Ruiz, Mario H; Castano, Rodrigo; Alvarez, Oscar A; Velez, Alejandro; Munera, Veronica

    2002-01-01

    No surgical pathologic confirmation of malignant bile duct strictures is desirable for defining subsequent treatment and prognosis. Endoscopic retrograde cholangiopancreatography is frequently performed in patients suspected of having pancreaticobiliary obstruction, but there exists no standardized method or instruments for defining benign or malignant nature of obstructing lesions by ERCP. We prospectively evaluated the yields of endoscopic retrograde brush cytology for the diagnosis of malignant bile and pancreatic duct strictures. Fluoroscopically guided endobiliary brush cytology was performed during endoscopic retrograde cholangiopancreatography in 29 consecutive patients, 20 with malignant strictures and 9 with benign stricture. A single pathologist classified the results of these studies as positive, or negative for malignancy. The sensitivities of the procedure were 69%. Specificity proved excellent, 100%. Two major complications that occurred in the same patient were acute pancreatitis in a patient with chronic pancreatitis and bleeding from pancreatic duct. Both were managed medically and improved. This study indicates that endoscopic retrograde brush cytology alone may be sufficient in daily practice, to differentiate against benign and malignant biliary or pancreatic stenosis

  10. Meckel's cave access: anatomic study comparing the endoscopic transantral and endonasal approaches.

    Van Rompaey, Jason; Suruliraj, Anand; Carrau, Ricardo; Panizza, Benedict; Solares, C Arturo

    2014-04-01

    Recent advances in endonasal endoscopy have facilitated the surgical access to the lateral skull base including areas such as Meckel's cave. This approach has been well documented, however, few studies have outlined transantral specific access to Meckel's. A transantral approach provides a direct pathway to this region obviating the need for extensive endonasal and transsphenoidal resection. Our aim in this study is to compare the anatomical perspectives obtained in endonasal and transantral approaches. We prepared 14 cadaveric specimens with intravascular injections of colored latex. Eight cadavers underwent endoscopic endonasal transpterygoid approaches to Meckel's cave. Six additional specimens underwent an endoscopic transantral approach to the same region. Photographic evidence was obtained for review. 30 CT scans were analyzed to measure comparative distances to Meckel's cave for both approaches. The endoscopic approaches provided a direct access to the anterior and inferior portions of Meckel's cave. However, the transantral approach required shorter instrumentation, and did not require clearing of the endonasal corridor. This approach gave an anterior view of Meckel's cave making posterior dissection more difficult. A transantral approach to Meckel's cave provides access similar to the endonasal approach with minimal invasiveness. Some of the morbidity associated with extensive endonasal resection could possibly be avoided. Better understanding of the complex skull base anatomy, from different perspectives, helps to improve current endoscopic skull base surgery and to develop new alternatives, consequently, leading to improvements in safety and efficacy.

  11. Endoscopic surgery and photodynamic therapy for behign and malignant neoplasms of colon

    А. А. Razzhivina

    2013-01-01

    Full Text Available The review of literature for current methods of endoscopic treatment for colon epithelial neoplasms is represented. Such types of endoscopic interventions as loop electroresection, submucosal dissection, coagulation and destruction of tumors and combination of several options depending on efficiency of previous therapy is analyzed. Limitations of every method, its special aspects and possible complications are described. Special focus is on specifics of neoplasms for which selected methods may be the most effective. Thus, hot biopsy and destruction using high-energy laser is efficient for small flat neoplasms, endoscopic electroexcision – far small pedunculated lesions, and fragmentation is adequate for exophytic tumors more than 2.0 cm. Long-term results of endoscopic treatment, recurrence rates after different options are represented. The literature for photodynamic therapy consists mostly articles about development (on pre-clenecal stage of new photosensitizers which are effective for colon cancer, new methods of treatment including combination with hyperthermia in low-dose light irradiation etc. The literature data shows the prospectivity of subsequent developments in this field. 

  12. endoscope-i: an innovation in mobile endoscopic technology transforming the delivery of patient care in otolaryngology.

    Mistry, N; Coulson, C; George, A

    2017-11-01

    Digital and mobile device technology in healthcare is a growing market. The introduction of the endoscope-i, the world's first endoscopic mobile imaging system, allows the acquisition of high definition images of the ear, nose and throat (ENT). The system combines the e-i Pro camera app with a bespoke engineered endoscope-i adaptor which fits securely onto the iPhone or iPod touch. Endoscopic examination forms a salient aspect of the ENT work-up. The endoscope-i therefore provides a mobile and compact alternative to the existing bulky endoscopic systems currently in use which often restrict the clinician to the clinic setting. Areas covered: This article gives a detailed overview of the endoscope-i system together with its applications. A review and comparison of alternative devices on the market offering smartphone adapted endoscopic viewing systems is also presented. Expert commentary: The endoscope-i fulfils unmet needs by providing a compact, highly portable, simple to use endoscopic viewing system which is cost-effective and which makes use of smartphone technology most clinicians have in their pocket. The system allows real-time feedback to the patient and has the potential to transform the way that healthcare is delivered in ENT as well as having applications further afield.

  13. LEARNING CURVE IN ENDOSCOPIC TRANSNASAL SELLAR REGION SURGERY

    Ananth G

    2016-07-01

    Full Text Available BACKGROUND The endoscopic endonasal approach for the sellar region lesions is a novel technique and an effective surgical option. The evidence thus far has been conflicting with reports in favour and against a learning curve. We attempt to determine the learning curve associated with this approach. METHODS Retrospective and prospective data of the patients who were surgically treated for sellar region lesions between the year 2013 and 2016 was collected, 32 patients were operated by the endoscopic endonasal approach at Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Age, sex, presenting symptoms, length of hospital stay, surgical approach, type of dissection, duration of surgery, sellar floor repair, intraoperative and postoperative complications were noted. All the procedures were performed by a single neurosurgeon. RESULTS A total of 32 patients were operated amongst which 21 patients were non-functioning pituitary adenomas, 2 were growth hormone secreting functional adenomas, 1 was an invasive pituitary adenoma, 4 were craniopharyngiomas, 2 were meningiomas, 1 was Rathke’s cleft cyst and 1 was a clival chordoma. Headache was the mode of presentation in 12 patients, 12 patients had visual deficits, 6 patients presented with hormonal disturbances amongst which 4 patients presented with features of panhypopituitarism and 2 with acromegaly. Amongst the 4 patients with panhypopituitarism, 2 also had DI, two patients presented with CSF rhinorrhoea. There was a 100% improvement in the patients who presented with visual symptoms. Gross total resection was achieved in all 4 cases of craniopharyngiomas and 13 cases of pituitary adenomas. Postoperative CSF leak was seen in 4 patients who underwent re-exploration and sellar floor repair, 9 patients had postoperative Diabetes Insipidus (DI which was transient, the incidence of DI reduced towards the end of the study. There was a 25% decrease in the operating time towards the end of

  14. Specific features of acute stroke in the Russian Federation and in the People’s Republic of China (according to the data of some big stroke units

    S. S. Yu

    2016-01-01

    Full Text Available The study focuses on comparison and analysis of the work of big stroke units in the Russian Federation and the People’s Republic of China specialized in the medical care for patients with acute stroke. 522 patients were surveyed in Russia’s and China’s regional stroke units. In the Russian Federation, patients being treated in the «City Hospital No.26» (SaintPetersburg took part in the study. In China patients of the First Affiliated Hospital of the Chongqing Medical University, Central Hospital Jiang jin, Regional People’s Hospital Yubei district, Regional People’s Hospital Bishan (Chongqing Province. The analysis of differences was performed by the following parameters: personality traits, age, gender, level of education, income, health insurance category, profession, employment, professional activities over the last year, place of residence of the patient, features of the stroke, time during the first symptoms of stroke to hospitalization, kinds of medical services, the main risk factors and value of prevention before stroke.

  15. Species-specific differences in the accumulation features of organohalogen contaminants and their metabolites in the blood of Japanese terrestrial mammals

    Mizukawa, Hazuki; Nomiyama, Kei; Nakatsu, Susumu; Yachimori, Shuuji; Hayashi, Terutake; Tashiro, Yutaka; Nagano, Yasuko; Tanabe, Shinsuke

    2013-01-01

    Residue levels and patterns of polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), their hydroxylated metabolites (OH-PCBs, OH-PBDEs), and methoxylated PBDEs (MeO-PBDEs) in the blood of various terrestrial mammals in Japan, including cats, raccoon dogs, dogs, masked palm civets, foxes, raccoons, badgers, and mongooses were determined. Tri- through penta-chlorinated OH-PCBs were predominant in cat blood, whereas hexa- through octa-chlorinated OH-PCBs were found in other species. High proportion of BDE209 was found in all species, suggesting exposure to municipal waste and soil containing higher levels of deca-BDE products. 6OH-/MeO-BDE47 and 2′OH-/MeO-BDE68 were dominant in all terrestrial mammals. This is first report on the detection of OH-/MeO-PBDEs in the blood of terrestrial mammals. High concentrations of OH-/MeO-PBDEs were found in cats, suggesting the intake of these compounds from seafood. Cats exhibited higher accumulation and specific patterns of OH-PCBs, OH-PBDEs, and MeO-PBDEs, they may be at a high risk from these metabolites. -- Highlights: ► Analysis of organohalogen metabolites in the blood of Japanese terrestrial mammals. ► First study on analysis of OH-/MeO-PBDEs in terrestrial mammals. ► Cats showed specific residue pattern of OH-PCBs compare to other species. ► Metabolic capacities of PCBs in carnivore were higher than marine mammals. ► Marine natural occurrence OH-/MeO-PBDEs were found in terrestrial mammals. -- Cats showed specific residue pattern of OH-PCBs compare to other species and marine natural occurrence OH-/MeO-PBDEs were detected in terrestrial mammals

  16. [Specific features of the functional state of the cardiorespiratory system in athletes differing in the types of muscular activity during the preparatory period of the training cycle].

    Ivanova, N B

    2011-01-01

    The present study of the functional state of the cadiorespiratory system included athletes engaged in cyclic team sports. The state of the cardiorespiratory system was estimated from the measurement of central hemodynamics and cardiac rhythm variability, results of electrocardiography, spirography, and pneumotachography performed during the preparatory period for the training cycle. It was shown that the cardiovascular and respiratory systems as well as vegetative regulation of the cardiac rhythm of the athletes under examination underwent differently directed structural modification depending on the specific patterns of muscular activity.

  17. Clinical features and prognosis of patients with acute non-specific chest pain in emergency and cardiology departments after the introduction of high-sensitivity troponins

    Ilangkovan, Nivethitha; Mickley, Hans; Diederichsen, Axel

    2017-01-01

    OBJECTIVES: To determine the incidence of clinical, cardiac-related endpoints and mortality among patients presenting to an emergency or cardiology department with non-specific chest pain (NSCP), and who receive testing with a high-sensitivity troponin. A second objective was to identify risk...... factors for the above-noted endpoints during 12 months of follow-up. DESIGN: A prospective multicentre study. SETTING: Emergency and cardiology departments in Southern Denmark. SUBJECTS: The study enrolled 1027 patients who were assessed for acute chest pain in an emergency or cardiology department...

  18. Devices and Endoscopic Bariatric Therapies for Obesity.

    Saunders, Katherine H; Igel, Leon I; Saumoy, Monica; Sharaiha, Reem Z; Aronne, Louis J

    2018-04-17

    In this review, we describe the FDA-approved and investigational devices and endoscopic bariatric therapies for the treatment of obesity. We focus on literature published in the past few years and present mechanisms of action as well as efficacy and safety data. Devices and endoscopic procedures are emerging options to fill the significant treatment gap in the management of obesity. Not only are these devices and procedures minimally invasive and reversible, but they are potentially more effective than antiobesity medications, often safer for poor surgical candidates and possibly less expensive than bariatric surgery. As many patients require a variety of management strategies (medications, devices, procedures, and/or surgery) in addition to lifestyle modifications to achieve clinically significant weight loss, the future of obesity treatment involves a multidisciplinary approach. Combinations of advanced treatment strategies can lead to additive or synergistic weight loss. This is an area that requires further investigation.

  19. Fundus imaging with a nasal endoscope

    P Mahesh Shanmugam

    2015-01-01

    Full Text Available Wide field fundus imaging is needed to diagnose, treat, and follow-up patients with retinal pathology. This is more applicable for pediatric patients as repeated evaluation is a challenge. The presently available imaging machines though provide high definition images, but carry the obvious disadvantages of either being costly or bulky or sometimes both, which limits its usage only to large centers. We hereby report a technique of fundus imaging using a nasal endoscope coupled with viscoelastic. A regular nasal endoscope with viscoelastic coupling was placed on the cornea to image the fundus of infants under general anesthesia. Wide angle fundus images of various fundus pathologies in infants could be obtained easily with readily available instruments and without the much financial investment for the institutes.

  20. Emerging indications of endoscopic radiofrequency ablation

    Becq, Aymeric; Camus, Marine; Rahmi, Gabriel; de Parades, Vincent; Marteau, Philippe

    2015-01-01

    Introduction Radiofrequency ablation (RFA) is a well-validated treatment of dysplastic Barrett's esophagus. Other indications of endoscopic RFA are under evaluation. Results Four prospective studies (total 69 patients) have shown that RFA achieved complete remission of early esophageal squamous intra-epithelial neoplasia at a rate of 80%, but with a substantial risk of stricture. In the setting of gastric antral vascular ectasia, two prospective monocenter studies, and a retrospective multicenter study, (total 51 patients), suggest that RFA is efficacious in terms of reducing transfusion dependency. In the setting of chronic hemorrhagic radiation proctopathy, a prospective monocenter study and a retrospective multicenter study (total 56 patients) suggest that RFA is an efficient treatment. A retrospective comparative study (64 patients) suggests that RFA improves stents patency in malignant biliary strictures. Conclusions Endoscopic RFA is an upcoming treatment modality in early esophageal squamous intra-epithelial neoplasia, as well as in gastric, rectal, and biliary diseases. PMID:26279839