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Sample records for surgery utilizing homologous

  1. Exceptional cosmetic surgeries on homology spheres

    OpenAIRE

    Ravelomanana, Huygens C.

    2016-01-01

    The cosmetic surgery conjecture is a longstanding conjecture in 3-manifold theory. We present a theorem about exceptional cosmetic surgery for homology spheres. Along the way we prove that if the surgery is not a small seifert $\\mathbb{Z}/2\\mathbb{Z}$-homology sphere or a toroidal irreducible non-Seifert surgery then there is at most one pair of exceptional truly cosmetic slope. We also prove that toroidal truly cosmetic surgeries on integer homology spheres must be integer homology spheres.

  2. Cost-utility of routine cataract surgery

    Directory of Open Access Journals (Sweden)

    Ryynänen Olli-Pekka

    2006-09-01

    Full Text Available Abstract Background If decisions on health care spending are to be as rational and objective as possible, knowledge on cost-effectiveness of routine care is essential. Our aim, therefore, was to evaluate the cost-utility of routine cataract surgery in a real-world setting. Methods Prospective assessment of health-related quality of life (HRQoL of patients undergoing cataract surgery. 219 patients (mean (SD age 71 (11 years entering cataract surgery (in 87 only first eye operated, in 73 both eyes operated, in 59 first eye had been operated earlier filled in the 15D HRQoL questionnaire before and six months after operation. Direct hospital costs were obtained from a clinical patient administration database and cost-utility analysis performed from the perspective of the secondary care provider extrapolating benefits of surgery to the remaining statistical life-expectancy of the patients. Results Mean (SD utility score (on a 0–1 scale increased statistically insignificantly from 0.82 (0.13 to 0.83 (0.14. Of the 15 dimensions of the HRQoL instrument, only seeing improved significantly after operation. Mean utility score improved statistically significantly only in patients reporting significant or major preoperative seeing problems. Of the subgroups, only those whose both eyes were operated during follow-up showed a statistically significant (p Conclusion Mean utility gain after routine cataract surgery in a real-world setting was relatively small and confined mostly to patients whose both eyes were operated. The cost of cataract surgery per quality-adjusted life year gained was much higher than previously reported and associated with considerable uncertainty.

  3. The results of denatured homologous vein grafts as conduits for secondary haemodialysis access surgery.

    Science.gov (United States)

    Heintjes, R J; Eikelboom, B C; Steijling, J J; van Reedt Dortland, R W; van der Heijden, F H; Bastini, M; van der Graaf, Y; Blankestijn, P J; Vos, J

    1995-01-01

    To determine the value of denatured homologous vein grafts as a conduit for secondary haemodialysis access. Retrospective clinical study. 2 University Hospitals. One-hundred-and-twenty-five patients received 195 grafts over a period of five years. Fifty-six first grafts (45%) functioned without complications throughout the study period of 5.8 years. Primary patency was 57% after 1 year and 25% after 3 years of follow-up. Of the initial grafts, 69 (55%) needed 161 interventions, for thrombosis (n = 59), stenosis (n = 43), failure beyond repair (n = 40), aneurysm (n = 12), infection (n = 4), steal syndrome (n = 1), and other causes (n = 2). Secondary patency was 76% at 1 year and 52% at 3 years of follow-up. A major advantage of these grafts was the low rate (2.6%) of infection. Aneurysm formation occurred 17 times in 195 grafts (8.7%). Denatured homologous vein graft is a good alternative in secondary access surgery.

  4. The adiponectin receptor homologs in C. elegans promote energy utilization and homeostasis

    DEFF Research Database (Denmark)

    Svensson, Emma; Olsen, Louise Cathrine Braun; Mörck, Catarina

    2011-01-01

    Adiponectin is an adipokine with insulin-sensitising actions in vertebrates. Its receptors, AdipoR1 and AdipoR2, are PAQR-type proteins with 7-transmembrane domains and topologies reversed that of GPCR's, i.e. their C-termini are extracellular. We identified three adiponectin receptor homologs in...... metabolism and cold adaptation in C. elegans, that their main function is to promote energy utilization rather than storage, and that PAQR class proteins have regulated metabolism in metazoans for at least 700 million years....

  5. [Utility of radioguided surgery in splenosis].

    Science.gov (United States)

    Marí Hualde, A; Rotger Regí, A; Orcajo Rincón, J; Simal Badiola, I; Cerdá Berrocal, J A; Alonso Farto, J C

    2014-01-01

    Splenosis is a common finding after traumatic rupture of the spleen or therapeutic splenectomy, defined as a heterotopic autotransplantation of the spleen in peritoneal cavity and surface. In splenectomized patients due to hematologic disease, splenosis can lead to disease recurrence. We present a case of splenosis in a patient with idiopathic thrombocytopenic purpura who relapsed after splenectomy. For its localization, conventional imaging and scintigraphy with (99m)Tc-denatured red cells was performed, and at least five splenic foci were observed. Given the difficult intraoperative localization of these nodules, radioguided surgery was performed, with excellent localization and removal of all known nodules and multiple peritoneal implants of millimeter size that were not previously observed. We conclude that radioguided surgery is an excellent tool for locating foci of peritoneal splenosis, which have difficult access, thus avoiding early recurrence of the disease. Copyright © 2013 Elsevier España, S.L. y SEMNIM. All rights reserved.

  6. Health Disparities in Adolescent Bariatric Surgery: Nationwide Outcomes and Utilization.

    Science.gov (United States)

    Nunez Lopez, Omar; Jupiter, Daniel C; Bohanon, Fredrick J; Radhakrishnan, Ravi S; Bowen-Jallow, Kanika A

    2017-11-01

    Bariatric surgery represents an appropriate treatment for adolescent severe obesity, but its utilization remains low in this patient population. We studied the impact of race and sex on preoperative characteristics, outcomes, and utilization of adolescent bariatric surgery. Retrospective analysis (2007-2014) of adolescent bariatric surgery using the Bariatric Outcomes Longitudinal Database, a national database that collects bariatric surgical care data. We assessed the relationships between baseline characteristics and outcomes (weight loss and remission of obesity-related conditions [ORCs]). Using the National Health and Nutrition Examination Survey and U.S. census data, we calculated the ratio of severe obesity and bariatric procedures among races and determined the ratio of ratios to assess for disparities. About 1,539 adolescents underwent bariatric surgery. Males had higher preoperative body mass index (BMI; 51.8 ± 10.5 vs. 47.1 ± 8.7, p bariatric surgery at a higher proportion than blacks and Hispanics (2.5 and 2.3 times higher, respectively). Preoperative characteristics vary according to race and sex. Race and sex do not impact 12-month weight loss or ORC's remission rates. Minority adolescents undergo bariatric surgery at lower-than-expected rates. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  7. A restraint molecular dynamics and simulated annealing approach for protein homology modeling utilizing mean angles

    Directory of Open Access Journals (Sweden)

    Maurer Till

    2005-04-01

    Full Text Available Abstract Background We have developed the program PERMOL for semi-automated homology modeling of proteins. It is based on restrained molecular dynamics using a simulated annealing protocol in torsion angle space. As main restraints defining the optimal local geometry of the structure weighted mean dihedral angles and their standard deviations are used which are calculated with an algorithm described earlier by Döker et al. (1999, BBRC, 257, 348–350. The overall long-range contacts are established via a small number of distance restraints between atoms involved in hydrogen bonds and backbone atoms of conserved residues. Employing the restraints generated by PERMOL three-dimensional structures are obtained using standard molecular dynamics programs such as DYANA or CNS. Results To test this modeling approach it has been used for predicting the structure of the histidine-containing phosphocarrier protein HPr from E. coli and the structure of the human peroxisome proliferator activated receptor γ (Ppar γ. The divergence between the modeled HPr and the previously determined X-ray structure was comparable to the divergence between the X-ray structure and the published NMR structure. The modeled structure of Ppar γ was also very close to the previously solved X-ray structure with an RMSD of 0.262 nm for the backbone atoms. Conclusion In summary, we present a new method for homology modeling capable of producing high-quality structure models. An advantage of the method is that it can be used in combination with incomplete NMR data to obtain reasonable structure models in accordance with the experimental data.

  8. Homology, Analogy, and Ethology.

    Science.gov (United States)

    Beer, Colin G.

    1984-01-01

    Because the main criterion of structural homology (the principle of connections) does not exist for behavioral homology, the utility of the ethological concept of homology has been questioned. The confidence with which behavioral homologies can be claimed varies inversely with taxonomic distance. Thus, conjectures about long-range phylogenetic…

  9. The Ustilago maydis Nit2 Homolog Regulates Nitrogen Utilization and Is Required for Efficient Induction of Filamentous Growth

    Science.gov (United States)

    Horst, Robin J.; Zeh, Christine; Saur, Alexandra; Sonnewald, Sophia; Sonnewald, Uwe

    2012-01-01

    Nitrogen catabolite repression (NCR) is a regulatory strategy found in microorganisms that restricts the utilization of complex and unfavored nitrogen sources in the presence of favored nitrogen sources. In fungi, this concept has been best studied in yeasts and filamentous ascomycetes, where the GATA transcription factors Gln3p and Gat1p (in yeasts) and Nit2/AreA (in ascomycetes) constitute the main positive regulators of NCR. The reason why functional Nit2 homologs of some phytopathogenic fungi are required for full virulence in their hosts has remained elusive. We have identified the Nit2 homolog in the basidiomycetous phytopathogen Ustilago maydis and show that it is a major, but not the exclusive, positive regulator of nitrogen utilization. By transcriptome analysis of sporidia grown on artificial media devoid of favored nitrogen sources, we show that only a subset of nitrogen-responsive genes are regulated by Nit2, including the Gal4-like transcription factor Ton1 (a target of Nit2). Ustilagic acid biosynthesis is not under the control of Nit2, while nitrogen starvation-induced filamentous growth is largely dependent on functional Nit2. nit2 deletion mutants show the delayed initiation of filamentous growth on maize leaves and exhibit strongly compromised virulence, demonstrating that Nit2 is required to efficiently initiate the pathogenicity program of U. maydis. PMID:22247264

  10. The Utility of Outcome Measures in Total Knee Replacement Surgery

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    Michelle M. Dowsey

    2013-01-01

    Full Text Available Total knee replacement (TKR is the mainstay of treatment for people with end-stage knee OA among suitably “fit” candidates. As a high cost, high volume procedure with a worldwide demand that continues to grow it has become increasingly popular to measure response to surgery. While the majority who undergo TKR report improvements in pain and function following surgery, a significant proportion of patients report dissatisfaction with surgery as a result of ongoing pain or poor function. Poor outcomes of TKR require care that imposes on already overburdened health systems. Accurate and meaningful capture and interpretation of outcome data are imperative for appropriate patient selection, informing those at risk, and for developing strategies to mitigate the risk of poor results and dissatisfaction. The ways in which TKR outcomes are captured and analysed, the level of follow-up, the types of outcome measures used, and the timing of their application vary considerably within the literature. With this in mind, we reviewed four of the most commonly used joint specific outcome measures in TKR. We report on the utility, strengths, and limitations of the Oxford knee score (OKS, knee injury and osteoarthritis outcome score (KOOS, Western Ontario and McMaster Universities osteoarthritis index (WOMAC, and knee society clinical rating system (KSS.

  11. Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children

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    Aymen N Naguib

    2015-01-01

    Full Text Available Introduction: Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass. Materials and Methods: In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1 st year of life. Cases were done from May 2011 to December 2013. Children were assessed using the Stanford-Binet Intelligence Scales (5 th edition. Multiple regression analysis was used to test different parental and perioperative factors that could significantly predict the different neurodevelopmental outcomes in the entire cohort of patients. Results: When comparing the three groups regarding the major cognitive scores, a high-dose fentanyl (HDF patients scored significantly higher than the low-dose fentanyl (LDF + dexmedetomidine (DEX (LDF + DEX group in the quantitative reasoning scores (106 ± 22 vs. 82 ± 15 P = 0.046. The bispectral index (BIS value at the end of surgery for the -LDF group was significantly higher than that in LDF + DEX group (P = 0.011. For the entire cohort, a strong correlation was seen between the standard verbal intelligence quotient (IQ score and the baseline adrenocorticotropic hormone level, the interleukin-6 level at the end of surgery and the BIS value at the end of the procedure with an R 2 value of 0.67 and P < 0.04. There was an inverse correlation between the cardiac Intensive Care Unit length of stay and the full-scale IQ score (R = 0.4675 and P 0.027. Conclusions: Patients in the HDF group demonstrated overall higher neurodevelopmental scores, although it did not reach statistical significance except in fluid reasoning scores. Our results may point to a possible correlation between blunting the stress response and improvement of the neurodevelopmental

  12. Cost utility analysis of endoscopic sinus surgery for chronic rhinosinusitis.

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    Scangas, George A; Su, Brooke M; Remenschneider, Aaron K; Shrime, Mark G; Metson, Ralph

    2016-06-01

    The purpose of this work was to evaluate the cost-effectiveness of endoscopic sinus surgery (ESS) compared to medical therapy for patients with chronic rhinosinusitis (CRS). The study design consisted of a microsimulation Markov decision-tree economic model with a 31-year time horizon. A cohort of 489 patients who underwent ESS for CRS were matched 1 to 1 with a cohort of 489 patients from the national Medical Expenditures Panel Survey database who underwent medical management for CRS. Utility scores were calculated from responses to the EuroQol 5-Dimension instrument in both cohorts. Decision-tree analysis and a subsequent 10-state Markov model utilized published event probabilities as well as primary data from a large multisurgeon prospective outcomes study to calculate long-term costs and utility. The primary outcome measure was incremental cost per quality-adjusted life year (QALY). Multiple sensitivity analyses were performed. The incremental cost-effectiveness ratio (ICER) for ESS vs medical therapy alone was $13,851.26 per QALY. The cost effectiveness acceptability curve demonstrated 85.84% and 98.69% certainty that the ESS strategy was the most cost-effective option at willingness-to-pay thresholds of $25,000 and $50,000 per QALY, respectively. This study shows ESS to be a cost-effective intervention compared to medical therapy alone for the management of patients with CRS. © 2016 ARS-AAOA, LLC.

  13. The Utility of Outcome Studies in Plastic Surgery

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    Hani Sinno, MD, MEng

    2014-07-01

    Full Text Available Summary: Outcome studies help provide the evidence-based science rationalizing treatment end results that factor the experience of patients and the impact on society. They improve the recognition of the shortcoming in clinical practice and provide the foundation for the development of gold standard care. With such evidence, health care practitioners can develop evidence-based justification for treatments and offer patients with superior informed consent for their treatment options. Furthermore, health care and insurance agencies can recognize improved cost-benefit options in the purpose of disease prevention and alleviation of its impact on the patient and society. Health care outcomes are ultimately measured by the treatment of disease, the reduction of symptoms, the normalization of laboratory results and physical measures, saving a life, and patient satisfaction. In this review, we outline the tools available to measure outcomes in plastic surgery and subsequently allow the objective measurements of plastic surgical conditions. Six major outcome categories are discussed: (1 functional measures; (2 preference-based measures and utility outcome scores; (3 patient satisfaction; (4 health outcomes and time; (5 other tools: patient-reported outcome measurement information system, BREAST-Q, and Tracking Operations and Outcomes for Plastic Surgeons; and (6 cost-effectiveness analysis. We use breast hypertrophy requiring breast reduction as an example throughout this review as a representative plastic surgical condition with multiple treatments available.

  14. 77 FR 67380 - Submission for OMB Review; Comment Request: Ethical Dilemmas in Surgery and Utilization of...

    Science.gov (United States)

    2012-11-09

    ... Dilemmas in Surgery and Utilization of Hospital Ethics Consultation Service: A Survey SUMMARY: Under the... Collection: Title: Ethical Dilemmas in Surgery and Utilization of Hospital Ethics Consultation Service: A... is intended to collect information about the ethical dilemmas that surgeons have faced in their...

  15. Utility of onsite interviews in the pediatric surgery match.

    Science.gov (United States)

    Downard, Cynthia D; Goldin, Adam; Garrison, Michelle M; Waldhausen, John; Langham, Max; Hirschl, Ronald

    2015-06-01

    The value of onsite interviews for the pediatric surgery match remains undefined despite substantial cost to applicants. This study assesses the impact of onsite interviews on the rank order lists submitted to the match by pediatric surgery residency training program directors (PDs). PDs were asked prospectively to evaluate pediatric surgery residency candidates based solely on their ERAS application and generate a "pre-interview rank list." Interviews were then held based on the usual practice of each program. PDs then submitted de-identified pre-interview and final rank lists. The impact of the interview process upon rank list movement of candidates was assessed. Of 44 programs, 16 (36%) provided data for analysis. Onsite interviews resulted in candidates moving a mean of 5.2 ± 1.2 rank positions, whereas candidates ranked in the first 5 positions moved an average of 4 ± 2 places, 81% of the initial top-ranked candidates moved out of this position, and 36% of top 10 candidates moved out of the top 10. Onsite interviews are high-stakes events which substantially affect the final rank order list in the pediatric surgery match. Programs should take these data into account when determining the number of interview invitations. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Utilizing the American Board of Surgery in-training exam in a ...

    African Journals Online (AJOL)

    Utilizing the American Board of Surgery in-training exam in a Rwandan surgical residency program: Alignment of exam topics with the University of Rwanda general surgery curriculum. ... Of this, 76% of medical knowledge and 71% of patient care content was covered in UR curriculum. 41% of operations and procedures ...

  17. Survey on Robot-Assisted Surgical Techniques Utilization in US Pediatric Surgery Fellowships.

    Science.gov (United States)

    Maizlin, Ilan I; Shroyer, Michelle C; Yu, David C; Martin, Colin A; Chen, Mike K; Russell, Robert T

    2017-02-01

    Robotic technology has transformed both practice and education in many adult surgical specialties; no standardized training guidelines in pediatric surgery currently exist. The purpose of our study was to assess the prevalence of robotic procedures and extent of robotic surgery education in US pediatric surgery fellowships. A deidentified survey measured utilization of the robot, perception on the utility of the robot, and its incorporation in training among the program directors of Accreditation Council for Graduate Medical Education (ACGME) pediatric surgery fellowships in the United States. Forty-one of the 47 fellowship programs (87%) responded to the survey. While 67% of respondents indicated the presence of a robot in their facility, only 26% reported its utilizing in their surgical practice. Among programs not utilizing the robot, most common reasons provided were lack of clear supportive evidence, increased intraoperative time, and incompatibility of instrument size to pediatric patients. While 58% of program directors believe that there is a future role for robotic surgery in children, only 18% indicated that robotic training should play a part in pediatric surgery education. Consequently, while over 66% of survey respondents received training in robot-assisted surgical technique, only 29% of fellows receive robot-assisted training during their fellowship. A majority of fellowships have access to a robot, but few utilize the technology in their current practice or as part of training. Further investigation is required into both the technology's potential benefits in the pediatric population and its role in pediatric surgery training.

  18. Impact of Bariatric Surgery on Healthcare Utilization and Costs among Patients with Diabetes

    Science.gov (United States)

    Bleich, Sara N.; Chang, Hsien-Yen; Lau, Bryan; Steele, Kimberly; Clark, Jeanne M.; Richards, Thomas; Weiner, Jonathan P; Wu, Albert W.; Segal, Jodi B.

    2011-01-01

    Background The effect of bariatric surgery on health care utilization and costs among individuals with type 2 diabetes remains unclear. Objective To examine healthcare utilization and costs in an insured cohort of individuals with type 2 diabetes after bariatric surgery. Research Design Cohort study derived from administrative data from 2002–2008 from 7 Blue Cross Blue Shield Plans. Subjects 7,806 individuals with type 2 diabetes who had bariatric surgery Measures Cost (inpatient, outpatient, pharmacy, other) and utilization (number of inpatient days, outpatient visits, specialist visits). Results Compared to pre-surgical costs, the ratio of hospital costs (excluding the initial surgery), among beneficiaries who had any hospital costs, was higher in years 2 through 6 of the post-surgery period and increased over time [post 1: OR = 0.58 (95% CI: 0.50, 0.67); post 6: OR = 3.43 (95% CI: 2.60, 4.53)]. In comparison to the pre-surgical period, the odds of having any healthcare costs was lower in the post-surgery period and remained relatively flat over time. Among those with hospitalizations, the adjusted ratio of inpatient days was higher after surgery [post 1: OR = 1.05 (95% CI: 0.94, 1.16); post 6: OR = 2.77 (95% CI: 1.57, 4.90)]. Among those with primary care visits, the adjusted odds ratio was lower after surgery [post 1: OR = 0.80 (95% CI: 0.78, 0.82); post 6: OR = 0.66 (95% CI: 0.57, 0.76)]. Conclusion In the six years following surgery, individuals with type 2 diabetes did not have lower healthcare costs than before surgery. PMID:22167064

  19. Cost-utility analysis of rhegmatogenous retinal detachment surgery in Shanghai, China.

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    Ma, Yingyan; Ying, Xiaohua; Zou, Haidong; Xu, Xiaocheng; Liu, Haiyun; Bai, Lin; Xu, Xun; Zhang, Xi

    2015-02-01

    To perform a short-term and a long-term cost-utility analysis of rhegmatogenous retinal detachment (RRD) surgery in Shanghai, China. A total of 117 patients who underwent RRD surgery at Shanghai First People's Hospital, Affiliated Shanghai Jiaotong University, and then underwent follow-up for at least 1 year, were included in the study. Costs associated with RRD surgery and time trade-off utility values before and after surgery were recorded. Short-term analysis was made for 1 year. Quality-adjusted life years (QALYs) gained by RRD surgery over the lifetime were calculated at a 3% discount rate in the long-term analysis. This study used the bootstrap method in statistical analysis and one-way sensitivity analyses to test robustness of the results. Compared with no treatment, the mean incremental costs of RRD surgery was 11,384 Chinese yuan (CN¥) (US$1751); the mean additional QALYs gained was 0.05 (95% confidence interval [CI] 0.04-0.06) for 1 year and 0.88 (95% CI 0.64-1.13) for life expectancy; the incremental cost effectiveness ratio (ICER) was CN¥224,921 (US$34,603)/QALY for the short-term, and CN¥13,794 (US$2122)/QALY for the long-term. In short-term analysis, the ICER was CN¥150,087 (US$23,090)/QALY for scleral buckling surgery, and CN¥507,727 (US$78,112)/QALY for vitreous surgery. In the long-term analysis, the ICER was CN¥6280 (US$966)/QALY for scleral buckling, and CN¥30,756 (US$4732)/QALY for vitreous surgery. For RRD patients, surgery increases QALYs. In a 1-year analysis, surgery is not a cost-effective treatment, however it is cost-effective over the lifetime.

  20. The utility of routine polyp histopathology after endoscopic sinus surgery.

    Science.gov (United States)

    Yeh, David H; Wong, Jay; Hoffbauer, Stephanie; Wehrli, Bret; Sommer, Doron; Rotenberg, Brian W

    2014-11-01

    Routine histopathological assessment is standard practice for nasal polyp specimens obtained during endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Retrospective studies suggest that routine histopathology of nasal polyps shows few unexpected diagnoses that alter patient management. Our objective was to study the use of routine pathological analysis, and its cost to the healthcare system, in a prospective manner. A multicenter prospective assessment was performed from data collected between 2007 and 2013. Only cases of patients undergoing ESS for bilateral CRS were included. We excluded unilateral disease cases, and cases in which diagnoses other than polyps were suspected either preoperatively or intraoperatively. We then compared the preoperative diagnosis with the final histopathology and identified the rate of unexpected pathologies. A cost analysis was performed. Only 4 of 866 pathological specimens were identified as having a clinically significant unexpected diagnosis. All unexpected pathologies in this series were benign. These 4 cases account for 0.46% of all specimens reviewed. This translates to a number needed to screen of 217 cases of bilateral CRS to discover 1 unexpected pathology. The associated cost for making an unexpected diagnosis was $19,192.73. Routine histopathology of nasal polyps in ESS for bilateral CRS with polyps yields few unexpected and management-altering diagnoses. It carries a significant cost to the healthcare system. In cases of bilateral CRS with no other concerning clinical features, clinicians should exercise judgment in submitting polyp specimens for pathology rather than routinely sending polyps for histopathologic analysis. © 2014 ARS-AAOA, LLC.

  1. Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling

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    Marcello Lucchese

    2017-06-01

    Full Text Available Objective: To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years and a long-term (lifetime horizon. Methods: A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. Results: In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs. Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. Conclusion: In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and cost-saving over the lifetime of the Italian patient cohort considered in this analysis.

  2. Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling.

    Science.gov (United States)

    Lucchese, Marcello; Borisenko, Oleg; Mantovani, Lorenzo Giovanni; Cortesi, Paolo Angelo; Cesana, Giancarlo; Adam, Daniel; Burdukova, Elisabeth; Lukyanov, Vasily; Di Lorenzo, Nicola

    2017-01-01

    To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years) and a long-term (lifetime) horizon. A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs). Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and cost-saving over the lifetime of the Italian patient cohort considered in this analysis. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

  3. Role of socio-economic factors in cataract surgery utilization in JIPMER Pondicherry

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    Prasanna T

    2007-01-01

    Full Text Available Background : This study was conducted in JIPMER & Kurusukuppam, Pondicherry. Objectives : To identify the socioeconomic factors influencing the utilization of cataract surgery & to identify the persons motivating the patients to utilize these services. This was a case-control study; cases were patients (age group 50-70 years who were operated in JIPMER for senile cataract without complications and one control was selected for each case. Controls were also of the same age group residing at Kurusukuppam with complaints of dimness of vision and who had not undergone cataract surgery, selected by random sampling. Both the groups were interviewed using a pretested interview schedule. Results : Subjects who were literate and with high school education and more and with income more than Rs.1050 (class III utilized the cataract surgery services more. In majority of cases, motivation for getting operated comes from relatives. Peer groups who have undergone the surgery before, were the predominant sources of health information about the surgery. Higher income & higher education affect the utilization significantly. Relatives & Previously operated peers play an important role.

  4. SV40 utilizes ATM kinase activity to prevent non-homologous end joining of broken viral DNA replication products.

    Science.gov (United States)

    Sowd, Gregory A; Mody, Dviti; Eggold, Joshua; Cortez, David; Friedman, Katherine L; Fanning, Ellen

    2014-12-01

    Simian virus 40 (SV40) and cellular DNA replication rely on host ATM and ATR DNA damage signaling kinases to facilitate DNA repair and elicit cell cycle arrest following DNA damage. During SV40 DNA replication, ATM kinase activity prevents concatemerization of the viral genome whereas ATR activity prevents accumulation of aberrant genomes resulting from breakage of a moving replication fork as it converges with a stalled fork. However, the repair pathways that ATM and ATR orchestrate to prevent these aberrant SV40 DNA replication products are unclear. Using two-dimensional gel electrophoresis and Southern blotting, we show that ATR kinase activity, but not DNA-PK(cs) kinase activity, facilitates some aspects of double strand break (DSB) repair when ATM is inhibited during SV40 infection. To clarify which repair factors associate with viral DNA replication centers, we examined the localization of DSB repair proteins in response to SV40 infection. Under normal conditions, viral replication centers exclusively associate with homology-directed repair (HDR) and do not colocalize with non-homologous end joining (NHEJ) factors. Following ATM inhibition, but not ATR inhibition, activated DNA-PK(cs) and KU70/80 accumulate at the viral replication centers while CtIP and BLM, proteins that initiate 5' to 3' end resection during HDR, become undetectable. Similar to what has been observed during cellular DSB repair in S phase, these data suggest that ATM kinase influences DSB repair pathway choice by preventing the recruitment of NHEJ factors to replicating viral DNA. These data may explain how ATM prevents concatemerization of the viral genome and promotes viral propagation. We suggest that inhibitors of DNA damage signaling and DNA repair could be used during infection to disrupt productive viral DNA replication.

  5. SV40 Utilizes ATM Kinase Activity to Prevent Non-homologous End Joining of Broken Viral DNA Replication Products

    Science.gov (United States)

    Sowd, Gregory A.; Mody, Dviti; Eggold, Joshua; Cortez, David; Friedman, Katherine L.; Fanning, Ellen

    2014-01-01

    Simian virus 40 (SV40) and cellular DNA replication rely on host ATM and ATR DNA damage signaling kinases to facilitate DNA repair and elicit cell cycle arrest following DNA damage. During SV40 DNA replication, ATM kinase activity prevents concatemerization of the viral genome whereas ATR activity prevents accumulation of aberrant genomes resulting from breakage of a moving replication fork as it converges with a stalled fork. However, the repair pathways that ATM and ATR orchestrate to prevent these aberrant SV40 DNA replication products are unclear. Using two-dimensional gel electrophoresis and Southern blotting, we show that ATR kinase activity, but not DNA-PKcs kinase activity, facilitates some aspects of double strand break (DSB) repair when ATM is inhibited during SV40 infection. To clarify which repair factors associate with viral DNA replication centers, we examined the localization of DSB repair proteins in response to SV40 infection. Under normal conditions, viral replication centers exclusively associate with homology-directed repair (HDR) and do not colocalize with non-homologous end joining (NHEJ) factors. Following ATM inhibition, but not ATR inhibition, activated DNA-PKcs and KU70/80 accumulate at the viral replication centers while CtIP and BLM, proteins that initiate 5′ to 3′ end resection during HDR, become undetectable. Similar to what has been observed during cellular DSB repair in S phase, these data suggest that ATM kinase influences DSB repair pathway choice by preventing the recruitment of NHEJ factors to replicating viral DNA. These data may explain how ATM prevents concatemerization of the viral genome and promotes viral propagation. We suggest that inhibitors of DNA damage signaling and DNA repair could be used during infection to disrupt productive viral DNA replication. PMID:25474690

  6. SV40 utilizes ATM kinase activity to prevent non-homologous end joining of broken viral DNA replication products.

    Directory of Open Access Journals (Sweden)

    Gregory A Sowd

    2014-12-01

    Full Text Available Simian virus 40 (SV40 and cellular DNA replication rely on host ATM and ATR DNA damage signaling kinases to facilitate DNA repair and elicit cell cycle arrest following DNA damage. During SV40 DNA replication, ATM kinase activity prevents concatemerization of the viral genome whereas ATR activity prevents accumulation of aberrant genomes resulting from breakage of a moving replication fork as it converges with a stalled fork. However, the repair pathways that ATM and ATR orchestrate to prevent these aberrant SV40 DNA replication products are unclear. Using two-dimensional gel electrophoresis and Southern blotting, we show that ATR kinase activity, but not DNA-PK(cs kinase activity, facilitates some aspects of double strand break (DSB repair when ATM is inhibited during SV40 infection. To clarify which repair factors associate with viral DNA replication centers, we examined the localization of DSB repair proteins in response to SV40 infection. Under normal conditions, viral replication centers exclusively associate with homology-directed repair (HDR and do not colocalize with non-homologous end joining (NHEJ factors. Following ATM inhibition, but not ATR inhibition, activated DNA-PK(cs and KU70/80 accumulate at the viral replication centers while CtIP and BLM, proteins that initiate 5' to 3' end resection during HDR, become undetectable. Similar to what has been observed during cellular DSB repair in S phase, these data suggest that ATM kinase influences DSB repair pathway choice by preventing the recruitment of NHEJ factors to replicating viral DNA. These data may explain how ATM prevents concatemerization of the viral genome and promotes viral propagation. We suggest that inhibitors of DNA damage signaling and DNA repair could be used during infection to disrupt productive viral DNA replication.

  7. The clinical utility of new combination phenylephrine/ketorolac injection in cataract surgery

    Directory of Open Access Journals (Sweden)

    Lawuyi LE

    2015-07-01

    Full Text Available Lola Elizabeth Lawuyi, Avinash Gurbaxani Moorfields Eye Hospital Dubai, Dubai, UAE Abstract: The maintenance of mydriasis throughout cataract extraction surgery and the control of ocular inflammation are crucial for successful surgical outcomes. The development of miosis during cataract surgery compromises the visualization of the surgical field and working space for surgeons. This may lead to complications that include posterior capsular tear and associated vitreous loss, longer surgical time, and postoperative inflammation. Postoperative inflammation is often uncomfortable and frustrating for patients. It causes pain, redness, and photophobia. This compromises the best-uncorrected vision following surgery and often leads to multiple clinic visits. This article examines the literature published on the current treatments used to manage mydriasis, pain, and inflammation in cataract extraction surgery. Combination phenylephrine/ketorolac injection offers an exciting new class of medication for use in cataract surgery. With the recent approval of Omidria™ (combination of phenylephrine 1% and ketorolac 0.3% by the US Food and Drug Administration (FDA for intraocular use, we review the clinical utility of this new combination injection in cataract surgery. PubMed, MEDLINE, and conference proceedings were searched for the relevant literature using a combination of the following search terms: cataract extraction surgery, pupil dilation (mydriasis, miosis, phenylephrine, ketorolac, Omidria™, intracameral mydriatic. Relevant articles were reviewed and their references checked for further relevant literature. All abstracts were reviewed and full texts retrieved where available. Keywords: cataract extraction surgery, ketorolac, mydriasis, miosis, Omidria™, phenylephrine

  8. Plastic Surgery-Related Hashtag Utilization on Instagram: Implications for Education and Marketing.

    Science.gov (United States)

    Dorfman, Robert G; Vaca, Elbert E; Mahmood, Eitezaz; Fine, Neil A; Schierle, Clark F

    2018-02-15

    Recent data suggest patients are seeking aesthetic surgery to improve their appearance on Instagram and other social media. Despite the rising influence of Instagram in plastic surgery, few academic publications address Instagram, let alone evaluate its utilization in plastic surgery. We set out to answer the following three questions: 1) what plastic surgery-related content is being posted to Instagram; 2) who is posting this content; and 3) what specific hashtags are they using? Our study queried 21 Instagram plastic surgery-related hashtags. Content analysis was used to qualitatively evaluate each of the nine "top" posts associated with each hashtag (189 posts). Duplicate posts and those not relevant to plastic surgery were excluded. A total of 1,789,270 posts utilized the 21 hashtags sampled in this study. Of the top 189 posts for these 21 queried hashtags, 163 posts met inclusion criteria. Plastic surgeons eligible for membership in American Society for Aesthetic Plastic Surgery (ASAPS) accounted for only 17.8% of top posts, whereas noneligible physicians accounted for 26.4%. All nonplastic surgery trained physicians marketed themselves as "cosmetic surgeons." Nine top posts (5.5%) were by nonphysicians, including dentists, spas with no associated physician, and a hair salon. The majority of these posts were self-promotional (67.1%) as opposed to educational (32.9%). Board-certified plastic surgeons were significantly more likely to post educational content to Instagram as compared to nonplastic surgeons (62.1% vs 38.1%, P = 0.02). ASAPS eligible board-certified plastic surgeons are underrepresented amongst physicians posting top plastic surgery-related content to Instagram.

  9. Cost-utility analysis of cardiac rehabilitation after conventional heart valve surgery versus usual care

    DEFF Research Database (Denmark)

    Hansen, Tina Birgitte; Zwisler, Ann Dorthe; Kikkenborg Berg, Selina

    2017-01-01

    Background While cardiac rehabilitation in patients with ischaemic heart disease and heart failure is considered cost-effective, this evidence may not be transferable to heart valve surgery patients. The aim of this study was to investigate the cost-effectiveness of cardiac rehabilitation following...... heart valve surgery. Design We conducted a cost-utility analysis based on a randomised controlled trial of 147 patients who had undergone heart valve surgery and were followed for 6 months. Methods Patients were randomised to cardiac rehabilitation consisting of 12 weeks of physical exercise training...... rehabilitation compared to usual care is at minimum 75%, driven by a tendency towards costs savings. Conclusions Cardiac rehabilitation after heart valve surgery may not have improved health-related quality of life in this study, but is likely to be cost-effective for society, outweighing the extra costs...

  10. The Effect of Ptosis Surgery on Brow Position and the Utility of Preoperative Phenylephrine Testing.

    Science.gov (United States)

    Rootman, Daniel B; Karlin, Justin; Moore, Grant; Goldberg, Robert

    2016-01-01

    Many reports have suggested that upper eyelid position and brow height can be interdependent; however, the relation is not universally observed. This study aims to understand the prevalence of this phenomenon and examine the utility of phenylephrine testing in predicting brow height change after surgery. Ptotic eyelids undergoing Muller's muscle conjunctiva resection surgery in which phenylephrine testing was performed were included. The distance from both the center of the pupil to the upper eyelid and the lower brow margin were measured in the midpupillary line. Measurements were performed based on photographs taken on presentation, after phenylephrine testing and at postsurgical follow-up. Change in eyelid margin and brow position between each of these conditions was assessed. Associations between changes in eyelid margin and brow position were analyzed, and a receiver operating characteristic curve for brow change after phenylephrine instillation as a predictor of postoperative brow change was fit. In the sample of 125 eyes, there was a significant change in mean marginal reflex distance one both with application of phenylephrine and after surgery (p 0.05). There was a significant change in brow height with surgery (1 mm; p surgery or with phenylephrine was not significantly correlated with change in brow height after surgery (Pearson's r = 0.06; p > 0.05). Brow height change with phenylephrine was significantly correlated with brow height change after surgery (p surgery. Patients who do not demonstrate a reduction in brow height of at least 3.5 mm after phenylephrine instillation preoperatively are unlikely to have clinically relevant brow height reduction after surgery.

  11. Cost-utility analysis comparing laparoscopic vs open aortobifemoral bypass surgery

    Directory of Open Access Journals (Sweden)

    Krog AH

    2017-06-01

    .001 in favor of laparoscopic aortobifemoral bypass. The total cost of surgery, equipment and hospital stay after laparoscopic surgery (9,953 € was less than open surgery (17,260 €, (p=0.001. Conclusion: Laparoscopic aortobifemoral bypass seems to be cost-effective compared with open surgery, due to an increase in QALYs and lower procedure-related costs. Keywords: laparoscopy, aortobifemoral bypass, cost-utility, quality-adjusted life years, QALYs, EQ-5D, health-related quality of life, HRQoL, cost-effectiveness

  12. Directed homology

    DEFF Research Database (Denmark)

    Fahrenberg, Uli

    2004-01-01

    We introduce a new notion of directed homology for semicubical sets. We show that it respects directed homotopy and is functorial, and that it appears to enjoy some good algebraic properties. Our work has applications to higher-dimensional automata.......We introduce a new notion of directed homology for semicubical sets. We show that it respects directed homotopy and is functorial, and that it appears to enjoy some good algebraic properties. Our work has applications to higher-dimensional automata....

  13. Cost-Utility Analysis of Cataract Surgery in Advanced Glaucoma Patients.

    Science.gov (United States)

    Xu, Xian; Ma, Ying-Yan; Zou, Hai-Dong

    2016-07-01

    To assess the cost-effectiveness of cataract surgery in advanced glaucoma (AG) patients. A total of 93 patients with AG who underwent cataract surgeries were collected prospectively from June 2010 through June 2013 in Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, and were followed up for at least 3 months. A standard phacoemulsification technique was used to remove cataract(s). No complications occurred intraoperatively or postoperatively. Costs associated with surgery were recorded. Utility values of cataract surgery were obtained by using time trade-off method. Quality-adjusted life-years (QALYs) were calculated using the patients' life expectancy at a 3% discounted rate. Incremental cost-utility analysis was performed (compared with no treatment) by calculating the incremental cost-effectiveness ratio (ICER), that is, the mean incremental cost for each QALY. The bootstrap method was used for statistical analysis, and sensitivity analyses were performed to test robustness of the results. The mean incremental cost of cataract surgery was 9876 Chinese yuan (CNY) [1593 US dollar (USD)] [95% confidence interval (CI), 9144-10,570 CNY (1475-1705 USD)].The mean additional QALYs gained were 2.20 (95% CI, 1.85-2.54), and the incremental cost for each additional QALY was 4508 CNY (727 USD) [95% CI, 3890-5234 CNY (627-844 USD)], far lower than the per capita annual disposable income in Shanghai, 40,188 CNY (6482 USD). For AG patients, cataract surgery does help obtain more QALYs and was highly cost effective.

  14. Utility of three-dimensional computed tomography in general thoracic surgery.

    Science.gov (United States)

    Akiba, Tadashi

    2013-12-01

    It is important for general thoracic surgeons to understand the relationship between tumors and surrounding organs during surgery; however, many anatomical variations are possible in the thorax, which can complicate this goal. Multidetector computed tomography (MDCT) is the latest technical breakthrough in CT imaging. MDCT permits rapid scanning of large areas of the body with multiple detectors, thereby allowing for simultaneous acquisition of an increased number of transaxial CT slices, which reduce motion artifacts. Three-dimensional (3D) rendering involves the creation of two-dimensional images that convey the 3D relationship of objects. The 3D reconstruction allows for enormous quantity of data to be utilized intuitively and effectively. The final images can reveal various lesions or organs of interest with high anatomical detail and accuracy to the general thoracic surgeon, which is helpful in performing safer surgeries. Surgeries for the following can benefit from this technology: lung lobectomy or segmentectomy, pulmonary sequestration, cardiovascular malformation, tracheobronchial tree, mediastinum, and chest wall. This article reviews the utility of 3D-MDCT imaging in the field of general thoracic surgery.

  15. Laparoscopic sleeve gastrectomy leads the U.S. utilization of bariatric surgery at academic medical centers.

    Science.gov (United States)

    Varela, J Esteban; Nguyen, Ninh T

    2015-01-01

    Analysis of a recent single state bariatric surgery registry revealed that laparoscopic sleeve gastrectomy was the most common bariatric procedure starting in 2012. The objective of this study was to examine the trend in utilization of laparoscopic sleeve gastrectomy performed at academic medical centers in the United States. Using ICD-9 diagnosis and procedure codes, clinical data obtained from the University HealthSystem Consortium database for all bariatric procedures performed for the treatment of severe obesity between October 1, 2011, and June 30, 2014. Quarterly trends in utilization for the 4 most commonly performed bariatric operations were examined, and comparisons between procedures were performed. A total of 54,953 bariatric procedures were performed. Utilization of laparoscopic sleeve gastrectomy increased from 23.7% of all bariatric procedures during the fourth quarter of 2011 to 60.7% during the second quarter of 2014 while laparoscopic gastric bypass decreased from 62.2% to 37.0%, respectively. Utilization of laparoscopic sleeve gastrectomy surpassed that of laparoscopic gastric bypass in the second quarter of 2013 (50.6% versus 45.8%). During the same time period, utilization of open gastric bypass fell from 6.6% to 1.5%, and the use of laparoscopic adjustable gastric banding decreased from 7.5% to .8%. Within the context of U.S. academic medical centers, there has been a significant increase in the utilization of laparoscopic sleeve gastrectomy, which has surpassed laparoscopic gastric bypass utilization since 2013. Laparoscopic sleeve gastrectomy is now the most commonly performed bariatric procedure at the national level within academic centers. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  16. Current utilization of balloon dilation versus endoscopic techniques in pediatric sinus surgery.

    Science.gov (United States)

    Ference, Elisabeth H; Schroeder, James W; Qureshi, Hannan; Conley, David; Chandra, Rakesh K; Tan, Bruce K; Shintani Smith, Stephanie

    2014-11-01

    To study the utilization of balloon catheter dilation (BCD) compared to traditional endoscopic surgery (ESS) in pediatric patients. Cross-sectional analysis. Hospital and freestanding ambulatory surgery centers in California, Florida, Maryland, and New York Patients less than 18 years who underwent BCD(316) or ESS(2346), as identified by CPT codes from the State Ambulatory Surgery Databases 2011. Patient and facility demographics, mean charges, and operating room time were examined using bivariate and multivariate analyses. A total of 2662 children underwent surgery, with BCD used in 10.6% of maxillary, 8.4% of sphenoid, and 11.8% of frontal procedures. Adjusted analysis found that children with asthma, allergic rhinitis (AR), GERD, or concomitant adenoidectomy were more likely to have BCD compared to patients without these comorbidities, asthma odds ratio (OR) = 1.94 (95% CI, 1.84-3.41), AR OR = 1.77 (95% CI, 1.03-3.07), GERD OR = 2.79 (95% CI, .59-4.90), or without adenoidectomy OR = 2.50 (95% CI, 1.84-3.41). Patients with cystic fibrosis were less likely to have BCD, OR = 0.33 (95% CI, 0.11-0.95). Median charges for patients undergoing maxillary antrostomy alone by BCD (P = .042) or with adenoidectomy (P time was similar (P = .81) between patients undergoing maxillary antrostomy, regardless of whether BCD was used, but was longer (P time compared to procedures that only utilized ESS. Future research is necessary to evaluate whether BCD may lead to improved outcomes and eventually decreased operating room time for pediatric patients with chronic rhinosinusitis. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2014.

  17. Utilizing integrated facility design to improve the quality of a pediatric ambulatory surgery center.

    Science.gov (United States)

    Pelly, Nicole; Zeallear, Brian; Reed, Mark; Martin, Lynn

    2013-07-01

    The aim was to use Integrated Facility Design (IFD) to design a surgery center that enhances the delivery of health care by developing processes that provide highly efficient patient, family, and provider flows while adding value and utilizing costly resources effectively. Integrated Facility Design is an adaptation of the Toyota 3P (Production, Preparation, Process) Program. The goal of IFD is to accelerate development time and lower start-up costs. The use of IFD produced a savings of $30 million in project costs and enabled a completion date 3.5 months ahead of schedule. The designed patient flow processes resulted in dramatic improvements in patient, family, and provider throughput. The use of IFD in the design of a pediatric ambulatory clinic and surgery resulted in significant cost savings and improved clinical efficiency. © 2013 John Wiley & Sons Ltd.

  18. Predictors of Major Morbidity and Mortality After Pneumonectomy Utilizing The Society for Thoracic Surgeons General Thoracic Surgery Database

    National Research Council Canada - National Science Library

    Shapiro, Mark; Swanson, Scott J; Wright, Cameron D; Chin, Cynthia; Sheng, Shubin; Wisnivesky, Juan; Weiser, Todd S

    2010-01-01

    .... The purpose of this study is to identify the risk factors responsible for adverse outcomes in patients after pneumonectomy utilizing The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTDB...

  19. Method, apparatus, and system for utilizing augmented reality to improve surgery

    KAUST Repository

    Cali, Corrado

    2016-10-13

    A method, apparatus, and computer readable medium are provided for utilizing augmented reality visualization to assist surgery. An example method includes generating a three dimensional reconstruction of an image stack representing a target area of a patient, and superimposing, by a head-mounted display, a projection of the three dimensional reconstruction onto a field of view of a user. The method further includes maintaining alignment between the projection and the user\\'s actual view of the target area using a plurality of fiducial markers associated with the target area. In some embodiments, the method further includes scanning the target area to generate the image stack.

  20. Utilization of a novel unidirectional knotless suture during minimal access procedures in pediatric surgery.

    Science.gov (United States)

    Lukish, Jeffrey; Rasmussen, Sara; Garrett, Deidra; Stewart, Dylan; Buck, James; Abdullah, Fizan; Colombani, Paul

    2013-06-01

    The application of minimally invasive surgery (MIS) for advanced procedures in children is logical. However, the intracorporeal placement and tying of suture can be challenging, leading to prolonged anesthesia and morbidity. We describe our initial experience with the use of a novel unidirectional barbed knotless suture (V-LOC, Covidien, Mansfield, MA) that permits a safe and efficient advanced MIS reconstruction in infants and children. From August 2010 to February 2012, 11 infants and children underwent diaphragmatic reconstruction utilizing either the absorbable or the permanent V-LOC suture. Data retrieval included gender, weight, diagnosis, operative time, complications and follow up. Thoracoscopic or laparoscopic repairs were carried out in all children. Two of the infants with congenital diaphragmatic hernia of Bochdalek (CDH) developed a recurrence at 4 and 6 months of age and required reoperation. There were no other complications or recurrence in the remaining 9 children, and there were no mortalities in the group. This is the first study to evaluate the use of the unidirectional barbed knotless suture in pediatric surgery. We demonstrate that the use of the V-LOC barbed suture is an innovative, safe and time saving option for pediatric MIS. Prospective analysis with long-term follow-up is required to confirm these initial results and to ascertain if this novel approach can be utilized in other pediatric surgical conditions. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Utilization of Post-Penile Surgery Illustrated Healing Atlas: a Comparative Study.

    Science.gov (United States)

    Chua, Michael E; Ming, Jessica M; Sauders, Megan A; Fernandez, Nicolas; Hannick, Jessica H; Abu Awazayed, Ibraheem; Odeh, Rakan I; Bagli, Darius J; Koyle, Martin A; Farhat, Walid A

    2017-10-11

    To determine the effect of the post-penile surgery illustrated healing atlas on caregivers' anxiety levels pre- and post-operatively, the frequency of family's post-operative communication with the urology care team, and the number of unplanned emergency room (ER) return for wound checks. A prospective cohort enrolled children who underwent penile surgeries (distal hypospadias repair and phalloplasty) with no concomitant procedures from December 2016 to June 2017. A six-item short-form Spielberger State-Trait Anxiety Inventory (STAI) was used to determine baseline and post-operative anxiety levels of the caregivers. Two groups were created: caregivers who did not view the illustrated atlas versus those who were shown the atlas. Baseline characteristics and demographics were compared, along with caregiver's pre- to post-operative anxiety level difference, frequency of post-operative communication, and number of unplanned ER-return for wound checks. Fifty-four patients were enrolled with 27 families in each group. Baseline characteristics and demographics were comparable with no significant differences. The assessment of the pre- to post-operative anxiety levels in both groups showed no significant differences (median difference -5 [IQR -8 to -5] versus -5 [IQR -8 to -4], p=0.94). Although no differences were noted for ER-return rates between the groups (18% versus 11.1%, p=0.704), significantly less post-operative calls and e-mails were noted amongst families who received or viewed the post-penile surgery illustrated healing atlas (51.9% versus 11.1%, p=0.003). The utilization of a post-penile surgery illustrated healing atlas as part of the post-operative support provided to families was able to decrease post-operative calls and emails. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Comparison of organic electroluminescence and liquid crystal displays for clinical utility in orthopedic endoscopic surgery.

    Science.gov (United States)

    Dezawa, Akira; Sairyo, Koichi

    2014-05-01

    Organic electroluminescence displays (OELD) use organic materials that self-emit light with the passage of an electric current. OELD provide high contrast, excellent color reproducibility at low brightness, excellent video images, and less restricted viewing angles. OELD are thus promising for medical use. This study compared the utility of an OELD with conventional liquid crystal displays (LCD) for imaging in orthopedic endoscopic surgery. One OELD and two conventional LCD that were indistinguishable in external appearance were used in this study. Images from 18 patients were displayed simultaneously on three monitors and evaluated by six orthopedic surgeons with extensive surgical experience. Images were shown for 2 min, repeated twice, and viewed from the front and side (diagonally). Surgeon rated both clinical utility (12 parameters) and image quality (11 parameters) for each image on a 5-point scale: 1, very good; 2, good; 3, average; 4, poor; and 5, very poor. For clinical utility in 16 percutaneous endoscopic discectomy cases, mean scores for all 12 parameters were significantly better on the OELD than on the LCD, including organ distinguishability (2.1 vs 3.2, respectively), lesion identification (2.2 vs 3.1), and overall viewing impression (2.1 vs 3.1). For image quality, all 11 parameters were better on the OELD than on LCD. Significant differences were identified in six parameters, including contrast (1.8 vs 2.9), color reproducibility in dark areas (1.8 vs 2.9), and viewing angle (2.2 vs 2.9). The high contrast and excellent color reproducibility of the OELD reduced the constraints of imaging under endoscopy, in which securing a field of view may be difficult. Distinguishability of organs was good, including ligaments, dura mater, nerves, and adipose tissue, contributing to good stereoscopic images of the surgical field. These findings suggest the utility of OELD for excellent display of surgical images and for enabling safe and highly accurate

  3. Cost Utility Analysis of Percutaneous Adhesiolysis in Managing Pain of Post-lumbar Surgery Syndrome and Lumbar Central Spinal Stenosis.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Helm, Standiford; Pampati, Vidyasagar; Racz, Gabor B

    2015-06-01

    The increase in the number of interventions for the management of chronic pain and associated escalation of healthcare costs has captured the attention of health policymakers, in no small part due to the lack of documentation of efficacy, cost-effectiveness, or cost utility analysis. A recent cost utility analysis of caudal epidural injections in managing chronic low back pain of various pathologies showed a high cost utility with improvement in quality of life years, competitive with various other modalities of treatments. However, there are no analyses derived from high-quality controlled studies related to the cost utility of percutaneous adhesiolysis in the treatment of post-lumbar surgery syndrome or lumbar central spinal stenosis. This analysis is based on 2 previously published controlled studies. To assess the cost utility of percutaneous adhesiolysis procedures in managing chronic low back and lower extremity pain secondary to post-lumbar surgery syndrome and lumbar central spinal stenosis. A private, specialty referral interventional pain management center in the United States. Two controlled studies were conducted assessing the clinical effectiveness of percutaneous adhesiolysis for post-lumbar surgery syndrome and lumbar central spinal stenosis in an interventional pain management setting utilizing contemporary interventional pain management practices. A cost utility analysis was performed with direct payment data for a total of 130 patients in treatment groups over a 2-year period. Various outcome measures were included with significant improvement, defined as at least 50% improvement with reduction in pain and disability status. The results of 2 controlled studies of low back pain with 60 and 70 patients and a 2-year follow-up with the actual reimbursement data showed cost utility for 1 year of quality-adjusted life year (QALY) of USD $2,652 for post-lumbar surgery syndrome and USD $2,649 for lumbar central spinal stenosis. The results of this

  4. Estimation of utility values from visual analog scale measures of health in patients undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    Oddershede L

    2014-01-01

    Full Text Available Lars Oddershede,1,2 Jan Jesper Andreasen,1 Lars Ehlers2 1Department of Cardiothoracic Surgery, Center for Cardiovascular Research, Aalborg University Hospital, Aalborg, Denmark; 2Danish Center for Healthcare Improvements, Faculty of Social Sciences and Faculty of Health Sciences, Aalborg University, Aalborg East, Denmark Introduction: In health economic evaluations, mapping can be used to estimate utility values from other health outcomes in order to calculate quality adjusted life-years. Currently, no methods exist to map visual analog scale (VAS scores to utility values. This study aimed to develop and propose a statistical algorithm for mapping five dimensions of health, measured on VASs, to utility scores in patients suffering from cardiovascular disease. Methods: Patients undergoing coronary artery bypass grafting at Aalborg University Hospital in Denmark were asked to score their health using the five VAS items (mobility, self-care, ability to perform usual activities, pain, and presence of anxiety or depression and the EuroQol 5 Dimensions questionnaire. Regression analysis was used to estimate four mapping models from patients' age, sex, and the self-reported VAS scores. Prediction errors were compared between mapping models and on subsets of the observed utility scores. Agreement between predicted and observed values was assessed using Bland–Altman plots. Results: Random effects generalized least squares (GLS regression yielded the best results when quadratic terms of VAS scores were included. Mapping models fitted using the Tobit model and censored least absolute deviation regression did not appear superior to GLS regression. The mapping models were able to explain approximately 63%–65% of the variation in the observed utility scores. The mean absolute error of predictions increased as the observed utility values decreased. Conclusion: We concluded that it was possible to predict utility scores from VAS scores of the five

  5. Validity and utility of monopolar spinal cord stimulation in pediatric scoliosis surgery.

    Science.gov (United States)

    Gomes, Constantin; Kuchenbuch, Mathieu; Lucas, Grégory; Argaud, Soizic; Violas, Philippe; Sauleau, Paul

    2016-10-01

    To assess the validity and utility of monopolar stimulation (between a peridural needle and a large adhesive anode placed in the sternal area) for intraoperative monitoring in scoliosis surgery. This procedure was assessed during 41 operations involving either arthrodesis with posterior instrumentation or a Vertical Expandable Prosthetic Titanium Rib (VEPTR). Responses evoked by monopolar stimulation were compared with those evoked by bipolar stimulation between two epidural needle electrodes. Potentials evoked by monopolar stimulation in the upper limbs were compared with those evoked in the lower limbs during the same stimulation procedure. Monopolar stimulation yielded equivalent and, if anything, more stable responses in the lower limbs. Recording in the upper limbs was satisfactory and allowed a decrease in responses to be detected in two patients. Acceptable thresholds for changes in amplitude relative to baseline were 40 % for upper limbs and 30 % for lower limbs. Monopolar stimulation can be used to monitor the spinal cord during surgery for scoliosis correction. This procedure is more convenient for the surgeon and allows for the combined recording of responses in all four limbs, which can be useful in the case of surgical techniques such as those involving a VEPTR.

  6. The utility of mock oral examinations in preparation for the American Board of Surgery certifying examination.

    Science.gov (United States)

    Higgins, Rana M; Deal, Rebecca A; Rinewalt, Daniel; Hollinger, Edward F; Janssen, Imke; Poirier, Jennifer; Austin, Delores; Rendina, Megan; Francescatti, Amanda; Myers, Jonathan A; Millikan, Keith W; Luu, Minh B

    2016-02-01

    Determine the utility of mock oral examinations in preparation for the American Board of Surgery certifying examination (ABS CE). Between 2002 and 2012, blinded data were collected on 63 general surgery residents: 4th and 5th-year mock oral examination scores, first-time pass rates on ABS CE, and an online survey. Fifty-seven residents took the 4th-year mock oral examination: 30 (52.6%) passed and 27 (47.4%) failed, with first-time ABS CE pass rates 93.3% and 81.5% (P = .238). Fifty-nine residents took the 5th-year mock oral examination: 28 (47.5%) passed and 31 (52.5%) failed, with first-time ABS CE pass rates 82.1% and 93.5% (P = .240). Thirty-eight responded to the online survey, 77.1% ranked mock oral examinations as very or extremely helpful with ABS CE preparation. Although mock oral examinations and ABS CE passing rates do not directly correlate, residents perceive the mock oral examinations to be helpful. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Renal ultrasound provides low utility in evaluating cardiac surgery associated acute kidney injury.

    Science.gov (United States)

    Young, Allen; Crawford, Todd; Pierre, Alejandro Suarez; Trent Magruder, J; Fraser, Charles; Conte, John; Whitman, Glenn; Sciortino, Christopher

    2017-09-02

    Renal ultrasonography is part of the algorithm in assessing acute kidney injury (AKI). The purpose of this study was to assess the clinical utility of renal US in postoperative cardiac patients who develop AKI. We conducted a retrospective study of 90 postoperative cardiac surgery patients at a single institution from 1/19/2010 to 3/19/2016 who underwent renal US for AKI. We reviewed provider documentation to determine whether renal US changed management. We defined change as: administration of crystalloid or colloid, addition of inotropic or vasopressor, or procedural interventions on the renal system. Mean age of study patients was 68 ± 13 years. 48/90 patients (53.3%) had pre-existing chronic kidney disease of varying severity. 48 patients (53.3%) had normal renal US with incidental findings and 31 patients (34.4%) had US evidence of medical kidney disease. 10 patients (11.1%) had limited US results due to poor visualization and 1 patient (1.1%) had mild right-sided hydronephrosis. No patients were found to have obstructive uropathy or renal artery stenosis. Clinical management was altered in only 4/90 patients (4.4%), which included 3 patients that received a fluid bolus and 1 patient that received a fluid bolus and inotropes. No vascular or urologic procedures resulted from US findings. Although renal ultrasound is often utilized in the work-up of AKI, our study shows that renal US provides little benefit in managing postoperative cardiac patients. This diagnostic modality should be scrutinized rather than viewed as a universal measure in the cardiac surgery population.

  8. Clover calculus for homology 3-spheres via basic algebraic topology

    National Research Council Canada - National Science Library

    Auclair, Emmanuel; Lescop, Christine

    2005-01-01

    We present an alternative definition for the Goussarov--Habiro filtration of the Z-module freely generated by oriented integral homology 3-spheres, by means of Lagrangian-preserving homology handlebody replacements (LP-surgeries...

  9. Cost utility analysis of endoscopic sinus surgery for chronic rhinosinusitis with and without nasal polyposis.

    Science.gov (United States)

    Scangas, George A; Remenschneider, Aaron K; Su, Brooke M; Shrime, Mark G; Metson, Ralph

    2017-01-01

    To evaluate the cost-effectiveness of endoscopic sinus surgery (ESS) compared to medical therapy for patients with chronic rhinosinusitis (CRS) with and without nasal polyposis (NP). Cohort-style Markov decision-tree economic model with a 36-year time horizon. Two cohorts of 229 CRS patients with and without NP who underwent ESS were compared with a matched cohort of 229 CRS patients from the Medical Expenditures Survey Panel database (Agency for Healthcare Research and Quality, Rockville, MD) who underwent medical management. Utility scores were calculated from sequential patient responses to the EuroQol five-dimensions questionnaire. Decision-tree analysis and a 10-state Markov model utilized published event probabilities and primary data to calculate long-term costs and utility. The primary outcome was the incremental cost per quality-adjusted life year (QALY). Thorough sensitivity analyses were performed. The reference case for CRS with NP yielded an incremental cost-effectiveness ratio (ICER) for ESS versus medical therapy of $5,687.41/QALY. The reference case for CRS without NP yielded an ICER of $5,405.44/QALY. The cost-effectiveness acceptability curve in both cases demonstrated 95% certainty that the ESS strategy was the most cost-effective option at a willingness-to-pay threshold of $20,000/QALY or higher. These results were robust to one-way and probabilistic sensitivity analysis. This study demonstrates the cost-effectiveness of ESS compared to medical therapy alone for the management of CRS patients both with and without NP. The presence of nasal polyps was not found to affect the overall cost-effectiveness of ESS. 2C. Laryngoscope, 127:29-37, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  10. The effect of the Ontario Bariatric Network on health services utilization after bariatric surgery: a retrospective cohort study.

    Science.gov (United States)

    Elnahas, Ahmad; Jackson, Timothy D; Okrainec, Allan; Austin, Peter C; Bell, Chaim M; Urbach, David R

    2016-01-01

    In 2009, the Ontario Bariatric Network was established to address the exploding demand by Ontario residents for bariatric surgery services outside Canada. We compared the use of postoperative hospital services between out-of-country surgery recipients and patients within the Ontario Bariatric Network. We conducted a population-based, comparative study using administrative data held at the Institute for Clinical Evaluative Sciences. We included Ontario residents who underwent bariatric surgery between 2007 and 2012 either outside the country or at one of the Ontario Bariatric Network's designated centres of excellence. The primary outcome was use of hospital services in Ontario within 1 year after surgery. A total of 4852 patients received bariatric surgery out of country, and 5179 patients underwent surgery through the Ontario Bariatric Network. After adjustment, surgery at a network centre was associated with a significantly lower utilization rate of postoperative hospital services than surgery out of country (rate ratio 0.90, 95% confidence interval [CI] 0.84 to 0.97). No statistically significant differences were found with respect to time in critical care or mortality. However, the physician assessment and reoperation rates were significantly higher among patients who received surgery at a network centre than among those who had bariatric surgery out of country (rate ratio 4.10, 95% CI 3.69 to 4.56, and rate ratio 1.84, 95% CI 1.34 to 2.53, respectively). The implementation of a comprehensive, multidisciplinary provincial program to replace outsourcing of bariatric surgical services was associated with less use of postoperative hospital services by Ontario residents undergoing bariatric surgery. Future research should include an economic evaluation to determine the costs and benefits of the Ontario Bariatric Network.

  11. Trends and the utilization of transoral robotic surgery with neck dissection in New York State.

    Science.gov (United States)

    Frenkel, Catherine H; Yang, Jie; Zhang, Mengru; Regenbogen, Elliot; Telem, Dana A; Samara, Ghassan J

    2017-07-01

    The timing of neck dissection (ND) in relation to transoral robotic surgery (TORS) is controversial. This study identifies local practice patterns and economic and social access disparities during adoption of TORS. We analyzed utilization patterns of TORS and ND using the New York Statewide Planning and Research Cooperative System all-payer administrative database. Statewide head and neck cancer incidence from the Centers for Disease Control and Prevention (Bethesda, MD) was used to control for overall cancer incidence. Patient demographic, insurer, and institutional information of patients aged ≥ 18 (n = 225) years from 2008 to 2012 were evaluated. Temporal trends were analyzed with Poisson regression models for counts. Transoral robotic surgery was used in 386 procedures, and 58.3% involved ND (n = 225). Concurrent ND was most frequent (n = 173), followed by staged TORS then ND (n = 44) and staged ND preceding TORS (n = 8). Caucasians were more likely than Blacks/Hispanics to undergo TORS (P = 0.03). Medicare (26.2%) and Medicaid (2.7%) payers comprised a minority of patients compared to those commercially insured (70.2%). Only 20% of patients received care outside a major urban center, and these patients were more likely to undergo staged procedures, P = 0.02. Staged procedures resulted in higher mean hospital charges (P = 0.02). Concurrent TORS + ND, the most common practice in New York, is more cost-effective. Patients without commercial insurance, patients in racial minorities, or patients residing outside major urban centers may be targeted to improve care access disparities with respect to minimally invasive TORS technology. 2c. Laryngoscope, 127:1571-1576, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Intraoperative neuromonitoring in thyroid surgery: a point prevalence survey on utilization, management, and documentation in Italy.

    Science.gov (United States)

    Dionigi, Gianlorenzo; Lombardi, Davide; Lombardi, Celestino Pio; Carcoforo, Paolo; Boniardi, Marco; Innaro, Nadia; Chiofalo, Maria Grazia; Cavicchi, Ottavio; Biondi, Antonio; Basile, Francesco; Zaccaroni, Angelo; Mangano, Alberto; Leotta, Andrea; Lavazza, Matteo; Calò, Pietro Giorgio; Nicolosi, Angelo; Castelnuovo, Paolo; Nicolai, Piero; Pezzullo, Luciano; De Toma, Giorgio; Bellantone, Rocco; Sacco, Rosario

    2014-12-01

    The frequency of neuromonitoring during thyroid surgery is underreported in Italy. The present survey depicts and describes the patterns of use, management, documentation for IONM devices of IONM during thyroid surgery by surgeons in Italy. A point prevalence survey was undertaken. Source data were mixed from Italian surgeons attending the 2014 International Neuromonitoring Study Group (INMSG) meeting, four IONM manufacturers available in Italy and surgical units were identified from Company sales data. Qualitative and quantitative data were used to analyze. Questions probed IONM prevalence, surgeon background, hospital geographic practice locations, type of hospital, rationale for IONM use, sources of initial capital investment for IONM acquisition, type of equipment, use of continuous IONM, monitoring management, use of distinctive standards, and IONM documentation. IONM is currently delivered through 48 units in Italy. In 2013, the distribution of IONM by specialties included: general (50 %), ENT (46 %), and thoracic surgery (4 %). Overall, 12.853 IONM procedures were performed in the period from 2006 to 2013: 253 were performed in 2007 and about 5,100 in 2013. Distribution according to the type of hospital is: public 48 %, academic setting 37 %, and private maintenance 15 %. The use category of high volume thyroid hospitals represented 33 %. Initial capital investment for the acquisition of the monitoring equipment was 67 % public and 33 % with charitable/private funding. Audio plus graphic and EMG electrodes surface endotracheal tube-based monitoring systems accounted for the majority. Continuous IONM was introduced in 5 Academic Centers. Overall motivations expressed are legal (30 %), RLN confirmation (20 %), RLN identification (20 %), prognosis (10 %), helpful in difficult cases (10 %), decrease surgical time (5 %), and educational (5 %). The survey revealed that participants had few experience with the standardized approach of IONM technique (28 %). General

  13. 76 FR 72955 - Proposed Collection; Comment Request: “Ethical Dilemmas in Surgery and Utilization of Hospital...

    Science.gov (United States)

    2011-11-28

    ... HUMAN SERVICES National Institutes of Health Proposed Collection; Comment Request: ``Ethical Dilemmas in...: Ethical Dilemmas in Surgery and Utilization of Hospital Ethics Consultation Service: A Survey. Type of... collect information about the ethical dilemmas that surgeons have faced in their practices over the past...

  14. Utility of postoperative radiographs for cervical spine fusion: a comprehensive evaluation of operative technique, surgical indication, and duration since surgery.

    Science.gov (United States)

    Shau, David N; Bible, Jesse E; Samade, Richard; Gadomski, Stephen P; Mushtaq, Bushra; Wallace, Ato; McGirt, Matthew J; O'Neill, Kevin R; Devin, Clinton J

    2012-11-15

    A retrospective study. To assess the utility of postoperative radiographs in patients across a spectrum of cervical fusion procedures, surgical indication, and time since surgery. Postoperative radiographs are routinely obtained after cervical spine fusion despite lack of evidence supporting such practice. Studies assessing postoperative radiographical utility in the cervical spine have been limited. To date, no study has comprehensively evaluated the utility of obtaining such radiographs across multiple cervical fusion procedures. A total of 972 clinic notes from 301 patients during a 10-year period at a single institution were retrospectively reviewed. Patients in this study underwent an anterior cervical discectomy and fusion, anterior corpectomy and fusion, a combined anterior cervical discectomy and fusion and anterior corpectomy and fusion (hybrid), posterior spine fusion, or 360° fusion. All postoperative clinic notes and radiographs were reviewed for abnormalities and changes in treatment course. It was determined whether an abnormal radiograph alone led to a change in treatment course among the various operative techniques, surgical indication, or time since surgery. No statistical significant difference in radiograph utility between anterior cervical discectomy and fusion (0 changes in treatment course due to radiograph alone out of 332 clinic notes), anterior corpectomy and fusion (0 of 140), hybrid procedure (1 of 72), posterior spine fusion (5 of 357), and 360° fusion (0 of 71) was found. Surgical indication (trauma vs. degeneration) and duration from surgery yielded no statistical significant difference in radiograph utility. The overall sensitivity, specificity, and positive and negative predictive values of radiographs were 33.8%, 87.6%, 19.0%, and 93.9%, respectively. Regardless of operative techniques performed, surgical indication, and time since surgery, routine postoperative radiographs provide low utility in guiding treatment course in

  15. The Effect of Bariatric Surgery on Mobility, Health-Related Quality of Life, Healthcare Resource Utilization, and Employment Status.

    Science.gov (United States)

    Tarride, Jean-Eric; Breau, Ruth; Sharma, Arya M; Hong, Dennis; Gmora, Scott; Guertin, Jason R; O'Reilly, Daria; Xie, Feng; Mehran, Anvari

    2017-02-01

    A sub-study of the Ontario Bariatric Registry was conducted to evaluate the impact of bariatric surgery on mobility, health-related quality of life (HRQoL), healthcare resource utilization (HRU), and employment status. The 1-year change in mobility following bariatric surgery was evaluated using the mobility domain of the EuroQOL-5D-5L (EQ-5D-5L), which was self-administered at baseline and 1 year after bariatric surgery along with questions on HRU. Another questionnaire was used to document employment status at time of surgery and 1 year later. The population included 304 individuals (mean age = 46 years; 85 % female). At baseline, 68 % of participants had some problems in walking compared to 14 % at 1 year following surgery (p bariatric surgery has a major impact on mobility and HRQoL. More research is warranted to understand the benefits, costs, and cost-effectiveness of bariatric surgery in Canada.

  16. Increasing Utilization Of Pediatric Epilepsy Surgery In The United States Between 1997 and 2009

    Science.gov (United States)

    Pestana Knight, Elia M.; Schiltz, Nicholas K.; Bakaki, Paul M.; Koroukian, Siran M.; Lhatoo, Samden D.; Kaiboriboon, Kitti

    2014-01-01

    SUMMARY OBJECTIVE To examine national trends of pediatric epilepsy surgery usage in the United States between 1997 and 2009. METHODS We performed a serial cross-sectional study of pediatric epilepsy surgery using triennial data from the Kids’ Inpatient Database from 1997 to 2009. The rates of epilepsy surgery for lobectomies, partial lobectomies, and hemispherectomies in each study year were calculated based on the number of prevalent epilepsy cases in the corresponding year. The age-race-sex adjusted rates of surgeries were also estimated. Mann-Kendall trend test was used to test for changes in the rates of surgeries over time. Multivariable regression analysis was also performed to estimate the effect of time, age, race, and sex on the annual incidence of epilepsy surgery. RESULTS The rates of pediatric epilepsy surgery significantly increased from 0.85 epilepsy surgeries per 1,000 children with epilepsy in 1997 to 1.44 epilepsy surgeries per 1,000 children with epilepsy in 2009. An increment in the rates of epilepsy surgeries was noted across all age groups, in boys and girls, all races, and all payer types. The rate of increase was lowest in blacks and in children with public insurance. The overall number of surgical cases for each study year was lower than 35% of children who were expected to have surgery, based on the estimates from the Connecticut Study of Epilepsy. SIGNIFICANCE In contrast to adults, pediatric epilepsy surgery numbers have increased significantly in the past decade. However, epilepsy surgery remains an underutilized treatment for children with epilepsy. In addition, black children and those with public insurance continue to face disparities in the receipt of epilepsy surgery. PMID:25630252

  17. Increasing utilization of pediatric epilepsy surgery in the United States between 1997 and 2009.

    Science.gov (United States)

    Pestana Knight, Elia M; Schiltz, Nicholas K; Bakaki, Paul M; Koroukian, Siran M; Lhatoo, Samden D; Kaiboriboon, Kitti

    2015-03-01

    To examine national trends of pediatric epilepsy surgery usage in the United States between 1997 and 2009. We performed a serial cross-sectional study of pediatric epilepsy surgery using triennial data from the Kids' Inpatient Database from 1997 to 2009. The rates of epilepsy surgery for lobectomies, partial lobectomies, and hemispherectomies in each study year were calculated based on the number of prevalent epilepsy cases in the corresponding year. The age-race-sex adjusted rates of surgeries were also estimated. Mann-Kendall trend test was used to test for changes in the rates of surgeries over time. Multivariable regression analysis was also performed to estimate the effect of time, age, race, and sex on the annual incidence of epilepsy surgery. The rates of pediatric epilepsy surgery increased significantly from 0.85 epilepsy surgeries per 1,000 children with epilepsy in 1997 to 1.44 epilepsy surgeries per 1,000 children with epilepsy in 2009. An increment in the rates of epilepsy surgeries was noted across all age groups, in boys and girls, all races, and all payer types. The rate of increase was lowest in blacks and in children with public insurance. The overall number of surgical cases for each study year was lower than 35% of children who were expected to have surgery, based on the estimates from the Connecticut Study of Epilepsy. In contrast to adults, pediatric epilepsy surgery numbers have increased significantly in the past decade. However, epilepsy surgery remains an underutilized treatment for children with epilepsy. In addition, black children and those with public insurance continue to face disparities in the receipt of epilepsy surgery. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

  18. The utility of endovascular simulation to improve technical performance and stimulate continued interest of preclinical medical students in vascular surgery.

    Science.gov (United States)

    Lee, Jason T; Qiu, Mary; Teshome, Mediget; Raghavan, Shyam S; Tedesco, Maureen M; Dalman, Ronald L

    2009-01-01

    New training paradigms in vascular surgery allow for early specialization out of medical school. Surgical simulation has emerged as an educational tool for trainees to practice procedures in a controlled environment allowing interested medical students to perform procedures without compromising patient safety. The purpose of this study is to assess the ability of a simulation-based curriculum to improve the technical performance and interest level of medical students in vascular surgery. Prospective observational cohort study of medical student performance. Academic medical center. Forty-one medical students (23 first year, 15 second year, 3 other) enrolled in a vascular surgery elective course. Students completed a survey of their interests and performed a renal stent procedure on an endovascular simulator (pretest). The curriculum consisted of didactic teaching and weekly mentored simulator sessions and concluded with a final renal stent procedure on the simulator (posttest). Objective procedural measures were determined during the pre- and posttest by the simulator, and subjective performance was graded by expert observers utilizing a structured global assessment scale. After the course, the students were surveyed as to their opinions about vascular surgery as a career option. Finally, 1 year after the course, all students were again surveyed to determine continued interest in vascular surgery. The objective and subjective criteria measured on the simulator and structured global assessment scale significantly improved from pre- to posttest in terms of performer technical skill, patient safety measures, and structured global assessments. Before beginning the course, 8.5% of the students expressed high interest in vascular surgery, and after completing the course 70% were seriously considering vascular surgery as a career option (p = 0.0001). More than 95% of the students responded that endovascular simulation increased their knowledge and interest in vascular

  19. Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.

    Science.gov (United States)

    Huo, Jinhai; Du, Xianglin L; Lairson, David R; Chan, Wenyaw; Jiang, Jing; Buchholz, Thomas A; Guadagnolo, B Ashleigh

    2015-06-01

    To examine the patterns of utilization of radiation therapy, chemotherapy, surgery, and hospice at the end-of-life care for patients diagnosed with metastatic melanoma. We identified 816 Medicare beneficiaries toward who were 65 years of age or older, with pathologically confirmed metastatic malignant melanoma between January 1, 2000, and December 31, 2007. We evaluated trends and associations between sociodemographic and health service characteristics and the use of hospice care, chemotherapy, surgery, and radiation therapy. We found increasing use of surgery for patients with metastatic melanoma from 13% in 2000 to 30% in 2007 (P=0.03 for trend), and no significant fluctuation in the use of chemotherapy (P=0.43) or radiation therapy (P=0.46). Older patients were less likely to receive radiation therapy or chemotherapy. The use of hospice care increased from 61% in 2000 to 79% in 2007 (P=0.07 for trend). Enrollment in short-term (1 to 3 d) hospice care use increased, whereas long-term hospice care (≥4 d) remained stable. Patients living in the SEER (Surveillance, Epidemiology and End Results) northeast and south regions were less likely to undergo surgery. Patients enrolled in long-term hospice care used significantly less chemotherapy, surgery, and radiation therapy. Surgery and hospice care use increased over the years of this study, whereas the use of chemotherapy and radiation therapy remained consistent for patients diagnosed with metastatic melanoma.

  20. Utilization of day surgery services at Upper hill Medical Centre and the Karen hospital in Nairobi: the influence of medical providers, cost and patient awareness

    OpenAIRE

    Odhiambo, Mildred Adhiambo; Njuguna, Susan; Waireri-Onyango, Rachel; Mulimba, Josephat; Ngugi, Peter Mungai

    2015-01-01

    Introduction Health systems face challenges of improving access to health services due to rising health care costs. Innovative services such as day surgery would improve service delivery. Day surgery is a concept where patients are admitted for surgical procedures and discharged the same day. Though used widely in developed countries due to its advantages, utilization in developing countries has been low. This study sought to establish how utilization of day surgery services was influenced by...

  1. Social Media Impact: Utility of Reflective Approach in the Practice of Surgery.

    Science.gov (United States)

    Mohiuddin, Zia; Shahid, Hassan; Shuaib, Waqas

    2015-12-01

    Social media is rapidly being incorporated into medical education. We created a small group, reflective practice sessions by integrating specific medical cases to improve awareness about professionalism on social media. Medical scenarios were generated for reflective practice sessions on social media professionalism. Anonymous pre/post-session surveys evaluated residents' use of social media and gathered their opinions on the session. Thirty-eight of 48 (79 %) residents replied to the presession survey with 50 % (19/38) reporting daily digital media use, 76 % (29/38) witnessed unprofessional postings on social media, and 21 % (8/38) posted unprofessional content themselves. Of the 79 % (30/38) residents who attended the session, 74 % (28/38) completed the post-session survey. Residents reported the session added to the longevity of their professional career 4.11, 95 % CI (3.89-4.36). As a result of the session, they were more conscious of using the social media more professionally 3.47, 95 % CI (2.88-3.96) and would be proactive in protecting patient privacy and confidentiality on social media sites 3.96, 95 % CI (3.50-4.37). In summary, reflective practice-based sessions regarding the impact of social media on professionalism in surgery was well favored by the residents. The majority agreed that it had important implications for the longevity of their professional career. Participants reported having an increased awareness to protect patient privacy and utilize social media more professionally.

  2. Utilization of day surgery services at Upper hill Medical Centre and the Karen hospital in Nairobi: the influence of medical providers, cost and patient awareness.

    Science.gov (United States)

    Odhiambo, Mildred Adhiambo; Njuguna, Susan; Waireri-Onyango, Rachel; Mulimba, Josephat; Ngugi, Peter Mungai

    2015-01-01

    Health systems face challenges of improving access to health services due to rising health care costs. Innovative services such as day surgery would improve service delivery. Day surgery is a concept where patients are admitted for surgical procedures and discharged the same day. Though used widely in developed countries due to its advantages, utilization in developing countries has been low. This study sought to establish how utilization of day surgery services was influenced by medical providers, patient awareness and cost among other factors. The study design was cross sectional with self administered questionnaires used to collect data. Data analysis was done by using statistical package for social science (SPSS) and presented as frequencies, percentages and Spearman's correlation to establish relationship among variables. Medical providers included doctors, their employees and medical insurance providers. Most doctors were aware of day surgery services but their frequency of utilization was low. Furthermore, medical insurance providers approved only half of the requests for day surgery. Doctors' employees were aware of the services and most of them would recommend it to patients. Although, most patients were not aware of day surgery services those who were aware would prefer day surgery to in patient. Moreover, doctors and medical insurance providers considered day surgery to be cheaper than in patient. The study showed that medical providers and patient awareness had influence over day surgery utilization, though, cost alone did not influence day surgery utilization but as a combination with other factors.

  3. Utility of melatonin to treat surgical stress after major vascular surgery - a safety study

    DEFF Research Database (Denmark)

    Kücükakin, Bülent; Lykkesfeldt, Jens; Nielsen, Hans Jørgen

    2008-01-01

    Surgery for abdominal aortic aneurysm is associated with elevated oxidative stress. As an antioxidant in animal and human studies, melatonin has the potential of ameliorating some of this oxidative stress, but melatonin has never been administered to adults during surgery for the purpose of reduc...

  4. Utility of melatonin to treat surgical stress after major vascular surgery--a safety study

    DEFF Research Database (Denmark)

    Kücükakin, Bülent; Lykkesfeldt, Jens; Nielsen, Hans Jørgen

    2008-01-01

    Surgery for abdominal aortic aneurysm is associated with elevated oxidative stress. As an antioxidant in animal and human studies, melatonin has the potential of ameliorating some of this oxidative stress, but melatonin has never been administered to adults during surgery for the purpose of reduc...

  5. [Results of the utilization of the ECMO-VA following cardiac surgery, in the Department of Cardiothoracic Surgery of Santa Maria Hospital].

    Science.gov (United States)

    Junqueira, Nádia; Côrte-Real, Hugo; Gallego, Javier; Ferreira, Ricardo; Guerra, Nuno; Carvalheiro, Catarina; Ferreira, Hugo; Sena, André; Arruda, Ricardo; Mendes, Mário; Lucas Nobre, Angelo

    2015-01-01

    Extracorporeal membrane oxygenation through a veno-arterial circuit (ECMO-VA) is an organ support option in refractory cardiogenic shock, when the primary cause of decompensation is thought to be reversible. We report the clinical results of this technique in patients submitted to cardiac surgery at our center. We present a retrospective study of patients that underwent ECMO-VA after cardiac surgery and subsequent admission at the intensive care unit (ICU), in our center. The data were collected from clinical records. The statistical analysis was made with an SPSS 22.0 data base. We report data on 7 patients with an average age of 62 years. The mean SAPS II was 56 points, the Euroscore II was 17% and the British Columbia Cardiac Surgery Intensive Care Score was 71%. 57% of patiens underwent myocardial revascularization surgery, 29% were submitted to valvular surgery and 14% of the patients underwent an aortic surgery. All of the patients underwent peripheral cannulation, 71% of which was placed during surgery and in the remaining 29%, immediately after. All of the patients were put on mechanical ventilation and 86% needed an intra-aortic baloon and renal support. The main complications were acute renal injury (100%), coagulopathy (86%), emergency re-sternothomy (43%) ischaemia of the cannulated limb (29%) and central nervous system complications (29%). The average time of ECMO-VA use was 5 days and the mean stay in the ICU was 19 days. In 57% of patients, the de-cannulation was successful. The average in-patient survival was 43%. Extracorporeal membrane oxygenation through a veno-arterial circuit (ECMO-VA) is an organ support option in refractory cardiogenic shock, when the primary cause of decompensation is thought to be reversible. The timely utilization of the procedure is crucial in cases with high probability of reversible causes of cardiogenic shock, where the rational for its use is to allow time for the myocardium to recover. The main difficulty identified

  6. [The way from cost approval to bariatric surgery : Analysis of resource utilization in a maximum care hospital].

    Science.gov (United States)

    Nickel, F; Tapking, C; Zech, U; Huennemeyer, K; Billeter, A T; Müller, P C; Kenngott, H G; Müller-Stich, B P; Fischer, L

    2017-07-01

    Morbid obesity is a medical and economic challenge. Patients who have the indications for bariatric surgery face a long way from the first visit until surgery and a high utilization of resources is required. The present study aimed to evaluate labor costs and labor time required to supervise obese patients from their first visit until preparation of a bariatric report to ask for cost acceptance of bariatric surgery from their health insurance. In addition, the reasons for not receiving bariatric surgery after receiving cost acceptance from the health insurance were evaluated. Patients who had indications for bariatric surgery according to the S3 guidelines between 2012 and 2013, were evaluated regarding labor costs and labor time of the process from the first visit until receiving cost acceptance from their health insurance. Furthermore, body mass index (BMI), age, sex, Edmonton Obesity Staging System (EOSS) stage and comorbidities were evaluated. Patients who had not received surgery up to December 2015 were contacted via telephone to ask for the reasons. In the present study 176 patients were evaluated (110 females, 62.5%). Until preparation of a bariatric report the patients required an average of 2.7 combined visits in the department of surgery with the department of nutrition, 1.7 visits in the department of psychosomatic medicine, 1.5 separate visits in the department of nutrition and 1.4 visits in the department of internal medicine. Average labor costs from the first visit until the bariatric survey were 404.90 ± 117.00 euros and 130 out of 176 bariatric reports were accepted by the health insurance (73.8%). For another 40 patients a second bariatric survey was made and 20 of these (50%) were accepted, which results in a total acceptance rate of 85.2% (150 out of 176). After a mean follow-up of 2.8 ± 1.1 years only 93 out of 176 patients had received bariatric surgery (53.8%). Of these 16 had received acceptance of surgery by their

  7. Surgery

    Science.gov (United States)

    ... Disease Lookup > COPD > Diagnosing and Treating COPD Surgery Chronic obstructive pulmonary disease (COPD) includes two separate lung problems, emphysema and chronic bronchitis. Some people with COPD have ...

  8. Cost-utility analysis comparing laparoscopic vs open aortobifemoral bypass surgery.

    Science.gov (United States)

    Krog, Anne Helene; Sahba, Mehdi; Pettersen, Erik M; Wisløff, Torbjørn; Sundhagen, Jon O; Kazmi, Syed Sh

    2017-01-01

    Laparoscopic aortobifemoral bypass has become an established treatment option for symptomatic aortoiliac obstructive disease at dedicated centers. Minimally invasive surgical techniques like laparoscopic surgery have often been shown to reduce expenses and increase patients' health-related quality of life. The main objective of our study was to measure quality-adjusted life years (QALYs) and costs after totally laparoscopic and open aortobifemoral bypass. This was a within trial analysis in a larger ongoing randomized controlled prospective multicenter trial, Norwegian Laparoscopic Aortic Surgery Trial. Fifty consecutive patients suffering from symptomatic aortoiliac occlusive disease suitable for aortobifemoral bypass surgery were randomized to either totally laparoscopic (n=25) or open surgical procedure (n=25). One patient dropped out of the study before surgery. We measured health-related quality of life using the EuroQol (EQ-5D-5L) questionnaire at 4 different time points, before surgery and for 6 months during follow-up. We calculated the QALYs gained by using the area under the curve for both groups. Costs were calculated based on prices for surgical equipment, vascular prosthesis and hospital stay. We found a significantly higher increase in QALYs after laparoscopic vs open aortobifemoral bypass surgery, with a difference of 0.07 QALYs, (p=0.001) in favor of laparoscopic aortobifemoral bypass. The total cost of surgery, equipment and hospital stay after laparoscopic surgery (9,953 €) was less than open surgery (17,260 €), (p=0.001). Laparoscopic aortobifemoral bypass seems to be cost-effective compared with open surgery, due to an increase in QALYs and lower procedure-related costs.

  9. Surgery Goes Social: The Extent and Patterns of Social Media Utilization by Major Trauma, Acute and Critical Care Surgery Societies.

    Science.gov (United States)

    Khalifeh, Jawad M; Kaafarani, Haytham M A

    2017-01-01

    The evolving influence of social media in trauma, acute, and critical care surgery (TACCS) cannot be ignored. We sought to investigate the extent and patterns of use of social networks by major regional, national and international TACCS societies. The two leading social networking sites, Facebook (FB) and Twitter (TW), were thoroughly examined for the presence of official accounts for each of the major TACCS societies. An official FB or TW account was defined as one which has a blue verified badge and/or is linked the society's official website. For societies with confirmed official accounts, the extent and patterns of use of the two platforms were systematically examined over a 2-week period through: (1) manual inspection of the societies' FB and TW pages, (2) the SQLite database containing downloaded samples of posts, and (3) the TW analytics database, symplur.com. Standardized social media metrics were calculated for each society. Posted content was categorized as being: (1) society news updates, (2) event announcements, or (3) general medical information. From a total of 64 TACCS societies, only 27 (42%) had FB and/or TW accounts. Ten out of the 12 American societies had accounts compared to 13/39 of European, 2/9 of Australasian, and 0/2 of international societies. For the societies with social media presence, the mean numbers of monthly tweets and FB posts per society were 22 and 8, respectively. We summarize the FB and TW activity of the studied TACCS societies. Most tweets/posts were society news updates and event announcements intended to the society's constituents not the general public. A text cloud was constructed to summarize the major featured topics. Less than half of the TACCS societies are currently using social media; those that do are arguably underutilizing its potential. Non-American societies in particular lag behind in their use of social networking.

  10. Surgery

    Science.gov (United States)

    ... and impairs lung function. People need to stop smoking several weeks before surgery so that the defense mechanisms of the respiratory system can recover. Doctors' evaluations The surgeon does a ...

  11. The yeast Shu complex utilizes homologous recombination machinery for error-free lesion bypass via physical interaction with a Rad51 paralogue.

    Science.gov (United States)

    Xu, Xin; Ball, Lindsay; Chen, Wangyang; Tian, Xuelei; Lambrecht, Amanda; Hanna, Michelle; Xiao, Wei

    2013-01-01

    DNA-damage tolerance (DDT) is defined as a mechanism by which eukaryotic cells resume DNA synthesis to fill the single-stranded DNA gaps left by replication-blocking lesions. Eukaryotic cells employ two different means of DDT, namely translesion DNA synthesis (TLS) and template switching, both of which are coordinately regulated through sequential ubiquitination of PCNA at the K164 residue. In the budding yeast Saccharomyces cerevisiae, the same PCNA-K164 residue can also be sumoylated, which recruits the Srs2 helicase to prevent undesired homologous recombination (HR). While the mediation of TLS by PCNA monoubiquitination has been extensively characterized, the method by which K63-linked PCNA polyubiquitination leads to template switching remains unclear. We recently identified a yeast heterotetrameric Shu complex that couples error-free DDT to HR as a critical step of template switching. Here we report that the Csm2 subunit of Shu physically interacts with Rad55, an accessory protein involved in HR. Rad55 and Rad57 are Rad51 paralogues and form a heterodimer to promote Rad51-ssDNA filament formation by antagonizing Srs2 activity. Although Rad55-Rad57 and Shu function in the same pathway and both act to inhibit Srs2 activity, Shu appears to be dedicated to error-free DDT while the Rad55-Rad57 complex is also involved in double-strand break repair. This study reveals the detailed steps of error-free lesion bypass and also brings to light an intrinsic interplay between error-free DDT and Srs2-mediated inhibition of HR.

  12. The yeast Shu complex utilizes homologous recombination machinery for error-free lesion bypass via physical interaction with a Rad51 paralogue.

    Directory of Open Access Journals (Sweden)

    Xin Xu

    Full Text Available DNA-damage tolerance (DDT is defined as a mechanism by which eukaryotic cells resume DNA synthesis to fill the single-stranded DNA gaps left by replication-blocking lesions. Eukaryotic cells employ two different means of DDT, namely translesion DNA synthesis (TLS and template switching, both of which are coordinately regulated through sequential ubiquitination of PCNA at the K164 residue. In the budding yeast Saccharomyces cerevisiae, the same PCNA-K164 residue can also be sumoylated, which recruits the Srs2 helicase to prevent undesired homologous recombination (HR. While the mediation of TLS by PCNA monoubiquitination has been extensively characterized, the method by which K63-linked PCNA polyubiquitination leads to template switching remains unclear. We recently identified a yeast heterotetrameric Shu complex that couples error-free DDT to HR as a critical step of template switching. Here we report that the Csm2 subunit of Shu physically interacts with Rad55, an accessory protein involved in HR. Rad55 and Rad57 are Rad51 paralogues and form a heterodimer to promote Rad51-ssDNA filament formation by antagonizing Srs2 activity. Although Rad55-Rad57 and Shu function in the same pathway and both act to inhibit Srs2 activity, Shu appears to be dedicated to error-free DDT while the Rad55-Rad57 complex is also involved in double-strand break repair. This study reveals the detailed steps of error-free lesion bypass and also brings to light an intrinsic interplay between error-free DDT and Srs2-mediated inhibition of HR.

  13. Disparities in Utilization of Jaw Surgery for Treatment of Sleep Apnea: A Nationwide Analysis.

    Science.gov (United States)

    Garg, Ravi K; Shan, Ying; Havlena, Jeffrey A; Afifi, Ahmed M

    2016-12-01

    Maxillomandibular advancement has been shown to be one of the most effective operations for management of severe obstructive sleep apnea, yet pharyngeal surgery is more commonly performed. The goal of this study was to identify socioeconomic factors associated with this phenomenon. Patients aged 14 or older with a primary hospital diagnosis of sleep apnea were identified using the National Inpatient Sample from 2005 to 2012. ICD9 codes were used to determine whether a pharyngeal or jaw procedure was performed. Patient demographics, comorbidities, and complications were compared. Among 6316 sleep surgeries, 5964 (94.4%) were pharyngeal and 352 (5.6%) were jaw procedures. Women were significantly more likely to receive jaw surgery than men (odds ratio [OR] = 1.68, P = 0.0007). African Americans (OR = 0.19, P surgery than Caucasians. Patients falling into lower-income brackets (OR = 0.39 and 0.57, P = 0.02 and 0.04) and patients with Medicare compared with private or Health Maintenance Organization insurance (OR = 0.46, P = 0.008) also had significantly decreased odds of undergoing jaw surgery. Comorbidities were similar between surgical groups, and there were no significant differences in bleeding, infection, or cardiopulmonary complications. We identified no significant difference in complication rates between pharyngeal and jaw procedures. Nonetheless, African American, Hispanic, and Asian patients, in addition to lower-income patients and patients with Medicare, had a significantly lower odds of receiving jaw surgery. Awareness of these disparities may help guide efforts to improve patients' surgical options for sleep apnea.

  14. Primary closure of inadvertent durotomies utilizing the U-Clip in minimally invasive spinal surgery.

    Science.gov (United States)

    Song, Debbie; Park, Paul

    2011-12-15

    Retrospective clinical cohort study. To examine performance of the U-Clip for the closure of inadvertent durotomy occurring during minimally invasive spinal surgery. Primary closure of inadvertent durotomies that occur during minimally invasive spinal surgery can be technically difficult to accomplish when using standard knot-tying and suture management techniques, owing to the narrow and deep surgical corridor afforded by tubular retraction systems. The U-Clip is a novel device that can achieve tight tissue approximation without the need for knot-tying and excessive suture manipulation, making it ideally suited for use in minimally invasive spinal surgeries. We performed a retrospective review of patients who underwent minimally invasive decompressive procedures complicated by durotomy and repaired using U-Clips for the period January 2008 to January 2010. A total of seven patients were identified. Four of the seven patients were male. Six patients underwent lumbar laminectomy or discectomy. One patient underwent resection of a cervical synovial cyst. In each patient, the durotomy was repaired primarily using U-Clips. All six lumbar patients were discharged home on the same day, and the remaining patient was discharged the following morning. Mean follow-up was 6.3 months. No patient experienced symptoms related to persistent cerebrospinal fluid leakage. Primary closure of an inadvertent durotomy occurring during minimally invasive spinal surgery can be effectively achieved using the self-closing U-Clip device.

  15. Methods and clinical utility of intraoperative radiotherapy (IORT) in breast-conserving surgery

    Energy Technology Data Exchange (ETDEWEB)

    Miyauchi, Mitsuru; Yamamoto, Naoto; Fujita, Yoshihiro; Honda, Ichiro; Hatano, Kazuo; Sekiya, Yuichi [Chiba Cancer Center (Japan); Suzuki, Masato; Nakajima, Nobuyuki

    1996-03-01

    We have developed an intraoperative radiotherapy technique in breast-conserving surgery. Following lumpectomy and axillary dissection up to Level II, the subcutaneous fat layer was lifted from the gland over the entire breast. Electron beams of 25 Gy were irradiated within cylinder, avoiding the skin and subcutaneous tissue. The surface of the gland was covered with cotton swabs saturated with normal saline to equalize the energy depth to the chest wall. This technique has so far been applied to 8 patients, all of whom went through a successful postoperative period without serious complications. The cosmetic results were satisfactory from immediately after the operation. Intraoperative radiotherapy combined with breast-conserving surgery may be helpful in improving the QOL of patients by eliminating the adverse effects associated radiation injury to the skin of the breast and long-term postoperative follow-up. (author).

  16. Assessment of mechanical properties and dimensions of suture threads utilized in orthopedic surgeries

    Directory of Open Access Journals (Sweden)

    Sardenberg Trajano

    2003-01-01

    Full Text Available Surgical materials of monofilament nylon (0, 3-0 and 4-0, braided polyester (0, 3-0 and 4-0 and monofilament polypropylene (0, 3-0 and 4-0 of 7 trademarks commercialized in Brazil, was submitted to analysis of diameter, length, enchasement resistance, tensile strength of surgery materials knotted and unknotted, according to ABNT. The results show that most of surgical materials was inside of preconizing patterns of ABNT.

  17. Single dose myocardial protection technique utilizing del Nido cardioplegia solution during congenital heart surgery procedures.

    Science.gov (United States)

    Charette, K; Gerrah, R; Quaegebeur, J; Chen, J; Riley, D; Mongero, L; Corda, R; Bacha, E

    2012-03-01

    The single dose cardioplegia technique for myocardial protection during congenital heart surgery is a viable alternative to multidose protocols. Thirty-four pediatric patients with aortic cross clamp times greater than 90 minutes were grouped by modified adult (MA) multidose solution or del Nido (dN) single dose solution. Also, data from eight patients where the cross clamp times were greater than two hours on one dose of dN solution were included. In the 90-minute plus arm of the study, there were no significant differences between the groups when comparing the risk adjustment for congenital heart surgery (RACHS) (p=0.6), cardiopulmonary bypass times (CPB) (p=0.5), aortic cross camp times (p=0.5), weights (p=0.7) and number of intraoperative exogenous blood units (p=0.5). There were significant differences between the groups (p<0.05) in the number of cardioplegia doses and with perioperative glucose levels. In the greater than two hours group, the incidence of complete heart block (CHB) was 0.125% and there were no deaths or mechanical circulatory support (MCS) devices used. del Nido cardioplegia solution is a reasonable tool for myocardial protection during congenital heart surgery that significantly decreased the number of cardioplegic interventions and perioperative glucose values in our study groups.

  18. Lectures on functor homology

    CERN Document Server

    Touzé, Antoine

    2015-01-01

    This book features a series of lectures that explores three different fields in which functor homology (short for homological algebra in functor categories) has recently played a significant role. For each of these applications, the functor viewpoint provides both essential insights and new methods for tackling difficult mathematical problems. In the lectures by Aurélien Djament, polynomial functors appear as coefficients in the homology of infinite families of classical groups, e.g. general linear groups or symplectic groups, and their stabilization. Djament’s theorem states that this stable homology can be computed using only the homology with trivial coefficients and the manageable functor homology. The series includes an intriguing development of Scorichenko’s unpublished results. The lectures by Wilberd van der Kallen lead to the solution of the general cohomological finite generation problem, extending Hilbert’s fourteenth problem and its solution to the context of cohomology. The focus here is o...

  19. Safety and Utility of the Drainless Abdominoplasty in the Post-Bariatric Surgery Patient.

    Science.gov (United States)

    Gallagher, Sidhbh; Soleimani, Tahereh; Wang, Christine; Tholpady, Sunil; Jones, Christopher; Sando, William

    2018-02-01

    Surgical drains are used in abdominoplasty patients to combat wound closure disruption by hematoma or seroma formation. Several recent publications have described techniques that allow abdominoplasty to be performed safely without the need for surgical drains. This has not, however, been described in the case of the bariatric patient, who is often considered to be of higher postoperative complication risk. Here, we describe our experience of the drainless abdominoplasty in patients who have undergone massive weight loss (MWL) after a bariatric procedure. A retrospective review was conducted of 172 patients who had undergone drainless abdominoplasty using the progressive tension suture technique from 2011 to 2014. Thirty-five patients who had undergone MWL after bariatric surgery were assigned to group A. One hundred thirty-seven patients who had not undergone MWL with no history of bariatric surgery were assigned to group B. Demographics, intraoperative outcomes, and postoperative outcomes were compared. Patients in group A were older (mean age, 48.7 vs 42.7 years; P = 0.003) and had a higher body mass index (26.6 vs 24.6 kg/m, P = 0.01), a significantly larger tissue resection (2379 vs 1228 g, P = 0.0001), and a higher estimated blood loss (100 vs 120 mL, P = 0.049). There was also a significant group-to-group difference in the American Society of Anesthesiologists Physical Status Classification distribution, with a higher percentage of MWL patients having higher scores. Despite these differences, group A did not have a statistically higher incidence of complications. There was no statistically significant difference in the rate of seroma formation (11% vs 2%, P = 0.055), wound infection (2.9% vs 4.4%, P = 0.68), wound dehiscence (8.6% vs 8.0%, P = 0.91), meralgia paresthetica (2.8% vs 1.5%, P = 0.51), or rate of reoperation (11.4% vs 13.9%, P = 0.7) between the 2 groups. Despite post-bariatric surgery patients being considered higher risk for postoperative

  20. Real Topological Cyclic Homology

    DEFF Research Database (Denmark)

    Høgenhaven, Amalie

    , where O(2) is the semi-direct product of T, the multiplicative group of complex number of modulus 1, by the group G=Gal(C/R). We refer to this O(2)-spectrum as the real topological Hochschild homology. This generalization leads to a G-equivariant version of topological cyclic homology, which we call...... real topological cyclic homology. The first part of the thesis computes the G-equivariant homotopy type of the real topological cyclic homology of spherical group rings at a prime p with anti-involution induced by taking inverses in the group. The second part of the thesis investigates the derived G...

  1. Utility of intraoperative and postoperative radiographs in pediatric cochlear implant surgery.

    Science.gov (United States)

    Anne, Samantha; Juarez, Jose Miguel; Shaffer, Amber; Eleff, David; Kitsko, Dennis; Sydlowski, Sarah; Woodson, Erika; Chi, David

    2017-08-01

    Routine plain film radiographs are often obtained to confirm proper placement of electrode after pediatric cochlear implant surgery. Objective is to evaluate necessity of routine radiographs in pediatric cochlear implant cases. Retrospective review. Two tertiary care academic centers. Review of all children that underwent cochlear implantation from January 2003 thru June 2015. Exclusions include patients without intraoperative evoked compound action potential (ECAP) data or radiographs and patients undergoing revision surgeries. 235 pediatric patients underwent 371 cochlear implants. ECAP measurements were not available in two cases and were excluded from study. Radiographs were obtained in 35/369 cases due to intraoperative concern and four had abnormal findings. All four cases underwent change in management. One other patient had an x-ray because of difficult insertion and abnormal ECAP. Radiograph was normal; however, incision was opened and electrodes inserted further. Overall, 5/369 cases had changes in management intraoperatively. In all five cases, abnormalities were suspected by clinician judgment or abnormal ECAP measurements. Routine radiographs were completed in 349/369 cases and one was abnormal. This patient had known partial insertion due to cochlear fibrosis from meningitis and abnormal radiograph did not result in change in management. Clinician suspicion and/or abnormal ECAP prompted suspicion for abnormal electrode placement prior to evaluation with radiograph in all cases in which change in management occurred. Intraoperative radiographs may be valuable in setting of clinical suspicion. Routine radiographs do not result in change in management and are, therefore, unnecessary. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Determination of feasibility and utility of microscope-integrated optical coherence tomography during ophthalmic surgery: the DISCOVER Study RESCAN Results.

    Science.gov (United States)

    Ehlers, Justis P; Goshe, Jeff; Dupps, William J; Kaiser, Peter K; Singh, Rishi P; Gans, Richard; Eisengart, Jonathan; Srivastava, Sunil K

    2015-10-01

    Optical coherence tomography (OCT) has transformed the clinical management of a myriad of ophthalmic conditions. Applying OCT to ophthalmic surgery may have implications for surgical decision making and patient outcomes. To assess the feasibility and effect on surgical decision making of a microscope-integrated intraoperative OCT (iOCT) system. Report highlighting the 1-year results (March 2014-February 2015) of the RESCAN 700 portion of the DISCOVER (Determination of Feasibility of Intraoperative Spectral Domain Microscope Combined/Integrated OCT Visualization During En Face Retinal and Ophthalmic Surgery) study, a single-site, multisurgeon, prospective consecutive case series regarding this investigational device. Participants included patients undergoing ophthalmic surgery. Data on clinical characteristics were collected, and iOCT was performed during surgical milestones, as directed by the operating surgeon. A surgeon questionnaire was issued to each surgeon and was completed after each case to evaluate the role of iOCT during surgery and its particular role in select surgical procedures. Percentage of cases with successful acquisition of iOCT (ie, feasibility). Percentage of cases in which iOCT altered surgical decision making (ie, utility). During year 1 of the DISCOVER study, a total of 227 eyes (91 anterior segment cases and 136 posterior segment cases) underwent imaging with the RESCAN 700 system. Successful imaging (eg, the ability to acquire an OCT image of the tissue of interest) was obtained for 224 of 227 eyes (99% [95% CI, 98%-100%]). During lamellar keratoplasty, the iOCT data provided information that altered the surgeon's decision making in 38% of the cases (eg, complete graft apposition when the surgeon believed there was interface fluid). In membrane peeling procedures, iOCT information was discordant with the surgeon's impression of membrane peel completeness in 19% of cases (eg, lack of residual membrane or presence of occult membrane), thus

  3. Utility of Ultraportable Echocardiography in the Preoperative Evaluation of Noncardiac Surgery.

    Science.gov (United States)

    Costa, Jean Allan; Almeida, Maria Lucia Pereira; Estrada, Tereza Cristina Duque; Werneck, Guilherme Lobosco; Rocha, Alexandre Marins; Rosa, Maria Luiza Garcia; Ribeiro, Mario Luiz; Mesquita, Claudio Tinoco

    2016-11-01

    The ultraportable echocardiogram machine, with relevant portability and easiness in performing diagnoses, when in experienced hands, may contribute to the reliability of preoperative evaluation in noncardiac surgeries. To assess cardiac function parameters in patients aged older than 60 years, candidates of elective noncardiac surgeries, classified as ASA1 or ASA 2 according to surgical risk. A total of 211 patients referred for elective surgeries, without suspicion of previous heart diseases, were included in the study. Assessment of patients was conducted by conventional echocardiogram using the ultraportable V Scan (GE) device right after the pre-anesthetic clinical evaluation. We assessed the clinical impact of echocardiography results by using a questionnaire addressed to the anesthetist. Mean age of patients was 68.9 ± 7.0 years, 154 were women. The most frequent surgeries were: a) facectomy - cataract - 18; b) inguinal hernia surgery - 18; c) Cholecystectomy - 16. We found 58 normal tests (27.5%), 70 (33.2%) with mild valve reflux, and 83 (39.3%) with relevant abnormality, such as increase in heart chamber size, global and/or segmental contractile dysfunction, significant valve dysfunction or other unspecified. Test results caused delay of surgical procedure for a more detailed cardiac evaluation in 20 (9.5%) patients, and change in anesthetic management in 7 (3.3%). There was a considerable clinical impact with the use of the ultraportable echocardiography, since one out of every ten patients evaluated had their clinical management changed due to the detection of previously unsuspected, significant heart diseases, with the potential for severe complications. O ecocardiógrafo ultraportátil, com importante mobilidade e facilidade diagnóstica em mãos experientes pode contribuir para a segurança na avaliação pré-operatória em cirurgias não cardíacas. Avaliar os parâmetros de função cardíaca nos pacientes com mais de 60 anos de idade, candidatos

  4. Utilizing a Collaborative Learning Model to Promote Early Extubation Following Infant Heart Surgery.

    Science.gov (United States)

    Mahle, William T; Nicolson, Susan C; Hollenbeck-Pringle, Danielle; Gaies, Michael G; Witte, Madolin K; Lee, Eva K; Goldsworthy, Michelle; Stark, Paul C; Burns, Kristin M; Scheurer, Mark A; Cooper, David S; Thiagarajan, Ravi; Sivarajan, V Ben; Colan, Steven D; Schamberger, Marcus S; Shekerdemian, Lara S

    2016-10-01

    To determine whether a collaborative learning strategy-derived clinical practice guideline can reduce the duration of endotracheal intubation following infant heart surgery. Prospective and retrospective data collected from the Pediatric Heart Network in the 12 months pre- and post-clinical practice guideline implementation at the four sites participating in the collaborative (active sites) compared with data from five Pediatric Heart Network centers not participating in collaborative learning (control sites). Ten children's hospitals. Data were collected for infants following two-index operations: 1) repair of isolated coarctation of the aorta (birth to 365 d) and 2) repair of tetralogy of Fallot (29-365 d). There were 240 subjects eligible for the clinical practice guideline at active sites and 259 subjects at control sites. Development and application of early extubation clinical practice guideline. After clinical practice guideline implementation, the rate of early extubation at active sites increased significantly from 11.7% to 66.9% (p collaborative learning strategy designed clinical practice guideline significantly increased the rate of early extubation with no change in the rate of reintubation. The early extubation clinical practice guideline did not significantly change postoperative ICU length of stay.

  5. "Knife to skin" time is a poor marker of operating room utilization and efficiency in cardiac surgery.

    Science.gov (United States)

    Luthra, Suvitesh; Ramady, Omar; Monge, Mary; Fitzsimons, Michael G; Kaleta, Terry R; Sundt, Thoralf M

    2015-06-01

    Markers of operation room (OR) efficiency in cardiac surgery are focused on "knife to skin" and "start time tardiness." These do not evaluate the middle and later parts of the cardiac surgical pathway. The purpose of this analysis was to evaluate knife to skin time as an efficiency marker in cardiac surgery. We looked at knife to skin time, procedure time, and transfer times in the cardiac operational pathway for their correlation with predefined indices of operational efficiency (Index of Operation Efficiency - InOE, Surgical Index of Operational Efficiency - sInOE). A regression analysis was performed to test the goodness of fit of the regression curves estimated for InOE relative to the times on the operational pathway. The mean knife to skin time was 90.6 ± 13 minutes (23% of total OR time). The mean procedure time was 282 ± 123 minutes (71% of total OR time). Utilization efficiencies were highest for aortic valve replacement and coronary artery bypass grafting and least for complex aortic procedures. There were no significant procedure-specific or team-specific differences for standard procedures. Procedure times correlated the strongest with InOE (r = -0.98, p efficiency. A statistically significant linear dependence on InOE was observed with "procedure times" only. Procedure times are a better marker of OR efficiency than knife to skin in cardiac cases. Strategies to increase OR utilization and efficiency should address procedure times in addition to knife to skin times. © 2015 Wiley Periodicals, Inc.

  6. The Impact of Early Involvement in a Postdischarge Support Program for Ostomy Surgery Patients on Preventable Healthcare Utilization.

    Science.gov (United States)

    Rojanasarot, Sirikan

    2017-11-20

    To evaluate the impact of a postdischarge ostomy support program as an adjunct to nurse-led ostomy care on preventable healthcare utilization. A cross-sectional study. A postdischarge support program offered by an ostomy product's manufacturer provides persons living with an ostomy with patient-centered and easily accessible assistance. Individuals who underwent ostomy surgery within 18 months prior to the survey date were selected from an ostomy patient database maintained by the ostomy patient support program provider. Of 7026 surveys sent to program enrollees, 493 (7%) responded, compared with 225 (5%) out of 4149 surveys sent to individuals in a comparison group. The 2 groups were similar in demographics. A majority of the survey respondents were female (60% of program enrollees vs 55% of respondents in the comparison group). Among the program enrollees, 44% had colostomy, 43% had ileostomy, 10% had urostomy, and 4% had at least 2 types of ostomy surgery compared with 52%, 32%, 12%, and 4% of the respondents in a comparison group, respectively. The study compared hospital readmission and emergency room (ER) visit rates attributable to ostomy complications between program enrollees and respondents in the comparison group. The event rates were measured in 2 study periods: within the first month of discharge and after the first month of discharge. Eligible individuals received an online survey that included the following domains: characteristics of ostomy surgery; readmissions and ER visits within the first month or after the first month of discharge, including reasons for preventable events; and level of health care access. Multivariate logistic regressions controlling for covariates were applied to investigate associations between program enrollment and ostomy-related readmission or ER visit rates. Logistic regression analyses showed that, when compared with respondents in the comparison group, program enrollees had a significantly lower likelihood of being

  7. The use of computer-guided flapless dental implant surgery (NobelGuide) and immediate function to support a fixed full-arch prosthesis in fresh-frozen homologous patients with bone grafts.

    Science.gov (United States)

    Nocini, Pier Francesco; Castellani, Roberto; Zanotti, Guglielmo; Bertossi, Dario; Luciano, Umberto; De Santis, Daniele

    2013-11-01

    The behavior of fresh-frozen homologous bone (FFB) when used in combination with computer-guided implant surgery has not been investigated yet, and there is a lack of clinical evidence in the literature. The purpose of this retrospective study is to evaluate the implant survival and related fixed full-arch prostheses at the 1- to 5-year follow-up when performed with immediate function using a flapless surgical procedure and computer-aided technology (NobelGuide; Nobel Biocare AB, Goteborg, Sweden) in patients previously treated with FFB grafts. Furthermore, the related values of torque and complications observed were analyzed and discussed. Clinical charts of patients with edentulous arches treated with FFB grafts and NobelGuide system with at least 1 year follow-up were reviewed retrospectively.A total of 65 patients met the criteria of inclusion, receiving a total of 342 implants and 77 full-arch prostheses, with a mean follow-up of 32.87 months (range, 1-5 years). Survival of implants and prostheses was high, reaching 96.5% and 95%, respectively. Factors significantly related to failure of the implants were smoking, position of the implant as last distal abutment, and fracture of basal maxillary bone. Prostheses survival was influenced by bruxism, failure of multiple implants, and torque level of implant equal to 0 at implant insertion. All implants and prostheses failures occurred in the first year. A higher torque level at implant insertion did not correspond to a lower risk of implant failure.Within the limitations of our retrospective study, this treatment modality was predictable with high survival rates and high insertion torque. However, a few implant and prosthetic failures were found, together with several complications.

  8. Drug Utilization Review of parenteral opioid analgesics in cardiovascular surgery department of Shahid Modarres Hospital, Tehran

    Directory of Open Access Journals (Sweden)

    Vatanpour H, Soltani M,

    2016-08-01

    Full Text Available Persistent pain continues to be a common problem among patients undergoing cardiac operations and the need for controlling such pain is believed to be as a prime necessity in terms of the patient’s well being, health care costs and avoiding negative consequences provoked by the pain itself. Regarding to the newly established guidelines, opioid analgesic agents are considered as the mainstay of moderate to severe acute pain. Nonetheless, the underutilization of opioids for pain relief is still a persisting huge challenge. This survey, applying as a concurrent Drug Utilization Review using ATC/DDD system provided and recommended by the DUR group of the World Health Organization, conducted on 108 inpatients who received opioid drugs by parenteral route during 9 months from February to November 2013 at the post-ICU ward of Shahid Modarres Cardiovascular Hospital, affiliated to Shahid Beheshti University of Medical Science, in Tehran. Our findings revealed that morphine was the most commonly prescribed parenteral opioid in the hospitalized patients and pethidine usage was in the lowest level for the geriatric patients, resulting in satisfaction with the analgesic procedure among most of the cases in our study. Both of the mentioned drugs were prescribed by intramuscular route, regarding PRN way of injecting as well. Comparative results of our study with the literature revealed relatively moderate and roughly rational consumption of morphine (10.282 DDD/100bed-days and pethidine (0.013 DDD/100bed-days. Applying multivariate conditional regression modeling on the question of determining independent predictors for opioid usage, disclosed a direct correlation between the patient’s weight and daily dose of parenteral opioid consumption.

  9. Factors influencing the surgery intentions and choices of women with early breast cancer: the predictive utility of an extended theory of planned behaviour.

    Science.gov (United States)

    Sivell, Stephanie; Elwyn, Glyn; Edwards, Adrian; Manstead, Antony S R

    2013-08-20

    Women diagnosed with early breast cancer (stage I or II) can be offered the choice between mastectomy or breast conservation surgery with radiotherapy due to equivalence in survival rates. A wide variation in the surgical management of breast cancer and a lack of theoretically guided research on this issue highlight the need for further research into the factors influencing women's choices. An extended Theory of Planned Behaviour (TPB) could provide a basis to understand and predict women's surgery choices. The aims of this study were to understand and predict the surgery intentions and choices of women newly diagnosed with early breast cancer, examining the predictive utility of an extended TPB. Sixty-two women recruited from three UK breast clinics participated in the study; 48 women, newly diagnosed with early breast cancer, completed online questionnaires both before their surgery and after accessing an online decision support intervention (BresDex). Questionnaires assessed views about breast cancer and the available treatment options using items designed to measure constructs of an extended TPB (i.e., attitudes, subjective norms, perceived behavioural control, and anticipated regret), and women's intentions to choose mastectomy or BCS. Objective data were collected on women's choice of surgery via the clinical breast teams. Multiple and logistic regression analyses examined predictors of surgery intentions and subsequent choice of surgery. The extended TPB accounted for 69.9% of the variance in intentions (p subjective norms were significant predictors. Including additional variables revealed anticipated regret to be a more important predictor than subjective norms. Surgery intentions significantly predicted surgery choices (p TPB in predicting and understanding women's surgery intentions and choices for early breast cancer. Understanding these factors should help to identify key components of interventions to support women while considering their surgery

  10. Homology, convergence and parallelism.

    Science.gov (United States)

    Ghiselin, Michael T

    2016-01-05

    Homology is a relation of correspondence between parts of parts of larger wholes. It is used when tracking objects of interest through space and time and in the context of explanatory historical narratives. Homologues can be traced through a genealogical nexus back to a common ancestral precursor. Homology being a transitive relation, homologues remain homologous however much they may come to differ. Analogy is a relationship of correspondence between parts of members of classes having no relationship of common ancestry. Although homology is often treated as an alternative to convergence, the latter is not a kind of correspondence: rather, it is one of a class of processes that also includes divergence and parallelism. These often give rise to misleading appearances (homoplasies). Parallelism can be particularly hard to detect, especially when not accompanied by divergences in some parts of the body. © 2015 The Author(s).

  11. Reliability, validity, and utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in assessments of bariatric surgery candidates.

    Science.gov (United States)

    Tarescavage, Anthony M; Wygant, Dustin B; Boutacoff, Lana I; Ben-Porath, Yossef S

    2013-12-01

    In the current study, we examined the reliability, validity, and clinical utility of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2011) scores in a sample of 759 bariatric surgery candidates. We provide descriptives for all scales, internal consistency and standard error of measurement estimates for all substantive scales, external correlates of substantive scales using chart review and self-report criteria, and relative risk ratios to assess the clinical utility of the instrument. Results generally support the reliability, validity, and clinical utility of MMPI-2-RF scale scores in the psychological evaluation of bariatric surgery candidates. Limitations, future directions, and practical application of these results are discussed. (c) 2013 APA, all rights reserved.

  12. Utilizing Forced Vital Capacity to Predict Low Lung Compliance and Select Intraoperative Tidal Volume During Thoracic Surgery.

    Science.gov (United States)

    Hoftman, Nir; Eikermann, Eric; Shin, John; Buckley, Jack; Navab, Kaveh; Abtin, Fereidoun; Grogan, Tristan; Cannesson, Maxime; Mahajan, Aman

    2017-12-01

    Tidal volume selection during mechanical ventilation utilizes dogmatic formulas that only consider a patient's predicted body weight (PBW). In this study, we investigate whether forced vital capacity (FVC) (1) correlates better to total lung capacity (TLC) than PBW, (2) predicts low pulmonary compliance, and (3) provides an alternative method for tidal volume selection. One hundred thirty thoracic surgery patients had their preoperative TLC calculated via 2 methods: (1) pulmonary function test (PFT; TLCPFT) and (2) computed tomography 3D reconstruction (TLCCT). We compared the correlation between TLC and PBW with the correlation between TLC and FVC to determine which was stronger. Dynamic pulmonary compliance was then calculated from intraoperative ventilator data and logistic regression models constructed to determine which clinical measure best predicted low compliance. Ratios of tidal volume/FVC plotted against peak inspiratory pressure were utilized to construct a new model for tidal volume selection. Calculated tidal volumes generated by this model were then compared with those generated by the standard lung-protective formula Vt = 7 cc/kg. The correlation between FVC and TLC (0.82 for TLCPFT and 0.76 for TLCCT) was stronger than the correlation between PBW and TLC (0.65 for TLCPFT and 0.58 for TLCCT). Patients with very low compliance had significantly smaller lung volumes (forced expiratory volume at 1 second, FVC, TLC) and lower diffusion capacity of the lungs for carbon monoxide when compared with patients with normal compliance. An FVC cutoff of 3470 cc was 100% sensitive and 51% specific for predicting low compliance. The proposed equation Vt = FVC/8 significantly reduced calculated tidal volume by a mean of 22.5% in patients with low pulmonary compliance without affecting the mean tidal volume in patients with normal compliance (mean difference 0.9%). FVC is more strongly correlated to TLC than PBW and a cutoff of about 3.5 L can be utilized to predict

  13. Using GoPro to Give Video-Assisted Operative Feedback for Surgery Residents: A Feasibility and Utility Assessment.

    Science.gov (United States)

    Moore, Maureen D; Abelson, Jonathan S; O'Mahoney, Paul; Bagautdinov, Iskander; Yeo, Heather; Watkins, Anthony C

    2017-08-21

    As an adjunct to simulation-based teaching, laparoscopic video-based surgical coaching has been an effective tool to augment surgical education. However, the wide use of video review in open surgery has been limited primarily due to technological and logistical challenges. The aims of our study were to (1) evaluate perceptions of general surgery (GS) residents on video-assisted operative instruction and (2) conduct a pilot study using a head-mounted GoPro in conjunction with the operative performance rating system to assess feasibility of providing video review to enhance operative feedback during open procedures. GS residents were anonymously surveyed to evaluate their perceptions of oral and written operative feedback and use of video-based operative resources. We then conducted a pilot study of 10 GS residents to assess the utility and feasibility of using a GoPro to record resident performance of an arteriovenous fistula creation with an attending surgeon. Categorical variables were analyzed using the chi-square test. Academic, tertiary medical center. GS residents and faculty. A total of 59 GS residents were anonymously surveyed (response rate = 65.5%). A total of 40% (n = 24) of residents reported that structured evaluations rarely or never provided meaningful feedback. When feedback was received, 55% (n = 32) residents reported that it was only rarely or sometimes in regard to their operative skills. There was no significant difference in surveyed responses among junior postgraduate year (PGY 1-2), senior (PGY 3-4), or chief residents (PGY-5). A total of 80% (n = 8) of residents found the use of GoPro video review very or extremely useful for education; they also deemed video review more useful for operative feedback than written or communicative feedback. An overwhelming majority (90%, n = 9) felt that video review would lead to improved technical skills, wanted to review the video with the attending surgeon for further feedback, and desired expansion of

  14. Gorenstein homological dimensions

    DEFF Research Database (Denmark)

    Holm, Henrik Granau

    2004-01-01

    In basic homological algebra, the projective, injective and 2at dimensions of modules play an important and fundamental role. In this paper, the closely related Gorenstein projective, Gorenstein injective and Gorenstein 2at dimensions are studied. There is a variety of nice results about Gorenstein...

  15. Changes in utilization and peri-operative outcomes of bariatric surgery in large U.S. hospital database, 2011-2014.

    Directory of Open Access Journals (Sweden)

    Lu Zhang

    Full Text Available With the epidemic of morbid obesity, bariatric surgery has been accepted as one of the most effective treatments of obesity.To investigate recent changes in the utilization of bariatric surgery, patients and hospital characteristics, and in-hospital complications in a nationwide hospital database in the United States.This is a secondary data analysis of the Premier Perspective database.ICD-9 codes were used to identify bariatric surgeries performed between 2011 and 2014. Descriptive statistics were computed and regression was used.A total of 74,774 bariatric procedures were identified from 436 hospitals between 2011 and 2014. During this time period, the proportion of gastric bypass (from 44.8% to 31.3%; P for trend < 0.0001 and gastric banding (from 22.8% to 5.2%; P for trend < 0.0001 decreased, while the proportion of sleeve gastrectomy (from 13.7% to 56.9%; P for trend < 0.0001 increased substantially. The proportion of bariatric surgery performed for outpatients decreased from 17.15% in 2011 to 8.11% in 2014 (P for trend < 0.0001. The majority of patients undergoing surgery were female (78.5%, white (65.6%, younger than 65 years (93.8%, and insured with managed care (53.6%. In-hospital mortality rate and length of hospital stay remained stable. The majority of surgeries were performed in high-volume (71.8% and urban (91.6% hospitals.Results based on our study sample indicated that the popularity of various bariatric surgery procedures changed significantly from 2011 to 2014. While the rates of in-hospital complications were stable, disparities in the use of bariatric surgery regarding gender, race, and insurance still exist.

  16. Algebra V homological algebra

    CERN Document Server

    Shafarevich, I

    1994-01-01

    This book, the first printing of which was published as volume 38 of the Encyclopaedia of Mathematical Sciences, presents a modern approach to homological algebra, based on the systematic use of the terminology and ideas of derived categories and derived functors. The book contains applications of homological algebra to the theory of sheaves on topological spaces, to Hodge theory, and to the theory of modules over rings of algebraic differential operators (algebraic D-modules). The authors Gelfand and Manin explain all the main ideas of the theory of derived categories. Both authors are well-known researchers and the second, Manin, is famous for his work in algebraic geometry and mathematical physics. The book is an excellent reference for graduate students and researchers in mathematics and also for physicists who use methods from algebraic geometry and algebraic topology.

  17. Cost-utility analysis of the insufflation of warmed humidified carbon dioxide during open and laparoscopic colorectal surgery.

    Science.gov (United States)

    Jenks, Michelle; Taylor, Matthew; Shore, Judith

    2017-02-01

    An evaluation was conducted to estimate the cost-effectiveness of insufflation of warmed humidified CO2 during open and laparoscopic colorectal surgery compared with usual care from a UK NHS perspective. Decision analytic models were developed for open and laparoscopic surgery. Incremental costs per quality-adjusted life year (QALY) were estimated. The open surgery model used data on the incidence of intra-operative hypothermia and applied risks of complications for hypothermia and normothermia. The laparoscopic surgery model utilised data describing complications directly. Sensitivity analyses were conducted. Compared with usual care, insufflation of warmed humidified CO2 dominated. For open surgery, savings of £20 and incremental QALYs of 0.013 were estimated per patient. For laparoscopic surgery, savings of £345 and incremental QALYs of 0.001 per patient were estimated. Results were robust to most sensitivity analyses. Considering the current evidence base, the intervention is likely to be cost-effective compared with usual care in patients undergoing colorectal surgery.

  18. The utility of weight loss medications after bariatric surgery for weight regain or inadequate weight loss: A multi-center study.

    Science.gov (United States)

    Stanford, Fatima Cody; Alfaris, Nasreen; Gomez, Gricelda; Ricks, Elizabeth T; Shukla, Alpana P; Corey, Kathleen E; Pratt, Janey S; Pomp, Alfons; Rubino, Francesco; Aronne, Louis J

    2017-03-01

    Patients who undergo bariatric surgery often have inadequate weight loss or weight regain. We sought to discern the utility of weight loss pharmacotherapy as an adjunct to bariatric surgery in patients with inadequate weight loss or weight regain. Two academic medical centers. We completed a retrospective study to identify patients who had undergone bariatric surgery in the form of a Roux-en-Y gastric bypass (RYGB) or a sleeve gastrectomy from 2000-2014. From this cohort, we identified patients who were placed on weight loss pharmacotherapy postoperatively for inadequate weight loss or weight regain. We extracted key demographic data, medical history, and examined weight loss in response to surgery and after the initiation of weight loss pharmacotherapy. A total of 319 patients (RYGB = 258; sleeve gastrectomy = 61) met inclusion criteria for analysis. More than half (54%; n = 172) of all study patients lost≥5% (7.2 to 195.2 lbs) of their total weight with medications after surgery. There were several high responders with 30.3% of patients (n = 96) and 15% (n = 49) losing≥10% (16.7 to 195.2 lbs) and≥15% (25 to 195.2 lbs) of their total weight, respectively, Topiramate was the only medication that demonstrated a statistically significant response for weight loss with patients being twice as likely to lose at least 10% of their weight when placed on this medication (odds ratio = 1.9; P = .018). Regardless of the postoperative body mass index, patients who underwent RYGB were significantly more likely to lose≥5% of their total weight with the aid of weight loss medications. Weight loss pharmacotherapy serves as a useful adjunct to bariatric surgery in patients with inadequate weight loss or weight regain. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  19. Cost utility analysis of caudal epidural injections in the treatment of lumbar disc herniation, axial or discogenic low back pain, central spinal stenosis, and post lumbar surgery syndrome.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Falco, Frank J E; Pampati, Vidyasagar; Cash, Kimberly A; Benyamin, Ramsin M; Hirsch, Joshua A

    2013-01-01

    In this era of escalating health care costs and the questionable effectiveness of multiple interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine, and has an influence coverage decisions. Even though multiple cost effectiveness analysis studies have been performed over the years, extensive literature is lacking for interventional techniques. Cost utility analysis studies of epidural injections for managing chronic low back pain demonstrated highly variable results including a lack of cost utility in randomized trials and contrasting results in observational studies. There has not been any cost utility analysis studies of epidural injections in large randomized trials performed in interventional pain management settings. To assess the cost utility of caudal epidural injections in managing chronic low back pain secondary to lumbar disc herniation, axial or discogenic low back pain, lumbar central spinal stenosis, and lumbar post surgery syndrome. This analysis is based on 4 previously published randomized trials. A private, specialty referral interventional pain management center in the United States. Four randomized trials were conducted assessing the clinical effectiveness of caudal epidural injections with or without steroids for lumbar disc herniation, lumbar discogenic or axial low back pain, lumbar central spinal stenosis, and post surgery syndrome. A cost utility analysis was performed with direct payment data for a total of 480 patients over a period of 2 years from these 4 trials. Outcome included various measures with significant improvement defined as at least a 50% improvement in pain reduction and disability status. The results of 4 randomized controlled trials of low back pain with 480 patients with a 2 year follow-up with the actual reimbursement data showed cost utility for one year of quality-adjusted life year (QALY) of $2,206 for disc herniation, $2,136 for axial or discogenic pain without

  20. Investigating homology between proteins using energetic profiles.

    Directory of Open Access Journals (Sweden)

    James O Wrabl

    2010-03-01

    Full Text Available Accumulated experimental observations demonstrate that protein stability is often preserved upon conservative point mutation. In contrast, less is known about the effects of large sequence or structure changes on the stability of a particular fold. Almost completely unknown is the degree to which stability of different regions of a protein is generally preserved throughout evolution. In this work, these questions are addressed through thermodynamic analysis of a large representative sample of protein fold space based on remote, yet accepted, homology. More than 3,000 proteins were computationally analyzed using the structural-thermodynamic algorithm COREX/BEST. Estimated position-specific stability (i.e., local Gibbs free energy of folding and its component enthalpy and entropy were quantitatively compared between all proteins in the sample according to all-vs.-all pairwise structural alignment. It was discovered that the local stabilities of homologous pairs were significantly more correlated than those of non-homologous pairs, indicating that local stability was indeed generally conserved throughout evolution. However, the position-specific enthalpy and entropy underlying stability were less correlated, suggesting that the overall regional stability of a protein was more important than the thermodynamic mechanism utilized to achieve that stability. Finally, two different types of statistically exceptional evolutionary structure-thermodynamic relationships were noted. First, many homologous proteins contained regions of similar thermodynamics despite localized structure change, suggesting a thermodynamic mechanism enabling evolutionary fold change. Second, some homologous proteins with extremely similar structures nonetheless exhibited different local stabilities, a phenomenon previously observed experimentally in this laboratory. These two observations, in conjunction with the principal conclusion that homologous proteins generally conserved

  1. An Innovative Streaming Video System With a Point-of-View Head Camera Transmission of Surgeries to Smartphones and Tablets: An Educational Utility.

    Science.gov (United States)

    Chaves, Rafael Oliveira; de Oliveira, Pedro Armando Valente; Rocha, Luciano Chaves; David, Joacy Pedro Franco; Ferreira, Sanmari Costa; Santos, Alex de Assis Santos Dos; Melo, Rômulo Müller Dos Santos; Yasojima, Edson Yuzur; Brito, Marcus Vinicius Henriques

    2017-10-01

    In order to engage medical students and residents from public health centers to utilize the telemedicine features of surgery on their own smartphones and tablets as an educational tool, an innovative streaming system was developed with the purpose of streaming live footage from open surgeries to smartphones and tablets, allowing the visualization of the surgical field from the surgeon's perspective. The current study aims to describe the results of an evaluation on level 1 of Kirkpatrick's Model for Evaluation of the streaming system usage during gynecological surgeries, based on the perception of medical students and gynecology residents. Consisted of a live video streaming (from the surgeon's point of view) of gynecological surgeries for smartphones and tablets, one for each volunteer. The volunteers were able to connect to the local wireless network, created by the streaming system, through an access password and watch the video transmission on a web browser on their smartphones. Then, they answered a Likert-type questionnaire containing 14 items about the educational applicability of the streaming system, as well as comparing it to watching an in loco procedure. This study is formally approved by the local ethics commission (Certificate No. 53175915.7.0000.5171/2016). Twenty-one volunteers participated, totalizing 294 items answered, in which 94.2% were in agreement with the items affirmative, 4.1% were neutral, and only 1.7% answers corresponded to negative impressions. Cronbach's α was .82, which represents a good reliability level. Spearman's coefficients were highly significant in 4 comparisons and moderately significant in the other 20 comparisons. This study presents a local streaming video system of live surgeries to smartphones and tablets and shows its educational utility, low cost, and simple usage, which offers convenience and satisfactory image resolution, thus being potentially applicable in surgical teaching.

  2. [Utilization of Rehabilitation after Disk Surgery - A Cross-Sectoral Analysis of Claims Data from Statutory Health Insurance and German Federal Pension Fund].

    Science.gov (United States)

    Dannenmaier, Julia; Ritter, Sabrina; Jankowiak, Silke; Kaluscha, Rainer; Krischak, Gert

    2017-10-01

    The aim of this study was to identify relevant factors that influence utilization and interim period between hospitalization and postoperative rehabilitation after disk surgery. Logistic regression was performed for utilization of an early postoperative rehabilitation and for an interim period, when patients were going to a rehabilitation facility (directly after hospitalization or after a period at home) on claims data from statutory pension insurance and statutory health insurance. Increased utilization of postoperative rehabilitation was found in older and German patients. Moreover, adiposity and additional physiotherapy in hospital increased the utilization of postoperative rehabilitation, while blood transfusion during hospitalization was an inhibiting factor.Female gender, older age and additional physiotherapy in hospital decreased the probability for an interim period between hospitalization and postoperative rehabilitation. However, the probability for an interim period increased from 2005 to 2010. Utilization and interim period between hospitalization and postoperative rehabilitation meet patient's needs and seem adequate. Nevertheless, there are indications for under-utilization of certain patient groups (foreign citizens, unemployed persons, male patients). © Georg Thieme Verlag KG Stuttgart · New York.

  3. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery utilizing computer-assisted surgical simulation.

    Science.gov (United States)

    Movahed, Reza; Teschke, Marcus; Wolford, Larry M

    2013-12-01

    Clinicians who address temporomandibular joint (TMJ) pathology and dentofacial deformities surgically can perform the surgery in 1 stage or 2 separate stages. The 2-stage approach requires the patient to undergo 2 separate operations and anesthesia, significantly prolonging the overall treatment. However, performing concomitant TMJ and orthognathic surgery (CTOS) in these cases requires careful treatment planning and surgical proficiency in the 2 surgical areas. This article presents a new treatment protocol for the application of computer-assisted surgical simulation in CTOS cases requiring reconstruction with patient-fitted total joint prostheses. The traditional and new CTOS protocols are described and compared. The new CTOS protocol helps decrease the preoperative workup time and increase the accuracy of model surgery. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Induction of osteogenesis by demineralized homologous and xenograft bone matrix

    Directory of Open Access Journals (Sweden)

    Dall'Agnol Rosiris

    2003-01-01

    Full Text Available The osteogenesis induction by demineralized bone matrix grafts remains as a challenge in the reconstructions of the mandible through homologous and xenografts or in implants in abdominal muscle. PURPOSE: Observed the behaviour of implants of demineralized bone matrix at the mandible (right side with homologous graft and left side with xenograft of pig. METHODS: Experimental study with homologous and heterologous implants of demineralized bone matrix at the mandible and in ectopic muscle at the Center of Experimental Surgery of Heliopolis Hospital, Hosphel, São Paulo, Brazil. In 6 white New Zeland rabbits, 46 grafts were performed being 23 with homologous (rabbit and 23 with xenograft (pig. 12 homologous implants (6 at the right side of the mandible and 6 at abdominal muscle of the rabbit and 12 heterologous implants of pigs (6 at the left side of the mandible and 6 at abdominal muscle rabbit were performed with demineralized bone matrix. RESULTS: Osteogenesis was assessed through histologic features after 30 and 60 days. After 1 rabbit dead, osteogenesis (mandible were detected in 9 of 11 (82% rabbits that received homologous matrix, in spite of heterologous implants showed osteogenesis in 6 out of 11 (54% (p=0,18. The abdominal muscle showed induced osteogenesis in 3 out of 11(27% animals with homologous and 0% with heterologous implants (p=0,10. CONCLUSIONS: Osteogenesis induction through homologous grafts in rabbit mandible and abdominal muscle were more effective than xenografts.

  5. The Utility of Diagnostic Laparoscopy in Post-Bariatric Surgery Patients with Chronic Abdominal Pain of Unknown Etiology.

    Science.gov (United States)

    Alsulaimy, Mohammad; Punchai, Suriya; Ali, Fouzeyah A; Kroh, Matthew; Schauer, Philip R; Brethauer, Stacy A; Aminian, Ali

    2017-08-01

    Chronic abdominal pain after bariatric surgery is associated with diagnostic and therapeutic challenges. The aim of this study was to evaluate the yield of laparoscopy as a diagnostic and therapeutic tool in post-bariatric surgery patients with chronic abdominal pain who had negative imaging and endoscopic studies. A retrospective analysis was performed on post-bariatric surgery patients who underwent laparoscopy for diagnosis and treatment of chronic abdominal pain at a single academic center. Only patients with both negative preoperative CT scan and upper endoscopy were included. Total of 35 post-bariatric surgery patients met the inclusion criteria, and all had history of Roux-en-Y gastric bypass. Twenty out of 35 patients (57%) had positive findings on diagnostic laparoscopy including presence of adhesions (n = 12), chronic cholecystitis (n = 4), mesenteric defect (n = 2), internal hernia (n = 1), and necrotic omentum (n = 1). Two patients developed post-operative complications including a pelvic abscess and an abdominal wall abscess. Overall, 15 patients (43%) had symptomatic improvement after laparoscopy; 14 of these patients had positive laparoscopic findings requiring intervention (70% of the patients with positive laparoscopy). Conversely, 20 (57%) patients required long-term medical treatment for management of chronic abdominal pain. Diagnostic laparoscopy, which is a safe procedure, can detect pathological findings in more than half of post-bariatric surgery patients with chronic abdominal pain of unknown etiology. About 40% of patients who undergo diagnostic laparoscopy and 70% of patients with positive findings on laparoscopy experience significant symptom improvement. Patients should be informed that diagnostic laparoscopy is associated with no symptom improvement in about half of cases.

  6. Cost-Utility of Video-Electroencephalography Monitoring Followed by Surgery in Adults with Drug-Resistant Focal Epilepsy in Thailand.

    Science.gov (United States)

    Kitwitee, Pimprapa; Unnwongse, Kanjana; Srikijvilaikul, Teeradej; Yadee, Tinonkorn; Limwattananon, Chulaporn

    2017-02-01

    This study assessed whether video-electroencephalography (VEEG) monitoring followed by surgery was cost-effective in adult patients with drug-resistant focal epilepsy under Thai health care context, as compared with continued medical treatment without VEEG. The total cost (in Thai Baht, THB) and effectiveness (in quality-adjusted life years, QALYs) were estimated over a lifetime horizon, using a decision tree and a Markov model. Data on short-term surgical outcomes, direct health care costs, and utilities were collected from Thai patients in a specialized hospital. Long-term outcomes and relative effectiveness of the surgery over medical treatment were derived, using systematic reviews of published literature. Seizure-free rates at years 1 and 2 after surgery were 79.4% and 77.8%, respectively. Costs of VEEG and surgery plus 1-year follow-up care were 216,782 THB, of which the VEEG and other necessary investigations were the main cost drivers (42.8%). On the basis of societal perspective, the total cost over a 40-year horizon accrued to 1,168,679 THB for the VEEG option, 64,939 THB higher than that for no VEEG. The VEEG option contributed to an additional 1.50 QALYs over no VEEG, resulting in an incremental cost-effectiveness ratio of 43,251 THB (USD 1236) per 1 QALY gained. Changes in key parameters had a minimal impact on the incremental cost-effectiveness ratio. Accounting for uncertainty, there was an 84% probability that the VEEG option was cost-effective on the basis of Thailand's cost-effective threshold of 160,000 THB/QALY. For patients with drug-resistant epilepsy, VEEG monitoring followed by epilepsy surgery was cost-effective in Thailand. Therefore it should be recommended for health insurance coverage. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. The utility of the additive EuroSCORE, RIFLE and AKIN staging scores in the prediction and diagnosis of acute kidney injury after cardiac surgery.

    Science.gov (United States)

    Duthie, Fiona A I; McGeehan, Paul; Hill, Sharleen; Phelps, Richard; Kluth, David C; Zamvar, Vipin; Hughes, Jeremy; Ferenbach, David A

    2014-01-01

    Acute kidney injury (AKI) following cardiac surgery is a complication associated with high rates of morbidity and mortality. We compared staging systems for the diagnosis of AKI after cardiac surgery, and assessed pre-operative factors predictive of post-operative AKI. Clinical data, surgical risk scores, procedure and clinical outcome were obtained on all 4,651 patients undergoing cardiac surgery to the Royal Infirmary of Edinburgh between April 2006 and March 2011, of whom 4,572 had sufficient measurements of creatinine before and after surgery to permit inclusion and analysis. The presence of AKI was assessed using the AKIN and RIFLE criteria. By AKIN criteria, 12.4% of the studied population developed AKI versus 6.5% by RIFLE criteria. Any post-operation AKI was associated with increased mortality from 2.2 to 13.5% (relative risk 7.0, p < 0.001), and increased inpatient stay from a median of 7 (IQR 4) to 9 (IQR 11) days (p < 0.05). Patients identified by AKIN, but not RIFLE, had a mean peak creatinine rise of 34% from baseline and had a significantly lower mortality compared to RIFLE-'Risk' AKI (mortality 6.1 vs. 9.7%; p < 0.05). Pre-operative creatinine, diabetes, NYHA Class IV dyspnoea and EuroSCORE-1 (a surgical risk score) all predicted subsequent AKI on multivariate analysis. EuroSCORE-1 outperformed any single demographic factor in predicting post-operative AKI risk, equating to an 8% increase in relative risk for each additional point. AKI after cardiac surgery is associated with delayed discharge and high mortality rates. The AKIN and RIFLE criteria identify patients at a range of AKI severity levels suitable for trial recruitment. The utility of EuroSCORE as a risk stratification tool to identify high AKI-risk subjects for prospective intervention merits further study.

  8. Utility of preoperative in vitro platelet function tests for predicting bleeding risk in patients undergoing functional endoscopic sinus surgery

    Directory of Open Access Journals (Sweden)

    Lee AJ

    2016-10-01

    Full Text Available A-Jin Lee, Sang-Gyung Kim Department of Laboratory Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea Background: It is necessary to predict the bleeding risk in patients undergoing functional endoscopic sinus surgery (FESS. To evaluate the adequacy of primary hemostasis, preoperative hemostatic screening tests are used. In the present study, we determined whether there is a positive correlation between prolonged closure time (CT with collagen/epinephrine (CT-epi, prothrombin time (PT, international normalized ratio (INR, activated partial thromboplastin time (aPTT and bleeding during FESS.Patients and methods: We reviewed the medical records of 90 patients without bleeding histories who had undergone FESS from March 2013 to June 2014. More than 200 mL of blood loss was defined as moderate bleeding during surgery. With respect to bleeding during surgery, we determined the sensitivity, specificity, negative predictive value (NPV and positive predictive value (PPV of CT-epi, PT, INR and aPTT.Results: Of the 90 patients, 17 (18.9% patients had preoperative prolonged CT values and three (17.6% patients had bleeding. In comparison, five (6.8% of the 73 (81.1% patients who had undergone FESS with preoperative normal PFA values experienced bleeding (P=0.171. On the other hand, patients with prolonged PT values (2, 2.2%, prolonged INR values (3, 3.3% or prolonged PTT values (1, 1.1% had no bleeding episode. Preoperative CT had low sensitivity (44.4% and PPV (23.5%.Conclusion: During preoperative period, the hemostatic screening may not be helpful to detect the bleeding tendency in adult patients undergoing FESS. Routine measurement of CT-epi, PT, INR and aPTT for preoperative screening may not be recommended for FESS patients. Keywords: bleeding time, platelet function tests, blood coagulation tests, surgery, screening

  9. Compositional Homology and Creative Thinking

    OpenAIRE

    Tedesco, S.

    2015-01-01

    The concept of homology is the most solid theoretical basis elaborated by the morphological thinking during its history. The enucleation of some general criteria for the interpretation of homology is today a fundamental tool for life sciences, and for restoring their own opening to the question of qualitative innovation that arose so powerfully in the original Darwinian project. The aim of this paper is to verify the possible uses of the concept of compositional homology in order to provide o...

  10. Grid diagrams and Khovanov homology

    DEFF Research Database (Denmark)

    Droz, Jean-Marie; Wagner, Emmanuel

    2009-01-01

    We explain how to compute the Jones polynomial of a link from one of its grid diagrams and we observe a connection between Bigelow’s homological definition of the Jones polynomial and Kauffman’s definition of the Jones polynomial. Consequently, we prove that the Maslov grading on the Seidel–Smith...... symplectic link invariant coincides with the difference between the homological grading on Khovanov homology and the Jones grading on Khovanov homology. We give some evidence for the truth of the Seidel–Smith conjecture....

  11. A cost-utility analysis of dabigatran, enoxaparin, and usual care for venous thromboprophylaxis after hip or knee replacement surgery in Thailand.

    Science.gov (United States)

    Kotirum, Surachai; Chongmelaxme, Bunchai; Chaiyakunapruk, Nathorn

    2017-02-01

    To analyze the cost-utility of oral dabigatran etexilate, enoxaparin sodium injection, and no intervention for venous thromboembolism (VTE) prophylaxis after total hip or knee replacement (THR/TKR) surgery among Thai patients. A cost-utility analysis using a decision tree model was conducted using societal and healthcare payers' perspectives to simulate relevant costs and health outcomes covering a 3-month time horizon. Costs were adjusted to year 2014. The willingness-to-pay threshold of THB 160,000 (USD 4926) was used. One-way sensitivity and probabilistic sensitivity analyses using a Monte Carlo simulation were performed. Compared with no VTE prophylaxis, dabigatran and enoxaparin after THR and TKR surgery incurred higher costs and increased quality adjusted life years (QALYs). However, their incremental cost-effectiveness ratios were high above the willingness to pay. Compared with enoxaparin, dabigatran for THR/TKR lowered VTE complications but increased bleeding cases; dabigatran was cost-saving by reducing the costs [by THB 3809.96 (USD 117.30) for THR] and producing more QALYs gained (by 0.00013 for THR). Dabigatran (vs. enoxaparin) had a 98 % likelihood of being cost effective. Dabigatran is cost-saving compared to enoxaparin for VTE prophylaxis after THR or TKR under the Thai context. However, both medications are not cost-effective compared to no thromboprophylaxis.

  12. Scheduling elective surgeries: the tradeoff among bed capacity, waiting patients and operating room utilization using goal programming.

    Science.gov (United States)

    Li, Xiangyong; Rafaliya, N; Baki, M Fazle; Chaouch, Ben A

    2017-03-01

    Scheduling of surgeries in the operating rooms under limited competing resources such as surgical and nursing staff, anesthesiologist, medical equipment, and recovery beds in surgical wards is a complicated process. A well-designed schedule should be concerned with the welfare of the entire system by allocating the available resources in an efficient and effective manner. In this paper, we develop an integer linear programming model in a manner useful for multiple goals for optimally scheduling elective surgeries based on the availability of surgeons and operating rooms over a time horizon. In particular, the model is concerned with the minimization of the following important goals: (1) the anticipated number of patients waiting for service; (2) the underutilization of operating room time; (3) the maximum expected number of patients in the recovery unit; and (4) the expected range (the difference between maximum and minimum expected number) of patients in the recovery unit. We develop two goal programming (GP) models: lexicographic GP model and weighted GP model. The lexicographic GP model schedules operating rooms when various preemptive priority levels are given to these four goals. A numerical study is conducted to illustrate the optimal master-surgery schedule obtained from the models. The numerical results demonstrate that when the available number of surgeons and operating rooms is known without error over the planning horizon, the proposed models can produce good schedules and priority levels and preference weights of four goals affect the resulting schedules. The results quantify the tradeoffs that must take place as the preemptive-weights of the four goals are changed.

  13. PET-Probe: Evaluation of Technical Performance and Clinical Utility of a Handheld High-Energy Gamma Probe in Oncologic Surgery.

    Science.gov (United States)

    Gulec, Seza A; Daghighian, Farhad; Essner, Richard

    2016-12-01

    Positron emission tomography (PET) has become an invaluable part of patient evaluation in surgical oncology. PET is less than optimal for detecting lesions PET-positive lesions can be challenging as a result of difficulties in surgical exposure. We undertook this investigation to assess the utility of a handheld high-energy gamma probe (PET-Probe) for intraoperative identification of 18F-deoxyglucose (FDG)-avid tumors. Forty patients underwent a diagnostic whole-body FDG-PET scan for consideration for surgical exploration and resection. Before surgery, all patients received an intravenous injection of 7 to 10 mCi of FDG. At surgery, the PET-Probe was used to determine absolute counts per second at the known tumor site(s) demonstrated by whole-body PET and at adjacent normal tissue (at least 4 cm away from tumor-bearing sites). Tumor-to-background ratios were calculated. Thirty-two patients (80%) underwent PET-Probe-guided surgery with therapeutic intent in a recurrent or metastatic disease setting. Eight patients underwent surgery for diagnostic exploration. Anatomical locations of the PET-identified lesions were neck and supraclavicular (n = 8), axilla (n = 5), groin and deep iliac (n = 4), trunk and extremity soft tissue (n = 3), abdominal and retroperitoneal (n = 19), and lung (n = 2). PET-Probe detected all PET-positive lesions. The PET-Probe was instrumental in localization of lesions in 15 patients that were not immediately apparent by surgical exploration. The PET-Probe identified all lesions demonstrated by PET scanning and, in selected cases, was useful in localizing FDG-avid disease not seen with conventional PET scanning.

  14. Utility of nonpenetrating titanium clips for dural closure during spinal surgery to prevent postoperative cerebrospinal fluid leakage.

    Science.gov (United States)

    Ito, Kiyoshi; Aoyama, Tatsuro; Horiuchi, Tetsuyoshi; Hongo, Kazuhiro

    2015-12-01

    The nonpenetrating titanium clip has been successfully used in peripheral arterial bypass surgery. The purpose of this study was to evaluate the leakage pressures and patterns of nonpenetrating titanium clips using a simple model that mimicked spinal surgery. In addition, the authors describe their surgical experience with these clips and the follow-up results in 31 consecutive patients. The authors compared nonpenetrating titanium clips and expanded polytetrafluoroethylene (ePTFE) sutures in relation to the water pressure that could be tolerated by sutured ePTFE sheets, and the leakage pressure patterns were determined. The changes in leakage pressures at 5 minutes, 30 minutes, and 12 hours were examined when the clips and sutures were used in combination with the mesh-and-glue technique in an in vitro study. Thirty-one patients underwent spinal intradural procedures using nonpenetrating titanium clips to suture the dura maters using the meshand-glue technique, involving fibrin glue and polyglycolic acid-fibrin sheets. A significant difference was apparent between the ePTFE suture group and the nonpenetrating titanium clip group, with the latter showing a leakage pressure that could be sustained and was 1508% higher than that of the former (p = 0.001). In relation to leakage patterns, the nonpenetrating titanium clips did not make any suture holes in the ePTFE sheet and fluid leakage occurred between the clips, whereas fluid leakage was associated with the pressure elevation that occurred at the suture holes made by the ePTFE sutures. Of the 31 patients who underwent spinal intradural procedures using nonpenetrating titanium clips, 1 (3.2%) experienced cerebrospinal fluid (CSF) leakage postoperatively. No other complications-for example, allergic reactions, adhesions, or infections--were encountered. The interrupted placement of nonpenetrating titanium clips enables dural closure without creating any holes. These clips facilitate improvements in the initial

  15. Federal Health Coverage Mandates and Health Care Utilization: The Case of the Women's Health and Cancer Rights Act and Use of Breast Reconstruction Surgery.

    Science.gov (United States)

    Xie, Yang; Tang, Yuexin; Wehby, George L

    2015-08-01

    Utilization of breast reconstruction services remains low among women who underwent mastectomy despite the improvement in quality of life associated with this treatment. The objective of this study is to identify the effect of the Women's Health and Cancer Rights Act (WHCRA)-an understudied ongoing federal law that mandated insurance coverage of breast reconstruction following mastectomy beginning in 1999-on use of reconstructive surgery after mastectomy. We use a difference-in-differences (DD) approach to identify the change in breast reconstruction utilization induced by WHCRA by comparing the pre- and post-policy changes in utilization between states that did not have existing laws mandating coverage before the WHCRA (treatment group) and those that had such state laws (control group). The data are from the Surveillance, Epidemiology, and End Results program. The main sample includes 15,737 female patients who were under the age of 64 and underwent mastectomy within 4 months of diagnosis of early stage breast cancer during 1998 and 2000. Based on the DD model, the odds of using reconstruction services in the states without preexisting laws increased after the WHCRA by 31% in 1999 and 36% in 2000 (compared with 1998 before the WHCRA). These effects are masked in a simple pre/post model for change in reconstruction across all states. Additional analyses through 2007 indicate that the WHCRA had long-term effects on utilization. Furthermore, analyses by state indicate that most states in the treatment group experienced a significance increase in utilization. The use of breast reconstruction after mastectomy significantly increased after the WHCRA. At a minimum, our estimates may be considered the lower bound of the real policy effect.

  16. The Utility of the Weight and Lifestyle Inventory (WALI) in Predicting 2-Year Weight Loss After Bariatric Surgery.

    Science.gov (United States)

    Fink-Miller, Erin; Rigby, Andrea

    2017-04-01

    Emotional eating (EE) has been implicated as an important variable in bariatric surgery and is frequently assessed during preoperative evaluations. Little is known about the association between preoperative EE and postoperative outcomes. This study examined associations between preoperative EE, as measured by the Weight and Lifestyle Inventory, and 2-year postoperative percent weight loss. Data collected during preoperative evaluations were analyzed retrospectively. A total of 685 patients completed intake data, with 357 patients (52 %) completing 2-year follow-up measures. The average time from the initial appointment to surgery is 6 months. Preoperative data was collected at approximately month 2 of this 6-month period. Follow-up data was collected during 2-year postoperative follow-up visits. The average percent of weight lost was 22.93 (SD = 13.62). Analyses indicated that (1) EE was not associated with percent weight loss for the overall sample, (2) EE was not associated with percent weight loss for females, (3) EE in response to positive affect was associated with percent weight loss for males, and (4) the interaction between preoperative depressive symptoms and EE was not associated with percent weight loss for either sex. While the WALI provides a fruitful means of gathering clinical information, results suggested no association between scores on Section H of the WALI and weight loss. The results suggest that EE may impact surgical outcomes differentially in men as compared to women. Future research should seek to replicate these findings and focus on gender differences related to surgical outcomes.

  17. Mod two homology and cohomology

    CERN Document Server

    Hausmann, Jean-Claude

    2014-01-01

    Cohomology and homology modulo 2 helps the reader grasp more readily the basics of a major tool in algebraic topology. Compared to a more general approach to (co)homology this refreshing approach has many pedagogical advantages: It leads more quickly to the essentials of the subject, An absence of signs and orientation considerations simplifies the theory, Computations and advanced applications can be presented at an earlier stage, Simple geometrical interpretations of (co)chains. Mod 2 (co)homology was developed in the first quarter of the twentieth century as an alternative to integral homology, before both became particular cases of (co)homology with arbitrary coefficients. The first chapters of this book may serve as a basis for a graduate-level introductory course to (co)homology. Simplicial and singular mod 2 (co)homology are introduced, with their products and Steenrod squares, as well as equivariant cohomology. Classical applications include Brouwer's fixed point theorem, Poincaré duality, Borsuk-Ula...

  18. Homology theory on algebraic varieties

    CERN Document Server

    Wallace, Andrew H

    1958-01-01

    Homology Theory on Algebraic Varieties, Volume 6 deals with the principles of homology theory in algebraic geometry and includes the main theorems first formulated by Lefschetz, one of which is interpreted in terms of relative homology and another concerns the Poincaré formula. The actual details of the proofs of these theorems are introduced by geometrical descriptions, sometimes aided with diagrams. This book is comprised of eight chapters and begins with a discussion on linear sections of an algebraic variety, with emphasis on the fibring of a variety defined over the complex numbers. The n

  19. Compositional Homology and Creative Thinking

    Directory of Open Access Journals (Sweden)

    Salvatore Tedesco

    2015-05-01

    Full Text Available The concept of homology is the most solid theoretical basis elaborated by the morphological thinking during its history. The enucleation of some general criteria for the interpretation of homology is today a fundamental tool for life sciences, and for restoring their own opening to the question of qualitative innovation that arose so powerfully in the original Darwinian project. The aim of this paper is to verify the possible uses of the concept of compositional homology in order to provide of an adequate understanding of the dynamics of creative thinking.

  20. Predicting patient nonappearance for surgery as a scheduling strategy to optimize operating room utilization in a veterans' administration hospital.

    Science.gov (United States)

    Basson, Marc D; Butler, Timothy W; Verma, Harish

    2006-04-01

    Previous attempts at improving operating room utilization have generally emphasized more accurate scheduling, starting the first case on time, and reducing turnover time. Surgical case cancellations have largely been ignored except for recommendations for preoperative screening and good physician-patient communication to improve patient compliance. A retrospective review of operating room records was initially used to identify reasons for surgical cancellations. This was followed by a retrospective stratified case-control study of patient records to identify preexisting factors that predict the failure of patients to appear for surgical procedures as scheduled. Factors assessed included demographics, type of surgical procedure, compliance with previous healthcare visits, substance abuse, mental illness, travel distance, and neurologic problems. The authors reviewed their operating room utilization and found patient nonappearance rates to be a substantial source of surgical cancellations. Furthermore, multivariate analysis demonstrated that patient nonappearance could be strongly predicted from patient noncompliance with clinic visits and other clinical procedures without reference to the other variables assessed. Further analysis of data from an independent sample of patients confirmed this observation. Noncompliance with hospital visits for surgical procedures can be predicted from noncompliance with other healthcare encounters. Surgical procedures for previously noncompliant patients should be booked at the end of the operating room day, when the cancellation is least likely to interfere with operating room flow.

  1. Interactive navigation-guided ophthalmic plastic surgery: the utility of 3D CT-DCG-guided dacryolocalization in secondary acquired lacrimal duct obstructions

    Directory of Open Access Journals (Sweden)

    Ali MJ

    2016-12-01

    Full Text Available Mohammad Javed Ali,1 Swati Singh,1 Milind N Naik,1 Swathi Kaliki,2 Tarjani Vivek Dave1 1Govindram Seksaria Institute of Dacryology, 2The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, Telangana, India Aim: The aim of this study was to report the preliminary experience with the techniques and utility of navigation-guided, 3D, computed tomography–dacryocystography (CT-DCG in the management of secondary acquired lacrimal drainage obstructions.Methods: Stereotactic surgeries using CT-DCG as the intraoperative image-guiding tool were performed in 3 patients. One patient had nasolacrimal duct obstruction (NLDO following a complete maxillectomy for a sinus malignancy, and the other 2 had NLDO following extensive maxillofacial trauma. All patients underwent a 3D CT-DCG. Image-guided dacryolocalization (IGDL was performed using the intraoperative image-guided StealthStation™ system in the electromagnetic mode. All patients underwent navigation-guided powered endoscopic dacryocystorhinostomy (DCR. The utility of intraoperative dacryocystographic guidance and the ability to localize the lacrimal drainage system in the altered endoscopic anatomical milieu were noted.Results: Intraoperative geometric localization of the lacrimal sac and the nasolacrimal duct could be easily achieved. Constant orientation of the lacrimal drainage system was possible while navigating in the vicinity of altered endoscopic perilacrimal anatomy. Useful clues with regard to modifications while performing a powered endoscopic DCR could be obtained. Surgeries could be performed with utmost safety and precision, thereby avoiding complications. Detailed preoperative 3D CT-DCG reconstructions with constant intraoperative dacryolocalization were found to be essential for successful outcomes.Conclusion: The 3D CT-DCG-guided navigation procedure is very useful while performing endoscopic DCRs in cases of secondary acquired and complex

  2. Cost-Effectiveness and Cost-Utility Analysis of Spinal Cord Stimulation in Patients With Failed Back Surgery Syndrome: Results From the PRECISE Study.

    Science.gov (United States)

    Zucco, Furio; Ciampichini, Roberta; Lavano, Angelo; Costantini, Amedeo; De Rose, Marisa; Poli, Paolo; Fortini, Gianpaolo; Demartini, Laura; De Simone, Enrico; Menardo, Valentino; Cisotto, Piero; Meglio, Mario; Scalone, Luciana; Mantovani, Lorenzo G

    2015-06-01

    To assess the cost-effectiveness and cost-utility of Spinal Cord Stimulation (SCS) in patients with failed back surgery syndrome (FBSS) refractory to conventional medical management (CMM). We conducted an observational, multicenter, longitudinal ambispective study, where patients with predominant leg pain refractory to CMM expecting to receive SCS+CMM were recruited in 9 Italian centers and followed up to 24 months after SCS. We collected data on clinical status (pain intensity, disability), Health-Related Quality-of-Life (HRQoL) and on direct and indirect costs before (pre-SCS) and after (post-SCS) the SCS intervention. Costs were quantified in € 2009, adopting the National Health Service's (NHS), patient and societal perspectives. Benefits and costs pre-SCS versus post-SCS were compared to estimate the incremental cost-effectiveness and cost utility ratios. 80 patients (40% male, mean age 58 years) were recruited. Between baseline and 24 months post-SCS, clinical outcomes and HRQoL significantly improved. The EQ-5D utility index increased from 0.421 to 0.630 (p costs increased from €6600 (pre-SCS) to €13,200 (post-SCS) per patient per year. Accordingly, the cost-utility acceptability curve suggested that if decision makers' willingness to pay per Quality-Adjusted-Life-Years (QALYs) was €60,000, SCS implantation would be cost-effective in 80% and 85% of cases, according to the NHS's and societal point of views, respectively. Our results suggest that in clinical practice, SCS+CMM treatment of FBSS patients refractory to CMM provides good value for money. Further research is encouraged in the form of larger, long-term studies. © 2015 International Neuromodulation Society.

  3. Combining Evidence from Homologous Datasets

    National Research Council Canada - National Science Library

    Feng, Ao; Allan, James

    2006-01-01

    .... We argue that combining evidence from these "homologous" datasets can give us better representation of the original data, and our experiments show that a model combining all sources outperforms each...

  4. Enhanced recovery pathways optimize health outcomes and resource utilization: A meta-analysis of randomized controlled trials in colorectal surgery

    DEFF Research Database (Denmark)

    Adamina, Michel; Kehlet, Henrik; Tomlinson, George A

    2011-01-01

    in costs that threatens the stability of health care systems. Enhanced recovery pathways (ERP) have been proposed as a means to reduce morbidity and improve effectiveness of care. We have reviewed the evidence supporting the implementation of ERP in clinical practice. Methods Medline, Embase...... in the development and implementation of ERP. Results A random-effect Bayesian meta-analysis was performed, including 6 randomized, controlled trials totalizing 452 patients. For patients adhering to ERP, length of stay decreased by 2.5 days (95% credible interval [CrI] -3.92 to -1.11), whereas 30-day morbidity...... of health care processes. Thus, while accelerating recovery and safely reducing hospital stay, ERPs optimize utilization of health care resources. ERPs can and should be routinely used in care after colorectal and other major gastrointestinal procedures....

  5. The utility of sparse 2D fully electronically steerable focused ultrasound phased arrays for thermal surgery: a simulation study

    Energy Technology Data Exchange (ETDEWEB)

    Ellens, Nicholas; Pulkkinen, Aki; Song Junho; Hynynen, Kullervo, E-mail: nicholas.ellens@utoronto.ca [Department of Imaging Research, Sunnybrook Research Institute, Toronto (Canada)

    2011-08-07

    Sparse arrays are widely used in diagnostic ultrasound for their strong performance and relative technical simplicity. This simulation study assessed the efficacy of phased arrays of varied sparseness for thermal surgery, especially with regard to power consumption and near-field heating. It employs a linear ultrasound propagation model and a semi-analytical solution to the Pennes' bioheat transfer equation. The basic design had 4912 cylindrical transducers (500 kHz) arranged on a flat 12 cm disk (1.5 mm spacing). This array was compared to randomly-thinned sparse arrays with 75%, 50% and 25% populations. Temperature elevations of 60 and 70 deg. C were induced in sonication times of 5-20 s, at foci spanning depths of 50-150 mm and radii of 0-60 mm. The sparse arrays produced nearly indistinguishable focal patterns but, averaged across the foci, required 132%, 200% and 393% of the power of the full array, respectively, applied through fewer transducer elements. Comparable results were found at 1 MHz from equivalent arrays. Simulated lesions were formed (thermal dose {>=} 240 equivalent minutes at 43 deg. C (T{sub 43})) and 'transition' and 'unsafe' regions (both defined as 5 min < T{sub 43} < 240 min) were identified, the former immediately surrounding the lesion and the latter anywhere else. At a depth of 100 mm, sparse arrays were found to produce comparable lesions to the full array at the focus, but 'unsafe', over-heated near-field regions after some ablated lesion volume: about 12 mL for the 25% array, around 100 mL for the 50% array, while the 75% and full arrays produced 150 mL lesions safely.

  6. Efficacy and utility of phone call follow-up after pediatric general surgery versus traditional clinic follow-up.

    Science.gov (United States)

    Fischer, Kevin; Hogan, Virginia; Jager, Alesha; von Allmen, Daniel

    2015-01-01

    Typical follow-up for surgical procedures consists of an interim history and brief focused physical examination. These appointments occupy clinic resources, require a time investment by the family, and rarely identify problems. Previous studies have demonstrated the safety of a postoperative phone call. Compare a traditional in-person clinic postoperative visit with postoperative phone call follow-up regarding patient satisfaction, rate of successful follow-up, and clinic resource utilization in a large academic practice. A retrospective review of charts of patients who underwent select surgical procedures, along with a review of the clinic schedule for the same time period. Efficacy, patient/family satisfaction, and impact on the clinic. Families were contacted by telephone two weeks after select surgical procedures to assess for complications and questions. Cohorts of patients six months before and six months after implementation were assessed for main outcome measures. Before implementation, 55.5% of patients (427/769) who had one of the select surgical procedures were seen in the clinic postoperatively, and 62.6% (435/695) had a successful postoperative phone call follow-up. There were also 1090 overall scheduled postoperative appointments. Six months after implementation, overall postoperative appointments decreased 35.5% to 703. Overall, postoperative-scheduled visits decreased by 6% compared with new visits and other general follow-up visits, which each increased by 3%. A satisfaction survey revealed that 93% of patients (n = 231) were highly satisfied with the process. A hospital cost analysis suggested an 89% cost savings ($101.75 per patient for clinic visit vs $12.50 per patient for phone call follow-up). Postoperative phone call follow-up is an effective tool that improves patient and physician efficiency and satisfaction.

  7. The utility of pre-test clinical scoring for clinical diagnosis of heparin-induced thrombocytopenia in cardiac surgery patients of a tertiary care centre in north India.

    Science.gov (United States)

    Sachan, D; Gupta, N; Agarwal, P; Chaudhary, R

    2011-08-01

    Heparin-induced thrombocytopenia (HIT) should be diagnosed clinically as well as by laboratory assays for timely recognition, prevention and management of complications. To evaluate the clinical utility of pre-test clinical scoring system in combination with two immunoassays for the diagnosis of HIT in cardiac surgery patients. A total of 100 consecutive patients undergoing cardiac surgery were studied. Pre-test clinical scoring was carried out in patients with thrombocytopenia and further tested by two immunoassays, i.e., Heparin platelet factor 4 (H-PF4) enzyme-linked immunosorbent assay (ELISA) and particle gel immunoassay (PaGIA). Of the 100 patients studied, 42 patients developed thrombocytopenia post-operatively. On pre-test clinical scoring, low T-score was observed in 6 patients, intermediate in 28 and high score in 8 patients, whereas 19 patients (45.2%) were positive by H-PF4 ELISA and 10 (23.8%) by PaGIA for H-PF4 antibody. The difference in the incidence of clinically significant HIT antibodies in the three categories was statistically significant. A good correlation was also observed with ELISA optical density, T-scoring and PaGIA. Pre-test clinical scoring correlates well with the development of H-PF4 antibodies which are incriminated in the causation of thrombotic complications in patients with HIT. We also propose a protocol for diagnosing patients with clinical suspicion of HIT using pre-test clinical scoring and immunoassay. © 2011 The Authors. Transfusion Medicine © 2011 British Blood Transfusion Society.

  8. Homological stability of diffeomorphism groups

    DEFF Research Database (Denmark)

    Berglund, Alexander; Madsen, Ib Henning

    2013-01-01

    In this paper we prove a stability theorem for block diffeomorphisms of 2d -dimensional manifolds that are connected sums of S d ×S d . Combining this with a recent theorem of S. Galatius and O. Randal-Williams and Morlet’s lemma of disjunction, we determine the homology of the classifying space ...

  9. Cost-effectiveness of transoral robotic surgery versus (chemo)radiotherapy for early T classification oropharyngeal carcinoma: A cost-utility analysis.

    Science.gov (United States)

    de Almeida, John R; Moskowitz, Alan J; Miles, Brett A; Goldstein, David P; Teng, Marita S; Sikora, Andrew G; Gupta, Vishal; Posner, Marshall; Genden, Eric M

    2016-04-01

    The present study is an economic evaluation comparing transoral robotic surgery (TORS) to (chemo)radiotherapy for the management of early T-classification oropharyngeal cancer. A societal perspective was adopted. Treatment for TORS and (chemo)radiotherapy were modeled using decision analysis and recurrences were modeled over a 10 year horizon with a Markov model. Model parameters were derived from systematic review. Deterministic and probabilistic sensitivity analyses were used to test model robustness. TORS demonstrated a cost savings of $1366 and an increase of 0.25 quality-adjusted life years (QALYs) per case in comparison to (chemo)radiotherapy. TORS was sensitive to variations in adjuvant therapy, costs, utilities, complications, and recurrence rates in deterministic and probabilistic sensitivity analysis. In two-way sensitivity analysis, with increasing adjuvant therapy for TORS and decreasing concurrent chemotherapy for radiotherapy, TORS is decreasingly cost-effective. TORS is cost-effective for treatment of early oropharyngeal cancer. Case selection to minimize adjuvant therapy ensures cost-effective treatment. © 2015 Wiley Periodicals, Inc.

  10. Clinical utility of 99mTc-ubiquicidin (29-41) as an adjunct to bone scan in differentiating infected versus noninfected loosening of prosthesis before revision surgery.

    Science.gov (United States)

    Shinto, Ajit S; Mukherjee, Archana; Karuppusamy, Kamalaeshwaran Koramadai; Joseph, Jephy; Bhatt, Jyotsna; Korde, Aruna; Upadhya, Indira; Arjun, Chanda; Samuel, Grace; Dash, Ashutosh

    2017-04-01

    The aim of this study was to evaluate the utility of Tc-ubiquicidin (Tc-UBI) (29-41) as an adjunct to an methylene diphosphonate (MDP) bone scan in differentiating septic versus aseptic loosening in patients with painful prosthesis posted for revision surgery. A two-vial cold kit of UBI (29-41) was prepared and utilized for the preparation of patient dose of Tc-UBI (29-41). Twenty two patients with painful hip or knee prosthesis and scheduled for revision surgery were included in the study. Overall, 370-555 MBq of Tc-UBI (29-41) was injected intravenously in all the patients. A blood pool image at 20 min after injection was followed by spot views of the suspected region of infection (target) and a corresponding normal area (nontarget) at 60 min. All patients underwent a routine Tc-MDP three-phase whole-body bone scan, followed by single-photon emission computed tomography/computed tomography of the prosthesis within a week of the Tc-UBI (29-41) study. For Tc-UBI scans, a visual score (0-3) was used to categorize studies as positive or negative, with scores of 0 (minimal or no uptake; less than soft tissue or contralateral extremity) and 1 (mild; equivalent to soft tissue or contralateral extremity) being considered negative and scores of 2 (moderate; uptake greater than soft tissue or contralateral extremity, but less than the liver) or 3 (intense; uptake greater than soft tissue or contralateral extremity and equivalent to the liver) being considered positive. The final correlation was on the basis of bacterial culture as the major criterion and the results of clinical tests, radiography, fluorine-18-fluorodeoxyglucose PET-CT, and three-phase bone scanning as the minor criteria. In all, 22 studies were carried out with Tc-UBI (29-41). Of these, 16 scans were considered positive and six were negative for infection foci. All negative scans were subsequently confirmed to be true negative. Adverse reactions were not observed during image acquisition and within 5

  11. Bloom DNA helicase facilitates homologous recombination between diverged homologous sequences.

    Science.gov (United States)

    Kikuchi, Koji; Abdel-Aziz, H Ismail; Taniguchi, Yoshihito; Yamazoe, Mitsuyoshi; Takeda, Shunichi; Hirota, Kouji

    2009-09-25

    Bloom syndrome caused by inactivation of the Bloom DNA helicase (Blm) is characterized by increases in the level of sister chromatid exchange, homologous recombination (HR) associated with cross-over. It is therefore believed that Blm works as an anti-recombinase. Meanwhile, in Drosophila, DmBlm is required specifically to promote the synthesis-dependent strand anneal (SDSA), a type of HR not associating with cross-over. However, conservation of Blm function in SDSA through higher eukaryotes has been a matter of debate. Here, we demonstrate the function of Blm in SDSA type HR in chicken DT40 B lymphocyte line, where Ig gene conversion diversifies the immunoglobulin V gene through intragenic HR between diverged homologous segments. This reaction is initiated by the activation-induced cytidine deaminase enzyme-mediated uracil formation at the V gene, which in turn converts into abasic site, presumably leading to a single strand gap. Ig gene conversion frequency was drastically reduced in BLM(-/-) cells. In addition, BLM(-/-) cells used limited donor segments harboring higher identity compared with other segments in Ig gene conversion event, suggesting that Blm can promote HR between diverged sequences. To further understand the role of Blm in HR between diverged homologous sequences, we measured the frequency of gene targeting induced by an I-SceI-endonuclease-mediated double-strand break. BLM(-/-) cells showed a severer defect in the gene targeting frequency as the number of heterologous sequences increased at the double-strand break site. Conversely, the overexpression of Blm, even an ATPase-defective mutant, strongly stimulated gene targeting. In summary, Blm promotes HR between diverged sequences through a novel ATPase-independent mechanism.

  12. Discrete homology theory for metric spaces

    NARCIS (Netherlands)

    H. Barcelo (Hélène); V. Capraro (Valerio); J. A. White; H. Barcelo (Hélène)

    2014-01-01

    htmlabstractWe define and study a notion of discrete homology theory for metric spaces. Instead of working with simplicial homology, our chain complexes are given by Lipschitz maps from an n n -dimensional cube to a fixed metric space. We prove that the resulting homology theory satisfies a

  13. A Head-to-Head Comparison of the EQ-5D-5L and AQoL-8D Multi-Attribute Utility Instruments in Patients Who Have Previously Undergone Bariatric Surgery.

    Science.gov (United States)

    Campbell, Julie A; Palmer, Andrew J; Venn, Alison; Sharman, Melanie; Otahal, Petr; Neil, Amanda

    2016-08-01

    Psychosocial health status is an important and dynamic outcome for bariatric/metabolic surgery patients, as acknowledged in recent international standardised outcomes reporting guidelines. Multi-attribute utility-instruments (MAUIs) capture and assess an individual's health-related quality-of-life (HRQoL) within a single valuation, their utility. Neither MAUIs nor utilities were discussed in the guidelines. Many MAUIs (e.g. EQ-5D) target physical health. Not so the AQoL-8D. Our objective was to explore agreement between, and suitability of, the EQ-5D-5L and AQoL-8D for assessing health state utility, and to determine whether either MAUI could be preferentially recommended for metabolic/bariatric surgery patients. Utilities for post-surgical private-sector patients (n = 33) were assessed using both instruments and summary statistics expressed as mean [standard deviation (SD)] and median [interquartile range (IQR)]. Interchangeability of the MAUIs was assessed with Bland-Altman analysis. Discriminatory attributes were investigated through floor/ceiling effects and dimension-to-dimension comparisons. Spearman's rank measured associations between the instruments' utility values and with the body mass index (BMI). Mean (SD) EQ-5D-5L utility value was 0.84 (0.15) and median 0.84 (IQR 0.75-1.00). Mean (SD) AQoL-8D utility value was 0.76 (0.17) and median 0.81 (IQR 0.63-0.88). Spearman's rank was r = 0.68; (p instrument gave rise to floor effects. A ceiling effect was observed with the EQ-5D-5L, with 36 % of participants obtaining a utility value of 1.00 (perfect health). These same participants obtained a mean utility of 0.87 on the AQoL-8D, primarily driven by the mental-super-dimension score (0.52). The AQoL-8D preferentially captures psychosocial aspects of metabolic/bariatric surgery patients' HRQoL. We recommend the AQoL-8D as a preferred MAUI for these patients given their complex physical/psychosocial needs.

  14. Catching homologies by geometric entropy

    Science.gov (United States)

    Felice, Domenico; Franzosi, Roberto; Mancini, Stefano; Pettini, Marco

    2018-02-01

    A geometric entropy is defined in terms of the Riemannian volume of the parameter space of a statistical manifold associated with a given network. As such it can be a good candidate for measuring networks complexity. Here we investigate its ability to single out topological features of networks proceeding in a bottom-up manner: first we consider small size networks by analytical methods and then large size networks by numerical techniques. Two different classes of networks, the random graphs and the scale-free networks, are investigated computing their Betti numbers and then showing the capability of geometric entropy of detecting homologies.

  15. The utility of erythrocyte sedimentation rate values and white blood cell counts after spinal deformity surgery in the early (≤3 months) post-operative period.

    Science.gov (United States)

    Kuhn, Margaret G; Lenke, Lawrence G; Bridwell, Keith H; O'Donnell, June C; Luhmann, Scott J

    2012-03-01

    The erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count are frequently obtained in the work-up of post-operative fever. However, their diagnostic utility depends upon comparison with normative peri-operative trends which have not yet been described. The purpose of this study is to define a range of erythrocyte sedimentation rates and white blood cell counts following spinal instrumentation and fusion in non-infected patients. Seventy-five patients underwent spinal instrumentation and fusion. The erythrocyte sedimentation rate and white blood cell count were recorded pre-operatively, at 3 and 7 days post-operatively, and at 1 and 3 months post-operatively. Both erythrocyte sedimentation rate and white blood cell count trends demonstrated an early peak, followed by a gradual return to normal. Peak erythrocyte sedimentation rates occurred within the first week post-operatively in 98% of patients. Peak white blood cell counts occurred with the first week in 85% of patients. In the absence of infection, the erythrocyte sedimentation rate was abnormally elevated in 78% of patients at 1 month and in 53% of patients at 3 months post-operatively. The white blood cell count was abnormally elevated in only 6% of patients at 1 month post-operatively. Longer surgical time was associated with elevated white cell count at 1 week post-operatively. The fusion of more vertebral levels had a negative relationship with elevated erythrocyte sedimentation rate at 1 week post-operatively. The anterior surgical approach was associated with significantly lower erythrocyte sedimentation rate at 1 month post-operatively and with lower white cell count at 1 week post-operatively. In non-infected spinal fusion surgeries, erythrocyte sedimentation rates are in the abnormal range in 78% of patients at 1 month and in 53% of patients at 3 months post-operatively, suggesting that the erythrocyte sedimentation rate is of limited diagnostic value in the early post

  16. Retrospective US database analysis of drug utilization patterns, health care resource use, and costs associated with adjuvant interferon alfa-2b therapy for treatment of malignant melanoma following surgery

    Directory of Open Access Journals (Sweden)

    Krishna A

    2012-06-01

    Full Text Available Michelle D Hackshaw,1 Arun Krishna,2 David J Mauro31,2Global Health Outcomes, Merck, Sharpe and Dohme Corporation, Whitehouse Station, NJ, USA; 3Clinical Research, Merck Research Laboratories, Upper Gwynedd, PA, USABackground: The purpose of this study was to identify a real-world US population having undergone surgery for malignant melanoma and describe treatment patterns, health care resource utilization, and costs for patients who subsequently received interferon alfa-2b (IFN therapy or other standard of care chemotherapies.Methods: A retrospective cohort study was conducted using administrative claims from MarketScan® databases among melanoma patients diagnosed between 2004 and 2008 who had surgery and were subsequently treated with IFN or other chemotherapies. Health care resource utilization and costs of services (converted to 2009 dollars were evaluated. Cost refers to the amount paid to providers associated with the health service.Results: Of 18,075 subjects with melanoma surgery claims, 1525 (8.4% were treated with IFN and 1194 (6.6% with other chemotherapies. Median duration (days and number of doses of IFN therapy were 29 and 20, respectively. Approximately half of patients who received IFN discontinued therapy within or after the one-month induction phase. For IFN therapy patients, average total cost per patient for the last melanoma-related surgery prior to start of therapy, including costs of the surgery itself, pathology, anesthesia, and hospital care, was $2219. The average total cost per patient related to IFN therapy was $1188; this included costs for drug, office visits, blood work, and infusions. Other chemotherapy costs ranged from $146 to $2678.Conclusion: There is an unmet treatment need, considering that this study observed that melanoma patients on IFN therapy post-surgery do not complete the recommended one-year course of treatment which may compromise its full therapeutic benefits. Further study to investigate reasons

  17. The Homological Nature of Entropy

    Directory of Open Access Journals (Sweden)

    Pierre Baudot

    2015-05-01

    Full Text Available We propose that entropy is a universal co-homological class in a theory associated to a family of observable quantities and a family of probability distributions. Three cases are presented: (1 classical probabilities and random variables; (2 quantum probabilities and observable operators; (3 dynamic probabilities and observation trees. This gives rise to a new kind of topology for information processes, that accounts for the main information functions: entropy, mutual-informations at all orders, and Kullback–Leibler divergence and generalizes them in several ways. The article is divided into two parts, that can be read independently. In the first part, the introduction, we provide an overview of the results, some open questions, future results and lines of research, and discuss briefly the application to complex data. In the second part we give the complete definitions and proofs of the theorems A, C and E in the introduction, which show why entropy is the first homological invariant of a structure of information in four contexts: static classical or quantum probability, dynamics of classical or quantum strategies of observation of a finite system.

  18. Equivariant ordinary homology and cohomology

    CERN Document Server

    Costenoble, Steven R

    2016-01-01

    Filling a gap in the literature, this book takes the reader to the frontiers of equivariant topology, the study of objects with specified symmetries. The discussion is motivated by reference to a list of instructive “toy” examples and calculations in what is a relatively unexplored field. The authors also provide a reading path for the first-time reader less interested in working through sophisticated machinery but still desiring a rigorous understanding of the main concepts. The subject’s classical counterparts, ordinary homology and cohomology, dating back to the work of Henri Poincaré in topology, are calculational and theoretical tools which are important in many parts of mathematics and theoretical physics, particularly in the study of manifolds. Similarly powerful tools have been lacking, however, in the context of equivariant topology. Aimed at advanced graduate students and researchers in algebraic topology and related fields, the book assumes knowledge of basic algebraic topology and group act...

  19. Split marker transformation increases homologous integration frequency in Cryptococcus neoformans.

    Science.gov (United States)

    Fu, J; Hettler, E; Wickes, B L

    2006-03-01

    Gene disruption in Cryptococcus neoformans can be problematic due to high frequencies of ectopic integration and telomerization. To improve the frequency of homologous integration, a transformation strategy was employed called split marker, which utilizes a mixture of DNAs comprised of overlapping truncations of the selectable marker. Five genes were compared for homologous integration frequencies using various constructs. Homologous integration was highest when the split marker approach was used, with rates as high as 60% depending on target gene. A second factor that contributed to an increased homologous integration frequency was strain background, which was highest when a double auxotroph was used as a host. The split marker strategy was combined with an ura-blaster construct, which has been used in other fungi to recycle ura5 or ura3 mutations. When a hisG-URA5-hisG cassette was successfully integrated at the target locus, the URA5 gene could be easily evicted by plating onto 5-FOA agar. The cassette was then successfully used for a second cycle of transformation-eviction. The effectiveness of the split marker disruption strategy suggests that continued investigation and modification of traditional molecular techniques could increase the efficiency of C. neoformans molecular manipulation.

  20. Multiresolution persistent homology for excessively large biomolecular datasets

    Energy Technology Data Exchange (ETDEWEB)

    Xia, Kelin; Zhao, Zhixiong [Department of Mathematics, Michigan State University, East Lansing, Michigan 48824 (United States); Wei, Guo-Wei, E-mail: wei@math.msu.edu [Department of Mathematics, Michigan State University, East Lansing, Michigan 48824 (United States); Department of Electrical and Computer Engineering, Michigan State University, East Lansing, Michigan 48824 (United States); Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, Michigan 48824 (United States)

    2015-10-07

    Although persistent homology has emerged as a promising tool for the topological simplification of complex data, it is computationally intractable for large datasets. We introduce multiresolution persistent homology to handle excessively large datasets. We match the resolution with the scale of interest so as to represent large scale datasets with appropriate resolution. We utilize flexibility-rigidity index to access the topological connectivity of the data set and define a rigidity density for the filtration analysis. By appropriately tuning the resolution of the rigidity density, we are able to focus the topological lens on the scale of interest. The proposed multiresolution topological analysis is validated by a hexagonal fractal image which has three distinct scales. We further demonstrate the proposed method for extracting topological fingerprints from DNA molecules. In particular, the topological persistence of a virus capsid with 273 780 atoms is successfully analyzed which would otherwise be inaccessible to the normal point cloud method and unreliable by using coarse-grained multiscale persistent homology. The proposed method has also been successfully applied to the protein domain classification, which is the first time that persistent homology is used for practical protein domain analysis, to our knowledge. The proposed multiresolution topological method has potential applications in arbitrary data sets, such as social networks, biological networks, and graphs.

  1. Feasibility Study of Utilization of Action Camera, GoPro Hero 4, Google Glass, and Panasonic HX-A100 in Spine Surgery.

    Science.gov (United States)

    Lee, Chang Kyu; Kim, Youngjun; Lee, Nam; Kim, Byeongwoo; Kim, Doyoung; Yi, Seong

    2017-02-15

    Study for feasibility of commercially available action cameras in recording video of spine. Recent innovation of the wearable action camera with high-definition video recording enables surgeons to use camera in the operation at ease without high costs. The purpose of this study is to compare the feasibility, safety, and efficacy of commercially available action cameras in recording video of spine surgery. There are early reports of medical professionals using Google Glass throughout the hospital, Panasonic HX-A100 action camera, and GoPro. This study is the first report for spine surgery. Three commercially available cameras were tested: GoPro Hero 4 Silver, Google Glass, and Panasonic HX-A100 action camera. Typical spine surgery was selected for video recording; posterior lumbar laminectomy and fusion. Three cameras were used by one surgeon and video was recorded throughout the operation. The comparison was made on the perspective of human factor, specification, and video quality. The most convenient and lightweight device for wearing and holding throughout the long operation time was Google Glass. The image quality; all devices except Google Glass supported HD format and GoPro has unique 2.7K or 4K resolution. Quality of video resolution was best in GoPro. Field of view, GoPro can adjust point of interest, field of view according to the surgery. Narrow FOV option was the best for recording in GoPro to share the video clip. Google Glass has potentials by using application programs. Connectivity such as Wi-Fi and Bluetooth enables video streaming for audience, but only Google Glass has two-way communication feature in device. Action cameras have the potential to improve patient safety, operator comfort, and procedure efficiency in the field of spinal surgery and broadcasting a surgery with development of the device and applied program in the future. N/A.

  2. Homology and the nonlinear heat diffusion equation

    Science.gov (United States)

    Burgan, J. R.; Munier, A.; Feix, M. R.; Fijalkow, E.

    1984-02-01

    A theorem is presented which generalizes the concept of homology, introduced by Munier et al. (1981), to a large class of nonlinear diffusion coefficients. Possible changes in both initial and boundary conditions induced by self-homologous transformations are investigated. In order to be consistent with previously established definitions, generalized homology is expressed in terms of a Baecklund transformation, the only remaining process to overstep self-similar transformations.

  3. Homology in Electromagnetic Boundary Value Problems

    Directory of Open Access Journals (Sweden)

    Pellikka Matti

    2010-01-01

    Full Text Available We discuss how homology computation can be exploited in computational electromagnetism. We represent various cellular mesh reduction techniques, which enable the computation of generators of homology spaces in an acceptable time. Furthermore, we show how the generators can be used for setting up and analysis of an electromagnetic boundary value problem. The aim is to provide a rationale for homology computation in electromagnetic modeling software.

  4. Factors influencing the surgery intentions and choices of women with early breast cancer: the predictive utility of an extended theory of planned behaviour

    NARCIS (Netherlands)

    Sivell, S.; Elwyn, G.; Edwards, A.; Manstead, A.S.; BresDex, g.

    2013-01-01

    BACKGROUND: Women diagnosed with early breast cancer (stage I or II) can be offered the choice between mastectomy or breast conservation surgery with radiotherapy due to equivalence in survival rates. A wide variation in the surgical management of breast cancer and a lack of theoretically guided

  5. Stability of p53 homologs.

    Directory of Open Access Journals (Sweden)

    Tobias Brandt

    Full Text Available Most proteins have not evolved for maximal thermal stability. Some are only marginally stable, as for example, the DNA-binding domains of p53 and its homologs, whose kinetic and thermodynamic stabilities are strongly correlated. Here, we applied high-throughput methods using a real-time PCR thermocycler to study the stability of several full-length orthologs and paralogs of the p53 family of transcription factors, which have diverse functions, ranging from tumour suppression to control of developmental processes. From isothermal denaturation fluorimetry and differential scanning fluorimetry, we found that full-length proteins showed the same correlation between kinetic and thermodynamic stability as their isolated DNA-binding domains. The stabilities of the full-length p53 orthologs were marginal and correlated with the temperature of their organism, paralleling the stability of the isolated DNA-binding domains. Additionally, the paralogs p63 and p73 were significantly more stable and long-lived than p53. The short half-life of p53 orthologs and the greater persistence of the paralogs may be biologically relevant.

  6. Borromean surgery formula for the Casson invariant

    DEFF Research Database (Denmark)

    Meilhan, Jean-Baptiste Odet Thierry

    2008-01-01

    It is known that every oriented integral homology 3-sphere can be obtained from S3 by a finite sequence of Borromean surgeries. We give an explicit formula for the variation of the Casson invariant under such a surgery move. The formula involves simple classical invariants, namely the framing, li...

  7. Homotopic Chain Maps Have Equal s-Homology and d-Homology

    Directory of Open Access Journals (Sweden)

    M. Z. Kazemi-Baneh

    2016-01-01

    Full Text Available The homotopy of chain maps on preabelian categories is investigated and the equality of standard homologies and d-homologies of homotopic chain maps is established. As a special case, if X and Y are the same homotopy type, then their nth d-homology R-modules are isomorphic, and if X is a contractible space, then its nth d-homology R-modules for n≠0 are trivial.

  8. Robust surgery loading

    NARCIS (Netherlands)

    Hans, Elias W.; Wullink, Gerhard; van Houdenhoven, Mark; Kazemier, Geert

    2008-01-01

    We consider the robust surgery loading problem for a hospital’s operating theatre department, which concerns assigning surgeries and sufficient planned slack to operating room days. The objective is to maximize capacity utilization and minimize the risk of overtime, and thus cancelled patients. This

  9. Homology Groups of a Pipeline Petri Net

    Directory of Open Access Journals (Sweden)

    A. A. Husainov

    2013-01-01

    Full Text Available Petri net is said to be elementary if every place can contain no more than one token. In this paper, it is studied topological properties of the elementary Petri net for a pipeline consisting of n functional devices. If the work of the functional devices is considered continuous, we can come to some topological space of “intermediate” states. In the paper, it is calculated the homology groups of this topological space. By induction on n, using the Addition Sequence for homology groups of semicubical sets, it is proved that in dimension 0 and 1 the integer homology groups of these nets are equal to the group of integers, and in the remaining dimensions are zero. Directed homology groups are studied. A connection of these groups with deadlocks and newsletters is found. This helps to prove that all directed homology groups of the pipeline elementary Petri nets are zeroth.

  10. Bariatric Surgery

    Science.gov (United States)

    ... Loss Featured Resource Find an Endocrinologist Search Bariatric Surgery September 2017 Download PDFs English Espanol Editors Durga ... Metabolic and Bariatric Surgery MedlinePlus What is bariatric surgery? Bariatric surgery helps people who are very obese ...

  11. Bariatric Surgery

    Science.gov (United States)

    ... Weight Loss Featured Resource Find an Endocrinologist Search Bariatric Surgery September 2017 Download PDFs English Espanol Editors Durga ... for Metabolic and Bariatric Surgery MedlinePlus What is bariatric surgery? Bariatric surgery helps people who are very obese ...

  12. USE OF TWO STEP FOOT - REST UTILIZED FOR MAKING LITHOTOMY POSITION FOR ANORECTO - UROGENITAL SURGERIES IN INFANT PATIENTS WITH EASY APPROACH FOR ANAESTHESIOLOGIST AS WELL AS FOR SURGEON

    Directory of Open Access Journals (Sweden)

    Suresh Chandra

    2015-06-01

    Full Text Available This study was carried out in 40 infant patients with the aim is to provide optimal position for better surgical access and better access for anaesthesiologist regarding patient’s monitoring while minimizing manpower with easily available resourc es i.e. two step foot - rest for positioning of infant patient undergoing anorecto - urogenital operating procedures in operation theatre with less potential risk to the patient including peripheral neuropathies. This article addresses towards use of two step foot - rest, which is comfortable for the patient as well as for the anaesthesia team. The single surgeon may carry out perineal surgeries without much assistance.

  13. The Utilization of the iOS Platform to Create LearnENT: An Interactive Educational App in Otolaryngology—Head and Neck Surgery

    Directory of Open Access Journals (Sweden)

    S. Kohlert

    2012-01-01

    Full Text Available LearnENT, an educational app for iOS, was developed to promote a standardized experience otolaryngology in head and neck surgery (OTOHNS for University of Ottawa medical students. Its development was grounded in pedagogical theory including Laurillard’s design process, Honey and Mumford’s learning styles, and Nielsen’s theory of usability. This paper examines LearnENT's design and development processes as well as the role of mobile apps in medical education. Features of the LearnENT app as they apply to Constructivist learning are also highlighted.

  14. Homologous Recombination in Protozoan Parasites and Recombinase Inhibitors.

    Science.gov (United States)

    Kelso, Andrew A; Waldvogel, Sarah M; Luthman, Adam J; Sehorn, Michael G

    2017-01-01

    Homologous recombination (HR) is a DNA double-strand break (DSB) repair pathway that utilizes a homologous template to fully repair the damaged DNA. HR is critical to maintain genome stability and to ensure genetic diversity during meiosis. A specialized class of enzymes known as recombinases facilitate the exchange of genetic information between sister chromatids or homologous chromosomes with the help of numerous protein accessory factors. The majority of the HR machinery is highly conserved among eukaryotes. In many protozoan parasites, HR is an essential DSB repair pathway that allows these organisms to adapt to environmental conditions and evade host immune systems through genetic recombination. Therefore, small molecule inhibitors, capable of disrupting HR in protozoan parasites, represent potential therapeutic options. A number of small molecule inhibitors were identified that disrupt the activities of the human recombinase RAD51. Recent studies have examined the effect of two of these molecules on the Entamoeba recombinases. Here, we discuss the current understandings of HR in the protozoan parasites Trypanosoma, Leishmania, Plasmodium, and Entamoeba, and we review the small molecule inhibitors known to disrupt human RAD51 activity.

  15. Homologous Recombination in Protozoan Parasites and Recombinase Inhibitors

    Directory of Open Access Journals (Sweden)

    Andrew A. Kelso

    2017-09-01

    Full Text Available Homologous recombination (HR is a DNA double-strand break (DSB repair pathway that utilizes a homologous template to fully repair the damaged DNA. HR is critical to maintain genome stability and to ensure genetic diversity during meiosis. A specialized class of enzymes known as recombinases facilitate the exchange of genetic information between sister chromatids or homologous chromosomes with the help of numerous protein accessory factors. The majority of the HR machinery is highly conserved among eukaryotes. In many protozoan parasites, HR is an essential DSB repair pathway that allows these organisms to adapt to environmental conditions and evade host immune systems through genetic recombination. Therefore, small molecule inhibitors, capable of disrupting HR in protozoan parasites, represent potential therapeutic options. A number of small molecule inhibitors were identified that disrupt the activities of the human recombinase RAD51. Recent studies have examined the effect of two of these molecules on the Entamoeba recombinases. Here, we discuss the current understandings of HR in the protozoan parasites Trypanosoma, Leishmania, Plasmodium, and Entamoeba, and we review the small molecule inhibitors known to disrupt human RAD51 activity.

  16. Dualities in Persistent (Co)Homology

    Energy Technology Data Exchange (ETDEWEB)

    de Silva, Vin; Morozov, Dmitriy; Vejdemo-Johansson, Mikael

    2011-09-16

    We consider sequences of absolute and relative homology and cohomology groups that arise naturally for a filtered cell complex. We establishalgebraic relationships between their persistence modules, and show that they contain equivalent information. We explain how one can use the existingalgorithm for persistent homology to process any of the four modules, and relate it to a recently introduced persistent cohomology algorithm. Wepresent experimental evidence for the practical efficiency of the latter algorithm.

  17. Thyroid Surgery

    Science.gov (United States)

    ... has had a previous neck operation (thyroid surgery, parathyroid surgery, spine surgery, carotid artery surgery, etc.) and/or who has had a suspected invasive thyroid cancer should have their vocal cord function evaluated routinely before surgery. This is necessary to ...

  18. [Utilizing the Rorschach Test in the diagnosis of gender identity disorder and in the evaluation of eligibility for sex reassignment surgery].

    Science.gov (United States)

    Affatati, Valeria; Grattagliano, Ignazio; Todarello, Orlando; Catanesi, Roberto

    2012-01-01

    Gender identity disorder (GID) is a mental disorder in which gender identity is incongruent with the anatomical sex, in the absence of any clear and defined genetic or biological alteration. The diagnosis of GID as well as the assessment of patient eligibility for sex reassignment surgery (SRS) are prerequisite to the legal recognition procedure. The aim of this study was to evaluate the usefulness of the Rorschach test in differential diagnosis determination and primarily in providing information on patient eligibility for SRS, in the framework of the clinical, therapeutic and forensic psychometric and psychodiagnostic assessment, and according to the World Professional Association for Transgender Health (WPATH) criteria. For this purpose we analysed the Rorschach test of 47 patients (33 GID and 14 GID NAS). Results show that GID NAS patients have greater difficulties in stress control and less adaptability, which could lead to disorganisation, impulsiveness, behavioural disorders, as well as higher levels of situational and chronic stress, with altered thought patterns and uncontrolled ideation, a higher frequency of thought disorders and disturbed relations, with lower quality and less adaptive interpersonal relationships, which are characterized by dependency and aggressive behaviours. This research shows that the Rorschach test cannot be used alone in the determination of the differential diagnosis between GID and GID NAS in the diagnosis and evaluation of patient eligibility for SRS, especially when comparing groups which do not shows significant differences in the prevalence of the main psychopathological disorders.

  19. Foot Surgery

    Science.gov (United States)

    ... Heel Spur Surgery: Based on the condition and the nature of the disease, heel surgery can provide relief of pain ... Prior to surgery, the podiatrist will review your medical history and medical conditions. Specific diseases, illnesses, allergies, ...

  20. Foot Surgery

    Science.gov (United States)

    ... Foot Health Awareness Month Diabetes Awareness When is Foot Surgery Necessary? Many foot problems do not respond ... restore the function of your foot. Types of Foot Surgery Bunion Surgery: There are many different types ...

  1. Robotic surgery

    Science.gov (United States)

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... computer station and directs the movements of a robot. Small surgical tools are attached to the robot's ...

  2. Plastic Surgery

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Plastic Surgery KidsHealth / For Teens / Plastic Surgery What's in ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word " ...

  3. On the hodological criterion for homology

    Directory of Open Access Journals (Sweden)

    Macarena eFaunes

    2015-06-01

    Full Text Available Owen’s pre-evolutionary definition of a homologue as the same organ in different animals under every variety of form and function and its redefinition after Darwin as the same trait in different lineages due to common ancestry entail the same heuristic problem: how to establish sameness. Although different criteria for homology often conflict, there is currently a generalized acceptance of gene expression as the best criterion. This gene-centered view of homology results from a reductionist and preformationist concept of living beings. Here, we adopt an alternative organismic-epigenetic viewpoint, and conceive living beings as systems whose identity is given by the dynamic interactions between their components at their multiple levels of composition. We posit that there cannot be an absolute homology criterion, and instead, homology should be inferred from comparisons at the levels and developmental stages where the delimitation of the compared trait lies. In this line, we argue that neural connectivity, i.e., the hodological criterion, should prevail in the determination of homologies between brain supra-cellular structures, such as the vertebrate pallium.

  4. Parallelism, deep homology, and evo-devo.

    Science.gov (United States)

    Hall, Brian K

    2012-01-01

    Parallelism has been the subject of a number of recent studies that have resulted in reassessment of the term and the process. Parallelism has been aligned with homology leaving convergence as the only case of homoplasy, regarded as a transition between homologous and convergent characters, and defined as the independent evolution of genetic traits. Another study advocates abolishing the term parallelism and treating all cases of the independent evolution of characters as convergence. With the sophistication of modern genomics and genetic analysis, parallelism of characters of the phenotype is being discovered to reflect parallel genetic evolution. Approaching parallelism from developmental and genetic perspectives enables us to tease out the degree to which the reuse of pathways represent deep homology and is a major task for evolutionary developmental biology in the coming decades. © 2012 Wiley Periodicals, Inc.

  5. Robot Autonomy for Surgery

    OpenAIRE

    Yip, Michael; Das, Nikhil

    2017-01-01

    Autonomous surgery involves having surgical tasks performed by a robot operating under its own will, with partial or no human involvement. There are several important advantages of automation in surgery, which include increasing precision of care due to sub-millimeter robot control, real-time utilization of biosignals for interventional care, improvements to surgical efficiency and execution, and computer-aided guidance under various medical imaging and sensing modalities. While these methods...

  6. Relative K-homology and normal operators

    DEFF Research Database (Denmark)

    Manuilov, Vladimir; Thomsen, Klaus

    2009-01-01

    -term exact sequence which generalizes the excision six-term exact sequence in the first variable of KK-theory. Subsequently we investigate the relative K-homology which arises from the group of relative extensions by specializing to abelian $C^*$-algebras. It turns out that this relative K-homology carries...... substantial information also in the operator theoretic setting from which the BDF theory was developed and we conclude the paper by extracting some of this information on approximation of normal operators....

  7. LAPARoseome SURGERY:

    African Journals Online (AJOL)

    Laparoscopic Surgery has been rightly described as the "dawn of a new era" in surgery. It has come to stay and has altered permanently the practice and teaching of surgery as we used to know it. It is not about. "new gadgets" but a new way of practicing an old art surgery. ~ The surgical world has moved on and.

  8. Cell biology of homologous recombination in yeast

    DEFF Research Database (Denmark)

    Eckert-Boulet, Nadine Valerie; Rothstein, Rodney; Lisby, Michael

    2011-01-01

    Homologous recombination is an important pathway for error-free repair of DNA lesions, such as single- and double-strand breaks, and for rescue of collapsed replication forks. Here, we describe protocols for live cell imaging of single-lesion recombination events in the yeast Saccharomyces...

  9. GPCR Homology Model Generation for Lead Optimization.

    Science.gov (United States)

    Tautermann, Christofer S

    2018-01-01

    The vast increase of recently solved GPCR X-ray structures forms the basis for GPCR homology modeling to atomistic accuracy. Nowadays, homology models can be employed for GPCR-ligand optimization and have been reported as invaluable tools for drug design in the last few years. Elucidation of the complex GPCR pharmacology and the associated GPCR conformations made clear that different homology models have to be constructed for different activation states of the GPCRs. Therefore, templates have to be chosen accordingly to their sequence homology as well as to their activation state. The subsequent ligand placement is nontrivial, as some recent X-ray structures show very unusual ligand binding sites and solvent involvement, expanding the space of the putative ligand binding site from the generic retinal binding pocket to the whole receptor. In the present study, a workflow is presented starting from the selection of the target sequence, guiding through the GPCR modeling process, and finishing with ligand placement and pose validation.

  10. Homological stability for unordered configuration spaces

    DEFF Research Database (Denmark)

    Randal-Williams, Oscar

    2013-01-01

    This paper consists of two related parts. In the first part we give a self-contained proof of homological stability for the spaces C_n(M;X) of configurations of n unordered points in a connected open manifold M with labels in a path-connected space X, with the best possible integral stability ran...

  11. Homological algebra in n-abelian categories

    Indian Academy of Sciences (India)

    In this paper, we study the homological theory in n -abelian categories. First, we prove some useful properties of n -abelian categories, such as ( n + 2 ) × ( n + 2 ) -lemma, 5-lemma and n -Horseshoes lemma. Secondly, we introduce the notions of right(left) n -derived functors of left(right) n -exact functors, n -(co)resolutions, ...

  12. Threading homology through algebra selected patterns

    CERN Document Server

    Boffi, Giandomenico

    2006-01-01

    Aimed at graduate students and researchers in mathematics, this book takes homological themes, such as Koszul complexes and their generalizations, and shows how these can be used to clarify certain problems in selected parts of algebra, as well as their success in solving a number of them.

  13. Homology modeling of γ-aminobutyrateaminotransferase, a ...

    African Journals Online (AJOL)

    γ-Aminobutyrate aminotransferase (GABA-AT) is a pyridoxal phosphate dependent homodimeric enzyme of 50-kD subunits. It is a potential drug target against epilepsy. The three-dimensional structure of GABA-AT is not experimentally known, and we thus resorted to homology modelling to build a model based on x-ray ...

  14. Nash equilibria via duality and homological selection

    Indian Academy of Sciences (India)

    Keywords. Nash equilibria; Dold–Thom theorem; homological selection. 2010 Mathematics Subject Classification. Primary: 55M05, 55N45, 91A10. 1. Introduction. The main topological problem addressed in this paper is the following: Let X be a metric space and Subk(X) denote the collection of subsets of X with at most.

  15. On the homology length spectrum of surfaces

    OpenAIRE

    Massart, Daniel; Parlier, Hugo

    2014-01-01

    On a surface with a Finsler metric, we investigate the asymptotic growth of the number of closed geodesics of length less than L which minimize length among all geodesic multicurves in the same homology class. An important class of surfaces which are of interest to us are hyperbolic surfaces.

  16. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  17. Dental Implant Surgery

    Science.gov (United States)

    ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ...

  18. Multimodal imaging and detection approach to 18F-FDG-directed surgery for patients with known or suspected malignancies: a comprehensive description of the specific methodology utilized in a single-institution cumulative retrospective experience

    Directory of Open Access Journals (Sweden)

    Povoski Stephen P

    2011-11-01

    Full Text Available Abstract Background 18F-FDG PET/CT is widely utilized in the management of cancer patients. The aim of this paper was to comprehensively describe the specific methodology utilized in our single-institution cumulative retrospective experience with a multimodal imaging and detection approach to 18F-FDG-directed surgery for known/suspected malignancies. Methods From June 2005-June 2010, 145 patients were injected with 18F-FDG in anticipation of surgical exploration, biopsy, and possible resection of known/suspected malignancy. Each patient underwent one or more of the following: (1 same-day preoperative patient diagnostic PET/CT imaging, (2 intraoperative gamma probe assessment, (3 clinical PET/CT specimen scanning of whole surgically resected specimens (WSRS, research designated tissues (RDT, and/or sectioned research designated tissues (SRDT, (4 micro PET/CT specimen scanning of WSRS, RDT, and/or SRDT, (5 total radioactivity counting of each SRDT piece by an automatic gamma well counter, and (6 same-day postoperative patient diagnostic PET/CT imaging. Results Same-day 18F-FDG injection dose was 15.1 (± 3.5, 4.6-26.1 mCi. Fifty-five same-day preoperative patient diagnostic PET/CT scans were performed. One hundred forty-two patients were taken to surgery. Three of the same-day preoperative patient diagnostic PET/CT scans led to the cancellation of the anticipated surgical procedure. One hundred forty-one cases utilized intraoperative gamma probe assessment. Sixty-two same-day postoperative patient diagnostic PET/CT scans were performed. WSRS, RDT, and SRDT were scanned by clinical PET/CT imaging and micro PET/CT imaging in 109 and 32 cases, 33 and 22 cases, and 49 and 26 cases, respectively. Time from 18F-FDG injection to same-day preoperative patient diagnostic PET/CT scan, intraoperative gamma probe assessment, and same-day postoperative patient diagnostic PET/CT scan were 73 (± 9, 53-114, 286 (± 93, 176-532, and 516 (± 134, 178-853 minutes

  19. Blood conservation pediatric cardiac surgery in all ages and complexity levels.

    Science.gov (United States)

    Karimi, Mohsen; Sullivan, Jill M; Linthicum, Carrie; Mathew, Anil

    2017-04-26

    To demonstrate the feasibility of blood conservation methods and practice across all ages and risk categories in congenital cardiac surgery. We retrospectively analyzed a collected database of 356 patients who underwent cardiac surgery using cardiopulmonary bypass (CPB) from 2010-2015. The patients were grouped into blood conservation (n = 138) and non-conservation (n = 218) groups and sub-grouped based on their ages and procedural complexity scores. There were no statistical differences in gender, weight, pre-operative and pre-CPB hematocrit levels in both groups. Despite equivalent hematocrit levels during and after CPB for both groups, there was significantly less operative homologous blood utilized in blood conservation group across all ages and complexity levels. Blood conservation surgery can be performed in congenital patients needing cardiac surgery in all age groups and complexity categories. The above findings in addition to attendant risks and side effects of blood transfusion and the rising cost of safer blood products justify blood conservation in congenital cardiac surgery.

  20. Homological mirror symmetry and tropical geometry

    CERN Document Server

    Catanese, Fabrizio; Kontsevich, Maxim; Pantev, Tony; Soibelman, Yan; Zharkov, Ilia

    2014-01-01

    The relationship between Tropical Geometry and Mirror Symmetry goes back to the work of Kontsevich and Y. Soibelman (2000), who applied methods of non-archimedean geometry (in particular, tropical curves) to Homological Mirror Symmetry. In combination with the subsequent work of Mikhalkin on the “tropical” approach to Gromov-Witten theory, and the work of Gross and Siebert, Tropical Geometry has now become a powerful tool. Homological Mirror Symmetry is the area of mathematics concentrated around several categorical equivalences connecting symplectic and holomorphic (or algebraic) geometry. The central ideas first appeared in the work of Maxim Kontsevich (1993). Roughly speaking, the subject can be approached in two ways: either one uses Lagrangian torus fibrations of Calabi-Yau manifolds (the so-called Strominger-Yau-Zaslow picture, further developed by Kontsevich and Soibelman) or one uses Lefschetz fibrations of symplectic manifolds (suggested by Kontsevich and further developed by Seidel). Tropical Ge...

  1. Statins in cardiac surgery

    African Journals Online (AJOL)

    Abstract. Background: Recent studies on the utility of statins in cardiac surgery appear to show conflicting results. Most studies are either retrospective or prospective observational, with small sample sizes. In order to address these limitations, we systematically reviewed studies from 2008 to the present, in order to determine ...

  2. Homological characterisation of Lambda-ranks

    OpenAIRE

    Howson, Susan

    1999-01-01

    If G is a pro-p, p-adic, Lie group and if $\\Lambda(G)$ denotes the Iwasawa algebra of G then we present a formula for determining the $\\Lambda(G)$-rank of a finitely generated $\\Lambda(G)$-module. This is given in terms of the G homology groups of the module. We explore some consequences of this for the structure of $\\Lambda(G)$-modules.

  3. Surfaces with pulleys and Khovanov homology

    OpenAIRE

    Audoux, Benjamin

    2011-01-01

    International audience; In this short note, we define surfaces with pulleys which are unions of 1 and 2-dimensional manifolds, glued together on a finite number of points of their interiors. Then, by seeing them as cobordisms, we give a refinment of Bar-Natan geometrical construction of Khovanov homology which can be applied to different notions of refined links as links in I-bundle or braid-like links.

  4. Language evolution: neural homologies and neuroinformatics.

    Science.gov (United States)

    Arbib, Michael; Bota, Mihail

    2003-11-01

    This paper contributes to neurolinguistics by grounding an evolutionary account of the readiness of the human brain for language in the search for homologies between different cortical areas in macaque and human. We consider two hypotheses for this grounding, that of Aboitiz and Garci;a [Brain Res. Rev. 25 (1997) 381] and the Mirror System Hypothesis of Rizzolatti and Arbib [Trends Neurosci. 21 (1998) 188] and note the promise of computational modeling of neural circuitry of the macaque and its linkage to analysis of human brain imaging data. In addition to the functional differences between the two hypotheses, problems arise because they are grounded in different cortical maps of the macaque brain. In order to address these divergences, we have developed several neuroinformatics tools included in an on-line knowledge management system, the NeuroHomology Database, which is equipped with inference engines both to relate and translate information across equivalent cortical maps and to evaluate degrees of homology for brain regions of interest in different species.

  5. Sinus Surgery

    Science.gov (United States)

    ... Patient Health Home Copyright © 2018 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2018. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  6. Nose Surgery

    Science.gov (United States)

    ... Patient Health Home Copyright © 2018 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2018. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  7. After Surgery

    Science.gov (United States)

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  8. Turbinate surgery

    Science.gov (United States)

    ... anesthesia with sedation, so you are asleep and pain-free during surgery. Turbinoplasty: A tool is placed in ... anesthesia with sedation, so you are asleep and pain-free during surgery. Radiofrequency or laser ablation: A thin ...

  9. Lung surgery

    Science.gov (United States)

    ... cavity, particularly after trauma Surgery to remove small balloon-like tissues (blebs) that cause lung collapse ( pneumothorax ) ... this surgery include: Failure of the lung to expand Injury to the lungs or blood vessels Need ...

  10. Which way up? Recognition of homologous DNA segments in parallel and antiparallel alignments

    Science.gov (United States)

    O'Lee, Dominic J.; Wynveen, Aaron; Albrecht, Tim; Kornyshev, Alexei A.

    2015-01-01

    Homologous gene shuffling between DNA molecules promotes genetic diversity and is an important pathway for DNA repair. For this to occur, homologous genes need to find and recognize each other. However, despite its central role in homologous recombination, the mechanism of homology recognition has remained an unsolved puzzle of molecular biology. While specific proteins are known to play a role at later stages of recombination, an initial coarse grained recognition step has, however, been proposed. This relies on the sequence dependence of the DNA structural parameters, such as twist and rise, mediated by intermolecular interactions, in particular, electrostatic ones. In this proposed mechanism, sequences that have the same base pair text, or are homologous, have lower interaction energy than those sequences with uncorrelated base pair texts. The difference between the two energies is termed the "recognition energy." Here, we probe how the recognition energy changes when one DNA fragment slides past another, and consider, for the first time, homologous sequences in antiparallel alignment. This dependence on sliding is termed the "recognition well." We find there is a recognition well for anti-parallel, homologous DNA tracts, but only a very shallow one, so that their interaction will differ little from the interaction between two nonhomologous tracts. This fact may be utilized in single molecule experiments specially targeted to test the theory. As well as this, we test previous theoretical approximations in calculating the recognition well for parallel molecules against MC simulations and consider more rigorously the optimization of the orientations of the fragments about their long axes upon calculating these recognition energies. The more rigorous treatment affects the recognition energy a little, when the molecules are considered rigid. When torsional flexibility of the DNA molecules is introduced, we find excellent agreement between the analytical

  11. Pediatric epilepsy surgery.

    Science.gov (United States)

    Dorfmüller, Georg; Delalande, Olivier

    2013-01-01

    Whereas there is no specific neurosurgical technique in pediatric epilepsy, the frequency of each type of surgery is very different from epilepsy surgery applied in adults, and reflects the underlying etiologies, which are much more diverse in children, with malformations of cortical development and tumors as the prevailing etiologies. Extensive resective or disconnective procedures for extratemporal epilepsy are more frequently performed in infants and younger children, whereas temporo-mesial resection is by far the most common surgical treatment for adults with epilepsy. More recently, less invasive techniques in children with an extensive epileptogenic zone, such as multilobar disconnection, hemispherotomy and other functional hemispherectomy variants, have been introduced in order to reduce duration of surgery, perioperative morbidity and length of hospital stay. Likewise, minimally invasive techniques are utilized, such as the endoscopic disconnection of hypothalamic hamartomas for gelastic epilepsy. This development has been encouraged with the introduction of image-guided navigation systems for the preoperative planning and during surgery. Historically, epilepsy surgery for children has been established much later than for adults. Apart from the particular aspects in perioperative management of younger infants, surgery-related morbidity as well as seizure outcome is in general similar to those in adults, depending rather on each type of surgery. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Craniofacial Surgery Fellowship Websites.

    Science.gov (United States)

    Silvestre, Jason; Agarwal, Divyansh; Taylor, Jesse A

    2016-06-01

    Applicants for craniofacial surgery fellowships utilize Internet-based resources like the San Francisco (SF) Match to manage applications. The purpose of this study was to evaluate the accessibility and content of craniofacial surgery fellowship websites (CSFWs). A list of available craniofacial surgery fellowships was compiled from directories of the American Society of Craniofacial Surgery (ACSFS) and SF Match. Accessibility of CSFWs was assessed via links from these directories and a Google search. Craniofacial surgery fellowship websites were evaluated on education and recruitment content and compared via program characteristics. Twenty-four of the 28 US-based craniofacial surgery fellowship programs had a CSFW (86%). The ACSFS and SF Match databases had limited CSFW accessibility, but a Google search revealed most CSFWs had the top search result (76%). In total, CSFWs provided an average of 39% of education and recruitment variables. While most programs provided fellowship program descriptions (96%), application links (96%), and faculty listings (83%), relatively few provided rotation schedules (13%), fellow selection process information (13%), or interview dates (8%). CSFW content did not vary by program location, faculty size, accreditation status, or institutional affiliations (P > 0.05). Craniofacial surgery fellowships often lack readily accessible websites from national program lists and have limited information for interested applicants. The consistent lack of online information across programs suggests future opportunities exist to improve these educational resources.

  13. LAPARoseome SURGERY:

    African Journals Online (AJOL)

    ofSurgery,. University College Hospital, Ibadan, Nigeria. SUMMARY. Laparoscopic Surgery has been rightly described as the "dawn of a new era" in surgery. It has come to stay and ... gases (CO2 and N20) require special devices for delivery to regulate ... wound, not to talk of the cosmetics that also makes the technique ...

  14. Cosmetic Surgery

    Science.gov (United States)

    ... Don’t rely on surgery to change your life in a huge way. Make sure any doctor you consider is qualified for the surgery you’re considering and is certified by the American Board of Plastic Surgery. Some doctors won’t ...

  15. PLASTIC SURGERY

    African Journals Online (AJOL)

    provide correct nipple areolar complex position and shape. PLASTIC SURGERY. T Jay, K Segwapa. Department of Plastic and Reconstructive Surgery Sefako Makgatho Health Science University, Pretoria South-Africa. Corresponding author: T Jay (drtonijay@gmail.com). Background: In surgery for gynaecomastia, excision ...

  16. Pareto utility

    NARCIS (Netherlands)

    Ikefuji, M.; Laeven, R.J.A.; Magnus, J.R.; Muris, C.H.M.

    2013-01-01

    In searching for an appropriate utility function in the expected utility framework, we formulate four properties that we want the utility function to satisfy. We conduct a search for such a function, and we identify Pareto utility as a function satisfying all four desired properties. Pareto utility

  17. Robotic utilization in esophageal cancer surgery

    NARCIS (Netherlands)

    Van Hillegersberg, Richard; Verhage, Roy J J; Van der Sluis, Pieter C.; Ruurda, Jelle P H; Kroese, A. Christiaan

    2015-01-01

    Minimally invasive esophagectomy (MIE) was designed to reduce surgical trauma, resulting in lower rates of morbidity and mortality. MIE has been shown to decrease blood loss, reduce postoperative complications, and shorten hospital stay, with comparable oncological results. In 2003 the

  18. Anticipating urgent surgery in operating room departments

    NARCIS (Netherlands)

    van der Lans, M.; Hans, Elias W.; Hurink, Johann L.; Wullink, Gerhard; van Houdenhoven, M.; Kazemier, G.

    2005-01-01

    Operating Room (OR) departments need to create robust surgical schedules that anticipate urgent surgery, while minimizing urgent surgery waiting time and overtime, and maximizing utilization. We consider two levels of planning and control to anticipate urgent surgery. At the tactical level, we study

  19. A PHF8 homolog in C. elegans promotes DNA repair via homologous recombination.

    Directory of Open Access Journals (Sweden)

    Changrim Lee

    Full Text Available PHF8 is a JmjC domain-containing histone demethylase, defects in which are associated with X-linked mental retardation. In this study, we examined the roles of two PHF8 homologs, JMJD-1.1 and JMJD-1.2, in the model organism C. elegans in response to DNA damage. A deletion mutation in either of the genes led to hypersensitivity to interstrand DNA crosslinks (ICLs, while only mutation of jmjd-1.1 resulted in hypersensitivity to double-strand DNA breaks (DSBs. In response to ICLs, JMJD-1.1 did not affect the focus formation of FCD-2, a homolog of FANCD2, a key protein in the Fanconi anemia pathway. However, the dynamic behavior of RPA-1 and RAD-51 was affected by the mutation: the accumulations of both proteins at ICLs appeared normal, but their subsequent disappearance was retarded, suggesting that later steps of homologous recombination were defective. Similar changes in the dynamic behavior of RPA-1 and RAD-51 were seen in response to DSBs, supporting a role of JMJD-1.1 in homologous recombination. Such a role was also supported by our finding that the hypersensitivity of jmjd-1.1 worms to ICLs was rescued by knockdown of lig-4, a homolog of Ligase 4 active in nonhomologous end-joining. The hypersensitivity of jmjd-1.1 worms to ICLs was increased by rad-54 knockdown, suggesting that JMJD-1.1 acts in parallel with RAD-54 in modulating chromatin structure. Indeed, the level of histone H3 Lys9 tri-methylation, a marker of heterochromatin, was higher in jmjd-1.1 cells than in wild-type cells. We conclude that the histone demethylase JMJD-1.1 influences homologous recombination either by relaxing heterochromatin structure or by indirectly regulating the expression of multiple genes affecting DNA repair.

  20. Homological Perturbation Theory for Nonperturbative Integrals

    Science.gov (United States)

    Johnson-Freyd, Theo

    2015-11-01

    We use the homological perturbation lemma to produce explicit formulas computing the class in the twisted de Rham complex represented by an arbitrary polynomial. This is a non-asymptotic version of the method of Feynman diagrams. In particular, we explain that phenomena usually thought of as particular to asymptotic integrals in fact also occur exactly: integrals of the type appearing in quantum field theory can be reduced in a totally algebraic fashion to integrals over an Euler-Lagrange locus, provided this locus is understood in the scheme-theoretic sense, so that imaginary critical points and multiplicities of degenerate critical points contribute.

  1. Genetic Homologies Among Streptomyces violaceoruber Strains

    Science.gov (United States)

    Monson, A. M.; Bradley, S. G.; Enquist, L. W.; Cruces, Griselda

    1969-01-01

    Most of the genetic studies on streptomycetes have been done with cultures erroneously designated as Streptomyces coelicolor. To determine whether these cultures are genetically homologous with the S. violaceoruber nominifer, their deoxyribonucleic acids (DNA) were analyzed, and selected pairs of mutants were crossed. The four cultures used in genetic studies, and called S. coelicolor in the literature, were found to constitute a genospecies, based upon DNA hybridization and recombination tests. In addition, DNA from Actinopycnidium caeruleum formed extensive duplexes with S. violaceoruber DNA. S. violaceoruber cultures and A. caeruleum were distinctly different from the S. coelicolor nominifer. PMID:5370275

  2. Railway vehicle performance optimisation using virtual homologation

    Science.gov (United States)

    Magalhães, H.; Madeira, J. F. A.; Ambrósio, J.; Pombo, J.

    2016-09-01

    Unlike regular automotive vehicles, which are designed to travel in different types of roads, railway vehicles travel mostly in the same route during their life cycle. To accept the operation of a railway vehicle in a particular network, a homologation process is required according to local standard regulations. In Europe, the standards EN 14363 and UIC 518, which are used for railway vehicle acceptance, require on-track tests and/or numerical simulations. An important advantage of using virtual homologation is the reduction of the high costs associated with on-track tests by studying the railway vehicle performance in different operation conditions. This work proposes a methodology for the improvement of railway vehicle design with the objective of its operation in selected railway tracks by using optimisation. The analyses required for the vehicle improvement are performed under control of the optimisation method global and local optimisation using direct search. To quantify the performance of the vehicle, a new objective function is proposed, which includes: a Dynamic Performance Index, defined as a weighted sum of the indices obtained from the virtual homologation process; the non-compensated acceleration, which is related to the operational velocity; and a penalty associated with cases where the vehicle presents an unacceptable dynamic behaviour according to the standards. Thus, the optimisation process intends not only to improve the quality of the vehicle in terms of running safety and ride quality, but also to increase the vehicle availability via the reduction of the time for a journey while ensuring its operational acceptance under the standards. The design variables include the suspension characteristics and the operational velocity of the vehicle, which are allowed to vary in an acceptable range of variation. The results of the optimisation lead to a global minimum of the objective function in which the suspensions characteristics of the vehicle are

  3. Excluded volume effect enhances the homology pairing of model chromosomes

    Science.gov (United States)

    Takamiya, Kazunori; Yamamoto, Keisuke; Isami, Shuhei; Nishimori, Hiraku; Awazu, Akinori

    To investigate the structural dynamics of the homology pairing of polymers, we mod- eled the scenario of homologous chromosome pairings during meiosis in Schizosaccharomyces pombe, one of the simplest model organisms of eukaryotes. We consider a simple model consist- ing of pairs of homologous polymers with the same structures that are confined in a cylindrical container, which represents the local parts of chromosomes contained in an elongated nucleus of S. pombe. Brownian dynamics simulations of this model showed that the excluded volume effects among non-homological chromosomes and the transitional dynamics of nuclear shape serve to enhance the pairing of homologous chromosomes.

  4. Towards alignment independent quantitative assessment of homology detection.

    Directory of Open Access Journals (Sweden)

    Avihay Apatoff

    Full Text Available Identification of homologous proteins provides a basis for protein annotation. Sequence alignment tools reliably identify homologs sharing high sequence similarity. However, identification of homologs that share low sequence similarity remains a challenge. Lowering the cutoff value could enable the identification of diverged homologs, but also introduces numerous false hits. Methods are being continuously developed to minimize this problem. Estimation of the fraction of homologs in a set of protein alignments can help in the assessment and development of such methods, and provides the users with intuitive quantitative assessment of protein alignment results. Herein, we present a computational approach that estimates the amount of homologs in a set of protein pairs. The method requires a prevalent and detectable protein feature that is conserved between homologs. By analyzing the feature prevalence in a set of pairwise protein alignments, the method can estimate the number of homolog pairs in the set independently of the alignments' quality. Using the HomoloGene database as a standard of truth, we implemented this approach in a proteome-wide analysis. The results revealed that this approach, which is independent of the alignments themselves, works well for estimating the number of homologous proteins in a wide range of homology values. In summary, the presented method can accompany homology searches and method development, provides validation to search results, and allows tuning of tools and methods.

  5. [Homologous amelogenin gene test of archaeological samples].

    Science.gov (United States)

    Zhang, Hu-Qin; Yang, Zhou-Qi; Liu, Fang-E; Zhang, Jin; Zhao, Wen-Ming

    2006-06-01

    Based on the sequence differences of Amelogenin homologous gene in the X and Y chromosomes, a pair of specific primers was designed to identify the sex of archaeological samples. Ancient DNA fragments were extracted from the bones and teeth of sacrificial slaves with an improved method that combines phenol-chloroform extraction, silicon dioxide adsorption with ultrafiltration concentration. The polyacrylamide gel electrophoresis (PAGE) was used to detect PCR products. Seven in sixteen samples from eight graves showed positive results and the targeted segments were visible: a male with two bands of 106bp (Amel-X) and 112 bp (Amel-Y), while a female with only one band of 106 bp (Amel-X). Ancient DNA analyzing results from tooth samples are more marked than that from bones. The improved extraction method is more effective for ancient DNA extraction, which reduced the PCR inhibitors and lowered experimental costs. The sex determination technology based on Amelogenin homologous gene is an important and feasible method in the molecular archaeological research.

  6. Productive homologous and non-homologous recombination of hepatitis C virus in cell culture

    DEFF Research Database (Denmark)

    Scheel, Troels K H; Galli, Andrea; Li, Yi-Ping

    2013-01-01

    -genotypic recombination could occur, but at a lower frequency than intra-genotypic recombination. Productive recombination of attenuated HCV genomes depended on expression of all HCV proteins and tolerated duplicated sequence. In general, no strong site specificity was observed. Non-homologous recombination was observed...

  7. Structure of the 40S ribosomal subunit of Plasmodium falciparum by homology and de novo modeling

    Directory of Open Access Journals (Sweden)

    Harrison Ndung'u Mwangi

    2017-01-01

    Full Text Available Generation of three dimensional structures of macromolecules using in silico structural modeling technologies such as homology and de novo modeling has improved dramatically and increased the speed by which tertiary structures of organisms can be generated. This is especially the case if a homologous crystal structure is already available. High-resolution structures can be rapidly created using only their sequence information as input, a process that has the potential to increase the speed of scientific discovery. In this study, homology modeling and structure prediction tools such as RNA123 and SWISS–MODEL were used to generate the 40S ribosomal subunit from Plasmodium falciparum. This structure was modeled using the published crystal structure from Tetrahymena thermophila, a homologous eukaryote. In the absence of the Plasmodium falciparum 40S ribosomal crystal structure, the model accurately depicts a global topology, secondary and tertiary connections, and gives an overall root mean square deviation (RMSD value of 3.9 Å relative to the template׳s crystal structure. Deviations are somewhat larger in areas with no homology between the templates. These results demonstrate that this approach has the power to identify motifs of interest in RNA and identify potential drug targets for macromolecules whose crystal structures are unknown. The results also show the utility of RNA homology modeling software for structure determination and lay the groundwork for applying this approach to larger and more complex eukaryotic ribosomes and other RNA-protein complexes. Structures generated from this study can be used in in silico screening experiments and lead to the determination of structures for targets/hit complexes.

  8. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ...

  9. Weight Loss Surgery (Bariatric Surgery) (For Parents)

    Science.gov (United States)

    ... for Educators Search English Español Weight Loss Surgery (Bariatric Surgery) KidsHealth / For Parents / Weight Loss Surgery (Bariatric Surgery) ... or bariatric surgery might be an option. About Bariatric Surgery Bariatric surgery had its beginnings in the 1960s, ...

  10. Clustering evolving proteins into homologous families.

    Science.gov (United States)

    Chan, Cheong Xin; Mahbob, Maisarah; Ragan, Mark A

    2013-04-08

    Clustering sequences into groups of putative homologs (families) is a critical first step in many areas of comparative biology and bioinformatics. The performance of clustering approaches in delineating biologically meaningful families depends strongly on characteristics of the data, including content bias and degree of divergence. New, highly scalable methods have recently been introduced to cluster the very large datasets being generated by next-generation sequencing technologies. However, there has been little systematic investigation of how characteristics of the data impact the performance of these approaches. Using clusters from a manually curated dataset as reference, we examined the performance of a widely used graph-based Markov clustering algorithm (MCL) and a greedy heuristic approach (UCLUST) in delineating protein families coded by three sets of bacterial genomes of different G+C content. Both MCL and UCLUST generated clusters that are comparable to the reference sets at specific parameter settings, although UCLUST tends to under-cluster compositionally biased sequences (G+C content 33% and 66%). Using simulated data, we sought to assess the individual effects of sequence divergence, rate heterogeneity, and underlying G+C content. Performance decreased with increasing sequence divergence, decreasing among-site rate variation, and increasing G+C bias. Two MCL-based methods recovered the simulated families more accurately than did UCLUST. MCL using local alignment distances is more robust across the investigated range of sequence features than are greedy heuristics using distances based on global alignment. Our results demonstrate that sequence divergence, rate heterogeneity and content bias can individually and in combination affect the accuracy with which MCL and UCLUST can recover homologous protein families. For application to data that are more divergent, and exhibit higher among-site rate variation and/or content bias, MCL may often be the better

  11. Modeling Non-homologous End Joining

    Science.gov (United States)

    Li, Yongfeng

    2013-01-01

    Non-homologous end joining (NHEJ) is the dominant DNA double strand break (DSB) repair pathway and involves several NHEJ proteins such as Ku, DNA-PKcs, XRCC4, Ligase IV and so on. Once DSBs are generated, Ku is first recruited to the DNA end, followed by other NHEJ proteins for DNA end processing and ligation. Because of the direct ligation of break ends without the need for a homologous template, NHEJ turns out to be an error-prone but efficient repair pathway. Some mechanisms have been proposed of how the efficiency of NHEJ repair is affected. The type of DNA damage is an important factor of NHEJ repair. For instance, the length of DNA fragment may determine the recruitment efficiency of NHEJ protein such as Ku [1], or the complexity of the DNA breaks [2] is accounted for the choice of NHEJ proteins and subpathway of NHEJ repair. On the other hand, the chromatin structure also plays a role of the accessibility of NHEJ protein to the DNA damage site. In this talk, some mathematical models of NHEJ, that consist of series of biochemical reactions complying with the laws of chemical reaction (e.g. mass action, etc.), will be introduced. By mathematical and numerical analysis and parameter estimation, the models are able to capture the qualitative biological features and show good agreement with experimental data. As conclusions, from the viewpoint of modeling, how the NHEJ proteins are recruited will be first discussed for connection between the classical sequential model [4] and recently proposed two-phase model [5]. Then how the NHEJ repair pathway is affected, by the length of DNA fragment [6], the complexity of DNA damage [7] and the chromatin structure [8], will be addressed

  12. SVM-BALSA: Remote Homology Detection based on Bayesian Sequence Alignment

    Energy Technology Data Exchange (ETDEWEB)

    Webb-Robertson, Bobbie-Jo M.; Oehmen, Chris S.; Matzke, Melissa M.

    2005-11-10

    Using biopolymer sequence comparison methods to identify evolutionarily related proteins is one of the most common tasks in bioinformatics. Recently, support vector machines (SVMs) utilizing statistical learning theory have been employed in the problem of remote homology detection and shown to outperform iterative profile methods such as PSI-BLAST. In this study we demonstrate the utilization of a Bayesian alignment score, which accounts for the uncertainty of all possible alignments, in the SVM construction improves sensitivity compared to the traditional dynamic programming implementation.

  13. Searching remote homology with spectral clustering with symmetry in neighborhood cluster kernels.

    Science.gov (United States)

    Maulik, Ujjwal; Sarkar, Anasua

    2013-01-01

    Remote homology detection among proteins utilizing only the unlabelled sequences is a central problem in comparative genomics. The existing cluster kernel methods based on neighborhoods and profiles and the Markov clustering algorithms are currently the most popular methods for protein family recognition. The deviation from random walks with inflation or dependency on hard threshold in similarity measure in those methods requires an enhancement for homology detection among multi-domain proteins. We propose to combine spectral clustering with neighborhood kernels in Markov similarity for enhancing sensitivity in detecting homology independent of "recent" paralogs. The spectral clustering approach with new combined local alignment kernels more effectively exploits the unsupervised protein sequences globally reducing inter-cluster walks. When combined with the corrections based on modified symmetry based proximity norm deemphasizing outliers, the technique proposed in this article outperforms other state-of-the-art cluster kernels among all twelve implemented kernels. The comparison with the state-of-the-art string and mismatch kernels also show the superior performance scores provided by the proposed kernels. Similar performance improvement also is found over an existing large dataset. Therefore the proposed spectral clustering framework over combined local alignment kernels with modified symmetry based correction achieves superior performance for unsupervised remote homolog detection even in multi-domain and promiscuous domain proteins from Genolevures database families with better biological relevance. Source code available upon request. sarkar@labri.fr.

  14. A geometric model for Hochschild homology of Soergel bimodules

    DEFF Research Database (Denmark)

    Webster, Ben; Williamson, Geordie

    2008-01-01

    An important step in the calculation of the triply graded link homology of Khovanov and Rozansky is the determination of the Hochschild homology of Soergel bimodules for SL(n). We present a geometric model for this Hochschild homology for any simple group G, as B–equivariant intersection cohomology...... of B×B–orbit closures in G. We show that, in type A, these orbit closures are equivariantly formal for the conjugation B–action. We use this fact to show that, in the case where the corresponding orbit closure is smooth, this Hochschild homology is an exterior algebra over a polynomial ring...

  15. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  16. Rodding Surgery

    Science.gov (United States)

    ... above-the-knee splint or lightweight plaster or fiberglass splint instead. Bracing may be used after the ... level. Potential Complications Complications from rodding surgery include risks related to:  General anesthesia,  Fractures during the procedure,  ...

  17. Epilepsy Surgery

    Science.gov (United States)

    ... if the seizure occurs during a bath or swimming Brain damage from prolonged seizures Sudden death, a ... a candidate for epilepsy surgery, your pre-surgical evaluation may include: Baseline electroencephalogram (EEG). In this test, ...

  18. The fate of linear DNA in Saccharomyces cerevisiae and Candida glabrata: the role of homologous and non-homologous end joining.

    Directory of Open Access Journals (Sweden)

    Mary W Corrigan

    Full Text Available In vivo assembly of plasmids has become an increasingly used process, as high throughput studies in molecular biology seek to examine gene function. In this study, we investigated the plasmid construction technique called gap repair cloning (GRC in two closely related species of yeast - Saccharomyces cerevisiae and Candida glabrata. GRC utilizes homologous recombination (HR activity to join a linear vector and a linear piece of DNA that contains base pair homology. We demonstrate that a minimum of 20 bp of homology on each side of the linear DNA is required for GRC to occur with at least 10% efficiency. Between the two species, we determine that S. cerevisiae is slightly more efficient at performing GRC. GRC is less efficient in rad52 deletion mutants, which are defective in HR in both species. In dnl4 deletion mutants, which perform less non-homologous end joining (NHEJ, the frequency of GRC increases in C. glabrata, whereas GRC frequency only minimally increases in S. cerevisiae, suggesting that NHEJ is more prevalent in C. glabrata. Our studies allow for a model of the fate of linear DNA when transformed into yeast cells. This model is not the same for both species. Most significantly, during GRC, C. glabrata performs NHEJ activity at a detectable rate (>5%, while S. cerevisiae does not. Our model suggests that S. cerevisiae is more efficient at HR because NHEJ is less prevalent than in C. glabrata. This work demonstrates the determinants for GRC and that while C. glabrata has a lower efficiency of GRC, this species still provides a viable option for GRC.

  19. The fate of linear DNA in Saccharomyces cerevisiae and Candida glabrata: the role of homologous and non-homologous end joining.

    Science.gov (United States)

    Corrigan, Mary W; Kerwin-Iosue, Christine L; Kuczmarski, Alexander S; Amin, Kunj B; Wykoff, Dennis D

    2013-01-01

    In vivo assembly of plasmids has become an increasingly used process, as high throughput studies in molecular biology seek to examine gene function. In this study, we investigated the plasmid construction technique called gap repair cloning (GRC) in two closely related species of yeast - Saccharomyces cerevisiae and Candida glabrata. GRC utilizes homologous recombination (HR) activity to join a linear vector and a linear piece of DNA that contains base pair homology. We demonstrate that a minimum of 20 bp of homology on each side of the linear DNA is required for GRC to occur with at least 10% efficiency. Between the two species, we determine that S. cerevisiae is slightly more efficient at performing GRC. GRC is less efficient in rad52 deletion mutants, which are defective in HR in both species. In dnl4 deletion mutants, which perform less non-homologous end joining (NHEJ), the frequency of GRC increases in C. glabrata, whereas GRC frequency only minimally increases in S. cerevisiae, suggesting that NHEJ is more prevalent in C. glabrata. Our studies allow for a model of the fate of linear DNA when transformed into yeast cells. This model is not the same for both species. Most significantly, during GRC, C. glabrata performs NHEJ activity at a detectable rate (>5%), while S. cerevisiae does not. Our model suggests that S. cerevisiae is more efficient at HR because NHEJ is less prevalent than in C. glabrata. This work demonstrates the determinants for GRC and that while C. glabrata has a lower efficiency of GRC, this species still provides a viable option for GRC.

  20. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

  1. [Robotic surgery].

    Science.gov (United States)

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era.

  2. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ...

  3. Increasing coverage of transcription factor position weight matrices through domain-level homology.

    Directory of Open Access Journals (Sweden)

    Brady Bernard

    enable utilization of additional information sources in the study of transcription factors. The domain-level homology search method, resulting PWM mappings, web-based user interface, and web API are publicly available at http://dodoma.systemsbiology.netdodoma.systemsbiology.net.

  4. Labview utilities

    Energy Technology Data Exchange (ETDEWEB)

    2011-09-30

    The software package provides several utilities written in LabView. These utilities don't form independent programs, but rather can be used as a library or controls in other labview programs. The utilities include several new controls (xcontrols), VIs for input and output routines, as well as other 'helper'-functions not provided in the standard LabView environment.

  5. Efficacy of homologous peste des petits ruminants vaccine on sheep ...

    African Journals Online (AJOL)

    Efficacy of homologous peste des petits ruminants vaccine on sheep and goats at dengi, plateau state, Nigeria. ... Bulletin of Animal Health and Production in Africa ... The effect of homologous peste des petits ruminants vaccine (HPPRV) on flock size, morbidity and mortality in sheep and goats was determined in five ...

  6. CBH1 homologs and varian CBH1 cellulase

    Energy Technology Data Exchange (ETDEWEB)

    Goedegebuur, Frits; Gualfetti, Peter; Mitchinson, Colin; Neefe, Paulien

    2014-07-01

    Disclosed are a number of homologs and variants of Hypocrea jecorina Cel7A (formerly Trichoderma reesei cellobiohydrolase I or CBH1), nucleic acids encoding the same and methods for producing the same. The homologs and variant cellulases have the amino acid sequence of a glycosyl hydrolase of family 7A wherein one or more amino acid residues are substituted and/or deleted.

  7. Cloning and expression analysis of a LFY homologous gene in ...

    African Journals Online (AJOL)

    LEAFY (LFY) homologous genes are necessary for the transition from vegetative to reproductive development in flowering plants. The full-length cDNA of a LFY homolog was successfully isolated from floral buds of Chinese Jujube (Ziziphus jujube Mill.) by degenerate reverse transcriptase-polymerase chain reaction ...

  8. Regulation of homologous recombination at telomeres in budding yeast

    DEFF Research Database (Denmark)

    Eckert-Boulet, Nadine; Lisby, Michael

    2010-01-01

    Homologous recombination is suppressed at normal length telomere sequences. In contrast, telomere recombination is allowed when telomeres erode in the absence of telomerase activity or as a consequence of nucleolytic degradation or incomplete replication. Here, we review the mechanisms...... that contribute to regulating mitotic homologous recombination at telomeres and the role of these mechanisms in signalling short telomeres in the budding yeast Saccharomyces cerevisiae....

  9. Dynamic protein assemblies in homologous recombination with single DNA molecules

    NARCIS (Netherlands)

    van der Heijden, A.H.

    2007-01-01

    What happens when your DNA breaks? This thesis describes experimental work on the single-molecule level focusing on the interaction between DNA and DNA-repair proteins, in particular bacterial RecA and human Rad51, involved in homologous recombination. Homologous recombination and its central event

  10. Homology modelling and spectroscopy, a never-ending love story.

    NARCIS (Netherlands)

    Venselaar, H.; Joosten, R.P.; Vroling, B.; Baakman, C.A.; Hekkelman, M.L.; Krieger, E.; Vriend, G.

    2010-01-01

    Homology modelling is normally the technique of choice when experimental structure data are not available but three-dimensional coordinates are needed, for example, to aid with detailed interpretation of results of spectroscopic studies. Herein, the state of the art of homology modelling will be

  11. FBH1 helicase disrupts RAD51 filaments in vitro and modulates homologous recombination in mammalian cells

    DEFF Research Database (Denmark)

    Simandlova, Jitka; Zagelbaum, Jennifer; Payne, Miranda J

    2013-01-01

    Efficient repair of DNA double strand breaks and interstrand cross-links requires the homologous recombination (HR) pathway, a potentially error-free process that utilizes a homologous sequence as a repair template. A key player in HR is RAD51, the eukaryotic ortholog of bacterial RecA protein. RAD....... Using a combination of molecular genetic, biochemical, and single-molecule biophysical techniques, we provide mechanistic insight into the mode of action of the FBH1 helicase as a regulator of RAD51-dependent HR in mammalian cells. We show that FBH1 binds directly to RAD51 and is able to disrupt RAD51...... filaments on DNA through its ssDNA translocase function. Consistent with this, a mutant mouse embryonic stem cell line with a deletion in the FBH1 helicase domain fails to limit RAD51 chromatin association and shows hyper-recombination. Our data are consistent with FBH1 restraining RAD51 DNA binding under...

  12. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  13. Statistical Inference for Porous Materials using Persistent Homology.

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Chul [Univ. of Georgia, Athens, GA (United States); Heath, Jason E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mitchell, Scott A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-12-01

    We propose a porous materials analysis pipeline using persistent homology. We rst compute persistent homology of binarized 3D images of sampled material subvolumes. For each image we compute sets of homology intervals, which are represented as summary graphics called persistence diagrams. We convert persistence diagrams into image vectors in order to analyze the similarity of the homology of the material images using the mature tools for image analysis. Each image is treated as a vector and we compute its principal components to extract features. We t a statistical model using the loadings of principal components to estimate material porosity, permeability, anisotropy, and tortuosity. We also propose an adaptive version of the structural similarity index (SSIM), a similarity metric for images, as a measure to determine the statistical representative elementary volumes (sREV) for persistence homology. Thus we provide a capability for making a statistical inference of the uid ow and transport properties of porous materials based on their geometry and connectivity.

  14. Estimating Utility

    DEFF Research Database (Denmark)

    Arndt, Channing; Simler, Kenneth R.

    2010-01-01

    an information-theoretic approach to estimating cost-of-basic-needs (CBN) poverty lines that are utility consistent. Applications to date illustrate that utility-consistent poverty measurements derived from the proposed approach and those derived from current CBN best practices often differ substantially...

  15. Television Utilization.

    Science.gov (United States)

    Dobosh, O.; Wright, E. N.

    The utilization of educational television (ETV) in schools can be ascertained by considering the teacher training in ETV, the extent of access to ETV, the student reaction, and the programing. Using a questionnaire survey method combined with detailed ETV logs, this study was able to analyze both ETV and film utilization in 13 elementary and…

  16. Genetic probing of homologous recombination and non-homologous end joining during meiotic prophase in irradiated mouse spermatocytes.

    NARCIS (Netherlands)

    Ahmed, E.A.; Philippens, M.E.P.; Kal, H.B.; Rooij, D.G. de; Boer, P. de

    2010-01-01

    This study was designed to obtain a better insight into the relative contribution of homologous recombination (HR) and non-homologous end joining (NHEJ) to the repair of radiation-induced DNA double-strand breaks (DSBs) at first meiotic prophase. Early and late pachytene and early diplotene

  17. Robotic surgery.

    Science.gov (United States)

    Diana, M; Marescaux, J

    2015-01-01

    Proficiency in minimally invasive surgery requires intensive and continuous training, as it is technically challenging for unnatural visual and haptic perceptions. Robotic and computer sciences are producing innovations to augment the surgeon's skills to achieve accuracy and high precision during complex surgery. This article reviews the current use of robotically assisted surgery, focusing on technology as well as main applications in digestive surgery, and future perspectives. The PubMed database was interrogated to retrieve evidence-based data on surgical applications. Internal and external consulting with key opinion leaders, renowned robotics laboratories and robotic platform manufacturers was used to produce state-of-the art business intelligence around robotically assisted surgery. Selected digestive procedures (oesophagectomy, gastric bypass, pancreatic and liver resections, rectal resection for cancer) might benefit from robotic assistance, although the current level of evidence is insufficient to support widespread adoption. The surgical robotic market is growing, and a variety of projects have recently been launched at both academic and corporate levels to develop lightweight, miniaturized surgical robotic prototypes. The magnified view, and improved ergonomics and dexterity offered by robotic platforms, might facilitate the uptake of minimally invasive procedures. Image guidance to complement robotically assisted procedures, through the concepts of augmented reality, could well represent a major revolution to increase safety and deal with difficulties associated with the new minimally invasive approaches. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  18. Robotic assisted minimally invasive surgery

    Directory of Open Access Journals (Sweden)

    Palep Jaydeep

    2009-01-01

    Full Text Available The term "robot" was coined by the Czech playright Karel Capek in 1921 in his play Rossom′s Universal Robots. The word "robot" is from the check word robota which means forced labor.The era of robots in surgery commenced in 1994 when the first AESOP (voice controlled camera holder prototype robot was used clinically in 1993 and then marketed as the first surgical robot ever in 1994 by the US FDA. Since then many robot prototypes like the Endoassist (Armstrong Healthcare Ltd., High Wycombe, Buck, UK, FIPS endoarm (Karlsruhe Research Center, Karlsruhe, Germany have been developed to add to the functions of the robot and try and increase its utility. Integrated Surgical Systems (now Intuitive Surgery, Inc. redesigned the SRI Green Telepresence Surgery system and created the daVinci Surgical System ® classified as a master-slave surgical system. It uses true 3-D visualization and EndoWrist ® . It was approved by FDA in July 2000 for general laparoscopic surgery, in November 2002 for mitral valve repair surgery. The da Vinci robot is currently being used in various fields such as urology, general surgery, gynecology, cardio-thoracic, pediatric and ENT surgery. It provides several advantages to conventional laparoscopy such as 3D vision, motion scaling, intuitive movements, visual immersion and tremor filtration. The advent of robotics has increased the use of minimally invasive surgery among laparoscopically naοve surgeons and expanded the repertoire of experienced surgeons to include more advanced and complex reconstructions.

  19. Over surgery in breast cancer.

    Science.gov (United States)

    MacNeill, Fiona; Karakatsanis, Andreas

    2017-02-01

    Breast surgery remains the original and most effective 'targeted' therapy: excision of early cancer is curative and for more advanced disease surgery improves local disease control. However in well intentioned pursuit of cure and local disease control, some cancers are over-treated resulting in major physical and emotional morbidity. Less breast surgery is safe, as evidenced by steady reductions in mortality and local recurrence; earlier diagnosis and widespread use of systemic therapies and radiotherapy have allowed more conservative surgery. As tumour biology dictates cancer outcomes not surgery extent, surgery can safely be 'minimum required' rather than 'more is better' with the focus on removal of disease rather than healthy tissue. Surgeons can reduce the burden of surgery further but it is important that less surgery is not over-compensated by more radical or unnecessary systemic therapies and/or radiotherapy with their own toxicities and morbidity. We all need to be alert to the potential drivers of over treatment and over surgery such as failure to work within a multidisciplinary team, failure to design a multimodality treatment plan at diagnosis or overuse of novel assessment technologies of uncertain clinical utility. Pursuit of wide margins and the removal of the contra-lateral healthy breast for marginal risk-reduction gains are also to be discouraged as is routine local/regional surgery in stage 4 disease. The surgeon has a pivotal role in minimizing breast surgery to what is required to achieve the best oncological, functional and aesthetic outcomes. Copyright © 2016. Published by Elsevier Ltd.

  20. Metabolic Surgery

    DEFF Research Database (Denmark)

    Pareek, Manan; Schauer, Philip R; Kaplan, Lee M

    2018-01-01

    The alarming rise in the worldwide prevalence of obesity is paralleled by an increasing burden of type 2 diabetes mellitus. Metabolic surgery is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Randomized trials have recently shown the superio......The alarming rise in the worldwide prevalence of obesity is paralleled by an increasing burden of type 2 diabetes mellitus. Metabolic surgery is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Randomized trials have recently shown...... the superiority of surgery over medical treatment alone in achieving improved glycemic control, as well as a reduction in cardiovascular risk factors. The mechanisms seem to extend beyond the magnitude of weight loss alone and include improvements in incretin profiles, insulin secretion, and insulin sensitivity...

  1. Intestinal Surgery.

    Science.gov (United States)

    Desrochers, André; Anderson, David E

    2016-11-01

    A wide variety of disorders affecting the intestinal tract in cattle may require surgery. Among those disorders the more common are: intestinal volvulus, jejunal hemorrhage syndrome and more recently the duodenal sigmoid flexure volvulus. Although general principles of intestinal surgery can be applied, cattle has anatomical and behavior particularities that must be known before invading the abdomen. This article focuses on surgical techniques used to optimize outcomes and discusses specific disorders of small intestine. Diagnoses and surgical techniques presented can be applied in field conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Homologous recombination in bovine pestiviruses. Phylogenetic and statistic evidence.

    Science.gov (United States)

    Jones, Leandro Roberto; Weber, E Laura

    2004-12-01

    Bovine pestiviruses (Bovine Viral Diarrea Virus 1 (BVDV 1) and Bovine Viral Diarrea Virus 2 (BVDV 2)) belong to the genus Pestivirus (Flaviviridae), which is composed of positive stranded RNA viruses causing significant economic losses world-wide. We used phylogenetic and bootstrap analyses to systematically scan alignments of previously sequenced genomes in order to explore further the evolutionary mechanisms responsible for variation in the virus. Previously published data suggested that homologous crossover might be one of the mechanisms responsible for the genomic rearrangements observed in cytopathic (cp) strains of bovine pestiviruses. Nevertheless, homologous recombination involves not just homologous crossovers, but also replacement of a homologous region of the acceptor RNA. Furthermore, cytopathic strains represent dead paths in evolution, since they are isolated exclusively from the fatal cases of mucosal disease. Herein, we report evidence of homologous inter-genotype recombination in the genome of a non-cytopathic (ncp) strain of Bovine Viral Diarrea Virus 1, the type species of the genus Pestivirus. We also show that intra-genotype homologous recombination might be a common phenomenon in both species of Pestivirus. This evidence demonstrates that homologous recombination contribute to the diversification of bovine pestiviruses in nature. Implications for virus evolution, taxonomy and phylogenetics are discussed.

  3. Cataract surgery after refractive surgery.

    Science.gov (United States)

    Naseri, Ayman; McLeod, Stephen D

    2010-01-01

    To review recent contributions addressing the challenge of intraocular lens (IOL) calculation in patients undergoing cataract extraction following corneal refractive surgery. Although several articles have provided excellent summaries of IOL selection in patients wherein prerefractive surgery data are available, numerous authors have recently described approaches to attempt more accurate IOL power calculations for patients who present with no reliable clinical information regarding their refractive history. Additionally, results have been reported using the Scheimpflug camera system to measure corneal power in an attempt to resolve the most important potential source of error for IOL determination in these patients. IOL selection in patients undergoing cataract surgery after corneal refractive surgery continues to be a challenging and complex issue despite numerous strategies and formulas described in the literature. Current focus seems to be directed toward approaches that do not require preoperative refractive surgery information. Due to the relative dearth of comparative clinical outcomes data, the optimal solution to this ongoing clinical problem has yet to be determined. Until such data are available, many cataract surgeons compare the results of multiple formulas to assist them in IOL selection for these patients.

  4. The history of the homology concept and the "Phylogenetisches Symposium".

    Science.gov (United States)

    Hossfeld, Uwe; Olsson, Lennart

    2005-11-01

    The homology concept has had a long and varied history, starting out as a geometrical term in ancient Greece. Here we describe briefly how a typological use of homology to designate organs and body parts in the same position anatomically in different organisms was changed by Darwin's theory of evolution into a phylogenetic concept. We try to indicate the diversity of opinions on how to define and test for homology that has prevailed historically, before the important books by Hennig (1950. Grundzüge einer Theorie der Phylogenetischen Systematik. Deutscher Zentralverlag, Berlin) and Remane (1952. Die Grundlagen des Natürlichen Systems, der Vergleichenden Anatomie und der Phylogenetik. Geest & Portig, Leipzig) brought more rigor into both the debate on homology and into the usage of the term homology among systematists. Homology as a theme has recurred repeatedly throughout the history of the "Phylogenetisches Symposium" and we give a very brief overview of the different aspects of homology that have been discussed at specific symposia over the last 48 years. We also honour the fact that the 2004 symposium was held in Jena by pointing to the roles played by biologists active in Jena, such as Ernst Haeckel and Carl Gegenbaur, in starting the development towards a homology concept concordant with an evolutionary world view. As historians of biology, we emphasize the importance of major treatises on homology and its history that may be little read by systematists active today, and have sometimes also received less attention by historians of biology than they deserve. Prominent among these are the works of Dietrich Starck, who also happened to be both a student, and later a benefactor, of systematics at Jena University.

  5. Importing the homology concept from biology into developmental psychology.

    Science.gov (United States)

    Moore, David S

    2013-01-01

    To help introduce the idea of homology into developmental psychology, this article presents some of the concepts, distinctions, and guidelines biologists and philosophers of biology have devised to study homology. Some unresolved issues related to this idea are considered as well. Because homology reflects continuity across time, developmental scientists should find this concept to be useful in the study of psychological/behavioral development, just as biologists have found it essential in the study of the evolution and development of morphological and other characteristics. Copyright © 2012 Wiley Periodicals, Inc.

  6. Recent advances in urologic laparoscopic surgeries: laparoendoscopic single-site surgery, natural orifice transluminal endoscopic surgery, robotics and navigation.

    Science.gov (United States)

    Matsuda, Tadashi

    2013-05-01

    Laparoscopic surgery was developed at the end of the 1980s and has been utilized in almost all urologic surgical procedures. It offers the benefits of less invasiveness and earlier recovery than open surgery. The introduction of laparoendoscopic single-site surgery has offered reduced pain and improved cosmetic satisfaction to patients. Scarless nephrectomy has been realized with transvaginal natural orifice transluminal endoscopic surgery in women. The development of surgical robots has decreased the technical difficulty of complicated procedures, shortened the learning curve, and improved perioperative outcomes relative to laparoscopic surgery. Surgical navigation using real-time sonography, augmented reality, fluorescence, or radioisotope images will improve the quality of these surgeries. © 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  7. GENERAL SURGERY

    African Journals Online (AJOL)

    body temperature to derive an equation for the purpose of predicting mortality in damage control surgery. It was shown to ... equation to have 100% positive predictive value (PPV) for both datasets and 24% sensitivity. The aim of the study was to .... predictive systems assess average, and not individual, risk. Increasing the ...

  8. PAEDIATRIC SURGERY

    African Journals Online (AJOL)

    Background: The management of cystic lymphangiomas is and challenging. Of all the available modalities of treatment, surgery remains the gold standard but it is associated with significant morbidity and mortality. Method: Retrospective analysis of 28 cases of cystic lymphangioma seen at the. Obafemi Awolowo University ...

  9. GENERAL SURGERY

    African Journals Online (AJOL)

    At Surgery she had a floating gall bladder with the fundus at the left side of __the porta hepatis due to adhesions attached to the Hartmann ' s pouch. A choiecystectomy was performed, then a choledochotomy was madci in etwcen 2 stay sutures of 3—0 silk” The. Chi) stones were removed with. Dcsjardin forceps, irrigation ...

  10. ARQIOTHORACIC SURGERY

    African Journals Online (AJOL)

    Key words: Palliative surgery, transposition, great arteries. Introduction. Transposition 'ol' the great arteries (TGA) was first observed by Sterro in 1672l and was subsequently described by Morgagni. (1761) 2 and Baille (r797). '1 in this severe congenital cyanotic heart disease, the aorta arises from the right ventricle and the ...

  11. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard

    2009-01-01

    ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in...

  12. PAEDIATRIC SURGERY

    African Journals Online (AJOL)

    examination of the abdomen at four specific locations: the right upper quandrant, left upper quadrant, suprapubic area. Role of focused assessment with sonography for trauma as a screening tool for blunt abdominal trauma in young children after high energy trauma. PAEDIATRIC SURGERY. W Tummers,1 J van Schuppen ...

  13. GENERAL SURGERY

    African Journals Online (AJOL)

    services at public hospitals across the country are currently delivered by IMGs.6 Although some IMGs wish to stay on in the hope of entering ... accredited by the Health Professions Council of South Africa. (HPCSA), the national regulatory authority for medical licensing. The general surgery registrar programme lasts for a.

  14. GENERAL SURGERY

    African Journals Online (AJOL)

    within surgical societies, where mentors and role models have a significant impact on ..... al.12 suggested that although women have high self-efficacy in surgery, they .... Ling M, Young CJ, Shepherd HL, Mak C, Saw RPM. Workplace bullying ...

  15. GENERAL SURGERY

    African Journals Online (AJOL)

    intraperitoneal space, and infrequently at other sites.2-13. The traditional operative approach is an open surgical one to drain the cysts and remove their germinal layer by either controlled evacuation of the cystic cavity or resectional surgery. Since the first laparoscopic treatment of hydatid disease was described in 1992,14 ...

  16. TRAUMA SURGERY

    African Journals Online (AJOL)

    of shock and who require “damage control” surgery are more likely to suffer a worse outcome, particularly when multiple physiological derangements .... Gun shot. 13. 15. Shot gun. 0. 1. Level of injury. Infrarenal. 11. 7. 0.248. Juxtarenal. 2. 7. Suprarenal. 2. 1. Retrohepatic. 2. 2. Trauma scores. RTS (mean). 7.28. 6.44. 0.095.

  17. Arthroscopic Surgery.

    Science.gov (United States)

    Connors, G. Patrick

    Arthroscopic surgery (or microsurgery) is a significant breakthrough in treating knee injuries. Its applications range from basic diagnosis to arthroscopic menisectomy, although its use in some procedures is still highly controversial. Many surgeons perform the diagnostic procedure, but follow this with the conventional surgical approach.…

  18. Missionary surgery.

    Science.gov (United States)

    Naylor, Rebekah

    2010-02-01

    A career in missionary surgery offers professional challenge, much opportunity, and high job satisfaction. Preparation, financial support, job requirements, and difficulties are issues to be considered. However, these are secondary in the context of seeing needy people made whole physically and spiritually. Copyright 2010 Elsevier Inc. All rights reserved.

  19. Controversies in gynaecologic endoscopic surgery

    NARCIS (Netherlands)

    Darwish, A.M.M.

    2009-01-01

    Despite the widespread utilization of assisted reproductive techniques in recent years, hysteroscopic as well as laparoscopic surgery should be firstly offered for patients with adnexal and uterine lesions desiring fertility. Permanent correction of the patient’s problem with frequent chances of

  20. Transplante de córnea com uso inadvertido de córnea de doador previamente submetido à cirurgia refrativa: relato de caso Corneal transplant utilizing a corneal graft that had undergone laser surgery: case report

    Directory of Open Access Journals (Sweden)

    Roberta Jansen de Mello Farias

    2005-04-01

    Full Text Available Relato de caso de paciente atendido no Departamento de Córnea do Hospital Oftalmológico de Sorocaba e submetido a transplante penetrante de córnea para correção de ceratocone no olho esquerdo. Foi utilizada córnea doadora previamente submetida a LASIK. A cirurgia foi completada sem intercorrências, embora durante o ato cirúrgico o cirurgião tenha percebido que havia um "flap" no botão doador. O paciente está no 6º mês pós-operatório com visão de 20/40 com correção. O PAM era de 20/40. Há epitélio na interface superior do "flap" sem sinais de progressão. Devem-se procurar novos métodos de avaliação de córneas doadoras; a utilização inadvertida de córnea doadora submetida a LASIK não interferiu até o 6º mês pós-operatório no resultado final do transplante; acompanhamento prolongado é necessário para avaliar a transparência e evolução da ceratometria e erro refracional deste transplante a longo prazo.Report on a successful clinical case of a corneal penetrating keratoplasty using inadvertently a corneal graft that had undergone laser assisted in situ keratomileusis (LASIK. Review of a clinical case of a patient of the Cornea Department of the "Hospital Oftalmológico de Sorocaba" who underwent a penetrating keratoplasty (PK to correct keratoconus in his left eye. A corneal graft from a donor who had LASIK surgery was used. Surgery was completed without complications, although a separation of the corneal lamellae was noted during surgery. Patient evolution was good with a final corrected visual acuity of 20/40. PAM was also 20/40. Epithelial growth was noticed on the flap interface, although, without progression of this finding. Eye Banks should improve screening techniques to rule out refractive surgery in the donor corneas; there was no impairment of the final result of this transplant until the 6th month after surgery; long-term follow-up is necessary to reveal if surgical success was impaired by prior

  1. Germline progenitors escape the widespread phenomenon of homolog pairing during Drosophila development.

    Directory of Open Access Journals (Sweden)

    Eric F Joyce

    Full Text Available Homolog pairing, which plays a critical role in meiosis, poses a potential risk if it occurs in inappropriate tissues or between nonallelic sites, as it can lead to changes in gene expression, chromosome entanglements, and loss-of-heterozygosity due to mitotic recombination. This is particularly true in Drosophila, which supports organismal-wide pairing throughout development. Discovered over a century ago, such extensive pairing has led to the perception that germline pairing in the adult gonad is an extension of the pairing established during embryogenesis and, therefore, differs from the mechanism utilized in most species to initiate pairing specifically in the germline. Here, we show that, contrary to long-standing assumptions, Drosophila meiotic pairing in the gonad is not an extension of pairing established during embryogenesis. Instead, we find that homologous chromosomes are unpaired in primordial germ cells from the moment the germline can be distinguished from the soma in the embryo and remain unpaired even in the germline stem cells of the adult gonad. We further establish that pairing originates immediately after the stem cell stage. This pairing occurs well before the initiation of meiosis and, strikingly, continues through the several mitotic divisions preceding meiosis. These discoveries indicate that the spatial organization of the Drosophila genome differs between the germline and the soma from the earliest moments of development and thus argue that homolog pairing in the germline is an active process as versus a passive continuation of pairing established during embryogenesis.

  2. ATR inhibition preferentially targets homologous recombination-deficient tumor cells

    NARCIS (Netherlands)

    Krajewska, M.; Fehrmann, R. S. N.; Schoonen, P. M.; Labib, S.; de Vries, E. G. E.; Franke, L.; van Vugt, M. A. T. M.

    Homologous recombination (HR) is required for faithful repair of double-strand DNA breaks. Defects in HR repair cause severe genomic instability and challenge cellular viability. Paradoxically, various cancers are HR defective and have apparently acquired characteristics to survive genomic

  3. Substrate and Cation Binding Mechanism of Glutamate Transporter Homologs

    NARCIS (Netherlands)

    Jensen, Sonja

    2017-01-01

    Glutamate transporters and their homologs are membrane proteins that transport glutamate and aspartate together with sodium ions and/or protons. Human glutamate transporters remove the neurotransmitter glutamate after signal transmission. Therefore, glutamate transporters play a great role in

  4. Homology of normal chains and cohomology of charges

    CERN Document Server

    Pauw, Th De; Pfeffer, W F

    2017-01-01

    The authors consider a category of pairs of compact metric spaces and Lipschitz maps where the pairs satisfy a linearly isoperimetric condition related to the solvability of the Plateau problem with partially free boundary. It includes properly all pairs of compact Lipschitz neighborhood retracts of a large class of Banach spaces. On this category the authors define homology and cohomology functors with real coefficients which satisfy the Eilenberg-Steenrod axioms, but reflect the metric properties of the underlying spaces. As an example they show that the zero-dimensional homology of a space in our category is trivial if and only if the space is path connected by arcs of finite length. The homology and cohomology of a pair are, respectively, locally convex and Banach spaces that are in duality. Ignoring the topological structures, the homology and cohomology extend to all pairs of compact metric spaces. For locally acyclic spaces, the authors establish a natural isomorphism between their cohomology and the �...

  5. Robotic surgery in pediatric urology

    Directory of Open Access Journals (Sweden)

    Adam Howe

    2017-01-01

    Full Text Available While robotic surgery has shown clear utility and advantages in the adult population, its role in pediatrics remains controversial. Pediatric-sized robotic instruments and equipment are not readily available yet, so certain modifications can be made in order to make robotic surgery successful in children. While the cost of robotic surgery remains high compared to open procedures, patients experience greater satisfaction and quality of life with robotic surgery. Robotic pyeloplasty is a standard of care in older children, and has even been performed in infants and re-do surgery. Other robotic procedures performed in children include heminephroureterectomy, ureteroureterostomy, ureteral reimplantation, urachal cyst excision, bladder diverticulectomy, and bladder reconstructive procedures such as augmentation, appendicovesicostomy, antegrade continence enema, bladder neck reconstruction and sling, as well as other procedures. Robotic surgery has also been used in oncologic cases such as partial nephrectomy and retroperitoneal lymph node dissection. Future improvements in technology with production of pediatric-sized robotic instruments, along with increases in robotic-trained pediatric urologists and surgeon experience along each's learning curve, will help to further advance the field of robotic surgery in pediatric urology.

  6. Cosmetic surgery training in Canadian plastic surgery residencies: are we training competent surgeons?

    Science.gov (United States)

    Chivers, Quinton J; Ahmad, Jamil; Lista, Frank; Warren, Richard J; Arkoubi, Amr Y; Mahabir, Raman C; Murray, Kenneth A; Islur, Avinash

    2013-01-01

    With the demand for cosmetic surgery continuing to rise, it is necessary to reevaluate the current state of cosmetic surgery training during plastic surgery residency. An evaluation of cosmetic surgery training in US plastic surgery residency programs in 2006 identified several areas for improvement, resulting in changes to both the duration and content of training. The authors assess the current state of cosmetic surgery training in Canadian plastic surgery residency programs. A paper survey of all graduating Canadian plastic surgery residents eligible to complete the 2009 Royal College of Physicians and Surgeons of Canada fellowship examinations was performed (N = 29). The survey was conducted primarily at the Canadian Plastic Surgery Review Course in February 2009, with surveys collected from absent residents by e-mail within 1 month after the course. The survey covered 2 broad areas: (1) specifics regarding resident cosmetic surgery training and (2) confidence and satisfaction associated with this experience. Of the 29 residents surveyed, 28 responded (96%). The majority of Canadian plastic surgery residency programs (75%) have a designated cosmetic surgery rotation, but 90% of respondents felt it has become increasingly difficult to gain exposure to cosmetic procedures as most are performed at private surgery centers. Elective rotations at cosmetic surgery practices and resident cosmetic clinics were considered the most beneficial for cosmetic surgery education. Residents considered cosmetic surgery procedures of the face (such as rhinoplasty and facelift) more challenging, but they had more confidence with breast and body contouring procedures. Canadian plastic surgery residency programs need to ensure that residents continue to receive comprehensive exposure to both surgical and nonsurgical cosmetic procedures to ensure our specialty's continued leadership in this evolving and highly competitive field. A multidimensional approach utilizing a variety of

  7. Targeted recombination between homologous chromosomes for precise breeding in tomato

    OpenAIRE

    Filler Hayut, Shdema; Melamed Bessudo, Cathy; Levy, Avraham A

    2017-01-01

    Homologous recombination (HR) between parental chromosomes occurs stochastically. Here, we report on targeted recombination between homologous chromosomes upon somatic induction of DNA double-strand breaks (DSBs) via CRISPR-Cas9. We demonstrate this via a visual and molecular assay whereby DSB induction between two alleles carrying different mutations in the PHYTOENE SYNTHASE (PSY1) gene results in yellow fruits with wild type red sectors forming via HR-mediated DSB repair. We also show that ...

  8. The structure of information: from probability to homology

    OpenAIRE

    Vigneaux, Juan Pablo

    2017-01-01

    D. Bennequin and P. Baudot introduced a cohomological construction adapted to information theory, called "information cohomology" (see "The homological nature of Entropy", 2015). Our text serves as a detailed introduction to information cohomology, containing the necessary background in probability theory and homological algebra. It makes explicit the link with topos theory, as introduced by Grothendieck, Verdier and their collaborators in the SGA IV. It also contains several new construction...

  9. Metagenomic gene annotation by a homology-independent approach

    Energy Technology Data Exchange (ETDEWEB)

    Froula, Jeff; Zhang, Tao; Salmeen, Annette; Hess, Matthias; Kerfeld, Cheryl A.; Wang, Zhong; Du, Changbin

    2011-06-02

    Fully understanding the genetic potential of a microbial community requires functional annotation of all the genes it encodes. The recently developed deep metagenome sequencing approach has enabled rapid identification of millions of genes from a complex microbial community without cultivation. Current homology-based gene annotation fails to detect distantly-related or structural homologs. Furthermore, homology searches with millions of genes are very computational intensive. To overcome these limitations, we developed rhModeller, a homology-independent software pipeline to efficiently annotate genes from metagenomic sequencing projects. Using cellulases and carbonic anhydrases as two independent test cases, we demonstrated that rhModeller is much faster than HMMER but with comparable accuracy, at 94.5percent and 99.9percent accuracy, respectively. More importantly, rhModeller has the ability to detect novel proteins that do not share significant homology to any known protein families. As {approx}50percent of the 2 million genes derived from the cow rumen metagenome failed to be annotated based on sequence homology, we tested whether rhModeller could be used to annotate these genes. Preliminary results suggest that rhModeller is robust in the presence of missense and frameshift mutations, two common errors in metagenomic genes. Applying the pipeline to the cow rumen genes identified 4,990 novel cellulases candidates and 8,196 novel carbonic anhydrase candidates.In summary, we expect rhModeller to dramatically increase the speed and quality of metagnomic gene annotation.

  10. Urate-responsive MarR homologs from Burkholderia.

    Science.gov (United States)

    Grove, Anne

    2010-11-01

    The genus Burkholderia includes a large number of species, some of which are serious human pathogens. A genomic locus is conserved that consists of a gene encoding a member of the multiple antibiotic resistance regulator (MarR) family of transcriptional regulators and a divergently oriented gene encoding a major facilitator transport protein (MFTP), a predicted membrane efflux pump. Homology modeling shows that the MarR homolog conserves the location of four conserved amino acid residues previously shown to bind the ligand urate in the Deinococcus radiodurans-encoded MarR homolog HucR. Analysis of the B. thailandensis-encoded homolog shows that its specific DNA binding to two adjacent sites in the intergenic region between the genes encoding the transcription factor and the MFTP is attenuated by urate and to a lesser extent by xanthine and hypoxanthine, but not by adenine or the product of urate degradation, allantoin. These data suggest the existence of a four amino acid urate-binding signature in a subset of MarR homologs, and that homologs bearing this signature will respond to the ligand urate by attenuated DNA binding. The location of binding sites predicts regulation of the MFTP and prompts a proposal to name the cognate transcription factor MftR (major facilitator transport regulator).

  11. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Dental and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the ... Dental and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the ...

  12. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Craniofacial Surgery A cleft lip may require one or more surgeries depending on the extent of ... and Craniofacial Surgery A cleft lip may require one or more surgeries depending on the extent of ...

  13. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ...

  14. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the soft tissues ... and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the soft tissues ...

  15. Tennis elbow surgery - discharge

    Science.gov (United States)

    Lateral epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... Soon after surgery, severe pain will decrease, but you may have mild soreness for 3 to 6 months.

  16. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  17. Heart bypass surgery

    Science.gov (United States)

    Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

  18. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ...

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Corrective Jaw Surgery Dental and Soft Tissue Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures ...

  20. Orthognathic Surgery

    DEFF Research Database (Denmark)

    Kjærgaard Larsen, Marie; Thygesen, Torben Henrik

    2016-01-01

    The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence...... to sex, age, and somatosensory change. High satisfaction and improvement in facial esthetic after OS were seen. Young patients (16-25 years) and men indicated a higher degree of satisfaction than old (>25 years) patients and women. The use of social media seems to be an interesting platform...... on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were...

  1. Telerobotic surgery

    Directory of Open Access Journals (Sweden)

    Prokar Dasgupta

    2005-01-01

    Full Text Available With continued advances in medical robotic technology and global telecommunications, the concept of remote telerobotic surgery continues to develop. The ultimate goal of an experienced specialist operating remotely using a robot controlled by high-speed audiovisual connections has been shown to be feasible but is limited by local resources and a lack of evidence from randomised controlled trials. This article looks at the development of this exciting field and its impact on modern urology.

  2. The feasibility and physiological aspects of anesthesia and surgery without homologous blood transfusion

    NARCIS (Netherlands)

    R. Lapin (Ronny)

    1983-01-01

    textabstractThe modern practice of medicine has an ever-increasing dependency on the blood bank industry. Indeed, on many occasions there is an unwarranted and inappropriate use of hemotherapy. The first recorded blood transfusion was given to Pope Innocent VIII in 1492 (Narengo-Rowe, 1982). three

  3. Robotic assisted andrological surgery

    Science.gov (United States)

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE). PMID:23241637

  4. Quantifying innovation in surgery.

    Science.gov (United States)

    Hughes-Hallett, Archie; Mayer, Erik K; Marcus, Hani J; Cundy, Thomas P; Pratt, Philip J; Parston, Greg; Vale, Justin A; Darzi, Ara W

    2014-08-01

    The objectives of this study were to assess the applicability of patents and publications as metrics of surgical technology and innovation; evaluate the historical relationship between patents and publications; develop a methodology that can be used to determine the rate of innovation growth in any given health care technology. The study of health care innovation represents an emerging academic field, yet it is limited by a lack of valid scientific methods for quantitative analysis. This article explores and cross-validates 2 innovation metrics using surgical technology as an exemplar. Electronic patenting databases and the MEDLINE database were searched between 1980 and 2010 for "surgeon" OR "surgical" OR "surgery." Resulting patent codes were grouped into technology clusters. Growth curves were plotted for these technology clusters to establish the rate and characteristics of growth. The initial search retrieved 52,046 patents and 1,801,075 publications. The top performing technology cluster of the last 30 years was minimally invasive surgery. Robotic surgery, surgical staplers, and image guidance were the most emergent technology clusters. When examining the growth curves for these clusters they were found to follow an S-shaped pattern of growth, with the emergent technologies lying on the exponential phases of their respective growth curves. In addition, publication and patent counts were closely correlated in areas of technology expansion. This article demonstrates the utility of publically available patent and publication data to quantify innovations within surgical technology and proposes a novel methodology for assessing and forecasting areas of technological innovation.

  5. Regeneration of periapical lesions post-endodontic treatment and periapical surgeries in experimental animals utilizing thermo-responsive nano-β-tricalcium phosphate/chitosan hydrogel: a proof of concept.

    Science.gov (United States)

    Abdel-Fattah, Wafa I; El Ashry, Salma Hassan; Ali, Ghareib W; Hamid, Mohamed Aiad Abdel; El-Din, Amina Gamal; El-Ashry, Bassma

    2017-07-05

    Using phosphate nanoparticles/polymeric hydrogels presents an interesting approach, especially concerning the reduced particle migration and enhanced biocompatibility. The current work aims to achieve a proof of concept for the development of a thermo-sensitive nano β-tricalcium phosphate (β-TCP)/chitosan (Cs)/glycerophosphate (Gl)/glyoxal (Gly) hydrogel to be applied in periapical surgeries post endodontic treatment. Physicochemical characterization using x-ray powder diffraction, Fourier transform infrared, TEM and SEM was performed. Bone formation efficiency of the achieved β-TCP/Cs/Gl/Gly hydrogel was followed. The composite gels were tested in vivo in dogs in comparison with the commercially available and surgically applied Klipdent-PL® up to three months. Radiographic examinations were performed. Histological evaluations were achieved through histomorphological criteria being apical cementum surface, bone tissue resorption, apical PDL thickness, the intensity of inflammatory reaction and osseous repair. The cytotoxicity results proved the safety of the developed hydrogel. The thermo-sensitive hydrogel possessed comparable enhanced biocompatibility with anti-inflammatory activity. New bone formation was clearly enhanced in the infected teeth. Therefore, it can be directly applied in specific non-invasive dental surgeries.

  6. Multiscale analysis of nonlinear systems using computational homology

    Energy Technology Data Exchange (ETDEWEB)

    Konstantin Mischaikow, Rutgers University/Georgia Institute of Technology, Michael Schatz, Georgia Institute of Technology, William Kalies, Florida Atlantic University, Thomas Wanner,George Mason University

    2010-05-19

    This is a collaborative project between the principal investigators. However, as is to be expected, different PIs have greater focus on different aspects of the project. This report lists these major directions of research which were pursued during the funding period: (1) Computational Homology in Fluids - For the computational homology effort in thermal convection, the focus of the work during the first two years of the funding period included: (1) A clear demonstration that homology can sensitively detect the presence or absence of an important flow symmetry, (2) An investigation of homology as a probe for flow dynamics, and (3) The construction of a new convection apparatus for probing the effects of large-aspect-ratio. (2) Computational Homology in Cardiac Dynamics - We have initiated an effort to test the use of homology in characterizing data from both laboratory experiments and numerical simulations of arrhythmia in the heart. Recently, the use of high speed, high sensitivity digital imaging in conjunction with voltage sensitive fluorescent dyes has enabled researchers to visualize electrical activity on the surface of cardiac tissue, both in vitro and in vivo. (3) Magnetohydrodynamics - A new research direction is to use computational homology to analyze results of large scale simulations of 2D turbulence in the presence of magnetic fields. Such simulations are relevant to the dynamics of black hole accretion disks. The complex flow patterns from simulations exhibit strong qualitative changes as a function of magnetic field strength. Efforts to characterize the pattern changes using Fourier methods and wavelet analysis have been unsuccessful. (4) Granular Flow - two experts in the area of granular media are studying 2D model experiments of earthquake dynamics where the stress fields can be measured; these stress fields from complex patterns of 'force chains' that may be amenable to analysis using computational homology. (5) Microstructure

  7. Multiscale analysis of nonlinear systems using computational homology

    Energy Technology Data Exchange (ETDEWEB)

    Konstantin Mischaikow; Michael Schatz; William Kalies; Thomas Wanner

    2010-05-24

    This is a collaborative project between the principal investigators. However, as is to be expected, different PIs have greater focus on different aspects of the project. This report lists these major directions of research which were pursued during the funding period: (1) Computational Homology in Fluids - For the computational homology effort in thermal convection, the focus of the work during the first two years of the funding period included: (1) A clear demonstration that homology can sensitively detect the presence or absence of an important flow symmetry, (2) An investigation of homology as a probe for flow dynamics, and (3) The construction of a new convection apparatus for probing the effects of large-aspect-ratio. (2) Computational Homology in Cardiac Dynamics - We have initiated an effort to test the use of homology in characterizing data from both laboratory experiments and numerical simulations of arrhythmia in the heart. Recently, the use of high speed, high sensitivity digital imaging in conjunction with voltage sensitive fluorescent dyes has enabled researchers to visualize electrical activity on the surface of cardiac tissue, both in vitro and in vivo. (3) Magnetohydrodynamics - A new research direction is to use computational homology to analyze results of large scale simulations of 2D turbulence in the presence of magnetic fields. Such simulations are relevant to the dynamics of black hole accretion disks. The complex flow patterns from simulations exhibit strong qualitative changes as a function of magnetic field strength. Efforts to characterize the pattern changes using Fourier methods and wavelet analysis have been unsuccessful. (4) Granular Flow - two experts in the area of granular media are studying 2D model experiments of earthquake dynamics where the stress fields can be measured; these stress fields from complex patterns of 'force chains' that may be amenable to analysis using computational homology. (5) Microstructure

  8. PDBalert: automatic, recurrent remote homology tracking and protein structure prediction

    Directory of Open Access Journals (Sweden)

    Söding Johannes

    2008-11-01

    Full Text Available Abstract Background During the last years, methods for remote homology detection have grown more and more sensitive and reliable. Automatic structure prediction servers relying on these methods can generate useful 3D models even below 20% sequence identity between the protein of interest and the known structure (template. When no homologs can be found in the protein structure database (PDB, the user would need to rerun the same search at regular intervals in order to make timely use of a template once it becomes available. Results PDBalert is a web-based automatic system that sends an email alert as soon as a structure with homology to a protein in the user's watch list is released to the PDB database or appears among the sequences on hold. The mail contains links to the search results and to an automatically generated 3D homology model. The sequence search is performed with the same software as used by the very sensitive and reliable remote homology detection server HHpred, which is based on pairwise comparison of Hidden Markov models. Conclusion PDBalert will accelerate the information flow from the PDB database to all those who can profit from the newly released protein structures for predicting the 3D structure or function of their proteins of interest.

  9. Heterozygous genome assembly via binary classification of homologous sequence.

    Science.gov (United States)

    Bodily, Paul M; Fujimoto, M; Ortega, Cameron; Okuda, Nozomu; Price, Jared C; Clement, Mark J; Snell, Quinn

    2015-01-01

    Genome assemblers to date have predominantly targeted haploid reference reconstruction from homozygous data. When applied to diploid genome assembly, these assemblers perform poorly, owing to the violation of assumptions during both the contigging and scaffolding phases. Effective tools to overcome these problems are in growing demand. Increasing parameter stringency during contigging is an effective solution to obtaining haplotype-specific contigs; however, effective algorithms for scaffolding such contigs are lacking. We present a stand-alone scaffolding algorithm, ScaffoldScaffolder, designed specifically for scaffolding diploid genomes. The algorithm identifies homologous sequences as found in "bubble" structures in scaffold graphs. Machine learning classification is used to then classify sequences in partial bubbles as homologous or non-homologous sequences prior to reconstructing haplotype-specific scaffolds. We define four new metrics for assessing diploid scaffolding accuracy: contig sequencing depth, contig homogeneity, phase group homogeneity, and heterogeneity between phase groups. We demonstrate the viability of using bubbles to identify heterozygous homologous contigs, which we term homolotigs. We show that machine learning classification trained on these homolotig pairs can be used effectively for identifying homologous sequences elsewhere in the data with high precision (assuming error-free reads). More work is required to comparatively analyze this approach on real data with various parameters and classifiers against other diploid genome assembly methods. However, the initial results of ScaffoldScaffolder supply validity to the idea of employing machine learning in the difficult task of diploid genome assembly. Software is available at http://bioresearch.byu.edu/scaffoldscaffolder.

  10. The OGCleaner: filtering false-positive homology clusters.

    Science.gov (United States)

    Fujimoto, M Stanley; Suvorov, Anton; Jensen, Nicholas O; Clement, Mark J; Snell, Quinn; Bybee, Seth M

    2017-01-01

    Detecting homologous sequences in organisms is an essential step in protein structure and function prediction, gene annotation and phylogenetic tree construction. Heuristic methods are often employed for quality control of putative homology clusters. These heuristics, however, usually only apply to pairwise sequence comparison and do not examine clusters as a whole. We present the Orthology Group Cleaner (the OGCleaner), a tool designed for filtering putative orthology groups as homology or non-homology clusters by considering all sequences in a cluster. The OGCleaner relies on high-quality orthologous groups identified in OrthoDB to train machine learning algorithms that are able to distinguish between true-positive and false-positive homology groups. This package aims to improve the quality of phylogenetic tree construction especially in instances of lower-quality transcriptome assemblies. https://github.com/byucsl/ogcleaner CONTACT: sfujimoto@gmail.comSupplementary information: Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. Primary homologies of the circumorbital bones of snakes.

    Science.gov (United States)

    Palci, Alessandro; Caldwell, Michael W

    2013-09-01

    Some snakes have two circumorbital ossifications that in the current literature are usually referred to as the postorbital and supraorbital. We review the arguments that have been proposed to justify this interpretation and provide counter-arguments that reject those conjectures of primary homology based on the observation of 32 species of lizards and 81 species of snakes (both extant and fossil). We present similarity arguments, both topological and structural, for reinterpretation of the primary homologies of the dorsal and posterior orbital ossifications of snakes. Applying the test of similarity, we conclude that the posterior orbital ossification of snakes is topologically consistent as the homolog of the lacertilian jugal, and that the dorsal orbital ossification present in some snakes (e.g., pythons, Loxocemus, and Calabaria) is the homolog of the lacertilian postfrontal. We therefore propose that the terms postorbital and supraorbital should be abandoned as reference language for the circumorbital bones of snakes, and be replaced with the terms jugal and postfrontal, respectively. The primary homology claim for the snake "postorbital" fails the test of similarity, while the term "supraorbital" is an unnecessary and inaccurate application of the concept of a neomorphic ossification, for an element that passes the test of similarity as a postfrontal. This reinterpretation of the circumorbital bones of snakes is bound to have important repercussions for future phylogenetic analyses and consequently for our understanding of the origin and evolution of snakes. Copyright © 2013 Wiley Periodicals, Inc.

  12. Homology groups for particles on one-connected graphs

    Science.gov (United States)

    MaciÄ Żek, Tomasz; Sawicki, Adam

    2017-06-01

    We present a mathematical framework for describing the topology of configuration spaces for particles on one-connected graphs. In particular, we compute the homology groups over integers for different classes of one-connected graphs. Our approach is based on some fundamental combinatorial properties of the configuration spaces, Mayer-Vietoris sequences for different parts of configuration spaces, and some limited use of discrete Morse theory. As one of the results, we derive the closed-form formulae for ranks of the homology groups for indistinguishable particles on tree graphs. We also give a detailed discussion of the second homology group of the configuration space of both distinguishable and indistinguishable particles. Our motivation is the search for new kinds of quantum statistics.

  13. Quantization of gauge fields, graph polynomials and graph homology

    Energy Technology Data Exchange (ETDEWEB)

    Kreimer, Dirk, E-mail: kreimer@physik.hu-berlin.de [Humboldt University, 10099 Berlin (Germany); Sars, Matthias [Humboldt University, 10099 Berlin (Germany); Suijlekom, Walter D. van [Radboud University Nijmegen, 6525 AJ Nijmegen (Netherlands)

    2013-09-15

    We review quantization of gauge fields using algebraic properties of 3-regular graphs. We derive the Feynman integrand at n loops for a non-abelian gauge theory quantized in a covariant gauge from scalar integrands for connected 3-regular graphs, obtained from the two Symanzik polynomials. The transition to the full gauge theory amplitude is obtained by the use of a third, new, graph polynomial, the corolla polynomial. This implies effectively a covariant quantization without ghosts, where all the relevant signs of the ghost sector are incorporated in a double complex furnished by the corolla polynomial–we call it cycle homology–and by graph homology. -- Highlights: •We derive gauge theory Feynman from scalar field theory with 3-valent vertices. •We clarify the role of graph homology and cycle homology. •We use parametric renormalization and the new corolla polynomial.

  14. Protein Remote Homology Detection Based on an Ensemble Learning Approach.

    Science.gov (United States)

    Chen, Junjie; Liu, Bingquan; Huang, Dong

    2016-01-01

    Protein remote homology detection is one of the central problems in bioinformatics. Although some computational methods have been proposed, the problem is still far from being solved. In this paper, an ensemble classifier for protein remote homology detection, called SVM-Ensemble, was proposed with a weighted voting strategy. SVM-Ensemble combined three basic classifiers based on different feature spaces, including Kmer, ACC, and SC-PseAAC. These features consider the characteristics of proteins from various perspectives, incorporating both the sequence composition and the sequence-order information along the protein sequences. Experimental results on a widely used benchmark dataset showed that the proposed SVM-Ensemble can obviously improve the predictive performance for the protein remote homology detection. Moreover, it achieved the best performance and outperformed other state-of-the-art methods.

  15. Robotic assisted minimally invasive surgery

    Science.gov (United States)

    Palep, Jaydeep H

    2009-01-01

    The term “robot” was coined by the Czech playright Karel Capek in 1921 in his play Rossom's Universal Robots. The word “robot” is from the check word robota which means forced labor. The era of robots in surgery commenced in 1994 when the first AESOP (voice controlled camera holder) prototype robot was used clinically in 1993 and then marketed as the first surgical robot ever in 1994 by the US FDA. Since then many robot prototypes like the Endoassist (Armstrong Healthcare Ltd., High Wycombe, Buck, UK), FIPS endoarm (Karlsruhe Research Center, Karlsruhe, Germany) have been developed to add to the functions of the robot and try and increase its utility. Integrated Surgical Systems (now Intuitive Surgery, Inc.) redesigned the SRI Green Telepresence Surgery system and created the daVinci Surgical System® classified as a master-slave surgical system. It uses true 3-D visualization and EndoWrist®. It was approved by FDA in July 2000 for general laparoscopic surgery, in November 2002 for mitral valve repair surgery. The da Vinci robot is currently being used in various fields such as urology, general surgery, gynecology, cardio-thoracic, pediatric and ENT surgery. It provides several advantages to conventional laparoscopy such as 3D vision, motion scaling, intuitive movements, visual immersion and tremor filtration. The advent of robotics has increased the use of minimally invasive surgery among laparoscopically naïve surgeons and expanded the repertoire of experienced surgeons to include more advanced and complex reconstructions. PMID:19547687

  16. Distribution and evolution of het gene homologs in the basidiomycota.

    Science.gov (United States)

    Van der Nest, M A; Olson, A; Lind, M; Vélëz, H; Dalman, K; Brandström Durling, M; Karlsson, M; Stenlid, J

    2014-03-01

    In filamentous fungi a system known as somatic incompatibility (SI) governs self/non-self recognition. SI is controlled by a regulatory signaling network involving proteins encoded at the het (heterokaryon incompatible) loci. Despite the wide occurrence of SI, the molecular identity and structure of only a small number of het genes and their products have been characterized in the model fungi Neurospora crassa and Podospora anserina. Our aim was to identify and study the distribution and evolution of putative het gene homologs in the Basidiomycota. For this purpose we used the information available for the model fungi to identify homologs of het genes in other fungi, especially the Basidiomycota. Putative het-c, het-c2 and un-24 homologs, as well as sequences containing the NACHT, HET or WD40 domains present in the het-e, het-r, het-6 and het-d genes were identified in certain members of the Ascomycota and Basidiomycota. The widespread phylogenetic distribution of certain het genes may reflect the fact that the encoded proteins are involved in fundamental cellular processes other than SI. Although homologs of het-S were previously known only from the Sordariomycetes (Ascomycota), we also identified a putative homolog of this gene in Gymnopus luxurians (Basidiomycota, class Agaricomycetes). Furthermore, with the exception of un-24, all of the putative het genes identified occurred mostly in a multi-copy fashion, some with lineage and species-specific expansions. Overall our results indicated that gene duplication followed by gene loss and/or gene family expansion, as well as multiple events of domain fusion and shuffling played an important role in the evolution of het gene homologs of Basidiomycota and other filamentous fungi. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Khovanov-Rozansky Graph Homology and Composition Product

    DEFF Research Database (Denmark)

    Wagner, Emmanuel

    2008-01-01

    In analogy with a recursive formula for the HOMFLY-PT polynomial of links given by Jaeger, we give a recursive formula for the graph polynomial introduced by Kauffman and Vogel. We show how this formula extends to the Khovanov–Rozansky graph homology.......In analogy with a recursive formula for the HOMFLY-PT polynomial of links given by Jaeger, we give a recursive formula for the graph polynomial introduced by Kauffman and Vogel. We show how this formula extends to the Khovanov–Rozansky graph homology....

  18. The tedious task of finding homologous noncoding RNA genes

    DEFF Research Database (Denmark)

    Menzel, Karl Peter; Gorodkin, Jan; Stadler, Peter F

    2009-01-01

    acknowledged. Here, we qualitatively describe a realistic scenario for what a "regular user" (i.e., a nonexpert in a particular RNA family) can do in practice, and what kind of results are likely to be achieved. Despite the indisputable advances in computational RNA biology, the conclusion is discouraging......: BLAST still works better or equally good as other methods unless extensive expert knowledge on the RNA family is included. However, when good curated data are available the recent development yields further improvements in finding remote homologs. Homology search beyond the reach of BLAST hence...... is not at all a routine task....

  19. Ecdysone receptor homologs from mollusks, leeches and a polychaete worm.

    Science.gov (United States)

    Laguerre, Michel; Veenstra, Jan A

    2010-11-05

    The genomes of the mollusk Lottia gigantea, the leech Helobdella robusta and the polychaete worm Capitella teleta each have a gene encoding an ecdysone receptor homolog. Publicly available genomic and EST sequences also contain evidence for ecdysone receptors in the seahare Aplysia californica, the bobtail squid Euprymna scolopes and the medicinal leech Hirudo medicinalis. Three-dimensional models of the ligand binding domains of these predicted ecdysone receptor homologs suggest that each of them could potentially bind an ecdysone-related steroid. Thus, ecdysone receptors are not limited to arthropods and nematodes. Copyright © 2010 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

  20. Tumor malignancy is engaged to prokaryotic homolog toolbox.

    Science.gov (United States)

    Fernandes, Janaina; Guedes, Patrícia G; Lage, Celso Luiz S; Rodrigues, Juliany Cola F; Lage, Claudia de Alencar S

    2012-04-01

    Cancer cells display high proliferation rates and survival provided by high glycolysis, chemoresistance and radioresistance, metabolic features that appear to be activated with malignancy, and seemed to have arisen as early in evolution as in unicellular/prokaryotic organisms. Based on these assumptions, we hypothesize that aggressive phenotypes found in malignant cells may be related to acquired unicellular behavior, launched within a tumor when viral and prokaryotic homologs are overexpressed performing likely robust functions. The ensemble of these expressed viral and prokaryotic close homologs in the proteome of a tumor tissue gives them advantage over normal cells. To assess the hypothesis validity, sequences of human proteins involved in apoptosis, energetic metabolism, cell mobility and adhesion, chemo- and radio-resistance were aligned to homologs present in other life forms, excluding all eukaryotes, using PSI-BLAST, with further corroboration from data available in the literature. The analysis revealed that selected sequences of proteins involved in apoptosis and tumor suppression (as p53 and pRB) scored non-significant (E-value>0.001) with prokaryotic homologs; on the other hand, human proteins involved in cellular chemo- and radio-resistance scored highly significant with prokaryotic and viral homologs (as catalase, E-value=zero). We inferred that such upregulated and/or functionally activated proteins in aggressive malignant cells represent a toolbox of modern human homologs evolved from a similar key set that have granted survival of ancient prokaryotes against extremely harsh environments. According to what has been discussed along this analysis, high mutation rates usually hit hotspots in important conserved protein domains, allowing uncontrolled expansion of more resistant, death-evading malignant clones. That is the case of point mutations in key viral proteins affording viruses escape to chemotherapy, and human homologs of such retroviral

  1. What Is Heart Surgery?

    Science.gov (United States)

    ... heart surgery that is becoming more common is robotic-assisted surgery. For this surgery, a surgeon uses a computer ... surgeon always is in total control of the robotic arms; they don't move on their own. Who Needs Heart Surgery? Heart surgery is used to treat many heart ...

  2. Homologous expression of a subcomplex of Pyrococcus furiosus hydrogenase that interacts with pyruvate ferredoxin oxidoreductase.

    Directory of Open Access Journals (Sweden)

    R Christopher Hopkins

    Full Text Available Hydrogen gas is an attractive alternative fuel as it is carbon neutral and has higher energy content per unit mass than fossil fuels. The biological enzyme responsible for utilizing molecular hydrogen is hydrogenase, a heteromeric metalloenzyme requiring a complex maturation process to assemble its O(2-sensitive dinuclear-catalytic site containing nickel and iron atoms. To facilitate their utility in applied processes, it is essential that tools are available to engineer hydrogenases to tailor catalytic activity and electron carrier specificity, and decrease oxygen sensitivity using standard molecular biology techniques. As a model system we are using hydrogen-producing Pyrococcus furiosus, which grows optimally at 100°C. We have taken advantage of a recently developed genetic system that allows markerless chromosomal integrations via homologous recombination. We have combined a new gene marker system with a highly-expressed constitutive promoter to enable high-level homologous expression of an engineered form of the cytoplasmic NADP-dependent hydrogenase (SHI of P. furiosus. In a step towards obtaining 'minimal' hydrogenases, we have successfully produced the heterodimeric form of SHI that contains only two of the four subunits found in the native heterotetrameric enzyme. The heterodimeric form is highly active (150 units mg(-1 in H(2 production using the artificial electron donor methyl viologen and thermostable (t(1/2 ∼0.5 hour at 90°C. Moreover, the heterodimer does not use NADPH and instead can directly utilize reductant supplied by pyruvate ferredoxin oxidoreductase from P. furiosus. The SHI heterodimer and POR therefore represent a two-enzyme system that oxidizes pyruvate and produces H(2 in vitro without the need for an intermediate electron carrier.

  3. DEK is required for homologous recombination repair of DNA breaks

    DEFF Research Database (Denmark)

    Smith, Eric A; Gole, Boris; Willis, Nicholas A

    2017-01-01

    mice. Furthermore, DEK knockout cells were sensitive to apoptosis with NHEJ inhibition. Thus, we hypothesized DEK plays additional roles in homologous recombination (HR). Using episomal and integrated reporters, we demonstrate that HR repair of conventional DSBs is severely compromised in DEK...

  4. Phenylbutyrate inhibits homologous recombination induced by camptothecin and methyl methanesulfonate

    DEFF Research Database (Denmark)

    Kaiser, Gitte Schalck; Germann, Susanne Manuela; Westergaard, Tine

    2011-01-01

    . Treatment with PBA is accompanied by a dramatic reduction in histone H4 lysine 8 acetylation. Live cell imaging of homologous recombination proteins indicates that repair of CPT-induced DNA damage is redirected to a non-recombinogenic pathway in the presence of PBA without loss in cell viability...

  5. Synthesis and characterization of new homologous series of ...

    Indian Academy of Sciences (India)

    Two homologous series of unsymmetrical alkylated chalcones and 3,5-diaryl isoxazoles, consisting of 20 members, with various n-alkyl bromides (n=2−7, 10, 12, 14, 16) have been synthesized and studied for their liquid crystalline property. Simple strategy was employed to achieve the target materials. Flexibilityin the ...

  6. Hypoxia influences expression profile of Pleckstrin homology-like ...

    Indian Academy of Sciences (India)

    The deduced CbPHLDA2 protein of 139 amino acids shared high homology with PHLD2A of other fishes as well as that of vertebrates. Importantly, a single amino acid (asparagine/lysine) insertion was identified in the PH domain of CbPHLDA2 and other fishes, which was absent in other vertebrates studied. Furthermore ...

  7. Homeomorphisms and the homology of non-orientable surfaces

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    Indian Acad. Sci. (Math. Sci.) Vol. 115, No. 3, August 2005, pp. 251–257. © Printed in India. Homeomorphisms and the homology of non-orientable surfaces ... that every element of K is induced by a homeomorphism of F. Further, we shall show that ... (up to sign) the elements representing the boundary components.

  8. Homology modelling and bivalent single-chain Fv construction of ...

    Indian Academy of Sciences (India)

    PRAKASH KUMAR

    structure of SLH10 was modelled by the Insight II molecule simulation software. The structure was refined using the molecular ... the Homology module of the Insight II software package. (Biosym/MSI, San Diego, Accelrys ..... Feng J, Xie Z, Guo N and Shen B 2003 Design and assembly of anti-CD16 ScFv antibody with two ...

  9. New mesogenic homologous series of α-methylcinnamates

    Indian Academy of Sciences (India)

    Compounds of a new smectogenic homologous series of -methylcinnamates were prepared by condensing different 4--alkoxybenzoyl chloride with methoxyethyl trans-4-hydroxy- -methylcinnamate. In this series, the first six members are non-mesogenic. -Heptyloxy derivative exhibits monotropic smectic A phase ...

  10. Cloning and expression analysis of a LFY homologous gene in ...

    African Journals Online (AJOL)

    madam

    2012-01-10

    Jan 10, 2012 ... LEAFY (LFY) homologous genes are necessary for the transition from vegetative to reproductive development in flowering plants. ... most important developmental switches in the life cycle of angiosperm that involves a ... far in some plant species including potato (Solanum tuberosum) (Guo and Yang, ...

  11. Practical Challenge of Shredded Documents: Clustering of Chinese Homologous Pieces

    Directory of Open Access Journals (Sweden)

    Nan Xing

    2017-09-01

    Full Text Available When recovering a shredded document that has numerous mixed pieces, the difficulty of the recovery process can be reduced by clustering, which is a method of grouping pieces that originally belonged to the same page. Restoring homologous shredded documents (pieces from different pages of the same file is a frequent problem, and because these pieces have nearly indistinguishable visual characteristics, grouping them is extremely difficult. Clustering research has important practical significance for document recovery because homologous pieces are ubiquitous. Because of the wide usage of Chinese and the huge demand for Chinese shredded document recovery, our research focuses on Chinese homologous pieces. In this paper, we propose a method of completely clustering Chinese homologous pieces in which the distribution features of the characters in the pieces and the document layout are used to correlate adjacent pieces and cluster them in different areas of a document. The experimental results show that the proposed method has a good clustering effect on real pieces. For the dataset containing 10 page documents (a total of 462 pieces, its average accuracy is 97.19%.

  12. Monitoring homologous recombination in rice (Oryza sativa L.)

    Energy Technology Data Exchange (ETDEWEB)

    Yang Zhuanying; Tang Li [Guangdong Provincial Key Lab of Biotechnology for Plant Development, College of Life Sciences, South China Normal University, Guangzhou 510631 (China); Li Meiru [South China Botanic Garden, Chinese Academy of Sciences, Guangzhou 510650 (China); Chen Lei; Xu Jie [Guangdong Provincial Key Lab of Biotechnology for Plant Development, College of Life Sciences, South China Normal University, Guangzhou 510631 (China); Wu Goujiang [South China Botanic Garden, Chinese Academy of Sciences, Guangzhou 510650 (China); Li Hongqing, E-mail: hqli@scnu.edu.cn [Guangdong Provincial Key Lab of Biotechnology for Plant Development, College of Life Sciences, South China Normal University, Guangzhou 510631 (China)

    2010-09-10

    Here we describe a system to assay homologous recombination during the complete life cycle of rice (Oryza sativa L.). Rice plants were transformed with two copies of non-functional GUS reporter overlap fragments as recombination substrate. Recombination was observed in all plant organs examined, from the seed stage until the flowering stage of somatic plant development. Embryogenic cells exhibited the highest recombination ability with an average of 3 x 10{sup -5} recombination events per genome, which is about 10-fold of that observed in root cells, and two orders of that observed in leaf cells. Histological analysis revealed that recombination events occurred in diverse cell types, but preferentially in cells with small size. Examples of this included embryogenic cells in callus, phloem cells in the leaf vein, and cells located in the root apical meristem. Steady state RNA analysis revealed that the expression levels of rice Rad51 homologs are positively correlated with increased recombination rates in embryogenic calli, roots and anthers. Finally, radiation treatment of plantlets from distinct recombination lines increased the recombination frequency to different extents. These results showed that homologous recombination frequency can be effectively measured in rice using a transgene reporter assay. This system will facilitate the study of DNA damage signaling and homologous recombination in rice, a model monocot.

  13. Quantum algorithms for the Jones polynomial and Khovanov homology

    Science.gov (United States)

    Kauffman, Louis H.; Lomonaco, Samuel J., Jr.

    2012-06-01

    This paper generalizes the AJL algorithm for quantum computation of the Jones polynomial to continuous ranges of values on the unit circle for the Jones parameter and shows that the Kauffman-Lomonaco 3-strand algorithm for the Jones polynomial is a special case of this generalization. We then describe a quantum algorithm for the Jones polynomial that is related to Khovanov homology.

  14. The homological content of the Jones representations at $q = -1$

    DEFF Research Database (Denmark)

    Egsgaard, Jens Kristian; Fuglede Jørgensen, Søren

    We generalize a discovery of Kasahara and show that the Jones representations of braid groups, when evaluated at $q = -1$, are related to the action on homology of a branched double cover of the underlying punctured disk. As an application, we prove for a large family of pseudo-Anosov mapping cla...

  15. Hidden Markov Models for Protein Domain Homology Identification and Analysis.

    Science.gov (United States)

    Jablonowski, Karl

    2017-01-01

    Protein domain identification and analysis are cornerstones of modern proteomics. The tools available to protein domain researchers avail a variety of approaches to understanding large protein domain families. Hidden Markov Models (HMM) form the basis for identifying and categorizing evolutionarily linked protein domains. Here I describe the use of HMM models for predicting and identifying Src Homology 2 (SH2) domains within the proteome.

  16. Isolation and characterization of an AGAMOUS homolog from Fraxinus pennsylvanica

    Science.gov (United States)

    Ningxia Du; Paula M. Pijut

    2010-01-01

    An AGAMOUS homolog (FpAG) was isolated from green ash (Fraxinus pennsylvanica) using a reverse transcriptase polymerase chain reaction method. Southern blot analysis indicated that FpAG was present as a single-copy sequence in the genome of green ash. RNA accumulated in the reproductive tissues (female...

  17. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... surgery, orthognathic surgery is performed to correct functional problems. Jaw Surgery can have a dramatic effect on ... without straining Chronic mouth breathing Sleep apnea (breathing problems when sleeping, including snoring) Your dentist, orthodontist and ...

  18. Laser surgery - skin

    Science.gov (United States)

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  19. Oophorectomy (Ovary Removal Surgery)

    Science.gov (United States)

    ... also be robotically assisted in certain cases. During robotic surgery, the surgeon watches a 3-D monitor and ... weeks after surgery. Those who undergo laparoscopic or robotic surgery may return to full activity sooner — as early ...

  20. Ureteral reimplantation surgery - children

    Science.gov (United States)

    ... 3 or 4 small cuts in the belly. Robotic surgery is similar to laparoscopic surgery, except that the ... Elsevier Saunders; 2011:560. Richstone L, Scherr DS. Robotic and laparoscopic surgery. In: Wein AJ, Kavoussi LR, Partin AW, Peters ...

  1. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures ...

  2. Surgery for pancreatic cancer

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007649.htm Surgery for pancreatic cancer To use the sharing features on this page, ... surgeries are used in the surgical treatment of pancreatic cancer. Whipple procedure: This is the most common surgery ...

  3. Bariatric Surgery Procedures

    Science.gov (United States)

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by ... minimally invasive techniques (laparoscopic surgery). The most common bariatric surgery procedures are gastric bypass, sleeve gastrectomy, adjustable gastric ...

  4. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Soft Tissue Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures Administration of Anesthesia Administration of Anesthesia Oral ...

  5. LASIK - Laser Eye Surgery

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Glaucoma Education Center Pediatric Ophthalmology Education Center Oculofacial Plastic ... Center Laser Surgery Education Center Redmond Ethics Center ...

  6. What Is Refractive Surgery?

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Glaucoma Education Center Pediatric Ophthalmology Education Center Oculofacial Plastic ... Center Laser Surgery Education Center Redmond Ethics Center ...

  7. Gastric bypass surgery - discharge

    Science.gov (United States)

    ... heart disease Gastric bypass surgery Laparoscopic gastric banding Obesity Obstructive sleep apnea - adults Type 2 diabetes Patient Instructions Getting out of bed after surgery Weight-loss surgery - after - what to ask your doctor Weight- ...

  8. Gastric bypass surgery

    Science.gov (United States)

    ... Y gastric bypass; Gastric bypass - Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass Patient Instructions Bathroom safety - adults Gastric bypass surgery - discharge Laparoscopic gastric banding - discharge ...

  9. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Do Who We Are News Videos Contact Find a Surgeon What We Do Administration of Anesthesia Administration ... Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more surgeries ...

  10. Illustrating and homology modeling the proteins of the Zika virus.

    Science.gov (United States)

    Ekins, Sean; Liebler, John; Neves, Bruno J; Lewis, Warren G; Coffee, Megan; Bienstock, Rachelle; Southan, Christopher; Andrade, Carolina H

    2016-01-01

    The Zika virus (ZIKV) is a flavivirus of the family Flaviviridae, which is similar to dengue virus, yellow fever and West Nile virus. Recent outbreaks in South America, Latin America, the Caribbean and in particular Brazil have led to concern for the spread of the disease and potential to cause Guillain-Barré syndrome and microcephaly. Although ZIKV has been known of for over 60 years there is very little in the way of knowledge of the virus with few publications and no crystal structures. No antivirals have been tested against it either in vitro or in vivo. ZIKV therefore epitomizes a neglected disease. Several suggested steps have been proposed which could be taken to initiate ZIKV antiviral drug discovery using both high throughput screens as well as structure-based design based on homology models for the key proteins. We now describe preliminary homology models created for NS5, FtsJ, NS4B, NS4A, HELICc, DEXDc, peptidase S7, NS2B, NS2A, NS1, E stem, glycoprotein M, propeptide, capsid and glycoprotein E using SWISS-MODEL. Eleven out of 15 models pass our model quality criteria for their further use. While a ZIKV glycoprotein E homology model was initially described in the immature conformation as a trimer, we now describe the mature dimer conformer which allowed the construction of an illustration of the complete virion. By comparing illustrations of ZIKV based on this new homology model and the dengue virus crystal structure we propose potential differences that could be exploited for antiviral and vaccine design. The prediction of sites for glycosylation on this protein may also be useful in this regard. While we await a cryo-EM structure of ZIKV and eventual crystal structures of the individual proteins, these homology models provide the community with a starting point for structure-based design of drugs and vaccines as well as a for computational virtual screening.

  11. Single-stranded heteroduplex intermediates in λ Red homologous recombination

    Directory of Open Access Journals (Sweden)

    Zhang Youming

    2010-07-01

    Full Text Available Abstract Background The Red proteins of lambda phage mediate probably the simplest and most efficient homologous recombination reactions yet described. However the mechanism of dsDNA recombination remains undefined. Results Here we show that the Red proteins can act via full length single stranded intermediates to establish single stranded heteroduplexes at the replication fork. We created asymmetrically digestible dsDNA substrates by exploiting the fact that Redα exonuclease activity requires a 5' phosphorylated end, or is blocked by phosphothioates. Using these substrates, we found that the most efficient configuration for dsDNA recombination occurred when the strand that can prime Okazaki-like synthesis contained both homology regions on the same ssDNA molecule. Furthermore, we show that Red recombination requires replication of the target molecule. Conclusions Hence we propose a new model for dsDNA recombination, termed 'beta' recombination, based on the formation of ssDNA heteroduplexes at the replication fork. Implications of the model were tested using (i an in situ assay for recombination, which showed that recombination generated mixed wild type and recombinant colonies; and (ii the predicted asymmetries of the homology arms, which showed that recombination is more sensitive to non-homologies attached to 5' than 3' ends. Whereas beta recombination can generate deletions in target BACs of at least 50 kb at about the same efficiency as small deletions, the converse event of insertion is very sensitive to increasing size. Insertions up to 3 kb are most efficiently achieved using beta recombination, however at greater sizes, an alternative Red-mediated mechanism(s appears to be equally efficient. These findings define a new intermediate in homologous recombination, which also has practical implications for recombineering with the Red proteins.

  12. Smartphones in Surgery

    Directory of Open Access Journals (Sweden)

    Ara A. Salibian

    2011-01-01

    Full Text Available Smartphones have the capability of enhancing many aspects of the continuum of surgical care by providing an efficient means of multimedia communication among surgeons and healthcare personnel. The ability for mobile Internet and email access, along with features such as built-in cameras and video calling, allow surgeons to rapidly access, send and receive patient information without being restricted by issues of connectivity. Smartphones create an unrestricted network of data sharing, improving the flexibility of patient consultation, timeliness of preoperative preparation, efficiency of post-operative care and the effectiveness of a surgical team. Furthermore, smartphones provide mobile access to a multitude of surgical resources to bolster continued surgical education. This article presents a review of the current literature on the utilizations of smartphones in surgery, discusses their benefits and limitations, and addresses the possibility of incorporating smartphones into the protocol of surgical care.

  13. Less extensive surgery compared to extensive surgery

    DEFF Research Database (Denmark)

    Lauszus, Finn F; Petersen, Astrid C; Neumann, Gudrun

    2014-01-01

    OBJECTIVE: To describe the outcome of adult granulosa cell tumor (AGCT) with respect to initial clinical findings, methods of surgery, and perioperative treatment. STUDY DESIGN: Retrospective follow-up study. Setting: All hospitals in Jutland. Sample: 163 women diagnosed with AGCT. Methods: Follo...... with similar survival compared to extensive surgery, but with advancing age conservative surgery increased the risk of relapse and death....

  14. Heart bypass surgery - discharge

    Science.gov (United States)

    Off-pump coronary artery bypass - discharge; OPCAB - discharge; Beating heart surgery - discharge; Bypass surgery - heart - discharge; CABG - discharge; Coronary artery bypass graft - discharge; Coronary artery ...

  15. Robotic surgery: urologic implications.

    Science.gov (United States)

    Moran, Michael E

    2003-11-01

    Current medical robots have nothing in common with the anthropomorphic robots in science fiction classics. They are in fact, manipulators, working on a master-slave principle. Robots can be defined as "automatically controlled multitask manipulators, which are freely programmable in three or more spaces." The success of robots in surgery is based on their precision, lack of fatigue, and speed of action. This review describes the theory, advantages, disadvantages, and clinical utilization of mechanical and robotic arm systems to replace the second assistant and provide camera direction and stability during laparoscopic surgery. The Robotrac system (Aesculap, Burlingame, CA), the First Assistant (Leonard Medical Inc, Huntingdon Valley, PA), AESOP (Computer Motion, Goleta, CA), ZEUS (Computer Motion), and the da Vinci (Intuitive Surgical, Mountain View, CA) system are reviewed, as are simple mechanical-assist systems such as Omnitract (Minnesota Scientific, St. Paul, MN), Iron Intern (Automated Medical Products Corp., New York, NY), the Bookwalter retraction system (Codman , Somerville, NJ), the Surgassistant trade mark (Solos Endoscopy, Irvine, CA), the Trocar Sleeve Stabilizer (Richard Wolf Medical Instruments Corp., Rosemont, IL), and the Endoholder (Codman, Somerville, NJ).

  16. Silencing the lettuce homologs of small rubber particle protein does not influence natural rubber biosynthesis in lettuce (Lactuca sativa).

    Science.gov (United States)

    Chakrabarty, Romit; Qu, Yang; Ro, Dae-Kyun

    2015-05-01

    Natural rubber, cis-1,4-polyisoprene, is an important raw material in chemical industries, but its biosynthetic mechanism remains elusive. Natural rubber is known to be synthesized in rubber particles suspended in laticifer cells in the Brazilian rubber tree (Hevea brasiliensis). In the rubber tree, rubber elongation factor (REF) and its homolog, small rubber particle protein (SRPP), were found to be the most abundant proteins in rubber particles, and they have been implicated in natural rubber biosynthesis. As lettuce (Lactuca sativa) can synthesize natural rubber, we utilized this annual, transformable plant to examine in planta roles of the lettuce REF/SRPP homologs by RNA interference. Among eight lettuce REF/SRPP homologs identified, transcripts of two genes (LsSRPP4 and LsSRPP8) accounted for more than 90% of total transcripts of REF/SRPP homologs in lettuce latex. LsSRPP4 displays a typical primary protein sequence as other REF/SRPP, while LsSRPP8 is twice as long as LsSRPP4. These two major LsSRPP transcripts were individually and simultaneously silenced by RNA interference, and relative abundance, polymer molecular weight, and polydispersity of natural rubber were analyzed from the LsSRPP4- and LsSRPP8-silenced transgenic lettuce. Despite previous data suggesting the implications of REF/SRPP in natural rubber biosynthesis, qualitative and quantitative alterations of natural rubber could not be observed in transgenic lettuce lines. It is concluded that lettuce REF/SRPP homologs are not critically important proteins in natural rubber biosynthesis in lettuce. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Gene targeting using homologous recombination in embryonic stem cells: The future for behavior genetics?

    Directory of Open Access Journals (Sweden)

    Robert eGerlai

    2016-04-01

    Full Text Available Gene targeting with homologous recombination in embryonic stem cells created a revolution in the analysis of the function of genes in behavioral brain research. The technology allowed unprecedented precision with which one could manipulate genes and study the effect of this manipulation on the central nervous system. With gene targeting, the uncertainty inherent in psychopharmacology regarding whether a particular compound would act only through a specific target was removed. Thus, gene targeting became highly popular. However, with this popularity came the realization that like other methods, gene targeting also suffered from some technical and principal problems. For example, two decades ago, issues about compensatory changes and about genetic linkage were raised. Since then, the technology developed, and its utility has been better delineated. This review will discuss the pros and cons of the technique along with these advancements from the perspective of the neuroscientist user. It will also compare and contrast methods that may represent novel alternatives to the homologous recombination based gene targeting approach, including the TALEN and the CRISPR/Cas9 systems. The goal of the review is not to provide detailed recipes, but to attempt to present a short summary of these approaches a behavioral geneticist or neuroscientist may consider for the analysis of brain function and behavior.

  18. BioAssemblyModeler (BAM): user-friendly homology modeling of protein homo- and heterooligomers.

    Science.gov (United States)

    Shapovalov, Maxim V; Wang, Qiang; Xu, Qifang; Andrake, Mark; Dunbrack, Roland L

    2014-01-01

    Many if not most proteins function in oligomeric assemblies of one or more protein sequences. The Protein Data Bank provides coordinates for biological assemblies for each entry, at least 60% of which are dimers or larger assemblies. BioAssemblyModeler (BAM) is a graphical user interface to the basic steps in homology modeling of protein homooligomers and heterooligomers from the biological assemblies provided in the PDB. BAM takes as input up to six different protein sequences and begins by assigning Pfam domains to the target sequences. The program utilizes a complete assignment of Pfam domains to sequences in the PDB, PDBfam (http://dunbrack2.fccc.edu/protcid/pdbfam), to obtain templates that contain any or all of the domains assigned to the target sequence(s). The contents of the biological assemblies of potential templates are provided, and alignments of the target sequences to the templates are produced with a profile-profile alignment algorithm. BAM provides for visual examination and mouse-editing of the alignments supported by target and template secondary structure information and a 3D viewer of the template biological assembly. Side-chain coordinates for a model of the biological assembly are built with the program SCWRL4. A built-in protocol navigation system guides the user through all stages of homology modeling from input sequences to a three-dimensional model of the target complex. http://dunbrack.fccc.edu/BAM.

  19. Robot-assisted surgery: applications in urology

    Directory of Open Access Journals (Sweden)

    Mathew C Raynor

    2010-05-01

    Full Text Available Mathew C Raynor, Raj S PruthiDivision of Urologic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USAAbstract: The past decade has seen a dramatic shift in the surgical management of certain urologic conditions with the advent of a robotic surgical platform. In fact, the surgical management of prostate cancer has seen the most dramatic shift, with the majority of cases now being performed robotically. Technical refinements over the years have led to improved outcomes regarding oncologic and functional results. Recently, robotic surgery has also been utilized for the surgical management of bladder cancer, renal cancer, and other benign conditions. As further experience is gained and longer-term outcomes are realized, robotic surgery will likely play an increasing role in the surgical management of many urologic conditions.Keywords: robot-assisted surgery, robotic surgery, cystectomy, prostatectomy, partial nephrectomy

  20. Transition from video-assisted thoracic surgery to robotic pulmonary surgery

    Science.gov (United States)

    2017-01-01

    The “da Vinci Surgical System” is a robotic surgical system that utilizes multi-jointed robotic arms and a high-resolution three-dimensional video-monitoring system. We report on the state of transition from video-assisted thoracoscopic surgery (VATS) to robotic pulmonary surgery, the surgical outcomes of robotic surgery compared to VATS, and the future of robotic surgery. Surgery utilizing the da Vinci Surgical System requires a console surgeon and assistant who have been certified by Intuitive Surgical, Inc., the system manufacturer. On the basis of the available medical literature, a robotic lobectomy has a learning curve that extends over approximately 20 cases for a surgeon who has mastered VATS. Surgery using the da Vinci System is safe, is associated with lower morbidity and mortality rates than thoracotomy, leads to shorter postoperative hospital stays, and ensures improved postoperative quality of life. Currently, no prospective studies comparing it to VATS have been conducted. The various studies that have compared robotic surgery and VATS have reported different results. At the present time, the benefits to patients of robotic surgery compared to VATS remain unclear. Areas in which robotic surgery may be superior to VATS include the superior operability of robotic surgery that improves safety and decreases the incidence of complication. To show that the costly robotic surgery is superior to VATS, prospective multicenter randomized studies need to be conducted. The da Vinci robot-assisted surgical system has already been highly evaluated for its safety, with recent studies reporting satisfactory outcomes. It remains necessary to verify whether the benefits to patients justify the higher cost of robotic surgery. Future developments in the field of robotic engineering will likely lead to the creation of systems that are even less invasive and allow for more advanced surgical techniques. PMID:29078618

  1. Mortality Caused by Surgery for Degenerative Lumbar Spine.

    Science.gov (United States)

    Salmenkivi, Jyrki; Sund, Reijo; Paavola, Mika; Ruuth, Iiris; Malmivaara, Antti

    2017-07-15

    Register study. The purpose of this study was to assess the safety of lumbar spine surgery for degenerative disorders and to assess the predictive factors for mortality and causes of death. Growing numbers and relative indications of spine surgery emphasize the importance of patient safety. We assessed the incidence of mortality related to surgery, overall case fatality and factors predicting mortality in elective spinal surgery. A national database was utilized to assess patient characteristics, surgical procedures, and outcomes of degenerative spinal surgery in Finland. Patients were classified into four diagnostic categories: disc herniation, spinal stenosis, degenerative disc disease, and spondylolysis and spondylolisthesis. The mortality related to surgery and overall mortality in each diagnostic group was analyzed at 7 days, 30 days, 90 days, and 1 year after surgery. We categorized the deaths into medical errors, sequelae of surgery, surgery probably a contributing factor, and deaths not associated with surgery. Age, sex, comorbid conditions, and hospital characteristics were considered as potential risk factors for mortality. Out of 408 deaths (0.67% of total of 61,166 patients) deaths that occurred during the 1-year follow up, 49 deaths (12% of deaths, 0.08% of patients) were classified as having an association with surgery: two deaths by medical errors, 28 deaths by complications after surgery and 19 deaths related to the surgery. The surgery-related 1-year mortality was 0.08%. Age >75 years, male sex, diabetes, and hypertension showed an association with increased risk of death related to surgery. Mortality caused by elective spinal surgery is rare. Cardiovascular incidents are the most common reasons for deaths occurring soon after surgery. Consideration of expected gains and risks of surgery, prevention of unintended errors during surgery and recognition and treatment of complications once they occur are recommended. 3.

  2. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  3. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... can also invite bacteria that lead to gum disease. Click here to find out more. Who We Are Find a Surgeon News Videos Contact Administration of Anesthesia Cleft Lip/Palate and Craniofacial Surgery Corrective Jaw Surgery Dental and Soft Tissue Surgery Dental Implant Surgery Facial ...

  4. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  5. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and gums to improve function, appearance and oral health. Click here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education and training. Click here to find out more. ...

  6. Electrostatic braiding and homologous pairing of DNA double helices.

    Science.gov (United States)

    Cortini, Ruggero; Kornyshev, Alexei A; Lee, Dominic J; Leikin, Sergey

    2011-08-17

    Homologous pairing and braiding (supercoiling) have crucial effects on genome organization, maintenance, and evolution. Generally, the pairing and braiding processes are discussed in different contexts, independently of each other. However, analysis of electrostatic interactions between DNA double helices suggests that in some situations these processes may be related. Here we present a theory of DNA braiding that accounts for the elastic energy of DNA double helices as well as for the chiral nature of the discrete helical patterns of DNA charges. This theory shows that DNA braiding may be affected, stabilized, or even driven by chiral electrostatic interactions. For example, electrostatically driven braiding may explain the surprising recent observation of stable pairing of homologous double-stranded DNA in solutions containing only monovalent salt. Electrostatic stabilization of left-handed braids may stand behind the chiral selectivity of type II topoisomerases and positive plasmid supercoiling in hyperthermophilic bacteria and archea. Copyright © 2011 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  7. Homology and isomorphism: Bourdieu in conversation with New Institutionalism.

    Science.gov (United States)

    Wang, Yingyao

    2016-06-01

    Bourdieusian Field Theory (BFT) provided decisive inspiration for the early conceptual formulation of New Institutionalism (NI). This paper attempts to reinvigorate the stalled intellectual dialogue between NI and BFT by comparing NI's concept of isomorphism with BFT's notion of homology. I argue that Bourdieu's understanding of domination-oriented social action, transposable habitus, and a non-linear causality, embodied in his neglected concept of homology, provides an alternative theorization of field-level convergence to New Institutionalism's central idea of institutional isomorphism. To showcase how BFT can be useful for organizational research, I postulate a habitus-informed and field-conditioned theory of transference to enrich NI's spin-off thesis of 'diffusion'. I propose that while NI can benefit from BFT's potential of bringing social structure back into organizational research, BFT can enrich its social analysis by borrowing from NI's elaboration of the symbolic system of organizations. © London School of Economics and Political Science 2016.

  8. Targeted recombination between homologous chromosomes for precise breeding in tomato.

    Science.gov (United States)

    Filler Hayut, Shdema; Melamed Bessudo, Cathy; Levy, Avraham A

    2017-05-26

    Homologous recombination (HR) between parental chromosomes occurs stochastically. Here, we report on targeted recombination between homologous chromosomes upon somatic induction of DNA double-strand breaks (DSBs) via CRISPR-Cas9. We demonstrate this via a visual and molecular assay whereby DSB induction between two alleles carrying different mutations in the PHYTOENE SYNTHASE (PSY1) gene results in yellow fruits with wild type red sectors forming via HR-mediated DSB repair. We also show that in heterozygote plants containing one psy1 allele immune and one sensitive to CRISPR, repair of the broken allele using the unbroken allele sequence template is a common outcome. In another assay, we show evidence of a somatically induced DSB in a cross between a psy1 edible tomato mutant and wild type Solanum pimpinellifolium, targeting only the S. pimpinellifolium allele. This enables characterization of germinally transmitted targeted somatic HR events, demonstrating that somatically induced DSBs can be exploited for precise breeding of crops.

  9. Identification of rodent homologs of hepatitis C virus and pegiviruses

    DEFF Research Database (Denmark)

    Kapoor, Amit; Simmonds, Peter; Scheel, Troels K H

    2013-01-01

    Flaviviridae. The genetic diversity of the rodent hepaciviruses exceeded that observed for hepaciviruses infecting either humans or non-primates, leading to new insights into the origin, evolution, and host range of hepaciviruses. The presence of genes, encoded proteins, and translation elements homologous......UNLABELLED: Hepatitis C virus (HCV) and human pegivirus (HPgV or GB virus C) are globally distributed and infect 2 to 5% of the human population. The lack of tractable-animal models for these viruses, in particular for HCV, has hampered the study of infection, transmission, virulence, immunity...... to those found in human hepaciviruses and pegiviruses suggests the potential for the development of new animal systems with which to model HCV pathogenesis, vaccine design, and treatment. IMPORTANCE: The genetic and biological characterization of animal homologs of human viruses provides insights...

  10. Intersection spaces, spatial homology truncation, and string theory

    CERN Document Server

    Banagl, Markus

    2010-01-01

    Intersection cohomology assigns groups which satisfy a generalized form of Poincaré duality over the rationals to a stratified singular space. The present monograph introduces a method that assigns to certain classes of stratified spaces cell complexes, called intersection spaces, whose ordinary rational homology satisfies generalized Poincaré duality. The cornerstone of the method is a process of spatial homology truncation, whose functoriality properties are analyzed in detail. The material on truncation is autonomous and may be of independent interest to homotopy theorists. The cohomology of intersection spaces is not isomorphic to intersection cohomology and possesses algebraic features such as perversity-internal cup-products and cohomology operations that are not generally available for intersection cohomology. A mirror-symmetric interpretation, as well as applications to string theory concerning massless D-branes arising in type IIB theory during a Calabi-Yau conifold transition, are discussed.

  11. Homologous recombination in the archaea: the means justify the ends.

    Science.gov (United States)

    White, Malcolm F

    2011-01-01

    The process of information exchange between two homologous DNA duplexes is known as homologous recombination (HR) or double-strand break repair (DSBR), depending on the context. HR is the fundamental process underlying the genome shuffling that expands genetic diversity (for example during meiosis in eukaryotes). DSBR is an essential repair pathway in all three domains of life, and plays a major role in the rescue of stalled or collapsed replication forks, a phenomenon known as recombination-dependent replication (RDR). The process of HR in the archaea is gradually being elucidated, initially from structural and biochemical studies, but increasingly using new genetic systems. The present review focuses on our current understanding of the structures, functions and interactions of archaeal HR proteins, with an emphasis on recent advances. There are still many unknown aspects of archaeal HR, most notably the mechanism of branch migration of Holliday junctions, which is also an open question in eukarya.

  12. Evaluation of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in a community setting: A cost-utility analysis of a hospital's initial experience and reflections on the health care system.

    Science.gov (United States)

    Naffouje, Samer A; O'Donoghue, Cristina; Salti, George I

    2016-04-01

    The combination of Cytoreductive Surgery (CRS) plus Hyperthermic Intraperitoneal Chemotherapy (HIPEC) has been gaining a considerable interest by surgeons throughout the United States due to the significant survival improvement it provides for peritoneal surface malignancies and the ability to reproduce comparable clinical results in numerous health care centers. However, CRS plus HIPEC has not been sufficiently investigated from the economic standpoint in the United States where a wide variety of health care insurers exists. This study was conducted to analyze hospital/surgeon cost and reimbursement data at a community hospital offering a new peritoneal surface malignancy program, and expand the discussion to analyze future healthcare implementation on this procedure in the United States. This is a retrospective economic analysis of an initial CRS plus HIPEC experience at a community non-teaching medical center. This study was conducted using hospital/surgeon cost and reimbursement based on the Office of Finance data at Edward Hospital Cancer Center (Naperville, IL). All patients who underwent CRS and HIPEC between June 2013 and August 2014 were included in this analysis. We aimed to assess CRS plus HIPEC purely from the financial perspective on the initial admission regardless of the patients' advancement of the disease or postoperative adverse events. Twenty-five patients underwent 26 CRS plus HIPEC procedures. Twelve patients had private insurance plans (PRV) whereas 13 were covered by public insurers (PUB). Median overall length of stay (LOS) was 10 days (PRV 10 days vs. PUB 11 days; P = 0.76.) Average hospital cost was $38,369 (PRV $37,093 vs. PUB $39,463; P = 0.67), and average reimbursement for our patient population was $45,243 (PRV $48,954 vs. PUB $42,062; P = 0.53). It was noted that CRS plus HIPEC generated more net profit in patients with private insurance than in those with public plans, however, not statistically significant ($11,861 vs

  13. Morse homology for the Yang–Mills gradient flow

    National Research Council Canada - National Science Library

    Swoboda, Jan

    2012-01-01

    ...€¢â€¢â€¢ (••••) •••–••• www.elsevier.com/locate/matpur Morse homology for the Yang–Mills gradient flow Jan Swoboda ∗ Max-Planck-Institut...

  14. Quasi-homologous spherically symmetric branes and their symmetry breaking

    Energy Technology Data Exchange (ETDEWEB)

    Abdalla, M.C.B.; Carlesso, P.F. [UNESP - Universidade Estadual Paulista, Instituto de Fisica Teorica, Rua Dr. Bento Teobaldo Ferraz, 271, Bloco II, Barra-Funda, Caixa Postal 70532-2, Sao Paulo, SP (Brazil); Hoff da Silva, J.M. [UNESP - Universidade Estadual Paulista, Departamento de Fisica e Quimica, Guaratingueta, SP (Brazil)

    2013-06-15

    We revisit the dynamical system-based approach of spherically symmetric vacuum braneworlds, pointing out and studying the existence of a transcritical bifurcation as the dark pressure parameter changes its sign, we analyze some consequences of not discard the brane cosmological constant. For instance, it is noteworthy that the existence of an isothermal state equation between the dark fluid parameters cannot be obtained via the requirement of a quasi-homologous symmetry of the vacuum. (orig.)

  15. Protein Identification Pipeline for the Homology Driven Proteomics

    Science.gov (United States)

    Junqueira, Magno; Spirin, Victor; Balbuena, Tiago Santana; Thomas, Henrik; Adzhubei, Ivan; Sunyaev, Shamil; Shevchenko, Andrej

    2008-01-01

    Homology-driven proteomics is a major tool to characterize proteomes of organisms with unsequenced genomes. This paper addresses practical aspects of automated homology–driven protein identifications by LC-MS/MS on a hybrid LTQ Orbitrap mass spectrometer. All essential software elements supporting the presented pipeline are either hosted at the publicly accessible web server, or are available for free download. PMID:18639657

  16. Persistent homology for the quantitative prediction of fullerene stability.

    Science.gov (United States)

    Xia, Kelin; Feng, Xin; Tong, Yiying; Wei, Guo Wei

    2015-03-05

    Persistent homology is a relatively new tool often used for qualitative analysis of intrinsic topological features in images and data originated from scientific and engineering applications. In this article, we report novel quantitative predictions of the energy and stability of fullerene molecules, the very first attempt in using persistent homology in this context. The ground-state structures of a series of small fullerene molecules are first investigated with the standard Vietoris-Rips complex. We decipher all the barcodes, including both short-lived local bars and long-lived global bars arising from topological invariants, and associate them with fullerene structural details. Using accumulated bar lengths, we build quantitative models to correlate local and global Betti-2 bars, respectively with the heat of formation and total curvature energies of fullerenes. It is found that the heat of formation energy is related to the local hexagonal cavities of small fullerenes, while the total curvature energies of fullerene isomers are associated with their sphericities, which are measured by the lengths of their long-lived Betti-2 bars. Excellent correlation coefficients (>0.94) between persistent homology predictions and those of quantum or curvature analysis have been observed. A correlation matrix based filtration is introduced to further verify our findings. © 2014 Wiley Periodicals, Inc.

  17. Persistent Homology for The Quantitative Prediction of Fullerene Stability

    Science.gov (United States)

    Xia, Kelin; Feng, Xin; Tong, Yiying; Wei, Guo Wei

    2014-01-01

    Persistent homology is a relatively new tool often used for qualitative analysis of intrinsic topological features in images and data originated from scientific and engineering applications. In this paper, we report novel quantitative predictions of the energy and stability of fullerene molecules, the very first attempt in employing persistent homology in this context. The ground-state structures of a series of small fullerene molecules are first investigated with the standard Vietoris-Rips complex. We decipher all the barcodes, including both short-lived local bars and long-lived global bars arising from topological invariants, and associate them with fullerene structural details. By using accumulated bar lengths, we build quantitative models to correlate local and global Betti-2 bars respectively with the heat of formation and total curvature energies of fullerenes. It is found that the heat of formation energy is related to the local hexagonal cavities of small fullerenes, while the total curvature energies of fullerene isomers are associated with their sphericities, which are measured by the lengths of their long-lived Betti-2 bars. Excellent correlation coefficients (> 0.94) between persistent homology predictions and those of quantum or curvature analysis have been observed. A correlation matrix based filtration is introduced to further verify our findings. PMID:25523342

  18. Accelerated homologous recombination and subsequent genome modification in Drosophila.

    Science.gov (United States)

    Baena-Lopez, Luis Alberto; Alexandre, Cyrille; Mitchell, Alice; Pasakarnis, Laurynas; Vincent, Jean-Paul

    2013-12-01

    Gene targeting by 'ends-out' homologous recombination enables the deletion of genomic sequences and concurrent introduction of exogenous DNA with base-pair precision without sequence constraint. In Drosophila, this powerful technique has remained laborious and hence seldom implemented. We describe a targeting vector and protocols that achieve this at high frequency and with very few false positives in Drosophila, either with a two-generation crossing scheme or by direct injection in embryos. The frequency of injection-mediated gene targeting can be further increased with CRISPR-induced double-strand breaks within the region to be deleted, thus making homologous recombination almost as easy as conventional transgenesis. Our targeting vector replaces genomic sequences with a multifunctional fragment comprising an easy-to-select genetic marker, a fluorescent reporter, as well as an attP site, which acts as a landing platform for reintegration vectors. These vectors allow the insertion of a variety of transcription reporters or cDNAs to express tagged or mutant isoforms at endogenous levels. In addition, they pave the way for difficult experiments such as tissue-specific allele switching and functional analysis in post-mitotic or polyploid cells. Therefore, our method retains the advantages of homologous recombination while capitalising on the mutagenic power of CRISPR.

  19. PAR-TERRA directs homologous sex chromosome pairing.

    Science.gov (United States)

    Chu, Hsueh-Ping; Froberg, John E; Kesner, Barry; Oh, Hyun Jung; Ji, Fei; Sadreyev, Ruslan; Pinter, Stefan F; Lee, Jeannie T

    2017-08-01

    In mammals, homologous chromosomes rarely pair outside meiosis. One exception is the X chromosome, which transiently pairs during X-chromosome inactivation (XCI). How two chromosomes find each other in 3D space is not known. Here, we reveal a required interaction between the X-inactivation center (Xic) and the telomere in mouse embryonic stem (ES) cells. The subtelomeric, pseudoautosomal regions (PARs) of the two sex chromosomes (X and Y) also undergo pairing in both female and male cells. PARs transcribe a class of telomeric RNA, dubbed PAR-TERRA, which accounts for a vast majority of all TERRA transcripts. PAR-TERRA binds throughout the genome, including to the PAR and Xic. During X-chromosome pairing, PAR-TERRA anchors the Xic to the PAR, creating a 'tetrad' of pairwise homologous interactions (Xic-Xic, PAR-PAR, and Xic-PAR). Xic pairing occurs within the tetrad. Depleting PAR-TERRA abrogates pairing and blocks initiation of XCI, whereas autosomal PAR-TERRA induces ectopic pairing. We propose a 'constrained diffusion model' in which PAR-TERRA creates an interaction hub to guide Xic homology searching during XCI.

  20. Allergen homologs in the Euroglyphus maynei draft genome.

    Directory of Open Access Journals (Sweden)

    S Dean Rider

    Full Text Available Euroglyphus maynei is a house dust mite commonly found in homes worldwide and is the source of allergens that sensitize and induce allergic reactions in humans. It is the source of species-specific allergens as well as allergens that are cross-reactive with the allergens from house dust mites Dermatophagoides farinae and D. pteronyssinus, and the ectoparasitic scabies mite Sarcoptes scabiei. The genomics, proteomics and molecular biology of E. maynei and its allergens have not been as extensively investigated as those of D. farinae, D. pteronyssinus, and S. scabiei where natural and recombinant allergens from these species have been characterized. Until now, little was known about the genome of E. maynei and it allergens but this information will be important for producing recombinant allergens for diagnostic and therapeutic purposes and for understanding the allergic response mechanism by immune effector cells that mediate the allergic reaction. We sequenced and assembled the 59 Mb E. maynei genome to aid the identification of homologs for known allergenic proteins. The predicted proteome shared orthologs with D. farinae and S. scabiei, and included proteins with homology to more than 30 different groups of allergens. However, the majority of allergen candidates could not be assigned as clear orthologs to known mite allergens. The genomic sequence data, predicted proteome, and allergen homologs identified from E. maynei provide insight into the relationships among astigmatid mites and their allergens, which should allow for the development of improved diagnostics and immunotherapy.

  1. Membrane and Protein Interactions of the Pleckstrin Homology Domain Superfamily.

    Science.gov (United States)

    Lenoir, Marc; Kufareva, Irina; Abagyan, Ruben; Overduin, Michael

    2015-10-23

    The human genome encodes about 285 proteins that contain at least one annotated pleckstrin homology (PH) domain. As the first phosphoinositide binding module domain to be discovered, the PH domain recruits diverse protein architectures to cellular membranes. PH domains constitute one of the largest protein superfamilies, and have diverged to regulate many different signaling proteins and modules such as Dbl homology (DH) and Tec homology (TH) domains. The ligands of approximately 70 PH domains have been validated by binding assays and complexed structures, allowing meaningful extrapolation across the entire superfamily. Here the Membrane Optimal Docking Area (MODA) program is used at a genome-wide level to identify all membrane docking PH structures and map their lipid-binding determinants. In addition to the linear sequence motifs which are employed for phosphoinositide recognition, the three dimensional structural features that allow peripheral membrane domains to approach and insert into the bilayer are pinpointed and can be predicted ab initio. The analysis shows that conserved structural surfaces distinguish which PH domains associate with membrane from those that do not. Moreover, the results indicate that lipid-binding PH domains can be classified into different functional subgroups based on the type of membrane insertion elements they project towards the bilayer.

  2. Membrane and Protein Interactions of the Pleckstrin Homology Domain Superfamily

    Directory of Open Access Journals (Sweden)

    Marc Lenoir

    2015-10-01

    Full Text Available The human genome encodes about 285 proteins that contain at least one annotated pleckstrin homology (PH domain. As the first phosphoinositide binding module domain to be discovered, the PH domain recruits diverse protein architectures to cellular membranes. PH domains constitute one of the largest protein superfamilies, and have diverged to regulate many different signaling proteins and modules such as Dbl homology (DH and Tec homology (TH domains. The ligands of approximately 70 PH domains have been validated by binding assays and complexed structures, allowing meaningful extrapolation across the entire superfamily. Here the Membrane Optimal Docking Area (MODA program is used at a genome-wide level to identify all membrane docking PH structures and map their lipid-binding determinants. In addition to the linear sequence motifs which are employed for phosphoinositide recognition, the three dimensional structural features that allow peripheral membrane domains to approach and insert into the bilayer are pinpointed and can be predicted ab initio. The analysis shows that conserved structural surfaces distinguish which PH domains associate with membrane from those that do not. Moreover, the results indicate that lipid-binding PH domains can be classified into different functional subgroups based on the type of membrane insertion elements they project towards the bilayer.

  3. Remote homology detection incorporating the context of physicochemical properties.

    Science.gov (United States)

    Bedoya, Oscar; Tischer, Irene

    2014-02-01

    A new method for remote protein homology detection, called support vector machine incorporating the context of physicochemical properties (SVM-CP), is presented. Recent discriminative methods are based on concatenating information extracted from each protein by considering several physicochemical properties. We show that there are physicochemical properties that reflect the functional or structural characteristics of each specific protein family, but there are also some physicochemical properties that affect the accuracy of the classification techniques. The research highlights the importance of the selection of physicochemical properties in remote homology detection. Most of the methods slide a window over every protein sequence to extract physicochemical information. This extraction is usually performed by giving the same importance to every value in the window, i.e., averaging the physicochemical values in the observation window. SVM-CP takes into account that every residue in a sliding window has a different weight, which reflects the importance or contribution to the representative value of the window. The SVM-CP method reaches a receiver operating characteristic (ROC) score of 0.93462, which is the highest value for a remote homology detection method based on the sequence composition information. © 2013 Published by Elsevier Ltd.

  4. The Implementation of Robotic Surgery in Israel.

    Science.gov (United States)

    Matanes, Emad; Boulus, Sari; Lowenstein, Lior

    2015-09-01

    In the last decade the number of robotic devices and the medical procedures utilizing them increased significantly around the world. To evaluate the implementation of robotic surgeries in Israel in various surgical disciplines. We conducted a retrospective study accessing information about the annual purchases of robots, the number of physicians trained for their use, and the number of robotic surgeries performed each year, according to indications of surgery and the disciplines of the operating medical staff. The data were taken from the database of Intuitive Surgical Inc. Six robots were purchased by six medical centers in Israel during the years 2008-2013. There are currently 150 physicians trained to use the robot in one of the simulators of Intuitive Surgical Inc. Of them, 104 are listed as active robotic surgeons. Most of these physicians are urologists, gynecologists, or general surgeons. The number of robotic surgeries increased each year in all fields in which it was implemented. In 2013, 975 robotic surgeries were performed in Israel. Of them, 52% were performed by urologists; 89% of them were radical prostatectomy. The use of robotic surgery increased considerably in Israel over recent years, in urology, gynecology, general surgery, and otolaryngology. Despite the lack of conclusive evidence of the advantages of robotic surgery over the laparoscopic approach, the market power and the desire to be at the technological forefront drive many medical centers to purchase the robot and to train physicians in its use.

  5. Utility of multilevel lateral interbody fusion of the thoracolumbar coronal curve apex in adult deformity surgery in combination with open posterior instrumentation and L5-S1 interbody fusion: a case-matched evaluation of 32 patients.

    Science.gov (United States)

    Theologis, Alexander A; Mundis, Gregory M; Nguyen, Stacie; Okonkwo, David O; Mummaneni, Praveen V; Smith, Justin S; Shaffrey, Christopher I; Fessler, Richard; Bess, Shay; Schwab, Frank; Diebo, Bassel G; Burton, Douglas; Hart, Robert; Deviren, Vedat; Ames, Christopher

    2017-02-01

    OBJECTIVE The aim of this study was to evaluate the utility of supplementing long thoracolumbar posterior instrumented fusion (posterior spinal fusion, PSF) with lateral interbody fusion (LIF) of the lumbar/thoracolumbar coronal curve apex in adult spinal deformity (ASD). METHODS Two multicenter databases were evaluated. Adults who had undergone multilevel LIF of the coronal curve apex in addition to PSF with L5-S1 interbody fusion (LS+Apex group) were matched by number of posterior levels fused with patients who had undergone PSF with L5-S1 interbody fusion without LIF (LS-Only group). All patients had at least 2 years of follow-up. Percutaneous PSF and 3-column osteotomy (3CO) were excluded. Demographics, perioperative details, radiographic spinal deformity measurements, and HRQoL data were analyzed. RESULTS Thirty-two patients were matched (LS+Apex: 16; LS: 16) (6 men, 26 women; mean age 63 ± 10 years). Overall, the average values for measures of deformity were as follows: Cobb angle > 40°, sagittal vertical axis (SVA) > 6 cm, pelvic tilt (PT) > 25°, and mismatch between pelvic incidence (PI) and lumbar lordosis (LL) > 15°. There were no significant intergroup differences in preoperative radiographic parameters, although patients in the LS+Apex group had greater Cobb angles and less LL. Patients in the LS+Apex group had significantly more anterior levels fused (4.6 vs 1), longer operative times (859 vs 379 minutes), and longer length of stay (12 vs 7.5 days) (all p < 0.01). For patients in the LS+Apex group, Cobb angle, pelvic tilt (PT), lumbar lordosis (LL), PI-LL (lumbopelvic mismatch), Oswestry Disability Index (ODI) scores, and visual analog scale (VAS) scores for back and leg pain improved significantly (p < 0.05). For patients in the LS-Only group, there were significant improvements in Cobb angle, ODI score, and VAS scores for back and leg pain. The LS+Apex group had better correction of Cobb angles (56% vs 33%, p = 0.02), SVA (43% vs 5%, p = 0

  6. Prior Bariatric Surgery Is Linked to Improved Colorectal Cancer Surgery Outcomes and Costs: A Propensity-Matched Analysis.

    Science.gov (United States)

    Hussan, Hisham; Stanich, Peter P; Gray, Darrell M; Krishna, Somashekar G; Porter, Kyle; Conwell, Darwin L; Clinton, Steven K

    2017-04-01

    Morbid obesity is associated with worse colorectal cancer (CRC) perioperative outcomes. The impact of bariatric surgery on these outcomes is unknown. The National Inpatient Sample Database (2006-2012) was used to identify adults with prior bariatric surgery (divided into BMI ≤35 kg/m2 and BMI >35 kg/m2) or morbid obesity that underwent CRC surgery. Main outcomes were mortality, surgical complications and health care utilization. There were 1813 patients with prior bariatric surgery and 22,552 morbidly obese patients that underwent CRC surgery between 2006 and 2012. Prior bariatric surgery patients were younger, with fewer comorbidities, and had less emergency CRC surgery admissions (p bariatric surgery and CRC perioperative mortality. Notably, multivariate analysis revealed that bariatric surgery patients undergoing CRC surgery had fewer accidental surgical lacerations (OR 0.38, 95 % CI = 0.15 to 0.93), shorter hospitalizations (-1.85 days, 95 % CI = 2.03 to 1.67), decreased total hospital costs (US$-5374, 95 % CI = -5935 to -4813) and lower disposition to short-term rehabilitation facilities (OR 0.65, 95 % CI = -0.43 to 0.97). Propensity score matched analysis validated these reductions in surgical complications and health care utilization in bariatric surgery patients, which were further more pronounced when bariatric surgery patients were restricted to BMI ≤35 kg/m2. Analysis of national-level data demonstrates that prior bariatric surgery is associated with fewer colorectal cancer surgical complications and improved health care resource utilization compared to morbidly obese patients. These findings emphasize and extend the therapeutic effect of bariatric surgery to the colorectal cancer perioperative setting.

  7. Genetic selection and DNA sequences of 4.5S RNA homologs

    DEFF Research Database (Denmark)

    Brown, S; Thon, G; Tolentino, E

    1989-01-01

    A general strategy for cloning the functional homologs of an Escherichia coli gene was used to clone homologs of 4.5S RNA from other bacteria. The genes encoding these homologs were selected by their ability to complement a deletion of the gene for 4.5S RNA. DNA sequences of the regions encoding...

  8. In vivo blunt-end cloning through CRISPR/Cas9-facilitated non-homologous end-joining

    Science.gov (United States)

    Geisinger, Jonathan M.; Turan, Sören; Hernandez, Sophia; Spector, Laura P.; Calos, Michele P.

    2016-01-01

    The CRISPR/Cas9 system facilitates precise DNA modifications by generating RNA-guided blunt-ended double-strand breaks. We demonstrate that guide RNA pairs generate deletions that are repaired with a high level of precision by non-homologous end-joining in mammalian cells. We present a method called knock-in blunt ligation for exploiting these breaks to insert exogenous PCR-generated sequences in a homology-independent manner without loss of additional nucleotides. This method is useful for making precise additions to the genome such as insertions of marker gene cassettes or functional elements, without the need for homology arms. We successfully utilized this method in human and mouse cells to insert fluorescent protein cassettes into various loci, with efficiencies up to 36% in HEK293 cells without selection. We also created versions of Cas9 fused to the FKBP12-L106P destabilization domain in an effort to improve Cas9 performance. Our in vivo blunt-end cloning method and destabilization-domain-fused Cas9 variant increase the repertoire of precision genome engineering approaches. PMID:26762978

  9. Metals used in maxillofacial surgery.

    Science.gov (United States)

    Pacifici, L; DE Angelis, F; Orefici, A; Cielo, A

    2016-01-01

    The goal of maxillofacial surgery is to restore the shape and functionality of maxillofacial region. In the past years, there has been a tremendous progress in this field because of significant advances in biotechnology that provided innovative biomaterials to efficiently reconstruct the maxillofacial injured region. By using appropriate selection of the implant biomaterial, it is possible to reconstruct the native tissue, both in form and function. The ideal biomaterial should mimic native tissues regarding density, strength, and modulus of elasticity. Autografts are currently the gold standard for replacement of missing tissues, but synthetic biomaterials have been widely used because they eliminate the discomfort to take the replacement tissue from the donor site. Among synthetic biomaterials, different metals may be utilized to efficiently reconstruct the maxillofacial injured region. This article makes an effort to summarize the most important metals in use in maxillofacial surgery, and point out advantages and disadvantage of each type.

  10. Reasons for cancellation of elective surgery in Ilorin | Kolawole ...

    African Journals Online (AJOL)

    Cancellation of cases on the scheduled day of surgery leads to inefficient utilization of theatre space, waste of valuable manpower and scarce resources for ... from surgery for personal reasons not communicated to the Surgeons in 13.60% of cases, while unanticipated logistic problems accounted for another 9.93%.

  11. Initial Experience With Neuroendoscopic Surgery In West Africa ...

    African Journals Online (AJOL)

    Initial Experience With Neuroendoscopic Surgery In West Africa. ... African Journal of Neurological Sciences ... Introduction Neuroendoscopic surgery is commonly utilized for the management of intracranial cystic lesions, hydrocephalus, tumor resections and biopsies and for all types of microsurgical procedures that can ...

  12. The PIKE homolog Centaurin gamma regulates developmental timing in Drosophila.

    Directory of Open Access Journals (Sweden)

    Anna Lisa Gündner

    Full Text Available Phosphoinositide-3-kinase enhancer (PIKE proteins encoded by the PIKE/CENTG1 gene are members of the gamma subgroup of the Centaurin superfamily of small GTPases. They are characterized by their chimeric protein domain architecture consisting of a pleckstrin homology (PH domain, a GTPase-activating (GAP domain, Ankyrin repeats as well as an intrinsic GTPase domain. In mammals, three PIKE isoforms with variations in protein structure and subcellular localization are encoded by the PIKE locus. PIKE inactivation in mice results in a broad range of defects, including neuronal cell death during brain development and misregulation of mammary gland development. PIKE -/- mutant mice are smaller, contain less white adipose tissue, and show insulin resistance due to misregulation of AMP-activated protein kinase (AMPK and insulin receptor/Akt signaling. here, we have studied the role of PIKE proteins in metabolic regulation in the fly. We show that the Drosophila PIKE homolog, ceng1A, encodes functional GTPases whose internal GAP domains catalyze their GTPase activity. To elucidate the biological function of ceng1A in flies, we introduced a deletion in the ceng1A gene by homologous recombination that removes all predicted functional PIKE domains. We found that homozygous ceng1A mutant animals survive to adulthood. In contrast to PIKE -/- mouse mutants, genetic ablation of Drosophila ceng1A does not result in growth defects or weight reduction. Although metabolic pathways such as insulin signaling, sensitivity towards starvation and mobilization of lipids under high fed conditions are not perturbed in ceng1A mutants, homozygous ceng1A mutants show a prolonged development in second instar larval stage, leading to a late onset of pupariation. In line with these results we found that expression of ecdysone inducible genes is reduced in ceng1A mutants. Together, we propose a novel role for Drosophila Ceng1A in regulating ecdysone signaling-dependent second to

  13. Homology of the open moduli space of curves

    DEFF Research Database (Denmark)

    Madsen, Ib Henning

    2012-01-01

    This is a survey on the proof of a generalized version of the Mumford conjecture obtained in joint work with M. Weiss stating that a certain map between some classifying spaces which a priori have different natures induces an isomorphism at the level of integral homology. We also discuss our proof...... of the original Mumford conjecture stating that the stable rational cohomology of the moduli space of Riemann surfaces is a certain polynomial algebra generated by the Mumford–Morita–Miller cohomology classes of even degrees....

  14. Parallel Computation of Persistent Homology using the Blowup Complex

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, Ryan [Stanford Univ., CA (United States); Morozov, Dmitriy [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-04-27

    We describe a parallel algorithm that computes persistent homology, an algebraic descriptor of a filtered topological space. Our algorithm is distinguished by operating on a spatial decomposition of the domain, as opposed to a decomposition with respect to the filtration. We rely on a classical construction, called the Mayer--Vietoris blowup complex, to glue global topological information about a space from its disjoint subsets. We introduce an efficient algorithm to perform this gluing operation, which may be of independent interest, and describe how to process the domain hierarchically. We report on a set of experiments that help assess the strengths and identify the limitations of our method.

  15. The colocalization transition of homologous chromosomes at meiosis

    Science.gov (United States)

    Nicodemi, Mario; Panning, Barbara; Prisco, Antonella

    2008-06-01

    Meiosis is the specialized cell division required in sexual reproduction. During its early stages, in the mother cell nucleus, homologous chromosomes recognize each other and colocalize in a crucial step that remains one of the most mysterious of meiosis. Starting from recent discoveries on the system molecular components and interactions, we discuss a statistical mechanics model of chromosome early pairing. Binding molecules mediate long-distance interaction of special DNA recognition sequences and, if their concentration exceeds a critical threshold, they induce a spontaneous colocalization transition of chromosomes, otherwise independently diffusing.

  16. A Hochschild homology Euler characteristic for circle actions

    OpenAIRE

    Geoghegan, Ross; Nicas, Andrew

    1998-01-01

    We define a "circle Euler characteristic" of a circle action on a compact manifold or finite complex X. It lies in the first Hochschild homology group of ZG where G is the fundamental group of X. It is analogous in many ways to the ordinary Euler characteristic. One application is an intuitively satisfying formula for the Euler class (integer coefficients) of the normal bundle to a smooth circle action without fixed points on a manifold. In the special case of a 3-dimensional Seifert fibered ...

  17. [Thymus surgery in a general surgery department].

    Science.gov (United States)

    Mega, Raquel; Coelho, Fátima; Pimentel, Teresa; Ribero, Rui; Matos, Novo de; Araújo, António

    2005-01-01

    Evaluation of thymectomy cases between 1990-2003, in a General Surgery Department. Evaluation of the therapeutic efficacy in Miastenia Gravis patients. Retrospective study based on evaluation of data from Serviço de Cirurgia, Neurologia and Consult de Neurology processes, between 1990-2003, of 15 patients submitted to total thymectomy. 15 patients, aged 17 to 72, 11 female and 4 male. Miastenia Gravis was the main indication for surgery, for uncontrollable symptoms or suspicion of thymoma. In patients with myasthenia, surgery was accomplish after compensation of symptoms. There weren't post-surgery complications. Pathology were divided in thymic hyperplasia and thymoma. Miastenia patients have there symptoms diminished or stable with reduction or cessation of medical therapy. Miastenia was the most frequent indication for thymectomy. Surgery was good results, with low morbimortality, as long as the protocols are respected.

  18. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... about when your child can return to school, daycare, or take part in sports. Pain after surgery ... for your child to return to school or daycare. Most often, the first few weeks after surgery ...

  19. Coronary Artery Bypass Surgery

    Science.gov (United States)

    ... don't help, you may need coronary artery bypass surgery. The surgery creates a new path for ... narrowed area or blockage. This allows blood to bypass (get around) the blockage. Sometimes people need more ...

  20. Heart bypass surgery - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100190.htm Heart bypass surgery - series—Normal anatomy To use the sharing ... Editorial team. Related MedlinePlus Health Topics Coronary Artery Bypass Surgery A.D.A.M., Inc. is accredited ...

  1. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... results of stenting versus endarterectomy for carotid-artery stenosis. N Engl J Med . 2016;374(11):1021- ...

  2. Abdominal wall surgery

    Science.gov (United States)

    Cosmetic surgery of the abdomen; Tummy tuck; Abdominoplasty ... Most of the time, this surgery is an elective or cosmetic procedure because it is an operation you choose to have. It is not usually needed for health reasons. Cosmetic abdomen repair ...

  3. Cosmetic ear surgery

    Science.gov (United States)

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  4. Hip fracture surgery

    Science.gov (United States)

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis - hip ... You may receive general anesthesia for this surgery. This means you ... spinal anesthesia . With this kind of anesthesia, medicine is ...

  5. Lasik eye surgery - discharge

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000525.htm Lasik eye surgery - discharge To use the sharing features on this page, please enable JavaScript. Lasik eye surgery permanently changes the shape of the cornea ( ...

  6. Refractive corneal surgery - discharge

    Science.gov (United States)

    ... after surgery, it should be OK to use artificial tears. Check with your provider. DO NOT wear contact lenses on the eye that had surgery, even if you have blurry vision. DO NOT use any makeup, creams, or lotions ...

  7. Smoking and surgery

    Science.gov (United States)

    Surgery - quitting smoking; Surgery - quitting tobacco; Wound healing - smoking ... Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: Blood clots and aneurysms in ...

  8. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Jaw Surgery Download Download the ebook for further information Corrective jaw, or orthognathic surgery is performed by ... your treatment. Correction of Common Dentofacial Deformities ​ ​ The information provided here is not intended as a substitute ...

  9. Cosmetic breast surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000273.htm Cosmetic breast surgery - discharge To use the sharing features on this page, please enable JavaScript. You had cosmetic breast surgery to change the size or shape ...

  10. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  11. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Lip/Palate and Craniofacial Surgery A cleft lip may require one or more surgeries depending on the ... are not uncommon. Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, ...

  12. Laparoscopic Spine Surgery

    Science.gov (United States)

    ... Global Affairs and Humanitarian Efforts Log In Laparoscopic Spine Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Laparoscopic Spine Surgery Your spine surgeon has determined that you ...

  13. Scoliosis surgery - child

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007383.htm Scoliosis surgery - child To use the sharing features on this page, please enable JavaScript. Scoliosis surgery repairs abnormal curving of the spine ( scoliosis ). ...

  14. Homologous recombination induced by doxazosin mesylate and saw palmetto in the Drosophila wing-spot test.

    Science.gov (United States)

    Gabriel, Katiane Cella; Dihl, Rafael Rodrigues; Lehmann, Mauricio; Reguly, Maria Luiza; Richter, Marc François; Andrade, Heloisa Helena Rodrigues de

    2013-03-01

    Benign prostatic hyperplasia (BPH) is the most common tumor in men over 40 years of age. Acute urinary retention (AUR) is regarded as the most serious hazard of untreated BPH. α-Blockers, such as doxazosin mesylate, and 5-α reductase inhibitors, such as finasteride, are frequently used because they decrease both AUR and the need for BPH-related surgery. An extract of the fruit from American saw palmetto plant has also been used as an alternative treatment for BPH. The paucity of information available concerning the genotoxic action of these compounds led us to assess their activity as inducers of different types of DNA lesions using the somatic mutation and recombination test in Drosophila melanogaster. Finasteride did not induce gene mutation, chromosomal mutation or mitotic recombination, which means it was nongenotoxic in our experimental conditions. On the other hand, doxazosin mesylate and saw palmetto induced significant increases in spot frequencies in trans-heterozygous flies. In order to establish the actual role played by mitotic recombination and by mutation in the genotoxicity observed, the balancer-heterozygous flies were also analyzed, showing no increment in the total spot frequencies in relation to the negative control, for both drugs. Doxazosin mesylate and saw palmetto were classified as specific inducers of homologous recombination in Drosophila proliferative cells, an event linked to the loss of heterozygosity. Copyright © 2011 John Wiley & Sons, Ltd.

  15. Multi-Homologous Recombination-Based Gene Manipulation in the Rice Pathogen Fusarium fujikuroi

    Directory of Open Access Journals (Sweden)

    In Sun Hwang

    2016-06-01

    Full Text Available Gene disruption by homologous recombination is widely used to investigate and analyze the function of genes in Fusarium fujikuroi, a fungus that causes bakanae disease and root rot symptoms in rice. To generate gene deletion constructs, the use of conventional cloning methods, which rely on restriction enzymes and ligases, has had limited success due to a lack of unique restriction enzyme sites. Although strategies that avoid the use of restriction enzymes have been employed to overcome this issue, these methods require complicated PCR steps or are frequently inefficient. Here, we introduce a cloning system that utilizes multi-fragment assembly by In-Fusion to generate a gene disruption construct. This method utilizes DNA fragment fusion and requires only one PCR step and one reaction for construction. Using this strategy, a gene disruption construct for Fusarium cyclin C1 (FCC1 , which is associated with fumonisin B1 biosynthesis, was successfully created and used for fungal transformation. In vivo and in vitro experiments using confirmed fcc1 mutants suggest that fumonisin production is closely related to disease symptoms exhibited by F. fujikuroi strain B14. Taken together, this multi-fragment assembly method represents a simpler and a more convenient process for targeted gene disruption in fungi.

  16. Breast Cancer Surgery

    Science.gov (United States)

    FACTS FOR LIFE Breast Cancer Surgery The goal of breast cancer surgery is to remove the whole tumor from the breast. Some lymph nodes ... might still be in the body. Types of breast cancer surgery There are two types of breast cancer ...

  17. Cavus Foot Surgery

    Science.gov (United States)

    ... Toes All Site Content AOFAS / FootCareMD / Treatments Cavus Foot Surgery Page Content What is a cavus foot? A cavus or high-arched foot may have ... related problems. What are the goals of cavus foot surgery? The main goal of surgery is to ...

  18. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

  19. Bloom Syndrome Helicase Promotes Meiotic Crossover Patterning and Homolog Disjunction.

    Science.gov (United States)

    Hatkevich, Talia; Kohl, Kathryn P; McMahan, Susan; Hartmann, Michaelyn A; Williams, Andrew M; Sekelsky, Jeff

    2017-01-09

    In most sexually reproducing organisms, crossover formation between homologous chromosomes is necessary for proper chromosome disjunction during meiosis I. During meiotic recombination, a subset of programmed DNA double-strand breaks (DSBs) are repaired as crossovers, with the remainder becoming noncrossovers [1]. Whether a repair intermediate is designated to become a crossover is a highly regulated decision that integrates several crossover patterning processes, both along chromosome arms (interference and the centromere effect) and between chromosomes (crossover assurance) [2]. Because the mechanisms that generate crossover patterning have remained elusive for over a century, it has been difficult to assess the relationship between crossover patterning and meiotic chromosome behavior. We show here that meiotic crossover patterning is lost in Drosophila melanogaster mutants that lack the Bloom syndrome helicase. In the absence of interference and the centromere effect, crossovers are distributed more uniformly along chromosomes. Crossovers even occur on the small chromosome 4, which normally never has meiotic crossovers [3]. Regulated distribution of crossovers between chromosome pairs is also lost, resulting in an elevated frequency of homologs that do not receive a crossover, which in turn leads to elevated nondisjunction. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Ontogeny and homology of the claustra in otophysan Ostariophysi (Teleostei).

    Science.gov (United States)

    Britz, Ralf; Hoffmann, Matthias

    2006-08-01

    We studied the ontogeny of the claustrum comparatively in representatives of all otophysan subgroups. The claustrum of cypriniforms has a cartilaginous precursor, the claustral cartilage, which subsequently ossifies perichondrally at its anterior face and develops an extensive lamina of membrane bone. The membrane bone component of the claustrum and its close association with the atrium sinus imparis, a perilymphatic space of the Weberian apparatus, are both synapomorphies of cypriniforms. The characiform claustrum is not preformed in cartilage and originates as a membrane bone ossification, a putative synapomorphy of that taxon. Among siluriforms, the claustrum is present only in more basal groups and originates as an elongate cartilage that ossifies in a characteristic ventrodorsal direction, possibly a synapomorphy of catfishes. Gymnotiforms lack the claustral cartilage and claustrum. We review all previous hypothesis of claustrum homology in light of the above findings and conclude that the most plausible hypothesis is the one originally proposed by Bloch ([1900] Jen Z Naturw 34:1-64) that claustra are homologs of the supradorsals of the first vertebra. Copyright 2006 Wiley-Liss, Inc.

  1. Overexpression of enhancer of zests homolog 2 in lymphoma.

    Science.gov (United States)

    Guo, Shan-Qi; Zhang, Yi-Zhuo

    2012-10-01

    This article aimed to review the biological characteristics of enhancer of zests homolog 2 (EZH2), and the transcriptional repression mechanism of action of EZH2 in tumors, particularly in the progression of lymphoma. The data cited in this review were mainly obtained from the articles listed in PubMed and HighWare that were published from March 2004 to April 2012. The search terms were "enhancer of zests homolog 2", "polycomb group", and "lymphoma". Articles regarding the mechanism of EZH2 in post-transcriptional modification, functions of polycomb group proteins, and the roles of EZH2 in lymphoma were selected. EZH2 acts as oncogene and involved in many kinds of tumors. Moreover, it plays an important role in tumorigenesis and lymphomagenesis by promoting the proliferation and aggressiveness of neoplastic cells, facilitating malignant tumor cell diffusion, and mediating transcriptional silencing. EZH2 mediated transcriptional repression through its methyltransferase activity at the chromatin level has certain influence on lymphoma, and there might exist a therapeutic window for the development of new agents and identification of novel diagnostic markers based on EZH2.

  2. Homology-Directed Recombination for Enhanced Engineering of Chimeric Antigen Receptor T Cells

    Directory of Open Access Journals (Sweden)

    Malika Hale

    2017-03-01

    Full Text Available Gene editing by homology-directed recombination (HDR can be used to couple delivery of a therapeutic gene cassette with targeted genomic modifications to generate engineered human T cells with clinically useful profiles. Here, we explore the functionality of therapeutic cassettes delivered by these means and test the flexibility of this approach to clinically relevant alleles. Because CCR5-negative T cells are resistant to HIV-1 infection, CCR5-negative anti-CD19 chimeric antigen receptor (CAR T cells could be used to treat patients with HIV-associated B cell malignancies. We show that targeted delivery of an anti-CD19 CAR cassette to the CCR5 locus using a recombinant AAV homology template and an engineered megaTAL nuclease results in T cells that are functionally equivalent, in both in vitro and in vivo tumor models, to CAR T cells generated by random integration using lentiviral delivery. With the goal of developing off-the-shelf CAR T cell therapies, we next targeted CARs to the T cell receptor alpha constant (TRAC locus by HDR, producing TCR-negative anti-CD19 CAR and anti-B cell maturation antigen (BCMA CAR T cells. These novel cell products exhibited in vitro cytolytic activity against both tumor cell lines and primary cell targets. Our combined results indicate that high-efficiency HDR delivery of therapeutic genes may provide a flexible and robust method that can extend the clinical utility of cell therapeutics.

  3. The homologous recombination protein RAD51D protects the genome from large deletions.

    Science.gov (United States)

    Reh, Wade A; Nairn, Rodney S; Lowery, Megan P; Vasquez, Karen M

    2017-02-28

    Homologous recombination (HR) is a DNA double-strand break (DSB) repair pathway that protects the genome from chromosomal instability. RAD51 mediator proteins (i.e. paralogs) are critical for efficient HR in mammalian cells. However, how HR-deficient cells process DSBs is not clear. Here, we utilized a loss-of-function HR-reporter substrate to simultaneously monitor HR-mediated gene conversion and non-conservative mutation events. The assay is designed around a heteroallelic duplication of the Aprt gene at its endogenous locus in isogenic Chinese hamster ovary cell lines. We found that RAD51D-deficient cells had a reduced capacity for HR-mediated gene conversion both spontaneously and in response to I-SceI-induced DSBs. Further, RAD51D-deficiency shifted DSB repair toward highly deleterious single-strand annealing (SSA) and end-joining processes that led to the loss of large chromosomal segments surrounding site-specific DSBs at an exceptionally high frequency. Deletions in the proximity of the break were due to a non-homologous end-joining pathway, while larger deletions were processed via a SSA pathway. Overall, our data revealed that, in addition to leading to chromosomal abnormalities, RAD51D-deficiency resulted in a high frequency of deletions advancing our understanding of how a RAD51 paralog is involved in maintaining genomic stability and how its deficiency may predispose cells to tumorigenesis. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  4. Change of gene structure and function by non-homologous end-joining, homologous recombination, and transposition of DNA.

    Directory of Open Access Journals (Sweden)

    Wolfgang Goettel

    2009-06-01

    Full Text Available An important objective in genome research is to relate genome structure to gene function. Sequence comparisons among orthologous and paralogous genes and their allelic variants can reveal sequences of functional significance. Here, we describe a 379-kb region on chromosome 1 of maize that enables us to reconstruct chromosome breakage, transposition, non-homologous end-joining, and homologous recombination events. Such a high-density composition of various mechanisms in a small chromosomal interval exemplifies the evolution of gene regulation and allelic diversity in general. It also illustrates the evolutionary pace of changes in plants, where many of the above mechanisms are of somatic origin. In contrast to animals, somatic alterations can easily be transmitted through meiosis because the germline in plants is contiguous to somatic tissue, permitting the recovery of such chromosomal rearrangements. The analyzed region contains the P1-wr allele, a variant of the genetically well-defined p1 gene, which encodes a Myb-like transcriptional activator in maize. The P1-wr allele consists of eleven nearly perfect P1-wr 12-kb repeats that are arranged in a tandem head-to-tail array. Although a technical challenge to sequence such a structure by shotgun sequencing, we overcame this problem by subcloning each repeat and ordering them based on nucleotide variations. These polymorphisms were also critical for recombination and expression analysis in presence and absence of the trans-acting epigenetic factor Ufo1. Interestingly, chimeras of the p1 and p2 genes, p2/p1 and p1/p2, are framing the P1-wr cluster. Reconstruction of sequence amplification steps at the p locus showed the evolution from a single Myb-homolog to the multi-gene P1-wr cluster. It also demonstrates how non-homologous end-joining can create novel gene fusions. Comparisons to orthologous regions in sorghum and rice also indicate a greater instability of the maize genome, probably due to

  5. Laser applications in surgery.

    Science.gov (United States)

    Azadgoli, Beina; Baker, Regina Y

    2016-12-01

    In modern medicine, lasers are increasingly utilized for treatment of a variety of pathologies as interest in less invasive treatment modalities intensifies. The physics behind lasers allows the same basic principles to be applied to a multitude of tissue types using slight modifications of the system. Multiple laser systems have been studied within each field of medicine. The term "laser" was combined with "surgery," "ablation," "lithotripsy," "cancer treatment," "tumor ablation," "dermatology," "skin rejuvenation," "lipolysis," "cardiology," "atrial fibrillation (AF)," and "epilepsy" during separate searches in the PubMed database. Original articles that studied the application of laser energy for these conditions were reviewed and included. A review of laser therapy is presented. Laser energy can be safely and effectively used for lithotripsy, for the treatment of various types of cancer, for a multitude of cosmetic and reconstructive procedures, and for the ablation of abnormal conductive pathways. For each of these conditions, management with lasers is comparable to, and potentially superior to, management with more traditional methods.

  6. ALKYLARYLKETONE HOMOLOGOUS SERIES FOR DETERMINATION OF KOVATS RETENTION INDICES WITH RP-HPLC USING ACETONITRILE/WATER SYSTEM

    Directory of Open Access Journals (Sweden)

    Rinaldi Idroes

    2010-06-01

    Full Text Available Some factors such as the changes of the stationary phase, temperature, pH-value, mobile-phase composition and flow rate play a crucial role in effecting the sensitivity of retention times in high performance liquid chromatography (HPLC system. Utilizing a retention index system is one of the methods to minimize those effects. Besides the mentioned factors, dead-time influences on determining the retention index as well. In comparison with Gas Chromatography (GC, the retention Index determination method in HPLC is still widely discussed, due to the difficulty of utilizing n-alkane as standard. In addition, the solutes in HPLC interact with the mobile-phase, thus the retention behavior also depend on the mobile-phase. Actually, It is difficult to use n-alkanes in HPLC as standards in case of some considerable problems, due to they are very non polar but also large retention times which lack of chromophores. Therefore, using n-alkane in routine analysis could be inconvenient. In comparison with n-alkanes, the alkylarylketones homologous series are stable compounds, commercially available and easily detected by a UV detector. This paper introduces Determination of Kovats Retention Index in the HPLC using Alkylarylketone homologous series and then is connected with n-alkane as a frame of reference. Steroids were used as test substance for calculating Kovats retention index values in acetonitrile/water system.   Keywords: Kovats Retention Index, RP- HPLC, n-alkane, alkylarylketone

  7. Homologous recombination and non-homologous end-joining repair pathways in bovine embryos with different developmental competence

    Energy Technology Data Exchange (ETDEWEB)

    Henrique Barreta, Marcos [Universidade Federal de Santa Catarina, Campus Universitario de Curitibanos, Curitibanos, SC (Brazil); Laboratorio de Biotecnologia e Reproducao Animal-BioRep, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Garziera Gasperin, Bernardo; Braga Rissi, Vitor; Cesaro, Matheus Pedrotti de [Laboratorio de Biotecnologia e Reproducao Animal-BioRep, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Ferreira, Rogerio [Centro de Educacao Superior do Oeste-Universidade do Estado de Santa Catarina, Chapeco, SC (Brazil); Oliveira, Joao Francisco de; Goncalves, Paulo Bayard Dias [Laboratorio de Biotecnologia e Reproducao Animal-BioRep, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Bordignon, Vilceu, E-mail: vilceu.bordignon@mcgill.ca [Department of Animal Science, McGill University, Ste-Anne-De-Bellevue, QC (Canada)

    2012-10-01

    This study investigated the expression of genes controlling homologous recombination (HR), and non-homologous end-joining (NHEJ) DNA-repair pathways in bovine embryos of different developmental potential. It also evaluated whether bovine embryos can respond to DNA double-strand breaks (DSBs) induced with ultraviolet irradiation by regulating expression of genes involved in HR and NHEJ repair pathways. Embryos with high, intermediate or low developmental competence were selected based on the cleavage time after in vitro insemination and were removed from in vitro culture before (36 h), during (72 h) and after (96 h) the expected period of embryonic genome activation. All studied genes were expressed before, during and after the genome activation period regardless the developmental competence of the embryos. Higher mRNA expression of 53BP1 and RAD52 was found before genome activation in embryos with low developmental competence. Expression of 53BP1, RAD51 and KU70 was downregulated at 72 h and upregulated at 168 h post-insemination in response to DSBs induced by ultraviolet irradiation. In conclusion, important genes controlling HR and NHEJ DNA-repair pathways are expressed in bovine embryos, however genes participating in these pathways are only regulated after the period of embryo genome activation in response to ultraviolet-induced DSBs.

  8. Epiretinal membrane surgery

    DEFF Research Database (Denmark)

    Hamoudi, Hassan; Correll Christensen, Ulrik; La Cour, Morten

    2017-01-01

    Purpose: To assess the impact of combined phacoemulsification-vitrectomy and sequential surgery for idiopathic epiretinal membrane (ERM) on refractive error (RE) and macular morphology. Methods: In this prospective clinical trial, we allocated phakic eyes with ERM to (1) cataract surgery...... between the groups. Four cases (17%) in the CAT group had resolved visual complaints and improved BCVA after cataract surgery resulting in no need for PPV within the follow-up period. Conclusion: Surgery for idiopathic ERM in phakic eyes with either phaco-vitrectomy or sequential surgery are equal...... and subsequent pars plana vitrectomy (PPV) (CAT group), (2) PPV and subsequent cataract surgery (VIT group) or (3) phaco-vitrectomy (COMBI group). Examinations were at baseline, one month after each surgery, and at 3 months and 12 months of follow-up. Primary outcome was the RE (the difference between predicted...

  9. High-Risk Alphapapillomavirus Oncogenes Impair the Homologous Recombination Pathway.

    Science.gov (United States)

    Wallace, Nicholas A; Khanal, Sujita; Robinson, Kristin L; Wendel, Sebastian O; Messer, Joshua J; Galloway, Denise A

    2017-10-15

    Persistent high-risk genus human Alphapapillomavirus (HPV) infections cause nearly every cervical carcinoma and a subset of tumors in the oropharyngeal tract. During the decades required for HPV-associated tumorigenesis, the cellular genome becomes significantly destabilized. Our analysis of cervical tumors from four separate data sets found a significant upregulation of the homologous-recombination (HR) pathway genes. The increased abundance of HR proteins can be replicated in primary cells by expression of the two HPV oncogenes (E6 and E7) required for HPV-associated transformation. HPV E6 and E7 also enhanced the ability of HR proteins to form repair foci, and yet both E6 and E7 reduce the ability of the HR pathway to complete double-strand break (DSB) repair by about 50%. The HPV oncogenes hinder HR by allowing the process to begin at points in the cell cycle when the lack of a sister chromatid to serve as a homologous template prevents completion of the repair. Further, HPV E6 attenuates repair by causing RAD51 to be mislocalized away from both transient and persistent DSBs, whereas HPV E7 is only capable of impairing RAD51 localization to transient lesions. Finally, we show that the inability to robustly repair DSBs causes some of these lesions to be more persistent, a phenotype that correlates with increased integration of episomal DNA. Together, these data support our hypothesis that HPV oncogenes contribute to the genomic instability observed in HPV-associated malignancies by attenuating the repair of damaged DNA.IMPORTANCE This study expands the understanding of HPV biology, establishing a direct role for both HPV E6 and E7 in the destabilization of the host genome by blocking the homologous repair of DSBs. To our knowledge, this is the first time that both viral oncogenes were shown to disrupt this DSB repair pathway. We show that HPV E6 and E7 allow HR to initiate at an inappropriate part of the cell cycle. The mislocalization of RAD51 away from DSBs in

  10. [Indications and surveillance of platelet transfusions in surgery].

    Science.gov (United States)

    Coffe, C; Bardiaux, L; Couteret, Y; Devillers, M; Leroy, M; Morel, P; Pouthier-Stein, F; Hervé, P

    1995-01-01

    Surgery, after hematology, is the biggest consumer of homologous platelet concentrates. Platelet transfusion is indicated to prevent or control bleeding associated with deficiencies in platelet number or function. In surgery, general patterns (in function of pre-surgery platelet count) can be adopted in most of the indications for platelets. In emergency situations, and in some particular cases (related to the patient, the type of operation, etc.), the transfusion procedure depends on the team's experience, the results of the available clinical and biological tests, and the drugs. Strict monitoring is required during the transfusion procedure. The efficacy of the transfusion must be controlled 1 h and 24 hours after the transfusion, and a number of factors must be assessed, namely the immunological impact of the transfusion (on red blood cells, leukocytes and platelets) and the occurrence of infectious diseases transmitted via transfusion. In addition, for a possible future transfusion, a strategy must be proposed.

  11. Rural Bypass for Elective Surgeries.

    Science.gov (United States)

    Weigel, Paula A M; Ullrich, Fred; Finegan, Chance N; Ward, Marcia M

    2017-04-01

    Rural bypass of Critical Access Hospitals (CAHs) for elective inpatient and outpatient surgical procedures has not been studied. Residents choosing to have their elective surgeries elsewhere, when the local CAH provides those surgical services, erode their rural hospital's financial base. The purpose of this research is to describe the elective surgical bypass rate, the procedures most commonly bypassed by rural residents, the distribution of volume among CAHs that offer elective surgical services, and factors predictive of bypass. A sample of elective surgery discharges was created from the 2011 Healthcare Cost and Utilization Project State Inpatient Databases and State Ambulatory Surgery Databases for Colorado, North Carolina, Vermont, and Wisconsin. Frequencies of procedures bypassed and CAH volume distribution were performed. Logistic regression was used to model factors associated with rural bypass for elective surgical care. The rural bypass rate for elective surgical procedures is 48.4%. Procedures bypassed most are operations on the musculoskeletal system, eye, and digestive system. Annual volume distribution for elective surgical procedures among CAHs varied widely. Patients who are younger, medically complex, at higher surgical risk, and have private insurance are at higher odds of bypass. Patients are also more likely to bypass low-volume hospitals. Rural hospitals should consider developing surgical services that are performed electively and on an outpatient basis that are attractive to a broader rural population. CAHs that already offer elective surgical procedures and yet who are still bypassed must examine the mutable factors that drive bypass behavior. © 2015 National Rural Health Association.

  12. Bundled payments in orthopedic surgery.

    Science.gov (United States)

    Bushnell, Brandon D

    2015-02-01

    As a result of reading this article, physicians should be able to: 1. Describe the concept of bundled payments and the potential applications of bundled payments in orthopedic surgery. 2. For specific situations, outline a clinical episode of care, determine the participants in a bundling situation, and define care protocols and pathways. 3. Recognize the importance of resource utilization management, quality outcome measurement, and combined economic-clinical value in determining the value of bundled payment arrangements. 4. Identify the implications of bundled payments for practicing orthopedists, as well as the legal issues and potential future directions of this increasingly popular alternative payment method. Bundled payments, the idea of paying a single price for a bundle of goods and services, is a financial concept familiar to most American consumers because examples appear in many industries. The idea of bundled payments has recently gained significant momentum as a financial model with the potential to decrease the significant current costs of health care. Orthopedic surgery as a field of medicine is uniquely positioned for success in an environment of bundled payments. This article reviews the history, logistics, and implications of the bundled payment model relative to orthopedic surgery. Copyright 2015, SLACK Incorporated.

  13. Enhanced Recovery After Surgery in Laparoscopic Surgery.

    Science.gov (United States)

    Leissner, Kay B; Shanahan, Jessica L; Bekker, Peter L; Amirfarzan, Houman

    2017-09-01

    As part of an effort to maximize value in the perioperative setting, a paradigm shift is underway in the way that patients are cared for preoperatively, on the day of surgery, and postoperatively-a setting collectively known as the perioperative care. Enhanced Recovery After Surgery (ERAS(®)) is an evidence-based, patient-centered team approach to delivering high-quality perioperative care to surgical patients. This review focuses on anesthesiologists, with their unique purview of perioperative setting, who are important drivers of change in the delivery of valuable perioperative care. ERAS care pathways begin in the preoperative setting by both preparing the patient for the psychological stress of surgery and optimizing the patient's medical and physiologic status so the body is ready for the physical demands of surgery. Minimization of perioperative fasting is important to maintain volume status-decreasing reliance on intravenous fluid administration, and to reduce protein catabolism around the time of surgery. Intraoperative management in ERAS pathways relies on goal-directed fluid therapy and opioid-sparing multimodal analgesia. Postoperatively, early feeding and ambulation, as well as discontinuation of extraneous lines and catheters facilitate patients' functional recovery. The laparoscopic approach to surgery, when possible, compliments ERAS techniques by reducing abdominal wall trauma and the resultant milieu of inflammatory, neurohumoral, and pain responses. Anesthesiologists driving change in the perioperative setting, in collaboration with surgeons and other disciplines, can improve value in healthcare and provide optimal outcomes that matter most to patients and healthcare providers alike.

  14. Flexoelectric and elastic coefficients of odd and even homologous bimesogens

    Science.gov (United States)

    Atkinson, Katie L.; Morris, Stephen M.; Castles, Flynn; Qasim, Malik M.; Gardiner, Damian J.; Coles, Harry J.

    2012-01-01

    It is known that bimesogenic liquid crystals exhibit a marked “odd-even” effect in the flexoelastic ratio (the effective flexoelectric coefficient to the average elastic coefficient), with the ratio being higher for the “odd-spaced” bimesogens (those with an odd number of alkyl groups in the spacer chain) than their neighboring even-spaced counterparts. To determine the contribution of each property to the flexoelastic ratio, we present experimental results on the flexoelectric and elastic coefficients of two homologous nonsymmetric bimesogens which possess odd and even alkyl spacers. Our results show that, although there are differences in the flexoelectric coefficients, there are substantially larger differences in the effective elastic coefficient. Specifically, the odd bimesogen is found to have both a low splay elastic coefficient and a very low bend elastic coefficient which, when combined, results in a significantly lower effective elastic coefficient and consequently a higher flexoelastic ratio.

  15. Supersensitive gastrin assay using antibodies raised against a cholecystokinin homolog.

    Science.gov (United States)

    Rehfeld, Jens F; Ericsson, Peter

    2012-04-01

    Peptide hormones may occur in particularly low amounts in samples from small animals. Hence, in a rat microdialysis study conventional immunoassays were not sufficiently sensitive to measure gastrin in the dialysis samples. We therefore exploited the observation that antibodies raised against the homologous hormone cholecystokinin (CCK) occasionally bind gastrin peptides with significantly higher affinity than the proper ligand. The immunoassay thus established could detect 1.0 pmol/l in 15 μl microdialysate, which corresponds to 23 attomol gastrin. Such detection limit is five-fold lower than that obtained with the most avid conventional gastrin antibodies. The results may encourage similar approaches for other peptides using homologue-raised antibodies when supersensitivity is required.

  16. Supersensitive gastrin assay using antibodies raised against a cholecystokinin homolog

    DEFF Research Database (Denmark)

    Rehfeld, Jens F; Ericsson, Peter

    2012-01-01

    Peptide hormones may occur in particularly low amounts in samples from small animals. Hence, in a rat microdialysis study conventional immunoassays were not sufficiently sensitive to measure gastrin in the dialysis samples. We therefore exploited the observation that antibodies raised against...... the homologous hormone cholecystokinin (CCK) occasionally bind gastrin peptides with significantly higher affinity than the proper ligand. The immunoassay thus established could detect 1.0 pmol/l in 15 μl microdialysate, which corresponds to 23 attomol gastrin. Such detection limit is five-fold lower than...... that obtained with the most avid conventional gastrin antibodies. The results may encourage similar approaches for other peptides using homologue-raised antibodies when supersensitivity is required....

  17. Homology models of main proteinase from coronavirus associated with SARS

    Science.gov (United States)

    Liu, Hsuan-Liang; Lin, Jin-Chung; Ho, Yih; Chen, Chin-Wen

    2005-01-01

    In this study, two homology models of the main proteinase (M pro) from the novel coronavirus associated with severe acute respiratory syndrome (SARS-CoV) were constructed. These models reveal three distinct functional domains, in which an intervening loop connecting domains II and III as well as a catalytic cleft containing the substrate binding subsites S1 and S2 between domains I and II are observed. S2 exhibits structural variations more significantly than S1 during the 200 ps molecular dynamics simulations because it is located at the open mouth of the catalytic cleft and the amino acid residues lining up this subsite are least conserved. In addition, the higher structural variation of S2 makes it flexible enough to accommodate a bulky hydrophobic residue from the substrate.

  18. Representation theory a homological algebra point of view

    CERN Document Server

    Zimmermann, Alexander

    2014-01-01

      Introducing the representation theory of groups and finite dimensional algebras, this book first studies basic non-commutative ring theory, covering the necessary background of elementary homological algebra and representations of groups to block theory. It further discusses vertices, defect groups, Green and Brauer correspondences and Clifford theory. Whenever possible the statements are presented in a general setting for more general algebras, such as symmetric finite dimensional algebras over a field. Then, abelian and derived categories are introduced in detail and are used to explain stable module categories, as well as derived categories and their main invariants and links between them. Group theoretical applications of these theories are given – such as the structure of blocks of cyclic defect groups – whenever appropriate. Overall, many methods from the representation theory of algebras are introduced. Representation Theory assumes only the most basic knowledge of linear algebra, groups, rings ...

  19. Homologies and homeotic transformation of the theropod 'semilunate' carpal.

    Science.gov (United States)

    Xu, Xing; Han, Fenglu; Zhao, Qi

    2014-08-13

    The homology of the 'semilunate' carpal, an important structure linking non-avian and avian dinosaurs, has been controversial. Here we describe the morphology of some theropod wrists, demonstrating that the 'semilunate' carpal is not formed by the same carpal elements in all theropods possessing this feature and that the involvement of the lateralmost distal carpal in forming the 'semilunate' carpal of birds is an inheritance from their non-avian theropod ancestors. Optimization of relevant morphological features indicates that these features evolved in an incremental way and the 'semilunate' structure underwent a lateral shift in position during theropod evolution, possibly as a result of selection for foldable wings in birds and their close theropod relatives. We propose that homeotic transformation was involved in the evolution of the 'semilunate' carpal. In combination with developmental data on avian wing digits, this suggests that homeosis played a significant role in theropod hand evolution in general.

  20. Functional roles of enhancer of zeste homolog 2 in gliomas.

    Science.gov (United States)

    Yin, Yatao; Qiu, Shuwei; Peng, Ying

    2016-01-15

    Gliomas are the most common and lethal type of primary malignant brain tumor. Due to the infiltrative nature and high resistance to standard first line treatment with combinations of radiation and chemotherapy, the prognosis of patient is very poor. Recently, accumulated evidence suggests that enhancer of zeste homolog 2 (EZH2) serves as an oncogene and is involved in multiple glioma cell processes, including cell cycle, invasion, glioma stem cell maintenance, drug and radiotherapy resistance and so on. In this review, we will focus on updating current knowledge of EZH2 in gliomas. Moreover, the regulation of EZH2 by microRNAs and long non-coding RNAs and the therapeutic strategies targeting EZH2 for gliomas will also be discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Crystal Structure of a Fructokinase Homolog from Halothermothrix orenii

    Energy Technology Data Exchange (ETDEWEB)

    Khiang, C.; Seetharaman, J; Kasprzak, J; Cherlyn, N; Patel, B; Love, C; Bujnicki, J; Sivaraman, J

    2010-01-01

    Fructokinase (FRK; EC 2.7.1.4) catalyzes the phosphorylation of D-fructose to D-fructose 6-phosphate (F6P). This irreversible and near rate-limiting step is a central and regulatory process in plants and bacteria, which channels fructose into a metabolically active state for glycolysis. Towards understanding the mechanism of FRK, here we report the crystal structure of a FRK homolog from a thermohalophilic bacterium Halothermothrix orenii (Hore{_}18220 in sequence databases). The structure of the Hore{_}18220 protein reveals a catalytic domain with a Rossmann-like fold and a b-sheet 'lid' for dimerization. Based on comparison of Hore{_}18220 to structures of related proteins, we propose its mechanism of action, in which the lid serves to regulate access to the substrate binding sites. Close relationship of Hore{_}18220 and plant FRK enzymes allows us to propose a model for the structure and function of FRKs.

  2. On the homology of the shoulder girdle in turtles.

    Science.gov (United States)

    Nagashima, Hiroshi; Sugahara, Fumiaki; Takechi, Masaki; Sato, Noboru; Kuratani, Shigeru

    2015-05-01

    The shoulder girdle in turtles is encapsulated in the shell and has a triradiate morphology. Due to its unique configuration among amniotes, many theories have been proposed about the skeletal identities of the projections for the past two centuries. Although the dorsal ramus represents the scapular blade, the ventral two rami remain uncertain. In particular, the ventrorostral process has been compared to a clavicle, an acromion, and a procoracoid based on its morphology, its connectivity to the rest of the skeleton and to muscles, as well as with its ossification center, cell lineage, and gene expression. In making these comparisons, the shoulder girdle skeleton of anurans has often been used as a reference. This review traces the history of the debate on the homology of the shoulder girdle in turtles. And based on the integrative aspects of developmental biology, comparative morphology, and paleontology, we suggest acromion and procoracoid identities for the two ventral processes. © 2014 Wiley Periodicals, Inc.

  3. DEK is required for homologous recombination repair of DNA breaks

    DEFF Research Database (Denmark)

    Smith, Eric A; Gole, Boris; Willis, Nicholas A

    2017-01-01

    DEK is a highly conserved chromatin-bound protein whose upregulation across cancer types correlates with genotoxic therapy resistance. Loss of DEK induces genome instability and sensitizes cells to DNA double strand breaks (DSBs), suggesting defects in DNA repair. While these DEK-deficiency pheno......DEK is a highly conserved chromatin-bound protein whose upregulation across cancer types correlates with genotoxic therapy resistance. Loss of DEK induces genome instability and sensitizes cells to DNA double strand breaks (DSBs), suggesting defects in DNA repair. While these DEK......-deficiency phenotypes were thought to arise from a moderate attenuation of non-homologous end joining (NHEJ) repair, the role of DEK in DNA repair remains incompletely understood. We present new evidence demonstrating the observed decrease in NHEJ is insufficient to impact immunoglobulin class switching in DEK knockout...

  4. Homology and evolution of the chaetae in Echiura (Annelida).

    Science.gov (United States)

    Tilic, Ekin; Lehrke, Janina; Bartolomaeus, Thomas

    2015-01-01

    Echiura is traditionally regarded as a small phylum of unsegmented spiralian worms. Molecular analyses, however, provide unquestionable evidence that Echiura are derived annelids that lost segmentation. Like annelids, echiurans possess chaetae, a single ventral pair in all species and one or two additional caudal hemi-circles of chaetae in two subgroups, but their evolutionary origin and affiliation to annelid chaetae are unresolved. Since annelids possess segmental pairs of dorsal (notopodial) and ventral (neuropodial) chaetae that are arranged in a row, the ventral chaetae in Echiura either represent a single or a paired neuropodial group of chaetae, while the caudal circle may represent fused rows of chaetae. In annelids, chaetogenesis is generally restricted to the ventral part of the notopodial chaetal sac and to the dorsal part of the neuropodial chaetal sac. We used the exact position of the chaetal formation site in the echiuran species, Thalassema thalassemum (Pallas, 1766) and Echiurus echiurus (Pallas, 1767), to test different hypotheses of the evolution of echiurid chaetae. As in annelids, a single chaetoblast is responsible for chaetogenesis in both species. Each chaeta of the ventral pair arises from its own chaetal sac and possesses a lateral formation site, evidencing that the pair of ventral chaetae in Echiura is homologous to a pair of neuropodia that fused on the ventral side, while the notopodia were reduced. Both caudal hemi-circles of chaetae in Echiurus echiurus are composed of several individual chaetal sacs, each with its own formative site. This finding argues against a homology of these hemi-circles of chaetae and annelids' rows of chaetae and leads to the hypothesis that the caudal chaetal rings evolved once within the Echiura by multiplication of ventral chaetae.

  5. Reaktivitas Antibodi Poliklonal SSV terhadap Antigen Homolog dan Heterolog

    Directory of Open Access Journals (Sweden)

    Sri Sulandari

    1998-07-01

    Full Text Available Polyclonal antibodies for Soybean Stunt Virus (SSV were produced in white rabbit through the following procedures: approximately 100 mg of purified virions emulsified in Complete Freund’s Adjuvant (CFA were injected intramuscularly first. In the second and third injection 150 mg of purified virions in Incomplete Freund’s Adjuvant (IFA per injection were injected intramuscularly. Finally, about 300 mg of purified virions were injected intravenously as a booster. The injection were done at 2 weeks interval. Antiserum was collected 5 days after the final injection. Antisera was purified by precipitation in saturated ammonium sulfate. Purified antibody was tested for the titer and reactivity of antibodies against the homologous and heterologous antigen. The studies were conducted with non-precoated I-ELISA test. This research was able to obtain about 25 ml of crude antisera for SSV, the concentration of purified polyclonal antibodies was about 9 mg/ml. the titer of polyclonal antibodies was 10.000 in I-ELISA. Without absorbtion with sap of healthy plant, the antibodies could not be use to identify the infected and healthy plant samples. In the following test, the absorbed antibody was used. Using antibodies to SSV at a dilution of 1:1000 and 1:10.000 against sap extracts sample of healthy and infected plant at a dilution of 1:10 by non-precoated I-ELISA test, indicated that the antibody could be used to identify the healthy and infected samples. By the same test, the antibody could be reacted to both homologous antigen (SSV and heterologous antigen (CMV isolated from banana. Key words: SSV, polyclonal antibodies, ELISA

  6. Is homologous recombination really an error-free process?

    Directory of Open Access Journals (Sweden)

    Bernard S Lopez

    2014-06-01

    Full Text Available Homologous recombination (HR is an evolutionarily conserved process that plays a pivotal role in the equilibrium between genetic stability and diversity. HR is commonly considered to be error-free, but several studies have shown that HR can be error-prone. Here, we discuss the actual accuracy of HR.First, we present the product of genetic exchanges (gene conversion, GC, and crossing over, CO and the mechanisms of HR during double strand break repair and replication restart. We discuss the intrinsic capacities of HR to generate genome rearrangements by GC or CO, either during DSB repair or replication restart. During this process, abortive HR intermediates generate genetic instability and cell toxicity. In addition to genome rearrangements, HR also primes error-prone DNA synthesis and favors mutagenesis on single stranded DNA, a key DNA intermediate during the HR process. The fact that cells have developed several mechanisms protecting against HR excess emphasize its potential risks. Consistent with this duality, several pro-oncogenic situations have been consistently associated with either decreased or increased HR levels. Nevertheless, this versatility also has advantages that we outline here.We conclude that HR is a double-edged sword, which on one hand controls the equilibrium between genome stability and diversity but, on the other hand, can jeopardize the maintenance of genomic integrity. Therefore, whether non-homologous end joining (which, in contrast with HR, is not intrinsically mutagenic or HR is the more mutagenic process is a question that should be re-evaluated. Both processes can be Dr. Jekyll in maintaining genome stability/variability and Mr. Hyde in jeopardizing genome integrity.

  7. DNA damage, homology-directed repair, and DNA methylation.

    Directory of Open Access Journals (Sweden)

    Concetta Cuozzo

    2007-07-01

    Full Text Available To explore the link between DNA damage and gene silencing, we induced a DNA double-strand break in the genome of Hela or mouse embryonic stem (ES cells using I-SceI restriction endonuclease. The I-SceI site lies within one copy of two inactivated tandem repeated green fluorescent protein (GFP genes (DR-GFP. A total of 2%-4% of the cells generated a functional GFP by homology-directed repair (HR and gene conversion. However, approximately 50% of these recombinants expressed GFP poorly. Silencing was rapid and associated with HR and DNA methylation of the recombinant gene, since it was prevented in Hela cells by 5-aza-2'-deoxycytidine. ES cells deficient in DNA methyl transferase 1 yielded as many recombinants as wild-type cells, but most of these recombinants expressed GFP robustly. Half of the HR DNA molecules were de novo methylated, principally downstream to the double-strand break, and half were undermethylated relative to the uncut DNA. Methylation of the repaired gene was independent of the methylation status of the converting template. The methylation pattern of recombinant molecules derived from pools of cells carrying DR-GFP at different loci, or from an individual clone carrying DR-GFP at a single locus, was comparable. ClustalW analysis of the sequenced GFP molecules in Hela and ES cells distinguished recombinant and nonrecombinant DNA solely on the basis of their methylation profile and indicated that HR superimposed novel methylation profiles on top of the old patterns. Chromatin immunoprecipitation and RNA analysis revealed that DNA methyl transferase 1 was bound specifically to HR GFP DNA and that methylation of the repaired segment contributed to the silencing of GFP expression. Taken together, our data support a mechanistic link between HR and DNA methylation and suggest that DNA methylation in eukaryotes marks homologous recombined segments.

  8. BLANNOTATOR: enhanced homology-based function prediction of bacterial proteins.

    Science.gov (United States)

    Kankainen, Matti; Ojala, Teija; Holm, Liisa

    2012-02-15

    Automated function prediction has played a central role in determining the biological functions of bacterial proteins. Typically, protein function annotation relies on homology, and function is inferred from other proteins with similar sequences. This approach has become popular in bacterial genomics because it is one of the few methods that is practical for large datasets and because it does not require additional functional genomics experiments. However, the existing solutions produce erroneous predictions in many cases, especially when query sequences have low levels of identity with the annotated source protein. This problem has created a pressing need for improvements in homology-based annotation. We present an automated method for the functional annotation of bacterial protein sequences. Based on sequence similarity searches, BLANNOTATOR accurately annotates query sequences with one-line summary descriptions of protein function. It groups sequences identified by BLAST into subsets according to their annotation and bases its prediction on a set of sequences with consistent functional information. We show the results of BLANNOTATOR's performance in sets of bacterial proteins with known functions. We simulated the annotation process for 3090 SWISS-PROT proteins using a database in its state preceding the functional characterisation of the query protein. For this dataset, our method outperformed the five others that we tested, and the improved performance was maintained even in the absence of highly related sequence hits. We further demonstrate the value of our tool by analysing the putative proteome of Lactobacillus crispatus strain ST1. BLANNOTATOR is an accurate method for bacterial protein function prediction. It is practical for genome-scale data and does not require pre-existing sequence clustering; thus, this method suits the needs of bacterial genome and metagenome researchers. The method and a web-server are available at http://ekhidna.biocenter.helsinki.fi/poxo/blannotator/.

  9. Analyses of homologous rotavirus infection in the mouse model.

    Science.gov (United States)

    Burns, J W; Krishnaney, A A; Vo, P T; Rouse, R V; Anderson, L J; Greenberg, H B

    1995-02-20

    The group A rotaviruses are significant human and veterinary pathogens in terms of morbidity, mortality, and economic loss. Despite its importance, an effective vaccine remains elusive due at least in part to our incomplete understanding of rotavirus immunity and protection. Both large and small animal model systems have been established to address these issues. One significant drawback of these models is the lack of well-characterized wild-type homologous viruses and their cell culture-adapted variants. We have characterized four strains of murine rotaviruses, EC, EHP, EL, and EW, in the infant and adult mouse model using wild-type isolates and cell culture-adapted variants of each strain. Wild-type murine rotaviruses appear to be equally infectious in infant and adult mice in terms of the intensity and duration of virus shedding following primary infection. Spread of infection to naive cagemates is seen in both age groups. Clearance of shedding following primary infection appears to correlate with the development of virus-specific intestinal IgA. Protective immunity is developed in both infant and adult mice following oral infection as demonstrated by a lack of shedding after subsequent wild-type virus challenge. Cell culture-adapted murine rotaviruses appear to be highly attenuated when administered to naive animals and do not spread efficiently to nonimmune cagemates. The availability of these wild-type and cell culture-adapted virus preparations should allow a more systematic evaluation of rotavirus infection and immunity. Furthermore, future vaccine strategies can be evaluated in the mouse model using several fully virulent homologous viruses for challenge.

  10. Gene expression and digit homology in the chicken embryo wing.

    Science.gov (United States)

    Welten, Monique C M; Verbeek, Fons J; Meijer, Annemarie H; Richardson, Michael K

    2005-01-01

    The bird wing is of special interest to students of homology and avian evolution. Fossil and developmental data give conflicting indications of digit homology if a pentadactyl "archetype" is assumed. Morphological signs of a vestigial digit I are seen in bird embryos, but no digit-like structure develops in wild-type embryos. To examine the developmental mechanisms of digit loss, we studied the expression of the high-mobility group box containing Sox9 gene, and bone morphogenetic protein receptor 1b (bmpR-1b)-markers for precondensation and prechondrogenic cells, respectively. We find an elongated domain of Sox9 expression, but no bmpR-1b expression, anterior to digit II. We interpret this as a digit I domain that reaches precondensation, but not condensation or precartilage stages. It develops late, when the tissue in which it is lodged is being remodeled. We consider these findings in the light of previous Hoxd-11 misexpression studies. Together, they suggest that there is a digit I vestige in the wing that can be rescued and undergo development if posterior patterning cues are enhanced. We observed Sox9 expression in the elusive "element X" that is sometimes stated to represent a sixth digit. Indeed, incongruity between digit domains and identities in theropods disappears if birds and other archosaurs are considered primitively polydactyl. Our study provides the first gene expression evidence for at least five digital domains in the chick wing. The failure of the first to develop may be plausibly linked to attenuation of posterior signals.

  11. Inhibition of homologous recombination with vorinostat synergistically enhances ganciclovir cytotoxicity.

    Science.gov (United States)

    Ladd, Brendon; Ackroyd, Jeffrey J; Hicks, J Kevin; Canman, Christine E; Flanagan, Sheryl A; Shewach, Donna S

    2013-12-01

    The nucleoside analog ganciclovir (GCV) elicits cytotoxicity in tumor cells via a novel mechanism in which drug incorporation into DNA produces minimal disruption of replication, but numerous DNA double strand breaks occur during the second S-phase after drug exposure. We propose that homologous recombination (HR), a major repair pathway for DNA double strand breaks, can prevent GCV-induced DNA damage, and that inhibition of HR will enhance cytotoxicity with GCV. Survival after GCV treatment in cells expressing a herpes simplex virus thymidine kinase was strongly dependent on HR (>14-fold decrease in IC50 in HR-deficient vs. HR-proficient CHO cells). In a homologous recombination reporter assay, the histone deacetylase inhibitor, suberoylanilide hydroxamic acid (SAHA; vorinostat), decreased HR repair events up to 85%. SAHA plus GCV produced synergistic cytotoxicity in U251tk human glioblastoma cells. Elucidation of the synergistic mechanism demonstrated that SAHA produced a concentration-dependent decrease in the HR proteins Rad51 and CtIP. GCV alone produced numerous Rad51 foci, demonstrating activation of HR. However, the addition of SAHA blocked GCV-induced Rad51 foci formation completely and increased γH2AX, a marker of DNA double strand breaks. SAHA plus GCV also produced synergistic cytotoxicity in HR-proficient CHO cells, but the combination was antagonistic or additive in HR-deficient CHO cells. Collectively, these data demonstrate that HR promotes survival with GCV and compromise of HR by SAHA results in synergistic cytotoxicity, revealing a new mechanism for enhancing anticancer activity with GCV. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Homologous Circular-ribbon Flares Driven by Twisted Flux Emergence

    Science.gov (United States)

    Xu, Z.; Yang, K.; Guo, Y.; Zhao, J.; Zhao, Z. J.; Kashapova, L.

    2017-12-01

    In this paper, we report two homologous circular-ribbon flares associated with two filament eruptions. They were well observed by the New Vacuum Solar Telescope and the Solar Dynamics Observatory on 2014 March 5. Prior to the flare, two small-scale filaments enclosed by a circular pre-flare brightening lie along the circular polarity inversion line around the parasitic polarity, which has shown a continuous rotation since its first appearance. Two filaments eventually erupt in sequence associated with two homologous circular-ribbon flares and display an apparent writhing signature. Supplemented by the nonlinear force-free field extrapolation and the magnetic field squashing factor investigation, the following are revealed. (1) This event involves the emergence of magnetic flux ropes into a pre-existing polarity area, which yields the formation of a 3D null-point topology in the corona. (2) Continuous input of the free energy in the form of a flux rope from beneath the photosphere may drive a breakout-type reconnection occurring high in the corona, supported by the pre-flare brightening. (3) This initiation reconnection could release the constraint on the flux rope and trigger the MHD instability to first make filament F1 lose equilibrium. The subsequent more violent magnetic reconnection with the overlying flux is driven during the filament rising. In return, the eruption of filament F2 is further facilitated by the reduction of the magnetic tension force above. These two processes form a positive feedback to each other to cause the energetic mass eruption and flare.

  13. Homology and Evolution of the Chaetae in Echiura (Annelida)

    Science.gov (United States)

    Tilic, Ekin; Lehrke, Janina; Bartolomaeus, Thomas

    2015-01-01

    Echiura is traditionally regarded as a small phylum of unsegmented spiralian worms. Molecular analyses, however, provide unquestionable evidence that Echiura are derived annelids that lost segmentation. Like annelids, echiurans possess chaetae, a single ventral pair in all species and one or two additional caudal hemi-circles of chaetae in two subgroups, but their evolutionary origin and affiliation to annelid chaetae are unresolved. Since annelids possess segmental pairs of dorsal (notopodial) and ventral (neuropodial) chaetae that are arranged in a row, the ventral chaetae in Echiura either represent a single or a paired neuropodial group of chaetae, while the caudal circle may represent fused rows of chaetae. In annelids, chaetogenesis is generally restricted to the ventral part of the notopodial chaetal sac and to the dorsal part of the neuropodial chaetal sac. We used the exact position of the chaetal formation site in the echiuran species, Thalassema thalassemum (Pallas, 1766) and Echiurus echiurus (Pallas, 1767), to test different hypotheses of the evolution of echiurid chaetae. As in annelids, a single chaetoblast is responsible for chaetogenesis in both species. Each chaeta of the ventral pair arises from its own chaetal sac and possesses a lateral formation site, evidencing that the pair of ventral chaetae in Echiura is homologous to a pair of neuropodia that fused on the ventral side, while the notopodia were reduced. Both caudal hemi-circles of chaetae in Echiurus echiurus are composed of several individual chaetal sacs, each with its own formative site. This finding argues against a homology of these hemi-circles of chaetae and annelids’ rows of chaetae and leads to the hypothesis that the caudal chaetal rings evolved once within the Echiura by multiplication of ventral chaetae. PMID:25734664

  14. FLASH: a fast look-up algorithm for string homology.

    Science.gov (United States)

    Califano, A; Rigoutsos, I

    1993-01-01

    A key issue in managing today's large amounts of genetic data is the availability of efficient, accurate, and selective techniques for detecting homologies (similarities) between newly discovered and already stored sequences. A common characteristic of today's most advanced algorithms, such as FASTA, BLAST, and BLAZE is the need to scan the contents of the entire database, in order to find one or more matches. This design decision results in either excessively long search times or, as is the case of BLAST, in a sharp trade-off between the achieved accuracy and the required amount of computation. The homology detection algorithm presented in this paper, on the other hand, is based on a probabilistic indexing framework. The algorithm requires minimal access to the database in order to determine matches. This minimal requirement is achieved by using the sequences of interest to generate a highly redundant number of very descriptive tuples; these tuples are subsequently used as indices in a table look-up paradigm. In addition to the description of the algorithm, theoretical and experimental results on the sensitivity and accuracy of the suggested approach are provided. The storage and computational requirements are described and the probability of correct matches and false alarms is derived. Sensitivity and accuracy are shown to be close to those of dynamic programming techniques. A prototype system has been implemented using the described ideas. It contains the full Swiss-Prot database rel 25 (10 MR) and the genome of E. Coli (2 MR). The system is currently being expanded to include the complete Genbank database.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Possible quantum algorithm for the Lipshitz-Sarkar-Steenrod square for Khovanov homology

    Science.gov (United States)

    Ospina, Juan

    2013-05-01

    Recently the celebrated Khovanov Homology was introduced as a target for Topological Quantum Computation given that the Khovanov Homology provides a generalization of the Jones polynomal and then it is possible to think about of a generalization of the Aharonov.-Jones-Landau algorithm. Recently, Lipshitz and Sarkar introduced a space-level refinement of Khovanov homology. which is called Khovanov Homotopy. This refinement induces a Steenrod square operation Sq2 on Khovanov homology which they describe explicitly and then some computations of Sq2 were presented. Particularly, examples of links with identical integral Khovanov homology but with distinct Khovanov homotopy types were showed. In the presente work we will introduce possible quantum algorithms for the Lipshitz- Sarkar-Steenrod square for Khovanov Homolog and their possible simulations using computer algebra.

  16. Caffeine suppresses homologous recombination through interference with RAD51-mediated joint molecule formation

    Science.gov (United States)

    Zelensky, Alex N.; Sanchez, Humberto; Ristic, Dejan; Vidic, Iztok; van Rossum-Fikkert, Sari E.; Essers, Jeroen; Wyman, Claire; Kanaar, Roland

    2013-01-01

    Caffeine is a widely used inhibitor of the protein kinases that play a central role in the DNA damage response. We used chemical inhibitors and genetically deficient mouse embryonic stem cell lines to study the role of DNA damage response in stable integration of the transfected DNA and found that caffeine rapidly, efficiently and reversibly inhibited homologous integration of the transfected DNA as measured by several homologous recombination-mediated gene-targeting assays. Biochemical and structural biology experiments revealed that caffeine interfered with a pivotal step in homologous recombination, homologous joint molecule formation, through increasing interactions of the RAD51 nucleoprotein filament with non-homologous DNA. Our results suggest that recombination pathways dependent on extensive homology search are caffeine-sensitive and stress the importance of considering direct checkpoint-independent mechanisms in the interpretation of the effects of caffeine on DNA repair. PMID:23666627

  17. What makes homologous chromosomes find each other in meiosis? A review and an hypothesis.

    Science.gov (United States)

    Sybenga, J

    1999-08-01

    The conditions re reviewed that must be met by any model of long distance attraction and transport of homologous chromosomes to the points of intimate DNA synapsis. A proposal for possible mechanisms is presented. It includes transcription and repair factors acting on coding sequences as a preparatory step toward pairing, and the attachment of specific pairing proteins to these sequences. Double-strand break formation is prepared but not immediately completed at the same sites. It is concluded that DNA-DNA interactions cannot bridge the distances between homologous chromosomes in the nucleus, and it is suggested that protein chains are formed between homologous segments. These attach to homologous chains emanating from homologous sequences in other chromosomes, and the chains move along each other until the homologous DNA sequences meet. Then, if required, a synaptonemal complex is formed, and exchange can take place.

  18. The complex of looped diagrams and natural operations on Hochschild homology

    DEFF Research Database (Denmark)

    Klamt, Angela

    In this thesis natural operations on the (higher) Hochschild complex of a given family of algebras are investigated. We give a description of all formal operations (in the sense of Wahl) for the class of commutative algebras using Loday's lambda operation, Connes' boundary operator and shue produ...... of formal operations on Hochschild homology to higher Hochschild homology. We also generalize statements about the formal operations and give smaller models for the formal operations on higher Hochschild homology in certain cases....

  19. Genetic probing of homologous recombination and non-homologous end joining during meiotic prophase in irradiated mouse spermatocytes

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Emad A. [Department of Endocrinology and Metabolism, Faculty of Science, Utrecht University, Padualaan 8, 3584 CH Utrecht (Netherlands); Department of Zoology, Faculty of Science, Assiut University, 71516 Assiut (Egypt); Philippens, Marielle E.P.; Kal, Henk B. [Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Rooij, Dirk G. de, E-mail: d.g.derooij@uu.nl [Department of Endocrinology and Metabolism, Faculty of Science, Utrecht University, Padualaan 8, 3584 CH Utrecht (Netherlands); Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam (Netherlands); Boer, Peter de [Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen (Netherlands)

    2010-06-01

    This study was designed to obtain a better insight into the relative contribution of homologous recombination (HR) and non-homologous end joining (NHEJ) to the repair of radiation-induced DNA double-strand breaks (DSBs) at first meiotic prophase. Early and late pachytene and early diplotene spermatocytes that had completed crossing over were sampled. We studied the kinetics of {gamma}-H2AX chromatin foci removal after irradiation of mice deficient for HR and mice deficient for NHEJ. Analyzing {gamma}-H2AX signals in unirradiated RAD54/RAD54B deficient spermatocytes indicated incomplete meiotic recombination repair due to the pronounced increase of {gamma}-H2AX foci in late prophase primary spermatocytes. In these mice, 8 h after irradiation, early pachytene spermatocytes showed a reduction of the numbers of {gamma}-H2AX foci by 52% compared to 82% in the wild type, the difference being significant. However, after crossing over (in late pachytene and early diplotene), no effect of RAD54/RAD54B deficiency on the reduction of irradiation-induced foci was observed. In NHEJ deficient SCID mice, repair kinetics in early spermatocytes were similar to those in wild type mice. However, 1 h after irradiation in late pachytene and early diplotene spermatocytes 1.7 times more foci were found than in wild type mice. This difference might be related to the absence of a DNA-PKcs dependent fast repair component in SCID mice. As subsequent repair is normal, HR likely is taking over. Taken together, the results obtained in RAD54/RAD54B deficient mice and in SCID mice indicate that DSB repair in early pachytene spermatocytes is mainly carried out through HR. In late spermatocytes (late pachytenes and early diplotenes) NHEJ is active. However, probably there is an interplay between these repair pathways and when in late spermatocytes the NHEJ pathway is compromised HR may take over.

  20. [Robotics in general surgery: personal experience, critical analysis and prospectives].

    Science.gov (United States)

    Fracastoro, Gerolamo; Borzellino, Giuseppe; Castelli, Annalisa; Fiorini, Paolo

    2005-01-01

    Today mini invasive surgery has the chance to be enhanced with sophisticated informative systems (Computer Assisted Surgery, CAS) like robotics, tele-mentoring and tele-presence. ZEUS and da Vinci, present in more than 120 Centres in the world, have been used in many fields of surgery and have been tested in some general surgical procedures. Since the end of 2003, we have performed 70 experimental procedures and 24 operations of general surgery with ZEUS robotic system, after having properly trained 3 surgeons and the operating room staff. Apart from the robot set-up, the mean operative time of the robotic operations was similar to the laparoscopic ones; no complications due to robotic technique occurred. The Authors report benefits and disadvantages related to robots' utilization, problems still to be solved and the possibility to make use of them with tele-surgery, training and virtual surgery.

  1. Ergonomics in laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Supe Avinash

    2010-01-01

    Full Text Available Laparoscopic surgery provides patients with less painful surgery but is more demanding for the surgeon. The increased technological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparoscopic surgery. Ergonomic integration and suitable laparoscopic operating room environment are essential to improve efficiency, safety, and comfort for the operating team. Understanding ergonomics can not only make life of surgeon comfortable in the operating room but also reduce physical strains on surgeon.

  2. SEBACEOUS CYSTS MINOR SURGERY

    OpenAIRE

    I Gusti Ayu Agung Laksemi; Sri Maliawan; Ketut Siki Kawiyana

    2013-01-01

    Minor surgery is small surgery or localized example cut ulcers and boils, cyst excision, and suturing. Somethings that need to be considered in the preparation of the surgery is minor tools, operating rooms and operating tables, lighting, maintenance of tools and equipment, sterilization and desinfection equipment, preparation of patients and anesthesia. In general cysts is walled chamber that consist of fluid, cells and the remaining cells. Cysts are formed not due to inflammation although ...

  3. [Breast cancer surgery].

    Science.gov (United States)

    Vlastos, Georges; Berclaz, Gilles; Langer, Igor; Pittet-Cuenod, Brigitte; Delaloye, Jean-François

    2007-10-24

    Breast conserving surgery followed by radiation therapy is the treatment of choice for early breast cancer. For patients who choice or need a mastectomy, breast reconstruction provides an acceptable alternative. Breast cancer surgery has been evolving through minimally invasive approaches. Sentinel node biopsy has already remplaced axillary lymph node dissection in the evaluation of the axilla. Local ablation of the tumor may be a valuable alternative to surgery in the future.

  4. Recovery Following Orthognathic Surgery

    Science.gov (United States)

    1993-01-01

    mobility after different procedures of orthoganthic surgery. Eur J Orthod 1992;14:188-197. 4. Aragon SB, Van Sickels JE: Mandibular range of motion with...Meredeth J, Alexander JM, Mercuri LG, Brophy C: Psychological Factors in Adjustment to Orthognathic Surgery. J Oral Maxillofac Surg 1984;42:435-440. 12...Flanary C, Barwell GM, Alexander JM: Patient perceptions of orthog nathic surgery. Am J Orthod 1985;88:137-145. 13. Kehlet H: Anesthetic Technique and

  5. Ergonomics in laparoscopic surgery

    Science.gov (United States)

    Supe, Avinash N; Kulkarni, Gaurav V; Supe, Pradnya A

    2010-01-01

    Laparoscopic surgery provides patients with less painful surgery but is more demanding for the surgeon. The increased technological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparoscopic surgery. Ergonomic integration and suitable laparoscopic operating room environment are essential to improve efficiency, safety, and comfort for the operating team. Understanding ergonomics can not only make life of surgeon comfortable in the operating room but also reduce physical strains on surgeon. PMID:20814508

  6. ROBOTIC SURGERY: BIOETHICAL ASPECTS

    OpenAIRE

    SIQUEIRA-BATISTA, Rodrigo; SOUZA, Camila Ribeiro; MAIA, Polyana Mendes; SIQUEIRA, Sávio Lana

    2016-01-01

    ABSTRACT Introduction: The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. Objective: To present review of the ethical aspects of robot use in surgery. Method: Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Results: Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains br...

  7. Robotic surgery is ready for prime time in India: Against the motion

    Directory of Open Access Journals (Sweden)

    Tehemton E Udwadia

    2015-01-01

    Full Text Available The use of Robotic Surgery as a purported adjunct and aid to Minimal Access Surgery (MAS is growing in several areas. The acknowledged advantages as also the obvious and hidden disadvantages of Robotic Surgery are highlighted. Survey of literature shows that while Robotic Surgery is "feasible" and the results are "comparable" there is no convincing evidence that it is any better than MAS or even open surgery in most areas. To move "Robotic Surgery is ready for prime time in India" with no less than two dozen robots, many sub-optimally utilized for a population of 1.2 billion seems untenable.

  8. Pediatric refractive surgery.

    Science.gov (United States)

    Stahl, Erin D

    2017-07-01

    Refractive surgery procedures have been performed on children since the early 1980s. This article will review this history as well as current thoughts on treating children with large refractive errors. Pediatric refractive surgery has developed slowly as very few children fit the criteria for treatment. For this reason, practice patterns are varied and publications are rare. Publications in recent years have focused on intraocular procedures over laser refractive surgery. Pediatric refractive surgery is an evolving field as surgeons try to find the best long-term treatments for these young patients.

  9. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B

    1994-01-01

    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems....

  10. Preoperative Lifestyle Intervention in Bariatric Surgery: A Randomized Clinical Trial

    Science.gov (United States)

    Kalarchian, Melissa A.; Marcus, Marsha D.; Courcoulas, Anita P.; Cheng, Yu; Levine, Michele D.

    2015-01-01

    Background Studies of the impact of pre-surgery weight loss and lifestyle preparation on outcomes following bariatric surgery are needed. Objective To evaluate whether a pre-surgery behavioral lifestyle intervention improves weight loss through 24-months post-surgery. Setting Bariatric Center of Excellence at a large, urban medical center. Methods Candidates for bariatric surgery were randomized to a 6-month behavioral lifestyle intervention or to 6 months of usual pre-surgical care. The lifestyle intervention consisted of 8 weekly face-to-face sessions followed by 16 weeks of face-to-face and telephone sessions prior to surgery; the intervention also included 3 monthly telephone contacts after surgery. Assessments were conducted at 6-, 12- and 24-months post-surgery. Results Participants who underwent surgery (n = 143) were 90.2% female and 86.7% White. Average age was 44.9 years, and average BMI was 47.5 kg/m2 at study enrollment. At follow-up, 131 (91.6%), 126 (88.1%), 117 (81.8%) patients participated in the 6-, 12- and 24 month assessments, respectively. Percent weight loss from study enrollment to 6- and 12-months post-surgery was comparable for both groups, but at 24-months post-surgery, the lifestyle group had significantly smaller percent weight loss than the usual care group (26.5% vs. 29.5%, respectively, p = 0.02). Conclusions Pre-surgery lifestyle intervention did not improve weight loss at 24 months post-surgery. Findings raise questions about the utility and timing of adjunctive lifestyle interventions for bariatric surgery patients. PMID:26410538

  11. Melatonin utility in neonates and children

    Directory of Open Access Journals (Sweden)

    Yu-Chieh Chen

    2012-02-01

    Full Text Available Melatonin (N-acetyl-5-methoxytryptamine is an endogenously produced indoleamine secreted by the pineal gland and the secretion is suppressed by light. Melatonin is a highly effective antioxidant, free radical scavenger, and has anti-inflammatory effect. Plenty of evidence supports the utility of melatonin in adults for cancer, neurodegenerative disorders, and aging. In children and neonates, melatonin has been used widely, including for respiratory distress syndrome, bronchopulmonary dysplasia, periventricular leukomalacia (PVL, hypoxia–ischemia encephalopathy and sepsis. In addition, melatonin can be used in childhood sleep and seizure disorders, and in neonates and children receiving surgery. This review article discusses the utility of melatonin in neonates and children.

  12. The LUX Score: A Metric for Lipidome Homology.

    Directory of Open Access Journals (Sweden)

    Chakravarthy Marella

    Full Text Available A lipidome is the set of lipids in a given organism, cell or cell compartment and this set reflects the organism's synthetic pathways and interactions with its environment. Recently, lipidomes of biological model organisms and cell lines were published and the number of functional studies of lipids is increasing. In this study we propose a homology metric that can quantify systematic differences in the composition of a lipidome. Algorithms were developed to 1. consistently convert lipids structure into SMILES, 2. determine structural similarity between molecular species and 3. describe a lipidome in a chemical space model. We tested lipid structure conversion and structure similarity metrics, in detail, using sets of isomeric ceramide molecules and chemically related phosphatidylinositols. Template-based SMILES showed the best properties for representing lipid-specific structural diversity. We also show that sequence analysis algorithms are best suited to calculate distances between such template-based SMILES and we adjudged the Levenshtein distance as best choice for quantifying structural changes. When all lipid molecules of the LIPIDMAPS structure database were mapped in chemical space, they automatically formed clusters corresponding to conventional chemical families. Accordingly, we mapped a pair of lipidomes into the same chemical space and determined the degree of overlap by calculating the Hausdorff distance. We named this metric the 'Lipidome jUXtaposition (LUX score'. First, we tested this approach for estimating the lipidome similarity on four yeast strains with known genetic alteration in fatty acid synthesis. We show that the LUX score reflects the genetic relationship and growth temperature better than conventional methods although the score is based solely on lipid structures. Next, we applied this metric to high-throughput data of larval tissue lipidomes of Drosophila. This showed that the LUX score is sufficient to cluster

  13. Studies of Flerovium and Element 115 Homologs with Macrocyclic Extractants

    Energy Technology Data Exchange (ETDEWEB)

    Despotopulos, John D. [Univ. of Nevada, Las Vegas, NV (United States)

    2015-03-12

    Study of the chemistry of the heaviest elements, Z ≥ 104, poses a unique challenge due to their low production cross-sections and short half-lives. Chemistry also must be studied on the one-atom-at-a-time scale, requiring automated, fast, and very efficient chemical schemes. Recent studies of the chemical behavior of copernicium (Cn, element 112) and flerovium (Fl, element 114) together with the discovery of isotopes of these elements with half-lives suitable for chemical studies have spurred a renewed interest in the development of rapid systems designed to study the chemical properties of elements with Z ≥ 114. This dissertation explores both extraction chromatography and solvent extraction as methods for development of a rapid chemical separation scheme for the homologs of flerovium (Pb, Sn, Hg) and element 115 (Bi, Sb), with the goal of developing a chemical scheme that, in the future, can be applied to on-line chemistry of both Fl and element 115. Carrier-free radionuclides, used in these studies, of the homologs of Fl and element 115 were obtained by proton activation of high-purity metal foils at the Lawrence Livermore National Laboratory (LLNL) Center for Accelerator Mass Spectrometry (CAMS): natIn(p,n)113Sn, natSn(p,n)124Sb, and Au(p,n)197m,gHg. The carrier-free activity was separated from the foils by novel separation schemes based on ion exchange and extraction chromatography techniques. Carrier-free Pb and Bi isotopes were obtained from development of a novel generator based on cation exchange chromatography using the 232U parent to generate 212Pb and 212Bi. Macrocyclic extractants, specifically crown ethers and their derivatives, were chosen for these studies; crown ethers show high selectivity for metal ions. Finally. a potential chemical system for Fl was established based on the Eichrom Pb resin, and insight to an improved system based on thiacrown ethers is

  14. Insights into hydrocarbon formation by nitrogenase cofactor homologs.

    Science.gov (United States)

    Lee, Chi Chung; Hu, Yilin; Ribbe, Markus W

    2015-04-14

    The L-cluster is an all-iron homolog of nitrogenase cofactors. Driven by europium(II) diethylenetriaminepentaacetate [Eu(II)-DTPA], the isolated L-cluster is capable of ATP-independent reduction of CO and CN(-) to C1 to C4 and C1 to C6 hydrocarbons, respectively. Compared to its cofactor homologs, the L-cluster generates considerably more CH4 from the reduction of CO and CN(-), which could be explained by the presence of a "free" Fe atom that is "unmasked" by homocitrate as an additional site for methanation. Moreover, the elevated CH4 formation is accompanied by a decrease in the amount of longer hydrocarbons and/or the lengths of the hydrocarbon products, illustrating a competition between CH4 formation/release and C-C coupling/chain extension. These observations suggest the possibility of designing simpler synthetic clusters for hydrocarbon formation while establishing the L-cluster as a platform for mechanistic investigations of CO and CN(-) reduction without complications originating from the heterometal and homocitrate components. Nitrogenase is a metalloenzyme that is highly complex in structure and uniquely versatile in function. It catalyzes two reactions that parallel two important industrial processes: the reduction of nitrogen to ammonia, which parallels the Haber-Bosch process in ammonia production, and the reduction of carbon monoxide to hydrocarbons, which parallels the Fischer-Tropsch process in fuel production. Thus, the significance of nitrogenase can be appreciated from the perspective of the useful products it generates: (i) ammonia, the "fixed" nitrogen that is essential for the existence of the entire human population; and (ii) hydrocarbons, the "recycled" carbon fuel that could be used to directly address the worldwide energy shortage. This article provides initial insights into the catalytic characteristics of various nitrogenase cofactors in hydrocarbon formation. The reported assay system provides a useful tool for mechanistic

  15. Homologous Basal Ganglia Network Models in Physiological and Parkinsonian Conditions

    Directory of Open Access Journals (Sweden)

    Jyotika Bahuguna

    2017-08-01

    Full Text Available The classical model of basal ganglia has been refined in recent years with discoveries of subpopulations within a nucleus and previously unknown projections. One such discovery is the presence of subpopulations of arkypallidal and prototypical neurons in external globus pallidus, which was previously considered to be a primarily homogeneous nucleus. Developing a computational model of these multiple interconnected nuclei is challenging, because the strengths of the connections are largely unknown. We therefore use a genetic algorithm to search for the unknown connectivity parameters in a firing rate model. We apply a binary cost function derived from empirical firing rate and phase relationship data for the physiological and Parkinsonian conditions. Our approach generates ensembles of over 1,000 configurations, or homologies, for each condition, with broad distributions for many of the parameter values and overlap between the two conditions. However, the resulting effective weights of connections from or to prototypical and arkypallidal neurons are consistent with the experimental data. We investigate the significance of the weight variability by manipulating the parameters individually and cumulatively, and conclude that the correlation observed between the parameters is necessary for generating the dynamics of the two conditions. We then investigate the response of the networks to a transient cortical stimulus, and demonstrate that networks classified as physiological effectively suppress activity in the internal globus pallidus, and are not susceptible to oscillations, whereas parkinsonian networks show the opposite tendency. Thus, we conclude that the rates and phase relationships observed in the globus pallidus are predictive of experimentally observed higher level dynamical features of the physiological and parkinsonian basal ganglia, and that the multiplicity of solutions generated by our method may well be indicative of a natural

  16. A mex3 homolog is required for differentiation during planarian stem cell lineage development

    Science.gov (United States)

    Zhu, Shu Jun; Hallows, Stephanie E; Currie, Ko W; Xu, ChangJiang; Pearson, Bret J

    2015-01-01

    Neoblasts are adult stem cells (ASCs) in planarians that sustain cell replacement during homeostasis and regeneration of any missing tissue. While numerous studies have examined genes underlying neoblast pluripotency, molecular pathways driving postmitotic fates remain poorly defined. In this study, we used transcriptional profiling of irradiation-sensitive and irradiation-insensitive cell populations and RNA interference (RNAi) functional screening to uncover markers and regulators of postmitotic progeny. We identified 32 new markers distinguishing two main epithelial progenitor populations and a planarian homolog to the MEX3 RNA-binding protein (Smed-mex3-1) as a key regulator of lineage progression. mex3-1 was required for generating differentiated cells of multiple lineages, while restricting the size of the stem cell compartment. We also demonstrated the utility of using mex3-1(RNAi) animals to identify additional progenitor markers. These results identified mex3-1 as a cell fate regulator, broadly required for differentiation, and suggest that mex3-1 helps to mediate the balance between ASC self-renewal and commitment. DOI: http://dx.doi.org/10.7554/eLife.07025.001 PMID:26114597

  17. ATPase activity tightly regulates RecA nucleofilaments to promote homologous recombination.

    Science.gov (United States)

    Zhao, Bailin; Zhang, Dapeng; Li, Chengmin; Yuan, Zheng; Yu, Fangzhi; Zhong, Shangwei; Jiang, Guibin; Yang, Yun-Gui; Le, X Chris; Weinfeld, Michael; Zhu, Ping; Wang, Hailin

    2017-01-01

    Homologous recombination (HR), catalyzed in an evolutionarily conserved manner by active RecA/Rad51 nucleofilaments, maintains genomic integrity and promotes biological evolution and diversity. The structures of RecA/Rad51 nucleofilaments provide information critical for the entire HR process. By exploiting a unique capillary electrophoresis-laser-induced fluorescence polarization assay, we have discovered an active form of RecA nucleofilament, stimulated by ATP hydrolysis, that contains mainly unbound nucleotide sites. This finding was confirmed by a nuclease protection assay and electron microscopy (EM) imaging. We further found that these RecA-unsaturated filaments promote strand exchange in vitro and HR in vivo. RecA mutants (P67D and P67E), which only form RecA-unsaturated nucleofilaments, were able to mediate HR in vitro and in vivo, but mutants favoring the formation of the saturated nucleofilaments failed to support HR. We thus present a new model for RecA-mediated HR in which RecA utilizes its intrinsic DNA binding-dependent ATPase activity to remodel the nucleofilaments to a less saturated form and thereby promote HR.

  18. Enhancer of zeste homolog 2 (EZH2) expression in bladder cancer.

    Science.gov (United States)

    Warrick, Joshua I; Raman, Jay D; Kaag, Matthew; Bruggeman, Trey; Cates, Justin; Clark, Peter; DeGraff, David J

    2016-06-01

    Studies evaluating enhancer of zeste homolog 2 (EZH2) expression and oncologic outcomes in bladder cancer have been discrepant. EZH2 expression in noninvasive bladder cancer is not well studied. We thus set out to address the discrepancy in previous reports, and to study expression of EZH2 in noninvasive bladder cancer and its associations, in a large cystectomy cohort. EZH2 expression was evaluated in tissue microarray material (invasive and noninvasive cancer). Associations between EZH2 expression and oncologic outcomes, tumor stage, and disease type were determined. Receiver operating characteristic analysis was performed for EZH2 expression in the diagnosis of invasive carcinoma and flat carcinoma in situ (CIS) compared to benign urothelium. EZH2 expression was most common in CIS, followed by invasive carcinoma, noninvasive papillary urothelial carcinoma, and benign urothelium, in decreasing order (PEZH2 expression was not associated with oncologic outcomes, including recurrence-free survival and death from bladder cancer. The EZH2 expression status (positive or negative) of noninvasive and invasive carcinomas taken from the same bladder correlated (P = 0.05, Fisher exact). That EZH2 status of noninvasive and invasive cancer correlated in individual patients suggests that EZH2 may be a marker of lineage. EZH2 may offer diagnostic utility, particularly in flat urothelial CIS vs. benign urothelium. The present study supports that EZH2 expression in bladder cancer is not predictive of oncologic outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Increased ICU resource needs for an academic emergency general surgery service*.

    Science.gov (United States)

    Lissauer, Matthew E; Galvagno, Samuel M; Rock, Peter; Narayan, Mayur; Shah, Paulesh; Spencer, Heather; Hong, Caron; Diaz, Jose J

    2014-04-01

    ICU needs of nontrauma emergency general surgery patients are poorly described. This study was designed to compare ICU utilization of emergency general surgery patients admitted to an acute care emergency surgery service with other general surgery patients. Our hypothesis is that tertiary care emergency general surgery patients utilize more ICU resources than other general surgical patients. Retrospective database review. Academic, tertiary care, nontrauma surgical ICU. All patients admitted to the surgical ICU over age 18 between March 2004 and June 2012. None. Six thousand ninety-eight patients were evaluated: 1,053 acute care emergency surgery, 1,964 general surgery, 1,491 transplant surgery, 995 facial surgery/otolaryngology, and 595 neurosurgery. Acute care emergency surgery patients had statistically significantly longer ICU lengths of stay than other groups: acute care emergency surgery (13.5 ± 17.4 d) versus general surgery (8.7 ± 12.9), transplant (7.8 ± 11.6), oral-maxillofacial surgery (5.5 ± 4.2), and neurosurgery (4.47 ± 9.8) (all psurgery patients: acute care emergency surgery 73.4% versus general surgery 64.9%, transplant 63.3%, oral-maxillofacial surgery 58.4%, and neurosurgery 53.1% (all p surgery patients: acute care emergency surgery 10.8% versus general surgery 4.3%, transplant 6.6%, oral-maxillofacial surgery 0%, and neurosurgery 0.5% (all p surgery patients were more likely interhospital transfers for tertiary care services than general surgery or transplant (24.5% vs 15.5% and 8.3% respectively, p surgery (13.7% vs 6.7% and 3.5%, all p surgery and general surgery, whereas transplant had fewer. Emergency general surgery patients have increased ICU needs in terms of length of stay, ventilator usage, and continuous renal replacement therapy usage compared with other services, perhaps due to the higher percentage of transfers and emergent surgery required. These patients represent a distinct population. Understanding their resource needs

  20. The insect antenna: segmentation, patterning and positional homology

    Directory of Open Access Journals (Sweden)

    A. Minelli

    2017-04-01

    Full Text Available The basic mechanism by which the antennal flagellum is subdivided into flagellomeres is probably the same in all insects, irrespective of whether the process occurs in the embryo, in the eye/antenna imaginal disc, or through a series of post-embryonic increments punctuated by moults. The ultimate origin of (all? flagellomeres is the first antennomere following the pedicel, from which split off in apical direction new primary flagellomeres, each of which is eventually the source of secondary flagellomeres, according to specific spatial and temporal patterns subject to heterochrony. Only a detailed knowledge of the underlying segmentation processes could provide the ultimate background for determining positional homology between flagellomeres of two antennae with different number of antennomeres. The antennae of the Heteroptera are likely re-segmented, as their second antennomere seems to include a flagellar component. The larval antennae of the holometabolans are temporal serial homologues of those of the adult, but their segmental composition is problematic. Significant progress will be done by understanding what differentiates antennomeres that divide, either embryonically or post-embryonically, from those that do not; and by discovering whether the spatial and temporal pattern of division along the flagellum depends on local cues, or on signals travelling along the whole proximo-distal axis of the appendage.

  1. A somatic origin of homologous Robertsonian translocations and isochromosomes

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, W.P.; Bernasconi, F.; Schinzel, A.A. (Univ. of Zurich (Switzerland)); Basaran, S.; Yueksel-Apak, M. (Univ. of Istanbul (Turkey)); Neri, G. (Universita Cattolica, Rome (Italy)); Serville, F. (Hopital d' Enfants Pellegrin, Bordeaux (France)); Balicek, P.; Haluza, R. (Univ. Hospital of Hradeck Kralove, Hradec Kralove (Czech Republic)); Farah, L.M.S. (Escuola Paulista de Medicina, Sao Paulo (Brazil)) (and others)

    1994-02-01

    One t(14q 14q), three t(15q 15q), two t(21q21q), and two t(22q22q) nonmosaic, apparently balanced, de novo Robertsonian translocation cases were investigated with polymorphic markers to establish the origin of the translocated chromosomes. Four cases had results indicative of an isochromosome: one t(14q14q) case with mild mental retardation and maternal uniparental disomy (UPD) for chromosome 14, one t(15q15q) case with the Prader-Willi syndrome and UPD(15), a phenotypically normal carrier of t(22q22q) with maternal UPD(22), and a phenotypically normal t(21q21q) case of paternal UPD(21). All UPD cases showed complete homozygosity throughout the involved chromosome, which is supportive of a postmeiotic origin. In the remaining four cases, maternal and paternal inheritance of the involved chromosome was found, which unambiguously implies a somatic origin. One t(15q15q) female had a child with a ring chromosome 15, which was also of probable postmeiotic origin as recombination between grandparental haplotypes had occurred prior to ring formation. UPD might be expected to result from de novo Robertsonian translocations of meiotic origin; however, all de novo homologous translocation cases, so far reported, with UPD of chromosomes 14, 15, 21, or 22 have been isochromosomes. These data provide the first direct evidence that nonmosaic Robertsonian translocations, as well as isochromosomes, are commonly the result of a mitotic exchange. 75 refs., 1 fig., 4 tabs.

  2. Transcription-coupled homologous recombination after oxidative damage.

    Science.gov (United States)

    Wei, Leizhen; Levine, Arthur Samuel; Lan, Li

    2016-08-01

    Oxidative DNA damage induces genomic instability and may lead to mutagenesis and carcinogenesis. As severe blockades to RNA polymerase II (RNA POLII) during transcription, oxidative DNA damage and the associated DNA strand breaks have a profoundly deleterious impact on cell survival. To protect the integrity of coding regions, high fidelity DNA repair at a transcriptionally active site in non-dividing somatic cells, (i.e., terminally differentiated and quiescent/G0 cells) is necessary to maintain the sequence integrity of transcribed regions. Recent studies indicate that an RNA-templated, transcription-associated recombination mechanism is important to protect coding regions from DNA damage-induced genomic instability. Here, we describe the discovery that G1/G0 cells exhibit Cockayne syndrome (CS) B (CSB)-dependent assembly of homologous recombination (HR) factors at double strand break (DSB) sites within actively transcribed regions. This discovery is a challenge to the current dogma that HR occurs only in S/G2 cells where undamaged sister chromatids are available as donor templates. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Identification, localization, and sequencing of fetal bovine VASA homolog.

    Science.gov (United States)

    Bartholomew, Rachel A; Parks, John E

    2007-10-01

    The vasa gene, first described in Drosophila, is purported to be important in germ cell development. Vasa is present across several invertebrate and vertebrate taxa, including frogs, fish, chickens, and humans. Vasa, a DEAD (asparagine-glutamine-alanine-asparagine) box protein shown to function as an RNA helicase in vitro, has not been investigated previously in fetal stage cattle. Total RNA was extracted from bovine fetal gonads obtained at 35-55 days, 55-80 days, and 80-120 days of gestation to amplify a 296 bp reverse transcription polymerase chain reaction (RT-PCR) product using primers for human vasa. The complete coding sequence of bovine vasa was cloned with 5' and 3' random amplification of cDNA ends polymerase chain reaction (RACE-PCR) and subsequently identified as bovine vasa homolog (BVH). Northern blot analysis revealed that among the tissues examined (gonad, liver, heart, brain, and femur), the vasa gene was expressed in the gonad. This localization, the conserved pattern of gene expression, and the gene sequence suggests that BVH plays a role in bovine germ cell development as proposed for other mammalian species.

  4. Coherent Structure Detection using Persistent Homology and other Topological Tools

    Science.gov (United States)

    Smith, Spencer; Roberts, Eric; Sindi, Suzanne; Mitchell, Kevin

    2017-11-01

    For non-autonomous, aperiodic fluid flows, coherent structures help organize the dynamics, much as invariant manifolds and periodic orbits do for autonomous or periodic systems. The prevalence of such flows in nature and industry has motivated many successful techniques for defining and detecting coherent structures. However, often these approaches require very fine trajectory data to reconstruct velocity fields and compute Cauchy-Green-tensor-related quantities. We use topological techniques to help detect coherent trajectory sets in relatively sparse 2D advection problems. More specifically, we have developed a homotopy-based algorithm, the ensemble-based topological entropy calculation (E-tec), which assigns to each edge in an initial triangulation of advected points a topologically forced lower bound on its future stretching rate. The triangulation and its weighted edges allow us to analyze flows using persistent homology. This topological data analysis tool detects clusters and loops in the triangulation that are robust in the presence of noise and in this case correspond to coherent trajectory sets.

  5. A persistent homology approach to collective behavior in insect swarms

    Science.gov (United States)

    Sinhuber, Michael; Ouellette, Nicholas T.

    Various animals from birds and fish to insects tend to form aggregates, displaying self-organized collective swarming behavior. Due to their frequent occurrence in nature and their implications for engineered, collective systems, these systems have been investigated and modeled thoroughly for decades. Common approaches range from modeling them with coupled differential equations on the individual level up to continuum approaches. We present an alternative, topology-based approach for describing swarming behavior at the macroscale rather than the microscale. We study laboratory swarms of Chironomus riparius, a flying, non-biting midge. To obtain the time-resolved three-dimensional trajectories of individual insects, we use a multi-camera stereoimaging and particle-tracking setup. To investigate the swarming behavior in a topological sense, we employ a persistent homology approach to identify persisting structures and features in the insect swarm that elude a direct, ensemble-averaging approach. We are able to identify features of sub-clusters in the swarm that show behavior distinct from that of the remaining swarm members. The coexistence of sub-swarms with different features resembles some non-biological systems such as active colloids or even thermodynamic systems.

  6. Soft Ngram Representation and Modeling for Protein Remote Homology Detection.

    Science.gov (United States)

    Lovato, Pietro; Cristani, Marco; Bicego, Manuele

    2017-01-01

    Remote homology detection represents a central problem in bioinformatics, where the challenge is to detect functionally related proteins when their sequence similarity is low. Recent solutions employ representations derived from the sequence profile, obtained by replacing each amino acid of the sequence by the corresponding most probable amino acid in the profile. However, the information contained in the profile could be exploited more deeply, provided that there is a representation able to capture and properly model such crucial evolutionary information. In this paper, we propose a novel profile-based representation for sequences, called soft Ngram. This representation, which extends the traditional Ngram scheme (obtained by grouping N consecutive amino acids), permits considering all of the evolutionary information in the profile: this is achieved by extracting Ngrams from the whole profile, equipping them with a weight directly computed from the corresponding evolutionary frequencies. We illustrate two different approaches to model the proposed representation and to derive a feature vector, which can be effectively used for classification using a support vector machine (SVM). A thorough evaluation on three benchmarks demonstrates that the new approach outperforms other Ngram-based methods, and shows very promising results also in comparison with a broader spectrum of techniques.

  7. Prehabilitation Before Major Surgery

    OpenAIRE

    Johnson Francis

    2018-01-01

    Prehabilitation is a new term for preoperative rehabilitation before major surgery. Some authors use the short form 'Prehab', though it is not so widely used. Prehabilitation involves measures to improve the physical, physiological, metabolic and psychosocial reserves in preparation for an elective surgery. This involves exercise, nutrition, education and psychosocial interventions.

  8. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    The Annals of Pediatric Surgery is striving to fill an important niche that provides focus to clinical care, technical innovation and clinical research. The Annals of Pediatric Surgery has the responsibility to serve not only pediatric surgeons in the Middle East and North Africa but also should be an important conduit for scientific ...

  9. Hand Surgery: Anesthesia

    Science.gov (United States)

    ... or asleep, depending on what you and the surgical team decide. You will not be able to see the surgery itself because a large sterile drape is placed between you and the surgeon. This is to protect the “sterile field,” the important area of your surgery, from any ...

  10. [Cognitive deterioration after surgery

    DEFF Research Database (Denmark)

    Steinmetz, J.; Rasmussen, L.S.

    2008-01-01

    Delirium and postoperative cognitive dysfunction are important and common complications after surgery. Risk factors are first of all increasing age and type of surgery, whereas the type of anaesthesia does not seem to play an important role. Mortality is higher among patients with cognitive...

  11. Weight Loss Surgery

    Science.gov (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you cannot lose weight through diet and exercise or have serious health problems caused by obesity. There are different types of weight loss surgery. They often limit the amount of food ...

  12. Contemporary endodontic surgery.

    Science.gov (United States)

    Rubinstein, Richard; Torabinejad, Mahmoud

    2004-06-01

    During the past decade, endodontics has seen a dramatic shift in the application of periradicular surgery and the role it plays in endodontic treatment. With the introduction of enhanced magnification, periradicular ultrasonics and other associative technologies, teeth that might otherwise be extracted now have a chance for retention. This article describes the role of these advances in contemporary endodontic surgery.

  13. Safety in cardiac surgery

    NARCIS (Netherlands)

    Siregar, S.

    2013-01-01

    The monitoring of safety in cardiac surgery is a complex process, which involves many clinical, practical, methodological and statistical issues. The objective of this thesis was to measure and to compare safety in cardiac surgery in The Netherlands using the Netherlands Association for

  14. Dyschromatopsia following cataract surgery.

    Science.gov (United States)

    Jordan, D R; Valberg, J D

    1986-06-01

    The authors report on 19 individuals who experienced colour obscurations (dyschromatopsia) following cataract surgery. Although a transient blue discoloration (cyanopsia) might be expected following cataract surgery, an erythropsia (red vision) is more common. Symptoms generally begin after outdoor activity in bright sunlight, vary in duration and are recurrent. It is important to look for a history of drug use, migraine or cerebrovascular accidents.

  15. Annals of African Surgery

    African Journals Online (AJOL)

    The goal of the Annals of African Surgery is to provide a medium for the exchange of current information between surgeons in the African region. The journal embraces surgery in all its aspects; basic science, clinical research, experimental research, surgical education. It will assist surgeons in the region to keep abreast of ...

  16. Tennis elbow surgery

    Science.gov (United States)

    ... people. Many people are able to return to sports and other activities that use the elbow within 4 to 6 months. Keeping up with recommended exercise helps ensure the problem will not return. Alternative Names Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral ...

  17. Utility usage forecasting

    Energy Technology Data Exchange (ETDEWEB)

    Hosking, Jonathan R. M.; Natarajan, Ramesh

    2017-08-22

    The computer creates a utility demand forecast model for weather parameters by receiving a plurality of utility parameter values, wherein each received utility parameter value corresponds to a weather parameter value. Determining that a range of weather parameter values lacks a sufficient amount of corresponding received utility parameter values. Determining one or more utility parameter values that corresponds to the range of weather parameter values. Creating a model which correlates the received and the determined utility parameter values with the corresponding weather parameters values.

  18. The Safety and Therapeutic Effectiveness of Nonwashed Mediastinal Shed Blood Reinfused Into Patients Following Open Heart Surgery

    Science.gov (United States)

    1992-05-06

    Brea, CA). Total protein and albumin levels were measured by the Biuret reactions method of Kingsley [11]. Factor V (% normal), Factor VIII...mediastinal blood which could be transfused without producing hemorrhagic complications. PATIENTS AND METHODS Patients. The experimental protocol for this...related hematologic functions following cardiopulmonary bypass for open heart surgery. Methods to minimize the use of homologous blood replacement

  19. Assessment of driving outcomes after epilepsy surgery.

    Science.gov (United States)

    Dawkins, Ross L; Omar, Nidal B; Agee, Bonita S; Walters, Beverly C; Riley, Kristen O

    2015-11-01

    Driving is an important factor contributing to good quality of life in patients with epilepsy. Little work has been undertaken to explore the details of driving experience alone in this patient population. We assessed the driving status of our patients prior to and following surgery for epilepsy. We also sought to determine what associations exist between patient characteristics and postoperative driving status. The participants were selected from those adult patients with epilepsy who have required surgical treatment at our home institution between 2006 and 2010. Each participant received a questionnaire asking about driving and seizure status before and after surgery. The surveys were distributed using a modified Dillman approach. Perioperative patient data were obtained from the electronic medical record system in addition to a previously assembled epilepsy database from the Neurology Department at our institution. Independent variables were analyzed to look for significant associations with driving outcomes. One hundred forty eligible patients were included in the survey population; 78 patients returned a questionnaire for a response rate of 55.7%. Eighty percent of patients experienced driving as a regular part of life at some point prior to surgery. At the time of the questionnaire distribution, 68% of patients had returned to regular driving. Demographic characteristics did not play a significant role in whether or not the patient had a favorable driving outcome after surgery. However, patients who had a history of driving on a regular basis prior to surgery and those who had an Engel Class I outcome after surgery had significantly higher rates of good driving outcomes. Also, patients with an unfavorable preoperative driving status were more likely to have a favorable driving outcome after surgery if they had an Engel Class I outcome. Patients in whom intracranial electroencephalography (EEG) was utilized prior to resection had worse driving outcomes. A

  20. Guidelines for flapless surgery.

    Science.gov (United States)

    Sclar, Anthony G

    2007-07-01

    With the introduction of in-office cone beam computed tomography (CT), improved access to conventional CT scanning, and dental implant treatment planning software allowing on-the-spot 3-dimensional evaluations of potential implant sites, the use of "flapless" implant surgery has gained popularity among surgeons. Although the flapless approach was initially suggested for and embraced by novice implant surgeons, the successful use of this approach often requires advanced clinical experience and surgical judgment. This article reviews the advantages and disadvantages of and indications and contraindications for flapless dental implant surgery, with special emphasis on requirements for establishing or maintaining long-term health and stability of the peri-implant soft tissues. Prerequisites for surgeons wishing to use the flapless tissue punch approach in dental implant surgery are outlined and put into perspective relative to conventional open-flap surgery techniques and other minimally invasive procedures currently used in implant surgery. Procedures for single- and multiple-tooth applications are illustrated.

  1. ROBOTIC SURGERY: BIOETHICAL ASPECTS

    Science.gov (United States)

    SIQUEIRA-BATISTA, Rodrigo; SOUZA, Camila Ribeiro; MAIA, Polyana Mendes; SIQUEIRA, Sávio Lana

    2016-01-01

    ABSTRACT Introduction: The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. Objective: To present review of the ethical aspects of robot use in surgery. Method: Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Results: Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains brief presentation on robotics, its inclusion in health and bioethical aspects, and the use of robots in surgery. Conclusion: Robotic surgery is a reality today in many hospitals, which makes essential bioethical reflection on the relationship between health professionals, automata and patients. PMID:28076489

  2. Minimally invasive orthognathic surgery.

    Science.gov (United States)

    Resnick, Cory M; Kaban, Leonard B; Troulis, Maria J

    2009-02-01

    Minimally invasive surgery is defined as the discipline in which operative procedures are performed in novel ways to diminish the sequelae of standard surgical dissections. The goals of minimally invasive surgery are to reduce tissue trauma and to minimize bleeding, edema, and injury, thereby improving the rate and quality of healing. In orthognathic surgery, there are two minimally invasive techniques that can be used separately or in combination: (1) endoscopic exposure and (2) distraction osteogenesis. This article describes the historical developments of the fields of orthognathic surgery and minimally invasive surgery, as well as the integration of the two disciplines. Indications, techniques, and the most current outcome data for specific minimally invasive orthognathic surgical procedures are presented.

  3. Sinus surgery: optimal surgery, optimal outcome?

    NARCIS (Netherlands)

    Fokkens, Wytske J.

    2016-01-01

    Sinus surgery remains an issue of discussion. We lack data on a number of important issues. In this issue of the journal Jiang et al. show that 67 % of their patients who underwent FESS for CRS had OSAS (of which more than half moderate to severe) but only 38% complained of daytime sleepiness

  4. CPHmodels-3.0--remote homology modeling using structure-guided sequence profiles

    DEFF Research Database (Denmark)

    Nielsen, Morten; Lundegaard, Claus; Lund, Ole

    2010-01-01

    CPHmodels-3.0 is a web server predicting protein 3D structure by use of single template homology modeling. The server employs a hybrid of the scoring functions of CPHmodels-2.0 and a novel remote homology-modeling algorithm. A query sequence is first attempted modeled using the fast CPHmodels-2...

  5. Translog, a web browser for studying the expression divergence of homologous genes.

    Science.gov (United States)

    Dong, Xianjun; Akalin, Altuna; Sharma, Yogita; Lenhard, Boris

    2010-01-18

    Increasing amount of data from comparative genomics, and newly developed technologies producing accurate gene expression data facilitate the study of the expression divergence of homologous genes. Previous studies have individually highlighted factors that contribute to the expression divergence of duplicate genes, e.g. promoter changes, exon structure heterogeneity, asymmetric histone modifications and genomic neighborhood conservation. However, there is a lack of a tool to integrate multiple factors and visualize their variety among homologous genes in a straightforward way. We introduce Translog (a web-based tool for Transcriptome comparison of homologous genes) that assists in the comparison of homologous genes by displaying the loci in three different views: promoter view for studying the sharing/turnover of transcription initiations, exon structure for displaying the exon-intron structure changes, and genomic neighborhood to show the macro-synteny conservation in a larger scale. CAGE data for transcription initiation are mapped for each transcript and can be used to study transcription turnover and expression changes. Alignment anchors between homologous loci can be used to define the precise homologous transcripts. We demonstrate how these views can be used to visualize the changes of homologous genes during evolution, particularly after the 2R and 3R whole genome duplication. We have developed a web-based tool for assisting in the transcriptome comparison of homologous genes, facilitating the study of expression divergence.

  6. Better Understanding of Homologous Recombination through a 12-Week Laboratory Course for Undergraduates Majoring in Biotechnology

    Science.gov (United States)

    Li, Ming; Shen, Xiaodong; Zhao, Yan; Hu, Xiaomei; Hu, Fuquan; Rao, Xiancai

    2017-01-01

    Homologous recombination, a central concept in biology, is defined as the exchange of DNA strands between two similar or identical nucleotide sequences. Unfortunately, undergraduate students majoring in biotechnology often experience difficulties in understanding the molecular basis of homologous recombination. In this study, we developed and…

  7. Homologous Recombination as a Replication Fork Escort: Fork-Protection and Recovery

    Directory of Open Access Journals (Sweden)

    Audrey Costes

    2012-12-01

    Full Text Available Homologous recombination is a universal mechanism that allows DNA repair and ensures the efficiency of DNA replication. The substrate initiating the process of homologous recombination is a single-stranded DNA that promotes a strand exchange reaction resulting in a genetic exchange that promotes genetic diversity and DNA repair. The molecular mechanisms by which homologous recombination repairs a double-strand break have been extensively studied and are now well characterized. However, the mechanisms by which homologous recombination contribute to DNA replication in eukaryotes remains poorly understood. Studies in bacteria have identified multiple roles for the machinery of homologous recombination at replication forks. Here, we review our understanding of the molecular pathways involving the homologous recombination machinery to support the robustness of DNA replication. In addition to its role in fork-recovery and in rebuilding a functional replication fork apparatus, homologous recombination may also act as a fork-protection mechanism. We discuss that some of the fork-escort functions of homologous recombination might be achieved by loading of the recombination machinery at inactivated forks without a need for a strand exchange step; as well as the consequence of such a model for the stability of eukaryotic genomes.

  8. Origin, fate and homology of the precarotid plate in Pterocles alchata caudacutus

    Directory of Open Access Journals (Sweden)

    M.M. Zaher

    2012-05-01

    Full Text Available A peculiar median transitory cartilaginous precarotid plate is developed forming a floor to the hypophyseal fenestra in the posterior orbital region of the intermediate developmental embryos of Pterocles alchata. Only its anterior portion is homologized with the precarotid commissure of some birds. Its homology to the taenia intertrabecularis of some other birds and reptiles, is refuted.

  9. Origin, fate and homology of the precarotid plate in Pterocles alchata caudacutus

    OpenAIRE

    Zaher, M.M.; A.M. Riad

    2012-01-01

    A peculiar median transitory cartilaginous precarotid plate is developed forming a floor to the hypophyseal fenestra in the posterior orbital region of the intermediate developmental embryos of Pterocles alchata. Only its anterior portion is homologized with the precarotid commissure of some birds. Its homology to the taenia intertrabecularis of some other birds and reptiles, is refuted.

  10. Density parameter estimation for finding clusters of homologous proteins-tracing actinobacterial pathogenicity lifestyles

    DEFF Research Database (Denmark)

    Röttger, Richard; Kalaghatgi, Prabhav; Sun, Peng

    2013-01-01

    Homology detection is a long-standing challenge in computational biology. To tackle this problem, typically all-versus-all BLAST results are coupled with data partitioning approaches resulting in clusters of putative homologous proteins. One of the main problems, however, has been widely neglected...

  11. Cloning and expression pattern of vat-1 homolog gene in zebrafish.

    Science.gov (United States)

    Loeb-Hennard, Christine; Cousin, Xavier; Prengel, Isabel; Kremmer, Elisabeth

    2004-11-01

    The VAT-1 protein is present in the electric organ of marine rays where it is suggested to play a central role in nerve signal transmission. VAT-1 homolog protein was also identified in mouse and human but its function remains to be determined. We have investigated VAT-1 homolog in zebrafish Danio rerio since it is an excellent model amenable to the combination of genetic, molecular and embryological studies. Amino acid sequence analysis shows that the zebrafish VAT-1 homolog shares approximately 51-61% identity with the electric ray, mouse, and human counterparts. By in situ hybridization, vat-1 homolog mRNA is first observed in the trigeminal nuclei at the 8-somite stage. At 20-somite stage, vat-1 homolog is detected in the brain, namely in primary clusters of neurons, in the epiphysis and in the hindbrain. vat-1 homolog is also present in the neural tube but this expression disappears after 72 h post-fertilization. At 24 h post-fertilization, vat-1 homolog starts to be expressed in the developing gut. At later stages, vat-1 homolog is present throughout the brain, appears in the maturing retina and the pharyngeal cavity.

  12. Stimulation of homology-directed gene targeting at an endogenous human locus by a nicking endonuclease

    NARCIS (Netherlands)

    G.P. van Nierop (Gijs); A.A.F. de Vries (Antoine); M. Holkers (Maarten); K.R. Vrijsen (Krijn); M.A.F.V. Gonçalves (Manuel)

    2009-01-01

    textabstractHomologous recombination (HR) is a highly accurate mechanism of DNA repair that can be exploited for homology-directed gene targeting. Since in most cell types HR occurs very infrequently (̃10.-6to 10.-8), its practical application has been largely restricted to specific experimental

  13. Homologous and Nonhomologous Recombination Resulting in Deletion: Effects of p53 Status, Microhomology, and Repetitive DNA Length and Orientation

    Science.gov (United States)

    Gebow, Dan; Miselis, Nathan; Liber, Howard L.

    2000-01-01

    Repetitive DNA elements frequently are precursors to chromosomal deletions in prokaryotes and lower eukaryotes. However, little is known about the relationship between repeated sequences and deletion formation in mammalian cells. We have created a novel integrated plasmid-based recombination assay to investigate repeated sequence instability in human cells. In a control cell line, the presence of direct or inverted repeats did not appreciably influence the very low deletion frequencies (2 × 10−7 to 9 × 10−7) in the region containing the repeat. Similar to what has been observed in lower eukaryotes, the majority of deletions resulted from the loss of the largest direct repeat present in the system along with the intervening sequence. Interestingly, in closely related cell lines that possess a mutant p53 gene, deletion frequencies in the control and direct-repeat plasmids were 40 to 300 times higher than in their wild-type counterparts. However, mutant p53 cells did not preferentially utilize the largest available homology in the formation of the deletion. Surprisingly, inverted repeats were approximately 10,000 times more unstable in all mutant p53 cells than in wild-type cells. Finally, several deletion junctions were marked by the addition of novel bases that were homologous to one of the preexisting DNA ends. Contrary to our expectations, only 6% of deletions in all cell lines could be classified as arising from nonhomologous recombination. PMID:10805745

  14. Classifying short genomic fragments from novel lineages using composition and homology

    Directory of Open Access Journals (Sweden)

    Beiko Robert G

    2011-08-01

    Full Text Available Abstract Background The assignment of taxonomic attributions to DNA fragments recovered directly from the environment is a vital step in metagenomic data analysis. Assignments can be made using rank-specific classifiers, which assign reads to taxonomic labels from a predetermined level such as named species or strain, or rank-flexible classifiers, which choose an appropriate taxonomic rank for each sequence in a data set. The choice of rank typically depends on the optimal model for a given sequence and on the breadth of taxonomic groups seen in a set of close-to-optimal models. Homology-based (e.g., LCA and composition-based (e.g., PhyloPythia, TACOA rank-flexible classifiers have been proposed, but there is at present no hybrid approach that utilizes both homology and composition. Results We first develop a hybrid, rank-specific classifier based on BLAST and Naïve Bayes (NB that has comparable accuracy and a faster running time than the current best approach, PhymmBL. By substituting LCA for BLAST or allowing the inclusion of suboptimal NB models, we obtain a rank-flexible classifier. This hybrid classifier outperforms established rank-flexible approaches on simulated metagenomic fragments of length 200 bp to 1000 bp and is able to assign taxonomic attributions to a subset of sequences with few misclassifications. We then demonstrate the performance of different classifiers on an enhanced biological phosphorous removal metagenome, illustrating the advantages of rank-flexible classifiers when representative genomes are absent from the set of reference genomes. Application to a glacier ice metagenome demonstrates that similar taxonomic profiles are obtained across a set of classifiers which are increasingly conservative in their classification. Conclusions Our NB-based classification scheme is faster than the current best composition-based algorithm, Phymm, while providing equally accurate predictions. The rank-flexible variant of NB, which we

  15. SURGERY AND CARDIOVASCULAR SURGERY JOURNALS ANALYSIS

    Directory of Open Access Journals (Sweden)

    Alberto Schanaider

    Full Text Available Objective: To analyze critically the effectiveness and value of bibliometric indicators in journals of Surgery or Cardiovacular Surgery in the context of the postgraduate programs of CAPES Medicine III. Methods: A sampling with 16 academic programs and one professional master of Medicine III, encompassing the General and Digestive System Surgery, Cardiovascular Surgery and Multidisciplinary courses with such contents, was evaluated. Thomson Reuters/ISI (JCR, Elsevier/Scopus (SJR, and also Scielo databases were used. Results: Only in seven programs, the teachers had an average of Qualis A1 articles greater than the others strata. Eleven journals in the surgical area are in stratum A1 (5% and it reaches 25% in Cardiovascular Surgery. Among the six journals with the largest number of publications Qualis A1 in area Medicine III, five are from non-specific areas. The Acta Cirúrgica Brasileira represented 58% of the publications in the stratum A2. There are some obstacles in the Qualis classification with little uniformity among the Medicine areas I, II and III. Conclusions: A permanent committee should be set to update the Qualis, composed by the three medical areas. It should be considered using other index databases and the unification of the Qualis criteria for journals in medicine. Rating criteria of multi and transdisciplinary journals need to be reviewed. It is essential an institutional financial support for national journals chosen by peers aiming to provide a full computerization process and a professional reviewer of the English language, in order to increase the impact factor.

  16. Proposed maximum surgical blood ordering schedule for common orthopedic surgeries in a Tertiary Health - Care Center in Northern India

    Directory of Open Access Journals (Sweden)

    Sonam Kumari

    2017-01-01

    CONCLUSIONS: MSBOS based on the past blood utilization records for different surgeries and keeping patients variables in consideration wherever required would provide an efficient way of blood utilization and appropriate management of blood bank resources.

  17. Homology Modeling and Molecular Docking for the Science Curriculum

    Science.gov (United States)

    McDougal, Owen M.; Cornia, Nic; Sambasivarao, S. V.; Remm, Andrew; Mallory, Chris; Oxford, Julia Thom; Maupin, C. Mark; Andersen, Tim

    2014-01-01

    DockoMatic 2.0 is a powerful open source software program (downloadable from sourceforge.net) that allows users to utilize a readily accessible computational tool to explore biomolecules and their interactions. This manuscript describes a practical tutorial for use in the undergraduate curriculum that introduces students to macromolecular…

  18. Policy Analysis of Surgical Utilization at Blanchfield Army Community Hospital

    Science.gov (United States)

    2009-04-09

    Utilization 12 anterior /posterior cruciate ligament (ACL/PCL) reconstruction surgery may take 2-3 hours and a cataract surgery may only take 10-20 minutes...equipment, or secondary services like an ICU or physical therapy . Larger, more in depth cases could be performed at Gateway, thus allowing for an...Fort Campbell’s Post Office is on the Kentucky side which, ultimately, provides the post with a Kentucky mailing address. The physical facility of BACH

  19. Heart failure - surgeries and devices

    Science.gov (United States)

    ... surgery; HF - surgery; Intra-aortic balloon pumps - heart failure; IABP - heart failure; Catheter based assist devices - heart failure ... problem may cause heart failure or make heart failure worse. Heart valve surgery may be needed to repair or ...

  20. Entrez Programming Utilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Entrez Programming Utilities (E-utilities) are a set of eight server-side programs that provide a stable interface into the Entrez query and database system at...