Sample records for traat jri olt

  1. Missugustes virtuaalsetes võrgustikes sina kaasa lööd? / Johanna Helin, Mart Laanpere, Uno Traat ... [jt.

    Index Scriptorium Estoniae


    Küsimusele vastavad maailmahariduse projekti "Vaata ja muuda!" juht Johanna Helin, TLÜ haridustehnoloogia keskuse juhataja Mart Laanpere, Sisekaitse Akadeemia kriminoloogia õppejõud Uno Traat, TLÜ Haapsalu kolledži direktor Eve Eisenschmidt, Kose Gümnaasiumi saksa keele õpetaja Astrid Sildnik, TÜ füüsika instituudi dotsent Toomas Plank


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    Radu Lucian PÂNZARU


    Full Text Available In 1920 was established stallions deposit Brebeni in order to improve horses from Oltenia. Deposit began to operate effectively in 1928 with a staff of 20 heads, until 1984 when it was founded Slatina stud on Repository stud structure, which was moved to the location in Slatina. During 2002 the unit went into administration Romsilva National Forest as OLT Forestry Department Section. The unit is located in Slatina, Recea Street, no. 24, about 2 km from Slatina on DJ 653 Slatina - receive. In terms of administrative membership unit can be found on the municipality Slatina. Unit promotes its activities through participation in exhibition events (fairs, exhibitions, public events, etc.., Supply breeding stallions for public breeding resorts consultations for reproduction, horse riding, dressage, equestrian leisure and tourism. 2010 is the year of minimum and year 2011 is maximum in terms of value (level financial indicators - in most cases, except for external expenses, personal expenses, insurance expenses, adjustments for property, loss of use, the current and Gross (including related rates.

  3. OLT-centralized sampling frequency offset compensation scheme for OFDM-PON. (United States)

    Chen, Ming; Zhou, Hui; Zheng, Zhiwei; Deng, Rui; Chen, Qinghui; Peng, Miao; Liu, Cuiwei; He, Jing; Chen, Lin; Tang, Xionggui


    We propose an optical line terminal (OLT)-centralized sampling frequency offset (SFO) compensation scheme for adaptively-modulated OFDM-PON systems. By using the proposed SFO scheme, the phase rotation and inter-symbol interference (ISI) caused by SFOs between OLT and multiple optical network units (ONUs) can be centrally compensated in the OLT, which reduces the complexity of ONUs. Firstly, the optimal fast Fourier transform (FFT) size is identified in the intensity-modulated and direct-detection (IMDD) OFDM system in the presence of SFO. Then, the proposed SFO compensation scheme including phase rotation modulation (PRM) and length-adaptive OFDM frame has been experimentally demonstrated in the downlink transmission of an adaptively modulated optical OFDM with the optimal FFT size. The experimental results show that up to ± 300 ppm SFO can be successfully compensated without introducing any receiver performance penalties.


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    Full Text Available This paper aims at investigating the current situation of rural development perspective based on knowledge of the human factor in Olt County. The first and most important observation is the repercussions on the demographics of rural population structure and balance in Olt County where it appears on one side of its unevenness, with a trend of diminishing the employment, hence the number of employees. The analysis of agricultural density, represented by the area in hectares / capita reveals the existence of a low level of rural population pressure on agricultural space. On the structure of agricultural branches it was surprised on one hand the annual variation in levels of achievement, but on the other hand the share of services which is insignificant. All this contributes to the low attractiveness of agriculture for young people in the rural county of Olt.

  5. Software defined multi-OLT passive optical network for flexible traffic allocation (United States)

    Zhang, Shizong; Gu, Rentao; Ji, Yuefeng; Zhang, Jiawei; Li, Hui


    With the rapid growth of 4G mobile network and vehicular network services mobile terminal users have increasing demand on data sharing among different radio remote units (RRUs) and roadside units (RSUs). Meanwhile, commercial video-streaming, video/voice conference applications delivered through peer-to-peer (P2P) technology are still keep on stimulating the sharp increment of bandwidth demand in both business and residential subscribers. However, a significant issue is that, although wavelength division multiplexing (WDM) and orthogonal frequency division multiplexing (OFDM) technology have been proposed to fulfil the ever-increasing bandwidth demand in access network, the bandwidth of optical fiber is not unlimited due to the restriction of optical component properties and modulation/demodulation technology, and blindly increase the wavelength cannot meet the cost-sensitive characteristic of the access network. In this paper, we propose a software defined multi-OLT PON architecture to support efficient scheduling of access network traffic. By introducing software defined networking technology and wavelength selective switch into TWDM PON system in central office, multiple OLTs can be considered as a bandwidth resource pool and support flexible traffic allocation for optical network units (ONUs). Moreover, under the configuration of the control plane, ONUs have the capability of changing affiliation between different OLTs under different traffic situations, thus the inter-OLT traffic can be localized and the data exchange pressure of the core network can be released. Considering this architecture is designed to be maximum following the TWDM PON specification, the existing optical distribution network (ODN) investment can be saved and conventional EPON/GPON equipment can be compatible with the proposed architecture. What's more, based on this architecture, we propose a dynamic wavelength scheduling algorithm, which can be deployed as an application on control plane

  6. Cycle Tourism in Olt County, Romania. (ReDiscovering Potential of History and Geography for Tourism

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    Viorel Mionel


    Full Text Available Olt is among Romania's counties that remains hidden when it comes to tourism. Unlike other Romania's counties that possess tourism advantages in the form of landscape or anthropic heritage, Olt county appears to lack the first part. However, the landscape is developed on a wavy morphology with not so crowded roads that favours cyclotourism. Therefore, the analysis focused on highlighting the historical-geographic objectives with touristic potential, as well as turing them to good account in the form of cycle routes. The novelty of the research is to design four cycle routes using Strava app and choosing a county in the lowlands as a case study. At the time of this analysis cycle tourism in Olt county, there was only one route for cyclists, currently online, but without no touristic importance. The methodology used involved identifying historical and geographical ob jectives of national importance, structuring categories and grouping them into four mixed tracks which were dedicated to cyclists. Previous stages were followed by field research in order to collect technical data (map, time, distance, total ascent etc.. Finally, a critical review of proposed bicycle routes was undertaken in the research. Study results showed that cycling tourism is a real opportunity for Olt county economy thanks to the number and value of the present tourism potential objectives. Nevertheless, at this stage, the lack of infrastructure, promotion and the small number of units makes it difficult to organize cycle tourism. What is more, the lack of cycle paths endangers cyclotourists’ safety.

  7. Efficient traffic grooming with dynamic ONU grouping for multiple-OLT-based access network (United States)

    Zhang, Shizong; Gu, Rentao; Ji, Yuefeng; Wang, Hongxiang


    Fast bandwidth growth urges large-scale high-density access scenarios, where the multiple Passive Optical Networking (PON) system clustered deployment can be adopted as an appropriate solution to fulfill the huge bandwidth demands, especially for a future 5G mobile network. However, the lack of interaction between different optical line terminals (OLTs) results in part of the bandwidth resources waste. To increase the bandwidth efficiency, as well as reduce bandwidth pressure at the edge of a network, we propose a centralized flexible PON architecture based on Time- and Wavelength-Division Multiplexing PON (TWDM PON). It can provide flexible affiliation for optical network units (ONUs) and different OLTs to support access network traffic localization. Specifically, a dynamic ONU grouping algorithm (DGA) is provided to obtain the minimal OLT outbound traffic. Simulation results show that DGA obtains an average 25.23% traffic gain increment under different OLT numbers within a small ONU number situation, and the traffic gain will increase dramatically with the increment of the ONU number. As the DGA can be deployed easily as an application running above the centralized control plane, the proposed architecture can be helpful to improve the network efficiency for future traffic-intensive access scenarios.

  8. Orthotopic liver transplantation (OLT): contribution of imaging and interventional radiology in preparing the transplantation and managing complications. Part 2: post-OLT complications and their treatment

    International Nuclear Information System (INIS)

    Golfieri, Rita; Gianpalma, Emanuela; Fusco, Francesca


    Despite standardisation of the surgical technique and refinement of immunosuppressive therapy, life-threatening complications are still frequent after orthotopic liver transplantation (OLT). These are caused by a number of factors: patients usually reach the day of the transplant in a debilitated condition, they undergo a complex surgical operation and then receive immunosuppressive therapy to prevent rejection. Post-OLT complications therefore usually have a nonspecific clinical presentation, which makes the role of imaging crucial for identifying and differentiating among the various possible clinical scenarios. The most common complications are rejection, vascular thrombosis or stenosis, biliary obstruction or leakage, infarction or haemorrhage, abscesses and, at a later stage, recurrence of the primary disease. If identified early on, some of these complications can be resolved by surgery or interventional radiology, thereby preventing irreversible damage to the graft that would require a repeat transplant or lead the patient to death. During the follow-up of the transplant patient, imaging enables: a) monitoring of the vascular (arterial, portal and hepatic) and biliary anastomoses to assess and treat possible complications; b) identification of conditions related to immunosuppressive therapy (infections or abscesses); c) identification of possible development of tumours or disease recurrence. In the immediate post-OLT period the patient is normally monitored by ultrasound and Doppler-ultrasound, carried out both immediately after the operation to evaluate the patency of the vascular anastomoses, and at the patient's bedside in the ICU unit during the first 24 hours and daily for the first week. If the sonographic findings are positive or there is a strong clinical suspicion of vascular complications, the patient is first studied by the less invasive techniques (CT-angiography and MR-angiography), reserving a confirmatory role for angiographic techniques


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    Alina – Mihaela Truţă


    Full Text Available The Olt River is an important component of the Danube Hydrographic Basin, with a total area of 24 050 square kilometers. At EU level, concern for the quality of the aquatic environment has always been a very topical issue. Implementation of strategies and policies related to water management were materialized through the adoption of the Framework Directive "Water" 2000/60 / EC by the European Parliament. The aim of these strategies is the balanced management of water resources and the protection of aquatic ecosystems, with the main objective to achieve a "good condition" of surface and groundwater water. Following the objectives of the Directive 2000/60/EC, the present study aims at assessing the environmental quality in the Olt River, Drăgăşani city, thus highlighting the influence of the city's wastewater discharge on the river water quality.

  10. [Evolution of endemic tuberculosis in Olt county, Romania, between 1990 and 2008]. (United States)

    Golli, Andreea-Loredana; Didilescu, C; Niţu, Mimi-Floarea; Eparu, Ion


    A world-wide recrudescence of tuberculosis has been seen, due to the deterioration of the health state of the population from many areas of the world, because of increasing number of homeless persons, and also the immigrants from countries with TB epidemic. The present epidemiological context draw attention to the necessity of early detection of the disease and the beginning of early directly observed treatment, preferably ambulatory, if the sick person doesn't have other complications, isn't infected with multidrog resistant bacili and lives in a properly social environment for his support. For the evaluation of tuberculosis epidemic in Olt county, the authors realised a retrospective study on a period of over 15 years (1990-2008), based on the analysis of the main epidemiological indices of TB epidemic in this county compared with Romania: global incidence both in adults and children, for new cases nd relapses apart, incidence of MDR-TB (multidrug resistant-tuberculosis) cases, mortality through tuberculosis. Global incidence of TB in Olt county almost doubled between 1990-2008, reaching 147, 4 per hundred thousand, with much higher values compared with the national ones. Olt county presents constant values over the national ones between 1995-2008, due to the global incidence and also to the new cases and relapses. The incidence of new cases in children in 2008 (20,4 per hundred thousand) was below the national level (28 per hundred thousand). The risk of illness for the 0-14 years old children from Olt county was significantly lower in 2008 compared with the previous year, which, toghether with a number of MDR-TB cases under 15, signifies a regress of the epidemic.

  11. Ventral incisional hernia (VIH) repair after liver transplantation (OLT) with a biological mesh: experience in 3 cases. (United States)

    Schaffellner, S; Sereinigg, M; Wagner, D; Jakoby, E; Kniepeiss, D; Stiegler, P; Haybäck, J; Müller, H


    Hernias after orthotopic liver transplant (OLT) occur in about 30 % of cases. Predisposing factors in liver cirrhotic patients of cases are ascites, low abdominal muscle mass and cachexia before and immunosuppression after OLT. Standard operative transplant-technique even in small hernias is to implant a mesh. For patients after liver transplantation a porcine non-cross linked biological patch being less immunogenic than synthetic and cross-linked meshes is chosen for ventral incisional hernia repair. 3 patients (1 female, 2 male), OLT indications Hepatitis C, exogenous- toxic cirrhosis, median-age 53 (51 - 56) and median time to hernia occurrence after OLT were 10 month (6 - 18 m) are documented. 2 patients suffered from diabetes, 2 from chronic-obstructive lung disease. Maintenance immunosuppressions were Everolimus in 1 patient, Everolimus + MMF in the second and Everolimus +Tacrolimus in the third patient. The biological was chosen for hernia repair due to the preexisting risk- factors. Meshes, 10 × 16 cm were placed, in IPOM (Intra-Peritonel-Onlay-Mesh) -position by relaparatomy. Insolvable, monofile, interrupted sutures were used. All patients recovered primarily, and were dismissed within 10 d post OP. No wound healing disorders or signs of postoperative infections occurred. All are free of hernia recurrence in a mean observation time of 22 month (10 - 36). The usage of porcine non-cross-linked biological patches seems feasible for incisional hernia repair after OLT. Wound infections in these patients have been observed with other meshes. Further investigation is needed to prove potential superiority of this biological to the other meshes. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Biofilm composition in the Olt River (Romania) reservoirs impacted by a chlor-alkali production plant. (United States)

    Dranguet, P; Cosio, C; Le Faucheur, S; Hug Peter, D; Loizeau, J-L; Ungureanu, V-Gh; Slaveykova, V I


    Freshwater biofilms can be useful indicators of water quality and offer the possibility to assess contaminant effects at the community level. The present field study examines the effects of chlor-alkali plant effluents on the community composition of biofilms grown in the Olt River (Romania) reservoirs. The relationship between ambient water quality variables and community composition alterations was explored. Amplicon sequencing revealed a significant modification of the composition of microalgal, bacterial and fungal communities in the biofilms collected in the impacted reservoirs in comparison with those living in the uncontaminated control reservoir. The abundance corrected Simpson index showed lower richness and diversity in biofilms collected in the impacted reservoirs than in the control reservoir. The biofilm bacterial communities of the impacted reservoirs were characterized by the contaminant-tolerant Cyanobacteria and Bacteroidetes, whereas microalgal communities were predominantly composed of Bacillariophyta and fungal communities of Lecanoromycetes and Paraglomycetes. A principal component analysis revealed that major contaminants present in the waste water of the chlor-alkali production plant, i.e. Na + , Ca 2+ , Cl - and Hg, were correlated with the alteration of biofilm community composition in the impacted reservoirs. However, the biofilm composition was also influenced by water quality variables such as NO 3 - , SO 4 2- , DOC and Zn from unknown sources. The results of the present study imply that, even when below the environmental quality standards, typical contaminants of chlor-alkali plant releases may affect biofilm composition and that their impacts on the microbial biodiversity might be currently overlooked.

  13. Ars Poetica : [luuletused] / Mats Traat

    Index Scriptorium Estoniae

    Traat, Mats, 1936-


    Sisu: Ars poetica ; Veepeegel ; Kontrollõed ; Mandariiniriik ; Nikolai Siamashvili (1888-1911) ; Kolmekümne kolmas aasta ; Kiri linast 1966 ; Italmaz Nuriyev ; Rudolf Rimmelile mõeldes ; Gennadi Aigi

  14. L’Eglise de l’hopital du monastère Brâncoveni (Département Olt. Recherches iconographiques / The Church of the Hospital from Brancoveni Monastery (Olt County. Iconographic Research

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    Tereza Sinigalia


    Full Text Available The present paper aims to provide information on the recent restoration of the murals inside the small church of the „Bolniţa” (Romanian word for a chapel lying next to a monastic hospital of the Brâncoveni Monastery (Department Olt, built by the Prince of Wallachia Constantin Brâncoveanu in 1700. All the inside of the church was covered with frescoes, but my attention focused on the paintings in the narthex. As the church is dedicated to The Archangels, the upper part of the walls is covered with 10 compositions illustrating facts from the Ancient Testament and from the inter-testamental texts in which Angels Michael et Gabriel were involved: The Sacrifice of Abraham, Lot and the destruction of Sodom; Prophet Gideon; The Fake Prophet Balaam; Prophet Daniel and the dream of the king Nabucodonosor; The dream of the Prophet Elijah; Archangel Gabriel announces Zacharias and his wife Elisabeth about the birth of a son, the future John the Baptist; Archangel Gabriel announces Joachim and Ann about the birth of a daughter, Mary; Archangel Gabriel advises Joseph to take Mary as his fiancé; Annunciation. A huge Votive composition of the ancestors of the Prince Constantin Brâncoveanu (grandfather, father, grand uncle, the Prince Matei Basarab and his father is painted on the lower register of the room. Princess Maria, Brâncoveanu’s wife, is present, too.

  15. Using stable isotopes in tracing contaminant sources in an industrial area: A case study on the hydrological basin of the Olt River, Romania. (United States)

    Popescu, Raluca; Mimmo, Tanja; Dinca, Oana Romina; Capici, Calogero; Costinel, Diana; Sandru, Claudia; Ionete, Roxana Elena; Stefanescu, Ioan; Axente, Damian


    Tracing pollution sources and transformation of nitrogen compounds in surface- and groundwater is an issue of great significance worldwide due to the increased human activity, translated in high demand of water resources and pollution. In this work, the hydrological basin of an important chemical industrial platform in Romania (Ramnicu Valcea industrial area) was characterized in terms of the physico-chemical and isotope composition of δ(18)O and δ(2)H in water samples and δ(15)N of the inorganic nitrogen species. Throughout a period of one year, water samples from the Olt River and its more important tributaries were collected monthly in the industrial area, when the seasonal and spatial isotope patterns of the surface waters and the main sources of pollution were determined. Higher inorganic nitrogen concentrations (up to 10.2 mg N L(-1)) were measured between November 2012 and April 2013, which were designated as anthropogenic additions using the mixing calculations. The main sources of pollution with inorganic nitrogen were agriculture and residential release. The inorganic nitrogen from the industrial waste water duct had a distinct δ(15)N fingerprint (mean of -8.6‰). Also, one industrial release into the environment was identified for Olt River, at Ionesti site, in November 2012. The mean precipitation samples had the lowest inorganic nitrogen concentrations (less than 5.5 mg N L(-1)) with a distinct δ(15)N fingerprint compared to the surface and industrial waters. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Mats Traat sai kultuurkapitali proosapreemia / Mari Peegel

    Index Scriptorium Estoniae

    Peegel, Mari, 1978-


    Eesti Kultuurkapitali aastapreemiad: Mats Traadi romaan "Naised ja pojad", Indrek Ryytle luulekogu "Inglid rokijaamas", Jim Ashilevi näidend "Nagu poisid vihma käes", Peeter Sauteri "Laiskade laste raamat". Esseistikapreemia Hasso Krullile "Loomise mõnu ja kiri". Tõlkepreemia said Kalle Kasemaa, Eric Dickens. Vabaauhind: Cornelius Hasselblatt. Venekeelse autori kirjandusauhind: Jelena Skulskaja, Aleksandr Uris. Artikliauhind: Toomas Haug

  17. Students enabling students in a Student Partnership Project: A case study emerging from the OLT Transforming Practice Project on Student Partnerships

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    Megan Kek


    Full Text Available This emerging initiative stemmed from an Office for Learning and Teaching Project (OLT project, Transforming Practice Programme 2016: Student Engagement: Students as Partners in Teaching and Learning. The initiative, trialed in semester two, 2016, involved the selection and training of two experienced students to be leaders of a Closed Facebook ‘students-only’ community which provided advice and triaged queries to appropriate channels. The evaluative processes comprised a participatory action research methodology. Two student leaders who facilitated the Closed Facebook and four academic staff of the project were the participants. The findings demonstrate that the Closed Facebook students-only site provided a safe space, outside the formal learning/classroom environment, where student participants were able to ask and share knowledge. The informal student-for-student learning community complemented the formal structure by facilitating the opportunity for students to become ‘experts’ as university students as they move-through their learning journey.


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    Elena Daniela MITITELU


    Full Text Available The wide distribution of benthic invertebrates and their different sensitivity shown upon modifying the qualitative parameters of aquatic ecosystems led to a frequent use of these group as bioindicators in different studies. The present study aims at presenting a list concerning the different macroinvertebrates identified in the larva stage in three watersheds (Jiu, Olt, Ialomiţa and establishing the water quality of the monitored sections using this benthic macroinvertebrates. The sample collecting points were represented by 23 stations. The abundance and frequency values recorded for benthic communities varied according to the physical-chemical conditions specific to each sample collecting station. There were identified 15 groups in total. The most frequent were Ephemeroptera, Plecoptera, Trichoptera, Diptera (Chironomidae and others. The deterioration of water quality is marked by the decrease in the biotic index EPT/Ch value.

  19. Persistent Hg contamination and occurrence of Hg-methylating transcript (hgcA) downstream of a chlor-alkali plant in the Olt River (Romania). (United States)

    Bravo, Andrea G; Loizeau, Jean-Luc; Dranguet, Perrine; Makri, Stamatina; Björn, Erik; Ungureanu, Viorel Gh; Slaveykova, Vera I; Cosio, Claudia


    Chlor-alkali plants using mercury (Hg) cell technology are acute point sources of Hg pollution in the aquatic environment. While there have been recent efforts to reduce the use of Hg cells, some of the emitted Hg can be transformed to neurotoxic methylmercury (MeHg). Here, we aimed (i) to study the dispersion of Hg in four reservoirs located downstream of a chlor-alkali plant along the Olt River (Romania) and (ii) to track the activity of bacterial functional genes involved in Hg methylation. Total Hg (THg) concentrations in water and sediments decreased successively from the initial reservoir to downstream reservoirs. Suspended fine size particles and seston appeared to be responsible for the transport of THg into downstream reservoirs, while macrophytes reflected the local bioavailability of Hg. The concentration and proportion of MeHg were correlated with THg, but were not correlated with bacterial activity in sediments, while the abundance of hgcA transcript correlated with organic matter and Cl(-) concentration, indicating the importance of Hg bioavailability in sediments for Hg methylation. Our data clearly highlights the importance of considering Hg contamination as a legacy pollutant since there is a high risk of continued Hg accumulation in food webs long after Hg-cell phase out.

  20. Greta Kaits 9. apr. 1928 - 29. aug. 1946 : [luuletused] / Mats Traat

    Index Scriptorium Estoniae

    Traat, Mats, 1936-


    Sisu : Greta Kaits 9. apr. 1928 - 29. aug. 1946 ; Villem Hänilane 1898 - 1952 ; Peeter Pedak 1897 - 1953 ; Max Äidse 1903 - 1959 ; Lavinia Laidam ; Buchard Pruus ; Sergei Krivokopõtov ; Allan Luht 5. VII 1962 - 17. V 2007 ; Karl Saarmets 9. III 1924 - 14. IX 1981 ; Raimo Ritsik

  1. Oda brjutshnomu remnju : [luuletused] / Mats Traat ; lühibiograafia: Irina Belobrovtseva

    Index Scriptorium Estoniae

    Traat, Mats, 1936-


    Sisu: Oda brjutshnomu remnju ; Vazhnja ; Lebed ; Tartu, dekabr ; Pozdnije jagnjata ; Ultima Thule ; Poezija 1-2 / tlk. Svetlan Semenenko ; Utrennaja muzõka ; Lipovaja alleja ; Slova dlja zagovora ; Adrian Virginius 1706 ORH / tlk. Boris Baljasnõi ; Malev Suits (tsüklist "Haralsaskije zhizneopissanija") / tlk. V. Kalabugin. Orig.: Ood püksirihmale ; Kaalukoda ; Luik ; Detsember, Tartu ; Hilised talled ; Ultima Thule ; Luule 1-2 ; Hommikumuusika ; Adrian Virginius AD 1706 ; Malev Suits (tsüklist "Harala elulood")

  2. How to Recommend by Online Lifestyle Tagging (OLT)


    Yu Pan; Lijuan Luo; Dan Liu; Li Gao; Xiaobo Xu; Wenjing Shen; Jiang Gao


    With the rapid development of the Internet, the online shopping market expands constantly. Inspired by fierce competition and complex and diverse consumer demand, personalized recommendation has become an effective marketing tool for e-commerce enterprises. However, the existing recommendation methods based on online consumer behavior or preferences are characterized by poor accuracy and low efficiency. The paper mainly conducts three studies, the study1 proves that seven online lifestyles, w...

  3. Selection of DNA barcoding loci and phylogenetic study of a medicinal and endemic plant, Plectranthus asirensis J.R.I. Wood from Saudi Arabia. (United States)

    Al-Qurainy, F; Khan, S; Nadeem, M; Tarroum, M; Al-Ameri, A


    Genuine medicinal plant materials are very important for potential crude drug production, which can be used to cure many human diseases. DNA barcoding of medicinal plants is an effective way to identify adulterated or contaminated market materials, but it can be quite challenging to generate barcodes and analyze the data to determine discrimination power. The molecular phylogeny of a plant species infers its relationship to other species. We screened the various loci of the nuclear and chloroplast genome for the barcoding of Plectranthus asirensis, an endemic plant of Saudi Arabia. The chloroplast genome loci such as rps16 and rpoB showed maximum similarity to taxa of the same and other genera via BLAST of the National Center for Biotechnology Information (NCBI) GenBank database; hence, they are less preferable for the development of a DNA barcode. However, nrDNA-ITS and chloroplast loci rbcL and rpoC1 showed less similarity via BLAST of the NCBI GenBank database; therefore, they could be used for DNA barcoding for this species.

  4. Sabanejewia Aurata (De Filippi, 1863 Populations Management Decisions Support System for Rosci0132 (Olt River Basin

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    Curtean-Bănăduc Angela


    Full Text Available The ADONIS: CE was used to design a specific management model for the Sabanejewia aurata (De Filippi, 1863 populations. The proposed model is based on this species, in situ identified biological/ecological necessities in relation to the habitats, the conservation status indicators and appropriate management actions and the pressures and threats founded in the study area. Such on species, on habitats and on site based management system was done to complete this approach for ROSCI0132, the other fish species which are living there being treated already in this respect.

  5. Raamatupärlid / Mihkel Mutt

    Index Scriptorium Estoniae

    Mutt, Mihkel, 1953-


    Tutvustus: Traat, Mats. Naised ja pojad ajakirjas Looming, nr. 2-5 ; Applebaum, Anne. Gulag. Tallinn : Varrak, 2005 ; Yourcenar, Marguerite. Silmapaistmatu inimene. Ilus hommik. Tallinn : Kultuurileht, 2006

  6. Výtvarné a materiálové znaky dielne Majstra Matejovského oltára, 15. storočie, Slovensko

    Czech Academy of Sciences Publication Activity Database

    Hradilová, J.; Hradil, David; Svetková, A.; Novotná, M.

    -, č. 6 (2008), s. 98-123 ISSN 1211-3018 Institutional research plan: CEZ:AV0Z40320502 Keywords : Gothic paintings * Cracow school * Master of Matejovce Altarpiece Subject RIV: CA - Inorganic Chemistry


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    Radu Lucian PÂNZARU


    Full Text Available The unit was established in 2003, with the object of activity "Support activities to agriculture and post-harvest activities" - CAEN code 0161 from 02.08.2006. The company has the legal form of a limited liability company and operates in accordance with Romanian legislation. In addition to the main business - support activities for crop production, the company may carry on business as a secondary objective: the cultivation of cereals, legumes and oilseeds producing plant; Growing of vegetables and melons, roots and tubers, tobacco cultivation; cultivation of plants for the preparation of beverages; dairy cattle; pig breeding, poultry farming; Raising of other animals; post-harvest activities; preparing seed; activities (mixed farming of crops combined with farming of animals; Silviculture and other forestry; forestry and forestry; Freshwater aquaculture; processing and preserving of meat; processing and preserving of poultry meat; processing and preserving of potatoes; Manufacture of fruit and vegetables; mill products; manufacture of dairy products and cheeses, bread making, making cakes and fresh pastry; manufacture of other food products. Duration of the company's is one unlimited, and the subscribed capital was Lei 300 (wholly owned only by the shareholder, increase or reduction of capital, and its transmission can be achieved in concrete terms stipulated in the articles of incorporation.

  8. Wavelength Tuning Free Transceiver Module in OLT Downstream Multicasting 4λ × 10 Gb/s TWDM-PON System


    M. S. Salleh; A. S. M. Supa’at; S. M. Idrus; S. Yaakob; Z. M. Yusof


    We propose a new architecture of dynamic time-wavelength division multiplexing-passive optical network (TWDM-PON) system that employs integrated all-optical packet routing (AOPR) module using 4λ×10 Gbps downstream signal to support 20 km fiber transmission. This module has been designed to support high speed L2 aggregation and routing in the physical layer PON system by using multicasting cross-gain modulation (XGM) to route packet from any PON port to multiple PON links. Meanwhile, the fixed...

  9. Design and performance of 10-Gb/s L-band REAM-SOA for OLT Transmitter in next generation access networks. (United States)

    Lee, Dong-Hun; Jeong, Jong Sool; Kim, Ki-Soo; Kim, Hyun-Soo; Kim, Dong Churl; Park, Mi-Ran; Han, Yong-Tak; Kwon, Oh Kee; Kwon, O-Kyun


    We present a 10-Gb/s L-band reflective electro-absorption modulator integrated with a semiconductor optical amplifier (REAM-SOA) having improved transmission performance at very low input power of seed light. To decrease the input power of seed light, the absorption characteristics of the REAM are adjusted to reduce the amplified spontaneous emission light returned into the SOA, suppressing the gain saturation effect of the SOA. At a considerably low input power of -16 dBm, the REAM-SOA exhibits a low transmission penalty of about 1.2 dB after 50-km SMF transmission. Over a wide input power range from -16 dBm to 5 dBm, a penalty of less than 1.6 dB is achieved at 50-km transmission.

  10. Mariánský oltářík svatovítského pokladu a gotické obrazy katedrály

    Czech Academy of Sciences Publication Activity Database

    Kořán, Ivo


    Roč. 54, č. 4 (2006), s. 316-326 ISSN 0049-5123 Institutional research plan: CEZ:AV0Z80330511 Keywords : St Vitus cathedral * Gothic * inventory Subject RIV: AL - Art, Architecture, Cultural Heritage

  11. Sistema reprodutivo e polinização de Lepidagathis sessilifolia (Pohl Kameyama ex Wassh. & J.R.I. Wood (Acanthaceae, em remanescente florestal da região sudoeste de Mato Grosso, Brasil Breeding system and pollination of Lepidagathis sessilifolia (Pohl Kameyama Wassh ex. & J.R.I.Wood (Acanthaceae in remnant forest in the southwest region of Mato Grosso, Brazil

    Directory of Open Access Journals (Sweden)

    Celice Alexandre Silva


    Full Text Available O gênero Lepidagathis apresenta distribuição pantropical com cerca de 100 espécies. No Brasil ocorrem 16 espécies, a maioria nas regiões Centro - Oeste e Sudeste. O estudo foi realizado em sub - bosque de remanescente florestal do município de Tangará da Serra - MT e teve como objetivo analisar a fenologia de floração, descrever a morfologia e biologia floral, verificar os visitantes florais e avaliar o sistema e o sucesso reprodutivo por meio de polinizações manuais. Lepidagathis sessilifolia apresenta inflorescências espiciformes, terminais, com cálice de cor rósea vistosa e corola de coloração branco-rósea. A floração ficou restrita aos meses de março a abril, durante a estação chuvosa. A senescência floral ocorreu após 24 ou 48 horas. A viabilidade dos grãos de pólen foi elevada (92,5%. O único polinizador observado visitando as flores de L. sessilifolia foi a abelha Partamona nhambiquara (Apidae - Meliponini. O sistema reprodutivo misto da espécie é caracterizado pela formação de frutos por meio de agamospermia, autopolinização e polinização cruzada. Esse sistema reprodutivo flexível é vantajoso, pois, garante a manutenção da espécie na área de estudo mesmo na ausência de polinizadores.The genus Lepidagathis has pantropical distribution and about 100 species, 16 occurring in Brazil, mostly in the Midwest and Southeast regions. The research was carried out to evaluate in the understory of a forest remnant in Tangará da Serra County - MT to examine the flowering phenology, describe the floral morphology and biology and verify the floral visitors to evaluate the system and reproductive success through hand pollination tests. Lepidagathis sessilifolia shows spiciform and terminal inflorescence with calyx of pink color and corolla whitish-pink. Flowering was restricted from March to April, during the rainy season. Floral senescence occurred after 24 or 48 hours. The viability of pollen grains was high (92.5%. The effective pollinator of L. sessilifolia was Partamona nhambiquara (Apidae - Meliponini. The mixed mating system of the species is characterized by the formation of fruits by agamospermy, self and cross-pollination, spontaneous self-pollination, agamospermy and outcrossing. This flexible reproductive system is advantageous because it ensures the maintenance of species in the study area even in the absence of pollinators.

  12. A Study on the Joint Reliability Importance with Applications to the Maintenance Policy

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jung Sik; Kwon, Hong Je; Song, Mi Ja; Kim, Woong Kil; Yoong, Do Hwa [Seoul National Polytechnic University, Seoul (Korea, Republic of); Moon, Sin Myung; Cho, Bong Je; Moon, Jae Phil; Koo, Hoon Young; Lee, Jin Seung [Seoul National University, Seoul (Korea, Republic of)


    The objective of this project is to investigate the possibility of applying the Joint Reliability Importance(JRI) of two components to the establishment of system maintenance policy. Components are classified into reliability substitutes and reliability compliments. If the sign of JRI of two components is positive, they are called as reliability compliments. If the sign of JRI of two components is negative, they are called as reliability substitutes. In case of reliability compliments, one component becomes more important as the other one works and in case of reliability substitutes, one component becomes more important as the other one fails. Therefore, when the preventive maintenance is carried out, two components which are reliability substitutes should not be maintained at the same time. Also, when the corrective maintenance is carried out, we not only repair the failed components but pay attention to the functioning components which are reliability substitutes with respect to the failed components. The sign of JRI of any two components in series (parallel) system is positive (negative). Then, what is the sign of any two components in k-out-of-n:G system? This project presents an idea of characterizing the k-out-of-n:G system by calculating the JRI of two components in that system, assuming that reliability of all components are equal. In addition to the JRI of two components, JRI of two gates is introduced in this project. The algorithm to compute the JRI of two gates is presented. Bridge system is considered and the co-relation of two min cut sets is illustrated by using the cut-set representation of bridge system and calculating the JRI of two gates. 28 refs., 20 tabs., 32 figs. (author)

  13. Lood ajast ja elust / Indrek Rohtmets

    Index Scriptorium Estoniae

    Rohtmets, Indrek, 1953-


    Joonisfilm "Elulood" : stsenaristid Rao Heidmets ja Mats Traat : režissöör Rao Heidmets : kunstnik Ave Nahkur : helilooja Olav Ehala : Rao Heidmetsa Filmistuudio, 2007. Lk. 111-112 lühidalt R. Heidmetsa biograafia ja filmograafia

  14. Rao Heidmets tegi eestlaste traagilised elulood filmiks / Tiit Tuumalu

    Index Scriptorium Estoniae

    Tuumalu, Tiit, 1971-


    Joonisfilm "Elulood" : stsenaristid Rao Heidmets ja Mats Traat : režissöör Rao Heidmets : kunstnik Ave Nahkur : helilooja Olav Ehala : esilinastus Torontos, oktoober 2007 : Eesti esilinastus 25. nov. 2007. Lisatud "Filmis kõlavaid elulookatkeid"

  15. Eesti proosa 1994 : [ka Noor-Eesti fenomenist 1994. a eesti proosas] / Toomas Liiv

    Index Scriptorium Estoniae

    Liiv, Toomas, 1946-2009


    Kangro, Bernard. Härjanädalate aegu; Kõiv, Madis Rännuaastad. Studia memoriae. I; Vanapa, Andres. Riiulid; Mutt, Mihkel. Rahvusvaheline mees; Berg, Maimu. Ma armastasin venelast. Nemad; Kross, Jaan. Järelehüüd; Kudu, Reet. Vabadus ja armastus; Mikelsaar, Henn. Käiski Nuustakul ära; Mihkelson, Ene. Nime vaev; Pukk, Holger. Suvest suveni; Trubetsky, Tõnu & Anti Pathique. Daam sinises; Traat, Mats. Kodu on ilus; Traat, Mats. Minge üles mägedele. Teine raamat, jt.

  16. Reinsertion of an inverted osteochondral lesion of the talus: a case report

    NARCIS (Netherlands)

    Schepers, Tim; de Rooij, Philippe P.; van Lieshout, Esther M. M.; Patka, Peter


    Osteochondral lesions of the talus (OLTs) occur infrequently and are missed at the initial presentation in up to 67% of cases. Probably more than 1500 OLTs have been reported in published studies, of which, thus far, only 5 cases have been an inverted anterolateral OLT. An anterolateral OLT results

  17. Demonstration of Laser Plasma X-Ray Source with X-Ray Collimator Final Report CRADA No. TC-1564-99

    Energy Technology Data Exchange (ETDEWEB)

    Lane, S. M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Forber, R. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)


    This collaborative effort between the University of California, Lawrence Livermore National Laboratory (LLNL) and JMAR Research, Inc. (JRI), was to demonstrate that LLNL x-ray collimators can effectively increase the wafer throughput of JRI's laser based x-ray lithography systems. The technical objectives were expected to be achieved by completion of the following tasks, which are separated into two task lists by funding source. The organization (LLNL or JMAR) having primary responsibility is given parenthetically for each task.

  18. GIS for the Valorization of Hardly Accessible Alpine Areas with Complex Potentials for Tourism, with a View to Their Inclusion in Tourist Routes. Development of the Valleys of Lotru and Olteţ

    Directory of Open Access Journals (Sweden)



    Full Text Available VALOT originates in the experience of European countries from the Alpine Space that succeeded to establish three top priorities for hardly accessible mountain areas based on communitarian programs (Natura 2000, Interreg IIIB – AlpNa Tour, VIADVENTURE, RegioMarket, etc.: competitiveness and attractiveness of the Alpine Space, accessibility and connectivity between high altitude settlements, environmental protection and prevention of natural hazards and disasters (snow falls, land slides, etc.. Starting from the project of Law on Approving the National Spatial Plan – Section VI – Tourism, the project aims at evaluating the current resources of hardly accessible mountain areas with complex potentials for tourism according to the experience of the European Union. GIS analysis will underline national/regional disparities of these areas, leading to conclusions on their typology and intervention proposals. The second part will focus on a case study of a hardly accessible area with a high landscape value and still un-valorized potentials for tourism. The existing situation of the area between the Lotru and Parâng mountains, consisting of the territories of four communes and a city, belonging to the counties of Vâlcea and Gorj, will be analyzed. Based on a spatial development scenario using selected statistical and geographic indicators, intervention priorities will be analyzed with the SPATIAL ANALYST, as well as funding possibilities for the creation of a cluster of mountain resorts (Rânca, Vidra, Voineasa in order to valorize the recreational and balneary patrimony of the area, observing principles and objectives of sustainable development in mountain areas. The project will create a methodology for diagnosing problems and dysfunctions of such areas, development possibilities based on the experience of the pilot study, proposals for improving the institutional framework for implementing, monitoring and evaluating the results and (last but not least funding sources.

  19. Šlechtické kaple v kostele Panny Marie ve Staré Boleslavi. Oltářní výzdoba a fundace v 17. století

    Czech Academy of Sciences Publication Activity Database

    Vácha, Štěpán


    Roč. 58, č. 1 (2010), s. 17-41 ISSN 0049-5123 Grant - others:FM EHP/Norsko(XE) CZ 0112 Institutional research plan: CEZ:AV0Z80330511 Keywords : Stará Boleslav * aristocracy * baroque painting Subject RIV: AL - Art, Architecture, Cultural Heritage

  20. Logical optical line terminal technologies towards flexible and highly reliable metro- and access-integrated networks (United States)

    Okamoto, Satoru; Sato, Takehiro; Yamanaka, Naoaki


    In this paper, flexible and highly reliable metro and access integrated networks with network virtualization and software defined networking technologies will be presented. Logical optical line terminal (L-OLT) technologies and active optical distribution networks (ODNs) are the key to introduce flexibility and high reliability into the metro and access integrated networks. In the Elastic Lambda Aggregation Network (EλAN) project which was started in 2012, a concept of the programmable optical line terminal (P-OLT) has been proposed. A role of the P-OLT is providing multiple network services that have different protocols and quality of service requirements by single OLT box. Accommodated services will be Internet access, mobile front-haul/back-haul, data-center access, and leased line. L-OLTs are configured within the P-OLT box to support the functions required for each network service. Multiple P-OLTs and programmable optical network units (P-ONUs) are connected by the active ODN. Optical access paths which have flexible capacity are set on the ODN to provide network services from L-OLT to logical ONUs (L-ONUs). The L-OLT to L-ONU path on the active ODN provides a logical connection. Therefore, introducing virtualization technologies becomes possible. One example is moving an L-OLT from one P-OLT to another P-OLT like a virtual machine. This movement is called L-OLT migration. The L-OLT migration provides flexible and reliable network functions such as energy saving by aggregating L-OLTs to a limited number of P-OLTs, and network wide optical access path restoration. Other L-OLT virtualization technologies and experimental results will be also discussed in the paper.

  1. Matrix metalloproteinase 2 genotype is associated with nonanastomotic biliary strictures after orthotopic liver transplantation

    NARCIS (Netherlands)

    Ten Hove, W. Rogier; Korkmaz, Kerem S.; den Dries, Sanna Op; de Rooij, Bert-Jan F.; van Hoek, Bart; Porte, Robert J.; van der Reijden, Johan J.; Coenraad, Minneke J.; Dubbeld, Jeroen; Hommes, Daniel W.; Verspaget, Hein W.

    Background: Nonanastomotic biliary strictures (NAS) are a serious complication after orthotopic liver transplantation (OLT). Matrix metalloproteinases (MMPs) are involved in connective tissue remodelling in chronic liver disease and complications after OLT. Aim: To evaluate the relationship between

  2. Orthotropic liver transplantation for intractable neurological manifestations of Wilson′s disease

    Directory of Open Access Journals (Sweden)

    Vaibhav K Sutariya


    Full Text Available Wilson′s disease (WD is an inherited autosomal recessive disorder characterized by copper accumulation and toxicity, affecting mainly the liver and brain. Orthotopic liver transplantation (OLT is the definitive therapy for patients with WD. Acute fulminant hepatic failure and decompensated cirrhosis are well-established indications for OLT. Patients with severe neurologic impairment can also be benefited by OLT. Here, we present a patient who underwent OLT for isolated neurological WD.

  3. Reinsertion of an inverted osteochondral lesion of the talus: A case report

    NARCIS (Netherlands)

    T. Schepers (Tim); P.P. de Rooij (Philippe); E.M.M. van Lieshout (Esther); P. Patka (Peter)


    textabstractOsteochondral lesions of the talus (OLTs) occur infrequently and are missed at the initial presentation in up to 67% of cases. Probably more than 1500 OLTs have been reported in published studies, of which, thus far, only 5 cases have been an inverted anterolateral OLT. An anterolateral

  4. Cost-effectiveness of cadaveric and living-donor liver transplantation. (United States)

    Sagmeister, Markus; Mullhaupt, Beat; Kadry, Zakiyah; Kullak-Ublick, Gerd A; Clavien, Pierre A; Renner, Eberhard L


    Cadaveric liver transplantation (5-year survival >80%) represents the standard of care for end-stage liver disease (ESLD). Because the demand for cadaveric organs exceeds their availability, living-donor liver transplantation has gained increasing acceptance. Our aim was to assess the marginal cost-effectiveness of cadaveric and living-donor orthotopic liver transplantation (OLT) in adults with ESLD. Using a Markov model, outcomes and costs of ESLD treated (1) conservatively, (2) with cadaveric OLT alone, and (3) with cadaveric OLT or living-donor OLT were computed. The model was validated with published data. The case-based scenario consisted of data on all 15 ESLD patients currently on our waiting list (3 women, 12 men; median age, 48 years [range, 33-59 years]) and on the outcome of all OLT performed for ESLD at our institution since 1995 (n=51; actuarial 5-year survival 93%). Living-donor OLT was allowed in 15% during the first year of listing; fulminant hepatic failure and hepatocellular carcinoma were excluded. Cadaveric OLT gained on average 6.2 quality-adjusted life-years (QALYs) per patient compared with conservative treatment, living-donor OLT, an additional 1.3 QALYs compared with cadaveric OLT alone. Marginal cost-effectiveness of a program with cadaveric OLT alone and a program with cadaveric and living-donor OLT combined were similar (E 22,451 and E 23,530 per QALY gained). Results were sensitive to recipient age and postoperative survival rate. Offering living-donor OLT in addition to cadaveric OLT improves survival at costs comparable to accepted therapies in medicine. Cadaveric OLT and living-donor OLT are cost-effective.

  5. Läbi klaasi tähtede poole / Margus Mikomägi

    Index Scriptorium Estoniae

    Mikomägi, Margus, 1956-


    Meleski vanas klaasivabrikus Viljandimaal 6. augustil esietendunud Ugala teatri suvelavastusest "Läbi klaasi". Autor Mats Traat, lavastaja Priit Pedajas, kunstnik Liina Unt. Klaasitegemise osas andis nõu ja näitleja Aarne Sorole õpetas klaasipuhumist klaasikunstnik Eili Soon

  6. Teekonnad tajutunnelites / Aita Kivi

    Index Scriptorium Estoniae

    Kivi, Aita, 1954-


    Sisu : Siri Hustvedt. Pimesi; Boris Vian. Päevade vaht; Christian Lore Weber. Altarimuusika; Kurt Vonnegut. Kassikangas; Jean Sasson. Printsess Sultana tütred; Karen Robards. Senaatori naine; Matthias Johann Eisen. Näkid, kratid, luupainajad; Mats Traat. Harala elulood; Steven L. McKenzie. Kuningas Taavet; Sally Ward. Terane laps; Ted Hughes. Luuletused

  7. Iz perevodov : [tõlkevalimik] / Svetlan Semenenko

    Index Scriptorium Estoniae

    Semenenko, Svetlan, 1938-2007


    Sisu: Traat, Mats. Samoje lutshsheje vremja; Suuman, Aleksander. 'Voronu ne popast domoi...'; Viiding, Juhan. 'Vo sadu vo zeljonom...'; Kurg, Kalle. 'I zdes to Zhe samoje zdes to zhe samoje...'; Rummo, Paul-Eerik. Uteshenje; Nitshja; Alver, Betti. Mezhdu Jõgeva i Pedja : iz poemõ; S dikim krikom

  8. Mati Hint - sünge keeleteadlane ja pessimistlik ühiskonnategelane / Mari Klein

    Index Scriptorium Estoniae

    Klein, Mari, 1979-


    11. septembril peeti Tallinna Ülikoolis seminari, mis oli pühendatud Mati Hindi 70. sünnipäevale. Ettekannetega esinesid ülikoolikaaslased, sõbrad ja kolleegid Rein Veidemann, Haldur Õim, Martin Ehala, Mats Traat, Tapani Lehtinen, Jaan Kaplinski

  9. Plasma succinylacetone is persistently raised after liver transplantation in tyrosinaemia type 1. (United States)

    Bartlett, David C; Preece, Mary Anne; Holme, Elisabeth; Lloyd, Carla; Newsome, Phil N; McKiernan, Patrick J


    Tyrosinaemia type 1 (HT1) is a rare disorder leading to accumulation of toxic metabolites such as succinylacetone (SA) and a high risk of hepatocellular carcinoma. Children with HT1 traditionally required liver transplantation (OLT) and while the need for this has been reduced by the introduction of nitisinone some still require OLT. SA inhibits the enzyme porphobilinogen (PBG) synthase and its activity can be used as a marker of active SA. Elevated urinary SA post OLT has been reported previously. This study describes a novel finding of elevated plasma SA following OLT for HT1. A retrospective analysis was performed of patients treated for HT1 at our institution from 1989-2010. Thirteen patients had an OLT for HT1. In patients who received nitisinone prior to OLT, mean urinary and plasma SA were elevated prior to treatment but normalised by the time of OLT (p ≤ 0.01). Mean PBG synthase activity increased from 0.032 to 0.99 nkat/gHb (ref range 0.58-1.25) at the time of OLT (p PBG synthase activity were not available prior to OLT for this group. Following OLT, mean urinary and plasma SA were elevated in all for the duration of follow-up and associated with low-normal PBG synthase activity. Urinary and plasma SA levels are elevated following OLT for HT1. Low-normal PBG synthase activity suggests the plasma SA may be active. The clinical significance of this is unclear.

  10. Anatomic feature of deltoid ligament attachment in posteromedial osteochondral lesion of talar dome. (United States)

    Nakasa, Tomoyuki; Sawa, Mikiya; Ikuta, Yasunari; Yoshikawa, Masahiro; Tsuyuguchi, Yusuke; Adachi, Nobuo


    Osteochondral lesions of the talus (OLT) are recognized as being commonly associated with trauma. However, the etiology of OLT remains unclear. In the case of a posteromedial lesion of OLT (medial OLT), the deep layer of the deltoid ligament is located close to the medial OLT, and this relationship between a medial lesion and deltoid ligament could be a risk factor for medial OLT. The purpose of this study is to investigate the unique anatomic feature of the deep deltoid attachment to the talus in patients with medial OLT compared with patients with non-medial OLT. Forty ankles with medial OLT and 40 ankles without medial OLT were retrospectively reviewed in this study. On the coronal images of MRI, the attachment of deltoid ligament was measured. The continuity of the osteochondral fragment and its bed was evaluated on MRI and arthroscopic findings. Coronal MRI images showed that the attachment of the deep deltoid ligament to the medial OLT was broader and located more proximally than in non-medial OLT. The continuity of fibers from the insertion site of deltoid ligament to the talus to the osteochondral fragment was observed (76.7%). In the arthroscopic findings, the osteochondral fragment was obviously connected to the talus at the medial site in 85.2% of feet. The location of the deep deltoid ligament attachment to the medial OLT was more proximal and there was the possibility of these anatomic feature might contribute to the pathogenesis of medial OLT. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  11. Wetting of Functionalized Polyethylene Film Having Ionizable Organic Acids and Bases at the Polymer-Water Interface: Relations between Functional Group Polarity, Extent of Ionization, and Contact Angle with Water. (United States)


    Figure 17 and for the sulfonamides and fluorinated ainides shown in Figures 9 and 15. The labels correspond to the labels used in those figures; A12’ and...soaked in 30 mL of Jry diethyl ether quickly removed and used immediately without workup t.o mini,nize hydrolysis of the acid chloride groups by

  12. Societal reintegration following cadaveric orthotopic liver transplantation (United States)

    Kelly, Ryan; Hurton, Scott; Ayloo, Subhashini; Cwinn, Mathew; De Coutere-Bosse, Sarah


    Background Studies on patients’ societal reintegration following orthotopic liver transplantation (OLT) are scarce. Methods Between September 2006 and January 2008, all adults who were alive after 3 years post OLT were included in this prospective cohort study. Validated questionnaires were administered to all candidates with the primary aim of investigating the rate of their social re-integration following OLT and potential barriers they might have encountered. Results Among 157 eligible patients 110 (70%) participated. Mean participants’ age was 57 years (SD 11.4) and 43% were females. Prior to OLT, 75% of patients were married and 6% were divorced. Following OLT there was no significant difference in marital status. Employment rate fell from 72% to 30% post-OLT. Patients who had been employed in either low-skill or advanced-skill jobs were less likely to return to work. After OLT, personal income fell an average of 4,363 Canadian dollars (CAN$) (SD 20,733) (P=0.03) but the majority of recipients (80%) reported high levels of satisfaction for their role in society. Conclusions Although patients’ satisfaction post-OLT is high, employment status is likely to be negatively affected for individuals who are not self-employed. Strategies to assist recipients in returning to their pre-OLT jobs should be developed to improve patients’ economical status and societal ability to recoup resources committed for OLT. PMID:27275465

  13. Operative Technique and Clinical Outcome in Endoscopic Core Decompression of Osteochondral Lesions of the Talus: A Pilot Study


    Beck, Sascha; Cla?en, Tim; Haversath, Marcel; J?ger, Marcus; Landgraeber, Stefan


    Background Revitalizing the necrotic subchondral bone and preserving the intact cartilage layer by retrograde drilling is the preferred option for treatment of undetached osteochondral lesions of the talus (OLT). We assessed the effectiveness of Endoscopic Core Decompression (ECD) in treatment of OLT. Material/Methods Seven patients with an undetached OLT of the medial talar dome underwent surgical treatment using an arthroscopically-guided transtalar drill meatus for core decompression of th...

  14. Distribution and landscape controls of organic layer thickness and carbon within the Alaskan Yukon River Basin (United States)

    Pastick, Neal J.; Rigge, Matthew B.; Wylie, Bruce K.; Jorgenson, M. Torre; Rose, Joshua R.; Johnson, Kristofer D.; Ji, Lei


    Understanding of the organic layer thickness (OLT) and organic layer carbon (OLC) stocks in subarctic ecosystems is critical due to their importance in the global carbon cycle. Moreover, post-fire OLT provides an indicator of long-term successional trajectories and permafrost susceptibility to thaw. To these ends, we 1) mapped OLT and associated uncertainty at 30 m resolution in the Yukon River Basin (YRB), Alaska, employing decision tree models linking remotely sensed imagery with field and ancillary data, 2) converted OLT to OLC using a non-linear regression, 3) evaluate landscape controls on OLT and OLC, and 4) quantified the post-fire recovery of OLT and OLC. Areas of shallow (2 = 0.68; OLC: R2 = 0.66), where an average of 16 cm OLT and 5.3 kg/m2 OLC were consumed by fires. Strong predictors of OLT included climate, topography, near-surface permafrost distributions, soil wetness, and spectral information. Our modeling approach enabled us to produce regional maps of OLT and OLC, which will be useful in understanding risks and feedbacks associated with fires and climate feedbacks.

  15. Estonian authors / Janika Kronberg, Rutt Hinrikus

    Index Scriptorium Estoniae

    Kronberg, Janika, 1963-


    Tutvustus: Mattheus, Ülo.¡India armastus. Tallinn : Eesti Keele Sihtasutus, 2006 ;¡Teder,¡Tarmo. Onanistid. Tallinn :¡Tuum, 2006 ;¡Hirv, Indrek. Surmapõletaja. Tallinn :¡Tuum, 2006 ;¡Hvostov, Andrei. Henrik : näidend 12-s pildis. Tallinn : Kultuurileht, 2006. (Loomingu Raamatukogu ;¡20) ;¡Traat,¡Mats. Naised ja pojad. Tallinn : Looming, 2006, nr. 2-5 ;¡Traat, Mats. Sarviku armastus. Tallinn :¡Looming, 2006, nr. 11 ;¡Kaardipakk II. Tallinn : Näo Kirik, 2006 ;¡Kivirähk,¡Andrus. Mees, kes teadis ussisõnu. Tallinn :¡Eesti Keele Sihtasutus, 2007 ;¡Õunapuu,¡Ervin. Meie igapäevane jää :¡eesti gootika III. Tallinn : Varrak, 2006 ;¡Ehlvest, Jüri. Palverännak. Tallinn :¡Tuum, 2005

  16. Short outlines of books by Estonian authors / Rutt Hinrikus, Janika Kronberg

    Index Scriptorium Estoniae

    Hinrikus, Rutt, 1946-


    Arvo Valton. Leidik; Mats Traat. Valge lind; Mats Traat. Harala elulood; Kärt Hellerma. Kassandra; Uku Masing. Luule 1.; Ilmar Vene. Trotsija : katse mõista Uku Masingut; Eesti identiteet ja iseseisvus / koost. A. Bertricau; Ene Mihkelson. Kaalud ei kõnele : valitud luuletusi 1967-1977; Mehis Heinsaar. Vanameeste näppaja; Eesti kirjanduslugu / Epp Annus, Luule Epner, Ants Järv jt.; Aarne Ruben. Volta annab kaeblikku vilet; Mart Kivastik. Näidendid; Kaardipakk / Jürgen Rooste, Karl Martin Sinijärv, Triin Soomets, Elo Viiding, Asko Künnap; Hasso Krull. Kornukoopia : sada luuletust; Tiia Toomet. Vana aja koolilood; Aidi Vallik. Kuidas elad, Ann?; Enn Vetemaa. Neitsist sündinud

  17. Short outlines of books by Estonian authors / Brita Melts, Rutt Hinrikus and Janika Kronberg

    Index Scriptorium Estoniae

    Melts, Brita


    Arvustus: Afanasjev, Vahur. Tünsamäe tigu. Tartu Tartu NAK, 2015 ; Vadi, Urmas. Kuidas me kõik reas niimoodi läheme. Tallinn : Tuum, 2014 ; Traat, Mats. Kolm Solveigi. Tartu : Ilmamaa, 2015 ; Saat, Mari. Matused ja laulupeod. Tartu : Petrone Print, 2015 ; Kivisilla, Veronika. Cantus firmus. Tallinn : Näo Kirik, 2015 ; Kolk, Jüri. Suur võidujooks. Tallinn : Tuum, 2015 ; Mudlum. Tõsine inimene. Tallinn : ZA/UM, 2014

  18. Short outlines of books by Estonian authors : [annotations] / Rutt Hinrikus, Janika Kronberg

    Index Scriptorium Estoniae

    Hinrikus, Rutt, 1946-


    Laretei, Käbi. Eksiil; Toona, Elin. Lotukata; Park, Eeva. Naeru õpilane; Luik, Viivi. Inimese kapike; Laaman, Ilona. Vesi ahjus; Viiding, Juhan (Üdi, Jüri). Kogutud luuletused; Paju, Juhan. Katkenud romaan; Paju, Juhan. Hõõguv rist; Estonian short stories / toim. Kajar Pruul ja Darlene Reddaway; Traat, Mats. Kartaago kiirrong; Kauksi Ülle. Säng; Kross, Jaan. Paigallend; Puhvel, Madli. Symbol of dawn; Kaplinski, Jaan. Võimaluste võimalikkus; Kaplinski, Jaan. Usk on uskmatus

  19. Short outlines of books by Estonian authors / Rutt Hinrikus, Janika Kronberg

    Index Scriptorium Estoniae

    Hinrikus, Rutt, 1946-


    Traat, Mats. Peremees võtab naise; Raudam, Toomas. Muusika kuum sai; Baturin, Nikolai. Ringi vangid; Õunapuu, Ervin. Olivia. Meistriklass; Mattheus, Ülo. Läheb ega peatu; Nõu, Enn. Kojutulek; Valton, Arvo. Väike ilus vangimaja; Unt, Mati. Brecht ilmub öösel; Alliksaar, Artur. Päikesepillaja; Kareva, Doris. Hingring; Kaplinski, Jaan. See ja teine; Hellerma, Kärt. Alkeemia

  20. [Liver transplantation in primary and secondary tumors of the liver. Review of the literature and perspectives]. (United States)

    Vennarecci, Giovanni; Ettorre, Giuseppe Maria; Boschetto, Arianna; Carboni, Fabio; Lepiane, Pasquale; Lonardo, Maria Teresa; Santoro, Roberto; Santoro, Eugenio


    Liver transplantation for malignancies still remains a controversial issue. There is concern for tumour recurrence, poor results and waste of organs, which in the sitting of organ shortage would penalize patients with non-malignant disease. Many centers worldwide perform liver transplantation (OLT) for hepatocellular (HCC) carcinoma associated with liver cirrhosis; the results in these cases are similar to those of patients transplanted for other indications. On the contrary are very few the centers that perform OLT for tumour other than HCC. This reflects that tumours other than HCC are less common and survival is poor compared to patients transplanted for non-malignant disease. Acceptable indications for OLT in case of tumours other than HCC are liver metastases from neuroendocrine tumours and epithelioid emangio-endothelioma. However should be kept in mind that OLT may offer the sole opportunity to cure the tumour and the underlying disease in some patients while providing meaningful palliation for others. At the present the overall experience with OLT for tumours other than HCC is still not significant and the results are discouraging. There is no evidence that OLT is beneficial for non-HCC tumours. Hopefully for the next future new adjuvant and neoadjuvant therapies combined with OLT would provide improved survival. Nevertheless, long-term survivors continue to be reported suggesting that OLT may be beneficial in individual selected cases with non-HCC tumour.

  1. Images in medicine

    African Journals Online (AJOL)



    Jan 8, 2016 ... TSH secreting adenoma: a rare cause of severe headache. Serdar Olt1,&, Mehmet Şirik2. 1Adıyaman University Medical Faculty Department of Internal Medicine, Adıyaman, Turkey, 2Adıyaman University Medical Faculty Department of. Radiology, Adıyaman, Turkey. &Corresponding author: Serdar Olt, ...

  2. Bone histomorphometric changes after liver transplantation for chronic cholestatic liver disease

    NARCIS (Netherlands)

    Guichelaar, MMJ; Malinchoc, M; Sibonga, JD; Clarke, BL; Hay, JE


    Introduction: Patients with advanced liver disease, especially chronic cholestasis, often have osteopenia, which worsens early after orthotopic liver transplantation (OLT) before starting to recover. The changes in bone metabolism leading to this rapid loss of bone after OLT, and to its recovery,

  3. Multifocal manifestation does not affect vascular invasion of hepatocellular carcinoma: implications for patient selection in liver transplantation

    NARCIS (Netherlands)

    Löhe, Florian; Angele, Martin K.; Rentsch, Markus; Graeb, Christian; Gerbes, Alexander; Löhrs, Udo; Beuers, Ulrich; Jauch, Karl-Walter


    BACKGROUND AND AIMS: Liver transplantation (OLT) for hepatocellular carcinoma (HCC) improves patient survival when tumor size and number are limited according to the Milan criteria. However, the impact of tumor size vs. the number of lesions for tumor recurrence after OLT is unclear. Microvascular

  4. Electromagnetic Actuators. (United States)


    CONSIDERATIONS The maximum allowable displacement is a function of the spring mec ).a- nism and the initial air qap between the base and the armature. For the...8217 U-) 10 II L jr-I 0 & ~ ~A2 0 . I w~L oc 0047 I ~ ~ ~ E~W-Ga7- 2075i--YYY-: oi a~ I I - LEI 2 :1; r- zf z3 l:2 ri ii48 fibi ism


    Directory of Open Access Journals (Sweden)

    T. G. Mikhaylichenko


    Full Text Available Being based on a private experience, authors considered necessary to study features of emotional disorders that will allow understanding the mechanism of mental adaptation to disease at patients before and after OLT. In comparative research of structure of emotional frustration at the patients making the most numerous groups of patients before transplantation of a liver (viral hepatitis and autoimmune liver diseases, 129 persons, from them 75 before OLT are included at entering into a waiting list and 54 to through 22 ± 9 days after OLT. Distinctions in structure of emotional frustration are revealed: at patients with autoimmune liver diseases be- fore OLT and viral hepatitis after OLT the semiology combined with disturbing-depressive experiences and hypochondriac fixings is brightly expressed neurotic, them distinguishes high level of personal uneasiness. For patients with autoimmune liver diseases after OLT and viral hepatitis before OLT are characteristic moderately expressed neurotic frustration of an asthenia circle and low level of personal and situational anxiety. 

  6. Acute renal failure and renal replacement therapy in the postoperative period of orthotopic liver transplant patients versus nonelective abdominal surgery patients. (United States)

    Biagioni, E; Cavazzuti, I; Busani, S; Trevisan, D; Zavatti, L; Ferrari, E; Girardis, M; Massimo, G


    Acute renal failure (ARF) often complicates the postoperative period of patients undergoing orthotopic liver transplantation (OLT); it is habitually associated with high mortality rates. Similarly, patients undergoing major nonelective abdominal surgery are prone to ARF because of their frequent preexistent morbidities, abdominal sepsis, and needed for extended surgical procedures. The aim of this study was to evaluate the incidence of ARF and use of renal replacement therapy (RRT) among OLT versus nonelective abdominal surgery patients and associations with clinical outcomes. We studied all the patients admitted to a surgical intensive care unit (ICU) from January 2008 to December 2009 after OLT or nonelective abdominal surgery. The inclusion criteria were an ICU stay of at least 48 hours and without prior end-stage renal failure. OLT patients (n=84) were younger and less severly ill than surgery patients (n=60). ARF occurrence was lower among the OLT (29%) than the surgery group (47%) requiring RRT in 71% and 53% of patients due to ARF, respectively. The ICU mortality of ARF patients in both groups (29% OLT and 51% surgery) were greater than among subjects without ARF (2% and 6%). The occurrence of ARF is common among these two patient groups, and associated with increased risk of death among in surgery (+45%) versus in OLT (+27%) patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Multifocal manifestation does not affect vascular invasion of hepatocellular carcinoma: implications for patient selection in liver transplantation. (United States)

    Löhe, Florian; Angele, Martin K; Rentsch, Markus; Graeb, Christian; Gerbes, Alexander; Löhrs, Udo; Beuers, Ulrich; Jauch, Karl-Walter


    Liver transplantation (OLT) for hepatocellular carcinoma (HCC) improves patient survival when tumor size and number are limited according to the Milan criteria. However, the impact of tumor size vs. the number of lesions for tumor recurrence after OLT is unclear. Microvascular invasion appears to be a significant risk factor for tumor recurrence. Therefore, it was the aim of this study to investigate tumor differentiation and microvascular invasion in relation to tumor number and size and their impact on survival after transplantation. In 97 adult HCC patients who underwent OLT between June 1985 and December 2005 the incidence of microvascular invasion, tumor differentiation, and the number and size of tumor lesions were analyzed retrospectively. Their impact on survival was studied by multivariate analysis. Microvascular invasion was the only independent negative predictor of survival after OLT for HCC (p = 0.025). Tumor size > 5 cm was predictive for microvascular invasion (p = 0.007). In contrast, tumor number did not affect the incidence of microvascular invasion or cumulative survival. The size of the largest HCC lesion, but not the number of tumors, determined microvascular invasion, a predictor of the outcome following OLT for HCC. Thus, the number of HCC lesions should not be applied to patient selection prior to OLT. These data support the extension of the Milan criteria for the selection of HCC patients for OLT with regard to tumor number, but not tumor size.

  8. Primary non-function is frequently associated with fatty liver allografts and high mortality after re-transplantation. (United States)

    Kulik, Ulf; Lehner, Frank; Klempnauer, Jürgen; Borlak, Jürgen


    The shortage of liver donations demands the use of suboptimal grafts with steatosis being a frequent finding. Although ≤30% macrovesicular steatosis is considered to be safe the risk for primary non-function (PNF) and outcome after re-transplantation (re-OLT) is unknown. Among 1205 orthotopic liver transplantations performed at our institution the frequency, survival and reason of re-OLT were evaluated. PNF (group A) cases and those with initial transplant function but subsequent need for re-OLT (group B) were analysed. Histopathology and clinical judgement determined the cause of PNF and included an assessment of hepatic steatosis. Additionally, survival of fatty liver allografts (group C) not requiring re-OLT was considered in Kaplan-Meier and multivariate regression analysis. A total of 77 high urgency re-OLTs were identified and included 39 PNF cases. Nearly 70% of PNF cases were due to primary fatty liver allografts. The 3-month in-hospital mortality for PNF cases after re-OLT was 46% and the mean survival after re-OLT was 0.5 years as compared to 5.2 and 5.1 years for group B, C, respectively, (Pfatty liver allografts to be a major cause for PNF with excessive mortality after re-transplantation. The findings demand the development of new methods to predict risk for PNF of fatty liver allografts. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Successful Treatment of Recurrent Primary Sclerosing Cholangitis after Orthotopic Liver Transplantation with Oral Vancomycin

    Directory of Open Access Journals (Sweden)

    Yinka K. Davies


    Full Text Available Primary sclerosing cholangitis (PSC is a progressive, cholestatic disease of the liver that is marked by inflammation of the bile ducts and damage to the hepatic biliary tree. Approximately 60–70% of patients also have inflammatory bowel disease and progression of PSC can lead to ulcerative colitis and cirrhosis of the liver. Due to limited understanding of the etiology and mechanism of PSC, the only existing treatment option is orthotopic liver transplantation (OLT; however, recurrence of PSC, after OLT is estimated to be between 5% and 35%. We discuss the successful treatment of a pediatric patient, with recurrent PSC, after OLT with oral Vancomycin.

  10. Short outlines of books by Estonian authors / Rutt Hinrikus, Janika Kronberg

    Index Scriptorium Estoniae

    Hinrikus, Rutt, 1946-


    Kõiv, Madis. Studia memoriae I. Rännuaastad; Krull, Hasso. Luuletused 1987-1991; Krull, Hasso. Swinburne; Mihkelson, Ene. Nime vaev; Saarsen, Karin. Poola suvi; Traat, Mats. Hirm ja iha; Murutar, Kati. Naisena sündinud; Unt, Mati. Tere, kollane kass; Unt, Mati. Argimütoloogia sõnastik 1983-93; Unt, Mati. Vastne argimütoloogia; Mutt, Mihkel. Pingviin ja raisakass; Mutt, Mihkel. Rahvusvaheline mees; Teder, Tarmo. Kurat kargas pähe; Suuman, Sass. Targemat ei ole; Hirv, Indrek. Tähekerjus; Kaplinski, Jaan. Mitu suve ja kevadet; Kaplinski, Jaan. Jää ja Titanic

  11. Laste kehaline karistamine tuleb keelata / Raivo Juurak

    Index Scriptorium Estoniae

    Juurak, Raivo, 1949-


    ÜRO peaassamblee on 2006. aastast alates taotlenud, et hiljemalt 2009. a. lõpuks oleks laste kehaline karistamine kõigis riikides nii koolis, karistusasutuses kui ka perekonnas täielikult keelatud. Kuidas on olukord Eestis, arutavad inimõiguste instituudi juhatuse liige Merle Haruoja, sisekaitseakadeemia kriminoloogia õppejõud Uno Traat, Lõuna politseiprefektuuri preventsioonitalituse vanemkomissar Marina Paddar, Pääsküla gümnaasiumi sotsiaalpedagoog Leena Arras, rahvusvahelise programmi "Eluväärtuste haridus" Eesti koordinaator Kalle Laane ja Audentese erakooli psühholoog Ann-Liis Ojaots

  12. Short outlines of books by Estonian authors / Brita Melts, Rutt Hinrikus and Janika Kronberg

    Index Scriptorium Estoniae

    Melts, Brita


    Arvustus: Kilusk, Ott. Veidrikud ja võpatused. Tallinn : Menu, 2012 ; Kilusk, Ott. Oktoobrikuine tuuker. Tallinn : Kirjastuskeskus, 2010 ; Hansen, Aime. Ma olin mereingel. Tallinn : Verb, 2011 ; Vallisoo, Mari. Koidutäht koolivihikus. Tartu : Ilmamaa, 2011 ; Sinijärv, Karl Martin. Krümitor 0671. Tallinn ; Näo Kirik, 2011 ; Aareleid, Kai. Vene veri. Tallinn : Varrak, 2011 ; Ashilevi, Jim. Ma olen elus olemise tunne. Luige : Verb, 2011 ; Traat, Mats. Vastsed Harala elulood. Tartu : Ilmamaa, 2011 ; Tamm, Margus. Unesnõiduja. Tallinn : Raudwara, 2011

  13. Short outlines of books by Estonian authors / Rutt Hinrikus, Janika Kronberg

    Index Scriptorium Estoniae

    Hinrikus, Rutt, 1946-


    Debora Vaarandi. See kauge hääl; Ene Mihkelson. Ahasveeruse uni; Jaan Puhvel. Ulgvel ja umbes; Haljand Udam. Orienditeekond, Jüri Talvet. Kas sul viinamarju ka on?; Leo Kunnas. Sõdurjumala teener; Hendrik Adamson. Laotuse õlmas; Mats Traat. Kõllane õtak; Mari Vallisoo. Ussisõnad; Jan Kaus. Maailm ja mõni; Helga Nõu. Tõmba uttu; Toomas Vint. Kaine kuu ja purjus päike; Kadri Kõusaar. Ego; Mihkel Mutt. Progressiivsed hiired; Jaan Kross. Tahtamaa; Valeria Ränik. Aitab ajast; Valeria Ränik. Ülejõel Kassilaiu pealinnas; Mihkel Samarüütel. 3 : [novellid

  14. Stereotactic body radiotherapy (SBRT for locally advanced extrahepatic and intrahepatic cholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Kiri A. Sandler, MD


    Conclusions: SBRT is a promising option for patients with unresectable or recurrent cholangiocarcinoma either as a component of neoadjuvant therapy prior to OLT or as part of definitive therapy for patients who are unresectable and not eligible for transplantation.

  15. A reconfigurable all-optical VPN based on XGM effect of SOA in WDM PON (United States)

    Hu, Xiaofeng; Zhang, Liang; Cao, Pan; Wang, Tao; Su, Yikai


    We propose and experimentally demonstrate a reconfigurable all-optical VPN scheme enabling intercommunications among different ONUs in a WDM PON. Reconfiguration is realized by dynamically setting wavelength conversion of optical VPN signal using a SOA in the OLT.

  16. Mannose-binding lectin and Ficolin-2 gene polymorphisms predispose to cytomegalovirus (re)infection after orthotopic liver transplantation

    NARCIS (Netherlands)

    de Rooij, Bert-Jan F.; van der Beek, Martha T.; van Hoek, Bart; Vossen, Ann C. T. M.; ten Hove, W. Rogier; Roos, Anja; Schaapherder, Alexander F.; Porte, Robert J.; van der Reijden, Johan J.; Coenraad, Minneke J.; Hommes, Daniel W.; Verspaget, Hein W.


    Background & Aims: The lectin pathway of complement activation is a crucial effector cascade of the innate immune response to pathogens. Cytomegalovirus (CMV) infection occurs frequently in immunocompromised patients after orthotopic liver transplantation (OLT). Single-nucleotide polymorphisms

  17. Critical evaluation of proteomic protocols for passion fruit ( Passiflora ...

    African Journals Online (AJOL)

    Critical evaluation of proteomic protocols for passion fruit (Passiflora edulis Sims) leaves, a crop with juice market benefits. VA Perdizio, OLT Machado, JS Araujo, AEA Oliveira, LR Monteiro, MN Costa, AT Ferreira, J Perales, T Jacinto ...

  18. Study of pulmonary dysfunctions in liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Amr M. Helmy


    Conclusion: Liver cirrhosis is associated with unique pulmonary complications. The early identification of pulmonary dysfunctions in cirrhotic patients is crucial as it affects the prognosis and guides the future management by speeding up orthotopic liver transplantation (OLT recommendations.

  19. Lasteraamatute pildid rändasid Chaplinisse / Katrin Nielsen

    Index Scriptorium Estoniae

    Nielsen, Katrin


    20. veebruarini saab Pärnu uue kunsti muuseumi trepigaleriis vaadata Eesti ilusamaid lasteraamatute illustratsioone 23-lt kunstnikult: Henno Käolt, Reti Saksalt, Ülle Meisterilt, Anne Linnamägilt, Kristiina Reinellerilt, Catherine Zaripilt jt.

  20. Outcome of Transplant-fallout Patients With Unresectable Cholangiocarcinoma. (United States)

    Sio, Terence T; Martenson, James A; Haddock, Michael G; Novotny, Paul J; Gores, Gregory J; Alberts, Steven R; Miller, Robert C; Heimbach, Julie K; Rosen, Charles B


    The aim of this was to determine survival after starting neoadjuvant therapy for patients who became ineligible for orthotopic liver transplantation (OLT). Since January 1993, 215 patients with unresectable cholangiocarcinoma began treatment with planned OLT. Treatment included external-beam radiation therapy (EBRT) with fluorouracil, bile duct brachytherapy, and postradiotherapy fluorouracil or capecitabine before OLT. Adverse findings at the staging operation, death, and other factors precluded OLT in 63 patients (29%), of whom 61 completed neoadjuvant chemoradiation. By October 2012, 56 (89%) of the 63 patients unable to undergo OLT had died. Twenty-two patients (35%) became ineligible for OLT before the staging operation, 38 (60%) at the staging operation, and 3 (5%) after staging. From the date of diagnosis, median overall survival was 12.3 months. Survival was 17% at 18 months and 7% at 24 months. Median survival after fallout was 6.8 months. Median survival after the staging operation was 6 months. Two patients lived for 3.7 and 8.7 years before dying of cancer or liver failure caused by persistent biliary stricture at the site of the original cancer, respectively. Univariate analysis showed that time from diagnosis to fallout correlated with overall survival (P=0.04). In highly selected patients initially suitable for OLT, the mortality rate for cholangiocarcinoma was high in patients who became ineligible for OLT. Their survival, however, was comparable to expected survival for patients with locally advanced or metastatic disease treated with nontransplant therapies. The most common reason for patient fallout was adverse findings at the staging operation.

  1. Energy Saving Scheme Based On Traffic Forwarding For Optical Fiber Access Networks

    DEFF Research Database (Denmark)

    Lopez, G. Arturo Rodes; Estaran Tolosa, Jose Manuel; Vegas Olmos, Juan José


    We report on an energy saving block that regroups and powers off OLTs during low traffic periods, resulting in energy savings up to 87,5% in the central office of optical access networks.......We report on an energy saving block that regroups and powers off OLTs during low traffic periods, resulting in energy savings up to 87,5% in the central office of optical access networks....

  2. Real time algorithm temperature compensation in tunable laser / VCSEL based WDM-PON system

    DEFF Research Database (Denmark)

    Iglesias Olmedo, Miguel; Rodes Lopez, Roberto; Pham, Tien Thang


    We report on a real time experimental validation of a centralized algorithm for temperature compensation of tunable laser/VCSEL at ONU and OLT, respectively. Locking to a chosen WDM channel is shown for temperature changes over 40°C.......We report on a real time experimental validation of a centralized algorithm for temperature compensation of tunable laser/VCSEL at ONU and OLT, respectively. Locking to a chosen WDM channel is shown for temperature changes over 40°C....

  3. Advantages of time-resolved contrast-enhanced 4D MR angiography in splenic arterial steal syndrome. (United States)

    Obmann, Verena C; Chalian, Majid; Mansoori, Bahar; Sanchez, Edmund; Gulani, Vikas


    Splenic artery steal syndrome (SASS) is a severe complication affecting up to 10% of orthotopic liver transplant (OLT) patients. In this case report, we present a 35-year-old male with OLT secondary to liver failure due to hemochromatosis, who developed SASS. We describe potential application of different imaging techniques for diagnosis of SASS with focus on the value of time-resolved contrast enhanced 4D magnetic resonance angiography (MRA). Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Predictive factors of neurological complications and one-month mortality after liver transplantation

    Directory of Open Access Journals (Sweden)

    Katherine eFu


    Full Text Available Background: Neurological complications are common after orthotopic liver transplantation (OLT. We aimed to characterize the risk factors associated with neurological complications and mortality among patients who underwent OLT in the post-model for end-stage liver disease (MELD era.Methods: In a retrospective review, we evaluated 227 consecutive patients at the Keck Hospital of the University of Southern California before and after OLT to define the type and frequency of and risk factors for neurological complications and mortality.Results: Neurological complications were common (n=98, with encephalopathy being most frequent (56.8%, followed by tremor (26.5%, hallucinations (11.2%, and seizure (8.2%. Factors associated with neurological complications after OLT included preoperative dialysis, hepatorenal syndrome, renal insufficiency, intra-operative dialysis, preoperative encephalopathy, preoperative mechanical ventilation, and infection. Preoperative infection was an independent predictor of neurological complications (OR 2.83, 1.47 – 5.44. One-month mortality was 8.8% and was independently associated with urgent re-transplant, preoperative intubation, intraoperative arrhythmia, and intraoperative use of multiple pressors.Conclusion: Neurological complications are common in patients undergoing OLT in the post-MELD era, with encephalopathy being most frequent. An improved understanding of the risk factors related to both neurological complications and one-month mortality post-transplantation can better guide perioperative care and help improve outcomes among OLT patients.

  5. Improved outcomes in pediatric liver transplantation for acute liver failure. (United States)

    Miloh, Tamir; Kerkar, Nanda; Parkar, Sanobar; Emre, Sukru; Annunziato, Rachel; Mendez, Carlos; Arnon, Ronen; Suchy, Frederick; Rodriguez-Laiz, Gonzalo; Del Rio Martin, Juan; Sturdevant, Mark; Iyer, Kishore


    OLT is a life-saving option for ALF. To evaluate our outcomes in pediatric OLT for ALF. Retrospective review of our data between 1992 and 2007. Of 142 children with ALF, 126 were listed, of which 40 spontaneously improved, nine died, and 77 underwent OLT (median waiting time four days). Fifty-three children received deceased donor grafts (34 whole and 19 split grafts), and there were 24 living donor grafts. The one- and five-yr patient survival was 87% and 80%, and graft survival 83% and 79%, respectively. Thirteen patients died after OLT, and there were nine retransplants in seven patients. Patient weight, length of stay, creatinine, and infection were significantly associated with death; increased weight and black ethnicity were associated with graft loss on univariate analysis, but not on multivariate analysis. There were no significant differences in patient survival (one and five yr), graft loss, or other complications between the groups. We report the largest single-center study of OLT in pediatric ALF, demonstrating no difference in outcomes between different graft types. Our liberal use of segmental grafts may allow earlier OLT in this high-risk cohort and contribute to our excellent outcomes. © 2010 John Wiley & Sons A/S.

  6. Graft-versus-host disease after orthotopic liver transplantation: multivariate analysis of risk factors. (United States)

    Elfeki, Mohamed A; Pungpapong, Surakit; Genco, Petrina V; Nakhleh, Raouf E; Nguyen, Justin H; Harnois, Denise M


    Graft-versus-host disease (GVHD) is a rare, fatal complication following orthotopic liver transplantation (OLT). To date, several risk factors have been proposed, but reports on these factors have been inconclusive. This is a retrospective, case-control study of prospectively collected data from 2775 OLTs performed at our institution. Eight cases of GVHD after OLT were diagnosed on the basis of the patient's clinical characteristics, and the findings were confirmed with skin and colonic biopsies. Each case was matched to three controls based on the diagnosis of liver disease, recipient's age, and blood group. Univariate and multivariate analyses were performed to identify risk factors associated with the development of GVHD after OLT. The univariate and multivariate analyses identified two main risk factors associated with development of GVHD in OLT recipients, a difference between recipient and donor age of >20 yr, and any human leukocyte antigen class I matches. Taking these two risk factors into consideration while matching prospective donors and recipients may reduce further incidence of GVHD in OLT patients. However, further studies are recommended to validate these findings. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Seasonal Water Transport in the Atmosphere of Mars: Applications of a Mars General Circulation Model Using Mars Global Surveyor Data (United States)

    Hollingsworth, Jeffery L.; Bridger, Alison F. C.; Haberle, Robert M.


    This is a Final Report for a Joint Research Interchange (JRI) between NASA Ames Research Center and San Jose State University, Department of Meteorology. We present below a summary of progress made during the duration of this JRI. The focus of this JRI has been to investigate seasonal water vapor transport in the atmosphere of Mars and its effects on the planet's present climate. To this end, the primary task has been to adapt a new dynamical processor for the adiabatic tendencies of the atmospheric circulation into the NASA Ames Mars general circulation model (MGCM). Using identical boundary and initial conditions, several comparative tests between the new and old MGCMs have been performed and the nature of the simulated circulations have been diagnosed. With confidence that the updated version of the Ames MGCM produces quite similar mean and eddy circulation statistics, the new climate model is well poised as a tool to pursue fundamental questions related to the spatial and seasonal variations of atmospheric water vapor on Mars, and to explore exchanges of water with non-atmospheric reservoirs and transport within its atmosphere. In particular, the role of surface sources and sinks can be explored, the range of water-vapor saturation altitudes can be investigated, and plausible precipitation mechanisms can be studied, for a range of atmospheric dust loadings. Such future investigations can contribute to a comprehensive study of surface inventories, exchange mechanisms, and the relative importance of atmospheric transport Mars' water cycle. A listing of presentations made and manuscripts submitted during the course of this project is provided.

  8. The Effects of Long-Term Graft Preservation on Intraoperative Hemostatic Changes in Liver Transplantation (United States)

    Bakker, C. Minke; Blankensteijn, Jan D.; Schlejen, Peter; Porte, Robert J.; Gomes, Maria J.; Lampe, Harald I. H.; Stibbe, Jeanne; Terpstra, Onno T.


    We compared hemostatic changes during OLT and HLT after various periods of graft storage, to investigate whether the host liver in HLT protects the recipient from hemostatic deterioration induced by severe graft storage damage. In particular, the mechanism of fibrinolytic deterioration was investigated. The effect of prostaglandin E1 (PGE1) on these parameters was also studied. Material and Methods: 69 pigs underwent either OLT (N = 32) or HLT (N = 37) with a graft stored for 2 hr (N = 31), 24 hr (N = 16), 48 hr (N = 7), or 72 hr (N = 15). PGE1 was given intravenously to both donor and recipient animals and was added to the preservation and flushing solutions. Fibrinolysis (euglobulin clot lysis time, t-PA activity and α2-antiplasmin) and coagulation parameters (activated partial thromboplasmin time, prothrombin time, fibrinogen and platelet count) were measured at several intervals during transplantation. Statistics: Univariate non-parametric tests were used for analysis of coagulation and fibrinolysis parameters. For the three main variables- i.e., the type of transplantation, the use of PGE1, and the preservation time, multiple regression analysis was performed. Results: Fibrinolytic activity increased during the anhepatic period of OLT. Graft reperfusion was followed by a rise in t-PA in both OLT and HLT. In HLT, t-PA quickly returned to normal, whereas a continuous increase was found in OLT. The coagulation parameters, in turn, remained unchanged during the anhepatic period and deteriorated in OLT compared to HLT. The duration of graft storage was directly related to the severity of the hemostatic changes, although this effect was more apparent in OLT than in HLT. Conclusions: Changes in hemostasis are more pronounced in OLT than in HLT. This suggests that the host liver protects the recipient from the effects of graft storage damage, even after long preservation times. Early postreperfusion fibrinolytic activity was presumably due to t-PA release from the

  9. Longterm follow-up of small pancreatic cystic lesions in liver transplant recipients. (United States)

    Vidhyarkorn, Sirachat; Siripongsakun, Surachate; Yu, Jennifer; Sayre, James; Agopian, Vatche G; Durazo, Francisco; Lu, David S


    Incidental small pancreatic cystic lesions (PCLs) are often found on preoperative imaging in patients undergoing orthotopic liver transplantation (OLT). Although these are considered benign or of low malignant potential, the influence of immunosuppression after OLT may be of concern. The aim of this study was to observe the longterm outcome of these small PCLs in post-OLT patients. An institutional OLT database of 1778 consecutive OLT patients from January 2000 to December 2010 was analyzed. Computed tomography, magnetic resonance imaging, or endoscopic ultrasound at the time of OLT and all subsequent imaging, cytology, fluid analysis of PCLs, and patient status were evaluated. A total of 70 patients with 182 PCLs, of benign or low malignant potential, were identified with a mean follow-up time of 64 months. At initial diagnosis of PCLs in 48 patients, 7 branch duct-type intraductal papillary mucinous neoplasms (B-IPMNs), 1 serous cystadenoma (SCA), and 40 nonspecific benign cysts were identified. Final diagnosis at the end of the follow-up revealed 16 B-IPMNs, 3 SCAs, and a mixed acinar-neuroendocrine carcinoma, in which the latter developed 9 years after initial diagnosis of B-IPMN. During the follow-up time, average increase in size and number of PCLs were 4.5 mm and 1.4, respectively (P < 0.001 for both). The majority of incidental PCLs in OLT patients showed an indolent behavior despite immunosuppression. Risk of malignancy development was very low and comparable with normal population. Liver Transplantation 23 324-329 2017 AASLD. © 2016 by the American Association for the Study of Liver Diseases.

  10. Operative Technique and Clinical Outcome in Endoscopic Core Decompression of Osteochondral Lesions of the Talus: A Pilot Study (United States)

    Beck, Sascha; Claßen, Tim; Haversath, Marcel; Jäger, Marcus; Landgraeber, Stefan


    Background Revitalizing the necrotic subchondral bone and preserving the intact cartilage layer by retrograde drilling is the preferred option for treatment of undetached osteochondral lesions of the talus (OLT). We assessed the effectiveness of Endoscopic Core Decompression (ECD) in treatment of OLT. Material/Methods Seven patients with an undetached OLT of the medial talar dome underwent surgical treatment using an arthroscopically-guided transtalar drill meatus for core decompression of the lesion. Under endoscopic visualization the OLT was completely debrided while preserving the cartilage layer covering the defect. The drill tunnel and debrided OLT were filled using an injectable bone graft substitute. Various clinical scores, radiographic imaging, and MRI were evaluated after a mean follow-up of 24.1 months. Results The American Orthopedic Foot and Ankle Society Score significantly improved from 71.0±2.4 to 90.3±5.9, and the Foot and Ankle Disability Index improved from 71.8±11.1 to 91.7±4.8. Radiographically, we observed good bone remodelling of the medial talar dome contour within 3 months. In MRI, an alteration of the bony signal of the drill tunnel and the excised OLT remained for more than 12 months. Conclusions First follow-up results for the surgical technique described in this study are highly promising for treatment of undetached stable OLT grade II or transitional stage II–III according to the Pritsch classification. Even lesions larger than 150 mm2 showed good clinical scores, with full restoration of the medial talar dome contour in radiographic imaging. PMID:27362485

  11. Incidental intracardiac thromboemboli during liver transplantation: incidence, risk factors, and management. (United States)

    Xia, Victor W; Ho, Jonathan K; Nourmand, Hamid; Wray, Christopher; Busuttil, Ronald W; Steadman, Randolph H


    Even though numerous cases of massive thromboemboli have been reported in the literature, intracardiac thromboemboli (ICTs) incidentally found during orthotopic liver transplantation (OLT) have not been examined. In this study, we retrospectively examined the incidence, risk factors, and management of incidental ICTs during OLT. After institutional review board approval, adult patients who underwent OLT between January 2004 and December 2008 at our center were reviewed. ICTs were identified and confirmed by the examination of OLT datasheets, anesthesia records, and recorded transesophageal echocardiography (TEE) clips. The clinical presentation, management, and outcomes of the patients with ICTs were reviewed. Risk factors were analyzed by multivariate logistic regression. During the study period, 426 of the 936 adult OLT patients (45.5%) underwent intraoperative TEE monitoring. Incidental ICTs were identified in 8 of these 426 patients (1.9%). Two ICTs occurred before reperfusion, and 6 ICTs occurred after reperfusion. The treatment was at the discretion of the treating physicians; however, none of the patients received an anticoagulant or thrombolytics. Multivariate analysis identified 2 independent risk factors for intraoperative incidental ICTs: the presence of symptomatic or surgically treated portal hypertension (a history of gastrointestinal bleeding, a transjugular intrahepatic portosystemic shunt procedure, or portocaval shunt surgery) before OLT and intraoperative hemodialysis (odds ratios of 4.05 and 7.29, respectively; P ICTs during OLT occurred at a rate of 1.9% and were associated with several preoperative and intraoperative risk factors. The use of TEE allows early identification, which may be important. Our management for incidental ICTs is described; however, no conclusions can be made about the optimal therapy. Copyright © 2010 American Association for the Study of Liver Diseases.

  12. Bridging Locoregional Therapy Prolongs Survival in Patients Listed for Liver Transplant with Hepatocellular Carcinoma

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    Xing, Minzhi; Sakaria, Sonali; Dhanasekaran, Renumathy; Parekh, Samir; Spivey, James; Knechtle, Stuart J.; Zhang, Di; Kim, Hyun S.


    Background and AimsTo evaluate the long-term survival benefit of bridging locoregional therapy (LRT) prior to orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC) within Milan criteria.MethodsOur transplant center registry was studied for all HCC patients within the Milan criteria who were listed for OLT from 1998 to 2013. Baseline clinical characteristics and median overall survival (OS) were calculated and stratified by LRT, OLT status, and wait times. Survival analysis was conducted using Kaplan–Meier estimation and log-rank test.ResultsOf 265 listed, 205 underwent OLT (mean follow-up 7.6 years). Of 205, 111 received bridging LRT (A), and 94 did not (B). Both were similar in demographics and tumor characteristics (p > 0.05). Median OS from HCC for A/B were 86.4 vs. 68.9 months (p = 0.01). Median OS from OLT for A/B were 74.6 vs. 63.6 months (p = 0.03). On multivariate analysis, independent predictors for survival from HCC were bridging LRT (p = 0.002) and high wait time (p = 0.008); independent predictors for survival from OLT were bridging LRT (p = 0.005) and high wait time (p = 0.005). Of 60 who were listed but did not undergo transplant, 44 received LRT (C) and 16 received best supportive care (D). Median OS from HCC for C/D were 37.1 vs. 24.8 months (p = 0.03).ConclusionsBridging LRT and high wait times were independent positive prognostic factors for survival from HCC diagnosis and OLT.

  13. Bridging Locoregional Therapy Prolongs Survival in Patients Listed for Liver Transplant with Hepatocellular Carcinoma

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    Xing, Minzhi [Yale School of Medicine, Interventional Radiology, Department of Radiology and Biomedical Imaging (United States); Sakaria, Sonali [Emory University School of Medicine, Division of Digestive Diseases, Department of Medicine (United States); Dhanasekaran, Renumathy [Stanford University School of Medicine, Division of Gastroenterology and Hepatology (United States); Parekh, Samir; Spivey, James [Emory University School of Medicine, Division of Digestive Diseases, Department of Medicine (United States); Knechtle, Stuart J. [Duke University School of Medicine, Division of Transplant Surgery, Department of Surgery (United States); Zhang, Di [University of Pittsburgh, Department of Biostatistics, Graduate School of Public Health (United States); Kim, Hyun S., E-mail: [Yale School of Medicine, Interventional Radiology, Department of Radiology and Biomedical Imaging (United States)


    Background and AimsTo evaluate the long-term survival benefit of bridging locoregional therapy (LRT) prior to orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC) within Milan criteria.MethodsOur transplant center registry was studied for all HCC patients within the Milan criteria who were listed for OLT from 1998 to 2013. Baseline clinical characteristics and median overall survival (OS) were calculated and stratified by LRT, OLT status, and wait times. Survival analysis was conducted using Kaplan–Meier estimation and log-rank test.ResultsOf 265 listed, 205 underwent OLT (mean follow-up 7.6 years). Of 205, 111 received bridging LRT (A), and 94 did not (B). Both were similar in demographics and tumor characteristics (p > 0.05). Median OS from HCC for A/B were 86.4 vs. 68.9 months (p = 0.01). Median OS from OLT for A/B were 74.6 vs. 63.6 months (p = 0.03). On multivariate analysis, independent predictors for survival from HCC were bridging LRT (p = 0.002) and high wait time (p = 0.008); independent predictors for survival from OLT were bridging LRT (p = 0.005) and high wait time (p = 0.005). Of 60 who were listed but did not undergo transplant, 44 received LRT (C) and 16 received best supportive care (D). Median OS from HCC for C/D were 37.1 vs. 24.8 months (p = 0.03).ConclusionsBridging LRT and high wait times were independent positive prognostic factors for survival from HCC diagnosis and OLT.

  14. Incidence, risk factors and outcome of de novo tumors in liver transplant recipients focusing on alcoholic cirrhosis (United States)

    Jiménez-Romero, Carlos; Justo-Alonso, Iago; Cambra-Molero, Félix; Calvo-Pulido, Jorge; García-Sesma, Álvaro; Abradelo-Usera, Manuel; Caso-Maestro, Oscar; Manrique-Municio, Alejandro


    Orthotopic liver transplantation (OLT) is an established life-saving procedure for alcoholic cirrhotic (AC) patients, but the incidence of de novo tumors ranges between 2.6% and 15.7% and is significantly increased in comparison with patients who undergo OLT for other etiologies. Tobacco, a known carcinogen, has been reported to be between 52% and 83.3% in AC patients before OLT. Other risk factors that contribute to the development of malignancies are dose-dependent immunosuppression, advanced age, viral infections, sun exposure, and premalignant lesions (inflammatory bowel disease, Barrett’s esophagus). A significantly more frequent incidence of upper aerodigestive (UAD) tract, lung, skin, and kidney-bladder tumors has been found in OLT recipients for AC in comparison with other etiologies. Liver transplant recipients who develop de novo non-skin tumors have a decreased long-term survival rate compared with controls. This significantly lower survival rate is more evident in AC recipients who develop UAD tract or lung tumors after OLT mainly because the diagnosis is usually performed at an advanced stage. All transplant candidates, especially AC patients, should be encouraged to cease smoking and alcohol consumption in the pre- and post-OLT periods, use skin protection, avoid sun exposure and over-immunosuppression, and have a yearly otopharyngolaryngeal exploration and chest computed tomography scan in order to prevent or reduce the incidence of de novo malignancies. Although still under investigation, substitution of calcineurin inhibitors for sirolimus or everolimus may reduce the incidence of de novo tumors after OLT. PMID:25954477

  15. An Intercomparison of the Dynamical Cores of Global Atmospheric Circulation Models for Mars (United States)

    Hollingsworth, Jeffery L.; Bridger, Alison F. C.; Haberle, Robert M.


    This is a Final Report for a Joint Research Interchange (JRI) between NASA Ames Research Center and San Jose State University, Department of Meteorology. The focus of this JRI has been to evaluate the dynamical 'cores' of two global atmospheric circulation models for Mars that are in operation at the NASA Ames Research Center. The two global circulation models in use are fundamentally different: one uses spherical harmonics in its horizontal representation of field variables; the other uses finite differences on a uniform longitude-latitude grid. Several simulations have been conducted to assess how the dynamical processors of each of these circulation models perform using identical 'simple physics' parameterizations. A variety of climate statistics (e.g., time-mean flows and eddy fields) have been compared for realistic solstitial mean basic states. Results of this research have demonstrated that the two Mars circulation models with completely different spatial representations and discretizations produce rather similar circulation statistics for first-order meteorological fields, suggestive of a tendency for convergence of numerical solutions. Second and higher-order fields can, however, vary significantly between the two models.

  16. Pathological Roles of Interleukin-22 in the Development of Recurrent Hepatitis C after Liver Transplantation.

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    Yinjie Gao

    Full Text Available The aim of this study was to longitudinally evaluate and analyze the role of interleukin-22-producing CD4 positive cells (IL-22 in the pathogenesis of Hepatitis C Virus recurrence after Orthotopic Liver Transplantation (HCV-OLT.15 HCV-OLT, 15 age- and gender- matched non-HCV post-OLT (OLT and 15 hepatitis C virus infected (HCV patients were enrolled into our study from the liver transplantation and research center at Beijing 302 Hospital. We determined the frequencies of IL-22 using flow cytometry and expression of IL-22 mRNA using PCR in peripheral blood and liver tissue. We also divided HCV-OLT patients into rapid fibrosis progression (RFP and slow fibrosis progression (SFP, examined IL-22 cells and analyzed the correlations between IL-22 frequencies and liver injury, fibrosis and clinical parameters. Moreover, we investigated the role of IL-22 in Human Hepatic Stellate Cells (HSCs.The levels of serum IL-22, frequencies of IL-22 producing cells in peripheral blood mononuclear cells, and expression of IL-22 mRNA and protein in the liver in the HCV-OLT group were significantly higher than that in the HCV and OLT groups. Furthermore, eight (53.3% patients developed RFP after two years; another three patients were diagnosed liver cirrhosis. The frequencies of IL-22 were much higher in RFP compared with SFP, while no significant difference existed between OLT and SFP. Intrahepatic IL-22 positive cells were located in fibrotic areas and significantly correlated with α-smooth muscle actin (α-SMA and fibrosis staging scores, not with grading scores and HCRVNA. In vitro, IL-22 administration prevented HSCs apoptosis, promoted HSCs proliferation and activation, up-regulated the expression of HSC-sourced growth factors including α-SMA, TGF-β and TIMP-1, and increased the production of liver fibrosis markers including laminin, hyaluronic acid and collagen type IV.Peripheral and intrahepatic IL-22 is up-regulated and plays a pathological role in

  17. Reconfigurable multiport EPON repeater (United States)

    Oishi, Masayuki; Inohara, Ryo; Agata, Akira; Horiuchi, Yukio


    An extended reach EPON repeater is one of the solutions to effectively expand FTTH service areas. In this paper, we propose a reconfigurable multi-port EPON repeater for effective accommodation of multiple ODNs with a single OLT line card. The proposed repeater, which has multi-ports in both OLT and ODN sides, consists of TRs, BTRs with the CDR function and a reconfigurable electrical matrix switch, can accommodate multiple ODNs to a single OLT line card by controlling the connection of the matrix switch. Although conventional EPON repeaters require full OLT line cards to accommodate subscribers from the initial installation stage, the proposed repeater can dramatically reduce the number of required line cards especially when the number of subscribers is less than a half of the maximum registerable users per OLT. Numerical calculation results show that the extended reach EPON system with the proposed EPON repeater can save 17.5% of the initial installation cost compared with a conventional repeater, and can be less expensive than conventional systems up to the maximum subscribers especially when the percentage of ODNs in lightly-populated areas is higher.

  18. Safety and Yield of Diagnostic ERCP in Liver Transplant Patients with Abnormal Liver Function Tests

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    Jayapal Ramesh


    Full Text Available Background. Abnormal liver enzymes postorthotopic liver transplant (OLT may indicate significant biliary pathology or organ rejection. There is very little known in the literature regarding the current role of diagnostic ERCP in this scenario. Aim. To review the utility of diagnostic ERCP in patients presenting with abnormal liver function tests in the setting of OLT. Methods. A retrospective review of diagnostic ERCPs in patients with OLT from 2002 to 2013 from a prospectively maintained, IRB approved database. Results. Of the 474 ERCPs performed in OLT patients, 210 (44.3%; 95% CI 39.8–48.8 were performed for abnormal liver function tests during the study period. Majority of patients were Caucasian (83.8%, male (62.4% with median age of 55 years (IQR 48–62 years. Biliary cannulation was successful in 99.6% of cases and findings included stricture in 45 (21.4 %; biliary stones/sludge in 23 (11%; biliary dilation alone in 31 (14.8%; and normal in 91 (43.3%. Three (1.4% patients developed mild, self-limiting pancreatitis; one patient (0.5% developed cholangitis and two (1% had postsphincterotomy bleeding. Multivariate analyses showed significant association between dilated ducts on imaging with a therapeutic outcome. Conclusion. Diagnostic ERCP in OLT patients presenting with liver function test abnormalities is safe and frequently therapeutic.

  19. A 20-year period of orthotopic liver transplantation activity in a single center: a time series analysis performed using the R Statistical Software. (United States)

    Santori, G; Andorno, E; Morelli, N; Casaccia, M; Bottino, G; Di Domenico, S; Valente, U


    In many Western countries a "minimum volume rule" policy has been adopted as a quality measure for complex surgical procedures. In Italy, the National Transplant Centre set the minimum number of orthotopic liver transplantation (OLT) procedures/y at 25/center. OLT procedures performed in a single center for a reasonably large period may be treated as a time series to evaluate trend, seasonal cycles, and nonsystematic fluctuations. Between January 1, 1987 and December 31, 2006, we performed 563 cadaveric donor OLTs to adult recipients. During 2007, there were another 28 procedures. The greatest numbers of OLTs/y were performed in 2001 (n = 51), 2005 (n = 50), and 2004 (n = 49). A time series analysis performed using R Statistical Software (Foundation for Statistical Computing, Vienna, Austria), a free software environment for statistical computing and graphics, showed an incremental trend after exponential smoothing as well as after seasonal decomposition. The predicted OLT/mo for 2007 calculated with the Holt-Winters exponential smoothing applied to the previous period 1987-2006 helped to identify the months where there was a major difference between predicted and performed procedures. The time series approach may be helpful to establish a minimum volume/y at a single-center level.

  20. No Apparent Benefit of Preemptive Sorafenib Therapy in Liver Transplant Recipients with advanced HCC on Explant. (United States)

    Satapathy, Sanjaya K; Das, Kanak; Kocak, Mehmet; Helmick, Ryan A; Eason, James D; Nair, Satheesh; Vanatta, Jason M


    Sorafenib has shown survival benefits in patients with advanced HCC; however limited data is available on its role in OLT recipients with advanced HCC in the explant. Evaluate the role of preemptive sorafenib therapy on HCC recurrence and survival after OLT with advanced HCC on explant pathology. We retrospectively reviewed the outcome after OLT of all HCC recipients with advanced HCC in the explant pathology from 04/2006 to 12/2012 based on preemptive treatment with sorafenib. During the observation period, 217 HCC recipients underwent OLT, 50 explants revealed advanced HCC. After exclusion of 5 patients who lost to follow up, 45 LT recipients were finally included for analysis. Recipients were grouped as sorafenib Gr (N=25), and non-sorafenib Gr (N=20). Both recurrence free survival (RFS) (p=0.67) and overall survival was similar between groups (p=0.53) on Kaplan-Meier analysis. Additionally, Sorafenib use was neither associated HCC recurrence free survival (HR 0.74, 95% CI [0.32-1.70]; p=0.48) nor overall survival (HR 0.92, 95% CI [0.39-2.15], P=0.84) on multivariate Cox proportional hazard model with sorafenib use as time-varying covariates. Preemptive treatment with sorafenib in OLT recipients with high risk features in explant does not improve HCC recurrence free or overall survival. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  1. Investigating bang for your training buck: a randomized controlled trial comparing three methods of training clinicians in two core strategies of dialectical behavior therapy. (United States)

    Dimeff, Linda A; Harned, Melanie S; Woodcock, Eric A; Skutch, Julie M; Koerner, Kelly; Linehan, Marsha M


    The present study examined the efficacy of online training (OLT), instructor-led training (ILT), and a treatment manual (TM) in training mental health clinicians in two core strategies of Dialectical Behavior Therapy (DBT): chain analysis and validation. A randomized controlled trial compared OLT, ILT, and TM among clinicians naïve to DBT (N=172) who were assessed at baseline, post-training, and 30, 60, and 90 days following training. Primary outcomes included satisfaction, self-efficacy, motivation, knowledge, clinical proficiency, and clinical use. Overall, ILT outperformed OLT and TM in satisfaction, self-efficacy, and motivation, whereas OLT was the most effective method for increasing knowledge. The conditions did not differ in observer-rated clinical proficiency or self-reported clinical use, which both increased to moderate levels after training. In addition, ILT was particularly effective at improving motivation to use chain analysis, whereas OLT was particularly effective at increasing knowledge of validation strategies. These findings suggest that these types of brief, didactic trainings may be effective methods of increasing knowledge of new treatment strategies, but may not be sufficient to enable clinicians to achieve a high level of clinical use or proficiency. Additional research examining the possible advantages of matching training methods to types of treatment strategies may help to determine a tailored, more effective approach to training clinicians in empirically supported treatments. Copyright © 2015. Published by Elsevier Ltd.

  2. Molecular Mechanisms to Control Post-Transplantation Hepatitis B Recurrence

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    Akinobu Takaki


    Full Text Available Hepatitis B often progresses to decompensated liver cirrhosis requiring orthotopic liver transplantation (OLT. Although newer nucleos(tide analogues result in >90% viral and hepatitis activity control, severely decompensated patients still need OLT because of drug-resistant virus, acute exacerbation, or hepatocellular carcinoma. Acute hepatitis B is also an indication for OLT, because it can progress to fatal acute liver failure. After OLT, the hepatitis B recurrence rate is >80% without prevention, while >90% of transplant recipients are clinically controlled with combined hepatitis B immunoglobulin (HBIG and nucleos(tide analogue treatment. However, long-term HBIG administration is associated with several unresolved issues, including limited availability and extremely high cost; therefore, several treatment protocols with low-dose HBIG, combined with nucleos(tide analogues, have been investigated. Another approach is to induce self-producing anti-hepatitis B virus (HBV antibodies using an HBV envelope (HBs antigen vaccine. Patients who are not HBV carriers, such as those with acutely infected liver failure, are good candidates for vaccination. For chronic HBV carrier liver cirrhosis patients, a successful vaccine response can only be achieved in selected patients, such as those treated with experimentally reduced immunosuppression protocols. The present protocol for post-OLT HBV control and the future prospects of newer treatment strategies are reviewed.

  3. Peroneal neuropathy after liver transplantation. (United States)

    Yoon, J S; Gwak, M S; Yang, M; Kim, G S; Kwon, C H; Joh, J W; Lee, S K; Kim, S J


    The incidence of peroneal neuropathy (PN), occurring predominantly in the left leg, increases after the incorporation of intermittent pneumatic compression (IPC) devices among adult liver transplantation (OLT) recipients in our hospital. The aim of this study was to investigate the possible risk factors for PN and the reason for the left-leg predominance. We retrospectively reviewed the medical records of 501 OLT recipients. The patients were first divided into 2 groups, PN (n = 33) and non-PN (n = 468), to assess possible risk factors. The patients were then categorized into IPC (n = 262) and non-IPC (n = 239) groups according to the use of IPC devices. In a subsequent prospective study, we measured the degree and duration of the tilt of the operating table during OLT to investigate their relationship to the predominant left-leg PN. The rate of IPC device use was significantly greater among the PN than non-PN group (78.8% vs 50.4%, P table were greater and longer than the right tilt. The use of IPC devices during OLT increased the occurrence of PN and the left tilt of the operating table was strongly related to the predominant left-leg PN. Careful protection of the vulnerable point and minimization of the tilting of the operating table is advised during OLT, especially when IPC devices are used.

  4. Orbital lymphoid tumors

    International Nuclear Information System (INIS)

    Matsumoto, Hiroko; Ueno, Hisayuki


    We examined 13 cases of orbital lymphoid tumors (OLT) and 1 of orbital hemangioma (OH), using dynamic MRI, to determine the biological behavior of the tumors before surgery. We measured time-dependent changes in the contrast enhancement of tumors and described time intensity curves (TIC), dividing the cases into 3 architectural types: completes septum (CS), incomplete septum (IS), and diffuse types. The TICs of reactive lymphoid hyperplasia (RLH, 2 cases) of CS type and idiopathic orbital inflamation (1), RLH (5) of IS type, atypical lymphoid hyperplasia (4), and malignant lymphoma (1) and OH (1) showed rapid increase with low peak and gradual decrease, rapid increase with high peak and gradual decrease, rapid increase and plateau, and gradual increase type, respectively. In order words, OLT showed various TIC, roughly correlating with pathological findings. These results indicate that dynamic MRI may be useful in the preoperative clinical diagnosis of OLT. (author)

  5. Orbital lymphoid tumors; Comparison of features of dynamic MRI with pathological findings

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    Matsumoto, Hiroko; Ueno, Hisayuki (Kochi Medical School, Nankoku (Japan))


    We examined 13 cases of orbital lymphoid tumors (OLT) and 1 of orbital hemangioma (OH), using dynamic MRI, to determine the biological behavior of the tumors before surgery. We measured time-dependent changes in the contrast enhancement of tumors and described time intensity curves (TIC), dividing the cases into 3 architectural types: completes septum (CS), incomplete septum (IS), and diffuse types. The TICs of reactive lymphoid hyperplasia (RLH, 2 cases) of CS type and idiopathic orbital inflamation (1), RLH (5) of IS type, atypical lymphoid hyperplasia (4), and malignant lymphoma (1) and OH (1) showed rapid increase with low peak and gradual decrease, rapid increase with high peak and gradual decrease, rapid increase and plateau, and gradual increase type, respectively. In order words, OLT showed various TIC, roughly correlating with pathological findings. These results indicate that dynamic MRI may be useful in the preoperative clinical diagnosis of OLT. (author).

  6. Orthotopic liver transplantation in glucose-6-phosphatase deficiency--Von Gierke disease--with multiple hepatic adenomas and concomitant focal nodular hyperplasia. (United States)

    Carreiro, Gerson; Villela-Nogueira, Cristiane A; Coelho, Henri ue Sérgio M; Basto, Samanta; Pannain, Vera Lucia; Caroli-Bottino, Adriana; Ribeiro Filho, Joaquim


    Von Gierke disease is occasionally complicated by hepatic adenomas (HAs) causing great concern owing to the current difficulties in monitoring them regarding malignant transformation. Orthotopic liver transplantation (OLT) is proposed as a therapeutic tool when multiple HAs and poor metabolic control are present, owing to the lack of a clear-cut criterion to detect early malignant transformation, whether or not associated with growth retardation. Focal nodular hyperplasia (FNH) has never been described together with multiple adenomas in von Gierke disease. We report a 26-year-old woman with von Gierke disease complicated by multiple HAs concomitant with FNH who underwent OLT and is now free from disease symptoms with good long-term outcome. In conclusion, although FNH could have been managed clinically, when multiple adenomas are present, OLT should be planned for some patients, mainly for those with poor metabolic control.

  7. A 20-year experience with liver transplantation for polycystic liver disease: does previous palliative surgical intervention affect outcomes? (United States)

    Baber, John T; Hiatt, Jonathan R; Busuttil, Ronald W; Agopian, Vatche G


    Although it is the only curative treatment for polycystic liver disease (PLD), orthotopic liver transplantation (OLT) has been reserved for severely symptomatic, malnourished, or refractory patients who are not candidates for palliative disease-directed interventions (DDI). Data on the effect of previous DDIs on post-transplant morbidity and mortality are scarce. We analyzed the outcomes after OLT for PLD recipients, and determined the effects of previous palliative surgical intervention on post-transplantation morbidity and mortality. We performed a retrospective analysis of factors affecting perioperative outcomes after OLT for PLD between 1992 and 2013, including comparisons of recipients with previous major open DDIs (Open DDI, n = 12) with recipients with minimally invasive or no previous DDIs (minimal DDI, n = 16). Over the 20-year period, 28 recipients underwent OLT for PLD, with overall 30-day, 1-, and 5-year graft and patient survivals of 96%, 89%, 75%, and 96%, 93%, 79%, respectively. Compared with the minimal DDI group, open DDI recipients accounted for all 5 deaths, had inferior 90-day and 1- and 5-year survivals (83%, 83%, and 48% vs 100%, 100%, 100%; p = 0.009), and greater intraoperative (42% vs 0%; p = 0.003), total (58% vs 19%; p = 0.031), and Clavien grade IV or greater (50% vs 6%; p = 0.007) postoperative complications, more unplanned reoperations (50% vs 13%; p = 0.003), and longer total hospital (27 days vs 17 days; p = 0.035) and ICU (10 days vs 4 days; p = 0.045) stays. In one of the largest single-institution experiences of OLT for PLD, we report excellent long-term graft and patient survival. Previous open DDIs are associated with increased risks of perioperative morbidity and mortality. Improved identification of PLD patients bound for OLT may mitigate perioperative complications and potentially improve post-transplantation outcomes. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Novel treatment of 99Tc-MDP improves clinical and radiographic results for patients with osteochondral lesions of the talus. (United States)

    Liu, Hongjuan; Guo, Huili; Guo, Shunong; Wang, Junhui; Ye, Yanju; Ma, Chao


    Management of osteochondral lesions of talus (OLT) remains controversial. 99Tc-MDP,a decay product of 99mTc-MDP which is widely used for bone scan, is effective in the clinical treatment of rheumatoid arthritis. The purpose of the study is to investigate the effects of 99Tc-MDP treatment on OLT. In the clinical evaluation, 66 patients with a total of 83 lesions of OLT who failed appropriate nonoperative treatment and surgery were retrospectively included and treated with intravenous injection of 99Tc-MDP and Chinese herbal fumigation (CHF). The effects of 99Tc-MDP and CHF on OLT were evaluated by the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS), visual analog scale (VAS), activities of daily living (Barthel index), and MRI, 99mTc-MDP SPECT/CT and CT. Radiographic changes were also assessed by the transverse long diameter of the cyst on CT. At the last follow up, AOFAS, VAS and Barthel index improved significantly from 68.66±9.76, 3.05±0.34 and 85±8.31 to 85.4±8.31, 1.85±0.36 and 94.7±4.99 (pMDP and CHF is effective in pain relief and return of function in a short term of follow up for patients with OLT. Our results suggest that the small cystic lesions with increased uptake of 99mTc-MDP on SPECT/CT can be well treated by 99Tc-MDP and CHF. This novel technique holds the potential to emerge as an effective conservative treatment for OLT without adverse effects. The Level of Evidence for 99Tc-MDP is medium for the number of patients and retrospective study.

  9. Rotational Thromboelastometry or Conventional Coagulation Tests in Liver Transplantation: Comparing Blood Loss, Transfusions, and Cost. (United States)

    Smart, Laura; Mumtaz, Khalid; Scharpf, Danielle; Gray, Nicole O'Bleness; Traetow, Daniel; Black, Sylvester; Michaels, Anthony J; Elkhammas, Elmahdi; Kirkpatrick, Robert; Hanje, A James

    Orthotopic liver transplantation (OLT) can be associated with significant bleeding requiring multiple blood product transfusions. Rotational thromboelastometry (ROTEM) is a point-of-care device that has been used to monitor coagulation during OLT. Whether it reduces blood loss/transfusions during OLT remains controversial. We aim to compare ROTEM with conventional coagulation tests (aPTT, PT, INR, platelet count, fibrinogen) to guide transfusion of platelets, cryoprecipitate, and fresh frozen plasma (FFP) during OLT over 3 years. Thirty-four patients who had transfusions guided by ROTEM were compared to 34 controls who received transfusions guided by conventional coagulation tests (CCT). Intraoperative blood loss, type/ amount of blood products transfused, and direct costs were compared between the two groups. The ROTEM group had significantly less intra-operative blood loss (2.0 vs. 3.0 L, p = 0.04) and fresh frozen plasma (FFP) transfusion (4 units vs. 6.5 units, p = 0.015) compared to the CCT group (2.0L vs. 3.0L, p = 0.04). However, total number of patients transfused cryoprecipitate was increased in ROTEM (n = 25;73%) as compared to CCT (n = 19; 56%), p = 0.033. The direct cost of blood products plus testing was reduced in the ROTEM group ($113,142.89 vs. $127,814.77). In conclusion implementation of a ROTEM-guided transfusion algorithm resulted in a reduction in intra-operative blood loss, FFP transfusion and a decrease in direct cost during OLT. ROTEM is a useful and safe point of care device in OLT setting.

  10. Liver transplantation for chronic hepatitis C virus infection in the United States 2002-2014: An analysis of the UNOS/OPTN registry.

    Directory of Open Access Journals (Sweden)

    Georg Dultz

    Full Text Available Chronic hepatitis C virus (HCV infection is a leading cause for orthotopic liver transplantation (OLT in the U.S. We investigated characteristics of HCV-infected patients registered for OLT, and explored factors associated with mortality. Data were obtained from the United Network for Organ Sharing and Organ Procurement and Transplantation network (UNOS/OPTN registry. Analyses included 41,157 HCV-mono-infected patients ≥18 years of age listed for cadaveric OLT between February 2002 and June 2014. Characteristics associated with pre- and post-transplant survival and time trends over the study period were determined by logistic and Cox proportional hazard regression analyses and Poisson regressions. Most patients were white (69.1% and male (70.8%. At waitlist registration, mean age was 54.6 years and mean MELD was 16. HCC was recorded in 26.9% of the records. A total of 51.2% of the patients received an OLT, 21.0% died or were too sick; 15.6% were delisted and 10.4% were still waiting. Factors associated with increased waitlist mortality were older age, female gender, blood type 0, diabetes, no HCC and transplant region (p<0.001. OLT recipient characteristics associated with increased risk for post OLT mortality were female gender, age, diabetes, race (p<0,0001, and allocation MELD (p = 0.005. Donor characteristics associated with waitlist mortality included age, ethnicity (p<0.0001 and diabetes (p<0.03. Waitlist registrations and OLTs for HCC significantly increased from 14.4% to 37.3% and 27.8% to 38.5%, respectively (p<0.0001. Pre- and post-transplant survival depended on a variety of patient-, donor-, and allocation- characteristics of which most remain relevant in the DAA-era. Still, intensified HCV screening strategies and timely and effective treatment of HCV are highly relevant to reduce the burden of HCV-related OLTs in the U.S.

  11. Energy Efficiency in Ethernet Passive Optical Networks (EPONs): Protocol Design and Performance Evaluation

    DEFF Research Database (Denmark)

    Yan, Ying; Dittmann, Lars


    a suitable wakeup time scheduler at the Optical Line Terminal (OLT). A generic EPON system is considered, which is composed of an OLT and several ONUs that are EMM enabled. An energy consumption optimization problem aimed at saving energy is proposed and two heuristic sleep mode scheduling policies...... Mechanism (EMM) for downlink EPON systems. The proposed mechanism is designed to enhance the standardized control scheme in EPON with the objective to increase energy efficiency while satisfying diverse QoS requirements. The main idea is to put an Optical Network Unit (ONU) into the sleep mode and determine...

  12. Congestion estimation technique in the optical network unit registration process. (United States)

    Kim, Geunyong; Yoo, Hark; Lee, Dongsoo; Kim, Youngsun; Lim, Hyuk


    We present a congestion estimation technique (CET) to estimate the optical network unit (ONU) registration success ratio for the ONU registration process in passive optical networks. An optical line terminal (OLT) estimates the number of collided ONUs via the proposed scheme during the serial number state. The OLT can obtain congestion level among ONUs to be registered such that this information may be exploited to change the size of a quiet window to decrease the collision probability. We verified the efficiency of the proposed method through simulation and experimental results.

  13. Tammsaare kirjanduspreemiate laureaadid / šaržid: Hugo Hiibus

    Index Scriptorium Estoniae


    Preemiat on antud välja alates 1978. a. Preemia saajad : Helene Siimisker. 'A. H. Tammsaare pildikroonika eluteest ja tööst'. (1977); Juhan Peegel. 'Ma langesin esimesel sõjasuvel'. (1978); Ilmar Sikemäe. 'Kirjad Vargamäelt'. (1979); Vello Lattik. 'Kuus head inimest'. (1980); Veera Saar. 'Aprillipäev'. (1981); Mats Traat. 'Karukell, kurvameelsuse rohi'. (1982); Raimond Kaugver. 'Vana mees tahab koju'. (1983); Mari Saat. 'Õun valguses ja varjus'. (1984); Viivi Luik. 'Seitsmes rahukevad'. (1985); Heino Kiik. 'Elupadrik'. (1986); Luise Vaher. 'Põlev pärisosa'. (1987); Hando Runnel. 'Laulud eestiaegsetele meestele'. (1988); Arvo Valton. 'Masendus ja lootus'. (1989); Kalju Lepik. 'Rukkilille murdmise laul'. (1990); Illar Mõttus. Dramatiseering 'Jumalaga Vargamäe'. (1991); Leelo Tungal. 'Barbara ja suvekoerad'. (1992); Aili Viitar. 'Kummelimuru'. (1993); Albert Uustulnd. 'Rajud ei rauge', 'Lummav meri'. (1994)

  14. Literary awards 2001 / Piret Viires

    Index Scriptorium Estoniae

    Viires, Piret, 1963-


    Riigi kultuuripreemia - Ain Kaalep (elutööpreemia) ; Haljand Udam (artiklikogu "Orienditeekond") ; Mati Unt (lavastuste eest Vanemuises, Eesti Draamateatris ja Rakvere Teatris). Eesti Kultuurkapitali aastapreemia - Ene Mihkelson (romaan "Ahasveeruse uni"). Kultuurkapitali kirjanduse aastapreemiad: proosa - Mehis Heinsaar ("Härra Pauli kroonikad"), luule - Hasso Krull ("Kornukoopia"), esseistika - Jaan Puhvel ("Ulgvel ja umbes"), näitekirjandus - Jaan Kruusvall (näidend "Hullumeelne professor" kogumikust "Olen öösse eksind karjus"), lastekirjandus - Aino Pervik (Paula-sari), tõlge eesti keelde - Udo Uibo, tõlge eesti keelest - Guntars Godinsh, artiklipreemia - Toomas Haug, venekeelsete autorite kirjandusauhind - Larissa Vanejeva ("Liki"). B. Alveri kirjandusauhind - Mehis Heinsaar (jutukogu "Vanameeste näppaja"). F. Tuglase novelliauhind - Mehis Heinsaar ("Ilus Armin") ja Mats Traat ("Kohtupeegel")

  15. Short outlines of books by Estonian authors / Janika Kronberg, Rutt Hinrikus

    Index Scriptorium Estoniae

    Kronberg, Janika, 1963-


    Tutvustus: Baturin, Nikolai. Kentaur. Tallinn : Eesti Raamat, 2003 ; Kaplinski, Jaan. Isale. Tallinn : Varrak, 2003 ; Jaks, Ilmar. Pimedus. Tartu : Ilmamaa, 2003 ; Ivask, Ivar. Tähtede tähendust tunda. Tartu : Ilmamaa, 2003 ; Vint, Toomas. Minu abielu prostituudiga. Tallinn : Eesti Keele Sihtasutus, 2003 ; Ehin, Kristiina. Luigeluulinn. Tallinn : Huma, 2004 ; Kivisildnik. Päike, mida sa õhtul teed? Tallinn : Perioodika, 2003 ; Kivisildnik. Rahvuseepos Kalevipoeg ehk armastus. Tallinn : Tuum, 2003 ; Veidemann, Rein. Lastekodu. Tallinn : Eesti Keele Sihtasutus, 2003 ; Park, Eeva. Lõks lõpmatuses. Tallinn : Tänapäev, 2003 ; Traat, Mats. Islandi suvi. Tartu : Ilmamaa, 2003 ; Kauksi Ülle. Uibu. Tartu : Kauksi Ülle Mänedsment, 2003 ; Kross, Jaan. Kallid kaasteelised. Tallinn : Eesti Keele Sihtasutus, 2003 ; Undusk, Jaan. Quevedo. Tallinn : Perioodika, 2003

  16. "Scripta" üldpilt on muljetavaldav / Tiina Kolk

    Index Scriptorium Estoniae

    Kolk, Tiina


    Rahvusvahelisest köitenäitusest "Scripta manet III" Eesti Tarbekunsti- ja Disainimuuseumis. Osaleb 130 kunstnikku 17 riigist. Näitusega kaasneval konkursil pälvisid Kuldraamatu auhinna eesti kunstnikud Külli Grünbach-Sein, Kaire Olt ja Jaana Päeva

  17. Outcome and development of symptoms after orthotopic liver transplantation for Wilson disease. (United States)

    Weiss, Karl Heinz; Schäfer, Mark; Gotthardt, Daniel Nils; Angerer, Alexandra; Mogler, Carolin; Schirmacher, Peter; Schemmer, Peter; Stremmel, Wolfgang; Sauer, Peter


    Wilson disease (WD) is an autosomal recessive copper storage disease resulting in hepatic and neurologic dysfunction. Liver transplantation is an effective treatment for fulminant cases for patients with chronic liver disease. Reports on the outcome of neuropsychiatric symptoms after orthotopic liver transplantation (OLT) are limited. To assess the course of neuropsychiatric and hepatic symptoms after liver transplantation for Wilson disease Nineteen patients with Wilson disease received liver transplantation and were followed prospectively from 2005 to 2010 for the development of hepatic, neurological and psychiatric symptoms. Eight patients (all female) were transplanted for acute liver failure and eleven patients for chronic liver failure. Patient survival rates one and five yr after transplantation were 78% and 65%, respectively. Of the surviving patients, hepatic symptom scores improved in all patients and neurological symptom scores improved in all but one patient after OLT compared to the time of initial diagnosis and compared to pre-OLT status. Psychiatric symptoms showed moderate improvements. Survival after OLT for Wilson disease with end-stage liver disease is excellent. Overall, neuropsychiatric symptoms improved after transplantation, substantiating arguments for widening of the indication for liver transplantation in symptomatic neurologic Wilson disease patients with stable liver function. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. "Bush Law 101": Realising Place Conscious Pedagogy in the Law Curriculum (United States)

    Kennedy, Amanda; Mundy, Trish; Nielsen, Jennifer M.


    In 2012, a team of academics from six universities worked on an OLT-funded project, "Rethinking Law Curriculum: developing strategies to prepare law graduates for practice in rural and regional Australia." The project was motivated by the declining proportion of lawyers being attracted to and remaining in practice in rural and regional…

  19. Haematological and biochemical responses to training and overtraining. (United States)

    Tyler-McGowan, C M; Golland, L C; Evans, D L; Hodgson, D R; Rose, R J


    We sought a physiological marker of overtraining in horses, using commonly practised field and laboratory tests to allow early prediction and treatment of the syndrome. Thirteen Standardbred horses were trained as follows: phase 1 (endurance, 7 weeks), phase 2 (high intensity, 9 weeks) and phase 3 (overload, 18 weeks). In phase 3 the horses were divided into 2 groups: overload training (OLT) and control (C). The OLT group exercised at greater intensities, frequencies and durations than the C group. Overtraining occurred after 31 weeks and was defined as a significant decrease in treadmill run time to fatigue (RT) in response to a standardised exercise test (SET). Variables measured included: feed intake, bodyweight (BWT), resting haematology and plasma biochemistry and treadmill SETs to measure RT. The OLT group had a decrease in BWT after week 28 (P overtraining. Haematology and biochemistry failed to detect any markers of overtraining. Although no physiological markers of overtraining were identified, empirical observations revealed that the behaviour of horses in the OLT group was different from those in the C group during the period of overtraining. This study reflects that a model of overtraining has been developed based on measurement of a reduction in performance; however, there were no consistent changes in haematology or serum biochemical values in association with the decrement in performance capacity.

  20. Sliceable Transponders for Metro-Access Transmission Links

    DEFF Research Database (Denmark)

    Wagner, Christoph; Madsen, P.; Spolitis, S.


    the service provider (OLT - optical line terminal) to the end user (ONU – optical network unit) over an optical distribution network (ODN) via low bandwidth equipment. We show simulation and experimental results for duobinary signaling of 1 Gbit/s and 10 Gbit/s waveforms. The number of slices is adjusted...

  1. Traffic-aware energy saving scheme with modularization supporting in TWDM-PON (United States)

    Xiong, Yu; Sun, Peng; Liu, Chuanbo; Guan, Jianjun


    Time and wavelength division multiplexed passive optical network (TWDM-PON) is considered to be a primary solution for next-generation passive optical network stage 2 (NG-PON2). Due to the feature of multi-wavelength transmission of TWDM-PON, some of the transmitters/receivers at the optical line terminal (OLT) could be shut down to reduce the energy consumption. Therefore, a novel scheme called traffic-aware energy saving scheme with modularization supporting is proposed. Through establishing the modular energy consumption model of OLT, the wavelength transmitters/receivers at OLT could be switched on or shut down adaptively depending on sensing the status of network traffic load, thus the energy consumption of OLT will be effectively reduced. Furthermore, exploring the technology of optical network unit (ONU) modularization, each module of ONU could be switched to sleep or active mode independently in order to reduce the energy consumption of ONU. Simultaneously, the polling sequence of ONU could be changed dynamically via sensing the packet arrival time. In order to guarantee the delay performance of network traffic, the sub-cycle division strategy is designed to transmit the real-time traffic preferentially. Finally, simulation results verify that the proposed scheme is able to reduce the energy consumption of the network while maintaining the traffic delay performance.

  2. Contemporary Policies Regarding Alcohol and Marijuana Use Among Liver Transplant Programs in the United States. (United States)

    Zhu, Jiaming; Chen, Ping-Yu; Frankel, Marla; Selby, Robert Rick; Fong, Tse-Ling


    Alcoholic liver disease is a common indication for orthotopic liver transplantation (OLT). Although OLT has been shown to confer survival benefit to patients with acute alcoholic hepatitis (AAH), historically most programs require a 6-month abstinence period before OLT which excludes patients with AAH. Marijuana has become legal in more than half the states in the United States. This survey of liver transplant programs was conducted to evaluate current policies regarding alcohol, marijuana and methadone use. A questionnaire was distributed to 100 United Network for Organ Sharing-approved liver transplant programs in North America that have performed at least 30 liver transplants/year in the last 5 years. Forty-nine programs responded. Only 43% of the programs required a specific period of abstinence before transplant for alcoholic liver disease and only 26% enforced 6-month abstinence policy. For patients with AAH, 71% programs waived the 6-month abstinence requirement and considered psychosocial factors, such as family support, patient's motivation, or commitment to rehabilitate. Few programs used validated instruments to assess risk of relapse in AAH patients. Fourteen percent of programs transplant patients actively using marijuana and an additional 28% of programs listed patients using marijuana provided they discontinue by the time of OLT. Active methadone users were accepted in 45% of the programs. Policies regarding alcohol use have become more flexible particularly toward patients with AAH. Marijuana use is also more accepted. Although policies regarding alcohol and marijuana have changed significantly in the last decade, they remain highly variable among programs.

  3. Impact of non-anastomotic biliary strictures after liver transplantation on healthcare consumption, use of ionizing radiation and infectious events

    NARCIS (Netherlands)

    de Vries, A. Boudewijn; Koornstra, Jan J.; Ten Foe, Jerome R. Lo; Porte, Robert J.; van den Berg, Aad P.; Blokzijl, Hans; Verdonk, Robert C.

    BackgroundNon-anastomotic biliary strictures (NAS) after orthotopic liver transplantation (OLT) have a negative influence on graft survival. Expert opinion suggests a negative effect of NAS on other important aspects of post-transplant care, although its impact is largely unknown as data are scarce.


    Directory of Open Access Journals (Sweden)

    V. P. Buzulina


    Full Text Available Aim. Comparative evaluation of two biochemical markers of bone resorption and hormonal regulation of bone metabolism in liver recipients. Methods and results. Bоne densitometry of L2–L4 and neck of femur, serum level of some hormones (PTH, vitamin D3, estradiol, testosterone regulating osteoclastogenesis as well as com- parative analyses of two bone resorption markers β-crosslaps and tartrate-resistant acid phosphatase type 5b (TRAP-5b were fulfilled in patients after orthotopic liver transplantation (OLT. In 1 month after OLT bone density reduction of L2–L4 and neck of femur; decrease of vitamin D3, estradiol in women, testosterone in men and increase levels of bone resorption markers were observed. In 1 and 2 years after OLT the rise of bone density, increased levels of PTH, estradiol, testosterone and decreased β-crosslaps levels were revealed, while vitamin D3 and TRAP-5b levels remained stable. Conclusion. TRAP-5b was found to be a more speciffic marker of bone resorption, independent from collagen metabolism in liver. Osteoporosis defined in long-term period after OLT was associated with higher TRAP-5b and revialed in women with low estradiol level. 

  5. Orthotopic Liver Transplantation in Human-Immunodeficiency-Virus-Positive Patients in Germany

    Directory of Open Access Journals (Sweden)

    E. Anadol


    Full Text Available Objectives. This summary evaluates the outcomes of orthotopic liver transplantation (OLT of HIV-positive patients in Germany. Methods. Retrospective chart analysis of HIV-positive patients, who had been liver-transplanted in Germany between July 1997 and July 2011. Results. 38 transplantations were performed in 32 patients at 9 German transplant centres. The reasons for OLT were end-stage liver disease (ESLD and/or liver failure due to hepatitis C (HCV (=19, hepatitis B (HBV (=10, multiple viral infections of the liver (=2 and Budd-Chiari-Syndrome. In July 2011 19/32 (60% of the transplanted patients were still alive with a median survival of 61 months (IQR (interquartile range: 41–86 months. 6 patients had died in the early post-transplantation period from septicaemia (=4, primary graft dysfunction (=1, and intrathoracal hemorrhage (=1. Later on 7 patients had died from septicaemia (=2, delayed graft failure (=2, recurrent HCC (=2, and renal failure (=1. Recurrent HBV infection was efficiently prevented in 11/12 patients; HCV reinfection occurred in all patients and contributed considerably to the overall mortality. Conclusions. Overall OLT is a feasible approach in HIV-infected patients with acceptable survival rates in Germany. Reinfection with HCV still remains a major clinical challenge in HIV/HCV coinfection after OLT.

  6. Early hepatocyte, endothelial, and bile duct cell injury after pediatric liver transplantation from cadaveric or living-related donors. (United States)

    Reding, R; Wallemacq, P; Moulin, D; Manicourt, D; Lambotte, L; Jamart, J; Sokal, E; de Ville de Goyet, J; Otte, J B


    When compared with cadaveric grafts (Cad), the potential advantages of pediatric orthotopic liver transplantation (OLT) from living-related (LR) donors may include better graft quality, shorter ischemic time, appropriate preparation of the recipient, and better immunologic compatibility. The aim of this study was to analyze early hepatocyte, endothelial, and bile duct cell injury following pediatric OLT using LR (n=15) or uncomplicated Cad reduced-size (n=10) grafts. Median (range) total ischemic times were 190 min (105-261) versus 760 min (418-948) in LR and Cad groups, respectively (PBile duct cell injury, as assessed using plasma gamma-glutamyl transferase levels, was similar in both groups, with a progressive increase at the end of the first week after OLT, which was correlated with a similar incidence of early acute rejection in both groups (80% in the LR group vs. 62% in the Cad group, NS). (1) The hepatocellular and endothelial cell damage was reduced after OLT with LR grafts, which may be related to shorter ischemic time when compared with Cad grafts; (2) the putative immunologic advantage for LR grafts was not confirmed in terms of incidence of acute rejection.


    NARCIS (Netherlands)


    Despite the availability of Doppler ultrasound, angiography still forms part of the protocol for evaluating children after orthotopic liver transplantation (OLT) at our department. To investigate whether Doppler ultrasound is a reliable method for evaluating the patency of the hepatic artery, portal

  8. Sequential and simultaneous revascularization in adult orthotopic piggyback liver transplantation

    NARCIS (Netherlands)

    Polak, WG; Miyamoto, S; Nemes, BA; Peeters, PMJG; de Jong, KP; Porte, RJ; Slooff, MJH

    The aim of the study was to assess whether there is a difference in outcome after sequential or simultaneous revascularization during orthotopic liver transplantation (OLT) in terms of patient and graft survival, mortality, morbidity, and liver function. The study population consisted of 102 adult

  9. Increase in de novo food allergies after pediatric liver transplantation: tacrolimus vs. cyclosporine immunosuppression. (United States)

    Lebel, Marie-Jeanne; Chapdelaine, Hugo; Paradis, Louis; Des Roches, Anne; Alvarez, Fernando


    Post-TAFA is an uncommon but serious complication of organ transplantation. This study aimed to compare the incidence of FA in CsA and tacrolimus-treated children following OLT and identify risk factors. The medical charts of all patients who underwent OLT at our institution were reviewed. Between 1985 and 2010, 218 OLTs were performed on 188 pediatric recipients, of which 154 were included in the study. Three patients (3%) of the 102 receiving CsA developed FA, compared with nine (17%) in the 52 tacrolimus-treated patients, the latter exceeding general population reported FA prevalence (RR 5.88; 95% CI: 1.66-20.81). All TAFA cases underwent transplantation before the age of three with an incidence of 29% (9/31) in the tacrolimus-treated children in comparison with 7% (3/41) in the CsA group (RR 3.97; 95% CI: 1.17-13.45). Eosinophilia was present in 81% of children receiving tacrolimus compared with 54% in the CsA group (p = 0.002). We observed a statistically significant increase incidence of FA in tacrolimus-treated children following an OLT and those under the age of three are particularly vulnerable. The underlying process is still unknown and probably multifactorial. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.


    Directory of Open Access Journals (Sweden)

    O.A Gerasimova


    Full Text Available Russian Scientist Centre for Radiology and Surgical Technology has sufficient experience of orthotopic liver transplantation (100 OLT, which allowed comparing the outcomes of the terminal stages of liver disease in the two most numerous groups of patients: viral cirrhosis (VH and autoimmune liver diseases (AILD. Despite the fact that patients with VH indicator of urgency performing OLT (MELD lower, rate of deaths on the waiting list higher than AILD, due to more favorable course of immune disease. After OLT significant differences during the early and last posttransplant periods were not found, although the recurrences of viral hepatitis are recorded much more frequently than AILD. One-year and a three-year survival rates were comparable. To prevent reinfection of the hepatitis B successfully used nucleoside analogues (telbivudine, which allowed minimizing recurrence of the disease. Prevention and treatment of hepatitis C after the OLT is a relevant problem, despite the low efficiency of antiviral therapy. Relapses AILD not represent a real threat to the life of the patients, because the modification of immunosuppressive therapy can limit the progression of the disease. 

  11. Delayed immune recovery following sequential orthotopic liver transplantation and haploidentical stem cell transplantation in erythropoietic protoporphyria

    NARCIS (Netherlands)

    Smiers, Frans J.; Van de Vijver, Els; Delsing, Bas J. P.; Lankester, Arjan C.; Ball, Lynne M.; Rings, Edmund H. H. M.; van Rheenen, Patrick F.; Bredius, Robbert G. M.

    A nine-yr-old boy with EPP suffered from severe skin burns and liver failure caused by progressive cholestasis and fibrosis. OLT was performed without major complications. Four months following liver transplantation he underwent parental haploidentical HSCT. The myeloablative conditioning regimen

  12. Designing Journalism Capstone Units That Demonstrate Student Skills (United States)

    Cullen, Trevor


    There are considerable differences in the structure, content, and delivery of tertiary journalism degrees in Australia as identified in a 2014 Office for Learning and Teaching (OLT) Innovation and Development Project report on graduate qualities and journalism curriculum renewal. To address this situation, the author argues for journalism capstone…

  13. Using old liver grafts for liver transplantation: Where are the limits? (United States)

    Jiménez-Romero, Carlos; Caso Maestro, Oscar; Cambra Molero, Félix; Justo Alonso, Iago; Alegre Torrado, Cristina; Manrique Municio, Alejandro; Calvo Pulido, Jorge; Loinaz Segurola, Carmelo; Moreno González, Enrique


    The scarcity of ideal liver grafts for orthotopic liver transplantation (OLT) has led transplant teams to investigate other sources of grafts in order to augment the donor liver pool. One way to get more liver grafts is to use marginal donors, a not well-defined group which includes mainly donors > 60 years, donors with hypernatremia or macrosteatosis > 30%, donors with hepatitis C virus or hepatitis B virus positive serologies, cold ischemia time > 12 h, non-heart-beating donors, and grafts from split-livers or living-related donations. Perhaps the most practical and frequent measure to increase the liver pool, and thus to reduce waiting list mortality, is to use older livers. In the past years the results of OLT with old livers have improved, mainly due to better selection and maintenance of donors, improvements in surgical techniques in donors and recipients, and intra- and post-OLT management. At the present time, sexagenarian livers are generally accepted, but there still exists some controversy regarding the use of septuagenarian and octogenarian liver grafts. The aim of this paper is to briefly review the aging process of the liver and reported experiences using old livers for OLT. Fundamentally, the series of septuagenarian and octogenarian livers will be addressed to see if there is a limit to using these aged grafts. PMID:25152573

  14. Experience with the use of Ultrasound at Queen Elizabeth Central ...

    African Journals Online (AJOL)

    ultrasound in 76% of cues. Burkitt s lymphoma accounted for 28% of these abdominal tumours. The. mOlt usual indication for ultrasound of the heart was for determining the cause of 70 patients had cardiomegaly on chat radiography; of these 42 had pericardia! effu- sions. 14 had constrictive pericarditis with fibrinous exu-.

  15. Bridging a patient with acute liver failure to liver transplantation by the AMC-bioartificial liver

    NARCIS (Netherlands)

    van de Kerkhove, Maarten-Paul; di Florio, Ernesto; Scuderi, Vincenzo; Mancini, Antonio; Belli, Antonello; Bracco, Adele; Scala, Daniela; Scala, Simona; Zeuli, Laura; Di Nicuolo, Giuseppe; Amoroso, Pietro; Calise, Fulvio; Chamuleau, Robert A. F. M.


    Recently a phase I clinical trial has been started in Italy to bridge patients with acute liver failure (ALF) to orthotopic liver transplantation (OLT) by the AMC-bioartificial liver (AMC-BAL). The AMC-BAL is charged with 10 X 109 viable primary porcine hepatocytes isolated from a specified

  16. Eesti kotkad Euroopa taevas / Raimo Pullat

    Index Scriptorium Estoniae

    Pullat, Raimo, 1935-


    Teises Maailmasõjas Briti kuninglike õhujõudude koosseisus teeninud eesti sõjaväelendurite võitlusest Poola iseseisvuse ja Euroopa vabaduse eest. Briti õhujõududes võitlesid eestlastest leitnandid Ants Liblikmaa ja Mihkel Kristiani, lennukaptenid Peeter Olt ja Endel Susi, teadaolevalt ka naislendurid Raissa (Raja) Gillespie (Tamm) ja Lea (Karin) Lintrop-Hughes

  17. Eesti-Poola sõpruse veripunane õis / Raimo Pullat

    Index Scriptorium Estoniae

    Pullat, Raimo, 1935-


    Eesti sõjaväelendurite osalemine Briti Kuninglikes Õhujõududes võitluses Poola iseseisvuse eest pärast 1. sept. 1939. Ants Liblikmaa, Mihkel Kristiani, Endel Susi, Peeter Olt, Raja Tamm (Raissa Gillespie), Lea (Karin) Lintrop-Hughes

  18. Epistaxis in end stage liver disease masquerading as severe upper gastrointestinal hemorrhage. (United States)

    Camus, Marine; Jensen, Dennis M; Matthews, Jason D; Ohning, Gordon V; Kovacs, Thomas O; Jutabha, Rome; Ghassemi, Kevin A; Machicado, Gustavo A; Dulai, Gareth S


    To describe the prevalence, diagnosis, treatment, and outcomes of end stage liver disease (ESLD) patients with severe epistaxis thought to be severe upper gastrointestinal hemorrhage (UGIH). This observational single center study included all consecutive patients with ESLD and epistaxis identified from consecutive subjects hospitalized with suspected UGIH and prospectively enrolled in our databases of severe UGIH between 1998 and 2011. A total of 1249 patients were registered for severe UGIH in the data basis, 461 (36.9%) were cirrhotics. Epistaxis rather than UGIH was the bleeding source in 20 patients. All patients had severe coagulopathy. Epistaxis was initially controlled in all cases. Fifteen (75%) subjects required posterior nasal packing and 2 (10%) embolization in addition to correction of coagulopathy. Five (25%) patients died in the hospital, 12 (60%) received orthotopic liver transplantation (OLT), and 3 (15%) were discharged without OLT. The mortality rate was 63% in patients without OLT. Severe epistaxis in patients with ESLD is (1) a diagnosis of exclusion that requires upper endoscopy to exclude severe UGIH; and (2) associated with a high mortality rate in patients not receiving OLT.

  19. Feature-space-based FMRI analysis using the optimal linear transformation. (United States)

    Sun, Fengrong; Morris, Drew; Lee, Wayne; Taylor, Margot J; Mills, Travis; Babyn, Paul S


    The optimal linear transformation (OLT), an image analysis technique of feature space, was first presented in the field of MRI. This paper proposes a method of extending OLT from MRI to functional MRI (fMRI) to improve the activation-detection performance over conventional approaches of fMRI analysis. In this method, first, ideal hemodynamic response time series for different stimuli were generated by convolving the theoretical hemodynamic response model with the stimulus timing. Second, constructing hypothetical signature vectors for different activity patterns of interest by virtue of the ideal hemodynamic responses, OLT was used to extract features of fMRI data. The resultant feature space had particular geometric clustering properties. It was then classified into different groups, each pertaining to an activity pattern of interest; the applied signature vector for each group was obtained by averaging. Third, using the applied signature vectors, OLT was applied again to generate fMRI composite images with high SNRs for the desired activity patterns. Simulations and a blocked fMRI experiment were employed for the method to be verified and compared with the general linear model (GLM)-based analysis. The simulation studies and the experimental results indicated the superiority of the proposed method over the GLM-based analysis in detecting brain activities.

  20. Organ sharing in the management of acute liver failure. (United States)

    Pezzati, D; Ghinolfi, D; De Simone, P; Tincani, G; Fiorenza, G; Filipponi, F


    Liver transplantation (OLT) for acute liver failure (ALF) is associated with high morbidity and mortality rates in the early posttransplant course. An efficient organ-sharing organization may grant favorable results. This is a retrospective analysis of prospectively collected data on patients wait listed for ALF at a single center. Patients were listed for OLT when matching King's College Criteria. Based on patients' clinical status, ABO-incompatible grafts were used. From January 2001 to December 2010, 37 patients were wait listed for ALF. Two patients were de-listed (5.4%) for improvement of their clinical conditions; two patients (5.4%) died on the list and 33 (89.2%) underwent OLT. Among these latter, 21 (63.6%) were Italian and 12 (36.4%) were foreign citizens, with four referred from their home country on the basis of international agreements on ALF management. Donors were procured in our region in 10 cases (30.3%), nationally in 22 (66.6%), and outside Italy in 1 (3.1%). Mean time from wait listing to OLT was 1 day (range 0-6), and seven patients received an ABO-incompatible graft. Graft and patient survivals at 1 month, 1 year, and 3 years were 78.8%, 72.7%, 66.5%, and 81.8%, 75.8%, and 72.7%, respectively. Five patients underwent retransplantation: two on postoperative day (POD) 2 for primary nonfunction of the liver graft, two on POD 8 and 95 for hepatic artery thrombosis, and one at 18 months for nonanastomotic biliary stenosis. Prompt referral to a OLT center and efficient organ-sharing system play a fundamental role in optimizing the outcome of the patient with ALF. Development of international organ exchange programs might further improve the results for this category of patients. In very selected cases, ABO-incompatible grafts may be a valuable resource. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Experience of combined liver-kidney transplantation for acute-on-chronic liver failure patients with renal dysfunction. (United States)

    Xing, T; Zhong, L; Chen, D; Peng, Z


    The aim of this study was to evaluate the outcomes of orthotopic liver transplantation (OLT) or combined liver-kidney transplantation (CLKT) for acute-on-chronic liver failure (ACLF) patients with renal dysfunction. From January 2001 to December 2009, 133 patients underwent OLT for ACLF at our center. Among them, 30 had both ACLF and renal dysfunction. Of the 30 patients, 12 underwent CLKT for end-stage renal disease (ESRD), and the other 18 with hepatorenal syndrome type 1 (HRS1) underwent OLT alone. ACLF was defined according to the Asian Pacific Association for the Study of Liver Consensus Meeting. Clinical data were reviewed for survival outcomes. The median model for end-stage liver disease score (MELD) of patients with ACLF was 28. Among the 133 patients, all of whom received deceased donor liver grafts, 12 also got the kidney grafts from the same deceased donor. The hospital mortality rate was 21.8% for all patients with ACLF. The 5-year survival rates were 72.8% for patients without renal dysfunction and 70% for patients with renal dysfunction. The results of patients with ESRD who underwent CLKT were better than those of subjects without renal dysfunction or patients with HRS1 who underwent OLT alone. OLT alone improved renal function in most patients with HRS1, including those requiring short-term hemodialysis. Simultaneous liver-kidney transplantation was an excellent strategy for patients with both ACLF and ESRD. It provided protection to the kidney allograft for liver-based metabolic diseases affecting the kidney. The rate of acute rejection episodes in kidneys was low. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. All-optical virtual private network system in OFDM based long-reach PON using RSOA re-modulation technique (United States)

    Kim, Chang-Hun; Jung, Sang-Min; Kang, Su-Min; Han, Sang-Kook


    We propose an all-optical virtual private network (VPN) system in an orthogonal frequency division multiplexing (OFDM) based long reach PON (LR-PON). In the optical access network field, technologies based on fundamental upstream (U/S) and downstream (D/S) have been actively researched to accommodate explosion of data capacity. However, data transmission among the end users which is arisen from cloud computing, file-sharing and interactive game takes a large weight inside of internet traffic. Moreover, this traffic is predicted to increase more if Internet of Things (IoT) services are activated. In a conventional PON, VPN data is transmitted through ONU-OLT-ONU via U/S and D/S carriers. It leads to waste of bandwidth and energy due to O-E-O conversion in the OLT and round-trip propagation between OLT and remote node (RN). Also, it causes inevitable load to the OLT for electrical buffer, scheduling and routing. The network inefficiency becomes more critical in a LR-PON which has been researched as an effort to reduce CAPEX and OPEX through metro-access consolidation. In the proposed system, the VPN data is separated from conventional U/S and re-modulated on the D/S carrier by using RSOA in the ONUs to avoid bandwidth consumption of U/S and D/S unlike in previously reported system. Moreover, the transmitted VPN data is re-directed to the ONUs by wavelength selective reflector device in the RN without passing through the OLT. Experimental demonstration for the VPN communication system in an OFDM based LR-PON has been verified.

  3. Patients with NASH and cryptogenic cirrhosis are less likely than those with hepatitis C to receive liver transplants. (United States)

    O'Leary, Jacqueline G; Landaverde, Carmen; Jennings, Linda; Goldstein, Robert M; Davis, Gary L


    Many patients with cryptogenic cirrhosis (CC) have other conditions associated with nonalcoholic steatohepatitis (NASH) that put them at risk for complications that preclude orthotopic liver transplantation (OLT). We followed all patients with NASH and CC who were evaluated for OLT (n = 218) at Baylor Simmons Transplant Institute between March 2002 and May 2008. Data were compared with those from patients evaluated for OLT because of hepatitis C virus (HCV)-associated cirrhosis (n = 646). Patients with NASH and CC were older, more likely to be female, had a higher body mass index, and a greater prevalence of diabetes and hypertension, compared with patients with HCV-associated cirrhosis, but the 2 groups had similar model for end-stage liver disease (MELD) scores. NASH and CC in patients with MELD scores ≤15 were less likely to progress; these patients were less likely to receive OLT and more likely to die or be taken off the wait list because they were too sick, compared with patients with HCV-associated cirrhosis. The median progression rate among patients with NASH and CC was 1.3 MELD points per year versus 3.2 MELD points per year for the HCV group (P = .003). Among patients with MELD scores >15, there were no differences among groups in percentage that received transplants or rate of MELD score progression. Hepatocellular carcinoma occurred in 2.7% of patients with NASH and CC per year, compared with 4.7% per year among those with HCV-associated cirrhosis. Patients with NASH and CC and low MELD scores have slower disease progression than patients with HCV-associated cirrhosis and are less likely to receive OLT. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

  4. Intraoperative blood salvage during liver transplantation in patients with hepatocellular carcinoma: efficiency of leukocyte depletion filters in the removal of tumor cells. (United States)

    Liang, Ting-Bo; Li, Dong-Lin; Liang, Liang; Li, Jun-Jian; Bai, Xue-Li; Yu, Wei; Wang, Wei-Lin; Shen, Yan; Zhang, Min; Zheng, Shu-Sen


    Intraoperative blood salvage (IBS) reduces homologous transfusion in orthotopic liver transplantation (OLT), but may carry with it the risk of reinfusing tumor cells in patients with hepatocellular carcinoma (HCC). The use of leukocyte depletion filters (LDFs) for the removal of tumor cells is rarely reported in clinical OLT. The aims of this study were to evaluate the frequency of tumor cell contamination in surgical field during OLT for HCC recipients and to investigate the efficiency of additional LDFs for eliminating tumor cells from IBS. Thirty-two HCC patients with preoperatively elevated serum alpha-fetoprotein (AFP) underwent OLT. The blood from the surgical field was collected and processed by an autotransfusion device (Cell Saver 5), followed by 2 consecutive LDF filtrations. The HCC cells in IBS samples and filtered samples were determined using a nested RT-PCR technique to detect the AFP mRNA. The shed blood samples from 20 (62.5%) of the 32 HCC patients were contaminated with HCC cells and 15 of them remained positive after Cell Saver processing. Patients within the Milan or UCSF criteria were less likely to have HCC cell contamination and the contaminated HCC cells were more likely to be removed by the Cell Saver in these patients as compared to other patients (P<0.01). After filtration through an additional LDF, most cases (13/15) became negative except for those with ruptured tumors (P<0.05). Our results suggest that blood filtration with the LDF can efficiently remove tumor cells and the use of an additional LDF after use of the Cell Saver could markedly reduce the risk of tumor cell reintroduction during the OLT in HCC recipients with nonruptured tumors.

  5. Role of Stereotactic Body Radiation Therapy Before Orthotopic Liver Transplantation: Retrospective Evaluation of Pathologic Response and Outcomes

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    Mannina, Edward Michael, E-mail: [Department of Radiation Oncology, Slidell Memorial Hospital Regional Cancer Center, Slidell, Louisiana (United States); Cardenes, Higinia Rosa [Department of Radiation Oncology, Schneck Medical Center, Seymour, Indiana (United States); Lasley, Foster D. [Department of Radiation Oncology, Mercy Hospital, Oklahoma City, Oklahoma (United States); Goodman, Benjamin [Department of Radiation Oncology, St. Francis Healthcare, Cape Girardeau, Missouri (United States); Zook, Jennifer [Department of Radiation Oncology, Community Hospital Anderson, Anderson, Indiana (United States); Althouse, Sandra [Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana (United States); Cox, John Alvin [Department of Radiation Oncology, Columbus Regional, Columbus, Indiana (United States); Saxena, Romil [Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Tector, Joseph [Department of Surgery, University of Alabama-Birmingham, Birmingham, Alabama (United States); Maluccio, Mary [Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana (United States)


    Purpose: To analyze the results of stereotactic body radiation therapy (SBRT) in patients with early-stage, localized hepatocellular carcinoma who underwent definitive orthotopic liver transplantation (OLT). Methods and Materials: The subjects of this retrospective report are 38 patients diagnosed with hepatocellular carcinoma who underwent SBRT per institutional phase 1 to 2 eligibility criteria, before definitive OLT. Pre-OLT radiographs were compared with pathologic gold standard. Analysis of treatment failures and deaths was undertaken. Results: With median follow-up of 4.8 years from OLT, 9 of 38 patients (24%) recurred, whereas 10 of 38 patients (26%) died. Kaplan-Meier estimates of 3-year overall survival and disease-free survival are 77% and 74%, respectively. Sum longest dimension of tumors was significantly associated with disease-free survival (hazard ratio 1.93, P=.026). Pathologic response rate (complete plus partial response) was 68%. Radiographic scoring criteria performed poorly; modified Response Evaluation Criteria in Solid Tumors produced highest concordance (κ = 0.224). Explants revealed viable tumor in 74% of evaluable patients. Treatment failures had statistically larger sum longest dimension of tumors (4.0 cm vs 2.8 cm, P=.014) and non–statistically significant higher rates of lymphovascular space invasion (44% vs 17%), cT2 disease (44% vs 21%), ≥pT2 disease (67% vs 34%), multifocal tumors at time of SBRT (44% vs 21%), and less robust mean α-fetoprotein response (−25 IU/mL vs −162 IU/mL). Conclusions: Stereotactic body radiation therapy before to OLT is a well-tolerated treatment providing 68% pathologic response, though 74% of explants ultimately contained viable tumor. Radiographic response criteria poorly approximate pathology. Our data suggest further stratification of patients according to initial disease burden and treatment response.

  6. p53, Ki-67, and serum alpha feto-protein as predictors of hepatocellular carcinoma recurrence in liver transplant patients. (United States)

    Guzman, Grace; Alagiozian-Angelova, Victoria; Layden-Almer, Jennifer E; Layden, Thomas J; Testa, Guiliano; Benedetti, Enrico; Kajdacsy-Balla, André; Cotler, Scott J


    Patients with hepatocellular carcinoma who undergo orthotopic liver transplantation (OLT) are at risk for post-transplant tumor recurrence. The aim of this study was to evaluate whether expression of p53 and Ki-67 in hepatocellular carcinoma lesions present in explanted liver tissue was associated with time to tumor recurrence after OLT. Subjects consisted of 20 consecutive patients who underwent OLT and were found to have hepatocellular carcinoma in the liver explant. Immunostaining for p53 and Ki-67 was performed by standard methods. The presence of nuclear immunostaining in >10% of the tumor tissue was considered positive. Time to recurrence of hepatocellular carcinoma after OLT was compared between patients with positive and negative immunostaining by the log rank test. Multivariate analysis was performed using a Cox regression model to control for potentially confounding clinical factors. Time to post-transplant hepatocellular carcinoma recurrence was significantly more rapid in p53+ (P=0.0007) and Ki-67+ cases (P=0.001). These associations remained significant in multivariate analysis. Furthermore, time to recurrent hepatocellular carcinoma was significantly shorter in patients with a serum alpha feto-protein (AFP) level >or=100 ng/ml at time of diagnosis, compared to those with an AFP level or=100 ng/ml were associated with more rapid recurrence of hepatocellular carcinoma after OLT. Identification of patients at risk for early post-transplant recurrence could be used to guide surveillance and adjuvant treatment strategies. Modern Pathology (2005) 18, 1498-1503. doi:10.1038/modpathol.3800458; published online 8 July 2005.

  7. Role of Stereotactic Body Radiation Therapy Before Orthotopic Liver Transplantation: Retrospective Evaluation of Pathologic Response and Outcomes. (United States)

    Mannina, Edward Michael; Cardenes, Higinia Rosa; Lasley, Foster D; Goodman, Benjamin; Zook, Jennifer; Althouse, Sandra; Cox, John Alvin; Saxena, Romil; Tector, Joseph; Maluccio, Mary


    To analyze the results of stereotactic body radiation therapy (SBRT) in patients with early-stage, localized hepatocellular carcinoma who underwent definitive orthotopic liver transplantation (OLT). The subjects of this retrospective report are 38 patients diagnosed with hepatocellular carcinoma who underwent SBRT per institutional phase 1 to 2 eligibility criteria, before definitive OLT. Pre-OLT radiographs were compared with pathologic gold standard. Analysis of treatment failures and deaths was undertaken. With median follow-up of 4.8 years from OLT, 9 of 38 patients (24%) recurred, whereas 10 of 38 patients (26%) died. Kaplan-Meier estimates of 3-year overall survival and disease-free survival are 77% and 74%, respectively. Sum longest dimension of tumors was significantly associated with disease-free survival (hazard ratio 1.93, P=.026). Pathologic response rate (complete plus partial response) was 68%. Radiographic scoring criteria performed poorly; modified Response Evaluation Criteria in Solid Tumors produced highest concordance (κ = 0.224). Explants revealed viable tumor in 74% of evaluable patients. Treatment failures had statistically larger sum longest dimension of tumors (4.0 cm vs 2.8 cm, P=.014) and non-statistically significant higher rates of lymphovascular space invasion (44% vs 17%), cT2 disease (44% vs 21%), ≥pT2 disease (67% vs 34%), multifocal tumors at time of SBRT (44% vs 21%), and less robust mean α-fetoprotein response (-25 IU/mL vs -162 IU/mL). Stereotactic body radiation therapy before to OLT is a well-tolerated treatment providing 68% pathologic response, though 74% of explants ultimately contained viable tumor. Radiographic response criteria poorly approximate pathology. Our data suggest further stratification of patients according to initial disease burden and treatment response. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Diagnostic imaging to select the candidates to orthotopic transplantation: Experience in a general hospital

    International Nuclear Information System (INIS)

    Pozzato, Carlo; Baldini, Umberto; Gattoni, Filippo; Raiteri, Riccardo; Lazzerini, Francesco; Uslenghi, Carlo Matteo; Mevoli, Alessandra


    The authors report the experience of our general hospital in selecting the patients for orthotopic liver transplantation (OLT). The accuracy of duplex Doppler and color flow Doppler for portal and/or mesenteric vein thrombosis was evaluated by correlation with resected livers, computerized tomography and angiographic findings. Pathologic examinations diagnosed HCC in 5/20 transplant recipients: 2 lesions were found in 2 resected specimens (total hepatectomy) and 1 lesion was found in 3 cases. The sensitivity of US, plain and dynamic computerized tomography in identifying HCC patients was 20%; US and computerized tomography specificity rates were 100% and 87%, respectively. CTAP sensitivity was 75% and the sensitivity of Lipiodol computerized tomography and angiography was 100%. Therefore, in our series, US was poorly sensitivity in the detection of liver cancers, which may depend on the small number of patients, lesion size and the radiologists ignoring clinical and laboratory data on purpose. Nevertheless, the patients with a single HCC not exceeding 5 cm in diameter or with no more than 3 tumors, none of them exceeding 3 cm in diameter, are generally considered eligible for transplantation: therefore, our patients chosen for OLT on the basis of US and computerized tomography findings were actually eligible for transplantation in spite of US and computerized tomography false negative results. In conclusion, considering also the long stand-by list for OLT, the first selection of transplant candidates could be performed with US and color flow Doppler, plain and dynamic computerized tomography. The patients who are not ruled out as candidates for OLT on the basis of the findings of these imaging techniques and of clinical and laboratory findings are submitted to no further examination and referred to the transplantation unit. Otherwise, if conventional and color flow Doppler US and conventional computerized tomography are not enough to exclude a patient from OLT, the

  9. Percutaneous osteoplasty for the treatment of a painful osteochondral lesion of the talus: a case report and literature review. (United States)

    Seo, Sung-Suk; Park, Joo-Yeon; Kim, Hae-Jin; Yoon, Ji-Wook; Park, Sang-Hyun; Kim, Kyung-Hoon


    An osteochondral lesion of the talus (OLT) is a lesion involving the talar articular cartilage and its subchondral bone. OLT is a known cause of chronic ankle pain after ankle sprains in the active population. The lesion causes deep ankle pain associated with weight-bearing, impaired function, limited range of motion, stiffness, catching, locking, and swelling. There are 2 common patterns of OLTs. Anterolateral talar dome lesions result from inversion and dorsiflexion injuries of the ankle at the area impacting against the fibula. Posteromedial lesions result from inversion, plantar flexion, and external rotation injuries of the ankle at the area impacting against the tibial ceiling of the ankle joint. Early diagnosis of an OLT is particularly important because the tibiotalar joint is exposed to more compressive load per unit area than any other joint in the body. Failure of diagnosis can lead to the evolution of a small, stable lesion into a larger lesion or an unstable fragment, which can result in chronic pain, joint instability, and premature osteoarthritis. A 43-year-old man, with a history of ankle sprain one year previously, visited our pain clinic for continuous right ankle pain after walking or standing for more than 30 minutes. There was a focal tenderness on the posteromedial area of the right talus. Imaging studies revealed a posteromedial OLT classified as having a geode form according to the FOG (fractures, osteonecroses, geodes) radiological classification and categorized as a stage 2a lesion on magnetic resonance imaging. The patient was scheduled for aspiration and osteoplasty with hydroxyapatite under arthroscopic and fluoroscopic guidance. A 26-gauge needle was inserted to infiltrate local anesthetics into the skin over the cyst and ankle joint. An arthroscope was placed into the joint to approach the OLT. The arthroscopic view showed that there was no connection between the OLT and the cyst of the talus body. A 13-gauge bone biopsy needle was

  10. The use of perioperative serial blood lactate levels, the APACHE II and the postoperative MELD as predictors of early mortality after liver transplantation O uso da dosagem seriada do lactato sérico no perioperatório, do APACHE II e do MELD pós-operatório como preditores de mortalidade precoce após transplante hepático

    Directory of Open Access Journals (Sweden)

    Anibal Basile-Filho


    Full Text Available PURPOSE: To evaluate the accuracy of different parameters in predicting early (one-month mortality of patients submitted to orthotopic liver transplantation (OLT. METHODS: This is a retrospective study of forty-four patients (38 males and 10 females, mean age of 52.2 ± 8.9 years admitted to the Intensive Care Unit of a tertiary hospital. Serial lactate blood levels, APACHE II, MELD post-OLT, creatinine, bilirubin and INR parameters were analyzed by receiver-operator characteristic (ROC curves as evidenced by the area under the curve (AUC. The level of significance was set at 0.05. RESULTS: The mortality of OLT patients within one month was 17.3%. Differences in blood lactate levels became statistically significant between survivors and nonsurvivors at the end of the surgery (pOBJETIVO: Avaliar qual parâmetro é o mais eficiente na predição de mortalidade precoce (um mês de pacientes submetidos a transplante ortotópico de fígado (OLT. MÉTODOS: Estudo retrospectivo em cinqüenta e oito pacientes adultos (44 homens e 14 mulheres, com uma idade média de 51,7 ± 10,1 anos admitidos na Unidade de Terapia Intensiva de um hospital terciário. Os parâmetros como a dosagem seriada de lactato no sangue, APACHE II, MELD pós-OLT, creatinina, bilirrubina e INR foram analisados por curvas ROC (Receiver-operator characteristic, evidenciado pela área abaixo da curva (AUC. O nível de significância foi definido em 0,05. RESULTADOS: A mortalidade dos pacientes OLT em até um mês foi de 17,3%. As diferenças no nível de lactato no sangue tornaram-se estatisticamente significantes entre sobreviventes e não sobreviventes no final da cirurgia (p < 0,05. A AUC foi de 0,726 (95%CI = 0,593-0,835 para APACHE II (p = 0,02; 0,770 (95%CI = 0,596-0,849 para o lactato sérico (L7-L8 (p = 0,03; 0,814 (95%CI = 0,690-0,904 para MELD post-OLT (p < 0,01; 0,550 (95%CI = 0,414-0,651 de creatinina (p = 0,64; 0,705 (95%CI = 0,571-0,818 de bilirrubina (p = 0,05 e 0

  11. Liver transplantation in children using organ donation after circulatory death: a case-control outcomes analysis of a 20-year experience in a single center. (United States)

    Hong, Johnny C; Venick, Robert; Yersiz, Hasan; Kositamongkol, Prawat; Kaldas, Fady M; Petrowsky, Henrik; Farmer, Douglas G; Agopian, Vatche; McDiarmid, Sue V; Hiatt, Jonathan R; Busuttil, Ronald W


    While orthotopic liver transplantation (OLT) is a durable life-saving treatment for patients with irreversible liver disease, the waiting list mortality rate for children younger than 6 years is 4 times higher than for children aged 11 to 17 years and adults owing to scarce availability of size-appropriate grafts for transplantation. To compare long-term outcomes for children (aged ≤18 years) undergoing OLT using grafts from donation after circulatory death (DCD) and donation after brain death (DBD). Retrospective study using case-control matched groups at a university transplant center. All patients aged 18 years and younger who underwent OLT using DCD organs between February 1, 1990, and November 30, 2010, at the University of California, Los Angeles, were matched in a 1 to 3 ratio with patients who received primary OLT from DBD donors within a 12-month period. Other matching criteria included recipient age, weight, cause of liver disease, and acuity of illness. Outcomes after OLT were compared for DCD (n = 7) and DBD (n = 21) donors. The median follow-up was 4.5 years. The primary outcome measure was graft failure-free survival; the secondary end point was the development of ischemic cholangiopathy. Comparing DCD and DBD groups, recipient median age (28.4 vs 20.1 months, respectively; P = .80), weight (12.0 vs 11.6 kg, respectively; P = .87), Model for End-Stage Liver Disease/Pediatric End-Stage Liver Disease score (19 vs 11, respectively; P = .48), and donor age (24.0 vs 13.1 months, respectively; P = .72) were similar. For the DCD donors, the median donor warm ischemia duration was 24 minutes. Liver test results were similar for both groups at 1 week and 3, 6, and 12 months following OLT. Ten-year patient and graft survival rates for both DCD and DBD were 100%. Neither ischemic cholangiopathy nor vascular complications occurred in the DCD group. Biliary anastomotic strictures occurred in 1 DCD patient and 3 DBD patients. Our study

  12. Results of treatment of acute liver failure patients with use of the prometheus FPSA system. (United States)

    Grodzicki, M; Kotulski, M; Leonowicz, D; Zieniewicz, K; Krawczyk, M


    Herein we have presented the results of treatment of acute liver failure (ALF) patients with the use of the Prometheus FPSA dialysis system. To January 2009, we performed 278 FPSA procedures in 114 patients, including 52 experience and ALF. The patients who underwent the FPSA procedure consisted of 32 women and 20 men of overall mean age of 33 +/- 12 years. The causes of ALF were: Wilson's disease (n = 15), unknown origin ALF (n = 11), amanita phalloides intoxication (n = 7), paracetamol intoxication (n = 8), acute hepatitis B virus (HBV)/hepatitis C virus (HCV) infection (n = 7), liver insufficiency after parenchymal resection (n = 2) drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome (n = 1), rabdomyolysis (n = 1), or primary nonfunction (PNF) after orthotopic liver transplantation (OLT) (n = 1). All procedures were performed using the Prometheus 4008H Fresenius Medical Care liver support system. The average number of treatments per patient was 2.41 and the average time for each FPSA treatment was 6.3 hours. The average heparin dose used during the procedure was 750 IU/h. After the whole treatment regimen, we observed significant improvements in the biochemical results. The average concentrations improved: serum ammonia (before 249.2 mug/dL versus after 109.7 mug/dL); serum bilirubin (before 21.53 mg/dL versus after 8.81 mg/dL), serum aspartate aminotransferase (AST; before 2456.4 U/L versus after 1068.8 U/L); serum alanine aminotransferase (ALT; before 2958.2 U/L versus after 1595.8 U/L); serum urea (before 58.5 mg/dL versus after 21.1 mg/dL); serum creatinine (before 2.9 mg/dL versus after 1.7 mg/dL); and pH value (before 7.11 versus after 7.32). After Prometheus treatment OLT was performed in 33 patients. Among the 28 who survived (53.8%), 22 underwent OLT and 6 did not have OLT. Among the 24 patients who died (46.2%), 13 were before OLT and 11 after OLT. The Prometheus 4008H Fresenius Medical Care Liver support system was useful method of

  13. Serious gaming for orthotopic liver transplant anesthesiology: A randomized control trial. (United States)

    Katz, Daniel; Zerillo, Jeron; Kim, Sang; Hill, Bryan; Wang, Ryan; Goldberg, Andrew; DeMaria, Samuel


    Anesthetic management of orthotopic liver transplantation (OLT) is complex. Given the unequal distributions of liver transplant surgeries performed at different centers, anesthesiology providers receive relatively uneven OLT training and exposure. One well-suited modality for OLT training is the "serious game," an interactive application created for the purpose of imparting knowledge or skills, while leveraging the self-motivating elements of video games. We therefore developed a serious game designed to teach best practices for the anesthetic management of a standard OLT and determined if the game would improve resident performance in a simulated OLT. Forty-four residents on the liver transplant rotation were randomized to either the gaming group (GG) or the control group (CG) prior to their introductory simulation. Both groups were given access to the same educational materials and literature during their rotation, but the GG also had access to the OLT Trainer. Performance on the simulations were recorded on a standardized grading rubric. Both groups experienced an increase in score relative to baseline that was statistically significant at every stage. The improvements in scores were greater for the GG participants than the CG participants. Overall score improvement between the GG and CG (mean [standard deviation]) was statistically significant (GG, 7.95 [3.65]; CG, 4.8 [4.48]; P = 0.02), as were scores for preoperative assessment (GG, 2.67 [2.09]; CG, 1.17 [1.43]; P = 0.01) and anhepatic phase (GG, 1.62 [1.01]; CG, 0.75 [1.28]; P = 0.02). Of the residents with game access, 81% were "very satisfied" or "satisfied" with the game overall. In conclusion, adding a serious game to an existing educational curriculum for liver transplant anesthesia resulted in significant learning gains for rotating anesthesia residents. The intervention was straightforward to implement and cost-effective. Liver Transplantation 23 430-439 2017 AASLD. © 2017 by the American Association

  14. Energy-efficient WDM-OFDM-PON employing shared OFDM modulation modules in optical line terminal. (United States)

    Hu, Xiaofeng; Zhang, Liang; Cao, Pan; Wang, Kongtao; Su, Yikai


    We propose and experimentally demonstrate a scheme to improve the energy efficiency of wavelength division multiplexing - orthogonal frequency division multiplexing - passive optical networks (WDM-OFDM-PONs). By using an N × M opto-mechanic switch in optical line terminal (OLT), an OFDM modulation module is shared by several channels to deliver data to multiple users with low traffic demands during non-peak hours of the day, thus greatly reducing the number of operating devices and minimizing the energy consumption of the OLT. An experiment utilizing one OFDM modulation module to serve three optical network units (ONUs) in a WDM-OFDM-PON is performed to verify the feasibility of our proposal. Theoretical analysis and numerical calculation show that the proposed scheme can achieve a saving of 23.6% in the energy consumption of the OFDM modulation modules compared to conventional WDM-OFDM-PON.

  15. Stem Cell-Based Therapies for Liver Diseases: State of the Art and New Perspectives

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    Anna Chiara Piscaglia


    Full Text Available Millions of patients worldwide suffer from end-stage liver pathologies, whose only curative therapy is liver transplantation (OLT. Given the donor organ shortage, alternatives to OLT have been evaluated, including cell therapies. Hepatocyte transplantation has been attempted to cure metabolic liver disorders and end-stage liver diseases. The evaluation of its efficacy is complicated by the shortage of human hepatocytes and their difficult expansion and cryopreservation. Recent advances in cell biology have led to the concept of “regenerative medicine”, based on the therapeutic potential of stem cells (SCs. Different types of SCs are theoretically eligible for liver cell replacement. These include embryonic and fetal SCs, induced pluripotent cells, annex SCs, endogenous liver SCs, and extrahepatic adult SCs. Aim of this paper is to critically analyze the possible sources of SCs suitable for liver repopulation and the results of the clinical trials that have been published until now.

  16. Experimental demonstration of time- and mode-division multiplexed passive optical network (United States)

    Ren, Fang; Li, Juhao; Tang, Ruizhi; Hu, Tao; Yu, Jinyi; Mo, Qi; He, Yongqi; Chen, Zhangyuan; Li, Zhengbin


    A time- and mode-division multiplexed passive optical network (TMDM-PON) architecture is proposed, in which each optical network unit (ONU) communicates with the optical line terminal (OLT) independently utilizing both different time slots and switched optical linearly polarized (LP) spatial modes. Combination of a mode multiplexer/demultiplexer (MUX/DEUX) and a simple N × 1 optical switch is employed to select the specific LP mode in each ONU. A mode-insensitive power splitter is used for signal broadcast/combination between OLT and ONUs. We theoretically propose a dynamic mode and time slot assignment scheme for TMDM-PON based on inter-ONU priority rating, in which the time delay and packet loss ratio's variation tendency are investigated by simulation. Moreover, we experimentally demonstrate 2-mode TMDM-PON transmission over 10 km FMF with 10-Gb/s on-off keying (OOK) signal and direct detection.

  17. Application of Fiber Ring for Protection of Passive Optical Infrastructure

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    P. Lafata


    Full Text Available Today, passive optical networks (PONs are mostly used as modern high-speed access networks for various applications. However, there are also several specific applications, such as in business, office, army or science sector, which require a complex protection and backup system against failures and malfunctions. Typically, tree or star topologies are used for passive optical networks PONs. These topologies are vulnerable mainly against the failures of central optical line termination (OLT unit. This paper presents an innovative method for protecting PONs by using ring topologies, especially the OLT unit. The method is described in the article, and an elementary mathematical model for calculations of asymmetric passive optical splitters together with an example is included as well.

  18. Prevention of hypothermia in patients undergoing orthotopic liver transplantation using the humigard® open surgery humidification system: a prospective randomized pilot and feasibility clinical trial. (United States)

    Weinberg, Laurence; Huang, Andrew; Alban, Daniel; Jones, Robert; Story, David; McNicol, Larry; Pearce, Brett


    Perioperative thermal disturbances during orthotopic liver transplantation (OLT) are common. We hypothesized that in patients undergoing OLT the use of a humidified high flow CO 2 warming system maintains higher intraoperative temperatures when compared to standardized multimodal strategies to maintain thermoregulatory homeostasis. We performed a randomized pilot study in adult patients undergoing primary OLT. Participants were randomized to receive either open wound humidification with a high flow CO 2 warming system in addition to standard care (Humidification group) or to standard care alone (Control group). The primary end point was nasopharyngeal core temperature measured 5 min immediately prior to reperfusion of the donor liver (Stage 3 - 5 min). Secondary endpoints included intraoperative PaCO 2 , minute ventilation and the use of vasoconstrictors. Eleven patients were randomized to each group. Both groups were similar for age, body mass index, MELD, SOFA and APACHE II scores, baseline temperature, and duration of surgery. Immediately prior to reperfusion (Stage 3 - 5 min) the mean (SD) core temperature was higher in the Humidification Group compared to the Control Group: 36.0 °C (0.13) vs. 35.4 °C (0.22), p = 0.028. Repeated measured ANOVA showed that core temperatures over time during the stages of the transplant were higher in the Humidification Group compared to the Control Group (p < 0.0001). There were no significant differences in the ETCO 2 , PaCO 2 , minute ventilation, or inotropic support. The humidified high flow CO 2 warming system was superior to standardized multimodal strategies in maintaining normothermia in patients undergoing OLT. Use of the device was feasible and did not interfere with any aspects of surgery. A larger study is needed to investigate if the improved thermoregulation observed is associated with improved patient outcomes. ACTRN12616001631493 . Retrospectively registered 25 November 2016.

  19. "Scripta manent" on meie regioonis ainulaadne üritus / Sirje Kriisa, Lennart Mänd, Rene Haljasmäe...[jt.] ; üles kirjutanud Reet Varblane

    Index Scriptorium Estoniae


    Kuni 2. X Eesti Tarbekunsti- ja Disainimuuseumis avatud rahvusvahelisest köitekunstinäitusest "Scripta manent III. Maailma parim asi". Köitekunstist kõnelesid näituse korralduskomitee liikmed. Žürii koosseis. Kuldraamatud pälvisid Külli Grünbach-Sein, Kaire Olt ja Jaana Päeva. Näituse korralduskomitees ka Tulvi-Hanneli Turo ja Rene Haljasmäe TLÜARist

  20. Peritransplant pancreatitis: A marker of high mortality and graft failure in liver transplant patients. (United States)

    Russell, Tara A; Park, Sarah; Agopian, Vatche G; Zarrinpar, Ali; Farmer, Douglas G; O'Neill, Sean; Korayem, Islam; Ebaid, Samer; Gornbein, Jeffrey; Busuttil, Ronald W; Kaldas, Fady M


    Perioperative pancreatitis is a significant comorbid condition in surgical patients. However, the degree to which pancreatitis affects graft and overall survival in liver transplant recipients has not been evaluated. This study assesses the impact of pancreatitis on graft and patient survival in adult orthotopic liver transplantation (OLT). All patients undergoing OLT at a single academic institution from 2007 to 2015 were reviewed. Pancreatitis was classified by method of diagnosis (intraoperative/radiographic [IO/R] versus isolated serologic diagnosis) and timing (preoperative versus postoperative diagnosis). Twenty-three patients were identified with peritransplant pancreatitis (within 30 days preoperatively or postoperatively). A control group of patients without pancreatitis undergoing OLT was composed of 775 patients. Graft failure/death rates for patients with versus without pancreatitis were 7.4% versus 7.4% at 30 days, 33.3% versus 12.6% at 90 days, and 44.4% versus 26.9% at 12 months. Four patients with pancreatitis (17.4%) required emergent retransplantation and subsequently died within 90 days of their second transplant. Overall, 6 patients with pancreatitis (26.1%) died within 90 days of transplantation. Patients with pancreatitis had a hazard ratio (HR) for death or graft failure of 2.28 as compared with controls (P pancreatitis is most pronounced among those diagnosed by IO/R findings, with an adjusted HR of 2.53 (P pancreatitis is associated with early graft failure and patient mortality, regardless of the method or timing of the diagnosis. Given these results, IO/R findings of pancreatitis should induce caution and potentially preclude OLT until resolved. Liver Transplantation 23 925-932 2017 AASLD. © 2017 by the American Association for the Study of Liver Diseases.

  1. Single-center transfusion rate for 555 consecutive liver transplantations: impact of two eras. (United States)

    Coêlho, G R; Feitosa Neto, B A; de G Teixeira, C C; Marinho, D S; Rangel, M L M; Garcia, J H P


    Orthotopic liver transplantation (OLT) is the treatment of choice for patients with acute or chronic end-stage liver disease, irresectable primary liver tumor, and metabolic disorders. Historically, OLT has been associated with considerable blood loss and the need for transfusions. However, over the years there has been reduction is need for blood products. The aim of this article was to compare two distinct eras for perioperative blood transfusion rate among patients undergoing OLT; Era I, 200 transplantations in 188 patients, and Era II, 355 transplantations in 339 patients. The donor mean age was 33.70 (Era I) versus 35.34 (Era II). Cause of death in both eras was traumatic brain injury followed by cerebral vascular accident. Organ recipient data showed a mean age of 48.87 (Era I) versus 46.49 (Era II). During Era I patients with Child B (56.8%) prevailed, followed by Child C (35.4%) and Child A (7.8%). In Era II also patients with Child B (53.1%) prevailed, followed by Child C (39.6%) and Child A (7.3%). The prevalence of hepatocellular carcinoma (HCC) during Era I was 9% (18) and in Era II 20% (71). The use of blood products in the perioperative period: was as follows packed red blood cells 1.76 (Era I) versus 0.57 (Era II) units; fresh frozen plasma 1.89 (Era I) versus 0.49 (Era II) units; platelets 2.16 (Era I) versus 0.28 (Era II) units; and cryoprecipitate 0.08 (Era I) versus 0.03 (Era II) units. OLT using the piggyback technique was performed with a transfusion rate below <30%, and it reduced blood loss and prevented severe hemodynamic instability. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Liver transplantation in highest acuity recipients: identifying factors to avoid futility. (United States)

    Petrowsky, Henrik; Rana, Abbas; Kaldas, Fady M; Sharma, Anuj; Hong, Johnny C; Agopian, Vatche G; Durazo, Francisco; Honda, Henry; Gornbein, Jeffrey; Wu, Victor; Farmer, Douglas G; Hiatt, Jonathan R; Busuttil, Ronald W


    To identify medical predictors of futility in recipients with laboratory Model of End-Stage Liver Disease (MELD) scores of 40 or more at the time of orthotopic liver transplantation (OLT). Although the survival benefit for transplant patients with the highest MELD scores is indisputable, the medical and economic effort to bring these highest acuity recipients through OLT presents a major challenge for every transplant center. This study was undertaken to analyze outcomes in patients with MELD scores of 40 or more undergoing OLT during the period February 2002 to December 2010. The analysis was focused on futile outcome (3-month or in-hospital mortality) and long-term posttransplant outcome. Independent predictors of futility and failure-free survival were identified and a futility risk model was created. During the study period, 1522 adult cadaveric OLTs were performed, and 169 patients (13%) had a MELD score of 40 or more. The overall 1, 3, 5, and 8-year patient survivals were 72%, 64%, 60%, and 56%. Futile outcome occurred in 37 patients (22%). MELD score, pretransplant septic shock, cardiac risk, and comorbidities were independent predictors of futile outcome. Using all 4 factors, the futility risk model had a good discriminatory ability (c-statistic 0.75). Recipient age per year, life-threatening postoperative complications, hepatitis C, and metabolic syndrome were independent predictors for long-term survival in nonfutile patients (Harrels c-statistic 0.72). Short- and long-term outcomes of recipients with MELD scores of 40 or more are primarily determined by disease-specific factors. Cardiac risk, pretransplant septic shock, and comorbidities are the most important predictors and can be used for risk stratification in these highest acuity recipients.

  3. Photonic integrated transmitter and receiver for NG-PON2 (United States)

    Tavares, Ana; Lopes, Ana; Rodrigues, Cláudio; Mãocheia, Paulo; Mendes, Tiago; Brandão, Simão.; Rodrigues, Francisco; Ferreira, Ricardo; Teixeira, António


    In this paper the authors present a monolithic Photonic Integrated Circuit which includes a transmitter and a receiver for NG-PON2. With this layout it is possible to build an OLT and, by redesigning some filters, also an ONU. This technology allows reducing the losses in the transmitter and in the receiver, increasing power budget, and also reducing the OEO conversions, which has been a major problem that operators want to surpass.

  4. A novel wavelength reused bidirectional RoF-WDM-PON architecture to mitigate reflection and Rayleigh backscattered noise in multi-Gb/s m-QAM OFDM SSB upstream and downstream transmission over a single fiber (United States)

    Patel, Dhananjay; Dalal, U. D.


    A novel m-QAM Orthogonal Frequency Division Multiplexing (OFDM) Single Sideband (SSB) architecture is proposed for centralized light source (CLS) bidirectional Radio over Fiber (RoF) - Wavelength Division Multiplexing (WDM) - Passive Optical Network (PON). In bidirectional transmission with carrier reuse over the single fiber, the Rayleigh Backscattering (RB) noise and reflection (RE) interferences from optical components can seriously deteriorate the transmission performance of the fiber optic systems. These interferometric noises can be mitigated by utilizing the optical modulation schemes at the Optical Line Terminal (OLT) and Optical Network Unit (ONU) such that the spectral overlap between the optical data spectrum and the RB and RE noise is minimum. A mathematical model is developed for the proposed architecture to accurately measure the performance of the transmission system and also to analyze the effect of interferometric noise caused by the RB and RE. The model takes into the account the different modulation schemes employed at the OLT and the ONU using a Mach Zehnder Modulator (MZM), the optical launch power and the bit-rates of the downstream and upstream signals, the gain of the amplifiers at the OLT and the ONU, the RB-RE noise, chromatic dispersion of the single mode fiber and optical filter responses. In addition, the model analyzes all the components of the RB-RE noise such as carrier RB, signal RB, carrier RE and signal RE, thus providing the complete representation of all the physical phenomena involved. An optical m-QAM OFDM SSB signal acts as a test signal to validate the model which provides excellent agreement with simulation results. The SSB modulation technique using the MZM at the OLT and the ONU differs in the data transmission technique that takes place through the first-order higher and the lower optical sideband respectively. This spectral gap between the downstream and upstream signals reduces the effect of Rayleigh backscattering and

  5. 10Gbps monolithic silicon FTTH transceiver for PON (United States)

    Zhang, J.; Liow, T. Y.; Lo, G. Q.; Kwong, D. L.


    We propose a new passive optical network (PON) configuration and a novel silicon photonic transceiver architecture for optical network unit (ONU), eliminating the need for an internal laser source in ONU. We adopt dual fiber network configuration. The internal light source in each of the ONUs is eliminated. Instead, an extra seed laser source in the optical line termination (OLT) operates in continuous wave mode to serve the ONUs in the PON as a shared and centralized laser source. λ1 from OLT Tx and λ2 from the seed laser are combined by using a WDM combiner and connected to serve the multiple ONUs through the downstream fibers. The ONUs receive the data in λ1. Meanwhile, the ONUs encode and transmit data in λ2, which are sent back to OLT. The monolithic ONU transceiver contains a wavelength-division-multiplexing (WDM) filter component, a silicon modulator and a Ge photo-detector. The WDM in ONU selectively guides λ1 to the Ge-PD where the data in λ1 are detected and converted to electrical signals, and λ2 to the transmitter where the light is modulated by upstream data. The modulated optical signals in λ2 from ONUs are connected back to OLT through upstream fibers. The monolithic ONU transceiver chip size is only 2mm by 4mm. The crosstalk between the Tx and Rx is measured to be less than -20dB. The transceiver chip is integrated on a SFP+ transceiver board. Both Tx and Rx demonstrated data rate capabilities of up to 10Gbps. By implementing this scheme, the ONU transceiver size can be significantly reduced and the assembly processes will be greatly simplified. The results demonstrate the feasibility of mass manufacturing monolithic silicon ONU transceivers via low cost

  6. Hypothermic oxygenated machine perfusion (HOPE) for orthotopic liver transplantation of human liver allografts from extended criteria donors (ECD) in donation after brain death (DBD): a prospective multicentre randomised controlled trial (HOPE ECD-DBD) (United States)

    Czigany, Zoltan; Schöning, Wenzel; Ulmer, Tom Florian; Bednarsch, Jan; Amygdalos, Iakovos; Cramer, Thorsten; Rogiers, Xavier; Popescu, Irinel; Botea, Florin; Froněk, Jiří; Kroy, Daniela; Koch, Alexander; Tacke, Frank; Trautwein, Christian; Tolba, Rene H; Hein, Marc; Koek, Ger H; Dejong, Cornelis H C; Neumann, Ulf Peter; Lurje, Georg


    Introduction Orthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. In an attempt to improve the availability of donor allografts and reduce waiting list mortality, graft acceptance criteria were extended increasingly over the decades. The use of extended criteria donor (ECD) allografts is associated with a higher incidence of primary graft non-function and/or delayed graft function. As such, several strategies have been developed aiming at reconditioning poor quality ECD liver allografts. Hypothermic oxygenated machine perfusion (HOPE) has been successfully tested in preclinical experiments and in few clinical series of donation after cardiac death OLT. Methods and analysis HOPE ECD-DBD is an investigator-initiated, open-label, phase-II, prospective multicentre randomised controlled trial on the effects of HOPE on ECD allografts in donation after brain death (DBD) OLT. Human whole organ liver grafts will be submitted to 1–2 hours of HOPE (n=23) via the portal vein before implantation and are going to be compared with a control group (n=23) of patients transplanted after conventional cold storage. Primary (peak and Δ peak alanine aminotransferase within 7 days) and secondary (aspartate aminotransferase, bilirubin and international normalised ratio, postoperative complications, early allograft dysfunction, duration of hospital and intensive care unit stay, 1-year patient and graft survival) endpoints will be analysed within a 12-month follow-up. Extent of ischaemia–reperfusion (I/R) injury will be assessed using liver tissue, perfusate, bile and serum samples taken during the perioperative phase of OLT. Ethics and dissemination The study was approved by the institutional review board of the RWTH Aachen University, Aachen, Germany (EK 049/17). The current paper represent the pre-results phase. First results are expected in 2018. Trial registration number NCT03124641. PMID:29018070

  7. Bone marrow-derived cells and biophysical stimulation for talar osteochondral lesions: a randomized controlled study. (United States)

    Cadossi, Matteo; Buda, Roberto Emanuele; Ramponi, Laura; Sambri, Andrea; Natali, Simone; Giannini, Sandro


    Osteochondral lesions of the talus (OLT) frequently occur after ankle sprains in young patients participating in sports activities. These injuries may lead to chronic pain, joint swelling, and finally osteoarthritis, therefore, surgical repair is frequently needed. A collagen scaffold seeded with bone marrow-derived cells (BMDCs) harvested from patient's iliac crest and implanted into the OLT through a single arthroscopic procedure has been recently proposed as an effective treatment option. Nevertheless, BMDCs, embedded in an inflammatory environment, tend to differentiate toward a fibroblast phenotype with a consequential loss of mechanical characteristics. Biophysical stimulation with pulsed electromagnetic fields (PEMFs) has been shown to promote anabolic chondrocyte activity, stimulate proteoglycan synthesis, and reduce the release of the most relevant pro-inflammatory cytokines. The aim of this randomized controlled trial was to evaluate the effects of PEMFs on clinical outcome in patients who underwent BMDCs transplantation for OLT. Thirty patients affected by grade III and IV Outerbridge OLT underwent BMDCs transplantation. After surgery, patients were randomly assigned to either experimental group (PEMFs 4 hours per day for 60 days starting within 3 days after operation) or control group. Clinical outcome was evaluated with (American Orthopaedic Foot and Ankle Society) AOFAS score, Visual Analog Scale (VAS), and Short Form-36 (SF-36). Significantly higher AOFAS score was recorded in the experimental group both at 6 or 12 months follow-up. At 60 days and 6 and 12 months follow-up, significant lower pain was observed in the experimental group. No significant difference was found in SF-36 between groups. A superior clinical outcome was found in the experimental group with more than 10 points higher AOFAS score at final follow-up. Biophysical stimulation started soon after surgery aided patient recovery leading to pain control and a better clinical outcome

  8. General Urban Warfare Amphibious Logistics Applications. Volume 1. Technical Report. (United States)


    IN HST TOTAL SUBORDINATE TO OLT 1 1 FM MED ON S LIAISON SECTION "LkMENT " NORMA , -,ST A HST T _ " _ ’ " ______ __-. _,__ H& LS CC b Com ?2 14 i ...4 * I...0. 63 FOR 4 D Sr, TOTLS- 82 88 82 80 18576. 47 ..415. 71 A-45 9; ,; ; -.. .. .- . . . ... . . LO’ATION INDLITRIRL APA Off PA)IIUl OF RCTION= 45 N

  9. The Effect of Intraoperative Restricted Normal Saline during Orthotopic Liver Transplantation on Amount of Administered Sodium Bicarbonate

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Sahmeddini


    Full Text Available Background: Severe metabolic acidosis occurs during orthotopic liver transplantation (OLT particularly during the anhepatic phase. Although NaHCO3 is considered as the current standard therapy, there are numerous adverse effects. The aim of this study was to determine whether the restricted use of normal saline during anesthesia could reduce the need for NaHCO3. Methods: In this study we enrolled 75 patients with end-stage liver disease who underwent OLT from February 2010 until September 2010 at the Shiraz Organ Transplantation Center. Fluid management of two different transplant anesthetics were compared. The effect of restricted normal saline fluid was compared with non-restricted normal saline fluid on hemodynamic and acid-base parameters at three times during OLT: after the skin incision (T1, 15 min before reperfusion (T2, and 5 min after reperfusion (T3. Results: There were no significant differences in demographic characteristics of the donors and recipients (P>0.05. In the restricted normal saline group there was significantly lower central venous pressure (CVP than in the non-restricted normal saline group (P=0.002. No significant differences were noted in the other hemodynamic parameters between the two groups (P>0.05. In the non-restricted normal saline group arterial blood pH (P=0.01 and HCO3 (P=0.0001 were significantly less than the restricted normal saline group. The NaHCO3 requirement before reperfusion was significantly more than with the restricted normal saline group (P=0.001. Conclusion: Restricted normal saline administration during OLT reduced the severity of metabolic acidosis and the need for NaHCO3 during the anhepatic phase. Trial Registration Number: IRCT2013110711662N5

  10. Final Remedial Investigation/Baseline Risk Assessment for the Ravines and Beach Area Study of the Surplus Operable Unit, Fort Sheridan, Illinois. Volume 1: RI Text and RI Appendices A-I. (United States)


    Environmental Science & Engineering, Inc. Aquatic Toxicology Laboratory Gainesville, Florida Project: ,^^( G HP/.O ■V^-gfafa DAILY LOG Page: ESE QA Form...Engineering, Inc. Page: __ I Aquatic Toxicology Laboratory ESE QA Form Number: 018 Gainesville, Florida Effective: APR 1993 ■ Project: 4Qf...Qg(^f>nnov4>rgr?- OL*T t Environmental Science & Engineering, Inc. w*tlZI nTs -" Aquatic Toxicology Laboratory ESE QA Form Number 018 Gainesville

  11. Soil thermal properties at two different sites on James Ross Island in the period 2012/13 (United States)

    Hrbáček, Filip; Láska, Kamil


    James Ross Island (JRI) is the largest island in the eastern part of the Antarctic Peninsula. Ulu Peninsula in the northern part of JRI is considered the largest ice free area in the Maritime Antarctica region. However, information about permafrost on JRI, active layer and its soil properties in general are poorly known. In this study, results of soil thermal measurements at two different sites on Ulu Peninsula are presented between 1 April 2012 and 30 April 2013. The study sites are located (1) on an old Holocene marine terrace (10 m a. s. l.) in the closest vicinity of Johann Gregor Mendel (JGM) Station and (2) on top of a volcanic plateau named Johnson Mesa (340 m a. s. l.) about 4 km south of the JGM Station. The soil temperatures were measured at 30 min interval using platinum resistance thermometers Pt100/8 in two profiles up to 200 cm at JGM Station and 75 cm at Johnson Mesa respectively. Decagon 10HS volumetric water content sensors were installed up 30 cm at Johnson Mesa to 50 cm at JGM Station, while Hukseflux HFP01 soil heat flux sensors were used for direct monitoring of soil physical properties at 2.5 cm depth at both sites. The mean soil temperature varied between -5.7°C at 50 cm and -6.3°C at 5 cm at JGM Station, while that for Johnson Mesa varied between -6.9°C at 50 cm and -7.1°C at 10 cm. Maximum active layer thickness estimated from 0 °C isotherm reached 52 cm at JGM Station and 50 cm at Johnson Mesa respectively which corresponded with maximum observed annual temperature at 50 cm at both sites. The warmest part of both profiles detected at 50 cm depth corresponded with maximum thickness of active layer, estimated from 0°C isotherm, reached 52 cm at JGM Station and 50 cm at Johnson Mesa respectively. Volumetric water content at 5 cm varied around 0.25 m3m-3 at both sites. The slight increase to 0.32 m3m-3 was observed at JGM Station at 50 cm and at Johnson Mesa at 30 cm depth. Soil texture analysis showed distinctly higher share of coarser

  12. Ventilator associated pneumonia following liver transplantation: Etiology, risk factors and outcome (United States)

    Siniscalchi, Antonio; Aurini, Lucia; Benini, Beatrice; Gamberini, Lorenzo; Nava, Stefano; Viale, Pierluigi; Faenza, Stefano


    AIM: To determine the incidence, etiology, risk factors and outcome of ventilator-associated pneumonia (VAP) in patients undergoing orthotopic liver transplantation (OLT). METHODS: This retrospective study considered 242 patients undergoing deceased donor OLT. VAP was diagnosed according to clinical and microbiological criteria. RESULTS: VAP occurred in 18 (7.4%) patients, with an incidence of 10 per 1000 d of mechanical ventilation (MV). Isolated bacterial etiologic agents were mainly Enterobacteriaceae (79%). Univariate logistic analysis showed that model for end-stage liver disease (MELD) score, pre-operative hospitalization, treatment with terlipressin, Child-Turcotte-Pugh score, days of MV and red cell transfusion were risk factors for VAP. Multivariate analysis, considering significant risk factors in univariate analysis, demonstrated that pneumonia was strongly associated with terlipressin usage, pre-operative hospitalization, days of MV and red cell transfusion. Mortality rate was 22% in the VAP group vs 4% in the group without VAP. CONCLUSION: Our data suggest that VAP is an important cause of nosocomial infection during postoperative period in OLT patients. MELD score was a significant risk factor in univariate analysis. Multiple transfusions, treatment with terlipressin, preoperative hospitalization rather than called to the hospital while at home and days of MV constitute important risk factors for VAP development. PMID:27358784

  13. An investigation of noise performance in optical lock-in thermography (United States)

    Rajic, Nik; Antolis, Cedric


    An investigation into the noise performance of optical lock-in thermography (OLT) is described. The study aims to clarify the influence of infrared detector type and key inspection parameters such as illumination strength and lock-in duration on the quality of OLT amplitude and phase imagery. The study compares the performance of a state-of-the-art cooled photon detector with several lower-cost microbolometers. The results reveal a significant noise performance advantage to the photon detector. Under certain inspection regimes the advantage with respect to phase image quality is disproportionately high relative to detector sensitivities. This is shown to result from an explicit dependence in the phase signal variance on the ratio between the signal amplitude and the detector sensitivity. While this finding supports the preferred use of photon detectors for OLT inspections, it does not exclude microbolometers from a useful role. In cases where the significantly lower capital cost and improved practicality of microbolometers provide an advantage it is shown that performance shortfalls can be overcome with a relatively small factorial increase in optical illumination intensity.

  14. Power budget of direct-detection ultra-dense WDM-Nyquist-SCM PON with low-complexity SSBI mitigation (United States)

    Soeiro, Ricardo O. J.; Alves, Tiago M. F.; Cartaxo, Adolfo V. T.


    The power budget (PB) of a direct-detection ultra-dense wavelength division/subcarrier multiplexing (SCM) passive optical network (PON) is assessed numerically for downstream, when a low-complexity iterative signal-to-signal beat interference (SSBI) mitigation technique is employed. Each SCM signal, inserted in a 12.5 GHz width optical channel, is comprised of two or three electrically generated and multiplexed 16-quadrature-amplitude-modulation (QAM) or 32-QAM Nyquist pulse-shaped subcarriers, each with a 7% forward error correction bit rate of 10.7 Gbit/s. The PB and maximum number of optical network units (ONUs) served by each optical line terminal (OLT) are compared with and without SSBI mitigation. When SSBI mitigation is realized, PB gains up to 4.5 dB are attained relative to the PB in the absence of SSBI mitigation. The PB gain enabled by the SSBI mitigation technique proposed in this work increases the number of ONUs served per OLT at least by a factor of 2, for the cases of higher spectral efficiency. In particular, for a SCM signal comprised of three subcarriers, the maximum number of ONUs served per OLT is between 2 and 32, and between 8 and 64, in the absence of SSBI mitigation, and when SSBI mitigation is employed, respectively, depending on the fiber length (up to 50 km) and order of QAM.

  15. Acute respiratory distress syndrome after orthotopic liver transplantation. (United States)

    Zhao, Wei; Ge, Xupeng; Sun, Kai; Agopian, Vatche G; Wang, Yuelan; Yan, Min; Busuttil, Ronald W; Steadman, Randolph H; Xia, Victor W


    Acute respiratory distress syndrome (ARDS) is a devastating complication with substantial mortality. The aims of this study were to identify the incidence, preoperative and intraoperative risk factors, and impact of ARDS on outcomes in patients after orthotopic liver transplantation (OLT). Adult OLT patients between January 2004 and October 2013 at our center were included. Postoperative ARDS was determined using the criteria proposed by the Berlin Definition. Multivariate logistic models were used to identify preoperative and intraoperative risk factors for ARDS. Of 1726 patients during the study period, 71 (4.1%) developed ARDS. In the preoperative model, encephalopathy (odds ratio [OR], 2.22; P = .022), preoperative requirement of intubation (OR, 2.06; P = .020), and total bilirubin (OR, 1.02; P = .003) were independent risk factors. In the intraoperative model, large pressor bolus was the sole risk factor for ARDS (OR, 2.69; P = .001). Postoperatively, patients with ARDS had a 2-fold increase in 1-year mortality, mechanical ventilation time, and length of hospital stay. Acute respiratory distress syndrome occurred at a rate of 4.1% following OLT in adult patients and was associated with preoperative encephalopathy, requirement of intubation, and total bilirubin and intraoperative large boluses of pressors. Acute respiratory distress syndrome was associated with increased mortality, longer ventilation time, and hospital stay. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Design of a mutual authentication based on NTRUsign with a perturbation and inherent multipoint control protocol frames in an Ethernet-based passive optical network (United States)

    Yin, Aihan; Ding, Yisheng


    Identity-related security issues inherently present in passive optical networks (PON) still exist in the current (1G) and next-generation (10G) Ethernet-based passive optical network (EPON) systems. We propose a mutual authentication scheme that integrates an NTRUsign digital signature algorithm with inherent multipoint control protocol (MPCP) frames over an EPON system between the optical line terminal (OLT) and optical network unit (ONU). Here, a primitive NTRUsign algorithm is significantly modified through the use of a new perturbation so that it can be effectively used for simultaneously completing signature and authentication functions on the OLT and the ONU sides. Also, in order to transmit their individual sensitive messages, which include public key, signature, and random value and so forth, to each other, we redefine three unique frames according to MPCP format frame. These generated messages can be added into the frames and delivered to each other, allowing the OLT and the ONU to go ahead with a mutual identity authentication process to verify their legal identities. Our simulation results show that this proposed scheme performs very well in resisting security attacks and has low influence on the registration efficiency to to-be-registered ONUs. A performance comparison with traditional authentication algorithms is also presented. To the best of our knowledge, no detailed design of mutual authentication in EPON can be found in the literature up to now.

  17. An autonomous recovery mechanism against optical distribution network failures in EPON (United States)

    Liem, Andrew Tanny; Hwang, I.-Shyan; Nikoukar, AliAkbar


    Ethernet Passive Optical Network (EPON) is chosen for servicing diverse applications with higher bandwidth and Quality-of-Service (QoS), starting from Fiber-To-The-Home (FTTH), FTTB (business/building) and FTTO (office). Typically, a single OLT can provide services to both residential and business customers on the same Optical Line Terminal (OLT) port; thus, any failures in the system will cause a great loss for both network operators and customers. Network operators are looking for low-cost and high service availability mechanisms that focus on the failures that occur within the drop fiber section because the majority of faults are in this particular section. Therefore, in this paper, we propose an autonomous recovery mechanism that provides protection and recovery against Drop Distribution Fiber (DDF) link faults or transceiver failure at the ONU(s) in EPON systems. In the proposed mechanism, the ONU can automatically detect any signal anomalies in the physical layer or transceiver failure, switching the working line to the protection line and sending the critical event alarm to OLT via its neighbor. Each ONU has a protection line, which is connected to the nearest neighbor ONU, and therefore, when failure occurs, the ONU can still transmit and receive data via the neighbor ONU. Lastly, the Fault Dynamic Bandwidth Allocation for recovery mechanism is presented. Simulation results show that our proposed autonomous recovery mechanism is able to maintain the overall QoS performance in terms of mean packet delay, system throughput, packet loss and EF jitter.

  18. Regenerative treatment in osteochondral lesions of the talus: autologous chondrocyte implantation versus one-step bone marrow derived cells transplantation. (United States)

    Buda, Roberto; Vannini, Francesca; Castagnini, Francesco; Cavallo, Marco; Ruffilli, Alberto; Ramponi, Laura; Pagliazzi, Gherardo; Giannini, Sandro


    Osteochondral lesions of the talus (OLT) usually require surgical treatment. Regenerative techniques for hyaline cartilage restoration, like autologous chondrocytes implantation (ACI) or bone marrow derived cells transplantation (BMDCT), should be preferred. The aim of this work is comparing two clusters with OLT, treated with ACI or BMDCT. Eighty patients were treated with regenerative techniques, 40 with ACI and 40 with BMDCT. The two groups were homogenous regarding age, lesion size and depth, previous surgeries, etiology of the lesion, subchondral bone graft, final follow-up and pre-operative AOFAS score. The two procedures were performed arthroscopically. The scaffold was a hyaluronic acid membrane in all the cases, loaded with previously cultured chondrocytes (ACI) or with bone marrow concentrated cells, harvested in the same surgical session (BMDCT). All the patients were clinically and radiologically evaluated, using MRI Mocart score and T2 mapping sequence. Clinical results were similar in both groups at 48 months. No statistically significant influence was reported after evaluation of all the pre-operative parameters. The rate of return to sport activity showed slightly better results for BMDCT than ACI. MRI Mocart score was similar in both groups. MRI T2 mapping evaluation highlighted a higher presence of hyaline like values in the BMDCT group, and lower incidence of fibrocartilage as well. To date, ACI and BMDCT showed to be effective regenerative techniques for the treatment of OLT. BMDCT could be preferred over ACI for the single step procedure, patients' discomfort and lower costs.

  19. Hyperosmolar nonketotic hyperglycemic coma induced by methylprednisolone pulse therapy for acute rejection after liver transplantation: a case report and review of the literature

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    Zhou J


    Full Text Available Jian Zhou,* Weiqiang Ju,* Xiaopeng Yuan, Xiaofeng Zhu, Dongping Wang, Xiaoshun HeOrgan Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China *These authors contributed equally to this work Abstract: Hyperosmolar nonketotic hyperglycemic coma (HNKHC is a serious, rare complication induced by methylprednisolone (MP pulse therapy for acute rejection after orthotopic liver transplantation (OLT. Herein, we report an unusual case of a 58-year-old woman who experienced acute rejection at 30 months after OLT, only one case in which HNKHC resulted in MP pulse therapy for acute rejection in all 913 recipients in our center. The general morbidity of HNKHC was 1.09‰ in this study. HNKHC is characterized by rapid onset, rapid progression, and a lack of specific clinical manifestations. High-dose MP management was a clear risk factor. The principle of treatment included rapid rehydration, low-dose insulin infusion, and correcting disorders of electrolytes and acidosis. In conclusion, clinicians considering MP pulse therapy after OLT should be alert to the occurrence of HNKHC. Keywords: liver transplantation, complications, hyperosmolar nonketotic hyperglycemic coma, methylprednisolone pulse therapy, principle of treatment

  20. A CLS-based survivable and energy-saving WDM-PON architecture (United States)

    Zhu, Min; Zhong, Wen-De; Zhang, Zhenrong; Luan, Feng


    We propose and demonstrate an improved survivable and energy-saving WDM-PON with colorless ONUs. It incorporates both energy-saving and self-healing operations. A simple effective energy-saving scheme is proposed by including an energy-saving control unit in the OLT and a control unit at each ONU. The energy-saving scheme realizes both dozing and sleep (offline) modes, which greatly improves the energy-saving efficiency for WDM-PONs. An intelligent protection switching scheme is designed in the OLT, which can distinguish if an ONU is in dozing/sleep (offline) state or a fiber is faulty. Moreover, by monitoring the optical power of each channel on both working and protection paths, the OLT can know the connection status of every fiber path, thus facilitating an effective protection switching and a faster failure recovery. The improved WDM-PON architecture not only significantly reduces energy consumption, but also performs self-healing operation in practical operation scenarios. The scheme feasibility is experimentally verified with 10 Gbit/s downstream and 1.25 Gbit/s upstream transmissions. We also examine the energy-saving efficiency of our proposed energy-saving scheme by simulation, which reveals that energy saving mainly arises from the dozing mode, not from the sleep mode when the ONU is in the online state.

  1. Protection of Passive Optical Networks by Using Ring Topology and Tunable Splitters

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    Pavel Lafata


    Full Text Available This article proposes an innovative method for protecting of passive optical networks (PONs, especially the central optical unit – optical line termination (OLT. PON networks are typically used in modern high-speed access networks, but there are also several specific applications, such as in business, army or science sector, which require a complex protection and backup system against failures and malfunctions. A standard tree or star topologies, which are usually used for PON networks, are significantly vulnerable mainly against the malfunctions and failures of OLT unit or feeder optical cable. The method proposed in this paper is focused on forming PON network with ring topology using passive optical splitters. The main idea is based on the possibility of placing both OLT units (primary and secondary on the opposite sides of the ring, which can potentially increase the resistance of network. This method is described in the article and scenarios and calculations using symmetric or tunable asymmetric passive optical splitters are included as well.

  2. Biliary Leak in Post-Liver-Transplant Patients: Is There Any Place for Metal Stent?

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    Fernanda P. Martins


    Full Text Available Objectives. Endoscopic management of bile leak after orthotopic liver transplant (OLT is widely accepted. Preliminary studies demonstrated encouraging results for covered self-expandable metal stents (CSEMS in complex bile leaks. Methods. Thirty-one patients with post-OLT bile leaks underwent endoscopic temporary placement of CSEMS (3 partially CSEMS , 18 fully CSEMS with fins and 10 fully CSEMS with flare ends between December 2003 and December 2010. Long-term clinical success and safety were evaluated. Results. Median stent indwelling and follow-up were 89 and 1,353 days for PCSEMS, 102 and 849 for FCSEMS with fins and 98 and 203 for FCSEMS with flare ends. Clinical success was achieved in 100%, 77.8%, and 70%, respectively. Postplacement complications: cholangitis (1 and proximal migration (1, both in the FCSEMS with fins. Postremoval complications were biliary strictures requiring drainage: PCSEMS (1, FCSEMS with fins (6 and with flare ends (1. There was no significant differences in the FCSEMS groups regarding clinical success, age, gender, leak location, previous treatment, stent indwelling, and complications. Conclusion. Temporary placement of CSEMS is effective to treat post-OLT biliary leaks. However, a high number of post removal biliary strictures occurred especially in the FCSEMS with fins. CSEMS cannot be recommended in this patient population.

  3. Fatal gastrointestinal histoplasmosis 15 years after orthotopic liver transplantation. (United States)

    Agrawal, Nikita; Jones, David Ej; Dyson, Jessica K; Hoare, Tim; Melmore, Sharon A; Needham, Stephanie; Thompson, Nick P


    We report a case of ileo-colonic Histoplasmosis without apparent respiratory involvement in a patient who had previously undergone an orthotopic liver transplant (OLT) for primary biliary cholangitis 15 years earlier. The recipient lived in the United Kingdom, a non-endemic region for Histoplasmosis. However, she had previously lived in rural southern Africa prior to her OLT. The patient presented with iron deficiency anaemia, diarrhoea, abdominal pain and progressive weight loss. She reported no previous foreign travel, however, it later became known that following her OLT she had been on holiday to rural southern Africa. On investigation, a mild granulomatous colitis primarily affecting the right colon was identified, that initially improved with mesalazine. Her symptoms worsened after 18 mo with progressive ulceration of her distal small bowel and right colon. Mycobacterial, Yersinia, cytomegalovirus and human immunodeficiency virus infections were excluded and the patient was treated with prednisolone for a working diagnosis of Crohn's disease. Despite some early symptom improvement following steroids, there was subsequent deterioration with the patient developing gram-negative sepsis and multi-organ failure, leading to her death. Post-mortem examination revealed that her ileo-colonic inflammation was caused by Histoplasmosis.

  4. Biliary Cast Syndrome: Hepatic Artery Resistance Index, Pathological Changes, Morphology and Endoscopic Therapy

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    Hu Tian


    Full Text Available Background: Biliary cast syndrome (BCS was a postoperative complication of orthotopic liver transplantation (OLT, and the reason for BSC was considered to relate with ischemic type biliary lesions. This study aimed to evaluate the relationship between BCS following OLT and the hepatic artery resistance index (HARI, and to observe pathological changes and morphology of biliary casts. Methods: Totally, 18 patients were diagnosed with BCS by cholangiography following OLT using choledochoscope or endoscopic retrograde cholangiopancreatography. In addition, 36 patients who did not present with BCS in the corresponding period had detectable postoperative HARI on weeks 1, 2, 3 shown by color Doppler flow imaging. The compositions of biliary casts were analyzed by pathological examination and scanning electron microscopy. Results: HARI values of the BCS group were significantly decreased as compared with the non-BCS group on postoperative weeks 2 and 3 (P 1 (OR = 1.300; 1.223; and 1.889, respectively. The OR of HARI 3 was statistically significant (OR = 1.889; 95% confidence interval = 1.166-7.490; P = 0.024. The compositions of biliary casts were different when bile duct stones were present. Furthermore, vascular epithelial cells were found by pathological examination in biliary casts. Conclusions: HARI may possibly serve as an independent risk factor and early predictive factor of BCS. Components and formation of biliary casts and bile duct stones are different.

  5. A proposal for an SDN-based SIEPON architecture (United States)

    Khalili, Hamzeh; Sallent, Sebastià; Piney, José Ramón; Rincón, David


    Passive Optical Network (PON) elements such as Optical Line Terminal (OLT) and Optical Network Units (ONUs) are currently managed by inflexible legacy network management systems. Software-Defined Networking (SDN) is a new networking paradigm that improves the operation and management of networks. In this paper, we propose a novel architecture, based on the SDN concept, for Ethernet Passive Optical Networks (EPON) that includes the Service Interoperability standard (SIEPON). In our proposal, the OLT is partially virtualized and some of its functionalities are allocated to the core network management system, while the OLT itself is replaced by an OpenFlow (OF) switch. A new MultiPoint MAC Control (MPMC) sublayer extension based on the OpenFlow protocol is presented. This would allow the SDN controller to manage and enhance the resource utilization, flow monitoring, bandwidth assignment, quality-of-service (QoS) guarantees, and energy management of the optical network access, to name a few possibilities. The OpenFlow switch is extended with synchronous ports to retain the time-critical nature of the EPON network. OpenFlow messages are also extended with new functionalities to implement the concept of EPON Service Paths (ESPs). Our simulation-based results demonstrate the effectiveness of the new architecture, while retaining a similar (or improved) performance in terms of delay and throughput when compared to legacy PONs.

  6. Microwave thermal ablation for hepatocarcinoma: six liver transplantation cases. (United States)

    Zanus, G; Boetto, R; Gringeri, E; Vitale, A; D'Amico, F; Carraro, A; Bassi, D; Bonsignore, P; Noaro, G; Mescoli, C; Rugge, M; Angeli, P; Senzolo, M; Burra, P; Feltracco, P; Cillo, U


    Surgical resection for malignant hepatic tumors, especially hepatocarcinoma (HCC), has been demonstrated to increase overall survival; however, the majority of patients are not suitable for resection. Radiofrequency ablation (RFA) is the most widely used modality for radical treatment of small HCC (alcool (ETOH)-related (n=42; 27%), hepatitis B virus (HBV)-related (n=16; 10.5%); and cryptogenic cases (n=26; 17%). The cases were performed for radical treatment down-staging for multifocal pathology or bridging liver transplantation to orthotopic (OLT) in selected patients with single nodules. A computed tomography (CT) scan was performed at 1 month after the surgical procedure to evalue responses to treatment. Among 6 selected patients who underwent OLT; 5 (83.3%) showed disease-free survival at one-year follow-up. The radical treatment achieved no intraoperative evidence of tumor spread or of pathological signs of active HCC among the explanted liver specimens. In conclusion, a MWA seemed to be a safe novel approach to treat HCC and could serve as a "bridge" to OLT and down-staging for patients with HCC. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Selective decontamination in pediatric liver transplants. A randomized prospective study. (United States)

    Smith, S D; Jackson, R J; Hannakan, C J; Wadowsky, R M; Tzakis, A G; Rowe, M I


    Although it has been suggested that selective decontamination of the digestive tract (SDD) decreases postoperative aerobic Gram-negative and fungal infections in orthotopic liver transplantation (OLT), no controlled trials exist in pediatric patients. This prospective, randomized controlled study of 36 pediatric OLT patients examines the effect of short-term SDD on postoperative infection and digestive tract flora. Patients were randomized into two groups. The control group received perioperative parenteral antibiotics only. The SDD group received in addition polymyxin E, tobramycin, and amphotericin B enterally and by oropharyngeal swab postoperatively until oral intake was tolerated (6 +/- 4 days). Indications for operation, preoperative status, age, and intensive care unit and hospital length of stay were no different in SDD (n = 18) and control (n = 18) groups. A total of 14 Gram-negative infections (intraabdominal abscess 7, septicemia 5, pneumonia 1, urinary tract 1) developed in the 36 patients studied. Mortality was not significantly different in the two groups. However, there were significantly fewer patients with Gram-negative infections in the SDD group: 3/18 patients (11%) vs. 11/18 patients (50%) in the control group, P < 0.001. There was also significant reduction in aerobic Gram-negative flora in the stool and pharynx in patients receiving SDD. Gram-positive and anaerobic organisms were unaffected. We conclude that short-term postoperative SDD significantly reduces Gram-negative infections in pediatric OLT patients.

  8. Bidirectional multi-optical line terminals incorporated converged WSN-PON network using M/M/1 queuing (United States)

    Kumar, Love; Sharma, Vishal; Singh, Amarpal


    Wireless Sensor Networks (WSNs) have an assortment of application areas, for instance, civil, military, and video surveillance with restricted power resources and transmission link. To accommodate the massive traffic load in hefty sensor networks is another key issue. Subsequently, there is a necessity to backhaul the sensed information of such networks and prolong the transmission link to access the distinct receivers. Passive Optical Network (PON), a next-generation access technology, comes out as a suitable candidate for the convergence of the sensed data to the core system. The earlier demonstrated work with single-OLT-PON introduces an overloaded buffer akin to video surveillance scenarios. In this paper, to combine the bandwidth potential of PONs with the mobility capability of WSNs, the viability for the convergence of PONs and WSNs incorporating multi-optical line terminals is demonstrated to handle the overloaded OLTs. The existing M/M/1 queue theory with interleaving polling with adaptive cycle time as dynamic bandwidth algorithm is used to shun the probability of packets clash. Further, the proposed multi-sink WSN and multi-OLT PON converged structure is investigated in bidirectional mode analytically and through computer simulations. The observations establish the proposed structure competent to accommodate the colossal data traffic through less time consumption.

  9. Postreperfusion biopsies are useful in predicting complications after liver transplantation. (United States)

    Busquets, J; Figueras, J; Serrano, T; Torras, J; Ramos, E; Rafecas, A; Fabregat, J; Lama, C; Xiol, X; Baliellas, C; Jaurrieta, E


    Biliary complications after orthotopic liver transplantation (OLT) may occur because of preservation injury (PI). In this study, we examine findings on routine reperfusion biopsy specimens in relation to the occurrence of biliary complications and graft outcome. From 1997 to 2000, a total of 193 OLTs were performed in our center. Postreperfusion biopsy specimens were analyzed and histological lesions were graded. For analysis, grafts were grouped into 2 categories: the presence or absence of PI (severe to moderate lesions versus mild or no lesions). Histological evidence of PI was present in 17% of the biopsy specimens. The incidence of grafts with PI and ischemia time longer than 12 hours was 38% compared with 14% in PI and short ischemia time (P =.02). Biliary complications were also more frequent in the PI group (28% v 14%; P =.03). Study of risk factors by means of logistic regression analysis confirmed that the PI group had a greater risk for biliary complications (relative risk, 2.8; 95% confidence interval, 1 to 7.4; P =.03). Moreover, moderate macrovesicular steatosis was found in 6% of the grafts, resulting in a 40% graft loss rate. We found that an increased presence of neutrophilic infiltrates in the postreperfusion biopsy specimen, indicating PI, was related to an increased incidence of biliary complications. Moreover, moderate macrovesicular steatosis was associated with increased graft loss. Therefore, postreperfusion biopsies are useful in anticipating post-OLT complications.

  10. Efficacy, safety, and pharmacokinetics of simeprevir, daclatasvir, and ribavirin in patients with recurrent hepatitis C virus genotype 1b infection after orthotopic liver transplantation: The Phase II SATURN study. (United States)

    Forns, Xavier; Berenguer, Marina; Herzer, Kerstin; Sterneck, Martina; Donato, Maria Francesca; Andreone, Pietro; Fagiuoli, Stefano; Cieciura, Tomasz; Durlik, Magdalena; Calleja, Jose Luis; Mariño, Zoe; Shukla, Umesh; Verbinnen, Thierry; Lenz, Oliver; Ouwerkerk-Mahadevan, Sivi; Peeters, Monika; Janssen, Katrien; Kalmeijer, Ronald; Jessner, Wolfgang


    Recurrent hepatitis C virus (HCV) infection following liver transplantation is associated with accelerated progression to graft failure and reduced patient survival. The Phase II, open-label SATURN study (NCT01938625) investigated the combination of simeprevir (SMV), daclatasvir (DCV), and ribavirin (RBV) administered for 24 weeks in 35 patients with recurrent HCV genotype (GT) 1b infection after orthotopic liver transplantation (OLT). High rates of both on-treatment and sustained virologic response 12 weeks after end of treatment (SVR12) were achieved in patients who were either treatment-naïve or had failed post-OLT treatment with peginterferon and RBV. Overall, 91% of patients (32/35) achieved SVR12. The combination was generally well tolerated, with an adverse event profile consistent with that observed in previous clinical trials of SMV or DCV separately. Co-administration of SMV with cyclosporine resulted in significantly increased SMV plasma exposures, which was not the case with the co-administration of SMV with tacrolimus. Therefore, the concomitant use of SMV with cyclosporine is not recommended. The interferon-free combination of SMV, DCV, and RBV administered for 24 weeks was shown to be effective and well tolerated in the treatment of post-OLT HCV GT1b-infected patients. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Glacial–interglacial dynamics of Antarctic firn columns: comparison between simulations and ice core air-δ15N measurements

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    E. Capron


    Full Text Available Correct estimation of the firn lock-in depth is essential for correctly linking gas and ice chronologies in ice core studies. Here, two approaches to constrain the firn depth evolution in Antarctica are presented over the last deglaciation: outputs of a firn densification model, and measurements of δ15N of N2 in air trapped in ice core, assuming that δ15N is only affected by gravitational fractionation in the firn column. Since the firn densification process is largely governed by surface temperature and accumulation rate, we have investigated four ice cores drilled in coastal (Berkner Island, BI, and James Ross Island, JRI and semi-coastal (TALDICE and EPICA Dronning Maud Land, EDML Antarctic regions. Combined with available ice core air-δ15N measurements from the EPICA Dome C (EDC site, the studied regions encompass a large range of surface accumulation rates and temperature conditions. Our δ15N profiles reveal a heterogeneous response of the firn structure to glacial–interglacial climatic changes. While firn densification simulations correctly predict TALDICE δ15N variations, they systematically fail to capture the large millennial-scale δ15N variations measured at BI and the δ15N glacial levels measured at JRI and EDML – a mismatch previously reported for central East Antarctic ice cores. New constraints of the EDML gas–ice depth offset during the Laschamp event (~41 ka and the last deglaciation do not favour the hypothesis of a large convective zone within the firn as the explanation of the glacial firn model–δ15N data mismatch for this site. While we could not conduct an in-depth study of the influence of impurities in snow for firnification from the existing datasets, our detailed comparison between the δ15N profiles and firn model simulations under different temperature and accumulation rate scenarios suggests that the role of accumulation rate may have been underestimated in the current description of firnification

  12. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of placing preventive fissure sealants (United States)


    Background Psychological models are used to understand and predict behaviour in a wide range of settings, but have not been consistently applied to health professional behaviours, and the contribution of differing theories is not clear. This study explored the usefulness of a range of models to predict an evidence-based behaviour -- the placing of fissure sealants. Methods Measures were collected by postal questionnaire from a random sample of general dental practitioners (GDPs) in Scotland. Outcomes were behavioural simulation (scenario decision-making), and behavioural intention. Predictor variables were from the Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Stage Model, and knowledge (a non-theoretical construct). Multiple regression analysis was used to examine the predictive value of each theoretical model individually. Significant constructs from all theories were then entered into a 'cross theory' stepwise regression analysis to investigate their combined predictive value Results Behavioural simulation - theory level variance explained was: TPB 31%; SCT 29%; II 7%; OLT 30%. Neither CS-SRM nor stage explained significant variance. In the cross theory analysis, habit (OLT), timeline acute (CS-SRM), and outcome expectancy (SCT) entered the equation, together explaining 38% of the variance. Behavioural intention - theory level variance explained was: TPB 30%; SCT 24%; OLT 58%, CS-SRM 27%. GDPs in the action stage had significantly higher intention to place fissure sealants. In the cross theory analysis, habit (OLT) and attitude (TPB) entered the equation, together explaining 68% of the variance in intention. Summary The study provides evidence that psychological models can be useful in understanding and predicting clinical behaviour. Taking a theory-based approach enables the creation of a replicable methodology for identifying factors

  13. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of placing preventive fissure sealants

    Directory of Open Access Journals (Sweden)

    Maclennan Graeme


    Full Text Available Abstract Background Psychological models are used to understand and predict behaviour in a wide range of settings, but have not been consistently applied to health professional behaviours, and the contribution of differing theories is not clear. This study explored the usefulness of a range of models to predict an evidence-based behaviour -- the placing of fissure sealants. Methods Measures were collected by postal questionnaire from a random sample of general dental practitioners (GDPs in Scotland. Outcomes were behavioural simulation (scenario decision-making, and behavioural intention. Predictor variables were from the Theory of Planned Behaviour (TPB, Social Cognitive Theory (SCT, Common Sense Self-regulation Model (CS-SRM, Operant Learning Theory (OLT, Implementation Intention (II, Stage Model, and knowledge (a non-theoretical construct. Multiple regression analysis was used to examine the predictive value of each theoretical model individually. Significant constructs from all theories were then entered into a 'cross theory' stepwise regression analysis to investigate their combined predictive value Results Behavioural simulation - theory level variance explained was: TPB 31%; SCT 29%; II 7%; OLT 30%. Neither CS-SRM nor stage explained significant variance. In the cross theory analysis, habit (OLT, timeline acute (CS-SRM, and outcome expectancy (SCT entered the equation, together explaining 38% of the variance. Behavioural intention - theory level variance explained was: TPB 30%; SCT 24%; OLT 58%, CS-SRM 27%. GDPs in the action stage had significantly higher intention to place fissure sealants. In the cross theory analysis, habit (OLT and attitude (TPB entered the equation, together explaining 68% of the variance in intention. Summary The study provides evidence that psychological models can be useful in understanding and predicting clinical behaviour. Taking a theory-based approach enables the creation of a replicable methodology for

  14. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice. (United States)

    Grimshaw, Jeremy M; Eccles, Martin P; Steen, Nick; Johnston, Marie; Pitts, Nigel B; Glidewell, Liz; Maclennan, Graeme; Thomas, Ruth; Bonetti, Debbie; Walker, Anne


    Psychological models predict behaviour in a wide range of settings. The aim of this study was to explore the usefulness of a range of psychological models to predict the health professional behaviour 'referral for lumbar spine x-ray in patients presenting with low back pain' by UK primary care physicians. Psychological measures were collected by postal questionnaire survey from a random sample of primary care physicians in Scotland and north England. The outcome measures were clinical behaviour (referral rates for lumbar spine x-rays), behavioural simulation (lumbar spine x-ray referral decisions based upon scenarios), and behavioural intention (general intention to refer for lumbar spine x-rays in patients with low back pain). Explanatory variables were the constructs within the Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-Regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Weinstein's Stage Model termed the Precaution Adoption Process (PAP), and knowledge. For each of the outcome measures, a generalised linear model was used to examine the predictive value of each theory individually. Linear regression was used for the intention and simulation outcomes, and negative binomial regression was used for the behaviour outcome. Following this 'theory level' analysis, a 'cross-theoretical construct' analysis was conducted to investigate the combined predictive value of all individual constructs across theories. Constructs from TPB, SCT, CS-SRM, and OLT predicted behaviour; however, the theoretical models did not fit the data well. When predicting behavioural simulation, the proportion of variance explained by individual theories was TPB 11.6%, SCT 12.1%, OLT 8.1%, and II 1.5% of the variance, and in the cross-theory analysis constructs from TPB, CS-SRM and II explained 16.5% of the variance in simulated behaviours. When predicting intention, the proportion of variance explained by individual

  15. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of placing preventive fissure sealants. (United States)

    Bonetti, Debbie; Johnston, Marie; Clarkson, Jan E; Grimshaw, Jeremy; Pitts, Nigel B; Eccles, Martin; Steen, Nick; Thomas, Ruth; Maclennan, Graeme; Glidewell, Liz; Walker, Anne


    Psychological models are used to understand and predict behaviour in a wide range of settings, but have not been consistently applied to health professional behaviours, and the contribution of differing theories is not clear. This study explored the usefulness of a range of models to predict an evidence-based behaviour -- the placing of fissure sealants. Measures were collected by postal questionnaire from a random sample of general dental practitioners (GDPs) in Scotland. Outcomes were behavioural simulation (scenario decision-making), and behavioural intention. Predictor variables were from the Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Stage Model, and knowledge (a non-theoretical construct). Multiple regression analysis was used to examine the predictive value of each theoretical model individually. Significant constructs from all theories were then entered into a 'cross theory' stepwise regression analysis to investigate their combined predictive value. Behavioural simulation - theory level variance explained was: TPB 31%; SCT 29%; II 7%; OLT 30%. Neither CS-SRM nor stage explained significant variance. In the cross theory analysis, habit (OLT), timeline acute (CS-SRM), and outcome expectancy (SCT) entered the equation, together explaining 38% of the variance. Behavioural intention - theory level variance explained was: TPB 30%; SCT 24%; OLT 58%, CS-SRM 27%. GDPs in the action stage had significantly higher intention to place fissure sealants. In the cross theory analysis, habit (OLT) and attitude (TPB) entered the equation, together explaining 68% of the variance in intention. The study provides evidence that psychological models can be useful in understanding and predicting clinical behaviour. Taking a theory-based approach enables the creation of a replicable methodology for identifying factors that may predict clinical behaviour

  16. Kuidas sünnib pealkiri? / Pärt Lias

    Index Scriptorium Estoniae

    Lias, Pärt


    Pealkiri, pühendus, moto, joonealune märge, ees- ja järelsõna on teose teksti manused, mis ei kuulu otse teksti, kuid selgitavad, täiendavad ja täpsustavad seda. Gerard Genette on need teksti lisandid koondanud üldnimetuse paratekstid alla. Eesti kirjanikud vastavad Pärt Liase küsimusele oma teoste pealkirjade saamisloo kohta: Aimee Beekman, Henn-Kaarel Hellat, Joel Sang ja Arvo Mägi (4); Lennart Meri, Heino Kiik ja Fanny de Sivers (5); Helga Nõu, Ülle Kauksi, Maie Kalda ja Cornelius Hasselblatt (6); Debora Vaarandi, Vaino Vahing, Arved Viirlaid ja Wimberg (7); Vahur Afanasjev, Matt Barker, Andrus Kivirähk, Jürgen Rooste ja Contra (8); Elin Toona, Jaak Rähesoo, Enn Soosaar, Juhan Peegel ja Toomas Kall (9); Kerttu Rakke, Aare Pilv, Aarne Ruben, Indrek Hargla, Jan Kaus ja Karen Orlau (10); Ene Mihkelson, Mats Traat ja Boriss Baljasnõi (11); Maimu Berg, Ain Kaalep, Enn Nõu ja Madis Kõiv (12)

  17. Proosa 1977. Kirjanduse argipäev / Mall Jõgi

    Index Scriptorium Estoniae

    Jõgi, Mall, 1947-


    Sisaldab joonealuseid märkusi ja bibliograafiat. - Varem ilmunud Looming 1978, nr. 2. - Ülevaade 1977. aastal ilmunud eesti proosast. Käsitletakse järgmisi autoreid ja nende teoseid: Ustav Mikelsaar "Ohver", Lembit Kivisaar "Vana diivan", Albert Uustulnd "Avali väraval", Asta Põldmäe "Me", Lilli Promet "Tüdrukud taevast", Nikolai Baturin "Leiud kajast", Aadu Hint "Oma saar", Paul Kuusberg "Linnukesega", Aimée Beekman "Sugupuu", Mari Saat "Mida teha emaga?", Veera Saar "Isa niinepuu", Villem Gross "Vaikimise motiivid", Jüri Tuulik "Meretagune asi", Aira Kaal "Teedla Riia aknas põleb tuli", Tõnis Lehtmets "Tume laas", Väino Ilus "Kinsli peremehed", Einar Maasik "Hispaania tants", Aino Müür "Linnuvere lugu", Jaan Kross "Kolme katku vahel" 3. osa, Endel Nirk "Kaanekukk", Paul Kuusberg "Võõras või õige mees", Toomas Vint "Perekondlikud mängud", Ine Viiding "Kümme käsku kaaskodanikele", Mats Traat "Irdinimene. Türgi oad", Teet Kallas "Õhtuvalgus", Teet Kallas "Insener Paberiti juhtum", Einar Maasik "Üksinda detsembris", Enn Vetemaa "Hõbedaketrajad", Herta Laipaik "Kummitus muusikatoas. Doktor Vallaku mõistatus", Raimond Kaugver "Külalisteraamat"

  18. Applying psychological theories to evidence-based clinical practice: Identifying factors predictive of managing upper respiratory tract infections without antibiotics

    Directory of Open Access Journals (Sweden)

    Glidewell Elizabeth


    Full Text Available Abstract Background Psychological models can be used to understand and predict behaviour in a wide range of settings. However, they have not been consistently applied to health professional behaviours, and the contribution of differing theories is not clear. The aim of this study was to explore the usefulness of a range of psychological theories to predict health professional behaviour relating to management of upper respiratory tract infections (URTIs without antibiotics. Methods Psychological measures were collected by postal questionnaire survey from a random sample of general practitioners (GPs in Scotland. The outcome measures were clinical behaviour (using antibiotic prescription rates as a proxy indicator, behavioural simulation (scenario-based decisions to managing URTI with or without antibiotics and behavioural intention (general intention to managing URTI without antibiotics. Explanatory variables were the constructs within the following theories: Theory of Planned Behaviour (TPB, Social Cognitive Theory (SCT, Common Sense Self-Regulation Model (CS-SRM, Operant Learning Theory (OLT, Implementation Intention (II, Stage Model (SM, and knowledge (a non-theoretical construct. For each outcome measure, multiple regression analysis was used to examine the predictive value of each theoretical model individually. Following this 'theory level' analysis, a 'cross theory' analysis was conducted to investigate the combined predictive value of all significant individual constructs across theories. Results All theories were tested, but only significant results are presented. When predicting behaviour, at the theory level, OLT explained 6% of the variance and, in a cross theory analysis, OLT 'evidence of habitual behaviour' also explained 6%. When predicting behavioural simulation, at the theory level, the proportion of variance explained was: TPB, 31%; SCT, 26%; II, 6%; OLT, 24%. GPs who reported having already decided to change their management to

  19. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of managing upper respiratory tract infections without antibiotics. (United States)

    Eccles, Martin P; Grimshaw, Jeremy M; Johnston, Marie; Steen, Nick; Pitts, Nigel B; Thomas, Ruth; Glidewell, Elizabeth; Maclennan, Graeme; Bonetti, Debbie; Walker, Anne


    Psychological models can be used to understand and predict behaviour in a wide range of settings. However, they have not been consistently applied to health professional behaviours, and the contribution of differing theories is not clear. The aim of this study was to explore the usefulness of a range of psychological theories to predict health professional behaviour relating to management of upper respiratory tract infections (URTIs) without antibiotics. Psychological measures were collected by postal questionnaire survey from a random sample of general practitioners (GPs) in Scotland. The outcome measures were clinical behaviour (using antibiotic prescription rates as a proxy indicator), behavioural simulation (scenario-based decisions to managing URTI with or without antibiotics) and behavioural intention (general intention to managing URTI without antibiotics). Explanatory variables were the constructs within the following theories: Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-Regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Stage Model (SM), and knowledge (a non-theoretical construct). For each outcome measure, multiple regression analysis was used to examine the predictive value of each theoretical model individually. Following this 'theory level' analysis, a 'cross theory' analysis was conducted to investigate the combined predictive value of all significant individual constructs across theories. All theories were tested, but only significant results are presented. When predicting behaviour, at the theory level, OLT explained 6% of the variance and, in a cross theory analysis, OLT 'evidence of habitual behaviour' also explained 6%. When predicting behavioural simulation, at the theory level, the proportion of variance explained was: TPB, 31%; SCT, 26%; II, 6%; OLT, 24%. GPs who reported having already decided to change their management to try to avoid the use of antibiotics made

  20. Evidências de hiperfluxo portal no pós-operatório de transplantes hepáticos Postoperative hyperflow in portal vein after liver transplantation

    Directory of Open Access Journals (Sweden)

    Luciana Costa Silva


    Full Text Available OBJETIVO: A cirrose hepática causa alterações acentuadas na circulação esplâncnica. Com o objetivo de investigar as alterações hemodinâmicas na velocidade do fluxo da veia porta, realizamos estudos com eco-Doppler em pacientes com cirrose hepática em estágio final antes, durante e após transplante hepático ortotópico (THO. MATERIAIS E MÉTODOS: Cinqüenta e quatro pacientes submetidos a THO e eco-Doppler intra-operatório foram avaliados prospectivamente, entre janeiro de 2002 e julho de 2003. Dezessete pacientes foram excluídos devido a dados incompletos relacionados a dificuldades técnicas para obter medidas ou morte prematura. Os 37 pacientes incluídos na análise tinham cirrose hepática associada principalmente a infecção pelo vírus da hepatite C e doença alcoólica. Todos os pacientes foram submetidos ao eco-Doppler imediatamente antes do THO, no período intra-operatório após a reperfusão do enxerto e no primeiro e sétimo dias do pós-operatório. A velocidade média do fluxo foi medida no tronco, ramo direito e ramo esquerdo da veia porta. A análise estatística foi realizada utilizando-se o teste t pareado e as diferenças foram consideradas significantes se p OBJECTIVE: A marked impact on the splanchnic circulation is seen in liver cirrhosis. Doppler ultrasonography (DUS was performed in a group of patients with end-stage liver cirrhosis before, during and after orthotopic liver transplantation (OLT in order to investigate the hemodynamic changes in portal vein flow velocity. MATERIALS AND METHODS: Fifty-four patients submitted to OLT and intraoperative DUS were prospectively studied from January 2002 to July 2003. Seventeen patients were excluded because of missing data due to either technical difficulties to obtain the measurements or early patient death. All 37 patients included in the analysis had liver cirrhosis mainly associated with hepatitis C virus infection and alcoholic disease. Patients were

  1. Pre-Liver Transplant: Tips Versus Distal Splenorenal Shunt

    Directory of Open Access Journals (Sweden)

    Thomas W. Faust


    Full Text Available Recurrent variceal bleeding in liver transplant candidates with end-stage liver disease can complicate or even prohibit a subsequent transplant procedure (OLT. Endoscopic sclero-therapy and medical therapy are considered as first-line management with surgical shunts reserved for refractory situations. Surgical shunts can be associated with a high mortality in this population and may complicate subsequent OLT. The transjugular intrahepatic portosystemic shunt (TIPS has been recommended in these patients as a bridge to OLT. This is a new modality that has not been compared with previously established therapies such as the distal splenorenal shunt (DSRS. In this study we report our experience with 35 liver transplant recipients who had a previous TIPS (18 patients or DSRS (17 patients for variceal bleeding. The TIPS group had a significantly larger proportion of critically ill and Child-Pugh C patients. Mean operating time was more prolonged in the DSRS group (P=0.014 but transfusion requirements were similar. Intraoperative portal vein blood flow measurements averaged 2132±725 ml/min in the TIPS group compared with 1120±351ml/min in the DSRS group (P<0.001. Arterial flows were similar. Mean ICU and hospital stays were similar. There were 3 hospital mortalities in the DSRS group and none in the TIPS group (P=0.1. We conclude that TIPS is a valuable tool in the management of recurrent variceal bleeding prior to liver transplantation. Intra0Perative hemodynamic measurements suggest a theoretical advantage with TIPS. In a group of patients with advanced liver disease we report an outcome that is similar to patients treated with DSRS prior to liver transplantation. The role of TIPS in the treatment of nontransplant candidates remains to be clarified.

  2. Liver Transplantation for Acute Intermittent Porphyria: Biochemical and Pathologic Studies of the Explanted Liver. (United States)

    Yasuda, Makiko; Erwin, Angelika L; Liu, Lawrence U; Balwani, Manisha; Chen, Brenden; Kadirvel, Senkottuvelan; Gan, Lin; Fiel, M Isabel; Gordon, Ronald E; Yu, Chunli; Clavero, Sonia; Arvelakis, Antonios; Naik, Hetanshi; Martin, L David; Phillips, John D; Anderson, Karl E; Sadagoparamanujam, Vaithamanithi M; Florman, Sander S; Desnick, Robert J


    Acute intermittent porphyria (AIP) is an autosomal-dominant hepatic disorder caused by the half-normal activity of hydroxymethylbilane (HMB) synthase. Symptomatic individuals experience life-threatening acute neurovisceral attacks that are precipitated by factors that induce the hepatic expression of 5-aminolevulinic acid synthase 1 (ALAS1), resulting in the marked accumulation of the putative neurotoxic porphyrin precursors 5-aminolevulinic acid (ALA) and porphobilinogen (PBG). Here, we provide the first detailed description of the biochemical and pathologic alterations in the explanted liver of an AIP patient who underwent orthotopic liver transplantation (OLT) due to untreatable and debilitating chronic attacks. After OLT, the recipient's plasma and urinary ALA and PBG rapidly normalized, and her attacks immediately stopped. In the explanted liver, (a) ALAS1 mRNA and activity were elevated approximately ~3- and 5-fold, and ALA and PBG concentrations were increased ~3- and 1,760-fold, respectively; (b) uroporphyrin III concentration was elevated; (c) microsomal heme content was sufficient, and representative cytochrome P450 activities were essentially normal; (d) HMB synthase activity was approximately half-normal (~42%); (e) iron concentration was slightly elevated; and (f) heme oxygenase I mRNA was increased approximately three-fold. Notable pathologic findings included nodular regenerative hyperplasia, previously not reported in AIP livers, and minimal iron deposition, despite the large number of hemin infusions received before OLT. These findings suggest that the neurovisceral symptoms of AIP are not associated with generalized hepatic heme deficiency and support the neurotoxicity of ALA and/or PBG. Additionally, they indicate that substrate inhibition of hepatic HMB synthase activity by PBG is not a pathogenic mechanism in acute attacks.

  3. Stereotactic body radiotherapy (SBRT) for locally advanced extrahepatic and intrahepatic cholangiocarcinoma. (United States)

    Sandler, Kiri A; Veruttipong, Darlene; Agopian, Vatche G; Finn, Richard S; Hong, Johnny C; Kaldas, Fady M; Sadeghi, Saeed; Busuttil, Ronald W; Lee, Percy


    We report single-institution clinical efficacy and safety outcomes for patients with unresectable locally advanced cholangiocarcinoma who were treated with stereotactic body radiation therapy (SBRT) and a subset of patients who received neoadjuvant SBRT and chemotherapy as part of an orthotopic liver transplantation (OLT) protocol. From October 2008 to June 2015, 31 consecutive patients with unresectable extrahepatic (n = 25) or intrahepatic (n = 6) cholangiocarcinoma were treated with SBRT and retrospectively analyzed. Four patients underwent liver transplantation, and 1 underwent resection. SBRT was delivered in 5 fractions with a median dose of 40 Gy. Toxicity was scored using the Common Terminology Criteria for Adverse Events Version 4.0. Overall survival (OS), time to progression, and local control were estimated using the Kaplan-Meier method. The median follow-up time was 11.5 months. The 1- and 2-year OS rates were 59% and 33%, respectively, with a median survival of 15.7 months. The 1- and 2-year freedom from progression was 67% and 34%, respectively. Median time to progression was 16.8 months. Nine patients had local failure. The actuarial 1- and 2-year local control rates were 78% and 47%, respectively. Among patients who also had OLT, the median OS was 31.3 months. Twenty-four patients (77%) experienced some form of acute grade 1-2 toxicity, most commonly fatigue or pain. Five patients (16%) experienced grade ≥3 toxicity. SBRT is a promising option for patients with unresectable or recurrent cholangiocarcinoma either as a component of neoadjuvant therapy prior to OLT or as part of definitive therapy for patients who are unresectable and not eligible for transplantation.

  4. Effect of Organic Layer Thickness on Black Spruce Aging Mistakes in Canadian Boreal Forests

    Directory of Open Access Journals (Sweden)

    Ahmed Laamrani


    Full Text Available Boreal black spruce (Picea mariana forests are prone to developing thick organic layers (paludification. Black spruce is adapted to this environment by the continuous development of adventitious roots, masking the root collar and making it difficult to age trees. Ring counts above the root collar underestimate age of trees, but the magnitude of age underestimation of trees in relation to organic layer thickness (OLT is unknown. This age underestimation is required to produce appropriate age-correction tools to be used in land resource management. The goal of this study was to assess aging errors that are done with standard ring counts of trees growing in sites with different degrees of paludification (OLT; 0–25 cm, 26–65 cm, >65 cm. Age of 81 trees sampled at three geographical locations was determined by ring counts at ground level and at 1 m height, and real age of trees was determined by cross-dating growth rings down to the root collar (root/shoot interface. Ring counts at 1 m height underestimated age of trees by a mean of 22 years (range 13–49 and 52 years (range 14–112 in null to low vs. moderately to highly paludified stands, respectively. The percentage of aging-error explained by our linear model was relatively high (R2adj = 0.71 and showed that OLT class and age at 0-m could be used to predict total aging-error while neither DBH nor geographic location could. The resulting model has important implications for forest management to accurately estimate productivity of these forests.

  5. Prevalence of myocardial perfusion abnormalities in end-stage liver disease

    International Nuclear Information System (INIS)

    Fathala, Ahmed; Safar, Bander; Al Muhaideb, Ahmed


    The prevalence of coronary artery disease (CAD) in end-stage liver disease (ESLD) being evaluated for orthotopic liver transplantation (OLT) is unclear based on variable definition used for CAD. The aim of this study to investigate the prevalence of abnormal stress myocardial perfusion single-photon emission computed tomography (MPS) imaging, as a marker for CAD, among patients with ESLD who were referred for stress MPS imaging as a routine work up before OLT. This was a single-center, retrospective study. We reviewed data on 167 patients who were referred for MPS as a routine work up before OLT over the last 2 years. All patients underwent evaluation for CAD risk factors [age, hypercholesterolemia, diabetes mellitus (DM), hypertension (HTN), and smoking], and stress MPS as per standard protocol. The total number of patients referred for stress MPS was 167. Seven patients (4% of total study population) were excluded from the study due to poor and/or nondiagnostic studies. 147 patients (92%) had normal, but only 13 patients (8%) had abnormal MPS scans. DM and male gender were the most independent risk factors for abnormal MPS with P value of 0.046, and 0.26, respectively. There was no significant association between the abnormal MPS result and HTN, hypercholesterolemia, smoking, age or etiology of the liver disease. Based on our data, the prevalence of abnormal MPS and left ventricular ejection fraction in patients with ESLD was found to be 8%. DM and male gender were the most independent predictor factors for abnormal MPS. True prevalence of CAD and usefulness of MPS in patients with ESLD can only be studied using a very large and randomized prospective study

  6. Panax notoginseng saponins preconditioning protects rat liver grafts from ischemia/reperfusion injury via an antiapoptotic pathway. (United States)

    Zhang, Yi; Ye, Qi-Fa; Lu, Li; Xu, Xian-Lin; Ming, Ying-Zi; Xiao, Jian-Sheng


    Ischemia/reperfusion (I/R) injury is a major cause of primary graft dysfunction and renders an allograft more immunogenic in orthotopic liver transplantation (OLT). Panax notoginseng saponins (PNS) has been reported to exert protective effects against I/R injury to various organs. The objective of this study is to investigate whether PNS preconditioning protects rat liver grafts from I/R injury via an antiapoptotic pathway. Male Sprague-Dawley rats were used as donors and recipients of orthotopic liver transplantation (OLT) and were divided into PNS preconditioning group(group P) and normal saline control group (group N) randomly according to whether PNS (50 mg/kg) was injected intravenously 1 hour before liver grafts harvesting, and sham group (group S). The animals were separately killed 2, 6 and 24 hours after reperfusion. Plasma samples were collected for test of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Liver tissues were collected to detect histological changes, apoptosis and the expression of TNF-alpha, Bcl-2 and Caspase-3 mRNA. The serum levels of ALT and AST and the apoptosis index (AI) of liver tissue in group P were lower than in group N significantly 2, 6 and 24 hours after reperfusion. Compared with group N, the expression of TNF-alpha and Caspase-3 mRNA was reduced significantly in group P 2 and 6 hours after reperfusion and the expression of Bcl-2 mRNA was enhanced significantly in group P 6 and 24 hours after reperfusion. PNS preconditioning protects liver grafts from I/R injury effectively in rat OLT via an antiapoptotic pathway. The antiapoptotic mechanisms of PNS may include inhibiting the expression of TNF-alpha and Caspase-3 and enhancing the expression of Bcl-2.

  7. Stress Analysis of the LHA-1 Class Superheater Header by Finite Element Method. (United States)


    Advisor G. Cantin Co-Advisor E.L. Wilson Approved for public release; distribution is unlimited. 87 9 8 7 UNCLASSIFIED . jk uRTYf (I ASS.ZATION 0...8217 RSPONSB !.DO1 AL 110 tELEPPONE(Includoe AreaCodel 22C Oi’(t SyvMBO. Professor G. CANTIN (408) 646-2364 69Ci 00 FORM 1473,54 MAR Si APR rd? OA -My be...OF SCIENCE IN MECHANICAL ENGINEERING from the NAVAL POSTGRADUATE SCHOOL June 1987 Author: ,.. Olt Kau mann Approved by: _ _ _ _ _ _ _ __ _ G. Cantin

  8. Analysis of the Teaching Staff in the Pre-University Education System

    Directory of Open Access Journals (Sweden)

    Todea Nicolae


    Full Text Available In order to realize the activities and achieve the expected results, the pre-university education institutions use several categories of resources, including the human resources that play an important role. Thus, taking into account their importance, I made a presentation of the situation of the teachers in Olt County in the period 2014-2017 and their distribution by degree. On the basis of the conclusions drawn, it was carried out a SWOT analysis of human resources in pre-university education. In parallel, we presented the forecast of the population aged 0-14 on development regions in 2010-2020.

  9. The evolution of liver transplantation during 3 decades: analysis of 5347 consecutive liver transplants at a single center. (United States)

    Agopian, Vatche G; Petrowsky, Henrik; Kaldas, Fady M; Zarrinpar, Ali; Farmer, Douglas G; Yersiz, Hasan; Holt, Curtis; Harlander-Locke, Michael; Hong, Johnny C; Rana, Abbas R; Venick, Robert; McDiarmid, Sue V; Goldstein, Leonard I; Durazo, Francisco; Saab, Sammy; Han, Steven; Xia, Victor; Hiatt, Jonathan R; Busuttil, Ronald W


    To analyze a 28-year single-center experience with orthotopic liver transplantation (OLT) for patients with irreversible liver failure. The implementation of the model for end-stage liver disease (MELD) in 2002 represented a fundamental shift in liver donor allocation to recipients with the highest acuity, raising concerns about posttransplant outcome and morbidity. Outcomes and factors affecting survival were analyzed in 5347 consecutive OLTs performed in 3752 adults and 822 children between 1984 and 2012, including comparisons of recipient and donor characteristics, graft and patient outcomes, and postoperative morbidity before (n = 3218) and after (n = 2129) implementation of the MELD allocation system. Independent predictors of survival were identified. Overall, 1-, 5-, 10-, and 20-year patient and graft survival estimates were 82%, 70%, 63%, 52%, and 73%, 61%, 54%, 43%, respectively. Recipient survival was best in children with biliary atresia and worst in adults with malignancy. Post-MELD era recipients were older (54 vs 49, P < 0.001), more likely to be hospitalized (50% vs 47%, P = 0.026) and receiving pretransplant renal replacement therapy (34% vs 12%, P < 0.001), and had significantly greater laboratory MELD scores (28 vs 19, P < 0.001), longer wait-list times (270 days vs 186 days, P < 0.001), and pretransplant hospital stays (10 days vs 8 days, P < 0.001). Despite increased acuity, post-MELD era recipients achieved superior 1-, 5-, and 10-year patient survival (82%, 70%, and 65% vs 77%, 66%, and 58%, P < 0.001) and graft survival (78%, 66%, and 61% vs 69%, 58%, and 51%, P < 0.001) compared with pre-MELD recipients. Of 17 recipient and donor variables, era of transplantation, etiology of liver disease, recipient and donor age, prior transplantation, MELD score, hospitalization at time of OLT, and cold and warm ischemia time were independent predictors of survival. We present the world's largest reported single-institution experience with OLT. Despite

  10. Reoperative complications after primary orthotopic liver transplantation: a contemporary single-center experience in the post-model for end-stage liver disease era. (United States)

    DiNorcia, Joseph; Lee, Minna K; Harlander-Locke, Michael; Zarrinpar, Ali; Kaldas, Fady M; Yersiz, Hasan; Farmer, Douglas G; Hiatt, Jonathan R; Busuttil, Ronald W; Agopian, Vatche G


    Data on complications requiring reoperation after orthotopic liver transplantation (OLT) are limited. We sought to describe the spectrum of reoperative complications after OLT, evaluate the associations with graft and patient survival, and identify predictors of need for reoperation. We retrospectively studied adult patients who underwent primary OLT at our institution from February 2002 to July 2012. The primary outcomes included occurrence of a reoperative complication. Secondary outcomes were graft and patient survival. Multivariable logistic regression analysis was used to model the associations of recipient, donor, and operative variables with reoperation. Of 1,620 patients, 470 (29%) had complications requiring reoperation. The most common reoperative complication was bleeding (17.3%). Compared with patients not requiring reoperation, patients with reoperative complications had greater Model for End-Stage Liver Disease scores and need for pretransplantation hospitalization, mechanical ventilation, vasopressors, and renal replacement therapy; considerably longer cold and warm ischemia times and greater intraoperative blood transfusion requirements; and substantially worse 1-, 3-, and 5-year graft and patient survival rates. In multivariable analysis, predictors of reoperative complications included intraoperative transfusion of packed RBCs (odds ratio [OR] = 2.21; 95% CI, 1.91-2.56), donor length of hospitalization >8 days (OR = 1.87; 95% CI, 1.28-2.73), recipient pretransplantation mechanical ventilation (OR = 1.65; 95% CI, 1.21-2.24), cold ischemia time >9 hours (OR = 1.63; 95% CI, 1.23-2.17), warm ischemia time >55 minutes (OR = 1.58; 95% CI, 1.02-2.44), earlier major abdominal surgery (OR = 1.41; 95% CI, 1.03-1.92), and elevated donor serum sodium (OR = 1.17; 95% CI, 1.03-1.31). Patients who require reoperation for complications after OLT have high pretransplantation acuity and inferior post-transplantation survival. We identified factors associated

  11. "Küsse lat's ..." : [luuletused] / Kauksi Ülle

    Index Scriptorium Estoniae

    Kauksi Ülle, pseud., 1962-


    Sisu: "Küsse lat's ..." ; "Vanaimä, ma lupa, ku suurõss kasu ..." ; "Mis-ti küsüt, et ..." ; Ussõ pääl üteld ; "Mis' sõs ku olõ 'pihlõ' ma kesk umma mäke ..." "Kos' sa olt? ..." ; "Maarahva miil ..." ; "Havvakirju ragi yts miis ..." ; Hanõ vai luigõ ; Võlg ; Mu viimäne laul sullõ ; "üts korgõ puu pak mullõ paika ...". Eluloolisi andmeid autori kohta lk. 369

  12. Bidirectional and simultaneous FTTX/Ethernet services using RSOA based remodulation and polarization multiplexing technique (United States)

    Das, Anindya S.; Patra, Ardhendu S.


    A bidirectional and simultaneous transmission of Ethernet, FTTX services through single optical carrier wavelength employing polarization multiplexing technique in the transmitter end and the user end. 10 Gbps and 2.5 Gbps datarates are transmitted over 50 km single mode fiber employing POLMUX technique at OLT and ONU to provide Ethernet and FTTX services concurrently to the user. Reflective semiconductor optical amplifier is used to reuse and remodulate the downlink signal to uplink transmission. The upstream and the downstream transmission performances are observed by the bit error rate values and the eye diagrams obtained by the BER analyzer.

  13. Study of dual-polarization OQAM-OFDM PON with direct detection (United States)

    Luo, Qing-long; Feng, Min; Bai, Cheng-lin; Hu, Wei-sheng


    An offset quadrature amplitude modulation orthogonal frequency-division multiplexing (OQAM-OFDM) passive optical network (PON) architecture with direct detection is brought up to increase the transmission range and improve the system performance. In optical line terminal (OLT), OQAM-OFDM signals at 40 Gbit/s are transmitted as downstream. At each optical network unit (ONU), the optical OQAM-OFDM signal is demodulated with direct detection. The results show that the transmission distance can exceed 20 km with negligible penalty under the experimental conditions.

  14. 10 Gb/s full-duplex bidirectional transmission with RSOA-based ONU using detuned optical filtering and decision feedback equalization. (United States)

    Omella, M; Papagiannakis, I; Schrenk, B; Klonidis, D; Lázaro, J A; Birbas, A N; Kikidis, J; Prat, J; Tomkos, I


    Full-duplex bidirectional transmission at 10 Gb/s is demonstrated for extended wavelength division multiplexed passive optical network (WDM-PON) applications, achieving transmission distances up to 25 km of standard single mode fiber (SSMF) when using a low-bandwidth (approximately 1.2 GHz) reflective semiconductor optical amplifier (RSOA) for signal re-modulation at the optical network unit (ONU). The system is assisted by optimum offset filtering at the optical line terminal (OLT)-receiver and the performance is further improved with the use of decision-feedback equalization (DFE). Chromatic dispersion (CD) and Rayleigh Backscattering (RB) effects are considered and analyzed.

  15. In-service communication channel sensing based on reflectometry for TWDM-PON systems (United States)

    Iida, Daisuke; Kuwano, Shigeru; Terada, Jun


    Many base stations are accommodated in TWDM-PON based mobile backhaul and fronthaul networks for future radio access, and failed connections in an optical network unit (ONU) wavelength channel severely degrade system performance. A cost effective in-service ONU wavelength channel monitor is essential to ensure proper system operation without failed connections. To address this issue we propose a reflectometry-based remote sensing method that provides wavelength channel information with the optical line terminal (OLT)-ONU distance. The method realizes real-time monitoring of ONU wavelength channels without signal quality degradation. Experimental results show it achieves wavelength channel distinction with high distance resolution.

  16. Powering FITL for Deutsche Telekom

    Energy Technology Data Exchange (ETDEWEB)

    Schulz, W. [T-Nova Deutsche Telekom Innovationsgesellschaft mbH Technologiezentrum (Germany)


    Deutsche Telekom introduced the project OPAL (optical access line) 8 years ago. The development of new applications for FITL (FTTH, FTTB, FTTC) leads to new challenges for power systems. For the establishment of an optical fibre infrastructure at the subscriber line level a wide variety of possible optical fibre network topologies can be imagined. Different powering architectures must be developed including remote or local powering. This paper presents results and performances of the powering configurations to feed the optical network units (ONU) and remote OLT. Compared to conventional powering the centralised powering with remote feeding supply was implemented to power the ONU in the field economically. (orig.)

  17. How Has Saddam Hussein Survived? Economic Sanctions, 1990-1993 (United States)


    tighting took p! ao thle aliscoUld qui~ckly prexojl . nlt mtp~atd ithat sanctions.\\, % henl inposed. could impairI’ the Ikeadi ie."N 10 lraq\\ý ad\\ anlced...Su’VRMEl ICNAI( 11% 1 tOl Io Wud 11~~ asa )OLt1 lItIICtIIIIs.lis \\¶,otitin ha"s milakl\\d tl. m,, ao~ ,Ilc LateCil l)t Ws ~ic tfl to) oduiioii- N~tiatc thAt

  18. Long reach DWDM-PON with 12.5 GHz channel spacing based on comb source seeding (United States)

    Zhou, Zhao; Nie, Hai-tao; Wang, Yao-jun


    A long reach dense wavelength division multiplexing passive optical network (DWDM-PON) with 12.5 GHz channel spacing is proposed and experimentally demonstrated. An optical frequency comb source is used to provide the multiwavelength seeding light, while reflective semiconductor optical amplifiers (RSOAs) are installed in both optical line terminal (OLT) and optical network units (ONUs) as colorless transmitter. The experimental results show that the bidirectional transmission for 1.2 Gbit/s data rate is achieved over 80 km single mode fiber (SMF).

  19. Immediate IPTV channel leave by explicit user tracking in PON (United States)

    Zhu, Peng; Yoshiuchi, Hideya; Yoshizawa, Satoshi


    In this paper, we propose a novel IPTV channel leave mechanism for Passive Optical Network (PON). By explicit user tracking and automatic differentiation of IGMP v2 and v3 users, the proposed mechanism can realize immediate channel leave in both Optical Line Terminal (OLT) and Optical Network Unit (ONU) while avoiding removing the channel which still has users. Simulation results show that the proposed mechanism can significantly save the bandwidth consumption during "channel surf" by users, compared to the standard IGMP timeout mechanism.

  20. Adverse Effect of Post-Discharge Care Fragmentation on Outcomes after Readmissions after Liver Transplantation. (United States)

    Kothari, Anai N; Loy, Veronica M; Brownlee, Sarah A; Ezure, Yoshiki; Schaidle-Blackburn, Colleen; Cotler, Scott J; di Sabato, Diego; Kuo, Paul C; Lu, Amy D


    Post-discharge surgical care fragmentation is defined as readmission to any hospital other than the hospital at which surgery was performed. The objective of this study was to assess the impact of fragmented readmissions within the first year after orthotopic liver transplantation (OLT). The Healthcare Cost and Utilization Project State Inpatient Databases for Florida and California from 2006 to 2011 were used to identify OLT patients. Post-discharge fragmentation was defined as any readmission to a non-index hospital, including readmitted patients transferred to the index hospital after 24 hours. Outcomes included adverse events, defined as 30-day mortality and 30-day readmission after a fragmented readmission. All statistical analyses considered a hierarchical data structure and were performed with multilevel, mixed-effects models. We analyzed 2,996 patients with 7,485 readmission encounters at 299 hospitals; 1,236 (16.5%) readmissions were fragmented. After adjustment for age, sex, readmission reason, index liver transplantation cost, readmission length of stay, number of previous readmissions, and time from transplantation, post-discharge fragmentation increased the odds of both 30-day mortality (odds ratio [OR] = 1.75; 95% CI 1.16 to 2.65) and 30-day readmission (OR = 2.14; 95% CI 1.83 to 2.49). Predictors of adverse events after a fragmented readmission included increased number of previous readmissions (OR = 1.07; 95% CI 1.01 to 1.14) and readmission within 90 days of OLT (OR = 2.19; 95% CI 1.61 to 2.98). Post-discharge fragmentation significantly increases the risk of both 30-day mortality and subsequent readmission after a readmission in the first year after OLT. More inpatient visits before a readmission and less time elapsed from index surgery increase the odds of an adverse event after discharge from a fragmented readmission. These parameters could guide transfer decisions for patients with post-discharge fragmentation. Copyright © 2017 American

  1. Conformal Antenna Array Design Handbook (United States)


    PLOTI-e2#Yo2) AsYSCL*(J-1 )-YSL CALL N~IE(7.*L ,-LH2tH~oto4HF4.0) GO TO 10 11 CALL PLOT(-oltY92) 10 YuY ..Y DX. XM/NX NNX=NX+1 DO 20 K-19NNX CALL PLUT...polynomial. Then the coefficients are determined from the Chebyshev polynomial (Taylor, 1952; Tseng and Cheng , 1968). As in the case of linear arrays, a...used ( Cheng and Tseng, 1967). Difference pattern parameters such as slope (Powers, 1967) or directivity (Bayliss, 1968) can also be maximized at the

  2. Intraoperative hemodynamic monitoring during liver transplantation: goals and devices

    DEFF Research Database (Denmark)

    Nissen, Peter; Frederiksen, H J; Secher, N H


    With the introduction of orthotopic liver transplantation (OLT) almost 40 years ago, changes in the cardiovascular system that manifest during the different phases of the operation combined, sometimes with massive hemorrhage in likely critically ill patients have been a challenge. Here hemodynamic...... for other categories of patients when a flow related parameter (cardiac stroke volume, cardiac output or (mixed) venous oxygen saturation) does not respond to a fluid challenge, i.e. the patient is "normovolaemic". Also the administration strategy for liver transplantation is considered with emphasis...

  3. DHC Professor Dr. Eng. Florea Dudita, at the Age of 80 - a Life Dedicated to Higher Education and to Scientific Research in Engineering

    Directory of Open Access Journals (Sweden)

    Ionel Staretu


    Full Text Available Professor Florea Dudita was born in April 12, 1934, in Dejesti, Olt county. After primary education at the Gymnasium of Dragasani, he attended ‘Andrei Saguna’ High School in Brasov, graduating in 1952. During the same year, he entered the Institute of Mechanics of Brasov, where he is selected in 1954 to attend the Institute of Automotive and Tractors of Moscow, graduating with a diploma of merit in 1958. Since 1959, he had been working at the Polytechnic Institute of Brasov, since 1990, called ‘Transilvania’ University of Brasov, going through all stages of the academic career, up to professor.

  4. [Osteochondritis dissecans of the talus. Diagnosis and treatment]. (United States)

    Preiss, A; Heitmann, M; Frosch, K-H


    Osteochondritis dissecans of the talus (ODT) describes a special entity of osteochondral lesions of the talus (OLT) which has to be distinguished from acute traumatic lesions. Its exact etiology still remains uncertain with multiple predispositioning factors being discussed. Following the knee and elbow, the ankle joint with 4% is the third most affected joint. Early stages can often be treated conservatively. In case of an advanced stage or failure of conservative treatment, a variety of operative techniques are available, which can be used based on the patient and the stage.

  5. Analysis of opioid-mediated analgesia in Phase III studies of methylnaltrexone for opioid-induced constipation in patients with chronic noncancer pain

    Directory of Open Access Journals (Sweden)

    Webster LR


    Full Text Available Lynn R Webster,1 Darren M Brenner,2 Andrew C Barrett,3 Craig Paterson,3 Enoch Bortey,3 William P Forbes3 1PRA Health Sciences, Salt Lake City, UT, 2Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 3Salix, a Division of Valeant Pharmaceuticals North America LLC, Bridgewater, NJ, USA Background: Subcutaneous methylnaltrexone is efficacious and well tolerated for opioid-induced constipation (OIC but may theoretically disrupt opioid-mediated analgesia. Methods: Opioid use, pain intensity, and opioid withdrawal (Objective Opioid Withdrawal Scale [OOWS] and Subjective Opiate Withdrawal Scale [SOWS] scores were reported in a randomized, double-blind trial with an open-label extension (RCT and an open-label trial (OLT evaluating safety in adults with chronic noncancer pain. In the RCT, patients taking ≥50 mg of oral morphine equivalents daily with <3 rescue-free bowel movements weekly received methylnaltrexone 12 mg once daily (n=150, every other day (n=148, or placebo (n=162 for 4 weeks, followed by open-label methylnaltrexone 12 mg (as needed [prn]; n=364 for 8 weeks. In the OLT, patients (n=1,034 on stable opioid doses with OIC received methylnaltrexone 12 mg prn for up to 48 weeks. Results: Minimal fluctuations of median morphine equivalent dose from baseline (BL were observed in the RCT double-blind period (BL, 154.8–161.0 mg/d; range, 137.1–168.0 mg/d, RCT open-label period (BL, 156.3–174.6; range, 144.0–180.0 and OLT (BL, 120 mg/d; range, 117.3–121.1 mg/d. No significant change from BL in pain intensity score occurred in any group at weeks 2 or 4 (both P≥0.1 of the RCT double-blind period, and scores remained stable during the open-label period and in the OLT (mean change, —0.2 to 0.1. Changes from BL in OOWS and SOWS scores during the double-blind period were not significantly impacted by methylnaltrexone exposure at weeks 2 or 4 (P>0.05 for all. Conclusion: Methylnaltrexone did not affect

  6. Use of yttrium-90 microspheres (TheraSphere) in a patient with unresectable hepatocellular carcinoma leading to liver transplantation: a case report. (United States)

    Kulik, Laura M; Mulcahy, Mary F; Hunter, Russell D; Nemcek, Albert A; Abecassis, Michael M; Salem, Riad


    Prior to therapy, model for end stage liver disease (MELD) scoring, diagnostic imaging and tumor staging were performed in a patient with T3 HCC. The patient received an orthotopic liver transplant (OLT) 42 days after treatment. The explant specimen showed complete necrosis of the target tumor. Follow-up of this patient has demonstrated no evidence of recurrence. There was no life threatening or fatal adverse experiences related to treatment. This case report documents the natural course, history and outcome of a patient treated with yttrium-90 for unresectable HCC. The patient was downstaged from T3 to T2 and was subsequently transplanted.

  7. Luuleaasta 1994 : parlamendi koosseis on selgunud / Barbi Pilvre

    Index Scriptorium Estoniae

    Pilvre, Barbi, 1963-


    Rannit, Aleksis. Nii näen sind ikka; Kangur, Kalju. Sõna sees olek; Traat, Mats. Koidu kätes; Rimmel, Rudolf. Setu netu; Suislepp, Harald. Köögertali kojutulek; Piir, Enno. Sunnitöölise Mekka; Üllaste, Leenart. Lind tormis; Hirv, Indrek. Taskuraamat (taskutähekerjus); Mirtem, Valev [Luhaäär, Ingvar]. Maithunad Eestis; Mirtem, Valev [Luhaäär, Ingvar]. Armuühtepühad; Mirtem, Valev [Luhaäär, Ingvar]. Tulevaas; Kurvits, Lembit. Matle laul; Lillemets, Enn. Olemise valge koer ehk Ingli kolju; Jessod, Mats [Jakobson, Mati]. Jah, luuletused; Jessod, Mats [Jakobson, Mati]. Ohjad Oti mäel; Jessod, Mats [Jakobson, Mati]. Poeetilisi prohmakaid; Ivar, Ivo. Riimiskid; Kilokalor, Kalle. Öösel näeb halvemini kui päeval; Trubetsky, Tõnu. Anarhia; Laanvee, Ervin. Jaa. Mina olen; Kuningas, Marko J. ...jääb USK, LOOTUS, ARMASTUS; Ruben, Arne. Ajakirjanik; Ollinovski, Jim [Ollino, Ott]. Luuletused; Toomik, Tõnu. 27 luuletust; Tosin, Ants. Õnnetähestik; Krüger, Urmas. Ka nii võib...; Kärner, Siim. Usseaid; Sikk, Heino. Võrokõstõlõ: poeem; Kollin, Viktor. Kodutunne; Alo, Ülo [Võsar, Ülo Alo]. Ööbikuvalgus; Sepp, Vello. Vigased pärlid; Palo, Wilhelm. Tuule-luuled; Soomets, Triin. Randmes unejanu; Soomets, Triin. Janu masinas; Ränik, Valeria. Ajast väljas; Kivi, Aita. Kalender-päevik Aita Kivi luuletustega; Maagemust, Maarika. Kaaludes kaldaid; Hiiussaar, Ann. Valgete uste taga; Kolkkanen, Imbi. Mina ja maailm; Mets, Neeme. Kesalill; Kolesnitshenko, Kaidi-Ly. Kaks silma; Kahro, Anne. Nälkjast!; Kabe, Aino. Tuulema mõtteriim. Raatma, Salme. Laululatern; Osila, Virve. Lootuse luiged; Isak, Asta. Valguse ja varjude vahel; Õunapuu, Meeli. Mööda teid ja radu

  8. Noncoherent Spectral Optical CDMA System Using 1D Active Weight Two-Code Keying Codes

    Directory of Open Access Journals (Sweden)

    Bih-Chyun Yeh


    Full Text Available We propose a new family of one-dimensional (1D active weight two-code keying (TCK in spectral amplitude coding (SAC optical code division multiple access (OCDMA networks. We use encoding and decoding transfer functions to operate the 1D active weight TCK. The proposed structure includes an optical line terminal (OLT and optical network units (ONUs to produce the encoding and decoding codes of the proposed OLT and ONUs, respectively. The proposed ONU uses the modified cross-correlation to remove interferences from other simultaneous users, that is, the multiuser interference (MUI. When the phase-induced intensity noise (PIIN is the most important noise, the modified cross-correlation suppresses the PIIN. In the numerical results, we find that the bit error rate (BER for the proposed system using the 1D active weight TCK codes outperforms that for two other systems using the 1D M-Seq codes and 1D balanced incomplete block design (BIBD codes. The effective source power for the proposed system can achieve −10 dBm, which has less power than that for the other systems.

  9. Estimation of aluminum and argon activation sources in the HANARO coolant

    International Nuclear Information System (INIS)

    Jun, Byung Jin; Lee, Byung Chul; Kim, Myong Seop


    The activation products of aluminum and argon are key radionuclides for operational and environmental radiological safety during the normal operation of open-tank-in-pool type research reactors using aluminum-clad fuels. Their activities measured in the primary coolant and pool surface water of HANARO have been consistent. We estimated their sources from the measured activities and then compared these values with their production rates obtained by a core calculation. For each aluminum activation product, an equivalent aluminum thickness (EAT) in which its production rate is identical to its release rate into the coolant is determined. For the argon activation calculation, the saturated argon concentration in the water at the temperature of the pool surface is assumed. The EATs are 5680, 266 and 1.2 nm, respectively, for Na-24, Mg-27 and Al-28, which are much larger than the flight lengths of the respective recoil nuclides. These values coincide with the water solubility levels and with the half-lives. The EAT for Na-24 is similar to the average oxide layer thickness (OLT) of fuel cladding as well; hence, the majority of them in the oxide layer may be released to the coolant. However, while the average OLT clearly increases with the fuel burn-up during an operation cycle, its effect on the pool-top radiation is not distinguishable. The source of Ar-41 is in good agreement with the calculated reaction rate of Ar-40 dissolved in the coolant

  10. The impact of everolimus on renal function in maintenance liver transplantation. (United States)

    De Simone, P; Precisi, A; Petruccelli, S; Balzano, E; Carrai, P; Catalano, G; Campani, D; Filipponi, F


    We retrospectively investigated the impact on renal function (RF) of conversion from calcineurin inhibitors (CNI) to everolimus (EVL) monotherapy in orthotopic liver transplant (OLT) recipients. Between January 2006 and July 2007, 70 deceased donor OLT recipients including 51 men and 19 women of overall mean age of 55.9 +/- 11 years were enrolled into a program of conversion to EVL monotherapy at a mean interval of 45 +/- 35.9 months from transplantation (range, 7-192 months). The indication for conversion was deteriorating RF in 64 (91.4%). Efficacy failure was defined as the persistence of CNI, EVL discontinuation, death, graft loss, loss to follow-up, or need for dialysis at 12 months. Twelve months after switching, 53 patients (75.7%) were on EVL monotherapy. Their mean change in creatinine clearance (CrCl) from baseline (day 1 before EVL introduction) to endpoint (12 months) was 5.8 +/- 13.1 mL/min. On univariate and multivariate analyses, the clinical variable correlated with the greatest probability of improvement was the baseline CrCl (P EVL monotherapy was successful in 75.7% of cases with improvement in RF correlated with baseline CrCl. These data supported preemptive minimization of CNI in the posttransplant course, seeking to delay the decline in RF.

  11. Integrated coding-aware intra-ONU scheduling for passive optical networks with inter-ONU traffic (United States)

    Li, Yan; Dai, Shifang; Wu, Weiwei


    Recently, with the soaring of traffic among optical network units (ONUs), network coding (NC) is becoming an appealing technique for improving the performance of passive optical networks (PONs) with such inter-ONU traffic. However, in the existed NC-based PONs, NC can only be implemented by buffering inter-ONU traffic at the optical line terminal (OLT) to wait for the establishment of coding condition, such passive uncertain waiting severely limits the effect of NC technique. In this paper, we will study integrated coding-aware intra-ONU scheduling in which the scheduling of inter-ONU traffic within each ONU will be undertaken by the OLT to actively facilitate the forming of coding inter-ONU traffic based on the global inter-ONU traffic distribution, and then the performance of PONs with inter-ONU traffic can be significantly improved. We firstly design two report message patterns and an inter-ONU traffic transmission framework as the basis for the integrated coding-aware intra-ONU scheduling. Three specific scheduling strategies are then proposed for adapting diverse global inter-ONU traffic distributions. The effectiveness of the work is finally evaluated by both theoretical analysis and simulations.


    Directory of Open Access Journals (Sweden)

    Alexandru Dimache


    Full Text Available Gerai Pond is one of the last natural wetlands along the Danube, being connected to natural flooding regime of the Danube and is situated at the confluence of the Danube River, between Gârcov and Islaz localities, in Olt County. Aquatic vegetation characteristic is a favorable habitat for two species of conservation concern that nest along the Danube: red duck and pygmy cormorant. During 1961-1970, Gerai Pond has changed radically due to impoundment and draining under the program of drainage and flood meadow regulate of the Danube. These works of land reclamation for decreasing surface lakes and wetlands and water stagnation period, had reduced the breeding areas of the two species mentioned above. Ecological reconstruction of Gerai Pond project was conducted by Technical University of Civil Engineering of Bucharest in collaboration with E.P.A. Olt and W.W.F.-Romania. The project was based on a hydrological study (which included a component related to flooding for the area analyzed, study in which were highlighted the areas which have water access to and from the Pond, surfaces and volumes of water corresponding to different rates, the optimal level of water for restoration of the nesting area. Based on this study were identified the areas of artificial feed-water discharge to and from the Danube. This paper presents the possible solutions for ecological reconstruction of Gerai Pond, identified in the project.

  13. Liver transplant-related anastomotic biliary strictures: a novel, rapid, safe, radiation-sparing, and cost-effective management approach. (United States)

    Barakat, Monique T; Huang, Robert J; Thosani, Nirav C; Choudhary, Abhishek; Girotra, Mohit; Banerjee, Subhas


    Biliary strictures after orthotopic liver transplantation (OLT) are typically managed by sequential ERCP procedures, with incremental dilation of the stricture and stent exchange (IDSE) and placement of new stents. This approach resolves >80% of strictures after 12 months but requires costly, lengthy ERCPs with significant patient radiation exposure. Increasing awareness of the harmful effects of radiation, escalating healthcare costs, and decreasing reimbursement for procedures mandate maximal efficiency in performing ERCP. We compared the traditional IDSE protocol with a sequential stent addition (SSA) protocol, in which additional stents are placed across the stricture during sequential ERCPs, without stent removal/exchange or stricture dilation. Patients undergoing ERCP for OLT-related anastomotic strictures from 2010 to 2016 were identified from a prospectively maintained endoscopy database. Procedure duration, fluoroscopy time, stricture resolution rates, adverse events, materials fees, and facility fees were analyzed for IDSE and SSA procedures. Seventy-seven patients underwent 277 IDSE and 132 SSA procedures. Mean fluoroscopy time was 64.5% shorter (P 95%, and low adverse event rates did not significantly differ. SSA results in shorter, cost-effective procedures requiring fewer accessory devices and exposing patients to less radiation. Stricture resolution rates are equivalent to IDSE, and adverse events do not differ significantly, even in this immunocompromised population. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  14. De-optical-line-terminal hybrid access-aggregation optical network for time-sensitive services based on software-defined networking orchestration (United States)

    Bai, Wei; Yang, Hui; Xiao, Hongyun; Yu, Ao; He, Linkuan; Zhang, Jie; Li, Zhen; Du, Yi


    With the increase in varieties of services in network, time-sensitive services (TSSs) appear and bring forward an impending need for delay performance. Ultralow-latency communication has become one of the important development goals for many scenarios in the coming 5G era (e.g., robotics and driverless cars). However, the conventional methods, which decrease delay by promoting the available resources and the network transmission speed, have limited effect; a new breakthrough for ultralow-latency communication is necessary. We propose a de-optical-line-terminal (De-OLT) hybrid access-aggregation optical network (DAON) for TSS based on software-defined networking (SDN) orchestration. In this network, low-latency all-optical communication based on optical burst switching can be achieved by removing OLT. For supporting this network and guaranteeing the quality of service for TSSs, we design SDN-driven control method and service provision method. Numerical results demonstrate the proposed DAON promotes network service efficiency and avoids traffic congestion.

  15. A novel IPTV program multiplex access system to EPON (United States)

    Xu, Xian; Liu, Deming; He, Wei; Lu, Xi


    With the rapid development of high speed networks, such as Ethernet Passive Optical Network (EPON), traffic patterns in access networks have evolved from traditional text-oriented service to the mixed text-, voice- and video- based services, leading to so called "Triple Play". For supporting IPTV service in EPON access network infrastructure, in this article we propose a novel IPTV program multiplex access system to EPON, which enables multiple IPTV program source servers to seamlessly access to IPTV service access port of optical line terminal (OLT) in EPON. There are two multiplex schemes, namely static multiplex scheme and dynamic multiplex scheme, in implementing the program multiplexing. Static multiplex scheme is to multiplex all the IPTV programs and forward them to the OLT, regardless of the need of end-users. While dynamic multiplex scheme can dynamically multiplex and forward IPTV programs according to what the end-users actually demand and those watched by no end-user would not be multiplexed. By comparing these two schemes, a reduced traffic of EPON can be achieved by using dynamic multiplex scheme, especially when most end-users are watching the same few IPTV programs. Both schemes are implemented in our system, with their hardware and software designs described.

  16. Lack of Clinical Relevance of ANA and ASMA Positivity in Patients with Liver Transplantation without a History of Autoimmune Diseases. (United States)

    Pellegrini, Lucienne; Parrilli, Gianpaolo; Santonicola, Antonella; Cinquanta, Luigi; Caputo, Cesare; Ciacci, Carolina; Zingone, Fabiana


    The relevance of isolated autoimmunity elevation in orthotopic liver transplantation (OLT) patients is unknown. Our aim was to analyse how serum autoantibodies change in time and to evaluate their clinical relevance in OLT patients. Patients were invited to provide samples to evaluate ANA, AMA, ASMA, and LKM at the time of enrolment ( T 0), after 6 months ( T 6), and after 12 months ( T 12). We included 114 patients in the study (76% males, median age 62.5 years), finding isolated elevation of at least one serum antibody in up to 80% of them. We described fluctuating positive autoantibodies in the one year of observation, with only 45.6% of patients positive for ANA and less than 2% positive for ASMA, at all three times. Isolated elevation of tissue antibodies was not related to gender, age, HCC at transplant, early rejection, cause of transplantation, immunotherapy taken, and age at the time of the study. We did not detect a higher prevalence of positive autoimmunity in patients with signs of liver injury. ANA and ASMA evaluation in patients with liver transplantation and no history of autoimmune disease has no clinical relevance, since it varies in time and is not related to any risk factors or liver injury. Routine autoimmunity evaluation should be avoided.

  17. The effect of basolateral amygdala nucleus lesion on memory under acute,mid and chronic stress in male rats. (United States)

    Ranjbar, Hoda; Radahmadi, Maryam; Alaei, Hojjatallah; Reisi, Parham; Karimi, Sara


    The basolateral amygdala (BLA) modulates memory for emotional events and is involved in both stress and memory. This study investigated different durations of stress and the role of BLA on serum corticosterone level and spatial and cognitive memory. Different durations of stress (acute, mid, and chronic stress), with and without BLA lesion were induced in rats by 6 h/day restraint stress for 1, 7, and 21 days. Memory functions were evaluated by novel object recognition (NOR) and object location test (OLT). The OLT findings showed locomotor activity and spatial memory slightly decreased with different durations of stress. The NOR findings significantly showed locomotor activity impairment in different durations of stress. Cognitive memory deficit was observed in mid stress. The corticosterone level significantly increased in the mid and chronic stress groups. Moreover, the mid stress was the strongest stress condition. There is a possibility that different stress durations act by different mechanisms. The recognition of a novel location decreased in all lesion groups. It was more severe in the NOR. The BLA lesion significantly decreased corticosterone level in the mid and chronic stress groups compared to similar groups without lesion. The BLA lesion caused more damage to cognitive than spatial memory in stressed groups.

  18. Automatic delineation of a watershed using a DEM. Case study – The Oltet watershed

    Directory of Open Access Journals (Sweden)

    Andreea ZAMFIR


    Full Text Available This paper aims to present some solutions for automatic delineation of a watershed. In order to find this study’s applicability in the geographical reality, we decided that the river whose watershed will be delineated to be Oltet river. Automatic delineation of the Olteţ watershed was carried out comparatively, using two softwares, ArcGIS Desktop 9.3 andQuantum GIS 1.7.0 Wroclaw, and it based on a SRTM digital elevation model of 90 m. After using GIS techniques, there have resulted two maps showing the boundary of theOlteţ watershed. By overlapping the resulted maps, obtained with ArcGIS and QGIS, we found some small differences generated by the different way of working of each softwareinvolved in this study. We have also calculated a circularity coefficient for the Oltet watershed and the value obtained supports its elongated form and all the implication of it.

  19. Histone H1 vaccine therapy for overcoming acute rejection in experimental organ transplantation. (United States)

    Nakano, T; Ono, K; Goto, S; Lai, C-Y; Hsu, L-W; Kawamoto, S; Lin, Y-C; Kao, Y-H; Chiang, K-C; Ohmori, N; Goto, T; Sato, S; Jawan, B; Cheng, Y-F; Chen, C-L


    In a rat tolerogenic orthotopic liver transplantation (OLT) model, the recipient serum (post-OLT serum) shows strong immunosuppressive activity. In our previous reports, we suggested that autoreactive antibody (Ab) against histone H1 is a major immunosuppressive factor in this serum. The present study sought to determine whether up-regulation of anti-histone H1 Ab by histone H1 vaccination led to tolerance. Using mixed lymphocyte reactions (MLR) and heterotopic heart transplantations (HHT), the alloreactive T-cell responses and allograft survivals of histone H1-immunized rats were compared with those of control rats. Cytokine and cellular profiles were determined by enzyme-linked immunosorbent assay (ELISA) and flow cytometry. The alloreactive T-cell response of histone H1-immunized rats was significantly lower than that of control rats, although there was no difference in nonspecific T-cell activation between the 2 groups. The allograft survival of histone H1-immunized rats was significantly prolonged after HHT. The major histocompatibility complex (MHC) class II and CD25 molecules of histone H1-immunized rats were significantly down-regulated compared with those of control rats. Moreover, the serum cytokine profile was modified by the immunization with histone H1. These results suggest that histone H1 vaccination of transplant recipients leads to the production of immunosuppressive factors and the modification of cytokine/cellular profiles.

  20. Communication Network Architectures Based on Ethernet Passive Optical Network for Offshore Wind Power Farms

    Directory of Open Access Journals (Sweden)

    Mohamed A. Ahmed


    Full Text Available Nowadays, with large-scale offshore wind power farms (WPFs becoming a reality, more efforts are needed to maintain a reliable communication network for WPF monitoring. Deployment topologies, redundancy, and network availability are the main items to enhance the communication reliability between wind turbines (WTs and control centers. Traditional communication networks for monitoring and control (i.e., supervisory control and data acquisition (SCADA systems using switched gigabit Ethernet will not be sufficient for the huge amount of data passing through the network. In this paper, the optical power budget, optical path loss, reliability, and network cost of the proposed Ethernet Passive Optical Network (EPON-based communication network for small-size offshore WPFs have been evaluated for five different network architectures. The proposed network model consists of an optical network unit device (ONU deployed on the WT side for collecting data from different internal networks. All ONUs from different WTs are connected to a central optical line terminal (OLT, placed in the control center. There are no active electronic elements used between the ONUs and the OLT, which reduces the costs and complexity of maintenance and deployment. As fiber access networks without any protection are characterized by poor reliability, three different protection schemes have been configured, explained, and discussed. Considering the cost of network components, the total implementation expense of different architectures with, or without, protection have been calculated and compared. The proposed network model can significantly contribute to the communication network architecture for next generation WPFs.

  1. Impact of non-anastomotic biliary strictures after liver transplantation on healthcare consumption, use of ionizing radiation and infectious events. (United States)

    de Vries, A Boudewijn; Koornstra, Jan J; Lo Ten Foe, Jerome R; Porte, Robert J; van den Berg, Aad P; Blokzijl, Hans; Verdonk, Robert C


    Non-anastomotic biliary strictures (NAS) after orthotopic liver transplantation (OLT) have a negative influence on graft survival. Expert opinion suggests a negative effect of NAS on other important aspects of post-transplant care, although its impact is largely unknown as data are scarce. This retrospective single center study analyzed data on healthcare consumption, use of ionizing radiation, infectious complications and development of highly resistant microorganisms (HRMO) in adult patients with NAS. A comparison with a matched control group was made. Forty-three liver recipients with NAS and 43 controls were included. Hospital admissions were higher in patients with NAS. Most common reason for admission was bacterial cholangitis (BC), with 70% of the patients having at least one episode compared to 9% in the control group. In patients with NAS, 67% received at least one ERCP compared to 21% in the control group (p = 0.001). This resulted in a larger yearly received radiation dose for patients with NAS (p = 0.001). Frequency of intravenous antibiotic therapy was higher (p = 0.001) for patients with NAS, consistently resulting in a higher number of cultures found with HRMO (p = 0.012). NAS after OLT have a negative effect on post-transplant care, increasing readmission rates, interventional procedures, exposure to ionizing radiation, use of antibiotics, and development of HRMO. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Overflow control mechanism (OCM) for Ethernet passive optical networks (EPONs) (United States)

    Hajduczenia, Marek; da Silva, Henrique J. A.; Monteiro, Paulo P.


    The nonfragmentable nature of Ethernet data frames, as well as operation of the priority oriented packet schedulers in the optical network units, in conjunction with heavy network load conditions and the lack of detailed knowledge about the queue's composition at the optical line terminal (OLT) level, result in the creation of upstream channel slot remainders. The existing methods, in the form of nonpreemptive packet schedulers and multithreshold reporting process defined vaguely by the IEEE 802.3-2005 standard, result in either increased packet delay or Ethernet passive optical network (EPON) system incompatibility, respectively, since threshold processing was never officially defined in the scope of the respective EPON standard. We propose an alternative approach, based on basic modifications of the standard and extended GATE multipoint control protocol data unit format and meaning, allowing for the OLT packet scheduling agent to grant always exactly the requested slot size, thus preventing creation of any upstream channel slot remainders. It is estimated that, on average, ˜3% of upstream channel bandwidth can be salvaged when slot remainders are absent in the upstream channel transmission.

  3. Surgical treatment of biliary tract complications after liver transplantation. (United States)

    Lladó, L; Fabregat, J; Baliellas, C; Gonzalez-Castillo, A; Ramos, E; Gonzalez-Vilatarsana, E; Torras, J; Rafecas, A


    Biliary strictures are the most common biliary tract complication after liver transplantation. There are scarce data on the results of hepaticojejunostomy (HJ) in the management of biliary complications after orthotopic liver transplantation (OLT). Thus, the role of surgery in this setting remains to be established. The aim of this study was to evaluate the results of surgical treatment of patients with biliary complications at our institution. We reviewed 1000 consecutive liver transplantations performed at our institution from 1984 to 2007. We used a prospectively recorded database to identify patients who underwent HJ to treat any biliary tract complication. Overall, 62 patients (6.2%) underwent HJ, 40 for an anastomotic and 7 for a non-anastomotic stricture as well as 15 for biliary leaks. Postoperative morbidity was 16%, and postoperative mortality 1.6%. There were 7 cases of anastomotic stenosis (11.3%). Four patients (5%) required retransplantation. HJ is a safe procedure to manage biliary complications after OLT. It may be the first treatment choice especially for cases with anastomotic strictures. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Intravenous spiral CT angiography for assessment before orthotopic liver transplantation: Comparison between tomography, MIP, 3-dimensional surface imaging and intraarterial DSA; Intravenoese Spiral-CT-Angiographie zur Evaluation vor orthotoper Lebertransplantation: Vergleiche zwischen Schnittbilddarstellung, MIP, dreidimensionaler Oberflaechendarstellung und intraarterieller DSA

    Energy Technology Data Exchange (ETDEWEB)

    Hidajat, N. [Medizinische Fakultaet der Humboldt-Univ., Berlin (Germany). Strahlenklinik und Poliklinik; Vogl, T.J. [Medizinische Fakultaet der Humboldt-Univ., Berlin (Germany). Strahlenklinik und Poliklinik; Moeller, M. [Medizinische Fakultaet der Humboldt-Univ., Berlin (Germany). Strahlenklinik und Poliklinik; Bechstein, W.O. [Medizinische Fakultaet der Humboldt-Univ., Berlin (Germany). Klinik und Poliklinik fuer Allgemein- und Transplantationschirurgie; Felix, R. [Medizinische Fakultaet der Humboldt-Univ., Berlin (Germany). Strahlenklinik und Poliklinik


    Purpose: To analyse the efficacy of intravenous spiral CT angiography (SCTA) for the evaluation before orthotopic liver transplantation (oLT) compared with DSA. Methods: Spiral CT was performed on 31 potential recipients of a liver graft in order to examine hepatic vessels, coeliac axis, splenic artery and superior mesenteric artery. The arterial vessels were reconstructed in `Maximum Intensity Projection (MIP)` and `Shaded Surface Display (SSD)`-technique. The axial images, MIP and SSD were compared in 25 patients with DSA with regard to the visualisation of the vascular anatomy, detectability of stenosis and vascular diameters. Results: The type of arterial liver supply could be determined via SCTA in all patients. Stenosis of the coeliac axis was seen in ten patients on the DSA, MIP and SSD and in eight patients on the axial images. Occlusion of the hepatic artery was clearly visualised in two patients on the DSA, axial images and MIP and in one patient on the SSD. There was no false positive diagnosis with SCTA. SSD was seen as the best technique to visualise the vessels without overshadowing. There were no significant differences between the diamters measured from the axial images, MIP and SSD images in transversal direction and the DSA images (p>0.05). Conclusion: SCTA is a greatly promising method for the imaging of vessels supplying the liver before oLT, and may convey more diagnostic information than DSA. (orig.) [Deutsch] Ziel: Bewertung der Einsetzbarkeit in intravenoesen Spiral-CT-Angiographie (SCTA) zur Evaluation vor orthotoper Lebertransplantation (oLT) im Vergleich zur DSA. Methoden: Es wurde bei 31 Patienten vor moeglicher oLT eine SCTA der Lebergefaesse einschliesslich des Truncus coeliacus, der A. lienalis und A. mesenterica superior durchgefuehrt. Die arteriellen Gefaesse wurden mittels `Maximum-Intensitaets-Projektion (MIP)`- und `Oberflaechenschattierungs(SSD)`-Technik rekonstruiert. Die Schnittbilder, MIP und SSD, wurden bei 25 Patienten

  5. Natural radioactivity in stream sediments of Oltet River, Romania (United States)

    Ion, Adriana


    The concentration of naturally occurring radionuclides (U-238, Th-232 and K-40) in stream sediments of the Oltet River was measured in order to establish the primary sources of radionuclides, the transport pathways and the geochemical factors favouring their mobilisation and concentration in the existing geological context. The Oltet River has a length of 185 Km and crosses the southern central part of the country, being the right tributary of the Olt River. The range in elevation of the watercourse varies between 1963 m in the springs area (Parîng Mountains) and 200 m at the confluence with the Olt River, whereas the relief of the Oltet Basin has a varied character, manifested by the presence of diverse forms of relief, starting with major mountainous heights and ending with low-lying plains regions. In cross section from North to South, the Olteț River cuts metamorphic rocks (schist, gneisses, quartzite, marble, mica-schist's), magmatic rocks (granite and granitoid massifs - intruded by veins of microgranite, aplite, pegmatite and lamprophyre) and limestone, followed by deposits composed of clays, marls, sands and gravels, that are characterized by the presence of lignite seams. 44 stream sediment samples were collected in summer of 2016 from sampling points distributed along the river with an equidistance of about 4 - 5 km. The activity concentrations of the U-238, Th-232 and K-40 were measured by gamma ray spectrometry using HPGe detector (ORTEC) with 26% relative efficiency in multilayer shielding. The reference materials used were IAEA - RGK-1 and IAEA - 314. Analysis was performed on the chemical decomposition. In the middle part of the river as result of almost abrupt passage between mountain and hilly terrains increases and concentration of radionuclides; effect of large quantities of clastic material deposited by torrents. The mechanical migration of resistant uranium, thorium and potassium bearing mineral determines the movement of rock particles under

  6. Early-Life Stress Does Not Aggravate Spatial Memory or the Process of Hippocampal Neurogenesis in Adult and Middle-Aged APP/PS1 Mice

    Directory of Open Access Journals (Sweden)

    Lianne Hoeijmakers


    Full Text Available Life-time experiences are thought to influence the risk to develop the neurodegenerative disorder Alzheimer’s disease (AD. In particular, early-life stress (ES may modulate the onset and progression of AD. There is recent evidence by our group and others that AD-related neuropathological progression and the associated neuroimmune responses are modulated by ES in the classic APPswe/PS1dE9 mouse model for AD. We here extend our previous study on ES mediated modulation of neuropathology and neuroinflammation and address in the same cohort of mice whether ES accelerates and/or aggravates AD-induced cognitive decline and alterations in the process of adult hippocampal neurogenesis (AHN, a form of brain plasticity. Chronic ES was induced by limiting bedding and nesting material during the first postnatal week and is known to induce cognitive deficits by 4 months in wild type (WT mice. The onset of cognitive decline in APP/PS1 mice generally starts around 6 months of age. We here tested mice at ages 2–4 months to study acceleration and at ages 8–10 months for aggravation of the APP/PS1 phenotype. ES-exposed WT and APP/PS1 mice were able to perform the object recognition (ORT and location tasks (OLT at 2 months of age. Interestingly, at 3 months, ES induced impairments in the performance of the OLT in WT, but not in APP/PS1 mice. APP/PS1 mice exhibited alterations in hippocampal cell proliferation and differentiation, but ES exposure did not further change this. At 9 months, APP/PS1 mice exhibited impaired performance in the Morris Water Maze (MWM task, as well as reductions in markers of the AHN process, which were not further modulated by ES exposure. In addition, we observed a so far unreported hyperactivity in ES-exposed mice at 8 months of age, which hampered assessment of cognitive functions in the ORT and OLT. In conclusion, while ES has been reported to modulate AD neuropathology and neuroinflammation before, it failed to accelerate or

  7. Survival after liver transplantation in cirrhotic patients with and without hepatocellular carcinoma: a comparative study. (United States)

    Figueras, J; Jaurrieta, E; Valls, C; Benasco, C; Rafecas, A; Xiol, X; Fabregat, J; Casanovas, T; Torras, J; Baliellas, C; Ibañez, L; Moreno, P; Casais, L


    Cumulative recurrence after surgical resection for hepatocellular carcinoma (HCC) is very high. Several retrospective analyses have shown that liver transplantation was more effective than resection for patients with HCC at early tumor stages. Consequently, in January 1990, we decided to prospectively indicate orthotopic liver transplantation (OLT) as the first surgical treatment for small, localized HCC in cirrhotic patients without nodal involvement independently of the degree of liver function. The aim of this prospective cohort study was to analyze prognosis, recurrence rate, and survival after liver transplantation in patients in whom the main indication was HCC with cirrhosis. Thirty-eight patients in whom the main indication for liver transplantation was HCC and hepatic cirrhosis were compared with 136 transplantations because of cirrhosis without tumor, performed in our unit from January 1990 to December 1995. HCC arising in noncirrhotic livers and those incidently discovered after OLT were excluded from the study. Chemoembolization using doxorubicin, lipiodol, and Gelfoam was performed before OLT in 31 patients with good liver function. There were no differences in gender, but HCC patients were older (57 +/- 7 vs. 50 +/- 10 years [P < .001]). Liver function was better in HCC (Child-Pugh score: 6.9 +/- 2 vs. 8.6 +/- 1.8; P < .001), and hepatitis C virus antibody was positive in 31 (82%) vs. 51 (37%) (P < .007). Seven tumors had bilobar involvement (18%). Capsule was present in 22 (58%). The mean size of the tumor was 3.4 +/- 2 cm. Seventeen tumors (45%) were larger than 3 cm, and 4 (11%) were larger than 5 cm. The average number of nodules was 2 +/- 1. The tumor-node-metastasis stage of the tumors was pT1 in 6 patients (16%), 11 were pT2 (29%), 12 were pT3 (31%), and 9 were pT4 (24%). Seven patients were retransplanted in the HCC group (18%) and 19 (14%) in the nontumor group (not significant). Tumor recurrence was detected in three patients (8%). One, 3

  8. Mastimännid ja muu mets : mitmekülgsuse võlu Eesti proosast aastal 2007 / Sirje Olesk

    Index Scriptorium Estoniae

    Olesk, Sirje, 1954-


    Ülevaade 2007. aasta eesti proosast. Käsitletakse järgimisi autoreid ja nende teoseid: Ene Mihkelson "Katkuhaud", Andrus Kivirähk "Mees, kes teadis ussisõnu", Jaan Kaplinski "Seesama jõgi", Tõnu Õnnepalu "Flandria päevik", Toomas Vint "Mäluauguga naine", Indrek Hargla "French ja Koulu Tarbatus", Kalle Käsper "Buridanid IV", Jaan Tooming "Teekond mäe südamesse", Ustav Mikelsaar "Tunnimehed", Henn Mikelsaar "Teema variatsioonidega", Reet Kudu "Pidupäevad võõrsil", Mara Maret Aronovich "Tagasikäiguga edasi", Aimée Beekman "Proovielu", Valentine Nõlvak "Ellujääja : mälestused", Mehis Heinsaar "Rändaja õnn", Maimu Berg "Unustatud inimesed", Mats Traat "Sarviku armastus : valik kultuuriloolisi novelle", Mihkel Mutt "Siseemigrant : novellid Rui taevalike kommentaaridega", Paavo Kivine "Kaks kavaleri", Kärt Hellerma "Ma armastasin David Copperfieldi", Piret Bristol "Paralleelmeri", Imre Siil "Mereröövlite loss", Kalju Saaber "Issanda loomaaed. Viru sektor", Veiko Märka "Lendas üle marmortahvli", Vahur Afanasjev "Kaadrid otsustavad, ehk, Sööbik ja Pisik seiklevad jälle, ehk, Eesti rahva lühike, kuid õnnelik ajalugu, Ehk kirjalik komejant tühjusest", Aarne Ruuben "Lugusid Anveltist ja Kingissepast", Epp Annus "Sina, Matilda", Peeter Helme "Puudutus", Ivar Sild "Tantsiv linn", Tui Hirv "Tähe tänav. Per musica ad astra", Tiina Laanem "Väikesed vanamehed", Angela Hofberg (pseud.) "Päev nagu elu", Marion Andra "Vähemalt...", Olle Lauli "Niguliste õpilased", Aarne Biin "Linna valitsemine", Erik Tohvri "Mürgiliblikas", Riina Kangur "Elisa", Kerttu Rakke "Küpsiseparadiis", Epp Petrone ja Dagmar Reintam "Õun ära süüa?", Elme Väljaste "Päriselu Proletariaadi puiesteel", Ketlin Priilinn "Hõbeingel", Ira Lember "Kohvik pärnade all", Paul Pajos "Krimijutud edasijõudnuile", Andres Anvelt "Punane elavhõbe", Klaara ja Kaarel Kivi "Mõrvasügis", Tiit Sepa "Hommik ühele", Lembit Uustulnd "Ruutuemanda sündroom : rahvusvaheline

  9. (LBA-and-WRM)-based DBA scheme for multi-wavelength upstream transmission supporting 10 Gbps and 1 Gbps in MAN (United States)

    Zhang, Yuchao; Gan, Chaoqin; Gou, Kaiyu; Xu, Anni; Ma, Jiamin


    DBA scheme based on Load balance algorithm (LBA) and wavelength recycle mechanism (WRM) for multi-wavelength upstream transmission is proposed in this paper. According to 1 Gbps and 10 Gbps line rates, ONUs are grouped into different VPONs. To facilitate wavelength management, resource pool is proposed to record wavelength state. To realize quantitative analysis, a mathematical model describing metro-access network (MAN) environment is presented. To 10G-EPON upstream, load balance algorithm is designed to ensure load distribution fairness for 10G-OLTs. To 1G-EPON upstream, wavelength recycle mechanism is designed to share remained wavelengths. Finally, the effectiveness of the proposed scheme is demonstrated by simulation and analysis.

  10. Bandwidth efficient bidirectional 5 Gb/s overlapped-SCM WDM PON with electronic equalization and forward-error correction. (United States)

    Buset, Jonathan M; El-Sahn, Ziad A; Plant, David V


    We demonstrate an improved overlapped-subcarrier multiplexed (O-SCM) WDM PON architecture transmitting over a single feeder using cost sensitive intensity modulation/direct detection transceivers, data re-modulation and simple electronics. Incorporating electronic equalization and Reed-Solomon forward-error correction codes helps to overcome the bandwidth limitation of a remotely seeded reflective semiconductor optical amplifier (RSOA)-based ONU transmitter. The O-SCM architecture yields greater spectral efficiency and higher bit rates than many other SCM techniques while maintaining resilience to upstream impairments. We demonstrate full-duplex 5 Gb/s transmission over 20 km and analyze BER performance as a function of transmitted and received power. The architecture provides flexibility to network operators by relaxing common design constraints and enabling full-duplex operation at BER ∼ 10(-10) over a wide range of OLT launch powers from 3.5 to 8 dBm.

  11. PAM4 based symmetrical 112-Gbps long-reach TWDM-PON (United States)

    Wu, Liyu; Gao, Fan; Zhang, Minming; Fu, Songnian; Deng, Lei; Choi, Michael; Chang, Donald; Lei, Gordon K. P.; Liu, Deming


    We experimentally demonstrate cost effective symmetrical 112-Gbps long-reach passive optical network (LR-PON) over 70-km standard signal mode fiber (SSMF), based on pulse amplitude modulation (PAM)-4. Four 10G-class directly modulated lasers (DMLs) at C-band are used for achieving 4 × 28-Gbps downstream transmission, while two 18G-class DMLs at O-band are used to realize 2 × 56-Gbps upstream transmission, without any optical amplification in optical distributed network (ODN). Both dispersion compensation fiber (DCF) for downstream signal and praseodymium-doped fiber amplifier (PDFA) for upstream signal are equipped at optical line terminal (OLT). Meanwhile, sparse Volterra filter (SVF) equalizer is proposed to mitigate the transmission impairments with substantial reduction of computation complexity. Finally, we can successfully provide a loss budget of 33 dB per downstream wavelength channel, indicating of 64 optical network units (ONUs) with more than 1.25 Gbps per ONU.

  12. Sleep-time sizing and scheduling in green passive optical networks

    KAUST Repository

    Elrasad, Amr


    Next-generation passive optical network (PON) has been widely considered as a cost-effective broadband access technology. With the ever-increasing power saving concern, energy efficiency has been an important issue for its operations. In this paper, we present a novel sleep time sizing and scheduling framework that satisfies power efficient bandwidth allocation in PONs. We consider the downstream links from an optical line terminal (OLT) to an optical network unit (ONU). The ONU has two classes of traffic, control and data. Control traffic are delay intolerant with higher priority than the data traffic. Closed form model for average ONU sleeping time and end-to-end data traffic delay are presented and evaluated. Our framework decouples the dependency between ONU sleeping time and the QoS of the traffic.

  13. Suppression of optical beat interference-noise in orthogonal frequency division multiple access-passive optical network link using self-homodyne balanced detection (United States)

    Won, Yong-Yuk; Jung, Sang-Min; Han, Sang-Kook


    A new technique, which reduces optical beat interference (OBI) noise in orthogonal frequency division multiple access-passive optical network (OFDMA-PON) links, is proposed. A self-homodyne balanced detection, which uses a single laser for the optical line terminal (OLT) as well as for the optical network unit (ONU), reduces OBI noise and also improves the signal to noise ratio (SNR) of the discrete multi-tone (DMT) signal. The proposed scheme is verified by transmitting quadrature phase shift keying (QPSK)-modulated DMT signal over a 20-km single mode fiber. The optical signal to noise ratio (OSNR), that is required for BER of 10-5, is reduced by 2 dB in the balanced detection compared with a single channel due to the cancellation of OBI noise in conjunction with the local laser.

  14. 1.25-3.125 Gb/s per user PON with RSOA as phase modulator for statistical wavelength ONU (United States)

    Chu, Guang Yong; Polo, Victor; Lerín, Adolfo; Tabares, Jeison; Cano, Iván N.; Prat, Josep


    We report a new scheme to support, cost efficiently, ultra-dense wavelength division multiplexing (UDWDM) for optical access networks. As validating experiment, we apply phase modulation of a reflective semiconductor optical amplifier (RSOA) at the ONU with a single DFB, and simplified coherent receiver at OLT for upstream. We extend the limited 3-dB modulation bandwidth of available uncooled To-can packaged RSOA (~400 MHz) and operate it at 3.125 Gb/s with the optimal performance for phase modulation using small and large signal measurement characteristics. The optimal condition is selected at input power of 0 dBm, with 70 mA bias condition. The sensitivities at 3.125 Gb/s (at BER=10-3) for heterodyne and intradyne detection reach -34.3 dBm and -38.8 dBm, respectively.

  15. Energy-efficient orthogonal frequency division multiplexing-based passive optical network based on adaptive sleep-mode control and dynamic bandwidth allocation (United States)

    Zhang, Chongfu; Xiao, Nengwu; Chen, Chen; Yuan, Weicheng; Qiu, Kun


    We propose an energy-efficient orthogonal frequency division multiplexing-based passive optical network (OFDM-PON) using adaptive sleep-mode control and dynamic bandwidth allocation. In this scheme, a bidirectional-centralized algorithm named the receiver and transmitter accurate sleep control and dynamic bandwidth allocation (RTASC-DBA), which has an overall bandwidth scheduling policy, is employed to enhance the energy efficiency of the OFDM-PON. The RTASC-DBA algorithm is used in an optical line terminal (OLT) to control the sleep mode of an optical network unit (ONU) sleep and guarantee the quality of service of different services of the OFDM-PON. The obtained results show that, by using the proposed scheme, the average power consumption of the ONU is reduced by ˜40% when the normalized ONU load is less than 80%, compared with the average power consumption without using the proposed scheme.

  16. Performance analysis of cross-seeding WDM-PON system using transfer matrix method (United States)

    Simatupang, Joni Welman; Pukhrambam, Puspa Devi; Huang, Yen-Ru


    In this paper, a model based on the transfer matrix method is adopted to analyze the effects of Rayleigh backscattering and Fresnel multiple reflections on a cross-seeding WDM-PON system. As part of analytical approximation methods, this time-independent model is quite simple but very efficient when it is applied to various WDM-PON transmission systems, including the cross-seeding scheme. The cross seeding scheme is most beneficial for systems with low loop-back ONU gain or low reflection loss at the drop fiber for upstream data in bidirectional transmission. However for downstream data transmission, multiple reflections power could destroy the usefulness of the cross-seeding scheme when the reflectivity is high enough and the RN is positioned near OLT or close to ONU.

  17. Power Budget Analysis of Colorless Hybrid WDM/TDM-PON Scheme Using Downstream DPSK and Re-modulated Upstream OOK Data Signals (United States)

    Khan, Yousaf; Afridi, Muhammad Idrees; Khan, Ahmed Mudassir; Rehman, Waheed Ur; Khan, Jahanzeb


    Hybrid wavelength-division multiplexed/time-division multiplexed passive optical access networks (WDM/TDM-PONs) combine the advance features of both WDM and TDM PONs to provide a cost-effective access network solution. We demonstrate and analyze the transmission performances and power budget issues of a colorless hybrid WDM/TDM-PON scheme. A 10-Gb/s downstream differential phase shift keying (DPSK) and remodulated upstream on/off keying (OOK) data signals are transmitted over 25 km standard single mode fiber. Simulation results show error free transmission having adequate power margins in both downstream and upstream transmission, which prove the applicability of the proposed scheme to future passive optical access networks. The power budget confines both the PON splitting ratio and the distance between the Optical Line Terminal (OLT) and Optical Network Unit (ONU).

  18. Sliceable transponders for metro-access transmission links (United States)

    Wagner, C.; Madsen, P.; Spolitis, S.; Vegas Olmos, J. J.; Tafur Monroy, I.


    This paper presents a solution for upgrading optical access networks by reusing existing electronics or optical equipment: sliceable transponders using signal spectrum slicing and stitching back method after direct detection. This technique allows transmission of wide bandwidth signals from the service provider (OLT - optical line terminal) to the end user (ONU - optical network unit) over an optical distribution network (ODN) via low bandwidth equipment. We show simulation and experimental results for duobinary signaling of 1 Gbit/s and 10 Gbit/s waveforms. The number of slices is adjusted to match the lowest analog bandwidth of used electrical devices and scale from 2 slices to 10 slices. Results of experimental transmission show error free signal recovery by using post forward error correction with 7% overhead.

  19. A cost-effective WDM-PON architecture simultaneously supporting wired, wireless and optical VPN services (United States)

    Wu, Yanzhi; Ye, Tong; Zhang, Liang; Hu, Xiaofeng; Li, Xinwan; Su, Yikai


    It is believed that next-generation passive optical networks (PONs) are required to provide flexible and various services to users in a cost-effective way. To address this issue, for the first time, this paper proposes and demonstrates a novel wavelength-division-multiplexed PON (WDM-PON) architecture to simultaneously support three types of services: 1) wireless access traffic, 2) optical virtual passive network (VPN) communications, and 3) conventional wired services. In the optical line terminal (OLT), we use two cascaded Mach-Zehnder modulators (MZMs) on each wavelength channel to generate an optical carrier, and produce the wireless and the downstream traffic using the orthogonal modulation technique. In each optical network unit (ONU), the obtained optical carrier is modulated by a single MZM to provide the VPN and upstream communications. Consequently, the light sources in the ONUs are saved and the system cost is reduced. The feasibility of our proposal is experimentally and numerically verified.

  20. Review of Mechanical, Processing, and Immunologic Factors Associated With Outcomes of Fresh Osteochondral Allograft Transplantation of the Talus. (United States)

    Okeagu, Chikezie N; Baker, Erin A; Barreras, Nicholas A; Vaupel, Zachary M; Fortin, Paul T; Baker, Kevin C


    Osteochondral lesions of the talus (OLTs) are an increasingly implicated cause of ankle pain and instability. Several treatment methods exist with varying clinical outcomes. Due in part to successful osteochondral allografting (OCA) in other joints, such as the knee and shoulder, OCA has gained popularity as a treatment option, especially in the setting of large lesions. The clinical outcomes of talar OCA have been inconsistent relative to the positive results observed in other joints. Current literature regarding OCA failure focuses mainly on 3 factors: the effect of graft storage conditions on chondrocyte viability, graft/lesion size, and operative technique. Several preclinical studies have demonstrated the ability for bone and cartilage tissue to invoke an immune response, and a limited number of clinical studies have suggested that this response may have the potential to influence outcomes after transplantation. Further research is warranted to investigate the role of immunological mechanisms as an etiology of OCA failure. Level V, expert opinion.

  1. A Fast Channel Switching Method in EPON System for IPTV Service (United States)

    Nie, Yaling; Yoshiuchi, Hideya

    This paper presents a fast channel switching method in Ethernet Passive Optical Network (EPON) system for IPTV service. Fast channel switching is one of the important features of successful IPTV systems. Users surely prefer IPTV systems with small channel switching time rather than a longer one. Thus a channel switching control module and a channel/permission list in EPON system’s ONU or OLT is designed. When EPON system receives channel switching message from IPTV end user, the channel switching control module will catch the message and search the channel list and permission list maintained in EPON system, then got the matching parameter of EPON for the new channel. The new channel’s data transmission will be enabled by directly updating the optical filter of the ONU that end user connected. By using this method in EPON system, it provides a solution for dealing with channel switching delays in IPTV service.

  2. Simulation and Evaluation of Ethernet Passive Optical Network

    Directory of Open Access Journals (Sweden)

    Salah A. Jaro Alabady


    Full Text Available      This paper studies simulation and evaluation of Ethernet Passive Optical Network (EPON system, IEEE802.3ah based OPTISM 3.6 simulation program. The simulation program is used in this paper to build a typical ethernet passive optical network, and to evaluate the network performance when using the (1580, 1625 nm wavelength instead of (1310, 1490 nm that used in Optical Line Terminal (OLT and Optical Network Units (ONU's in system architecture of Ethernet passive optical network at different bit rate and different fiber optic length. The results showed enhancement in network performance by increase the number of nodes (subscribers connected to the network, increase the transmission distance, reduces the received power and reduces the Bit Error Rate (BER.   

  3. Evaluation of the Tellabs 1150 GPON multiservice access platform

    Energy Technology Data Exchange (ETDEWEB)

    Brenkosh, Joseph Peter [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Wolf, Jimmie V. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)


    For over two years, Sandia National Laboratories has been using a Gigabit Passive Optical Network (GPON) access layer for selected networks. The GPON equipment includes the Tellabs 1150 Multiservice Access Platform (MSAP) Optical Line Terminal (OLT), the Tellabs ONT709 and ONT709GP Optical Network Terminals (ONTs), and the Panorama PON Network Manager. In late 2013, the Tellabs equipment was updated to Software Release FP27.1_015130. Because a new software release has the potential to affect performance and functionality, it needed to be thoroughly tested. This report documents that testing. It also provides a comparison between the current release and the previous Software Release FP25.5.1_013274 that was being used.

  4. Increased availability of phosphoribosyl pyrophosphate as the basis for enhanced 6-mercaptopurine incorporation by methotrexate, in cultured human lymphoblasts

    International Nuclear Information System (INIS)

    Boekkerink, J.P.M.; de Abreu, R.A.; van Laarhoven, J.P.R.M.; Bakker, M.A.H.; Hulscher, T.W.; Schretlen, E.D.A.M.


    The authors examine the enhancement of 6 MP incorporation in MOLT 4 and Raji cells, pretreated with MTX. A schematic representation shows the inhibition of MTX on purine de novo synthesis. The block of MTX induces an elevation of PRPP levels. The result of the elevation of PRPP is an increased incorporation of 6MP to thio IMP and ultimately in DNA and RNA. The increased availability of pRPP, after pretreatment of mOLT 4 cells with MTX, can be used for enhanced incorporation of 6 MP. At incicated times after pretreatment with MTX, aliquots were taken and the cells were incubated during 20 minutes with 10 um 8-( 14 C)-6MP, and 100 um 8-( 14 C)-6MP, respectively. The enhanced invorporation of 6MP follows the increase of PRPP levels

  5. [Chemoembolization in the treatment of hepatocarcinoma]. (United States)

    Figueras, J; Valls, C; Pamies, J J; Benasco, C; Sancho, C; Rafecas, A; Domínguez, J; Torras, J; Fabregat, J; Baliellas, C


    Transcatheter arterial chemoembolization with lipiodol and adriamycin was performed in 46 patients with hepatocellular carcinoma (HCC). In 27, this procedure was followed by selective arterial embolization using gelatin sponge particles. Surgical resection was carried out in 5 cases and 13 patients were transplanted (OLT). The aim of the study was to analyze the survival and degree of tumor necrosis. In the nonsurgical group the overall survival was 67% after 24 months in the OKUDA I stage, 31% after 20 months in the OKUDA II stage and 25% after 6 months in the OKUDA III stage. For the patients who underwent surgery, survival was 38% after 20 months in 5 patients who were resected and 72% after 24 months in 13 patients who were transplanted. Transcatheter arterial chemoembolization improves survival in patients who are not operated on, and can be used as a complementary treatment for patients who undergo surgery. A full tumor necrosis was observed in well encapsulated tumors.

  6. Hierarchy Bayesian model based services awareness of high-speed optical access networks (United States)

    Bai, Hui-feng


    As the speed of optical access networks soars with ever increasing multiple services, the service-supporting ability of optical access networks suffers greatly from the shortage of service awareness. Aiming to solve this problem, a hierarchy Bayesian model based services awareness mechanism is proposed for high-speed optical access networks. This approach builds a so-called hierarchy Bayesian model, according to the structure of typical optical access networks. Moreover, the proposed scheme is able to conduct simple services awareness operation in each optical network unit (ONU) and to perform complex services awareness from the whole view of system in optical line terminal (OLT). Simulation results show that the proposed scheme is able to achieve better quality of services (QoS), in terms of packet loss rate and time delay.

  7. Variations of intracavitary applicator geometry during multiple HDR brachytherapy insertions in carcinoma cervix and its influence on reporting as per ICRU report 38

    International Nuclear Information System (INIS)

    Datta, Niloy Ranjan; Kumar, Shaleen; Das, Koilpillai Joseph Maria; Pandey, Chandra Mani; Halder, Shikha; Ayyagari, Sunder


    Purpose: This paper examines the extent of variation in the applicator geometry during multiple high dose rate (HDR) intracavitary brachytherapy (ICBT) applications and its impact on reporting as per ICRU report 38. Materials and methods: Eighty orthogonal radiographs from 20 consecutive patients of carcinoma cervix (FIGO stages, IIA-IIIB) having four HDR ICBT applications of 6 Gy each at weekly intervals following teletherapy were evaluated. The applicator consisted of a flexible intrauterine tandem (IUT) independent of the ovoid assembly. The applicator geometry was evaluated in terms of: α angle, β angle, intrauterine length (IUTL), interovoid (IOV), os to right ovoid (ORT) and os to left ovoid (OLT) distances along with vertical (VDL) and anteroposterior displacements (ADL) of the os with respect to the ovoids. The Cartesian co-ordinates (X, Y, and Z) of the IUT tip, centre of both ovoids and os were also measured. Doses to right point A (ARD), left point A (ALD), along with a reference volume of 6 Gy for ICRU height (IRH), width (IRW), thickness (IRT) and volume (IRV) were estimated for each application. Results: Highly significant differences (P<0.001) between four insertions in any given patient across 20 patients for α angle, β angle, IUTL, IOV, ORT, VDL, co-ordinates of the IUT, ovoids and os were observed, except for ADL (P=0.041) and OLT (P=0.247). As a consequence, variations were observed in ARD (P=0.027), ALD (P=0.017); IRH, IRW, IRT and IRV (all P<0.001). Applicator factors which influenced the various dose specification parameters were: β angle and ORT for both ARD and ALD; UTLN, VDL and ORT for IRH; UTLN and IOV for IRW; UTLN for IRT and VDL for the 6 Gy IRV. Conclusions: A significant variation of the applicator geometry and its movement was observed in patients undergoing multiple HDR ICBT. This could have implications for reporting dose and volume specifications as required by ICRU report 38

  8. Effects of curcumin on short-term spatial and recognition memory, adult neurogenesis and neuroinflammation in a streptozotocin-induced rat model of dementia of Alzheimer's type. (United States)

    Bassani, Taysa B; Turnes, Joelle M; Moura, Eric L R; Bonato, Jéssica M; Cóppola-Segovia, Valentín; Zanata, Silvio M; Oliveira, Rúbia M M W; Vital, Maria A B F


    Curcumin is a natural polyphenol with evidence of antioxidant, anti-inflammatory and neuroprotective properties. Recent evidence also suggests that curcumin increases cognitive performance in animal models of dementia, and this effect would be related to its capacity to enhance adult neurogenesis. The aim of this study was to test the hypothesis that curcumin treatment would be able to preserve cognition by increasing neurogenesis and decreasing neuroinflammation in the model of dementia of Alzheimer's type induced by an intracerebroventricular injection of streptozotocin (ICV-STZ) in Wistar rats. The animals were injected with ICV-STZ or vehicle and curcumin treatments (25, 50 and 100mg/kg, gavage) were performed for 30days. Four weeks after surgery, STZ-lesioned animals exhibited impairments in short-term spatial memory (Object Location Test (OLT) and Y maze) and short-term recognition memory (Object Recognition Test - ORT), decreased cell proliferation and immature neurons (Ki-67- and doublecortin-positive cells, respectively) in the subventricular zone (SVZ) and dentate gyrus (DG) of hippocampus, and increased immunoreactivity for the glial markers GFAP and Iba-1 (neuroinflammation). Curcumin treatment in the doses of 50 and 100mg/kg prevented the deficits in recognition memory in the ORT, but not in spatial memory in the OLT and Y maze. Curcumin treatment exerted only slight improvements in neuroinflammation, resulting in no improvements in hippocampal and subventricular neurogenesis. These results suggest a positive effect of curcumin in object recognition memory which was not related to hippocampal neurogenesis. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Alopecia in a viable phospholipase C delta 1 and phospholipase C delta 3 double mutant.

    Directory of Open Access Journals (Sweden)

    Fabian Runkel

    Full Text Available BACKGROUND: Inositol 1,4,5trisphosphate (IP(3 and diacylglycerol (DAG are important intracellular signalling molecules in various tissues. They are generated by the phospholipase C family of enzymes, of which phospholipase C delta (PLCD forms one class. Studies with functional inactivation of Plcd isozyme encoding genes in mice have revealed that loss of both Plcd1 and Plcd3 causes early embryonic death. Inactivation of Plcd1 alone causes loss of hair (alopecia, whereas inactivation of Plcd3 alone has no apparent phenotypic effect. To investigate a possible synergy of Plcd1 and Plcd3 in postnatal mice, novel mutations of these genes compatible with life after birth need to be found. METHODOLOGY/PRINCIPAL FINDINGS: We characterise a novel mouse mutant with a spontaneously arisen mutation in Plcd3 (Plcd3(mNab that resulted from the insertion of an intracisternal A particle (IAP into intron 2 of the Plcd3 gene. This mutation leads to the predominant expression of a truncated PLCD3 protein lacking the N-terminal PH domain. C3H mice that carry one or two mutant Plcd3(mNab alleles are phenotypically normal. However, the presence of one Plcd3(mNab allele exacerbates the alopecia caused by the loss of functional Plcd1 in Del(9olt1Pas mutant mice with respect to the number of hair follicles affected and the body region involved. Mice double homozygous for both the Del(9olt1Pas and the Plcd3(mNab mutations survive for several weeks and exhibit total alopecia associated with fragile hair shafts showing altered expression of some structural genes and shortened phases of proliferation in hair follicle matrix cells. CONCLUSIONS/SIGNIFICANCE: The Plcd3(mNab mutation is a novel hypomorphic mutation of Plcd3. Our investigations suggest that Plcd1 and Plcd3 have synergistic effects on the murine hair follicle in specific regions of the body surface.

  10. Rolipram improves cognition, reduces anxiety- and despair-like behaviors and impacts hippocampal neuroplasticity after transient global cerebral ischemia. (United States)

    Soares, Lígia Mendes; De Vry, Jochen; Steinbusch, Harry W M; Milani, Humberto; Prickaerts, Jos; Weffort de Oliveira, Rúbia M


    Cognitive impairment, anxiety- and depressive-like symptoms are well recognized outcome of cerebral ischemia in clinical and preclinical settings. Rolipram, a phosphodiesterase-4 (PDE-4) inhibitor, improves cognition and produces anxiolytic- and antidepressant-like effects in rodents. Rolipram also exerts anti-inflammatory effects and enhances survival of newborn hippocampal neurons in mice subjected to transient global cerebral ischemia. Here, we evaluated the effects of chronic rolipram treatment in mice subjected to transient global brain ischemia. C56B6/7 mice were subjected to bilateral common carotid artery occlusion (BCCAO) and were then tested in a multi-tiered behavioral battery including the elevated zero maze (EZM), open field (OF), object location test (OLT), and forced swim test (FST). We also investigated the effects of rolipram on hippocampal neurodegeneration and the expression of the neuronal plasticity markers doublecortin (DCX) and microtubule-associated protein (MAP-2). Ischemic mice exhibited memory deficits OLT, higher levels of anxiety EZM and behavioral despair FST. BCCAO caused neuronal loss in the CA3 hippocampal subfield and basolateral amygdala (BLA). In the hippocampus of BCCAO mice, a disrupted neuronal plasticity was evidenced by decreased DCX expression. Chronic treatment with rolipram attenuated the behavioral effects of BCCAO. Rolipram also decreased neurodegeneration in the CA3 while it increased dendritic arborization of DCX-immunoreactive (DCX-IR) neurons and microtubule associate MAP-2 expression in the hippocampus of BCCAO mice. These data suggest that chronic inhibition of PDE-4 can be a useful therapeutic strategy to improve the emotional and cognitive outcomes of transient global cerebral ischemia. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  11. The prognosis and prognostic risk factors of patients with hepatic artery complications after liver transplantation treated with the interventional techniques

    International Nuclear Information System (INIS)

    Shan Hong; Huang Mingsheng; Jiang Zaipo; Zhu Kangshun; Yang Yang; Chen Guihua


    Objective: To investigate the prognosis and prognostic risk factors of hepatic artery complications after orthotopic liver transplantation (OLT) treated with the interventional techniques. Methods: The clinical data of 21 patients with hepatic artery complication after liver transplantation receiving thrombolysis, PTA, and stent placement in our institute from November 2003 to April 2007 were retrospectively analyzed. Based on the prognosis of grafts, 21 patients were divided into poor-prognosis group and non-poor-prognosis group. Fifteen variables (including biliary complication, hepatic artery restenosis, early or late artery complication, and so on) were analyzed in both groups with binary logistic regression analysis to screen out the risk factors related to prognosis of pereutaneous interventional treatment for hepatic artery complications after OLT. Results: Twenty-one patients were followed for mean 436 days, median 464 days (3-1037 days). The poor-prognosis group included 11 patients (5 cases received retransplantation, and 6 died). The mean survival time of grafts in poor-prognosis group was 191 days, and median survival time was 73 days (3-616 days). The mean survival time of grafts in non-poor-prognosis group which included 10 patients was 706 days, and median survival time was 692 days (245-1037 days). Univariate analysis showed there were significant difference in biliary complication, total bilimbin and indirect bilirubin between the two groups. The binary, logistic regression analysis showed the risk factor related to prognosis was with biliary complication before the interventional management (P=0.027, OR=22.818). Conclusion: Biliary complication before interventional management is the risk factor related to poor prognosis of patients with hepatic artery stenosis or thrombosis receiving interventional treatment. (authors)

  12. Repeated Neck Restraint Stress Bidirectionally Modulates Excitatory Transmission in the Dentate Gyrus and Performance in a Hippocampus-dependent Memory Task. (United States)

    Spyrka, Jadwiga; Hess, Grzegorz


    The consequences of stress depend on characteristics of the stressor, including the duration of exposure, severity, and predictability. Exposure of mice to repeated neck restraint has been shown to bidirectionally modulate the potential for long-term potentiation (LTP) in the dentate gyrus (DG) in a manner dependent on the number of restraint repetitions, but the influence of repeated brief neck restraint on electrophysiology of single DG neurons has not yet been investigated. Here, we aimed at finding the effects of 1, 3, 7, 14, or 21 daily neck restraint sessions lasting 10 min on electrophysiological characteristics of DG granule cells as well as excitatory and inhibitory synaptic inputs to these neurons. While the excitability of DG granule cells and inhibitory synaptic transmission were unchanged, neck restraint decreased the frequency of spontaneous excitatory currents after three repetitions but enhanced it after 14 and 21 repetitions. The consequences of repeated neck restraint on hippocampus-dependent memory were investigated using the object location test (OLT). Neck restraint stress impaired cognitive performance in the OLT after three repetitions but improved it after 14 and 21 repetitions. Mice subjected to three neck restraint sessions displayed an increase in the measures of depressive and anxiety-like behaviors, however, prolongation of the exposure to neck restraint resulted in a gradual decline in the intensity of these measures. These data indicate that stress imposed by an increasing number of repeated neck restraint episodes bidirectionally modulates both excitatory synaptic transmission in the DG and cognitive performance in the object location memory task. Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.

  13. Repair Potential of Matrix-Induced Bone Marrow Aspirate Concentrate and Matrix-Induced Autologous Chondrocyte Implantation for Talar Osteochondral Repair: Patterns of Some Catabolic, Inflammatory, and Pain Mediators. (United States)

    Desando, Giovanna; Bartolotti, Isabella; Vannini, Francesca; Cavallo, Carola; Castagnini, Francesco; Buda, Roberto; Giannini, Sandro; Mosca, Massimiliano; Mariani, Erminia; Grigolo, Brunella


    The low regenerative potential of cartilage contributed to the development of different cell therapies aimed to improve the clinical outcome in young patients with Osteochondral Lesions of the Talus (OLT). This study is designed to assess the regenerative potential of autologous matrix-induced Bone Marrow Aspirate Concentrate (mBMAC) and matrix-induced Autologous Chondrocyte Implantation (mACI) evaluating, on a small number of osteochondral biopsies, the expression of some catabolic, inflammatory, and pain mediators. Twenty-two patients with OLT were analyzed in this study; 7 were treated with mACI and 15 with mBMAC. Informed consent was obtained from all the patients. Clinical assessments were performed pre-operatively and at 12, 24, and 36 months after surgery using the American Orthopedic Foot and Ankle Society (AOFAS). Histology and immunohistochemistry were used to assess cartilage repair at 24 months. Data were analyzed using non-parametric Wilcoxon-Mann-Whitney and Spearman tests. A remarkable improvement in AOFAS score was noticed for both treatments up to 36 months; however, patients treated with mACI reported the best AOFAS score. Various degrees of tissue remodeling were observed by histological analysis for both cell strategies. However, mBMAC treatment showed a higher expression of some fibrous and hypertrophic markers compared to mACI group. A mild positivity for nerve growth factor, as pain mediator, was noticed for both treatments.M. Our findings demonstrated the best histological and clinical results following mACI treatment since different fibrotic and hypertrophic features were evident in the mBMAC group at 24-month follow-up.

  14. Repair Potential of Matrix-Induced Bone Marrow Aspirate Concentrate and Matrix-Induced Autologous Chondrocyte Implantation for Talar Osteochondral Repair (United States)

    Desando, Giovanna; Bartolotti, Isabella; Vannini, Francesca; Cavallo, Carola; Castagnini, Francesco; Buda, Roberto; Giannini, Sandro; Mosca, Massimiliano; Mariani, Erminia; Grigolo, Brunella


    Objective The low regenerative potential of cartilage contributed to the development of different cell therapies aimed to improve the clinical outcome in young patients with Osteochondral Lesions of the Talus (OLT). This study is designed to assess the regenerative potential of autologous matrix-induced Bone Marrow Aspirate Concentrate (mBMAC) and matrix-induced Autologous Chondrocyte Implantation (mACI) evaluating, on a small number of osteochondral biopsies, the expression of some catabolic, inflammatory, and pain mediators. Design Twenty-two patients with OLT were analyzed in this study; 7 were treated with mACI and 15 with mBMAC. Informed consent was obtained from all the patients. Clinical assessments were performed pre-operatively and at 12, 24, and 36 months after surgery using the American Orthopedic Foot and Ankle Society (AOFAS). Histology and immunohistochemistry were used to assess cartilage repair at 24 months. Data were analyzed using non-parametric Wilcoxon-Mann-Whitney and Spearman tests. Results A remarkable improvement in AOFAS score was noticed for both treatments up to 36 months; however, patients treated with mACI reported the best AOFAS score. Various degrees of tissue remodeling were observed by histological analysis for both cell strategies. However, mBMAC treatment showed a higher expression of some fibrous and hypertrophic markers compared to mACI group. A mild positivity for nerve growth factor, as pain mediator, was noticed for both treatments.M Conclusions Our findings demonstrated the best histological and clinical results following mACI treatment since different fibrotic and hypertrophic features were evident in the mBMAC group at 24-month follow-up. PMID:27994720

  15. Epstein-Barr virus load in transplant patients: Early detection of post-transplant lymphoproliferative disorders. (United States)

    Fellner, María Dolores; Durand, Karina A; Solernou, Veronica; Bosaleh, Andrea; Balbarrey, Ziomara; García de Dávila, María T; Rodríguez, Marcelo; Irazu, Lucía; Alonio, Lidia V; Picconi, María A


    High levels of circulating EBV load are used as a marker of post-transplant lymphoproliferative disorders (PTLD). There is no consensus regarding the threshold level indicative of an increase in peripheral EBV DNA. The aim of the study was to clinically validate a developed EBV quantification assay for early PTLD detection. Transversal study: paired peripheral blood mononuclear cells (PBMC), plasma and oropharyngeal lymphoid tissue (OLT) from children undergoing a solid organ transplant with (n=58) and without (n=47) PTLD. Retrospective follow-up: 71 paired PBMC and plasma from recipients with (n=6) and without (n=6) PTLD history. EBV load was determined by real-time PCR. The diagnostic ability to detect all PTLD (categories 1-4), advanced PTLD (categories 2-4) or neoplastic PTLD (categories 3 and 4) was estimated by analyzing the test performance at different cut-off values or with a load variation greater than 0.5log units. The higher diagnostic performance for identifying all, advanced or neoplastic PTLD, was achieved with cut-off values of 1.08; 1.60 and 2.47log EBVgEq/10(5) PBMC or 2.30; 2.60; 4.47loggEq/10(5) OLT cells, respectively. EBV DNA detection in plasma showed high specificity but low (all categories) or high (advanced/neoplastic categories) sensitivity for PTLD identification. Diagnostic performance was greater when: (1) a load variation in PBMC or plasma was identified; (2) combining the measure of EBV load in PBMC and plasma. The best diagnostic ability to identify early PTLD stages was achieved by monitoring EBV load in PBMC and plasma simultaneously; an algorithm was proposed. Copyright © 2016 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Fibronectin-α4β1 Integrin-Mediated Blockade Protects Genetically Fat Zucker Rat Livers from Ischemia/Reperfusion Injury (United States)

    Amersi, Farin; Shen, Xiu-Da; Moore, Carolina; Melinek, Judy; Busuttil, Ronald W.; Kupiec-Weglinski, Jerzy W.; Coito, Ana J.


    We tested a hypothesis that interactions between fibronectin (FN), the major extracellular matrix component, and its integrin α4β1 receptor is important in the development of ischemia/reperfusion injury of steatotic liver transplants. We examined the effect of connecting segment-1 (CS1) peptide-facilitated blockade of FN-α4β1 interaction in a well-established steatotic rat liver model of ex vivo cold ischemia followed by iso-transplantation. In this model, CS1 peptides were administered through the portal vein of steatotic Zucker rat livers before and after cold ischemic storage. Lean Zucker recipients of fatty liver transplants received an additional 3-day course of CS1 peptides after transplant. CS1 peptide therapy significantly inhibited the recruitment of T lymphocytes, neutrophil activation/infiltration, and repressed the expression of proinflammatory tumor necrosis factor-α and interferon-γ. Moreover, it resulted in selective inhibition of inducible nitric oxide synthase expression, peroxynitrite formation, and hepatic necrosis. Importantly, CS1 peptide therapy improved function/histological preservation of steatotic liver grafts, and extended their 14-day survival in lean recipients from 40% in untreated to 100% in CS1-treated OLTs. Thus, CS1 peptide-mediated blockade of FN-α4β1 interaction protects against severe ischemia/reperfusion injury experienced otherwise by steatotic OLTs. These novel findings document the potential of targeting FN-α4β1 in vivo interaction to increase the transplant donor pool through modulation of marginal steatotic livers. PMID:12651615

  17. Radioembolization of hepatocellular carcinoma. (United States)

    Van de Wiele, Christophe


    In this review paper, available data on radioembolization of unresectable hepatocellular carcinoma (HCC) using commercially available radiopharmaceuticals, respectively (131)I-Lipiodol, Therasphere (glass-microspheres) and SIRspheres (resin-microspheres) are reviewed. In the palliative setting, (131)I-Lipiodol was shown to yield response rates of 17-92% which in patients with portal vein thrombosis (PVT) translate into a survival benefit as evidenced by a phase III randomized trial. Furthermore, in terms of efficacy, (131)I-Lipiodol is as efficacious as trans-arterial chemoembolization (TACE) but far better tolerated. In the adjuvant setting, improved recurrence-free and overall survival when compared to surgery alone have been reported but these results warrant confirmation by randomized prospective trials. Similar to (131)I-Lipiodol, when administered in a palliative setting, radioembolization using (90)Y microspheres was proven effective for selected cases of non-resectable HCC and well tolerated. Available data suggest that Therasphere treatment outperforms TACE both in terms of response as in terms of event-free survival in unresectable HCC. However, this finding needs confirmation by randomized prospective trials. Therasphere treatment was also shown to limit progression of HCC allowing potential candidates for orthotopic liver transplantation (OLT) more time to wait for donor organs as well as to downstage the HCC disease to such an extent that patients that were initially not, as yet become eligible for OLT with a gain in survival. Finally, Therasphere was shown to be safe and efficacious in HCC patients presenting with PVT, reason for which approval was granted for this indication by the FDA.

  18. Experimental demonstration of large capacity WSDM optical access network with multicore fibers and advanced modulation formats. (United States)

    Li, Borui; Feng, Zhenhua; Tang, Ming; Xu, Zhilin; Fu, Songnian; Wu, Qiong; Deng, Lei; Tong, Weijun; Liu, Shuang; Shum, Perry Ping


    Towards the next generation optical access network supporting large capacity data transmission to enormous number of users covering a wider area, we proposed a hybrid wavelength-space division multiplexing (WSDM) optical access network architecture utilizing multicore fibers with advanced modulation formats. As a proof of concept, we experimentally demonstrated a WSDM optical access network with duplex transmission using our developed and fabricated multicore (7-core) fibers with 58.7km distance. As a cost-effective modulation scheme for access network, the optical OFDM-QPSK signal has been intensity modulated on the downstream transmission in the optical line terminal (OLT) and it was directly detected in the optical network unit (ONU) after MCF transmission. 10 wavelengths with 25GHz channel spacing from an optical comb generator are employed and each wavelength is loaded with 5Gb/s OFDM-QPSK signal. After amplification, power splitting, and fan-in multiplexer, 10-wavelength downstream signal was injected into six outer layer cores simultaneously and the aggregation downstream capacity reaches 300 Gb/s. -16 dBm sensitivity has been achieved for 3.8 × 10-3 bit error ratio (BER) with 7% Forward Error Correction (FEC) limit for all wavelengths in every core. Upstream signal from ONU side has also been generated and the bidirectional transmission in the same core causes negligible performance degradation to the downstream signal. As a universal platform for wired/wireless data access, our proposed architecture provides additional dimension for high speed mobile signal transmission and we hence demonstrated an upstream delivery of 20Gb/s per wavelength with QPSK modulation formats using the inner core of MCF emulating a mobile backhaul service. The IQ modulated data was coherently detected in the OLT side. -19 dBm sensitivity has been achieved under the FEC limit and more than 18 dB power budget is guaranteed.

  19. Non-Dipole Features of the Geomagnetic Field May Persist for Millions of Years (United States)

    Biasi, J.; Kirschvink, J. L.


    Here we present paleointensity results from within the South Atlantic Anomaly (SAA), which is a large non-dipole feature of the geomagnetic field. Within the area of the SAA, anomalous declinations, inclinations, and intensities are observed. Our results suggest that the SAA has been present for at least 5 Ma. This is orders-of-magnitude greater than any previous estimate, and suggests that some non-dipole features do not `average out' over geologic time, which is a fundamental assumption in all paleodirectional studies. The SAA has been steadily growing in size since the first magnetic measurements were made in the South Atlantic, and it is widely believed to have appeared 400 years ago. Recent studies from South Africa (Tarduno et al. (2015)) and Tristan da Cunha (Shah et al. (2016)) have suggested that the SAA has persisted for 1 ka and 96 ka respectively. We conducted paleointensity (PI) experiments on basaltic lavas from James Ross Island, on the Antarctic Peninsula. This large shield volcano has been erupting regularly over the last 6+ Ma (dated via Ar/Ar geochronology), and therefore contains the most complete volcanostratigraphic record in the south Atlantic. Our PI experiments used the Thellier-Thellier method, the IZZI protocol, and the same selection criteria as the Lawrence et al. (2009) study of Ross Island lavas (near McMurdo Station), which is the only comparable PI study on the Antarctic continent. We determined an average paleointensity at JRI of 13.8±5.2 μT, which is far lower than what we would expect from a dipole field (55 μT). In addition, this is far lower than the current value over James Ross Island of 36 μT. These results support the following conclusions: The time-averaged field model of Juarez et al. (1998) and Tauxe et al. (2013) is strongly favored by our PI data. The SAA has persisted over James Ross Island for at least 5 Ma, and has not drifted significantly over that time. The strength of non-dipole features such as the SAA

  20. Altered alkaline phosphatase activity in obese Zucker rats liver respect to lean Zucker and Wistar rats discussed in terms of all putative roles ascribed to the enzyme

    Directory of Open Access Journals (Sweden)

    V. Bertone


    Full Text Available Biliary complications often lead to acute and chronic liver injury after orthotopic liver transplantation (OLT. Bile composition and secretion depend on the integrated action of all the components of the biliary tree, starting from hepatocytes. Fatty livers are often discarded as grafts for OLT, since they are extremely vulnerable to conventional cold storage (CS. However, the insufficiency of donors has stimulated research to improve the usage of such marginal organs as well as grafts. Our group has recently developed a machine perfusion system at subnormothermic temperature (20°C; MP20 that allows a marked improvement in preservation of fatty and even of normal rat livers as compared with CS. We sought to evaluate the response of the biliary tree of fatty liver to MP20, and a suitable marker was essential to this purpose. Alkaline phosphatase (AlkP, EC, frequently used as marker of membrane transport in hepatocytes and bile ducts, was our first choice. Since no histochemical data were available on AlkP distribution and activity in fatty liver, we have first settled to investigate AlkP activity in the steatotic liver of fatty Zucker rats (fa/fa, using as controls lean Zucker (fa/+ and normal Wistar rats. The AlkP reaction in Wistar rats was in accordance with the existing data and, in particular, was present in bile canaliculi of hepatocytes in the periportal region and midzone, in the canals of Hering and in small bile ducts but not in large bile ducts. In lean ZR liver the AlkP reaction in Hering canals and small bile ducts was similar to Wistar rat liver but hepatocytes had lower canalicular activity and besides presented moderate basolateral reaction. The difference between lean Zucker and Wistar rats, both phenotypically normal animals, could be related to the fact that lean Zucker rats are genotypically heterozygous for a recessive mutated allele. In fatty liver, the activity in ductules and small bile ducts was unchanged, but

  1. Altered alkaline phosphatase activity in obese Zucker rats liver respect to lean Zucker and Wistar rats discussed in terms of all putative roles ascribed to the enzyme. (United States)

    Bertone, V; Tarantola, E; Ferrigno, A; Gringeri, E; Barni, S; Vairetti, M; Freitas, I


    Biliary complications often lead to acute and chronic liver injury after orthotopic liver transplantation (OLT). Bile composition and secretion depend on the integrated action of all the components of the biliary tree, starting from hepatocytes. Fatty livers are often discarded as grafts for OLT, since they are extremely vulnerable to conventional cold storage (CS). However, the insufficiency of donors has stimulated research to improve the usage of such marginal organs as well as grafts. Our group has recently developed a machine perfusion system at subnormothermic temperature (20°C; MP20) that allows a marked improvement in preservation of fatty and even of normal rat livers as compared with CS. We sought to evaluate the response of the biliary tree of fatty liver to MP20, and a suitable marker was essential to this purpose. Alkaline phosphatase (AlkP, EC, frequently used as marker of membrane transport in hepatocytes and bile ducts, was our first choice. Since no histochemical data were available on AlkP distribution and activity in fatty liver, we have first settled to investigate AlkP activity in the steatotic liver of fatty Zucker rats (fa/fa), using as controls lean Zucker (fa/+) and normal Wistar rats. The AlkP reaction in Wistar rats was in accordance with the existing data and, in particular, was present in bile canaliculi of hepatocytes in the periportal region and midzone, in the canals of Hering and in small bile ducts but not in large bile ducts. In lean ZR liver the AlkP reaction in Hering canals and small bile ducts was similar to Wistar rat liver but hepatocytes had lower canalicular activity and besides presented moderate basolateral reaction. The difference between lean Zucker and Wistar rats, both phenotypically normal animals, could be related to the fact that lean Zucker rats are genotypically heterozygous for a recessive mutated allele. In fatty liver, the activity in ductules and small bile ducts was unchanged, but most hepatocytes

  2. Why should we pay more for layout designers? (United States)

    Khan, Samee U.


    In this paper, we discuss the Passive Optical Network (PON) deployment on an arbitrary grid with guarenteed p-1 equipment failure. We show that this problem in general is NP-hard. We propose an algorithm, which guarantees a solution of 4-approximation to the optimal deployment, and further argue that this is the best lower bound achievable in our case.A basic architecture of PON is shown in figure 1.The main component of PON is an optical splitter device. Depending on which direction the light is travelling, it splits the incoming light and distributes it to multiple fibers towards Optical Network Termination (ONT), or combines it into one towards Optical Line Terminal (OLT). The PON technology uses a double-star architecture. The first star topology centers at the OLT, and the second at the optical splitter. PROBLEM DESCRIPTION: We can formulate the problem of optimal p-1 fault-tolerent PON Network Layout (PNL)as a graph theoretical problem. Consider a graph G(V,E), such that V represent the physical locations of the subscriber's, CO, and another location acquired by the CO to expand its network, and E represent the communication lines between two Vi's. If there is no direct communication line c(i,j) between Vi and Vj, we consider the shortest path between them measured in terms of simple distance or cost constraints. Without the loss of generality we assume that c(i,j)=c(j,i). For simplicity we do not further sub-divide V into the obvious categories that represent the locations of OLT, ONT, CO, optical splitters and the subscribers. We can now formulate the PNL problem as follows: "Given an undirected graph G, find the locations of ONTs and splitters such that the cost of the equipment is minimized and for QoS the maximum distance from an ONT to the pth splitter and from a splitter to the pth OLT is minimized". We assume that the OLT is residing inside the CO. The problem definition does not consider the optimization of ONT to the customer premises. This is due

  3. The onset of the volcanism in the Ciomadul Volcanic Dome Complex (Eastern Carpathians): Eruption chronology and magma type variation (United States)

    Molnár, Kata; Harangi, Szabolcs; Lukács, Réka; Dunkl, István; Schmitt, Axel K.; Kiss, Balázs; Garamhegyi, Tamás; Seghedi, Ioan


    Combined zircon U-Th-Pb and (U-Th)/He dating was applied to refine the eruption chronology of the last 2 Myr for the andesitic and dacitic Pilişca volcano and Ciomadul Volcanic Dome Complex (CVDC), the youngest volcanic area of the Carpathian-Pannonian region, located in the southernmost Harghita, eastern-central Europe. The proposed eruption ages, which are supported also by the youngest zircon crystallization ages, are much younger than the previously determined K/Ar ages. By dating every known eruption center in the CVDC, repose times between eruptive events were also accurately determined. Eruption of the andesite at Murgul Mare (1865 ± 87 ka) and dacite of the Pilişca volcanic complex (1640 ± 37 ka) terminated an earlier pulse of volcanic activity within the southernmost Harghita region, west of the Olt valley. This was followed by the onset of the volcanism in the CVDC, which occurred after several 100s kyr of eruptive quiescence. At ca. 1 Ma a significant change in the composition of erupted magma occurred from medium-K calc-alkaline compositions to high-K dacitic (Baba-Laposa dome at 942 ± 65 ka) and shoshonitic magmas (Malnaş and Bixad domes; 964 ± 46 ka and 907 ± 66 ka, respectively). Noteworthy, eruptions of magmas with distinct chemical compositions occurred within a restricted area, a few km from one another. These oldest lava domes of the CVDC form a NNE-SSW striking tectonic lineament along the Olt valley. Following a brief (ca. 100 kyr) hiatus, extrusion of high-K andesitic magma continued at Dealul Mare (842 ± 53 ka). After another ca. 200 kyr period of quiescence two high-K dacitic lava domes extruded (Puturosul: 642 ± 44 ka and Balvanyos: 583 ± 30 ka). The Turnul Apor lava extrusion occurred after a ca. 200 kyr repose time (at 344 ± 33 ka), whereas formation of the Haramul Mic lava dome (154 ± 16 ka) represents the onset of the development of the prominent Ciomadul volcano. The accurate determination of eruption dates shows that the

  4. Moderate-dose Regular Lifelong Alcohol Intake Changes the Intestinal Flora, Protects against Aging, and Keeps Spatial Memory in the Senescence-accelerated Mouse Prone 8 (SAMP8) Model. (United States)

    Shimizu, Chikako; Oki, Yasuhiro; Mitani, Yutaka; Tsuchiya, Youichi; Nabeshima, Toshitaka

    Heavy and long-term alcohol consumption increase the risk of alcohol-related diseases. Epidemiological studies show moderate drinking reduces the risk of mortality, cardiovascular diseases, and brain infarction in the J-shaped or U-shaped curve effect. However, why moderate drinkers may be healthy and non-drinkers may be ill in diverse populations remains controversial. Herein, we examined the relationship between moderate/lifelong alcohol intake and aging, especially aging-related cognitive functions in senescence-accelerated mouse prone 8 (SAMP8) model.  Methods: SAMP8 model (5-week-old, male, n = 36), a model of age-related cognitive deficit, were group-housed (n = 6/cage) and provided free access to water (water group, n = 18) or 1% ethanol (EtOH group, n = 18, intake started when mice were 9 weeks old). The object recognition test (ORT) and object location test (OLT) were used to evaluate cognitive functions. The intestinal flora at the age of 87 weeks was analyzed by terminal restriction fragment length polymorphism (T-RFLP).  The lifespan of the EtOH-group mice was about 4 weeks longer than that of the water-group mice. In the EtOH group, spatial recognition impairment, assessed by OLT, was observed later (age, 73 weeks) than that in the water group (age, 52 weeks). The spinal curvature and skin conditions progressed significantly slower in the EtOH group than in the water group. Moreover, diarrhea symptoms only appeared in the water group, at the age of 82 weeks. The T-RFLP analysis of the intestinal flora indicated higher Lactobacillales order and lower Clostridium cluster XI in the EtOH group than in the water group, although those were extremely high in some mice close to death in both groups. Water-group mice with diarrhea presented significantly higher Clostridium cluster XI than did those without diarrhea (P = 0.017).  Moderate alcohol intake changes intestinal flora and positively affects aging of SAMP8 model.

  5. Comparison of hepatic MDCT, MRI, and DSA to explant pathology for the detection and treatment planning of hepatocellular carcinoma

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    Lauren M. Ladd


    Full Text Available Background/Aims The diagnosis and treatment plan for hepatocellular carcinoma (HCC can be made from radiologic imaging. However, lesion detection may vary depending on the imaging modality. This study aims to evaluate the sensitivities of hepatic multidetector computed tomography (MDCT, magnetic resonance imaging (MRI, and digital subtraction angiography (DSA in the detection of HCC and the consequent management impact on potential liver transplant patients. Methods One hundred and sixteen HCC lesions were analyzed in 41 patients who received an orthotopic liver transplant (OLT. All of the patients underwent pretransplantation hepatic DSA, MDCT, and/or MRI. The imaging results were independently reviewed retrospectively in a blinded fashion by two interventional and two abdominal radiologists. The liver explant pathology was used as the gold standard for assessing each imaging modality. Results The sensitivity for overall HCC detection was higher for cross-sectional imaging using MRI (51.5%, 95% confidence interval [CI]=36.2-58.4% and MDCT (49.8%, 95% CI=43.7-55.9% than for DSA (41.7%, 95% CI=36.2-47.3% (P=0.05. The difference in false-positive rate was not statistically significant between MRI (22%, MDCT (29%, and DSA (29% (P=0.67. The sensitivity was significantly higher for detecting right lobe lesions than left lobe lesions for all modalities (MRI: 56.1% vs. 43.1%, MDCT: 55.0% vs. 42.0%, and DSA: 46.9% vs. 33.9%; all P<0.01. The sensitivities of the three imaging modalities were also higher for lesions ≥2 cm vs. <2 cm (MRI: 73.4% vs. 32.7%, MDCT: 66.9% vs. 33.8%, and DSA: 62.2% vs. 24.1%; all P<0.01. The interobserver correlation was rated as very good to excellent. Conclusion The sensitivity for detecting HCC is higher for MRI and MDCT than for DSA, and so cross-sectional imaging modalities should be used to evaluate OLT candidacy.

  6. Everolimus in clinical practice after liver transplantation: a single-center experience

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    O. A. Gerasimova


    Full Text Available Aim. Single-center analysis of everolimus treatment after liver transplantation. Materials and methods. 23 patients having received Certican after OLT in RSCRST were observed in period from 6 months to 5 years; comparison group consisted of 50 patients who received immunosuppressive scheme with tacrolimus. Conversion to everolimus was performed in the period from 1 month after OLT after discharge and at later time according to the indications: hepatocellular cancer, cumulative CNI nephrotoxicity, the development of malignancies, and intolerance to CNI. The concentrations of CNI and everolimus in the blood (target concentration of tacrolimus 1.5–2 ng/ml, everolimus 3–8 ng/ml were monitored. Glomerular filtration rate (GFR was determined using the CKD-EPI equation. Adverse events of everolimus were evaluated. Results. The immunosuppressive scheme with everolimus is presented; adverse events with dose-dependent hypercholesterolemia (34.7% as the main; the average level of blood cholesterol was not significantly different from that in the control group, 5.6 ± 0.9 vs 5.1 ± 1.4 mmol/l (Z = 1.3, p = 0.17. Renal function was stable throughout the observation period (35 ± 16 months. GFR (CKD-EPI before conversion was 75.8 ± 17.5 ml/min. 6 patients treated with Certican for 5 years had final GFR 96.6 ± 5.1 ml/min. GFR in the group of Certican at 12 months post conversion was 87.5 ± 16.3 ml/min vs 94.2 ± 16.8 ml/min (p = 0.08 in the control group. We revealed metastases to the liver and lungs in 5 patients from 13 patients with HCC, survival rate in this group depended on the compliance with the Milan criteria (Z = 2.4, p = 0.02. Conclusion. Everolimus allows maintaining of a stable renal function to prevent progression of renal failure; conversion should be initiated as early as possible. Combination of everolimus with reduced dose of CNI is optimal. Despite the fact that side effects are developing in most patients, adequate monitoring of

  7. TEM analysis of the initial stages of BaSO4 crystallization (United States)

    Ruiz Agudo, Cristina; Putnis, Christine V.; Ruiz Agudo, Encarnación; Putnis, Andrew


    observed ex-situ in a Transmission Electron Microscope. We found that barite precipitation involves the initial formation of nanometer-size (5-10 nm) particles that fuse in an oriented way to form larger particles. Two hierarchical levels of aggregation are observed: first, the aggregation of 5-10 nm particles to form larger, but still nanometer-sized (20-60 nm) particles. In a second stage, these latter particles aggregate to produce larger single crystals (200-500 nm). No evidence of an amorphous or crystalline precursor phase previous to crystalline barite was found. These results are of importance for the design of scale prevention methods, particularly in the choice of the most suitable scale inhibitor. Gebauer D., Cölfen H., Verch A. and Antonietti M. (2009) The multiple roles of additives in CaCO3 crystallization: a quantitative case study. Adv. Mater. 21, 435-439. Gebauer D., Völkel A. and Cölfen H. (2008) Stable prenucleation calcium carbonate clusters. Science 332, 1819-1822. Van Driessche A.E.S., Benning L.G., Rodriguez-Blanco J. D., Ossorio M., Bots P. and García-Ruiz J. M. (2012) The role and implications of bassanite as a stable precursor phase to gypsum precipitation. Science 336, 69-71. Baumgartner J., Dey A., Bomans P. H. H., Le Coadou C., Fratzl P., Sommerdijk N. A. J. M. and Faivre D. (2013) Nucleation and growth of magnetite from solution. Nature 12, 310-314. Li D., Nielsen M.H., Lee J.R.I, Frandsen C., Banfield J.F. and De Yoreo J.J.(2012) Direction-Specific Interactions Control Crystal Growth by Oriented Attachment. Science 336, 1014-1018.

  8. Experimental demonstration of novel source-free ONUs in bidirectional RF up-converted optical OFDM-PON utilizing polarization multiplexing. (United States)

    Zhang, Chongfu; Chen, Chen; Feng, Yuan; Qiu, Kun


    We propose and experimentally demonstrate a novel cost-effective optical orthogonal frequency-division multiplexing-based passive optical network (OFDM-PON) system, wherein all optical network units (ONUs) are source-free not only in the optical domain but also in the electric domain, by utilizing polarization multiplexing (PolMUX) in the downlink transmission. Two pure optical bands with a frequency interval of 10 GHz and downlink up-converted 10 GHz OFDM signal are carried in two orthogonal states of polarization (SOPs), respectively. 10 GHz radio frequency (RF) source can be generated by a heterodyne of two pure optical bands after polarization beam splitting in each ONU, therefore it can be used to down-convert the downlink OFDM signal and up-convert the uplink OFDM signal. In the whole bidirectional up-converted OFDM-PON system, only one single RF source is employed in the optical line terminal (OLT). Experimental results successfully verify the feasibility of our proposed cost-effective optical OFDM-PON system.

  9. A Hybrid OFDM-TDM Architecture with Decentralized Dynamic Bandwidth Allocation for PONs (United States)

    Cevik, Taner


    One of the major challenges of passive optical networks is to achieve a fair arbitration mechanism that will prevent possible collisions from occurring at the upstream channel when multiple users attempt to access the common fiber at the same time. Therefore, in this study we mainly focus on fair bandwidth allocation among users, and present a hybrid Orthogonal Frequency Division Multiplexed/Time Division Multiplexed architecture with a dynamic bandwidth allocation scheme that provides satisfying service qualities to the users depending on their varying bandwidth requirements. Unnecessary delays in centralized schemes occurring during bandwidth assignment stage are eliminated by utilizing a decentralized approach. Instead of sending bandwidth demands to the optical line terminal (OLT) which is the only competent authority, each optical network unit (ONU) runs the same bandwidth demand determination algorithm. ONUs inform each other via signaling channel about the status of their queues. This information is fed to the bandwidth determination algorithm which is run by each ONU in a distributed manner. Furthermore, Light Load Penalty, which is a phenomenon in optical communications, is mitigated by limiting the amount of bandwidth that an ONU can demand. PMID:24194684

  10. Electrical properties, phase transitions and conduction mechanisms of the [(C{sub 2}H{sub 5})NH{sub 3}]{sub 2}CdCl{sub 4} compound

    Energy Technology Data Exchange (ETDEWEB)

    Mohamed, C. Ben; Karoui, K. [Laboratory of Condensed Matter, Faculty of Science of Sfax, University of Sfax, BP1171- 3000 Sfax (Tunisia); Saidi, S. [Laboratory of Materials, Organization and Properties (LMOP), Faculty of Sciences of Tunis, Tunis-El Manar University, 2092 Tunis (Tunisia); Guidara, K. [Laboratory of Condensed Matter, Faculty of Science of Sfax, University of Sfax, BP1171- 3000 Sfax (Tunisia); Rhaiem, A. Ben, E-mail: [Laboratory of Condensed Matter, Faculty of Science of Sfax, University of Sfax, BP1171- 3000 Sfax (Tunisia)


    The [(C{sub 2}H{sub 5})NH{sub 3}]{sub 2}CdCl{sub 4} hybrid material was prepared and its calorimetric study and electric properties were investigated at low temperature. The X-ray powder diffractogram has shown that the compound is crystallized in the orthorhombic system with Abma space group, and the refined unit cell parameters are a=7.546 Å, b=7.443 Å, and c=21.831 Å. The calorimetric study has revealed two endothermic peaks at 216 K and 357 K, which are confirmed by the variation of f{sub p} and σ{sub dc} as a function of temperature. The equivalent circuit based on the Z-View-software was proposed and the conduction mechanisms were determined. The obtained results have been discussed in terms of the correlated barrier hopping model (CBH) in phase I (low temperature (OLT)), non-overlapping small polaron tunneling model (NSPT) in phase II (room temperature (ORT)) and the overlapping large polaron tunneling model in phase III (high temperature (OHT)). The density of localized states N{sub F}(E) at the Fermi level and the binding energy W{sub m} were calculated. The variation of the dielectric loss log(ε″) with log(ω) was found to follow the empirical law, ε″=B ω{sup m(T)}.


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    Full Text Available Aspects of flood occurrence on the Vedea River. This study addresses several aspects of floods on the Vedea River, located in the Central Romanian Plain, located between Olt and Argeş rivers. Data recorded in the most important hydrological stations (Buzeşti, Văleni, Alexandria along the Vedea River were used, for a period of 40 years (1970-2009. Flood generating conditions, their typology and parameters were analyzed. Cavis software developed by specialists from INHGA Bucharest was employed, in order to draft the flood hydrographs and calculate the floods parameters. Also, we calculated the multi-annual and seasonal frequencies of flood occurrence. There are two main conclusions emerging from specific analysis. First, the most floods occur in late winter and early spring while the least are specific to autumn season. Second conclusion is that the highest flash floods recorded along the Vedea River are associated to heavy rainfall periods and they occurred in late spring and early summer.

  12. Human Adipose-Derived Mesenchymal Stem Cells Are Resistant to HBV Infection during Differentiation into Hepatocytes in Vitro

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    Ying Wang


    Full Text Available The therapeutic methods for chronic hepatitis B are limited. The shortage of organ donors and hepatitis B virus (HBV reinfection obstruct the clinical application of orthotopic liver transplantation (OLT. In the present study, adipose-derived mesenchymal stem cells (AD-MSCs and bone marrow-derived mesenchymal stem cells (BM-MSCs were isolated from chronic hepatitis B patients and characterized for morphology, growth potency, surface phenotype and the differentiation potential. The results showed that both MSCs had adipogenic, osteogenic and neuron differentiation potential, and nearly all MSCs expressed CD105, CD44 and CD29. Compared with AD-MSCs, BM-MSCs of chronic hepatitis B patients proliferated defectively. In addition, the ability of AD-MSCs to differentiate into hepatocyte was evaluated and the susceptibility to HBV infection were assessed. AD-MSCs could differentiate into functional hepatocyte-like cells. These cells express the hepatic-specific markers and have glycogen production and albumin secretion function. AD-MSCs and hepatic differentiation AD-MSCs were not susceptible to infection by HBV in vitro. Compared with BM-MSCs, AD-MSCs may be alternative stem cells for chronic hepatitis B patients.

  13. 128 Gb/s TWDM PON system using dispersion-supported transmission method (United States)

    Bindhaiq, Salem; Zulkifli, Nadiatulhuda; Supa'at, Abusahmah M.; Idrus, Sevia M.; Salleh, M. S.


    Time and wavelength division multiplexed passive optical network (TWDM-PON) trend is considered as the most extraordinary trend of the next generation solution to accommodate exponential traffic growth for converged new services. In this paper, we briefly review recent progress on TWDM-PON system through the use of low cost directly modulated lasers (DMLs) transmission for various line rate transmissions to date. Furthermore, through simulation, we propose and evaluate a cost effective way to upgrade TWDM-PON up to a symmetric capacity of 128 Gb/s using fiber Bragg gratings (FBGs) in optical line terminal (OLT) as a paramount dispersion manager in high speed light-wave systems in both upstream and downstream directions. A low cost and potential chirpless directed modulated grating laser (DMGL) is employed for downstream link and DML with a single delay-interferometer (DI) is employed for upstream link. After illustrating the demonstrated system architecture and configuration, we present the results and analysis to prove the system feasibility. The results show that a successful transmission is achieved over 40 km single mode fiber with a power budget of 33.7 dB, which could support 1:256 splitting ratio.

  14. Recent progress in InP/polymer-based devices for telecom and data center applications (United States)

    Kleinert, Moritz; Zhang, Ziyang; de Felipe, David; Zawadzki, Crispin; Maese Novo, Alejandro; Brinker, Walter; Möhrle, Martin; Keil, Norbert


    Recent progress on polymer-based photonic devices and hybrid photonic integration technology using InP-based active components is presented. High performance thermo-optic components, including compact polymer variable optical attenuators and switches are powerful tools to regulate and control the light flow in the optical backbone. Polymer arrayed waveguide gratings integrated with InP laser and detector arrays function as low-cost optical line terminals (OLTs) in the WDM-PON network. External cavity tunable lasers combined with C/L band thinfilm filter, on-chip U-groove and 45° mirrors construct a compact, bi-directional and color-less optical network unit (ONU). A tunable laser integrated with VOAs, TFEs and two 90° hybrids builds the optical front-end of a colorless, dual-polarization coherent receiver. Multicore polymer waveguides and multi-step 45°mirrors are demonstrated as bridging devices between the spatialdivision- multiplexing transmission technology using multi-core fibers and the conventional PLCbased photonic platforms, appealing to the fast development of dense 3D photonic integration.

  15. A study on the multiple dynamic wavelength distribution for gigabit capable passive optical networks

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    Gustavo Adolfo Puerto Leguizamón


    Full Text Available This paper presents a data traffic based study aiming at evaluating the impact of dynamic wavelength allocation on a Gigabit capable Passive Optical Network (GPON. In Passive Optical Networks (PON, an Optical Line Terminal (OLT feeds different PONs in such a way that a given wavelength channel is evenly distributed between the Optical Network Units (ONU at each PON. However, PONs do not specify any kind of dynamic behavior on the way the wavelengths are allocated in the network, a completely static distribution is implemented instead. In thispaper we evaluate the network performance in terms of packet losses and throughput for a number of ONUs being out-of-profile while featuring a given percentage of traffic in excess for a fixed wavelength distribution and for multiple dynamic wavelength allocation. Results show that for a multichannel operation with four wavelengths, the network throughput increases up to a rough value of 19% while the packet losses drop from 22 % to 1.8 % as compared with a static wavelength distribution.

  16. Hybrid scheduling mechanisms for Next-generation Passive Optical Networks based on network coding (United States)

    Zhao, Jijun; Bai, Wei; Liu, Xin; Feng, Nan; Maier, Martin


    Network coding (NC) integrated into Passive Optical Networks (PONs) is regarded as a promising solution to achieve higher throughput and energy efficiency. To efficiently support multimedia traffic under this new transmission mode, novel NC-based hybrid scheduling mechanisms for Next-generation PONs (NG-PONs) including energy management, time slot management, resource allocation, and Quality-of-Service (QoS) scheduling are proposed in this paper. First, we design an energy-saving scheme that is based on Bidirectional Centric Scheduling (BCS) to reduce the energy consumption of both the Optical Line Terminal (OLT) and Optical Network Units (ONUs). Next, we propose an intra-ONU scheduling and an inter-ONU scheduling scheme, which takes NC into account to support service differentiation and QoS assurance. The presented simulation results show that BCS achieves higher energy efficiency under low traffic loads, clearly outperforming the alternative NC-based Upstream Centric Scheduling (UCS) scheme. Furthermore, BCS is shown to provide better QoS assurance.

  17. Comparision of Splitting Properties of Various 1x16 Splitters

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    Catalina Burtscher


    Full Text Available Optical Access Networks (OAN mostly use optical splitters to distribute the services from Optical Line Terminal (OLT on the provider's side to the subscribers in Optical Network Unit (ONU. Optical splitters are the key components in such access networks as for example GPON and XG-PON by ITU-T. In this paper we investigate the optical properties of 1x16 Y-branch splitter and 1x16 MMI splitters based on different widths of multimode interference section and different lengths of the output ports. These two splitters were designed, simulated and the obtained results of both were studied and compared with each other. Additionally, we show that the used standard waveguide core size (usually 6x6 µm2 to match the diameter of the single mode input/output fibers, i.e. to keep the coupling loses as low as possible supports not only propagation of the single mode but of the first mode too, leading to an asymmetric splitting ratio (increasing non-uniformity of split power over all the output waveguides. Decreasing waveguide core size, it is possible to suppress presence of the first mode and this way to reduce non-uniformity.

  18. An adaptive two-stage energy-efficiency mechanism for the doze mode in EPON (United States)

    Nikoukar, AliAkbar; Hwang, I.-Shyan; Su, Yu-Min; Liem, Andrew Tanny


    Sleep and doze power-saving modes are the common ways to reduce power consumption of optical network units (ONUs) in Ethernet passive optical network (EPON). The doze mode turns off the ONU transmitter when there is no traffic in the upstream direction while the sleep mode turns off the ONU transmitter and receiver. As the result, the sleep mode is more efficient compared to the doze mode, but it introduces additional complexity of scheduling and signaling, losses the clock synchronization and requires long clock recovery time; furthermore, it requires the cooperation of the optical line terminal (OLT) in the downstream direction to queue frames. To improve the energy-saving in the doze mode, a new two-stage mechanism is introduced that the doze sleep duration is extended for longer time with acceptable quality-of-services (QoS) metrics when ONU is idle in the current cycle. By this way the ONU enters the doze mode even in the high load traffic; moreover, the green dynamic bandwidth allocation (GBA) is proposed to calculate the doze sleep duration based on the ONU queue state and incoming traffic ratio. Simulation results show that the proposed mechanism significantly improves the energy-saving 74% and 54% when traffic load is from the light load to the high load in different traffic situations, and also promises the QoS performance.

  19. Efficient eNB inter-communication scheme in converged mobile and NG-PON2 system (United States)

    Xiao, Simiao; Sun, Xiao; Zhang, Kaibin


    In LTE, a new X2-interface is defined to facilitate direct communication between neighboring eNBs. Since LTE is an all-IP network, the X2-interface traffic currently needs to be routed and transponded in L3 at the edge router by IP addressing. As mobile data increases, it is a promising trend to backhaul mobile services based on PON. In this paper, an effective approach for eNB inter-communication over TWDM-PON is proposed. By associating the IP address of eNB and the MAC address of ONU, the "inter-eNB communication in L3" can be mapped into "inter-ONU communication in L2" and transponded via the protocol of PON at the OLT. Thus, fast and cost-effective eNB inter-communication can be realized based on TWDM-PON within one wavelength channel and between different wavelength channels. The increasing data traffic pressure to the core network can also be alleviated.

  20. OTACT: ONU Turning with Adaptive Cycle Times in Long-Reach PONs (United States)

    Zare, Sajjad; Ghaffarpour Rahbar, Akbar


    With the expansion of PON networks as Long-Reach PON (LR-PON) networks, the problem of degrading the efficiency of centralized bandwidth allocation algorithms threatens this network due to high propagation delay. This is because these algorithms are based on bandwidth negotiation messages frequently exchanged between the optical line terminal (OLT) in the Central Office and optical network units (ONUs) near the users, which become seriously delayed when the network is extended. To solve this problem, some decentralized algorithms are proposed based on bandwidth negotiation messages frequently exchanged between the Remote Node (RN)/Local Exchange (LX) and ONUs near the users. The network has a relatively high delay since there are relatively large distances between RN/LX and ONUs, and therefore, control messages should travel twice between ONUs and RN/LX in order to go from one ONU to another ONU. In this paper, we propose a novel framework, called ONU Turning with Adaptive Cycle Times (OTACT), that uses Power Line Communication (PLC) to connect two adjacent ONUs. Since there is a large population density in urban areas, ONUs are closer to each other. Thus, the efficiency of the proposed method is high. We investigate the performance of the proposed scheme in contrast with other decentralized schemes under the worst case conditions. Simulation results show that the average upstream packet delay can be decreased under the proposed scheme.


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    Full Text Available Bu çalışmada Kocaeli İli Derince İlçesine bağlı 11�ıu Köyü Bölgesi'nde Nisan - Mayıs 2003 ayları asında kirli sularla sulama yapılan ekili alanlarda bakteriolojik kirlilik araştırması yapılmıştır. ra�tırmamızda Slıigella (2050, E.�clıericlıia coli (1 0000, Enterobcıcter (10000 olmak üzere toplam 2�050 ba kteri gözlenmiştir. Aynı bölgedeki temiz sularda Sizige/la (50, Esclıericlıia coli görülmemiş, Enterobacter ise (300 olarak tespit edilmiştir. raştırmaınııda kirli sularta sulama yapılan ekili a l anlarda insan sağlığı üzerinde potansiyel risk oltı�turan ba kteriyoloj ik llt;.irliliğin olduğu gözlenmiştir. r Keliı11eler - Slıigella, Esclıericlıia co


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    Gheorghe ROMANESCU


    Full Text Available The dams represent hydrotechnical constructions meant to ensure a judicious use of water resources. The international literature is extremely rich in data regarding the large dams on Earth. In this context, a hierarchy of the main dams is attempted and the role they play in the economic development of the regions they were built in is underlined. The largest dams are built on the big rivers in Asia, North America, South America and Africa. The reservoirs have multiple roles: electricity production, drinking or industrial water supply, irrigations, recreation, etc. High costs and land fragility do not allow the construction of dams in the places most affected by drought or flood. This is why they are usually built in mountainous areas, at great distance from the populated centres. On the Romanian territory, there are 246 large dams, built in the hydrographical basins of Siret, Olt, Arges, Somes, etc. The largest rivers on Earth, by discharge, (Amazon and Zair do not also include the largest dams because the landform and the type of flow have not allowed such constructions.

  3. Effect of Elodea nuttallii roots on bacterial communities and MMHg proportion in a Hg polluted sediment. (United States)

    Regier, Nicole; Frey, Beat; Converse, Brandon; Roden, Eric; Grosse-Honebrink, Alexander; Bravo, Andrea Garcia; Cosio, Claudia


    The objective of this study was to assess the effect of a rooted macrophyte Elodea nuttallii on rhizosphere bacterial communities in Hg contaminated sediments. Specimens of E. nuttallii were exposed to sediments from the Hg contaminated Babeni reservoir (Olt River, Romania) in our microcosm. Plants were allowed to grow for two months until they occupied the entirety of the sediments. Total Hg and MMHg were analysed in sediments where an increased MMHg percentage of the total Hg in pore water of rhizosphere sediments was found. E. nuttallii roots also significantly changed the bacterial community structure in rhizosphere sediments compared to bulk sediments. Deltaproteobacteria dominated the rhizosphere bacterial community where members of Geobacteraceae within the Desulfuromonadales and Desulfobacteraceae were identified. Two bacterial operational taxonomic units (OTUs) which were phylogenetically related to sulfate-reducing bacteria (SRB) became abundant in the rhizosphere. We suggest that these phylotypes could be potentially methylating bacteria and might be responsible for the higher MMHg percentage of the total Hg in rhizosphere sediments. However, SRB were not significantly favoured in rhizosphere sediments as shown by qPCR. Our findings support the hypothesis that rooted macrophytes created a microenvironment favorable for Hg methylation. The presence of E. nuttallii in Hg contaminated sediments should therefore not be overlooked.

  4. Effect of Elodea nuttallii roots on bacterial communities and MMHg proportion in a Hg polluted sediment.

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    Nicole Regier

    Full Text Available The objective of this study was to assess the effect of a rooted macrophyte Elodea nuttallii on rhizosphere bacterial communities in Hg contaminated sediments. Specimens of E. nuttallii were exposed to sediments from the Hg contaminated Babeni reservoir (Olt River, Romania in our microcosm. Plants were allowed to grow for two months until they occupied the entirety of the sediments. Total Hg and MMHg were analysed in sediments where an increased MMHg percentage of the total Hg in pore water of rhizosphere sediments was found. E. nuttallii roots also significantly changed the bacterial community structure in rhizosphere sediments compared to bulk sediments. Deltaproteobacteria dominated the rhizosphere bacterial community where members of Geobacteraceae within the Desulfuromonadales and Desulfobacteraceae were identified. Two bacterial operational taxonomic units (OTUs which were phylogenetically related to sulfate-reducing bacteria (SRB became abundant in the rhizosphere. We suggest that these phylotypes could be potentially methylating bacteria and might be responsible for the higher MMHg percentage of the total Hg in rhizosphere sediments. However, SRB were not significantly favoured in rhizosphere sediments as shown by qPCR. Our findings support the hypothesis that rooted macrophytes created a microenvironment favorable for Hg methylation. The presence of E. nuttallii in Hg contaminated sediments should therefore not be overlooked.

  5. A novel EPON architecture for supporting direct communication between ONUs (United States)

    Wang, Liqian; Chen, Xue; Wang, Zhen


    In the traditional EPON network, optical signal from one ONU can not reach other ONUs. So ONUs can not directly transmit packets to other ONUs .The packets must be transferred by the OLT and it consumes both upstream bandwidth and downstream bandwidth. The bandwidth utilization is low and becomes lower when there are more packets among ONUs. When the EPON network carries P2P (Peer-to-Peer) applications and VPN applications, there would be a great lot of packets among ONUs and the traditional EPON network meets the problem of low bandwidth utilization. In the worst situation the bandwidth utilization of traditional EPON only is 50 percent. This paper proposed a novel EPON architecture and a novel medium access control protocol to realize direct packets transmission between ONUs. In the proposed EPON we adopt a novel circled architecture in the splitter. Due to the circled-splitter, optical signals from an ONU can reach the other ONUs and packets could be directly transmitted between two ONUs. The traffic between two ONUs only consumes upstream bandwidth and the bandwidth cost is reduced by 50 percent. Moreover, this kind of directly transmission reduces the packet's latency.

  6. The use Prometheus FPSA system in the treatment of acute liver failure: preliminary results. (United States)

    Skwarek, A; Grodzicki, M; Nyckowski, P; Kotulski, M; Zieniewicz, K; Michalowicz, B; Patkowski, W; Grzelak, I; Paczkowska, A; Giercuszkiewicz, D; Sańko-Resmer, J; Paczek, L; Krawczyk, M


    The preliminary outcomes of patients with acute liver failure treated with the Prometheus Fractionated Plasma Separation and Absorption (FPSA) system are presented herein. The procedures were performed in 13 patients (4, intoxication by Amanita phalloides; 4, unknown reason; 3, acetaminophen intoxication; 1, Wilson disease, and 1, liver insufficiency after hemihepatectomy owing to metastases of colon adenocarcinoma). The patients were qualified for the procedure according to the King's College Hospital criteria. The patients' general status was assessed on basic of GCS, UNOS, and the 4-grade encephalopathy classifications. The procedures were performed with the Prometheus 4008H Fresenius Medical Care unit. The 29 procedures were of mean duration 6.5 hours. There were statistically significant reductions in total bilirubin, ammonia, and aminotransferase levels. In addition, the procedures corrected water, mineral, and carbohydrate disorders. One patient did not require liver transplantation. Seven patients received liver transplants: three patients with positive outcomes; two died due to septicemia within 30 days perioperatively, one died at 6 months after OLT owing to respiratory failure; and one, owing to hemorrhagic diathesis. Four patients did not receive a liver transplant because of lack of a organ, no consent for the surgery, or neoplastic disease with metastases. The Prometheus FPSA-System was an effective detoxication method for patients with acute liver failure. The system was useful as a symptomatic treatment before liver transplantation allowing a longer wait for a graft.

  7. Environmental monitoring for tritium at tritium separation facility

    International Nuclear Information System (INIS)

    Varlam, C.; Stefanescu, I.; Steflea, D.; Lazar, R.E.


    The Cryogenic Pilot is an experimental project in the nuclear energy national research program, which has the aim of developing technologies for tritium and deuterium separation by cryogenic distillation. The experimental installation is located 15 km near the highest city of the area and 1 km near Olt River. An important chemical activity is developed in the area and the Experimental Cryogenic Pilot's, almost the entire neighborhood are chemical plants. It is necessary to emphasize this aspect because the sewerage system is connected with the other three chemical plants from the neighborhood. This is the reason that we progressively established elements of an environmental monitoring program well in advance of tritium operation in order to determine baseline levels. The first step was the tritium level monitoring in environmental water and waste water of industrial activity from neighborhood. In this work, a low background liquid scintillation is used to determine tritium activity concentration according to ISO 9698/1998. We measured drinking water, precipitation, river water, underground water and waste water. The tritium level was between 10 TU and 27 TU that indicates there is no source of tritium contamination in the neighborhood of Cryogenic Pilot. In order to determine baseline levels we decide to monitories monthly each location. In this paper a standard method is presented which it is used for tritium determination in water sample, the precautions needed in order to achieve reliable results, and the evolution of tritium level in different location near the Experimental Pilot Tritium and Deuterium Cryogenic Separation.(author)


    Directory of Open Access Journals (Sweden)

    Dana-Maria OPREA


    Full Text Available The article discusses issues of air quality in the area of Slatina city regarding the pollution index – sulfur dioxide, describing the main characteristics of the polluter, emission sources, and especially its evolution in time and space of the concentrations and the annual trend, correlated with causes that may increase or diminish the monthly and annually concentrator’s values. Data was collected and provided by The Environmental Agency of Olt County and The Analysis Laboratory for Evaluation of Emissions of ALRO S.A. Company. During the analyzed period, 1996-2006, there were no average monthly levels in the time and space distribution higher than the maximum allowed concentration, which is of 0,125 mg/m3in 24 hours; also, the annual average values of the index follow a decreasing trend. However, when put together with other urban polluters, the vegetation along with the population of Slatina city is put under discomfort. Towards the end of the article, there are presented conclusions mentioning the main effects over the environment.

  9. Link Power Budget and Traffict QoS Performance Analysis of Gygabit Passive Optical Network (United States)

    Ubaidillah, A.; Alfita, R.; Toyyibah


    Data service of telecommunication network is needed widely in the world; therefore extra wide bandwidth must be provided. For this case, PT. Telekomunikasi Tbk. applies GPON (Gigabit Passive Optical Network) as optical fibre based on telecommunication network system. GPON is a point to a multipoint technology of FTTx (Fiber to The x) that transmits information signals to the subscriber over optical fibre. In GPON trunking system, from OLT (Optical Line Terminal), the network is split to many ONT (Optical Network Terminal) of the subscribers, so it causes path loss and attenuation. In this research, the GPON performance is measured from the link power budget system and the Quality of Service (QoS) of the traffic. And the observation result shows that the link power budget system of this GPON is in good condition. The link power budget values from the mathematical calculation and direct measurement are satisfy the ITU-T G984 Class B standard, that the power level must be between -8 dBm to -27 dBm. While from the traffic performance, the observation result shows that the network resource utility of the subscribers of the observed area is not optimum. The mean of subscriber utility rate is 27.985 bps for upstream and 79.687 bps for downstream. While maximally, It should be 60.800 bps for upstream and 486.400 bps for downstream.

  10. Letter to Dimitrie Gusti (21.10.1938

    Directory of Open Access Journals (Sweden)



    Full Text Available This section contains two important documents here published for the first time. The first is the text of a paper presented by St.C.-G. in 1939 at the Romanian Institute for Social Research and meant to accompany 12 sociological maps on the practices and interdictions concerning confined women in 35 villages of Țara Oltului (Olt county. This paper will allow us to reconstruct the lost maps in the near future. The second document consists of three completed forms of the social inquiry conducted by Șt. C.-G. concerning the everyday lives of students in an industrial College of Bucharest during World War II. The Report prepared by D. Gusti in view of awarding the Vernescu Academy prize to Șt. C.-G. for her book The Household in the Beliefs and Magic Rituals of the Women of Drăguș (Făgăraș, an activity report by Șt. C. and two letters (one by D. Gusti and the other by a former student teaching in her turn complete the picture of Șt. C.-G. at a professional and a personal level.

  11. High output power of differently cut Nd:MgO:LiTaO3 CW lasers (United States)

    Sun, D. H.; Liu, S. D.; Wang, D. Z.; Sang, Y. H.; Kang, X. L.; Liu, H.; Bi, Y.; Yan, B. X.; He, J. L.; Wang, J. Y.


    A high-quality Nd3+ and Mg2+ co-doped LiTaO3 (Nd:MgO:LT) crystal was grown by the Czochralski method. The polarized absorption spectra and fluorescence spectra were studied, and the absorption cross section was calculated by Judd-Ofelt (J-O) theory. The laser performance with different sample cuts of the crystal was investigated for the first time, and it was found that Nd:MgO:LT crystal with different cutting directions (a and c) exhibits different laser properties. By optimizing a partial reflectivity mirror in the laser experimental setting, a high continuous wave output power of 3.58 W was obtained at 1092 and 1076 nm with an optical-to-optical conversion efficiency of 22.78% and slope efficiency of 26.06%. The results indicate that Nd:MgO:LT crystal is a promising candidate for the manufacture of Nd3+ doped periodically poled MgO:LiTaO3 crystal (Nd:PPMgOLT), which should have considerable applications in self-frequency doubling and optical parametric oscillation laser devices.

  12. High output power of differently cut Nd:MgO:LiTaO3 CW lasers

    International Nuclear Information System (INIS)

    Sun, D H; Liu, S D; Wang, D Z; Sang, Y H; Kang, X L; Liu, H; He, J L; Wang, J Y; Bi, Y; Yan, B X


    A high-quality Nd 3+ and Mg 2+ co-doped LiTaO 3 (Nd:MgO:LT) crystal was grown by the Czochralski method. The polarized absorption spectra and fluorescence spectra were studied, and the absorption cross section was calculated by Judd–Ofelt (J–O) theory. The laser performance with different sample cuts of the crystal was investigated for the first time, and it was found that Nd:MgO:LT crystal with different cutting directions (a and c) exhibits different laser properties. By optimizing a partial reflectivity mirror in the laser experimental setting, a high continuous wave output power of 3.58 W was obtained at 1092 and 1076 nm with an optical-to-optical conversion efficiency of 22.78% and slope efficiency of 26.06%. The results indicate that Nd:MgO:LT crystal is a promising candidate for the manufacture of Nd 3+ doped periodically poled MgO:LiTaO 3 crystal (Nd:PPMgOLT), which should have considerable applications in self-frequency doubling and optical parametric oscillation laser devices. (paper)

  13. Impact of vaccine therapy using nuclear histone H1 on allograft survival in experimental organ transplantation. (United States)

    Nakano, Toshiaki; Goto, Shigeru; Lai, Chia-Yun; Hsu, Li-Wen; Ono, Kazuhisa; Kawamoto, Seiji; Lin, Yu-Chun; Kao, Ying-Hsien; Chiang, Kuei-Chen; Ohmori, Naoya; Goto, Takeshi; Sato, Shuji; Tu, Chieh-Hsien; Jawan, Bruno; Cheng, Yu-Fan; Chen, Chao-Long


    We recently reported that autoreactive antibody (Ab) against nuclear histone H1 had been identified as an immunosuppressive factor in a rat tolerogenic orthotopic liver transplantation (OLT) model. The present study aimed to determine whether the up-regulation of antihistone H1 Ab by histone H1 vaccination leads to tolerance. Histone H1-immunized rats were established by intraperitoneal vaccination with histone H1 at every two-weekly interval. By using mixed lymphocyte reaction (MLR) and heterotopic heart transplantation (HHT), the alloreactive T cell response and allograft survival of histone H1-immunized rats were compared with those of control rats. Cytokine and cellular profiles in histone H1-immunized rats were determined by reverse transcriptase polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA) and flow cytometry. Immunization with histone H1 in Freund's adjuvant induced alloreactive T cell unresponsiveness and prolonged heterotopic heart allograft survival. It also down-regulated the expression of major histocompatibility complex (MHC) class II and CD25 on splenic cells, elevated the T helper cell type 2 (Th2) skewing index (Interleukin (IL)-4/interferon (IFN)-gamma ratio or IL-4/IL-2 ratio) and modified the serum cytokine profiles. The present results suggest that histone H1 vaccination of transplant recipients, which leads to the production of immunosuppressive factor and the modification of the cytokine/cellular profiles, has great potential as a tolerance therapy for prospective transplantation.

  14. Prognostic Factors for Tumor Recurrence after a 12-Year, Single-Center Experience of Liver Transplantations in Patients with Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Matteo Cescon


    Full Text Available Background. Factors affecting outcomes after orthotopic liver transplantation (OLT for hepatocellular carcinoma (HCC have been extensively studied, but some of them have only recently been discovered or reassessed. Methods. We analyzed classical and more recently emerging variables with a hypothetical impact on recurrence-free survival (RFS in a single-center series of 283 patients transplanted for HCC between 1997 and 2009. Results. Five-year patient survival and RFS were 75% and 86%, respectively. Thirty-four (12% patients had HCC recurrence. Elevated preoperative alpha-fetoprotein (AFP levels, preoperative treatments of HCC, unfulfilled Milan and up-to-seven criteria at final histology, poor tumor differentiation, and tumor microvascular invasion negatively affected RFS by univariate analysis. Milan and up-to-seven criteria applied preoperatively, and the use of m-TOR inhibitors did not reach statistical significance. Cox's proportional hazard model showed that only elevated AFP levels (Odds Ratio=2.88; 95% C.I.=1.43–5.80; =.003, preoperative tumor treatments (Odds Ratio=4.84; 95% C.I.=1.42–16.42; =.01, and microvascular invasion (Odds Ratio=4.82; 95% C.I.=1.87–12.41; =.001 were predictors of lower RFS. Conclusions. Biological aggressiveness and preoperative tumor treatment, rather than traditional and expanded dimensional criteria, conditioned the outcomes in patients transplanted for HCC.

  15. Differential Antitumoral Properties and Renal-Associated Tissue Damage Induced by Tacrolimus and Mammalian Target of Rapamycin Inhibitors in Hepatocarcinoma: In Vitro and In Vivo Studies.

    Directory of Open Access Journals (Sweden)

    Elena Navarro-Villarán

    Full Text Available Orthotopic liver transplantation (OLT is the recommended treatment for patients at early stages of hepatocarcinoma (HCC with potential portal hypertension and/or bilirubinemia, but without vascular-associated diseases. The patients are receiving immunosuppressive therapy to reduce graft rejection, but differential side effects have been related to calcineurin and mTOR inhibitor administration regarding tumor recurrence and nephrotoxicity. The in vitro studies showed that Tacrolimus exerted a more potent pro-apoptotic effect than Everolimus (Huh 7>Hep 3B>HepG2, being sirolimus only active in Hep3B cell line. Tacrolimus and Everolimus exerted potent antiproliferative properties in Huh 7 and Hep3B in which cells Sirolimus was inactive. Interestingly, Tacrolimus- and Everolimus-dependent G0/G1 cell accumulation occurred as a consequence of drastic reduction in S, as well as in S and G2+M phases, respectively. The in vivo studies support data on the more effective antitumoral properties of Everolimus, eventual risk of pro-angiogenic tumoral properties and nephrotoxicity of Tacrolimus, and pro-proliferative properties of Sirolimus in tumors developed in nude mice.

  16. Plant communities with Pinus mugo (alliance Pinion mugo in the subalpine belt of the Western Carpathians - a numerical approach

    Directory of Open Access Journals (Sweden)

    Jozef Šibík


    Full Text Available A syntaxonomical revision of plant communities with dominant Pinus mugo in the Western Carpathians is presented. The data set of 341 relevés was examined and analysed using the detrended correspondence analysis and the cluster analysis. Major gradients and clusters were interpreted using Ellenberg’s indicator values. The major gradient in species composition was associated with available nutrients and moisture. The authors suggest distinguishing the dwarf pine stands of the supramontanous and subalpine belts of the Western Carpathians referred to the alliance Pinion mugo Pawłowski in Pawłowski et al. 1928 of the order Junipero-Pinetalia mugo Boşcaiu 1971 and the class Roso pendulinae-Pinetea mugo Theurillat in Theurillat et al. 1995, into three separate associations: the Cetrario-Pinetum mugo Hadač 1956, the Homogyno alpinae-Pinetum mugo (Sillinger 1933 nom. nov., and the Adenostylo alliariae-Pinetum mugo (Sillinger 1933 Šoltésová 1974. The authors also elucidated the unauthorized name of the association Vaccinio myrtilli-Pinetum mugo Hadač 1956, which is a younger homonym of the valid name of the association Vaccinio myrtilli-Pinetum montanae Morton 1927 that characterises the acidophilous dwarf pine stands on calcareous bedrocks in the Alps.

  17. [Osteochondritis Dissecans of the Talus with Hindfoot Malalignment--Autologous Matrix-Induced Chondrogenesis with Lateral Calcaneal Distraction Osteotomy in an Internationally Successful Young Female Ski Racer]. (United States)

    Hotfiel, T; Engelhardt, M


    Osteochondritis dissecans of the talus (ODT) describes a special entity of osteochondral lesions of the talus (OLT). In the case of an advanced stage or failure of conservative treatment, a wide variety of surgical treatment strategies for osteochondral defects of the ankle have been described. In most cases, the ODT leads to a loss in sports time and competition. In the following case report we describe a case dealing with a young alpine ski racer who competes in international races. An osteochondritis dissecans of the talus was observed and led to pain and loss of sports function. We decided for an operative treatment with an autologous matrix-associated chondrogenesis (AMIC). In addition to the AMIC we performed a lateral calcaneal distraction osteotomy, based on the findings of a flatfoot in order to correct the hindfoot malalignment. At an early time pain relief could be detected. Step by step, the presented ski racer could increase the intensity of training sessions. Based on the findings in the MRI at the follow-up, an integrated repair tissue could be detected. The following case report describes a positive course after an autologous matrix-associated chondrogenesis (AMIC) combined with a lateral calcaneal distraction osteotomy. At this time the athlete is reintegrated in elite sports and takes part in the normal training programmes. © Georg Thieme Verlag KG Stuttgart · New York.

  18. CT-guided interstitial brachytherapy of hepatocellular carcinoma before liver transplantation: an equivalent alternative to transarterial chemoembolization?

    Energy Technology Data Exchange (ETDEWEB)

    Denecke, Timm; Stelter, Lars; Schnapauff, Dirk; Steffen, Ingo; Gebauer, Bernhard; Lopez Haenninen, Enrique; Wust, Peter [Universitaetsmedizin Berlin, Klinik fuer Radiologie, Charite, Berlin (Germany); Sinn, Bruno [Charite - Universitaetsmedizin Berlin, Institut fuer Pathologie, Berlin (Germany); Schott, Eckart [Charite 2 - Universitaetsmedizin Berlin, Medizinische Klinik m.S. Hepatologie und Gastroenterologie, Berlin (Germany); Seidensticker, Ricarda [Universitaetsklinikum der Otto-v.-Gericke-Universitaet, Klinik fuer Radiologie und Nuklearmedizin, Magdeburg (Germany); Puhl, Gero; Neuhaus, Peter; Seehofer, Daniel [Charite - Universitaetsmedizin Berlin, Klinik fuer Allgemein-, Viszeral- und Transplantationschirurgie, Berlin (Germany)


    Transarterial chemoembolization (TACE) is established as bridging therapy of HCC listed for transplantation (LT). CT-guided brachytherapy (CTB) has not been evaluated as a bridging concept. We compared CTB and TACE for bridging before LT in HCC patients. Twelve patients with HCC received LT after CTB (minimal tumour dose, 15-20 Gy). Patients were matched (CTB:TACE, 1:2) by sex, age, number and size of lesions, and underlying liver disease with patients who received TACE before transplantation. Study endpoints were extent of necrosis at histopathology and recurrence rate after OLT. There were no significant differences between the CTB and TACE groups regarding Child-Pugh category (p = 0.732), AFP (0.765), time on waiting list (p = 0.659), number (p = 0.698) and size (p = 0.853) of HCC lesions, fulfilment of Milan-criteria (p = 0.638), or previous liver-specific treatments. CTB achieved higher tumour necrosis rates than TACE (p = 0.018). The 1- and 3-year recurrence rate in the CTB group was 10 and 10 % vs. TACE, 14 and 30 % (p = 0.292). Our data show comparable or even better response and post-LT recurrence rates of CTB compared to TACE for treating HCC in patients prior to LT. CTB should be further evaluated as an alternative bridging modality, especially for patients not suited for TACE. (orig.)

  19. [Is surgery for portal hypertension a contraindication for liver transplantation?]. (United States)

    Poves, I; Figueras, J; Lama, C; Fabregat, J; Rafecas, A; Torras, J; Ramos, E; Ruiz, D; Casanovas, T; Xiol, X; Baliellas, C; Jaurrieta, E


    Orthotopic liver transplantation (OLT) is the only curative treatment for hepatic cirrhosis and is the most effective in the control of portal hypertension. The aim of this study was to analyze whether greater morbi-mortality is observed in patients undergoing liver transplantation with previous surgery for portal hypertension with respect to patients not having undergone this surgery. Different variables were analyzed in 2 groups of transplanted patients: one of 18 patients who had previously undergone surgery for portal hypertension and another group of 54 patients without this previous surgery. The following factors were studied: mean operative time and length of anahepatic phase, intraoperative consumption of concentrates of erythrocytes, fresh frozen plasma, units of platelets and cryoprecipitates, days of mechanical ventilation, stay in the ICU and total postoperative stay. No significant differences were observed (p < 0.05) in any of these factors or in survival. On analysis of the difficulty of surgical technique, postoperative evolution and survival and based on the variables described it may be concluded that previous surgery for portal hypertension does not only not contraindicate posterior liver transplantation, but rather may be useful in patients with an adequate hepative reserve presenting variceal hemorrhage since posterior transplantation does not present a worsened prognosis.

  20. Yttrium-90 microspheres (TheraSphere) treatment of unresectable hepatocellular carcinoma: downstaging to resection, RFA and bridge to transplantation. (United States)

    Kulik, Laura M; Atassi, Bassel; van Holsbeeck, Lodewijk; Souman, Tameem; Lewandowski, Robert J; Mulcahy, Mary F; Hunter, Russell D; Nemcek, Albert A; Abecassis, Michael M; Haines, Kenneth G; Salem, Riad


    To present the clinical data of 35 patients with T3 unresectable hepatocellular carcinoma (HCC) that were treated with (90)Y with the specific intent of downstaging to resection, radiofrequency ablation (RFA) candidate, United Network for Organ Sharing (UNOS) stage T2 or liver transplantation. One hundred fifty patients with unresectable HCC were treated with (90)Y microspheres. Of these, 35 patients were UNOS stage T3 at the time of treatment. Patients were followed for clinical toxicities, alterations in model for end-stage-liver disease (MELD) score, tumor response, downstaging to RFA, resection, transplantation, and survival. Nineteen of 34 patients (56%) were successfully downstaged from T3 to T2 following treatment. 11 of 34 (32%) patients treated were downstaged to target lesions measuring 3.0 cm or less. Twenty-three of 35 (66%) were downstaged to either T2 status, lesion < 3.0 cm (RFA candidate), or resection. Seventeen of 34 (50%) had an objective tumor response by WHO criteria. Eight patients (23%) were successfully downstaged and underwent OLT following treatment. 1, 2, and 3-year survival was 84%, 54%, and 27%, respectively. Median survival by Kaplan-Meier analysis for the entire cohort was 800 days. These data suggest that intra-arterial (90)Y microspheres can be used as a bridge to transplantation, surgical resection, or RFA. (c) 2006 Wiley-Liss, Inc.

  1. Dipeptidylpeptidase-­IV, a key enzyme for the degradation of incretins and neuropeptides: activity and expression in the liver of lean and obese rats

    Directory of Open Access Journals (Sweden)

    E. Tarantola


    Full Text Available Given the scarcity of donors, moderately fatty livers (FLs are currently being considered as possible grafts for orthotopic liver transplantation (OLT, notwithstanding their poor tolerance to conventional cold preservation. The behaviour of parenchymal and sinusoidal liver cells during transplantation is being studied worldwide. Much less attention has been paid to the biliary tree, although this is considered the Achille’s heel even of normal liver transplantation. To evaluate the response of the biliary compartment of FLs to the various phases of OLT reliable markers are necessary. Previously we demonstrated that Alkaline Phosphatase was scarcely active in bile canaliculi of FLs and thus ruled it out as a marker. As an alternative, dipeptidylpeptidase-IV (DPP-IV, was investigated. This ecto-peptidase plays an important role in glucose metabolism, rapidly inactivating insulin secreting hormones (incretins that are important regulators of glucose metabolism. DPP-IV inhibitors are indeed used to treat Type II diabetes. Neuropeptides regulating bile transport and composition are further important substrates of DPP-IV in the enterohepatic axis. DPP-IV activity was investigated with an azo-coupling method in the liver of fatty Zucker rats (fa/fa, using as controls lean Zucker (fa/+ and normal Wistar rats. Protein expression was studied by immunofluorescence with the monoclonal antibody (clone 5E8. In Wistar rat liver, DPP-IV activity and expression were high in the whole biliary tree, and moderate in sinusoid endothelial cells, in agreement with the literature. Main substrates of DPP-IV in hepatocytes and cholangiocytes could be incretins GLP-1 and GIP, and neuropeptides such as vasoactive intestinal peptide (VIP and substance P, suggesting that these substances are inactivated or modified through the biliary route. In lean Zucker rat liver the enzyme reaction and protein expression patterns were similar to those of Wistar rat. In obese rat liver

  2. Grant management procedure for energy saving TDM-PONs (United States)

    Alaelddin, Fuad Yousif Mohammed; Newaz, S. H. Shah; AL-Hazemi, Fawaz; Choi, Jun Kyun


    In order to minimize energy consumption in Time Division Multiplexing-Passive Optical Network (TDM-PON), IEEE and ITU-T have mandated sleep mode mechanism for Optical Network Units (ONUs) in the latest TDM-PON standards (e.g. IEEE P1904.1 SIEPON, ITU-T G.sup45). The sleep mode mechanism is a promising mean for maximizing energy saving in an ONU. An ONU in sleep mode flips between sleep and active state depending on the presence or absent of upstream and downstream frames. To ensure Quality of Service (QoS) of upstream frames, the recent TDM-PON standards introduced an early wake-up mechanism, in which an ONU is forced to leave the sleep state on upstream frame arrival. When the Optical Line Terminal (OLT) of a TDM-PON allows early wake-up of its connected ONUs, it allocates gratuitous grants for the sleeping ONUs along with allocating upstream grants for the ONUs in active state. Note that, the gratuitous grants control message sent periodically by the OLT on Inter-Gratuitous grant Interval (IGI) time. After leaving sleep state due to the arrival of upstream frame, the ONU uses its allocated gratuitous grant to send a control message mentioning the amount of upstream bandwidth (upstream grant) required in order to forward the remaining frames in its buffer. However, the existing early wake-up process of ONU can lead to increase the energy consumption of an ONU. It is because of the ONU wakes-up immediately from the sleep state on arrival of the upstream frame, but even so, it needs to wait for forwarding the frame until its allocated gratuitous grant period, resulting in spending energy unnecessarily. In addition, current energy saving solution for TDM-PONs do not provide a clear solution on how to manage different types of grants (e.g. listening grant, upstream transmission grant) within a Dynamic Bandwidth Allocation (DBA) polling cycle. To address this problem, we propose a state-of-art Grant Management Procedure (GMP) in order to maximize energy saving in a TDM

  3. Risk factors and outcome in patients with primary sclerosing cholangitis with persistent biliary candidiasis. (United States)

    Rupp, Christian; Bode, Konrad Alexander; Chahoud, Fadi; Wannhoff, Andreas; Friedrich, Kilian; Weiss, Karl-Heinz; Sauer, Peter; Stremmel, Wolfgang; Gotthardt, Daniel Nils


    Candidiasis is commonly observed in patients with primary sclerosing cholangitis (PSC), but the clinical risk factors associated with its presence have not been fully investigated. In this study, we aimed to analyse the incidence, risk factors, and transplantation-free survival in primary sclerosing cholangitis (PSC) patients with persistent biliary candidiasis. We retrospectively analysed patients diagnosed with PSC who were admitted to our department during 2002 to 2012. One-hundred fifty patients whose bile cultures were tested for fungal species were selected, and their clinical and laboratory parameters were investigated. The results of endoscopic retrograde cholangiography (ERC) and bile cultures were analysed using chart reviews. The cases of biliary candidiasis were sub-classified as transient or persistent. Thirty out of 150 (20.0%) patients had biliary candidiasis. Although all patients demonstrated comparable baseline characteristics, those with biliary candidiasis showed significantly reduced transplantation-free survival (p candidiasis. A subgroup analysis showed reduced survival with a greater necessity for orthotopic liver transplantation (OLT) only in patients with persistence of Candida (p = 0.007). The survival in the patients with transient biliary candidiasis was comparable to that in candidiasis-free patients. In a multivariate regression analysis that included Mayo risk score (MRS), sex, age, dominant stenosis, inflammatory bowel disease, autoimmune hepatitis overlap syndrome, and number of times ERC was performed, biliary candidiasis was an independent risk factor for reduced survival (p = 0.008). Risk factors associated with acquisition of biliary candidiasis were age at PSC diagnosis and number of ERCs. The persistence of biliary candidiasis is associated with markedly reduced transplantation-free survival in PSC patients. By contrast, actuarial survival in patients with transient biliary candidiasis approaches that for patients without any

  4. Novel toggle-rate based energy-efficient scheme for heavy load real-time IM-DD OFDM-PON with ONU LLID identification in time-domain using amplitude decision. (United States)

    Qin, Youxiang; Zhang, Junjie


    A novel low complexity and energy-efficient scheme by controlling the toggle-rate of ONU with time-domain amplitude identification is proposed for a heavy load downlink in an intensity-modulation and direct-detection orthogonal frequency division multiplexing passive optical network (IM-DD OFDM-PON). In a conventional OFDM-PON downlink, all ONUs have to perform demodulation for all the OFDM frames in a broadcast way no matter whether the frames are targeted to or not, which causes a huge energy waste. However, in our scheme, the optical network unit (ONU) logical link identifications (LLIDs) are inserted into each downlink OFDM frame in time-domain at the optical line terminal (OLT) side. At the ONU side, the LLID is obtained with a low complexity and high precision amplitude identification method. The ONU sets the toggle-rate of demodulation module to zero when the frames are not targeted to, which avoids unnecessary digital signal processing (DSP) energy consumption. Compared with the sleep-mode methods consisting of clock recovery and synchronization, toggle-rate shows its advantage in fast changing, which is more suitable for the heavy load scenarios. Moreover, for the first time to our knowledge, the characteristics of the proposed scheme are investigated in a real-time IM-DD OFDM system, which performs well at the received optical power as low as -21dBm. The experimental results show that 25.1% energy consumption can be saved in the receiver compared to the conventional configurations.

  5. All-optical VPN utilizing DSP-based digital orthogonal filters access for PONs (United States)

    Zhang, Xiaoling; Zhang, Chongfu; Chen, Chen; Jin, Wei; Qiu, Kun


    Utilizing digital filtering-enabled signal multiplexing and de-multiplexing, a cost-effective all-optical virtual private network (VPN) system is proposed, for the first time to our best knowledge, in digital filter multiple access passive optical networks (DFMA-PONs). Based on the DFMA technology, the proposed system can be easily designed to meet the requirements of next generation network's flexibility, elasticity, adaptability and compatibility. Through dynamic digital filter allocation and recycling, the proposed all-optical VPN system can provide dynamic establishments and cancellations of multiple VPN communications with arbitrary traffic volumes. More importantly, due to the employment of DFMA technology, the system is not limited to a fixed signal format and different signal formats such as pulse amplitude modulation (PAM), quadrature amplitude modulation (QAM) and orthogonal frequency division multiplexing (OFDM) can be used. Moreover, one transceiver is sufficient to simultaneously transmit upstream (US)/VPN data to optical line terminal (OLT) or other VPN optical network units (ONUs), thus leading to great reduction in network constructions and operation expenditures. The proposed all-optical VPN system is demonstrated with the transceiver incorporating the formats of QAM and OFDM, which can be made transparent to downstream (DS), US and VPN communications. The bit error rates (BERs) of DS, US and VPN for OFDM signals are below the forward-error-correction (FEC) limit of 3 . 8 × 10-3 when the received optical powers are about -16.8 dBm, -14.5 dBm and -15.7 dBm, respectively.

  6. Argininosuccinate lyase deficiency. (United States)

    Nagamani, Sandesh C S; Erez, Ayelet; Lee, Brendan


    The urea cycle consists of six consecutive enzymatic reactions that convert waste nitrogen into urea. Deficiencies of any of these enzymes of the cycle result in urea cycle disorders (UCDs), a group of inborn errors of hepatic metabolism that often result in life-threatening hyperammonemia. Argininosuccinate lyase (ASL) catalyzes the fourth reaction in this cycle, resulting in the breakdown of argininosuccinic acid to arginine and fumarate. ASL deficiency (ASLD) is the second most common UCD, with a prevalence of ~1 in 70,000 live births. ASLD can manifest as either a severe neonatal-onset form with hyperammonemia within the first few days after birth or as a late-onset form with episodic hyperammonemia and/or long-term complications that include liver dysfunction, neurocognitive deficits, and hypertension. These long-term complications can occur in the absence of hyperammonemic episodes, implying that ASL has functions outside of its role in ureagenesis and the tissue-specific lack of ASL may be responsible for these manifestations. The biochemical diagnosis of ASLD is typically established with elevation of plasma citrulline together with elevated argininosuccinic acid in the plasma or urine. Molecular genetic testing of ASL and assay of ASL enzyme activity are helpful when the biochemical findings are equivocal. However, there is no correlation between the genotype or enzyme activity and clinical outcome. Treatment of acute metabolic decompensations with hyperammonemia involves discontinuing oral protein intake, supplementing oral intake with intravenous lipids and/or glucose, and use of intravenous arginine and nitrogen-scavenging therapy. Dietary restriction of protein and dietary supplementation with arginine are the mainstays in long-term management. Orthotopic liver transplantation (OLT) is best considered only in patients with recurrent hyperammonemia or metabolic decompensations resistant to conventional medical therapy.

  7. Network coding based joint signaling and dynamic bandwidth allocation scheme for inter optical network unit communication in passive optical networks (United States)

    Wei, Pei; Gu, Rentao; Ji, Yuefeng


    As an innovative and promising technology, network coding has been introduced to passive optical networks (PON) in recent years to support inter optical network unit (ONU) communication, yet the signaling process and dynamic bandwidth allocation (DBA) in PON with network coding (NC-PON) still need further study. Thus, we propose a joint signaling and DBA scheme for efficiently supporting differentiated services of inter ONU communication in NC-PON. In the proposed joint scheme, the signaling process lays the foundation to fulfill network coding in PON, and it can not only avoid the potential threat to downstream security in previous schemes but also be suitable for the proposed hybrid dynamic bandwidth allocation (HDBA) scheme. In HDBA, a DBA cycle is divided into two sub-cycles for applying different coding, scheduling and bandwidth allocation strategies to differentiated classes of services. Besides, as network traffic load varies, the entire upstream transmission window for all REPORT messages slides accordingly, leaving the transmission time of one or two sub-cycles to overlap with the bandwidth allocation calculation time at the optical line terminal (the OLT), so that the upstream idle time can be efficiently eliminated. Performance evaluation results validate that compared with the existing two DBA algorithms deployed in NC-PON, HDBA demonstrates the best quality of service (QoS) support in terms of delay for all classes of services, especially guarantees the end-to-end delay bound of high class services. Specifically, HDBA can eliminate queuing delay and scheduling delay of high class services, reduce those of lower class services by at least 20%, and reduce the average end-to-end delay of all services over 50%. Moreover, HDBA also achieves the maximum delay fairness between coded and uncoded lower class services, and medium delay fairness for high class services.

  8. Genetic expression programming-based DBA for enhancing peer-assisted music-on-demand service in EPON (United States)

    Liem, Andrew Tanny; Hwang, I.-Shyan; Nikoukar, AliAkbar; Lee, Jhong-Yue


    Today, the popularity of peer-assisted music-on-demand (MoD) has increased significantly worldwide. This service allows users to access large music library tracks, listen to music, and share their playlist with other users. Unlike the conventional voice traffic, such an application maintains music quality that ranges from 160 kbps to 320 kbps, which most likely consumes more bandwidth than other traffics. In the access network, Ethernet passive optical network (EPON) is one of the best candidates for delivering such a service because of being cost-effective and with high bandwidth. To maintain music quality, a stutter needs to be prevented because of either network effects or when the due user was not receiving enough resources to play in a timely manner. Therefore, in this paper, we propose two genetic expression programming (GEP)-based dynamic bandwidth allocations (DBAs). The first DBA is a generic DBA that aims to find an optimum formula for voice, video, and data services. The second DBA aims to find optimum formulas so that Optical Line Terminal (OLT) can satisfy not only the voice and Peer-to-Peer (P2P) MoD traffics but also reduce the stutter. Optical Network Unit (ONU) traits such as REPORT and GATE messages, cycle time, and mean packet delay are set to be predictor variables. Simulation results show that our proposed DBAs can satisfy the voice and P2P MoD services packet delay and monitor other overall system performances such as expedited forwarding (EF) jitter, packet loss, bandwidth waste, and system throughputs.

  9. A SIEPON based transmitter sleep mode energy-efficient mechanism in EPON (United States)

    Nikoukar, AliAkbar; Hwang, I.-Shyan; Wang, Chien-Jung; Ab-Rahman, Mohammad Syuhaimi; Liem, Andrew Tanny


    The main energy consumption in computer networks is the access networks. The passive optical network (PON) has the least energy consumption among access network technologies. In addition, the time division multiplexing (TDM) Ethernet PON (EPON) is one of the best candidates to improve energy consumption by time utilization. The optical network unit (ONU) can utilize the time and save the energy in the EPON by turning off its transmitter/receiver when there is no upstream/downstream traffic. The ITU-T and IEEE organizations are published standards for energy-saving in the TDM-PON. Although their standards provide the framework to accomplish the energy-saving, the algorithms/criteria to generate events to accommodate various operational policies, time to wake up, parameter values for timers are out of scope of the standards. Many studies have proposed schemes for energy-saving in TDM-PON to achieve maximum energy saving. Even so, these schemes increase the mean packet delay and consequently, reduce the quality of service (QoS). In this paper, first we take a look to the state of the art for PON energy-saving. Additionally, a mechanism based on SIEPON standard in EPON with new components in the ONUs and optical line terminal (OLT) is proposed to save the transmitter energy and guarantee QoS. The proposed mechanism follows the SIEPON standard, considers the QoS first, and then saves the energy as far as possible. The ONU sleep controller unit (OSC) and green dynamic bandwidth allocation (GDBA) are used to calculate the ONU transmitter sleep (Tx) duration and grant the proper time to the ONUs. Simulation results show that the proposed energy-saving mechanism not only promises the QoS performance in terms of mean packet delay, packet loss, throughput, and jitter, but also saves energy in different maximum cycle times.

  10. Pulmonary complications of liver transplantation: radiological appearance and statistical evaluation of risk factors in 300 cases

    International Nuclear Information System (INIS)

    Golfieri, R.; Giampalma, E.; D'Arienzo, P.; Maffei, M.; Muzzi, C.; Tancioni, S.; Gavelli, G.; Morselli Labate, A.M.; Sama, C.; Jovine, E.; Grazi, G.L.; Mazziotti, A.; Cavallari, A.


    The aim of this study was to evaluate the incidence, radiographic appearance, time of onset, outcome and risk factors of non-infectious and infectious pulmonary complications following liver transplantation. Chest X-ray features of 300 consecutive patients who had undergone 333 liver transplants over an 11-year period were analysed: the type of pulmonary complication, the infecting pathogens and the mean time of their occurrence are described. The main risk factors for lung infections were quantified through univariate and multivariate statistical analysis. Non-infectious pulmonary abnormalities (atelectasis and/or pleural effusion: 86.7%) and pulmonary oedema (44.7%) appeared during the first postoperative week. Infectious pneumonia was observed in 13.7%, with a mortality of 36.6%. Bacterial and viral pneumonia made up the bulk of infections (63.4 and 29.3%, respectively) followed by fungal infiltrates (24.4%). A fairly good correlation between radiological chest X-ray pattern, time of onset and the cultured microorganisms has been observed in all cases. In multivariate analysis, persistent non-infectious abnormalities and pulmonary oedema were identified as the major independent predictors of posttransplant pneumonia, followed by prolonged assisted mechanical ventilation and traditional caval anastomosis. A ''pneumonia-risk score'' was calculated: low-risk score ( 3.30) population. The ''pneumonia-risk score'' identifies a specific group of patients in whom closer radiographic monitoring is recommended. In addition, a highly significant correlation (p<0.001) was observed between pneumonia-risk score and the expected survival, thus confirming pulmonary infections as a major cause of death in OLT recipients. (orig.)

  11. [Current developments in liver transplantation in Germany: MELD-based organ allocation and incentives for transplant centres]. (United States)

    Schlitt, H J; Loss, M; Scherer, M N; Becker, T; Jauch, K-W; Nashan, B; Schmidt, H; Settmacher, U; Rogiers, X; Neuhaus, P; Strassburg, C


    Liver transplantation represents a successful and well-established therapeutic concept for patients with advanced liver diseases. Organ donor shortage continues to pose a significant problem. To ensure fair and transparent allocation of too few post-mortem grafts, the model of end-stage liver disease (MELD)-based allocation was implemented in December 2006. This has decreased waiting list mortality from 20 to 10 % but at the same time has reduced post OLT survival (1-year survival from almost 90% to below 80%), which is largely due to patients with a labMELD score > 30. Following MELD introduction the regular allocation threshold has increased from a matchMELD of initially 25 to meanwhile 34. At the same time the quality of donor organs has seen a continuous deterioration over the last 10 - 15 years: 63% of organs are "suboptimal" with a donor risk index of > 1.5. Moreover, the numbers of living-related liver transplantations have decreased. In Germany incentives for transplant centres are inappropriate: patients with decompensated cirrhosis, high MELD scores and high post-transplant mortality as well as marginal liver grafts are accepted for transplantation without the necessary consideration of outcomes, and against a background of the still absent publication and transparency of outcome results. The outlined development calls for measures for improvement: (i) the increase of donor grafts (e. g., living donation, opt-out solutions, non-heart beating donors), (ii) the elimination of inappropriate incentives for transplant centres, (iii) changes of allocation guidelines, that take the current situation and suboptimal donor grafts into account, and (iv) the systematic and complete collection of transplant-related data in order to allow for the development of improved prognostic scores. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Symmetric 40-Gb/s TWDM-PON with 51-dB loss budget by using a single SOA as preamplifier, booster and format converter in ONU. (United States)

    Li, Zhengxuan; Yi, Lilin; Hu, Weisheng


    In this paper, we propose to use a semiconductor optical amplifier (SOA) in the optical network unit (ONU) to improve the loss budget in time and wavelength division multiplexed-passive optical network (TWDM-PON) systems. The SOA boosts the upstream signal to increase the output power of the electro-absorption modulated laser (EML) and simultaneously pre-amplifies the downstream signal for sensitivity improvement. The penalty caused by cross gain modulation (XGM) effect is negligible due to the low extinction ratio (ER) of upstream signal and the large wavelength difference between upstream and downstream links. In order to achieve a higher output power, the SOA is driven into its saturation region, where the self-phase modulation (SPM) effect converts the intensity into phase information and realizes on-off-keying (OOK) to phase-shifted-keying (PSK) format conversion. In this way, the pattern effect is eliminated, which releases the requirement of gain-clamping on SOA. To further improve the loss budget of upstream link, an Erbium doped fiber amplifier (EDFA) is used in the optical line terminal (OLT) to pre-amplify the received signal. For the downstream direction, directly modulated laser (DML) is used as the laser source. Taking advantage of its carrier-less characteristic, directly modulated signal shows high tolerance to fiber nonlinearity, which could support a downstream launch power as high as + 16 dBm per channel. In addition, the signal is pre-amplified by the SOA in ONU before being detected, so the sensitivity limitation for downstream link is also removed. As a result, a truly passive symmetric 40-Gb/s TWDM-PON was demonstrated, achieving a link loss budget of 51 dB.

  13. Performance analysis of TCP traffic and its influence on ONU's energy saving in energy efficient TDM-PON (United States)

    Alaelddin, Fuad Yousif Mohammed; Newaz, S. H. Shah; Lee, Joohyung; Uddin, Mohammad Rakib; Lee, Gyu Myoung; Choi, Jun Kyun


    The majority of the traffic over the Internet is TCP based, which is very sensitive to packet loss and delay. Existing research efforts in TDM-Passive Optical Networks (TDM-PONs) mostly evaluate energy saving and traffic delay performances under different energy saving solutions. However, to the best of our knowledge, how energy saving mechanisms could affect TCP traffic performance in TDM-PONs has hardly been studied. In this paper, by means of our state-of-art OPNET Modular based TDM-PON simulator, we evaluate TCP traffic delay, throughput, and Optical Network Unit (ONU) energy consumption performances in a TDM-PON where energy saving mechanisms are employed in ONUs. Here, we study the performances under commonly used energy saving mechanisms defined in standards for TDM-PONs: cyclic sleep and doze mode. In cyclic sleep mode, we evaluate the performances under two well-known sleep interval length deciding algorithms (i.e. fixed sleep interval (FSI) and exponential sleep interval deciding (ESID)) that an OLT uses to decide sleep interval lengths for an ONU. Findings in this paper put forward the strong relationship among TCP traffic delay, throughput and ONU energy consumption under different sleep interval lengths. Moreover, we reveal that under high TCP traffic, both FSI and ESID will end up showing similar delay, energy and throughput performance. Our findings also show that doze mode can offer better TCP throughput and delay performance at the price of consuming more energy than cyclic sleep mode. In addition, our results provide a glimpse on understanding at what point doze mode becomes futile in improving energy saving of an ONU under TCP traffic. Furthermore, in this paper, we highlight important research issues that should be studied in future research to maximize energy saving in TDM-PONs while meeting traffic Quality of Service requirements.

  14. Outcomes of Locoregional Tumor Therapy for Patients with Hepatocellular Carcinoma and Transjugular Intrahepatic Portosystemic Shunts

    Energy Technology Data Exchange (ETDEWEB)

    Padia, Siddharth A., E-mail:; Chewning, Rush H., E-mail:; Kogut, Matthew J., E-mail:; Ingraham, Christopher R., E-mail:; Johnson, Guy E., E-mail: [University of Washington Medical Center, Section of Interventional Radiology, Department of Radiology (United States); Bhattacharya, Renuka, E-mail: [University of Washington Medical Center, Division of Gastroenterology and Hepatology, Department of Medicine (United States); Kwan, Sharon W., E-mail:; Monsky, Wayne L., E-mail:; Vaidya, Sandeep, E-mail: [University of Washington Medical Center, Section of Interventional Radiology, Department of Radiology (United States); Hippe, Daniel S., E-mail: [University of Washington Medical Center, Department of Radiology (United States); Valji, Karim, E-mail: [University of Washington Medical Center, Section of Interventional Radiology, Department of Radiology (United States)


    PurposeLocoregional therapy for hepatocellular carcinoma (HCC) can be challenging in patients with a transjugular intrahepatic portosystemic shunt (TIPS). This study compares safety and imaging response of ablation, chemoembolization, radioembolization, and supportive care in patients with both TIPS and HCC.MethodsThis retrospective study included 48 patients who had both a TIPS and a diagnosis of HCC. Twenty-nine of 48 (60 %) underwent treatment for HCC, and 19/48 (40 %) received best supportive care (i.e., symptomatic management only). While etiology of cirrhosis and indication for TIPS were similar between the two groups, treated patients had better baseline liver function (34 vs. 67 % Child-Pugh class C). Tumor characteristics were similar between the two groups. A total of 39 ablations, 17 chemoembolizations, and 10 yttrium-90 radioembolizations were performed on 29 patients.ResultsAblation procedures resulted in low rates of hepatotoxicity and clinical toxicity. Post-embolization/ablation syndrome occurred more frequently in patients undergoing chemoembolization than ablation (47 vs. 15 %). Significant hepatic dysfunction occurred more frequently in the chemoembolization group than the ablation group. Follow-up imaging response showed objective response in 100 % of ablation procedures, 67 % of radioembolization procedures, and 50 % of chemoembolization procedures (p = 0.001). When censored for OLT, patients undergoing treatment survived longer than patients receiving supportive care (2273 v. 439 days, p = 0.001).ConclusionsAblation appears to be safe and efficacious for HCC in patients with TIPS. Catheter-based approaches are associated with potential increased toxicity in this patient population. Chemoembolization appears to be associated with increased toxicity compared to radioembolization.

  15. Arthroscopic autologous chondrocyte implantation in the ankle joint. (United States)

    Giannini, Sandro; Buda, Roberto; Ruffilli, Alberto; Cavallo, Marco; Pagliazzi, Gherardo; Bulzamini, Maria Chiara; Desando, Giovanna; Luciani, Deianira; Vannini, Francesca


    Autologous chondrocyte implantation (ACI) is an established procedure in the ankle providing satisfactory results. The development of a completely arthroscopic ACI procedure in the ankle joint made the technique easier and reduced the morbidity. The purpose of this investigation was to report the clinical results of a series of patients who underwent arthroscopic ACI of the talus at a mean of 7 ± 1.2-year follow-up. Forty-six patients (mean age 31.4 ± 7.6) affected by osteochondral lesions of the talar dome (OLT) received arthroscopic ACI between 2001 and 2006. Patients were clinically evaluated using AOFAS score pre-operatively and at 12, 36 months and at final follow-up of 87.2 ± 14.5 months. The mean pre-operative AOFAS score was 57.2 ± 14.3. At the 12-month follow-up, the mean AOFAS score was 86.8 ± 13.4 (p = 0.0005); at 36 months after surgery, the mean score was 89.5 ± 13.4 (p = 0.0005); whereas at final follow-up of 87.2 ± 14.5 months it was 92.0 ± 11.2 (p = 0.0005). There were three failures. Histological and immunohistochemical evaluations of specimens harvested from failed implants generally showed several aspects of a fibro-cartilaginous tissue associated with some aspects of cartilage tissue remodelling as indicated by the presence of type II collagen expression. This study confirmed the ability of arthroscopic ACI to repair osteochondral lesions in the ankle joint with satisfactory clinical results after mid-term follow-up. IV, retrospective case series.

  16. Liver transplantation in Greek children: 15 years experience

    Directory of Open Access Journals (Sweden)

    Dimitrios Takoudas


    Full Text Available Liver transplantation (LT is the only available live-saving procedure for children with irreversible liver failure. This paper reports our experience from the follow-up of 16 Greek children with end-stage liver failure who underwent a LT. Over a period of 15 years, 16 pediatric liver recipients received follow up after being subjected to OLT (orthotopic liver transplantation due to end-stage liver failure. Nine children initially presented with extrahepatic biliary atresia, 2 with acute liver failure after toxic mushroom ingestion, 2 with intrahepatic cholestasis, 2 with metabolic diseases and one with hepatoblastoma. Ten children received a liver transplant in the Organ Transplantation Unit of Aristotle University of Thessaloniki and the rest in other transplant centers. Three transplants came from a living-related donor and 13 from a deceased donor. Six children underwent immunosuppressive treatment with cyclo­sporine, mycophenolate mofetil and corticosteroids, and 7 with tacrolimus, mycophenolate mofetil and corticosteroids. Three out of 16 children died within the first month after the transplantation due to post-transplant complications. Three children presented with acute rejection and one with chronic organ rejection which was successfully managed. Five children presented with cytomegalovirus infection, 5 with Epstein-Barr virus, 2 with HSV1,2, 2 with ParvoB19 virus, 2 with varicella-zoster virus and one with C. Albicans infection. One child presented with upper gastrointestinal hemorrhage and one with small biliary paucity. A satisfying outcome was achieved in most cases, with good graft function, except for the patient with small biliary paucity who required re-transplantation. The long-term clinical course of liver transplanted children is good under the condition that they are attended in specialized centers.

  17. [Effect of mechanical self-cleaning of tongue coating on malodor in halitosis patients originating from tongue coating]. (United States)

    Wang, J; He, L


    To evaluate the malodor level and to explore the effect of mechanical self-cleaning of tongue coating in patients with halitosis originating from tongue coating. Ten patients with halitosis originating from tongue coating were enrolled and divided into two groups randomly. The patients in test group received instruction of mechanical cleaning of tongue coating while no such instruction was given to control group. Organoleptic test (OLT) score, volatile sulfide compounds (VSC) value, area of tongue coating (Ta), thickness of tongue coating (Tt) and periodontal condition were recorded at baseline and were repeated at the end of 1 week, 2 weeks, 4 weeks and 8 weeks later. The clinical outcomes were compared at different time points between the groups. Also, changes within the group were analyzed. As time went by, tongue coating area and thickness tended to decrease in test group while the changes showed no statistically difference (P>0.05). The organoleptic score in test group decreased significantly (P0.05), though they showed a tendency to decrease and fewer changes in control group were found. Compared with the baseline, average probing depth and bleeding index (P0.05). Plaque index showed no difference at different time points in both the groups (P>0.05). Mechanical self-cleaning of tongue coating did not influence plaque index while it had tendency to reduce tongue coating area and thickness. Malodor could be released after self-cleaning of tongue coating to a certain extent, indicating necessity and importance of intervention role by dentists.

  18. Biofilms as bioindicators of mercury exposure in surface waters (United States)

    Le Faucheur, S.; Dranguet, P.; Freiburghaus, A.; Slaveykova, V. I.; Carmen, M.


    Biofilms are communities of microorganisms living in shallow waters, which possess several interesting characteristics to be a good bioindicator, i.e. ubiquitous, easy to collect, integrator of the quality of their ambient environment and sensitive to pollutants. Our work investigated whether biofilm could be used as a bioindicator of Hg contamination in natural waters and explore the links between ambient Hg concentrations, its bioaccumulation and biofilm composition. To that end, field- and lab-based experiments were performed with biofilm grown on artificial substrata in either Hg-impacted waters and in microcosms spiked with Hg. The field experiments were performed in contrasted environments: the Olt River (Romania) impacted by chloro-alkali releases and the lagoon of Venice (Italy) affected by urban, industrial and agricultural activities. The field studies were complemented with microcosm experiments using Geneva Lake water enriched with Hg (13 pM to 1.4 nM). Bioaccumulated inorganic HgII and methylmercury (CH3Hg) in biofilms were measured w/o cysteine washing step to assess the total and intracellular Hg content. Biofilm composition was examined from gene to community levels using several techniques, notably qPCR, epifluorescent microscopy and pyrosequencing. In parallel the physico-chemical parameters of the ambient waters (pH, anion/cation and dissolved organic matter concentrations) were well characterized and dissolved Hg concentrations measured. Commercially available DGTs for Hg were additionally used in the lagoon of Venice. The main findings of the study can be summarized as follows: (i) accumulation of Hg in biofilms well correlates with ambient Hg concentration in a specific environment, but (ii) that bioaccumulation highly depends of biofilm composition, with bacterial-dominated biofilms having higher uptake rate constants than algal-dominated biofilms, and (iii) Hg exposure at environmental low concentrations (pM levels) strongly impacts algal

  19. Utilizing generalized autocalibrating partial parallel acquisition (GRAPPA) to achieve high-resolution contrast-enhanced MR angiography of hepatic artery: Initial experience in orthotopic liver transplantation candidates

    Energy Technology Data Exchange (ETDEWEB)

    Xu Pengju [Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai (China)]. E-mail:; Yan Fuhua [Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai (China)]. E-mail:; Wang Jianhua [Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai (China); Lin Jiang [Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai (China); Fan Jia [Liver Cancer Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai (China)


    evaluating OLT candidate000.

  20. Avaliação hemodinâmica como critério de prescrição de oxigénioterapia de longo termo na insuficiência respiratória crónica grave secundária a bronquite crónica e enfisema

    Directory of Open Access Journals (Sweden)

    Joaquim Moita


    Full Text Available RESUMO: A presença e magnitude da hipertensão da hipertensão da artéria pulmonar (HTAP tem um impacto negativo no prognóstico dos doentes com Insuficiência Respiratória Crónica Grave (IRCG, definida por PaO2<65 mmHg, secundária a Bronquite Crónica e Enfisema (BCE. O aumento de sobrevida destes doentes depende, em grande medida, da identificação precoce da HTA e da sua correcção com a administração de Oxigénioterapia de Longo Termo (OLT, motivo pelo qual a medição directa da Pressão da Artéria Pulmonar (PAP, por cateterismo de Swan-Ganz, integra o protocolo de avaliação a que subtemos todos os doentes com IRCG.Com vista a esclarecer o papel do cateterismo como critério complementar na selecção de candidatos a OLT, apresentamos nos primeiros 49 doentes cateterizados, a relação da PAP com: VEMS, PaO2 e PaCO2, sinais electrocardiogréficos de Cor Pulmonale Crónico (CPC e sinais de Insuficiência Cardíaca Direita (ICD.No grupo de 39 doentes com HTAP (PAP≥20 os valores de VEMS, PaO2, e PaCO2 (28,9;54,6 e 49,0 são mais graves que os encontrados nos doentes sem HTAP (40,0;58,4 e 46,7.A HTAP está presente quase universalmente nos doentes com PaO2≤55 mmHg (em 24 de 27 casos nestas circunstâncias e, em grande número de doentes com PaO2≤65 mmHg (15 de 22.O padrão electrocardiográfico de CPC e/ou semiologia de ICD, presente em cerca de 1/3 dos doentes, mostraram-se elementos diagnósticos de HTAP específicos, mas pouco sensíveis.Conclui-se que o cateterismo do coração direito desempenha um papel importante na selecção de candidatos a OLT com critérios de prescrição “borderline” (55 ≤: PaO2≥65. ABTRACT: HEMODYNAMIC EVALUATION AS A CRITERION IN THE PRESCRIPTION OF LONG TERM OXYGEN THERAPY IN SEVERE CHRONIC RESPIRATORY FAILURE SECONDARY TO CHRONIC OBSTRUCTIVE PULMONARY DISEASEThe

  1. Four-fold increase in users of time-wavelength division multiplexing (TWDM) passive optical network (PON) by delayed optical amplitude modulation (AM) upstream (United States)

    Kachhatiya, Vivek; Prince, Shanthi


    In this paper, we have proposed and simulated optical time division multiplexed passive optical network (TDM-PON) using delayed optical amplitude modulation (AM). Eight upstream wavelengths are demonstrated to show optical time wavelength division multiplexed (TWDM) by combining optical network units (ONU) users data at the remote node (RN). Each ONU generates 2.5 Gb/s user data, and it is modulated using novel return to zero (RZ) delayed AM. Optical TDM aggregates 10 Gb/s data per wavelength from four 2.5 Gb/s upstream user data, which facilitates four different ONU data on the same wavelength as 10 Gb/s per upstream wavelength and, simplify the laser requirements (2.5 Gb/s) at each optical network unit (ONU) transmitter. Upstream optical TWDM-PON is investigated for eight wavelengths with wavelength spacing of 100 GHz. Novel optical TDM for upstream increased the number of the simultaneous user to fourfold from conventional TWDM-PON using delayed AM with a high-quality-factor of received signal. Despite performance degradation due to different fiber reach and dispersion compensation technique, Optical TWDM link shows significant improvement regarding receiver sensitivity when compared with common TWDM link. Hence, it offers optimistic thinking to show optical TDM at this phase as one of the future direction, where complex digital signal processing (DSP) and coherent optical communication are frequently demonstrated to serve the access network. Downstream side conventional TWDM eight wavelengths are multiplexed at the OLT and sent downstream to serve distributed tunable ONU receivers through an optical distribution network (ODN). Each downstream wavelengths are modulated at the peak rate of 10 Gb/s using non-return to zero external modulation (NRZ-EM). The proposed architecture is cost efficient and supports high data rates as well as ;pay as you grow; network for both service providers and the users perspectives. Users are classified into two categories viz home

  2. Ring-like reliable PON planning with physical constraints for a smart grid (United States)

    Wang, Xin; Gu, Rentao; Ji, Yuefeng


    Due to the high reliability requirements in the communication networks of a smart grid, a ring-like reliable PON is an ideal choice to carry power distribution information. Economical network planning is also very important for the smart grid communication infrastructure. Although the ring-like reliable PON has been widely used in the real applications, as far as we know, little research has been done on the network optimization subject of the ring-like reliable PON. Most PON planning research studies only consider a star-like topology or cascaded PON network, which barely guarantees the reliability requirements of the smart grid. In this paper, we mainly investigate the economical network planning problem for the ring-like reliable PON of the smart grid. To address this issue, we built a mathematical model for the planning problem of the ring-like reliable PON, and the objective was to minimize the total deployment costs under physical constraints. The model is simplified such that all of the nodes have the same properties, except OLT, because each potential splitter site can be located in the same ONU position in power communication networks. The simplified model is used to construct an optimal main tree topology in the complete graph and a backup-protected tree topology in the residual graph. An efficient heuristic algorithm, called the Constraints and Minimal Weight Oriented Fast Searching Algorithm (CMW-FSA), is proposed. In CMW-FSA, a feasible solution can be obtained directly with oriented constraints and a few recursive search processes. From the simulation results, the proposed planning model and CMW-FSA are verified to be accurate (the error rates are less than 0.4%) and effective compared with the accurate solution (CAESA), especially in small and sparse scenarios. The CMW-FSA significantly reduces the computation time compared with the CAESA. The time complexity algorithm of the CMW-FSA is acceptable and calculated as T(n) = O(n3). After evaluating the

  3. FTTH passive optical networks and fiber plant design (United States)

    Shen, Steven; Rich, Bill


    With extraordinary increase of bandwidth requirement nowadays, service providers are compelled to push fiber deeper into the access networks in order to be able to offer the emerging services that customers are demanding. The economic aspects from the business side also put pressure on operators to deploy single network for multiple applications in order to maximize profitability. There are various technologies used today to increase the capacity of the access network. Fiber-To-The-Home (FTTH) utilizing ATM Passive Optical Networking (APON) has been developed for and field-tried in numerous networks all over the world. The advantages of APON solution lies in its future proof fiber based access technology (high bandwidth and long service life). Fiber and passive components used in the network are very reliable and low in the maintenance cost. The APON technology is standardized in ITU-T G.983, which is originated from Full Services Access Network (FSAN) initiatives. It supports multiple applications and provides powerful quality of service (QoS). In this paper, the requirements for APON FTTH network architecture, transport protocol and operation are examined in line with G.983 standards. The comparisons of APON to other existing high data rate access network solutions are then briefly discussed. Case studies of APON FTTH field trials are used as examples. These trials represented current status of APON FTTH development in US, on both network system elements and fiber plant components. A complete picture of APON FTTH network system and Outside Plant (OSP) design from CO to the residential homes is illustrated by these field trials. Discussions are given on topics related to APON FTTH system elements, such as OLT/ONT design, lifeline support, optical power budget and operation/fault management. Considerations regarding the design and deployment of OSP components focus on the configuration and construction of the fiber plant. Common issues related to field

  4. SNL evaluation of Gigabit Passive Optical Networks (GPON).

    Energy Technology Data Exchange (ETDEWEB)

    Heckart, David G.; Roybal, Glen B.; Walker, Betty R.; Pratt, Thomas Joseph; Gossage, Steven Allen; Trujillo, Sandra M.; Fischer, Bob; Brenkosh, Joseph Peter; Rudolfo, Gerald F.; Dirks, David H.; Schutt, James Alan


    Gigabit Passive Optical Networks (GPON) is a networking technology which offers the potential to provide significant cost savings to Sandia National Laboratories in the area of network operations. However, a large scale GPON deployment requires a significant investment in equipment and infrastructure. Before a large scale GPON system was acquired and built, a small GPON system manufactured by Motorola was acquired and tested. The testing performed was to determine the suitability of GPON for use at SNL. This report documents that testing. This report presents test results of GPON system consisting of Motorola and Juniper equipment. The GPON system was tested in areas of data throughput, video conferencing, VOIP, security, and operations and management. The GPON system performed well in almost all areas. GPON will not meet the needs of the low percentage of users requiring a true 1-10 Gbps network connection. GPON will also most likely not meet the need of some servers requiring dedicated throughput of 1-10 Gbps. Because of that, there will be some legacy network connections that must remain. If these legacy network connections can not be reduced to a bare minimum and possibly consolidated to a few locations, any cost savings gained by switching to GPON will be negated by maintaining two networks. A contract has been recently awarded for new GPON equipment with larger buffers. This equipment should improve performance and further reduce the need for legacy network connections. Because GPON has fewer components than a typical hierarchical network, it should be easier to manage. For the system tested, the management was performed by using the AXSVison client. Access to the client must be tightly controlled, because if client/server communications are compromised, security will be an issue. As with any network, the reliability of individual components will determine overall system reliability. There were no failures with the routers, OLT, or Sun Workstation Management


    Directory of Open Access Journals (Sweden)

    Enea Constanta


    Full Text Available With EU accession, Romania will follow the development of convergence with EU policies both in real terms and as absolute values. The process of reducing disparities in Romania is maintaining sustained growth rates during 2007 - 2013, keeping at the same time, macroeconomic equilibrium levels more stable. The determining factor for economic growth, on the open market a competitor, is to increase economic competitiveness. In addition, exploitation of competitive advantages must be a permanent objective, taking into account both European trends, and the challenges of globalization. Therefore, increasing competitiveness should not be viewed as a process of exploitation of short-term advantages (eg low cost of labor, but as a process of building an economic structure based on capital investment and research processes, development and innovation. In other words, articulating a vision of convergence on medium and long term need to consider developing a knowledge-based economy. Although substantial progress in recent years, Romania has serious gaps in competitiveness in relation to the Western and Central Europe. The reasons for this sluggishness can be found in all the elements that determine the competitive ability. All are translated, ultimately, in a low productivity, which defines competitiveness problem in Romania. Transalpina road is the highest road in Romania and even the entire chain of the Carpathian Mountains, both in Romania and beyond, reaching maximum altitude 2145 m in Step Urdele (Transfăgărăşan, more commonly known, is the second road in Romania high altitude, climb to 2042 meters. Parang Mountains cross the road from N to S is parallel to the Olt Valley Jiu Valley being placed between them. Although higher than the oldest and most beautiful Transfagarasan, is less known because Transalpina, although it is classified national road DN 67C (part, was never paved until 2009. Transalpina was built by the Roman armies on their way to

  6. Solutal convection induced by dissolution. Influence on erosion dynamics and interface shaping. (United States)

    Berhanu, Michael; Philippi, Julien; Cohen, Caroline; Derr, Julien; Courrech du Pont, Sylvain


    dissolution patterns can be related to the characteristic of the convective flow. C. Oltéan, F. Golfier and M.A. Buès, Numerical and experimental investigation of buoyancy-driven dissolution in vertical fracture, J. Geophys. Res. Solid Earth, 118(5), 2038-2048 (2013) C. Cohen, M. Berhanu, J. Derr and S. Courrech du Pont, Erosion patterns on dissolving and melting bodies (2015 Gallery of Fluid motion), Phys. Rev. Fluids, 1, 050508 (2016) T. S. Sullivan, Y. Liu, and R. E. Ecke, Turbulent solutal convection and surface patterning in solid dissolution, Phys. Rev. E 54, 486 (1996)

  7. Utilizing generalized autocalibrating partial parallel acquisition (GRAPPA) to achieve high-resolution contrast-enhanced MR angiography of hepatic artery: Initial experience in orthotopic liver transplantation candidates

    International Nuclear Information System (INIS)

    Xu Pengju; Yan Fuhua; Wang Jianhua; Lin Jiang; Fan Jia


    OLT candidates

  8. Impact of dietary intake and nutritional status on outcomes after liver transplantation Efecto de la ingesta y del estado nutricional en el trasplante hepático

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    D. A. de Luis


    Full Text Available Objective: the aim of our study was to examine, in a prospective way, whether any nutritional parameter could predict outcomes after liver transplantation. Material and subjects: a nutritional assessment was performed in 31 consecutive patients six months prior to undergoing orthotopic liver transplantation (OLT at a single center (Hospital U. Río Hortega and after six months of OLT (December 2002-June 2004. The nutritional evaluation included Subjective Global Assessment (SGA, Mini Nutritional Assessment test (MNA, anthropometry, laboratory tests, and three-day diet diary completed. The body composition analysis was performed by tetrapolar body electrical bioimpedance and skin folds in a standard way. Results: our patients had an average age of 56.2 ± 8.11 years; weight was 72.9 ± 15.3 kg, and body mass index was 26.6 ± 4.1. The anthropometric evaluation showed the following data: tricipital skin fold 12.2 ± 6.1 mm, mid-arm circumference 24.5 ± 4.1 cm, fat-free mass 54.5 ± 10.9 kg, fat mass 18.4 ± 6.5 mm, and body water 41.4 ± 9.1 kg. After six months from liver transplantation, these parameters remained unchanged. Energy intake, as corrected by weight, was similar pre- and post-liver transplantation (28.1 ± 6 kcal/kg vs. 27.5 ± 5.8 kcal/kg: ns. Albumin, prealbumin and transferrin improved after 6 months from transplantation. Length of stay in hospital was 22.4 ± 14.9 days, and length of stay in ICU was 0.7 ± 1.7 days. The nutritional status (SGA and MNA tests of patients did not influence length of stay in either hospital or ICU. No intercurrent events (infections: urinary tract infection, pneumonia, and peritonitis were recorded during the 6-month study period. Two patients died after liver transplantation (6.5%, and 3 patients had acute rejection (9.6%. Patients with malnutrition (SGA and MNA tests classification showed no differences in rejection and mortality. Conclusions: our liver transplantation population had normal

  9. Metroticket 2.0 Model for Analysis of Competing Risks of Death After Liver Transplantation for Hepatocellular Carcinoma. (United States)

    Mazzaferro, Vincenzo; Sposito, Carlo; Zhou, Jian; Pinna, Antonio D; De Carlis, Luciano; Fan, Jia; Cescon, Matteo; Di Sandro, Stefano; Yi-Feng, He; Lauterio, Andrea; Bongini, Marco; Cucchetti, Alessandro


    % chance of HCC-specific survival 5 years after transplantation, their level of AFP should be <200 ng/mL and the sum of number and size of tumors (in centimeters) should not exceed 7; if the level of AFP was 200-400 ng/mL, the sum of the number and size of tumors should be ≤5; if their level of AFP was 400-1000 ng/mL, the sum of the number and size of tumors should be ≤4. In the validation set, the model identified patients who survived 5 years after liver transplantation with 0.721 accuracy (95% confidence interval, 0.648%-0.793%). Our model, based on patients' level of AFP and HCC number and size, outperformed the Milan; University of California, San Francisco; Shanghai-Fudan; Up-to-7 criteria (P < .001); and AFP French model (P = .044) to predict which patients will survive for 5 years after liver transplantation. We developed a model based on level of AFP, tumor size, and tumor number, to determine risk of death from HCC-related factors after liver transplantation. This model might be used to select end points and refine selection criteria for liver transplantation for patients with HCC. To predict 5-year survival and risk of HCC-related death using an online calculator, please see ID NCT02898415. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

  10. Quantitation of HCV RNA in liver of patients with chronic hepatitis C Quantificação do RNA-HCV no fígado de pacientes com hepatite C crônica

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    Ana de Lôurdes Candolo MARTINELLI


    Full Text Available Background/Aims - Liver HCV RNA has been quantitated in few studies and the feasibility and the role of this parameter in the evaluation of patients with chronic HCV hepatitis still warrant study. Our aim was to determine the concentrations of HCV RNA in the liver of chronic HCV patients and to correlate the results with serum viral load. We also studied the relation of levels of HCV RNA in the liver with serum aminotransferases levels and with the presence of cirrhosis. Methods - Twenty patients (14 males, aged 28 to 61 years were studied. Twelve were infected by HCV type 1, six by type 3 and one by type 5. Percutaneous liver biopsy samples were obtained from 14 patients, and the remainder from liver explant in patients undergoing OLT. Twelve had chronic hepatitis and eight cirrhosis. HCV RNA levels were determined by bDNA. Results - HCV RNA levels below the detection limit were found in one liver and in five serum samples. HCV RNA (mean ± SD was 2.1 x 10(8 ± 2.2 x 10(8Eq/gm in the liver and 94 x 10(5 ± 93 x 10(5Eq/mL in serum, with a significant correlation between these values (r = 0.89; P Introdução/Objetivos - Poucos estudos avaliam a quantificação do RNA-HCV no fígado, portanto a praticabilidade e a aplicação desse parâmetro na avaliação de pacientes com hepatite C crônica ainda não estão definidas. O objetivo foi determinar as concentrações do RNA-HCV no fígado de pacientes com infecção crônica pelo vírus C da hepatite e correlacionar os resultados com a carga viral do soro. Foram também estudadas a relação dos níveis de RNA-HCV no fígado com os de aminotransferases no soro e com a presença de cirrose. Métodos - Foram estudados 20 pacientes (14 homens, 28 a 61 anos. A genotipagem do vírus da hepatite C revelou: tipo 1 (12 pacientes, tipo 3 (6 pacientes , tipo 5 (1 paciente. Amostras de fígado foram obtidas por via percutânea em 14 pacientes e de explantes de fígado de pacientes submetidos a transplante em