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Sample records for triple intussusception involving

  1. Double Intussusception in a Shih-Tzu Puppy: The Triple-Circle Sign

    Directory of Open Access Journals (Sweden)

    J. M. Kim, S. S. Kang1, G. Kim and S. H. Choi*

    2012-05-01

    Full Text Available Intussusception is a common surgical disorder in puppies. Double intussusception (DI however, is an extremely rare form of this pathology. The authors report a case of a 3-month-old, Shih-Tzu puppy referred to Veterinary Medical Center of Chungbuk National University, Korea with symptoms of abdominal discomfort, intermittent vomiting and bloody diarrhea for 5 days. Ultrasonographic examination of the left mid-abdominal region revealed a mass with a ‘triple case’ sign completely different from the classic ‘target sign’. The surgical intervention confirmed it to be an ileocecal DI in ascending colon. The case emphasizes the rare ‘triple case’ sign as a descriptive finding on ultrasonography in DI presentations.

  2. Type A Dissection Involving Intimo-Intimal Intussusception Through the Aortic Valve.

    Science.gov (United States)

    Armour, Trygve; Armour, Sarah; Reddy, Pingle; Brinster, Derek

    2015-07-15

    The presentation, evaluation, management, and outcome of a case of type A circumferential dissection involving repeated retrograde intussusception of the intimal flap through the aortic valve is described in this case report. Fewer than 20 intimo-intimal intussusception cases have been described since the first report was published by Hufnagel in 1962, and outcomes have typically been poor because of delays in diagnosis. This case shows the potential for a positive outcome when the diagnosis of intimo-intimal intussusception is entertained and confirmed early in the course of treatment. Preoperative computed tomography and intraoperative transesophageal echocardiography were essential in diagnosis and operative planning.

  3. Ileocaecal Intussusception with a Lead Point: Unusual MDCT Findings of Active Crohn’s Disease Involving the Appendix

    Directory of Open Access Journals (Sweden)

    Ebru Ozan

    2015-01-01

    Full Text Available Adult intussusception is a rare entity accounting for 1% of all bowel obstructions. Unlike intussusceptions in children, which are idiopathic in 90% of cases, adult intussusceptions have an identifiable cause (lead point in the majority of cases. Crohn’s disease (CD may affect any part of the gastrointestinal tract, including the appendix. It was shown to be a predisposing factor for intussusception. Here, we report a rare case of adult intussusception with a lead point, emphasizing diagnostic input of multidetector computed tomography (MDCT in a patient with active CD that involves the appendix.

  4. Complicated colonic intussusception

    Directory of Open Access Journals (Sweden)

    Justin James

    2012-01-01

    Full Text Available The manuscript deals with the case of a 53-year-old woman who developed large bowel obstruction. Per-rectal examination revealed a pedunculated lesion in the rectum; rigid sigmoidoscopy revealed a prolapsing pedunculated mass with a necrotic surface. The patient recovered well following anterior resection. Histology confirmed a pedunculated sub mucosal lipoma as the lead point for intussusception. Colonic intussusception is a rare cause of adult large bowel obstruction, and the preoperative clinical diagnosis of this condition can be difficult. Resection of the involved segment of the colon is the most appropriate choice of treatment in most such cases.

  5. Prolapsed ileocolic intussusception

    African Journals Online (AJOL)

    Resection and anastomosis were performed in six cases, sigmoid colostomy was performed in one case, and reduction by milking without resection was performed in three cases. All the patients recovered well. Conclusion Prolapsed intussusception is a rare presentation of intussusceptions; its diagnosis is easy but may be ...

  6. INTUSSUSCEPTION - A RARE ETIOLOGY

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    Mariana Branco

    2017-02-01

    Discussion / Conclusions: The clinical case described is intended to alert to the importance of investigating an underlying disease in some children and adolescents with intussusception. In this case the study led to the diagnosis of cystic fibrosis

  7. Pediatric radiology fellows' experience with intussusception reduction

    International Nuclear Information System (INIS)

    Stein-Wexler, Rebecca; Bateni, Cyrus; Wootton-Gorges, Sandra L.; Li, Chin-Shang

    2011-01-01

    Intussusception reduction allows young children to avoid surgery. However, graduating residents have had relatively little training in intussusception reduction and, for the most part, consider themselves ill-prepared to perform this procedure. The goal of this study was to assess the extent of training in intussusception reduction during one year of a pediatric radiology fellowship and to determine whether graduating fellows consider themselves adequately trained in this technique. Pediatric radiology fellows were surveyed during June 2010 and asked to characterize their fellowship, to indicate the number of intussusception reductions performed (both the total number and those performed with faculty oversight but without active faculty involvement), and to assess the adequacy of their training. There were 31 responses, representing almost 1/3 of current fellows. Pediatric radiology fellows perform on average 6.9 reductions, 3.8 of which are with faculty oversight but without active faculty involvement. Ninety percent consider themselves well-trained in the technique, whereas 10% are uncertain (none consider their training inadequate). Almost all pediatric radiology fellows consider their training in intussusception reduction to be adequate. (orig.)

  8. Intussusception in dogs and cats: A review of 36 cases

    Science.gov (United States)

    Levitt, Lyndell; Bauer, Michael S.

    1992-01-01

    Intussusception is recognized as a common cause of bowel obstruction in small animals. This study documents the clinical and surgical findings in nine cats and 27 dogs diagnosed as having intussusception. The main purposes of the study were to define the predisposing causes and clinical signs of intussusception and to evaluate various surgical techniques commonly employed in its treatment. No common predisposing cause could be established. Diagnosis of intussusception was based most often on clinical signs of bowel obstruction in association with the palpable abdominal mass. The majority of the intussusceptions involved the enterocolic junction. Formation of adhesions was more frequent in cats. Surgical treatments included simple reduction, manual reduction with plication, intestinal resection/anastomosis, and intestinal resection/anastamosis with plication. There was no statistically significant difference (p>0.05) in the recurrence rate of the intussusceptions when the various surgical techniques were compared. Recurrence of an intussusception was not related to either the bowel segment involved or whether a simple reduction, bowel resection, or intestinal plication was performed at the initial surgery. PMID:17424091

  9. Intussusception secondary to endometriosis of the cecum

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    Hideki Katagiri

    2014-01-01

    CONCLUSION: Intussusception in an adult is a rare cause of bowel obstruction and intussusception caused by endometriosis is also rare. Although rare, the diagnosis of endometriosis as a cause of intussusception must be considered as part of the differential diagnosis.

  10. The imaging of intussusception

    Energy Technology Data Exchange (ETDEWEB)

    Byrne, A.T. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland)]. E-mail: angelabyrenx@hotmail.com; Goeghegan, T. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland); Govender, P. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland); Lyburn, I.D. [Department of Radiology, Frenchay Hospital, Bristol (United Kingdom); Colhoun, E. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland); Torreggiani, W.C. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland)]. E-mail: william.torreggiani@amnch.ie

    2005-01-01

    Intussusception is defined as the telescoping of one segment of the gastrointestinal tract into an adjacent one. It is relatively common in children and is the second most common cause of an acute abdomen in this age group. It is much less common in adults and accounts for less than 5% of cases of mechanical small bowel obstruction. Whereas the diagnosis is usually already suspected in children before imaging, it is often made unexpectedly in adults. In addition, although in children there is usually no specific underlying cause, an underlying lead point is often present in adults. Plain film radiography, barium studies and ultrasound imaging play major roles in both the diagnosis and management of this condition, and it is increasingly common for the diagnosis to be made by CT and MRI, particularly in adults. This pictorial essay reviews the imaging features that may be found in patients with bowel intussusception. As well as describing the imaging features of the more commonly used tests, we also stress the role of emerging technologies such as MRI using ultrafast half-fourier sequences with single shot turbo spin echo.

  11. The imaging of intussusception

    International Nuclear Information System (INIS)

    Byrne, A.T.; Goeghegan, T.; Govender, P.; Lyburn, I.D.; Colhoun, E.; Torreggiani, W.C.

    2005-01-01

    Intussusception is defined as the telescoping of one segment of the gastrointestinal tract into an adjacent one. It is relatively common in children and is the second most common cause of an acute abdomen in this age group. It is much less common in adults and accounts for less than 5% of cases of mechanical small bowel obstruction. Whereas the diagnosis is usually already suspected in children before imaging, it is often made unexpectedly in adults. In addition, although in children there is usually no specific underlying cause, an underlying lead point is often present in adults. Plain film radiography, barium studies and ultrasound imaging play major roles in both the diagnosis and management of this condition, and it is increasingly common for the diagnosis to be made by CT and MRI, particularly in adults. This pictorial essay reviews the imaging features that may be found in patients with bowel intussusception. As well as describing the imaging features of the more commonly used tests, we also stress the role of emerging technologies such as MRI using ultrafast half-fourier sequences with single shot turbo spin echo

  12. CT features of intussusception through an Ileostomy

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    Jung, Mi Ran; Park, Mi Hyun; Jee, Keum Nahn; Namgung, Hwan [Dankook University School of Medicine, Cheonan (Korea, Republic of)

    2017-08-15

    Intussusception of the small bowel through an ileostomy is very rare; when it causes necrosis of the bowel, immediate surgery is required. Computed tomography (CT) features of intussusception through an ileostomy have not been reported in the literature. Herein, we report the typical CT features of intussusception through an ileostomy, followed by a brief literature review.

  13. Lymphangiectasia of small intestine presenting as intussusception

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    Katoch Pervez

    2008-07-01

    Full Text Available Intussusception is defined as telescoping of a segment of gastrointestinal tract into an adjacent one. In small children, it is the commonest cause of intestinal obstruction. More than 90% of childhood intussusceptions are idiopathic. We report a rare case of localized small intestinal lymphangiectasia, presenting as intussusception in a 6-month-old male child. The child presented with features of acute intestinal obstruction for which he was later operated. The gross examination of excised ileocecal mass revealed intussusception. Histopathologic examination revealed lymphangiectasia of small intestine, which acted as a lead point for ileocecal intussusception. Postoperative period was uneventful.

  14. Lymphangiectasia of small intestine presenting as intussusception.

    Science.gov (United States)

    Katoch, Pervez; Bhardwaj, Subhash

    2008-01-01

    Intussusception is defined as telescoping of a segment of gastrointestinal tract into an adjacent one. In small children, it is the commonest cause of intestinal obstruction. More than 90% of childhood intussusceptions are idiopathic. We report a rare case of localized small intestinal lymphangiectasia, presenting as intussusception in a 6-month-old male child. The child presented with features of acute intestinal obstruction for which he was later operated. The gross examination of excised ileocecal mass revealed intussusception. Histopathologic examination revealed lymphangiectasia of small intestine, which acted as a lead point for ileocecal intussusception. Postoperative period was uneventful.

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

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

    2004-09-01

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  17. Intraoperative hydrostatic reduction of intussusception

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    Chatterjee Uday

    2008-01-01

    Full Text Available Aims: To find out an easier way of reduction of intussusception during open surgery to avoid unnecessary bowel injury. Materials and Methods: Under general anesthesia, before laparotomy, warm normal saline was infused into the rectum with a Foley catheter and an intravenous drip set maintaining the level of the bottle at 80 cm above the operating table. After opening the abdomen, pressure was applied on the colon filled with normal saline distal to the intussusceptum. The pressure was transmitted to the intussusceptum and the walls of the intussuscipient and caused reduction of intussusception without any injury to the intussuscipient and intussusceptum. This procedure was performed on those patients on whom laparotomy was performed as a primary procedure due to nonavailability of fluoroscopy or ultrasonography. Results: Between August 1998 and July 2005, we had six patients of mean (range age 11 months (7-17 months. In two cases, at laparotomy, the intussusceptions were found to have already reduced. Conclusions: Gentle finger pressure is necessary for reduction of intussusception. This subjective "gentleness" is dependant on experience of the surgeon and varies from person to person. Focal pressure on the intussuscipient and apex of the intussusceptum by the finger during reduction may be more damaging than the diffusely transmitted hydrostatic pressure even by a less-experienced surgeon. This will avoid the needless resection and anastomosis of the intestine on many occasions.

  18. Retrograde Jejuno‑gastric Intussusception

    African Journals Online (AJOL)

    Bowel sounds were normal. Abdominal X‑ray showed dilated stomach with dilated small bowel loops ... This was reduced and fixed to the abdominal wall and transverse mesocolon. It should be ... reduction of intussusception, but it is contraindicated when signs of peritoneal irritation are present.[9] Due to a limited view on ...

  19. [Gastroduodenal intussusception causing gastric retention.

    DEFF Research Database (Denmark)

    Alamili, M.; Berg, J.O.; Lindstrom, C.

    2008-01-01

    A case of gastroduodenal intussusception caused by a duodenal lipoma is presented. The condition was characterized by severe upper gastrointestinal retention, epigastric pain and weight loss. The mass was diagnosed by CT scan. The diagnosis was confirmed by operation. The patient was treated succ...

  20. [Gastroduodenal intussusception causing gastric retention.

    DEFF Research Database (Denmark)

    Alamili, M.; Berg, J.O.; Lindstrom, C.

    2008-01-01

    A case of gastroduodenal intussusception caused by a duodenal lipoma is presented. The condition was characterized by severe upper gastrointestinal retention, epigastric pain and weight loss. The mass was diagnosed by CT scan. The diagnosis was confirmed by operation. The patient was treated...

  1. Management for intussusception in children.

    Science.gov (United States)

    Gluckman, Steven; Karpelowsky, Jonathan; Webster, Angela C; McGee, Richard G

    2017-06-01

    Intussusception is a common abdominal emergency in children with significant morbidity. Prompt diagnosis and management reduces associated risks and the need for surgical intervention. Despite widespread agreement on the use of contrast enema as opposed to surgery for initial management in most cases, debate persists on the appropriate contrast medium, imaging modality, pharmacological adjuvant, and protocol for delayed repeat enema, and on the best approach for surgical management for intussusception in children. To assess the safety and effectiveness of non-surgical and surgical approaches in the management of intussusception in children. We searched the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8) in the Cochrane Library; Ovid MEDLINE (1950 to September 2016); Ovid Embase (1974 to September 2016); Science Citation Index Expanded (via Web of Science) (1900 to September 2016); and BIOSIS Previews (1969 to September 2016).We examined the reference lists of all eligible trials to identify additional studies. To locate unpublished studies, we contacted content experts, searched the World Health Organization International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov (September 2016), and explored proceedings from meetings of the British Association of Paedatric Surgeons (BAPS), the American Soceity of Pediatric Surgery, and the World Congress of Pediatric Surgery. We included all randomised controlled trials comparing contrast media, imaging modalities, pharmacological adjuvants, protocols for delayed repeat enema, and/or surgical approaches for the management of intussusception in children. We applied no language, publication date, or publication status restrictions. Two review authors independently conducted study selection and data extraction and assessed risk of bias using a standardised form. We resolved disagreements by consensus with a third review author when necessary. We reported

  2. Multiple Intussusceptions Associated with Polycythemia in an ...

    African Journals Online (AJOL)

    Intussusceptions are generally associated with mechanical lead points or localized inflammation that function as foci for intestinal telescoping. We present the case of a patient whose abuse of anabolic steroids resulted in the development of multiple simultaneous intussusceptions. Our patient had no additional identifiable ...

  3. Radiology residents' experience with intussusception reduction

    International Nuclear Information System (INIS)

    Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L.; Li, Chin-Shang

    2011-01-01

    Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure. We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution. U.S. radiology residency program directors were asked to encourage their residents to complete a 12-question online survey describing characteristics of their pediatric radiology department, experiences with intussusception reduction, and confidence in their own ability to perform the procedure. Six hundred sixty-four residents responded during the study period. Of those, 308 (46.4%) had not experienced an intussusception reduction, and 228 (34%) had experienced only one or two. Twenty-two percent of fourth-year residents had never experienced an intussusception reduction, and 21% had experienced only one. Among second- through fourth-year residents, only 99 (18.3%) felt confident that they could competently reduce an intussusception (P < 0.0001), and 336 (62.2%) thought they would benefit from a computer-assisted training model simulating intussusception reduction (P < 0.0001). Radiology residents have limited opportunity to learn intussusception reduction and therefore lack confidence. Most think they would benefit from additional training with a computer-simulation model. (orig.)

  4. Recurrent intussusception in children and infants

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    Amine Ksia

    2013-01-01

    Full Text Available Background: Recurrent intussusceptions in child and infants are problematic and there are controversies about its management. The aim of this study is to determine the details of the clinical diagnosis of recurrent intussusception and to determine the aetiology of recurrent intussusceptions. Patients and Methods: It′s a retrospective study of 28 cases of recurrent intussusception treated in the paediatric surgery department of Monastir (Tunisia between January 1998 and December 2011. Results: During the study period, 505 patients were treated for 544 episodes of intussusception; there were 39 episodes of recurrent intussusceptions in 28 patients; the rate of patients with recurrence was 5.5%. With comparison to the initial episode, clinical features were similar to the recurrent episode, except bloody stool that was absent in the recurrent group (P = 0,016. Only one patient had a pathologic local point. Conclusion: In recurrent intussusception, patients are less symptomatic and consult quickly. Systematic surgical exploration is not needed as recurrent intussusceptions are easily reduced by air or hydrostatic enema and are not associated with a high rate of pathologic leading points.

  5. Triple solutions for a Dirichlet boundary value problem involving a perturbed discrete p(k-Laplacian operator

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    Khaleghi Moghadam Mohsen

    2017-08-01

    Full Text Available Triple solutions are obtained for a discrete problem involving a nonlinearly perturbed one-dimensional p(k-Laplacian operator and satisfying Dirichlet boundary conditions. The methods for existence rely on a Ricceri-local minimum theorem for differentiable functionals. Several examples are included to illustrate the main results.

  6. Anaesthetic management of intussusception in pregnancy | Nwasor ...

    African Journals Online (AJOL)

    Teamwork will win and effective communication between obstetrician, surgeon, anesthesiologist and neonatologist is obligatory. Good knowledge of the simplest and fastest anaesthetic techniques available will ensure a fruitful outcome. Keywords: anaesthesia, intussusception, obstetric patients. Annals of African Medicine ...

  7. Diagnosis and Treatment of Intussusception in Children

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    O.V. Spakhi

    2016-08-01

    Full Text Available Intussusception is the most common form of acquired gastrointestinal obstruction in children. The aim is to study the features of clinical course and treatment strategy for intussusception in children and to analyze limitations of diagnostic, clinical and special research methods. Materials and methods of the study. The analysis of treatment outcomes has been carried out in 272 children in pediatric surgery clinic from 2004 to 2015. We have developed the objective criteria for evaluation of intussusception stages that correlate with the degree of endotoxemia, changes in respiratory function and circulation, the disorders of gut motility, as well as ultrasound of the abdominal organs. Results and discussion. Patients with intussusception stage I (233 children had no signs of endotoxemia or they were non-significant. In 10 children we performed surgery, in 4 cases — laporoscopically. Of the 32 patients with stage II, in 8 cases the intussusception was straightened conservatively on the first try. We don’t make a second attempt in children with intussusception stage II. Surgical straightening was perfomed in 24 patients. Intussusception stage III in children (7 patients had signs of third degree endotoxemia. All patients of the third stage of intussusception underwent median laparotomy. In 5 cases we have detected intussusceptum necrosis, and these children were made bowel resection followed by the imposition of final ileostomy and intubation of the small intestine. In the rest (2 of patients, we managed to straighten the intussusceptum, and the gut was recognized as vital. Imposing primary anastomosis after the bowel resection in peritonitis we consider unacceptable. Conclusions. 1. Comprehensive survey of children using laboratory and instrumental methods became the basis for the allocation of 3 stages of intussusception, which correlated with the degree of endotoxemia and impaired bowel functions: stage I — compensated; stage II

  8. Adult intussusception: A case series and review

    OpenAIRE

    Shenoy, Santosh

    2017-01-01

    AIM To identify factors differentiating pathologic adult intussusception (AI) from benign causes and the need for an operative intervention. Current evidence available from the literature is discussed. METHODS This is a case series of eleven patients over the age of 18 and a surgical consultation for ?Intussusception? at a single veteran?s hospital over a five-year period (2011-2016). AI was diagnosed on computed tomography (CT) scan and or flexible endoscopy (colonoscopy). Surgical referrals...

  9. Antegrade bowel intussusception after remote Whipple and Puestow procedures for treatment of pancreas divisum

    OpenAIRE

    Gigena, Manuel; Villar, Hugo V; Knowles, Negar G; Cunningham, John T; Outwater, Erik K; Leon Jr, Luis R

    2007-01-01

    To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old woman with a history of chronic pancreatitis due to pancreas divisum. Four years preceding this event, the patient had undergone a Whipple procedure, and three years prior to that, a Puestow operation. The patient was successfully treated with bowel resection and a side-to-side ...

  10. Antegrade bowel intussusception after remote Whipple and Puestow procedures for treatment of pancreas divisum.

    Science.gov (United States)

    Gigena, Manuel; Villar, Hugo V; Knowles, Negar G; Cunningham, John T; Outwater, Erik K; Leon, Luis R

    2007-11-28

    To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old woman with a history of chronic pancreatitis due to pancreas divisum. Four years preceding this event, the patient had undergone a Whipple procedure, and three years prior to that, a Puestow operation. The patient was successfully treated with bowel resection and a side-to-side anastomosis between the most distal aspect of the bowel and the most distal Roux-en-Y reconstruction, which preserved both Roux-en-Y reconstructions.

  11. Intussusception in dogs and cats: A review of 36 cases

    OpenAIRE

    Levitt, Lyndell; Bauer, Michael S.

    1992-01-01

    Intussusception is recognized as a common cause of bowel obstruction in small animals. This study documents the clinical and surgical findings in nine cats and 27 dogs diagnosed as having intussusception. The main purposes of the study were to define the predisposing causes and clinical signs of intussusception and to evaluate various surgical techniques commonly employed in its treatment. No common predisposing cause could be established. Diagnosis of intussusception was based most often on ...

  12. [Heterotopic pancreas as a cause of intussusception: first case reported in Peru].

    Science.gov (United States)

    Bazán Zender, Carlos; Reyes Coloma, Luis; León Cueto, José Luis; Revoredo Palacios, Giancarlo; Arias Stella Castillo, Javier; Pezo, Alonso

    2015-01-01

    The heterotopic pancreas (HP) is a rare condition in the pediatric population. HP cases involving an ileal intussusception are rare in children and very rarely reported, usually presenting with symptoms of intestinal obstruction. We report the case of a one year old male patient with a chronic history of anorexia, irritability, abdominal pain, accompanied by intermittent episodes of "currant jelly" stools that evolved to rectal bleeding. The patient presented a concomitant diagnosis of allergic colitis, which prolonged the effective surgical treatment at an external health center. In the abdominal CT scan, the classic "target" sign was found. In the exploratory laparotomy an ileoileal intussusception was confirmed, a mass was found that the histopathology laboratory confirmed as HP. To our knowledge, it is the first case of pediatric intussusception by HP reported in Peru.

  13. Clinical case definition for the diagnosis of acute intussusception.

    Science.gov (United States)

    Bines, Julie E; Ivanoff, Bernard; Justice, Frances; Mulholland, Kim

    2004-11-01

    Because of the reported association between intussusception and a rotavirus vaccine, future clinical trials of rotavirus vaccines will need to include intussusception surveillance in the evaluation of vaccine safety. The aim of this study is to develop and validate a clinical case definition for the diagnosis of acute intussusception. A clinical case definition for the diagnosis of acute intussusception was developed by analysis of an extensive literature review that defined the clinical presentation of intussusception in 70 developed and developing countries. The clinical case definition was then assessed for sensitivity and specificity using a retrospective chart review of hospital admissions. Sensitivity of the clinical case definition was assessed in children diagnosed with intussusception over a 6.5-year period. Specificity was assessed in patients aged clinical case definition accurately identified 185 of 191 assessable cases as "probable" intussusception and six cases as "possible" intussusception (sensitivity, 97%). No case of radiologic or surgically proven intussusception failed to be identified by the clinical case definition. The specificity of the definition in correctly identifying patients who did not have intussusception ranged from 87% to 91%. The clinical case definition for intussusception may assist in the prompt identification of patients with intussusception and may provide an important tool for the future trials of enteric vaccines.

  14. Ileocecocolic Intussusception Induced by Acute Appendicitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Bang Sil; Kim, Min Jeong; Jang, Kyung Mi; Lee, Hyun; Jeon, Eui Yong; Lee, Kwan Seop; Lee, Yul [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2009-09-15

    Intussusception is a rare disease in adults. Moreover, appendiceal disease is very rarely the leading cause of adult intussusception. We report a case in which ileocecocolic intussusception is secondary to an acute appendicitis in an adult, and describe the radiologic, clinical, and pathologic findings.

  15. Computed tomography of intussusception in adult

    International Nuclear Information System (INIS)

    Jeon, Hae Jeong; Ahn, Byeong Yeob; Cha, Soon Joo; Seol, Hae Young; Chung, Kyoo Byung; Suh, Won Hyuck

    1984-01-01

    Intussusception is rare in adult and usually caused by organic lesions, although there is a significant number of so-called idiopathic cases. The diagnosis of intussusception have been made by plain abdomen, barium enema and small bowel series. But recently ultrasound and computed tomography make a contribution to diagnose intussusception. Computed tomography is not the primary means for evaluating a gastrointestinal tract abnormality but also provides valuable information in evaluating disorders affecting the hollow viscera of the alimentary tract. Computed tomography image of intussusception demonstrates a whirl like pattern of bowel loops separated by fatty stripe correlating of the intestinal walls. Abdominal ultrasonogram was used as the initial diagnostic test in 2 cases out of total 4 cases, with abdominal mass of unknown cause. It revealed a typical pattern, composed of a round or oval mass with central dense echoes and peripheral poor echoes. We report 4 all cases of intussusception in adult who were performed by computed tomography and/or ultrasound. All cases were correlated with barium enema examination and/or surgical reports.

  16. Preoperative Diagnosis of Adult Intussusception Caused by Small Bowel Lipoma

    Directory of Open Access Journals (Sweden)

    Hiroaki Shiba

    2009-11-01

    Full Text Available Adult intussusception is rare, accounting for only 5% of all intussusceptions, for which preoperative diagnosis is difficult. We herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma. A 33-year-old man was admitted to our hospital with three weeks history of colicky epigastric pain. Computed tomography revealed thickening of the ileal wall suggestive of intussusception. Colonoscopy revealed an ileocolic intussusception. Barium enema for reduction of ileocolic intussusception demonstrated a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve. The intussusception was reduced, and the patient underwent partial resection of the ileum encompassing the small bowel tumor. Histological findings confirmed the diagnosis of lipoma of the small bowel. The patient made a satisfactory recovery and remains well.

  17. Adult Intussusception Caused by Heterotopic Pancreas

    Directory of Open Access Journals (Sweden)

    Va-Kei Kok

    2007-05-01

    Full Text Available Heterotopic pancreas causing small bowel intussusception is rare. We report the case of a 24-year-old woman who presented with intermittent episodes of abdominal cramping and pain that had persisted for 10 days. A target-shaped lesion consisting of multiple concentric rings was found on the left side on contrast-enhanced computed tomography. Surgical intervention demonstrated jejunal intussusception caused by a jejunal heterotopic pancreas. Microscopically, several nesidioblastoses of pancreas were identified. Although very rare, small intestinal pancreatic rests may cause subacute bowel obstruction.

  18. Intestinal schistosomiasis associated with intussusception: a case ...

    African Journals Online (AJOL)

    A 7-year-old boy presented with the history of abdominal pain and difficulties in passing stool for two months. Ultrasound examination revealed doughnut signs characterized with multiple concentric rings at the lateral abdomen, and the bowel loop appeared distended. Exploratory laparatomy confirmed intussusception of ...

  19. in diagnosis of secondary intussusception in children

    African Journals Online (AJOL)

    Ahmed Abougabal

    2014-12-02

    Dec 2, 2014 ... the most common cause of acute bowel obstruction and pain in infants. This leads to venous congestion and bowel wall edema. If intussusception is not diagnosed and treated adequately, reduced arterial blood supply, bowel infarction and perforation may follow, causing peritonitis and may even.

  20. Transanal protrusion of intussusceptions in children

    Directory of Open Access Journals (Sweden)

    Ezomike Uchechukwu Obiora

    2014-01-01

    Full Text Available Background: The aim of the following study is to report our management experience and outcome of transanal protrusion of intussusceptions. Patients and Methods: Retrospective analysis of all cases of intussusceptions protruding through the anal opening from January 2008 to June 2013. Results: Of 62 cases of intussusceptions, transanal protrusion occurred in 10 patients (16% anal protrusion rate with a male:female ratio of 2:3. They were aged 4-96 months (mean 22.6 ± 30.7, median 7.5 months. Six were infants while four were above 1 year. Duration of symptoms ranged from 2 to 14 days (mean 5.9 days ± 3.4 with only two patients presenting within 48 h. Clinical features included vomiting (100%, abdominal pains (100%, bloody mucoid stool (100%, abdominal distension (90%, and palpable left iliac fossa mass (70%. Three patients had preceding diarrhoea (30% and two had preceding upper respiratory tract infection (20%. Duration of hospital stay ranged from 5 to 23 days (mean 12 days ± 5.6. Findings at surgery included seven ileocolic and two colocolic intussusceptions (one patient died before surgery. Operative procedures were right hemicolectomy (5, operative manual reduction (3, left hemicolectomy (1 giving a 67% bowel resection rate. One patient died giving a 10% mortality rate. Conclusion: Transanal protrusion occurred more in females and is associated with late presentation, older age, high bowel resection rate, and high mortality.

  1. Gastrointestinal stromal tumour presenting as gastroduodenal intussusception.

    LENUS (Irish Health Repository)

    Wilson, Mark H

    2012-08-01

    Gastroduodenal intussusception secondary to gastrointestinal stromal tumour is a very rare cause for intestinal obstruction. The diagnosis of this condition can be challenging, as symptoms are often non-specific and intermittent. This article reports a case where the diagnosis was made preoperatively with abdominal imaging and was treated by a combination of endoscopic reduction and laparoscopic resection.

  2. Transient small-bowel intussusception in children on CT

    International Nuclear Information System (INIS)

    Strouse, Peter J.; DiPietro, Michael A.; Saez, Fermin

    2003-01-01

    To determine the frequency and significance of small-bowel intussusception identified in children on CT. All abdomen CT reports between July 1995 and April 2002 were reviewed to identify patients with small-bowel intussusception. Intussusceptions were identified as an intraluminal mass with a characteristic layered appearance and/or continuity with adjacent mesenteric fat. Ileocolic intussusceptions and intussusceptions related to feeding tubes were excluded. Imaging studies and medical records were reviewed. Twenty-five pediatric patients (16 boys, 9 girls; mean age 11.2 years) were identified with small-bowel intussusception on CT. No patient had a persistent intussusception requiring surgery. Fourteen had limited immediate repeat CT images as part of the same examination, ten of which demonstrated resolution of the CT abnormality. Follow-up CT [n=13 (6 within 24 h)], ultrasound (n=3), small-bowel follow-through (n=4) and surgery (n=3) showed no intussusception. In four patients with persistent symptoms, underlying pathology was identified requiring treatment (giardiasis, 2; small-bowel inflammation/strictures, 1; abscess and partial small-bowel obstruction after perforated appendicitis, 1). In 21 other patients, direct correlation of symptoms to CT abnormality was absent or questionable, no treatment was required, and there was no clinical or imaging evidence of persistence or recurrence. Most small-bowel intussusceptions identified in children by CT are transient and of no clinical significance. (orig.)

  3. Endoglin inhibition leads to intussusceptive angiogenesis via activation of factors related to COUP-TFII signaling pathway.

    Directory of Open Access Journals (Sweden)

    Ruslan Hlushchuk

    Full Text Available Angiogenesis is a highly coordinated, extremely complex process orchestrated by multiple signaling molecules and blood flow conditions. While sprouting mode of angiogenesis is very well investigated, the molecular mechanisms underlying intussusception, the second mode of angiogenesis, remain largely unclear. In the current study two molecules involved in vascular growth and differentiation, namely endoglin (ENG/CD105 and chicken ovalbumin upstream promoter transcription factor II (COUP-TFII were examined to unravel their specific roles in angiogenesis. Down- respectively up-regulation of both molecules tightly correlates with intussusceptive microvascular growth. Upon ENG inhibition in chicken embryo model, formation of irregular capillary meshwork accompanied by increased expression of COUP-TFII could be observed. This dynamic expression pattern of ENG and COUP-TFII during vascular development and remodeling correlated with formation of pillars and progression of intussusceptive angiogenesis. Similar findings could be observed in mammalian model of acute rat Thy1.1 glomerulonephritis, which was induced by intravenous injection of anti-Thy1 antibody and has shown upregulation of COUP-TFII in initial phase of intussusception, while ENG expression was not disturbed compared to the controls but decreased over the time of pillar formation. In this study, we have shown that ENG inhibition and at the same time up-regulation of COUP-TFII expression promotes intussusceptive angiogenesis.

  4. The diagnostic role of abdominal CT imaging findings in adults intussusception: Focused on the vascular compromise

    International Nuclear Information System (INIS)

    Park, Sung Bin; Ha, Hyun Kwon; Kim, Ah Young; Lee, Seung Soo; Kim, Hye Jin; Park, Beom Jin; Jin, Yong Hyun; Park, Seong Ho; Kim, Kyoung Won

    2007-01-01

    Intussusception is defined as telescoping of one segment of the gastrointestinal tract into an adjacent one. Unlike that in children, adult intussusception is a relatively rare condition. More than 90% of patients with adult intussusception have been reported to have an organic cause, with benign or malignant tumors for accounting for approximately 65% of the cases. In general, the diagnosis is easily made by means of computed tomography (CT) or magnetic resonance (MR) imaging. The imaging appearance of a bowel-within-bowel configuration with or without contained fat and mesenteric vessels, is pathognomonic. As the intussusceptum enters into the intussuscipiens, the mesentery is carried forward and trapped between the overlapping layers of bowel. The twisting or severe constriction of the mesenteric vessels may result in vascular compromise with subsequent edematous thickening of the involved bowel. In these circumstances, ischemic necrosis may develop if timely intervention is not undertaken. Therefore, determination of the presence or absence of intestinal necrosis in intussusception is important in patient management. On CT, the presence of well-known diagnostic CT criteria for strangulated obstruction (especially severe engorgement or twisting of the mesenteric vessels) as well as evidence of loss of the layered pattern, accumulation of extraluminal fluid collection, and bowel perforation, may suggest the diagnosis of intestinal necrosis. CT and MR imaging are limited in determining the primary disease causing intussusception. However, CT and MR provide excellent pre-operative evaluation, including the possible extension and/or dissemination of a malignant tumor. CT and MR imaging may also be useful in suggesting the presence of vascular compromise

  5. [Acute abdomen secondary to appendiceal intussusception].

    Science.gov (United States)

    Betancourth-Alvarenga, J E; Vázquez-Rueda, F; Murcia-Pascual, F J; Ayala-Montoro, J

    2015-01-01

    Appendiceal intussusception is a rare condition that can occur at any age. Only a few cases have been reported, and most are found during surgery. The therapeutic approach is usually surgical, ranging from an appendectomy to a hemicolectomy, primarily for biopsy and to rule out possible malignancy. Three cases of children under 14 years who underwent surgery for acute abdominal pain located in the right iliac fossa are presented; one with preoperative diagnosis by ultrasound, and the other two with positive intraoperative findings of intussusception of the cecal appendix, with acute appendicitis being histologically confirmed. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  6. Ileal perineurioma as a cause of intussusception

    Directory of Open Access Journals (Sweden)

    Sheila Cristina Lordelo Wludarski

    2011-01-01

    Full Text Available CONTEXT: Perineuriomas are rare tumors composed of cells resembling those of the normal perineurium. It usually occurs in subcutaneous, soft-tissue or intraneural locations. Very few reports in the literature have described perineuriomas in the gastrointestinal tract, including the stomach, colon and jejunum. CASE REPORT: We report the clinicopathological and immunohistochemical features of a case of ileal perineurioma that was manifested clinically as intestinal obstruction due to intussusception. Ileal perineurioma has not previously been reported at this anatomical location

  7. Deep sedation during pneumatic reduction of intussusception.

    Science.gov (United States)

    Ilivitzki, Anat; Shtark, Luda Glozman; Arish, Karin; Engel, Ahuva

    2012-05-01

    Pneumatic reduction of intussusception under fluoroscopic guidance is a routine procedure. The unsedated child may resist the procedure, which may lengthen its duration and increase the radiation dose. We use deep sedation during the procedure to overcome these difficulties. The purpose of this study was to summarize our experience with deep sedation during fluoroscopic reduction of intussusception and assess the added value and complication rate of deep sedation. All children with intussusception who underwent pneumatic reduction in our hospital between January 2004 and June 2011 were included in this retrospective study. Anesthetists sedated the children using propofol. The fluoroscopic studies, ultrasound (US) studies and the childrens' charts were reviewed. One hundred thirty-one attempted reductions were performed in 119 children, of which 121 (92%) were successful and 10 (8%) failed. Two perforations (1.5%) occurred during attempted reduction. Average fluoroscopic time was 1.5 minutes. No complication to sedation was recorded. Deep sedation with propofol did not add any complication to the pneumatic reduction. The fluoroscopic time was short. The success rate of reduction was high,raising the possibility that sedation is beneficial, possibly by smooth muscle relaxation.

  8. BARIUM REDUCTION OF INTUSSUSCEPTION IN INFANCY

    Science.gov (United States)

    Denenholz, Edward J.; Feher, George. S.

    1955-01-01

    Barium enema reduction was used as the initial routine treatment in 29 infants with intussusception. In 22 of them the intussusception was reduced by this means. In three of eight patients operated upon the intussusception was found to be reduced. Four of the remaining five patients had clinical or x-ray evidence of complications before reduction by barium enema was attempted. Twenty-one of the patients, all of whom were observed in private practice, were treated without admission to the hospital. After reduction, these patients were observed closely by the clinician. None of these patients showed clinical or x-ray signs of complications before reduction. Certain clinical and roentgen criteria must be satisfied before it can be concluded that reduction by barium enema is complete. If there are clinical signs of complications with x-ray evidence of small bowel obstruction, only a very cautious attempt at hydrostatic reduction should be made. As the time factor is generally a reliable clinical guide to reducibility, the late cases should be viewed with greater caution. Long duration of symptoms, however, is not per se a contraindication to an attempt at hydrostatic reduction. PMID:13230908

  9. Delayed presentation of intussusception in children–a surgical audit

    African Journals Online (AJOL)

    473–480. 2 Kaiser AD, Applegate KE, Ladd AP. Current success in the treatment of intussusception in children. Surgery 2007; 142:469–477. 3 Herwig K, Brenkert T, Losek JD. Enema-reduced intussusception management: is hospitalization ...

  10. An audit of paediatric intussusception radiological reduction at the ...

    African Journals Online (AJOL)

    Methods. This retrospective analytic cohort study assessed data from the records of all paediatric patients with the diagnosis of idiopathic intussusception discharged from the Department of Paediatric Surgery between 1 January 2003 and 30 September 2011. Results. Thirty-five children with intussusception were identified.

  11. Post-Myomectomy Intussusception: Report of Two Cases | Okafor ...

    African Journals Online (AJOL)

    Exploratory laparotomies later revealed ileo-ileal and jejuno-ileal intussusceptions which were reduced without resection with good outcome. CONCLUSION: Intussusception is a rare but serious complication of myomectomy. High index of suspicion with prompt intervention and early team management optimize outcomes.

  12. a case of compound intussusceptions in a nigerian child

    African Journals Online (AJOL)

    is a major contributor to morbidity and mortality in the treatment of intestinal obstruction. We report the first documented case of double compound intussusception in an. African child and reviewed relevant literature. Keywords: Antegrade and retrograde; Children; Compound; Intussusception. Annals of Ibadan Postgraduate ...

  13. Colo-colic intussusception associated with pneumatosis cystoides intestinalis

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, O.; Daneman, A.; Alton, D.J. [Department of Diagnostic Imaging, Hospital for Sick Children and the University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8 (Canada); Thorner, P. [The Division of Pathology, Hospital for Sick Children and the University of Toronto, Toronto (Canada)

    1998-07-01

    This paper describes pneumatosis cystoides intestinalis in association with colo-colic intussusception in a young teenager. The intussusception was easily reduced at barium enema. The recognition of the characteristic filling defects in the barium column facilitates a correct diagnosis. This association has only been reported previously in six adults. (orig.) With 2 figs., 9 refs.

  14. Ultrasonographic diagnosis and surgical management of double intestinal intussusception in 3 dogs

    OpenAIRE

    Atray, Mandeep; Raghunath, Mulinti; Singh, Tarunbir; Saini, Narinder Singh

    2012-01-01

    The diagnosis and treatment of double intestinal intussusception in 3 pups with persistent vomiting, diarrhea, dehydration, anemia, leucocytosis, and electrolyte imbalance are described. Ultrasonography confirmed intussusception and laparotomy revealed double intussusceptions. Intussusceptions were corrected by manual reduction in 1 pup and intestinal resection and anastomosis in 2 pups. Two pups survived and 1 pup died on the 4th day after surgery.

  15. Ultrasonographic diagnosis and surgical management of double intestinal intussusception in 3 dogs.

    Science.gov (United States)

    Atray, Mandeep; Raghunath, Mulinti; Singh, Tarunbir; Saini, Narinder Singh

    2012-08-01

    The diagnosis and treatment of double intestinal intussusception in 3 pups with persistent vomiting, diarrhea, dehydration, anemia, leucocytosis, and electrolyte imbalance are described. Ultrasonography confirmed intussusception and laparotomy revealed double intussusceptions. Intussusceptions were corrected by manual reduction in 1 pup and intestinal resection and anastomosis in 2 pups. Two pups survived and 1 pup died on the 4th day after surgery.

  16. Downregulation of Smurf2, a tumor-suppressive ubiquitin ligase, in triple-negative breast cancers: Involvement of the RB-microRNA axis

    International Nuclear Information System (INIS)

    Liu, Xianpeng; Gu, Xin; Sun, Limin; Flowers, Ashley B; Rademaker, Alfred W; Zhou, Yiran; Kiyokawa, Hiroaki

    2014-01-01

    The HECT family ubiquitin ligase Smurf2 regulates cell polarity, migration, division, differentiation and death, by targeting diverse substrates that are critical for receptor signaling, cytoskeleton, chromatin remodeling and transcription. Recent studies suggest that Smurf2 functions as a tumor suppressor in mice. However, no inactivating mutation of SMURF2 has been reported in human, and information about Smurf2 expression in human cancer remains limited or complicated. Here we demonstrate that Smurf2 expression is downregulated in human breast cancer tissues, especially of the triple-negative subtype, and address the mechanism of Smurf2 downregulation in triple-negative breast cancer cells. Human breast cancer tissues (47 samples expressing estrogen receptor (ER) and 43 samples with triple-negative status) were examined by immunohistochemistry for the expression of Smurf2. Ten widely-studied human breast cancer cell lines were examined for the expression of Smurf2. Furthermore, microRNA-mediated regulation of Smurf2 was investigated in triple-negative cancer cell lines. Immunohistochemical analysis showed that benign mammary epithelial cells expressed high levels of Smurf2, so did cells in ductal carcinomas in situ. In contrast, invasive ductal carcinomas showed focal or diffuse decrease in Smurf2 expression, which was observed more frequently in triple-negative tumors than in ER-positive tumors. Consistently, human triple-negative breast cancer cell lines such as BT549, MDA-MB-436, DU-4475 and MDA-MB-468 cells showed significantly lower expression of Smurf2 protein, compared to ER + or HER2+ cell lines. Studies using quantitative PCR and specific microRNA inhibitors indicated that increased expression of miR-15a, miR-15b, miR-16 and miR-128 was involved in Smurf2 downregulation in those triple-negative cancer cell lines, which have mutations in the retinoblastoma (RB) gene. Forced expression of RB increased levels of Smurf2 protein with concomitant decreases in

  17. Ultrasonographic findings of intestinal intussusception in seven cats.

    Science.gov (United States)

    Patsikas, M N; Papazoglou, L G; Papaioannou, N G; Savvas, I; Kazakos, G M; Dessiris, A K

    2003-12-01

    The medical records of seven cats with intestinal intussusception that were diagnosed by abdominal ultrasonography and exploratory laparotomy were reviewed. In transverse ultrasonographic sections the intussusception appeared as a target-like mass consisting of one, two or more hyperechoic and hypoechoic concentric rings surrounding a C-shaped, circular or non-specific shaped hyperechoic centre. Part of the intestine representing the inner intussusceptum, located close to the hyperechoic centre and surrounded by concentric rings, was also detected. In longitudinal sections the intussusception appeared as multiple hyperechoic and hypoechoic parallel lines in four cases and as an ovoid mass in three cases. In one case the ovoid mass had a 'kidney' configuration. Additional ultrasonographic findings associated with intestinal intussusception included an intestinal neoplasm in one cat. The results of the present study demonstrate that the ultrasonographic findings of intestinal intussusception in cats bear some similarities to those described in dogs and humans, are relatively consistent, and facilitate a specific diagnosis.

  18. Intussusception. Part 1: A review of diagnostic approaches

    Energy Technology Data Exchange (ETDEWEB)

    Daneman, Alan; Navarro, Oscar [Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8 (Canada)

    2003-02-01

    The vast majority of symptomatic intussusceptions in children arise in the ileum and are either ileocolic or ileoileocolic. The clinical diagnosis of these ''idiopathic'' intussusceptions may be difficult to make. Failure to make a prompt diagnosis and initiate appropriate treatment may lead to bowel ischemia, perforation, peritonitis, shock and even death. The clinician, therefore, may have to rely on imaging procedures to diagnose or exclude the presence of intussusception promptly and accurately. The imaging diagnosis of intussusception can be made with sonography or plain abdominal radiographs or by contrast (including air) enema examinations of the colon. This article highlights the current concepts and some controversial issues related to the imaging diagnosis of intussusception. (orig.)

  19. Intussusception in children: not only surgical treatment

    Directory of Open Access Journals (Sweden)

    Anna Maria Caruso

    2017-02-01

    Full Text Available Introduction: Intussusception is the commonest cause of acute in­testinal obstruction in children. Failure of timely diagnosis and treatment results in a surgical emergency leading to fatal outcome. The classic triad of symptoms is seen in less than one-third of the children affected. Aim of this study was to evaluate the comprehensive management of intussusception in children, evaluating the outcome of conservative treatment with hydrostatic ultrasound reduction and surgery.Material and methods: A retrospective analysis was conducted including pediatric patients (up to 14 years old with diagnosis of bowel intussusception. The management and treatment depended on the patients’ situation: for children in good general conditions initial hydrostatic reduction under continuous ultrasonographic monitoring was attempted; if severe dehydration and/or septic shock was observed, the conservative treatment was contraindicated and direct surgical treatment was performed.Result: A total of 44 pediatric patients were included in the study. The most frequent symptoms observed were paroxysmal abdominal pain (100% of cases and vomiting (72%; only 29% of patients presented with the classic triad of symptoms (abdominal pain, palpable mass and blood stained stools. 28 patients (64% were managed conservatively with ultrasound hydrostatic reduction. 10 patients (23% required primary surgical intervention because of clinical conditions; 6 patients (14% were operated after failure of conservative approach. The total percentage of operated patients was 36%, with lead points identified in 12 cases.Conclusion: Our data confirm that hydrostatic reduction is a simple, real time procedure, free of radiations, non invasive and safe. Age had no impact on the reducibility whereas bloody stool, a prolonged duration of symptoms and the presence of lead point were risk factors of failure.

  20. Intussusception in adults: US and CT findings

    International Nuclear Information System (INIS)

    Wolff, Laura; Azulay, Guillermo; Pfister, Martin; Florenzano, Nestor V.; Vega, Alejandro de la; Serini, Veronica

    2002-01-01

    Ileocolic invagination is the penetration of an ileum segment into the right colon. Four cases of ileocolic intussisception are described by US and CT with its surgical pathologic confirmation. Three different patterns are described by CT which reflect its severity and duration. These are: target, in layers and kidney form. Ultrasound signs are: 'pseudo kidney', 'target' and 'donut crescent' being the latter the only distinctive sign. Flow suggests that the intussusception could be reductable. The presence of fluid in peritoneal cavity could mean ischemia and irreductibility. (author)

  1. Childhood intussusception in Uzbekistan: Analysis of retrospective surveillance data

    Directory of Open Access Journals (Sweden)

    Flem Elmira

    2011-03-01

    Full Text Available Abstract Background Estimates of baseline incidence of childhood intussusception could help safety monitoring after the introduction of rotavirus vaccines. We studied the incidence of intussusception in Uzbekistan, a GAVI-fund eligible state in Central Asia. Methods We retrospectively reviewed intussusception cases in children Results Over a 5-year study period, 67 confirmed cases were identified, of which 67% were boys. The median age was 12 months, and no seasonal trend in the distribution of cases was observed. The diagnostic methods used included abdominal radiography (87% and ultrasonography (57%. Intussusception reduction by air enema was successful in 33 (49% patients and 34 (50% cases underwent surgery. A total of 4 deaths occurred, including 3 deaths in infants aged 0-6 months. The median length of hospital stay was 7.3 (range 0-37 days. The incidence of intussusception is estimated at 23 (95% CI 13.6-32.4 cases per 100,000 child-years, corresponding to approximately 237 cases annually. Conclusions This is the first study to estimate the incidence of childhood intussusception prior to the introduction of the rotavirus vaccination in Uzbekistan. A prospective surveillance system using a standardized case definition is needed in order to better examine the occurrence of intussusception in developing countries.

  2. [Adult transient intestinal intussusception: can abdominal CT guide resolution?].

    Science.gov (United States)

    Stabile Ianora, Amato Antonio; Telegrafo, Michele; Lorusso, Valentina; Rella, Leonarda; Niccoli Asabella, Artor; La Porta, Michele; Moschetta, Marco

    2013-01-01

    The purpose of this study was to evaluate the adult transient intestinal intussusceptions on CT before and after the administration of gastrointestinal contrast material. We evaluated two different gastrointestinal contrast materials: hyperdense and hypodense. In all cases the gastrointestinal contrast agent solved the invaginations. In the group of patients treated with hypodense contrast medium relapses occurred in the short and long term; no recurrence was observed in the other group. CT is useful in the recognition of intestinal intussusception. The gastrointestinal contrast agent could define the real transience of intussusceptions and hyperdense contrast agent could be more effective in short and long term resolution.

  3. Adult ileocolic intussusception secondary to ileocaecal valve polyp.

    LENUS (Irish Health Repository)

    Chugthai, Saqib Zeeshan

    2012-01-31

    Intussusception is relatively common in children, but it is a rare cause of abdominal pain and intestinal obstruction in adults. The aetiology, clinical presentation and management of this condition differs in adults and children. Preoperative clinical diagnosis is usually difficult due to the non-specific and intermittent nature of the symptoms. Ultrasound and computed tomography can be helpful in establishing the diagnosis. We present a case of adult ileocolic intussusception with classical radiological signs and operative findings. In adults the diagnosis of intussusception should be considered in a case of intermittent abdominal pain, especially with clinical signs of intermittent bowel obstruction.

  4. Jejunojejunal Intussusception Induced by Lipomatous Polyp of Jejunum

    Directory of Open Access Journals (Sweden)

    Jayant Kumar Biswal

    2017-10-01

    Full Text Available Adult intussusception is rare unlike childhood variety where it is the leading cause of intestinal obstruction. Preoperative diagnosis is often difficult as the symptoms are nonspecific and so high index of suspicion is needed for early diagnosis by appropriate investigations. This is a case of 65-year-old man presented with acute intestinal obstruction whose laparotomy revealed a jejunojejunal intussusception secondary to a lipomatous lesion which was successfully treated with resection and primary anastomosis. When dealing with a case of chronic intermittent intestinal obstruction, intussusception must be kept in mind as one of the differential diagnosis.

  5. Ultrasound guided reduction of childhood intussusception

    International Nuclear Information System (INIS)

    Yoon, Chong Hyun; Kim, Han Suk

    1986-01-01

    Following on from diagnosis using ultrasound, hydrostatic reduction using saline enema under ultrasound guidance was tried in 20 cases of childhood intussusception. The conclusions were as follows: 1. Success rates of saline enema under ultrasound guidance during a first-8 month period (P1) and a second-10 month period (P2) were 55.6% (5/9) and 54.5% (6/11) respectively. Average success rate was 55% (11/20). 2. During the periods of P1 and P2, no case was reduced by barium enema in 6 cases of failed reduction with saline enema. 3. During the period of P2, 5 cases of successful reduction with saline enema were confirmed by clinical follow-up without barium enema. 4. During the periods of P1 and P2, 9 cases of failed reduction with saline enema were operated, resulting in 6 cases of segmental resection and 3 cases of manual reduction. 5. The obvious advantages of this method are: 1. No radiation hazard. 2. No fear of barium peritonitis. 3. Detection of leading point. 6. With above results, this method could completely replace barium enema. And ultrasonography should be the initial study in the evaluation of intussusception in children and then if necessary, saline enema under ultrasound guidance should be done.

  6. Chronic nonischemic ileo-ileo-colic intussusception

    International Nuclear Information System (INIS)

    Roic, G.; Posaric, V.; Boric, I.; Vrtar, Z.; Cigit, I.

    2005-01-01

    Background. Chronic intussusception is a prolapse of a portion of the bowel into the lumen of an immediately adjacent segment of the bowel; it lasts for 14 days or more. The aim of the article is to present a rare cause of nonacute abdominal pain. Case report. We report about 14-year-old girl who presented with a one-month history of intermittent cramping lower abdominal pain and change in bowel behavior. Plain abdominal x-ray, ultrasonography and CT were performed. Laparatomy revealed an ileo-ileo-colic intusussception (70 cm long); invaginated Meckel's diverticulum was a prevailing anomaly. Conclusions. Atypical clinical presentation of chronic intussusception often results in delayed or inadequate management of such cases because of the lack of suspicion of a correct diagnosis. Preoperative diagnosis of invagination was based on ultrasonography and computed tomography (CT) which proved again as the most effective and useful preoperative diagnostic method. Surgical intervention is always needed in adults and older children because of high incidence of underlying lesions in them. (author)

  7. A Grounded Theory for Regional Development through the IT Offshoring Industry with the Triple-Helix Involvment

    Science.gov (United States)

    Villarreal de la Garza, Sonia

    2011-01-01

    The purpose of this qualitative grounded study was to explore the thoughts, experiences, and needs of potential clients and of the triple-helix members with the intention to establish a framework to support the development of the regional economy through the information technology (IT) and business processing outsourcing (BPO) offshoring industry.…

  8. Intussusception in children seen at Muhimbili National Hospital, Dar ...

    African Journals Online (AJOL)

    Intussusception in children seen at Muhimbili National Hospital, Dar es salaam. ... its magnitude of concern and any seasonal variation in our environment. ... majority of the children present late, >48 hours from the onset of symptoms and ...

  9. Retrograde Jejuno-Jejunal Intussusception after Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Akira Yoneda

    2008-08-01

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

  10. Intussusception in children: imaging evaluation and therapeutic approach

    International Nuclear Information System (INIS)

    Cunha, Fabio Motta da; Figueiredo, Sizenildo da Silva; Nobrega, Bruno Barcelos da; Monteiro, Soraya Silveira; Lederman, Henrique Manoel; Oliveira, Galba Leite

    2005-01-01

    Intussusception is a medical emergency that occur with higher frequency in children under 2 years of age. Diagnosis can be difficult as the classical triad of abdominal pain, jelly stools and palpable abdominal mass is seen in less than 50% of the patients. However, the diagnosis of intussusception can be established with variable degree of accuracy using plain abdominal x-ray films, ultrasound, computed tomography or barium (or air/saline) enema. Some of these imaging methods are also useful during treatment of this condition. The authors present a review of the literature and a pictorial essay of the imaging findings in patients with intussusception. In addition, a discussion on the current and controversial issues related to the treatment of intussusception is presented. (author)

  11. Simultaneous intussusception and sigmoid volvulus in a child

    Energy Technology Data Exchange (ETDEWEB)

    Leeba, J.M.; Boas, R.N.

    1986-03-01

    This radiographically documented case of synchronous ileoileocolic intussusception and sigmoid volvulus is without apparent precedence. Etiological factors relevant to each of these conditions are discussed. Reasons for possible underdiagnosis of sigmoid volvulus and simultaneous lesions are included.

  12. Meckel's diverticulum: the lead point of intrauterine intussusception ...

    African Journals Online (AJOL)

    Meckel's diverticulum: the lead point of intrauterine intussusception with subsequent intestinal atresia in a newborn. Viet H. Le, Paul A. Perry, Allyson L. Hale, Robert L. Gates, John C. Chandler ...

  13. Recurrent intussusception, coeliac disease and cholelithiasis: A unique combination

    Directory of Open Access Journals (Sweden)

    Sinha C

    2007-01-01

    Full Text Available Authors report an 11-month-old female child, who presented with recurrent episodes of colicky abdominal pain and diarrhea. An abdominal ultrasound revealed small bowel intussusception. She was also noted to have a thick walled gall bladder and a solitary gallstone. Further investigations confirmed the diagnosis of coeliac disease. The combination of small bowel intussusception, coeliac disease and cholelithiasis is unique and has not been reported in the literature.

  14. Time requirement for barium reduction in intussusception

    International Nuclear Information System (INIS)

    Hwang, Hye Eun; Kim, Seung Ho; Kang, In Young; Park, Byoung Lan; Kim, Byoung Geun

    1988-01-01

    During the period between January 1985 and December 1987, barium reduction was performed in 146 cases of intussusception who were admitted to Kwangju Christian Hospital. The results were as follows: 1. Success rate to the symptom duration is relatively constant. 2. The success rate in infants with severe dehydration was 50% but it was gradually increased in infants with moderate dehydration and in infants with mild dehydration, 83.3% and 100% respectively. 3. The success rate of 12 cases in severely dehydrated infants with positive dissection sign was 16.7%. 4. The success rate of 15 cases in moderately dehydrated infants with positive dissection sign was 66.7%. 5. The average time requirement for barium reduction was 58.3 minutes. No serious complications were noted during barium reduction, except mild vomiting. 6. With above results, it is desirable that barium reduction should be performed according to the patient's physical status and radiologic findings.

  15. Emergency medicine physicians performed ultrasound for pediatric intussusceptions

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    Yi-Jung Chang

    2013-08-01

    Full Text Available Background: Intussusception is the common acute abdomen in children with difficult clinical diagnosis. The routine ultrasound has recently been proposed as the initial diagnostic modality with high accuracy, but is not available for 24 h by gastroenterologists. We aimed to evaluate the validation of bedside ultrasound for intussusceptions performed by pediatric emergency physicians with ultrasound training during the night or holiday. Methods: A retrospective study was conducted in children with suspected intussusceptions when routine ultrasounds by gastroenterologists were not available over the period from July 2004 to July 2008. Patients were divided into two groups: those diagnosed by emergency physicians with ultrasound training and without training. The clinical characteristics and course for all patients were reviewed and compared for seeking the difference. Results: A total of 186 children were included. One hundred and thirteen (61% children were diagnosed by pediatric emergency physician with ultrasound training. The clinical symptoms were not statistically different between the two groups. The diagnostic sensitivity of the ultrasound training group was significantly higher (90% vs. 79%, p = 0.034. Children of the training group also had significantly shorter hospital stay duration at emergency departments before reduction (2.41 ± 2.01 vs. 4.58 ± 4.80 h, p = 0.002. Conclusion: Bedside ultrasound performed by pediatric emergency physicians with ultrasound training is a sensitive test for detecting intussusceptions. Knowledge and use of bedside ultrasound can aid the emergency physician in the diagnosis of pediatric intussusceptions with less delay in treatment.

  16. US features of transient small bowel intussusception in pediatric patients

    International Nuclear Information System (INIS)

    Kim, Ji Hye

    2004-01-01

    To describe the sonographic (US) and clinical features of spontaneously reduced small bowel intussusception, and to discuss the management options for small bowel intussusception based on US findings with clinical correlation. During a five years of period, 34 small bowel intussusceptions were diagnosed on US in 32 infants and children. The clinical presentations and imaging findings of the patients were reviewed. The clinical presentations included abdominal pain or irritability (n = 25), vomiting (n 5), diarrhea (n = 3), bloody stool (n = 1), and abdominal distension (n = 1), in combination or alone. US showed multi-layered round masses of small (mean, 1.5 ± 0.3 cm) diameters and with thin (mean, 3.5 ± 1 mm) outer rims along the course of the small bowel. The mean length was 1.8 ± 0.5 cm and peristalsis was seen on the video records. There were no visible lead points. The vascular flow signal appeared on color Doppler images in all 21 patients examined. Spontaneous reduction was confirmed by combinations of US (n = 28), small bowel series (n = 6), CT scan (n = 3), and surgical exploration (n 2). All patients discharged with improved condition. Typical US findings of the transient small bowel intussusception included 1) small size without wall swelling, 2) short segment, 3) preserved wall motion, and 4) absence of the lead point. Conservative management with US monitoring rather than an immediate operation is recommended for those patient with typical transient small bowel intussusceptions. Atypical US findings or clinical deterioration of the patient with persistent intussusception warrant surgical exploration

  17. Mantle cell lymphoma of the gastrointestinal tract presenting with multiple intussusceptions – case report and review of literature

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    Abo Stephen M

    2009-07-01

    Full Text Available Abstract Background Mantle cell lymphoma (MCL is an aggressive type of B-cell non-Hodgkin's lymphoma that originates from small to medium sized lymphocytes located in the mantle zone of the lymph node. Extra nodal involvement is present in the majority of cases, with a peculiar tendency to invade the gastro-intestinal tract in the form of multiple lymphomatous polyposis. MCL can be accurately diagnosed with the use of the highly specific marker Cyclin D1. Few cases of mantle cell lymphoma presenting with intussuception have been reported. Here we present a rare case of multiple intussusceptions caused by mantle cell lymphoma and review the literature of this disease. Case presentation A 68-year-old male presented with pain, tenderness in the right lower abdomen, associated with nausea and non-bilious vomiting. CT scan of abdomen revealed ileo-colic intussusception. Laparoscopy confirmed multiple intussusceptions involving ileo-colic and ileo-ileal segments of gastrointestinal tract. A laparoscopically assisted right hemicolectomy and extended ileal resection was performed. Postoperative recovery was uneventful. The histology and immuno-histochemistry of the excised small and large bowel revealed mantle cell lymphoma with multiple lymphomatous polyposis and positivity to Cyclin D1 marker. The patient was successfully treated with Rituximab-CHOP chemotherapy and remains in complete remission at one-year follow-up. Conclusion This is a rare case of intestinal lymphomatous polyposis due to mantle cell lymphoma presenting with multiple small bowel intussusceptions. Our case highlights laparoscopic-assisted bowel resection as a potential and feasible option in the multi-disciplinary treatment of mantle cell lymphoma.

  18. Intussusception caused by dried apricot: A case report

    Directory of Open Access Journals (Sweden)

    Yana Puckett

    2014-01-01

    CONCLUSION: Bezoars are an extremely rare cause of intussusception in adults. A high level of suspicion needs to exist in the presence of a history of eating dried fruit, history of gastric surgery, diabetes mellitus, and problems with mastication. Various treatment modalities exist to treat obstructions secondary to bezoars, including open reduction and removal of bezoar via enterotomy.

  19. Retrograde pylorogastric intussusception – Case report and review

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    Efrat Avinadav

    2016-07-01

    Full Text Available A case of gastric outlet obstruction in an infant due to retrograde intussusception of the pylorus into the stomach is presented. This anomaly is extremely rare, with almost no reports in the literature. The patient underwent formal Heineke-Mikulicz pyloroplasty with an uneventful recovery and resumed full enteral feeding.

  20. Endoscopic Diagnosis of Jejuno-Gastric Intussusception | Mwachiro ...

    African Journals Online (AJOL)

    Jejunogastric intussusception is a rare complication of gastric surgery that is potentially life threatening if it is not diagnosed early. This condition is a surgical emergency and is most commonly seen after gastro-jejunostomy. The authors report a case of an elderly female patient who presented with hematemesis and ...

  1. Chronic Ileocecal Intussusception Secondary to Non-Hodgkins ...

    African Journals Online (AJOL)

    Chronic intussusception is a distinct clinical entity which is unfortunately poorly recognized due to its atypical presentation. A 5½ year old female patient presented with a 5 month history of abdominal pain associated with occasional vomiting, anorexia and progressive weight loss. 5 days prior to admission she developed ...

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

    2015-11-02

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

  4. Hydrostatic reduction of intussusception with normal saline using the ...

    African Journals Online (AJOL)

    Hydrostatic reduction of intussusception with normal saline using the gravity aided method in a Nigerian teaching hospital. M.A. Abdulsalam, B.O. Balogun, R.I. Osuoji, O.O. Olofinlade, O.M. Faboya, M.A. Bankole ...

  5. Meckel's diverticulum: the lead point of intrauterine intussusception ...

    African Journals Online (AJOL)

    management of a newborn with intrauterine intussusception of a Meckel's diverticulum as a cause of the vascular malformation leading to ileal atresia. To our knowledge, this is the fifth case report of this phenomenon. In all cases, definitive management required ... dense collection of small bowel and a small rim of proximal.

  6. Seasonality and surgical management of intussusception over 10 ...

    African Journals Online (AJOL)

    47.5%of patients had resection and primary anastomosis while 24.0% had manual reduction at laparotomy. Conclusion: Intussusception is one of the most common paediatric surgical emergencies at Harare Central Hospital. The age and sex of patients are the same as those found in literature. In contrast with previous data ...

  7. Acute intussusception in children seen at El Obeid Hospital, Western ...

    African Journals Online (AJOL)

    54.2% of cases had resection and anastomosis for bowel ischaemia, while in 45.8% manual reduction was done. The post-operative mortality was 16.7%. Conclusions: Childhood intussusception was common in male infants from rural areas in the dry season. Late presentation to the surgeon necessitated major operative ...

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

    African Journals Online (AJOL)

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

  9. Childhood intussusception at the Moi teaching and referral hospital ...

    African Journals Online (AJOL)

    Objective: To review the management of childhood intussusception at the Moi Teaching and Referral Hospital, Eldoret and identify factors that require attention for improved outcome. Design: A retrospective descriptive study covering the period January 2000 to December 2003. Setting: Moi Teaching and Referral Hospital, ...

  10. Intussusception in children: Experience with 105 patients in a ...

    African Journals Online (AJOL)

    Aim. The aim of this study was to present our experience in patients with intussusception (IN). Materials and methods. One hundred and five cases of IN treated between 1991 and 2007 were analysed. Age, gender, symptoms, signs, diagnostic and treatment methods, types of IN including leading point, and postoperative ...

  11. Intussusception in childhood: the role of plain abdominal radiographs

    International Nuclear Information System (INIS)

    Ji, Joo Yun; Kim, Min Joong; Kim, Young Mook; Park, Won Gyu; Ko, Kang Seok; Kim, Se Jong; Park, Byung Ran; Kim, Byong Geun

    1995-01-01

    The purposes of this study were to evaluate the plain radiologic findings of the childhood intussusception and to evaluate the role of plain abdominal films in predicting the success of air or barium reduction. We retrospectively reviewed 140 cases with the diagnosis of intussusception in childhood. The radiological signs that included soft tissue mass, dilatation of small bowel suggesting obstruction, crescent sign, and target sign were evaluated in terms of frequency. The relationship between radiological findings and outcome of reduction was analyzed. The site of soft tissue mass or crescent sign seen on plain radiographs was correlated with the position of the apex of the intussusceptum seen at the beginning of barium edema. The degree of dilated small bowel was evaluated by calculating the proportion of air-filled small bowel occupying peritoneal cavity and measuring the maximal diameter of dilated bowel lumen. The radiological finding for small bowel obstruction is determined by observation of the degree of small bowel dilatation and/or air-fluid levels. Ninety-two cases out of 140 showed one or more radiographic signs. Two most common signs were soft tissue mass and small bowel obstruction. The success rate of air or barium reduction was significantly lower in patients with most severe degree of dilatation of small bowel and/or more than 7 air-fluid levels on erect view. The suspected location of intussusception on plain radiographs correlated well with the true location of intussusception seen in the first few seconds of barium reduction. Plain abdominal radiography is useful in the diagnosis of intussusception and provides helpful information for the reduction procedure as well as for the exclusion of the contraindications such as bowel perforation

  12. Indications for repeated enema reduction of intussusception in children

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    Vujović Dragana

    2014-01-01

    Full Text Available Introduction. Intussusception is a common abdominal emergency in early childhood. It is idiopathic in more than 90% of cases with incidence of 1.5-4 per 1,000 live births. The treatment of choice is nonoperative hydrostatic or air enema reduction. Objective. The aim of the study was to evaluate the influence of clinical presentation and symptom duration in non-operative treatment, considering the indications for delayed enema reduction and its efficacy. Methods. From the total number of 107 patients with intusussception, aged from 2 months to 14 years (median 9 months, 102 (95% patients with ileo-colic intussusceptions were treated initially by ultrasound guided saline enema. Records were reviewed for patients with failed initial treatment and delayed repeated enemas or operative procedure. The predictor variable included duration of presenting symptoms. Results. Successful treatment by hydrostatic saline enemas had 58/102 (57% patients. Success in reduction was greater if symptom duration was 24 hours, (4/45 cases; 9%. Despite failed initial attempts, enema reduction was reattempted in 12 patients, with success in 7/12 (60% patients. Children with symptom duration >24 hours had a greater risk of requiring surgery (41/45 cases; 91%, p<0.001, including 5 (5% patients with ileo-ileal intussusceptions. Conclusion. The accuracy of ultrasound guided saline enema in intussusception reduction is high. Delay in presentation decreases success of non-operative treatment. Delayed enema reduction is important therapeutic option for intussusceptions. Surgical treatment is indicated in cases of complications.

  13. Childhood intussusception in Ile-ife: What has changed?

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    Ademola Olusegun Talabi

    2013-01-01

    Full Text Available Background: Intussusception is one of the most common causes of intestinal obstruction in children. While the outcome has improved in the developed nations, the same cannot be said of the developing countries, more especially in the sub-Saharan region. This study aims to review our current experience in the management of childhood intussusception and factors affecting surgical outcome at the Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife. Patients and Methods: This was a retrospective study of 78 patients treated for intussusception at paediatric surgical unit of Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife between January 1993 and December 2011. The case notes of the patients were retrieved and the following information was recorded: Demographic characteristics, month of occurrence, clinical presentation, investigations, and management as well as the post-operative outcome. The patients were divided into two groups in terms of outcome. Results: There were 58 males and 20 females (M:F = 2.9-1. The age of most of the patients was between 3 months and 9 months with peak incidence at 6 months. Most patients 46 (58.9% were seen during the dry season of December to April. Only six patients (7.7% presented within 24 hours of onset of illness. More than half of the patients presented after 24 hours. Passage of red currant stool, vomiting, abdominal pain, fever, and abdominal distension, passage of watery stool, anal protrusion and palpable abdominal mass in various combinations were the clinical features. All the patients had surgical operations. The most common type of intussusception was ileo-colic type in 64 patients (82.1%. Intestinal resection rate was 41%. The overall mortality rate was 15.4%. Conclusion: There was a delay in presentation of children with intussusception with high post-operative mortality.

  14. Intussusception in children: Comparison between ultrasound diagnosis and operation findings in a tropical developing country

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    Usang E Usang

    2013-01-01

    Full Text Available Background: Intussusception is one of the more common causes of intestinal obstruction in children. The diagnosis may be based mainly on clinical features; however, there are no classic signs and symptoms that are common to all cases. This study reports our experience at US diagnosis and operation findings of children with intussusceptions in a tropical developing economy. Materials and Methods: This was an 8 years retrospective review of intussusceptions in children in a tertiary health facility in a tropical developing country from January 2004 to December 2011. Results: Twenty-five out of 41 children (M:F = 2.2:1 admitted with intussusceptions within the period were studied. The median age was 6.0 ± 5.57 months (range 3 months- 7 years. US positively diagnosed intussusceptions in 20 (80% cases. Conclusion: US can increase diagnostic confidence in intussusceptions.

  15. Intussusception due to Peutz-Jeghers syndrome - a case report and review of the literature

    International Nuclear Information System (INIS)

    Grasso Filho, Luiz Eduardo; Albertotti, Flavio; Carvalho, Claudio Sobral de; Nersessian, Ana Carolina; Docema, Marcos F. Lima; Ogasawara, Aparecida M.; Peng Yong Sheng; Costacurta, Marco Antonio; Albertotti, Cesar Jose; Cerri, Giovanni Guido

    2000-01-01

    The authors report a case of a 28-year-old woman with ileocecocolic intussusception due to Peutz-Jeghers syndrome, an autosomal dominant disorder characterized by hamartomatous polyposis of the gastrointestinal tract and mucocutaneous pigmentation. This condition frequently presents complications such as intestinal obstruction due to invagination or hemorrhage. In this patient, the diagnosis of intussusception was made preoperatively. The excised material revealed three large polyps which were considered to be the cause of the intussusception. (author)

  16. Adult jejunojejunal intussusception - a case report and review of the literature. Radiological findings

    International Nuclear Information System (INIS)

    Setubal, Roger; Souza, Ricardo Pires de; Endo, Erica; Kataoka, Kazumi; Soares, Aldemir Humberto

    1996-01-01

    The author report a case of jejunojejunal intussusception caused by an adenomatous polyp in an adult. The majority of intussusception's cases occur in children with less than 2 years of age, with only 5% to 15% of cases occurring in adults. In contrast to pediatrics group intussusception, which is idiopathic in 90% of cases, adult intussusception has a demonstrable cause in more than 90% of cases. The pre-operative diagnosis is made by the association between the clinical presentation and plain abdominal radiographs, barium study of small intestine, ultrasound and computed tomography, described and discussed in this paper. (author)

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-12-01

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

  19. Presentation of GIST as jejuno-jejunal intussusception

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    Anil Kumar

    2018-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Tara J. Fetzer

    2017-09-01

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

  1. Jejunogastric intussusception in a child: A case report

    Directory of Open Access Journals (Sweden)

    Nathan Smith

    2014-11-01

    Full Text Available Jejunogastric intussusception is a rare event following gastrointestinal reconstruction. We present a case report in which jejunogastric intussuception was diagnosed in a child four years after a gastrectomy with jejunogastric reconstruction for duodenal duplication. Prompt diagnosis and emergent resection of any non-viable bowel, and revision to a Roux-En-Y anastomosis with or without pexy of the Roux limb to the colon or Y-limb mesentery appear to be the appropriate treatment for this clinical entity.

  2. Perforated appendicitis: an underappreciated mimic of intussusception on ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Schmitz, Matthew; Gawande, Rakhee; Vasanawala, Shreyas; Barth, Richard [Lucile Packard Children' s Hospital, Department of Radiology, Stanford University, Stanford, CA (United States)

    2014-05-15

    We encountered multiple cases in which the US appearance of ruptured appendicitis mimicked intussusception, resulting in diagnostic and therapeutic delay and multiple additional imaging studies. To explore the clinical and imaging discriminatory features between the conditions. Initial US images in six children (age 16 months to 8 years; 4 boys, 2 girls) were reviewed independently and by consensus by three pediatric radiologists. These findings were compared and correlated with the original reports and subsequent US, fluoroscopic, and CT images and reports. All initial US studies demonstrated a multiple-ring-like appearance (target sign, most apparent on transverse views) with diagnostic consensus supportive of intussusception. In three cases, US findings were somewhat discrepant with clinical concerns. Subsequently, four of the six children had contrast enemas; two were thought to have partial or complete intussusception reduction. Three had a repeat US examination, with recognition of the correct diagnosis. None of the US examinations demonstrated definite intralesional lymph nodes or mesenteric fat, but central echogenicity caused by debris/appendicolith was misinterpreted as fat. All showed perilesional hyperechogenicity that, in retrospect, represented inflamed fat ''walling off'' of the perforated appendix. There were four CTs, all of which demonstrated a double-ring appearance that correlated with the US target appearance, with inner and outer rings representing the dilated appendix and walled-off appendiceal rupture, respectively. All six children had surgical confirmation of perforated appendicitis. Contained perforated appendicitis can produce US findings closely mimicking intussusception. Clinical correlation and careful multiplanar evaluation should allow for sonographic suspicion of perforated appendicitis, which can be confirmed on CT if necessary. (orig.)

  3. Multidrug resistant shigella flexneri infection simulating intestinal intussusception

    Directory of Open Access Journals (Sweden)

    Srirangaraj Sreenivasan

    2016-01-01

    Full Text Available Shigella enteritis remains an important cause of mortality and morbidity in all age groups, in developing as well as developed countries. Owing to the emerging resistance to multiple antibiotics among Shigella spp., it has been recognized as a major global public health concern and warrants constant monitoring of its resistance pattern. We report a case of segmental ileitis caused by non.-ESBL producing multidrug resistant Shigella flexneri in an infant clinically mimicking intussusception, which was effectively treated by ceftriaxone.

  4. Perforated appendicitis: an underappreciated mimic of intussusception on ultrasound

    International Nuclear Information System (INIS)

    Newman, Beverley; Schmitz, Matthew; Gawande, Rakhee; Vasanawala, Shreyas; Barth, Richard

    2014-01-01

    We encountered multiple cases in which the US appearance of ruptured appendicitis mimicked intussusception, resulting in diagnostic and therapeutic delay and multiple additional imaging studies. To explore the clinical and imaging discriminatory features between the conditions. Initial US images in six children (age 16 months to 8 years; 4 boys, 2 girls) were reviewed independently and by consensus by three pediatric radiologists. These findings were compared and correlated with the original reports and subsequent US, fluoroscopic, and CT images and reports. All initial US studies demonstrated a multiple-ring-like appearance (target sign, most apparent on transverse views) with diagnostic consensus supportive of intussusception. In three cases, US findings were somewhat discrepant with clinical concerns. Subsequently, four of the six children had contrast enemas; two were thought to have partial or complete intussusception reduction. Three had a repeat US examination, with recognition of the correct diagnosis. None of the US examinations demonstrated definite intralesional lymph nodes or mesenteric fat, but central echogenicity caused by debris/appendicolith was misinterpreted as fat. All showed perilesional hyperechogenicity that, in retrospect, represented inflamed fat ''walling off'' of the perforated appendix. There were four CTs, all of which demonstrated a double-ring appearance that correlated with the US target appearance, with inner and outer rings representing the dilated appendix and walled-off appendiceal rupture, respectively. All six children had surgical confirmation of perforated appendicitis. Contained perforated appendicitis can produce US findings closely mimicking intussusception. Clinical correlation and careful multiplanar evaluation should allow for sonographic suspicion of perforated appendicitis, which can be confirmed on CT if necessary. (orig.)

  5. Prognostic indicators for failed nonsurgical reduction of intussusception

    Directory of Open Access Journals (Sweden)

    Khorana J

    2016-08-01

    Full Text Available Jiraporn Khorana,1 Jesda Singhavejsakul,1 Nuthapong Ukarapol,2 Mongkol Laohapensang,3 Jakraphan Siriwongmongkol,1 Jayanton Patumanond4 1Division of Pediatric Surgery, Department of Surgery, 2Division of Gastroenterology, Department of Pediatrics, Chiang Mai University Hospital, Chiang Mai, 3Division of Pediatric Surgery, Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, 4Center of Excellence in Applied Epidemiology, Thammasat University Hospital, Pathumthani, Thailand Purpose: To identify the risk factors for failure of nonsurgical reduction of intussusception. Methods: Data from intussusception patients who were treated with nonsurgical reduction in Chiang Mai University Hospital and Siriraj Hospital between January 2006 and December 2012 were collected. Patients aged 0–15 years and without contraindications (peritonitis, abdominal X-ray signs of perforation, and/or hemodynamic instability were included for nonsurgical reduction. The success and failure groups were divided according to the results of the reduction. Prognostic indicators for failed reduction were identified by using generalized linear model for exponential risk regression. The risk ratio (RR was used to report each factor. Results: One hundred and ninety cases of intussusception were enrolled. Twenty cases were excluded due to contraindications. A total of 170 cases of intussusception were included for the final analysis. The significant risk factors for reduction failure clustered by an age of 3 years were weight <12 kg (RR =1.48, P=0.004, symptom duration >3 days (RR =1.26, P<0.001, vomiting (RR =1.63, P<0.001, rectal bleeding (RR =1.50, P<0.001, abdominal distension (RR =1.60, P=0.003, temperature >37.8°C (RR =1.51, P<0.001, palpable abdominal mass (RR =1.26, P<0.001, location of mass (left over right side (RR =1.48, P<0.001, poor prognostic signs on ultrasound scans (RR =1.35, P<0.001, and method of reduction (hydrostatic over pneumatic (RR =1

  6. Transient small-bowel intussusceptions in adults: significance of ultrasonographic detection

    International Nuclear Information System (INIS)

    Maconi, G.; Radice, E.; Greco, S.; Bezzio, C.; Bianchi Porro, G.

    2007-01-01

    Aim: To investigate the frequency, clinical significance, and outcome of small-bowel intussusceptions in adults detected using ultrasound in an outpatient setting. Patients and methods: In two different retrospective (January 2001 to April 2003) and prospective (May 2003 to June 2005) periods, 33 small-bowel intussusceptions were found in 32 patients (13 females; mean age: 38.1 years) with known or suspected intestinal disease. Patients underwent diagnostic work-up to assess any organic disease. Patients with self-limiting intussusception were submitted to clinical and ultrasonographic follow-up. Results: Of the 32 patients with small-bowel intussusception, 25 were identified in the prospective series of 4487 examinations (0.53%) and seven in the retrospective series of 5342 examinations (0.15%; p = 0.002). Four patients had persistent and 28 self-limiting intussusceptions. Self-limiting intussusceptions were idiopathic in 11 patients (39%) or associated with organic diseases in 17 (Crohn's disease in 11 patients, celiac disease in three, ulcerative colitis in one patient, and previous surgery for cancer in two). Self-limiting intussusceptions were asymptomatic in 25% of patients. Conclusion: Small-bowel intussusceptions in adults are not rare and are frequently self-limiting, idiopathic, or related to organic diseases, mainly Crohn's disease and coeliac disease

  7. Transient small-bowel intussusceptions in adults: significance of ultrasonographic detection

    Energy Technology Data Exchange (ETDEWEB)

    Maconi, G. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy)]. E-mail: giovanni.maconi@unimi.it; Radice, E. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy); Greco, S. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy); Bezzio, C. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy); Bianchi Porro, G. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy)

    2007-08-15

    Aim: To investigate the frequency, clinical significance, and outcome of small-bowel intussusceptions in adults detected using ultrasound in an outpatient setting. Patients and methods: In two different retrospective (January 2001 to April 2003) and prospective (May 2003 to June 2005) periods, 33 small-bowel intussusceptions were found in 32 patients (13 females; mean age: 38.1 years) with known or suspected intestinal disease. Patients underwent diagnostic work-up to assess any organic disease. Patients with self-limiting intussusception were submitted to clinical and ultrasonographic follow-up. Results: Of the 32 patients with small-bowel intussusception, 25 were identified in the prospective series of 4487 examinations (0.53%) and seven in the retrospective series of 5342 examinations (0.15%; p = 0.002). Four patients had persistent and 28 self-limiting intussusceptions. Self-limiting intussusceptions were idiopathic in 11 patients (39%) or associated with organic diseases in 17 (Crohn's disease in 11 patients, celiac disease in three, ulcerative colitis in one patient, and previous surgery for cancer in two). Self-limiting intussusceptions were asymptomatic in 25% of patients. Conclusion: Small-bowel intussusceptions in adults are not rare and are frequently self-limiting, idiopathic, or related to organic diseases, mainly Crohn's disease and coeliac disease.

  8. Duodenal intussusception secondary to web presenting as recurrent pancreatitis in a 7-year-old girl

    Energy Technology Data Exchange (ETDEWEB)

    Tu, Long H. [University of Connecticut School of Medicine, Farmington, CT (United States); Kaweah Delta Healthcare District, Graduate Medical Education, Visalia, CA (United States); Villalona, Gustavo A. [Yale School of Medicine, Department of Surgery, Section of Pediatric Surgery, New Haven, CT (United States); SSM Health Cardinal Glennon Children' s Hospital, Department of Pediatric Surgery, St. Louis, MO (United States); Cowles, Robert A. [Yale School of Medicine, Department of Surgery, Section of Pediatric Surgery, New Haven, CT (United States); Silva, Cicero T. [Yale School of Medicine, Department of Diagnostic Imaging, Section of Pediatric Radiology, 333 Cedar St., P.O. Box 208042, New Haven, CT (United States)

    2016-03-15

    Duodenal intussusception is a rare entity in children, with 32 cases reported in the English literature to our knowledge. Most reported cases are associated with endoluminal tubes or polyps, and the presenting symptoms are chronic and nonspecific. We report a case of duodenal intussusception in a 7-year-old girl secondary to a duodenal web and review the imaging findings. (orig.)

  9. Experience with Sonogram-guided hydrostatic reduction of Intussusception in Children in South-West Nigeria.

    Science.gov (United States)

    Ogundoyin, Oo; Lawal, Ta; Olulana, DI; Atalabi, Om

    2013-04-01

    Intussusception is a common cause of intestinal obstruction in young children. The diagnosis and treatment of intussusception has evolved over the years with ultrasound being the first choice imaging technique and a major player in the non-operative reduction of intussusception owing to its advantage of reduced morbidity and non-exposure to ionizing radiation when compared to other modalities of treatment. Aim & Objectives: The aim of this study was to evaluate the efficiency of ultrasound guided hydrostatic reduction in the management of intussusception in children and assess the predictors of reducibility. A prospective study of all infants and children who presented with uncomplicated intussusception was conducted between January, 2005 and September, 2013. The diagnosis of intussusception was made clinically and this was confirmed by an abdominal ultrasonography. Ultrasound guided hydrostatic reduction of intussusception was performed on the selected patients after they were adequately resuscitated. Failed reduction was abandoned in favour of operative reduction in some patients. Data collected included the age of the patients, duration of symptoms and the outcomes of the procedure and these were analyzed. Eighty-four patients with intussusception were treated over this period, 36(42.9%) patients were found suitable for hydrostatic reduction of intussusception. Twenty-four(66.7%) patients presented within 48 hours of onset of symptoms. Twenty-one(58.3%) patients had successful hydrostatic reduction of intussusception while 15(41.7%) patients had failed reduction. The procedure was successful in majority (58%) of the patients under the age of 1 year and one of the three (33%) patients older than one year. Hydrostatic reduction of intussusception was successful in 14 out of 24 patients (58.3%) who presented within 48 hours of onset of symptoms. Hydrostatic reduction of intussusception under ultrasound guidance is an effective and useful conservative method of

  10. Gastroduodenal Intussusception Caused by a Peutz- Jeghers Polyp in a Young Child: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Jae Eun; Cho, Bum Sang; Lee, Seung Young; Jeon, Min Hee; Lee, Ji Hyuk; Lee, Ho Chang; Koo, Ji Hae [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)

    2010-09-15

    Gastroduodenal intussusception is a rare condition caused by the prolapse of a gastric tumor with subsequent invagination of a portion of the gastric wall into the duodenum. Various gastric lesions including adenoma, lipoma, leiomyoma, hamartoma, adenocarcinoma, gastrointestinal stromal tumor (GIST), and as in our case a Peutz- Jeghers polyp, can serve as a lead point of intussusception. Only three cases of gastroduodenal intussusception secondary to a Peutz-Jeghers polyp have been reported. We experienced a case of gastroduodenal intussusception in a 36-month-old boy who presented with intermittent nonbilious vomiting, abdominal pain, and anemia. An abdominal ultrasound and contrast enhanced CT scan showed gastrointestinal intussusception and a mass-like lesion in the second portion of duodenum. A laparotomy revealed a 7x8 cm sized mass at the gastric body, which was pathologically confirmed as a Peutz-Jeghers polyp

  11. Concurrent acute appendicitis and ileocolic intussusception in a 1-year-old child

    Directory of Open Access Journals (Sweden)

    Lauren Marjon, MD

    2018-06-01

    Full Text Available Intussusception and acute appendicitis are part of a differential diagnosis for acute abdominal pain and vomiting in the pediatric population. We describe a unique case combining appendiceal intussusception with concurrent acute appendicitis, or “appendi-sception.” A 1-year-old boy presented with 1 day of fussiness, vomiting, and red, gelatinous stool. Initial diagnosis on ultrasound was a routine ileocolic intussusception with nonvisualization of the appendix. However, after a failed air enema decompression, the patient was taken to the operating room where the appendix was discovered to be inflamed within the intussusceptum. This case is unique as few cases of both conditions occurring simultaneously have been previously described. It is important for radiologists to be aware of this combination of diagnoses as both require urgent evaluation and prompt treatment. Keywords: Intussusception, Appendicitis, Appendiceal intussusception, Pediatric radiology

  12. [A Case of Small Intestinal Metastasis with Intussusception Due to Barium].

    Science.gov (United States)

    Tsujio, Gen; Nagahara, Hisashi; Nakao, Shigetomi; Fukuoka, Tatsunari; Shibutani, Masatsune; Maeda, Kiyoshi; Matsutani, Shinji; Kimura, Kenjiro; Toyokawa, Takahiro; Amano, Ryosuke; Tanaka, Hiroaki; Muguruma, Kazuya; Yashiro, Masakazu; Hirakawa, Kosei; Ohira, Masaichi

    2017-11-01

    A 48-year-old man noticed nausea and took health examination. After chest X-ray and gastrointestinal barium study was underwent, he was referred to our hospital because of abnormal shadow in the chest X-ray. CT scan revealed about 4 cm tumor in the hilum of left lung and target sign in the small intestine. He was diagnosed with intussusception and emergency operation was performed. During the laparotomy, we found 2 intussusceptions in the small intestine and we performed manual reduction using Hutchinson's maneuver. We confirmed the mass in oral side of the intussusception site but we did not confirmed any tumor in anal of the intussusception. This suggests the intussusception was caused by barium. Finally 3 small intestine tumor was observed and we resected and reconstructed each of the tumor. Histopathological examination showed small intestinal metastasis from pleomorphic carcinoma of the lung.

  13. Active surveillance for intussusception in a phase III efficacy trial of an oral monovalent rotavirus vaccine in India.

    Science.gov (United States)

    John, Jacob; Kawade, Anand; Rongsen-Chandola, Temsunaro; Bavdekar, Ashish; Bhandari, Nita; Taneja, Sunita; Antony, Kalpana; Bhatnagar, Veereshwar; Gupta, Arun; Kabra, Madhulika; Kang, Gagandeep

    2014-08-11

    Post licensure studies have identified an increased risk of intussusception following vaccination with currently licensed rotavirus vaccines, raising safety concerns generic to all rotavirus vaccines. We describe the surveillance for intussusception in a phase III clinical trial with an oral monovalent rotavirus vaccine developed from the neonatal 116E strain. Using broad screening criteria and active surveillance, the incidence of intussusception between 6 weeks and 2 years of age was measured in 4532 children who received three doses of vaccine and 2267 children who received a placebo in the clinical trial. Possible intussusceptions were evaluated with a screening ultrasonogram. An independent intussusception case adjudication committee reviewed all intussusceptions and graded them on Brighton Collaboration criteria for diagnostic certainty. We identified twenty-three intussusceptions on ultrasound from 1361 evaluated sentinel events. Eleven were of level 1 diagnostic certainty as determined by the independent intussusception case adjudication committee. None required surgical intervention, and the earliest identified intussusception was at 36 days following the third dose in a placebo recipient. Among vaccine recipients the first event of intussusception occurred 112 days after the third dose. The incidence of ultrasound-diagnosed intussusception was 200/100,000 child-years (95% CI, 120, 320) among those receiving the vaccine and 141/100,000 child-years (95% CI, 50, 310) among those receiving the placebo. The incidence rate of confirmed intussusception among vaccine recipients was 94/100,000 child-years (95% CI, 41, 185) and 71/100,000 child-years (95% CI, 15, 206) among those receiving the placebo. In this licensure study, 23 cases of intussusception were identified through an active surveillance system, but there was no temporal association with rotavirus vaccination. The use of active surveillance with broad criteria intended for ensuring safety of children

  14. Gastro-oesophageal intussusception in a young German Shepherd Dog

    International Nuclear Information System (INIS)

    Werthern, C.J. von; Montavon, P.M.; Fluckiger, M.A.

    1996-01-01

    A gastro-oesophageal intussusception in a female, six-week-old German shepherd dog was treated surgically with success. The dog was presented with acute dyspnoea and signs of shock. After laparotomy, the herniated organs were reduced from the lumen of the oesophagus into the abdomen and an imbrication of the oesophageal hiatus, an appositional fundoplication and a left-sided incisional fundopexy were performed. The dog made an uneventful recovery. Eighteen months after surgery the dog is still alive, with no clinical signs despite the persistent presence of megaoesophagus

  15. Limited utility of plain abdominal radiographs in evaluating intussusceptions secondary to long indwelling feeding tubes

    Directory of Open Access Journals (Sweden)

    Albert Yang

    2013-01-01

    Full Text Available Adult intussusception (AI is relatively rare and can be a difficult clinical diagnosis, often requiring cross-sectional imaging for confirmation. Unfortunately, intussusceptions in the setting of indwelling long enteral feeding tubes have been predominantly characterized in the pediatric population with minimal investigation in adults. We report three cases of AI in patients with long feeding catheters serving as anatomic lead points leading to intussusception diagnosed on cross-sectional imaging. We highlight the limited utility of the supine plain films for detection of AI, and it behooves the radiologist to hold a high index of suspicion if the patient has a long enteral catheter. Since the majority of these patients tend to be fairly ill and unable to stand for upright abdominal radiographs, in the setting of percutaneous feeding tubes, decubitus abdominal radiographs should always be obtained. These cases also highlight the importance of having a high clinical suspicion of intussusceptions in a patient presenting with abdominal pain in the setting of an enteral feeding tube. In post-operative patients, other factors can predispose the patient to intussusception, including adhesions. Another interesting feature in tube related AI is the reverse intussusception that may be seen with indwelling enteral tubes. Reverse intussusception is where the distal bowel telescopes into the proximal segment over the tube.

  16. Fluoroscopy-guided hydrostatic reduction of intussusception in infancy: role of pharmacological premedication.

    Science.gov (United States)

    Esposito, Francesco; Ambrosio, Concetta; De Fronzo, Simona; Panico, Maria Rita; D'Aprano, Marilena; Giugliano, Anna Marcella; Noviello, Domenico; Oresta, Patrizia

    2015-06-01

    Intussusception is one of the most common causes of paediatric emergency. Fluoroscopy-guided hydrostatic reduction is a common nonoperative management strategy for the treatment of intussusception. The role of pharmacological premedication in increasing the success rate of hydrostatic reduction is still controversial. The purpose of this study was to verify the presence of a possible correlation between pharmacological premedication and the percentage of hydrostatic reduction of intussusception in paediatric patients. This study considered children with a diagnosis of idiopathic intussusception treated at our hospital between January 2007 and June 2013. One group of patients underwent hydrostatic reduction by barium enema without any preliminary therapy. A second group of patients received pharmacological premedication with both a sedative and an anti-oedematous agent before the procedure. A total of 398 patients were treated with barium enema for therapeutic purposes. In the group of patients who received no premedication (n = 254), 165 (65 %) children achieved hydrostatic reduction of the intussusception. Among the patients who received pharmacological premedication prior to barium enema (n = 144), 122 (85 %) children achieved resolution of the intussusception. Our study shows that the use of pharmacological premedication is effective for the reduction of the intussusception, as its limit patient stress, fluoroscopic time and radiation dose.

  17. [Post-licensure passive safety surveillance of rotavirus vaccines: reporting sensitivity for intussusception].

    Science.gov (United States)

    Pérez-Vilar, S; Díez-Domingo, J; Gomar-Fayos, J; Pastor-Villalba, E; Sastre-Cantón, M; Puig-Barberà, J

    2014-08-01

    The aims of this study were to describe the reports of suspected adverse events due to rotavirus vaccines, and assess the reporting sensitivity for intussusception. Descriptive study performed using the reports of suspected adverse events following rotavirus vaccination in infants aged less than 10 months, as registered in the Pharmacovigilance Centre of the Valencian Community during 2007-2011. The reporting rate for intussusception was compared to the intussusception rate in vaccinated infants obtained using the hospital discharge database (CMBD), and the regional vaccine registry. The adverse event reporting rate was 20 per 100,000 administered doses, with the majority (74%) of the reports being classified as non-serious. Fever, vomiting, and diarrhea were the adverse events reported more frequently. Two intussusception cases, which occurred within the first seven days post-vaccination, were reported as temporarily associated to vaccination. The reporting sensitivity for intussusception at the Pharmacovigilance Centre in the 1-7 day interval following rotavirus vaccination was 50%. Our results suggest that rotavirus vaccines have, in general, a good safety profile. Intussusception reporting to the Pharmacovigilance Centre shows sensitivity similar to other passive surveillance systems. The intussusception risk should be further investigated using well-designed epidemiological studies, and evaluated in comparison with the well-known benefits provided by these vaccines. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  18. Intussusception secondary to Meckel's diverticulum in a 3-month-old girl. Case report

    Directory of Open Access Journals (Sweden)

    I. Camacho-Guerrero

    2018-04-01

    Full Text Available A 3-month-old female patient is presented, with ileo-ileal intussusception secondary to Meckel's diverticulum. The patient underwent emergency surgery due to a diagnosis of intestinal obstruction secondary to intussusception. Resumen: Se reporta caso de paciente femenino de 3 meses de edad, con una intususcepción intestinal íleo-ileal secundario a divertículo de Meckel, intervenida quirúrgicamente de urgencia por diagnóstico de obstrucción intestinal secundario a una invaginación intestinal. Keywords: Intussusception, Meckel's diverticulum, Palabras clave: Intususcepción intestinal, Divertículo Meckel

  19. Tuberculosis in a renal allograft recipient presenting with intussusception.

    Science.gov (United States)

    Mohapatra, A; Basu, G; Sen, I; Asirvatham, R; Michael, J S; Pulimood, A B; John, G T

    2012-01-01

    Extra-pulmonary tuberculosis (TB) is more common in renal allograft recipients and may present with dissemination or an atypical features. We report a renal allograft recipient with intestinal TB presenting 3 years after transplantation with persistent fever, weight loss, diarrhea, abdominal pain and mass in the abdomen with intestinal obstruction. He was diagnosed to be having an ileocolic intussusception which on resection showed a granulomatous inflammation with presence of acid-fast bacilli (AFB) typical of Mycobacterium tuberculosis. In addition, AFB was detected in the tracheal aspirate, indicating dissemination. He received anti-TB therapy (ATT) from the fourth postoperative day. However, he developed a probable immune reconstitution inflammatory syndrome (IRIS) with multiorgan failure and died on 11(th) postoperative day. This is the first report of intestinal TB presenting as intussusception in a renal allograft recipient. The development of IRIS after starting ATT is rare in renal allograft recipients. This report highlights the need for a high index of suspicion for diagnosing TB early among renal transplant recipients and the therapeutic dilemma with overwhelming infection and development of IRIS upon reduction of immunosuppression and starting ATT.

  20. Intussusception in children: Hydrostatic reduction under US guidance - own experience

    International Nuclear Information System (INIS)

    Roik, D.; Brzewski, M.; Biejat, A.; Marcinski, M.

    2008-01-01

    Intussusception in children is a common abdominal emergency. Recent years have brought a New promising method of nonsurgical invagination treatment, hydrostatic reduction under sonographic (US) guidance. The major advantage of this method is lack of the ionized radiation. The aim of our study is to asses the safety and effectiveness of hydrostatic reduction under US guidance used as a first choice method of invagination treatment in our department. >From July 2006 to December 2007, 33 procedures of hydrostatic reduction under US guidance were performed in 27 children, aged from 7 months to 6 years and 10 months. The procedure was performed in US room by radiologist and surgeon with the use of self-constructed set for saline enema. The sedation of patient was routinely performed. The initial procedure was effective in 23 patients (pts) (85%). In 5 pts the recurrence of intussusception occurred and in 3 of them next attempt of the reduction was successful. In 4 cases the initial procedures failed, and those children were operated. Total amount of 6 pts underwent an operation. We do not observe any complications connected with the procedure. Hydrostatic reduction of children intusussception under US-guidance is safe and effective method. Our initial results meet the recommended limits of successful reduction rates. It encouraged us to evaluation and further implementation of this method. Water enema is a first choice method of invagination treatment in our hospital. (authors)

  1. Intussusception of the small intestine caused by a primary melanoma?

    Science.gov (United States)

    Schoneveld, M; De Vogelaere, K; Van De Winkel, N; Hoorens, A; Delvaux, G

    2012-01-01

    Although the gastrointestinal tract is a fairly frequent site of melanoma metastases, reports of small bowel intussusception caused by melanoma are very rare. We report the case of a 77-year-old man who was admitted to our hospital with epigastric pain, melena and anaemia. After clinical examination, laboratory evaluation and radiological work-up the diagnosis of a jejunal intussusception was made. Exploratory laparoscopy revealed a large tumour arising from the jejunum, approximately 20 cm distal to the angle of Treitz. Small bowel resection with an end-to-end anastomosis was performed. Histological examination showed an intestinal melanoma. There are different theories concerning the origin of malignant melanoma in the small bowel. Although the small and large intestines normally contain no melanocytes, these cells have occasionally been found in the alimentary and respiratory tracts and even in lymph nodes, which supports the theory of a primary origin of melanoma at these sites. Since this was a solitary intestinal lesion and there was no history of cutaneous melanoma, we conclude that this could be an example of a very rare primary melanoma of the small intestine.

  2. Intussusception of the Small Intestine Caused by a Primary Melanoma

    Directory of Open Access Journals (Sweden)

    M. Schoneveld

    2012-01-01

    Full Text Available Although the gastrointestinal tract is a fairly frequent site of melanoma metastases, reports of small bowel intussusception caused by melanoma are very rare. We report the case of a 77-year-old man who was admitted to our hospital with epigastric pain, melena and anaemia. After clinical examination, laboratory evaluation and radiological work-up the diagnosis of a jejunal intussusception was made. Exploratory laparoscopy revealed a large tumour arising from the jejunum, approximately 20 cm distal to the angle of Treitz. Small bowel resection with an end-to-end anastomosis was performed. Histological examination showed an intestinal melanoma. There are different theories concerning the origin of malignant melanoma in the small bowel. Although the small and large intestines normally contain no melanocytes, these cells have occasionally been found in the alimentary and respiratory tracts and even in lymph nodes, which supports the theory of a primary origin of melanoma at these sites. Since this was a solitary intestinal lesion and there was no history of cutaneous melanoma, we conclude that this could be an example of a very rare primary melanoma of the small intestine.

  3. A Rare Cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception.

    Science.gov (United States)

    Sertkaya, Mehmet; Emre, Arif; Pircanoglu, Eyüp Mehmet; Yazar, Fatih Mehmet; Tepe, Murat; Cengiz, Emrah; Isler, Ali; Vicdan, Halit

    2016-01-01

    Intussusception in adults is very rarely seen, and this cause acute abdomen. A computed tomography (CT) scan, clinical suspicion, history, and a physical examination are important for the diagnosis. We present two cases of colonic intussusceptions induced by lipoma. The cases had similar locations, diagnoses, and management. Both lipomas were located close to the cecum in the ascending colon, and a right segmental colon resection was performed in both cases. The follow-up of both cases was uneventful. Although benign lesions can cause colonic intussusception, the high incidence of malignancy in colonic lesions should always be considered. Therefore, oncologic surgical procedures should be applied. The definitive diagnosis can be made by histopathology. Sertkaya M, Emre A, Pircanoglu EM, Yazar FM, Tepe M, Cengiz E, Isler A, Vicdan H. A Rare cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception. Euroasian J Hepato-Gastroenterol 2016;6(2):179-182.

  4. Ileocecal Burkitt's Lymphoma Presenting as Ileocolic Intussusception With Appendiceal Invagination and Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Sheng-Mine Wang

    2010-06-01

    Full Text Available Intussusception is a common cause of abdominal pain in children. Although most cases are idiopathic, about 10% of cases have a pathologic lead point. Burkitt's lymphoma is not a common etiology. Burkitt's lymphoma might present primarily as intussusception in children but has rarely been associated with appendicitis. We report a case in which a 10-year-old obese boy who initially presented with acute appendicitis due to ileocolic intussusception with appendiceal invagination. He underwent one-trocar laparoscopy and antibiotic treatment. The symptoms recurred 10 days after discharge. Colonoscopy disclosed ileocecal Burkitt's lymphoma as the pathological lead point. This case emphasizes the importance of the age of the patient and the anatomic location of the intussusception related to possible etiology, and hence the most appropriate surgical procedure.

  5. Jejunojejunal Intussusception due to Metastatic Melanoma Seven Years after the Primer

    Directory of Open Access Journals (Sweden)

    Alexander Giakoustidis

    2017-01-01

    Full Text Available Intestinal intussusception in adults is a rare medical condition accounting for less than 5% of all intussusceptions. Herein we present a 45-year-old patient with a history of abdominal pain and loss of weight. CT scan revealed jejunojejunal intussusceptions. The patient was subjected to exploratory operation and small intestine resection due to a mass causing intestinal intussusception. Pathology confirmed suspected diagnosis of metastatic melanoma to small intestine secondary to melanoma, 7 years after the initial manifestation. Postoperative evaluation with 18FDG-PET/CT revealed increased uptake in the thyroid gland. Subsequent total thyroidectomy revealed severe Hashimoto thyroiditis and no signs of metastasis. The patient received adjuvant immunotherapy and is healthy with no signs of recurrence 3 years after the initial diagnosis and treatment.

  6. Efficacy of US-guided Hydrostatic Reduction in Children with Intussusception

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Min; Chung, Tae Woong; Yoon, Woong; Chang, Nam Kyu; Heo, Suk Hee; Shin, Sang Soo; Lim, Hyo Sun; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2007-09-15

    To assess the success rate and efficacy of US-guided hydrostatic reduction in children with intussusception. We retrospectively evaluated the ultrasonographic findings and clinical features of 121 children (M:F=80:41, mean age= 18 months) who underwent US-guided hydrostatic reduction between November, 2002 and February, 2007 for the diagnosis and treatment of intussusception. The 121 patients underwent 147 procedures, including recurred cases. Successful reduction was achieved in 132 cases (89.8% success rate), as confirmed by post-procedure ultrasonography and clinical findings. Emergency operations were performed in the 10 (6.8%) cases of irreducible intussusceptions, 8 of ileocolic type and 2 of ileoileal type. Perforation occurred in 4 cases (2.7%), and seizure in 1 case during the procedure (0.7%). US-guided hydrostatic reduction is a safe and effective tool for the diagnosis and treatment of pediatric intussusception

  7. Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia.

    Science.gov (United States)

    Bines, Julie E; Liem, Nguyen Thanh; Justice, Frances; Son, Tran Ngoc; Carlin, John B; de Campo, Margaret; Jamsen, Kris; Mulholland, Kim; Barnett, Peter; Barnes, Graeme L

    2006-07-01

    To test the sensitivity and specificity of a clinical case definition of acute intussusception in infants to assist health-care workers in settings where diagnostic facilities are not available. Prospective studies were conducted at a major paediatric hospital in Viet Nam (the National Hospital of Pediatrics, Hanoi) from November 2002 to December 2003 and in Australia (the Royal Children's Hospital, Melbourne) from March 2002 to March 2004 using a clinical case definition of intussusception. Diagnosis of intussusception was confirmed by air enema or surgery and validated in a subset of participants by an independent clinician who was blinded to the participant's status. Sensitivity of the definition was evaluated in 584 infants agedclinical features consistent with intussusception but for whom another diagnosis was established (234 infants in Hanoi; 404 in Melbourne). In both locations the definition used was sensitive (96% sensitivity in Hanoi; 98% in Melbourne) and specific (95% specificity in Hanoi; 87% in Melbourne) for intussusception among infants with sufficient data to allow classification (449/533 in Hanoi; 50/51 in Melbourne). Reanalysis of patients with missing data suggests that modifying minor criteria would increase the applicability of the definition while maintaining good sensitivity (96-97%) and specificity (83-89%). The clinical case definition was sensitive and specific for the diagnosis of acute intussusception in infants in both a developing country and a developed country but minor modifications would enable it to be used more widely.

  8. Intestinal Obstruction Caused by Ileocolic and Colocolic Intussusception in an Adult Patient with Cecal Lipoma

    Directory of Open Access Journals (Sweden)

    Tiziana Casiraghi

    2016-01-01

    Full Text Available Introduction. Intussusception is a rare clinical entity in adults (<1% of intestinal obstructions. Colonic intussusception is even rarer, particularly when caused by lipomas. Case Presentation. A 47-year-old woman presented to our emergency department complaining of abdominal pain with vomiting and diarrhoea. X-ray and CT showed bowel obstruction due to ileocolonic and colocolonic intussusception; a giant colonic lipoma (9 × 4 × 4 cm was recognizable immediately distally to the splenic flexure of the colon. The patient underwent emergency laparotomy and right hemicolectomy. Assessment of the resected specimen confirmed the diagnosis of giant colonic polypoid lesion near to the ileocecal valve, causing a 12 cm long intussusception with moderate ischemic damage. Conclusion. Colonic obstruction due to intussusception caused by lipomas is a very rare condition that needs urgent treatment. CT is the radiologic modality of choice for diagnosis (sensitivity 80%, specificity near 100%; since the majority of colonic intussusceptions are caused by primary adenocarcinoma, if the etiology is uncertain, the lesion must be interpreted as malignant and extensive resection is recommended. At present, surgery is the treatment of choice and determines an excellent outcome.

  9. Intestinal Obstruction Caused by Ileocolic and Colocolic Intussusception in an Adult Patient with Cecal Lipoma.

    Science.gov (United States)

    Casiraghi, Tiziana; Masetto, Alessandro; Beltramo, Massimo; Girlando, Mauro; Di Bella, Camillo

    2016-01-01

    Introduction . Intussusception is a rare clinical entity in adults (<1% of intestinal obstructions). Colonic intussusception is even rarer, particularly when caused by lipomas. Case Presentation . A 47-year-old woman presented to our emergency department complaining of abdominal pain with vomiting and diarrhoea. X-ray and CT showed bowel obstruction due to ileocolonic and colocolonic intussusception; a giant colonic lipoma (9 × 4 × 4 cm) was recognizable immediately distally to the splenic flexure of the colon. The patient underwent emergency laparotomy and right hemicolectomy. Assessment of the resected specimen confirmed the diagnosis of giant colonic polypoid lesion near to the ileocecal valve, causing a 12 cm long intussusception with moderate ischemic damage. Conclusion . Colonic obstruction due to intussusception caused by lipomas is a very rare condition that needs urgent treatment. CT is the radiologic modality of choice for diagnosis (sensitivity 80%, specificity near 100%); since the majority of colonic intussusceptions are caused by primary adenocarcinoma, if the etiology is uncertain, the lesion must be interpreted as malignant and extensive resection is recommended. At present, surgery is the treatment of choice and determines an excellent outcome.

  10. [Henoch-Schönlein Purpura Presenting as Intussusception].

    Science.gov (United States)

    Kim, Keun Young

    2017-06-25

    Henoch-Schönlein purpura (HSP) is systemic vasculitis disease with various clinical manifestations. Gastrointestinal symptoms in patients with HSP are usually common, with an incidence rate of 62-90%. Most of these gastrointestinal symptoms occur after typical skin purpura, which is a very important clinical evidence for making a diagnosis of HSP. It is difficult to diagnose HSP without skin rash. About 25% of patients may experience gastrointestinal symptoms as their first symptoms. Herein, we report a case of ileo-colic intussusception associated with HSP in a 5-years-old girl presented with diffuse abdominal distension. Our patient did present any symptoms of HSP, such as purpura, arthralgia or arthritis, before surgery.

  11. UK intussusception audit: A national survey of practice and audit of reduction rates

    International Nuclear Information System (INIS)

    Hannon, Edward; Williams, Rhianydd; Allan, Rosemary; Okoye, Bruce

    2014-01-01

    Aim: To define current UK reduction practice and the reductions rates achieved. Materials and methods: Electronic surveys were sent to radiologists at 26 UK centres. This assessed methods of reduction, equipment, personnel, and protocol usage. Standardized audit proforma were also sent to evaluate all reductions performed in 2011. Results: Twenty-two of 26 centres (85%) replied. All used air enema under fluoroscopic guidance. Equipment was not standardized but could be broadly categorized into hand-pumped air-supply systems (seven centres) and pressurized air systems (15 centres). Seventeen centres followed a protocol based on British Society of Paediatric Radiologists (BSPR) guidelines. In 21 of the 22 centres a consultant paediatric radiologist led reductions and only 12 centres reported a surgeon being present. Three hundred and ten cases were reported across 22 centres. Cases per centre ranged from 0–31 (median 14). Reduction rates varied from 38–90% (median 71%). The overall perforation rate was 2.5%. Caseload did not significantly correlate with reduction rate, and there was no significant difference between the two types of equipment used. Median reduction rates were 15% higher in centres with a surgeon present at reduction (p < 0.05). Conclusion: Intussusception care in the UK lacks standardization of equipment and personnel involved. National reduction rates are lower than in current international literature. Improved standardization may lead to an improvement in reduction rates and a surgeon should always be present at reduction

  12. Baseline incidence of intussusception in early childhood before rotavirus vaccine introduction, the netherlands, january 2008 to december 2012

    NARCIS (Netherlands)

    Gadroen, Kartini; Kemmeren, Jeanet M.; Bruijning-Verhagen, P. C.; Straus, Sabine M J M; Weibel, Daniel; de Melker, Hester E.; Sturkenboom, M. C.

    2017-01-01

    Intussusception is a rare, potentially life-threatening condition in early childhood. It gained attention due to an unexpected association with the first rotavirus vaccine, RotaShield, which was subsequently withdrawn from the market. Across Europe, broad variations in intussusception incidence

  13. Baseline incidence of intussusception in early childhood before rotavirus vaccine introduction, the Netherlands, January 2008 to December 2012.

    NARCIS (Netherlands)

    Gadroen, Kartini; Kemmeren, Jeanet M; Bruijning-Verhagen, Patricia Cj; Straus, Sabine Mjm; Weibel, Daniel; de Melker, Hester E; Sturkenboom, Miriam Cjm

    2017-01-01

    Intussusception is a rare, potentially life-threatening condition in early childhood. It gained attention due to an unexpected association with the first rotavirus vaccine, RotaShield, which was subsequently withdrawn from the market. Across Europe, broad variations in intussusception incidence

  14. [An easy, safe and affective method for the treatment of intussusception: ultrasound-guided hydrostatic reduction].

    Science.gov (United States)

    Ülger, Fatma Esra Bahadır; Ülger, Aykut; Karakaya, Ali Erdal; Tüten, Fatih; Katı, Ömer; Çolak, Mustafa

    2014-03-01

    Intussusception is one of the important causes of intestinal obstruction in children. Hydrostatic reduction under ultrasound guidance is a popular treatment method for intussusception. In the present study, we aimed to explain the demographic characteristics of and treatment approaches in patients diagnosed with intussusception by ultrasound. Forty-one patients diagnosed with intussusception by ultrasound between August 2011 and May 2013 were retrospectively analyzed. Twenty-four of these patients who had no contraindications had been treated with ultrasound-guided hydrostatic reduction. Twenty-four of the patients were male and 17 were female, a 1.4/1 male-to-female ratio. The majority of the patients were between the ages of 6-24 months and 2-5 years. The mean age was 31.12±26.32 months (range 3-125). Patients were more frequently diagnosed in April and May. Seventeen patients who had clinical contraindications enrolled directly for surgery. In 20 of the 24 patients who underwent ultrasound-guided hydrostatic reduction, reduction was achieved. Three experienced recurrence. In two of these patients, successful reduction was achieved with the second attempt. The remaining patient was enrolled for surgery. Hydrostatic reduction was performed 26 times on these 24 patients, and in 22, success was achieved (84.6%). No procedure-related complications occurred in the patients. Ultrasound-guided hydrostatic reduction, with its high success rates and lack of radiation risk, should be the first choice therapeutic approach for children diagnosed with intussusception.

  15. Reduction of intussusception by air insufflation in children: recent three-year experience

    International Nuclear Information System (INIS)

    Lee, In Jae; Lim, Hyo Keun; Lee, Kyung Hwan; Yun, Ku Sub; Seo, Gwy Suk; Bae, Sang Hoon

    1994-01-01

    This study was conducted to evaluate success and perforation rates of pneumatic reduction and to find the predictors of reduction failure. We reviewed 224 cases of pediatric intussusception diagnosed by air-enema between July, 1989 and June, 1992. The mean age was 9.8 months(range, 1 month to 3 years). Logistic regression analysis was used to find predictors of reduction failure. Successful reduction was achieved in 197 cases(87.9% of success rate). Bowel perforation occurred in two cases(0.9% of perforation rate). There were two statistically significant predictors of failure;(1) ileoileocolic intussusception(ρ < .001), (2) long duration of symptom (ρ < .001). Surgery was performed in 26 cases (11.6%), of which seven required bowel resection. Pneumatic reduction is a useful means in the management of pediatric intussusception with a high success rate and no mortality

  16. Synchronous adenocarcinomas of the colon presenting as synchronous colocolic intussusceptions in an adult

    Directory of Open Access Journals (Sweden)

    Chen Chuang-Wei

    2012-12-01

    Full Text Available Abstract Intussusception is uncommon in adults. To our knowledge, synchronous colocolic intussusceptions have never been reported in the literature. Here we described the case of a 59-year-old female of synchronous colocolic intussusceptions presenting as acute abdomen that was diagnosed by CT preoperatively. Laparotomy with radical right hemicolectomy and sigmoidectomy was undertaken without reduction of the invagination due to a significant risk of associated malignancy. The final diagnosis was synchronous adenocarcinoma of proximal transverse colon and sigmoid colon without lymph nodes or distant metastasis. The patient had an uneventful recovery. The case also emphasizes the importance of thorough exploration during surgery for bowel invagination since synchronous events may occur.

  17. Invaginated meckel's diverticulum: A rare cause of small intestine intussusception in adults

    International Nuclear Information System (INIS)

    Rana, N. A.; Rathore, M. O.; Khan, M. U.

    2013-01-01

    Intussusception is commonly seen in infants. It is occasionally found in adults usually due to carcinomas, colonic diverticuli, polyps and rarely Meckel's diverticulum. An adult male presented with upper abdominal pain, nausea, anorexia and loose stools. The initial investigative workup was unremarkable and patient responded to treatment given for acute gastroenteritis. After 3 days, the pain recurred in right iliac fossa with rebound tenderness and leukocytosis. Surgery was performed with provisional diagnoses of acute appendicitis and/or acute Meckel's diverticulitis. Per-operative findings revealed invaginated Meckel's diverticulum causing non-obstructing intussusception. (author)

  18. Ultrasound-guided hydrostatic reduction of intestinal intussusception: description of three cases

    Directory of Open Access Journals (Sweden)

    Martha Hanemann Kim

    2008-09-01

    Full Text Available With the objective of reporting the technique of ultrasound-guided hydrostatic reduction of intestinal intussusception, three cases with confirmed diagnosis of the disease submitted to reduction with this technique are described. All cases had successful reductions with no complications. One patient experienced a recurrence of the invagination eight days after treatment, which was surgically corrected. The technique of hydrostatic reversal of intestinal intussusception guided by ultrasound may be used in place of the conventional barium enema, since it is a minimally invasive and safe method, with high rates of success and few complications.

  19. Effective dose at pneumatic reduction of paediatric intussusception

    International Nuclear Information System (INIS)

    Heenan, S.D.; Kyriou, J.; Fitzgerald, M.; Adam, E.J.

    2000-01-01

    AIM: The purpose of this study was to assess screening times and resulting dose implication at pneumatic reduction of intussusception in the paediatric age group and to examine the relationship with the outcome of the procedure. MATERIALS AND METHODS: We retrospectively reviewed the case notes and departmental records of 143 children who had undergone a total of 153 pneumatic reductions in our department over a 4-year period. Success rates, screening times and available dose-area products (DAP) were recorded. The DAPs were converted to effective dose (ED) for 77 procedures. RESULTS: A 76.5% (117/153) success rate was achieved with a recurrence rate of 6.5% and only one complication: a perforation. Screening times were recorded in 137 reductions and ranged from 15 s to 22.6 min. Although the longest screening time was associated with an unsuccessful outcome, the second longest time of 21 min was successful. This gave a DAP of 1278 cGy cm 2 and an ED of 12.73 mSv, which is equivalent to approximately 400 abdominal films for a 1-year-old. A lifetime risk of fatal cancer of one in 1000 was achieved, assuming the worst case, after a screening time of 30 min on our conventional fluoroscopy unit. CONCLUSION: Our success rate compares well with other centres. Our institution is a tertiary referral centre and the occasional long screening time may reflect the delay and complex nature of the patients referred. Persistence at air reduction may be successful and the success rate increases with delayed attempts but the risks of the increasing radiation burden must be weighed against the risks of emergency surgery and anaesthesia. Heenan, S.D. (2000)

  20. Understanding about diagnosis of acute small bowel retrograde intussusception in adults by means of 64-slice-spinal CT

    International Nuclear Information System (INIS)

    Jiang Ruizhou; Chen Jincheng

    2009-01-01

    Objective: To have a further study of the value of MSCT in diagnosing acute small bowel retrograde intussusception in adults by means of 64-slice-spinal CT. Methods: A 46-year-old female patient with the history of abdominal operation was found having acute mechanical small bowel obstruction through plain X-ray radiograph. 64-slice MSCT was performed afterwards (plain scan + 3 stage contrast scans). Hence, evidence is provided for operation. Results: Using the technique of MSCT for the patient can promptly approach the diagnosis of jejuno-jejunal intussusception with severe bowel obstruction; no small bowel tumor or other organic lesion found in this case. With the patient who has the history of abdominal operations, MSCT can predict the reason of adhesion causing bowel intussusception, and provide the evidence for operation; whereas MSCT with contrast media offers a further investigation of the blood supply to the bowels through SMA, and observation of blood circulation through the intussuscepting site, which represents venous congestion of intussusception. This case is a retrograde small bowel intussusception and confirmed with operation evidence. A greater amount of gas and fluid is accumulated between the dilated space of middle-distal portion of intussusceptum and intussuscipiens. Nevertheless, less gas at the proximal portion and that can be an important sign for retrograde intussusception. Conclusion: MSCT is a good choice of examination for diagnosis of adult's intussusception. As the literature mentioned the advantages of MSCT for observing the circulation of intussusceptum and whether the diagnosis is antegrade or retrograde intussusception is also essential. (authors)

  1. Intussusception due to a cecal duplication cyst: a rare cause of acute abdomen. Case report.

    Science.gov (United States)

    Corroppolo, M; Zampieri, N; Erculiani, E; Cecchetto, M; Camoglio, F S

    2007-01-01

    Duplications of the alimentary tract are rare congenital anomalies. The ileum is the most common site, whereas rectal, duodenal, gastric and cecal duplications are extremely rare. Duplication cysts of the cecum, in a neonate, are even rarer, with only 19 cases reported in medical literature to date. We report a case of intestinal intussusception due to a cecal duplication cyst.

  2. [Intestinal intussusception due to ileal gastrointestinal stromal tumor--a case report].

    Science.gov (United States)

    Andrei, S; Andrei, A; Tonea, A; Andronesi, D; Preda, C; Herlea, V; Popescu, I

    2011-01-01

    Intestinal occlusion due to intussusception produced by intestinal tumors is a very rare condition. Gastrointestinal stromal tumors are also rare digestive neopasias, with an impredictable malignant behavior, which are usually growing outside the intestinal wall, being rarely the initiators of an intestinal intussusception. We present the case of a 59 years old female, admitted in our hospital to elucidate the etiology of her iron deficient anaemia, which developed an intestinal occlusion at the intestinal preparation for colonoscopy. The abdominal CT scan performed in emergency conditions highlighted occlusive intestinal tumor complicated with intestinal intussusception. We performed an emergency laparotomy that revealed intestinal occlusion due to ileo-ileal intussusception produced by an ileal tumor. The surgical intervention consisted in segmental ileal enterectomy including the tumor with latero-lateral entero-enteral anastomosis. The patient recovered without complications. The histopathological and immunohisto-chemical examinations established the diagnose of gastro-intestinal stromal tumor with high risk malignant behavior, therefore the patient was guided in the oncological department for specific treatment and oncological surveillance.

  3. Sarcomatoid Carcinoma of the lung: A rare case of three small intestinal intussusceptions and literature review

    Directory of Open Access Journals (Sweden)

    Angela Romano

    2015-01-01

    Conclusion: There are rare reports of small intestinal intussusceptions caused by metastatic lung carcinosarcoma, this presentation shows the third case in literature. Physicians should be more alert to symptoms or signs indicating GI metastais in patients with a history of lung cancer.

  4. Ultrasound-guided hydrostatic reduction of intussusception with saline: Safe and effective.

    Science.gov (United States)

    Karadağ, Çetin Ali; Abbasoğlu, Latif; Sever, Nihat; Kalyoncu, Meltem Kaba; Yıldız, Abdullah; Akın, Melih; Candan, Mustafa; Dokucu, Ali İhsan

    2015-09-01

    The study was undertaken to assess the efficacy of ultrasound-guided saline enema in reducing intussusception and to determine the role of age and duration of symptoms on this event. The case records of patients who were treated for intussusception at our institutions over the past 10 years were retrospectively analyzed. A total of 419 patients were treated for intussusception and 375 of them were included into the study. Patients were excluded if they had symptoms and signs of acute abdominal disease and required surgery as an initial treatment. Hydrostatic reduction was successful in 313 of the 375 patients (83.46%). The procedure-related complication rate was nil. There were 29 episodes of recurrences in 23 patients, and recurrence rates did not differ between patients who responded to hydrostatic reduction and those who required surgery. Younger age [median (range); 11 months (3-108 months) vs. 20 months (1-180 months); phydrostatic reduction. Ultrasound-guided hydrostatic reduction is an easy, safe and effective method for the treatment of intussusception in the absence of acute abdominal findings. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Laparoscopy-assisted hydrostatic in situ reduction of intussusception: A reasonable alternative?

    Directory of Open Access Journals (Sweden)

    V. V. S. S. Chandrasekharam

    2011-01-01

    Full Text Available Aim: To evaluate an alternative way of reducing intussusceptions under laparoscopic guidance. Materials and Methods: This is a retrospective observational study of children who underwent laparoscopy-assisted hydrostatic in situ reduction of intussusceptions (LAHIRI. Under general anesthesia with laparoscopic vision, warm saline was infused into the rectum with a 16-18 F Foley catheter and a drip set till the intussusception was reduced. Results: Eleven patients [age 7.8 (±2.8 months] were operated over a period of 1 year. Ten (90.9% patients had ileocolic intussusception, which got completely reduced, but one (9% had ileo-ileocolic intusussception, in whom manual reduction by extending the subumbilical incision was required to reduce the ileoileal part. The mean duration of surgery was 38.5 (±6.6 min. No patient had bowel ischemia and there were no intra- or postoperative complications. Conclusions: LAHIRI appears to be an effective and safe technique in children. Specific advantages are that it is performed in a controlled environment in the operating room, avoids patient apprehension and discomfort, avoids bowel handling, provides a safe opportunity to create higher intraluminal pressure, ensures visual assessment of bowel vascularity and completeness of reduction.

  6. Ileocolic intussusception due to a cecal endometriosis: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Emmanuel Rivkine

    2012-06-01

    Full Text Available Abstract Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. We report a case of a woman who presented an ileocecal intussusception due to a cecal endometriosis. The patient gave two months history of chronic periombilical pain requiring regular hospital admission and analgesia. The symptoms were not related to menses. A laparotomy was performed and revealed an ileocolic intussusception. The abdominal exploration did not find any endometriosis lesion. Ileocaecal resection was performed. Microscopic examination showed a cystic component, lined by a regular cylindric epithelium. Foci of endometrial tissu were oberved in the cecal subserosa and muscularis mucosal, with irregular endometrial glands lined by cylindric epithelium without atypia immunostained with CK7, and characteristic endometrial stroma immunostained with CD10. Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. Diagnose of etiology remains challenging due to the absence of clinical and radiological specific characteristics. Virtual slide The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2975867306869166

  7. A randomized trial of pneumatic reduction versus hydrostatic reduction for intussusception in pediatric patients.

    Science.gov (United States)

    Xie, Xiaolong; Wu, Yang; Wang, Qi; Zhao, Yiyang; Chen, Guobin; Xiang, Bo

    2017-08-08

    Data of randomly controlled trials comparing the hydrostatic and pneumatic reduction for intussusception in pediatric patients as initial therapy are lacking. The aim of this study was to conduct a randomly controlled trial to compare the effectiveness and safety of the hydrostatic and pneumatic reduction techniques. All intussusception patients who visited West China Hospital of Sichuan University from January 2014 to December 2015 were enrolled in this study in which they underwent pneumatic reduction or hydrostatic reduction. Patients were randomized into ultrasound-guided hydrostatic or X-ray-guided pneumatic reduction group. The data collected includes demographic data, symptoms, signs, and investigations. The primary outcome of the study was the success rate of reduction. And the secondary outcomes of the study were the rates of intestinal perforations and recurrence. A total of 124 children with intussusception who had met the inclusion criteria were enrolled. The overall success rate of this study was 90.32%. Univariable analysis showed that the success rate of hydrostatic reduction with normal saline (96.77%) was significantly higher than that of pneumatic reduction with air (83.87%) (p=0.015). Perforation after reduction was found in only one of the pneumatic reduction group. The recurrence rate of intussusception in the hydrostatic reduction group was 4.84% compared with 3.23% of pneumatic reduction group. Our study found that ultrasound-guided hydrostatic reduction is a simple, safe and effective nonoperative treatment for pediatric patients suffering from intussusceptions, and should be firstly adopted in the treatment of qualified patients. Therapeutic study TYPE OF STUDY: Prospective study. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Theoretical investigation of compounds with triple bonds

    International Nuclear Information System (INIS)

    Devarajan, Deepa

    2011-01-01

    In this thesis, compounds with potential triple-bonding character involving the heavier main-group elements, Group 4 transition metals, and the actinides uranium and thorium were studied by using molecular quantum mechanics. The triple bonds are described in terms of the individual orbital contributions (σ, π parallel , and π perpendicular to ), involving electron-sharing covalent or donor-acceptor interactions between the orbitals of two atoms or fragments. Energy decomposition, natural bond orbital, and atoms in molecules analyses were used for the bonding analysis of the triple bonds. The results of this thesis suggest that the triple-bonding character between the heavier elements of the periodic table is important and worth further study and exploration.

  9. Metastatic osteosarcoma to the small bowel with resultant intussusception: a case report and review of the literature

    International Nuclear Information System (INIS)

    Wootton-Gorges, Sandra L.; Stein-Wexler, Rebecca; West, Danel C.

    2003-01-01

    Intussusception resulting from osteosarcoma metastasis to the small bowel is a rare diagnosis. This case report describes a patient with this diagnosis, demonstrates the CT appearance of this lesion, and reviews the literature. (orig.)

  10. Intussusception in children: imaging evaluation and therapeutic approach; Intussuscepcao em criancas: avaliacao por metodos de imagem e abordagem terapeutica

    Energy Technology Data Exchange (ETDEWEB)

    Cunha, Fabio Motta da; Figueiredo, Sizenildo da Silva; Nobrega, Bruno Barcelos da; Monteiro, Soraya Silveira; Lederman, Henrique Manoel [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: brunoradiol@hotmail.com; Oliveira, Galba Leite [Irmandade Santa Casa de Misericordia de Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem

    2005-05-15

    Intussusception is a medical emergency that occur with higher frequency in children under 2 years of age. Diagnosis can be difficult as the classical triad of abdominal pain, jelly stools and palpable abdominal mass is seen in less than 50% of the patients. However, the diagnosis of intussusception can be established with variable degree of accuracy using plain abdominal x-ray films, ultrasound, computed tomography or barium (or air/saline) enema. Some of these imaging methods are also useful during treatment of this condition. The authors present a review of the literature and a pictorial essay of the imaging findings in patients with intussusception. In addition, a discussion on the current and controversial issues related to the treatment of intussusception is presented. (author)

  11. Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

    OpenAIRE

    Krasniqi, Avdyl S; Hamza, Astrit R; Salihu, Lulzim M; Spahija, Gazmend S; Bicaj, Besnik X; Krasniqi, Selvete A; Kurshumliu, Fisnik I; Gashi-Luci, Lumturije H

    2011-01-01

    Abstract Introduction The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception. Case presentation A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdom...

  12. Wakeless triple soliton accelerator

    International Nuclear Information System (INIS)

    Mima, K.; Ohsuga, T.; Takabe, H.; Nishihara, K.; Tajima, T.; Zaidman, E.; Horton, W.

    1986-09-01

    We introduce and analyze the concept of a wakeless triple soliton accelerator in a plasma fiber. Under appropriate conditions the triple soliton with two electromagnetic and one electrostatic waves in the beat-wave resonance propagates with velocity c leaving no plasma wake behind, while the phase velocity of the electrostatic wave is made also c in the fiber

  13. Giant ileal inflammatory fibroid polyp: a rare cause of intestinal intussusception

    Directory of Open Access Journals (Sweden)

    Daniel Cury Ogata

    2012-09-01

    Full Text Available Ileal inflammatory fibroid polyp is a rare non-neoplastic lesion of the gastrointestinal tract. Intussusception caused by an inflammatory fibroid polyps is uncommon. The authors report a case of a 75 year-old female patient presenting with ileal obstruction due to intussusception of a polypoid lesion. The patient underwent surgical treatment and histopathology confirmed the diagnosis.Os pólipos fibroides inflamatórios são raras lesões não neoplásicas do trato gastrointestinal e a intussuscepção devido a essa entidade é incomum. Os autores relatam um caso de paciente do sexo feminino, 75 anos, que apresentou obstrução ileal devido a uma intussuscepção por lesão polipoide. A paciente foi submetida a tratamento cirúrgico, sendo diagnosticado pólipo fibroide inflamatório do íleo.

  14. A rare case of primary lymphoma of the caecum presenting as intussusception

    Directory of Open Access Journals (Sweden)

    Leena Jayabackthan

    2013-01-01

    Full Text Available Mucosa associated lymphoid tissue (MALT lymphomas are rare neoplasms. They are most common in the stomach followed by small intestine and colon. The symptoms are nonspecific and generally do not present with intussusception. Here we report a rare clinical entity in which a 35-year-old female presented to the emergency with severe abdominal pain which was sudden in onset. History revealed that she had been having vague mild abdominal pain for 2 years. Ultrasonography showed ileocolic intussusception with hypoechoic lesion of 54 × 46 mm seen at the lead point. Emergency laparotomy with the right hemi-colectomy was done. The specimen was sent for histopathological examination which revealed a diagnosis of MALT lymphoma. Awareness of the varied clinical presentation helps in formulating the appropriate therapeutic strategy.

  15. Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia.

    OpenAIRE

    Bines, JE; Liem, NT; Justice, F; Son, TN; Carlin, JB; de Campo, M; Jamsen, K; Mulholland, K; Barnett, P; Barnes, GL

    2006-01-01

    OBJECTIVE: To test the sensitivity and specificity of a clinical case definition of acute intussusception in infants to assist health-care workers in settings where diagnostic facilities are not available. METHODS: Prospective studies were conducted at a major paediatric hospital in Viet Nam (the National Hospital of Pediatrics, Hanoi) from November 2002 to December 2003 and in Australia (the Royal Children's Hospital, Melbourne) from March 2002 to March 2004 using a clinical case definition ...

  16. Metastatic melanoma causing double small intestinal intussusception: diagnosis by computed tomography

    International Nuclear Information System (INIS)

    Bortolucci, G.; Garcia, M.; Dalcim, L.; Dias, I.; Teshirogi, E.

    2011-01-01

    Full text: Introduction: Metastases from malignant melanoma to the gastrointestinal tract are uncommon. Often found in jejunum and ileum, they are responsible for up to 7% of complications pre mortem. These metastases manifest with bleeding, perforation, obstruction or intussusception and require immediate surgery. Intussusception is a rare finding in the report described and is presented in a double into distinct segments. History and Physical Examination: M.H.C.S, female, 50 years, presenting 3 cm ulcerated lesion in the calcaneous region of the right foot with two years of evolution, no signs of infection or neoplastic permeation shores. Surgical excision of the lesion was performed and histopathologic analysis showed non-classifiable malignant melanoma. Submitted material to immunohistochemistry showed that markers of antigens Melan A and HMB45 positive, favoring the diagnosis of malignant melanoma. Tumor resection with expanding margins and selective inguinal lymphadenectomy through the technique of sentinel node, with rates equal to V Clark and Breslow thickness of 1.3 cm. Patient presented with acute abdominal obstruction treated surgically. Despite an uneventful post-operative, brain metastases developed, and patient is currently undergoing chemotherapy. Complementary Exams: Contrasted abdominal CT showing distension of the small bowel and an image suggestive of double intussusception. Treatment and Results: Indicated that laparotomy confirmed the presence of double intussusception in small intestine, the first being 110 cm from the angle of Treitz with a palpable tumor mass and dilatation of the upstream and the second character equal to 220 cm of the same, treated with bowel resection followed by end anastomosis. The diagnosis of malignant melanoma was confirmed by immunohistochemical analysis of surgical specimens. Discussion/Conclusion: Metastatic lesions in the gastrointestinal tract are often asymptomatic or nonspecific. The diagnosis should be

  17. Idiopathic megaoesophagus and intermittent gastro-oesophageal intussusception in a cat.

    Science.gov (United States)

    van Geffen, C; Saunders, J H; Vandevelde, B; Van Ham, L; Hoybergs, Y; Daminet, S

    2006-08-01

    An eight-month-old domestic shorthair cat was presented with chronic vomiting for three months, with an acute increase in frequency during the past two days. A diagnosis of megaoesophagus was made by chest radiography. Diagnostic work-up for megaoesophagus was performed. A gastro-oesophageal intussusception was identified during endoscopy. Medical and nutritional therapy was instituted with a good response to the treatment.

  18. Intussusceptions as acute abdomen caused by Burkitt lymphoma: a case report

    OpenAIRE

    Hoxha, Faton T; Hashani, Shemsedin I; Krasniqi, Avdyl S; Kurshumliu, Fisnik I; Komoni, Driton S; Hasimja, Shpresa M; Maxhuni, Mehmet

    2009-01-01

    Introduction Burkitt's lymphoma is a highly malignant, aggressive and rapidly growing B-cell neoplasm, which has low long-term survival rates. The abdomen is the most frequent onset site of non endemic Burkitt's lymphoma. Symptoms are often misleading and make diagnosis difficult. Ileum intussusception as acute abdomen caused by Burkitt lymphoma is rare. Case presentation We are presenting a case of a 16 year-old male with acute abdomen, which three weeks prior initially has been surgically t...

  19. Simultaneous occurrence of intussusception and duodenal haematoma in a patient with Glanzmann's thrombasthenia

    Directory of Open Access Journals (Sweden)

    Iftikhar Ahmad Jan

    2016-01-01

    Full Text Available Glanzmann's thrombasthenia (GT is a rare autosomal recessive disorder in which the platelets have anomalies of fibrinogen receptors causing bleeding tendencies. The disease usually presents with mucosal bleeding, petechial haemorrhages or gastrointestinal (GI bleeding. Only sporadic cases of intussusception or duodenal haematoma have been reported with GT. We present a case of 5-year-old girl admitted with non-bilious vomiting, watery diarrhoea and abdominal pain. She is a known patient of Glanzmann's thrombasthenia.

  20. Enema reduction of intussusception: the success rate of hydrostatic and pneumatic reduction.

    Science.gov (United States)

    Khorana, Jiraporn; Singhavejsakul, Jesda; Ukarapol, Nuthapong; Laohapensang, Mongkol; Wakhanrittee, Junsujee; Patumanond, Jayanton

    2015-01-01

    Intussusception is a common surgical emergency in infants and children. The incidence of intussusception is from one to four per 2,000 infants and children. If there is no peritonitis, perforation sign on abdominal radiographic studies, and nonresponsive shock, nonoperative reduction by pneumatic or hydrostatic enema can be performed. The purpose of this study was to compare the success rates of both the methods. Two institutional retrospective cohort studies were performed. All intussusception patients (ICD-10 code K56.1) who had visited Chiang Mai University Hospital and Siriraj Hospital from January 2006 to December 2012 were included in the study. The data were obtained by chart reviews and electronic databases, which included demographic data, symptoms, signs, and investigations. The patients were grouped according to the method of reduction followed into pneumatic reduction and hydrostatic reduction groups with the outcome being the success of the reduction technique. One hundred and seventy episodes of intussusception occurring in the patients of Chiang Mai University Hospital and Siriraj Hospital were included in this study. The success rate of pneumatic reduction was 61% and that of hydrostatic reduction was 44% (P=0.036). Multivariable analysis and adjusting of the factors by propensity scores were performed; the success rate of pneumatic reduction was 1.48 times more than that of hydrostatic reduction (P=0.036, 95% confidence interval [CI] =1.03-2.13). Both pneumatic and hydrostatic reduction can be performed safely according to the experience of the radiologist or pediatric surgeon and hospital setting. This study showed that pneumatic reduction had a higher success rate than hydrostatic reduction.

  1. Intussusception reduction: Effect of air vs. liquid enema on radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan, Summer L.; Edgar, J.C.; Anupindi, Sudha A.; Zhu, Xiaowei [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (United States); Magill, Dennise; Felice, Marc A. [University of Pennsylvania, Environmental Health and Radiation Safety, Philadelphia, PA (United States)

    2017-10-15

    Both air and radiopaque liquid contrast are used to reduce ileocolic intussusception under fluoroscopy. Some suggest air lowers radiation dose due to shorter procedure times. However, air enema likely lowers radiation dose regardless of fluoroscopy time due to less density over the automatic exposure control cells. We test the hypothesis that air enema reduction of ileocolic intussusception results in lower radiation dose than liquid contrast enema independent of fluoroscopy time. We describe a role for automatic exposure control in this dose difference. We retrospectively evaluated air and liquid intussusception reductions performed on a single digital fluoroscopic unit during a 26-month period. We compared patient age, weight, gender, exam time of day and year, performing radiologist(s), radiographic image acquisitions, grid and magnification use, fluoroscopy time and dose area product. We compared categorical and continuous variables statistically using chi-square and Mann-Whitney U tests, respectively. The mean dose area product was 2.7-fold lower for air enema, 1.3 ± 0.9 dGy.cm{sup 2}, than for liquid, 3.5 ± 2.5 dGy.cm{sup 2} (P<0.005). The mean fluoroscopy time was similar between techniques. The mean dose area product/min was 2.3-fold lower for air, 0.6 ± 0.2 dGy.cm{sup 2}/min, than for liquid, 1.4 ± 0.5 dGy.cm{sup 2}/min (P<0.001). No group differences were identified in other measured dose parameters. Fluoroscopic intussusception reduction using air enema uses less than half the radiation dose of liquid contrast enema. Dose savings are independent of fluoroscopy time and are likely due to automatic exposure control interaction. (orig.)

  2. Gastrointestinal torsions and intussusception in northern koalas (Phascolarctos cinereus) at San Diego Zoo (1976-2012).

    Science.gov (United States)

    Joyce-Zuniga, Nicole M; Roesler, Jennifer; Andrus, Chris Hamlin; Sutherland-Smith, Meg; Rideout, Bruce A; Pye, Geoffrey W

    2014-03-01

    The recent classification as threatened status of the northern koala (Phascolarctos cinereus) by the Australian Government highlights the importance of the conservation and health management of this iconic Australian marsupial. This case series describes gastrointestinal torsion and intussusception in six northern koalas (three males, three females, 2-11 yr old) at the San Diego Zoo from 1976 to 2012. Two koalas died shortly after presentation. Diagnoses of ileocecal intussusception, resulting from enteritis in one case and cecal torsion in the other, were made at postmortem examination. One koala died 4 days after an exploratory laparotomy, with negative findings, and an acute double colonic intussusception was diagnosed at postmortem examination. Two small intestinal mesenteric torsion and one proximal colon mesenteric torsion cases were successfully corrected surgically. In the case of colonic mesenteric torsion, the koala had recurrent clinical signs 2 wk later, and a second surgery requiring resection and anastomosis of ischemic jejunum was performed, with the koala dying shortly afterward. One koala with small intestinal torsion had a recurrence of torsion 22 mo later and subsequently died. The koala with the second case of small intestinal torsion remains alive 14 mo postsurgical correction. All six koalas presented with signs of colic that included anorexia, lethargy, depression, acute abdominal distension, abdominal stretching, decreased fecal output, open-mouth gasping, or a combination of symptoms. Abdominal radiographs may show stacked gastrointestinal linear gas patterns and contrast stasis. Prevalence of torsion and intussusception is low at this institution (2%), although recurrence in individuals is common (50%) and overall survival is poor (83%), which emphasizes the importance of timely recognition, surgical correction, and postoperative management. While inciting etiologies were unable to be determined in these cases, monitoring generalized

  3. Rectal intussusception and unexplained faecal incontinence: findings of a proctographic study.

    Science.gov (United States)

    Collinson, R; Cunningham, C; D'Costa, H; Lindsey, I

    2009-01-01

    The aetiology of faecal incontinence is multifactorial, yet there remains an approach to assessment and treatment that focusses on the sphincter. Rectal intussusception (RI) is underdiagnosed and manifests primarily as obstructed defecation. Yet greater than 50% of these patients admit to faecal incontinence on closer questioning. We aimed to evaluate the incidence of RI at evacuation proctography selectively undertaken in the evaluation of patients with faecal incontinence. Patients with faecal incontinence seen in a pelvic floor clinic were evaluated with anorectal physiology and ultrasound. Where the faecal incontinence was not fully explained by physiology and ultrasound, evacuation proctography was undertaken. Studies were classified as 'normal', 'low-grade RI' (recto-rectal), 'high-grade RI' (recto-anal) or 'anismus'. Forty patients underwent evacuation proctography (33 women, 83%). Median age was 63 years (range 34-77 years). Seven patients (17%) had a normal proctogram. Three (8%) had recto-rectal RI. Twenty-five (63%) demonstrated recto-anal RI. Five patients (12%) had anismus. Recto-anal intussusception is common in patients undergoing selective evacuation proctography for investigation of faecal incontinence. The role of recto-anal intussusception in the multifactorial aetiology of faecal incontinence has been largely overlooked. Evacuation proctography should be considered as part of routine work-up of patients with faecal incontinence.

  4. Acute enteritis or gastroenteritis in young dogs as a predisposing factor for intestinal intussusception: a retrospective study.

    Science.gov (United States)

    Rallis, T S; Papazoglou, L G; Adamama-Moraitou, K K; Prassinos, N N

    2000-10-01

    Various types of intestinal intussusception were diagnosed in 29 of 220 young dogs with acute enteritis or gastroenteritis, due to canine parvovirus (85 cases) or presumably to other infectious agents, inflammation or less common hypermotility and metabolic derangements (135 cases). As the other causes of the disease were excluded, acute enteritis or gastroenteritis was considered to be the most likely predisposing factor for the intestinal intussusception. The most common type of intussusception was found to be the ileocolic. Of the 21 dogs that underwent surgical resection and anastomosis of the intestine, 18 dogs recovered completely and three died due to complications. The high survival rate was due to the effective pre-operative, surgical and post-operative therapy.

  5. Incidentally detected small intestine intussusception caused by primary small intenstine carcinoma on {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jong; Oh, So Won; Kim, Yu Kyeong [Dept. of Nuclear MedicineSeoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul (Korea, Republic of)

    2017-09-15

    Small intestine intussusception in adults is a rare condition mainly caused by primary or metastatic small intestine malignancy. Here, we present a 72-year-old male patient who was diagnosed with small intestine cancer that was presented as small intestine intussusception on hybrid {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). The patient was initially referred for an abnormality on a chest radiography and severe anemia. FDG PET/CT showed the lung lesion in the right upper lobe of lung as a high FDG uptake mass. Accidentally, FDG PET demonstrated another intense hypermetabolic intraluminal lesion in the small intestine accompanied with intussusception shown as a circumferential hypermetabolic wall. By pathologic examination, the patient was diagnosed as primary small intestine cancer with lung metastasis. This case highlights usefulness of hybrid FDG PET/CT to identify unexpected malignancy.

  6. Discovering Steiner Triple Systems through Problem Solving

    Science.gov (United States)

    Sriraman, Bharath

    2004-01-01

    An attempt to implement problem solving as a teacher of ninth grade algebra is described. The problems selected were not general ones, they involved combinations and represented various situations and were more complex which lead to the discovery of Steiner triple systems.

  7. Almost convergence of triple sequences

    OpenAIRE

    Ayhan Esi; M.Necdet Catalbas

    2013-01-01

    In this paper we introduce and study the concepts of almost convergence and almost Cauchy for triple sequences. Weshow that the set of almost convergent triple sequences of 0's and 1's is of the first category and also almost everytriple sequence of 0's and 1's is not almost convergent.Keywords: almost convergence, P-convergent, triple sequence.

  8. Retrospective hospital based surveillance of intussusception in children in a sentinel paediatric hospital: benefits and pitfalls for use in post-marketing surveillance of rotavirus vaccines.

    Science.gov (United States)

    Lloyd-Johnsen, C; Justice, F; Donath, S; Bines, J E

    2012-04-27

    Evaluation of the safety of rotavirus vaccines, particularly with respect to the risk of intussusception, is recommended for countries planning to introduce rotavirus vaccines into the National Immunisation Program. However, as prospective studies are costly, require time to conduct and may be difficult to perform in some settings, retrospective hospital based surveillance at sentinel sites has been suggested as an option for surveillance for intussusception following introduction of rotavirus vaccines. To assess the value of retrospective hospital based surveillance to describe clinical and epidemiological features of intussusception in children aged <24 months and to investigate any temporal association between receipt of a rotavirus vaccine and intussusception. A retrospective chart review of all patients diagnosed with intussusception at Royal Children's Hospital, Melbourne, Australia over an 8-year period including before and after rotavirus vaccine introduction into the National Immunisation Program, was conducted using patients identified by a medical record database (ICD-10-CM 56.1). Patient profile, clinical presentation, treatment and outcome were analysed along with records of immunisation status obtained using the Australian Childhood Immunisation Register. A 9% misclassification rate of discharge diagnosis of intussusception was identified on critical chart review. The incidence rate of intussusception at the Royal Children's Hospital over the study period was 1.91 per 10,000 infants <24 months (95% CI 1.65-2.20). Intestinal resection was required in 6.5% of infants (95% CI 3.6%, 11.0%). Intussusception occurred within 30 days after vaccination in 2 of 27 patients who had received at least 1 dose of a rotavirus vaccine. Valuable data on the incidence, clinical presentation and treatment outcomes of intussusception can be obtained from data retrieved from hospital medical records in a sentinel paediatric hospital using standardised methodology. However

  9. Ultrasound guided reduction of an ileocolic intussusception by a hydrostatic method by using normal saline enema in paediatric patients: a study of 30 cases.

    Science.gov (United States)

    Digant, Shastri Mona; Rucha, Seth; Eke, Dessai

    2012-12-01

    The conventional hydrostatic reduction of an intussusception with barium enema or the pneumatic reduction of an intussusception is associated with considerable ionizing radiations and a risk of perforation; while the hydrostatic reduction of an intussusception under ultrasound guidance is a very safe method because the whole procedure is visualized with real time ultrasound. Also, being a non-invasive method with a high success rate, this procedure has emerged as a useful alternative to a surgical intervention. The aim of this study was to evaluate the role of ultrasound and colour Doppler studies for the guidance of the hydrostatic reduction of a childhood intussusception by using normal saline. Among 41 children who were evaluated with ultrasonography for the confirmation of the presence of intussusceptions, hydrostatic reduction of intussusception were performed under a sonographic guidance in 30 patients, whereas 11 patients were excluded due to clinical contraindications. This disease was observed mostly at the ages of 6 months to 24 months. In 80% of the patients, there was a recent history of gastroenteritis and 40 % had a history of common cold. The most common site of the intussusception was the transverse colon near the hepatic flexor of the colon (90%), with a mean duration of 22.1±17.3 hours. The overall rate of a successful reduction was 87% and the mean reduction time was 14 minutes. None of the cases showed recurrence within 24 hrs. No complications were observed. We conclude that ultrasound with colour Doppler study is very useful for the diagnosis of intussusceptions, as well as for guided hydrostatic reductions by using normal saline enema. This is an optimal, simple, and a safe procedure for the treatment of intussusceptions in paediatric patients.

  10. A Rare Case of Intussusception Associated with Metastasize Small Cell Carcinoma of Lung

    Directory of Open Access Journals (Sweden)

    Razrim Rahim

    2012-11-01

    Full Text Available Intussusception is common cause of bowel obstruction in the paediatric age group compared to the elderly population. Many times, The diagnosis may be difficult because of asymptomatic nature of thisbowel disorder. We hereby describe the case of a 75-year-old male who presented with lethargy, weakness,loss of movement in the joints and was found to be anemic. The haemoglobin level was low so he wastransfused with packed cells. On gastrointestinal (GI endoscopy, upper GI bleed was observed. A mass was observed beyond ampulla at the 2nd and 3rd part of the duodenal junction. Computerized tomography (CTscan also showed a mass at the head of pancreas and the lesion at the left lung. In view of persistent bleed,‘Whipple’s procedure’ was performed. Histopathological examination showed small cell carcinoma of the lungs with metastasis to the pancreas and the jejunum. We here discuss the case of intussusception with intestinal metastasis which presented with gastrointestinal bleeding.

  11. Midgut pain due to an intussuscepting terminal ileal lipoma: a case report.

    LENUS (Irish Health Repository)

    Abbasakoor, Noormuhammad O

    2010-01-01

    ABSTRACT: INTRODUCTION: The occurrence of intussusception in adults is rare. The condition is found in 1 in 1300 abdominal operations and 1 in 100 patients operated for intestinal obstruction. The child to adult ratio is 20:1. CASE PRESENTATION: A 52-year-old Irish Caucasian woman was investigated for a 3-month history of intermittent episodes of colicky midgut pain and associated constipation. Ileocolonoscopy revealed a pedunculated lesion in the terminal ileum prolapsing into the caecum. Computed tomography confirmed a smooth-walled, nonobstructing, low density intramural lesion in the terminal ileum with secondary intussusception. A laparoscopic small bowel resection was performed. Histology revealed a large pedunculated polypoidal mass measuring 4 x 2.5 x 2 cm consistent with a submucosal lipoma. She had complete resolution of her symptoms and remained well at 12-month follow-up. CONCLUSION: This case highlights an unusual cause of incomplete small bowel obstruction successfully treated through interdisciplinary cooperation. Ileal lipomas are not typically amenable to endoscopic removal and require resection. This can be successfully achieved via a laparoscopic approach with early restoration of premorbid functioning.

  12. Improving Quality and Efficiency for Intussusception Management After Successful Enema Reduction.

    Science.gov (United States)

    Raval, Mehul V; Minneci, Peter C; Deans, Katherine J; Kurtovic, Kelli J; Dietrich, Ann; Bates, D Gregory; Rangel, Shawn J; Moss, R Lawrence; Kenney, Brian D

    2015-11-01

    The purpose of this project was to implement a protocol facilitating discharge from the emergency department (ED) after successful radiologic ileocolic intussusception reduction in a pediatric referral center. A multidisciplinary team identified drivers for successful quality improvement including educational brochures, a standardized radiologic report, an observation period in the ER with oral hydration challenges, and follow-up phone calls the day after discharge. Patient outcomes were tracked, and quarterly feedback was provided. Of 80 patients identified over a 24-month period, 34 (42.5%) did not qualify for discharge home due to need for surgical intervention (n = 9), specific radiologic findings (n = 11), need for additional intravenous hydration (n = 4), or other reasons (n = 7). Of 46 patients who qualified for discharge, 30 (65.2%) were successfully sent home from the ED. One patient returned with recurrent symptoms that required repeat enema reduction. Sixteen patients were observed and discharged within 23 hours. Adherence with discharge from the ED improved over time. Discharge from the ED was associated with cost savings and improved net margins at the hospital level for each encounter. A sustainable multidisciplinary quality improvement project to discharge intussusception patients from the ED after air-contrast enema reduction was successfully integrated in a high-volume referral center through education, standardized radiologic reporting, and protocoled follow-up. Copyright © 2015 by the American Academy of Pediatrics.

  13. Ileo-ceco-rectal Intussusception Requiring Intestinal Resection and Anastomosis in a Tawny Eagle (Aquila rapax).

    Science.gov (United States)

    Sabater, Mikel; Huynh, Minh; Forbes, Neil

    2015-03-01

    A 23-year-old male tawny eagle (Aquila rapax) was examined because of sudden onset of lethargy, regurgitation, and hematochezia. An intestinal obstruction was suspected based on radiographic findings, and an ileo-ceco-rectal intussusception was confirmed by coelioscopy. A 14.3-cm section of intestine was resected before an intestinal anastomosis was done. Coelomic endoscopic examination confirmed a postsurgical complication of adhesions between the intestinal anastomosis and the dorsal coelomic wall, resulting in a partial luminal stricture and requiring surgical removal of the adhesions. Rectoscopy was useful in diagnosing a mild luminal stricture related to the second surgery. Complete recovery was observed 2 months after surgery. Lack of further complications in the 2 years after surgery demonstrates good tolerance of intestinal resection and anastomosis of a large segment of bowel in an eagle. This report is the first reported case of intussusception in an eagle and emphasizes the potential use of endoscopic examination in the diagnosis as well as in the management of complications.

  14. A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Toshiaki Takahashi

    2014-01-01

    Full Text Available Colo-colonic intussusception (CI due to a colonic polyp is a rarely reported cause of intestinal obstruction in school-aged children. Hydrostatic reduction (HR and endoscopic polypectomy are minimally invasive and technically feasible for treating CI. We report a case of CI and review the literature, focusing on the diagnosis and treatment.

  15. Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

    Directory of Open Access Journals (Sweden)

    Bicaj Besnik X

    2011-09-01

    Full Text Available Abstract Introduction The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception. Case presentation A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdominal computed tomography scan revealed an intraluminal obstruction of his ascending colon. Plain abdominal X-rays showed diffuse air-fluid levels in his small intestine. A double ileoileal and ileocecocolic intussusception was found during an emergent laparotomy. A right hemicolectomy, including resection of a long segment of his ileum, was performed. The postoperative period was complicated by acute renal failure, shock liver, and pulmonary thromboembolism. Our patient was discharged from the hospital after 30 days. An anatomical pathology examination revealed a lipoma of his ileum. Conclusions Intussusception in adults requires early surgical resection regardless of the nature of the initial cause. Delayed treatment can cause very serious complications.

  16. Case of colonic intussusception secondary to mobile cecum syndrome repaired by laparoscopic cecopexy using a barbed wound suture device.

    Science.gov (United States)

    Yamamoto, Tetsu; Tajima, Yoshitsugu; Hyakudomi, Ryoji; Hirayama, Takanori; Taniura, Takahito; Ishitobi, Kazunari; Hirahara, Noriyuki

    2017-09-21

    A 27-year-old man with recurrent right lower quadrant pain was admitted to our hospital. Ultrasonography and computed tomography examination of the abdomen revealed a target sign in the ascending colon, which was compatible with the diagnosis of cecal intussusception. The intussusception was spontaneously resolved at that time, but it relapsed 6 mo later. The patient underwent a successful colonoscopic disinvagination; there was no evidence of neoplastic or inflammatory lesions in the colon and terminal ileum. The patient underwent laparoscopic surgery for recurring cecal intussusception. During laparoscopy, we observed an unfixed cecum on the posterior peritoneum (i.e. a mobile cecum). Thus, we performed laparoscopic appendectomy and cecopexy with a lateral peritoneal flap using a barbed wound suture device. The patient's post-operative course was uneventful, and he continued to do well without recurrence at 10 mo after surgery. Laparoscopic cecopexy using a barbed wound suture device is a simple and reliable procedure that can be the treatment of choice for recurrent cecal intussusception associated with a mobile cecum.

  17. Triple axis spectrometers

    International Nuclear Information System (INIS)

    Clausen, K.N.

    1997-01-01

    Conventional triple-axis neutron spectroscopy was developed by Brockhouse over thirty years ago' and remains today a versatile and powerful tool for probing the dynamics of condensed matter. The original design of the triple axis spectrometer is technically simple and probes momentum and energy space on a point-by-point basis. This ability to systematically probe the scattering function in a way which only requires a few angles to be moved under computer control and where the observed data in general can be analysed using a pencil and graph paper or a simple fitting routine, has been essential for the success of the method. These constraints were quite reasonable at the time the technique was developed. Advances in computer based data acquisition, neutron beam optics, and position sensitive area detectors have been gradually implemented on many triple axis spectrometer spectrometers, but the full potential of this has not been fully exploited yet. Further improvement in terms of efficiency (beyond point by point inspection) and increased sensitivity (use of focusing optics whenever the problem allows it) could easily be up to a factor of 10-20 over present instruments for many problems at a cost which is negligible compared to that of increasing the flux of the source. The real cost will be in complexity - finding the optimal set-up for a given scan and interpreting the data as the they are taken. On-line transformation of the data for an appropriate display in Q, ω space and analysis tools will be equally important for this task, and the success of these new ideas will crucially depend on how well we solve these problems. (author)

  18. Resolution of a triple axis spectrometer

    DEFF Research Database (Denmark)

    Nielsen, Mourits; Bjerrum Møller, Hans

    1969-01-01

    A new method for obtaining the resolution function for a triple-axis neutron spectrometer is described, involving a combination of direct measurement and analytical calculation. All factors which contribute to the finite resolution of the instrument may be taken into account, and Gaussian...... or experimentally determined probability distributions may be used. The application to the study of the dispersion relation for excitations in a crystal is outlined...

  19. Intussusception due to Peutz-Jeghers syndrome - a case report and review of the literature; Sindrome de Peutz-Jeghers e intussuscepcao - relato de um caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Grasso Filho, Luiz Eduardo; Albertotti, Flavio; Carvalho, Claudio Sobral de; Nersessian, Ana Carolina; Docema, Marcos F. Lima; Ogasawara, Aparecida M.; Peng Yong Sheng [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Centro de Diagnostico por Imagem; Costacurta, Marco Antonio [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Radiologia Geral; Albertotti, Cesar Jose [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Tomografia Computadorizada; Cerri, Giovanni Guido [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Ultra-Som

    2000-02-01

    The authors report a case of a 28-year-old woman with ileocecocolic intussusception due to Peutz-Jeghers syndrome, an autosomal dominant disorder characterized by hamartomatous polyposis of the gastrointestinal tract and mucocutaneous pigmentation. This condition frequently presents complications such as intestinal obstruction due to invagination or hemorrhage. In this patient, the diagnosis of intussusception was made preoperatively. The excised material revealed three large polyps which were considered to be the cause of the intussusception. (author)

  20. Jejunogastric intussusception presented with hematemesis: a case presentation and review of the literature

    Directory of Open Access Journals (Sweden)

    Papastratis George

    2001-01-01

    Full Text Available Abstract Background Jejunogastric intussusception (JGI is a rare but potentially very serious complication of gastrectomy or gastrojejunostomy. To avoid mortality early diagnosis and prompt surgical intervention is mandatory. Case presentation A young man presented with epigastric pain and bilous vomiting followed by hematemesis,10 years after vagotomy and gastrojejunostomy for a bleeding duodenal ulcer. Emergency endoscopy showed JGI and the CT scan of the abdomen was compatible with this diagnosis. At laparotomy a retrograde type II, JGI was confirmed and managed by reduction of JGI without intestinal resection. Postoperative recovery was uneventful. Conclusions JGI is a rare condition and less than 200 cases have been published since its first description in 1914. The clinical picture is almost diagnostic. Endoscopy performed by someone familiar with this rare entity is certainly diagnostic and CT-Scan of the abdomen could also help. There is no medical treatment for acute JGI and the correct treatment is surgical intervention as soon as possible.

  1. Harmonic analysis on triple spaces

    DEFF Research Database (Denmark)

    Danielsen, Thomas Hjortgaard

    In this thesis we study examples of triple spaces, both their structure theory, their invariant differential operators as well as analysis on them. The first major results provide us with some examples of triple spaces which are strongly spherical, i.e. satisfy some conditions reminiscent...

  2. Teaching Triple Science: GCSE Chemistry

    Science.gov (United States)

    Learning and Skills Network (NJ3), 2007

    2007-01-01

    The Department for Children, Schools and Families (DCSF) has contracted with the Learning and Skills Network to support awareness and take-up of Triple Science GCSEs through the Triple Science Support Programme. This publication provides an introduction to teaching and learning approaches for the extension topics within GCSE Chemistry. It…

  3. Intussusception - children

    Science.gov (United States)

    ... K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Abdominal Pain Read more Intestinal Obstruction Read more Toddler Health ...

  4. Bilateral triple renal arteries

    International Nuclear Information System (INIS)

    Pestemalci, Turan; Yildiz, Yusuf Zeki; Yildirim, Mehmet; Mavi, Ayfer; Gumusburun, Erdem

    2009-01-01

    Knowledge of the variations of the renal artery has grown in importance with increasing numbers of renal transplants, vascular reconstructions and various surgical and radio logic techniques being performed in recent years. We report the presence of bilateral triple renal arteries, discovered on routine dissection of a male cadaver. On the right side, one additional renal artery originated from the abdominal aorta (distributed to superior pole of the kidney) and one other originated from the right common iliac artery (distributed to lower pole of the kidney). On the left side, both additional renal arteries originated from the abdominal aorta. Our observation has been compared with variations described in the literature and their clinical importance has been emphasized. (author)

  5. On Spectral Triples in Quantum Gravity I

    DEFF Research Database (Denmark)

    Aastrup, Johannes; M. Grimstrup, Jesper; Nest, Ryszard

    2009-01-01

    This paper establishes a link between Noncommutative Geometry and canonical quantum gravity. A semi-finite spectral triple over a space of connections is presented. The triple involves an algebra of holonomy loops and a Dirac type operator which resembles a global functional derivation operator....... The interaction between the Dirac operator and the algebra reproduces the Poisson structure of General Relativity. Moreover, the associated Hilbert space corresponds, up to a discrete symmetry group, to the Hilbert space of diffeomorphism invariant states known from Loop Quantum Gravity. Correspondingly......, the square of the Dirac operator has, in terms of canonical quantum gravity, the form of a global area-squared operator. Furthermore, the spectral action resembles a partition function of Quantum Gravity. The construction is background independent and is based on an inductive system of triangulations...

  6. The risk of intussusception following monovalent rotavirus vaccination in England: A self-controlled case-series evaluation.

    Science.gov (United States)

    Stowe, Julia; Andrews, Nick; Ladhani, Shamez; Miller, Elizabeth

    2016-07-12

    To investigate the risk of intussusception after monovalent rotavirus vaccine (RV1) given to infants aged 2 and 3 months in England. Hospital Episode Statistics (HES) were used to identify infants aged 48-183 days admitted between 11/03/2013 and 31/10/2014 with intussusception. Diagnosis was confirmed from medical records and HES procedure codes. Vaccination status was obtained from general practitioners. The risk of admission within 1-7 and 8-21 days of vaccination was analysed using the self-controlled case-series (SCCS) method with age effect adjustment by including historical data before RVI introduction in July 2013. A total of 119 cases were identified during the study period and intussusception confirmed in 95 of whom 39 were vaccinated 1-21 days before onset. An increased relative incidence (RI) in this period was found, 4.53 (95% confidence interval 2.34-8.58) and 2.60 (1.43-4.81) respectively after the 1st and 2nd doses with an attributable risk of 1.91 and 1.49 per 100,000 doses respectively. The peak risk was 1-7 days after the first dose, RI 13.81 (6.44-28.32), with an estimated 93% of the 15 cases being vaccine-attributable. Mean interval between onset and admission, and clinical features were similar between vaccine-associated and background cases. Despite intussusception being a contraindication to rotavirus vaccination, 10 infants received a further dose; none had a recurrence. The RIs in a meta-analysis combing our results with Australia, Mexico, Brazil and Singapore using RV1, a 2, 4 month schedule and SCCS gave pooled RI estimates of 2.35 (1.45-3.8) and 1.77 (1.29-2.43) in the 21 day period after the 1st and 2nd doses, respectively. The earlier age at the 2nd dose in England did not affect the risk. We estimate that the RVI programme causes around 21 intussusception admissions annually in England but, since it prevents around 25,000 gastro-intestinal infection admissions, its benefit/risk profile remains strongly positive. Crown Copyright

  7. Jejunojejunal Intussusception as the Initial Presentation of Non-Hodgkin’s B-Cell Lymphoma in an Adult Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    V. Stohlner

    2013-01-01

    Full Text Available Introduction. Intussusception is a rare cause of bowel obstruction in adults and is usually associated with an underlying pathology, benign, or malignant. This is a report of a case of jejunojejunal intussusception secondary to non-Hodgkin’s B-cell lymphoma in an adult patient. Case Presentation. A 74-year-old male with no previous significant medical history presented with symptoms of acute intestinal obstruction. A CT scan of the abdomen and pelvis revealed 2 areas of jejunojejunal intussusception, which were surgically managed successfully. Histopathological examination of the specimen revealed the presence of high grade diffuse large B-cell-type non-Hodgkin’s lymphoma, and the patient was referred to the oncology team for further management. Discussion. B-cell lymphoma is a rare but well-documented cause of intussusception in adults, with most cases being at the ileocolic region. We present a rare case of jejunojejunal intussusception as the initial presentation of non-Hodgkin’s B-cell lymphoma in an adult patient.

  8. Prevalence of Germline Mutations in Genes Engaged in DNA Damage Repair by Homologous Recombination in Patients with Triple-Negative and Hereditary Non-Triple-Negative Breast Cancers.

    Directory of Open Access Journals (Sweden)

    Pawel Domagala

    Full Text Available This study sought to assess the prevalence of common germline mutations in several genes engaged in the repair of DNA double-strand break by homologous recombination in patients with triple-negative breast cancers and hereditary non-triple-negative breast cancers. Tumors deficient in this type of DNA damage repair are known to be especially sensitive to DNA cross-linking agents (e.g., platinum drugs and to poly(ADP-ribose polymerase (PARP inhibitors.Genetic testing was performed for 36 common germline mutations in genes engaged in the repair of DNA by homologous recombination, i.e., BRCA1, BRCA2, CHEK2, NBN, ATM, PALB2, BARD1, and RAD51D, in 202 consecutive patients with triple-negative breast cancers and hereditary non-triple-negative breast cancers.Thirty five (22.2% of 158 patients in the triple-negative group carried mutations in genes involved in DNA repair by homologous recombination, while 10 (22.7% of the 44 patients in the hereditary non-triple-negative group carried such mutations. Mutations in BRCA1 were most frequent in patients with triple-negative breast cancer (18.4%, and mutations in CHEK2 were most frequent in patients with hereditary non-triple-negative breast cancers (15.9%. In addition, in the triple-negative group, mutations in CHEK2, NBN, and ATM (3.8% combined were found, while mutations in BRCA1, NBN, and PALB2 (6.8% combined were identified in the hereditary non-triple-negative group.Identifying mutations in genes engaged in DNA damage repair by homologous recombination other than BRCA1/2 can substantially increase the proportion of patients with triple-negative breast cancer and hereditary non-triple-negative breast cancer who may be eligible for therapy using PARP inhibitors and platinum drugs.

  9. Retrograde gastroesophageal intussusception after peroral endoscopic myotomy in a patient with achalasia cardia: A case report.

    Science.gov (United States)

    Khan, Samiullah; Su, Shuai; Jiang, Kui; Wang, Bang-Mao

    2018-01-01

    Retrograde gastroesophageal intussusception (RGEI) is a relatively rare gastrointestinal (GI) disorder in which a portion of the stomach wall invaginates into the esophagus. More recently, peroral endoscopic myotomy (POEM) has emerged as an endoscopic alternative to surgical myotomy for achalasia, and, to the best of our knowledge, our case is the first RGEI after POEM to be reported. A 22-year-old male was presented with a history of vomiting, intractable retching and hematemesis for 3 days. He had a history of achalasia and underwent POEM 3 years ago caused by symptoms of severe dysphagia to solid and liquid. Initially, the patient was diagnosed with a blood-filled esophagus, and the mid esophagus was occluded with a ball-like mass, however, the final diagnosis of RGEI was made by thoracotomy. A therapeutic strategy of conservative treatment and left transthoracic surgery were applied. The surgery and post operative course were uneventful, and he remained asymptomatic 1 year after operation. POEM is a reliable and minimally invasive endoscopic method for esophageal achalasia. Early recognition and severity of RGEI are essential to decrease the unwanted complications. Upper GI series, esophagogastroduodenoscopy and computed tomography scan are helpful for diagnostic purposes of RGEI. Conservative treatment, endoscopic intervention, and surgery are the mainstay of treatments for RGEI. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  10. Anaesthetic Management of a patient with Myasthenia Gravis and Small Bowel Intussusception for Jejuno-Ileal Anastomoses

    Directory of Open Access Journals (Sweden)

    Pawan Kumar Jain

    2016-01-01

    Full Text Available Myasthenia gravis is a chronic autoimmune disease affecting voluntary skeletal muscles. The altered sensitivity of acetylcholine receptors to muscle relaxants and concomitant treatment with anticholinesterase in these patients affect their anaesthetic management. Patients who have undergone bowel anastomosis and are on regular anticholinesterase treatment are susceptible to anastomotic leaks. We report successful anaesthetic management of class I myasthenic patient with coexisting small bowel intussusception operated for jejuno-ileal anastomoses using regional, inhalational and intravenous (i.v anaesthesia based on train of four responses, and avoiding the use of reversal (anticholinesterase.

  11. Comparison of pressure between barium reduction and air reduction of the intussusception in children

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Hwan; Park, Sang Gyu; Park, Choong Ki; Yoon, Jong Sup [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1989-08-15

    There are many method of treatment of the intussusception in children, including surgery, barium reduction, air reduction, and saline enema under ultrasonographic monitoring. Among them, barium reduction and air reduction have been used widely as nonsurgical method of treatment in radiologic department. During barium reduction, the bottle filled with barium solution must not be elevated over a 3 feet from the operating table. In air reduction, diagnostic pressure is about 60 mmHg and pressure during reduction usually is maintained between 90 mmHg and 130 mmHg. The authors have studied about pressure difference of barium solution by changing height of the bottle filled with barium solution, and have compared with pressure in air reduction. The results are as follows; 1. Pressure of 20 w/v % barium solution at the 60 cm height is 44.4 mmHg, and 69.6 mmHg at the 90 cm height. 2. Pressure of 40 w/v % barium solution at the 60 cm height is 51.4 mmHg, and 80.1 mmHg at the 90 cm height. 3. Pressure of 40 w/v % barium solution at the 90cm height is much lower than the pressure maintained during air reduction, and this difference in pressure may be one of the causes of low reduction rate in barium reduction then air reduction. 4. The pressure gradient per 10 cm height is about 8.45 mmHg in 20 w/v % barium solution, about 9.21 mmHg in 30 w/v % barium solution, and about 9.72 mmHg 40 w/v % barium solution. 5. Intraluminal pressure difference between the barium reduction and the air reduction is probably of the major causes of rapid diagnosis and high reduction rate in the air reduction.

  12. Comparison of pressure between barium reduction and air reduction of the intussusception in children

    International Nuclear Information System (INIS)

    Lee, Kyung Hwan; Park, Sang Gyu; Park, Choong Ki; Yoon, Jong Sup

    1989-01-01

    There are many method of treatment of the intussusception in children, including surgery, barium reduction, air reduction, and saline enema under ultrasonographic monitoring. Among them, barium reduction and air reduction have been used widely as nonsurgical method of treatment in radiologic department. During barium reduction, the bottle filled with barium solution must not be elevated over a 3 feet from the operating table. In air reduction, diagnostic pressure is about 60 mmHg and pressure during reduction usually is maintained between 90 mmHg and 130 mmHg. The authors have studied about pressure difference of barium solution by changing height of the bottle filled with barium solution, and have compared with pressure in air reduction. The results are as follows; 1. Pressure of 20 w/v % barium solution at the 60 cm height is 44.4 mmHg, and 69.6 mmHg at the 90 cm height. 2. Pressure of 40 w/v % barium solution at the 60 cm height is 51.4 mmHg, and 80.1 mmHg at the 90 cm height. 3. Pressure of 40 w/v % barium solution at the 90cm height is much lower than the pressure maintained during air reduction, and this difference in pressure may be one of the causes of low reduction rate in barium reduction then air reduction. 4. The pressure gradient per 10 cm height is about 8.45 mmHg in 20 w/v % barium solution, about 9.21 mmHg in 30 w/v % barium solution, and about 9.72 mmHg 40 w/v % barium solution. 5. Intraluminal pressure difference between the barium reduction and the air reduction is probably of the major causes of rapid diagnosis and high reduction rate in the air reduction

  13. Natural triple beta-stranded fibrous folds.

    Science.gov (United States)

    Mitraki, Anna; Papanikolopoulou, Katerina; Van Raaij, Mark J

    2006-01-01

    A distinctive family of beta-structured folds has recently been described for fibrous proteins from viruses. Virus fibers are usually involved in specific host-cell recognition. They are asymmetric homotrimeric proteins consisting of an N-terminal virus-binding tail, a central shaft or stalk domain, and a C-terminal globular receptor-binding domain. Often they are entirely or nearly entirely composed of beta-structure. Apart from their biological relevance and possible gene therapy applications, their shape, stability, and rigidity suggest they may be useful as blueprints for biomechanical design. Folding and unfolding studies suggest their globular C-terminal domain may fold first, followed by a "zipping-up" of the shaft domains. The C-terminal domains appear to be important for registration because peptides corresponding to shaft domains alone aggregate into nonnative fibers and/or amyloid structures. C-terminal domains can be exchanged between different fibers and the resulting chimeric proteins are useful as a way to solve structures of unknown parts of the shaft domains. The following natural triple beta-stranded fibrous folds have been discovered by X-ray crystallography: the triple beta-spiral, triple beta-helix, and T4 short tail fiber fold. All have a central longitudinal hydrophobic core and extensive intermonomer polar and nonpolar interactions. Now that a reasonable body of structural and folding knowledge has been assembled about these fibrous proteins, the next challenge and opportunity is to start using this information in medical and industrial applications such as gene therapy and nanotechnology.

  14. Triple products of Eisenstein series

    Science.gov (United States)

    Venkatesh, Anil

    In this thesis, we construct a Massey triple product on the Deligne cohomology of the modular curve with coefficients in symmetric powers of the standard representation of the modular group. This result is obtained by constructing a Massey triple product on the extension groups in the category of admissible variations of mixed Hodge structure over the modular curve, which induces the desired construction on Deligne cohomology. The result extends Brown's construction of the cup product on Deligne cohomology to a higher cohomological product. Massey triple products on Deligne cohomology have been previously investigated by Deninger, who considered Deligne cohomology with trivial real coefficients. By working over the reals, Deninger was able to compute cohomology exclusively with differential forms. In this work, Deligne cohomology is studied over the rationals, which introduces an obstruction to applying Deninger's results. The obstruction arises from the fact that the integration map from the de Rham complex to the Eilenberg-MacLane complex of the modular group is not an algebra homomorphism. We compute the correction terms of the integration map as regularized iterated integrals of Eisenstein series, and show that these integrals arise in the cup product and Massey triple product on Deligne cohomology.

  15. Solution Patterns Predicting Pythagorean Triples

    Science.gov (United States)

    Ezenweani, Ugwunna Louis

    2013-01-01

    Pythagoras Theorem is an old mathematical treatise that has traversed the school curricula from secondary to tertiary levels. The patterns it produced are quite interesting that many researchers have tried to generate a kind of predictive approach to identifying triples. Two attempts, namely Diophantine equation and Brahmagupta trapezium presented…

  16. Intussusception as clinical presentation of primary non-Hodgkin lymphoma of the colon in a HIV-patient

    Directory of Open Access Journals (Sweden)

    Marcelo Corti

    Full Text Available Intestinal intussusception rarely occurs in the adult population and accounts only for 1% to 5% of all the causes of intestinal obstruction. This complication is more frequent in the small bowel and can be due to different aetiologies, including inflammatory, infectious or neoplastic diseases. Malignancies account for 50% to 60% of all cases of colon invagination. The gastrointestinal (GI tract is the most common site for extra-nodal non-Hodgkin lymphomas (NHL, representing 5% to 20% of all the cases. However, primary NHL of the GI tract is a very infrequent clinic-pathological entity and accounts only for 1% to 4% of all the neoplasms of the GI tract. Primary NHL of the colon is a rare disease and it comprises only 0.2% to 1.2% of all colonic malignancies. Here we describe a case of an AIDS adult patient who developed an intussusception secondary to a primary large B cell lymphoma of the transverse colon. English and Spanish literature was reviewed.

  17. Cystic colon duplication causing intussusception in a 25-year-old man: report of a case and review of the literature

    Directory of Open Access Journals (Sweden)

    Nährig Jörg

    2010-06-01

    Full Text Available Abstract Background Colonic intussusception is a rare congenital abnormality, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction with or without bleeding. In adults it may occur idiopathically or due to an intraluminal tumor mass. Case presentation A 25-year-old man presented with an acute abdomen and severe crampy abdominal pain. The clinical picture mimicked acute appendicitis. Transabdominal ultrasound examination revealed a 5 cm circular mass in the right upper abdomen. The ensuing computed tomography suggested an intussusception in the ascending colon. Intraoperatively, no full thickness invagination was detected. Due to a hard, intraluminal tumor a standard right hemicolectomy with ileotransversostomy was performed. The histopathological analysis revealed a cystic colon duplication leading to mucosal invagination and obstruction. Conclusions In adults, colon intussusception is a rare event causing approximately 1% of all acute intestinal obstructions. Unlike its preferentially nonsurgical management in children, a bowel intussusception in adults should be operated because an organic, often malignant lesion is present in most cases.

  18. The Centroid of a Lie Triple Algebra

    Directory of Open Access Journals (Sweden)

    Xiaohong Liu

    2013-01-01

    Full Text Available General results on the centroids of Lie triple algebras are developed. Centroids of the tensor product of a Lie triple algebra and a unitary commutative associative algebra are studied. Furthermore, the centroid of the tensor product of a simple Lie triple algebra and a polynomial ring is completely determined.

  19. Modal planes are spectral triples

    International Nuclear Information System (INIS)

    Gayral, Victor; Iochum, Bruno; Schuecker, Thomas; Gracia-Bondia, Jose M.; Varilly, Joseph C.

    2003-09-01

    Axioms for nonunital spectral triples, extending those introduced in the unital case by Connes, are proposed. As a guide, and for the sake of their importance in noncommutative quantum field theory, the spaces R 2N endowed with Moyal products are intensively investigated. Some physical applications, such as the construction of noncommutative Wick monomials and the computation of the Connes-Lott functional action, are given for these noncommutative hyperplanes. (author)

  20. Triple pelvic osteotomy in the treatment of hip dysplasia

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2009-01-01

    Full Text Available Introduction. Insufficient femoral head coverage is found in a variety of diseases, with acetabular dysplasia as the most frequent disorder and triple pelvic osteotomy as the most recently introduced surgical treatment. Objective. This study analyses pre- and postoperative pathoanatomic characteristics of triple in comparison to Salter and Chiari osteotomies, with a logistic regression analysis of outcome predictor and effect explanator factors in relation to the chosen type of operation. Methods. The study involved 136 adolescents treated with Salter and Chiari osteotomies or a triple pelvic osteotomy at the Institute of Orthopaedic Surgery 'Banjica' in Belgrade. The patients were between 10-20 years old at the time of operation. We collected and analyzed data from all the patients: illness history, operative parameters, preoperative and postoperative pathoanatomic data. The data was statistically processed using the statistical software SPSS, defining standard descriptive values, and by using the appropriate tests of analytic statistics: t-test for dependent and independent variables, χ2-test, Fisher's exact test, Wilcoxon's test, parameter correlation, one-way ANOVA, multi-factorial ANOVA and logistic regression, according to the type of the analyzed data and the conditions under which the statistical methods were applied. Results. The average CE angle after triple pelvic osteotomy was 43.5°, more improved than after the Salter osteotomy (33.0° and Chiari osteotomy (31.4° (F=16.822; p<0.01. Postoperative spherical congruence was also more frequent after the triple osteotomy than after the other two types of operations, and with a high significance. Preoperative painful discomfort was found to be a valid predictor of indications for the triple osteotomy over both Chiari and Salter osteotomies. The valid explanators of effect for the triple osteotomy are: postoperative joint congruence (compared to the Chiari osteotomy and increase in joint

  1. Energy Efficient Triple IG Automation EEE (Triple-E)

    Energy Technology Data Exchange (ETDEWEB)

    McGlinchy, Timothy B

    2013-02-28

    GED Integrated Solutions collaborated with US window and door manufactures to investigate, design and verify technical and cost feasibility for producing high performance, high volume, low material and labor cost window, utilizing a modified window design containing a triple insulating glass unit (IGU). This window design approach when combined with a high volume IGU manufacturing system, can produce R5 rated windows for an approximate additional consumer cost of only $4 per square foot when compared to conventional Low-E argon dual pane IG windows, resulting in a verify practical, reliable and affordable high performance window for public use.

  2. New-born born with patent vitellointestinal duct with prolapsed (intussusceptions of proximal and distal ileal loop: A case presentation

    Directory of Open Access Journals (Sweden)

    Fariha Akil Fazal

    2017-05-01

    Full Text Available Failure of obliteration of vitellointestinal duct (VID can present with a wide variety of congenital intestinal malformations. Patient can present with the anomaly itself or due to complications secondary to the anomaly like intestinal obstruction due to volvulus, intussusception or adhesions. Prolapsed ilial loops through a patent VID is a rare presentation of the above. To date only fourteen cases of this presentation have been reported in the English medical literature. We are reporting a case of the same in a new-born presenting with it from the time of birth, which to the best of our knowledge has not been reported before and therefore this the youngest reported case of its nature in the current English medical literature.

  3. Organizing product innovation: hierarchy, market or triple-helix networks?

    Science.gov (United States)

    Fitjar, Rune Dahl; Gjelsvik, Martin; Rodríguez-Pose, Andrés

    This paper assesses the extent to which the organization of the innovation effort in firms, as well as the geographical scale at which this effort is pursued, affects the capacity to benefit from product innovations. Three alternative modes of organization are studied: hierarchy, market and triple-helix-type networks. Furthermore, we consider triple-helix networks at three geographical scales: local, national and international. These relationships are tested on a random sample of 763 firms located in five urban regions of Norway which reported having introduced new products or services during the preceding 3 years. The analysis shows that firms exploiting internal hierarchy or triple-helix networks with a wide range of partners managed to derive a significantly higher share of their income from new products, compared to those that mainly relied on outsourcing within the market. In addition, the analysis shows that the geographical scale of cooperation in networks, as well as the type of partner used, matters for the capacity of firms to benefit from product innovation. In particular, firms that collaborate in international triple-helix-type networks involving suppliers, customers and R&D institutions extract a higher share of their income from product innovations, regardless of whether they organize the processes internally or through the network.

  4. Geodynamical simulation of the RRF triple junction

    Science.gov (United States)

    Wang, Z.; Wei, D.; Liu, M.; Shi, Y.; Wang, S.

    2017-12-01

    Triple junction is the point at which three plate boundaries meet. Three plates at the triple junction form a complex geological tectonics, which is a natural laboratory to study the interactions of plates. This work studies a special triple junction, the oceanic transform fault intersects the collinear ridges with different-spreading rates, which is free of influence of ridge-transform faults and nearby hotspots. First, we build 3-D numerical model of this triple junction used to calculate the stead-state velocity and temperature fields resulting from advective and conductive heat transfer. We discuss in detail the influence of the velocity and temperature fields of the triple junction from viscosity, spreading rate of the ridge. The two sides of the oceanic transform fault are different sensitivities to the two factors. And, the influence of the velocity mainly occurs within 200km of the triple junction. Then, we modify the model by adding a ridge-transform fault to above model and directly use the velocity structure of the Macquarie triple junction. The simulation results show that the temperature at both sides of the oceanic transform fault decreases gradually from the triple junction, but the temperature difference between the two sides is a constant about 200°. And, there is little effect of upwelling velocity away from the triple junction 100km. The model results are compared with observational data. The heat flux and thermal topography along the oceanic transform fault of this model are consistent with the observed data of the Macquarie triple junction. The earthquakes are strike slip distributed along the oceanic transform fault. Their depths are also consistent with the zone of maximum shear stress. This work can help us to understand the interactions of plates of triple junctions and help us with the foundation for the future study of triple junctions.

  5. Guided search for triple conjunctions.

    Science.gov (United States)

    Nordfang, Maria; Wolfe, Jeremy M

    2014-08-01

    A key tenet of feature integration theory and of related theories such as guided search (GS) is that the binding of basic features requires attention. This would seem to predict that conjunctions of features of objects that have not been attended should not influence search. However, Found (1998) reported that an irrelevant feature (size) improved the efficiency of search for a Color × Orientation conjunction if it was correlated with the other two features across the display, as compared to the case in which size was not correlated with color and orientation features. We examined this issue with somewhat different stimuli. We used triple conjunctions of color, orientation, and shape (e.g., search for a red, vertical, oval-shaped item). This allowed us to manipulate the number of features that each distractor shared with the target (sharing) and it allowed us to vary the total number of distractor types (and, thus, the number of groups of identical items: grouping). We found that these triple conjunction searches were generally very efficient--producing very shallow Reaction Time × Set Size slopes, consistent with strong guidance by basic features. Nevertheless, both of the variables, sharing and grouping, modulated performance. These influences were not predicted by previous accounts of GS; however, both can be accommodated in a GS framework. Alternatively, it is possible, though not necessary, to see these effects as evidence for "preattentive binding" of conjunctions.

  6. Abdominal Hernias, Giant Colon Diverticulum, GIST, Intestinal Pneumatosis, Colon Ischemia, Cold Intussusception, Gallstone Ileus, and Foreign Bodies: Our Experience and Literature Review of Incidental Gastrointestinal MDCT Findings

    OpenAIRE

    Di Grezia, G.; Gatta, G.; Rella, R.; Donatello, D.; Falco, G.; Grassi, R.; Grassi, R.

    2017-01-01

    Incidental gastrointestinal findings are commonly detected on MDCT exams performed for various medical indications. This review describes the radiological MDCT spectrum of appearances already present in the past literature and in today’s experience of several gastrointestinal acute conditions such as abdominal hernia, giant colon diverticulum, GIST, intestinal pneumatosis, colon ischemia, cold intussusception, gallstone ileus, and foreign bodies which can require medical and surgical interven...

  7. Sonography-guided hydrostatic reduction of ileocolic intussusception in children: analysis of failure and success in consecutive patients presenting timely to the hospital.

    Science.gov (United States)

    Menke, Jan; Kahl, Fritz

    2015-03-01

    In children with ileocolic intussusception sonography is increasingly being used for diagnosis, whereas fluoroscopy is frequently used for guiding non-invasive reduction. This study assessed the success rate of radiation-free sonography-guided hydrostatic reduction in children with ileocolic intussusception, using novel well-defined success rate indices. All children were evaluated who presented from 2005 to 2013 to the local university hospital with ileocolic intussusception. The patients were treated with sonography-guided hydrostatic reduction unless primary surgery was clinically indicated. The according success rate was determined by indices of Bekdash et al. They represent the ratio of persistently successful non-surgical reductions versus four different denominators, depending on including/excluding cases with primary surgery and including/excluding cases requiring bowel resection/intervention. Fifty-six consecutive patients were included (age, 3 months to 7.8 years). About 80% of the patients presented until 24 h and 20% until 48 h after the onset of symptoms. Seven patients underwent primary surgery, with bowel resection required in three cases. Hydrostatic reduction was attempted in 49 patients, being permanently successful in 41 cases (selective reduction rate 41/49 = 83.7%; crude reduction rate 41/56 = 73.2%). The remaining eight patients underwent secondary surgery, with just two patients not requiring surgical bowel resection/intervention (corrected selective reduction rate 41/43 = 95.3%). The composite reduction rate was 87.2% (successful/feasible reductions, 41/47). Radiation-free sonography-guided hydrostatic reduction has a good success rate in children with ileocolic intussusception. It may be particularly valuable in centers that are already experienced with using sonography for the diagnosis.

  8. Holonomy loops, spectral triples and quantum gravity

    DEFF Research Database (Denmark)

    Johannes, Aastrup; Grimstrup, Jesper Møller; Nest, Ryszard

    2009-01-01

    We review the motivation, construction and physical interpretation of a semi-finite spectral triple obtained through a rearrangement of central elements of loop quantum gravity. The triple is based on a countable set of oriented graphs and the algebra consists of generalized holonomy loops...

  9. Spectral triples and the geometry of fractals

    DEFF Research Database (Denmark)

    Christensen, Erik; Ivan, Cristina; Schroe, Elmar

    2012-01-01

    It is shown that one can construct a spectral triple for the Sierpinski gasket such that it represents any given K-homology class, On the other hand if the geodesic distance and the dimension has to be part of the data from the triple, there are certain restriction....

  10. Triple Test in Carcinoma Breast

    Science.gov (United States)

    Sameer; Mukherjee, Arindam

    2014-01-01

    Introduction: The commonest clinical presentation in majority of breast pathology is a lump. A definite diagnosis of breast lump is very important for the surgeon to decide on the final course of treatment and also saves the patient from unnecessary physical, emotional and psychological trauma if there is a definite preoperative diagnosis of benign lesion. The present study was done to evaluate the effectiveness and relevance of “TRIPLE TEST”in diagnosis of carcinoma breast in rural labour class population. Materials and Methods: The present study was a prospective study conducted on patients over 35 years of age having palpable breast lumps presenting in the out patient department of general surgery, ESI Hospital Basaidarapur New Delhi, India. The duration of study was from May 2007 to June 2009 and a total of 100 cases were studied. Each patient was subjected to a detailed history, clinical breast examination ,diagnostic mammography and FNAC. In this study, the results of each modality was divided in three groups: benign, suspicious and malignant. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of each test was calculated individually and as combined. Result: Out of 100 patients enrolled in this study, 60 cases were benign and 40 cases were of malignant breast disease. The age of patients with carcinoma breast in the series varied from 35 years to 70 years. The highest incidence of malignancy noted was 30% in 41-50 years age group (4th decade) followed by 27.5% in 51-60 years age group (5th decade). The sensitivity of clinical examination was found to be 75%, specificity was 83.3%, positive predictive value (PPV) of 75% and diagnostic accuracy of 80%. The sensitivity, specificity, positive predictive value and diagnostic accuracy of mammography was calculated and was found to be 94.9% , 90% , 86% and 92% respectively. The sensitivity, specificity, positive predictive value and diagnostic accuracy of

  11. NIM Realization of the Gallium Triple Point

    Science.gov (United States)

    Xiaoke, Yan; Ping, Qiu; Yuning, Duan; Yongmei, Qu

    2003-09-01

    In the last three years (1999 to 2001), the gallium triple-point cell has been successfully developed, and much corresponding research has been carried out at the National Institute of Metrology (NIM), Beijing, China. This paper presents the cell design, apparatus and procedure for realizing the gallium triple point, and presents studies on the different freezing methods. The reproducibility is 0.03 mK, and the expanded uncertainty of realization of the gallium triple point is evaluated to be 0.17 mK (p=0.99, k=2.9). Also, the reproducibility of the gallium triple point was compared with that of the triple point of water.

  12. Simulation of triple coincidences in PET

    International Nuclear Information System (INIS)

    Cal-González, J; Herranz, E; Vicente, E; Udias, J M; Lage, E; Dave, S R; Parot, V; Herraiz, J L; Moore, S C; Park, M-A

    2015-01-01

    Although current PET scanners are designed and optimized to detect double coincidence events, there is a significant amount of triple coincidences in any PET acquisition. Triple coincidences may arise from causes such as: inter-detector scatter (IDS), random triple interactions (R T ), or the detection of prompt gamma rays in coincidence with annihilation photons when non-pure positron-emitting radionuclides are used (β + γ events). Depending on the data acquisition settings of the PET scanner, these triple events are discarded or processed as a set of double coincidences if the energy of the three detected events is within the scanner’s energy window. This latter option introduces noise in the data, as at most, only one of the possible lines-of-response defined by triple interactions corresponds to the line along which the decay occurred. Several novel works have pointed out the possibility of using triple events to increase the sensitivity of PET scanners or to expand PET imaging capabilities by allowing differentiation between radiotracers labeled with non-pure and pure positron-emitting radionuclides. In this work, we extended the Monte Carlo simulator PeneloPET to assess the proportion of triple coincidences in PET acquisitions and to evaluate their possible applications. We validated the results of the simulator against experimental data acquired with a modified version of a commercial preclinical PET/CT scanner, which was enabled to acquire and process triple-coincidence events. We used as figures of merit the energy spectra for double and triple coincidences and the triples-to-doubles ratio for different energy windows and radionuclides. After validation, the simulator was used to predict the relative quantity of triple-coincidence events in two clinical scanners assuming different acquisition settings. Good agreement between simulations and preclinical experiments was found, with differences below 10% for most of the observables considered. For

  13. Isolated orbital mass as the primary presentation of a triple-hit lymphoma transformed from a systemic follicular lymphoma.

    Science.gov (United States)

    Zhou, Xiao Yi; Lu, Xinyan; Raparia, Kirtee; Chen, Yi-Hua

    2018-06-01

    Triple-hit lymphoma is a highly aggressive B-cell lymphoma. We report a case of triple-hit lymphoma transformed from systemic follicular lymphoma (FL) after 9-year remission and presented primarily as an isolated orbital mass without systemic symptoms or lymphadenopathy. A 58-year-old female presented with intermittent vertical binocular diplopia, left upper eyelid swelling and pain and was found to have a 2.9 cm orbital mass. Histological section revealed a CD10-positive large B-cell lymphoma, consistent with transformation of FL. Fluorescent in situ hybridization (FISH) analysis demonstrated rearrangements involving C-MYC, BCL-2 and BCL-6 genes, indicating a high grade, triple-hit lymphoma. Triple-hit lymphoma transformed from a low-grade lymphoma may initially present as an isolated orbital mass without systemic evidence of transformation. Early recognition of double or triple-hit lymphomas is important since these patients require aggressive chemotherapy.

  14. Molecular characterization of norovirus GII.17 detected in healthy adult, intussusception patient, and acute gastroenteritis children in Thailand.

    Science.gov (United States)

    Khamrin, Pattara; Kumthip, Kattareeya; Yodmeeklin, Arpaporn; Supadej, Kanittapon; Ukarapol, Nuthapong; Thongprachum, Aksara; Okitsu, Shoko; Hayakawa, Satoshi; Ushijima, Hiroshi; Maneekarn, Niwat

    2016-10-01

    Noroviruses (NoVs) have been recognized as a leading cause of sporadic cases and outbreaks of acute gastroenteritis in all age groups. During the surveillance of NoVs in Chiang Mai, Thailand, four cases of the novel GII.17 NoVs were sporadically detected by RT-PCR in 2014-2015. The first case of GII.17 was detected in a healthy adult who worked for a restaurant. The second case was found in a pediatric patient who admitted to the hospital with intussusception. The third and fourth cases were found in acute gastroenteritis children. Phylogenetic analysis clearly demonstrated that GII.17 NoVs detected in this study were genetically closely related with the novel GII.17 Kawasaki reference strains. These four GII.17 NoV positive specimens were also tested by two immunochromatographic test kits in order to evaluate the sensitivity for GII.17 NoV detection. The viral loads in those specimens were determined by real-time RT-PCR. The sensitivity of GII.17 NoV detection varies by individual test kits and also depending on the amount of the viruses contained in the fecal specimens. In summary, our study reported the detection of novel GII.17 NoVs in a wide range of subjects with and without diarrhea. Therefore, continued comprehensive screening and genetic molecular characterization of NoV strains circulating in this area need to be further investigated. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. The time domain triple probe method

    International Nuclear Information System (INIS)

    Meier, M.A.; Hallock, G.A.; Tsui, H.Y.W.; Bengtson, R.D.

    1994-01-01

    A new Langmuir probe technique based on the triple probe method is being developed to provide simultaneous measurement of plasma temperature, potential, and density with the temporal and spatial resolution required to accurately characterize plasma turbulence. When the conventional triple probe method is used in an inhomogeneous plasma, local differences in the plasma measured at each probe introduce significant error in the estimation of turbulence parameters. The Time Domain Triple Probe method (TDTP) uses high speed switching of Langmuir probe potential, rather than spatially separated probes, to gather the triple probe information thus avoiding these errors. Analysis indicates that plasma response times and recent electronics technology meet the requirements to implement the TDTP method. Data reduction techniques of TDTP data are to include linear and higher order correlation analysis to estimate fluctuation induced particle and thermal transport, as well as energy relationships between temperature, density, and potential fluctuations

  16. About the Triple A. Argentina 1973 - 1976

    OpenAIRE

    Rostica, Julieta

    2011-01-01

    On May 25, 1973, Peronism returned to govern Argentina after about two decades of prohibition and political persecution. After its establishment, certain crimes began to be signed with “AAA”. The Triple A adopted the particularity of disappearing with the coup on March 24 1976. Why could this organization only exist in a democracy erected in the middle of two military dictatorships? Why did it exist during the very wished Peronist government? The article offers an approach to the Triple A, th...

  17. Integrating Compassionate, Collaborative Care (the "Triple C") Into Health Professional Education to Advance the Triple Aim of Health Care.

    Science.gov (United States)

    Lown, Beth A; McIntosh, Sharrie; Gaines, Martha E; McGuinn, Kathy; Hatem, David S

    2016-03-01

    Empathy and compassion provide an important foundation for effective collaboration in health care. Compassion (the recognition of and response to the distress and suffering of others) should be consistently offered by health care professionals to patients, families, staff, and one another. However, compassion without collaboration may result in uncoordinated care, while collaboration without compassion may result in technically correct but depersonalized care that fails to meet the unique emotional and psychosocial needs of all involved. Providing compassionate, collaborative care (CCC) is critical to achieving the "triple aim" of improving patients' health and experiences of care while reducing costs. Yet, values and skills related to CCC (or the "Triple C") are not routinely taught, modeled, and assessed across the continuum of learning and practice. To change this paradigm, an interprofessional group of experts recently recommended approaches and a framework for integrating CCC into health professional education and postgraduate training as well as clinical care. In this Perspective, the authors describe how the Triple C framework can be integrated and enhance existing competency standards to advance CCC across the learning and practice continuum. They also discuss strategies for partnering with patients and families to improve health professional education and health care design and delivery through quality improvement projects. They emphasize that compassion and collaboration are important sources of professional, patient, and family satisfaction as well as critical aspects of professionalism and person-centered, relationship-based high-quality care.

  18. Clinical effect of calcium hydroxide paste combined with triple antibiotic paste on root canal disinfection

    Directory of Open Access Journals (Sweden)

    Chen QU

    2014-03-01

    Full Text Available Objective To compare the efficacy in disinfection and pain control of calcium hydroxide paste and triple antibiotic paste (ornidazole, ciprofloxacin and minocycline used individually or jointly for root canal disinfection. Methods Two hundred and thirty-five patients with chronic apical periodontitis (235 teeth were involved in the present study and divided into 2 groups: fistula group (n=118 and no fistula group (n=117. Each group was then randomly divided into 4 subgroups: calcium hydroxide paste group, triple antibiotic paste group, calcium hydroxide + triple antibiotic paste group, and camphor phenol group. After regular root canal preparation, root canals of patients in 4 groups were filled with tiny paper ends impregnated with fore 4 different drugs respectively. Visual analogue scales (VAS of pain were given to the patients with a guide for filling the scale. One week later, both the data of the scales and the effects of root canal disinfection were recorded and analyzed. Results Seven days after treatment, the clinical efficacy of calcium hydroxide paste, triple antibiotic paste and calcium hydroxide + triple antibiotic paste was similar (P>0.05 either in fistula group or in no fistula group, but all better than that of camphor phenol (P<0.05. VAS score analysis showed that, at least on the first 3 days after sealing medicine in the root canal, calcium hydroxide + triple antibiotic paste achieved better result of pain control than the other three groups (P<0.05 no matter with or without fistula. Conclusions  Calcium hydroxide paste, triple antibiotic paste, calcium hydroxide + triple antibiotic paste are effective in treatment of chronic apical periodontitis whether with or without fistula. However, the combined use of calcium hydroxide and three antibiotic pastes is better for controlling the pain after root canal preparation than other treatments, which is therefore worthy of clinical application. DOI: 10.11855/j.issn.0577-7402.2014.02.12

  19. Analysis of eco-innovation with triple helix approach: case-study of biofloc catfish farming in Yogyakarta

    Science.gov (United States)

    Purwadi, D.; Nurlaily, I.

    2018-03-01

    Concerning environmental into focus of innovation process will expand the number of actor involved. Eco-innovation and triple helix are often frameworks applied to analyse how environmental concern are integrated in innovation process and how different stakeholder groups are having inter relation. Case study from biofloc catfish farming in Yogyakarta is presented to demonstrate a possible approach for researching the success of triple helix frameworks. This case is considered on basic of the result of a survey among farmers, academician and government. The paper concludes the creating of full triple helix encounters problem in practice. It also includes suggestion for further research on fisheries development.

  20. What can triple helix frameworks offer to the analysis of eco-innovation dynamics? Theoretical and methodological considerations

    DEFF Research Database (Denmark)

    Yang, Yan; Holgaard, Jette Egelund; Remmen, Arne

    2012-01-01

    stakeholder groups are interacting in this connection. Taking the triple helix as the theoretical departure point, this paper discusses the opportunities offered by these triple helix frameworks for analyzing eco-innovation dynamics from both theoretical and practical perspectives. It adds to the debate about......Bringing environmental concerns into focus of innovation processes will in several cases also expand the numbers of actors involved. Eco-innovation and triple helix are often frameworks applied to analyse how environmental concerns are integrated in the innovation processes and how different...

  1. Drop evaporation and triple line dynamics

    Science.gov (United States)

    Sobac, Benjamin; Brutin, David; Gavillet, Jerome; Université de Provence Team; Cea Liten Team

    2011-03-01

    Sessile drop evaporation is a phenomenon commonly came across in nature or in industry with cooling, paintings or DNA mapping. However, the evaporation of a drop deposited on a substrate is not completely understood due to the complexity of the problem. Here we investigate, with several nano-coating of the substrate (PTFE, SiOx, SiOc and CF), the influence of the dynamic of the triple line on the evaporation process. The experiment consists in analyzing simultaneously the motion of the triple line, the kinetics of evaporation, the internal thermal motion and the heat and mass transfer. Measurements of temperature, heat-flux and visualizations with visible and infrared cameras are performed. The dynamics of the evaporative heat flux appears clearly different depending of the motion of the triple line

  2. A multi-country study of intussusception in children under 2 years of age in Latin America: analysis of prospective surveillance data.

    Science.gov (United States)

    Sáez-Llorens, Xavier; Velázquez, F Raúl; Lopez, Pio; Espinoza, Felix; Linhares, Alexandre C; Abate, Hector; Nuñez, Ernesto; Venegas, Guillermo; Vergara, Rodrigo; Jimenez, Ana L; Rivera, Maribel; Aranza, Carlos; Richardson, Vesta; Macias-Parra, Mercedes; Palacios, Guillermo Ruiz; Rivera, Luis; Ortega-Barria, Eduardo; Cervantes, Yolanda; Rüttimann, Ricardo; Rubio, Pilar; Acosta, Camilo J; Newbern, Claire; Verstraeten, Thomas; Breuer, Thomas

    2013-05-27

    Intussusception (IS) is a form of acute intestinal obstruction that occurs mainly in infants and is usually of unknown cause. An association between IS and the first licensed rotavirus vaccine, a reassortant-tetravalent, rhesus-based rotavirus vaccine (RRV-TV), led to the withdrawal of the vaccine. New rotavirus vaccines have now been developed and extensively studied for their potential association with IS. This study aimed to describe the epidemiology and to estimate the incidence of IS in Latin American infants prior to new vaccine introduction. Children under 2 years of age representing potential IS cases were enrolled in 16 centers in 11 Latin American countries from January 2003 to May 2005. IS cases were classified as definite, probable, possible or suspected as stated on the Brighton Collaboration Working Group guidelines. From 517 potential cases identified, 476 (92%) cases were classified as definite, 21 probable, 10 possible and 10 suspected for intussusception. Among the 476 definite IS cases, the median age at presentation was 6.4 months with 89% of cases aged days with a high prevalence of surgery as the primary treatment (65%). Most cases (88%) made a complete recovery, but 13 (3%) died. No clear seasonal pattern of IS cases emerged. This study describes the epidemiology and estimates the incidence of IS in Latin American infants prior to the introduction of new rotavirus vaccines. The incidence of IS was found to vary between different countries, as observed in previous studies. Clinical study identifier 999910/204 (SERO-EPI-IS-204).

  3. Normalization for triple-target microarray experiments

    Directory of Open Access Journals (Sweden)

    Magniette Frederic

    2008-04-01

    Full Text Available Abstract Background Most microarray studies are made using labelling with one or two dyes which allows the hybridization of one or two samples on the same slide. In such experiments, the most frequently used dyes are Cy3 and Cy5. Recent improvements in the technology (dye-labelling, scanner and, image analysis allow hybridization up to four samples simultaneously. The two additional dyes are Alexa488 and Alexa494. The triple-target or four-target technology is very promising, since it allows more flexibility in the design of experiments, an increase in the statistical power when comparing gene expressions induced by different conditions and a scaled down number of slides. However, there have been few methods proposed for statistical analysis of such data. Moreover the lowess correction of the global dye effect is available for only two-color experiments, and even if its application can be derived, it does not allow simultaneous correction of the raw data. Results We propose a two-step normalization procedure for triple-target experiments. First the dye bleeding is evaluated and corrected if necessary. Then the signal in each channel is normalized using a generalized lowess procedure to correct a global dye bias. The normalization procedure is validated using triple-self experiments and by comparing the results of triple-target and two-color experiments. Although the focus is on triple-target microarrays, the proposed method can be used to normalize p differently labelled targets co-hybridized on a same array, for any value of p greater than 2. Conclusion The proposed normalization procedure is effective: the technical biases are reduced, the number of false positives is under control in the analysis of differentially expressed genes, and the triple-target experiments are more powerful than the corresponding two-color experiments. There is room for improving the microarray experiments by simultaneously hybridizing more than two samples.

  4. ADAM-17: a novel therapeutic target for triple negative breast cancer.

    LENUS (Irish Health Repository)

    McGowan, P M

    2013-02-01

    Validated targeted therapy is currently unavailable for patients with invasive breast cancer negative for oestrogen receptors, progesterone receptors and HER2 [i.e., those with triple-negative (TN) disease]. ADAM-17 is a protease involved in the activations of several ligands that bind to and promotes intracellular signalling from the EGFR\\/HER family of receptors.

  5. A Triple Iron Triathlon Leads to a Decrease in Total Body Mass but Not to Dehydration

    Science.gov (United States)

    Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Oliver, Senn

    2010-01-01

    A loss in total body mass during an ultraendurance performance is usually attributed to dehydration. We identified the changes in total body mass, fat mass, skeletal muscle mass, and selected markers of hydration status in 31 male nonprofessional ultratriathletes participating in a Triple Iron triathlon involving 11.4 km swimming, 540 km cycling…

  6. Krein Spectral Triples and the Fermionic Action

    International Nuclear Information System (INIS)

    Dungen, Koen van den

    2016-01-01

    Motivated by the space of spinors on a Lorentzian manifold, we define Krein spectral triples, which generalise spectral triples from Hilbert spaces to Krein spaces. This Krein space approach allows for an improved formulation of the fermionic action for almost-commutative manifolds. We show by explicit calculation that this action functional recovers the correct Lagrangians for the cases of electrodynamics, the electro-weak theory, and the Standard Model. The description of these examples does not require a real structure, unless one includes Majorana masses, in which case the internal spaces also exhibit a Krein space structure.

  7. RITA: The reinvented triple axis spectrometer

    Energy Technology Data Exchange (ETDEWEB)

    Mason, T.E. [Toronto Univ., ON (Canada). Dept. of Physics; Clausen, K.N.; Aeppli, G.; McMorrow, D.R.; Kjems, J.K. [Risoe National Lab., Roskilde (Denmark)

    1995-11-01

    Risoe National Laboratory was reported to be in the process of developing a new spectrometer design, RITA, based on the triple axis design. The spectrometer will attempt to incorporate more recent innovations such as multilayer supermirrors and microstrip proportional counters into a rethinking of the triple-axis spectrometer. By optimizing the beam optics, using supermirrors and extending the analyser to map regions of (Q, {omega}) space using an array of independently controllable pyrolytic graphite crystals focussed on an area detector, it was hoped that the efficiency of single-crystal inelastic experiments could be increased by as much as a factor of 20. 7 figs., 20 refs.

  8. Triple helix interactions for eco-innovation

    DEFF Research Database (Denmark)

    Hermann, Roberto Rivas; Riisgaard, Henrik; Remmen, Arne

    the role of science parks in promoting eco-innovation. This study uses qualitative data gathered in two units of analysis: Panama Canal Authority and City of Knowledge Science Park. The study examines how Triple Helix interactions have built the regional system of eco-innovation at the Panama Canal...

  9. Triple-axis spectrometer DruechaL

    International Nuclear Information System (INIS)

    Buehrer, W.; Keller, P.

    1996-01-01

    DruechaL is a triple-axis spectrometer located at a cold guide. The characteristics of guide and instrument allow the use of a broad spectral range of neutrons. The resolution in momentum and energy transfer can be tuned to match the experimental requirements by using either collimators or focusing systems (monochromator, antitrumpet, analyser). (author) figs., tabs., refs

  10. A Biatrial Myxoma with Triple Ripples.

    Science.gov (United States)

    Barik, Ramachandra

    2018-01-01

    Cardiac myxoma is a benign tumor, but it is known for its space-occupying effect at the site of origin and frequent systemic embolization. This case report highlights a biatrial myxoma of interatrial septum who presented with significant tricuspid valve regurgitation, atrial fibrillation, and cardioembolic stroke of the left parietal lobe, i.e., a biatrial myxoma with triple ripples.

  11. Revised Reynolds Stress and Triple Product Models

    Science.gov (United States)

    Olsen, Michael E.; Lillard, Randolph P.

    2017-01-01

    Revised versions of Lag methodology Reynolds-stress and triple product models are applied to accepted test cases to assess the improvement, or lack thereof, in the prediction capability of the models. The Bachalo-Johnson bump flow is shown as an example for this abstract submission.

  12. Minimal representations and Freudenthal triple systems

    International Nuclear Information System (INIS)

    Olive, D.

    2004-01-01

    Unitary representations of noncompact Lie groups have long been sought in physics. The first nice concrete construction was found by Dirac in connection with the anti-de Sitter group. Some subsequent generalizations will be described, in particular the minimal representation thought to be relevant to realising duality in supergravity superstring theories. A relation to Freudenthal triple systems will be described. (author)

  13. Triple-axis spectrometer DruechaL

    Energy Technology Data Exchange (ETDEWEB)

    Buehrer, W; Keller, P [Lab. for Neutron Scattering ETH Zurich, Zurich (Switzerland) and Paul Scherrer Institute, Villigen (Switzerland)

    1996-11-01

    DruechaL is a triple-axis spectrometer located at a cold guide. The characteristics of guide and instrument allow the use of a broad spectral range of neutrons. The resolution in momentum and energy transfer can be tuned to match the experimental requirements by using either collimators or focusing systems (monochromator, antitrumpet, analyser). (author) figs., tabs., refs.

  14. Hydrothermal Exploration at the Chile Triple Junction - ABE's last adventure?

    Science.gov (United States)

    German, C. R.; Shank, T. M.; Lilley, M. D.; Lupton, J. E.; Blackman, D. K.; Brown, K. M.; Baumberger, T.; Früh-Green, G.; Greene, R.; Saito, M. A.; Sylva, S.; Nakamura, K.; Stanway, J.; Yoerger, D. R.; Levin, L. A.; Thurber, A. R.; Sellanes, J.; Mella, M.; Muñoz, J.; Diaz-Naveas, J. L.; Inspire Science Team

    2010-12-01

    In February and March 2010 we conducted preliminary exploration for hydrothermal plume signals along the East Chile Rise where it intersects the continental margin at the Chile Triple Junction (CTJ). This work was conducted as one component of our larger NOAA-OE funded INSPIRE project (Investigation of South Pacific Reducing Environments) aboard RV Melville cruise MV 1003 (PI: Andrew Thurber, Scripps) with all shiptime funded through an award of the State of California to Andrew Thurber and his co-PI's. Additional support came from the Census of Marine Life (ChEss and CoMarge projects). At sea, we conducted a series of CTD-rosette and ABE autonomous underwater vehicle operations to prospect for and determine the nature of any seafloor venting at, or adjacent to, the point where the the East Chile Rise subducts beneath the continental margin. Evidence from in situ sensing (optical backscatter, Eh) and water column analyses of dissolved CH4, δ3He and TDFe/TDMn concentrations document the presence of two discrete sites of venting, one right at the triple junction and the other a further 10km along axis, north of the Triple Junction, but still within the southernmost segment of the East Chile Rise. From an intercomparison of the abundance of different chemical signals we can intercompare likely characteristics of these differet source sites and also differentiate between them and the high methane concentrations released from cold seep sites further north along the Chile Margin, both with the CTJ region and also at the Concepcion Methane Seep Area (CMSA). This multi-disciplinary and international collaboration - involving scientists from Chile, the USA, Europe and Japan - can serve as an excellent and exciting launchpoint for wide-ranging future investigations of the Chile Triple Junction area - the only place on Earth where an oceanic spreading center is being actively subducted beneath a continent and also the only place on Earth where all known forms of deep

  15. Automated realization of the gallium melting and triple points

    Science.gov (United States)

    Yan, X.; Duan, Y.; Zhang, J. T.; Wang, W.

    2013-09-01

    In order to improve the automation and convenience of the process involved in realizing the gallium fixed points, an automated apparatus, based on thermoelectric and heat pipe technologies, was designed and developed. This paper describes the apparatus design and procedures for freezing gallium mantles and realizing gallium melting and triple points. Also, investigations on the melting behavior of a gallium melting point cell and of gallium triple point cells were carried out while controlling the temperature outside the gallium point cells at 30 °C, 30.5 °C, 31 °C, and 31.5 °C. The obtained melting plateau curves show dentate temperature oscillations on the melting plateaus for the gallium point cells when thermal couplings occurred between the outer and inner liquid-solid interfaces. The maximum amplitude of the temperature fluctuations was about 1.5 mK. Therefore, the temperature oscillations can be used to indicate the ending of the equilibrium phase transitions. The duration and amplitude of such temperature oscillations depend on the temperature difference between the setting temperature and the gallium point temperature; the smaller the temperature difference, the longer the duration of both the melting plateaus and the temperature fluctuations.

  16. Abdominal Hernias, Giant Colon Diverticulum, GIST, Intestinal Pneumatosis, Colon Ischemia, Cold Intussusception, Gallstone Ileus, and Foreign Bodies: Our Experience and Literature Review of Incidental Gastrointestinal MDCT Findings

    Science.gov (United States)

    Gatta, G.; Rella, R.; Donatello, D.; Falco, G.; Grassi, R.

    2017-01-01

    Incidental gastrointestinal findings are commonly detected on MDCT exams performed for various medical indications. This review describes the radiological MDCT spectrum of appearances already present in the past literature and in today's experience of several gastrointestinal acute conditions such as abdominal hernia, giant colon diverticulum, GIST, intestinal pneumatosis, colon ischemia, cold intussusception, gallstone ileus, and foreign bodies which can require medical and surgical intervention or clinical follow-up. The clinical presentation of this illness is frequently nonspecific: abdominal pain, distension, nausea, fever, rectal bleeding, vomiting, constipation, or a palpable mass, depending on the disease. A proper differential diagnosis is essential in the assessment of treatment and in this case MDCT exam plays a central rule. We wish that this article will familiarize the radiologist in the diagnosis of this kind of incidental MDCT findings for better orientation of the therapy. PMID:28638830

  17. Abdominal Hernias, Giant Colon Diverticulum, GIST, Intestinal Pneumatosis, Colon Ischemia, Cold Intussusception, Gallstone Ileus, and Foreign Bodies: Our Experience and Literature Review of Incidental Gastrointestinal MDCT Findings

    Directory of Open Access Journals (Sweden)

    G. Di Grezia

    2017-01-01

    Full Text Available Incidental gastrointestinal findings are commonly detected on MDCT exams performed for various medical indications. This review describes the radiological MDCT spectrum of appearances already present in the past literature and in today’s experience of several gastrointestinal acute conditions such as abdominal hernia, giant colon diverticulum, GIST, intestinal pneumatosis, colon ischemia, cold intussusception, gallstone ileus, and foreign bodies which can require medical and surgical intervention or clinical follow-up. The clinical presentation of this illness is frequently nonspecific: abdominal pain, distension, nausea, fever, rectal bleeding, vomiting, constipation, or a palpable mass, depending on the disease. A proper differential diagnosis is essential in the assessment of treatment and in this case MDCT exam plays a central rule. We wish that this article will familiarize the radiologist in the diagnosis of this kind of incidental MDCT findings for better orientation of the therapy.

  18. Abdominal Hernias, Giant Colon Diverticulum, GIST, Intestinal Pneumatosis, Colon Ischemia, Cold Intussusception, Gallstone Ileus, and Foreign Bodies: Our Experience and Literature Review of Incidental Gastrointestinal MDCT Findings.

    Science.gov (United States)

    Di Grezia, G; Gatta, G; Rella, R; Donatello, D; Falco, G; Grassi, R; Grassi, R

    2017-01-01

    Incidental gastrointestinal findings are commonly detected on MDCT exams performed for various medical indications. This review describes the radiological MDCT spectrum of appearances already present in the past literature and in today's experience of several gastrointestinal acute conditions such as abdominal hernia, giant colon diverticulum, GIST, intestinal pneumatosis, colon ischemia, cold intussusception, gallstone ileus, and foreign bodies which can require medical and surgical intervention or clinical follow-up. The clinical presentation of this illness is frequently nonspecific: abdominal pain, distension, nausea, fever, rectal bleeding, vomiting, constipation, or a palpable mass, depending on the disease. A proper differential diagnosis is essential in the assessment of treatment and in this case MDCT exam plays a central rule. We wish that this article will familiarize the radiologist in the diagnosis of this kind of incidental MDCT findings for better orientation of the therapy.

  19. Triple Achilles Tendon Rupture: Case Report.

    Science.gov (United States)

    Saxena, Amol; Hofer, Deann

    We present a case report with 1-year follow-up data of a 57-year-old male soccer referee who had sustained an acute triple Achilles tendon rupture injury during a game. His triple Achilles tendon rupture consisted of a rupture of the proximal watershed region, a rupture of the main body (mid-watershed area), and an avulsion-type rupture of insertional calcific tendinosis. The patient was treated surgically with primary repair of the tendon, including tenodesis with anchors. Postoperative treatment included non-weightbearing for 4 weeks and protected weightbearing until 10 weeks postoperative, followed by formal physical therapy, which incorporated an "antigravity" treadmill. The patient was able to return to full activity after 26 weeks, including running and refereeing, without limitations. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  20. WDVV equation and triple-product relation

    International Nuclear Information System (INIS)

    Shigechi, Keiichi; Wadati, Miki; Wang Ning

    2005-01-01

    We study the relation between the WDVV equations and the τ-function of the noncommutative KP (NCKP) hierarchy. WDVV-like equations (Hirota triple-product relation) in the noncommutative context appear as a consequence of the nontrivial equation for τ-function of the NC KP hierarchy, while the prepotential in the Seiberg-Witten (SW) theory has been identified to the τ-function of the Whitham hierarchy. We show that the spectral curve for the SW theory is the same as the Toda-chain hierarchy. We also show explicitly that Whitham hierarchy includes commutative Toda/KP hierarchy. Further, we comment on the origin of the Hirota triple-product relation in the context of the SW theory

  1. Triple Giant Resonance Excitations: A Microscopic Approach

    International Nuclear Information System (INIS)

    Lanza, E.G.; Andres, M.V.; Catara, F.; Chomaz, Ph.; Fallot, M.; Scarpaci, J.A.

    2007-01-01

    We present, for the first time, microscopic calculations of inelastic cross sections of the triple excitation of giant resonances induced by heavy ion probes. We start from a microscopic approach based on RPA. The mixing of three-phonon states among themselves and with two- and one-phonon states is considered within a boson expansion with Pauli corrections. In this way we go beyond the standard harmonic approximations and get anharmonic excitation spectra. At the same time we also introduce non-linearities in the external field. The calculations are done by solving semiclassical coupled channel equations, the channels being superpositions of one-, two- and three-phonon states. Previous calculations for the Double Giant Resonance excitation show good agreement with experimental cross sections. The inclusion of the three phonon components confirms the previous results for the DGR and produces a strong increase in the Triple GR energy region

  2. Frequency tripling with multimode-lasers

    International Nuclear Information System (INIS)

    Langer, H.; Roehr, H.; Wrobel, W.G.

    1978-10-01

    The presence of different modes with random phases in a laser beam leads to fluctuations in nonlinear optical interactions. This paper describes the influence of the linewidth of a dye laser on the generation of intensive Lyman-alpha radiation by frequency tripling. Using this Lyman-alpha source for resonance scattering on strongly doppler-broadened lines in fusion plasmas the detection limit of neutral hydrogen is nearly two orders higher with the multimode than the singlemode dye laser. (orig.) [de

  3. Triple collinear emissions in parton showers

    Energy Technology Data Exchange (ETDEWEB)

    Höche, Stefan; Prestel, Stefan

    2017-10-01

    A framework to include triple collinear splitting functions into parton showers is presented, and the implementation of flavor-changing NLO splitting kernels is discussed as a first application. The correspondence between the Monte-Carlo integration and the analytic computation of NLO DGLAP evolution kernels is made explicit for both timelike and spacelike parton evolution. Numerical simulation results are obtained with two independent implementations of the new algorithm, using the two independent event generation frameworks Pythia and Sherpa.

  4. A Tulczyjew triple for classical fields

    International Nuclear Information System (INIS)

    Grabowska, Katarzyna

    2012-01-01

    The geometrical structure known as the Tulczyjew triple has proved to be very useful in describing mechanical systems, even those with singular Lagrangians or subject to constraints. Starting from basic concepts of the variational calculus, we construct the Tulczyjew triple for first-order field theory. The important feature of our approach is that we do not postulate ad hoc the ingredients of the theory, but obtain them as unavoidable consequences of the variational calculus. This picture of field theory is covariant and complete, containing not only the Lagrangian formalism and Euler–Lagrange equations but also the phase space, the phase dynamics and the Hamiltonian formalism. Since the configuration space turns out to be an affine bundle, we have to use affine geometry, in particular the notion of the affine duality. In our formulation, the two maps α and β which constitute the Tulczyjew triple are morphisms of double structures of affine-vector bundles. We also discuss the Legendre transformation, i.e. the transition between the Lagrangian and the Hamiltonian formulation of the first-order field theory. (paper)

  5. Isolated orbital mass as the primary presentation of a triple-hit lymphoma transformed from a systemic follicular lymphoma

    Directory of Open Access Journals (Sweden)

    Xiao Yi Zhou

    2018-06-01

    Full Text Available Purpose: Triple-hit lymphoma is a highly aggressive B-cell lymphoma. We report a case of triple-hit lymphoma transformed from systemic follicular lymphoma (FL after 9-year remission and presented primarily as an isolated orbital mass without systemic symptoms or lymphadenopathy. Observations: A 58-year-old female presented with intermittent vertical binocular diplopia, left upper eyelid swelling and pain and was found to have a 2.9 cm orbital mass. Histological section revealed a CD10-positive large B-cell lymphoma, consistent with transformation of FL. Fluorescent in situ hybridization (FISH analysis demonstrated rearrangements involving C-MYC, BCL-2 and BCL-6 genes, indicating a high grade, triple-hit lymphoma. Conclusions and importance: Triple-hit lymphoma transformed from a low-grade lymphoma may initially present as an isolated orbital mass without systemic evidence of transformation. Early recognition of double or triple-hit lymphomas is important since these patients require aggressive chemotherapy. Keywords: Lymphoma, Triple-hit lymphoma, Orbital mass

  6. Generating Two-Dimensional Repertoire of siRNA Linc-ROR and siRNA mRNA ARF6 from the lincRNA-RoR/miR-145/ARF6 expression Pathway that involved in the progression of Triple Negative Breast Cancer

    Science.gov (United States)

    Aditya Parikesit, Arli; Nurdiansyah, Rizki

    2018-01-01

    The research for finding the cure for breast cancer is currently entering the interesting phase of the transcriptomics based method. With the application of Next Generation Sequencing (NGS), molecular information on breast cancer could be gathered. Thus, both in silico and wet lab research has determined that the role of lincRNA-RoR/miR-145/ARF6 expression Pathway could not be ignored as one of the cardinal starting points for Triple-Negative Breast Cancer (TNBC). As the most hazardous type of breast cancer, TNBC should be treated with the most advanced approach that available in the scientific community. Bioinformatics approach has found the possible siRNA-based drug candidates for TNBC. It was found that siRNA that interfere with lincRNA-ROR and mRNA ARF6 could be a feasible opportunity as the drug candidate for TNBC. However, this claim should be validated with more thorough thermodynamics and kinetics computational approach as the comprehensive way to comprehend their molecular repertoire. In this respect, the claim was validated using various tools such as the RNAfold server to determine the 2D structure, Barriers server to comprehend the RNA folding kinetics, RNAeval server to validate the siRNA-target interaction. It was found that the thermodynamics and kinetics repertoire of the siRNA are indeed rational and feasible. In this end, our computation approach has proven that our designed siRNA could interact with lincRNA-RoR/miR-145/ARF6 expression Pathway.

  7. On Pythagoras Theorem for Products of Spectral Triples

    OpenAIRE

    D'Andrea, Francesco; Martinetti, Pierre

    2013-01-01

    We discuss a version of Pythagoras theorem in noncommutative geometry. Usual Pythagoras theorem can be formulated in terms of Connes' distance, between pure states, in the product of commutative spectral triples. We investigate the generalization to both non pure states and arbitrary spectral triples. We show that Pythagoras theorem is replaced by some Pythagoras inequalities, that we prove for the product of arbitrary (i.e. non-necessarily commutative) spectral triples, assuming only some un...

  8. Targeting Histone Abnormality in Triple Negative Breast Cancer

    Science.gov (United States)

    2015-08-01

    κB pathway in triple negative breast cancer . 8th International Nitric Oxide Conference & 6th International Nitrite/ Nitrate Conference, Cleveland, OH...1 AWARD NUMBER: W81XWH-14-1-0237 TITLE: Targeting Histone Abnormality in Triple-Negative Breast Cancer PRINCIPAL INVESTIGATOR: Yi...TITLE AND SUBTITLE 5a. CONTRACT NUMBER Targeting Histone Abnormality in Triple-Negative Breast Cancer 5b. GRANT NUMBER W81XWH-14-1-0237 5c

  9. The Triple Axis and SPINS Spectrometers.

    Science.gov (United States)

    Trevino, S F

    1993-01-01

    In this paper are described the triple axis and spin polarized inelastic neutron scattering (SPINS) spectrometers which are installed at the NIST Cold Neutron Research Facility (CNRF). The general principle of operation of these two instruments is described in sufficient detail to allow the reader to make an informed decision as to their usefulness for his needs. However, it is the intention of the staff at the CNRF to provide the expert resources for their efficient use in any given situation. Thus, this work is not intended as a user manual but rather as a guide into the range of applicability of the two instruments.

  10. Binaries and triples among asteroid pairs

    Science.gov (United States)

    Pravec, Petr; Scheirich, Peter; Kušnirák, Peter; Hornoch, Kamil; Galád, Adrián

    2015-08-01

    Despite major achievements obtained during the past two decades, our knowledge of the population and properties of small binary and multiple asteroid systems is still far from advanced. There is a numerous indirect evidence for that most small asteroid systems were formed by rotational fission of cohesionless parent asteroids that were spun up to the critical frequency presumably by YORP, but details of the process are lacking. Furthermore, as we proceed with observations of more and more binary and paired asteroids, we reveal new facts that substantially refine and sometimes change our understanding of the asteroid systems. One significant new finding we have recently obtained is that primaries of many asteroid pairs are actually binary or triple systems. The first such case found is (3749) Balam (Vokrouhlický, ApJL 706, L37, 2009). We have found 9 more binary systems among asteroid pairs within our ongoing NEOSource photometric project since October 2012. They are (6369) 1983 UC, (8306) Shoko, (9783) Tensho-kan, (10123) Fideoja, (21436) Chaoyichi, (43008) 1999 UD31, (44620) 1999 RS43, (46829) 1998 OS14 and (80218) 1999 VO123. We will review their characteristics. These paired binaries as we call them are mostly similar to binaries in the general ("background") population (of unpaired asteroids), but there are a few trends. The paired binaries tend to have larger secondaries with D_2/D_1 = 0.3 to 0.5 and they also tend to be wider systems with 8 of the 10 having orbital periods between 30 and 81 hours, than average among binaries in the general population. There may be also a larger fraction of triples; (3749) Balam is a confirmed triple, having a larger close and a smaller distant satellite, and (8306) Shoko and (10123) Fideoja are suspect triples as they show additional rotational lightcurve components with periods of 61 and 38.8 h that differ from the orbital period of 36.2 and 56.5 h, respectively. The unbound secondaries tend to be of the same size or

  11. Designing Broadband Access Networks with Triple Redundancy

    DEFF Research Database (Denmark)

    Pedersen, Jens Myrup; Riaz, Muhammad Tahir; Knudsen, Thomas Phillip

    2005-01-01

    An architecture is proposed for designing broadband access networks, which offer triple redundancy to the end users, resulting in networks providing connectivity even in case of any two independent node or line failures. Two physically independent connections are offered by fiber, and the last...... provided by some wireless solution. Based on experience with planning Fiber To The Home, the architecture is designed to meet a number of demands, making it practicable and useful in realworld network planning. The proposed wired topology is planar, and suitable for being fitted onto the road network...

  12. Experimental observation of triple correlations in fluids

    Directory of Open Access Journals (Sweden)

    M.Ya. Sushko

    2013-03-01

    Full Text Available We present arguments for the hypothesis that under some conditions, triple correlations of density fluctuations in fluids can be detected experimentally by the method of molecular spectroscopy. These correlations manifest themselves in the form of so-called 1.5-(or sesquialteral scattering. The latter is of most significance in the pre-asymptotic vicinity of the critical point and can be registered along certain thermodynamic paths. Its presence in the overall scattering pattern is demonstrated by our processing available experimental data for the depolarization factor. Some consequences of these results are discussed.

  13. Triple valve endocarditis by mycobacterium tuberculosis. A case report

    Directory of Open Access Journals (Sweden)

    Shaikh Quratulain

    2012-09-01

    Full Text Available Abstract Background Granulomas caused by Mycobacterium Tuberculosis have been observed at autopsy in the heart, pre-dominantly in the myocardium and endocardium, but rarely involving the coronary vessels and valvular structures. Mycobacterium tuberculosis valvular endocarditis is extremely rare, with most reports coming from autopsy series. Case presentation We report the case of a 17 year old immunocompetent girl who presented with history of fever, malaise, foot gangrene and a left sided hemiparesis. On investigation she was found to have infective endocarditis involving the aortic, mitral and tricuspid valves. She had developed a right middle cerebral artery stroke. She underwent dual valve replacement and tricuspid repair. The vegetations showed granulomatous inflammation but blood cultures and other biological specimen cultures were negative for any organisms. She was started on antituberculous treatment and anticoagulation. Conclusion This is the first reported case of triple valve endocarditis by Mycobacterium Tuberculosis in an immunocompetent host. Especially important is the fact that the right heart is involved which has been historically described in the setting of intravenous drug abuse. This implies that Tuberculosis should be considered in cases of culture negative endocarditis in endemic areas like Pakistan even in immunocompetent hosts.

  14. Dispersion cancellation in a triple Laue interferometer

    International Nuclear Information System (INIS)

    Lemmel, Hartmut

    2014-01-01

    The concept of dispersion cancellation has been established in light optics to improve the resolution of interferometric measurements on dispersive media. Odd order dispersion cancellation allows to measure phase shifts without defocusing the interferometer due to wave packet displacements, while even order dispersion cancellation allows to measure time lags without losing resolution due to wave packet spreading. We report that either type of dispersion cancellation can be realized very easily in a triple Laue interferometer. Such interferometers are Mach–Zehnder interferometers based on Bragg diffraction, and are commonly used for neutrons and x-rays. Although the first x-ray interferometer was built nearly five decades ago, the feature of dispersion cancellation hasn't been recognized so far because the concept was hardly known in the neutron and x-ray community. However, it explains right away the surprising decoupling of phase shift and spatial displacement that we have discovered recently in neutron interferometry (Lemmel and Wagh 2010 Phys. Rev. A 82 033626). Furthermore, this article might inspire the light optics community to consider whether a triple Laue interferometer for laser light would be useful and feasible. We explain how dispersion cancellation works in neutron interferometry, and we describe the setup rigorously by solving the Schrödinger equation and by calculating the path integral. We point out, that the latter has to be evaluated with special care since in our setup the beam trajectory moves with respect to the crystal lattice of the interferometer. (paper)

  15. Robust Modeling of Stellar Triples in PHOEBE

    Science.gov (United States)

    Conroy, Kyle E.; Prsa, Andrej; Horvat, Martin; Stassun, Keivan G.

    2017-01-01

    The number of known mutually-eclipsing stellar triple and multiple systems has increased greatly during the Kepler era. These systems provide significant opportunities to both determine fundamental stellar parameters of benchmark systems to unprecedented precision as well as to study the dynamical interaction and formation mechanisms of stellar and planetary systems. Modeling these systems to their full potential, however, has not been feasible until recently. Most existing available codes are restricted to the two-body binary case and those that do provide N-body support for more components make sacrifices in precision by assuming no stellar surface distortion. We have completely redesigned and rewritten the PHOEBE binary modeling code to incorporate support for triple and higher-order systems while also robustly modeling data with Kepler precision. Here we present our approach, demonstrate several test cases based on real data, and discuss the current status of PHOEBE's support for modeling these types of systems. PHOEBE is funded in part by NSF grant #1517474.

  16. VERITAS: Versatile Triple-Axis Spectrometer

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Il

    2006-04-15

    Korea Atomic Energy Research Institute is planning to build a cold neutron triple-axis spectrometer at HANARO, the 30 MW research reactor. The spectrometer is expected to be completed in 2008 with the following configuration from the upstream to the downstream. Guide Supermirror m = 2, In-pile Straight Section, {approx} 5 m Curved Guide, {approx} 26 m w/ R 1500 m Straight Guide before the Instrument, {approx} 40 m Filters PG and Be Neutron Velocity Selector (Future) Monochromators Vertically Focusing Monochromators PG(002) and Heusler(111) Doubly Focusing Monochromators (Future) Monochromator-Sample Distance 2 m Collimation C1 Soller Collimators, 20', 40' 80'Beam Height at the Sample Table 1.5 m Sample-Analyzer Distance 1.0 m Collimation C2 Soller Collimators, 20', 40', 80' Radial Collimator Analyzers Horizontally Focusing Analyzers w/ Fixed Vertical Focusing PG(002) and Heusler(111) Analyzer-Detector Distance 0.5 m Detectors 5 cm Tube Detector 25 cm wide Position Sensitive Detector Once completed, the neutron flux at sample is expected to surpass that of SPINS at NCNR, making this instrument one of the most powerful 2nd generation cold neutron triple-axis spectrometers in the world.

  17. VERITAS: Versatile Triple-Axis Spectrometer

    International Nuclear Information System (INIS)

    Park, Sung Il

    2006-04-01

    Korea Atomic Energy Research Institute is planning to build a cold neutron triple-axis spectrometer at HANARO, the 30 MW research reactor. The spectrometer is expected to be completed in 2008 with the following configuration from the upstream to the downstream. Guide Supermirror m = 2, In-pile Straight Section, ∼ 5 m Curved Guide, ∼ 26 m w/ R 1500 m Straight Guide before the Instrument, ∼ 40 m Filters PG and Be Neutron Velocity Selector (Future) Monochromators Vertically Focusing Monochromators PG(002) and Heusler(111) Doubly Focusing Monochromators (Future) Monochromator-Sample Distance 2 m Collimation C1 Soller Collimators, 20', 40' 80'Beam Height at the Sample Table 1.5 m Sample-Analyzer Distance 1.0 m Collimation C2 Soller Collimators, 20', 40', 80' Radial Collimator Analyzers Horizontally Focusing Analyzers w/ Fixed Vertical Focusing PG(002) and Heusler(111) Analyzer-Detector Distance 0.5 m Detectors 5 cm Tube Detector 25 cm wide Position Sensitive Detector Once completed, the neutron flux at sample is expected to surpass that of SPINS at NCNR, making this instrument one of the most powerful 2nd generation cold neutron triple-axis spectrometers in the world

  18. BROWN DWARF BINARIES FROM DISINTEGRATING TRIPLE SYSTEMS

    International Nuclear Information System (INIS)

    Reipurth, Bo; Mikkola, Seppo

    2015-01-01

    Binaries in which both components are brown dwarfs (BDs) are being discovered at an increasing rate, and their properties may hold clues to their origin. We have carried out 200,000 N-body simulations of three identical stellar embryos with masses drawn from a Chabrier IMF and embedded in a molecular core. The bodies are initially non-hierarchical and undergo chaotic motions within the cloud core, while accreting using Bondi–Hoyle accretion. The coupling of dynamics and accretion often leads to one or two dominant bodies controlling the center of the cloud core, while banishing the other(s) to the lower-density outskirts, leading to stunted growth. Eventually each system transforms either to a bound hierarchical configuration or breaks apart into separate single and binary components. The orbital motion is followed for 100 Myr. In order to illustrate 200,000 end-states of such dynamical evolution with accretion, we introduce the “triple diagnostic diagram,” which plots two dimensionless numbers against each other, representing the binary mass ratio and the mass ratio of the third body to the total system mass. Numerous freefloating BD binaries are formed in these simulations, and statistical properties are derived. The separation distribution function is in good correspondence with observations, showing a steep rise at close separations, peaking around 13 AU and declining more gently, reaching zero at separations greater than 200 AU. Unresolved BD triple systems may appear as wider BD binaries. Mass ratios are strongly peaked toward unity, as observed, but this is partially due to the initial assumptions. Eccentricities gradually increase toward higher values, due to the lack of viscous interactions in the simulations, which would both shrink the orbits and decrease their eccentricities. Most newborn triple systems are unstable and while there are 9209 ejected BD binaries at 1 Myr, corresponding to about 4% of the 200,000 simulations, this number has grown to

  19. BROWN DWARF BINARIES FROM DISINTEGRATING TRIPLE SYSTEMS

    Energy Technology Data Exchange (ETDEWEB)

    Reipurth, Bo [Institute for Astronomy and NASA Astrobiology Institute University of Hawaii, 640 N. Aohoku Place, Hilo, HI 96720 (United States); Mikkola, Seppo, E-mail: reipurth@ifa.hawaii.edu, E-mail: Seppo.Mikkola@utu.fi [Tuorla Observatory, University of Turku, Väisäläntie 20, Piikkiö (Finland)

    2015-04-15

    Binaries in which both components are brown dwarfs (BDs) are being discovered at an increasing rate, and their properties may hold clues to their origin. We have carried out 200,000 N-body simulations of three identical stellar embryos with masses drawn from a Chabrier IMF and embedded in a molecular core. The bodies are initially non-hierarchical and undergo chaotic motions within the cloud core, while accreting using Bondi–Hoyle accretion. The coupling of dynamics and accretion often leads to one or two dominant bodies controlling the center of the cloud core, while banishing the other(s) to the lower-density outskirts, leading to stunted growth. Eventually each system transforms either to a bound hierarchical configuration or breaks apart into separate single and binary components. The orbital motion is followed for 100 Myr. In order to illustrate 200,000 end-states of such dynamical evolution with accretion, we introduce the “triple diagnostic diagram,” which plots two dimensionless numbers against each other, representing the binary mass ratio and the mass ratio of the third body to the total system mass. Numerous freefloating BD binaries are formed in these simulations, and statistical properties are derived. The separation distribution function is in good correspondence with observations, showing a steep rise at close separations, peaking around 13 AU and declining more gently, reaching zero at separations greater than 200 AU. Unresolved BD triple systems may appear as wider BD binaries. Mass ratios are strongly peaked toward unity, as observed, but this is partially due to the initial assumptions. Eccentricities gradually increase toward higher values, due to the lack of viscous interactions in the simulations, which would both shrink the orbits and decrease their eccentricities. Most newborn triple systems are unstable and while there are 9209 ejected BD binaries at 1 Myr, corresponding to about 4% of the 200,000 simulations, this number has grown to

  20. Recovery and normalization of triple coincidences in PET

    Energy Technology Data Exchange (ETDEWEB)

    Lage, Eduardo, E-mail: elage@mit.edu; Parot, Vicente; Dave, Shivang R.; Herraiz, Joaquin L. [Madrid-MIT M+Visión Consortium, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States); Moore, Stephen C.; Sitek, Arkadiusz; Park, Mi-Ae [Division of Nuclear Medicine, Department of Radiology, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts 02115 (United States); Udías, Jose M. [Grupo de Física Nuclear, Departamento de Física Atómica Molecular y Nuclear, Universidad Complutense de Madrid, CEI Moncloa, Madrid 28040 (Spain); Vaquero, Juan J. [Departamento de Ingeniería Biomédica e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Leganés 28911 (Spain)

    2015-03-15

    Purpose: Triple coincidences in positron emission tomography (PET) are events in which three γ-rays are detected simultaneously. These events, though potentially useful for enhancing the sensitivity of PET scanners, are discarded or processed without special consideration in current systems, because there is not a clear criterion for assigning them to a unique line-of-response (LOR). Methods proposed for recovering such events usually rely on the use of highly specialized detection systems, hampering general adoption, and/or are based on Compton-scatter kinematics and, consequently, are limited in accuracy by the energy resolution of standard PET detectors. In this work, the authors propose a simple and general solution for recovering triple coincidences, which does not require specialized detectors or additional energy resolution requirements. Methods: To recover triple coincidences, the authors’ method distributes such events among their possible LORs using the relative proportions of double coincidences in these LORs. The authors show analytically that this assignment scheme represents the maximum-likelihood solution for the triple-coincidence distribution problem. The PET component of a preclinical PET/CT scanner was adapted to enable the acquisition and processing of triple coincidences. Since the efficiencies for detecting double and triple events were found to be different throughout the scanner field-of-view, a normalization procedure specific for triple coincidences was also developed. The effect of including triple coincidences using their method was compared against the cases of equally weighting the triples among their possible LORs and discarding all the triple events. The authors used as figures of merit for this comparison sensitivity, noise-equivalent count (NEC) rates and image quality calculated as described in the NEMA NU-4 protocol for the assessment of preclinical PET scanners. Results: The addition of triple-coincidence events with the

  1. Recovery and normalization of triple coincidences in PET.

    Science.gov (United States)

    Lage, Eduardo; Parot, Vicente; Moore, Stephen C; Sitek, Arkadiusz; Udías, Jose M; Dave, Shivang R; Park, Mi-Ae; Vaquero, Juan J; Herraiz, Joaquin L

    2015-03-01

    Triple coincidences in positron emission tomography (PET) are events in which three γ-rays are detected simultaneously. These events, though potentially useful for enhancing the sensitivity of PET scanners, are discarded or processed without special consideration in current systems, because there is not a clear criterion for assigning them to a unique line-of-response (LOR). Methods proposed for recovering such events usually rely on the use of highly specialized detection systems, hampering general adoption, and/or are based on Compton-scatter kinematics and, consequently, are limited in accuracy by the energy resolution of standard PET detectors. In this work, the authors propose a simple and general solution for recovering triple coincidences, which does not require specialized detectors or additional energy resolution requirements. To recover triple coincidences, the authors' method distributes such events among their possible LORs using the relative proportions of double coincidences in these LORs. The authors show analytically that this assignment scheme represents the maximum-likelihood solution for the triple-coincidence distribution problem. The PET component of a preclinical PET/CT scanner was adapted to enable the acquisition and processing of triple coincidences. Since the efficiencies for detecting double and triple events were found to be different throughout the scanner field-of-view, a normalization procedure specific for triple coincidences was also developed. The effect of including triple coincidences using their method was compared against the cases of equally weighting the triples among their possible LORs and discarding all the triple events. The authors used as figures of merit for this comparison sensitivity, noise-equivalent count (NEC) rates and image quality calculated as described in the NEMA NU-4 protocol for the assessment of preclinical PET scanners. The addition of triple-coincidence events with the authors' method increased peak

  2. Stepping Stones Triple P : The importance of putting the findings into context - a response to Tellegen and Sofronoff

    NARCIS (Netherlands)

    Reijneveld, Sijmen A.; Kleefman, Marijke; Jansen, Danielle E. M. C.

    2015-01-01

    Recently, we reported the findings of a randomized controlled trial on the effectiveness of Stepping Stones Triple P (SSTP) compared to Care as Usual (CAU), in BMC Medicine. The study involved parents of 209 children with Borderline to Mild Intellectual Disability (BMID), included following a

  3. Twisted traces of quantum intertwiners and quantum dynamical R-matrices corresponding to generalized Belavin-Drinfeld triples

    International Nuclear Information System (INIS)

    Etingof, P.; Massachusetts Inst. of Tech., Cambridge, MA; Schiffmann, O.

    2001-01-01

    We consider weighted traces of products of intertwining operators for quantum groups U q (g), suitably twisted by a ''generalized Belavin-Drinfeld triple''. We derive two commuting sets of difference equations - the (twisted) Macdonald-Ruijsenaars system and the (twisted) quantum Knizhnik-Zamolodchikov-Bernard (qKZB) system. These systems involve the nonstandard quantum R-matrices defined in a previous joint work with T. Schedler (2000). When the generalized Belavin-Drinfeld triple comes from an automorphism of the Lie algebra g, we also derive two additional sets of difference equations, the dual Macdonald-Ruijsenaars system and the dual qKZB equations. (orig.)

  4. Triple Play Service and IPTV Services Offered within it

    Directory of Open Access Journals (Sweden)

    Dagmar Pajdusakova

    2008-01-01

    Full Text Available This paper deals with Triple Play multimedia service and figures its architecture. Triple Play offers voice, video and data services together in one customer connection. There is offered IPTV (Internet Protocol Television service within this service, where we can include also Video on Demand service and other different additional services. In the paper is described classification of Video on Demand services.

  5. Absolute migration and the evolution of the Rodriguez triple junction ...

    African Journals Online (AJOL)

    The Rodriguez Triple Junction (RTJ) is a junction connecting three mid-ocean ridges in the Indian Ocean: the Southwest Indian Ridge (SWIR), the Central Indian Ridge (CIR) and the Southeast Indian Ridge (SEIR). The evolution of the RTJ has been studied extensively for the past 10 Ma and the triple junction is believed to ...

  6. Government and Governance of Regional Triple Helix Interactions

    Science.gov (United States)

    Danson, Mike; Todeva, Emanuela

    2016-01-01

    This conceptual paper contributes to the discussion of the role of regional government and regional Triple Helix constellations driving economic development and growth within regional boundaries. The impact of regionalism and subsidiarity on regional Triple Helix constellations, and the questions of governmentality, governance and institutional…

  7. Unexpected Hydration of a Triple Bond During DNA Synthesis

    DEFF Research Database (Denmark)

    Fatthalla, Maha I.; Pedersen, Erik B.

    2016-01-01

    acidic conditions, polarizes the triple bond in the intercalator and this makes hydration of the triple bond possible during the DNA synthesis and an oligonucleotide with 1-(indol-3-yl)-2-(pyren-1-yl)ethanone as the intercalator is formed. Insertion of the unhydrated and hydrated linker systems gave...

  8. Triple junction polymer solar cells for photoelectrochemical water splitting

    NARCIS (Netherlands)

    Esiner, S.; Eersel, van H.; Wienk, M.M.; Janssen, R.A.J.

    2013-01-01

    A triple junction polymer solar cell in a novel 1 + 2 type configuration provides photoelectrochemical water splitting in its maximum power point at V ˜ 1.70 V with an estimated solar to hydrogen energy conversion efficiency of 3.1%. The triple junction cell consists of a wide bandgap front cell and

  9. Regional Dimensions of the Triple Helix Model: Setting the Context

    Science.gov (United States)

    Todeva, Emanuela; Danson, Mike

    2016-01-01

    This paper introduces the rationale for the special issue and its contributions, which bridge the literature on regional development and the Triple Helix model. The concept of the Triple Helix at the sub-national, and specifically regional, level is established and examined, with special regard to regional economic development founded on…

  10. "Special Issue": Regional Dimensions of the Triple Helix Model

    Science.gov (United States)

    Todeva, Emanuela; Danson, Mike

    2016-01-01

    This paper introduces the rationale for the special issue and its contributions, which bridge the literature on regional development and the Triple Helix model. The concept of the Triple Helix at the sub-national, and specifically regional, level is established and examined, with special regard to regional economic development founded on…

  11. Rooted triple consensus and anomalous gene trees

    Directory of Open Access Journals (Sweden)

    Schmidt Heiko A

    2008-04-01

    Full Text Available Abstract Background Anomalous gene trees (AGTs are gene trees with a topology different from a species tree that are more probable to observe than congruent gene trees. In this paper we propose a rooted triple approach to finding the correct species tree in the presence of AGTs. Results Based on simulated data we show that our method outperforms the extended majority rule consensus strategy, while still resolving the species tree. Applying both methods to a metazoan data set of 216 genes, we tested whether AGTs substantially interfere with the reconstruction of the metazoan phylogeny. Conclusion Evidence of AGTs was not found in this data set, suggesting that erroneously reconstructed gene trees are the most significant challenge in the reconstruction of phylogenetic relationships among species with current data. The new method does however rule out the erroneous reconstruction of deep or poorly resolved splits in the presence of lineage sorting.

  12. Radiation sterilization of triple sugar iron agar

    International Nuclear Information System (INIS)

    Altmann, G.; Eisenberg, E.; Bogokowsky, B.

    1979-01-01

    Triple sugar iron agar (TSI), a medium used for the identification of enteric bacteria, was sterilized by gamma radiation using radiation doses of 750-2000 krad. The radio-sterilized medium, slightly modified by increasing its Phenol Red content, performed well when tested with different enterobacteriaceae and other gram negative bacteria. Growth, change of indicator reaction in slant and butt and formation of gas and H 2 S were equal in irradiated and autoclaved TSI. Slants of irradiated TSI in stoppered plastic tubes kept their diagnostic properties during storage for at least 4 months. Gamma irradiation appears to be an attractive and economical method of sterilising nutrient media in sealed tubes or other containers, avoiding the risk of contamination during processing. (author)

  13. Triple-layer smart grid business model

    DEFF Research Database (Denmark)

    Ma, Zheng; Lundgaard, Morten; Jørgensen, Bo Nørregaard

    2016-01-01

    Viewing the smart grid with the theory of business models may open opportunities in understanding and capturing values in new markets. This study tries to discover and map the smart grid ecosystem-based business model framework with two different environments (sub-Saharan Africa and Denmark......), and identifies the parameters for the smart grid solutions to the emerging markets. This study develops a triple-layer business model including the organizational (Niche), environmental (Intermediate), and global (Dominators) factors. The result uncovers an interface of market factors and stakeholders...... in a generic smart grid constellation. The findings contribute the transferability potential of the smart grid solutions between countries, and indicate the potential to export and import smart grid solutions based on the business modeling....

  14. Polarized triple-axis spectrometer TASP

    Energy Technology Data Exchange (ETDEWEB)

    Boeni, P; Keller, P [Lab. for Neutron Scattering ETH Zurich, Zurich (Switzerland) and Paul Scherrer Institute, Villigen (Switzerland)

    1996-11-01

    The polarized triple-axis spectrometer TASP at SINQ has been optimized for measuring magnetic cross sections in condensed matter. The neutrons are polarized or analyzed either by means of benders or Heusler monochromators. The beam divergence, i.e. the intensity, and the spectral range of the neutrons is rather large because of the supermirror coatings of the feeding neutron guide. The intensity can be further increased at the sample position by means of a focussing monochromator and a focussing anti-trumpet. The end position of TASP allows the tailoring of the neutron beam already before the monochromator and to scatter neutrons over very wide ranges of angles. (author) 6 figs., 1 tab., 8 refs.

  15. RITA-type triple axis spectrometers

    International Nuclear Information System (INIS)

    Roennow, H.M.

    2001-01-01

    The RITA spectrometer at Risoe National Laboratory was the first to incorporate a complete re-thinking of the neutron-path from source, through detector to analysis. Since then, other RITA-type spectrometers such as SPINS at NIST, RITA-II at PSI have been built, and several new spectrometers around the world are adapting the same philosophy. The main novelty of RITA was the introduction of a single back-end tank featuring both an analyser block with multiple individually turnable analyser blades and a 2D position sensitive detector. Several new triple-axis spectrometers are presently being built at existing and future sources, and almost all of them have learnt from the experience with RITA. (R.P.)

  16. About the Triple A. Argentina 1973 - 1976

    OpenAIRE

    Rostica, Julieta

    2011-01-01

    El 25 de mayo de 1973 el peronismo volvió a gobernar la Argentina tras aproximadamente dos décadas de proscripción y persecución política. Tras su establecimiento, ciertos crímenes comenzaron a ser firmados con “AAA”. La Triple A tuvo la particularidad de desaparecer con el golpe de Estado del 24 de marzo de 1976. ¿Por qué esta organización sólo pudo existir en una democracia erigida en medio de dos dictaduras militares? ¿Por qué existió durante el tan anhelado gobierno peronista? El artículo...

  17. A randomized controlled trial of group Stepping Stones Triple P: a mixed-disability trial.

    Science.gov (United States)

    Roux, Gemma; Sofronoff, Kate; Sanders, Matthew

    2013-09-01

    Stepping Stones Triple P (SSTP) is a parenting program designed for families of a child with a disability. The current study involved a randomized controlled trial of Group Stepping Stones Triple P (GSSTP) for a mixed-disability group. Participants were 52 families of children diagnosed with an Autism Spectrum Disorder, Down syndrome, Cerebral Palsy, or an intellectual disability. The results demonstrated significant improvements in parent-reported child behavior, parenting styles, parental satisfaction, and conflict about parenting. Results among participants were similar despite children's differing impairments. The intervention effect was maintained at 6-month follow-up. The results indicate that GSSTP is a promising intervention for a mixed-disability group. Limitations of the study, along with areas for future research, are also discussed. © FPI, Inc.

  18. Triple negative breast cancer: an Indian perspective

    Directory of Open Access Journals (Sweden)

    Akhtar M

    2015-08-01

    Full Text Available Murtaza Akhtar, Subhrajit Dasgupta, Murtuza Rangwala Department of Surgery, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India Introduction: Breast cancer is the most common female cancer in the world. Triple negative breast cancer (TNBC is a recently identified biological variant with aggressive tumor behavior and poor prognosis. Data of hormonal status from the Indian population is scarce due to financial constraints in performing immunohistochemistry evaluation. The present study aims to prospectively analyze receptor status of all breast cancer patients and identify TNBC and compare their clinical profile and short term survival with other non-TNBC group. Materials and methods: All cytologically and histopathologically confirmed cases of carcinoma breast were prospectively enrolled. In a longitudinal study at tertiary care hospital in central India based on the hormonal status, they were further divided into TNBC and other groups. Comparison of risk factors, clinical profile and short-term survival was carried out. Results: A total 85 patients were enrolled and of them 37 (43.7% were TNBC. On comparing risk factors ie, age, age at menarche, total reproductive age, age at first child birth, and menopausal status – no statistical significance was observed between the TNBC and non-TNBC groups. But on comparison of clinical profile TNBC tumors were significantly large with majority of patients presenting as locally advanced breast cancer (83%. No statistical difference was observed in axillary lymph node status between two groups. TNBC tumors were histologically more aggressive (grade 3 compared to other groups. No statistically significant difference was observed in short term overall survival but all three deaths were observed in the TNBC group only and two local recurrences after surgery were observed in the TNBC group. Conclusion: TNBC forms a large proportion of carcinoma breast patients in a central

  19. Fractura triple del complejo suspensorio del hombro

    Directory of Open Access Journals (Sweden)

    Eraclio Delgado Rifá

    2015-06-01

    Full Text Available El complejo suspensorio del hombro es una estructura sumamente importante, compuesta por un anillo de huesos y tejidos blandos. Las lesiones aisladas de este complejo anatómico son frecuentes y no afectan su estabilidad. La interrupción doble conduce a la inestabilidad de esta estructura y usualmente requiere tratamiento quirúrgico. La triple interrupción, por su parte, es sumamente rara y es encontrada en casos de trauma de alta energía a menudo en asociación con otras lesiones. Se presenta una triple lesión del complejo suspensorio del hombro en un paciente de 46 años de edad, con una fractura de la glenoides, del acromion tipo III de Kuhn y de la coracoides tipo II de Ogawa. En este caso, la fractura del acromion fue tratada con fijación percutánea con alambres de Kirschner, por tener asociado lesiones de partes blandas que contraindicaron la reducción abierta. La fractura de la glenoides y de la apófisis coracoides fueron tratadas conservadoramente. Después de 6 meses de evolución, el paciente tuvo un resultado funcional aceptable, con una abducción de 90 grados, los 30 grados de rotación externa y 70 de rotación interna, además asintomático y consolidación de todas las fracturas. A pesar de ser catalogada de una lesión grave del cinturón escapular y estar asociada a otras lesiones se obtuvo un resultado satisfactorio al final del tratamiento.

  20. Adult intussusception: 14 case reports and their outcomes Intususcepción en el adulto: Revisión de 14 casos y su seguimiento

    Directory of Open Access Journals (Sweden)

    M. P. Guillén-Paredes

    2010-01-01

    Full Text Available Aims: to analyze diagnostic and therapeutic options depending on the clinical symptoms, location, and lesions associated with intussusception, together with their follow-up and complications. Patients and methods: patients admitted to the Morales Meseguer General University Hospital (Murcia between January 1995 and January 2009, and diagnosed with intestinal invagination. Data related to demographic and clinical features, complementary explorations, presumptive diagnosis, treatment, follow-up, and complications were collected. Results: there were 14 patients (7 males and 7 females; mean age: 41.9 years-range: 17-77 who presented with abdominal pain. The most reliable diagnostic technique was computed tomography (8 diagnoses from 10 CT scans. A preoperative diagnosis was established in 12 cases. Invaginations were ileocolic in 8 cases (the most common, enteric in 5, and colocolic in 2 (coexistence of 2 lesions in one patient. The etiology of these intussusceptions was idiopathic or secondary to a lesion acting as the lead point for invagination. Depending on the nature of this lead point, the cause of the enteric intussusceptions was benign in 3 cases and malignant in 2. Ileocolic invaginations were divided equally (4 benign and 4 malignant, and colocolic lesions were benign (2 cases. Conservative treatment was implemented for 4 patients and surgery for 10 (7 in emergency. Five right hemicolectomies, 3 small-bowel resections, 2 left hemicolectomies, and 1 ileocecal resection were performed. Surgical complications: 3 minor and 1 major (with malignant etiology and subsequent death. The lesion disappeared after 3 days to 6 weeks in patients with conservative management. Mean follow-up was 28.25 months (range: 5-72 months. Conclusions: a suitable imaging technique, preferably CT, is important for the diagnosis of intussusception. Surgery is usually necessary but we favor conservative treatment in selected cases.Objetivos: analizar las opciones terap

  1. A very rare case of a small bowel leiomyosarcoma leading to ileocaecal intussusception treated with a laparoscopic resection: a case report and a literature review.

    Science.gov (United States)

    Guzel, Tomasz; Mech, Katarzyna; Mazurkiewicz, Michał; Dąbrowski, Bohdan; Lech, Gustaw; Chaber, Andrzej; Słodkowski, Maciej

    2016-02-24

    Small bowel tumours are rare and comprise less than 2% of all primary gastrointestinal neoplasms. Among these tumours, a leiomyosarcoma belonging to soft tissue sarcomas is extremely rare and accounts for about 1 % of malignant mesenchymal lesions in the gastrointestinal tract. Due to its aggressive nature and slow growth, it is often diagnosed at the late stage when curative treatment is impossible. Authors report a first case of leiomyosarcoma with chronic recurrent ileocaecal intussusception and literature review to analyse diagnosis and treatment features of the ileum mesenchymal tumours. We present a case of an 87-year-old Caucasian man suffering from cramp-like abdominal pain for months. Due to lack of clinical signs and unspecific complaints, a diagnosis was delayed. Despite a detailed in-hospital examination, a proper diagnosis was established as late as during an operation. The patient was treated by surgery with good results. An uncommon laparoscopic resection of the small bowel with a tumour was performed. A histopathological investigation confirmed a very rare mesenchymal lesion of the distal ileum. The patient is under control with no recurrence for 1 year of the follow-up period. Reported case indicates that a usually asymptomatic tumour can cause uncommon chronic recurrent ileus signs. CT and MRI scans are investigation of choice in such cases, but they are sometimes inconclusive. It might be worth highlighting the good results of laparoscopic leiomyosarcoma lesion resection with a very good outcome.

  2. On Pythagoras Theorem for Products of Spectral Triples

    Science.gov (United States)

    D'Andrea, Francesco; Martinetti, Pierre

    2013-05-01

    We discuss a version of Pythagoras theorem in noncommutative geometry. Usual Pythagoras theorem can be formulated in terms of Connes' distance, between pure states, in the product of commutative spectral triples. We investigate the generalization to both non-pure states and arbitrary spectral triples. We show that Pythagoras theorem is replaced by some Pythagoras inequalities, that we prove for the product of arbitrary (i.e. non-necessarily commutative) spectral triples, assuming only some unitality condition. We show that these inequalities are optimal, and we provide non-unital counter-examples inspired by K-homology.

  3. Triple test cross analysis for salinity tolerance in wheat

    International Nuclear Information System (INIS)

    Zafar, M.; Khan, A.S.; Chowdhry, M.A.

    2008-01-01

    Triple test cross analysis applied to study additive, dominance and epistatic components of genetic variation for five seedling traits namely shoot length, fresh shoot weight, root length, fresh root weight and root shoot ratio at two salinity levels 0 (control) and 10 dSm/sup -1/ in wheat. The results revealed that the epistatic component is an important element for salinity tolerance at seedling stage in wheat. Both additive and dominance gene effects were involved in the inheritance of shoot length, fresh shoot weight, root length fresh root weight and root shoot ratio Complete dominance was indicated for shoot length, fresh root weight and root/shoot ratio and partial dominance was observed for other traits at control and over dominance was observed for shoot length, fresh shoot weight and root/shoot ratio, complete dominance for fresh root weight and partial dominance for root length at 10 dSm/sup -1/ salinity level. Significant epitasis was observed for all the traits except shoot length at both the salinity treatments. (author)

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

    Science.gov (United States)

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

    2015-09-09

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

  5. The First Experience of Triple Nerve Transfer in Proximal Radial Nerve Palsy.

    Science.gov (United States)

    Emamhadi, Mohammadreza; Andalib, Sasan

    2018-01-01

    Injury to distal portion of posterior cord of brachial plexus leads to palsy of radial and axillary nerves. Symptoms are usually motor deficits of the deltoid muscle; triceps brachii muscle; and extensor muscles of the wrist, thumb, and fingers. Tendon transfers, nerve grafts, and nerve transfers are options for surgical treatment of proximal radial nerve palsy to restore some motor functions. Tendon transfer is painful, requires a long immobilization, and decreases donor muscle strength; nevertheless, nerve transfer produces promising outcomes. We present a patient with proximal radial nerve palsy following a blunt injury undergoing triple nerve transfer. The patient was involved in a motorcycle accident with complete palsy of the radial and axillary nerves. After 6 months, on admission, he showed spontaneous recovery of axillary nerve palsy, but radial nerve palsy remained. We performed triple nerve transfer, fascicle of ulnar nerve to long head of the triceps branch of radial nerve, flexor digitorum superficialis branch of median nerve to extensor carpi radialis brevis branch of radial nerve, and flexor carpi radialis branch of median nerve to posterior interosseous nerve, for restoration of elbow, wrist, and finger extensions, respectively. Our experience confirmed functional elbow, wrist, and finger extensions in the patient. Triple nerve transfer restores functions of the upper limb in patients with debilitating radial nerve palsy after blunt injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Triple-porosity/permeability flow in faulted geothermal reservoirs: Two-dimensional effects

    Energy Technology Data Exchange (ETDEWEB)

    Cesar Suarez Arriaga, M. [Michoacan Univ. & CFE, Mich. (Mexico); Samaniego Verduzco, F. [National Autonomous Univ. of Mexico, Coyoacan (Mexico)

    1995-03-01

    An essential characteristic of some fractured geothermal reservoirs is noticeable when the drilled wells intersect an open fault or macrofracture. Several evidences observed, suggest that the fluid transport into this type of systems, occurs at least in three stages: flow between rock matrix and microfractures, flow between fractures and faults and flow between faults and wells. This pattern flow could define, by analogy to the classical double-porosity model, a triple-porosity, triple-permeability concept. From a mathematical modeling point of view, the non-linearity of the heterogeneous transport processes, occurring with abrupt changes on the petrophysical properties of the rock, makes impossible their exact or analytic solution. To simulate this phenomenon, a detailed two-dimensional geometric model was developed representing the matrix-fracture-fault system. The model was solved numerically using MULKOM with a H{sub 2}O=CO{sub 2} equation of state module. This approach helps to understand some real processes involved. Results obtained from this study, exhibit the importance of considering the triple porosity/permeability concept as a dominant mechanism producing, for example, strong pressure gradients between the reservoir and the bottom hole of some wells.

  7. Genome-wide binding of transcription factor ZEB1 in triple-negative breast cancer cells.

    Science.gov (United States)

    Maturi, Varun; Enroth, Stefan; Heldin, Carl-Henrik; Moustakas, Aristidis

    2018-05-10

    Zinc finger E-box binding homeobox 1 (ZEB1) is a transcriptional regulator involved in embryonic development and cancer progression. ZEB1 induces epithelial-mesenchymal transition (EMT). Triple-negative human breast cancers express high ZEB1 mRNA levels and exhibit features of EMT. In the human triple-negative breast cancer cell model Hs578T, ZEB1 associates with almost 2,000 genes, representing many cellular functions, including cell polarity regulation (DLG2 and FAT3). By introducing a CRISPR-Cas9-mediated 30 bp deletion into the ZEB1 second exon, we observed reduced migratory and anchorage-independent growth capacity of these tumor cells. Transcriptomic analysis of control and ZEB1 knockout cells, revealed 1,372 differentially expressed genes. The TIMP metallopeptidase inhibitor 3 and the teneurin transmembrane protein 2 genes showed increased expression upon loss of ZEB1, possibly mediating pro-tumorigenic actions of ZEB1. This work provides a resource for regulators of cancer progression that function under the transcriptional control of ZEB1. The data confirm that removing a single EMT transcription factor, such as ZEB1, is not sufficient for reverting the triple-negative mesenchymal breast cancer cells into more differentiated, epithelial-like clones, but can reduce tumorigenic potential, suggesting that not all pro-tumorigenic actions of ZEB1 are linked to the EMT. © 2018 The Authors. Journal of Cellular Physiology Published by Wiley Periodicals, Inc.

  8. Hermitian (ϵ,δ)-Freudenthal-Kantor Triple Systems and Certain Applications of *-Generalized Jordan Triple Systems to Field Theory

    International Nuclear Information System (INIS)

    Kamiya, Noriaki; Sato, Matsuo

    2014-01-01

    We define Hermitian (ϵ,δ)-Freudenthal-Kantor triple systems and prove a structure theorem. We also give some examples of triple systems that are generalizations of the u(N)⊕u(M) and sp(2N)⊕u(1) Hermitian 3-algebras. We apply a *-generalized Jordan triple system to a field theory and obtain a Chern-Simons gauge theory. We find that the novel Higgs mechanism works, where the Chern-Simons gauge theory reduces to a Yang-Mills theory in a certain limit

  9. Recurrent small intestine intussusception in a patient with Peutz-Jeghers syndrome Invaginación recurrente del intestino delgado en un paciente con síndrome de Pentz-Jeghers

    Directory of Open Access Journals (Sweden)

    Orestis Ioannidis

    2012-01-01

    Full Text Available Peutz-Jeghers syndrome is a rare hereditary autosomal dominant disease caused by a mutation of the tumor suppressor gene serine/threonine kinase 11 located in chromosome 19p13.3. It is characterized by the presence of extensive mucocutaneous pigmentation, especially of the lips and the occurrence of hamartomatous polyps throughout the gastrointestinal tract. Gastrointestinal hamartomas occur predominantly in the small intestine and can become symptomatic leading usually to intestinal obstruction and abdominal pain. We present a case of recurrent intestinal obstruction caused by small bowel intussusception treated by reduction, enterotomy and polypectomy and followed by intraoperative enteroscopy and endoscopic polypectomy.

  10. Applications of tripled chaotic maps in cryptography

    International Nuclear Information System (INIS)

    Behnia, S.; Akhshani, A.; Akhavan, A.; Mahmodi, H.

    2009-01-01

    Security of information has become a major issue during the last decades. New algorithms based on chaotic maps were suggested for protection of different types of multimedia data, especially digital images and videos in this period. However, many of them fundamentally were flawed by a lack of robustness and security. For getting higher security and higher complexity, in the current paper, we introduce a new kind of symmetric key block cipher algorithm that is based on tripled chaotic maps. In this algorithm, the utilization of two coupling parameters, as well as the increased complexity of the cryptosystem, make a contribution to the development of cryptosystem with higher security. In order to increase the security of the proposed algorithm, the size of key space and the computational complexity of the coupling parameters should be increased as well. Both the theoretical and experimental results state that the proposed algorithm has many capabilities such as acceptable speed and complexity in the algorithm due to the existence of two coupling parameters and high security. Note that the ciphertext has a flat distribution and has the same size as the plaintext. Therefore, it is suitable for practical use in secure communications.

  11. Triple echo steady-state (TESS) relaxometry.

    Science.gov (United States)

    Heule, Rahel; Ganter, Carl; Bieri, Oliver

    2014-01-01

    Rapid imaging techniques have attracted increased interest for relaxometry, but none are perfect: they are prone to static (B0 ) and transmit (B1 ) field heterogeneities, and commonly biased by T2 /T1 . The purpose of this study is the development of a rapid T1 and T2 relaxometry method that is completely (T2 ) or partly (T1 ) bias-free. A new method is introduced to simultaneously quantify T1 and T2 within one single scan based on a triple echo steady-state (TESS) approach in combination with an iterative golden section search. TESS relaxometry is optimized and evaluated from simulations, in vitro studies, and in vivo experiments. It is found that relaxometry with TESS is not biased by T2 /T1 , insensitive to B0 heterogeneities, and, surprisingly, that TESS-T2 is not affected by B1 field errors. Consequently, excellent correspondence between TESS and reference spin echo data is observed for T2 in vitro at 1.5 T and in vivo at 3 T. TESS offers rapid T1 and T2 quantification within one single scan, and in particular B1 -insensitive T2 estimation. As a result, the new proposed method is of high interest for fast and reliable high-resolution T2 mapping, especially of the musculoskeletal system at high to ultra-high fields. Copyright © 2013 Wiley Periodicals, Inc.

  12. Triple Isotope Water Analyzer for Extraplanetary Studies, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Los Gatos Research (LGR) proposes to employ Off-Axis ICOS to develop triple-isotope water analyzers for lunar and other extraplanetary exploration. This instrument...

  13. Uncovering the triple omeron vertex from Wilson line formalism

    International Nuclear Information System (INIS)

    Chirilli, G. A.; Szymanowski, L.; Wallon, S.

    2011-01-01

    We compute the triple omeron vertex from the Wilson line formalism, including both planar and nonplanar contributions, and get perfect agreement with the result obtained in the Extended Generalized Logarithmic Approximation based on Reggeon calculus.

  14. Tripled Fixed Point in Ordered Multiplicative Metric Spaces

    Directory of Open Access Journals (Sweden)

    Laishram Shanjit

    2017-06-01

    Full Text Available In this paper, we present some triple fixed point theorems in partially ordered multiplicative metric spaces depended on another function. Our results generalise the results of [6] and [5].

  15. Triple-membrane reduces need for ion exchange regeneration

    International Nuclear Information System (INIS)

    Valcour, H.

    1989-01-01

    Triple-membrane water treatment systems are comprised of ultrafiltration units for pretreatment, electrodialysis reversal primary demineralizers, reverse osmosis secondary demineralizers, portable ion exchange unit polishing demineralizers, and ultraviolet sterilizers. The triple-membrane process is designed to provide an unprecedented degree of pretreatment to maximize efficiency, durability and reliability of the reverse osmosis, whilst reducing the required regeneration frequency of the ion exchange demineralizer by one to two orders of magnitude. (author)

  16. Modified Genta triple stain for identifying Helicobacter pylori.

    OpenAIRE

    el-Zimaity, H M; Wu, J; Graham, D Y

    1999-01-01

    AIM: To evaluate whether lead nitrate could replace uranyl nitrate in the Genta stain for H pylori without sacrificing the advantages of the triple stain (Steiner silver impregnation combined with Alcian blue and haematoxylin/eosin (H&E)). METHODS: A comparison was made in 16 specimens between the original triple stain and the revised version. One pathologist evaluated all sections. RESULTS: Direct substitution of lead nitrate for uranium nitrate produced well stained organisms without interf...

  17. Immunohistochemical Characteristics of Triple Negative/Basal-like Breast Cancer

    OpenAIRE

    Emel Ebru PALA; Ümit BAYOL; Süheyla CUMURCU; Elif KESKİN

    2012-01-01

    Objective: Triple-negative-breast-cancer that accounts for 10-20% of all breast carcinomas is defined by the lack of estrogen receptor, progesterone receptor, HER2 expression, and agressive clinical behavior. Triple-negative-breast-cancer is categorized into basal like and other types. The basal-like subtype is characterized by the expression of myoepithelial/basal markers.Material and Method: We studied 41 immunohistochemically triplenegative- breast-cancer patients to determine EGFR, Cytoke...

  18. Targeting Prolyl Peptidases in Triple-Negative Breast Cancer

    Science.gov (United States)

    2017-02-01

    ABSTRACT Triple negative breast cancer (TNBC) is an aggressive sub-type with limited treatment options and poor prognosis. The most life -threatening... negative feedback loops within the pathway limit their effectiveness . For example, AKT inhibitors cause increased expression of IGF1R/ErbB3 and, as a...AWARD NUMBER: W81XWH-16-1-0025 TITLE: Targeting Prolyl Peptidases in Triple- Negative Breast Cancer PRINCIPAL INVESTIGATOR: Carl G. Maki, PhD

  19. Warps, grids and curvature in triple vector bundles

    Science.gov (United States)

    Flari, Magdalini K.; Mackenzie, Kirill

    2018-06-01

    A triple vector bundle is a cube of vector bundle structures which commute in the (strict) categorical sense. A grid in a triple vector bundle is a collection of sections of each bundle structure with certain linearity properties. A grid provides two routes around each face of the triple vector bundle, and six routes from the base manifold to the total manifold; the warps measure the lack of commutativity of these routes. In this paper we first prove that the sum of the warps in a triple vector bundle is zero. The proof we give is intrinsic and, we believe, clearer than the proof using decompositions given earlier by one of us. We apply this result to the triple tangent bundle T^3M of a manifold and deduce (as earlier) the Jacobi identity. We further apply the result to the triple vector bundle T^2A for a vector bundle A using a connection in A to define a grid in T^2A . In this case the curvature emerges from the warp theorem.

  20. Effect of Pretreatment with Lactobacillus delbrueckii and Streptococcus thermophillus on Tailored Triple Therapy for Helicobacter pylori Eradication: A Prospective Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Tongtawee, Taweesak; Dechsukhum, Chavaboon; Leeanansaksiri, Wilairat; Kaewpitoon, Soraya; Kaewpitoon, Natthawut; Loyd, Ryan A; Matrakool, Likit; Panpimanmas, Sukij

    2015-01-01

    Helicobacter pylori plays an important role in gastric cancer and typical eradication regimens are no longer effective in many countries, including Thailand. The aim of our study was to compare the effect of Lactobacillus delbrueckii and Streptococcus thermophillus on tailored triple therapy for Helicobacter pylori eradication. This prospective single-center study was conducted in Thailand. Helicobacter pylori associated gastritis patients were randomized to 2 groups: group 1 (n=100) was tailored triple therapy with placebo (esomeprazole 20 mg bid, clarithromycin 500 mg bid or metronidazole 400 mg tid if clarithromycin resistance and amoxicillin 1000 mg bid), and group 2 was tailored triple therapy plus pretreatment with probiotic containing yogurt. Successful eradication was defined as both negative histology and negative rapid urease test at four weeks after treatment. A total of 200 infected patients were enrolled. PP analysis involved 194 patients: 96 in the tailored triple therapy with placebo group (group 1) and 98 the in tailored triple therapy plus pretreatment with probiotic containing yogurt group (group 2). Successful eradication was observed in 170 (87.6%) patients; by PP analysis, the eradication rate was significantly higher in group 2 (P=0.04, 95%CI; 0.02-0.13) than in group 1. ITT analysis also showed that the value was significantly higher in the tailored triple threapy plus pretreatment with probiotic containing yogurt group (group 2) (89/100; 89%) than in the tailored triple therapy with placebo group (group 1) (P=0.01, 95%CI; 0.04-0.15). In terms of adverse events, there was no significant difference between the two groups. Pretreatment with probiotic containing yogurt can improve Helicobacter pylori eradication rates with tailored triple therapy. Adding probiotics does not reduce adverse effects of the medication.

  1. Parental involvement

    Directory of Open Access Journals (Sweden)

    Ezra S Simon

    2005-01-01

    Full Text Available Parent-Teacher Associations and other community groups can play a significant role in helping to establish and run refugee schools; their involvement can also help refugee adults adjust to their changed circumstances.

  2. The triple-A supply chain.

    Science.gov (United States)

    Lee, Hau L

    2004-10-01

    Building a strong supply chain is essential for business success. But when it comes to improving their supply chains, few companies take the right approach. Many businesses work to make their chains faster or more cost-effective, assuming that those steps are the keys to competitive advantage. To the contrary: Supply chains that focus on speed and costs tend to deteriorate over time. The author has spent 15 years studying more than 60 companies to gain insight into this and other supply chain dilemmas. His conclusion: Only companies that build supply chains that are agile, adaptable, and aligned get ahead of their rivals. All three components are essential; without any one of them, supply chains break down. Great companies create supply chains that respond to abrupt changes in markets. Agility is critical because in most industries, both demand and supply fluctuate rapidly and widely. Supply chains typically cope by playing speed against costs, but agile ones respond both quickly and cost-efficiently. Great companies also adapt their supply networks when markets or strategies change. The best supply chains allow managers to identify structural shifts early by recording the latest data, filtering out noise, and tracking key patterns. Finally, great companies align the interests of the partners in their supply chains with their own. That's important because every firm is concerned solely with its own interests. If its goals are out of alignment with those of other partners in the supply chain, performance will suffer. When companies hear about the triple-A supply chain, they assume that building one will require increased technology and investment. But most firms already have the infrastructure in place to create one. A fresh attitude alone can go a long way toward making it happen.

  3. Heterotopic pancreas in Meckel′s diverticulum in a 7-year-old child with intussusception and recurrent gastrointestinal bleeding: Case report and literature review focusing on diagnostic controversies

    Directory of Open Access Journals (Sweden)

    Guanà Riccardo

    2014-01-01

    Full Text Available Meckel′s diverticulum, the most common congenital abnormality of the small intestine, may be associated to heterotopic pancreas, often diagnosed incidentally on histopathological examination. Intussusception affects infants between the ages of 5 and 9 months, but it may also occur in older children, teenagers and adults, and in some cases can be derived by a Meckel′s diverticulum resulting in acute abdomen. We analyse the management and the recent literature on similar cases, describing diagnostic options. In May 2013, a 7-year-old girl admitted to our hospital with recurrent gastrointestinal bleeding, was discovered to have an ileoileal intussusception with a leading Meckel′s diverticulum with heterotopic pancreatic tissue. This association is rare evidence in children and its proper management can be controversial, in particular from a diagnostic point of view. In such cases, preoperative radiological diagnosis can be only suspected in the presence of suggestive signs, more often depicted by ultrasound or computed tomography scan. During laparotomy an accurate exploration of all ileum is recommended, for the possibility to find others heterotopic segments.

  4. Collagenolytic Matrix Metalloproteinase Activities toward Peptomeric Triple-Helical Substrates.

    Science.gov (United States)

    Stawikowski, Maciej J; Stawikowska, Roma; Fields, Gregg B

    2015-05-19

    Although collagenolytic matrix metalloproteinases (MMPs) possess common domain organizations, there are subtle differences in their processing of collagenous triple-helical substrates. In this study, we have incorporated peptoid residues into collagen model triple-helical peptides and examined MMP activities toward these peptomeric chimeras. Several different peptoid residues were incorporated into triple-helical substrates at subsites P3, P1, P1', and P10' individually or in combination, and the effects of the peptoid residues were evaluated on the activities of full-length MMP-1, MMP-8, MMP-13, and MMP-14/MT1-MMP. Most peptomers showed little discrimination between MMPs. However, a peptomer containing N-methyl Gly (sarcosine) in the P1' subsite and N-isobutyl Gly (NLeu) in the P10' subsite was hydrolyzed efficiently only by MMP-13 [nomenclature relative to the α1(I)772-786 sequence]. Cleavage site analysis showed hydrolysis at the Gly-Gln bond, indicating a shifted binding of the triple helix compared to the parent sequence. Favorable hydrolysis by MMP-13 was not due to sequence specificity or instability of the substrate triple helix but rather was based on the specific interactions of the P7' peptoid residue with the MMP-13 hemopexin-like domain. A fluorescence resonance energy transfer triple-helical peptomer was constructed and found to be readily processed by MMP-13, not cleaved by MMP-1 and MMP-8, and weakly hydrolyzed by MT1-MMP. The influence of the triple-helical structure containing peptoid residues on the interaction between MMP subsites and individual substrate residues may provide additional information about the mechanism of collagenolysis, the understanding of collagen specificity, and the design of selective MMP probes.

  5. Comparative study on mammography between triple negative and triple positive breast cancer

    International Nuclear Information System (INIS)

    Cui Chunxiao; Lin Qing; Yang Qing; Zhang Chuanyu; Wang Shaohua; Yu Hualong; Duan Feng; Liu Shihe

    2012-01-01

    Objective: To analyze the mammographic findings of triple-negative breast cancer [TNBC, which is estrogen receptor (ER) negative, progesterone receptor (PR) negative, and human epidermal growth factor receptor 2 (HER2) negative] and triple-positive breast cancer (TPBC, which is ER positive, PR positive, and HER2 positive), and to evaluate the relationship of immunohistochemologic receptor status and mammographic findings. Methods: The immunohistochemistry results of 631 cases with breast cancers were reviewed, including 117 cases of TNBC and 44 cases of TPBC. All of the patients took mammography at initial diagnosis. We retrospectively evaluated the visibility, morphology, distribution and size of the lesion (masses and calcifications) and breast density on mammography of TNBC, and compared them with those of TPBC. The age onset and tumor sizes of TNBC and TPBC were compared by using Chi-square test and t test. Results: The visibility rate of TNBC and TPBC on mammography were 88.0%(103/117) and 90.9% (40/44), and the difference between them was insignificant (χ 2 =0.055, P >0.05). TNBC was more frequently associated with merely a mass (56/103) than TPBC (12/40) (χ 2 =6.860, P<0.01), and the mean diameter of the mass of TNBC [(2.6 ± 1.4) cm] was larger than that of TPBC [(2.0 ± 0.6) cm] (t=2.087, P<0.05). TNBC were less frequently associated with microcalcifications (37/103) than TPBC (24/40) (χ 2 =7.423, P<0.01). Mammographic density and lesion visibility were similar between the two different immunophenotypes of breast cancers. The mean age of TNBC (52±9) was more than that of TPBC (48 ±8) (t=2.759, P<0.01). Infiltrating ductal carcinoma was the main pathologic type of both groups. Basal-like breast cancer accounted for 49% (57/117) of TNBC while none happened in TPBC. Conclusions: TNBC shows merely a mass with indistinct margins,lager size and is less associated with microcalcifications. These mammographic features might be useful in diagnosing triple

  6. The interface of mental health and human rights in Indigenous peoples: triple jeopardy and triple opportunity.

    Science.gov (United States)

    Tarantola, Daniel

    2007-01-01

    Insufficient understanding of the reciprocal interactions between health and human rights, mental health and human rights and the realization of all human rights by Indigenous peoples constitute a triple jeopardy in how these topics are currently being addressed and/or openly antagonized. This paper will attempt to show how a combined health and human rights approach to mental health in Indigenous peoples can transform a triple jeopardy into a triple opportunity. The vast and growing body of literature on mental health, health as a whole, and human rights as these relate to health and to Indigenous peoples will be used to frame the discussion. Attention to the complex interactions of health and human rights can guide policy formulation and action by offering a method of analysis, a process of participatory decision and a framework for accountability. In addition, mental health can find its rightful place in the health and human rights discourse through efforts to help policymakers and practitioners broaden their vision of mental illness to holistically encompass aspects of physical, social, emotional and cultural wellbeing. Finally, connecting the role that rights realization plays in determining health and wellbeing will add power to the rightful claims by Indigenous peoples to the promotion and protection of all their human rights--civil, political, economic, social and cultural. Broadening the research agenda by applying systematically a health and human rights analytical framework to the understanding of social determinants of health would minimize the risk of assigning health outcome merely to behaviours, practices and lifestyles, uncovering structural determinants of holistic health entrenched in policies and governmental conduct. Building the evidence of the negative impact of human rights violation on health and the negative impact of ill-health on the fulfilment of other human rights can help in designing comprehensive interventions, building on the

  7. Concrescent triplets involving primary anterior teeth

    Directory of Open Access Journals (Sweden)

    Urvashi Sharma

    2013-01-01

    Full Text Available Odontogenesis is a complex process wherein more than 200 genes are known to play a significant role in tooth development. An imbalance can lead to an abnormality in the number, size, shape or structure of the developing tooth/teeth. The presence of an extra dental lamina forms a supernumerary tooth. The supernumerary teeth are of two types: A rudimentary tooth where the supernumerary tooth does not resemble any tooth in the normal series or a supplemental tooth in which this anomalous tooth resembles one in the normal series. It is also very rare to encounter triple teeth in primary dentition. The union of these teeth may be through fusion, gemination, concrescence or a combination of fusion and gemination. Presented is a rare case of concrescence involving maxillary deciduous incisors and a supplemental tooth in a 7-year-old boy. The differential diagnosis, etiology, and complications of primary anterior triple teeth are discussed.

  8. A new method for the preparation of Tc-99m radiopharamaceuticals containing the Tc triple-bond N multiple bond

    International Nuclear Information System (INIS)

    Duatti, A.; Marchi, A.; Pasqualini, R.

    1990-01-01

    A new method for the preparation of technetium 99 radiopharmaceuticals containing the technetium-nitrogen triple bond has been developed. The method involves the reaction of pertechnetate anion with the S-methyl ester of dithiocarbazic acid in the presence of HCl and triphenylphosphine. The technetium-nitrido intermediate thus produced is then combined with the ligand in the same reaction solution to produce the final technetium 99-labelled radiopharmaceutical

  9. Ocular Problems in Triple-A Syndrome and Their Management

    Directory of Open Access Journals (Sweden)

    Seydi Okumuş

    2012-12-01

    Full Text Available Triple-A syndrome (Allgrove syndrome, is a rare autosomal recessive syndrome that is characterized by adrenal insufficiency, alacrimia and achalasia. In this report, we present a case of triple-A syndrome and discuss the ocular manifestations of the diseases along with evaluation of the therapeutic options. In addition to the classic triad of triple-A syndrome, our patient had intermittent exotropia. The patient was receiving oral steroids for adrenal insufficiency and artificial tear drops for eye dryness. Surgery was planned for exotropia. Punctum plug insertion was made simultaneously with bilateral lateral rectus recessions. Postoperative follow-up revealed near and distant horizontal deviation at the interval of ±10 PD. The patient’s complaints about eyes regressed significantly as well. Triple-A syndrome is a life threatening and rare disorder that could be fatal when undiagnosed. Punctum plugs are convenient therapy option for the treatment of xerophthalmia encountered in triple-A syndrome. With strabismus surgery including punctum plug insertion, any other surgery can be simultaneously carried out during a single session of general anesthesia. (Turk J Ophthalmol 2012; 42: 492-4

  10. Development of 600 kV triple resonance pulse transformer.

    Science.gov (United States)

    Li, Mingjia; Zhang, Faqiang; Liang, Chuan; Xu, Zhou

    2015-06-01

    In this paper, a triple-resonance pulse transformer based on an air-core transformer is introduced. The voltage across the high-voltage winding of the air-core transformer is significantly less than the output voltage; instead, the full output voltage appears across the tuning inductor. The maximum ratio of peak load voltage to peak transformer voltage is 2.77 in theory. By analyzing pulse transformer's lossless circuit, the analytical expression for the output voltage and the characteristic equation of the triple-resonance circuit are presented. Design method for the triple-resonance pulse transformer (iterated simulation method) is presented, and a triple-resonance pulse transformer is developed based on the existing air-core transformer. The experimental results indicate that the maximum ratio of peak voltage across the load to peak voltage across the high-voltage winding of the air-core transformer is approximately 2.0 and the peak output voltage of the triple-resonance pulse transformer is approximately 600 kV.

  11. Longitudinal Neuropsychological Profile in a Patient with Triple A Syndrome

    Directory of Open Access Journals (Sweden)

    Luigi Mazzone

    2013-01-01

    Full Text Available Triple A syndrome is an autosomal recessive disorder characterized by the triad of adrenocorticotropic hormone resistant adrenal insufficiency, achalasia, and alacrima. Our aim was to describe the neuropsychological characteristics and the cooccurring psychopathological and neurological disorders in an Italian male child suffering from Triple A syndrome at the time of admission (T0 and after one year of follow-up (T1. Many difficulties were observed in the motor domain, as well as in manual dexterity and static/dynamic balance domains of the motor task over time. In sharp contrast with previous literature reports on frequent mild cognitive dysfunction in patients with Triple A syndrome, our child did not show any mental retardation. By contrast, he showed an average IQ at T0 with a slight improvement at T1. To our knowledge, this report is the first describing neuropsychological profile and co-occurring psychopathological problems in a child with Triple A syndrome. Considering that the Triple A syndrome is a progressive disorder which can take years to develop the full-blown clinical picture, these patients require periodical medical controls. Moreover, assessment of neuropsychological and psychopathological features should be performed in patients with this disease, in order to underline the variability of this syndrome.

  12. The influence of triple bottom line on international operations management

    Directory of Open Access Journals (Sweden)

    Francisco Sperotto Flores

    2017-12-01

    Full Text Available This paper takes a triple bottom line perspective to analyze how the international operations literature integrates economic, social, and environmental issues. Additionally, it shows the main drivers of and barriers to the adoption of triple bottom line practices by companies in an international context. We conducted a literature review in English language journals which publish research of production and operations management and sustainability, resulting in a final sample of 29 papers. Results show that social and legal pressure for companies to adopt a responsible behavior prompts an isomorphic process that leads them to conduct their operations on behalf of triple bottom line goals. Behavioral differences between spin-offs in various countries caused institutions to create mechanisms that can press and change private standards through regulation and enforcement. There is room for progress in studies that seek to analyze the company’s relationships in its international experience and its multi-institutional relations.

  13. BPS dynamics of the triple (p,q) string junction

    International Nuclear Information System (INIS)

    Rey, S.-J.; Yee, J.-T.

    1998-01-01

    We study the dynamics of the triple junction of (p,q) strings in type IIB string theory. We probe the tension and mass density of (p,q) strings by studying harmonic fluctuations of the triple junction. We show that they agree perfectly with the BPS formula provided a suitable geometric interpretation of the junction is given. We provide a precise statement of the BPS limit and force-balance property. At weak coupling and sufficiently dense limit, we argue that a (p,q) string embedded in the string network is a 'wiggly string', whose low-energy dynamics can be described via a renormalization group evolved, smooth effective non-relativistic string. We also suggest the possibility that, upon type IIB strings being promoted to the M-theory membrane, there can exist 'evanescent' bound-states at the triple junction in the continuum. (orig.)

  14. Use of triple microcatheters for endovascular treatment of wide-necked intracranial aneurysms: A single center experience

    International Nuclear Information System (INIS)

    Cho, Young Dae; Rhim, Jong Kook; Kang, Hyun Seung; Kim, Jeong Eun; Cho, Won Sang; Han, Moon Hee; Park, Jeong Jin; Jeon, Jin Pyeong

    2015-01-01

    The dual microcatheter technique is common practice for coil embolization of a wide-necked aneurysm, due to safety and efficacy. However, technical limitations of some complex configurations may necessitate additional microcatheters to bolster coil stability, compact the coil, or for protection. Described herein is a triple microcatheter technique for endovascular management of wide-necked intracranial aneurysms. Data accruing prospectively between January 2006 and October 2014 on simultaneously executed triple microcatheter coil embolization procedures done in 38 saccular aneurysms were reviewed. Clinical and morphological outcomes were assessed, with emphasis on technical aspects of treatment. The triple microcatheter technique was successfully applied to all 38 saccular aneurysms, involving the posterior communicating artery (n = 13), the middle cerebral artery (n = 10), the basilar tip (n = 7), the anterior cerebral artery (n = 5), and the internal carotid artery (n = 3). Stent protection was added in four patients and balloon remodeling in one. Dual microcatheters (n = 24) were usually deployed to deliver the coil within sacs of aneurysms, with the additional microcatheter used for protection. Otherwise, triple microcatheters were deployed for coil delivery (n = 11) or coils were delivered via a single microcatheter, with dual microcatheters deployed for protection (n = 3). Successful occlusion of aneurysms was achieved in 89.5% of cases, with no procedure-related morbidity or mortality. Stable occlusion was maintained in 72.2% (26/36) of the aneurysms at the final follow-up (mean interval, 30.2 ± 22.7 months). The outcomes of this limited study suggest that the triple microcatheter technique may be an effective and safe therapeutic option for wide-necked aneurysms, using technical strategies tailored to complex angio-anatomic configurations

  15. Triple shape memory polymers by 4D printing

    Science.gov (United States)

    Bodaghi, M.; Damanpack, A. R.; Liao, W. H.

    2018-06-01

    This article aims at introducing triple shape memory polymers (SMPs) by four-dimensional (4D) printing technology and shaping adaptive structures for mechanical/bio-medical devices. The main approach is based on arranging hot–cold programming of SMPs with fused decomposition modeling technology to engineer adaptive structures with triple shape memory effect (SME). Experiments are conducted to characterize elasto-plastic and hyper-elastic thermo-mechanical material properties of SMPs in low and high temperatures at large deformation regime. The feasibility of the dual and triple SMPs with self-bending features is demonstrated experimentally. It is advantageous in situations either where it is desired to perform mechanical manipulations on the 4D printed objects for specific purposes or when they experience cold programming inevitably before activation. A phenomenological 3D constitutive model is developed for quantitative understanding of dual/triple SME of SMPs fabricated by 4D printing in the large deformation range. Governing equations of equilibrium are established for adaptive structures on the basis of the nonlinear Green–Lagrange strains. They are then solved by developing a finite element approach along with an elastic-predictor plastic-corrector return map procedure accomplished by the Newton–Raphson method. The computational tool is applied to simulate dual/triple SMP structures enabled by 4D printing and explore hot–cold programming mechanisms behind material tailoring. It is shown that the 4D printed dual/triple SMPs have great potential in mechanical/bio-medical applications such as self-bending gripers/stents and self-shrinking/tightening staples.

  16. Prem Baby Triple P: a randomised controlled trial of enhanced parenting capacity to improve developmental outcomes in preterm infants.

    Science.gov (United States)

    Colditz, Paul; Sanders, Matthew R; Boyd, Roslyn; Pritchard, Margo; Gray, Peter; O'Callaghan, Michael J; Slaughter, Virginia; Whittingham, Koa; O'Rourke, Peter; Winter, Leanne; Evans, Tracey; Herd, Michael; Ahern, Jessica; Jardine, Luke

    2015-03-04

    Very preterm birth (parenting have the greatest potential to create sustained effects on child development and parental psychopathology. Triple P (Positive Parenting Program) has shown positive effects on child behaviour and adjustment, parenting practices and family functioning. Baby Triple P for Preterm infants, has been developed to target parents of very preterm infants. This study tests the effectiveness of Baby Triple P for Preterm infants in improving child and parent/couple outcomes at 24 months corrected age (CA). Families will be randomised to receive either Baby Triple P for Preterm infants or Care as Usual (CAU). Baby Triple P for Preterm infants involves 4 × 2 hr group sessions at the hospital plus 4 × 30 min telephone consultations soon after transfer (42 weeks C.A.). After discharge participants will be linked to community based Triple P and intervention maintenance up to 24 months C.A. Assessments will be: baseline, post-intervention (6 weeks C.A.), at 12 and 24 months C.A. The primary outcome measure is the Infant Toddler Social & Emotional Assessment (ITSEA) at 24 months C.A. Child behavioural and emotional problems will be coded using the mother-toddler version of the Family Observation Schedule at 24 months C.A. Secondary outcome will be the Bayley Scales of Infant and Toddler Development (BSID III) cognitive development, language and motor abilities. Proximal targets of parenting style, parental self-efficacy, parental mental health, parental adjustment, parent-infant attachment, couple relationship satisfaction and couple communication will also be assessed. Our sample size based on the ITSEA, has 80% power, predicted effect size of 0.33 and an 85% retention rate, requires 165 families are required in each group (total sample of 330 families). This protocol presents the study design, methods and intervention to be analysed in a randomised trial of Baby Triple P for Preterm infants compared to Care as Usual (CAU) for families of very preterm

  17. Tunable Hybrid Qubit in a Triple Quantum Dot

    Science.gov (United States)

    Wang, Bao-Chuan; Cao, Gang; Li, Hai-Ou; Xiao, Ming; Guo, Guang-Can; Hu, Xuedong; Jiang, Hong-Wen; Guo, Guo-Ping

    2017-12-01

    We experimentally demonstrate quantum-coherent dynamics of a triple-dot-based multielectron hybrid qubit. Pulsed experiments show that this system can be conveniently initialized, controlled, measured electrically, and has a good ratio Q ˜29 between the coherence time and gate time. Furthermore, the current multielectron hybrid qubit has an operation frequency that is tunable in a wide range, from 2 to about 15 GHz. We also provide a qualitative understanding of the experimental observations by mapping them onto a three-electron system. The demonstration of the high tunability in a triple dot system could be potentially useful for future quantum control.

  18. Non-resonant triple alpha reaction rate at low temperature

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, T.; Tamii, A.; Aoi, N.; Fujita, H.; Hashimoto, T.; Miki, K.; Ogata, K. [Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047 (Japan); Carter, J.; Donaldson, L.; Sideras-Haddad, E. [Schools of Physics, University of Witwatersrand, Johannesburg 2050 (South Africa); Furuno, T.; Kawabata, T. [Departments of Physics, Kyoto University, Sakyo, Kyoto, 606-8502 (Japan); Kamimura, M. [RIKEN Nishina Center, Wako, Saitama, 351-0198 (Japan); Nemulodi, F.; Neveling, R.; Smit, F. D.; Swarts, C. [iThemba Laboratory for Accelerator Based Sciences Somerset, West, 7129 (South Africa)

    2014-05-02

    Our experimental goal is to study the non-resonant triple alpha reaction rate at low temperture (T < 10{sup 8} K). The {sup 13}C(p,d) reaction at 66 MeV has been used to probe the alpha-unbound continuum state in {sup 12}C just below the 2{sup nd} 0{sup +} state at 7.65 MeV. The transition strength to the continuum state is predicted to be sensitive to the non-resonant triple alpha reaction rate. The experiment has been performed at iThemba LABS. We report the present status of the experiment.

  19. RDF 1.1 Turtle : terse RDF triple language

    OpenAIRE

    World Wide Web Consortium

    2014-01-01

    RDF es un lenguaje de objetivo general para la representación de la información en la Web. Este documento define una sintaxis textual para RDF llamada Turtle que permite a un grafo RDF ser completamente escrito en un formulario de texto compacto y natural, con las abreviaturas para los patrones y tipos de datos de uso común. Turtle ofrece niveles de compatibilidad con el formato N-Triples, así como la sintaxis de patrón triple de la Recomendación SPARQL del W3C.

  20. La región de la triple frontera: territorios de integración y desintegración The triple frontier region: territories of integration and disintegration

    Directory of Open Access Journals (Sweden)

    Ramón Fogel

    2008-12-01

    Full Text Available En el articulo se analiza la triple frontera (Foz de Iguazú, Puerto Iguazu e Ciudad del Elste como territorio construido, apropriado y controlado por actores, algunos extra regionales. Estos actores mantienen vínculos entre si que implican relaciones de poder, y están involucrados en actividades y procesos con incidencia en la integración regional.This article analyses the triple frontier (Foz do Iguaçú, Puerto Iguazu and Ciudad del Este as a constructed territory, owned and controlled by actors, some of them extra-regional. These actors maintain between themselves ties that imply relations of power, and they are involved in activities and processes that have an effect on regional integration.

  1. Inhibition of PKM2 sensitizes triple-negative breast cancer cells to doxorubicin

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Feng [Department of Gastroenterology, The Tenth People’s Hospital of Shanghai, Tongji University, Shanghai 200072 (China); Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX 77030 (United States); Yang, Yong, E-mail: yyang@houstonmethodist.org [Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX 77030 (United States); Department of Medicine, Weill Cornell Medical College, New York, NY 10065 (United States)

    2014-11-21

    Highlights: • Suppression of PKM2 sensitizes triple-negative breast cancer cells to doxorubicin. • Repression of PKM2 affects the glycolysis and decreases ATP production. • Downregulation of PKM2 increases the intracellular accumulation of doxorubicin. • Inhibition of PKM2 enhances the antitumor efficacy of doxorubicin in vivo. - Abstract: Cancer cells alter regular metabolic pathways in order to sustain rapid proliferation. One example of metabolic remodeling in cancerous tissue is the upregulation of pyruvate kinase isoenzyme M2 (PKM2), which is involved in aerobic glycolysis. Indeed, PKM2 has previously been identified as a tumor biomarker and as a potential target for cancer therapy. Here, we examined the effects of combined treatment with doxorubicin and anti-PKM2 small interfering RNA (siRNA) on triple-negative breast cancer (TNBC). The suppression of PKM2 resulted in changes in glucose metabolism, leading to decreased synthesis of adenosine triphosphate (ATP). Reduced levels of ATP resulted in the intracellular accumulation of doxorubicin, consequently enhancing the therapeutic efficacy of this drug in several triple-negative breast cancer cell lines. Furthermore, the combined effect of PKM2 siRNA and doxorubicin was evaluated in an in vivo MDA-MB-231 orthotopic breast cancer model. The siRNA was systemically administered through a polyethylenimine (PEI)-based delivery system that has been extensively used. We demonstrate that the combination treatment showed superior anticancer efficacy as compared to doxorubicin alone. These findings suggest that targeting PKM2 can increase the efficacy of chemotherapy, potentially providing a new approach for improving the outcome of chemotherapy in patients with TNBC.

  2. E-cigarette Use Triples Among Middle and High School Students in Just One Year

    Science.gov (United States)

    ... Information Act Office Public Health Image Library (PHIL) E-cigarette use triples among middle and high school students ... ET Contact: Media Relations (404) 639-3286 Current e-cigarette use among middle and high school students tripled ...

  3. Triple negative breast cancers have a reduced expression of DNA repair genes.

    Directory of Open Access Journals (Sweden)

    Enilze Ribeiro

    Full Text Available DNA repair is a key determinant in the cellular response to therapy and tumor repair status could play an important role in tailoring patient therapy. Our goal was to evaluate the mRNA of 13 genes involved in different DNA repair pathways (base excision, nucleotide excision, homologous recombination, and Fanconi anemia in paraffin embedded samples of triple negative breast cancer (TNBC compared to luminal A breast cancer (LABC. Most of the genes involved in nucleotide excision repair and Fanconi Anemia pathways, and CHK1 gene were significantly less expressed in TNBC than in LABC. PARP1 levels were higher in TNBC than in LABC. In univariate analysis high level of FANCA correlated with an increased overall survival and event free survival in TNBC; however multivariate analyses using Cox regression did not confirm FANCA as independent prognostic factor. These data support the evidence that TNBCs compared to LABCs harbour DNA repair defects.

  4. Living Labs as boundary-spanners between Triple Helix actors

    NARCIS (Netherlands)

    van Geenhuizen, M.S.

    2016-01-01

    Living labs are an increasingly popular methodology to enhance innovation. Living labs aim to span boundaries between different organizations, among others Triple helix actors, by acting as a network organization typically in a real-life environment to foster co-creation by user-groups. This paper

  5. Targeting histone abnormality in triple negative breast cancer

    Science.gov (United States)

    2017-08-01

    clinical trials for treatment of cancers such as acute myeloid leukemia (AML) and lung cancer (http://clinicaltrials. gov). LSD2 has been linked to...The Cancer Genome Atlas; AML, acute myeloid leukemia ; DNMT, DNA methyltransferase; TNBC, triple-negative breast cancer; BCSC, breast cancer stem cell

  6. Two path transport measurements on a triple quantum dot

    Energy Technology Data Exchange (ETDEWEB)

    Rogge, Maximilian C.; Haug, Rolf J. [Institut fuer Festkoerperphysik, Leibniz Universitaet Hannover, Appelstr. 2, 30167 Hannover (Germany)

    2008-07-01

    We present a novel triple quantum dot device made with local anodic oxidation on a GaAs/AlGaAs heterostructure. The geometry provides two path transport via a three lead setup with each lead connected to one of the three quantum dots. In addition charge detection is implemented via a quantum point contact. One lead is used as a common source contact, the other two are used as two separate drain contacts with independent current measurement. Thus two paths are formed with two dots in each path. Along both paths serial transport is observed at the triple points of the two corresponding dots. With four side gates a wide tunability is given. Thus the system can be tuned in and out of triple dot resonances. When all three dots come into resonance, quadruple points are formed with simultaneous transport along both paths. The data are analysed in combined two colour plots and compared to the charge detection showing sets of three different lines, one for each dot. This way the two path setup allows to investigate the transition from double dot physics to triple dot physics.

  7. Performance of Mercury Triple-Point Cells Made in Brazil

    Science.gov (United States)

    Petkovic, S. G.; Santiago, J. F. N.; Filho, R. R.; Teixeira, R. N.; Santos, P. R. F.

    2003-09-01

    Fixed-points cells are primary standards in ITS-90. They contain reference material with a purity of 99.999 % or more. The gallium in a melting-point cell, for example, can reach a purity of 99.99999 %. This level of purity is not easy to obtain. However, substances like water and mercury can be purified by means of distillation and chemical procedures. This paper presents the results of mercury triple-point cells made in Brazil that were directly compared to a mercury triple-point cell of 99.999% purity. This reference cell, made by Isotech (England), was previously compared to cells from CENAM (Mexico) and NRC (Canada) and the maximum deviation found was approximately 0.4 mK. The purification stage started with a sample of mercury 99.3 % pure, and the repeated use of both mechanical and chemical processes led to a purification grade considered good enough for calibration of standard platinum resistance thermometers. The purification procedures, the method of construction of the cell, the laboratory facilities, the comparison results and the budget of uncertainties are described in this paper. All of the cells tested have a triple-point temperature within 0.25 mK of the triple-point temperature of the Inmetro reference cell.

  8. Nanostructured thin films for multibandgap silicon triple junction solar cells

    NARCIS (Netherlands)

    Schropp, R.E.I.; Li, H. B. T.; Franken, R.H.; Rath, J.K.; van der Werf, C.H.M.; Schuttauf, J.A.; Stolk, R.L.

    2009-01-01

    A considerable improvement in performance has been achieved for multibandgap proto-Si/proto-SiGe/nc-Si:H triple junction n–i–p solar cells in which hot-wire chemical vapor deposition (HWCVD) is used to obtain the absorber layers of the bottom and the top cell. To achieve this, optimized Ag/ZnO

  9. Triple-negative breast cancer: present challenges and new perspectives

    NARCIS (Netherlands)

    Podo, Franca; Buydens, Lutgarde M. C.; Degani, Hadassa; Hilhorst, Riet; Klipp, Edda; Gribbestad, Ingrid S.; van Huffel, Sabine; van Laarhoven, Hanneke W. M.; Luts, Jan; Monleon, Daniel; Postma, Geert J.; Schneiderhan-Marra, Nicole; Santoro, Filippo; Wouters, Hans; Russnes, Hege G.; Sørlie, Therese; Tagliabue, Elda; Børresen-Dale, Anne-Lise

    2010-01-01

    Triple-negative breast cancers (TNBC), characterized by absence of estrogen receptor (ER), progesterone receptor (PR) and lack of overexpression of human epidermal growth factor receptor 2 (HER2), are typically associated with poor prognosis, due to aggressive tumor phenotype(s), only partial

  10. An improved computer controlled triple-axis neutron spectrometer

    International Nuclear Information System (INIS)

    Cooper, M.J.; Hall, J.W.; Hutchings, M.T.

    1975-07-01

    A description is given of the computer-controlled triple-axis neutron spectrometer installed at the PLUTO reactor at Harwell. The reasons for an nature of recent major improvements are discussed. Following a general description of the spectrometer, details are then given of the new computerised control system, including the functions of the various programs which are now available to the user. (author)

  11. Co-innovatie Triple P: integratie van marketingstrategie en personeelsbeleid

    NARCIS (Netherlands)

    Bartels, J.; Hendriks, R.; Ruyter, de P.; Zeelenberg, A.; Engelsman, V.; Eichelsheim, C.; Skoppek, H.; Schmidt, M.

    2008-01-01

    This project focuses on the integration of Triple P in marketing and personnel policy. The aim of the project is as follows: “How can you effectively use the intrinsic values of sustainable agriculture and corporate social responsibility in the marketing of organic fruit and vegetables?” In the

  12. The scalar spectrum of the triple seesaw mechanism

    International Nuclear Information System (INIS)

    Caetano, Wellington; Pires, Carlos

    2011-01-01

    Full text: The Triple seesaw mechanism provides an expression to the neutrino masses which get suppressed by high-scale M 3 in its denominator. Thus, we have a seesaw mechanism which works naturally at TeV scale, presenting, in this way, a great potential of being probed at LHC. In order to generate the small left-handed neutrino masses, the triple seesaw mechanism also requires only heavy right-handed neutrinos as extra fermionic content as the type I seesaw. The minimum Higgs sector required by the mechanism is composed by the standard Higgs doublet plus another Higgs doublet and a Higgs singlet. In this work we obtain the mass spectrum and the eigenvectors of the scalar sector that realizes the Triple seesaw mechanism. As our results, we recover the standard Higgs boson with mass in a region at 116 H < 151 GeV. We analyzed the expression given in the Triple seesaw mechanism for the neutrino mass in a scenario that is consistent with the small mass from the neutrino oscillation data and compatible with the requirements for a WIMP (weakly interacting massive particles) candidate. Finally, we obtain, as our main result, a neutral pseudoscalar with mass around 8-10 GeV which is stable and can be a possible WIMP dark matter candidate. (author)

  13. Triple Pulse Tester - Efficient Power Loss Characterization of Power Modules

    DEFF Research Database (Denmark)

    Trintis, Ionut; Poulsen, Thomas; Beczkowski, Szymon

    2015-01-01

    In this paper the triple pulse testing method and circuit for power loss characterization of power modules is introduced. The proposed test platform is able to accurately characterize both the switching and conduction losses of power modules in a single automated process. A configuration of a half...

  14. The EU must triple its energy saving policy effect

    NARCIS (Netherlands)

    Wesselink, B.; Eichhammer, W.; Harmsen, R.

    2010-01-01

    The impact of EU energy savings policy must triple to achieve the bloc’s 2020 energy savings goal. But such efforts could get a much better foundation if European leaders set a binding energy consumption target, rather than the current indicative savings target. The evidence for such

  15. On intersections of pairs of Steiner triple systems

    NARCIS (Netherlands)

    Hall, J.I.; Udding, J.T.

    1977-01-01

    Numerous articles exist in the literature concerning the intersection properties of collections of Steiner triple systems based on the same point set ([4], [5], [11], [12], [14], [15], [16], [19], [20]). In this paper we discuss several methods, first used by the authors in [7], for treating such

  16. Boundary triples for Schrodinger operators with singular interactions on hypersurfaces

    Czech Academy of Sciences Publication Activity Database

    Behrndt, J.; Langer, M.; Lotoreichik, Vladimir

    2016-01-01

    Roč. 7, č. 2 (2016), s. 290-302 ISSN 2220-8054 R&D Projects: GA ČR(CZ) GA14-06818S Institutional support: RVO:61389005 Keywords : boundary triple * Weyl function * Schrodinger operator * singular potential * delta-interaction * hypersurface Subject RIV: BE - Theoretical Physics

  17. Naval Assistance to Spain and the Triple Entente

    Directory of Open Access Journals (Sweden)

    Nicholas W. Mitiukov

    2015-03-01

    Full Text Available During the World War I Spain rendered military support to the Triple Entente, avoiding the regime of neutrality. Five trawlers, converted into minesweepers were sold to Russia and eight – to Italy. Data, concerning France, vary. There is information about no less than 27 trawlers. But probably 243 watercrafts were sold to France and 14 were contracted to build.

  18. December2004 Results of Triple Arthrodesis in Uganda.

    African Journals Online (AJOL)

    user

    2004-12-02

    Dec 2, 2004 ... Background: In Uganda, foot deformities of various kinds and complexities are common. The aim of this study was to evaluate ... Conclusion: In the developing world triple arthrodesis still has a role to play in treatment of feet deformities. The results ... on flat ground, high stepping gait, moderate deformity ...

  19. Molecular basis of the triple negative breast cancer

    Directory of Open Access Journals (Sweden)

    Ayse Feyda Nursal

    2015-06-01

    Full Text Available Breast cancer is the most common type of cancer in women and more than 1 million breast cancer cases are diagnosed each year all over the world. Breast cancer is a complex and heterogeneous disease in terms of its molecular structure, mutation type, metastase properties, clinical course and therapeutic response. Breast cancer is divided into subtypes based on expression properties of molecular markers as estrogen receptor, progestron receptor, human epidermal growth factor receptor 2. Triple-negative breast cancer is characterized by the lack of tumors that estrogen receptor, progestron receptor, human epidermal growth factor receptor 2 gene expression. These type of tumors lead to agressive clinical course due to unresponsiveness to systemic endocrine therapy and poor prognosis. Triple negative breast cancer constitutes 10-20% of all breast cancers. It affects generally young and African-American women. Triple negative breast cancer have several subtypes based on the gene expression properties. The majority of them are basal-like breast cancers. In this review, current literature is revised and summarized with respect to the molecular basis of triple negative cancers. [Archives Medical Review Journal 2015; 24(2.000: 251-259

  20. The Triple Helix Model and the Knowledge-Based Economy

    NARCIS (Netherlands)

    Leydesdorff, L.; Meyer, M.

    2010-01-01

    The Triple Helix model of university-industry-government relations can be generalized from a neo-institutional model of networks of relations to a neo-evolutionary model of how three selection environments operate upon one another. Two selection mechanisms operating upon each other can mutually

  1. Chemical application of positron annihilation through triple coincidence measurement

    International Nuclear Information System (INIS)

    Yegnasubramanian, S.; Gangadharan, S.

    1982-01-01

    This report summarises the work on the application of triple coincidence measurement of annihilation radiation for providing chemical state information; the observations have been corroborated by angular correlation and Doppler broadening measurements and supplemented by the magnetic quenching in the angular correlation and peak-to-valley ratio in the Ge(Li) singles spectrum for the 511 keV line. (author)

  2. Questioning triple rice intensification on the Vietnamese mekong delta floodplains

    NARCIS (Netherlands)

    Tran, Dung Duc; Halsema, van Gerardo; Hellegers, Petra J.G.J.; Ludwig, Fulco; Wyatt, Andrew

    2018-01-01

    Large areas of the Vietnamese Mekong Delta floodplains (VMDF) are protected by high dikes to facilitate three rice crops per year. While this has increased rice production, there is evidence that triple rice systems have negative long-term effects, both environmental and economic. Double rice

  3. The principle of relativity and the special relativity triple

    International Nuclear Information System (INIS)

    Guo Hanying; Wu Hongtu; Zhou Bin

    2009-01-01

    Based on the principle of relativity and the postulate on universal invariant constants (c,l) as well as Einstein's isotropy conditions, three kinds of special relativity form a triple with a common Lorentz group as isotropy group under full Umov-Weyl-Fock-Lorentz transformations among inertial motions

  4. Stellar evolution and the triple-α reactions

    International Nuclear Information System (INIS)

    Suda, Takuma

    2014-01-01

    Nuclear reaction rates play a crucial role in the evolution of stars. For low-mass stars, the triple-α reaction controls the helium burning stars in the red giant and asymptotic giant branch (AGB) phase. More importantly, the cross section of the triple-α reaction has a great impact on the helium ignition at the center of the electron degenerate helium core of red giants and on the helium shell flashes of AGB stars. It is to be noted that stellar evolution models are influenced not only by the value of the cross section, but also by the temperature dependence of the reaction rate. In this paper, I present the impact of the triple-α reaction rates on the evolution of low-mass metal-free stars and intermediate-mass AGB stars. According to the previous study, the constraint on the triple-α reaction rate is derived based on stellar evolution theory. It is found that the recent revisions of the rate proposed by nuclear physics calculations satisfy the condition for the ignition of the helium core flash in low-mass stars

  5. Quality of the spare triple-GEM detectors

    CERN Document Server

    Lenci, Rosario; Paoletti, Emiliano; Pasquali, Luigi; Pinci, Davide; Piscitelli, Carmelo; Poli Lener, Marco; Sciubba, Adalberto; Tskhadadze, Edisher

    2017-01-01

    Triple-GEM chambers equip the inner region of the M1 muon station. In order to provide spare detectors in case of problems in the operating ones, new chambers have been assembled at the Frascati National Laboratories of the INFN. This note summarizes the results of the quality tests performed at the end of the production procedure.

  6. Behavior of Triple Langmuir Probes in Non-Equilibrium Plasmas

    Science.gov (United States)

    Polzin, Kurt A.; Ratcliffe, Alicia C.

    2018-01-01

    The triple Langmuir probe is an electrostatic probe in which three probe tips collect current when inserted into a plasma. The triple probe differs from a simple single Langmuir probe in the nature of the voltage applied to the probe tips. In the single probe, a swept voltage is applied to the probe tip to acquire a waveform showing the collected current as a function of applied voltage (I-V curve). In a triple probe three probe tips are electrically coupled to each other with constant voltages applied between each of the tips. The voltages are selected such that they would represent three points on the single Langmuir probe I-V curve. Elimination of the voltage sweep makes it possible to measure time-varying plasma properties in transient plasmas. Under the assumption of a Maxwellian plasma, one can determine the time-varying plasma temperature T(sub e)(t) and number density n(sub e)(t) from the applied voltage levels and the time-histories of the collected currents. In the present paper we examine the theory of triple probe operation, specifically focusing on the assumption of a Maxwellian plasma. Triple probe measurements have been widely employed for a number of pulsed and timevarying plasmas, including pulsed plasma thrusters (PPTs), dense plasma focus devices, plasma flows, and fusion experiments. While the equilibrium assumption may be justified for some applications, it is unlikely that it is fully justifiable for all pulsed and time-varying plasmas or for all times during the pulse of a plasma device. To examine a simple non-equilibrium plasma case, we return to basic governing equations of probe current collection and compute the current to the probes for a distribution function consisting of two Maxwellian distributions with different temperatures (the two-temperature Maxwellian). A variation of this method is also employed, where one of the Maxwellians is offset from zero (in velocity space) to add a suprathermal beam of electrons to the tail of the

  7. Involving women.

    Science.gov (United States)

    Agbo, J

    1994-01-01

    I am a primary health care (PHC) coordinator working with the May Day Rural project, a local NGO involved in integrated approaches and programs with rural communities in the Ga District of the Greater-Accra region in Ghana. When we talk about the community development approach we must first and foremost recognize that we are talking about women, because in the developing world frequent childbirths mean that her burden of mortality is higher than a man's; her workload is extremely heavy--whether in gardening, farming, other household duties, caring for the sick, or the rearing of children; she has a key role in PHC and community development, because men are always looking for greener pastures elsewhere, leaving the women behind. Women's concerns are critical in most health care projects and women and children are their main beneficiaries. Why not include women in the management team, project design, implementation and evaluation processes? That is what the May Day Rural project is practicing, encouraging women's participation and creating a relationship of trust. full text

  8. Pursuing the Triple Aim: The First 7 Years.

    Science.gov (United States)

    Whittington, John W; Nolan, Kevin; Lewis, Ninon; Torres, Trissa

    2015-06-01

    POLICY POINTS: In 2008, researchers at the Institute for Healthcare Improvement (IHI) proposed the Triple Aim, strategic organizing principles for health care organizations and geographic communities that seek, simultaneously, to improve the individual experience of care and the health of populations and to reduce the per capita costs of care for populations. In 2010, the Triple Aim became part of the US national strategy for tackling health care issues, especially in the implementation of the Patient Protection and Affordable Care Act (ACA) of 2010. Since that time, IHI and others have worked together to determine how the implementation of the Triple Aim has progressed. Drawing on our 7 years of experience, we describe 3 major principles that guided the organizations and communities working on this endeavor: creating the right foundation for population management, managing services at scale for the population, and establishing a learning system to drive and sustain the work over time. In 2008, researchers at the Institute for Healthcare Improvement (IHI) described the Triple Aim as simultaneously "improving the individual experience of care; improving the health of populations; and reducing the per capita costs of care for populations." IHI and its close colleagues had determined that both individual and societal changes were needed. In 2007, IHI began recruiting organizations from around the world to participate in a collaborative to implement what became known as the Triple Aim. The 141 participating organizations included health care systems, hospitals, health care insurance companies, and others closely tied to health care. In addition, key groups outside the health care system were represented, such as public health agencies, social services groups, and community coalitions. This collaborative provided a structure for observational research. By noting the contrasts between the contexts and structures of those sites in the collaborative that progressed and

  9. Gastrointestinal involvement of recurrent renal cell carcinoma: CT findings and clinicpathologic features

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyo Jung; Kim, Hyun Jin; Park, Seung Ho; Lee, Jong Seok; Kim, Ah Young [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Ha, Hyun Kwon [Dept. of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2017-06-15

    To retrospectively evaluate the CT findings and clinicopathologic features in patients with gastrointestinal (GI) involvement of recurrent renal cell carcinoma (RCC). The medical records were reviewed for 15 patients with 19 pathologically proven GI tract metastases of RCC. The CT findings were analyzed to determine the involved sites and type of involvement; lesion size, morphology, and contrast enhancement pattern; and occurrence of lymphadenopathy, ascites and other complications. The most common presentation was GI bleeding (66.7%). The average interval between nephrectomy and the detection of GI involvement was 30.4 ± 37.4 months. GI lesions were most commonly found in the ileum (36.8%) and duodenum (31.6%). A distant metastasis (80%) was more common than a direct invasion from metastatic lesions. The mean lesion size was 34.1 ± 15.0 mm. Intraluminal polypoid masses (63.2%) with hyperenhancement (78.9%) and heterogeneous enhancement (63.2%) were the most common findings. No patients had regional lymphadenopathy. Complications occurred in four patients, with one each of bowel obstruction, intussusception, bile duct dilatation, and pancreatic duct dilatation. GI involvement of recurrent RCC could be included in the differential diagnosis of patients with heterogeneous, hyperenhanced intraluminal polypoid masses in the small bowel on CT scans along with a relative paucity of lymphadenopathy.

  10. A unified material decomposition framework for quantitative dual- and triple-energy CT imaging.

    Science.gov (United States)

    Zhao, Wei; Vernekohl, Don; Han, Fei; Han, Bin; Peng, Hao; Yang, Yong; Xing, Lei; Min, James K

    2018-04-21

    configurations. A unified framework for both dual- and triple-energy CT imaging has been estab-lished for the accurate extraction of material compositions using currently available commercial DECT configurations. The novel technique is promising to provide an urgently needed solution for several CT-based diagnostic and therapy applications, especially for the diagnosis of cardiovascular and abdominal diseases where multi-contrast imaging is involved. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. mTOR in breast cancer: differential expression in triple-negative and non-triple-negative tumors.

    LENUS (Irish Health Repository)

    Walsh, S

    2012-04-01

    Triple-negative breast cancer (TNBC) is defined by the absence of estrogen receptors (ER), progesterone receptors (PR) and overexpression of HER2. Targeted therapy is currently unavailable for this subgroup of breast cancer patients. mTOR controls cancer cell growth, survival and invasion and is thus a potential target for the treatment of patients with TNBC. Using immunohistochemistry, mTOR and p-mTOR were measured in 89 TNBCs and 99 non-TNBCs. While mTOR expression was confined to tumor cell cytoplasm, p-mTOR staining was located in the nucleus, perinuclear area and in the cytoplasm. Potentially important, was our finding that nuclear p-mTOR was found more frequently in triple-negative than non triple-negative cancers (p < 0.001). These results suggest that mTOR may play a more important role in the progression of TNBC compared to non-TNBC. Based on these findings, we conclude that mTOR may be a new target for the treatment of triple-negative breast cancer.

  12. 空气灌肠失败和晚期肠套迭的手术治疗%Surgical Treatment of Advanced Intussusceptions and Failure of Rectal Inflation Reduction

    Institute of Scientific and Technical Information of China (English)

    唐伟椿; 成守礼

    1983-01-01

    From Nov.,1975 to July,1982,80 cases(51 males and 29 females)of intussusceotion were operated on.Among them,31 rectal inflation reduction failed.49 cases were advanced intussusdeption including some small intestinal intussusception.66 cases were primary.62 children were aged under one.Most of them had either enlarged regional mesenteric lymph node or mobile cecum.14 had secondary intussusceptions,13 of whom aged over one.There were 5 cases of Meckel's diverticulum,4 polyps,4 ileal duplications and one allergic purpura complicated with hematoma in the anterior wall of the cecum.Manual reductions were accomplished in 58 patients,together with simultaneous appendectomy.No plication of the cecum was attempted nor relapse noted.Intestinal resection followed by anastomosis was performed in 22 cases for intestinal gangrene.While rectal inflation on two patients with intestinal perforation was not successful,surgical repair was performed immediately.Only one death due to preoperative pneumonia and chickenpox was recorded.Thus mortality rate was 1.25%.%@@ 肠套迭是婴儿常见的急腹症,自从应用空气灌肠治疗以来,早期肠套迭的整复治疗取得了肯定的疗效,显著地降低了手术率.但对于复杂型和晚期肠套迭的病例使用空气灌肠,不但难以奏效,而且往往发生危险,而仍需手术治疗.

  13. Restoration of nuclear-import failure caused by triple A syndrome and oxidative stress

    International Nuclear Information System (INIS)

    Kiriyama, Takao; Hirano, Makito; Asai, Hirohide; Ikeda, Masanori; Furiya, Yoshiko; Ueno, Satoshi

    2008-01-01

    Triple A syndrome is an autosomal recessive neurological disease, mimicking motor neuron disease, and is caused by mutant ALADIN, a nuclear-pore complex component. We recently discovered that the pathogenesis involved impaired nuclear import of DNA repair proteins, including DNA ligase I and the cerebellar ataxia causative protein aprataxin. Such impairment was overcome by fusing classical nuclear localization signal (NLS) and 137-aa downstream sequence of XRCC1, designated stretched NLS (stNLS). We report here that the minimum essential sequence of stNLS (mstNLS) is residues 239-276, downsized by more than 100 aa. mstNLS enabled efficient nuclear import of DNA repair proteins in patient fibroblasts, functioned under oxidative stress, and reduced oxidative-stress-induced cell death, more effectively than stNLS. The stress-tolerability of mstNLS was also exerted in control fibroblasts and neuroblastoma cells. These findings may help develop treatments for currently intractable triple A syndrome and other oxidative-stress-related neurological diseases, and contribute to nuclear compartmentalization study

  14. Unexpected variations in the triple oxygen isotope composition of stratospheric carbon dioxide

    Science.gov (United States)

    Wiegel, Aaron A.; Cole, Amanda S.; Hoag, Katherine J.; Atlas, Elliot L.; Schauffler, Sue M.; Boering, Kristie A.

    2013-10-01

    We report observations of stratospheric CO2 that reveal surprisingly large anomalous enrichments in 17O that vary systematically with latitude, altitude, and season. The triple isotope slopes reached 1.95 ± 0.05(1σ) in the middle stratosphere and 2.22 ± 0.07 in the Arctic vortex versus 1.71 ± 0.03 from previous observations and a remarkable factor of 4 larger than the mass-dependent value of 0.52. Kinetics modeling of laboratory measurements of photochemical ozone-CO2 isotope exchange demonstrates that non-mass-dependent isotope effects in ozone formation alone quantitatively account for the 17O anomaly in CO2 in the laboratory, resolving long-standing discrepancies between models and laboratory measurements. Model sensitivities to hypothetical mass-dependent isotope effects in reactions involving O3, O(1D), or CO2 and to an empirically derived temperature dependence of the anomalous kinetic isotope effects in ozone formation then provide a conceptual framework for understanding the differences in the isotopic composition and the triple isotope slopes between the laboratory and the stratosphere and between different regions of the stratosphere. This understanding in turn provides a firmer foundation for the diverse biogeochemical and paleoclimate applications of 17O anomalies in tropospheric CO2, O2, mineral sulfates, and fossil bones and teeth, which all derive from stratospheric CO2.

  15. Triple valve infective endocarditis - a late diagnosis

    Directory of Open Access Journals (Sweden)

    Edme R. Mustafa

    2018-04-01

    Full Text Available Behcet's disease is a systemic vasculitis of unknown aetiology with cardiac involvement as well as damage to other organs. Whether the sterile valvular inflammation which occurs in this autoimmune disease predisposes to bacterial adhesion and infective endocarditis is not yet established. We present the case of a patient with Behcet disease in which transthoracic echocardiography showed mobile masses on the aortic, tricuspid, and mitral valves, leading to multivalvular infective endocarditis diagnosis, possibly in the context of valvular inflammation. The case presented in this article confirms observation of other studies, namely that ultrasonography plays an important role in the diagnosis and evaluation of rheumatic diseases and permits optimal management in daily practice.

  16. Procedimiento para la caracterización de una celda de punto triple de agua Isotech en el LATU

    Directory of Open Access Journals (Sweden)

    Ofelia Robatto

    2011-05-01

    Full Text Available La realización en el punto triple de agua es crucial para una mejor aproximación a la Escala Internacional de Temperatura (ITS-90, ya que la definición de esta última está directamente vinculada al punto fijo citado. Es necesario conocer la influencia de la presión hidrostática en el punto triple de agua para corregir los valores de resistencia medidos y obtener una mejor aproximación al valor real de la temperatura en dicho punto.Este artículo describe las dificultades encontradas al estudiar el perfil térmico correspondiente a una celda de punto triple de agua comercial bajo condiciones normales de operación con un baño Dewar termostatizado con hielo picado. Este trabajo fue llevado a cabo en dos fases: en la primera se detectaron problemas con los perfiles de temperatura, cuyo comportamiento era lejano al ideal. Para mejorar dicho comportamiento se hicieron cambios en el equipamiento, con el fin de minimizar el tiempo de estabilización de la celda y mejorar la transferencia de calor. El aislamiento del baño fue mejorado y se colocó un dispositivo ecualizador de temperatura de cobre en el pozo de la celda. Los resultados se discuten en el presente artículo.AbstractThe Realization of the Triple Point of Water (TPW is of main importance when approximating to the International Temperature Scale of 1990 (ITS-90, because it is properly involved in its definition. Therefore it is necessary to know the Hydrostatic Pressure influence at the Triple Point of Water to correct the values of resistance measured and to obtain a better approximation of the real temperature of this point. This article shows the difficulties found when studying the thermal profile of one commercial cell of the triple point of water under normal operation conditions in a Dewar thermostatic bath with crushed ice. The work was performed in two phases. In the first phase problems were detected with the temperature profiles, whose behaviors were far away from

  17. INTESTINAL INTUSSUSCEPTION DUE TO CONCURRENT ...

    African Journals Online (AJOL)

    Administrator

    Hymenolepis nana and Dentostomella ... worms (H. nana and D. translucida) were observed in the lumen of the intestine with severe cellular infiltration .... helminthosis and Balantidosis in Red monkey (Erythrocebus patas) in Ibadan Nigeria Nigerian ...

  18. Simultaneous determination of triple therapy for Helicobacter pylori in human plasma by reversed phase chromatography with online wavelength switching

    Science.gov (United States)

    Ahmed, Sameh; Atia, Noha N.

    2015-02-01

    The infection of gastric mucosa by Helicobacter pylori (HP) is an essential cofactor in the aetiology of gastroduodenal ulcer and gastric carcinoma. Because of the bacterial resistance, combination therapy containing omeprazole (OME), tinidazole (TNZ) and clarithromycin (CLA) is commonly used for eradication of HP. However, the simultaneous determination of the triple therapy in human plasma was not reported. A simple, reproducible, and selective HPLC method was developed for the simultaneous determination of the triple therapy mixture used for management of HP infections in human plasma. An HPLC procedure based on a liquid-liquid extraction, enrichment of the analytes and subsequent reversed-phase chromatography with UV detection was used. To enable sensitive and selective detection, the method involved the use of online wavelength switching detection, with two different detection wavelengths; 280 nm for detection of OME and TNZ and 210 nm for detection of CLA. Separations were performed on C18 analytical column with acetonitrile-10 mM phosphate buffer of pH = 3.0 at flow rate of 1.0 mL min-1. The linear ranges in human plasma were 0.05-10 μg mL-1 with correlation coefficients >0.9990. The detection limits in human plasma were 0.02-0.07 μg mL-1. Validation parameters were assessed in compliance with US-FDA guidelines. The method proved to be valuable for the therapeutic drug monitoring after oral administration of triple therapy tablets.

  19. Development of triple axis neutron spectrometer (Paper No. 24)

    International Nuclear Information System (INIS)

    Pal, B.C.; Wadhwa, N.R.; Goveas, S.H.

    1987-02-01

    The triple axis neutron spectrometers are the basic instruments intended for use with neutron beams from reactors. Various types of spectrometers, each devoted to different kinds of measurement can be designed and manufactured, once a prototype having all the attributes of a versatile instrument is designed and developed. With the view to achieving self reliance in this field, Central Workshops of Bhabha Atomic Research Centre (BARC), Bombay designed and developed a prototype of triple axis spectrometer meeting the specifications prepared by Nuclear Physics Division of BARC . This spectrometer, with a moving wedge system was successfully manufactured and installed at 'DHRUVA'. Another version of this spectrometer, called the 'Polarised Neutron Spectrometer' was also built and exported to South Korea and installed at Korea Advanced Energy Research Institute, Seoul. This paper deals with basic concept, development of design, engineering of mechanical assemblies, the manufacturing approach and problems encountered during manufacture. (author). 3 figs

  20. Grain boundary and triple junction diffusion in nanocrystalline copper

    Energy Technology Data Exchange (ETDEWEB)

    Wegner, M., E-mail: m.wegner@uni-muenster.de; Leuthold, J.; Peterlechner, M.; Divinski, S. V., E-mail: divin@uni-muenster.de [Institut für Materialphysik, Universität Münster, Wilhelm-Klemm-Straße 10, D-48149, Münster (Germany); Song, X., E-mail: xysong@bjut.edu.cn [College of Materials Science and Engineering, Beijing University of Technology, 100124 Beijing (China); Wilde, G. [Institut für Materialphysik, Universität Münster, Wilhelm-Klemm-Straße 10, D-48149, Münster (Germany); Institute of Nanochemistry and Nanobiology, School of Environmental and Chemical Engineering, Shanghai University, 200444 Shanghai (China)

    2014-09-07

    Grain boundary and triple junction diffusion in nanocrystalline Cu samples with grain sizes, 〈d〉, of ∼35 and ∼44 nm produced by spark plasma sintering were investigated by the radiotracer method using the {sup 63}Ni isotope. The measured diffusivities, D{sub eff}, are comparable with those determined previously for Ni grain boundary diffusion in well-annealed, high purity, coarse grained, polycrystalline copper, substantiating the absence of a grain size effect on the kinetic properties of grain boundaries in a nanocrystalline material at grain sizes d ≥ 35 nm. Simultaneously, the analysis predicts that if triple junction diffusion of Ni in Cu is enhanced with respect to the corresponding grain boundary diffusion rate, it is still less than 500⋅D{sub gb} within the temperature interval from 420 K to 470 K.

  1. Triple dividends of water consumption charges in South Africa

    Science.gov (United States)

    Letsoalo, Anthony; Blignaut, James; de Wet, Theuns; de Wit, Martin; Hess, Sebastiaan; Tol, Richard S. J.; van Heerden, Jan

    2007-05-01

    The South African government is exploring ways to address water scarcity problems by introducing a water resource management charge on the quantity of water used in sectors such as irrigated agriculture, mining, and forestry. It is expected that a more efficient water allocation, lower use, and a positive impact on poverty can be achieved. This paper reports on the validity of these claims by applying a computable general equilibrium model to analyze the triple dividend of water consumption charges in South Africa: reduced water use, more rapid economic growth, and a more equal income distribution. It is shown that an appropriate budget-neutral combination of water charges, particularly on irrigated agriculture and coal mining, and reduced indirect taxes, particularly on food, would yield triple dividends, that is, less water use, more growth, and less poverty.

  2. EXTREME AO OBSERVATIONS OF TWO TRIPLE ASTEROID SYSTEMS WITH SPHERE

    International Nuclear Information System (INIS)

    Yang, B.; Wahhaj, Z.; Dumas, C.; Marsset, M.; Beauvalet, L.; Marchis, F.; Nielsen, E. L.; Vachier, F.

    2016-01-01

    We present the discovery of a new satellite of asteroid (130) Elektra—S/2014 (130) 1—in differential imaging and in integral field spectroscopy data over multiple epochs obtained with Spectro-Polarimetric High-contrast Exoplanet Research/Very Large Telescope. This new (second) moonlet of Elektra is about 2 km across, on an eccentric orbit, and about 500 km away from the primary. For a comparative study, we also observed another triple asteroid system, (93) Minerva. For both systems, component-resolved reflectance spectra of the satellites and primary were obtained simultaneously. No significant spectral difference was observed between the satellites and the primary for either triple system. We find that the moonlets in both systems are more likely to have been created by sub-disruptive impacts as opposed to having been captured

  3. EXTREME AO OBSERVATIONS OF TWO TRIPLE ASTEROID SYSTEMS WITH SPHERE

    Energy Technology Data Exchange (ETDEWEB)

    Yang, B.; Wahhaj, Z.; Dumas, C.; Marsset, M. [European Southern Observatory, Santiago (Chile); Beauvalet, L. [National Observatory, Rio de Janeiro (Brazil); Marchis, F.; Nielsen, E. L. [Carl Sagan Center at the SETI Institute, Mountain View, CA (United States); Vachier, F., E-mail: byang@eso.org [Institut de Mécanique Céleste et de Calcul des Éphémérides, Paris (France)

    2016-04-01

    We present the discovery of a new satellite of asteroid (130) Elektra—S/2014 (130) 1—in differential imaging and in integral field spectroscopy data over multiple epochs obtained with Spectro-Polarimetric High-contrast Exoplanet Research/Very Large Telescope. This new (second) moonlet of Elektra is about 2 km across, on an eccentric orbit, and about 500 km away from the primary. For a comparative study, we also observed another triple asteroid system, (93) Minerva. For both systems, component-resolved reflectance spectra of the satellites and primary were obtained simultaneously. No significant spectral difference was observed between the satellites and the primary for either triple system. We find that the moonlets in both systems are more likely to have been created by sub-disruptive impacts as opposed to having been captured.

  4. Assembly of Liposomes Controlled by Triple Helix Formation

    DEFF Research Database (Denmark)

    Vogel, Stefan; Jakobsen, Ulla

    2013-01-01

    Attachment of DNA to the surface of different solid nanoparticles (e.g. gold- and silica nanoparticles) is well established and a number of DNA-modified solid nanoparticle systems have been applied to thermal denaturation analysis of oligonucleotides. We report herein the non-covalent immobilizat...... analysis (NTA) and dynamic light scattering (DLS) show independently from ultraviolet spectroscopy experiments the formation of liposome aggregates.......-covalent immobilization of oligonucleotides on the surface of soft nanoparticles (e.g. liposomes) and the subsequent controlled assembly by DNA triple helix formation. The non-covalent approach avoids tedious surface chemistry and necessary purification procedures and can simplify and extend the available methodology...... sequences (G or C-rich) to explore the applicability of the method for different triple helical assembly modes. We demonstrate advantages and limitations of the approach and proof the reversible and reproducible formation of liposome aggregates during thermal denaturation cycles. Nanoparticle tracking...

  5. Viscoplastic sculpting in stable triple layer heavy oil transport flow

    Science.gov (United States)

    Sarmadi, Parisa; Hormozi, Sarah; A. Frigaard, Ian

    2017-11-01

    In we introduced a novel methodology for efficient transport of heavy oil via a triple layer core-annular flow. Pumping pressures are significantly reduced by concentrating high shear rates to a lubricating layer, while ideas from Visco-Plastic Lubrication are used to eliminate interfacial instabilities. We purposefully position a shaped unyielded skin of a viscoplastic fluid between the transported oil and the lubricating fluid layer to balance the density difference between the fluids. Here we address the sculpting of the shaped skin within a concentric inflow manifold. We use the quasi-steady model to provide inputs to an axisymmetric triple layer computation, showing the development of the streamwise skin profile and establishment of the flow. For this, we use a finite element discretization with the augmented-Lagrangian method to represent the yield surface behaviour accurately and a PLIC method to track the interface motion.

  6. Triple and quartic gauge boson couplings at the LHC

    CERN Document Server

    Kupco, Alexander; The ATLAS collaboration

    2017-01-01

    This report at the conference Physics in Collision 2017 reviews recent results from the ATLAS and CMS experiments on production of gauge boson pairs, triples, and vector boson scattering (VBS) processes. Large datasets from LHC proton-proton collisions at $\\sqrt{s}=8$ and $13\\,\\mathrm{TeV}$ allowed the first observations of rare processes: triboson production in channel $Z\\gamma\\gamma$ at $\\sqrt{s}=8\\,\\mathrm{TeV}$ and VBS of same signed WW at $\\sqrt{s}=13\\,\\mathrm{TeV}$. Both experiments observe good agreement with the Standard model (SM) predictions. The data were used to set new limits on anomalous triple and quartic gauge couplings not present in the SM.

  7. Artificial neural network analysis of triple effect absorption refrigeration systems

    Energy Technology Data Exchange (ETDEWEB)

    Hajizadeh Aghdam, A. [Department of Mechanical Engineering, Islamic Azad University (Iran, Islamic Republic of)], email: a.hajizadeh@iaukashan.ac.ir; Nazmara, H.; Farzaneh, B. [Department of Mechanical Engineering, University of Tabriz (Iran, Islamic Republic of)], email: h.nazmara@nioec.org, email: b_farzaneh_ms@yahoo.com

    2011-07-01

    In this study, artificial neural networks are utilized to predict the performance of triple effect series and parallel flow absorption refrigeration systems, with lithium bromide/water as the working fluid. Important parameters such as high generator and evaporator temperatures were varied and their effects on the performance characteristics of the refrigeration unit were observed. Absorption refrigeration systems make energy savings possible because they can use heat energy to produce cooling, in place of the electricity used for conventional vapour compression chillers. In addition, non-conventional sources of energy (such as solar, waste heat, and geothermal) can be utilized as their primary energy input. Moreover, absorption units use environmentally friendly working fluid pairs instead of CFCs and HCFCs, which affect the ozone layer. Triple effect absorption cycles were analysed. Results apply for both series and parallel flow systems. A relative preference for parallel-flow over series-flow is also shown.

  8. From binary black hole simulation to triple black hole simulation

    International Nuclear Information System (INIS)

    Bai Shan; Cao Zhoujian; Han, Wen-Biao; Lin, Chun-Yu; Yo, Hwei-Jang; Yu, Jui-Ping

    2011-01-01

    Black hole systems are among the most promising sources for a gravitational wave detection project. Now, China is planning to construct a space-based laser interferometric detector as a follow-on mission of LISA in the near future. Aiming to provide some theoretical support to this detection project on the numerical relativity side, we focus on black hole systems simulation in this work. Considering the globular galaxy, multiple black hole systems also likely to exist in our universe and play a role as a source for the gravitational wave detector we are considering. We will give a progress report in this paper on our black hole system simulation. More specifically, we will present triple black hole simulation together with binary black hole simulation. On triple black hole simulations, one novel perturbational method is proposed.

  9. Lifestyle Triple P: a parenting intervention for childhood obesity

    Directory of Open Access Journals (Sweden)

    Gerards Sanne MPL

    2012-04-01

    Full Text Available Abstract Background Reversing the obesity epidemic requires the development and evaluation of childhood obesity intervention programs. Lifestyle Triple P is a parent-focused group program that addresses three topics: nutrition, physical activity, and positive parenting. Australian research has established the efficacy of Lifestyle Triple P, which aims to prevent excessive weight gain in overweight and obese children. The aim of the current randomized controlled trial is to assess the effectiveness of the Lifestyle Triple P intervention when applied to Dutch parents of overweight and obese children aged 4–8 years. This effectiveness study is called GO4fit. Methods/Design Parents of overweight and obese children are being randomized to either the intervention or the control group. Those assigned to the intervention condition receive the 14-week Lifestyle Triple P intervention, in which they learn a range of nutritional, physical activity and positive parenting strategies. Parents in the control group receive two brochures, web-based tailored advice, and suggestions for exercises to increase active playing at home. Measurements are taken at baseline, directly after the intervention, and at one year follow-up. Primary outcome measure is the children’s body composition, operationalized as BMI z-score, waist circumference, and fat mass (biceps and triceps skinfolds. Secondary outcome measures are children’s dietary behavior and physical activity level, parenting practices, parental feeding style, parenting style, parental self-efficacy, and body composition of family members (parents and siblings. Discussion Our intervention is characterized by a focus on changing general parenting styles, in addition to focusing on changing specific parenting practices, as obesity interventions typically do. Strengths of the current study are the randomized design, the long-term follow-up, and the broad range of both self-reported and objectively measured

  10. Trilayered Morphology of an ABC Triple Crystalline Triblock Terpolymer

    KAUST Repository

    Palacios, Jordana K.

    2017-09-07

    Triple crystalline triblock terpolymers are materials with remarkable semicrystalline superstructures. In this work, we report for first time the alternating triple lamellar morphology that self-assembles inside spherulites of a triblock terpolymer composed of poly(ethylene oxide) (PEO), poly(ε-caprolactone) (PCL), and poly(l-lactide) (PLLA). The morphology of the PEO-b-PCL-b-PLLA triblock terpolymer is compared to an analogous PCL-b-PLLA diblock copolymer. Both diblock and triblock form a single phase in the melt. Two crystallization protocols were employed to create particular crystalline morphologies. In both cases, the isothermal crystallization of the PLA block is induced first (at 81 °C, a temperature above the melting points of both PCL and PEO blocks) and PLLA spherulites form a template, whereupon cooling the other two blocks can crystallize within the PLLA interlamellar spaces. WAXS analysis demonstrated the double crystalline and triple crystalline nature of the materials. The lamellar structure was evaluated by AFM observations and SAXS measurements. Moreover, theoretical SAXS curves of one-dimensional structural models were calculated. AFM micrographs of the triblock terpolymer evidenced the three different lamellae of PLLA, PCL and PEO that coexist together within the same spherulite. Three different lamellar thickness were determined, and their dimensions suggested that all blocks crystallized in chain-folded conformations. The evolution of the triple lamellar morphology during heating of tricrystalline samples was followed by in situ synchrotron SAXS measurements. The theoretical analysis of the SAXS curves of the triblock terpolymer allowed us to propose a stacking morphological model, in which a particular trilayer structure exists, where one lamella of PCL or one lamella of PEO is inserted randomly between two adjacent PLLA lamellae.

  11. Lifestyle Triple P: a parenting intervention for childhood obesity.

    Science.gov (United States)

    Gerards, Sanne M P L; Dagnelie, Pieter C; Jansen, Maria W J; van der Goot, Lidy O H M; de Vries, Nanne K; Sanders, Matthew R; Kremers, Stef P J

    2012-04-03

    Reversing the obesity epidemic requires the development and evaluation of childhood obesity intervention programs. Lifestyle Triple P is a parent-focused group program that addresses three topics: nutrition, physical activity, and positive parenting. Australian research has established the efficacy of Lifestyle Triple P, which aims to prevent excessive weight gain in overweight and obese children. The aim of the current randomized controlled trial is to assess the effectiveness of the Lifestyle Triple P intervention when applied to Dutch parents of overweight and obese children aged 4-8 years. This effectiveness study is called GO4fit. Parents of overweight and obese children are being randomized to either the intervention or the control group. Those assigned to the intervention condition receive the 14-week Lifestyle Triple P intervention, in which they learn a range of nutritional, physical activity and positive parenting strategies. Parents in the control group receive two brochures, web-based tailored advice, and suggestions for exercises to increase active playing at home. Measurements are taken at baseline, directly after the intervention, and at one year follow-up. Primary outcome measure is the children's body composition, operationalized as BMI z-score, waist circumference, and fat mass (biceps and triceps skinfolds). Secondary outcome measures are children's dietary behavior and physical activity level, parenting practices, parental feeding style, parenting style, parental self-efficacy, and body composition of family members (parents and siblings). Our intervention is characterized by a focus on changing general parenting styles, in addition to focusing on changing specific parenting practices, as obesity interventions typically do. Strengths of the current study are the randomized design, the long-term follow-up, and the broad range of both self-reported and objectively measured outcomes. Current Controlled Trials NTR 2555 MEC AZM/UM: NL 31988

  12. Interaction Driven Interband Tunneling of Bosons in the Triple Well

    OpenAIRE

    Cao, Lushuai; Brouzos, Ioannis; Zöllner, Sascha; Schmelcher, Peter

    2010-01-01

    We study the tunneling of a small ensemble of strongly repulsive bosons in a one-dimensional triple-well potential. The usual treatment within the single-band approximation suggests suppression of tunneling in the strong interaction regime. However, we show that several windows of enhanced tunneling are opened in this regime. This enhanced tunneling results from higher band contributions, and has the character of interband tunneling. It can give rise to various tunneling processes, such as si...

  13. Tidal breakup of triple stars in the Galactic Centre

    Science.gov (United States)

    Fragione, Giacomo; Gualandris, Alessia

    2018-04-01

    The last decade has seen the detection of fast moving stars in the Galactic halo, the so-called hypervelocity stars (HVSs). While the bulk of this population is likely the result of a close encounter between a stellar binary and the supermassive black hole (MBH) in the Galactic Centre (GC), other mechanims may contribute fast stars to the sample. Few observed HVSs show apparent ages, which are shorter than the flight time from the GC, thereby making the binary disruption scenario unlikely. These stars may be the result of the breakup of a stellar triple in the GC, which led to the ejection of a hypervelocity binary (HVB). If such binary evolves into a blue straggler star due to internal processes after ejection, a rejuvenation is possible that make the star appear younger once detected in the halo. A triple disruption may also be responsible for the presence of HVBs, of which one candidate has now been observed. We present a numerical study of triple disruptions by the MBH in the GC and find that the most likely outcomes are the production of single HVSs and single/binary stars bound to the MBH, while the production of HVBs has a probability ≲ 1 per cent regardless of the initial parameters. Assuming a triple fraction of ≈ 10 per cent results in an ejection rate of ≲ 1 Gyr - 1, insufficient to explain the sample of HVSs with lifetimes shorter than their flight time. We conclude that alternative mechanisms are responsible for the origin of such objects and HVBs in general.

  14. Kramers Turnover Theory for a Triple Well Potential

    International Nuclear Information System (INIS)

    Pollak, E.; Talkner, P.

    2001-01-01

    Kramers turnover theory is solved for a particle in a symmetric triple well potential for temperatures above the crossover temperature between tunneling and activated barrier crossing. Comparison with the turnover theory for a double well potential shows that the presence of the intermediate well always leads to a decrease of the reaction rate. At most though, the rate is a factor of two smaller than in the case of a double well potential. (author)

  15. Triple-coincidence with automatic chance coincidence correction

    International Nuclear Information System (INIS)

    Chase, R.L.

    1975-05-01

    The chance coincidences in a triple-coincidence circuit are of two types--partially correlated and entirely uncorrelated. Their relative importance depends on source strength and source and detector geometry so that the total chance correction cannot, in general, be calculated. The system described makes use of several delays and straightforward integrated circuit logic to provide independent evaluation of the two components of the chance coincidence rate. (auth)

  16. One-loop triple collinear splitting amplitudes in QCD

    Energy Technology Data Exchange (ETDEWEB)

    Badger, Simon; Buciuni, Francesco; Peraro, Tiziano [Higgs Centre for Theoretical Physics, School of Physics and Astronomy, University of Edinburgh,Edinburgh EH9 3JZ, Scotland (United Kingdom)

    2015-09-28

    We study the factorisation properties of one-loop scattering amplitudes in the triple collinear limit and extract the universal splitting amplitudes for processes initiated by a gluon. The splitting amplitudes are derived from the analytic Higgs plus four partons amplitudes. We present compact results for primitive helicity splitting amplitudes making use of super-symmetric decompositions. The universality of the collinear factorisation is checked numerically against the full colour six parton squared matrix elements.

  17. Realization of the Gallium Triple Point at NMIJ/AIST

    Science.gov (United States)

    Nakano, T.; Tamura, O.; Sakurai, H.

    2008-02-01

    The triple point of gallium has been realized by a calorimetric method using capsule-type standard platinum resistance thermometers (CSPRTs) and a small glass cell containing about 97 mmol (6.8 g) of gallium with a nominal purity of 99.99999%. The melting curve shows a very flat and relatively linear dependence on 1/ F in the region from 1/ F = 1 to 1/ F = 20 with a narrow width of the melting curve within 0.1 mK. Also, a large gallium triple-point cell was fabricated for the calibration of client-owned CSPRTs. The gallium triple-point cell consists of a PTFE crucible and a PTFE cap with a re-entrant well and a small vent. The PTFE cell contains 780 g of gallium from the same source as used for the small glass cell. The PTFE cell is completely covered by a stainless-steel jacket with a valve to enable evacuation of the cell. The melting curve of the large cell shows a flat plateau that remains within 0.03 mK over 10 days and that is reproducible within 0.05 mK over 8 months. The calibrated value of a CSPRT obtained using the large cell agrees with that obtained using the small glass cell within the uncertainties of the calibrations.

  18. GATA3 expression in triple-negative breast cancers.

    Science.gov (United States)

    Byrne, David J; Deb, Siddhartha; Takano, Elena A; Fox, Stephen B

    2017-07-01

    GATA-binding protein 3 (GATA3) is a well-studied transcription factor found to be essential in the development of luminal breast epithelium and has been identified in a variety of tumour types, including breast and urothelial carcinomas, making it a useful immunohistochemistry marker in the diagnosis of both primary and metastatic disease. We investigated GATA3 protein expression in a 106 primary triple-negative breast carcinomas (100 basal-like, six non-basal-like) using Cell Marque mouse monoclonal anti-GATA3 (L50-823). Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to quantify mRNA expression in 22 triple-negative breast cancers (TNBCs) (20 primary and two cell lines), four luminal (three primary and one cell line) and five human epidermal growth factor receptor 2 (HER2) (four primary and one cell line) amplified tumours. In 98 TNBCs where IHC was assessable, 47 (48%) had a 1+ or greater staining with 20 (21%) having high GATA3 expression when using a weighted scoring. Our study has demonstrated that GATA3 expression is common in primary triple-negative breast carcinomas. It also suggests that although GATA3 is an oestrogen receptor (ER) regulated gene, it still proves useful in differentiating between primary and metastatic tumours in patients with a history of breast cancer regardless of its molecular subtype. © 2017 John Wiley & Sons Ltd.

  19. Layout compliance for triple patterning lithography: an iterative approach

    Science.gov (United States)

    Yu, Bei; Garreton, Gilda; Pan, David Z.

    2014-10-01

    As the semiconductor process further scales down, the industry encounters many lithography-related issues. In the 14nm logic node and beyond, triple patterning lithography (TPL) is one of the most promising techniques for Metal1 layer and possibly Via0 layer. As one of the most challenging problems in TPL, recently layout decomposition efforts have received more attention from both industry and academia. Ideally the decomposer should point out locations in the layout that are not triple patterning decomposable and therefore manual intervention by designers is required. A traditional decomposition flow would be an iterative process, where each iteration consists of an automatic layout decomposition step and manual layout modification task. However, due to the NP-hardness of triple patterning layout decomposition, automatic full chip level layout decomposition requires long computational time and therefore design closure issues continue to linger around in the traditional flow. Challenged by this issue, we present a novel incremental layout decomposition framework to facilitate accelerated iterative decomposition. In the first iteration, our decomposer not only points out all conflicts, but also provides the suggestions to fix them. After the layout modification, instead of solving the full chip problem from scratch, our decomposer can provide a quick solution for a selected portion of layout. We believe this framework is efficient, in terms of performance and designer friendly.

  20. Prenatal diagnosis and prognosis of triple X syndrome: 47, XXX.

    Science.gov (United States)

    Ben Hamouda, H; Mkacher, N; Elghezal, H; Bannour, H; Kamoun, M; Soua, H; Saad, A; Souissi, M M; Sfar, M T

    2009-11-01

    Triple X syndrome is a relatively common sex chromosomal abnormality occurring in 0,1% of live-born female infants. Most of these infants have a normal phenotype and only a few cases with 47, XXX karyotype have congenital malformations. We report three cases of triple X syndrome that were diagnosed prenatally by genetic amniocentesis for advanced maternal age and have been observed from birth to age of 3 to 12 years. A description of their growth and development is presented. The birth weight was normal in all patients and one of them had facial dysmorphism with right microphtalmia and auricular septal defect. During the first 2 years of life, the neuromotor development of these infants was not distinguishable from chromosomally normal children. By 3 years of age, two patients have a moderate developmental delay in speech and language. One girl 12-year-old had normal schooling. The diagnosis of the triple X syndrome can be never made because clinical demonstrations are not rather important to arouse the demand of a karyotype. Prenatal diagnosis is often made in front of the advanced maternal age. Expectant parents must be counseled as to the significance of this 47, XXX karyotype and prognostic information must be given.

  1. Second Law Of Thermodynamics Analysis Of Triple Cycle Power Plant

    Directory of Open Access Journals (Sweden)

    Matheus M. Dwinanto

    2012-11-01

    Full Text Available Triple cycle power plant with methane as a fuel has been analyzed on the basis of second law of thermodynamics.In this model, ideal Brayton cycle is selected as a topping cycle as it gives higher efficiency at lower pressure ratio comparedintercooler and reheat cycle. In trilple cycle the bottoming cycles are steam Rankine and organic Rankine cycle. Ammoniahas suitable working properties like critical temperature, boiling temperature, etc. Steam cycle consists of a deaerator andreheater. The bottoming ammonia cycle is a ideal Rankine cycle. Single pressure heat recovery steam and ammoniagenerators are selected for simplification of the analysis. The effects of pressure ratio and maximum temperature which aretaken as important parameters regarding the triple cycle are discussed on performance and exergetic losses. On the otherhand, the efficiency of the triple cycle can be raised, especially in the application of recovering low enthalpy content wasteheat. Therefore, by properly combining with a steam Rankine cycle, the ammonia Rankine cycle is expected to efficientlyutilize residual yet available energy to an optimal extent. The arrangement of multiple cycles is compared with combinedcycle having the same sink conditions. The parallel type of arrangement of bottoming cycle is selected due to increasedperformance.

  2. Static analysis of triple-effect adsorption refrigeration with compressor

    Directory of Open Access Journals (Sweden)

    Fumi Watanabe

    2017-03-01

    Full Text Available In order to improve the efficiency of the adsorption refrigeration cycle, this study proposes a triple-effect adsorption refrigeration cycle equipped with a compressor. This cycle can run in order to create a large variation in adsorbent concentration range by the compressor, even if there is little temperature variation in the desorption and adsorption processes. The objective of this study is to clarify the effect that regulating adsorption pressure using a compressor has on the adsorption refrigeration cycle, and to that end cycle efficiency was calculated using a static analysis based on a state of equilibrium. As a results from the simulation, the triple-effect cycles can operate by regulating adsorption pressure. Both COP and exergy efficiency can be improved by a factor of 1.2 if the cycled is regulated the adsorption pressure of each cycle rather than using a shared adsorption pressure. For heat sources in the temperature range of 70–100 °C, this method is superior in terms of COP and exergy efficiency. COP values of approximately 1.7–1.8 can be obtained, which is three times higher than single-effect cycles. The triple-effect cycles have one-third the SCE of single-effect cycles but about the same SCE as double-effect cycles.

  3. Nuclear collective flow from gaussian fits to triple differential distributions

    International Nuclear Information System (INIS)

    Gosset, J.; Babinet, R.; Cavata, C.; Marco, M. de; Demoulins, M.; Fanet, H.; Fodor, Z.; L'Hote, D.; Lucas, B.

    1990-01-01

    A simple characterization of triple differential cross sections is needed for a systematic study of the nuclear matter collective flow in relativistic nucleus-nucleus collisions. Our analysis is based upon a fitting procedure, so that the triple differential distributions need not be measured in the whole momentum space. If the detector acceptance eliminates most spectator particles or if it is artificially restricted for doing so, this method leads to a flow characterization of the participant nuclear matter. The center-of-mass triple-differential momentum distributions are fitted to a simple analytical shape, namely an anisotropic Gaussian distribution. The adjusted parameters (flow angle and aspect ratios) are corrected for uncertainty in the event-by-event determination of the reaction plane azimuth (finite-number effects). Results are presented for neon-nucleus and argon-nucleus collisions at incident energy between 400 and 800 MeV per nucleon. Flow is already significant for light systems, and depends clearly upon the impact parameter

  4. High-spin isomers in 212Rn in the region of triple neutron core-excitations

    Science.gov (United States)

    Dracoulis, G. D.; Lane, G. J.; Byrne, A. P.; Davidson, P. M.; Kibédi, T.; Nieminen, P.; Watanabe, H.; Wilson, A. N.

    2008-04-01

    The level scheme of 212Rn has been extended to spins of ∼ 38 ℏ and excitation energies of about 13 MeV using the 204Hg(13C, 5n)212Rn reaction and γ-ray spectroscopy. Time correlated techniques have been used to obtain sensitivity to weak transitions and channel selectivity. The excitation energy of the 22+ core-excited isomer has been established at 6174 keV. Two isomers with τ = 25 (2) ns and τ = 12 (2) ns are identified at 12211 and 12548 keV, respectively. These are the highest-spin nuclear isomers now known, and are attributed to configurations involving triple neutron core-excitations coupled to the aligned valence protons. Semi-empirical shell-model calculations can account for most states observed, but with significant energy discrepancies for some configurations.

  5. High-spin isomers in 212Rn in the region of triple neutron core-excitations

    International Nuclear Information System (INIS)

    Dracoulis, G.D.; Lane, G.J.; Byrne, A.P.; Davidson, P.M.; Kibedi, T.; Nieminen, P.; Watanabe, H.; Wilson, A.N.

    2008-01-01

    The level scheme of 212 Rn has been extended to spins of ∼38h and excitation energies of about 13 MeV using the 204 Hg( 13 C, 5n) 212 Rn reaction and γ-ray spectroscopy. Time correlated techniques have been used to obtain sensitivity to weak transitions and channel selectivity. The excitation energy of the 22 + core-excited isomer has been established at 6174 keV. Two isomers with τ=25(2) ns and τ=12(2) ns are identified at 12211 and 12548 keV, respectively. These are the highest-spin nuclear isomers now known, and are attributed to configurations involving triple neutron core-excitations coupled to the aligned valence protons. Semi-empirical shell-model calculations can account for most states observed, but with significant energy discrepancies for some configurations

  6. How evidence-based is an 'evidence-based parenting program'? A PRISMA systematic review and meta-analysis of Triple P

    Directory of Open Access Journals (Sweden)

    Wilson Philip

    2012-11-01

    Full Text Available Abstract Background Interventions to promote positive parenting are often reported to offer good outcomes for children but they can consume substantial resources and they require rigorous appraisal. Methods Evaluations of the Triple P parenting program were subjected to systematic review and meta-analysis with analysis of biases. PsychInfo, Embase and Ovid Medline were used as data sources. We selected published articles reporting any child-based outcome in which any variant of Triple P was evaluated in relation to a comparison condition. Unpublished data, papers in languages other than English and some book chapters were not examined. Studies reporting Eyberg Child Behavior Inventory or Child Behavior Checklist scores as outcomes were used in the meta-analysis. Results A total of 33 eligible studies was identified, most involving media-recruited families. Thirty-one of these 33 studies compared Triple P interventions with waiting list or no-treatment comparison groups. Most papers only reported maternal assessments of child behavior. Twenty-three papers were incorporated in the meta-analysis. No studies involved children younger than two-years old and comparisons of intervention and control groups beyond the duration of the intervention were only possible in five studies. For maternally-reported outcomes the summary effect size was 0.61 (95%CI 0.42, 0.79. Paternally-reported outcomes following Triple P intervention were smaller and did not differ significantly from the control condition (effect size 0.42 (95%CI -0.02, 0.87. The two studies involving an active control group showed no between-group differences. There was limited evidence of publication bias, but there was substantial selective reporting bias, and preferential reporting of positive results in article abstracts. Thirty-two of the 33 eligible studies were authored by Triple-P affiliated personnel. No trials were registered and only two papers contained conflict of interest

  7. An empirical understanding of triple collocation evaluation measure

    Science.gov (United States)

    Scipal, Klaus; Doubkova, Marcela; Hegyova, Alena; Dorigo, Wouter; Wagner, Wolfgang

    2013-04-01

    Triple collocation method is an advanced evaluation method that has been used in the soil moisture field for only about half a decade. The method requires three datasets with an independent error structure that represent an identical phenomenon. The main advantages of the method are that it a) doesn't require a reference dataset that has to be considered to represent the truth, b) limits the effect of random and systematic errors of other two datasets, and c) simultaneously assesses the error of three datasets. The objective of this presentation is to assess the triple collocation error (Tc) of the ASAR Global Mode Surface Soil Moisture (GM SSM 1) km dataset and highlight problems of the method related to its ability to cancel the effect of error of ancillary datasets. In particular, the goal is to a) investigate trends in Tc related to the change in spatial resolution from 5 to 25 km, b) to investigate trends in Tc related to the choice of a hydrological model, and c) to study the relationship between Tc and other absolute evaluation methods (namely RMSE and Error Propagation EP). The triple collocation method is implemented using ASAR GM, AMSR-E, and a model (either AWRA-L, GLDAS-NOAH, or ERA-Interim). First, the significance of the relationship between the three soil moisture datasets was tested that is a prerequisite for the triple collocation method. Second, the trends in Tc related to the choice of the third reference dataset and scale were assessed. For this purpose the triple collocation is repeated replacing AWRA-L with two different globally available model reanalysis dataset operating at different spatial resolution (ERA-Interim and GLDAS-NOAH). Finally, the retrieved results were compared to the results of the RMSE and EP evaluation measures. Our results demonstrate that the Tc method does not eliminate the random and time-variant systematic errors of the second and the third dataset used in the Tc. The possible reasons include the fact a) that the TC

  8. Probiotics improve the efficacy of standard triple therapy in the eradication of Helicobacter pylori: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Lau CSM

    2016-12-01

    Full Text Available Christine S M Lau,1,2 Amanda Ward,2 Ronald S Chamberlain1–4 1Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; 2Saint George’s University School of Medicine, Grenada, West Indies; 3Department of Surgery, Banner MD Anderson Cancer Center, Gilbert, AZ, USA; 4Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA Introduction: Helicobacter pylori colonization is present in half of the world’s population and can lead to numerous gastrointestinal diseases if left untreated, including peptic ulcer disease and gastric cancer. Although concurrent triple therapy remains the recommended treatment regimen for H. pylori eradication, its success rate and efficacy have been declining. Recent studies have shown that the addition of probiotics can significantly increase eradication rates by up to 50%. This meta-analysis examines the impact of probiotic supplementation on the efficacy of standard triple therapy in eradicating H. pylori. Methods: A comprehensive literature search was conducted using PubMed, Cochrane Central Registry of Controlled Trials, and Google Scholar (time of inception to 2016 to identify all published randomized control trials (RCTs assessing the use of probiotics in addition to triple therapy for the treatment of H. pylori. Searches were conducted using the keywords “probiotics”, “triple therapy”, and “Helicobacter pylori”. RCTs comparing the use of probiotics and standard triple therapy with standard triple therapy alone for any duration in patients of any age diagnosed with H. pylori infection were included. H. pylori eradication rates (detected using urea breath test or stool antigen were analyzed as-per-protocol (APP and intention-to-treat (ITT. Results: A total of 30 RCTs involving 4,302 patients APP and 4,515 patients ITT were analyzed. The addition of probiotics significantly increased eradication rates by 12.2% (relative risk [RR] =1.122; 95% confidence

  9. Vitamin D compounds inhibit cancer stem-like cells and induce differentiation in triple negative breast cancer.

    Science.gov (United States)

    Shan, Naing Lin; Wahler, Joseph; Lee, Hong Jin; Bak, Min Ji; Gupta, Soumyasri Das; Maehr, Hubert; Suh, Nanjoo

    2017-10-01

    Triple-negative breast cancer is one of the least responsive breast cancer subtypes to available targeted therapies due to the absence of hormonal receptors, aggressive phenotypes, and the high rate of relapse. Early breast cancer prevention may therefore play an important role in delaying the progression of triple-negative breast cancer. Cancer stem cells are a subset of cancer cells that are thought to be responsible for tumor progression, treatment resistance, and metastasis. We have previously shown that vitamin D compounds, including a Gemini vitamin D analog BXL0124, suppress progression of ductal carcinoma in situ in vivo and inhibit cancer stem-like cells in MCF10DCIS mammosphere cultures. In the present study, the effects of vitamin D compounds in regulating breast cancer stem-like cells and differentiation in triple-negative breast cancer were assessed. Mammosphere cultures, which enriches for breast cancer cells with stem-like properties, were used to assess the effects of 1α,25(OH) 2 D 3 and BXL0124 on cancer stem cell markers in the triple-negative breast cancer cell line, SUM159. Vitamin D compounds significantly reduced the mammosphere forming efficiency in primary, secondary and tertiary passages of mammospheres compared to control groups. Key markers of cancer stem-like phenotype and pluripotency were analyzed in mammospheres treated with 1α,25(OH) 2 D 3 and BXL0124. As a result, OCT4, CD44 and LAMA5 levels were decreased. The vitamin D compounds also down-regulated the Notch signaling molecules, Notch1, Notch2, Notch3, JAG1, JAG2, HES1 and NFκB, which are involved in breast cancer stem cell maintenance. In addition, the vitamin D compounds up-regulated myoepithelial differentiating markers, cytokeratin 14 and smooth muscle actin, and down-regulated the luminal marker, cytokeratin 18. Cytokeratin 5, a biomarker associated with basal-like breast cancer, was found to be significantly down-regulated by the vitamin D compounds. These results suggest

  10. Coupling characteristics of the spun optical fiber with triple stress elements

    Science.gov (United States)

    Ji, Minning; Shang, Fengtao; Chen, Dandan

    2018-06-01

    An empirical formula related to the stress field distribution in the optical fiber with triple stress elements is proposed and proved. The possible intercoupling between the fundamental modes and the higher order modes is demonstrated. The transmission property of the spun optical fiber with triple stress elements is analyzed. The experimental data from a sample of the spun optical fiber with triple stress elements confirm the theoretical results very well.

  11. Triple oxygen isotope systematics of structurally bonded water in gypsum

    Science.gov (United States)

    Herwartz, Daniel; Surma, Jakub; Voigt, Claudia; Assonov, Sergey; Staubwasser, Michael

    2017-07-01

    The triple oxygen isotopic composition of gypsum mother water (gmw) is recorded in structurally bonded water in gypsum (gsbw). Respective fractionation factors have been determined experimentally for 18O/16O and 17O/16O. By taking previous experiments into account we suggest using 18αgsbw-gmw = 1.0037; 17αgsbw-gmw = 1.00195 and θgsbw-gmw = 0.5285 as fractionation factors in triple oxygen isotope space. Recent gypsum was sampled from a series of 10 ponds located in the Salar de Llamara in the Atacama Desert, Chile. Total dissolved solids (TDS) in these ponds show a gradual increase from 23 g/l to 182 g/l that is accompanied by an increase in pond water 18O/16O. Gsbw falls on a parallel curve to the ambient water from the saline ponds. The offset is mainly due to the equilibrium fractionation between gsbw and gmw. However, gsbw represents a time integrated signal biased towards times of strong evaporation, hence the estimated gmw comprises elevated 18O/16O compositions when compared to pond water samples taken on site. Gypsum precipitation is associated with algae mats in the ponds with lower salinity. No evidence for respective vital effects on the triple oxygen isotopic composition of gypsum hydration water is observed, nor are such effects expected. In principle, the array of δ18Ogsbw vs. 17Oexcess can be used to: (1) provide information on the degree of evaporation during gypsum formation; (2) estimate pristine meteoric water compositions; and (3) estimate local relative humidity which is the controlling parameter of the slope of the array for simple hydrological situations. In our case study, local mining activities may have decreased deep groundwater recharge, causing a recent change of the local hydrology.

  12. Triple vacuum glazing: Heat transfer and basic mechanical design constraints

    Energy Technology Data Exchange (ETDEWEB)

    Manz, H.; Brunner, S.; Wullschleger, L. [Swiss Federal Laboratories for Materials Testing and Research (EMPA), Laboratory for Applied Physics in Building, Ueberlandstrasse 129, CH-8600 Duebendorf (Switzerland)

    2006-12-15

    Given the major role played by windows with regard to energy losses from buildings in cold climates, low thermal transmittance is an indispensable property of glazing in low-energy buildings. Evacuation offers the only means of achieving negligible gaseous conduction in glazing cavities. Application of low-emittance coatings to glass sheet surfaces inside the cavity reduces the radiative heat transfer. The feasibility of double vacuum glazing using arrays of support pillars between the glass sheets has been shown by other authors. This type of glazing is commercially manufactured today. Based on these achievements, our study set out to investigate heat transfer in triple vacuum glazing by means of (i) an analytical thermal network model and (ii) a numerical finite difference model. The study focused on the impact of the following parameters on thermal transmittance: emittances of glass sheet surfaces inside the cavity, support pillar radius, support pillar separation and thermal conductivity of support pillar material. The design procedure for triple vacuum glazing taking into account not only thermal but also mechanical stresses due to atmospheric pressure, i.e., to enable identification of favourable parameter sets, is presented. Our findings suggest that use of the triple vacuum glazing concept can significantly reduce the thermal transmittances achieved by the best insulation glazing units currently on the market. E.g., a centre-of-glazing thermal transmittance of less than 0.2Wm{sup -2}K{sup -1} is achievable using stainless steel support pillars, 6mm/4mm/6mm sheets of untempered soda-lime glass and four low-emittance coatings ({epsilon}=0.03). (author)

  13. Synthesis and crystal structure analysis of uranyl triple acetates

    Energy Technology Data Exchange (ETDEWEB)

    Klepov, Vladislav V., E-mail: vladislavklepov@gmail.com [Institute for Energy and Climate Research (IEK-6), Forschungszentrum Jülich GmbH, 52428 Jülich (Germany); Department of Chemistry, Samara National Research University, 443086 Samara (Russian Federation); Serezhkina, Larisa B.; Serezhkin, Victor N. [Department of Chemistry, Samara National Research University, 443086 Samara (Russian Federation); Alekseev, Evgeny V., E-mail: e.alekseev@fz-juelich.de [Institute for Energy and Climate Research (IEK-6), Forschungszentrum Jülich GmbH, 52428 Jülich (Germany); Institut für Kristallographie, RWTH Aachen University, 52066 Aachen (Germany)

    2016-12-15

    Single crystals of triple acetates NaR[UO{sub 2}(CH{sub 3}COO){sub 3}]{sub 3}·6H{sub 2}O (R=Mg, Co, Ni, Zn), well-known for their use as reagents for sodium determination, were grown from aqueous solutions and their structural and spectroscopic properties were studied. Crystal structures of the mentioned phases are based upon (Na[UO{sub 2}(CH{sub 3}COO){sub 3}]{sub 3}){sup 2–} clusters and [R(H{sub 2}O){sub 6}]{sup 2+} aqua-complexes. The cooling of a single crystal of NaMg[UO{sub 2}(CH{sub 3}COO){sub 3}]{sub 3}·6H{sub 2}O from 300 to 100 K leads to a phase transition from trigonal to monoclinic crystal system. Intermolecular interactions between the structural units and their mutual packing were studied and compared from the point of view of the stereoatomic model of crystal structures based on Voronoi-Dirichlet tessellation. Using this method we compared the crystal structures of the triple acetates with Na[UO{sub 2}(CH{sub 3}COO){sub 3}] and [R(H{sub 2}O){sub 6}][UO{sub 2}(CH{sub 3}COO){sub 3}]{sub 2} and proposed reasons of triple acetates stability. Infrared and Raman spectra were collected and their bands were assigned. - Graphical abstract: Single crystals of uranium based triple acetates, analytical reagents for sodium determination, were synthesized and structurally, spectroscopically and topologically characterized. The structures were compared with the structures of compounds from preceding families [M(H{sub 2}O){sub 6})][UO{sub 2}(CH{sub 3}COO){sub 3}]{sub 2} (M = Mg, Co, Ni, Zn) and Na[UO{sub 2}(CH{sub 3}COO){sub 3}]. Analysis was performed with the method of molecular Voronoi-Dirichlet polyhedra to reveal a large contribution of the hydrogen bonds into intermolecular interactions which can be a reason of low solubility of studied complexes.

  14. Targeting Histone Abnormality in Triple Negative Breast Cancer

    Science.gov (United States)

    2016-08-01

    W81XWH-14-1-0237 Triple-Negative Breast Cancer Davidson, PI U10 CA180844 NCI NCTN-Network Lead 5% 2014- 2019 $11,255 Davidson, Co-PI Academic Site...MD AACR High Tech Strategic Business Meeting, Sunnyvale, CA Medical Oncology Board Review, George Washington University, Washington, DC Great...both ductal car - cinoma in situ and invasive ductal carcinoma of the breast. Oncogene 2003; 22: 2021–2033. 25 Lin T, Ponn A, Hu X, Law BK, Lu J

  15. Efficacy of Neoadjuvant Cisplatin in Triple-Negative Breast Cancer

    DEFF Research Database (Denmark)

    Szallasi, Zoltan Imre; Eklund, Aron Charles; Li, Qiyuan

    2010-01-01

    PURPOSE Cisplatin is a chemotherapeutic agent not used routinely for breast cancer treatment. As a DNA cross-linking agent, cisplatin may be effective treatment for hereditary BRCA1-mutated breast cancers. Because sporadic triple-negative breast cancer (TNBC) and BRCA1-associated breast cancer...... samples were evaluated for selected biomarkers. Results Six (22%) of 28 patients achieved pathologic complete responses, including both patients with BRCA1 germline mutations;18 (64%) patients had a clinical complete or partial response. Fourteen (50%) patients showed good pathologic responses (Miller...

  16. Electrically protected resonant exchange qubits in triple quantum dots.

    Science.gov (United States)

    Taylor, J M; Srinivasa, V; Medford, J

    2013-08-02

    We present a modulated microwave approach for quantum computing with qubits comprising three spins in a triple quantum dot. This approach includes single- and two-qubit gates that are protected against low-frequency electrical noise, due to an operating point with a narrowband response to high frequency electric fields. Furthermore, existing double quantum dot advances, including robust preparation and measurement via spin-to-charge conversion, are immediately applicable to the new qubit. Finally, the electric dipole terms implicit in the high frequency coupling enable strong coupling with superconducting microwave resonators, leading to more robust two-qubit gates.

  17. Prisoners of War of the Triple Alliance within Kazakhstan

    OpenAIRE

    Gulzhaukhar K. Kokebayeva; Nurzipa K. Alpysbayeva; Shotbek T. Bulgauov

    2015-01-01

    The work studies the problem of the detention of prisoners of war of the Triple Alliance in the camps, located within Kazakhstan. During the first months of war, the Russian authorities treated the prisoners of war in accordance with ‘Convention on the Treatment of the Prisoners of War’, approved by the Emperor of Russia. The content of this document corresponded to the Hague Convention with Respect to the Laws and Customs of War on Land. The major areas of the detention of prisoners of war w...

  18. Wnt signaling in triple-negative breast cancer

    Science.gov (United States)

    Pohl, SÖ-G; Brook, N; Agostino, M; Arfuso, F; Kumar, A P; Dharmarajan, A

    2017-01-01

    Wnt signaling regulates a variety of cellular processes, including cell fate, differentiation, proliferation and stem cell pluripotency. Aberrant Wnt signaling is a hallmark of many cancers. An aggressive subtype of breast cancer, known as triple-negative breast cancer (TNBC), demonstrates dysregulation in canonical and non-canonical Wnt signaling. In this review, we summarize regulators of canonical and non-canonical Wnt signaling, as well as Wnt signaling dysfunction that mediates the progression of TNBC. We review the complex molecular nature of TNBC and the emerging therapies that are currently under investigation for the treatment of this disease. PMID:28368389

  19. Triple M-brane configurations and preserved supersymmetries

    International Nuclear Information System (INIS)

    Golubtsova, A.A.; Ivashchuk, V.D.

    2013-01-01

    We investigate all standard triple composite M-brane intersections defined on products of Ricci-flat manifolds for preserving supersymmetries in eleven-dimensional N=1 supergravity. The explicit formulae for computing the numbers of preserved supersymmetries are obtained, which generalize the relations for topologically trivial flat factor spaces presented in the classification by Bergshoeff et al. We obtain certain examples of configurations preserving some fractions of supersymmetries, e.g. containing such factor spaces as K3, C ⁎ 2 /Z 2 , a four-dimensional pp-wave manifold and the two-dimensional pseudo-Euclidean manifold R ⁎ 1,1 /Z 2

  20. Nonlinear triple-point problems on time scales

    Directory of Open Access Journals (Sweden)

    Douglas R. Anderson

    2004-04-01

    Full Text Available We establish the existence of multiple positive solutions to the nonlinear second-order triple-point boundary-value problem on time scales, $$displaylines{ u^{Delta abla}(t+h(tf(t,u(t=0, cr u(a=alpha u(b+delta u^Delta(a,quad eta u(c+gamma u^Delta(c=0 }$$ for $tin[a,c]subsetmathbb{T}$, where $mathbb{T}$ is a time scale, $eta, gamma, deltage 0$ with $Beta+gamma>0$, $0

  1. Triple-phase bone image abnormalities in Lyme arthritis

    International Nuclear Information System (INIS)

    Brown, S.J.; Dadparvar, S.; Slizofski, W.J.; Glab, L.B.; Burger, M.

    1989-01-01

    Arthritis is a frequent manifestation of Lyme disease. Limited triple-phase Tc-99m MDP bone imaging of the wrists and hands with delayed whole-body images was performed in a patient with Lyme arthritis. This demonstrated abnormal joint uptake in the wrists and hands in all three phases, with increased activity seen in other affected joints on delayed whole-body images. These findings are nonspecific and have been previously described in a variety of rheumatologic conditions, but not in Lyme disease. Lyme disease should be considered in the differential diagnosis of articular and periarticular bone scan abnormalities

  2. Synchrotron X-ray diffraction using triple-axis spectrometry

    International Nuclear Information System (INIS)

    Als-Nielsen, J.

    1980-12-01

    High resolution X-ray diffraction studies of (i) monolayers of the noble gases Kr and Ar physiosorbed on graphite (ii) smectic A fluctuations in the nematic and the smectic A phases of liquid crystals are described. The apparatus used is a triple axis spectrometer situated at the storage ring DORIS at Hasylab, DESY, Hamburg. A monochromatic, well collimated beam is extracted from the synchrotron radiation spectrum by Bragg reflection from perfect Si or Ge crystals. The direction of the beam scattered from the sample is determined by Bragg reflection from a perfect Si or Ge crystal. High intensities even with resolution extending beyond the wavelength of visible light can be obtained. (Auth.)

  3. Nuclear collective flow from gaussian fits to triple differential distributions

    International Nuclear Information System (INIS)

    Gosset, J.; Demoulins, M.; Babinet, R.; Cavata, C.; Fanet, H.; L'Hote, D.; Lucas, B.; Poitou, J.; Valette, O.; Alard, J.P.; Augerat, J.; Bastid, N.; Charmensat, P.; Dupieux, P.; Fraysse, L.; Marroncle, J.; Montarou, G.; Parizet, M.J.; Qassoud, D.; Rahmani, A.; Brochard, F.; Gorodetzky, P.; Racca, C.

    1990-01-01

    In order to study the nuclear collective flow, the triple differential momentum distributions of charged baryons are fitted to a simple anisotropic gaussian distribution, within an acceptance which removes most of the spectator contribution. The adjusted flow angle and aspect ratios are corrected for systematic errors in the determination of the reaction plane. This method has been tested with Monte Carlo simulations and applied to experimental results and intranuclear cascade simulations of argon-nucleus collisions at 400 MeV per nucleon. (orig.)

  4. Triple-root jump in spacecraft potential due to electron beam emission or impact

    International Nuclear Information System (INIS)

    Lai, S.T.

    1992-01-01

    Triple-root jump in spacecraft potential is well understood in the double Maxwellian model of the natural space environment. In this paper, however, the author points out that triple-root jumps in spacecraft potential may also occur during photoemission or electron beam emission from a spacecraft. Impact of an incoming electron beam on a spacecraft may also cause triple-root jumps provided that the beam, ambient plasma, and surface parameters satisfy certain inequality conditions. The parametric conditions under which such beam induced triple-root jumps may occur are presented

  5. Emission of partial dislocations from triple junctions of grain boundaries in nanocrystalline materials

    International Nuclear Information System (INIS)

    Gutkin, M Yu; Ovid'ko, I A; Skiba, N V

    2005-01-01

    A theoretical model is suggested that describes emission of partial Shockley dislocations from triple junctions of grain boundaries (GBs) in deformed nanocrystalline materials. In the framework of the model, triple junctions accumulate dislocations due to GB sliding along adjacent GBs. The dislocation accumulation at triple junctions causes partial Shockley dislocations to be emitted from the dislocated triple junctions and thus accommodates GB sliding. Ranges of parameters (applied stress, grain size, etc) are calculated in which the emission events are energetically favourable in nanocrystalline Al, Cu and Ni. The model accounts for the corresponding experimental data reported in the literature

  6. Meta-Design and the Triple Learning Organization in Architectural Design Process

    Science.gov (United States)

    Barelkowski, Robert

    2017-10-01

    The paper delves into the improvement of Meta-Design methodology being the result of implementation of triple learning organization. Grown from the concept of reflective practice, it offers an opportunity to segregate and hierarchize both criteria and knowledge management and at least twofold application. It induces constant feedback loops recharging the basic level of “design” with second level of “learning from design” and third level of “learning from learning”. While learning from design reflects the absorption of knowledge, structuralization of skills, management of information, learning from learning gives deeper understanding and provides axiological perspective which is necessary when combining cultural, social, and abstract conceptual problems. The second level involves multidisciplinary applications imported from many engineering disciplines, technical sciences, but also psychological background, or social environment. The third level confronts these applications with their respective sciences (wide extra-architectural knowledge) and axiological issues. This distinction may be represented in difference between e.g. purposeful, systemic use of participatory design which again generates experience-by-doing versus use of disciplinary knowledge starting from its theoretical framework, then narrowed down to be relevant to particular design task. The paper discusses the application in two cases: awarded competition proposal of Digital Arts Museum in Madrid and BAIRI university building. Both cases summarize the effects of implementation and expose the impact of triple-loop knowledge circles onto design, teaching the architect or helping them to learn how to manage information flows and how to accommodate paradigm shifts in the architectural design process.

  7. Development of a totally computer-controlled triple quadrupole mass spectrometer system

    International Nuclear Information System (INIS)

    Wong, C.M.; Crawford, R.W.; Barton, V.C.; Brand, H.R.; Neufeld, K.W.; Bowman, J.E.

    1983-01-01

    A totally computer-controlled triple quadrupole mass spectrometer (TQMS) is described. It has a number of unique features not available on current commercial instruments, including: complete computer control of source and all ion axial potentials; use of dual computers for data acquisition and data processing; and capability for self-adaptive control of experiments. Furthermore, it has been possible to produce this instrument at a cost significantly below that of commercial instruments. This triple quadrupole mass spectrometer has been constructed using components commercially available from several different manufacturers. The source is a standard Hewlett-Packard 5985B GC/MS source. The two quadrupole analyzers and the quadrupole CAD region contain Balzers QMA 150 rods with Balzers QMG 511 rf controllers for the analyzers and a Balzers QHS-511 controller for the CAD region. The pulsed-positive-ion-negative-ion-chemical ionization (PPINICI) detector is made by Finnigan Corporation. The mechanical and electronics design were developed at LLNL for linking these diverse elements into a functional TQMS as described. The computer design for total control of the system is unique in that two separate LSI-11/23 minicomputers and assorted I/O peripherals and interfaces from several manufacturers are used. The evolution of this design concept from totally computer-controlled instrumentation into future self-adaptive or ''expert'' systems for instrumental analysis is described. Operational characteristics of the instrument and initial results from experiments involving the analysis of the high explosive HMX (1,3,5,7-Tetranitro-1,3,5,7-Tetrazacyclooctane) are presented

  8. Benign metastasizing leiomyoma in triple location: lungs, parametria and appendix

    Directory of Open Access Journals (Sweden)

    Renata Raś

    2016-07-01

    Full Text Available Benign metastasizing leiomyoma (BML usually are situated in one organ, most often in lungs. BML patients typically have a history of uterine leiomyoma treated with hysterectomy, myomectomy or subtotal hysterectomy. The aim of the study was to present the case of a 53-year-old woman with triple location in the lungs, parametria and appendix. She had undergone a myomectomy 26 years earlier. In 2015, she was admitted to the surgical department because of abdominal pain, whereupon a cholecystectomy was performed. CT scans showed pelvic mass with pulmonary metastasis. Upon discharge the patient was referred to the Gynecology Clinic, where a laparotomy was performed. The intraoperative findings were: 1 uterus with multiple leiomyomas, 2 four tumors in the parametria, 3 tumor connected to the appendix. A subtotal hysterectomy, with a bilateral salpingo-oophorectomy, removal of the tumors from the parametria and appendectomy was performed. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining (strongly positive for estrogen receptors and SMA, while Ki67 was very low, below 1%. Upon postoperative recovery, the patient was referred to the Thoracic Surgery Department. During the thoracotomy, multiple nodes, surrounded by lung parenchyma, were revealed. Wedge resection was performed, for localized pulmonary lesions, and sent for pathological examination. The final pathological diagnosis was benign metastasizing leiomyomatosis. In conclusion, the triple location of BML could possibly be a result of a parallel different metastasizing mechanism, although it is impossible to exclude one mechanism, which may be the cause of the metastases in three locations.

  9. Shifting to triple value healthcare: Reflections from England.

    Science.gov (United States)

    Jani, Anant; Jungmann, Sven; Gray, Muir

    2018-02-01

    Increasing need and demand because of growing and aging populations combined with stagnant or decreasing resources being invested into healthcare globally mean that a radical shift is needed to ensure that healthcare systems can meet current and future challenges. Quality-, safety- and efficiency-improvement approaches have been used as means to address many problems in healthcare and while they are essential and necessary, they are not sufficient to meet our current challenges. To build resilient and sustainable healthcare systems, we need a shift to focus on triple value healthcare, which will help healthcare professionals improve outcomes at the process, patient and population levels while also optimising resource utilisation. Here we present a brief history of the Quality and Evidence-based Healthcare model and then describe how value emerged as a predominant theme in England. We then highlight the four solutions that we, as part of the RightCare programme, designed and refined in the English NHS to turn theory into practice: We end with a description of how triple value is being introduced into Germany and steps that can be taken to facilitate its adoption. Copyright © 2018. Published by Elsevier GmbH.

  10. Bridging disparate symptoms of schizophrenia: a Triple network dysfunction theory

    Directory of Open Access Journals (Sweden)

    Tereza eNekovarova

    2014-05-01

    Full Text Available Schizophrenia is a complex neuropsychiatric disorder with variable symptomatology, traditionally divided into positive and negative symptoms, and cognitive deficits. Yet, the etiology of this disorder has yet to be fully understood.Recent findings suggest that alteration of the basic sense of self-awareness may be an essential distortion of schizophrenia spectrum disorders. In addition, extensive research of social and mentalizing abilities has stressed the role of distortion of social skills in schizophrenia.This article aims to propose and support a concept of triple brain network model of the dysfunctional switching between default mode and central executive network related to the aberrant activity of salience network. This model could represent a unitary mechanism of a wide array of symptom domains present in schizophrenia including the deficit of SELF (self-awareness and self-representation and theory of mind (ToM dysfunctions along with the traditional positive, negative and cognitive domains. We review previous studies which document the dysfunctions of SELF and ToM in schizophrenia together with neuroimaging data elucidating the triple brain network model as a common neuronal substrate of this dysfunction.

  11. Drying of carrot slices in a triple pass solar dryer

    Directory of Open Access Journals (Sweden)

    Seshachalam Kesavan

    2017-01-01

    Full Text Available An indirect triple pass forced convection solar dryer was developed and its performance was evaluated for drying of carrot slices. The drying experiments were carried out under the meteorological conditions of Coimbatore city in India during the year 2016. The experimental set-up consists of a blower, triple pass packed bed air collector (using sand with wire mesh absorber plate, and a drying chamber. The air mass flow rate was optimized to 0.062 kg/s. The initial moisture content of the carrot slices was reduced from 87.5% (on wet basis to the final moisture content of 10% (wet basis in 6 h duration. The thin layer drying characteristics were analyzed using twelve mathematical models available in open literature. The results showed that the pick-up efficiency of the dryer was varied in the range between 14 and 43% with an average air collector thermal efficiency of 44% during the experimentation. The drying characteristics of carrot slices was predicted with good degree of accuracy using Wang and Singh drying model.

  12. Cellular uptake mechanism and comparative evaluation of antineoplastic effects of paclitaxel–cholesterol lipid emulsion on triple-negative and non-triple-negative breast cancer cell lines

    Directory of Open Access Journals (Sweden)

    Ye J

    2016-08-01

    LDL. The findings of this paper further confirm the therapeutic potential of PTX-CH Emul in clinical applications involving TNBC therapy. Keywords: paclitaxel, lipid emulsion, triple-negative breast cancers, low-density lipoprotein, tumor targeting

  13. Analysis of the Clinicopathologic Features and Prognosis in Triple-Negative Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Dehong Yang; Hong Liu; Jing Zhao

    2008-01-01

    OBJECTIVE To investigate the clinical and pathological features,as well as prognosis in triple-negative breast cancer patients.METHODS A total of 509 cases of operable breast cancer from January,2002 to June,2002 treated in the Cancer Hospital of Tianjin Medical University were analyzed.The Her-2,ER and PR status was determined using immunohistochemistry.Of the total cases,one group was identified as triple negative breast cancer,ie defined as ER,PR and Her-2 negative.The other group was nontriple-negative breast cancer.Clinicopathologic features of the groups were compared and 5-year disease-free survival (DFS)analyzed by the Kaplan-Meier method.RESULTS Of the total cases,21.4% (109/509) of cases were found to be triple- negative while 78.6% (400/509) were non-triplenegative.The triple negative group had higher incidence rates than the non-triple-negative group of the medullary type and Grade Ⅲ tumors (P < 0.05).There was no other difference in the clinicopathologic features between the 2 groups.From follow-up to June,2007,21.1% (23/109) of the triple-negative group and 12.7%(51/400) of the non-triple negative group had a local recurrence or distant metastasis,resulting in a significant difference (P < 0.05).In the triple-negative group and non-triple-negative group,5-year DFS were 78.9% and 87.3% respectively.There was a statistically significant difference between the 2 groups (P = 0.031).CONCLUSION Compared with non-triple-negative breast cancer,triple-negative breast cancer patients have an increased likehood of a local recurrence or distant metastasis and a poorer prognosis.

  14. Single-photon double and triple ionization of acetaldehyde (ethanal) studied by multi-electron coincidence spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Zagorodskikh, S. [Department of Physics and Astronomy, Uppsala University, Box 516, SE-751 20 Uppsala (Sweden); Department of Physics, University of Gothenburg, Origovägen 6B, SE-412 96 Gothenburg (Sweden); Zhaunerchyk, V. [Department of Physics, University of Gothenburg, Origovägen 6B, SE-412 96 Gothenburg (Sweden); Department of Physics and Astronomy, Uppsala University, Box 516, SE-751 20 Uppsala (Sweden); Mucke, M. [Department of Physics and Astronomy, Uppsala University, Box 516, SE-751 20 Uppsala (Sweden); Eland, J.H.D. [Department of Chemistry, Physical and Theoretical Chemistry Laboratory, Oxford University, South Parks Road, Oxford OX1 3QZ (United Kingdom); Department of Physics, University of Gothenburg, Origovägen 6B, SE-412 96 Gothenburg (Sweden); Department of Physics and Astronomy, Uppsala University, Box 516, SE-751 20 Uppsala (Sweden); Squibb, R.J. [Department of Physics, University of Gothenburg, Origovägen 6B, SE-412 96 Gothenburg (Sweden); Department of Physics and Astronomy, Uppsala University, Box 516, SE-751 20 Uppsala (Sweden); Karlsson, L. [Department of Physics and Astronomy, Uppsala University, Box 516, SE-751 20 Uppsala (Sweden); Linusson, P. [Department of Physics, Stockholm University, AlbaNova University Center, SE-106 91 Stockholm (Sweden); Feifel, R., E-mail: raimund.feifel@gu.se [Department of Physics, University of Gothenburg, Origovägen 6B, SE-412 96 Gothenburg (Sweden); Department of Physics and Astronomy, Uppsala University, Box 516, SE-751 20 Uppsala (Sweden)

    2015-12-16

    Highlights: • The first ever valence double ionization spectrum of acetaldehyde is reported. • The first ever site-selectively extracted Auger spectra of acetaldehyde are reported. • The first ever Auger spectra of acetaldehyde involving shake-up states are reported. • The first ever triple ionization spectra of acetaldehyde are reported. • The first ever energy sharing of electron pairs emitted by acetaldehyde is presented. - Abstract: Single-photon multiple ionization processes of acetaldehyde (ethanal) have been experimentally investigated by utilizing a multi-particle coincidence technique based on the time-of-flight magnetic bottle principle, in combination with either a synchrotron radiation source or a pulsed helium discharge lamp. The processes investigated include double and triple ionization in the valence region as well as single and double Auger decay of core-ionized acetaldehyde. The latter are studied site-selectively for chemically different carbon core vacancies, scrutinizing early theoretical predictions specifically made for the case of acetaldehyde. Moreover, Auger processes in shake-up and core-valence ionized states are investigated. In the cases where the processes involve simultaneous emission of two electrons, the distributions of the energy sharing are presented, emphasizing either the knock-out or shake-off mechanism.

  15. Evaluation of an interlaced triple procedure: penetrating keratoplasty, extracapsular cataract extraction, and nonopen-sky intraocular lens implantation.

    Science.gov (United States)

    Yang, Shuo; Wang, Bin; Zhang, Yangyang; Zhai, Hualei; Wang, Junyi; Wang, Shuang; Xie, Lixin

    2017-09-01

    To evaluate an interlaced triple procedure that involved penetrating keratoplasty (PKP), extracapsular cataract extraction (ECCE) using diathermy capsulotomy, and nonopen-sky intraocular lens (IOL) implantation.This retrospective study involved data from 34 patients who were diagnosed with severe corneal opacities and cataracts. These patients were divided into an interlaced procedure group (21 patients) and a traditional procedure group (13 patients). In the interlaced group, the method of continuous curvilinear capsulorhexis (CCC) was completed via diathermy capsulotomy. The donor corneal button was sutured at 8 positions (at equal intervals) using 10-0 nylon sutures, and the IOL was inserted into the capsular bag using a closed anterior chamber approach at the 10:30 to 12 o'clock positions between the sutures. In the traditional group, CCC was completed using side-port capsular forceps, and the IOL was implanted using an open anterior chamber approach.In the interlaced group, the CCC, open-sky, and total operation times were significantly shorter than in the traditional group (P < .05). Neither the best-corrected visual acuity (BCVA) nor corneal endothelial cell density was significantly different between the groups at 1 and 6 months after the operation.This interlaced triple procedure for the treatment of corneal diseases with cataracts appears to be feasible and practical.

  16. Effectiveness of the triple P positive parenting program on parenting: A meta-analysis

    NARCIS (Netherlands)

    Graaf, I. de; Speetjens, P.; Smit, F.; Wolff, M. de; Tavecchio, L.

    2008-01-01

    Triple P is a parenting program intended to prevent and to provide treatment for severe behavioral, emotional, and developmental problems in children. The aim of this meta-analysis was to assess the effectiveness of Triple P Level 4 interventions on parenting styles and parental competency. Level 4

  17. The effectiveness of lifestyle triple P in the Netherlands : A randomized controlled trial

    NARCIS (Netherlands)

    Gerards, Sanne M P L; Dagnelie, Pieter C.; Gubbels, Jessica S.; Van Buuren, Stef; Hamers, Femke J M; Jansen, Maria W J; Van Der Goot, Odilia H M; De Vries, Nanne K.; Sanders, Matthew R.; Kremers, Stef P J

    2015-01-01

    Introduction Lifestyle Triple P is a general parenting intervention which focuses on preventing further excessive weight gain in overweight and obese children. The objective of the current study was to assess the effectiveness of the Lifestyle Triple P intervention in the Netherlands. Method We used

  18. Triple Value System Dynamics Modeling to Help Stakeholders Engage with Food-Energy-Water Problems

    Science.gov (United States)

    Triple Value (3V) Community scoping projects and Triple Value Simulation (3VS) models help decision makers and stakeholders apply systems-analysis methodology to complex problems related to food production, water quality, and energy use. 3VS models are decision support tools that...

  19. Software-Enabled Project Management Techniques and Their Relationship to the Triple Constraints

    Science.gov (United States)

    Elleh, Festus U.

    2013-01-01

    This study investigated the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). There was the dearth of academic literature that focused on the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). Based on the gap…

  20. Micro-photoluminescence of GaAs/AlGaAs triple concentric quantum rings.

    Science.gov (United States)

    Abbarchi, Marco; Cavigli, Lucia; Somaschini, Claudio; Bietti, Sergio; Gurioli, Massimo; Vinattieri, Anna; Sanguinetti, Stefano

    2011-10-31

    A systematic optical study, including micro, ensemble and time resolved photoluminescence of GaAs/AlGaAs triple concentric quantum rings, self-assembled via droplet epitaxy, is presented. Clear emission from localized states belonging to the ring structures is reported. The triple rings show a fast decay dynamics, around 40 ps, which is expected to be useful for ultrafast optical switching applications.

  1. Selective intercalation of six ligands molecules in a self-assembled triple helix

    NARCIS (Netherlands)

    Mateos timoneda, Miguel; Kerckhoffs, J.M.C.A.; Reinhoudt, David; Crego Calama, Mercedes

    2007-01-01

    The addition of a ligand molecule to an artificial self-assembled triple helix leads to the selective intercalation of two hydrogen-bonded trimers in specific binding pockets. Furthermore, the triple helix suffers large conformational rearrangements in order to accommodate the ligand molecules in a

  2. The effectiveness of lifestyle triple P in the Netherlands: A randomized controlled trial

    NARCIS (Netherlands)

    Gerards, S.M.P.L.; Dagnelie, P.C.; Gubbels, J.S.; Buuren, S. van; Hamers, F.J.M.; Jansen, M.W.J.; Goot, O.H.M. van der; Vries, N.K. de; Sanders, M.R.; Kremers, S.P.J.

    2015-01-01

    Introduction Lifestyle Triple P is a general parenting intervention which focuses on preventing further excessive weight gain in overweight and obese children. The objective of the current study was to assess the effectiveness of the Lifestyle Triple P intervention in the Netherlands. Method We used

  3. Banach Gelfand Triples for Applications in Physics and Engineering

    Science.gov (United States)

    Feichtinger, Hans G.

    2009-07-01

    The principle of extension is widespread within mathematics. Starting from simple objects one constructs more sophisticated ones, with a kind of natural embedding from the set of old objects to the new, enlarged set. Usually a set of operations on the old set can still be carried out, but maybe also some new ones. Done properly one obtains more completed objects of a similar kind, with additional useful properties. Let us give a simple example: While multiplication and addition can be done exactly and perfectly in the setting of Q, the rational numbers, the field R of real numbers has the advantage of being complete (Cauchy sequences have a limit…) and hence allowing for numbers like π or √2 . Finally the even "more complicated" field C of complex numbers allows to find solutions to equations like z2 = -1. The chain of inclusions of fields, Q⊂R⊂C is a good motivating example in the domain of "numbers." The main subject of the present survey-type article is a new theory of Banach Gelfand triples (BGTs), providing a similar setting in the context of (generalized) functions. Test functions are the simple objects, elements of the Hilbert space L2(Rd) are well suited in order to describe concepts of orthogonality, and they can be approximated to any given precision (in the ‖ṡ‖2-norm) by test functions. Finally one needs an even larger (Banach) space of generalized functions resp. distributions, containing among others pure frequencies and Dirac measures in order to describe various mappings between such Banach Gelfand triples in terms of the most important "elementary building blocks," in a clear analogy to the finite/discrete setting (where Dirac measures correspond to unit vectors). Our concrete Banach Gelfand triple is based on the Segal algebra S0(Rd), which coincides with the modulation space M1(Rd) = M01,1(Rd), and plays a very important and natural role for time-frequency analysis. We will point out that it provides the appropriate setting for a

  4. Common breast cancer susceptibility loci are associated with triple negative breast cancer

    Science.gov (United States)

    Stevens, Kristen N.; Vachon, Celine M.; Lee, Adam M.; Slager, Susan; Lesnick, Timothy; Olswold, Curtis; Fasching, Peter A.; Miron, Penelope; Eccles, Diana; Carpenter, Jane E.; Godwin, Andrew K.; Ambrosone, Christine; Winqvist, Robert; Schmidt, Marjanka K.; Cox, Angela; Cross, Simon S.; Sawyer, Elinor; Hartmann, Arndt; Beckmann, Matthias W.; Schulz-Wendtland, Rüdiger; Ekici, Arif B.; Tapper, William J; Gerty, Susan M; Durcan, Lorraine; Graham, Nikki; Hein, Rebecca; Nickels, Stephan; Flesch-Janys, Dieter; Heinz, Judith; Sinn, Hans-Peter; Konstantopoulou, Irene; Fostira, Florentia; Pectasides, Dimitrios; Dimopoulos, Athanasios M.; Fountzilas, George; Clarke, Christine L.; Balleine, Rosemary; Olson, Janet E.; Fredericksen, Zachary; Diasio, Robert B.; Pathak, Harsh; Ross, Eric; Weaver, JoEllen; Rüdiger, Thomas; Försti, Asta; Dünnebier, Thomas; Ademuyiwa, Foluso; Kulkarni, Swati; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Ko, Yon-Dschun; Van Limbergen, Erik; Janssen, Hilde; Peto, Julian; Fletcher, Olivia; Giles, Graham G.; Baglietto, Laura; Verhoef, Senno; Tomlinson, Ian; Kosma, Veli-Matti; Beesley, Jonathan; Greco, Dario; Blomqvist, Carl; Irwanto, Astrid; Liu, Jianjun; Blows, Fiona M.; Dawson, Sarah-Jane; Margolin, Sara; Mannermaa, Arto; Martin, Nicholas G.; Montgomery, Grant W; Lambrechts, Diether; dos Santos Silva, Isabel; Severi, Gianluca; Hamann, Ute; Pharoah, Paul; Easton, Douglas F.; Chang-Claude, Jenny; Yannoukakos, Drakoulis; Nevanlinna, Heli; Wang, Xianshu; Couch, Fergus J.

    2012-01-01

    Triple negative breast cancers are an aggressive subtype of breast cancer with poor survival, but there remains little known about the etiological factors which promote its initiation and development. Commonly inherited breast cancer risk factors identified through genome wide association studies (GWAS) display heterogeneity of effect among breast cancer subtypes as defined by estrogen receptor (ER) and progesterone receptor (PR) status. In the Triple Negative Breast Cancer Consortium (TNBCC), 22 common breast cancer susceptibility variants were investigated in 2,980 Caucasian women with triple negative breast cancer and 4,978 healthy controls. We identified six single nucleotide polymorphisms (SNPs) significantly associated with risk of triple negative breast cancer, including rs2046210 (ESR1), rs12662670 (ESR1), rs3803662 (TOX3), rs999737 (RAD51L1), rs8170 (19p13.11) and rs8100241 (19p13.11). Together, our results provide convincing evidence of genetic susceptibility for triple negative breast cancer. PMID:21844186

  5. Empirical validation of the triple-code model of numerical processing for complex math operations using functional MRI and group Independent Component Analysis of the mental addition and subtraction of fractions.

    Science.gov (United States)

    Schmithorst, Vincent J; Brown, Rhonda Douglas

    2004-07-01

    The suitability of a previously hypothesized triple-code model of numerical processing, involving analog magnitude, auditory verbal, and visual Arabic codes of representation, was investigated for the complex mathematical task of the mental addition and subtraction of fractions. Functional magnetic resonance imaging (fMRI) data from 15 normal adult subjects were processed using exploratory group Independent Component Analysis (ICA). Separate task-related components were found with activation in bilateral inferior parietal, left perisylvian, and ventral occipitotemporal areas. These results support the hypothesized triple-code model corresponding to the activated regions found in the individual components and indicate that the triple-code model may be a suitable framework for analyzing the neuropsychological bases of the performance of complex mathematical tasks. Copyright 2004 Elsevier Inc.

  6. An investigation into scalability and compliance for triple patterning with stitches for metal 1 at the 14nm node

    Science.gov (United States)

    Cork, Christopher; Miloslavsky, Alexander; Friedberg, Paul; Luk-Pat, Gerry

    2013-04-01

    Lithographers had hoped that single patterning would be enabled at the 20nm node by way of EUV lithography. However, due to delays in EUV readiness, double patterning with 193i lithography is currently relied upon for volume production for the 20nm node's metal 1 layer. At the 14nm and likely at the 10nm node, LE-LE-LE triple patterning technology (TPT) is one of the favored options [1,2] for patterning local interconnect and Metal 1 layers. While previous research has focused on TPT for contact mask, metal layers offer new challenges and opportunities, in particular the ability to decompose design polygons across more than one mask. The extra flexibility offered by the third mask and ability to leverage polygon stitching both serve to improve compliance. However, ensuring TPT compliance - the task of finding a 3-color mask decomposition for a design - is still a difficult task. Moreover, scalability concerns multiply the difficulty of triple patterning decomposition which is an NP-complete problem. Indeed previous work shows that network sizes above a few thousand nodes or polygons start to take significantly longer times to compute [3], making full chip decomposition for arbitrary layouts impractical. In practice Metal 1 layouts can be considered as two separate problem domains, namely: decomposition of standard cells and decomposition of IP blocks. Standard cells typically include only a few 10's of polygons and should be amenable to fast decomposition. Successive design iterations should resolve compliance issues and improve packing density. Density improvements are multiplied repeatedly as standard cells are placed multiple times. IP blocks, on the other hand, may involve very large networks. This paper evaluates multiple approaches to triple patterning decomposition for the Metal 1 layer. The benefits of polygon stitching, in particular, the ability to resolve commonly encountered non-compliant layout configurations and improve packing density, are weighed

  7. Cadmium promotes the proliferation of triple-negative breast cancer cells through EGFR-mediated cell cycle regulation

    International Nuclear Information System (INIS)

    Wei, Zhengxi; Song, Xiulong; Shaikh, Zahir A.

    2015-01-01

    Cadmium (Cd) is a carcinogenic metal which is implicated in breast cancer by epidemiological studies. It is reported to promote breast cancer cell growth in vitro through membrane receptors. The study described here examined Cd-mediated growth of non-metastatic human breast cancer derived cells that lack receptors for estrogen, progesterone, and HER2. Treatment of triple-negative HCC 1937 cells with 0.1–0.5 μM Cd increased cell growth by activation of AKT and ERK. Accelerated cell cycle progression was achieved by increasing the levels of cyclins A, B, and E, as well as those of CDKs 1 and 2. Although triple negative cells lack estrogen receptor, they express high levels of EGFR. Therefore, further studies on HCC 1937 and another triple-negative cell line, HCC 38, were conducted using specific siRNA and an inhibitor of EGFR to determine whether EGFR was responsible for mediating the effect of Cd. The results revealed that in both cell types EGFR was not only activated upon Cd treatment, but was also essential for the downstream activation of AKT and ERK. Based on these observations, it is concluded that, in breast cancer cells lacking estrogen receptor, sub-micromolar concentration of Cd can promote cell proliferation. Furthermore, that EGFR plays a critical role in this process. - Highlights: • Sub-micromolar concentrations of Cd promote cell growth in breast cancer cells that lack ER, PR, and HER2. • The increase in cell number is not due to reduction in apoptosis. • Growth promotion involves AKT and ERK signaling and downstream stimulation of cell cycle progression. • Initiation of cell growth by Cd occurs at the cell membrane and requires the activation of EGFR.

  8. Loss of PTEN expression is associated with aggressive behavior and poor prognosis in Middle Eastern triple-negative breast cancer.

    Science.gov (United States)

    Beg, Shaham; Siraj, Abdul K; Prabhakaran, Sarita; Jehan, Zeenath; Ajarim, Dahish; Al-Dayel, Fouad; Tulbah, Asma; Al-Kuraya, Khawla S

    2015-06-01

    PTEN is a tumor suppressor that negatively regulates the PI3 K-AKT signaling pathway which is involved in the pathogenesis of many different tumor types and serves as a prognostic marker in breast cancer. However, the significance of the role of PTEN in Middle Eastern ethnic breast cancer has not been explored especially with the fact that breast cancer originating from this ethnic population tend to behave more aggressively than breast cancer in the west. In this study, we analyzed PTEN alteration in a tissue microarray format containing more than 1000 primary breast cancers with clinical follow-up data. Tissue Microarray sections were analyzed for protein expression and copy number change using immunohistochemistry and fluorescence in situ hybridization. Loss of PTEN immunostaining was observed in 77 % of the cases. PTEN loss was significantly associated with large tumor size (p = 0.0030), high grade (p = 0.0281), tumor recurrence (p = 0.0333), and triple-negative breast cancers (p = 0.0086). PTEN loss in triple-negative breast cancers was significantly associated with rapid tumor cell proliferation (p = 0.0396) and poor prognosis (p = 0.0408). PTEN deletion was found only in 60 cases (6.4 %). Loss of PTEN protein expression occurs at high frequency in Middle Eastern breast cancer. PTEN inactivation may potentially lead to an aggressive behavior of tumor cells through stimulation of tumor cell proliferation. Furthermore, PTEN signaling pathway might be used as potential therapeutic target in triple-negative breast cancers since loss of its expression is shown to be significantly associated with this aggressive subtype of breast cancer.

  9. CT and US demonstration of gastrointestinal involvement in children with rheumatoid purpura

    International Nuclear Information System (INIS)

    Li Xin; Li Lin; Wang Chunxiang; Zhao Bin

    2002-01-01

    Objective: To evaluate the usefulness of CT and US in the diagnosis of gastrointestinal involvement in children with rheumatoid purpura. Methods: Abdominal CT and US findings in 14 cases of clinical and laboratory confirmed of rheumatoid purpura were analyzed. There were 9 males and 5 females with the age ranged from 6 months to 14 years. All patients was hospitalized because of acute abdominal emergency, and the clinical presentations included paroxysm of abdomen pain, vomiting, without skin rashes and subcutaneous hemorrhage. CT examination was done in 7 cases, and contrast enhancement was performed in 1 case. Abdominal ultrasound was done in 9 cases. Both CT and US were done in 2 cases. Results: All patients demonstrated multiple or single areas of bowel-wall thickening, localized intraluminal narrowing, mesenteric edema, and liquid in abdominal cavity by CT and ultrasound. Conclusion: Abdominal CT and US examination have important values in differential diagnosis of acute abdominal disorders in children patients with rheumatoid purpura. Before appearing skin rashes, classical picture can help for the diagnosis and clinical treatment. Abdominal CT and US examination can also find the intussusception, bowel obstruction, and perforation in rheumatoid purpura

  10. Multilayer Antireflection Coating for Triple Junction Solar Cells

    International Nuclear Information System (INIS)

    Zhan Feng; Wang Hai-Li; He Ji-Fang; Wang Juan; Huang She-Song; Ni Hi-Qiao; Niu Zhi-Chuan

    2011-01-01

    According to the theory of optical films, we simulate the reflectivity of antireflection coatings (ARCs) for solar cells of Ga 0.5 In 0.5 P/GaAs/Ge based on an optical transfer matrix. In order to provide sufficient consideration of the refractive index dispersion effect of multilayer ARCs, we use multi-dimensional matrix data for reliable simulation. After the reflection curves are obtained, the effective average reflectance R e is introduced to optimize the film system by minimizing R e . Optimization of single layer (Al 2 O 3 ), double layer (MgF 2 /ZnS) and triple layer (MgF 2 /Al 2 O 3 /ZnS) ARCs is realized by using this method for space and terrestrial applications. Effects of these ARCs are compared after optimization. These theoretical parameters can be used to guide experiments. (condensed matter: electronic structure, electrical, magnetic, and optical properties)

  11. Double-membrane triple-electrolyte redox flow battery design

    Science.gov (United States)

    Yushan, Yan; Gu, Shuang; Gong, Ke

    2018-03-13

    A redox flow battery is provided having a double-membrane (one cation exchange membrane and one anion exchange membrane), triple-electrolyte (one electrolyte in contact with the negative electrode, one electrolyte in contact with the positive electrode, and one electrolyte positioned between and in contact with the two membranes). The cation exchange membrane is used to separate the negative or positive electrolyte and the middle electrolyte, and the anion exchange membrane is used to separate the middle electrolyte and the positive or negative electrolyte. This design physically isolates, but ionically connects, the negative electrolyte and positive electrolyte. The physical isolation offers great freedom in choosing redox pairs in the negative electrolyte and positive electrolyte, making high voltage of redox flow batteries possible. The ionic conduction drastically reduces the overall ionic crossover between negative electrolyte and positive one, leading to high columbic efficiency.

  12. Application of artificial intelligence to triple quadrupole mass spectrometry (TQMS)

    International Nuclear Information System (INIS)

    Wong, C.M.; Crawford, R.W.; Kehler, T.P.; Kunz, J.C.

    1984-01-01

    At Lawrence Livermore National Laboratory the authors have designed a totally computerized triple quadrupole mass spectrometer with the ultimate goal of using it as a prototype for ''knowledge-based'' instrument control. As an ''intelligent'' instrument, with its computer-based data acquisition and control system, it has the ability to learn and respond quickly. The intelligence is encoded in the system using the representation and rule-based reasoning heuristic techniques of Artificial Intelligence. These techniques are used to encode heuristic knowledge, or the intuition, formal and informal rules, and experiential knowledge that the human expert normally uses to make decisions and arrive at solutions in a specific domain problem. In this specific case, the knowledge the authors are encoding is a tuning procedure for the spectrometer, including heuristics to describe a self-adaptive, feedback control process for real-time optimization or tuning of the data acquisition procedure throughout the entire data collection process

  13. OPTIMIZING THE DYNAMIC APERTURE FOR TRIPLE BEND ACHROMATIC LATTICES

    International Nuclear Information System (INIS)

    KRAMER, S.L.; BENGTSSON, J.

    2006-01-01

    The Triple Bend Achromatic (TBA) lattice has the potential for lower natural emittance per period than the Double Bend Achromatic (DBA) lattice for high brightness light sources. However, the DBA has been chosen for 3rd generation light sources more often due to the higher number of undulator straight section available for a comparable emittance. The TBA has considerable flexibility in linear optics tuning while maintaining this emittance advantage. We have used the tune and chromaticity flexibility of a TBA lattice to minimize the lowest order nonlinearities to implement a 3rd order achromatic tune, while maintaining a constant emittance. This frees the geometric sextupoles to counter the higher order nonlinearities. This procedure is being used to improve the nonlinear dynamics of the TBA as a proposed lattice for NSLS-II facility. The flexibility of the TBA lattice will also provide for future upgrade capabilities of the beam parameters

  14. Prisoners of War of the Triple Alliance within Kazakhstan

    Directory of Open Access Journals (Sweden)

    Gulzhaukhar K. Kokebayeva

    2015-03-01

    Full Text Available The work studies the problem of the detention of prisoners of war of the Triple Alliance in the camps, located within Kazakhstan. During the first months of war, the Russian authorities treated the prisoners of war in accordance with ‘Convention on the Treatment of the Prisoners of War’, approved by the Emperor of Russia. The content of this document corresponded to the Hague Convention with Respect to the Laws and Customs of War on Land. The major areas of the detention of prisoners of war were Turkestan and Omsk Military Okrug, combining all military institutions of the Steppe Governorate General, including the ones of North-Eastern and Central Kazakhstan. The source base of the research is the materials of Kazakhstan and German archives, the recollections of the former prisoners of war and the published collections of documents and materials.

  15. Distinct microbiological signatures associated with triple negative breast cancer.

    Science.gov (United States)

    Banerjee, Sagarika; Wei, Zhi; Tan, Fei; Peck, Kristen N; Shih, Natalie; Feldman, Michael; Rebbeck, Timothy R; Alwine, James C; Robertson, Erle S

    2015-10-15

    Infectious agents are the third highest human cancer risk factor and may have a greater role in the origin and/or progression of cancers, and related pathogenesis. Thus, knowing the specific viruses and microbial agents associated with a cancer type may provide insights into cause, diagnosis and treatment. We utilized a pan-pathogen array technology to identify the microbial signatures associated with triple negative breast cancer (TNBC). This technology detects low copy number and fragmented genomes extracted from formalin-fixed paraffin embedded archival tissues. The results, validated by PCR and sequencing, define a microbial signature present in TNBC tissue which was underrepresented in normal tissue. Hierarchical clustering analysis displayed two broad microbial signatures, one prevalent in bacteria and parasites and one prevalent in viruses. These signatures demonstrate a new paradigm in our understanding of the link between microorganisms and cancer, as causative or commensal in the tumor microenvironment and provide new diagnostic potential.

  16. Triple F - A Comet Nucleus Sample Return Mission

    Science.gov (United States)

    Kueppers, Michael; Keller, Horst Uwe; Kuhrt, Ekkehard; A'Hearn, Michael; Altwegg, Kathrin; Betrand, Regis; Busemann, Henner; Capria, Maria Teresa; Colangeli, Luigi

    2008-01-01

    The Triple F (Fresh From the Fridge) mission, a Comet Nucleus Sample Return, has been proposed to ESA s Cosmic Vision program. A sample return from a comet enables us to reach the ultimate goal of cometary research. Since comets are the least processed bodies in the solar system, the proposal goes far beyond cometary science topics (like the explanation of cometary activity) and delivers invaluable information about the formation of the solar system and the interstellar molecular cloud from which it formed. The proposed mission would extract three samples of the upper 50 cm from three locations on a cometary nucleus and return them cooled to Earth for analysis in the laboratory. The simple mission concept with a touch-and-go sampling by a single spacecraft was proposed as an M-class mission in collaboration with the Russian space agency ROSCOSMOS.

  17. Triple M-brane configurations and preserved supersymmetries

    Energy Technology Data Exchange (ETDEWEB)

    Golubtsova, A.A., E-mail: siedhe@gmail.com [Institute of Gravitation and Cosmology, Peoples' Friendship University of Russia, 6 Miklukho-Maklaya Str., Moscow 117198 (Russian Federation); Laboratoire de Univers et Théories (LUTh), Observatoire de Paris, Place Jules Janssen 5, 92190 Meudon (France); Ivashchuk, V.D., E-mail: ivashchuk@mail.ru [Center for Gravitation and Fundamental Metrology, VNIIMS, 46 Ozyornaya Str., Moscow 119361 (Russian Federation); Institute of Gravitation and Cosmology, Peoples' Friendship University of Russia, 6 Miklukho-Maklaya Str., Moscow 117198 (Russian Federation)

    2013-07-21

    We investigate all standard triple composite M-brane intersections defined on products of Ricci-flat manifolds for preserving supersymmetries in eleven-dimensional N=1 supergravity. The explicit formulae for computing the numbers of preserved supersymmetries are obtained, which generalize the relations for topologically trivial flat factor spaces presented in the classification by Bergshoeff et al. We obtain certain examples of configurations preserving some fractions of supersymmetries, e.g. containing such factor spaces as K3, C{sub ⁎}{sup 2}/Z{sub 2}, a four-dimensional pp-wave manifold and the two-dimensional pseudo-Euclidean manifold R{sub ⁎}{sup 1,1}/Z{sub 2}.

  18. Hybrid Steepest-Descent Methods for Triple Hierarchical Variational Inequalities

    Directory of Open Access Journals (Sweden)

    L. C. Ceng

    2015-01-01

    Full Text Available We introduce and analyze a relaxed iterative algorithm by combining Korpelevich’s extragradient method, hybrid steepest-descent method, and Mann’s iteration method. We prove that, under appropriate assumptions, the proposed algorithm converges strongly to a common element of the fixed point set of infinitely many nonexpansive mappings, the solution set of finitely many generalized mixed equilibrium problems (GMEPs, the solution set of finitely many variational inclusions, and the solution set of general system of variational inequalities (GSVI, which is just a unique solution of a triple hierarchical variational inequality (THVI in a real Hilbert space. In addition, we also consider the application of the proposed algorithm for solving a hierarchical variational inequality problem with constraints of finitely many GMEPs, finitely many variational inclusions, and the GSVI. The results obtained in this paper improve and extend the corresponding results announced by many others.

  19. Triple inverter pierce oscillator circuit suitable for CMOS

    Science.gov (United States)

    Wessendorf,; Kurt, O [Albuquerque, NM

    2007-02-27

    An oscillator circuit is disclosed which can be formed using discrete field-effect transistors (FETs), or as a complementary metal-oxide-semiconductor (CMOS) integrated circuit. The oscillator circuit utilizes a Pierce oscillator design with three inverter stages connected in series. A feedback resistor provided in a feedback loop about a second inverter stage provides an almost ideal inverting transconductance thereby allowing high-Q operation at the resonator-controlled frequency while suppressing a parasitic oscillation frequency that is inherent in a Pierce configuration using a "standard" triple inverter for the sustaining amplifier. The oscillator circuit, which operates in a range of 10 50 MHz, has applications for use as a clock in a microprocessor and can also be used for sensor applications.

  20. Small angle neutron scattering using a triple axis spectrometer

    International Nuclear Information System (INIS)

    Ahmed, F.U.; Goyal, P.S.; Kamal, L.; Yunus, S.M.; Datta, T.K.; Rahman, M.O.; Azad, A.K.; Begum, S.; Zakaria, A.K.

    1994-01-01

    SANS techniques has been developed on a triple axis neutron spectrometer at TRIGA Mark II (3 MW) research reactor, AERE, Savar, Dhaka, Bangladesh. Double crystal (with very small mosaic spread ∼ 1 min.) diffraction known as Bonse and Hart's method has been employed. Such a device is a useful tool for small angle scattering in the Q range between 10 -5 and 10 -1 Angstroms -1 and for real time experiments at short time scales. Therefore, large objects and large distance interparticle correlations can be easily investigated. The results of SANS' measurements using alumina (A1 2 0 3 ) sample are presented. The radius of gyration has been determined and the data has been fitted to the scattering function of a sphere. 9 refs., 6 figs.,

  1. Gastric Metastasis of Triple Negative Invasive Lobular Carcinoma.

    Science.gov (United States)

    Geredeli, Caglayan; Dogru, Osman; Omeroglu, Ethem; Yilmaz, Farise; Cicekci, Faruk

    2015-05-05

    Invasive lobular carcinomas are the second most common type (5% to 15%) of invasive breast carcinomas. The most frequent sites of breast cancer metastasis are the local and distant lymph nodes, brain, lung, liver, and bones; metastasis to the gastrointestinal system, especially to the stomach, is rare. When a mass is detected in an unusual place in a patient with invasive lobular carcinoma, it should be kept in mind that such a mass may be either a second primary carcinoma or the metastasis of an invasive lobular carcinoma. In this report, we present a case of gastric metastasis from triple-negative invasive lobular breast cancer. It is important to make an accurate diagnosis by distinguishing gastric metastasis from breast cancer in order to select the best initial treatment for systemic diseases of breast cancer. Considering our case, healthcare professionals should take into account that cases with invasive lobular breast cancer may experience unusual metastases.

  2. Chaotic dynamics in the (47171) Lempo triple system

    Science.gov (United States)

    Correia, Alexandre C. M.

    2018-05-01

    We investigate the dynamics of the (47171) Lempo triple system, also known by 1999 TC36. We derive a full 3D N-body model that takes into account the orbital and spin evolution of all bodies, which are assumed triaxial ellipsoids. We show that, for reasonable values of the shapes and rotational periods, the present best fitted orbital solution for the Lempo system is chaotic and unstable in short time-scales. The formation mechanism of this system is unknown, but the orbits can be stabilised when tidal dissipation is taken into account. The dynamics of the Lempo system is very rich, but depends on many parameters that are presently unknown. A better understanding of this systems thus requires more observations, which also need to be fitted with a complete model like the one presented here.

  3. Triple-server blind quantum computation using entanglement swapping

    Science.gov (United States)

    Li, Qin; Chan, Wai Hong; Wu, Chunhui; Wen, Zhonghua

    2014-04-01

    Blind quantum computation allows a client who does not have enough quantum resources or technologies to achieve quantum computation on a remote quantum server such that the client's input, output, and algorithm remain unknown to the server. Up to now, single- and double-server blind quantum computation have been considered. In this work, we propose a triple-server blind computation protocol where the client can delegate quantum computation to three quantum servers by the use of entanglement swapping. Furthermore, the three quantum servers can communicate with each other and the client is almost classical since one does not require any quantum computational power, quantum memory, and the ability to prepare any quantum states and only needs to be capable of getting access to quantum channels.

  4. Fractal Based Triple Band High Gain Monopole Antenna

    Science.gov (United States)

    Pandey, Shashi Kant; Pandey, Ganga Prasad; Sarun, P. M.

    2017-10-01

    A novel triple-band microstrip fed planar monopole antenna is proposed and investigated. A fractal antenna is created by iterating a narrow pulse (NP) generator model at upper side of modified ground plane, which has a rhombic patch, for enhancing the bandwidth and gain. Three iterations are carried out to study the effects of fractal geometry on the antenna performance. The proposed antenna can operate over three frequency ranges viz, 3.34-4.8 GHz, 5.5-10.6 GHz and 13-14.96 GHz suitable for WLAN 5.2/5.8 GHz, WiMAX 3.5/5.5 GHz and X band applications respectively. Simulated and measured results are in good agreements with each others. Results show that antenna provides wide/ultra wide bandwidths, monopole like radiation patterns and very high antenna gains over the operating frequency bands.

  5. A triple GEM gamma camera for medical application

    Energy Technology Data Exchange (ETDEWEB)

    Anulli, F. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Balla, A. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Bencivenni, G. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Corradi, G. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); D' Ambrosio, C. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Domenici, D. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Felici, G. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Gatta, M. [Laboratori Nazionali di Frascati INFN, Frascati (Italy); Morone, M.C. [Dipartimento di Biopatologia e Diagnostica per immagini, Universita di Roma Tor Vergata (Italy); INFN - Sezione di Roma Tor Vergata (Italy); Murtas, F. [Laboratori Nazionali di Frascati INFN, Frascati (Italy)]. E-mail: fabrizio.murtas@lnf.infn.it; Schillaci, O. [Dipartimento di Biopatologia e Diagnostica per immagini, Universita di Roma Tor Vergata (Italy)

    2007-03-01

    A Gamma Camera for medical applications 10x10cm{sup 2} has been built using a triple GEM chamber prototype. The photon converters placed in front of the three GEM foils, has been realized with different technologies. The chamber, High Voltage supplied with a new active divider made in Frascati, is readout through 64 pads, 1mm{sup 2} wide, organized in a row of 8cm long, with LHCb ASDQ chip. This Gamma Camera can be used both for X-ray movie and PET-SPECT imaging; this chamber prototype is placed in a scanner system, creating images of 8x8cm{sup 2}. Several measurements have been performed using phantom and radioactive sources of Tc99m(140keV) and Na22(511keV). Results on spatial resolution and image reconstruction are presented.

  6. Multistep Hybrid Extragradient Method for Triple Hierarchical Variational Inequalities

    Directory of Open Access Journals (Sweden)

    Zhao-Rong Kong

    2013-01-01

    Full Text Available We consider a triple hierarchical variational inequality problem (THVIP, that is, a variational inequality problem defined over the set of solutions of another variational inequality problem which is defined over the intersection of the fixed point set of a strict pseudocontractive mapping and the solution set of the classical variational inequality problem. Moreover, we propose a multistep hybrid extragradient method to compute the approximate solutions of the THVIP and present the convergence analysis of the sequence generated by the proposed method. We also derive a solution method for solving a system of hierarchical variational inequalities (SHVI, that is, a system of variational inequalities defined over the intersection of the fixed point set of a strict pseudocontractive mapping and the solution set of the classical variational inequality problem. Under very mild conditions, it is proven that the sequence generated by the proposed method converges strongly to a unique solution of the SHVI.

  7. Triple-Vessel Percutaneous Coronary Revascularization In Situs Inversus Dextrocardia

    Directory of Open Access Journals (Sweden)

    Nikolaos Kakouros

    2010-01-01

    Full Text Available Dextrocardia with situs inversus occurs in approximately one in 10,000 individuals of whom 20% have primary ciliary dyskinesia inherited as an autosomal recessive trait. These patients have a high incidence of congenital cardiac disease but their risk of coronary artery disease is similar to that of the general population. We report what is, to our knowledge, the first case of total triple-vessel coronary revascularization by percutaneous stent implantation in a 79-year-old woman with situs inversus dextrocardia. We describe the successful use of standard diagnostic and interventional guide catheters with counter rotation and transversely inversed image acquisition techniques. The case also highlights that the right precordial pain may represent cardiac ischemia in this population.

  8. The Michelson Stellar Interferometer Error Budget for Triple Triple-Satellite Configuration

    Science.gov (United States)

    Marathay, Arvind S.; Shiefman, Joe

    1996-01-01

    This report presents the results of a study of the instrumentation tolerances for a conventional style Michelson stellar interferometer (MSI). The method used to determine the tolerances was to determine the change, due to the instrument errors, in the measured fringe visibility and phase relative to the ideal values. The ideal values are those values of fringe visibility and phase that would be measured by a perfect MSI and are attributable solely to the object being detected. Once the functional relationship for changes in visibility and phase as a function of various instrument errors is understood it is then possible to set limits on the instrument errors in order to ensure that the measured visibility and phase are different from the ideal values by no more than some specified amount. This was done as part of this study. The limits we obtained are based on a visibility error of no more than 1% and a phase error of no more than 0.063 radians (this comes from 1% of 2(pi) radians). The choice of these 1% limits is supported in the literture. The approach employed in the study involved the use of ASAP (Advanced System Analysis Program) software provided by Breault Research Organization, Inc., in conjunction with parallel analytical calculations. The interferometer accepts object radiation into two separate arms each consisting of an outer mirror, an inner mirror, a delay line (made up of two moveable mirrors and two static mirrors), and a 10:1 afocal reduction telescope. The radiation coming out of both arms is incident on a slit plane which is opaque with two openings (slits). One of the two slits is centered directly under one of the two arms of the interferometer and the other slit is centered directly under the other arm. The slit plane is followed immediately by an ideal combining lens which images the radiation in the fringe plane (also referred to subsequently as the detector plane).

  9. Triple A (Allgrove) syndrome: an unusual association with syringomyelia

    Science.gov (United States)

    2013-01-01

    Triple A (Allgrove) syndrome was first described by Allgrove in 1978 in two pairs of siblings. Since then, about 100 cases have been reported, all of them displaying an autosomal recessive pattern of inheritance. Clinical picture is characterized by achalasia, alacrimia and ACTH-resistant adrenal failure. A progressive neurological syndrome including central, peripheral and autonomic nervous system impairment, and mild mental retardation is often associated. The triple A syndrome gene, designated AAAS, is localized on chromosome 12q13. It consists of 16 exons, encoding for a 546 aminoacid protein called ALADIN (Alacrimia-Achalasia-aDrenal Insufficiency Neurologic disorder). We report on a 13 year-old boy presenting with Addison’s disease, dysphagia, muscle weakness, excessive fatigue and recent onset gait ataxia. The analysis of the AAAS gene revealed a homozygous missense mutation in exon 12. It was a T > G transversion at nucleotide position 1224, resulting in a change of leucine at amino acid position 381 into arginine (Leu381Arg or L381R). Brain appearance was found normal at magnetic resonance imaging (MRI) and functional spectroscopy analysis showed normal levels of the main metabolites. Spine MRI showed a cystic cavity within the spinal cord (syringomyelia), localized between the sixth cervical vertebra and the first thoracic vertebra. Cerebellar tonsils descended 7 mm caudal to foramen magnum, consistently with a mild type 1 Chiari malformation. Mild posterior inter-vertebral disk protrusions were evident between T9 and T10 and between L4 and L5. To our knowledge, this is the first report describing type 1 Chiari malformation and multiple spinal cord abnormalities in a patient with Allgrove syndrome. PMID:23800107

  10. Triple-negative breast cancer: new perspectives for targeted therapies

    Directory of Open Access Journals (Sweden)

    Tomao F

    2015-01-01

    Full Text Available Federica Tomao,1 Anselmo Papa,2 Eleonora Zaccarelli,2 Luigi Rossi,2 Davide Caruso,2 Marina Minozzi,2 Patrizia Vici,3 Luigi Frati,4 Silverio Tomao21Department of Gynecology and Obstetrics, “Sapienza” University of Rome, Policlinico “Umberto I”, Rome, 2Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, Oncology Unit, Istituto Chirurgico Ortopedico Traumatologico, Latina, 3Division of Medical Oncology B, Regina Elena National Cancer Institute, Rome, Italy; 4Department of Molecular Medicine, “Sapienza” University of Rome, Policlinico “Umberto I”, Rome, ItalyAbstract: Breast cancer is a heterogeneous disease, encompassing a large number of entities showing different morphological features and having clinical behaviors. It has became apparent that this diversity may be justified by distinct patterns of genetic, epigenetic, and transcriptomic aberrations. The identification of gene-expression microarray-based characteristics has led to the identification of at least five breast cancer subgroups: luminal A, luminal B, normal breast-like, human epidermal growth factor receptor 2, and basal-like. Triple-negative breast cancer is a complex disease diagnosed by immunohistochemistry, and it is characterized by malignant cells not expressing estrogen receptors or progesterone receptors at all, and human epidermal growth factor receptor 2. Along with this knowledge, recent data show that triple-negative breast cancer has specific molecular features that could be possible targets for new biological targeted drugs. The aim of this article is to explore the use of new drugs in this particular setting, which is still associated with poor prognosis and high risk of distant recurrence and death.Keywords: basal-like breast cancer, estrogen–progesterone receptors, gene-expression microarray, human epidermal growth factor receptor 2, chemotherapy, target therapy

  11. Derivation of a triple mosaic adenovirus for cancer gene therapy.

    Directory of Open Access Journals (Sweden)

    Yizhe Tang

    2009-12-01

    Full Text Available A safe and efficacious cancer medicine is necessary due to the increasing population of cancer patients whose particular diseases cannot be cured by the currently available treatment. Adenoviral (Ad vectors represent a promising therapeutic medicine for human cancer therapy. However, several improvements are needed in order for Ad vectors to be effective cancer therapeutics, which include, but are not limited to, improvement of cellular uptake, enhanced cancer cell killing activity, and the capability of vector visualization and tracking once injected into the patients. To this end, we attempted to develop an Ad as a multifunctional platform incorporating targeting, imaging, and therapeutic motifs. In this study, we explored the utility of this proposed platform by generating an Ad vector containing the poly-lysine (pK, the herpes simplex virus type 1 (HSV-1 thymidine kinase (TK, and the monomeric red fluorescent protein (mRFP1 as targeting, tumor cell killing, and imaging motifs, respectively. Our study herein demonstrates the generation of the triple mosaic Ad vector with pK, HSV-1 TK, and mRFP1 at the carboxyl termini of Ad minor capsid protein IX (pIX. In addition, the functionalities of pK, HSV-1 TK, and mRFP1 proteins on the Ad vector were retained as confirmed by corresponding functional assays, indicating the potential multifunctional application of this new Ad vector for cancer gene therapy. The validation of the triple mosaic Ad vectors also argues for the ability of pIX modification as a base for the development of multifunctional Ad vectors.

  12. The TWA 3 Young Triple System: Orbits, Disks, Evolution

    Energy Technology Data Exchange (ETDEWEB)

    Kellogg, Kendra [Department of Physics and Astronomy, The University of Western Ontario, London, ON N6A 3K7 (Canada); Prato, L.; Avilez, I.; Wasserman, L. H.; Levine, S. E.; Bosh, A. S. [Lowell Observatory, 1400 West Mars Hill Road, Flagstaff, AZ 86001 (United States); Torres, Guillermo [Harvard-Smithsonian Center for Astrophysics, Cambridge, MA 02138 (United States); Schaefer, G. H. [The CHARA Array of Georgia State University, Mount Wilson Observatory, Mount Wilson, CA 91023 (United States); Ruíz-Rodríguez, D. [Research School of Astronomy and Astrophysics, Australian National University, Canberra, ACT 2611 (Australia); Bonanos, Alceste Z. [IAASARS, National Observatory of Athens, 15236 Penteli (Greece); Guenther, E. W. [Thüringer Landessternwarte Tautenburg, D-07778 Tautenburg (Germany); Neuhäuser, R. [Astrophysikalisches Institut und Universitäts-Sternwarte, FSU Jena, Schillergäßchen 2-3, D-07745 Jena (Germany); Morzinski, Katie M.; Close, Laird; Hinz, Phil; Males, Jared R. [Steward Observatory, University of Arizona, 933 N. Cherry Ave, Tucson, AZ 85721 (United States); Bailey, Vanessa, E-mail: kkellogg@uwo.ca, E-mail: lprato@lowell.edu [Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, Stanford University, Stanford, CA, 94305 (United States)

    2017-08-01

    We have characterized the spectroscopic orbit of the TWA 3A binary and provide preliminary families of probable solutions for the TWA 3A visual orbit, as well as for the wide TWA 3A–B orbit. TWA 3 is a hierarchical triple located at 34 pc in the ∼10 Myr old TW Hya association. The wide component separation is 1.″55; the close pair was first identified as a possible binary almost 20 years ago. We initially identified the 35-day period orbital solution using high-resolution infrared spectroscopy that angularly resolved the A and B components. We then refined the preliminary orbit by combining the infrared data with a reanalysis of our high-resolution optical spectroscopy. The orbital period from the combined spectroscopic solution is ∼35 days, the eccentricity is ∼0.63, and the mass ratio is ∼0.84; although this high mass ratio would suggest that optical spectroscopy alone should be sufficient to identify the orbital solution, the presence of the tertiary B component likely introduced confusion in the blended optical spectra. Using millimeter imaging from the literature, we also estimate the inclinations of the stellar orbital planes with respect to the TWA 3A circumbinary disk inclination and find that all three planes are likely misaligned by at least ∼30°. The TWA 3A spectroscopic binary components have spectral types of M4.0 and M4.5; TWA 3B is an M3. We speculate that the system formed as a triple, is bound, and that its properties were shaped by dynamical interactions between the inclined orbits and disk.

  13. [Immunohistochemical characteristics of triple negative/basal-like breast cancer].

    Science.gov (United States)

    Pala, Emel Ebru; Bayol, Ümit; Cumurcu, Süheyla; Keskın, Elif

    2012-01-01

    Triple-negative-breast-cancer that accounts for 10-20% of all breast carcinomas is defined by the lack of estrogen receptor, progesterone receptor, HER2 expression, and agressive clinical behavior. Triple-negative-breast-cancer is categorized into basal like and other types. The basal-like subtype is characterized by the expression of myoepithelial/basal markers. We studied 41 immunohistochemically triplenegative- breast-cancer patients to determine EGFR, Cytokeratine 5/6, p53, Ki67, GCDFP-15 expression profiles, HER2 and Chromosome 17 centromere gene status by fluorescence-in-situ-hybridization method. Histological type was invasive ductal carcinoma in 90.2% of the tumors. p53, Ki67, GCDFP-15 mean positivity rates were 55.6%, 51.7%, and 3.2%, respectively. GCDFP-15 positivity was noted in 8 cases of which 6 were Cytokeratine 5/6 negative. The cut-off value for Cytokeratine 5/6 positivity was 5%. EGFR immunoreactivity was grouped into 0, 1+ as negative; 2+, 3+ as positive categories. Cytokeratine 5/6 was positive in 56,1%, EGFR was positive in 51.2% of the patients. The relation between Cytokeratine 5/6 and EGFR expression was statistically significant (p < 0.01). None of the cases showed HER2 amplification by fluorescence-in-situ-hybridization method. GCDFP-15 alone is not a useful marker to detect the metastasis of basaloid type breast cancers. Cytokeratine 5/6 and EGFR expressions showed correlation so these markers are reliable to diagnose basaloid type tumors with a 5% cut-off value.

  14. A millisecond pulsar in a stellar triple system.

    Science.gov (United States)

    Ransom, S M; Stairs, I H; Archibald, A M; Hessels, J W T; Kaplan, D L; van Kerkwijk, M H; Boyles, J; Deller, A T; Chatterjee, S; Schechtman-Rook, A; Berndsen, A; Lynch, R S; Lorimer, D R; Karako-Argaman, C; Kaspi, V M; Kondratiev, V I; McLaughlin, M A; van Leeuwen, J; Rosen, R; Roberts, M S E; Stovall, K

    2014-01-23

    Gravitationally bound three-body systems have been studied for hundreds of years and are common in our Galaxy. They show complex orbital interactions, which can constrain the compositions, masses and interior structures of the bodies and test theories of gravity, if sufficiently precise measurements are available. A triple system containing a radio pulsar could provide such measurements, but the only previously known such system, PSR B1620-26 (refs 7, 8; with a millisecond pulsar, a white dwarf, and a planetary-mass object in an orbit of several decades), shows only weak interactions. Here we report precision timing and multiwavelength observations of PSR J0337+1715, a millisecond pulsar in a hierarchical triple system with two other stars. Strong gravitational interactions are apparent and provide the masses of the pulsar M[Symbol: see text](1.4378(13), where M[Symbol: see text]is the solar mass and the parentheses contain the uncertainty in the final decimal places) and the two white dwarf companions (0.19751(15)M[Symbol: see text] and 0.4101(3))M[Symbol: see text], as well as the inclinations of the orbits (both about 39.2°). The unexpectedly coplanar and nearly circular orbits indicate a complex and exotic evolutionary past that differs from those of known stellar systems. The gravitational field of the outer white dwarf strongly accelerates the inner binary containing the neutron star, and the system will thus provide an ideal laboratory in which to test the strong equivalence principle of general relativity.

  15. Acute kidney injury secondary to a combination of renin-angiotensin system inhibitors, diuretics and NSAIDS: "The Triple Whammy".

    Science.gov (United States)

    Camin, Rosa Maria Garcia; Cols, Montse; Chevarria, Julio Leonel; Osuna, Rosa García; Carreras, Marc; Lisbona, Josep Maria; Coderch, Jordi

    2015-01-01

    Renin-angiotensin system inhibitors (ACEI/ARB-II), diuretics and NSAIDs, a combination known as "Triple Whammy", can result in decreased glomerular filtration rate (GFR) and acute kidney injury (AKI). Objectives: To describe the incidence of AKI for each drug type and their combinations. To define the profile of patients admitted for drug-related AKI secondary to Triple Whammy drugs (AKITW), with an assessment of costs and mortality. A retrospective observational 15-month study developed in three stages: - First: a cross-sectional stage to identify and describe hospitalizations due to AKITW. - Second: a follow-up stage of an outpatient cohort consuming these drugs (15,307 subjects). - Third: a cohort stage to assess costs and mortality, which compared 62 hospitalized patients with AKITW and 62 without AKI, paired by medical specialty, sex, age and comorbidity according to their Clinical Risk Groups. There were 85 hospitalization episodes due to AKITW, and 78% of patients were over the age of 70. The incidence of AKITW in the population was 3.40 cases/1000 users/year (95% CI: 2.59-4.45). By categories, these were: NSAIDs + diuretics 8.99 (95% CI: 3.16-25.3); Triple Whammy 8.82 (95% CI: 4.4-17.3); ACEI/ARB-II + diuretics 6.87 (95% CI: 4.81-9.82); and monotherapy with diuretics 3.31 (95% CI: 1.39-7.85). Mean hospital stay was 7.6 days (SD 6.4), and mean avoidable costs were estimated at €214,604/100,000 inhabitants/year. Mortality during hospitalization and at 12 months was 11.3% and 38.7% respectively, and there were no significant differences when compared with the control group. Treatment with ACEI, ARB-II, diuretics and/or NSAIDs shows a high incidence of hospitalization episodes due to AKI; diuretics as monotherapy or dual and triple combination therapy cause the highest incidence. AKITW involves high health care costs and avoidable mortality. Copyright © 2015. Published by Elsevier España, S.L.U.

  16. Technical Aspects of Delivering Simultaneous Dual and Triple Ion Beams to a Target at the Michigan Ion Beam Laboratory

    Science.gov (United States)

    Toader, O.; Naab, F.; Uberseder, E.; Kubley, T.; Taller, S.; Was, G.

    The Michigan Ion Beam Laboratory (MIBL) at the University of Michigan in Ann Arbor, Michigan, USA, plays a significant role in supporting the mission of the U.S. DOE Office of Nuclear Energy. MIBL is a charter laboratory of the NSUF (National Scientific User Facility - US DoE) and hosts users worldwide. The laboratory has evolved from a single accelerator laboratory to a highly versatile facility with three accelerators (3 MV Tandem, a 400 kV Ion Implanter and a 1.7 MV Tandem), seven beam lines and five target chambers that together, provide unique capabilities to capture the extreme environment experienced by materials in reactor systems. This capability now includes simultaneous multiple (dual, triple) ion irradiations, an irradiation accelerated corrosion cell, and soon, in-situ dual beam irradiation in a transmission electron microscope (TEM) for the study of radiation damage coupled with injection of transmutation elements. The two beam lines that will connect to the 300 kV FEI Tecnai G2 F30 microscope are expected to be operational by the end of 2017. Multiple simultaneous ion beam experiments involving light and heavy ions are already in progress. This paper will outline the current equipment and will focus on the new capability of running dual and triple ion beam experiments.

  17. Topological regularizations of the triple collision singularity in the 3-vortex problem

    International Nuclear Information System (INIS)

    Hiraoka, Yasuaki

    2008-01-01

    The triple collision singularity in the 3-vortex problem is studied in this paper. Under the necessary condition k 1 -1 +k 2 -1 +k 3 -1 =0 for vorticities to have the triple collision, the main results are summarized as follows: (i) For k 1 = k 2 , the triple collision singularity is topologically regularizable. (ii) For 0 1 − k 2 | < ε with a sufficiently small ε, the triple collision singularity is not topologically regularizable. First of all, in order to prove these statements, all singularities in the 3-vortex problem are classified. Then, we introduce a dynamical system by blowing up the triple collision singularity with an appropriate time scaling. Roughly speaking, it corresponds to pasting an invariant manifold at the triple collision singularity on the original phase space. This technique is well known as McGehee's collision manifold (1974 Inventions Math. 27 191–227) in the N-body problem of celestial mechanics. Finally, by adopting the viewpoint of Easton (1971 J. Diff. Eqns 10 92–9), topological regularizations of the triple collision singularity are studied in detail

  18. Reliability of twin-dependent triple junction distributions measured from a section plane

    International Nuclear Information System (INIS)

    Hardy, Graden B.; Field, David P.

    2016-01-01

    Numerous studies indicate polycrystalline triple junctions are independent microstructural features with distinct properties from their constituent grain boundaries. Despite the influence of triple junctions on material properties, it is impractical to characterize triple junctions on a large scale using current three-dimensional methods. This work demonstrates the ability to characterize twin-dependent triple junction distributions from a section plane by adopting a grain boundary plane stereology. The technique is validated through simulated distributions and simulated electron back-scatter diffraction (EBSD) data. Measures of validation and convergence are adopted to demonstrate the quantitative reliability of the technique as well as the convergence behavior of twin-dependent triple junction distributions. This technique expands the characterization power of EBSD and prepares the way for characterizing general triple junction distributions from a section plane. - Graphical abstract: The distribution of planes forming a triple junction with a given twin boundary is shown partially in the stereographic projections below from a given projection. The plot on the left shows the ideal/measured distribution and the plot on the right shows the distribution obtained from the stereological method presented here.

  19. Stapled trans-anal rectal resection (STARR) by a new dedicated device for the surgical treatment of obstructed defaecation syndrome caused by rectal intussusception and rectocele: early results of a multicenter prospective study.

    Science.gov (United States)

    Renzi, Adolfo; Talento, Pasquale; Giardiello, Cristiano; Angelone, Giovanni; Izzo, Domenico; Di Sarno, Giandomenico

    2008-10-01

    Obstructed defaecation syndrome (ODS) represents a very common clinical problem. The aim of the this prospective multicenter study was to evaluate the efficacy and safety of stapler trans-anal rectal resection (STARR) performed by a new dedicated device, CCS-30 Contour Transtar, in patients with ODS caused by rectal intussusception (RI) and/or rectocele (RE). All the patients who underwent STARR for ODS caused by RI and/or RE at Colorectal Surgery Units of S. Stefano Hospital, Naples, Gepos Hospital, Telese, Benevento and S. Maria della Pietà Hospital, Casoria, Naples, Italy were prospectively introduced into a database. Preoperatively, all the patients underwent anorectal manometry and cinedefecography. The grade of ODS was assessed using a dedicated obstructed defaecation syndrome score (ODS-S). All the patients with a ODS-S >or=12 and RI and/or RE were enrolled. Patients were followed up clinically at 6 months. Thirty patients, 28 (93.3%) women, mean age 56.6+/-12.7 years, underwent STARR, by Transtar, between February and October 2006. Preoperatively, ODS-S was 15.8+/-2.4. RI was present in 26 (89.6%) and RE (34.4+/-15.2 mm) in 27 (93.1%) patients. No major postoperative complications occurred. The length of hospital stay was 2.5+/-0.6 days. At 6-month follow-up, ODS-S was 5.0+/-2.3 (P<0.001). Successful outcome was achieved in 25 (86.2%) patients. STARR, performed by the new dedicated device, CCS-30 Contour Transtar, seems to be an effective and safe procedure to treat ODS caused by RE and/or RI. A longer follow-up and a larger number of patients is needed to confirm these results.

  20. Interspecies and intraspecies transmission of triple reassortant H3N2 influenza A viruses

    OpenAIRE

    Lee Chang-Won; Al-Natour Mohammad Q; Yassine Hadi M; Saif Yehia M

    2007-01-01

    1. Abstract The triple reassortant H3N2 viruses were isolated for the first time from pigs in 1998 and are known to be endemic in swine and turkey populations in the United States. In 2004, we isolated two H3N2 triple reassortant viruses from two turkey breeder flocks in Ohio and Illinois. Infected hens showed no clinical signs, but experienced a complete cessation of egg production. In this study, we evaluated three triple reassortant H3N2 isolates of turkey origin and one isolate of swine o...

  1. Dirac operators and spectral triples for some fractal sets built on curves

    DEFF Research Database (Denmark)

    Christensen, Erik; Ivan, Cristina; Lapidus, Michel L.

    2008-01-01

    A spectral triple is an object which is described using an algebra of operators on a Hilbert space and an unbounded self-adjoint operator, called a Dirac operator. This model may be applied to the study of classical geometrical objects .The article contains a construction of a spectral triple ass...... associated to some classical fractal subsets of the plane, and it is demonstrated that you can read of many classical geometrical structures, such as distance, measure and Hausdorff dimension from the spectral triple....

  2. EURAMET.T-K7 Key Comparison of Water Triple-Point Cells

    Science.gov (United States)

    Peruzzi, A.; Bosma, R.; Kerkhof, O.; Rosenkranz, P.; Del Campo Maldonado, M. D.; Strnad, R.; Nielsen, J.; Anagnostou, M.; Veliki, T.; Zvizdic, D.; Grudnewicz, E.; Nedea, M.; Neagu, D. M.; Steur, P.; Filipe, E.; Lobo, I.; Antonsen, I.; Renaot, E.; Heinonen, M.; Weckstrom, T.; Bojkovski, J.; Turzo-Andras, E.; Nemeth, S.; White, M.; Tegeler, E.; Dobre, M.; Duris, S.; Kartal Dogan, A.; Uytun, A.; Augevicius, V.; Pauzha, A.; Pokhodun, A.; Simic, S.

    2011-12-01

    The results of a EURAMET key comparison of water triple-point cells (EURAMET.T-K7) are reported. The equipment used, the measuring conditions applied, and the procedures adopted for the water triple-point measurement at the participating laboratories are synthetically presented. The definitions of the national reference for the water triple-point temperature adopted by each laboratory are disclosed. The multiplicity of degrees of equivalence arising for the linking laboratories with respect to the "mother" comparison CCT-K7 is discussed in detail.

  3. Recovery by triple junction motion in aluminium deformed to ultrahigh strains

    DEFF Research Database (Denmark)

    Yu, Tianbo; Hansen, Niels; Huang, Xiaoxu

    2011-01-01

    during plastic deformation and decreases during isochronal and isothermal annealing. Based on TEM and EBSD observations, thermally activated triple junction motion is identified as the key process during the recovery of highly strained aluminium, leading to the removal of thin lamellae with small...... dihedral angles at the ends and structural coarsening. A mechanism for recovery by triple junction motion is proposed, which can underpin the general observation that a lamellar structure formed by plastic deformation during annealing can evolve into an equiaxed structure, preceding further structural...... coarsening and recrystallization. Within this framework, the grain boundary surface tension on triple junctions is discussed based on the structural parameters characterizing the deformed and annealed microstructure....

  4. ACA and the Triple Aim: Musings of a Health Care Actuary.

    Science.gov (United States)

    McCarthy, Mac

    2015-01-01

    In 2008, the Institute for Healthcare Improvement (IHI) promulgated the Triple Aim, which advocates simultaneous improvements in patient experiences, improved population health and lower cost per capita. In 2010, the Patient Protection and Affordable Care Act (ACA) promised quality, affordable health care for all Americans. It's fair to assume that the framers of ACA were aware of the Triple Aim, and it is likely that much of ACA was heavily influenced by IHI's positions. So it is reasonable, from time to time, to assess ACA's impact on health care against the Triple Aim principles.

  5. Triple-phase enhanced MSCT in evaluating solitary pulmonary nodules

    International Nuclear Information System (INIS)

    Zhang Jin'e; Zhao Zhenjun; Liang Changhong; He Hui; Zhang Jia; Ru Guangteng

    2005-01-01

    Objective: An evaluation of the triple-phase enhanced MSCT in the assessment of solitary pulmonary nodules (SPN). Methods: Prospective study was made on 102 SPN using triple-phase enhanced MSCT, and the net elevation of the CT value of nodules as well as the neoplastic blood vessels were assessed. In total 102 patients were enrolled, including 63 males and 39 females, aged from 17 to 87 years (57.2 years in average). The nodules sized from 2.1 to 4.0 cm (3.3cm in average). Pulmonary carcinoma was proved in 71 cases and benign SPN in 31 cases(including 11 inflammatory pseudo tumors, 6 tuberculosis, 3 inflammatory granulomas, 3 lesions of acute nonspecific inflammation, 3 hamartomas, 3 mycosis and 2 abscesses). The spiral scan was performed on an 8-row detector spiral CT (GE/light speed Qx/I Extra) with 5mm/4 slices. The scan time was 1 second per circle. The 5mm sliced imaging was done for CT value measurement and 1.25mm sliced imaging was for MPR(multiplanar reconstruction) or VR(volume rendering), 20ml Ultravist(300 mg/I) was administered at first at a rate of 4ml/s via forearm superficial vein by a power injector. The peak CT values in pulmonary artery and aorta were to determine the delay time for the acquisition in pulmonary phase and aortal phase. Then Ultravist in a volume of lml/ body kilogram was injected, followed by 50 ml of sodium chloride. Delay phase was 3 minutes. Results: The differences of net increased CT value in three phases were statistically significant respectively between lung cancer and benign nodules (F=30.668, 4.495 and 56.141, respectively, P=0.000, 0.036 and 0. 000, respectively). When the net increased CT value≥20 HU was set as a diagnostic threshold, the sensitivity, specificity, positive predict value, negative predict value and veracity were 93%, 29%, 75%, 64.3% and 73.5%. When net increased CT value ≥20 HU in aortal phase while net increased CT value < 20 HU in pulmonary phase was set as a di- agnostic threshold, those values

  6. Triple-differential cross sections of the (π+/,pp) reaction on lithium isotopes

    International Nuclear Information System (INIS)

    Rieder, R.; Barnes, P.D.; Bassalleck, B.

    1985-01-01

    The (π + ,pp) reactions on 6 Li and 7 Li have been studied at T/sub π/ = 59.4 MeV with high resolution. The first triple-differential cross sections for these reactions are presented. The data are fitted to a T-matrix and compared to the π + d → pp reaction. A model in which the pion is absorbed on a 3 S 1 (pn) pair in the lithium nucleus describes many features of the data very well. An extrapolation of our data into unmeasured regions of phase space suggests that about 60% of the pion absorption cross section on 6 Li at 59.4 MeV goes into the (π + ,pp) channel. One surprising feature of the data is that the 6 Li(π + ,pp) 4 He (2 - ) transition at 22.1 MeV excitation is strongly populated, similar to what is observed in the 6 Li(d,α) 4 He reaction. This transition involves removing one nucleon from the 1p shell and one from the 1s shell. 25 refs., 15 figs., 3 tabs

  7. Double- and triple-differential cross sections for electron-impact ionization of helium

    International Nuclear Information System (INIS)

    Biswas, R.; Sinha, C.

    1995-01-01

    Triple- (TDCS) and double- (DDCS) differential cross sections have been calculated for single ionization in electron-helium collisions for asymmetric geometry at intermediate and medium high energies. The TDCS and DDCS results have been presented for different kinematical situations and have been compared with the corresponding experiments. In the present prescription, the final-state wave function involves the correlation between the two continuum electrons and satisfies the three-body asymptotic boundary condition (for asymmetric geometry), which is an important criterion for reliable ionization cross sections. The sensitivity of the ionization cross sections (particularly of the TDCS) with respect to the choice of the bound-state wave function of the He atom has also been studied, using two different forms of wave function of the He atom. The binary-to-recoil peak intensity ratio against momentum transfer in TDCS is found to be in closer agreement with the experiment for the simple Hylleraas wave function than for the Hartree-Fock wave function. The DDCS results are found to be in good agreement with the experimental data of Mueller-Fiedler et al. [J. Phys. B 19, 1211 (1986)] for lower ejected energy (E 2 ), while for higher E 2 the results are closer to the measurements of Shyn et al. [Phys. Rev. A 19, 557 (1979)] and Avaldi et al. [Nuovo Cimento D 9, 97 (1987)

  8. Learning the ropes : winning in the international arena takes strong performances on a triple bottom line

    Energy Technology Data Exchange (ETDEWEB)

    Falkenberg, L.

    2000-10-02

    The challenges facing the petroleum industry in terms of their social and environmental responsibilities at an international level were discussed. Compared to a decade ago, today's company must satisfy shareholders of different types, including environmentalists, non-governmental organizations, religious groups, social activists, international charity agencies and the media. These groups have demanded a shift from financial accountability to a triple bottom line which includes the reporting of financial, social and environmental outcomes. In particular, this paper presented an example where Talisman Energy of Calgary started work in civil war raged Sudan and became the target of criticism from the American Secretary of State. Canada's Minister of Foreign Affairs was pressured by interest groups to impose sanctions on Talisman regardless of the constructive development in the local Sudanese community through projects supported by Talisman. Talisman is responding by communicating the real benefits of its involvement in Sudan, including vaccination campaigns, provision of clean water, funding for schools, jobs for local people, and support for human rights monitoring. 1 fig.

  9. Study and optimization of the light-yield of a triple-GEM detector

    CERN Document Server

    Campagnola, Roberto; Mazzitelli, Giovanni

    The high-resolution tracking of low energy release particles had a remarkable development in recent years and will give a crucial contribution in different fields, from medical uses to those in dark matter search. Characteristics, such as high space and time resolution, low material budget, large volumes, low costs, make gas detectors ideal candidates for this type of devices. A very promising technique involves the optical reading of the light produced by the de-excitation of gas molecules during the processes of electron multiplication. This type of detector has been made possible thanks to the great progresses achieved in last years in the performance in micro pattern gas detector and in the evolution of the CMOS technology which led to the production of sensors able of offering high sensitivity and granularity combined with a very low noise level. In this thesis the performance of a prototype where the light is produced through the multiplication of electrons in a triple GEM structure and acquired by a c...

  10. Geriatrics and the triple aim: defining preventable hospitalizations in the long-term care population.

    Science.gov (United States)

    Ouslander, Joseph G; Maslow, Katie

    2012-12-01

    Reducing preventable hospitalizations is fundamental to the "triple aim" of improving care, improving health, and reducing costs. New federal government initiatives that create strong pressure to reduce such hospitalizations are being or will soon be implemented. These initiatives use quality measures to define which hospitalizations are preventable. Reducing hospitalizations could greatly benefit frail and chronically ill adults and older people who receive long-term care (LTC) because they often experience negative effects of hospitalization, including hospital-acquired conditions, morbidity, and loss of functional abilities. Conversely, reducing hospitalizations could mean that some people will not receive hospital care they need, especially if the selected measures do not adequately define hospitalizations that can be prevented without jeopardizing the person's health and safety. An extensive literature search identified 250 measures of preventable hospitalizations, but the measures have not been validated in the LTC population and generally do not account for comorbidity or the capacity of various LTC settings to provide the required care without hospitalization. Additional efforts are needed to develop measures that accurately differentiate preventable from necessary hospitalizations for the LTC population, are transparent and fair to providers, and minimize the potential for gaming and unintended consequences. As the new initiatives take effect, it is critical to monitor their effect and to develop and disseminate training and resources to support the many community- and institution-based healthcare professionals and emergency department staff involved in decisions about hospitalization for this population. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  11. FOXP3 Transcription Factor: A Candidate Marker for Susceptibility and Prognosis in Triple Negative Breast Cancer

    Directory of Open Access Journals (Sweden)

    Leandra Fiori Lopes

    2014-01-01

    Full Text Available Triple negative breast cancer (TNBC is a relevant subgroup of neoplasia which presents negative phenotype of estrogen and progesterone receptors and has no overexpression of the human epidermal growth factor 2 (HER2. FOXP3 (forkhead transcription factor 3 is a marker of regulatory T cells (Tregs, whose expression may be increased in tumor cells. This study aimed to investigate a polymorphism (rs3761548 and the protein expression of FOXP3 for a possible involvement in TNBC susceptibility and prognosis. Genetic polymorphism was evaluated in 50 patients and in 115 controls by allele-specific PCR (polymerase chain reaction. Protein expression was evaluated in 38 patients by immunohistochemistry. It was observed a positive association for homozygous AA (OR = 3.78; 95% CI = 1.02–14.06 in relation to TNBC susceptibility. Most of the patients (83% showed a strong staining for FOXP3 protein in the tumor cells. In relation to FOXP3-positive infiltrate, 47% and 58% of patients had a moderate or intense intratumoral and peritumoral mononuclear infiltrate cells, respectively. Tumor size was positively correlated to intratumoral FOXP3-positive infiltrate (P=0.026. In conclusion, since FOXP3 was positively associated with TNBC susceptibility and prognosis, it seems to be a promising candidate for further investigation in larger TNBC samples.

  12. Measurement of Triple Gauge-Boson Couplings at LEP energies up to 189 GeV

    CERN Document Server

    Heister, A.; Barate, R.; De Bonis, I.; Decamp, D.; Ghez, Philippe; Goy, C.; Jezequel, S.; Lees, J.P.; Martin, F.; Merle, E.; Minard, M.N.; Pietrzyk, B.; Trocme, B.; Bravo, S.; Casado, M.P.; Chmeissani, M.; Crespo, J.M.; Fernandez, E.; Fernandez-Bosman, M.; Garrido, L.; Grauges, E.; Lopez, J.; Martinez, M.; Merino, G.; Miquel, R.; Mir, L.M.; Pacheco, A.; Paneque, D.; Ruiz, H.; Colaleo, A.; Creanza, D.; De Filippis, N.; de Palma, M.; Iaselli, G.; Maggi, G.; Maggi, M.; Nuzzo, S.; Ranieri, A.; Raso, G.; Ruggieri, F.; Selvaggi, G.; Silvestris, L.; Tempesta, P.; Tricomi, A.; Zito, G.; Huang, X.; Lin, J.; Ouyang, Q.; Wang, T.; Xie, Y.; Xu, R.; Xue, S.; Zhang, J.; Zhang, L.; Zhao, W.; Abbaneo, D.; Azzurri, P.; Barklow, T.; Boix, G.; Buchmuller, O.; Cattaneo, M.; Cerutti, F.; Clerbaux, B.; Dissertori, G.; Drevermann, H.; Forty, R.W.; Frank, M.; Gianotti, F.; Greening, T.C.; Hansen, J.B.; Harvey, John; Hutchcroft, D.E.; Janot, P.; Jost, B.; Kado, M.; Lemaitre, V.; Maley, P.; Mato, P.; Moutoussi, A.; Ranjard, F.; Rolandi, Gigi; Schlatter, D.; Spagnolo, P.; Tejessy, W.; Teubert, F.; Tournefier, E.; Valassi, A.; Ward, J.J.; Wright, A.E.; Ajaltouni, Z.; Badaud, F.; Dessagne, S.; Falvard, A.; Fayolle, D.; Gay, P.; Henrard, P.; Jousset, J.; Michel, B.; Monteil, S.; Montret, J.C.; Pallin, D.; Pascolo, J.M.; Perret, P.; Podlyski, F.; Hansen, J.D.; Hansen, J.R.; Hansen, P.H.; Nilsson, B.S.; Waananen, A.; Daskalakis, G.; Kyriakis, A.; Markou, C.; Simopoulou, E.; Vayaki, A.; Blondel, A.; Brient, J.C.; Machefert, F.; Rouge, A.; Swynghedauw, M.; Tanaka, R.; Videau, H.; Focardi, E.; Parrini, G.; Zachariadou, K.; Antonelli, A.; Antonelli, M.; Bencivenni, G.; Bologna, G.; Bossi, F.; Campana, P.; Capon, G.; Chiarella, V.; Laurelli, P.; Mannocchi, G.; Murtas, F.; Murtas, G.P.; Passalacqua, L.; Pepe-Altarelli, M.; Chalmers, M.; Halley, A.W.; Kennedy, J.; Lynch, J.G.; Negus, P.; O'Shea, V.; Raeven, B.; Smith, D.; Thompson, A.S.; Wasserbaech, S.; Cavanaugh, R.; Dhamotharan, S.; Geweniger, C.; Hanke, P.; Hepp, V.; Kluge, E.E.; Leibenguth, G.; Putzer, A.; Tittel, K.; Werner, S.; Wunsch, M.; Beuselinck, R.; Binnie, D.M.; Cameron, W.; Davies, G.; Dornan, P.J.; Girone, M.; Marinelli, N.; Nowell, J.; Przysiezniak, H.; Rutherford, S.; Sedgbeer, J.K.; Thompson, J.C.; White, R.; Ghete, V.M.; Girtler, P.; Kneringer, E.; Kuhn, D.; Rudolph, G.; Bouhova-Thacker, E.; Bowdery, C.K.; Clarke, D.P.; Ellis, G.; Finch, A.J.; Foster, F.; Hughes, G.; Jones, R.W.L.; Pearson, M.R.; Robertson, N.A.; Smizanska, M.; Giehl, I.; Holldorfer, F.; Jakobs, K.; Kleinknecht, K.; Krocker, M.; Muller, A.S.; Nurnberger, H.A.; Quast, G.; Renk, B.; Rohne, E.; Sander, H.G.; Schmeling, S.; Wachsmuth, H.; Zeitnitz, C.; Ziegler, T.; Bonissent, A.; Carr, J.; Coyle, P.; Curtil, C.; Ealet, A.; Fouchez, D.; Leroy, O.; Kachelhoffer, T.; Payre, P.; Rousseau, D.; Tilquin, A.; Aleppo, M.; Gilardoni, Simone S.; Ragusa, F.; David, A.; Dietl, H.; Ganis, G.; Huttmann, K.; Lutjens, G.; Mannert, C.; Manner, W.; Moser, H.G.; Settles, R.; Stenzel, H.; Wolf, G.; Boucrot, J.; Callot, O.; Davier, M.; Duflot, L.; Grivaz, J.F.; Heusse, P.; Jacholkowska, A.; Serin, L.; Veillet, J.J.; Videau, I.; de Vivie de Regie, J.B.; Yuan, C.; Bagliesi, Giuseppe; Boccali, T.; Calderini, G.; Ciulli, V.; Foa, L.; Giammanco, A.; Giassi, A.; Ligabue, F.; Messineo, A.; Palla, F.; Sanguinetti, G.; Sciaba, A.; Sguazzoni, G.; Tenchini, R.; Venturi, A.; Verdini, P.G.; Awunor, O.; Blair, G.A.; Coles, J.; Cowan, G.; Garcia-Bellido, A.; Green, M.G.; Jones, L.T.; Medcalf, T.; Misiejuk, A.; Strong, J.A.; Teixeira-Dias, P.; Clifft, R.W.; Edgecock, T.R.; Norton, P.R.; Tomalin, I.R.; Bloch-Devaux, Brigitte; Boumediene, D.; Colas, P.; Fabbro, B.; Lancon, E.; Lemaire, M.C.; Locci, E.; Perez, P.; Rander, J.; Renardy, J.F.; Rosowsky, A.; Seager, P.; Trabelsi, A.; Tuchming, B.; Vallage, B.; Konstantinidis, N.; Litke, A.M.; Loomis, C.; Taylor, G.; Booth, C.N.; Cartwright, S.; Combley, F.; Hodgson, P.N.; Lehto, M.; Thompson, L.F.; Affholderbach, K.; Boehrer, Armin; Brandt, S.; Grupen, C.; Hess, J.; Ngac, A.; Prange, G.; Sieler, U.; Borean, C.; Giannini, G.; He, H.; Putz, J.; Rothberg, J.; Armstrong, S.R.; Cranmer, K.; Elmer, P.; Ferguson, D.P.S.; Gao, Y.; Gonzalez, S.; Hayes, O.J.; Hu, H.; Jin, S.; Kile, J.; McNamara, P.A., III; Nielsen, J.; Orejudos, W.; Pan, Y.B.; Saadi, Y.; Scott, I.J.; von Wimmersperg Toeller, J.H.; Walsh, J.; Wiedenmann, W.; Wu, J.; Wu, Sau Lan; Wu, X.; Zobernig, G.

    2001-01-01

    The triple gauge-boson couplings involving the W are determined using data samples collected with the ALEPH detector at mean centre-of-mass energies of 183 GeV and 189 GeV, corresponding to integrated luminosities of 57 pb^-1 and 174 pb^-1, respectively. The couplings, g^Z_1, Kappa_gamma and lambda_gamma, are measured using W-pair events, single-W production and single-gamma production. Each coupling is measured individually with the other two coupling fixed at their Standard Model value. Including ALEPH results from lower energies, the 95% confidence level intervals for the deviation to the Standard Model are -0.087 < Dg^Z_1 < 0.141 -0.200 < DKappa_gamma < 0.258 -0.062 < Lambda_gamma < 0.147. Fits are also presented where two or all three couplings are allowed to vary. In addition, W-pair events are used to set limits on the C- or P-violating couplings g^V_4, g^V_5, Kappa~_V, and Lambda~_V, where V denotes either gamma or Z. No deviations from the Standard Model expectations are observed.

  13. Surgery: Modified Pi with Triple-Bonnet Flap and Fronto-Orbital Advancement.

    Science.gov (United States)

    Singh Raswan, Uday; Singh Chhiber, Sarbjit; Ramzan, Altaf Umar

    2017-01-01

    Craniosynostosis is the premature fusion of one or more of the cranial sutures and can occur as part of a syndrome or as an isolated defect. Pansynostosis is a rare form of craniosynostosis that involves premature fusion of all the cranial sutures (coronal, sagittal, metopic, and occipital). Particularly in cases of late presentation, there are heightened clinical concerns, both functional and aesthetic. In untreated cases of pansynostosis and increased intracranial pressure, optic nerve damage progresses to optic atrophy and then blindness. Cranial vault reconstruction is the standard surgical treatment. We attempt to highlight the importance of modifying the osteotomies and reshaping of the cranial vault based on individual requirements in order to achieve the best possible result and to prevent catastrophic blood loss. We present a case of modified pi with triple-bonnet flap and fronto-orbital advancement, an individual modification of the techniques of cranial vault reconstruction, in a patient with pansynostosis with optic atrophy. The technical variation can be applied to any case of pansynostosis requiring cranial vault reconstruction. © 2017 S. Karger AG, Basel.

  14. ONC201 activates ER stress to inhibit the growth of triple-negative breast cancer cells.

    Science.gov (United States)

    Yuan, Xun; Kho, Dhonghyo; Xu, Jing; Gajan, Ambikai; Wu, Kongming; Wu, Gen Sheng

    2017-03-28

    ONC201 was previously identified as a first-in-class antitumor agent and small-molecule inducer of the TRAIL (tumor necrosis factor-related apoptosis-inducing ligand) gene that induces apoptosis in cancer cells. ONC201 has a safety profile and is currently in phase II clinical trials for the treatment of various malignancies. In the current study, we examine the effect of ONC201 on triple-negative breast cancer cells (TNBC), a subtype of breast cancer that is sensitive to TRAIL. We find that ONC201 inhibits the growth of TNBC cells including TNBC cells that have developed acquired TRAIL resistance. However, TNBC cells that have developed acquired ONC201 resistance are cross-resistant to TRAIL. Mechanistically, ONC201 triggers an integrated stress response (ISR) involving the activation of the transcription factor ATF4. Knockdown of ATF4 impairs ONC201-induced apoptosis of TNBC cells. Importantly, the activation of ATF4 is compromised in ONC201-resistant TNBC cells. Thus, our results indicate that ONC201 induces an ISR to cause TNBC cell death and suggest that TNBC patients may benefit from ONC201-based therapies.

  15. Triple-aspect monism: physiological, mental unconscious and conscious aspects of brain activity.

    Science.gov (United States)

    Pereira, Alfredo

    2014-06-01

    Brain activity contains three fundamental aspects: (a) The physiological aspect, covering all kinds of processes that involve matter and/or energy; (b) the mental unconscious aspect, consisting of dynamical patterns (i.e., frequency, amplitude and phase-modulated waves) embodied in neural activity. These patterns are variously operated (transmitted, stored, combined, matched, amplified, erased, etc), forming cognitive and emotional unconscious processes and (c) the mental conscious aspect, consisting of feelings experienced in the first-person perspective and cognitive functions grounded in feelings, as memory formation, selection of the focus of attention, voluntary behavior, aesthetical appraisal and ethical judgment. Triple-aspect monism (TAM) is a philosophical theory that provides a model of the relation of the three aspects. Spatially distributed neuronal dendritic potentials generate amplitude-modulated waveforms transmitted to the extracellular medium and adjacent astrocytes, prompting the formation of large waves in the astrocyte network, which are claimed to both integrate distributed information and instantiate feelings. According to the valence of the feeling, the large wave feeds back on neuronal synapses, modulating (reinforcing or depressing) cognitive and behavioral functions.

  16. Metabolic Syndrome and Triple-Negative Breast Cancer: A New Paradigm

    International Nuclear Information System (INIS)

    Davis, A.A.; Kaklamani, V.G.

    2012-01-01

    Triple-negative breast cancers (TNBCs) are aggressive tumors with poor prognosis compared to other breast cancer subtypes. The evidence linking TNBC with the metabolic syndrome, which consists of central obesity, insulin resistance, impaired glucose tolerance, dyslipidemia, and hypertension, has emerged from clinical studies and experiments using cell lines and mouse models. Epidemiological studies have associated abdominal obesity with increased incidence of TNBC. Additionally, insulin resistance, dyslipidemia, and hypertension are associated with increased incidence of breast cancer across all subtypes. The insulin-leptin-adiponectin axis has been implicated mechanistically in breast cancer tumorigenesis. Specifically, increased leptin and decreased adiponectin levels disrupt homeostatic signaling pathways involved in cell proliferation, survival, cell-cycle regulation, and angio genesis. Insulin, insulin-like growth factor I (IGF-I), and epidermal growth factor receptor (EGFR) may mediate interactions between these two hormones. Further research will facilitate the development of targeted therapeutics and programs to modify lifestyle factors to modulate the insulin-leptin-adiponectin axis for TNBC

  17. Metabolic Syndrome and Triple-Negative Breast Cancer: A New Paradigm

    Energy Technology Data Exchange (ETDEWEB)

    Davis, A A; Kaklamani, V G [Cancer Genetics Program, Division of Hematology/Oncology, Department of Medicine and Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611 (Ukraine)

    2012-07-01

    Triple-negative breast cancers (TNBCs) are aggressive tumors with poor prognosis compared to other breast cancer subtypes. The evidence linking TNBC with the metabolic syndrome, which consists of central obesity, insulin resistance, impaired glucose tolerance, dyslipidemia, and hypertension, has emerged from clinical studies and experiments using cell lines and mouse models. Epidemiological studies have associated abdominal obesity with increased incidence of TNBC. Additionally, insulin resistance, dyslipidemia, and hypertension are associated with increased incidence of breast cancer across all subtypes. The insulin-leptin-adiponectin axis has been implicated mechanistically in breast cancer tumorigenesis. Specifically, increased leptin and decreased adiponectin levels disrupt homeostatic signaling pathways involved in cell proliferation, survival, cell-cycle regulation, and angio genesis. Insulin, insulin-like growth factor I (IGF-I), and epidermal growth factor receptor (EGFR) may mediate interactions between these two hormones. Further research will facilitate the development of targeted therapeutics and programs to modify lifestyle factors to modulate the insulin-leptin-adiponectin axis for TNBC

  18. New - Nucleus - NucNet. The ENS triple communication system

    Energy Technology Data Exchange (ETDEWEB)

    Feuz, Peter [ENS and NucNet (Belgium); Holt, Peter [Nuclear Europe Worldscan and Nucleus (Belgium)

    1993-07-01

    The ENS triple communication system was built up as a step-by-step response to practical needs. In fact the triple communication system has the fourth issue, namely WINFO. Nuclear Europe was started in 1981 with three pilot issues. Now, Nuclear Europe Worldscan has become an integrator, between over 20 000 members of ENS Member Societies, from the Atlantic to the Urals and beyond; an integrator between Europe and the rest-of-the world nuclear community; between industry and science and engineering; between the bosses and the staff; and finally, an integrator between the nuclear community and those outsiders who take an interest in nuclear issues. Nucleus started in 1987, selected by the ENS Steering Committee for as the most worthwhile for transferring messages from nuclear community to the politicians and opinion-leaders, i.e. to non-technical outsiders. It is a briefing sheet for people who work with key policy principles, politicians and journalists. It is designed and written for people having no time to read. The keys to each two-page Nucleus are headlines. Nucleus appears in English, French, Croatian, Russian, Dutch, Hungarian, Romanian and Finnish. When the need grew really urgent for Europe, the ENS Information Committee proposed a feasibility study, which the European nuclear community entrusted to ENS in 1989. NucNet was launched in January 1991 - first as a European, and later as a truly worldwide, communications system. NucNet is the worldwide network which circulates nuclear news and information that the public should be informed of, written in a language that the public can easily understand. NucNet is highly appreciated, for instance, by NPP managers because they are informed about incidents faster than by any other means. But, NucNet is not merely an incident reporting system. (As a general rule, the network only reports on incidents in nuclear plants if they are rated at level 2 or above on the IAEA's International Nuclear Event Scale). The more

  19. New - Nucleus - NucNet. The ENS triple communication system

    International Nuclear Information System (INIS)

    Feuz, Peter; Holt, Peter

    1993-01-01

    The ENS triple communication system was built up as a step-by-step response to practical needs. In fact the triple communication system has the fourth issue, namely WINFO. Nuclear Europe was started in 1981 with three pilot issues. Now, Nuclear Europe Worldscan has become an integrator, between over 20 000 members of ENS Member Societies, from the Atlantic to the Urals and beyond; an integrator between Europe and the rest-of-the world nuclear community; between industry and science and engineering; between the bosses and the staff; and finally, an integrator between the nuclear community and those outsiders who take an interest in nuclear issues. Nucleus started in 1987, selected by the ENS Steering Committee for as the most worthwhile for transferring messages from nuclear community to the politicians and opinion-leaders, i.e. to non-technical outsiders. It is a briefing sheet for people who work with key policy principles, politicians and journalists. It is designed and written for people having no time to read. The keys to each two-page Nucleus are headlines. Nucleus appears in English, French, Croatian, Russian, Dutch, Hungarian, Romanian and Finnish. When the need grew really urgent for Europe, the ENS Information Committee proposed a feasibility study, which the European nuclear community entrusted to ENS in 1989. NucNet was launched in January 1991 - first as a European, and later as a truly worldwide, communications system. NucNet is the worldwide network which circulates nuclear news and information that the public should be informed of, written in a language that the public can easily understand. NucNet is highly appreciated, for instance, by NPP managers because they are informed about incidents faster than by any other means. But, NucNet is not merely an incident reporting system. (As a general rule, the network only reports on incidents in nuclear plants if they are rated at level 2 or above on the IAEA's International Nuclear Event Scale). The more

  20. Geochemistry of the mantle beneath the Rodriguez Triple Junction and the South-East Indian Ridge

    International Nuclear Information System (INIS)

    Michard, A.; Montigny, R.; Schlich, R.

    1986-01-01

    Rare earth element abundances and SR, Nd, Pb isotope compositions have been measured on zero-age dredge samples from the Rodriguez Triple Junction (RTJ) and the South-East Indian Ridge (SEIR). Along the SEIR, the geochemical ''halo'' of the St. Paul hot spot has a half-width of about 400 km and the data may be fairly well accounted for by a binary mixing between an Indian MORB-type component ( 87 Sr/ 86 Sr=0.7028, 143 Nd/ 144 Nd=0.51304, 206 Pb/ 204 Pb=17.8) and the plume type St. Paul component (0.7036, 0.5129 and 18.7 respectively). The alignment of the lead isotope data is particularly good with age of 1.95+-0.13 Ga and Th/U source value of 3.94. One sample dredged on the ridge 60 km southeast of St. Paul bears a definite Kertguelen isotopic signature. The RTJ has distinctive geochemical properties which contrast with those of the adjacent ridge segments. Low 206 Pb/ 204 Pb ratios which plots to the left of the geochron, rather high 208 Pb/ 204 Pb and 87 Sr/ 86 Sr ratios (17.4, 37.4, and 0.7031 respectively) a striking isotopic homogeneity, and variable LRE/HREE fractionation with (LA/S)sub(N) 0.3-0.8 make this triple junction an anomalous site. The geochemical properties of the Indian Ocean basalts have been examined using a three-component mantle model involving (a) a normal MORB-type source though to represent the depleted upper mantle matrix, (b) an OIB-type source of uncertain parentage (recycled oceanic crust), and (c) a component with low μ, Low Sm/Nd, high Rb/Sr (time-averaged value) which is tentatively assigned to ancient hydrothermal and abyssal sediments recycled in the mantle. The high 208 Pb/ 204 Pb and 87 Sr/ 86 Sr ratios typical of the Dupal anomaly are likely due to the widespread distribution of this latter component in the basalt source from this area, including that for MORBs. (orig.)

  1. Geochemistry of the mantle beneath the Rodriguez Triple Junction and the South-East Indian Ridge

    Science.gov (United States)

    Michard, A.; Montigny, R.; Schlich, R.

    1986-05-01

    Rare earth element abundances and Sr, Nd. Pb isotope compositions have been measured on zero-age dredge samples from the Rodriguez Triple Junction (RTJ) and the South-East Indian Ridge (SEIR), Along the SEIR. the geochemical "halo" of the St. Paul hot spot has a half-width of about 400 km and the data may be fairly well accounted for by a binary mixing between an Indian MORB-type component ( 87Sr/ 86Sr = 0.7028. 143Nd/ 144Nd = 0.51304. 206Pb/ 204Pb = 17.8) and the plume-type St. Paul component (0.7036, 0.5129, and 18.7 respectively). The alignment of the lead isotope data is particularly good with an apparent age of 1.95 ± 0.13 Ga and Th/U source value of 3.94. One sample dredged on the ridge 60 km southeast of St. Paul bears a definite Kerguelen isotopic signature. The RTJ has distinctive geochemical properties which contrast with those of the adjacent ridge segments. Low 206Pb/ 204Pb ratios which plots to the left of the geochron, rather high 208Pb/ 204Pb and 87Sr/ 87Sr ratios (17.4. 37.4, and 0.7031 respectively), a striking isotopic homogeneity, and variable LREE/HREE fractionation with (La/Sm) N, = 0.3-0.8 make this triple junction an anomalous site. The geochemical properties of the Indian Ocean basats have been examined using a three-component mantle model involving (a) a normal MORB-type source though to represent the depleted upper mantle matrix, (b) an OIB-type source of uncertain parentage (recycled oceanic crust?), and (c) a component with low μ. low Sm/Nd. high Rb/Sr (time-averaged value) which is tentatively assigned to ancient hydrothermal and abyssal sediments recycled in the mantle. The high 208Pb/ 204Pb and 87Sr/ 86Sr ratios typical of the Dupal anomaly are likely due to the widespread distribution of this latter component in the basalt source from this area. including that for MORBs.

  2. Who and What Does Involvement Involve?

    DEFF Research Database (Denmark)

    Hansen, Jeppe Oute; Petersen, Anders; Huniche, Lotte

    2015-01-01

    This article gives an account of aspects of a multi-sited field study of involvement of relatives in Danish psychiatry. By following metaphors of involvement across three sites of the psychiatric systema family site, a clinical site and a policy sitethe first author (J.O.) investigated how...... theoretical perspective laid out by Ernesto Laclau and Chantal Mouffe, the aim of this study is to show how the dominant discourse about involvement at the political and clinical sites is constituted by understandings of mentally ill individuals and by political objectives of involvement. The analysis...... the responsibility toward the mental health of the ill individual as well as toward the psychological milieu of the family....

  3. Two-week, high-dose proton pump inhibitor, moxifloxacin triple Helicobacter pylori therapy after failure of standard triple or non-bismuth quadruple treatments.

    Science.gov (United States)

    Gisbert, Javier P; Romano, Marco; Molina-Infante, Javier; Lucendo, Alfredo J; Medina, Enrique; Modolell, Inés; Rodríguez-Tellez, Manuel; Gomez, Blas; Barrio, Jesús; Perona, Monica; Ortuño, Juan; Ariño, Inés; Domínguez-Muñoz, Juan Enrique; Perez-Aisa, Ángeles; Bermejo, Fernando; Domínguez, Jose Luis; Almela, Pedro; Gomez-Camarero, Judith; Millastre, Judith; Martin-Noguerol, Elisa; Gravina, Antonietta G; Martorano, Marco; Miranda, Agnese; Federico, Alessandro; Fernandez-Bermejo, Miguel; Angueira, Teresa; Ferrer-Barcelo, Luis; Fernández, Nuria; Marín, Alicia C; McNicholl, Adrián G

    2015-02-01

    Aim was to evaluate the efficacy and tolerability of a moxifloxacin-containing second-line triple regimen in patients whose previous Helicobacter pylori eradication treatment failed. Prospective multicentre study including patients in whom a triple therapy or a non-bismuth-quadruple-therapy failed. Moxifloxacin (400mg qd), amoxicillin (1g bid), and esomeprazole (40 mg bid) were prescribed for 14 days. Eradication was confirmed by (13)C-urea-breath-test. Compliance was determined through questioning and recovery of empty medication envelopes. 250 patients were consecutively included (mean age 48 ± 15 years, 11% with ulcer). Previous (failed) therapy included: standard triple (n = 179), sequential (n = 27), and concomitant (n = 44); 97% of patients took all medications, 4 were lost to follow-up. Intention-to-treat and per-protocol eradication rates were 82.4% (95% CI, 77-87%) and 85.7% (95% CI, 81-90%). Cure rates were similar independently of diagnosis (ulcer, 77%; dyspepsia, 82%) and previous treatment (standard triple, 83%; sequential, 89%; concomitant, 77%). At multivariate analysis, only age was associated with eradication (OR = 0.957; 95% CI, 0.933-0.981). Adverse events were reported in 25.2% of patients: diarrhoea (9.6%), abdominal pain (9.6%), and nausea (9.2%). 14-day moxifloxacin-containing triple therapy is an effective and safe second-line strategy in patients whose previous standard triple therapy or non-bismuth quadruple (sequential or concomitant) therapy has failed, providing a simple alternative to bismuth quadruple regimen. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. Optimization of elliptic neutron guides for triple-axis spectroscopy

    International Nuclear Information System (INIS)

    Janoschek, M.; Boeni, P.; Braden, M.

    2010-01-01

    In the last decade the performance of neutron guides for the transport of neutrons has been significantly increased. The most recent developments have shown that elliptic guide systems can be used to focus neutron beams while simultaneously reducing the number of neutron reflections, hence, leading to considerable gains in neutron flux. We have carried out Monte-Carlo simulations for a new triple-axis spectrometer that will be built at the end position of the conventional cold guide NL-1 in the neutron guide hall of the research reactor FRM-II in Munich, Germany. Our results demonstrate that an elliptic guide section at the end of a conventional guide can be used to at least maintain the total neutron flux onto the sample, while significantly improving the energy resolution of the spectrometer. The simulation further allows detailed insight how the defining parameters of an elliptic guide have to be chosen to obtain optimum results. Finally, we show that the elliptic guide limits losses in the neutron flux that generally arise at the gaps, where the monochromator system of the upstream instrument is situated.

  5. Triple synchronous cancers. A medical and ethical problem

    International Nuclear Information System (INIS)

    Debevec, L.; Cesar, R.; Kern, I.

    2007-01-01

    In a patient with suspicious synchronous multiple tumours, there are limited possibilities for effective therapy. Therefore, the decision for invasive diagnostics and precise staging of tumours is questionable, especially in elderly patients suitable only for symptomatic therapy. A 78-year-old man with hypertension and angina pectoris was admitted to the hospital due to syncope. Two primary lung tumours and a kidney tumour were detected by imaging investigation. The patient refused invasive diagnostics and left the hospital. After 19 months he was readmitted in an impaired clinical condition and subsequently died of bronchopneumonia. The autopsy revealed squamous cell carcinoma of the right upper lobe with metastases to regional lymph nodes and to the brain, small-cell carcinoma of the left upper lobe with metastases to regional lymph nodes and to the spleen, and clear-cell kidney carcinoma with multiple metastases to the lungs. All tumours were necrotizing, and therefore we assumed that any attempt at specific therapy would have been ineffective. In an elderly patient with advanced lung tumors and suspicious synchronous triple cancers, the ''wait and see'' option can be suitable. (author)

  6. Performance of a Horizontal Triple Cylinder Type Pulping Machine

    Directory of Open Access Journals (Sweden)

    Sukrisno Widyotomo

    2011-05-01

    Full Text Available Pulping is one important step in wet coffee processing method. Pulping process usually uses a machine which constructed by wood or metal materials. A horizontal single cylinder type of fresh coffee cherries pulping machine is the most popular machine in coffee processing. One of the weaknesses of a horizontal single cylinder type of fresh coffee cherries pulping machine is higher in broken beans. Broken bean is one of mayor aspects in defect system that contribute to low quality. Indonesian Coffee and Cocoa Research Institute has designed and tested a horizontal double cylinder type of fresh coffee cherries pulping machine which resulted in 12.6—21.4% of broken beans. To reduce percentage of broken beans, Indonesian Coffee and Cocoa Research Institute has developed and tested a horizontal triple cylinder type of fresh coffee cherries pulping machine. Material tested was fresh mature Robusta coffee cherries, 60—65% (wet basis moisture content; has classified on 3 levels i.e. unsorted, small and medium, and clean from metal and foreign materials. The result showed that the machine produced 6,340 kg/h in optimal capacity for operational conditions, 1400 rpm rotor rotation speed for unsorted coffee cherries with composition 55.5% whole parchment coffee, 3.66% broken beans, and 1% beans in wet skin.Key words : coffee, pulp, pulper, cylinder, quality.

  7. BIPM project: Intercomparison of water triple-point cells

    Science.gov (United States)

    Chattle, M. V.; Butler, J.

    1994-12-01

    The paper presents the results of an intercomparison between 3 triple point of water cells circulated by the Bureau International des Poids et Measures (BIPM), and a cell which is one of those used as a reference cell at the National Physical Laboratory (NPL). All 4 cells were prepared, stored and measured in the manner normally adopted at NPL. The results of the intercomparison show that over the course of about 6 weeks the temperatures of the 3 circulated cells generally agreed within 0.20 mK, with a maximum difference of 0.27(7) mK. Over the same period, the total variations of temperature measured in the 3 individual cells were 0.04 mK, 0.08 mK and 0.18 mK, respectively; the NPL cell varied by 0.10 mK. Gallium point measurements made over a similar period confirmed that these differences were partly due to small drifts in the thermometer resistance or in the measuring system.

  8. Triple Bioluminescence Imaging for In Vivo Monitoring of Cellular Processes

    Directory of Open Access Journals (Sweden)

    Casey A Maguire

    2013-01-01

    Full Text Available Bioluminescence imaging (BLI has shown to be crucial for monitoring in vivo biological processes. So far, only dual bioluminescence imaging using firefly (Fluc and Renilla or Gaussia (Gluc luciferase has been achieved due to the lack of availability of other efficiently expressed luciferases using different substrates. Here, we characterized a codon-optimized luciferase from Vargula hilgendorfii (Vluc as a reporter for mammalian gene expression. We showed that Vluc can be multiplexed with Gluc and Fluc for sequential imaging of three distinct cellular phenomena in the same biological system using vargulin, coelenterazine, and D-luciferin substrates, respectively. We applied this triple imaging system to monitor the effect of soluble tumor necrosis factor-related apoptosis-inducing ligand (sTRAIL delivered using an adeno-associated viral vector (AAV on brain tumors in mice. Vluc imaging showed efficient sTRAIL gene delivery to the brain, while Fluc imaging revealed a robust antiglioma therapy. Further, nuclear factor-κB (NF-κB activation in response to sTRAIL binding to glioma cells death receptors was monitored by Gluc imaging. This work is the first demonstration of trimodal in vivo bioluminescence imaging and will have a broad applicability in many different fields including immunology, oncology, virology, and neuroscience.

  9. Temozolomide Enhances Triple-Negative Breast Cancer Virotherapy In Vitro

    Directory of Open Access Journals (Sweden)

    Rodolfo Garza-Morales

    2018-05-01

    Full Text Available Triple-negative breast cancer (TNBC is one of the most aggressive types of cancer, and treatment is limited to chemotherapy and radiation. Oncolytic virotherapy may be a promising approach to treat TNBC. However, oncolytic adenovirus (OAd-based mono-therapeutic clinical trials have resulted in modest outcomes. The OAd potency could be increased by chemotherapy-induced autophagy, an intracellular degradation system that delivers cytoplasmic constituents to the lysosome. In this study, the ability of alkylating agent temozolomide (TMZ-induced autophagy to increase OAd replication and oncolysis in TNBC cells was evaluated. Human TNBC MDA-MB-231 and HCC1937 cells and mouse 4T1 cells were infected with an OAd expressing the red fluorescent protein mCherry on the virus capsid (OAdmCherry alone or in combination with TMZ. TNBC cells treated with OAdmCherry/TMZ displayed greater mCherry and adenovirus (Ad early region 1A (E1A expression and enhanced cancer-cell killing compared to OAdmCherry or TMZ alone. The combined therapy-mediated cell death was associated with virus replication and accumulation of the autophagy marker light chain 3 (LC3-II. Overall, this study provides experimental evidence of TMZ’s ability to increase oncolytic virotherapy in both human and murine TNBC cells.

  10. Triple negative breast cancer: new therapeutic approaches and BRCA status.

    Science.gov (United States)

    Guney Eskiler, Gamze; Cecener, Gulsah; Egeli, Unal; Tunca, Berrin

    2018-05-01

    Treatment of triple negative breast cancer (TNBC) is a clinically challenging problem due to intriguing clinical and pathologic features of TNBC and natural or induced resistance to existing therapies. However, a great understanding of features of TNBC particularly associated with BRCA mutations has led to the development of different therapeutic approaches. Besides, identification of TNBC subtypes contribute to investigation of the underlying molecular differences and development of new strategies for the treatment of TNBC patients. In this review, we discussed the definition and characteristic properties of TNBC. We summarized an up-to-date description of the reported clinical trials of novel targeted strategies especially PARP inhibitors (PARPi) due to novel and highly potent for the treatment of TNBC. Additionally, we reviewed published studies which investigated the prevalence and types of BRCA1/2 mutation in breast cancer patients to assess and draw attention of association of BRCA status with TNBC. Consequently, the definition subtype of TNBC has important predictive value for the development of new therapeutic agents in the treatment of TNBC. Additionally, the incidence and types of mutations in BRCA-related pathways may be affected by ethnic origin and contribute to the risk of developing TNBC. © 2018 APMIS. Published by John Wiley & Sons Ltd.

  11. 12 loops and triple wrapping in ABJM theory from integrability

    International Nuclear Information System (INIS)

    Anselmetti, Lorenzo; Bombardelli, Diego; Cavaglià, Andrea; Tateo, Roberto

    2015-01-01

    Adapting a method recently proposed by C. Marboe and D. Volin for N=4 super-Yang-Mills, we develop an algorithm for a systematic weak coupling expansion of the spectrum of anomalous dimensions in the sl(2)-like sector of planar N=6 super-Chern-Simons. The method relies on the Quantum Spectral Curve formulation of the problem and the expansion is written in terms of the interpolating function h(λ), with coefficients expressible as combinations of Euler-Zagier sums with alternating signs. We present explicit results up to 12 loops (six nontrivial orders) for various twist-1 and twist-2 operators, corresponding to triple and double wrapping terms, respectively, which are beyond the reach of the Asymptotic Bethe Ansatz as well as Lüscher’s corrections. The algorithm works for generic states in this sector and in principle can be used to compute arbitrary orders of the weak coupling expansion. For the simplest operator with L=1 and spin S=1, the Padé extrapolation of the 12-loop result nicely agrees with the available Thermodynamic Bethe Ansatz data in a relatively wide range of values of the coupling. A Mathematica notebook with a selection of results is attached.

  12. Numerical simulation of triple concentric-tube heat exchangers

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Valladares, O. [Centro de Investigacion en Energia (CIE), Universidad Nacional Autonoma de Mexico (UNAM), Privada Xochicalco S/N, Temixco, 62580, Morelos (Mexico)

    2004-10-01

    A detailed one-dimensional steady and transient numerical simulation of the thermal and fluid-dynamic behaviour of triple concentric-tube heat exchangers has been developed. The governing equations (continuity, momentum and energy) inside the inner tube and the annulus (inner and outer), together with the energy equations in the inner, intermediate and outermost tube wall and insulation, are solved iteratively in a segregated manner. The discretized governing equations in the zones with fluid flow are coupled using an implicit step by step method. This formulation requires the use of empirical information for the evaluation of convective heat transfer, shear stress and void fraction. An implicit central difference numerical scheme and a line-by-line solver was used in the inner and intermediate tube walls and the outermost tube wall with insulation. All the flow variables (enthalpies, temperatures, pressures, mass fractions, velocities, heat fluxes, etc.) together with the thermophysical properties are evaluated at each point of the grid in which the domain is discretized. Different numerical aspects and comparisons with results obtained from the technical literature are presented in order to verify and validate the model. (authors)

  13. Clinical Characteristics in Patients with Triple Negative Breast Cancer

    Directory of Open Access Journals (Sweden)

    Janet Yeh

    2017-01-01

    Full Text Available Purpose. The purpose of this study was to compare and contrast the clinical characteristics of the triple negative breast cancer (TNBC and non-TNBC patients, with a particular focus on genetic susceptibility and risk factors prior to diagnosis. Methods. Our institutional database was queried for all patients diagnosed with invasive breast cancer between January 2010 and May 2016. Results. Out of a total of 1964 patients, 190 (10% patients had TNBC. The median age for both TNBC and non-TNBC was 59 years. There was a significantly higher proportion of African American and Asian patients with TNBC (p=0.0003 compared to patients with non-TNBC. BRCA1 and BRCA2 were significantly associated with TNBC (p<0.0001, p=0.0007. A prior history of breast cancer was significantly associated with TNBC (p=0.0003. There was no relationship observed between TNBC and a history of chemoprevention or patients who had a history of AH or LCIS. Conclusions. We found that having Asian ancestry, a prior history of breast cancer, and a BRCA1 or BRCA2 mutation all appear to be positively associated with TNBC. In order to develop more effective treatments, better surveillance, and improved prevention strategies, it is necessary to improve our understanding of the population at risk for TNBC.

  14. MCNP analysis and optimization of a triple crystal phoswich detector

    CERN Document Server

    Childress, N L

    2002-01-01

    Researchers at the University of Missouri-Columbia have designed a triple crystal phoswich detector that allows for simultaneous detection of alpha, beta, and gamma radiation. A ZnS:Ag layer detects alpha particles, a CaF sub 2 :Eu scintillator preferentially interacts with beta particles, and a NaI:Tl cell is used for gamma detection. The detector output is digitally collected, processed, and analyzed by a personal computer using custom software. Monte Carlo N-Particle version 4C simulations of this detector found that the phoswich design has inherent minimum energy limits of 250 keV E sub m sub a sub x for beta particles and 50 keV for gamma-rays. For a 2.54 cm thick NaI:Tl crystal, intrinsic gamma efficiency for photons ranges from a maximum of 80% at 100 keV to 26% for 2 MeV photons. Mischaracterized gamma events in the CaF sub 2 :Eu crystal above 175 keV can be corrected by subtracting 26+-4% of the total number of counts in the NaI:Tl crystal from the CaF sub 2 :Eu response. Beta induced events in the N...

  15. Motifs in triadic random graphs based on Steiner triple systems

    Science.gov (United States)

    Winkler, Marco; Reichardt, Jörg

    2013-08-01

    Conventionally, pairwise relationships between nodes are considered to be the fundamental building blocks of complex networks. However, over the last decade, the overabundance of certain subnetwork patterns, i.e., the so-called motifs, has attracted much attention. It has been hypothesized that these motifs, instead of links, serve as the building blocks of network structures. Although the relation between a network's topology and the general properties of the system, such as its function, its robustness against perturbations, or its efficiency in spreading information, is the central theme of network science, there is still a lack of sound generative models needed for testing the functional role of subgraph motifs. Our work aims to overcome this limitation. We employ the framework of exponential random graph models (ERGMs) to define models based on triadic substructures. The fact that only a small portion of triads can actually be set independently poses a challenge for the formulation of such models. To overcome this obstacle, we use Steiner triple systems (STSs). These are partitions of sets of nodes into pair-disjoint triads, which thus can be specified independently. Combining the concepts of ERGMs and STSs, we suggest generative models capable of generating ensembles of networks with nontrivial triadic Z-score profiles. Further, we discover inevitable correlations between the abundance of triad patterns, which occur solely for statistical reasons and need to be taken into account when discussing the functional implications of motif statistics. Moreover, we calculate the degree distributions of our triadic random graphs analytically.

  16. Triple Modular Redundancy verification via heuristic netlist analysis

    Directory of Open Access Journals (Sweden)

    Giovanni Beltrame

    2015-08-01

    Full Text Available Triple Modular Redundancy (TMR is a common technique to protect memory elements for digital processing systems subject to radiation effects (such as in space, high-altitude, or near nuclear sources. This paper presents an approach to verify the correct implementation of TMR for the memory elements of a given netlist (i.e., a digital circuit specification using heuristic analysis. The purpose is detecting any issues that might incur during the use of automatic tools for TMR insertion, optimization, place and route, etc. Our analysis does not require a testbench and can perform full, exhaustive coverage within less than an hour even for large designs. This is achieved by applying a divide et impera approach, splitting the circuit into smaller submodules without loss of generality, instead of applying formal verification to the whole netlist at once. The methodology has been applied to a production netlist of the LEON2-FT processor that had reported errors during radiation testing, successfully showing a number of unprotected memory elements, namely 351 flip-flops.

  17. Optimization of the triple-pressure combined cycle power plant

    Directory of Open Access Journals (Sweden)

    Alus Muammer

    2012-01-01

    Full Text Available The aim of this work was to develop a new system for optimization of parameters for combined cycle power plants (CCGTs with triple-pressure heat recovery steam generator (HRSG. Thermodynamic and thermoeconomic optimizations were carried out. The objective of the thermodynamic optimization is to enhance the efficiency of the CCGTs and to maximize the power production in the steam cycle (steam turbine gross power. Improvement of the efficiency of the CCGT plants is achieved through optimization of the operating parameters: temperature difference between the gas and steam (pinch point P.P. and the steam pressure in the HRSG. The objective of the thermoeconomic optimization is to minimize the production costs per unit of the generated electricity. Defining the optimal P.P. was the first step in the optimization procedure. Then, through the developed optimization process, other optimal operating parameters (steam pressure and condenser pressure were identified. The developed system was demonstrated for the case of a 282 MW CCGT power plant with a typical design for commercial combined cycle power plants. The optimized combined cycle was compared with the regular CCGT plant.

  18. Integrating health impact assessment into the triple bottom line concept

    International Nuclear Information System (INIS)

    Mahoney, Mary; Potter, Jenny-Lynn

    2004-01-01

    This theoretical study explores the links between the Triple Bottom Line (TBL) concept and the principles of HIA and considers the potential role of HIA to provide a mechanism for integrating health concerns within a broader agenda of government and business. TBL is a framework linked to the broader sustainability agenda that underpins and reviews environmental, economic and social performance of organizations. In its simplest form, TBL acts as a tool for reporting to stakeholders/shareholders organizational performance and the nature of the impacts on the community. The links to HIA are clear as both seek to determine the impact (potential and actual) on the health and well-being of the population. The study found that TBL can operate at four levels within organizations ranging from reporting through to full integration with the organization's goals and practices. Health is narrowly defined and there are tensions about how to undertake the social accountability functions. The study shows the potential role for HIA within the broader policy and accountability agenda. As health is one of the main outcomes of an organization's activities it needs to be taken into account at all levels of activity

  19. Triple Halo Coil: Development and Comparison with Other TMS Coils

    Science.gov (United States)

    Rastogi, Priyam; Hadimani, Ravi; Jiles, David

    Transcranial Magnetic Stimulation (TMS) is a non-invasive stimulation technique that can be used for the treatment of various neurological disorders such as Parkinson's Disease, PTSD, TBI and anxiety by regulating synaptic activity. TMS is FDA approved for the treatment of major depressive disorder. There is a critical need to develop deep TMS coils that can stimulate deeper regions of the brain without excessively stimulating the cortex in order to provide an alternative to surgical methods. We have developed a novel multi-coil configuration called ``Triple Halo Coil'' (THC) that can stimulate deep brain regions. Investigation of induced electric and magnetic field in these regions have been achieved by computer modelling. Comparison of the results due to THC configuration have been conducted with other TMS coils such as ``Halo Coil'', circular coil and ``Figure of Eight'' coil. There was an improvement of more than 15 times in the strength of magnetic field, induced by THC configuration at 10 cm below the vertex of the head when compared with the ``Figure of Eight'' coil alone. Carver Charitable Trust.

  20. W mass and Triple Gauge Couplings at Tevatron

    Directory of Open Access Journals (Sweden)

    Pétroff Pierre

    2013-05-01

    Full Text Available The W mass is a crucial parameter in the Standard Model (SM of particle physics, providing constraints on the mass of the Higgs boson as well as on new physics models via quantum loop corrections. On the other hand, any deviation of the triple gauge boson couplings (TGC from their values predicted by the SM would be also an indication for new physics. We present recent measurements on W boson mass and searches for anomalous TGC (aTGC in Wγ, Zγ, WW, WZ and ZZ at Fermilab Tevatron both by CDF and DØ Collaborations. The CDF Collaboration has measured the W boson mass using data corresponding to 2.2 fb−1 of integrated luminosity. The measurement, performed using electron and muon decays of W boson, yields a mass of MW = 80387 ± 19 MeV. The DØ Collaboration has measured MW = 80367 ± 26 MeV with data corresponding to 4.3 fb−1 of integrated luminosity in the channel W → ev. The combination with an earlier DØ result, using independant data sample at 1 fb−1 of integrated luminosity, yields MW = 80375 ± 23 MeV. The limits on anomalous TGCs parameters are consistent with the SM expectations.