163 research outputs found

    Prevention of post-ERCP pancreatitis: the search continues

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    Plea Bargains: Efficient or Unjust?

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    The vast majority of state and federal cases end in plea bargains. The practice has eased backlogs and may benefit some defendants — but the trade-offs, some say, are too steep. Is there a better way

    Chemistry of a Protoplanetary Disk with Grain Settling and Ly_ Radiation

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    We present results from a model of the chemical evolution of protoplanetary disks. In our models, we directly calculate the changing propagation and penetration of a high energy radiation field with Ly_ radiation included. We also explore the effect on our models of including dust grain settling. We find that, in agreement with earlier studies, the evolution of dust grains plays a large role in determining how deep the UV radiation penetrates into the disk. Significant grain settling at the midplane leads to much smaller freeze-out regions and a correspondingly larger molecular layer, which leads to an increase in column density for molecular species such as CO, CN, and SO. The inclusion of Ly_ radiation impacts the disk chemistry through specific species that have large photodissociation cross sections at 1216 Å. These include HCN, NH 3 , and CH 4 , for which the column densities are decreased by an order of magnitude or more due to the presence of Ly_ radiation in the UV spectrum. A few species, such as CO 2 and SO, are enhanced by the presence of Ly_ radiation, but rarely by more than a factor of a few.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90767/1/0004-637X_726_1_29.pd

    Annular pancreas: endoscopic and pancreatographic findings from a tertiary referral ERCP center

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    Background and Aims Annular pancreas is a congenital anomaly whereby pancreatic tissue encircles the duodenum. Current knowledge of endoscopic findings of annular pancreas is limited to small case series. The aim of this study was to describe the endoscopic and pancreatographic findings of patients with annular pancreas at a large tertiary care ERCP center. Methods This is a retrospective observational study. Our Institutional Review Board–approved, prospectively collected ERCP database was queried for cases of annular pancreas. The electronic medical records were searched for patient and procedure-related data. Results From January 1, 1994, to December 31, 2016, 46 patients with annular pancreas underwent ERCP at our institution. Index ERCP was technically successful in 42 patients (91.3%), and technical success was achieved in all 46 patients (100%) after 2 attempts, when required. A duodenal narrowing or ring was found in most patients (n = 39, 84.8%), yet only 2 (4.3%) had retained gastric contents. Pancreas divisum was found in 21 patients (45.7%), 18 of which were complete divisum. Pancreatobiliary neoplasia was the indication for ERCP in 7 patients (15.2%). Pancreatographic findings consistent with chronic pancreatitis were noted in 15 patients (32.6%) at the index ERCP. Conclusion This is the largest series describing the endoscopic and pancreatographic findings of patients with annular pancreas. We found that 45.7% of patients had concurrent pancreas divisum. Endoscopic therapy was successful in most patients at our institution after 1 ERCP, and in all patients after a second ERCP. Nearly one-third of patients had findings consistent with chronic pancreatitis at the time of index ERCP. It is unclear whether this may be a feature of the natural history of annular pancreas

    Endoscopic retrieval of a proximally migrated biliary stent: digital cholangioscope to the rescue

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    Endoscopic techniques for the retrieval of proximally migrated biliary stents include the following: fluoroscopy-guided grasping of the stent with a rat-tooth forceps, balloon placement parallel to the stent with traction retrieval, cannulation of the stent lumen with a wire (standard technique, or use of the curved plastic tip of a modified Soehendra stent retriever [Cook Medical, Bloomington, Ind]) followed by use of standard or modified Soehendra stent retriever, wire-guided retrieval basket, and snare. The technique used depends on the extent of proximal stent migration, the presence of ductal dilatation or biliary stricture, and the endoscopist’s experience. This report describes the retrieval of a proximally migrated biliary stent within an aberrant right hepatic duct (RHD) using a digital cholangioscope (SpyGlass DS system; Boston Scientific, Natick, Mass

    Far-Ultraviolet H_2 Emission from Circumstellar Disks

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    We analyze the far-ultraviolet (FUV) spectra of 33 classical T Tauri stars (CTTS), including 20 new spectra obtained with the Advanced Camera for Surveys Solar Blind Channel (ACS/SBC) on the Hubble Space Telescope. Of the sources, 28 are in the ~1 Myr old Taurus-Auriga complex or Orion Molecular Cloud, 4 in the 8-10 Myr old Orion OB1a complex, and 1, TW Hya, in the 10 Myr old TW Hydrae Association. We also obtained FUV ACS/SBC spectra of 10 non-accreting sources surrounded by debris disks with ages between 10 and 125 Myr. We use a feature in the FUV spectra due mostly to electron impact excitation of H_2 to study the evolution of the gas in the inner disk. We find that the H_2 feature is absent in non-accreting sources, but is detected in the spectra of CTTS and correlates with accretion luminosity. Since all young stars have active chromospheres which produce strong X-ray and UV emission capable of exciting H_2 in the disk, the fact that the non-accreting sources show no H_2 emission implies that the H_2 gas in the inner disk has dissipated in the non-accreting sources, although dust (and possibly gas) remains at larger radii. Using the flux at 1600 Å, we estimate that the column density of H_2 left in the inner regions of the debris disks in our sample is less than ~3 × 10^(–6) g cm^(-2), 9 orders of magnitude below the surface density of the minimum mass solar nebula at 1 AU

    Disk Imaging Survey of Chemistry with SMA (DISCS): I. Taurus Protoplanetary Disk Data

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    Chemistry plays an important role in the structure and evolution of protoplanetary disks, with implications for the composition of comets and planets. This is the first of a series of papers based on data from DISCS, a Submillimeter Array survey of the chemical composition of protoplanetary disks. The six Taurus sources in the program (DM Tau, AA Tau, LkCa 15, GM Aur, CQ Tau and MWC 480) range in stellar spectral type from M1 to A4 and offer an opportunity to test the effects of stellar luminosity on the disk chemistry. The disks were observed in 10 different lines at ~3" resolution and an rms of ~100 mJy beam-1 at ~0.5 km s-1. The four brightest lines are CO 2-1, HCO+ 3-2, CN 2_3-1_2 and HCN 3-2 and these are detected toward all sources (except for HCN toward CQ Tau). The weaker lines of CN 2_2-1_1, DCO+ 3-2, N2H+ 3-2, H2CO 3_03-2_02 and 4_14-3_13 are detected toward two to three disks each, and DCN 3-2 only toward LkCa 15. CH3OH 4_21-3_12 and c-C3H2 are not detected. There is no obvious difference between the T Tauri and Herbig Ae sources with regard to CN and HCN intensities. In contrast, DCO+, DCN, N2H+ and H2CO are detected only toward the T Tauri stars, suggesting that the disks around Herbig Ae stars lack cold regions for long enough timescales to allow for efficient deuterium chemistry, CO freeze-out, and grain chemistry.Comment: 29 pages, 4 figures, accepted for publication in Ap
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