411 research outputs found

    Robotic telesurgery for achalasia

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    Complex Transitions Between C3 and C4 Photosynthesis During the Evolution of Paniceae: A Phylogenetic Case Study Emphasizing the Position of Steinchisma Hians (Poaceae), A C3-C4 Intermediate

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    A two-tiered, nested molecular phylogenetic study of panicoid grasses to explore character state transitions between the C3 and C4 adaptive syndromes is presented. A broad survey of 92 panicoid species was sampled for the grass-specific insert sequence in the chloroplast RNA polymerase locus (rpoC2), combining published and unpublished sequences. This portion of the study also included an intensive phylogenetic investigation of one clade of seven species that included Steinchisma hians, which is notable for exhibiting intermediacy between the C3 and C4 photosynthetic types. Both rpoC2 data and previously published sequences of the F subunit of an NADH-dependent dehydrogenase were analyzed together for this small group. A rigorous phylogenetic investigation of S. hians and 13 other species of Panicoideae included in the broad survey was then performed with sequences of both rpoC2 and the externally transcribed spacer region of the nuclear ribosomal repeat. These 14 species were selected to maximize representation among photosynthetic subtypes. Combined analysis resolved single origins of two photosynthetic subtypes. A reversion of C4 to C3 photosynthesis during the evolution of the lineage that includes S. hians is identified. These and other recent results indicate that repeated reversions from C4 to C3 have occurred. The C3 species Panicum laxum has a strongly supported sister group relationship to S. hians (C3-C4). The most parsimonious interpretation is that S. hians represents an incipient reversal from C3 to C4 photosynthesis, beginning with the capacity to compartmentalize photorespiratory metabolism in the bundle sheath tissue

    Phylogenetically Widespread Multiple Paternity in New World Natricine Snakes

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    We used microsatellite DNA markers to identify the extent to which multiple paternity within litters occurs among species of New World natricine snakes. We selected seven species to represent the three major clades of Natricinae and all three subclades of the gartersnake clade. Microsatellite DNA genotyping of dams and litters confirmed multiple paternity within litters of six species, including Thamnophis radix, T. sauritus, Storeria dekayi, S. occipitomaculata, Nerodia rhombifer, and Regina septemvittata. Multiple paternity was not evident in one litter of nine Thamnophis melanogaster. Together with published data documenting multiple paternity in T. bulteri, T. elegans, T. sirtalis, and N. sipedon, these results confirm the phylogenetically widespread occurrence of multiple paternity among New World natricines, emphasizing the need to consider phylogenetic (historical) explanations when analyzing snake mating systems

    Laparoscopic Distal Pancreatectomy with Splenic Conservation: An Operation without Increased Morbidity

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    Objectives. The advent of minimally invasive techniques was marked by a paradigm shift towards the use of laparoscopy for benign distal pancreatic masses. Herein we describe one center's experience with laparoscopic distal pancreatectomy. Methods. A retrospective chart review was performed for all distal pancreatectomies completed laparoscopically from 1999 to 2009. Outcomes from those cases completed with a concurrent splenectomy were compared to the spleen-preserving procedures. Results. Twenty-four patients underwent laparoscopic distal pancreatectomy. Seven had spleen-conserving operations. There was no difference in the mean estimated blood loss (316 versus 285 mL, P = .5) or operative time (179 versus 170 minutes, P = .9). The mean tumor size was not significantly different (3.1 versus 2.2 cm, P = .9). There was no difference in the average hospital stay (7.1 versus 7.0 days, P = .7). Complications in the spleen-preserving group included one iatrogenic colon injury, two pancreatic fistulas, and two cases of iatrogenic diabetes. In the splenectomy group, two developed respiratory failure, three acquired iatrogenic diabetes, and two suffered pancreatic fistulas (71% versus 41%, P = .4). Conclusions. The laparoscopic distal pancreatectomy is a safe operation with a low morbidity. Splenic conservation does not significantly increase the morbidity of the procedure

    Wetland Design Considerations for Urban Stormwater Management Basin Design

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    Proceedings of the 1989 Georgia Water Resources Conference, May 16-17, 1989, Athens, Georgia.Sponsored by U.S. Geological Survey, Georgia Department of Natural Resources, the University of Georgia, Georgia State University, and Georgia Institute of Technology.This book was published by the Institute of Natural Resources, The University of Georgia, Athens, Georgia 30602 with partial funding provided by the U.S. Department of the Interior, Geological Survey, through the Georgia Water Research Institute as authorized by the Water Resources Research Act of 1984 (P.L. 98242). The views and statements advanced in this publication are solely those of the authors and do not represent official views or policies of The University of Georgia or the U.S. Geological Survey or the conference sponsors

    Esophageal sphincter device for gastroesophageal reflux disease

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    BACKGROUND Patients with gastroesophageal reflux disease who have a partial response to proton-pump inhibitors often seek alternative therapy. We evaluated the safety and effectiveness of a new magnetic device to augment the lower esophageal sphincter. METHODS We prospectively assessed 100 patients with gastroesophageal reflux disease before and after sphincter augmentation. The study did not include a concurrent control group. The primary outcome measure was normalization of esophageal acid exposure or a 50% or greater reduction in exposure at 1 year. Secondary outcomes were 50% or greater improvement in quality of life related to gastroesophageal reflux disease and a 50% or greater reduction in the use of proton-pump inhibitors at 1 year. For each outcome, the prespecified definition of successful treatment was achievement of the outcome in at least 60% of the patients. The 3-year results of a 5-year study are reported. RESULTS The primary outcome was achieved in 64% of patients (95% confidence interval [CI], 54 to 73). For the secondary outcomes, a reduction of 50% or more in the use of proton-pump inhibitors occurred in 93% of patients, and there was improvement of 50% or more in quality-of-life scores in 92%, as compared with scores for patients assessed at baseline while they were not taking proton-pump inhibitors. The most frequent adverse event was dysphagia (in 68% of patients postoperatively, in 11% at 1 year, and in 4% at 3 years). Serious adverse events occurred in six patients, and in six patients the device was removed. CONCLUSIONS In this single-group evaluation of 100 patients before and after sphincter augmentation with a magnetic device, exposure to esophageal acid decreased, reflux symptoms improved, and use of proton-pump inhibitors decreased. Follow-up studies are needed to assess long-term safety. (Funded by Torax Medical; ClinicalTrials.gov number, NCT00776997.

    Incorporating New Technologies Into Toxicity Testing and Risk Assessment: Moving From 21st Century Vision to a Data-Driven Framework

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    Based on existing data and previous work, a series of studies is proposed as a basis toward a pragmatic early step in transforming toxicity testing. These studies were assembled into a data-driven framework that invokes successive tiers of testing with margin of exposure (MOE) as the primary metric. The first tier of the framework integrates data from high-throughput in vitro assays, in vitro-to-in vivo extrapolation (IVIVE) pharmacokinetic modeling, and exposure modeling. The in vitro assays are used to separate chemicals based on their relative selectivity in interacting with biological targets and identify the concentration at which these interactions occur. The IVIVE modeling converts in vitro concentrations into external dose for calculation of the point of departure (POD) and comparisons to human exposure estimates to yield a MOE. The second tier involves short-term in vivo studies, expanded pharmacokinetic evaluations, and refined human exposure estimates. The results from the second tier studies provide more accurate estimates of the POD and the MOE. The third tier contains the traditional animal studies currently used to assess chemical safety. In each tier, the POD for selective chemicals is based primarily on endpoints associated with a proposed mode of action, whereas the POD for nonselective chemicals is based on potential biological perturbation. Based on the MOE, a significant percentage of chemicals evaluated in the first 2 tiers could be eliminated from further testing. The framework provides a risk-based and animal-sparing approach to evaluate chemical safety, drawing broadly from previous experience but incorporating technological advances to increase efficiency

    Elevated Incidence of Dental Caries in a Mouse Model of Cystic Fibrosis

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    Saliva bicarbonate constitutes the main buffering system which neutralizes the pH fall generated by the plaque bacteria during sugar metabolism. We found that the saliva pH is severely decreased in a mouse model of cystic fibrosis disease (CF). Given the close relationship between pH and caries development, we hypothesized that caries incidence might be elevated in the mouse CF model.). are enhanced at low pH values, we speculate that the decrease in the bicarbonate content and pH buffering of the saliva is at least partially responsible for the increased severity of lesions observed in the CF mouse
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