Endorectal repair of rectocele.

A modification of Sullivan\u27s procedure for endorectal repair of low rectocele was completed in 59 patients with local anesthesia. Associated anorectal pathology was corrected in all patients. The technique is described. At follow-up, the results were as follows: 37 excellent (62.7 per cent), 10 good (16.9 per cent), eight fair (13.6 per cent), and four poor (6.7 per cent)

Ileorectal anastomosis for ulcerative and Crohn\u27s colitis.

Except in the presence of severe perineal suppuration or sphincter damage by previous surgery for fistulas, the rectum was preserved in all patients considered candidates for surgery for inflammatory disease of the bowel. A primary anastomosis with a single-layer 5-0 monofilament stainless steel wire was carried out when a relatively healthy rectum with erythema and granularity presented. For patients with more severe disease of the rectum, a two-stage operation with intensive interval treatment of the rectum stump with topical corticosteroids was carried out. Of a total of eighty-six patients with involvement of the colon and rectum with either Crohn\u27s disease or chronic ulcerative colitis, fifty-six patients were treated by local abdominal colectomy and ileorectal anastomosis. Twenty-four had primary anastomosis and thiry-two had a two-stage operation. One anastomotic dehiscence developed. A mean follow-up of 8.4 years (6 months to 20 years) has been satisfactory. Only three anastomoses have been taken down for unsatisfactory results. With the proper selection of patients and with appropriate treatment of the diseased rectal segment, a large majority of patients with inflammatory disease of the bowel can have long-term salutory results after colectomy and ileorectal anastomosis

WDHA syndrome caused by pheochromocytoma: report of a case.

A case in which a pheochromocytoma secreted vasoactive intestinal peptide, causing WDHA syndrome, is reported. The patient, a 43-year-old woman, was seen because of intractable watery diarrhea, hypokalemia and weight loss. She was found to have a mass in the right adrenal area. Preoperatively, vasoactive intestinal peptide levels were elevated, and the diagnosis of WDHA syndrome was entertained. Exploratory laparotomy revealed a tumor of the right adrenal gland, measuring 15 x 15 cm, which was resected. Histologic examination revealed it to be a pheochromocytoma. Postoperatively, vasoactive intestinal peptide returned to normal. The patient had complete remission of symptoms, and has remained well since

Port-Hamiltonian Neural Networks with State-Dependent Ports

Hybrid machine learning based on Hamiltonian formulations has recently been successfully demonstrated for simple mechanical systems, both energy conserving and not energy conserving. We show that port-Hamiltonian neural network models can be used to learn external forces acting on a system. We argue that this property is particularly useful when the external forces are state dependent, in which case it is the port-Hamiltonian structure that facilitates the separation of internal and external forces. Numerical results are provided for a forced and damped mass-spring system and a tank system of higher complexity, and a symmetric fourth-order integration scheme is introduced for improved training on sparse and noisy data.Comment: 21 pages, 12 figures; v3: restructured the paper for more clarity, major changes to the text, updated plot

Swift follow-up of IceCube triggers, and implications for the Advanced-LIGO era

Between 2011 March and 2014 August Swift responded to 20 triggers from the IceCube neutrino observatory, observing the IceCube 50% confidence error circle in X-rays, typically within 5 hours of the trigger. No confirmed counterpart has been detected. We describe the Swift follow up strategy and data analysis and present the results of the campaign. We discuss the challenges of distinguishing the X-ray counterpart to a neutrino trigger from serendipitous uncatalogued X-ray sources in the error circle, and consider the implications of our results for future strategies for multi-messenger astronomy, with particular reference to the follow up of gravitational wave triggers from the advanced-era detectors.Comment: Accepted for publication in MNRAS. 18 pages, including 8 figures and 4 tables; two of which are landscape-oriente

Differential affinity of FLIP and procaspase 8 for FADD’s DED binding surfaces regulates DISC assembly

Death receptor activation triggers recruitment of FADD, which via its death effector domain (DED) engages the DEDs of procaspase 8 and its inhibitor FLIP to form death-inducing signalling complexes (DISCs). The DEDs of FADD, FLIP and procaspase 8 interact with one another using two binding surfaces defined by α1/α4 and α2/α5 helices, respectively. Here we report that FLIP has preferential affinity for the α1/α4 surface of FADD, whereas procaspase 8 has preferential affinity for FADD's α2/α5 surface. These relative affinities contribute to FLIP being recruited to the DISC at comparable levels to procaspase 8 despite lower cellular expression. Additional studies, including assessment of DISC stoichiometry and functional assays, suggest that following death receptor recruitment, the FADD DED preferentially engages FLIP using its α1/α4 surface and procaspase 8 using its α2/α5 surface; these tripartite intermediates then interact via the α1/α4 surface of FLIP DED1 and the α2/α5 surface of procaspase 8 DED2