DEMOLISH TERMINAL TIPE A TERBOYO

Seiring berkembangnya zaman, kota Semarang telah mengalami kemajuannya masing masing terlebih dibidang ekonomi. Kemajuan terhadap segala aspek di tiap kota tak luput dari berkembangnya mobilitas dan jumlah kendaraan yang membuat kota tersebut menjadi sibuk. Namun kenaikan mobilitas yang begitu tinggi akan menimbulkan kemacetan dan tentu dampak ini akan sangat merugikan bagi pemerintah karena juga akan berdampak pada arus ekonomi mereka. Padahal jika dilihat kembali tentu banyak pekerja di Semarang yang berasal dari luar kota Semarang. Belum lagi banyaknya mahasiswa di kota Semarang ini yang berasal dari luar kota. Peningkatan mobilitas perlu dilakukan yang tentunya akan dapat mengurangi angka kemacetan yang ada di kota semarang ini. Perlu dilakukan berbagai macam tindakan untuk mengatasi permasalahan tersebut, salah satunya adalah dengan mengembangkan transportasi umum yang ada ditiap kota semarang seperti terminal untuk memberikan kenyamanan terhadap pengguna sehingga dapat mengurangi jumlah penggunaaan kendaraan pribadi dan dapat meminimalisir kemacetan yang ada. Terminal merupakan salah satu fasilitas umum penting yang mendukung kelancaran mobilitas masyarakat dijalan raya. Perancangan terminal bus tipe A dilakukan untuk mengatasi masalah dan kebutuhan transportasi yang ada di kota semarang. Namun, sangat disayangkan apabila salah satu terminal yang ada di Kota Semarang yaitu Terminal Terboyo tidak berfungsi dengan baik, sehingga diperlukan adanya demolish terhadap terminal ini agar mampu memaksimalkan fungsi terminal sebagai sarana umum. Diperlukan adanya demolish karena bangunan yang saat ini dinilai sudah tidak mendukung desain baru pada terminal sehingga diperlukan adanya pemerataan secara total pada bangunan terminal. Dibarengi dengan pemanfaatan teknologi yang mendukung sistem operasional terminal tidak seperti terminal terboyo ini sebelumnya diharapkan mampu mengoptimalkan Terminal Terboyo ini. Terminal bus tipe A ini nantinya akan digunakan sebagai tempat pengelola tranportasi umum jalan raya seperti Bus Antar Kota Antar Provinsi (AKAP), Bus Antar Kota Dalam Provinsi (AKDP), Bus Angkutan Kotan (AK), dan angkutan umum lainnya

MK2 and ETV1 Are Prognostic Factors in Esophageal Adenocarcinomas

Background. Esophageal cancer is ranked in the top ten of diagnosed tumors worldwide. Even though improvements in survival could be noticed over the last years, prognosis remains poor. ETS translocation variant 1 (ETV1) is a member of a family of transcription factors and is phosphorylated by mitogen-activated protein kinase (MAPK)-activated protein kinase 2 (MK2). Aim of this study was to evaluate the prognostic role of MK2 and ETV1 in esophageal cancer. Methods. Consecutive patients that underwent surgical resection at the department of surgery at the Medical University of Vienna between 1991 and 2012 were included into this study. After microscopic analysis, tissue micro arrays (TMAs) were created and immunohistochemistry was performed with antibodies against MK2 and ETV1. Results. 323 patients were included in this study. Clinical data was achieved from a prospective patient data base. Nuclear overexpression of MK2 was observed in 143 (44.3%) cases for nuclear staining and in 142 (44.0%) cases a cytoplasmic overexpression of MK2 was observed. Nuclear and cytoplasmic ETV1 overexpression was detected in 20 cases (6.2%) and 30 cases (9.3%), respectively. In univariate survival analysis, cMK2 and nETV1 were found to be significantly associated with patients' overall survival. Whereas overexpression of cMK2 was associated with shorter, nETV1 was associated with longer overall survival. In multivariate survival analysis, both cMK2 and nETV1 were found to be independent prognostic factors for the subgroup of EAC as well. Discussion. Expression of MK2 and ETV1 are prognostic factors in patients, with esophageal adenocarcinoma

Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients

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Allograft rejection is associated with development of functional IgE specific for donor MHC antigens.

BACKGROUND: Donor-specific antibodies of the IgG isotype are measured routinely for diagnostic purposes in renal transplant recipients and are associated with antibody-mediated rejection and long-term graft loss. OBJECTIVE: This study aimed to investigate whether MHC-specific antibodies of the IgE isotype are induced during allograft rejection. METHODS: Anti-MHC/HLA IgE levels were measured in sera of mice grafted with skin or heart transplants from various donor strains and in sera of kidney transplant patients with high levels of HLA IgG. Mediator release was triggered in vitro by stimulating basophils that were coated with murine or human IgE-positive serum, respectively, with specific recombinant MHC/HLA antigens. Kidney tissue samples obtained from organ donors were analyzed by using flow cytometry for cells expressing the high-affinity receptor for IgE (FcεRI). RESULTS: Donor MHC class I- and MHC class II-specific IgE was found on acute rejection of skin and heart grafts in several murine strain combinations, as well as during chronic antibody-mediated heart graft rejection. Anti-HLA IgE, including donor HLA class I and II specificities, was identified in a group of sensitized transplant recipients. Murine and human anti-MHC/HLA IgE triggered mediator release in coated basophils on stimulation with specific MHC/HLA antigens. HLA-specific IgE was not linked to atopy, and allergen-specific IgE present in allergic patients did not cross-react with HLA antigens. FcεRI+ cells were found in the human renal cortex and medulla and provide targets for HLA-specific IgE. CONCLUSION: These results demonstrate that MHC/HLA-specific IgE develops during an alloresponse and is functional in mediating effector mechanisms

Minimal-invasive approach for penetrating Crohns disease is not associated with increased complications

Background Laparoscopic surgery for penetrating Crohns disease (CD) still remains highly conflicting due to a lack of sufficient data. Therefore, the following large study was designed to compare postoperative outcomes after minimal-invasive resections for penetrating and non-penetrating CD. Methods Consecutive patients, who underwent laparoscopic intestinal resection for symptomatic CD at a tertiary academic referral center, were included. Patients were divided according to perioperative findings in penetrating and non-penetrating type of disease. All clinical data were obtained from an institutional database and analyzed retrospectively. Results Of 234 patients enrolled, 101 patients [females: n = 54 (53.5 %)] were operated on for non-penetrating CD and 133 patients [females: n = 50 (37.6 %)] for penetrating CD. Fistulas (p < 0.001), inflammatory mass (p < 0.001) and abscess formation (p < 0.001) were observed more frequently in the perforating group. Ileocolic resections were performed predominantly in both groups [perforating CD: n = 110 (82.7 %), non-perforating CD: n = 82 (81.2 %)], with more complex resections (>1 intestinal resection) found in perforating CD (p < 0.001). Conversion rates did not differ significantly. Notably, 30-day postoperative morbidity was comparable for both groups [perforating CD: n = 20 (15 %), non-perforating CD: n = 19 (18.8 %), p = 0.44]. Postoperative complication rates graded according to the ClavienDindo classification showed no difference too (p = 0.49). Conclusion Laparoscopic surgery can be conducted safely in selected patients with penetrating CD without increasing the risk of postoperative complications. This finding needs to be implemented in future guidelines.(VLID)348927