Ancillary Elements Research Articles

The ancillary element predicting ST elevation myocardial infarction in the symptom complex of acute coronary syndrome

The ancillary element predicting ST elevation myocardial infarction in the symptom complex of acute coronary syndrome

V2157 UMBILICAL SINGLE PORT PIELOLITHECTOMY ON HORSESHOE KIDNEY

You have accessJournal of UrologySingle Port Surgery1 Apr 2012V2157 UMBILICAL SINGLE PORT PIELOLITHECTOMY ON HORSESHOE KIDNEY Pedro Manuel Cabrera, Felipe Caceres, Jose María Garcia Mediero, and Javier Angulo Pedro Manuel CabreraPedro Manuel Cabrera Madrid, Spain More articles by this author , Felipe CaceresFelipe Caceres Madrid, Spain More articles by this author , Jose María Garcia MedieroJose María Garcia Mediero Madrid, Spain More articles by this author , and Javier AnguloJavier Angulo Madrid, Spain More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2329AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic surgery through a single port is an evolution of laparoscopic surgery, possible after recent technological development of new access systems. It is an established minimally invasive technique, although its indications in the field of Urology are currently under development. METHODS We present a surgical demonstration of incision-less pyelolithectomy, performed through a single-port placed in the umbilicus, in a 47 years-old male patient (Body Mass Index 38.2) with solitary 4 cm diameter lithiasis in a horseshoe kidney. An umbilical 2.5 cm incision was used for the introduction of a prototype of the reusable Richard Wolf single-port system, without any ancillary elements. The size of the stone appeared too large to perform retrograde intrarenal surgery as first option. RESULTS After placement of left double-J stent proximal left ureter and renal pelvis, pyelolithectomy and pyelorraphy were performed with DuoRotate-Instruments © (Richard Wolf). Water-tightness was demonstrated with methylene blue intravesical instillation and no drain was placed. The procedure lasted for 280 min and bleeding was 30 cc. The patient was discharged 24 hours later without pain. Incision was not visible at one month follow-up. CONCLUSIONS Incision-less pyelolithectomy through a single-port umbilically placed is a feasible solution to treat pelvic lithiasis and can even be more easily performed than percutaneous nephrolithotomy in anatomically difficult cases. It can be considered the most beneficial option in aesthetical terms in experienced centers, especially in peculiar cases like horseshoe kidney. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e870-e871 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pedro Manuel Cabrera Madrid, Spain More articles by this author Felipe Caceres Madrid, Spain More articles by this author Jose María Garcia Mediero Madrid, Spain More articles by this author Javier Angulo Madrid, Spain More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...

Umbilical single-port pyelolithectomy on horseshoe kidney: A new indication

IntroductionLaparoscopic surgery through a single port is an evolution of laparoscopic surgery, possible after recent technological development of new access systems. It is an established minimally invasive technique, although its indications in the field of Urology are currently under development. Materials and methodsWe present the first case of incision-less pyelolithectomy, performed through a single-port placed in the umbilicus, performed in a 47-year-old male patient (38.2 BMI) with solitary 4-cm-diameter lithiasis in a horseshoe kidney. An umbilical 2.5-cm incision was used for the introduction of a prototype of the reusable Richard Wolf single-port system, without any ancillary elements. ResultsAfter placement of left double-J stent proximal left ureter and renal pelvis, pyelolithectomy and pyelorraphy were performed with DuoRotate-Instruments © (Richard Wolf). Water-tightness was demonstrated with methylene blue intravesical instillation and no drain was placed. The procedure lasted for 280min and bleeding was 30cm3. The patient was discharged 24h later without pain. ConclusionIncision-less pyelolithectomy is a feasible and resolutive option to treat pelvic lithiasis. It can be considered the most beneficial option in esthetical terms in experienced centers, especially in peculiar cases like horseshoe kidney.

Pielolitectomía por puerto único umbilical sobre riñón en herradura: una nueva indicación

Introduction Laparoscopic surgery through a single port is an evolution of laparoscopic surgery, possible after recent technological development of new access systems. It is an established minimally invasive technique, although its indications in the field of Urology are currently under development. Material and methods We present the first case of incision-less pyelolithectomy, performed through a single-port placed in the umbilicus, performed in a 47 years-old male patient (38.2 BMI) with solitary 4 cm diameter lithiasis in a horseshoe kidney. An umbilical 2.5 cm incision was used for the introduction of a prototype of the reusable Richard Wolf single-port system, without any ancillary elements. Results After placement of left double-J stent proximal left ureter and renal pelvis, pyelolithectomy and pyelorraphy were performed with DuoRotate-Instruments© (Richard Wolf). Water-tightness was demostrated with methylene blue intravesical instillation and no drain was placed. The procedure lasted for 280 min and bleeding was 30 cc. The patient was discharged 24 hours later without pain. Conclusion Incision-less pyelolithectomy is a feasible and resolutive option to treat pelvic lithiasis. It can be considered the most beneficial option in aesthetical terms in experienced centers, especially in peculiar cases like horseshoe kidney.

Evidence of solitary chemosensory cells in a large mammal: the diffuse chemosensory system in Bos taurus airways

The diffuse chemosensory system (DCS) of the respiratory apparatus is composed of solitary chemosensory cells (SCCs) that resemble taste cells but are not organized in end organs. The discovery of the DCS may open up new approaches to respiratory diseases. However, available data on mammalian SCCs have so far been collected from rodents, the airways of which display some differences from those of large mammals. Here we investigated the presence of the DCS and of SCCs in cows and bulls (Bos taurus), in which the airway cytology is similar to that in humans, focusing our attention on detection in the airways of molecules involved in the transduction cascade of taste [i.e. alpha-gustducin and phospholipase C of the beta2 subtype (PLCbeta2)]. The aim of the research was to extend our understanding of airway chemoreceptors and to compare the organization of the DCS in a large mammal with that in rodents. Using immunocytochemistry for alpha-gustducin, the taste buds of the tongue and arytenoid were visualized. In the trachea and bronchi, alpha-gustducin-immunoreactive SCCs were frequently found. Using immunocytochemistry for PLCbeta2, the staining pattern was generally similar to those seen for alpha-gustducin. Immunoblotting confirmed the expression of alpha-gustducin in the tongue and in all the airway regions tested. The study demonstrated the presence of SCCs in cows and bulls, suggesting that DCSs are present in many mammalian species. The description of areas with a high density of SCCs in bovine bronchi seems to indicate that the view of the DCS as made up of isolated cells totally devoid of ancillary elements is probably an oversimplification.

A phylogenetically conserved cis-regulatory module in the Msx2 promoter is sufficient for BMP-dependent transcription in murine and Drosophila embryos.

To understand the actions of morphogens, it is crucial to determine how they elicit different transcriptional responses in different cell types. Here, we identify a BMP-responsive enhancer of Msx2, an immediate early target of bone morphogenetic protein (BMP) signaling. We show that the BMP-responsive region of Msx2 consists of a core element, required generally for BMP-dependent expression, and ancillary elements that mediate signaling in diverse developmental settings. Analysis of the core element identified two classes of functional sites: GCCG sequences related to the consensus binding site of Mad/Smad-related BMP signal transducers; and a single TTAATT sequence, matching the consensus site for Antennapedia superclass homeodomain proteins. Chromatin immunoprecipitation and mutagenesis experiments indicate that the GCCG sites are direct targets of BMP restricted Smads. Intriguingly, however, these sites are not sufficient for BMP responsiveness in mouse embryos; the TTAATT sequence is also required. DNA sequence comparisons reveal this element is highly conserved in Msx2 promoters from mammalian orders but is not detectable in other vertebrates or non-vertebrates. Despite this lack of conservation outside mammals, the Msx2 BMP-responsive element serves as an accurate readout of Dpp signaling in a distantly related bilaterian - Drosophila. Strikingly, in Drosophila embryos, as in mice, both TTAATT and GCCG sequences are required for Dpp responsiveness, showing that a common cis-regulatory apparatus can mediate the transcriptional activation of BMP-regulated genes in widely divergent bilaterians.

History, Timelessness and the Monumental: the Oboos of the Mergen Environs, Inner Mongolia

Concerned with the ‘meaning’, variability and material transformation of the sacred oboo cairns of Inner Asia, this study focuses upon four of these stone settings within the environs of Mergen Monastery. Two have been rebuilt since their destruction during the Cultural Revolution, and one markedly registers its recent history. The layout of these complex monuments (involving diverse ancillary elements) reflects the processes of Buddhicization of the landscape. Comparison between their form and Buddhist texts outlining oboo construction allows appraisal of their prescription and actuality. These monuments raise issues relevant beyond their immediate cultural and geographical context, as they express an interplay between history and ‘timelessness’; the latter effectively amounting to a ‘reincarnation’ of material culture (i.e. denial of change). Finally, the deployment of oboos relates to broader concepts of landscape orientation; their relationship with Mongolian directional systems is explored.

European Union Water Policy—Tasks for Implementing “Water Framework Directive” in Pre-accession Countries

Water Framework Directive aiming to maintain and improve the aquatic environment in the EU was launched by the European Parliament in 2000. According to this directive, control of quantity is an ancillary element in securing good water quality and therefore measures on quantity, serving the objective of ensuring good quality should also be established. Accordingly, it is a comprehensive and coordinated package that will ensure all European waters to be protected according to a common standard. Therefore, it refers to all other Directives related to water resources management such as Urban Wastewater Treatment Directive Nitrates Directive, Drinking Water Directive, Integrated Pollution Prevention Control etc. Turkey, as a candidate state targeting full-membership, should comply the necessary preparations for the implementation of the “Water Framework Directive” as soon as possible. In this study, the necessary legislative, political, institutional, and technical attempts of the pre-accession countries have been discussed and effective recommendations have been offered for future activities in Turkey.

The replicator of the Epstein-Barr virus latent cycle origin of DNA replication, oriP, is composed of multiple functional elements.

Replication of the Epstein-Barr virus genome initiates at one of several sites in latently infected, dividing cells. One of these replication origins is close to the viral DNA maintenance element, and, together, this replication origin and the maintenance element are referred to as oriP. The replicator of oriP contains four binding sites for Epstein-Barr virus nuclear antigen 1 (EBNA-1), the sole viral protein required for the replication and maintenance of oriP plasmids. We showed previously that these EBNA-1 sites function in pairs and that mutational inactivation of one pair does not eliminate replicator function. In this study we characterized the contribution of each EBNA-1 site within the replicator and flanking sequences through the use of an internally controlled replication assay. We present evidence that shows that all four EBNA-1 sites are required for an oriP plasmid to be replicated in every cell cycle. Results from these experiments also show that the paired EBNA-1 binding sites are not functionally equivalent and that the low affinity of sites 2 and 3 compared to that of sites 1 and 4 is not essential for replicator function. Our results suggest that a host cell protein(s) binds sequences flanking the EBNA-1 sites and that interactions between EBNA-1 and this protein(s) are critical for replicator function. Finally, we present evidence that shows that the minimal replicator of oriP consists of EBNA-1 sites 3 and 4 and two copies of a 14-bp repeat that is present in inverse orientation flanking these EBNA-1 sites. EBNA-1 sites 1 and 2, together with an element(s) within nucleotides 9138 to 9516, are ancillary elements required for full replicator activity.

Nature of Jury Response to the Expert Witness

Abstract Communications to jurors entail not only primary content—the subject matter of the testimony—designated as the message, but also secondary content emanating from the witnesses as sources, from peripheral aspects of the message itself, and from the environment of the trial—designated as the paramessage. Interviews with jurors after a trial involving extensive expert testimony to introduce a new technology for identification evidence, popularly referred to as “voiceprinting,” found they responded mainly to the paramessage. The general implication is that when confronted with complex or confusing testimony, expert or otherwise, jurors will shift their focus to observable characteristics of the sources of the information, or to other ancillary elements of the situation, and will be guided in their response by information and inferences derived from such data.

Diurnal changes in compound eye fine structure in the blue crab Callinectes: 1. Differences between noon and midnight retinas on an LD 11: 13 cycle

To begin an in-depth comparative study of its photoreceptor membrane turnover compound eye fine structure in the crab Callinectes sapidus has been compared when light adapted at noon and dark adapted at midnight. Between these two states photoreceptive membrane area increases by factors of 3.71 distally, 1.77 proximally, and 2.18 overall. In most retinulas rhabdomeric microvilli become longer, thicker, and more numerous at midnight. Correlated changes in receptor cell cytoplasmic organelles are extensive and in some cases localized at different retinular levels. Multivesicular and lamellar bodies, numerous in light adaptation, are few at midnight; perirhabdomal vacuoles are reduced by day but cytoplasmic vacuoles increase; the well-developed smooth endoplasmic reticulum, cisternal at noon, becomes saccular at night. A minority of midnight retinulas appear in an intermediate state perhaps of incomplete dark adaptation. They have wavy microvilli instead of the usually straight ones, many multivesicular bodies, extensive cisternal endoplasmic reticulum, and reduced perirhabdomal vacuoles. Ancillary elements are implicated in the basic renewal and turnover process by many correlated changes in shape, contents, and relations of the crystalline cone, in distal pigment cells, as well as free macrophages in or near the retina. Clearly interaction between membrane cycling and adaptation is profound and complex.

Effect of thermal and thermo-mechanical processing on the properties of Al-Mg alloys

Results are presented of the influence of thermal and thermo-mechanical processing on the tensile strength and stress corrosion resistance of Al-Mg alloys characterized by different combinations of the ancillary elements Cr, Mn and Zr. As a result of the processes described, the final wrought products exhibit higher yield strengths for a given stress corrosion resistance than conventional materials. This is attributed to the favorable distribution of dislocations and precipitates that is induced by the treatment. The combination of ancil lary elements is an important factor for optimizing the metallurgical properties of the alloys; evidence is given for the role played by the dispersoids containing Cr, Mn and Zr on both the grain structure and the distribution of β(Mp2Al3) particles.