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Natural orifice translumenal endoscopic surgery: Progress in humans since white paper

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World Journal of Gastroenterology 2011年第13期17卷 1655-1665页

作者： Byron F santos eric s Hungness Department of surgery Feinberg School of Medicine Northwestern University Chicago IL 60611 United States

since the first description of the concept of natural orifice translumenal endoscopic surgery (NOTEs), a substantial number of clinical NOTEs reports have appeared in the literature. This editorial reviews the available human data addressing research questions originally proposed by the white paper, including determining the optimal method of access for NOTEs, developing safe methods of lumenal closure, suturing and anastomotic devices, advanced multitasking platforms, addressing the risk of infection, managing complications, addressing challenges with visualization, and training for NOTEs procedures. An analysis of the literature reveals that so far transvaginal access and closure appear to be the most feasible techniques for NOTEs, with a limited, but growing transgastric, transrectal, and transesophageal NOTEs experience in humans. The theoretically increased risk of infection as a result of NOTEs procedures has not been substantiated in transvaginal and transgastric procedures so far. Development of suturing and anastomotic devices and advanced platforms for NOTEs has progressed slowly, with limited clinical data on their use so far. Data onthe optimal management and incidence of intraoperative complications remain sparse, although possible factors contributing to complications are discussed. Finally, this editorial discusses the likely direction of future NOTEs development and its possible role in clinical practice.

关键词： Natural orifice translumenal endoscopic surgery Outcomes Complications Endoscopic surgery

Management of non-variceal upper gastrointestinal tract hemorrhage:Controversies and areas of uncertainty

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World Journal of Gastroenterology 2012年第11期18卷 1159-1165页

作者： eric P Trawick Patrick s Yachimski Division of Gastroenterology Hepatology and NutritionVanderbilt University Medical Center

Upper gastrointestinal tract hemorrhage （UGIH） remains a common presentation requiring urgent evaluation and treatment. Accurate assessment, appropriate intervention and apt clinical skills are needed for proper management from time of presentation to discharge. The advent of pharmacologic acid suppression, endoscopic hemostatic techniques, and recognition of Helicobacter pylori as an etiologic agent in peptic ulcer disease （PUD） has revolutionized the treatment of UGIH. Despite this, acute UGIH still carries considerable rates of morbidity and mortality. This review aims to discuss current areas of uncertainty and controversy in the management of UGIH. Neoadjuvant proton pump inhibitor （PPI） therapy has become standard empiric treatment for UGIH given that PUD is the leading cause of non variceal UGIH, and PPIs are extremely effective at promoting ulcer healing. Howeve, neoadjuvant PPI administration has not been shown to affect hard clinical outcomes such as rebleeding or mortality. The optimal timing of upper endoscopy in UGIH is often debated. Upon completion of volume resuscitation and hemodynamic stabilization, upper endoscopy should be performed within 24 h in all patientswith evidence of UGIH for both diagnostic and therapeutic purposes. With rising healthcare cost paramount in today＇s medical landscape, the ability to appropriately triage UGIH patients is of increasing value. Upper en- doscopy in conjunction with the clinical scenario allows for accurate decision making concerning early discharge home in low risk lesions or admission for further moni toring and treatment in higher risk lesions. Concomitant pharmacotherapy with non steroidal antiinflammatory drugs （NsAIDs） and antiplatelet agents, such as clopidogrel, has a major impact on the etiology, severib/, and potential treatment of UGIH. Long term PPI use in patients taking chronic NsAIDs or clopidogrel is discussed thoroughly in this review.

关键词： Hemorrhage Proton pump inhibitors He/i-cobacter py/ori Prokinetic agents Hemostasis Thieno-pyridines

Immunotherapeutic approaches in biliary tract carcinoma:Current status and emerging strategies

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World Journal of Gastrointestinal Oncology 2015年第11期7卷 338-346页

作者： eric I Marks Nelson s Yee Department of Medicine Penn State Milton S.Hershey Medical Center Division of Hematology-Oncology Program of Experimental TherapeuticsDepartment of MedicinePenn State Hershey Medical CenterPenn State Hershey Cancer Institute

For biliary tract carcinoma(BTC),complete surgical resection of tumor is only feasible in a minority of patients,and the treatment options for patients with unresectable or metastatic disease are *** in cancer immunology have led to identification of tumor-infiltrating immune cells as indicators of prognosis and response to treatment in *** has also facilitated development of immunotherapy that focuses on enhancing the immune system against biliary *** includes peptide- and dendritic cell-based vaccines that stimulate in-vivo immune responses against tumorspecific *** immunotherapy,which entails the ex-vivo expansion of tumor-infiltrating immune cells for subsequent reintroduction,and cytokinebased therapies have been developed in *** studies indicate that this type of therapy is generally well *** therapy with dendritic cell-based vaccines and adoptive immunotherapy has shown particularly good *** strategies through discovery of novel antigen targets and by reversal of tumor-associated immunosuppression are expected to improve the efficacy of immunotherapy in *** efforts by integration of targeted immunotherapeutics with molecular profiling of biliary tumor will hopefully make a positive impact on advancing towards the goal of developing precision treatment of patients with this highly lethal disease.

关键词： Adoptive immunotherapy Cancer vaccines Biliary tra

Molecular genetics and targeted therapeutics in biliary tractcarcinoma

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World Journal of Gastroenterology 2016年第4期22卷 1335-1347页

作者： eric I Marks Nelson s Yee Department of Medicine Penn State Milton S.Hershey Medical CenterHersheyPA 17033United States Division of Hematology-Oncology Department of MedicinePenn State Hershey Medical CenterHersheyPA 17033United States Program of Experimental Therapeutics Penn State Hershey Cancer InstituteHersheyPA 17033United States

The primary malignancies of the biliary tract, cholangio-carcinoma and gallbladder cancer, often present at an advanced stage and are marginally sensitive to radiation and chemotherapy. Accumulating evidence indicates that molecularly targeted agents may provide new hope for improving treatment response in biliary tract carcinoma(BTC). In this article, we provide a critical review of the pathogenesis and genetic abnormalities of biliary tract neoplasms, in addition to discussing the current and emerging targeted therapeutics in BTC. Genetic studies of biliary tumors have identified the growth factors and receptors as well as their downstream signaling pathways that control the growth and survival of biliary epithelia. Target-specific monoclonal antibodies and small molecules inhibitors directed against the signaling pathways that drive BTC growth and invasion have been developed. Numerous clinical trials designed to test these agents as either monotherapy or in combination with conventional chemotherapy have been completed or are currently underway. Research focusing on understanding the molecular basis of biliary tumorigenesis will continue to identify for targeted therapy the key mutations that drive growth and invasion of biliary neoplasms. Additional strategies that have emerged for treating this malignant disease include targeting the epigenetic alterations of BTC and immunotherapy. By integrating targeted therapy with molecular profiles of biliary tumor, we hope to provide precision treatment for patients with malignant diseases of the biliary tract.

关键词： Biliary tract carcinoma Cholangiocarcinoma Gallbladder carcinoma Molecular genetics Personalizedtreatment Precision therapy Targeted therapy

Natural Hazard-Induced Disasters and Production Efficiency:Moving Closer to or Further from the Frontier?

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International Journal of Disaster Risk science 2019年第2期10卷 166-178页

作者： Preeya s.Mohan Nekeisha spencer eric strobl sir Arthur Lewis Institute of social and Economic studies(sALIsEs) University of the West IndiesSt AugustineTrinidad and Tobago University of the West Indies MonaKingstonJamaica University of Bern 3012BernSwitzerland

Production efficiency is a key determinant of economic growth and demonstrates how a country uses its resources by relating the quantity of its inputs to its outputs. When a natural hazard-induced disaster strikes, it has a devastating impact on capital and labor, but at the same time provides an opportunity to upgrade capital and increase labor demand and training opportunities, thereby potentially boosting production efficiency. We studied the impact of natural hazard-induced disasters on countries’ production efficiency, using the case study of hurricanes in the Caribbean. To this end we built a country-specific,time-varying data set of hurricane damage and national output and input indicators for 17 Caribbean countries for the period 1940–2014. Our results, using a stochastic frontier approach, show that there is a short-lived production efficiency boost, and that this can be large for very damaging storms.

关键词： Caribbean Hurricanes Production efficiency

The impact of hypoxic-ischemic brain injury on stem cell mobilization,migration,adhesion,and proliferation

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Neural Regeneration Research 2018年第7期13卷 1125-1135页

作者： stephanie M.Parry eric s.Peeples Department of Pediatrics University of Nebraska Medical Center

Neonatal hypoxic-ischemic encephalopathy continues to be a significant cause of death or neurodevelopmental delays despite standard use of therapeutic *** use of stem cell transplantation has recently emerged as a promising supplemental therapy to further improve the outcomes of infants with hypoxic-ischemic *** the injury,the brain releases several chemical mediators,many of which communicate directly with stem cells to encourage mobilization,migration,cell adhesion and *** manuscript reviews the biomarkers that are released from the injured brain and their interactions with stem cells,providing insight regarding how their upregulation could improve stem cell therapy by maximizing cell delivery to the injured tissue.

关键词： brain-derived neurotrophic hypoxia inducible erythropoietin factor matrix metalloproteinase neonatal stromal cell-derived vascular endothelial growth

Retrieving Phenomenology： Introduction to the special Theme

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Frontiers of Philosophy in China 2016年第3期11卷 329-337页

作者： eric s. Nelson Hong Kong University of science and Technology

Phenomenology ordinarily signifies the investigation （logos） of that which appears （phainomenon）. It is frequently understood, outside of phenomenology as a philosophical movement, to be experiential description from the first person perspective. Critics of phenomenology, including contemporary critics as diverse as Daniel Dennett and John searle, as well as speculative realism and object oriented ontology, construe it as being intrinsically subjective, idealistic, and trapped in the first-person point of view （Dennett 2003, 19-30; searle 2008, 107-36; sparrow 2014; Zahavi 289-309）.

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High levels of arbuscular mycorrhizal fungus colonization on Medicago truncatula reduces plant suitability as a host for pea aphids (Acyrthosiphon pisum)

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Insect science 2020年第1期27卷 99-112页

作者： Elisa Garzo eric Rizzo Alberto Fereres s.Karen Gomez nstituto de Ciencias Agrarias-Consejo superior de Investigaciones Cientificas(ICA-CsIC) MadridSpain school of Biological sciences University of Northern ColoradoGreeleyColoradoUSA

This study sheds light on a poorly understood area in insect-plant-microbe interactions,focusing on aphid probing and feeding behavior on plants with varying levels of arbuscular mycorrhizal(AM)fungus root *** investigates a commonly occurring interaction of three species:pea aphid Acyrthosiphon pisum,barrel medic Medicago truncatula,and the AM fungus Rhizophagus irregularis,examining whether aphid-feeding behavior changes when insects feed on plants at different levels of AM fungus colonization(42% and 84% root length colonized).Aphid probing and feeding behavior was monitored throughout 8 h of recording using the electrical penetration graph(EPG)technique,also,foliar nutrient content and plant growth were ***,aphids took longer to reach their 1st sustained phloem ingestion on the 84% AM plants than on the 42% AM plants or on *** aphids showed phloem ingestion on the 84% AM plants relative to the 42% AM *** of the 84% AM plants had higher percent carbon(43.7%)relative to controls(40.5%),and the 84% AM plants had reduced percent nitrogen(5.3%)relative to the 42% AM plants(6%).In conclusion,EPG and foliar nutrient data support the hypothesis that modifications in plant anatomy(e.g.,thicker leaves),and poor food quality(reduced nitrogen)in the 84% AM plants contribute to reduced aphid success in locating phloem and ultimately to differences in phloem sap *** work suggests that *** plants benefit from AM symbiosis not only because of increased nutrient uptake but also because of reduced susceptibility to aphids.

关键词： Aphididae arbuscular mycorrhizal fungus electrical penetration graph(EPG) Fabaceae Glomeraceae insect-plant-microbe interactions symbiosis

Review of single incision laparoscopic surgery in colorectal surgery

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World Journal of Gastroenterology 2015年第38期21卷 10824-10829页

作者： Nisreen Madhoun Deborah s Keller eric M Haas Colorectal surgical Associates Division of Minimally Invasive Colorectal surgery Department of SurgeryUniversity of Texas Medical School at Houston Houston Methodist Hospital

As surgical techniques continue to move towards less invasive techniques,single incision laparoscopic surgery(sILs),a hybrid between traditional multiport laparoscopy and natural orifice transluminal endoscopic surgery,was introduced to further the enhanced outcomes of multiport laparoscopy. The safety and feasibility of sILs for both benign and malignant colorectal disease has been proven. sILs provides the potential for improved cosmesis,postoperative pain,recovery time,and quality of life at the drawback of higher technical skill required. In this article,we review the history,describe the available technology and techniques,and evaluate the benefits and limitations of sILs for colorectal surgery in the published literature.

关键词： Laparoscopic colectomy Minimally invasive colorect