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Function of longitudinal vs circular muscle fibers in esophageal peristalsis, deduced with mathematical modeling

World journal of Gastroenterology 2007年第9期13卷 1335-1346页

作者： james G Brasseur mark A Nicosia Anupam Pal Larry s Miller Department of Mechanical Engineering Pennsylvania State UniversityUniversity Park PA 16802United States Department of Mechanical Engineering Widener University ChesterPA 19013 United States Department of Biological sciences & Bio-engineering Indian Institute of Technology Kanpur UP 208016 India Department of Gastroenterology Temple University Medical CenterPhiladelphiaPA 19140United States

We summarize from previous works the functions of circular vs. longitudinal muscle in esophageal peristaltic bolus transport using a mix of experimental data, the conservation laws of mechanics and mathematical modeling. Whereas circular muscle tone generates radial closure pressure to create a local peristaltic closure wave, longitudinal muscle tone has two functions, one physiological with mechanical implications, and one purely mechanical. Each of these functions independently reduces the tension of individual circular muscle fibers to maintain closure as a consequence of shortening of longitudinal muscle locally coordinated with increasing circular muscle tone. The physiological function is deduced by combining basic laws of mechanics with concurrent measurements of intraluminal pressure from manometry, and changes in cross sectional muscle area from endoluminal ultrasound from which local longitudinal shortening (LLs) can be accurately obtained. The purely mechanical function of LLs was discovered from mathematical modeling of peristaltic esophageal transport with the axial wall motion generated by LLs. Physiologically, LLs concentrates circular muscle fibers where closure pressure is highest. However, the mechanical function of LLs is to reduce the level of pressure required to maintain closure. The combined physiological and mechanical consequences of LLs are to reduce circular muscle fiber tension and power by as much as 1/10 what would be requiredfor peristalsis without the longitudinal muscle layer, a tremendous benefit that may explain the existence of longitudinal muscle fiber in the gut. We also review what is understood of the role of longitudinal muscle in esophageal emptying, reflux and pathology.

关键词： Esophagus Longitudinal muscle Circular muscle Longitudinal shortening Peristalsis

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Miniature gastrointestinal endoscopy: Now and the future

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World journal of Gastroenterology 2019年第30期25卷 4051-4060页

作者： john j McGoran mark E McAlindon Prasad G Iyer Eric j seibel Rehan Haidry Laurence B Lovat sarmed s sami Digestive Diseases Centre Leicester Royal InfirmaryLeicester LE1 5WWUnited Kingdom Department of Gastroenterology Royal Hallamshire HospitalSheffield S10 2JFUnited Kingdom Division of Gastroenterology and Hepatology Mayo Clinic RochesterMN 55905United States Department of Mechanical Engineering University of Washington4000 Mason StSeattleWA 98195United States Division of surgery and Interventional science University College LondonLondon WC1E 6BTUnited Kingdom

since its original application,gastrointestinal(GI)endoscopy has undergone many innovative transformations aimed at expanding the scope,safety,accuracy,acceptability and cost-effectiveness of this area of clinical *** method of achieving this has been to reduce the caliber of endoscopic *** propose the collective term“Miniature GI Endoscopy”.In this Opinion Review,the innovations in this field are explored and *** progress and clinical use of the three main areas of miniature GI endoscopy(ultrathin endoscopy,wireless endoscopy and scanning fiber endoscopy)are *** opportunities presented by these technologies are set out in a clinical context,as are their current *** of the positive aspects of miniature endoscopy are clear,in that smaller devices provide access to potentially all of the alimentary canal,while conferring high patient *** must be balanced with the costs of new technologies and recognition of device specific *** on future application are also considered and the efforts being made to bring new innovations to a clinical platform are *** devices demonstrate that miniature GI endoscopy has a valuable place in investigation of symptoms,therapeutic intervention and *** technologies give promise that the potential for enhancing the investigation and management of GI complaints is significant.

关键词： Ultrathin endoscopy Capsule endoscopy single fiber endoscopy

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Ketamine and midazolam sedation for pediatric gastrointestinal endoscopy in the Arab world

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World journal of Gastroenterology 2011年第31期17卷 3630-3635页

作者： Mohamad-Iqbal s Miqdady Wail A Hayajneh Ruba Abdelhadi mark A Gilger Pediatric Department Medical SchoolJordan University of Science and Technology Pediatric Institute Sheikh Khalifa Medical Citymanaged by Cleveland ClinicAbu Dhabi Pediatric Department University of Texas Health Science CenterSan AntoniaTXSan Antonia Pediatric Department Baylor College of Medicine

AIM:To evaluate the safety and effectiveness of intravenous ketamine-midazolam sedation during pediatric endoscopy in the Arab ***:A retrospective cohort study of all pediatric endoscopic procedures performed between 2002-2008 at the shared endoscopy suite of King Abdullah University Hospital,jordan University of science & Technology,jordan was *** children were > 1 year old and weighed > 10 kg with American society of Anesthesiologists class 1 or *** was performed in terms of sedation-related complications(desaturation,respiratory distress,apnea,bradycar-dia,cardiac arrest,emergence reactions),adequacy of sedation,need for sedation reversal,or failure to complete the ***:A total of 301 patients(including 160 males) with a mean age of 9.26 years(range,1-18 years) were *** were premedicated with atropine;and 79.4%(239/301) had effective and uneventful *** 248(82.4%) of the 301 patients received a mean dose of 0.16 mg/kg(range,0.07-0.39) midazolam and 1.06 mg/kg(range,0.31-2.67) ketamine,respectively within the recommended dosage *** maximum midazolam dose was exceeded in 17.6% patients [34 female(F):19 male(M),P = 0.003] and ketamine in 2.7%(3 M:5 F).Maximum midazolam dose was more likely to be exceeded than ketamine(P saturation occurred in 37(12.3%) patients,and was reversible by supplemental oxygen in all except 4 who continue to have desaturation despite supplemental ***(1.3%) patients had respiratory distress and 6(2%) were difficult to sedate and required a 3rd sedative;12(4%) required reversal and 7(2.3%) failed to complete the *** developed apnea,bradycardia,arrest,or emergence ***:Ketamine-midazolam sedation appears safe and effective for diagnostic pediatric gastrointestinal endoscopy in the Arab world for children aged > 1 year and weighing > 10 kg without co-morbidities.

关键词： Pediatric endoscopy sedation Ketamine Arab

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The First Pilot Epigenetic Type Improvement of Neuropsychiatric symptoms in a Polymorphic Dopamine D2 (-DRD2/ANKK (Taq1A)), OPRM1 (A/G), DRD3 (C/T), and MAOA (4R) Compromised Preadolescence Male with Putative PANDAs/CANs: Positive Clinical Outcome with Precision-Guided DNA Testing and Pro-Dopamine Regulation (KB220) and Antibacterial Therapies

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Open journal of Immunology 2024年第3期14卷 60-86页

作者： Kenneth Blum Igor Elman David Han Colin Hanna David Baron Ashim Gupta shan Kazmi jag Khalsa Debasis Bagchi Thomas McLaughlin Rajendra D. Badgaiyan Edward j. Modestino Drew Edwards Catherine A. Dennen Eric R. Braverman Abdalla Bowirrat Keerthy sunder Kevin Murphy Nicole jafari Foojan Zeine Paul R. Carney mark s. Gold Kai-Uwe Lewandowski Alireza sharafshah Aryeh R. Pollack Panayotis K. Thanos Division of Addiction Research & Education Center for Sports and Mental Health Western University of Health Sciences Pomona CA USA Department of Psychiatry Boonshoft School of Medicine Wright State University and Dayton VA Medical Centre Dayton OH USA Division of Nutrigenomics Victory Nutrition International Lederoch PA USA Institute of Psychology ELTE Etvs Lornd University Budapest Hungary Department of Psychiatry School of Medicine University of Vermont Burlington VT USA The Kenneth Blum Behavioral & Neurogenetic Institute LLC. Austin TX USA Department of Molecular Biology Adelson School of Medicine Ariel University Ariel Israel Division of Neuromodulation Research Karma Doctors & Karma TMS Palm Springs CA USA Division of Personalized Interventions Peak Logic Del Mar CA USA Division of Personalized Medicine Cross-Cultural Research & Educational Institute San Clemente CA USA Awaren.ss Integration Institute San Clemente CA USA Division of Personalized Pain Therapy Center for Advanced Spine Care of Southern Arizona Tucson AZ USA Department of Psychiatry Harvard School of Medicine Cambridge MA USA Department of Management science and statistics University of Texas San Antonio TX USA Behavioral Neuropharmacology and Neuroimaging Laboratory Clinical Research Institute on Addictions Department of Pharmacology and Toxicology Jacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo NY USA Future Biologics Lawrenceville GA USA Department of Microbiology Immunology & Tropic Diseases School of Medicine Georgetown University Washington DC USA Department of Pharmaceutical sciences College of Pharmacy Texas Southern University Houston TX USA Department of Psychiatry School of Medicine Case Western University Cleveland OH USA Brain and Behavior Laboratory Curry College Milton MA USA The Neurogenesis Project Jacksonville FL USA Department of Family Medicine Jefferson Health Northeast Philadelphia PA USA Departmen

Pediatric autoimmune neuropsychiatric disorders associated with or without streptococcal and other bacterial infections (PANDAs/CANs) are emerging as a featured pediatric disorder. Although there is some controversy regarding treatment approaches, especially related to the behavioral sequelae, we have hypothesized in other published work that it is characterized by the rapid onset of Reward Deficiency syndrome (RDs) in children. We propose utilizing a multi-systems biological approach involving the coupling of genetic addiction risk testing and pro-dopamine regulation (KB220/POLYGEN®) to help induce “dopamine homeostasis” in patients with PANDAs, especially those with known DNA-induced hypodopaminergia. This case study examines a 12-year-old Caucasian male with no prior psychiatric issues who presented with a sudden onset of severe anxiety, depression, emotional liability, and suicidal ideation. The patient underwent genotyping and the genetic addiction risk score (GARs) testing, which revealed risk polymorphisms in the dopamine D2 (-DRD2/ANKK (Taq1A), OPRM1 (A/G), DRD3 (C/T), and MAOA (4R) genes. These polymorphisms have been linked to hypodopaminergia. The patient was subsequently placed on research ID-KB220ZPBMPOLY (POLYGEN®), and albeit the possibility of bias, based upon self and parental assessment, a marked rapid improvement in psychiatric symptoms was observed. In the second phase of treatment (102 days utilizing KB220), the patient received standard antibody testing, which was positive for Lyme. Antibacterial therapy started immediately, and KB220z was discontinued to provide a wash-out period. A monotonic trend analysis was performed on each outcome measure, and a consistently decreasing trend was observed utilizing antibacterial therapy. Our recommendation, albeit only one case, is to utilize and further research a combined therapeutic approach, involving precision-guided DNA testing and pro-dopamine regulation along with antibacterial therapy, as well as

关键词： PANDAs CANs Genetic Addiction Risk Testing (GARs) Pro-Dopamine Regulation Hypodopaminergia Polymorphisms Antibacterial Therapy Infections

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Models to predict injury, physical fitness failure and attrition in recruit training: a retrospective cohort study

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Military Medical Research 2020年第4期7卷 391-400页

作者： Robin M.Orr Bruce s.Cohen stephen C.Allison Lakmini Bulathsinhala Edward j.Zambraski mark jaffrey Tactical Research Unit Bond University2 Promethean WayGold CoastRobinaQLD 4226Australia United states Army Research Institute for Environmental Medicine NatickMA 01760USA Defence science and Technology Group Port MelbourneVIC 3207Australia

Background:Attrition rate in new army recruits is higher than in incumbent *** the current study,we identified the risk factors for attrition due to injuries and physical fitness failure in recruit training.A variety of predictive models were ***:This retrospective cohort included 19,769 Army soldiers of the Australian Defence Force receiving recruit training during a period from 2006 to *** them,7692 reserve soldiers received a 28-day training course,and the remaining 12,077 full-time soldiers received an 80-day training *** data included anthropometric measures,course-specific variables,injury,and physical fitness *** regression was used to develop a variety of models to predict the rate of attrition due to injuries and physical fitness *** area under the receiver operating characteristic curve was used to compare the performance of the ***:In the overall analysis that included both the 28-day and 80-day courses,the incidence of injury of any type was 27.8%.The 80-day course had a higher rate of injury if calculated per course(34.3%vs.17.6%in the 28-day course),but lower number of injuries per person-year(1.56 vs.2.29).Fitness test failure rate was significantly higher in the 28-day course(30.0%vs.12.1%).The overall attrition rate was 5.2%and 5.0%in the 28-day and 80-day courses,*** fracture was common in the 80-day course(n=44)and rare in the 28-day course(n=1).The areas under the receiver operating characteristic curves for the course-specific predictive models were relatively low(ranging from 0.51 to 0.69),consistent with"failed"to"poor"predictive *** course-combined models performed somewhat better than the course-specific models,with two models having AUC of 0.70 and 0.78,which are considered"fair"predictive ***:Attrition rate was similar between 28-day and 80-day *** comparison to the 80-day full course,the 28-day course had a lower rat

关键词： Military training Predictive modelling Risk management soldier

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Yttrium-90 microsphere selective internal radiation therapy for liver metastases following systemic chemotherapy and surgical resection for metastatic adrenocortical carcinoma

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World journal of Clinical Oncology 2018年第1期9卷 20-25页

作者： Mina s Makary Lawrence s Krishner Evan j Wuthrick mark P Bloomston joshua D Dowell Division of Vascular and Interventional Radiology Department of Radiology the Ohio State University Comprehensive Cancer Center Division of Medical Oncology Department of Internal Medicine the Ohio State University Comprehensive Cancer Center Department of Radiation Oncology the Ohio State University Comprehensive Cancer Center Division of surgical Oncology Department of Surgery and James Cancer Hospital and Richard Solove Research Institute the Ohio State University Comprehensive Cancer Center

Adrenocortical carcinoma(ACC)is a rare malignancy with generally poor outcomes and limited treatment *** surgical resection can be curative for early local disease,most patients present with advanced ACC owing to nonspecific *** those patients,treatment options include systemic chemotherapy and locoregional therapies including radiofrequency ablation and transarterial *** present the first reported case of utilizing yttrium-90 microsphere selective internal radiation therapy(sIRT)in combination with first line EDP-M(Etoposide,Doxorubicin,Cisplatin,Mitotane)chemotherapy and debulking surgical primary tumor resection for treatment of metastatic *** complete radiologic response has been maintained after twelve months with resolution of clinical *** findings prompt the need for further consideration and studies to elucidate the role of sIRT in combination with systemic and surgical treatment for metastatic ACC.

关键词： Adrenocortical carcinoma Hepatic metastases Radioembolization Yttrium-90

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Daoism and the German Mission in Martin Heidegger's“The Thing”

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Frontiers of Philosophy in China 2019年第4期14卷 570-592页

作者： mark Kevin s.Cabural Division of Humanities Hong Kong University of Science and TechnologyHong KongChina

In this article,I examine Martin Heidegger’s 1950 lecture/essay“The Thing”(Das Ding)in two ***,as a piece influenced by chapter 11 of the *** second,as a postwar writing which can be interpreted vis-a-vis the Black Notebooks and his other *** are instances in“The Thing”which are analogous to his statements found in the Black Notebooks and his other writings which describe and clarify his controversial political *** brief,I suggest here that Heidegger’s articulation of the concept of wu 無 of chapter 11 of the Daodejing as the void of the jug in“The Thing”may potentially describe his controversial engagement with German National socialism as part of his response to the call for German ***,the fundamentality of the void of the jug is comparable to the exclusivity and exceptionality of the Germans in their mission;and the use of the void of the jug as outpouring is an interesting way to emphasize his disagreement with the regime by pointing out that his support to German National socialism is not to the extent of brutally annihilating the jews.

关键词： Martin Heidegger Daodejing German mission nothing void emptiness

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Heterozygous carriers of galactocerebrosidase mutations that cause Krabbe disease have impaired microglial function and defective repair of myelin damage

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Neural Regeneration Research 2018年第3期13卷 393-401页

作者： Nicole j.scott-Hewitt Christopher j.Folts mark D.Noble Department of Biomedical Genetics University of Rochester School of Medicine and Dentistry

This review addresses two puzzling findings related to mutations in galactocerebrosidase （GALC） that cause Krabbe disease （KD）, a severe lysosomal storage disorder characterized by extensive myelin damage in children with mutations in both GALC alleles. First, heterozygous carriers of KD-causing mutations, which include the biological paren.s of children with KD, exhibit increased risk for developing other diseases. second, variants in the GALC locus increase the risk of developing multiple sclerosis （Ms）, another disease characterized by extensive myelin damage. What explains these correlations？ In studies on cuprizone-induced myelin damage in heterozygous （GALC＋/–） mice carrying one copy of a mutation that causes KD-like disease, the extent of damage was similar in GALC＋/– and wild-type （WT） mice. In contrast, GALC＋/- mice had striking defects in repair of cuprizone-induced damage. We further found unexpected microglial defects in myelin debris clearance and in the ability to up-regulate the Trem2 microglial protein critical for debris uptake. These defects were rescued by exposure to a lysosomal re-acidifying drug discovered in our studies on KD, and which provides multiple clinically relevant benefits in the twitcher （GALC＋/–） mouse model of KD. Thus, heterozygous GALC mutations cause effects on biological function that may help to understand the increased disease risk in heterozygous carriers of such mutations and to understand why GALC variations increase the risk of Ms. Our findings indicate that while some genetic risk factors may contribute to complex diseases by increasing the risk of tissue damage, others may do so by compromising tissue repair.

关键词： vulnerability locus multiple sclerosis Krabbe disease galactocerebrosidase microglia myelin repair lysosomal storage disorders heterozygous carriers Trem2 demyelination

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The variable codons of H5N1 avian influenza A virus haemagglutinin genes

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science China(Life sciences) 2008年第11期51卷 987-993页

作者： mark j.GIBBs Robert W.MURPHY school of Botany and Zoology Faculty of ScienceAustralian National UniversityACT 0200Australia Department of Natural History Royal Ontario MuseumTorontoON M5S 2C6Canada

We investigated the selection pressures on the haemagglutinin genes of H5N1 avian influenza viruses using fixed effects likelihood models. We found evidence of positive selection in the sequences from isolates from 1997 to 2007, except viruses from 2000. The haemagglutinin sequences of viruses from southeast Asia, Hong Kong and China's Mainland were the most polymorphic and had similar nonsyn-onymous profiles. some sites were positively selected in viruses from most regions and a few of these sites displayed different amino acid patterns. selection appeared to produce different outcomes in vi-ruses from Europe, Africa and Russia and from different host types. One position was found to be positively selected for human isolates only. Although the functions of some positively selected posi-tions are unknown, our analysis provided evidence of different temporal, spatial and host adaptations for H5N1 avian influenza viruses.

关键词： positive selection pressure H5N1 avian influenza virus HA codon

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Analysis of the human Atox 1 homologue in Wilson patients

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World journal of Gastroenterology 2008年第15期14卷 2383-2387页

作者： Isabel simon mark schaefer jürgen Reichert Wolfgang stremmel Department of Gastroenterology University of HeidelbergGermany

AIM: To analyze the metallochaperone antioxidant-1 (Atox1) gene sequence in Wilson disease patients. METHODs: Mutation analysis of the four exons of the Atox1 gene including the intron- exon boundaries was performed in 63 Wilson disease patients by direct sequencing. REsULTs: From 63 selected patients no mutations were identified after the entire coding region including the intron- exon boundaries of Atox1 were sequenced. One known polymorphism within the Atox1 gene (5’UTR -99 T>C) in 31 (49%) of the Wilson patients as well as one previously undescribed variation (5’UTR -68 C>T) in 2 of the Wilson patients could be detected. statistical analyses revealed that the existence of a variation within the Atox1- gene showed a tendency towards an earlier onset of the disease. CONCLUsION: Based on the data of this study, no major role can be attributed to Atox1 in the pathophysiology or clinical variation of Wilson disease.

关键词： Antioxidant-1 Wilson disease Wilson's disease protein Mutation analysis

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