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Diagnostic and therapeutic direct peroral cholangioscopy using an intraductal anchoring balloon

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World journal of Gastroenterology 2012年第30期18卷 3992-3996页

作者： Mansour A Parsi tyler Stevens john j Vargo Department of Gastroenterology and Hepatology Digestive Disease InstituteCleveland ClinicClevelandOH 44195United States

AIM:To report our experience using a recently introduced anchoring balloon for diagnostic and therapeutic direct peroral cholangioscopy(DPOC).METHODS:Consecutive patients referred for diagnostic or therapeutic peroral cholangioscopy were evaluated in a prospective cohort *** patients underwent DPOC using an intraductal anchoring balloon,which was recently introduced to allow consistent access to the biliary tree with an ultraslim upper *** device was later voluntarily withdrawn from the market by the ***:Fourteen patients underwent DPOC using the anchoring *** access with an ultraslim upper endoscope was accomplished in all 14 *** 12(86%) patients,ductal access required sphincteroplasty with a 10-mm dilating *** placement of the ultraslim upper endoscope allowed satisfactory visualization of the biliary mucosa to the level of the confluence of the right and left hepatic ducts in 13 of 14 patients(93%).Therapeutic interventions by DPOC were successfully completed in all five attempted cases(intraductal biopsy in one and DPOC guided laser lithotripsy in four).Adverse events occurred in a patient on immunosuppressive therapy who developed an intrahepatic biloma at the site of the anchoring *** required hospitalization and *** endoscopic retrograde cholangiopancreatography 8 wk after the index procedure showed resolution of the ***:Use of this anchoring balloon allowed consistent access to the biliary tree for performance of diagnostic and therapeutic DPOC distal to the biliary bifurcation.

关键词： Anchoring balloon Direct peroral cholangioscopy Cholangiocarcinoma Endoscopic retrograde cholangiopancreatography Choledocholithiasis

A General Algorithm for Calculating Irreducible Brillouin Zones

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Communications in Computational Physics 2022年第2期31卷 495-515页

作者： jeremy j.jorgensen john E.Christensen tyler j.jarvis Gus L.W.Hart Department of Physics and Astronomy Brigham Young UniversityProvoUtah84602USA Department ofMathematics BrighamYoungUniversityProvoUtah84602USA

Calculations of properties of materials require performing numerical integrals over the Brillouin zone(BZ).Integration points in density functional theory codes are uniformly spread over the BZ(despite integration error being concentrated in small regions of the BZ)and preserve symmetry to improve computational *** points over an irreducible Brillouin zone(IBZ),a rotationally distinct region of the BZ,do not have to preserve crystal symmetry for greater *** freedom allows the use of adaptive meshes with higher concentrations of points at locations of large error,resulting in improved algorithmic *** have created an algorithm for constructing an IBZ of any crystal structure in 2D and *** algorithmuses convex hull and half-space representations for the BZ and IBZ to make many aspects of construction and symmetry reduction of the BZ *** algorithm is simple,general,and available as open-source software.

关键词： Brillouin zone irreducible Brillouin zone

Magnetic anchor guidance for endoscopic submucosal dissection and other endoscopic procedures

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World journal of Gastroenterology 2017年第16期23卷 2883-2890页

作者： Mohamed Mortagy Neal Mehta Mansour A Parsi Seiichiro Abe tyler Stevens john j Vargo Yutaka Saito Amit Bhatt Department of Internal Medicine Homer Stryker MD School of MedicineWestern Michigan UniversityKalamazooMI 49008United States Department of Internal Medicine Medicine InstituteCleveland ClinicClevelandOH 44195United States Department of Gastroenterology and Hepatology Digestive Disease InstituteCleveland ClinicClevelandOH 44195United States Endoscopy Division National Cancer Center HospitalTokyo 104-0045Japan

Endoscopic submucosal dissection(ESD) is a wellestablished, minimally invasive treatment for superficial neoplasms of the gastrointestinal tract. The universal adoption of ESD has been limited by its slow learning curve, long procedure times, and high risk of complications. One technical challenge is the lack of a second hand that can provide traction, as in conventional surgery. Reliable tissue retraction that exposes the submucosal plane of dissection would allow for safer and more efficient dissection. Magnetic anchor guided endoscopic submucosal dissection(MAGESD) has potential benefits compared to other current traction methods. MAG-ESD offers dynamic tissue retraction independent of the endoscope mimicking a surgeon's "second hand". Two types of magnets can be used: electromagnets and permanent magnets. In this article we review the MAG-ESD technology, published work and studies of magnets in ESD. We also review the use of magnetic anchor guidance systems in natural orifice transluminal endoscopic surgery and the idea of magnetic non-contact retraction using surface ferromagentization. We discuss the current limitations, the future potential of MAG-ESD and the developments needed for adoption of this technology.

关键词： Endoscopic submucosal dissection Gastric cancer Magnetic anchor guidance Esophageal cancer Magnets Traction Natural orifice transluminal endoscopic surgery

Coactivation Does Not Contribute to Fatigue-Induced Decreases in Isokinetic Forearm Flexion and Extension Torque

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journal of Science in Sport and Exercise 2023年第4期5卷 314-321页

作者： tyler j.Neltner john Paul V.Anders Robert W.Smith jocelyn E.Arnett joshua L.Keller Terry j.Housh Richard j.Schmidt Glen O.johnson Department of Nutrition and Health Sciences University of Nebraska-LincolnLincolnNE 68510USA Integrative Laboratory of Exercise and Applied Physiology(iLEAP) Department of HealthKinesiology and SportUniversity of South AlabamaMobileAL 36688USA

Purpose The present study examined the effects of a reciprocal,slow velocity forearm flexion and extension task on fatigue-induced changes in isokinetic torque,agonist and antagonist muscle activation,and coactivation ratios at slow and moderate *** Nine women(mean±SD:age=21.0±1.7 years;body mass=68.1±8.2 kg;height=167.4±7.2 cm)completed pre-testing for forearm flexion and extension isokinetic peak torque at 60 and 180°/s,a fatiguing task of 50 maximal,recip-rocal,isokinetic muscle actions at 60°/s,and *** amplitude(AMP)of the electromyographic(EMG)signals from the biceps and triceps were simultaneously *** and EMG AMP were normalized to the corresponding values from the pre-testing peak torque *** measures ANOVAs and pairwise comparisons were used to identify mean changes in torque,EMG AMP,and coactivation *** The torque analyses indicated significant decreases from pre-to post-testing for forearm flexion(14.1%±5.0%;P0.05)from pre-to post-testing for either velocity or *** The torque responses were velocity-specific,with greater fatigability exhibited for forearm extension versus flexion at 60°/s,but no differences at 180°/*** parallel EMG AMP responses between the agonist and antagonist muscles for both velocities supported the lack of fatigue-induced changes in coactivation ***,our results demonstrated that fatigue-induced decreases in torque were not attributable to increases in antagonist activation or coactivation.

关键词： Coactivation Isokinetic Fatigue Forearm flexion Extension

Clinical outcomes of endoscopic management of pancreatic fluid collections in cirrhotics vs non-cirrhotics: A comparative study

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World journal of Gastrointestinal Endoscopy 2019年第6期11卷 403-412页

作者： Sobia Laique Matheus C Franco tyler Stevens Amit Bhatt john j Vargo Prabhleen Chahal Internal Medicine Cleveland ClinicClevelandOH 44195United States Digestive Disease Institute Cleveland ClinicClevelandOH 44195United States

BACKGROUND Endoscopic management of symptomatic pancreatic fluid collections (PFCs) using self-expandable metal stents (SEMS) placement has emerged as an innovative therapeutic approach with excellent efficacy, safety, and relatively few adverse outcomes. However, their use has not been studied in patients with cirrhosis. Cirrhotics tend to be considered less than optimal candidates due to concern for portal hypertension and coagulopathy related complications. AIM To compare the efficacy and safety of using SEMS for drainage of symptomatic PFCs in cirrhotic vs non-cirrhotic patients. METHODS We conducted a retrospective comparative analysis of patients with symptomatic PFCs [pancreatic pseudocyst (PP) or walled-off necrosis (WON)] who underwent endoscopic ultrasound (EUS)-guided placement of fully covered self-expandable metals stents or lumen-apposing self-expandable metal stents. All patients were followed clinically until resolution of PFCs or death. Definition:(1) Technical success was defined as successful placement of SEMS;and (2) Clinical success was defined as complete resolution of the PFCs without additional interventions including interventional radiology or surgery. Number of procedures performed per patient, number of patients who achieved complete resolution of the PFCs without additional interventions and procedure related adverse events were *** From january 2012 to December 2017, a total of 88 patients underwent EUSguided drainage of symptomatic PFCs. Of these, 58 non cirrhotic patients underwent plastic stent insertion for management of PFC and 30 patients, 5 with cirrhosis and 25 without cirrhosis, underwent EUS-guided transmural drainage with SEMS, including 18 (60%) PP and 12 (40%) WON. Technical success was achieved in all 30 patients. Clinical success was achieved in 60% cirrhotic patients and 92% non-cirrhotics (P = 0.12). Procedure-related adverse events were 60% in cirrhotic and 28% non-cirrhotic (P = 0.62). Moreover, fatal adv

关键词： Endoscopic ultrasonography Pancreatic pseudocysts Liver cirrhosis

Comparative functional genomics identifies an iron-limited bottleneck in a Saccharomyces cerevisiae strain with a cytosolic-localized isobutanol pathway

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Synthetic and Systems Biotechnology 2022年第2期7卷 738-749页

作者： Francesca V.Gambacorta Ellen R.Wagner tyler B.jacobson Mary Tremaine Laura K.Muehlbauer Mick A.McGee justin j.Baerwald Russell L.Wrobel john F.Wolters Mike Place joshua j.Dietrich Dan Xie jose Serate Shabda Gajbhiye Lisa Liu Maikayeng Vang-Smith joshua j.Coon Yaoping Zhang Audrey P.Gasch Daniel Amador-Noguez Chris Todd Hittinger Trey K.Sato Brian F.Pfleger DOE Great Lakes Bioenergy Research Center University of Wisconsin-MadisonMadisonWIUSA Department of Chemical and Biological Engineering University of Wisconsin-MadisonMadisonWIUSA Laboratory of Genetics Center for Genomic Science InnovationUniversity of Wisconsin-MadisonMadisonWIUSA Department of Bacteriology University of Wisconsin-MadisonMadisonWIUSA Department of Chemistry University of Wisconsin-MadisonMadisonWIUSA Wisconsin Energy Institute J.F.Crow Institute for the Study of EvolutionUniversity of Wisconsin-MadisonMadisonWIUSA Department of Biomolecular Chemistry University of Wisconsin-MadisonMadisonWIUSA

Metabolic engineering strategies have been successfully implemented to improve the production of isobutanol,a next-generation biofuel,in Saccharomyces ***,we explore how two of these strategies,pathway re-localization and redox cofactor-balancing,affect the performance and physiology of isobutanol producing *** equipped yeast with isobutanol cassettes which had either a mitochondrial or cytosolic localized isobutanol pathway and used either a redox-imbalanced(NADPH-dependent)or redox-balanced(NADH-dependent)ketol-acid reductoisomerase *** then conducted transcriptomic,proteomic and metabolomic analyses to elucidate molecular differences between the engineered *** localization had a large effect on isobutanol production with the strain expressing the mitochondrial-localized enzymes producing 3.8-fold more isobutanol than strains expressing the cytosolic ***-balancing did not improve isobutanol titers and instead the strain with the redox-imbalanced pathway produced 1.5-fold more isobutanol than the balanced version,albeit at low overall pathway *** genomic analyses suggested that the poor performances of the cytosolic pathway strains were in part due to a shortage in cytosolic Fe-S clusters,which are required cofactors for the dihydroxyacid dehydratase *** then demonstrated that this cofactor limitation may be partially recovered by disrupting iron homeostasis with a fra2 mutation,thereby increasing cellular iron *** resulting isobutanol titer of the fra2 null strain harboring a cytosolic-localized isobutanol pathway outperformed the strain with the mitochondrial-localized pathway by 1.3-fold,demonstrating that both localizations can support flux to isobutanol.

关键词： Saccharomyces cerevisiae Isobutanol Functional genomics analysis Pathway localization Fe incorporation

Mouse tumor susceptibility genes identify drug combinations for multiple myeloma

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journal of Cancer Metastasis and Treatment 2020年第1期6卷 214-224页

作者： Shuling Zhang Wendy DuBois Ke Zhang john K.Simmons VKeith Hughitt Sayeh Gorjifard Snehal Gaikwad tyler j.Peat Beverly A.Mock Laboratory of Cancer Biology and Genetics CCRNCINIHBethesdaMD 20892USA Personal Genome Diagnostics BaltimoreMD 21224USA University of Washington School of Medicine Department of Genome SciencesSeattleWA 98195USA

Long-term genetic studies utilizing backcross and congenic strain analyses coupled with positional cloning strategies and functional studies identified Cdkn2a,Mtor,and Mndal as mouse plasmacytoma susceptibility/resistance *** incidence data in congenic strains carrying the resistance alleles of Cdkn2a and Mtor led us to hypothesize that drug combinations affecting these pathways are likely to have an additive,if not synergistic effect in inhibiting tumor cell *** and novel systems-level genomic approaches were used to assess combination activity,disease specificity,and clinical potential of a drug combination involving rapamycin/everolimus,an Mtor inhibitor,with entinostat,an histone deacetylase *** combination synergistically repressed oncogenic MYC and activated the Cdkn2a tumor *** identification of MYC as a primary upstream regulator led to the identification of small molecule binders of the G-quadruplex structure that forms in the NHEIII region of the MYC *** studies highlight the importance of identifying drug combinations which simultaneously upregulate tumor suppressors and downregulate oncogenes.

关键词： Complex genetic trait plasma cell tumor multiple myeloma entinostat rapamycin drug combinations Cdkn2a Mtor Mndal MYC

透皮东莨菪碱贴剂联合昂丹司琼对比单独应用昂丹司琼用于预防门诊手术后恶心呕吐的一项随机双盲多中心研究

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麻醉与镇痛 2010年第5期6卷 34-40页

作者： Tong j. Gan, MD Ashish C. Sinha, MD, PhD Anthony L. Kovac, MD R. Kevin jones, MD, CPI Stephen A.Cohen,MD,MBA jean P. Battildaa, MS jonathan S. Deutsch, MD joseph V. Pergolizzi, jr., MD] TDS Study Group 王琦(译) 李文志(校) Department of Anesthesiology Duke University Medical Center Durham North Carolina University of Pennsylvania Philadelphia Pennsylvania ＊University of Kansas Medical Center Kansas City Kansas Accurate Clinical Trials Inc./Saddleback Memorial Medical Center Laguna Hills California Beth Israel Deaconess Medical Center Boston Massachusetts Baxter Healthcare Corporation New Providence New Jersey Departrnent of Medicine Johns Hopkins University School of Medicine Baltimore Maryland The TDS Study Group consists of the following members: Gregory H. Adkisson (St. Agnes Healthcare Inc. Baltimore MD St. Agnes Healthcare Inc. Clinical Research Center Baltimore MD) I(eith Candiotti(University of Miami School of Medidne Jackson Health Systems Miami FL) Stephen & Cohen(Beth Israel Deaconess Medical Center Boston MA) Nell R. Connelly(Baystate Medical Center Springfield MA) Patricia L. Dalby(Magee Women's Hospital of UPMC Pittsburgh PA) Robert D'Angelo(Forsyth Medical Center Winston-Salem NC) Albert R. Davis(Loyola University Medical Center Chicago IL) David 1L Drover (Stanford Hospital and Clinics Stanford CA) Tong J. Gan Fernando Altermatt Dianne Scott(Duke University Medical Center Durham NC Duke Health Raleigh Hospital Raleigh NC and Duke Center for Aesthetic Services Durham NC) Joseph S. Gimbel(AZ Research Center John C. Lincoln Hospital North Mountain and John C. Lincoln Hospital Deer Valley Phoenix AZ)R.Kevin Jones (Saddleback Memorial Medical Center Laguna Hills CA) Anthony L. Kovac(University of Kansas Medical Center Kansas City Kansas KS) John B. Leslie(Mayo Clinic Hospital Phoenix AZ) Roberta McI(inney Jr. (Trinity Clinic North Park Mother Frances Hospital and Tyler Square Tyler TX) Tricia A. Meyer ( Scott and White Hospital Temple TX ) Joseph Pergolizzi (Physicians Day Surgery Center Naples FL) Beverly tC Philip (Brigham and Women's Hospital Boston MA) Martin I. Redmond(State University of New York at Stony Brook Ambulatory Surgica

背景手术后恶心、呕吐（PONV）是门诊手术常见的并发症。本试验目的是观察透皮东莨菪碱贴剂（TDS）联合静脉注射昂丹司琼（OND）对门诊患者PONV的疗效是否优于单独应用昂丹司琼。方法此项随机双盲多中心的临床试验纳入了620例接受门诊... 详细信息

背景手术后恶心、呕吐（PONV）是门诊手术常见的并发症。本试验目的是观察透皮东莨菪碱贴剂（TDS）联合静脉注射昂丹司琼（OND）对门诊患者PONV的疗效是否优于单独应用昂丹司琼。方法此项随机双盲多中心的临床试验纳入了620例接受门诊腹腔镜或隆胸手术的PONV高危女性患者，进入手术室前2小时分别给患者贴上TDS贴剂或外观相同的空白贴剂。在全麻诱导前2—5分钟给所有患者静脉注射OND4mg。手术后24~48小时评估止吐是否完善（彻底止吐标准为无呕吐或干呕，且没有追加止吐药）。同时记录发生呕吐、干呕、恶心以及追加止吐药的患者比例，记录手术后首次发生PONV的时间及离院时间，记录呕吐、干呕、恶心的发作次数与严重程度及患者对于止吐治疗的满意度。结果TDS＋OND组与OND组相比，手术后24小时恶心、呕吐的发生率显著降低，但手术后48小时两者差异无显著性。TDS＋OND组没有呕吐、干呕且未追加过止吐药的患者占48％，而OND组占39％（P〈0．02）。TDS＋OND组的彻底止吐（无恶心、呕吐或干呕，且未追加止吐药）率显著高于OND组（分别为35％和25％，P〈0．01）。TDS＋OND组手术后首次发生恶心、呕吐、干呕及追加止吐药的时间明显晚于OND组（P〈0．05）。前者不良反应的总发生率也低于后者（分别为36．7％和49％，P〈0．01）。结论与单独应用OND相比。TDS＋OND能更大程度地减少PONV，主要是通过减少不良反应而获得。

关键词：手术后恶心呕吐东莨菪碱贴剂多中心研究昂丹司琼门诊手术随机双盲应用单独