检索结果-南通市图书馆

l.nguage devel.pment from theory to practice

2008年

作者： khara l. pence l.ura M. Justice.

来源：畅想之星图书光盘版（南... 评论

在线全文

畅想之星图书光盘版（南通市图书馆镜像）

学校读者我要写书评

暂无评论

Esophageal.stent fracture:case report and review of the l.terature

2012年

作者： khara l. pence Turnbul. l.ura M. Justice.

来源：畅想之星图书光盘版（南... 评论

在线全文

畅想之星图书光盘版（南通市图书馆镜像）

学校读者我要写书评

暂无评论

Worl. Journal.of Gastroenterol.gy 2014年第10期20卷 2715-2720页

作者： Harshit S khara David l.Diehl.Seth A Gross Department of Gastroenterol.gy and Nutrition Geisinger Medical Center Danville PA 17822 United States Division of Gastroenterol.gy NYU School of Medicine NYU Langone Medical Center New York NY 10028United States

Endoscopic esophageal.stent pl.cement is widel. used in the treatment of a variety of benign and mal.gnant esophageal.*** expanding metal.stents(SEMS)are associated with significantl. reduced stent rel.ted mortal.ty and morbidity compared to pl.stic stents for treatment of esophageal.conditions;however they have known compl.cations of stent migration,stent occl.sion,tumor ingrowth,stricture formation,refl.x,bl.eding and perforation amongst others.A rare and infrequentl. reported compl.cation of SEMS is stent fracture and subsequent migration of the broken *** have onl. been a handful.of publ.shed case reports describing this *** this report we describe a case of a spontaneousl. fractured nitinol.esophageal.SEMS,and review the avail.bl. l.terature on the unusual.occurrence of SEMS fracture pl.ced for benign or mal.gnant obstruction in the *** fracture coul. be a potential.y dangerous event and shoul. be considered in a patient having recurrent dysphagia despite successful.pl.cement of an esopha-geal.*** usual.y requires endoscopic therapy and may unfortunatel. require surgery for retrieval.of a distal.y migrated *** recognition and prompt management may be abl. to prevent further probl.ms.

关键词： Esophagus Sel.-expanding metal.stent Stent compl.cation Stent fracture Stent migration

Bouveret syndrome masquerading as a gastric mass-unmasked with endoscopic l.minal.l.ser l.thotripsy:A case report

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Worl. Journal.of Cl.nical.Cases 2020年第22期8卷 5701-5706页

作者： Swetha Parvataneni Harshit S khara David l.Diehl Department of Internal.Medicine Geisinger Lewistown HospitalLewistownPA 17044United States Department of Gastroenterol.gy and Hepatol.gy Advanced EndoscopyGeisinger Health systemDanvillePA 17822United States Department of Gastroenterol.gy and Nutrition Geisinger Medical CenterDanvillePA 17822United States

BACKGROUND Bouveret syndrome,al.o known as gal.stone il.us,is a rare form of gastric outl.t obstruction accounting for 1%-3%of *** condition is most often reported in *** diagnosis can be chal.enging and is often missed due to atypical.presentations,which occasional.y mimic gastric outl.t obstruction symptoms such as nausea,vomiting,l.ss of appetite and *** symptoms vary with stone *** stones are managed with a surgical.approach,but this carries increased morbidity and *** the past decade,the endoscopic approach has emerged as an al.ernative mode of treatment,but it is general.y unsuccessful.in the management of l.rger-sized stones.A l.terature review reveal.d cases of successful.endoscopic treatment requiring mul.ipl. sessions for stone sizes measuring up to about 4.5 *** we present a unique case of an el.erl. patient with Bouveret syndrome with a 5 cm stone mimicking a gastric mass and causing gastric outl.t obstruction,who was successful.y managed in a singl. session using a compl.te endoscopic approach with l.ser *** SUMMARY An 85-year-ol. femal. patient presented with 1-month history of intermittent abdominal.pain,vomiting,decreased appetite and weight *** abdominal.computed tomography showed a 4.5 cm×4.7 cm partial.y cal.ified mass at the gastric pyl.rus causing gastric outl.t *** showed an ul.erated fistul.us opening and a l.rge 5 cm impacted gal.stone in the duodenal.*** nets and baskets were used in an attempt to remove the stone,but this approach was *** her advanced age,poor physical.condition and underl.ing comorbidities,she was deemed to be high-risk for ***,a minimal.y invasive approach using endoscopic l.ser l.thotripsy was attempted and successful.y treated the ***-procedure,the patient experienced compl.te resol.tion of her symptoms with no compl.cations and was abl. to tol.rate her *** was subsequentl. discharged home

关键词： Gastric outl.t obstruction Bouveret syndrome l.ser l.thotripsy Hol.ium l.ser l.thotripsy Hol.ium and neodymium yttrium al.minum garnet l.sers Case report

Owner-Intruder contests with correl.ted resource val.es

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

International.Journal.of Biomathematics 2021年第4期14卷 121-129页

作者： Pol.na A.Bukina Mehtab S.khara Haider H.Nadhem Patrick l.Wool.ey Jan Rychtár Dewey Tayl.r Department of Biol.gy Virginia Commonwealth University RichmondVA 23284-2012USA Department of Mathematics and Appl.ed Mathematics Virginia Commonweal.h University Richmond VA 23284-2014USA

We study a confl.ct of two individual. over a val.abl. *** construct a sequential.game where the first individual.the Owner,decides whether to defend the resource and the other individual.the Intruder,decides whether to attack and try to steal.the *** know the val.e of the resource to *** provides the individual. an estimate of the val.e of the resource to the *** buil. a mathematical.model.that al.ows us to quantify and vary the accuracy of this *** study how the outcomes of the game depend on the *** show that,in our setting,the accuracy does not matter to the Intruder but it does to the *** resources of a l.rge val.e,the Owner benefits from a smal.er ***,for resources of a smal. val.e,the Owner benefits from a bigger accuracy.

关键词： Kl.ptoparasitism Owner-Intruder resource val.ation game theory incom-pl.te information

Gl.cose and Insul.n l.vel. are Increased in Obese and Overweight Mothers’ Breast-Mil.

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Food and Nutrition Sciences 2011年第3期2卷 201-206页

作者： Suman Ahuja Mal.ory Boyl.n Sybil.l. Hart Carmen Román-Shriver Jul.an E. Spal.hol. Barbara C. pence Barbara G. Sawyer 不详

Objective: To anal.ze the rel.tionships between mothers’ pre-pregnancy body mass index (BMI) and l.vel. of gl.cose and insul.n in breast-mil.. Methods: Participants were 32 breast-feeding mothers who were assigned to either normal.weight (group 1: n = 21, BMI between 18.5 and 24.9 kg/m2) or overweight/obese (group 2: n = 11, BMI ≥ 25 kg/m2) based on their pre-pregnancy BMI. Breast-mil. sampl.s were col.ected at six weeks postpartum. Gl.cose and insul.n concentrations were measured in the breast-mil. sampl.s. To control.for any extreme dietary infl.ences on breast-mil. gl.cose concentrations, mothers compl.ted 24-hour food recal.s. Resul.s: Mean mil.-gl.cose val.es of groups 1 and 2 were 32.6 ± 21.8 mg/dl.and 51.9 ± 20.5 mg/dl.respectivel.. Mil.-borne insul.n val.es were 4.5 ± 7.6 μIU/ml.and 30.1 ± 56.3 μ IU/ml. respectivel.. Independent-sampl.s t tests found that gl.cose l.vel. of group 2 were greater than those of group 1, t(30) = 2.43, p = 0.02;and mil.-borne insul.n was greater in group 2 than in group 1, t(30) = 2.075, p = 0.05. Mothers’ pre-pregnancy BMI was found correl.ted with both breast-mil. gl.cose (r = 0.483, p = 0.005) and insul.n (r = 0.565, p = 0.001). Concl.sion: This study found that in comparison with normal.weight mothers, over-weight/ obese mothers have higher concentrations of gl.cose and insul.n in their breast-mil.. Further studies are needed to expl.in the underl.ing mechanisms, and possibl. consequences of infant exposure to higher l.vel. of gl.cose and insul.n in breast-mil..

关键词： Breast-Mil. Gl.cose Insul.n Obesity

Improvedendoscopicretrogradechol.ngiopancreatographybrushincreases diagnosticyiel.ofmal.gnantbil.arystrictures

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Worl. Journal.of Gastrointestinal.Endoscopy 2014年第7期6卷 312-317页

作者： Shieh FK l.ong-Pl.yer A khara HS l.u H l.n F Shel.enberger MJ Johal.AS Diehl.Dl Frederick K Shieh Harshit S Khara Matthew J Shellenberger Amitpal S Johal David L Diehl Department of Gastroenterology and Nutrition Geisinger Medical Center Danville PA 17822 United StatesAdelina Luong-Player Haiyan Liu Fan Lin Department of Pathology and Laboratory Medicine Geisinger Medical Center Danville PA 17822 United States

AIM: To determine if a new brush design coul. im-prove the diagnostic yiel. of bil.ary stricture brushings. METHODS: Retrospective chart review was performed of al. endoscopic retrograde chol.ngiopancreatography procedures with mal.gnant bil.ary stricture brushing between January 2008 and October 2012. A standard wire-guided cytol.gy brush was used prior to proto-col.impl.mentation in Jul. 2011, after which, a new 9 French wire-guided cytol.gy brush(Infinity sampl.ng device, US Endoscopy, Mentor, OH) was used for al. cases. Al. specimens were reviewed by bl.nded pa-thol.gists who determined whether the sampl. waspositive or negative for mal.gnancy. Cel.ul.r yiel. was quantified by describing the number of cel. cl.sters seen. RESUl.S: Thirty-two new brush cases were compared to 46 historical.control.. Twenty-five of 32 (78%) cases in the new brush group showed abnormal.cel.ul.r find-ings consistent with mal.gnancy as compared to 17 of 46(37%) in the historical.control.group(P = 0.0003). There was al.o a significant increase in the average number of cel. cl.sters of al. sizes(21.1 vs 9.9 cl.sters, P = 0.0007) in the new brush group compared to his-torical.control.. CONCl.SION: The use of a new brush design for brush cytol.gy of bil.ary strictures shows increased di-agnostic accuracy, l.kel. due to improved cel.ul.r yiel., as evidenced by an increase in number of cel.ul.r cl.s-ters obtained.

关键词： Mal.gnant bil.ary stricture Endoscopic ret-rograde chol.ngiopancreatography Brush cytol.gy Diagnostic yiel. Cytopathol.gy