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Esophagogastric junction outflow obstruction successfully treated with laparoscopic Heller myotomy and Dor fundoplication: First case report in the literature

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World Journal of Gastrointestinal Surgery 2019年第2期11卷 112-116页

作者： Pedro F Pereira Andre RP Rosa Leonardo A Mesquita Marcelle J Anzolch Rafael N Branchi Augusto L Giongo Francisco C Paix?o Marcio F Chedid Cleber DP Kruel Division of Gastrointestinal Surgery and Liver Transplantation Hospital de Clinicas de Porto AlegreFederal University of Rio Grande do Sul

BACKGROUND Esophagogastric junction outflow obstruction(EGJOO) is a rare syndrome,characterized by an elevation of the integrated relaxation pressure of the lower esophageal sphincter, not accompanied by alterations in esophageal motility that may lead to the criteria for achalasia. We were unable to find any prior report of the combination of Heller myotomy with anterior partial fundoplication(Dor) as the treatment for EGJOO. We herein report a case of EGJOO treated with laparoscopic Heller myotomy combined with Dor fundoplication.CASE SUMMARY A 26-year-old man presented with a 3-year history of solid dysphagia and a 30-kg weight loss. He was treated with oral nifedipine, isosorbide, and omeprazole,without resolution of symptoms. An upper gastrointestinal series(barium swallow) revealed a "bird's beak" sign. Esophagogastroduodenoscopy was positive for Los Angeles grade A peptic esophagitis. High-resolution esophageal manometry was compatible with EGJOO. Esophageal pH monitoring showed pathological acid reflux both in orthostatic and decubitus position. An 8-cm laparoscopic Heller myotomy combined with an anterior 220° Dor fundoplication was performed. Solid diet was introduced on postoperative day 2, and the patient was discharged home the same day. At 17-mo follow-up, he reported no symptoms. Barium swallow was compatible with complete radiologic resolution.Both esophageal manometry and upper endoscopy showed normal findings 9 mo after the operation.CONCLUSION Surgical treatment with Heller myotomy and Dor fundoplication is a potential treatment option for EGJOO refractory to medical treatment.

关键词： Esophagogastric junction outflow obstruction Heller myotomy Partial fundoplication Dor fundoplication Case report

A review of synoptic weather effects on sea ice outflow through Fram Strait: cyclone vs. anticyclone

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Advances in Polar Science 2020年第1期31卷 43-54页

作者： LIANG Yu BI Haibo WANG Yunhe ZHANG Zehua ZHANG Yi LIU Yanxia HUANG Haijun Key laboratory of Marine Geology and Environment Institute of OceanologyChinese Academy of SciencesQingdao 266071China University of Chinese Academy of Sciences Beijing 100049China Laboratory for Marine Geology Qingdao National Laboratory for Marine Science and TechnologyQingdao 266237China Center for Ocean Mega-Science Chinese Academy of SciencesQingdao 266071China

Sea ice outflow through Fram Strait is a vital component of the sea ice mass balance of the Arctic Ocean.Previous studies have examined the role of large-scale modes of atmospheric circulation variability such as the Arctic Oscillation,North Atlantic Oscillation,and Dipole Anomaly in the movement of sea ice.This review emphasizes the distinct impacts of synoptic weather on sea ice export as well as on other relevant fields(i.e.,sea ice concentration and sea ice drift).We identify deficiencies in previous studies that should be addressed,and we summarize potential research subjects that should be investigated to further our understanding of the relationship between synoptic weather and sea ice export via Fram Strait.For example,the connection between summertime anticyclones and weakened potential vorticity related to the observed extensive spring Eurasian snow and Siberian Ocean sea ice loss is of considerable interest.In-depth exploration of this type of geophysical mechanism will be particularly useful in assessment of the robustness of such linkages inferred through statistical analyses.

关键词： sea ice outflow Fram Strait cyclone anticyclone

How does stiffness of trabecular meshwork affect outflow resistance in human eyes?

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医用生物力学 2013年第S1期28卷 86-88页

作者： Fan Yuan Lucinda J.Camras W.Daniel Stamer David Epstein Pedro Gonzalez Department of Biomedical Engineering Duke University Department of Ophthalmology Duke University

Purpose Ocular hypertension is the primary risk factor for development of glaucoma and the only modifiable endpoint[1,2].Clinical trials involving thousands of patients have shown consistently that lowering intraocular pressure（IOP）in those with glaucoma,whether or not their IOP is above normal,slows vision loss.IOP elevation is the result of diminished outflow facility in the conventional outflow pathway;and the highest resistance to aqueous humor outflow resides in the juxtacanalicular tissue（JCT）layer of trabecular meshwork（TM）and the inner wall of Schlemm’s canal（SC）.However,mechanisms of outflow facility decrease in glaucomatous eyes remain to be determined.

关键词： outflow trabecular glaucoma intraocular facility consistently stiffness canal lowering endpoint

Intraocular pressure control of a novel glaucoma drainage device-in vitro and in vivo studies

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International Journal of Ophthalmology(English edition) 2017年第9期10卷 1354-1360页

作者： Li-Jun Cui Di-Chen Li Jian Liu Lei Zhang Yao Xing Department of Ophthalmology the First Affiliated Hospital ofXi'an Jiaotong UniversityXi'an 710061Shaanxi ProvinceChina Institute of Advanced Manufacturing Technology School of Mechanical EngineeringXi'an Jiaotong UniversityXi'an 710061Shaanxi ProvinceChina Department of Physiology and Pathophysiology College of MedicineXi'an Jiaotong UniversityXi'an 710061Shaanxi ProvinceChina Department of Cardiovascular Medicine the Armed Police Corps Hospital of ShaanxiXi'an 710054Shaanxi ProvinceChina

AIM：To evaluate the intraocular pressure（IOP）control of an artificial trabeculum drainage system（ATDS）,a newly designed glaucoma drainage device,and postoperative complications in normal rabbit eyes.METHODS：Pressure drops in air and fluid of 30 ATDS were measured after being connected to a closed manometric system.Twenty of them were then chosen and implanted randomly into the eyes of 20 rabbits.Postoperative slitlamp,gonioscopic examination and IOP measurements were recorded periodically.Ultrasound biomicroscopy and B-scan ultrasonography were also used to observe the complications.Eyes were enucleated on day 60.RESULTS：Pressure drops of 4.6-9.4 mm Hg were obtained at physiological aqueous flow rates in the tests in vitro.The average postoperative IOP of the experimental eyes（11.6-12.8 mm Hg）was lower than the controls significantly（P〈0.05）at each time point.Complications of hemorrhage（n=1）,cellulosic exudation（two cases）and local iris congestion（two cases）were observed.The lumina of the devices were devoid of obstructions in all specimens examined and a thin fibrous capsule was found around the endplate.CONCLUSION：ATDS reduce IOP effectively.However,further studies on the structure are needed to reduce complications.

关键词： drainage device aqueous humor outflow intraocular pressure rabbit

Tailoring the area of hepatic resection using inflow and outflow modulation

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World Journal of Gastroenterology 2013年第7期19卷 1049-1055页

作者： Matteo Donadon Fabio Procopio Guido Torzilli Liver Surgery Unit Department of General SurgeryUniversity of Milan School of MedicineHumanitas Clinical and Research Center20089 MilanItaly

The performance of hepatic surgery without a parenchyma-sparing strategy carries significant risks for patient survival because of the not negligible occurrence of postoperative liver failure.The key factor of modern hepatic surgery is the use of the intraoperative ultrasound(IOUS),not only to stage the disease,but more importantly to guide resection with the specific aim to maximize the sparing of the functional parenchyma.Whether in patients with hepatocellular carcinoma and underlying liver cirrhosis,or in patients with colorectal liver metastasis,IOUS allows the performance of the so-called "radical but conservative surgery",which is the pivotal factor to offer a chance of cure to an increasing proportion of patients,who until few years ago were considered only for palliative care.Using some new IOUS-guided surgical maneuvers,which are based on the liver inflow and outflow modulations,more precise anatomically subsegmental-and segmentaloriented resections can be effectively performed.The present work describes the rationale and the surgical technique for a precise tailoring of the area of hepatic resection using the most recent attainments in IOUS.Such important technical achievements should be a fundamental part of the surgical armamentarium of the modern liver surgeon.

关键词： Hepatic resection Intraoperative ultrasound Liver inflow Liver outflow Resection guidance

outflow Vessel in the Plane of Main Vortex of Large Cerebral Aneurysms: A Study of Hemodynamic Analyses

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Neuroscience & Medicine 2015年第2期6卷 65-70页

作者： Hao Li Tangming Peng Jing Wu Changren Huang Yong Jiang Ligang Chen Department of Neurosurgery The Affiliated Hospital of Luzhou Medical College Luzhou China Department of Interventional Neuroradiology Beijing Tiantan Hospital Capital Medical University Beijing China

Purpose: This study was designed to quantify and characterize the variations of hemodynamic parameters for those large cerebral aneurysms with outflow vessel in the plane of main vortex. Materials and Methods: A total of 19 consecutive patients with large cerebral aneurysms were constructed with the data of digital subtraction angiography. Those large cerebral aneurysms with outflow vessel in the plane of main vortex were included. Blood flow was hypothesized to be laminar and incompressible and blood Newtonian fluid. Computational fluid dynamics ICEM and Fluent software were used to simulate the computational hemodynamics of large cerebral aneurysms. Results: Hemodynamics parameters result of computational fluid dynamics showed that the velocity in the aneurysm neck, impact fields and the origin area of outflow vessels was obvious higher than that in the aneurysm sac and aneurysm dome. Wall shear stress was obvious higher in aneurysm neck, impact fields and the origin area of outflow vessels than that in the aneurysm sac and aneurysm dome. Conclusions: The location of outflow vessel played an impact on the level of blood flow within aneurysm sac for those large cerebral aneurysms with outflow vessel in the plane of main vortex.

关键词： Aneurysm Hemodynamic outflow Vessel Vortex

High-velocity molecular outflows hear massive young stellar objects

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Science China Mathematics 1999年第7期42卷 732-738页

作者：吴月芳李月兴杨传义雷成明孙金江吕静韩溥 Beijing Astrophysics Center Beijing China Department of Geophysics Peking University Beijing China Shanghai Observatory Chinese Academy of Sciences Shanghai China Qinghai Station of Purple Mountain Observatory Chinese Academy of Sciences Qinghai China

By mapping the 12CO J=1—0 lines in IRAS 05391-0217, 06114+1745 and 06291+0421, three new high-velocity bipolar molecular outflows are found. Parameters of these outflows are derived, which suggest that they are massive and energetic outflows with total kinetic energies of about 1038 J and mass loss rates about 10-5 M⊙/a. The driving sources are identified by analyzing the positions, intensities and color temperatures of the associated infrared sources. These outflows are most likely driven by single sources which correspond to massive young stellar objects. In these regions H2O masers have been detected located near the embedded infrared sources, which indicates that their exciting mechanism may be correlated with that of the CO outflows. The relationship between the parameters of outflows and central sources shows that high-velocity outflow and thermal radiation of a star are two basic correlated but different features in the evolution of young stars.

关键词： interstellar molecule jet and outflow star formation.

CO observations of massive star forming regions at different evolutionary phases

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Science China(Physics,Mechanics & Astronomy) 2006年第5期49卷 626-640页

作者： CHEN Xi1,2, XU Ye1,3, SHEN Zhiqiang1,3 & LI Jingjing1,2 1. Shanghai Astronomical Observatory, Chinese Academy of Sciences, Shanghai 200030, China 2. Graduate School of the Chinese Academy of Sciences, Beijing 100034, China 3. Joint Institute for Galaxy and Cosmology, Shanghai Astronomical Observatory and the University of Science and Technology of China, Shanghai 200030, China Shanghai Astronomical Observatory Chinese Academy of Sciences Shanghai China Graduate School of the Chinese Academy of Sciences Beijing China Joint Institute for Galaxy and Cosmology Shanghai Astronomical Observatory and the University of Science and Technology of China Shanghai China

The 12CO (J=1-0), 13CO (J=1-0) and C18O (J=1-0) emissions in 9 massive star forming regions, which are believed to be at different stages of massive star formation, were mapped with the 13.7 m millimeter wave telescope at Qinghai Station of Purple Mountain Observatory. Of the observed 9 sources, 13CO cores were detected in seven of them, and C18O cores in five of them. And only two sources associated with C18O cores and H2O masers showed the extended structures and strong outflows. This is the first detection of outflow associated with IRAS 22566+5828 in the observing field of S152/S153. The physical parameters of cores and outflows for these sources, derived from Local Thermal Equilibrium (LTE) analysis, are presented. These observing results suggest that the C18O cores will only appear when the gas density is high enough and the probability to have an outflow is very high when the clumps show the C18O and H2O maser simulta- neously.

关键词： star formation cloud core outflow H2O maser

Effects of Bentonite,Hydrogel and Biochar Amendments on Soil Hydraulic Properties from Saturation to Oven Dryness

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Pedosphere 2019年第5期29卷 598-607页

作者： Osama M0HAWESH Wolfgang DURNER Department of Plant Production Faculty of AgricultureMutah UniversityKarak 61710 (Jordan) Division of Environmental Science and Technology Graduate School of AgricultureKyoto UniversityKyoto 6110011 (Japan) Institute of Geoecology Technical University of BraunschweigLanger Kamp 19cBraunschweig 38106 (Germany)

Effects of hydrogel, bentonite, and biochar as soil amendments on soil hydraulic properties and improving water availability from saturation to oven dryness were investigated. Soils were mixed with hydrogel (0.10%, 0.25%, and 0.50%), bentonite (0.5%, 1.0%, and 2.5%), and biochar (1.0%, 2.5%, and 5.0%) as soil amendments (weight:weight). Three methods (extended multistep outflow (XMSO), evaporation (EVA), and WP4 dewpoint potentiometer) were used to measure soil hydraulic properties from saturation to oven dryness. The cumulative XMSO results were more uniform across all the applied pressure steps for the amended soils. The EVA exhibited a shorter linear decrease during the first evaporation stage and a lower evaporation rate during the second evaporation stage. The WP4 results also exhibited that soil amendments increased the soil water content of the amended soils at low matric potentials. The results of soil water retention curves revealed that the unamended soil retained less water at any matric potential compared to the amended soils. Soil hydraulic conductivity decreased with increasing amount of soil amendments. The saturated hydraulic conductivity was higher for the unamended soil than the soils amended w计h 2.5% bentonite, 0.50% hydrogel, and 5.0% biochar by 11, 3, and 18 times, respectively. These results suggested that soil amendments improved soil water retentivity, which confirmed the appropriateness of these soil amendments for potential use in sandy soil improvements. However, field experiments and economical perception studies should be considered for further investigation.

关键词： evaporation extended multistep outflow soil amendment soil matric potential soil moisture soil water retentivity water availability WP4 dewpoint potentiometer