1,720,997 research outputs found
Diagnostic flexible laparoscopy: a single incision procedure.
No full textA novel, minimally invasive diagnostic laparoscopy procedure is described in this report. After positioning a percutaneous trocar and inducing CO2 pneumoperitoneum, a flexible endoscope is introduced through the trocar to inspect intra-abdominal organs, including the surface of the liver, the gallbladder, the stomach, the intestine, the pelvic organs, and free intraperitoneal fluid. Simple procedures such as gathering histological or cytological samples, intraperitoneal lavage, collecting peritoneal fluid for culture, removing adhesions and cyst puncturing are carried out at the endoscopic surgeon's discretion through 1 or 2 working channels. Only a single incision is necessary and, unlike Natural Orifice Translumenal Endoscopic Surgery, visceral iatrogenic perforations are unnecessar
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Antilymphocyte induction is no longer necessary in simultaneous pancreas and kidney transplantation
No full textAntilymphocyte induction therapy (ALI) has been widely used in simultaneous kidney and pancreas transplantation (SPK) because of the high immunogenicity of this transplant. In the United States, almost three-quarters of 1996 to 2000 SPK recipients received anti-T-cell agents as induction, regardless of the maintenance immunosuppression regimen.1 In the past, ATG and OKT3 were preferred; more recently, anti-IL2 receptor monoclonal antibodies have become more common. The advantages of ALI are a lower rejection rate, the delayed onset of rejection episodes, and a lower severity of rejection. On the other hand, ALI treatment carries the risk of overimmunosuppression and a higher cost of the treatment. The introduction of tacrolimus (TAC) and mycophenolate mofetil (MMF) has significantly reduced the rejection rate, suggesting that SPK could be performed without ALI.
The aim of our study was to review our experience of SPK without ALI in a group of patients operated using a single surgical technique and treated a single immunosuppressive protocol
Mycophenolate mofetil (MMF) versus azathioprine (AZA) in pancreas transplantation: a single-center experience
No full textAim: Advances in immunosuppression and careful monitoring for rejection are largely responsible for improved results in pancreas transplantation. We conducted a retrospective study to establish the effectiveness of immunosuppressive therapy with mycophenolate mofetil (MMF) instead of azatioprine (AZA) in pancreas transplantation and to assess adverse effects in the two different immunosuppressive regimes. Subjects and methods, Since 1991,27 pancreas transplantations were performed in 25 patients at our Institute. For induction therapy, immunosuppressant protocol consisted of quadruple immunosuppressive therapy with cyclosporine, steroids, antilymphocyte globulin and AZA in 13 patients or MMF in 12 patients respectively. Results: Acute rejection occurred in 76% of patients in the AZA group compared with 53% in the MMF group. Steroid-resistant rejection was observed in 7% in the MMF group compared to 38% of patients on AZA (p < 0.01). Two kidney grafts were lost due to acute rejection in the AZA group, one pancreas was lost due to acute rejection and one to chronic rejection in the MMF group. There were no significant differences in CMV infection. Severe fungal infections were noted in 2 patients treated with MMF. Malignancy occurred in 1 patient (pancreas graft lymphoma) in MMF. Conclusions: In conclusion, patients treated with MMF required less frequent and less intensive treatment for acute rejection. However, its short- and long-term side effects should be further investigated
Biphasic behavior of the kinetics of 31P-containing metabolites in ischemic porcine kidneys
No full textThe assessment of kidney viability before transplantation (with a view of discarding nonviable organs) remains an obstacle to confidently extending organ harvesting to marginal donors. In the present study phosphorus magnetic resonance spectroscopy was used to monitor metabolic changes in 31P-containing metabolites in isolated porcine kidneys. After various warm ischemia times, the organs were stored at 0°C. Time-dependent changes in the phosphomonoester/inorganic-phosphate ratio were recorded at 0°C were shown to follow a biexponential decay. The first-order kinetic rate constant of the short-time decay was strongly dependent on the warm ischemia time, a result that was discreted in terms of the underlying biochemistry. The metabolic events responsible for the dramatic decrease in phosphomonoester/inorganic phosphate ratio that occur immediately after organ perfusion and storage, suggest that any procedure to minimize organ damage must occur immediately after harvesting.
Many reports have dealt with the application of magnetic resonance spectroscopy (MRS) and imaging (MRI) to kidney studies in vitro or in vivo. Most of these studies have provided physiologic and biochemical information on kidney metabolism, but an increasing number of investigations have aimed to monitor renal function in disease.1 A particular field of application for MRS in renal studies concerns monitoring of organs for transplantation. [2], [3] and [4] In fact, quantitative organ viability parameters are difficult to obtain using conventional techniques, whereas 31P MRS provides an elegant, noninvasive image of the organ's energy status. [5] and [6] These investigations have assessed kidney viability before transplantation with a view to discarding nonviable organs, or monitored metabolic modifications during organ storage to understand the biochemical processes behind transplant failure and thereby optimize the storage conditions. Moreover, it has recently been suggested that 31P metabolites be measured in the early, period after renal transplantation to diagnose primary and early allograft dysfunction.4 Both animal and human studies have reported the use of 31P MRS to assess renal viability, specific metabolic parameters have been correlated with organ quality vis-a-vis transplantation. In particular, the recovery of renal function has been shown to be inversely related to the depletion of high-energy metabolites. [7] and [8] Because ATP or ADP peaks almost disappear during storage, the ratio between the phosphomonoesters and the inorganic phosphate ([PME]/[Pi]) has been proposed as a reliable viability parameter. [9] and [10] It has been monitored under various storage conditions in several animal models or in cadaveric human organs. However, these studies obtained semiempirical parameters as prognostic indices of renal recovery after transplantation, but provided little information on the biochemical events responsible for renal injury. Moeller et al [11] and [12] reported time-dependent changes in pH and metabolite concentrations during hypothermic storage of cadaveric kidneys. They described a model of ischemic phosphate turnover using human kidneys beginning almost 3 hours after organ excision; all information concerning shorter storage times was lost. However, the processes occurring just after excision must have a great influence on organ viability, because a rapid [PME]/[Pi] decay was observed after nephrectomy.6 As a consequence, understanding the metabolic events after excision should improve organ preservation and clinical outcomes of organ transplantation. Herein we present a study on the kinetics of metabolic changes induced by cold and warm ischemia in pig kidneys monitored from about 20 minutes after organ explanation. The remarkable early metabolic events and quantitative kinetic data are assessed
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Evaluation of 84 elderly donors in renal transplantation
No full textBACKGROUND: The use of elderly donors (ED) and dual kidney transplantation (DKT) procedures have become common in clinical practice. A correct evaluation of kidneys from ED is crucial to avoid unsuccessful transplantation or the use of DKT when a single transplant (ST) would be equally successful. The aim of this investigation was to assess the role of renal biopsy (RB) in the assessment of kidneys from ED.
PATIENTS AND METHODS: A total of 84 ED aged > or = 60 yr were evaluated. In 19 cases, the kidneys were not used, mainly because of atherosclerotic vascular lesions. A histological score (HS) from 0 to 12 was awarded, considering the proportion of glomerulosclerosis, tubular atrophy, interstitial fibrosis, and arterial and arteriolar narrowing. On the basis of the HS, 37 donors were selected for 40 ST and 21 for DKT, three were discarded. All recipients received triple-drug therapy based on calcineurin inhibitors, mycophenolate mofetil and steroids.
RESULTS: Primary non-function was observed in three of 40 ST and one of 21 DKT. Acute tubular necrosis occurred in 22/40 ST and in 11/21 DKT. Acute rejection occurred in 16/40 ST and four of 21 DKT. Renal function was satisfactory in both groups, with 1-yr S-Cr = 171 micromol/L and 137 micromol/L, respectively in the ST and DKT groups. One-year patient survival was 92% in ST and 100% in DKT; 1-yr graft function was 87% in ST and 95% in DKT.
CONCLUSION: The histological assessment of kidneys from ED enables a correct selection of kidneys for ST or DKT and prevents the transplantation of high-risk kidneys
Assessment of pretransplantation warm ischemia time by phosphorous-31 magnetic resonance spectroscopy in pig kidneys
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