316 resultados para BILIOPANCREATIC DIVERSION


Relevância:

10.00% 10.00%

Publicador:

Resumo:

Investigation on the effects of explosive shock on marine life. Necessary that the "commercial" effects, the actual damage to commercially important stocks of fish and shellfish, be evaluated. Equally important are the "biological" effects, the immediate physical effects of shock waves on animals and the indirect effects on future stocks. Indirect effects might include the diversion of migratory stocks from an area, or actual damage to the habitat, rendering it unfit for sedentary or non-migratory native species. Interruption of the food chains in an area by destruction of forge forms or vegetation. (PDF contains 43 pages)

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Hematopoiesis is a well-established system used to study developmental choices amongst cells with multiple lineage potentials, as well as the transcription factor network interactions that drive these developmental paths. Multipotent progenitors travel from the bone marrow to the thymus where T-cell development is initiated and these early T-cell precursors retain lineage plasticity even after initiating a T-cell program. The development of these early cells is driven by Notch signaling and the combinatorial expression of many transcription factors, several of which are also involved in the development of other cell lineages. The ETS family transcription factor PU.1 is involved in the development of progenitor, myeloid, and lymphoid cells, and can divert progenitor T-cells from the T-lineage to a myeloid lineage. This diversion of early T-cells by PU.1 can be blocked by Notch signaling. The PU.1 and Notch interaction creates a switch wherein PU.1 in the presence of Notch promotes T-cell identity and PU.1 in the absence of Notch signaling promotes a myeloid identity. Here we characterized an early T-cell cell line, Scid.adh.2c2, as a good model system for studying the myeloid vs. lymphoid developmental choice dependent on PU.1 and Notch signaling. We then used the Scid.adh.2c2 system to identify mechanisms mediating PU.1 and Notch signaling interactions during early T-cell development. We show that the mechanism by which Notch signaling is protecting pro-T cells is neither degradation nor modification of the PU.1 protein. Instead we give evidence that Notch signaling is blocking the PU.1-driven inhibition of a key set of T-regulatory genes including Myb, Tcf7, and Gata3. We show that the protection of Gata3 from PU.1-mediated inhibition, by Notch signaling and Myb, is important for retaining a T-lineage identity. We also discuss a PU.1-driven mechanism involving E-protein inhibition that leads to the inhibition of Notch target genes. This is mechanism may be used as a lockdown mechanism in pro-T-cells that have made the decision to divert to the myeloid pathway.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The problem of the Atchison, Topeka, and Santa Fe railroad in Pasadena is a very dynamic one, as is readily recognized by engineers, city officials, and laymen. The route of the railroad was first laid out in the eighties and because of certain liberal concessions granted by the City of Pasadena, the right-of-way was located through Pasadena, despite the fact that the grade coming into the city either from Los Angeles or San Bernardino was enormous. Some years later, other transcontinental routes of the Santa Fe out of Los Angles were sought, and a right-of-way was obtained by way of Fullerton and Riverside to San Bernardino, where this route joins the one from Los Angeles through Pasadena. This route, however, is ten miles longer than the one through Pasadena, which means a considerable loss of time in a short diversion of approximately only sixty miles in length.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

A obesidade e o Diabetes mellitus tipo 2 se tornaram importantes problemas de saúde pública nos últimos anos. O aumento da prevalência do diabetes está intimamente relacionado ao aumento da prevalência da obesidade. As cirurgias bariátricas surgiram nos últimos cinqüenta anos e vêm se popularizando como uma opção terapêutica efetiva para a redução do peso e controle ou reversão do diabetes no paciente obeso. Dentre as técnicas cirúrgicas disponíveis, o Sleeve gástrico, que era utilizado como parte integrante da técnica de derivação bílio-pancreática ou como primeiro estágio, em pacientes de alto risco, a fim de prepará-los para a cirurgia definitiva, tem sido adotado, por alguns grupos de cirurgiões, como técnica definitiva. Como é recente sua utilização como procedimento bariátrico definitivo, faltam estudos que avaliem sua efetividade. O presente estudo teve por objetivo avaliar o Sleeve gástrico, para o controle ou reversão do Diabetes mellitus tipo 2, no paciente obeso. Para tanto, foi realizada uma revisão sistemática. A busca na literatura resultou em 698 títulos e resumos. Após aplicação dos critérios de inclusão foram recuperados 96 textos completos e incluídos, na revisão sistemática, sete artigos com ensaios clínicos controlados. Foi possível realizar metanálise entre estudos comparando o Sleeve gástrico à derivação gástrica com Y de Roux e com a bandagem gástrica. Foram avaliados os desfechos glicemia de jejum e hemoglobina glicosilada. O resultado da metanálise foi favorável ao Sleeve gástrico, em comparação ao Y de Roux, para o desfecho redução pós-operatória da hemoglobina glicosilada. O Sleeve gástrico se apresenta como mais uma opção terapêutica para a obesidade e correção das co-morbidades associadas. Porém, os resultados são bastante preliminares, e ensaios clínicos controlados, de boa qualidade metodológica, são necessários para melhor avaliação.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Este trabalho teve como objetivos conhecer as demandas judiciais relacionadas à obtenção de medicamentos no município de Niterói no ano de 2010 e as estratégias desenvolvidas pela gestão municipal para lidar com este problema. Foi realizado estudo exploratório-descritivo, de abordagem quali-quantitativa, que seguiu dois caminhos metodológicos complementares: (1) levantamento e análise das demandas judiciais para obtenção de medicamentos registrados junto à Superintendência de Assessoria Jurídica da FMS, no período de janeiro a dezembro de 2010; e (2) entrevistas com 11 profissionais, gerentes e gestores envolvidos com os fluxos de atendimento das demandas judiciais no município em questão. Das 123 ações judiciais contra a FMS para obtenção de produtos e procedimentos em saúde em 2010, 98 (80,3%) visavam à obtenção de medicamentos, correspondendo a 342 medicamentos solicitados e 182 fármacos diferentes. destacaram-se, pela frequência nas ações, os seguintes medicamentos: losartana potássica, sinvastatina, ácido acetilsalicílico, furosemida e cloridrato de metformina, utilizados para problemas de saúde de elevada prevalência na população e frequentemente atendidos na atenção básica. Cabe ser assinalado que 48,6% dos medicamentos solicitados faziam parte de algum tipo de lista oficial, indicando possíveis problemas com a gestão da assistência farmacêutica no município. Os relatos dos entrevistados apontaram, entre outros: (a) dificuldades importantes presentes na gestão da Assistência Farmacêutica local, onde convivem o desabastecimento da rede e restrições orçamentárias e financeiras, como elementos que ajudam a agravar a situação estudada; (b) problemas no atendimento dos usuários pela via dos processos administrativos que, criados para facilitar o acesso do usuário aos medicamentos não disponíveis na rede, acabam sendo fontes de ações judiciais; (c) necessidade de maior empenho dos gestores na busca de soluções através de articulações interinstitucionais. O acesso a medicamentos pela via judicial tem contribuído para o desvio de recursos da atenção básica, assim como de outras contas municipais, através das multas e bloqueios determinados pelo Poder Judiciário, em decorrência do não-cumprimento dos mandados judiciais em tempo oportuno. O fenômeno da judicialização de medicamentos é um problema que dificilmente será resolvido em curto espaço de tempo e eventuais abusos que envolvem esse fenômeno devem ser identificados e combatidos de forma rigorosa. Entretanto, o Poder Público, por meio das diversas esferas governamentais, deve proporcionar à população meios eficazes para acesso aos medicamentos necessários e adequados aos pacientes. Apenas dessa maneira será possível reduzir a demanda judicial, sem comprometer o direito constitucional à saúde.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Esta dissertação possui como objetivo oferecer uma contribuição para o estudo dos controles internos no setor público brasileiro, por meio de comparação entre os aspectos do sistema de controle interno de um órgão público com os conceitos disseminados pelo COSO e literatura correlata. O senso comum, apoiado em inúmeras denúncias veiculadas na mídia sobre superfaturamentos e fraudes ocorridas na Administração Pública, remete à ideia de que os órgãos desse setor não possuem mecanismos suficientes que visem evitar esses desvios de recurso do Erário. A pesquisa foi conduzida por meio de um estudo de caso, tendo como unidade de análise o processo de pagamento de pessoal de uma Organização Militar da Marinha. Para tanto, foi elaborado um instrumento de avaliação do controle interno, baseado no modelo COSO-I adequado à realidade da entidade estudada, para em seguida, com o apoio dessa ferramenta, verificar o nível de harmonização do sistema de controle interno da organização com a estrutura teórica, evidenciando as similaridades e diferenças entre eles. Os resultados apontam para um nível de harmonização de 76,58%. Das diferenças encontradas, 71% das diferenças podem ser explicadas por fatores externos à organização e 29% podem ser explicados pelo modelo interno de gestão, podendo ser convertidos em proximidades com ações executadas na própria organização.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

This is the report from the Lune, Wyre and Furness Fisheries Advisory Committee meeting, which was held on the 15th January, 1979. It covers information on the proposed net limitation order and new fishery byelaws for the Rivers Lune and Wyre, the proposed byelaws for Skerton Weir, issues with the electric fish diversion screens for the Lune and the Wyre, and the monitoring of levels of radioactivity in migratory fish. The section on the report by the area fisheries officer on fishing activities includes river conditions and fishing for the Lune, Wyre and Furness and figures for migratory fish counted at Haverthwaite on the River Leven, Broadraine, Forge Weir and Skerton Weir on the River Lune and Duddon Hall. Also included is an update on Middleton Hatchery, fish disease, fish mortalities and net catch figures for 1978 of grilse, salmon and sea trout for the Lune, Kent, Leven and Duddon. The Fisheries Advisory Committee was part of the Regional Water Authorities, in this case the North West Water Authority. This preceded the Environment Agency which came into existence in 1996.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

What Are ~umulat iveE ffects? Coastal managers now recognize that many of the most serious resource degradation problems have built up gradually as the combined outcome of numerous actions and choices which alone may have had relatively minor impacts. For example, alteration of essential habitat through wetland loss, degradation of water quality from nonpoint source pollution, and changes in salinity of estuarine waters from water diversion projects can be attributed to numerous small actions and choices. These incremental losses have broad spatial and temporal dimensions, resulting in the gradual alteration of structure and functioning of biophysical systems. In the environmental management field, the term "cumulative effects" is generally used to describe this phenomenon of changes in the environment that result from numerous, small-scale alterations.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

A depth-averaged two-dimensional hydrodynamics model and a two-dimensional water quality model, bases on the alternating direction implicit (ADI) method, is developed to study the distribution characteristics of total phosphorus (TP) in Taihu Lake. Wind stress, the pollution source from the inflow rivers, releasing rate of TP from the bottom sediment and water diversion from Yangtze River are the effecting factors of TP distribution. By using the model proposed in this paper, the concentration field of the total phosphorus was simulated, which leads to the conclusion that the flow field has a great influence on the spatial and temporal distribution of TP in the Taihu Lake.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Taihu Lake is the third largest fresh water lake in China. With the fast economic development, abundant industrial and agricultural waste water has been discharged into Taihu Lake, causing the eutrophication of the water quality, which greatly affected the water utility. In the past decades, the treatment of Taihu Lake has witnessed limited success. Therefore, it is practically and theoretically significant to study the eutrophication of Taihu Lake. This research has focused on the issue of water quality including the characteristics of spatial and temporal distributions, and the rules of nutrient diffusion in the Taihu lake area. Based on the monitoring data, the basis distribution characteristics of water quality in Taihu Lake are analyzed. Comparing Taihu Lake with other Lakes shows that one important reason for Taihu eutrophication is the long period of water retention. A transporting and diffusing model of Taihu nutrient is developed by combining with the hydrodynamics model. Using the model, the concentration field of the total phosphorus (TP) and the influence of wind-driven current are numerically investigated, which leads to the conclusion that the flow field has a great influence on the spatial and temporal distributions of TP in Taihu Lake. Furthermore, the effect for improving the water quality by the project of water diversion from the Yangtze River to Taihu Lake was analyzed by simulation. The results demonstrate that short-term water diversion cannot improve the water quality of the heavily-polluted Meiliang Bay and the western bank areas of Taihu Lake.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Hydrological statistical data, remote sensing images, and bathymetric charts were used to study the recent evolution of the Huanghe (Yellow) River delta under human-induced interventions. It was clear that water and sediment discharge from the Huanghe River had dropped rapidly since 1970, particularly after 1986. The water and sediment discharges for the period of 1986-2000 were found to have been reduced to only 29.2% and 31.2% of those in the period of 1950-69. This was caused by human factors in the upper and middle reaches of the Huanghe River, including water diversion, damming and reservoir construction, and water and soil conservation. Based on the results from visual interpretation of processed Landsat (MSS or TMJETM+) images dated from 1976 to 2001 and two digital elevation models generated from bathymetric charts surveyed in 1976 and 1992, we found that human-induced reduction of water and sediment discharge led to coastline retrogradation, with the maximum mean recession rate of -0.51 km yr-1 over the period of 1976-98, and seabed erosion beyond the -20 m isobath between 1976 and 1992. Other impacts of human activities on the recent evolution of the Huanghe River delta, including tidal flats shrinking, artificial coastline increasing, land surface sinking and so on, were also analyzed. We found that: (i) the whole delta, including subaerial and subaqueous, has turned from a highly constructive period to a destructive phase; (ii) channelization and dredging were two of the main causes of delta destruction; (iii) land loss in the Huanghe River delta caused by submersion will be increased in the near future; (iv) the Huanghe River delta was becoming more fragile and susceptible to natural hazards.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

血管生成是肿瘤生长、发展的必经之路,并且与实体瘤的发生、转移有着密切的关系,抑制肿瘤新生血管生成具有特异性高、疗效好、不易产生耐药性以及毒副作用低等特点,因此抑制肿瘤血管形成可望成为治疗癌症的一个突破点,以抗血管生成为主的肿瘤生物治疗研究已成为近十年的研究热点。玻璃海鞘(Coina intestinalis)属于内性目、玻璃海鞘科,因其进化上的独特地位常作为研究神经发育、免疫系统进化的材料。在其它种属的海鞘中分离发现了多种具有抗肿瘤活性的多肽,但关于玻璃海鞘抗血管生成活性多肽的分离纯化和活性研究未见报道。本文利用多种分离纯化手段,采用活性追踪的方法首次从玻璃海鞘中分离得到具有抗新生血管生成作用的多肽,并对其抗血管生成活性做了初步研究。 本研究利用冷丙酮分级沉淀,超滤截留分子量小于5kDa的蛋白,再经SephadexG25、Superdex75柱层析,µRPC C2/C18反相柱层析等分离手段,采用活性追踪的方法,由玻璃海鞘(Coina intestinalis)中分离纯化出抗血管生成多肽PCI,据保留时间计算其分子量为1.8 kDa。MTT检测表明其对人脐静脉血管内皮细胞(HUVEC)具有强烈的抑制作用,IC50为7.5 μg/ml,并对多种肿瘤细胞有直接的抑制作用。斑马鱼胚胎体内实验进一步表明PCI在40 μg/ml的浓度下作用12h,斑马鱼胚胎新生血管生成受到显著抑制,肠下静脉血管长度为正常组的30%,斑马鱼胚胎血管生成率为正常组的45%。

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Hulun Lake, China’s fifth-largest inland lake, experienced severe declines in water level in the period of 2000-2010. This has prompted concerns whether the lake is drying up gradually. A multi-million US dollar engineering project to construct a water channel to transfer part of the river flow from a nearby river to maintain the water level was completed in August 2010. This study aimed to advance the understanding of the key processes controlling the lake water level variation over the last five decades, as well as investigate the impact of the river transfer engineering project on the water level. A water balance model was developed to investigate the lake water level variations over the last five decades, using hydrological and climatic data as well as satellite-based measurements and results from land surface modelling. The investigation reveals that the severe reduction of river discharge (- 364±64 mm/yr, ~70% of the five-decade average) into the lake was the key factor behind the decline of the lake water level between 2000 and 2010. The decline of river discharge was due to the reduction of total runoff from the lake watershed. This was a result of the reduction of soil moisture due to the decrease of precipitation (-49±45 mm/yr) over this period. The water budget calculation suggests that the groundwater component from the surrounding lake area as well as surface run off from the un-gauged area surrounding the lake contributed ~ net 210 Mm3/yr (equivalent to ~ 100 mm/yr) water inflows into the lake. The results also show that the water diversion project did prevent a further water level decline of over 0.5 m by the end of 2012. Overall, the monthly water balance model gave an excellent prediction of the lake water level fluctuation over the last five decades and can be a useful tool to manage lake water resources in the future.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

PURPOSE: Malignant ureteral obstruction often necessitates chronic urinary diversion and is associated with high rates of failure with traditional ureteral stents. We evaluated the outcomes of a metallic stent placed for malignant ureteral obstruction and determined the impact of risk factors previously associated with increased failure rates of traditional stents. MATERIALS AND METHODS: Patients undergoing placement of the metallic Resonance® stent for malignant ureteral obstruction at an academic referral center were identified retrospectively. Stent failure was defined as unplanned stent exchange or nephrostomy tube placement for signs or symptoms of recurrent ureteral obstruction (recurrent hydroureteronephrosis or increasing creatinine). Predictors of time to stent failure were assessed using Cox regression. RESULTS: A total of 37 stents were placed in 25 patients with malignant ureteral obstruction. Of these stents 12 (35%) were identified to fail. Progressive hydroureteronephrosis and increasing creatinine were the most common signs of stent failure. Three failed stents had migrated distally and no stents required removal for recurrent infection. Patients with evidence of prostate cancer invading the bladder at stent placement were found to have a significantly increased risk of failure (HR 6.50, 95% CI 1.45-29.20, p = 0.015). Notably symptomatic subcapsular hematomas were identified in 3 patients after metallic stent placement. CONCLUSIONS: Failure rates with a metallic stent are similar to those historically observed with traditional polyurethane based stents in malignant ureteral obstruction. The invasion of prostate cancer in the bladder significantly increases the risk of failure. Patients should be counseled and observed for subcapsular hematoma formation with this device.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The effect of different salinity levels on colonial growth and gonozooid frequency of the hydroid Campanularia flexuosa Hincks has been studied. It is shown that the usual cumulative presentation of growth data tends to obscure evidence of acclimation and other features of importance to an interpretation of adaptations of the growth process to salinity changes. A method of analysis is described that not only demonstrates acclimation, but apparently shows how growth is controlled after disturbance by changes in salinity. One other response to reduced salinity and other unfavourable changes in water chemistry is an increase in gonozooid frequency due to the diversion of resources from the formation of new hydranths.