Assessment of anastomotic leakage: A Novel System for the Training of Surgeons to Perform a Tubular Anastomosis and Objectively Evaluate Anastomotic Leak

Introduction: Dehiscence of the suture line of an anastomosis can lead to reoperation, temporary or permanent stoma, and even sepsis or death. Few techniques for the laboratory training of tubular anastomosis use ex-vivo animal tissues. We describe a novel model that can be used in the laboratory for the training of anastomosis in tubular tissues and objectively assess any anastomotic leak. [See PDF for complete abstract]

COEFPLOT: Stata module to plot regression coefficients and other results

coefplot plots results from estimation commands or Stata matrices. Results from multiple models or matrices can be combined in a single graph. The default behavior of coefplot is to draw markers for coefficients and horizontal spikes for confidence intervals. However, coefplot can also produce various other types of graphs.

Incomplete Distal Renal Tubular Acidosis from a Heterozygous Mutation of the V-ATPase B1 Subunit

Congenital distal renal tubular acidosis (dRTA) from mutations of the B1 subunit of the V-ATPase is considered an autosomal recessive disease. We analyzed a dRTA kindred with a truncation-mutation of B1 (p.Phe468fsX487) previously shown to have failure of assembly into the V1 domain of the V-ATPase. All heterozygous carriers in this kindred have normal plasma bicarbonate concentrations, thus evaded the diagnosis of RTA. However, inappropriately high urine pH, hypocitraturia, and hypercalciuria are present either individually or in combination in the heterozygotes at baseline. Two of the heterozygotes studied also have inappropriate urinary acidification with acute ammonium chloride loading and impaired urine-blood pCO2 gradient during bicarbonaturia indicating presence of H+ gradient and flux defects. In normal human renal papillae, wild type B1 is located primarily on the plasma membrane but papilla from one of the heterozygote who had kidney stones had renal tissue secured from surgery showed B1 in both plasma membrane as well as a diffuse intracellular staining. Titrating increasing amounts of the mutant B1 subunit did not exhibit negative dominance over the expression, cellular distribution, or H+-pump activity of the wild type B1 in mammalian HEK293 cells and in V-ATPase-deficient S. cerevisiae. This is the first demonstration of renal acidification defects and nephrolithiasis in heterozygous carriers of mutant B1 subunit; which cannot be attributable to negative dominance. We propose that heterozygosity may lead to mild real acidification defects due to haploinsufficiency. B1 heterozygosity should be considered in patients with calcium nephrolithiasis and urinary abnormalities such as alkalinuria or hypocitraturia.

ADDPLOT: Stata module to add twoway plot objects to an existing twoway graph

addplot adds twoway plot objects to an existing twoway graph. This is useful if you want to add additional objects such as titles or extra data points to a twoway graph after it has been created. Most of what addplot can do, can also be done by rerunning the original graph command including additional options or plot statements. addplot, however, might be useful if you have to modify a graph for which you cannot rerun the original command, for example, because you only have the graph file but not the data that were used to create the graph. Furthermore, addplot can do certain things that would be difficult to achieve in a single graph command (e.g. customizing individual subgraphs within a by-graph). addplot also provides a substitute for some of the functionality of the graph editor.

ROBREG: Stata module providing robust regression estimators

robreg provides a number of robust estimators for linear regression models. Among them are the high breakdown-point and high efficiency MM-estimator, the Huber and bisquare M-estimator, and the S-estimator, each supporting classic or robust standard errors. Furthermore, basic versions of the LMS/LQS (least median of squares) and LTS (least trimmed squares) estimators are provided. Note that the moremata package, also available from SSC, is required.

Training Module for ALS Moderators: Report on conceptual and methodological aspects of the first workshop in Pemba Metuge, Cabo Delgado, Mozambique, April 2005

Report on conceptual and methodological aspects of the first workshop for training moderators and trainers in ALS and sustainable management of natural resources, in Pemba Metuge, Cabo Delgado, Mozambique, April 2005.

Associations of Urinary Uromodulin with Clinical Characteristics and Markers of Tubular Function in the General Population

BACKGROUND AND OBJECTIVES Allelic variants in UMOD, the gene coding for uromodulin, are associated with rare tubulointerstitial kidney disorders and risk of CKD and hypertension in the general population. The factors associated with uromodulin excretion in the normal population remain largely unknown, and were therefore explored in this study. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Urinary uromodulin excretion was measured using a validated ELISA in two population-based cohorts that included more than 6500 individuals. The Swiss Kidney Project on Genes in Hypertension study (SKIPOGH) included 817 adults (mean age±SD, 45±17 years) who underwent renal ultrasonography and performed a 24-hour urine collection. The Cohorte Lausannoise study included 5706 adults (mean age, 53±11 years) with fresh spot morning urine samples. We calculated eGFRs using the CKD-Epidemiology Collaboration formula and by 24-hour creatinine clearance. RESULTS In both studies, positive associations were found between uromodulin and urinary sodium, chloride, and potassium excretion and osmolality. In SKIPOGH, 24-hour uromodulin excretion (median, 41 [interquartile range, 29-57] mg/24 h) was positively associated with kidney length and volume and with creatinine excretion and urine volume. It was negatively associated with age and diabetes. Both spot uromodulin concentration and 24-hour uromodulin excretion were linearly and positively associated (multivariate analyses) with eGFR<90 ml/min per 1.73 m(2). CONCLUSION Age, creatinine excretion, diabetes, and urinary volume are independent clinical correlates of urinary uromodulin excretion. The associations of uromodulin excretion with markers of tubular functions and kidney dimensions suggest that it may reflect tubule activity in the general population.

PSHARE: Stata module to compute and graph percentile shares

-pshare- computes and graphs percentile shares from individual level data. Percentile shares are often used in inequality research to study the distribution of income or wealth. They are defined as differences between Lorenz ordinates of the outcome variable. Technically, the observations are sorted in increasing order of the outcome variable and the specified percentiles are computed from the running sum of the outcomes. Percentile shares are then computed as differences between percentiles, divided by total outcome. pshare requires moremata to be installed on the system; see ssc describe moremata.

A growth factor-induced, spatially organizing cytoskeletal module enables rapid and persistent fibroblast migration

Directional migration requires robust front/back polarity. We find that fibroblasts treated with platelet-derived growth factor (PDGF) and prepolarized by plating on a fibronectin line substrate exhibit persistent migration for hours. This does not occur in the absence of PDGF or on uniformly coated fibronectin substrates. Persistent migration arises from establishment of two functional modules at cell front and back. At the front, formation of a zone containing podosome-like structures (PLS) dynamically correlates with low RhoA and myosin activity and absence of a contractile lamella. At the back, myosin contractility specifically controls tail retraction with minimal crosstalk to the front module. The PLS zone is maintained in a dynamic steady state that preserves size and position relative to the cell front, allowing for long-term coordination of front and back modules. We propose that front/back uncoupling achieved by the PLS zone is crucial for persistent migration in the absence of directional cues.

LORENZ: Stata module to estimate and display Lorenz curves and concentration curves

Lorenz estimates Lorenz and concentration curves from individual-level data and, optionally, displays the results in a graph. Relative as well as generalized, absolute, unnormalized, or custom-normalized Lorenz or concentration curves are supported, and tools for computing contrasts between different subpopulations or outcome variables are provided. Variance estimation for complex samples is fully supported.

PANELS: Stata module to count panels and apply a command to panel units

panels provides a quick way to count the number of panels (groups) in a dataset and display some basic information about the sizes of the panels. Furthermore, -panels- can be used as a prefix command to other Stata commands to apply them to panel units instead of individual observations. This is useful, for example, if you want to compute frequency distributions or summary statistics for panel characteristics.