Gastrointestinal stromal tumors are rare tumors of the gastrointestinal tract. They, however, occur most commonly in the stomach where they present with abdominal pain, bleeding, and obstruction. ...Many are asymptomatic and are discovered incidentally or at postmortem. We present a case-report of a rare complication of gastrointestinal stromal tumors of the stomach causing gastroduodenal intussusception and how patient was successfully managed by laparoscopic Billroth II distal gastrectomy.
Summary
Background
Anti‐drug antibodies are associated with treatment failure to anti‐TNF agents in patients with inflammatory bowel disease (IBD).
Aim
To assess whether immunogenicity to a patient's ...first anti‐TNF agent would be associated with immunogenicity to the second, irrespective of drug sequence
Methods
We conducted a UK‐wide, multicentre, retrospective cohort study to report rates of immunogenicity and treatment failure of second anti‐TNF therapies in 1058 patients with IBD who underwent therapeutic drug monitoring for both infliximab and adalimumab. The primary outcome was immunogenicity to the second anti‐TNF agent, defined at any timepoint as an anti‐TNF antibody concentration ≥9 AU/ml for infliximab and ≥6 AU/ml for adalimumab.
Results
In patients treated with infliximab and then adalimumab, those who developed antibodies to infliximab were more likely to develop antibodies to adalimumab, than patients who did not develop antibodies to infliximab (OR 1.99, 95%CI 1.27–3.20, p = 0.002). Similarly, in patients treated with adalimumab and then infliximab, immunogenicity to adalimumab was associated with subsequent immunogenicity to infliximab (OR 2.63, 95%CI 1.46–4.80, p < 0.001). For each 10‐fold increase in anti‐infliximab and anti‐adalimumab antibody concentration, the odds of subsequently developing antibodies to adalimumab and infliximab increased by 1.73 (95% CI 1.38–2.17, p < 0.001) and 1.99 (95%CI 1.34–2.99, p < 0.001), respectively. Patients who developed immunogenicity with undetectable drug levels to infliximab were more likely to develop immunogenicity with undetectable drug levels to adalimumab (OR 2.37, 95% CI 1.39–4.19, p < 0.001). Commencing an immunomodulator at the time of switching to the second anti‐TNF was associated with improved drug persistence in patients with immunogenic, but not pharmacodynamic failure.
Conclusion
Irrespective of drug sequence, immunogenicity to the first anti‐TNF agent was associated with immunogenicity to the second, which was mitigated by the introduction of an immunomodulator in patients with immunogenic, but not pharmacodynamic treatment failure.
In 1058 patients with inflammatory bowel disease who underwent therapeutic drug monitoring for both infliximab and adalimumab, those who developed antibodies to a first anti‐TNF were more likely to develop antibodies to a second anti‐TNF, irrespective of drug sequence. Commencing an immunomodulator at the time of switching to the second anti‐TNF was associated with improved drug persistence in patients with immunogenic but not pharmacodynamic failure.
The Robotic Optical Transient Search Experiment (ROTSE) seeks to measure simultaneous and early afterglow optical emission from gamma-ray bursts (GRBs). A search for optical counterparts to six GRBs ...with localization errors of 1 deg2 or better produced no detections. The earliest limiting sensitivity is mROTSE>13.1 at 10.85 s (5 s exposure) after the gamma-ray rise, and the best limit is mROTSE>16.0 at 62 minutes (897 s exposure). These are the most stringent limits obtained for the GRB optical counterpart brightness in the first hour after the burst. Consideration of the gamma-ray fluence and peak flux for these bursts and for GRB 990123 indicates that there is not a strong positive correlation between optical flux and gamma-ray emission.
The Imitative Mind Meltzoff, Andrew N; Prinz, Wolfgang
04/2002, Letnik:
v.Series Number 6
eBook
Imitation guides the behaviour of a range of species. Scientific advances in the study of imitation at multiple levels from neurons to behaviour have far-reaching implications for cognitive science, ...neuroscience, and evolutionary and developmental psychology. This volume, first published in 2002, provides a summary of the research on imitation in both Europe and America, including work on infants, adults, and nonhuman primates, with speculations about robotics. A special feature of the book is that it provides a concrete instance of the links between developmental psychology, neuroscience, and cognitive science. It showcases how an interdisciplinary approach to imitation can illuminate long-standing problems in the brain sciences, including consciousness, self, perception-action coding, theory of mind, and intersubjectivity. The book addresses what it means to be human and how we get that way.
Gamma-ray bursts of short duration may harbor vital clues to the range of
phenomena producing bursts. However, recent progress from the observation of
optical counterparts has not benefitted the ...study of short bursts. We have
searched for early optical emission from six gamma-ray bursts using the ROTSE-I
telephoto array. Three of these events were of short duration, including GRB
980527 which is among the brightest short bursts yet observed. The data consist
of unfiltered CCD optical images taken in response to BATSE triggers delivered
via the GCN. For the first time, we have analyzed the entire 16 degree by 16
degree field covered for five of these bursts. In addition, we discuss a search
for the optical counterpart to GRB 000201, a well-localized long burst. Single
image sensitivities range from 13th to 14th magnitude around 10 s after the
initial burst detection, and 14 - 15.8 one hour later. No new optical
counterparts were discovered in this analysis suggesting short burst optical
and gamma-ray fluxes are uncorrelated.
The Robotic Optical Transient Search Experiment (ROTSE) seeks to measure
simultaneous and early afterglow optical emission from gamma-ray bursts (GRBs).
A search for optical counterparts to six GRBs ...with localization errors of 1
square degree or better produced no detections. The earliest limiting
sensitivity is m(ROTSE) > 13.1 at 10.85 seconds (5 second exposure) after the
gamma-ray rise, and the best limit is m(ROTSE) > 16.0 at 62 minutes (897 second
exposure). These are the most stringent limits obtained for GRB optical
counterpart brightness in the first hour after the burst. Consideration of the
gamma-ray fluence and peak flux for these bursts and for GRB990123 indicates
that there is not a strong positive correlation between optical flux and
gamma-ray emission.
The Robotic Optical Transient Search Experiment (ROTSE) seeks to measure
contemporaneous and early afterglow optical emission from gamma-ray bursts
(GRBs). The ROTSE-I telescope array has been fully ...automated and responding to
burst alerts from the GRB Coordinates Network since March 1998, taking prompt
optical data for 30 bursts in its first year. We will briefly review
observations of GRB990123 which revealed the first detection of an optical
burst occurring during the gamma-ray emission, reaching 9th magnitude at its
peak. In addition, we present here preliminary optical results for seven other
gamma-ray bursts. No other optical counterparts were seen in this analysis, and
the best limiting sensitivities are m(V) > 13.0 at 14.7 seconds after the
gamma-ray rise, and m(V) > 16.4 at 62 minutes. These are the most stringent
limits obtained for GRB optical counterpart brightness in the first hour after
the burst. This analysis suggests that there is not a strong correlation
between optical flux and gamma-ray emission.
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