Patients with suspected gastroesophageal reflux disease (GERD) often are treated empirically with proton pump inhibitors (PPIs). Patients whose symptoms are not reduced during the PPI trial are ...referred for further tests. We investigated whether patients referred for the evaluation of reflux symptoms had GERD. We also aimed to categorize patients with a poor response to PPIs into groups with hypersensitive esophagus or functional heartburn.
We performed a retrospective study, searching a clinical database of patients referred for GERD testing from 2006 through 2011. We collected data on all patients who underwent upper endoscopy, esophageal manometry, and 24-hour pH-impedance monitoring, and were off PPIs for at least 1 week. Evidence of GERD was determined by an abnormal upper endoscopy or 24-hour pH-impedance monitoring. Further categorization was determined by impedance results and the symptom association probability index.
We identified 221 patients (mean age, 47.6 ± 13.3 y; 56% male; 61% Caucasians); 97% previously had been prescribed PPIs, before they were tested. The patients had erosive esophagitis (n = 21; 10%), nonerosive reflux disease with increased pH (n = 61; 27%), nonerosive reflux disease with abnormal impedance (n = 18; 8%), hypersensitive esophagus (n = 30; 14%), functional heartburn (n = 18; 8%), functional disorders other than heartburn (n = 30; 14%), and undetermined disorders (n = 43; 19%).
In a retrospective analysis of 221 patients, roughly half of the patients referred for testing did not have evidence of GERD. Further categorization of patients can help guide diagnosis and management.
Acute hepatotoxicity secondary to infliximab can occur with or without autoimmunity. A growing body of infliximab drug-induced liver injury cases without autoantibody formation is emerging. Nearly ...all other reported cases occur after at least three doses. This suggests infliximab may have a direct cytotoxic effect on the liver. We report a case of drug-induced liver injury resulting after an initial dose of infliximab.
Pathfinding by growing nerve processes in the developing nervous system depends on the turning response of the growth cone to extracellular guidance cues. Embryonic spinal neurons were prepared from ...1-day-old Xenopus embryos. After 4 h incubation, a repetitive pulse application was used to produce microscopic chemical gradients near the growth cone. A micropipette containing the protein kinase C (PKC) activator 12-O-tetradecanoyl-phorbol 13-acetate (TPA) or phorbol 12,13-dibutyrate, produced a significant growth cone turning response. A micropipette containing adenosine 5'-triphosphate (ATP) also induced growth cone turning towards the pipette tip. H-7, a PKC inhibitor, inhibited the ATP-induced turning response of the growth cone. Our results suggest that the activation of PKC in developing motoneurons may induce the turning response of growth cones.
Towards energy-saving, high efficiency, and low pollution, the lighting of light-emitting diode systems, the solid state lighting, is important for the future of green energy technology industry. It ...becomes the replacement of traditional lighting, such as light bulbs and compact fluorescent lamps. Because of the characteristics of semiconductor, the electrical property of light-emitting diodes is varying with operating temperature. Then, the alternation of electrical property changes the heating power and operating temperature of light-emitting diodes. This is a mutual interaction between electrical property and operating temperature until they reach the steady state. The final current and temperature distributions decide the optical and chromatic characteristics of light-emitting diodes. Besides increasing the luminous efficiency, effectively controlling electricity and thermal characteristics in the design of light-emitting diode lighting products is the key point to achieve the demand of light and color. In this paper, we designed experiments and calculation algorithm to do the temperature distribution simulation of light-emitting diode module. Then, we obtained the analysis technology to predict the reliably optical and chromatic characteristics of light-emitting diode module in practical use.
We use the three-dimensional finite-difference time-domain method to investigate surface plasmon polariton coupling between two nano-recording marks which are of different shapes. The different ...coupling characteristics and the influence of these coupling effects on the read-out reflection signal will be discussed.
Chronic infusion of atrial natriuretic peptide (ANP) has been shown to cause natriuresis, diuresis, and hypotension in rats and humans. We explored the effect of a continuous supply of ANP by somatic ...ANP delivery on genetically hypertensive rats. A DNA construct containing the human ANP gene fused to the Rous sarcoma virus 3'-long terminal repeat (RSV-LTR) was injected intravenously into spontaneously hypertensive rats (SHR) through the tail vein. Expression of human ANP in SHR was identified in the heart, lung, and kidney by radioimmunoassay and reverse transcription-polymerase chain reaction followed by Southern blot analysis. A single injection of naked ANP plasmid DNA (12.3 kb) caused a significant reduction of systemic blood pressure in young SHR (4 weeks old), and the effect continued for 7 weeks. The differences were significant at 1 to 2 weeks (n = 6, P < .05) and 3 to 6 weeks after injection (n = 6, P < .01) A maximal blood pressure reduction of 21 mm Hg in young SHR was observed 5 weeks after injection with ANP DNA (159.4 +/- 3.02 mm Hg, mean +/- SEM, n = 6) compared with SHR injected with vector DNA alone (180.2 +/- 3.02 mm Hg, mean +/- SEM; n = 6; P < .01). Somatic gene delivery of human ANP DNA had no effect on the blood pressure of adult SHR (12 weeks old). After ANP gene delivery, there were significant increases in urinary volume and urinary potassium output (n = 6, P < .05) but not in body weight, heart rate, water intake, urinary sodium output, urinary creatine, and urinary protein.
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