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Search Results: 1 - 10 of 733 matches for " Miklosh Bala "
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A Transgenic Model for Conditional Induction and Rescue of Portal Hypertension Reveals a Role of VEGF-Mediated Regulation of Sinusoidal Fenestrations
Dalit May, Valentin Djonov, Gideon Zamir, Miklosh Bala, Rifaat Safadi, Miriam Sklair-Levy, Eli Keshet
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0021478
Abstract: Portal hypertension (PH) is a common complication and a leading cause of death in patients with chronic liver diseases. PH is underlined by structural and functional derangement of liver sinusoid vessels and its fenestrated endothelium. Because in most clinical settings PH is accompanied by parenchymal injury, it has been difficult to determine the precise role of microvascular perturbations in causing PH. Reasoning that Vascular Endothelial Growth Factor (VEGF) is required to maintain functional integrity of the hepatic microcirculation, we developed a transgenic mouse system for a liver-specific-, reversible VEGF inhibition. The system is based on conditional induction and de-induction of a VEGF decoy receptor that sequesters VEGF and preclude signaling. VEGF blockade results in sinusoidal endothelial cells (SECs) fenestrations closure and in accumulation and transformation of the normally quiescent hepatic stellate cells, i.e. provoking the two processes underlying sinusoidal capillarization. Importantly, sinusoidal capillarization was sufficient to cause PH and its typical sequela, ascites, splenomegaly and venous collateralization without inflicting parenchymal damage or fibrosis. Remarkably, these dramatic phenotypes were fully reversed within few days from lifting-off VEGF blockade and resultant re-opening of SECs' fenestrations. This study not only uncovered an indispensible role for VEGF in maintaining structure and function of mature SECs, but also highlights the vasculo-centric nature of PH pathogenesis. Unprecedented ability to rescue PH and its secondary manifestations via manipulating a single vascular factor may also be harnessed for examining the potential utility of de-capillarization treatment modalities.
Complications of high grade liver injuries: management and outcomewith focus on bile leaks
Miklosh Bala, Samir Gazalla, Mohammad Faroja, Allan I Bloom, Gideon Zamir, Avraham I Rivkind, Gidon Almogy
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-20
Abstract: This is a retrospective study of patients with liver injury admitted to Hadassah-Hebrew University Medical Centre over a 10-year period. Grade 3-5 injuries were considered to be high grade. Collected data included the number and types of liver-related complications. Interventions which were required for these complications in patients who survived longer than 24 hours were analysed.Of 398 patients with liver trauma, 64 (16%) were found to have high-grade liver injuries. Mechanism of injury was blunt trauma in 43 cases, and penetrating in 21. Forty patients (62%) required operative treatment. Among survivors 22 patients (47.8%) developed liver-related complications which required additional interventional treatment. Bilomas and bile leaks were diagnosed in 16 cases post-injury. The diagnosis of bile leaks was suspected with abdominal CT scan, which revealed intraabdominal collections (n = 6), and ascites (n = 2). Three patients had continuous biliary leak from intraabdominal drains left after laparotomy. Nine patients required ERCP with biliary stent placement, and 2 required percutaneous transhepatic biliary drainage. ERCP failed in one case. Four angioembolizations (AE) were performed in 3 patients for rebleeding. Surgical treatment was found to be associated with higher complication rate. AE at admission was associated with a significantly higher rate of biliary complications. There were 24 deaths (37%), the majority from uncontrolled haemorrhage (18 patients). There were only 2 hepatic-related mortalities due to liver failure.A high complication rate following high-grade liver injuries should be anticipated. In patients with clinical evidence of biliary complications, CT scan is a useful diagnostic and therapeutic tool. AE, ERCP and temporary internal stenting, together with percutaneous drainage of intra-abdominal or intrahepatic bile collections, represents a safe and effective strategy for the management of complications following both blunt and penetrating he
Indicators of the need for ICU admission following suicide bombing attacks
Miklosh Bala, Dafna Willner, Asaf Keidar, Avraham I Rivkind, Tali Bdolah-Abram, Gidon Almogy
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-19
Abstract: A database was collected prospectively from patients who were admitted to Hadassah University Hospital Level I Trauma Centre, Jerusalem, Israel from August 2001-August 2005 following a SBA. One hundred and sixty four victims of 17 suicide bombing attacks were divided into two groups according to ICU and non-ICU admission.There were 86 patients in the ICU group (52.4%) and 78 patients in the non-ICU group (47.6%). Patients in the ICU group required significantly more operating room time compared with patients in the non-ICU group (59.3% vs. 25.6%, respectively, p = 0.0003). For the ICU group, median ICU stay was 4 days (IQR 2 to 8.25 days). On multivariable analysis only the presence of facial fractures (p = 0.014), peripheral vascular injury (p = 0.015), injury ≥ 4 body areas (p = 0.002) and skull fractures (p = 0.017) were found to be independent predictors of the need for ICU admission. Sixteen survivors (19.5%) in the ICU group were admitted to the ICU for one day only (ICU-LOS = 1) and were defined as over-triaged. Median ISS for this group was significantly lower compared with patients who were admitted to the ICU for > 1 day (ICU-LOS > 1). This group of over-triaged patients could not be distinguished from the other ICU patients based on external signs of trauma. None of the patients in the non-ICU group were subsequently transferred to the ICU.Our results show that following SBA, injury to ≥ 4 areas, and certain types of injuries such as facial and skull fractures, and peripheral vascular injury, can serve as surrogates of severe trauma and the need for ICU admission. Over-triage rates following SBA can be limited by a concerted, focused plan implemented by dedicated personnel and by the liberal utilization of imaging studies.We are currently witnessing suicidal attacks in several countries against diverse populations using violence or the threat of violence to attain political, religious, or ideological goals resulting in physical harm and material damages,
Enigma of primary aortoduodenal fistula
Miklosh Bala, Jacob Sosna, Liat Appelbaum, Eran Israeli, Avraham I Rivkind
World Journal of Gastroenterology , 2009,
Abstract: A diagnosis of primary aortoenteric fistula is difficult to make despite a high level of clinical suspicion. It should be considered in any elderly patient who presents with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm. We present the case of young man with no history of abdominal aortic aneurysm who presented with massive upper gastrointestinal bleeding. Initial misdiagnosis led to a delay in treatment and the patient succumbing to the illness. This case is unique in that the fistula formed as a result of complex atherosclerotic disease of the abdominal aorta, and not from an aneurysm.
Performance Tradeoff with Routing Protocols for Radio Models in Wireless Sensor Networks  [PDF]
Manju Bala, Lalit Awasthi
Wireless Engineering and Technology (WET) , 2011, DOI: 10.4236/wet.2011.22008
Abstract: In this paper, we have simulated and evaluated the performance tradeoff with routing protocols: Constrained Flooding, the Real-Time Search and the Adaptive Tree on MICA and MICAz platform with different radio models using PROWLER for wireless sensor networks. The simulation results establish that the MICAz motes give low latency, high throughput, high energy consumption, low efficiency but better lifetime while the MICA motes give high success rate and less loss rate. It has been, thus, concluded that in case of all the radio models the MICAz is preferably better than MICA in applications where energy is a constraint. Moreover, use of MICAz motes increases the network lifetime in comparison to MICA for the radio models. Further, the AT protocol can be applied to achieve better energy consumption, efficiency and lifetime in real time for wireless sensor networks.
On Rayleigh Wave in Two-Temperature Generalized Thermoelastic Medium without Energy Dissipation  [PDF]
Baljeet Singh, Kiran Bala
Applied Mathematics (AM) , 2013, DOI: 10.4236/am.2013.41019
Abstract:

In this paper, Rayleigh surface wave is studied at a stress free thermally insulated surface of a two-temperature thermoelastic solid half-space in absence of energy dissipation. The governing equations of two-temperature generalized thermoelastic medium without energy dissipation are solved for surface wave solutions. The appropriate particular solutions are applied to the required boundary conditions to obtain the frequency equation of the Rayleigh wave. Some special cases are also derived. The non-dimensional speed is computed numerically and shown graphically to show the dependence on the frequency and two-temperature parameter.

Propagation of Waves in a Two-Temperature Rotating Thermoelastic Solid Half-Space without Energy Dissipation  [PDF]
Baljeet Singh, Kiran Bala
Applied Mathematics (AM) , 2012, DOI: 10.4236/am.2012.312261
Abstract: The present paper is concerned with the propagation of plane waves in an isotropic two-temperature generalized thermoelastic solid half-space in context of Green and Naghdi theory of type II (without energy dissipation). The governing equations in xz plane are solved to show the existence of three coupled plane waves. The reflection of plane waves from a thermally insulated free surface is considered to obtain the relations between the reflection coefficients. A particular example of the half-space is chosen for numerical computations of the speeds and reflection coefficients of plane waves. Effects of two-temperature and rotation parameters on the speeds and the reflection coefficients of plane waves are shown graphically.
Deformation of a two-phase medium due to a long buried strike-slip fault  [PDF]
Sunita Rani, Neeru Bala
Natural Science (NS) , 2013, DOI: 10.4236/ns.2013.510132
Abstract:

The aim of the present paper is to obtain the two-dimensional deformation of a two-phase elastic medium consisting of half-spaces of different ri- gidities in welded contact due to a buried long strike-slip fault. The solution is valid for arbitrary values of the fault-depth and the dip angle. The effect of fault-depth on the displacement and stress fields for different values of dip angle has been studied numerically. It is found that the displacement field varies significantly for a buried fault from the corresponding displacement field for an interface-breaking fault. The contour maps showing the stress field for various dip angles for buried and interface-breaking fault have been plotted. It has been observed that the stress field varies significantly for a buried fault from the corresponding stress field for an interface-breaking fault.

Landmarks in Urban Space as Signs  [PDF]
Havva Alkan Bala
Current Urban Studies (CUS) , 2016, DOI: 10.4236/cus.2016.44027
Abstract: A signal or a symbol has been sent with conscious. Urban space has signified elements like landmark. Landmarks as references signs orient the people. Landmarks are defined as an external point of reference that helps orienting in a familiar or an unfamiliar environment. This study is about to clear out the meaning of landmark for the city users who have perceived reference point with their memory and perception. In other words, this study is about discovering how the city affects the people who experience the urban space within semiotic of landmarks in Konya, Turkey. The method of this study is photo-elicitation to understand how people orient themselves in moving within urban space considering landmarks. Analysis of interview texts, there were six different type of landmarks as; city memory-historical, city landscape/ square, high rise/skyscraper, daily life/city usage, personal memory/personal perception, circulation pattern. In this study the semiology of communication studies codes established by society to produce messages consciously sent and received as signals, signs and symbols.
Stewart's Textbook of Acid-Base, 2nd edition
Bala Venkatesh
Critical Care , 2009, DOI: 10.1186/cc7906
Abstract: Retaining Stewart's original masterly work represents one of the highlights of the book. In the new section, the coverage is broad, and certain chapters such as those on intracellular [H], buffers, and the use of the Stewart model at the bedside are exceedingly well written. The chapters on the Stewart approach during pregnancy and a review of comparative animal physiology are useful additions.However, criticisms can be made. Important errors of fact have slipped through the proofreading process, along with some controversial assertions. To illustrate:Table 13.1: The normal plasma ionized calcium concentration is reported as 1 mEq/L, which is equivalent to 0.5 mmol/L. The normal plasma ionized calcium concentration ranges from 1.1 to 1.3 mmol/L. Similarly, the generic intracellular fluid (ICF) calcium concentration is reported as 35 mEq/L, which is equivalent to 17.5 mmol/L. This is exceedingly high. The intracellular [Ca] is of the order of nanomoles per litre.Table 21.1: The strong ion difference (SID) of gelofusine is reported as 30, whereas the correct value is 34 (manufacturer's data).Table 28.2: The SID of 5% albumin is reported as 0. The SID of 4% albumin is 12. The SID of 5% albumin is unlikely to be 0, which would result in a highly acidic solution.Section 27.4: It is suggested that elevated lactate from catecholamines results from increased Krebs cycle activity. It is actually due to accelerated glycolysis. In this section, it is also suggested that reliance on base excess as a resuscitation target in patients receiving catecholamines may lead to an inappropriate diagnosis of hypoperfusion, as base deficits can result purely from catecholamine-induced hyperlactatemia. Similar errors can result from the use of strong ion gap (SIG) (when lactate is not included in the calculation). Finally, it is asserted that standard base excess (SBE) is unstable as partial pressure of carbon dioxide (PCO2) changes. SBE, unlike actual base excess (ABE), is extremely stable
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